Assessing the accuracy of intracameral phenylephrine preparation in cataract surgery

Purpose: Unpreserved phenylephrine is often used as an off-licence intracameral surgical adjunct during cataract surgery to assist with pupil dilation and/or stabilise the iris in floppy iris syndrome. It can be delivered as a neat 0.2 ml bolus of either 2.5 or 10% strength, or in a range of ad-hoc dilutions. We wished to assess the accuracy of intracameral phenylephrine preparation in clinical practice. Methods: Phenylephrine 0.2 ml was analysed both neat (2.5 and 10%) and in diluted form (ratio of 1:1 and 1:3). Samples were analysed using the validated spectrophotometric method. Results: A total of 36 samples were analysed. The standard curve showed linearity for phenylephrine (R2 = 0.99). Wide variability was observed across all dilution groups. There was evidence of significant differences in the percentage deviations from intended results between dilutions (p < 0.001). Mean percentage deviation for 1:3 dilution was significantly greater than neat (p = 0.003) and 1:1 dilution (p = 0.001). There was no evidence of a significant difference between 1:1 and neat (p = 0.827). Conclusions: Current ad-hoc dilution methods used to prepare intracameral phenylephrine are inaccurate and highly variable. Small volume 1 ml syringes should not be used for mixing or dilution of drug. Commercial intracameral phenylephrine products would address dosage concerns and could improve surgical outcomes in cases of poor pupil dilation and/or floppy iris syndrome

CCN3 modulates bone turnover and is a novel regulator of skeletal metastasis

The CCN family of proteins is composed of six secreted proteins (CCN1-6), which are grouped together based on their structural similarity. These matricellular proteins are involved in a large spectrum of biological processes, ranging from development to disease. In this review, we focus on CCN3, a founding member of this family, and its role in regulating cells within the bone microenvironment. CCN3 impairs normal osteoblast differentiation through multiple mechanisms, which include the neutralization of pro-osteoblastogenic stimuli such as BMP and Wnt family signals or the activation of pathways that suppress osteoblastogenesis, such as Notch. In contrast, CCN3 is known to promote chondrocyte differentiation. Given these functions, it is not surprising that CCN3 has been implicated in the progression of primary bone cancers such as osteosarcoma, Ewing’s sarcoma and chondrosarcoma. More recently, emerging evidence suggests that CCN3 may also influence the ability of metastatic cancers to colonize and grow in bone

A critical analysis of decision support systems research revisited: The rise of design science

© Association for Information Technology Trust 2016.Decision support systems (DSS) is the area of the information systems (IS) discipline that is focused on supporting and improving managerial decision making. In 2005 the Journal of Information Technology (JIT) published our paper that critically analyzed DSS research from 1990 to 2003 (Arnott and Pervan, 2005). That paper used bibliometric content analysis as its method and analyzed 1020 articles in 14 journals. The analysis illuminated a vibrant and important part of IS research. Personal DSS and group support systems (GSS) dominated DSS research and two-thirds of DSS research was empirical, a higher proportion than general IS research. Interpretive DSS research was growing from a low base while design-science research (DSR) and laboratory experiments were major research categories. Unfortunately, it was found that DSS research to 2003 was relatively poorly founded on judgment and decision-making theory and faced what was described as ‘a crisis of relevance’

Necessity of minimum floor area ratio regulation: a second-best policy

R11, R13, R14, R52,

Stag beetle battle behavior and its associated anatomical adaptations

Male stag beetles battle for females with their impressive, oversized mandibles. We describe their fighting behavior, which is essential to understand the evolution and morphology of their weaponry. Our behavioral analysis reveals several anatomical structures that are important for fighting, and our morphological investigations show how these may be adapted for their functions. Stag beetle fights are much more variable than other armed beetles' battles. They spend considerable time and effort in dislodging their opponent, that clings to the substrate with its tarsal claws. These tarsal claws are also indispensable to maintain balance in the most spectacular battles, when they lift a rival high in the air. The male claws are highly curved and have an increased height for this purpose. The prothoracic muscles are hypertrophied to support the lifting movement. The largest beetle wins in 85 % of the fights and the smaller the difference in mandible length is between the rivals, the longer the battles can last. The long mandibles enable males to reach the opponent's legs in order to dislodge it. For this purpose, they bite with all parts of their mandibles, even though the distal part is more vulnerable for failure and transfers less bite force. Blindfolded experiments prove that visual information is not a requisite for a successful battle