Ametropia detection using a novel, compact wavefront autorefractor

Introduction: Despite the well-known reproducibility issues of subjective refraction, most studies evaluating autorefractors compared differences between the device and subjective refraction. This work evaluated the performance of a novel handheld Hartmann–Shack-based autorefractor using an alternative protocol, which considered the inherent variability of subjective refraction. Methods: Participants underwent an initial measurement with a desktop autorefractor, two subjective refractions (SR1 and SR2) and a final measurement with the QuickSee Free (QSFree) portable autorefractor. Autorefractor performance was evaluated by comparing the differences between the QSFree and each of the subjective refractions with the difference between the subjective refractions (SR1 vs. SR2) using Bland–Altman analysis and percentage of agreement. Results: A total of 75 subjects (53±14years) were enrolled in the study. The average difference in the absolute spherical equivalent (M) between the QSFree and the SR1 and SR2 was ±0.24 and ±0.02D, respectively, that is, very similar or smaller than the SR1 versus SR2 difference (±0.26D). Average differences in astigmatic components were found to be negligible. The results demonstrate that differences between QSFree and both subjective refractions in J0 and J45 were within ±0.50 D for at least 96% of the measurements. The limits of agreement (LOAs) of the differences between QSFree and SR1, as well as QSFree and SR2, were higher than those observed between SR1 and SR2 for M, J0 and J45. Conclusions: A protocol was designed and validated for the evaluation of a refractive device to account for the variability of subjective refraction. This protocol was used to evaluate a novel portable autorefractor and observed a smaller difference between the device and subjective refractions than the difference between the two subjective refraction measurements in terms of mean bias error, although the standard deviation was higherComunidad de Madrid, Grant/Award Number: IND-15478, IND2019/TIC-17116 and IND2020/TIC-17340; Ministerio de Economía y Competitividad, Grant/Award Number: RYC-2016-21125; National Eye Institute, Grant/ Award Number: R44EY025452; Translational Research Institute for Space Health, Grant/ Award Number: NASA NNX16AO69

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Alquimia, Ocultismo, Maçonaria: o ouro e o simbolismo hermético dos cadinhos (Séculos XVIII e XIX)

Este artigo apresenta a arqueologia das enigmáticas marcas impressas na base de cadinhos dos séculos XVIII e XIX recuperados nas escavações da Casa da Moeda do Rio de Janeiro, na década de 1980, e a explanação do seu significado simbólico à luz da alquimia, do ocultismo e da Maçonaria. Espraiando-se extraordinariamente mundo afora através de uma bem-sucedida estratégia de comunicação visual, a Maçonaria utilizou símbolos herméticos para a difusão de seus princípios nos mais diferentes suportes. Aparentemente estamos diante de um sinal de reconhecimento maçônico, o sinal exterior de uma organização oculta, só partilhado por iniciados e incompreensível para os demais, que contribuiu para difundir veladamente a doutrina maçônica por diferentes pontos do globo

La Auriculopuntura con semillas en el tratamiento del asma bronquial en edad pediátrica

Se realizó un estudio descriptivo investigativo en el Policlínico Docente "19 de Abril" durante el año 1996 en el que se incluyó a 97 niños portadores de asma bronquial, cuyas edades oscilaban entre 1 y 14 años. Fueron tratados con auriculopuntura usando el método de pega y presión, con semillas Wang Bu Liu Xin, desarrollado por la escuela de la profesora Huan Li Chung. Se obtuvo una disminución del uso de medicamentos durante la crisis y la intercrisis, así como del número de pacientes clasificados como asmáticos severos y moderados; incrementándose por ende el total de pacientes con asma ligera.<br>A descriptive and investigative study was conducted at the "19 de Abril" Teaching Polyclinic during 1996. 97 children carriers of bronchial asthma, who were between 1 and 14 years old, were treated with auriculopuncture by the method of sticking and pressuring with Wang Bu Liu Xin seeds, a method that is developed by the school of professor Huan Li Chung. It was possible to reduce the use of drugs during the crises and intercrises, as well as the number of patients classified as severe and moderate asthmatic patients. As a result, there was an increase of patients with mild asthma

Systematicity and Variation In Word Structure Processing Across Languages: A Neuro-Typology Approach

ESRC Funded grant project running March 1st 2021-Sept. 30 2024. PI: Linnaea Stockall, QMUL

Contribution of Snow to Arctic First‐Year and Multi‐Year Sea Ice Mass Balance Within the Last Ice Area

We present the δ18O isotope composition of 16 multi-year ice (MYI) and eight first-year ice (FYI) cores collected during spring from the Lincoln Sea, a region within the Last Ice Area, which is expected to retain MYI longest into the future. Isotopic signatures were used to quantify the contribution of snow to sea ice mass. These estimates yield a higher total snow contribution in MYI (10 ± 5%) than to FYI (4 ± 2%). Converted to Snow Depth Equivalent (SDE), MYI had five times larger SDE (0.79 ± 0.38 m) than FYI (0.16 ± 0.11 m). The difference is explained by the contribution of refrozen surface and under-ice melt ponds as well as superimposed/interposed ice for MYI resulting from higher accumulation of snow over multiple, longer accumulation seasons compared to FYI. Given the impending replacement of MYI by FYI, the large difference in absolute snow contributions between MYI and FYI highlights the potential implications in terms of the redistribution of precipitation-derived (meteoric) freshwater throughout the Arctic Ocean. Furthermore, we observed high relative snow contributions to ice mass in the surface of one-third of older FYI cores, which we attributed to flooding and formation of snow-ice. Our results support the premise that flooding events on FYI may be more prevalent throughout the Arctic Ocean than previously assumed