Technology Enhanced Learning has become more popular in recent times and many organizations and universities use it as a key instrument in various teaching and training scenarios. At the University of Technology of Graz, some courses require randomized quizzes where question variables can be assigned by arbitrary mathematical functions and this feature is missing in the current solutions. This article describes the development of a quiz application that can be integrated into Moodle by utilization of the Learning Tools Interoperability protocol (LTI). The PHP application is built to support programmable questions that can contain JavaScript and HTML code. Teachers are able to build interactive, randomized quizzes, in which the random variables can be assigned with complex mathematical functions. Furthermore, the application provides a programmable grading mechanism. With this mechanism, it is possible for students to self-assess their performance, as well as for teachers to formally assess their students' learning success automatically and send the results back to Moodle (or other LTI compatible consumer applications).
Accurate biometry, appropriate intraocular lens (IOL) power formula, and modern techniques are very important for cataract surgery as a refractive procedure aiming at the intended refractive result. Main sources of postoperative refractive surprise are errors in biometry, such as, inaccurate preoperative measurements (axial length [AL] or keratometry), IOL calculation formula, IOL insertion, and lens constant's errors [1]. Other common reasons for 'wrong' IOL implantation as reported by Steeples in their study of 178 cases are: inaccurate biometry, wrong IOL selection, transcription errors, handwriting misinterpretations, change in list order, right/left eye confusion, patient identification issues, misfiled biometry, wrong IOL written on theater white board, optimal IOL power unavailable in stock, wrong IOL power implantation after complicated surgery, wrong patient notes, communication errors, or-as in the case presented hereinan IOL mislabeled by the manufacturer [2]. In case of a refractive surprise following cataract surgery, identification of the failure cause will lead us to an optimal solution. Corneal irregularities, long-term history of contact lens use, superficial punctate keratitis, posterior capsular opacity, decentered IOL, preoperative inaccurate measurement, implantation of the wrong IOL, intraoperative possible upside-down implantation, or fundus problems have to be excluded [3]. Corneal topography and corneal tomography often provide the best overall assessment of the corneal status and degree of astigmatism, irregularity, and symmetry, and
The purpose of this study was to compare the corneal endothelial morphology and cell density of diabetic smokers and nonsmokers with 50 to 70 age-matched healthy subjects and to determine whether smoking increases the effects of type 2 diabetes mellitus (DM) on these corneal parameters.Methods: This prospective cohort study included 200 patients who were assigned to 4 groups, including smokers with type 2 DM (group 1), nonsmokers with type 2 DM (group 2), healthy smokers (group 3), and healthy nonsmokers (control group, group 4). Noncontact specular microscopy was used to measure central endothelial cell density (ECD), coefficient of variation of cell area, percentage of hexagonal cells, and central corneal pachymetry (CCT).Results: According to the ECD and CCT values (P , 0.001 and P = 0.013, respectively), a significant difference was observed between the groups. The mean ECD was lowest in diabetic smokers (1917 6 399 cells/mm 2 ). Healthy smokers and diabetic smokers had significantly lower ECD compared with the control group (P = 0.03 and P , 0.001, respectively). Healthy smokers and diabetic smokers had significantly lower ECD compared with diabetic nonsmokers (P = 0.012 and P , 0.001, respectively). The cornea was significantly thicker in the diabetic smokers than in the control group (P = 0.013). Conclusions:The coexistence of DM and smoking causes a significant decrease in ECD and an increase in CCT. Cigarette smoking is more harmful to corneal endothelial cells than DM alone.
Up to now cataract represents a leading cause of loss of visual acuity in patients with inflammation of the uvea. Several studies in recent years have shown that cataract surgery can achieve an improvement in visual acuity; however, the prognosis is greatly reduced in comparison to a normal patient group.
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