Effect of anatomical differences and intraocular lens design on negative dysphotopsia

Purpose: To assess the effect of ocular anatomy and intraocular lens (IOL) design on negative dysphotopsia (ND).Setting: Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.Design: Ray-tracing study based on clinical data.Methods: Ray-tracing simulations were performed to assess the effect of anatomical differences and differences in IOL design on the peripheral retinal illumination. To that end, eye models that incorporate clinically measured anatomical differences between eyes of patients with ND and eyes of pseudophakic controls were created. The anatomical differences included pupil size, pupil centration, and iris tilt. The simulations were performed with different IOL designs, including a simple biconvex IOL design and a more complex clinical IOL design with a convex-concave anterior surface. Both IOL designs were analyzed using a clear edge and a frosted edge. As ND is generally considered to be caused by a discontinuity in peripheral retinal illumination, this illumination profile was determined for each eye model and the severity of the discontinuity was compared between eye models.Results: The peripheral retinal illumination consistently showed a more severe discontinuity in illumination with ND-specific anatomy. This difference was the least pronounced, 8%, with the frosted edge clinical IOL and the most pronounced, 18%, with the clear edge biconvex IOL.Conclusions: These results show that small differences in the ocular anatomy or IOL design affect the peripheral retinal illumination. Therewith, they can increase the severity of ND by up to 18%. Copyright (c) 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of ASCRS and ESCRSOphthalmic researc

STUDI DESKRIPTIF LEVEL BERPIKIR GEOMETRI VAN HIELE SISWA DI SMP NEGERI PERCONTOHAN DI LEMBANG

Geometri sekolah mempunyai peluang besar untuk dipahami oleh siswa dibandingkan dengan cabang ilmu matematika yang lainnya. Hal ini dikarenakan pengenalan konsep dasar geometri sudah dikenal oleh siswa sejak usia dini, seperti mengenal bangun-bangun geometri. Namun beberapa penelitian menunjukkan bahwa masih banyak siswa yang mengalami kesulitan dalam belajar geeometri, khususnya pada tingkat SMP. Oleh karena itu diperlukan penelitian terhadap level berpikir geometri siswa. Penelitian ini bertujuan untuk mengetahui: (1) level berpikir geometri siswa di SMP Negeri percontohan di Lembang, dan (2) menelaah apakah pembelajaran geometri yang berlangsung di sekolah menerapkan tahapan pembelajaran Van Hiele atau tidak. Metode dalam penelitian ini merupakan studi deskriptif dengan subjek penelitian adalah siswa kelas IX dari dua sekolah menengah pertama di Lembang. Instrumen dalam penelitian ini terdiri dari: (1) instrumen tes, yaitu tes level berpikir geometri Van Hiele pada materi bangun datar. Hasil dari tes ini dianalisis dengan kategori level berpikir sebagai berikut: level 0 adalah tahap pengenalan; level 1 adalah tahap analisis; level 2 adalah tahap pengurutan; level 3 adalah tahap deduksi formal; dan level 4 adalah tahap akurasi. (2) Instrumen non tes, yaitu berupa wawancara terhadap guru dan murid. Berdasarkan hasil penelitian diperoleh kesimpulan bahwa: (1) secara keseluruhan siswa SMP telah memasuki tahap berpikir geometri Van Hiele. Sebagian besar siswa berada pada tahap pengenalan (level 0) yaitu 81,16%, sedangkan sisanya telah memasuki tahap analisis (level 1) sebesar 17,39% dan tahap pengurutan (level 2) sebesar 1,45%. (2) Pembelajaran geometri di sekolah kurang memperhatikan tahapan pembelajaran geometri Van Hiele---------- Student has a big opportunity to understand geometry because the basic concept has early familiar, such as know the geometry’s objects. However, some of the research were show that many student difficult to learn geometry, specifically for junior high school. Because of that, it necessary to research about the geometry level thinking. The goal of the research are to know: (1) student geometry level thinking at the model of junior high school in Lembang, and (2) observe the lesson geometry at school by use the phase of Van Hiele geometry learning. The method is descriptive study with the subject are the student from IX class of two junior high school in Lembang. The instrument is: (1) test instrument, is Van Hiele geometry level test. The result will be analysis by categories of Van Hiele: level 0 is visualization; level 1 is analysis; level 2 is informal deduction; level 3 is deduction; and level 4 is rigor. (2) Non-test instrument, is interview to the teacher and student. Base of the research, the conclusion are: (1) by and large the student has include the Van Hiele geometry level. Student at level 0 is 81, 16%, at level 1 is 17,3% and at level 2 is 1,45%. (2) School did’nt use the phase of Van Hiele geometry learning

Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance

To compare risk-adjusted mortality of children non-electively admitted during off-hours with risk-adjusted mortality of children admitted during office hours to two pediatric intensive care units (PICUs) without 24-h in-house attendance of senior staff. Prospective observational study, performed between January 2003 and December 2007, in two PICUs without 24-h in-house attendance of senior staff, located in tertiary referral children's hospitals in the Netherlands. Standardized mortality rates (SMRs) of patients admitted during off-hours were compared to SMRs of patients admitted during office hours using Pediatric Index of Mortality (PIM1) and Pediatric Risk of Mortality (PRISM2) scores. Office hours were defined as week days between 8:00 a.m. and 6:00 p.m., with in-house attendance of senior staff, and off-hours as week days between 6:00 p.m. and 8:00 a.m., Saturdays, Sundays and public holidays, with one resident covering the PICU and senior staff directly available on-call. Of 3,212 non-elective patients admitted to the PICUs, 2,122 (66%) were admitted during off-hours. SMRs calculated according to PIM1 and PRISM2 did not show a significant difference with those of patients admitted during office hours. There was no significant effect of admission time on mortality in multivariate logistic regression with odds ratios of death in off-hours of 0.95 (PIM1, 95% CI 0.71-1.27, p = 0.73) and 1.03 (PRISM2, 95% CI 0.76-1.39, p = 0.82). Off-hours admission to our PICUs without 24-h in-house attendance of senior staff was not associated with higher SMRs than admission during office hours when senior staff were available in-house

Proposal for a multilevel university cybermetric analysis model

The final publication is available at Springer via http://dx.doi.org/10.1007/s11192-012-0868-5Universities’ online seats have gradually become complex systems of dynamic information where all their institutions and services are linked and potentially accessible. These online seats now constitute a central node around which universities construct and document their main activities and services. This information can be quantitative measured by cybermetric techniques in order to design university web rankings, taking the university as a global reference unit. However, previous research into web subunits shows that it is possible to carry out systemic web analyses, which open up the possibility of carrying out studies which address university diversity, necessary for both describing the university in greater detail and for establishing comparable ranking units. To address this issue, a multilevel university cybermetric analysis model is proposed, based on parts (core and satellite), levels (institutional and external) and sublevels (contour and internal), providing a deeper analysis of institutions. Finally the model is integrated into another which is independent of the technique used, and applied by analysing Harvard University as an example of use.Orduña Malea, E.; Ontalba Ruipérez, JA. (2013). Proposal for a multilevel university cybermetric analysis model. Scientometrics. 95(3):863-884. doi:10.1007/s11192-012-0868-5S863884953Acosta Márquez, T., Igartua Perosanz, J.J. & Gómez Isla, J. (2009). Páginas web de las universidades españolas. Enred: revista digital de la Universidad de Salamanca, 5 [online; discontinued].Aguillo, I. F. (1998). Hacia un concepto documental de sede web. El Profesional de la Información, 7(1–2), 45–46.Aguillo, I. F. (2009). Measuring the institutions’ footprint in the web. 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Journal of the American Society for Information Science and Technology, 55(14), 1216–1227.Buenadicha, M., Chamorro, A., Miranda, F. J., & González, O. R. (2001). A new web assessment index: Spanish Universities Analysis. Internet Research, 11(3), 226–234.Castells, M. (2001). La galaxia Internet. Barcelona: Plaza y Janés.Chu, H., He, S., & Thelwall, M. (2002). Library and Information Science Schools in Canada and USA: a Webometric perspective. Journal of Education for Library and Information Science, 43(2), 110–125.Crowston, K., & Williams, M. (2000). Reproduced and Emergent Genres of Communication on the World Wide Web. The Information Society: an International Journal, 16(3), 201–215.Goldfarb, A. (2006). The (teaching) role of universities in the diffusion of the Internet. International Journal of Industrial Organization, 24(2), 203–225.Ingwersen, P. (1998). The calculation of web impact factors. Journal of Documentation, 54(2), 236–243.Katz, R. N. (2008a). The tower and the cloud: Higher education in the age of cloud computing. USA: Educause.Katz, R. N. (2008b). The gathering cloud: is this the end of the middle. In R. N. Katz (Ed.), The tower and the cloud: Higher education in the age of cloud computing (p. 2008). USA: Educause.Li, X. (2005). National and international university departmental Web site interlinking: a webometric analysis. [Unpublished doctoral dissertation]. Wolverhampton, UK: University of Wolverhampton.Li, X., Thelwall, M., Musgrove, P., & Wilkinson, D. (2003). The relationship between the links/Web Impact Factors of computer science departments in UK and their RAE (Research Assessment Exercise) ranking in 2001. Scientometrics, 57(2), 239–255.Middleton, I., McConnell, M., & Davidson, G. (1999). Presenting a model for the structure and content of a University World Wide Web site. Journal of Information Science, 25(3), 217–219.Orduña-Malea, E. (2012). Propuesta de un modelo de análisis redinformétrico multinivel para el estudio sistémico de las universidades españolas (2010). Valencia: Polytechnic University of Valencia.Ortega, J. L., & Aguillo, Isidro. F. (2007). La web académica española en el contexto del Espacio Europeo de Educación Superior: estudio exploratorio. El profesional de la información, 16(5), 417–425.Pareja, V. M., Ortega, J. L., Prieto, J. A., Arroyo, N., & Aguillo, I. F. (2005). Desarrollo y aplicación del concepto de sede web como unidad documental de análisis en Cibermetría. Jornadas Españolas de Documentación, 9, 325–340.Saorín, T. (2012). Arquitectura de la dispersión: gestionar los riesgos cíclicos de fragmentación de las webs corporativas. Anuario ThinkEPI, 6, 281–287.Tang, R., & Thelwall, M. (2003). U.S. academic departmental Web-site interlinking: disciplinary differences. Library & Information Science Research, 25(4), 437–458.Tang, R., & Thelwall, M. (2004). 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Use of news articles and announcements on official websites of universities. Turkish Online Journal of Educational Technology, 10(2), 287–296

Construction and psychometric testing of the EMPATHIC questionnaire measuring parent satisfaction in the pediatric intensive care unit

Abstract PURPOSE: To construct and test the reliability and validity of the EMpowerment of PArents in THe Intensive Care (EMPATHIC) questionnaire measuring parent satisfaction in the pediatric intensive care unit (PICU). METHODS: Structured development and psychometric testing of a parent satisfaction-with-care instrument with the results of two cohorts of parents (n = 2,046) from eight PICUs in the Netherlands. RESULTS: In the first cohort, 667/1,055 (63%) parents participated followed by 551/991 (56%) parents in the second cohort. The empirical structure of the instrument was established by confirmatory factor analysis with the first sample of parents confirming 65 statements within five theoretically conceptualized domains: information, care and cure, organization, parental participation, and professional attitude. The standardized factor loadings were greater than 0.40 in 63 statements. Cronbach's α, a measure of reliability, per domain ranged from 0.73 to 0.93 in both cohorts with no significant difference documenting the reliability over time. Beside rigorous content and face validity, the congruent validity of the instrument showed adequate correlation with four gold standard questions measuring overall satisfaction. The non-differential validity was confirmed with no significant differences between the population characteristics and the domains, except that parents with a child for a surgical admission were more satisfied on information issues. CONCLUSIONS: The final EMPATHIC questionnaire incorporates 65 statements. The empirical structure of the satisfaction statements and domains was satisfactory. The reliability and validity proved to be adequate. The EMPATHIC questionnaire is a valid quality performance indicator to measure quality of care as perceived by parents

Perceptions of parents on satisfaction with care in the pediatric intensive care unit: the EMPATHIC study

Abstract: PURPOSE: To identify parental perceptions on pediatric intensive care-related satisfaction items within the framework of developing a Dutch pediatric intensive care unit (PICU) satisfaction instrument. METHODS: Prospective cohort study in tertiary PICUs at seven university medical centers in The Netherlands. PARTICIPANTS: Parents of 1,042 children discharged from a PICU. RESULTS: A 78-item questionnaire was sent to 1,042 parents and completed by 559 (54%). Seventeen satisfaction items were rated with mean scores or =1.65, and thus considered of limited value. The empirical structure of the items was in agreement with the theoretically formulated domains: Information, Care a

The Epidemic of Hip Fractures: Are We on the Right Track?

Background: Hip fractures are a public health problem, leading to hospitalization, long-term rehabilitation, reduced quality of life, large healthcare expenses, and a high 1-year mortality. Especially older adults are at greater risk of fractures than the general population, due to the combination of an increased fall risk and osteoporosis. The aim of this study was to determine time trends in numbers and incidence rates of hip fracture-related hospitalizations and admission duration in the older Dutch population. Methods and Findings: Secular trend analysis of all hospitalizations in the older Dutch population (≥65 years) from 1981 throughout 2008, using the National Hospital Discharge Registry. Numbers, age-specific and age-adjusted incidence rates (per 10,000 persons) of hospital admissions and hospital days due to a hip fracture were used as outcome measures in each year of the study. Between 1981 and 2008, the absolute number of hip fractures doubled in the older Dutch population. Incidence rates of hip fracture-related hospital admissions increased with age, and were higher in women than in men. The age-adjusted incidence rate increased from 52.0 to 67.6 per 10,000 older persons. However, since 1994 the incidence rate decreased (percentage annual change -0.5%, 95% CI: -0.7; -0.3), compared with the period 1981-1993 (percentage annual change 2.3%, 95% CI: 2.0; 2.7). The total number of hospital days was reduced by a fifth, due to a reduced admission duration in all age groups. A possible limitation was that data were obtained from a linked administrative database, which did not include information on medication use or co-morbidities. Conclusions: A trend break in the incidence rates of hip fracture-related hospitalizations was observed in the Netherlands around 1994, possibly as a first result of efforts to prevent falls and fractures. However, the true cause of the observation is unknown

A qualitative study exploring the experiences of parents of children admitted to seven Dutch pediatric intensive care units

Purpose: To explore parents' experiences during the admission of their children to a pediatric intensive care unit (PICU). Method: Qualitative method using in-depth interviews. Thematic analysis was applied to capture parents' experiences. Thirty-nine mothers and 25 fathers of 41 children admitted to seven of the eight PICUs in university medical centers in The Netherlands were interviewed. Results: Parents were interviewed within 1 month after their child's discharge from a PICU. Thematic analysis identified 1,514 quotations that were coded into 63 subthemes. The subthemes were categorized into six major themes: attitude of the professionals; coordination of care; emotional intensity; information management; environmental factors; parent participation. Most themes had an overarching relationship representing the array of experiences encountered by parents when their child was staying in a PICU. The theme of emotional intensity was in particular associated with all the other themes. Conclusions: The findings provided a range of themes and subthemes describing the complexity of the parental experiences of a PICU admission. The subthemes presen

Angiopoietin-1 Treatment Reduces Inflammation but Does Not Prevent Ventilator-Induced Lung Injury

Background: Loss of integrity of the epithelial and endothelial barriers is thought to be a prominent feature of ventilator-induced lung injury (VILI). Based on its function in vascular integrity, we hypothesize that the angiopoietin (Ang)-Tie2 system plays a role in the development of VILI. The present study was designed to examine the effects of mechanical ventilation on the Ang-Tie2 system in lung tissue. Moreover, we evaluated whether treatment with Ang-1, a Tie2 receptor agonist, protects against inflammation, vascular leakage and impaired gas exchange induced by mechanical ventilation. Methods: Mice were anesthetized, tracheotomized and mechanically ventilated for 5 hours with either an inspiratory pressure of 10 cmH(2)O ('low' tidal volume similar to 7.5 ml/kg; LVT) or 18 cmH(2)O ('high' tidal volume similar to 15 ml/kg; HVT). At initiation of HVT-ventilation, recombinant human Ang-1 was intravenously administered (1 or 4 mu g per animal). Non-ventilated mice served as controls. Results: HVT-ventilation influenced the Ang-Tie2 system in lungs of healthy mice since Ang-1, Ang-2 and Tie2 mRNA were decreased. Treatment with Ang-1 increased Akt-phosphorylation indicating Tie2 signaling. Ang-1 treatment reduced infiltration of granulocytes and expression of keratinocyte-derived chemokine (KC), macrophage inflammatory protein (MIP)-2, monocyte chemotactic protein (MCP)-1 and interleukin (IL)-1 beta caused by HVT-ventilation. Importantly, Ang-1 treatment did not prevent vascular leakage and impaired gas exchange in HVT-ventilated mice despite inhibition of inflammation, vascular endothelial growth factor (VEGF) and Ang-2 expression. Conclusions: Ang-1 treatment downregulates pulmonary inflammation, VEGF and Ang-2 expression but does not protect against vascular leakage and impaired gas exchange induced by HVT-ventilatio