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To the Editor: The management of corneal astigmatism during cataract surgery is of crucial importance because it may determine the refractive outcomes, visual performance, and overall satisfaction rate of patients undergoing the procedure.1 Accurate determination of the astigmatism axis is crucial to its optimal correction, whereas the procedures for corneal astigmatism management may be categorized as corneal-based and lens-based.2,3 Several approaches have been used in clinical practice to mark the axis of corneal astigmatism prior to surgery.4,5 The most common is freehand marking at the level of the cornea using a surgical pen, but marking instruments using gyroscopic technology have been also used.4 More recently, preoperative iris registration using corneal topography platforms has been implemented, allowing for axis determination through overlay imaging via the surgical microscope. Prior to cataract surgery, corneal astigmatism is assessed using the Cassini topography platform (i-optics, Hague, Netherlands), which allows for corneal astigmatism axis repeatability of 3°7,8 while offering iris registration and for image acquisition to be coupled with the LENSAR laser platform (LENSAR LLC, Orlando, FL). 10.1097/ICO.0000000000000476 Dr. Weinstock is a consultant to Abbott Medical Optics, Inc., Alcon Laboratories, Inc., Bausch & Lomb, Inc., Calhoun Vision, Inc., Doctor's Allergy, Healthe LLC, i-Optics Corp., Lensar, Inc., Omeros Corp., Rapid Pathogen Screening, Inc., STAAR Surgical Co., and Truvision Systems, Inc. The remaining authors have no financial or proprietary interest in the materials presented herein.

For many years 3H and 14C labelling of molecules of pharmaceutical interest has been performed to study their in vivo biodistribution on animal tissue sections through β-particles detection. Film autoradiography has progressively been replaced by digital β-imagers capable of high sensitivity, real-time imaging and activity counting for absolute quantification of radioactive compounds in tissue sections. After the discovery of the tumor heterogeneity phenomenon, research efforts for characterizing cell heterogeneity have been at the heart of oncology research, aiming at a better understanding of the causes and progression of the disease. This new perspective has also allowed for cell-targeting drugs, and radically changed both sample sizes and radiotracer activities. In this context, Medica-Plus, a transversal project gathering biologists, microfluidics specialists and detector developers, intends to perform quantification of low dose 3H- or 14C-labelled drugs inside single cells. This article reports preliminary results obtained with a prototype detector measuring tritium-generated signal.

Sport management programs often partner with intercollegiate athletic departments or community sport organizations to provide student volunteers. Motivating, satisfying, and retaining the student population may constitute a challenge for academic program stakeholders. The purpose of this study was to examine the relationship between motivation, satisfaction, and retention of volunteers at undergraduate sport management programs. Three hundred and twenty-two undergraduate students from five Midwestern institutions completed a 46-item questionnaire assessing their volunteer motivation, satisfaction, and retention. Results indicated students were predominantly motivated to volunteer by Love of Sport and Career motivation factors. Career, Social, Understanding, and Enhancement motivations significantly aided in predicting satisfaction, while Career, Social, and satisfaction significantly predicted retention. Implications for sport management academic programs and directions for future research are discussed.

Solid-phase synthesis of phosphinic peptides was introduced 10 years ago. A major application of this chemistry has been the development of potent synthetic inhibitors of zinc metalloproteases. Specific properties of the inhibitors produced in recent years are reviewed, supporting the notion that phosphinic pseudo-peptides are useful tools for studying the structural and functional biology of zinc proteases.

Fish-farming can lead to eutrophication of freshwater environments through the increase in organic matter resulting from food supplementation and fish wastes. Eutrophication can induce an excessive development of plants and algae on various substrates, including living organisms (algal epibiosis). Although algal epibiosis has been shown to reduce mobility by increasing drag in marine species, its consequences on host species in freshwater ecosystems remain poorly known. In this study, we investigated the individual (age and sex) and environmental (extensive versus intensive fish-farming) determinants of epizoic algae presence and abundance on European pond turtles ( Emys orbicularis ). We also explored the potential consequences of algal epibiosis on fitness-related traits of E. orbicularis . Based on a large sample size (1112 turtles from 23 ponds), we found that the abundance of algae growing on turtles increased during spring and summer. However, such increase was different across ages and sex; presumably reflecting the influence of thermoregulation (required to increase metabolic rates to sustain growth and reproduction) and thus, periodical drying of the shell, in reducing algal cover. We also found that intensive fish-farming increased algal epibiosis, especially when fish-farming involved food supplementation. Finally, we found that adult female body condition and reproduction of turtles were negatively linked to algal cover, thereby suggesting a potential negative impact of algal fouling on some fitness-related traits of adult female turtles. Future studies should usefully assess the demographic consequences of algal epibiosis induced by fish farming in this long-lived vertebrate.

Background Systemic onset juvenile idiopathic arthritis (SoJIA) and adult onset still disease (AoSD) are unlicensed indications for anakinra. Although safety has been reported to be good, increase of liver enzymes have been noted in four SoJIA patients1,2,3 and we have recently described acute hepatitis in two patients with AoSD4,5. Methods The charts of six patients with SoJIA (n=3, ILAR criteria) and AoSD (n=3, Yamaguchi criteria) who developed acute hepatitis during anakinra treatment were retrospectively studied. Strength of association between liver injury and the medication was assessed through the Roussel-Uclaf Causality Assessment Method6. Results All patients were female taking anakinra for 27 days (range 21-39) at hepatitis diagnosis. Cytolysis was variable (aspartate aminotransferase: 1041UI/L (range 336-2386), alanine aminotransferase (ASAT): 2647 UI/L (range 568-3346)), cholestasis was moderate compared to cytolysis (alkaline phosphatase (ALP): 262UI/L (range 71-376), total bilirubin 94UI/L (range 17-171) Gamma-glutamyl transpeptidase 397UI/L (range 62-538)) with ALAT/ALP ratio >5 in all cases (range 7-13). Factor V amount were systematically >100%. One patient had vomiting, the others were asymptomatic, and none had clinical evidence of SoJIA or AoSD activity. Median CRP, ferritin and polynuclear count were respectively 0.8mg/dL (range 0.1-7.0), 409µg/L (range77-3108) and 4170/mm3 (range 1500-10650). Non-drug related causes were systematically researched. Acute viral infection were excluded in all patients by serology (VHA, VHB, VHC, (n=6), VHE (n=5), HSV 1&2 (n=6), EBV (n=6), CMV (n=4)) but one patient had detectable EBV genome (2450 copies/ml). None patient tested positive for anti-smooth muscle, anti-mitochondria, anti-LKM1, anti-SLA or anti-liver cytosol antibodies. When tested (n=4), cupremia and ceruloplasmin were normal. Abdominal ultrasound revealed moderate hepatomegaly in one patient and no abnormalities in the others. Four patients underwent liver biopsy that did not show autoimmune hepatitis or hemophagocytosis but nonspecific hepatitis. Withdrawal of anakinra, made 4 days after the diagnosis of hepatitis (range 1-27), was followed by liver enzymes normalisation in all patients (time to reaction 3.5 days (range 1-56); time to 50% improvement 26 days (range 4-64)). Co-treatments with a compatible latency and that were also withdrawn were omeprazole (n=2), dalteparin (n=1), tetrazepam (n=1). When anakinra was re-administrated (n=2), hepatitis relapsed. According to the Roussel-Uclaf Causality Assessment Method, anakinra was the definite cause of hepatitis (score>8) in two patients and the probable cause (score 6-8) in the four others. Conclusions In SoJIA and AoSD patients treated with anakinra, liver enzymes should be monitored as this treatment might cause acute cytolytic hepatitis. References Quartier et al. Ann Rheum Dis. 2011; 70:747-54. Nigrovic PA et al. Arthritis Rheum. 2011; 63:545-55. Canna et al. Pediatr Rheumatol Online J. 2009;7:21 Meyer et al. Congrès de la Société francaise deRhumatologie. Paris: Elsevier; 2011. A264. Diallo et al. Rev Med Interne. 2012 [Epub]. Danan and Benichou. J. Clin. Epidemiol. 1993; 46:1323–1330. Disclosure of Interest None Declared

The purpose of this study was to investigate three propositions: a) What are the coaches and officials issues most pertinent to interscholastic sport today, as well as the next five years?, b) How important are those coaches and officials issues to athletic administrators?, and c) What are the potential implications of those pertinent coaches and officials issues to practicing athletic administrators? The literature provides a general overview of relevant issues surrounding interscholastic athletics. However, the importance and implications of relevant issues to practicing interscholastic athletic administrators are difficult to discern. First, the Minnesota State High School League (MSHSL) provided nine contemporary coaches and officials issues that were pertinent to interscholastic sport today, as well as the next five years. Second, a Likert-Scale was created so that practicing athletic administrators could rate each issue on a scale of 5 = extremely important to 1 = very little importance. A national study was conducted with athletic administrators attending the National Interscholastic Athletic Administrators Association (N = 170) annual conference. A one-tailed ANOVA was executed to determine significant differences among the nine issues rated. One issue was found to be significant; Lack of Officials. A Games-Howell post hoc was executed to determine significant differences across geographical regions of the United States. Third, semistructured interviews were completed to provide insight on the implications for practicing athletic administrators. The results offer insight from which further investigations could be conducted to continue building on policies that influence the day-to-day accountability when overseeing their athletic programs.

In 1964, Life magazine called Madalyn Murray O’Hair “the most hated woman in America.” Another critic described her as “rude, impertinent, blasphemous, a destroyer not only of beliefs but of esteemed values.” In this first full-length biography, Bryan F. Le Beau offers a penetrating assessment of O’Hair’s beliefs and actions and a probing discussion of how she came to represent both what Americans hated in their enemies and feared in themselves. Born in 1919, O’Hair was a divorced mother of two children born out of wedlock. She launched a crusade against God, often using foul language as she became adept at shocking people and making effective use of the media in delivering her message. She first gained notoriety as one of the primary litigants in the 1963 case Murray v. Curlett which led the Supreme Court to ban school prayer. The decision stunned a nation engaged in fighting “godless Communism” and made O’Hair America’s most famous—and most despised—atheist. O’Hair led a colorful life, facing assault charges and extradition from Mexico, as well as the defection of her son William, who as an adult denounced her. She later served as Hustler publisher Larry Flynt’s chief speech writer in his bid for President of the United States. Drawing on original research, O’Hair’s diaries, and interviews, Le Beau traces her development from a child of the Depression to the dictatorial, abrasive woman who founded the American Atheists, wrote books denouncing religion, and challenged the words “Under God” in the Pledge of Allegiance, “In God We Trust” on American currency, the tax exempt status of religious organizations, and other activities she saw as violating the separation of church and state. O’Hair remained a spokesperson for atheism until 1995, when she and her son and granddaughter vanished. It was later discovered that they were murdered by O’Hair’s former office manager and an accomplice. Fast-paced, engagingly written, and sharply relevant to ongoing debates about school prayer and other religious issues, The Atheist tells the colorful life-story of a woman who challenged America’s most deeply held beliefs.