Central connections of the lacrimal functional unit

Purpose: To study the contribution of each eye to the reflex tear response, after unilateral and bilateral topical anaesthesia. Method: A closed eye, modified Schirmer test was performed bilaterally in 8 normal subjects, in a controlled environment chamber set to 23°C, 45% relative humidity and 0.08m/s airflow. Eye drops were instilled into each eye 10 minutes before the Schirmer test. Experiments were: a) bilateral saline (control) b) unilateral anaesthesia (ipsilateral anaesthetic; contralateral saline) and c) bilateral anaesthesia. Results: There was no difference in between-eye wetting lengths in the saline control eyes (p = 0.394) or the bilaterally anaesthetised eyes (p = 0.171). Wetting length was reduced in both eyes after bilateral anaesthesia compared to saline controls (p = 0.001; p = <0.0005). After unilateral anaesthesia, wetting length was reduced in the anaesthetised eye compared to its saline control by 51.4% (p = <0.0005) and compared to its fellow, unanaesthetised eye (p = 0.005). The fellow eye value was also reduced compared to its saline control (p = 0.06). Conclusions: Wetting length was reduced by topical anaesthesia, when instilled bilaterally and ipsilaterally. The latter response implies an ipsilateral, reflex sensory drive to lacrimal secretion. In the unanaesthetised fellow eye the reduction compared to its saline control was not quite significant. This implies a relative lack of central, sensory, reflex cross-innervation, although the possibility cannot entirely be ruled out. These results are relevant to the possibility of reflex lacrimal compensation from a normal, fellow eye, in cases of unilateral corneal anaesthesia

Diurnal Intraocular Pressure and the Relationship With Swept-Source OCT–Derived Anterior Chamber Dimensions in Angle Closure: The IMPACT Study

Purpose: To evaluate diurnal intraocular pressure (DIOP) among individuals with Primary Angle Closure (PAC) or Primary Angle Closure Suspect (PACS). Additionally the hypothesis that greater DIOP fluctuation is related to smaller angle parameters was investigated. Methods: 40 Caucasian newly referred untreated patients with bilateral PAC or PACS were recruited. Intraocular pressure (IOP) was measured hourly between 09.00 and 16.00 with Goldmann applanation tonometry. DIOP fluctuation was defined as difference between maximum and minimum IOP. Angle Opening Distance, AOD; Trabecular-Iris Angle (TIA); Angle Recess Area (ARA); Trabecular Iris Space Area (TISA) were measured with AS-OCT (CASIA) in dark (0.3-0.5 lux) and light (170-200 lux) on the same day as DIOP measurements in eight angle sections. Results: IOP declined as the day progressed (p<0.001), unrelated to presence of PAS. At each timepoint, eyes with PAS (n=31) had significantly higher IOPs than eyes without PAS (n=49; p=0.043). DIOP fluctuation varied from 1.50 mmHg to 14.50 mmHg (mean 5.99 mmHg, SD 2.70 mmHg). DIOP fluctuation was unrelated to PAS. Multiple-predictor models investigating association of angle dimensions and greater DIOP fluctuation were statistically significant for AOD 750 (light), ARA 750 (light and dark), TISA 500 (light), TISA 750 (light), TIA 500 (light) and TIA 750 (light and dark). Conclusions: DIOP variation has clinical implications given that IOP level is used to distinguish between diagnostic categories of PACS and PAC. OCT angle parameter measurements may predict for magnitude of IOP diurnal fluctuations in at-risk patients, which may be clinical useful when considering a clinical intervention

Rent appropriation in global value chains: the past, present, and future of intangible assets

Research Summary The argument of this article is that global strategy research should devote greater attention to rent appropriation in global value chains (GVCs). We discuss the concept of intangible assets, emphasize their scalability at low marginal cost and highlight strategies for the appropriation of rents from these assets. Returns captured by intangible assets are shown to be much greater than those captured by tangible assets in GVCs of manufactured products. Regions in the world are found to be specializing in different GVC stages, with China rising as a key location for rent generation in upstream and production activities. We conclude that the rents from intangible assets are major drivers of economic development and of corporate success and offer insights into rent appropriation trends in the future. Managerial Summary Intangible assets include computerized information (such as databases and software), innovative property (such as patents, trademarks, and copyrights), and economic competencies (such as brand equity and organizational capital). Our analysis shows that the returns to intangible assets in the GVCs of manufactured goods have risen substantially in importance over the past 20 years. A further finding is that within GVCs, the rent share of upstream stages has been increasing at the expense of rents shares of both the production and downstream stages. These findings suggest that the effective deployment, management, and protection of intangible assets is of critical importance to the ability of firms to create and maintain sustainable competitive advantages in global markets. In GVCs, intangibles matter, big time

Summer 1966

Massachusetts Turf and Lawn Grass CouncilBetter Turf Through Research and Educatio

Satisfaction of Older Patients With Emergency Department Care: Psychometric Properties and Construct Validity of the Consumer Emergency Care Satisfaction Scale.

BACKGROUND: Patient satisfaction is an important indicator of quality of care, but its measurement remains challenging. The Consumer Emergency Care Satisfaction Scale (CECSS) was developed to measure patient satisfaction in the emergency department (ED). Although this is a valid and reliable tool, several aspects of the CECSS need to be improved, including the definition, dimension, and scoring of scales. PURPOSE: The purpose of this study was to examine the construct validity of the CECSS and make suggestions on how to improve the tool to measure overall satisfaction with ED care. METHODS: We administered 2 surveys to older adults who presented with a fall to the ED and used electronic health record data to examine construct validity of the CECSS and ceiling effects. RESULTS: Using several criteria, we improved construct validity of the CECSS, reduced ceiling effects, and standardized scoring. CONCLUSION: We addressed several methodological issues with the CECSS and provided recommendations for improvement

Reviewing research priorities in weed ecology, evolution and management: A horizon scan

Weedy plants pose a major threat to food security, biodiversity, ecosystem services and consequently to human health and wellbeing. However, many currently used weed management approaches are increasingly unsustainable. To address this knowledge and practice gap, in June 2014, 35 weed and invasion ecologists, weed scientists, evolutionary biologists and social scientists convened a workshop to explore current and future perspectives and approaches in weed ecology and management. A horizon scanning exercise ranked a list of 124 pre-submitted questions to identify a priority list of 30 questions. These questions are discussed under seven themed headings that represent areas for renewed and emerging focus for the disciplines of weed research and practice. The themed areas considered the need for transdisciplinarity, increased adoption of integrated weed management and agroecological approaches, better understanding of weed evolution, climate change, weed invasiveness and finally, disciplinary challenges for weed science. Almost all the challenges identified rested on the need for continued efforts to diversify and integrate agroecological, socio-economic and technological approaches in weed management. These challenges are not newly conceived, though their continued prominence as research priorities highlights an ongoing intransigence that must be addressed through a more system-oriented and transdisciplinary research agenda that seeks an embedded integration of public and private research approaches. This horizon scanning exercise thus set out the building blocks needed for future weed management research and practice; however, the challenge ahead is to identify effective ways in which sufficient research and implementation efforts can be directed towards these needs

A Phase II Trial of Sorafenib in Metastatic Melanoma with Tissue Correlates

Sorafenib monotherapy in patients with metastatic melanoma was explored in this multi-institutional phase II study. In correlative studies the impact of sorafenib on cyclin D1 and Ki67 was assessed. mutational status and clinical activity. No significant changes in expression of cyclin D1 or Ki67 with sorafenib treatment were demonstrable in the 15 patients with pre-and post-treatment tumor samples. mutational status of the tumor was not associated with clinical activity and no significant effect of sorafenib on cyclin D1 or Ki67 was seen, suggesting that sorafenib is not an effective BRAF inhibitor or that additional signaling pathways are equally important in the patients who benefit from sorafenib

Video-Game Play Induces Plasticity in the Visual System of Adults with Amblyopia

A pilot study suggests that playing video games may enhance a range of spatial vision functions in adults with amblyopia

Are Hylobates lar Extirpated from China?

The Nangunhe Nature Reserve in Southwest Yunnan (PRC) has long been presumed to be the last stronghold of lar (or white-handed) gibbons (Hylobates lar) in China and the likely last place of occurrence of Hylobates lar yunnanensis. We conducted a comprehensive survey to assess the status of lar gibbons at Nangunhe. We found no visual or auditory evidence of them still residing at the reserve and therefore tentatively conclude that lar gibbons have become extinct in China. It appears that large-scale destruction of primary forests in the 1960s and 1970s brought about an initial decline in their numbers, and subsequent uncontrolled hunting has resulted in their extirpation. The situation for the six Chinese ape taxa is nothing less than disastrous, with 1 taxon assumed to have become extinct during the last few years, 1 taxon not having been confirmed since the 1980s, and 2 species at the very brink of extinction with only tens of individuals remaining in China