Ophthalmologists traditionally have been unable to provide teachers and parents with useful information about a severely handicapped child's functional vision. Literature concerning the assessment of vision in handicapped children is reviewed and a guide is proposed for use by teachers in evaluating the severely handicapped child's functional vision.

Size is a fundamental cellular trait that is important in determining phytoplankton physiological and ecological processes. Fossil coccospheres, the external calcite structure produced by the excretion of interlocking plates by the phytoplankton coccolithophores, can provide a rare window into cell size in the past. Coccospheres are delicate however and are therefore poorly preserved in sediment. We demonstrate a novel technique combining imaging flow cytometry and cross-polarised light (ISX+PL) to rapidly and reliably visually isolate and quantify the morphological characteristics of coccospheres from marine sediment by exploiting their unique optical and morphological properties. Imaging flow cytometry combines the morphological information provided by microscopy with high sample numbers associated with flow cytometry. High throughput imaging overcomes the constraints of labour-intensive manual microscopy and allows statistically robust analysis of morphological features and coccosphere concentration despite low coccosphere concentrations in sediments. Applying this technique to the fine-fraction of sediments, hundreds of coccospheres can be visually isolated quickly with minimal sample preparation. This approach has the potential to enable rapid processing of down-core sediment records and/or high spatial coverage from surface sediments and may prove valuable in investigating the interplay between climate change and coccolithophore physiological/ecological response.

<p>Fossil coccospheres provide a wealth of information on cellular traits that can be compared directly to the living coccosphere such as cell size. Cell size is critical to ecosystem dynamics and particle sinking which has implications on the carbon cycle. However, cell size reconstruction is hindered by the poor preservation of coccospheres as coccospheres often disintegrate into individual coccoliths. Although palaeoecological information can be attained from individual coccoliths, assumptions must be made when correlating cell size to coccolith size. We demonstrate a novel technique using imaging flow cytometry to rapidly and reliably sort coccospheres from marine sediment by exploiting their unique optical and morphological properties. Imaging flow cytometry combines the functional insight of morphological information provided by microscopy with high sample numbers that are associated with flow cytometry. High throughput imaging overcomes the constraints of laborious manual microscopy enabling the analysis of sediments containing low concentrations of coccospheres that would simply not be feasible to manually hunt for coccospheres. By applying this technique to the fine fraction of sediments, hundreds of coccospheres can be isolated without the need for additional sample processing. Morphological information of individual coccospheres is obtained and graphical and statistical information can be extracted. This approach lends itself perfectly to rapid processing of down-core sediment samples or high spatial coverage from core-top samples and may prove valuable in investigating the interplay between a changing climate and coccolithophore response.</p><p> </p>

Introduction: After limb loss, many patients undergo treatment with an osseointegrated implant. Unfortunately, some develop persistent peristomal pain after surgery. This can be sufficiently severe to reduce the speed of their rehabilitation or may halt the process altogether. The pain may be due to an enthesopathy of the residual muscles. We describe the phenomenon and outcomes of treatment in a series of patients who underwent treatment with an osseointegrated prosthetic limb, bone-anchor. Materials and Methods: Over 36 months, we followed 14 patients with symptoms consistent with enthesopathy. Thirteen had undergone treatment with a transfemoral bone-anchor and one underwent treatment with a transhumeral bone-anchor. One patient had a bilateral transfemoral amputation. Analysis of the patients' ages, heights, weight at the time of surgery, length of residual femur, or preoperative dual-energy x-ray absorptiometry scans showed no correlation with the development of enthesopathy pain. Thirteen patients received steroid injections. Most received at least one injection of Adcortyl™ and bupivacaine. Patients were then encouraged to follow a program of physiotherapy to stretch out their enthesis, after injection. Results: All patients experienced relief from their symptoms, but only two were rendered completely pain free. The remaining 11 patients gained sufficient control of their symptoms to allow them to continue daily use of their prosthesis with less difficulty or, where rehabilitation had been delayed or halted completely, to resume this process. Conclusion: Enthesopathy seems to be a common phenomenon after bone-anchor surgery in individuals with transfemoral amputation. Steroid injections can help to relieve pain, allowing physiotherapy to be carried out. Patients undergoing treatment with a bone-anchor should be advised of the possibility of enthesopathy pain but can be reassured that there is a solution that works well in most cases. Clinical Relevance: This article may be of benefit to clinicians who are struggling to manage patients with persistent peristomal pain after insertion of a bone-anchor. It may also encourage further research into measures for securing the soft tissues around the stoma for patients undergoing bone-anchor surgery.