bluuebunny/crossref_metadata_2025 huggingface dataset:
Pengaruh Vitamin D3 Terhadap Kadar Hemoglobin Tikus Wistar yang Dipapar Asap Rokok
Authors: Rusmini Hetti , Fitriani Dita , Hermawan Dessy , Emilda Diah Adelia
Published: December 2019

Hemoglobin is a tetrametric erythrocyte protein that carries O2 to the tissues and returns CO2 and protons to the lungs. Cigarette smoke is proven that could reduce hemoglobin levels through oxidative stress which causes the erythrocyte membrane to be easily lysed. The lysis erythrocyte membrane causes hemoglobin levels to be low. Vitamin D is included in natural antioxidants which have a neuroprotective tendency through antioxidative mechanisms. To determine the effect of giving vitamin D3 on hemoglobin levels in white rats (Rattus norvegicus) male Wistar strain after being exposed by cigarette smoke. This type of pure experimental research (tue-experiment) used pre and post with control group design. Samples were white rats (Rattus norvegicus) male Wistar strain aged 10-12 weeks with the weight of around 150-200 grams in a total of 24 individuals. Samples were divided into four groups including K1 which is not exposed by cigarette smoke and not given of vitamin D3, K2 is a group exposed by cigarette smoke but not given of vitamin D3, K3 is a group that is not exposed by cigarette smoke but given of vitamin D3 a dose of 0.2 µgr /head, P1 is a group exposed by cigarette smoke and given a vitamin D3 dose of 0.2 µgr /head. The test of paired t-test showed a significant difference p <0.05 in the K2 group with p = 0.044, the K3 group with p = 0.013, and P1 group with p = 0.037. Whereas in group 1 there was no significant difference p = 0.932. The One-way Anova test obtained results with a value of p = 0.027 (p <0.05) which means that there were significant differences between groups. The Post Hoc LSD test showed a significant difference in group 1 whit group 2 p = 0.025 and in group 2 with group 3 p = 0.012.
Evaluasi Iklim Kerja di Bagian Produksi pada Industri Keramik di Wilayah Gresik
Authors: Sunaryo Merry , Sahri Moch.
Published: December 2019

Hot work climate starts from the emergence of heat energy that comes from a heat source that is emitted directly or through an intermediary and enters the work environment, and becomes a heat pressure as an additional burden on the workforce. This can worsen health conditions and labor stamina when added to the heavy physical workload. The ceramics industry requires special and unique techniques such as combustion. The hot work climate itself can affect the physical and mental condition of workers. The impact that often occurs in workers due to the heat of work is fatigue and dehydration. The purpose of this study is to analyze the conditions of the work climate in the work environment and evaluate the work climate in the production section, which will be compared to the threshold value so that it can be used as a basis for carrying out control measures in an effort to prevent occupational diseases in the industry. This research is a descriptive study, using a cross sectional study design. Measurements of work climate carried out on 4 companies in the ceramics industry in the Gresik region with 10 measurement points in each company, are known to have results, most of which have ISBB values> 30ºC. Observations that have been carried out workloads on the ceramics industry are moderate workloads with a working time of 75% -100% with 25% rest time. based on the results of an average of 10 points from the four companies the ISBB value of measurement results is greater than the value of the NAB that has been set, with a value of 28ºC NAB. Therefore, the need to control the work climate both in its environment and its workers. These controls are general controls such as training (education / training), heat pressure control through the application of hygiene.
Pengaruh Sistem Manajemen Mutu Terhadap Kinerja Operasional Di Pt Waskita Beton Precast
Authors: Huda Miftakul , Syifaul M Luthfi
Published: December 2019

Tujuan penelitian ini adalah menguji pengaruh sistem manajemen mutu terhadap kinerja operasional perusahaan di PT. Waskita Beton Precast. Data penelitian diperoleh dari sampel 100 responden karyawan yang dipilih secara acak serta proporsional pada setiap unit kerja. Metode analisa yang digunakan dalam menguji hubungan antar konstruk laten sistem manajemen mutu terhadap kinerja operasional perusahaan adalah Structural Equation Modeling (SEM) menggunakan program AMOS V.24. Hasil penelitian menemukan bahwa sistem manajemen mutu pada karyawan dipersepsikan sudah baik oleh karyawan. Hasil pengujian pada analisis full model, menunjukkan bahwa model secara keseluruhan memenuhi kriteria model fit. Keseluruhan indikator konstruk, yaitu fokus pada pelanggan, kepemimpinan, keterlibatan personel, pendekatan proses, pendekatan sistem terhadap menejemen, peningkatan berkesinambungan, pendekatan factual dalam mengambil keputusan, dan hubungan pemasok yang saling menguntungkan adalah valid dan reliabel dalam mengukur konstruk kinerja operasional perusahaan, serta pelanggan, tanggung jawab manajemen, realisasi produk, pengukuran analisa dan perbaikan adalah valid dan reliabel dalam mengukur konstruk pengaruh sistem manajemen mutu. Pengujian hipotesis menunjukkan hasil yang konsisten dengan kajian teoritis bahwa sistem manajemen mutu berpengaruh positif dan signifikan terhadap kinerja operasional perusahaan.
Protostellar Evolution in Serpens Main: Possible Origin of Disk-size Diversity
Authors: Aso Yusuke , Hirano Naomi , Aikawa Yuri , Machida Masahiro N. , Ohashi Nagayoshi , Saito Masao , Takakuwa Shigehisa , Yen Hsi-Wei , Williams Jonathan P.
Published: December 2019

We have observed the submillimeter continuum condensations SMM2, SMM4, SMM9, and SMM11 in the star-forming cluster Serpens Main using the Atacama Large Millimeter/submillimeter Array during Cycle 3 in the 1.3 mm continuum, 12CO J = 2 − 1, SO J

N
 = 65 − 54, and C18O J = 2 − 1 lines at an angular resolution of ∼0.″55 (240 au). Sixteen sources have been detected in the 1.3 mm continuum, which can be classified into three groups. Group 1 consists of six sources showing extended continuum emission and bipolar/monopolar 12CO outflows. Although all the Group 1 members are classified as Class 0 protostars, our observations suggest evolutionary trends among them in terms of 12CO outflow dynamical time, SO emission distribution, C18O fractional abundance, and continuum morphology. Group 2 consists of four sources associated with a continuum filamentary structure and no 12CO outflows. Central densities estimated from the 1.3 mm continuum intensity suggest that they are prestellar sources in a marginally Jeans unstable state. Group 3 consists of six Spitzer sources showing point-like 1.3 mm continuum emission and clumpy 12CO outflows. These features of Group 3 suggest envelope dissipation, preventing disk growth from the present size, r ≲ 60 au. The Group 3 members are protostars that may be precursors to the T Tauri stars associated with small disks at radii, of tens of astronomical units, identified in recent surveys.
Proton–Proton Collisions in the Turbulent Solar Wind: Hybrid Boltzmann–Maxwell Simulations
Authors: Pezzi O. , Perrone D. , Servidio S. , Valentini F. , Sorriso-Valvo L. , Veltri P.
Published: December 2019

The mechanism of heating for hot, dilute, and turbulent plasmas represents a long-standing problem in space physics, whose implications concern both near-Earth environments and astrophysical systems. In order to explore the possible role of interparticle collisions, simulations of plasma turbulence—in both collisionless and weakly collisional regimes—have been compared by adopting Eulerian Hybrid Boltzmann–Maxwell simulations, being proton–proton collisions explicitly introduced through the nonlinear Dougherty operator. Although collisions do not significantly influence the statistical characteristics of the turbulence, they dissipate nonthermal features in the proton distribution function and suppress the enstrophy/entropy cascade in the velocity space, damping the spectral transfer toward large Hermite modes. This enstrophy dissipation is particularly effective in regions where the plasma distribution function is strongly distorted, suggesting that collisional effects are enhanced by fine velocity–space structures. A qualitative connection between the turbulent energy cascade in fluids and the enstrophy cascade in plasmas has been established, opening a new path to the understanding of astrophysical plasma turbulence.
Thermal State of the Intergalactic Medium at z ∼ 2–4
Authors: Telikova K. N. , Shternin P. S. , Balashev S. A.
Published: December 2019

We present a new method to infer parameters of the temperature–density relation in the intergalactic medium in the post-reionization epoch at z ∼ 2–4. This method is based on the analysis of the distribution of Lyα absorbers over column densities and Doppler parameters by the model joint probability density function. This approach allows us to measure the power-law index γ of the temperature–density relation and a certain combination of the temperature at the mean density T
0 and hydrogen photoionization rate Γ. To estimate T
0 and Γ separately, we employ measurements of the Lyα forest effective opacity and the model gas probability density function. We show that γ tends to be lower than 1.6 and reaches 1.3 at redshift ∼3. The inferred temperatures at the mean density are ∼(2 ± 0.5) × 104 K in the studied redshift range. Both these estimates favor He II reionization at z ≳ 3. We find that the hydrogen photoionization rate is ∼0.6 × 10−12 s−1, which is consistent with previous measurements.
Consequences of Energetic Magnetar-like Outbursts of Nearby Neutron Stars: 14C Events and the Cosmic Electron Spectrum
Authors: Wang F. Y. , Li Xinyu , Chernyshov D. O. , Hui C. Y. , Zhang G. Q. , Cheng K. S.
Published: December 2019

Four significant events of rapid 14C increase have taken place within the past several thousand years. The physical origin of these rapid increases is still a mystery but must be associated with extremely energetic cosmic processes. Pulsars are highly magnetized neutron stars that emit a beam of electromagnetic radiations. Any sudden release of the energy stored in the magnetic multipole field will trigger outbursts similar to the giant flares of magnetars. Here we show that the relativistic outflow from the outbursts of a nearby pulsar interacting with the interstellar medium generates a shock, which accelerates electrons to trillions of electron volts. The high-energy photons from synchrotron emission of the shock interact with Earth’s atmosphere, producing the cosmogenic nuclide 14C, which can cause the rapid 14C increases discovered in tree rings. These same relativistic electrons can account for a significant fraction of the cosmic electron spectrum in the trillion electron volts energy range, as observed by space-borne satellites. Since these outburst events can significantly affect our environment, monitoring nearby pulsars for such outbursts may be important in the future.
A Dissection of Spatially Resolved AGN Feedback across the Electromagnetic Spectrum
Authors: Fischer Travis , Smith Krista Lynne , Kraemer Steve , Schmitt Henrique , Michael Crenshaw D. , Koss Michael , Mushotzky Richard , Larson Kirsten , U Vivian , Rigby Jane
Published: December 2019

We present optical SuperNova Integral Field Spectrograph integral field spectroscopy, Hubble Space Telescope optical imaging, Chandra X-ray imaging, and Very Large Array radio interferometry of the merging galaxy 2MASX J04234080+0408017, which hosts a Seyfert 2 active galactic nucleus (AGN) at z = 0.046. Our observations reveal that radiatively driven, ionized gas outflows are successful to distances >10 kpc due to the low mass of the host system, encompassing the entirety of the observed optical emission. We also find that at large radii, where observed velocities cannot be reproduced by radiative driving models, high-velocity kinematics are likely due to mechanical driving from AGN winds impacting high-density host material. This impacting deposits sufficient energy to shock the host material, producing thermal X-ray emission and cosmic rays, which in turn promote the formation of in situ radio structure in a pseudo-jet morphology along the high-density lanes.
Combined Effects of Rotation and Age Spreads on Extended Main-Sequence Turn Offs
Authors: Gossage Seth , Conroy Charlie , Dotter Aaron , Cabrera-Ziri Ivan , Dolphin Andrew E. , Bastian Nate , Dalcanton Julianne J. , Goudfrooij Paul , Johnson L. Clifton , Williams Benjamin F. , Rosenfield Philip , Kalirai Jason , Fouesneau Morgan
Published: December 2019

The extended main-sequence turn offs (eMSTOs) of several young to intermediate age clusters are examined in the Magellanic Clouds and the Milky Way. We explore the effects of extended star formation (eSF) and a range of stellar rotation rates on the behavior of the color–magnitude diagram, paying particular attention to the MSTO. We create synthetic stellar populations based on MESA stellar models to simulate observed Hubble Space Telescope and Gaia star cluster data. We model the effect of rotation as a nonparametric distribution, allowing for maximum flexibility. In our models the slow rotators comprise the blueward, and fast rotators the redward portion of the eMSTO. We simulate data under three scenarios: nonrotating eSF, a range of rotation rates with a single age, and a combination of age and rotation effects. We find that two of the five clusters (the youngest and oldest) favor an age spread, but these also achieve the overall worst fits of all clusters. The other three clusters show comparable statistical evidence between rotation and an age spread. In all five cases, a rotation-rate distribution alone is capable of qualitatively matching the observed eMSTO structure. In future work, we aim to compare our predicted

V
sin
i

with observations in order to better constrain the physics related to stellar rotation.
Impact of Clouds and Hazes on the Simulated JWST Transmission Spectra of Habitable Zone Planets in the TRAPPIST-1 System
Authors: Fauchez Thomas J. , Turbet Martin , Villanueva Geronimo L. , Wolf Eric T. , Arney Giada , Kopparapu Ravi K. , Lincowski Andrew , Mandell Avi , Wit Julien de , Pidhorodetska Daria , Domagal-Goldman Shawn D. , Stevenson Kevin B.
Published: December 2019

The TRAPPIST-1 system, consisting of an ultracool host star having seven known Earth-sized planets, will be a prime target for atmospheric characterization with the James Webb Space Telescope (JWST). However, the detectability of atmospheric molecular species may be severely impacted by the presence of clouds and/or hazes. In this work, we perform 3D general circulation model (GCM) simulations with the LMD-G model supplemented by 1D photochemistry simulations at the terminator with the Atmos model to simulate several possible atmospheres for TRAPPIST-1e, 1f, and 1g: (1) modern Earth, (2) Archean Earth, and (3) CO2-rich atmospheres. The JWST synthetic transit spectra were computed using the GSFC Planetary Spectrum Generator. We find that the TRAPPIST-1e, 1f, and 1g atmospheres, with clouds and/or hazes, could be detected using JWST’s NIRSpec Prism from the CO2 absorption line at 4.3 μm in less than 15 transits at 3σ or less than 35 transits at 5σ. However, our analysis suggests that other gases would require hundreds (or thousands) of transits to be detectable. We also find that H2O, mostly confined in the lower atmosphere, is very challenging to detect for these planets or similar systems if the planets’ atmospheres are not in a moist greenhouse state. This result demonstrates that the use of GCMs, self-consistently taking into account the effect of clouds and subsaturation, is crucial to evaluate the detectability of atmospheric molecules of interest, as well as for interpreting future detections in a more global (and thus robust and relevant) approach.
Elemental Abundance Distributions in the (R, Vϕ) Plane with LAMOST DR5 and Gaia DR2
Authors: Liang Xilong , Zhao Jingkun , Chen Yuqin , Zuo Wenbo , Zhang Jiajun , Zhu Jia , Zhao Gang
Published: December 2019

Since Gaia DR2 was released, many velocity structures in the disk have been revealed, such as large-scale ridge-like patterns in phase space. Both kinematic information and stellar elemental abundances are needed to reveal their evolution history. We have used labels from the APOGEE survey to predict elemental abundances for a huge amount of low-resolution spectra from the Large Sky Area Multi-Object Fibre Spectroscopic Telescope survey. Deep learning with artificial neural networks can automatically draw on physically sensible features in the spectrum for their predictions. Abundances of 12 individual elements, [C/Fe], [N/Fe], [O/Fe], [Mg/Fe], [Al/Fe], [Si/Fe], [S/Fe], [Cl/Fe], [Ca/Fe], [Ti/Fe], [Mn/Fe], and [Ni/Fe], along with basic stellar labels T
eff, log g, metallicity ([M/H] and [Fe/H]), and [α/M] for 1,063,386 stars have been estimated. Then, those stars were cross-matched with Gaia DR2 data to obtain kinematic parameters. We present distributions of chemical abundances in the V

ϕ
versus R coordinate. Our results extend the chemical characterization of the ridges in the (R, V

ϕ
) plane to about R = 13 kpc toward the anticenter direction. In addition, radial elemental abundance gradients for disk stars with abs(z) < 0.5 kpc are investigated, and we fitted a line for median abundance values of bins of stars with galactocentric distance between R > 7.84 kpc and R < 15.84 kpc. The radial metallicity gradients for disk stars are, respectively, −0.0475 ± 0.0015 for R ≥ 13.09 kpc and −0.0173 ± 0.0028 for R < 13.09 kpc. Gradients for other elemental abundances are also obtained for disk stars: the [α/M] gradient is 0.0030 ± 0.0002; the [Al/Fe] gradient is 0.0030 ± 0.0002; and the [Mn/Fe] gradient is −0.0078 ± 0.0005.
Reproductive features of Pisidium casertanum (Poli, 1791) (Bivalvia: Sphaeriidae) in relict lakes of Bolshezemelskaya Tundra
Authors: Bespalaya YuV , Aksenova OV , Aksenov AS , Sokolova SE , Shevchenko AR , Travina OV , Kropotin AV
Published: December 2019

The reproductive features of the pea clam Pisidium casertanum in relict lakes of Bolshezemelskaya Tundra were studied. The P. casertanum population in the Vashutkiny Lakes of Bolshezemelskaya Tundra has a single period of summer reproduction. We suppose that the release of embryos mainly occurs between July and August and the breeding season could probably begin in May-June. The positive relationship between brood size and parent shell length was detected. We did not find a specific brooding mechanism, accompanied by asynchronous development and release of embryos by the parent in the population of P. casertanum in the Vashutkiny Lakes. The reason for this is probably related with the environmentally more stable freshwater habitats of the relict Vashutkiny Lakes in comparison with the lakes of the High Arctic.
Plant associations for three sawfly species (Hymenoptera, Tenthredinidae) in the Pacific Northwest
Authors: Baine Quinlyn , Looney Chris
Published: December 2019

Plant associations are newly recorded for three tenthredinid species in the Pacific Northwest. A singleMonardis pullaD.R. Smith, 1969 emerged from a chamber inside a cynipid gall onRosa nutkanaC. Presl. (Rosaceae). This is the first plant association record forM. pulla. TwoAphilodyctium fidum(Cresson, 1880) emerged from a stem and cynipid gall ofRosa rugibinosaLinnaeus, 1758, respectively. SeveralRhogogaster lateraria(Cresson, 1880) eggs were discovered onCastillejasp., which has no previously recorded sawfly associations.
Resilience and Culture
Authors: Stokes Mary Ann
Published: December 2019

Please click here to read the article.
Providing Psychiatric-Mental Health Care for Native Americans: Lessons Learned by a Non-Native American PMHNP
Authors: Barnard Amy G.
Published: December 2019

Providing culturally sensitive psychiatric-mental health nursing care to Native Americans requires a unique set of understandings. Traditional tribal customs and beliefs, historical events of the past 500 years, and acculturation and enculturation have affected Native Americans’ health and well-being.

In 2004, I had the opportunity to practice as a psychiatric-mental health nurse practitioner with a Native American tribe in the southwestern United States. This article describes the lessons I learned while practicing on the reservation and suggests ways other non-Native American practitioners can best serve this population.

ABOUT THE AUTHOR

Dr. Barnard is Assistant Professor, School of Nursing, University of Massachusetts, Amherst, Amherst, Massachusetts.

The author discloses that she has no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.

Address correspondence to Amy G. Barnard, PhD, APRN, BC, Assistant Professor, School of Nursing, Arnold House, University of Massachusetts, 715 N. Pleasant Street, Amherst, MA 01003-9304; e-mail: barnard@nursing.umass.edu.
Victimization of Society’s Most Vulnerable Citizens
Authors: Perese Eris F.
Published: December 2019

EXCERPT

Victimization of individuals with severe mental illness living in the community has been described by nurses and others since the early 1980s. Krauss and Slavinsky (1982) wrote that people discharged to the community “fall prey to criminal abuse” (p. 83). Even in board-and-care facilities, which might be assumed to offer some security, one third of the patients were victims of robbery and assault in a 1-year period (Lehman & Linn, 1984). More than a decade later, 30% of the members of the (then-named) National Alliance for the Mentally Ill who had severe mental illness reported being victimized in a 1-year period (Perese, 1997). Twenty-one years later, victimization rates of 25% to 38%, nearly 12 times that of the general population, are still being reported (Teplin, McClelland, Abram, & Weiner, 2005).

ABOUT THE AUTHOR

Eris F. Perese, DSN, APRN, PMH is a Clinical Associate Professor at University at Buffalo, School of Nursing, Buffalo, New York.
How Young is Too Young for Psychotropic Medication?
Authors: McGuiness Teena M.
Published: December 2019

Please click here to read a letter to the editor about this article.

 

Approximately 1.5% of preschool-age children receive prescribed psychiatric medications, and most of these prescriptions are written for off-label indications. These circumstances create numerous ethical issues. Few studies support the use of psychotropic medications in children younger than age 6. In addition, the effects of these medications are not fully understood in young children with rapidly maturing brains and bodies. Suggestions for nurses are offered.

ABOUT THE AUTHOR

Dr. McGuinness is Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama.

Address correspondence to Teena M. McGuinness, PhD, APRN, BC, Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL 35294; e-mail: teenamcg@gmail.com.
Compliance Therapy: An Intervention to Improve Inpatients' Attitudes Toward Treatment
Authors: Tay Sim-Eng Clara
Published: December 2019

Nonadherence to prescription medication is the leading cause of relapse or recurrence of psychotic illness. Literature has shown that compliance therapy, a brief intervention based on motivational interviewing and cognitive approaches, can lead to improved attitudes, adherence to treatment, and insight. This descriptive study aimed to examine the effectiveness of compliance therapy on treatment adherence. The 69 participants were patients of the same ward, either referred for patient education by the psychiatrist or selected from a convenience sample of patients on the clinical pathway of relapsed schizophrenia or major depression. Compliance therapy was conducted individually or in small groups of 2 to 3 patients. The shortened version of the Drug Attitude Inventory (DAI-10), along with a rating scale adapted from another study, was used to measure attitude and the rate of adherence before and after therapy. Patients in both individual and group sessions showed significant improvements in attitude. Those with six or more admissions had slightly less significant improvement, and those with personality disorder or substance abuse showed no significant improvement. Compliance therapy benefits patients and improves their attitude toward treatment. Psychiatric nurses could be trained in this clinical intervention to enable them to conduct compliance therapy in the hospital or in the community.
ABOUT THE AUTHOR

Ms. Tay is Psychiatric Nurse Clinician, Institute of Mental Health, Woodbridge Hospital, Singapore.

The author discloses that she has no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.

The author thanks the nurses on ward 33A for their help; Dr. Lynn Chua for her permission to use the Chinese version of the Drug Attitude Inventory-10; Ms. Wong Hung Chew for her guidance on statistical analysis; Ms. Yeo Soo Gim, Ms. Pauline Tan, and Ms. Chng Mui Lee Cecilia for their guidance and support; and Dr. Chan Yiong Huak for his help with statistical analysis.

Address correspondence to Sim-Eng Clara Tay, RN, RMN, BHSc, Grad. Dip. Psychotherapy, Psychiatric Nurse Clinician, Nursing Department (Training), Institute of Mental Health, Woodbridge Hospital, 10 Buangkok View, Singapore 539747; e-mail: sim_eng_tay@imh.com.sg.
The Use of Animal-Assisted Therapy in Psychiatric Nursing: The Story of Timmy and Buddy
Authors: Niksa Eileen
Published: December 2019

A therapy session gone wrong and a therapy dog in training having a bad day combined to remind those of us who work daily with people who have chronic, severe mental illnesses that our idea of what is successful is not always true. This is the story of how a tiny dog acting in a nontherapeutic way helped a young man learn how to get along better with other human beings, as well as how a nurse who thought she knew better learned a lesson about conflict resolution in human-animal relationships.
ABOUT THE AUTHOR

Ms. Niksa works for the Mental Health Association of Southeastern Pennsylvania.

The author thanks Aaron Katcher, MD, who developed the Certification in Animal Assisted Activities and Therapy, for his lifelong interest in and study of the effects of animals on human health. The author also thanks her dog, Buddy.

Address correspondence to Eileen Niksa, MSN, RN, CNS-Psychiatric, Mental Health Association of Southeastern Pennsylvania, 1211 Chestnut Street, 11th Floor, Philadelphia, PA 19107; e-mail: eniksa@mhasp.org or eniksa@hotmail.com
The Effect of Laser in situ Keratomileusis on Low Contrast Vision
Authors: Tumbocon Joseph Anthony J , Suresh Palanisamy , Slomovic Allan , Rootman David S
Published: December 2019

ABSTRACT

PURPOSE: To determine the effects of laser in situ keratomileusis (LASIK) on low contrast visual acuity.

METHODS: Thirty eyes of 15 LASIK patients with myopia and astigmatism were evaluated preoperatively, and 1 and 3 months postoperatively. High contrast visual acuity (HCVA), low contrast visual acuity (LCVA), and contrast threshold were determined.

RESULTS: Mean spherical correction (SE) was -3.24 ± 1.90 D; 16 eyes had a mean SE between -1.00 and -3.00 D, and 14 eyes were between -3.25 and -6.50 D. There was no significant change in HCVA observed at 1 and 3 months in any eye. There was a decrease in LCVA in eyes with a correction >3 D SE at 1 month (P=.04), which returned to normal at 3 months (P=.13). There was an increase in the contrast threshold at 1 month (P=.016). When eyes were divided into groups, those with >3D SE correction had an increase in contrast threshold at 1 month (P=.002); no change was seen in eyes with <3D SE correction (P=.15). At 3 months, contrast threshold was similar to baseline values in all eyes (P=.226).

CONCLUSION: LASIK transiently decreased low contrast visual function in patients with greater than 3.00 D of myopic correction. [J Refract Surg 2004;20(suppl):S689-S692]
Intraoperative Microkeratome Complications in 47,094 Laser in situ Keratomileusis Surgeries
Authors: Nakano Kozo , Nakano Eliane , Oliveira Marivaldo , Portellinha Waldir , Alvarenga Lenio
Published: December 2019

ABSTRACT

PURPOSE: We evaluated the incidence and intraoperative microkeratome-related complications in laser in situ keratomileusis (LASIK).

METHODS: We present non-randomized, retrospective, comparative, interventional case series. We reviewed the records of patients who underwent LASIK from August 2000 to March 2004 at Excimer Laser Santa Cruz, São Paulo, Brazil (47,094 eyes). We identified 369 eyes (0.0078%) with an intraoperative complication. Data were collected regarding microkeratome, average keratometric power, and type of complication.

RESULTS: The Hansatome microkeratome was the most common microkeratome used (34,182 eyes; 73%), followed by the Automated Corneal Shaper-ACS (11,164 eyes, 24%) and the Nidek MK-2000 (1748 eyes, 3.7%). Intraoperative complications were more common with the ACS (1.26%) than with the Hansatome (0.63%) and MK-2000 (0.63%) (P<.001; P=.03; respectively). Complications included incomplete flaps (0.23%), buttonholes (0.13%), thin flaps (0.08%), and free flaps (0.08%). Buttonholes were more frequent with the ACS (0.34%) than with the Hansatome (0.06%) (P<.001) and free flaps were more common with the ACS (0.20%) and MK-2000 (0.29%) than with the Hansatome (0.04%) (P<.001). Keratometric power of eyes with intraoperative complications was significantly higher in the ACS group compared to the Hansatome group.

CONCLUSIONS: Intraoperative complications were more common with the ACS than with the Hansatome or MK-2000. Buttonholes were most frequent with the ACS, and the Hansatome had the lowest incidence of free flaps. [J Refract Surg 2004;20(suppl):S723-S726]
Factors Influencing the Need for Enhancement After Laser in situ Keratomileusis
Authors: Perlman Elliot M , Reinert Steven E
Published: December 2019

ABSTRACT

PURPOSE: To confirm that enhancements after primary laser in situ keratomileusis (LASIK) are effective in dealing with residual refractive errors, and to determine if any variables prior to or during the primary LASIK procedure predisposed eyes to require subsequent enhancement.

METHODS: A retrospective study of eyes undergoing primary LASIK with the VISX S2 or S3 laser and Hansatome microkeratome between January 1, 2000 and January 1, 2002 was done. Of the 393 eyes of 207 patients, 58 eyes (14%) underwent enhancement within a 16-month window of the primary procedure. Statistical comparisons were made between enhanced (n=37) and non-enhanced (n=148) patients, and enhanced (n=48) and non-enhanced (n=303) eyes, treated for myopia only.

RESULTS: In comparing the primary LASIK parameters of enhanced to non-enhanced eyes in myopic patients, no significant difference was found in right vs left eye, season of the primary treatment, preoperative astigmatism, pachymetry, or amount of attempted astigmatism correction. A multivariate logistic regression analysis revealed that male gender, patient age over 45 years, and a history of recent rigid contact lens use within 6 months of primary LASIK were significantly associated with the need for enhancement.

CONCLUSION: Enhancements were an effective way of dealing with residual refractive errors after primary LASIK. Age greater than 45 years or a history of recent rigid contact lens use were significantly associated with the need for enhancement in patients with myopia or myopic astigmatism. [J Refract Surg 2004;20:783-789]
Effect of Optical Zone Ablation Diameter on LASIK-induced Higher Order Optical Aberrations
Authors: Mok Kwok Hei , Lee Vincent Wing-hong
Published: December 2019

ABSTRACT

PURPOSE: To compare the postoperative higher order aberrations among eyes that had received conventional laser in situ keratomileusis (LASIK) treatment at different optical zone diameters using the Alcon LADARVision 4000 platform (Alcon, Ft Worth, Tex).

METHODS: Monochromatic wavefront aberrations at 6.5-mm pupil size of 96 eyes of 96 Hong Kong Chinese patients with normal myopic astigmatism were objectively measured using the Alcon LADARWave aberrometer before and after (at least 6 months) conventional LASIK with the Autonomous LADARVision 4000 excimer laser. Patients were divided into three groups according to optical zone diameter - group 1 (n=32), optical zone diameter <6.5 mm; group 2 (n=32), optical zone diameter 6.5 mm; and group 3 (n=32), optical zone diameter >6.5 mm).

RESULTS: Mean optical zone diameters of groups 1, 2, and 3 were 6.2±0.1 mm, 6.5±0.0 mm, and 6.9±0.2 mm, respectively. Total higher order, coma, and spherical aberrations before LASIK were 0.67 ±0.27 µm, 0.27±0.17 µm, and 0.41±0.14 µm in group 1; 0.56±0.26 µm, 0.28±0.15 µm, and 0.32±0.11 µm in group 2; and 0.62±0.25 µm, 0.34±0.15 µm, and 0.37 ±0.09 µm in group 3. After surgery, the aberrations increased to 1.20±0.21 µm, 0.71±0.25 µm, and 0.70±0.19 µm in group 1; 0.97±0.18 µm, 0.47±0.22 µm, and 0.69±0.13 µm in group 2; and 0.91±0.20 µm, 0.41±0.22 µm, and 0.56±0.12 µm in group 3. Compared to group 1, groups 2 and 3 had significantly less coma aberrations after LASIK (P =.03); the total high order aberration in group 3 was also significantly lower than in group 1 (P=. 04) after treatment.

CONCLUSIONS: In conventional LASIK treatment using the Alcon LADARVision 4000 platform, a larger surgical optical zone diameter significantly decreases higher order aberrations after LASIK. [J Refract Surg. 2005;21:141-143.]
Visual Acuity and Corneal Topographic Changes Related With Pterygium Surgery
Authors: Yagmur Meltem , Özcan Altan A , Sari Suphi , Ersöz T Reha
Published: December 2019

ABSTRACT

PURPOSE: Applied pre- and postoperative corneal topography outcomes with visual acuities were evaluated to determine the surgical results in pterygium therapy.

METHODS: The study group consisted of 30 eyes of 26 patients with primary and recurrent pterygium. Mean patient age was 52.26±11.50 years (range: 27 to 68 years). Pre- and postoperative visual acuity and corneal topography were evaluated for each case. Statistical analysis was performed using the repeated-measure test.

RESULTS: The mean uncorrected visual acuity was 0.41±0.30 preoperatively and 0.63±0.26 postoperatively (P<.001). The mean best spectacle-corrected visual acuity was 0.59±0.28 preoperatively and 0.84±0.22 postoperatively (P<.001). Surface regularity index ranged from 1.96±1.08 preoperatively to 1.09±0.76 postoperatively (P<.001). The mean surface asymmetry index was 3.05±2.85 preoperatively and 1.39±1.70 postoperatively (P=.003). The mean topographic astigmatism was 4.65±3.02 preoperatively and 2.33±2.26 postoperatively (P=.003).

CONCLUSIONS: Examination of the topographic records reveals pterygium-associated corneal flattening in the horizontal meridian along the line of the pterygium. The improvement in topographic pattern and best spectacle-corrected visual acuity can be used as one indicator of the success of pterygium surgery. [J Refract Surg. 2005;21:166-170.]
Racial Differences in Central Corneal Thickness and Refraction Among Refractive Surgery Candidates
Authors: Yo Christopher , Ariyasu Reginald G
Published: December 2019

ABSTRACT

PURPOSE: To examine the preoperative central corneal thickness and refractive status of Caucasians, Hispanics, Asians, and African Americans in a refractive surgery patient population.

METHODS: In a retrospective case series, a total of 803 consecutive eyes, which had no history of anterior segment surgery, underwent central corneal thickness and refraction measurement as part of a preoperative evaluation for refractive surgery from December 1999 to October 2002. Preoperative central corneal thickness was measured by a DGH-550 ultrasonic pachymeter, and spherical equivalence was determined by manifest refraction.

RESULTS: This study included Caucasian (34.4%), Hispanic (34.5%), Asian (20.7%), African American (8.9%), and other (1.5%) patients. A one-way analysis of variance (ANOVA) revealed no significant differences in the central corneal thickness measurements among Asians, Hispanics, and Caucasians. However, mean central corneal thickness was 14 µm thinner in African Americans compared to Caucasians, and was significantly different at the 95% confidence interval. A one-way ANOVA revealed a significant difference in the preoperative spherical equivalence among the four groups (F=4.91; df=3; P<.05) but no significant differences were noted in the preoperative astigmatism among any of the four groups (F=I. 08; df=3; P>.05). A significant difference was noted in age in the four preoperative groups.

CONCLUSIONS: Among the refractive population, African Americans were found to have thinner central corneal thickness than Caucasians. Asians were significantly (P<.05) more myopic compared to Caucasians, Hispanics, and African Americans. No difference was noted in the preoperative astigmatism among any of the four groups. Asians sought refractive surgery at a younger age whereas Caucasians sought it at an older age. [J Refract Surg. 2005;21:194-197.]
Optical Quality and Depth-of-field of Eyes Implanted With Spherical and Aspheric Intraocular Lenses
Authors: Marcos Susana , Barbero Sergio , Jiménez-Alfaro Ignacio
Published: December 2019

ABSTRACT

PURPOSE: To compare experimental optical performance in eyes implanted with spherical and aspheric intraocular lenses (IOLs).

METHODS: Corneal, total, and internal aberrations were measured in 19 eyes implanted with spherical (n=9) and aspheric (n=10) IOLs. Corneal aberrations were estimated by virtual ray tracing on corneal elevation maps, and total aberrations were measured using a second -generation laser ray tracing system. Corneal and total wave aberrations were fit to a Zernike polynomial expansion. Internal aberrations were measured by subtracting corneal from total wave aberrations. Optical performance was evaluated in terms of root-meansquare (RMS) wavefront error and Strehl ratio (estimated from the modulation transfer function). Depth-of-field was obtained from through-focus Strehl estimates from each individual eye.

RESULTS: Corneal aberrations increased after I OL implantation, particularly astigmatism and trefoil terms. Third and higher order RMS (and the corresponding Strehl ratio) were significantly better in eyes with aspheric IOLs than with spherical IOLs; however, this tendency was reversed when astigmatism was included. Spherical aberration was not significantly different in eyes with aspheric IOLs, whereas it was significantly positive in eyes with spherical IOLs. Third order aberrations were not significantly different across groups. Depth-of-field was significantly larger in eyes with spherical IOLs. Spherical IOLs showed better absolute optical quality in the presence of negative defocus > 1.00 D.

CONCLUSIONS: Our study shows a good degree of compensation of the corneal spherical aberration in eyes implanted with aspheric IOLs, as opposed to eyes implanted with spherical IOLs. Other sources of optical degradation, both with aspheric and spherical IOLs, are non-symmetric preoperative corneal aberrations, incision-induced aberrations, and third order internal aberrations. Although best corrected optical quality is significantly better with aspheric IOLs, tolerance to defocus tended to be lower. [J Refract Surg. 2005;21:223-235.]
Intracorneal Hydrogel Lenses and Corneal Aberrations
Authors: Alió Jorge L , Shabayek Mohamed Helmy , Montes-Mico Robert , Múlet M Emilia , Ahmed Ahmed Galal , Merayo Jesús
Published: December 2019

ABSTRACT

PURPOSE: To investigate the optical performance of the cornea based on corneal aberrometry following intracorneal hydrogel lens implantation.

METHODS: A retrospective, nonconsecutive, observational study of the anterior corneal surface aberration profile of four hyperopic eyes previously implanted with an intracorneal hydrogel lens were studied by videokeratographic elevation maps before and 6 months after surgery.

RESULTS: Intracorneal hydrogel lenses reduced the optical performance in all four eyes by increasing the spherical aberrations by a mean factor of 1.87 and 1.95, coma aberrations by a mean factor of 2.98 and 3.01, and total higher order aberrations by a mean factor of 2.6 and 2.17 at 3.0-mm and 6.5-mm pupils, respectively (P<.005).

CONCLUSIONS: Intracorneal hydrogel lenses decreased the optical performance of the cornea by significantly increasing spherical, coma, and total higher order aberrations. [J Refract Surg. 2005;21:247-252.]
Effect of Refractive and Topographic Astigmatic Axis on LASIK Correction of Myopic Astigmatism
Authors: Bragheeth Mohamed A , Dua Harminder S
Published: December 2019

ABSTRACT

PURPOSE: To evaluate whether agreement or disagreement between the axis of astigmatism as determined by refraction and corneal topography has any influence on the outcome of laser in situ keratomileusis (LASIK) correction of astigmatism.

METHODS: Charts of 122 consecutive eyes of 75 patients (46 women and 29 men) who underwent uncomplicated, primary LASIK for myopic astigmatism were reviewed. The series was divided into two groups - group 1, "agreement" (77 eyes) with a difference between refractive and topographic axis of astigmatism =sl5°, and group 2, "disagreement" (45 eyes) with a difference >15°.

RESULTS: The mean difference in axis of astigmatism was 10°±17.20° (range: 0° to 86°), and 63.11% of eyes were within a 15° difference. A significant negative correlation was found between the percentage of corrected astigmatism and the degree of disagreement. The percentage of corrected astigmatism differed significantly between the two groups (P=. 002) with better results in group 1 (agreement).

CONCLUSIONS: Disagreement between refractive and topographic astigmatic axis is common. Approximately one third of eyes with astigmatism have >15° disagreement. Disagreement between refractive and topographic determination of the astigmatic axis can be considered a prognostic factor for LASIK correction of myopic astigmatism. [J Refract Surg. 2005;21:269-275.]
Automated Lamellar Keratoplasty for Recurrent Granular Corneal Dystrophy After Phototherapeutic Keratectomy
Authors: Chen Wei , Qu Jia , Wang Qinmei , Lu Fan , Barabino Stefano
Published: December 2019

ABSTRACT

PURPOSE: To evaluate the safety and efficacy of automated lamellar keratoplasty for the treatment of recurrent granular corneal dystrophy after phototherapeutic keratectomy (PTK).

METHODS: We performed a prospective interventional noncomparative case study of nine eyes (seven patients) with severe recurrent granular corneal dystrophy after PTK. An automated microkeratome was used to cut partial-thickness sections through the anterior surface of the donor and host corneas. The donor disc was placed on the recipient bed with four or eight interrupted sutures. The sutures were removed between 4 and 6 weeks postoperatively. Visual acuity, corneal clarity, corneal thickness, and corneal topography were assessed before and at different time points after surgery.

RESULTS: During a mean follow-up period of 18.9±4.1 months, all grafts were transparent without visible opacity at the interface, and no serious complications occurred. In all cases, the visual acuity improved: seven eyes had best spectacle-corrected visual acuity of >20/40; two eyes reached 20/25. At last follow-up >12 months postoperatively, the mean corneal refractive power had significantly increased by 2. 34 ±0.93 diopters (D) (P<.001), and the corneal astigmatism significantly decreased by 0.91±0.98 D (P<.05). The mean corneal thickness was 477.4 ±26.9 µm preoperatively and 507.8±23.4µm at last follow-up (P<.001).

CONCLUSIONS: Our findings suggest that automated lamellar keratoplasty for the treatment of recurrent granular corneal dystrophy is a safe and effective method of improving visual acuity, but recurrence remains a risk. [J Refract Surg. 2005;21:288-293.]
Learning Aids of Risk Assessment Apps For Practical Engineering Student: A Case Study
Authors: Khamis Nor Kamaliana , Abdul Azam Amirul Mukhlish
Published: December 2019

In today's learning approaches for engineering students, practical courses frequently complement traditional theoretical lectures. This practical element allows an early perspective into the real world of engineering, augments student motivation, and enables students to acquire soft skills early. This paper aims to demonstrate the usage of one of the ergonomics risk assessment (ERA) apps that has been learned in the class; which can also be used as an assessment aid in student’s practical sessions in the workplace. This apps has been evaluated for its effectiveness by a group of students in the classroom setting prior to be used in the actual workplace. Evaluation results show that this learning aid improves student’s communication skills and assists companies to improve their working conditions. Based on the effectiveness assessment, students find that this apps is really useful for their assessment as it provides fast calculation on the results and can store it in the drive. Based on the practical session in the workplace, the findings from the ERA apps show that the current working condition in this study is under medium ergonomic risk exposure level. Therefore, there is a need to improve the working condition by considering improvement on the workplace environment as well as interaction between worker and tools for maintenance. This app is indeed beneficial for practical engineering students as a peer learning process and for industry in terms of work place improvements. In conclusion, this paper describes how this risk assessment app helps induce student to think as an actual engineer and also to solve real-world tasks with limited resources.
Customer Journey Construction of the Indonesian Open-Education Resources Platform
Authors: Santoso Harry Budi , Desprianto Danan Arief , Nurrohmah Isnaeni , Nursalamah Rahma Khairunisa , Putra Panca O. Hadi
Published: December 2019

Indonesia Open-Educational Resources (IOER) need an approach to design a massive open online course (MOOC) interaction to accommodate users’ needs and suggestions. The purpose of this research is to implement customer journey as an alternative approach for developing a MOOC’s interaction design. An online questionnaire, requirement gathering, prototyping, and contextual interview were used to support this research. As a result, there are three phases of customer journey consisting of planning, learning, and completion. In addition, a MOOC interaction design prototype was produced to depict the result.
Utilization of Contextual Knowledge Elements in 3D CAD Model Visualization from the Perspectives of Practicing Engineers
Authors: Adnan Mohd Fahmi , Daud Mohd Fadzil , Saud Muhammad Sukri , Wan Hussin Wan Nazdah
Published: December 2019

Today’s industry force demands for knowledgeable and skillful engineering graduates in using modern Computer Aided Design (CAD) tools. However, current practices show that there is a lack of contextual knowledge among Mechanical Engineering undergraduates and fresh graduate engineers in utilizing 3D CAD modeling software to develop a good product design. Hence, a study to address this issue is conducted by focusing on the representation of contextual knowledge in 3D CAD modeling. This article focused on presenting essential elements of contextual knowledge utilized among practicing engineers in their daily design works, in the aspect of Model Visualization. This study was conducted using a transcendental phenomenology approach. Four practicing engineers from engineering department of one shipbuilding company in Peninsular Malaysia were purposively selected to be studied. From the analysis, there are three most frequent emerging themes in the application of contextual knowledge in visualizing and presenting model using 3D CAD modeling: Realization, Design Intention and Normalization. These three elements play an important role in helping engineers to contextualize their design work during the stage of visualizing and presenting created model for new product development process.