Subscale Assessment of the NEI-RQL-42 Questionnaire with Rasch Analysis

This article is made available with the permission of the publisher, Association for Research in Vision and OphthalmologyPurpose.: To explore the psychometric properties of the 13 subscales of the NEI-RQL-42 questionnaire using Rasch analysis. Methods.: The NEI-RQL-42 is a refractive error-related quality of life (QoL) questionnaire with a complex design; its 13 subscales contain 42 questions, which include 16 different question/response category formats. It was completed by 100 laser refractive surgery subjects (spectacle and contact lens wearers) pre- and postoperatively. Rasch analysis was used to assess the use of response categories, success in measuring a single trait per subscale (unidimensionality), ability to discriminate persons (precision), and targeting of the questions to person QoL. Results.: Response categories were misused in four subscales (clarity of vision, diurnal fluctuation, symptoms, and appearance), which required repair before further analyses. Six subscales contained items that did not contribute to a single trait measurement (multidimensional). All subscales were found to be inadequate at distinguishing between persons (person separation >2.0), and targeting of the questions to QoL was poor for six subscales. Conclusions.: The NEI-RQL-42 questionnaire is deficient for all psychometric properties tested. Clinicians or researchers wishing to measure QoL related to refractive error correction should consider other questionnaires that have been rigorously developed and meet standard psychometric properties

A hybrid model of diffusion: international cooperation and domestic adoption of carbon capture and storage (CCS) within the People’s Republic of China (PRC)

As a suite of emerging technologies, carbon capture and storage (CCS) holds the potential to abate huge quantities of emissions from fossil fuel sources, making it appealing to industrialised nations seeking to mitigate climate change. Holding uncertainties around its technical viability and facing competition from low-carbon energy options, there is a need to enhance global learning and increase information sharing while removing hesitations through large-scale demonstrations. As international projects ran into difficulties, we saw a sharp increase in cooperation with China, hoping the country’s unique characteristics and circumstances might facilitate accelerated deployment. Despite showing enthusiasm, China demonstrated unclear appetite for the technologies, thus frustrating international partners. This research seeks to identify how motivated international entities can use international cooperation and communications to influence CCS development and decisions within China. It examines how the international CCS community is structured, how it functions, and how it communicates to influence CCS-related policy processes. It assesses the means and methods international parties use to cooperate, collaborate, and communicate to share information with Chinese parties about their experiences of CCS. Additionally, it seeks to better understand the motivations and behaviours of the Chinese parties engaging in CCS-related activities and what this tells us about the current and future domestic development of the technologies. Key to this investigation is to understand how international entities can employ various types of communication channels to diffuse CCS-related information that may influence Chinese decision making. This research has advanced Everett Rogers’ Diffusion of Innovations theory. Diffusionism has long been criticised as a form of elitist colonialism where linear channels are usually used to communicate pseudo-scientific arguments in order to influence a subject community. Even Rogers holds the view of a ‘centralised’ diffusion system, with expert sources using one-way communications to diffuse an innovation as a uniform package to relatively passive acceptors. Conversely, other scholars like Donald Schön, believe in ‘decentralised’ diffusion, where innovations emerge from numerous local sources and evolve as they are diffused across horizontal networks. This research challenges both theories by putting forward the proposition of a hybrid model of diffusion, which includes both centralised and decentralised elements. On the basis of a desktop scoping study of CCS-related projects and events, 840 Chinese stakeholders from Chinese government departments and agencies, state-owned enterprises and private industry, the Chinese Academy of Sciences and universities were identified. 16 case studies were conducted based on 71 quantitative data sets from an online Communications Survey, 40 qualitative semi-structured interviews in ten Chinese cities and secondary data. Understanding the structure, functions and communication influences of the International CCS Community, this thesis reveals parallel sources of CCS-related information, diffusion networks that create developed-developing country partnerships, and western strategies to influence Chinese decision-making. Moving beyond traditional CCS communications studies and investigating the emergence of new communication mechanisms, it lays out the sequencing of communication channels that have different effects on China’s CCS adoption. Through providing a comprehensive qualitative assessment of China’s appetite for CCS and the prospects for domestic adoption, it recognises the need to appeal to multiple Chinese stakeholder motivations and to bring them around a common goal. Responding to others, who have called for further analysis into how soft-governance can contribute to global diffusion frameworks and mechanisms for collaboration, I consider how alternative innovation-diffusion frameworks are employed to promote information sharing and learning by doing, acknowledging the flow of knowledge through social networks. Discovering that a hybrid model of innovation diffusion does exist, this incorporates linear and convergent communication channels. Diffusing an innovation as a uniform package that allows for reinvention, this provides opportunities for different parties to create and share information to reach a mutual understanding. As the decision making is shared between those at the top and those who may or may not wish to adopt, this holds potential to hasten the rate of adoption and accelerate technological deployment

Molecular insight into the association between cartilage regeneration and ear wound healing in genetic mouse models: Targeting new genes in regeneration

Tissue regeneration is a complex trait with few genetic models available. Mouse strains LG/J and MRL are exceptional healers. Using recombinant inbred strains from a large (LG/J, healer) and small (SM/J, nonhealer) intercross, we have previously shown a positive genetic correlation between ear wound healing, knee cartilage regeneration, and protection from osteoarthritis. We hypothesize that a common set of genes operates in tissue healing and articular cartilage regeneration. Taking advantage of archived histological sections from recombinant inbred strains, we analyzed expression of candidate genes through branched-chain DNA technology directly from tissue lysates. We determined broad-sense heritability of candidates, Pearson correlation of candidates with healing phenotypes, and Ward minimum variance cluster analysis for strains. A bioinformatic assessment of allelic polymorphisms within and near candidate genes was also performed. The expression of several candidates was significantly heritable among strains. Although several genes correlated with both ear wound healing and cartilage healing at a marginal level, the expression of four genes representing DNA repair (Xrcc2, Pcna) and Wnt signaling (Axin2, Wnt16) pathways was significantly positively correlated with both phenotypes. Cluster analysis accurately classified healers and nonhealers for seven out of eight strains based on gene expression. Specific sequence differences between LG/J and SM/J were identified as potential causal polymorphisms. Our study suggests a common genetic basis between tissue healing and osteoarthritis susceptibility. Mapping genetic variations causing differences in diverse healing responses in multiple tissues may reveal generic healing processes in pursuit of new therapeutic targets designed to induce or enhance regeneration and, potentially, protection from osteoarthritis

Vision in high-level football officials

YesOfficiating in football depends, at least to some extent, upon adequate visual function. However, there is no vision standard for football officiating and the nature of the relationship between officiating performance and level of vision is unknown. As a first step in characterising this relationship, we report on the clinically-measured vision and on the perceived level of vision in elite-level, Portuguese football officials. Seventy-one referees (R) and assistant referees (AR) participated in the study, representing 92% of the total population of elite level football officials in Portugal in the 2013/2014 season. Nine of the 22 Rs (40.9%) and ten of the 49 ARs (20.4%) were international-level. Information about visual history was also gathered. Perceived vision was assessed using the preference-values-assigned-to-global-visual-status (PVVS) and the Quality-of-Vision (QoV) questionnaire. Standard clinical vision measures (including visual acuity, contrast sensitivity and stereopsis) were gathered in a subset (n = 44, 62%) of the participants. Data were analysed according to the type (R/AR) and level (international/national) of official, and Bonferroni corrections were applied to reduce the risk of type I errors. Adopting criterion for statistical significance of p<0.01, PVVS scores did not differ between R and AR (p = 0.88), or between national- and international-level officials (p = 0.66). Similarly, QoV scores did not differ between R and AR in frequency (p = 0.50), severity (p = 0.71) or bothersomeness (p = 0.81) of symptoms, or between international-level vs national-level officials for frequency (p = 0.03) or bothersomeness (p = 0.07) of symptoms. However, international-level officials reported less severe symptoms than their national-level counterparts (p<0.01). Overall, 18.3% of officials had either never had an eye examination or if they had, it was more than 3 years previously. Regarding refractive correction, 4.2% had undergone refractive surgery and 23.9% wear contact lenses when officiating. Clinical vision measures in the football officials were similar to published normative values for young, adult populations and similar between R and AR. Clinically-measured vision did not differ according to officiating level. Visual acuity measured with and without a pinhole disc indicated that around one quarter of participants may be capable of better vision when officiating, as evidenced by better acuity (≥1 line of letters) using the pinhole. Amongst the clinical visual tests we used, we did not find evidence for above-average performance in elite-level football officials. Although the impact of uncorrected mild to moderate refractive error upon officiating performance is unknown, with a greater uptake of eye examinations, visual acuity may be improved in around a quarter of officials.Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UID/FIS/04650/2013

Biochemical and immuno-histochemical localization of type IIA procollagen in annulus fibrosus of mature bovine intervertebral disc

For next generation tissue-engineered constructs and regenerative medicine to succeed clinically, the basic biology and extracellular matrix composition of tissues that these repair techniques seek to restore have to be fully determined. Using the latest reagents coupled with tried and tested methodologies, we continue to uncover previously undetected structural proteins in mature intervertebral disc. In this study we show that the embryonic type IIA procollagen isoform (containing a cysteine-rich amino propeptide) was biochemically detectable in the annulus fibrosus of both calf and mature steer caudal intervertebral discs, but not in the nucleus pulposus where the type IIB isoform was predominantly localized. Specifically, the triple-helical type IIA procollagen isoform immunolocalized in the outer margins of the inner annulus fibrosus. Triple helical processed type II collagen exclusively localized within the inter-lamellae regions and with type IIA procollagen in the intra-lamellae regions. Mass spectrometry of the α1(II) collagen chains from the region where type IIA procollagen localized showed high 3-hydroxylation of Proline-944, a post-translational modification that is correlated with thin collagen fibrils as in the nucleus pulposus. The findings implicate small diameter fibrils of type IIA procollagen in select regions of the annulus fibrosus where it likely contributes to the organization of collagen bundles and structural properties within the type I-type II collagen transition zone

Epithelial Thickness Mapping in Keratoconic Corneas: Repeatability and Agreement Between CSO MS-39, Heidelberg Anterion, and Optovue Avanti OCT Devices

PURPOSE:To assess repeatability and agreement of corneal epithelial thickness mapping in eyes with keratoconus using three optical coherence tomography (OCT) devices featuring different technologies: spectral-domain (SD) OCT combined with Placido disk corneal topography (MS-39), swept-source OCT (Anterion), and SD-OCT (Avanti). METHODS:Three consecutive measurements were acquired with the three devices in 60 eyes with keratoconus. The mean epithelial thickness was calculated in the central 2-mm zone and in 2- to 5-mm and 5- to 7-mm diameter rings. The repeatability was calculated using pooled within-subject standard deviation (Sw). The agreement was assessed by paired t tests and Bland-Altman plots. RESULTS:The repeatability (Sw) of the epithelial thickness for the central 2-mm zone was 0.91, 0.71, and 0.93 μm for the MS-39, Anterion, and Avanti, respectively. All thicknesses with the MS-39 were greater than those of the Anterion and Avanti, with mean differences of 4.11 ± 1.34 μm (P < .001) and 0.52 ± 1.30 μm (P = .003), respectively. The 95% limits of agreement were 1.484 to 6.736 μm for the MS-39 and Anterion, −3.068 to 2.028 μm for the Avanti and MS-39, and 1.258 to 5.922 μm for for the Avanti and Anterion. CONCLUSIONS:Epithelial thickness mapping results were most repeatable with the Anterion, followed by the MS-39 and Avanti. The MS-39 gave the thickest values, followed by the Avanti and Anterion. The differences were significant, making the devices not interchangeable for epithelial thickness mapping in eyes with keratoconus

Morphological Criteria for Comparing Effects of X-Rays and Neon Ions on Mouse Small Intestine

Several techniques have been used to assess changes in different parts of mouse small intestine three days after a single dose of either 16.5 Gy X-rays or 11 Gy neon beam. The doses were chosen to be approximately equivalent in terms of their effect on the number of microcolonies present. In qualitative terms, villous damage was seen after both types of radiation exposure: collared crypts, similar to those seen in biopsies taken from patients suffering from coeliac disease, were conspicuous after neon irradiation. In semi quantitative terms the doses used, although estimated from previous work to give biologically equivalent damage, produced a greater drop in microcolony numbers after X-irradiation, This makes all the more important the fact that significantly greater changes were seen after neon irradiation - a greater drop was seen in the number of villous profiles and the number of goblet cells per villus. There was also greater breakdown in the integrity of the villous basement membrane. Different responses after the two types of irradiation are therefore seen in the cryptal and villous compartment. Progress is being made towards identifying and quantitating radiation induced changes in different populations of cells or tissues in the small intestine

Visual and refractive outcomes following implantation of a new trifocal intraocular lens.

BACKGROUND: Independence from all optical aids, and freedom from unwanted symptoms, following cataract and lens surgery remains the ultimate goal of both patient and surgeon. The development of trifocal IOL technology provides an ever-increasing range of options. The purpose of our study is to understand the predictability, safety and efficacy of a new trifocal intraocular lens (IOL) following cataract or refractive lens exchange (RLE) surgery. METHODS: This was a retrospective consecutive case series of patients undergoing cataract extraction or RLE followed by implantation of the Alcon IQ Panoptix IOL. Pre and postoperative refractive and visual parameters were recorded and evaluated. As the cohort followed a normal distribution, standard parametric tests were used. Paired t-test was used to compare the difference between target and postoperative refractive errors. The incidence of intraoperative and postoperative complications was also reported. RESULTS: The IOL was implanted in 66 eyes of 33 patients. Mean postoperative spherical equivalent (SE) refraction was -0.08 ± 0.25 dioptres (D). This was not significantly different from the target refraction (p = 0.841). Sixty-five percent of patients were within ± 0.25 D of the target SE refraction with 100% within ± 0.50 D of intended correction. Mean postoperative uncorrected distance visual acuity (UDVA) was 0.01 ± 0.10 LogMAR. All patients achieved an unaided distance acuity of 20/40 or better postoperatively. Binocularly, 100% saw 0.20 LogMAR or better at near without correction and 88.9% achieved this level for uncorrected intermediate visual acuity. No intraoperative complications were noted. Five patients complained of moderate haloes in the early postoperative period. CONCLUSION: The AcrySof IQ Panoptix IOL provides functional uncorrected visual acuity at distance, intermediate and near positions. Our results remain equivalent with existing trifocal IOL outcomes and provide surgeons with a further IOL alternative for the patient motivated to obtain true spectacle independence. Surgeons should consider individual reading and working requirements when counselling patients preoperatively to optimise postoperative patient satisfaction