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Lisa M Nijm,1,2 Justin Schweitzer,3 Jennifer Gould Blackmore4 1Warrenville EyeCare and LASIK, Warrenville, IL, USA; 2Department of Ophthalmology and Visual Sciences, University of Illinois Eye and Ear Infirmary, Chicago, IL, USA; 3Vance Thompson Vision, Sioux Falls, SD, USA; 4SUNY College of Optometry, University Eye Center, New York, NY, USACorrespondence: Lisa M Nijm, Warrenville EyeCare and LASIK, 2 South 631 State Route 59, Warrenville, IL, 60555, USA, Tel +1-630-393-7100, Fax +1-630-393-0597, Email lmnijm@uic.eduAbstract: Dry eye disease (DED) has been found to occur at a higher prevalence in individuals with glaucoma than in individuals without glaucoma. The relationship between glaucoma and DED may be, in part, a result of glaucoma therapy. Greater number of antiglaucoma medications used and greater number of antiglaucoma eyedrops instilled per day have been associated with ocular surface disease in patients with glaucoma. Use of antiglaucoma medication has also been associated with higher levels of ocular surface inflammatory markers and ocular surface alterations. There is evidence to suggest that antiglaucoma medications with preservatives and, to some extent, antiglaucoma medication formulations without preservatives may contribute to ocular surface signs and symptoms. Trabeculectomy for glaucoma has also been associated with ocular surface signs related to DED; however, there may be benefits of trabeculectomy and other procedures for glaucoma due to reduced use of antiglaucoma medications. Patients with glaucoma with ocular surface disease have been found to have greater ocular surface symptoms, poorer vision-related quality of life, and poorer antiglaucoma medication adherence compared with patients with glaucoma without ocular surface disease. Because of the potential negative impact of DED on patients with glaucoma, patients with glaucoma may benefit from evaluation for DED. Management of DED in patients with glaucoma may include modifications to antiglaucoma medications and use of treatments for DED.Keywords: ocular surface, quality of life, antiglaucoma medication, inflammation, preservatives

Nathan Radcliffe,1 John Berdahl,2 Mitchel Ibach,2 Justin Schweitzer,2 Jason Levine,3 Sean McCafferty3 1New York Eye Surgery Center, New York, NY, USA; 2Vance Thompson Vision, Sioux Falls, SD, USA; 3Arizona Eye Consultants, Tucson, AZ, USACorrespondence: Sean McCaffertyArizona Eye Consultants, 6422 E. Speedway Blvd, Tucson, AZ 85710, USATel +1 (520) 327-3487Email SJMccafferty66@hotmail.comPurpose: To evaluate intraocular pressure (IOP) reduction measured by a Goldmann applanation tonometer (GAT) prism and a modified surface Goldmann (CATS) prism with the institution of a topical prostaglandin analog (PGA) or alternatively a topical beta blocker.Design: Prospective, open-label, randomized, controlled, and reference device comparison.Methods: Thirty-six (36) treatment naïve glaucoma patients (72 eyes) were randomized equally to treatment with latanoprost 0.005% or timolol maleate 0.5%. Each patient underwent IOP measurement with standard GAT and CATS prisms before and at 1, 3, and 6 months of treatment. Central corneal thickness (CCT) and corneal hysteresis (CH) were also measured. Medication response was defined as a 20% reduction in IOP from baseline.Results: The CATS prism demonstrated the IOP reduction with topical latanoprost at a mean of 1.9 mmHg lower than the IOP measured with GAT (p=0.01). The CATS and GAT prisms detected no difference in IOP reduction with timolol (p=0.23). The number of latanoprost treatment non-responders was reduced from 36.1% measured with GAT to 13.8% when measured with the CATS prism (p=0.005). Timolol indicated no difference in the treatment non-response rate at 22.2% (p=0.999). CH increased significantly with latanoprost treatment by an average of 0.55 mmHg (p=0.014) and remained unchanged with timolol at − 0.014 mmHg (p=0.68).Discussion: IOP reduction and responder rates were increased when measured with a CATS prism in patients using latanoprost and not with timolol use. Latanoprost-induced alterations in corneal biomechanics may dampen the actual IOP reduction measured with a standard GAT prism.Clinical Trial Registration: ClinicalTrials.gov NCT04178863.Keywords: glaucoma, prostaglandins, IOP, tonometer, corneal biomechanics, timolol, latanoprost

Tanner J Ferguson,1 Keegan B Mechels,1 Zachary Dockter,2 Adam Bleeker,2 Mitch Ibach,3 Justin Schweitzer,3 John P Berdahl3 1Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA; 2University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA; 3Vance Thompson Vision, Sioux Falls, SD, USACorrespondence: Tanner J Ferguson Email tannerferg@gmail.comPurpose: To investigate the long-term safety and efficacy of an iStent trabecular microbypass stent in combination with cataract surgery in eyes with primary open-angle glaucoma (POAG).Setting: Private practice; Sioux Falls, South Dakota.Design: Retrospective, consecutive case series.Methods: This case series included eyes implanted with a single trabecular microbypass stent in combination with phacoemulsification in patients with mild to severe POAG. Data were collected preoperatively and at day 1, week 1, month 1, and up to 6 years postoperatively. Primary outcome measures included mean intraocular pressure (IOP) and number of glaucoma medications. Safety was noted by assessing the incidence of IOP spikes and need for additional surgery.Results: The study comprised 411 eyes. Mean IOP was reduced to 14.9± 4.2 mmHg compared to 18.8± 5.6 mmHg at baseline at 6 years postoperative. The mean number of medications was reduced to 1.2± 1.0 from 1.4± 1.1 at baseline. In eyes with severe stage of disease, there was a mean IOP reduction > 6 mmHg at 6 years postoperative. Eyes with baseline IOP ≥ 18 mmHg achieved a more robust reduction in IOP. Fifteen eyes underwent a secondary glaucoma procedure. There were no intra- or postoperative complications.Conclusion: Trabecular microbypass stent implantation in combination with cataract surgery provides a sustained IOP reduction in eyes with mild-to-severe POAG. The degree of IOP reduction was more significant in eyes with higher baseline IOP and severe stage of disease.Keywords: microinvasive glaucoma surgery, MIGS, trabecular microbypass stent, surgical glaucoma, primary open-angle glaucoma

Thomas W Samuelson,1 Tanner J Ferguson,2 Nathan M Radcliffe,3 Richard Lewis,4 Justin Schweitzer,5 Russell Swan,5 John P Berdahl5 1Minnesota Eye Consultants, Minneapolis, MN, USA; 2Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA; 3Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA; 4Sacramento Eye Consultants, Sacramento, CA, USA; 5Vance Thompson Vision, Sioux Falls, SD, USACorrespondence: Tanner J FergusonCole Eye Institute, Cleveland Clinic, Cleveland OH, USAEmail tannerferg@gmail.comPurpose: To investigate the safety and tolerability of the multi-pressure dial with a continuous 8-hr duration in subjects with open-angle glaucoma.Design: Prospective, controlled open-label, randomized, single site study.Subjects: Twenty eyes of 10 subjects with open-angle glaucoma were fitted with a multi-pressure dial and randomized to negative pressure application of −10 mmHg in one eye for 8 (continuous) hours and ambient atmospheric pressure in the contralateral eye.Methods: Main safety outcome measures include best-corrected visual acuity (BCVA), intraocular pressure (IOP) changes from baseline after negative pressure application, slit lamp and dilated fundus exam findings, and rate of adverse events. Subjective assessments were administered both hourly during the 8-hr study period and immediately following the study period.Results: There were no statistically significant changes in IOP, BCVA or TBUT immediately following the 8-hr study period or at the 1-week follow-up visit. Patient-reported tolerability was favorable with a mean response of 1.8 ± 0.4 (scale → 1=best, 10 = worst). Subjects also reported positive interest in the MPD as a glaucoma therapy with a mean response of 1.8 ± 0.5 (scale → 1=best, 10 = worst). One adverse event was reported (headache) and resolved at conclusion of the Day 0 visit.Conclusion: The MPD demonstrated favorable safety with key parameters remaining stable after an 8-hr wear with negative pressure. Negative pressure application through the MPD was well tolerated by subjects enrolled in the study. The favorable findings demonstrate the safety of sustained delivery of negative pressure over a continuous, uninterrupted 8-hr duration.Keywords: multi-pressure dial, normal-tension glaucoma, open-angle glaucoma, glaucoma treatment

Processes carrying out exothermic reactions must ensure safe operating conditions to avoid uncontrolled thermal excursion, also known as runaway. Therefore, a thermal stability analysis is necessary to determine the safe and productive range of operating conditions of highly exothermic processes. Hydrotreating gas oil feeds consists mainly of hydrogenation reactions; processing highly unsaturated feeds such as light cycle oils can be highly exothermic. For this reason, a thermal stability study of this complex refining is performed. Perturbations theory has already been applied to carry out a thermal stability study of this process under dynamic conditions. This method consists in the perturbation of the hydrotreating reactor model and solution of the perturbed model in the form of an eigenvalue problem. The stability condition imposes that all perturbations must tend to zero when time tends to infinity. Some methodology and numerical aspects applying this theory and the effect on stability results are tackled in this work. The formalization of the perturbed model solution as a standard eigenvalue problem or as a generalized eigenvalue problem are presented. The computation of the Jacobian by a numerical approach or with the analytical expressions is also carried out. In both cases, results are compared and their influence on the stability/instability results is presented. Les procédés qui mettent en oeuvre des réactions très exothermiques nécessitent une attention particulière afin d’éviter l’augmentation non contrôlée de la température connue comme emballement thermique. Une analyse de stabilité thermique est nécessaire afin d’établir les conditions d’opération sûre et productive des procédés exothermiques. L’hydrotraitement de gazoles met en oeuvre principalement des réactions d’hydrogénation ; l’hydrotraitement de charges très insaturées comme les gazoles light cycle oil peut être fortement exothermique. Pour cette raison, ce procédé fait l’objet d’une étude de stabilité thermique. La théorie des perturbations a déjà été appliquée pour effectuer une analyse de stabilité de ce procédé en conditions dynamiques. Cette méthode consiste à perturber le modèle et à résoudre le modèle perturbé sous forme d’un problème aux valeurs propres. La condition de stabilité impose que toutes les perturbations doivent s’amortir (tendre vers zéro) quand le temps tend vers l’infini. Quelques aspects sur l’application de cette théorie ainsi que des aspects numériques sont étudiés dans ce travail ainsi que leur effet sur les conclusions de stabilité. La formalisation de la solution du modèle perturbé comme un problème aux valeurs propres standards est comparée au problème aux valeurs propres généralisées. Aussi, le calcul du Jacobien par une approche numérique a-t-il été comparé au calcul par les expressions analytiques. Dans les deux cas, les résultats sont comparés et l’influence sur les résultats de stabilité/instabilité sont présentés.

The deposition of the Witwatersrand Supergroup commenced with a major marine transgression across the granite/greenstone terrain of the Kaapvaal Craton, depositing the predominantly marine West Rand Group. Possibly as a consequence of continental convergence the craton became subject to regional transpression, which began to fragment the widely distributed West Rand Group into a number of separate sub-basins, flanked by uplifts. The sedimentation style changed from shallow marine to fluvial, initiating the deposition of the Central Rand Group. The sub-basins in which sedimentation took place were separated by faults, anticlines or monoclines. In the Far East Rand these sub-basins included the Evander, Delmas, South Rand and East Rand Basins. Complete separation of these sub-basins only occurred after deposition of the Kimberley Reef. Left lateral transpression caused syn-depositional periclinal folding of Witwatersrand strata trending northwestsoutheast. Important structures that developed at this stage include the Springs Monocline, which formed a ledge separating the East Rand from the main Witwatersrand Basin, and the Fold-Fault, which formed a ridge dividing the Evander Basin into two. Contrary to previous interpretations, the Fold-Fault is not a basin margin structure because the Evander Basin continues to its northeast, and hence it is an intra-basinal fold. During the early phases of Central Rand Group deposition in the East Rand Basin, sediments were derived from greenstone poor granitic source rocks in the north and northwest. In contrast, in the adjoining Evander area, pre-Kimberley sediment was derived from greenstone-dominated terrain to the northeast. Underground mapping of the immediate footwall strata of the Kimberley Reef at Evander has provided unambiguous evidence for glacial activity at that time. It is unclear whether glaciation was involved in the formation of the Kimberley Reef itself. However, glacial activity was responsible for the deposition of extensive glaciogenic sediments across the Far East Rand in the form of diamictites (termed puddingstones in the older literature) and associated channel deposits (MK1, eskers?). A period of erosion followed this glacial episode and gave rise to an extensive gravel lag across the erosion surface, which constitutes the Kimberley Reef at Evander. The erosion surface on which the reef lies is thus a large pediment. The palaeocurrents responsible for this degradation flowed from the west and southwest and thus indicate a reversal of the local palaeoslope relative to pre-Kimberley Reef times. Palaeocurrent measurements in the Kimberley Reef and its hangingwall are consistent in their azimuths suggesting that flow was dispersed across the pediment rather than originating from a local point source. The sources of gold which became concentrated in the gravel lag appear to have been predominantly the LK1 and MK2 conglomerates and possibly gold present in the diamictites. The footwall strata had been derived from a greenstone-rich source in the east. Their greenstone signature was carried over into the Kimberley Reef, notably the presence of banded iron formation clasts and high concentrations of osmiridium and chromite. Northwest-southeast folding continued during Kimberley Reef formation. A synclinal trough bounded along its northeastern flank by an anticline, the Fold-Fault, developed across the pre-Kimberley surface. This structure created accommodation space, which caused local thickening of the Kimberley Reef package. Thickening of the reef in the Fold-Fault area is therefore not a consequence of fluvial channelisation but a result of thickening due to synsedimentary warping. Palaeocurrent directions in this trough continued in a northeasterly direction, perpendicular to the warp axis. The synclinal feature associated with the Fold-Fault remained active after the formation of the Kimberley Reef. As a consequence, isopachs of hangingwall strata also thicken towards the trough. The gold grade in the Kimberley Reef is inversely related to reef thickness: where the reef is thick, the gold grade is generally low. Most of the gold was scavenged from the footwall. The scavanged material was winnowed on the erosion surface, producing the high grades characteristic of the thin Kimberley Reef present at the southwestern and northwestern margins of the basin. In the trough which borders the western flank of the Fold-Fault, grade is lower due to an increase in quartzite partings. The Fold-Fault is a syn- to post depositional anticline and it is expected that the reef will thin onto the structure. Palaeocurrents are perpendicular to the anticline and therefore gold grades are expected to increase as the reef thins. Because of the local derivation of much of the Kimberley Reef, the proximal to distal indicators such as changes in pebble size, U/Au ratio and gold fineness are weakly developed to absent. Carbon is often associated with gold in the Witwatersrand Basin but in the case of the Evander Goldfield, carbon does not appear to have played a significant role in gold enrichment on a regional scale. However, there is anecdotal evidence of gold being associated with carbon on a local scale. We suggest that the burial of the Kimberley Reef occurred as a result of an increase in sediment supply to the depository. Distal deposits which characteristically contain a high proportion of quartzite partings (HW1 and HW2), transgressed across the palaeo-plain and buried the Kimberley pediment surface. [ABSTRACT FROM AUTHOR]

This pilot study assessed the feasibility and potential effectiveness of a single-session workshop in modifying parental beliefs/knowledge about attention-deficit/hyperactivity disorder (ADHD) in children and impact on treatment acceptance/utilization. Concerns raised by school professionals about lack of treatment follow-through after ADHD diagnosis and parental misinformation about medication usage catalyzed this project. A single-group pre-post quasi-experimental design was used. Sixty-eight parents completed ADHD knowledge/belief scales and stress inventories, and pre-ADHD and post-ADHD information workshop. Follow-up calls were made after the workshop to assess treatment utilization. Parents/caregivers experienced significant knowledge and belief changes regarding medication efficacy, willingness to accept physician treatment recommendations, and rejection of non-empirically based treatments. Follow-up data showed that 41% of contacted participants met with physicians to discuss medication utilization and behavioral treatments. Brief, one-session psycho-educational workshops were feasible and impacted parental beliefs and behaviors regarding scientifically supported interventions for ADHD. [ABSTRACT FROM AUTHOR]

A major question concerning the Bushveld Complex is the relationship between the layered mafic rocks and the overlying Rooiberg Group felsites and related granophyres. Here, we assemble bulk-rock analyses to gain insight into this question and investigate the petrogenesis of the felsic rocks. The data indicate that the Rooiberg Group consists of distinctive magnesian and ferroan lavas. The former dominates the basalts to rhyolites of the basal Dullstroom Formation, while nearly all the dacites to rhyolites of the overlying Damwal, Kwaggasnek, and Schrikkloof Formations are ferroan. The ferroan rocks also include the Stavoren Granophyre, which exists regionally as a several-hundred-meter-thick concordant sheet between the Bushveld Complex and Rooiberg lavas. The compositions of the magnesian lavas are similar to calc-alkaline granitoids found in convergent margins, suggesting that the lavas could have originated in a mantle affected by previous Archean subduction events that are recorded by xenoliths and inclusions in diamonds from most Kaapvaal kimberlites. In contrast, the compositions of the ferroan lavas indicate formation by fractional crystallization of basaltic liquids and are essentially identical to ferroan rhyolites associated with mafic rocks from other settings. The hypothesis that these rocks are fractional crystallization products of Bushveld mafic liquids is consistent with published radiogenic and stable isotope data and known age relations. Based on compositional characteristics and geologic relations, the Stavoren Granophyre is the most likely candidate for the residual liquid that escaped from the top of the Bushveld Complex. Whether the bulk of the Bushveld Province ferroan rhyolites formed in the chamber of the extant layered mafic sequence or in a deeper, hidden crustal magma reservoir remains unclear. Keywords Rhyolite * Layered intrusion * Bushveld Complex * Fractional crystallization * Basalt differentiation * Kaapvaal craton, Introduction The Bushveld Complex Province is unique in the geologic record. The layered mafic/ultramafic sequence, known as the Rustenburg Layered Suite (RLS), crops out as east and west arching limbs [...]