How to Make London's Roads Safer for Cyclists

L ondon's roads have become better suited to cyclists in recent years but two recent fatalities prove there is much work to be done. As the nights draw in and journeys become more difficult, it's time to look at the measures that cyclists, drivers and mayor Sadiq Khan must all undertake to keep our capital's cyclists safe through winter. Even after all the campaigns encouraging cyclists to make themselves visible, many on the city's roads fail even to abide by the legal requirements for night-time riding.

The Road Vehicles Lighting Regulations requires cyclists to use front and rear lights at night as well as front and rear reflectors. The rear light must be placed on the saddle stem - and not concealed by clothing - or on the right-hand seat stay, putting it on the same side as traffic. Legally, it should also be positioned between 35cm and 1.

5 metres from the ground, though you should aim for the higher end of that range to ensure visibility. The cheapest rear light will emit about 20 lumens but we recommend going at least for a mid-range one of about 50 lumens, to a maximum of 75. If your commute is confined to reasonably well-lit urban streets then purchase one with a brightness of at least 200 lumens, which is the same strength as a typical car's front light.

If your journey home sends you into dark, country lanes, however, go for one than can pump out as much as 500 lumens. T here is no legal requirement to wear high-visibility clothing though every good cyclist should know its benefits. As well as hardy perennials such as florescent jackets and Same Browne waistband belts, it is worth considering ankle or spoke reflectors, even if the latter is often anathema to those concerned with bike aesthetics.

"Both are brilliant because a car-driver will notice moving lights more than static ones," says Tony Doyle, a former professional cyclist, who frequently rides in the city. The same principle makes flashing lights more visible to drivers, though you need to weigh that up against the fact that a driver is better able to judge distance to a bike with a static light. T he social media site Strava has helped cyclists to connect in ways that was not previously possible and made riding a more rewarding experience by both breaking down the statistics of each journey and comparing riders' times on different segments of roads.

The problem is that, for the more reckless riders, Strava has turned cities into a series of time-trial routes in which they constantly try to better their own times and others'. The site allows riders to flag any hazardous' routes that should be exempt from segmentation but those are few and far between, certainly in London, ensuring that the site's affect on road safety remains a source of contention. For while Strava has successfully fought court cases alleging its responsibility for accidents in the United States, it has arguablymade commuting a more competitive activity.

"There is more organised bike-racing and bike circuits in the South East than any other part of the country," Doyle says. "If Mamils want to race then they would be far better off going to the Lea Valley Park circuit, to the velodrome at Herne Hill , to Crystal Palace or the road circuit over in Hillingdon , rather than tearing through town. It's crazy.

"If we want London to enjoy a cycling culture similar, say, to Copenhagen or Amsterdam, we should be riding our bikes in similar manner to its inhabitants, which means being controlled, calm and respectful of other road users." T he statistics relating to fatal accidents and heavy-goods vehicles in London have reached crisis point. HGVs account for half of cyclist fatalities in the capital and a fifth of pedestrian deaths, hence mayor Sadiq Khan's recently announced plan to ban all dangerous HGVS from the city's roads by 2020.

His proposal involves giving all lorries a safety rating between zero to five based on the drivers' level of visibility. By January 2020, those graded zero essentially construction-work lorries with a high cab and tall wheel clearance will be excluded from the city. By 2024, a truck will need a three-star rating to enter the city.

C ycling campaign groups welcomed Khan's plan, but a good number had reservations about its ambition. Some felt the timeframe given for it was too long, while others said that HGVs have no place in the city at all, especially during the working day. This argument gathered force with the two recent cyclist fatalities in the city.

Filippo Corsini , a young Italian nobleman, and the Italian woman Luciani Ciccolini were both killed after lorries struck them. "I would ban lorries altogether," says Emily Chappell, the author of What Goes Around; A London Cycle Courier's Story . "It's intolerable that we put up with something so dangerous and so inconvenient to other road-users.

"Those vehicles that absolutely need to be in the city - say, on construction sites - should be escorted while on the roads and subject to more stringent safety measures than are currently in place. But your standard delivery vehicles could easily stop at depots outside the city centre, say, with their goods decamped into smaller vehicles or cargo bikes. It might be an inconvenience for the drivers and businesses, but this is a question of life and death.

" T he relationship between car drivers and cyclists has improved with the sport's surge in popularity over the past decade but anyone who rides the city's roads will tell you that mutual hostility still exists, with both tribes believing the other is the most irresponsible with regard to road safety and a hot-tempered confrontation rarely more than one jumped traffic light away. Chappell, for example, insists cyclists are unfairly maligned for not adhering to the Highway Code, insisting that our culture permits car drivers and pedestrians to commit just as many infringements as cyclists without criticism. "I am geek for the Highway Code," she says.

"I ostentatiously abide by it, almost to make a point. But it's a myth that cyclists are more reckless with the rules of the road. A lot of pedestrians walkout on the road at zebra crossings, a lot ofcar drivers speed,blastthrough red lights or usetheir phones while driving.

But cyclists seem to be the ones who get it in the neck." W hile admitting her bias, Chappell believes this cultural problem stems partly from the misguided belief that cyclists rank below car-drivers in the road hierarchy. "The fact is that cyclists have as much right to be on a B road as a car or any other vehicle," she says.

T hat means car drivers should not lose patience with cyclists who slow the traffic and should think very carefully before attempting to overtake them. "The only way to change attitudes and improve people's awareness of the road hierarchy is through campaigning. It will be long, hard process, much like the drink-driving campaigns of the 1980s, but that worked.

Culturally it has become unacceptable now. That's the kind of change we need to bring about." A s the numbers of people riding to work continues to grow, it is easy for those returning to the bike after a long time away from it to think that they have nothing left to learn.

The truth is, roads are busier now than in decades past, the rules of the road are constantly updated and what we picked up in our youth is easily forgotten. Best, then, to avail of the free adult classes available in most London boroughs, whether through the National Standard for Cycle Training or Bikeability , which has replaced the old cycling proficiency scheme. The latter has three levels but do not think you need to complete the full programme.

"Just train to the level you're comfortable with and then go higher if you wish," says Ashok Sinha, chief executive of the London Cycling Campaign . "The important thing is to make a start." S tate authorities could help by making Bikeability a compulsory part of the school curriculum.

"We believe that every schoolchild should get at least the minimum level of training," Sinha adds. The former major Boris Johnson's foreign policy might have divided the nation but it was hard to argue against the good work he did for cyclists, rolling out the Boris Bikes, while investing in both the Cycle Super Highway and the 100million Mini-Holland cycle path-network programme across three boroughs. I t is important now that Khan makes good on his pledge to build on this legacy and transform London from a city partially suited to cyclists to one that will eventually rank alongside the best in Holland and Denmark, the countries that set the standard for cycling provisions within their urban infrastructure.

Specifically, Khan needs to realise his commitment to triple the amount of protected space for cycling in London by the end of his four-year term. That means improving the design of both the 33 worst junctionsidentified by the London Cycling Campaign and the especially busy thoroughfares that the LCC hastargeted as being in need of improvement. These include the stretch of roads running from Old Street roundabout to Oxford Street, carrying thousands of cyclists a day, and Oxford Street itself, which Khan has promised to make motor traffic-free.

Several studies have found that such measures significantly cut the number of collisions and injuries to cyclists. "At their best, the Cycle Super Highways match the Dutch standards, in terms of width, physical separation from motor traffic and the quality of the junctions, but this isn't always the case,"says Simon Munk, infrastructure campaigner at LCC. "The ultimate goal is a network of tracks , so that as many people as possible can make door-to-door journeys without encountering significant barriers in between.

" D rivers in London could learn from Addison Lee, the taxi firm who recently asked LCC for advice on how best to incorporate cycling into their driver-training courses. The Licensed Taxi Drivers' Association recommend cycling-awareness training, too, though the law could go further. The LCC believes that lorry-drivers, for one, should be required to take a Safer Urban Driving module as part of their Certificate of Professional Development, while all car-users should be more closely examined on cycling-awareness in the driving test.

"We need to make sure drivers stay aware of cyclists and understand the kind of things that might risk collisions," Sinha said. Finally, though being told toensureyour bike is set up properly might sound like elementary advice,scores of commuters use bikes that have not been properly adjusted to fit them. Most frequently, their saddle is set at the wrong height or the handlebar stem is the incorrect length, making for a less comfortable journey and, more importantly, undermining your control of the bike.

"In London, I'd say about one in two people on the road haven't had their position set up correctly," Doylesays. "It's incredible, especially when your local bike shop will do a sight-test for customers for free."A frequent commuter could also consider a professional fit, whether a traditional one using a plumbline and gonimeter, to measure angles, or a modern, computerised version that simulates your pedal stroke to model your ideal position on the bike.

"You see a lot of people in the city riding flat-footed or with their heel because it's easier or just lazy," Doyle adds. "They should be riding on the balls of their feet, which gives you better control of the bike." R obertDineen's bookKings of the Road; A journey into the heart of British cycling (Aurum Press) is out now.

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How to Interpret Visual Fields
IntroductionImagine you are assessing a patient with visual difficulties or optic disc swelling. After a bedside visual field examination with waggling fingers and even a red hatpin, you decide that there is an abnormality. After requesting quantified visual field tests, the patient returns with a black and white printout with numbers (eg, Humphrey fields) or coloured lines on a sheet (eg, Goldmann fields). Where is the report you ask? There is none!Static perimetry uses flashing stationary lights. This can be automated (eg, evenly spaced points on a grid) or manual (eg, as a small part of Goldmann test: detailed later). The Humphrey field analyser is by far the most commonly used for automated static perimetry, although there are also other machines such as Octopus and Henson. Later, we describe in detail the interpretation of Humphrey perimetry. oas_tag.loadAd("Middle1"); Kinetic perimetry uses a moving illuminated target and is done either manually (eg, Goldmann) or on an automated machine (eg, Octopus). Goldmann machines are no longer manufactured, being slowly replaced by Octopus machines. Nevertheless, Goldmann remains the most commonly used kinetic perimetry, and so we use this here to illustrate interpretation of kinetic fields. The principles for interpreting Goldmann also apply to results from Octopus machines.It is beyond the scope of this paper to cover the neuroanatomical localisation of visual field defects. Instead we recommend two excellent recent reviews.1 ,2 Skilled interpretation of visual field tests requires a good grasp and application of this prior knowledge.Useful aspects of eye anatomyThe fovea is the area of greatest visual sensitivity, where the cone photoreceptor density is at its highest. The visual sensitivity slopes off further from the fovea. This drop in sensitivity can be visualised as a hill, with the fovea is at the peak (figure 1). Conventional perimetry is carried out under photopic (well lit) conditions, and therefore, rod photoreceptors do not contribute to the findings.The normal field of vision extends to approximately 60 nasally, 90 temporally, 60 superiorly and 70 inferiorly.The blind spot indicates the location of the optic nerve headan area with no photoreceptorsin the temporal part of the visual field.Anything obstructing the travel of light towards the retina may affect the field tests, for example, lens opacity (cataract), ptosis (if not taped away from the pupil) or the rim of a correcting lens (test artefact)Download figure Open in new tab Download powerpoint Figure1 Normal hill of vision.Goldmann field testDuring a Goldmann field test, the patient positions their eye opposite the centre of a white hemispherical bowl (figure 2). The patient fixates upon the central target 33 cm away, while the examiner sits opposite viewing through an eyepiece to ensure good fixation throughout the test. The examiner moves an illuminated white target from the periphery towards the centre, and the patient presses a buzzer to indicate when they first see the target. This is repeated from different directionsallowing the examiner to plot the patient's field of visionusing targets varying in size and brightness. The examiner plots the blind spot and the edges of scotomas in a similar way, with the patient pressing the buzzer to indicate when they first see the light target moving from a blind to a seeing area. The examiner also performs static testinginvolving the brief appearance of the stationary light targetin the four quadrants within the central 20 or so, marking a tick on the chart when the patient sees the target and a cross if they do not.Download figure Open in new tab Download powerpoint Figure2 Goldmann machine. The patient's eye is positioned at the centre of a white hemispheric bowl, with the examiner looking through an eyepiece to ensure good fixation. A white light (indicated by yellow arrow in (A) is brought in from the periphery into the patient's field of vision. The examiner does this by controlling connecting levers (indicated by orange arrows in A and B). The patient presses a buzzer when the light target is seen (blue arrow).The target sizes are labelled with three alphanumeric digits, for example, V4e. The first digit is a Roman numeral (IV), indicating the size of the target, for example, V is equivalent to a target diameter of 9.03 mm. With every drop in number (eg, from V to IV) the diameter halves.The second digit is an Arabic number (14), indicating the brightness of the stimulus: the larger the number the higher the luminance.The third digit is a letter (ae), indicating a finer calibration of luminance. 4e is equivalent to 10-decibel (dB) brightness; each consecutive drop in number represents a 5 dB change and each drop in letter represents a 1 dB change.By convention, the examiner maps three isopters: lines of equal sensitivity to targets of a specified size and luminance. The first isopter, mapping the farthest peripheral vision, requires the largest and brightest target V4e. Another isopter is mapped in the central 30 of vision, and a third isopter is intermediate between these two. The isopter lines therefore show the margins of different visual sensitivity, analogous to the contour lines of a map marking different elevations. This allows us to visualise the hill of vision. The base of the hill represents the area at the periphery with least visual sensitivity, detecting only the largest and brightest target. As we move up towards the peak of the hill, the visual sensitivity increases and the patient sees smaller and dimmer targets.Humphrey field testThe same principles apply to the Humphrey test as to the Goldmann test, but instead with static light stimulation. The machine can also be programmed to perform kinetic tests though we have no experience with this.The illuminated targets appear for 200 ms at predetermined locations on a grid. Humphrey tests are widely used in glaucoma clinics, the most common set up being to test the central 24 (24-2 setting). Some examiners test smaller or wider visual angles; however, the wider the visual angle tested, the more coarse the grid, and hence the greater the likelihood of missing small scotomas. The 24-2 assesses the central 24 with a 54-point grid; 10-2 assesses the central 10 with a 68-point grid; and 30-2 assesses the central 30 with a 76-point grid.The examiner plots the hill of vision based upon the threshold for detecting different target luminance; as visual sensitivity improves towards the fovea, so the detection threshold for the target decreases. Unlike Goldmann, the target size stays the same during the test, with a default size equivalent to Goldmann size III targets. It is rare to need a different default size.The Swedish interactive threshold algorithm (SITA) is the most commonly used test algorithm,3 designed to reduce the time to complete a test; a short test duration limits the likelihood of errors from patient fatigue. SITA starts by determining the visual stimulation thresholds at the four quadrants. If the patient sees the initial stimulus, the examiner reduces its brightness to the level where it is no longer seen. Conversely, if the patient does not see the stimulus, its brightness is increased to find this threshold. The examiner adjusts the initial brightness at adjacent points according to the threshold of its neighbouring point. During the test, the examiner retests some locations to determine reliability (see false-negative errors, below). At completion, the computer generates a statistical analysis, which is compared to an age-matched normal population. Useful aspects of eye anatomyThe fovea is the area of greatest visual sensitivity, where the cone photoreceptor density is at its highest. The visual sensitivity slopes off further from the fovea. This drop in sensitivity can be visualised as a hill, with the fovea is at the peak (figure 1). Conventional perimetry is carried out under photopic (well lit) conditions, and therefore, rod photoreceptors do not contribute to the findings.The normal field of vision extends to approximately 60 nasally, 90 temporally, 60 superiorly and 70 inferiorly.The blind spot indicates the location of the optic nerve headan area with no photoreceptorsin the temporal part of the visual field.Anything obstructing the travel of light towards the retina may affect the field tests, for example, lens opacity (cataract), ptosis (if not taped away from the pupil) or the rim of a correcting lens (test artefact)Download figure Open in new tab Download powerpoint Figure1 Normal hill of vision. Goldmann field testDuring a Goldmann field test, the patient positions their eye opposite the centre of a white hemispherical bowl (figure 2). The patient fixates upon the central target 33 cm away, while the examiner sits opposite viewing through an eyepiece to ensure good fixation throughout the test. The examiner moves an illuminated white target from the periphery towards the centre, and the patient presses a buzzer to indicate when they first see the target. This is repeated from different directionsallowing the examiner to plot the patient's field of visionusing targets varying in size and brightness. The examiner plots the blind spot and the edges of scotomas in a similar way, with the patient pressing the buzzer to indicate when they first see the light target moving from a blind to a seeing area. The examiner also performs static testinginvolving the brief appearance of the stationary light targetin the four quadrants within the central 20 or so, marking a tick on the chart when the patient sees the target and a cross if they do not.Download figure Open in new tab Download powerpoint Figure2 Goldmann machine. The patient's eye is positioned at the centre of a white hemispheric bowl, with the examiner looking through an eyepiece to ensure good fixation. A white light (indicated by yellow arrow in (A) is brought in from the periphery into the patient's field of vision. The examiner does this by controlling connecting levers (indicated by orange arrows in A and B). The patient presses a buzzer when the light target is seen (blue arrow).The target sizes are labelled with three alphanumeric digits, for example, V4e. The first digit is a Roman numeral (IV), indicating the size of the target, for example, V is equivalent to a target diameter of 9.03 mm. With every drop in number (eg, from V to IV) the diameter halves.The second digit is an Arabic number (14), indicating the brightness of the stimulus: the larger the number the higher the luminance.The third digit is a letter (ae), indicating a finer calibration of luminance. 4e is equivalent to 10-decibel (dB) brightness; each consecutive drop in number represents a 5 dB change and each drop in letter represents a 1 dB change.By convention, the examiner maps three isopters: lines of equal sensitivity to targets of a specified size and luminance. The first isopter, mapping the farthest peripheral vision, requires the largest and brightest target V4e. Another isopter is mapped in the central 30 of vision, and a third isopter is intermediate between these two. The isopter lines therefore show the margins of different visual sensitivity, analogous to the contour lines of a map marking different elevations. This allows us to visualise the hill of vision. The base of the hill represents the area at the periphery with least visual sensitivity, detecting only the largest and brightest target. As we move up towards the peak of the hill, the visual sensitivity increases and the patient sees smaller and dimmer targets. Humphrey field testThe same principles apply to the Humphrey test as to the Goldmann test, but instead with static light stimulation. The machine can also be programmed to perform kinetic tests though we have no experience with this.The illuminated targets appear for 200 ms at predetermined locations on a grid. Humphrey tests are widely used in glaucoma clinics, the most common set up being to test the central 24 (24-2 setting). Some examiners test smaller or wider visual angles; however, the wider the visual angle tested, the more coarse the grid, and hence the greater the likelihood of missing small scotomas. The 24-2 assesses the central 24 with a 54-point grid; 10-2 assesses the central 10 with a 68-point grid; and 30-2 assesses the central 30 with a 76-point grid.The examiner plots the hill of vision based upon the threshold for detecting different target luminance; as visual sensitivity improves towards the fovea, so the detection threshold for the target decreases. Unlike Goldmann, the target size stays the same during the test, with a default size equivalent to Goldmann size III targets. It is rare to need a different default size.The Swedish interactive threshold algorithm (SITA) is the most commonly used test algorithm,3 designed to reduce the time to complete a test; a short test duration limits the likelihood of errors from patient fatigue. SITA starts by determining the visual stimulation thresholds at the four quadrants. If the patient sees the initial stimulus, the examiner reduces its brightness to the level where it is no longer seen. Conversely, if the patient does not see the stimulus, its brightness is increased to find this threshold. The examiner adjusts the initial brightness at adjacent points according to the threshold of its neighbouring point. During the test, the examiner retests some locations to determine reliability (see false-negative errors, below). At completion, the computer generates a statistical analysis, which is compared to an age-matched normal population. Humphrey or Goldmann?The choice may depend upon local availability. The Humphrey is slightly less operator-dependent than the Goldmann and has the advantage of numbers to indicate reliability of the test. The Goldmann tests peripheral fields better, may be more patient-friendly for those who are hesitant on the Humphrey, and is particularly useful for central scotoma, as it is easier to manage fixation losses. As a rule of thumb, when monitoring disease, it is sensible to use the same test as was used previously. Both tests can complement each other, confirming deficit patterns when in doubt.Interpreting the Goldmann field testThe key to interpreting Goldmann visual fields is to keep in mind the normal hill of vision (figure 1) and how it compares with the patient's results. The skill is in identifying patterns and observing any change with repeated tests. This may require experience to be adept, though the following checklist may help (figure 3): Patient name and date of test: a good habit always to check the test belongs to your patient!What is the largest peripheral field (V4e)? This can vary according to age and test response. It normally extends to approximately 60 nasally, 90 temporally, 60 superiorly and 70 inferiorly. Thus, the superior aspect of the field is usually less sensitive than the inferior field, though ptosis could also artefactually reduce it.Is there any distortion to the contours? (Contours are the smaller isopters corresponding to targets that are either smaller or dimmer or both). Is the isopter smooth, as expected for a normal hill of vision?Is there restriction? Examples would be a nasal step in papilloedema or an altitudinal defect in anterior ischaemic optic neuropathy.Are the isopters spaced, as expected for the normal hill of vision? (1) A tiny central field with stacked isoptersvery close to one another as in a steep hillusually denotes functional overlay (figure 7); however, patients with genuine retinal and striate cortex lesions may also have stacked isopters. (2) Isopter lines that cross always indicate unreliable test: isopters cannot cross since this would indicate two different sensitivities at one location. (3) Spiralling isopters suggest functional visual loss and indicate a steady decline in sensitivity during the test.Are there scotomas? It is important to correlate this with the patient's symptoms and clinical (bedside) examination.Is the blind spot size enlarged? This is particularly relevant in papilloedema (figure 5). The normal blind spot size is oval, roughly 10 in diameter, and located 1020 temporally from the central fixation point.Is the central field affected? Was static testing done (indicated with a tick when the patient saw the target)?Is any defect monocular or binocular, when comparing the fields for each eye? If binocular, is the defect homonymous or heteronymous?Any comments written about patient fixation or attention also help. Small pupil size, ptosis and incorrect positioning of a correcting lens may affect the peripheral field.Inadequate correction of refraction error for the viewing distance (33 cm) may affect the central field.Download figure Open in new tab Download powerpoint Figure3 Interpreting the Goldmann visual field.The chart is viewed from the perspective of the patient looking into the test bowl, as if patient is looking into the paper. Suggested checklist to review the Goldmann fields systematically (see text for details):1. Patient name and identification number, date of test.2. The largest isopter, that is, peripheral field.3. The other isoptersany distortion to the contours of the hill of vision? Any scotomas?4. Blind spot.5. Central vision.6. If there is an abnormality, is it monocular or binocular? If binocular, is it homonymous or heteronymous?7. Other, for example, comments about fixation or attention.This is an example of normal Goldmann fields. In contrast, this patient did not perform well on the Humphrey visual fields, with poor reliability and cloverleaf pattern (figure 4).Download figure Open in new tab Download powerpoint Figure4 Interpreting the Humphrey visual field. The charts are viewed from the perspective of the patient looking into the test bowl, as if patient is looking into the paper. Suggested checklist to systematically review Humphrey visual fields (see text for details): 1. Is this the correct test? A. Patient name and identification number B. Date of test C. Left or right eye? D. Test performed degree of visual angle tested test protocol: threshold or screening2. Can I rely on this test? A. False-positive errors B. False-negative errors C. Fixation-loss index D. Gaze-tracking graph 3. Is the test normal? A. Visual sensitivity map B. Total deviation map C. Pattern deviation mapThis patient's test was unreliable: high fixation loss index (and comment from technician, patient advised several times for both eyes (suggesting poor compliance), gaze-tracking graph also showed eye movements (indicated by upward spike from baseline) and high false-negative errors, up to 20% in the left eye. The grey scale visual sensitivity map suggests a clover leaf type pattern (figure 9). This provided the impression that the patient had difficulty with the Humphrey test itself. Clinical examination including visual acuity, colour vision, pupillary examination and visual field to confrontation to red pin was normal. The patient's Goldmann visual field test was normal (figure 3).Download figure Open in new tab Download powerpoint Figure5 Goldmann visual field from papilloedema. This patient has papilloedema from idiopathic intracranial hypertension. Goldmann fields show (1) an enlarged blind spot and (2) inferonasal field restriction.Download figure Open in new tab Download powerpoint Figure6 Goldmann visual fields of a patient with right optic neuropathy. All isopters are restricted but with preserved contours of the hill of vision, giving the appearance of a sunken hill. Compare this with figure 7 showing stacked isopters in a patient with functional visual loss.Download figure Open in new tab Download powerpoint Figure7 Goldmann visual fields of a patient with stacked isopters. This patient has functional overlay of a previous episode of mild optic neuritis affecting the right eye. Compare this with figure 6 of another patient with optic neuropathy. These stacked isopters would represent a hill vision that is too steep to be physiological, that is, the close contours here appear like a cliff drop. Clinical examination with a red target confirmed the presence of a tubular field (figure 8), with the size of visual field remaining unchanged when examined at 1 and 4 m. This is not keeping with the optics of light, whereby at a constant visual angle, the size of the field would appear larger the further away, that is, when examined at 4 m (with a proportionately larger target for acuity), the size of field to confrontation should be larger than on examination at 1 m.Download figure Open in new tab Download powerpoint Figure8 Tunnel vision: functional (ie, tubular field) versus physiological. The optics of light is such that at a constant visual angle, the size of the field appears larger when further away. When examined at 4 m (with a proportionately larger target for acuity), the size of field to confrontation should be larger than on examination at 1 m. Thus, a tubular field, where the size of field is unchanged, suggests functional overlay.Download figure Open in new tab Download powerpoint Figure9 Cloverleaf pattern on Humphrey visual fields. This artefactual visual field defect results from a reduced response rate as the test progresses. The Swedish interactive threshold algorithm (SITA) threshold test starts by determining the initial brightness in the four quadrants using the four points indicated by the arrows. Therefore, if a patient's response deteriorates as the test progresses, for example, because of reduced concentration, the visual field shows a cloverleaf pattern, where the thresholds are low at the four points initially tested and higher for the surrounding points. This pattern commonly occurs in non-organic visual loss and is equivalent to spiralling on the Goldmann. There will also be a high rate of negative errors. (A) Shows an example where the patient stops responding very early in the test, giving an extreme example of the cloverleaf pattern; (B) shows another example of cloverleaf pattern.Interpreting the Humphrey field testWe suggest the following framework to interpret Humphrey test results (figure 4), structured to answer three questions: 1. Is this the correct test?A. Name and patient number: confirm that the output belongs to your patient!B. Date of test: is this the output of interest? that is, timing in relation to symptoms.C. To which eye does this output correspond? Correlate the results with the history and clinical examination. Beware of fields that are mounted incorrectly: the conventional way of mounting is to place the left chart on the right and vice versa, ie, as if the patient is looking into the chart.D. What test was performed? This is particularly important when comparing to any previous tests.a. What degree of visual angle was tested?Most commonly set to 24-2 (central 24 tested with a 54-point grid). A smaller field with higher concentration of points gives further details of the foveal region. For example, 10-2 assesses the central 10 with a 68-point grid. 30-2 is similar to 24-2 but with an additional 6 and with a corresponding increase in the points tested (76-point grid for 30); thus, this is a longer test with the risk of more patient errors.b. Was it a threshold or a screening test?Screening tests use suprathreshold targets of single luminance and in the past were particularly useful because full threshold tests were time consuming. However, SITA threshold tests have superseded these, reducing test times (equivalent to the time taken for screening tests) without losing sensitivity.2. Can I rely on this test?A. False-positive errorsFalse-positive errors identify trigger happy patients who respond in the absence of light stimulus. They are calibrated according to the patient's overall responses, therefore detecting when responses occur too soon after presenting a stimulus is. A false-positive rate of >15% compromises test results.4B. False-negative errorsA false negative is the failure to respond to a relatively bright suprathreshold target in a region that previously responded to fainter stimuli. A high false-negative index may indicate hesitation or inattentiveness, though a true scotoma may also give false-negative results. However, in a true scotoma, the false-negative error rate is low for the contralateral (normal) eye.4 False-negative error may reduce with repeated testing as the patient gets used to the testing procedure.C. Fixation-loss indexFixation loss is tested by presenting a stimulus at the blind spot. If the patient sees this stimulus, it indicates loss of fixation. Values of >20% can compromise the test.4 However, this number could be artefactually elevated if the blind spot was inaccurately located, or in trigger-happy patients. Tracking of the gaze (below) is better for assessing fixation loss.D. Gaze-tracking graphThe eyes are tracked using video. The gaze tracking graph shows an upward spike when the eyes move and a downward spike when the eyes blink.3. Is the test normal?Three maps are generated with numbers and pictorial representations:A. Visual sensitivity mapThe numbers indicate the threshold of stimulus intensity detected in decibel (dB), with zero corresponding to the brightest intensity. Typical normal values centrally are around 30 dB. Values of 40 dB should not appear in standard test conditions but could occur in patients with high false-positive errors. The visual sensitivity may improve with repeat testing as patients become more familiar with it. The grey scale map is a visual representation of the numbers, with darker areas indicating poorer sensitivity to stimuli.B. Total deviation mapThis shows the deviations of the patient's visual sensitivity compared to an age-matched normal population. The numbers indicate the difference compared to the mean, that is, a negative value indicates less visual sensitivity compared to the mean population. The probability plot gives a visual representation of statistical analysis (t test) of this deviation from the mean; the larger departure from the mean, the darker the symbol.C. Pattern deviation mapThis shows the deviation of the pattern from a normal visual hill, where the peak is at the fovea. The numeric values show any departure from the mean of an age-matched population, and as above, the probability plot is a visual representation of statistical analysis indicating the extent of departure from mean. The pattern deviation adjusts for any shifts in overall sensitivity: for example, a patient with cataract might have a smaller or sunken hill but with normal contour patterns.By statistical chance, patients may have a few scattered dark symbols on the probability map, which may not be of concern. Instead, look for patterns, for example, whether these are around the blind spot, which might indicate a true enlargement. It is important to correlate the test results with the history and clinical examination.The visual sensitivity, total deviation and pattern deviation maps should be viewed together for any discrepancies. It is worth noting the following scenarios: Abnormal grey scale on stimulus intensity map but normal probability plots: lid partially obscuring the superior field.Abnormal total deviation but normal pattern deviation: cataract, small pupils, incorrect correction for refractive error.Abnormal pattern deviation but normal total deviation: a test with high false-positive (trigger happy) patient.Additional information that may help, especially when comparing with previous tests, include pupil diameter (is there a wide variation between tests?), lens modification (was the same correction used?), time taken to do the test (was this particularly long?). The global indices show the mean deviations, which can help to monitor progression, especially in glaucoma.Three summary indices appear on the printout4: The visual field index is a staging index designed to correspond to ganglion cell loss, that is, 100% represents normal fields and 0% represents blind fields.The mean deviation represents the degree of departure of the whole field's average values, from age-adjusted normal values.The pattern SD represents irregularities within the field, for example, of localised field defects. This can be small in completely normal patients or in those with complete blindness.The visual field index and the mean deviation can help to identify progression; the visual field index may be less prone to artefacts from cataract. These values may help to monitor progression, but with caution, since artefacts and test reliability can affect them. Interpreting the Goldmann field testThe key to interpreting Goldmann visual fields is to keep in mind the normal hill of vision (figure 1) and how it compares with the patient's results. The skill is in identifying patterns and observing any change with repeated tests. This may require experience to be adept, though the following checklist may help (figure 3): Patient name and date of test: a good habit always to check the test belongs to your patient!What is the largest peripheral field (V4e)? This can vary according to age and test response. It normally extends to approximately 60 nasally, 90 temporally, 60 superiorly and 70 inferiorly. Thus, the superior aspect of the field is usually less sensitive than the inferior field, though ptosis could also artefactually reduce it.Is there any distortion to the contours? (Contours are the smaller isopters corresponding to targets that are either smaller or dimmer or both). Is the isopter smooth, as expected for a normal hill of vision?Is there restriction? Examples would be a nasal step in papilloedema or an altitudinal defect in anterior ischaemic optic neuropathy.Are the isopters spaced, as expected for the normal hill of vision? (1) A tiny central field with stacked isoptersvery close to one another as in a steep hillusually denotes functional overlay (figure 7); however, patients with genuine retinal and striate cortex lesions may also have stacked isopters. (2) Isopter lines that cross always indicate unreliable test: isopters cannot cross since this would indicate two different sensitivities at one location. (3) Spiralling isopters suggest functional visual loss and indicate a steady decline in sensitivity during the test.Are there scotomas? It is important to correlate this with the patient's symptoms and clinical (bedside) examination.Is the blind spot size enlarged? This is particularly relevant in papilloedema (figure 5). The normal blind spot size is oval, roughly 10 in diameter, and located 1020 temporally from the central fixation point.Is the central field affected? Was static testing done (indicated with a tick when the patient saw the target)?Is any defect monocular or binocular, when comparing the fields for each eye? If binocular, is the defect homonymous or heteronymous?Any comments written about patient fixation or attention also help. Small pupil size, ptosis and incorrect positioning of a correcting lens may affect the peripheral field.Inadequate correction of refraction error for the viewing distance (33 cm) may affect the central field.Download figure Open in new tab Download powerpoint Figure3 Interpreting the Goldmann visual field.The chart is viewed from the perspective of the patient looking into the test bowl, as if patient is looking into the paper. Suggested checklist to review the Goldmann fields systematically (see text for details):1. Patient name and identification number, date of test.2. The largest isopter, that is, peripheral field.3. The other isoptersany distortion to the contours of the hill of vision? Any scotomas?4. Blind spot.5. Central vision.6. If there is an abnormality, is it monocular or binocular? If binocular, is it homonymous or heteronymous?7. Other, for example, comments about fixation or attention.This is an example of normal Goldmann fields. In contrast, this patient did not perform well on the Humphrey visual fields, with poor reliability and cloverleaf pattern (figure 4).Download figure Open in new tab Download powerpoint Figure4 Interpreting the Humphrey visual field. The charts are viewed from the perspective of the patient looking into the test bowl, as if patient is looking into the paper. Suggested checklist to systematically review Humphrey visual fields (see text for details): 1. Is this the correct test? A. Patient name and identification number B. Date of test C. Left or right eye? D. Test performed degree of visual angle tested test protocol: threshold or screening2. Can I rely on this test? A. False-positive errors B. False-negative errors C. Fixation-loss index D. Gaze-tracking graph 3. Is the test normal? A. Visual sensitivity map B. Total deviation map C. Pattern deviation mapThis patient's test was unreliable: high fixation loss index (and comment from technician, patient advised several times for both eyes (suggesting poor compliance), gaze-tracking graph also showed eye movements (indicated by upward spike from baseline) and high false-negative errors, up to 20% in the left eye. The grey scale visual sensitivity map suggests a clover leaf type pattern (figure 9). This provided the impression that the patient had difficulty with the Humphrey test itself. Clinical examination including visual acuity, colour vision, pupillary examination and visual field to confrontation to red pin was normal. The patient's Goldmann visual field test was normal (figure 3).Download figure Open in new tab Download powerpoint Figure5 Goldmann visual field from papilloedema. This patient has papilloedema from idiopathic intracranial hypertension. Goldmann fields show (1) an enlarged blind spot and (2) inferonasal field restriction.Download figure Open in new tab Download powerpoint Figure6 Goldmann visual fields of a patient with right optic neuropathy. All isopters are restricted but with preserved contours of the hill of vision, giving the appearance of a sunken hill. Compare this with figure 7 showing stacked isopters in a patient with functional visual loss.Download figure Open in new tab Download powerpoint Figure7 Goldmann visual fields of a patient with stacked isopters. This patient has functional overlay of a previous episode of mild optic neuritis affecting the right eye. Compare this with figure 6 of another patient with optic neuropathy. These stacked isopters would represent a hill vision that is too steep to be physiological, that is, the close contours here appear like a cliff drop. Clinical examination with a red target confirmed the presence of a tubular field (figure 8), with the size of visual field remaining unchanged when examined at 1 and 4 m. This is not keeping with the optics of light, whereby at a constant visual angle, the size of the field would appear larger the further away, that is, when examined at 4 m (with a proportionately larger target for acuity), the size of field to confrontation should be larger than on examination at 1 m.Download figure Open in new tab Download powerpoint Figure8 Tunnel vision: functional (ie, tubular field) versus physiological. The optics of light is such that at a constant visual angle, the size of the field appears larger when further away. When examined at 4 m (with a proportionately larger target for acuity), the size of field to confrontation should be larger than on examination at 1 m. Thus, a tubular field, where the size of field is unchanged, suggests functional overlay.Download figure Open in new tab Download powerpoint Figure9 Cloverleaf pattern on Humphrey visual fields. This artefactual visual field defect results from a reduced response rate as the test progresses. The Swedish interactive threshold algorithm (SITA) threshold test starts by determining the initial brightness in the four quadrants using the four points indicated by the arrows. Therefore, if a patient's response deteriorates as the test progresses, for example, because of reduced concentration, the visual field shows a cloverleaf pattern, where the thresholds are low at the four points initially tested and higher for the surrounding points. This pattern commonly occurs in non-organic visual loss and is equivalent to spiralling on the Goldmann. There will also be a high rate of negative errors. (A) Shows an example where the patient stops responding very early in the test, giving an extreme example of the cloverleaf pattern; (B) shows another example of cloverleaf pattern. Interpreting the Humphrey field testWe suggest the following framework to interpret Humphrey test results (figure 4), structured to answer three questions: 1. Is this the correct test?A. Name and patient number: confirm that the output belongs to your patient!B. Date of test: is this the output of interest? that is, timing in relation to symptoms.C. To which eye does this output correspond? Correlate the results with the history and clinical examination. Beware of fields that are mounted incorrectly: the conventional way of mounting is to place the left chart on the right and vice versa, ie, as if the patient is looking into the chart.D. What test was performed? This is particularly important when comparing to any previous tests.a. What degree of visual angle was tested?Most commonly set to 24-2 (central 24 tested with a 54-point grid). A smaller field with higher concentration of points gives further details of the foveal region. For example, 10-2 assesses the central 10 with a 68-point grid. 30-2 is similar to 24-2 but with an additional 6 and with a corresponding increase in the points tested (76-point grid for 30); thus, this is a longer test with the risk of more patient errors.b. Was it a threshold or a screening test?Screening tests use suprathreshold targets of single luminance and in the past were particularly useful because full threshold tests were time consuming. However, SITA threshold tests have superseded these, reducing test times (equivalent to the time taken for screening tests) without losing sensitivity.2. Can I rely on this test?A. False-positive errorsFalse-positive errors identify trigger happy patients who respond in the absence of light stimulus. They are calibrated according to the patient's overall responses, therefore detecting when responses occur too soon after presenting a stimulus is. A false-positive rate of >15% compromises test results.4B. False-negative errorsA false negative is the failure to respond to a relatively bright suprathreshold target in a region that previously responded to fainter stimuli. A high false-negative index may indicate hesitation or inattentiveness, though a true scotoma may also give false-negative results. However, in a true scotoma, the false-negative error rate is low for the contralateral (normal) eye.4 False-negative error may reduce with repeated testing as the patient gets used to the testing procedure.C. Fixation-loss indexFixation loss is tested by presenting a stimulus at the blind spot. If the patient sees this stimulus, it indicates loss of fixation. Values of >20% can compromise the test.4 However, this number could be artefactually elevated if the blind spot was inaccurately located, or in trigger-happy patients. Tracking of the gaze (below) is better for assessing fixation loss.D. Gaze-tracking graphThe eyes are tracked using video. The gaze tracking graph shows an upward spike when the eyes move and a downward spike when the eyes blink.3. Is the test normal?Three maps are generated with numbers and pictorial representations:A. Visual sensitivity mapThe numbers indicate the threshold of stimulus intensity detected in decibel (dB), with zero corresponding to the brightest intensity. Typical normal values centrally are around 30 dB. Values of 40 dB should not appear in standard test conditions but could occur in patients with high false-positive errors. The visual sensitivity may improve with repeat testing as patients become more familiar with it. The grey scale map is a visual representation of the numbers, with darker areas indicating poorer sensitivity to stimuli.B. Total deviation mapThis shows the deviations of the patient's visual sensitivity compared to an age-matched normal population. The numbers indicate the difference compared to the mean, that is, a negative value indicates less visual sensitivity compared to the mean population. The probability plot gives a visual representation of statistical analysis (t test) of this deviation from the mean; the larger departure from the mean, the darker the symbol.C. Pattern deviation mapThis shows the deviation of the pattern from a normal visual hill, where the peak is at the fovea. The numeric values show any departure from the mean of an age-matched population, and as above, the probability plot is a visual representation of statistical analysis indicating the extent of departure from mean. The pattern deviation adjusts for any shifts in overall sensitivity: for example, a patient with cataract might have a smaller or sunken hill but with normal contour patterns.By statistical chance, patients may have a few scattered dark symbols on the probability map, which may not be of concern. Instead, look for patterns, for example, whether these are around the blind spot, which might indicate a true enlargement. It is important to correlate the test results with the history and clinical examination.The visual sensitivity, total deviation and pattern deviation maps should be viewed together for any discrepancies. It is worth noting the following scenarios: Abnormal grey scale on stimulus intensity map but normal probability plots: lid partially obscuring the superior field.Abnormal total deviation but normal pattern deviation: cataract, small pupils, incorrect correction for refractive error.Abnormal pattern deviation but normal total deviation: a test with high false-positive (trigger happy) patient.Additional information that may help, especially when comparing with previous tests, include pupil diameter (is there a wide variation between tests?), lens modification (was the same correction used?), time taken to do the test (was this particularly long?). The global indices show the mean deviations, which can help to monitor progression, especially in glaucoma.Three summary indices appear on the printout4: The visual field index is a staging index designed to correspond to ganglion cell loss, that is, 100% represents normal fields and 0% represents blind fields.The mean deviation represents the degree of departure of the whole field's average values, from age-adjusted normal values.The pattern SD represents irregularities within the field, for example, of localised field defects. This can be small in completely normal patients or in those with complete blindness.The visual field index and the mean deviation can help to identify progression; the visual field index may be less prone to artefacts from cataract. These values may help to monitor progression, but with caution, since artefacts and test reliability can affect them. ConclusionWe present these simplified checklists to help neurologists to interpret Humphrey and Goldmann visual fields. We emphasise the importance of correlating these visual field outputs with careful patient history and clinical examination. Increased exposure to perimetry and its application in the clinical setting will help build up skills in its interpretation. For readers interested in deepening their understanding of fields and its nuances, we suggest further reading from the reference list.46 Key pointsPerimetry results give a pictorial representation of the patient's hill of vision; keep the normal hill in mind when reviewing these tests.Correlate perimetry results with the clinical history and examination (including examination to confrontation), as the tests often have artefacts.Watch out for patient performance effect, for example, high false-positive or false-negative errors, cloverleaf pattern (static perimetry) or spiralling of fields (kinetic fields).Perimetry results change if anything obstructs the travel of light towards the retina (eg cataract).Static and kinetic perimetry complement one another; consider the other if the first is unexpectedly normal or abnormal. ReferencesCooper SA, Metcalfe RA. Assess and interpret the visual fields at the bedside. Pract Neurol 2009;9:32434. doi:10.1136/jnnp.2009.193920OpenUrlAbstract/FREE Full TextHickman SJ. Neurological visual field defects. Neuro-ophthalmology 2011;35:24250. doi:10.3109/01658107.2011.616980OpenUrlBengtsson B, Olsson J, Heijl A, et al. A new generation of algorithms for computerized threshold perimetry, SITA. Acta Ophthalmol Scand 1997;75:36875. doi:10.1111/j.1600-0420.1997.tb00392.xOpenUrlPubMedWeb of ScienceHeijl A, Patella VM, Bengtsoon B. The field analyzer primer: effective perimetry. 2012, Carl Zeiss Meditec.Barton JJS, Benatar M. Field of vision: a manual and atlas of perimetry. Current Clinical Neurology series. New Jersey: Humana Press, 2003.Carl Zeiss Meditec, Inc. Humphrey Field Analyzer Manual Book II-i series system software version 5.1. 2012, Carl Zeiss Meditec. FootnotesContributors SHW wrote the first draft of the manuscript; GTP reviewed and made revisions to the manuscript.Competing interests None declared.Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by Mark Lawden, Leicester, UK.
Wedding Videography: 5 Questions to Consider Before Booking a Videographer
This article originally appeared on A Peachy Life Productions' blog The intention of this blog isnt to communicate that videography is necessary.Videography is popular enough so an argument centered on it needing to be a part of a wedding is useless. The point here is to communicate to those who are on the borderline and perhaps are still unfamiliar with what videography is or what the benefits are. Finding a photographer or a videographer that fits your needs and your budget is no easy task. Like all things involving your wedding, it takes a lot of work. It is obvious that you care a great deal about your wedding and you want it to be special and you want something that will help you commemorate the day, but it just doesnt fall into your lap. It is unfortunate that many people look only at the $$$ and pay little attention to the character or response of a videographer or photographer when an inquiry is made. Budget, of course, takes priority over most things, but you never really know what can be achieved if you just reach out and contact someone. How do you choose the right videographer? What is a videographer for anyway? Here are five things to think about when considering investing in a wedding film. 1. Why do I want my wedding filmed? Wedding films date back to before the 1980s, but it was that decade that saw the birth of the first consumer camcorder. Back then it was more of a hassle as it often took away from the aesthetic of the wedding since there was so much equipment required to make it work. Todays industry still sees a good deal of technology at work, but technology has allowed videographers more freedom in movement and it has become less necessary to use static light stands and such which can distract from the real purpose of the day: the wedding. Today, videographers are as agile and fluid as any photographer. Their ability to squeeze into impossibly tight areas and come away with elegant shots and flattering angles has catapulted the concept of a wedding film to astronomic heights. DSLRs have now standardized high definition film, bringing Hollywood-quality filmmaking into the hands of amateurs and semi-pros. This is something a number of people still have no idea about. Take a look at some portfolio work by videographers and see how much more you can get out of a wedding film when in the hands of a videographer, rather than a family member filming from one spot. 2. How much should I spend? This question probably carries the most weight. Theres a lot of consideration that goes into selecting a price for services by videographers as well as photographers. The prices generally have a lot to do with what is included in the packages that are offered. The hours provided usually make the biggest difference, but you have to think carefully about how many hours you need or would like to have filmed. Some couples want to have everything from start to finish, but this requires going towards longer hours which will mean more money. It is also imperative to look at what is included in each package. People tend to make the mistake of thinking that videographers will only provide a DVD with one highlights trailer that appears online, or oftentimes in their portfolio. But many companies have so much more to offer. These features, while they add more cost to your package, are usually designed to make remembering your wedding day an even more unique experience. The lowest-priced packages generally only offer a certain amount of coverage and are tailored towards jouranalizing the wedding experience, rather than capturing special moments that will tell a compelling story. Theres nothing wrong with taking this route, but if you want more bang for your buck, ask the videographer about what other features they have besides the highlights trailer. Its pivotal to be in constant communication with your videographer. If they care at all, they will do their best to get to know you as the more comfortable you both feel before the wedding, the easier it will be to film. It is also worth asking if packages can be customized. Perhaps you don't want your pre-ceremony prep work filmed, can you add more time for cocktail hour? Can you add a Save the Date video or an engagement video and take off a couple of hours of the wedding? 3. What is the difference between videographers? The answer to this question leads to another obvious question, "Which videographer is best?" To put it simply, it is just a matter of taste when it comes to which videographer is best. All videographers are in the business because they have talent to film. The spectrum can divide the n00bs from the Pros, but that gap is not as large as one might think. This is becoming more and more apparent with photographers as well. I'm not really involved in that industry at all, but it does seem like it is becoming harder and harder to break away from the pack and get your stuff recognized. Rather than depending on the quality of your work, there is so much that goes into how you advertise your product. Some argue that it is best to advertise only what YOU love to do and the type of weddings only YOU want to shoot. The flip side is to advertise a variety in your portfolio in order to attract a wide range of clients. Like the aforementioned, videographers have styles of their own. Some like to stay back and journalize the wedding experience, while others like to get in real close and create cinematic pieces of work that may ignore some of the conventional strategies of capturing every moment of the wedding. The best way to tell the difference is to watch their videos. If that doesn't do it for you, then looking at how they sell their product and their correspondence with you is the next best thing. 4. How can I be sure Im going to be happy with what I get? No one can be completely certain of anything in this life. If you do your research and actually watch the body of work of your videographer, you can make an educated guess at how your video will turn out. If the videographer is receptive to your ideas and wants to implement them, you can be sure to be even happier with the end result. If you see a great video by another videographer, don't be afraid to share that with them. Seeing fresh ideas will only help increase the quality of your video. 5. What is the point of having my wedding filmed when I already have a photographer? Theres nothing to take away from photographers or a beautiful photograph, but there are things that a wedding film can provide that a photograph simply cannot (and vice versa). Besides the obvious moving pictures, a wedding film adds the dimension of audio to your wedding experience. Now, in years to come, youll be able to hear the sounds of your wedding. Remember what you sounded like when you gave your vows, remember the toast by your father, your mother or other close relatives and friends. After all the glitz and glamour of the day has dispersed, how would you like to remember everything? It is likely, as bride and groom, that you will miss some moments of your wedding because youll be so busy with a million other things (like dancing, greeting guests, cutting the cake, etc). Your memory will serve as your only source aside from pictures, but how will you remember movement and sounds? The only way to preserve these precious memories is by capturing it on film. Film can capture the moment in real time and preserve it for generations to come. It will outlast you and it will inform future generations of how you approached love. You'll also get a unique view of your wedding, a view that no spectator can capture, a view that not even the bride and groom can see. Follow A Peachy Life on Twitter and 'Like' them on Facebook . Keep in touch! Check out HuffPost Weddings on Facebook , Twitter and Pinterest .
Atomistic Structures and Dynamics of Prenucleation Clusters in MOF-2 and MOF-5 Syntheses
Chemical reactions in solution almost always take place via a series of minute intermediates that are often in rapid equilibrium with each other, and hence hardly characterizable at the level of atomistic molecular structures. We found that single-molecule atomic-resolution real-time electron microscopic (SMART-EM) video imaging provides a unique methodology for capturing and analyzing the minute reaction intermediates, as illustrated here for single prenucleation clusters (PNCs) in the reaction mixture of metalorganic frameworks (MOFs). Specifically, we found two different types of PNCs are involved in the formation of MOF-2 and MOF-5 from a mixture of zinc nitrate and benzene dicarboxylates at 95 C and 120 C, respectively. SMART-EM identified a small amount of 1-nm-sized cube and cube-like PNCs in the MOF-5 synthesis, but not in the MOF-2 synthesis. In the latter, we instead found only linear and square PNCs, suggesting that the MOF-2/-5 bifurcation takes place at the PNC stage.Metal-organic frameworks (MOFs) are porous minerals that consist of nodes comprising metal ions connected by organic linkers. Their diversity in lattice structure, elemental composition and organic linkers offers tremendous opportunities in materials applications. Easy access to diverse structures is an asset of MOF science and technology, but their synthesis often shows hints of mechanistic complexity. As a classic example, MOF-2 having square lattice and MOF-5 having cubic lattice (Fig.) differ only in the conditions of the reaction between zinc nitrate and benzene dicarboxylic acid (HBDC) in dimethylformamide (DMF): heating at 95 C for several hours produces MOF-2 (Zn:BDC = 1:1, isolated in its DMF solvated form), and the mixture becomes acidic (Zn(NO) 2RCOOH = Zn(RCOO) 2HNO). Heating at 120 C produces between 0 and 4 h non-porous precipitates of unknown structure (Zn:BDC = 1: 1, called herein as ), which gradually changes in situ to MOF-5 nanocrystallites as the solution changes from acidic to basic because of thermal decomposition of DMF that generates a formal water dianion (O or ZnO). For a few tens of hours after formation, the nanocrystallites undergo Ostwald ripening to produce MOF-5 cubic polycrystals (Zn:BDC = 4:3). Thus, the system conforms the kinetics and thermodynamics of the reaction intermediates that serve as prenucleation clusters (PNCs) of crystallisation controlled by interface and bulk free energetics (Fig.). Although the MOF-2/-5 bifurcation suggests structural difference among the PNCs leading either MOF-2 or MOF-5 (Fig.), little has been known for PNCs in solution at molecular level. Earlier in situ studies by static light scattering, extended X-ray absorption fine structure, and liquid cell transmission electron microscopy (TEM) revealed small crystals but not PNCs. PNCs were identified only by mass spectrometry and by computer simulation. In this context, we focused on the MOF-2 and -5 formation through in situ capturing of PNCs and atomistic structural analysis by single-molecule atomic-resolution real-time electron microscopy (SMART-EM).In Fig., we summarise the correlation between the node structures based on reported crystal structures. The mononuclear structure of a digonal node A is ubiquitous among zinc carboxylates and forms linear polymers of Zn-BDC as found commonly in the MOF-2 and -5 synthesis. The dinuclear complex B is simply a dimer of A responsible for the formation of square PNCs, and represents a tetragonal node in MOF-2. The structural relationship between the mononuclear node A and a tetranuclear node D parallels the one between zinc acetate and basic zinc acetate (ZnO(CHCOO)), the latter converted readily to the former upon acidification. The trinuclear node C is an intermediate to D formed by replacement of one RCOO group on B by ZnO . Thus, the formation of D (MOF-5 node) from C requires the addition of one zinc cation and three molecules of BDC, with a considerable entropy loss. This chemical diagram suggests that the linear and square (lower order, LO) PNCs made only of Zn and BDC should form readily under mild conditions, while the cube and cube-like (higher order, HO) clusters requiring nodes C and D should increase in number as DMF decompose upon prolonged heating at 120 C. We verified this hypothesis experimentally by SMART-EM studies of the clusters isolated from the reaction mixture as described below.Here, we report that the MOF-2 synthesis produces square-shaped clusters, while the MOF-5 synthesis produces cube and cube-like clusters as structurally the most complex PNCs (Fig.). Commonly found in both cases were linear clusters of considerable structural flexibility - zinc carboxylate oligomers (Fig. (A)). In the synthesis of iodinated MOF-5 (I-MOF-5) from 2-iodoterephthalic acid (HIBDC), we established the structure of a slowly rotating 1.3-nm-sized cube cluster by determining the spatial locations of all 12 iodine atoms in sequential 2-D video images with approximately 1 precision. The SMART-EM technique recently revealed the feasibility of single-molecule level kinetics, and now allows us to investigate atomistic structures of minute intermediates of chemical reactions.
Enhanced Thylakoid Photoprotection Can Increase Yield and Canopy Radiation Use Efficiency in Rice
High sunlight can raise plant growth rates but can potentially cause cellular damage. The likelihood of deleterious effects is lowered by a sophisticated set of photoprotective mechanisms, one of the most important being the controlled dissipation of energy from chlorophyll within photosystem II (PSII) measured as non-photochemical quenching (NPQ). Although ubiquitous, the role of NPQ in plant productivity remains uncertain because it momentarily reduces the quantum efficiency of photosynthesis. Here we used plants overexpressing the gene encoding a central regulator of NPQ, the protein PsbS, withina major crop species(rice) to assess the effect of photoprotection at the whole canopy scale. We accounted for canopy light interception, to our knowledge for the first timein this context. We show that in comparison to wild-type plants, psbS overexpressors increased canopy radiation use efficiency and grain yield in fluctuating light, demonstrating that photoprotective mechanisms should be altered to improve rice crop productivity.Photosynthetic efficiency is a limitation to achieving gains in crop yield that will meet the needs of global food security in the coming century. However, we still lack a complete understanding of canopy photosynthesis in natural and agricultural environments. For example, plants are commonly exposed to light levels that fluctuate in time and space yet most of our understanding of photosynthesis arises from studies in static conditions.A plethora of mechanisms regulate the amount of energy received by plant leaves and pigment protein complexes. These include plant and chloroplast movement, pigment concentration and acclimation of pigment protein complexes. Over much shorter timescales (seconds and minutes) plants rapidly process excess absorbed light energy at the biochemical level. One such mechanism is the inducible dissipation, or quenching, of excitation energy (measured as non-photochemical quenching, NPQ) within photosystem (PS) II. It is able to respond to sudden increases in radiation quickly and in a regulated way with minimum energetic cost to the plant.Quenching measured as NPQ is engaged during periods of high radiation resulting in the prompt release of chlorophyll excitation energy as heat within PSII. It is thought to help prevent the onset of photoinhibition. NPQ responsiveness over short timescales results from its sensitive regulation via acidification of the thylakoid lumen and the increased pH between lumen and stroma. The rate of formation and the capacity for NPQ is under control of the protein PsbS and the xanthophyll cycle. PsbS was initially thought to be required for formation of the major component of NPQ, termed high-energy state quenching or qE but it has since been shown that NPQ can form in plants where PsbS is absent. It seems likely that PsbS is an important regulator and accelerator of qE formation in the thylakoid membrane. The xanthophyll cycle co-determines kinetics and capacity for qE and consists of the reversible formation (de-epoxidation) of zeaxanthin from violaxanthin in high light.qE dynamic properties are appropriate for rapid changes in the light environment. PsbS-dependent qE can be generated within seconds but the synthesis of zeaxanthin and its reconversion back to violaxanthin in low-light occurs on a timescale of minutes leading to the suggestion that zeaxanthin persistence is a memory of high-light events, enabling a rapid response to a re-occurrence of saturating light. Slower-relaxing components of NPQ include qI or inhibitory quenching which can be formed as a result of damage to PSII and its repair which is a process requiring time, energy and protein synthesis or from the more persistent retention of zeaxanthin.All components of NPQ must result in a reduction in quantum efficiency of PSII electron transport although this is unlikely to be a limiting factor during high-light periods. In particular, the impact of qI or photoinhibition on photosynthesis at whole-plant and ecological scales has been modelled and measured but empirical quantification of its effect on productivity lacks certainty. One of the problems is how to measure and predict the effects caused by changing light conditions. In naturally fluctuating light qE will provide protection at high light but also limit photosynthesis in low light via the lowered quantum yield. In an attempt to quantify this, Zhu et al. used a modelling approach to show that canopy photosynthesis could be substantially reduced by the slow recovery of qI and CO in low light. Similarly, Krah and Logan and Kromdjik et al. showed that qE may limit photosynthesis in fluctuating light in and tobacco. In rice, enhanced qE directly resulted in lower photosynthesis during induction. Chlorophyll fluorescence measurements in rice canopies provide evidence that NPQ results in reduced quantum efficiency at leaf level.Plant canopies are complex three-dimensional objects in which the light can fluctuate over short timescales by solar movement or wind, resulting in highly complex patterns. The operation of photoprotection, therefore, sets up a costbenefit dilemma. qE reduces the likelihood of photoinhibition and photooxidative stress but operation in a plant canopy may reduce photosynthesis in fluctuating light. We can hypothesise that the characteristics of qE should be suited to fluctuating not static light. However most work on qE has been carried out on plants grown in static conditions. Work with plants lacking PsbS has shown that qE is important for fitness of plants in the field, however, it is unclear whether this is directly attributable to a reduction in PSII electron transport. A severely reduced qE may have other signalling and metabolic effects on the plant. The dynamics of both induction and relaxation of qE seem to be important. A recent study using tobacco showed that upregulating PsbS, violaxanthin de-epoxidase and zeaxanthin epoxidase together could enhance NPQ recovery and quantum yield of CO assimilation and this was associated with increased plant biomass and yield.Photoprotection is, therefore, a significant target for crop improvement but it is necessary to understand the tradeoffs with CO assimilation and growth in fluctuating light environments. Improvements in photosynthesis per unit leaf area should result in increased growth and biomass. However, any increase in leaf area will itself enhance light capture and even if initially small can have a substantial effect on growth. To separate the effects of light capture from the altered leaf biochemistry we should measure radiation use efficiency (RUE), which is the amount of biomass produced per unit intercepted radiation. RUE shows a degree of variability in the field but it also responds in a predictable manner according to environmental conditions and is highly dependent on canopy photosynthesis. Canopies with high 3D complexity set-up this dilemma clearly where the frequency of large fluctuations (sunflecks) is high. A high NPQ may lead to impairment of CO assimilation during low-light or high-light induction periods. On the other hand if qE is acting predominantly in a protective manner to reduce photoinhibitory costs then RUE may rise.Here, we show that higher photoprotective capacity (via increased PsbS protein alone) levels results in enhanced biomass, RUE and grain yield in a major crop plant (rice) where biomass production is a major limitation to crop yield under fluctuating light. This is likely due to a reduction in the level of photoinhibition.
What properties are needed in static light raw materials?
What properties are needed in static light raw materials?
According to different needs of customers, GUANGZHOU TORY LIGHT CO.,LIMITED is capable of providing reasonable, comprehensive and optimal solutions for customers. moving head light is of reliable quality and high safety. It is widely applicable and is common in multi-purpose halls, studios, conference centers, auditoriums, theaters, concerts, stadiums, dance halls, and other entertainment venues. For product information, please feel free to contact TORY. moving led lights produced by TORY is very popular in the market.How does shallow sand filter work? Washing and filtering: when the system is in a filtering state, unfiltered water is evenly distributed by self-developed unique water distributor, the water passes through the filler layer in the filter in a laminar flow state (refined average quartz sand/Garnet ).When the water flows through the filler layer, impurities are trapped inside the filler layer.There are multiple evenly distributed water collectors at the bottom of the filter, which collect and extract the filtered water evenly, and the convection filter can make the filter at high flow rate, good filtering effect can still be achieved.Reverse Washing State: With the accumulation of impurities in the filler layer, the loss of internal head will continue to increase.When the loss of the inlet and outlet pressure head reaches the set value, the system will automatically activate the constant pressure device to convert it to the reverse washing state. when the counter washing is completed,The valve changes the dHow to choose the size of the precision filter in the air pressure system? In the modern industrial society, compressed air has become an indispensable power source in the enterprise. In general, untreated compressed air systems contain contaminants such as dust particles, water, oil mist, rust, and charcoal hydrogen compounds. These compressed air containing pollutants will not only damage your downstream equipment, instruments and meters, resulting in increased maintenance costs of the equipment, but also reduce the production efficiency of the enterprise and further affect the quality of the products. The main function of the precision filter is to filter the moisture and impurities in the air. the filter is the most effective and convenient way to improve the quality of compressed air. How much precision filter should be selected in the compressed air system?When determining the size of the dpc compressed air precision filter, remember that the filter is usually the cheapest component in the compressed
Traktor Audio 6 Recognizes Only One Deck When Pluging into My Mac Pro, What Should I Do?
I can not post this as a comment yet, so it will have to be an answer. Usually this happens when the audio signal is screwed up somehow coming from the table. Set Traktor to scope view and see what the signal looks like. Check the settings in the audio 6 control panel- is direct monitoring on? Are the line input sensitivities set properly? Did you try rebooting the Macbook and/or plugging the audio 6 in on a different USB? Are you using an external power supply, or are you powering over the USB? Are you using timecode vinyl? Are your needles clean/connected properly? Are your grounds connected? Do you have the deck set to CD/LINE rather than to TURNTABLE/PHONO? There are many things it could be; a better description of what it is doing might help. :) Hope this helps.1. Mac Pro: Kernel panic during HDD boot and DVD bootIt is probably your video card. The 2007 MBP's were prone to this.Here is how you can tell. Download the Ultimate Boot CD. Burn it to a DVD or a USB StickYou will launch Linux with a ton of useful diagnostic tools. Run everything, but especially the video display diagnostic tool.Mine was throwing errors and I was able to definitively find the cause of the problem. I was able to find a guy in Tampa that would upgrade the video card on the Logic Board for about $100. I did the service and it worked great. MBP still running to this day. Let me know if you are interested and I will post his info2. Mac Pro Memory Installation Problem: Missing RAM in certain slotsYou need to follow the memory layout suggested on the side door, and the instructions in the manual that shipped with your Mac Pro. The memory layouts have changed significantly from the older 2007 model Mac Pros.edit: link to the memory replacement manual for early 2008 Mac Pros.3. Formatted my mac pro HDD, how do i install mac os x on it?Did you not use or receive instructions or documentation on how to do this? Before you wiped the hard disk clean?4. What should I get, a Mac Pro 13" or a Sony Vaio CW?Macbook Pro* Mac Pro is the tower computer. And it depends on what you need it for. If you do not need something extremely fast the Macbook Pro should be plenty.5. Cannot access vital boot options on Mac Pro with OS X LionIt's extremely strange that you were not getting EFI boot options to work from a wired keyboard.I note that the EFI startup commands you listed that worked used either the Shift key modifier or the Option AND Cmd modifier. The commands that did not work used either Option OR Cmd. Makes you wonder. ..You do know that the keys that generate "Option" and "Cmd" keycodes are typically reversed from a PC to a Mac keyboard, correct? (It's easy to forget if you normally have them remapped in System Preferences->Keyboard.) Is it possible you were using the wrong modifier keys at startup time?Also very strange that the nvram dump shows your desktop machine had been assigned a name that implied it was previously a laptop. If the previous owner used some sort of imaging tool to initialize your machine but took the image from a different model of Mac I can imagine all sorts of strange things could be going wrong.6. What's your favorite MAC pro product?None of them. I bet better results and a much better price with mary Kay7. Why does my mac pro suddenly suck?Suddenly? haha They always suck dude. =] Try deleting unnecessary stuff and defragging your hard drive. Also check the programs running in the background. Like media players, anti-virus software, Limewire, ect; These things can slow down you are computer. Make sure you have all the most current updates also. That and more RAM will make your computer faster...8. My Mac Pro won't take a CD I try to insert. It's really important.?Does it take other CDs? Then that CD is bad. If it does not take any CD the drive is probably bad9. will a mac pro run diablo 3?Yh, My Brother has a Mac Book air and Plays Diablo 3. Really good game too
A Question About Reading and Calculating Thermal Resistance of a Voltage Regulator From Its Datashee
You have calculated the power dissipated in the wind gauge - what you need to know is the power dissipated in the LM317. The wind vane will draw 1 mA, and you have 3 volts across the LM317, for a power dissipation of 3 mW due to the load. However, the LM317 requires a minimum load current of 5 mA for proper operation - the voltage-setting resistors are usually selected to draw that current.With 1 mA for the wind gauge, and 5 mA for the LM317 operation, the LM317 will dissipate about 6 mW - no need for any heat sink at such a low power. You could use a TO-92 packaged LM317 without concernI have this voltage regulator from this supplier and the exact model name is given as: "LM317T/NOPB".I plan to use this circuit to power a windwane's potentiometer which is around 10k:As you see I want to set the excitation voltage for the vane pot to around 9 or 10V where the opamp will be supplied directly from a 12V switch mode power supply. For this purpose I will use an LM317 to obtain 9 or 10V for the vane excitation. So I will set LM317 for 9 or 10V DC. I will mount the vane in a box around 50m height which will stay there at least 3 months.Since I will use a linear voltage regulator I decided to find out whether I need a heatsink.I have encountered two challenges which I put here as questions:1-) In the datasheet when I check the thermal resistances I cannot figure out which model I should use:Mine is T0-220, but in the datasheet there is two types namely as KCT and KCS. But my model is "LM317T/NOPB". And on it it is written "LM317T P". So should I use the thermal resistance for KCT or KCS?2-) Here is how I calculate the T:T JA * PIn my case:P V^2 / R 10^2 / 10000 0.01WBut for junction to ambient temperature I used to use the following:Junction to ambient Junction to case Case to AmbientBut in the datasheet there is no Case to Ambient but there is Junction to ambient. Does "junction to ambient" already include "case to ambient"? Should I in my case only use Junction to ambient? If so in my case T becomes like 4C, and I conclude I don't need heatsink. Do I calculate correct and does it matter the duration like three months when it comes to using heatsink?
Dajiang UAV Emergency Rescue Alliance Operation
Since June, South China has experienced several rounds of heavy rainfall. The rainstorm is widely distributed, multi-point outbreak and high local intensity, causing dangerous situations such as waterlogging, landslide and overtopping, and the flood control situation is extremely severe.The emergency rescue alliance composed of DJI Dajiang industrial application and partners responded quickly, served local flood control and rescue teams, helped to improve the efficiency of emergency rescue and protect the safety of people's lives and property in the flood season.The duration of dam patrol is long, the map is far away, and continuous monitoring is carried out in rainstormAffected by the continuous increase of water from the upstream and the jacking of the Yangtze River flood, the water level of Dongting Lake continued to rise. On July 4, the water level of Chenglingji station, the landmark hydrological station of Dongting Lake, exceeded the warning. Since then, the water level of Dongting Lake has exceeded the warning."As a 'barometer' of the water situation of the Dongting Lake and the Yangtze River Basin, Chenglingji station exceeds the guaranteed water level, which means that the flood control situation of the whole Dongting Lake area has entered a very urgent state." the Yangtze Holly of the Ministry of water situation and information technology of Hunan hydrological Center said.In order to better monitor the water situation in the flood season, from July 5, the water conservancy department of Hunan Province began to use Dajiang UAV to carry out flood control inspection on the reach of Dongting Lake.Dajiang longitude and latitude M300 RTK took off from Qilishan hydrological station in Chenglingji, Yueyang, and met the Yangtze River about 7km along Dongting Hubei. With the help of the map transmission system as far as 15km, the UAV continues to stably transmit images for the flood control and drought relief command center of Hunan Province, helping flood control experts master the situation at the first time.In addition, the longitude latitude M300 RTK has the protection level against heavy rain, and can operate continuously even in the rain. In addition, it has the advantages of long endurance and battery thermal replacement, and realizes all-weather rotation monitoring during the flood season.The rapid inspection of flood control facilities, revetments, levees and other contents of the target segment by UAV has expanded the vision of the original manual inspection. Yueyang City will also start UAV flight inspection on the 1068 km first-line flood control embankment of Dongting Lake and the Yangtze River trunk line.At present, several groups of UAV teams have gone to Yueyang and Yiyang to track and monitor the lake potential of Dongting Lake, provide information support for flood prevention and ensure the safe transit of Dongting Lake flood.The landslide rescue 3D model calculates the landslide area and locks the rescue areaOn July 8, affected by continuous heavy rainfall, a sudden landslide triggered a debris flow in Shiban village, Songtao Autonomous County, Guizhou Province. The whole village suddenly turned into a flood beach, and some villagers were trapped. After receiving the rescue notice, Guizhou Skyway technology, an industrial application partner of DJI Dajiang, acted quickly and rushed to the scene to cooperate with the rescue at the first time.Due to the huge destructive force of landslides, local houses have been washed away and buried by soil. Only by comparing the local pre disaster and post disaster images can we determine the approximate location of the buried houses and look for the trapped people.The traditional solution is to understand the whole picture of the disaster area through satellite remote sensing. However, the timeliness and accuracy of satellite map are low. At the same time, the weather conditions of heavy rainfall and cloudy fog in this disaster will also lead to the poor effect of satellite images.The rescue team thought of Dajiang spirit 4 RTK aerial survey UAV for the first time - it has a centimeter level positioning system. Rescuers imported the images collected by spirit 4 RTK into Dajiang wisdom map and quickly obtained the first three-dimensional model of the disaster core area.According to the model, the command center analyzed four key rescue areas, and calculated the local landslide area and landslide earthwork.In addition, in the rescue process, the front-line rescue team continued to transmit the images taken by UAVs back to the command center in real time, so as to facilitate the command center to monitor the changes in the landslide area and adjust the rescue strategy in time. While efficiently looking for trapped people, it also ensures the safety of rescue workers.Quickly find out the disaster situation due to heavy rainfall and waterloggingGuangdong Province, which has experienced several rounds of heavy rainfall, recently encountered the strongest "dragon boat water" in recent 15 years, and the precipitation in many places broke through the historical extreme value. Guangdong Provincial three prevention office and Guangdong Provincial Emergency Management Department sent emergency support working group and emergency communication support group to carry Dajiang UAV to the rescue sites of Huadu, Qingyuan Fogang and Huizhou Longmen."When we arrived at fogangluo cave in Qingyuan, the water level in a village had been more than 2 meters, overflowing the first floor of the houses. The villagers were hiding upstairs. The village had been cut off from water, food and electricity." said the Guangdong Chengjin science and technology operator in charge of flight operations at the scene.In order to find out the disaster, the fire commanders and fighters quickly took off the Dajiang "Yu" 2 industry version UAV they carried with them. The UAV collects the panorama of the affected area with one click to truly restore the disaster scene.During the rescue, the fire commanders and fighters used the Dajiang longitude and latitude M300 RTK to continuously shoot the disaster situation on the scene in the rainstorm, and transmitted the captured picture back to the command center through the video live broadcast platform.Timely on-site first-hand information provides an important basis for the command center to realize accurate judgment, accurate organization, accurate coordination and accurate command of emergency rescue, so as to timely evacuate the masses, avoid casualties, reduce property losses and achieve prevention first.Intelligent flood control and scientific disaster reduction. With the unique advantages of high-altitude vision, as well as many strengths such as flexibility, reliability and intelligence, UAVs are providing efficient tools for rescue workers on the front line. DJI Dajiang industry application said that its emergency rescue alliance with national partners will also stick to the front line, go all out to fight the battle of flood control and disaster reduction, and build a "new dam" for scientific and technological flood control and disaster reduction in the affected areas.
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