Comparison of intraocular pressure measurement between rebound, non-contact and Goldmann applanation tonometry in treated glaucoma patients

Background: To compare the intraocular pressure readings obtained with the iCare rebound tonometer and the 7CR non-contact tonometer with those measured by Goldmann applanation tonometry in treated glaucoma patients. Design: A prospective, cross sectional study was conducted in a private tertiary glaucoma clinic. Participants: 109 (54M:55F) patients including only eyes under medical treatment for glaucoma. Methods: Measurement by Goldmann applanation tonometry, iCare rebound tonometry and 7CR non-contact tonometry. Main Outcome Measures: Intraocular pressure. Results: There were strong correlations between the intraocular pressure measurements obtained with Goldmann and both the rebound and non-contact tonometers (Spearman r values ≥ 0.79, p < 0.001). However, there were small, statistically significant differences between the average readings for each tonometer. For the rebound tonometer, the mean intraocular pressure was slightly higher compared to the Goldmann applanation tonometer in the right eyes (p = 0.02), and similar in the left eyes (p = 0.93) however these differences did not reach statistical significance. The Goldmann correlated measurements from the noncontact tonometer were lower than the average Goldmann reading for both right (p < 0.001) and left (p > 0.01) eyes. The corneal compensated measurements from the non-contact tonometer were significantly higher compared to the other tonometers (p ≤ 0.001). Conclusions: The iCare rebound tonometer and the 7CR non-contact tonometer measure IOP in fundamentally different ways to the Goldmann applanation tonometer. The resulting IOP values vary between the instruments and will need to be considered when comparing clinical versus home acquired measurements.

Using Fiber Bragg Grating (FBG) sensors for vertical displacement measurement of bridges

In many bridges, vertical displacements are one of the most relevant parameters for structural health monitoring in both the short and long terms. Bridge managers around the globe are always looking for a simple way to measure vertical displacements of bridges. However, it is difficult to carry out such measurements. On the other hand, in recent years, with the advancement of fiber-optic technologies, fiber Bragg grating (FBG) sensors are more commonly used in structural health monitoring due to their outstanding advantages including multiplexing capability, immunity of electromagnetic interference as well as high resolution and accuracy. For these reasons, using FBG sensors is proposed to develop a simple, inexpensive and practical method to measure vertical displacements of bridges. A curvature approach for vertical displacement measurement using curvature measurements is proposed. In addition, with the successful development of a FBG tilt sensors, an inclination approach is also proposed using inclination measurements. A series of simulation tests of a full-scale bridge was conducted. It shows that both the approaches can be implemented to determine vertical displacements for bridges with various support conditions, varying stiffness (EI) along the spans and without any prior known loading. These approaches can thus measure vertical displacements for most of slab-on-girder and box-girder bridges. Moreover, with the advantages of FBG sensors, they can be implemented to monitor bridge behavior remotely and in real time. Further recommendations of these approaches for developments will also be discussed at the end of the paper.

Triangular Linguistic Fuzzy based performance measurement model for supply chain to assess leanness attributes

Increasing global competitiveness worldwide has forced manufacturing organizations to produce high-quality products more quickly and at a competitive cost. In order to reach these goals, they need good quality components from suppliers at optimum price and lead time. This actually forced all the companies to adapt different improvement practices such as lean manufacturing, Just in Time (JIT) and effective supply chain management. Applying new improvement techniques and tools cause higher establishment costs and more Information Delay (ID). On the contrary, these new techniques may reduce the risk of stock outs and affect supply chain flexibility to give a better overall performance. But industry people are unable to measure the overall affects of those improvement techniques with a standard evaluation model .So an effective overall supply chain performance evaluation model is essential for suppliers as well as manufacturers to assess their companies under different supply chain strategies. However, literature on lean supply chain performance evaluation is comparatively limited. Moreover, most of the models assumed random values for performance variables. The purpose of this paper is to propose an effective supply chain performance evaluation model using triangular linguistic fuzzy numbers and to recommend optimum ranges for performance variables for lean implementation. The model initially considers all the supply chain performance criteria (input, output and flexibility), converts the values to triangular linguistic fuzzy numbers and evaluates overall supply chain performance under different situations. Results show that with the proposed performance measurement model, improvement area for each variable can be accurately identified.

When does pain and distress relief hastening death become killing?

This paper discusses the question of when pain and distress relief known to hasten death would cross the line between permissible conduct and killing. The issue is discussed in the context of organ donation after cardiac death, and considers the administration of analgesics, sedatives, and the controversial use of paralysing agents in the provision and withdrawal of ventilation.

Collision warning dissemination in vehicles strings : an empirical measurement

Inter-Vehicular Communications (IVC) are considered a promising technological approach for enhancing transportation safety and improving highway efficiency. Previous theoretical work has demonstrated the benefits of IVC in vehicles strings. Simulations of partially IVC-equipped vehicles strings showed that only a small equipment ratio is sufficient to drastically reduce the number of head on collisions. However, these results are based on the assumptions that IVC exhibit lossless and instantaneous messages transmission. This paper presents the research design of an empirical measurement of a vehicles string, with the goal of highlighting the constraints introduced by the actual characteristics of communication devices. A warning message diffusion system based on IEEE 802.11 wireless technology was developed for an emergency breaking scenario. Preliminary results are presented as well, showing the latencies introduced by using 802.11a and discussing early findings and experimental limitations

Methods used in cross-cultural comparisons of sexual symptoms and their determinants

This is the fourth in a series of reviews of cross-cultural studies of menopausal symptoms. The purpose of this review is to examine methods used in cross-cultural comparisons of sexual symptoms among women at midlife, and to examine the determinants of sexual symptoms and how those determinants were measured. The goal of this review is to make recommendations that will improve cross-cultural comparisons in the future. The review included nine studies that explicitly examined symptoms in different countries or different ethnic groups in the same country and included: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Mid-Aged Health in Women from the Indian Subcontinent (MAHWIS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and Women's International Study of Health and Sexuality (WISHeS). Although methods used for assessing sexual symptoms across cultures differed between studies, statistically significant differences were reported. Cross-cultural differences in sexual symptoms exist, and should be measured by including the following symptoms: loss of interest in sex, vaginal dryness, and the Females Sexual Function Index which covers desire, arousal, lubrication, orgasm, satisfaction, and pain on intercourse. The measurement of these symptoms will provide an evidence-based approach when forming any future menopause symptom list and allow for comparisons across studies.

Methods used in cross-cultural comparisons of somatic symptoms and their determinants

This paper is the third in a series of reviews of cross-cultural studies of symptoms at midlife. The goal of this review is to examine methods used previously in cross-cultural studies of menopause and women's health at midlife to (1) identify challenges in the measurement of somatic symptoms across cultures and (2) recommend questions and tools that can be used in future research. This review also aims to examine the determinants of somatic symptoms. The review concludes that methods used for assessing somatic symptoms differ across studies. Somatic symptoms, particularly, aches, pain, and fatigue have a high prevalence. Statistically significant differences were seen in the prevalence of somatic symptoms across cultures. Based on the number of studies that demonstrated cross-cultural differences in symptom prevalence, we recommend that the following symptoms be included in future studies of symptoms at midlife: headaches, aches/pain, palpitations, dizziness, fatigue, breathing difficulties, numbness or tingling, and gastrointestinal difficulties. We also recommend that objective measures of physical function be administered when possible to supplement subjective self-evaluation.

Reliability of ultrasonographic measurement of the architecture of the vastus lateralis and gastrocnemius medialis muscles in older adults

Objective To determine the test-retest reliability of measurements of thickness, fascicle length (Lf) and pennation angle (θ) of the vastus lateralis (VL) and gastrocnemius medialis (GM) muscles in older adults. Participants Twenty-one healthy older adults (11 men and ten women; average age 68·1 ± 5·2 years) participated in this study. Methods Ultrasound images (probe frequency 10 MHz) of the VL at two sites (VL site 1 and 2) were obtained with participants seated with knee at 90º flexion. For GM measures, participants lay prone with ankle fixed at 15º dorsiflexion. Measures were taken on two separate occasions, 7 days apart (T1 and T2). Results The ICCs (95% CI) were: VL site 1 thickness = 0·96(0·90–0·98); VL site 2 thickness = 0·96(0·90–0·98), VL θ = 0·87(0·68–0·95), VL Lf = 0·80(0·50–0·92), GM thickness = 0·97(0·92–0·99), GM θ = 0·85(0·62–0·94) and GM Lf =0·90(0·75–0·96). The 95% ratio limits of agreement (LOAs) for all measures, calculated by multiplying the standard deviation of the ratio of the results between T1 and T2 by 1·96, ranged from 10·59 to 38·01%. Conclusion The ability of these tests to determine a real change in VL and GM muscle architecture is good on a group level but problematic on an individual level as the relatively large 95% ratio LOAs in the current study may encompass the changes in architecture observed in other training studies. Therefore, the current findings suggest that B-mode ultrasonography can be used with confidence by researchers when investigating changes in muscle architecture in groups of older adults, but its use is limited in showing changes in individuals over time.

The Measurement of Information System Use: Preliminary Considerations

DeLone and McLean (1992, p. 16) argue that the concept of “system use” has suffered from a “too simplistic definition.” Despite decades of substantial research on system use, the concept is yet to receive strong theoretical scrutiny. Many measures of system use and the development of measures have been often idiosyncratic and lack credibility or comparability. This paper reviews various attempts at conceptualization and measurement of system use and then proposes a re-conceptualization of it as “the level of incorporation of an information system within a user’s processes.” The definition is supported with the theory of work systems, system, and Key-User-Group considerations. We then go on to develop the concept of a Functional- Interface-Point (FIP) and four dimensions of system usage: extent, the proportion of the FIPs used by the business process; frequency, the rate at which FIPs are used by the participants in the process; thoroughness, the level of use of information/functionality provided by the system at an FIP; and attitude towards use, a set of measures that assess the level of comfort, degree of respect and the challenges set forth by the system. The paper argues that the automation level, the proportion of the business process encoded by the information system has a mediating impact on system use. The article concludes with a discussion of some implications of this re-conceptualization and areas for follow on research.

Revealing common attributes of organizational identities using performance measurement systems

Identity is unique, multiple and dynamic. This paper explores common attributes of organisational identities, and examines the role of performance management systems (PMSs) on revealing identity attributes. One of the influential PMSs, the balanced scorecard, is used to illustrate the arguments. A case study of a public-sector organisation suggests that PMSs now place a value on the intangible aspects of organisational life as well as the financial, periodically revealing distinctiveness, relativity, visibility, fluidity and manageability of public-sector identities that sustain their viability. This paper contributes to a multi-disciplinary approach and its practical application, demonstrating an alternative pathway to identity-making using PMSs.

Understanding user experience of mobile video : framework, measurement, and optimization

Since users have become the focus of product/service design in last decade, the term User eXperience (UX) has been frequently used in the field of Human-Computer-Interaction (HCI). Research on UX facilitates a better understanding of the various aspects of the user’s interaction with the product or service. Mobile video, as a new and promising service and research field, has attracted great attention. Due to the significance of UX in the success of mobile video (Jordan, 2002), many researchers have centered on this area, examining users’ expectations, motivations, requirements, and usage context. As a result, many influencing factors have been explored (Buchinger, Kriglstein, Brandt & Hlavacs, 2011; Buchinger, Kriglstein & Hlavacs, 2009). However, a general framework for specific mobile video service is lacking for structuring such a great number of factors. To measure user experience of multimedia services such as mobile video, quality of experience (QoE) has recently become a prominent concept. In contrast to the traditionally used concept quality of service (QoS), QoE not only involves objectively measuring the delivered service but also takes into account user’s needs and desires when using the service, emphasizing the user’s overall acceptability on the service. Many QoE metrics are able to estimate the user perceived quality or acceptability of mobile video, but may be not enough accurate for the overall UX prediction due to the complexity of UX. Only a few frameworks of QoE have addressed more aspects of UX for mobile multimedia applications but need be transformed into practical measures. The challenge of optimizing UX remains adaptations to the resource constrains (e.g., network conditions, mobile device capabilities, and heterogeneous usage contexts) as well as meeting complicated user requirements (e.g., usage purposes and personal preferences). In this chapter, we investigate the existing important UX frameworks, compare their similarities and discuss some important features that fit in the mobile video service. Based on the previous research, we propose a simple UX framework for mobile video application by mapping a variety of influencing factors of UX upon a typical mobile video delivery system. Each component and its factors are explored with comprehensive literature reviews. The proposed framework may benefit in user-centred design of mobile video through taking a complete consideration of UX influences and in improvement of mobile videoservice quality by adjusting the values of certain factors to produce a positive user experience. It may also facilitate relative research in the way of locating important issues to study, clarifying research scopes, and setting up proper study procedures. We then review a great deal of research on UX measurement, including QoE metrics and QoE frameworks of mobile multimedia. Finally, we discuss how to achieve an optimal quality of user experience by focusing on the issues of various aspects of UX of mobile video. In the conclusion, we suggest some open issues for future study.

Use of the iPhone for Cobb angle measurement in scoliosis

Purpose: The Cobb technique is the universally accepted method for measuring the severity of spinal deformities. Traditionally, Cobb angles have been measured using protractor and pencil on hardcopy radiographic films. The new generation of mobile phones make accurate angle measurement possible using an integrated accelerometer, providing a potentially useful clinical tool for assessing Cobb angles. The purpose of this study was to compare Cobb angle measurements performed using an Apple iPhone and traditional protractor in a series of twenty Adolescent Idiopathic Scoliosis patients. Methods: Seven observers measured major Cobb angles on twenty pre-operative postero-anterior radiographs of Adolescent Idiopathic Scoliosis patients with both a standard protractor and using an Apple iPhone. Five of the observers repeated the measurements at least a week after the original measurements. Results: The mean absolute difference between pairs of iPhone/protractor measurements was 2.1°, with a small (1°) bias toward lower Cobb angles with the iPhone. 95% confidence intervals for intra-observer variability were ±3.3° for the protractor and ±3.9° for the iPhone. 95% confidence intervals for inter-observer variability were ±8.3° for the iPhone and ±7.1° for the protractor. Both of these confidence intervals were within the range of previously published Cobb measurement studies. Conclusions: We conclude that the iPhone is an equivalent Cobb measurement tool to the manual protractor, and measurement times are about 15% less. The widespread availability of inclinometer-equipped mobile phones and the ability to store measurements in later versions of the angle measurement software may make these new technologies attractive for clinical measurement applications.

Improving posture and decreasing pain with novel shoe insoles

A single subject longevity study is presented as a case study for the Medical Device Partnering Program (MDPP). The MDPP supports the development of cutting-edge medical devices and assistive technologies, through unique collaborations between researchers, industry, clinical end-users and government. The study aimed to identify what effect the innersole has on specific muscles that may influence stability and whether the innersole had any influence on gait. Three tests were conducted; a standard gait test, dynamic balance test and a standing balance test. Results from the kinematic analysis showed reduced variability in post testing results when compared to pre testing results. Reductions in muscle activation levels were also found across all tests. Further testing with a larger sample size is required to determine if these effects are due to the innersole.

The effect of hydrogel and silicone hydrogel contact lenses on the measurement of intraocular pressure with rebound tonometry

Purpose: To assess the accuracy of intraocular pressure(IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) and silicone hydrogel (senofilcon A) contact lenses (CLs) of different powers. Methods: The experimental group comprised 36 subjects (19 male, 17 female). IOP measurements were undertaken on the subject’s right eyes in random order using a rebound tonometer (ICare). The CLs had powers of +2.00D, −2.00D and−6.00D. Six measurements were taken over each contact lens and also before and after the CLs had been worn. Results: A good correlation was found between IOP measurements with and without CLs (all r≥0.80; p < 0.05). Bland Altman plots did not show any significant trend in the difference in IOP readings with and without CLs as a function of IOP value. A two-way ANOVA revealed a significant effect of material and power (p < 0.01) but no interaction. All the comparisons between the measurements without CLs and with hydrogel CLs were significant (p < 0.01). The comparisons with silicone hydrogel CLs were not significant. Conclusions: Rebound tonometry can be reliably performed over silicone hydrogel CLs. With hydrogel CLs, the measurements were lower than those without CLs. However, despite the fact that these differences were statistically significant, their clinical significance was minimal.