Development of appropriateness explicit criteria for cataract extraction by phacoemulsification

Background: Consensus development techniques were used in the late 1980s to create explicit criteria for the appropriateness of cataract extraction. We developed a new appropriateness of indications tool for cataract following the RAND method. We tested the validity of our panel results. Methods: Criteria were developed using a modified Delphi panel judgment process. A panel of 12 ophthalmologists was assembled. Ratings were analyzed regarding the level of agreement among panelists. We studied the influence of all variables on the final panel score using linear and logistic regression models. The explicit criteria developed were summarized by classification and regression tree analysis. Results: Of the 765 indications evaluated by the main panel in the second round, 32.9% were found appropriate, 30.1% uncertain, and 37% inappropriate. Agreement was found in 53% of the indications and disagreement in 0.9%. Seven variables were considered to create the indications and divided into three groups: simple cataract, with diabetic retinopathy, or with other ocular pathologies. The preoperative visual acuity in the cataractous eye and visual function were the variables that best explained the panel scoring. The panel results were synthesized and presented in three decision trees. Misclassification error in the decision trees, as compared with the panel original criteria, was 5.3%. Conclusion: The parameters tested showed acceptable validity for an evaluation tool. These results support the use of this indication algorithm as a screening tool for assessing the appropriateness of cataract extraction in field studies and for the development of practice guidelines.

Variable structure control for maximum wind power extraction

EuroPES 2009

Lignin extraction, purification and depolymerization study

280 p. : il.

Factors Resulting In Micron Indentation Hardness Descending In Indentation Tests

Some factors that affect the experimental results in nanoindentation tests such as the contact depth, contact area, load and loading duration are analyzed in this article. Combining with the results of finite element numerical simulation, we find that the creep property of the tested material is one of the important factors causing the micron indentation hardness descending with the increase of indentation depth. The analysis of experimental results with different indentation depths demonstrates that the hardness decrease can be bated if the continuous stiffness measurement technique is not adopted; this indicates that the test method itself may also be one of the factors causing the hardness being descended.