Repeatability and comparison of Corvis ST parameters before and after accelerated transepithelial corneal cross-linking in keratoconus eyes

AIM: To evaluate the repeatability and comparison of corneal visualization scheimpflug technology (Corvis ST) parameters in keratoconus eyes before and after accelerated transepithelial corneal cross-linking (ATE-CXL). METHODS: Thirty eyes of 30 progressive keratoconus patients were included in the prospective study. Three repeated corneal biomechanical measurements were performed preoperatively and one month postoperatively by Corvis ST. The interclass correlation coefficient (ICC) and 95% confidence interval (CI), Cronbach’ α, repeatability coefficient (RC), and coefficient of variation (CV) were used to evaluate the repeatability of Corvis ST parameters. Paired t test or Wilcoxon rank test was used to evaluate the differences between preoperative and postoperative data. RESULTS: At preoperative, 26 of 39 (66.67%) parameters showed good to excellent repeatability, 6 (15.38%) showed moderate, and 7 (17.95%) showed poor repeatability. Similarly, 34 (87.18%) parameters showed good to excellent repeatability, 3 (7.69%) showed moderate, and 2 (5.13%) showed poor repeatability after ATE-CXL. After ATE-CXL 1mo, the intraocular pressure (IOP), biomechanical corrected IOP (bIOP), first applanation time (A1T), Radius, deformation amplitude at the first applanation (A1DA), deflection length at the maximum deformation (HCDLL) and stiffness parameter at first applanation (SP A1) parameters increased, while the steep keratometry (Ks), flat keratometry (Kf), mean keratometry (Kmean), second applanation time (A2T), DA Ratio Max (2 mm) and integrated radius parameters decreased (all P<0.05). CONCLUSION: The repeatability of the Corvis ST parameters before and 1mo ATE-CXL follow up were both acceptable, and the corneal stiffness was improved after 1-month ATE-CXL.

Construction of learning tools based on the sets approach to empower students' environmental literacy on ecological materials

The development of learning tools with a SETS approach is considered important to foster student interest in learning and critical thinking as well as to instill and improve the level of environmental literacy of Indonesian students which is still relatively low. This study aims to determine the analysis of the needs of SETS-based learning tools, to know the process of developing SETS-based learning tools, and to determine the validity and reliability of SETS-based learning tools. The development in this study uses a 4-D model development with stages, namely define, design, develop, and disseminate. Then it is reduced to 3-D with the stages of define (defining), design (design), develop (development). This research produces a product in the form of learning tools, namely RPP (Learning Implementation Plan) and SETS-based modules. The lesson plans and modules that have been developed are then validated by five validators, namely three lecturers of Biology Education FKIP Untan, one teacher from MA Darul Ulum, and one teacher at SMAN 1 Rasau Jaya. The results of the validation of the learning tools were obtained and declared valid with the average acquisition of Aiken's V calculation of 0.84 with a minimum value of 0.80. The reliability of this learning device was tested using the ICC (Interclass Correlation Coefficient) technique with the help of the SPSS program. The reliability of the RPP obtained a result of 0.520 with a moderate category and there was an agreement between raters, while the reliability of the module obtained a result of 0.536 with moderate reliability and agreement between raters.

Hubungan Efikasi Diri dengan Kemampuan Orientasi Mobilitas Siswa Tunanetra SLB A YKAB Surakarta

Penelitian ini bertujuan untuk mengetahui hubungan antara efikasi diri dengan kemampuan orientasi mobilitas siswa tunanetra di SLB A YKAB Surakarta. Penelitian ini adalah penelitian kuantitatif dengan desain korelasional. Subjek dalam penelitian ini adalah seluruh siswa tunanetra SLB A YKAB Surakarta. Penentuan subjek pada penelitian ini dilakukan dengan teknik purposif sampling. Teknik pengumpulan data dalam penelitian ini dengan menggunakan angket efikasi diri dan tes kinerja kemampuan orientasi mobilitas. Penelitian ini menggunakan teknik uji validitas isi oleh para ahli (expert judgement) sebagai validator yang selanjutnya dihitung menggunakan Aiken’s V. Pada uji reliabilitasnya menggunakan Interclass Correlation Coefficient dengan bantuan SPSS 26. Teknik analisis data yang digunakan pada penelitian ini adalah analisis korelasi Sperman Rank. Hasil uji korelasi dalam penelitian ini menunjukkan nilai koefisien korelasi sebesar 0,654 dengan nilai rtabel 0,591, sehingga rhitung ? rtabel untuk taraf signifikansi 0,05. Berdasarkan hasil penelitian dan analisis data yang telah dilakukan, dapat disimpulkan bahwa terdapat hubungan positif yang signifikan antara efikasi diri dengan kemampuan orientasi mobilias siswa tunanetra SLB A YKAB Surakarta

Vacutainer serum separator sebagai alternatif tabung penampung darah pada pemeriksaan kadar ureum

ABSTRACT Serum using is preferred for urea level because it does not use anticoagulants which can interfere with activity and reaction to the results. The tubes that are widely used to collect blood into serum are vacutainer serum separator and vacutainer plain.This researche aims to determine the degree of agreement s between vacutainer serum separator and vacutainer plain usage on serum urea level result.This research was cross sectional design and hold on October 2020 with subject were taken from thirty blood samples of health analyst students which taken randomly and had no history of disease or kidney function disorder. Each student was taken 6 ml of blood drawn using a venoject with each vacutainer containing 3 ml, so we had 60 data. The data were analyzed by descriptively and inferentially using the Interclass Correlation Coefficient (ICC) statistical test. From the descriptive analysis, the difference in mean levels was 0.35 mg/dL and the ICC statistical test resulted in a degree of agreement 0.745. The data were analyzed by descriptively and inferentially using the Interclass Correlation Coefficient (ICC) statistical test. From the descriptive analysis, the difference in mean levels was 0.35 mg/dL and the ICC statistical test resulted in a degree of agreement was 0.745. The calculation of the average working time between the vacutainer serum separator and the vacutainer plain was 4 minutes 38 seconds and 35 minutes 58 seconds. The analysis concluded that the vacutainer serum separator and the vacutainer plain could be used as an alternative of blood collecting tubes for urea level testing which proved to be no significant difference in the results from this research. Keywords : Urea level, Vacutainer Serum Separator, Vacutainer Plain

Anatomy of the sonographic post-cesarean uterus

Purpose We aim to describe the sonographic uterine anatomy after a cesarean section (CS), test the reproducibility of predefined measurements from the BSUM study, and report the distribution of these measurements. Methods This is a descriptive observational study where 200 women with a history of only one CS were recruited 12–24 months postoperatively. A 5–13 MHz micro-convex transvaginal transducer was used for the acquisition of volumetric datasets for evaluating the CS scars. We defined 15 distinct measurements including the residual myometrial thickness (RMT). RMT ratio was calculated as a percentage of RMT to the assumed pre-cesarean anterior uterine wall thickness. A P value below 0.05 is utilized for significant statistical analysis. Results Patients were included on average 18.5 months post-cesarean. The uterus was anteflexed in 82.5% and retroflexed in 17.5%. Myometrial defects at the site of CS manifest in two forms, either as a niche or as fibrosis. Patients are classified into four groups: those with isolated niches (45%), combined niches and fibrosis (38.5%), isolated fibrosis (11%), and lacking both (5%). The median RMT ratio for these groups was 63.09, 40.93, 59.84, and 100% with a standard deviation of 16.73, 12.95, 16.59, and 0, respectively. The interclass correlation coefficient (ICC) remained above 0.9 for all distinct measurements among these groups except for those of RMT, where ICC varied between 0.47 and 0.96. The RMT ratio shows a constant ICC at 0.94 regardless of the group. Conclusion The post-cesarean uterus is often anteflexed, and a myometrial loss of about 50% is normally expected. The pattern of this loss is in the form of a predominantly sharp-edged and echogenic niche, fibrosis, or a combination of both. The proposed RMT ratio takes these changes into consideration and results in a reproducible quantification. We hypothesize that different adverse outcomes could be attributed to the different scar patterns.

Automated measurement of iris surface smoothness using anterior segment optical coherence tomography

Fuchs uveitis (FU) is a chronic and often unilateral ocular inflammation and characteristic iris atrophic changes, other than heterochromia, are common in FU and are key to the correct diagnosis in many cases. With the advent of anterior segment optical coherence tomography (AS-OCT), some investigators attempted to quantitatively study these atrophic changes; mostly by introducing various methods to measure iris thickness in AS-OCT images. We aimed to present an automated method in an observational case series to measure the smoothness index (SI) of the iris surface in AS-OCT images. The ratio of the length of the straight line connecting the most peripheral and central points of the anterior iris border (in nasal and temporal sides) to the actual length of this border on AS-OCT images, was defined as SI. In a uveitis referral center, twenty-two eyes of 11 patients with unilateral Fuchs uveitis (FU) (7 female) and 22 eyes of 11 healthy control subjects underwent AS-OCT imaging. Image J and a newly developed MATLAB algorithm were used for manual and automated SI measurements, respectively. Agreement between manual and automated measurements was evaluated with Bland–Altman analysis and interclass correlation coefficient. The inter-eye difference of SI was compared between the FU group and the control group. Automated mean overall SI was 0.868 ± 0.037 and 0.840 ± 0.039 in FU and healthy fellow eyes, respectively (estimated mean difference = − 0.028, 95% CI [− 0.038, − 0.018], p < 0.001). Bland- Altman plots showed good agreement between two methods in both healthy and FU eyes. The interclass correlation coefficient between the manual and automated measurements in the FU and healthy fellow eyes was 0.958 and 0.964, respectively. The inter-eye difference of overall SI was 0.029 ± 0.015 and 0.012 ± 0.008 in FU group and control group, respectively (p = 0.01). We concluded that the automated algorithm can rapidly and conveniently measure SI with results comparable to the manual method.

e-ASPECTS software improves interobserver agreement and accuracy of interpretation of aspects score

Introduction There is increased interest in the use of artificial intelligence-based (AI) software packages in the evaluation of neuroimaging studies for acute ischemic stroke. We studied whether, compared to standard image interpretation without AI, Brainomix e-ASPECTS software improved interobserver agreement and accuracy in detecting ASPECTS regions affected in anterior circulation LVO. Methods We included 60 consecutive patients with anterior circulation LVO who had TICI 3 revascularization within 60 minutes of their baseline CT. A total of 16 readers, including senior neuroradiologists, junior neuroradiologists and vascular neurologists participated. Readers interpreted CT scans on independent workstations and assessed final ASPECTS and evaluated whether each individual ASPECTS region was affected. Two months later, readers again evaluated the CT scans, but with assistance of e-ASPECTS software. We assessed interclass correlation coefficient for total ASPECTS and interobserver agreement with Fleiss’ Kappa for each ASPECTS region with and without assistance of the e-ASPECTS. We also assessed accuracy for the readers with and without e-ASPECTS assistance. In our assessment of accuracy, ground truth was the 24 hour CT in this cohort of patients who had prompt and complete revascularization. Results Interclass correlation coefficient for total ASPECTS without e-ASPECTS assistance was 0.395, indicating fair agreement compared, to 0.574 with e-ASPECTS assistance, indicating good agreement (P < 0.01). There was significant improvement in inter-rater agreement with e-ASPECTS assistance for each individual region with the exception of M6 and caudate. The e-ASPECTS software had higher accuracy than the overall cohort of readers (with and without e-ASPECTS assistance) for every region except the caudate. Conclusions Use of Brainomix e-ASPECTS software resulted in significant improvements in inter-rater agreement and accuracy of ASPECTS score evaluation in a large group of neuroradiologists and neurologists. e-ASPECTS software was more predictive of final infarct/ASPECTS than the overall group interpreting the CT scans with and without e-ASPECTS assistance.

Repeatability and reproducibility of apparent diffusion coefficient and fat fraction measurement of focal myeloma lesions on whole body magnetic resonance imaging

Objective: To assess intra- and inter-reader variability of apparent diffusion coefficient (ADC) and fat fraction (FF) measurement in focal myeloma bone lesions and the influence of lesion size. Methods: 22 myeloma patients with focal active disease on whole body MRI were included. Two readers outlined a small (5–10 mm) and large lesion (>10 mm) in each subject on derived ADC and FF maps; one reader performed this twice. Intra- and inter-reader agreement for small and large lesion groups were calculated for derived statistics from each map using within-subject standard deviation, coefficient of variation, interclass correlation coefficient measures, and visualized with Bland–Altman plots. Results: For mean ADC, intra- and inter-reader repeatability demonstrated equivalently low coefficient of variation (3.0–3.6%) and excellent interclass correlation coefficient (0.975–0.982) for both small and large lesions. For mean FF, intra- and inter-reader repeatability was significantly poorer for small lesions compared to large lesions (intra-reader within-subject standard variation estimate is 2.7 times higher for small lesions than large lesions (p = 0.0071), and for inter-reader variations is 3.8 times higher (p = 0.0070)). Conclusion: There is excellent intra- and inter-reader agreement for mean ADC estimates, even for lesions as small as 5 mm. For FF measurements, there is a significant increase in coefficient of variation for smaller lesions, suggesting lesions >10 mm should be selected for lesion FF measurement. Advances in knowledge: ADC measurements of focal myeloma have excellent intra- and inter-reader agreement. FF measurements are more susceptible to lesion size as intra- and inter-reader agreement is significantly impaired in lesions less than 10 mm.

Establishment of Normal Mechanical Tibial Joint Angles in Dachshunds

Objective The aim of this study was to establish breed-standard mechanical tibial joint reference angles in the frontal plane in Dachshunds. Study Design Craniocaudal (n = 38) and mediolateral (n = 32) radiographs of normal tibiae from Dachshunds were retrospectively reviewed. The mechanical medial proximal, mechanical medial distal, mechanical caudal proximal and mechanical cranial distal tibial angles were measured on three occasions by two separate observers using previously established methodology. Interclass correlation coefficient was used to assess the reliability of radiographic measurements. Results The mean and standard deviation for mechanical medial proximal, mechanical medial distal, mechanical caudal proximal and mechanical cranial distal were 93.1 degrees ± 4.2, 97.5 degrees ± 3.9, 75.3 degrees ± 3.7 and 85.0 degrees ± 5.3 respectively. Intra-observer reliability was good to excellent for all measures, while inter-observer reliability was moderate to excellent in the frontal plane and poor to good in the sagittal plane. Dachshund-specific joint reference angles were similar to a range of previously reported non-chondrodystrophic breeds in the frontal plane but differed to most in the sagittal plane. Conclusion Dachshund tibial joint reference angles are reported which can be used in surgical planning for correction of bilateral pes varus.

Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography

Fuchs uveitis (FU) is a chronic and often unilateral ocular inflammation and characteristic iris atrophic changes, other than heterochromia, are common in FU and are key to the correct diagnosis in many cases. With the advent of anterior segment optical coherence tomography (AS-OCT), some investigators attempted to quantitatively study these atrophic changes; mostly by introducing various methods to measure iris thickness in AS-OCT images. We aimed to present an automated method in a observational case series to measure the smoothness index (SI) of iris surface in AS-OCT images. The ratio of the length of the straight line connecting the most peripheral and central points of the anterior iris border (in nasal and temporal sides) to the actual length of this border on AS-OCT images, was defined as SI. In a uveitis referral center twenty-two eyes of 11 patients with unilateral Fuchs uveitis (FU) (7 female) and 22 eyes of 11 healthy control subjects underwent AS-OCT imaging. Image J and a newly developed MATLAB algorithm were used for manual and automated SI measurements, respectively. Agreement between manual and automated measurements was evaluated with Bland-Altman analysis and interclass correlation coefficient. The inter-eye difference of SI was compared between FU group and control group. Automated mean overall SI was 0.868 ± 0.037 and 0.840 ± 0.039 in FU and healthy fellow eyes, respectively (estimated mean difference = -0.028, 95% CI [-0.038, -0.018], p<0.001). Bland- Altman plots showed good agreement between two methods in both healthy and FU eyes. Interclass correlation coefficient between the manual and automated measurements in the FU and healthy fellow eyes was 0.958 and 0.964, respectively. Inter-eye difference of overall SI was 0.029 ± 0.015 and 0.012 ± 0.008 in FU group and control group, respectively (p=0.01). We concluded that he automated algorithm can rapidly and conveniently measure SI with results comparable to manual method.