bluuebunny/crossref_metadata_2025 huggingface dataset:
Seven-Year Follow-Up of Screening for Hypertension and Diabetes at a Dental Clinic
Authors: Friman Göran
Published: December 2019

Objective: To describe the distribution of risk, diagnosis and pharmacological treatments for diabetes and hypertension after seven years among patients provided with opportunistic medical screening in a dental setting.

Material and Methods: The initial screening’s 170 participants were asked to take part in a seven-year follow-up study. Data were collected through self-reported information in a written health declaration. Outcome measures:

• Number of study participants who had passed away

• Prescription of antidiabetics or antihypertensives

• Changes in weight and height to calculate body mass index (BMI)

Results: The follow-up study consisted of 151 participants. Twenty had passed away. The risk needs for medicating with antihypertensive drugs after seven years for those not receiving pharmacological treatment at the initial screening was 3.7 times greater (p=0.025 CI 1.2-11.3) for participants with a diastolic blood pressure (BP) ≥ 90 mm Hg (85 for diabetics) than for the others. The risk was 3.9 times greater (p=0.020 CI 1.2-12.6) for those with a systolic BP of 140-159 mm Hg and 54.2 times greater (p<0.0001 CI 9.8-300.3) for those with a systolic BP ≥ 160 mm Hg than for those with a systolic BP 140 mm Hg. There were no changes in BMI.

Conclusion: At least one in ten cases of incorrect medication or undiagnosed hypertension may be identifiable through opportunistic medical screening
Effect of Fluoride Mouthwash in Iranian Schools: Treatment or Exacerbation of the Disease
Authors: Karimi Mohammad
Published: December 2019

Dental and oral health is an important part that plays a significant role in the quality of life of people in our society, especially children, but due to insufficient attention, tooth decay in the world is increasing every year. Promoting oral hygiene requires the people's easy access to primary oral health care and the use of these services should be classified.
Anaesthesia Concerns in Apert Syndrome - A Case Report
Authors: Upadhyay Nitish
Published: December 2019

Apert syndrome (AS) a type of acrocephalosyndactyly is a rare congenital disorder with autosomal dominant mode of transmission that consists of craniofacial synostosis, midfacial hypoplasia and bilateral limb syndactyly. Patients present in early childhood for multiple surgeries which make it imperative to know about various anaesthetic implications like difficult airway ventilation, airway hyper reactivity, associated congenital anomalies, increased airway secretions and deranged temperature thermoregulation associated with this syndrome. The patient should be thoroughly evaluated preoperatively and managed accordingly. We discuss the successful management of a three and a half years old male child with Apert syndrome.
Topical Analgesic Formulations: Following the Transdermal Treatment Paradigm Only?
Authors: Hesselink Jan M Keppel
Published: December 2019

Topical analgesics are regarded as new inroads to treat peripheral neuropathic pain, with a number of advantages over oral treatments. Topical treatment reduces systemic induced side-effects and have good tolerability, without problems of misuse or abuse, or dependency. Furthermore, the onset of action is fast, mostly within 30 minutes. The mechanism of action of topical analgesics is either via transdermal delivery of the analgesic, or via intradermal mechanisms of action. In the latter case, plasma levels of analgesics in the blood are absent or very low. This perspective is missing in the approach of the ad hoc committee of the National Academies of Sciences, Engineering, and Medicine in the USA, installed by the FDA. In this short commentary, we plead for a more comprehensive approach of topical analgesics, including those formulations which explicitly are not based on transdermal penetration of the active pharmaceutical ingredient, but on intradermal mechanisms of action.
Characterization of Patients in Fertile Age with Vaginal Flow Syndrome: Consultation No. 10. Plinlinico Pàrraga
Authors: Rodríguez Pedro López
Published: December 2019

Introduction: Vaginal discharge syndrome is an infectious process of the vagina with a florid symptomatology and psychosocial impact on the female population.

Objective: To characterize the patients of childbearing age with vaginal discharge syndrome in the Basic Working Group number 2 of the Párraga polyclinic between January and December 2018. Method: Observational, descriptive, and cross-sectional study. 195 patients of childbearing age (between 15 and 49 years of age) of the medical office 10 were studied in the period from January to December 2018 who attended the medical consultation referring to presenting vaginal discharge and / or associated symptoms performing anamnesis, physical examination, and microbiological study.

Results: 32.8% were between 25 and 29 years old and 41.7% wereblack. At least half were 52.3% pre-university; more than 59.0% were workers. The majority began sexual intercourse before the age of 20. 90.3% presented risk factors associated with vaginal discharge. The white, lumpy caseous flow represented 63.1%. At least 9 out of 10 patients presented vaginitis. More than 75% had Monilia or Gardnerellavaginalis. It was found that 95% of patients with vaginitis had risk factors.

Conclusions: Patients predominated between the second and third decade of life, of the black race, with the pre-university concluded and workers. The majority were single or accompanied, had begun their sexual life at an early age and presented risk factors. Patients with vaginitis prevailed, with white, lumpy, case-like discharge and with Moniliaasthe germ causing vaginal discharge. There was a statistically significant relationship between the presence of risk factors and the flow classification.
Granular Cellular Tumor: A Disease to know and to recognize
Authors: Berkane Salah
Published: December 2019

We report here a rare case of granular cell tumor (GCT) operated on with diagnosis of bile duct cancer. All clinical, biological, morphological, operative and histological characteristics are described in this observation. We have done a whipple resection and postoperative course was uneventful. The patient is alive and well at postoperative month. This is the rare disease which must be known by the surgical community to choose the adequate surgery.
Evaluation of Nutritional Status among Adult Hemophilia patients enrolled in European Gaza hospital in Gaza strip, Palestine
Authors: Abu Mustafa Ayman M
Published: December 2019

Overview: Hemophilia is a genetic bleeding disorder caused by a deficiency of clotting factor and classified to Hemophilia A and B. Nutritional status is very important and proper nutrition among hemophilia patients is highly significant. This study aimed to evaluate nutritional status among adult hemophilia patients enrolled in the European Gaza Hospital in the Gaza strip.

Subject and Method: The present study is descriptive design. A census sample used and the subjects were 27 hemophilia patients enrolled in European Gaza Hospital and they enrolled in Hemophilia and Thalassemia clinic. Data collected by self-administrative questioners and statistical analysis done by using SPSS version 23.

Results: The study pointed out that the average age of patients was about 30.3 years and most patients have foods induce bleeding and only 3.7% of them take vitamin supplementation. Prevalence of hepatitis was 37%% of patients and the results not registered any patients obese while 37.0% of them were overweight. Only 5% of patients have a deficiency of total protein and albumin while 8% of them were anemic. Diversity score was the daily food that the highest score was starch followed by beverages while the lowest scores were nuts and sweeteners.

Conclusion: The study showed that the percentage of overweight, anemia, hepatitis, take foods to induce bleeding were elevated while the prevalence of hypoproteinemia and hypoalbuminemia was rare. Diet diversity score among hemophilia patients showed that the highest score of daily food was starch followed by beverages and the lowest score were nuts and sweeteners.

Recommendation: Hemophilia patients should avoid foods that increase their bleeding, and increasing the daily intake of food that improve blood clotting and maintain the normal weight. Also, we hope that the Ministry of Health in the Gaza strip, to use our findings as a first study ever in Gaza strip to increase workshops to advice the hemophilia patients to intake supplementation and increase awareness of patients to safe food guidelines.
Black Hole Spin Measurement Based on Time-domain VLBI Observations of Infalling Gas Clouds
Authors: Moriyama Kotaro , Mineshige Shin , Honma Mareki , Akiyama Kazunori
Published: December 2019

The black hole spacetime is described by general relativity and characterized by two quantities: the black hole mass and spin. Black hole spin measurement requires information from the vicinity of the event horizon, which is spatially resolved for the Galactic center Sagittarius A* (Sgr A*) and the nearby radio galaxy M87 by means of very long baseline interferometry observations with the Event Horizon Telescope (EHT). In this paper, we simulate EHT observations for a gas cloud intermittently falling onto a black hole and construct a method for spin measurement based on its relativistic flux variation. The light curve of the infalling gas cloud is composed of peaks formed by photons which directly reach a distant observer and by secondary ones reaching the observer after more than one rotation around the black hole. The time interval between the peaks is determined by a period of photon rotation near the photon circular orbit which uniquely depends on the spin. We perform synthetic EHT observations for Sgr A* under the more realistic situation where a number of gas clouds intermittently fall toward the black hole with various initial parameters. Even for this case, the black hole spin dependence is detectable in correlated flux densities which are accurately calibrated by baselines between sites with redundant stations. The synthetic observations indicate that our methodology can be applied to EHT observations of Sgr A* from 2017 April.
The 3D Structure of CO Depletion in High-mass Prestellar Regions
Authors: Bovino S. , Ferrada-Chamorro S. , Lupi A. , Sabatini G. , Giannetti A. , Schleicher D. R. G.
Published: December 2019

Disentangling the different stages of the star formation process, in particular in the high-mass regime, is a challenge in astrophysics. Chemical clocks could help alleviate this problem, but their evolution strongly depends on many parameters, leading to degeneracy in the interpretation of the observational data. One of these uncertainties is the degree of CO depletion. We present here the first self-consistent magneto-hydrodynamic simulations of high-mass, star-forming regions at different scales, fully coupled with a nonequilibrium chemical network, which includes C–N–O bearing molecules. Depletion and desorption processes are treated time dependently. The results show that full CO depletion (i.e., all gas-phase CO frozen-out on the surface of dust grains) can be reached very quickly, in one-third or even smaller fractions of the freefall time, whether the collapse proceeds on slow or fast timescales. This leads to a high level of deuteration in a short time, both for typical tracers like N2H+, as well as for the main ion

H

3

+

, the latter being in general larger and more extended. N2 depletion is slightly less efficient, and no direct effects on N-bearing molecules and deuterium fractionation are observed. We show that CO depletion is not the only driver of deuteration, and that there is a strong impact on D
frac when changing the grain size. We finally apply a two-dimensional Gaussian point-spread function to our results to mimic observations with single-dish and interferometers. Our findings suggest that the low-values observed in high-mass star-forming clumps are in reality masking a full-depletion stage in the inner 0.1 pc region.
The Spectral Evolution of AT 2018dyb and the Presence of Metal Lines in Tidal Disruption Events
Authors: Leloudas Giorgos , Dai Lixin , Arcavi Iair , Vreeswijk Paul M. , Mockler Brenna , Roy Rupak , Malesani Daniele B. , Schulze Steve , Wevers Thomas , Fraser Morgan , Ramirez-Ruiz Enrico , Auchettl Katie , Burke Jamison , Cannizzaro Giacomo , Charalampopoulos Panos , Chen Ting-Wan , Cikota Aleksandar , Della Valle Massimo , Galbany Lluis , Gromadzki Mariusz , Heintz Kasper E. , Hiramatsu Daichi , Jonker Peter G. , Kostrzewa-Rutkowska Zuzanna , Maguire Kate , Mandel Ilya , Nicholl Matt , Onori Francesca , Roth Nathaniel , Smartt Stephen J. , Wyrzykowski Lukasz , Young Dave R.
Published: December 2019

We present light curves and spectra of the tidal disruption event (TDE) ASASSN-18pg/AT 2018dyb spanning a period of one year. The event shows a plethora of strong emission lines, including the Balmer series, He ii, He i, and metal lines of O iii
λ3760 and N iii
λλ4100, 4640 (blended with He ii). The latter lines are consistent with originating from the Bowen fluorescence mechanism. By analyzing literature spectra of past events, we conclude that these lines are common in TDEs. The spectral diversity of optical TDEs is thus larger than previously thought and includes N-rich events besides H- and He-rich events. We study how the spectral lines evolve with time, by means of their width, relative strength, and velocity offsets. The velocity width of the lines starts at ∼13,000 km s−1 and decreases with time. The ratio of He ii to N iii increases with time. The same is true for ASASSN-14li, which has a very similar spectrum to AT 2018dyb but its lines are narrower by a factor of >2. We estimate a black hole mass of M
BH = 

3.3

−
2.0

+
5.0

×

10

6

M
⊙ by using the M–σ relation. This is consistent with the black hole mass derived using the MOSFiT transient fitting code. The detection of strong Bowen lines in the optical spectrum is an indirect proof for extreme ultraviolet and (reprocessed) X-ray radiation and favors an accretion origin for the TDE optical luminosity. A model where photons escape after multiple scatterings through a super-Eddington thick disk and its optically thick wind, viewed at an angle close to the disk plane, is consistent with the observations.
Imaging the Sun's Far-side Active Regions by Applying Multiple Measurement Schemes on Multiskip Acoustic Waves
Authors: Zhao Junwei , Hing Dominick , Chen Ruizhu , Webber Shea Hess
Published: December 2019

Being able to image active regions (ARs) on the Sun’s far side is useful for modeling the global-scale magnetic field around the Sun and for predicting the arrival of major ARs that rotate around the limb onto the near side. Helioseismic methods have already been developed to image the Sun’s far-side ARs using near-side high-cadence Doppler-velocity observations; however, the existing methods primarily explore the 3-, 4-, and 5-skip helioseismic waves, leaving room for further improvement in the imaging quality by including waves with more multiskip waves. Taking advantage of the fact that 6-skip waves have the same target-annuli geometry as 3- and 4-skip waves and that 8-skip waves have the same target-annuli geometry as 4-skip waves, we further develop a time–distance helioseismic code to include a total of 14 sets of measurement schemes. We then apply the new code on the Solar Dynamics Observatory/Helioseismic and Magnetic Imager observed Dopplergrams and find that the new code provides substantial improvements over the existing codes in mapping newly emerged ARs and ARs near both far-side limbs. Comparing 3 months of far-side helioseismic images with the Solar TErrestrial RElations Observatory/Extreme UltraViolet Imager observed 304 Å images, we find that 97.3% of the helioseismically detected far-side ARs that are larger than a certain size correspond to an observed region with strong EUV brightening. The high reliability of the new imaging tool will potentially allow us to further calibrate the far-side helioseismic images into maps of magnetic flux.
On the Origin of Solar Torsional Oscillations and Extended Solar Cycle
Authors: Pipin V. V. , Kosovichev A. G.
Published: December 2019

We present a nonlinear mean-field model of the solar interior dynamics and dynamo, which reproduces the observed cyclic variations of the global magnetic field of the Sun, as well as the differential rotation and meridional circulation. Using this model, we explain, for the first time, the extended 22 yr pattern of the solar torsional oscillations, observed as propagation of zonal variations of the angular velocity from high latitudes to the equator during the time equal to the full dynamo cycle. In the literature, this effect is usually attributed to the so-called “extended solar cycle.” In agreement with the commonly accepted idea, our model shows that the torsional oscillations can be driven by a combination of magnetic field effects acting on turbulent angular momentum transport and the large-scale Lorentz force. We find that the 22 yr pattern of the torsional oscillations can result from a combined effect of an overlap of subsequent magnetic cycles and magnetic quenching of the convective heat transport. The latter effect results in cyclic variations of the meridional circulation in the sunspot formation zone, in agreement with helioseismology results. The variations of the meridional circulation, together with other drivers of the torsional oscillations, maintain their migration to the equator during the 22 yr magnetic cycle, resulting in the observed extended pattern of the torsional oscillations.
Perspectivas para a educação superior pública brasileira: entrevista com o Prof. Dr. Luiz Alberto Pilatti
Authors: Rutz da Silva Sani De Carvalho , De Souza Graziela Ferreira
Published: December 2019

Este texto tem como objetivo apresentar um panorama sobre o trabalho desenvolvido na Universidade Tecnológica Federal do Paraná e estimular reflexões sobre os desafios e enfrentamentos vivenciados na educação pública de nosso país, a partir da fala do Prof. Dr. Luiz Alberto Pilatti, Reitor desta instituição. A entrevista concedida à RBECT inaugura essa seção temática, que visa ser um espaço de discussão e reflexão sobre a Área de Ensino e Educação. Nesta primeira publicação da seção “Entrevistas”, o Prof. Dr. Luiz Alberto Pilatti apresenta sua trajetória frente a reitoria da instituição, destacando os objetivos e metas traçadas para o desenvolvimento de uma universidade de classe mundial. Na entrevista, o professor também destaca o histórico da instituição e sua característica particular como a única universidade tecnológica do país, apresentando os desafios dessa peculiaridade e a importância da consolidação identitária da instituição.
Análise da trajetória subjetiva de uma professora de ciências em um curso de formação continuada: um estudo de caso
Authors: Barros Marcelo Alves , Laburú Carlos Eduardo
Published: December 2019

Este trabalho tem como objetivo analisar a trajetória subjetiva de uma professora em um curso de formação continuada de ciências de 1ª a 4ª séries. Ao analisar nossos dados foi possível identificar quatro etapas marcantes: a primeira, caracterizada por uma situação marcada por uma queixa generalizada; a segunda, pela necessidade de capacitação e superação das deficiências de conteúdo decorrentes da precária formação no magistério; a terceira, por uma ênfase nos aspectos metodológicos das atividades de ensino e; a quarta, por um engajamento e uma postura mais reflexiva. Para interpretar nossos resultados utilizamos um esquema conceitual inspirado na psicanálise de orientação lacaniana, denominado captura por discursos. Concluímos com algumas considerações para a formação de professores, em que destacamos a necessidade do professor saber identificar qual o tipo de discurso dominante empregado por ele em sala de aula, abrindo espaço para suas escolhas subjetivas.
A incomensurabilidade na ciência e suas implicações na divulgação científica a partir da epistemologia de Thomas Kuhn
Authors: Busko Paula Simone
Published: December 2019

A importância de explanar a relação entre os estudos da epistemologia à educação científica e tecnológica revela a necessidade de se promover um entendimento mais aprofundado da natureza da ciência e suas múltiplas dimensões. A incomensurabilidade da teoria de Kuhn aponta que não é possível traçar pontos comuns entre teorias divergentes, não há como direcioná-las para um mesmo ponto, há termos diferentes e linguagem específica de cada comunidade científica. Trabalhar o ensino de ciência sob alguns aspectos como o da investigação científica através de atividades que levem os alunos a questionar os conhecimentos estabelecidos como verdade única e argumentar que a transmissão de conhecimentos está relacionada a fatores históricos, sociais, culturais e políticos, por exemplo, poderão caracterizar as múltiplas faces da natureza da ciência.
Soins communautaires et pratiques en réseau pour des usagers psychotiques : le cas de l’« Open dialogue » dans le cadre d’un centre de jour à Athènes
Authors: Stylianidis Stelios
Published: December 2019

Le modèle et la pratique d’« open dialogue » ont émergé en Finlande pour soigner dans la communauté des patients présentant des troubles psychotiques graves. C’est un espace dialogique de travail en réseau inspiré du modèle systémique de thérapie familiale qui implique les usagers, la famille, le réseau de soutien et les professionnels de santé mentale. Dans cet article, nous présentons la mise en place de ce modèle dans le cadre du Centre de jour « Franco Basaglia » de l’ ong epapsy à Athénes, les résistances, les écueils et la motivation de l’équipe à créer un lieu psychique-réseau face à une situation clinique de folie à deux extrêmement difficile. Les questions ouvertes émergeant de la négociation entre processus primaire et secondaires et les processus de liaison/déliaison soulignent la nécessité d’une théorisation psychanalytique dans l’application de cette pratique innovante de réseau.
Les fantasmes des réseaux… ou les logiques imaginaires de la fraternité
Authors: Dessez Patrick
Published: December 2019

Les réseaux sont porteurs d’aspirations à travailler autrement. La facilité d’accès aux informations, la parité des fonctions, l’égalité des membres en constituent ses principes de fonctionnement. Le mode de compréhension est collaboratif et pluri-professionnel. Ils sont influencés par les cultures numériques, par la recherche du commun et par les procédures de l’organisation. Ils sont noués par les scénarios imaginaires de la fraternité et du lien fraternel. Les angoisses dominantes sont celles de la dispersion et du cercle vide. L’organisation fantasmatique sous-jacente de tels réseaux a plus trait au complexe fraternel qu’à une structuration œdipienne bien marquée. La centralité attribuée au récit narratif dans leurs élaborations groupales est certainement ce qui contribue à conserver un esprit de partage d’une réalité clinique et groupale.
Effective Management of Major Lower Extremity Wounds Using an Acellular Regenerative Tissue Matrix: A Pilot Study
Authors: Brigido Stephen A , Boc Steven F , Lopez Ramon C
Published: December 2019

Abstract

Wound healing is a significant problem in orthopedics. Graftjacket tissue matrix (Wright Medical Technology, Ine, Arlington, Tenn), a novel acellular regenerative tissue matrix, has been designed to aid wound closure. A prospective, randomized study was initiated to determine the efficacy of this tissue product in wound repair compared with conventional treatment. Lower extremity wounds are refractile to healing in patients with diabetes mellitus. Therefore, researchers used diabetic foot ulcers to evaluate the efficacy of Graftjacket tissue matrix in wound repair. Only a single administration of the tissue matrix was required. After 1 month of treatment, preliminary results demonstrate that this novel tissue matrix promotes faster healing at a statistically significant rate over conventional treatment. Because wounds in this series of patients are deep and circulation around the wound is poor, the preliminary results suggest that this tissue matrix will be applicable to other types of orthopedic wounds.
Accuracy of the Axillary Projection to Determine Fracture Angulation of the Proximal Humerus
Authors: Simon Jordan A , Puopolo Steven M , Capla Edward L , Egol Kenneth A , Zuckerman Joseph D , Koval Kenneth J
Published: December 2019

Abstract

The accuracy of measuring angulation of stable proximal humerus fractures using the axillary lateral projection was investigated. A closing wedge osteotomy with apex anterior angulation was performed on two cadaveric humeri to simulate a stable surgical neck fracture. One specimen was fixed at 30° angulation and the other at 55°. Axillary radiographs were taken with each specimen articulating with the glenoid of a cadaveric scapula. The humerus was held in neutral rotation. Abduction was set at 30°, 60°, and 90°. In each position of abduction, an axillary lateral radiograph was taken in 30° forward flexion, neutral, and 30° extension to simulate various arm positions. A total of nine radiographs were taken for each specimen.

The axillary view is not accurate for measurement of proximal humerus angulation at the arm positions commonly encountered in the trauma setting.
The Process of Seeking Stress-Care: Coping as Experienced by Senior Baccalaureate Nursing Students in Response to Appraised Clinical Stress
Authors: Shipton Sharon P
Published: December 2019

ABSTRACT

High levels of clinical stress experienced by nursing students continue to be identified in the literature. However, much is still unexplored about the coping processes of nursing students in response to appraised clinical stress. A grounded theory methodological approach was used to acquire a substantive theory of the processes through which senior baccalaureate nursing students manage the demands of the clinical person-environment relationships that are appraised as stressful and the emotions they generate. A theoretical sample of 16 volunteer senior generic nursing students from two baccalaureate nursing programs was determined by saturation of the data. Each participant was interviewed twice. The basic social problem experienced by these senior baccalaureate nursing students was the chaos created in their lives while trying to manage the demands of the appraised clinical stress (i.e., the clinical person-environment relationship). The three-stage process of seeking stress- care, including encountering changing self, loss of self, and regaining managed self, helped the students manage this chaos. Each of the stages related to the processes that transpired within the students as they dealt with the chaos created in their life while trying to manage the demands of appraised clinical stress. Implications include the development of the stress-care construct and innovative instructor interventions in the clinical setting.
Reasons for not Performing LASIK in Refractive Surgery Candidates
Authors: Sharma Namrata , Singhvi Arun , Sinha Rajesh , Vajpayee Rasik B
Published: December 2019

ABSTRACT

PURPOSE: To analyze the reasons for which LASIK was rejected in eyes of patients who requested surgical correction of their refractive errors.

METHODS: A retrospective study was performed in which data pertaining to refractive and ocular status of 338 patients who presented for refractive surgery at our LASIK facility between November 2002 and December 2003 were reviewed. The reasons for not performing LASIK in cases that were rejected were also noted.

RESULTS: Among the 338 patients who requested refractive surgery, 223 (66%) underwent LASIK; surgery was not performed in 115 (34%) patients. The most common reason for rejecting LASIK was suboptimal central corneal thickness (55.1%). High myopia >-12.00 diopters (18.4%), keratoconus (9.6%), and hyperopia (5.9%) were other significant reasons.

CONCLUSIONS: Suboptimal corneal thickness combined with a high amount of refractive error was found to be the leading cause of rejection of patients for LASIK in India. [J Refract Surg. 2005;21:496-498.]
The Effect of Tear Film on Higher Order Corrections Applied to the Corneal Surface During Wavefront-guided Refractive Surgery
Authors: Campbell Charles
Published: December 2019

ABSTRACT

PURPOSE: To investigate whether the property of the surface of a fluid film to smooth irregularities in the underlying surface will cause the tear film to partially erase the effect of higher order corrections ablated onto a corneal surface during wavefront-guided refractive surgical correction.

METHODS: Coating flow theory shows that the film surface initially replicates the underlying surface. An iteration method is given to allow calculations to be made of the tear fluid flow and resulting surface change during the time between blinks. A new experimental technique is introduced using a corneal topographer and live video imaging to observe changes in tear surface curvature as the tear film flows.

RESULTS: Tear flow changes in an eye with a high amount of aberration due to an unsuccessful LASIK procedure are simulated to show that while tear fluid occurs and causes changes in the tear/air surface, the change when expressed in terms of unwanted aberrations is below that which would cause any image degradation. Results of the live video technique on a cornea with an irregular surface 4 days after photorefractive keratectomy show that irregularities in the tear film surface immediately after a blink are not smoothed to any extent in the time before the next blink.

CONCLUSIONS: Tear film flow following initial film formation by a blink can be demonstrated by computer simulation and observed with live corneal topography video. Tear film dynamics will not erase the effects of ablative corrections for higher order aberrations. [J Refract Surg. 2005;21:S519-S524.]
Changes in Wavefront Aberration With Pharmaceutical Dilating Agents
Authors: Tuan K Ashley , Somani Seema , Chernyak Dimitri A
Published: December 2019

ABSTRACT

PURPOSE: Finding the best way to capture the wavefronts of small pupils for refractive surgery has become a more pressing issue as the general population ages. This study explores whether pharmaceutical dilation impacts wavefront measurement and pupil centroid.

METHODS: Baseline measurements were performed on 32 eyes using the VISX WaveScan Wavefront system. Pupils were dark adapted. One drop of 0.05% tropica mide was placed in each eye, and wavefront measurements were conducted at 10, 20, and 30 minutes. One drop each of 0.5% tropicamide and 2.5% phenylephrine were administered after the measurements. Wavefronts were captured again 30 minutes after the last eye drop. All patients returned for repeated procedures. Wavefront analysis was performed using the same pupillary area as the smallest capture from the same visit. Pupil center shift was taken into account.

RESULTS: Mean patient age was 40?12 years (range: 20 to 59 years). Mean dark-adapted pupil was 6.40?1.17 mm. Pupil centers shifted randomly after pharmacological dilation compared to the dark-adapted condition. Pupil centers of 45% of the population shifted by 5* 0.2 mm. Repeatability coefficients were established for the wavefront measurements. After controlling for pupil diameter and pupil center, total high order aberrations root-mean-square (RMS) had changed significantly in 18% of the population. The diluted tropicamide formula, which caused less dilation effect, also induced less high order aberration RMS change.

CONCLUSIONS: Pharmaceutical dilation agents cause random shifts of the pupil centroid from the dark-adapted pupil condition and could induce changes in wavefront measurements. Caution is required when resorting to dilation to obtain a wavefront measurement of smaller pupils. [J Refract Surg. 2005;21:S530-S534.]
Limitations of Correcting Spherical Aberration With Aspheric Intraocular Lenses
Authors: Dietze Holger H , Cox Michael J
Published: December 2019

ABSTRACT

PURPOSE: Aspheric intraocular lenses (IOLs) are designed to correct spherical aberration in Pseudophakie eyes. We predict the benefit from correcting spherical aberration based on simulations and aberrometry of Pseudophakie eyes implanted with spherical IOLs.

METHODS: Ray tracing was performed through a model eye with an equi-biconvex spherical IOL and with a spherical aberration-correcting aspheric IOL. The IOLs were increasingly tilted and/or displaced, and the resulting transverse aberrations of 169 rays were transformed into Zernike coefficients for different pupil sizes. The benefit from correcting spherical aberration at individual mesopic pupils was investigated by canceling C? in the sets of Zernike coefficients for 41 eyes implanted with a spherical IOL.

RESULTS: Both the model eye and the real eye data predict that age-related miosis reduces spherical aberration in the eye implanted with a spherical IOL to approximately 1/3 of the spherical aberration at a 6-mm pupil. A reduction of similar magnitude occurs when spherical aberration -induced non-pa raxia I defocus is corrected by a spectacle lens. For natural mesopic pupils, canceling the Zernike C? coefficient improved the objective image quality at a rate similar to changing defocus by 0.05 diopters. Average decentration and tilt levels diminish the lead of aspheric IOLs over spherical IOLs, depending on the direction of decentration.

CONCLUSIONS: The benefit from correcting spherical aberration in a Pseudophakie eye is limited for some or all of the following reasons: wearing glasses, age-related miosis, tilt and decentration of IOL, small contribution of spherical aberration to all aberrations, and intersubject variability. [J Refract Surg. 2005;21:S541-S546.]
Modal Reconstruction Methods With Zernike Polynomials
Authors: Schwiegerling Jim
Published: December 2019

ABSTRACT

PURPOSE: To compare the advantages and disadvantages of different techniques for fitting Zernike polynomials to surfaces.

METHODS: Two different methods, Orthogonal Projection and Gram-Schmidt orthogonalization, are compared in terms of speed and performance at fitting a complex object.

RESULTS: Orthogonal Projection provides an extremely rapid fitting of a surface, but leaves residual high frequency noise. The Gram-Schmidt technique provides a more accurate fit of the original object, but consumes much more computing time. Orthogonal Projection, and its associated noise, may be tolerated in classifying corneal topography.

CONCLUSIONS: Orthogonal Projection has a distinct advantage in calculation time over other methods for fitting surfaces. This advantage may be exploited in cases where accurate surface fitting is not necessary, but only general features need to be extracted for classification. If fit accuracy is needed, then slower fitting techniques, such as Gram-Schmidt, should be used. [J Refract Surg. 2005;21:S552-S557.]
Objective Quality of Vision in Presbyopic and Non-presbyopic Patients After Pseudoaccommodative Advanced Surface Ablation
Authors: Cantú Roberto , Rosales Marco A , Tepichín Eduardo , Curioca Andrée , Montes Víctor , Ramirez-Zavaleta J Gustavo
Published: December 2019

ABSTRACT

PURPOSE: To analyze the objective quality of vision at 6 months postoperatively after pseudoaccommodative (presbyopic) advanced surface ablation (PASA).

METHODS: The study comprised 62 eyes of 35 patients with 6-month follow-up that underwent primary or secondary treatments using PASA. Pre- and postoperative results of distance and near uncorrected visual acuity (UCVA), spherical aberration (coefficient of the Z12 Zernike polynomial), and the asphericity (Q) index were reviewed. The corresponding wavefront maps (total, low, and high order aberrations) and the corresponding point spread function and modulation transfer function (MTF) were also calculated.

RESULTS: Our results show that PASA improves distance and near mean UCVA, increases negative spherical aberration and negative asphericity index, and improves the corresponding MTF.

CONCLUSIONS: Pseudoaccommodative advanced surface ablation is a promising approach for the surgical correction of presbyopia with distance refractive error (myopia and hyperopia with or without astigmatism). This PASA technique could theoretically be used in non-presbyopic patients with refractive error or post cataract patients with monofocal intraocular lenses. The increase in negative spherical aberration and asphericity/eccentricity index seems to increase the depth of focus of the eye, improving the near vision and compensating the agerelated lens changes. Rather than creating a multifocal cornea, PASA appears to create an improved aspheric (prolate) ablation profile. [J Refract Surg. 2005;21(Suppl): S603-S605.]
LASIK for High Myopic Astigmatism Resulting From Perforating Ocular Injury
Authors: Khoury Johnny M , Haddad Walid F , Noureddin Baha
Published: December 2019

ABSTRACT

PURPOSE: To present a case of successful treatment of high myopic astigmatism after a perforating injury with significant corneal laceration and pupil ectopia using excimer LASIK.

METHODS: A 30-year-old man presented for treatment of high myopic astigmatism in his right eye resulting from perforating ocular trauma, which occurred 8 years prior to presentation. The corneoscleral wound repair was performed with posterior chamber intraocular lens implantation. Uncorrected visual acuity (UCVA) in the right eye was counting fingers at 1 m, best corrected to 20/30 with -7.00 +5.00 X 110. Visual acuity in the left eye was 20/20 with -1.5 D. The patient was unable to tolerate spectacles and contact lenses because of asthenopia and high astigmatism, respectively. As an alternative, LASIK with the Allegretto Wave excimer laser was performed.

RESULTS: Three months postoperatively, UCVA was 20/25 in the right eye and 20/15 in the left eye.

CONCLUSIONS: This case indicates that LASIK can be a useful surgical method for correcting high myopic astigmatism resulting from ocular trauma with significant corneoscleral laceration. [J Refract Surg. 2005;21:756-759.]
A Comparison of Induced Astigmatism in Conventional and Wavefront-guided Myopic LASIK Using LADARVision4000 and VISX S4 Platforms
Authors: Awwad Shady T , Haithcock Kelly K , Oral Deniz , Bowman R Wayne , Cavanagh H Dwight , McCulley James P
Published: December 2019

ABSTRACT

PURPOSE: To evaluate and compare the surgically induced astigmatism in myopic eyes undergoing conventional and wavefront-guided LASIK.

METHODS: A retrospective review was performed of the charts of 200 myopic eyes of 121 patients who underwent either custom or conventional treatments via the VISX S4 or LADARVision4000 platforms (50 consecutive eyes in each of the four groups). The primary outcome measure was manifest refraction, which was evaluated preoperatively and at 3 months postoperatively. The magnitude and axis of the unintended surgically induced astigmatism were calculated using vector analysis. The Student t test was used to compare the magnitudes of the surgically induced astigmatism and the absolute angle of error.

RESULTS: The mean preoperative manifest cylinder was 0.66?0.38 diopters (D) for conventional VISX S4 and 0.68?0.39 D for VISX CustomVue (P=. 795), and 0.76?0.56 D for LADARVision and 0.61?0.36 D for LADAR CustomCornea (P=. 114). The success index was 0.19?0.41 for VISX S4 and 0.49?0.49 for VISX CustomVue (P= .0013), and 0.25 ?0.47 for LADARVision and 0.20?0.39 for LADAR CustomCornea (P=.5721). The absolute mean angle of error was 4.4?13.9? for VISX S4 versus 14.9?23.9? for VISX CustomVue (P=.0085), and 6.1?12.3? for LADARVision versus 3.9?11.1? for LADAR CustomCornea (P=.3501). Of the VISX CustomVue eyes, 32% had an absolute angle of error >10?, as compared to 10% for both the VISX S4 and LADAR CustomCornea eyes (P=. 013), and 16% for the LADARVision group (P=. 056).

CONCLUSIONS: Wavefront-guided ablation is associated with higher surgically induced astigmatism and larger astigmatic axis shift on the VISX platform as compared to the LADAR CustomCornea and the LADAR and VISX conventional platforms. Care should be emphasized mainly during registration/alignment to minimize surgically induced astigmatism in wavefront-guided LASIK. [J Refract Surg. 2005;21:S792-S798.]
Higher Order Aberrations After LASIK for Myopia With Alcon and WaveLight Lasers: A Prospective Randomized Trial
Authors: Brint Stephen F
Published: December 2019

ABSTRACT

PURPOSE: To evaluate the differences in higher order aberration outcomes between bilateral wavefront-guided and wavefront-optimized LASIK treatments on two closely matched patient groups 1 and 3 months following surgery.

METHODS: Thirty patients were enrolled in the study and randomly assigned to undergo bilateral LASIK with either the Alcon CustomCornea laser system or the WaveLight Allegretto Wave laser system. Standard clinical outcomes such as visual acuity and manifest refraction were evaluated as well as quality of vision measures such as subjective questionnaires and higher order aberrations. All patients completed follow-up examinations for 3 months following surgery.

RESULTS: At 1 and 3 months after surgery, the uncorrected visual acuity and the refractive outcome were similar for the two laser platforms, with 90% to 93% eyes being within ?0.5 D of intended outcome. At 1 and 3 months the Alcon CustomCornea group had a statistically significant lower amount of induced total higher order aberrations compared to the Allegretto Wave group (P<.05).

CONCLUSIONS: LASIK for myopia with the Alcon CustomCornea and WaveLight Allegretto Wave systems is highly effective in terms of refractive outcome and uncorrected visual acuity. However, aberrations were statistically significantly greater after treatment with the WaveLight Allegretto Wave system than with the Alcon CustomCornea. [J Refract Surg. 2005;21:S799S803.]
“Now Quickly, Now Again Slowly”: Tempo Modification in and Around Praetorius
Authors: Marinčič Domen
Published: December 2019

Michael Praetorius describes tempo modification in a variety of contexts. Performers changed the speed of the tactus according to text and music, to move the affects, in accordance with dynamics or scoring, to adjust to changes in prevailing note-values, and for reasons of variety. Such practices were an important part of performance aesthetics and are confirmed by a number of German and Italian sources.
Aumento de calidad en uniones soldadas de estructuras de paredes delgadas mediante modelo de simulación
Authors: Panchuk Myroslav , Matviienkiv Oleh , Shlapak Lubomyr , Szkodo Marek , Kiełczynski Wojciech , Panchuk Andrii
Published: December 2019

El módulo de cálculo de simulación y el paquete de software solidworks han ayudado a definir la forma y las dimensiones óptimas de uniones soldadas simples que pueden servir de base para calcular los parámetros de proceso de soldadura. Habiendo comparado los modelos con diferentes secciones transversales de soldadura, el autor ha determinado que la altura y el ancho de la soldadura no afectan significativamente la concentración de tensión, y la concentración y el valor de la tensión dependen principalmente de la forma del latido de la raíz y del punto de separación entre las partes soldadas.
Qohéleth ou l’Ecclésiaste : la vanité sous le soleil
Authors: Causse Jean-Daniel
Published: December 2019

Cette contribution thématise la célèbre maxime de l’Ecclésiaste — « Vanité des vanités tout est vanité » — en tant qu’elle est un dévoilement radical des formes multiples du semblant. Dans cette perspective, l’Ecclésiaste n’appelle pas « vanité » ce qui apparaît ainsi dans l’espace social ou religieux, mais ce à quoi on accorde généralement de la valeur ou de l’importance. Il opère une démystification de tout un monde, y compris un système de causalité, illustré en particulier par la théorie religieuse de la rétribution qui établit un simple rapport de cause à effet entre l’acte juste et sa récompense ou au contraire la peine découlant de l’acte injuste. Cela étant, contrairement à ce qu’on aurait pu penser, l’Ecclésiaste ne postule pas au terme de sa réflexion l’existence d’une vérité qui, enfin débarrassée de ses artifices, se manifesterait dans toute sa splendeur. Il invite plutôt chacun à trouver sa réjouissance dans la vanité même du monde. Il ne s’agit donc pas de se défaire du semblant, mais de s’y inscrire autrement sans avoir à justifier de son être et dans l’attente de nouvelles possibilités.
Les « deux notes » de Chateaubriand
Authors: Verlet Agnès
Published: December 2019

Le vanitas vanitatum, qui est un topos inhérent au genre mémorialiste est amplifié, chez Chateaubriand, par la mélancolie romantique et se construit dans son œuvre à partir d’un syncrétisme de philosophies antiques et bibliques aux résonances stoïciennes et épicuriennes. La peinture des Vanités constitue pour lui moins une réserve thématique qu’une forme poétique qui structure son œuvre, particulièrement dans le rapport réflexif que suppose le portrait, dans un face à face avec la mort, in figura mortui. Et pour l’auteur des Mémoires d’outre-tombe, le portrait devient le plus souvent autoportrait confrontation de sa propre image à une figure allégorique ou moderne de la vanité.
Quality Management in German Higher Education
Authors: Mörth Anita
Published: December 2019

This chapter provides an insight into quality management in university continuing education at German higher education institutions. First, it sets the context by explaining the position and characteristics of university continuing education within the German higher education system as well as current provisions, existing recommendations, and concepts for quality management (QM) within this area. Based on the analysis of selected university continuing education programs, the chapter then (1) outlines crucial aspects that need to be tackled in regard to QM, (2) presents a variety of concrete quality management activities that have been put into practice, and (3) describes empirically based quality dimensions specific to university continuing education. The chapter includes possible areas for future research and development.
How Colleges and Universities Create the Value of Their Degrees
Authors: Miller Michael T. , Nadler Daniel P.
Published: December 2019

This chapter explores how colleges and universities have struggled to define who they are and what they are responsible for doing. From the understanding that society has increasingly equated educated with employed and highly compensated, the discussion highlights the formal and informal education students receive, as well as the external stakeholders who attempt to regulate this learning. Authors extend the idea of a formal curriculum to the ‘hidden curriculum,' that is, the unintended learning and experiences students encounter on campus. The hidden curriculum can play an important role in the student development process, and in many cases, has become the de facto value-added experience that an institution can offer. College policy makers and leaders can use the idea of a hidden curriculum to their advantage in working with students, but must first take the step of creating expectations of student learning and aligning their activities with learning outcomes.
Integrating MOOCs in Higher Education
Authors: Rouveix Florence , Guyon Magali , Bachelet Rémi
Published: December 2019

From the context of the emergence of MOOCs, this chapter studies the benefit of blending them with a face-to-face course in higher education. This approach highlights the wealth of opportunities offered by blended learning through the design methods and experience of the GdP MOOC that are transferable to other MOOCs. The implications for a cohort of students and in the pedagogical choices of their teacher show the advantage of a team dedicated to the partnerships to provide the interface between the format of training provided on the platform and the objectives of the host institution. From the awareness of the diversity of methods of integration into students' curricula, the question of the quality and the personalisation of the supporting tool in practical terms is based on the teachers' needs. Three functions are identified for effective blending: pedagogical scenarisation, delivering the training solution, and the methods of assessment.