Dynamic measurement of accommodation and pupil size using the portable Grand Seiko FR-5000 autorefractor

PURPOSE. The purpose of this study was to evaluate the potential of the portable Grand Seiko FR-5000 autorefractor to allow objective, continuous, open-field measurement of accommodation and pupil size for the investigation of the visual response to real-world environments and changes in the optical components of the eye. METHODS. The FR-5000 projects a pair of infrared horizontal and vertical lines on either side of fixation, analyzing the separation of the bars in the reflected image. The measurement bars were turned on permanently and the video output of the FR-5000 fed into a PC for real-time analysis. The calibration between infrared bar separation and the refractive error was assessed over a range of 10.0 D with a model eye. Tolerance to longitudinal instrument head shift was investigated over a ±15 mm range and to eye alignment away from the visual axis over eccentricities up to 25.0°. The minimum pupil size for measurement was determined with a model eye. RESULTS. The separation of the measurement bars changed linearly (r = 0.99), allowing continuous online analysis of the refractive state at 60 Hz temporal and approximately 0.01 D system resolution with pupils >2 mm. The pupil edge could be analyzed on the diagonal axes at the same rate with a system resolution of approximately 0.05 mm. The measurement of accommodation and pupil size were affected by eccentricity of viewing and instrument focusing inaccuracies. CONCLUSIONS. The small size of the instrument together with its resolution and temporal properties and ability to measure through a 2 mm pupil make it useful for the measurement of dynamic accommodation and pupil responses in confined environments, although good eye alignment is important. Copyright © 2006 American Academy of Optometry.

Objective accommodative amplitude and dynamics with the 1CU accommodative intraocular lens

PURPOSE. To compare the objective accommodative amplitude and dynamics of eyes implanted with the one-compartment-unit (1CU; HumanOptics AG, Erlangen, Germany) accommodative intraocular lenses (IOLs) with that measured subjectively. METHODS. Twenty eyes with a 1CU accommodative IOL implanted were refracted and distance and near acuity measured with a logMAR (logarithm of the minimum angle of resolution) chart. The objective accommodative stimulus-response curve for static targets between 0.17 and 4.00 D accommodative demand was measured with the SRW-5000 (Shin-Nippon Commerce Inc., Tokyo, Japan) and PowerRefractor (PlusOptiX, Nürnberg, Germany) autorefractors. Continuous objective recording of dynamic accommodation was measured with the SRW-5000, with the subject viewing a target moving from 0 to 2.50 D at 0.3 Hz through a Badal lens system. Wavefront aberrometry measures (Zywave; Bausch & Lomb, Rochester, NY) were made through undilated pupils. Subjective amplitude of accommodation was measured with the RAF (Royal Air Force accommodation and vergence measurement) rule. RESULTS. Four months after implantation best-corrected acuity was -0.01 ± 0.16 logMAR at distance and 0.60 ± 0.09 logMAR at near. Objectively, the static amplitude of accommodation was 0.72 ± 0.38 D. The average dynamic amplitude of accommodation was 0.71 ± 0.47 D, with a lag behind the target of 0.50 ± 0.48 seconds. Aberrometry showed a decrease in power of the lens-eye combination from the center to the periphery in all subjects (on average, -0.38 ± 0.28 D/mm). Subjective amplitude of accommodation was 2.24 ± 0.42 D. Two years after 1CU implantation, refractive error and distance visual acuity remained relatively stable, but near visual acuity, and the subjective and objective amplitudes of accommodation decreased. CONCLUSIONS. The objective accommodating effects of the 1CU lens appear to be limited, although patients are able to track a moving target. Subjective and objective accommodation was reduced at the 2-year follow-up. The greater subjective amplitude of accommodation is likely to result from the eye's depth of focus of and the aspheric nature of the IOL. Copyright © Association for Research in Vision and Ophthalmology.

Simultaneous continuous recording of accommodation and pupil size using the modified Shin-Nippon SRW-5000 autorefractor

The internal optics of the recent models of the Shin-Nippon SRW-5000 autorefractor (also marketed as the Grand Seiko WV-500) have been modified by the manufacturer so that the infrared measurement ring has been replaced by pairs of horizontal and vertical infrared bars, on either side of fixation. The binocular, open field-of-view, allowing the accommodative state to be objectively monitored while a natural environment is viewed, has made the SRW-5000 a valuable tool in further understanding the nature of the oculomotor response. It is shown that the root-mean-square of model eye measures was least (0.017 ± 0.002D) when the separation of the horizontal measurement bars were averaged twice. The separation of the horizontal bars changes by 3.59 pixels/dioptre (r2 = 0.99), allowing continuous on-line analysis of the refractive state at up to 60 Hz temporal resolution to an accuracy of <0.001D, with pupils >3 mm. The pupil edge is not obscured in the diagonal axis by the measurement bars, unlike the ring of the original optics, so in the newer model pupil size can be measured simultaneously at the same rate with a resolution of <0.001 mm. The measurements of accommodation and pupil size are relatively unaffected by eccentricity of viewing up to ±10° from the visual axis and instrument focusing inaccuracies over a range of 10 mm towards the eye and 5 mm away from the eye. The resolution and temporal properties of the analysis are therefore ideal for the simultaneous measurement of dynamic accommodation and pupil responses. © 2004 The College of Optometrists.

Continuous recording of accommodation and pupil size using the Shin-Nippon SRW-5000 autorefractor

A newly released commercial autorefractor, the Shin-Nippon SRW-5000 (Japan), has been found to be valid compared to subjective refraction and repeatable over a wide prescription range. Its binocular open field-of-view allows the accommodative state to be monitored while a natural environment is viewed. In conventional static mode, the device can take up to 45 readings in 1min using digital image analysis of the reflected retinal image of a measurement ring. Continuous on-line analysis of the ring provides high (up to 60Hz) temporal resolution of the refractive state to an accuracy of <0.001D. Pupil size can also be analysed to a resolution of <0.001mm. The measurement of accommodation and pupil size was relatively unaffected by eccentricity of viewing up to ±10° and instrument focusing inaccuracies of ±5mm. The resolution properties of the analysis are shown to be ideal for measurement of dynamic accommodation and pupil responses. Copyright © 2001 The College of Optometrists.

Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in adults:an update

Purpose: The Shin-Nippon SRW-5000 is an open view autorefractor that superseded the Canon R-1 autorefractor in the mid-1990s and has been used widely in optometry and vision science laboratories. It has been used to measure refractive error, accommodation responses both statically and dynamically, off-axis refractive error, and adapted to measure pupil size. This paper presents an overview of the original 2001 clinical evaluation of the SRW-5000 in adults (Mallen et al., Ophthal Physiol Opt 2001; 21: 101) and provides an update on the use and modification of the instrument since the original publication. Recent findings: The SRW-5000 instrument, and the family of devices which followed, have shown excellent validity, repeatability, and utility in clinical and research settings. The instruments have also shown great potential for increased research functionality following a number of modifications. Summary: The SRW-5000 and its derivatives have been, and continue to be, of significant importance in our drive to understand myopia progression, myopia control techniques, and oculomotor function in human vision.

Variables affecting the precision and accuracy of the Intoxilyzer 5000

The Intoxilyzer 5000 was tested for calibration curve linearity for ethanol vapor concentration between 0.020 and 0.400g/210L with excellent linearity. Calibration error using reference solutions outside of the allowed concentration range, response to the same ethanol reference solution at different temperatures between 34 and 38$\sp\circ$C, and its response to eleven chemicals, 10 mixtures of two at the time, and one mixture of four chemicals potentially found in human breath have been evaluated. Potential interferents were chosen on the basis of their infrared signatures and the concentration range of solutions corresponding to the non-lethal blood concentration range of various volatile organic compounds reported in the literature. The result of this study indicates that the instrument calibrates with solutions outside the allowed range up to $\pm$10% of target value. Headspace FID dual column GC analysis was used to confirm the concentrations of the solutions. Increasing the temperature of the reference solution from 34 to 38$\sp\circ$C resulted in linear increases in instrument recorded ethanol readings with an average increase of 6.25%/$\sp\circ$C. Of the eleven chemicals studied during this experiment, six, isopropanol, toluene, methyl ethyl ketone, trichloroethylene, acetaldehyde, and methanol could reasonably interfere with the test at non-lethal reported blood concentration ranges, the mixtures of those six chemicals showed linear additive results with a combined effect of as much as a 0.080g/210L reading (Florida's legal limit) without any ethanol present. ^

PROGNOSTIC FACTORS PREDICTING FUNCTIONAL OUTCOME AT FOUR MONTHS FOLLOWING ACUTE ANKLE SPRAIN

PROGNOSTIC FACTORS PREDICTING FUNCTIONAL OUTCOME AT FOUR MONTHS FOLLOWING ACUTE ANKLE SPRAINBleakley C.M.1, O'Connor S.R.1, Tully M.A.2, Rocke L.G.3, MacAuley D.C.1, Bradbury I.4, Keegan S.4, McDonough S.M.11University of Ulster, Health & Rehabilitation Sciences Research Institute, Newtownabbey, United Kingdom, 2Queen's University, UKCRC Centre of Excellence for Public Health (NI), Belfast, United Kingdom, 3Royal Victoria Hospital, Department of Emergency Medicine, Belfast, United Kingdom, 4Frontier Science (Scotland), Kincraig, Inverness-shire, United KingdomPurpose: To identify clinically relevant factors assessed following acute ankle sprain that predict functional recovery at four months post-injury.Relevance: Ankle sprains are one of the most common musculoskeletal injuries with an estimated 5000 new cases occurring each day in the United Kingdom. In the acute phase, ankle sprains may be associated with pain and loss of function. In the longer-term there is a risk of residual problems including chronic pain or reinjury. Few studies have sought to examine factors associated with a poor long-term prognosis.Participants: 101 patients (Age: Mean (SD) 25.9 (7.9) years; Body Mass Index (BMI): 25.3 (3.5) kg/m2) with an acute grade 1 or 2 ankle sprain attending an accident and emergency department or sports injury clinic. Exclusion criteria included complete (grade 3) rupture of the ankle ligament complex, bony ankle injury or multiple injuries.Methods: Participants were allocated as part of a randomised controlled trial to an accelerated intervention incorporating intermittent ice and early therapeutic exercise or a standard protection, rest, ice, compression, and elevation intervention for one week. Treatment was then standardised in both groups and consisted of ankle rehabilitation exercises focusing on muscle strengthening, neuromuscular training, and sports specific functional exercises for a period of approximately four to six weeks. On initial assessment age, gender, mechanism of injury, presence of an audible pop or snap and the presence of contact during the injury were recorded. The following factors were also recorded at baseline and at one and four weeks post-injury: weight-bearing dorsi-flexion test, lateral hop test, presence of medial pain on palpation and a positive impingement sign. Functional status was assessed using the Karlsson score at baseline, at week four and at four months. Reinjury rates were recorded throughout the intervention phase and at four months.Analysis: A mixed between-within subjects analysis of variance (ANOVA) was used to determine the effect of each factor on functional status at week four and at four months. Significance was set at a Bonferroni adjusted level of 0.0125 (0.05/4).Results: Eighty-five participants (84%) were available at final follow-up assessment. Pain on weight-bearing dorsi-flexion and lateral hop tests at week four were both associated with a lower functional score at four months post-injury (P = 0.011 and P = 0.001). No other significant interactions were observed at any other timepoint (baseline or week one). There were only two reinjuries within the four month follow-up period with a further two reported at approximately six months post-injury. We were therefore unable to determine whether any factors were associated with an increased risk of reinjury.Conclusions: Potential prognostic factors on initial or early examination after acute ankle sprain did not help predict functional recovery at four months post-injury. However, pain on weight-bearing dorsi-flexion and lateral hop tests observed at four weeks were associated with a slower rate of recovery.Implications: Some clinical tests may help identify patients at risk of poor functional recovery after acute ankle sprain. However, further work is required to examine factors which may be predictive on initial assessment.Key-words: 1. Prognostic factors 2. Recovery 3. Ankle sprainFunding acknowledgements: Physiotherapy Research Foundation, Chartered Society of Physiotherapy, Strategic Priority Fund; Department of Employment and Learning, Northern Ireland.Ethics approval: Office for Research Ethics Committee (UK).

Agreed-upon procedures report for the Heart of Iowa Regional Transit Agency relating to the Boone County Transportation, Inc. for the years ended June 30, 2014 and June 30, 2015

Agreed-upon procedures report for the Heart of Iowa Regional Transit Agency relating to the Boone County Transportation, Inc. for the years ended June 30, 2014 and June 30, 2015

Diseño de gestión de proyectos bajo la guía metodológica del Project Management Institute, INC. - PMI® para la empresa MABEGO S.A.S.

En la actualidad, las buenas prácticas del Project Management Institute, Inc. (PMI®) son utilizadas en muchas organizaciones para la estructuración, ejecución y cierre de diversos proyectos; las buenas prácticas recogidas por este Instituto han servido de base para que las empresas logren conseguir los objetivos estratégicos con una correcta gestión de los programas y proyectos que se vayan a emprender -- El sector de la construcción no es ajeno a la aplicación de estos estándares, más aún cuando el común denominador son los sobrecostos, la prolongación del cronograma y la variación del alcance, que finalmente terminan afectado la rentabilidad de los proyectos y redundan en la rentabilidad de la empresa -- Mabego S.A.S., es una empresa nueva dedicada a la estructuración, ejecución y venta de proyectos inmobiliarios, cuyo centro de operación es la ciudad de Pasto-Departamento de Nariño, el objetivo principal de la empresa es penetrar el mercado inmobiliario local, teniendo como fortalezas la experiencia y conocimiento aportado por los socios -- Con el presente trabajo se analizan los cuarenta y siete (47) procesos dentro de los grupos de inicio, planeación, ejecución, monitoreo y control, además de cierre establecidos en las diez (10) áreas del conocimiento que establece el PMI® en la guía de los fundamentos para la dirección de proyectos (Guía del PMBOK® - Project Management Body of Knowledge) quinta edición; se crea una metodología de acuerdo a las necesidades de la organización; para conseguirlo se analizaron cada uno de los procesos establecidos en el PMI® y como resultado se presenta la estandarización por medio de formatos y procedimientos que ayudan a la empresa a cumplir con los objetivos específicos de cada uno de sus proyectos -- La pertinencia del trabajo radica en la necesidad de la empresa Mabego S.A.S., de formalizar los procedimientos dentro de la misma, esto debido a que se pretende lograr una correcta estructuración, ejecución y liquidación de los proyectos, además, se aplicó una metodología definida con el objetivo de estandarizar los procesos internos y así lograr un posicionamiento en el sector de la construcción por medio del reconocimiento del cliente en la entrega a tiempo y con la calidad propuesta en los documentos de venta del proyecto

Plan of a tract of land (marked in the General Plan no. 7), containing in the whole 5000 acres, & divided into 20 plantations of 250 acres each, situate on a left hand branch of Elk River, & on the head waters of Salt Lick Creek, in Harrison County, State of Virginia /

Covers part of Harrison County (W.Va.)

Planeación estratégica como herramienta administrativa para la toma de decisiones para la Fundación Seraphim Inc.

El Salvador como un país del tercer mundo experimenta necesidades básicas insatisfechas por el estado, razón por la cual a lo largo de la historia de nuestro país se han dado condiciones para el establecimiento de Organizaciones No Gubernamentales (ONG’s) sin fines de lucro que han buscado contribuir al desarrollo del país mediante la canalización de donaciones internacionales destinadas al financiamiento de proyectos en distintos sectores sociales y económicos; de esta manera existen ONG’s que se dedican específicamente al desarrollo del sector salud, siendo una de ellas la Fundación Seraphim Inc. Las ONG’s se desarrollan actualmente en un ambiente económico-social diferente al que les dio origen, razón por la cual estas instituciones se ven en la necesidad de elaborar planes que aseguren el éxito de sus operaciones. Es por ello que el presente trabajo tiene como finalidad brindar una Planeación Estratégica que les sirva como herramienta en la toma de decisiones para optimizar sus recursos y enfrentar de la mejor forma el ambiente externo en que se desarrollan a través de la prestación de servicios de salud y educación materno infantil de calidad. La investigación de campo se realizó en las instalaciones de la Fundación Seraphim en la ciudad de San Salvador a través de cuestionarios dirigidos al personal operativo y entrevistas al personal administrativo. Se abarcó a todo el personal de la institución para no dejar de fuera datos valiosos por aportar en la elaboración de la Planeación Estratégica, obteniendo información que refleja aspectos importantes tales como: carencia de conocimientos administrativos por parte de los ejecutivos encargados de la administración de los proyectos, la administración contingencial en manos del Gerente de Proyecto y la carencia de nuevos proyectos complementarios que garanticen la continuidad de los mismos. Los elementos señalados anteriormente y la información complementaria obtenida, permitieron elaborar las siguientes recomendaciones: capacitación al personal administrativo en cargos de dirección para lograr que cada empleado desempeñe las funciones asignadas, asi mismo la descentralización de la gerencia de proyectos para que dicha área se dedique a desarrollar los mismos. Todos los elementos antes mencionados permitieron la formulación del Plan Estratégico como Herramienta Administrativa en la Toma de Decisiones.