Quality of life and visual function in Nigeria: findings from the National Survey of Blindness and Visual Impairment

Aims To assess associations of visual function (VF) and quality of life (QOL) by visual acuity (VA), causes of blindness and types of cataract procedures in Nigeria. Methods Multi-stage stratified cluster random sampling was used to identify a nationally representative sample of persons aged >= 40 years. VF/QOL questionnaires were administered to participants with VA = 6/12. Results VF/QOL questionnaires were administered to 2076 participants. Spearman's rank correlation showed a strong correlation between decreasing VA and VF/QOL scores (p< 0.0001) with greatest impact on social (p< 0.0001) and mobility-related activities (p< 0.0001). People who were blind due to glaucoma had lower VF and QOL scores than those who were blind due to cataract. Mean VF and QOL scores were lower after couching compared with conventional cataract surgery (mean VF score=51.0 vs 63.0 and mean QOL score=71.3 vs 79.3). Finally, VF and QOL scores were lower among populations with specific characteristics. Conclusions Populations with the following characteristics should be targeted to improve VF and QOL: people who are blind, older people, women, manual labourers, people living in rural areas, those living in the northern geopolitical zones, those practising Islamic and Traditionalism faith, those not currently married and those who have undergone couching

Observing Brownian motion in vibration-fluidized granular matter

At the beginning of last century, Gerlach and Lehrer observed the rotational Brownian motion of a very fine wire immersed in an equilibrium environment, a gas. This simple experiment eventually permitted the full development of one of the most important ideas of equilibrium statistical mechanics: the very complicated many-particle problem of a large number of molecules colliding with the wire, can be represented by two macroscopic parameters only, namely viscosity and the temperature. Can this idea, mathematically developed in the so-called Langevin model and the fluctuation-dissipation theorem be used to describe systems that are far from equilibrium? Here we address the question and reproduce the Gerlach and Lehrer experiment in an archetype non-equilibrium system, by immersing a sensitive torsion oscillator in a granular system of millimetre-size grains, fluidized by strong external vibrations. The vibro-fluidized granular medium is a driven environment, with continuous injection and dissipation of energy, and the immersed oscillator can be seen as analogous to an elastically bound Brownian particle. We show, by measuring the noise and the susceptibility, that the experiment can be treated, in first approximation, with the same formalism as in the equilibrium case, giving experimental access to a ''granular viscosity'' and an ''effective temperature'', however anisotropic and inhomogeneous, and yielding the surprising result that the vibro-fluidized granular matter behaves as a ''thermal'' bath satisfying a fluctuation-dissipation relation

The UK Transport Carbon Model : An integrated life cycle approach to explore low carbon futures

Peer reviewedPostprin

Application of a central design composed of surface of response for the determination of the flatness in the steel sheets of a Colombian steel

In this paper the results of research are shown in which the response surface was applied with central composite design for estimating the values of flatness as shown and accepted by the quality department and production company of the Caribbean region, taking into account factors such as voltage control in the winding sheet and the coefficient of friction. Initially, a first-order model was proposed to estimate the variance of the error and consider a quantitative model that takes into account the effects of combination. The method of steepest descent is used to sequentially move the descent path, i.e., in the direction of the minimum response decrement, until a new interval near optimal experimentation. Subsequently, a model of higher order was developed using a central composite design with center points and stars, taking into account control other variables additional response flatness, such as the roughness and hardness of the sheets in a range of flexible and acceptable tolerances for the company through a canonical model, and that will be the focus of future research

Modelling transport energy demand : a socio-technical approach

Peer reviewedPostprin

International students and further education colleges in England: The context, policy tensions, and some aspects of practice

This chapter sets out the context of publicly funded further education colleges in England, outlining the position and development of these complex institutions within the broader educational structure. This is followed by discussion of some tensions and contradictions which arise from government policies partially driven by anxieties derived from debates surrounding levels of immigration together with recognition of the imperatives and opportunities arising from globalisation. The benefits of the internationalisation of education have been expounded whilst simultaneously enforcing visa regulations which impede the efforts of colleges to make inroads in the international student market. In particular, disparities between the treatment of the further and higher education sectors are highlighted. The paper also provides an account of practices which have emerged in a single FE college in England over a decade of working with international students following an access to HE course. The chapter indicates some of the many benefits which have been brought to FE by international students as well as the ways in which a college has developed its practices in response to their needs

Using stem cells in skin regeneration: possibilities and reality

Tissue-engineered skin has a long history of clinical applications, yet current treatments are not capable of completely regenerating normal, uninjured skin. Nonetheless, the field has experienced a tremendous development in the past 10 years, encountering the summit of tissue engineering (TE) and the arising of stem cell research. Since then, unique features of these cells such as self-renewal capacity, multi-lineage differentiation potential, and wound healing properties have been highlighted. However, a realistic perspective of their outcome in skin regenerative medicine applications is still absent. This review intends to discuss the directions that adult and embryonic stem cells (ESCs) can take, strengthening the skin regeneration field. Distinctively, a critical overview of stem cellsâ differentiation potential onto skin main lineages, along with a highlight of their participation in wound healing mechanisms, is herein provided. We aim to compile and review significant work to allow a better understanding of the best skin TE approaches, enabling the embodiment of the materialization of a new era in skin regeneration to come, with a conscious overview of the current limitations

Treating asthma with omega-3 fatty acids: where is the evidence? A systematic review

BACKGROUND: Considerable interest exists in the potential therapeutic value of dietary supplementation with the omega-3 fatty acids. Given the interplay between pro-inflammatory omega-6 fatty acids, and the less pro-inflammatory omega-3 fatty acids, it has been thought that the latter could play a key role in treating or preventing asthma. The purpose was to systematically review the scientific-medical literature in order to identify, appraise, and synthesize the evidence for possible treatment effects of omega-3 fatty acids in asthma. METHODS: Medline, Premedline, Embase, Cochrane Central Register of Controlled Trials, CAB Health, and, Dissertation Abstracts were searched to April 2003. We included randomized controlled trials (RCT's) of subjects of any age that used any foods or extracts containing omega-3 fatty acids as treatment or prevention for asthma. Data included all asthma related outcomes, potential covariates, characteristics of the study, design, population, intervention/exposure, comparators, and co interventions. RESULTS: Ten RCT's were found pertinent to the present report. CONCLUSION: Given the largely inconsistent picture within and across respiratory outcomes, it is impossible to determine whether or not omega-3 fatty acids are an efficacious adjuvant or monotherapy for children or adults. Based on this systematic review we recommend a large randomized controlled study of the effects of high-dose encapsulated omega-3 fatty acids on ventilatory and inflammatory measures of asthma controlling diet and other asthma risk factors. This review was limited because Meta-analysis was considered inappropriate due to missing data; poorly or heterogeneously defined populations, interventions, intervention-comparator combinations, and outcomes. In addition, small sample sizes made it impossible to meaningfully assess the impact on clinical outcomes of co-variables. Last, few significant effects were found

Validation of a 22-Gene Genomic Classifier in Patients With Recurrent Prostate Cancer An Ancillary Study of the NRG/RTOG 9601 Randomized Clinical Trial

IMPORTANCE: Decipher (Decipher Biosciences Inc) is a genomic classifier (GC) developed to estimate the risk of distant metastasis (DM) after radical prostatectomy (RP) in patients with prostate cancer. OBJECTIVE: To validate the GC in the context of a randomized phase 3 trial. DESIGN, SETTING, AND PARTICIPANTS: This ancillary study used RP specimens from the phase 3 placebo-controlled NRG/RTOG 9601 randomized clinical trial conducted from March 1998 to March 2003. The specimens were centrally reviewed, and RNA was extracted from the highest-grade tumor available in 2019 with a median follow-up of 13 years. Clinical-grade whole transcriptomes from samples passing quality control were assigned GC scores (scale, 0-1). A National Clinical Trials Network–approved prespecified statistical plan included the primary objective of validating the independent prognostic ability of GC for DM, with secondary end points of prostate cancer–specific mortality (PCSM) and overall survival (OS). Data were analyzed from September 2019 to December 2019. INTERVENTIONS: Salvage radiotherapy (sRT) with or without 2 years of bicalutamide. MAIN OUTCOMES AND MEASURES: The preplanned primary end point of this study was the independent association of the GC with the development of DM. RESULTS: In this ancillary study of specimens from a phase 3 randomized clinical trial, GC scores were generated from 486 of 760 randomized patients with a median follow-up of 13 years; samples from a total of 352 men (median [interquartile range] age, 64.5 (60-70) years; 314 White [89.2%] participants) passed microarray quality control and comprised the final cohort for analysis. On multivariable analysis, the GC (continuous variable, per 0.1 unit) was independently associated with DM (hazard ratio [HR], 1.17; 95% CI, 1.05-1.32; P = .006), PCSM (HR, 1.39; 95% CI, 1.20-1.63; P < .001), and OS (HR, 1.17; 95% CI, 1.06-1.29; P = .002) after adjusting for age, race/ethnicity, Gleason score, T stage, margin status, entry prostate-specific antigen, and treatment arm. Although the original planned analysis was not powered to detect a treatment effect interaction by GC score, the estimated absolute effect of bicalutamide on 12-year OS was less when comparing patients with lower vs higher GC scores (2.4% vs 8.9%), which was further demonstrated in men receiving early sRT at a prostate-specific antigen level lower than 0.7 ng/mL (−7.8% vs 4.6%). CONCLUSIONS AND RELEVANCE: This ancillary validation study of the Decipher GC in a randomized trial cohort demonstrated association of the GC with DM, PCSM, and OS independent of standard clinicopathologic variables. These results suggest that not all men with biochemically recurrent prostate cancer after surgery benefit equally from the addition of hormone therapy to sRT. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT0000287