The Influence of Analysis Mode Selection on Prediction Accuracy of Corneal Astigmatism Using Pentacam

Purpose: To evaluate the influence of analysis mode selection on prediction accuracy of corneal astigmatism using Pentacam.Methods: Fifty-nine eyes of 59 patients implanted with toric intraocular lenses (IOLs) were included in the retrospective study. Preoperative corneal astigmatism (total refractive power) measured with Pentacam was analyzed based on 2-, 3-, 4-, or 5-mm ring or zone mode either centered on corneal apex or pupil center. Actual corneal astigmatism was calculated based on residual astigmatism on the corneal plane, surgical-induced astigmatism, and effective toric power on the corneal plane. Prediction error, the difference between actual corneal astigmatism and measured astigmatism, was compared among different analysis modes. Influences of local topography on prediction error were also evaluated.Results: Based on the zone mode, prediction error was lower when centered on corneal apex than on pupil center at different diameters, whereas based on the ring mode, this difference was only seen at 2-mm cornea (all P < 0.05). When centered on the corneal apex, the zone mode showed lower prediction error than the ring mode at 4- and 5-mm corneas (both P < 0.001), regardless of asymmetric or symmetric astigmatism. In symmetric bowtie, the zone mode showed lower prediction error than the ring mode at 2-mm cornea of the small bowtie, and 4- and 5-mm corneas of the large bowtie (all P < 0.05).Conclusions: For toric IOL planning, the corneal apex may be a better reference center. At a cornea diameter ≥4 mm, the zone mode is more accurate than the ring mode. Local topography affects prediction accuracy in the symmetric bowtie.

Programming Directional Deep Brain Stimulation in Parkinson’s Disease: A Randomized Prospective Trial Comparing Early versus Delayed Stimulation Steering

<b><i>Introduction:</i></b> Programming directional leads poses new challenges as the optimal strategy is yet to be established. We designed a randomized control study to establish an evidence-based programming algorithm for patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation with directional leads. <b><i>Methods:</i></b> Fourteen consecutive patients were randomized to programming with either early or delayed (i.e., starting with a “ring mode”) steered stimulation. Motor scores, number of programming visits, calls to the clinic, battery consumption, and stimulation adjustments required were recorded and compared between groups, using the Wilcoxon signed-ranks test, after 3 months of open-label programming. <b><i>Results:</i></b> Thirteen patients (25 electrodes) were included, of which 23 were steerable. Nine out of 14 electrodes allocated to delayed steered stimulation were changed to steered mode due to side effects during the course of the study. No patients (11 electrodes) initially allocated to early steered stimulation were converted to ring mode. The 2 study arms did not differ in any of the considered measures at 3 months. <b><i>Conclusion:</i></b> Programming with early or delayed steered stimulation is equally effective in the short term. However, delayed steering is less time consuming and is not always needed.

Simulation and Experiment of a Kind of Thin-Walled Tube Crushing Member Used for Antiimpact Column

In order to solve the problem of poor antiimpact ability of hydraulic support under rock bursting, a kind of thin-walled cylinder crushing component used in the composite spiral antiimpact device was developed, and different structural models were proposed and simulated. On this basis, the model was verified by experiments. The results show that the arrangement of the hollow structure can restrain the ring mode deformation and Euler instability of the tube member in the crushing yield and can carry out the buckling deformation according to the expected crushing force during the compression deformation process and effectively reduce the initial peak force. The arrangement of guide grooves can make the buckling deformation more stable and regular, which can effectively reduce the initial peak force and elastic displacement. With the smaller wall thickness and the smaller wall thickness of the induced groove, the effective deformation yield stroke of the crushing member increases, and the initial peak force, total energy absorption, average reaction force, and elastic displacement decrease. The simulation results are consistent with the experimental results which will be used in the future works.

Laser–Material Interactions of High-Quality Ultrashort Pulsed Vector Vortex Beams

Diffractive multi-beams based on 1 × 5 and 2 × 2 binary Dammann gratings applied to a spatial light modulator (SLM) combined with a nanostructured S-wave plate have been used to generate uniform multiple cylindrical vector beams with radial and azimuthal polarizations. The vector quality factor (concurrence) of the single vector vortex beam was found to be C = 0.95 ± 0.02, hence showing a high degree of vector purity. The multi-beams have been used to ablate polished metal samples (Ti-6Al-4V) with laser-induced periodic surface structures (LIPSS), which confirm the polarization states unambiguously. The measured ablation thresholds of the ring mode radial and azimuthal polarizations are close to those of a Gaussian mode when allowance is made for the expected absolute intensity distribution of a ring beam generated from a Gaussian. In addition, ring mode vortex beams with varying orbital angular momentum (OAM) exhibit the same ablation threshold on titanium alloy. Beam scanning with ring modes for surface LIPSS formation can increase micro-structuring throughput by optimizing fluence over a larger effective beam diameter. The comparison of each machined spot was analysed with a machine learning method—cosine similarity—which confirmed the degree of spatial uniformity achieved, reaching cosθ > 0.96 and 0.92 for the 1 × 5 and 2 × 2 arrays, respectively. Scanning electron microscopy (SEM), optical microscopy and white light surface profiling were used to characterize and quantify the effects of surface modification.

Directional sensory thalamus deep brain stimulation in poststroke refractory pain

Thalamic deep brain stimulation (DBS) for chronic pain is performed in selected patients with a variable success rate. We report the use of recently developed directional DBS in a patient with hemibody central poststroke pain (CPSP) and its added value in the induction of pleasant, pain-distracting paresthesia’s throughout the contralateral body side. A 68-year-old man suffered from multiple strokes in the left hemisphere 11 years before presentation, resulting in medically refractory right-sided hemibody CPSP. He was implanted with a directional DBS electrode in the left ventrocaudal nucleus of the thalamus. A directional single-segment contact configuration produced a better improvement throughout the contralateral body side than ring-mode and other directional configurations. Treatment led to a reduction of almost 50% in pain. This case demonstrates the value of directional DBS in the treatment of chronic pain, as steering increases selectivity and reduces side effects in a small target area surrounded by structures with high functional diversity.