Path to Diagnosis and Clinical Characteristics of Advanced Glaucoma at Initial Diagnosis: a Tertiary Single Center Experience

Purpose: As routine health examinations become more common, many patients first diagnosed with glaucoma have advanced glaucoma. We analyzed the routes to diagnosis and the characteristics of patients initially diagnosed with advanced glaucoma.Methods: We retrospectively retrieved the medical records of patients first diagnosed with advanced glaucoma in our tertiary care center. The inclusion criteria were a mean deviation (MD) less than -12 dB on the visual field test, accompanied by structural damage. All patients were classified in terms of unilateral/bilateral disease, the intraocular pressure before medication, and lens status. We divided patients into those with monocular or binocular advanced glaucoma, high- or normal-pressure glaucoma, and those who were pseudophakic or phakic.Results: We included 73 patients of mean age 69.3 years. The visual field test MD was -19.6 dB. In those with binocular advanced glaucoma, incidental ophthalmic examination was the most common means of diagnosis (52.2%). Central-island visual field defects were the most common defects (54.2%). In those with monocular advanced glaucoma, glaucoma-associated symptoms most commonly triggered diagnosis (46.9%). Both superior and inferiorvisual field defects were the most common defects (42.8%). Glaucoma-associated symptoms were present in 68.2 and 22.8% of patients with high- and normal-pressure glaucoma, respectively. Central-island visual field defects were present in 43.6 and 29.4% of those with high- and normal-pressure glaucoma, respectively.Conclusions: We analyzed the routes to diagnosis and the clinical characteristics of patients with advanced glaucoma. In those with binocular disease, glaucoma was most commonly diagnosed on incidental ophthalmic examination. Central-island visual field defects were the most common defects in patients with binocular and high-pressure glaucoma, and the pseudophakic group. A multi-center longitudinal study on risk factors for delayed glaucoma diagnosis is needed.

Operational Evaluation of a Throughabout to Give Priority to Public Transport at Standard Roundabouts

The presence of roundabouts in the central business districts (CBD) of cities can reduce the travel speed of bus rapid transit (BRT) along the radial routes. A throughabout is an unconventional and low-cost design in which the central island is split to provide exclusive lanes for major traffic streams. Although the operation of throughabout has been limitedly investigated for private transport, it has been less considered by designers for public transport and for increasing the speed of the BRT system. The current study aims to evaluate the effects of throughabouts on private and public transports and to compare the design with standard roundabouts and conventional intersections. The calibrated and validated results of the microsimulation tool (AIMSUN) indicated that the throughabout improved the travel time of both public and private transports through better use of the space and kept the traffic flowing at all volume levels. The travel speed of the BRT in the throughabout was remarkably stable in both signal-controlled and unsignalized intersections. The standard roundabout was the second-best design. The throughabout can be very helpful in corridors along which the demand for the bus transit is high and the system needs to receive priority.

Geometric Design of Suburban Roundabouts

A modern roundabout is an intersection with a circulatory roadway at which the vehicle speed is low, and the traffic is continuous and circulating in one direction around the central island towards the exits at the approach legs. Modern roundabout design is an iterative process that is composed of the following steps: (1) the identification of the roundabout as the optimal traffic solution; (2) the definition of the number of lanes at the intersection based on the required capacity and the level of service; (3) the initial design of the roundabout geometry; (4) design vehicle swept path, the fastest path analysis, and visibility performance checks; and (5) detailed roundabout design if the results of the performance checks are in line with the design recommendations. Initial roundabout geometry design elements are not independent of each other; therefore, care must be taken to provide compatibility between them. An overview and a comparative analysis of the initial geometric design elements for suburban single-lane roundabouts defined in roundabout design guidelines and norms used in Croatia, Austria, France, the Netherlands, Germany, Serbia, and Switzerland is given in this entry.

Near-resonances of superinertial and tidal fluctuations at islands

A linear numerical model of an island or a tall seamount is used to explore superinertial leaky resonances forced by ambient vertically and horizontally uniform current fluctuations. The model assumes a circularly symmetric topography (including a shallow reef) and allows realistic stratification and bottom friction. As long as there is substantial stratification, a number of leaky resonances are found, and when the island’s flanks are narrow relative to the internal Rossby radius, some of the near-resonant modes resemble leaky internal Kelvin waves. Other “resonances” resemble higher radial mode long gravity waves as explored by Chambers (1965). The near-resonances amplify the cross-reef velocities that help fuel biological activity. Results for cases with the central island replaced by a lagoon do not differ greatly from the island case which has land at the center. As an aside, insight is provided on the question of offshore boundary conditions for superinertial nearly trapped waves along a straight coast.

Corneal epithelial thickness analysis of forme fruste keratoconus with optical coherence tomography

AIM: To explore the significance of corneal epithelial thickness analysis in diagnosing early keratoconus. METHODS: There were 26 clinical keratoconus, 21 forme fruste keratoconus, 40 high corneal astigmatism (ΔK) and 40 low ΔK eyes involved in the study. Fourier-domain optical coherence tomography was used to measure the corneal epithelial thickness of four groups. The morphological features of topographic map and the thickness of corneal epithelial thinnest point were analyzed. The distribution curve of corneal epithelial thickness at 45°, 90°, and 135° axial directions that are through the pupil center was also analyzed. One-way ANOVA was performed to compare the data. RESULTS: The topographic map of forme fruste keratoconus corneal epithelial thickness was uniformity shape; crater shape existed only in clinical keratoconus group; and central island shape mainly existed in high ΔK group. The thinnest point of corneal epithelial thickness of forme fruste keratoconus group was significantly lower than that of low ΔK group (P=0.022). The thickness of corneal epithelium in the forme fruste keratoconus at 90° was thinner than that in the low astigmatism group at -1, and -2 mm points (P-1 mm=0.015, P-2 mm=0.036). CONCLUSION: The analysis of the thinnest point in forme fruste keratoconus corneal epithelium appears earlier than corneal epithelial remodeling. The topographic map of corneal epithelium in high ΔK eyes appears in central island shape, and can be used for the differential diagnosis of early keratoconus.

Deciphering wintertime air pollution upon the West Lake of Hangzhou, China

The West Lake of Hangzhou, a world famous landscape and cultural symbol of China, suffered from severe air quality degradation in January 2015. In this work, Random Forest (RF) and Recurrent Neural Networks (RNN) are used to analyze and predict air pollutants on the central island of the West Lake. We quantitatively demonstrate that the PM2.5 and PM10 were chiefly associated by the ups and downs of the gaseous air pollutants (SO2, NO2 and CO). Compared with the gaseous air pollutants, meteorological circumstances and regional transport played trivial roles in shaping PM. The predominant meteorological factor for SO2, NO2 and surface O3 was dew-point deficit. The proportion of sulfate in PM10 was higher than that in PM2.5. CO was strongly positively linked with PM. We discover that machine learning can accurately predict daily average wintertime SO2, NO2, PM2.5 and PM10, casting new light on the forecast and early warning of the high episodes of air pollutants in the future.

DETERMINATION OF THE BANDWIDTH OF THE TRAFFIC LANE OF THE CIRCULAR PART OF THE CIRCULAR INTERSECTION WITH TRAFFIC LIGHT REGULATION AND A CUT-THROUGH CENTRAL ISLAND

The capacity of a road (street) is the maximum number of cars that a section of a road (street) can pass per unit of time in one or two directions in the considered road and weather and climatic conditions. In science, there are several approaches to determine the capacity: models based on dynamic models of traffic flow, the model of Birul A. K., Silyanov V. V., Tribunsky V. M., Khomyak Ya. V., Bilyatinsky A. A. and etc. In a practical way, they divide: theoretical, practical and maximum throughput. In the Russian Federation, there are a large number of guidelines for its determination. However, for a circular intersection with traffic light regulation and a cut-through central island (hereinafter referred to as KPSRPTSO), no such recommendations have been presented. After analyzing this traffic organization scheme, it was for the first time proposed to determine the capacity of the traffic lane of the KPSRPTSO half-ring. The purpose of the study is to improve the efficiency of the KPSRPTSO by determining the theoretical bandwidth of the traffic lane of a semi-ring of a traffic intersection. The article hypothesizes that the investigated theoretical throughput depends on two factors: the diameter of the traffic junction ring and the effective duration of regulation for the main road. To substantiate the adequacy of the calculations, the simulation method was used in the Aimsun software package (micromodeling). On the basis of data from field surveys of sections of the road network, a simulation model was created with a high degree of reliability, reflecting the current situation at regulated intersections, and the effectiveness of design solutions when organizing the KPSRPTSO was assessed. The relationship between the theoretical bandwidth of the KPSRPTSO half-ring and the diameter of the ring and the effective duration of regulation for the main road has been established. Comparison of the experimental data with the calculated values performed according to the recommendations of the methodological literature shows a discrepancy from 1% to 13%, which shows the qualitative convergence of the data. Further research involves the development of a methodology for calculating the parameters of the KPSRPTSO.

Eusocial wasp fauna of Sulawesi Island, the central island of Wallacea (Hymenoptera: Vespidae; Polistinae, Vespinae)

Taxonomy of eusocial wasps (Polistinae and Vespinae) occurring in Sulawesi Island, the central island of Wallacea, is reviewed. Sixteen (12 polistine and four vespine) species are recognized. Polistes (Polistella) stigma, known to be widely distributed in southern Asia and Australasia, is newly recorded for Sulawesi Island. A key to the Sulawesian eusocial wasp species is provided. Their biogeographical characteristics are discussed to show that the Sulawesian eusocial wasp fauna is composed of Oriental elements.

Safety and Efficiency Analysis of Turbo Roundabout with Simulations Based on the Lujiazui Roundabout in Shanghai

Traditional multilane roundabouts have many branch lanes without traffic signs and channelization, which leads to a high tendency for traffic collisions. Turbo roundabouts are a new design that has the potential to reduce lane-change conflicts using canalization to force drivers to keep in specific lanes based on their intended destination. This paper evaluates the safety and efficiency performance of turbo roundabouts for the case of a five-leg roundabout called Lujiazui in Shanghai and provides design and construction guidelines when applying the turbo design. The models for the Lujiazui roundabout and the reconstructed turbo version were built in Vissim, and a comprehensive series of experiments under different traffic volumes and central island radii was performed. Afterward, the conflict statistics extracted from the trajectory files in the Surrogate Safety Assessment Model (SSAM) were analyzed using the conflict severity index (CSI) and were then integrated to calculate the modified conflict frequency (MCF) for safety performance evaluation. A comparative efficiency analysis was also conducted as a supplement. Based on the results, the relative characteristics for safety and efficiency between the turbo and original designs of the Lujiazui roundabout were analyzed. Suggestions to apply the turbo design on a five-leg roundabout are introduced.