Development of a questionnaire to assess the relative subjective benefits of presbyopia correction

Purpose To develop a standardized questionnaire of near visual function and satisfaction to complement visual function evaluations of presbyopic corrections. Setting Eye Clinic, School of Life and Health Sciences, Aston University, Midland Eye Institute and Solihull Hospital, Birmingham, United Kingdom. Design Questionnaire development. Methods A preliminary 26-item questionnaire of previously used near visual function items was completed by patients with monofocal intraocular lenses (IOLs), multifocal IOLs, accommodating IOLs, multifocal contact lenses, or varifocal spectacles. Rasch analysis was used for item reduction, after which internal and test–retest reliabilities were determined. Construct validity was determined by correlating the resulting Near Activity Visual Questionnaire (NAVQ) scores with near visual acuity and critical print size (CPS), which was measured using the Minnesota Low Vision Reading Test chart. Discrimination ability was assessed through receiver-operating characteristic (ROC) curve analysis. Results One hundred fifty patients completed the questionnaire. Item reduction resulted in a 10-item NAVQ with excellent separation (2.92), internal consistency (Cronbach a = 0.95), and test–retest reliability (intraclass correlation coefficient = 0.72). Correlations of questionnaire scores with near visual acuity (r = 0.32) and CPS (r = 0.27) provided evidence of validity, and discrimination ability was excellent (area under ROC curve = 0.91). Conclusion Results show the NAVQ is a reliable, valid instrument that can be incorporated into the evaluation of presbyopic corrections.

The use of flow control devices to improve the flow pattern and throughput of sieve trays

Compared to packings trays are more cost effective column internals because they create a large interfacial area for mass transfer by the interaction of the vapour on the liquid. The tray supports a mass of froth or spray which on most trays (including the most widely used sieve trays) is not in any way controlled. The two important results of the gas/liquid interaction are the tray efficiency and the tray throughput or capacity. After many years of practical experience, both may be predicted by empirical correlations, despite the lack of understanding. It is known that the tray efficiency is in part determined by the liquid flow pattern and the throughput by the liquid froth height which in turn depends on the liquid hold-up and vapour velocity. This thesis describes experimental work on sieve trays in an air-water simulator, 2.44 m in diameter. The liquid flow pattern, for flow rates similar to those used in commercial scale distillation, was observed experimentally by direct observation; by water-cooling, to simulate mass transfer; use of potassium permanganate dye to observe areas of longer residence time; and by height of clear liquid measurements across the tray and in the downcomer using manometers. This work presents experiments designed to evaluate flow control devices proposed to improve the gas liquid interaction and hence improve the tray efficiency and throughput. These are (a) the use of intermediate weirs to redirect liquid to the sides of the tray so as to remove slow moving/stagnant liquid and (b) the use of vapour-directing slots designed to use the vapour to cause liquid to be directed towards the outlet weir thus reducing the liquid hold-up at a given rate i.e. increased throughput. This method also has the advantage of removing slow moving/stagnant liquid. In the experiments using intermediate weirs, which were placed in the centre of the tray. it was found that in general the effect of an intermediate weir depends on the depth of liquid downstream of the weir. If the weir is deeper than the downstream depth it will cause the upstream liquid to be deeper than the downstream liquid. If the weir is not as deep as deep as the downstream depth it may have little or no effect on the upstream depth. An intermediate weir placed at an angle to the direction of flow of liquid increases the liquid towards the sides of the tray without causing an increase in liquid hold-up/ froth height. The maximum proportion of liquid caused to flow sideways by the weir is between 5% and 10%. Experimental work using vapour-directing slots on a rectangular sieve tray has shown that the horizontal momentum that is imparted to the liquid is dependent upon the size of the slot. If too much momentum is transferred to the liquid it causes hydraulic jumps to occur at the mouth of the slot coupled with liquid being entrained, The use of slots also helps to eliminate the hydraulic gradient across sieve trays and provides a more uniform froth height on the tray. By comparing the results obtained of the tray and point efficiencies, it is shown that a slotted tray reduces both values by approximately 10%. This reduction is due to the fact that with a slotted tray the liquid has a reduced residence time Ion the tray coupled also with the fact that large size bubbles are passing through the slots. The effectiveness of using vapour-directing slots on a full circular tray was investigated by using dye to completely colour the biphase. The removal of the dye by clear liquid entering the tray was monitored using an overhead camera. Results obtained show that the slots are successful in their aim of reducing slow moving liquid from the sides of the tray, The net effect of this is an increase in tray efficiency. Measurements of slot vapour-velocity found it to be approximately equal to the hole velocity.

The effect of flow regimes in the distillation of systems containing two liquid phases

Single phase solutions containing three components have been observed to exhibit foaminess near a single to two liquid phase boundary. It was seen, in a sintered plate column under mass transfer conditions, that distillation systems where the liquid appeared as one phase in one part of a column and two phases in another part, exhibited foaminess when the liquid concentration was near the one phase to two phase boundary. Various ternary systems have been studied in a 50 plate. 30mm i.d. Oldershaw column and it was observed that severe foaming occurred in the middle section of the column near the one liquid phase to two liquid phase boundary and no foaming occurred at the end of the column where liquid was either one phase or two phase. This is known as Ross type foam. Mass transfer experiments with Ross type ternary systems have been carried out in a perspex simulator with small and large hole diameter trays. It was observed that by removal of the more volatile component, Ross type foam did not build up on the tray. Severe entrainment of liquid was observed in all cases leading to a 'dry' tray, even with a low free area small diameter hole tray which was expected to produce a bubbly mixture. Entrainment was more severe for high gas superficial velocities and large hole diameters. This behaviour is quite different from the build up of foam observed when one liquid phase/two liquid phase Ross systems were contacted with air above a small sintered disc or with vapour in an Oldershaw distillation column. This observation explains why distillation columns processing mixtures which change from one liquid phase to two liquid phases (or vice versa) must be severely derated to avoid flooding. Single liquid phase holdups at the spray to bubbly transition were measured using a perspex simulator similar to that of Porter & Wong (17). i.e. with no liquid cross flow. A light transmission technique was used to measure the transition from spray regime to bubbly regime. The effect of tray thickness and the ratio of hole diameter to tray thickness on the transition was evaluated using trays of the same hole diameter and free area but having thickness of 2.38 mm, 4 mm, and 6.35 mm. The liquid holdup at the transition was less with the thin metal trays. This result may be interpreted by the theory of Lockett (101), which predicts the transition liquid holdup in terms of the angle of the gas iet leaving the holes in the sieve plate. All the existing correlations have been compared and none were found to be satisfactory and these correlations have been modified in view of the experimental results obtained. A new correlation has been proposed which takes into account the effect of the hole diameter to tray thickness ratio on the transition and good agreement was obtained between the experimental results and the correlated values of the liquid holdup at the transition. Results have been obtained for two immiscible liquids [kerosene and water] on trays to determine whether foaming can be eliminated by operating in the spray regime. Kerosene was added to a fixed volume of water or water was added to a fixed volume of kerosene. In both cases, there was a transition from spray to bubbly. In the water fixed system. the liquid holdup at the transition was slightly less than the pure kerosene system. Whilst for the kerosene fixed system, the transition occurred at much lower liquid holdups. Trends In the results were similar to those for single liquid phase. New correlations have been proposed for the two cases. It has been found that Ross type foams, observed in a sintered plate column and in the Oldershaw column can be eliminated by either carrying out the separation in a packed column or by the addition of defoaming additives.

Linear stability of flow past two circular cylinders in a side-by-side arrangement

The linear stability of flow past two circular cylinders in a side-by-side arrangement is investigated theoretically, numerically and experimentally under the assumption of a two-dimensional flow field, in order to explore the origin of in-phase and antiphase oscillatory flows. Steady symmetric flow is realized at a small Reynolds number, but becomes unstable above a critical Reynolds number though the solution corresponding to the flow still satisfies the basic equations irrespective of the magnitude of the Reynolds number. We obtained the solution numerically and investigated its linear stability. We found that there are two kinds of unstable modes, i.e., antisymmetric and symmetric modes, which lead to in-phase and antiphase oscillatory flows, respectively. We determined the critical Reynolds numbers for the two modes and evaluated the critical distance at which the most unstable disturbance changes from the antisymmetric to the symmetric mode, or vice versa. ©2005 The Physical Society of Japan.

Special classes of iron(II) azole spin-crossover compounds

In this chapter, selected results obtained so far on Fe(II) spin crossover compounds of 1,2,4-triazole, isoxazole and tetrazole derivatives are summarized and analysed. These materials include the only compounds known to have Fe(II)N6 spin crossover chromophores consisting of six chemically identical heterocyclic ligands. Particular attention is paid to the coordination modes for substituted 1,2,4-triazole derivatives towards Fe(II) resulting in polynuclear and mononuclear compounds exhibiting Fe(II) spin transitions. Furthermore, the physical properties of mononuclear Fe(II) isoxazole and 1-alkyl-tetrazole compounds are discussed in relation to their structures. It will also be shown that the use of α,β- and α,ω-bis(tetrazol-1-yl)alkane type ligands allowed a novel strategy towards obtaining polynuclear Fe(II) spin crossover materials.

Influence of QT correction on temporal and amplitude features for human identification via ECG

Identification of humans via ECG is being increasingly studied because it can have several advantages over the traditional biometric identification techniques. However, difficulties arise because of the heartrate variability. In this study we analysed the influence of QT interval correction on the performance of an identification system based on temporal and amplitude features of ECG. In particular we tested MLP, Naive Bayes and 3-NN classifiers on the Fantasia database. Results indicate that QT correction can significantly improve the overall system performance. © 2013 IEEE.

Oxidation of protein in human low-density lipoprotein exposed to peroxyl radicals facilitates uptake by monocytes; protection by antioxidants in vitro

Generation of neoepitopes on apolipoprotein B within oxidised low-density lipoprotein (LDL) is important in the unregulated uptake of LDL by monocytic scavenger receptors (CD36, SR-AI, LOX-1). Freshly isolated LDL was oxidised by peroxyl radicals generated from the thermal decomposition of an aqueous azo-compound. We describe that formation of carbonyl groups on the protein component is early as protein oxidation was seen after 90min. This is associated with an increased propensity for LDL uptake by U937 monocytes. Three classes of antioxidants (quercetin, dehydroepiandrosterone (DHEA) and ascorbic acid) have been examined for their capacity to inhibit AAPH-induced protein oxidation, (protein carbonyls, Δ electrophoretic mobility and LDL uptake by U937 monocytes). CD36 expression was assessed by flow cytometry and was seen to be unaltered by oxidised LDL uptake. All three classes were effective antioxidants, quercetin (P<0.01), ascorbic acid (P<0.01), DHEA (P<0.05). As LDL protein is the control point for LDL metabolism, the degree of oxidation and protection by antioxidants is likely to be of great importance for (patho)-physiological uptake of LDL by monocytes. © 2003 Elsevier B.V. All rights reserved.

A review of the surgical options for the correction of presbyopia

Presbyopia is an age-related eye condition where one of the signs is the reduction in the amplitude of accommodation, resulting in the loss of ability to change the eye's focus from far to near. It is the most common age-related ailments affecting everyone around their mid-40s. Methods for the correction of presbyopia include contact lens and spectacle options but the surgical correction of presbyopia still remains a significant challenge for refractive surgeons. Surgical strategies for dealing with presbyopia may be extraocular (corneal or scleral) or intraocular (removal and replacement of the crystalline lens or some type of treatment on the crystalline lens itself). There are however a number of limitations and considerations that have limited the widespread acceptance of surgical correction of presbyopia. Each surgical strategy presents its own unique set of advantages and disadvantages. For example, lens removal and replacement with an intraocular lens may not be preferable in a young patient with presbyopia without a refractive error. Similarly treatment on the crystalline lens may not be a suitable choice for a patient with early signs of cataract. This article is a review of the options available and those that are in development stages and are likely to be available in the near future for the surgical correction of presbyopia.

Comparison of near visual acuity and reading metrics in presbyopia correction

PURPOSE: To provide a consistent standard for the evaluation of different types of presbyopic correction. SETTING: Eye Clinic, School of Life and Health Sciences, Aston University, Birmingham, United Kingdom. METHODS: Presbyopic corrections examined were accommodating intraocular lenses (IOLs), simultaneous multifocal and monovision contact lenses, and varifocal spectacles. Binocular near visual acuity measured with different optotypes (uppercase letters, lowercase letters, and words) and reading metrics assessed with the Minnesota Near Reading chart (reading acuity, critical print size [CPS], CPS reading speed) were intercorrelated (Pearson product moment correlations) and assessed for concordance (intraclass correlation coefficients [ICC]) and agreement (Bland-Altman analysis) for indication of clinical usefulness. RESULTS: Nineteen accommodating IOL cases, 40 simultaneous contact lens cases, and 38 varifocal spectacle cases were evaluated. Other than CPS reading speed, all near visual acuity and reading metrics correlated well with each other (r>0.70, P<.001). Near visual acuity measured with uppercase letters was highly concordant (ICC, 0.78) and in close agreement with lowercase letters (+/- 0.17 logMAR). Near word acuity agreed well with reading acuity (+/- 0.16 logMAR), which in turn agreed well with near visual acuity measured with uppercase letters 0.16 logMAR). Concordance (ICC, 0.18 to 0.46) and agreement (+/- 0.24 to 0.30 logMAR) of CPS with the other near metrics was moderate. CONCLUSION: Measurement of near visual ability in presbyopia should be standardized to include assessment of near visual acuity with logMAR uppercase-letter optotypes, smallest logMAR print size that maintains maximum reading speed (CPS), and reading speed. J Cataract Refract Surg 2009; 35:1401-1409 (C) 2009 ASCRS and ESCRS

Surgical correction of astigmatism during cataract surgery

High levels of corneal astigmatism are prevalent in a significant proportion of the population. During cataract surgery pre-existing astigmatism can be corrected using single or paired incisions on the steep axis of the cornea, using relaxing incisions or with the use of a toric intraocular lens. This review provides an overview of the conventional methods of astigmatic correction during cataract surgery and in particular, discusses the various types of toric lenses presently available and the techniques used in determining the correct axis for the placement of such lenses. Furthermore, the potential causes of rotation in toric lenses are identified, along with techniques for assessing and quantifying the amount of rotation and subsequent management options for addressing post-operative rotation.

The flow behaviour of shallow fluidised beds

The flow behaviour of shallow gas-fluidised beds was studied. experimentally using a rotational viscometer, and an inclined open channel. Initially, tests were carried out with the viscometer in order to establish qualitative trends in the flow properties of a variety of materials over a wide range of fluidising conditions. Also, a technique was developed which enabled quantitative viscosity data to be extracted from the experimental results. The flow properties were found to be sensitive to the size, size-range and density of the fluidised material, the type of distributor used, and the moisture content of the fluidising gas. Tests in beds up to 120 mm deep showed that the fluidity of the bed improves with reduction in depth; and indicated a range of flow behaviour from shear-thinning to Newtonian, depending chiefly on fluidising velocity .. Later, an apparatus was built which provided for a steady, continuous flow of fluidised material down an inclined open channel of 3m length x 0.15m square, up to a mass flowrate of 10 kg/s (35 ton/hr). This facility has enabled data to be obtained that is of practical value in industrial applications; which is otherwise difficult in view of the present limited understanding of the true mechanism of fluidised flow. A correlation has been devised, based on analogy with laminar liquid flow, which describes the channel flow behaviour with reasonable accuracy over the whole range of shear-rates used. 1he channeI results indicated that at low fluidiising velocities the flow was adversely affected by settlement of a stagnant layer of particles on to the distributor, which gave rise to increased flow resistance. Conversely, at higher fluidising velocities the resistance at the distributor appeared to be less than at the walls. In view of this, and also because of the disparity in shear-rates between the two types of apparatus, it is not possible as yet to predict exactly the flow behaviour in an open channel from small-scale viscometer tests.

Characterization of Acanthamoeba-microsphere association by multiparameter flow cytometry and confocal microscopy

Background: Acanthamoebae, in common with other protozoa, readily endocytose particulate material, which in turn may lead to the spread of infectious disease. Methods: Evaluation and quantification of plain and carboxylate FITC-microsphere association with acanthamoebal trophzoites was undertaken using a combination of flow cytometry and confocal microscopy. Trophozoites from strains and species of Acanthamoeba were exposed to plain and carboxylate FITC-microspheres. Microsphere size and aspects such as trophozoite starvation, maturity, and exposure to metabolic inhibitors were assessed. Results: All species and strains of Acanthamoeba readily endocytosed plain and carboxylate microspheres. Starving trophozoites significantly increased binding and potential ingestion of microspheres, whereas trophozoites of increasing maturity lost such abilities. Trophozoites showed a significant preference for 2.0- and 3.0-μm-diameter microspheres when compared with other sizes, which in turn could occupy much of the cytoplasm. The physiological inhibitors sodium azide, 2,4-clinitrophenol, and cytochalasin B reduced microsphere association with trophozoites; however, some microspheres still bound and associated with trophozoites after inhibitor exposure, a manifestation of both active and inactive agent involvement in microsphere endocytosis. Conclusions: Even though the origins of microsphere binding by acanthamoebal trophozoite remains shrouded, the combination of flow cytometry and confocal microscopy supported synergistic quantification and qualification of trophozoite-microsphere endocytosis. © 2006 International Society for Analytical Cytology.