Comparison of Anterior Segment Optical Tomography Parameters Measured Using a Semi-Automatic Software to Standard Clinical Instruments

10.1371/journal.pone.0065559PLoS ONE86

Comparison of central corneal thickness and anterior chamber depth measurements using three imaging technologies in normal eyes and after phakic intraocular lens implantation

Contains fulltext : 81835.pdf (Publisher’s version ) (Open Access)BACKGROUND: The repeatability and interchangeability of imaging devices measuring central corneal thickness (CCT) and anterior chamber depth (ACD) are important in the assessment of patients considering refractive surgery. The purpose of this study was to investigate the agreement of CCT and ACD measurements using three imaging technologies in healthy eyes and in eyes after phakic intraocular lens implantation (pIOL). METHODS: In this comparative study, CCT and ACD were measured using anterior segment optical coherence tomography (AS-OCT), Orbscan II, and Pentacam in 33 healthy volunteers (66 eyes) and 22 patients (42 eyes) after pIOL implantation. Intraobserver repeatability was evaluated for all three devices in the healthy volunteer group. RESULTS: Pairwise comparison of CCT measurements showed significant differences between all devices (P < 0.001), except for the AS-OCT and Orbscan II in the healthy volunteer group (P = 0.422) and the Orbscan II and Pentacam in the pIOL group (P = 0.214). ACD measurements demonstrated significant differences between all pairwise comparisons in both groups (P < or = 0.001). Intraobserver reliability was high for CCT and ACD measurements in the healthy volunteer group, with coefficients of variation ranging from 0.6% to 1.2% and 0.4% to 0.5% respectively. CONCLUSIONS: CCT and ACD measurements using AS-OCT, Orbscan II, and Pentacam demonstrated high intraobserver reliability. However, these devices should not be used interchangeably for measurements of CCT and ACD in healthy subject and patients after pIOL implantation

ESL programs at U.S. community colleges: a multistate analysis of placement tests, course offerings, and course content

When U.S. English learners (ELs) attend college, they are more likely to enroll in 2‐year community colleges than in 4‐year colleges. Prior research points to the tension between English as a second language (ESL) programs providing support to ELs and lengthy ESL programs acting as barriers to ELs seeking access to mainstream college coursework. Nevertheless, community college ELs and ESL programs remain understudied. The researchers investigated community college ESL placement, course sequence length, and types of ESL courses offered across the United States by examining the 2017–2018 catalogs of community colleges in nine states. Two hundred seventy‐two community college catalogs were analyzed. Findings include that 81% of colleges reported offering some ESL‐specific coursework and that ESL course sequences varied on average from 2.3 to 4.7 semesters in length across states. For most states studied, ESL courses were solely structured around skills‐based instruction. Furthermore, although general English placement information was accessible and often standardized within states, ESL placement information was rarely available and sometimes out of date. Based on these findings, the authors recommend that community college ESL programs implement valid placement procedures, award college credit for ESL coursework, and streamline student access to discipline‐specific academic and vocational content.Accepted manuscrip

Complex needs in homelessness practice; a review of 'new markets of vulnerability'

This article reviews institutional responses to adult homeless people, to argue that there is a contemporary flourishing of debates about complex needs across homelessness research and practice fields. These understand housing need as a mental and physical health issue and a care and support need, with foundations in biographical and societal events, issues and experiences, including trauma. Responses to complex needs are conceptualised as enterprising in scope; articulated as fresh, proactive, preventative and positive. The article suggests that there are a range of legislative, policy and funding drivers for these developments, from across homelessness, housing support and adult social care fields, which are distinctive to the English context. At the same time, debates about what complex needs are, and how best to respond to them, are evident in international debates about service delivery models with homeless service users in the Global Western North. ‘Complex needs’ is defined as a travelling concept, with affective qualities, which provides foundation for practice interventions, techniques and principles in different locations. The article conceptualises institutional machinations around the governance of complex needs as ‘new markets of vulnerability’. This term theorises new markets and new marketising strategies around complex needs in the context of a much larger reconfiguring of the mixed economies of welfare around markets and market mimicking devices and practices. It is argued that the intensification of activities around complex needs give insight into processes of neoliberalisation in contemporary modernized welfare ‘mixes’

Model to predict endothelial cell loss after iris-fixated phakic intraocular lens implantation.

Purpose: To describe a model predicting endothelial cell (EC) loss after iris-fixated phakic intraocular lens (pIOL) implantation, taking distance from the edge of the pIOL to endothelium into account. Methods: This prospective observational study, monitored long term EC changes in 306 eyes after pIOL implantation. EC density (ECD) was determined preoperatively, 6 months postoperatively and then yearly, up to 8 years postoperatively. Mean follow-up was 31.7 +/- 25.7 months. All eyes underwent anterior segment optical coherence tomography to determine minimum distance from the edge of the pIOL to endothelium. Linear mixed model analysis was performed to present a model which describes EC loss as a linear decrease and an additional decrease depending on the postoperative edge-distance of the patient. Results: Mean minimum edge-distance was 1.43 +/- 0.23mm (range 0.70-2.21mm). For this mean edge-distance, the model predicted a yearly EC loss of 1.0%, whereas an edge-distance of 1.20mm resulted in a yearly EC loss of 1.7%, and 1.66mm led to a yearly EC loss of only 0.2%. Furthermore, the model predicted that for patients with preoperative ECDs of 3000, 2500 or 2000 cells/mm2 and edge-distances of 1.43mm, a critical ECD of 1500 cells/mm2 (at which point pIOL explantation and cataract extraction can still safely be performed) will be reached at 56, 37, and 18 years after implantation. Conclusions: The presented model predicts EC loss after iris-fixated pIOL implantation in relation to the measured edge-distance, patient age, and preoperative ECD, which can assist ophthalmologists in patient selection and follow-up process of pIOLs