Monovision LASIK in emmetropic presbyopic patients.

BackgroundTo evaluate the efficacy and patient satisfaction of laser in situ keratomileusis (LASIK) monovision correction in presbyopic emmetropic patients.MethodsA retrospective review of 294 patients who underwent LASIK for monovision was conducted. All patients had preoperative uncorrected distance visual acuity in each eye of 20/25 or better in both eyes and underwent primary LASIK treatment in one eye with a near target; 82 patients underwent surgery in the distant eye for hypermetropia. Patients completed a patient-reported-outcome questionnaire at their one-month postoperative visit. Analysis was performed on a per patient basis with a logistic regression model.ResultsPatients achieved a postoperative mean spherical equivalent of -0.05 diopters (D) in the distant eye and -1.92 D in the near eye. Prior to surgery, 64.7% (n=178) of patients reported they were satisfied or very satisfied with their vision; postoperatively, this increased to 85.4% (n=251). The greatest predictor of dissatisfaction after surgery was severe patient-reported visual phenomena (glare, halos, starbursts, ghosting) (odds ratio 1.18, P=0.001).ConclusionsLASIK monovision for presbyopic patients with low refractive error and good preoperative uncorrected distance visual acuity is both safe and effective with high patient satisfaction. Patients who were dissatisfied in the postoperative period tended to be those with postoperative visual symptoms

Informed consent in refractive surgery: in-person vs telemedicine approach.

Purpose:The aim of this study was to compare the quality of consent process in refractive surgery between patients who had a preoperative consent discussion with the surgeon using a telemedicine approach and those who had a face-to-face discussion. Methods:Patients treated between January and December 2017 (8,184 laser vision correction [LVC] and 3,754 refractive lens exchange [RLE] patients) that attended day 1 and 1-month postoperative visit were retrospectively reviewed. Preoperative consent preparation included a consultation with an optometrist, observation of an educational video, and written information. Patients then selected either a face-to-face appointment with their surgeon (in-clinic group) or a telemedicine appointment (remote group) for their consent discussion, according to their preference. Patient experience questionnaire and clinical data were included in a multivariate model to explore factors associated with consent quality. Results:Prior to surgery, 80.1% of LVC and 47.9% of RLE patients selected remote consent. Of all LVC patients, 97.5% of in-clinic and 98.3% of remote patients responded that they were adequately consented for surgery (P=0.04). Similar percentages in the RLE group were 97.6% for in-clinic and 97.9% for remote patients (P=0.47). In a multivariate model, the major predictor of patient's satisfaction with the consent process was postoperative satisfaction with visual acuity, responsible for 80.4% of variance explained by the model. Other significant contributors were postoperative visual phenomena and dry eyes, difficulty with night driving, close-up and distance vision, postoperative uncorrected distance visual acuity, change in corrected distance visual acuity, and satisfaction with the surgeon's approach. The type of consent (remote or in-clinic) had no impact on patient's perception of consent quality in the regression model. Conclusion:The majority of patients opted for telemedicine-assisted consent. Those who chose it were equally satisfied as those who had a face-to-face meeting with their surgeon. Dissatisfaction with surgical outcome was the major factor affecting patient's perception of consent quality, regardless of the method of their consent

Revisiting the Core Ontology and Problem in Requirements Engineering

In their seminal paper in the ACM Transactions on Software Engineering and Methodology, Zave and Jackson established a core ontology for Requirements Engineering (RE) and used it to formulate the "requirements problem", thereby defining what it means to successfully complete RE. Given that stakeholders of the system-to-be communicate the information needed to perform RE, we show that Zave and Jackson's ontology is incomplete. It does not cover all types of basic concerns that the stakeholders communicate. These include beliefs, desires, intentions, and attitudes. In response, we propose a core ontology that covers these concerns and is grounded in sound conceptual foundations resting on a foundational ontology. The new core ontology for RE leads to a new formulation of the requirements problem that extends Zave and Jackson's formulation. We thereby establish new standards for what minimum information should be represented in RE languages and new criteria for determining whether RE has been successfully completed.Comment: Appears in the proceedings of the 16th IEEE International Requirements Engineering Conference, 2008 (RE'08). Best paper awar

Convergence Conditions for Random Quantum Circuits

Efficient methods for generating pseudo-randomly distributed unitary operators are needed for the practical application of Haar distributed random operators in quantum communication and noise estimation protocols. We develop a theoretical framework for analyzing pseudo-random ensembles generated through a random circuit composition. We prove that the measure over random circuits converges exponentially (with increasing circuit length) to the uniform (Haar) measure on the unitary group and describe how the rate of convergence may be calculated for specific applications.Comment: 4 pages (revtex), comments welcome. v2: reference added, title changed; v3: published version, minor changes, references update

Polynomial Cointegration among Stationary Processes with Long Memory

n this paper we consider polynomial cointegrating relationships among stationary processes with long range dependence. We express the regression functions in terms of Hermite polynomials and we consider a form of spectral regression around frequency zero. For these estimates, we establish consistency by means of a more general result on continuously averaged estimates of the spectral density matrix at frequency zeroComment: 25 pages, 7 figures. Submitted in August 200

Conditional Allocation of Control Rights in Venture Capital Finance

When a young entrepreneurial firm matures, it is often necessary to replace the founding entrepreneur by a professional manager. This replacement decision can be affected by the private benefits of control enjoyed by the entrepreneur which gives rise to a conflict of interest between the entrepreneur and the venture capitalist. We show that a combination of convertible securities and contingent control rights can be used to resolve this conflict efficiently. This contractual arrangement is frequently observed in venture capital finance

Mission Design for the Lunar Pallet Lander

Marshall Space Flight Center is developing a small lunar lander capable of delivering up to 300 kg of payload to the lunar surface near the North or South Pole. Originally designed as a lander for a small rover, the Lunar Pallet Lander, has seen several design iterations over the last couple of years. This paper will cover how the vehicle and mission design changed from being a co-manifested payload candidate in NASAs Space Launch System to its current design, which could be launched with an Evolved Expendable Launch Vehicle (EELV), and reach a wide range of polar landing sites

Nominal Logic Programming

Nominal logic is an extension of first-order logic which provides a simple foundation for formalizing and reasoning about abstract syntax modulo consistent renaming of bound names (that is, alpha-equivalence). This article investigates logic programming based on nominal logic. We describe some typical nominal logic programs, and develop the model-theoretic, proof-theoretic, and operational semantics of such programs. Besides being of interest for ensuring the correct behavior of implementations, these results provide a rigorous foundation for techniques for analysis and reasoning about nominal logic programs, as we illustrate via examples.Comment: 46 pages; 19 page appendix; 13 figures. Revised journal submission as of July 23, 200