bluuebunny/crossref_metadata_2025 huggingface dataset:
Restored Oyster Reef Location and Design Affect Responses of Resident and Transient Fish, Crab, and Shellfish Species in Mobile Bay, Alabama
Authors: Gregalis Kevan C. , Johnson Matthew W. , Powers Sean P.
Published: March 2009

Recent efforts to restore oyster reefs have resulted in the creation of many reefs with the explicit objective of benefiting local shellfish and finfish fisheries. We evaluated the community responses of the fish (transient and resident), crab, and shellfish species that colonized or utilized a series of restored high‐ and low‐relief oyster reefs at three different locations within Mobile Bay, Alabama. Sites were chosen to represent different combinations of sediment type, proximity to established oyster reefs, water quality, and water movement patterns. The results showed substantial differences in reef community among the three sites and, compared with unstructured bottoms, increased abundance of several species of small demersal fishes and sessile invertebrates. Common mud crabs Panopeus herbstii and flatback mud crabs Eurypanopeus depressus were the only species to exhibit any consistent patterns in habitat use that could be directly attributed to reef height. The species composition of transient fishes did vary among treatments, but the total abundance on low‐relief reefs and unstructured control areas was similar and often greater than that on high‐relief reefs. There were significant two‐way interactions between season, reef location, and reef design for most species abundances. These results suggest that the responses by resident and transient species to reef restoration were highly variable and that our ability to predict the community responses of resident and transient fishes to oyster reef restoration may be limited because of the interactions among location‐specific biophysical characteristics.
Procurement, design and construction of the Clyde Arc, Glasgow
Authors: Walker C. , Scott T. , Trail D.
Published: March 2009

The design and construction of the Clyde Arc has created a new landmark structure on the River Clyde waterfront in Glasgow. The construction of the £20·3 million project commenced in May 2005 and was completed in September 2006. The bridge is a three-span structure, the central span comprising a tied bow string arch with a single steel diamond-shaped arch rib spanning the long diagonal of the span. The main deck consists of a composite steel ladder beam arrangement with two longitudinal plate girders and cross girders at 4 m centres acting compositely with a reinforced concrete deck. The centre span is supported directly from 14 hanger bars, each 110 mm in diameter. The lower hanger connections are attached to outriggers from the main longitudinal girders, which are connected longitudinally with tubular members. The back spans are supported at the pier cross girders and are integral with the reinforced concrete abutments, which are in turn supported on reinforced concrete piles of small diameter. The centre span is supported on tubular steel piles of large diameter, within the river. This paper describes the procurement, design and construction of this structure.
Influence of clogging on the effective life of permeable pavements
Authors: Pezzaniti D. , Beecham S. , Kandasamy J.
Published: March 2009

This paper investigates the ‘effective life’ (or useful lifespan) of permeable pavement installations subject to sediment loadings. The broad aims of this study, which included both laboratory and field work components, were to improve understanding of the long-term pavement hydraulic conductivity, to assess the effective life of permeable pavements and to quantify the degree of sediment trapping and associated pollutant retention. Three types of permeable pavement were investigated. For each type the effects of pavement cleaning were also investigated. Over a simulated 35 years of sediment loading conducted in the laboratory, the results showed reductions of 59–75% in hydraulic conductivity with an average sediment retention of 94%. Suspended sediment concentrations measured at the outflow of the laboratory test beds did not show any significant difference between pavers that were subjected to cleaning and those that were not. For the field studies presented in this paper, hydraulic conductivities were very high in locations where permeable pavements are subjected to small to moderate sediment loads. At other locations with high coarse sediment and organic sediment loads, hydraulic conductivity tests indicated that clogging occurred at a rapid rate, particularly where runoff flowing onto the pavement was concentrated.
Adverse Effects of a Clinically Relevant Dose of Hydroxyurea Used for the Treatment of Sickle Cell Disease on Male Fertility Endpoints
Authors: Jones Kea M. , Niaz Mohammad S. , Brooks Cynthia M. , Roberson Shannon I. , Aguinaga Maria P. , Hills Edward R. , Rice Valerie Montgomery , Bourne Phillip , Bruce Donald , Archibong Anthony E.
Published: March 2009

Two experiments were conducted to determine: 1) whether the adult male transgenic sickle cell mouse (Tg58 × Tg98; TSCM), exhibits the patterns of reproductive endpoints (hypogonadism) characteristic of men with sickle cell disease (SCD) and 2) whether hydroxyurea (HU) exacerbates this condition. In Experiment 1, blood samples were collected from adult age-matched TSCM and ICR mice (ICRM) (N = 10/group) for plasma testosterone measurements. Subsequently, mice were sacrificed, testes excised and weighed and stored spermatozoa recovered for the determination of sperm density, progressive motility and percentage of spermatozoa with normal morphology. In experiment 2, adult male TSCM were orally treated with 25 mg HU/kg body weight/day for 28 or 56 days. Control mice received the vehicle for HU (saline) as described above. At the end of the treatment periods, blood samples were collected for quantification of circulating testosterone. Subsequently, mice were sacrificed, testes and epididymides were recovered and weighed and one testis per mouse was subjected to histopathology. Stored spermatozoa were recovered for the determination of indices of sperm quality mentioned in Experiment 1. Testis weight, stored sperm density, progressive motility, percentage of spermatozoa with normal morphology and plasma testosterone concentrations of TSCM were significantly lower by 40, 65, 40, 69 and 66%, respectively than those of ICRM. These data indicate that adult TSCM used in this study suffered from hypogonadism, characteristically observed among adult male SCD patients. In Experiment 2, HU treatment significantly decreased testis weight on day 28, (0.09 ± 0.004g) that was further decreased on day 56 (0.06 ± 0.003g; treatment x time interaction) compared with controls (day 28, 0.15 ± 0.01g; day 56, 2, 0.16 ± 0.01g). Concomitant with a 52% shrinkage (P
Ultra Low-Dose Radiation: Stress Responses and Impacts Using Rice as a Grass Model
Authors: Rakwal Randeep , Agrawal Ganesh Kumar , Shibato Junko , Imanaka Tetsuji , Fukutani Satoshi , Tamogami Shigeru , Endo Satoru , Sahoo Sarata Kumar Sahoo , Masuo Yoshinori , Kimura Shinzo
Published: March 2009

We report molecular changes in leaves of rice plants (Oryza sativa L. - reference crop plant and grass model) exposed to ultra low-dose ionizing radiation, first using contaminated soil from the exclusion zone around Chernobyl reactor site. Results revealed induction of stress-related marker genes (Northern blot) and secondary metabolites (LC-MS/MS) in irradiated leaf segments over appropriate control. Second, employing the same in vitro model system, we replicated results of the first experiment using in-house fabricated sources of ultra low-dose gamma (g) rays and selected marker genes by RT-PCR. Results suggest the usefulness of the rice model in studying ultra low-dose radiation response/s.
Sea Clutter Reduction and Target Enhancement by Neural Networks in a Marine Radar System
Authors: Vicen-Bueno Raúl , Carrasco-Álvarez Rubén , Rosa-Zurera Manuel , Nieto-Borge José Carlos
Published: March 2009

The presence of sea clutter in marine radar signals is sometimes not desired. So, efficient radar signal processing techniques are needed to reduce it. In this way, nonlinear signal processing techniques based on neural networks (NNs) are used in the proposed clutter reduction system. The developed experiments show promising results characterized by different subjective (visual analysis of the processed radar images) and objective (clutter reduction, target enhancement and signal-to-clutter ratio improvement) criteria. Moreover, a deep study of the NN structure is done, where the low computational cost and the high processing speed of the proposed NN structure are emphasized.
Hearing Impairment: Significant but Underassessed in Primary Care Settings
Authors: Wallhagen Margaret I. , Pettengill Elaine
Published: March 2009

In this study, 91 older adults with hearing impairment were interviewed and asked whether their primary care providers had ever inquired about or initiated screening for hearing loss. A total of 85% indicated there had been no physician inquiry, and additional data demonstrated that the rate of inquiry was unrelated to either objective or subjective levels of hearing loss. In addition, interview narratives revealed that hearing impairment was sometimes dismissed by primary care providers, with detrimental consequences for both the individuals with hearing impairment and their communication partners. Nurses could positively influence the initiation of treatment for hearing loss by incorporating screening techniques into their assessment routines.
A Revised Index for Social Engagement for Long-Term Care
Authors: Gerritsen Debby L. , Steverink Nardi , Frijters Dinnus H.M. , Hirdes John P. , Ooms Marcel E. , Ribbe Miel W.
Published: March 2009

The objective of this study was to improve validity and reliability estimates of the Index for Social Engagement (ISE) for long-term care. After exploring content validity and internal consistency in Dutch and Canadian data, two ISE items were dropped, and two new items were added. Reliability of this Revised ISE (RISE) was tested in 189 nursing home residents. It appeared that the RISE has enhanced reliability estimates, especially in residents with cognitive impairment. The RISE for long-term care improves the existing index by including additional dimensions of social engagement and by increasing the reliability of results for residents with cognitive impairment.
End-Of-Life Nursing Education Consortium Geriatric Training Program: Improving Palliative Care in Community Geriatric Care Settings
Authors: Kelly Kathe , Ersek Mary , Virani Rose , Malloy Pamela , Ferrell Betty
Published: March 2009

Recent studies of end-of-life care in nursing homes and other long-term care settings point to a significant need to improve care. The End-of-Life Nursing Education Consortium (ELNEC)–Geriatric Training Program is an important educational initiative to advance palliative care and end-of-life education for licensed nurses and nursing assistants. The ELNEC–Geriatric Training Program prepares nurses as educators and leaders to improve the quality of end-of-life care in geriatric care facilities. This article presents evaluation data from the 2007 pilot ELNEC–Geriatric Training Program and follow-up evaluation of the “train-the-trainer” model to disseminate comprehensive palliative care education in geriatric settings.
Therapeutic Environments for Older Adults: Constituents and Meanings
Authors: Edvardsson David
Published: March 2009

This article presents the findings of a study that aimed to describe what constitutes therapeutic environments and interpret what it means to be in such environments for older adults. Interview and observational data collected in Swedish health care contexts were subjected to qualitative content analysis. The findings describe therapeutic environments as being constituted by three interacting and interwoven categories: the physical environment, people’s doing and being in the environment, and an organizational philosophy of care. The findings are interpreted in light of the existential philosophy of home as a concept, a place, and an existential experience, highlighting that therapeutic environments can support existential at-homeness among patients. The findings of this study can contribute to nursing practice by providing a conceptual basis for reflecting on and evaluating how the physical environment, staff’s doing and being, and the organizational philosophy of care cooperate to support well-being among older adults living in long-term care facilities.
Residential and Caregiver Preferences of Older Korean Americans
Authors: Shin Dong-soo
Published: March 2009

The purpose of this study was to explore the residential and caregiver preferences of older Korean Americans if they were to become bedridden. The purposive sample consisted of 12 individuals from three residential settings in the Chicago area: senior housing, co-residing with adult children, and nursing homes. Data were collected using ethnographic interviews and participant observation. The older adults’ preferences included nine themes in three domains. Long-term care providers should be aware of the foundations of Korean Americans’ elder care preferences, which are a blend of traditional Korean beliefs about filial piety and adopted American values of independence.
Clinical Perspectives on Portable Do-Not-Resuscitate Orders
Authors: Payne Judith K. , Thornlow Deirdre K.
Published: March 2009

A do-not-resuscitate (DNR) order is a written medical order that documents a patient’s wishes regarding resuscitation and, more specifically, the patient’s desire to avoid cardiopulmonary resuscitation (CPR). A DNR order is one of the most important patient care directives that can be issued because it has dramatic and irreversible consequences. A portable DNR order is a do-not-resuscitate directive that travels with the patient. One way to improve continuity among providers and organizations is to develop statewide portable DNR and end-of-life orders that ensure patients’ wishes are followed regardless of setting.
How Sweet the Sound: Research Evidence for the Use of Music in Alzheimer’s Dementia
Authors: Witzke Jan , Rhone Rebecca A. , Backhaus Diane , Shaver Nanette A.
Published: March 2009

The purpose of this article is to provide an evidence-based synthesis of the research literature on music intervention for agitated behavior in Alzheimer’s dementia. A qualitative review of the literature supported music as a low-cost, simple alternative to traditional methods of management, with minimal risk to the client. A rating system assigning levels of evidence to support these interventions was used, and implications for nursing practice innovations and further research are discussed.
Perceived Advantages and Disadvantages of Using Agency Staff Related to Care in Nursing Homes: A Conceptual Model
Authors: Castle Nicholas G.
Published: March 2009

Data from 3,946 nursing homes (66% response rate) were used to examine the advantages and disadvantages of using agency staff. A conceptual model showing potential reasons for the relationship between agency use and care quality was also developed. Fifty-nine percent of nursing homes used some agency staff (i.e., RNs, licensed practical nurses, nurse aides) in 2006. The conceptual model and empirical analyses show that agency staff likely influence other staff, facility operations, and residents. Administrators listed more disadvantages than advantages of using agency staff.
Revisiting Geriatric Failure to Thrive: A Complex and Compelling Clinical Condition
Authors: Rocchiccioli Judith Townsend , Sanford Julie Tanner
Published: March 2009

Geriatric failure to thrive (GFTT) poses a complex clinical issue in gerontological nursing practice. GFTT is not a normal part of aging, nor is it an outcome of chronic illness. Rather, GFTT describes a lack of vitality and diminished capacity for life and outlines a process of functional decline that is often difficult to explain. The purpose of this article is to review GFTT, examine the literature on GFTT, and suggest strategies for the identification, assessment, and creative management of this complex condition that affects millions of older adults.
Eccentric Reaming in Total Shoulder Arthroplasty: A Cadaveric Study
Authors: Gillespie Robert , Lyons Robert , Lazarus Mark
Published: March 2009

Posterior glenoid bone loss often is seen in association with glenohumeral osteoarthritis. Many different techniques have been proposed to account for this bone loss during total shoulder arthroplasty, the most popular being eccentric anterior reaming. However, the amount of correction that can be achieved has not been been well quantified. The purpose of this study was to define the amount of eccentric posterior glenoid wear that can be corrected by anterior glenoid reaming. Eight cadaveric scapulae were studied. Simulations of posterior glenoid wear in 5° increments were performed on each scapula. The specimens were then eccentrically reamed to correct the deformity. Anteroposterior width, superior-inferior height, and the best-fit pegged glenoid prosthesis size were measured. Anterior reaming to correct a 10° posterior defect resulted in a decrease in anteroposterior glenoid diameter from 26.7±2.5 mm to 23.8±3.1 mm (
P
=.006). In 4 of 8 specimens, placing a glenoid prosthesis was not possible after correcting a 15° deformity because of inadequate bony support (N=2), peg penetration (N=1) or both (N=1). A 20° deformity was correctable in 2 of 8 specimens and only after downsizing the glenoid component. Anterior glenoid reaming to correct eccentric posterior wear of ⩾10° results in significant narrowing of the anteroposterior glenoid width. A 15° deformity has only a 50% chance of successful correction by anterior, eccentric reaming. Orthopedic surgeons need to be cognizant of this in their preoperative planning for total shoulder arthroplasty.
Histologic Evaluation of High Speed Burr Shavings Collected During Spinal Decompression Surgery
Authors: Patel Vikas V. , Estes Susan M. , Naar Erick M. , Lindley Emily M. , Burger Evalina
Published: March 2009

In spinal decompression and fusion surgery, a high speed burr is often used to remove bony material. The generated bone shavings are typically washed away and discarded. This study histologically examined the content of burr shavings to determine whether the collected tissue has the potential to augment local autograft. Our findings verified that burr shavings collected during spinal decompression are primarily composed of bone (65%) with blood product (32%). The bone shavings appear to remain viable after burring, as there was no microscopic evidence of damage to the cells. These findings indicate that bone shavings can be easily collected and could be added to local laminectomy bone with minimal cost. This technique is also beneficial given that it does not increase morbidity, as does iliac crest bone graft harvesting. Furthermore, the putty-like consistency of the bone shavings may facilitate the placement of morselized autograft bone. Despite these advantages, collected bone shavings are by no means a substitute for autograft or allograft bone. Their osteogenic potential is not comparable to that of iliac crest bone and the shavings lack the structural scaffolding of allograft bone. This technique, however, provides a resource for augmenting local autograft during spinal fusion, and is not associated with any significant cost or effort. Future studies should compare the clinical and radiographic fusion outcomes of high speed burr bony shavings combined with local laminectomy bone versus either iliac crest autograft or local laminectomy bone used with other bone graft extenders.
Blood Management in Total Knee Arthroplasty: A Comparison of Techniques
Authors: Sinclair Kyle C. , Clarke Henry D. , Noble Brie N.
Published: March 2009

Patients undergoing total knee arthroplasty (TKA) are at high risk for postoperative anemia and allogeneic blood transfusions. Risks associated with allogeneic blood exposure (ie, infection, fluid overload, and longer hospital stays) have prompted alternative blood management strategies. The main goal of this study was to evaluate whether a single change in the clinical blood management of patients undergoing TKA reduced the severity of postoperative anemia or the need for allogeneic blood transfusions. A second goal of this study was to assess the financial impact of the change on the institution. This study compared perioperative cell salvage, preoperative autologous blood donation, and the practice of using allogeneic blood alone in patients undergoing TKA. Clinical and financial data of 154 unique cases of primary TKA at the Mayo Clinic Arizona were retrospectively reviewed. Transfusion rates were 25%, 18%, and 52% respectively for patients in the cell salvage, preoperative autologous blood donation, and allogeneic blood only groups. Respective relative risk reductions were 51.9% (
P
=.007) and 65.4% (
P
=.002) with the use of cell salvage or preoperative autologous blood donation versus allogeneic alone. Cell salvage and preoperative autologous blood donation were found to significantly reduce the requirements for allogeneic blood transfusions; these techniques were found to be roughly equivalent in clinical benefit when compared to the use of allogeneic blood alone. The logistical advantages of cell salvage (ie, no preoperative blood donation, no risk of wasting blood units) were associated with greater costs to the institution.
Supracondylar Femur Fracture After Knee Manipulation: A Report of 3 Cases
Authors: Smith Eric L. , Banerjee Sarah B. , Bono James V.
Published: March 2009

Supracondylar femur fracture is a rare but devastating complication of knee manipulation following total knee arthroplasty (TKA). Avoidance of this complication can be achieved by careful attention to the indications and contraindications, timing, and technique of closed manipulation. We performed a retrospective chart and radiographic review to identify all patients who underwent closed manipulation under anesthesia for a diagnosis of aseptic arthrofibrosis after TKA. This article presents 3 cases of supracondylar femur fracture following closed knee manipulation of stiff TKAs that occurred at our institution over a 4-year period (1999–2002). Patient age ranged from 44 to 73 years. All patients underwent cruciate retaining TKA. Time from TKA to manipulation ranged from 3 months to 3 years. Two patients sustained an extension type supracondylar fracture. Two of the 3 patients were treated with closed reduction and casting/bracing. At a minimum 8-month follow-up after fracture, range of motion was poor with average flexion to 77° and average flexion contracture of 13°. In our patients, risk factors for fracture included prolonged time from arthroplasty to manipulation, arthrofibrosis, radiographic osteopenia, and rheumatoid arthritis. To our knowledge, this represents the largest case series of iatrogenic supracondylar femur fractures reported in the literature. Two manipulation techniques are described in detail. The alternative manipulation technique is highlighted with no fractures or complications over the same period. We believe that the alternative manipulation technique is a safe and effective technique to manipulate stiff TKA's and has been used for over >10 years by the senior surgeon (J.V.B.).
Multiple Pilomatrixomas Affecting the Eyelid and Face
Authors: Gündüz Kaan , Ecel Mahmut , Erden Esra
Published: March 2009

A 3-year-old girl presented with a right upper eyelid mass. The lesion had a reddish appearance, was firm to palpation, and was fixed to underlying tissues. Fourteen months after the lesion was excised, a similar lesion was discovered on the left side of the nose and was also excised. Histopathologic examination of the excised tumors revealed variable basophilic hair matrix cells and sheets of nonviable eosinophilic shadow cells. Foci of dystrophic calcification were also seen in the necrotic tumor areas. The histopathologic findings were found to be consistent with pilomatrixoma. Results of limited clinical work-up of the child for Gardner’s syndrome, sarcoidosis, and myotonic dystrophy were negative. Multiple periocular and facial pilomatrixomas can occur in children in the clinical absence of myotonic dystrophy, Gardner’s syndrome, and sarcoidosis.
A Pilot Study of the Value of Prism Adaptation in Planning Strabismus Reoperations
Authors: Kassem Rehab R.
Published: March 2009

Purpose:
To evaluate the value of prism adaptation in planning strabismus reoperations.

Methods:
Of 15 patients with persistent strabismus, 9 underwent prism adaptation prior to strabismus reoperation and 6 underwent strabismus reoperation without preoperative prism adaptation. Corrective surgery was performed on the same or new muscles. Follow-up ranged from 3 months to 2 years. A horizontal deviation of 10 prism diopters or less was considered a successful outcome. Statistical analysis of the results was done.

Results:
Of the 9 patients who had prism adaptation, 3 (33%) were responders and 6 (67%) were nonresponders. A successful outcome was achieved in 6 patients (67%) who had prism adaptation and 3 patients (50%) who did not. The difference between groups was statistically insignificant (P > .05).

Conclusion:
These results suggest that the benefits of prism adaptation are not significant enough to justify the time consumption and expenses of this test when planning strabismus reoperations, but a larger group of patients should be studied.
Higher Order Aberrations in Children With Amblyopia
Authors: Kirwan Caitriona , O’Keefe Michael
Published: March 2009

Purpose:
To quantify and characterize higher order aberrations in eyes of children with amblyopia.

Methods:
Higher order aberrations were measured in a group of children using the iTrace Visual Function Analyzer (Tracey Technologies, Houston, TX). Children involved in the study had unilateral amblyopia secondary to strabismus or anisometropia.

Results:
Thirty children between 6 and 17 years old (mean: 10.7 years) were studied. Fifteen children had strabismic and 15 had anisometropic amblyopia. No statistically significant difference was found in mean root mean square values of total higher order aberrations, coma, spherical, higher order astigmatism, trefoil, or 3rd, 4th, 5th, or 6th order terms of normal and amblyopic eyes.

Conclusion:
Higher order aberrations are similar in amblyopic eyes due to strabismus or anisometropia and normal fellow eyes. Unlike lower order aberrations such as sphere and cylinder, higher order aberrations are unlikely to play a role in the development of amblyopia.
A Review of Pediatric Uveitis: Part I. Infectious Causes and the Masquerade Syndromes
Authors: Madigan William P. , Raymond William R. , Wroblewski Keith J. , Thebpatiphat Nuthida , Birdsong Richard H. , Jaafar Mohamad S.
Published: March 2009

Uveitis is a manifestation of complex processes that can represent an infectious or a purely immune system modulated condition and may have grave effects on the eye. Much of the morbidity in these conditions is the result of the immune response to these stimuli. These infectious diseases may be successfully treated by addressing the inciting organism with recognized interventions. Treatment of the immune response to the organism often must be pursued simultaneously to minimize long-term complications caused by structural changes within the eye. Assisting the individual’s immune response to eliminate the organism while minimizing the immune response’s damaging effects remains a unique challenge drawing on both the science and the art of medicine. Several non-infectious conditions that are not autoimmune diseases may commonly masquerade as uveitis, leading to delays in appropriate treatment.
Acute Bilateral Dense Cortical Cataracts as a First Manifestation of Juvenile Diabetes Mellitus in a 12-Year-Old Girl
Authors: Taskapili Muhittin , Gulkilik Gokhan , Ozsutcu Mustafa , Kucuksahin Hasan
Published: March 2009

A 12-year-old girl with no previous visual complaints or diagnosis of diabetes mellitus presented with suddenly developing bilateral cataracts and related decreased vision. On examination, visual acuity was bilateral light perception and dense cortical cataract was identified. This is an unusual manifestation in a 12-year-old patient. After regulation of blood glucose levels, phacoemulsification was performed in both eyes in different sessions. The patient’s vision improved.
Manpower Issues in Pediatric Ophthalmology
Authors: Simon John , Koller Harold P.
Published: March 2009

Nelson: We’re going to discuss manpower issues in pediatric ophthalmology. A recent study reported that although the number of American Association for Pediatric Ophthalmology and Strabismus (AAPOS) members has not really changed, primarily in large urban areas, there are no members in many metropolitan areas with pediatric populations of 35% or populations of more than 250,000 people. What are your thoughts about how distribution issues pertaining to pediatric ophthalmology can be addressed?
Atypical Persistence of Tunica Vasculosa Lentis
Authors: Kumar Ashima V. , Chhabra Manpreet S. , Mets Marilyn B.
Published: March 2009

The authors report an unusual case of persistent tunica vasculosa lentis in a patient with minimal retinopathy of prematurity (ROP). A 3-month-old male infant who had been born at 31 weeks’ gestation presented with a significant amount of persistent tunica vasculosa lentis and arteriolar tortuosity with minimal ROP and no plus disease. After weekly observation and no surgical intervention, the arteriolar tortuosity lessened but the tunica vasculosa lentis persisted. Persistent tunica vasculosa lentis can be mistaken for iris vascular engorgement, suggesting plus disease and high-risk prethreshold ROP. Differentiation between tunica vasculosa lentis and iris vascular engorgement, as well as correct diagnosis of plus disease, is critical when considering laser treatment for high-risk prethreshold ROP.
Screening for Retinopathy of Prematurity in a Tertiary Care Newborn Unit in Turkey: Frequency, Outcomes, and Risk Factor Analysis
Authors: Mutlu Fatih Mehmet , Altinsoy H. Ibrahim , Mumcuoglu Tarkan , Kerimoglu Hürkan , Kiliç Selim , Kul Mustafa , Sarici S. Ümit , Alpay Faruk
Published: March 2009

Purpose:
To report the frequency, risk factors, and outcomes of screening for retinopathy of prematurity (ROP).

Methods:
Data of neonates with a gestational age of 34 weeks or less were analyzed and the predictors on the development of ROP were determined by using logistic regression analysis.

Results:
Of the 318 neonates, the frequency of ROP was 37.1% for any stage and 7.2% for stage 3 or greater. Treatment was needed in 16.1% of neonates with ROP. No treatment was required in neonates with a gestational age of greater than 32 weeks. Oxygen therapy, sepsis, gestational age of 32 weeks or less, and birth weight of less than 1,250 g were determined as the independent risk factors.

Conclusions:
Although frequency of ROP in Turkey is similar to that in the United States, the rate of severe ROP necessitating treatment seems to be higher in Turkey. Neonates with a gestational age of 32 weeks or less, a birth weight of less than 1,250 g, sepsis, and oxygen therapy may have a greater risk of developing ROP and screening should be intensified in the presence of these risk factors.
Structural Sequelae and Refractive Outcome After Successful Laser Treatment for Threshold Retinopathy of Prematurity
Authors: Dhawan Anuradha , Dogra Mangat , Vinekar Anand , Gupta Amod , Dutta Saurabh
Published: March 2009

Purpose:
To study the structural sequelae and refractive outcome in eyes with a favorable structural outcome following laser treatment for threshold retinopathy of prematurity (ROP).

Methods:
Premature infants with threshold ROP had laser treatment with a minimum follow-up of 1 year. Complete ocular examination and refraction was done. Analysis and correlation of structural sequelae and refractive outcome was done.

Results:
One hundred eighty-four eyes of 93 pre-term infants were followed up. Structural changes such as vascular tortuosity, narrowing of arcades, temporal crescent, disc drag, and macular heterotopia were seen. Mean refractive error observed was −4.71 D spherical equivalent. Myopia was seen in 80.43% of eyes.

Conclusions:
The study revealed various structural sequelae and their correlation with refractive outcome.
Isolated Trichomegaly Causing Mechanical Ptosis
Authors: Walton David S. , Manjunatha Nonavinakere P. , Gnanaraj Lawrence
Published: March 2009

The Images in Pediatric Ophthalmology column is a 1-page photo essay showing encounters in the field of pediatric ophthalmology.
Current Thoughts in Pediatric Refractive Surgery
Authors: Stahl Erin D.
Published: March 2009

The goal of this article is to review current literature regarding the emerging field of pediatric refractive surgery. This encompasses current thought in adult refractive surgery, published literature in pediatric refractive surgery, and future possibilities for refractive technology in the pediatric population. This study includes a comprehensive review of literature in the general refractive surgery, cornea, and pediatric literature.
Optical Coherence Tomography Findings in Delayed Subretinal Fluid Absorption After Scleral Buckling Surgery
Authors: Singh Gurdeep , Saravanan Veerappan Rathinasapathy , Narendran Venkatapathy , Narendran Kalpana
Published: March 2009

The occurrence of loculated bleb-like delayed subretinal fluid absorption has been reported following scleral buckling surgery and more commonly following pneumatic retinopexy among adults and seldom in children. The authors report the occurrence of delayed subretinal fluid absorption following scleral buckling surgery for rhegmatogenous retinal detachment in a 15-year-old girl, indicating the need for routine optical coherence tomography evaluation in the non-amblyogenic age group of children who have good anatomical but poor functional outcome following retinal reattachment surgery.
[J Pediatr Ophthalmol Strabismus 2009;46:54–55.]
Street Crossing by Typically Developed Children in Real and Virtual Environments
Authors: Bart Orit , Katz Noomi , Weiss Patrice L. , Josman Naomi
Published: March 2009

Independent street crossing is a necessary skill for children to have so they can engage in different occupations and complete tasks such as arriving at school or after-school activities. Without the appropriate opportunities to practice and master street crossing, children's participation will be incomplete and they will not be able to attain their physical, emotional, and intellectual potentials. Training children in safe street crossing is especially important because pedestrian injury is the second leading cause of death and serious injury among children between 5 and 14 years old. The existing methods for teaching children how to cross a street safely are difficult to transfer to real-life situations. The purpose of the current study was to evaluate the effectiveness of a virtual reality environment in teaching children how to cross a street safely. Eighty-six typical children (55 girls and 31 boys) between 7 and 12 years old participated in the study. The children who failed the virtual reality test were randomly assigned to training and control groups. The children were observed while crossing a real street and tested within the virtual environment both before and after the virtual reality training. Results indicate that children in the training group significantly improved their street crossing abilities in both the virtual reality simulation and the real street crossing in comparison to the control group. Street crossing became safer with increasing age, but no differences were found between boys and girls. This low-cost and readily available street crossing simulation had a positive effect on children's street crossing behavior in the real environment and on their self-reported satisfaction. These results provide support for the potential of training in a virtual street crossing simulation to transfer to actual street crossing.
A Proposed Conceptual Model of Organizational Development for Occupational Therapists and Occupational Scientists
Authors: Ikiugu Moses N.
Published: March 2009

This article proposes that the idea of meaningful occupations can be used by occupational therapists and occupational scientists to create organizational development interventions to help build sustainable business organizations. Review of recent organizational development literature indicates a trend toward an increasing lack of concern for individual employee needs. A conceptual model of organizational development that reinstates focus on the well-being of the individual as a basis for building sustainable organizations in which employee and organizational goals match is proposed for use by occupational therapists and occupational scientists who may be interested in contributing to this area of human endeavor. An occupation-based worker evaluation formula based on participation in occupations that are meaningful to an employee is suggested.
Mastering Handwriting: How Children with Developmental Coordination Disorder Succeed with CO-OP
Authors: Banks Rebecca , Rodger Sylvia , Polatajko Helene J.
Published: March 2009

Cognitive Orientation to (daily) Occupational Performance (CO-OP) is an intervention that facilitates motor skill acquisition in children with developmental coordination disorder (DCD). Preliminary research has recently begun to investigate the significance of the cognitive strategies fundamental to the CO-OP approach. This study aimed to elucidate the specific strategies used by children with DCD while addressing handwriting goals. In this descriptive study, four boys aged 6 to 11 years who had DCD were videotaped while engaging in 10 hour-long CO-OP treatment sessions over 5 consecutive weeks. Subsequently, 180 minutes of handwriting videotapes were randomly selected for systematic behavioral observation. Discussion, not practice, was the predominant tool employed to improve performance. Significantly, the children most often used strategies that increased their awareness and understanding of task requirements. This supports the theory that DCD represents the physical or motor manifestation of a learning problem.
The Effect of the Length of Observation on Test of Playfulness Scores
Authors: Brentnall Jennie , Bundy Anita C. , Catherine Fiona , Kay Scott
Published: March 2009

The Test of Playfulness (ToP) is a unique observational rating scale assessment used to systematically observe and quantify a child's approach to activities (also called playfulness). This study investigated the effect of the length of observation on ToP scores. Twenty typically developing preschool-aged children were videotaped during two 30-minute sessions that were separated by 2 to 3 weeks. Three trained raters then scored the first 15 minutes, the last 15 minutes, and the entire 30 minutes of each recording. The mean scores for each observation length were significantly different ( p < .05), but the longer observation did not provide additional unique information. Further, the test—retest reliability of the 30 minute scores (intraclass correlation = .03, p = .44) was less than that of either the first or last 15 minute scores (intraclass correlation = .67, p < .01; intraclass correlation = .41, p = .03, respectively). These findings are discussed in light of the existing literature and recommendations are made for use of the ToP in practice and research.
The Panel Study of Income Dynamics: Opportunities for the Study of Occupation
Authors: Daunhauer Lisa , Bundy-Fazioli Kimberly
Published: March 2009

This technical report describes a publicly available database for researchers examining occupation, socioeconomic status, and health on a large, nationally representative population. The Panel Study of Income Dynamics (PSID) is a useful tool to investigate complex processes from a multidisciplinary perspective. The PSID is a longitudinal database that allows researchers to examine economic and social phenomena, including time-use. Secondary analysis of data from the PSID can support research and teaching.
The Promise of Internationally Collaborative Research for Studying Occupation: The Example of the Older Women's Food Preparation Study
Authors: Hocking Clare , Pierce Doris , Shordike Anne , Wright-St. Clair Valerie , Bunrayong Wannipa , Vittayakorn Soisuda , Rattakorn Phuanjai
Published: March 2009

Growing awareness of the Western perspectives underpinning occupational science and occupational therapy's values, theories, and evaluation tools has given rise to questions about culturally relevant knowledge and practice with non-Western populations. To make sense of attempts to develop cross-cultural knowledge taking place within the profession and discipline, the authors review epistemological perspectives and methodological advances in anthropology and psychology. Thus informed, they both summarize and critique constructivist and positivist approaches to knowledge development and practice that cross or resist the crossing of cultures. The authors outline a multicultural collaborative research method that supports extending and refining the profession's knowledge in a way that both honors local perspectives and reveals concepts that cross cultures. Insights from a study that explored the meaning of food preparation to older Thai, American, and New Zealand women provide illustrative examples.
Cognitive Orientation to (Daily) Occupational Performance: Changes in Strategy and Session Time Use over the Course of Intervention
Authors: Rodger Sylvia , Liu Silvia
Published: March 2009

Cognitive Orientation to (daily) Occupational Performance (CO-OP) is a cognitive intervention that was developed to assist children with developmental coordination disorder (DCD) enhance their motor performance in everyday activities. Using a computer-based analysis of 10 videotaped treatment sessions for each of four boys with DCD who were 6 to 9 years of age, this study investigated changes in cognitive strategy use and session time use over the course of intervention. Cognitive strategy use focused on the child's use of global and domain-specific strategies during intervention. Session time use referred to the duration of Talking About Task (describing the task or plans that will be executed), Practicing Task (actually doing the task or activity), and Dual Tasking (both talking and doing) coded during video segments observations. Trends in strategy and session time use over 10 sessions appeared to be child- and goal-specific, with few systematic patterns observed. This article discusses the use of specific strategies over time both within and across the four participants. Individual results were varied and highlight the unique child—task—environment interactions that occur during intervention, reinforcing the individualized and client-centered focus of the CO-OP.
The Use of Anterior Segment Optical Coherence Tomography in Glaucoma Drainage Implant Surgery
Authors: Au Leon , Fenerty Cecilia
Published: March 2009

Anterior segment optical coherence tomography is a rapid, non-contact method of assessing anterior segment structures and has high reliability and repeatability. Three cases are presented to illustrate how this technology can be used in the assessment and management of a glaucoma drainage implant. Anterior segment optical coherence tomography provides high-resolution images of the glaucoma drainage implant to assess its position, patency, drainage, and the intraluminal stenting suture. This proved to be useful in the case of postoperative hypotony. The non-contact advantage is useful in pediatric patients.
Hypotonous Malignant Glaucoma: Aqueous Misdirection with Low Intraocular Pressure
Authors: Burgansky-Eliash Zvia , Ishikawa Hiroshi , Schuman Joel S.
Published: March 2009

Two patients who underwent trabeculectomy and postoperatively manifested axially shallow anterior chamber associated with hypotony but without choroidal effusion are described. The first patient was treated conservatively with topical cycloplegics. The second patient was treated with pars plana anterior vitrectomy. The interventions resulted in deepening of the anterior chamber and posterior rotation of the ciliary body to a natural position as observed by ultrasound biomicroscopy. Intraocular pressure remained low in both cases. These cases demonstrate that hypotony and axial shallowing of the anterior chamber after trabeculectomy can result in a malignant glaucoma-like appearance.
Bilateral Vision Loss Reveals Occult Pregnancy
Authors: Ehlers Justis P. , Maguire Joseph I.
Published: March 2009

Preeclampsia is a life-threatening disorder for both the mother and fetus. A 43-year-old woman presented with a 1-day history of bilateral decreased vision and no systemic complaints. Physical examination revealed an abdominal mass and further diagnostic testing revealed a previously unknown pregnancy. Admission resulted in an emergency cesarean section for fetal distress. This case provides a unique primer of the various diagnostic tests and their results in the diagnosis of preeclampsia. It also highlights the critical role ophthalmologists may play in the diagnosis of this potentially devastating disease.
Vitreous Substitute Removal Rates with the Accurus® and Millennium™ Vitrectomy Systems
Authors: Wals Kenneth T. , Friberg Thomas R.
Published: March 2009

Recent innovations in vitrectors have led to studies of evaluated aspiration rates of basic saline solution, porcine vitreous, and human vitreous, but each of these substances has potential drawbacks. The authors determined the timed removal rates of egg white with the Accurus 20-, 23-, and 25-gauge vitreous cutters (Alcon Laboratories, Inc., Fort Worth, TX) and the Millennium AVE 20-and 25-gauge system (Bausch & Lomb, St. Louis, MO and MID Labs, Inc., San Diego, CA) using various machine parameters. The Accurus 20-and 23-gauge cutters and the Millennium AVE 20-and 25-gauge cutters removed egg white easily. At higher cut rates, where slow and delicate removal of vitreous is typically desired, the probes, as expected, removed egg white more slowly.
Perforating Corneal Injury with a Fish Hook
Authors: Yildirim Nilgün , Kabadere Erdal , Ermis Zeki
Published: March 2009

A 10-year-old boy presented with a corneal perforation of the right eye caused by a fish hook injury while watching a friend fish. Surgical removal of the fish hook was performed. Under general anesthesia, the shank of the fish hook was cut and the hook was advanced and released. The observation of fly fishing is accompanied by risk similar to participation. Management is guided by the peculiarities of the injury.
Uveal Prolapse Following Cataract Extraction Simulating Melanoma
Authors: Marr Brian P. , Shields Jerry A. , Shields Carol L. , Materin Miguel A. , Tuncer Samuray
Published: March 2009

Prolapsed uveal tissue through a cataract incision can simulate any pigmented epibulbar mass, including conjunctival melanoma, extraocular extension of a ciliary body or choroidal melanoma, and pigmented squamous cell carcinoma of the conjunctiva. The authors describe an 88-year-old woman who presented with an enlarging pigmented epibulbar mass on the left eye. Although the lesion closely simulated a conjunctival melanoma or extraocular extension of a uveal melanoma, closer evaluation revealed thin uveal tissue extending through partial wound dehiscence from cataract surgery that was performed 3 years earlier. The lesion was consistent with prolapsed uveal tissue through a cataract wound masquerading as a melanoma. Therefore, uveal prolapse should be considered in the differential diagnosis of conjunctival melanoma or extraocular extension of uveal melanoma. [Ophthalmic Surg Lasers Imaging 2008;39:250-251.]

AUTHORS From the Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania. Accepted for publication March 13, 2008. Supported by the Eye Tumor Research Foundation, Philadelphia, Pennsylvania (CLS, JAS), the Paul Kayser International Award of Merit in Retina Research, Houston, Texas (JAS), the Macula Foundation, New York, New York (CLS), and the Scientific and Technical Research Council of the Turkish Republic, Ankara, Turkey (ST). Address correspondence to Jerry A. Shields, MD, Ocular Oncology Service, Wills Eye Institute, 840 Walnut Street, Suite 1440, Philadelphia, PA 19107.