Ophthalmoscopy

2009 ◽  
Author(s):  
Daniel A. Brinton ◽  
Charles P. Wilkinson
Keyword(s):  
Optical System ◽  
Indirect Method ◽  
Direct Method ◽  
Standard Of Care ◽  
Field Of View ◽  
Resolving Power ◽  
Optical Components ◽  
Indirect Ophthalmoscopy ◽  
Direct Ophthalmoscopy

Indirect viewing systems, including the binocular indirect ophthalmoscope and slit lamp biomicroscopy through an indirect lens, have become the standard of care for management of retinal detachments. Comparison with direct ophthalmoscopy illustrates the capabilities of indirect systems. The technique of indirect ophthalmoscopy with scleral depression is presente The characteristics of direct and indirect ophthalmoscopy are compared in Table 3–1. Figure 3–1A shows the optical principles of direct ophthalmoscopy, and Figure 3–1B illustrates the optics of the indirect method. Substantial clinical differences between the two methods are due to the differences in optical characteristics. The direct ophthalmoscope offers 14X magnification compared with 3X with the indirect using the usual +20 diopter lens. However, this does not mean the direct device has an equal advantage in resolution. Resolution is a function of how close together two points can be and remain distinguished as separate when viewed through an optical system. The visualization of detail that an optical system permits is a function of its resolving power and not its magnifi cation. Resolution is a function of the light available at the points to be resolved and of the quality of the optical components of the system. Magnification plays a role only if the resolution of the optical system exceeds the resolution of the observing human eye at a given level of magnification. Too much magnification of a poorly resolved image results in a loss of detail, such as if one were to examine a halftone newspaper photograph under a microscope. With the direct method, the greater the degree of myopia, the higher the magnification of the fundus image and the smaller the field of view. In very high myopes, the field of view with the direct instrument becomes very limited. High cylindric errors strongly and adversely affect the image of direct ophthalmoscopy because the high magnification of the system also magnifies the effects of refractive errors on the image. With the indirect method, the lower magnification minimizes this effect. Furthermore, the condensing lens can be tilted slightly to overcome astigmatic aberrations. Examination of the retinal periphery entails the travel of light obliquely through the cornea and lens, introducing cylindrical aberrations that are likewise problematic with the direct ophthalmoscope and easily overcome with the indirect.

scholarly journals Pengaruh Variasi Mutu Beton Bertulang Terhadap Cepat Rambat Gelombang Dengan Menggunakan Metode Non Destructive Test

2020 ◽  
Vol 14 (1) ◽  
pp. 60-69
Author(s):  
A.A. Lingga Ariya D. ◽  
◽  
Indradi Wijatmiko ◽  
Christin Remayanti Nainggolan ◽  
◽  
...  
Keyword(s):  
Reinforced Concrete ◽  
Indirect Method ◽  
Direct Method ◽  
Ultrasonic Pulse Velocity ◽  
Pulse Velocity ◽  
Reinforced Concrete Beams ◽  
Building Structures ◽  
Non Destructive ◽  
Test Objects

Preferably in testing, building structures need not be destroyed. Tests that can be used on the concrete can use non-destructive methods that do not damage the test objects. Examples of testing can use UPV tests that are aimed at knowing the quality of concrete from the pulse velocity. The test objects used in this study are reinforced concrete beams with dimensions 20 x 20 x 100 cm. Test objects are differentiated into 3 quality variations of reinforced concrete with quality of concrete12.5 MPa, 18.75 MPa, and 25 MPa. To conduct analysis of the concrete density used PUNDIT PL-200. Ultrasonic pulse velocity into parameters on this test. From the results of the tests, there are differences in the value of different coefficient of the R2 determination. Acquired coefficient value of determination R2 = 0.9076 in direct method. The coefficient value of determination R2 = 0.8718 in the semi-direct method. Coefficient value of determination R2 = 0.3042 at Indirect Method 2 point, and in indirect method 3 point the coefficient value of determination R2 = 0.7524. From this research also obtained comparisons between the three methods, namely between the direct method and the semi-direct method, direct method and indirect method, also semi-direct method and indirect method.

scholarly journals The influence of the microbial quality of wastewater, lettuce cultivars and enumeration technique when estimating the microbial contamination of wastewater-irrigated lettuce

2016 ◽  
Vol 15 (2) ◽  
pp. 228-238 ◽  
Author(s):  
P. Makkaew ◽  
M. Miller ◽  
N. J. Cromar ◽  
H. J. Fallowfield
Keyword(s):  
Indirect Method ◽  
Microbial Contamination ◽  
Direct Method ◽  
Composite Sample ◽  
Microbial Quality ◽  
E Coli ◽  
Linear Relationships ◽  
Different Parts ◽  
Surrogate Method

This study investigated the volume of wastewater retained on the surface of three different varieties of lettuce, Iceberg, Cos, and Oak leaf, following submersion in wastewater of different microbial qualities (10, 102, 103, and 104E. coli MPN/100 mL) as a surrogate method for estimation of contamination of spray-irrigated lettuce. Uniquely, Escherichiacoli was enumerated, after submersion, on both the outer and inner leaves and in a composite sample of lettuce. E. coli were enumerated using two techniques. Firstly, from samples of leaves – the direct method. Secondly, using an indirect method, where the E. coli concentrations were estimated from the volume of wastewater retained by the lettuce and the E. coli concentration of the wastewater. The results showed that different varieties of lettuce retained significantly different volumes of wastewater (p < 0.01). No statistical differences (p > 0.01) were detected between E. coli counts obtained from different parts of lettuce, nor between the direct and indirect enumeration methods. Statistically significant linear relationships were derived relating the E. coli concentration of the wastewater in which the lettuces were submerged to the subsequent E. coli count on each variety the lettuce.

scholarly journals Use of an advanced collagen matrix dressing on patients with complex chronic lower extremity ulcers: A case series

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110136
Author(s):  
Afsaneh Alavi ◽  
Jeannine Archer ◽  
Patricia Coutts
Keyword(s):  
Wound Healing ◽  
Lower Extremity ◽  
Ethylenediaminetetraacetic Acid ◽  
Case Series ◽  
Standard Of Care ◽  
Collagen Matrix ◽  
Contact Layer ◽  
Complete Healing ◽  
Average Decrease

The objective of this case series was to assess the wound healing effectiveness of a collagen matrix wound dressing containing partially denatured collagen, carboxymethyl cellulose, alginate and ethylenediaminetetraacetic acid in chronic lower extremity ulcers. A total of nine patients with refractory lower extremity ulcers were treated with the collagen contact layer in addition to standard of care. Wound healing progress was measured at 2, 4 and 8 weeks. An average decrease in wound size of 73% was achieved across patients at week 8, with complete healing in two patients. The intervention was easy to use and well tolerated by patients. The results of this study, although preliminary, suggest that the advanced collagen matrix dressing represents an effective and safe treatment strategy for healing refractory chronic lower extremity ulcers of varying etiologies. Further investigation is needed to evaluate efficacy in a larger randomized clinical trial with focus on cost-effectiveness and impact on patient’s quality-of-life.

Improving the quality of disaggregated SDG indicators with cluster information for small area estimates

2020 ◽  
Vol 36 (4) ◽  
pp. 955-961
Author(s):  
Rizky Zulkarnain ◽  
Dwi Jayanti ◽  
Tri Listianingrum
Keyword(s):  
Small Area ◽  
Research University ◽  
Direct Method ◽  
Random Effect ◽  
Auxiliary Information ◽  
District Level ◽  
Small Areas ◽  
Associate Dean ◽  
Development Goals

The increasing needs for more disaggregated data motivates National Statistical Offices (NSOs) to develop efficient methods for producing official statistics without compromising on quality. In Indonesia, regional autonomy requires that Sustainable Development Goals (SDGs) indicators are available up to the district level. However, several surveys such as the Indonesian Demographic and Health Survey produce estimates up to the provincial level only. This generates gaps in support for district level policies. Small area estimation (SAE) techniques are often considered as alternatives for overcoming this issue. SAE enables more reliable estimation of the small areas by utilizing auxiliary information from other sources. However, the standard SAE approach has limitations in estimating non-sampled areas. This paper introduces an approach to estimating the non-sampled area random effect by utilizing cluster information. This model is demonstrated via the estimation of contraception prevalence rates at district levels in North Sumatera province. The results showed that small area estimates considering cluster information (SAE-cluster) produce more precise estimates than the direct method. The SAE-cluster approach revises the direct estimates upward or downward. This approach has important implications for improving the quality of disaggregated SDGs indicators without increasing cost. The paper was prepared under the kind mentorship of Professor James J. Cochran, Associate Dean for Research, Prof. of Statistics and Operations Research, University of Alabama.

scholarly journals Impact of simple, specific, verbal instructions on the quality of bowel preparation in hospitalized patients undergoing colonoscopy: a multicenter randomized controlled trial

2021 ◽  
Vol 09 (03) ◽  
pp. E378-E387
Author(s):  
Konstantinos Triantafyllou ◽  
Paraskevas Gkolfakis ◽  
Alexandros Skamnelos ◽  
Georgia Diamantopoulou ◽  
Athanasios Dagas ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Intervention Group ◽  
Standard Of Care ◽  
Hospitalized Patients ◽  
Verbal Instructions ◽  
Multicenter Randomized Controlled Trial ◽  
The Impact

Abstract Background and study aims Bowel preparation for colonoscopy is frequently inadequate in hospitalized patients. We explored the impact of specific verbal instructions on the quality of inpatients bowel preparation and factors associated with preparation failure. Patients and methods Randomized (1:1), two strata (mobilized vs. bedridden; 3:2) trial of consecutive inpatients from four tertiary centers, who received either specific, verbal instructions or the standard of care (SOC) ward instructions about bowel preparation. The rate of adequate bowel preparation (Boston Bowel Preparation Score [BBPS] ≥ 6, no segment < 2) comprised the primary endpoint. Mean BBPS score, good (BBPS score ≥ 7, no segment score < 2) and excellent (BBPS = 9) were among secondary endpoints. Results We randomized 300 inpatients (180 mobile) aged 71.7 ± 15.1 years in the intervention (49.7 %) and SOC (50.3 %) groups, respectively. Overall, more patients in the intervention group achieved adequate bowel preparation, but this difference did not reach statistical significance neither in the intention-to-treat [90/149 (60.4 %) vs. 82/151 (54.3 %); P = 0.29] nor in the per-protocol analysis [90/129 (69.8 %) vs. 82/132 (62.1 %); P = 0.19]. Overall BBPS score did not differ statistical significantly in the two groups, but the provision of specific verbal instructions was associated with significant higher rates of good (58.1 % vs. 43.2 %; P = 0.02) and excellent (31.8 % vs. 16.7 %; P = 0.004) bowel preparation compared to the SOC group. Administration of same-day bowel preparation and patient American Society of Anesthesiologists score > 2 were identified as risk factors for inadequate bowel preparation. Conclusions Provision of specific verbal instructions did not increase the rate of adequate bowel preparation in a population of mobilized and bedridden hospitalized patients.

Superabsorbent Wound Dressing for Management of Patients With Moderate-to-Highly Exuding Chronic Leg Ulcers: An Early Stage Model-Based Benefit–Harm Assessment

2021 ◽  
pp. 153473462110093
Author(s):  
Vladica M. Velickovic ◽  
Jean P. Lembelembe ◽  
Francisco Cegri ◽  
Ivana Binic ◽  
Amr B. Abdelaziz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Stage ◽  
Absolute Risk ◽  
Standard Of Care ◽  
Risk Difference ◽  
Wound Dressings ◽  
Leg Ulcers ◽  
Related Quality ◽  
Health Related

The aim of the research is to assess the benefit–harm of superabsorbent polymers wound dressings based on polyacrylate polymers (SAPs) compared with standard of care (SoC) dressing mix for patients with moderate-to-highly exuding hard-to-heal leg ulcers. The SoC dressings mix was composed of other superabsorbents in 29% of cases, antimicrobials 26%, foams 20%, alginates 5%, and other dressings 19% weighted according to their frequency. We have used the decision-analytic modeling method, Markov process, as an adequate analytical solution for medical prognosis. We have combined the systematic literature search to identify the most relevant inputs for the analysis, with available patient-level clinical data concerning benefits of superabsorbent to generate a robust prediction of patient-relevant outcomes, including healing rates and health-related quality of life. Besides, we have qualitatively described adverse events associated with those treatments. Our research indicates that SAPs when compared with SoC dressing mix in a patient with moderate-to-highly excluding leg ulcers are leading to an improved healing rate with an absolute risk difference of 2.20% in 6 months and a relative risk of 1.07 in favor of SAP dressings. The attributable fraction among those exposed to SAP dressings of 6.6%, meaning that 6.6% of the healed ulcers could be attributed to having had the SAP dressing treatment instead of the SoC dressing treatment. Besides, SAP dressings lead to improved quality of life measured as incremental quality-adjusted life weeks (QALWs) of 0.13 QALWs.

scholarly journals Diagnostic Capabilities of a Smartphone- Based Low-Cost Microscope

2020 ◽  
Vol 6 (3) ◽  
pp. 522-525
Author(s):  
Dorina Hasselbeck ◽  
Max B. Schäfer ◽  
Kent W. Stewart ◽  
Peter P. Pott
Keyword(s):  
Low Cost ◽  
Field Of View ◽  
Parasitic Diseases ◽  
Optical Parameters ◽  
Trade Off ◽  
Resource Limited ◽  
Wide Range ◽  
Diagnostic Applications ◽  
Diagnostic Capabilities

AbstractMicroscopy enables fast and effective diagnostics. However, in resource-limited regions microscopy is not accessible to everyone. Smartphone-based low-cost microscopes could be a powerful tool for diagnostic and educational purposes. In this paper, the imaging quality of a smartphone-based microscope with four different optical parameters is presented and a systematic overview of the resulting diagnostic applications is given. With the chosen configuration, aiming for a reasonable trade-off, an average resolution of 1.23 μm and a field of view of 1.12 mm2 was achieved. This enables a wide range of diagnostic applications such as the diagnosis of Malaria and other parasitic diseases.

scholarly journals 225Actinium-labeled prostate-specific membrane antigen targeting peptide induces complete response in a metastatic prostate cancer patient

2021 ◽  
Vol 10 (5) ◽  
pp. 205846012110225
Author(s):  
Omer Aras ◽  
Stefan Harmsen ◽  
Richard Ting ◽  
Haluk B Sayman
Keyword(s):  
Prostate Cancer ◽  
Standard Of Care ◽  
Complete Response ◽  
Prostate Specific Membrane Antigen ◽  
Limited Data ◽  
Castrate Resistant Prostate Cancer ◽  
Targeting Peptide ◽  
Castrate Resistant ◽  
Specific Membrane

Targeted radionuclide therapy has emerged as a promising and potentially curative strategy for high-grade prostate cancer. However, limited data are available on efficacy, quality of life, and pretherapeutic biomarkers. Here, we highlight the case of a patient with prostate-specific membrane antigen (PSMA)-positive metastatic castrate-resistant prostate cancer who displayed complete response to 225Ac-PSMA-617 after having been resistant to standard-of-care therapy, then initially partially responsive but later resistant to subsequent immunotherapy, and resistant to successive 177Lu-PSMA-617. In addition, the patient’s baseline germline mutation likely predisposed him to more aggressive disease.

scholarly journals Wide field-of-view crossed Dragone optical system using anamorphic aspherical surfaces

2018 ◽  
Vol 57 (15) ◽  
pp. 4171 ◽  
Author(s):  
Shingo Kashima ◽  
Masashi Hazumi ◽  
Hiroaki Imada ◽  
Nobuhiko Katayama ◽  
Tomotake Matsumura ◽  
...  
Keyword(s):  
Optical System ◽  
Field Of View ◽  
Wide Field ◽  
Wide Field Of View

Changes in weight and weight-related quality of life in a multicentre, randomized trial of aripiprazole versus standard of care

2008 ◽  
Vol 23 (8) ◽  
pp. 561-566 ◽  
Author(s):  
Ronette L. Kolotkin ◽  
Patricia K. Corey-Lisle ◽  
Ross D. Crosby ◽  
Hong J. Kan ◽  
Robert D. McQuade
Keyword(s):  
Quality Of Life ◽  
Clinical Symptoms ◽  
Clinical Trial Data ◽  
Standard Of Care ◽  
Random Regression ◽  
Sexual Life ◽  
Baseline Body Mass Index ◽  
Meaningful Change ◽  
Related Quality

AbstractBackgroundThis is a secondary analysis of clinical trial data collected in 12 European countries. We examined changes in weight and weight-related quality of life among community patients with schizophrenia treated with aripiprazole (ARI) versus standard of care (SOC), consisting of other marketed atypical antipsychotics (olanzapine, quetiapine, and risperidone).MethodFive-hundred and fifty-five patients whose clinical symptoms were not optimally controlled and/or experienced tolerability problems with current medication were randomized to ARI (10–30 mg/day) or SOC. Weight and weight-related quality of life (using the IWQOL-Lite) were assessed at baseline, and weeks 8, 18 and 26. Random regression analysis across all time points using all available data was used to compare groups on changes in weight and IWQOL-Lite. Meaningful change from baseline was also assessed.ResultsParticipants were 59.7% male, with a mean age of 38.5 years (SD 10.9) and mean baseline body mass index of 27.2 (SD 5.1). ARI participants lost an average of 1.7% of baseline weight in comparison to a gain of 2.1% by SOC participants (p < 0.0001) at 26 weeks. ARI participants experienced significantly greater increases in physical function, self-esteem, sexual life, and IWQOL-Lite total score. At 26 weeks, 20.7% of ARI participants experienced meaningful improvements in IWQOL-Lite score, versus 13.5% of SOC participants. A clinically meaningful change in weight was also associated with a meaningful change in quality of life (p < 0.001). A potential limitation of this study was its funding by a pharmaceutical company.ConclusionsCompared to standard of care, patients with schizophrenia treated with aripiprazole experienced decreased weight and improved weight-related quality of life over 26 weeks. These changes were both statistically and clinically significant.

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