Minimum Time Span Research Articles

The Definition of Recurrence of Differentiated Thyroid Cancer: A Systematic Review of the Literature.

Background: Recurrence is a key outcome to evaluate the treatment effect of differentiated thyroid carcinoma (DTC). However, no consistent definition of recurrence is available in current literature or international guidelines. Therefore, the primary aim of this systematic review was to delineate the definitions of recurrence of DTC, categorized by total thyroidectomy with radioactive iodine ablation (RAI), total thyroidectomy without RAI and lobectomy, to assess if there is a generally accepted definition among these categories. Methods: This study adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. In December 2023, a systematic literature search in MEDLINE and EMBASE was performed for studies reporting on the recurrence of DTC, from January 2018 to December 2023. Studies that did not provide a definition were excluded. Primary outcome was the definition of recurrence of DTC. Secondary outcome was whether studies differentiated between recurrence and persistent disease. Two independent investigators screened the titles and abstracts, followed by full-text assessment and data extraction. The study protocol was registered in PROSPERO, CRD42021291753. Results: In total, 1450 studies were identified. Seventy studies met the inclusion criteria, including 69 retrospective studies and 1 randomised controlled trial (RCT). Median number of patients in the included studies was 438 (range 25-2297). In total, 17 studies (24.3%) reported on lobectomy, 4 studies (5.7%) on total thyroidectomy without RAI, and 49 studies (70.0%) with RAI. All studies defined recurrence using one or a combination of four diagnostic modalities cytology/pathology, imaging studies, thyroglobulin (-antibodies), and a predetermined minimum tumor-free time span. The most common definition of recurrence following lobectomy was cytology/pathology-proven recurrence (47.1% of this subgroup), following total thyroidectomy with RAI was cytology/pathology-proven recurrence and/or anomalies detected on imaging studies (22.4% of this subgroup). No consistent definition was found following total thyroidectomy without RAI. Nine studies (12.9%) differentiated between recurrence and persistent disease. Conclusion: Our main finding is that there is no universally accepted definition for recurrence of DTC in the current studies across any of the treatment categories. The findings of this study will provide the basis for a future, international Delphi-based proposal to establish a universally accepted definition of recurrence of DTC. A uniform definition could facilitate global discussion and enhance the assessment of treatment outcomes regarding recurrence of DTC.

Daymet and DeGAUSS: Development of a Novel Method that Links High Spatial Resolution Gridded Meteorological Data with Geocoded Healthcare Encounters

ObjectiveDue to human-caused climate change, extreme temperature-related morbidity/mortality are increasing global public health concerns. To better understand the burdens of heat exposure, researchers must merge accurate/granular environmental data with clinical data. We developed a privacy-preserving method that links high-spatial-resolution continuous, gridded, meteorological data to geocoded healthcare encounters. ApproachIn an R environment, we developed code that links geocoded healthcare encounters to publicly-available Daymet data via the corresponding Daymet raster cell number and healthcare encounter date. Daymet provides daily 1km x 1km surface meteorological data over North America since 1980. User specifications include the bounding box latitude/longitude of Daymet data download, which Daymet environmental variables are linked, and the day-lag of Daymet data matching to healthcare encounter date. ResultsLinking 500,000 healthcare encounters over a 7-day lag with 7 years of Daymet data comprising minimum/maximum temperature over a bounding box encompassing Cook County, Illinois (5,670 1km raster cells) took 11.92 minutes with 4 CPUs and 8GB RAM. Thirteen years of Daymet data took 23.85 minutes. Linking 7.5 million encounters with 7 years of data took 28.49 minutes. ConclusionsOur newly-developed method for linking Daymet data to geocoded healthcare encounters preserves patient privacy, and processes the data efficiently over a minimal timespan. ImplicationsDaymet data linked to healthcare encounters allows for accurate assessment of the association between environmental variable exposure and any clinical outcome over North America. Packaging the code allows for public distribution within the Decentralized Geomarker Assessment for Multi-Site Studies (DeGAUSS) universe of geoanalytic tools.

Chronological Changes in Sagittal Femoral Bowing after Primary Cementless Total Hip Arthroplasty: A Comparative 3D CT Study.

Little is known about dynamic changes of femoral anatomy after total hip arthroplasty (THA), in particular about sagittal femoral bowing (SFB). A 3D CT study was designed to evaluate the chronological changes of SFB after cementless femoral stem implantation for primary THA. Ten patients who underwent unilateral primary THA with a cementless femoral stem, with 2 consecutive CT scans (extending from the fourth lumbar vertebra to the tibial plateaus), performed before THA and at least 3 years after THA, were enrolled. The 3D models of femurs were created using image segmentation software. Using the two CT scans, SFB values of the proximal and middle thirds were calculated on the replaced and untreated sides by two different observers. Eight anatomical stems and two conical stems were involved. The post-operative CT was performed at an average follow-up of 6.5 years after THA (range: 3-12.5). The measurements performed by the two observers did not differ in the proximal and middle regions. A significant difference between the pre-operative and post-operative SFB compared to the untreated side was found in the proximal femur segment (p = 0.004). Use of a cementless stem in THA induced chronological changes in SFB of the proximal femur, after a minimum timespan of 3 years.

Novel experimental data-driven bubble breakage model for universal application in Euler-Lagrange multiphase frameworks

An experimental data driven model for the prediction of bubble breakage in gas–liquid multiphase reactors was developed which fulfills requirements of the Euler-Lagrangian (EL) framework for the analysis of individual bubbles. The critical Weber number (Wecrit) serves as the breakage criterion in combination with the minimum time between two consecutive breakage events. Wecrit indicates when the hydrodynamic forces acting on an individual bubble surmount its surface tension. Once the threshold is passed a binary bubble breakup event occurs, which results in the formation of daughter bubbles assigned to an M−shaped daughter size distribution (DSD). Optimum Wecrit values were obtained by minimizing the difference between simulated and measured Sauter mean diameters d32. The latter were derived from bubble size distributions (BSDs) measurements that cover about 11 – 89 W m−3 power inputs. Using deionized water and a minimum timespan of 30 ms between two consecutive breakages Wecrit = 6.1 was determined. To extend the scope of the model, characteristic media compositions for so-called syngas fermentations with Clostridium ljungdahlii were investigated. To match surface tension and viscosity with those of fresh medium (FM) and late phase medium (LPM), two aqueous solutions containing sodium dodecyl sulfate (SDS) and glycerol were prepared. Notably, the breakage model managed to well predict the impact of altered fluid properties of FM and LPM without requiring further calibration. The sum of Sauter diameter deviation between simulations and experiments was only 0.21 and 0.40 mm for FM and LPM, respectively.

Non-fragile output-feedback control for time-delay neural networks with persistent dwell time switching: A system mode and time scheduler dual-dependent design

This paper is concerned with non-fragile output-feedback control for time-delay neural networks with persistent dwell time (PDT) switching in a continuous-time setting. The main purpose is to design an output-feedback controller subject to gain fluctuations, guaranteeing both asymptotic stability and L2-gain of the closed-loop control system. To achieve reduced conservatism, the controller is formulated to depend not only on the system mode but also on a time scheduler constructed based on the PDT switching rule and minimum time span. A criterion for the asymptotic stability and L2-gain analysis is established through the application of the Gronwall–Bellman inequality and mathematical induction. Then, a numerically tractable design approach for the desired controller is proposed, utilizing a four-section piecewise time-dependent Lyapunov–Krasovskii functional and several nonlinearity decoupling techniques. For comparative purposes, a simple case, independent of the time scheduler, is also investigated, and the corresponding controller design approach is presented. Finally, a simulation example is given to illustrate the effectiveness and superiority of the proposed system mode and time scheduler dual-dependent controller design approach.

Joint Energy Loss and Time Span Minimization for Energy-Redistribution-Assisted Charging of WRSNs With a Mobile Charger

The use of mobile chargers (MCs) to charge the nodes in wireless rechargeable sensor networks via wireless power transfer (WPT) has attracted much research effort. Existing works mostly concentrate on path planning whereas neglecting the opportunities to improve charging coverage and efficiency by exploiting the energy redistribution (ERD) process among nodes and an MC’s capability of charging multiple nodes simultaneously via WPT. To exploit such opportunities, we study the underlying ERD-assisted MC charge scheduling (ERAMCCS) problem, i.e., to find a charging schedule satisfying the nodes’ energy demands with minimum energy loss and minimum time span. After proving that the problem is NP-hard, we propose a charge scheduling algorithm based on the greedy idea (CSBGI), which provides a solution by decoupling the problem into two subproblems: 1) ERAMCCS-Energy and 2) ERAMCCS-Time, to minimize the energy loss and the time span, respectively. By partitioning the energy loss into transmission energy loss and moving energy loss, we solve the ERAMCCS-Energy problem by minimizing the two parts, respectively, by formulating and solving some linear programming problems and traveling salesman problem problems based on the charging position set. The charging position set is iteratively refined by identifying and removing redundant charging positions. For the ERAMCCS-Time problem, concurrent energy transmission opportunities are exploited to try to minimize the time span of the schedule. We demonstrate some key properties of CSBGI, such as its approximation ratio in terms of energy loss and its time complexity. Testbed experiments and numerical simulations confirm the superiority of CSBGI over typical algorithms.

Enhanced Mseec Routing Protocol Involving Tabu Search with Static and Mobile Nodes in Wsns

Background: Background of this paper has taken place in mainly heterogeneous network in which three types of nodes are present like normal node, advance node and super node with different amount of energy. The energy of super node is greater than that of advance and normal nodes and the energy of advance nodes are also greater than that of normal nodes in the designed network. The optimization techniques have to be studied from the swarm intelligence based on the different aspects of routing. Objective: The objective of this paper is to propose a new heterogeneous protocol with the help of hybrid meta-heuristic technique. In this technique, the shortest route has been selected and forwarded the data to the sink in a minimal time span to save the energy and make the network more stable. Methods: To evaluate the technique, a new hybrid technique has been created, where the data transmission is implemented from the beginning. This technique contains the route process of the algorithm which was made available through a hybrid meta-heuristic technique. Results: Simulation results show that the hybrid meta-heuristic technique has high throughput with less number of dead nodes with existing methods and also show that the efficiency and stability of new proposed protocol. Conclusion: The conclusion to this paper is a novel, energy-efficient technique applied for randomly deployed sensor nodes over the wireless sensor network and enhancement has been done in stability and throughput of a new proposed algorithm in case of static as well as moving nodes.

Water cycle algorithm: an approach for improvement of navigational strategy of multiple humanoid robots

AbstractThis paper presents an efficient water cycle algorithm based on the processes of water cycle with movement of streams and rivers in to the sea. This optimization algorithm is applied to obtain the optimal feasible path with minimum travel duration during motion planning of both single and multiple humanoid robots in both static and dynamic cluttered environments. This technique discards the rainfall process considering falling water droplets forming streams during raining and the process of flowing. The flowing process searches the solution space and finds the more accurate solution and represents the local search. Motion planning of humanoids is carried out in V-REP software. The performance of proposed algorithm is tested in experimental scenario under laboratory conditions and shows the developed algorithm performs well in terms of obtaining optimal path length and minimum time span of travel. Here, navigational analysis has been performed on both single as well as multiple humanoid robots. Statistical analysis of results obtained from both simulation and experimental environments is carried out for both single and multiple humanoids, along with the comparison with another existing optimization technique that indicate the strength and effectiveness of the proposed water cycle algorithm.

RivFishTIME: A global database of fish time‐series to study global change ecology in riverine systems

AbstractMotivationWe compiled a global database of long‐term riverine fish surveys from 46 regional and national monitoring programmes and from individual academic research efforts, with which numerous basic and applied questions in ecology and global change research can be explored. Such spatially and temporally extensive datasets have been lacking for freshwater systems in comparison to terrestrial ones.Main types of variables containedThe database includes 11,386 time‐series of riverine fish community catch data, including 646,270 species‐specific abundance records, together with metadata related to the geographical location and sampling methodology of each time‐series.Spatial location and grainThe database contains 11,072 unique sampling locations (stream reach), spanning 19 countries, five biogeographical realms and 402 hydrographical basins world‐wide.Time period and grainThe database encompasses the period 1951–2019. Each time‐series is composed of a minimum of two yearly surveys (mean = 8 years) and represents a minimum time span of 10 years (mean = 19 years).Major taxa and level of measurementThe database includes 944 species of ray‐finned fishes (Class Actinopterygii).Software formatcsv.Main conclusionOur collective effort provides the most comprehensive long‐term community database of riverine fishes to date. This unique database should interest ecologists who seek to understand the impacts of human activities on riverine fish biodiversity and to model and predict how fish communities will respond to future environmental change. Together, we hope it will promote advances in macroecological research in the freshwater realm.

Energy Efficient TABU Optimization Routing Protocol for WSN

Introduction: This article is the result of the research “Energy efficient routing protocols in wireless sensor network: Examine the impact of M-SEEC routing protocols on the lifetime of WSN with an energy efficient TABU optimization routing protocol”developed in the IKG, Punjab Technical University, India in 2019.Problem: The task of finding and maintaining routes in WSNs is non-trivialsince energy restrictions and sudden changes in node status cause frequent and unpredictable changes.Objective: The objective of this paper is to propose an energy efficient heterogeneous protocolwith the help of a hybrid meta-heuristic technique.Methodology: In the hybrid meta-heuristic technique, the shortest route has been selected and the data forwarded to the sink in a minimal time span,savingenergy and making the network more stable. To evaluate the technique, a new hybrid technique has been created where the data transmission is implemented from the beginning under MATLAB 2013a.Results: The proposed technique is better than the existing ones since the remaining energy in the network is increased by 62% compared to normal nodes in MSEEC, 65% compared to advanced nodes in MSEEC and 70% compared to super nodes in MSEEC. The network lifetime was also enhanced by 70.8% compared to MSEEC.Conclusion: The proposed protocol was found to be superior based on the average residual energy.This paper proposes an efficient routing mechanism towards the energy efficient network.Originality: Through this research, a novel version of MSEEC protocol is carried out using the TABU search mechanism to generate the functions of two neighbourhoods to detect the optimum path with the aim of maximizing the network lifetime in an area of 200×200m2.Limitations: The lack of other routing techniques falls under swarm intelligence.

Investigation of Site Condition Using Elliptical Curve Inversion from Horizontal-to-Vertical Spectral Ratio (HVSR)

This study aims to investigate site conditions based on the dominant period and elliptical curve inversion of Horizontal-to-Vertical Spectral Ratio (HVSR). The data were taken using a seismometer portable short period in the minimum time span of data retrieval for 30 minutes. The Nakamura method as known as Horizontal-to-Vertical Spectral Ratio (HVSR) is used to obtain the value of the dominant frequency and amplification factor. The dominant frequency is changed to the dominant period which can indicate the type of soil. HVSR processing use Geopsy software with a guide from the SESAME Project. The results of processing show that the dominant frequency and the amplification factor. In Geopsy there are several modules and packages. This processing uses TFA Module and Max2curve Package and Dinver Package. Waveform can be inversed based on the elliptical curve of HVSR model to produce a shear wave velocity model (Vs) uses that modules and packages. From the velocity model, we can know Vs30 to determine the type of soil layer. The shear wave velocity model obtained can show the estimation of sediment thickness in the area under investigation.

An Optimized Mobile Cloud Computational Offloading Framework using K-Means Algorithm

Offloading the execution of heavy computational modules from mobile devices to Mobile Cloud Computing (MCC) is inevitable in today’s era as it mainly focuses in consuming less battery power and execution time. But, the problem incurred with identifying the most optimal cloud device to map each module still remains a challenge in cloud computing environment. In this paper, a novel MCC offloading framework is proposed to fasten the allocation and execution of high computational modules that runs in the mobile device, effectively on the cloud. The framework employs K-Means clustering algorithm to group the nearest cloud virtual machines that best suits for executing modules of software running in the mobile. The objective of the paper is to maximize the energy savings by extending the battery life and execution speed of mobile device when executing heavy computational modules. The optimal selection of cloud device is attained by grouping the requirements of each module with the nearest cloud devices offering the same requirements using K-Means Algorithm. The proposed framework is compared with the existing mobile computation offloading frameworks with respect to energy saving, execution time and energy consumption. The results show that the proposed work executes the modules of computationally intensive modules in minimum time span with maximized energy savings than the existing frameworks.

Towards an effective approach for architectural knowledge management considering global software development

Architectural design is expected to provide virtuous outcomes of quality software products by satisfying customer requirements. A foremost apprehension of the customer is to have a better quality product within a minimal time span. The evaporation of architectural knowledge causes snags for the quality of a system being developed. The research study aims to propose and validate a framework bridging the gaps in architectural knowledge management. A mixed research approach has been employed. In order to align closely with industry practices, action research has been considered as research methodology, while the evaluation has been performed using a multiple case study approach. The results show that the framework enables the architects to cope with complex designs in distributed software development environments. The developed tool enabled to shift the theory into practice by assisting in creation of system architecture, knowledge survival and support architectural evolution with changing requirements.

Quick Routing in Autonomous Vehicles using Boosting Algorithms

Self-driving automobiles are understandably the most attention grabbing utility of artificial intelligence. Until recently, we have just considered the prototypes of these cars in Sci-fi movies, with the whole thing else left to our imagination. But with advances in technology, this super notion has acquired a lifestyles of its own. Autonomous vehicle promises to improve traffic safety while at the same time, it must increase the fuel efficiency, reduce congestion and arrive to the destination at a minimum time span. We propose a novel technique to boost the algorithm to take the shortest path while the vehicle is in movement.

What are they doing? And where? Tracking the Traffic as one of the instruments in an evidence-based redesign of a university library

During the last decade we have seen an increased focus on the future use of academic libraries, both in terms of their legitimacy and the use of the physical library space itself.
 Prior to a planned, major rebuilding of the Humanities and Social Sciences Library at the University of Oslo (HumSam library), a thorough study was required to establish the current use of the library space, as well as users’ wishes and needs for change.
 Several different methods were used to collect this data. One was the method Tracking the Traffic (TTT), developed by Tord Høivik. This is a purely quantitative method, where the users in the library are counted several times during the opening hours. This registration takes place over a set period, for example, at fixed hours every day over a minimum time span of two weeks. The activities of the users are also registered, but without talking to the user, so one can register that one user is reading a book or using a laptop, but not what kind of book or what the laptop is being used for. Other methods used were a user survey, different kinds of interview and photo documentation.
 This article aims at demonstrating how the use of the TTT method contributed when the HumSam library conducted studies to ensure an evidence-based renewal of the library. The experiences with this type of data collection are described, and a discussion of the methodology based on our experiences is presented. There are also examples for how this data affected the rebuilding and renewal of the HumSam library. The TTT method needs to be a part of a suite of methods to give an adequate profile of library use. Being a method based on observation, it is necessary to compliment it with other qualitative methods to fill in the picture of library users and to ensure library development soundly based on full evidence (Evidence-based Practice – EBP).
 Of course, the library staff had many pre-assumptions about the library use; however, documenting use in this way may lead to more accurate knowledge.
 When visiting the redesigned HumSam library today, the responses to the results of the TTT and the other studies mentioned in this article can be clearly seen. The most obvious are the number and variation of seating facilities, the number of group rooms and the reduced height and number of shelves for the physical collection. Scenes and special places for events have also been created, opening hours in exam periods have been increased and the library counters have a more inviting design than before.

Detectability of Repeated Airborne Laser Scanning for Mountain Landslide Monitoring

Multi-temporal airborne laser scanning (ALS) surveys have become a prime consideration for detecting landslide movements and evaluating landslide risk in mountain areas. The minimum elevation change (or detectability) that can be detected by repeated ALS surveys has become a critical threshold for landslide researchers and engineers to decide if ALS is a capable tool for detecting targeted landslides and arranging the minimum time span between two scans if ALS is a choice. The National Center for Airborne Laser Mapping (NCALM) at the University of Houston conducted three repeated ALS surveys at the Slumgullion landslide site in Colorado, U.S. over one week in July of 2015. These repeated ALS surveys provide valuable datasets for evaluating the vertical detectability of multi-temporal ALS surveys in a typical mountain area. According to this study, the difference of digital elevation models (DDEM) derived from ALS has the ability of detecting a minimum elevation change of 5 cm over flatter and moderately rugged terrain areas (slope < 20 degrees) and a minimum of a 10-cm elevation change over rugged terrain areas (20 degrees < slope < 40 degrees). However, the DDEM values over highly rugged terrain areas (slope > 40 degrees), such as cliff and landslide scarps, should be interpolated with caution. Global Navigation Satellite Systems (GNSS) and Terrestrial Laser Scanning (TLS) surveys were also performed at the middle portion of the landslide area for assessing the accuracy of ALS datasets. The accuracy of ALS varies from approximately one decimeter (~10 cm) to one foot (~30 cm) depending on the roughness of terrain surface and vegetation coverage (point density). The detectability and accuracy estimates of ALS measurements obtained from the case study could be used as a reference for estimating the performance of modern ALS in mountain areas with similar topography and vegetation coverage.

Longer observation time increases adenoma detection in the proximal colon - a prospective study.

Background and study aims Longer observation times are associated with increased adenoma detection rates (ADR) in the entire colon. However, adenomas in the proximal colon are at risk of being missed during colonoscopy. The aim of this study was to investigate the impact of observation time on detection of adenomatous polyps in the proximal colon. Patients and methods This was a prospective study at a university hospital in Germany. Colonoscopies were conducted using magnetic endoscope imaging (MEI) in order to determine the exact position of the scope. Exact observation times spent for the detection of polyps in the proximal and distal colon segments were assessed. The primary outcome was adenoma detection in the proximal colon. ROC curves were generated in order to test the correlation between observation time and adenoma detection. Logistic regression analysis was used to check for interfering factors. Results A total 480 procedures with 538 polyps were available for analysis. The overall adenoma detection rate was 38.5 %. ADR in the proximal colon was 28.0 %. There was a significant association between observation time in the proximal colon and the detection of proximal adenomas ( P < 0.001). The impact of the time factor on ADR was stronger in the proximal compared to the distal colon ( P = 0.030). A net period of 4 min 7 sec was found to be the minimum time span for sufficient adenoma detection in the proximal colon. Conclusion Observation time is significant in terms of adenoma detection in the proximal colon. The impact of observation time on ADR is stronger in the proximal compared to the distal colon. In the proximal colon a minimum time span of 4 minutes should be spent in order to ensure adequate adenoma detection.

Short interval between two Pap smears: effect on the result of the second smear? A prospective randomized trial.

A repeat Pap smear is sometimes necessary after a short time interval or even immediately, when patients seek for a second opinion or due to study participation. Only limited information is available on the possible impact of a short interval between two Pap smears. Most institutions therefore practice a minimum time span of 6-8weeks before obtaining a second smear since a short interval is commonly believed to be associated with an increase of false negative results in the second smear. Two consecutive Pap smears were obtained from 81 women. 41 smears were processed using the conventional technique, whereas liquid-based cytology was used in the remaining 40 women. Smears were independently evaluated by four different cytopathologists. We analyzed the effect of time interval, both processing techniques and inter-observer variance in cytological evaluation. While the result of the second smear shows a tendency towards a more benign outcome (odds ratio (OR) 1.436, 95% CI 0.972-2.121), this difference was not statistically significant (p=0.07). No significant differences were observed between conservative and liquid-based cytology (OR 1.554, 95% CI 0.659-3.667, p=0.31). There was considerable inter-observer variability, and the observer was a strong predictor of the cytological result (OR 0.632-5.083, 95% CI 0.355-8.975, p<0.01). We document a tendency towards a more benign outcome without statistical significance in the second smear. Inter-observer variability of different cytopathologists is high and should be kept in mind when evaluating cytology results.

Intraocular Pressure, Axial Length, and Refractive Changes after Phacoemulsification and Trabeculectomy for Open-Angle Glaucoma.

Purpose To compare changes in intraocular pressure (IOP), axial eye length (AEL), and refractive outcome in primary open-angle glaucoma patients undergoing cataract surgery and trabeculectomy in dependence of the sequence of surgeries. Materials and Methods We retrospectively analysed 48 eyes. The changes in refraction, intraocular pressure, and axial eye length were analysed after surgery. In group A (21 subjects), phacoemulsification was performed before trabeculectomy, and in group B (27 subjects), trabeculectomy was performed before phacoemulsification with a minimum time span between interventions of 6 months. Results The reduction in IOP and the decrease in AEL after trabeculectomy were significant after 6 and 12 months postsurgery (p < 0.001 each). The decrease in AEL was 0.42 ± 0.11% at 6 months after surgery and 0.40 ± 0.13% after 12 months from surgery; this decrease in AEL was comparable between the groups. The refractive outcome was significantly different between the groups (group A: 0.35 ± 0.75 dpt, group B: −0.05 ± 0.36 dpt, p = 0.018); in group A, trabeculectomy caused a hyperopic shift of 0.34 ± 0.44 dpt (p = 0.002) at 12 months postsurgery. Conclusion IOP reduction after trabeculectomy causes AEL shortening. The effect on refractive outcome depends on the sequence of surgeries. Better refractive outcome is achieved if phacoemulsification is performed after trabeculectomy.

SaaS Level based Middleware Database Integrator Platform

In purpose of data searching acceleration, the fastest data response is the major concern for latest cloud environment. Regarding this, the intellectual decision is to enrich the SaaS level applications. Amongst the SaaS based applications, service level database integration is the recent trend to provide the integrated view of the heterogeneous cloud databases through shared services using DBaaS. But the generic limitations interacted during the database integration are dynamic adaptability of multiple databases structure, dynamic data location identification in the concern databases, data response using the data commonality. Data migration technique and single query approach are the two individual solutions for the proposed limitations. But the side effects during data migration technique are extra space utilisation and excess time consumption. Again, the single query approach suffers from worst case time complexity for data connectivity, data aggregation and query evaluation. So, to find a suitable data response solution by eliminating these combined major issues, a graph based Middleware Database Integrator Platform or MDIP model has been proposed. This integrator platform is actually the flexible metadata representation technique for the concerned heterogeneous cloud databases. The associativity and commonality among components of multiple databases would be further helpful for efficient data searching in an integrated way. For the incorporation within the service level but not in the services, MDIP is considered as the different platform. It is applicable over any service based database integration in purpose of data response efficiency. Finally, the quality assessment using evaluated query time compared with already proposed SLDI shows better data access quality. Thus, its expertise dedication in data response can overcome summarised challenges like data adaptation flexibility, dynamic identification of data location, wastage of data storage, data accessing within minimal time span and optimised cost in presence of data consistency, data partitioning and user side scalability.