Cluster-randomized controlled trial of the effects of free glasses on purchase of children's glasses in China:The PRICE (Potentiating Rural Investment in Children's Eyecare) study

Offering free glasses can be important to increase children's wear. We sought to assess whether "Upgrade glasses" could avoid reduced glasses sales when offering free glasses to children in China.In this cluster-randomized, controlled trial, children with uncorrected visual acuity (VA)6/12 in both eyes at 138 randomly-selected primary schools in 9 counties in Guangdong and Yunnan provinces, China, were randomized by school to one of four groups: glasses prescription only (Control); Free Glasses; Free Glasses + offer of $15 Upgrade Glasses; Free Glasses + offer of$30 Upgrade Glasses. Spectacle purchase (main outcome) was assessed 6 months after randomization.Among 10,234 children screened, 882 (8.62%, mean age 10.6 years, 45.5% boys) were eligible and randomized: 257 (29.1%) at 37 schools to Control; 253 (28.7%) at 32 schools to Free Glasses; 187 (21.2%) at 31 schools to Free Glasses + $15 Upgrade; and 185 (21.0$30 Upgrade. Baseline ownership among these children needing glasses was 11.8% (104/882), and 867 (98.3%) children completed follow-up. Glasses purchase was significantly less likely when free glasses were given: Control: 59/250 = 23.6%; Free glasses: 32/252 = 12.7%, P = 0.010. Offering Upgrade Glasses eliminated this difference: Free + $15 Upgrade: 39/183 = 21.3$30 Upgrade: 38/182 = 20.9%, RR 0.91 (0.59, 1.42), P = 0.69.Upgrade glasses can prevent reductions in glasses purchase when free spectacles are provided, providing important program income.ClinicalTrials.gov Identifier: NCT02231606. Registered on 31 August 2014

Effects of frozen soil on soil temperature, spring infiltration, and runoff: results from the PILPS 2(d) experiment at Valdai, Russia

Permission to place copies of these works on this server has been provided by the American Meteorological Society (AMS). The AMS does not guarantee that the copies provided here are accurate copies of the published work. © Copyright 2003 American Meteorological Society (AMS). Permission to use figures, tables, and brief excerpts from this work in scientific and educational works is hereby granted provided that the source is acknowledged. Any use of material in this work that is determined to be “fair use” under Section 107 of the U.S. Copyright Act or that satisfies the conditions specified in Section 108 of the U.S. Copyright Act (17 USC §108, as revised by P.L. 94-553) does not require the AMS’s permission. Republication, systematic reproduction, posting in electronic form on servers, or other uses of this material, except as exempted by the above statement, requires written permission or a license from the AMS. Additional details are provided in the AMS Copyright Policy, available on the AMS Web site located at (http://www.ametsoc.org/AMS) or from the AMS at 617-227-2425 or [email protected] Project for Intercomparison of Land-Surface Parameterization Schemes phase 2(d) experiment at Valdai, Russia, offers a unique opportunity to evaluate land surface schemes, especially snow and frozen soil parameterizations. Here, the ability of the 21 schemes that participated in the experiment to correctly simulate the thermal and hydrological properties of the soil on several different timescales was examined. Using observed vertical profiles of soil temperature and soil moisture, the impact of frozen soil schemes in the land surface models on the soil temperature and soil moisture simulations was evaluated. It was found that when soil-water freezing is explicitly included in a model, it improves the simulation of soil temperature and its variability at seasonal and interannual scales. Although change of thermal conductivity of the soil also affects soil temperature simulation, this effect is rather weak. The impact of frozen soil on soil moisture is inconclusive in this experiment due to the particular climate at Valdai, where the top 1 m of soil is very close to saturation during winter and the range for soil moisture changes at the time of snowmelt is very limited. The results also imply that inclusion of explicit snow processes in the models would contribute to substantially improved simulations. More sophisticated snow models based on snow physics tend to produce better snow simulations, especially of snow ablation. Hysteresis of snow-cover fraction as a function of snow depth is observed at the catchment but not in any of the models

Effects of Frozen Soil on Soil Temperature, Spring Infiltration, and Runoff: Results from the PILPS 2(d) Experiment at Valdai, Russia

The Project for Intercomparison of Land-Surface Parameterization Schemes phase 2(d) experiment at Valdai, Russia, offers a unique opportunity to evaluate land surface schemes, especially snow and frozen soil parameterizations. Here, the ability of the 21 schemes that participated in the experiment to correctly simulate the thermal and hydrological properties of the soil on several different timescales was examined. Using observed vertical profiles of soil temperature and soil moisture, the impact of frozen soil schemes in the land surface models on the soil temperature and soil moisture simulations was evaluated. It was found that when soil-water freezing is explicitly included in a model, it improves the simulation of soil temperature and its variability at seasonal and interannual scales. Although change of thermal conductivity of the soil also affects soil temperature simulation, this effect is rather weak. The impact of frozen soil on soil moisture is inconclusive in this experiment due to the particular climate at Valdai, where the top 1 m of soil is very close to saturation during winter and the range for soil moisture changes at the time of snowmelt is very limited. The results also imply that inclusion of explicit snow processes in the models would contribute to substantially improved simulations. More sophisticated snow models based on snow physics tend to produce better snow simulations, especially of snow ablation. Hysteresis of snow-cover fraction as a function of snow depth is observed at the catchment but not in any of the models

The representation of snow in land surface schemes: results from PILPS 2(d)

Permission to place copies of these works on this server has been provided by the American Meteorological Society (AMS). The AMS does not guarantee that the copies provided here are accurate copies of the published work. © Copyright 2001 American Meteorological Society (AMS). Permission to use figures, tables, and brief excerpts from this work in scientific and educational works is hereby granted provided that the source is acknowledged. Any use of material in this work that is determined to be “fair use” under Section 107 of the U.S. Copyright Act or that satisfies the conditions specified in Section 108 of the U.S. Copyright Act (17 USC §108, as revised by P.L. 94-553) does not require the AMS’s permission. Republication, systematic reproduction, posting in electronic form on servers, or other uses of this material, except as exempted by the above statement, requires written permission or a license from the AMS. Additional details are provided in the AMS Copyright Policy, available on the AMS Web site located at (http://www.ametsoc.org/AMS) or from the AMS at 617-227-2425 or [email protected] land surface schemes (LSSs) performed simulations forced by 18 yr of observed meteorological data from a grassland catchment at Valdai, Russia, as part of the Project for the Intercomparison of Land-Surface Parameterization Schemes (PILPS) Phase 2(d). In this paper the authors examine the simulation of snow. In comparison with observations, the models are able to capture the broad features of the snow regime on both an intra- and interannual basis. However, weaknesses in the simulations exist, and early season ablation events are a significant source of model scatter. Over the 18-yr simulation, systematic differences between the models’ snow simulations are evident and reveal specific aspects of snow model parameterization and design as being responsible. Vapor exchange at the snow surface varies widely among the models, ranging from a large net loss to a small net source for the snow season. Snow albedo, fractional snow cover, and their interplay have a large effect on energy available for ablation, with differences among models most evident at low snow depths. The incorporation of the snowpack within an LSS structure affects the method by which snow accesses, as well as utilizes, available energy for ablation. The sensitivity of some models to longwave radiation, the dominant winter radiative flux, is partly due to a stability-induced feedback and the differing abilities of models to exchange turbulent energy with the atmosphere. Results presented in this paper suggest where weaknesses in macroscale snow modeling lie and where both theoretical and observational work should be focused to address these weaknesses

Study on Construction Molding Technology of Long-Span Space Truss Suspended Dome Structure

Typically, the upper part of the roof a gymnasium building is a radial inverted triangular truss structure, and the lower part is a cable structure. They are connected by vertical braces to form a self-balancing structural system. The whole roof is supported by a complex, spatial, prestressed structure comprising tilted Y-shaped laced columns. Such structures rely on the integrity of the form and the application of prestress to achieve the best performance; it is in an extremely unstable state during construction. In order to study the mechanical behavior of the structure in this process, finite element software was used to analyze the cumulative slip of the structure and the construction process of cable tension, and the simulation values were compared to the actual monitoring values. The stress and deformation of the structure in different construction stages were investigated, and a reasonable structural unloading scheme was put forward. The study results showed that the stiffness of the long-span space truss suspended dome structure gradually increased with the structural integrity during construction, and the vertical deformation decreased from 25.4 mm to 19.26 mm with the construction process. The location and magnitude of the structure’s maximum internal force and maximum stress varied greatly compared to the static analysis when considering the construction process effects. Hence, conducting a construction process analysis is necessary. The construction technology of symmetrical rotating cumulative slip proposed in this paper has the advantages of a short construction duration, safe and stable construction process, etc., providing technical references for similar engineering constructions

Long QT syndrome with potassium voltage-gated channel subfamily H member 2 gene mutation mimicking refractory epilepsy: case report.

BackgroundEpileptic seizures can be difficult to distinguish from other etiologies that cause cerebral hypoxia, especially cardiac diseases. Long QT syndrome (LQTS), especially LQTS type 2 (LQT2), frequently masquerades as seizures because of the transient cerebral hypoxia caused by ventricular arrhythmia. The high rate of sudden death in LQTS highlights the importance of accurate and early diagnosis; correct diagnosis of LQTS also prevents inappropriate treatment with anti-epileptic drugs (AEDs).Case presentationWe report a case of congenital LQT2 with potassium voltage-gated channel subfamily H member 2 gene (KCNH2) mutation misdiagnosed as refractory epilepsy and treated with various AEDs for 22 years. The possibility of cardiac arrhythmia was suspected after the patient presented to the emergency room and the electrocardiograph (ECG) monitor showed paroxysmal ventricular tachycardia during attacks. Atypical seizure like attacks with prodromal uncomfortable chest sensation and palpitation, triggered by auditory stimulation, and typical ventricular tachycardia monitored by ECG raised suspicion for LQT2, which was confirmed by exome sequencing and epileptic seizure was ruled out by 24-h EEG monitoring. Although the patient rejected implantation of an implantable cardioverter defibrillator, β blocker was given and the syncope only attacked 1-2 per year when there was an incentive during the 5 years follow up.ConclusionsOur case illustrates how long LQTS can masquerade convincingly as epilepsy and can be treated wrongly with AEDs, putting the patient at high risk of sudden cardiac death. Careful ECG evaluation is recommend for both patients with first seizure and those with refractory epilepsy

Population prevalence of myopia, glasses wear and free glasses acceptance among minority versus Han schoolchildren in China.

AimTo measure myopia, glasses wear and free glasses acceptance among minority and Han children in China.MethodsVisual acuity testing and questionnaires assessing ethnicity, study time, and parental and teacher factors were administered to a population-based sample of 9-12 year old minority and Han children in Yunnan and Guangdong, and their teachers and parents. Refraction was performed on children with uncorrected visual acuity (VA) Main outcome measuresBaseline myopia (uncorrected visual acuity = 1 eye and spherical equivalent refractive power ResultsAmong 10,037 children (mean age 10.6 years, 52.3% boys), 800 (8.0%) were myopic, 4.04% among Yunnan Minority children (OR 0.47, 95%CI 0.33, 0.67, PConclusionMyopia is more common among Han children and in wealthier Guangdong. Baseline differences in glasses wear could be explained by student, teacher and parental factors. Yunnan Minority children were more likely to accept free glasses

Baseline characteristics of 882 children with correctable refractive error by randomization groups.

<p>Values are numbers (percentages) unless stated otherwise.</p

Effect of randomization group and other potential determinants on purchase of glasses prior to endline (main study outcome) adjusting for cluster effects within school.

<p>Effect of randomization group and other potential determinants on purchase of glasses prior to endline (main study outcome) adjusting for cluster effects within school.</p

Enrolment and progression of children through the study.

<p>Enrolment and progression of children through the study.</p