Care pathways for glaucoma detection and monitoring in the UK

Glaucoma presents considerable challenges in providing clinically and cost-effective care pathways. While UK population screening is not seen as justifiable, arrangements for case finding have historically been considered relatively ineffective. Detection challenges include an undetected disease burden, whether from populations failing to access services or difficulties in delivering effective case-finding strategies, and a high false positive rate from referrals via traditional case finding pathways. The enhanced General Ophthalmic Service (GOS) in Scotland and locally commissioned glaucoma referral filtering services (GRFS) elsewhere have undoubtedly reduced false positive referrals, and there is emerging evidence of effectiveness of these pathways. At the same time, it is recognised that implementing GRFS does not intrinsically reduce the burden of undetected glaucoma and late presentation, and obvious challenges remain. In terms of diagnosis and monitoring, considerable growth in capacity remains essential, and non-medical health care professional (HCP) co-management and virtual clinics continue to be important solutions in offering requisite capacity. National guidelines, commissioning recommendations, and the Common Clinical Competency Framework have clarified requirements for such services, including recommendations on training and accreditation of HCPs. At the same time, the nature of consultant-delivered care and expectations on the glaucoma specialist's role has evolved alongside these developments. Despite progress in recent decades, given projected capacity requirements, further care pathways innovations appear mandated. While the timeline for implementing potential artificial intelligence innovations in streamlining care pathways is far from established, the glaucoma burden presents an expectation that such developments will need to be at the vanguard of future developments

Holocene LSA archaeology from Equus Cave, Buxton-Norlim Limeworks, South Africa : an analysis of the bone tool assemblage

Abstract: Equus Cave, Buxton-Norlim Limeworks, near Taung, North West Province, South Africa, was first excavated between 1978 and 1982. While the site dates to the terminal Pleistocene and Holocene the precise age of the different layers is debated, as is the technological assignment of the deepest deposits, which are said to contain both Later or Middle Stone Age elements. While the faunal assemblage and some of the human remains have been published, the archaeology has never been fully analysed or reported. New excavations in 2012 revealed numerous artefacts including ochre, something not previously noted for this site. Comparison of total lithic artefact counts versus faunal NISPs and MNIs shows that the height of human occupation occurred during the Holocene, with preliminary analysis of the >6000 lithic assemblage indicating a dominance of notched artefacts, which, coupled with the presence of 16 bone points, is characteristic of other HoloceneWilton (Later Stone Age) sites in the region. The focus of this paper is the 16 bone points, which include projectile points and link-shafts, and how these items were manufactured and used. The results provide one of the first detailed descriptions of Later Stone Age bone tools, including rare specimens that are mostly complete or still preserve the tips, making an important contribution to our limited understanding of Later Stone Age bone tool technology

Cervelleite, Ag4TeS: solution and description of the crystal structure

Copyright: Springer-Verlag Wien 2015. This is the final, post refereeing version. You are advised to consult the publisher's version if you wish to cite from it, http://link.springer.com/article/10.1007%2Fs00710-015-0384-

The application of deep eutectic solvent ionic liquids for environmentally-friendly dissolution and recovery of precious metals

publisher: Elsevier articletitle: The application of deep eutectic solvent ionic liquids for environmentally-friendly dissolution and recovery of precious metals journaltitle: Minerals Engineering articlelink: http://dx.doi.org/10.1016/j.mineng.2015.09.026 content_type: article copyright: Copyright © 2015 The Authors. Published by Elsevier Ltd.© 2015 Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Pre-conception self-harm, maternal mental health and mother-infant bonding problems:a 20-year prospective cohort study

Background: Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother&ndash;infant bonding problems.MethodsThe Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3&ndash;9. VIHCS enrolment began in 2006 (when participants were aged 28&ndash;29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother&ndash;infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.ResultsFive hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20&ndash;29) reported higher levels of perinatal depressive symptoms and mother&ndash;infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted &beta; = 5.40, 95% confidence interval (CI) 3.42&ndash;7.39; mother&ndash;infant bonding problems adjusted &beta; = 7.51, 95% CI 3.09&ndash;11.92]. There was no evidence that self-harm in adolescence (ages 15&ndash;17) was associated with either perinatal outcome.ConclusionsSelf-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother&ndash;infant bonding problems.</jats:sec

Energy Trends: September 2020

Energy Trends and Energy Prices are produced by the Department for Business, Energy and Industrial Strategy (BEIS) on a quarterly basis. Both periodicals are published concurrently in June, September, December and March. The September editions cover the second quarter of the current year

4H-SiC JFET Multilayer Integrated Circuit Technologies Tested Up to 1000 K

Testing of semiconductor electronics at temperatures above their designed operating envelope is recognized as vital to qualification and lifetime prediction of circuits. This work describes the high temperature electrical testing of prototype 4H silicon carbide (SiC) junction field effect transistor (JFET) integrated circuits (ICs) technology implemented with multilayer interconnects; these ICs are intended for prolonged operation at temperatures up to 773K (500 C). A 50 mm diameter sapphire wafer was used in place of the standard NASA packaging for this experiment. Testing was carried out between 300K (27 C) and 1150K (877 C) with successful electrical operation of all devices observed up to 1000K (727 C)