A collaborative care pathway for patients with suspected angle closure glaucoma spectrum disease

Background: Currently, no specific collaborative care pathway exists that distinguishes open angle glaucoma from narrow angle or angle closure disease. This study evaluates a newly developed referral and collaborative care pathway specifically for patients with angle closure spectrum disease. Methods: The medical records of consecutive patients referred to the Centre for Eye Health for glaucoma assessment were examined, six months before (Pre Suite) and after (Post Suite) the introduction of a novel referral pathway for anterior chamber angle assessment (Angle Suite). Patient demographic and clinical data, the referral letter and practitioner characteristics were extracted. Results: Angle Suite (n = 77) patients had an appointment much sooner compared to Pre (n = 383) and Post Suite (n = 425) patients (p < 0.0001). Following the introduction of Angle Suites, there was a reduction of incidental angle closure disease found in routine, non-angle closure glaucoma assessment. Onward referral was required by 36.4 per cent of patients referred for suspected angle closure disease, while the rest could be discharged back into the community (13.0 per cent) or reviewed at the Centre for Eye Health (50.6 per cent). Multinomial logistic regression found that the presence of an angle description in the referral letter improved the true positive rate for angle closure disease (p < 0.0001). Conclusions: The clinical pathway may reduce the number of incidental angle closure patients and improved the timeliness of appropriate clinical care delivered to a subset of patients who may benefit from prompt medical attention. This pathway provides an opportunity for appropriately staffed and equipped collaborative care clinics to reduce the burden on tertiary level ophthalmic facilities

Fish assemblages associated with artificial reefs assessed using multiple gear types in the northwest Gulf of Mexico

Quantitative surveys of fishes associated with artificial reefs in the northwest Gulf of Mexico were conducted over a 4-yr period (2014-2017). Artificial reefs surveyed were comprised of three types: concrete structures, rig jackets, and decommissioned ships. All reefs were surveyed using vertical long line ( VLL), fish traps, and Adaptive Resolution Imaging Sonar (ARIS 1800). Mean fish abundance did not significantly differ using VLL [1.7 ind set(-1) (SD 2.2)] among the three reef types. However, relative abundance among all fishes collected was significantly highest on rig reefs using traps [6.2 ind soak(-1) (SD 3.8)], while results from sonar surveys indicated that the mean relative fish density was highest on concrete reefs [15.3 fish frame(-1) (SD 26.8)]. Red snapper (n = 792), followed by gray triggerfish (n = 130), pigfish (n = 70), tomtate (n = 69), and hardhead catfish (n = 57) were the most numerically abundant species using VLL and traps; red snapper comprised 90.7% of total catch using VLL and 43.9% using traps. Mean Brillouin\u27s diversity (HB) was highest on ships using VLL [0.41 (SD 0.14)] and highest on rigs using traps [0.87 (SD 0.58)] compared to the lowest diversity found on concrete [VLL 0.07 (SD 0.11); traps 0.36 (SD 0.32)]. Findings from this study can be used to inform the planning of future artificial reefs and their effect on the assemblages of reef-associated fishes. Additionally, these results highlight the value of using multiple gear types to survey reef fish assemblages associated with artificial reefs

On discretization in time in simulations of particulate flows

We propose a time discretization scheme for a class of ordinary differential equations arising in simulations of fluid/particle flows. The scheme is intended to work robustly in the lubrication regime when the distance between two particles immersed in the fluid or between a particle and the wall tends to zero. The idea consists in introducing a small threshold for the particle-wall distance below which the real trajectory of the particle is replaced by an approximated one where the distance is kept equal to the threshold value. The error of this approximation is estimated both theoretically and by numerical experiments. Our time marching scheme can be easily incorporated into a full simulation method where the velocity of the fluid is obtained by a numerical solution to Stokes or Navier-Stokes equations. We also provide a derivation of the asymptotic expansion for the lubrication force (used in our numerical experiments) acting on a disk immersed in a Newtonian fluid and approaching the wall. The method of this derivation is new and can be easily adapted to other cases

On the feasibility of N2 fixation via a single-site FeI/FeIV cycle: Spectroscopic studies of FeI(N2)FeI, FeIV=N, and related species

The electronic properties of an unusually redox-rich iron system, [PhBPR 3]FeNx (where [PhBPR 3] is [PhB(CH2PR2)3]−), are explored by Mössbauer, EPR, magnetization, and density-functional methods to gain a detailed picture regarding their oxidation states and electronic structures. The complexes of primary interest in this article are the two terminal iron(IV) nitride species, [PhBPiPr 3]FeN (3a) and [PhBPCH2Cy 3]FeN (3b), and the formally diiron(I) bridged-Fe(μ-N2)Fe species, {[PhBPiPr 3]Fe}2(μ-N2) (4). Complex 4 is chemically related to 3a via a spontaneous nitride coupling reaction. The diamagnetic iron(IV) nitrides 3a and 3b exhibit unique electronic environments that are reflected in their unusual Mössbauer parameters, including quadrupole-splitting values of 6.01(1) mm/s and isomer shift values of −0.34(1) mm/s. The data for 4 suggest that this complex can be described by a weak ferromagnetic interaction (J/D < 1) between two iron(I) centers. For comparison, four other relevant complexes also are characterized: a diamagnetic iron(IV) trihydride [PhBPiPr 3]Fe(H)3(PMe3) (5), an S = 3/2 iron(I) phosphine adduct [PhBPiPr 3]FePMe3 (6), and the S = 2 iron(II) precursors to 3a, [PhBPiPr 3]FeCl and [PhBPiPr 3]Fe-2,3:5,6-dibenzo-7-aza bicyclo[2.2.1]hepta-2,5-diene (dbabh). The electronic properties of these respective complexes also have been explored by density-functional methods to help corroborate our spectral assignments and to probe their electronic structures further

Ensemble prediction for nowcasting with a convection-permitting model - II: forecast error statistics

A 24-member ensemble of 1-h high-resolution forecasts over the Southern United Kingdom is used to study short-range forecast error statistics. The initial conditions are found from perturbations from an ensemble transform Kalman filter. Forecasts from this system are assumed to lie within the bounds of forecast error of an operational forecast system. Although noisy, this system is capable of producing physically reasonable statistics which are analysed and compared to statistics implied from a variational assimilation system. The variances for temperature errors for instance show structures that reflect convective activity. Some variables, notably potential temperature and specific humidity perturbations, have autocorrelation functions that deviate from 3-D isotropy at the convective-scale (horizontal scales less than 10 km). Other variables, notably the velocity potential for horizontal divergence perturbations, maintain 3-D isotropy at all scales. Geostrophic and hydrostatic balances are studied by examining correlations between terms in the divergence and vertical momentum equations respectively. Both balances are found to decay as the horizontal scale decreases. It is estimated that geostrophic balance becomes less important at scales smaller than 75 km, and hydrostatic balance becomes less important at scales smaller than 35 km, although more work is required to validate these findings. The implications of these results for high-resolution data assimilation are discussed

PB.23: Effect of detector type on cancer detection in digital mammography

This work measured the effect that image quality associated with different detectors has on cancer detection in mammography using a novel method for changing the appearance of images.\ud \ud A set of 270 mammography cases (one view, both breasts) was acquired using five Hologic Selenias and two Hologic Dimensions X-ray units: 80 normal, 80 with simulated inserted subtle calcification clusters, 80 with subtle real noncalcification malignant lesions and 30 with benign lesions (biopsy proven). These 270 cases (Arm 1) were converted to appear as if they had been acquired on two other imaging systems: needle image plate computed radiography (CR) (Arm 2) and powder phosphor CR (Arm 3). Three experienced mammography readers marked the location of suspected cancers in the images and classified whether each lesion would require further investigation and the confidence in that decision. Performance was calculated as the area under curve (AUC) of the alternative free-response receiver operating characteristic curv

Documentation of Atlantic Tarpon (Megalops atlanticus) Space Use and Move Persistence in the Northern Gulf of Mexico Facilitated by Angler Advocates

Atlantic tarpon (Megalops atlanticus, hereafter tarpon) are facing a multitude of stressors and are considered Vulnerable by the IUCN; however, significant gaps remain in our understanding of tarpon space use and movement. From 2018 to 2019, citizen scientists facilitated tagging of 23 tarpon with SPOT tags to examine space use and movement across the northern Gulf of Mexico. Movement-based kernel densities were used to estimate simplified biased random bridge-based utilization distributions and a joint move persistence model was used to estimate a behavioral index for each fish. Tarpon showed consistent east–west movement from the Alabama/Florida border to Louisiana, and utilization distributions were highest in the Mississippi River Delta. Move persistence was highest in Alabama and Mississippi and lowest in Louisiana. Our examination of tarpon space use and movement indicates that Louisiana is a critical, yet understudied, part of their range

Measurement of the angle, temperature and flux of fast electrons emitted from intense laser-solid interactions

High-intensity laser-solid interactions generate relativistic electrons, as well as high-energy (multi-MeV) ions and X-rays. The directionality, spectra and total number of electrons that escape atarget-foil is dependent on the absorption, transport and rear-side sheath conditions. Measuring the electrons escaping the target will aid in improving our understanding of these absorption processes and the rear-surface sheath fields that retard the escaping electrons and accelerate ions via the target normal sheath acceleration (TNSA) mechanism. A comprehensive Geant4 study was performed to help analyse measurements made with a wrap-around diagnostic that surrounds the target and uses differential filtering with a FUJI-film image plate detector. The contribution of secondary sources such as X-rays and protons to the measured signal have been taken into account to aid in the retrieval of the electron signal. Angular and spectral data from a high-intensity laser-solid interaction are presented and accompanied by simulations. The total number of emitted electrons has been measured as 2.6 × 1013 with an estimated total energy of 12 ± 1 J from a 100 mu;m Cu target with140 J of incident laser energy during a 4 × 1020 W cm-2 interaction