Highlights from the 2019 International Myopia Summit on 'controversies in myopia'.

Myopia is an emerging public health issue with potentially significant economic and social impact, especially in East Asia. However, many uncertainties about myopia and its clinical management remain. The International Myopia Summit workgroup was convened by the Singapore Eye Research Institute, the WHO Regional Office for the Western Pacific and the International Agency for the Prevention of Blindness in 2019. The aim of this workgroup was to summarise available evidence, identify gaps or unmet needs and provide consensus on future directions for clinical research in myopia. In this review, among the many 'controversies in myopia' discussed, we highlight three main areas of consensus. First, development of interventions for the prevention of axial elongation and pathologic myopia is needed, which may require a multifaceted approach targeting the Bruch's membrane, choroid and/or sclera. Second, clinical myopia management requires co-operation between optometrists and ophthalmologists to provide patients with holistic care and a tailored approach that balances risks and benefits of treatment by using optical and pharmacological interventions. Third, current diagnostic technologies to detect myopic complications may be improved through collaboration between clinicians, researchers and industry. There is an unmet need to develop new imaging modalities for both structural and functional analyses and to establish normative databases for myopic eyes. In conclusion, the workgroup's call to action advocated for a paradigm shift towards a collaborative approach in the holistic clinical management of myopia

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Advanced Robotic Therapy Integrated Centers (ARTIC): an international collaboration facilitating the application of rehabilitation technologies

Background: The application of rehabilitation robots has grown during the last decade. While meta-analyses have shown beneficial effects of robotic interventions for some patient groups, the evidence is less in others. We established the Advanced Robotic Therapy Integrated Centers (ARTIC) network with the goal of advancing the science and clinical practice of rehabilitation robotics. The investigators hope to exploit variations in practice to learn about current clinical application and outcomes. The aim of this paper is to introduce the ARTIC network to the clinical and research community, present the initial data set and its characteristics and compare the outcome data collected so far with data from prior studies. Methods: ARTIC is a pragmatic observational study of clinical care. The database includes patients with various neurological and gait deficits who used the driven gait orthosis Lokomat® as part of their treatment. Patient characteristics, diagnosis-specific information, and indicators of impairment severity are collected. Core clinical assessments include the 10-Meter Walk Test and the Goal Attainment Scaling. Data from each Lokomat® training session are automatically collected. Results: At time of analysis, the database contained data collected from 595 patients (cerebral palsy: n = 208; stroke: n = 129; spinal cord injury: n = 93; traumatic brain injury: n = 39; and various other diagnoses: n = 126). At onset, average walking speeds were slow. The training intensity increased from the first to the final therapy session and most patients achieved their goals. Conclusions: The characteristics of the patients matched epidemiological data for the target populations. When patient characteristics differed from epidemiological data, this was mainly due to the selection criteria used to assess eligibility for Lokomat® training. While patients included in randomized controlled interventional trials have to fulfill many inclusion and exclusion criteria, the only selection criteria applying to patients in the ARTIC database are those required for use of the Lokomat®. We suggest that the ARTIC network offers an opportunity to investigate the clinical application and effectiveness of rehabilitation technologies for various diagnoses. Due to the standardization of assessments and the use of a common technology, this network could serve as a basis for researchers interested in specific interventional studies expanding beyond the Lokomat®

EARLY CHILDHOOD EDUCATION: THE ROLE OF NATURE IN SHAPING YOUNG MINDS

Master'sMASTER OF ARCHITECTURE (M.ARCH

Child welfare NGOs in China : implications for state-society relations

The civil society perspective and the corporatist perspective have thus far dominated studies on state-society relations in the Chinese context. While these paradigms are insightful, their unidirectional and rigid natures may no longer adequately describe the complex nature of evolving state-society relations in China. As such, Joel S. Migdal’s State-in-Society framework is adopted as the theoretical premise of this study. Allowing for more fluidity, the State-in-Society theory serves as an alternative approach towards examining interactions between the state and nonprofits and between the state and society. The concept of social control within the framework is examined in further detail. Descriptive multiple case study was used as a method of inquiry, followed by thematic analysis. Findings generally corroborate with the logic of social control, with compliance, participation and legitimacy being the incremental stages with which both nonprofits and the state seek to attain from each other and from the public. It was found that the state employ strategies including co-optation, procedural validation and hijacking scholarship to gain participation whereas moral reinforcement, rhetoric validation, and image consolidation are used to attain legitimacy. Ironically, nonprofits employ similar strategies in an attempt to change the state’s behaviour. Vilification and shaming are used to gain compliance, while resource appropriation and preemptive engagement are employed to attain participation. Moral reinforcement, image consolidation, individual credibility and persistence were found to be critical factors in bolstering organizational legitimacy. Furthermore, findings generally support the claim that nonprofits operating in rural areas enjoy greater autonomy than those active in urban areas. Even so, state-society relations is highly localized and therefore overgeneralization should be avoided. In addition to contributing to the discourse on state-society relations, this study seeks to identify the role of nongovernmental organizations in orphan care provision in China. Along with content analysis and field observations, 10 in-depth cases are presented to illustrate existing obstacles pertaining to orphan care provision. Identified barriers are subsequently compartmentalized into five main categories: knowledge level, policy level, cultural level, organizational level, and state-NGO relations. Given the distinct welfare system extant between rural and urban areas, findings indicate that orphans in rural areas are disproportionately disadvantaged compared to those residing in cities. This may be due to the relatively weak economic and human resources that often characterize rural China. One important observation is the growing tendency for local governments to regard nongovernmental organizations as critical service partners. However, the sustainability of this service model is questionable, especially when the state claims to carry primary responsibility over citizen welfare. The legal ambiguity concerning the registration and governance of nonprofits also jeopardizes future undertakings. Nevertheless, it is strategically and rationally sensible for local governments to ally with nonprofits insofar as there are deficiencies in the former’s capacity to deliver social services for disadvantaged children. This study concludes by discussing policy implications on China’s third sector and social development.published_or_final_versionSocial Work and Social AdministrationDoctoralDoctor of Philosoph

From good practice to policy formation-The impact of third sector on disaster management in Taiwan

Using the Advocacy Coalition Framework (ACF) first developed by Sabatier and Jenkins (1987, 1988) as a conceptual lens, this paper explores its usefulness in understanding policy changes in the context of disaster management in Taiwan. The 921 Alliance and the 88 Alliance formed in light of two natural disasters were subjects of analyses. Overall, the ACF is an effective tool in analyzing Taiwan's policy changes in response to natural disasters, especially regarding the importance of policy core beliefs in reinforcing the cohesiveness of coalitions and their drive to influence government's decisions. Yet, this paper argues that a critical attribution within the two coalitions was that of social capital, an aspect that the originally ACF as posited by Sabatier conceptually lacks. The impacts of 921 and 88 Alliances on Taiwan's civil society development are also discussed. © 2014 Elsevier Ltd.Link_to_subscribed_fulltex

PDELab: An Object-Oriented Framework for Building Problem Solving Environments for PDE Based Applications

In this paper we present an object-oriented methodology and tools for creating high level, high performance problem solving systems (workbenches) for scientific applications modeled by partial differential equations. This methodology is validated by the creation of a scientific computing workbench for bioseparation analysis. One of the design objectives of PDELab is to provide workbench developers and users with much the same kind of independence in software as they have come to expect in hardware. The adopted architecture of this software platform for creating problem solving environments for PDE applications is devoted to "clean layering." At the bottom are the various "smart" libraries that support the numerical simulation of various "physical" objects together with the corresponding knowledge bases needed to support the computational intelligence aspects of the various workbenches; at the top is a set of interactive tools that allow the user to carry out his objectives ..

Multiple precarity and intimate family life among African-Chinese families in Guangzhou

Formal ties between China and several African states have intensified in recent years. Alongside growing economic and trade cooperation, the international mobility of people between China and African states is increasing. Recent studies have shown that African migrants face institutional barriers to integration in Chinese society, however, and the personal and social consequences of these barriers remain under-researched, especially the dynamics of intimate family life. Drawing upon concepts of precarity and 'low-end globalisation', this study examines how African-Chinese families navigate everyday life, including work, family and children's education. It is based on ethnographic fieldwork comprising observations and in-depth interviews with African-Chinese families and one community leader (n = 19). These reveal how families confront the pervasiveness of legal, economic and social precarization in multiple overlapping domains. These social forces have intergenerational repercussions, with adverse impacts on family life, interpersonal relationships and sense of belonging to the local community. Yet precarity offers conditions for practices of empowerment. We conclude with implications for migration studies

Multiple precarity and intimate family life among African-Chinese families in Guangzhou

Formal ties between China and several African states have intensified in recent years. Alongside growing economic and trade cooperation, the international mobility of people between China and African states is increasing. Recent studies have shown that African migrants face institutional barriers to integration in Chinese society, however, and the personal and social consequences of these barriers remain under-researched, especially the dynamics of intimate family life. Drawing upon concepts of precarity and 'low-end globalisation', this study examines how African-Chinese families navigate everyday life, including work, family and children's education. It is based on ethnographic fieldwork comprising observations and in-depth interviews with African-Chinese families and one community leader (n = 19). These reveal how families confront the pervasiveness of legal, economic and social precarization in multiple overlapping domains. These social forces have intergenerational repercussions, with adverse impacts on family life, interpersonal relationships and sense of belonging to the local community. Yet precarity offers conditions for practices of empowerment. We conclude with implications for migration studies

Epigenetic programming in response to maternal nutrition

Fetal programming is a well-established phenomenon in which suboptimal maternal nutrition during gestation ‘programs’ offspring to have an increased predisposition to metabolic disease in adulthood. The mechanism underlying fetal programming remains unknown; however, many researchers have proposed that epigenetics may play a significant role. Epigenetic markers of gene activity and silence are established early on in embryonic development, after which they are faithfully inherited and stably maintained in all cells of an organism. The epigenetic programming hypothesis therefore proposes that perturbed maternal nutrition during gestation may effect epigenetic changes in the fetus that are maintained into adulthood and predispose to late-onset disease. There has only been limited evidence for this hypothesis so far, however. The aim of my study was to use mouse models to investigate whether epigenetic changes occur in offspring exposed to three different maternal dietary modifications: maternal methyl donor supplementation, maternal overnutrition and maternal undernutrition. A microarray methylation analysis strategy was chosen to allow thorough characterization of global methylation changes in offspring. The results of this study show that offspring exposed to changes in maternal nutrition exhibit small and subtle methylation changes throughout the genome that can affect overall methylation variability. These changes primarily occur in genes involved in development and gene expression and may contribute to the phenotypic changes that occur in fetal programming. More epigenetic changes were also found to occur with multiple generations of exposure, suggesting that epigenetic programming may provide a means of adaptive evolution in response to long-term nutritional challenges