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Applications of Biotechnology: Biology Doing Chemistry
Published in Richard J. Sundberg, The Chemical Century, 2017
Medical uses of BoTN have evolved as physicians learned to use it to control muscle functions. The use of BoTN was introduced by an opthamologist, Alan B. Scott. It was first used in treatment of blepharospasm (involuntary blinking). It can be used to treat strabismus (the inability to maintain binocular focus) due to an imbalance in eye muscle strength. BoTN can also be used in treating muscle dystonia, the loss of proper muscle tonicity. Use of the recombinant toxin for treatment of strabismus and blepharospasm was approved by the FDA in 1989. J. S. Elston pioneered introduction of BoTN in the United Kingdom, working with material supplied by national Public Health Service. This was the source of material eventually commercialized as Dysport. In 2000, BoTN was approved in the United States by the FDA for uses in cervical, pharyngolaryngeal, and oromandibular dystonia. These conditions are caused by malfunction of particular muscles. By targeting the specific muscle, the contractions can be relieved. The beneficial effects usually last several months. BoTN has several favorable characteristic for these and related therapies. (1) It is extremely potent, meaning that small (ng) quantities are effective. (2) It can be injected into localized areas targeting specific muscles and generally does not relocate. (3) Its duration of action is quite long, usually in the range of months. (4) Because it is used in very small doses and a high state of purity, development antigenic response is rare. Currently the most frequent medical use of BoTN-A is for pharmacocosmetic purposes. Following its introduction for use in blepharospasm and related facial spasms, it was noticed that treatment led to the disappearance of wrinkles. This observation led Alistair and Jean Carruthers, a dermatologist and opthamologist, respectively, to investigate the potential for cosmetic use.23 Injections are used to tighten facial muscle, reducing the wrinkled appearance of facial skin. In 2006, there were more than 3 million treatments of patients with BoTN-A for cosmetic purposes.24
The short-term effects of artificially-impaired binocular vision on driving performance
Published in Ergonomics, 2021
Rubén Molina, Beatríz Redondo, Leandro Luigi Di Stasi, Rosario G. Anera, Jesús Vera, Raimundo Jiménez
To avoid the presence of any visual signs or symptoms that could have masked the results of this study, only participants who met all the following criteria were included: (a) no strabismus or amblyopia and no history of these conditions; (b) presenting a static monocular VA ≤0 LogMAR in both eyes with their best optical correction; if needed, participant VA was compensated with soft contact lenses; (c) near and far stereoacuity scores ≤50 and ≤60 arcseconds, respectively; (d) asymptomatic for visual fatigue according to the Conlon survey (cut-off value <24) (Conlon et al. 1999); (e) not taking any medication (except contraceptives); and (f) a score ≤3 on the Stanford Sleepiness scale (SSS) before starting the experimental sessions (see the procedure section) (Hoddes et al. 1973).
Application of SHERPA technique in ophthalmic operating rooms to identify and evaluate human errors: a case study of strabismus surgery process
Published in IISE Transactions on Healthcare Systems Engineering, 2023
Masoud Ghanbari Kakavandi, Farzaneh Molla Bahrami, Hossein Ashtarian, Rohollah Fallah Madvari, Kamran Najafi
Sometimes, in performing an activity, there is a task or sub-task that can recover probable errors. Having such tasks or sub-tasks can significantly reduce the probability of an error occurring. Of course, the ability to recover for an error does not mean that the probability of an error is eliminated. In some cases, it is possible to recover the error simultaneously as it occurs, so the same task number is written in the error recovery column on the SHERPA technique worksheet. All errors detected in postoperative procedures have a task in which the error is recovered, while only 50% of the errors detected in the anesthesia phase are recoverable. This rate is close to 90% in strabismus surgery. The high rate of recoverable errors in the various stages of postoperative recovery and strabismus surgery has helped to make these activities safer. Table 4 provides information on recovering detected errors. The results obtained from this table show that the ratio of action errors without recovery to total errors without recovery is 61.5%. This number indicates that the highest number of non-recovery errors is related to this type of error. It should be noted that this high ratio is due to the high frequency of action errors compared to other types of errors. On the other hand, the ratio of action errors without recovery to the total number of action errors is only 21.62%, which shows that errors without recovery should be weighed against the total number of the same type of error to have a better index to determine the most significant type of error without recovery. In this regard, checking errors with 30% have the highest rate of errors without recovery according to the type of error.