Natural history of corneal nerve morphology in mild neuropathy associated with type 1 diabetes : Development of a potential measure of diabetic peripheral neuropathy

Purpose To investigate longitudinal changes of subbasal nerve plexus (SNP) morphology and its relationship with conventional measures of neuropathy in individuals with diabetes. Methods A cohort of 147 individuals with type 1 diabetes and 60 age-balanced controls underwent detailed assessment of clinical and metabolic factors, neurologic deficits, quantitative sensory testing, nerve conduction studies and corneal confocal microscopy at baseline and four subsequent annual visits. The SNP parameters included corneal nerve fiber density (CNFD), branch density (CNBD) and fiber length (CNFL) and were quantified using a fully-automated algorithm. Linear mixed models were fitted to examine the changes in corneal nerve parameters over time. Results At baseline, 27% of the participants had mild diabetic neuropathy. All SNP parameters were significantly lower in the neuropathy group compared to controls (P<0.05). Overall, 89% of participants examined at baseline also completed the final visit. There was no clinically significant change to health and metabolic parameters and neuropathy measures from baseline to the final visit. Linear mixed model revealed a significant linear decline of CNFD (annual change rate, -0.9 nerve/mm2, P=0.01) in the neuropathy group compared to controls, which was associated with age (β=-0.06, P=0.04) and duration of diabetes (β=-0.08, P=0.03). In the neuropathy group, absolute changes of CNBD and CNFL showed moderate correlations with peroneal conduction velocity and cold sensation threshold, respectively (rs, 0.38 and 0.40, P<0.05). Conclusion This study demonstrates dynamic small fiber damage at the SNP, thus providing justification for our ongoing efforts to establish corneal nerve morphology as an appropriate adjunct to conventional measures of DPN.

The science of assessment : identifying and predicting environmental impacts

The historical challenge of environmental impact assessment (EIA) has been to predict project-based impacts accurately. Both EIA legislation and the practice of EIA have evolved over the last three decades in Canada, and the development of the discipline and science of environmental assessment has improved how we apply environmental assessment to complex projects. The practice of environmental assessment integrates the social and natural sciences and relies on an eclectic knowledge base from a wide range of sources. EIA methods and tools provide a means to structure and integrate knowledge in order to evaluate and predict environmental impacts.----- This Chapter will provide a brief overview of how impacts are identified and predicted. How do we determine what aspect of the natural and social environment will be affected when a mine is excavated? How does the practitioner determine the range of potential impacts, assess whether they are significant, and predict the consequences? There are no standard answers to these questions, but there are established methods to provide a foundation for scoping and predicting the potential impacts of a project.----- Of course, the community and publics play an important role in this process, and this will be discussed in subsequent chapters. In the first part of this chapter, we will deal with impact identification, which involves appplying scoping to critical issues and determining impact significance, baseline ecosystem evaluation techniques, and how to communicate environmental impacts. In the second part of the chapter, we discuss the prediction of impacts in relation to the complexity of the environment, ecological risk assessment, and modelling.

A Short History of Cultural Studies (Taiwanese edition)

This is the first volume to capture the essence of the burgeoning field of cultural studies in a concise and accessible manner. Other books have explored the British and North American traditions, but this is the first guide to the ideas, purposes and controversies that have shaped the subject. The author sheds new light on neglected pioneers and a clear route map through the terrain. He provides lively critical narratives on a dazzling array of key figures including, Arnold, Barrell, Bennett, Carey, Fiske, Foucault, Grossberg, Hall, Hawkes, hooks, Hoggart, Leadbeater, Lissistzky, Malevich, Marx, McLuhan, McRobbie, D Miller, T Miller, Morris, Quiller-Couch, Ross, Shaw, Urry, Williams, Wilson, Wolfe and Woolf. Hartley also examines a host of central themes in the subject including literary and political writing, publishing, civic humanism, political economy and Marxism, sociology, feminism, anthropology and the pedagogy of cultural studies.

Marketplace forces and the history of retailing : The cycle of control

This paper traces the history of store (retailer-controlled) and national (manufacture controlled)brands; identifies the key historical characteristics of the past 200 years of marketing history;describes the four main time periods of U.S. retail marketing (1800 - 2000); and comments on the most likely developments within the current phases of brand marketing. Will the future focus on technology and new forms of communications? The Internet exemplifies an unconventional retailing environment, with etailer numbers growing rapidly. The central proposition of this paper is that a "cycle of control" - a pattern of marketing developments within the history of retailing and national marketing communications - Can indicate the success of marketing strategies in the future.