Ideal Fit Research Articles

Comparison of Cox Proportional Hazards Model and Lognormal Accelerated Failure Time Model: Application in Time to Event Analysis of Acute Liver Failure Patients in India

Background: Different survival analysis techniques such as nonparametric, semi-parametric, parametric Accelerated Failure Time (AFT) models have been generally applied to analyze time to event data. In order to identify the prognostic factors for survival of Acute Liver Failure (ALF) patients, previous studies applied Cox Proportional hazards (CPH) model, Lognormal AFT and Log-Logistic AFT model satisfying respective model’s assumptions and goodness of fit of each model. However, comparison of CPH model and AFT model has not been reported so far for ALF data with short follow up time.
 Objective: To compare CPH model and Lognormal AFT model based on different parameters for assessing the model performance and prospective validation of the finally selected model.
 Materials and Methods: Altogether 1099 ALF patients’ data from liver clinic of All India Institute of Medical Sciences, New Delhi India were analyzed based on the retrospective cohort study design. For validating the final model, a separate data set of 138 ALF patients from the same clinic was used. CPH model and Lognormal model’s performance was assessed through selection of variables in the final model, R2 type statistic, goodness of fit of the model, visual assessment of Cox-Snell’s residuals plot and robustness of the model. The prospective validation of the over scored CPH model was done by comparing overall survival, regression coefficients, observed and predicted survival curves between original and validation data set.
 Results: It is found that 60% of variation in the partial log-likelihood is explained by the CPH model whereas 39% of variation in full log-likelihood is explained by Lognormal AFT model. Cox-Snell residuals plot for CPH model seems less deviated from the line of ideal fit, replications of variables measured through bootstrapping resampling technique in CPH model are on the higher side, model predicted and observed survival curves in each risk stratum were closer than that of Lognormal model. The survival experience of original data and validation data set for CPH model does not seem to be very different (p = 0.07) at 5% level of significance.
 Conclusion: Both CPH and Lognormal AFT model are found well fitted and can be applied either of them for this ALF data. While comparing the model performance, the CPH model for the identification of prognostic factors for the survival of ALF patients is found comparatively better.

Simple and Rapid Creation of Customized 3D Printed Bolus Utilizing iPhone X True Depth Camera

Three-dimensional (3D) printing has effectively produced patient-specific bolus materials during radiation treatment for superficial tumors along irregular skin surfaces. Traditional bolus materials in comparison, are often difficult to manipulate for proper fit, and can be difficult to reproduce. Current 3D printed boluses are made from either pre-existing computed tomography (CT) scans or complex surface scanning methods. Here, we introduce an inexpensive, convenient approach to generating 3D printed bolus from surface scanning technology available in common smartphones. 3D printed bolus was designed using surface scans from iphone X true depth cameras and a low cost 3D printer. The percentage density infill was adjusted to achieve tissue equivalence. To evaluate the clinical feasibility, fit against skin surface and radiation dose distribution was compared to traditional bolus. We fabricated customized 3D printed bolus for different areas of the face utilizing an iphone X camera and an inexpensive commercially available 3D printer. When printed at 100% density this bolus material approximated soft tissue/water and provided an equivalent dose distribution to that found with standard bolus materials on direct comparison. The bolus material was inexpensive and produces an ideal fit with the scanned anatomy. We present a simplified method of highly customized bolus production that requires minimal experience with computer modeling programs and can be accomplished with an iphone true depth camera.

Heat Transfer and Fluid Flow Analysis on Microchannel Heat Sink with Varying Plenum Size

Computational fluid analysis study has been carried out to find a better prospect of perfect design, shape and plenum size microchannel heat sink (MCHS). Distinctive structure parameters were chosen to plan microchannel heat sink with shifting channel planum sizes of 10 mm, 20 mm and 30 mm. The material taken of circle type heat sink is taken as copper. The liquid taken is plane fluid. Amid liquid stream distinctive speed stream states of significant worth 0.25 lpm, 0.50 lpm and 0.75 lpm were chosen. In computational liquid examination changing weight, temperature and speed conditions impacts were additionally contemplated. Huge weight drop is recorded in the speed rating of 0.25 lpm. Speed readings were recorded high en 30 mm plenum estimate with 0.75 lpm speed stream. Investigation gives thought of an ideal structure fit as a fiddle with stream of liquid at 0.75 speed stream. The stream space were understood utilizing ANSYS programming as economically accessible for CFD examination. A special plan is set up from the examination which can exchange extensive measure of warmth in the state of microchannel heat sinks with microchannel length of 48 mm long and with other chose structure paramters. To accomplish more warmth expulsion from the MCHS the microchannel estimate upgrade is done diagnostically. For ordinary convective warmth trade coefficient, outlet temperature, grinding and weight drop, siphoning power and warm impediment have been plotted against Nusselt number qualities for various stream conditions. By settling the correct control of the liquid stream and warmth exchange propensity of a 3- dimensional MCHS has been accomplished computationally

Inclusive fitness as a criterion for improvement

I distinguish two roles for a fitness concept in the context of explaining cumulative adaptive evolution: fitness as a predictor of gene frequency change, and fitness as a criterion for phenotypic improvement. Critics of inclusive fitness argue, correctly, that it is not an ideal fitness concept for the purpose of predicting gene-frequency change, since it relies on assumptions about the causal structure of social interaction that are unlikely to be exactly true in real populations, and that hold as approximations only given a specific type of weak selection. However, Hamilton took this type of weak selection, on independent grounds, to be responsible for cumulative assembly of complex adaptations. In this special context, I argue that inclusive fitness is distinctively valuable as a criterion for improvement and a standard for optimality. Yet to call inclusive fitness a criterion for improvement and a standard for optimality is not to make any claim about the frequency with which inclusive fitness optimization actually occurs in nature. This is an empirical question that cannot be settled by theory alone. I close with some reflections on the place of inclusive fitness in the long running clash between ‘causalist’ and ‘statisticalist’ conceptions of fitness.

Effect of Base Curve on Silicone Hydrogel Contact lens Fitting Characteristics and Comfort

Purpose : To compare the fitting assessment and subjective comfort according to the base curves of silicone hydrogel lens. Methods : Thirty adults (60 eyes, mean age: 21.9 years) who had no ocular disease and no problem in wearing contact lenses were included. Contact lens fittings were performed with empirical and trial fitting methods. ln empirical fitting. base curve of contact lenses were selected based on K–reading (fitting contact lens with 8.5 mm base curve in the case of steeper than 7.8 mm. 9.0 mm base curve in the case of flatter than 7.8 mm), and in trial fitting, two base curves were fitted by a double blind method. The fitting characteristics were assessed with centration, movement, lag, push-up test and keratometer mire. The subjective comfort was evaluated through questionnaires with Likert 5-point scale. Results : It was shown that 91.67% of the subjects was acceptable to base curve determined by empirical fitting. However, 33.33% of steep curve group showed ideal fitting with 9.0 mm base curve and 25% of flat curve group showed ideal fitting with 8.5 mm base curve, and empirical and trial fitting showed 71.67%, 100% in success rate, respectively. It was appeared that 63.33% of subjects felt no difference in the comfort sensation of contact lenses with different base curves, but the comfort sensation with the 8.5 mm base curve (3.53 points) was significantly higher than 9.0 mm base curve (2.75 points), (t=4.528, p<0.001) and 27.78% of a flat cornea group felt comfortable with steeper fitting. Conclusion : In order to determine the base curve of silicone hydrogel contact lenses, it is suggested that evaluating the fitting condition is more important than subjective fitting condition of the wearer or empirical determination.

Shoulder Rehabilitation Protocol and Equipment Fit Recommendations for the Wheelchair Sport Athlete With Shoulder Pain.

Shoulder injuries in wheelchair sport athletes is the most commonly reported injury site and can directly impact not only sport performance, but everyday function and mobility. There is abundant research on shoulder rehabilitation for able bodied athletes, but minimal specifically related to wheelchair sport athletes. The purpose of this paper is to outline an exercise protocol and wheelchair sport equipment fit guidelines based off current research and expert opinion. Further research is needed on the effectiveness of a wheelchair athlete specific shoulder rehabilitation protocol, and biomechanical analysis of ideal wheelchair sport equipment fit to reduce shoulder injury and optimize performance.

Introduction: Alexis Wright's Significant, Growing Oeuvre

Introduction:Alexis Wright's Significant, Growing Oeuvre Belinda Wheeler (bio) This issue of Antipodes includes essays about several works written by the leading Waanyi author Alexis Wright (1950–). Wright's growing canon is continuing to make a major impression on both Australian literature and the global canon. Wright's novels have won numerous awards, including Australia's highest literary award, the prestigious Miles Franklin Literary Award. She won the award in 2006 for her breakthrough novel Carpentaria, and in 2013 her novel The Swan Book was shortlisted for the award. In 2018, her latest contribution, Tracker, a five-hundredplus-page tribute to the Indigenous Australian activist Leigh Bruce, won the Stella Prize, an award specifically for female authors that is also in honor of Stella Maria Sarah "Miles" Franklin. In addition to the accolades Wright has received for her work, her books are often published by international publishing houses (Carpentaria with Atria Press, an imprint of Simon and Schuster, for example) or Australian publishers with international distribution. Wright has also published in other literary genres including short stories and essays. Several of Wright's works have also been written primarily for a French audience, as was the case with Croire en l'incroyable and Le pacte du serpent arc-en ciel, the subject of several essays included here. Originally when I had proposed my follow-up to A Companion to Australian Aboriginal Literature (2013) to my publisher, Camden House (an imprint of Boydell and Brewer), it was as a joint companion to the works of Alexis Wright and Kim Scott. These two Indigenous Australian authors were selected because of their exceptional growing oeuvre that is making a decisive impact locally, nationally, and globally. My publisher saw much promise in the collection and asked me to consider two companions: A Companion to the Works of Kim Scott and A Companion to the Works of Alexis Wright. Work on the Scott companion was seamless, and it was released in 2016. Things were moving forward with the Wright collection, but various personal and professional situations would have delayed production of the companion on Wright's work even further. Thankfully, several of the essays that were to originally appear in the Wright companion have now found a wonderful home at Antipodes.1 The four essays published in this issue are an ideal fit for Antipodes as they are written from the lens of diverse authors from different countries with either a direct or an indirect connection to Australia. Each essay also discusses one or more of Wright's most canonical works. [End Page 62] The essay by Geoff Rodoreda focuses on Alexis Wright's Grog War (1997), a critically important text in Wright's canon as it is her first nonfiction book and it details a debilitating problem—alcohol abuse—that was gripping her home country in Northern Australia.2 Like landmark anthropologist-writers such as Zora Neale Hurston, according to Rodoreda, Wright draws on "historical research, government documentation, newspaper reportage, and interviews with community members" to tell the community's story from their perspective. Rodoreda's essay eloquently argues that while Grog War is "about one community organization's resourcefulness and perseverance to overcome racism and white indifference in one remote town, it can also be read as an allegory for Indigenous campaigning across Australia in an ongoing struggle for community improvements at a local level." As Wright scholars know, Northern Australia plays a prominent role throughout much of her work. Thus, if one wishes to truly begin to understand Wright's important growing oeuvre, reading Grog War and important essays like Rodoreda's is a must. Not long after Wright completed Grog War, she embarked on a successful collaboration with Actes Sud, a French publisher. In 2000, Wright wrote a commissioned essay, Croire en l'incroyable (Believe in the unbelievable), for Actes Sud, which was translated by Sabine Porte. As of 2019, the essay has not been published in English, despite requests for to the author to allow it to be translated and republished in English. Estelle Castro-Koshy and Philippe Guerre explore Wright's essay in conversation along with her collection of short stories translated into French, Le pacte du serpent...

Psychometric properties of the Desensitization to Violence Scale for Adolescents

Introduction: Desensitization to violence is the result of exposure to violence. It reduces the negative emotions in cognitive and physiological responses to violence and can even generate a positive response to it.Method: A mixed sequential method yielding a transactional analytic design for Exploratory Factor Analysis and Confirmatory Factor Analysis with a sample of 1720 participants of 25 different high schools and a juvenile detention center. Followed by convergent validity (as a criterion validity) with a different sample.Results: The EFA’s cumulative explained variance was 52% with a GFI of .98 with a three-factor model: sensitivity to violence, amusement with physical violence, and enjoyment of psychological violence. The CFA showed scores above .50 in Average Explained Variance in every factor, and an ideal model fit in every measure (CFI, AGFI, RMSEA, SRMR, and ECVI). The remaining factors are only those related with enjoying or amusement with violent behavior, indicating that the desensitization to violence is related not only with the normalization and legitimation of violence, but the increasing of the performance and amusement of it.Discussion or Conclusion: The scale of desensitization to violence for adolescents has adequate psychometric properties and can be a valuable instrument to generate intervention or prevention programs, especially for its intimate relationship with high scores in people interned because of their criminal behavior.

Local Control After Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer

Numerous dose and fractionation schedules have been used to treat medically inoperable stage I non-small cell lung cancer (NSCLC) with stereotactic body radiation therapy (SBRT) or stereotactic ablative radiation therapy. We evaluated published experiences with SBRT to determine local control (LC) rates as a function of SBRT dose. One hundred sixty published articles reporting LC rates after SBRT for stage I NSCLC were identified. Quality of the series was assessed by evaluating the number of patients in the study, homogeneity of the dose regimen, length of follow-up time, and reporting of LC. Clinical data including 1, 2, 3, and 5-year tumor control probabilities for stages T1, T2, and combined T1 and T2 as a function of the biological effective dose were fitted to the linear quadratic, universal survival curve, and regrowth models. Forty-six studies met inclusion criteria. As measured by the goodness of fit χ2/ndf, with ndf as the number of degrees of freedom, none of the models were ideal fits for the data. Of the 3 models, the regrowth model provides the best fit to the clinical data. For the regrowth model, the fitting yielded an α-to-β ratio of approximately 25Gy for T1 tumors, 19Gy for T2 tumors, and 21Gy for T1 and T2 combined. To achieve the maximal LC rate, the predicted physical dose schemes when prescribed at the periphery of the planning target volume are 43±1Gy in 3 fractions, 47±1Gy in 4 fractions, and 50±1Gy in 5 fractions for combined T1 and T2 tumors. Early-stage NSCLC is radioresponsive when treated with SBRT or stereotactic ablative radiation therapy. A steep dose-response relationship exists with high rates of durable LC when physical doses of 43-50Gy are delivered in 3 to 5 fractions.

Simple and Rapid Creation of Customized 3-dimensional Printed Bolus Using iPhone X True Depth Camera

PurposeThree-dimensional printing has produced customized bolus during radiation therapy for superficial tumors along irregular skin surfaces. In comparison, traditional bolus materials are often difficult to manipulate for a proper fit. Current 3-dimensional printed boluses are made from either preexisting computed tomography scans or complex surface scanning methods. Herein, we introduce an inexpensive, convenient approach to generate a 3-dimensional printed bolus from surface scanning technology available in common smartphones. Methods and materialsA three-dimensional printed bolus was designed using surface scans from iPhone X true depth cameras and a low-cost 3-dimensional printer. The percentage density infill was adjusted to achieve tissue equivalence. To evaluate the clinical feasibility, fit against the skin surface and radiation dose distribution were compared with those of the traditional bolus. ResultsWe fabricated a customized 3-dimensional printed bolus for different areas of the face using an iPhone X camera and inexpensive commercially available 3-dimensional printer. When printed at 100% density, the bolus material approximated soft tissue/water and provided an equivalent dose distribution to that found with standard bolus materials on direct comparison. The bolus material is inexpensive and produces an ideal fit with the scanned anatomy. ConclusionsWe present a simplified method of highly customized bolus production that requires minimal experience with computer modeling programs and can be accomplished with an iPhone true depth camera.

Finding joy in your career

When was the last time you were truly excited about your work? If it’s been a while, maybe it’s time to start asking why, and what you can do about it. Maybe your personal interests or expertise have changed, maybe your organization has changed, or maybe it was never an ideal fit. In any case, if you are unhappy more often than not, now is the time to do something about it. Even if you love your current position, it’s not a bad idea to reassess your situation at least annually, just to make sure you’re on the right track. Uncover what excites you. What is it that you love? What do you look forward to, talk about for hours, and think about in your time off? Is it the details of your research—how 2-D nuclear magnetic resonance works, how you could improve it, and the subtle nuances you can

Peptidomimetics Targeting Protein-Protein Interactions for Therapeutic Development.

Interactions between proteins play a key role in nearly all cellular process, and therefore, its dysregulation may lead to many different types of cellular dysfunctions. Hence, pathologic Protein-Protein Interactions (PPIs) constitute highly attractive drug targets and hold great potential for developing novel therapeutic agents for the treatment of incurable human diseases. Unfortunately, the identification of PPI inhibitors is an extremely challenging task, since traditionally used small molecules ligands are mostly unable to cover and anchor on the extensive and flat surfaces that define those binary protein complexes. In contrast, large biomolecules such as proteins or peptides are ideal fits for this so-called "undruggable" sites. However, their poor pharmacokinetic properties have also limited their applications as therapeutics. In this context, peptidomimetic molecules have emerged as an alternative and viable solution to this problem, since they conserve the architectural and structural features of peptides and also exhibit substantially improved pharmacokinetic profiles. In the last decades, a wide array of chemical approaches granting access to conformationally constrained peptides with substantially improved pharmacokinetic profiles have been described, with a special focus on those affording stapled peptides and allowing large-scale macrocyclizations. These peptidomimetic molecules have been successfully applied to target a plethora of biological hosts, which highlights their promising future as novel therapeutics for the treatment of incurable human diseases.

Survey of various Techniques to Reduce Leakage Power in FPGA

FPGA is known as Field Programmable Gate Array that can be programmed in the field after manufacture. It can be reprogrammed to desired application or functionality requirements after manufacturing. The major difference between FPGA and Application Specific Integrated Circuits (ASICs), which are custom manufactured for specific design tasks. Due to their programmable nature, FPGAs are an ideal fit for many different markets. As the industry leader, Xilinx provides comprehensive solutions consisting of FPGA devices, advanced software, and configurable, ready-to-use IP cores for markets and applications. However, the power consumption of FPGAs remains prohibitive for some applications. Power dissipation and Leakage power is the major issue of FPGAs. Thus, low-leakage FPGAs are essential if they are to be used for hand-held applications. Some more techniques are discussed here to reduce power dissipation. Power gating and Clock gating techniques are more efficient for leakage power reduction

The Act Of Balance: Weight Management

The word balance is a complicated term in the human life. It is often heard relating to everyday tasks, but often forgotten is the most important balance that of which is found within the human body. One pivotal marker of an individual having balance is having full control of body weight. It is a significant challenge to maintain an ideal fitness and weight. The human body has a complex set of hormones and signaling systems that monitor and adjust to retain balance. The systems, if properly maintained, work in harmony. However, if there is a slight issue, the systems can turn on the human body and cause damage. Insulin is able to work in the body as a positive and a negative asset. If properly managed, insulin can assist in weight loss by metabolizing glucose and reducing the need for fat synthesis, however if improperly managed, poor diet can lead to rising levels of insulin and eventually result in weight gain and type II diabetes. To sustain the body’s energy, two important hormones work in opposition of each other - leptin and adiponectin. Leptin suppresses appetite and increases metabolic rate while adiponectin increases appetite and decreases metabolic rate. These hormones exert their actions via other hormones and neuropeptides. Others include ghrelin, neuropeptide Y (NPY) and agouti-related peptide (AgRP) which work together to increase energy intake and promote weight gain. With weight loss, hormones such as ghrelin will increase to guard against continued weight loss. There are several other hormones involved in body weight control that are activated with exercise including testosterone, cortisol, and growth hormone. The duration and intensity of the exercise affects them differently. For example, after an intensive exercise, the body upkeeps the balance by repairing and building muscles via these hormones. While there are large strides being made in research on the correct way to balance weight in the human body, there is still research to be done to help combat worldwide obesity and obesity related diseases. There are questions left to be answered, however basic understanding of all the systems and its hormones can progress everyone on the correct path for balance.

A Comparison of O’Sullivan Penalized Spline and Penalized Spline Based Truncated Power Basis Methods to Predict Ozone Concentrations

This paper aims to predict ozone concentrations based on the effects of ultraviolet light. Spline regression is piecewise polynomials that connect join points called knots. In spline regression, parameter estimation was fit by OLS (Ordinary Least Square) method. However, the OLS method leads to over parameterized and in the plot of estimated regression curve is fluctuated when using too much knots. Therefore, it needs an additional constraint which contains smoothing parameter, so that results an ideal fit. This parameter estimation method is known as PLS (Penalized Least Square) method. Spline regression using PLS method is called as penalized spline regression. O’Sullivan (1986) introduced a class of penalised splines based on B-spline basis functions. OPS (O’sullivan Penalized Spline) is a direct generalisation of smoothing splines that latter arises when the maximal number of B-spline basis functions included. One of the top performance measures the predicted regression curve that can be used is MSE (Mean Square Error). Results showed that the OPS method had a smaller MSE and GCV than the PSTPB (Penalized Spline Based Truncated Power Basis) method, so the use of the OPS method for predicting ozone against ultraviolet light was suitable to use.

Influence of vertical misfit in screw fatigue behavior in dental implants: A three-dimensional finite element approach.

Misfit is unavoidable in dental implant-supported prostheses due to machining process or inappropriate assembling, and the definition of an admissible misfit is still a controversial issue. This work aims to understand the behavior of the screws in dental implant-supported prostheses to estimate an admissible vertical misfit value in terms of screw fatigue failure. For that purpose, a finite element model of a dental implant-supported prosthesis was created and analyzed. Vertical misfits were introduced in different positions, the lower and upper screws were tightened to the bolting force values recommended by the manufacturer, and two different occlusal loads were analyzed. In addition, two different prosthesis materials were studied. Screw load variations were reported and a fatigue analysis was performed. As a result, it was observed that the screw tightening sequence closed small vertical misfits (equal to or less than 40 µm), whereas larger misfits (more than 40 µm) remained open. If the vertical misfit is closed by the end of the tightening sequence, it may be considered equivalent to the ideal fit situation in regard to screw fatigue failure. The prosthesis material had no significant influence on the fatigue behavior.

How can tourism policy influence the path to sustainable tourism development in Guyana by 2025?

PurposeThis paper aims to outline the key realities which need to be under consideration as Guyana crafts a vision for sustainable tourism development – 2025. These key realities are borne out of the current vision statement, strategic objectives and actions in the National Draft Tourism Policy 2016-2020.Design/methodology/approachThe paper is exploratory in nature and uses document analysis as primary means of data collection.FindingsThe achievement of sustainable tourism development is an ideal fit with the tabling of strategic policy documents that seek to guide its implementation. However, these objectives and actions need to be structured and measurable to ensure that monitoring and evaluation can occur.Originality/valueIt is anticipated that this research will serve as a valuable reference tool for researchers, policymakers and other relevant bodies with an interest in strategic action for the achievement of sustainable tourism development.

Optical Properties and Spatial Variation of Tropical Cyclone Cloud Systems From TRMM and MODIS in the East Asia Region: 2010–2014

AbstractThe tropical cyclone (TC) in East Asia varies strongly each year, indicating the different spectral characteristics of the TC cloud systems (TCCSs) with the distance from the center of TC. We report a new perspective of optical properties of TCCS by using the Moderate Resolution Imaging Spectroradiometer and Tropical Rainfall Measuring Mission data over the years from 2010 to 2014 for the 35 TCs in East Asia. We investigate the spatial distribution of the cloud‐top height, radar reflectivity, polarization corrected temperature in 85.5 GHz (PCT85.5), hydrometeor vertical profile, cloud water path, cloud optical thickness, and cloud particle effective radius of TCCS in the development, maturity, and decay stages of TC. The results indicate the significant differences of cloud characteristics in the maturity stage in comparison to other two stages, showing the higher radar reflectivity up to 30 dBZ and the PCT85.5 as low as 232.98 K in the TC eye wall. Meanwhile, the mean hydrometeor profile indicates more ice particles accumulating above the height of 10 km but less liquid droplets near 3 km. The peak of cloud water path and cloud optical thickness in the maturity stage can reach to 1,300 g/m2 and 75, respectively. The mean cloud particle effective radius and precipitation in the three stages could be influenced by aerosols. Based on these quantified results, several ideal fitting equations and the models are constructed to denote the properties of TCCS. Two cases are analyzed to examine the accuracy of the quantified mean state for different stages of TCCS and the relationship between aerosols and clouds.

Adventures in prosthetics – A contact lens approach to improving cosmetic appearance

Two patients with corneal graft failures with subsequent vision loss and ocular hypertension presented to the clinic concerned with the cosmetic appearance of their non-seeing eye. Both were fit into a prosthetic contact lens modality to address this concern while maintaining proper ocular health. Each patient was evaluated with slit lamp biomicroscopy, corneal topography, and high-resolution photography. Due to the steepening of the corneas of each patient secondary to increased intraocular pressure, scleral cover shells were presented as a best option to each patient. One patient was unable to complete the sceleral cover shell fitting due to discomfort with the procedure itself, and opted to be fit into a hydrogel soft contact lens. Although the lens was decentered and not an ideal fit, the patient expressed desire to wear for only short periods of time until she is comfortable to attempt refit with a scleral shell. The hydrogel lens was tinted in-office with a brown iris and a center black-out pupil, and the tint was decentered opposite of lens decentration on a toric modality for stability. The second patient opted for the scleral shell, but the central steepening of the cornea did not allow for a stable and healthy fit. A scleral contact lens design of 18.2 mm was fit appropriately and then ordered in PMMA material to allow for pigment uptake during the prosthetic artistry process. One patient was fit with an in-office tinted hydrogel soft contact lens, and the other in a PMMA hand-painted scleral contact lens; both patients are maintaining comfortable and healthy wear of the device. Both patients initially expressed concerns of cosmesis of their blind eye, attributing their psychological distress to anxiety with their appearance in public. Each patient showed significant improvement in cosmesis as well as confidence following dispense of a personalized prosthetic contact lens.

Engineering optimization based on dynamic technique for order preference by similarity to ideal solution fitness: Application to unmanned aerial vehicle wing airfoil geometry definition

AbstractModern engineering requires finding an optimal trade‐off point among conflicting requirements that must be satisfied to reach the end user's satisfaction. One of the most challenging problems in multidisciplinary optimization is to find a fitness function that can best translate what the designer really aims to obtain. In this paper, a particle swarm optimization (PSO) algorithm is coupled to a fitness function based on the definition of a technique for order preference by similarity to ideal solution (TOPSIS) in order to obtain a new algorithm called PSOTOP. The fitness of a candidate solution is found by comparing its attributes to those of an “ideal best” and “ideal worst” solution, which is dynamically updated at each iteration of the algorithm. The advantage of this solution is that the fitness allows combining attributes of different magnitude and measurement units in an effective way; this approach can be applied to whatsoever optimization problem in engineering, economics, medicine, and statistics. This paper presents a case study dealing with the optimal design of an airfoil to be adopted on the wing of an unmanned air vehicle to support civil protection operations in order to show how this strategy can impact the design of a complex product. The main limitation of this approach relates to the fact that the user must possess a good knowledge of the specific problem to be solved in order to set proper ranges for design parameters and attributes' weight in the fitness evaluation.