Consensus on Outcome Measures for Glaucoma Effectiveness Trials: Results From a Delphi and Nominal Group Technique Approaches

PURPOSE: Comparing the relative effectiveness of interventions across glaucoma trials can be problematic due to differences in definitions of outcomes. We sought to identify a key set of clinical outcomes and reach consensus on how best to measure them from the perspective of glaucoma experts.

METHODS: A 2-round electronic Delphi survey was conducted. Round 1 involved 25 items identified from a systematic review. Round 2 was developed based on information gathered in round 1. A 10-point Likert scale was used to quantify importance and consensus of outcomes (7 outcomes) and ways of measuring them (44 measures). Experts were identified through 2 glaucoma societies membership-the UK and Eire Glaucoma Society and the European Glaucoma Society. A Nominal Group Technique (NGT) followed the Delphi process. Results were analyzed using descriptive statistics.

RESULTS: A total of 65 participants completed round 1 out of 320; of whom 56 completed round 2 (86%). Agreement on the importance of outcomes was reached on 48/51 items (94%). Intraocular pressure (IOP), visual field (VF), safety, and anatomic outcomes were classified as highly important. Regarding methods of measurement of IOP, "mean follow-up IOP" using Goldmann applanation tonometry achieved the highest importance, whereas for evaluating VFs "global index mean deviation/defect (MD)" and "rate of VF progression" were the most important. Retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) was identified as highly important. The NGT results reached consensus on "change of IOP (mean of 3 consecutive measurements taken at fixed time of day) from baseline," change of VF-MD values (3 reliable VFs at baseline and follow-up visit) from baseline, and change of RNFL thickness (2 good quality OCT images) from baseline.

CONCLUSIONS: Consensus was reached among glaucoma experts on how best to measure IOP, VF, and anatomic outcomes in glaucoma randomized controlled trials.

Eutrophication and some European waters of restricted exchange

Regions of Restricted Exchange (RREs) are an important feature of the European coastline. They are historically preferred sites for human settlement and aquaculture and their ecosystems, and consequent human use, may be at risk from eutrophication. The OAERRE project (EVK3-CT1999-0002 concerns ‘Oceanographic Applications to Eutrophication in Regions of Restricted Exchange’. It began in July 2000, and studies six sites. Four of these sites are fjords: Kongsfjorden (west coast of Spitzbergen); Gullmaren (Skagerrak coast of Sweden); Himmerfj.arden (Baltic coast of Sweden); and the Firth of Clyde (west coast of Scotland). Two are bays sheltered by sand bars: Golfe de Fos (French Mediterranean); and Ria Formosa (Portuguese Algarve). Together they exemplify a range of hydrographic and enrichment conditions. The project aims to understand the physical, biogeochemical and biological processes, and their interactions, that determine the trophic status of these coastal marine RRE through the development of simple screening models to define, predict and assess eutrophication. This paper introduces the sites and describes the component parts of a basic screening model and its application to each site using historical data. The model forms the starting point for the OAERRE project and views an RRE as a well-mixed box, exchanging with the sea at a daily rate E determined by physical processes, and converting nutrient to phytoplankton chlorophyll at a fixed yield q: It thus uses nutrient levels to estimate maximum biomass; these preliminary results are discussed in relation to objective criteria used to assess trophic status. The influence of factors such as grazing and vertical mixing on key parameters in the screening model are further studied using simulations of a complex‘research’ model for the Firth of Clyde. The future development of screening models in general and within OAERRE in particular is discussed. In addition, the paper looks ahead with a broad discussion of progress in the scientific understanding of eutrophication and the legal and socioeconomic issues that need to be taken into account in managing the trophic status of RREs.

Air-sea CO2 exchange in the Kuroshio and its importance to the global CO2 uptake

Senior thesis written for Oceanography 444

Modelling and optimization of the ion exchange membrane bioreactor for removal of anionic pollutants from drinking water streams

Dissertação para obtenção do Grau de Doutor em Engenharia Química, especialidade de Engenharia Bioquímica

Orientation of Non-Native 2-Monosubstituted and 2,3-Disubstituted 1,4-Naphthoquinones in the A1 binding site of PSI and the effect on the rate of electron transfer : an electron paramagnetic resonance spectroscopy study

The proce-ss ofoxygenic photosynthesis is vital to life on Earth. the central event in photosynthesis is light induced electron transfer that converts light into energy for growth. Ofparticular significance is the membrane bound multisubunit protein known as Photosystem I (PSI). PSI is a reaction centre that is responsible for the transfer of electrons across the membrane to reduce NADP+ to NADPH. The recent publication ofa high resolution X-ray structure of PSI has shown new information about the structure, in particular the electron transfer cofactors, which allows us to study it in more detail. In PSI, the secondary acceptor is crucial for forward electron transfer. In this thesis, the effect of removing the native acceptor phylloquinone and replacing it with a series of structurally related quinones was investigated via transient electron paramagnetic resonance (EPR) experiments. The orientation of non native quinones in the binding site and their ability to function in the electron transfer process was determined. It was found that PSI will readily accept alkyl naphthoquinones and anthraquinone. Q band EPR experiments revealed that the non-native quinones are incorporated into the binding site with the same orientation of the headgroup as in the native system. X band EPR spectra and deuteration experiments indicate that monosubstituted naphthoquinones are bound to the Al site with their side group in the position occupied by the methyl group in native PSI (meta to the hydrogen bonded carbonyl oxygen). X band EPR experiments show that 2, 3- disubstituted methyl naphthoquinones are also incorporated into the Al site in the same orientation as phylloquinone, even with the presence of a halogen- or sulfur-containing side chain in the position normally occupied by the phytyl tail ofphylloquinone. The exception to this is 2-bromo-3-methyl --.- _. -. - -- - - 4 _._ _ _ - _ _ naphthoquinone which has a poorly resolved spectrum, making determination of the orientation difficuh. All of the non-native quinones studied act as efficient electron acceptors. However, forward electron transfer past the quinone could only be demonstrated for anthraquinone, which has a more negative midpoint potential than phylloquinone. In the case of anthraquinone, an increased rate of forward electron transfer compared to native PSI was found. From these results we can conclude that the rate ofelectron transfer from Al to Fx in native PSI lies in the normal region ofthe Marcus Curve.

Macroeconomic News Effects and Foreign Exchange Jumps

This thesis investigates how macroeconomic news announcements affect jumps and cojumps in foreign exchange markets, especially under different business cycles. We use 5-min interval from high frequency data on Euro/Dollar, Pound/Dollar and Yen/Dollar from Nov. 1, 2004 to Feb. 28, 2015. The jump detection method was proposed by Andersen et al. (2007c), Lee & Mykland (2008) and then modified by Boudt et al. (2011a) for robustness. Then we apply the two-regime smooth transition regression model of Teräsvirta (1994) to explore news effects under different business cycles. We find that scheduled news related to employment, real activity, forward expectations, monetary policy, current account, price and consumption influences forex jumps, but only FOMC Rate Decisions has consistent effects on cojumps. Speeches given by major central bank officials near a crisis also significantly affect jumps and cojumps. However, the impacts of some macroeconomic news are not the same under different economic states.

Development of Zero Water Exchange Shrimp Culture System Integrated With Bioremediation of Detritus and Ammonia- Nitrogen

Aquaculture is one of the fastest growing food sectors in the world. Amongst the various branches of aquaculture, shrimp culture has expanded rapidly across the globe because of its faster growth rate, short culture period, high export value and demand in the International market. Indian shrimp farming has experienced phenomenal development over the decades due to its excellent commercial viability. Farmers have adopted a number of innovative technologies to improve the production and to maximize the returns per unit area. The culture methods adopted can be classified in to extensive, modified extensive and semi intensive based on the management strategies adopted in terms of pond size, stocking density, feeding and environmental control. In all these systems water exchanges through the natural tidal effects, or pump fed either from creek or from estuaries is a common practice. In all the cases, the systems are prone to epizootics due to the pathogen introduction through the incoming water, either brought by vectors, reservoir hosts, infected tissue debris and free pathogens themselves. In this scenario, measures to prevent the introduction of pathogen have become a necessity to protect the crop from the onslaught of diseases as well as to prevent the discharge of waste water in to the culture environment.The present thesis deals with Standardization of bioremediation technology for zero water exchange shrimp culture system

Water relations, growth and gas exchange in Acacia auriculiformis under experimental and natural conditions

Investigations on the water relations and gas exchange of/tcacia aun'culiji_2rmis were carried out in natural and controlled environments. The experiments were performed in both seedlings and five year old trees. Different sets of experiments were conducted in Acacia plantations, at Kothachira, Palakkad District and in .seedlings, at KFRI campus nursery mainly during the summer months. Investigations were also extended to seedlings of A.mangium, Aaulacocarpa and /Lholocericea, which are also phyllodinous species with the intention of comparing their physiology with Acacia auriculifomus. Potted seedlings of four species of Acacia viz., A. auriculi/E)/7r:i.r, /I. aulacocarpa, A. holocericea and A. mangium were used for the study. Measurements of relative water content (RWC), water potential, photosynthetic rate, transpiration, stomatal conductance, water use efficiency etc. of phyllodes were measured diumally in plants subjected to three stress conditions namely, drought, salinity and flooding

Foreign exchange reserves in India and China

Professor Irma Glicman Adelman, an Irish Economist working in California University at Berkely, in her research work on ‘Development Over Two Centuries’, which is published in the Journal of Evolutionary Economics, 1995, has identified that India, along with China, would be one of the largest economies in this 21st Century. She has stated that the period 1700 - 1820 is the period of Netherlands, the period 1820 - 1890 is the period of England the period 1890 - 2000 is the period of America and this 21st Century is the century of China and India. World Bank has also identified India as one of the leading players of this century after China. India will be third largest economy after USA and China. India will challenge the Global Economic Order in the next 15 years. India will overtake Italian economy in 2015, England economy in 2020, Japan economy in 2025 and USA economy in 2050 (China will overtake Japan economy in 2016 and USA economy in 2027). India has the following advantages compared with other economies. India is 4th largest GDP in the world in terms of Purchasing Power. India is third fastest growing economy in the world after China and Vietnam. Service sector contributes around 57% of GDP. The share of agriculture is around 17% and Manufacture is 16% in 2005 - 2006. This is a character of a developed country. Expected GDP growth rate is 10% shortly (It has come down from 9.2% in 2006 - 2007 to 6.2% during 2008 - 2009 due to recession. It is only a temporary phenomenon). India has $284 billion as Foreign Exchange Reserve as on today. India had just $1 billion as Foreign Exchange Reserve when it opened its economy in the year 1991. In this research paper an attempt has been made to study the two booming economies of the globe with respect to their foreign exchange reserves. This study mainly based on secondary data published by respective governments and various studies done on this area

Observations of the inter-ocean exchange around South Africa

There is growing evidence that the interocean exchange south of Africa is an important link in the global overturning circulation of the ocean, the so‐called ocean conveyer belt. At this location, warm and salty Indian Ocean waters enter the South Atlantic and are pulled by currents that eventually reach the North Atlantic, where water cools and sinks. A major contributor to the exchange is the frequent shedding of ring eddies from the termination of the Agulhas Current south of the tip of Africa. This shedding is controlled by developments far upstream in the Indian Ocean, and variations in this ‘Agulhas Leakage’ can lead to changes in the rate and stability of the Atlantic overturning, with possible associated global climate variations [Weijer et al., 1999]. Regional climate variations in the tropical and subtropical Indian Ocean are known to affect the whole system of the Agulhas Current, including the interocean exchanges. This article reports on some of the seminal results of ongoing multinational, multidisciplinary projects that explore these issues.

Gas-phase kinetics of chlorosilylene reactions. I. ClSiH + Me3SiH: absolute rate measurements and theoretical calculations for prototype Si−H insertion reactions

Time-resolved studies of chlorosilylene, CISiH, generated by the 193 nm laser flash photolysis of 1-chloro-1-silacyclopent-3-ene, have been carried out to obtain rate constants for its bimolecular reaction with trimethylsilane, Me3SiH, in the gas phase. The reaction was studied at total pressures up to 100 torr (with and without added SF6) over the temperature range 297-407 K. The rate constants were found to be pressure independent and gave the following Arrhenius equation: log(k/cm(3) molecule(-1) s(-1)) = (-13.97 +/- 0.25) + (12.57 +/- 1.64) kJ mol(-1)/RT In 10. The Arrhenius parameters are consistent with a mechanism involving an intermediate complex, whose rearrangement is the rate-determining step. Quantum chemical calculations of the potential energy surface for this reaction and also the reactions of CISiH with SiH4 and the other methylsilanes support this conclusion. Comparisons of both experiment and theory with the analogous Si-H insertion processes of SiH2 and SiMe2 show that the main factor causing the lower reactivity of ClSiH is the secondary energy barrier. The calculations also show the existence of a novel intramolecular H-atom exchange process in the complex of ClSiH with MeSiH3.

A model for exchange rates with crawling bands: an application to the Colombian peso

This paper builds upon previous research on currency bands, and provides a model for the Colombian peso. Stochastic differential equations are combined with information related to the Colombian currency band to estimate competing models of the behaviour of the Colombian peso within the limits of the currency band. The resulting moments of the density function for the simulated returns describe adequately most of the characteristics of the sample returns data. The factor included to account for the intra-marginal intervention performed to drive the rate towards the Central Parity accounts only for 6.5% of the daily change, which supports the argument that intervention, if performed by the Central Bank, it is not directed to push the currency towards the limits. Moreover, the credibility of the Colombian Central Bank, Banco de la República’s ability to defend the band seems low.

Eddy-driven exchange between the open ocean and a sub-ice shelf cavity

The exchange between the open ocean and sub-ice shelf cavities is important to both water mass transformations and ice shelf melting. Here we use a high-resolution (500 m) numerical model to investigate to which degree eddies produced by frontal instability at the edge of a polynya are capable of transporting dense High Salinity Shelf Water (HSSW) underneath an ice shelf. The applied surface buoyancy flux and ice shelf geometry is based on Ronne Ice Shelf in the southern Weddell Sea, an area of intense wintertime sea ice production where a flow of HSSW into the cavity has been observed. Results show that eddies are able to enter the cavity at the southwestern corner of the polynya where an anticyclonic rim current intersects the ice shelf front. The size and time scale of simulated eddies are in agreement with observations close to the Ronne Ice Front. The properties and strength of the inflow are sensitive to the prescribed total ice production, flushing the ice shelf cavity at a rate of 0.2–0.4 × 106 m3 s−1 depending on polynya size and magnitude of surface buoyancy flux. Eddy-driven HSSW transport into the cavity is reduced by about 50% if the model grid resolution is decreased to 2-5 km and eddies are not properly resolved.

Magnetic interaction in exchange-biased bilayers: a first-order reversal curve analysis

The distributions of coercivities and magnetic interactions in a set of polycrystalline Ni(0.8)Fe(0.2)/FeMn bilayers have been determined using the first-order reversal curve (FORC) formalism. The thickness of the permalloy (Py) film was fixed at 10 nm (nominal), while that of the FeMn film varied within the range 0-20 nm. The FORC diagrams of each bilayer displayed two clearly distinguishable regions. The main region was generated by Py particles whose coercivities were enhanced in comparison with those in which the FeMn film was absent (sample O). The minor region was produced by Py particles with coercivities similar to or slightly higher than those of particles in the Py film of sample O. Each sample presented two distributions of interaction fields, one for each region, and both were centred slightly below the exchange-bias field, thus indicating a prevalence of magnetizing interactions. These results are consistent with a grain size distribution in the Py layer and the presence of uncompensated antiferromagnetic moments.

First-order-reversal-curve analysis of Pr-Fe-B-based exchange spring magnets

Ribbons of nominal composition (Pr(9.5)Fe(84.5)B(6))(0.96)Cr(0.01)(TiC)(0.03) were produced by arc-melting and melt-spinning the alloys on a Cu wheel. X-ray diffraction (XRD) reveals two main phases, one based upon alpha-Fe and the other upon Pr(2)Fe(14)B. The ribbons show exchange spring behavior with H (c) = 12.5 kOe and (BH)(max) = 13.6 MGOe when these two phases are well coupled. Transmission electron microscopy revealed the coupled behavior is observed when the microstructure consists predominantly of alpha-Fe grains (diameter similar to 100 nm.) surrounded by hard material containing Pr(2)Fe(14)B. The microstructure is discussed in terms of a calculation by Skomski and Coey. A first-order-reversal-curve (FORC) analysis was performed for both a well-coupled sample and a poorly coupled sample. The FORC diagrams show two strong peaks for both the poorly coupled sample and for the well-coupled material. In both cases, the localization of the FORC probability suggests magnetizing interactions between particles. Switching field distributions were calculated and are consistent with the sample microstructure.