The incidence and rate of rhegmatogenous retinal detachment seven years after cataract surgery in patients with high myopia

Background: Cataract extraction is the most commonly performed surgery in the National Health Service. Myopia increases the risk of postoperative rhegmatogenous retinal detachment (RRD). The aim of this study was to determine the incidence and rate of RRD seven years after cataract extraction in highly myopic eyes. Methods: Retrospective review was performed of notes of all high myopes (axial length 26.0 mm or more) who underwent cataract extraction during the study period in one centre. Results: 84 eyes met the study criteria. Follow-up time from surgery was 93 to 147 months (median 127 months). The average axial length was 28.72 mm (sd 1.37). Two eyes developed post-operative RRD; the incidence was 2.4% and the rate one RRD per 441.6 person-years. The results of 15 other studies on the incidence of RRD after cataract extraction in high myopia were pooled and combined with our estimate. Conclusion: Both patients in our study who developed RRD had risk factors for this complication as well as high myopia. Risk factors are discussed in the light of our results and the pooled estimate. Our follow-up time is longer than most. Future case series should calculate rates to allow meaningful comparison of case series. © The Ulster Medical Society, 2009.

The Human Rights Act 1998 – Future Prospects

It is now over fifteen years since the Human Rights Act was enacted in November 1998. Although in legal terms it is difficult to argue with the proposition that the Act is working in an effective manner, in political terms the Act remains one of the most highly debated pieces of legislation on the UK statute books. In recent years there have been numerous calls for the repeal of the Act, and for its replacement with a ‘UK Bill of Rights’. Such calls led to the establishment of a Commission on a Bill of Rights, which issued its final report in December 2012. Little progress has since been made on the issue. One notable occurrence however was the introduction of the Human Rights Act 1998 (Repeal and Substitution) Bill, a Private Member’s Bill which was eventually withdrawn in March 2013. This article seeks to assess the current situation regarding the bill of rights debate, and ultimately the question of the future prospects of the Human Rights Act, an issue of immense legal significance. Overall, it will be questioned whether the enactment of a UK Bill of Rights would constitute an improvement on the current position under the Human Rights Act.

Living in The Matrix: Virtual Reality Systems and Hyperspatial Representation in Architecture

In the digital age, the hyperspace of virtual reality systems stands out as a new spatial concept creating a parallel realm to "real" space. Virtual reality influences one’s experience of and interaction with architectural space. This "otherworld" brings up the criticism of the existing conception of space, time and body. Hyperspaces are relatively new to designers but not to filmmakers. Their cinematic representations help the comprehension of the outcomes of these new spaces. Visualisation of futuristic ideas on the big screen turns film into a medium for spatial experimentation. Creating a possible future, The Matrix (Andy and Larry Wachowski, 1999) takes the concept of hyperspace to a level not-yet-realised but imagined. With a critical gaze at the existing norms of architecture, the film creates new horizons in terms of space. In this context, this study introduces science fiction cinema as a discussion medium to understand the potentials of virtual reality systems for the architecture of the twenty first century. As a "role model" cinema helps to better understand technological and spatial shifts. It acts as a vehicle for going beyond the spatial theories and designs of the twentieth century, and defining the conception of space in contemporary architecture.

An anatomical study of the arterial and nerve supply of the infrahyoid muscles

A precise knowledge of the sources of the arterial and neural supply of the sternohyoid (SH), sternothyroid (STM), and superior belly of omohyoid (OM) is of value to surgeons using the infrahyoid muscles in reconstruction procedures of the head and neck. This study was designed to define the anatomical bases of the variable sources of the arterial and neural supply of these muscles. Fourteen cadavers were unilaterally dissected in the neck region, and the arterial pedicles of these muscles were followed and accurate measurements were taken. For the SH, two arterial pedicles (superior and inferior) originated from the superior thyroid artery ST and supplied the muscle in 57.1% of cases. The inferior pedicle was absent in 42.9% of cases. As regards the STM, one arterial pedicle from the ST supplied its upper end by multiple branches in 57.1% of cases. In 14.3% of cases, branches from the inferior thyroid artery (IT) supplied the STM in addition to its supply from the ST. As regards the OM, two arterial pedicles originated from the ST and supplied its upper and lower ends in 57.1% of cases. The main artery from the ST to the superior belly of OM entered at its superior portion. The ansa cervicalis (AC) innervated the infrahyoid muscles. SH usually had a double nerve supply. In 57.1% of cases, its superior part was innervated by the nerve to the superior belly of OM. Its inferior part received branches from the AC. In 35.7% of cases, its superior part received direct branches from the AC. As regards the STM, in (71.4%) of cases, a common trunk arose from the loop and supplied the inferior part of both the SH and STM. The nerve supply to the superior belly of OM originated from the AC below the loop in 64.3% of cases. These data will be useful for preserving the neuro-vascular supply of the infrahyoid muscles during flap preparation.

Mode of insertion of the abductor hallucis muscle in human feet and its arterial supply

The abductor hallucis flap is commonly used as a pedicled flap (distally or proximally based) in the management of ankle, heel, and mid-foot lesions, where it is ideally used for closing defects. This study investigates the anatomical details of this muscle regarding its various forms of insertion and its arterial supply in 15 cadaveric feet. Four types of insertion could be distinguished: type A, insertion at the proximal phalanx of the big toe (46.7%); type B, insertion by two slips into the base of the proximal phalanx and the sesamoid bone (33.3%); type C, insertion at the sesamoid bone (6.7%); And type D, the insertion is divided into superficial tendinous and deep fleshy parts which are attached to the base of the proximal phalanx and to the metatarsophalangeal joint capsule of the big toe, respectively (13.3%). As regards the arterial supply, three patterns were noticed: pattern A (40%) where the medial plantar artery (MPA) is divided into superficial and deep branches that supplied the muscle; pattern B (53.3%) where the MPA failed to produce a deep branch but instead continued as the superficial branch supplying the two ends of the muscle; and pattern C (6.6%) where the MPA continued as a deep branch supplying the muscle. A superficial branch of MPA provided a branch to the abductor hallucis muscle from its proximal part. In two specimens (13.3%), the lateral plantar artery shared in the supply of the most proximal part of the muscle. These results can be useful in determining the appropriate flap design based on the abductor hallucis type of insertion and the pattern of its arterial supply in the patients.

Tensor products of subspace lattices and rank one density

We show that, if M is a subspace lattice with the property that the rank one subspace of its operator algebra is weak* dense, L is a commutative subspace lattice and P is the lattice of all projections on a separable Hilbert space, then L⊗M⊗P is reflexive. If M is moreover an atomic Boolean subspace lattice while L is any subspace lattice, we provide a concrete lattice theoretic description of L⊗M in terms of projection valued functions defined on the set of atoms of M . As a consequence, we show that the Lattice Tensor Product Formula holds for AlgM and any other reflexive operator algebra and give several further corollaries of these results.

Multi-Dimensional Simulations of the Expanding Supernova Remnant of SN 1987A

The expanding remnant from SN 1987A is an excellent laboratory for investigating the physics of supernovae explosions. There is still a large number of outstanding questions, such as the reason for the asymmetric radio morphology, the structure of the pre-supernova environment, and the efficiency of particle acceleration at the supernova shock. We explore these questions using three-dimensional simulations of the expanding remnant between days 820 and 10,000 after the supernova. We combine a hydrodynamical simulation with semi-analytic treatments of diffusive shock acceleration and magnetic field amplification to derive radio emission as part of an inverse problem. Simulations show that an asymmetric explosion, combined with magnetic field amplification at the expanding shock, is able to replicate the persistent one-sided radio morphology of the remnant. We use an asymmetric Truelove & McKee progenitor with an envelope mass of 10 M-circle dot and an energy of 1.5 x 10(44) J. A termination shock in the progenitor's stellar wind at a distance of 0 ''.43-0 ''.51 provides a good fit to the turn on of radio emission around day 1200. For the H II region, a minimum distance of 0 ''.63 +/- 0 ''.01 and maximum particle number density of (7.11 +/- 1.78) x 10(7) m(-3) produces a good fit to the evolving average radius and velocity of the expanding shocks from day 2000 to day 7000 after explosion. The model predicts a noticeable reduction, and possibly a temporary reversal, in the asymmetric radio morphology of the remnant after day 7000, when the forward shock left the eastern lobe of the equatorial ring.

THE ARTIFICIAL URINARY SPHINCTER - A NEW SOLUTION FOR INCONTINENT PATIENTS

Treatment of urinary incontinence with the artificial urinary sphincter has been available in centres such as London and Liverpool for a number of years. This service is now available in the department of urology of the Belfast City Hospital. Twelve patients have had successful implantation of an artificial urinary sphincter for urinary incontinence, and ten are now fully continent. One patient with Wegener's granulomatosis developed active disease in his urethra which has precluded activation of the device. One patient has had the device removed because of erosion into the urethra.

On the Complexity of Strong and Epistemic Credal Networks

Credal networks are graph-based statistical models whose parameters take values on a set, instead of being sharply specified as in traditional statistical models (e.g., Bayesian networks). The result of inferences with such models depends on the irrelevance/independence concept adopted. In this paper, we study the computational complexity of inferences under the concepts of epistemic irrelevance and strong independence. We strengthen complexity results by showing that inferences with strong independence are NP-hard even in credal trees with ternary variables, which indicates that tractable algorithms, including the existing one for epistemic trees, cannot be used for strong independence. We prove that the polynomial time of inferences in credal trees under epistemic irrelevance is not likely to extend to more general models, because the problem becomes NP-hard even in simple polytrees. These results draw a definite line between networks with efficient inferences and those where inferences are hard, and close several open questions regarding the computational complexity of such models.

THE SURFACE-STRUCTURE OF A C(2 X-2) POTASSIUM OVERLAYER ON CO(1010)

The surface structure of the clean Co{1010BAR} surface and a c(2 x 2) potassium overlayer have been determined by quantitative low energy electron diffraction. The Co{1010BAR} sample has been shown to be laterally unreconstructed with the surface being uniquely terminated by an outermost closely packed double layer (dz12 = 0.68 angstrom). A damped oscillatory relaxation of the outermost three atomic layers occurs, with relaxations DELTA-dz12 = -6.5 +/- 2% and DELTA-dz23 = +1.0 +/- 2%.

The c(2 x 2) overlayer formed at a coverage of 0.5 ML was subjected to a full I-V analysis. A range of adsorption sites were tested including fourfold hollow, on-top, and both long and short bridge sites in combination with both "long" and "short" cobalt interlayer terminations. A clear preference was found for adsorption in the maximal coordination fourfold hollow site. No switching of surface termination occurs. The potassium adatoms reside in the [1210BAR] surface channels directly above second layer cobalt atoms with a potassium to outermost cobalt interlayer separation of 2.44 +/- 0.05 angstrom. Potassium-cobalt bond lengths of 3.40 +/- 0.05 and 3.12 +/- 0.05 angstrom between the four (one) outermost (second) layer nearest-neighbour substrate atoms suggests a potassium effective radius of 1.87 +/- 0.05 angstrom, somewhat smaller than the Pauling covalent radius and considerably larger than the ionic radius (1.38 angstrom). The alkali-surface bonding is thus predominantly "covalent"/"metallic".

A multi-proxy chronological reconstruction of palaeosalinity in the eastern Limfjord, Denmark

The Jutland peninsula in northern Denmark is home to the Limfjord, one of the largest estuarine bodies of water in the region. Human inhabitance of the Limfjord’s surrounding coastlines stretches back further than 7,800 cal BP, with anthropogenic influence on the landscape beginning approximately 6,000 cal BP. Understanding how the Limfjord as a system has changed throughout time is useful in comprehending subsistence patterns and anthropogenic influence. This research is part of a larger project aimed at discerning subsistence patterns and environmental change in the region. Following the Younger Dryas, as the Fennoscandian ice sheet began to melt, Denmark experienced isostatic rebound, which contributed to the complex sea level history in the region. Between ice melt and isostatic rebound, the Jutland peninsula experienced many transgression and regression events. Connections to surrounding seas have shifted throughout time, with most attention focused on the western connection of the Limfjord with the North Sea, which has experienced numerous closures and subsequent re-openings throughout the Holocene. Furthermore, the Limfjord-North Sea connection has been the focal point of research because of the west to east water flow in the system, and the present day higher salinity in the west compared to the east. Little to no consideration has been paid to the influence of the Kattegat and Baltic on the Limfjord until now. A 10m sediment core was taken from Sebbersund (near Nibe, Limfjord), along the connection between the Limfjord and the Kattegat in the east to understand how the eastern part of the system has changed and differed from changes observed in the west. The Sebbersund sequence spans a majority of the Holocene, from 9600 cal BP to 1030 cal BP, determined via radiocarbon dating of terrestrial macrofossils and bulk sediment. Over this time period palaeoenvironmental conditions were reconstructed through the use of geochemical analyses (13C, 15N, C:N), physical sediment analyses, dinoflagellate cyst abundances and molluscan analyses. apart from two instances of low salinity, one at the top and one at the bottom of the core, the sequence has a strong marine signal for a majority of the Holocene. Radiocarbon dating of bulk sediment samples showed the presence of old carbon in the system, creating an age offset between 1,300 ± 200 and 2,800 ± 200 calibrated 14C years compared to the age-depth curve based on the terrestrial macrofossils. This finding, along with the strong marine influence in the system, discerned through geochemical data, dinoflagellate cyst and mollusc counts, is important for obtaining accurate radiocarbon ages in the region and stresses the importance of understanding both the marine and freshwater reservoir effects. The marine dominance in the eastern Limfjord differs from the west, which is characterized by a number of freshwater events when the North Sea connection was closed off during the Holocene. The eastern connection was open to the Kattegat throughout a large portion of the Holocene, with influx of open ocean water entering the system during periods of higher sea level.

Astrophysics: Cosmic explosions in the young Universe

The discovery of two superluminous supernovae at large distances from Earth pushes the frontier of supernova studies to just 1.5 billion years after the Big Bang, and suggests that they may be common in the young Universe. See Letter p.228

Rapid, simple method for determining the porosity of mesoporous TiO2 films using a quartz crystal microbalance (QCM)

Two different mesoporous films of TiO2 were coated onto a QCM disc and fired at 450o C for 30 min. The first film was derived from a sol-gel paste that was popular in the early days of dye-sensitised solar cell, i.e. dssc, research, a TiO2(sg) film. The other was a commercial colloidal paste used to make examples of the current dssc cell; a TiO2(ds) film. A QCM was used to determine the mass of the TiO2 film deposited on each disc and the increase in the mass of the film when immersed in water/glycerol solutions with wt% values spanning the range 0-70%. The results of this work reveal that with both TiO2 mesoporous films the solution fills the film's pores and acts as a rigid mass, thereby allowing the porosity of each film to be calculated as: 59.1% and 71.6% for the TiO2(sg) and TiO2(ds) films, respectively. These results, coupled with surface area data, allowed the pore radii of the two films to be calculated as: 9.6 and 17.8 nm, respectively. This method is then simplified further, to just a few frequency measurements in water and only air to reveal the same porosity values. The value of the latter ‘one point’ method for making porosity measurements is discussed briefly.

A study protocol for a pilot randomised trial of a structured education programme for the self-management of type 2 diabetes for adults with intellectual disabilities

BACKGROUND: The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmes are not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID. This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrative details.

METHODS/DESIGN: This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical, psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial.

DISCUSSION: The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are significant benefits to be gained globally, if structured education programmes are adapted and shown to be successful for people with ID and other cognitive impairments.

TRIAL REGISTRATION: Registered with International Standard Randomised Controlled Trial (identifier: ISRCTN93185560 ) on 10 November 2014.

Essays on James Clarence Mangan: The Man in the Cloak

This volume explores the extraordinary literary achievement of James Clarence Mangan (1803-1849), increasingly recognised as one of the most important Irish writers of the nineteenth century and a crucial influence on later writers such as W.B. Yeats and James Joyce. It is the first collection of essays to focus on Mangan, and features articles by leading scholars in the field (including Jacques Chuto and David Lloyd) as well as contributions from acclaimed contemporary writers, Paul Muldoon and Ciaran Carson. The collection expands existing fields of debate--translation, the supernatural, intertextuality, nationalism, romanticism-- and introduces new ones: Mangan's afterlife in the English literary canon, cosmopolitanism and Weltliteratur, antiquity and futurity, nineteenth-century spiritualism and magical thinking. 'The man in the cloak', one of Mangan's favourite pseudonyms, is still a a resonant soubriquet for a writer who has eluded sustained critical attention, and this volumes restores him to his proper place in European and British, as well as Irish literary history.