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Purpose: To analyze the 5-year results of accelerated corneal collagen crosslinking (CXL) for progressive keratoconus and identify preoperative characteristics predictive of visual and topographic outcomes.Methods: A prospective interventional case series. Nineteen eyes of 19 patients receiving accelerated CXL with settings of 18 mW/cm2 for 5 min were included. Clinical and topographic parameters were assessed. Linear regression and logistic regression were used to compare the R2 and odds ratio (OR), respectively, between baseline characteristics and postoperative outcomes.Results: Corrected distance visual acuity (CDVA) remained stable from 0.28 ± 0.21 to 0.25 ± 0.18 logMAR (P = 0.486). The mean cylindrical refraction was stable (P = 0.119). The maximal keratometry (Kmax) decreased from 61.99 ± 10.37 to 59.25 ± 7.75 D (P < 0.001), flattening in the flattest and steepest meridians and mean keratometry were also observed (P ≤ 0.040). The mean anterior elevation at the apex reduced from 21.42 ± 16.69 to 18.53 ± 12.74 μm (P = 0.013) and changes in posterior elevation were non-significant (P = 0.629). Preoperative Kmax best predicted the postoperative change in Kmax (R2 = 0.55, P < 0.001) compared to the other baseline characteristics (P ≤ 0.028), whereas preoperative CDVA was the only significant predictor of postoperative change in CDVA (R2 = 0.41, P = 0.003). Accelerated CXL is less likely to fail in eyes with a steeper preoperative Kmax (OR = 0.74, P = 0.040) or greater posterior elevation at the apex (OR = 0.91, P = 0.042).Conclusion: Kmax significantly decreased following accelerated CXL. Eyes with worse preoperative CDVA and higher Kmax were more likely to have an improvement in visual acuity and corneal flattening. [ABSTRACT FROM AUTHOR]

We systematically reviewed published research on dry eye disease and its association with higher order aberrations (HOAs). The purpose of this review was to first determine if an association between tear film metrics and HOAs exists and second to determine if the treatment of dry eyes can improve tear film metrics and HOAs together. A search was conducted in Entrez PubMed on 25 April 2021 using the keywords "higher order aberrations" and "dry eye". The initial search yielded 61 articles. After publications were restricted to only original articles measuring HOA outcomes in patients with dry eye, the final yield was 27 relevant articles. Of these 27 papers, 12 directly looked at associations and correlations between dry eyes and HOA parameters. The remaining 15 studies looked at dry eye interventions and HOA outcomes and parameters. There is clear evidence demonstrating that dry eyes and HOAs have an association, and that the tear film is one of the most important factors in this relationship. There is also a direct correlation between tear film metrics and HOAs. Improvements in HOAs with dry eye interventions provide further evidence to support the intricate relationship between the two. Despite the clear association between HOAs and dry eye disease, further research is still required in the realm of clinical application as dry eye interventions vary depending on many factors, including patient severity and eye drop viscosity. [ABSTRACT FROM AUTHOR]

To evaluate the repeatability and agreement of corneal and biometry measurements obtained with two swept-source optical coherence tomography (SSOCT) and a partial coherence interferometry-based device. This is a cross-sectional study. Forty-eight eyes of 48 patients had three consecutive measurements for ANTERION (Heidelberg Engineering, Germany), CASIAII (Tomey, Japan) and IOLMaster500 (Carl Zeiss Meditec, USA) on the same visit. Mean keratometry (Km), central corneal thickness (CCT), anterior chamber depth (ACD) and axial length (AL) were recorded. Corneal astigmatic measurements were converted into vector components—J0 and J45. Intra-device repeatability and agreements of measurements amongst the devices were evaluated using repeatability coefficients (RCs) and Bland–Altman plots, respectively. All devices demonstrated comparable repeatability for Km (p ≥ 0.138). ANTERION had the lowest RC for J0 amongst the devices (p ≤ 0.039). Systematic difference was found for the Km and J0 obtained with IOLMaster500 compared to either SSOCTs (p ≤ 0.010). The ACD and AL measured by IOLMaster500 showed a higher RC compared with either SSOCTs (p < 0.002). Systematic difference was found in CCT and ACD between the two SSOCTs (p < 0.001), and in AL between ANTERION and IOLMaster500 (p < 0.001), with a mean difference of 1.6 µm, 0.022 mm and 0.021 mm, respectively. Both SSOCTs demonstrated smaller test–retest variability for measuring ACD and AL compared with IOLMaster500. There were significant disagreement in keratometry and AL measurements between the SSOCTs and PCI-based device; their measurements should not be considered as interchangeable. [ABSTRACT FROM AUTHOR]

Objective: Emotion dysregulation is relevant to the aetiology of schizophrenia spectrum disorders (SSD). While most studies have focused on the chronic phase of SSD, little is known about the effects of emotion dysregulation and associated cognitive risk factors during the early phase of the illness, with negative implications for early intervention. The purpose of this study is to examine the impact of maladaptive cognitive emotion regulation strategies, global emotion dysregulation, and cognitive insight on psychotic and comorbid depressive symptoms in patients with early SSD. Method: Participants included 150 newly diagnosed outpatients with SSD who were seeking treatment at the Early Psychosis Intervention Program. All participants completed the Cognitive Emotion Regulation Questionnaire, Difficulties with Emotion Regulation Scale, and Beck Cognitive Insight Scale. Severity of psychotic and depressive symptoms were rated on the Brief Psychiatric Rating Scale. Results: Multivariate regression adjusting for gender and psychiatric comorbidity revealed that global emotion dysregulation was associated with more severe positive and depressive symptoms. Further moderation analyses revealed a significant interaction between global emotion dysregulation and cognitive insight (self‐certainty) on depression such that for patients with high self‐certainty, greater global emotion dysregulation was associated with increased severity of depressive symptoms. There was no interaction between global emotion dysregulation and cognitive insight on positive symptoms. Conclusions: Our findings provide preliminary support for the associations between emotion dysregulation and psychopathology in early SSD. Further research is needed to examine the transdiagnostic role of emotion dysregulation in the aetiology and treatment of a wider range of psychotic disorders. [ABSTRACT FROM AUTHOR]

In March of 2020, the COVID‐19 pandemic led to drastic changes in clinical practice and teaching methods. This article relates the experience of developing an almost virtual headache fellowship in response to the pandemic. [ABSTRACT FROM AUTHOR]

In this research, ultrasonic tests were performed on a prestressed concrete box-girder model to identify the prestressed force according to the acoustoelastic theory. During the tests, the ultrasonic wave was generated using piezoelectric transducers and emitted to the prestressed concrete bridge model. The concrete bridge model was subjected to three different levels of prestress force (PF), which were limited to about 30%, 50% and 80% of the ultimate tensile strength. The experimental results showed the increase in prestress force level leads to an increase in the relative change in the wave velocity and the amplitude energy of the ultrasonic wave which proved the acoustoelastic effect theory. This study contributes to the knowledge of the acoustoelastic behavior of the prestressed concrete and presents the capability of the ultrasonic system in evaluating the stress state in the prestressed concrete bridge. [ABSTRACT FROM AUTHOR]

Irrespective to how well structures were built, they all deteriorate. Herein, deterioration is defined as a slow and continuous reduction of structural performance, which if prolonged can lead to damage. Deterioration occurs due to different factors such as ageing, environmental and operational (E&O) variations including those due to service loads. Structural performance can be defined as load-carrying capacity, deformation capacity, service life and so on. This paper aims to develop an effective method to detect and locate deterioration in the presence of E&O variations and high measurement noise content. For this reason, a novel vibration-based deterioration assessment method is developed. Since deterioration alters the unique vibration characteristics of a structure, it can be identified by tracking the changes in the vibration characteristics. This study uses enhanced autoregressive (AR) time-series models to fit the vibration response data of a structure. Then, the statistical hypotheses of chi-square variance test and two-sample t -test are applied to the model residuals. To precisely evaluate changes in the vibration characteristics, an integrated deterioration identification (DI) is defined using the calculated statistical hypotheses and a Hampel filter is used to detect and remove false positive and negative results. Model residual is the difference between the predicted signal from the time series model and the actual measured response data at each time interval. The response data of two numerically simulated case studies of 3-storey and 20-storey reinforced concrete (RC) shear frames contaminated with different noise contents demonstrate the efficacy of the proposed method. Multiple deterioration and damage locations, as well as preventive maintenance actions, are also considered in these case studies. Furthermore, the method was successfully verified utilizing measured data from an experiment carried out on a box-girder bridge (BGB) structure. [ABSTRACT FROM AUTHOR]

Structural health monitoring data has been widely acknowledged as a significant source for evaluating the performance and health conditions of structures. However, a holistic framework that efficiently incorporates monitored data into structural identification and, in turn, provides a realistic life-cycle performance assessment of structures is yet to be established. There are different sources of uncertainty, such as structural parameters, computer model bias and measurement errors. Neglecting to account for these factors results in unreliable structural identifications, consequent financial losses, and a threat to the safety of structures and human lives. This paper proposes a new framework for structural performance assessment that integrates a comprehensive probabilistic finite element model updating approach, which deals with various structural identification uncertainties and structural reliability analysis. In this framework, Gaussian process surrogate models are replaced with a finite element model and its associate discrepancy function to provide a computationally efficient and all-round uncertainty quantification. Herein, the structural parameters that are most sensitive to measured structural dynamic characteristics are investigated and used to update the numerical model. Sequentially, the updated model is applied to compute the structural capacity with respect to loading demand to evaluate its as-is performance. The proposed framework's feasibility is investigated and validated on a large lab-scale box girder bridge in two different health states, undamaged and damaged, with the latter state representing changes in structural parameters resulted from overloading actions. The results from the box girder bridge indicate a reduced structural performance evidenced by a significant drop in the structural reliability index and an increased probability of failure in the damaged state. The results also demonstrate that the proposed methodology contributes to more reliable judgment about structural safety, which in turn enables more informed maintenance decisions to be made. [ABSTRACT FROM AUTHOR]

Accurate measurements of the size distribution of atmospheric aerosol nanoparticles are essential to build an understanding of new particle formation and growth. This is particularly crucial at the sub-3 nm range due to the growth of newly formed nanoparticles. The challenge in recovering the size distribution is due its complexity and the fact that not many instruments currently measure at this size range. In this study, we used the particle size magnifier (PSM) to measure atmospheric aerosols. Each day was classified into one of the following three event types: a new particle formation (NPF) event, a non-event or a haze event. We then compared four inversion methods (stepwise, kernel, Hagen–Alofs and expectation–maximization) to determine their feasibility to recover the particle size distribution. In addition, we proposed a method to pretreat the measured data, and we introduced a simple test to estimate the efficacy of the inversion itself. Results showed that all four methods inverted NPF events well; however, the stepwise and kernel methods fared poorly when inverting non-events or haze events. This was due to their algorithm and the fact that, when encountering noisy data (e.g. air mass fluctuations or low sub-3 nm particle concentrations) and under the influence of larger particles, these methods overestimated the size distribution and reported artificial particles during inversion. Therefore, using a statistical hypothesis test to discard noisy scans prior to inversion is an important first step toward achieving a good size distribution. After inversion, it is ideal to compare the integrated concentration to the raw estimate (i.e. the concentration difference at the lowest supersaturation and the highest supersaturation) to ascertain whether the inversion itself is sound. Finally, based on the analysis of the inversion methods, we provide procedures and codes related to the PSM data inversion. [ABSTRACT FROM AUTHOR]

Objective: To synthesize the evidence on the efficacy of calcitonin gene‐related peptide receptor antagonists (gepants) from all clinical trials addressing nausea treatment for episodic migraine. Introduction: Nausea is one of the most bothersome symptoms in patients with migraine. The most bothersome symptom is part of the outcomes explored in clinical trials. Methods: Published clinical trials for this project were identified via searches of 4 bibliographic databases: PubMed (includes MEDLINE), Embase, Web of Science, and the Cochrane Library. Individual search strategies included terms related to calcitonin gene‐related peptide, nausea, and vomiting. Random‐effects meta‐analysis was conducted to estimate the overall efficacy of gepants for nausea treatment. Heterogeneity, publication bias, small‐study bias, and potential confounders were explored using Galbraith plot, sensitivity analysis, meta‐regression, and Egger's regression tests. Cumulative meta‐analysis was done to detect temporal trend from accumulating trials. Results: The meta‐analysis involved 23,008 participants in 65 clinical trials from 14 published articles; 10,770 subjects participated in gepant treatment arms while 12,238 subjects participated in placebo or non‐gepant arms (85% females, mean age 41 years in both arms). Nearly all studies used a 2‐hour incidence of nausea as an outcome measure. An overall combined effect size with an odds ratio of 1.29 (95% CI 1.18, 1.40, P =.001; I2 = 42.8%) showed the efficacy of gepants for the treatment of nausea in episodic migraine. Galbraith plot demonstrated that 98.4% of studies were within 2 standard deviations from the regression line, indicating lack of significant heterogeneity and outliers. Meta‐analysis results were robust to sensitivity analysis, small‐study bias, and publication bias (Kendall's Tau −0.09, P =.29; Egger's regression P =.67). Meta‐regression showed that both age and sex ratio were not confounding the meta‐analysis (omnibus P =.69). Cumulative meta‐analysis indicated that the effect size remained stable for studies conducted after 2011, with accumulating evidence continuing to favor efficacy of gepants for the treatment of nausea in episodic migraine. Conclusion: There is sufficient evidence to support the efficacy of gepants for the treatment of nausea in episodic migraine. Future research may focus on examining this efficacy in under‐represented patient populations (males, older age groups) and in chronic migraine. [ABSTRACT FROM AUTHOR]

Background: Spinal cerebrospinal fluid (CSF) leak can lead to intracranial hypotension and is an important differential diagnosis to consider in patients with sudden-onset chronic daily headaches. Pars interarticularis (PI) fracture is a potential rare cause of suspected spinal CSF leak.Methods: This is a retrospective case series of 6 patients with suspected spinal CSF leak evaluated between January 2016 and September 2019. All patients received a magnetic resonance imaging (MRI) of the brain with and without gadolinium, MRI whole spine and full spine computed tomography (CT) myelogram. Targeted epidural patches with fibrin sealant were performed. Treatment response at return visit (3 months post-patch) was documented.Results: Six patients (4 females, 2 males) were diagnosed with a suspected spinal CSF leak and PI fracture. Mean age at the time of headache onset was 39 years old, and a range from 32 to 50 years old. Mean time to targeted epidural patches with fibrin sealant was 4.5 years. All 6 patients had PI fractures identified on CT myelogram and received targeted epidural patches with fibrin sealant at the site of the PI fracture. All patients had significant improvement in their headache intensity.Conclusion: Our study highlights: 1) the importance of PI fracture as a possible culprit of suspected spinal CSF leak in patients with intracranial hypotension; 2) the added benefit of CT imaging for detecting bony abnormalities such as fractures in patients with intracranial hypotension; and 3) the successful treatment of suspected spinal CSF leak when targeting the fracture site. [ABSTRACT FROM AUTHOR]

We report a case of transient corneal ectasia developed after phacoemulsification in an eye previously treated with INTRACOR. There was a myopic refractive surprise after cataract surgery. Corneal tomography showed an increase in keratometry and elevation profile compared with preoperative examination. Soft contact lenses and intraocular pressure-lowering medications were prescribed as interim treatment. Clinical improvement was seen gradually, and the resolution of myopia and ectasia was achieved at 3 months. We believe that high intraocular pressure during phacoemulsification and the weakening effect of femtosecond intrastromal presbyopic treatment can be the culprits. [ABSTRACT FROM AUTHOR]

Determining the particle size distribution of atmospheric aerosol particles is an important component to understand nucleation, formation and growth. This is particularly crucial at the sub 3 nm range because of the growth of newly-formed nanoparticles. The challenge in recovering the size distribution is due its complexity and the fact that not many instruments currently measure at this size range. In this study, we used the particle size magnifier (PSM) to measure atmospheric aerosols. Each event was classified into one of the three types: new particle formation (NPF), non-event and haze events. We then compared four inversion methods (step-wise, kernel, Hagen and Alofs and expectation-maximization) to determine its feasibility to recover the particle size distribution. In addition, we proposed a method to pre-treat measured data and introduced a simple test to estimate the efficacy of the inversion itself. Results showed that all four methods inverted NPF events well; but the step-wise and kernel methods fared poorly when inverting non-event and haze events. This was due to their algorithm, such that when encountering noisy data (e.g. air mass fluctuations) and under the influence of larger particles, these methods overestimated the size distribution and reported artificial particles during inversion. Therefore, using a statistical hypothesis test to discard noisy scans prior to inversion is an important first step to achieve a good size distribution. As a first step after inversion, it is ideal to compare the integrated concentration to the raw estimate (i.e., the concentration difference at the lowest supersaturation and the highest supersaturation) to ascertain whether the inversion itself is sound. Finally, based on the analysis of the inversion methods, we provide recommendations and codes related to the PSM data inversion. [ABSTRACT FROM AUTHOR]

Background. Sclerocornea is a rare congenital disorder characterized with the opacification of the cornea. Here, we report a nonconsanguineous Chinese family with multiple peripheral sclerocornea patients spanning across three generations inherited in an autosomal dominant manner. Methods. This is a retrospective case series of a peripheral sclerocornea pedigree. Comprehensive ophthalmic examinations were conducted and assessed on 14 pedigree members. Whole-exome sequencing was used to identify the genetic alterations in the affected pedigree members. Lymphoblastoid cell lines (LCLs) were established using blood samples from the family members. Functional tests were performed with these cell lines. Results. Six affected and eight unaffected members of a family with peripheral sclerocornea were examined. All affected individuals showed features of scleralization over the peripheral cornea of both eyes. Mean horizontal and vertical corneal diameter were found significantly decreased in the affected members. Significant differences were also observed on the mean apex pachymetry between affected and unaffected subjects. These ophthalmic parameters did not resemble that of cornea plana. A RAD21C1348T variant was identified by whole-exome sequencing. Although this variant causes RAD21 R450C substitution at the separase cleavage site, cells from peripheral sclerocornea family members had no mitosis and ploidy defects. Conclusion. We report a family of peripheral sclerocornea with no association with cornea plana. A RAD21 variant was found cosegregating with peripheral sclerocornea. Our results suggest that RAD21 functions, other than its cell cycle and chromosome segregation regulations, could underline the pathogenesis of peripheral sclerocornea. [ABSTRACT FROM AUTHOR]

• A preconditioned least square QR-factorization approach is developed for moving force identification. • The regularization matrix L is introduced to improve the ill-posed problems. • The number of iterations j is introduced to avoid noise disturbance and ensure the robustness. • Preconditioned least square QR-factorization approach is validated through numerical simulation. This paper develops a novel method for moving force identification (MFI) called preconditioned least square QR-factorization (PLSQR) method. The algorithm seeks to reduce the impact of identification errors caused by unknown noise. The biaxial moving forces travel on a simply supported bridge at three different speeds is used to generate numerical simulations to assess the effectiveness and applicability of the algorithm. Results indicate that the method is more robust towards ill-posed problem and has higher identification precision than the conventional time domain method (TDM). In addition, the robustness and ill-posed immunity of PLSQR are directly affected by two kinds of regularization parameters, namely, number of iterations j and regularization matrix L. Compared with the standard form of least square QR-factorization (LSQR), i.e., the regularization matrix L being the identity matrix I n , the PLSQR with the optimal number of iterations j and regularization matrix L has many advantages on MFI and it is more suitable for field trials due to better adaptability with type of sensors and number of sensors. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 48-year-old woman has presented to the headache clinic with a 5-year history of continuous right-sided frontal, temporal, and occipital pressure and stabbing headaches associated with right eye congestion and restlessness. Topics include the nerve blocks were suggested based on tenderness on palpation on examination, and the magnetic resonance imaging with gadolinium of the head demonstrated a large macroadenoma invading the parasellar structures.

Background: Static sitting is thought to be related to low back pain. Of various common seated postures, slouched sitting has been suggested to cause viscoelastic creep. This, in turn, may compromise trunk muscle activity and proprioception, and heightening the risk of low back pain. To date, no research has evaluated immediate and short-term effects of brief exposures to different sitting postures on spinal biomechanics and trunk proprioception.Research Question: This study aimed to compare the impacts of 20 min of static slouched, upright and supported sitting with a backrest on trunk range of motion, muscle activity, and proprioception immediately after and 30 min after the sitting tasks.Methods: Thirty-seven adults were randomly assigned to the three sitting posture groups. Surface electromyography of six trunk muscles during maximum voluntary contractions were measured at baseline for normalization. Pain intensity, lumbar range of motion, and proprioceptive postural control strategy were assessed at baseline, 20 min (immediately post-test) and at 50 min (recovery). Trunk muscle activity during sitting was continuously monitored by surface electromyography.Results: While the slouched sitting group demonstrated the lowest bilateral obliquus internus/transversus abdominis activity as compared to other sitting postures (F = 4.87, p < 0.05), no significant temporal changes in pain intensity, lumbar range of motion nor proprioceptive strategy were noted in any of the groups.Significance: Sitting for 20 min of duration appears to have no adverse effects on symptoms or spinal biomechanics regardless of the posture adopted. Future research should determine if there is a point at which does slouched sitting cause significant changes in pain/spinal biomechanics in people both with and without low back pain. [ABSTRACT FROM AUTHOR]

Purpose: To determine the association between anterior corneal curvature and optical zone centration as well as its impact on aberration profiles in small-incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK).Methods: Seventy-eight eyes of 78 patients treated with SMILE (45 eyes) and LASIK (33 eyes) were included. The centration of the optical zone was evaluated on the instantaneous curvature difference map between the preoperative and 3-month postoperative scans using a superimposed set of concentric circles. The correlation between optical zone decentration and anterior keratometry values was evaluated. The effect of optical zone decentration on vector components of astigmatic correction and induction of higher-order aberrations (HOA) was assessed.Results: The mean decentration distance was 0.21 ± 0.11 mm for SMILE and 0.20 ± 0.09 mm for LASIK (p = 0.808). There was a significant correlation between anterior keratometric astigmatism and decentration distance (r = 0.653, p < 0.001) for SMILE but not for LASIK (r = − 0.264, p = 0.138). Astigmatic correction was performed in 67 eyes. Optical zone decentration and the vector components of astigmatic correction were not correlated (p ≥ 0.420). Significant correlation was demonstrated between the decentration distance and the induced total coma (SMILE: r = 0.384, p = 0.009; LASIK: r = 0.553, p = 0.001) as well as the induced total HOA (SMILE: r = 0.498, p = 0.001; LASIK: r = 0.555, p = 0.001).Conclusion: Anterior cornea astigmatism affected the treatment centration in SMILE but not LASIK. Subclinical decentration was associated with the induction of total coma and total HOA, but it did not affect the lower-order astigmatic correction. [ABSTRACT FROM AUTHOR]

Evaluating the performance of beam-like structures in terms of their current boundary conditions, stiffness and modal properties can be challenging as the structures behave differently from their designed conditions due to aging. The purpose of the current study is to determine the flexural rigidity of beam-like structures when their support conditions are not fully understood. A novel optimization scheme is proposed for estimation of the flexural stiffness and the capacity of the beam-like structures under moving loads. The proposed method is applied to various profiles of the beams made of different materials with unknown boundary conditions, and the effects of damage, excitation and optimization algorithm are rigorously investigated. The results of the numerical and experimental studies showed that the proposed substructural bending rigidity identification (SBI) method can correctly assess the in-service flexural stiffness, fixity of the boundary condition and the load-carrying capacity. This technique can be considered as a cost-effective method for periodic monitoring, load rating and model updating of the beam-like structures. [ABSTRACT FROM AUTHOR]

This paper presents a study on detecting structural deterioration in existing buildings using ambient vibration measurements. Deterioration is a slow and progressive process which reduces the structural performance, including load-bearing capacity. Each building has unique vibration characteristics which change in time due to deterioration and damage. However, the changes due to deterioration are generally subtler than the changes due to damage. Examples of deterioration include subtle loss of steel-concrete bond strength, slight corrosion of reinforcement and onset of internal cracks in structural members. Whereas damage can be defined as major sudden structural changes, such as major external cracks of concrete covers. Herein, a deterioration detection method which uses structural health monitoring (SHM) data is proposed to address the deterioration assessment problem. The proposed novel vibration-based deterioration identification method is a parametric-based approach, incorporated with a nonparametric statistical test, to capture changes in the dynamic characteristics of structures. First, autoregressive (AR) time-series models are fitted to the vibration response time histories at different sensor locations. A sensitive deterioration feature is proposed for detecting deterioration by applying statistical hypotheses of two-sample f -test on the model residuals, based on which a function of the resulting P -values is calculated. A novel AR model order estimation procedure is proposed to enhance the sensitivity of the method. The performance of the proposed method is demonstrated through comprehensive simulations of deterioration at single and multiple locations in finite element models (FEM) of 3- and 20-storey reinforced concrete (RC) frames. The method shows a promising sensitivity to detect small levels of structural deterioration prior to damage, even in the presence of noise. [ABSTRACT FROM AUTHOR]

Current methods to study relations between stem respiration and stem growth have been hampered by problems in quantifying stem growth from dendrometer measurements, particularly on a daily time scale. This is mainly due to the water-related influences within these measurements that mask growth. A previously published model was used to remove water-related influences from measured radial stem variations to reveal a daily radial growth signal (Δ ˆ G m). We analysed the intra- and inter-annual relations between Δ ˆ G m and estimated growth respiration rates (R g) on a daily scale for 5 years. Results showed that R g was weakly correlated to stem growth prior to tracheid formation, but was significant during the early summer. In the late summer, the correlation decreased slightly relative to the early summer. A 1-day time lag was found of Δ ˆ G m preceding R g. Using wavelet analysis and measurements from eddy covariance, it was found that R g followed gross primary production and temperature with a 2 and 3 h time lag, respectively.This study shows that further in-depth analysis of in-situ growth and growth respiration dynamics is greatly needed, with a focus on cellular respiration at specific developmental stages, its woody tissue costs and linkages to source–sink processes and environmental drivers. [ABSTRACT FROM AUTHOR]

Purpose To compare the astigmatic correction in high myopic astigmatism between small-incision lenticule extraction and laser in situ keratomileusis (LASIK) using vector analysis. Setting Hong Kong Laser Eye Center, Hong Kong. Design Retrospective case series. Methods Patients who had correction of myopic astigmatism of 3.0 diopters (D) or more and had either small-incision lenticule extraction or femtosecond laser–assisted LASIK were included. Only the left eye was included for analysis. Visual and refractive results were presented and compared between groups. Results The study comprised 105 patients (40 eyes in the small-incision lenticule extraction group and 65 eyes in the femtosecond laser–assisted LASIK group.) The mean preoperative manifest cylinder was −3.42 D ± 0.55 (SD) in the small-incision lenticule extraction group and −3.47 ± 0.49 D in the LASIK group ( P = .655). At 3 months, there was no significant between-group difference in uncorrected distance visual acuity ( P = .915) and manifest spherical equivalent ( P = .145). Ninety percent and 95.4% of eyes were within ± 0.5 D of the attempted cylindrical correction for the small-incision lenticule extraction and LASIK group, respectively ( P = .423). Vector analysis showed comparable target-induced astigmatism ( P = .709), surgically induced astigmatism vector ( P = .449), difference vector ( P = .335), and magnitude of error ( P = .413) between groups. The absolute angle of error was 1.88 ± 2.25 degrees in the small-incision lenticule extraction group and 1.37 ± 1.58 degrees in the LASIK group ( P = .217). Conclusion Small-incision lenticule extraction offered astigmatic correction comparable to LASIK in eyes with high myopic astigmatism. [ABSTRACT FROM AUTHOR]

This paper develops a modified preconditioned conjugate gradient (M-PCG) method for moving force identification (MFI) by improving the conjugate gradient (CG) and preconditioned conjugate gradient (PCG) methods with a modified Gram-Schmidt algorithm. The method aims to obtain more accurate and more efficient identification results from the responses of bridge deck caused by vehicles passing by, which are known to be sensitive to ill-posed problems that exist in the inverse problem. A simply supported beam model with biaxial time-varying forces is used to generate numerical simulations with various analysis scenarios to assess the effectiveness of the method. Evaluation results show that regularization matrix L and number of iterations j are very important influence factors to identification accuracy and noise immunity of M-PCG. Compared with the conventional counterpart SVD embedded in the time domain method (TDM) and the standard form of CG, the M-PCG with proper regularization matrix has many advantages such as better adaptability and more robust to ill-posed problems. More importantly, it is shown that the average optimal numbers of iterations of M-PCG can be reduced by more than 70% compared with PCG and this apparently makes M-PCG a preferred choice for field MFI applications. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the effects of inhibiting, motivating, and technological factors on users’ intention to participate in the sharing economy.Design/methodology/approach A self-reported online survey was conducted among Uber users in Hong Kong. A total of 295 valid responses were collected. The research model was empirically tested using the structural equation modeling technique.Findings The results suggested that perceived risks, perceived benefits, trust in the platform, and perceived platform qualities were significant predictors of users’ intention to participate in Uber.Research limitations/implications This study bridged the research gaps in the sharing economy literature by examining the effects of perceived risks, perceived benefits, and trust in the platform on users’ intention to participate in the sharing economy. Moreover, this study enriched the extended valence framework by incorporating perceived platform qualities into the research model, responding to the calls for the inclusion of technological variables in information systems research.Practical implications The findings provided practitioners with insights into enhancing users’ intention to participate in the sharing economy.Originality/value This study presented one of the first attempts to systematically examine the effects of inhibiting, motivating, and technological factors on users’ intention to participate in the sharing economy. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To investigate the corneal backward scattering and higher‐order aberrations (HOAs) in children with vernal keratoconjunctivitis (VKC) and normal topography. Methods: Thirty‐six eyes of 22 patients with VKC and 54 eyes of 34 normal subjects were included. All participants had clear cornea, absence of dry eyes and a normal corneal tomography. Scheimpflug imaging was used to measure corneal backward scattering in zones centred on the corneal apex (central 2‐mm zone and paracentral 2‐ to 6‐mm zone), and HOAs were compared between VKC and normal control. Results: The mean age of participants was 12.0 ± 4.1 years in VKC group and 11.2 ± 4.1 years in control group (p = 0.339). There was no significant intergroup difference in mean keratometry, astigmatism and apex pachymetry (p ≥ 0.076). Total corneal backscatter was higher in the VKC group compared to the control group (p ≤ 0.012). Anterior and posterior cornea displayed a higher level of backward scattering in the VKC group (p < 0.001 for anterior; p ≤ 0.048 for posterior). Patients with VKC exhibited higher total HOAs and coma (p ≤ 0.036). There were significant correlations between total anterior HOAs and backward scattering measured at the central (r = 0.500; p = 0.032) and paracentral zones (r = 0.470; p = 0.024) for VKC. Conclusion: The current study showed optical quality changes in patients with clear corneas and quiescent VKC. An increase in corneal backward scattering and HOAs was noted in patients with VKC as compared to normal patients. [ABSTRACT FROM AUTHOR]

Abstract: Corneal imaging is essential for diagnosing and management of a wide variety of ocular diseases. Corneal topography is used to characterize the shape of the cornea, specifically, the anterior surface of the cornea. Most corneal topographical systems are based on Placido disc that analyse rings that are reflected off the corneal surface. The posterior corneal surface cannot be characterized using Placido disc technology. Imaging of the posterior corneal surface is useful for diagnosis of corneal ectasia. Unlike corneal topographers, tomographers generate a three‐dimensional recreation of the anterior segment and provide information about the corneal thickness. Scheimpflug imaging is one of the most commonly used techniques for corneal tomography. The cross‐sectional images generated by a rotating Scheimpflug camera are used to locate the anterior and posterior corneal surfaces. The clinical uses of corneal topography include, diagnosis of corneal ectasia, assessment of corneal astigmatism, and refractive surgery planning. This review will discuss the applications of corneal topography and tomography in clinical practice. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to provide a comprehensive comparison of reliability of corneal topographic measurements in keratoconic eyes using swept-source optical coherence tomography ( OCT) and a combined Placido-Scheimpflug imaging. Methods A total of 30 eyes of 30 patients were included. The mean age was 31.2 ± 8.4 years. Two consecutive topographic measurements were obtained for one eye of each patient using swept-source OCT ( CASIA) and combined Placido-Scheimpflug imaging ( TMS-5). Test-retest reliability of CASIA and TMS-5 measurements including central corneal thickness ( CCT) and thinnest corneal thickness ( TCT), keratometry at steep (Ks) and flat (Kf) axes, average keratometry (Avg K), cylinder, and, best-fit spheres ( BFS) of the anterior and posterior corneal surfaces were evaluated. Results There was no systematic or scaling bias in any parameter in both devices. Systematic differences between CASIA and TMS-5 were found in posterior corneal Kf, Avg K and BFS, CCT and TCT (p ≤ 0.002); scaling differences between CASIA and TMS-5 were also found in CCT and TCT (p ≤ 0.002). Both machines illustrated adequate reliability. Intraclass correlation coefficients ( ICC) ≥0.952 was recorded for all parameters measured with CASIA and ICC ≥ 0.914 was recorded for all parameters on TMS-5. CASIA showed significantly higher ICCs in CCT and TCT, and posterior corneal BFS (p < 0.001). Conclusions This study showed significant differences in posterior corneal surface and corneal thickness measurements between swept-source OCT and combined Placido-Scheimpflug imaging in eyes with keratoconus. Swept-source OCT might be preferred over Placido-Scheimpflug imaging owing to better repeatability of measurements. [ABSTRACT FROM AUTHOR]

This paper proposes a new methodology for moving force identification (MFI) from the responses of bridge deck. Based on the existing time domain method (TDM), the MFI problem eventually becomes solving the linear algebraic equation in the form Ax = b . The vector b is usually contaminated by an unknown error e generating from measurement error, which often called the vector e as ‘‘noise’’. With the ill-posed problems that exist in the inverse problem, the identification force would be sensitive to the noise e . The proposed truncated generalized singular value decomposition method (TGSVD) aims at obtaining an acceptable solution and making the noise to be less sensitive to perturbations with the ill-posed problems. The illustrated results show that the TGSVD has many advantages such as higher precision, better adaptability and noise immunity compared with TDM. In addition, choosing a proper regularization matrix L and a truncation parameter k are very useful to improve the identification accuracy and to solve ill-posed problems when it is used to identify the moving force on bridge. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the shift in keratoconus progression rate after corneal collagen crosslinking (CXL). Setting Chinese University of Hong Kong Eye Centre, Hong Kong, China. Design Prospective case series. Method Accelerated epithelium-off CXL was performed in patients with progressive keratoconus. Optical coherence tomography–based corneal measurements were recorded. The data collected after the first postoperative month were used for analysis. The main outcome measure was the rate of progression of steep keratometry (K), flat K, average K, and best-fit sphere (BFS) using linear mixed-effects models. Progression was defined based on a significant slope against time in these models. Results Forty-seven eyes (38 patients; mean age 27.6 years ± 6.5 [SD]) were included. The median number of preoperative visits and postoperative visits was 3 and 5, respectively. A significant reduction in the progression rate of the anterior average K (0.063 ± 0.138 diopter [D]/mo to −0.022 ± 0.029 D/mo) and posterior average K (−0.011 ± 0.025 D/mo to 0.000 ± 0.009 D/mo) occurred (both P < .001). On univariate analysis, the baseline anterior average K had the strongest association with the progression rate of the anterior average K after CXL. On multivariate analysis, the preoperative progression rate of the posterior BFS was significantly associated with postoperative progression rate of the anterior ( P < .001) and posterior average K ( P ≤ .05). Conclusions A significant reduction in the progression rate of average K occurred after accelerated epithelium-off CXL. The reduction was associated with the baseline anterior average K and preoperative progression of posterior BFS. [ABSTRACT FROM AUTHOR]

The rising success of anti-vascular endothelial growth factor ( VEGF) therapies in ocular disease has stimulated the use of such treatments in the surgical management of pterygium. We reviewed the literature to better understand the safety and efficacy of the adjunctive role of anti- VEGF treatments for pterygium excision. Without surgery, anti- VEGF alone may favourably alter symptoms and vascularity, but does not cause pterygium regression. Some evidence supports the use of anti- VEGF as an adjuvant therapy to surgery, especially when using a higher dose and a more frequent dosing regimen. Overall, anti- VEGF is generally safe and well tolerated in patients with pterygium. Currently, the evidence does not conclusively support the use of anti- VEGF in pterygium surgery. However, further research may guide unanswered questions regarding the interaction between VEGF and other factors responsible for pterygium growth. In addition, the optimal route and dosage of anti- VEGF administration is not yet known. [ABSTRACT FROM AUTHOR]

Purpose: To analyse the outcomes of phacoemulsification in extreme axial myopia Methods: Consecutive cases of phacoemulsification in eyes with axial length ≥ 30.0 mm from January 1, 2010 to Dec 31, 2013 in a tertiary referral eye hospital were retrospectively reviewed. A single intraocular lens (IOL) type was used for all cases. Main outcome measures included perioperative complications and refractive outcome. Results: Two hundred and twenty-one eyes were identified. Intraoperatively, two eyes (0.9 %) had unstable capsular bag and three (1.4 %) had posterior capsular rupture. At a mean follow-up duration was 27.4 ± 14.6 months, three eyes (1.5 % of 198 eyes with no history of retinal detachment or macular hole) developed retinal detachment. There was an overall hyperopic shift with a mean biometry error of 0.45 ± 1.21 D in all eyes. The mean absolute biometry prediction error was 0.98 ± 0.83 D in all eyes, 1.11 ± 0.86 D and 0.85 ± 0.82 D in eyes receiving negative- and positive-power IOL, respectively ( p = 0.042). A total of 61.2 % of eyes had refractive outcome within ± 1.0 D of target spherical equivalent. Regression analysis showed low IOL power as an independent predictor for greater postoperative absolute biometry error ( p = 0.014). Conclusions: We showed no increase in perioperative complications in eyes with extreme high axial myopia. In eyes with long axial length, implantation of IOL with lower power was associated with more hyperopic shift, which was more pronounced with negative-power IOL. [ABSTRACT FROM AUTHOR]

The article present a case study of a 34-year-old female with a 2-day history of multiple thunderclap headaches followed by status epilepticus. It mentions Initial head computed tomography and magnetic resonance imaging (MRI) showed a hematoma at the level of the right marginal sulcus and subarachnoid hemorrhage over the convexities; and also mentions her headaches were managed with simple analgesics and they slowly dissipated over 1 week.

Purpose To report the 1-year visual and keratometric results of epithelium-on corneal collagen crosslinking (CXL) for advanced keratoconus (median maximum keratometry [K] ≥58.0 diopters [D]). Setting School of Ophthalmology and Optometry and Eye Hospital of Wenzhou Medical College, Wenzhou, China. Design Prospective case series. Methods Patients with bilateral progressive keratoconus had tetracaine-enhanced epithelium-on CXL. The worse eye had CXL, and the fellow eye was not treated. Results were reported 1, 3, 6, and 12 months postoperatively. The outcomes were compared with those in the fellow untreated eyes. Results Twenty-one eyes of 21 patients with a median age of 20.4 years (interquartile range [IQR], 9.5 years) were treated. A significant improvement in postoperative uncorrected distance visual acuity was observed at 12 months ( P = .002). Postoperative corrected distance visual acuity improved at 6 months and 12 months ( P ≤ .009) compared with baseline values. The maximum K decreased by 1.63 D from the median preoperative maximum K of 62.7 D (IQR, 12.9 D) at 12 months ( P < .001). The reduction in maximum K was higher after CXL than in untreated eyes at the end of 12 months ( P = .001). Correlation analysis between the preoperative maximum K values and the change over 6 to 12 months between different studies showed a significant correlation ( r = −0.764, P < .001; Spearman correlation). Conclusions Epithelium-on CXL was an effective treatment for patients with advanced keratoconus. A higher preoperative maximum K value correlated with greater corneal flattening after CXL. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned. [ABSTRACT FROM AUTHOR]

Background. To compare the early outcome of combined SMILE and collagen crosslinking (SMILE Xtra) with SMILE. Method. Prospective, comparative interventional study of 21 eyes receiving SMILE Xtra using a low energy protocol and 32 control eyes receiving SMILE only. The outcomes were compared at 1, 3, and 6 months postoperatively. Results. Both groups had myopia with spherical equivalent refraction (SEQ) > 4.00 D. The SMILE Xtra group had thinner preoperative central corneal thickness and residual stromal bed thickness (p<0.021). At 6 months, no eyes lost more than 1 line in corrected distance visual acuity. The safety index was 0.96±0.06 and 1.00±0.00 in SMILE Xtra and control, respectively (p<0.001). 89% and 94% of eyes were within ±0.50 D of target refraction, respectively, with the mean error in SEQ correction being -0.17±0.26 D for SMILE Xtra and +0.03±0.25 D for control (p=0.021). The efficacy index was 0.88±0.13 and 0.97±0.06, respectively (p=0.005). Conclusion. SMILE Xtra had good overall safety profile and predictability at 6 months. However, when compared with control, the safety index and efficacy index were statistically significantly lower in the early postoperative period. [ABSTRACT FROM AUTHOR]

Aim To compare astigmatic correction between femtosecond-assisted laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE). Methods A total of 111 patients were included in this prospective study. Fifty-seven eyes were treated with LASIK and 54 eyes were treated with SMILE for myopia with low to moderate (-0.25 to -4.0 D) astigmatism. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity and manifest refraction were measured preoperatively and at 1 and 3 months postoperatively. Visual and refractive outcomes were reported. Changes in refractive astigmatism were evaluated using vector analysis. Results Preoperative characteristics were similar between both groups. The UDVA at 1 and 3 months was better in the LASIK group compared with the SMILE group ( p<0.009). Postoperative cylinder was higher in the SMILE group ( p<0.001). Fewer eyes attained the attempted cylindrical correction in the SMILE group (p<0.029). Vector analysis showed no significant difference in target-induced astigmatism (p=0.091) and angle of error ( p>0.596) between the two groups. Surgically induced astigmatism was significantly lower in the SMILE group ( p<0.023), while the difference vector (p<0.001) and absolute angle of error (p<0.016) were significantly higher in the SMILE group. No significant difference was found in these parameters between 1 and 3 months in both groups ( p>0.122). Conclusions Our results showed that SMILE offered a less favourable astigmatic correction comparable to femtosecond-assisted LASIK in eyes with low to moderate myopic astigmatism. The alignment of treatment was more variable in SMILE, leading to a lower efficacy compared with LASIK by 3 months postoperatively. [ABSTRACT FROM AUTHOR]

The quantification of cambial growth over short time periods has been hampered by problems to discern between growth and the swelling and shrinking of a tree stem. This paper presents a model, which separates cambial growth and reversible water-potential induced diurnal changes from simultaneously measured whole stem and xylem radial variations, from field-measured Scots pine trees in Finland. The modelled growth, which includes osmotic concentration changes, was compared with (direct) dendrometer measurements and microcore samples. In addition, the relationship of modelled growth and dendrometer measurements to environmental factors was analysed. The results showed that the water-potential induced changes of tree radius were successfully separated from stem growth. Daily growth predicted by the model exhibited a high correlation with the modelled daily changes of osmotic concentration in phloem, and a temperature dependency in early summer. Late-summer growth saw higher dependency on water availability and temperature. Evaluation of the model against dendrometer measurements showed that the latter masked a true environmental signal in stem growth due to water-potential induced changes. The model provides better understanding of radial growth physiology and offers potential to examine growth dynamics and changes due to osmotic concentration, and how the environment affects growth. [ABSTRACT FROM AUTHOR]

Background This study aims to compare the effect of conventional corneal collagen cross-linking ( CXL) with accelerated corneal collagen cross-linking in treatment of keratoconus. Design A comparative interventional study was employed. Participants Participants were consecutive cases of progressive keratoconus receiving either conventional (3 mW/cm2 irradiance for 30 min) or accelerated CXL (9 mW/cm2 irradiance for 10 min). Methods Clinical and topographic parameters were compared between the two groups. Postoperative corneal stromal demarcation line was measured using anterior segment optical coherence tomography. Main Outcome Measures Clinical and topographic parameters such as corrected distant visual acuity ( CDVA), maximum keratometry ( Kmax), mean keratometry ( Kmean), demarcation line depth were gathered from medical records. Results There were a total of 26 eyes with an average follow up of 13.9 ± 6.3 months. Fourteen eyes received conventional CXL, and 12 eyes had accelerated CXL. In the conventional CXL group, CDVA improved significantly ( P = 0.021). There was also a significant reduction in Kmax ( P = 0.003) and Kmean ( P = 0.002). In the accelerated CXL group, no significant changes were found in CDVA ( P = 0.395), Kmax ( P = 0.388) and Kmean ( P = 0.952) postoperatively. A significantly greater reduction in Kmax and Kmean were seen in conventional CXL compared to its accelerated counterpart ( P = 0.001 and 0.015, respectively). The demarcation line was deeper in eyes with conventional CXL ( P = 0.013), and the depth correlated significantly with the change in Kmean (r = −0.432, P = 0.045). Conclusion Conventional and accelerated CXL are effective in stabilizing keratoconus progression after a mean of 12 months. Patients undergoing conventional CXL showed clinical improvement with greater corneal flattening, which correlated with a deeper corneal stromal demarcation line. This current study is the first to report such correlation. [ABSTRACT FROM AUTHOR]

In the structural health monitoring (SHM) field, long-term continuous vibration-based monitoring is becoming increasingly popular as this could keep track of the health status of structures during their service lives. However, implementing such a system is not always feasible due to on-going conflicts between budget constraints and the need of sophisticated systems to monitor real-world structures under their demanding in-service conditions. To address this problem, this paper presents a comprehensive development of a cost-effective and flexible vibration DAQ system for long-term continuous SHM of a newly constructed institutional complex with a special focus on the main building. First, selections of sensor type and sensor positions are scrutinized to overcome adversities such as low-frequency and low-level vibration measurements. In order to economically tackle the sparse measurement problem, a cost-optimized Ethernet-based peripheral DAQ model is first adopted to form the system skeleton. A combination of a high-resolution timing coordination method based on the TCP/IP command communication medium and a periodic system resynchronization strategy is then proposed to synchronize data from multiple distributed DAQ units. The results of both experimental evaluations and experimental–numerical verifications show that the proposed DAQ system in general and the data synchronization solution in particular work well and they can provide a promising cost-effective and flexible alternative for use in real-world SHM projects. Finally, the paper demonstrates simple but effective ways to make use of the developed monitoring system for long-term continuous structural health evaluation as well as to use the instrumented building herein as a multi-purpose benchmark structure for studying not only practical SHM problems but also synchronization related issues. [ABSTRACT FROM AUTHOR]

Fiber Bragg Grating (FBG) accelerometers using transverse forces with an inertial object placed at the middle of the FBG have a high sensitivity but low resonant frequency. The resonant frequency 26 Hz and sensitivity at 6 Hz 1.29 nm/g were reported based on a 50 mm-long FBG accelerometer. We demonstrate that the first FBG accelerometer based on a transversely rotating stick, which can, at the same or even larger size, keep the high sensitivity and significantly increase the low resonant frequency. In our experiments, a 77.5 mm-long FBG accelerometer has achieved a similar sensitivity but 65% higher resonant frequency. This novel structure not only significantly widens the potential applications of FBG accelerometers by increasing their resonant frequencies but also provides a new route to design other accelerometers, e.g. micro accelerometers. [ABSTRACT FROM AUTHOR]

Collagen cross-linking (CXL) with ultraviolet light-activated riboflavin is a corneal surface procedure developed for the treatment of keratoconus and corneal ectasia. With the known microbicidal and corneal stiffening effects of ultraviolet irradiation and photoactivated riboflavin, it has recently been introduced for the management of infectious keratitis, especially for ulcers resistant to antimicrobial therapy or associated with corneal melting. Various authors have attempted to use CXL as an adjunctive, salvage or even as the sole treatment for infectious corneal ulcers. The aim of this review was to provide a summary of the clinical studies in the literature. It is worth noting that there is still no consensus on the treatment protocol of CXL against infectious keratitis. The disparities in outcome measures, treatment protocol and study design can confound the interpretation and hamper the generalization of the study results. Based on current evidence, the role of CXL in infectious keratitis remained unclear despite the reported success in some clinical cases. Further investigations are warranted concerning the efficacy and safety of treating infectious keratitis with CXL. [ABSTRACT FROM AUTHOR]

Viral conjunctivitis caused by adenovirus is the most common infectious conjunctivitis. Adenoviruses are highly contagious pathogens. The modes of transmission are mainly through hand to eye contact, ocular secretions, respiratory droplets, and contact with ophthalmic care providers and their medical instruments. The most frequent manifestation of ocular adenoviral infection is epidemic keratoconjunctivitis, followed by pharyngoconjunctival fever. Epidemic keratoconjunctivitis is also the most severe form and presents with watery discharge, hyperemia, cheosis, and ipsilateral lymphadenopathy. Pharyngoconjunctival fever is characterized by abrupt onset of high fever, pharyngitis, bilateral conjunctivitis, and periauricular lymph node enlargement. Isolated follicular conjunctivitis without corneal or systemic involvement also occurs. The rate of clinical accuracy in diagnosing viral conjunctivitis is less than 50%. Rapid diagnostic tests now being used decrease unnecessary antibiotic use. Treatment for viral conjunctivitis is mostly supportive. The majority of cases are self-limited, and no treatment is necessary in uncomplicated cases. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the outcomes of femtosecond-assisted arcuate keratotomy combined with cataract surgery in eyes with low to moderate corneal astigmatism. Design: Retrospective, interventional case series. Methods: This study included patients who underwent combined femtosecond-assisted phacoemulsification and arcuate keratotomy between March 2013 and August 2013. Keratometric astigmatism was evaluated before and 2 months after the surgery. Vector analysis of the astigmatic changes was performed using the Alpins method. Results: Overall, 54 eyes of 54 patients (18 male and 36 female; mean age, 68.8 ± 11.4 years) were included. The mean preoperative (target-induced astigmatism) and postoperative astigmatism was 1.33 ± 0.57 diopters (D) and 0.87 ± 0.56 D, respectively (P < .001). The magnitude of error (difference between surgically induced and target-induced astigmatism) (-0.13 ± 0.68 D), as well as the correction index (ratio of surgically induced and target-induced astigmatism) (0.86 ± 0.52), demonstrated slight undercorrection. The angle of error was very close to 0, indicating no significant systematic error of misaligned treatment. However, the absolute angle of error showed a less favorable range (17.5 ± 19.2 degrees), suggesting variable factors such as healing or alignment at an individual level. There were no intraoperative or postoperative complications. Conclusions: Combined phacoemulsification with arcuate keratotomy using femtosecond laser appears to be a relatively easy and safe means for management of low to moderate corneal astigmatism in cataract surgery candidates. Misalignment at an individual level can reduce its effectiveness. This issue remains to be elucidated in future studies. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 30-year-old lady with epithelial ingrowth after small incision lenticule extraction (SMILE) treated successfully with a novel hydrogel ocular sealant. It is mentioned that underwent repeat scraping, followed by hydrogel ocular sealant placement, which prevented recurrence of epithelial ingrowth and reduced corneal haze. The article adds that Interface epithelial ingrowth is a potential complication after SMILE and diabetes may be a risk factor.

A case study is presented of a 35-year old healthy male presented with the history of headache associated with bilateral ear erythema. Neurological and ontological examinations showed normal results; and magnetic resonance imaging of head and cervical spine were norma. Further he was treated with pathophysiology of idiopathic red ear syndrome using indomethacin drug.

We present a novel case of a focal stabbing headache sharing features of primary stabbing headache that started and resolved with the onset and resolution of a course of self-limiting peripheral vertigo. The association of onset and improvement of the stabbing headaches support the trigeminal and vestibular reciprocal relationships. Vestibular input may be the driving force and a potential target for treatment. [ABSTRACT FROM AUTHOR]

Purpose To investigate the change in posterior corneal elevation up to 1 year after myopic femtosecond-assisted LASIK and photorefractive keratectomy (PRK). Design Prospective, longitudinal, comparative study. Participants Patients undergoing femtosecond-assisted LASIK or PRK. Methods Corneal imaging was performed using swept-source optical coherence tomography at baseline and at each postoperative follow-up. A 2-way analysis of variance model with repeated measures and a linear mixed effect model were used to compare the differences in posterior corneal elevation between LASIK and PRK at different points after adjusting for the preoperative spherical equivalent (SEQ), central corneal thickness (CCT), thinnest corneal thickness (TCT), residual bed thickness (RST), and ablation depth (AD). Main Outcome Measures The changes in posterior corneal elevation 1 month, 3 months, 6 months, and 12 months after surgery. Results Ninety-eight eyes of 49 patients (mean age 35.2 ± 8.5 years) (62 LASIK, 36 PRK) were included. The mean change in posterior corneal elevation values after LASIK and PRK were 4.88±0.47 μm versus 3.67±0.48 μm (B-1), 2.42±0.56 μm versus 3.00±0.47 μm (B-3), 3.76±0.46 μm versus 2.76±0.46 μm (B-6), and 2.92±0.46 μm versus 2.72±0.46 μm (B-12), respectively. Significant differences in posterior corneal elevation after LASIK were found from month 1, to month 3, to month 6, to month 12 ( P ≤ 0.001), whereas posterior corneal elevation did not change significantly from month 3, to month 6, to month 12 ( P ≥ 0.373) after PRK. LASIK and PRK eyes showed significant differences at months 3 and 12 ( P ≤ 0.023). A similar pattern was observed for the changes in posterior corneal elevation after LASIK and PRK after adjusting for the effect of SEQ, CCT, TCT, RST, and AD. The adjusted forward displacements of the posterior corneal surface were statistically significant throughout the study period after both refractive surgeries ( P < 0.05). Conclusions The findings of our study suggested that there was a mild but significant forward protrusion of the posterior cornea after femtosecond laser-assisted LASIK and PRK. The posterior cornea fluctuated during the first postoperative year after LASIK, whereas it stabilized as early as 3 months after PRK. [ABSTRACT FROM AUTHOR]

Purpose. The study aims to compare the long-term outcome of conjunctival autograft (CAU) and mitomycin C (MMC) in double-head pterygium surgery. Methods. This is a follow-up study of a comparative interventional trial. Thirty-nine eyes of the 36 patients with double-head pterygium excision in the original study 12 years ago were recruited for clinical assessment. Seven out of the 36 patients were lost. In the original study, each eye with double-head pterygium was randomized to have pterygium excision with CAU on one “head” (temporal or nasal) and MMC on the other “head.” All patients were invited for clinical assessment for conjunctival bed status and the presence of pterygium recurrence in the current study. Results. There was no significant difference between the size, morphology, and type of pterygium among the two treatment groups. The recurrence rate of CAU group and MMC group 12 years after excision was 6.3% and 28.1%, respectively (P=0.020). Among eyes without recurrence, the conjunctival bed was graded higher in the MMC group than the CAU group (P=0.024). Conclusion. The use of conjunctival autograft has a significantly lower long-term recurrence rate than mitomycin C in double-head pterygium surgery. [ABSTRACT FROM AUTHOR]