Does eye examination order for standard automated perimetry matter?

PURPOSE: In spite of faster examination procedures, visual field (VF) results are potentially influenced by fatigue. We use large-scale VF data collected from clinics to test the hypothesis that perimetric fatigue effects are greater in the eye examined second. METHODS: Series of six Humphrey Swedish Interactive Testing Algorithm (SITA) VFs from 6901 patients were retrospectively extracted from a VF database from four different glaucoma clinics. Mean deviation (MD) was compared between first and second tested eyes. A surrogate measure of longitudinal MD variability over time was estimated from errors using linear regression of MD against time then compared between first and second tested eye. RESULTS: Right eye VF was tested consistently first throughout in 6320 (91.6%) patients. Median (interquartile range; IQR) MD in the first tested (right) eye and second tested (left) eye was -2.57 (-6.15, -0.58) dB and -2.70 (-6.34, -0.80) dB respectively (median reduction VF sensitivity of 0.13 dB; p < 0.001). Median (IQR) increase in our surrogate measure of longitudinal MD variability in the second eye tested was 3% (-43%, 50%); this effect was not associated with patient age or rest time between examinations. CONCLUSION: Statistically significant perimetric fatigue effects manifest on average in the second eye tested in routine clinics using Humphrey Field Analyzer SITA examinations. However, the average effects were very small and there was enormous variation among patients. We recommend starting with a right eye examination so that any perimetric fatigue effects, if they exist in an individual, will be as constant as possible from visit to visit

Rich nations, poor nations: how much can multiple equilibria explain?

This paper asks whether the income gap between rich and poor nations can be explained by multiple equilibria. We explore the quantitative implications of a simple two sector general equilibrium model that gives rise to multiplicity, and calibrate the model for a large number of countries. Under the assumptions of the model, around a quarter of the world’s economies are found to be in a low output equilibrium. The output gains associated with an equilibrium switch are sizeable, but well short of the vast income disparity observed in the data.poverty traps, multiple equilibria, TFP differences,calibration

Surgery in Rheumatoid Arthritis: General Indications and Philosophic Considerations

In summary, orthopedic surgery has much to offer the rheumatoid patient, particularly if the proper patient is chosen at the proper time. The advent of the total joint replacements, now in its infancy, gives renewed hope for the salvage of many derelicts and for the prevention of the severe disabilities and deformities which were all too frequent in the past

Progression from ocular hypertension to visual field loss in the English hospital eye service

Background There are more than one million National Health Service visits in England and Wales each year for patients with glaucoma or ocular hypertension (OHT). With the ageing population and an increase in optometric testing, the economic burden of glaucoma-related visits is predicted to increase. We examined the conversion rates of OHT to primary open-angle glaucoma (POAG) in England and assessed factors associated with risk of conversion. Methods Electronic medical records of 45 309 patients from five regionally different glaucoma clinics in England were retrospectively examined. Conversion to POAG from OHT was defined by deterioration in visual field (two consecutive tests classified as stage 1 or worse as per the glaucoma staging system 2). Cox proportional hazards models were used to examine factors (age, sex, treatment status and baseline intraocular pressure (IOP)) associated with conversion. Results The cumulative risk of conversion to POAG was 17.5% (95% CI 15.4% to 19.6%) at 5 years. Older age (HR 1.35 per decade, 95% CI 1.22 to 1.50, p<0.001) was associated with a higher risk of conversion. IOP-lowering therapy (HR 0.45, 95% CI 0.35 to 0.57, p<0.001) was associated with a lower risk of conversion. Predicted 5-year conversion rates for treated and untreated groups were 14.0% and 26.9%, respectively. Conclusion Less than one-fifth of OHT patients managed in glaucoma clinics in the UK converted to POAG over a 5-year period, suggesting many patients may require less intensive follow-up. Our study provides real-world evidence for the efficacy of current management (including IOP-lowering treatment) at reducing risk of conversion

Capacitor-type micrometeoroid detectors

The metal oxide semiconductor (MOS) capacitor micrometeroid detector consists of a thin dielectric capacitor fabricated on a silicon wafer. In operation, the device is charged to a voltage level sufficiently near breakdown that micrometeoroid impacts will cause dielectric deformation or heating and subsequent arc-over at the point of impact. Each detector is capable of recording multiple impacts because of the self-healing characteristics of the device. Support instrumentation requirements consist of a voltage source and pulse counters that monitor the pulse of recharging current following every impact. An investigation has been conducted in which 0.5 to 5 micron diameter carbonized iron spheres traveling at velocities of 4 to 10 Km/sec were impacted on to detectors with either a dielectric thickness of 0.4 or 1.0 micron. This study demonstrated that an ion microprobe tuned to sufficiently high resolution can detect Fe remaining on the detector after the impact. Furthermore, it is also possible to resolve Fe ion images free of mass interferences from Si, for example, giving its spatial distribution after impact. Specifically this technique has shown that significant amounts of impacting particles remain in the crater and near it which can be analyzed for isotopic content. Further testing and calibration could lead to quantitive analysis. This study has shown that the capacitor type micrometeroid detector is capable of not only time and flux measurements but can also be used for isotopic analysis

Regrowth-related defect formation and evolution in 1 MeV amorphized (001) Ge

Geimplanted with 1MeV Si⁺ at a dose of 1×10¹⁵cm⁻² creates a buried amorphous layer that, upon regrowth, exhibits several forms of defects–end-of-range (EOR), regrowth-related, and clamshell defects. Unlike Si, no planar {311} defects are observed. The minimal EOR defects are small dotlike defects and are very unstable, dissolving between 450 and 550°C. This is in contrast to Si, where the EOR defects are very stable. The amorphous layer results in both regrowth-related defects and clamshell defects, which were more stable than the EOR damage.This work is supported by Semiconductor Research Corporation Contract No. 00057787

The Momentum Distribution of Liquid 3^3He

We present high-resolution neutron Compton scattering measurements of liquid $^3$He below its renormalized Fermi temperature. Theoretical predictions are in excellent agreement with the experimental data when instrumental resolution and final state effects are accounted for. Our results resolve the long-standing inconsistency between theoretical and experimental estimates of the average atomic kinetic energy.Comment: 5 pages, 4 figure

A New Graphical Tool for Assessing Visual Field Progression in Clinical Populations

Purpose: We demonstrate a new approach for assessing and visualizing visual field (VF) progression in clinics. Methods: Two summary measures for VF progression, Rate of Progression (RP) and Loss of Sight Years (LSY), are combined with a novel visualization (Hedgehog Plots). RP is calculated per eye using linear regression of mean deviation (MD) against time of follow-up. LSY is a novel parameter, linked to actuarial data, which estimates the number of years that a patient will have advanced bilateral VF loss in their predicted remaining lifetime. Every eye is given a rank within the sample based on RP and LSY allowing for ‘‘ priority ’’ patients to be identified. We illustrate differences between the parameters with an experiment comparing the cases flagged as ‘‘ priority ’’ by each method using data from 1263 VF records. Results: RP for every eye in a ‘‘ clinic ’’ can be visualized and assessed using a Hedgehog Plot. Eyes are ranked against all other eyes by RP and LSY; these parameters provide different and complementary information on a patient’s VF progression status. A purpose written interactive application demonstrating the techniques is available in the public domain at https://crabblab.shinyapps.io/ hedgehog. Conclusion: Hedgehog Plots provide a tool for visualizing VF progression in groups of patients and can be used potentially to prioritize monitoring resources. Translational Relevance: This study illustrates a novel visualization technique and an interactive application that can be used to help determine VF progression in large groups of patients

Web Usability Before And After Resource Discovery

This session will discuss performing usability studies of library websites and Resource Discovery systems. The presentation will cover how the studies were conducted with a minimal budget and with almost no equipment. The interaction between the search widget on the library home page for the Resource Discovery system, Primo will be discussed in the frame of the “one stop shop” model. An analysis of the task completion rate for specific tasks will also be shared with the attendees. A discussion of changes to the resource discovery interface to improve usability will be highlighted. Suggestions for both conducting usability studies as well as areas for further research will be shared with the participants