Empowering patients with high myopia:The significance of education

Purpose: To investigate the status of patient education among highly myopic individuals focusing on the presence, sources, content, timing of the education and impact on patients. Methods: Self-reported data were collected through an online 13-item questionnaire consisting of open and multiple-choice questions. The questionnaire was sent to 250 highly myopic members of a patient organization in the Netherlands, of whom 128 (51%) responded. Results: At least one acute event had occurred in 66% (84/128) of participants at the time of the questionnaire. Among all participants, 25% (32/128) had not received patient education regarding alarm symptoms for any of these events. Among those who had been informed, the ophthalmologist was the most frequent (57%, 73/128) source of information. Participants who visited the ophthalmologist annually were more frequently informed than participants without annual visits (53%, 26/49 versus 26%, 9/35, p = 0.002). Those not informed were more likely to have a more than 3 days patient delay (92%, 12/13). Doctors delay was also present; 26% (22/84) of the participants with alarm symptoms had to wait 2 or more days before the first appointment. Long-term consequences of myopia had been discussed with 102 participants (80%, 102/128), again with the ophthalmologist as the most frequent source (59%, 76/128). Perspectives: Many myopic individuals have not been educated about their increased risk of acute events, which can result in patient delay and serious consequences with respect to visual prognosis. These findings underscore the critical importance of integrating patient education across the entire ophthalmic care chain for myopia.</p

Automatic mode tracking for flight dynamic analysis using a spanning algorithm

Identifying and tracking dynamic modes in a multi-dimensional parameter space is a problem that presents itself in many engineering disciplines. In a flight dynamics context, the dynamic modes refer to the modes of motion obtained from a linearisation of the aircraft system about a known operating point. Typically dynamic results derived from these linear models are unsorted, where mode indices are unrelated from one operating point to the next. When varying the parameters, or in this case operating point, difficulties in automating the process of relating modes from a linear system derived at one parameter set to the next exists. This paper builds on the work in tracking modes in a structural context, using the Modal Assurance Criterion (MAC) to numerically relate modes from two comparable linear systems. The (MAC) is deployed within a spanning algorithm to discover and identify all modes within all conditions, with their relationship to adjacent/neighbouring conditions. This is tested on a 1-, 2- and 3-dimensional parameter space, twelve state system

Characterization of PECVD Silicon Nitride Photonic Components at 532 and 900 nm Wavelength

Low temperature PECVD silicon nitride photonic waveguides have been fabricated by both electron beam lithography and 200 mm DUV lithography. Propagation losses and bend losses were both measured at 532 and 900 nm wavelength, revealing sub 1dB/cm propagation losses for cladded waveguides at both wavelengths for single mode operation. Without cladding, propagation losses were measured to be in the 1-3 dB range for 532 nm and remain below 1 dB/cm for 900 nm for single mode waveguides. Bend losses were measured for 532 nm and were well below 0.1 dB per 90 degree bend for radii larger than 10 mu m

Life Cycle of Multi Technology Machine Tools – Modularization and Integral Design

AbstractFor reasons of high flexibility but still maximum productivity, machine tools integrating various production technologies have recently received particular attention. Combining and integrating multiple manufacturing techniques into one single system in early stages of the product emergence process is challenging. To keep the effort for implementation to a minimum, an initiation already in the concept phase is being actively pursued. Design guidelines are currently investigated based on the examination of different technology combinations.This approach focuses on systematic conceptual design for such hybrid machine technologies. Product architectures are used to describe the modularity and create a specific delimitation for standardization. Reference product architectures for Multi Technology Machine Tools (MTMT) carry high potential for saving expenses in product development. The main emphasis is on technology and system integration. A technological similarity assessment of the single processes involved forms the basis of this approach to assure potential for synergies. Monetary aspects in early stages of product development are considered. Based on the analysis a generic system model is connected with general product architectures for MTMT.The method introduced is validated by a Multi-Technology Machining Centre with two simultaneously usable workspaces integrating a milling spindle and two laser processing units. The research undertaken is part of the Cluster of Excellence “Integrative Production Technology for High-Wage Countries” and has been funded by German Research Foundation (DFG)

Proof of concept of high-rate decentralized pre-composting of kitchen waste : optimizing design and operation of a novel drum reactor

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A view from the clinic – Perspectives from Dutch patients and professionals on high myopia care

Purpose: To understand and compare perspectives of patients and professionals on current ophthalmologic care for high myopia, and to identify challenges and future opportunities. Methods: Self-reported data were collected through two online questionnaires. Patient perspective was obtained from highly myopic members of a patient organisation based in the Netherlands using a 17-item questionnaire consisting of open and multiple-choice questions regarding personal experience with myopia care. The ophthalmologist perspective was obtained from practising Dutch ophthalmologists with a 12-item questionnaire of multiple-choice questions on work-related demographics, myopia care in daily practice and need for improvement. The response rate for patients was 27% (n = 136/500) and for ophthalmologists, 24% (n = 169/716). Results: Patients were highly concerned about personal progressive loss of vision (69%) and feared their psychological well-being (82%) in case this would happen. The quality of performance of care provided by ophthalmologists was rated as excellent or satisfactory by 64% of the patients. These ratings for multidisciplinary care and insurance reimbursement were as low as 28% and 18% respectively. The mean concern among ophthalmologists about the rise in high myopia was 6.9 (SEM 0.1) on a 10-point scale. Sixty-nine per cent of the ophthalmologists reported that asymptomatic myopic patients should not be examined regularly at outpatient clinics. Ophthalmologists urged the development of clinical guidelines (74%), but did report (95%) that they informed patients about risk factors and complications. This contrasted with the view of patients, of whom 42% were discontent with information provided by ophthalmologists. Conclusions: These questionnaires demonstrated that the current clinical care delivered to highly myopic patients is in need of improvement. The expected higher demand for myopia care in the near future requires preferred practice patterns, professionals specifically trained to manage myopic pathology, accurate and comprehensive information exchange and collaboration of in- and out-of-hospital professionals across the full eye care chain.</p

Differential Forms on Log Canonical Spaces

The present paper is concerned with differential forms on log canonical varieties. It is shown that any p-form defined on the smooth locus of a variety with canonical or klt singularities extends regularly to any resolution of singularities. In fact, a much more general theorem for log canonical pairs is established. The proof relies on vanishing theorems for log canonical varieties and on methods of the minimal model program. In addition, a theory of differential forms on dlt pairs is developed. It is shown that many of the fundamental theorems and techniques known for sheaves of logarithmic differentials on smooth varieties also hold in the dlt setting. Immediate applications include the existence of a pull-back map for reflexive differentials, generalisations of Bogomolov-Sommese type vanishing results, and a positive answer to the Lipman-Zariski conjecture for klt spaces.Comment: 72 pages, 6 figures. A shortened version of this paper has appeared in Publications math\'ematiques de l'IH\'ES. The final publication is available at http://www.springerlink.co

Assessing the Impact of Blood Pressure on Cardiac Function Using Interpretable Biomarkers and Variational Autoencoders

Maintaining good cardiac function for as long as possible is a major concern for healthcare systems worldwide and there is much interest in learning more about the impact of different risk factors on cardiac health. The aim of this study is to analyze the impact of systolic blood pressure (SBP) on cardiac function while preserving the interpretability of the model using known clinical biomarkers in a large cohort of the UK Biobank population. We propose a novel framework that combines deep learning based estimation of interpretable clinical biomarkers from cardiac cine MR data with a variational autoencoder (VAE). The VAE architecture integrates a regression loss in the latent space, which enables the progression of cardiac health with SBP to be learnt. Results on 3,600 subjects from the UK Biobank show that the proposed model allows us to gain important insight into the deterioration of cardiac function with increasing SBP, identify key interpretable factors involved in this process, and lastly exploit the model to understand patterns of positive and adverse adaptation of cardiac function

Iron, manganese and aluminum solubility with permafrost thaw in an Arctic peatland: coupled geochemical and geophysical measurements

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