Morphology of the Corneal Limbus Following Standard and Accelerated Corneal Collagen Cross-Linking (9 mW/cm2) for Keratoconus.

PubMed

Uçakhan, Ömür Ö; Bayraktutar, Betül

2017-01-01

To evaluate the morphological features of the corneal limbus as measured by in vivo confocal microscopy (IVCM) following standard and accelerated corneal collagen cross-linking (CXL) for keratoconus. Patients with progressive keratoconus scheduled to undergo standard CXL (group 1; 31 patients, 3 mW/cm, 370 nm, 30 minutes), or accelerated CXL (group 2; 20 patients, 9 mW/cm, 370 nm, 10 minutes) in the worse eye were included in this prospective study. Thirty eyes of 30 age-matched patients served as controls (group 3). All patient eyes underwent IVCM scanning of the central cornea and the inferior limbal area at baseline and 1, 3, and 6 months after CXL. After CXL, epithelial regrowth was complete by day 4 in both groups 1 and 2. There were no statistically significant differences between the baseline mean central corneal wing or basal cell density, limbus-palisade middle or basal cell densities of groups 1, 2, or 3. At postoperative months 1, 3, and 6, there were no statistically significant differences in either central or limbus-palisade epithelial cell densities or diameters in keratoconic eyes that underwent standard or accelerated CXL (P > 0.05). The morphology of the limbal cells was preserved as well. The morphology of limbus structures seems to be preserved following standard and accelerated CXL in short-term follow-up, as measured using IVCM.

Mean Posterior Corneal Power and Astigmatism in Normal Versus Keratoconic Eyes.

PubMed

Feizi, Sepehr; Delfazayebaher, Siamak; Javadi, Mohammad Ali; Karimian, Farid; Ownagh, Vahid; Sadeghpour, Fatemeh

2018-01-01

To compare mean posterior corneal power and astigmatism in normal versus keratoconus affected eyes and determine the optimal cut-off points to maximize sensitivity and specificity in discriminating keratoconus from normal corneas. A total of 204 normal eyes and 142 keratoconus affected eyes were enrolled in this prospective comparative study. Mean posterior corneal power and astigmatism were measured using a dual Scheimpflug camera. Correlation coefficients were calculated to assess the relationship between the magnitudes of keratometric and posterior corneal astigmatism in the study groups. Receiver operating characteristic curves were used to compare the sensitivity and specificity of the measured parameters and to identify the optimal cut-off points for discriminating keratoconus from normal corneas. The mean posterior corneal power was -6.29 ± 0.20 D in the normal group and -7.77 ± 0.87 D in the keratoconus group ( P < 0.001). The mean magnitudes of the posterior corneal astigmatisms were -0.32 ± 0.15 D and -0.94 ± 0.39 D in the normal and keratoconus groups, respectively ( P < 0.001). Significant correlations were found between the magnitudes of keratometric and posterior corneal astigmatism in the normal (r=-0.76, P < 0.001) and keratoconus (r=-0.72, P < 0.001) groups. The mean posterior corneal power and astigmatism were highly reliable characteristics that distinguished keratoconus from normal corneas (area under the curve, 0.99 and 0.95, respectively). The optimal cut-off points of mean posterior corneal power and astigmatism were -6.70 D and -0.54 D, respectively. Mean posterior corneal power and astigmatism measured using a Galilei analyzer camera might have potential in diagnosing keratoconus. The cut-off points provided can be used for keratoconus screening.

Clinical Outcomes after Keraring Implantation for Keratoconus Management in Patients Older Than 40 Years: A Retrospective, Interventional, Cohort Study.

PubMed

Gatzioufas, Zisis; Khine, Aye; Elalfy, Mohamed; Guber, Ivo; McLintock, Cameron; Sabatino, Francesco; Hamada, Samer; Lake, Damian

2018-06-01

Intracorneal ring segment implantation is an effective and safe method of visual improvement in patients with keratoconus. The aim of our study was to evaluate the long-term clinical outcomes after Keraring implantation for keratoconus in patients older than 40 years. Eleven eyes from 11 patients with keratoconus who underwent femtosecond laser-assisted Keraring implantation for keratoconus were included in this retrospective study. The uncorrected visual acuity (UCVA), corrected visual acuity, keratometric readings, central corneal thickness and thinnest corneal pachymetry were evaluated preoperatively and 6 months after the Keraring implantation. UCVA, BCVA and keratometric readings improved at 6 months postoperatively. Our data showed significant keratometric amelioration and visual improvement after Keraring implantation for keratoconus in patients older than 40 years at 6 months postoperatively.

The influence of gender and hormone status on the severity and progression of keratoconus.

PubMed

Fink, Barbara A; Sinnott, Loraine T; Wagner, Heidi; Friedman, Chad; Zadnik, Karla

2010-01-01

To assess the effects of gender and hormone status on the severity and progression of keratoconus in patients enrolled in the Collaborative Longitudinal Evaluation of Keratoconus Study. The severity and progression of keratoconus in both men (M) and women were evaluated over a 4-year period that encompassed menopausal transition for hormone-active women (HA) and hormone-inactive women (HI). Four outcome measures were selected as indicators of the severity of keratoconus: high-contrast best-corrected visual acuity, low-contrast best-corrected visual acuity, the steep keratometric measurement, and corneal scarring (yes/no). There were no statistically significant differences among the 3 groups (M, HA, and HI) in race, history of atopic disease, family history of keratoconus, or rigid contact lens wear in the right and left eyes. At baseline, there were no significant differences among the 3 groups in high-contrast best-corrected visual acuity, low-contrast best-corrected visual acuity, or steep keratometric reading. Progression of keratoconus, as assessed by changes in these 3 continuous variables, was equal for the 3 groups. M had more corneal scarring than did HA or HI; however, there was no progression of scarring for any of the groups. Keratoconus progressed in both men and women, aged 48-59 years; however, there were no differences among the groups in progression.

[Evaluation of corneal biomechanics in keratoconus using dynamic ultra-high-speed Scheimpflug measurements].

PubMed

Brettl, S; Franko Zeitz, P; Fuchsluger, T A

2018-06-22

The in vivo analysis of corneal biomechanics in patients with keratoconus is especially of interest with respect to diagnosis, follow-up and monitoring of the disease. For a better understanding it is necessary to describe the potential of dynamic Scheimpflug measurements for the detection and interpretation of biomechanical changes in keratoconus. The current state of analyzing biomechanical changes in keratoconus with the Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) is described. This technique represents a new approach for understanding corneal biomechanics. Furthermore, it was investigated whether the device can biomechanically quantify a rigidity increasing effect of therapeutic UV-crosslinking and whether early stages of keratoconus can be detected using dynamic Scheimpflug analysis. In patients with keratoconus, the in vivo analysis of corneal biomechanics using dynamic Scheimpflug measurements as a supplementary procedure can be of advantage with respect to disease management. By optimization of screening of subclinical keratoconus stages, this method widens the analytic spectrum regarding diagnosis and follow-up of the disease; however, further studies are required to evaluate whether visual outcome of affected patients can be improved by earlier diagnosis.

Keratoconus: an inflammatory disorder?

PubMed Central

Galvis, V; Sherwin, T; Tello, A; Merayo, J; Barrera, R; Acera, A

2015-01-01

Keratoconus has been classically defined as a progressive, non-inflammatory condition, which produces a thinning and steepening of the cornea. Its pathophysiological mechanisms have been investigated for a long time. Both genetic and environmental factors have been associated with the disease. Recent studies have shown a significant role of proteolytic enzymes, cytokines, and free radicals; therefore, although keratoconus does not meet all the classic criteria for an inflammatory disease, the lack of inflammation has been questioned. The majority of studies in the tears of patients with keratoconus have found increased levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), and matrix metalloproteinase (MMP)-9. Eye rubbing, a proven risk factor for keratoconus, has been also shown recently to increase the tear levels of MMP-13, IL-6, and TNF-α. In the tear fluid of patients with ocular rosacea, IL-1α and MMP-9 have been reported to be significantly elevated, and cases of inferior corneal thinning, resembling keratoconus, have been reported. We performed a literature review of published biochemical changes in keratoconus that would support that this could be, at least in part, an inflammatory condition. PMID:25931166

Central and peripheral corneal thinning in keratoconus.

PubMed

Brautaset, Rune L; Nilsson, Maria; Miller, William L; Leach, Norman E; Tukler, Johanna H; Bergmanson, Jan P G

2013-03-01

Recent data regarding the mid-peripheral portion of the removed corneal button in transplant surgery indicate histopathologically that keratoconus was present also in the peripheral portion of the button. The intent of this study was therefore to investigate if peripheral changes could also be detected clinically by measuring the central and peripheral corneal thickness of KC patients. Corneal pachymetry was measured with the Visante optical coherence tomography and Orbscan II. Of 52 subjects, 26 were KC subjects and 26 were age- and sex-matched control subjects. Corneal thickness, in KC patients, was significantly reduced in all areas compared with corneal thickness among controls with both the Visante optical coherence tomography and Orbscan II. The results of the present study have provided clinical evidence that KC is a disease affecting a wider area of the cornea. Although the KC cornea shows the greatest change in thickness in the ectatic region, this attenuation declines toward the periphery. The presence of peripheral thinning indicated that KC may be a "pancorneal" pathology and not limited to the ectatic portion.

Incidence and severity of keratoconus in Asir province, Saudi Arabia.

PubMed

Assiri, A A; Yousuf, B I; Quantock, A J; Murphy, P J

2005-11-01

To assess the incidence and associated signs and symptoms of patients with keratoconus in Asir Province, Saudi Arabia. 125 new keratoconus patients (51 male, 74 female; mean age 18.5 (SD 3.8) years; range 8--28 years) were recruited from referrals to the department of ophthalmology, Asir Central Hospital, over a 1 year period. Age, visual acuity, and keratometry were recorded along with clinical signs and symptoms. The incidence of keratoconus in Asir Province is 20 cases per 100,000 population. Also, the disease severity is high, as indicated by an early mean age (17.7 (3.6) years) with advanced stage keratoconus. Visual acuity, with either spectacles or rigid contact lenses, was 6/12 or better in 98% of eyes measured. Just over half (56%) of patients had atopic ocular disease. 16% of patients had a positive family history of the disease and 16% had atopic dermatitis (eczema and/or vitiligo). The incidence and severity of keratoconus in Asir Province, Saudi Arabia, is high with an early onset and more rapid progress to the severe disease stage at a young age. This might reflect the influence of genetic and/or environmental factor(s) in the aetiology of keratoconus.

Tear film inflammatory mediators in patients with keratoconus.

PubMed

Sorkhabi, Rana; Ghorbanihaghjo, Amir; Taheri, Nazli; Ahoor, Mohammad Hosein

2015-08-01

To determine the concentration of inflammatory mediators in the tear film of patients with keratoconus. Basal tears from patients with keratoconus and from normal controls were collected using a capillary tube. Patients with keratoconus were examined in a routine fashion, and keratometric readings were also taken from corneal topographic maps .The concentration of cytokines including Interleukin 6,10,1b and Interferon-γ was measured by enzyme-linked immunoadsorbent assay. Seventy-two subjects were enrolled in the study including 42 patients with keratoconus and 30 normals. Patients with keratoconus had significantly higher levels of Interlukin 6,1b and Interferon-γ (17.49 ± 1.92 pg/ml), (8.58 ± 1.15 pg/ml), and (33.33 ± 7.57 pg/ml) compared with control subjects (13.81 ± 1.71 pg/ml), (4.98 ± 0.52 pg/ml), and (22.99 ± 4.68 pg/ml), (P = 0.0001, P = 0.0001, and P = 0.0001). But the level of Interlukin-10 in keratoconus patients was significantly lower (6.07 ± 1.35 pg/ml) than controls (8.99 ± 0.70 pg/ml) (P = 0.0001). We realized that the proinflammatory markers (Interlukin-6,1-b and Interferon-γ) are over expressed, whereas the anti-inflammatory marker (Interlukin-10) is under expressed, indicating that the pathogenesis of keratoconus may involve complex chronic inflammatory events. Additional future studies will reveal the exact molecular and biochemical mechanisms that are required to better manage the disease and halt its progression.

Corneal Cross-Linking for the Treatment of Keratoconus in a Patient with Ipsilateral Myelinated Retinal Nerve Fiber Layer

PubMed Central

Leozappa, M.; Ciani, S.; Ferrari, T. Micelli

2011-01-01

Keratoconus associated with myelinated retinal nerve fibers is not frequent and the relationship between the two pathologies is difficult to explain, therefore studies and further investigation are required. The etiology of each condition may suggest the role of genetic factors. Follow-up is important to evaluate the progression of keratoconus and myelination. Here we describe the unusual coexistence of keratoconus and ipsilateral myelinated retinal nerve fiber layer and, for the first time, the corneal cross-linking treatment in this condition. PMID:21475609

Incidence and severity of keratoconus in Asir province, Saudi Arabia

PubMed Central

Assiri, A A; Yousuf, B I; Quantock, A J; Murphy, P J

2005-01-01

Aim: To assess the incidence and associated signs and symptoms of patients with keratoconus in Asir Province, Saudi Arabia. Methods: 125 new keratoconus patients (51 male, 74 female; mean age 18.5 (SD 3.8) years; range 8–28 years) were recruited from referrals to the department of ophthalmology, Asir Central Hospital, over a 1 year period. Age, visual acuity, and keratometry were recorded along with clinical signs and symptoms. Results: The incidence of keratoconus in Asir Province is 20 cases per 100 000 population. Also, the disease severity is high, as indicated by an early mean age (17.7 (3.6) years) with advanced stage keratoconus. Visual acuity, with either spectacles or rigid contact lenses, was 6/12 or better in 98% of eyes measured. Just over half (56%) of patients had atopic ocular disease. 16% of patients had a positive family history of the disease and 16% had atopic dermatitis (eczema and/or vitiligo). Conclusion: The incidence and severity of keratoconus in Asir Province, Saudi Arabia, is high with an early onset and more rapid progress to the severe disease stage at a young age. This might reflect the influence of genetic and/or environmental factor(s) in the aetiology of keratoconus. PMID:16234439

Urea, Uric Acid, Prolactin and fT4 Concentrations in Aqueous Humor of Keratoconus Patients.

PubMed

Stachon, Tanja; Stachon, Axel; Hartmann, Ulrike; Seitz, Berthold; Langenbucher, Achim; Szentmáry, Nóra

2017-06-01

Keratoconus is a noninflammatory disease of the cornea associated with progressive thinning and conical shape. Metabolic alterations in the urea cycle, with changes in collagen fibril stability, oxidative stress, thyroid hormones and prolactin with regulatory effect on biosynthesis and biomechanical stability of corneal stroma, may all play a role in keratoconus etiology. Our purpose was to determine urea, uric acid, prolactin and free thyroxin (fT4) concentrations in human aqueous humor (hAH) of keratoconus and cataract patients. hAH was collected from 100 keratoconus (penetrating keratoplasty) (41.9 ± 14.9 years, 69 males) and 100 cataract patients (cataract surgery) (71.2 ± 12.4 years, 58 males). Urea, uric acid, prolactin and fT4 concentrations were measured by Siemens clinical chemistry or immunoassay system. For statistical analysis, a generalized linear model (GLM) was used. Urea concentration was 11.88 ± 3.03 mg/dl in keratoconus and 16.44 ± 6.40 mg/dl in cataract patients, uric acid 2.04 ± 0.59 mg/dl in keratoconus and 2.18 ± 0.73 mg/dl in cataract groups. Prolactin concentration was 3.18 ± 0.34 ng/ml in keratoconus and 3.33 ± 0.32 ng/ml in cataract patients, fT4 20.57 ± 4.76 pmol/l in KC and 19.06 ± 3.86 pmol/l in cataract group. Urea concentration was effected through gender (p = 0.039), age (p = 0.001) and diagnosis (p = 0.025). Uric acid concentration was not effected through any of the analyzed parameters (p > 0.056). Prolactin and fT4 concentration were effected only through diagnosis (p = 0.009 and p = 0.006). Urea and prolactin concentrations are decreased, fT4 concentration is increased in aqueous humor of keratoconus patients, and uric acid concentration remains unchanged. Urea concentration in aqueous humor is also increased in older and male patients. Therefore, metabolic disorder and hormonal balance may both have an impact on keratoconus development. Further studies are necessary to assess the specific impact.

A new approach to keratoconus detection based on corneal morphogeometric analysis.

PubMed

Cavas-Martínez, Francisco; Bataille, Laurent; Fernández-Pacheco, Daniel G; Cañavate, Francisco J F; Alió, Jorge L

2017-01-01

To characterize corneal structural changes in keratoconus using a new morphogeometric approach and to evaluate its potential diagnostic ability. Comparative study including 464 eyes of 464 patients (age, 16 and 72 years) divided into two groups: control group (143 healthy eyes) and keratoconus group (321 keratoconus eyes). Topographic information (Sirius, CSO, Italy) was processed with SolidWorks v2012 and a solid model representing the geometry of each cornea was generated. The following parameters were defined: anterior (Aant) and posterior (Apost) corneal surface areas, area of the cornea within the sagittal plane passing through the Z axis and the apex (Aapexant, Aapexpost) and minimum thickness points (Amctant, Amctpost) of the anterior and posterior corneal surfaces, and average distance from the Z axis to the apex (Dapexant, Dapexpost) and minimum thickness points (Dmctant, Dmctpost) of both corneal surfaces. Significant differences among control and keratoconus group were found in Aapexant, Aapexpost, Amctant, Amctpost, Dapexant, Dapexpost (all p<0.001), Apost (p = 0.014), and Dmctpost (p = 0.035). Significant correlations in keratoconus group were found between Aant and Apost (r = 0.836), Amctant and Amctpost (r = 0.983), and Dmctant and Dmctpost (r = 0.954, all p<0.001). A logistic regression analysis revealed that the detection of keratoconus grade I (Amsler Krumeich) was related to Apost, Atot, Aapexant, Amctant, Amctpost, Dapexpost, Dmctant and Dmctpost (Hosmer-Lemeshow: p>0.05, R2 Nagelkerke: 0.926). The overall percentage of cases correctly classified by the model was 97.30%. Our morphogeometric approach based on the analysis of the cornea as a solid is useful for the characterization and detection of keratoconus.

Simulating Photo-Refraction Images of Keratoconus and Near-Sightedness Eyes

NASA Astrophysics Data System (ADS)

Baker, Kevin; Lewis, James W. L.; Chen, Ying-Ling

2004-11-01

Keratoconus is an abnormal condition of the eye resulting from cone-shaped features on the cornea that degrade the quality of vision. These corneal features result from thinning and subsequent bulging due to intraocular pressure. The abnormal corneal curvature increases the refractive power asymmetrically and can be misdiagnosed by examiners as astigmatism and nearsightedness. Since corrective treatment is possible, early detection of this condition is desirable. Photo-refraction (PR) detects the retinal irradiance reflected from a single light source and is an inexpensive method used to identify refractive errors. For near- (far-) sighted eye, a crescent appears on the same (opposite) side of the light source. The capability of a PR device to detect keratoconus and to differentiate this condition from myopia was investigated. Using a commercial optical program, synthetic eye models were constructed for both near-sighted and keratoconus eyes. PR images of various eye conditions were calculated. The keratoconus cone shapes were modeled with typical published cone locations and sizes. The results indicate significant differences between the images of keratoconus and near-sighted eyes.

SVM-based automatic diagnosis method for keratoconus

NASA Astrophysics Data System (ADS)

Gao, Yuhong; Wu, Qiang; Li, Jing; Sun, Jiande; Wan, Wenbo

2017-06-01

Keratoconus is a progressive cornea disease that can lead to serious myopia and astigmatism, or even to corneal transplantation, if it becomes worse. The early detection of keratoconus is extremely important to know and control its condition. In this paper, we propose an automatic diagnosis algorithm for keratoconus to discriminate the normal eyes and keratoconus ones. We select the parameters obtained by Oculyzer as the feature of cornea, which characterize the cornea both directly and indirectly. In our experiment, 289 normal cases and 128 keratoconus cases are divided into training and test sets respectively. Far better than other kernels, the linear kernel of SVM has sensitivity of 94.94% and specificity of 97.87% with all the parameters training in the model. In single parameter experiment of linear kernel, elevation with 92.03% sensitivity and 98.61% specificity and thickness with 97.28% sensitivity and 97.82% specificity showed their good classification abilities. Combining elevation and thickness of the cornea, the proposed method can reach 97.43% sensitivity and 99.19% specificity. The experiments demonstrate that the proposed automatic diagnosis method is feasible and reliable.

Interleukin 1 beta promoter polymorphism is associated with keratoconus in a Japanese population

PubMed Central

Mikami, Takenori; Teshigawara, Takeshi; Takeuchi, Masaki; Uemoto, Riyo; Kawagoe, Tatsukata; Nomura, Eiichi; Asukata, Yuri; Ishioka, Misaki; Iwasaki, Miki; Fukagawa, Kazumi; Konomi, Kenji; Shimazaki, Jun; Nishida, Teruo; Mizuki, Nobuhisa

2013-01-01

Purpose Polymorphisms in the interleukin 1 alpha (IL1A) and IL1B gene regions were previously associated with keratoconus in a Korean population. In the present study, we investigated whether the IL1A and IL1B polymorphisms are associated with keratoconus in a Japanese population. Methods A total of 169 Japanese patients with keratoconus and 390 Japanese healthy controls were recruited. We genotyped one IL1A single nucleotide polymorphism (SNP; rs2071376) and two IL1B SNPs (rs1143627 and rs16944) to compare the frequencies of alleles, genotypes, and haplotypes between cases and controls. Results Statistically significant association was observed for rs1143627 (−31 T>C) in the IL1B promoter region; the T allele of rs1143627 was associated with an increased risk of keratoconus (p=0.014, corrected p value [pc]=0.043, odds ratio=1.38). The C allele of rs16944 (−511 C>T) in the IL1B promoter region had a 1.33-fold increased risk of keratoconus, although this increase did not reach statistical significance (p=0.033, pc=0.098). The TT genotype of rs1143627 was weakly associated with an increased risk of keratoconus (p=0.033, pc=0.099, odds ratio=1.52). However, no significant differences were found in the allele and genotype frequencies between the cases and controls for rs2071376 in IL1A. Regarding haplotypic diversity, the haplotype created by the T allele of rs1143627 and C allele of rs16944 was associated with a 1.72-fold increased risk of keratoconus (p=4.0×10−5, pc=1.6×10−4). Conclusions Our results replicate associations reported recently in a Korean population. Thus, IL1B may play an important role in the development of keratoconus through genetic polymorphisms. PMID:23592922

Interleukin 1 beta promoter polymorphism is associated with keratoconus in a Japanese population.

PubMed

Mikami, Takenori; Meguro, Akira; Teshigawara, Takeshi; Takeuchi, Masaki; Uemoto, Riyo; Kawagoe, Tatsukata; Nomura, Eiichi; Asukata, Yuri; Ishioka, Misaki; Iwasaki, Miki; Fukagawa, Kazumi; Konomi, Kenji; Shimazaki, Jun; Nishida, Teruo; Mizuki, Nobuhisa

2013-01-01

Polymorphisms in the interleukin 1 alpha (IL1A) and IL1B gene regions were previously associated with keratoconus in a Korean population. In the present study, we investigated whether the IL1A and IL1B polymorphisms are associated with keratoconus in a Japanese population. A total of 169 Japanese patients with keratoconus and 390 Japanese healthy controls were recruited. We genotyped one IL1A single nucleotide polymorphism (SNP; rs2071376) and two IL1B SNPs (rs1143627 and rs16944) to compare the frequencies of alleles, genotypes, and haplotypes between cases and controls. Statistically significant association was observed for rs1143627 (-31 T>C) in the IL1B promoter region; the T allele of rs1143627 was associated with an increased risk of keratoconus (p=0.014, corrected p value [pc]=0.043, odds ratio=1.38). The C allele of rs16944 (-511 C>T) in the IL1B promoter region had a 1.33-fold increased risk of keratoconus, although this increase did not reach statistical significance (p=0.033, pc=0.098). The TT genotype of rs1143627 was weakly associated with an increased risk of keratoconus (p=0.033, pc=0.099, odds ratio=1.52). However, no significant differences were found in the allele and genotype frequencies between the cases and controls for rs2071376 in IL1A. Regarding haplotypic diversity, the haplotype created by the T allele of rs1143627 and C allele of rs16944 was associated with a 1.72-fold increased risk of keratoconus (p=4.0×10(-5), pc=1.6×10(-4)). Our results replicate associations reported recently in a Korean population. Thus, IL1B may play an important role in the development of keratoconus through genetic polymorphisms.

Brittle cornea syndrome ZNF469 mutation carrier phenotype and segregation analysis of rare ZNF469 variants in familial keratoconus.

PubMed

Davidson, Alice E; Borasio, Edmondo; Liskova, Petra; Khan, Arif O; Hassan, Hala; Cheetham, Michael E; Plagnol, Vincent; Alkuraya, Fowzan S; Tuft, Stephen J; Hardcastle, Alison J

2015-01-06

Brittle cornea syndrome 1 (BCS1) is a rare recessive condition characterized by extreme thinning of the cornea and sclera, caused by mutations in ZNF469. Keratoconus is a relatively common disease characterized by progressive thinning and ectasia of the cornea. The etiology of keratoconus is complex and not yet understood, but rare ZNF469 variants have recently been associated with disease. We investigated the phenotype of BCS1 carriers with known pathogenic ZNF469 mutations, and recruited families in which aggregation of keratoconus was observed to establish if rare variants in ZNF469 segregated with disease. Patients and family members were recruited and underwent comprehensive anterior segment examination, including corneal topography. Blood samples were donated and genomic DNA was extracted. The coding sequence and splice sites of ZNF469 were PCR amplified and Sanger sequenced. Four carriers of three BCS1-associated ZNF469 loss-of-function mutations (p.[Glu1392Ter], p.[Gln1930Argfs*6], p.[Gln1930fs*133]) were examined and none had keratoconus. One carrier had partially penetrant features of BCS1, including joint hypermobility. ZNF469 sequencing in 11 keratoconus families identified 9 rare (minor allele frequency [MAF] ≤ 0.025) variants predicted to be potentially damaging. However, in each instance the rare variant(s) identified, including two previously reported as potentially keratoconus-associated, did not segregate with the disease. The presence of heterozygous loss-of-function alleles in the ZNF469 gene did not cause keratoconus in the individuals examined. None of the rare nonsynonymous ZNF469 variants identified in the familial cohort conferred a high risk of keratoconus; therefore, genetic variants contributing to disease pathogenesis in these 11 families remain to be identified. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

Comparison of three-dimensional optical coherence tomography and combining a rotating Scheimpflug camera with a Placido topography system for forme fruste keratoconus diagnosis.

PubMed

Fukuda, Shinichi; Beheregaray, Simone; Hoshi, Sujin; Yamanari, Masahiro; Lim, Yiheng; Hiraoka, Takahiro; Yasuno, Yoshiaki; Oshika, Tetsuro

2013-12-01

To evaluate the ability of parameters measured by three-dimensional (3D) corneal and anterior segment optical coherence tomography (CAS-OCT) and a rotating Scheimpflug camera combined with a Placido topography system (Scheimpflug camera with topography) to discriminate between normal eyes and forme fruste keratoconus. Forty-eight eyes of 48 patients with keratoconus, 25 eyes of 25 patients with forme fruste keratoconus and 128 eyes of 128 normal subjects were evaluated. Anterior and posterior keratometric parameters (steep K, flat K, average K), elevation, topographic parameters, regular and irregular astigmatism (spherical, asymmetry, regular and higher-order astigmatism) and five pachymetric parameters (minimum, minimum-median, inferior-superior, inferotemporal-superonasal, vertical thinnest location of the cornea) were measured using 3D CAS-OCT and a Scheimpflug camera with topography. The area under the receiver operating curve (AUROC) was calculated to assess the discrimination ability. Compatibility and repeatability of both devices were evaluated. Posterior surface elevation showed higher AUROC values in discrimination analysis of forme fruste keratoconus using both devices. Both instruments showed significant linear correlations (p<0.05, Pearson's correlation coefficient) and good repeatability (ICCs: 0.885-0.999) for normal and forme fruste keratoconus. Posterior elevation was the best discrimination parameter for forme fruste keratoconus. Both instruments presented good correlation and repeatability for this condition.

A new approach to keratoconus detection based on corneal morphogeometric analysis

PubMed Central

Bataille, Laurent; Fernández-Pacheco, Daniel G.; Cañavate, Francisco J. F.; Alió, Jorge L.

2017-01-01

Purpose To characterize corneal structural changes in keratoconus using a new morphogeometric approach and to evaluate its potential diagnostic ability. Methods Comparative study including 464 eyes of 464 patients (age, 16 and 72 years) divided into two groups: control group (143 healthy eyes) and keratoconus group (321 keratoconus eyes). Topographic information (Sirius, CSO, Italy) was processed with SolidWorks v2012 and a solid model representing the geometry of each cornea was generated. The following parameters were defined: anterior (Aant) and posterior (Apost) corneal surface areas, area of the cornea within the sagittal plane passing through the Z axis and the apex (Aapexant, Aapexpost) and minimum thickness points (Amctant, Amctpost) of the anterior and posterior corneal surfaces, and average distance from the Z axis to the apex (Dapexant, Dapexpost) and minimum thickness points (Dmctant, Dmctpost) of both corneal surfaces. Results Significant differences among control and keratoconus group were found in Aapexant, Aapexpost, Amctant, Amctpost, Dapexant, Dapexpost (all p<0.001), Apost (p = 0.014), and Dmctpost (p = 0.035). Significant correlations in keratoconus group were found between Aant and Apost (r = 0.836), Amctant and Amctpost (r = 0.983), and Dmctant and Dmctpost (r = 0.954, all p<0.001). A logistic regression analysis revealed that the detection of keratoconus grade I (Amsler Krumeich) was related to Apost, Atot, Aapexant, Amctant, Amctpost, Dapexpost, Dmctant and Dmctpost (Hosmer-Lemeshow: p>0.05, R2 Nagelkerke: 0.926). The overall percentage of cases correctly classified by the model was 97.30%. Conclusions Our morphogeometric approach based on the analysis of the cornea as a solid is useful for the characterization and detection of keratoconus. PMID:28886157

Association of -31T>C and -511 C>T polymorphisms in the interleukin 1 beta (IL1B) promoter in Korean keratoconus patients.

PubMed

Kim, So-Hee; Mok, Jee-Won; Kim, Hyun-Seok; Joo, C K

2008-01-01

To investigate the genetic association between unrelated Korean keratoconus patients and interleukin 1 alpha (IL1A), interleukin 1 beta (IL1B), and IL1 receptor antagonist (IL1RN) gene polymorphisms. We investigated the association between IL1A (rs1800587, rs2071376, and rs17561), IL1B (rs1143627, rs16944, rs1143634, and rs1143633), and IL1RN (rs419598, rs423904, rs424078, and rs315952, variable number tandem repeat [VNTR]) polymorphisms in 100 unrelated Korean keratoconus patients. One hundred control individuals without any corneal disease were selected from the general population. Polymerase chain reaction (PCR) - restriction fragment length polymorphism (RFLP) analysis and direct sequencing were used to screen for genetic variations in the IL1 gene cluster. Haplotypes for the IL1 gene cluster were constructed using Haploview version 4.0. We analyzed a total of 12 polymorphic sites in the IL1 gene cluster. Among them, the -511 (rs16944) and -31 (rs1143627) positions in the promoter region of IL1B were significantly different between patient and control groups. The C allele of rs16944 (-511C>T, p=0.022, odds ratio of risk [OR]=1.46, 95% confidence intervals [CI] 0.94<2.27) and the T allele of rs1143627 (-31T>C, p=0.025, OR=1.43, 95% CI 0.92<2.22) were associated with a significantly increased risk of keratoconus in Korean patients. Linkage of the two alleles, -31*C and -511*T, was associated with an increased risk for keratoconus with OR=2.38 (p=0.012, 95% CI=1.116-5.046). The *C/*A genotype of rs2071376 in IL1A intron 6 was significantly different between the keratoconus patients and control subjects (p=0.034, OR=0.59, 95% CI 0.32<1.11). Other polymorphisms did not show an association with keratoconus risk. This is the first report of IL1 gene cluster mutation screening in Korean keratoconus patients. Significant differences in allelic frequency of IL1B between keratoconus patients and the control group suggest that IL1B polymorphisms may play a role in the susceptibility of unrelated Koreans to develop keratoconus.

Proteases, proteolysis and inflammatory molecules in the tears of people with keratoconus.

PubMed

Balasubramanian, Sivaraman Arumugam; Mohan, Sujatha; Pye, David Cecil; Willcox, Mark Duncan Perry

2012-06-01

To investigate the expression of proteases, proteolytic activity and cytokines in the tear film of people with keratoconus. Basal tears from people with keratoconus, from individuals who had undergone corneal collagen cross-linking for the treatment of keratoconus, and from normal controls were collected using a capillary tube. Corneal curvature of each subject was mapped. The total protein in tears was estimated. Levels and activity of proteases in the tears were analysed using specific antibody arrays and activity assays. The total tear protein level was significantly reduced in keratoconus (4.1 ± 0.9 mg/ml) compared with normals (6.7 ± 1.4 mg/ml) (p < 0.0001) or subjects who had undergone corneal collagen cross-linking (5.7 ± 2.3 mg/ml) (p < 0.005). Significantly (p < 0.05) increased tear expression of matrix metalloproteinases (MMP) -1, -3, -7, -13, interleukins (IL) -4, -5, -6, -8 and tumour necrosis factor (TNF) -α, -β were evident in keratoconus. Tear IL-6 was the only cytokine significantly (p < 0.05) increased in tears of keratoconus subjects compared with the collagen cross-linked group. No significant difference in tear proteases were observed between the normal and the cross-linked groups, although the expression of TNF-α was significantly (p < 0.05) increased in the cross-linked group compared with the controls. Elevated gelatinolytic (87.5 ± 33.6 versus 45.8 ± 24.6 FIU, p < 0.0001) and collagenolytic (6.1 ± 3.2 versus 3.6 ± 2.0 FIU, p < 0.05) activities were observed in tears from keratoconus compared with normal subjects. The activity of tear gelatinases (69.6 ± 22.2 FIU) and collagenases (5.7 ± 3.3 FIU) in the collagen cross-linked group was not significantly different compared with either keratoconus or normals. Tears of people with keratoconus had 1.9 times higher levels of proteolytic activity and over expression of several MMPs and cytokines compared with tears from controls. Further investigations are required to study the possible implications of these changes and whether they can be used to monitor disease progression or determine the success of corneal collagen cross-linking. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

Combining primary and piggyback intraocular lenses to treat extreme myopic astigmatism in stable keratoconus following cataract surgery.

PubMed

Goh, Yi Wei; Misra, Stuti; Patel, Dipika V; McGhee, Charles N J

2013-03-01

The majority of those with keratoconus can maximise visual acuity with spectacle or contact lens correction as they age; however, as subjects enter their sixties, cataracts may supervene and contact lens tolerance diminishes with consequent reduction in visual acuity. Following cataract extraction, the complex refractive error associated with keratoconus may not be readily corrected by an intraocular lens alone. This report highlights the planned implantation of a primary posterior chamber toric intraocular lens with a secondary piggyback, sulcus-based, intraocular lens in advanced but stable keratoconus with extreme myopic astigmatism and cataract. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

Penetrating keratoplasty for keratoconus: role of videokeratoscopy and trephine sizing.

PubMed

Serdarevic, O N; Renard, G J; Pouliquen, Y

1996-11-01

To evaluate whether determining graft-host trephine disparity on the basis of videokeratoscopic data of keratoconus patients having penetrating keratoplasty (PKP) reduces ametropia and to correlate preoperative videokeratoscopic values, posterior axial length (PAL), and trephine disparity with postoperative refractive outcomes. Hôtel-Dieu, University of Paris, France. This randomized clinical trial comprised 18 keratoconus patients who had PKP. After computerized videokeratoscopic analysis, patients were randomly assigned to a test or control group with matching for midperipheral corneal keratoscopic criteria. One surgeon performed all grafts using the same technique (except for donor button punching with an 8.00 or 8.25 mm blade, depending on preoperative keratoscopy) with suction trephination (8.00) and a running 10-0 nylon suture. The PAL (total axial length minus the distance from the anterior corneal surface to the anterior lens surface) was measured by applanation ultrasonography. Refraction and videokeratoscopic analysis were done 18 months postoperatively (6 months after suture removal). The mean deviation from emmetropia corrected for PAL in test group patients who had trephine sizing based on the hypothesis that preoperative videokeratoscopy is a useful determining factor was 1.12 diopters (D) +/- 0.74 (SD), which was significantly smaller (P = .005) than that in the control group (2.19 +/- 0.85 D). The test group had uncorrected visual acuities of 20/50 or better. Postoperative spherical equivalent was affected by PAL (P = .0001), preoperative keratoscopy (P = .0001), and trephine disparity (P = .01). Central corneal power after grafting was influenced by keratoscopy (P = .0001) and trephine disparity (P = .002). Uncorrected visual acuity was affected by PAL (P = .001) and keratoscopic data (P = .01). Parameters for reducing ametropia after grafting of keratoconus patients can be developed for each surgeon based on trephine disparity dependent on preoperative keratoscopic values of the recipient midperipheral cornea and PAL. If the PAL is between 19.0 and 21.0 mm, preoperative midperipheral corneal videokeratoscopy to choose same-size or 0.25 mm different donor and recipient trephine blades is useful to achieve refractive results approximating emmetropia with the described technique.

Effect of Conus Eccentricity on Visual Outcomes After Intracorneal Ring Segments Implantation in Keratoconus.

PubMed

Gatzioufas, Zisis; Panos, Georgios D; Elalfy, Mohamed; Khine, Aye; Hamada, Samer; Lake, Damian; Kozeis, Nikos; Balidis, Miltos

2018-03-01

To investigate the potential impact of cone eccentricity on visual outcomes after Keraring (Mediphacos, Belo Horizonte, Brazil) implantation for keratoconus. Nineteen eyes from 19 patients with keratoconus who underwent femtosecond laser-assisted Keraring implantation for keratoconus were included in this retrospective study. Uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), keratometric readings, central corneal thickness, maximum keratometric distance from corneal apex (DKmax), corneal thinnest point from corneal apex (DTh), and coma were evaluated preoperatively and 6 months after the Keraring implantation. DKmax and DTh were used as metrics reflecting the eccentricity of the cone. UDVA, CDVA, keratometric readings, and coma improved at 6 months postoperatively. However, there was no correlation between DKmax or DTh and visual outcomes at 6 months postoperatively. The data did not show any impact of the cone eccentricity on visual outcomes after Keraring implantation for keratoconus at 6 months postoperatively. [J Refract Surg. 2018;34(3):196-200.]. Copyright 2018, SLACK Incorporated.

[Comparison of Discriminant Analysis and Decision Trees for the Detection of Subclinical Keratoconus].

PubMed

Kleinhans, Sonja; Herrmann, Eva; Kohnen, Thomas; Bühren, Jens

2017-08-15

Background Iatrogenic keratectasia is one of the most dreaded complications of refractive surgery. In most cases, keratectasia develops after refractive surgery of eyes suffering from subclinical stages of keratoconus with few or no signs. Unfortunately, there has been no reliable procedure for the early detection of keratoconus. In this study, we used binary decision trees (recursive partitioning) to assess their suitability for discrimination between normal eyes and eyes with subclinical keratoconus. Patients and Methods The method of decision tree analysis was compared with discriminant analysis which has shown good results in previous studies. Input data were 32 eyes of 32 patients with newly diagnosed keratoconus in the contralateral eye and preoperative data of 10 eyes of 5 patients with keratectasia after laser in-situ keratomileusis (LASIK). The control group was made up of 245 normal eyes after LASIK and 12-month follow-up without any signs of iatrogenic keratectasia. Results Decision trees gave better accuracy and specificity than did discriminant analysis. The sensitivity of decision trees was lower than the sensitivity of discriminant analysis. Conclusion On the basis of the patient population of this study, decision trees did not prove to be superior to linear discriminant analysis for the detection of subclinical keratoconus. Georg Thieme Verlag KG Stuttgart · New York.

Dr John Nottingham's 1854 Landmark Treatise on Conical Cornea Considered in the Context of the Current Knowledge of Keratoconus.

PubMed

Gokul, Akilesh; Patel, Dipika V; McGhee, Charles N J

2016-05-01

John Nottingham has been widely credited with the first accurate description of keratoconus in his treatise on conical cornea, published in 1854. Contained within the 270-page treatise are accounts and theories of keratoconus postulated by authors such as Scarpa, von Carion, von Ammon, and Mackenzie, synthesized by Nottingham in a treatise containing his own original observations. Nottingham's work delves deeply into keratoconus, with coverage reminiscent of a modern review, albeit in a far less succinct manner. He extensively describes the epidemiology, clinical presentation, underlying cause, and treatment of keratoconus. However, the concepts put forth are limited largely by the contemporary lack of understanding of the underlying anatomy and physiology of the eye, and the observations, by technological limitations. He postulates a similar treatment algorithm to that used today; optical devices being the management option of choice in the mild stages with surgery being a last resort. None of the surgical methods discussed are used in the modern era, but he does make reference to the possible efficacy of corneal transplantation. Nottingham's treatise was published over 160 years ago, yet his ideas and observations are surprisingly accurate. It is very possible that he was the first person to publish an accurate, comprehensive description of keratoconus.

Keratoconus in Civil Aviation Pilots in a Report of Six Cases.

PubMed

Rebello, Albert; Rodrigues, Bênesson; Pereira, Marcos

2017-06-01

Keratoconus is a progressive noninflammatory ectatic corneal dystrophy, characterized by corneal thinning and increased curvature with central or paracentral tapered protrusion. Such changes in corneal morphology induce irregular astigmatism and myopia, resulting in visual acuity impairment. This report assesses cases in which keratoconus is not an absolute disabling condition for civil aviation pilots. Six cases of keratoconus in active pilots are presented. This report includes cases which were treated with crosslinking therapy and even corneal transplantation. In such cases, the civil aviation medical authority considered four aspects in the medical assessment: best corrected visual acuity, condition stability, risk of sudden incapacitation, and pilot category. Six civil pilots with ages between 19 and 45 yr of age presented with keratoconus in different stages. Using the Snellen scale, best corrected visual acuity (BCVA) was measured in 12 eyes, all of them having equal or better than 20/30 (20/20, N = 9; 20/25, N = 2; 20/30, N = 1). All of them are currently fit for aviation activity and have been given an aviation medical certificate with limitation of use of corrective lenses by the Brazilian Civil Aviation Authority (ANAC in Portuguese). Among these cases, there is a pilot who had undergone treatment with crosslinking therapy and another that had undergone corneal transplantation. These cases demonstrate that keratoconus is not always a disabling condition for civil aviation pilots. Nevertheless, it has to be analyzed on a case-by-case basis.Rebello A, Rodrigues B, Pereira M. Keratoconus in civil aviation pilots in a report of six cases. Aerosp Med Hum Perform. 2017; 88(6):574-578.

New web-based algorithm to improve rigid gas permeable contact lens fitting in keratoconus.

PubMed

Ortiz-Toquero, Sara; Rodriguez, Guadalupe; de Juan, Victoria; Martin, Raul

2017-06-01

To calculate and validate a new web-based algorithm for selecting the back optic zone radius (BOZR) of spherical gas permeable (GP) lens in keratoconus eyes. A retrospective calculation (n=35; multiple regression analysis) and a posterior prospective validation (new sample of 50 keratoconus eyes) of a new algorithm to select the BOZR of spherical KAKC design GP lenses (Conoptica) in keratoconus were conducted. BOZR calculated with the new algorithm, manufacturer guidelines and APEX software were compared with the BOZR that was finally prescribed. Number of diagnostic lenses, ordered lenses and visits to achieve optimal fitting were recorded and compared those obtained for a control group [50 healthy eyes fitted with spherical GP (BIAS design; Conoptica)]. The new algorithm highly correlated with the final BOZR fitted (r 2 =0.825, p<0.001). BOZR of the first diagnostic lens using the new algorithm demonstrated lower difference with the final BOZR prescribed (-0.01±0.12mm, p=0.65; 58% difference≤0.05mm) than with the manufacturer guidelines (+0.12±0.22mm, p<0.001; 26% difference≤0.05mm) and APEX software (-0.14±0.16mm, p=0.001; 34% difference≤0.05mm). Close numbers of diagnostic lens (1.6±0.8, 1.3±0.5; p=0.02), ordered lens (1.4±0.6, 1.1±0.3; P<0.001), and visits (3.4±0.7, 3.2±0.4; p=0.08) were required to fit keratoconus and healthy eyes, respectively. This new algorithm (free access at www.calculens.com) improves spherical KAKC GP fitting in keratoconus and can reduce the practitioner and patient chair time to achieve a final acceptable fit in keratoconus. This algorithm reduces differences between keratoconus GP fitting (KAKC design) and standard GP (BIAS design) lenses fitting in healthy eyes. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Simplified refracting technique in keratoconus.

PubMed

Gasset, A R

1975-01-01

A simple but effective technique to refract keratoconus patients is presented. The theoretical objection to these methods are discussed. In addition, a formula to calculate lenticular astigmatism is presented.

Safety and efficacy of collagen crosslinking for the treatment of keratoconus.

PubMed

Kolli, Sai; Aslanides, Ioannis M

2010-11-01

Keratoconus is a condition that causes corneal ectasia and reduced vision in young adults. A proportion of these patients have progressive disease requiring corneal transplantation. A revolutionary new treatment that is purported to halt progression of keratoconus, known as collagen crosslinking (CXL), has recently been introduced into clinical practice. CXL involves the treatment of the cornea with riboflavin followed by photoactivation with UVA light leading to corneal strengthening. This article reviews the basic science, clinical protocols, safety aspects and clinical results of CXL. The reader will gain a comprehensive understanding of: i) the basic science of CXL; ii) the optimised protocols for clinical use of CXL; iii) the results of all the main clinical trials in the literature; iv) contraindications to treatment and v) full clinical safety profile of CXL. CXL represents a new treatment that uniquely allows the halt of progression of keratoconus, thus preventing visual loss and the need for surgical intervention. Available data suggest that this treatment has high efficacy and is very safe and may represent the future standard treatment for progressive keratoconus.

Noonan's syndrome with keratoconus and optic disc coloboma.

PubMed

Ascaso, F J; Del Buey, M A; Huerva, V; Latre, B; Palomar, A

1993-01-01

We report the case of a 14-year-old girl with multiple findings characteristic of Noonan's syndrome, including short stature, mild mental retardation, facial, skeletal and renal abnormalities. In addition, ophthalmic examination revealed a keratoconus in the left eye and a right optic disc coloboma. To date, only two cases of Noonan's syndrome with keratoconus have been reported, and this is the second case of this syndrome with optic disc coloboma. To our knowledge, this is the first report of Noonan's syndrome associated with unilateral keratoconus and contralateral optic disc coloboma. In view of the large number of patients with Noonan's syndrome reported to date and the rarity of these ocular abnormalities, it is most likely that this association is fortuitous. Ocular findings reported in patients with Noonan's syndrome are reviewed.

Cataract and keratoconus: minimizing complications in intraocular lens calculations.

PubMed

Bozorg, Sara; Pineda, Roberto

2014-01-01

Patients with both cataract and keratoconus present unique challenges for the surgeon. Accurate keratometry (K) and axial length (AL) readings may be impossible, and uncertainty is introduced when estimating the corneal power for intraocular lens (IOL) selection. Different options on how to choose an IOL and how to manage irregular astigmatism of a keratoconic patient with cataract have been proposed and are reviewed. The stage of keratoconus and the history of the patient are both critical in determining the strategy used in treatment of cataracts.

Evaluation of keratoconus progression.

PubMed

Shajari, Mehdi; Steinwender, Gernot; Herrmann, Kim; Kubiak, Kate Barbara; Pavlovic, Ivana; Plawetzki, Elena; Schmack, Ingo; Kohnen, Thomas

2018-06-01

To define variables for the evaluation of keratoconus progression and to determine cut-off values. In this retrospective cohort study (2010-2016), 265 eyes of 165 patients diagnosed with keratoconus underwent two Scheimpflug measurements (Pentacam) that took place 1 year apart ±3 months. Variables used for keratoconus detection were evaluated for progression and a correlation analysis was performed. By logistic regression analysis, a keratoconus progression index (KPI) was defined. Receiver-operating characteristic curve (ROC) analysis was performed and Youden Index calculated to determine cut-off values. Variables used for keratoconus detection showed a weak correlation with each other (eg, correlation r=0.245 between RPImin and Kmax, p<0.001). Therefore, we used parameters that took several variables into consideration (eg, D-index, index of surface variance, index for height asymmetry, KPI). KPI was defined by logistic regression and consisted of a Pachymin coefficient of -0.78 (p=0.001), a maximum elevation of back surface coefficient of 0.27 and coefficient of corneal curvature at the zone 3 mm away from the thinnest point on the posterior corneal surface of -12.44 (both p<0.001). The two variables with the highest Youden Index in the ROC analysis were D-index and KPI: D-index had a cut-off of 0.4175 (70.6% sensitivity) and Youden Index of 0.606. Cut-off for KPI was -0.78196 (84.7% sensitivity) and a Youden Index of 0.747; both 90% specificity. Keratoconus progression should be defined by evaluating parameters that consider several corneal changes; we suggest D-index and KPI to detect progression. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Fixed dilated pupil (Urrets-Zavalia syndrome) after air/gas injection after deep lamellar keratoplasty for keratoconus.

PubMed

Maurino, Vincenzo; Allan, Bruce D S; Stevens, Julian D; Tuft, Stephen J

2002-02-01

To describe three cases of fixed dilated pupil and presumed iris ischemia (Urrets-Zavalia syndrome) after anterior chamber air/gas injection after deep lamellar keratoplasty for keratoconus. Interventional case series. Three eyes of three patients with keratoconus underwent deep lamellar keratoplasty and intraoperative or postoperative injection of air/gas in the anterior chamber to appose the host-donor lamellar graft interface. Urrets-Zavalia syndrome was diagnosed on clinical grounds in three cases and was associated with the Descemet membrane microperforation intraoperatively and introduction of air/gas into the anterior chamber intraoperatively or postoperatively. A fixed dilated pupil is an uncommon complication of penetrating keratoplasty for keratoconus that can also develop after deep lamellar keratoplasty. Leaving an air or gas bubble in the anterior chamber of a phakic eye after deep lamellar keratoplasty is a risk factor and should therefore be avoided.

[Freiburg keratoconus registry : Example of application of smart data for clinical research and inititial results].

PubMed

Lang, S J; Böhringer, D; Reinhard, T

2016-06-01

Keratoconus is a progressive corneal disease with thinning and scarring of the cornea. Diagnostic and treatment options are usually evaluated in large prospective or retrospective trials. Big data and smart data provide the possibility to analyze routine data for clinical research. In this article we report the generation of a monocentric keratoconus registry by means of computerized data analysis of routine data. This demonstrates the potential of clinical research by means of routine data. A "clinical data warehouse" was created from all available routine electronic data. At the time of first presentation, each eye was classified into one out of four categories: suspected, early disease, late disease and status postkeratoplasty. Through integration of multiple data sources the clinical course for each patient was documented in the registry. A total of 3681 eyes from 1841 patients were included. The median follow-up time was 0.54 years. Patient age was higher in the groups with more severe stages of keratoconus, the proportion of female patients was higher in the group of suspected keratoconus and patient age and male to female ratios showed statistically significant differences between the groups (p < 0.001). We were able to create a "clinical data warehouse" by linking multiple data sources and normalizing the data. With this tool we established a novel, monocentric keratoconus registry. Only the grading of disease severity and the exclusion of false positive results were carried out manually. In our opinion establishing a structured clinical data warehouse has a huge potential for clinical and retrospective studies and proves the value of the Smart Data concept.

Autorefraction Versus Manifest Refraction in Patients With Keratoconus.

PubMed

Soeters, Nienke; Muijzer, Marc B; Molenaar, Jurrian; Godefrooij, Daniel A; Wisse, Robert P L

2018-01-01

To compare visual performance using autorefraction and manifest refraction assessments in patients with keratoconus and investigate whether autorefraction measurements lead to suboptimal visual performance. Corrected distance visual acuity (CDVA) was measured in 90 eyes of 61 patients with keratoconus with both autorefraction and manifest refraction, in a random order. Maximum keratometry (Kmax), cone location, and wavefront aberration were determined with Scheimpflug tomography. The difference between the autorefraction and manifest refraction outcomes was converted to vectors and a multivariable analysis was performed to identify potential underlying causes of this difference. A significantly better CDVA was achieved with manifest refraction (0.06 vs 0.29 logMAR [20/23 vs 20/38 Snellen], P < .001). After vector analysis, a mean difference of 4.83 diopters was found between autorefraction and manifest refraction. Increased Kmax was strongly and significantly associated with better visual performance of manifest refraction compared to autorefraction (B = 0.496, P = .002). This study showed that a superior CDVA is achieved with manifest refraction compared to autorefraction in patients with keratoconus. Furthermore, the difference between the two refraction methods increases as the cornea steepens. According to this study, autorefraction is unreliable in patients with keratoconus and should be avoided. [J Refract Surg. 2018;34(1):30-34.]. Copyright 2018, SLACK Incorporated.

Stromal demarcation line induced by corneal cross-linking in eyes with keratoconus and nonkeratoconic asymmetric topography.

PubMed

Malta, João B N; Renesto, Adimara C; Moscovici, Bernardo K; Soong, H K; Campos, Mauro

2015-02-01

To evaluate stromal demarcation lines following corneal cross-linking (CXL) using anterior segment optical coherence tomography in patients with keratoconus and nonkeratoconic asymmetric topography. Fifth-nine eyes of 59 patients were enrolled in a retrospective comparative case series, of which 19 eyes had keratoconus and 40 eyes had asymmetric topography. Eyes with asymmetric topography were treated in preparation for photorefractive keratectomy. One month after CXL, a stromal demarcation line was evaluated at 5 standardized corneal points using anterior segment optical coherence tomography. Mean stromal demarcation line depths were measured at 5 points on the cornea, namely, centrally, 3.0 mm temporally, 1.5 mm temporally, 3.0 mm nasally, and 1.5 mm nasally. For the keratoconus group, the values were 178 ± 47, 123 ± 15, 152 ± 47, 125 ± 23, and 160 ± 43 μm, respectively. For the asymmetric corneal topography group (without keratoconus), they were 305 ± 64, 235 ± 57, 294 ± 50, 214 ± 54, and 285 ± 58 μm, respectively. There was no correlation between central corneal pachymetry and stromal demarcation line depth in all 5 measured corneal points in both groups. CXL treatment profiles are similar in keratoconic and nonkeratoconic eyes with asymmetric topography.

Surgical Options for the Refractive Correction of Keratoconus: Myth or Reality

PubMed Central

Zaldivar, R.; Aiello, F.; Madrid-Costa, D.

2017-01-01

Keratoconus provides a decrease of quality of life to the patients who suffer from it. The treatment used as well as the method to correct the refractive error of these patients may influence on the impact of the disease on their quality of life. The purpose of this review is to describe the evidence about the conservative surgical treatment for keratoconus aiming to therapeutic and refractive effect. The visual rehabilitation for keratoconic corneas requires addressing three concerns: halting the ectatic process, improving corneal shape, and minimizing the residual refractive error. Cross-linking can halt the disease progression, intrastromal corneal ring segments can improve the corneal shape and hence the visual quality and reduce the refractive error, PRK can correct mild-moderate refractive error, and intraocular lenses can correct from low to high refractive error associated with keratoconus. Any of these surgical options can be performed alone or combined with the other techniques depending on what the case requires. Although it could be considered that the surgical option for the refracto-therapeutic treatment of the keratoconus is a reality, controlled, randomized studies with larger cohorts and longer follow-up periods are needed to determine which refractive procedure and/or sequence are most suitable for each case. PMID:29403662

Involvement of Sp1 elements in the promoter activity of genes affected in keratoconus.

PubMed

Maruyama, Y; Wang, X; Li, Y; Sugar, J; Yue, B Y

2001-08-01

Keratoconus is a progressive disease that thins and scars the corneal stroma. In keratoconus corneas, levels of degradative enzymes, including lysosomal acid phosphatase (LAP) and cathepsin B, are elevated, and those of the inhibitors alpha1-proteinase inhibitor (alpha 1-PI) and alpha 2-macroglobulin (alpha 2-M) are reduced, especially in the epithelial layer. An increased expression of the transcription factor Sp1 was also demonstrated. The role of Sp1 in regulation of the genes affected in keratoconus was examined in this study. DNA segments, containing 5'-flanking promoter sequences of the alpha 1-PI, LAP, cathepsin B, and alpha 2-M genes were ligated into the secreted alkaline phosphatase (SEAP) reporter gene vector. These constructs, along with the pSV beta-galactosidase control vector, were transfected into cultured human corneal epithelial and stromal cells and skin fibroblasts. Cotransfection with the Sp1 expression vector was performed in parallel. SEAP and beta-galactosidase enzyme activities were assayed. In corneal epithelial cells, as in stromal cells, alpha 1-PI promoter activity was suppressed by cotransfection of pPacSp1. The LAP, cathepsin B, and alpha 2-M promoters were functional in corneal cells, whereas activities of these promoters were much lower in skin fibroblasts. Cotransfection experiments indicated that the up- or downregulation of LAP, cathepsin B, and alpha 2-M observed in keratoconus-affected corneas was not mediated by Sp1. These results support the theory that the corneal epithelium, along with the stroma, is involved in keratoconus. An upstream role of Sp1 is indicated and the Sp1-mediated downregulation of the alpha 1-PI gene may be a key event in the disease development.

Consanguineous Marriage as a Risk Factor for Developing Keratoconus

PubMed Central

JAMALI, Hossein; BEIGI, Vahid; SADEGHI-SARVESTANI, Ali

2018-01-01

Heredity plays an important role in keratoconus (KC). Consanguineous marriage (CM) can affect the transmission of recessively inherited conditions. We aimed to investigate the role of consanguineous marriage in the development of KC. This study included two groups: the first group comprised 415 patients who underwent surgery for KC for the first time at Khalili University Hospital (Shiraz, Iran), between 2010 and 2014; the second group comprised 415 healthy individuals who served as age- and sex-matched controls for the patient group. All study subjects were from the Fars province in Iran. CM type was evaluated by a standard checklist in both groups. The mean inbreeding coefficient (α) was evaluated and compared between the two groups. The percentage of parental first-cousin marriages was 35.4% in the patient group and 18.3% in the control group. The mean inbreeding coefficient (α) was 0.0291 in the patient group and 0.0135 in the control group. Patients with KC had a significantly higher mean inbreeding coefficient (α) than controls (T = 8, df = 828, P < 0.001). Our study suggests that CM can play a role in the pathogenesis of KC. As this disease is among the most frequent ocular disorders in our country, CM should be considered by health care systems within their screening programs. PMID:29644240

Keratoconus presenting with bilateral simultaneous acute corneal hydrops.

PubMed

Bilgin, Burak; Unal, Betül; Unal, Mustafa; Doğan, Erkan; Cetinkaya, Aslı; Akyol, Mahmut; Yücel, Iclal; Akar, Yusuf; Apaydın, Cemil; Ilhan, Deniz

2013-04-01

To report a case of unknown keratoconus presenting with bilateral simultaneous acute corneal hydrops. Case report. A case of a 12-year-old male patient with Leber congenital amaurosis (LCA) presented with sudden whitening and lacrimation for 2 days in both eyes simultaneously. At the initial examination, there were bilateral acute corneal hydrops, enophthalmic eyes and roving nystagmus. Ultrasonography revealed clear crystalline lenses and attached retina. Initial management consisted of topical hypertonic solutions, steroids and artificial tears. Bilateral simultaneous acute corneal hydrops has not been reported before in the literature. It may be the presenting sign of keratoconus. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Scanning-slit topography in patients with keratoconus.

PubMed

Módis, László; Németh, Gábor; Szalai, Eszter; Flaskó, Zsuzsa; Seitz, Berthold

2017-01-01

To evaluate the anterior and posterior corneal surfaces using scanning-slit topography and to determine the diagnostic ability of the measured corneal parameters in keratoconus. Orbscan II measurements were taken in 39 keratoconic corneas previously diagnosed by corneal topography and in 39 healthy eyes. The central minimum, maximum, and astigmatic simulated keratometry (K) and anterior axial power values were determined. Spherical and cylindrical mean power diopters were obtained at the central and at the steepest point of the cornea both on anterior and on posterior mean power maps. Pachymetry evaluations were taken at the center and paracentrally in the 3 mm zone from the center at a location of every 45 degrees. Receiver operating characteristic (ROC) analysis was used to determine the best cut-off values and to evaluate the utility of the measured parameters in identifying patients with keratoconus. The minimum, maximum and astigmatic simulated K readings were 44.80±3.06 D, 47.17±3.67 D and 2.42±1.84 D respectively in keratoconus patients and these values differed significantly ( P <0.0001 for all comparisons) from healthy subjects. For all pachymetry measurements and for anterior and posterior mean power values significant differences were found between the two groups. Moreover, anterior central cylindrical power had the best discrimination ability (area under the ROC curve=0.948). The results suggest that scanning-slit topography and pachymetry are accurate methods both for keratoconus screening and for confirmation of the diagnosis.

A case of unilateral circumscribed posterior keratoconus evaluated by three different imaging tools: optical coherence tomography, videokeratography, and Scheimpflug corneal tomography.

PubMed

Spadea, Leopoldo; Maraone, Giorgia; Cagini, Carlo

2017-02-01

Posterior keratoconus is a rare corneal anomaly which is part of the ectatic corneal disorders. We report a clinical presentation of a unilateral posterior keratoconus in a 42-year-old man. At the time of presentation, corrected distance visual acuity (CDVA) was 20/20 with a correction of +2.50 +2.50 × 90° in the right eye and 20/40 with +1 +3.00 × 105° in the left eye. Slit lamp microscopy showed in the left eye an evidence of corneal thinning with a mild anterior protrusion and a remarkable posterior excavation. The intraocular pressure was 19 mmHg in right eye and 16 mmHg in left eye. Ultrasound pachymetry showed a minimum corneal thickness of 556 μ in right eye and 289 μ in left eye. The anterior segment optical coherence tomography (AS-OCT) revealed central corneal thinning and showed a reduced epithelial thickness. Videokeratography showed an increase of the corneal curvature in a defined area with central steepening in the area of the posterior corneal depression with gradual paracentral flattening. The description of this case underlines the importance of this instruments such us AS-OCT and corneal topography in diagnosis of posterior keratoconus. It can also be observed that in the contralateral eye there are no signs of ectasia as in the rare condition of unilateral keratoconus.

The value-based medicine comparative effectiveness and cost-effectiveness of penetrating keratoplasty for keratoconus.

PubMed

Roe, Richard H; Lass, Jonathan H; Brown, Gary C; Brown, Melissa M

2008-10-01

To perform a base case, comparative effectiveness, and cost-effectiveness (cost-utility) analysis of penetrating keratoplasty for patients with severe keratoconus. Visual acuity data were obtained from a large, retrospective multicenter study in which patients with keratoconus with less than 20/40 best corrected visual acuity and/or the inability to wear contact lenses underwent penetrating keratoplasty, with an average follow-up of 2.1 years. The results were combined with other retrospective studies investigating complication rates of penetrating keratoplasty. The data were then incorporated into a cost-utility model using patient preference-based, time trade-off utilities, computer-based decision analysis, and a net present value model to account for the time value of outcomes and money. The comparative effectiveness of the intervention is expressed in quality-of-life gain and QALYs (quality-adjusted life-years), and the cost-effectiveness results are expressed in the outcome of $/QALY (dollars spent per QALY). Penetrating keratoplasty in 1 eye for patients with severe keratoconus results in a comparative effectiveness (value gain) of 16.5% improvement in quality of life every day over the 44-year life expectancy of the average patient with severe keratoconus. Discounting the total value gain of 5.36 QALYs at a 3% annual discount rate yields 3.05 QALYs gained. The incremental cost for penetrating keratoplasty, including all complications, is $5934 ($5913 discounted at 3% per year). Thus, the incremental cost-utility (discounted at 3% annually) for this intervention is $5913/3.05 QALYs = $1942/QALY. If both eyes undergo corneal transplant, the total discounted value gain is 30% and the overall cost-utility is $2003. Surgery on the second eye confers a total discounted value gain of 2.5 QALYs, yielding a quality-of-life gain of 11.6% and a discounted cost-utility of $2238/QALY. Penetrating keratoplasty for patients with severe keratoconus seems to be a comparatively effective and cost-effective procedure when compared with other interventions across different medical specialties.

Multifocal Choroiditis with Retinal Vasculitis, Optic Neuropathy, and Keratoconus in a Young Saudi Male.

PubMed

Dhafiri, Yousef; Al Rubaie, Khalid; Kirat, Omar; May, William N; Nguyen, Quan D; Kozak, Igor

2017-01-01

The purpose of this study is to describe an association of unilateral multifocal choroiditis (MFC), retinal vasculitis, optic neuropathy, and bilateral keratoconus in a young Saudi male. A 27-year-old male patient with stable bilateral keratoconus presented with a painless vision loss in his left eye. Ophthalmic examinations revealed multiple foci of idiopathic chorioretinitis, retinal vasculitis, and mild optic disc leakage on fluorescein angiography, all of which resolved on systemic therapy with mycophenolate mofetil and prednisone after 3 months. Systemic medication was stopped after 8 months. One year after presentation, patient's visual acuity has improved and remained stable. Systemic immunomodulatory therapy can be effective in managing and leading to resolution of MFC, retinal vasculitis, and optic disc leak in young patients.

Meta-analysis of Pentacam vs. ultrasound pachymetry in central corneal thickness measurement in normal, post-LASIK or PRK, and keratoconic or keratoconus-suspect eyes.

PubMed

Wu, Wenjing; Wang, Yan; Xu, Lulu

2014-01-01

The aim of this meta-analysis is to evaluate the central corneal thickness (CCT) measurement differences between Pentacam (Oculus Inc., Germany) and Ultrasound Pachymetry (USP) in normal (unoperated eyes , myopic and astigmatic eyes without corneal disease or topographic irregularity), after laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK), and keratoconic or keratoconus suspected eyes. We assess whether Pentacam and USP have similar CCT differences in normal, thinner corneas after LASIK or PRK procedures, and kerotoconic or keratoconus suspected eyes. Data sources, including PubMed, Medline, EMBASE, and Cochrane Central Registry of Controlled Trials on the Cochrane Library, were searched to find the relevant studies. Primary outcome measures were CCT measurement between Pentacam and USP. Three groups of eyes were analyzed: normal; LASIK or PRK eyes; and keratoconus suspected or keratoconic eyes. Nineteen studies describing 1,908 eyes were enrolled in the normal group. Pentacam results were 1.47 μm ,95 % confidence interval (CI) -2.32 to 5.27, higher than USP without statistically significant difference (P = 0.45). Nine studies with total 539 eyes were included in the corneas after LASIK or PRK. The mean difference in the CCT measurement with Pentacam and ultrasound pachymetry was 1.03 μm, with the 95 % CI -3.36 to 5.42, there was no statistically difference (P = 0.64). Four studies with a total of 185 eyes were included in the keratoconic eyes or keratoconus-suspect group, however,the mean difference was -6.33 μm (95 % CI -9.17 to-3.49), which was statistically different between Pentacam and ultrasound pachymetry in the CCT measurement (P < 0.0001). Pentacam offers similar CCT results to ultrasound pachymetry in normal eyes, thinner corneas after LASIK or PRK procedures. However, in keratoconic or keratoconus-suspect eyes, Pentacam slightly underestimates the central corneal thickness than does ultrasound pachymetry, which may result from the difficulty in fixation of keratoconic eyes, misalignment of Pentacam and the variation of ultrasonic velocity due to the histological deformation.

Wavefront-Guided Scleral Lens Correction in Keratoconus

PubMed Central

Marsack, Jason D.; Ravikumar, Ayeswarya; Nguyen, Chi; Ticak, Anita; Koenig, Darren E.; Elswick, James D.; Applegate, Raymond A.

2014-01-01

Purpose To examine the performance of state-of-the-art wavefront-guided scleral contact lenses (wfgSCLs) on a sample of keratoconic eyes, with emphasis on performance quantified with visual quality metrics; and to provide a detailed discussion of the process used to design, manufacture and evaluate wfgSCLs. Methods Fourteen eyes of 7 subjects with keratoconus were enrolled and a wfgSCL was designed for each eye. High-contrast visual acuity and visual quality metrics were used to assess the on-eye performance of the lenses. Results The wfgSCL provided statistically lower levels of both lower-order RMS (p < 0.001) and higher-order RMS (p < 0.02) than an intermediate spherical equivalent scleral contact lens. The wfgSCL provided lower levels of lower-order RMS than a normal group of well-corrected observers (p < < 0.001). However, the wfgSCL does not provide less higher-order RMS than the normal group (p = 0.41). Of the 14 eyes studied, 10 successfully reached the exit criteria, achieving residual higher-order root mean square wavefront error (HORMS) less than or within 1 SD of the levels experienced by normal, age-matched subjects. In addition, measures of visual image quality (logVSX, logNS and logLIB) for the 10 eyes were well distributed within the range of values seen in normal eyes. However, visual performance as measured by high contrast acuity did not reach normal, age-matched levels, which is in agreement with prior results associated with the acute application of wavefront correction to KC eyes. Conclusions Wavefront-guided scleral contact lenses are capable of optically compensating for the deleterious effects of higher-order aberration concomitant with the disease, and can provide visual image quality equivalent to that seen in normal eyes. Longer duration studies are needed to assess whether the visual system of the highly aberrated eye wearing a wfgSCL is capable of producing visual performance levels typical of the normal population. PMID:24830371

Intracameral air injection for acute hydrops in keratoconus.

PubMed

Miyata, Kazunori; Tsuji, Hideki; Tanabe, Tatsuro; Mimura, Yoshiko; Amano, Shiro; Oshika, Tetsuro

2002-06-01

To evaluate the efficacy and safety of intracameral air injection in treating acute hydrops in keratoconus. Retrospective, nonrandomized, comparative trial. Thirty eyes (30 patients) with acute hydrops secondary to keratoconus. Nine eyes (nine patients) with acute hydrops in keratoconus were treated with intracameral injection of 0.1 ml filtered air. Additional 0.1 ml filtered air was injected if corneal edema persisted when air disappeared from the anterior chamber. Twenty-one eyes (21 patients) with acute hydrops that received no therapy or conventional therapy not likely to shorten the duration of hydrops served as controls. The period of persistence of corneal edema, the interval between the onset of acute hydrops, and the time when the eye could begin to wear a hard-contact lens, and best spectacle-corrected and hard-contact lens-corrected visual acuity after corneal edema subsided were used as criteria to evaluate any differences between the two groups. The average period of persistence of corneal edema was 20.1 +/- 9.0 days (+/- SD) in the intracameral air injection group and 64.7 +/- 34.6 days in the control (P =.0008). The average interval between the onset of acute hydrops and the time when the eye could begin to wear a hard-contact lens, was 33.4 +/- 5.6 days in the air injection group and 128.9 +/- 85.8 days in the control group (P =.0058). The best-corrected visual acuity after corneal edema subsided was similar between the two groups. Intracameral air injection induced no complications. The results suggest that the intracameral air injection is a safe and useful therapy to shorten the period of corneal edema in acute hydrops secondary to keratoconus.

An Analysis of Factors Influencing Quality of Vision After Big-Bubble Deep Anterior Lamellar Keratoplasty in Keratoconus.

PubMed

Feizi, Sepehr; Javadi, Mohammad Ali; Mohammad-Rabei, Hossein

2016-02-01

To identify causes of reduced visual acuity and contrast sensitivity after big-bubble deep anterior lamellar keratoplasty (DALK) in keratoconus. Prospective interventional case series. This study included 36 eyes in 36 patients with keratoconus who underwent DALK using the big-bubble technique. A bare Descemet membrane was achieved in all cases. Univariate analyses and multiple linear regression were used to investigate recipient-, donor-, and postoperative-related variables capable of influencing the postoperative quality of vision, including best spectacle-corrected visual acuity (BSCVA) and contrast sensitivity. The mean patient age was 27.7 ± 6.9 years, and the patients were followed for 24.6 ± 15.1 months postoperatively. The mean postoperative BSCVA was 0.17 ± 0.09 logMAR. Postoperative BSCVA ≥20/25 was achieved in 14 eyes (38.9%), whereas a BSCVA of 20/30, 20/40, or 20/50 was observed in 15 eyes (41.7%), 6 eyes (16.6%), and 1 eye (2.8%), respectively. Preoperative vitreous length was significantly associated with postoperative BSCVA (β = 0.02, P = .03). Donor-recipient interface reflectivity significantly influenced scotopic (β = -0.002, P = .04) and photopic (β = -0.003, P = .02) contrast sensitivity. The root mean square of tetrafoil was significantly negatively associated with scotopic (β = -0.25, P = .01) and photopic (β = -0.23, P = .04) contrast sensitivity. Recipient age, keratoconus severity, donor-related variables, recipient trephination size, and graft and recipient bed thickness were not significantly associated with postoperative visual acuity or contrast sensitivity. Large vitreous length, higher-order aberrations, and surgical interface haze may contribute to poor visual outcomes after big-bubble DALK in keratoconus. Copyright © 2016 Elsevier Inc. All rights reserved.

Correlation between visual function and refractive, topographic, pachymetric and aberrometric data in eyes with keratoconus

PubMed Central

Bayraktar Bilen, Neslihan; Hepsen, Ibrahim F.; Arce, Carlos G.

2016-01-01

AIM To analyze the relationship between two visual functions and refractive, topographic, pachymetric and aberrometric indicators in eyes with keratoconus. METHODS Corrected distance visual acuity (CDVA), and letter contrast sensitivity (CS) were correlated with refraction, corneal topography, pachymetry, and total corneal wavefront data prospectively in 71 eyes with keratoconus. The topographic indices assessed were simulated keratometry for the flattest and steepest meridians (SimK1 and SimK2), posterior steeper K (Ks), elevation value in best-fit sphere (BFS) maps, squared eccentricity (Є2), aspheric asymmetric index (AAI), pachymetry, thickness progression index (TPI), the amount of pachymetric decentralization (APD), and GalileiTM-keratoconus indices. RESULTS The mean CDVA (expressed as logMAR) were 0.25±0.21. The mean CS was 1.25±0.46. The spherical refraction correlated well with CDVA (r=-0.526, P<0.001). From topographic indices, SRI correlated with CS (r=-0.695), and IAI with CS (r=-0.672) (P<0.001 for all). Root mean square (RMS) was 4.3±1.81 µm, spherical aberration (SA) was -0.4±0.67 µm, vertical and horizontal coma were -2.1±1.47 and -0.4±0.72 µm. All wavefront data (except horizontal coma), AAI, Є2 and maximum BFS correlated significantly with the visual function (P≤0.001 for all). CONCLUSION In this study, CS is more affected than CDVA as a visual function. The quantity and quality of vision is significantly correlated with well-known and new topographic indices. There is not a significant correlation between visual function and pachymetric parameters. The significantly correlated indices can be used in staging keratoconus and to follow the outcome of a treatment. PMID:27588266

Current optometric practices and attitudes in keratoconus patient management.

PubMed

Ortiz-Toquero, Sara; Martin, Raul

2017-08-01

To compare the current optometric practices and attitudes in the management of keratoconus patients in the UK and Spain. An online survey (adapted to optometric practices) was distributed via a newsletter emailed by various professional organizations in the UK and Spain. Four hundred and sixty-four practitioners (126 in the UK; 338 in Spain) who prescribed gas permeable GP contact lenses (CLs) more than once per month (54.8% of UK practitioners and 28.1% of practitioners in Spain; p<0.01) responded to the questionnaire. A combination of multiple factors is considered necessary in the keratoconus detection (79.4% in the UK, 75% in Spain; p=0.68), and the use of classification criteria is considered relevant (67.5% in the UK, 70.7% in Spain; p=0.49). There is a high consensus on the consideration that GP CL fitting is more difficult in keratoconus (79.4% in the UK, 80.5% in Spain; p=0.79) requiring more diagnostic lenses (3.2±1.4 and 3.4±1.2 in the UK and Spain, respectively; p=0.72) than are necessary for healthy eyes. Using corneal topography is uncommon from both countries (38.1% in the UK, 59.8% in Spain; p<0.01), with a similar ophthalmologist referral pattern (at initial diagnosis, 50% in both the UK and Spain; p=1.00). Few cases of co-management with ophthalmologists were noted (no co-management reported by 60.3% in the UK and 72.8% in Spain, p=0.01). This study provides initial observations and evidence regarding keratoconus management by optometrists in the UK and Spain and shows similarity in the professional practices and attitudes of practitioners in these two countries. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Comparison of stromal corneal nerves between normal and keratoconus patients using confocal microscopy.

PubMed

Ramírez Fernández, M; Hernández Quintela, E; Naranjo Tackman, R

2014-08-01

To evaluate the differences in stromal corneal nerves between normal patients and keratoconus patients. A total of 140 eyes of 70 normal patients (group A) and 122 eyes of 87 keratoconus patients (group B) were examined with the confocal microscope, with a central scan of the total corneal thickness being taken. The morphology and thickness of the corneal stromal nerves were evaluated by using the Navis v. 3.5.0. software. Nerve thickness was obtained from the mean between the widest and the narrowest portions of each stromal nerve. Corneal stromal nerves were observed as irregular linear hyper-reflective structures with wide and narrow portions in all cases. Mean corneal stromal nerves thickness in group A was 5.7±1.7 (range from 3.3 to 10.4 μ), mean corneal stromal nerves thickness in group B was 7.2±1.9 (range from 3.5 to 12.0 μ). There was a statistical significant difference (P<.05) in stromal corneal nerves thickness between group A and group B. Stromal corneal nerves morphology was similar in both groups, but stromal nerves were thicker in keratoconus patients. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

[Keratoconus special soft contact lens fitting].

PubMed

Yamazaki, Ester Sakae; da Silva, Vanessa Cristina Batista; Morimitsu, Vagner; Sobrinho, Marcelo; Fukushima, Nelson; Lipener, César

2006-01-01

To evaluate the fitting and use of a soft contact lens in keratoconic patients. Retrospective study on 80 eyes of 66 patients, fitted with a special soft contact lens for keratoconus, at the Contact Lens Section of UNIFESP and private clinics. Keratoconus was classified according to degrees of disease severity by keratometric pattern. Age, gender, diagnosis, keratometry, visual acuity, spherical equivalent (SE), base curve and clinical indication were recorded. Of 66 patients (80 eyes) with keratoconus the mean age was 29 years, 51.5% were men and 48.5% women. According to the groups: 15.0% were incipient, 53.7% moderate, 26.3% advanced and 5.0% were severe. The majority of the eyes of patients using contact lenses (91.25%) achieved visual acuity better than 20/40. To 88 eyes 58% were tihed with lens with spherical power (mean -5.45 diopters) and 41% with spherocylinder power (from -0.5 to -5.00 cylindrical diopters). The most frequent base curve was 7.6 in 61% of the eyes. The main reasons for this special lens fitting were due to reduced tolerance and poor fitting pattern achieved with other lenses. The special soft contact lens is useful in fitting difficult keratoconic patients by offering comfort and improving visual rehabilitation that may allow more patients to postpone the need for corneal transplant.

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation

PubMed Central

El Emam, Dalia Sabry; Farag, Rania Kamel; Abouelkheir, Hossam Youssef

2016-01-01

Aim. To compare objective and subjective outcome after simultaneous wave front guided (WFG) PRK and accelerated corneal cross-linking (CXL) in patients with progressive keratoconus versus sequential WFG PRK 6 months after CXL. Methods. 62 eyes with progressive keratoconus were divided into two groups; the first including 30 eyes underwent simultaneous WFG PRK with accelerated CXL. The second including 32 eyes underwent subsequent WFG PRK performed 6 months later after accelerated CXL. Visual, refractive, topographic, and aberrometric data were determined preoperatively and during 1-year follow-up period and the results compared in between the 2 studied groups. Results. All evaluated visual, refractive, and aberrometric parameters demonstrated highly significant improvement in both studied groups (all P < 0.001). A significant improvement was observed in keratometric and Q values. The improvement in all parameters was stable till the end of follow-up. Likewise, no significant difference was determined in between the 2 groups in any of recorded parameters. Subjective data revealed similarly significant improvement in both groups. Conclusions. WFG PRK and accelerated CXL is an effective and safe option to improve the vision in mild to moderate keratoconus. In one-year follow-up, there is no statistically significant difference between the simultaneous and sequential procedure. PMID:28127465

Simultaneous topography-guided PRK followed by corneal collagen cross-linking for keratoconus.

PubMed

Kymionis, George D; Kontadakis, Georgios A; Kounis, George A; Portaliou, Dimitra M; Karavitaki, Alexandra E; Magarakis, Michael; Yoo, Sonia; Pallikaris, Ioannis G

2009-09-01

To present the results after simultaneous photorefractive keratectomy (PRK) followed by corneal collagen cross-linking (CXL) for progressive keratoconus. Twelve patients (14 eyes) with progressive keratoconus were prospectively treated with customized topography-guided PRK with the Pulzar Z1 (wavelength 213 nm, CustomVis) immediately followed by corneal collagen CXL with the use of riboflavin and ultraviolet A irradiation. Mean follow-up was 10.69+/-5.95 months (range: 3 to 16 months). Mean preoperative spherical equivalent refraction (SE) was -3.03+/-3.23 diopters (D) and defocus was 4.67+/-3.29 D; at last follow-up SE and defocus were statistically significantly reduced to -1.29+/-2.05 D and 3.04+/-2.53 D, respectively (P<.01). Preoperative mean (logMAR) uncorrected visual acuity was 0.99+/-0.81 and best spectacle-corrected visual acuity was 0.21+/-0.19, which improved postoperatively to 0.16+/-0.15 and 0.11+/-0.15, respectively. The mean steepest keratometry was reduced from 48.20+/-3.40 D preoperatively to 45.13+/-1.80 D at last follow-up. Simultaneous PRK followed by CXL seems to be a promising treatment capable of offering functional vision in patients with keratoconus. Copyright 2009, SLACK Incorporated.

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation.

PubMed

Abou Samra, Waleed Ali; El Emam, Dalia Sabry; Farag, Rania Kamel; Abouelkheir, Hossam Youssef

2016-01-01

Aim . To compare objective and subjective outcome after simultaneous wave front guided (WFG) PRK and accelerated corneal cross-linking (CXL) in patients with progressive keratoconus versus sequential WFG PRK 6 months after CXL. Methods . 62 eyes with progressive keratoconus were divided into two groups; the first including 30 eyes underwent simultaneous WFG PRK with accelerated CXL. The second including 32 eyes underwent subsequent WFG PRK performed 6 months later after accelerated CXL. Visual, refractive, topographic, and aberrometric data were determined preoperatively and during 1-year follow-up period and the results compared in between the 2 studied groups. Results . All evaluated visual, refractive, and aberrometric parameters demonstrated highly significant improvement in both studied groups (all P < 0.001). A significant improvement was observed in keratometric and Q values. The improvement in all parameters was stable till the end of follow-up. Likewise, no significant difference was determined in between the 2 groups in any of recorded parameters. Subjective data revealed similarly significant improvement in both groups. Conclusions . WFG PRK and accelerated CXL is an effective and safe option to improve the vision in mild to moderate keratoconus. In one-year follow-up, there is no statistically significant difference between the simultaneous and sequential procedure.

Femtosecond laser-assisted deep anterior lamellar keratoplasty with big-bubble technique for keratoconus.

PubMed

Lu, Yan; Chen, Xiangfei; Yang, Liping; Xue, Chunyan; Huang, Zhenping

2016-09-01

The purpose of this study was to evaluate the clinical results after deep anterior lamellar keratoplasty (DALK) assisted by the femtosecond laser with big-bubble technique for keratoconus. A case series of 22 eyes in 19 patients with keratoconus was enrolled in the study. The 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec AG, Jena, Germany) was used to create a vertical side cut on donor and recipient corneas. Intraoperative and postoperative complications, uncorrected visual acuity, best-corrected visual acuity, corneal curvature, and central corneal thickness were evaluated in all patients. Big-bubble and naked Descemet's membrane (DM) were successfully achieved in twenty eyes (90.9%). Intraoperative macroperforation of DM occurred in two cases and converted to full-thickness keratoplasty. The mean follow-up time was 18.8 ± 5.3 months. The best-corrected visual acuity was increased from 0.3 to 1.0, mean corneal curvature was 43.0 ± 2.3D, and mean central corneal thickness was 508.9 ± 60.1 μm (range, from 430 to 600 μm) postoperatively. Our results indicate that femtosecond laser-assisted DALK with big-bubble technique is an accurate, safe, and effective method to treat the patients with keratoconus.

Bilateral ring-shaped intrastromal opacities after corneal cross-linking for keratoconus.

PubMed

Camesasca, Fabrizio I; Vinciguerra, Paolo; Seiler, Theo

2011-12-01

To report a case of bilateral, ring-shaped, intrastromal corneal opacities after corneal cross-linking (CXL) for progressive keratoconus. A 21-year-old man with bilateral, progressive keratoconus underwent CXL with riboflavin 0.1% and ultraviolet A (UVA) light in the right eye and, 6 months later, in the left eye. One day after CXL, the right eye showed a sharply demarcated white ring in the corneal periphery. The ring involved the superficial stroma at 2 mm from the limbus, extended from 1 to 11 o'clock, and was 1.5-mm wide. Corneal topography showed marked central flattening. Six months after treatment, a residual, faint, ring-shaped opacity remained, with a decrease in corneal ectasia. Cross-linking was then performed in the left eye. Different ultraviolet devices were used in the two eyes. On postoperative day 1, the left eye also showed a white ring of stromal opacity. Scheimpflug imaging showed corneal stromal contraction in the zone of whitening. At final examination, >1 year after surgery, corrected visual acuity was 0.00 logMAR with cylinder of 2.00 diopters in both eyes. The bilateral intrastromal corneal changes were innocuous in the long-term, with preservation of good visual acuity and successful stabilization of progressive keratoconus.

Measurement centration and zone diameter in anterior, posterior and total corneal astigmatism in keratoconus.

PubMed

Fredriksson, Anneli; Behndig, Anders

2017-12-01

To investigate the central and paracentral astigmatism and the significance of centration and measurement zone diameter compared to a 3-mm pupil-centred measurement zone in keratoconus and in healthy eyes. Twenty-eight right eyes from 28 KC patients with an inferotemporal cone were selected according to specified criteria based on Oculus Pentacam HR ® measurements and were matched with healthy control eyes. The flat (K1) and steep (K2) keratometry readings were registered from the 'Total Corneal Refractive Power' (TCRP) display as well as the anterior and posterior corneal astigmatism displays (ACA and PCA, respectively). Astigmatic power vectors KP0 and KP45 were calculated and analysed for a 6-mm and two 3-mm zones centred on the corneal apex and the pupil, and for 8 paracentral 3-mm zones. The astigmatism was generally higher in KC. Many astigmatic values in KC differed between the 3-mm pupil-centred and the 3- and 6-mm apex-centred zones in KC. In the controls, no corresponding differences between measurement zones were seen, apart from PCA, which differed. The magnitude and direction of KP0 and KP45 varied greatly between the paracentral measurements in KC. Centration and measurement zone diameter have great impacts on the astigmatic values in KC. A small pupil-centred measurement zone should be considered when evaluating the astigmatism in KC. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Distribution of ABO and Rh Blood Groups in Patients With Keratoconus: A Case-Control Study.

PubMed

Naderan, Mohammad; Rajabi, Mohammad Taher; Shoar, Saeed; Kamaleddin, Mohammad Amin; Naderan, Morteza; Rezagholizadeh, Farzaneh; Zolfaghari, Masoome; Pahlevani, Rozhin

2015-07-01

Association of keratoconus (KC) with genetic predisposition and environmental factors has been well documented. However, no single study has investigated the possible relationship between ABO and Rh blood groups and KC. A case-control study was designed in a university hospital enrolling 214 patients with KC in the case group and equal number of age- and sex-matched healthy subjects in the control group. Primary characteristics, ABO blood group, and Rh factors were compared between the two groups. Topographic findings of KC eyes and the severity of the diseases were investigated according to the distribution of the blood groups. Blood group O and Rh(+) phenotype were most frequent in both groups. There was no significant difference between the two groups in terms of ABO blood groups or Rh factors. Mean keratometery (K), central corneal thickness, thinnest corneal thickness, flat K, steep K, sphere and cylinder, spherical equivalent, and uncorrected visual acuity were all similar between ABO blood groups and Rh(+) and Rh(-) groups. However, the best spectacle-corrected visual acuity (BCVA) had the highest value in AB blood group (0.35 ± 0.22 logMAR, P=0.005). Moreover, the blood group AB revealed the highest frequency for grade 3 KC, followed by grades 1, 2, and 4 (P=0.003). We observed no significant excess of any particular blood group among KC cases compared with healthy subjects. Except BCVA, none of the keratometric or topographic findings was significantly different between blood groups.

Corneal Collagen Cross-Linking in the Management of Keratoconus in Canada: A Cost-Effectiveness Analysis.

PubMed

Leung, Victoria C; Pechlivanoglou, Petros; Chew, Hall F; Hatch, Wendy

2017-08-01

To use patient-level microsimulation models to evaluate the comparative cost-effectiveness of early corneal cross-linking (CXL) and conventional management with penetrating keratoplasty (PKP) when indicated in managing keratoconus in Canada. Cost-utility analysis using individual-based, state-transition microsimulation models. Simulated cohorts of 100 000 individuals with keratoconus who entered each treatment arm at 25 years of age. Fellow eyes were modeled separately. Simulated individuals lived up to a maximum of 110 years. We developed 2 state-transition microsimulation models to reflect the natural history of keratoconus progression and the impact of conventional management with PKP versus CXL. We collected data from the published literature to inform model parameters. We used realistic parameters that maximized the potential costs and complications of CXL, while minimizing those associated with PKP. In each treatment arm, we allowed simulated individuals to move through health states in monthly cycles from diagnosis until death. For each treatment strategy, we calculated the total cost and number of quality-adjusted life years (QALYs) gained. Costs were measured in Canadian dollars. Costs and QALYs were discounted at 5%, converting future costs and QALYs into present values. We used an incremental cost-effectiveness ratio (ICER = difference in lifetime costs/difference in lifetime health outcomes) to compare the cost-effectiveness of CXL versus conventional management with PKP. Lifetime costs and QALYs for CXL were estimated to be Can$5530 (Can$4512, discounted) and 50.12 QALYs (16.42 QALYs, discounted). Lifetime costs and QALYs for conventional management with PKP were Can$2675 (Can$1508, discounted) and 48.93 QALYs (16.09 QALYs, discounted). The discounted ICER comparing CXL to conventional management was Can$9090/QALY gained. Sensitivity analyses revealed that in general, parameter variations did not influence the cost-effectiveness of CXL. CXL is cost-effective compared with conventional management with PKP in the treatment of keratoconus. Our ICER of Can$9090/QALY falls well below the range of Can$20 000 to Can$100 000/QALY and below US$50 000/QALY, thresholds generally used to evaluate the cost-effectiveness of health interventions in Canada and the United States. This study provides strong economic evidence for the cost-effectiveness of early CXL in keratoconus. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Keratoconus corneal architecture after riboflavin/ultraviolet A cross-linking: Ultrastructural studies

PubMed Central

Almubrad, Turki; Paladini, Iacopo; Mencucci, Rita

2013-01-01

Purpose Study to investigate the effects of collagen cross-linking on the ultrastructural organization of the corneal stroma in the human keratoconus cornea (KC). Methods Three normal, three keratoconus (KC1, KC2, KC3), and three cross-linked keratoconus (CXL1, CXL2, CXL3) corneas were analyzed. The KC corneas were treated with a riboflavin-ultraviolet A (UVA) treatment (CXL) method described by Wollensak et al. Penetrating keratoplasty (PKP) was performed 6 months after treatment. All samples were processed for electron microscopy. Results The riboflavin-UVA-treated CXL corneal stroma showed interlacing lamellae in the anterior stroma followed by well-organized parallel running lamellae. The lamellae contained uniformly distributed collagen fibrils (CFs) decorated with normal proteoglycans (PGs). The CF diameter and interfibrillar spacing in the CXL cornea were significantly increased compared to those in the KC cornea. The PG area in the CXL corneas were significantly smaller than the PGs in the KC cornea. The epithelium and Bowman’s layer were also normal. On rare occasions, a thick basement membrane and collagenous pannus were also observed. Conclusions Corneal cross-linking leads to modifications of the cornea stroma. The KC corneal structure showed a modification in the CF diameter, interfibrillar spacing, and PG area. This resulted in a more uniform distribution of collagen fibrils, a key feature for corneal transparency. PMID:23878503

Reasons For Not Performing Keratorefractive Surgery in Patients Seeking Refractive Surgery in a Hospital-Based Cohort in “Yemen”

PubMed Central

Bamashmus, Mahfouth A.; Saleh, Mahmoud F.; Awadalla, Mohamed A.

2010-01-01

Background: To determine and analyze the reasons why keratorefractive surgery, laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) were not performed in patients who presented for refractive surgery consultation. Materials and Methods: A retrospective observational study was performed between January 2006 and December 2007 in the Yemen Magrabi Hospital. The case records of 2,091 consecutive new patients who presented for refractive surgery were reviewed. Information from the pre-operative ophthalmic examination, such as refractive error, corneal topography and visual acuity, were analyzed. The reasons for not performing LASIK and PRK in the cases that were rejected were recorded and analyzed. Results: In this cohort, 1,660 (79.4%) patients were advised to have LASIK or PRK from the 2,091 patients examined. LASIK and PRK were not advised in 431 (21%) patients. The most common reasons for not performing the surgery were high myopia >-11.00 Diopters (19%), keratoconus (18%), suboptimal central corneal thickness (15%), cataract (12%) and keratoconus suspect (forme fruste keratoconus) (10%). Conclusion: Patients who requested keratorefractive surgery have a variety of problems and warrant comprehensive attention to selection criteria on the part of the surgeon. Corneal topographies and pachymetry of refractive surgery candidates need to be read cautiously. High-refractive error, keratoconus and insufficient corneal thickness were found to be the leading reasons for not performing keratorefractive surgery in this study. PMID:21180437

Effects of the rigid gas permeable contact lense use on tear and ocular surface among keratoconus patients.

PubMed

Yuksel Elgin, Cansu; Iskeleli, Guzin; Aydin, Ovgu

2018-06-01

To investigate changes in tear and ocular surface of patients with keratoconus using rigid gas permeable contact lenses (RGPCL) and compare them against keratoconus patients who were not using lenses as well as a control group of healthy subjects. 24 keratoconus patients using RGPCL (Group 1) 22 patients who were not using lenses (Group 3) and 21 healthy subjects (Group 3) were included in the study. Subjective complaints about the subjects' eyes have been investigated using the ocular-surface disease index (OSDI). After the control of best-corrected visual acuity, anterior chamber and fundus examinations were performed. Schirmer (p-value=0.01) and tear break up mean comparison tests (p-value=0.002) revealed significant differences across different groups but tear osmolarity analysis did not (p-value >0.05). Oxford and OSDI scores were compatible with Schirmer and tear break up test comparisons. (for both p-value=0.001) Moreover, no statistical differences were seen in impression cytology measures between groups. (p-value >0.05) CONCLUSIONS: The erosion in the tear film stability is in line with the erosion in the ocular surface epithelium. Taking into account the statistical indifference between the impression cytology measures across groups, the break up time differences may be attributed to the collagen destruction in tear. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series.

PubMed

Kolozsvári, Bence L; Losonczy, Gergely; Pásztor, Dorottya; Fodor, Mariann

2017-01-13

Toric intraocular lens (IOL) implantation can be an effective method for correcting corneal astigmatism in patients with vitreoretinal diseases and cataract. Our purpose is to report the outcome of toric IOL implantation in two cases - a patient with scleral-buckle-induced regular corneal astigmatism and a patient with keratoconus following pars plana vitrectomy. As far as we are aware, there are no reported cases of toric IOL implantation in a vitrectomized eye with keratoconus nor of toric IOL implantation in patients with scleral-buckle-induced regular corneal astigmatism. Two patients with myopia and high corneal astigmatism underwent cataract operation with toric IOL implantation after posterior segment surgery. Myopia and high astigmatism (>2.5 diopter) were caused by previous scleral buckling in one case and by keratoconus in the other case. Pre- and postoperative examinations during the follow-up of included uncorrected and spectacle corrected distance visual acuity (UCDVA/CDVA), automated kerato-refractometry (Topcon), Pentacam HR, IOL Master (Zeiss) axial length measurements and fundus optical coherence tomography (Zeiss). One year postoperatively, the UCDVA and CDVA were 20/25 and 20/20 in both cases, respectively. The absolute residual refractive astigmatism was 1.0 and 0.75 Diopters, respectively. The IOL rotation was within 3° in both eyes, therefore IOL repositioning was not necessary. Complications were not observed in our cases. These cases demonstrate that toric IOL implantation is a predictable and safe method for the correction of high corneal astigmatism in complicated cases with different origins. Irregular corneal astigmatism in keratoconus or scleral-buckle-induced regular astigmatisms can be equally well corrected with the use of toric IOL during cataract surgery. Previous scleral buckling or pars plana vitrectomy seem to have no impact on the success of the toric IOL implantation, even in keratoconus. IOL rotational stability and refractive predictability in patients with a previous vitreoretinal surgery can be as good as in uncomplicated cases.

Altered tear inflammatory profile in Indian keratoconus patients - The 2015 Col Rangachari Award paper

PubMed Central

Shetty, Rohit; Deshmukh, Rashmi; Ghosh, Arkasubhra; Sethu, Swaminathan; Jayadev, Chaitra

2017-01-01

Purpose: Conventionally, keratoconus (KC) has been considered a noninflammatory corneal ectatic disorder. Recent evidence suggests a possible role of inflammation in the pathogenesis of KC. Hence, we analyzed the levels of inflammatory factors in the tear fluid of Indian KC patients. Methods: Tear fluid samples were collected from age- and sex-matched healthy controls and KC patients (with different grades). The levels of the inflammatory factors in tears were analyzed using cytometric bead array (Human Soluble Protein Flex Set System, BD Biosciences) for levels of interleukin-1α (IL-1α), IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-9, IL-10, IL-12p70, IL-23p40, IL-13, IL-17A, IL-17F, IL-21, interferon-α (IFNα), IFNγ, tumor necrosis factor-α, CCL2/monocyte chemotactic protein-1, CCL4/macrophage inflammatory protein-1β (MIP-1β), MIP-1α, CCL5/RANTES, CXCL10/IP10, ICAM1, CD62E, vascular endothelial growth factor and transforming growth factor β. Results: An increase in Kmax and Kmean, and a decrease in central corneal thickness was observed with increasing grades of KC. Tear analysis showed that most of the tear soluble factors, including cytokines, chemokines, growth factors and cell adhesion molecules were significantly elevated in the KC patients compared to the controls. Conclusion: Our findings suggest that inflammatory factors associated with KC may play a role in its pathogenesis. This opens the potential to explore anti-inflammatory strategies to either halt or delay the progression of KC. PMID:29133633

Efficacy of Corneal Collagen Cross-Linking for Treatment of Keratoconus: A Meta-Analysis of Randomized Controlled Trials

PubMed Central

Lin, Xiaoti

2015-01-01

Objective To evaluate the efficacy of corneal collagen cross-linking (CXL) for the treatment of keratoconus. Methods We performed a literature search for randomized controlled trials that assessed the effect of CXL in slowing progression of keratoconus. The primary outcome measures included changes of topographic parameters, visual acuity, and refraction. Efficacy estimates were evaluated by weighted mean difference (WMD) and 95% confidence interval (CI) for absolute changes of the interested outcomes. Results Significant decrease in mean keratometry value, maximum keratometry value and minimum keratometry value were demonstrated in the CXL group compared with the control group (WMD = -1.65; 95% CI: -2.51 to -0.80; P < 0.00001; WMD = -2.05; 95% CI: -3.10 to -1.00; P < 0.00001; WMD = -1.94; 95% CI: -2.63 to -1.26; P < 0.00001; respectively). Best spectacle-corrected visual acuity improved significantly in CXL group (WMD = -0.10; 95% CI: -0.15 to -0.05; P < 0.00001), whereas uncorrected visual acuity did not differ statistically. Manifest cylinder error decreased significantly in patients undergoing CXL procedure compared with control patients in sensitivity analysis (WMD = -0.388; 95% CI: -0.757 to -0. 019; P = 0.04). The changes in central corneal thickness and intraocular pressure were not statistically significant. Conclusion CXL may be an effective option in stabilizing keratoconus. Further long-term follow-up studies will be necessary to assess the persistence of CXL. PMID:25985208

Simultaneous topography-guided PRK followed by corneal collagen cross-linking after lamellar keratoplasty for keratoconus.

PubMed

Spadea, Leopoldo; Paroli, Marino

2012-01-01

The purpose of this paper is to report the results of using combined treatment of customized excimer laser-assisted photorefractive keratectomy (PRK) and prophylactic corneal collagen crosslinking (CXL) for residual refractive error in a group of patients who had previously undergone lamellar keratoplasty for keratoconus. The study included 14 eyes from 14 patients who had originally been treated for keratoconus in one eye by excimer laser-assisted lamellar keratoplasty (ELLK), and subsequently presented with residual ametropia (-6.11 D ± 2.48, range -2.50 to -9.50). After a mean 40.1 ± 12.4 months since ELLK they underwent combined simultaneous corneal regularization treatment with topographically guided transepithelial excimer laser PRK (central corneal regularization) and corneal CXL induced by riboflavin-ultraviolet A. After a mean 15 ± 6.5 (range 6-24) months, all eyes gained at least one Snellen line of uncorrected distance visual acuity (range 1-10). No patient lost lines of corrected distance visual acuity, and four patients gained three lines of corrected distance visual acuity. Mean manifest refractive spherical equivalent was -0.79 ± 2.09 (range +1 to -3.0) D, and topographic keratometric astigmatism was 5.02 ± 2.93 (range 0.8-8.9) D. All the corneas remained clear (haze < 1). The combination of customized PRK and corneal CXL provided safe and effective results in the management of corneal regularization for refractive purposes after ELLK for keratoconus.

Transepithelial photorefractive keratectomy with crosslinking for keratoconus.

PubMed

Mukherjee, Achyut N; Selimis, Vasilis; Aslanides, Ioannis

2013-01-01

To analyse visual, refractive and topographic outcomes of combining transepithelial photorefractive keratectomy (tPRK) with simultaneous corneal crosslinking for the visual rehabilitation of contact lens intolerant keratoconus patients. Patients with topographically significant keratoconus, limited corrected vision and intolerant of contact lenses were prospectively recruited, subject to ethical approval and consent. All patients underwent single step aspheric tPRK and sequential crosslinking. Preoperative vision, refraction, corneal topography and wavefront were assessed, with postoperative assessment at 1, 3, 6, and 12 months. 22 eyes of 14 patients were included in the pilot study. Mean age was 32 years (SD 6.8, range 24 to 43). Mean preoperative unaided vision was 1.39 LogMAR (SD 0.5) best corrected 0.31 LogMAR (SD 0.2). Mean preoperative spherical equivalent was -2.74 Diopters (D) (SD 4.1 range -12.25 to +7.75), and mean cylinder -2.9 D (SD 1.2, range 0 to -5.5). Mean central corneal thickness was 461um (SD 29, range 411 to 516). Vision improved postoperatively; unaided 0.32 LogMAR (SD 0.4), best corrected 0.11 (SD 0.13) (P=<0.005). Mean postoperative cylinder was -1.4D (SD1.2), significantly reduced (p<0.005). Maximum keratometry (Kmax) was stable throughout postoperative follow up. (p<0.05). Non topographic transepithelial PRK with simultaneous crosslinking improves vision, and may offer an alternative to keratoplasty in contact lens intolerant keratoconus. Further comparative studies to topographic PRK techniques are indicated.

Transepithelial Photorefractive Keratectomy with Crosslinking for Keratoconus

PubMed Central

Mukherjee, Achyut N; Selimis, Vasilis; Aslanides, Ioannis

2013-01-01

Purpose: To analyse visual, refractive and topographic outcomes of combining transepithelial photorefractive keratectomy (tPRK) with simultaneous corneal crosslinking for the visual rehabilitation of contact lens intolerant keratoconus patients. Methods: Patients with topographically significant keratoconus, limited corrected vision and intolerant of contact lenses were prospectively recruited, subject to ethical approval and consent. All patients underwent single step aspheric tPRK and sequential crosslinking. Preoperative vision, refraction, corneal topography and wavefront were assessed, with postoperative assessment at 1, 3, 6, and 12 months. Results: 22 eyes of 14 patients were included in the pilot study. Mean age was 32 years (SD 6.8, range 24 to 43). Mean preoperative unaided vision was 1.39 LogMAR (SD 0.5) best corrected 0.31 LogMAR (SD 0.2). Mean preoperative spherical equivalent was -2.74 Diopters (D) (SD 4.1 range -12.25 to +7.75), and mean cylinder -2.9 D (SD 1.2, range 0 to -5.5). Mean central corneal thickness was 461um (SD 29, range 411 to 516). Vision improved postoperatively; unaided 0.32 LogMAR (SD 0.4), best corrected 0.11 (SD 0.13) (P=<0.005). Mean postoperative cylinder was -1.4D (SD1.2), significantly reduced (p<0.005). Maximum keratometry (Kmax) was stable throughout postoperative follow up. (p<0.05). Conclusions: Non topographic transepithelial PRK with simultaneous crosslinking improves vision, and may offer an alternative to keratoplasty in contact lens intolerant keratoconus. Further comparative studies to topographic PRK techniques are indicated. PMID:24222809

Algorithm for Correcting the Keratometric Error in the Estimation of the Corneal Power in Keratoconus Eyes after Accelerated Corneal Collagen Crosslinking

PubMed Central

Caravaca-Arens, Esteban; de Fez, Dolores; Blanes-Mompó, Francisco J.

2017-01-01

Purpose To analyze the errors associated to corneal power calculation using the keratometric approach in keratoconus eyes after accelerated corneal collagen crosslinking (CXL) surgery and to obtain a model for the estimation of an adjusted corneal refractive index (nkadj) minimizing such errors. Methods Potential differences (ΔPc) among keratometric (Pk) and Gaussian corneal power (PcGauss) were simulated. Three algorithms based on the use of nkadj for the estimation of an adjusted keratometric corneal power (Pkadj) were developed. The agreement between Pk(1.3375) (keratometric power using the keratometric index of 1.3375), PcGauss, and Pkadj was evaluated. The validity of the algorithm developed was investigated in 21 keratoconus eyes undergoing accelerated CXL. Results P k(1.3375) overestimated corneal power between 0.3 and 3.2 D in theoretical simulations and between 0.8 and 2.9 D in the clinical study (ΔPc). Three linear equations were defined for nkadj to be used for different ranges of r1c. In the clinical study, differences between Pkadj and PcGauss did not exceed ±0.8 D nk = 1.3375. No statistically significant differences were found between Pkadj and PcGauss (p > 0.05) and Pk(1.3375) and Pkadj (p < 0.001). Conclusions The use of the keratometric approach in keratoconus eyes after accelerated CXL can lead to significant clinical errors. These errors can be minimized with an adjusted keratometric approach. PMID:29201459

Arginase activity, urea, and hydroxyproline concentration are reduced in keratoconus keratocytes.

PubMed

Stachon, Tanja; Kolev, Krasimir; Flaskó, Zsuzsa; Seitz, Berthold; Langenbucher, Achim; Szentmáry, Nóra

2017-01-01

Keratoconus (KC) is a disease characterized by thinning and deformation of the cornea, but its etiology remains unknown. Seventy percent of the corneal stroma consists of collagen, which is composed of three intertwined polypeptide chains with glycine-hydroxyproline-proline repeats along their sequence. Arginase is a cytoplasmatic enzyme and catalyzes the conversion of arginine to urea and ornithine, which serves as a precursor for the endogenous synthesis of proline and hydroxyproline. The purpose of this study was to analyze arginase activity, as well as collagen and urea formation in normal and KC-keratocytes and to determine the impact of urea on keratocyte viability and proliferation in vitro. Primary human keratocytes were isolated by digestion in collagenase (1.0 mg/mL) from surgically removed corneas of eight keratoconus patients and eight normal human corneal buttons and cultured in DMEM/Ham's F12 medium supplemented with 5 % fetal calf serum. Arginase activity and urea concentration were measured in cell-lysates, hydroxyproline concentration in supernatant of cultured keratocytes using colorimetric assay. Cell viability and cell proliferation of cultured keratocytes were assessed after treatment with urea at concentrations up to10 mM for 24 h using assays for metabolic activity and DNA replication. Arginase activity and urea concentration in KC-keratocytes decreased by about 50 % compared to normal keratocytes (p = 0.003 and p = 0.008). Hydroxyproline synthesized by cultured KC-keratocytes was also approximately 50 % less compared to normal keratocytes (p = 0.02) and this difference decreased following treatment with 5.0 or 10.0 mM urea (p = 0.02; 0.03), without any change in cell viability (p > 0.09). However, the urea treatment increased modestly (by 20 %) the proliferation rate of KC-keratocytes (p = 0.04; 0.04; 0.04), without any effect on normal cultured keratocytes (p > 0.09). We identified suppressed arginase activity in the metabolic program of cultured keratoconus keratocytes. The level of urea, as one product of the enzyme arginase was also decreased. This results in impaired collagen synthesis, evidenced in the culture by reduced hydroxyproline concentration. In addition, our data showed that the other product of the arginase reaction, urea supports the proliferation of KC-keratocytes, without changes in their viability. The metabolic reprogramming of keratoconus keratocytes and its impact on development of a clinically detectable keratoconus disease has to be further analyzed.

Simulation of realistic retinoscopic measurement

NASA Astrophysics Data System (ADS)

Tan, Bo; Chen, Ying-Ling; Baker, K.; Lewis, J. W.; Swartz, T.; Jiang, Y.; Wang, M.

2007-03-01

Realistic simulation of ophthalmic measurements on normal and diseased eyes is presented. We use clinical data of ametropic and keratoconus patients to construct anatomically accurate three-dimensional eye models and simulate the measurement of a streak retinoscope with all the optical elements. The results show the clinical observations including the anomalous motion in high myopia and the scissors reflex in keratoconus. The demonstrated technique can be applied to other ophthalmic instruments and to other and more extensively abnormal eye conditions. It provides promising features for medical training and for evaluating and developing ocular instruments.

Signs and Symptoms of Dry Eye in Keratoconus Patients Before and After Intrastromal Corneal Rings Surgery.

PubMed

Carracedo, Gonzalo; Recchioni, Alberto; Alejandre-Alba, Nicolás; Martin-Gil, Alba; Batres, Laura; Morote, Ignacio Jimenez-Alfaro; Pintor, Jesús

2017-04-01

Based on the relationship between keratoconus and dry eye, the aim of this study was to evaluate changes in signs and symptoms of dry eye in keratoconus patients before and after intrastromal corneal ring surgery. Fifteen keratoconus patients were enrolled in Fundación Jiménez-Díaz of Madrid and University Clinic of Optometry of the Universidad Complutense de Madrid (Madrid, Spain). Tear break up time (TBUT), Schirmer test without anesthesia, corneal staining, diadenosine tetraphosphate (Ap 4 A) concentration, and ocular surface disease index (OSDI) were evaluated. Impression cytology combined with laser confocal microscopy was performed to evaluate goblet cell density, mucin cloud height (MCH), and cell layer thickness (CLT). All measurements were performed before (pre) surgery, 1 month (post) and 6 months after surgery (post6m). We found no statistical differences in time in Schirmer test, TBUT, and corneal staining. OSDI scores were 44.96  ±  8.65, 26.30 ± 6.79, and 19.31 ± 4.28 for (pre), (post), and (post6m) surgery, respectively (p < 0.001). Impression cytology showed a decrease in cell density at (post6m) compared with presurgery (47.36 ± 35.15 cells/mm 2 and 84.88 ± 32.08 cells/mm 2 , respectively, p = 0.04). At post6m, the MCH increased compared with presurgery values (13.97 ± 4.26 µm and 6.77 ± 2.51 µm, respectively, p < 0.001). There was a statistically significant increase in CLT in time. Ap 4 A tear concentrations were lower post6m than presurgery (1.02  ±  0.65 and 2.56   ± 1.10  µM, respectively, p < 0.001). Intrastromal corneal ring surgery induces changes improving dry eye symptoms but no changes were found in signs of dry eye after surgery in keratoconus patients except for the MCH that increases drastically. More studies are needed to clarify the reason of its improvement.

Bilateral Keratoconus Induced by Secondary Hypothyroidism After Radioactive Iodine Therapy.

PubMed

Lee, Ramon; Hafezi, Farhad; Randleman, J Bradley

2018-05-01

To present a case of new-onset, bilateral, rapidly progressive keratoconus induced by secondary hypothyroidism after radioactive iodine therapy during the sixth decade of life that was successfully treated with corneal cross-linking. Case report and literature review. A 53-year-old woman with no ocular complaints but with a history of Graves' disease and thyrotoxicosis was treated with radioactive iodine therapy and oral levothyroxine for secondary acquired hypothyroidism 3 years prior. Initially, uncorrected distance visual acuity (UDVA) was 20/40 and corrected distance visual acuity (CDVA) was 20/25 in both eyes. Over the following 3 years, the patient developed worsening UDVA and CDVA, with increasing manifest astigmatism of greater than 7.00 diopters (D) in the right eye and 4.75 D in the left eye, with corneal thinning and focal steepening and was diagnosed as having bilateral progressive keratoconus. The patient underwent sequential corneal cross-linking with resultant postoperative CDVA of 20/20 and reduced maximum keratometry and manifest astigmatism in both eyes. The patient's thyroid levels were within normal limits throughout the clinical course. This case provides evidence of the relationship between keratoconus development and thyroid gland dysfunction. The pathophysiology of this relationship has yet to be completely elucidated, but elevated levels of thyroxine in the aqueous humor and tear film and thyroxine receptors in the cornea likely play a role. Screening topographies for patients with thyroid gland dysfunction may be of value for these higher risk patients. [J Refract Surg. 2018;34(5):351-353.]. Copyright 2018, SLACK Incorporated.

[Complications and postoperative therapeutic strategies in cross-linking].

PubMed

Kohlhaas, M

2017-08-01

The reduced corneal mechanical stability in keratoconus and similar collagen diseases can lead to a progressive and irregular corneal shape and decrease of visual acuity. A progression of keratectatic diseases can be shown with corneal topography. Keratoconus can be treated by photo-oxidative cross-linking of the corneal collagen. In order to achieve a high absorption of irradiation energy in the cornea, riboflavin at a concentration of 0.1% and UVA light at a wavelength of 370 nm corresponding to the relative maximum absorption of riboflavin (vitamin B2) are used. Evidence for corneal cross-linking are the increase of biomechanical stiffness, the increased resistance against enzymatic degradation, a higher shrinkage temperature, a lower swelling rate and an increased diameter of collagen fibers. The currently available data demonstrate that the therapeutic cross-linking procedure is safe when respecting the important theoretical and clinical parameters and that a progression of the keratoconus can be avoided. In 80% of cases an average levelling of the curvature of approximately 2 dpt can be achieved, which leads not only to stabilization but also to an increase in visual acuity of approximately 1.2 lines. In a Cochrane review from 2015 publications about complications and results were reviewed. Complication rates ranged from 1-10% depending on the initial situation, comorbidities and stage of the keratoconus. The most important complications are early epithelial wound healing problems as well as extremely rare perforations. Corneal cross-linking is a well-established and safe procedure but is not free of complications.

Safety and efficacy of simultaneous corneal collagen cross-linking with topography-guided PRK in managing low-grade keratoconus: 1-year follow-up.

PubMed

Tuwairqi, Waleed S; Sinjab, Mazen M

2012-05-01

To evaluate 1-year visual and topographic outcomes and safety and efficacy of corneal collagen cross-linking (CXL) combined with topography-guided photorefractive keratectomy (TG-PRK) to achieve near emmetropia in eyes with low-grade keratoconus. Twenty-two eyes from 15 patients (11 women, 4 men) were included in a prospective, nonrandomized, noncontrolled clinical study. Mean patient age was 26.6±6.07 years (range: 19 to 40 years). Inclusion criteria were low-grade keratoconus with evidence of progression, transparent cornea, corrected distance visual acuity (CDVA) 0.8 (decimal) or better, corneal thickness >440 μm, and maximum keratometry readings (K-max) <51.00 diopters (D). All patients underwent simultaneous TG-PRK with CXL. Study parameters were uncorrected distance visual acuity, CDVA, manifest refractive error, manifest and topographic (corneal) astigmatism, patient satisfaction, and efficacy and safety of the treatment. Follow-up was 1 year. After 1 year, statistically significant improvement was noted in all study parameters (P<.01). The safety and efficacy indices were 1.6 and 0.4, respectively. Patient satisfaction questionnaire showed that 91% were satisfied, 9% were not completely satisfied but believed they improved, and none were dissatisfied. Corneal topography demonstrated significant improvement in 55%, improvement in 36%, and minor improvement in 9% of cases. No cases progressed as evidenced by keratometry readings. Simultaneous TG-PRK with CXL is an effective and safe treatment with remarkable visual and topographic outcomes in patients with low-grade keratoconus who meet the recommended inclusion criteria. Copyright 2012, SLACK Incorporated.

Imaging of Keratoconic and normal human cornea with a Brillouin imaging system (Conference Presentation)

NASA Astrophysics Data System (ADS)

Besner, Sebastien; Shao, Peng; Scarcelli, Giuliano; Pineda, Roberto; Yun, Seok-Hyun (Andy)

2016-03-01

Keratoconus is a degenerative disorder of the eye characterized by human cornea thinning and morphological change to a more conical shape. Current diagnosis of this disease relies on topographic imaging of the cornea. Early and differential diagnosis is difficult. In keratoconus, mechanical properties are found to be compromised. A clinically available invasive technique capable of measuring the mechanical properties of the cornea is of significant importance for understanding the mechanism of keratoconus development and improve detection and intervention in keratoconus. The capability of Brillouin imaging to detect local longitudinal modulus in human cornea has been demonstrated previously. We report our non-contact, non-invasive, clinically viable Brillouin imaging system engineered to evaluate mechanical properties human cornea in vivo. The system takes advantage of a highly dispersive 2-stage virtually imaged phased array (VIPA) to detect weak Brillouin scattering signal from biological samples. With a 1.5-mW light beam from a 780-nm single-wavelength laser source, the system is able to detect Brillouin frequency shift of a single point in human cornea less than 0.3 second, at a 5μm/30μm lateral/axial resolution. Sensitivity of the system was quantified to be ~ 10 MHz. A-scans at different sample locations on a human cornea with a motorized human interface. We imaged both normal and keratoconic human corneas with this system. Whereas no significantly difference were observed outside keratocnic cones compared with normal cornea, a highly statistically significantly decrease was found in the cone regions.

Simultaneous topography-guided PRK followed by corneal collagen cross-linking after lamellar keratoplasty for keratoconus

PubMed Central

Spadea, Leopoldo; Paroli, Marino

2012-01-01

Background The purpose of this paper is to report the results of using combined treatment of customized excimer laser-assisted photorefractive keratectomy (PRK) and prophylactic corneal collagen crosslinking (CXL) for residual refractive error in a group of patients who had previously undergone lamellar keratoplasty for keratoconus. Methods The study included 14 eyes from 14 patients who had originally been treated for keratoconus in one eye by excimer laser-assisted lamellar keratoplasty (ELLK), and subsequently presented with residual ametropia (−6.11 D ± 2.48, range −2.50 to −9.50). After a mean 40.1 ± 12.4 months since ELLK they underwent combined simultaneous corneal regularization treatment with topographically guided transepithelial excimer laser PRK (central corneal regularization) and corneal CXL induced by riboflavin-ultraviolet A. Results After a mean 15 ± 6.5 (range 6–24) months, all eyes gained at least one Snellen line of uncorrected distance visual acuity (range 1–10). No patient lost lines of corrected distance visual acuity, and four patients gained three lines of corrected distance visual acuity. Mean manifest refractive spherical equivalent was −0.79 ± 2.09 (range +1 to −3.0) D, and topographic keratometric astigmatism was 5.02 ± 2.93 (range 0.8–8.9) D. All the corneas remained clear (haze < 1). Conclusion The combination of customized PRK and corneal CXL provided safe and effective results in the management of corneal regularization for refractive purposes after ELLK for keratoconus. PMID:23152658

Effects of central corneal thickness on measurement of intra-ocular pressure in keratoconus and post-keratoplasty.

PubMed

Patel, S; McLaughlin, J M

1999-05-01

To measure and compare central corneal thickness (CT) and intraocular pressure (IOP) in keratoconus and post-keratoplasty subjects and examine the CT-IOP relationship. 22 keratoconus (category I: six female sixteen male, average age 27.0 range 12-47) and 19 post-keratoplasty (category II: ten female nine male average age 34.6 range 16-54) patients without other anterior segment conditions were recruited. Only one, non-contact lens wearing, eye of the patient was included for analysis. Cornea was anaesthetised with non-preserved 0.4% Benoxinate Hydrochloride. Using a randomised approach, CT was measured using a standard ultrasonic pachymeter. IOP was then measured using a standard Goldmann tonometer. At all times the tonometrist remained unaware of the corneal thickness values. The mean (+/- s.d.) values for CT and IOP respectively in the two categories were: (I), 445 (45) mu and 9.8 (2.3) mmHg, (II), 564(44) microns and 15.8 (3.9) mmHg. Differences between I and II for both CT and IOP were significant (t-test, p = 0.01). Within each category, a significant correlation between CT and IOP was not found. Pooling all pairs of data (n = 41) a significant relationship between CT and IOP was detected (r = 0.635, p = 0.0001). The results confirm the hypothesis that an eye with a thicker cornea tends to present with a higher measured IOP. In the management of keratoconus and other corneal surgical procedures, changes in CT will contribute to any apparent changes in measured IOP.

The influence of Australian eye banking practices on corneal graft survival.

PubMed

Keane, Miriam C; Lowe, Marie T; Coster, Douglas J; Pollock, Graeme A; Williams, Keryn A

2013-08-19

To identify eye banking practices that influence corneal graft survival. Prospective cohort study of records of 19,254 followed corneal grafts in 15160 patients, submitted to the Australian Corneal Graft Registry between May 1985 and July 2012. Influence of corneal preservation method (organ culture, moist pot, Optisol, other); death-to-enucleation, death-to-preservation and enucleation-to-graft times; transportation by air; graft era; and indication for graft on probability of graft survival at most recent follow-up. In multivariate analysis, 919 penetrating grafts performed using corneas transported interstate by air exhibited worse survival than 14,684 grafts performed using corneas retrieved and used locally (hazard ratio [HR], 1.44; 95% CI, 1.21-1.73; P = 0.001). This was also the case for traditional lamellar grafts (64 corneas transported by air and 813 used locally; HR, 1.69; 95% CI, 1.03-2.78; P = 0.038). Indication for graft influenced survival of penetrating grafts (4611 keratoconus, 727 emergency or high-risk, 10,265 other indication; global P < 0.001) and traditional lamellar grafts (65 keratoconus, 212 emergency or high-risk, 600 other indication; global P < 0.001). The preservation medium in which corneas used for traditional lamellar grafts were stored exerted a marginal influence on graft survival (global P = 0.047). Donor corneas transported interstate exhibited poorer survival after transplantation than those retrieved and grafted locally. Higher proportions of emergency procedures involving transported corneas did not account for this difference. Where possible, efforts to avoid transportation of corneal tissue by air freight within Australia may be warranted.

Cross-ancestry genome-wide association analysis of corneal thickness strengthens link between complex and Mendelian eye diseases.

PubMed

Iglesias, Adriana I; Mishra, Aniket; Vitart, Veronique; Bykhovskaya, Yelena; Höhn, René; Springelkamp, Henriët; Cuellar-Partida, Gabriel; Gharahkhani, Puya; Bailey, Jessica N Cooke; Willoughby, Colin E; Li, Xiaohui; Yazar, Seyhan; Nag, Abhishek; Khawaja, Anthony P; Polašek, Ozren; Siscovick, David; Mitchell, Paul; Tham, Yih Chung; Haines, Jonathan L; Kearns, Lisa S; Hayward, Caroline; Shi, Yuan; van Leeuwen, Elisabeth M; Taylor, Kent D; Bonnemaijer, Pieter; Rotter, Jerome I; Martin, Nicholas G; Zeller, Tanja; Mills, Richard A; Staffieri, Sandra E; Jonas, Jost B; Schmidtmann, Irene; Boutin, Thibaud; Kang, Jae H; Lucas, Sionne E M; Wong, Tien Yin; Beutel, Manfred E; Wilson, James F; Uitterlinden, André G; Vithana, Eranga N; Foster, Paul J; Hysi, Pirro G; Hewitt, Alex W; Khor, Chiea Chuen; Pasquale, Louis R; Montgomery, Grant W; Klaver, Caroline C W; Aung, Tin; Pfeiffer, Norbert; Mackey, David A; Hammond, Christopher J; Cheng, Ching-Yu; Craig, Jamie E; Rabinowitz, Yaron S; Wiggs, Janey L; Burdon, Kathryn P; van Duijn, Cornelia M; MacGregor, Stuart

2018-05-14

Central corneal thickness (CCT) is a highly heritable trait associated with complex eye diseases such as keratoconus and glaucoma. We perform a genome-wide association meta-analysis of CCT and identify 19 novel regions. In addition to adding support for known connective tissue-related pathways, pathway analyses uncover previously unreported gene sets. Remarkably, >20% of the CCT-loci are near or within Mendelian disorder genes. These included FBN1, ADAMTS2 and TGFB2 which associate with connective tissue disorders (Marfan, Ehlers-Danlos and Loeys-Dietz syndromes), and the LUM-DCN-KERA gene complex involved in myopia, corneal dystrophies and cornea plana. Using index CCT-increasing variants, we find a significant inverse correlation in effect sizes between CCT and keratoconus (r = -0.62, P = 5.30 × 10 -5 ) but not between CCT and primary open-angle glaucoma (r = -0.17, P = 0.2). Our findings provide evidence for shared genetic influences between CCT and keratoconus, and implicate candidate genes acting in collagen and extracellular matrix regulation.

Comparison of femtosecond laser-assisted descemetic and predescemetic lamellar keratoplasty for keratoconus.

PubMed

Lu, Yan; Grisolia, Ana Beatriz Diniz; Ge, Yi-Rui; Xue, Chun-Yan; Cao, Qian; Yang, Li-Ping; Huang, Zhen-Ping

2017-01-01

The purpose of this study is to compare the outcomes following femtosecond laser-assisted deep anterior lamellar keratoplasty (DALK) with 75% of stromal dissection (predescemetic group) and femtosecond laser-assisted DALK using big-bubble technique with total stromal resection (descemetic group) for the treatment of keratoconus. Twenty eyes of 17 patients with keratoconus were studied. There were 10 eyes of 9 patients in predescemetic group and 10 eyes of 8 patients in descemetic group. The postoperative best-corrected visual acuity (BCVA), manifest refraction, keratometry, endothelial cell density (ECD), and central corneal thickness (CCT) were analyzed. All surgeries were performed uneventfully. At 1 year after surgery, the BCVA, corneal astigmatism, keratometry, CCT, and ECD between two groups were not statistically significant (all P > 0.05). However, the mean manifest refraction was -9.43 ± 7.44 diopter (D) and -1.03 ± 1.13D in predescemetic and descemetic groups, respectively, which was statistically significant between two groups (P < 0.05). The results of BCVA and corneal astigmatism, keratometry, ECD, and CCT were comparable between two groups. However, the mean postoperative manifest refraction was lower in descemetic group.

Brillouin microscopy: assessing ocular tissue biomechanics.

PubMed

Yun, Seok Hyun; Chernyak, Dimitri

2018-07-01

Assessment of corneal biomechanics has been an unmet clinical need in ophthalmology for many years. Many researchers and clinicians have identified corneal biomechanics as source of variability in refractive procedures and one of the main factors in keratoconus. However, it has been difficult to accurately characterize corneal biomechanics in patients. The recent development of Brillouin light scattering microscopy heightens the promise of bringing biomechanics into the clinic. The aim of this review is to overview the progress and discuss prospective applications of this new technology. Brillouin microscopy uses a low-power near-infrared laser beam to determine longitudinal modulus or mechanical compressibility of tissue by analyzing the return signal spectrum. Human clinical studies have demonstrated significant difference in the elastic properties of normal corneas versus corneas diagnosed with mild and severe keratoconus. Clinical data have also shown biomechanical changes after corneal cross-linking treatment of keratoconus patients. Brillouin measurements of the crystalline lens and sclera have also been demonstrated. Brillouin microscopy is a promising technology under commercial development at present. The technique enables physicians to characterize the biomechanical properties of ocular tissues.

Collagen crosslinking for ectasia following PRK performed in excimer laser-assisted keratoplasty for keratoconus.

PubMed

Spadea, Leopoldo

2012-01-01

To report the results of corneal collagen crosslinking (CXL) in a patient with corneal ectasia developed after excimer laser-assisted lamellar keratoplasty for keratoconus and a secondary photorefractive keratectomy (PRK) for residual refractive error. A 33-year-old woman, who had originally been treated for keratoconus in the right eye by excimer laser-assisted lamellar keratoplasty, subsequently had her residual ametropia treated by topographically guided, transepithelial excimer laser PRK. Five years after PRK, the patient developed corneal ectasia showing concomitant visual changes of best spectacle-corrected visual acuity (BSCVA) reduced to 20/33 with a refraction of -6.00 +6.00 × 30. The minimum corneal thickness at the ectasia apex was 406 µm. A treatment of riboflavin-UVA-induced corneal CXL was performed on the right eye. Two years after the CXL treatment, the right eye improved to 20/20 BSCVA with a refraction of plano +1.00 × 50 while exhibiting a clear lamellar graft. Corneal CXL provided safe and effective management of ectasia developed after excimer laser-assisted lamellar keratoplasty and PRK.

Scheimpflug imaged corneal changes on anterior and posterior surfaces after collagen cross-linking

PubMed Central

Hassan, Ziad; Modis, Laszlo; Szalai, Eszter; Berta, Andras; Nemeth, Gabor

2014-01-01

AIM To compare the anterior and posterior corneal parameters before and after collagen cross-linking therapy for keratoconus. METHODS Collagen cross-linking was performed in 31 eyes of 31 keratoconus patients (mean age 30.6±8.9y). Prior to treatment and an average 7mo after therapy, Scheimpflug analysis was performed using Pentacam HR. In addition to corneal thickness assessments, corneal radius, elevation, and aberrometric measurements were performed both on anterior and posterior corneal surfaces. Data obtained before and after surgery were statistically analyzed. RESULTS In terms of horizontal and vertical corneal radius, and central corneal thickness no deviations were observed an average 7mo after operation. Corneal higher order aberration showed no difference neither on anterior nor on posterior corneal surfaces. During follow-up period, no significant deviation was detected regarding elevation values obtained by measurement in mm units between the 3.0-8.0 mm-zones. CONCLUSION Corneal stabilization could be observed in terms of anterior and posterior corneal surfaces, elevation and higher order aberration values 7mo after collagen cross-linking therapy for keratoconus. PMID:24790876

Outcomes of Same-Size Host and Donor Trephine in Deep Anterior Lamellar Keratoplasty for Keratoconus.

PubMed

Huang, Ting; Ouyang, Chen; Hou, Chao; Wu, Qianni; Hu, Yunwei

2016-06-01

To evaluate the efficacy of the same-size host and donor trephine on reducing myopic refractive errors for patients with keratoconus when deep anterior lamellar keratoplasty (DALK) was used. Randomized controlled clinical trial. One hundred eighteen eyes of 118 patients with keratoconus were enrolled. Using stratified blocked randomization, eligible eyes were allocated into the same-size trephine group or oversize trephine group. Postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), spherical equivalent (SE), topography data, and eye axial length were compared at each year for 5 years. The same-size trephine group had comparable UCVA to the oversize trephine group through 5 years after surgery. But the former had better BSCVA than the latter after 3 years of follow-up. At 5 years, mean BSCVA was 0.17 ± 0.10 logMAR in the same-size trephine group vs 0.25 ± 0.13 logMAR in the oversize trephine group (P = .03). The same-size trephine group had lower topographic power than the oversize trephine group after 3 years of follow-up. At 5 years, mean topographic power was 45.30 ± 2.28 diopters (D) in the same-size trephine group vs 46.75 ± 2.60 D in the oversize trephine group (P = .006). Eye axial lengths at 5 years were longer than those preoperatively as well as at 1 year follow-up after surgery in both groups. The same-size host and donor trephine could reduce late-stage myopic refractive errors for the patients with keratoconus after DALK. The mechanism may be late-stage axial length increase with time. Copyright © 2016 Elsevier Inc. All rights reserved.

Corneo-scleral contact lenses in an uncommon case of keratoconus with high hyperopia and astigmatism.

PubMed

Porcar, Esteban; Montalt, Juan Carlos; España-Gregori, Enrique; Peris-Martínez, Cristina

2017-10-01

To analyse the visual quality achieved by fitting corneo-scleral contact lenses (CScL) in an uncommon case of bilateral keratoconus, high hyperopia and astigmatism. A 45-year-old man presented for eye examination due to the unsatisfactory quality of his vision wearing soft toric contact lenses. He presented high hyperopia and astigmatism with bilateral keratoconus. He was fitted with CScL to correct his irregular astigmatism and ocular aberrations. A diagnostic trial set was used in the fitting process and he was assessed according to standardised fitting methodology. Visual acuity, corneal topography, biometry and ocular aberrations were evaluated. The follow-up period was 1year. The best spectacle-corrected visual acuity was 20/32 with +8.00/-4.50×30° for the right eye (RE) and 20/25 with +7.75/-2.25×120° for the left eye (LE). After CScL fitting, visual acuity was improved to 20/20 and 20/16 for the RE and LE, respectively. The patient wore these contact lenses an average of 13h a day. The total high order aberrations decreased by approximately 79% in the RE (2.37-0.50μm) and 47% in the LE (1.04-0.55μm) after CScL fitting. Visual quality and wearing time were maintained after 1year wearing CScL. In addition, no adverse ocular effects were found during this period. The present case report describes how the patient had CScL fitted successfully for management of keratoconus with high hyperopia and astigmatism. They provided optimal visual quality, along with prolonged use times and no adverse effects to the cornea. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Influence of Posterior Corneal Astigmatism on Total Corneal Astigmatism in Eyes With Keratoconus.

PubMed

Savini, Giacomo; Næser, Kristian; Schiano-Lomoriello, Domenico; Mularoni, Alessandro

2016-11-01

To measure posterior corneal astigmatism (PCA) and investigate its influence on total corneal astigmatism (TCA) in eyes with keratoconus. Keratometric astigmatism (KA), PCA, and TCA were investigated by means of a dual Scheimpflug analyzer in patients with keratoconus. Vector analysis was carried out with the Næser polar value method. We enrolled 119 eyes. PCA magnitude averaged 0.77 ± 0.43 diopters (D) and exceeded 0.50, 1.00, and 2.00 D in 73.9%, 21.8%, and 16.8% of eyes, respectively. PCA averaged 0.95 ± 0.48, 0.55 ± 0.28, and 0.70 ± 0.35 D in eyes with with-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism. The steepest posterior meridian was oriented vertically (between 61 and 119 degrees) in 55.5% of eyes, thus generating ATR astigmatism. The difference between the location of the steepest meridian of KA and that of TCA was >10 degrees in 8.4% of eyes. On average, KA overestimated TCA in eyes with WTR astigmatism by 0.16 D and underestimated TCA in eyes with ATR astigmatism by 0.22 D. The PCA power oriented along the steeper anterior corneal meridian averaged -0.83 ± 0.40, -0.40 ± 0.37, and -0.53 ± 0.43 D for WTR, ATR, and obliquely astigmatic eyes, respectively. Linear regression disclosed a statistically significant correlation (P < 0.0001, r = 0.16) between the meridional powers of TCA and PCA. In eyes with keratoconus, PCA displays large, variable values and is correlated to TCA. The influence of PCA on TCA cannot be disregarded when planning astigmatism correction by toric intraocular lenses.

Which soft lens power is better for piggyback in keratoconus? Part II.

PubMed

Romero-Jiménez, Miguel; Santodomingo-Rubido, Jacinto; González-Meijóme, Jose-Manuel; Flores-Rodriguez, Patricia; Villa-Collar, Cesar

2015-02-01

To evaluate how soft lens power affects rigid gas-permeable (RGP) lens power and visual acuity (VA) in piggyback fittings for keratoconus. Sixteen keratoconus subjects (30 eyes) were included in the study. Piggyback contact lens fittings combining Senofilcon-A soft lenses of -6.00, -3.00, +3.00 and +6.00 D with Rose K2 RGP contact lenses were performed. Corneal topography was taken on the naked eye and over each soft contact lens before fitting RGP lenses. Mean central keratometry, over-refraction, RGP back optic zone radius (BOZR) and estimated final power as well as VA were recorded and analyzed. In comparison to the naked eye, the mean central keratometry flattened with both negative lens powers (p<0.05 in all cases), did not change with the +3.00 soft lens power (p=1.0); and steepened with the +6.00 soft lens power (p=0.02). Rigid gas-permeable over-refraction did not change significantly between different soft lens powers (all p>0.05). RGP's BOZR decreased significantly with both positive in comparison with both negative soft lens powers (all p<0.001), but no significant differences were found among negative- or positive-powers separately (both p>0.05). Estimated RGP's final power increased significantly with positive in comparison with negative lens powers (all p<0.001), but no significant differences were found among negative or positive lens powers separately (both p>0.05). Visual acuity did not change significantly between the different soft lens powers assessed (all p>0.05). The use of negative-powered soft lenses in piggyback fitting reduces RGP lens power without impacting VA in keratoconus subjects. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Intracorneal ring segments implantation followed by same-day topography-guided PRK and corneal collagen CXL in low to moderate keratoconus.

PubMed

Al-Tuwairqi, Waleed; Sinjab, Mazen M

2013-01-01

To evaluate the safety and efficacy of intrastromal corneal ring segments (ICRS) implantation followed by same-day topography-guided photorefractive keratectomy (PRK) and ultraviolet-A/riboflavin collagen cross-linking (CXL) in patients with low to moderate keratoconus. Patients with low to moderate keratoconus and contact lens intolerance were included in the study. All patients first underwent femtosecond laser-enabled placement of ICRS (Keraring, Mediphacos) (first step). Same-day topography-guided PRK and CXL (second step) were subsequently performed in all patients after the refraction was stable (average 6 months [range: 3 to 11 months]). Thirteen eyes from 13 patients were included in the study. Based on values before the first step and 6 months after the second step, significant improvements were noted in uncorrected distance visual acuity (0.7±0.32 logMAR vs 0.08±0.08 logMAR), corrected distance visual acuity (CDVA) (0.16±0.19 logMAR vs 0.02±0.04 log-MAR), sphere (-3.65±3.08 diopters [D] vs 0.06±1.6 D), astigmatism (-3.31±1.5 D vs -0.98±0.75 D), average K (47.28±1.99 D vs 41.42±3.22 D), and coma (2.36±1.23 μm vs 1.47±0.68 μm) (P<.05). Approximately 63% of eyes gained ⩾2 lines of CDVA, whereas no change in CDVA was reported in ∼27% of eyes. No eyes lost lines of CDVA. The combination of ICRS implantation followed by sequential same-day topography-guided PRK/CXL may be a reasonable option for improving visual acuity in patients with low to moderate keratoconus. Copyright 2013, SLACK Incorporated.

Algorithm for Correcting the Keratometric Error in the Estimation of the Corneal Power in Keratoconus Eyes after Accelerated Corneal Collagen Crosslinking.

PubMed

Piñero, David P; Camps, Vicente J; Caravaca-Arens, Esteban; de Fez, Dolores; Blanes-Mompó, Francisco J

2017-01-01

To analyze the errors associated to corneal power calculation using the keratometric approach in keratoconus eyes after accelerated corneal collagen crosslinking (CXL) surgery and to obtain a model for the estimation of an adjusted corneal refractive index ( n k adj ) minimizing such errors. Potential differences (Δ P c ) among keratometric ( P k ) and Gaussian corneal power ( P c Gauss ) were simulated. Three algorithms based on the use of n k adj for the estimation of an adjusted keratometric corneal power ( P k adj ) were developed. The agreement between P k (1.3375) (keratometric power using the keratometric index of 1.3375), P c Gauss , and P k adj was evaluated. The validity of the algorithm developed was investigated in 21 keratoconus eyes undergoing accelerated CXL. P k (1.3375) overestimated corneal power between 0.3 and 3.2 D in theoretical simulations and between 0.8 and 2.9 D in the clinical study (Δ P c ). Three linear equations were defined for n k adj to be used for different ranges of r 1c . In the clinical study, differences between P k adj and P c Gauss did not exceed ±0.8 D n k = 1.3375. No statistically significant differences were found between P k adj and P c Gauss ( p > 0.05) and P k (1.3375) and P k adj ( p < 0.001). The use of the keratometric approach in keratoconus eyes after accelerated CXL can lead to significant clinical errors. These errors can be minimized with an adjusted keratometric approach.

Which soft contact lens power is better for piggyback fitting in keratoconus?

PubMed

Romero-Jiménez, Miguel; Santodomingo-Rubido, Jacinto; Flores-Rodríguez, Patricia; González-Méijome, Jose Manuel

2013-02-01

To evaluate the impact of differente soft contact lens power in the anterior corneal curvature and regularity in subjects with keratoconus. Nineteen subjects (30 eyes) with keratoconus were included in the study. Six corneal topographies were taken with Pentacam Eye System over the naked eye and successively with soft lens (Senofilcon A) powers of -3.00, -1.50, 0.00, +1.50 and +3.00 D. Corneal measurements of mean central keratometry (MCK), maximum tangential curvature (TK), maximum front elevation (MFE) and eccentricity (Ecc) at 6 and 8 mm diameters as well as anterior corneal surface high order aberrations (i.e. total RMS, spherical- and coma-like and secondary astigmatism) were evaluated. Negative- and plano-powered soft lenses flattened (p<0.05 in all cases), whereas positive-powered lenses did not induce any significant changes (p>0.05 in all cases) in MCK in comparison to the naked eye. The TK power decreased with negative lenses (p<0.05 in both cases) and increased with +3.00 D lenses (p=0.03) in comparison to the naked eye. No statistically significant differences were found in MFE with any soft lens power in comparison to the naked eye (p>0.05 in all cases). Corneal eccentricity increased at 8 mm diameter for all lens powers (p<0.05 in all cases). No statistically differences were found in HOA RMS and spherical-like aberration (both p>0.05). Statistically differences were found in coma-like and secondary astigmatism (both p<0.05). Negative-powered soft contact lenses provide a flatter anterior surface in comparison to positive-powered lenses in subjects with keratoconus and thus they might be more suitable for piggyback contact lens fitting. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Short-term corneal changes with gas-permeable contact lens wear in keratoconus subjects: a comparison of two fitting approaches.

PubMed

Romero-Jiménez, Miguel; Santodomingo-Rubido, Jacinto; Flores-Rodríguez, Patricia; González-Méijome, Jose-Manuel

2015-01-01

To evaluate changes in anterior corneal topography and higher-order aberrations (HOA) after 14-days of rigid gas-permeable (RGP) contact lens (CL) wear in keratoconus subjects comparing two different fitting approaches. Thirty-one keratoconus subjects (50 eyes) without previous history of CL wear were recruited for the study. Subjects were randomly fitted to either an apical-touch or three-point-touch fitting approach. The lens' back optic zone radius (BOZR) was 0.4mm and 0.1mm flatter than the first definite apical clearance lens, respectively. Differences between the baseline and post-CL wear for steepest, flattest and average corneal power (ACP) readings, central corneal astigmatism (CCA), maximum tangential curvature (KTag), anterior corneal surface asphericity, anterior corneal surface HOA and thinnest corneal thickness measured with Pentacam were compared. A statistically significant flattening was found over time on the flattest and steepest simulated keratometry and ACP in apical-touch group (all p<0.01). A statistically significant reduction in KTag was found in both groups after contact lens wear (all p<0.05). Significant reduction was found over time in CCA (p=0.001) and anterior corneal asphericity in both groups (p<0.001). Thickness at the thinnest corneal point increased significantly after CL wear (p<0.0001). Coma-like and total HOA root mean square (RMS) error were significantly reduced following CL wearing in both fitting approaches (all p<0.05). Short-term rigid gas-permeable CL wear flattens the anterior cornea, increases the thinnest corneal thickness and reduces anterior surface HOA in keratoconus subjects. Apical-touch was associated with greater corneal flattening in comparison to three-point-touch lens wear. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

Reliability and repeatability of swept-source Fourier-domain optical coherence tomography and Scheimpflug imaging in keratoconus.

PubMed

Szalai, Eszter; Berta, András; Hassan, Ziad; Módis, László

2012-03-01

To evaluate the repeatability and reliability of a recently introduced swept-source Fourier-domain anterior segment optical coherence tomography (AS-OCT) system and a high-resolution Scheimpflug camera and to assess the agreement between the 2 instruments when measuring healthy eyes and eyes with keratoconus. Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. Evaluation of diagnostic test or technology. Three consecutive series of anterior segment images were taken with AS-OCT (Casia SS-1000) followed by rotating Scheimpflug imaging (Pentacam high resolution). Axial keratometry in the steep and flat meridians and astigmatism values were recorded. Pachymetry in the apex, center, and the thinnest position and anterior chamber depth (ACD) measurements were also taken. This study enrolled 57 healthy volunteers (57 eyes) and 56 patients (84 eyes) with keratoconus. Significant difference was found in all measured anterior segment parameters between normal eyes and keratoconic eyes (P<.05). In keratoconic eyes, the difference between repeated measurements was less with AS-OCT than with Scheimpflug imaging in every keratometry and astigmatism value, in apical thickness, and in ACD. For keratometry, the thinnest and central pachymetry measurement repeatability was better in healthy eyes than in keratoconic eyes with both instruments. In general, the mean difference between AS-OCT and Scheimpflug imaging was higher in cases of keratoconus. Significant differences in keratometry, pachymetry, and ACD results were found between AS-OCT and Scheimpflug imaging. However, the repeatability of the measurements was comparable. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Corneal collagen cross-linking in the stabilization of PRK, LASIK, thermal keratoplasty, and orthokeratology.

PubMed

Nguyen, Michelle K; Chuck, Roy S

2013-07-01

To describe the use of corneal collagen cross-linking (CXL) and its efficacy in the stabilization of keratorefractive procedures, including PRK, laser in-situ keratomileusis (LASIK), thermal keratoplasty, and orthokeratology. Since its introduction, CXL has quickly gained interest in the treatment of ectactic disorders due to its ability to increase the biomechanical stability of the cornea. In its earliest use, it has shown to be effective in the treatment of both keratoconus and post-LASIK ectasia. More recent studies of CXL in combination with keratorefractive procedures have shown varying degrees of success. CXL with PRK has shown to be effective in slowing or halting the progression of keratoconus, pellucid marginal degeneration, and post-LASIK ectasia, in addition to potentially decreasing or delaying the need for penetrating keratoplasty. Several small case series have also demonstrated improved stability and efficacy of PRK and LASIK when combined with CXL, as well as a potentially decreased risk of postprocedure ectasia. In conjunction with thermokeratoplasty and orthokeratology, CXL has shown improved but only temporary results in the treatment of keratoconus. Future studies are needed to determine the efficacy and long-term stability of CXL in combination with keratorefractive procedures, as well as to address possible complications.

Corneal transplantation trends in France from 2004 to 2015: A 12-year review.

PubMed

Bigan, Guillaume; Puyraveau, Marc; Saleh, Maher; Gain, Philippe; Martinache, Isabelle; Delbosc, Bernard; Gauthier, Anne-Sophie

2018-04-01

The aim of this study was to report the 12-year longitudinal trends in indication and corneal transplantation techniques in France from 2004 to 2015. The records of all corneal transplantations performed from 2004 to 2015 in France were retrospectively reviewed. The patient indications and types of transplant performed were analyzed. A total of 46,658 corneal transplantations were performed between 2004 and 2015, with 34,187 (73.3%) penetrating keratoplasty and 10,452 (22.4%) lamellar keratoplasty. The leading surgical indications were secondary endothelial failure (24.3%), keratoconus (18.8%), regraft (13.5%), and Fuchs endothelial corneal dystrophy (15.1%). Endothelial keratoplasty became the preferred technique for endothelial diseases and deep anterior lamellar keratoplasty the preferred technique for keratoconus, surpassing penetrating keratoplasty in 2013. Secondary endothelial failure is the top indication for performing a keratoplasty over the 12-year period. There was a shift from penetrating keratoplasty to endothelial keratoplasty performed for Fuchs endothelial corneal dystrophy and secondary endothelial failure, and to deep anterior lamellar keratoplasty, performed for keratoconus. This highlights an important shift in managing corneal diseases toward the application of selective and more conservative surgeries and changes in indications in corneal transplantation.

Laser Vision Correction with Q Factor Modification for Keratoconus Management.

PubMed

Pahuja, Natasha Kishore; Shetty, Rohit; Sinha Roy, Abhijit; Thakkar, Maithil Mukesh; Jayadev, Chaitra; Nuijts, Rudy Mma; Nagaraja, Harsha

2017-04-01

To evaluate the outcomes of corneal laser ablation with Q factor modification for vision correction in patients with progressive keratoconus. In this prospective study, 50 eyes of 50 patients were divided into two groups based on Q factor (>-1 in Group I and ≤-1 in Group II). All patients underwent a detailed ophthalmic examination including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), subjective acceptance and corneal topography using the Pentacam. The topolyzer was used to measure the corneal asphericity (Q). Ablation was performed based on the preoperative Q values and thinnest pachymetry to obtain a target of near normal Q. This was followed by corneal collagen crosslinking to stabilize the progression. Statistically significant improvement (p ≤ 0.05) was noticed in refractive, topographic, and Q values posttreatment in both groups. The improvement in higher-order aberrations and total aberrations were statistically significant in both groups; however, the spherical aberration showed statistically significant improvement only in Group II. Ablation based on the preoperative Q and pachymetry for a near normal postoperative Q value appears to be an effective method to improve the visual acuity and quality in patients with keratoconus.

The Effect of Corneal Epithelium on Corneal Curvature in Patients with Keratoconus.

PubMed

Akcay, Emine Kalkan; Uysal, Betul Seher; Sarac, Ozge; Ugurlu, Nagehan; Yulek, Fatma; Cagil, Nurullah; Aslan, Nabi

2015-01-01

To investigate the effects of corneal epithelium on corneal curvature in patients with keratoconus. This is a prospective, nonrandomized study. Fifty-nine eyes of 47 patients diagnosed as keratoconus and for whom corneal collagen crosslinking (CXL) was recruited in this study. This study is a single-center clinical trial. Pregnancy, lactation, connective tissue disease, corneal thickness below 350 μm, severe dry eyes, or scar of corneal surgery were exclusion criteria. Before and during CXL procedure after removing the corneal epithelium, maximum values of corneal apical curvature, simulated keratometry 1 (Sim-K1), simulated keratometry 2 (Sim-K2), temporal and inferior curvature values, all of which are 1.5 mm from the corneal center, were calculated. These values before and after removal of epithelium were compared statistically. Mean age of patients was 23.30 ± 5.5 (12-38) years. Twenty-eight (59%) were male while 19 (41%) were female. Mean values measured before and after removing the corneal epithelium were: apical curvature; 59.19 ± 7.2 (47.06-82.40) diopter (D) and 61.70 ± 8.8 (49.19-92.66) D (p = 0.001), SimK1; 47.57 ± 4.3 (39.14-64.57) D and 48.23 ± 4.3 (41.89-66.70) D (p = 0.001), SimK2; 52.04 ± 5.3 (43.56-69.34) D and 53.34 ± 5.6 (43.73-70.89) D (p = 0.001), inferior curvature; 53,85 ± 5.2 (43.47-76.56) D and 55.05 ± 5.8 (44.56-81.93) D (p = 0.002), temporal curvature 49.49 ± 5.1 (41.50-71.03) D and 51.53 ± 5.4 (41.58-73.34) D (p = 0.001), respectively. In keratoconus patients during CXL treatment, after removing the corneal epithelium, more steepness is detected in the curvature of the steeper area of the cornea. When evaluating patients with keratoconus, the masking effect of corneal epithelium on values of curvature should be taken into consideration.

Betting on Illusory Patterns: Probability Matching in Habitual Gamblers.

PubMed

Gaissmaier, Wolfgang; Wilke, Andreas; Scheibehenne, Benjamin; McCanney, Paige; Barrett, H Clark

2016-03-01

Why do people gamble? A large body of research suggests that cognitive distortions play an important role in pathological gambling. Many of these distortions are specific cases of a more general misperception of randomness, specifically of an illusory perception of patterns in random sequences. In this article, we provide further evidence for the assumption that gamblers are particularly prone to perceiving illusory patterns. In particular, we compared habitual gamblers to a matched sample of community members with regard to how much they exhibit the choice anomaly 'probability matching'. Probability matching describes the tendency to match response proportions to outcome probabilities when predicting binary outcomes. It leads to a lower expected accuracy than the maximizing strategy of predicting the most likely event on each trial. Previous research has shown that an illusory perception of patterns in random sequences fuels probability matching. So does impulsivity, which is also reported to be higher in gamblers. We therefore hypothesized that gamblers will exhibit more probability matching than non-gamblers, which was confirmed in a controlled laboratory experiment. Additionally, gamblers scored much lower than community members on the cognitive reflection task, which indicates higher impulsivity. This difference could account for the difference in probability matching between the samples. These results suggest that gamblers are more willing to bet impulsively on perceived illusory patterns.

Pharmaceutical Approval Update.

PubMed

Kaufman, Michele B

2016-08-01

Venetoclax (Venclexta) for chronic lymphocytic leukemia; riboflavin 5'-phosphate solutions (Photrexa Viscous and Photrexa) for progressive keratoconus; and pimavanserin (Nuplazid) for Parkinson's disease psychosis.

The cornea in connective tissue diseases.

PubMed

Maumenee, I H

1978-10-01

Even though lenticular and retinal abnormalities seem to dominate the ophthalmologic picture in Marfan's syndrome, the cornea shows significant abnormalities consisting of a striking flattening and corneal astigmatism. The use of conjunctival biopsies followed by histochemical and electron-microscopic evaluation shows low morbidity but an excellent yield of diagnostic information on storage diseases, and an ectopic collagen may be the basis of at least one type of keratoconus. Much more work has to be done on defining the collagens of the human eye in embryologic, fetal, and postnatal stages under normal and pathologic conditions. The yield of such studies may be high for an understanding of such diseases as myopia, retinal detachment, and keratoconus.

Probability matching in perceptrons: Effects of conditional dependence and linear nonseparability.

PubMed

Dawson, Michael R W; Gupta, Maya

2017-01-01

Probability matching occurs when the behavior of an agent matches the likelihood of occurrence of events in the agent's environment. For instance, when artificial neural networks match probability, the activity in their output unit equals the past probability of reward in the presence of a stimulus. Our previous research demonstrated that simple artificial neural networks (perceptrons, which consist of a set of input units directly connected to a single output unit) learn to match probability when presented different cues in isolation. The current paper extends this research by showing that perceptrons can match probabilities when presented simultaneous cues, with each cue signaling different reward likelihoods. In our first simulation, we presented up to four different cues simultaneously; the likelihood of reward signaled by the presence of one cue was independent of the likelihood of reward signaled by other cues. Perceptrons learned to match reward probabilities by treating each cue as an independent source of information about the likelihood of reward. In a second simulation, we violated the independence between cues by making some reward probabilities depend upon cue interactions. We did so by basing reward probabilities on a logical combination (AND or XOR) of two of the four possible cues. We also varied the size of the reward associated with the logical combination. We discovered that this latter manipulation was a much better predictor of perceptron performance than was the logical structure of the interaction between cues. This indicates that when perceptrons learn to match probabilities, they do so by assuming that each signal of a reward is independent of any other; the best predictor of perceptron performance is a quantitative measure of the independence of these input signals, and not the logical structure of the problem being learned.

Probability matching in perceptrons: Effects of conditional dependence and linear nonseparability

PubMed Central

2017-01-01

Probability matching occurs when the behavior of an agent matches the likelihood of occurrence of events in the agent’s environment. For instance, when artificial neural networks match probability, the activity in their output unit equals the past probability of reward in the presence of a stimulus. Our previous research demonstrated that simple artificial neural networks (perceptrons, which consist of a set of input units directly connected to a single output unit) learn to match probability when presented different cues in isolation. The current paper extends this research by showing that perceptrons can match probabilities when presented simultaneous cues, with each cue signaling different reward likelihoods. In our first simulation, we presented up to four different cues simultaneously; the likelihood of reward signaled by the presence of one cue was independent of the likelihood of reward signaled by other cues. Perceptrons learned to match reward probabilities by treating each cue as an independent source of information about the likelihood of reward. In a second simulation, we violated the independence between cues by making some reward probabilities depend upon cue interactions. We did so by basing reward probabilities on a logical combination (AND or XOR) of two of the four possible cues. We also varied the size of the reward associated with the logical combination. We discovered that this latter manipulation was a much better predictor of perceptron performance than was the logical structure of the interaction between cues. This indicates that when perceptrons learn to match probabilities, they do so by assuming that each signal of a reward is independent of any other; the best predictor of perceptron performance is a quantitative measure of the independence of these input signals, and not the logical structure of the problem being learned. PMID:28212422

Rotating Scheimpflug Imaging Indices in Different Grades of Keratoconus

PubMed Central

2016-01-01

Purpose. To evaluate accuracy of various Keratoconus (KC) screening indices, in relation to Topographic Keratoconus (TKC) grading. Setting. Al Watany Eye Hospital, Cairo, Egypt. Methods. Data of 103 normal (group 1) and 73 KC eyes (group 2), imaged by Pentacam (branded as Allegro Oculyzer), were analysed. Group 2 was divided into 2a: 14 eyes (TKC = 1, early KC), 2b: 25 eyes (TKC = 1 to 2 or 2, moderate KC), and 2c: 34 eyes (TKC = 2 to 3 up to 4, severe KC). Participants were followed up for six years to confirm diagnosis. Area under the receiver operating characteristic curve (AUROC) was calculated for evaluated curvature, elevation, and pachymetry indices with various reference shapes at different diameters. Results. When comparing normal to KC eyes, ten indices had significantly higher AUROC. Only five of them had significantly higher AUROC in early KC compared to normal corneas: Pachymetry Progression Index- (PPI-) Maximum (Max), Ambrósio's Relational Thickness- (ART-) Max, PPI-Max minus PPI-Minimum (Min), central corneal thickness (CCT), and diagonal decentration of thinnest point from the apex (AUROC = 0.690, 0.690, 0.687, 0.683, and 0.674, resp.). Conclusion. Generally, ten pachymetry and elevation-based indices had significantly higher AUROC. Five indices had statistically significant high AUROC when comparing early KC to normal corneas. PMID:27579178

Acute corneal hydrops mimicking full thickness perforation.

PubMed

Ch'ng, S W; Pillai, M B; Aazeem, S; Tu, K L

2012-05-11

A 26-year-old Caucasian female with keratoconus presented with an acutely painful and red left eye. Visual acuity on presentation was 3/60. Slit lamp examination revealed localised Descemet's membrane break with iris partially plugging it. There was a bulging stromal cyst which would intermittently flatten and reform. The appearance when the cyst was flattened mimicked a full thickness corneal perforation. However, no obvious overlying epithelial defect was detected and an intermittent leakage through micro-perforations in the corneal epithelium was the probable cause of the variable appearance. The anterior chamber reformed and iris plug freed following an insertion of a bandage contact lens and taped eyelid. On follow-up, the Descement's membrane had healed with visual acuity improving to 6/18. Our case illustrates the importance of identifying corneal hydrops mimicking a full thickness perforation as conservative management has a greater chance of recovery.

Femtosecond Intrastromal Lenticular Implantation Combined With Accelerated Collagen Cross-Linking for the Treatment of Keratoconus--Initial Clinical Result in 6 Eyes.

PubMed

Ganesh, Sri; Brar, Sheetal

2015-10-01

To evaluate the initial outcomes of femtosecond intrastromal lenticular implantation (FILI) combined with accelerated collagen cross-linking in patients with progressive keratoconus. In this interventional, prospective, exploratory case series, patients with progressive keratoconus and contact lens intolerance were included. All eyes underwent femtosecond laser-enabled placement of stromal donor tissue and simultaneous accelerated collagen cross-linking. Follow-up of patients was conducted for a mean period of 190 ± 13 days (range, 177-193 days). Six eyes from 6 patients were included in the study. Based on values before and 6 months after the procedure, clinical improvement was noted in uncorrected distance visual acuity (1.06 ± 0.48 logMAR vs. 0.38 ± 0.27 logMAR), corrected distance visual acuity (0.51 ± 0.20 logMAR vs. 0.20 ± 0.24 logMAR), and manifest spherical equivalent (-3.47 ± 1.15 D vs. -1.77 ± 1.7 D). There was flattening of mean keratometry in 3-mm and 5-mm zones by 3.42 ± 2.09 D and 1.70 ± 1.31 D, respectively. Mean pachymetry in the central and midperipheral zones increased by 18.3 ± 7.3 μm and 33.0 ± 8.8 μm, respectively. All eyes had reduction in higher-order aberrations, specifically coma. No eye lost lines of corrected distance visual acuity. No adverse events such as haze, infection, or allogeneic graft rejection were observed. Initial experience with this small number of eyes suggests that the combination of tissue addition and accelerated collagen cross-linking may be a feasible option for low to moderate keratoconus. A larger cohort and longer follow-up are required to validate our results and establish long-term safety and efficacy of the procedure.

Refractive improvements and safety with topography-guided corneal crosslinking for keratoconus: 1-year results.

PubMed

Nordström, Maria; Schiller, Maria; Fredriksson, Anneli; Behndig, Anders

2017-07-01

To assess the refractive improvements and the corneal endothelial safety of an individualised topography-guided regimen for corneal crosslinking in progressive keratoconus. An open-label prospective randomised clinical trial was performed at the Department of Clinical Sciences, Ophthalmology, Umeå University Hospital, Umeå, Sweden. Thirty-seven patients (50 eyes) with progressive keratoconus planned for corneal crosslinking were included. The patients were randomised to topography-guided crosslinking (photorefractive intrastromal crosslinking (PiXL); n=25) or uniform 9 mm crosslinking (corneal collagen crosslinking (CXL); n=25). Visual acuity, refraction, keratometry (K1, K2 and K max ) and corneal endothelial morphometry were assessed preoperatively and at 1, 3, 6 and 12 months postoperatively. The PiXL treatment involved an asymmetrical treatment zone centred on the area of maximum corneal steepness with treatment energies ranging from 7.2 to 15.0 J/cm 2 ; the CXL treatment was a uniform 9 mm 5.4 J/cm 2 pulsed crosslinking. The main outcome measures were changes in refractive errors and corneal endothelial cell density. The spherical refractive errors decreased (p<0.05) and the visual acuity improved (p<0.01) at 3, 6 and 12 months after PiXL, but not after CXL. The between-groups differences, however, were not significant. K2 and K max decreased at 3, 6 and 12 months after PiXL (p<0.01), but not after CXL (p<0.01 when comparing the two treatments). No corneal endothelial cell loss was seen after either treatment. Individualised topography-based crosslinking treatment centred on the ectatic cone has the potential to improve the corneal shape in keratoconus with decreased spherical refractive errors and improved visual acuity, without damage to the corneal endothelium. NCT02514200, Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Visual rehabilitation in low-moderate keratoconus: intracorneal ring segment implantation followed by same-day topography-guided photorefractive keratectomy and collagen cross linking

PubMed Central

Zeraid, Ferial M; Jawkhab, Asma A; Al-Tuwairqi, Waleed S; Osuagwu, Uchechukwu L

2014-01-01

AIM To present the results of same-day topography-guided photorefractive keratectomy (TG-PRK) and corneal collagen crosslinking (CXL) after previous intrastromal corneal ring segment (ISCR) implantation for keratoconus. METHODS An experimental clinical study on twenty-one eyes of 19 patients aged 27.1±6.6y (range 19-43y), with low to moderate keratoconus who were selected to undergo customized TG-PRK immediately followed by same-day CXL, 9mo after ISCR implantation in a university ophthalmology clinic. Refraction, uncorrected distance visual acuities (UDVA) and corrected distance visual acuities (CDVA), keratometry (K) values, central corneal thickness (CCT) and coma were assessed 3mo after TG-PRK and CXL. RESULTS After TG-PRK/CXL: the mean UDVA (logMAR) improved significantly from 0.66±0.41 to 0.20±0.25 (P<0.05); Kflat value decreased from: 48.44±3.66 D to 43.71±1.95 D; Ksteep value decreased from 45.61±2.40 D to 41.56±2.05 D; Kaverage also decreased from 47.00±2.66 D to 42.42±2.07 D (P<0.05 for all). The mean sphere and cylinder decreased significantly post-surgery from, -3.10±2.99 D to -0.11±0.93 D and from -3.68±1.53 to -1.11±0.75 D respectively, while the CDVA, CCT and coma showed no significant changes. Compared to post-ISCR, significant reductions (P<0.05 or all) in all K values, sphere and cylinder were observed after TG-PRK/CXL. CONCLUSION Same-day combined topography-guided PRK and corneal crosslinking following placement of ISCR is a safe and potentially effective option in treating low-moderate keratoconus. It significantly improves all visual acuity, reduced keratometry, sphere and astigmatism, but causes no change in central corneal thickness and coma. PMID:25349796

Short-term Effect of Scleral Lens on the Dry Eye Biomarkers in Keratoconus.

PubMed

Carracedo, Gonzalo; Blanco, Maria Serramito; Martin-Gil, Alba; Zicheng, Wang; Alvarez, Jesús Carballo; Pintor, Jesús

2016-02-01

To evaluate the most important signs of dry eye, such as osmolarity, inflammation, and diadenosine tetraphosphate (Ap(4)A) concentration before and after wearing scleral lenses for 8 h in keratoconus patients. A pilot, experimental, short-term study involved 26 keratoconus patients (average age, 36.95 ± 8.95 years). They voluntarily enrolled in the study at the Optometry Clinic of the Faculty of Optics and Optometry in the University Complutense of Madrid. They were divided into two groups: patients with intrastromal corneal ring, the ICRS group, and patients without ICRS, the keratoconus (KC) group. Ocular Surface Disease Index questionnaire, the Schirmer test without anesthesia, tear break-up time, matrix metalloproteinase 9 (MMP-9) concentration, osmolarity, and Ap4A concentration were evaluated before and after wearing a scleral lens for 8 h. The patients wore the scleral lenses from 6 to 9 h, with a mean of 7.59 ± 0.73 h. The mean scleral lens sag for all patients was 4310 ± 166.31 μm, ranging from 4200 μm to 4800 μm. No significant changes in the Schirmer test and tear break-up time were found for either group. Ocular Surface Disease Index scores were statistically lower after wearing scleral lenses for both groups (p < 0.05). A significantly lower osmolarity and a significant rise of MMP-9 concentration after wearing scleral lenses were found in both groups (p < 0.05). Diadenosine tetraphosphate concentration was lower after wearing the scleral lens in the KC group (p < 0.05) but no significant difference was found for the ICRS group (p > 0.05). Short-term scleral lens wearing improves the symptomatology and some signs of dry eye, such as osmolarity and Ap4A concentration. The increase of MMP-9 concentration could be caused by tear film stagnation and use of preserved saline.

New approach for correction of error associated with keratometric estimation of corneal power in keratoconus.

PubMed

Camps, Vicente J; Piñero, David P; Caravaca-Arens, Esteban; de Fez, Dolores; Pérez-Cambrodí, Rafael J; Artola, Alberto

2014-09-01

The aim of this study was to obtain the exact value of the keratometric index (nkexact) and to clinically validate a variable keratometric index (nkadj) that minimizes this error. The nkexact value was determined by obtaining differences (ΔPc) between keratometric corneal power (Pk) and Gaussian corneal power ((Equation is included in full-text article.)) equal to 0. The nkexact was defined as the value associated with an equivalent difference in the magnitude of ΔPc for extreme values of posterior corneal radius (r2c) for each anterior corneal radius value (r1c). This nkadj was considered for the calculation of the adjusted corneal power (Pkadj). Values of r1c ∈ (4.2, 8.5) mm and r2c ∈ (3.1, 8.2) mm were considered. Differences of True Net Power with (Equation is included in full-text article.), Pkadj, and Pk(1.3375) were calculated in a clinical sample of 44 eyes with keratoconus. nkexact ranged from 1.3153 to 1.3396 and nkadj from 1.3190 to 1.3339 depending on the eye model analyzed. All the nkadj values adjusted perfectly to 8 linear algorithms. Differences between Pkadj and (Equation is included in full-text article.)did not exceed ±0.7 D (Diopter). Clinically, nk = 1.3375 was not valid in any case. Pkadj and True Net Power and Pk(1.3375) and Pkadj were statistically different (P < 0.01), whereas no differences were found between (Equation is included in full-text article.)and Pkadj (P > 0.01). The use of a single value of nk for the calculation of the total corneal power in keratoconus has been shown to be imprecise, leading to inaccuracies in the detection and classification of this corneal condition. Furthermore, our study shows the relevance of corneal thickness in corneal power calculations in keratoconus.

Quantitative assessment of corneal vibrations during intraocular pressure measurement with the air-puff method in patients with keratoconus.

PubMed

Koprowski, Robert; Ambrósio, Renato

2015-11-01

One of the current methods for measuring intraocular pressure is the air-puff method. A tonometer which uses this method is the Corvis device. With the ultra-high-speed (UHS) Scheimpflug camera, it is also possible to observe corneal deformation during measurement. The use of modern image analysis and processing methods allows for analysis of higher harmonics of corneal deflection above 100 Hz. 493 eyes of healthy subjects and 279 eyes of patients with keratoconus were used in the measurements. For each eye, 140 corneal deformation images were recorded during intraocular pressure measurement. Each image was recorded every 230 µs and had a resolution of 200 × 576 pixels. A new, original algorithm for image analysis and processing has been proposed. It enables to separate the eyeball reaction as well as low-frequency and high-frequency corneal deformations from the eye response to an air puff. Furthermore, a method for classification of healthy subjects and patients with keratoconus based on decision trees has been proposed. The obtained results confirm the possibility to distinguish between patients with keratoconus and healthy subjects. The features used in this classification are directly related to corneal vibrations. They are only available in the proposed software and provide specificity of 98%, sensitivity-85%, and accuracy-92%. This confirms the usefulness of the proposed method in this type of classification that uses corneal vibrations during intraocular pressure measurement with the Corvis tonometer. With the new proposed algorithm for image analysis and processing allowing for the separation of individual features from a corneal deformation image, it is possible to: automatically measure corneal vibrations in a few characteristic points of the cornea, obtain fully repeatable measurement of vibrations for the same registered sequence of images and measure vibration parameters for large inter-individual variability in patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Review of Collagen Cross-Linking in Cornea and Sclera

PubMed Central

Zhang, Xiao; Tao, Xiang-chen; Zhang, Jian; Li, Zhi-wei; Xu, Yan-yun; Wang, Yu-meng; Zhang, Chun-xiao; Mu, Guo-ying

2015-01-01

Riboflavin/UVA cross-linking is a technique introduced in the past decades for the treatment of keratoconus, keratectasia, and infectious keratitis. Its efficacy and safety have been investigated with clinical and laboratory studies since its first clinical application by Wollensak for the treatment of keratoconus. Although its complications are encountered during clinical practice, such as infection inducing risk, minimal invasion merits a further investigation on its future application in clinical practice. Recently, collagen cross-linking in sclera shows a promising prospect. In present study, we summarized the representative studies describing the clinical and laboratory application of collagen cross-linking published in past decades and provided our opinion on the positive and negative results of cross-linking in the treatment of ophthalmic disorders. PMID:25922758

There Are at Least Two Kinds of Probability Matching: Evidence from a Secondary Task

ERIC Educational Resources Information Center

Otto, A. Ross; Taylor, Eric G.; Markman, Arthur B.

2011-01-01

Probability matching is a suboptimal behavior that often plagues human decision-making in simple repeated choice tasks. Despite decades of research, recent studies cannot find agreement on what choice strategies lead to probability matching. We propose a solution, showing that two distinct local choice strategies--which make different demands on…

Influences of Source-Item Contingency and Schematic Knowledge on Source Monitoring: Tests of the Probability-Matching Account

ERIC Educational Resources Information Center

Bayen, Ute J.; Kuhlmann, Beatrice G.

2011-01-01

The authors investigated conditions under which judgments in source-monitoring tasks are influenced by prior schematic knowledge. According to a probability-matching account of source guessing (Spaniol & Bayen, 2002), when people do not remember the source of information, they match source-guessing probabilities to the perceived contingency…

Match probabilities in a finite, subdivided population

PubMed Central

Malaspinas, Anna-Sapfo; Slatkin, Montgomery; Song, Yun S.

2011-01-01

We generalize a recently introduced graphical framework to compute the probability that haplotypes or genotypes of two individuals drawn from a finite, subdivided population match. As in the previous work, we assume an infinite-alleles model. We focus on the case of a population divided into two subpopulations, but the underlying framework can be applied to a general model of population subdivision. We examine the effect of population subdivision on the match probabilities and the accuracy of the product rule which approximates multi-locus match probabilities as a product of one-locus match probabilities. We quantify the deviation from predictions of the product rule by R, the ratio of the multi-locus match probability to the product of the one-locus match probabilities.We carry out the computation for two loci and find that ignoring subdivision can lead to underestimation of the match probabilities if the population under consideration actually has subdivision structure and the individuals originate from the same subpopulation. On the other hand, under a given model of population subdivision, we find that the ratio R for two loci is only slightly greater than 1 for a large range of symmetric and asymmetric migration rates. Keeping in mind that the infinite-alleles model is not the appropriate mutation model for STR loci, we conclude that, for two loci and biologically reasonable parameter values, population subdivision may lead to results that disfavor innocent suspects because of an increase in identity-by-descent in finite populations. On the other hand, for the same range of parameters, population subdivision does not lead to a substantial increase in linkage disequilibrium between loci. Those results are consistent with established practice. PMID:21266180

Effect of the Regenerative Agent Poly(Carboxymethylglucose Sulfate) on Corneal Wound Healing After Corneal Cross-Linking for Keratoconus.

PubMed

Kymionis, George D; Liakopoulos, Dimitrios A; Grentzelos, Michael A; Tsoulnaras, Konstantinos I; Detorakis, Efstathios T; Cochener, Béatrice; Tsilimbaris, Miltiadis K

2015-08-01

To evaluate the effect of a regenerative agent (RGTA) [Cacicol20-poly(carboxymethyl glucose sulfate); OTR3, Paris, France] on corneal reepithelialization and pain after corneal cross-linking (CXL) for keratoconus. In this prospective comparative (contralateral) clinical study, patients with bilateral progressive keratoconus underwent CXL treatment. The corneal epithelium during CXL was removed using transepithelial phototherapeutic keratectomy (Cretan protocol). One eye of each patient was randomly instilled with an RGTA (Cacicol20) once a day (study group), whereas the fellow eye was instilled with artificial tears (control group). Patients were examined daily until complete reepithelialization. Postoperative examinations included slit-lamp biomicroscopy to assess the epithelial defect size and subjective evaluation of pain. The study enrolled 18 patients (36 eyes). The mean epithelial defect size for study and control groups was 19.6 ± 4.2 mm versus 21.5 ± 2.8 mm, respectively, at day 1 (P = 0.019) and 6.4 ± 3.4 mm versus 7.9 ± 4.3 mm, respectively, at day 2 (P = 0.014). At day 3 postoperatively, 61.1% of study eyes were fully reepithelialized, compared with 11.1% of control eyes (P = 0.002). RGTA (Cacicol20) instillation seems to result in faster corneal reepithelialization after CXL in this study. However, there was no significant effect in subjective pain/discomfort.

New screening methods for donor eye-bank eyes.

PubMed

Terry, M A; Ousley, P J

1999-07-01

Current methods of screening donor eyes for corneal transplantation are not always effective in excluding corneas with abnormal topography. We used the Orbscan to determine whether corneal-thickness maps could be used as a technique for donor tissue screening. Forty eye-bank eyes were measured with the Orbscan, and a corneal-thickness map was generated. Average central pachymetry measurements from each map were compared with the thinnest midperipheral thickness reading. Two eyes from a donor who had photorefractive keratectomy (PRK) and two eyes from a donor with keratoconus were then compared with the normal donor eye results. The average difference between the thinnest midperipheral pachymetry and the central pachymetry in the control group was 0.040 +/- 0.026 mm. The eyes from the donor with PRK showed larger disparities between the central and midperipheral thicknesses because of the thinned central cornea, with differences of 0.154 mm in the right eye and 0.106 mm in the left eye. The eyes from the donor with keratoconus had midperipheral corneas that were thinner than the center, indicating eccentric, ectatic cones. The differences in thickness between the center and midperiphery in the eyes from the donor with PRK and the donor with keratoconus differed from the control group by >2 SD. Diseases or surgery that affect the relationship between the central and midperipheral corneal thickness may be screened through Orbscan pachymetry mapping with comparison with a normal range.

Determination of corneal elasticity coefficient using the ORA database.

PubMed

Avetisov, Sergei E; Novikov, Ivan A; Bubnova, Irina A; Antonov, Alexei A; Siplivyi, Vladimir I

2010-07-01

To propose a new approach for the study of corneal biomechanics using the Reichert Ocular Response Analyzer (ORA) database, which is based on changes in velocity retardation in the central cornea at the peak of flattening. The ORA applanation curve was analyzed using a mathematical technique, which allowed calculation of the elasticity coefficient (Ke), which is primarily characteristic of the elastic properties of the cornea. Elasticity coefficient values were obtained in patients with presumably different biomechanical properties of the cornea: "normal" cornea (71 eyes, normal group), keratoconus (34 eyes, keratoconus group), LASIK (36 eyes, LASIK group), and glaucoma with elevated and compensated intraocular pressure (lOP) (38 eyes, glaucoma group). The mean Ke value in the normal group was 11.05 +/- 1.6, and the corneal thickness correlation coefficient r2 was 0.48. In the keratoconus group, the mean Ke value was 4.91 +/- 1.87 and the corneal thickness correlation coefficient r2 was 0.47. In the LASIK group, Ke and r2 were 5.99 +/- 1.18 and 0.39, respectively. In the glaucoma group, the same eyes that experienced a two-fold reduction in lOP developed a statistically significant reduction in the Ke (1.06 times lower), whereas their corneal hysteresis value increased 1.25 times. The elasticity coefficient calculated using the ORA applanation curve can be used in the evaluation of corneal biomechanical properties.

Effects of vernal and allergic conjunctivitis on severity of keratoconus

PubMed Central

Cingu, Abdullah Kursat; Cinar, Yasin; Turkcu, Fatih Mehmet; Sahin, Alparslan; Ari, Seyhmus; Yuksel, Harun; Sahin, Muhammed; Caca, Ihsan

2013-01-01

AIM To demonstrate the effects of two different types of allergic conjunctivitis on severity of keratoconus (KC). METHODS We retrospectively reviewed the medical records of 171 KC patients referred between June 2010 and June 2011. The KC patients were divided into 3 groups as KC (group A), KC with vernal keratoconjunctivitis (VKC) (group B) and KC with allergic conjunctivitis (AC) (group C). Main outcome measures were demographic and ocular clinical features including age at presentation, gender, spherical equivalent (SE), best spectacle corrected visual acuity (BCVA), mean keratometric measurement (Km), central corneal thickness (CCT), and intraocular pressure (IOP). Groups were compared in term of study variables. RESULTS The median age at presentation was significantly lower in group B (P<0.001). According to the median SE (P=0.003), BCVA (P=0.022), Km (P<0.001), CCT (P=0.015) and Amsler–Krumeich classification (P<0.001), KC was more severe in group B. There was no significant difference in terms of IOP and corrected IOP among the groups (P=0.44), however there were 4 patients who had increased corrected IOP developed after topical corticosteroid use in group B. The differences among the groups persisted even after controlling for age and gender. CONCLUSION Our findings demonstrated a more severe KC in VKC patients despite their younger age which suggests evaluation of VKC patients as a separate group in keratoconus disease. PMID:23826535

Effects of vernal and allergic conjunctivitis on severity of keratoconus.

PubMed

Cingu, Abdullah Kursat; Cinar, Yasin; Turkcu, Fatih Mehmet; Sahin, Alparslan; Ari, Seyhmus; Yuksel, Harun; Sahin, Muhammed; Caca, Ihsan

2013-01-01

To demonstrate the effects of two different types of allergic conjunctivitis on severity of keratoconus (KC). We retrospectively reviewed the medical records of 171 KC patients referred between June 2010 and June 2011. The KC patients were divided into 3 groups as KC (group A), KC with vernal keratoconjunctivitis (VKC) (group B) and KC with allergic conjunctivitis (AC) (group C). Main outcome measures were demographic and ocular clinical features including age at presentation, gender, spherical equivalent (SE), best spectacle corrected visual acuity (BCVA), mean keratometric measurement (Km), central corneal thickness (CCT), and intraocular pressure (IOP). Groups were compared in term of study variables. The median age at presentation was significantly lower in group B (P<0.001). According to the median SE (P=0.003), BCVA (P=0.022), Km (P<0.001), CCT (P=0.015) and Amsler-Krumeich classification (P<0.001), KC was more severe in group B. There was no significant difference in terms of IOP and corrected IOP among the groups (P=0.44), however there were 4 patients who had increased corrected IOP developed after topical corticosteroid use in group B. The differences among the groups persisted even after controlling for age and gender. Our findings demonstrated a more severe KC in VKC patients despite their younger age which suggests evaluation of VKC patients as a separate group in keratoconus disease.

In vitro model suggests oxidative stress involved in keratoconus disease

PubMed Central

Karamichos, D.; Hutcheon, A. E. K.; Rich, C. B.; Trinkaus-Randall, V.; Asara, J. M.; Zieske, J. D.

2014-01-01

Keratoconus (KC) affects 1:2000 people and is a disorder where cornea thins and assumes a conical shape. Advanced KC requires surgery to maintain vision. The role of oxidative stress in KC remains unclear. We aimed to identify oxidative stress levels between human corneal keratocytes (HCKs), fibroblasts (HCFs) and keratoconus cells (HKCs). Cells were cultured in 2D and 3D systems. Vitamin C (VitC) and TGF-β3 (T3) were used for 4 weeks to stimulate self-assembled extracellular matrix (ECM). No T3 used as controls. Samples were analyzed using qRT-PCR and metabolomics. qRT-PCR data showed low levels of collagen I and V, as well as keratocan for HKCs, indicating differentiation to a myofibroblast phenotype. Collagen type III, a marker for fibrosis, was up regulated in HKCs. We robustly detected more than 150 metabolites of the targeted 250 by LC-MS/MS per condition and among those metabolites several were related to oxidative stress. Lactate levels, lactate/malate and lactate/pyruvate ratios were elevated in HKCs, while arginine and glutathione/oxidized glutathione ratio were reduced. Similar patterns found in both 2D and 3D. Our data shows that fibroblasts exhibit enhanced oxidative stress compared to keratocytes. Furthermore the HKC cells exhibit the greatest level suggesting they may have a myofibroblast phenotype. PMID:24714342

Patient-specific simulation of the intrastromal ring segment implantation in corneas with keratoconus.

PubMed

Lago, M A; Rupérez, M J; Monserrat, C; Martínez-Martínez, F; Martínez-Sanchis, S; Larra, E; Díez-Ajenjo, M A; Peris-Martínez, C

2015-11-01

The purpose of this study was the simulation of the implantation of intrastromal corneal-ring segments for patients with keratoconus. The aim of the study was the prediction of the corneal curvature recovery after this intervention. Seven patients with keratoconus diagnosed and treated by implantation of intrastromal corneal-ring segments were enrolled in the study. The 3D geometry of the cornea of each patient was obtained from its specific topography and a hyperelastic model was assumed to characterize its mechanical behavior. To simulate the intervention, the intrastromal corneal-ring segments were modeled and placed at the same location at which they were placed in the surgery. The finite element method was then used to obtain a simulation of the deformation of the cornea after the ring segment insertion. Finally, the predicted curvature was compared with the real curvature after the intervention. The simulation of the ring segment insertion was validated comparing the curvature change with the data after the surgery. Results showed a flattening of the cornea which was in consonance with the real improvement of the corneal curvature. The mean difference obtained was of 0.74 mm using properties of healthy corneas. For the first time, a patient-specific model of the cornea has been used to predict the outcomes of the surgery after the intrastromal corneal-ring segments implantation in real patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Thick keratoconic cornea associated with posterior polymorphous corneal dystrophy.

PubMed

Zaarour, K; Slim, E; Antoun, J; Waked, N

2017-03-01

We herein report a case of bilateral unusually thick non-edematous keratoconic corneas with associated endothelial features of posterior polymorphous corneal dystrophy (PPCD). We report the case of a 27-year-old myopic woman who presented for refractive surgery. Slit lamp exam showed bilateral corneal protrusion with diffuse deep stromal and endothelial vesicular opacities and small paracentral bands. Topography showed generalized advanced corneal steepening in both eyes with increased anterior and posterior central corneal elevations in comparison to the best fit sphere. Ultrasound pachymetry showed central corneal thickness of 605μm (RE) and 612μm (LE). On specular biomicroscopy, cell density of 2503 cells/mm 2 RE and 1526 cells/mm 2 LE with significant cellular pleomorphism and polymegathism were noted. Clinical and paraclinical findings together suggest the presence of simultaneous keratoconus and PPCD. The literature has suggested an association between PPCD and steep cornea. Moreover, many reports have also described cases of associated PPCD and keratoconus with characteristic thinning and ectasia, in comparison to the unusual thick corneas noted in our patient, despite the absence of edema. Identification of genetics factors is further needed to clarify this association. This case describes a patient whose corneas present features of both keratoconus and PPCD and is unique due to the presence of increased corneal thickness despite the absence of edema. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Keratoconus

MedlinePlus

... condition may be due to a defect in collagen. This is the tissue that provides the shape ... the cornea so contact lenses fit better Corneal collagen cross-linking is a treatment that causes the ...

The non-parametric Parzen's window in stereo vision matching.

PubMed

Pajares, G; de la Cruz, J

2002-01-01

This paper presents an approach to the local stereovision matching problem using edge segments as features with four attributes. From these attributes we compute a matching probability between pairs of features of the stereo images. A correspondence is said true when such a probability is maximum. We introduce a nonparametric strategy based on Parzen's window (1962) to estimate a probability density function (PDF) which is used to obtain the matching probability. This is the main finding of the paper. A comparative analysis of other recent matching methods is included to show that this finding can be justified theoretically. A generalization of the proposed method is made in order to give guidelines about its use with the similarity constraint and also in different environments where other features and attributes are more suitable.

Astigmatism evaluation prior to cataract surgery.

PubMed

Gupta, Pankaj C; Caty, Jane T

2018-01-01

To evaluate and summarize literature from the past 18 months reporting advancements and issues in astigmatism assessment prior to cataract surgery. New and updated toric calculators and regression formulas offer the opportunity for more accurate lens selection for our patients. Concurrently, improvements in topographic evaluation of corneal keratometry have allowed for a decrease in unplanned residual corneal astigmatism. Measuring posterior corneal astigmatism is especially valuable in eyes with keratoconus when planning to implant toric intraocular lens (IOL) and now allows access to this patient population. Improved accuracy of astigmatism evaluation now occurs with point reflections on the corneal surface along with the latest generation toric lens formulas which integrated posterior corneal astigmatism, predicted lens position, and intended spherical power of the IOL. These improvements can allow for incorporation of toric lenses in keratoconus patients.

Topography-Guided PRK and Crosslinking in Eyes with Keratoconus and Post-LASIK Ectasia.

PubMed

Müller, T M; Lange, A P

2017-04-01

Topography-guided photorefractive keratectomy (TG-PRK) combined with corneal collagen crosslinking (CXL) has been shown to potentially improve vision and stabilize progression in patients with keratoconus (KC). We attempted to reproduce the previously published results using a different laser platform (AMARIS 500E) in patients with KC and post-LASIK ectasia (PLE). All of the 9 included eyes showed improved topography (Kmax, Kmean, RMS HOA, vertical coma, cylinder; p < 0.05) and improved visual acuity (BCVA, UCVA; p < 0.05) after 18 months. Despite some still uncontrollable factors, the combination of TG-PRK and CXL may be a promising option to regularize and stabilize corneas with KC and PLE and improve visual acuity. Georg Thieme Verlag KG Stuttgart · New York.

Non-topography-guided PRK combined with CXL for the correction of refractive errors in patients with early stage keratoconus.

PubMed

Fadlallah, Ali; Dirani, Ali; Chelala, Elias; Antonios, Rafic; Cherfan, George; Jarade, Elias

2014-10-01

To evaluate the safety and clinical outcome of combined non-topography-guided photorefractive keratectomy (PRK) and corneal collagen cross-linking (CXL) for the treatment of mild refractive errors in patients with early stage keratoconus. A retrospective, nonrandomized study of patients with early stage keratoconus (stage 1 or 2) who underwent simultaneous non-topography-guided PRK and CXL. All patients had at least 2 years of follow-up. Data were collected preoperatively and postoperatively at the 6-month, 1-year, and 2-year follow-up visit after combined non-topography-guided PRK and CXL. Seventy-nine patients (140 eyes) were included in the study. Combined non-topography-guided PRK and CXL induced a significant improvement in both visual acuity and refraction. Uncorrected distance visual acuity significantly improved from 0.39 ± 0.22 logMAR before combined non-topography-guided PRK and CXL to 0.12 ± 0.14 logMAR at the last follow-up visit (P <.001) and corrected distance visual acuity remained stable (0.035 ± 0.062 logMAR preoperatively vs 0.036 ± 0.058 logMAR postoperatively, P =.79). The mean spherical equivalent decreased from -1.78 ± 1.43 to -0.42 ± 0.60 diopters (D) (P <.001), and the mean cylinder decreased from 1.47 ± 1.10 to 0.83 ± 0.55 D (P <.001). At the last follow-up visit mean keratometry flat was 43.30 ± 1.75 vs 45.62 ± 1.72 D preoperatively (P = .03) and mean keratometry steep was 44.39 ± 3.14 vs 46.53 ± 2.13 D preoperatively (P = .02). Mean central corneal thickness decreased from 501.74 ± 13.11 to 475.93 ± 12.25 µm following combined non-topography-guided PRK and CXL (P < .001). No intraoperative complications occurred. Four eyes developed mild haze that responded well to a short course of topical steroids. No eye developed infectious keratitis. Combined non-topography-guided PRK and CXL is an effective and safe option for correcting mild refractive error and improving visual acuity in patients with early stable keratoconus. Copyright 2014, SLACK Incorporated.

Comparison of spectra using a Bayesian approach. An argument using oil spills as an example.

PubMed

Li, Jianfeng; Hibbert, D Brynn; Fuller, Steven; Cattle, Julie; Pang Way, Christopher

2005-01-15

The problem of assigning a probability of matching a number of spectra is addressed. The context is in environmental spills when an EPA needs to show that the material from a polluting spill (e.g., oil) is likely to have originated at a particular site (factory, refinery) or from a vehicle (road tanker or ship). Samples are taken from the spill, and candidate sources and are analyzed by spectroscopy (IR, fluorescence) or chromatography (GC or GC/MS). A matching algorithm is applied to pairs of spectra giving a single statistic (R). This can be a point-to-point match giving a correlation coefficient or a Euclidean distance or a derivative of these parameters. The distributions of R for same and different samples are established from existing data. For matching statistics with values in the range {0,1} corresponding to no match (0) to a perfect match (1) a beta distribution can be fitted to most data. The values of R from the match of the spectrum of a spilled oil and of each of a number of suspects are calculated and Bayes' theorem is applied to give a probability of matches between spill sample and each candidate and the probability of no match at all. The method is most effective when simple inspection of the matching parameters does not lead to an obvious conclusion; i.e., there is overlap of the distributions giving rise to dubiety of an assignment. The probability of finding a matching statistic if there were a match to the probability of finding it if there were no match, expressed as a ratio (called the likelihood ratio), is a sensitive and useful parameter to guide the analyst. It is proposed that this approach may be acceptable to a court of law and avoid challenges of apparently subjective opinion of an analyst. Examples of matching the fluorescence and infrared spectra of diesel oils are given.

Simulation of keratoconus observation in photorefraction

NASA Astrophysics Data System (ADS)

Chen, Ying-Ling; Tan, B.; Baker, K.; Lewis, J. W. L.; Swartz, T.; Jiang, Y.; Wang, M.

2006-11-01

In the recent years, keratoconus (KC) has increasingly gained attention due to its treatment options and to the popularity of keratorefractive surgery. This paper investigates the potential of identification of KC using photorefraction (PR), an optical technique that is similar to objective retinoscopy and is commonly used for large-scale ocular screening. Using personalized eye models of both KC and pre-LASIK patients, computer simulations were performed to achieve visualization of this ophthalmic measurement. The simulations are validated by comparing results to two sets of experimental measurements. These PR images show distinguishable differences between KC eyes and eyes that are either normal or ametropic. The simulation technique with personalized modeling can be extended to other ophthalmic instrument developments. It makes possible investigation with the least number of real human subjects. The application is also of great interest in medical training.

Evaluation of corneal biomechanics in patients with keratectasia following LASIK using dynamic Scheimpflug analyzer.

PubMed

Ueki, Ryotaro; Maeda, Naoyuki; Fuchihata, Mutsumi; Asai, Tomoko; Koh, Shizuka; Fujimoto, Hisataka; Uematsu, Masafumi; Nishida, Kohji

2018-04-26

To investigate the corneal biomechanics in eyes with keratectasia following LASIK using a dynamic Scheimpflug analyzer. Case-Control study. The subjects in the study included 12 eyes with keratectasia after LASIK (KE), 24 eyes with keratoconus (KC), 17 eyes without keratectasia after LASIK (LASIK), and 34 eyes with normal corneas (Normal). Corneal biomechanics of the four groups were evaluated using a dynamic Scheimpflug analyzer. Compared with Normal (7.06 ± 0.54), the radius at the highest concavity (radius, mm) of LASIK (5.96 ± 0.76), KE (4.93 ± 0.61) and KC (5.39 ± 1.02) were significantly small. The Deflection Amplitude (HCDLA, mm) of Normal (0.94 ± 0.07) was significantly lower than those of KE (1.11 ± 0.10) and KC (1.06 ± 0.16), and was not significantly different from that of LASIK (0.98 ± 0.07). There were significant differences between LASIK and KE in radius and HCDLA (P < 0.05), whereas KE and KC had no differences in these parameters. Corneal biomechanical features evaluated using the dynamic Scheimpflug analyzer suggest that biomechanical properties in eyes with keratectasia, keratoconus, and LASIK are different from those of normal eyes. Although the biomechanics in eyes with keratectasia differs from that in eyes with LASIK, it is similar to that in eyes with keratoconus.

Mechanisms of rubbing-related corneal trauma in keratoconus.

PubMed

McMonnies, Charles W

2009-07-01

Corneal scarring in keratoconus, which is observed prior to contact lens wear and in association with a chronic habit of abnormal rubbing, suggests a keratocyte change to a repair phenotype in response to rubbing trauma. This review examines known and putative mechanisms for rubbing-related corneal trauma and cone formation. Responses to eye rubbing (and possible causal links) may include increased corneal temperature, epithelial thinning, increased concentrations of inflammatory mediators in the precorneal tears, abnormal enzyme activity, large intraocular pressure spikes, high hydrostatic tissue pressure, thixotropically reduced ground substance viscosity, temporary displacement of ground substance from the corneal apex, buckling and flexure of fibrils associated with waves of corneal indentation, biomechanically coupled curvature transfer to the cone apex, slippage between collagen fibrils at the cone apex, and changes to keratocytes due to mechanical trauma and/or high hydrostatic pressure, in addition to scar formation. Cone formation appears to depend on a loss of shear strength and may be a consequence of a reduction in ground substance viscosity and glue function, which could allow the cornea to bend and yield to intraocular pressure. For some forms of keratoconus, a reduction in shear strength and cone-forming deformation may be responses to rubbing trauma. Some of the mechanisms for corneal rubbing trauma may be relevant to post-laser-assisted in situ keratomileusis ectasia or complications following other types of corneal surgery. There appear to be indications for the control of chronic habits of abnormal rubbing.

Indications and outcomes of pediatric keratoplasty in a tertiary eye care center: A retrospective review.

PubMed

Gulias-Cañizo, Rosario; Gonzalez-Salinas, Roberto; Hernandez-Zimbron, Luis Fernando; Hernandez-Quintela, Everardo; Sanchez-Huerta, Valeria

2017-11-01

To evaluate indications and outcomes of pediatric keratoplasty in a tertiary eye center, and identify factors that affect visual outcomes.We performed a retrospective review of penetrating keratoplasty in children aged 0 to 18 years between 1995 and 2011 in the Asociación para Evitar la Ceguera en México IAP, Hospital "Dr. Luis Sánchez Bulnes".A total of 574 penetrating keratoplasties were performed during the study interval. Median follow-up was 5.0 years. Main indications included keratoconus (55.58%), postherpetic scarring (9.58%), traumatic opacities (7.49%), and bullous keratopathy (6.09%). Rejection rates at 5 years were 27% overall, and among indications, keratoconus showed the best graft survival at 60-months follow-up (85%). The percentage of patients with best corrected visual acuity (BCVA) posttransplant >20/400 at 5 years in the nonrejection group was 81.25% and 82.74% in < and > 10 years of age (YOA) groups, respectively, versus a BCVA posttransplant > 20/400 at 5 years in the rejection group of 53.68% and 51.72% in < and > 10 YOA groups, respectively. There was a statistically significant reduced rejection rate between genders at 18 months of follow-up, favoring males.Despite being considered a high-risk procedure in children, penetrating keratoplasty can achieve good results, especially in patients with keratoconus. It can achieve significative improvements of visual acuity, provided there is an adequate follow-up and treatment adherence.

Population-specific FST values for forensic STR markers: A worldwide survey.

PubMed

Buckleton, John; Curran, James; Goudet, Jérôme; Taylor, Duncan; Thiery, Alexandre; Weir, B S

2016-07-01

The interpretation of matching between DNA profiles of a person of interest and an item of evidence is undertaken using population genetic models to predict the probability of matching by chance. Calculation of matching probabilities is straightforward if allelic probabilities are known, or can be estimated, in the relevant population. It is more often the case, however, that the relevant population has not been sampled and allele frequencies are available only from a broader collection of populations as might be represented in a national or regional database. Variation of allele probabilities among the relevant populations is quantified by the population structure quantity FST and this quantity affects matching proportions. Matching within a population can be interpreted only with respect to matching between populations and we show here that FST, can be estimated from sample allelic matching proportions within and between populations. We report such estimates from data we extracted from 250 papers in the forensic literature, representing STR profiles at up to 24 loci from nearly 500,000 people in 446 different populations. The results suggest that theta values in current forensic use do not have the buffer of conservatism often thought. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Population-specific FST values for forensic STR markers: A worldwide survey

PubMed Central

Buckleton, John; Curran, James; Goudet, Jérôme; Taylor, Duncan; Thiery, Alexandre; Weir, B.S.

2016-01-01

The interpretation of matching between DNA profiles of a person of interest and an item of evidence is undertaken using population genetic models to predict the probability of matching by chance. Calculation of matching probabilities is straightforward if allelic probabilities are known, or can be estimated, in the relevant population. It is more often the case, however, that the relevant population has not been sampled and allele frequencies are available only from a broader collection of populations as might be represented in a national or regional database. Variation of allele probabilities among the relevant populations is quantified by the population structure quantity FST and this quanity affects matching propoptions. Matching within a population can be interpreted only with respect to matching between populations and we show here that FST, can be estimated from sample allelic matching proportions within and between populations. We report such estimates from data we extracted from 250 papers in the forensic literature, representing STR profiles at up to 24 loci from nearly 500,000 people in 446 different populations. The results suggest that theta values in current forensic use do not have the buffer of conservativism often thought. PMID:27082756

[Analysis on the role of Sirius combined topography and tomography system in screening for suspect keratoconus].

PubMed

Zhang, Y; Chen, Y G; Yang, H Y; Xia, Y J; Zhao, R

2018-01-11

Objective: To evaluate the role of Sirius combined topography and tomography system in screening for suspect keratoconus among the corneal refractive surgery candidates. Methods: Retrospective case series study. Eight hundred and sixteen consecutive ametropic patients (1 632 eyes) who underwent routine examinations before corneal refractive surgery at Peking University Third Hospital from January 2016 to September 2016 were reviewed. All the cases were analyzed with Sirius combined topography and tomography system. Fifty-nine eyes of 37 patients, aged (28.9±7.4) years, classified as suspect keratoconus by the system were enrolled in the suspect group, including 25 females (40 eyes) and 12 males (19 eyes). A random eye of the first 59 patients, aged (27.1±6.4)years, whose both eyes were classified as normal by Sirius system were enrolled in the control group, including 38 females and 21 males. The corneal anterior surface, posterior surface and minimum thickness data of the suspect group were analyzed and then compared with the control group. The classified results were further verified by Pentacam system. Independent-samples t test and Mann-Whitney U test were applied to analyze the normal distribution and non-normal distribution data respectively. Results: The medians of anterior surface and posterior surface symmetry index and Baiocchi Calossi Versaci index of anterior surface and posterior surface of the suspect group were 0.84, 0.22, 0.58 and 0.51 D, and that of the control group were 0.05, 0.04, 0.09 and 0.06 D, and the differences were of statistical significance ( Z=- 18.764, -8.351, -12.248, -10.709, P< 0.01). Mean corneal minimum thickness data of the suspect group were (504.4±30.0)μm, and that of the control group were (541.2±32.1)μm, the differences were of statistical significance ( t=- 6.408, P< 0.01). In the suspect group, the eyes related with suspect or abnormal corneal anterior indices accounted for 47.5% (28/59), the eyes related with suspect or abnormal corneal posterior indices accounted for 55.9% (33/59), and the eyes related with suspect or abnormal corneal minimum thickness accounted for 40.7% (24/59). In the suspect group, 45 eyes (76.3%) were classified as suspect or abnormal according to the overall variance index "D" by Belin-Ambrósio Display (BAD) of the Pentacam system, and the other 14 eyes exhibited at least one abnormal index related with keratoconus. Conclusions: Sirius 3D combined topography and tomography and its integral automatic classification system is capable to screen out the suspect keratoconus simply and effectively. These indices maybe arranged in descending order in terms of the sensitivity as corneal posterior surface, followed by corneal anterior surface and then corneal thinnest point thickness. (Chin J Ophthalmol, 2018, 54: 33-38) .

A new approach based on Machine Learning for predicting corneal curvature (K1) and astigmatism in patients with keratoconus after intracorneal ring implantation.

PubMed

Valdés-Mas, M A; Martín-Guerrero, J D; Rupérez, M J; Pastor, F; Dualde, C; Monserrat, C; Peris-Martínez, C

2014-08-01

Keratoconus (KC) is the most common type of corneal ectasia. A corneal transplantation was the treatment of choice until the last decade. However, intra-corneal ring implantation has become more and more common, and it is commonly used to treat KC thus avoiding a corneal transplantation. This work proposes a new approach based on Machine Learning to predict the vision gain of KC patients after ring implantation. That vision gain is assessed by means of the corneal curvature and the astigmatism. Different models were proposed; the best results were achieved by an artificial neural network based on the Multilayer Perceptron. The error provided by the best model was 0.97D of corneal curvature and 0.93D of astigmatism. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Three-dimensional ray-tracing model for the study of advanced refractive errors in keratoconus.

PubMed

Schedin, Staffan; Hallberg, Per; Behndig, Anders

2016-01-20

We propose a numerical three-dimensional (3D) ray-tracing model for the analysis of advanced corneal refractive errors. The 3D modeling was based on measured corneal elevation data by means of Scheimpflug photography. A mathematical description of the measured corneal surfaces from a keratoconus (KC) patient was used for the 3D ray tracing, based on Snell's law of refraction. A model of a commercial intraocular lens (IOL) was included in the analysis. By modifying the posterior IOL surface, it was shown that the imaging quality could be significantly improved. The RMS values were reduced by approximately 50% close to the retina, both for on- and off-axis geometries. The 3D ray-tracing model can constitute a basis for simulation of customized IOLs that are able to correct the advanced, irregular refractive errors in KC.

Adult Regularization of Inconsistent Input Depends on Pragmatic Factors

ERIC Educational Resources Information Center

Perfors, Amy

2016-01-01

In a variety of domains, adults who are given input that is only partially consistent do not discard the inconsistent portion (regularize) but rather maintain the probability of consistent and inconsistent portions in their behavior (probability match). This research investigates the possibility that adults probability match, at least in part,…

How Important Is a Cricket Test Match?

ERIC Educational Resources Information Center

Glaister, P.

2007-01-01

In this article, the author analyzes the cricket series match between England and Australia by applying the concept of probability. The author presents solutions for obtaining results of either team winning or both ending up in a draw in the situation of a five-match series. The author also analyzes the probability wherein the series is still…

On the Effects of Signaling Reinforcer Probability and Magnitude in Delayed Matching to Sample

ERIC Educational Resources Information Center

Brown, Glenn S.; White, K. Geoffrey

2005-01-01

Two experiments examined whether postsample signals of reinforcer probability or magnitude affected the accuracy of delayed matching to sample in pigeons. On each trial, red or green choice responses that matched red or green stimuli seen shortly before a variable retention interval were reinforced with wheat access. In Experiment 1, the…

Reliability of Entire Corneal Thickness Mapping in Normal Post-Laser in situ Keratomileusis and Keratoconus Eyes Using Long Scan Depth Spectral Domain Optical Coherence Tomography.

PubMed

Xu, Zhe; Chen, Sisi; Yang, Chun; Huang, Shenghai; Shen, Meixiao; Wang, Yuanyuan

2018-01-01

To investigate the repeatability and reproducibility of mapping the entire corneal thickness using spectral domain optical coherence tomography (SD-OCT). Thirty normal eyes, 30 post-laser in situ keratomileusis (LASIK) surgery eyes, and 30 keratoconus eyes were analyzed. A custom-built long scan depth SD-OCT device was used to obtain entire corneal images. Ten-millimeter-diameter corneal thickness maps were generated by an automated segmentation algorithm. Intraclass correlation coefficients of repeatability (ICC1) and reproducibility (ICC2), and coefficients of repeatability (CoR1) and reproducibility (CoR2), were calculated to quantify the precision and accuracy of corneal pachymetry measurements using the Bland-Altman method. For SD-OCT measurements in healthy subjects, CoR1 and CoR2 were less than 5.00 and 5.53 μm. ICC1 and ICC2 were more than 0.997 and 0.996. For SD-OCT measurements in LASIK patients, CoR1 and CoR2 were less than 5.09 and 5.34 μm. ICC1 and ICC2 were more than 0.997 and 0.996. For SD-OCT measurements in keratoconus patients, CoR1 and CoR2 were less than 11.57 and 10.92 μm. ICC1 and ICC2 were more than 0.995 and 0.996. The measurements of corneal pachymetric mapping by long scan depth SD-OCT can be assessed over the entire corneal area with good repeatability and reproducibility. © 2017 S. Karger AG, Basel.

Orbscan II anterior elevation changes following corneal collagen cross-linking treatment for keratoconus.

PubMed

Tu, Kyaw Lin; Aslanides, Ioannis M

2009-08-01

To analyze anterior corneal elevation changes on Orbscan II following corneal collagen cross-linking (CXL) with riboflavin. This retrospective study included 8 patients (14 eyes) with keratoconus who underwent CXL, with a mean follow-up of 7 months (range: 5 to 10 months). Pre- and postoperative (at last clinic attendance) anterior elevation difference maps were examined for overall patterns of change. On preoperative maps, distances from maximum anterior elevation to pupil center and to topographic geometric center were compared between the two patterns identified. Pre- and postoperative topography, best spectacle-corrected visual acuity (BSCVA), and refraction were also compared between the two patterns. Two patterns of anterior elevation change were visually identified: (1) paracentral steepening, no change, or flattening centrally; and (2) central steepening. The preoperative maps of eyes that manifested pattern 1 had shorter mean distances for maximum anterior elevation to pupil center (1.70 vs. 2.27 mm) and maximum anterior elevation to geometric center (1.45 vs. 1.99 mm) than those that resulted in pattern 2. Mean maximum topographic simulated keratometry decreased (P = .004) and mean irregularity indices at 3 mm (P =.03) and 5 mm (P =.04) were reduced postoperatively in pattern 1 eyes; all increased in pattern 2 eyes. Mean BSCVA improved postoperatively for both patterns. Mean preoperative myopia decreased in pattern 1 eyes by 0.44 diopters (D), whereas it increased for pattern 2 eyes by 1.83 D. Corneal shape change influenced by anisotropy of collagen distribution is a factor in the outcome of CXL treatment for keratoconus.

Transient corneal endothelial changes following accelerated collagen cross-linking for the treatment of progressive keratoconus.

PubMed

Cingü, Abdullah Kürşat; Sogutlu-Sari, Esin; Cınar, Yasin; Sahin, Muhammed; Türkçü, Fatih Mehmet; Yüksel, Harun; Sahin, Alparslan; Caça, Ihsan

2014-06-01

To evaluate the corneal endothelial changes following accelerated collagen cross-linking (CXL) for the treatment of progressive keratoconus. Thirty-six consecutive progressive keratoconus patients who received accelerated CXL treatment were enrolled in the study. Following de-epithelization, isoosmolar 0.1% riboflavin solution without dextran was instilled every 3 min throughout the 30 min of soaking time before the 5 min of 18 mW/cm(2) UVA irradiation and every 2 min during the UVA irradiation. Corneal specular microscopy was performed on both treated and fellow eyes of each patient preoperatively, in the first week, and in the first, third and sixth month postoperatively. There were significant differences in endothelial cell density (ECD), percentages of hexagonality (6A) and coefficient of variation of endothelial cell area (CV) in the first week and first month postoperatively in the treated eyes when compared to their preoperative values and also to the first week and first month ECD, 6A and CV values of the non-operative eyes. ECD returned to the preoperative values at sixth month whereas 6A and CV returned to the preoperative values at third month. Our results suggested that there may be transient changes in human corneal endothelium following accelerated UVA/riboflavin CXL. Resolution of these changes during the follow-up may indicate a safe recovery. However, the treatment guidelines for accelerated CXL including irradiance level and soaking time should be clearly established to minimize the toxic effects of the treatment.

The relationship between corneal biomechanical properties and confocal microscopy findings in normal and keratoconic eyes.

PubMed

Hurmeric, Volkan; Sahin, Afsun; Ozge, Gokhan; Bayer, Atilla

2010-06-01

To investigate the relationship between corneal biomechanical properties and confocal microscopy (CM) findings in normal and keratoconic eyes. The study consisted of 28 eyes of 28 healthy volunteers and 23 eyes of 15 patients with keratoconus. The diagnosis of keratoconus was made with corneal topography and clinical findings. The corneal hysteresis (CH) and corneal resistance factor (CRF) were measured by the ocular response analyzer. In vivo CM was performed with NIDEK Confoscan 3. CH and CRF were compared with corneal morphological findings (detailed cell counts of endothelial, stromal, and epithelial cells) in vivo. CH was 10.1 +/- 1.3 mm Hg in normal eyes and 7.4 +/- 1.5 mm Hg in keratoconic eyes (P < 0.0001). CRF was 10.1 +/- 1.8 mm Hg in normal eyes and 6.2 +/- 1.4 mm Hg in keratoconic eyes (P < 0.0001). CH and CRF were negatively correlated with full-thickness stromal keratocyte density (P < 0.01; r = -0.52 and P < 0.001; r = -0.67, respectively) in healthy eyes. Keratocyte density of the posterior half of the stroma was found to be significantly related with CRF in healthy eyes (beta = -0.404; P = 0.01). There was no significant relationship among CH, CRF, and CM findings in eyes with keratoconus. There is a significant relationship between CRF and keratocyte density of the posterior half of the stroma in healthy eyes. Our results suggest that corneal elasticity is related to not only stromal matrix but also cellular structure of the cornea.

Simple artificial neural networks that match probability and exploit and explore when confronting a multiarmed bandit.

PubMed

Dawson, Michael R W; Dupuis, Brian; Spetch, Marcia L; Kelly, Debbie M

2009-08-01

The matching law (Herrnstein 1961) states that response rates become proportional to reinforcement rates; this is related to the empirical phenomenon called probability matching (Vulkan 2000). Here, we show that a simple artificial neural network generates responses consistent with probability matching. This behavior was then used to create an operant procedure for network learning. We use the multiarmed bandit (Gittins 1989), a classic problem of choice behavior, to illustrate that operant training balances exploiting the bandit arm expected to pay off most frequently with exploring other arms. Perceptrons provide a medium for relating results from neural networks, genetic algorithms, animal learning, contingency theory, reinforcement learning, and theories of choice.

Randomized Controlled Trial Comparing Transepithelial Corneal Cross-linking Using Iontophoresis with the Dresden Protocol in Progressive Keratoconus.

PubMed

Lombardo, Marco; Giannini, Daniela; Lombardo, Giuseppe; Serrao, Sebastiano

2017-06-01

To compare clinical outcomes of transepithelial corneal cross-linking using iontophoresis (T-ionto CL) and standard corneal cross-linking (standard CL) for the treatment of progressive keratoconus 12 months after the operation. Prospective randomized controlled clinical trial. Thirty-four eyes of 25 participants with progressive keratoconus were randomized into T-ionto CL (22 eyes) or standard CL (12 eyes). T-ionto CL was performed using an iontophoresis device with dextran-free 0.1% riboflavin-5-phosphate solution with enhancers and by irradiating the cornea with a 10 mW/cm 2 ultraviolet A device for 9 minutes. Standard CL was performed according to the Dresden protocol. The primary outcome measure was stabilization of keratoconus after 12 months through analysis of maximum simulated keratometry readings (K max , diopters). Other outcome measures were corrected distance visual acuity (CDVA, logarithm of the minimum angle of resolution [logMAR]), manifest spherical equivalent refraction (D), central corneal thickness (CCT, micrometers) and endothelial cell density (ECD). Follow-up examinations were arranged at 3 and 7 days and 1, 3, 6, and 12 months. Twelve months after T-ionto CL and standard CL, K max on average flattened by -0.52±1.30 D (P = 0.06) and -0.82±1.20 D (P = 0.04), respectively. The mean change in CDVA was -0.10±0.12 logMAR (P = 0.003) and -0.03±0.06 logMAR (P = 0.10) after T-ionto CL and standard CL, respectively. The manifest spherical equivalent refraction changed on average by +0.71±1.44 D (P = 0.03) and +0.21±0.76 D (P = 0.38), respectively. The CCT and ECD measures did not change significantly in any group at 12 months. Significant differences in the outcome measures between treatments were found in the first week postoperatively. No complications occurred in the T-ionto CL group; 1 eye (8%) had sterile corneal infiltrates, which did not affect the final visual acuity, in the standard CL group. Significant visual and refractive improvements were found 12 months after T-ionto CL, though the average improvement in corneal topography readings was slightly lower than the Dresden protocol in the same period. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Comparison of sequential vs same-day simultaneous collagen cross-linking and topography-guided PRK for treatment of keratoconus.

PubMed

Kanellopoulos, Anastasios John

2009-09-01

The safety and efficacy of corneal collagen cross-linking (CXL) and topography-guided photorefractive keratectomy (PRK) using a different sequence and timing were evaluated in consecutive keratoconus cases. This study included a total of 325 eyes with keratoconus. Eyes were divided into two groups. The first group (n=127 eyes) underwent CXL with subsequent topography-guided PRK performed 6 months later (sequential group) and the second group (n=198 eyes) underwent CXL and PRK in a combined procedure on the same day (simultaneous group). Statistical differences were examined for pre- to postoperative changes in uncorrected (UCVA, logMAR) and best-spectacle-corrected visual acuity (BSCVA, logMAR), manifest refraction spherical equivalent (MRSE), keratometry (K), topography, central corneal thickness, endothelial cell count, corneal haze, and ectatic progression. Mean follow-up was 36+/-18 months (range: 24 to 68 months). At last follow-up in the sequential group, the mean UCVA improved from 0.9+/-0.3 logMAR to 0.49+/-0.25 logMAR, and mean BSCVA from 0.41+/-0.25 logMAR to 0.16+/-0.22 logMAR. Mean reduction in spherical equivalent refraction was 2.50+/-1.20 diopters (D), mean haze score was 1.2+/-0.5, and mean reduction in K was 2.75+/-1.30 D. In the simultaneous group, mean UCVA improved from 0.96+/-0.2 logMAR to 0.3+/-0.2 logMAR, and mean BSCVA from 0.39+/-0.3 logMAR to 0.11+/-0.16 logMAR. Mean reduction in spherical equivalent refraction was 3.20+/-1.40 D, mean haze score was 0.5+/-0.3, and mean reduction in K was 3.50+/-1.3 D. Endothelial cell count preoperatively and at last follow-up was unchanged (P<.05) in both groups. Statistically, the simultaneous group did better (P<.05) in all fields evaluated, with improvement in UCVA and BSCVA, a greater mean reduction in spherical equivalent refraction and keratometry, and less corneal haze. Same-day simultaneous topography-guided PRK and CXL appears to be superior to sequential CXL with later PRK in the visual rehabilitation of progressing keratoconus. Copyright 2009, SLACK Incorporated.

Selection method of terrain matching area for TERCOM algorithm

NASA Astrophysics Data System (ADS)

Zhang, Qieqie; Zhao, Long

2017-10-01

The performance of terrain aided navigation is closely related to the selection of terrain matching area. The different matching algorithms have different adaptability to terrain. This paper mainly studies the adaptability to terrain of TERCOM algorithm, analyze the relation between terrain feature and terrain characteristic parameters by qualitative and quantitative methods, and then research the relation between matching probability and terrain characteristic parameters by the Monte Carlo method. After that, we propose a selection method of terrain matching area for TERCOM algorithm, and verify the method correctness with real terrain data by simulation experiment. Experimental results show that the matching area obtained by the method in this paper has the good navigation performance and the matching probability of TERCOM algorithm is great than 90%

Probability matching and strategy availability.

PubMed

Koehler, Derek J; James, Greta

2010-09-01

Findings from two experiments indicate that probability matching in sequential choice arises from an asymmetry in strategy availability: The matching strategy comes readily to mind, whereas a superior alternative strategy, maximizing, does not. First, compared with the minority who spontaneously engage in maximizing, the majority of participants endorse maximizing as superior to matching in a direct comparison when both strategies are described. Second, when the maximizing strategy is brought to their attention, more participants subsequently engage in maximizing. Third, matchers are more likely than maximizers to base decisions in other tasks on their initial intuitions, suggesting that they are more inclined to use a choice strategy that comes to mind quickly. These results indicate that a substantial subset of probability matchers are victims of "underthinking" rather than "overthinking": They fail to engage in sufficient deliberation to generate a superior alternative to the matching strategy that comes so readily to mind.

Elastic microfibril distribution in the cornea: Differences between normal and keratoconic stroma.

PubMed

White, Tomas L; Lewis, Philip N; Young, Robert D; Kitazawa, Koji; Inatomi, Tsutomu; Kinoshita, Shigeru; Meek, Keith M

2017-06-01

The optical and biomechanical properties of the cornea are largely governed by the collagen-rich stroma, a layer that represents approximately 90% of the total thickness. Within the stroma, the specific arrangement of superimposed lamellae provides the tissue with tensile strength, whilst the spatial arrangement of individual collagen fibrils within the lamellae confers transparency. In keratoconus, this precise stromal arrangement is lost, resulting in ectasia and visual impairment. In the normal cornea, we previously characterised the three-dimensional arrangement of an elastic fiber network spanning the posterior stroma from limbus-to-limbus. In the peripheral cornea/limbus there are elastin-containing sheets or broad fibers, most of which become microfibril bundles (MBs) with little or no elastin component when reaching the central cornea. The purpose of the current study was to compare this network with the elastic fiber distribution in post-surgical keratoconic corneal buttons, using serial block face scanning electron microscopy and transmission electron microscopy. We have demonstrated that the MB distribution is very different in keratoconus. MBs are absent from a region of stroma anterior to Descemet's membrane, an area that is densely populated in normal cornea, whilst being concentrated below the epithelium, an area in which they are absent in normal cornea. We contend that these latter microfibrils are produced as a biomechanical response to provide additional strength to the anterior stroma in order to prevent tissue rupture at the apex of the cone. A lack of MBs anterior to Descemet's membrane in keratoconus would alter the biomechanical properties of the tissue, potentially contributing to the pathogenesis of the disease. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Automated Decision Tree Classification of Corneal Shape

PubMed Central

Twa, Michael D.; Parthasarathy, Srinivasan; Roberts, Cynthia; Mahmoud, Ashraf M.; Raasch, Thomas W.; Bullimore, Mark A.

2011-01-01

Purpose The volume and complexity of data produced during videokeratography examinations present a challenge of interpretation. As a consequence, results are often analyzed qualitatively by subjective pattern recognition or reduced to comparisons of summary indices. We describe the application of decision tree induction, an automated machine learning classification method, to discriminate between normal and keratoconic corneal shapes in an objective and quantitative way. We then compared this method with other known classification methods. Methods The corneal surface was modeled with a seventh-order Zernike polynomial for 132 normal eyes of 92 subjects and 112 eyes of 71 subjects diagnosed with keratoconus. A decision tree classifier was induced using the C4.5 algorithm, and its classification performance was compared with the modified Rabinowitz–McDonnell index, Schwiegerling’s Z3 index (Z3), Keratoconus Prediction Index (KPI), KISA%, and Cone Location and Magnitude Index using recommended classification thresholds for each method. We also evaluated the area under the receiver operator characteristic (ROC) curve for each classification method. Results Our decision tree classifier performed equal to or better than the other classifiers tested: accuracy was 92% and the area under the ROC curve was 0.97. Our decision tree classifier reduced the information needed to distinguish between normal and keratoconus eyes using four of 36 Zernike polynomial coefficients. The four surface features selected as classification attributes by the decision tree method were inferior elevation, greater sagittal depth, oblique toricity, and trefoil. Conclusions Automated decision tree classification of corneal shape through Zernike polynomials is an accurate quantitative method of classification that is interpretable and can be generated from any instrument platform capable of raw elevation data output. This method of pattern classification is extendable to other classification problems. PMID:16357645

Comparative study of long-term outcomes of accelerated and conventional collagen crosslinking for progressive keratoconus.

PubMed

Males, J J; Viswanathan, D

2018-01-01

PurposeTo compare the long-term outcomes of accelerated corneal collagen crosslinking (CXL) to conventional CXL for progressive keratoconus.Patients and methodsComparative clinical study of consecutive progressive keratoconic eyes that underwent either accelerated CXL (9 mW/cm 2 ultraviolet A (UVA) light irradiance for 10 min) or conventional CXL (3 mW/cm 2 UVA light irradiance for 30 min). Eyes with minimum 12 months' follow-up were included. Post-procedure changes in keratometry readings (Flat meridian: K1; steep meridian: K2), central corneal thickness (CCT), best spectacle-corrected visual acuity (BSCVA), and manifest refraction spherical equivalent (MRSE) were analysed.ResultsA total of 42 eyes were included. In all, 21 eyes had accelerated CXL (20.5±5.5 months' follow-up) and 21 eyes had conventional CXL group (20.2±5.6 months' follow-up). In the accelerated CXL group, a significant reduction in K2 (P=0.02), however no significant change in K1 (P=0.35) and CCT (P=0.62) was noted. In the conventional CXL group, a significant reduction was seen in K1 (P=0.01) and K2 (P=0.04), but not in CCT (P=0.95). Although both groups exhibited significant reductions in K2 readings, no noteworthy differences were noted between them (P=0.36). Improvements in BSCVA (accelerated CXL; P=0.22 and conventional CXL; P=0.20) and MRSE (accelerated CXL; P=0.97 and conventional CXL; P=0.54) were noted, however were not significant in either group.ConclusionAccelerated and conventional CXL appear to be effective procedures for stabilising progressive keratoconus in the long-term.

Topography-guided transepithelial PRK after intracorneal ring segments implantation and corneal collagen CXL in a three-step procedure for keratoconus.

PubMed

Coskunseven, Efekan; Jankov, Mirko R; Grentzelos, Michael A; Plaka, Argyro D; Limnopoulou, Aliki N; Kymionis, George D

2013-01-01

To present the results of topography-guided transepithelial photorefractive keratectomy (PRK) after intracorneal ring segments implantation followed by corneal collagen cross-linking (CXL) for keratoconus. In this prospective case series, 10 patients (16 eyes) with progressive keratoconus were included. All patients underwent topography-guided transepithelial PRK after Keraring intracorneal ring segments (Mediphacos Ltda) implantation, followed by CXL treatment. The follow-up period was 6 months after the last procedure for all patients. Time interval between both intracorneal ring segments implantation and CXL and between CXL and topography-guided transepithelial PRK was 6 months. LogMAR mean uncorrected distance visual acuity and mean corrected distance visual acuity were significantly improved (P<.05) from 1.14±0.36 and 0.75±0.24 preoperatively to 0.25±0.13 and 0.13±0.06 after the completion of the three-step procedure, respectively. Mean spherical equivalent refraction was significantly reduced (P<.05) from -5.66±5.63 diopters (D) preoperatively to -0.98±2.21 D after the three-step procedure. Mean steep and flat keratometry values were significantly reduced (P<.05) from 54.65±5.80 D and 47.80±3.97 D preoperatively to 45.99±3.12 D and 44.69±3.19 D after the three-step procedure, respectively. Combined topography-guided transepithelial PRK with intracorneal ring segments implantation and CXL in a three-step procedure seems to be an effective, promising treatment sequence offering patients a functional visual acuity and ceasing progression of the ectatic disorder. A longer follow-up and larger case series are necessary to thoroughly evaluate safety, stability, and efficacy of this innovative procedure. Copyright 2013, SLACK Incorporated.

Fourier analysis algorithm for the posterior corneal keratometric data: clinical usefulness in keratoconus.

PubMed

Sideroudi, Haris; Labiris, Georgios; Georgantzoglou, Kimon; Ntonti, Panagiota; Siganos, Charalambos; Kozobolis, Vassilios

2017-07-01

To develop an algorithm for the Fourier analysis of posterior corneal videokeratographic data and to evaluate the derived parameters in the diagnosis of Subclinical Keratoconus (SKC) and Keratoconus (KC). This was a cross-sectional, observational study that took place in the Eye Institute of Thrace, Democritus University, Greece. Eighty eyes formed the KC group, 55 eyes formed the SKC group while 50 normal eyes populated the control group. A self-developed algorithm in visual basic for Microsoft Excel performed a Fourier series harmonic analysis for the posterior corneal sagittal curvature data. The algorithm decomposed the obtained curvatures into a spherical component, regular astigmatism, asymmetry and higher order irregularities for averaged central 4 mm and for each individual ring separately (1, 2, 3 and 4 mm). The obtained values were evaluated for their diagnostic capacity using receiver operating curves (ROC). Logistic regression was attempted for the identification of a combined diagnostic model. Significant differences were detected in regular astigmatism, asymmetry and higher order irregularities among groups. For the SKC group, the parameters with high diagnostic ability (AUC > 90%) were the higher order irregularities, the asymmetry and the regular astigmatism, mainly in the corneal periphery. Higher predictive accuracy was identified using diagnostic models that combined the asymmetry, regular astigmatism and higher order irregularities in averaged 3and 4 mm area (AUC: 98.4%, Sensitivity: 91.7% and Specificity:100%). Fourier decomposition of posterior Keratometric data provides parameters with high accuracy in differentiating SKC from normal corneas and should be included in the prompt diagnosis of KC. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

Effects of eye rubbing on the levels of protease, protease activity and cytokines in tears: relevance in keratoconus.

PubMed

Balasubramanian, Sivaraman A; Pye, David C; Willcox, Mark D P

2013-03-01

Proteases, protease activity and inflammatory molecules in tears have been found to be relevant in the pathogenesis of keratoconus. We sought to determine the influence of eye rubbing on protease expression, protease activity and concentration of inflammatory molecules in tears. Basal tears were collected from normal volunteers before and after 60 seconds of experimental eye rubbing. The total amount of matrix metalloproteinase (MMP)-13 and inflammatory molecules interleukin (IL)-6 and tumour necrosis factor (TNF)-α in the tear samples were measured using specific enzyme-linked immunosorbent assays (ELISA). Tear collagenase activity was investigated using a specific activity assay. The concentrations of MMP-13 (51.9 ± 34.3 versus 63 ± 36.8 pg/ml, p = 0.006), IL-6 (1.24 ± 0.98 versus 2.02 ± 1.52 pg/ml, p = 0.004) and TNF-α (1.16 ± 0.74 versus 1.44 ± 0.66 pg/ml, p = 0.003) were significantly increased in normal subjects after eye rubbing. The experimental eye rub did not alter significantly the collagenase activity (5.02 ± 3 versus 7.50 ± 3.90 fluorescent intensity units, p = 0.14) of tears. Eye rubbing for 60 seconds increased the level of tear MMP-13, IL-6 and TNF-α in normal study subjects. This increase in protease, protease activity and inflammatory mediators in tears after eye rubbing may be exacerbated even further during persistent and forceful eye rubbing seen in people with keratoconus and this in turn may contribute to the progression of the disease. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

Diamond knife-assisted deep anterior lamellar keratoplasty to manage keratoconus.

PubMed

Vajpayee, Rasik B; Maharana, Prafulla K; Sharma, Namrata; Agarwal, Tushar; Jhanji, Vishal

2014-02-01

To evaluate the outcomes of a new surgical technique, diamond knife-assisted deep anterior lamellar keratoplasty (DALK), and compare its visual and refractive results with big-bubble DALK in cases of keratoconus. Tertiary eyecare hospital. Comparative case series. The visual and surgical outcomes of diamond knife-assisted DALK were compared with those of successful big-bubble DALK. Diamond knife-assisted DALK was performed in 19 eyes and big-bubble DALK, in 11 eyes. All surgeries were completed successfully. No intraoperative or postoperative complications occurred with diamond knife-assisted DALK. Six months after diamond knife-assisted DALK, the mean corrected distance visual acuity (CDVA) improved significantly from 1.87 logMAR ± 0.22 (SD) to 0.23 ± 0.06 logMAR, the mean keratometry improved from 65.99 ± 8.86 diopters (D) to 45.13 ± 1.16 D, and the mean keratometric cylinder improved from 7.99 ± 3.81 D to 2.87 ± 0.59 D (all P=.005). Postoperatively, the mean refractive astigmatism was 2.55 ± 0.49 D and the mean spherical equivalent was -1.97 ± 0.56 D. The mean logMAR CDVA (P = .06), postoperative keratometry (P=.64), refractive cylinder (P=.63), and endothelial cell loss (P=.11) were comparable between diamond knife-assisted DALK and big-bubble DALK. Diamond knife-assisted DALK was effective and predictable as a surgical technique for management of keratoconus cases. This technique has the potential to offer visual and refractive outcomes comparable to those of big-bubble DALK. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Corneal Transplantation in Auckland, New Zealand, 1999-2009: Indications, Patient Characteristics, Ethnicity, Social Deprivation, and Access to Services.

PubMed

Crawford, Alexandra Z; McKelvie, James; Craig, Jennifer P; McGhee, Charles N J; Patel, Dipika V

2017-05-01

To analyze characteristics and indications for corneal transplantation in patients undergoing penetrating, lamellar, and endothelial keratoplasty in Auckland, New Zealand (NZ). Corneal transplantation data from the NZ National Eye Bank and hospital records of corneal transplant recipients in the Auckland region from January 1, 2000, to December 31, 2009, were collated. Patient demographics, preoperative diagnosis, indication, ocular and medical history, visual acuity, deprivation index, and access to transplantation surgery were analyzed. A total of 941 corneal transplants involving 770 patients were included for analysis. Mean age was 46 years. Age and ethnicity varied according to the transplant indication. A male preponderance and disproportionally high rates of Māori and Pacific ethnicity with a mean age of 30 years were observed in transplants for keratoconus. A total of 67.2% of corneal transplants were completed in the public health system and were associated with higher levels of deprivation than those completed in private facilities. Preoperative visual acuity varied according to the transplant type and indication. The most common clinical indication for corneal transplantation was keratoconus (41.3%), followed by repeat transplantation (21.0%). There was no significant change in the relative proportion of transplant indications in any year over the duration of this study (P = 0.41). A contralateral corneal transplant was present in 24.4% and glaucoma in 12.8% of penetrating keratoplasty recipients. Keratoconus is the leading indication for corneal transplantation in Auckland, NZ, and involves a disproportionately high rate of Māori and Pacific transplant recipients with a male preponderance and comparatively low mean age at the time of surgery.

[Fitting Monocurve and Bicurve (Soper-McGuire design) rigid gas-permeable contact lenses in keratoconus patients: a prospective randomized comparative clinical trial].

PubMed

Coral-Ghanem, Cleusa; Alves, Milton Ruiz

2008-01-01

To evaluate the clinical performance of Monocurve and Bicurve (Soper-McGuire design) rigid gas-permeable contact lens fitting in patients with keratoconus. A prospective and randomized comparative clinical trial was conducted with a minimum follow-up of six months in two groups of 63 patients. One group was fitted with Monocurve contact lenses and the other with Bicurve Soper-McGuire design. Study variables included fluoresceinic pattern of lens-to-cornea fitting relationship, location and morphology of the cone, presence and degree of punctate keratitis and other corneal surface alterations, topographic changes, visual acuity for distance corrected with contact lenses and survival analysis for remaining with the same contact lens design during the study. During the follow-up there was a decrease in the number of eyes with advanced and central cones fitted with Monocurve lenses, and an increase in those fitted with Soper-McGuire design. In the Monocurve group, a flattening of both the steepest and the flattest keratometric curve was observed. In the Soper-McGuire group, a steepening of the flattest keratometric curve and a flattening of the steepest keratometric curve were observed. There was a decrease in best-corrected visual acuity with contact lens in the Monocurve group. Survival analysis for the Monocurve lens was 60.32% and for the Soper-McGuire was 71.43% at a mean follow-up of six months. This study showed that due to the changes observed in corneal topography, the same contact lens design did not provide an ideal fitting for all patients during the follow-up period. The Soper-McGuire lenses had a better performance than the Monocurve lenses in advanced and central keratoconus.

Late onset of a persistent, deep stromal scarring after PRK and corneal cross-linking in a patient with forme fruste keratoconus.

PubMed

Güell, Jose L; Verdaguer, Paula; Elies, Daniel; Gris, Oscar; Manero, Felicidad

2014-04-01

To present a case of a late, deep stromal scar in a 22-year-old patient with forme fruste keratoconus who underwent combined corneal cross-linking and photorefractive keratectomy (PRK). Topography-guided corneal cross-linking combined with corneal PRK (without complications) was performed in both eyes with a delay of 2 weeks between each eye. At the 5-month postoperative examination of the right eye, a localized corneal haze was circumscribed to the posterior deep stroma, signifying a decrease of visual acuity. However, this improved partially and temporarily when treated with topical corticoids during 2 years of follow-up and then reoccurred, affecting the corrected distance visual acuity. To the authors' knowledge, this is the first documented, clinical case presenting a deep stromal affectation without endothelial decompensation and visual acuity affectation as a postoperative complication following topography-guided PRK and corneal cross-linking. Copyright 2014, SLACK Incorporated.

Combined application of prophylactic corneal cross-linking and laser in-situ keratomileusis - a review of literature.

PubMed

Chan, Tommy C Y; Ng, Alex L K; Chan, Karen K W; Cheng, George P M; Wong, Ian Y H; Jhanji, Vishal

2017-11-01

Laser in-situ keratomileusis (LASIK) is safe and effective laser refractive procedures in treating refractive errors. However, regression of treatment and iatrogenic keratectasia remain to be a major concern, especially in treating thin cornea with high ametropia. Collagen cross-linking (CXL) is an effective method in stopping keratoconus progression through increasing the biomechanical strength of the cornea. Adjuvant cross-linking to refractive procedures can theoretically help prevent regression and reduce the risk of keratectasia development by increasing the mechanical stability of cornea. During the procedure, riboflavin is directly applied to the corneal stroma, thereby reducing the need of de-epithelialization as in the conventional protocol for keratoconus. Currently, there is still no consensus regarding the indication of CXL during refractive procedure, nor any standardized treatment protocol. This article aims to summarize the current evidence regarding the use of adjuvant CXL in LASIK. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Clinical and epidemiological aspects of cornea transplant patients of a reference hospital 1

PubMed Central

Cruz, Giovanna Karinny Pereira; de Azevedo, Isabelle Campos; Carvalho, Diana Paula de Souza Rego Pinto; Vitor, Allyne Fortes; Santos, Viviane Euzébia Pereira; Ferreira, Marcos Antonio

2017-01-01

ABSTRACT Objective: clinically characterizing cornea transplant patients and their distribution according to indicated and post-operative conditions of cornea transplantation, as well as estimating the average waiting time. Method: a cross-sectional, descriptive and analytical study performed for all cornea transplants performed at a reference service (n=258). Data were analyzed using Statistical Package for the Social Sciences, version 20.0. Results: the main indicator for cornea transplant was keratoconus. The mean waiting time for the transplant was approximately 5 months and 3 weeks for elective transplants and 9 days for urgent cases. An association between the type of corneal disorder with gender, age, previous surgery, eye classification, glaucoma and anterior graft failure were found. Conclusion: keratoconus was the main indicator for cornea transplant. Factors such as age, previous corneal graft failure (retransplantation), glaucoma, cases of surgeries prior to cornea transplant (especially cataract surgery) may be related to the onset corneal endothelium disorders. PMID:28614429

Accuracy of very low pretest probability estimates for pulmonary embolism using the method of attribute matching compared with the Wells score.

PubMed

Kline, Jeffrey A; Courtney, D Mark; Than, Martin P; Hogg, Kerstin; Miller, Chadwick D; Johnson, Charles L; Smithline, Howard A

2010-02-01

Attribute matching matches an explicit clinical profile of a patient to a reference database to estimate the numeric value for the pretest probability of an acute disease. The authors tested the accuracy of this method for forecasting a very low probability of venous thromboembolism (VTE) in symptomatic emergency department (ED) patients. The authors performed a secondary analysis of five data sets from 15 hospitals in three countries. All patients had data collected at the time of clinical evaluation for suspected pulmonary embolism (PE). The criterion standard to exclude VTE required no evidence of PE or deep venous thrombosis (DVT) within 45 days of enrollment. To estimate pretest probabilities, a computer program selected, from a large reference database of patients previously evaluated for PE, patients who matched 10 predictor variables recorded for each current test patient. The authors compared the outcome frequency of having VTE [VTE(+)] in patients with a pretest probability estimate of <2.5% by attribute matching, compared with a value of 0 from the Wells score. The five data sets included 10,734 patients, and 747 (7.0%, 95% confidence interval [CI] = 6.5% to 7.5%) were VTE(+) within 45 days. The pretest probability estimate for PE was <2.5% in 2,975 of 10,734 (27.7%) patients, and within this subset, the observed frequency of VTE(+) was 48 of 2,975 (1.6%, 95% CI = 1.2% to 2.1%). The lowest possible Wells score (0) was observed in 3,412 (31.7%) patients, and within this subset, the observed frequency of VTE(+) was 79 of 3,412 (2.3%, 95% CI = 1.8% to 2.9%) patients. Attribute matching categorizes over one-quarter of patients tested for PE as having a pretest probability of <2.5%, and the observed rate of VTE within 45 days in this subset was <2.5%. (c) 2010 by the Society for Academic Emergency Medicine.

Identification of a G‐Protein Subunit‐α11 Gain‐of‐Function Mutation, Val340Met, in a Family With Autosomal Dominant Hypocalcemia Type 2 (ADH2)

PubMed Central

Piret, Sian E; Gorvin, Caroline M; Pagnamenta, Alistair T; Howles, Sarah A; Cranston, Treena; Rust, Nigel; Nesbit, M Andrew; Glaser, Ben; Taylor, Jenny C; Buchs, Andreas E; Hannan, Fadil M

2016-01-01

ABSTRACT Autosomal dominant hypocalcemia (ADH) is characterized by hypocalcemia, inappropriately low serum parathyroid hormone concentrations and hypercalciuria. ADH is genetically heterogeneous with ADH type 1 (ADH1), the predominant form, being caused by germline gain‐of‐function mutations of the G‐protein coupled calcium‐sensing receptor (CaSR), and ADH2 caused by germline gain‐of‐function mutations of G‐protein subunit α‐11 (Gα11). To date Gα11 mutations causing ADH2 have been reported in only five probands. We investigated a multigenerational nonconsanguineous family, from Iran, with ADH and keratoconus which are not known to be associated, for causative mutations by whole‐exome sequencing in two individuals with hypoparathyroidism, of whom one also had keratoconus, followed by cosegregation analysis of variants. This identified a novel heterozygous germline Val340Met Gα11 mutation in both individuals, and this was also present in the other two relatives with hypocalcemia that were tested. Three‐dimensional modeling revealed the Val340Met mutation to likely alter the conformation of the C‐terminal α5 helix, which may affect G‐protein coupled receptor binding and G‐protein activation. In vitro functional expression of wild‐type (Val340) and mutant (Met340) Gα11 proteins in HEK293 cells stably expressing the CaSR, demonstrated that the intracellular calcium responses following stimulation with extracellular calcium, of the mutant Met340 Gα11 led to a leftward shift of the concentration‐response curve with a significantly (p < 0.0001) reduced mean half‐maximal concentration (EC50) value of 2.44 mM (95% CI, 2.31 to 2.77 mM) when compared to the wild‐type EC50 of 3.14 mM (95% CI, 3.03 to 3.26 mM), consistent with a gain‐of‐function mutation. A novel His403Gln variant in transforming growth factor, beta‐induced (TGFBI), that may be causing keratoconus was also identified, indicating likely digenic inheritance of keratoconus and ADH2 in this family. In conclusion, our identification of a novel germline gain‐of‐function Gα11 mutation, Val340Met, causing ADH2 demonstrates the importance of the Gα11 C‐terminal region for G‐protein function and CaSR signal transduction. © 2016 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR). PMID:26818911

Probability Matching in the Right Hemisphere

ERIC Educational Resources Information Center

Miller, M.B.; Valsangkar-Smyth, M.

2005-01-01

Previously it has been shown that the left hemisphere, but not the right, of split-brain patients tends to match the frequency of previous occurrences in probability-guessing paradigms (Wolford, Miller, & Gazzaniga, 2000). This phenomenon has been attributed to an ''interpreter,'' a mechanism for making interpretations and forming hypotheses,…

The association between Myers-Briggs Type Indicator and Psychiatry as the specialty choice.

PubMed

Yang, Chong; Richard, George; Durkin, Martin

2016-02-06

The purpose of this pilot study is to examine the association between Myers-Briggs Type Indicator (MBTI) and prospective psychiatry residents. Forty-six American medical schools were contacted and asked to participate in this study. Data were collected and an aggregated list was compiled that included the following information: date of MBTI administration, academic year, MBTI form/version, residency match information and student demographic information. The data includes 835 American medical students who completed the MBTI survey and matched into a residency training program in the United States. All analyses were performed using R 3.1.2. The probability of an introvert matching to a psychiatry residency is no different than that of an extravert (p= 0.30). The probability of an intuitive individual matching to a psychiatry residency is no different than that of a sensing type (p=0.20). The probability of a feeling type matching to a psychiatry residency is no different than that of a thinking type (p= 0.50). The probability of a perceiving type matching to a psychiatry residency is no different than that of a judging type (p= 0.60). Further analyses may elicit more accurate information regarding the personality profile of prospective psychiatry residents. The improvement in communication, team dynamics, mentor-mentee relationships and reduction in workplace conflicts are possible with the awareness of MBTI personality profiles.

The association between Myers-Briggs Type Indicator and Psychiatry as the specialty choice

PubMed Central

Richard, George; Durkin, Martin

2016-01-01

Objectives The purpose of this pilot study is to examine the association between Myers-Briggs Type Indicator (MBTI) and prospective psychiatry residents. Methods Forty-six American medical schools were contacted and asked to participate in this study. Data were collected and an aggregated list was compiled that included the following information: date of MBTI administration, academic year, MBTI form/version, residency match information and student demographic information. The data includes 835 American medical students who completed the MBTI survey and matched into a residency training program in the United States. All analyses were performed using R 3.1.2. Results The probability of an introvert matching to a psychiatry residency is no different than that of an extravert (p= 0.30). The probability of an intuitive individual matching to a psychiatry residency is no different than that of a sensing type (p=0.20). The probability of a feeling type matching to a psychiatry residency is no different than that of a thinking type (p= 0.50). The probability of a perceiving type matching to a psychiatry residency is no different than that of a judging type (p= 0.60). Conclusions Further analyses may elicit more accurate information regarding the personality profile of prospective psychiatry residents. The improvement in communication, team dynamics, mentor-mentee relationships and reduction in workplace conflicts are possible with the awareness of MBTI personality profiles. PMID:26851600

Soccer Matches as Experiments - How Often Does the 'Best' Team Win?

NASA Technical Reports Server (NTRS)

Skinner, Gerald K.; Freeman, G. H.

2009-01-01

Models in which the number of goals scored by a team in a soccer match follow a Poisson distribution or a closely related one, have been widely discussed. We here consider a soccer match as an experiment to assess which of two teams is superior and examine the probability that the outcome of the experiment (match) truly represents the relative abilities of the two teams. Given a final score it is possible by using a Bayesian approach to quantify the probability that it was or was not the case that the best team won. For typical scores, the probability of a misleading result is significant. Modifying the rules of the game to increase thc typical number of goals scored would improve the situation, but a level of confidence that would normally be regarded as satisfactory could not be obtained unless the character of the game were radically changed.

Are Soccer Matches Badly Designed Experiments?

NASA Technical Reports Server (NTRS)

Skinner, G. K.; Freeman, G. H.

2008-01-01

Models in which the number of goals scored by a team in a soccer match follow a Poisson distribution, or a closely related one. have been widely discussed. We here consider a soccer match as an experiment to assess which of two teams is superior and examine the probability that the outcome of the experiment (match) truly represents the relative abilities of the two teams. Given a final score it is possible by using a Bayesian approach to quantify the probability that it was or was not the case that 'the best team won'. For typical scores, the probability of a misleading result is significant. Modifying the rules of the game to increase the typical number of goals scored would improve the situation, but a level of confidence that would normally be regarded as satisfactory could not be obtained unless the character of the game were radically changed.

Electrophysiological evidence that top-down knowledge controls working memory processing for subsequent visual search.

PubMed

Kawashima, Tomoya; Matsumoto, Eriko

2016-03-23

Items in working memory guide visual attention toward a memory-matching object. Recent studies have shown that when searching for an object this attentional guidance can be modulated by knowing the probability that the target will match an item in working memory. Here, we recorded the P3 and contralateral delay activity to investigate how top-down knowledge controls the processing of working memory items. Participants performed memory task (recognition only) and memory-or-search task (recognition or visual search) in which they were asked to maintain two colored oriented bars in working memory. For visual search, we manipulated the probability that target had the same color as memorized items (0, 50, or 100%). Participants knew the probabilities before the task. Target detection in 100% match condition was faster than that in 50% match condition, indicating that participants used their knowledge of the probabilities. We found that the P3 amplitude in 100% condition was larger than in other conditions and that contralateral delay activity amplitude did not vary across conditions. These results suggest that more attention was allocated to the memory items when observers knew in advance that their color would likely match a target. This led to better search performance despite using qualitatively equal working memory representations.

Information Density and Syntactic Repetition.

PubMed

Temperley, David; Gildea, Daniel

2015-11-01

In noun phrase (NP) coordinate constructions (e.g., NP and NP), there is a strong tendency for the syntactic structure of the second conjunct to match that of the first; the second conjunct in such constructions is therefore low in syntactic information. The theory of uniform information density predicts that low-information syntactic constructions will be counterbalanced by high information in other aspects of that part of the sentence, and high-information constructions will be counterbalanced by other low-information components. Three predictions follow: (a) lexical probabilities (measured by N-gram probabilities and head-dependent probabilities) will be lower in second conjuncts than first conjuncts; (b) lexical probabilities will be lower in matching second conjuncts (those whose syntactic expansions match the first conjunct) than nonmatching ones; and (c) syntactic repetition should be especially common for low-frequency NP expansions. Corpus analysis provides support for all three of these predictions. Copyright © 2015 Cognitive Science Society, Inc.

A new model for bed load sampler calibration to replace the probability-matching method

Treesearch

Robert B. Thomas; Jack Lewis

1993-01-01

In 1977 extensive data were collected to calibrate six Helley-Smith bed load samplers with four sediment particle sizes in a flume at the St. Anthony Falls Hydraulic Laboratory at the University of Minnesota. Because sampler data cannot be collected at the same time and place as ""true"" trap measurements, the ""probability-matching...

Histopathologic analysis of successful endothelial keratoplasty following multiple failed keratoplasties.

PubMed

Epstein, Rachel H; Mamalis, Nick; Price, Francis W; Price, Marianne O

2015-02-01

A 68-year-old woman with bilateral keratoconus presented with persistent visual acuity deficits following cataract extraction with a neodymium:YAG capsulotomy in the right eye 2 years earlier. Penetrating keratoplasty (PKP) had been performed for keratoconus in the right eye without complications until steroid drops were discontinued after 10 years because of persistent elevated intraocular pressure. The right eye experienced immunologic rejection and failure of 3 PKPs, 1 Descemet-stripping endothelial keratoplasty (DSEK), and a trabeculectomy with an eventual anatomically successful DSEK before the patient died at 95 years of age. The left eye improved following a single PKP. Postmortem histopathologic analysis of the cornea showed an anatomically successful DSEK graft with intact donor Descemet membrane and viable graft endothelial cells. To our knowledge, this is the first histopathologic analysis of an anatomically successful DSEK after multiple failed PKPs and trabeculectomy. The course in this case supports early consideration of lamellar keratoplasty, especially in patients with ocular comorbidities. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Intraocular lens power estimation by accurate ray tracing for eyes underwent previous refractive surgeries

NASA Astrophysics Data System (ADS)

Yang, Que; Wang, Shanshan; Wang, Kai; Zhang, Chunyu; Zhang, Lu; Meng, Qingyu; Zhu, Qiudong

2015-08-01

For normal eyes without history of any ocular surgery, traditional equations for calculating intraocular lens (IOL) power, such as SRK-T, Holladay, Higis, SRK-II, et al., all were relativley accurate. However, for eyes underwent refractive surgeries, such as LASIK, or eyes diagnosed as keratoconus, these equations may cause significant postoperative refractive error, which may cause poor satisfaction after cataract surgery. Although some methods have been carried out to solve this problem, such as Hagis-L equation[1], or using preoperative data (data before LASIK) to estimate K value[2], no precise equations were available for these eyes. Here, we introduced a novel intraocular lens power estimation method by accurate ray tracing with optical design software ZEMAX. Instead of using traditional regression formula, we adopted the exact measured corneal elevation distribution, central corneal thickness, anterior chamber depth, axial length, and estimated effective lens plane as the input parameters. The calculation of intraocular lens power for a patient with keratoconus and another LASIK postoperative patient met very well with their visual capacity after cataract surgery.

Average probability that a "cold hit" in a DNA database search results in an erroneous attribution.

PubMed

Song, Yun S; Patil, Anand; Murphy, Erin E; Slatkin, Montgomery

2009-01-01

We consider a hypothetical series of cases in which the DNA profile of a crime-scene sample is found to match a known profile in a DNA database (i.e., a "cold hit"), resulting in the identification of a suspect based only on genetic evidence. We show that the average probability that there is another person in the population whose profile matches the crime-scene sample but who is not in the database is approximately 2(N - d)p(A), where N is the number of individuals in the population, d is the number of profiles in the database, and p(A) is the average match probability (AMP) for the population. The AMP is estimated by computing the average of the probabilities that two individuals in the population have the same profile. We show further that if a priori each individual in the population is equally likely to have left the crime-scene sample, then the average probability that the database search attributes the crime-scene sample to a wrong person is (N - d)p(A).

Wavefront-Guided Scleral Lens Prosthetic Device for Keratoconus

PubMed Central

Sabesan, Ramkumar; Johns, Lynette; Tomashevskaya, Olga; Jacobs, Deborah S.; Rosenthal, Perry; Yoon, Geunyoung

2016-01-01

Purpose To investigate the feasibility of correcting ocular higher order aberrations (HOA) in keratoconus (KC) using wavefront-guided optics in a scleral lens prosthetic device (SLPD). Methods Six advanced keratoconus patients (11 eyes) were fitted with a SLPD with conventional spherical optics. A custom-made Shack-Hartmann wavefront sensor was used to measure aberrations through a dilated pupil wearing the SLPD. The position of SLPD, i.e. horizontal and vertical decentration relative to the pupil and rotation were measured and incorporated into the design of the wavefront-guided optics for the customized SLPD. A submicron-precision lathe created the designed irregular profile on the front surface of the device. The residual aberrations of the same eyes wearing the SLPD with wavefront-guided optics were subsequently measured. Visual performance with natural mesopic pupil was compared between SLPDs having conventional spherical and wavefront-guided optics by measuring best-corrected high-contrast visual acuity and contrast sensitivity. Results Root-mean-square of HOA(RMS) in the 11 eyes wearing conventional SLPD with spherical optics was 1.17±0.57μm for a 6 mm pupil. HOA were effectively corrected by the customized SLPD with wavefront-guided optics and RMS was reduced 3.1 times on average to 0.37±0.19μm for the same pupil. This correction resulted in significant improvement of 1.9 lines in mean visual acuity (p<0.05). Contrast sensitivity was also significantly improved by a factor of 2.4, 1.8 and 1.4 on average for 4, 8 and 12 cycles/degree, respectively (p<0.05 for all frequencies). Although the residual aberration was comparable to that of normal eyes, the average visual acuity in logMAR with the customized SLPD was 0.21, substantially worse than normal acuity. Conclusions The customized SLPD with wavefront-guided optics corrected the HOA of advanced KC patients to normal levels and improved their vision significantly. PMID:23478630

Intacs for keratoconus and post-LASIK ectasia: mechanical versus femtosecond laser-assisted channel creation.

PubMed

Carrasquillo, Karen G; Rand, Janet; Talamo, Jonathan H

2007-09-01

To evaluate the efficacy of intracorneal ring segments to treat keratoconus and post-laser in situ keratomileusis (LASIK) keratectasia implanted by using either mechanical dissection or a femtosecond laser. Thirty-three eyes of 29 patients had intracorneal ring segments implanted by using mechanical dissection (17 eyes) or a femtosecond laser (16 eyes). Mean follow-up was 10.3 months. Parameters assessed before and after surgery included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refractive spherical equivalent (MRSE), refractive cylinder (RC), best contact lens-corrected visual acuity (BCLVA), and contact lens tolerance. Statistically significant changes occurred for all parameters when we analyzed all 33 eyes as 1 group. Mean UCVA LogMar values improved from 1.0 +/- 0.3 (20/200) to 0.6 +/- 0.4 (20/80) (P < 0.0005). Mean BSCVA changed from 0.3 +/- 0.2 (20/40) to 0.2 +/- 0.2 (20/30) (10%; P < 0.05), and MRSE from -9 +/- 4 to -7 +/- 4 D (P < 0.05; 20%). There was a decrease of 0.5 D or more of RC in 62% of eyes. BCLVA improved from 0.2 +/- 0.2 (20/30) to 0.1 +/- 0.1 (20/25) after surgery (P < 0.02). Contact lens tolerance improved in 81% of eyes. There was no statistically significant difference in outcomes between mechanical dissection and femtosecond laser-assisted techniques. However, although statistical power was adequate to detect changes in clinical parameters as a result of surgery, it was not sufficient to conclusively show such differences between surgical techniques. For mild to moderate cases of keratoconus and post-LASIK keratectasia, the use of a femtosecond laser for Intacs channel creation seems as effective as mechanical dissection. Future studies are warranted to further evaluate channel creation by a femtosecond laser.

Modified big-bubble technique compared to manual dissection deep anterior lamellar keratoplasty in the treatment of keratoconus.

PubMed

Knutsson, Karl Anders; Rama, Paolo; Paganoni, Giorgio

2015-08-01

To evaluate the clinical findings and results of manual dissection deep anterior lamellar keratoplasty (DALK) compared to a modified big-bubble DALK technique in eyes affected by keratoconus. Sixty eyes of 60 patients with keratoconus were treated with one of the two surgical techniques manual DALK (n = 30); big-bubble DALK (n = 30). The main outcomes measured were visual acuity, corneal topographic parameters, thickness of residual stroma and endothelial cell density (ECD). Patients were examined postoperatively at 1 month, 6 months, 1 year and 1 month after suture removal. Final best spectacle-corrected visual acuity (BSCVA) measured 1 month after suture removal was 0.11 ± 0.08 LogMAR in the big-bubble group compared to 0.13 ± 0.08 in the manual DALK group (p = 0.227). In patients treated with the big-bubble technique without complications (Descemet's membrane completely bared), the stromal residue was not measureable. Mean stromal residual thickness in the manual DALK group was 30.50 ± 27.60 μm. Data analysis of the manual DALK group demonstrated a significant correlation between BSCVA and residual stromal thickness; lower residual stromal thickness correlated with better BSCVA values (Spearman ρ = 0.509, p = 0.018). Postoperative ECD was similar in both groups at all intervals, with no statistically significant differences. In both groups, ECD loss was only significant during the 1- to 6-month interval (p = 0.001 and p < 0.001 in the big-bubble DALK and manual DALK groups, respectively). Manual DALK provides comparable results to big-bubble DALK. Big-bubble DALK permits faster visual recovery and is a surgical technique, which can be easily converted to manual DALK in cases of unsuccessful 'big-bubble' formation. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Changes in corneal topography and biomechanical properties after collagen cross linking for keratoconus: 1-year results.

PubMed

Sedaghat, Mohammadreza; Bagheri, Mansooreh; Ghavami, Shahri; Bamdad, Shahram

2015-01-01

To evaluate changes in corneal topography and biomechanical properties after collagen cross-linking (CXL) for progressive keratoconus. Collagen cross-linking was performed on 97 eyes. We assessed uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Corneal topography indices were evaluated using placido disc topography, scanning slit anterior topography (Orbscan II), and rotating Scheimpflug topography (Pentacam). Specular microscopy and corneal biomechanics were evaluated. A 1-year-follow-up results revealed that UCVA improved from 0.31 to 0.45 and BCVA changed from 0.78 to 0.84 (P < 0.001). The mean of average keratometry value decreased from 49.62 to 47.95 D (P < 0.001). Astigmatism decreased from 4.84 to 4.24 D (P < 0.001). Apex corneal thickness decreased from 458.11 to 444.46 μm. Corneal volume decreased from 56.66 to 55.97 mm(3) (P < 0.001). Posterior best fit sphere increased from 55.50 to 46.03 mm (P = 0.025). Posterior elevation increased from 99.2 to 112.22 μm (P < 0.001). Average progressive index increased from 2.26 to 2.56 (P < 0.001). A nonsignificant decrease was observed in mean endothelial count from 2996 to 2928 cell/mm(2) (P = 0.190). Endothelial coefficient of variation (CV) increased nonsignificantly from 18.26 to 20.29 (P = 0.112). Corneal hysteresis changed from 8.18 to 8.36 (P = 0.552) and corneal resistance factor increased from 6.98 to 7.21 (P = 0.202), so these changes were not significant. Visual acuity and K values improved after CXL. In spite of the nonsignificant increase in endothelial cell count and increase in the CV, CLX seems to be a safe treatment for keratoconus. Further studies with larger sample sizes and longer follow-up periods are recommended.

Training in two-tier labor markets: The role of job match quality.

PubMed

Akgündüz, Yusuf Emre; van Huizen, Thomas

2015-07-01

This study examines training investments in two-tier labor markets, focusing on the role of job match quality. Temporary workers are in general more likely than permanent workers to leave their employer and therefore are less likely to receive employer-funded training. However, as firms prefer to continue productive job matches, we hypothesize that the negative effect of holding a temporary contract on the probability to be trained diminishes with the quality of the job match. Using a recent longitudinal survey from the Netherlands, we find that temporary workers indeed participate less frequently in firm-sponsored training. However, this effect is fully driven by mismatches: holding a temporary contract does not significantly decrease the probability to receive training for workers in good job matches. Depending on match quality, a temporary job can either be a stepping stone or a dead-end. Copyright © 2015 Elsevier Inc. All rights reserved.

A multi-part matching strategy for mapping LOINC with laboratory terminologies

PubMed Central

Lee, Li-Hui; Groß, Anika; Hartung, Michael; Liou, Der-Ming; Rahm, Erhard

2014-01-01

Objective To address the problem of mapping local laboratory terminologies to Logical Observation Identifiers Names and Codes (LOINC). To study different ontology matching algorithms and investigate how the probability of term combinations in LOINC helps to increase match quality and reduce manual effort. Materials and methods We proposed two matching strategies: full name and multi-part. The multi-part approach also considers the occurrence probability of combined concept parts. It can further recommend possible combinations of concept parts to allow more local terms to be mapped. Three real-world laboratory databases from Taiwanese hospitals were used to validate the proposed strategies with respect to different quality measures and execution run time. A comparison with the commonly used tool, Regenstrief LOINC Mapping Assistant (RELMA) Lab Auto Mapper (LAM), was also carried out. Results The new multi-part strategy yields the best match quality, with F-measure values between 89% and 96%. It can automatically match 70–85% of the laboratory terminologies to LOINC. The recommendation step can further propose mapping to (proposed) LOINC concepts for 9–20% of the local terminology concepts. On average, 91% of the local terminology concepts can be correctly mapped to existing or newly proposed LOINC concepts. Conclusions The mapping quality of the multi-part strategy is significantly better than that of LAM. It enables domain experts to perform LOINC matching with little manual work. The probability of term combinations proved to be a valuable strategy for increasing the quality of match results, providing recommendations for proposed LOINC conepts, and decreasing the run time for match processing. PMID:24363318

Epidemiology of ametropia of U.S. Army recruits.

PubMed

McAlister, W H; Wingert, T A

1995-02-01

All people attempting to enlist in the U.S. Army must undergo a physical examination that requires a rudimentary vision screening. Those who pass the physical, upon reporting to basic training, are again evaluated and any treatment necessary to allow the recruits to function during their initial indoctrination is provided. Those who fail to see 20/20 O.D. and O.S. with their current spectacles fail the screening and are evaluated by an optometrist. If their condition is not disqualifying, appropriate correction is prescribed. We reviewed the records of all the recruits in a 1-month period who either required spectacles to see 20/20 or failed the screening at the 43rd AG BN (reception). Epidemiological evaluation revealed most to be either simple myopes or myopic astigmats. Hyperopia and hyperopic astigmatism accounted for the next most common diagnosis. Other conditions included anisometropia, antimetropia, amblyopia, keratoconus, and nystagmus. Examinations of these recruits were very limited, with dilated fundus evaluations being performed only when there was a high probability of a disqualifying condition. Therefore, it is unknown what retinal disease or degeneration may be present other than what would be visible with direct ophthalmoscopy.

Taking the easy way out? Increasing implementation effort reduces probability maximizing under cognitive load.

PubMed

Schulze, Christin; Newell, Ben R

2016-07-01

Cognitive load has previously been found to have a positive effect on strategy selection in repeated risky choice. Specifically, whereas inferior probability matching often prevails under single-task conditions, optimal probability maximizing sometimes dominates when a concurrent task competes for cognitive resources. We examined the extent to which this seemingly beneficial effect of increased task demands hinges on the effort required to implement each of the choice strategies. Probability maximizing typically involves a simple repeated response to a single option, whereas probability matching requires choice proportions to be tracked carefully throughout a sequential choice task. Here, we flipped this pattern by introducing a manipulation that made the implementation of maximizing more taxing and, at the same time, allowed decision makers to probability match via a simple repeated response to a single option. The results from two experiments showed that increasing the implementation effort of probability maximizing resulted in decreased adoption rates of this strategy. This was the case both when decision makers simultaneously learned about the outcome probabilities and responded to a dual task (Exp. 1) and when these two aspects were procedurally separated in two distinct stages (Exp. 2). We conclude that the effort involved in implementing a choice strategy is a key factor in shaping repeated choice under uncertainty. Moreover, highlighting the importance of implementation effort casts new light on the sometimes surprising and inconsistent effects of cognitive load that have previously been reported in the literature.

Introducing a Method for Calculating the Allocation of Attention in a Cognitive “Two-Armed Bandit” Procedure: Probability Matching Gives Way to Maximizing

PubMed Central

Heyman, Gene M.; Grisanzio, Katherine A.; Liang, Victor

2016-01-01

We tested whether principles that describe the allocation of overt behavior, as in choice experiments, also describe the allocation of cognition, as in attention experiments. Our procedure is a cognitive version of the “two-armed bandit choice procedure.” The two-armed bandit procedure has been of interest to psychologistsand economists because it tends to support patterns of responding that are suboptimal. Each of two alternatives provides rewards according to fixed probabilities. The optimal solution is to choose the alternative with the higher probability of reward on each trial. However, subjects often allocate responses so that the probability of a response approximates its probability of reward. Although it is this result which has attracted most interest, probability matching is not always observed. As a function of monetary incentives, practice, and individual differences, subjects tend to deviate from probability matching toward exclusive preference, as predicted by maximizing. In our version of the two-armed bandit procedure, the monitor briefly displayed two, small adjacent stimuli that predicted correct responses according to fixed probabilities, as in a two-armed bandit procedure. We show that in this setting, a simple linear equation describes the relationship between attention and correct responses, and that the equation’s solution is the allocation of attention between the two stimuli. The calculations showed that attention allocation varied as a function of the degree to which the stimuli predicted correct responses. Linear regression revealed a strong correlation (r = 0.99) between the predictiveness of a stimulus and the probability of attending to it. Nevertheless there were deviations from probability matching, and although small, they were systematic and statistically significant. As in choice studies, attention allocation deviated toward maximizing as a function of practice, feedback, and incentives. Our approach also predicts the frequency of correct guesses and the relationship between attention allocation and response latencies. The results were consistent with these two predictions, the assumptions of the equations used to calculate attention allocation, and recent studies which show that predictiveness and reward are important determinants of attention. PMID:27014109

Estimating trace-suspect match probabilities for singleton Y-STR haplotypes using coalescent theory.

PubMed

Andersen, Mikkel Meyer; Caliebe, Amke; Jochens, Arne; Willuweit, Sascha; Krawczak, Michael

2013-02-01

Estimation of match probabilities for singleton haplotypes of lineage markers, i.e. for haplotypes observed only once in a reference database augmented by a suspect profile, is an important problem in forensic genetics. We compared the performance of four estimators of singleton match probabilities for Y-STRs, namely the count estimate, both with and without Brenner's so-called 'kappa correction', the surveying estimate, and a previously proposed, but rarely used, coalescent-based approach implemented in the BATWING software. Extensive simulation with BATWING of the underlying population history, haplotype evolution and subsequent database sampling revealed that the coalescent-based approach is characterized by lower bias and lower mean squared error than the uncorrected count estimator and the surveying estimator. Moreover, in contrast to the two count estimators, both the surveying and the coalescent-based approach exhibited a good correlation between the estimated and true match probabilities. However, although its overall performance is thus better than that of any other recognized method, the coalescent-based estimator is still computation-intense on the verge of general impracticability. Its application in forensic practice therefore will have to be limited to small reference databases, or to isolated cases of particular interest, until more powerful algorithms for coalescent simulation have become available. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Fitting an MSD (mini scleral design) rigid contact lens in advanced keratoconus with INTACS.

PubMed

Dalton, Kristine; Sorbara, Luigina

2011-12-01

Keratoconus is a bilateral degenerative disease characterized by a non-inflammatory, progressive central corneal ectasia (typically asymmetric) and decreased vision. In its early stages it may be managed with spectacles and soft contact lenses but more commonly it is managed with rigid contact lenses. In advanced stages, when contact lenses can no longer be fit, have become intolerable, or corneal damage is severe, a penetrating keratoplasty is commonly performed. Alternative surgical techniques, such as the use of intra-stromal corneal ring segments (INTACS) have been developed to try and improve the fit of rigid contact lenses in keratoconic patients and avoid penetrating keratoplasties. This case report follows through the fitting of rigid contact lenses in an advanced keratoconic cornea after an INTACS procedure and discusses clinical findings, treatment options, and the use of mini-scleral and scleral lens designs as they relate to the challenges encountered in managing such a patient. Mini-scleral and scleral lenses are relatively easy to fit, and can be of benefit to many patients, including advanced keratoconic patients, post-INTAC patients and post-penetrating keratoplasty patients. 2011 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Self-reported hand washing behaviors and foodborne illness: a propensity score matching approach.

PubMed

Ali, Mir M; Verrill, Linda; Zhang, Yuanting

2014-03-01

Hand washing is a simple and effective but easily overlooked way to reduce cross-contamination and the transmission of foodborne pathogens. In this study, we used the propensity score matching methodology to account for potential selection bias to explore our hypothesis that always washing hands before food preparation tasks is associated with a reduction in the probability of reported foodborne illness. Propensity score matching can simulate random assignment to a condition so that pretreatment observable differences between a treatment group and a control group are homogenous on all the covariates except the treatment variable. Using the U.S. Food and Drug Administration's 2010 Food Safety Survey, we estimated the effect of self-reported hand washing behavior on the probability of self-reported foodborne illness. Our results indicate that reported washing of hands with soap always before food preparation leads to a reduction in the probability of reported foodborne illness.

Sensitivity Simulation of Compressed Sensing Based Electronic Warfare Receiver Using Orthogonal Matching Pursuit Algorithm

DTIC Science & Technology

2016-02-01

algorithm is used to process CS data. The insufficient nature of the sparcity of the signal adversely affects the signal detection probability for...with equal probability. The scheme was proposed [2] for image processing using single pixel camera, where the field of view was masked by a grid...modulation. The orthogonal matching pursuit (OMP) algorithm is used to process CS data. The insufficient nature of the sparcity of the signal

Topographic corneal changes after collagen cross-linking in patients with corneal keratoconus.

PubMed

Razmjoo, Hasan; Nasrollahi, Alireza Peyman Kobra; Salam, Hasan; Karbasi, Najmeh; Najarzadegan, Mohammad Reza

2013-10-01

Corneal collagen cross-linking with riboflavin, also known as collagen cross-linking (CXL), involves the application of riboflavin solution to the eye that is activated by illumination with ultraviolet A (UVA) light. We survey here the topographic corneal changes one year after CXL in patients with corneal keratoconus. This prospective randomized clinical trial study comprised 66 patients with progression of keratoconus during one year who were enrolled at Feiz University Referral Eye Center in Isfahan. Before and after the operation, patients were examined with slit lamp and funduscopic examinations and measurement of uncorrected visual acuity (UCVA), and best spectacle-corrected visual acuity (BSCVA) was done with a logarithm of minimal angle of resolution (logMAR) scale. Corneal topographic and pachymetry values were derived from Orbscan II. The paired t-test test was used for statistical analyses with SPSS software version 20 (SPSS Inc., Chicago, IL, USA). All 66 patients completed postoperative follow-up at 12 months. The mean age of the patients was 22.4 ± 5.4 years (range: 18-29 years). Thirty-six (54.55%) subjects were men and 30 (45.45%) were women. The mean preoperative sphere was -2.66 ± 2.14 diopter (D), the mean cylinder was -3.97 ± 2.29, and the mean spherical equivalent (SE) was -4.64 ± 2.56. Postoperatively, the mean sphere was -2.22 ± 2.57 D, the mean cylinder was -3.60 ± 2.40 D, and SE was -4.02 ± 2.93 D (P = 0.037). SE also demonstrated a mean difference of 0.62 ± 0.37 D significantly (P = 0.006). The mean diameter of preoperative posterior best-fit sphere (BFS) was 6.33 ± 0.35mm (range: 5.51-7.73 mm) before operation, and it improved to 6.28 ± 0.34mm (range: 4.36-6.13 mm) after operation; the difference was significant (P = 0.039). Our study showed a significant improvement in topographic corneal changes and refractive results in patients with corneal ectasia after CXL.

Topographic corneal changes after collagen cross-linking in patients with corneal keratoconus

PubMed Central

Razmjoo, Hasan; Nasrollahi, Alireza Peyman Kobra; Salam, Hasan; Karbasi, Najmeh; Najarzadegan, Mohammad Reza

2013-01-01

Background: Corneal collagen cross-linking with riboflavin, also known as collagen cross-linking (CXL), involves the application of riboflavin solution to the eye that is activated by illumination with ultraviolet A (UVA) light. We survey here the topographic corneal changes one year after CXL in patients with corneal keratoconus. Materials and Methods: This prospective randomized clinical trial study comprised 66 patients with progression of keratoconus during one year who were enrolled at Feiz University Referral Eye Center in Isfahan. Before and after the operation, patients were examined with slit lamp and funduscopic examinations and measurement of uncorrected visual acuity (UCVA), and best spectacle-corrected visual acuity (BSCVA) was done with a logarithm of minimal angle of resolution (logMAR) scale. Corneal topographic and pachymetry values were derived from Orbscan II. The paired t-test test was used for statistical analyses with SPSS software version 20 (SPSS Inc., Chicago, IL, USA). Results: All 66 patients completed postoperative follow-up at 12 months. The mean age of the patients was 22.4 ± 5.4 years (range: 18-29 years). Thirty-six (54.55%) subjects were men and 30 (45.45%) were women. The mean preoperative sphere was −2.66 ± 2.14 diopter (D), the mean cylinder was −3.97 ± 2.29, and the mean spherical equivalent (SE) was −4.64 ± 2.56. Postoperatively, the mean sphere was −2.22 ± 2.57 D, the mean cylinder was −3.60 ± 2.40 D, and SE was −4.02 ± 2.93 D (P = 0.037). SE also demonstrated a mean difference of 0.62 ± 0.37 D significantly (P = 0.006). The mean diameter of preoperative posterior best-fit sphere (BFS) was 6.33 ± 0.35mm (range: 5.51-7.73 mm) before operation, and it improved to 6.28 ± 0.34mm (range: 4.36-6.13 mm) after operation; the difference was significant (P = 0.039). Conclusion: Our study showed a significant improvement in topographic corneal changes and refractive results in patients with corneal ectasia after CXL. PMID:24497860

Rose-K versus Soper contact lens in keratoconus: a randomized comparative trial.

PubMed

Gupta, Raghav; Sinha, Rajesh; Singh, Pooja; Sharma, Namrata; Tandon, Radhika; Titiyal, Jeewan S

2014-01-01

To perform a comparative evaluation of the efficacy and acceptability of Rose-K and Soper contact lenses in Keratoconus. Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. A randomized comparative clinical trial was performed in keratoconic eyes fitted with Rose-K (Rose-K group) and Soper (Soper group) contact lenses. Patients data were evaluated for best spectacle corrected visual acuity, best contact lens corrected visual acuity (BCLCVA), corneal topography, glare acuity, contrast sensitivity, tear function tests and specular microscopy. Patients were also asked to complete a self-reported comfort questionnaire at each visit. Sixty eyes were randomized to the Rose-K and Soper groups. The two groups were comparable in all the baseline parameters. There was a statistically significant improvement in BCLCVA in both groups at 3 months (P < 0.01, both groups). The difference between in BCLCVA in both groups was not statistically significant. In both groups, there was a significant improvement in the comfort score at 3 months compared to baseline (P < 0.05, both group). The Rose-K group had statistically significantly better scores at 1 and 3 months compared with the Soper group (P = 0.006 and P < 0.001 respectively). Both groups were associated with a significant (P < 0.01), but comparable improvement in glare acuity at 3 months. There was a significant improvement in contrast sensitivity at 3 months in both groups (P < 0.01); the Rose-K group was significantly better than the Soper group at 1 and 3 months (P = 0.001 and 0.002 respectively). The mean number of trial lenses required for fitting Rose-K lens (2.00 ± 0.59) was significantly lower than the Soper lens (3.43 ± 0.82; P < 0.001). Both the contact lens designs provide an equal improvement in visual acuity in patients with Keratoconus. However, Rose-K contact lens provides greater comfort, better quality of vision and requires less chair time compared with the Soper lens and hence may possibly have a greater acceptability.

How many genetic markers to tag an individual? An empirical assessment of false matching rates among close relatives.

PubMed

Rew, Mary Beth; Robbins, Jooke; Mattila, David; Palsbøll, Per J; Bérube, Martine

2011-04-01

Genetic identification of individuals is now commonplace, enabling the application of tagging methods to elusive species or species that cannot be tagged by traditional methods. A key aspect is determining the number of loci required to ensure that different individuals have non-matching multi-locus genotypes. Closely related individuals are of particular concern because of elevated matching probabilities caused by their recent co-ancestry. This issue may be addressed by increasing the number of loci to a level where full siblings (the relatedness category with the highest matching probability) are expected to have non-matching multi-locus genotypes. However, increasing the number of loci to meet this "full-sib criterion" greatly increases the laboratory effort, which in turn may increase the genotyping error rate resulting in an upward-biased mark-recapture estimate of abundance as recaptures are missed due to genotyping errors. We assessed the contribution of false matches from close relatives among 425 maternally related humpback whales, each genotyped at 20 microsatellite loci. We observed a very low (0.5-4%) contribution to falsely matching samples from pairs of first-order relatives (i.e., parent and offspring or full siblings). The main contribution to falsely matching individuals from close relatives originated from second-order relatives (e.g., half siblings), which was estimated at 9%. In our study, the total number of observed matches agreed well with expectations based upon the matching probability estimated for unrelated individuals, suggesting that the full-sib criterion is overly conservative, and would have required a 280% relative increase in effort. We suggest that, under most circumstances, the overall contribution to falsely matching samples from close relatives is likely to be low, and hence applying the full-sib criterion is unnecessary. In those cases where close relatives may present a significant issue, such as unrepresentative sampling, we propose three different genotyping strategies requiring only a modest increase in effort, which will greatly reduce the number of false matches due to the presence of related individuals.

Model for spectral and chromatographic data

DOEpatents

Jarman, Kristin [Richland, WA; Willse, Alan [Richland, WA; Wahl, Karen [Richland, WA; Wahl, Jon [Richland, WA

2002-11-26

A method and apparatus using a spectral analysis technique are disclosed. In one form of the invention, probabilities are selected to characterize the presence (and in another form, also a quantification of a characteristic) of peaks in an indexed data set for samples that match a reference species, and other probabilities are selected for samples that do not match the reference species. An indexed data set is acquired for a sample, and a determination is made according to techniques exemplified herein as to whether the sample matches or does not match the reference species. When quantification of peak characteristics is undertaken, the model is appropriately expanded, and the analysis accounts for the characteristic model and data. Further techniques are provided to apply the methods and apparatuses to process control, cluster analysis, hypothesis testing, analysis of variance, and other procedures involving multiple comparisons of indexed data.

A Simple Artificial Life Model Explains Irrational Behavior in Human Decision-Making

PubMed Central

Feher da Silva, Carolina; Baldo, Marcus Vinícius Chrysóstomo

2012-01-01

Although praised for their rationality, humans often make poor decisions, even in simple situations. In the repeated binary choice experiment, an individual has to choose repeatedly between the same two alternatives, where a reward is assigned to one of them with fixed probability. The optimal strategy is to perseverate with choosing the alternative with the best expected return. Whereas many species perseverate, humans tend to match the frequencies of their choices to the frequencies of the alternatives, a sub-optimal strategy known as probability matching. Our goal was to find the primary cognitive constraints under which a set of simple evolutionary rules can lead to such contrasting behaviors. We simulated the evolution of artificial populations, wherein the fitness of each animat (artificial animal) depended on its ability to predict the next element of a sequence made up of a repeating binary string of varying size. When the string was short relative to the animats’ neural capacity, they could learn it and correctly predict the next element of the sequence. When it was long, they could not learn it, turning to the next best option: to perseverate. Animats from the last generation then performed the task of predicting the next element of a non-periodical binary sequence. We found that, whereas animats with smaller neural capacity kept perseverating with the best alternative as before, animats with larger neural capacity, which had previously been able to learn the pattern of repeating strings, adopted probability matching, being outperformed by the perseverating animats. Our results demonstrate how the ability to make predictions in an environment endowed with regular patterns may lead to probability matching under less structured conditions. They point to probability matching as a likely by-product of adaptive cognitive strategies that were crucial in human evolution, but may lead to sub-optimal performances in other environments. PMID:22563454

A simple artificial life model explains irrational behavior in human decision-making.

PubMed

Feher da Silva, Carolina; Baldo, Marcus Vinícius Chrysóstomo

2012-01-01

Although praised for their rationality, humans often make poor decisions, even in simple situations. In the repeated binary choice experiment, an individual has to choose repeatedly between the same two alternatives, where a reward is assigned to one of them with fixed probability. The optimal strategy is to perseverate with choosing the alternative with the best expected return. Whereas many species perseverate, humans tend to match the frequencies of their choices to the frequencies of the alternatives, a sub-optimal strategy known as probability matching. Our goal was to find the primary cognitive constraints under which a set of simple evolutionary rules can lead to such contrasting behaviors. We simulated the evolution of artificial populations, wherein the fitness of each animat (artificial animal) depended on its ability to predict the next element of a sequence made up of a repeating binary string of varying size. When the string was short relative to the animats' neural capacity, they could learn it and correctly predict the next element of the sequence. When it was long, they could not learn it, turning to the next best option: to perseverate. Animats from the last generation then performed the task of predicting the next element of a non-periodical binary sequence. We found that, whereas animats with smaller neural capacity kept perseverating with the best alternative as before, animats with larger neural capacity, which had previously been able to learn the pattern of repeating strings, adopted probability matching, being outperformed by the perseverating animats. Our results demonstrate how the ability to make predictions in an environment endowed with regular patterns may lead to probability matching under less structured conditions. They point to probability matching as a likely by-product of adaptive cognitive strategies that were crucial in human evolution, but may lead to sub-optimal performances in other environments.

Influences of Source - Item Contingency and Schematic Knowledge on Source Monitoring: Tests of the Probability-Matching Account

PubMed Central

Bayen, Ute J.; Kuhlmann, Beatrice G.

2010-01-01

The authors investigated conditions under which judgments in source-monitoring tasks are influenced by prior schematic knowledge. According to a probability-matching account of source guessing (Spaniol & Bayen, 2002), when people do not remember the source of information, they match source guessing probabilities to the perceived contingency between sources and item types. When they do not have a representation of a contingency, they base their guesses on prior schematic knowledge. The authors provide support for this account in two experiments with sources presenting information that was expected for one source and somewhat unexpected for another. Schema-relevant information about the sources was provided at the time of encoding. When contingency perception was impeded by dividing attention, participants showed schema-based guessing (Experiment 1). Manipulating source - item contingency also affected guessing (Experiment 2). When this contingency was schema-inconsistent, it superseded schema-based expectations and led to schema-inconsistent guessing. PMID:21603251

The Context Matters: Outcome Probability and Expectation Mismatch Modulate the Feedback Negativity When Self-Evaluation of Response Correctness Is Possible

PubMed Central

Leue, Anja; Cano Rodilla, Carmen; Beauducel, André

2015-01-01

Individuals typically evaluate whether their performance and the obtained feedback match. Previous research has shown that feedback negativity (FN) depends on outcome probability and feedback valence. It is, however, less clear to what extent previous effects of outcome probability on FN depend on self-evaluations of response correctness. Therefore, we investigated the effects of outcome probability on FN amplitude in a simple go/no-go task that allowed for the self-evaluation of response correctness. We also investigated effects of performance incompatibility and feedback valence. In a sample of N = 22 participants, outcome probability was manipulated by means of precues, feedback valence by means of monetary feedback, and performance incompatibility by means of feedback that induced a match versus mismatch with individuals' performance. We found that the 100% outcome probability condition induced a more negative FN following no-loss than the 50% outcome probability condition. The FN following loss was more negative in the 50% compared to the 100% outcome probability condition. Performance-incompatible loss resulted in a more negative FN than performance-compatible loss. Our results indicate that the self-evaluation of the correctness of responses should be taken into account when the effects of outcome probability and expectation mismatch on FN are investigated. PMID:26783525

The Context Matters: Outcome Probability and Expectation Mismatch Modulate the Feedback Negativity When Self-Evaluation of Response Correctness Is Possible.

PubMed

Leue, Anja; Cano Rodilla, Carmen; Beauducel, André

2015-01-01

Individuals typically evaluate whether their performance and the obtained feedback match. Previous research has shown that feedback negativity (FN) depends on outcome probability and feedback valence. It is, however, less clear to what extent previous effects of outcome probability on FN depend on self-evaluations of response correctness. Therefore, we investigated the effects of outcome probability on FN amplitude in a simple go/no-go task that allowed for the self-evaluation of response correctness. We also investigated effects of performance incompatibility and feedback valence. In a sample of N = 22 participants, outcome probability was manipulated by means of precues, feedback valence by means of monetary feedback, and performance incompatibility by means of feedback that induced a match versus mismatch with individuals' performance. We found that the 100% outcome probability condition induced a more negative FN following no-loss than the 50% outcome probability condition. The FN following loss was more negative in the 50% compared to the 100% outcome probability condition. Performance-incompatible loss resulted in a more negative FN than performance-compatible loss. Our results indicate that the self-evaluation of the correctness of responses should be taken into account when the effects of outcome probability and expectation mismatch on FN are investigated.

Evaluation of Topical Cyclosporine in Preventing the Development of Corneal Haze after Photorefractive Keratectomy

DTIC Science & Technology

2014-05-13

use of systemic corticosteroids, abnormal ophthalmic examination, and topographic evidence of keratoconus or warpage from contact 4 lenses...Systemic medications were permitted unless they were known to affect the cornea. Soft contact lenses were removed at least thirty days and hard contact ... contact lens was placed at conclusion of the treatment. All eyes received standard postoperative management during the first week including topical

Estimating parameters for probabilistic linkage of privacy-preserved datasets.

PubMed

Brown, Adrian P; Randall, Sean M; Ferrante, Anna M; Semmens, James B; Boyd, James H

2017-07-10

Probabilistic record linkage is a process used to bring together person-based records from within the same dataset (de-duplication) or from disparate datasets using pairwise comparisons and matching probabilities. The linkage strategy and associated match probabilities are often estimated through investigations into data quality and manual inspection. However, as privacy-preserved datasets comprise encrypted data, such methods are not possible. In this paper, we present a method for estimating the probabilities and threshold values for probabilistic privacy-preserved record linkage using Bloom filters. Our method was tested through a simulation study using synthetic data, followed by an application using real-world administrative data. Synthetic datasets were generated with error rates from zero to 20% error. Our method was used to estimate parameters (probabilities and thresholds) for de-duplication linkages. Linkage quality was determined by F-measure. Each dataset was privacy-preserved using separate Bloom filters for each field. Match probabilities were estimated using the expectation-maximisation (EM) algorithm on the privacy-preserved data. Threshold cut-off values were determined by an extension to the EM algorithm allowing linkage quality to be estimated for each possible threshold. De-duplication linkages of each privacy-preserved dataset were performed using both estimated and calculated probabilities. Linkage quality using the F-measure at the estimated threshold values was also compared to the highest F-measure. Three large administrative datasets were used to demonstrate the applicability of the probability and threshold estimation technique on real-world data. Linkage of the synthetic datasets using the estimated probabilities produced an F-measure that was comparable to the F-measure using calculated probabilities, even with up to 20% error. Linkage of the administrative datasets using estimated probabilities produced an F-measure that was higher than the F-measure using calculated probabilities. Further, the threshold estimation yielded results for F-measure that were only slightly below the highest possible for those probabilities. The method appears highly accurate across a spectrum of datasets with varying degrees of error. As there are few alternatives for parameter estimation, the approach is a major step towards providing a complete operational approach for probabilistic linkage of privacy-preserved datasets.

Does lamellar surgery for keratoconus experience the popularity it deserves?

PubMed

Wisse, Robert P L; van den Hoven, Célinde M L; Van der Lelij, Allegonda

2014-08-01

To analyse developments in surgical treatment for keratoconus (KC) by assessing rates and types of corneal surgery from 2005 to 2010. The Dutch Transplantation Foundation supplied data on all keratoplasty procedures for KC performed from 2005 to 2010 in the Netherlands. Registration was carried out by the eyebank at allocation and by the surgeon at the time of surgery. The type of surgery was categorized as either a penetrating or a lamellar procedure. Five hundred and seventy-five anonymized records were received, with excellent data completion (99%). Patients undergoing penetrating surgery had on average a lower visual acuity, higher k-readings and were slightly older compared with the lamellar group. A previous corneal hydrops was recorded for 19.1% of patients. Regular penetrating keratoplasty decreased in popularity from 79.7% in 2005 to 43.7% in 2010, due to the increased rate of lamellar surgery (42.5% in 2010) and 'mushroom' penetrating keratoplasty (13.8% in 2010). When hydrops cases were excluded, popularity became equal (47.6% penetrating versus 52.4% lamellar surgery, in 2010). Lamellar surgery is gaining in popularity, although regular penetrating keratoplasty is still the more commonly performed procedure. Only when hydrops cases are excluded do transplant rates become comparable. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

A Patient with Keratoconus, Nanophthalmos, Lipodermoids, and Pigmentary Retinopathy.

PubMed

Sammouh, Fady K; Baban, Tania A; Warrak, Elias L

2016-06-01

A 44-year-old male with no pertinent history other than poor vision for more than 25 years was examined. Best corrected visual acuity was 20/80 OD [MR: +14.25 +1.00 × 15°] and 20/200 OS [MR: +15.00 +1.50 × 175°]. Significant limitation in ocular movements and the presence of an orbital lipodermoid in the infero-temporal aspect of each eye were noted. Forced duction test was positive for the same directions of limitation indicating possible extraocular muscle fibrosis. Ophthalmoscopy was remarkable for the presence of peripheral bony spicules. Corneal topography was compatible with keratoconus (Kmax = 55.04D OD and 52.87D OS). A-scan revealed axial lengths of 16.96 mm OD and 16.32 mm OS, compatible with a diagnosis of nanophthalmos. OCT revealed diffuse macular thickening for both eyes with foveal thickness of 350 µm OD and 353 µm OS. Over the next 12 years the patient had stable visual acuity, manifest refractions and anterior segment examination. Ophthalmoscopy revealed only minimal progression of pigmentary changes. We report the first case of these simultaneous multiple findings which may refer to a possible syndromic association of congenital or early childhood onset.

Differential Effects of Hormones on Cellular Metabolism in Keratoconus In Vitro

PubMed Central

McKay, Tina B.; Hjortdal, Jesper; Sejersen, Henrik; Karamichos, Dimitrios

2017-01-01

Keratoconus (KC) is a corneal thinning disease with an onset commonly immediately post-puberty and stabilization by 40 to 50 years of age. The role of hormones in regulating corneal tissue structure in homeostatic and pathological conditions is unknown. Our group recently linked altered hormone levels to KC. Our current study sought to investigate and delineate the effects of exogenous hormones, such as androgen, luteotropin, and estrogen, on corneal stroma bioenergetics. We utilized our established 3D in vitro model to characterize the effects of DHEA, prolactin, 17β-estradiol on insulin-growth factor-1 and -2 (IGF-1, -2) signaling and metabolic function in primary corneal fibroblasts from healthy controls (HCFs) and KC patients (HKCs). Our data showed that exogenous DHEA significantly downregulated IGF-1 and its receptor in both HCFs and HKCs with HKCs showing consistently lower basal pentose phosphate flux. Prolactin caused no significant change in IGF-1 levels and an increase in IGF-2 in HKCs correlating with an increase in ATP and NADH levels. 17β-estradiol led to a significant upregulation in pentose phosphate flux and glycolytic intermediates in HCFs. Our results identified hormone-specific responses regulated in HKCs compared to HCFs revealing a novel role for hormones on bioenergetics in KC. PMID:28211546

Persistent Epithelial Defects and Corneal Opacity After Collagen Cross-Linking With Substitution of Dextran (T-500) With Dextran Sulfate in Compounded Topical Riboflavin.

PubMed

Höllhumer, Roland; Watson, Stephanie; Beckingsale, Peter

2017-03-01

Collagen cross-linking (CXL) is a commonly performed procedure to prevent the progression of keratoconus. Riboflavin is an essential part of the procedure, which facilitates both the cross-linking process and protection of intraocular structures. Dextran can be added to riboflavin to create an isotonic solution. This case report highlights the importance of compounding riboflavin with the correct dextran solution. A retrospective case series. Six eyes of 4 male patients with keratoconus aged from 20 to 38 years underwent CXL with substitution of 20% dextran (T-500) with 20% dextran sulfate in a compounded riboflavin 0.1% solution. Postoperatively, persistent corneal epithelial defects, stromal haze, and then scarring occurred. Corneal transplantation was performed for visual rehabilitation but was complicated by graft rejection followed by failure (n = 1 eye), dehiscence (n = 4), cataract (n = 2), post-laser ablation haze (n = 1), and steroid-induced glaucoma (n = 2). The visual outcome was <6/18 in all 6 cases because of irregular astigmatism and stromal haze. Thinning, vascularization, and scarring of the residual host tissue were noted. Substitution of dextran (T-500) with dextran sulfate in riboflavin solutions during CXL results in loss of vision from permanent corneal opacity. Residual host changes may compromise the results of corneal transplantation.

The Effects of Heuristics and Apophenia on Probabilistic Choice.

PubMed

Ellerby, Zack W; Tunney, Richard J

2017-01-01

Given a repeated choice between two or more options with independent and identically distributed reward probabilities, overall pay-offs can be maximized by the exclusive selection of the option with the greatest likelihood of reward. The tendency to match response proportions to reward contingencies is suboptimal. Nevertheless, this behaviour is well documented. A number of explanatory accounts have been proposed for probability matching. These include failed pattern matching, driven by apophenia, and a heuristic-driven response that can be overruled with sufficient deliberation. We report two experiments that were designed to test the relative effects on choice behaviour of both an intuitive versus strategic approach to the task and belief that there was a predictable pattern in the reward sequence, through a combination of both direct experimental manipulation and post-experimental self-report. Mediation analysis was used to model the pathways of effects. Neither of two attempted experimental manipulations of apophenia, nor self-reported levels of apophenia, had a significant effect on proportions of maximizing choices. However, the use of strategy over intuition proved a consistent predictor of maximizing, across all experimental conditions. A parallel analysis was conducted to assess the effect of controlling for individual variance in perceptions of reward contingencies. Although this analysis suggested that apophenia did increase probability matching in the standard task preparation, this effect was found to result from an unforeseen relationship between self-reported apophenia and perceived reward probabilities. A Win-Stay Lose-Shift (WSLS ) analysis indicated no reliable relationship between WSLS and either intuition or strategy use.

Clinician gestalt estimate of pretest probability for acute coronary syndrome and pulmonary embolism in patients with chest pain and dyspnea.

PubMed

Kline, Jeffrey A; Stubblefield, William B

2014-03-01

Pretest probability helps guide diagnostic testing for patients with suspected acute coronary syndrome and pulmonary embolism. Pretest probability derived from the clinician's unstructured gestalt estimate is easier and more readily available than methods that require computation. We compare the diagnostic accuracy of physician gestalt estimate for the pretest probability of acute coronary syndrome and pulmonary embolism with a validated, computerized method. This was a secondary analysis of a prospectively collected, multicenter study. Patients (N=840) had chest pain, dyspnea, nondiagnostic ECGs, and no obvious diagnosis. Clinician gestalt pretest probability for both acute coronary syndrome and pulmonary embolism was assessed by visual analog scale and from the method of attribute matching using a Web-based computer program. Patients were followed for outcomes at 90 days. Clinicians had significantly higher estimates than attribute matching for both acute coronary syndrome (17% versus 4%; P<.001, paired t test) and pulmonary embolism (12% versus 6%; P<.001). The 2 methods had poor correlation for both acute coronary syndrome (r(2)=0.15) and pulmonary embolism (r(2)=0.06). Areas under the receiver operating characteristic curve were lower for clinician estimate compared with the computerized method for acute coronary syndrome: 0.64 (95% confidence interval [CI] 0.51 to 0.77) for clinician gestalt versus 0.78 (95% CI 0.71 to 0.85) for attribute matching. For pulmonary embolism, these values were 0.81 (95% CI 0.79 to 0.92) for clinician gestalt and 0.84 (95% CI 0.76 to 0.93) for attribute matching. Compared with a validated machine-based method, clinicians consistently overestimated pretest probability but on receiver operating curve analysis were as accurate for pulmonary embolism but not acute coronary syndrome. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Erectile Dysfunction in Patients with Sleep Apnea--A Nationwide Population-Based Study.

PubMed

Chen, Chia-Min; Tsai, Ming-Ju; Wei, Po-Ju; Su, Yu-Chung; Yang, Chih-Jen; Wu, Meng-Ni; Hsu, Chung-Yao; Hwang, Shang-Jyh; Chong, Inn-Wen; Huang, Ming-Shyan

2015-01-01

Increased incidence of erectile dysfunction (ED) has been reported among patients with sleep apnea (SA). However, this association has not been confirmed in a large-scale study. We therefore performed a population-based cohort study using Taiwan National Health Insurance (NHI) database to investigate the association of SA and ED. From the database of one million representative subjects randomly sampled from individuals enrolled in the NHI system in 2010, we identified adult patients having SA and excluded those having a diagnosis of ED prior to SA. From these suspected SA patients, those having SA diagnosis after polysomnography were defined as probable SA patients. The dates of their first SA diagnosis were defined as their index dates. Each SA patient was matched to 30 randomly-selected, age-matched control subjects without any SA diagnosis. The control subjects were assigned index dates as their corresponding SA patients, and were ensured having no ED diagnosis prior to their index dates. Totally, 4,835 male patients with suspected SA (including 1,946 probable SA patients) were matched to 145,050 control subjects (including 58,380 subjects matched to probable SA patients). The incidence rate of ED was significantly higher in probable SA patients as compared with the corresponding control subjects (5.7 vs. 2.3 per 1000 patient-year; adjusted incidence rate ratio = 2.0 [95% CI: 1.8-2.2], p<0.0001). The cumulative incidence was also significantly higher in the probable SA patients (p<0.0001). In multivariable Cox regression analysis, probable SA remained a significant risk factor for the development of ED after adjusting for age, residency, income level and comorbidities (hazard ratio = 2.0 [95%CI: 1.5-2.7], p<0.0001). In line with previous studies, this population-based large-scale study confirmed an increased ED incidence in SA patients in Chinese population. Physicians need to pay attention to the possible underlying SA while treating ED patients.

Using hidden Markov models to align multiple sequences.

PubMed

Mount, David W

2009-07-01

A hidden Markov model (HMM) is a probabilistic model of a multiple sequence alignment (msa) of proteins. In the model, each column of symbols in the alignment is represented by a frequency distribution of the symbols (called a "state"), and insertions and deletions are represented by other states. One moves through the model along a particular path from state to state in a Markov chain (i.e., random choice of next move), trying to match a given sequence. The next matching symbol is chosen from each state, recording its probability (frequency) and also the probability of going to that state from a previous one (the transition probability). State and transition probabilities are multiplied to obtain a probability of the given sequence. The hidden nature of the HMM is due to the lack of information about the value of a specific state, which is instead represented by a probability distribution over all possible values. This article discusses the advantages and disadvantages of HMMs in msa and presents algorithms for calculating an HMM and the conditions for producing the best HMM.

Performance indicators related to points scoring and winning in international rugby sevens.

PubMed

Higham, Dean G; Hopkins, Will G; Pyne, David B; Anson, Judith M

2014-05-01

Identification of performance indicators related to scoring points and winning is needed to inform tactical approaches to international rugby sevens competition. The aim of this study was to characterize team performance indicators in international rugby sevens and quantify their relationship with a team's points scored and probability of winning. Performance indicators of each team during 196 matches of the 2011/2012 International Rugby Board Sevens World Series were modeled for their linear relationships with points scored and likelihood of winning within (changes in team values from match to match) and between (differences between team values averaged over all matches) teams. Relationships were evaluated as the change and difference in points and probability of winning associated with a two within- and between-team standard deviations increase in performance indicator values. Inferences about relationships were assessed using a smallest meaningful difference of one point and a 10% probability of a team changing the outcome of a close match. All indicators exhibited high within-team match-to-match variability (intraclass correlation coefficients ranged from 0.00 to 0.23). Excluding indicators representing points-scoring actions or events occurring on average less than once per match, 13 of 17 indicators had substantial clear within-team relationships with points scored and/or likelihood of victory. Relationships between teams were generally similar in magnitude but unclear. Tactics that increase points scoring and likelihood of winning should be based on greater ball possession, fewer rucks, mauls, turnovers, penalties and free kicks, and limited passing. Key pointsSuccessful international rugby sevens teams tend to maintain ball possession; more frequently avoid taking the ball into contact; concede fewer turnovers, penalties and free kicks; retain possession in scrums, rucks and mauls; and limit passing the ball.Selected performance indicators may be used to evaluate team performances and plan more effective tactical approaches to competition.There is greater match-to-match variability in performance indicator values within than between international rugby sevens teams.The priorities for a rugby sevens team's technical and tactical preparation should reflect the magnitudes of the relationships between performance indicators, points scoring and the likelihood of winning.

Performance Indicators Related to Points Scoring and Winning in International Rugby Sevens

PubMed Central

Higham, Dean G.; Hopkins, Will G.; Pyne, David B.; Anson, Judith M.

2014-01-01

Identification of performance indicators related to scoring points and winning is needed to inform tactical approaches to international rugby sevens competition. The aim of this study was to characterize team performance indicators in international rugby sevens and quantify their relationship with a team’s points scored and probability of winning. Performance indicators of each team during 196 matches of the 2011/2012 International Rugby Board Sevens World Series were modeled for their linear relationships with points scored and likelihood of winning within (changes in team values from match to match) and between (differences between team values averaged over all matches) teams. Relationships were evaluated as the change and difference in points and probability of winning associated with a two within- and between-team standard deviations increase in performance indicator values. Inferences about relationships were assessed using a smallest meaningful difference of one point and a 10% probability of a team changing the outcome of a close match. All indicators exhibited high within-team match-to-match variability (intraclass correlation coefficients ranged from 0.00 to 0.23). Excluding indicators representing points-scoring actions or events occurring on average less than once per match, 13 of 17 indicators had substantial clear within-team relationships with points scored and/or likelihood of victory. Relationships between teams were generally similar in magnitude but unclear. Tactics that increase points scoring and likelihood of winning should be based on greater ball possession, fewer rucks, mauls, turnovers, penalties and free kicks, and limited passing. Key points Successful international rugby sevens teams tend to maintain ball possession; more frequently avoid taking the ball into contact; concede fewer turnovers, penalties and free kicks; retain possession in scrums, rucks and mauls; and limit passing the ball. Selected performance indicators may be used to evaluate team performances and plan more effective tactical approaches to competition. There is greater match-to-match variability in performance indicator values within than between international rugby sevens teams. The priorities for a rugby sevens team’s technical and tactical preparation should reflect the magnitudes of the relationships between performance indicators, points scoring and the likelihood of winning. PMID:24790490

Forecasting a winner for Malaysian Cup 2013 using soccer simulation model

NASA Astrophysics Data System (ADS)

Yusof, Muhammad Mat; Fauzee, Mohd Soffian Omar; Latif, Rozita Abdul

2014-07-01

This paper investigates through soccer simulation the calculation of the probability for each team winning Malaysia Cup 2013. Our methodology used here is we predict the outcomes of individual matches and then we simulate the Malaysia Cup 2013 tournament 5000 times. As match outcomes are always a matter of uncertainty, statistical model, in particular a double Poisson model is used to predict the number of goals scored and conceded for each team. Maximum likelihood estimation is use to measure the attacking strength and defensive weakness for each team. Based on our simulation result, LionXII has a higher probability in becoming the winner, followed by Selangor, ATM, JDT and Kelantan. Meanwhile, T-Team, Negeri Sembilan and Felda United have lower probabilities to win Malaysia Cup 2013. In summary, we find that the probability for each team becominga winner is small, indicating that the level of competitive balance in Malaysia Cup 2013 is quite high.

Effect of Intermittent Reinforcement on Acquisition and Retention in Delayed Matching-to-Sample in Pigeons

ERIC Educational Resources Information Center

Grant, Douglas S.

2011-01-01

Experiments 1 and 2 involved independent groups that received primary reinforcement after a correct match with a probability of 1.0, 0.50 or 0.25. Correct matches that did not produce primary reinforcement produced a conditioned reinforcer. Both experiments revealed little evidence that acquisition or retention was adversely affected by use of…

Efficient Iris Recognition Based on Optimal Subfeature Selection and Weighted Subregion Fusion

PubMed Central

Deng, Ning

2014-01-01

In this paper, we propose three discriminative feature selection strategies and weighted subregion matching method to improve the performance of iris recognition system. Firstly, we introduce the process of feature extraction and representation based on scale invariant feature transformation (SIFT) in detail. Secondly, three strategies are described, which are orientation probability distribution function (OPDF) based strategy to delete some redundant feature keypoints, magnitude probability distribution function (MPDF) based strategy to reduce dimensionality of feature element, and compounded strategy combined OPDF and MPDF to further select optimal subfeature. Thirdly, to make matching more effective, this paper proposes a novel matching method based on weighted sub-region matching fusion. Particle swarm optimization is utilized to accelerate achieve different sub-region's weights and then weighted different subregions' matching scores to generate the final decision. The experimental results, on three public and renowned iris databases (CASIA-V3 Interval, Lamp, andMMU-V1), demonstrate that our proposed methods outperform some of the existing methods in terms of correct recognition rate, equal error rate, and computation complexity. PMID:24683317

Efficient iris recognition based on optimal subfeature selection and weighted subregion fusion.

PubMed

Chen, Ying; Liu, Yuanning; Zhu, Xiaodong; He, Fei; Wang, Hongye; Deng, Ning

2014-01-01

In this paper, we propose three discriminative feature selection strategies and weighted subregion matching method to improve the performance of iris recognition system. Firstly, we introduce the process of feature extraction and representation based on scale invariant feature transformation (SIFT) in detail. Secondly, three strategies are described, which are orientation probability distribution function (OPDF) based strategy to delete some redundant feature keypoints, magnitude probability distribution function (MPDF) based strategy to reduce dimensionality of feature element, and compounded strategy combined OPDF and MPDF to further select optimal subfeature. Thirdly, to make matching more effective, this paper proposes a novel matching method based on weighted sub-region matching fusion. Particle swarm optimization is utilized to accelerate achieve different sub-region's weights and then weighted different subregions' matching scores to generate the final decision. The experimental results, on three public and renowned iris databases (CASIA-V3 Interval, Lamp, and MMU-V1), demonstrate that our proposed methods outperform some of the existing methods in terms of correct recognition rate, equal error rate, and computation complexity.

Match statistics related to winning in the group stage of 2014 Brazil FIFA World Cup.

PubMed

Liu, Hongyou; Gomez, Miguel-Ángel; Lago-Peñas, Carlos; Sampaio, Jaime

2015-01-01

Identifying match statistics that strongly contribute to winning in football matches is a very important step towards a more predictive and prescriptive performance analysis. The current study aimed to determine relationships between 24 match statistics and the match outcome (win, loss and draw) in all games and close games of the group stage of FIFA World Cup (2014, Brazil) by employing the generalised linear model. The cumulative logistic regression was run in the model taking the value of each match statistic as independent variable to predict the logarithm of the odds of winning. Relationships were assessed as effects of a two-standard-deviation increase in the value of each variable on the change in the probability of a team winning a match. Non-clinical magnitude-based inferences were employed and were evaluated by using the smallest worthwhile change. Results showed that for all the games, nine match statistics had clearly positive effects on the probability of winning (Shot, Shot on Target, Shot from Counter Attack, Shot from Inside Area, Ball Possession, Short Pass, Average Pass Streak, Aerial Advantage and Tackle), four had clearly negative effects (Shot Blocked, Cross, Dribble and Red Card), other 12 statistics had either trivial or unclear effects. While for the close games, the effects of Aerial Advantage and Yellow Card turned to trivial and clearly negative, respectively. Information from the tactical modelling can provide a more thorough and objective match understanding to coaches and performance analysts for evaluating post-match performances and for scouting upcoming oppositions.

Nonparametric Bayesian Modeling for Automated Database Schema Matching

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ferragut, Erik M; Laska, Jason A

2015-01-01

The problem of merging databases arises in many government and commercial applications. Schema matching, a common first step, identifies equivalent fields between databases. We introduce a schema matching framework that builds nonparametric Bayesian models for each field and compares them by computing the probability that a single model could have generated both fields. Our experiments show that our method is more accurate and faster than the existing instance-based matching algorithms in part because of the use of nonparametric Bayesian models.

a Probability-Based Statistical Method to Extract Water Body of TM Images with Missing Information

NASA Astrophysics Data System (ADS)

Lian, Shizhong; Chen, Jiangping; Luo, Minghai

2016-06-01

Water information cannot be accurately extracted using TM images because true information is lost in some images because of blocking clouds and missing data stripes, thereby water information cannot be accurately extracted. Water is continuously distributed in natural conditions; thus, this paper proposed a new method of water body extraction based on probability statistics to improve the accuracy of water information extraction of TM images with missing information. Different disturbing information of clouds and missing data stripes are simulated. Water information is extracted using global histogram matching, local histogram matching, and the probability-based statistical method in the simulated images. Experiments show that smaller Areal Error and higher Boundary Recall can be obtained using this method compared with the conventional methods.

Probability matching in risky choice: the interplay of feedback and strategy availability.

PubMed

Newell, Ben R; Koehler, Derek J; James, Greta; Rakow, Tim; van Ravenzwaaij, Don

2013-04-01

Probability matching in sequential decision making is a striking violation of rational choice that has been observed in hundreds of experiments. Recent studies have demonstrated that matching persists even in described tasks in which all the information required for identifying a superior alternative strategy-maximizing-is present before the first choice is made. These studies have also indicated that maximizing increases when (1) the asymmetry in the availability of matching and maximizing strategies is reduced and (2) normatively irrelevant outcome feedback is provided. In the two experiments reported here, we examined the joint influences of these factors, revealing that strategy availability and outcome feedback operate on different time courses. Both behavioral and modeling results showed that while availability of the maximizing strategy increases the choice of maximizing early during the task, feedback appears to act more slowly to erode misconceptions about the task and to reinforce optimal responding. The results illuminate the interplay between "top-down" identification of choice strategies and "bottom-up" discovery of those strategies via feedback.

More than words: Adults learn probabilities over categories and relationships between them.

PubMed

Hudson Kam, Carla L

2009-04-01

This study examines whether human learners can acquire statistics over abstract categories and their relationships to each other. Adult learners were exposed to miniature artificial languages containing variation in the ordering of the Subject, Object, and Verb constituents. Different orders (e.g. SOV, VSO) occurred in the input with different frequencies, but the occurrence of one order versus another was not predictable. Importantly, the language was constructed such that participants could only match the overall input probabilities if they were tracking statistics over abstract categories, not over individual words. At test, participants reproduced the probabilities present in the input with a high degree of accuracy. Closer examination revealed that learner's were matching the probabilities associated with individual verbs rather than the category as a whole. However, individual nouns had no impact on word orders produced. Thus, participants learned the probabilities of a particular ordering of the abstract grammatical categories Subject and Object associated with each verb. Results suggest that statistical learning mechanisms are capable of tracking relationships between abstract linguistic categories in addition to individual items.

How enhanced molecular ions in Cold EI improve compound identification by the NIST library.

PubMed

Alon, Tal; Amirav, Aviv

2015-12-15

Library-based compound identification with electron ionization (EI) mass spectrometry (MS) is a well-established identification method which provides the names and structures of sample compounds up to the isomer level. The library (such as NIST) search algorithm compares different EI mass spectra in the library's database with the measured EI mass spectrum, assigning each of them a similarity score called 'Match' and an overall identification probability. Cold EI, electron ionization of vibrationally cold molecules in supersonic molecular beams, provides mass spectra with all the standard EI fragment ions combined with enhanced Molecular Ions and high-mass fragments. As a result, Cold EI mass spectra differ from those provided by standard EI and tend to yield lower matching scores. However, in most cases, library identification actually improves with Cold EI, as library identification probabilities for the correct library mass spectra increase, despite the lower matching factors. This research examined the way that enhanced molecular ion abundances affect library identification probability and the way that Cold EI mass spectra, which include enhanced molecular ions and high-mass fragment ions, typically improve library identification results. It involved several computer simulations, which incrementally modified the relative abundances of the various ions and analyzed the resulting mass spectra. The simulation results support previous measurements, showing that while enhanced molecular ion and high-mass fragment ions lower the matching factor of the correct library compound, the matching factors of the incorrect library candidates are lowered even more, resulting in a rise in the identification probability for the correct compound. This behavior which was previously observed by analyzing Cold EI mass spectra can be explained by the fact that high-mass ions, and especially the molecular ion, characterize a compound more than low-mass ions and therefore carries more weight in library search identification algorithms. These ions are uniquely abundant in Cold EI, which therefore enables enhanced compound characterization along with improved NIST library based identification. Copyright © 2015 John Wiley & Sons, Ltd.

Bayesian deterministic decision making: a normative account of the operant matching law and heavy-tailed reward history dependency of choices.

PubMed

Saito, Hiroshi; Katahira, Kentaro; Okanoya, Kazuo; Okada, Masato

2014-01-01

The decision making behaviors of humans and animals adapt and then satisfy an "operant matching law" in certain type of tasks. This was first pointed out by Herrnstein in his foraging experiments on pigeons. The matching law has been one landmark for elucidating the underlying processes of decision making and its learning in the brain. An interesting question is whether decisions are made deterministically or probabilistically. Conventional learning models of the matching law are based on the latter idea; they assume that subjects learn choice probabilities of respective alternatives and decide stochastically with the probabilities. However, it is unknown whether the matching law can be accounted for by a deterministic strategy or not. To answer this question, we propose several deterministic Bayesian decision making models that have certain incorrect beliefs about an environment. We claim that a simple model produces behavior satisfying the matching law in static settings of a foraging task but not in dynamic settings. We found that the model that has a belief that the environment is volatile works well in the dynamic foraging task and exhibits undermatching, which is a slight deviation from the matching law observed in many experiments. This model also demonstrates the double-exponential reward history dependency of a choice and a heavier-tailed run-length distribution, as has recently been reported in experiments on monkeys.

Visual performance with changes in eccentricity in PROSE device: a case report.

PubMed

Jagadeesh, Divya; Mahadevan, Rajeswari

2014-01-01

This case report describes the variations in visual performance of a subject with moderate keratoconus with changes in front surface eccentricities (FSEs) of PROSE (Prosthetic Replacement of Ocular Surface Ecosystem). PROSE device of 0.6 FSE provided maximum visual improvement and reduction in Higher Order Aberrations (HOAs) compared to 0, 0.3 and 0.8 FSEs in this clinical condition. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

Severe acute corneal hydrops in a patient with Down syndrome and persistent eye rubbing.

PubMed

Ozcan, Altan A; Ersoz, T Reha

2007-01-01

We report a case of severe acute corneal hydrops in an 11-year-old boy with keratoconus associated with Down syndrome and vigorous eye rubbing. Complete resolution of the corneal edema and a central corneal scar was seen in the 8th week of final follow-up. Eye-rubbing may play a role in the pathogenesis of acute hydrops, and conventional therapy can be successful in its management, even in severe cases.

[Biomechanical condition of the cornea as a new indicator for pathological and structural changes].

PubMed

Spörl, E; Terai, N; Haustein, M; Böhm, A G; Raiskup-Wolf, F; Pillunat, L E

2009-06-01

Several methods permit the measurement of geometric parameters of the cornea, but until now biomechanical conditions of the cornea have been ignored (e.g. in refractive corneal surgery). Besides the geometric condition, biomechanical properties of the cornea have been shown to influence applanation measurement of intra-ocular pressure (IOP) and epidemiological studies have identified corneal thickness as an independent risk factor for the development and progression of glaucoma. The aim of this investigation was to characterize the biomechanical properties of the cornea using the ocular response analyzer (ORA). The ocular response analyzer (ORA) is a new method available for non-contact measurement of the biomechanical properties of the cornea. We evaluated the reproducibility of measurements, the difference between static and dynamic factors and the impact of independent factors (e.g. IOP, age, CCT, swelling of the cornea) on 2,500 measurements of corneal hysteresis (CH) and corneal resistance factor (CRF). In a large sample size we observed changes in CH and CRF after refractive surgery procedures (LASIK, UV-A cross-linking, keratoplasty) and in other corneal disorders (keratoconus, corneal dystrophies). CRF and CH changes may reflect structural changes of the cornea. Thus, the ORA provides valuable information for a better understanding and characterization of the biomechanical condition of the cornea, especially with regard to diseases such as keratoconus and glaucoma.

Behaviour modification in the management of chronic habits of abnormal eye rubbing.

PubMed

McMonnies, Charles W

2009-04-01

To describe how and why many keratoconus patients do not comply with strong advice to control chronic habits of abnormal rubbing. To outline a behaviour modification approach for controlling chronic habits of abnormal rubbing. Common reasons for chronic habits of abnormal rubbing have been reviewed as a basis for specifying a behavioural modification approach to habit reversal. The methods described are organized into the classic behavioural modification structure of: (1) habit awareness, (2) competing responses, (3) development of motivation, and (4) social support. This structure is supported by the application of social influence principles to achieve optimum compliance. The use of take-home written information in the form of an Abnormal Rubbing Guide is the basis for the development of motivation. Family social support is based upon a widening of the responsibility for avoiding eye rubbing to all family members. Some patients will need minimal application of these principles with patient education being sufficient intervention to achieve habit reversal. For patients with strong provocation to rubbing and/or by having a well established rubbing habit, a greater exposure to the habit reversal program described is indicated. Successful habit reversal may slow the rate of ectasia progression. Prophylactic application of the methods described for patients who are at risk for developing keratoconus, or post-laser assisted in situ keratomileusis keratectasia, may show that some forms of keratectasia are preventable.

Intraoperative Optical Coherence Tomography Using the RESCAN 700: Preliminary Results in Collagen Crosslinking.

PubMed

Pahuja, Natasha; Shetty, Rohit; Jayadev, Chaitra; Nuijts, Rudy; Hedge, Bharath; Arora, Vishal

2015-01-01

To compare the penetration of riboflavin using a microscope-integrated real time spectral domain optical coherence tomography (ZEISS OPMI LUMERA 700 and ZEISS RESCAN 700) in keratoconus patients undergoing accelerated collagen crosslinking (ACXL) between epithelium on (epi-on) and epithelium off (epi-off). Intraoperative images were obtained during each of the procedures. Seven keratoconus patients underwent epi-on ACXL and four underwent epi-off ACXL. A software tool was developed using Microsoft.NET and Open Computer Vision (OpenCV) libraries for image analysis. Pre- and postprocedure images were analyzed for changes in the corneal hyperreflectance pattern as a measure of the depth of riboflavin penetration. The mean corneal hyperreflectance in the epi-on group was 12.97 ± 1.49 gray scale units (GSU) before instillation of riboflavin and 14.46 ± 2.09 GSU after AXCL (P = 0.019) while in the epi-off group it was 11.43 ± 2.68 GSU and 16.98 ± 8.49 GSU, respectively (P = 0.002). The average depth of the band of hyperreflectance in the epi-on group was 149.39 ± 15.63 microns and in the epi-off group it was 191.04 ± 32.18 microns. This novel in vivo, real time imaging study demonstrates riboflavin penetration during epi-on and epi-off ACXL.

Comparison of accelerated and conventional corneal collagen cross-linking for progressive keratoconus.

PubMed

Cınar, Yasin; Cingü, Abdullah Kürşat; Türkcü, Fatih Mehmet; Çınar, Tuba; Yüksel, Harun; Özkurt, Zeynep Gürsel; Çaça, Ihsan

2014-09-01

To compare outcomes of accelerated and conventional corneal cross-linking (CXL) for progressive keratoconus (KC). Patients were divided into two groups as the accelerated CXL group and the conventional CXL group. The uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), refraction and keratometric values were measured preoperatively and postoperatively. The data of the two groups were compared statistically. The mean UDVA and CDVA were better at the six month postoperative when compared with preoperative values in two groups. While change in UDVA and CDVA was statistically significant in the accelerated CXL group (p = 0.035 and p = 0.047, respectively), it did not reach statistical significance in the conventional CXL group (p = 0.184 and p = 0.113, respectively). The decrease in the mean corneal power (Km) and maximum keratometric value (Kmax) were statistically significant in both groups (p = 0.012 and 0.046, respectively in the accelerated CXL group, p = 0.012 and 0.041, respectively, in the conventional CXL group). There was no statistically significant difference in visual and refractive results between the two groups (p > 0.05). Refractive and visual results of the accelerated CXL method and the conventional CXL method for the treatment of KC in short time period were similar. The accelerated CXL method faster and provide high throughput of the patients.

Effect of vernal keratoconjunctivitis on vitreous depth in patients with keratoconus.

PubMed

Cingü, Abdullah Kürşat; Kaya, Savaş; Çınar, Yasin; Şahin, Muhammed; Türkçü, Fatih Mehmet; Yüksel, Harun; Murat, Mehmet; Çaça, İhsan

2015-05-01

The aim of this study was to comparatively evaluate the vitreous depth (VD) of keratoconic eyes in patients with or without vernal keratoconjunctivitis (VKC). Eighty eyes of 80 consecutive keratoconus (KC) patients and 40 emmetropic control subjects were enrolled. KC patients were divided into two groups according to accompanying VKC (VKC-KC group and KC group). Mean outcome measures were best-corrected visual acuity (BCVA), spherical equivalent (SE), mean keratometry (Km), intraocular pressure (IOP), and axial length (AL) and its components. The eyes with the highest Km were selected for statistical analysis for each participant. There were 50, 30, and 40 patients in the VKC-KC group, KC group, and control group respectively. The KC group and VKC-KC group were similar in BCVA, SE, Km, CCT, ACD, LT, and IOP (p>0.05). The mean ACD was significantly lower in the control group when compared with the KC group and VKC-KC group. The mean AL and VD were significantly higher in VKC-KC group than those of KC group and the control group, whereas similar in KC and control groups (p>0.05). In the current study we showed that VKC-associated KC patients have significantly longer AL and VD when compared with KC patients without VKC. Posterior segment elongation in VKC-KC group may be associated with the type IV collagen destruction due to chronic longstanding inflammation in VKC patients.

Delivery of Riboflavin-5'-Monophosphate Into the Cornea: Can Liposomes Provide Any Enhancement Effects?

PubMed

Kandzija, Neva; Khutoryanskiy, Vitaliy V

2017-10-01

Keratoconus is a progressive condition caused by the thinning of the cornea, which eventually deforms the front surface of the eye into a cone shape leading to ghosting, multiple images, glare, and several other vision problems. Currently, keratoconus is treated with UV-induced riboflavin (Rb)-mediated collagen cross-linking, which requires a physical removal of the corneal epithelium under topical anesthesia. This study reports the penetration of Rb and its more water-soluble form, riboflavin-5'-monophosphate (RbP), into the bovine cornea ex vivo. Using ex vivo bovine corneal tissues and 0.8 mg/mL drug solutions in phosphate buffer, it was established that RbP penetration into the cornea within 3 h of diffusion experiment was greater (17.3 ± 0.8 μg) compared with Rb (10.4 ± 4.2 μg). In the cornea, RbP was found to convert to Rb, which is mediated with enzymes present in this tissue. Several formulations including the conventional and propylene glycol-containing liposomes with encapsulated RbP have been developed, and their effect on the drug penetration into the bovine cornea was evaluated. Encapsulation of RbP into the liposomes did not provide any statistically significant improvement in the penetration of RbP into the cornea. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Acanthamoeba keratitis in patients wearing scleral contact lenses.

PubMed

Sticca, Matheus Porto; Carrijo-Carvalho, Linda C; Silva, Isa M B; Vieira, Luiz A; Souza, Luciene B; Junior, Rubens Belfort; Carvalho, Fábio Ramos S; Freitas, Denise

2018-06-01

To report a series of cases of Acanthamoeba keratitis (AK) in scleral lens wearers with keratoconus to determine whether this type of contact lens presents a greater risk for development of infection. This study reports three patients who wore scleral contact lenses to correct keratoconus and developed AK. The diagnoses of AK were established based on cultures of the cornea, scleral contact lenses, and contact lens paraphernalia. This study investigated the risk factors for infections. The possible risks for AK in scleral contact lens wearers are hypoxic changes in the corneal epithelium because of the large diameter and minimal tear exchange, use of large amounts of saline solution necessary for scleral lens fitting, storing the scleral lens overnight in saline solution rather than contact lens multipurpose solutions, not rubbing the contact lens during cleaning, and the space between the cornea and the back surface of the scleral lens that might serve as a fluid reservoir and environment for Acanthamoeba multiplication. Two patients responded well to medical treatment of AK; one is still being treated. The recommendations for use and care of scleral contact lenses should be emphasized, especially regarding use of sterile saline (preferably single use), attention to rubbing the lens during cleaning, cleaning of the plunger, and overnight storage in fresh contact lens multipurpose solutions without topping off the lens solution in the case. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Normal and keratoconic corneal epithelial thickness mapping using Fourier-domain optical coherence tomography

NASA Astrophysics Data System (ADS)

Li, Yan; Tan, Ou; Huang, David

2011-03-01

The detection of early-stage keratoconus is one of the most important safety issues in screening candidates for corneal refractive surgeries. We propose to use epithelial thickness maps to assist the diagnosis of keratoconus. The corneal epithelial thickness in normal and keratoconic eyes was mapped with optical coherence tomography (OCT). A Fourier-domain OCT system capable of acquiring 26,000 axial-scans per second was used. It has an axial resolution of 5μm in cornea. A pachymetry scan pattern (8 radials, 1024 axial-scans each, 6mm diameter, repeat 3 times) centered at the pupil center was used to image the cornea. The 3 repeated radial scans on each meridian were registered and averaged. Then the anterior corneal, posterior corneal and epithelial boundaries were segmented automatically with a computer algorithm by increased signal intensity at corresponding boundaries. The epithelial thickness map was generated by interpolating epithelial thickness profile calculated from each meridian. Normal and keratoconic eyes (24 eyes each) were scanned 3 times. The central epithelial thickness in normal eyes was thicker than those of keratoconic eyes (mean difference 2.1 μm, t-test p=0.05). The epithelium was thinner superiorly than inferiorly in normal eyes (mean difference -1.4+/-1.1μm, p<0.001) while thicker superiorly than inferiorly in keratoconic eyes (2.0+/-4.1 μm, p=0.02).

Characteristic of entire corneal topography and tomography for the detection of sub-clinical keratoconus with Zernike polynomials using Pentacam.

PubMed

Xu, Zhe; Li, Weibo; Jiang, Jun; Zhuang, Xiran; Chen, Wei; Peng, Mei; Wang, Jianhua; Lu, Fan; Shen, Meixiao; Wang, Yuanyuan

2017-11-28

The study aimed to characterize the entire corneal topography and tomography for the detection of sub-clinical keratoconus (KC) with a Zernike application method. Normal subjects (n = 147; 147 eyes), sub-clinical KC patients (n = 77; 77 eyes), and KC patients (n = 139; 139 eyes) were imaged with the Pentacam HR system. The entire corneal data of pachymetry and elevation of both the anterior and posterior surfaces were exported from the Pentacam HR software. Zernike polynomials fitting was used to quantify the 3D distribution of the corneal thickness and surface elevation. The root mean square (RMS) values for each order and the total high-order irregularity were calculated. Multimeric discriminant functions combined with individual indices were built using linear step discriminant analysis. Receiver operating characteristic curves determined the diagnostic accuracy (area under the curve, AUC). The 3rd-order RMS of the posterior surface (AUC: 0.928) obtained the highest discriminating capability in sub-clinical KC eyes. The multimeric function, which consisted of the Zernike fitting indices of corneal posterior elevation, showed the highest discriminant ability (AUC: 0.951). Indices generated from the elevation of posterior surface and thickness measurements over the entire cornea using the Zernike method based on the Pentacam HR system were able to identify very early KC.

Corneal confocal microscopy following conventional, transepithelial, and accelerated corneal collagen cross-linking procedures for keratoconus.

PubMed

Touboul, David; Efron, Nathan; Smadja, David; Praud, Delphine; Malet, Florence; Colin, Joseph

2012-11-01

To compare early corneal healing following conventional, transepithelial, and accelerated corneal collagen cross-linking (CXL) protocols. Twenty-four patients with progressive keratoconus were divided into three groups to receive conventional, transepithelial, or accelerated CXL. In vivo corneal confocal microscopy was performed on each patient preoperatively and at 1, 3, and 6 months postoperatively. Closure of the epithelial wound was complete 3 days following conventional and accelerated CXL. The subbasal nerve plexus was essentially obliterated immediately following conventional and accelerated CXL, and virtually no nerve fibers had regenerated by 6 months. The anterior stroma showed significant changes 1 month following conventional CXL; these changes were similar but more pronounced following accelerated CXL. Observed stromal changes included complete obliteration of keratocytes, increased tissue reflectivity, a honeycomb-like appearance, and circular lacunae. Some recovery of keratocyte density was noted after 6 months. These changes were less pronounced in the mid-stroma, and there were no apparent changes to the posterior stroma or endothelium. The cornea appeared to be unaltered following transepithelial CXL. In vivo corneal confocal microscopy analysis of the postoperative impact of CXL on the cornea revealed clear differences among conventional, accelerated, and transepithelial CXL protocols. Accelerated CXL had a greater impact than conventional CXL on the anterior cornea, whereas transepithelial CXL did not appear to alter corneal morphology. Copyright 2012, SLACK Incorporated.

Accurate recapture identification for genetic mark–recapture studies with error-tolerant likelihood-based match calling and sample clustering

USGS Publications Warehouse

Sethi, Suresh; Linden, Daniel; Wenburg, John; Lewis, Cara; Lemons, Patrick R.; Fuller, Angela K.; Hare, Matthew P.

2016-01-01

Error-tolerant likelihood-based match calling presents a promising technique to accurately identify recapture events in genetic mark–recapture studies by combining probabilities of latent genotypes and probabilities of observed genotypes, which may contain genotyping errors. Combined with clustering algorithms to group samples into sets of recaptures based upon pairwise match calls, these tools can be used to reconstruct accurate capture histories for mark–recapture modelling. Here, we assess the performance of a recently introduced error-tolerant likelihood-based match-calling model and sample clustering algorithm for genetic mark–recapture studies. We assessed both biallelic (i.e. single nucleotide polymorphisms; SNP) and multiallelic (i.e. microsatellite; MSAT) markers using a combination of simulation analyses and case study data on Pacific walrus (Odobenus rosmarus divergens) and fishers (Pekania pennanti). A novel two-stage clustering approach is demonstrated for genetic mark–recapture applications. First, repeat captures within a sampling occasion are identified. Subsequently, recaptures across sampling occasions are identified. The likelihood-based matching protocol performed well in simulation trials, demonstrating utility for use in a wide range of genetic mark–recapture studies. Moderately sized SNP (64+) and MSAT (10–15) panels produced accurate match calls for recaptures and accurate non-match calls for samples from closely related individuals in the face of low to moderate genotyping error. Furthermore, matching performance remained stable or increased as the number of genetic markers increased, genotyping error notwithstanding.

Can Palliative Home Care Reduce 30-Day Readmissions? Results of a Propensity Score Matched Cohort Study

PubMed Central

Ranganathan, Anjana; Dougherty, Meredith; Waite, David

2013-01-01

Abstract Objective This study examined the impact of palliative home nursing care on rates of hospital 30-day readmissions. Methods The electronic health record based retrospective cohort study was performed within home care and palliative home care programs. Participants were home care patients discharged from one of three urban teaching hospitals. Outcome measures were propensity score matched rates of hospital readmissions within 30 days of hospital discharge. Results Of 406 palliative home care patients, matches were identified for 392 (96%). Of 15,709 home care patients, 890 were used at least once as a match for palliative care patients, for a total final sample of 1282. Using the matched sample we calculated the average treatment effect for treated patients. In this sample, palliative care patients had a 30-day readmission probability of 9.1% compared to a probability of 17.4% in the home care group (mean ATT: 8.3%; 95% confidence interval [CI] 8.0%–8.6%). This effect persisted after adjustment for visit frequency. Conclusions Palliative home care may offer benefits to health systems by allowing patients to remain at home and thereby avoiding 30-day rehospitalizations. PMID:24007348

The effect of unresolved contaminant stars on the cross-matching of photometric catalogues

NASA Astrophysics Data System (ADS)

Wilson, Tom J.; Naylor, Tim

2017-07-01

A fundamental process in astrophysics is the matching of two photometric catalogues. It is crucial that the correct objects be paired, and that their photometry does not suffer from any spurious additional flux. We compare the positions of sources in Wide-field Infrared Survey Explorer (WISE), INT Photometric H α Survey, Two Micron All Sky Survey and AAVSO Photometric All Sky Survey with Gaia Data Release 1 astrometric positions. We find that the separations are described by a combination of a Gaussian distribution, wider than naively assumed based on their quoted uncertainties, and a large wing, which some authors ascribe to proper motions. We show that this is caused by flux contamination from blended stars not treated separately. We provide linear fits between the quoted Gaussian uncertainty and the core fit to the separation distributions. We show that at least one in three of the stars in the faint half of a given catalogue will suffer from flux contamination above the 1 per cent level when the density of catalogue objects per point spread function area is above approximately 0.005. This has important implications for the creation of composite catalogues. It is important for any closest neighbour matches as there will be a given fraction of matches that are flux contaminated, while some matches will be missed due to significant astrometric perturbation by faint contaminants. In the case of probability-based matching, this contamination affects the probability density function of matches as a function of distance. This effect results in up to 50 per cent fewer counterparts being returned as matches, assuming Gaussian astrometric uncertainties for WISE-Gaia matching in crowded Galactic plane regions, compared with a closest neighbour match.

Inclusion probability for DNA mixtures is a subjective one-sided match statistic unrelated to identification information

PubMed Central

Perlin, Mark William

2015-01-01

Background: DNA mixtures of two or more people are a common type of forensic crime scene evidence. A match statistic that connects the evidence to a criminal defendant is usually needed for court. Jurors rely on this strength of match to help decide guilt or innocence. However, the reliability of unsophisticated match statistics for DNA mixtures has been questioned. Materials and Methods: The most prevalent match statistic for DNA mixtures is the combined probability of inclusion (CPI), used by crime labs for over 15 years. When testing 13 short tandem repeat (STR) genetic loci, the CPI-1 value is typically around a million, regardless of DNA mixture composition. However, actual identification information, as measured by a likelihood ratio (LR), spans a much broader range. This study examined probability of inclusion (PI) mixture statistics for 517 locus experiments drawn from 16 reported cases and compared them with LR locus information calculated independently on the same data. The log(PI-1) values were examined and compared with corresponding log(LR) values. Results: The LR and CPI methods were compared in case examples of false inclusion, false exclusion, a homicide, and criminal justice outcomes. Statistical analysis of crime laboratory STR data shows that inclusion match statistics exhibit a truncated normal distribution having zero center, with little correlation to actual identification information. By the law of large numbers (LLN), CPI-1 increases with the number of tested genetic loci, regardless of DNA mixture composition or match information. These statistical findings explain why CPI is relatively constant, with implications for DNA policy, criminal justice, cost of crime, and crime prevention. Conclusions: Forensic crime laboratories have generated CPI statistics on hundreds of thousands of DNA mixture evidence items. However, this commonly used match statistic behaves like a random generator of inclusionary values, following the LLN rather than measuring identification information. A quantitative CPI number adds little meaningful information beyond the analyst's initial qualitative assessment that a person's DNA is included in a mixture. Statistical methods for reporting on DNA mixture evidence should be scientifically validated before they are relied upon by criminal justice. PMID:26605124

Inclusion probability for DNA mixtures is a subjective one-sided match statistic unrelated to identification information.

PubMed

Perlin, Mark William

2015-01-01

DNA mixtures of two or more people are a common type of forensic crime scene evidence. A match statistic that connects the evidence to a criminal defendant is usually needed for court. Jurors rely on this strength of match to help decide guilt or innocence. However, the reliability of unsophisticated match statistics for DNA mixtures has been questioned. The most prevalent match statistic for DNA mixtures is the combined probability of inclusion (CPI), used by crime labs for over 15 years. When testing 13 short tandem repeat (STR) genetic loci, the CPI(-1) value is typically around a million, regardless of DNA mixture composition. However, actual identification information, as measured by a likelihood ratio (LR), spans a much broader range. This study examined probability of inclusion (PI) mixture statistics for 517 locus experiments drawn from 16 reported cases and compared them with LR locus information calculated independently on the same data. The log(PI(-1)) values were examined and compared with corresponding log(LR) values. The LR and CPI methods were compared in case examples of false inclusion, false exclusion, a homicide, and criminal justice outcomes. Statistical analysis of crime laboratory STR data shows that inclusion match statistics exhibit a truncated normal distribution having zero center, with little correlation to actual identification information. By the law of large numbers (LLN), CPI(-1) increases with the number of tested genetic loci, regardless of DNA mixture composition or match information. These statistical findings explain why CPI is relatively constant, with implications for DNA policy, criminal justice, cost of crime, and crime prevention. Forensic crime laboratories have generated CPI statistics on hundreds of thousands of DNA mixture evidence items. However, this commonly used match statistic behaves like a random generator of inclusionary values, following the LLN rather than measuring identification information. A quantitative CPI number adds little meaningful information beyond the analyst's initial qualitative assessment that a person's DNA is included in a mixture. Statistical methods for reporting on DNA mixture evidence should be scientifically validated before they are relied upon by criminal justice.

A new plan-scoring method using normal tissue complication probability for personalized treatment plan decisions in prostate cancer

NASA Astrophysics Data System (ADS)

Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie; Chang, Kyung Hwan

2018-01-01

The aim of this study was to derive a new plan-scoring index using normal tissue complication probabilities to verify different plans in the selection of personalized treatment. Plans for 12 patients treated with tomotherapy were used to compare scoring for ranking. Dosimetric and biological indexes were analyzed for the plans for a clearly distinguishable group ( n = 7) and a similar group ( n = 12), using treatment plan verification software that we developed. The quality factor ( QF) of our support software for treatment decisions was consistent with the final treatment plan for the clearly distinguishable group (average QF = 1.202, 100% match rate, n = 7) and the similar group (average QF = 1.058, 33% match rate, n = 12). Therefore, we propose a normal tissue complication probability (NTCP) based on the plan scoring index for verification of different plans for personalized treatment-plan selection. Scoring using the new QF showed a 100% match rate (average NTCP QF = 1.0420). The NTCP-based new QF scoring method was adequate for obtaining biological verification quality and organ risk saving using the treatment-planning decision-support software we developed for prostate cancer.

A statistical method for assessing peptide identification confidence in accurate mass and time tag proteomics

PubMed Central

Stanley, Jeffrey R.; Adkins, Joshua N.; Slysz, Gordon W.; Monroe, Matthew E.; Purvine, Samuel O.; Karpievitch, Yuliya V.; Anderson, Gordon A.; Smith, Richard D.; Dabney, Alan R.

2011-01-01

Current algorithms for quantifying peptide identification confidence in the accurate mass and time (AMT) tag approach assume that the AMT tags themselves have been correctly identified. However, there is uncertainty in the identification of AMT tags, as this is based on matching LC-MS/MS fragmentation spectra to peptide sequences. In this paper, we incorporate confidence measures for the AMT tag identifications into the calculation of probabilities for correct matches to an AMT tag database, resulting in a more accurate overall measure of identification confidence for the AMT tag approach. The method is referred to as Statistical Tools for AMT tag Confidence (STAC). STAC additionally provides a Uniqueness Probability (UP) to help distinguish between multiple matches to an AMT tag and a method to calculate an overall false discovery rate (FDR). STAC is freely available for download as both a command line and a Windows graphical application. PMID:21692516

Human instrumental performance in ratio and interval contingencies: A challenge for associative theory.

PubMed

Pérez, Omar D; Aitken, Michael R F; Zhukovsky, Peter; Soto, Fabián A; Urcelay, Gonzalo P; Dickinson, Anthony

2016-12-15

Associative learning theories regard the probability of reinforcement as the critical factor determining responding. However, the role of this factor in instrumental conditioning is not completely clear. In fact, free-operant experiments show that participants respond at a higher rate on variable ratio than on variable interval schedules even though the reinforcement probability is matched between the schedules. This difference has been attributed to the differential reinforcement of long inter-response times (IRTs) by interval schedules, which acts to slow responding. In the present study, we used a novel experimental design to investigate human responding under random ratio (RR) and regulated probability interval (RPI) schedules, a type of interval schedule that sets a reinforcement probability independently of the IRT duration. Participants responded on each type of schedule before a final choice test in which they distributed responding between two schedules similar to those experienced during training. Although response rates did not differ during training, the participants responded at a lower rate on the RPI schedule than on the matched RR schedule during the choice test. This preference cannot be attributed to a higher probability of reinforcement for long IRTs and questions the idea that similar associative processes underlie classical and instrumental conditioning.

Moisture Content Influences Ignitability of Slash Pine Litter

Treesearch

Winfred H. Blackmarr

1972-01-01

The influence of moisture content on the ignitability of slash pine litter was measured by dropping lighted matches onto fuel beds conditioned to different levels of moisture content.The percentage of matches igniting the fuel bed was used to indicate ignition probability at each moisture content. The "critical range" of fuel moisture contents within which...

A stochastic Markov chain approach for tennis: Monte Carlo simulation and modeling

NASA Astrophysics Data System (ADS)

Aslam, Kamran

This dissertation describes the computational formulation of probability density functions (pdfs) that facilitate head-to-head match simulations in tennis along with ranking systems developed from their use. A background on the statistical method used to develop the pdfs , the Monte Carlo method, and the resulting rankings are included along with a discussion on ranking methods currently being used both in professional sports and in other applications. Using an analytical theory developed by Newton and Keller in [34] that defines a tennis player's probability of winning a game, set, match and single elimination tournament, a computational simulation has been developed in Matlab that allows further modeling not previously possible with the analytical theory alone. Such experimentation consists of the exploration of non-iid effects, considers the concept the varying importance of points in a match and allows an unlimited number of matches to be simulated between unlikely opponents. The results of these studies have provided pdfs that accurately model an individual tennis player's ability along with a realistic, fair and mathematically sound platform for ranking them.

Brief communication: Drought likelihood for East Africa

NASA Astrophysics Data System (ADS)

Yang, Hui; Huntingford, Chris

2018-02-01

The East Africa drought in autumn of year 2016 caused malnutrition, illness and death. Close to 16 million people across Somalia, Ethiopia and Kenya needed food, water and medical assistance. Many factors influence drought stress and response. However, inevitably the following question is asked: are elevated greenhouse gas concentrations altering extreme rainfall deficit frequency? We investigate this with general circulation models (GCMs). After GCM bias correction to match the climatological mean of the CHIRPS data-based rainfall product, climate models project small decreases in probability of drought with the same (or worse) severity as 2016 ASO (August to October) East African event. This is by the end of the 21st century compared to the probabilities for present day. However, when further adjusting the climatological variability of GCMs to also match CHIRPS data, by additionally bias-correcting for variance, then the probability of drought occurrence will increase slightly over the same period.

Application of random match probability calculations to mixed STR profiles.

PubMed

Bille, Todd; Bright, Jo-Anne; Buckleton, John

2013-03-01

Mixed DNA profiles are being encountered more frequently as laboratories analyze increasing amounts of touch evidence. If it is determined that an individual could be a possible contributor to the mixture, it is necessary to perform a statistical analysis to allow an assignment of weight to the evidence. Currently, the combined probability of inclusion (CPI) and the likelihood ratio (LR) are the most commonly used methods to perform the statistical analysis. A third method, random match probability (RMP), is available. This article compares the advantages and disadvantages of the CPI and LR methods to the RMP method. We demonstrate that although the LR method is still considered the most powerful of the binary methods, the RMP and LR methods make similar use of the observed data such as peak height, assumed number of contributors, and known contributors where the CPI calculation tends to waste information and be less informative. © 2013 American Academy of Forensic Sciences.

Depth of word processing in Alzheimer patients and normal controls: a magnetoencephalographic (MEG) study.

PubMed

Walla, P; Püregger, E; Lehrner, J; Mayer, D; Deecke, L; Dal Bianco, P

2005-05-01

Effects related to depth of verbal information processing were investigated in probable Alzheimer's disease patients (AD) and age matched controls. During word encoding sessions 10 patients and 10 controls had either to decide whether the letter "s" appeared in visually presented words (alphabetical decision, shallow encoding), or whether the meaning of each presented word was animate or inanimate (lexical decision, deep encoding). These encoding sessions were followed by test sessions during which all previously encoded words were presented again together with the same number of new words. The task was then to discriminate between repeated and new words. Magnetic field changes related to brain activity were recorded with a whole cortex MEG.5 probable AD patients showed recognition performances above chance level related to both depths of information processing. Those patients and 5 age matched controls were then further analysed. Recognition performance was poorer in probable AD patients compared to controls for both levels of processing. However, in both groups deep encoding led to a higher recognition performance than shallow encoding. We therefore conclude that the performance reduction in the patient group was independent of depth of processing. Reaction times related to false alarms differed between patients and controls after deep encoding which perhaps could already be used for supporting an early diagnosis. The analysis of the physiological data revealed significant differences between correctly recognised repetitions and correctly classified new words (old/new-effect) in the control group which were missing in the patient group after deep encoding. The lack of such an effect in the patient group is interpreted as being due to the respective neuropathology related to probable AD. The present results demonstrate that magnetic field recordings represent a useful tool to physiologically distinguish between probable AD and age matched controls.

Identification of biomechanical properties of the cornea: the ocular response analyzer.

PubMed

Terai, Naim; Raiskup, Frederik; Haustein, Michael; Pillunat, Lutz E; Spoerl, Eberhard

2012-07-01

Several methods have been devised for measuring geometric parameters of the cornea but, until now, the biomechanics of the cornea have been largely ignored. The relatively new Ocular Response Analyzer (ORA) provides such biomechanical information. In order to correctly interpret the underlying biomechanics of ORA data, we review reported ORA measurements and provide a compendium of factors influencing these measurements, with discussion of possible explanations for ORA measurement results. This review comprised a literature search using "ocular response analyzer" and "ocular response analyser" as keywords. We reviewed and compared reported results from recent ORA studies so obtained, with an eye to understanding corneal biomechanics. Several ORA biomechanical parameters of the cornea - corneal hysteresis (CH) and corneal resistant factor (CRF) - characterize the viscoelastic properties of the cornea, especially those of the ground substance. The impact on CH and CRF values of various independent factors, e.g. intraocular pressure (IOP), age, central corneal thickness (CCT), and corneal swelling, are discussed. The impact on CH and CRF of treatment-related structural changes of the cornea, i.e. those occurring after refractive surgical procedures, placement of intracorneal rings, and collagen crosslinking (CXL), as well as pathological changes of the cornea, e.g. those resulting from keratoconus, edema, and glaucoma, are discussed. Changes in CRF and CH may be reflective of structural changes in the ground substance of the cornea. Thus, ORA provides invaluable information for delineating biomechanical conditions pertaining to the cornea, with special regard to ocular diseases, e.g. keratoconus and glaucoma.

Corneal Complications And Visual Impairment In Vernal Keratoconjunctivitis Patients.

PubMed

Arif, Abdus Salam; Aaqil, Bushra; Siddiqui, Afsheen; Nazneen, Zainab; Farooq, Umer

2017-01-01

Vernal kerato-conjunctivitis (VKC) is an infrequent but serious form of allergic conjunctivitis common in warm and humid areas where air is rich in allergens. It affects both eyes asymmetrically. Although VKC is a self-limiting disease but visions affecting corneal complications influence the quality of life in school children. The aim of this study was to list the corneal complications due to this condition and to find out the extent of visual impairment among VKC patients. This cross-sectional study was conducted in the department of Ophthalmology, Benazir Bhutto Shaheed Hospital on 290 eyes of diagnosed cases of VKC. The diagnosis of VKC was made on the basis of history and examination. Visual acuity was recorded using Snellen's notation and visual impairment was classified according to World Health Organization classification for visual disabilities. The mean age of presentation was 10.83±6.13 years. There were 207 (71.4%) males and 83 (28.6%) females. Corneal scarring was observed in 59 (20.3%) eyes. Keratoconus was found to be in 17 (5.9%) eyes. Shield ulcer was detected in 09 (3.1%) eyes while 07 (2.4%) eyes had corneal neovascularization. Majority of the patients with visual loss had corneal scarring and the complication that led to severe visual loss in most of the eyes was Keratoconus. Vernal kerato-conjunctivitis in the presence of corneal complications is a sight threatening disease and can lead to severe visual impairment.

Evaluation of a Machine-Learning Classifier for Keratoconus Detection Based on Scheimpflug Tomography.

PubMed

Ruiz Hidalgo, Irene; Rodriguez, Pablo; Rozema, Jos J; Ní Dhubhghaill, Sorcha; Zakaria, Nadia; Tassignon, Marie-José; Koppen, Carina

2016-06-01

To evaluate the performance of a support vector machine algorithm that automatically and objectively identifies corneal patterns based on a combination of 22 parameters obtained from Pentacam measurements and to compare this method with other known keratoconus (KC) classification methods. Pentacam data from 860 eyes were included in the study and divided into 5 groups: 454 KC, 67 forme fruste (FF), 28 astigmatic, 117 after refractive surgery (PR), and 194 normal eyes (N). Twenty-two parameters were used for classification using a support vector machine algorithm developed in Weka, a machine-learning computer software. The cross-validation accuracy for 3 different classification tasks (KC vs. N, FF vs. N and all 5 groups) was calculated and compared with other known classification methods. The accuracy achieved in the KC versus N discrimination task was 98.9%, with 99.1% sensitivity and 98.5% specificity for KC detection. The accuracy in the FF versus N task was 93.1%, with 79.1% sensitivity and 97.9% specificity for the FF discrimination. Finally, for the 5-groups classification, the accuracy was 88.8%, with a weighted average sensitivity of 89.0% and specificity of 95.2%. Despite using the strictest definition for FF KC, the present study obtained comparable or better results than the single-parameter methods and indices reported in the literature. In some cases, direct comparisons with the literature were not possible because of differences in the compositions and definitions of the study groups, especially the FF KC.

Removal and Repositioning of Intracorneal Ring Segments: Improving Corneal Topography and Clinical Outcomes in Keratoconus and Ectasia.

PubMed

Chan, Kahei; Hersh, Peter S

2017-02-01

To evaluate the efficacy of removal and relocation of intracorneal ring segments for improving outcomes in treatment of keratoconus and corneal ectasia. This is a retrospective case series conducted at a cornea and refractive surgery subspecialty practice setting. Patients with previous insertion of 2 intracorneal ring segments underwent surgical removal and repositioning of segments because of unsatisfactory visual and topographic outcomes. The principal outcomes included uncorrected and corrected visual acuities, manifest refraction, topography-derived maximum keratometry (Kmax), inferior-superior topography power difference (I - S), and higher-order aberration profile derived from wavefront analysis. Three patients are presented in this case series. Uncorrected visual acuity improved in all eyes by an average of 2.75 lines. Corrected visual acuity improved in 2 eyes and remained unchanged in 1 eye. Refractive astigmatism decreased in all patients by an average of 2.50 D. Kmax decreased by an average of 1.43 D. All patients had improvement in the I - S value with a mean decrease of 5.13 D. Topography-guided repositioning and/or replacement of corneal ring segments can result in improved topographic, optical, and visual outcomes in patients in whom the initial result is suboptimal. In these cases, a single segment repositioned beneath the cone resulted in an improved outcome. Analysis of corneal topography can guide the surgeon in treatment planning and can suggest patients in whom such an effort will be rewarded with better results.

I Remember You: Independence and the Binomial Model

ERIC Educational Resources Information Center

Levine, Douglas W.; Rockhill, Beverly

2006-01-01

We focus on the problem of ignoring statistical independence. A binomial experiment is used to determine whether judges could match, based on looks alone, dogs to their owners. The experimental design introduces dependencies such that the probability of a given judge correctly matching a dog and an owner changes from trial to trial. We show how…

Analysis of pupil and corneal wave aberration data supplied by the SN CT 1000 topography system

NASA Astrophysics Data System (ADS)

Comastri, S. A.; Martin, G.; Pfortner, T.

2006-11-01

Ocular aberrations depend on pupil size and centring and the retinal image quality under natural conditions differs from that corresponding to laboratory ones. In the present article, pupil and wave aberration data supplied by the Shin Nippon CT 1000 (SN CT 1000) topography system are analysed. Two groups of eyes under natural viewing conditions are considered ((260+/-20) lux at the eye under study). The first group consists of 10 normal eyes (-1.25 to 3 D sphere; 0 to -1.75 D cylinder) of five young subjects (age between 18 and 33 years). For this group, five determinations per eye are performed and the repeatability of results is analysed. Pupil centre is displaced from corneal vertex towards the temporal region, the largest displacement being (0.5+/-0.1) mm. The variation of pupil diameter in each eye is less than 21% while the inter-subject variability is large since diameters are between (3+/-0.3) and (5.3+/-0.6) mm. Aberrations are evaluated for two different pupil sizes, the natural one and a fictitious one of 6 mm. The corneal higher-order root-mean square wavefront error (RMSHO) for a 6 mm pupil centred in the corneal vertex, averaged across all eyes, is (0.37+/-0.06) [mu]m while, considering the natural pupil diameter, the average in each eye is significantly lower, up to eight times smaller. The fourth-order spherical aberration is an important aberration in the considered eyes, its maximum value for a 6 mm pupil being (0.38+/-0.02) [mu]m. The second group consists of 24 eyes of 12 subjects (age between 25 and 68 years) such that four eyes are of normal adults (1.25 to +6 D sphere; 0 to -0.5 D cylinder), eight have astigmatisms (-5.5 to +3.25 D sphere; -1.5 to -4.5 D cylinder), six have post-refractive surgery (+0.5 to +3.5 D sphere; -0.5 to -4 D cylinder) and six have keratoconus (-9.5 to +1 D sphere; -1 to -4.5 D cylinder). For this group only one determination per eye is performed. Pupil centre is displaced from corneal vertex towards the temporal region except in cases of keratoconus, where there can be a dominant upwards displacement. Pupil diameters are between 2.7 and 5.6 mm. The corneal higher order root mean square wavefront error for a 6 mm pupil ranges between 0.3 (normal eye) and 5.3 [mu]m (keratoconus).

A-MUPS score to differentiate patients with somatic symptom disorder from those with medical disease for complaints of non-acute pain

PubMed Central

Suzuki, Shingo; Ohira, Yoshiyuki; Noda, Kazutaka; Ikusaka, Masatomi

2017-01-01

Purpose To develop a clinical score to discriminate patients with somatic symptom disorder (SSD) from those with medical disease (MD) for complaints of non-acute pain. Methods We retrospectively examined the clinical records of consecutive patients with pain for a duration of ≥1 month in our department from April 2003 to March 2015. We divided the subjects according to the diagnoses of definite SSD (as diagnosed and tracked by psychiatrists in our hospital), probable SSD (without evaluation by psychiatrists in our hospital), matched MD (randomly matched two patients by age, sex, and pain location for each definite SSD patient), unmatched MD, other mental disease, or functional somatic syndrome (FSS). We investigated eight clinical factors for definite SSD and matched MD, and developed a diagnostic score to identify SSD. We subsequently validated the model with cases of probable SSD and unmatched MD. Results The number of patients with definite SSD, probable SSD, matched MD, unmatched MD, other mental disease, and FSS was 104 (3.5%), 214 (7.3%), 197 (6.7%), 742 (25%), 708 (24%), and 978 (33%), respectively. In a conditional logistic regression analysis, the following five factors were included as independent predictors of SSD: Analgesics ineffective, Mental disorder history, Unclear provocative/palliative factors, Persistence without cessation, and Stress feelings/episodes (A-MUPS). The area under the receiver operating characteristic curve (AUC) of the model was 0.900 (95% CI: 0.864–0.937, p<0.001), and the McFadden’s pseudo-R-squared was 0.709. For internal validation, the AUC between probable SSD and unmatched MD was 0.930 (95% CI: 0.910–0.950, p<0.001). The prevalence and the likelihood ratio of SSD increased as the score increased. Conclusion The A-MUPS score was useful for discriminating patients with SSD from those with MD for complaints of non-acute pain, although external validation and refinement should be needed. PMID:28652807

A-MUPS score to differentiate patients with somatic symptom disorder from those with medical disease for complaints of non-acute pain.

PubMed

Suzuki, Shingo; Ohira, Yoshiyuki; Noda, Kazutaka; Ikusaka, Masatomi

2017-01-01

To develop a clinical score to discriminate patients with somatic symptom disorder (SSD) from those with medical disease (MD) for complaints of non-acute pain. We retrospectively examined the clinical records of consecutive patients with pain for a duration of ≥1 month in our department from April 2003 to March 2015. We divided the subjects according to the diagnoses of definite SSD (as diagnosed and tracked by psychiatrists in our hospital), probable SSD (without evaluation by psychiatrists in our hospital), matched MD (randomly matched two patients by age, sex, and pain location for each definite SSD patient), unmatched MD, other mental disease, or functional somatic syndrome (FSS). We investigated eight clinical factors for definite SSD and matched MD, and developed a diagnostic score to identify SSD. We subsequently validated the model with cases of probable SSD and unmatched MD. The number of patients with definite SSD, probable SSD, matched MD, unmatched MD, other mental disease, and FSS was 104 (3.5%), 214 (7.3%), 197 (6.7%), 742 (25%), 708 (24%), and 978 (33%), respectively. In a conditional logistic regression analysis, the following five factors were included as independent predictors of SSD: Analgesics ineffective, Mental disorder history, Unclear provocative/palliative factors, Persistence without cessation, and Stress feelings/episodes (A-MUPS). The area under the receiver operating characteristic curve (AUC) of the model was 0.900 (95% CI: 0.864-0.937, p <0.001), and the McFadden's pseudo- R -squared was 0.709. For internal validation, the AUC between probable SSD and unmatched MD was 0.930 (95% CI: 0.910-0.950, p <0.001). The prevalence and the likelihood ratio of SSD increased as the score increased. The A-MUPS score was useful for discriminating patients with SSD from those with MD for complaints of non-acute pain, although external validation and refinement should be needed.

Recognizing human actions by learning and matching shape-motion prototype trees.

PubMed

Jiang, Zhuolin; Lin, Zhe; Davis, Larry S

2012-03-01

A shape-motion prototype-based approach is introduced for action recognition. The approach represents an action as a sequence of prototypes for efficient and flexible action matching in long video sequences. During training, an action prototype tree is learned in a joint shape and motion space via hierarchical K-means clustering and each training sequence is represented as a labeled prototype sequence; then a look-up table of prototype-to-prototype distances is generated. During testing, based on a joint probability model of the actor location and action prototype, the actor is tracked while a frame-to-prototype correspondence is established by maximizing the joint probability, which is efficiently performed by searching the learned prototype tree; then actions are recognized using dynamic prototype sequence matching. Distance measures used for sequence matching are rapidly obtained by look-up table indexing, which is an order of magnitude faster than brute-force computation of frame-to-frame distances. Our approach enables robust action matching in challenging situations (such as moving cameras, dynamic backgrounds) and allows automatic alignment of action sequences. Experimental results demonstrate that our approach achieves recognition rates of 92.86 percent on a large gesture data set (with dynamic backgrounds), 100 percent on the Weizmann action data set, 95.77 percent on the KTH action data set, 88 percent on the UCF sports data set, and 87.27 percent on the CMU action data set.

Wolf Attack Probability: A Theoretical Security Measure in Biometric Authentication Systems

NASA Astrophysics Data System (ADS)

Une, Masashi; Otsuka, Akira; Imai, Hideki

This paper will propose a wolf attack probability (WAP) as a new measure for evaluating security of biometric authentication systems. The wolf attack is an attempt to impersonate a victim by feeding “wolves” into the system to be attacked. The “wolf” means an input value which can be falsely accepted as a match with multiple templates. WAP is defined as a maximum success probability of the wolf attack with one wolf sample. In this paper, we give a rigorous definition of the new security measure which gives strength estimation of an individual biometric authentication system against impersonation attacks. We show that if one reestimates using our WAP measure, a typical fingerprint algorithm turns out to be much weaker than theoretically estimated by Ratha et al. Moreover, we apply the wolf attack to a finger-vein-pattern based algorithm. Surprisingly, we show that there exists an extremely strong wolf which falsely matches all templates for any threshold value.

Work Disability among Women: The Role of Divorce in a Retrospective Cohort Study.

PubMed

Tamborini, Christopher R; Reznik, Gayle L; Couch, Kenneth A

2016-03-01

We assess how divorce through midlife affects the subsequent probability of work-limiting health among U.S. women. Using retrospective marital and work disability histories from the Survey of Income and Program Participation matched to Social Security earnings records, we identify women whose first marriage dissolved between 1975 and 1984 (n = 1,214) and women who remain continuously married (n = 3,394). Probit and propensity score matching models examine the cumulative probability of a work disability over a 20-year follow-up period. We find that divorce is associated with a significantly higher cumulative probability of a work disability, controlling for a range of factors. This association is strongest among divorced women who do not remarry. No consistent relationships are observed among divorced women who remarry and remained married. We find that economic hardship, work history, and selection into divorce influence, but do not substantially alter, the lasting impact of divorce on work-limiting health. © American Sociological Association 2016.

Test-retest reliability of the Middlesex Assessment of Mental State (MEAMS): a preliminary investigation in people with probable dementia.

PubMed

Powell, T; Brooker, D J; Papadopolous, A

1993-05-01

Relative and absolute test-retest reliability of the MEAMS was examined in 12 subjects with probable dementia and 12 matched controls. Relative reliability was good. Measures of absolute reliability showed scores changing by up to 3 points over an interval of a week. A version effect was found to be in evidence.

Using fingerprint image quality to improve the identification performance of the U.S. Visitor and Immigrant Status Indicator Technology Program

PubMed Central

Wein, Lawrence M.; Baveja, Manas

2005-01-01

Motivated by the difficulty of biometric systems to correctly match fingerprints with poor image quality, we formulate and solve a game-theoretic formulation of the identification problem in two settings: U.S. visa applicants are checked against a list of visa holders to detect visa fraud, and visitors entering the U.S. are checked against a watchlist of criminals and suspected terrorists. For three types of biometric strategies, we solve the game in which the U.S. Government chooses the strategy's optimal parameter values to maximize the detection probability subject to a constraint on the mean biometric processing time per legal visitor, and then the terrorist chooses the image quality to minimize the detection probability. At current inspector staffing levels at ports of entry, our model predicts that a quality-dependent two-finger strategy achieves a detection probability of 0.733, compared to 0.526 under the quality-independent two-finger strategy that is currently implemented at the U.S. border. Increasing the staffing level of inspectors offers only minor increases in the detection probability for these two strategies. Using more than two fingers to match visitors with poor image quality allows a detection probability of 0.949 under current staffing levels, but may require major changes to the current U.S. biometric program. The detection probabilities during visa application are ≈11–22% smaller than at ports of entry for all three strategies, but the same qualitative conclusions hold. PMID:15894628

Using fingerprint image quality to improve the identification performance of the U.S. Visitor and Immigrant Status Indicator Technology Program.

PubMed

Wein, Lawrence M; Baveja, Manas

2005-05-24

Motivated by the difficulty of biometric systems to correctly match fingerprints with poor image quality, we formulate and solve a game-theoretic formulation of the identification problem in two settings: U.S. visa applicants are checked against a list of visa holders to detect visa fraud, and visitors entering the U.S. are checked against a watchlist of criminals and suspected terrorists. For three types of biometric strategies, we solve the game in which the U.S. Government chooses the strategy's optimal parameter values to maximize the detection probability subject to a constraint on the mean biometric processing time per legal visitor, and then the terrorist chooses the image quality to minimize the detection probability. At current inspector staffing levels at ports of entry, our model predicts that a quality-dependent two-finger strategy achieves a detection probability of 0.733, compared to 0.526 under the quality-independent two-finger strategy that is currently implemented at the U.S. border. Increasing the staffing level of inspectors offers only minor increases in the detection probability for these two strategies. Using more than two fingers to match visitors with poor image quality allows a detection probability of 0.949 under current staffing levels, but may require major changes to the current U.S. biometric program. The detection probabilities during visa application are approximately 11-22% smaller than at ports of entry for all three strategies, but the same qualitative conclusions hold.

New pinhole sulcus implant for the correction of irregular corneal astigmatism.

PubMed

Trindade, Claudio C; Trindade, Bruno C; Trindade, Fernando C; Werner, Liliana; Osher, Robert; Santhiago, Marcony R

2017-10-01

To evaluate the effect on visual acuity of the implantation of a new intraocular pinhole device (Xtrafocus) in cases of irregular corneal astigmatism with significant visual impairment. University of São Paulo, São Paulo, Brazil. Prospective case series. Pseudophakic eyes of patients with irregular corneal astigmatism were treated with the pinhole device. The causes of irregular corneal astigmatism were keratoconus, post radial keratotomy (RK), post-penetrating keratoplasty (PKP), and traumatic corneal laceration. The device was implanted in the ciliary sulcus in a piggyback configuration to minimize the effect of corneal aberrations. Preoperative and postoperative visual parameters were compared. The main outcome variables were manifest refraction, uncorrected and corrected distance and near visual acuities, subjective patient satisfaction, and intraoperative and postoperative adverse events and complications. Twenty-one patients (ages 35 to 85 years) were included. There was statistically significant improvement in uncorrected and corrected (CDVA) distance visual acuities. The median CDVA improved from 20/200 (range 20/800 to 20/60) preoperatively to 20/50 (range 20/200 to 20/20) in the first month postoperatively and remained stable over the following months. Manifest refraction remained unchanged, while a subjective visual performance questionnaire revealed perception of improvement in all the tested working distances. No major complication was observed. One case presented with decentration of the device, which required an additional surgical intervention. The intraocular pinhole device performed well in patients with irregular astigmatism caused by keratoconus, RK, PKP, and traumatic corneal laceration. There was marked improvement in visual function, with high patient satisfaction. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Outcomes of Corneal Cross-Linking Correlate With Cone-Specific Lysyl Oxidase Expression in Patients With Keratoconus.

PubMed

Shetty, Rohit; Rajiv Kumar, Nimisha; Pahuja, Natasha; Deshmukh, Rashmi; Vunnava, KrishnaPoojita; Abilash, Valsala Gopalakrishnan; Sinha Roy, Abhijit; Ghosh, Arkasubhra

2018-03-01

To evaluate the correlation of visual and keratometry outcomes after corneal cross-linking (CXL) in patients with keratoconus with cone epithelium-specific gene expression levels. Corneal epithelium was obtained from 35 eyes that underwent accelerated CXL (KXLII, 9 mW/cm for 10 min). Using corneal topography, epithelium over the cone and periphery was obtained separately from each subject. The ratio of gene expression for lysyl oxidase (LOX), matrix metalloproteinase 9 (MMP9), bone morphogenic protein 7, tissue inhibitor of metalloproteinase 1, collagen, type I, alpha 1, and collagen, type IV, alpha 1 (COL IVA1) from the cone and peripheral cornea was correlated with the outcome of cross-linking surgery. Patients were assessed for visual acuity, keratometry, refraction, and corneal densitometry before and 6 months after surgery. Based on the change in corneal flattening indicated by ΔKmax, the outcomes were classified as a higher response or lower response. Reduction in keratometric indices correlated with improved spherical equivalent after CXL. Preoperative levels of cone-specific LOX expression in cases with a higher response were significant (P = 0.001). COL IVA1, bone morphogenic protein 7, and tissue inhibitor of metalloproteinase 1 gene expressions were reduced in the cones of the subjects with a lower response. MMP9 levels were relatively lower in cases with a higher response compared with those with a lower response. Our study demonstrates that preoperative levels of molecular factors such as LOX, MMP9, and COL IVA1 aid in understanding CXL outcomes at the tissue level.

Cellular Therapy With Human Autologous Adipose-Derived Adult Stem Cells for Advanced Keratoconus.

PubMed

Alió Del Barrio, Jorge L; El Zarif, Mona; de Miguel, María P; Azaar, Albert; Makdissy, Norman; Harb, Walid; El Achkar, Ibrahim; Arnalich-Montiel, Francisco; Alió, Jorge L

2017-08-01

The aim of this phase 1 study was to preliminarily evaluate the safety and efficacy of autologous adipose-derived adult stem cell (ADASC) implantation within the corneal stroma of patients with advanced keratoconus. Five consecutive patients were selected. Autologous ADASCs were obtained by elective liposuction. ADASCs (3 × 10) contained in 1 mL saline were injected into the corneal stroma through a femtosecond-assisted 9.5-mm diameter lamellar pocket under topical anesthesia. Patients were reviewed at 1 day, 1 week, 1, 3, and 6 months postoperatively. Visual function, manifest refraction, slit-lamp biomicroscopy, intraocular pressure, endothelial cell density, corneal topography, corneal optical coherence tomography, and corneal confocal biomicroscopy were recorded. No intraoperative or postoperative complications were recorded, with full corneal transparency recovery within 24 hours. Four patients completed the full follow-up. All patients improved their visual function (mean: 1 line of unaided and spectacle-corrected distance vision and 2 lines of rigid contact lens distance vision). Manifest refraction and topographic keratometry remained stable. Corneal optical coherence tomography showed a mean improvement of 16.5 μm in the central corneal thickness, and new collagen production was observed as patchy hyperreflective areas at the level of the stromal pocket. Confocal biomicroscopy confirmed the survival of the implanted stem cells at the surgical plane. Intraocular pressure and endothelial cell density remained stable. Cellular therapy of the human corneal stroma in vivo with autologous ADASCs appears to be safe. Stem cells survive in vivo with intrastromal new collagen production. Future studies with larger samples are required to confirm these preliminary results.

Is it really important to form a big bubble in DALK to enhance the visual acuity?

PubMed

Acar, Banu Torun; Vural, Ece Turan; Acar, Suphi

2012-09-01

The aim of this study was to investigate the prognosis of visual acuity (VA) in the patients with keratoconus, who underwent deep anterior lamellar keratoplasty (DALK) with a successful big bubble or lamellar dissection. Sixty-eight eyes of 60 patients with keratoconus, who underwent DALK using the big-bubble technique, were enrolled in this retrospective comparative study. The VA and refractive errors were assessed before the operation and, thereafter, at months 1, 3, 6, and 12 after the operation (1) in the patients who achieved a big-bubble formation, and in those who required layer-by-layer lamellar dissection (2) to reach the Descemet membrane. Successful big bubble was achieved in 50 eyes (73.5 %) (group 1), and lamellar dissection was performed in 18 eyes (26.5 %) (group 2). The mean follow-up period was 22.4±6.2 months in group 1 and 23.7±7.8 months in group 2 (P=0.562). Although best-corrected visual acuity (BCVA) values observed at months 1 and 3 were significantly higher in group 1 than in group 2 (P=0.016 and P=0.024, respectively), there was no statistically significant difference between the two groups for BCVA values observed at months 6 and 12 (P=0.412 and P=0.528, respectively). Although the visual recovery was delayed in the early postoperative follow-up because of residual stroma in lamellar dissection, the final results were comparable between the achievement of big-bubble formation and lamellar dissection.

Refractive Surgery: Malpractice Litigation Outcomes.

PubMed

Custer, Benjamin L; Ballard, Steven R; Carroll, Robert B; Barnes, Scott D; Justin, Grant A

2017-10-01

To review data on malpractice claims related to refractive surgery to identify common allegations and injuries and financial outcomes. The WestlawNext database was reviewed for all malpractice lawsuits/settlements related to refractive eye surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes. A total of 167 cases met the inclusion criteria, of which 108 cases (64.7%) were found to be favorable and 59 cases (35.3%) unfavorable to the defendant. A total of 141 cases were tried by a jury with 108 cases (76.4%) favorable and 33 cases (23.6%) unfavorable to the defendant. Laser in situ keratomileusis was performed in 127 cases (76%). The most common allegations were negligence in treatment or surgery in 127 cases (76%) and lack of informed consent in 83 cases (49.7%). For all cases, the need for future surgery (P = 0.0001) and surgery resulting in keratoconus (P = 0.05) were more likely to favor the plaintiff. In jury verdict decisions, cases in which failure to diagnose a preoperative condition was alleged favored the defendant (P = 0.03), whereas machine malfunction (P = 0.05) favored the plaintiff. After adjustment for inflation, the overall mean award was $1,287,872. Jury verdicts and settlements led to mean awards of $1,604,801 and $826,883, respectively. Malpractice litigation in refractive surgery tends to favor the defendant. However, large awards and settlements were given in cases that were favorable to the plaintiff. The need for future surgery and surgery leading to keratoconus increased the chance of an unfavorable outcome.

Boston type 1 keratoprosthesis for failed keratoplasty.

PubMed

Hager, Jonathan L; Phillips, David L; Goins, Kenneth M; Kitzmann, Anna S; Greiner, Mark A; Cohen, Alex W; Welder, Jeffrey D; Wagoner, Michael D

2016-02-01

The purpose of this study was to evaluate the outcomes of the Boston type 1 keratoprosthesis (Kpro-1) in eyes with failed keratoplasty. A retrospective review was performed of every patient treated with a Kpro-1 at a tertiary eye care center between January 1, 2008 and July 1, 2013. Eyes with a failed keratoplasty originally performed for corneal edema, trauma, or keratoconus were included in the statistical analysis. The main outcome measures were visual outcome, prosthesis retention, and postoperative complications. Twenty-four eyes met the inclusion criteria, including 13 eyes with corneal edema, 8 eyes with trauma, and 3 eyes with keratoconus. After a mean follow-up period of 28.9 months (range 7-63 months), the median best corrected visual acuity (BCVA) was 20/125. The BCVA was ≥ 20/40 in 4 (16.7 %) eyes, ≥ 20/70 in 9 (37.5 %) eyes, and ≥ 20/200 in 14 (58.3 %) eyes. Overall, the postoperative BCVA improved in 17 (70.9 %) eyes, was unchanged in 3 (12.5 %) eyes, and was worse in 4 (16.7 %) eyes. The initial Kpro-1 was retained in 22 (91.7 %) eyes, and was successfully repeated in the other 2 eyes. One or more serious prosthesis- or sight-threatening complications occurred in 8 (33.3 %) eyes. These included 1 case of wound dehiscence leading to prosthesis extrusion, 1 case of fungal keratitis leading to prosthesis extrusion, 4 cases of endophthalmitis, and 5 retinal detachments. The Boston Kpro-1 is associated with an excellent prognosis for prosthesis retention and satisfactory visual improvement in eyes with previous failed keratoplasty.

Improved High-Frequency Ultrasound Corneal Biometric Accuracy by Micrometer-Resolution Acoustic-Property Maps of the Cornea.

PubMed

Rohrbach, Daniel; Silverman, Ronald H; Chun, Dan; Lloyd, Harriet O; Urs, Raksha; Mamou, Jonathan

2018-04-01

Mapping of epithelial thickness (ET) is useful for detection of keratoconus, a disease characterized by corneal thinning and bulging in which epithelial thinning occurs over the apex. In prior clinical studies, optical coherence tomography (OCT) measurements of ET were systematically thinner than those obtained by 40-MHz high-frequency ultrasound (HFU) where a constant speed of sound ( c ) of 1636 m/s was used for all corneal layers. The purpose of this work was to study the acoustic properties, that is, c , acoustic impedance ( Z ), and attenuation ( α ) of the corneal epithelium and stroma independently using a scanning acoustic microscope (SAM) to investigate the discrepancy between OCT and HFU estimates of ET. Twelve unfixed pig corneas were snap-frozen and 6-μm sections were scanned using a custom-built SAM with an F-1.08, 500-MHz transducer and a 264-MHz bandwidth. Two-dimensional maps of c , Z , and α with a spatial resolution of 4 μm were derived. SAM showed that the value of c in the epithelium (i.e., 1548 ± 18 m/s) is substantially lower than the value of c in the stroma (i.e., 1686 ± 33 m/s). SAM results demonstrated that the assumption of a constant value of c for all corneal layers is incorrect and explains the prior discrepancy between OCT and HFU ET determinations. The findings of this study have important implications for HFU-based ET measurements and will improve future keratoconus diagnosis by providing more-accurate ET estimates.

Analysis of sphingolipids in human corneal fibroblasts from normal and keratoconus patients[S

PubMed Central

Qi, Hui; Priyadarsini, Shrestha; Nicholas, Sarah E.; Sarker-Nag, Akhee; Allegood, Jeremy; Chalfant, Charles E.; Mandal, Nawajes A.; Karamichos, Dimitrios

2017-01-01

The pathophysiology of human keratoconus (KC), a bilateral progressive corneal disease leading to protrusion of the cornea, stromal thinning, and scarring, is not well-understood. In this study, we investigated a novel sphingolipid (SPL) signaling pathway through which KC may be regulated. Using human corneal fibroblasts (HCFs) and human KC cells (HKCs), we examined the SPL pathway modulation. Both cell types were stimulated by the three transforming growth factor (TGF)-β isoforms: TGF-β1 (T1), TGF-β2 (T2), and TGF-β3 (T3). All samples were analyzed using lipidomics and real-time PCR. Our data showed that HKCs have increased levels of signaling SPLs, ceramide (Cer), and sphingosine 1-phosphate (S1P). Treatment with T1 reversed the increase in Cer in HKCs and treatment with T3 reversed the increase in S1P. S1P3 receptor mRNA levels were also significantly upregulated in HKCs, but were reduced to normal levels following T3 treatment. Furthermore, stimulation with Cer and S1P led to significant upregulation of fibrotic markers in HCFs, but not in HKCs. Additionally, stimulation with a Cer synthesis inhibitor (FTY720) led to significant downregulation of specific fibrotic markers in HKCs (TGF-β1, collagen type III, and α smooth muscle actin) without an effect on healthy HCFs, suggesting a causative role of Cer and S1P in fibrogenesis. Overall, this study suggests an association of the SPL signaling pathway in KC disease and its relation with the TGF-β pathway. PMID:28188148

Outcome of Keratoconus Management: Review of the Past 20 Years' Contemporary Treatment Modalities.

PubMed

Mandathara, Preeji S; Stapleton, Fiona J; Willcox, Mark D P

2017-05-01

To describe the past 20 years' contemporary management modalities for keratoconus (KC) and their outcomes and failures and to propose recommendations in reporting their outcomes. A systematic review of the literature on KC management options for the last 20 years was performed. Original articles that reported the outcome of any form of KC management other than full-thickness or lamellar corneal graft were reviewed to collect information on their outcomes and complications and the level of scientific evidence of the study. A total of 1,147 articles retrieved and of those, 241 satisfied the inclusion criteria, and 41.1% of them were prospective case series. The higher level of evidence studies, that is, randomized controlled trials (RCTs), were limited to only one intervention, that is, corneal collagen cross-linking (CXL). However, the quality of most RCTs was limited because of performance and detection bias. Contact lenses (CLs) remain the mainstream of KC management and were associated with reversible and non-sight-threatening complications. Surgical options such as intracorneal segment implantation and phakic intraocular lens are considered in the visual rehabilitation of CL intolerants, and CXL is the only available option to stop or delay the disease progression. Generally, these surgical procedures are associated with transient inflammatory events and permanent sequelae. The published studies on KC management options varied significantly with respect to the study population, age of participants, severity of KC, clinical outcome measurements, and follow-up period. High-quality longer follow-up RCTs are required to evaluate the long-term effects of KC interventions.

Automatic and strategic effects in the guidance of attention by working memory representations

PubMed Central

Carlisle, Nancy B.; Woodman, Geoffrey F.

2010-01-01

Theories of visual attention suggest that working memory representations automatically guide attention toward memory-matching objects. Some empirical tests of this prediction have produced results consistent with working memory automatically guiding attention. However, others have shown that individuals can strategically control whether working memory representations guide visual attention. Previous studies have not independently measured automatic and strategic contributions to the interactions between working memory and attention. In this study, we used a classic manipulation of the probability of valid, neutral, and invalid cues to tease apart the nature of such interactions. This framework utilizes measures of reaction time (RT) to quantify the costs and benefits of attending to memory-matching items and infer the relative magnitudes of automatic and strategic effects. We found both costs and benefits even when the memory-matching item was no more likely to be the target than other items, indicating an automatic component of attentional guidance. However, the costs and benefits essentially doubled as the probability of a trial with a valid cue increased from 20% to 80%, demonstrating a potent strategic effect. We also show that the instructions given to participants led to a significant change in guidance distinct from the actual probability of events during the experiment. Together, these findings demonstrate that the influence of working memory representations on attention is driven by both automatic and strategic interactions. PMID:20643386

Automatic and strategic effects in the guidance of attention by working memory representations.

PubMed

Carlisle, Nancy B; Woodman, Geoffrey F

2011-06-01

Theories of visual attention suggest that working memory representations automatically guide attention toward memory-matching objects. Some empirical tests of this prediction have produced results consistent with working memory automatically guiding attention. However, others have shown that individuals can strategically control whether working memory representations guide visual attention. Previous studies have not independently measured automatic and strategic contributions to the interactions between working memory and attention. In this study, we used a classic manipulation of the probability of valid, neutral, and invalid cues to tease apart the nature of such interactions. This framework utilizes measures of reaction time (RT) to quantify the costs and benefits of attending to memory-matching items and infer the relative magnitudes of automatic and strategic effects. We found both costs and benefits even when the memory-matching item was no more likely to be the target than other items, indicating an automatic component of attentional guidance. However, the costs and benefits essentially doubled as the probability of a trial with a valid cue increased from 20% to 80%, demonstrating a potent strategic effect. We also show that the instructions given to participants led to a significant change in guidance distinct from the actual probability of events during the experiment. Together, these findings demonstrate that the influence of working memory representations on attention is driven by both automatic and strategic interactions. Copyright © 2010 Elsevier B.V. All rights reserved.

Modified Toxicity Probability Interval Design: A Safer and More Reliable Method Than the 3 + 3 Design for Practical Phase I Trials

PubMed Central

Ji, Yuan; Wang, Sue-Jane

2013-01-01

The 3 + 3 design is the most common choice among clinicians for phase I dose-escalation oncology trials. In recent reviews, more than 95% of phase I trials have been based on the 3 + 3 design. Given that it is intuitive and its implementation does not require a computer program, clinicians can conduct 3 + 3 dose escalations in practice with virtually no logistic cost, and trial protocols based on the 3 + 3 design pass institutional review board and biostatistics reviews quickly. However, the performance of the 3 + 3 design has rarely been compared with model-based designs in simulation studies with matched sample sizes. In the vast majority of statistical literature, the 3 + 3 design has been shown to be inferior in identifying true maximum-tolerated doses (MTDs), although the sample size required by the 3 + 3 design is often orders-of-magnitude smaller than model-based designs. In this article, through comparative simulation studies with matched sample sizes, we demonstrate that the 3 + 3 design has higher risks of exposing patients to toxic doses above the MTD than the modified toxicity probability interval (mTPI) design, a newly developed adaptive method. In addition, compared with the mTPI design, the 3 + 3 design does not yield higher probabilities in identifying the correct MTD, even when the sample size is matched. Given that the mTPI design is equally transparent, costless to implement with free software, and more flexible in practical situations, we highly encourage its adoption in early dose-escalation studies whenever the 3 + 3 design is also considered. We provide free software to allow direct comparisons of the 3 + 3 design with other model-based designs in simulation studies with matched sample sizes. PMID:23569307

Research on sparse feature matching of improved RANSAC algorithm

NASA Astrophysics Data System (ADS)

Kong, Xiangsi; Zhao, Xian

2018-04-01

In this paper, a sparse feature matching method based on modified RANSAC algorithm is proposed to improve the precision and speed. Firstly, the feature points of the images are extracted using the SIFT algorithm. Then, the image pair is matched roughly by generating SIFT feature descriptor. At last, the precision of image matching is optimized by the modified RANSAC algorithm,. The RANSAC algorithm is improved from three aspects: instead of the homography matrix, this paper uses the fundamental matrix generated by the 8 point algorithm as the model; the sample is selected by a random block selecting method, which ensures the uniform distribution and the accuracy; adds sequential probability ratio test(SPRT) on the basis of standard RANSAC, which cut down the overall running time of the algorithm. The experimental results show that this method can not only get higher matching accuracy, but also greatly reduce the computation and improve the matching speed.

Delayed Matching to Sample: Probability of Responding in Accord with Equivalence as a Function of Different Delays

ERIC Educational Resources Information Center

Arntzen, Erik

2006-01-01

The present series of 4 experiments investigated the probability of responding in accord with equivalence in adult human participants as a function of increasing or decreasing delays in a many-to-one (MTO) or comparison-as-node and one-to-many (OTM) or sample-as-node conditional discrimination procedure. In Experiment 1, 12 participants started…

Unconventional signal detection techniques with Gaussian probability mixtures adaptation in non-AWGN channels: full resolution receiver

NASA Astrophysics Data System (ADS)

Chabdarov, Shamil M.; Nadeev, Adel F.; Chickrin, Dmitry E.; Faizullin, Rashid R.

2011-04-01

In this paper we discuss unconventional detection technique also known as «full resolution receiver». This receiver uses Gaussian probability mixtures for interference structure adaptation. Full resolution receiver is alternative to conventional matched filter receivers in the case of non-Gaussian interferences. For the DS-CDMA forward channel with presence of complex interferences sufficient performance increasing was shown.

Methods, systems, and computer program products for network firewall policy optimization

DOEpatents

Fulp, Errin W [Winston-Salem, NC; Tarsa, Stephen J [Duxbury, MA

2011-10-18

Methods, systems, and computer program products for firewall policy optimization are disclosed. According to one method, a firewall policy including an ordered list of firewall rules is defined. For each rule, a probability indicating a likelihood of receiving a packet matching the rule is determined. The rules are sorted in order of non-increasing probability in a manner that preserves the firewall policy.

Effect of Phonotactic Probability and Neighborhood Density on Word-Learning Configuration by Preschoolers with Typical Development and Specific Language Impairment

ERIC Educational Resources Information Center

Gray, Shelley; Pittman, Andrea; Weinhold, Juliet

2014-01-01

Purpose: In this study, the authors assessed the effects of phonotactic probability and neighborhood density on word-learning configuration by preschoolers with specific language impairment (SLI) and typical language development (TD). Method: One hundred thirty-one children participated: 48 with SLI, 44 with TD matched on age and gender, and 39…

The Assessment of Recognition Memory Using the Remember/Know Procedure in Amnestic Mild Cognitive Impairment and Probable Alzheimer's Disease

ERIC Educational Resources Information Center

Hudon, Carol; Belleville, Sylvie; Gauthier, Serge

2009-01-01

This study used the Remember/Know (R/K) procedure combined with signal detection analyses to assess recognition memory in 20 elders with amnestic mild cognitive impairment (aMCI), 10 patients with probable Alzheimer's disease (AD) as well as matched healthy older adults. Signal detection analyses first indicated that aMCI and control participants…

Single, Complete, Probability Spaces Consistent With EPR-Bohm-Bell Experimental Data

NASA Astrophysics Data System (ADS)

Avis, David; Fischer, Paul; Hilbert, Astrid; Khrennikov, Andrei

2009-03-01

We show that paradoxical consequences of violations of Bell's inequality are induced by the use of an unsuitable probabilistic description for the EPR-Bohm-Bell experiment. The conventional description (due to Bell) is based on a combination of statistical data collected for different settings of polarization beam splitters (PBSs). In fact, such data consists of some conditional probabilities which only partially define a probability space. Ignoring this conditioning leads to apparent contradictions in the classical probabilistic model (due to Kolmogorov). We show how to make a completely consistent probabilistic model by taking into account the probabilities of selecting the settings of the PBSs. Our model matches both the experimental data and is consistent with classical probability theory.

More heads choose better than one: Group decision making can eliminate probability matching.

PubMed

Schulze, Christin; Newell, Ben R

2016-06-01

Probability matching is a robust and common failure to adhere to normative predictions in sequential decision making. We show that this choice anomaly is nearly eradicated by gathering individual decision makers into small groups and asking the groups to decide. The group choice advantage emerged both when participants generated responses for an entire sequence of choices without outcome feedback (Exp. 1a) and when participants made trial-by-trial predictions with outcome feedback after each decision (Exp. 1b). We show that the dramatic improvement observed in group settings stands in stark contrast to a complete lack of effective solitary deliberation. These findings suggest a crucial role of group discussion in alleviating the impact of hasty intuitive responses in tasks better suited to careful deliberation.

Influence of the HLA characteristics of Italian patients on donor search outcome in unrelated hematopoietic stem cell transplantation.

PubMed

Testi, M; Andreani, M; Locatelli, F; Arcese, W; Troiano, M; Battarra, M; Gaziev, J; Lucarelli, G

2014-08-01

The information regarding the probability of finding a matched unrelated donor (MUD) within a relatively short time is crucial for the success of hematopoietic stem cell transplantation (HSCT), particularly in patients with malignancies. In this study, we retrospectively analyzed 315 Italian patients who started a search for a MUD, in order to assess the distribution of human leukocyte antigen (HLA) alleles and haplotypes in this population of patients and to evaluate the probability of finding a donor. Comparing two groups of patients based on whether or not a 10/10 HLA-matched donor was available, we found that patients who had a fully-matched MUD possessed at least one frequent haplotype more often than the others (45.6% vs 14.3%; P = 0.000003). In addition, analysis of data pertaining to the HLA class I alleles distribution showed that, in the first group of patients, less common alleles were under-represented (20.2% vs 40.0%; P = 0.006). Therefore, the presence of less frequent alleles represents a negative factor for the search for a potential compatible donor being successful, whereas the presence of one frequent haplotype represents a positive predictive factor. Antigenic differences between patient and donor observed at C and DQB1 loci, were mostly represented by particular B/C or DRB1/DQB1 allelic associations. Thus, having a particular B or DRB1 allele, linked to multiple C or DQB1 alleles, respectively, might be considered to be associated with a lower probability of a successful search. Taken together, these data may help determine in advance the probability of finding a suitable unrelated donor for an Italian patient. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sleep Stage Transition Dynamics Reveal Specific Stage 2 Vulnerability in Insomnia.

PubMed

Wei, Yishul; Colombo, Michele A; Ramautar, Jennifer R; Blanken, Tessa F; van der Werf, Ysbrand D; Spiegelhalder, Kai; Feige, Bernd; Riemann, Dieter; Van Someren, Eus J W

2017-09-01

Objective sleep impairments in insomnia disorder (ID) are insufficiently understood. The present study evaluated whether whole-night sleep stage dynamics derived from polysomnography (PSG) differ between people with ID and matched controls and whether sleep stage dynamic features discriminate them better than conventional sleep parameters. Eighty-eight participants aged 21-70 years, including 46 with ID and 42 age- and sex-matched controls without sleep complaints, were recruited through www.sleepregistry.nl and completed two nights of laboratory PSG. Data of 100 people with ID and 100 age- and sex-matched controls from a previously reported study were used to validate the generalizability of findings. The second night was used to obtain, in addition to conventional sleep parameters, probabilities of transitions between stages and bout duration distributions of each stage. Group differences were evaluated with nonparametric tests. People with ID showed higher empirical probabilities to transition from stage N2 to the lighter sleep stage N1 or wakefulness and a faster decaying stage N2 bout survival function. The increased transition probability from stage N2 to stage N1 discriminated people with ID better than any of their deviations in conventional sleep parameters, including less total sleep time, less sleep efficiency, more stage N1, and more wake after sleep onset. Moreover, adding this transition probability significantly improved the discriminating power of a multiple logistic regression model based on conventional sleep parameters. Quantification of sleep stage dynamics revealed a particular vulnerability of stage N2 in insomnia. The feature characterizes insomnia better than-and independently of-any conventional sleep parameter. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Carlsberg alibi marketing in the UEFA euro 2016 football finals: implications of Probably inappropriate alcohol advertising.

PubMed

Murray, Rachael; Breton, Magdalena Opazo; Britton, John; Cranwell, Jo; Grant-Braham, Bruce

2018-04-25

Alcohol advertising is a key driver of alcohol consumption, and is prohibited in France by the Loi Evin. In 2016 the Danish brewer Carlsberg sponsored the UEFA Euro 2016 finals, held in France, and used the alibis 'Probably' and '…the best in the world' in place of Carlsberg in pitch-side advertising. We have quantified the advertising exposure achieved during the final seven games in the UEFA Euro 2016 championship. Appearances of the Carlsberg alibis 'Probably' and 'the best in the world' were counted and timed to the nearest second during all active play in live coverage of quarter final, semi-final and final matches broadcast in the UK. We used census data and viewing figures from Kantar Media to estimate gross and per capita impressions of these advertisements in the UK population. In 796 min, 29 s of active play there were 746 alibi appearances, totalling 68 min 35 s duration and representing 8.6% of active playing time. Appearances were particularly frequent at the end of normal time, extra time and penalties. The seven matches delivered up to 7.43 billion Carlsberg alibi impressions to UK adults and 163.3 million to children. In the only match involving a second country with laws prohibiting alcohol advertising (France versus Iceland), exposure occurred for only 1.8% of playing time. Alibi marketing achieved significant advertising coverage during the final seven EURO 2016 championship games, particularly to children. Since 'Probably' is registered by Carlsberg as a wordmark this advertising appears to contravene the Loi Evin, though Carlsberg have defended their marketing actions.

Discriminability limits in spatio-temporal stereo block matching.

PubMed

Jain, Ankit K; Nguyen, Truong Q

2014-05-01

Disparity estimation is a fundamental task in stereo imaging and is a well-studied problem. Recently, methods have been adapted to the video domain where motion is used as a matching criterion to help disambiguate spatially similar candidates. In this paper, we analyze the validity of the underlying assumptions of spatio-temporal disparity estimation, and determine the extent to which motion aids the matching process. By analyzing the error signal for spatio-temporal block matching under the sum of squared differences criterion and treating motion as a stochastic process, we determine the probability of a false match as a function of image features, motion distribution, image noise, and number of frames in the spatio-temporal patch. This performance quantification provides insight into when spatio-temporal matching is most beneficial in terms of the scene and motion, and can be used as a guide to select parameters for stereo matching algorithms. We validate our results through simulation and experiments on stereo video.

Generation of Stationary Non-Gaussian Time Histories with a Specified Cross-spectral Density

DOE PAGES

Smallwood, David O.

1997-01-01

The paper reviews several methods for the generation of stationary realizations of sampled time histories with non-Gaussian distributions and introduces a new method which can be used to control the cross-spectral density matrix and the probability density functions (pdfs) of the multiple input problem. Discussed first are two methods for the specialized case of matching the auto (power) spectrum, the skewness, and kurtosis using generalized shot noise and using polynomial functions. It is then shown that the skewness and kurtosis can also be controlled by the phase of a complex frequency domain description of the random process. The general casemore » of matching a target probability density function using a zero memory nonlinear (ZMNL) function is then covered. Next methods for generating vectors of random variables with a specified covariance matrix for a class of spherically invariant random vectors (SIRV) are discussed. Finally the general case of matching the cross-spectral density matrix of a vector of inputs with non-Gaussian marginal distributions is presented.« less

Slider--maximum use of probability information for alignment of short sequence reads and SNP detection.

PubMed

Malhis, Nawar; Butterfield, Yaron S N; Ester, Martin; Jones, Steven J M

2009-01-01

A plethora of alignment tools have been created that are designed to best fit different types of alignment conditions. While some of these are made for aligning Illumina Sequence Analyzer reads, none of these are fully utilizing its probability (prb) output. In this article, we will introduce a new alignment approach (Slider) that reduces the alignment problem space by utilizing each read base's probabilities given in the prb files. Compared with other aligners, Slider has higher alignment accuracy and efficiency. In addition, given that Slider matches bases with probabilities other than the most probable, it significantly reduces the percentage of base mismatches. The result is that its SNP predictions are more accurate than other SNP prediction approaches used today that start from the most probable sequence, including those using base quality.

A rational inference approach to group and individual-level sentence comprehension performance in aphasia.

PubMed

Warren, Tessa; Dickey, Michael Walsh; Liburd, Teljer L

2017-07-01

The rational inference, or noisy channel, account of language comprehension predicts that comprehenders are sensitive to the probabilities of different interpretations for a given sentence and adapt as these probabilities change (Gibson, Bergen & Piantadosi, 2013). This account provides an important new perspective on aphasic sentence comprehension: aphasia may increase the likelihood of sentence distortion, leading people with aphasia (PWA) to rely more on the prior probability of an interpretation and less on the form or structure of the sentence (Gibson, Sandberg, Fedorenko, Bergen & Kiran, 2015). We report the results of a sentence-picture matching experiment that tested the predictions of the rational inference account and other current models of aphasic sentence comprehension across a variety of sentence structures. Consistent with the rational inference account, PWA showed similar sensitivity to the probability of particular kinds of form distortions as age-matched controls, yet overall their interpretations relied more on prior probability and less on sentence form. As predicted by rational inference, but not by other models of sentence comprehension in aphasia, PWA's interpretations were more faithful to the form for active and passive sentences than for direct object and prepositional object sentences. However contra rational inference, there was no evidence that individual PWA's severity of syntactic or semantic impairment predicted their sensitivity to form versus the prior probability of a sentence, as cued by semantics. These findings confirm and extend previous findings that suggest the rational inference account holds promise for explaining aphasic and neurotypical comprehension, but they also raise new challenges for the account. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Birthday Problem Anew

ERIC Educational Resources Information Center

Braza, Peter A.

2006-01-01

Accurate and accessible expressions for the probability of having a matching birthday are obtained by using Stirling's formula and Taylor series. For interest, the results are applied to the planets of our solar system.

The Influence of Phonotactic Probability on Nonword Repetition and Fast Mapping in 3-Year-Olds with a History of Expressive Language Delay

ERIC Educational Resources Information Center

MacRoy-Higgins, Michelle; Dalton, Kevin Patrick

2015-01-01

Purpose: The purpose of this study was to examine the influence of phonotactic probability on sublexical (phonological) and lexical representations in 3-year-olds who had a history of being late talkers in comparison with their peers with typical language development. Method: Ten 3-year-olds who were late talkers and 10 age-matched typically…

Automated side-chain model building and sequence assignment by template matching.

PubMed

Terwilliger, Thomas C

2003-01-01

An algorithm is described for automated building of side chains in an electron-density map once a main-chain model is built and for alignment of the protein sequence to the map. The procedure is based on a comparison of electron density at the expected side-chain positions with electron-density templates. The templates are constructed from average amino-acid side-chain densities in 574 refined protein structures. For each contiguous segment of main chain, a matrix with entries corresponding to an estimate of the probability that each of the 20 amino acids is located at each position of the main-chain model is obtained. The probability that this segment corresponds to each possible alignment with the sequence of the protein is estimated using a Bayesian approach and high-confidence matches are kept. Once side-chain identities are determined, the most probable rotamer for each side chain is built into the model. The automated procedure has been implemented in the RESOLVE software. Combined with automated main-chain model building, the procedure produces a preliminary model suitable for refinement and extension by an experienced crystallographer.

Concurrent performance in a three-alternative choice situation: response allocation in a Rock/Paper/Scissors game.

PubMed

Kangas, Brian D; Berry, Meredith S; Cassidy, Rachel N; Dallery, Jesse; Vaidya, Manish; Hackenberg, Timothy D

2009-10-01

Adult human subjects engaged in a simulated Rock/Paper/Scissors game against a computer opponent. The computer opponent's responses were determined by programmed probabilities that differed across 10 blocks of 100 trials each. Response allocation in Experiment 1 was well described by a modified version of the generalized matching equation, with undermatching observed in all subjects. To assess the effects of instructions on response allocation, accurate probability-related information on how the computer was programmed to respond was provided to subjects in Experiment 2. Five of 6 subjects played the counter response of the computer's dominant programmed response near-exclusively (e.g., subjects played paper almost exclusively if the probability of rock was high), resulting in minor overmatching, and higher reinforcement rates relative to Experiment 1. On the whole, the study shows that the generalized matching law provides a good description of complex human choice in a gaming context, and illustrates a promising set of laboratory methods and analytic techniques that capture important features of human choice outside the laboratory.

Semantic priming in the lexical decision task: roles of prospective prime-generated expectancies and retrospective semantic matching.

PubMed

Neely, J H; Keefe, D E; Ross, K L

1989-11-01

In semantic priming paradigms for lexical decisions, the probability that a word target is semantically related to its prime (the relatedness proportion) has been confounded with the probability that a target is a nonword, given that it is unrelated to its prime (the nonword ratio). This study unconfounded these two probabilities in a lexical decision task with category names as primes and with high- and low-dominance exemplars as targets. Semantic priming for high-dominance exemplars was modulated by the relatedness proportion and, to a lesser degree, by the nonword ratio. However, the nonword ratio exerted a stronger influence than did the relatedness proportion on semantic priming for low-dominance exemplars and on the nonword facilitation effect (i.e., the superiority in performance for nonword targets that follow a category name rather than a neutral XXX prime). These results suggest that semantic priming for lexical decisions is affected by both a prospective prime-generated expectancy, modulated by the relatedness proportion, and a retrospective target/prime semantic matching process, modulated by the nonword ratio.

Modeling the probability distribution of positional errors incurred by residential address geocoding.

PubMed

Zimmerman, Dale L; Fang, Xiangming; Mazumdar, Soumya; Rushton, Gerard

2007-01-10

The assignment of a point-level geocode to subjects' residences is an important data assimilation component of many geographic public health studies. Often, these assignments are made by a method known as automated geocoding, which attempts to match each subject's address to an address-ranged street segment georeferenced within a streetline database and then interpolate the position of the address along that segment. Unfortunately, this process results in positional errors. Our study sought to model the probability distribution of positional errors associated with automated geocoding and E911 geocoding. Positional errors were determined for 1423 rural addresses in Carroll County, Iowa as the vector difference between each 100%-matched automated geocode and its true location as determined by orthophoto and parcel information. Errors were also determined for 1449 60%-matched geocodes and 2354 E911 geocodes. Huge (> 15 km) outliers occurred among the 60%-matched geocoding errors; outliers occurred for the other two types of geocoding errors also but were much smaller. E911 geocoding was more accurate (median error length = 44 m) than 100%-matched automated geocoding (median error length = 168 m). The empirical distributions of positional errors associated with 100%-matched automated geocoding and E911 geocoding exhibited a distinctive Greek-cross shape and had many other interesting features that were not capable of being fitted adequately by a single bivariate normal or t distribution. However, mixtures of t distributions with two or three components fit the errors very well. Mixtures of bivariate t distributions with few components appear to be flexible enough to fit many positional error datasets associated with geocoding, yet parsimonious enough to be feasible for nascent applications of measurement-error methodology to spatial epidemiology.

Combined use of ESI-QqTOF-MS and ESI-QqTOF-MS/MS with mass-spectral library search for qualitative analysis of drugs.

PubMed

Pavlic, Marion; Libiseller, Kathrin; Oberacher, Herbert

2006-09-01

The potential of the combined use of ESI-QqTOF-MS and ESI-QqTOF-MS/MS with mass-spectral library search for the identification of therapeutic and illicit drugs has been evaluated. Reserpine was used for standardizing experimental conditions and for characterization of the performance of the applied mass spectrometric system. Experiments revealed that because of the mass accuracy, the stability of calibration, and the reproducibility of fragmentation, the QqTOF mass spectrometer is an appropriate platform for establishment of a tandem-mass-spectral library. Three-hundred and nineteen substances were used as reference samples to build the spectral library. For each reference compound, product-ion spectra were acquired at ten different collision-energy values between 5 eV and 50 eV. For identification of unknown compounds, a library search algorithm was developed. The closeness of matching between a measured product-ion spectrum and a spectrum stored in the library was characterized by a value called "match probability", which took into account the number of matched fragment ions, the number of fragment ions observed in the two spectra, and the sum of the intensity differences calculated for matching fragments. A large value for the match probability indicated a close match between the measured and the reference spectrum. A unique feature of the library search algorithm-an implemented spectral purification option-enables characterization of multi-contributor fragment-ion spectra. With the aid of this software feature, substances comprising only 1.0% of the total amount of binary mixtures were unequivocally assigned, in addition to the isobaric main contributors. The spectral library was successfully applied to the characterization of 39 forensic casework samples.

Practical relevance of pattern uniqueness in forensic science.

PubMed

Jayaprakash, Paul T

2013-09-10

Uniqueness being unprovable, it has recently been argued that individualization in forensic science is irrelevant and, probability, as applied for DNA profiles, should be applied for all identifications. Critiques against uniqueness have omitted physical matching, a realistic and tangible individualization that supports uniqueness. Describing case examples illustrating pattern matches including physical matching, it is indicated that individualizations are practically relevant for forensic science as they establish facts on a definitive basis providing firm leads benefitting criminal investigation. As a tenet of forensic identification, uniqueness forms a fundamental paradigm relevant for individualization. Evidence on the indeterministic and stochastic causal pathways of characteristics in patterns available in the related fields of science sufficiently supports the proposition of uniqueness. Characteristics involved in physical matching and matching achieved in patterned evidence existing in the state of nature are not events amenable for counting; instead these are ensemble of visible units occupying the entire pattern area stretching the probability of re-occurrence of a verisimilitude pattern into infinity offering epistemic support to uniqueness. Observational methods are as respectable as instrumental or statistical methods since they are capable of generating results that are tangible and obviously valid as in physical matching. Applying the probabilistic interpretation used for DNA profiles to the other patterns would be unbefitting since these two are disparate, the causal pathways of the events, the loci, in the manipulated DNA profiles being determinable. While uniqueness enables individualizations, it does not vouch for eliminating errors. Instead of dismissing uniqueness and individualization, accepting errors as human or system failures and seeking remedial measures would benefit forensic science practice and criminal investigation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

On the inter-instrument and the inter-laboratory transferability of a tandem mass spectral reference library: 2. Optimization and characterization of the search algorithm.

PubMed

Oberacher, Herbert; Pavlic, Marion; Libiseller, Kathrin; Schubert, Birthe; Sulyok, Michael; Schuhmacher, Rainer; Csaszar, Edina; Köfeler, Harald C

2009-04-01

A sophisticated matching algorithm developed for highly efficient identity search within tandem mass spectral libraries is presented. For the optimization of the search procedure a collection of 410 tandem mass spectra corresponding to 22 compounds was used. The spectra were acquired in three different laboratories on four different instruments. The following types of tandem mass spectrometric instruments were used: quadrupole-quadrupole-time-of-flight (QqTOF), quadrupole-quadrupole-linear ion trap (QqLIT), quadrupole-quadrupole-quadrupole (QqQ), and linear ion trap-Fourier transform ion cyclotron resonance mass spectrometer (LIT-FTICR). The obtained spectra were matched to an established MS/MS-spectral library that contained 3759 MS/MS-spectra corresponding to 402 different reference compounds. All 22 test compounds were part of the library. A dynamic intensity cut-off, the search for neutral losses, and optimization of the formula used to calculate the match probability were shown to significantly enhance the performance of the presented library search approach. With the aid of these features the average number of correct assignments was increased to 98%. For statistical evaluation of the match reliability the set of fragment ion spectra was extended with 300 spectra corresponding to 100 compounds not included in the reference library. Performance was checked with the aid of receiver operating characteristic (ROC) curves. Using the magnitude of the match probability as well as the precursor ion mass as benchmarks to rate the obtained top hit, overall correct classification of a compound being included or not included in the mass spectrometric library, was obtained in more than 95% of cases clearly indicating a high predictive accuracy of the established matching procedure. Copyright (c) 2009 John Wiley & Sons, Ltd.

Do Pigeons Prefer Information in the Absence of Differential Reinforcement?

PubMed Central

Zentall, Thomas R.; Stagner, Jessica P.

2012-01-01

Prior research indicates that pigeons do not prefer an alternative that provides a sample (for matching-to-sample) over an alternative that does not provide a sample (i.e., there is no indication of which comparison stimulus is correct). However, Zentall and Stagner (2010) showed that when delay of reinforcement was controlled, pigeons had a strong preference for matching over pseudo-matching (there was a sample but it did not indicate which comparison stimulus was correct). Experiment 1 of the present study replicated and extended the results of the Zentall and Stagner study by including an identity relation between the sample and one of the comparison stimuli in both the matching and pseudo-matching tasks. In Experiment 2, when we asked if the pigeons would still prefer matching if we equated the two tasks for probability of reinforcement, we found no systematic preference for matching over pseudo-matching. Thus, it appears that in the absence of differential reinforcement, the information provided by a sample that signals which of the two comparison stimuli is correct is insufficient to produce a preference for that alternative. PMID:22367755

Graft biomechanical properties after penetrating keratoplasty in keratoconus.

PubMed

Feizi, Sepehr; Einollahi, Bahram; Yazdani, Shahin; Hashemloo, Ali

2012-08-01

To measure corneal graft biomechanical properties after penetrating keratoplasty (PKP) in a group of keratoconic eyes using the ocular response analyzer (ORA) and to evaluate the relationship between donor size, donor-recipient disparity and central graft thickness (CGT), and ORA parameters. This cross-sectional study was conducted on 34 eyes of 34 keratoconus patients who had undergone PKP. Corneal hysteresis (CH), corneal resistance factor (CRF), and cornea-compensated intraocular pressure were measured at least 6 months after complete suture removal. Two groups of donor-recipient disparity (0.25 vs. 0.50 mm) were compared using the independent t test. Multivariate regression analysis was used to investigate the correlation of donor trephine size and CGT with ORA parameters. Factors influencing intraocular pressure measured with the Goldmann applanation tonometer (IOP GAT) after PKP were determined using multiple regression analysis. Mean patient age and follow-up period were 29.6 ± 6.2 years and 82.4 ± 59.6 months, respectively. Mean CGT, CH, and CRF were 564.7 ± 36.9 μm, 10.1 ± 2.1 mm Hg, and 10.0 ± 2.3 mm Hg, respectively. CH and CRF had a significant positive correlation with donor trephine size and CGT. Significantly greater values of CH and CRF were observed in the 0.5-mm disparity group compared with the 0.25-mm disparity group. Among the studied parameters, only CH, CRF, and cornea-compensated intraocular pressure had a significant positive correlation with IOP GAT. Graft biomechanics seem to be closer to normal values with larger grafts and greater donor-recipient disparity. These metrics had a significant correlation with IOP GAT after PKP.

Characteristics of Posterior Corneal Astigmatism in Different Stages of Keratoconus.

PubMed

Aslani, Fereshteh; Khorrami-Nejad, Masoud; Aghazadeh Amiri, Mohammad; Hashemian, Hesam; Askarizadeh, Farshad; Khosravi, Bahram

2018-01-01

To evaluate the magnitudes and axis orientation of anterior corneal astigmatism (ACA) and posterior corneal astigmatism (PCA), the ratio of ACA to PCA, and the correlation between ACA and PCA in the different stages of keratoconus (KCN). This retrospective case series comprised 161 eyes of 161 patients with KCN (104 men, 57 women; mean age, 22.35 ± 6.10 years). The participants were divided into four subgroups according to the Amsler-Krumeich classification. A Scheimpflug imaging system was used to measure the magnitude and axis orientation of ACA and PCA. The posterior-anterior corneal astigmatism ratio was also calculated. The results were compared among different subgroups. The average amounts of anterior, posterior, and total corneal astigmatism were 4.08 ± 2.21 diopters (D), 0.86 ± 0.46 D, and 3.50 ± 1.94 D, respectively. With-the-rule, against-the-rule, and oblique astigmatisms of the posterior surface of the cornea were found in 61 eyes (37.9%), 67 eyes (41.6%), and 33 eyes (20.5%), respectively; corresponding figures in the anterior corneal surface were 55 eyes (32.4%), 56 eyes (34.8%), and 50 eyes (31.1%), respectively. A strong correlation ( P ≤ 0.001, r = 0.839) was found between ACA and PCA in the different stages of KCN; the correlation was weaker in eyes with grade 3 ( P ≤ 0.001, r = 0.711) and grade 4 ( P ≤ 0.001, r = 0.717) KCN. The maximum posterior-anterior corneal astigmatism ratio (PCA/ACA, 0.246) was found in patients with stage 1 KCN. Corneal astigmatism in anterior surface was more affected than posterior surface by increasing in the KCN severity, although PCA was more affected than ACA in an early stage of KCN.

Central Corneal Thickness Measurement Using Ultrasonic Pachymetry, Rotating Scheimpflug Camera, and Scanning-slit Topography Exclusively in Thin Non-keratoconic Corneas.

PubMed

Mohammadpour, Mehrdad; Mohammad, Kazem; Karimi, Nasser

2016-01-01

To evaluate the agreement among Pentacam, Orbscan and ultrasound (US) pachymetry for measurement of central corneal thickness (CCT) in thin corneas with normal topographic pattern. We included 88 eyes of 44 refractive surgery candidates with thinnest pachymetric readings of 500 micrometers (μm) or less on Orbscan, a normal topographic pattern, no sign of keratoconus, and best corrected visual acuity (BCVA) of 20/20. Pentacam, Orbscan and US were performed in one session by the same examiner. Exclusion criteria were history of ocular surgery, topographic abnormalities suggesting forme fruste keratoconus or keratectasia, and recent contact lens wear. The difference in CCT measurements by US pachymetry and Orbscan II [using an acoustic factor (AF) of 0.92] ranged from -34 to +34 μm. The difference between the thinnest point and central readings measured by US reached 16 μm with Orbscan II (AF: 0.92) and 2 μm with Pentacam. Mean differences between the employed devices were 0.2 μm for Pentacam versus US (P = 0.727), 30.1 μm for uncorrected Orbscan versus US (P < 0.001), 10.4 μm for Orbscan II (AF = 0.92) versus US (P < 0.001), and 0.2 μm for Orbscan II (AF = 0.94) versus US (P = 0.851). In normal thin corneas, Pentacam demonstrated better agreement with US pachymetry as compared to corrected Orbscan readings. Results achieved by Orbscan were better consistent with US pachymetry using an AF of 0.94. We speculate that a dynamically graded AF in reverse proportion to CCT constitutes a better approach for correcting Orbscan measurements.

Identification of four novel variants that influence central corneal thickness in multi-ethnic Asian populations.

PubMed

Cornes, Belinda K; Khor, Chiea Chuen; Nongpiur, Monisha E; Xu, Liang; Tay, Wan-Ting; Zheng, Yingfeng; Lavanya, Raghavan; Li, Yang; Wu, Renyi; Sim, Xueling; Wang, Ya-Xing; Chen, Peng; Teo, Yik Ying; Chia, Kee-Seng; Seielstad, Mark; Liu, Jianjun; Hibberd, Martin L; Cheng, Ching-Yu; Saw, Seang-Mei; Tai, E-Shyong; Jonas, Jost B; Vithana, Eranga N; Wong, Tien Y; Aung, Tin

2012-01-15

Central corneal thickness (CCT) is a highly heritable trait. Genes that significantly influence CCT can be candidate genes for common disorders in which CCT has been implicated, such as primary open-angle glaucoma (POAG) and keratoconus. Because the genetic factors controlling CCT in different Asian populations are unclear, we have built on previous work conducted on Singaporean Indians and Malays and extended our hypothesis to individuals of Chinese descent. We have followed up on all suggestive signals of association with CCT (P < 10(-4)) from the previously reported meta-analysis comprising Indians and Malays in a sample of Chinese individuals (n= 2681). In the combined sample (n= 7711), strong evidence of association was observed at four novel loci: IBTK on chromosome 6q14.1; CHSY1 on chromosome 15q26.3; and intergenic regions on chromosomes 7q11.2 and 9p23 (8.01 × 10(-11) < λ(GC) corrected P(meta) < 8.72 × 10(-8)). These four new loci explain an additional 4.3% of the total CCT variance across the sample cohorts over and above that of previously identified loci. We also extend on a previous finding at a fifth locus (AKAP13) where a new single-nucleotide polymorphism (rs1821481, P(meta) = 9.99 × 10(-9)) was found to be significantly more informative compared with the previously reported rs6496932 (P(meta) = 3.64 × 10(-5)). Performing association analysis in Asians may lead to the discovery of ethnic-specific genes that control CCT, offering further mechanistic insights into the regulation of CCT. In addition, it may also provide several candidate genes for interrogation for POAG, keratoconus and possible racial/ethnic variations. © The Author 2011. Published by Oxford University Press. All rights reserved.

Eccentric small-zone ray tracing wavefront aberrometry for refraction in keratoconus.

PubMed

Fredriksson, Anneli; Behndig, Anders

2016-11-01

To compare objective refraction using small-zone eccentric laser ray tracing (LRT) wavefront aberrometry to standard autorefraction in keratoconus (KC), and whether the visual acuities achieved with these refractions differ from corresponding values in healthy eyes. Twenty-nine eyes of 29 patients with KC and 29 eyes of 29 healthy controls were included in this prospective unmasked case-control study. The uncorrected (UCVA) and spectacle-corrected (SCVA) Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuities based on refractions derived from LRT in central and four eccentric zones were compared to those achieved with standard autorefraction. The spherical equivalent (M) and two astigmatic power vectors (C0 and C45) were calculated for all refractions. Pentacam HR ® was used to generate keratometry readings of the corresponding zones. In KC, the refraction from the upper nasal zone rendered a higher SCVA than the standard autorefraction more often than in the controls (p < 0.001). There were no significant variation in M between the different LRT measurement points in the control group, but central data provided the best SCVA. The UCVA:s and SCVA:s were worse in KC, and the KC eyes showed inferior myopia and superior hyperopia. Multiple refractions rendered similar SCVA:s in KC. Pentacam HR ® showed higher keratometry readings infero-temporally, but also lower readings supero-nasally, compared to controls. In KC, eccentric LRT measurements gave better SCVA than standard autorefraction more often than in healthy eyes. Eccentric LRT may become a valuable tool in the demanding task of subjective refraction in KC. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Accelerated versus conventional corneal collagen cross-linking in patients with keratoconus: an intrapatient comparative study.

PubMed

Sadoughi, Mohammad Mehdi; Einollahi, Bahram; Baradaran-Rafii, Alireza; Roshandel, Danial; Hasani, Hamidreza; Nazeri, Mehrdad

2018-02-01

To compare the outcomes of the conventional and accelerated corneal collagen cross-linking (CXL) in patients with bilateral progressive keratoconus (KC). Fifteen consecutive patients with bilateral progressive KC were enrolled. In each patient, the fellow eyes were randomly assigned to the conventional CXL (3 mW/cm 2 for 30 min) or accelerated CXL (ACXL) (9 mW/cm 2 for 10 min) groups. Manifest refraction; uncorrected and corrected distant visual acuity; maximum and mean keratometry; corneal hysteresis and corneal resistance factor; endothelial cell density and morphology; central corneal thickness; and wavefront aberrations were measured before and 12 months after the CXL. Manifest refraction spherical equivalent and refractive cylinder improved significantly only in conventional group. Uncorrected and corrected distant visual acuity did not change significantly in either group. Also there was no significant change in the maximum and mean keratometry after 12 months. There was significant decrease in central corneal thickness in both groups which was more prominent in conventional group. Endothelial cell density reduced only in the conventional group which was not statistically significant (P = 0.147). CH, CRF, and wavefront aberrations did not change significantly in either group. We did not observe any significant difference in the changes of the variables between the two groups. Accelerated CXL with 9 mW/cm 2 irradiation for 10 min had similar refractive, visual, keratometric, and aberrometric results and less adverse effects on the corneal thickness and endothelial cells as compared with the conventional method after 12 months follow-up. However, randomized clinical trials with longer follow-ups and larger sample sizes are needed.

Enhanced Combined Tomography and Biomechanics Data for Distinguishing Forme Fruste Keratoconus.

PubMed

Luz, Allan; Lopes, Bernardo; Hallahan, Katie M; Valbon, Bruno; Ramos, Isaac; Faria-Correia, Fernando; Schor, Paulo; Dupps, William J; Ambrósio, Renato

2016-07-01

To evaluate the performance of the Ocular Response Analyzer (ORA) (Reichert Ophthalmic Instruments, Depew, NY) variables and Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) tomographic parameters in differentiating forme fruste keratoconus (FFKC) from normal corneas, and to assess a combined biomechanical and tomographic parameter to improve outcomes. Seventy-six eyes of 76 normal patients and 21 eyes of 21 patients with FFKC were included in the study. Fifteen variables were derived from exported ORA signals to characterize putative indicators of biomechanical behavior and 37 ORA waveform parameters were tested. Sixteen tomographic parameters from Pentacam HR were tested. Logistic regression was used to produce a combined biomechanical and tomography linear model. Differences between groups were assessed by the Mann-Whitney U test. The area under the receiver operating characteristics curve (AUROC) was used to compare diagnostic performance. No statistically significant differences were found in age, thinnest point, central corneal thickness, and maximum keratometry between groups. Twenty-one parameters showed significant differences between the FFKC and control groups. Among the ORA waveform measurements, the best parameters were those related to the area under the first peak, p1area1 (AUROC, 0.717 ± 0.065). Among the investigator ORA variables, a measure incorporating the pressure-deformation relationship of the entire response cycle was the best predictor (hysteresis loop area, AUROC, 0.688 ± 0.068). Among tomographic parameters, Belin/Ambrósio display showed the highest predictive value (AUROC, 0.91 ± 0.057). A combination of parameters showed the best result (AUROC, 0.953 ± 0.024) outperforming individual parameters. Tomographic and biomechanical parameters demonstrated the ability to differentiate FFKC from normal eyes. A combination of both types of information further improved predictive value. [J Refract Surg. 2016;32(7):479-485.]. Copyright 2016, SLACK Incorporated.

Corneal thickness and elevation measurements using swept-source optical coherence tomography and slit scanning topography in normal and keratoconic eyes.

PubMed

Jhanji, Vishal; Yang, Bingzhi; Yu, Marco; Ye, Cong; Leung, Christopher K S

2013-11-01

To compare corneal thickness and corneal elevation using swept source optical coherence tomography and slit scanning topography. Prospective study. 41 normal and 46 keratoconus subjects. All eyes were imaged using swept source optical coherence tomography and slit scanning tomography during the same visit. Mean corneal thickness and best-fit sphere measurements were compared between the instruments. Agreement of measurements between swept source optical coherence tomography and scanning slit topography was analyzed. Intra-rater reproducibility coefficient and intraclass correlation coefficient were evaluated. In normal eyes, central corneal thickness measured by swept source optical coherence tomography was thinner compared with slit scanning topography (p < 0.0001) and ultrasound pachymetry (p = < .0001). Ultrasound pachymetry readings had better 95% limits of agreement with swept source optical coherence tomography than slit scanning topography. In keratoconus eyes, central corneal thickness was thinner on swept source optical coherence tomography than slit scanning topography (p = 0.081) and ultrasound pachymetry (p = 0.001). There were significant differences between thinnest corneal thickness, and, anterior and posterior best-fit sphere measurements between both instruments (p < 0.05 for all). Overall, reproducibility coefficients and intraclass correlation coefficients were significantly better with swept source optical coherence tomography for measurement of central corneal thickness, anterior best-fit sphere and, posterior best-fit sphere (all p < 0.001). Corneal thickness and elevation measurements were significantly different between swept source optical coherence tomography and slit scanning topography. With better reproducibility coefficients and intraclass correlation coefficients, swept source optical coherence tomography may provide a reliable alternative for measurement of corneal parameters. © 2013 The Authors. Clinical and Experimental Ophthalmology © 2013 Royal Australian and New Zealand College of Ophthalmologists.

An Evaluation of Lysyl Oxidase–Derived Cross-Linking in Keratoconus by Liquid Chromatography/Mass Spectrometry

PubMed Central

Takaoka, Anna; Babar, Natasha; Hogan, Julia; Kim, MiJung; Price, Marianne O.; Price, Francis W.; Trokel, Stephen L.; Paik, David C.

2016-01-01

Purpose Current literature contains scant information regarding the extent of enzymatic collagen cross-linking in the keratoconus (KC) cornea. The aim of the present study was to examine levels of enzymatic lysyl oxidase–derived cross-links in stromal collagen in KC tissue, and to correlate the cross-link levels with collagen fibril stability as determined by thermal denaturation temperature (Tm). Methods Surgical KC samples (n = 17) and Eye-Bank control (n = 11) corneas of age 18 to 68 years were analyzed. The samples were defatted, reduced (NaBH4), hydrolyzed (6N HCl at 110°C for 18 hours), and cellulose enriched before analysis by C8 high-performance liquid chromatography equipped with parallel fluorescent and mass detectors in selective ion monitoring mode (20 mM heptafluorobutyric acid/methanol 70:30 isocratic at 1 mL/min). Nine different cross-links were measured, and the cross-link density was determined relative to collagen content (determined colorimetrically). The Tm was determined by differential scanning calorimetry. Results Cross-links detected were dihydroxylysinonorleucine (DHLNL), hydroxylysinonorleucine, lysinonorleucine (LNL), and histidinohydroxylysinonorleucine in both control and KC samples. Higher DHLNL levels were detected in KC, whereas the dominant cross-link, LNL, was decreased in KC samples. Decreased LNL levels were observed among KC ≤ 40 corneas. There was no difference in total cross-link density between KC samples and the controls. Pyridinolines, desmosines, and pentosidine were not detected. There was no notable correlation between cross-link levels with fibril instability as determined by Tm. Conclusions Lower levels of LNL in the KC cornea suggest that there might be a cross-linking defect either in fibrillar collagen or the microfibrillar elastic network composed of fibrillin. PMID:26780316

Transepithelial corneal collagen cross-linking in keratoconus.

PubMed

Leccisotti, Antonio; Islam, Tahmina

2010-12-01

To evaluate the clinical effects of transepithelial corneal cross-linking (CXL) on keratoconic eyes pre-treated with substances enhancing epithelial permeability. Prospective, consecutive, single-masked, paired-eye study on 51 patients. The eye with more severe keratoconus was treated; the fellow eye served as the control. Gentamicin, benzalkonium chloride, and ethylenediaminetetraacetic acid were instilled for 3 hours, then oxybuprocaine for 30 minutes. Riboflavin 0.1% in 20% dextran T500 and oxybuprocaine were instilled for 30 minutes. Finally, ultraviolet A irradiation to the central 7.5 mm of the cornea was applied for 30 minutes, while riboflavin was instilled every 5 minutes. Mean corrected distance visual acuity improved by 0.036 logMAR after CXL and worsened by 0.039 logMAR in the control eyes (P<.05). Safety index was 1.05 after CXL and 0.96 in the control group. Mean spherical equivalent refraction decreased by 0.35 D (less myopic) after CXL and increased by 0.83 diopters (D) in the control eyes (P<.05). Mean apex curvature on tangential videokeratography increased by 0.51 D after CXL and by 1.61 D in the control eyes (P=.16). Mean average simulated keratometry decreased by 0.10 D after CXL and increased by 0.88 D in the control eyes (P<.05). Mean index of surface variance increased (worsened) by 0.9 after CXL and 5.3 in the control eyes (P<.05). Mean endothelial cell density was unchanged. A limited but favorable effect of transepithelial CXL was noted on keratoconic eyes, without complications. The effect appears to be less pronounced than described in the literature after CXL with de-epithelialization. Copyright 2010, SLACK Incorporated.

Variants in SKP1, PROB1, and IL17B genes at keratoconus 5q31.1–q35.3 susceptibility locus identified by whole-exome sequencing

PubMed Central

Karolak, Justyna A; Gambin, Tomasz; Pitarque, Jose A; Molinari, Andrea; Jhangiani, Shalini; Stankiewicz, Pawel; Lupski, James R; Gajecka, Marzena

2017-01-01

Keratoconus (KTCN) is a protrusion and thinning of the cornea, resulting in impairment of visual function. The extreme genetic heterogeneity makes it difficult to discover factors unambiguously influencing the KTCN phenotype. In this study, we used whole-exome sequencing (WES) and Sanger sequencing to reduce the number of candidate genes at the 5q31.1–q35.3 locus and to prioritize other potentially relevant variants in an Ecuadorian family with KTCN. We applied WES in two affected KTCN individuals from the Ecuadorian family that showed a suggestive linkage between the KTCN phenotype and the 5q31.1–q35.3 locus. Putative variants identified by WES were further evaluated in this family using Sanger sequencing. Exome capture discovered a total of 173 rare (minor allele frequency <0.001 in control population) nonsynonymous variants in both affected individuals. Among them, 16 SNVs were selected for further evaluation. Segregation analysis revealed that variants c.475T>G in SKP1, c.671G>A in PROB1, and c.527G>A in IL17B in the 5q31.1–q35.3 linkage region, and c.850G>A in HKDC1 in the 10q22 locus completely segregated with the phenotype in the studied KTCN family. We demonstrate that a combination of various techniques significantly narrowed the studied genomic region and reduced the list of the putative exonic variants. Moreover, since this locus overlapped two other chromosomal regions previously recognized in distinct KTCN studies, our findings suggest that this 5q31.1–q35.3 locus might be linked with KTCN. PMID:27703147

Reliability of Pentacam HR Thickness Maps of the Entire Cornea in Normal, Post-Laser In Situ Keratomileusis, and Keratoconus Eyes.

PubMed

Xu, Zhe; Peng, Mei; Jiang, Jun; Yang, Chun; Zhu, Weigen; Lu, Fan; Shen, Meixiao

2016-02-01

To measure the repeatability and reproducibility of Pentacam HR system thickness maps for the entire cornea in normal, post-laser in situ keratomileusis (post-LASIK), and keratoconus (KC) eyes. Reliability study. Sixty normal subjects (60 eyes), 30 post-LASIK subjects (60 eyes), and 14 KC patients (27 eyes) were imaged with the Pentacam HR system by 2 well-trained operators. For pachymetry the cornea was divided into 4 zones: a central zone (2-mm diameter) and concentric pericentral zone (2-5 mm), transitional zone (5-7 mm), and peripheral zone (7-10 mm). The 3 concentric zones were subdivided into 8 sectors. Intraobserver repeatability and interobserver reproducibility of entire corneal thickness maps were tested by the repeatability and reproducibility coefficients, intraclass correlation coefficients, coefficient of variation, and 95% limits of agreement. From central to peripheral zones, the precision of corneal thickness measurements became gradually smaller. Central zone repeatability and reproducibility were the best in the normal, post-LASIK, and KC groups. The peripheral superior sectors showed poorer repeatability and reproducibility for all subjects. The intraobserver repeatability and interobserver reproducibility for all zones were ≤19.3 μm, ≤22.1 μm, and ≤20.7 μm, in the normal, post-LASIK, and KC groups, respectively. The intraobserver and interobserver coefficients of variation for all zones were ≤1.3%, ≤1.6%, and ≤1.6% for all 3 groups. Pentacam HR system pachymetry of the entire cornea provided good precision in normal, post-LASIK, and KC corneas. Thickness measurements in the peripheral cornea should be interpreted with caution in abnormal corneas after surgery or with diseases. Copyright © 2016 Elsevier Inc. All rights reserved.

Post-lens tear turbidity and visual quality after scleral lens wear.

PubMed

Carracedo, Gonzalo; Serramito-Blanco, Maria; Martin-Gil, Alba; Wang, Zicheng; Rodriguez-Pomar, Candela; Pintor, Jesús

2017-11-01

The aim was to evaluate the turbidity and thickness of the post-lens tear layer and its effect on visual quality in patients with keratoconus after the beginning of lens wear and before lens removal at the end of eight hours. Twenty-six patients with keratoconus (aged 36.95 ± 8.95 years) participated voluntarily in the study. The sample was divided into two groups: patients with intrastromal corneal ring (ICRS group) and patients without ICRS (KC group). Distance visual acuity (VA), contrast sensitivity, pachymetry, post-lens tear layer height and post-lens tear layer turbidity (percentage area occupied and number of particles per mm 2 ) were evaluated with optical coherence tomography before and after wearing a scleral lens. A significant increase of turbidity was found in all groups assessed (p < 0.05). The number of particles per square millimetre was eight times higher after scleral lens wear than at the beginning of wearing the lens for all groups. VA decreases in all groups after scleral lens wear (p < 0.001). All patients showed a statistical diminishing of contrast sensitivity after scleral lens wear (p < 0.05). A significant correlation was found for both turbidity parameters with distance VA but no correlation between turbidity and post-lens tear layer thickness at the beginning was found (p > 0.05). A strong correlation in all groups between the post-lens tear layer at the beginning and differences of tear layer thickness between two measures was also found (p < 0.05). The VA decrease during the scleral lens wearing, filled with preserved saline solution, was due to the increasing post-lens tear layer turbidity. © 2017 Optometry Australia.

Patient-Specific Computational Modeling of Keratoconus Progression and Differential Responses to Collagen Cross-linking

PubMed Central

Sinha Roy, Abhijit

2011-01-01

Purpose. To model keratoconus (KC) progression and investigate the differential responses of central and eccentric cones to standard and alternative collagen cross-linking (CXL) patterns. Methods. Three-dimensional finite element models (FEMs) were generated with clinical tomography and IOP measurements. Graded reductions in regional corneal hyperelastic properties and thickness were imposed separately in the less affected eye of a KC patient. Topographic results, including maximum curvature and first-surface, higher-order aberrations (HOAs), were compared to those of the more affected contralateral eye. In two eyes with central and eccentric cones, a standard broad-beam CXL protocol was simulated with 200- and 300-μm treatment depths and compared to spatially graded broad-beam and cone-centered CXL simulations. Results. In a model of KC progression, maximum curvature and HOA increased as regional corneal hyperelastic properties were decreased. A topographic cone could be generated without a reduction in corneal thickness. Simulation of standard 9-mm-diameter CXL produced decreases in corneal curvature comparable to clinical reports and affected cone location. A 100-μm increase in CXL depth enhanced flattening by 24% to 34% and decreased HOA by 22% to 31%. Topographic effects were greatest with cone-centered CXL simulations. Conclusions. Progressive hyperelastic weakening of a cornea with subclinical KC produced topographic features of manifest KC. The clinical phenomenon of topographic flattening after CXL was replicated. The magnitude and higher-order optics of this response depended on IOP and the spatial distribution of stiffening relative to the cone location. Smaller diameter simulated treatments centered on the cone provided greater reductions in curvature and HOA than a standard broad-beam CXL pattern. PMID:22039252

Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls.

PubMed

Johnson, Matthew W; Johnson, Patrick S; Herrmann, Evan S; Sweeney, Mary M

2015-01-01

Individuals with cocaine use disorders are disproportionately affected by HIV/AIDS, partly due to higher rates of unprotected sex. Recent research suggests delay discounting of condom use is a factor in sexual HIV risk. Delay discounting is a behavioral economic concept describing how delaying an event reduces that event's value or impact on behavior. Probability discounting is a related concept describing how the uncertainty of an event decreases its impact on behavior. Individuals with cocaine use disorders (n = 23) and matched non-cocaine-using controls (n = 24) were compared in decision-making tasks involving hypothetical outcomes: delay discounting of condom-protected sex (Sexual Delay Discounting Task), delay discounting of money, the effect of sexually transmitted infection (STI) risk on likelihood of condom use (Sexual Probability Discounting Task), and probability discounting of money. The Cocaine group discounted delayed condom-protected sex (i.e., were more likely to have unprotected sex vs. wait for a condom) significantly more than controls in two of four Sexual Delay Discounting Task partner conditions. The Cocaine group also discounted delayed money (i.e., preferred smaller immediate amounts over larger delayed amounts) significantly more than controls. In the Sexual Probability Discounting Task, both groups showed sensitivity to STI risk, however the groups did not differ. The Cocaine group did not consistently discount probabilistic money more or less than controls. Steeper discounting of delayed, but not probabilistic, sexual outcomes may contribute to greater rates of sexual HIV risk among individuals with cocaine use disorders. Probability discounting of sexual outcomes may contribute to risk of unprotected sex in both groups. Correlations showed sexual and monetary results were unrelated, for both delay and probability discounting. The results highlight the importance of studying specific behavioral processes (e.g., delay and probability discounting) with respect to specific outcomes (e.g., monetary and sexual) to understand decision making in problematic behavior.

Delay and Probability Discounting of Sexual and Monetary Outcomes in Individuals with Cocaine Use Disorders and Matched Controls

PubMed Central

Johnson, Matthew W.; Johnson, Patrick S.; Herrmann, Evan S.; Sweeney, Mary M.

2015-01-01

Individuals with cocaine use disorders are disproportionately affected by HIV/AIDS, partly due to higher rates of unprotected sex. Recent research suggests delay discounting of condom use is a factor in sexual HIV risk. Delay discounting is a behavioral economic concept describing how delaying an event reduces that event’s value or impact on behavior. Probability discounting is a related concept describing how the uncertainty of an event decreases its impact on behavior. Individuals with cocaine use disorders (n = 23) and matched non-cocaine-using controls (n = 24) were compared in decision-making tasks involving hypothetical outcomes: delay discounting of condom-protected sex (Sexual Delay Discounting Task), delay discounting of money, the effect of sexually transmitted infection (STI) risk on likelihood of condom use (Sexual Probability Discounting Task), and probability discounting of money. The Cocaine group discounted delayed condom-protected sex (i.e., were more likely to have unprotected sex vs. wait for a condom) significantly more than controls in two of four Sexual Delay Discounting Task partner conditions. The Cocaine group also discounted delayed money (i.e., preferred smaller immediate amounts over larger delayed amounts) significantly more than controls. In the Sexual Probability Discounting Task, both groups showed sensitivity to STI risk, however the groups did not differ. The Cocaine group did not consistently discount probabilistic money more or less than controls. Steeper discounting of delayed, but not probabilistic, sexual outcomes may contribute to greater rates of sexual HIV risk among individuals with cocaine use disorders. Probability discounting of sexual outcomes may contribute to risk of unprotected sex in both groups. Correlations showed sexual and monetary results were unrelated, for both delay and probability discounting. The results highlight the importance of studying specific behavioral processes (e.g., delay and probability discounting) with respect to specific outcomes (e.g., monetary and sexual) to understand decision making in problematic behavior. PMID:26017273

Realistic neurons can compute the operations needed by quantum probability theory and other vector symbolic architectures.

PubMed

Stewart, Terrence C; Eliasmith, Chris

2013-06-01

Quantum probability (QP) theory can be seen as a type of vector symbolic architecture (VSA): mental states are vectors storing structured information and manipulated using algebraic operations. Furthermore, the operations needed by QP match those in other VSAs. This allows existing biologically realistic neural models to be adapted to provide a mechanistic explanation of the cognitive phenomena described in the target article by Pothos & Busemeyer (P&B).

A Probability Based Approach for the Allocation of Player Draft Selections in Australian Rules Football

PubMed Central

Anthony, Bedford; Schembri, Adrian J.

2006-01-01

Australian Rules Football, governed by the Australian Football League (AFL) is the most popular winter sport played in Australia. Like North American team based leagues such as the NFL, NBA and NHL, the AFL uses a draft system for rookie players to join a team’s list. The existing method of allocating draft selections in the AFL is simply based on the reverse order of each team’s finishing position for that season, with teams winning less than or equal to 5 regular season matches obtaining an additional early round priority draft pick. Much criticism has been levelled at the existing system since it rewards losing teams and does not encourage poorly performing teams to win matches once their season is effectively over. We propose a probability-based system that allocates a score based on teams that win ‘unimportant’ matches (akin to Carl Morris’ definition of importance). We base the calculation of ‘unimportance’ on the likelihood of a team making the final eight following each round of the season. We then investigate a variety of approaches based on the ‘unimportance’ measure to derive a score for ‘unimportant’ and unlikely wins. We explore derivatives of this system, compare past draft picks with those obtained under our system, and discuss the attractiveness of teams knowing the draft reward for winning each match in a season. Key Points Draft choices are allocated using a probabilistic approach that rewards teams for winning unimportant matches. The method is based upon Carl Morris’ Importance and probabilistic calculations of making the finals. The importance of a match is calculated probabilistically to arrive at a DScore. Higher DScores are weighted towards teams winning unimportant matches which in turn lead to higher draft selections. Provides an alternative to current draft systems that are based on ‘losing to win’. PMID:24357945

Pretest probability assessment derived from attribute matching

PubMed Central

Kline, Jeffrey A; Johnson, Charles L; Pollack, Charles V; Diercks, Deborah B; Hollander, Judd E; Newgard, Craig D; Garvey, J Lee

2005-01-01

Background Pretest probability (PTP) assessment plays a central role in diagnosis. This report compares a novel attribute-matching method to generate a PTP for acute coronary syndrome (ACS). We compare the new method with a validated logistic regression equation (LRE). Methods Eight clinical variables (attributes) were chosen by classification and regression tree analysis of a prospectively collected reference database of 14,796 emergency department (ED) patients evaluated for possible ACS. For attribute matching, a computer program identifies patients within the database who have the exact profile defined by clinician input of the eight attributes. The novel method was compared with the LRE for ability to produce PTP estimation <2% in a validation set of 8,120 patients evaluated for possible ACS and did not have ST segment elevation on ECG. 1,061 patients were excluded prior to validation analysis because of ST-segment elevation (713), missing data (77) or being lost to follow-up (271). Results In the validation set, attribute matching produced 267 unique PTP estimates [median PTP value 6%, 1st–3rd quartile 1–10%] compared with the LRE, which produced 96 unique PTP estimates [median 24%, 1st–3rd quartile 10–30%]. The areas under the receiver operating characteristic curves were 0.74 (95% CI 0.65 to 0.82) for the attribute matching curve and 0.68 (95% CI 0.62 to 0.77) for LRE. The attribute matching system categorized 1,670 (24%, 95% CI = 23–25%) patients as having a PTP < 2.0%; 28 developed ACS (1.7% 95% CI = 1.1–2.4%). The LRE categorized 244 (4%, 95% CI = 3–4%) with PTP < 2.0%; four developed ACS (1.6%, 95% CI = 0.4–4.1%). Conclusion Attribute matching estimated a very low PTP for ACS in a significantly larger proportion of ED patients compared with a validated LRE. PMID:16095534

Low immunosuppressive burden after HLA-matched related or unrelated BMT using posttransplantation cyclophosphamide.

PubMed

Kanakry, Christopher G; Bolaños-Meade, Javier; Kasamon, Yvette L; Zahurak, Marianna; Durakovic, Nadira; Furlong, Terry; Mielcarek, Marco; Medeot, Marta; Gojo, Ivana; Smith, B Douglas; Kanakry, Jennifer A; Borrello, Ivan M; Brodsky, Robert A; Gladstone, Douglas E; Huff, Carol Ann; Matsui, William H; Swinnen, Lode J; Cooke, Kenneth R; Ambinder, Richard F; Fuchs, Ephraim J; de Lima, Marcos J; Andersson, Borje S; Varadhan, Ravi; O'Donnell, Paul V; Jones, Richard J; Luznik, Leo

2017-03-09

The intensive and prolonged immunosuppressive therapy required to prevent or treat graft-versus-host disease (GVHD) after allogeneic blood or marrow transplantation (alloBMT) puts patients at substantial risk for life-threatening infections, organ toxicity, and disease relapse. Posttransplantation cyclophosphamide (PTCy) can function as single-agent GVHD prophylaxis after myeloablative, HLA-matched related (MRD), or HLA-matched unrelated (MUD) donor T-cell-replete bone marrow allografting, obviating the need for additional prophylactic immunosuppression. However, patients who develop GVHD require supplemental treatment. We assessed the longitudinal requirement for immunosuppressive therapy in 339 patients treated with this transplantation platform: 247 receiving busulfan/cyclophosphamide (BuCy) conditioning (data collected retrospectively) and 92 receiving busulfan/fludarabine (BuFlu) conditioning (data collected prospectively). Approximately 50% of MRD patients and 30% of MUD patients never required immunosuppression beyond PTCy. In patients requiring further immunosuppression, typically only 1 to 2 agents were required, and the median durations of systemic pharmacologic immunosuppression for the BuCy MRD, BuFlu MRD, BuCy MUD, and BuFlu MUD groups all were 4.5 to 5 months. For these 4 groups, 1-year probabilities of being alive and off all systemic immunosuppression were 61%, 53%, 53%, and 51% and 3-year probabilities were 53%, 48%, 49%, and 56%, respectively. These data suggest that PTCy minimizes the global immunosuppressive burden experienced by patients undergoing HLA-matched alloBMT.

Prevention and treatment of corneal graft rejection: current practice patterns of the Cornea Society (2011).

PubMed

Kharod-Dholakia, Bhairavi; Randleman, J Bradley; Bromley, Jennifer G; Stulting, R Doyle

2015-06-01

To analyze current practice patterns in the prevention and treatment of corneal graft rejection for both penetrating keratoplasty (PK) and endothelial keratoplasty (EK) and to compare these patterns with previously reported practices. In 2011, an electronic survey was sent to 670 members of the Cornea Society worldwide addressing the routine postoperative management of corneal transplants at different time points, treatment of various manifestations of corneal graft rejection, and preferred surgical techniques. A total of 204 of 670 surveys (30%) were returned and evaluated. All respondents used topical corticosteroids for routine postoperative management and treatment of endothelial graft rejection. Prednisolone was the topical steroid of choice in all clinical scenarios, similar to previous surveys from 1989 to 2004. Use of subconjunctival and systemic steroids increased for many scenarios of probable and definite graft rejection. Routine use of prednisolone decreased by approximately 10% from previous surveys, whereas difluprednate was used in 13% of high-risk eyes during the first 6 months. Dexamethasone, fluorometholone, and loteprednol use remained stable. Adjunctive topical cyclosporine use increased significantly for PK and EK. EK was the preferred technique for endothelial dysfunction, whereas PK and deep anterior lamellar keratoplasty were both used for keratoconus and anterior scars. Most respondents (75%) felt that graft rejection occurs more frequently after PK than after EK. Prednisolone remains the treatment of choice for management and treatment of graft rejection; however, since the introduction of difluprednate, its use has declined slightly since the introduction of difluprednate. Despite perceived differences in rejection rates, there were no differences in prophylactic steroid treatment for PK and EK.

[Management of corneal hydrops using air and micro-punctures].

PubMed

Campos Polo, R; Chacón Iglesias, J; Gamazo Carrasco, M; Mencía Bartolomé, J M; Solana Fajardo, J; García Guisado, D; Fernández Miranda, C; Bueno Álvarez-Arenas, J; Sánchez Trancón, Á; García Ardoy, E

2015-04-01

A 22-year- old woman with an acute hydrops and Descemet membrane detachment was managed by intracameral air injection combined with multiple corneal stromal venting incisions for the drainage of intrastromal fluid. No intraoperative complications were encountered, and the intrastromal fluid was resolved over 2 weeks. Acute corneal hydrops is a significant complication of keratoconus. If not treated, resolution usually occurs over a period of 2-4 months. The persistent oedema can cause complications, such as corneal neovascularisation, infection and corneal perforation. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Graph edit distance from spectral seriation.

PubMed

Robles-Kelly, Antonio; Hancock, Edwin R

2005-03-01

This paper is concerned with computing graph edit distance. One of the criticisms that can be leveled at existing methods for computing graph edit distance is that they lack some of the formality and rigor of the computation of string edit distance. Hence, our aim is to convert graphs to string sequences so that string matching techniques can be used. To do this, we use a graph spectral seriation method to convert the adjacency matrix into a string or sequence order. We show how the serial ordering can be established using the leading eigenvector of the graph adjacency matrix. We pose the problem of graph-matching as a maximum a posteriori probability (MAP) alignment of the seriation sequences for pairs of graphs. This treatment leads to an expression in which the edit cost is the negative logarithm of the a posteriori sequence alignment probability. We compute the edit distance by finding the sequence of string edit operations which minimizes the cost of the path traversing the edit lattice. The edit costs are determined by the components of the leading eigenvectors of the adjacency matrix and by the edge densities of the graphs being matched. We demonstrate the utility of the edit distance on a number of graph clustering problems.

Optimal background matching camouflage.

PubMed

Michalis, Constantine; Scott-Samuel, Nicholas E; Gibson, David P; Cuthill, Innes C

2017-07-12

Background matching is the most familiar and widespread camouflage strategy: avoiding detection by having a similar colour and pattern to the background. Optimizing background matching is straightforward in a homogeneous environment, or when the habitat has very distinct sub-types and there is divergent selection leading to polymorphism. However, most backgrounds have continuous variation in colour and texture, so what is the best solution? Not all samples of the background are likely to be equally inconspicuous, and laboratory experiments on birds and humans support this view. Theory suggests that the most probable background sample (in the statistical sense), at the size of the prey, would, on average, be the most cryptic. We present an analysis, based on realistic assumptions about low-level vision, that estimates the distribution of background colours and visual textures, and predicts the best camouflage. We present data from a field experiment that tests and supports our predictions, using artificial moth-like targets under bird predation. Additionally, we present analogous data for humans, under tightly controlled viewing conditions, searching for targets on a computer screen. These data show that, in the absence of predator learning, the best single camouflage pattern for heterogeneous backgrounds is the most probable sample. © 2017 The Authors.

Matching weights to simultaneously compare three treatment groups: Comparison to three-way matching

PubMed Central

Yoshida, Kazuki; Hernández-Díaz, Sonia; Solomon, Daniel H.; Jackson, John W.; Gagne, Joshua J.; Glynn, Robert J.; Franklin, Jessica M.

2017-01-01

BACKGROUND Propensity score matching is a commonly used tool. However, its use in settings with more than two treatment groups has been less frequent. We examined the performance of a recently developed propensity score weighting method in the three treatment group setting. METHODS The matching weight method is an extension of inverse probability of treatment weighting (IPTW) that reweights both exposed and unexposed groups to emulate a propensity score matched population. Matching weights can generalize to multiple treatment groups. The performance of matching weights in the three-group setting was compared via simulation to three-way 1:1:1 propensity score matching and IPTW. We also applied these methods to an empirical example that compared the safety of three analgesics. RESULTS Matching weights had similar bias, but better mean squared error (MSE) compared to three-way matching in all scenarios. The benefits were more pronounced in scenarios with a rare outcome, unequally sized treatment groups, or poor covariate overlap. IPTW’s performance was highly dependent on covariate overlap. In the empirical example, matching weights achieved the best balance for 24 out of 35 covariates. Hazard ratios were numerically similar to matching. However, the confidence intervals were narrower for matching weights. CONCLUSIONS Matching weights demonstrated improved performance over three-way matching in terms of MSE, particularly in simulation scenarios where finding matched subjects was difficult. Given its natural extension to settings with even more than three groups, we recommend matching weights for comparing outcomes across multiple treatment groups, particularly in settings with rare outcomes or unequal exposure distributions. PMID:28151746

Drawbacks in the scientification of forensic science.

PubMed

Biedermann, A; Curran, J

2014-12-01

This letter to the Editor comments on the article On the limitations of probability in conceptualizing pattern matches in forensic science by P. T. Jayaprakash (Forensic Science International, [10]). Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Mercury: surface composition from the reflection spectrum.

PubMed

McCord, T B; Adams, J B

1972-11-17

The reflection spectrum for the integral disk of the planet Mercury was measured and was found to have a constant positive slope from 0.32 to 1.05 micrometers, except for absorption features in the infrared. The reflectivity curve matches closely the curve for the lunar upland and mare regions. Thus, the surface of Mercury is probably covered with a lunar-like soil rich in dark glasses of high iron and titanium content. Pyroxene is probably the dominant mafic mineral.

Reducing the likelihood of long tennis matches.

PubMed

Barnett, Tristan; Alan, Brown; Pollard, Graham

2006-01-01

Long matches can cause problems for tournaments. For example, the starting times of subsequent matches can be substantially delayed causing inconvenience to players, spectators, officials and television scheduling. They can even be seen as unfair in the tournament setting when the winner of a very long match, who may have negative aftereffects from such a match, plays the winner of an average or shorter length match in the next round. Long matches can also lead to injuries to the participating players. One factor that can lead to long matches is the use of the advantage set as the fifth set, as in the Australian Open, the French Open and Wimbledon. Another factor is long rallies and a greater than average number of points per game. This tends to occur more frequently on the slower surfaces such as at the French Open. The mathematical method of generating functions is used to show that the likelihood of long matches can be substantially reduced by using the tiebreak game in the fifth set, or more effectively by using a new type of game, the 50-40 game, throughout the match. Key PointsThe cumulant generating function has nice properties for calculating the parameters of distributions in a tennis matchA final tiebreaker set reduces the length of matches as currently being used in the US OpenA new 50-40 game reduces the length of matches whilst maintaining comparable probabilities for the better player to win the match.

Reducing the Likelihood of Long Tennis Matches

PubMed Central

Barnett, Tristan; Alan, Brown; Pollard, Graham

2006-01-01

Long matches can cause problems for tournaments. For example, the starting times of subsequent matches can be substantially delayed causing inconvenience to players, spectators, officials and television scheduling. They can even be seen as unfair in the tournament setting when the winner of a very long match, who may have negative aftereffects from such a match, plays the winner of an average or shorter length match in the next round. Long matches can also lead to injuries to the participating players. One factor that can lead to long matches is the use of the advantage set as the fifth set, as in the Australian Open, the French Open and Wimbledon. Another factor is long rallies and a greater than average number of points per game. This tends to occur more frequently on the slower surfaces such as at the French Open. The mathematical method of generating functions is used to show that the likelihood of long matches can be substantially reduced by using the tiebreak game in the fifth set, or more effectively by using a new type of game, the 50-40 game, throughout the match. Key Points The cumulant generating function has nice properties for calculating the parameters of distributions in a tennis match A final tiebreaker set reduces the length of matches as currently being used in the US Open A new 50-40 game reduces the length of matches whilst maintaining comparable probabilities for the better player to win the match. PMID:24357951

Radio-nuclide mixture identification using medium energy resolution detectors

DOEpatents

Nelson, Karl Einar

2013-09-17

According to one embodiment, a method for identifying radio-nuclides includes receiving spectral data, extracting a feature set from the spectral data comparable to a plurality of templates in a template library, and using a branch and bound method to determine a probable template match based on the feature set and templates in the template library. In another embodiment, a device for identifying unknown radio-nuclides includes a processor, a multi-channel analyzer, and a memory operatively coupled to the processor, the memory having computer readable code stored thereon. The computer readable code is configured, when executed by the processor, to receive spectral data, to extract a feature set from the spectral data comparable to a plurality of templates in a template library, and to use a branch and bound method to determine a probable template match based on the feature set and templates in the template library.

Analytical study of nano-scale logical operations

NASA Astrophysics Data System (ADS)

Patra, Moumita; Maiti, Santanu K.

2018-07-01

A complete analytical prescription is given to perform three basic (OR, AND, NOT) and two universal (NAND, NOR) logic gates at nano-scale level using simple tailor made geometries. Two different geometries, ring-like and chain-like, are taken into account where in each case the bridging conductor is coupled to a local atomic site through a dangling bond whose site energy can be controlled by means of external gate electrode. The main idea is that when injecting electron energy matches with site energy of local atomic site transmission probability drops exactly to zero, whereas the junction exhibits finite transmission for other energies. Utilizing this prescription we perform logical operations, and, we strongly believe that the proposed results can be verified in laboratory. Finally, we numerically compute two-terminal transmission probability considering general models and the numerical results match exactly well with our analytical findings.

Data registration for automated non-destructive inspection with multiple data sets

NASA Astrophysics Data System (ADS)

Tippetts, T.; Brierley, N.; Cawley, P.

2013-01-01

In many NDE applications, multiple sources of data are available covering the same region of a part under inspection. These overlapping data can come from intersecting scan patterns, sensors in an array configuration, or repeated inspections at different times. In many cases these data sets are analysed independently, with separate assessments for each channel or data file. It should be possible to improve the overall reliability of the inspection by combining multiple sources of information, simultaneously increasing the Probability of Detection (POD) and decreasing the Probability of False Alarm (PFA). Data registration, i.e. mapping the data to matching coordinates in space, is both an essential prerequisite and a challenging obstacle to this type of data fusion. This paper describes optimization techniques for matching and aligning features in NDE data. Examples from automated ultrasound inspection of aircraft engine discs illustrate the approach.

The correct estimate of the probability of false detection of the matched filter in weak-signal detection problems

NASA Astrophysics Data System (ADS)

Vio, R.; Andreani, P.

2016-05-01

The reliable detection of weak signals is a critical issue in many astronomical contexts and may have severe consequences for determining number counts and luminosity functions, but also for optimizing the use of telescope time in follow-up observations. Because of its optimal properties, one of the most popular and widely-used detection technique is the matched filter (MF). This is a linear filter designed to maximise the detectability of a signal of known structure that is buried in additive Gaussian random noise. In this work we show that in the very common situation where the number and position of the searched signals within a data sequence (e.g. an emission line in a spectrum) or an image (e.g. a point-source in an interferometric map) are unknown, this technique, when applied in its standard form, may severely underestimate the probability of false detection. This is because the correct use of the MF relies upon a priori knowledge of the position of the signal of interest. In the absence of this information, the statistical significance of features that are actually noise is overestimated and detections claimed that are actually spurious. For this reason, we present an alternative method of computing the probability of false detection that is based on the probability density function (PDF) of the peaks of a random field. It is able to provide a correct estimate of the probability of false detection for the one-, two- and three-dimensional case. We apply this technique to a real two-dimensional interferometric map obtained with ALMA.

Characterization of Ocular Biomechanics in Pellucid Marginal Degeneration.

PubMed

Lenk, Janine; Haustein, Michael; Terai, Naim; Spoerl, Eberhard; Raiskup, Frederik

2016-04-01

This study sought to investigate the diagnostic capacity of corneal biomechanical response parameters in a group of patients with pellucid marginal degeneration (PMD) using the Ocular Response Analyzer (ORA) and Corvis ST devices. In this prospective clinical study, we used the Corvis ST and ORA devices to investigate the ocular biomechanics of patients with PMD. Eighty-one eyes were included, and 2 study groups were formed: the PMD group (the study group, n = 29) and the control group (n = 52). We focused on 13 biomechanical parameters. Statistical analysis was performed using SPSS. Biomechanical parameters for the 2 groups were compared using analysis of covariance. The ORA results demonstrated that the Keratoconus Match Index was significantly lower in the PMD group than in the control group (0.031 ± 0.37 vs. 0.79 ± 0.33; P = 0.001). The 2 groups did not significantly differ with respect to intraocular pressure- and central corneal thickness-adjusted values for corneal hysteresis or corneal resistance factor. Regarding the Corvis parameters, differences between the control and PMD groups were detected for CorWmax amp (control 1.01 ± 0.01, PMD 1.06 ± 0.01; P = 0.020) and CorA2 t (control 21.78 ± 0.03, PMD 21.66 ± 0.04; P = 0.0003). We identified 2 Corvis parameters that could be used to characterize PMD and differentiate PMD corneas from normal corneas. These parameters support the hypothesis that there is significantly less deformation of the central cornea in PMD corneas than in healthy corneas. However, because useful "first-line" diagnostic devices for diagnosing PMD (such as Pentacam and the ORA) exist, the Corvis ST serves as an additional diagnostic tool that can also be used for long-term monitoring after diagnosis confirmation.

Quantitative OCT-based longitudinal evaluation of intracorneal ring segment implantation in keratoconus.

PubMed

Pérez-Merino, Pablo; Ortiz, Sergio; Alejandre, Nicolas; Jiménez-Alfaro, Ignacio; Marcos, Susana

2013-09-09

To characterize the geometrical properties of keratoconic corneas upon intracorneal ring segments (ICRS) implantation, using custom-developed optical coherence tomography (OCT). Ten keratoconic corneas were measured pre- and post-ICRS surgery (7, 30, and 90 days). Corneal topographic and pachymetric maps were obtained from three-dimensional (3D) images acquired with OCT, provided with custom algorithms for image analysis, distortion correction, and quantification. The 3D positioning of the ICRS was also estimated longitudinally, relative to the pupil center and iris plane. Preoperatively, the average corneal radii of curvature were 7.02 ± 0.54 mm (anterior) and 5.40 ± 0.77 mm (posterior), and the minimum corneal thickness was 384 ± 60 μm. At 90 days, the average corneal radii of curvature were 7.26 ± 0.53 mm (anterior) and 5.44 ± 0.71 mm (posterior), and the minimum corneal thickness was 396 ± 46 μm. ICRS implantation produced a significant decrease of corneal power (by 1.71 ± 1.83 diopters [D] at 90 days). Corneal irregularities (defined by high order Zernike terms of the corneal elevation maps) and the corneal thickness distribution decreased in some patients and increased in others. The 3D ICRS depth matched the planned ICRS depth well (within 23.93 ± 23.49 μm). On average, ICRS showed an overall tilt of -6.8 ± 2.6° (temporal) and -2.1 ± 0.8° (superior) at 7 days. Spectral OCT (sOCT) provided with distortion correction and analysis tools, is an excellent instrument for evaluating the changes produced by ICRS in keratoconic corneas, and for analyzing the 3D ICRS position during the follow up. ICRS produced flattening on the anterior corneal surface, although the benefit for corneal surface regularization varied across patients.

A multimodal detection model of dolphins to estimate abundance validated by field experiments.

PubMed

Akamatsu, Tomonari; Ura, Tamaki; Sugimatsu, Harumi; Bahl, Rajendar; Behera, Sandeep; Panda, Sudarsan; Khan, Muntaz; Kar, S K; Kar, C S; Kimura, Satoko; Sasaki-Yamamoto, Yukiko

2013-09-01

Abundance estimation of marine mammals requires matching of detection of an animal or a group of animal by two independent means. A multimodal detection model using visual and acoustic cues (surfacing and phonation) that enables abundance estimation of dolphins is proposed. The method does not require a specific time window to match the cues of both means for applying mark-recapture method. The proposed model was evaluated using data obtained in field observations of Ganges River dolphins and Irrawaddy dolphins, as examples of dispersed and condensed distributions of animals, respectively. The acoustic detection probability was approximately 80%, 20% higher than that of visual detection for both species, regardless of the distribution of the animals in present study sites. The abundance estimates of Ganges River dolphins and Irrawaddy dolphins fairly agreed with the numbers reported in previous monitoring studies. The single animal detection probability was smaller than that of larger cluster size, as predicted by the model and confirmed by field data. However, dense groups of Irrawaddy dolphins showed difference in cluster sizes observed by visual and acoustic methods. Lower detection probability of single clusters of this species seemed to be caused by the clumped distribution of this species.

No shortcut solution to the problem of Y-STR match probability calculation.

PubMed

Caliebe, Amke; Jochens, Arne; Willuweit, Sascha; Roewer, Lutz; Krawczak, Michael

2015-03-01

Match probability calculation is deemed much more intricate for lineage genetic markers, including Y-chromosomal short tandem repeats (Y-STRs), than for autosomal markers. This is because, owing to the lack of recombination, strong interdependence between markers is likely, which implies that haplotype frequency estimates cannot simply be obtained through the multiplication of allele frequency estimates. As yet, however, the practical relevance of this problem has not been studied in much detail using real data. In fact, such scrutiny appears well warranted because the high mutation rates of Y-STRs and the possibility of backward mutation should have worked against the statistical association of Y-STRs. We examined haplotype data of 21 markers included in the PowerPlex(®)Y23 set (PPY23, Promega Corporation, Madison, WI) originating from six different populations (four European and two Asian). Assessing the conditional entropies of the markers, given different subsets of markers from the same panel, we demonstrate that the PowerPlex(®)Y23 set cannot be decomposed into smaller marker subsets that would be (conditionally) independent. Nevertheless, in all six populations, >94% of the joint entropy of the 21 markers is explained by the seven most rapidly mutating markers. Although this result might render a reduction in marker number a sensible option for practical casework, the partial haplotypes would still be almost as diverse as the full haplotypes. Therefore, match probability calculation remains difficult and calls for the improvement of currently available methods of haplotype frequency estimation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The performance of different propensity score methods for estimating absolute effects of treatments on survival outcomes: A simulation study.

PubMed

Austin, Peter C; Schuster, Tibor

2016-10-01

Observational studies are increasingly being used to estimate the effect of treatments, interventions and exposures on outcomes that can occur over time. Historically, the hazard ratio, which is a relative measure of effect, has been reported. However, medical decision making is best informed when both relative and absolute measures of effect are reported. When outcomes are time-to-event in nature, the effect of treatment can also be quantified as the change in mean or median survival time due to treatment and the absolute reduction in the probability of the occurrence of an event within a specified duration of follow-up. We describe how three different propensity score methods, propensity score matching, stratification on the propensity score and inverse probability of treatment weighting using the propensity score, can be used to estimate absolute measures of treatment effect on survival outcomes. These methods are all based on estimating marginal survival functions under treatment and lack of treatment. We then conducted an extensive series of Monte Carlo simulations to compare the relative performance of these methods for estimating the absolute effects of treatment on survival outcomes. We found that stratification on the propensity score resulted in the greatest bias. Caliper matching on the propensity score and a method based on earlier work by Cole and Hernán tended to have the best performance for estimating absolute effects of treatment on survival outcomes. When the prevalence of treatment was less extreme, then inverse probability of treatment weighting-based methods tended to perform better than matching-based methods. © The Author(s) 2014.

The Influence of Phonotactic Probability on Nonword Repetition and Fast Mapping in 3-Year-Olds With a History of Expressive Language Delay.

PubMed

MacRoy-Higgins, Michelle; Dalton, Kevin Patrick

2015-12-01

The purpose of this study was to examine the influence of phonotactic probability on sublexical (phonological) and lexical representations in 3-year-olds who had a history of being late talkers in comparison with their peers with typical language development. Ten 3-year-olds who were late talkers and 10 age-matched typically developing controls completed nonword repetition and fast mapping tasks; stimuli for both experimental procedures differed in phonotactic probability. Both participant groups repeated nonwords containing high phonotactic probability sequences more accurately than nonwords containing low phonotactic probability sequences. Participants with typical language showed an early advantage for fast mapping high phonotactic probability words; children who were late talkers required more exposures to the novel words to show the same advantage for fast mapping high phonotactic probability words. Children who were late talkers showed similar sensitivities to phonotactic probability in nonword repetition and word learning when compared with their peers with no history of language delay. However, word learning in children who were late talkers appeared to be slower when compared with their peers.

Probability of Finding Marrow Unrelated Donor (MUD) for an Indian patient in a Multi-national Human Leukocyte Antigen (HLA) Registry.

PubMed

Tiwari, Aseem K; Bhati-Kushwaha, Himakshi; Kukreja, Pooja; Mishra, Vikash C; Tyagi, Neetu; Sharma, Ashish; Raina, Vimarsh

2015-06-01

With an increase in the number of transplants happening globally, hematopoietic stem cells (HSC) transplantation from matched unrelated donor (MUD) has begun. The increasing trend of MUD transplants across countries has been largely facilitated with the conspicuous growth of volunteer HSC donor noted in the last decade i.e. 8 million HSC donors in 2002 to more than 22 million in 2013 registered in 71 member registries of the Bone Marrow Donor Worldwide (BMDW). Some populations of the world are still very poorly represented in these registries. Since, the chances of successful engraftment and disease free survival are directly proportional to the HLA compatibility between the recipient and the prospective donor, the diversity of the HLA system at the antigenic and allelic level and the heterogeneity of HLA data of the registered donors has a bearing on the probability of finding a volunteer unrelated HSC donor for patients from such populations. In the present study 126 patients were identified suffering from hematological diseases requiring MUD transplant. Their HLA typing was performed and search was done using BMDW database. The search results for these Indian patients in the multinational registry as well as in the Indian Registries were analyzed using mean, range, standard deviation and finally evaluated in terms of probability for finding matched donor (MUD). Total Asian population is only 11 % in the BMDW making it difficult to find a MUD for an Asian patient. The current study supports this, experimentally; revealing that the probability of finding an allele match for an Indian patient in the multinational Human Leukocyte Antigen (HLA) registries is 16 % and a dismal 0.008 % in the Indian registries (donors in Indian registries is just 33,678 as compared to 22.5 million in BMDW). This greatly, emphasizes on enhancing the number of Indian donors in Indian and multi-national registries.

Increased Plasma Beta-Secretase 1 May Predict Conversion to Alzheimer's Disease Dementia in Individuals With Mild Cognitive Impairment.

PubMed

Shen, Yong; Wang, Haibo; Sun, Qiying; Yao, Hailan; Keegan, Andrew P; Mullan, Mike; Wilson, Jeffrey; Lista, Simone; Leyhe, Thomas; Laske, Christoph; Rujescu, Dan; Levey, Allan; Wallin, Anders; Blennow, Kaj; Li, Rena; Hampel, Harald

2018-03-01

Increased beta-secretase 1 (BACE1) activity has consistently been detected in brain tissue and cerebrospinal fluid of subjects with mild cognitive impairment (MCI) and probable Alzheimer's disease (AD) compared with control subjects. The collection of cerebrospinal fluid by lumbar puncture is invasive. We sought to identify the presence of plasma BACE1 activity and determine potential alterations in subjects with MCI with clinical follow-up examinations for 3 years using patients with diagnosed probable AD dementia compared with healthy control subjects. Seventy-five patients with probable AD, 96 individuals with MCI, and 53 age-matched and sex-matched healthy control subjects were recruited from three independent international academic memory clinics and AD research expert centers. Plasma BACE1 activity was measured by a synthetic fluorescence substrate enzyme-linked immunosorbent assay. BACE1 protein expression was assessed by Western blotting using three different antibodies that recognize the epitopes of the N-terminus, C-terminus, and full-length BACE1. Compared with healthy control subjects, plasma BACE1 activity (V max ) significantly increased by 53.2% in subjects with MCI and by 68.9% in patients with probable AD. Subjects with MCI who converted to probable AD dementia at follow-up examinations exhibited significantly higher BACE1 activity compared with cognitively stable MCI nonconverters and showed higher levels of BACE1 activity than patients with AD. Plasma BACE1 activity is significantly increased in MCI converters and patients with probable AD. The sensitivities and specificities of BACE1 activity for the patients were 84% and 88%, respectively. Our results indicate that plasma BACE1 activity may be a biomarker for AD risk and could predict progression from prodromal to probable AD dementia. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

The Chandra Source Catalog 2.0: Early Cross-matches

NASA Astrophysics Data System (ADS)

Rots, Arnold H.; Allen, Christopher E.; Anderson, Craig S.; Budynkiewicz, Jamie A.; Burke, Douglas; Chen, Judy C.; Civano, Francesca Maria; D'Abrusco, Raffaele; Doe, Stephen M.; Evans, Ian N.; Evans, Janet D.; Fabbiano, Giuseppina; Gibbs, Danny G., II; Glotfelty, Kenny J.; Graessle, Dale E.; Grier, John D.; Hain, Roger; Hall, Diane M.; Harbo, Peter N.; Houck, John C.; Lauer, Jennifer L.; Laurino, Omar; Lee, Nicholas P.; Martínez-Galarza, Rafael; McCollough, Michael L.; McDowell, Jonathan C.; Miller, Joseph; McLaughlin, Warren; Morgan, Douglas L.; Mossman, Amy E.; Nguyen, Dan T.; Nichols, Joy S.; Nowak, Michael A.; Paxson, Charles; Plummer, David A.; Primini, Francis Anthony; Siemiginowska, Aneta; Sundheim, Beth A.; Tibbetts, Michael; Van Stone, David W.; Zografou, Panagoula

2018-01-01

Cross-matching the Chandra Source Catalog (CSC) with other catalogs presents considerable challenges, since the Point Spread Function (PSF) of the Chandra X-ray Observatory varies significantly over the field of view. For the second release of the CSC (CSC2) we have been developing a cross-match tool that is based on the Bayesian algorithms by Budavari, Heinis, and Szalay (ApJ 679, 301 and 705, 739), making use of the error ellipses for the derived positions of the sources.However, calculating match probabilities only on the basis of error ellipses breaks down when the PSFs are significantly different. Not only can bonafide matches easily be missed, but the scene is also muddied by ambiguous multiple matches. These are issues that are not commonly addressed in cross-match tools. We have applied a satisfactory modification to the algorithm that, although not perfect, ameliorates the problems for the vast majority of such cases.We will present some early cross-matches of the CSC2 catalog with obvious candidate catalogs and report on the determination of the absolute astrometric error of the CSC2 based on such cross-matches.This work has been supported by NASA under contract NAS 8-03060 to the Smithsonian Astrophysical Observatory for operation of the Chandra X-ray Center.

Chronology of Postglacial Eruptive Activity and Calculation of Eruption Probabilities for Medicine Lake Volcano, Northern California

USGS Publications Warehouse

Nathenson, Manuel; Donnelly-Nolan, Julie M.; Champion, Duane E.; Lowenstern, Jacob B.

2007-01-01

Medicine Lake volcano has had 4 eruptive episodes in its postglacial history (since 13,000 years ago) comprising 16 eruptions. Time intervals between events within the episodes are relatively short, whereas time intervals between the episodes are much longer. An updated radiocarbon chronology for these eruptions is presented that uses paleomagnetic data to constrain the choice of calibrated ages. This chronology is used with exponential, Weibull, and mixed-exponential probability distributions to model the data for time intervals between eruptions. The mixed exponential distribution is the best match to the data and provides estimates for the conditional probability of a future eruption given the time since the last eruption. The probability of an eruption at Medicine Lake volcano in the next year from today is 0.00028.

Exact one-sided confidence limits for the difference between two correlated proportions.

PubMed

Lloyd, Chris J; Moldovan, Max V

2007-08-15

We construct exact and optimal one-sided upper and lower confidence bounds for the difference between two probabilities based on matched binary pairs using well-established optimality theory of Buehler. Starting with five different approximate lower and upper limits, we adjust them to have coverage probability exactly equal to the desired nominal level and then compare the resulting exact limits by their mean size. Exact limits based on the signed root likelihood ratio statistic are preferred and recommended for practical use.

Improved Real-Time Scan Matching Using Corner Features

NASA Astrophysics Data System (ADS)

Mohamed, H. A.; Moussa, A. M.; Elhabiby, M. M.; El-Sheimy, N.; Sesay, Abu B.

2016-06-01

The automation of unmanned vehicle operation has gained a lot of research attention, in the last few years, because of its numerous applications. The vehicle localization is more challenging in indoor environments where absolute positioning measurements (e.g. GPS) are typically unavailable. Laser range finders are among the most widely used sensors that help the unmanned vehicles to localize themselves in indoor environments. Typically, automatic real-time matching of the successive scans is performed either explicitly or implicitly by any localization approach that utilizes laser range finders. Many accustomed approaches such as Iterative Closest Point (ICP), Iterative Matching Range Point (IMRP), Iterative Dual Correspondence (IDC), and Polar Scan Matching (PSM) handles the scan matching problem in an iterative fashion which significantly affects the time consumption. Furthermore, the solution convergence is not guaranteed especially in cases of sharp maneuvers or fast movement. This paper proposes an automated real-time scan matching algorithm where the matching process is initialized using the detected corners. This initialization step aims to increase the convergence probability and to limit the number of iterations needed to reach convergence. The corner detection is preceded by line extraction from the laser scans. To evaluate the probability of line availability in indoor environments, various data sets, offered by different research groups, have been tested and the mean numbers of extracted lines per scan for these data sets are ranging from 4.10 to 8.86 lines of more than 7 points. The set of all intersections between extracted lines are detected as corners regardless of the physical intersection of these line segments in the scan. To account for the uncertainties of the detected corners, the covariance of the corners is estimated using the extracted lines variances. The detected corners are used to estimate the transformation parameters between the successive scan using least squares. These estimated transformation parameters are used to calculate an adjusted initialization for scan matching process. The presented method can be employed solely to match the successive scans and also can be used to aid other accustomed iterative methods to achieve more effective and faster converge. The performance and time consumption of the proposed approach is compared with ICP algorithm alone without initialization in different scenarios such as static period, fast straight movement, and sharp manoeuvers.

HLA Mismatching Strategies for Solid Organ Transplantation – A Balancing Act

PubMed Central

Zachary, Andrea A.; Leffell, Mary S.

2016-01-01

HLA matching provides numerous benefits in organ transplantation including better graft function, fewer rejection episodes, longer graft survival, and the possibility of reduced immunosuppression. Mismatches are attended by more frequent rejection episodes that require increased immunosuppression that, in turn, can increase the risk of infection and malignancy. HLA mismatches also incur the risk of sensitization, which can reduce the opportunity and increase waiting time for a subsequent transplant. However, other factors such as donor age, donor type, and immunosuppression protocol, can affect the benefit derived from matching. Furthermore, finding a well-matched donor may not be possible for all patients and usually prolongs waiting time. Strategies to optimize transplantation for patients without a well-matched donor should take into account the immunologic barrier represented by different mismatches: what are the least immunogenic mismatches considering the patient’s HLA phenotype; should repeated mismatches be avoided; is the patient sensitized to HLA and, if so, what are the strengths of the patient’s antibodies? This information can then be used to define the HLA type of an immunologically optimal donor and the probability of such a donor occurring. A probability that is considered to be too low may require expanding the donor population through paired donation or modifying what is acceptable, which may require employing treatment to overcome immunologic barriers such as increased immunosuppression or desensitization. Thus, transplantation must strike a balance between the risk associated with waiting for the optimal donor and the risk associated with a less than optimal donor. PMID:28003816

Towards a Next-Generation Catalogue Cross-Match Service

NASA Astrophysics Data System (ADS)

Pineau, F.; Boch, T.; Derriere, S.; Arches Consortium

2015-09-01

We have been developing in the past several catalogue cross-match tools. On one hand the CDS XMatch service (Pineau et al. 2011), able to perform basic but very efficient cross-matches, scalable to the largest catalogues on a single regular server. On the other hand, as part of the European project ARCHES1, we have been developing a generic and flexible tool which performs potentially complex multi-catalogue cross-matches and which computes probabilities of association based on a novel statistical framework. Although the two approaches have been managed so far as different tracks, the need for next generation cross-match services dealing with both efficiency and complexity is becoming pressing with forthcoming projects which will produce huge high quality catalogues. We are addressing this challenge which is both theoretical and technical. In ARCHES we generalize to N catalogues the candidate selection criteria - based on the chi-square distribution - described in Pineau et al. (2011). We formulate and test a number of Bayesian hypothesis which necessarily increases dramatically with the number of catalogues. To assign a probability to each hypotheses, we rely on estimated priors which account for local densities of sources. We validated our developments by comparing the theoretical curves we derived with the results of Monte-Carlo simulations. The current prototype is able to take into account heterogeneous positional errors, object extension and proper motion. The technical complexity is managed by OO programming design patterns and SQL-like functionalities. Large tasks are split into smaller independent pieces for scalability. Performances are achieved resorting to multi-threading, sequential reads and several tree data-structures. In addition to kd-trees, we account for heterogeneous positional errors and object's extension using M-trees. Proper-motions are supported using a modified M-tree we developed, inspired from Time Parametrized R-trees (TPR-tree). Quantitative tests in comparison with the basic cross-match will be presented.

Quick probabilistic binary image matching: changing the rules of the game

NASA Astrophysics Data System (ADS)

Mustafa, Adnan A. Y.

2016-09-01

A Probabilistic Matching Model for Binary Images (PMMBI) is presented that predicts the probability of matching binary images with any level of similarity. The model relates the number of mappings, the amount of similarity between the images and the detection confidence. We show the advantage of using a probabilistic approach to matching in similarity space as opposed to a linear search in size space. With PMMBI a complete model is available to predict the quick detection of dissimilar binary images. Furthermore, the similarity between the images can be measured to a good degree if the images are highly similar. PMMBI shows that only a few pixels need to be compared to detect dissimilarity between images, as low as two pixels in some cases. PMMBI is image size invariant; images of any size can be matched at the same quick speed. Near-duplicate images can also be detected without much difficulty. We present tests on real images that show the prediction accuracy of the model.

Nested case-control studies: should one break the matching?

PubMed

Borgan, Ørnulf; Keogh, Ruth

2015-10-01

In a nested case-control study, controls are selected for each case from the individuals who are at risk at the time at which the case occurs. We say that the controls are matched on study time. To adjust for possible confounding, it is common to match on other variables as well. The standard analysis of nested case-control data is based on a partial likelihood which compares the covariates of each case to those of its matched controls. It has been suggested that one may break the matching of nested case-control data and analyse them as case-cohort data using an inverse probability weighted (IPW) pseudo likelihood. Further, when some covariates are available for all individuals in the cohort, multiple imputation (MI) makes it possible to use all available data in the cohort. In the paper we review the standard method and the IPW and MI approaches, and compare their performance using simulations that cover a range of scenarios, including one and two endpoints.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kreuzer, Helen W.; Horita, Juske; Moran, James J.

Sodium and potassium cyanide are highly toxic, produced in large amounts by the chemical industry, and linked to numerous high-profile crimes. The U.S. Centers for Disease Control and Prevention has identified cyanide as one of the most probable agents to be used in a future chemical terrorism event. We investigated whether stable C and N isotopic content of sodium and potassium cyanide could serve as a forensic signature for sample matching, using a collection of 65 cyanide samples. A few of these samples displayed non-homogeneous isotopic content associated with degradation to a carbonate salt and loss of hydrogen cyanide. Mostmore » samples had highly reproducible isotope content. Of these, >95% could be properly matched based on C and N isotope ratios, with a false match rate <3%. These results suggest that stable C and N isotope ratios are a useful forensic signature for matching cyanide samples.« less

Minimum Bayes risk image correlation

NASA Technical Reports Server (NTRS)

Minter, T. C., Jr.

1980-01-01

In this paper, the problem of designing a matched filter for image correlation will be treated as a statistical pattern recognition problem. It is shown that, by minimizing a suitable criterion, a matched filter can be estimated which approximates the optimum Bayes discriminant function in a least-squares sense. It is well known that the use of the Bayes discriminant function in target classification minimizes the Bayes risk, which in turn directly minimizes the probability of a false fix. A fast Fourier implementation of the minimum Bayes risk correlation procedure is described.

The correct estimate of the probability of false detection of the matched filter in weak-signal detection problems . II. Further results with application to a set of ALMA and ATCA data

NASA Astrophysics Data System (ADS)

Vio, R.; Vergès, C.; Andreani, P.

2017-08-01

The matched filter (MF) is one of the most popular and reliable techniques to the detect signals of known structure and amplitude smaller than the level of the contaminating noise. Under the assumption of stationary Gaussian noise, MF maximizes the probability of detection subject to a constant probability of false detection or false alarm (PFA). This property relies upon a priori knowledge of the position of the searched signals, which is usually not available. Recently, it has been shown that when applied in its standard form, MF may severely underestimate the PFA. As a consequence the statistical significance of features that belong to noise is overestimated and the resulting detections are actually spurious. For this reason, an alternative method of computing the PFA has been proposed that is based on the probability density function (PDF) of the peaks of an isotropic Gaussian random field. In this paper we further develop this method. In particular, we discuss the statistical meaning of the PFA and show that, although useful as a preliminary step in a detection procedure, it is not able to quantify the actual reliability of a specific detection. For this reason, a new quantity is introduced called the specific probability of false alarm (SPFA), which is able to carry out this computation. We show how this method works in targeted simulations and apply it to a few interferometric maps taken with the Atacama Large Millimeter/submillimeter Array (ALMA) and the Australia Telescope Compact Array (ATCA). We select a few potential new point sources and assign an accurate detection reliability to these sources.

MATCH package for the ANL three-view geometry program. [For matching particle tracks from various views to obtain proper input for TVGP

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gieraltowski, G.F.

1976-02-01

The ANL MATCH package consists of a set of 13 subroutines which are linked to the current 12-foot and 15-foot versions of the ANL TVGP program. Their purpose is to match the tracks from the various measured views to obtain a proper matched set of tracks to be processed by TVGP. The MATCH package can effectively handle up to 20 tracks per event measured in 2 or 3 views and, in cases of ambiguous match solutions, allow up to 10 match ambiguities. A basic assumption made is that the same number of tracks is measured in each view. MATCH canmore » work in either two or three measured views with the assumption that, if only two views are measured, the last point measured on each track is a good representation of the true end-point of the track. This is not to say that, if this assumption is false, that MATCH cannot obtain a match solution. It is true, however, that the probability of obtaining a match solution is inversely proportional both to the number of tracks per vertex and to the momentum of the tracks. Current uses of MATCH are in obtaining match solutions for two-view K/sup -/p (6.5 GeV/c) events measured on POLLY III and in obtaining match solutions for events with large numbers of tracks (3 to 10) produced by an anti ..nu.. p interaction in the FNAL 15-foot bubble chamber with a spectrum of momentum values ranging from 5 to 25 Gev/c. (RWR)« less

Shedding light on some possible remedies against watermark desynchronization: a case study

NASA Astrophysics Data System (ADS)

Barni, Mauro

2005-03-01

Watermark de-synchronization is perhaps the most dangerous attack against the great majority of watermarking systems proposed so far. Exhaustive search and template matching are two of the most popular solution against it, however several doubts exist about their effectiveness. As a matter of fact, a controversial point in digital watermarking is whether these techniques are of any help to cope with watermark de-synchronization introduced by geometric attacks. On one side, watermark synchronization through exhaustive search dramatically increases the false detection probability. On the other side, for the template matching approach the probability of a synchronization error must be taken into account, thus deteriorating significantly the performance of the system. It is the scope of this paper to shed some light on the above points. To do so we focus on a very simple case study, whereby we show that as long as the size of the search space (the cardinality of the geometric attack) increases polynomially with the length of the to-be-marked host feature sequence, both methods provide an effective solution to the de-synchronization problem. Interestingly, and rather surprisingly, we also show that Exhaustive Search Detection (ESD) always outperforms Template Matching Detection (TMD), though the general behavior of the two schemes is rather similar.

Video attention deviation estimation using inter-frame visual saliency map analysis

NASA Astrophysics Data System (ADS)

Feng, Yunlong; Cheung, Gene; Le Callet, Patrick; Ji, Yusheng

2012-01-01

A viewer's visual attention during video playback is the matching of his eye gaze movement to the changing video content over time. If the gaze movement matches the video content (e.g., follow a rolling soccer ball), then the viewer keeps his visual attention. If the gaze location moves from one video object to another, then the viewer shifts his visual attention. A video that causes a viewer to shift his attention often is a "busy" video. Determination of which video content is busy is an important practical problem; a busy video is difficult for encoder to deploy region of interest (ROI)-based bit allocation, and hard for content provider to insert additional overlays like advertisements, making the video even busier. One way to determine the busyness of video content is to conduct eye gaze experiments with a sizable group of test subjects, but this is time-consuming and costineffective. In this paper, we propose an alternative method to determine the busyness of video-formally called video attention deviation (VAD): analyze the spatial visual saliency maps of the video frames across time. We first derive transition probabilities of a Markov model for eye gaze using saliency maps of a number of consecutive frames. We then compute steady state probability of the saccade state in the model-our estimate of VAD. We demonstrate that the computed steady state probability for saccade using saliency map analysis matches that computed using actual gaze traces for a range of videos with different degrees of busyness. Further, our analysis can also be used to segment video into shorter clips of different degrees of busyness by computing the Kullback-Leibler divergence using consecutive motion compensated saliency maps.

Communicating the risk of injury in schoolboy rugby: using Poisson probability as an alternative presentation of the epidemiology.

PubMed

Parekh, Nikesh; Hodges, Stewart D; Pollock, Allyson M; Kirkwood, Graham

2012-06-01

The communication of injury risk in rugby and other sports is underdeveloped and parents, children and coaches need to be better informed about risk. A Poisson distribution was used to transform population based incidence of injury into average probabilities of injury to individual players. The incidence of injury in schoolboy rugby matches range from 7 to 129.8 injuries per 1000 player-hours; these rates translate to average probabilities of injury to a player of between 12% and 90% over a season. Incidence of injury and average probabilities of injury over a season should be published together in all future epidemiological studies on school rugby and other sports. More research is required on informing and communicating injury risks to parents, staff and children and how it affects monitoring, decision making and prevention strategies.

Probabilistic #D data fusion for multiresolution surface generation

NASA Technical Reports Server (NTRS)

Manduchi, R.; Johnson, A. E.

2002-01-01

In this paper we present an algorithm for adaptive resolution integration of 3D data collected from multiple distributed sensors. The input to the algorithm is a set of 3D surface points and associated sensor models. Using a probabilistic rule, a surface probability function is generated that represents the probability that a particular volume of space contains the surface. The surface probability function is represented using an octree data structure; regions of space with samples of large conariance are stored at a coarser level than regions of space containing samples with smaller covariance. The algorithm outputs an adaptive resolution surface generated by connecting points that lie on the ridge of surface probability with triangles scaled to match the local discretization of space given by the algorithm, we present results from 3D data generated by scanning lidar and structure from motion.

Gaia Data Release 1. Cross-match with external catalogues. Algorithm and results

NASA Astrophysics Data System (ADS)

Marrese, P. M.; Marinoni, S.; Fabrizio, M.; Giuffrida, G.

2017-11-01

Context. Although the Gaia catalogue on its own will be a very powerful tool, it is the combination of this highly accurate archive with other archives that will truly open up amazing possibilities for astronomical research. The advanced interoperation of archives is based on cross-matching, leaving the user with the feeling of working with one single data archive. The data retrieval should work not only across data archives, but also across wavelength domains. The first step for seamless data access is the computation of the cross-match between Gaia and external surveys. Aims: The matching of astronomical catalogues is a complex and challenging problem both scientifically and technologically (especially when matching large surveys like Gaia). We describe the cross-match algorithm used to pre-compute the match of Gaia Data Release 1 (DR1) with a selected list of large publicly available optical and IR surveys. Methods: The overall principles of the adopted cross-match algorithm are outlined. Details are given on the developed algorithm, including the methods used to account for position errors, proper motions, and environment; to define the neighbours; and to define the figure of merit used to select the most probable counterpart. Results: Statistics on the results are also given. The results of the cross-match are part of the official Gaia DR1 catalogue.

HLA Match Likelihoods for Hematopoietic Stem-Cell Grafts in the U.S. Registry

PubMed Central

Gragert, Loren; Eapen, Mary; Williams, Eric; Freeman, John; Spellman, Stephen; Baitty, Robert; Hartzman, Robert; Rizzo, J. Douglas; Horowitz, Mary; Confer, Dennis; Maiers, Martin

2018-01-01

Background Hematopoietic stem-cell transplantation (HSCT) is a potentially lifesaving therapy for several blood cancers and other diseases. For patients without a suitable related HLA-matched donor, unrelated-donor registries of adult volunteers and banked umbilical cord–blood units, such as the Be the Match Registry operated by the National Marrow Donor Program (NMDP), provide potential sources of donors. Our goal in the present study was to measure the likelihood of finding a suitable donor in the U.S. registry. Methods Using human HLA data from the NMDP donor and cord-blood-unit registry, we built population-based genetic models for 21 U.S. racial and ethnic groups to predict the likelihood of identifying a suitable donor (either an adult donor or a cord-blood unit) for patients in each group. The models incorporated the degree of HLA matching, adult-donor availability (i.e., ability to donate), and cord-blood-unit cell dose. Results Our models indicated that most candidates for HSCT will have a suitable (HLA-matched or minimally mismatched) adult donor. However, many patients will not have an optimal adult donor — that is, a donor who is matched at high resolution at HLA-A, HLA-B, HLA-C, and HLA-DRB1. The likelihood of finding an optimal donor varies among racial and ethnic groups, with the highest probability among whites of European descent, at 75%, and the lowest probability among blacks of South or Central American descent, at 16%. Likelihoods for other groups are intermediate. Few patients will have an optimal cord-blood unit — that is, one matched at the antigen level at HLA-A and HLA-B and matched at high resolution at HLA-DRB1. However, cord-blood units mismatched at one or two HLA loci are available for almost all patients younger than 20 years of age and for more than 80% of patients 20 years of age or older, regardless of racial and ethnic background. Conclusions Most patients likely to benefit from HSCT will have a donor. Public investment in donor recruitment and cord-blood banks has expanded access to HSCT. (Funded by the Office of Naval Research, Department of the Navy, and the Health Resources and Services Administration, Department of Health and Human Services.) PMID:25054717

HLA-matched sibling bone marrow transplantation for β-thalassemia major

PubMed Central

Sabloff, Mitchell; Chandy, Mammen; Wang, Zhiwei; Logan, Brent R.; Ghavamzadeh, Ardeshir; Li, Chi-Kong; Irfan, Syed Mohammad; Bredeson, Christopher N.; Cowan, Morton J.; Gale, Robert Peter; Hale, Gregory A.; Horan, John; Hongeng, Suradej; Eapen, Mary

2011-01-01

We describe outcomes after human leukocyte antigen-matched sibling bone marrow transplantation (BMT) for 179 patients with β-thalassemia major. The median age at transplantation was 7 years and the median follow-up was 6 years. The distribution of Pesaro risk class I, II, and III categories was 2%, 42%, and 36%, respectively. The day 30 cumulative incidence of neutrophil recovery and day 100 platelet recovery were 90% and 86%, respectively. Seventeen patients had graft failure, which was fatal in 11. Six of 9 patients with graft failure are alive after a second transplantation. The day 100 probability of acute graft-versus-host disease and 5-year probability of chronic graft-versus-host disease was 38% and 13%, respectively. The 5-year probabilities of overall- and disease-free survival were 91% and 88%, respectively, for patients with Pesaro risk class II, and 64% and 62%, respectively, for Pesaro risk class III. In multivariate analysis, mortality risks were higher in patients 7 years of age and older and those with hepatomegaly before BMT. The leading causes of death were interstitial pneumonitis (n = 7), hemorrhage (n = 8), and veno-occlusive disease (n = 6). Proceeding to BMT in children younger than 7 years before development of end-organ damage, particularly in the liver, should improve results after BMT for β-thalassemia major. PMID:21119108

Selection and use of microsatellite markers for individual identification and meat traceability of six swine breeds in the Chinese market.

PubMed

Zhao, Jie; Li, Tingting; Zhu, Chao; Jiang, Xiaoling; Zhao, Yan; Xu, Zhenzhen; Yang, Shuming; Chen, Ailiang

2018-06-01

Meat traceability based on molecular markers is exerting a great influence on food safety and will enhance its key role in the future. This study aimed to investigate and verify the polymorphism of 23 microsatellite markers and select the most suitable markers for individual identification and meat traceability of six swine breeds in the Chinese market. The mean polymorphism information content value of these 23 loci was 0.7851, and each locus exhibited high polymorphism in the pooled population. There were 10 loci showing good polymorphism in each breed, namely, Sw632, S0155, Sw2406, Sw830, Sw2525, Sw72, Sw2448, Sw911, Sw122 and CGA. When six highly polymorphic loci were combined, the match probability value for two random individual genotypes among the pig breeds (Beijing Black, Sanyuan and Taihu) was lower than 1.151 E-06. An increasing number of loci indicated a gradually decreasing match probability value and therefore enhanced traceability accuracy. The validation results of tracing 18 blood and corresponding meat samples based on five highly polymorphic loci (Sw2525, S0005, Sw0107, Sw911 and Sw857) were successful, with 100% conformation probability, which provided a foundation for establishing a traceability system for pork in the Chinese market.

Modelling dynamics with context-free grammars

NASA Astrophysics Data System (ADS)

García-Huerta, Juan-M.; Jiménez-Hernández, Hugo; Herrera-Navarro, Ana-M.; Hernández-Díaz, Teresa; Terol-Villalobos, Ivan

2014-03-01

This article presents a strategy to model the dynamics performed by vehicles in a freeway. The proposal consists on encode the movement as a set of finite states. A watershed-based segmentation is used to localize regions with high-probability of motion. Each state represents a proportion of a camera projection in a two-dimensional space, where each state is associated to a symbol, such that any combination of symbols is expressed as a language. Starting from a sequence of symbols through a linear algorithm a free-context grammar is inferred. This grammar represents a hierarchical view of common sequences observed into the scene. Most probable grammar rules express common rules associated to normal movement behavior. Less probable rules express themselves a way to quantify non-common behaviors and they might need more attention. Finally, all sequences of symbols that does not match with the grammar rules, may express itself uncommon behaviors (abnormal). The grammar inference is built with several sequences of images taken from a freeway. Testing process uses the sequence of symbols emitted by the scenario, matching the grammar rules with common freeway behaviors. The process of detect abnormal/normal behaviors is managed as the task of verify if any word generated by the scenario is recognized by the grammar.

Allele frequencies of 23 autosomal short tandem repeat loci in the Philippine population.

PubMed

Rodriguez, Jae Joseph Russell Beltran; Salvador, Jazelyn M; Calacal, Gayvelline C; Laude, Rita P; De Ungria, Maria Corazon A

2015-07-01

We characterized diversity and forensic descriptive parameters of 23 autosomal STR loci (CSF1PO, D13S317, D16S539, D5S818, D7S820, TPOX, D18S51, D21S11, D3S1358, D8S1179, FGA, TH01, vWA, D1S1656, D10S1248, D12S391, D2S441, D22S1045, D19S433, D2S1338, D6S1043, Penta D and Penta E) among 167 unrelated Filipinos. The most variable autosomal STR loci observed is Penta E (observed heterozygosity: 0.9222, match probability: 0.0167). Results reveal matching probability of 8.21×10(-28) for 23 autosomal STR loci. This dataset for the Philippine population may now be used in evaluating the weight of DNA evidence for forensic applications such as in human identification, parentage/kinship testing, and interpretation of DNA mixtures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Plausibility of a String Quartet Performance in Virtual Reality.

PubMed

Bergstrom, Ilias; Azevedo, Sergio; Papiotis, Panos; Saldanha, Nuno; Slater, Mel

2017-04-01

We describe an experiment that explores the contribution of auditory and other features to the illusion of plausibility in a virtual environment that depicts the performance of a string quartet. 'Plausibility' refers to the component of presence that is the illusion that the perceived events in the virtual environment are really happening. The features studied were: Gaze (the musicians ignored the participant, the musicians sometimes looked towards and followed the participant's movements), Sound Spatialization (Mono, Stereo, Spatial), Auralization (no sound reflections, reflections corresponding to a room larger than the one perceived, reflections that exactly matched the virtual room), and Environment (no sound from outside of the room, birdsong and wind corresponding to the outside scene). We adopted the methodology based on color matching theory, where 20 participants were first able to assess their feeling of plausibility in the environment with each of the four features at their highest setting. Then five times participants started from a low setting on all features and were able to make transitions from one system configuration to another until they matched their original feeling of plausibility. From these transitions a Markov transition matrix was constructed, and also probabilities of a match conditional on feature configuration. The results show that Environment and Gaze were individually the most important factors influencing the level of plausibility. The highest probability transitions were to improve Environment and Gaze, and then Auralization and Spatialization. We present this work as both a contribution to the methodology of assessing presence without questionnaires, and showing how various aspects of a musical performance can influence plausibility.

Clinical Applications of Wavefront Refraction

PubMed Central

Bruce, Adrian S.; Catania, Louis J.

2014-01-01

ABSTRACT Purpose To determine normative reference ranges for higher-order wavefront error (HO-WFE), compare these values with those in common ocular pathologies, and evaluate treatments. Methods A review of 17 major studies on HO-WFE was made, involving data for a total of 31,605 subjects. The upper limit of the 95% confidence interval (CI) for HO-WFE was calculated from the most comprehensive of these studies using normal healthy patients aged 20 to 80 years. There were no studies identified using the natural pupil size for subjects, and for this reason, the HO-WFE was tabulated for pupil diameters of 3 to 7 mm. Effects of keratoconus, pterygium, cataract, and dry eye on HO-WFE were reviewed and treatment efficacy was considered. Results The calculated upper limit of the 95% CI for HO-WFE in a healthy normal 35-year-old patient with a mesopic pupil diameter of 6 mm would be 0.471 μm (471 nm) root-mean-square or less. Although the normal HO-WFE increases with age for a given pupil size, it is not yet completely clear how the concurrent influence of age-related pupillary miosis affects these findings. Abnormal ocular conditions such as keratoconus can induce a large HO-WFE, often in excess of 3.0 μm, particularly attributed to coma. For pterygium or cortical cataract, a combination of coma and trefoil was more commonly induced. Nuclear cataract can induce a negative spherical HO-WFE, usually in excess of 1.0 μm. Conclusions The upper limit of the 95% CI for HO-WFE root-mean-square is about 0.5 μm with normal physiological pupil sizes. With ocular pathologies, HO-WFE can be in excess of 1.0 μm, although many devices and therapeutic and surgical treatments are reported to be highly effective at minimizing HO-WFE. More accurate normative reference ranges for HO-WFE will require future studies using the subjects’ natural pupil size. PMID:25216319

Changing indications for lamellar keratoplasty in Shandong, 1993 - 2008.

PubMed

Qu, Li-jun; Xie, Li-xin

2010-11-01

With the advancement of microsurgical techniques, lamellar keratoplasty (LK) has been more valued and performed to treat corneal blindness. This study aimed to evaluate the indications and changing trends for LK during the past 16 years in Shandong Eye Institute, an eye center in China. A total of 1529 eyes, predominantly from male (70.7%) patients undergoing LK between January 1993 and December 2008, were enrolled in this study. Data were collected by reviewing patient medical records for demographic characteristics, clinical diagnosis, laboratory findings and risk factors. Surgical times, initial diagnoses and causes of regrafting were recorded. All LKs were sequentially divided into period 1 (from 1993 to 2000) and period 2 (from 2001 to 2008). Rural-dwelling patients in this study numbered 1089 (71.2%); in all cases of infectious keratitis, rural patients accounted for 90.5%. The leading indications for LK were infectious keratitis (31.0%), corneal trauma (21.1%), keratoconus (18.7%), corneal dystrophy and degeneration (7.3%), regrafting (7.1%), immunologic disorders (6.7%), congenital abnormalities and corneal tumor (4.1%) and corneal scarring (3.1%). The most common subcategory of infectious keratitis was fungal keratitis (67.5%). Fusarium solani was the most morbigenous fungi. Among the patients, 73.1% of thermal burns were caused by hot molten metal, and 47.8% of alkali burns by lime. Dermoid was the most common indication for congenital abnormalities. The two main initial diagnoses from 109 regrafting cases were corneal trauma (45.9%) and Mooren's ulcer (27.5%). The most common cause for regrafting was immune rejection (35.8%). Infectious keratitis was the most common indication for LK from 16.0% in period 1 to 41.1% in period 2, followed by keratoconus (16.8%) and corneal trauma (14.5%). During the past 16 years, there have been major changes in the constituent ratios of leading indications for LK in Shangdong. Infectious keratitis has become the most common indication for LK. Fungal keratitis was the most common subcategory of infectious keratitis.

Clinical spectrum of KIAA2022 pathogenic variants in males: Case report of two boys with KIAA2022 pathogenic variants and review of the literature.

PubMed

Lorenzo, Melissa; Stolte-Dijkstra, Irene; van Rheenen, Patrick; Smith, Ronald Garth; Scheers, Tom; Walia, Jagdeep S

2018-06-01

KIAA2022 is an X-linked intellectual disability (XLID) syndrome affecting males more severely than females. Few males with KIAA2022 variants and XLID have been reported. We present a clinical report of two unrelated males, with two nonsense KIAA2022 pathogenic variants, with profound intellectual disabilities, limited language development, strikingly similar autistic behavior, delay in motor milestones, and postnatal growth restriction. Patient 1, 19-years-old, has long ears, deeply set eyes with keratoconus, strabismus, a narrow forehead, anteverted nares, café-au-lait spots, macroglossia, thick vermilion of the upper and lower lips, and prognathism. He has gastroesophageal reflux, constipation with delayed rectosigmoid colonic transit time, difficulty regulating temperature, several musculoskeletal issues, and a history of one grand mal seizure. Patient 2, 10-years-old, has mild dysmorphic features, therapy resistant vomiting with diminished motility of the stomach, mild constipation, cortical visual impairment with intermittent strabismus, axial hypotonia, difficulty regulating temperature, and cutaneous mastocytosis. Genetic testing identified KIAA2022 variant c.652C > T(p.Arg218*) in Patient 1, and a novel nonsense de novo variant c.2707G > T(p.Glu903*) in Patient 2. We also summarized features of all reported males with KIAA2022 variants to date. This report not only adds knowledge of a novel pathogenic variant to the KIAA2022 variant database, but also likely extends the spectrum by describing novel dysmorphic features and medical conditions including macroglossia, café-au-lait spots, keratoconus, severe cutaneous mastocytosis, and motility problems of the GI tract, which may help physicians involved in the care of patients with this syndrome. Lastly, we describe the power of social media in bringing families with rare medical conditions together. © 2018 Wiley Periodicals, Inc.

The influence of rigid gas permeable lens wear on the concentrations of dinucleotides in tears and the effect on dry eye signs and symptoms in keratoconus.

PubMed

Carracedo, Gonzalo; González-Méijome, José Manuel; Martín-Gil, Alba; Carballo, Jesús; Pintor, Jesús

2016-10-01

To evaluate the signs and symptoms of dry eye and dinucleotide secretion in tears of keratoconus patients (KC) and the potential effect of rigid gas permeable (RGP) contact lens wear. Twenty-three KC patients and forty control subjects were enrolled in this study. Signs of dry eye including tear volume, tear stability and corneal staining along with symptoms were assessed using the McMonnies questionnaire. Tears were collected using Schirmer strips, and dinucleotide concentrations in collected tears measured using high pressure liquid chromatography. Values obtained in KC and controls were compared. The effect of contact lens wear in KC was also assessed. KC eyes showed a significantly lower tear volume compared to controls, shorter tear break up time (TBUT), higher corneal staining and higher McMonnies dry eye questionnaire scores (p<0.05). When compared with non-wearers, KC contact lens wearers showed significantly higher symptoms, lower Schirmer and TBUT values (p<0.05). Concentration of Ap4A (0.695±0.304μM vs. 0.185±0.178μM) and Ap5A (0.132±0.128μM vs. 0.045±0.036μM) were higher in KC compared to controls (p<0.001) and only Ap4A was statistically higher in RGP wearers compared to non-wearers (0.794±0.478μM vs. 0.417±0.313μM) (p<0.05). Signs and symptoms of dry eye as well as concentrations of Ap4A and Ap5A were markedly increased in KC patients compared to controls. Moreover, Ap4A and symptoms of dry eye were statistically higher in RGP wearers compared to non-wearers. This seems to indicate that factors such as RGP contact lens wear might exacerbate the clinical condition of dry eye. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Enhanced visual acuity and image perception following correction of highly aberrated eyes using an adaptive optics visual simulator.

PubMed

Rocha, Karolinne Maia; Vabre, Laurent; Chateau, Nicolas; Krueger, Ronald R

2010-01-01

To evaluate the changes in visual acuity and visual perception generated by correcting higher order aberrations in highly aberrated eyes using a large-stroke adaptive optics visual simulator. A crx1 Adaptive Optics Visual Simulator (Imagine Eyes) was used to correct and modify the wavefront aberrations in 12 keratoconic eyes and 8 symptomatic postoperative refractive surgery (LASIK) eyes. After measuring ocular aberrations, the device was programmed to compensate for the eye's wavefront error from the second order to the fifth order (6-mm pupil). Visual acuity was assessed through the adaptive optics system using computer-generated ETDRS opto-types and the Freiburg Visual Acuity and Contrast Test. Mean higher order aberration root-mean-square (RMS) errors in the keratoconus and symptomatic LASIK eyes were 1.88+/-0.99 microm and 1.62+/-0.79 microm (6-mm pupil), respectively. The visual simulator correction of the higher order aberrations present in the keratoconus eyes improved their visual acuity by a mean of 2 lines when compared to their best spherocylinder correction (mean decimal visual acuity with spherocylindrical correction was 0.31+/-0.18 and improved to 0.44+/-0.23 with higher order aberration correction). In the symptomatic LASIK eyes, the mean decimal visual acuity with spherocylindrical correction improved from 0.54+/-0.16 to 0.71+/-0.13 with higher order aberration correction. The visual perception of ETDRS letters was improved when correcting higher order aberrations. The adaptive optics visual simulator can effectively measure and compensate for higher order aberrations (second to fifth order), which are associated with diminished visual acuity and perception in highly aberrated eyes. The adaptive optics technology may be of clinical benefit when counseling patients with highly aberrated eyes regarding their maximum subjective potential for vision correction. Copyright 2010, SLACK Incorporated.

Comparing Change in Anterior Curvature after Corneal Cross-Linking Using Scanning-Slit and Scheimpflug Technology.

PubMed

Lang, Paul Z; Thulasi, Praneetha; Khandelwal, Sumitra S; Hafezi, Farhad; Randleman, J Bradley

2018-05-02

To evaluate the correlation between anterior axial curvature difference maps following corneal cross-linking (CXL) for progressive keratoconus obtained from Scheimpflug-based tomography and Placido-based topography. Between-devices reliability analysis of randomized clinical trial data METHODS: Corneal imaging was collected at a single center institution pre-operatively and at 3, 6, and 12 months post-operatively using Scheimpflug-based tomography (Pentacam, Oculus Inc., Lynnwood, WA) and Scanning-slit, Placido-based topography (Orbscan II, Bausch & Lomb, Rochester, NY) in patients with progressive keratoconus receiving standard protocol CXL (3mW/cm 2 for 30 minutes). Regularization index (RI), absolute maximum keratometry (K Max), and change in (ΔK Max) were compared between the two devices at each time point. 51 eyes from 36 patients were evaluated at all time points. values were significantly different at all time points [56.01±5.3D Scheimpflug vs. 55.04±5.1D scanning-slit pre-operatively (p=0.003); 54.58±5.3D Scheimpflug vs. 53.12±4.9D scanning-slit at 12 months (p<0.0001)] but strongly correlated between devices (r=0.90-0.93) at all time points. The devices were not significantly different at any time point for either ΔK Max or RI but were poorly correlated at all time points (r=0.41-0.53 for ΔK Max, r=0.29-0.48 for RI). At 12 months, 95% LOA was 7.51D for absolute, 8.61D for ΔK Max, and 19.86D for RI. Measurements using Scheimpflug and scanning-slit Placido-based technology are correlated but not interchangeable. Both devices appear reasonable for separately monitoring the cornea's response to CXL; however, caution should be used when comparing results obtained with one measuring technology to the other. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparison of Changes in Central Corneal Thickness During Corneal Collagen Cross-Linking, Using Isotonic Riboflavin Solutions With and Without Dextran, in the Treatment of Progressive Keratoconus.

PubMed

Zaheer, Naima; Khan, Wajid Ali; Khan, Shama; Khan, M Abdul Moqeet

2018-03-01

To compare intraoperative changes in central corneal thickness (CCT) during corneal cross-linking, using 2 different isotonic riboflavin solutions either with dextran or with hydroxy propyl methylcellulose, in the treatment of progressive keratoconus. In this retrospective study, we analyzed records of corneal thickness measurements, taken during various steps of cross-linking. Cross-linking was performed using either isotonic riboflavin with dextran (group A) or isotonic riboflavin with hydroxy propyl methylcellulose (without dextran) (group B). CCT measurements were recorded before and after epithelial removal, after saturation with respective isotonic riboflavin solution, after use of hypotonic riboflavin in selected cases, and after ultraviolet A (UV-A) application. A mixed-way analysis of variance was conducted on CCT readings within each group and between both groups, and p < 0.05 was considered significant. In group A (100 cases), after saturation with isotonic riboflavin, CCT was decreased by a mean of 51.4 μm (12.1%). In 64%, CCT was <400 μm and additional hypotonic riboflavin was used. After UV-A irradiation, CCT was decreased by a mean of 46.7 μm (11.4%). In group B (100 cases), after saturation with isotonic riboflavin, CCT was increased by a mean of 109.4 μm (26.1%). After UV-A exposure, CCT was increased by a mean of 59.2 μm (11.2%). There was a substantial main effect for time on CCT during corneal cross-linking (CXL), p < 0.001, within both groups. The main effect comparing CCT readings between groups A and B was also significant, p < 0.001. During cross-linking, isotonic riboflavin with dextran causes a significant decrease in corneal thickness, whereas dextran-free isotonic riboflavin causes a significant increase in corneal thickness, thus facilitating the procedure.

Probabilistic model for quick detection of dissimilar binary images

NASA Astrophysics Data System (ADS)

Mustafa, Adnan A. Y.

2015-09-01

We present a quick method to detect dissimilar binary images. The method is based on a "probabilistic matching model" for image matching. The matching model is used to predict the probability of occurrence of distinct-dissimilar image pairs (completely different images) when matching one image to another. Based on this model, distinct-dissimilar images can be detected by matching only a few points between two images with high confidence, namely 11 points for a 99.9% successful detection rate. For image pairs that are dissimilar but not distinct-dissimilar, more points need to be mapped. The number of points required to attain a certain successful detection rate or confidence depends on the amount of similarity between the compared images. As this similarity increases, more points are required. For example, images that differ by 1% can be detected by mapping fewer than 70 points on average. More importantly, the model is image size invariant; so, images of any sizes will produce high confidence levels with a limited number of matched points. As a result, this method does not suffer from the image size handicap that impedes current methods. We report on extensive tests conducted on real images of different sizes.

Session RPE and salivary immune-endocrine responses to simulated and official basketball matches in elite young male athletes.

PubMed

Moreira, A; Crewther, B; Freitas, C G; Arruda, A F S; Costa, E C; Aoki, M S

2012-12-01

The present study compared the ratings of perceived exertion (RPE) and immune-endocrine (IgA and cortisol) responses to simulated training matches (TM) and official matches (OM) in elite young male basketball players (N.=10). Saliva samples were collected from each player before and after three TM and two OM and subsequently tested for cortisol and IgA concentrations by immunoassay. The perceived intensity of each match was rated using a RPE scale (CR-10). The training match and official match data were pooled to provide an aggregate value for each setting. The session RPE scores from the OM were significantly (P<0.05) greater than the simulated TM. Pre- and postcortisol concentrations assessed during the OM were also found to be significantly higher than the TM (P<0.05). No significant changes in salivary IgA concentrations were observed across either the simulated or official match settings. In summary, the OM induced greater RPE and salivary cortisol responses than the simulated TM, probably due to the additional stressors associated with real competition. The data also suggests that acute changes in cortisol concentrations do not play a role in the regulation of salivary IgA under the current testing conditions.

Risk management.

PubMed

Chambers, David W

2010-01-01

Every plan contains risk. To proceed without planning some means of managing that risk is to court failure. The basic logic of risk is explained. It consists in identifying a threshold where some corrective action is necessary, the probability of exceeding that threshold, and the attendant cost should the undesired outcome occur. This is the probable cost of failure. Various risk categories in dentistry are identified, including lack of liquidity; poor quality; equipment or procedure failures; employee slips; competitive environments; new regulations; unreliable suppliers, partners, and patients; and threats to one's reputation. It is prudent to make investments in risk management to the extent that the cost of managing the risk is less than the probable loss due to risk failure and when risk management strategies can be matched to type of risk. Four risk management strategies are discussed: insurance, reducing the probability of failure, reducing the costs of failure, and learning. A risk management accounting of the financial meltdown of October 2008 is provided.

Monte Carlo tests of the ELIPGRID-PC algorithm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davidson, J.R.

1995-04-01

The standard tool for calculating the probability of detecting pockets of contamination called hot spots has been the ELIPGRID computer code of Singer and Wickman. The ELIPGRID-PC program has recently made this algorithm available for an IBM{reg_sign} PC. However, no known independent validation of the ELIPGRID algorithm exists. This document describes a Monte Carlo simulation-based validation of a modified version of the ELIPGRID-PC code. The modified ELIPGRID-PC code is shown to match Monte Carlo-calculated hot-spot detection probabilities to within {plus_minus}0.5% for 319 out of 320 test cases. The one exception, a very thin elliptical hot spot located within a rectangularmore » sampling grid, differed from the Monte Carlo-calculated probability by about 1%. These results provide confidence in the ability of the modified ELIPGRID-PC code to accurately predict hot-spot detection probabilities within an acceptable range of error.« less

The influence of working memory on the anger superiority effect.

PubMed

Moriya, Jun; Koster, Ernst H W; De Raedt, Rudi

2014-01-01

The anger superiority effect shows that an angry face is detected more efficiently than a happy face. However, it is still controversial whether attentional allocation to angry faces is a bottom-up process or not. We investigated whether the anger superiority effect is influenced by top-down control, especially working memory (WM). Participants remembered a colour and then searched for differently coloured facial expressions. Just holding the colour information in WM did not modulate the anger superiority effect. However, when increasing the probabilities of trials in which the colour of a target face matched the colour held in WM, participants were inclined to direct attention to the target face regardless of the facial expression. Moreover, the knowledge of high probability of valid trials eliminated the anger superiority effect. These results suggest that the anger superiority effect is modulated by top-down effects of WM, the probability of events and expectancy about these probabilities.

Large-scale database searching using tandem mass spectra: looking up the answer in the back of the book.

PubMed

Sadygov, Rovshan G; Cociorva, Daniel; Yates, John R

2004-12-01

Database searching is an essential element of large-scale proteomics. Because these methods are widely used, it is important to understand the rationale of the algorithms. Most algorithms are based on concepts first developed in SEQUEST and PeptideSearch. Four basic approaches are used to determine a match between a spectrum and sequence: descriptive, interpretative, stochastic and probability-based matching. We review the basic concepts used by most search algorithms, the computational modeling of peptide identification and current challenges and limitations of this approach for protein identification.

Advanced Issues in Propensity Scores: Longitudinal and Missing Data

ERIC Educational Resources Information Center

Kupzyk, Kevin A.; Beal, Sarah J.

2017-01-01

In order to investigate causality in situations where random assignment is not possible, propensity scores can be used in regression adjustment, stratification, inverse-probability treatment weighting, or matching. The basic concepts behind propensity scores have been extensively described. When data are longitudinal or missing, the estimation and…

Notes on Discounting

ERIC Educational Resources Information Center

Rachlin, Howard

2006-01-01

In general, if a variable can be expressed as a function of its own maximum value, that function may be called a discount function. Delay discounting and probability discounting are commonly studied in psychology, but memory, matching, and economic utility also may be viewed as discounting processes. When they are so viewed, the discount function…

Metaphor Comprehension in Alzheimer's Disease: Novelty Matters

ERIC Educational Resources Information Center

Amanzio, Martina; Geminiani, Giuliano; Leotta, Daniela; Cappa, Stefano

2008-01-01

The comprehension of non-literal language was investigated in 20 probable Alzheimer's disease (pAD) patients by comparing their performance to that of 20 matched control subjects. pAD patients were unimpaired in the comprehension of conventional metaphors and idioms. However, their performance was significantly lower in the case of…

A propensity score matching analysis of dasatinib and nilotinib as a frontline therapy for patients with chronic myeloid leukemia in chronic phase.

PubMed

Takahashi, Koichi; Kantarjian, Hagop M; Yang, Yulong; Sasaki, Koji; Jain, Preetesh; DellaSala, Sara; Ravandi, Farhad; Kadia, Tapan; Pemmaraju, Naveen; Daver, Naval; Borthakur, Gautam; Garcia-Manero, Guillermo; Jabbour, Elias; Cortes, Jorge E

2016-11-15

Both dasatinib and nilotinib are approved frontline therapy for chronic myeloid leukemia in chronic phase (CML-CP) based on randomized trials compared with imatinib. However, no head-to-head comparison of dasatinib and nilotinib has been conducted in patients with newly diagnosed CML-CP. The authors conducted a propensity score (PS) matched comparison of patients with CML-CP who received frontline therapy with either dasatinib (N = 102) or nilotinib (N = 104) under the respective phase 2 trials conducted in parallel. PS matching resulted in 87 patients from each trial being matched for pretreatment characteristics. The 3-month BCR-ABL1/ABL1 ratio <10% rate was 93% with dasatinib and 94% with nilotinib (P = .25); the rates of major molecular response at 12 months were 77% and 85%, respectively (P = .13); and the rates of molecular response with 4.5-log reduction in the ratio at 36 months were 66% and 64%, respectively (P = .96). All other clinically relevant responses were similar between the 2 treatment cohorts. The 3-year probability of event-free survival was 89% among the patients who received dasatinib and 87% among those who received nilotinib (P = .99), and the corresponding 3-year overall survival probabilities were 99% and 93%, respectively (P = .95). No statistical difference was observed between the dasatinib and nilotinib groups in any of the other survival endpoints. The treatment discontinuation rate also was similar between the 2 cohorts (dasatinib group, 18%; nilotinib group, 19%; P = .82). In a PS-matched cohort of patients with newly diagnosed CML-CP, dasatinib and nilotinib offer similar response and survival outcomes. Both drugs can be considered reasonable standard-of-care options as first-line therapy for patients with CML-CP. Cancer 2016;122:3336-3343. © 2016 American Cancer Society. © 2016 American Cancer Society.

Corneal transplantation in the United Kingdom and Republic of Ireland.

PubMed Central

Vail, A; Gore, S M; Bradley, B A; Easty, D L; Rogers, C A

1993-01-01

The Corneal Transplant Follow up Study has registered 4560 corneal grafts performed in the United Kingdom and Republic of Ireland from July 1987 to June 1991. Rates of reported grafts doubled during that time. This increase was greater for surgeons and regions reporting fewer grafts, but was consistent across patient factors. Eleven of 428 consultants were responsible for over 25% of grafts, and their patients' characteristics differed significantly from others. Overall, reasons for grafting were visual only (77%), visual and other (16%), and non-visual (7%). Most frequent diagnoses were endothelial failure (38%), inflammation (26%), and keratoconus (20%). Age ranged from 2 months to 97 years, and differed markedly with diagnosis. Eighteen per cent of transplants were regrafts, and 40% were vascularised preoperatively. PMID:8218035

Pediatric genetic disease of the cornea

PubMed Central

Fecarotta, Christopher M.; Huang, Wendy W.

2014-01-01

Our objective is to evaluate the literature regarding selected genetic diseases of the cornea, including megalocornea, keratoglobus, keratoconus, cystinosis, the mucopolysaccharidoses, sclerocornea, Peters' anomaly, familial dysautonomia, and various corneal dystrophies. The transparency of the cornea is a consequence of uniformity in both size and spacing of the collagen lamellae. The cornea's clarity depends on a delicate biochemical and structural balance; consequently, genetic disorders that disrupt either its metabolic or anatomic function can cause opacity and vision loss. Many childhood corneal diseases have a genetic etiology and are associated with known syndromes. Each disorder has unique associated set of possible complications. Prognosis often depends on the extent of opacity and disorganization of the anterior segment. Corneal transplantation has been performed for these disorders with variable success. PMID:27625877

Design of high power LED-based UVA emission system and a photosensitive substance for clinical application in corneal radiation

NASA Astrophysics Data System (ADS)

Mota, Alessandro D.; Cestari, André M.; de Oliveira, André O.; Oliveira, Anselmo G.; Terruggi, Cristina H. B.; Rossi, Giuliano; Castro, Jarbas C.; Ligabô, João. P. B.; Ortega, Tiago A.; Rosa, Tiago

2015-09-01

This work presents an innovative cross-linking procedure to keratoconus treatment, a corneal disease. It includes the development of an ultraviolet controlled emission portable device based on LED source and a new formulation of a photosensitive drug called riboflavin. Thus new formulation improves drug administration by its transepithelial property. The UV reaction with riboflavin in corneal tissue leads to a modification of corneal collagen fibers, turning them more rigid and dense, and consequently restraining the advance of the disease. We present the control procedures to maintain UV output power stable up to 45mw/cm2, the optical architecture that leads to a homogeneous UV spot and the new formulation of Riboflavin.

Statistical primer: propensity score matching and its alternatives.

PubMed

Benedetto, Umberto; Head, Stuart J; Angelini, Gianni D; Blackstone, Eugene H

2018-06-01

Propensity score (PS) methods offer certain advantages over more traditional regression methods to control for confounding by indication in observational studies. Although multivariable regression models adjust for confounders by modelling the relationship between covariates and outcome, the PS methods estimate the treatment effect by modelling the relationship between confounders and treatment assignment. Therefore, methods based on the PS are not limited by the number of events, and their use may be warranted when the number of confounders is large, or the number of outcomes is small. The PS is the probability for a subject to receive a treatment conditional on a set of baseline characteristics (confounders). The PS is commonly estimated using logistic regression, and it is used to match patients with similar distribution of confounders so that difference in outcomes gives unbiased estimate of treatment effect. This review summarizes basic concepts of the PS matching and provides guidance in implementing matching and other methods based on the PS, such as stratification, weighting and covariate adjustment.

Kappa statistic for clustered matched-pair data.

PubMed

Yang, Zhao; Zhou, Ming

2014-07-10

Kappa statistic is widely used to assess the agreement between two procedures in the independent matched-pair data. For matched-pair data collected in clusters, on the basis of the delta method and sampling techniques, we propose a nonparametric variance estimator for the kappa statistic without within-cluster correlation structure or distributional assumptions. The results of an extensive Monte Carlo simulation study demonstrate that the proposed kappa statistic provides consistent estimation and the proposed variance estimator behaves reasonably well for at least a moderately large number of clusters (e.g., K ≥50). Compared with the variance estimator ignoring dependence within a cluster, the proposed variance estimator performs better in maintaining the nominal coverage probability when the intra-cluster correlation is fair (ρ ≥0.3), with more pronounced improvement when ρ is further increased. To illustrate the practical application of the proposed estimator, we analyze two real data examples of clustered matched-pair data. Copyright © 2014 John Wiley & Sons, Ltd.

Stable carbon and nitrogen isotope ratios of sodium and potassium cyanide as a forensic signature.

PubMed

Kreuzer, Helen W; Horita, Juske; Moran, James J; Tomkins, Bruce A; Janszen, Derek B; Carman, April

2012-01-01

Sodium and potassium cyanide are highly toxic, produced in large amounts by the chemical industry, and linked to numerous high-profile crimes. The U.S. Centers for Disease Control and Prevention has identified cyanide as one of the most probable agents to be used in a chemical terrorism event. We investigated whether stable C and N isotopic content of sodium and potassium cyanide could serve as a forensic signature for sample matching, using a collection of 65 cyanide samples. Upon analysis, a few of the cyanide samples displayed nonhomogeneous isotopic content associated with degradation to a carbonate salt and loss of hydrogen cyanide. Most samples had highly reproducible isotope content. Of the 65 cyanide samples, >95% could be properly matched based on C and N isotope ratios, with a false match rate <3%. These results suggest that stable C and N isotope ratios are a useful forensic signature for matching cyanide samples. © 2011 American Academy of Forensic Sciences.

Stable Carbon and Nitrogen Isotope Ratios of Sodium and Potassium Cyanide as a Forensic Signature

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kruzer, Helen W; Horita, Juske; Moran, James J

2012-01-01

Sodium and potassium cyanide are highly toxic, produced in large amounts by the chemical industry, and linked to numerous high-profile crimes. The U.S. Centers for Disease Control and Prevention has identified cyanide as one of the most probable agents to be used in a future chemical terrorism event. We investigated whether stable C and N isotopic content of sodium and potassium cyanide could serve as a forensic signature for sample matching, using a collection of 65 cyanide samples. A few of these samples displayed non-homogeneous isotopic content associated with degradation to a carbonate salt and loss of hydrogen cyanide. Mostmore » samples had highly reproducible isotope content. Of these, >95% could be properly matched based on C and N isotope ratios, with a false match rate <3%. These results suggest that stable C and N isotope ratios are a useful forensic signature for matching cyanide samples.« less

Probabilistic multi-catalogue positional cross-match

NASA Astrophysics Data System (ADS)

Pineau, F.-X.; Derriere, S.; Motch, C.; Carrera, F. J.; Genova, F.; Michel, L.; Mingo, B.; Mints, A.; Nebot Gómez-Morán, A.; Rosen, S. R.; Ruiz Camuñas, A.

2017-01-01

Context. Catalogue cross-correlation is essential to building large sets of multi-wavelength data, whether it be to study the properties of populations of astrophysical objects or to build reference catalogues (or timeseries) from survey observations. Nevertheless, resorting to automated processes with limited sets of information available on large numbers of sources detected at different epochs with various filters and instruments inevitably leads to spurious associations. We need both statistical criteria to select detections to be merged as unique sources, and statistical indicators helping in achieving compromises between completeness and reliability of selected associations. Aims: We lay the foundations of a statistical framework for multi-catalogue cross-correlation and cross-identification based on explicit simplified catalogue models. A proper identification process should rely on both astrometric and photometric data. Under some conditions, the astrometric part and the photometric part can be processed separately and merged a posteriori to provide a single global probability of identification. The present paper addresses almost exclusively the astrometrical part and specifies the proper probabilities to be merged with photometric likelihoods. Methods: To select matching candidates in n catalogues, we used the Chi (or, indifferently, the Chi-square) test with 2(n-1) degrees of freedom. We thus call this cross-match a χ-match. In order to use Bayes' formula, we considered exhaustive sets of hypotheses based on combinatorial analysis. The volume of the χ-test domain of acceptance - a 2(n-1)-dimensional acceptance ellipsoid - is used to estimate the expected numbers of spurious associations. We derived priors for those numbers using a frequentist approach relying on simple geometrical considerations. Likelihoods are based on standard Rayleigh, χ and Poisson distributions that we normalized over the χ-test acceptance domain. We validated our theoretical results by generating and cross-matching synthetic catalogues. Results: The results we obtain do not depend on the order used to cross-correlate the catalogues. We applied the formalism described in the present paper to build the multi-wavelength catalogues used for the science cases of the Astronomical Resource Cross-matching for High Energy Studies (ARCHES) project. Our cross-matching engine is publicly available through a multi-purpose web interface. In a longer term, we plan to integrate this tool into the CDS XMatch Service.

Electronic propensity rules in Li-H+ collisions involving initial and/or final oriented states

NASA Astrophysics Data System (ADS)

Salas, P. J.

2000-12-01

Electronic excitation and capture processes are studied in collisions involving systems with only one active electron such as the alkaline (Li)-proton in the medium-energy region (0.1-15 keV). Using the semiclassical impact parameter method, the probabilities and the orientation parameter are calculated for transitions between initial and/or final oriented states. The results show a strong asymmetry in the probabilities depending on the orientation of the initial and/or final states. An intuitive view of the processes, by means of the concepts of propensity and velocity matching rules, is provided.

Initialising reservoir models for history matching using pre-production 3D seismic data: constraining methods and uncertainties

NASA Astrophysics Data System (ADS)

Niri, Mohammad Emami; Lumley, David E.

2017-10-01

Integration of 3D and time-lapse 4D seismic data into reservoir modelling and history matching processes poses a significant challenge due to the frequent mismatch between the initial reservoir model, the true reservoir geology, and the pre-production (baseline) seismic data. A fundamental step of a reservoir characterisation and performance study is the preconditioning of the initial reservoir model to equally honour both the geological knowledge and seismic data. In this paper we analyse the issues that have a significant impact on the (mis)match of the initial reservoir model with well logs and inverted 3D seismic data. These issues include the constraining methods for reservoir lithofacies modelling, the sensitivity of the results to the presence of realistic resolution and noise in the seismic data, the geostatistical modelling parameters, and the uncertainties associated with quantitative incorporation of inverted seismic data in reservoir lithofacies modelling. We demonstrate that in a geostatistical lithofacies simulation process, seismic constraining methods based on seismic litho-probability curves and seismic litho-probability cubes yield the best match to the reference model, even when realistic resolution and noise is included in the dataset. In addition, our analyses show that quantitative incorporation of inverted 3D seismic data in static reservoir modelling carries a range of uncertainties and should be cautiously applied in order to minimise the risk of misinterpretation. These uncertainties are due to the limited vertical resolution of the seismic data compared to the scale of the geological heterogeneities, the fundamental instability of the inverse problem, and the non-unique elastic properties of different lithofacies types.

Levels of depression in transgender people and its predictors: Results of a large matched control study with transgender people accessing clinical services.

PubMed

Witcomb, Gemma L; Bouman, Walter Pierre; Claes, Laurence; Brewin, Nicola; Crawford, John R; Arcelus, Jon

2018-08-01

Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not. Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression. Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression. Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression. This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition. Copyright © 2018. Published by Elsevier B.V.

Comparison of Core-Needle Biopsy and Fine-Needle Aspiration for Evaluating Thyroid Incidentalomas Detected by 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Propensity Score Analysis.

PubMed

Suh, Chong Hyun; Choi, Young Jun; Lee, Jong Jin; Shim, Woo Hyun; Baek, Jung Hwan; Chung, Han Cheol; Shong, Young Kee; Song, Dong Eun; Sung, Tae Yon; Lee, Jeong Hyun

2017-10-01

This study used a propensity score analysis to assess the roles of core-needle biopsy (CNB) and fine-needle aspiration (FNA) in the evaluation of thyroid incidentalomas detected on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT). The study population was obtained from a historical cohort who underwent 18 F-FDG PET/CT between October 2008 and September 2015. Patients were included who underwent ultrasound-guided CNB or FNA for incidental focal uptake of 18 F-FDG in the thyroid gland on PET/CT. The primary study outcomes included the inconclusive result rates in the CNB and FNA groups. The secondary outcome measures included the non-diagnostic result rate and the diagnostic performance for neoplasms. Multivariate analysis, propensity score matching, and inverse probability weighting were conducted. A total of 1360 nodules from 1338 patients were included in this study: 859 nodules from 850 patients underwent FNA, and 501 nodules from 488 patients underwent CNB. Compared to FNA, CNB demonstrated a significantly lower inconclusive result rate in the pooled cohort (23.8% vs. 35.4%; p < 0.001), propensity score-matched cohorts (22.9% vs. 36.6%; p < 0.001), and with inverse probability weighting (22.4% vs. 35.2%; p < 0.001). Non-diagnostic result rates were also significantly lower in CNB than in FNA. The diagnostic performance of the two groups in the pooled and matched cohorts was similar, with no significant differences found. The significantly lower inconclusive result rates in CNB than in FNA were consistent within the propensity score-matched cohorts. Therefore, CNB appears to be a promising diagnostic tool for patients with thyroid incidentalomas detected on 18 F-FDG PET/CT.

Approach to identifying pollutant source and matching flow field

NASA Astrophysics Data System (ADS)

Liping, Pang; Yu, Zhang; Hongquan, Qu; Tao, Hu; Wei, Wang

2013-07-01

Accidental pollution events often threaten people's health and lives, and it is necessary to identify a pollutant source rapidly so that prompt actions can be taken to prevent the spread of pollution. But this identification process is one of the difficulties in the inverse problem areas. This paper carries out some studies on this issue. An approach using single sensor information with noise was developed to identify a sudden continuous emission trace pollutant source in a steady velocity field. This approach first compares the characteristic distance of the measured concentration sequence to the multiple hypothetical measured concentration sequences at the sensor position, which are obtained based on a source-three-parameter multiple hypotheses. Then we realize the source identification by globally searching the optimal values with the objective function of the maximum location probability. Considering the large amount of computation load resulting from this global searching, a local fine-mesh source search method based on priori coarse-mesh location probabilities is further used to improve the efficiency of identification. Studies have shown that the flow field has a very important influence on the source identification. Therefore, we also discuss the impact of non-matching flow fields with estimation deviation on identification. Based on this analysis, a method for matching accurate flow field is presented to improve the accuracy of identification. In order to verify the practical application of the above method, an experimental system simulating a sudden pollution process in a steady flow field was set up and some experiments were conducted when the diffusion coefficient was known. The studies showed that the three parameters (position, emission strength and initial emission time) of the pollutant source in the experiment can be estimated by using the method for matching flow field and source identification.

Under the hood of statistical learning: A statistical MMN reflects the magnitude of transitional probabilities in auditory sequences.

PubMed

Koelsch, Stefan; Busch, Tobias; Jentschke, Sebastian; Rohrmeier, Martin

2016-02-02

Within the framework of statistical learning, many behavioural studies investigated the processing of unpredicted events. However, surprisingly few neurophysiological studies are available on this topic, and no statistical learning experiment has investigated electroencephalographic (EEG) correlates of processing events with different transition probabilities. We carried out an EEG study with a novel variant of the established statistical learning paradigm. Timbres were presented in isochronous sequences of triplets. The first two sounds of all triplets were equiprobable, while the third sound occurred with either low (10%), intermediate (30%), or high (60%) probability. Thus, the occurrence probability of the third item of each triplet (given the first two items) was varied. Compared to high-probability triplet endings, endings with low and intermediate probability elicited an early anterior negativity that had an onset around 100 ms and was maximal at around 180 ms. This effect was larger for events with low than for events with intermediate probability. Our results reveal that, when predictions are based on statistical learning, events that do not match a prediction evoke an early anterior negativity, with the amplitude of this mismatch response being inversely related to the probability of such events. Thus, we report a statistical mismatch negativity (sMMN) that reflects statistical learning of transitional probability distributions that go beyond auditory sensory memory capabilities.

Collagen Cross-Linking Using Riboflavin and Ultraviolet-A for Corneal Thinning Disorders

PubMed Central

Pron, G; Ieraci, L; Kaulback, K

2011-01-01

Executive Summary Objective The main objectives for this evidence-based analysis were to determine the safety and effectiveness of photochemical corneal collagen cross-linking with riboflavin (vitamin B2) and ultraviolet-A radiation, referred to as CXL, for the management of corneal thinning disease conditions. The comparative safety and effectiveness of corneal cross-linking with other minimally invasive treatments such as intrastromal corneal rings was also reviewed. The Medical Advisory Secretariat (MAS) evidence-based analysis was performed to support public financing decisions. Subject of the Evidence-Based Analysis The primary treatment objective for corneal cross-linking is to increase the strength of the corneal stroma, thereby stabilizing the underlying disease process. At the present time, it is the only procedure that treats the underlying disease condition. The proposed advantages for corneal cross-linking are that the procedure is minimally invasive, safe and effective, and it can potentially delay or defer the need for a corneal transplant. In addition, corneal cross-linking does not adversely affect subsequent surgical approaches, if they are necessary, or interfere with corneal transplants. The evidence for these claims for corneal cross-linking in the management of corneal thinning disorders such as keratoconus will be the focus of this review. The specific research questions for the evidence review were as follows: Technical: How technically demanding is corneal cross-linking and what are the operative risks? Safety: What is known about the broader safety profile of corneal cross-linking? Effectiveness - Corneal Surface Topographic Affects: What are the corneal surface remodeling effects of corneal cross-linking? Do these changes interfere with subsequent interventions, particularly corneal transplant known as penetrating keratoplasty (PKP)? Effectiveness -Visual Acuity: What impacts does the remodeling have on visual acuity? Are these impacts predictable, stable, adjustable and durable? Effectiveness - Refractive Outcomes: What impact does remodeling have on refractive outcomes? Effectiveness - Visual Quality (Symptoms): What impact does corneal cross-linking have on vision quality such as contrast vision, and decreased visual symptoms (halos, fluctuating vision)? Effectiveness - Contact lens tolerance: To what extent does contact lens intolerance improve after corneal cross-linking? Vision-Related QOL: What is the impact of corneal cross-linking on functional visual rehabilitation and quality of life? Patient satisfaction: Are patients satisfied with their vision following the procedure? Disease Process: What impact does corneal cross-linking have on the underling corneal thinning disease process? Does corneal cross-linking delay or defer the need for a corneal transplant? What is the comparative safety and effectiveness of corneal cross-linking compared with other minimally invasive treatments for corneal ectasia such as intrastromal corneal rings? Clinical Need: Target Population and Condition Corneal ectasia (thinning) disorders represent a range of disorders involving either primary disease conditions, such as keratoconus (KC) and pellucid marginal corneal degeneration, or secondary iatrogenic conditions, such as corneal thinning occurring after laser in situ keratomileusis (LASIK) refractive surgery. Corneal thinning is a disease that occurs when the normally round dome-shaped cornea progressively thins causing a cone-like bulge or forward protrusion in response to the normal pressure of the eye. The thinning occurs primarily in the stroma layers and is believed to be a breakdown in the collagen process. This bulging can lead to irregular astigmatism or shape of the cornea. Because the anterior part of the cornea is responsible for most of the focusing of the light on the retina, this can then result in loss of visual acuity. The reduced visual acuity can make even simple daily tasks, such as driving, watching television or reading, difficult to perform. Keratoconus is the most common form of corneal thinning disorder and involves a noninflammatory chronic disease process of progressive corneal thinning. Although the specific cause for the biomechanical alterations in the corneal stroma is unknown, there is a growing body of evidence suggesting that genetic factors may play an important role. Keratoconus is a rare disease (< 0.05% of the population) and is unique among chronic eye diseases because it has an early onset, with a median age of 25 years. Disease management for this condition follows a step-wise approach depending on disease severity. Contact lenses are the primary treatment of choice when there is irregular astigmatism associated with the disease. Patients are referred for corneal transplants as a last option when they can no longer tolerate contact lenses or when lenses no longer provide adequate vision. Keratoconus is one of the leading indications for corneal transplants and has been so for the last 3 decades. Despite the high success rate of corneal transplants (up to 20 years) there are reasons to defer it as long as possible. Patients with keratoconus are generally young and a longer-term graft survival of at least 30 or 40 years may be necessary. The surgery itself involves lengthy time off work and postsurgery, while potential complications include long-term steroid use, secondary cataracts, and glaucoma. After a corneal transplant, keratoconus may recur resulting in a need for subsequent interventions. Residual refractive errors and astigmatism can remain challenges after transplantation, and high refractive surgery and regraft rates in KC patients have been reported. Visual rehabilitation or recovery of visual acuity after transplant may be slow and/or unsatisfactory to patients. Description of Technology/Therapy Corneal cross-linking involves the use of riboflavin (vitamin B2) and ultraviolet-A (UVA) radiation. A UVA irradiation device known as the CXL® device (license number 77989) by ACCUTECH Medical Technologies Inc. has been licensed by Health Canada as a Class II device since September 19, 2008. An illumination device that emits homogeneous UVA, in combination with any generic form of riboflavin, is licensed by Health Canada for the indication to slow or stop the progression of corneal thinning caused by progressive keratectasia, iatrogenic keratectasia after laser-assisted in situ keratomileusis (LASIK) and pellucid marginal degeneration. The same device is named the UV-X® device by IROCMedical, with approvals in Argentina, the European Union and Australia. UVA devices all use light emitting diodes to generate UVA at a wavelength of 360-380 microns but vary in the number of diodes (5 to 25), focusing systems, working distance, beam diameter, beam uniformity and extent to which the operator can vary the parameters. In Ontario, CXL is currently offered at over 15 private eye clinics by refractive surgeons and ophthalmologists. The treatment is an outpatient procedure generally performed with topical anesthesia. The treatment consists of several well defined procedures. The epithelial cell layer is first removed, often using a blunt spatula in a 9.0 mm diameter under sterile conditions. This step is followed by the application of topical 0.1% riboflavin (vitamin B2) solution every 3 to 5 minutes for 25 minutes to ensure that the corneal stroma is fully penetrated. A solid-state UVA light source with a wavelength of 370 nm (maximum absorption of riboflavin) and an irradiance of 3 mW/cm2 is used to irradiate the central cornea. Following treatment, a soft bandage lens is applied and prescriptions are given for oral pain medications, preservative-free tears, anti-inflammatory drops (preferably not nonsteroidal anti-inflammatory drugs, or NSAIDs) and antibiotic eye drops. Patients are recalled 1 week following the procedure to evaluate re-epithelialization and they are followed-up subsequently. Evidence-Based Analysis Methods A literature search was conducted on photochemical corneal collagen cross-linking with riboflavin (vitamin B2) and ultraviolet-A for the management of corneal thinning disorders using a search strategy with appropriate keywords and subject headings for CXL for literature published up until April 17, 2011. The literature search for this Health Technology Assessment (HTA) review was performed using the Cochrane Library, the Emergency Care Research Institute (ECRI) and the Centre for Reviews and Dissemination. The websites of several other health technology agencies were also reviewed, including the Canadian Agency for Drugs and Technologies in Health (CADTH) and the United Kingdom’s National Institute for Clinical Excellence (NICE). The databases searched included OVID MEDLINE, MEDLINE IN-Process and other Non-Indexed Citations such as EMBASE. As the evidence review included an intervention for a rare condition, case series and case reports, particularly for complications and adverse events, were reviewed. A total of 316 citations were identified and all abstracts were reviewed by a single reviewer for eligibility. For those studies meeting the eligibility criteria, full-text articles were obtained. Reference lists were also examined for any additional relevant studies not identified through the search. Inclusion Criteria English-language reports and human studies patients with any corneal thinning disorder reports with CXL procedures used alone or in conjunction with other interventions original reports with defined study methodology reports including standardized measurements on outcome events such as technical success, safety effectiveness, durability, vision quality of life or patient satisfaction systematic reviews, meta-analyses, randomized controlled trials, observational studies, retrospective analyses, case series, or case reports for complications and adverse events Exclusion Criteria nonsystematic reviews, letters, comments and editorials reports not involving outcome events such as safety, effectiveness, durability, vision quality or patient satisfaction following an intervention with corneal implants reports not involving corneal thinning disorders and an intervention involving CXL Summary of Evidence Findings In the Medical Advisory Secretariat evidence review on corneal cross-linking, 65 reports (16 case reports) involving 1403 patients were identified on the use of CXL for managing corneal thinning disorders. The reports were summarized according to their primary clinical indication, whether or not secondary interventions were used in conjunction with CXL (referred to as CXL-Plus) and whether or not it was a safety-related report. The safety review was based on information from the cohort studies evaluating effectiveness, clinical studies evaluating safety, treatment response or recovery, and published case reports of complications. Complications, such as infection and noninfectious keratitis (inflammatory response), reported in case reports, generally occurred in the first week and were successfully treated with topical antibiotics and steroids. Other complications, such as the cytotoxic effects on the targeted corneal stroma, occurred as side effects of the photo-oxidative process generated by riboflavin and ultraviolet-A and were usually reversible. The reports on treatment effectiveness involved 15 pre-post longitudinal cohort follow-up studies ranging from follow-up of patients’ treated eye only, follow-up in both the treated and untreated fellow-eye; and follow-up in the treated eye only and a control group not receiving treatment. One study was a 3-arm randomized control study (RCT) involving 2 comparators: one comparator was a sham treatment in which one eye was treated with riboflavin only; and the other comparator was the untreated fellow-eye. The outcomes reported across the studies involved statistically significant and clinically relevant improvements in corneal topography and refraction after CXL. In addition, improvements in treated eyes were accompanied by worsening outcomes in the untreated fellow-eyes. Improvements in corneal topography reported at 6 months were maintained at 1- and 2-year follow-up. Visual acuity, although not always improved, was infrequently reported as vision loss. Additional procedures such as the use of intrastromal corneal ring segments, intraocular lenses and refractive surgical practices were reported to result in additional improvements in topography and visual acuity after CXL. Considerations for Ontario Health System The total costs of providing CXL therapy to keratoconus patients in Ontario was calculated based on estimated physician, clinic, and medication costs. The total cost per patient was approximately $1,036 for the treatment of one eye, and $1,751 for the treatment of both eyes. The prevalence of keratoconus was estimated at 4,047 patients in FY2011, with an anticipated annual incidence (new cases) of about 148 cases. After distributing the costs of CXL therapy for the FY2011 prevalent keratoconus population over the next 3 years, the estimated average annual cost was approximately $2.1 million, of which about $1.3 million would be physician costs specifically. Conclusion Corneal cross-linking effectively stabilizes the underlying disease, and in some cases reverses disease progression as measured by key corneal topographic measures. The affects of CXL on visual acuity are less predictable and the use of adjunct interventions with CXL, such as intrastromal corneal ring segments, refractive surgery, and intraocular lens implants are increasingly employed to both stabilize disease and restore visual acuity. Although the use of adjunct interventions have been shown to result in additional clinical benefit, the order, timing, and risks of performing adjunctive interventions have not been well established. Although there is potential for serious adverse events with corneal UVA irradiation and photochemical reactions, there have been few reported complications. Those that have occurred tended to be related to side effects of the induced photochemical reactions and were generally reversible. However, to ensure that there are minimal complications with the use of CXL and irradiation, strict adherence to defined CXL procedural protocols is essential. Keywords Keratoconus, corneal cross-linking, corneal topography, corneal transplant, visual acuity, refractive error. PMID:23074417

Properties of CGM-Absorbing Galaxies

NASA Astrophysics Data System (ADS)

Hamill, Colin; Conway, Matthew; Apala, Elizabeth; Scott, Jennifer

2018-01-01

We extend the results of a study of the sightlines of 45 low-redshift quasars (0.06 < z < 0.85) observed by HST/COS that lie within the Sloan Digital Sky Survey. We have used photometric data from the SDSS DR12, along with the known absorption characteristics of the intergalactic medium and circumgalactic medium, to identify the most probable galaxy matches to absorbers in the spectroscopic dataset. Here, we use photometric data and measured galaxy parameters from SDSS DR12 to examine the distributions of galaxy properties such as virial radius, morphology, and position angle among those that match to absorbers within a specific range of impact parameters. We compare those distributions to galaxies within the same impact parameter range that are not matched to any absorber in the HST/COS spectrum in order to investigate global properties of the circumgalactic medium.

Combining autosomal and Y chromosome match probabilities using coalescent theory.

PubMed

Buckleton, John; Myers, Steven

2014-07-01

Walsh et al. outlined a method for adjusting autosomal coancestry values, θA, to take account of the existence of a Y chromosome match, θA|Y. The framework established by Walsh et al. is flexible and allows an investigation of some real world effects such as family structure. It also allows the effect of a Y chromosome match to be placed within the construct of existing casework practice. Most notable is the ability to deal with an assigned value for the autosomal coancestry coefficient and the fact that most casework statistics report a value for unrelated individuals unless case circumstances suggest differently. The values of θA|Y are not much larger than θA and a coherent argument could be made that any adjustment is unnecessary. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Thinking about low-probability events. An Exemplar-Cuing theory.

PubMed

Koehler, Jonathan J; Macchi, Laura

2004-08-01

The way people respond to the chance that an unlikely event will occur depends on how the event is described. We propose that people attach more weight to unlikely events when they can easily generate or imagine examples in which the event has occurred or will occur than when they cannot. We tested this idea in two experiments with mock jurors using written murder scenarios. The results suggested that jurors attach more weight to the defendant's claim that an incriminating DNA match is merely coincidental when it is easy for them to imagine other individuals whose DNA would also match than when it is not easy for them to imagine such individuals. We manipulated the difficulty of imagining such examples by varying the description of the DNA-match statistic. Some of the variations that influenced the jurors were normatively irrelevant.

Collagen cross-linking using riboflavin and ultraviolet-a for corneal thinning disorders: an evidence-based analysis.

PubMed

Pron, G; Ieraci, L; Kaulback, K

2011-01-01

The main objectives for this evidence-based analysis were to determine the safety and effectiveness of photochemical corneal collagen cross-linking with riboflavin (vitamin B(2)) and ultraviolet-A radiation, referred to as CXL, for the management of corneal thinning disease conditions. The comparative safety and effectiveness of corneal cross-linking with other minimally invasive treatments such as intrastromal corneal rings was also reviewed. The Medical Advisory Secretariat (MAS) evidence-based analysis was performed to support public financing decisions. SUBJECT OF THE EVIDENCE-BASED ANALYSIS: The primary treatment objective for corneal cross-linking is to increase the strength of the corneal stroma, thereby stabilizing the underlying disease process. At the present time, it is the only procedure that treats the underlying disease condition. The proposed advantages for corneal cross-linking are that the procedure is minimally invasive, safe and effective, and it can potentially delay or defer the need for a corneal transplant. In addition, corneal cross-linking does not adversely affect subsequent surgical approaches, if they are necessary, or interfere with corneal transplants. The evidence for these claims for corneal cross-linking in the management of corneal thinning disorders such as keratoconus will be the focus of this review. The specific research questions for the evidence review were as follows: TECHNICAL: How technically demanding is corneal cross-linking and what are the operative risks? What is known about the broader safety profile of corneal cross-linking?Effectiveness - Corneal Surface Topographic Affects:What are the corneal surface remodeling effects of corneal cross-linking?Do these changes interfere with subsequent interventions, particularly corneal transplant known as penetrating keratoplasty (PKP)?Effectiveness -Visual Acuity:What impacts does the remodeling have on visual acuity?Are these impacts predictable, stable, adjustable and durable?Effectiveness - Refractive Outcomes: What impact does remodeling have on refractive outcomes?Effectiveness - Visual Quality (Symptoms): What impact does corneal cross-linking have on vision quality such as contrast vision, and decreased visual symptoms (halos, fluctuating vision)?Effectiveness - Contact lens tolerance: To what extent does contact lens intolerance improve after corneal cross-linking?Vision-Related QOL: What is the impact of corneal cross-linking on functional visual rehabilitation and quality of life?PATIENT SATISFACTION: Are patients satisfied with their vision following the procedure?Disease Process:What impact does corneal cross-linking have on the underling corneal thinning disease process?Does corneal cross-linking delay or defer the need for a corneal transplant?What is the comparative safety and effectiveness of corneal cross-linking compared with other minimally invasive treatments for corneal ectasia such as intrastromal corneal rings? TARGET POPULATION AND CONDITION Corneal ectasia (thinning) disorders represent a range of disorders involving either primary disease conditions, such as keratoconus (KC) and pellucid marginal corneal degeneration, or secondary iatrogenic conditions, such as corneal thinning occurring after laser in situ keratomileusis (LASIK) refractive surgery. Corneal thinning is a disease that occurs when the normally round dome-shaped cornea progressively thins causing a cone-like bulge or forward protrusion in response to the normal pressure of the eye. The thinning occurs primarily in the stroma layers and is believed to be a breakdown in the collagen process. This bulging can lead to irregular astigmatism or shape of the cornea. Because the anterior part of the cornea is responsible for most of the focusing of the light on the retina, this can then result in loss of visual acuity. The reduced visual acuity can make even simple daily tasks, such as driving, watching television or reading, difficult to perform. Keratoconus is the most common form of corneal thinning disorder and involves a noninflammatory chronic disease process of progressive corneal thinning. Although the specific cause for the biomechanical alterations in the corneal stroma is unknown, there is a growing body of evidence suggesting that genetic factors may play an important role. Keratoconus is a rare disease (< 0.05% of the population) and is unique among chronic eye diseases because it has an early onset, with a median age of 25 years. Disease management for this condition follows a step-wise approach depending on disease severity. Contact lenses are the primary treatment of choice when there is irregular astigmatism associated with the disease. Patients are referred for corneal transplants as a last option when they can no longer tolerate contact lenses or when lenses no longer provide adequate vision. Keratoconus is one of the leading indications for corneal transplants and has been so for the last 3 decades. Despite the high success rate of corneal transplants (up to 20 years) there are reasons to defer it as long as possible. Patients with keratoconus are generally young and a longer-term graft survival of at least 30 or 40 years may be necessary. The surgery itself involves lengthy time off work and postsurgery, while potential complications include long-term steroid use, secondary cataracts, and glaucoma. After a corneal transplant, keratoconus may recur resulting in a need for subsequent interventions. Residual refractive errors and astigmatism can remain challenges after transplantation, and high refractive surgery and regraft rates in KC patients have been reported. Visual rehabilitation or recovery of visual acuity after transplant may be slow and/or unsatisfactory to patients. Corneal cross-linking involves the use of riboflavin (vitamin B(2)) and ultraviolet-A (UVA) radiation. A UVA irradiation device known as the CXL® device (license number 77989) by ACCUTECH Medical Technologies Inc. has been licensed by Health Canada as a Class II device since September 19, 2008. An illumination device that emits homogeneous UVA, in combination with any generic form of riboflavin, is licensed by Health Canada for the indication to slow or stop the progression of corneal thinning caused by progressive keratectasia, iatrogenic keratectasia after laser-assisted in situ keratomileusis (LASIK) and pellucid marginal degeneration. The same device is named the UV-X® device by IROCMedical, with approvals in Argentina, the European Union and Australia. UVA devices all use light emitting diodes to generate UVA at a wavelength of 360-380 microns but vary in the number of diodes (5 to 25), focusing systems, working distance, beam diameter, beam uniformity and extent to which the operator can vary the parameters. In Ontario, CXL is currently offered at over 15 private eye clinics by refractive surgeons and ophthalmologists. The treatment is an outpatient procedure generally performed with topical anesthesia. The treatment consists of several well defined procedures. The epithelial cell layer is first removed, often using a blunt spatula in a 9.0 mm diameter under sterile conditions. This step is followed by the application of topical 0.1% riboflavin (vitamin B(2)) solution every 3 to 5 minutes for 25 minutes to ensure that the corneal stroma is fully penetrated. A solid-state UVA light source with a wavelength of 370 nm (maximum absorption of riboflavin) and an irradiance of 3 mW/cm(2) is used to irradiate the central cornea. Following treatment, a soft bandage lens is applied and prescriptions are given for oral pain medications, preservative-free tears, anti-inflammatory drops (preferably not nonsteroidal anti-inflammatory drugs, or NSAIDs) and antibiotic eye drops. Patients are recalled 1 week following the procedure to evaluate re-epithelialization and they are followed-up subsequently. A literature search was conducted on photochemical corneal collagen cross-linking with riboflavin (vitamin B(2)) and ultraviolet-A for the management of corneal thinning disorders using a search strategy with appropriate keywords and subject headings for CXL for literature published up until April 17, 2011. The literature search for this Health Technology Assessment (HTA) review was performed using the Cochrane Library, the Emergency Care Research Institute (ECRI) and the Centre for Reviews and Dissemination. The websites of several other health technology agencies were also reviewed, including the Canadian Agency for Drugs and Technologies in Health (CADTH) and the United Kingdom's National Institute for Clinical Excellence (NICE). The databases searched included OVID MEDLINE, MEDLINE IN-Process and other Non-Indexed Citations such as EMBASE. As the evidence review included an intervention for a rare condition, case series and case reports, particularly for complications and adverse events, were reviewed. A total of 316 citations were identified and all abstracts were reviewed by a single reviewer for eligibility. For those studies meeting the eligibility criteria, full-text articles were obtained. Reference lists were also examined for any additional relevant studies not identified through the search. (ABSTRACT TRUNCATED)

The statistical evaluation of duct tape end match as physical evidence

NASA Astrophysics Data System (ADS)

Chan, Ka Lok

Duct tapes are often submitted to crime laboratories as evidence associated with abductions, homicides, or construction of explosive devices. As a result, trace evidence examiners are often asked to analyze and compare commercial duct tapes so that they can establish possible evidentiary links. Duct tape end matches are believed to be the strongest association between exemplar and question samples because they are considered as evidence with unique individual characteristics. While end match analysis and comparison have long been undertaken by trace evidence examiners, there is a significant lack of scientific research for associating two or more segments of duct tapes. This study is designed to obtain statistical inferences on the uniqueness of duct tape tears. Three experiments were devised to compile the basis for a statistical assessment of the probability of duct tape end matches along with a proposed error rate. In one experiment, we conducted the equivalent of 10,000 end match examinations with an error rate of 0%. In the second experiment, we performed 2,704 end match examinations having 0% error rate. In the third experiment, using duct tape by an Elmendorf Tear tester, we conducted 576 end match examinations with an error rate of 0% and having all samples correctly associated. The results of this study indicate that end matches are distinguishable among a single roll of duct tape and between two different rolls of duct tape having very similar surface features and weave pattern.

Two-Phase chief complaint mapping to the UMLS metathesaurus in Korean electronic medical records.

PubMed

Kang, Bo-Yeong; Kim, Dae-Won; Kim, Hong-Gee

2009-01-01

The task of automatically determining the concepts referred to in chief complaint (CC) data from electronic medical records (EMRs) is an essential component of many EMR applications aimed at biosurveillance for disease outbreaks. Previous approaches that have been used for this concept mapping have mainly relied on term-level matching, whereby the medical terms in the raw text and their synonyms are matched with concepts in a terminology database. These previous approaches, however, have shortcomings that limit their efficacy in CC concept mapping, where the concepts for CC data are often represented by associative terms rather than by synonyms. Therefore, herein we propose a concept mapping scheme based on a two-phase matching approach, especially for application to Korean CCs, which uses term-level complete matching in the first phase and concept-level matching based on concept learning in the second phase. The proposed concept-level matching suggests the method to learn all the terms (associative terms as well as synonyms) that represent the concept and predict the most probable concept for a CC based on the learned terms. Experiments on 1204 CCs extracted from 15,618 discharge summaries of Korean EMRs showed that the proposed method gave significantly improved F-measure values compared to the baseline system, with improvements of up to 73.57%.

The Identities Hidden in the Matching Laws, and Their Uses

ERIC Educational Resources Information Center

Thorne, David R.

2010-01-01

Various theoretical equations have been proposed to predict response rate as a function of the rate of reinforcement. If both the rate and probability of reinforcement are considered, a simple identity, defining equation, or "law" holds. This identity places algebraic constraints on the allowable forms of our mathematical models and can help…

Labor Force Participation of Older Workers: Prospective Changes and Potential Policy Responses.

ERIC Educational Resources Information Center

Favreault, Melissa; Ratcliffe, Caroline; Toder, Eric

1999-01-01

Data from the Survey of Income and Program Participation were matched with longitudinal earnings histories and Social Security benefit data to estimate joint work and benefit receipt choices for people age 62 and older. The probability of working is shown to depend on worker characteristics and policy variables. (Author)

Adenosine triphosphate and diphosphoglycerate levels in red blood cells from patients with Down's syndrome.

PubMed

Knull, H R; Bronstein, W W; Porter, P J

1978-09-15

The levels of ATP and ATP plus DPG were significantly elevated in erythrocytes from Down's syndrome patients when compared to erythrocytes from age matched controls. The hemoglobin content and hematocrit values were significantly reduced. The resultant tendency towards anemia probably explains the elevation in metabolite levels.

The Use of Tactical Airlift as a Tool of Foreign Policy

DTIC Science & Technology

1990-04-01

needing the aid did not match our definition of human rights, they advocated terrorism , or one of several other foreign policy factors. In the Western...and Guyana in Latin America. Famine relief to Mauritania, Chad, and Mali in 1973 and 1974 probably displays our best attempt to stop comunism before

Equalization and detection for digital communication over nonlinear bandlimited satellite communication channels. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Gutierrez, Alberto, Jr.

1995-01-01

This dissertation evaluates receiver-based methods for mitigating the effects due to nonlinear bandlimited signal distortion present in high data rate satellite channels. The effects of the nonlinear bandlimited distortion is illustrated for digitally modulated signals. A lucid development of the low-pass Volterra discrete time model for a nonlinear communication channel is presented. In addition, finite-state machine models are explicitly developed for a nonlinear bandlimited satellite channel. A nonlinear fixed equalizer based on Volterra series has previously been studied for compensation of noiseless signal distortion due to a nonlinear satellite channel. This dissertation studies adaptive Volterra equalizers on a downlink-limited nonlinear bandlimited satellite channel. We employ as figure of merits performance in the mean-square error and probability of error senses. In addition, a receiver consisting of a fractionally-spaced equalizer (FSE) followed by a Volterra equalizer (FSE-Volterra) is found to give improvement beyond that gained by the Volterra equalizer. Significant probability of error performance improvement is found for multilevel modulation schemes. Also, it is found that probability of error improvement is more significant for modulation schemes, constant amplitude and multilevel, which require higher signal to noise ratios (i.e., higher modulation orders) for reliable operation. The maximum likelihood sequence detection (MLSD) receiver for a nonlinear satellite channel, a bank of matched filters followed by a Viterbi detector, serves as a probability of error lower bound for the Volterra and FSE-Volterra equalizers. However, this receiver has not been evaluated for a specific satellite channel. In this work, an MLSD receiver is evaluated for a specific downlink-limited satellite channel. Because of the bank of matched filters, the MLSD receiver may be high in complexity. Consequently, the probability of error performance of a more practical suboptimal MLSD receiver, requiring only a single receive filter, is evaluated.

Phonotactic Probability Effects in Children Who Stutter

PubMed Central

Anderson, Julie D.; Byrd, Courtney T.

2008-01-01

Purpose The purpose of this study was to examine the influence of phonotactic probability, the frequency of different sound segments and segment sequences, on the overall fluency with which words are produced by preschool children who stutter (CWS), as well as to determine whether it has an effect on the type of stuttered disfluency produced. Method A 500+ word language sample was obtained from 19 CWS. Each stuttered word was randomly paired with a fluently produced word that closely matched it in grammatical class, word length, familiarity, word and neighborhood frequency, and neighborhood density. Phonotactic probability values were obtained for the stuttered and fluent words from an online database. Results Phonotactic probability did not have a significant influence on the overall susceptibility of words to stuttering, but it did impact the type of stuttered disfluency produced. In specific, single-syllable word repetitions were significantly lower in phonotactic probability than fluently produced words, as well as part-word repetitions and sound prolongations. Conclusions In general, the differential impact of phonotactic probability on the type of stuttering-like disfluency produced by young CWS provides some support for the notion that different disfluency types may originate in the disruption of different levels of processing. PMID:18658056

Uncertainty plus prior equals rational bias: an intuitive Bayesian probability weighting function.

PubMed

Fennell, John; Baddeley, Roland

2012-10-01

Empirical research has shown that when making choices based on probabilistic options, people behave as if they overestimate small probabilities, underestimate large probabilities, and treat positive and negative outcomes differently. These distortions have been modeled using a nonlinear probability weighting function, which is found in several nonexpected utility theories, including rank-dependent models and prospect theory; here, we propose a Bayesian approach to the probability weighting function and, with it, a psychological rationale. In the real world, uncertainty is ubiquitous and, accordingly, the optimal strategy is to combine probability statements with prior information using Bayes' rule. First, we show that any reasonable prior on probabilities leads to 2 of the observed effects; overweighting of low probabilities and underweighting of high probabilities. We then investigate 2 plausible kinds of priors: informative priors based on previous experience and uninformative priors of ignorance. Individually, these priors potentially lead to large problems of bias and inefficiency, respectively; however, when combined using Bayesian model comparison methods, both forms of prior can be applied adaptively, gaining the efficiency of empirical priors and the robustness of ignorance priors. We illustrate this for the simple case of generic good and bad options, using Internet blogs to estimate the relevant priors of inference. Given this combined ignorant/informative prior, the Bayesian probability weighting function is not only robust and efficient but also matches all of the major characteristics of the distortions found in empirical research. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Improved first-order uncertainty method for water-quality modeling

USGS Publications Warehouse

Melching, C.S.; Anmangandla, S.

1992-01-01

Uncertainties are unavoidable in water-quality modeling and subsequent management decisions. Monte Carlo simulation and first-order uncertainty analysis (involving linearization at central values of the uncertain variables) have been frequently used to estimate probability distributions for water-quality model output due to their simplicity. Each method has its drawbacks: Monte Carlo simulation's is mainly computational time; and first-order analysis are mainly questions of accuracy and representativeness, especially for nonlinear systems and extreme conditions. An improved (advanced) first-order method is presented, where the linearization point varies to match the output level whose exceedance probability is sought. The advanced first-order method is tested on the Streeter-Phelps equation to estimate the probability distribution of critical dissolved-oxygen deficit and critical dissolved oxygen using two hypothetical examples from the literature. The advanced first-order method provides a close approximation of the exceedance probability for the Streeter-Phelps model output estimated by Monte Carlo simulation using less computer time - by two orders of magnitude - regardless of the probability distributions assumed for the uncertain model parameters.

Ladar range image denoising by a nonlocal probability statistics algorithm

NASA Astrophysics Data System (ADS)

Xia, Zhi-Wei; Li, Qi; Xiong, Zhi-Peng; Wang, Qi

2013-01-01

According to the characteristic of range images of coherent ladar and the basis of nonlocal means (NLM), a nonlocal probability statistics (NLPS) algorithm is proposed in this paper. The difference is that NLM performs denoising using the mean of the conditional probability distribution function (PDF) while NLPS using the maximum of the marginal PDF. In the algorithm, similar blocks are found out by the operation of block matching and form a group. Pixels in the group are analyzed by probability statistics and the gray value with maximum probability is used as the estimated value of the current pixel. The simulated range images of coherent ladar with different carrier-to-noise ratio and real range image of coherent ladar with 8 gray-scales are denoised by this algorithm, and the results are compared with those of median filter, multitemplate order mean filter, NLM, median nonlocal mean filter and its incorporation of anatomical side information, and unsupervised information-theoretic adaptive filter. The range abnormality noise and Gaussian noise in range image of coherent ladar are effectively suppressed by NLPS.

Quantitative evaluation of Alzheimer's disease

NASA Astrophysics Data System (ADS)

Duchesne, S.; Frisoni, G. B.

2009-02-01

We propose a single, quantitative metric called the disease evaluation factor (DEF) and assess its efficiency at estimating disease burden in normal, control subjects (CTRL) and probable Alzheimer's disease (AD) patients. The study group consisted in 75 patients with a diagnosis of probable AD and 75 age-matched normal CTRL without neurological or neuropsychological deficit. We calculated a reference eigenspace of MRI appearance from reference data, in which our CTRL and probable AD subjects were projected. We then calculated the multi-dimensional hyperplane separating the CTRL and probable AD groups. The DEF was estimated via a multidimensional weighted distance of eigencoordinates for a given subject and the CTRL group mean, along salient principal components forming the separating hyperplane. We used quantile plots, Kolmogorov-Smirnov and χ2 tests to compare the DEF values and test that their distribution was normal. We used a linear discriminant test to separate CTRL from probable AD based on the DEF factor, and reached an accuracy of 87%. A quantitative biomarker in AD would act as an important surrogate marker of disease status and progression.

What is preexisting strength? Predicting free association probabilities, similarity ratings, and cued recall probabilities.

PubMed

Nelson, Douglas L; Dyrdal, Gunvor M; Goodmon, Leilani B

2005-08-01

Measuring lexical knowledge poses a challenge to the study of the influence of preexisting knowledge on the retrieval of new memories. Many tasks focus on word pairs, but words are embedded in associative networks, so how should preexisting pair strength be measured? It has been measured by free association, similarity ratings, and co-occurrence statistics. Researchers interpret free association response probabilities as unbiased estimates of forward cue-to-target strength. In Study 1, analyses of large free association and extralist cued recall databases indicate that this interpretation is incorrect. Competitor and backward strengths bias free association probabilities, and as with other recall tasks, preexisting strength is described by a ratio rule. In Study 2, associative similarity ratings are predicted by forward and backward, but not by competitor, strength. Preexisting strength is not a unitary construct, because its measurement varies with method. Furthermore, free association probabilities predict extralist cued recall better than do ratings and co-occurrence statistics. The measure that most closely matches the criterion task may provide the best estimate of the identity of preexisting strength.

Conversion and matched filter approximations for serial minimum-shift keyed modulation

NASA Technical Reports Server (NTRS)

Ziemer, R. E.; Ryan, C. R.; Stilwell, J. H.

1982-01-01

Serial minimum-shift keyed (MSK) modulation, a technique for generating and detecting MSK using series filtering, is ideally suited for high data rate applications provided the required conversion and matched filters can be closely approximated. Low-pass implementations of these filters as parallel inphase- and quadrature-mixer structures are characterized in this paper in terms of signal-to-noise ratio (SNR) degradation from ideal and envelope deviation. Several hardware implementation techniques utilizing microwave devices or lumped elements are presented. Optimization of parameter values results in realizations whose SNR degradation is less than 0.5 dB at error probabilities of .000001.

A new exact and more powerful unconditional test of no treatment effect from binary matched pairs.

PubMed

Lloyd, Chris J

2008-09-01

We consider the problem of testing for a difference in the probability of success from matched binary pairs. Starting with three standard inexact tests, the nuisance parameter is first estimated and then the residual dependence is eliminated by maximization, producing what I call an E+M P-value. The E+M P-value based on McNemar's statistic is shown numerically to dominate previous suggestions, including partially maximized P-values as described in Berger and Sidik (2003, Statistical Methods in Medical Research 12, 91-108). The latter method, however, may have computational advantages for large samples.

Platform-Switching for Cemented Versus Screwed Fixed Dental Prostheses: Reliability and Failure Modes: An In Vitro Study.

PubMed

Anchieta, Rodolfo Brunieira; Machado, Lucas Silveira; Hirata, Ronaldo; Bonfante, Estevam Augusto; Coelho, Paulo G

2016-08-01

The aim of this study was to evaluate the probability of survival of cemented and screwed three-unit implant-supported fixed dental prostheses (ISFDP) using different implant-abutment horizontal matching configurations (regular vs switching platforms). One hundred and sixty-eight implants with internal hexagon connection (4 mm diameter, 10 mm length, Emfils; Colosso Evolution System, Itú, SP, Brazil) were selected for this study according to the horizontal implant-abutment matching configuration (regular or switching) and retention method and divided in four groups (n = 21 per group) as follows: 1) regular platform cemented (IRC); 2) or screw-retained (IRS); 3) switched-platform cemented (ISC); or 4) screw-retained (ISS). Regular and platform-switched abutments (Colosso evolution, 4 mm and 3.3 mm, respectively) were torqued, and 84 three-unit metal bridges were fabricated (first molar pontic). Implants were embedded in polymethyl-methacrylate resin and subjected to step-stress accelerated life testing in water. Weibull distribution was used to determine the probability of survival for a mission of 100,000 cycles at 400 N (90% two-sided confidence intervals). Polarized light and scanning electron microscopes were used for fractographic analysis. The β values of 0.50, 1.19, 1.25, and 1.95 for groups IRC, IRS, ISC, and ISS respectively, indicated that fatigue accelerated the failure for all groups, except IRC. The cement-retained groups presented significantly higher probability of survival (IRC - 98%, ISC - 59%) than screw-retained groups (IRS - 23% and ISS - 0%). Screw-retained FDPs exclusively failed by abutment-screw fractures, whereas cement-retained presented implant/screw/abutment fractures. The probability of survival of cement-retained ISFDP was higher than screw-retained, irrespective of implant-abutment horizontal configuration. © 2015 Wiley Periodicals, Inc.

PARTS: Probabilistic Alignment for RNA joinT Secondary structure prediction

PubMed Central

Harmanci, Arif Ozgun; Sharma, Gaurav; Mathews, David H.

2008-01-01

A novel method is presented for joint prediction of alignment and common secondary structures of two RNA sequences. The joint consideration of common secondary structures and alignment is accomplished by structural alignment over a search space defined by the newly introduced motif called matched helical regions. The matched helical region formulation generalizes previously employed constraints for structural alignment and thereby better accommodates the structural variability within RNA families. A probabilistic model based on pseudo free energies obtained from precomputed base pairing and alignment probabilities is utilized for scoring structural alignments. Maximum a posteriori (MAP) common secondary structures, sequence alignment and joint posterior probabilities of base pairing are obtained from the model via a dynamic programming algorithm called PARTS. The advantage of the more general structural alignment of PARTS is seen in secondary structure predictions for the RNase P family. For this family, the PARTS MAP predictions of secondary structures and alignment perform significantly better than prior methods that utilize a more restrictive structural alignment model. For the tRNA and 5S rRNA families, the richer structural alignment model of PARTS does not offer a benefit and the method therefore performs comparably with existing alternatives. For all RNA families studied, the posterior probability estimates obtained from PARTS offer an improvement over posterior probability estimates from a single sequence prediction. When considering the base pairings predicted over a threshold value of confidence, the combination of sensitivity and positive predictive value is superior for PARTS than for the single sequence prediction. PARTS source code is available for download under the GNU public license at http://rna.urmc.rochester.edu. PMID:18304945

Probability of Alzheimer's disease in breast cancer survivors based on gray-matter structural network efficiency.

PubMed

Kesler, Shelli R; Rao, Vikram; Ray, William J; Rao, Arvind

2017-01-01

Breast cancer chemotherapy is associated with accelerated aging and potentially increased risk for Alzheimer's disease (AD). We calculated the probability of AD diagnosis from brain network and demographic and genetic data obtained from 47 female AD converters and 47 matched healthy controls. We then applied this algorithm to data from 78 breast cancer survivors. The classifier discriminated between AD and healthy controls with 86% accuracy ( P  < .0001). Chemotherapy-treated breast cancer survivors demonstrated significantly higher probability of AD compared to healthy controls ( P  < .0001) and chemotherapy-naïve survivors ( P  = .007), even after stratifying for apolipoprotein e4 genotype. Chemotherapy-naïve survivors also showed higher AD probability compared to healthy controls ( P  = .014). Chemotherapy-treated breast cancer survivors who have a particular profile of brain structure may have a higher risk for AD, especially those who are older and have lower cognitive reserve.

Disabled Workers' Risk of Hospitalization and Death

PubMed Central

McCoy, John L.; Iams, Howard M.

1994-01-01

Data from the 1982 New Beneficiary Survey (NBS) were matched with 5 years (1984-88) of Social Security and Medicare data to analyze disabled workers' probability of death and inpatient care. Fifteen percent of the disabled workers died within 18-24 months of initial eligibility; 34 percent died within 5 years. Older disabled workers had higher probabilities of death and hospitalization. Males were two times as likely to die as females, but no more likely to be hospitalized. Black persons also had a higher risk of death but no greater risk of hospitalization than other races. Additional health insurance had no influence on survival, but was differentially associated with inpatient care. Married males were more likely to survive. Physical functioning capacity had no influence on survival or hospitalization. Respiratory, circulatory, and digestive disorders increased the probability of hospitalization and mortality. PMID:10172156

High-resolution HLA haplotype frequencies of stem cell donors in Germany with foreign parentage: how can they be used to improve unrelated donor searches?

PubMed

Pingel, Julia; Solloch, Ute V; Hofmann, Jan A; Lange, Vinzenz; Ehninger, Gerhard; Schmidt, Alexander H

2013-03-01

In hematopoietic stem cell transplantation, human leukocyte antigens (HLA), usually HLA loci A, B, C, DRB1 and DQB1, are required to check histocompatibility between a potential donor and the recipient suffering from a malignant or non-malignant blood disease. As databases of potential unrelated donors are very heterogeneous with respect to typing resolution and number of typed loci, donor registries make use of haplotype frequency-based algorithms to provide matching probabilities for each potentially matching recipient/donor pair. However, it is well known that HLA allele and haplotype frequencies differ significantly between populations. We estimated high-resolution HLA-A, -B, -C, -DRB1 haplotype and allele frequencies of donors within DKMS German Bone Marrow Donor Center with parentage from 17 different countries: Turkey, Poland, Italy, Russian Federation, Croatia, Greece, Austria, Kazakhstan, France, The Netherlands, Republic of China, Romania, Portugal, USA, Spain, United Kingdom and Bosnia and Herzegovina. 5-locus haplotypes including HLA-DQB1 are presented for Turkey, Poland, Italy and Russian Federation. We calculated linkage disequilibria for each sample. Genetic distances between included countries could be shown to reflect geography. We further demonstrate how genetic differences between populations are reflected in matching probabilities of recipient/donor pairs and how they influence the search for unrelated donors as well as strategic donor center typings. Copyright © 2012 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

Incidence of late atrial fibrillation in bilateral lung versus heart transplants.

PubMed

Magruder, J Trent; Plum, William; Crawford, Todd C; Grimm, Joshua C; Borja, Marvin C; Berger, Ronald D; Tandri, Harikrishna; Calkins, Hugh; Cameron, Duke E; Mandal, Kaushik

2016-10-01

We compared the incidence of late-onset atrial fibrillation in orthotopic heart transplant recipients and bilateral orthotopic lung transplant recipients. We reviewed the records of all heart and lung transplant operations carried out in our institution between 1995 and 2015. We performed 1:1 propensity-matching based on patient age, sex, body mass index, and hypertension. Our primary outcome, late-onset atrial fibrillation, was defined as atrial fibrillation occurring after discharge following hospitalization for transplantation. Over the study period, 397 orthotopic heart transplants and 240 bilateral orthotopic lung transplants were performed. Propensity matching resulted in 173 pairs who were matched with respect to age, sex, body mass index, and preoperative hypertension. The median follow-up was 5.3 years for heart transplant patients and 3.1 years for lung transplant patients. Late-onset atrial fibrillation occurred in 11 heart transplant patients (5 of whom had biopsy-proven evidence of rejection) and 19 lung transplant patients (2 of whom had biopsy-proven evidence of rejection). On Kaplan-Meier analysis, the probability of late-onset atrial fibrillation at 5 years was 4.3% for heart transplant patients vs. 13.9% for lung transplant patients (log-rank p = 0.01). We documented an increased probability of late-onset atrial fibrillation among bilateral orthotopic lung transplant patients compared to orthotopic heart transplant patients. This was a hypothesis-generating study that suggests a potential role for cardiac autonomic innervation in the genesis of atrial fibrillation. © The Author(s) 2016.

DNA Identification of Skeletal Remains from World War II Mass Graves Uncovered in Slovenia

PubMed Central

Marjanović, Damir; Durmić-Pašić, Adaleta; Bakal, Narcisa; Haverić, Sanin; Kalamujić, Belma; Kovačević, Lejla; Ramić, Jasmin; Pojskić, Naris; Škaro, Vedrana; Projić, Petar; Bajrović, Kasim; Hadžiselimović, Rifat; Drobnič, Katja; Huffine, Ed; Davoren, Jon; Primorac, Dragan

2007-01-01

Aim To present the joint effort of three institutions in the identification of human remains from the World War II found in two mass graves in the area of Škofja Loka, Slovenia. Methods The remains of 27 individuals were found in two small and closely located mass graves. The DNA was isolated from bone and teeth samples using either standard phenol/chloroform alcohol extraction or optimized Qiagen DNA extraction procedure. Some recovered samples required the employment of additional DNA purification methods, such as N-buthanol treatment. QuantifilerTM Human DNA Quantification Kit was used for DNA quantification. PowerPlex 16 kit was used to simultaneously amplify 15 short tandem repeat (STR) loci. Matching probabilities were estimated using the DNA View program. Results Out of all processed samples, 15 remains were fully profiled at all 15 STR loci. The other 12 profiles were partial. The least successful profile included 13 loci. Also, 69 referent samples (buccal swabs) from potential living relatives were collected and profiled. Comparison of victims' profile against referent samples database resulted in 4 strong matches. In addition, 5 other profiles were matched to certain referent samples with lower probability. Conclusion Our results show that more than 6 decades after the end of the World War II, DNA analysis may significantly contribute to the identification of the remains from that period. Additional analysis of Y-STRs and mitochondrial DNA (mtDNA) markers will be performed in the second phase of the identification project. PMID:17696306

Improved photo response non-uniformity (PRNU) based source camera identification.

PubMed

Cooper, Alan J

2013-03-10

The concept of using Photo Response Non-Uniformity (PRNU) as a reliable forensic tool to match an image to a source camera is now well established. Traditionally, the PRNU estimation methodologies have centred on a wavelet based de-noising approach. Resultant filtering artefacts in combination with image and JPEG contamination act to reduce the quality of PRNU estimation. In this paper, it is argued that the application calls for a simplified filtering strategy which at its base level may be realised using a combination of adaptive and median filtering applied in the spatial domain. The proposed filtering method is interlinked with a further two stage enhancement strategy where only pixels in the image having high probabilities of significant PRNU bias are retained. This methodology significantly improves the discrimination between matching and non-matching image data sets over that of the common wavelet filtering approach. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Probabilistic record linkage

PubMed Central

Sayers, Adrian; Ben-Shlomo, Yoav; Blom, Ashley W; Steele, Fiona

2016-01-01

Abstract Studies involving the use of probabilistic record linkage are becoming increasingly common. However, the methods underpinning probabilistic record linkage are not widely taught or understood, and therefore these studies can appear to be a ‘black box’ research tool. In this article, we aim to describe the process of probabilistic record linkage through a simple exemplar. We first introduce the concept of deterministic linkage and contrast this with probabilistic linkage. We illustrate each step of the process using a simple exemplar and describe the data structure required to perform a probabilistic linkage. We describe the process of calculating and interpreting matched weights and how to convert matched weights into posterior probabilities of a match using Bayes theorem. We conclude this article with a brief discussion of some of the computational demands of record linkage, how you might assess the quality of your linkage algorithm, and how epidemiologists can maximize the value of their record-linked research using robust record linkage methods. PMID:26686842

Deep lamellar keratoplasty on air with lyophilised tissue.

PubMed Central

Chau, G K; Dilly, S A; Sheard, C E; Rostron, C K

1992-01-01

Deep lamellar keratoplasty on air involves injecting air into the corneal stroma to expand it to several times its normal thickness. This method is designed to facilitate dissection of the deep stroma and reduce the risk of perforation of Descemet's membrane when carrying out deep lamellar keratoplasty. We have modified the technique by using prelathed freeze-dried donor tissue and report our results in a series of patients with corneal stromal scarring owing to a variety of corneal problems, namely, keratoconus, pterygium, and herpes zoster ophthalmicus. All patients achieved best corrected postoperative visual acuity of 6/12 or better without problems associated with graft failure or rejection. Histopathological examination of corneal tissue following air injection showed surgical emphysema within the cornea and separation of deep stromal fibres from the underlying Descemet's membrane. Images PMID:1477037

Combined microwave heating and surface cooling of the cornea.

PubMed

Trembly, B S; Keates, R H

1991-01-01

We investigated a nonsurgical means of reshaping the cornea to correct hyperopia, keratoconus, or myopia. The object was to heat the central stroma of the cornea to the shrinkage temperature of collagen, 55-58 degrees C. The heating device was an open-ended, coaxial, near-field applicator driven at 2450 MHz; it incorporates cooling of the cornea surface by flow of saline. We investigated the system theoretically by computing the 2-D, axisymmetric temperature distribution with the finite element method. We investigated the system experimentally by heating excised steer corneas. Histology showed the system could shrink the stroma to a depth of 0.6 mm while sparing the epithelium in 75% of cases; the diameter of shrinkage was 1.3 mm. Theory predicted a significantly deeper and narrower region of shrinkage than was observed.

Corneal collagen crosslinking and pigment dispersion syndrome.

PubMed

LaHood, Benjamin R; Moore, Sacha

2017-03-01

We describe the case of a keratoconus patient with pigment dispersion syndrome (PDS) who was treated for progressive corneal ectasia with corneal collagen crosslinking (CXL). Pigment dispersion syndrome has been shown to have associated morphologic changes of the corneal endothelium. Corneal CXL has the potential to cause toxicity to the corneal endothelium, and adjacent pigment might increase the likelihood of damage. In this case, the presence of PDS had no detrimental effect on the outcome of treatment, and no complications were observed at 12 months follow-up, indicating that it may be safe to perform corneal CXL in the setting of PDS. This is an important observation as the number of indications for corneal CXL grows. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Corneal curvature, pachymetry, and endothelial cell density in Marfan syndrome.

PubMed

Konradsen, Tiina R; Koivula, Annemari; Kugelberg, Maria; Zetterström, Charlotta

2012-06-01

To evaluate corneal curvature, pachymetry, and endothelial cell density (ECD) in Marfan syndrome (MFS). A case-control study in which K values, pachymetry, and ECD were compared in 39 MFS eyes and 40 control eyes matched for age and refraction was conducted. MFS eyes with lens subluxation also were compared with eyes without subluxation. The mean K(med) value in MFS eyes was lower than in the control eyes, 42.2 ± 1.9 versus 43.4 ± 1.4 dioptres (D), respectively (p = 0.02). Fifteen MFS eyes (38%) and three control eyes (8%) had K(med) values below 41.5 D (p = 0.0012). MFS eyes had generally more corneal astigmatism than control eyes, 1.1 ± 0.9 versus 0.8 ± 0.4 D (p = 0.035), and MFS eyes with lens subluxation had more corneal astigmatism than those without, 1.6 ± 1.1 versus 0.6 ± 0.3 D (p = 0.0002). Nine MFS eyes with corneal astigmatism exceeding 1.5 D also had a subluxated lens. No eyes had keratoconus. The mean pachymetry value was lower in MFS eyes compared to the controls, 485 ± 54.5 versus 514 ± 37.3 μm (p = 0.007); 24 MFS eyes (62%) and 10 control eyes (25%) had measurements below 500 μm (p = 0.01). The mean ECD values were similar in MFS and control eyes, 2815 ± 430 versus 2858 ± 458 cells/mm(2) (p = 0.66). The mean K value, pachymetry, and ECD values did not differ between MFS eyes with and without lens subluxation. Decreased K values and pachymetry could indicate MFS regardless of subluxation. High corneal astigmatism is associated with subluxation in MFS. Subluxation should be identified in MFS eyes with high corneal astigmatism. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

Infrared studies of galactic center x-ray sources

NASA Astrophysics Data System (ADS)

DeWitt, Curtis

In this dissertation I use a variety of approaches to discover the nature of a subset of the nearly 10,000 X-ray point sources in the 2° x 0.8° region around the Galactic Center. I produced a JHK s source catalog of the 170 x170 region around Sgr A* an area containing 4339 of these X-ray sources, with the ISPI camera on the CTIO 4-m telescope. I cross-correlated the Chandra and ISPI catalogs to find potential near-infrared (NIR) counterparts to the X-ray sources. The extreme NIR source crowding in the field means that it is not possible to establish the authenticity of the matches with astrometry and photometry alone. I found 2137 IR/X-ray astrometrically matched sources; statistically I calculated that my catalog contains 289+/-13 true matches to soft X-ray sources and 154 +/- 39 matches to hard X-ray sources. However, the fraction of matches to hard sources that are spurious is 90%, compared to 40% for soft source matches, making the hard source NIR matches particularly challenging for spectroscopic follow-up. I statistically investigated the parameter space of matched sources and identified a set of 98 NIR matches to hard X-ray sources with reddenings consistent with the GC distance which have a 45% probability of being true counterparts. I created two additional photometric catalogs of the GC region to investigate the variability of X-ray counterparts over a time baseline of several years. I found 48 variable NIR sources matched to X-ray sources, with 2 spectroscopically confirmed to be true counterparts (1 in previous literature and one in this study). I took spectra of 46 of my best candidates for counterparts to X-ray sources toward the GC, and spectroscopically confirmed 4 sources as the authentic physical counterpart on the basis of emission lines in the H and K band spectra. These sources include a Be high mass X-ray binary located 16 pc in projection away from Sgr A*; a hard X-ray symbiotic binary located 22 pc in projection from Sgr A*; an O-type supergiant at an distance of 3.7 kpc; and an O star at the Galactic Center distance. I also identified 3 foreground X-ray source counterparts within a distance of 1 kpc which do not show obvious emission features in their spectra. However, on the basis of the low surface density of unreddened sources along the line-of-sight to the Galactic Center and our previous statistical analysis (DeWitt et al., 2010), these can be securely identified as the true counterparts to their coincident X-ray point sources. Lastly, I used the results of my matching simulations to infer the presence of 7+/-2 true counterparts within a set of late type giants that I observed without detectable emission features. I conclude from this work that the probable excess in red giant X-ray counterparts without emission lines needs to be confirmed both with larger samples of spectroscopically surveyed counterparts and more advanced statistical simulations of the match authenticity. Also, the nature of the compact object in two of my counterpart discoveries, the Be HMXB and the symbiotic binary, can be strongly constrained with X-ray spectral fitting. Lastly, I conclude that spectroscopic surveys for new X-ray source counterparts in the GC may be able to increase their efficiency by specifically targeting photometric variables and very close astrometric matches of IR/X-ray sources.

Thermoluminescence: Potential Applications in Forensic Science

NASA Technical Reports Server (NTRS)

Ingham, J. D.; Lawson, D. D.

1973-01-01

In crime laboratories one of the most difficult operations is to determine unequivocally whether or not two samples of evidence of the same type were originally part of the same thing or were from the same source. It has been found that high temperature thermoluminescence (room temperature to 723 K) can be used for comparisons of this type, although work to date indicates that there is generally a finite probability for coincidental matching of glass or soil samples. Further work is required to determine and attempt to minimize these probabilities for different types of materials, and to define more clearly the scope of applicability of thermoluminescence to actual forensic situations.

Concurrent variation of response bias and sensitivity in an operant-psychophysical test.

NASA Technical Reports Server (NTRS)

Terman, M.; Terman, J. S.

1972-01-01

The yes-no signal detection procedure was applied to a single-response operant paradigm in which rats discriminated between a standard auditory intensity and attenuated comparison values. The payoff matrix was symmetrical (with reinforcing brain stimulation for correct detections and brief time-out for errors), but signal probability and intensity differences were varied to generate a family of isobias and isosensitivity functions. The d' parameter remained fairly constant across a wide range of bias levels. Isobias functions deviated from a strict matching strategy as discrimination difficulty increased, although an orderly relation was maintained between signal probability value and the degree and direction of response bias.

THEMATIC ACCURACY OF THE 1992 NATIONAL LAND-COVER DATA (NLCD) FOR THE EASTERN UNITED STATES: STATISTICAL METHODOLOGY AND REGIONAL RESULTS

EPA Science Inventory

The accuracy of the National Land Cover Data (NLCD) map is assessed via a probability sampling design incorporating three levels of stratification and two stages of selection. Agreement between the map and reference land-cover labels is defined as a match between the primary or a...

Psychopysics of Remembering: To Bias or Not to Bias?

ERIC Educational Resources Information Center

White, K. Geoffrey; Wixted, John T.

2010-01-01

Delayed matching to sample is typically a two-alternative forced-choice procedure with two sample stimuli. In this task the effects of varying the probability of reinforcers for correct choices and the resulting receiver operating characteristic are symmetrical. A version of the task where a sample is present on some trials and absent on others is…

Teacher Quality and Teacher Mobility. Working Paper 57

ERIC Educational Resources Information Center

Feng, Li; Sass, Tim

2011-01-01

Using matched student-teacher panel data from the state of Florida, the authors study the determinants of teacher job change and the impact of such mobility on the distribution of teacher quality. The probability a teacher stays at a school increases the more productive they are in their current school. The quality of teachers who exit teaching…

Reading Achievements of Vietnamese Grade 5 Pupils

ERIC Educational Resources Information Center

Griffin, Patrick; Thanh, Mai Thi

2006-01-01

This article described a national study in Vietnam whereby a probability sample of students was chosen from each of the 61 provinces. A reading test consisting of 60 items was administered. The items were matched to the Vietnam reading and language curriculum for Year 5 students. Using a skills audit of the items, a variable of reading development…

Accessibility of the Nondominant Language in Picture Naming: A Counterintuitive Effect of Dementia on Bilingual Language Production

ERIC Educational Resources Information Center

Gollan, Tamar H.; Salmon, David P.; Montoya, Rosa I.; da Pena, Eileen

2010-01-01

The current study tested the assumption that bilinguals with dementia regress to using primarily the dominant language. Spanish-English bilinguals with probable Alzheimer's disease (AD; n = 29), and matched bilingual controls (n = 42) named Boston Naming Test pictures in their dominant and nondominant languages. Surprisingly, differences between…

Saccade selection when reward probability is dynamically manipulated using Markov chains

PubMed Central

Lovejoy, Lee P.; Krauzlis, Richard J.

2012-01-01

Markov chains (stochastic processes where probabilities are assigned based on the previous outcome) are commonly used to examine the transitions between behavioral states, such as those that occur during foraging or social interactions. However, relatively little is known about how well primates can incorporate knowledge about Markov chains into their behavior. Saccadic eye movements are an example of a simple behavior influenced by information about probability, and thus are good candidates for testing whether subjects can learn Markov chains. In addition, when investigating the influence of probability on saccade target selection, the use of Markov chains could provide an alternative method that avoids confounds present in other task designs. To investigate these possibilities, we evaluated human behavior on a task in which stimulus reward probabilities were assigned using a Markov chain. On each trial, the subject selected one of four identical stimuli by saccade; after selection, feedback indicated the rewarded stimulus. Each session consisted of 200–600 trials, and on some sessions, the reward magnitude varied. On sessions with a uniform reward, subjects (n = 6) learned to select stimuli at a frequency close to reward probability, which is similar to human behavior on matching or probability classification tasks. When informed that a Markov chain assigned reward probabilities, subjects (n = 3) learned to select the greatest reward probability more often, bringing them close to behavior that maximizes reward. On sessions where reward magnitude varied across stimuli, subjects (n = 6) demonstrated preferences for both greater reward probability and greater reward magnitude, resulting in a preference for greater expected value (the product of reward probability and magnitude). These results demonstrate that Markov chains can be used to dynamically assign probabilities that are rapidly exploited by human subjects during saccade target selection. PMID:18330552

Saccade selection when reward probability is dynamically manipulated using Markov chains.

PubMed

Nummela, Samuel U; Lovejoy, Lee P; Krauzlis, Richard J

2008-05-01

Markov chains (stochastic processes where probabilities are assigned based on the previous outcome) are commonly used to examine the transitions between behavioral states, such as those that occur during foraging or social interactions. However, relatively little is known about how well primates can incorporate knowledge about Markov chains into their behavior. Saccadic eye movements are an example of a simple behavior influenced by information about probability, and thus are good candidates for testing whether subjects can learn Markov chains. In addition, when investigating the influence of probability on saccade target selection, the use of Markov chains could provide an alternative method that avoids confounds present in other task designs. To investigate these possibilities, we evaluated human behavior on a task in which stimulus reward probabilities were assigned using a Markov chain. On each trial, the subject selected one of four identical stimuli by saccade; after selection, feedback indicated the rewarded stimulus. Each session consisted of 200-600 trials, and on some sessions, the reward magnitude varied. On sessions with a uniform reward, subjects (n = 6) learned to select stimuli at a frequency close to reward probability, which is similar to human behavior on matching or probability classification tasks. When informed that a Markov chain assigned reward probabilities, subjects (n = 3) learned to select the greatest reward probability more often, bringing them close to behavior that maximizes reward. On sessions where reward magnitude varied across stimuli, subjects (n = 6) demonstrated preferences for both greater reward probability and greater reward magnitude, resulting in a preference for greater expected value (the product of reward probability and magnitude). These results demonstrate that Markov chains can be used to dynamically assign probabilities that are rapidly exploited by human subjects during saccade target selection.

Dynamic ride-sharing: Theory and practice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hall, R.W.; Qureshi, A.

1997-08-01

Dynamic Ride-sharing (DR) is envisioned as an automated process by which individuals find ride-matches on a trip by trip basis. This paper examines the DR concept on both a theoretical basis and on the basis of actual implementation in Los Angeles. Specifically, the paper investigates the likelihood that the user of a DR system would be successful in finding a ride-match. In a theoretical sense, this paper shows that dynamic ride-sharing is a viable concept. For a congested freeway corridor, the number of trips generated per unit time and space should be sufficient to yield a reasonably large population ofmore » potential ride-matches for a DR system. Unfortunately, as demonstrated in the experiment, theory and practice are not the same. Even when individuals share common trip patterns, consummating a ride-match is no easy task for logistical reasons. At best, one might expect a one in five change of someone offering a ride when trip patterns are similar. This probability would decline for casual trips, and when contacting individuals who have not expressed a prior willingness to carpool.« less

General Certificate of Secondary Education performance in very low birthweight infants

PubMed Central

Pharoah, P; Stevenson, C; West, C

2003-01-01

Aim: To compare children of very low birth weight with matched controls for their performance in the General Certificate of Secondary Education (GCSE). Methods: GCSE examination results of 167 children of birth weight ⩽1500 g attending mainstream schools and without clinical disability and 167 individually matched classroom controls were analysed. Results: In 143 instances, both children of a matched pair were entered for examination in one or more GCSE subjects. The total points score obtained was greater in the comparison group than in the index cases (difference between means 4.45: 95% CI 0.95 to 7.94; p = 0.01). The mean point score per examination subject was also significantly greater in the comparison group than in the index cases (mean of differences 0.43: 95% CI 0.12 to 0.73; p < 0.01). Conclusions: As the children were closely matched for school and several social variables, factors acting during fetal or early postnatal development of very low birthweight infants probably compromise performance in the GCSE examination to a greater extent than school or childhood social environmental factors. PMID:12651749

Graphic matching based on shape contexts and reweighted random walks

NASA Astrophysics Data System (ADS)

Zhang, Mingxuan; Niu, Dongmei; Zhao, Xiuyang; Liu, Mingjun

2018-04-01

Graphic matching is a very critical issue in all aspects of computer vision. In this paper, a new graphics matching algorithm combining shape contexts and reweighted random walks was proposed. On the basis of the local descriptor, shape contexts, the reweighted random walks algorithm was modified to possess stronger robustness and correctness in the final result. Our main process is to use the descriptor of the shape contexts for the random walk on the iteration, of which purpose is to control the random walk probability matrix. We calculate bias matrix by using descriptors and then in the iteration we use it to enhance random walks' and random jumps' accuracy, finally we get the one-to-one registration result by discretization of the matrix. The algorithm not only preserves the noise robustness of reweighted random walks but also possesses the rotation, translation, scale invariance of shape contexts. Through extensive experiments, based on real images and random synthetic point sets, and comparisons with other algorithms, it is confirmed that this new method can produce excellent results in graphic matching.

How temporal cues can aid colour constancy

PubMed Central

Foster, David H.; Amano, Kinjiro; Nascimento, Sérgio M. C.

2007-01-01

Colour constancy assessed by asymmetric simultaneous colour matching usually reveals limited levels of performance in the unadapted eye. Yet observers can readily discriminate illuminant changes on a scene from changes in the spectral reflectances of the surfaces making up the scene. This ability is probably based on judgements of relational colour constancy, in turn based on the physical stability of spatial ratios of cone excitations under illuminant changes. Evidence is presented suggesting that the ability to detect violations in relational colour constancy depends on temporal transient cues. Because colour constancy and relational colour constancy are closely connected, it should be possible to improve estimates of colour constancy by introducing similar transient cues into the matching task. To test this hypothesis, an experiment was performed in which observers made surface-colour matches between patterns presented in the same position in an alternating sequence with period 2 s or, as a control, presented simultaneously, side-by-side. The degree of constancy was significantly higher for sequential presentation, reaching 87% for matches averaged over 20 observers. Temporal cues may offer a useful source of information for making colour-constancy judgements. PMID:17515948

Coma cluster ultradiffuse galaxies are not standard radio galaxies

NASA Astrophysics Data System (ADS)

Struble, Mitchell F.

2018-02-01

Matching members in the Coma cluster catalogue of ultradiffuse galaxies (UDGs) from SUBARU imaging with a very deep radio continuum survey source catalogue of the cluster using the Karl G. Jansky Very Large Array (VLA) within a rectangular region of ∼1.19 deg2 centred on the cluster core reveals matches consistent with random. An overlapping set of 470 UDGs and 696 VLA radio sources in this rectangular area finds 33 matches within a separation of 25 arcsec; dividing the sample into bins with separations bounded by 5, 10, 20 and 25 arcsec finds 1, 4, 17 and 11 matches. An analytical model estimate, based on the Poisson probability distribution, of the number of randomly expected matches within these same separation bounds is 1.7, 4.9, 19.4 and 14.2, each, respectively, consistent with the 95 per cent Poisson confidence intervals of the observed values. Dividing the data into five clustercentric annuli of 0.1° and into the four separation bins, finds the same result. This random match of UDGs with VLA sources implies that UDGs are not radio galaxies by the standard definition. Those VLA sources having integrated flux >1 mJy at 1.4 GHz in Miller, Hornschemeier and Mobasher without SDSS galaxy matches are consistent with the known surface density of background radio sources. We briefly explore the possibility that some unresolved VLA sources near UDGs could be young, compact, bright, supernova remnants of Type Ia events, possibly in the intracluster volume.

Haploidentical transplant with posttransplant cyclophosphamide vs matched unrelated donor transplant for acute myeloid leukemia

PubMed Central

Zhang, Mei-Jie; Bacigalupo, Andrea A.; Bashey, Asad; Appelbaum, Frederick R.; Aljitawi, Omar S.; Armand, Philippe; Antin, Joseph H.; Chen, Junfang; Devine, Steven M.; Fowler, Daniel H.; Luznik, Leo; Nakamura, Ryotaro; O’Donnell, Paul V.; Perales, Miguel-Angel; Pingali, Sai Ravi; Porter, David L.; Riches, Marcie R.; Ringdén, Olle T. H.; Rocha, Vanderson; Vij, Ravi; Weisdorf, Daniel J.; Champlin, Richard E.; Horowitz, Mary M.; Fuchs, Ephraim J.; Eapen, Mary

2015-01-01

We studied adults with acute myeloid leukemia (AML) after haploidentical (n = 192) and 8/8 HLA-matched unrelated donor (n = 1982) transplantation. Haploidentical recipients received calcineurin inhibitor (CNI), mycophenolate, and posttransplant cyclophosphamide for graft-versus-host disease (GVHD) prophylaxis; 104 patients received myeloablative and 88 received reduced intensity conditioning regimens. Matched unrelated donor transplant recipients received CNI with mycophenolate or methotrexate for GVHD prophylaxis; 1245 patients received myeloablative and 737 received reduced intensity conditioning regimens. In the myeloablative setting, day 30 neutrophil recovery was lower after haploidentical compared with matched unrelated donor transplants (90% vs 97%, P = .02). Corresponding rates after reduced intensity conditioning transplants were 93% and 96% (P = .25). In the myeloablative setting, 3-month acute grade 2-4 (16% vs 33%, P < .0001) and 3-year chronic GVHD (30% vs 53%, P < .0001) were lower after haploidentical compared with matched unrelated donor transplants. Similar differences were observed after reduced intensity conditioning transplants, 19% vs 28% (P = .05) and 34% vs 52% (P = .002). Among patients receiving myeloablative regimens, 3-year probabilities of overall survival were 45% (95% CI, 36-54) and 50% (95% CI, 47-53) after haploidentical and matched unrelated donor transplants (P = .38). Corresponding rates after reduced intensity conditioning transplants were 46% (95% CI, 35-56) and 44% (95% CI, 0.40-47) (P = .71). Although statistical power is limited, these data suggests that survival for patients with AML after haploidentical transplantation with posttransplant cyclophosphamide is comparable with matched unrelated donor transplantation. PMID:26130705

Comparison of two equivalent model for end-stage liver disease scores for hepatocellular carcinoma patients using data from the United Network for Organ Sharing liver transplant waiting list registry.

PubMed

Alver, Sarah K; Lorenz, Douglas J; Washburn, Kenneth; Marvin, Michael R; Brock, Guy N

2017-11-01

Patients with hepatocellular carcinoma (HCC) have been advantaged on the liver transplant waiting list within the United States, and a 6-month delay and exception point cap have recently been implemented to address this disparity. An alternative approach to prioritization is an HCC-specific scoring model such as the MELD Equivalent (MELD EQ ) and the mixed new deMELD. Using data on adult patients added to the UNOS waitlist between 30 September 2009 and 30 June 2014, we compared projected dropout and transplant probabilities for patients with HCC under these two models. Both scores matched actual non-HCC dropout in groups with scores <22 and improved equity with non-HCC transplant probabilities overall. However, neither score matched non-HCC dropout accurately for scores of 25-40 and projected dropout increased beyond non-HCC probabilities for scores <16. The main differences between the two scores were as follows: (i) the MELD EQ assigns 6.85 more points after 6 months on the waitlist and (ii) the deMELD gives greater weight to tumor size and laboratory MELD. Post-transplant survival was lower for patients with scores in the 22-30 range compared with those with scores <16 (P = 0.007, MELD EQ ; P = 0.015, deMELD). While both scores result in better equity of waitlist outcomes compared with scheduled progression, continued development and calibration is recommended. © 2017 Steunstichting ESOT.

Characterization of GTA weldments in 10Ni-8CO-2Cr-1MO steel

NASA Technical Reports Server (NTRS)

Stonesifer, F. R.; Smith, H. L.

1972-01-01

This study of 10Ni-8Co-2Cr-1Mo steel includes evaluations of tensile, impact, hardness, fracture toughness properties, and metallographic features. Base plate and three weldments in one-inch thicknesses were examined to compare as-welded properties with those obtained after reaging, and results of welding the 10%Ni alloy with 9-4-20 wire as opposed to a matching weld wire composition. Critical crack sizes are calculated for the material. The most desirable weld properties are obtained using the matching weld wire and a reaging cycle. However, the improvement gained through reaging is probably not sufficient to justify the additional cost for most practical applications.

Modeling potential distribution of Oligoryzomys longicaudatus, the Andes virus (Genus: Hantavirus) reservoir, in Argentina.

PubMed

Andreo, Verónica; Glass, Gregory; Shields, Timothy; Provensal, Cecilia; Polop, Jaime

2011-09-01

We constructed a model to predict the potential distribution of Oligoryzomys longicaudatus, the reservoir of Andes virus (Genus: Hantavirus), in Argentina. We developed an extensive database of occurrence records from published studies and our own surveys and compared two methods to model the probability of O. longicaudatus presence; logistic regression and MaxEnt algorithm. The environmental variables used were tree, grass and bare soil cover from MODIS imagery and, altitude and 19 bioclimatic variables from WorldClim database. The models performances were evaluated and compared both by threshold dependent and independent measures. The best models included tree and grass cover, mean diurnal temperature range, and precipitation of the warmest and coldest seasons. The potential distribution maps for O. longicaudatus predicted the highest occurrence probabilities along the Andes range, from 32°S and narrowing southwards. They also predicted high probabilities for the south-central area of Argentina, reaching the Atlantic coast. The Hantavirus Pulmonary Syndrome cases coincided with mean occurrence probabilities of 95 and 77% for logistic and MaxEnt models, respectively. HPS transmission zones in Argentine Patagonia matched the areas with the highest probability of presence. Therefore, colilargos presence probability may provide an approximate risk of transmission and act as an early tool to guide control and prevention plans.

Acute hypoxia influences collagen and matrix metalloproteinase expression by human keratoconus cells in vitro.

PubMed

McKay, Tina B; Hjortdal, Jesper; Priyadarsini, Shrestha; Karamichos, Dimitrios

2017-01-01

Keratoconus (KC) is a progressive corneal ectasia linked to thinning of the central cornea. Hard contact lenses, rigid gas permeable lenses, and scleral lenses are the primary treatment modalities for early to mid- stages of KC to correct refractive error and astigmatism that develops as a result of an irregular corneal structure. These treatments are associated with significant drawbacks, including reduced availability of the tear film and oxygen to the corneal epithelium and stroma. However, it remains unknown whether hypoxia affects corneal integrity in the KC pathobiology. A number of studies have associated elevated oxidative stress with KC both in vitro and ex vivo. We hypothesized that KC-derived corneal fibroblasts are more susceptible to hypoxia-induced oxidative stress compared to healthy controls leading to exacerbation of corneal thinning in KC. This study investigated the effects of hypoxia on ECM secretion, assembly, and matrix metalloproteinase (MMP) expression in human corneal fibroblasts from healthy controls (HCFs) and KC patients (HKCs) in vitro. HCFs and HKCs were cultured in 3D constructs for 3 weeks and maintained or transferred to normoxic (21% O2) or hypoxic (2% O2) conditions, respectively, for 1 additional week. At the 4 week time-point, constructs were isolated and probed for Collagen I, III, and V, keratocan and MMP-1, -2, -3, -9, and -13, as well as hypoxia markers, hypoxia inducible factor-1α and lactoferrin. Conditioned media was also collected and probed for Collagen I, III, and V by Western blot. Thickness of the ECM assembled by HCFs and HKCs was measured using immunofluorescence microscopy. Results showed that hypoxia significantly reduced Collagen I secretion in HKCs, as well as upregulated the expression of MMP-1 and -2 with no significant effects on MMP-3, -9, or -13. ECM thickness was reduced in both cell types following 1 week in a low oxygen environment. Our study shows that hypoxia influences collagen and MMP expression by HKCs, which may have consequential effects on ECM structure in the context of KC.

Clinical results with two different pharmaceutical preparations of riboflavin in corneal cross-linking: an 18-month follow up.

PubMed

Hashemi, Hassan; Seyedian, Mohammad Amin; Miraftab, Mohammad; Bahrmandy, Hooman; Sabzevari, Araz; Asgari, Soheila

2015-01-24

Comparison of long-term clinical results of two different pharmaceutical formulations used in corneal cross-linking (CXL) in keratoconus patients. Sixty eyes of 60 keratoconus patients underwent CXL in two groups. We used riboflavin preparations from Sina Darou, Iran in group A, and Streuli Pharma, Switzerland in group B. Here we made inter-group comparison of changes in vision, refraction, Pentacam indices, corneal biomechanical indices, and endothelial cell count (ECC) 18 months after CXL. Since four patients were lost to follow-up, 56 eyes (28 eyes in each group) were compared. Mean improvement in uncorrected visual acuity (UCVA) was 0.31 ± 0.65 LogMAR (P=0.014) in group A and 0.24 ± 0.62 LogMAR (P=0.082) in group B. Best corrected visual acuity (BCVA) remained quite unchanged in both groups (P=0.774). Mean spherical refractive error reduced by 0.45 ± 1.15 diopter (D) (P=0.041) in group A and 0.27 ± 1.73 D (P=0.458) in group B (P=0.655). Cylinder error and spherical equivalent had a similar trend without any change. Max-K (P=0.006) and mean-K (P=0.044) decreased significantly more in group A compared to group B. The reduction in CCT was significantly more in group A than group B (P=0.004). Q-value was quite unchanged in both groups (P=0.704). The inter-group difference in CH reduction was borderline significant statistically (P=0.057). Changes in corneal resistance factor and endothelial cell count were not significantly different between two groups (P=0.117 and P=0.229). Clinical results of CXL with the domestic preparation of riboflavin are similar to that achieved with the Swiss made product in some aspects, and it is the preferred brand in some other aspects. This study will continue to report longer follow-up results. IRCT201212034333N2.

Decreased Integrity, Content, and Increased Transcript Level of Mitochondrial DNA Are Associated with Keratoconus

PubMed Central

Hao, Xiao-Dan; Chen, Zhao-Li; Qu, Ming-Li; Zhao, Xiao-Wen; Li, Su-Xia; Chen, Peng

2016-01-01

Oxidative stress may play an important role in the pathogenesis of keratoconus (KC). Mitochondrial DNA (mtDNA) is involved in mitochondrial function, and the mtDNA content, integrity, and transcript level may affect the generation of reactive oxygen species (ROS) and be involved in the pathogenesis of KC. We designed a case-control study to research the relationship between KC and mtDNA integrity, content and transcription. One-hundred ninety-eight KC corneas and 106 normal corneas from Chinese patients were studied. Quantitative real-time PCR was used to measure the relative mtDNA content, transcript levels of mtDNA and related genes. Long-extension PCR was used to detect mtDNA damage. ROS, mitochondrial membrane potential and ATP were measured by respective assay kit, and Mito-Tracker Green was used to label the mitochondria. The relative mtDNA content of KC corneas was significantly lower than that of normal corneas (P = 9.19×10−24), possibly due to decreased expression of the mitochondrial transcription factor A (TFAM) gene (P = 3.26×10−3). In contrast, the transcript levels of mtDNA genes were significantly increased in KC corneas compared with normal corneas (NADH dehydrogenase subunit 1 [ND1]: P = 1.79×10−3; cytochrome c oxidase subunit 1 [COX1]: P = 1.54×10−3; NADH dehydrogenase subunit 1, [ND6]: P = 4.62×10−3). The latter may be the result of increased expression levels of mtDNA transcription-related genes mitochondrial RNA polymerase (POLRMT) (P = 2.55×10−4) and transcription factor B2 mitochondrial (TFB2M) (P = 7.88×10−5). KC corneas also had increased mtDNA damage (P = 3.63×10−10), higher ROS levels, and lower mitochondrial membrane potential and ATP levels compared with normal corneas. Decreased integrity, content and increased transcript level of mtDNA are associated with KC. These changes may affect the generation of ROS and play a role in the pathogenesis of KC. PMID:27783701

A comparison of lamellar and penetrating keratoplasty outcomes: a registry study.

PubMed

Coster, Douglas J; Lowe, Marie T; Keane, Miriam C; Williams, Keryn A

2014-05-01

To investigate changing patterns of practice of keratoplasty in Australia, graft survival, visual outcomes, the influence of experience, and the surgeon learning curve for endothelial keratoplasty. Observational, prospective cohort study. From a long-standing national corneal transplantation register, 13 920 penetrating keratoplasties, 858 deep anterior lamellar keratoplasties (DALKs), and 2287 endokeratoplasties performed between January 1996 and February 2013 were identified. Kaplan-Meier functions were used to assess graft survival and surgeon experience, the Pearson chi-square test was used to compare visual acuities, and linear regression was used to examine learning curves. Graft survival. The total number of corneal grafts performed annually is increasing steadily. More DALKs but fewer penetrating grafts are being performed for keratoconus, and more endokeratoplasties but fewer penetrating grafts are being performed for Fuchs' dystrophy and pseudophakic bullous keratopathy. In 2012, 1482 grafts were performed, compared with 955 in 2002, translating to a requirement for 264 extra corneal donors across the country in 2012. Comparing penetrating grafts and DALKs performed for keratoconus over the same era, both graft survival (P <0.001) and visual outcomes (P <0.001) were significantly better for penetrating grafts. Survival of endokeratoplasties performed for Fuchs' dystrophy or pseudophakic bullous keratopathy was poorer than survival of penetrating grafts for the same indications over the same era (P <0.001). Visual outcomes were significantly better for penetrating grafts than for endokeratoplasties performed for Fuchs' dystrophy (P <0.001), but endokeratoplasties achieved better visual outcomes than penetrating grafts for pseudophakic bullous keratopathy (P <0.001). Experienced surgeons (>100 registered keratoplasties) achieved significantly better survival of endokeratoplasties (P <0.001) than surgeons who had performed fewer grafts (<100 registered keratoplasties). In the hands of experienced, high-volume surgeons, endokeratoplasty failures occurred even after 100 grafts had been performed. More corneal transplants, especially DALKs and endokeratoplasties, are being performed in Australia than ever before. Survival of DALKs and endokeratoplasties is worse than the survival of penetrating grafts performed for the same indications over the same timeframe. Many endokeratoplasties fail early, but the evidence for a surgeon learning curve is unconvincing. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Changes in astigmatism and corneal higher-order aberrations after phacoemulsification with toric intraocular lens implantation for mild keratoconus with cataract.

PubMed

Kamiya, Kazutaka; Shimizu, Kimiya; Miyake, Toshiyuki

2016-07-01

To assess the changes in astigmatism and higher-order aberrations (HOAs) after toric intraocular lens (IOL) implantation for mild non-progressive keratoconus with cataract. We prospectively examined 19 eyes of 19 consecutive keratoconic patients (mean age ± standard deviation, 63.1 ± 9.1 years) who underwent phacoemulsification with toric IOL implantation. We determined uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive astigmatism, corneal astigmatism, corneal HOAs and astigmatic axis rotation both preoperatively and 3 months postoperatively. Logarithm of the minimal angle of resolution (logMAR) UDVA was significantly improved from 1.14 ± 0.50 preoperatively to 0.46 ± 0.33 postoperatively (Wilcoxon signed-rank test, p < 0.001). LogMAR CDVA was also significantly improved from 0.27 ± 0.45 preoperatively to -0.01 ± 0.09 postoperatively (p < 0.001). In 5 of 6 eyes in which the target refraction was emmetropia, postoperative UDVA was better than 20/32. The achieved spherical equivalent correction was within ±0.5 diopters (D) of the targeted correction in 13 (68 %) eyes and 1.0 in 18 (95 %) eyes. The refractive astigmatism was significantly decreased from -1.92 ± 1.73 D preoperatively to -0.70 ± 0.60 D postoperatively (p = 0.006). The corneal astigmatism changed from 2.89 ± 1.30 D preoperatively to 2.98 ± 1.09 D postoperatively (p = 0.492), which was not statistically significant. The corneal HOAs for a 4-mm pupil was changed from 0.47 ± 0.23 µm preoperatively to 0.52 ± 0.26 µm postoperatively (p = 0.211), which was not statistically significant. According to our experience, toric IOL implantation for mild keratoconic patients having rigid gas-permeable lens intolerance appears to be effective for reducing refractive astigmatism without a significant induction of corneal HOAs.

Silicone hydrogel mini-scleral contact lenses in early stage after corneal collagen cross-linking for keratoconus: a retrospective case series.

PubMed

Severinsky, Boris; Wajnsztajn, Denise; Frucht-Pery, Joseph

2013-11-01

 The aim was to the evaluate performance of a novel silicone hydrogel mini-scleral contact lens (SHmS) for optical correction of keratoconus in the early stages after the corneal collagen cross-linking procedure (CXL).  We retrospectively analysed the visual acuity improvement and corneal adaptation in the first 10 eyes of nine patients fitted with SHmS lenses one to 3.5 months after corneal collagen cross-linking. The lenses were designed to rest over the patients' sclera and peri-limbal cornea and vault the central cornea with minimal support over it. Visual acuities with manifest refraction and contact lenses, refractive and topographical values (Kmin and Kmax) were evaluated on lens dispensing and after six month of lens wearing. Ocular physiological responses were evaluated using the Institute of Eye Research (IER) grading scales.  SHmS fitting was performed 2.1 ± 0.97 (SD) months after collagen cross-linking. Mean follow up was 10.9 ± 4.41 months (range six to 18 months). Mean decimal visual acuity with SHmS was 0.66 ± 0.22 (approximately 6/9 Snellen fraction, range 0.3 to 0.1) or 0.75 ± 0.14 (approximately 6/8.1, range 0.5 to 1.0), when omitting two amblyopic eyes. Nine (90 per cent) eyes were successfully fitted, that is, able to wear the lenses for 10 hours per day or longer. Mean wearing time was 11.7 hours (range six to 14) per day. No corneal neovascularisation or papillary reaction was found in all fitted eyes.  SHmS contact lenses provide successful visual rehabilitation shortly after corneal collagen cross-linking. This new soft contact lens design with scleral fixation and minimal apical touch was demonstrated to be safe shortly after collagen cross-linking, as the avoidance of contact with the treated zone minimises contact lens influence on corneal recovery. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

TNF-α Genetic Predisposition and Higher Expression of Inflammatory Pathway Components in Keratoconus.

PubMed

Arbab, Muneeza; Tahir, Saira; Niazi, Muhammad Khizar; Ishaq, Mazhar; Hussain, Alamdar; Siddique, Pir Muhammad; Saeed, Sadia; Khan, Wajid Ali; Qamar, Raheel; Butt, Azeem Mehmood; Azam, Maleeha

2017-07-01

To date keratoconus (KC) pathogenesis is undefined; however, the involvement of inflammatory pathways in disease development is becoming apparent. In the present study, we investigated the role of a promoter region polymorphism rs1800629 (-308G>A) in the inflammatory pathway component TNF-α and its effects on the expression of TNF-α and downstream molecules tumor necrosis factor receptor 1 and 2 (TNFR1 and TNFR2), v-rel avian reticuloendotheliosis viral oncogene homolog A (RELA), and interleukin 6 (IL-6) in KC development. TNF-α promoter polymorphism rs1800629 (-308G>A), was genotyped in 257 sporadic KC patients and 253 healthy controls. Enzyme-linked immunosorbent assay (ELISA) was performed to assess for the -308G>A genotypes. Quantitative polymerase chain reaction (qPCR) was carried out to compare the mRNA expression of TNF-α, TNFR1, TNFR2, RELA, and IL6 in the corneal tissues of 20 KC patients and 20 donor controls. The -308G>A genotype GA was found to be significantly associated with KC development (dominant model [odds ratio (OR) = 6.67 (95% confidence interval [CI] = 4.28-10.42), P < 0.001]) and allele-A (OR = 4.30, 95%CI = 2.93-6.34, P < 0.001). TNF-α serum levels were significantly raised in patients with GA genotype (196.5 ± 69.5 pg/mL) compared to reference genotype GG (21.7 ± 8.2 pg/mL) (P < 0.0001). There was a significant overexpression of TNF-α (P = 0.002), TNFR2 (P = 0.0001), RELA (P = 0.0117), and IL6 (P = 0.0007) in the KC corneal tissues as compared to the control. The GA genotype of the TNF-α -308G>A polymorphism is a significant genetic risk factor for the pathogenesis of KC. Moreover, this single nucleotide polymorphism (SNP) was observed to be associated with deregulated expression of downstream molecules, thus further reinforcing the role of the inflammatory pathway components in the development of KC.

Association of Interleukin-1 Gene Single Nucleotide Polymorphisms with Keratoconus in Chinese Han Population.

PubMed

Wang, Yani; Wei, Wei; Zhang, Changning; Zhang, XueHui; Liu, Ming; Zhu, Xiuping; Xu, Kun

2016-05-01

To investigate whether interleukin-1 alpha (IL1A) and interleukin-1 beta (IL1B) polymorphisms are associated with keratoconus (KC) in unrelated Chinese Han patients. The IL1A (rs2071376) and IL1B (rs1143627, rs16944) polymorphisms were genotyped in 115 unrelated Chinese Han KC patients and 101 healthy Chinese Han volunteers with the Sequenom MassARRAY RS1000. Sequenom Typer 4.0 software, PLINK 1.07, Haploview 4.0 software platform were used to analyze the allelic variants of IL1A and IL1B genes, and their association with KC risk factors were assessed. Among the variants, the three SNPs (rs2071376 in IL1A, rs1143627 and rs16944 in the promoter region of IL1B) were different between the two groups. The A allele of rs2071376 (A > C, p = 0.017, OR = 1.968, 95% C.I. 1.313-3.425), the C allele of rs1143627 (C > T, p < 0.001, OR = 2.864, 95% C.I. 1.631-4.968) and the A allele of rs16944 (A > G, p = 0.002, OR = 2.401, 95% C.I. 1.396-4.161) were associated with a increased risk of KC in Chinese Han patients. This study showed that rs2071376, rs1143627 and rs16944 had significant differences in associations between KC patients and the control group when different genotypes were analyzed in three models (dominant, recessive, and additive). In the haplotype analysis, the two single nucleotide polymorphisms (SNPs), rs1143627 and rs16944 showed strong linkage disequilibrium. In addition, Haplotype "ACA" was found to be associated with a higher risk of developing KC (OR = 12.91, p < 0.001). Keratocyte apoptosis is an initiating event in the pathogenesis of KC which could be induced by the altered levels of IL1 gene. These findings confirmed that polymorphisms in IL1 genes were associated with risk of KC in the Chinese Han population, which help us to gain insight into the pathogenesis of KC.

Potential of FTIR spectroscopy for analysis of tears for diagnosis purposes.

PubMed

Travo, Adrian; Paya, Clément; Déléris, Gérard; Colin, Joseph; Mortemousque, Bruno; Forfar, Isabelle

2014-04-01

It has been widely reported that the tear film, which is crucially important as a protective barrier of the eye, undergoes biochemical changes as a result of a wide range of ocular pathology. This tends to suggest the possibility of early detection of ocular diseases on the basis of biochemical analysis of tears. However, studies of tears by conventional methods of biomolecular and biochemical analysis are often limited by methodological difficulties. Moreover, such analysis could not be applied in the clinic, where structural and morphological analyses by, mainly, slit-lamp biomicroscopy remains the recommended method. In this study, we assessed, for the first time, the potential of FTIR spectroscopy combined with advanced chemometric processing of spectral data for analysis of raw tears for diagnosis purposes. We first optimized sampling and spectral acquisition (tears collection method, tear sample volume, and preservation of the samples) for accurate spectral measurement. On the basis of the results, we focused our study on the possibility of discriminating tears from normal individuals from those of patients with different ocular pathologies, and showed that the most discriminating spectral range is that corresponding to variations of CH2 and CH3 of lipid aliphatic chains. We also report more subtle discrimination of tears from patients with keratoconus and those from patients with non-specific inflammatory ocular diseases, on the basis of variations in spectral ranges attributed notably to lipid and carbohydrate vibrations. Finally, we also succeeded in distinguishing tears from patients with early-stage and late-stage keratoconus on the basis of spectral features attributed to protein structure. Therefore, this study strongly suggests that FTIR spectral analysis of tears could be developed as a valuable and cost-saving tool for biochemical-based detection of ocular diseases, potentially before the appearance of the first morphological signs of diseases. Combined with supervised modelling methods and with use of a spectral data base acquired for representative patients, such a spectral approach could be a useful addition to current methods of clinical analysis for improvement of patient care.

Social consequences of multiple sclerosis. Part 2. Divorce and separation: a historical prospective cohort study.

PubMed

Pfleger, C C H; Flachs, E M; Koch-Henriksen, Nils

2010-07-01

There is a need for follow-up studies of the familial situation of multiple sclerosis (MS) patients. To evaluate the probability of MS patients to remain in marriage or relationship with the same partner after onset of MS in comparison with the population. All 2538 Danes with onset of MS 1980-1989, retrieved from the Danish MS-Registry, and 50,760 matched and randomly drawn control persons were included. Information on family status was retrieved from Statistics Denmark. Cox analyses were used with onset as starting point. Five years after onset, the cumulative probability of remaining in the same relationship was 86% in patients vs. 89% in controls. The probabilities continued to deviate, and at 24 years, the probability was 33% in patients vs. 53% in the control persons (p < 0.001). Among patients with young onset (< 36 years of age), those with no children had a higher risk of divorce than those having children less than 7 years (Hazard Ratio 1.51; p < 0.0001), and men had a higher risk of divorce than women (Hazard Ratio 1.33; p < 0.01). MS significantly affects the probability of remaining in the same relationship compared with the background population.

Essential health care among Mexican indigenous people in a universal coverage context.

PubMed

Servan-Mori, Edson; Pelcastre-Villafuerte, Blanca; Heredia-Pi, Ileana; Montoya-Rodríguez, Arain

2014-01-01

To analyze the influence of indigenous condition on essential health care among Mexican children, older people and women in reproductive age. The influence of indigenous condition on the probability of receiving medical care due to acute respiratory infection (ARI) and acute diarrheal disease (ADD), vaccination coverage; and antenatal care (ANC) was analyzed using the 2012 National Health Survey and non-experimental matching methods. Indigenous condition does not influence per-se vaccination coverage (in < 1 year), probability of attention of ARI's and ADD's as well as, timely, frequent, and quality ANC. Being indigenous and older adult increases 9% the probability of receiving a fulfilled vaccination schedule. Unfavorable structural conditions in which Mexican indigenous live constitutes the persistent mechanisms of their health vulnerability. Public policy should consider this level of intervention, in a way that intensive and focalized health strategies contribute to improve their health condition and life.

Q-Learning-Based Adjustable Fixed-Phase Quantum Grover Search Algorithm

NASA Astrophysics Data System (ADS)

Guo, Ying; Shi, Wensha; Wang, Yijun; Hu, Jiankun

2017-02-01

We demonstrate that the rotation phase can be suitably chosen to increase the efficiency of the phase-based quantum search algorithm, leading to a dynamic balance between iterations and success probabilities of the fixed-phase quantum Grover search algorithm with Q-learning for a given number of solutions. In this search algorithm, the proposed Q-learning algorithm, which is a model-free reinforcement learning strategy in essence, is used for performing a matching algorithm based on the fraction of marked items λ and the rotation phase α. After establishing the policy function α = π(λ), we complete the fixed-phase Grover algorithm, where the phase parameter is selected via the learned policy. Simulation results show that the Q-learning-based Grover search algorithm (QLGA) enables fewer iterations and gives birth to higher success probabilities. Compared with the conventional Grover algorithms, it avoids the optimal local situations, thereby enabling success probabilities to approach one.

Agents Overcoming Resource Independent Scaling Threats (AORIST)

DTIC Science & Technology

2004-10-01

20 Table 8: Tilted Consumer Preferences Experiment (m=8, N=61, G=2, C=60, Mean over 13 experiments...probabilities. Non-uniform consumer preferences create a new potential for sub-optimal system performance and thus require an additional adaptive...distribu- tion of the capacities across the sup- plier population must match the non- uniform consumer preferences . The second plot in Table 8

Why Use Detective Fiction in the AP Classroom?

ERIC Educational Resources Information Center

Pollock, Eric J.; Chun, Hye Won

2008-01-01

Everyone loves a mystery story, probably for two reasons: The first is that the mystery story is the only literary genre that is written for the reader to follow and match their intellectual acumen with the protagonist. By doing so, the genre invites the reader into its own world as an active participant, not merely an innocent bystander (Pollock,…

Propensity score matching and persistence correction to reduce bias in comparative effectiveness: the effect of cinacalcet use on all-cause mortality.

PubMed

Gillespie, Iain A; Floege, Jürgen; Gioni, Ioanna; Drüeke, Tilman B; de Francisco, Angel L; Anker, Stefan D; Kubo, Yumi; Wheeler, David C; Froissart, Marc

2015-07-01

The generalisability of randomised controlled trials (RCTs) may be limited by restrictive entry criteria or by their experimental nature. Observational research can provide complementary findings but is prone to bias. Employing propensity score matching, to reduce such bias, we compared the real-life effect of cinacalcet use on all-cause mortality (ACM) with findings from the Evaluation of Cinacalcet Therapy to Lower Cardiovascular Events (EVOLVE) RCT in chronic haemodialysis patients. Incident adult haemodialysis patients receiving cinacalcet, recruited in a prospective observational cohort from 2007-2009 (AROii; n = 10,488), were matched to non-exposed patients regardless of future exposure status. The effect of treatment crossover was investigated with inverse probability of censoring weighted and lag-censored analyses. EVOLVE ACM data were analysed largely as described for the primary composite endpoint. AROii patients receiving cinacalcet (n = 532) were matched to 1790 non-exposed patients. The treatment effect of cinacalcet on ACM in the main AROii analysis (hazard ratio 1.03 [95% confidence interval (CI) 0.78-1.35]) was closer to the null than for the Intention to Treat (ITT) analysis of EVOLVE (0.94 [95%CI 0.85-1.04]). Adjusting for non-persistence by 0- and 6-month lag-censoring and by inverse probability of censoring weight, the hazard ratios in AROii (0.76 [95%CI 0.51-1.15], 0.84 [95%CI 0.60-1.18] and 0.79 [95%CI 0.56-1.11], respectively) were comparable with those of EVOLVE (0.82 [95%CI 0.67-1.01], 0.83 [95%CI 0.73-0.96] and 0.87 [95%CI 0.71-1.06], respectively). Correcting for treatment crossover, we observed results in the 'real-life' setting of the AROii observational cohort that closely mirrored the results of the EVOLVE RCT. Persistence-corrected analyses revealed a trend towards reduced ACM in haemodialysis patients receiving cinacalcet therapy. Copyright © 2015 John Wiley & Sons, Ltd.

The developmental race between maturing host plants and their butterfly herbivore - the influence of phenological matching and temperature.

PubMed

Posledovich, Diana; Toftegaard, Tenna; Wiklund, Christer; Ehrlén, Johan; Gotthard, Karl

2015-11-01

Interactions between herbivorous insects and their host plants that are limited in time are widespread. Therefore, many insect-plant interactions result in a developmental race, where herbivores need to complete their development before plants become unsuitable, while plants strive to minimize damage from herbivores by outgrowing them. When spring phenologies of interacting species change asymmetrically in response to climate warming, there will be a change in the developmental state of host plants at the time of insect herbivore emergence. In combination with altered temperatures during the subsequent developmental period, this is likely to affect interaction strength as well as fitness of interacting species. Here, we experimentally explore whether the combined effect of phenological matching and thermal conditions influence the outcome of an insect-host interaction. We manipulated both developmental stages of the host plants at the start of the interaction and temperature during the subsequent developmental period in a model system of a herbivorous butterfly, Anthocharis cardamines, and five of its Brassicaceae host plant species. Larval performance characteristics were favoured by earlier stages of host plants at oviposition as well as by higher developmental temperatures on most of the host species. The probability of a larva needing a second host plant covered the full range from no influence of either phenological matching or temperature to strong effects of both factors, and complex interactions between them. The probability of a plant outgrowing a larva was dependent only on the species identity. This study demonstrates that climatic variation can influence the outcome of consumer-resource interactions in multiple ways and that its effects differ among host plant species. Therefore, climate warming is likely to change the temporal match between larval and plant development in some plant species, but not in the others. This is likely to have important implications for host plant use and possibly influence competitive relationships. © 2015 The Authors. Journal of Animal Ecology © 2015 British Ecological Society.

Clinical and sonographic risk factors and complications of shoulder dystocia - a case-control study with parity and gestational age matched controls.

PubMed

Parantainen, Jukka; Palomäki, Outi; Talola, Nina; Uotila, Jukka

2014-06-01

To examine the clinical risk factors and complications of shoulder dystocia today and to evaluate ultrasound methods predicting it. Retrospective, matched case-control study at a University Hospital with 5000 annual deliveries. The study population consisted of 152 deliveries complicated by shoulder dystocia over a period of 8.5 years (January 2004-June 2012) and 152 controls matched for gestational age and parity. The data was collected from the medical records of mothers and children and analyzed by conditional logistic regression. Incidences and odds ratios were calculated for risk factors and complications. Antenatal ultrasound data was analyzed when available by conditional logistic regression to test for significant differences between study groups. Birthweight (OR 12.1 for ≥4000 g; 95% CI 4.18-35.0) and vacuum extraction (OR 3.98; 95% CI 1.25-12.7) remained the most significant clinical risk factors. Only a trend of an association of pregestational or gestational diabetes was noticed (OR 1.87; 95% CI 0.997-3.495, probability of type II error 51%). Of the complications of shoulder dystocia the incidence of brachial plexus palsies was high (40%). Antenatal ultrasound method based on the difference between abdominal and biparietal diameters had a significant difference between cases and controls. The impact of diabetes as a risk factor has diminished, which may reflect improved screening and treatment. Antenatal ultrasound methods are showing some promise, but the predictive value of ultrasound alone is probably low. Copyright © 2014. Published by Elsevier Ireland Ltd.

DNA typing of birch: Development of a forensic STR system for Betula pendula and Betula pubescens.

PubMed

Wesselink, Monique; Dragutinović, Aleksandar; Noordhoek, Jeroen W; Bergwerff, Leonie; Kuiper, Irene

2018-04-07

Although botanical trace evidence is often encountered in case investigations, the utilization of such traces in forensic investigations is still limited. Development of a forensic STR system for the two species of Betula (birch) indigenous to and abundant in North West Europe is a step in enhancing the applicability of traces from these species. We describe six microsatellite markers developed for birch species in detail, including repeat structure, and we propose a nomenclature for the encountered alleles. To assess the population characteristics, the genetic composition of wild, planted and intermediate populations of Betula pendula (a diploid species) and Betula pubescens (a tetraploid species) were investigated. The genetic differences between these two species were larger than the differences between populations of one species, even when both species co-occurred at one location. Therefore allele frequencies were estimated for both species separately. General, conservative random match probabilities were estimated for wild trees based on these allele frequencies (5∙10 -6 for the diploid B. pendula and 1∙10 -13 for the tetraploid B. pubescens), illustrating the potential relevance if trace evidence secured from a suspect is found to match a birch tree growing on or near a crime scene. Apart from wild trees, planted Betula trees also occur that may not originate from seeds, but may have been propagated through cloning. Based on the studied Betula trees, the random match probability of a potentially planted profile might be as high as 1.4∙10 -2 . Copyright © 2018 Elsevier B.V. All rights reserved.

Corneal topography with high-speed swept source OCT in clinical examination

PubMed Central

Karnowski, Karol; Kaluzny, Bartlomiej J.; Szkulmowski, Maciej; Gora, Michalina; Wojtkowski, Maciej

2011-01-01

We present the applicability of high-speed swept source (SS) optical coherence tomography (OCT) for quantitative evaluation of the corneal topography. A high-speed OCT device of 108,000 lines/s permits dense 3D imaging of the anterior segment within a time period of less than one fourth of second, minimizing the influence of motion artifacts on final images and topographic analysis. The swept laser performance was specially adapted to meet imaging depth requirements. For the first time to our knowledge the results of a quantitative corneal analysis based on SS OCT for clinical pathologies such as keratoconus, a cornea with superficial postinfectious scar, and a cornea 5 months after penetrating keratoplasty are presented. Additionally, a comparison with widely used commercial systems, a Placido-based topographer and a Scheimpflug imaging-based topographer, is demonstrated. PMID:21991558

An evaluation of exact matching and propensity score methods as applied in a comparative effectiveness study of inhaled corticosteroids in asthma.

PubMed

Burden, Anne; Roche, Nicolas; Miglio, Cristiana; Hillyer, Elizabeth V; Postma, Dirkje S; Herings, Ron Mc; Overbeek, Jetty A; Khalid, Javaria Mona; van Eickels, Daniela; Price, David B

2017-01-01

Cohort matching and regression modeling are used in observational studies to control for confounding factors when estimating treatment effects. Our objective was to evaluate exact matching and propensity score methods by applying them in a 1-year pre-post historical database study to investigate asthma-related outcomes by treatment. We drew on longitudinal medical record data in the PHARMO database for asthma patients prescribed the treatments to be compared (ciclesonide and fine-particle inhaled corticosteroid [ICS]). Propensity score methods that we evaluated were propensity score matching (PSM) using two different algorithms, the inverse probability of treatment weighting (IPTW), covariate adjustment using the propensity score, and propensity score stratification. We defined balance, using standardized differences, as differences of <10% between cohorts. Of 4064 eligible patients, 1382 (34%) were prescribed ciclesonide and 2682 (66%) fine-particle ICS. The IPTW and propensity score-based methods retained more patients (96%-100%) than exact matching (90%); exact matching selected less severe patients. Standardized differences were >10% for four variables in the exact-matched dataset and <10% for both PSM algorithms and the weighted pseudo-dataset used in the IPTW method. With all methods, ciclesonide was associated with better 1-year asthma-related outcomes, at one-third the prescribed dose, than fine-particle ICS; results varied slightly by method, but direction and statistical significance remained the same. We found that each method has its particular strengths, and we recommend at least two methods be applied for each matched cohort study to evaluate the robustness of the findings. Balance diagnostics should be applied with all methods to check the balance of confounders between treatment cohorts. If exact matching is used, the calculation of a propensity score could be useful to identify variables that require balancing, thereby informing the choice of matching criteria together with clinical considerations.

An evaluation of exact matching and propensity score methods as applied in a comparative effectiveness study of inhaled corticosteroids in asthma

PubMed Central

Burden, Anne; Roche, Nicolas; Miglio, Cristiana; Hillyer, Elizabeth V; Postma, Dirkje S; Herings, Ron MC; Overbeek, Jetty A; Khalid, Javaria Mona; van Eickels, Daniela; Price, David B

2017-01-01

Background Cohort matching and regression modeling are used in observational studies to control for confounding factors when estimating treatment effects. Our objective was to evaluate exact matching and propensity score methods by applying them in a 1-year pre–post historical database study to investigate asthma-related outcomes by treatment. Methods We drew on longitudinal medical record data in the PHARMO database for asthma patients prescribed the treatments to be compared (ciclesonide and fine-particle inhaled corticosteroid [ICS]). Propensity score methods that we evaluated were propensity score matching (PSM) using two different algorithms, the inverse probability of treatment weighting (IPTW), covariate adjustment using the propensity score, and propensity score stratification. We defined balance, using standardized differences, as differences of <10% between cohorts. Results Of 4064 eligible patients, 1382 (34%) were prescribed ciclesonide and 2682 (66%) fine-particle ICS. The IPTW and propensity score-based methods retained more patients (96%–100%) than exact matching (90%); exact matching selected less severe patients. Standardized differences were >10% for four variables in the exact-matched dataset and <10% for both PSM algorithms and the weighted pseudo-dataset used in the IPTW method. With all methods, ciclesonide was associated with better 1-year asthma-related outcomes, at one-third the prescribed dose, than fine-particle ICS; results varied slightly by method, but direction and statistical significance remained the same. Conclusion We found that each method has its particular strengths, and we recommend at least two methods be applied for each matched cohort study to evaluate the robustness of the findings. Balance diagnostics should be applied with all methods to check the balance of confounders between treatment cohorts. If exact matching is used, the calculation of a propensity score could be useful to identify variables that require balancing, thereby informing the choice of matching criteria together with clinical considerations. PMID:28356782

Prior probability and feature predictability interactively bias perceptual decisions

PubMed Central

Dunovan, Kyle E.; Tremel, Joshua J.; Wheeler, Mark E.

2014-01-01

Anticipating a forthcoming sensory experience facilitates perception for expected stimuli but also hinders perception for less likely alternatives. Recent neuroimaging studies suggest that expectation biases arise from feature-level predictions that enhance early sensory representations and facilitate evidence accumulation for contextually probable stimuli while suppressing alternatives. Reasonably then, the extent to which prior knowledge biases subsequent sensory processing should depend on the precision of expectations at the feature level as well as the degree to which expected features match those of an observed stimulus. In the present study we investigated how these two sources of uncertainty modulated pre- and post-stimulus bias mechanisms in the drift-diffusion model during a probabilistic face/house discrimination task. We tested several plausible models of choice bias, concluding that predictive cues led to a bias in both the starting-point and rate of evidence accumulation favoring the more probable stimulus category. We further tested the hypotheses that prior bias in the starting-point was conditional on the feature-level uncertainty of category expectations and that dynamic bias in the drift-rate was modulated by the match between expected and observed stimulus features. Starting-point estimates suggested that subjects formed a constant prior bias in favor of the face category, which exhibits less feature-level variability, that was strengthened or weakened by trial-wise predictive cues. Furthermore, we found that the gain on face/house evidence was increased for stimuli with less ambiguous features and that this relationship was enhanced by valid category expectations. These findings offer new evidence that bridges psychological models of decision-making with recent predictive coding theories of perception. PMID:24978303

Automated matching of supine and prone colonic polyps based on PCA and SVMs

NASA Astrophysics Data System (ADS)

Wang, Shijun; Van Uitert, Robert L.; Summers, Ronald M.

2008-03-01

Computed tomographic colonography (CTC) is a feasible and minimally invasive method for the detection of colorectal polyps and cancer screening. In current practice, a patient will be scanned twice during the CTC examination - once supine and once prone. In order to assist the radiologists in evaluating colon polyp candidates in both scans, we expect the computer aided detection (CAD) system can provide not only the locations of suspicious polyps, but also the possible matched pairs of polyps in two scans. In this paper, we propose a new automated matching method based on the extracted features of polyps by using principal component analysis (PCA) and Support Vector Machines (SVMs). Our dataset comes from the 104 CT scans of 52 patients with supine and prone positions collected from three medical centers. From it we constructed two groups of matched polyp candidates according to the size of true polyps: group A contains 12 true polyp pairs (> 9 mm) and 454 false pairs; group B contains 24 true polyp pairs (6-9 mm) and 514 false pairs. By using PCA, we reduced the dimensions of original data (with 157 attributes) to 30 dimensions. We did leave-one-patient-out test on the two groups of data. ROC analysis shows that it is easier to match bigger polyps than that of smaller polyps. On group A data, when false alarm probability is 0.18, the sensitivity of SVM achieves 0.83 which shows that automated matching of polyp candidates is practicable for clinical applications.

Match running performance and skill execution improves with age but not the number of disposals in young Australian footballers.

PubMed

Gastin, Paul B; Tangalos, Christie; Torres, Lorena; Robertson, Sam

2017-12-01

This study investigated age-related differences in maturity, physical and functional characteristics and playing performance in youth Australian Football (AF). Young male players (n = 156) were recruited from 12 teams across 6 age groups (U10-U15) of a recreational AF club. All players were tested for body size, maturity and fitness. Player performance was assessed during a match in which disposals (kicks and handballs) and their effectiveness were coded from a video recording and match running performance measured using Global Positioning System. Significant main effects (P < 0.01) for age group were observed for age, years to peak height velocity, body mass, height, 20 m sprint, maximal speed over 20 m, vertical jump, 20 m multistage shuttle run, match distance, high-speed running distance, peak speed, number of effective disposals and percentage of effective disposals. Age-related differences in fitness characteristics (speed, lower body power and endurance) appeared to transfer to match running performance. The frequency in which players disposed of the football did not differ between age groups, however the effectiveness of each disposal (i.e., % effective disposals) improved with age. Match statistics, particularly those that evaluate skill execution outcome (i.e., effectiveness), are useful to assess performance and to track player development over time. Differences between age groups, and probably variability within age groups, are strongly associated with chronological age and maturity.

The Langer-Improved Wald Test for DIF Testing with Multiple Groups: Evaluation and Comparison to Two-Group IRT

ERIC Educational Resources Information Center

Woods, Carol M.; Cai, Li; Wang, Mian

2013-01-01

Differential item functioning (DIF) occurs when the probability of responding in a particular category to an item differs for members of different groups who are matched on the construct being measured. The identification of DIF is important for valid measurement. This research evaluates an improved version of Lord's chi [superscript 2]…

Quantum Photonics Beyond Conventional Computing

DTIC Science & Technology

2015-07-10

polarisation using a half- wave plate (HWP), the two arms are combined by a polarising beam splitter (PBS). The resulting state is passed through the...phase-matched for Type-I SPDC, creating non -collinear degenerate horizontally polarised photon pairs at 808 nm. After converting one arm to vertical...For the case of non -interacting fermions, the transition probabilities for states under unitary evolution are governed by matrix determinants, which are

An Evaluative Review of Hemispheric Learning Potential

DTIC Science & Technology

1985-10-01

suggests that the name response (Aa) involves different mechanisms than the physically identical match (AA) (Posner & Mitchell, 1967). Furthermore, the...probably not Important In tasks employing suprathreshold stimulation . Benton and his colleagues used an electromechanical device to stimulate the...back of the hand. Three points lying In a straight line were stimulated In quick succession, and the subject’s task was to indicate from among four

Manifold Matching: Joint Optimization of Fidelity and Commensurability

DTIC Science & Technology

2011-11-12

identified separately in p◦m, will be geometrically incommensurate (see Figure 7). Thus the null distribution of the test statistic will be inflated...into the objective function obviates the geometric incommensurability phenomenon. Thus we can es- tablish that, for a range of Dirichlet product model...from the geometric incommensu- rability phenomenon. Then q p implies that cca suffers from the spurious correlation phe- nomenon with high probability

Employment Status, Quality of Matching, and Retirement in Korea: Evidence from Korean Longitudinal Study of Aging1

PubMed Central

Lee, Chulhee; Lee, Jinkook

2013-01-01

This paper explores the differing probabilities of retirement for self-employed and wage-and-salary workers. It finds self-employed workers are less likely to retire than wage-and-salary ones, and that differences in retirement incomes, health, productivity, job characteristics, and compulsory retirement practices do not explain the disparity. The difference between self-employed and wage-and-salary workers in the quality of matching between the job and the worker (i.e., between required and desired amount of work) explains the later retirement of the self-employed. We note the implications of these findings for labor-force participation at older ages and how policies might boost employment of the elderly. PMID:23935768

Probabilistic Cross-identification of Cosmic Events

NASA Astrophysics Data System (ADS)

Budavári, Tamás

2011-08-01

I discuss a novel approach to identifying cosmic events in separate and independent observations. The focus is on the true events, such as supernova explosions, that happen once and, hence, whose measurements are not repeatable. Their classification and analysis must make the best use of all available data. Bayesian hypothesis testing is used to associate streams of events in space and time. Probabilities are assigned to the matches by studying their rates of occurrence. A case study of Type Ia supernovae illustrates how to use light curves in the cross-identification process. Constraints from realistic light curves happen to be well approximated by Gaussians in time, which makes the matching process very efficient. Model-dependent associations are computationally more demanding but can further boost one's confidence.

Evaluation of DNA mixtures from database search.

PubMed

Chung, Yuk-Ka; Hu, Yue-Qing; Fung, Wing K

2010-03-01

With the aim of bridging the gap between DNA mixture analysis and DNA database search, a novel approach is proposed to evaluate the forensic evidence of DNA mixtures when the suspect is identified by the search of a database of DNA profiles. General formulae are developed for the calculation of the likelihood ratio for a two-person mixture under general situations including multiple matches and imperfect evidence. The influence of the prior probabilities on the weight of evidence under the scenario of multiple matches is demonstrated by a numerical example based on Hong Kong data. Our approach is shown to be capable of presenting the forensic evidence of DNA mixtures in a comprehensive way when the suspect is identified through database search.

Estimating the effect of gang membership on nonviolent and violent delinquency: a counterfactual analysis.

PubMed

Barnes, J C; Beaver, Kevin M; Miller, J Mitchell

2010-01-01

This study reconsiders the well-known link between gang membership and criminal involvement. Recently developed analytical techniques enabled the approximation of an experimental design to determine whether gang members, after being matched with similarly situated nongang members, exhibited greater involvement in nonviolent and violent delinquency. Findings indicated that while gang membership is a function of self-selection, selection effects alone do not account for the greater involvement in delinquency exhibited by gang members. After propensity score matching was employed, gang members maintained a greater involvement in both nonviolent and violent delinquency when measured cross-sectionally, but only violent delinquency when measured longitudinally. Additional analyses using inverse probability of treatment weights reaffirmed these conclusions. © 2010 Wiley-Liss, Inc.

Automatic identification of bullet signatures based on consecutive matching striae (CMS) criteria.

PubMed

Chu, Wei; Thompson, Robert M; Song, John; Vorburger, Theodore V

2013-09-10

The consecutive matching striae (CMS) numeric criteria for firearm and toolmark identifications have been widely accepted by forensic examiners, although there have been questions concerning its observer subjectivity and limited statistical support. In this paper, based on signal processing and extraction, a model for the automatic and objective counting of CMS is proposed. The position and shape information of the striae on the bullet land is represented by a feature profile, which is used for determining the CMS number automatically. Rapid counting of CMS number provides a basis for ballistics correlations with large databases and further statistical and probability analysis. Experimental results in this report using bullets fired from ten consecutively manufactured barrels support this developed model. Published by Elsevier Ireland Ltd.

Unsupervised learning of discriminative edge measures for vehicle matching between nonoverlapping cameras.

PubMed

Shan, Ying; Sawhney, Harpreet S; Kumar, Rakesh

2008-04-01

This paper proposes a novel unsupervised algorithm learning discriminative features in the context of matching road vehicles between two non-overlapping cameras. The matching problem is formulated as a same-different classification problem, which aims to compute the probability of vehicle images from two distinct cameras being from the same vehicle or different vehicle(s). We employ a novel measurement vector that consists of three independent edge-based measures and their associated robust measures computed from a pair of aligned vehicle edge maps. The weight of each measure is determined by an unsupervised learning algorithm that optimally separates the same-different classes in the combined measurement space. This is achieved with a weak classification algorithm that automatically collects representative samples from same-different classes, followed by a more discriminative classifier based on Fisher' s Linear Discriminants and Gibbs Sampling. The robustness of the match measures and the use of unsupervised discriminant analysis in the classification ensures that the proposed method performs consistently in the presence of missing/false features, temporally and spatially changing illumination conditions, and systematic misalignment caused by different camera configurations. Extensive experiments based on real data of over 200 vehicles at different times of day demonstrate promising results.