Extraocular Muscle Imbalance and Outcomes of Scleral Buckling Surgery for Primary Rhegmatogenous Retinal Detachment

Objective: The objective was to study the muscle imbalance, restrictive motility in unlike gazes and the outcomes of the scleral buckling surgery for rhegmatogenous retinal detachment. Study design: Prospective follow-up study Settings and duration: The study was conducted at Al-Shifa Trust Eye Hospital Rawalpindi from Aug 2015 to Jan 2016. Methodology: The patients were checked prior to surgery and two follow up visits were done afterwards. Thorough history was taken along with full orthoptic assessment and ocular motility in all four main gazes including elevation, depression, adduction and abduction. Vision, type and position of explants, site of detachment, and risk factors of detachment were also observed. Results: A total of 48 eyes of 46 patients were taken. Mean age of the study participants was 37.16±20.37 years. Horizontal, vertical and combined deviations were observed in study population. Exo deviation was most common deviation among patients. Most reported risk factors of retinal detachment included trauma, pseudophakia, aphakia and myopia. Motility limitations of all four gazes was observed and it was found out that after buckling the squint and restriction is been increased up till two months. Conclusion: Ocular restriction among the patients was observed over a period of 2 months and it depicted that encircling with sclera buckling elicited an increase in restrictive ocular motility from pre-operative to 1 week and 2 months after surgery

Outcome Mapping

{Excerpt} Development is about people—it is about how they relate to one another and their environment, and how they learn in doing so. Outcome mapping puts people and learning first and accepts unexpected change as a source of innovation. It shifts the focus from changes in state, viz. reduced poverty, to changes in behaviors, relationships, actions, and activities. Development agencies must show that their activities make significant and lasting contributions to the welfare of intended beneficiaries. But they may well be trying to measure results that are beyond their reach: the impacts they cite as evidence are often the result of a confluence of events for which they cannot realistically get full credit. Outcome mapping exposes myths about measuring impacts and helps to answer such questions. A project or program that uses the framework and vocabulary of outcome mapping does not claim the achievement of development impacts, nor does it belittle the importance of changes in state. Rather, it focuses on its contributions to outcomes (that may in turn enhance the possibility of development impacts—the relationship is not inevitably a direct one of cause and effect.) More positively, because outcome mapping limits its concerns to those results that fall strictly within a project or program’s sphere of influence, development agencies can become more specific about the actors they target, the changes they expect to see, and the strategies they employ

Heap : a command for estimating discrete outcome variable models in the presence of heaping at known points

Self-reported survey data are often plagued by the presence of heaping. Accounting for this measurement error is crucial for the identification and consistent estimation of the underlying model (parameters) from such data. In this article, we introduce two commands. The first command, heapmph, estimates the parameters of a discrete-time mixed proportional hazard model with gammaunobserved heterogeneity, allowing for fixed and individual-specific censoring and different-sized heap points. The second command, heapop, extends the framework to ordered choice outcomes, subject to heaping. We also provide suitable specification tests

Developing a core outcome set for future infertility research : an international consensus development study

Acknowledgements We would like to thank the Delphi survey and consensus development meeting participants and colleagues at the Cochrane Gynaecology and Fertility Group, University of Auckland, New Zealand. Funding This research was funded by the Catalyst Fund, Royal Society of New Zealand, Auckland Medical Research Fund and Maurice and Phyllis Paykel Trust. The funder had no role in the design and conduct of the study, the collection, management, analysis or interpretation of data, or manuscript preparation. B.W.J.M. is supported by a National Health and Medical Research Council Practitioner Fellowship (GNT1082548). S.B. was supported by University of Auckland Foundation Seelye Travelling Fellowship. This article has not been externally peer reviewed. This article has been published simultaneously in Fertility and Sterility.Peer reviewedPublisher PD

Standardizing definitions and reporting guidelines for the infertility core outcome set : an international consensus development study

Acknowledgments: We would like to thank the consensus development meeting participants and colleagues at the Cochrane Gynaecology and Fertility Group, University of Auckland, New Zealand. Funding This research was funded by the Catalyst Fund, Royal Society of New Zealand, Auckland Medical Research Fund, and Maurice and Phyllis Paykel Trust. The funder had no role in the design and conduct of the study, the collection, management, analysis, or interpretation of data, or manuscript preparation. Siladitya Bhattacharya was supported by the University of Auckland Foundation Seelye Travelling Fellowship. Ben Mol is supported by a National Health and Medical Research Council Practitioner Fellowship (GNT1082548). his article has not been externally peer reviewed.yThis article has been published simultaneously in Human ReproductionPeer reviewedPublisher PD

Functional outcome of patients with spinal cord injury: rehabilitation outcome study

Objective: To increase our knowledge of neurological recovery and functional outcome of patients with spinal cord injuries in order to make more successful rehabilitation programmes based on realistic goals.Design: Descriptive analysis of data gathered in an information system.Setting: Rehabilitation centre in The Netherlands with special department for patients with spinal cord injuries.Subjects: Fifty-five patients with traumatic spinal cord lesions admitted to the rehabilitation centre from 1988 to 1994. Main outcome measures: The functional improvement was presented in terms of progress in independence in nine daily activity skills. Independence was rated on a four-point scale.Results: From admission to discharge, lesions in 100% of patients with tetraplegia and 96% of patients with paraplegia remained complete. Significant progress in independence was made in self-care, ambulation and bladder and bowel care. Differences were found in the extent of functional improvement between subgroups of patients with different levels and extent of lesion. Contrary to expectations based on theoretical models, patients with complete paraplegia did not achieve maximal independence in self-care. Independent walking was only attained by patients with incomplete lesions. Regarding outcome of bladder and bowel care, poor results were found, especially the independence in defaecation and toilet transfers.Conclusions: The results of this study provided more insight into the functional outcome of a group of patients with traumatic spinal cord injury. More research is needed to evaluate the rehabilitation programmes for these patients

Outcome measures to be considered on asthma in elderly

El asma en pacientes mayores de 65 años tiene un impacto negativo importante en la calidad de vida. La fisiopatología y el tratamiento del asma en pacientes de edad avanzada no están tan bien identificados como en grupos de edades más jóvenes. En esta revisión pretendemos marcar las características encontradas en adultos mayores, que los distinguen de otros grupos de edad de pacientes con asma

Contemporary outcome measures in acute stroke research: choice of primary outcome measure

BACKGROUND AND PURPOSE: The diversity of available outcome measures for acute stroke trials is challenging and implies that the scales may be imperfect. To assist researchers planning trials and to aid interpretation, this article reviews and makes recommendations on the available choices of scales. The aim is to identify an approach that will be universally accepted and that should be included in most acute trials, without seeking to restrict options for special circumstances. METHODS: The article considers outcome measures that have been widely used or are currently advised. It examines desirable properties for outcome measures such as validity, relevance, responsiveness, statistical properties, availability of training, cultural and language issues, resistance to comorbidity, as well as potential weaknesses. Tracking and agreement among outcomes are covered. RESULTS: Typical ranges of scores for the common scales are described, along with their statistical properties, which in turn influence optimal analytic techniques. The timing of recovery on scores and usual practice in trial design are considered. CONCLUSIONS: The preferred outcome measure for acute trials is the modified Rankin Scale, assessed at 3 months after stroke onset or later. The interview should be conducted by a certified rater and should involve both the patient and any relevant caregiver. Incremental benefits at any level of the modified Rankin Scale may be acceptable. The modified Rankin Scale is imperfect but should be retained in its present form for comparability with existing treatment comparisons. No second measure should be required, but correlations with supporting scales may be used to confirm consistency in direction of effects on other measures

Outcome Prediction for Unipolar Depression

Although effective drug and non-drug treatment for unipolar depressive illness exist, different individuals respond differently to different treatments. It is not uncommon for a given patient to lw switched several times from one treatment to another until an effective remedy for that particular patient is found. This process is costly in terms of time, money and suffering. It is thus desirable to determine at the outset the likdy response of a patient to the available treatments, so that the optimal one can be selected. Although prior attempts at outcome prediction with linear regression models have failed, recent work on this problem has indicated that the nonlinear predictive techniques of backpropagation and quadratic regression call account for a significant proportion of the variance in the data. The present research applies the nonlinear predictive technique of kernel regression to this problcrn, and employs cross-validation to test the ability of the resulting model to extract, from extremely noisy dinical data, information with predictive value. The importance of comparison with a suitable null hypothesis is illustrated.Office of Naval Research (N00014-95-1-0409

Predicting the outcome of roulette

There have been several popular reports of various groups exploiting the deterministic nature of the game of roulette for profit. Moreover, through its history the inherent determinism in the game of roulette has attracted the attention of many luminaries of chaos theory. In this paper we provide a short review of that history and then set out to determine to what extent that determinism can really be exploited for profit. To do this, we provide a very simple model for the motion of a roulette wheel and ball and demonstrate that knowledge of initial position, velocity and acceleration is sufficient to predict the outcome with adequate certainty to achieve a positive expected return. We describe two physically realisable systems to obtain this knowledge both incognito and {\em in situ}. The first system relies only on a mechanical count of rotation of the ball and the wheel to measure the relevant parameters. By applying this techniques to a standard casino-grade European roulette wheel we demonstrate an expected return of at least 18%, well above the -2.7% expected of a random bet. With a more sophisticated, albeit more intrusive, system (mounting a digital camera above the wheel) we demonstrate a range of systematic and statistically significant biases which can be exploited to provide an improved guess of the outcome. Finally, our analysis demonstrates that even a very slight slant in the roulette table leads to a very pronounced bias which could be further exploited to substantially enhance returns.Comment: Revise