Clinical performance of daily disposable soft contact lenses using sustained release technology

Purpose: Polyvinyl alcohol (PVA) is a successful tear film stabiliser and is widely used in comfort drops and some soft contact lens materials. A PVA-containing lens, nelfilcon A has been modified to include additional (non-functional) PVA in order to provide improved comfort. This study aims to examine the clinical performance of this nelfilcon A lens with AquaRelease™ (AquaRelease). Methods: Two contralateral, investigator masked, open label, subjective and objective evaluations were conducted. The first examined the effect of adding increased molecular weight PVA to nelfilcon A (n = 5), and the second compared this AquaRelease lens to ocufilcon B (n = 34). The principal measures were non-invasive break-up time (NIBUT) and subjective comfort, which were assessed at the beginning and end of a week of daily wear, and three times throughout 1 day at 8, 12 and 16 h. Results: All subjects successfully completed the daily wearing schedule of 16 h. On initial insertion, subjective comfort and NIBUT improved for AquaRelease than original nelfilcon A lenses (p < 0.05). Initial comfort was better for AquaRelease compared to ocufilcon B lenses (p = 0.01); however, NIBUT was not statistically different (11.7 ± 15.6 s versus 8.4 ± 6.8 s; p = 0.26). Subjective comfort decreased with time (p < 0.001), but there was no significant difference between AquaRelease and ocufilcon B lenses (p = 0.16). NIBUT was not significantly affected by time (p = 0.56) or between lenses (p = 0.33). At the end of a weeks' wear, subjective initial, end-of-day, overall comfort and vision were rated significantly better with AquaRelease than ocufilcon B (p < 0.01). Conclusions: Release of additional non-functionalised PVA from the nelfilcon A lenses appears to enhance comfortable contact lens wear. © 2006 British Contact Lens Association.

Statnote 39: The binomial distribution: comparing two proportions

Many populations consist of two classes only, e.g., alive or dead, present or absent, clean or dirty, infected or non-infected, and it is the proportion or percentage of observations that fall into one of these classes that is of interest to an investigator. An observation that falls into one of the two classes is considered a ‘success’ (S), and ‘p’ is defined as the proportion of observations falling into that class. If a random sample of size ‘n’ is obtained from a population, the probability of obtaining 0, 1, 2, 3, etc., successes is then given by the binomial distribution. The binomial distribution can be used as the basis of a number of statistical tests but is most useful when comparing two proportions. This statnote describes two such scenarios in which the binomial distribution is used to compare: (1) two proportions when the samples are independent and (2) two proportions when the samples are paired.

Discovering biomarkers for antidepressant response:protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort

Background: Major Depressive Disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Identification of clinical and biological markers ("biomarkers") of treatment response could personalize clinical decisions and lead to better outcomes. This paper describes the aims, design, and methods of a discovery study of biomarkers in antidepressant treatment response, conducted by the Canadian Biomarker Integration Network in Depression (CAN-BIND). The CAN-BIND research program investigates and identifies biomarkers that help to predict outcomes in patients with MDD treated with antidepressant medication. The primary objective of this initial study (known as CAN-BIND-1) is to identify individual and integrated neuroimaging, electrophysiological, molecular, and clinical predictors of response to sequential antidepressant monotherapy and adjunctive therapy in MDD. Methods: CAN-BIND-1 is a multisite initiative involving 6 academic health centres working collaboratively with other universities and research centres. In the 16-week protocol, patients with MDD are treated with a first-line antidepressant (escitalopram 10-20 mg/d) that, if clinically warranted after eight weeks, is augmented with an evidence-based, add-on medication (aripiprazole 2-10 mg/d). Comprehensive datasets are obtained using clinical rating scales; behavioural, dimensional, and functioning/quality of life measures; neurocognitive testing; genomic, genetic, and proteomic profiling from blood samples; combined structural and functional magnetic resonance imaging; and electroencephalography. De-identified data from all sites are aggregated within a secure neuroinformatics platform for data integration, management, storage, and analyses. Statistical analyses will include multivariate and machine-learning techniques to identify predictors, moderators, and mediators of treatment response. Discussion: From June 2013 to February 2015, a cohort of 134 participants (85 outpatients with MDD and 49 healthy participants) has been evaluated at baseline. The clinical characteristics of this cohort are similar to other studies of MDD. Recruitment at all sites is ongoing to a target sample of 290 participants. CAN-BIND will identify biomarkers of treatment response in MDD through extensive clinical, molecular, and imaging assessments, in order to improve treatment practice and clinical outcomes. It will also create an innovative, robust platform and database for future research. Trial registration: ClinicalTrials.gov identifier NCT01655706. Registered July 27, 2012.

Effects of service-learning on student attitudes toward academic engagement and civic responsibility

This empirical study explored the impact of service-learning participation on high school students' attitudes toward academic engagement and civic responsibility. This study focused whether a group of high school students who participated in a service-learning project had more positive attitudes toward academic engagement and civic responsibility than their high school peers who did not participate in a service learning project. ^ Data were collected from 67 volunteer students as participants in grades 9–12. A service-learning treatment group of 34 high school students was examined relative to a comparison group of 33 high school students with similar demographic and academic characteristics. The investigator used questionnaires, an oral history/service-learning project, and interviews with the teacher-coordinators of the project to collect the data. The two surveys, one investigating high school students' attitudes about academic engagement, the other investigating high school students' attitudes toward civic responsibility, were administered in a pre-treatment/post-treatment design. There were 90 days between the pre-treatment and post-treatment administrations. A factor analysis of the civic responsibility instrument and multivariate analysis of gain scores were used to compare the means of the total aggregate scores of the treatment and comparison groups. Factor analysis was performed on the academic engagement instrument but it was determined that only the total scores could be used in subsequent analyses. Results were used to determine the efficacy of service-learning as interpreted in student attitudes toward academic engagement and student attitudes toward civic responsibility. ^ The study found no significant difference between the academic engagement and the civic responsibility attitudes of a high school service-learning project group and a high school comparison group with comparable school and similar demographic characteristics. One of the implications for educational practice and policy from the study results is a need to design and implement more powerful studies, studies implemented at many sites rather than just at two sites that were the basis of this study, and studies that investigate the research questions over longer time periods. Although it was not a focus of the study, the investigator concluded that service learning projects such as this might be more effective if they were better aligned with Dewey's principles. ^

The effects of self-monitoring on homework completion and accuracy rates of students with disabilities in an inclusive general education classroom

This study investigated the effects of self-monitoring on the homework completion and accuracy rates of four, fourth-grade students with disabilities in an inclusive general education classroom. A multiple baseline across subjects design was utilized to examine four dependent variables: completion of spelling homework, accuracy of spelling homework, completion of math homework, accuracy of math homework. Data were collected and analyzed during baseline, three phases of intervention, and maintenance. ^ Throughout baseline and all phases, participants followed typical classroom procedures, brought their homework to school each day and gave it to the general education teacher. During Phase I of the intervention, participants self-monitored with a daily sheet at home and on the computer at school in the morning using KidTools (Fitzgerald & Koury, 2003); a student friendly, self-monitoring program. They also participated in brief daily conferences to review their self-monitoring sheets with the investigator, their special education teacher. Phase II followed the same steps except conferencing was reduced to two days a week, which were randomly selected by the researcher and Phase III conferencing was one random day a week. Maintenance data were taken over a two-to-three week period subsequent to the end of the intervention. ^ Results of this study demonstrated self-monitoring substantially improved spelling and math homework completion and accuracy rates of students with disabilities in an inclusive, general education classroom. On average, completion and accuracy rates were highest over baseline in Phase III. Self-monitoring led to higher percentages of completion and accuracy during each phase of the intervention compared to baseline, group percentages also rose slightly during maintenance. Therefore, results suggest self-monitoring leads to short-term maintenance in spelling and math homework completion and accuracy. ^ This study adds to the existing literature by investigating the effects of self-monitoring of homework for students with disabilities included in general education classrooms. Future research should consider selecting participants with other demographic characteristics, using peers for conferencing instead of the teacher, and the use of self-monitoring with other academic subjects (e.g., science, history). Additionally, future research could investigate the effects of each of the two self-monitoring components used alone, with or without the conferencing.^

Non-Contact Femoral Fracture in a Collegiate Football Player

We present a unique athletic injury witnessed by the primary investigator who was compelled to convey the details of the incident to other Certified Athletic Trainers. This case is presented to increase awareness and ensure proper recognition, evaluation, and treatment of this potentially life-threatening injury.

The Acute Effects of Whole Body Vibration on Muscular Power and Agility

Context: While research suggests whole body vibration (WBV) positively affects measures of neuromuscular performance in athletes, researchers have yet to address appropriate and effective vibration protocols. Objective: To identify the acute effects of continuous and intermittent WBV on muscular power and agility in recreationally active females. Design: We used a randomized 3-period cross-over design to observe the effects of 3 vibration protocols on muscular power and agility. Setting: Sports Science and Medicine Research Laboratory at Florida International University. Patients or Other Participants: Eleven recreationally active female volunteers (age=24.4±5.7y; ht=166.0±10.3cm; mass=59.7±14.3kg). Interventions: Each session, subjects stood on the Galileo WBV platform (Orthometrix, White Plains, NY) and received one of three randomly assigned vibration protocols. Our independent variable was vibration length (continuous, intermittent, or no vibration). Main Outcome Measures: An investigator blinded to the vibration protocol measured muscular power and agility. We measured muscular power with heights of squat and countermovement jumps. We measured agility with the Illinois Agility Test. Results: Continuous WBV significantly increased SJ height from 97.9±7.6cm to 98.5±7.5cm (P=0.019, β=0.71, η2 =0.07) but not CMJ height [99.1±7.4cm pretest and 99.4±7.4cm posttest (P=0.167, β=0.27)] or agility [19.2±2.1s pretest and 19.0±2.1s posttest (P=0.232, β=0.21)]. Intermittent WBV significantly enhanced SJ height from 97.6±7.7cm to 98.5±7.7cm (P=0.017, β=0.71, η2 =0.11) and agility 19.4±2.2s to 19.0±2.1s (P=0.001, β=0.98, η2=0.16), but did not effect CMJ height [98.7±7.7cm pretest and 99.3±7.3cm posttest (P=0.058, β=0.49)]. Conclusion: Continuous WBV increased squat jump height, while intermittent vibration enhanced agility and squat jump height. Future research should continue investigating the effect of various vibration protocols on athletic performance.

Reliability of the Clinical Application of a Mechanical Inclinometer in Measuring Glenohumeral Motion

Objective: Establish intra- and inter-examiner reliability of glenohumeral range of motion (ROM) measures taken by a single-clinician using a mechanical inclinometer. Design: A single-session, repeated-measure, randomized, counterbalanced design. Setting: Athletic Training laboratory. Participants: Ten college-aged volunteers (9 right-hand dominant; 4 males, 6 females; age=23.2±2.4y, mass=73±16kg, height=170±8cm) without shoulder or neck injuries within one year. Interventions: Two Certified Athletic Trainers separately assessed passive glenohumeral (GH) internal (IR) and external (ER) rotation bilaterally. Each clinician secured the inclinometer to each subject’s distal forearm using elastic straps. Clinicians followed standard procedures for assessing ROM, with the participants supine on a standard treatment table with 90° of elbow flexion. A second investigator recorded the angle. Clinicians measured all shoulders once to assess inter-clinician reliability and eight shoulders twice to assess intra-clinician reliability. We used SPSS 14.0 (SPSS Inc., Chicago, IL) to calculate standard error of measure (SEM) and Intraclass Correlation Coefficients (ICC) to evaluate intra- and inter-clinician reliability. Main Outcome Measures: Dependent variables were degrees of IR, ER, glenohumeral internal rotation deficit (GIRD) and total arc of rotation. We calculated GIRD as the bilateral difference in IR (nondominant–dominant) and total arc for each shoulder (IR+ER). Results: Intra-clinician reliability for each examiner was excellent (ICC[1,1] range=0.90-0.96; SEM=2.2°-2.5°) for all measures. Examiners displayed excellent inter-clinician reliability (ICC[2,1] range=0.79-0.97; SEM=1.7°-3.0°) for all measures except nondominant IR which had good reliability(0.72). Conclusions: Results suggest that clinicians can achieve reliable measures of GH rotation and GIRD using a single-clinician technique and an inexpensive, readily available mechanical inclinometer.

Achievement motivation attributes of international students attending a *postsecondary institution

The purpose of this study was to identify and compare the causal attributes of achievement motivation for academic success possessed by international students to those causal attributes of achievement motivation by other legal immigrant student groups attending a postsecondary institution. In this study, F-1 international students have obtained permission from the federal Department of Immigration and Naturalization Services to attend Miami-Dade Community College in Miami, Florida. There were two additional groups of students selected to participate in this study: Permanent Resident students and Others comprised of asylees, refugees and paroles, which are specific categories of legal immigrant students.^ From the observations of the investigator, international students were more successful at the institution as compared to the other two student groups as measured by such variables as Grade Point Average, Number of Credits Earned and Honors Day awards. By identifying these attributes of achievement motivation, additional curricula, support services and activities can be developed to meet the needs of these highly motivated students.^ Incorporating the theories of McClelland and Weiner in the theoretical framework of the study, both quantitative and qualitative data were collected from 150 subjects using the Measurement of Achievement Motivation Questionnaire and the Guided Biography Interview as data collection instruments. Statistical analyses on the data collected from the three groups of foreign born students at the institution indicated differences in these identified attributes and their effects on academic success.^ Results indicated that F-1 international students at Miami-Dade Community College were highly motivated to achieve, possessed different causal attributes of achievement motivation and displayed their need for achievement in different activities and in different ways as compared to the Permanent Resident and Other student groups. Further investigation on the importance of residency status as an influencing factor of achievement motivation is suggested. ^

Paleoenvironmental change in wetlands of the Florida Everglades, southeast USA

In this special issue, we report on efforts to reconstruct paleoclimate/paleolimnology of the Florida Everglades, applying a wide range of techniques including sedimentological, micropaleontological and biogeochemical approaches. The papers included here describe results obtained by studies conducted in Everglades National Park and the greater South Florida Everglades by Florida Coastal Everglades Long Term Ecological Research Program (FCE LTER) collaborators. This multi-investigator project contrasts nutrient dynamics in two inland-to-marine transects aligned along separate drainages in southern Florida that differ in their susceptibility to coastal pressures and in volume of freshwater delivery. This effort focuses on the paleoecological aspects of FCE LTER research that address scales of ecosystem transformations driven by climate variability and change and human activities. The central question addressed by this body of work is “How is the shape of the freshwater-to-marine gradient in the Florida coastal Everglades controlled by changes in climate, freshwater inflow (i.e. through human activities), and disturbance (i.e. sea level rise, hurricanes, fire)?”

The effects of resilience and social influences on preventing repeat adolescent pregnancies in parenting adolescent mothers

Every year, 16 million women aged 15 to 19 years give birth globally. Adolescent births account for 11% of all births globally and 23% of the overall burden of disability and diseases due to pregnancy and childbirth. In the United States, 750,000 adolescents (15-19 years) become pregnant each year, making the United States the developed country with the highest rates of adolescent pregnancy. The economic burden of adolescent pregnancy in the U. S. is $7-15 billion per year. Adolescent pregnancy brings risks associated with pregnancy induced hypertension, preterm infants, maternal and neonatal mortality. Social factors include poverty, low educational levels, alcohol, and drug use. Between 30-50% of adolescent mothers who have a first birth before age 18 years will have a second child within 12 to 24 months. Subsequent adolescent pregnancies compound fetal and maternal risks. Many vulnerable adolescent mothers succumb to external pressures and have a repeat adolescent pregnancy while others are able to overcome the challenges of an adolescent pregnancy and prevent a repeat adolescent pregnancy. This cross sectional survey designed study investigated the effects of resilience and social influences on contraceptive use or abstinence by Black and Hispanic adolescent parenting mothers to prevent a repeat adolescent pregnancy. 140 adolescent mothers were recruited from three postpartum units of a tertiary hospital system in Miami, Florida. The Wagnild and Young Resilience Scale and the Adolescent Social Influence Scale were used to measure resilience and social influences, respectively. Demographic data, length of labor, plan for contraceptive use or abstinence were measured by an investigator developed instrument. Point biserial correlation showed a significant positive correlation between Black adolescent mothers' resilience and contraceptive use (r =.366, p2(11, N=133) = 27.08, p =.004. (OR = .28). These results indicate a need for interventional strategies to maximize resilience in parenting adolescents to prevent a repeat adolescent pregnancy.

The association of depression and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes

Background: Diabetes and diabetes-related complications are major causes of morbidity and mortality in the United States. Depressive symptoms and perceived stress have been identified as possible risk factors for beta cell dysfunction and diabetes. The purpose of this study was to assess associations between depression symptoms and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes. Participants and Methods: Informed consent and data were available for 462 participants (231 African Americans and 231 Haitian Americans) for this cross-sectional study. A demographic questionnaire developed by the Primary Investigator was used to collect information regarding age, gender, smoking, and ethnicity. Diabetes status was determined by self-report and confirmed by fasting blood glucose. Anthropometrics (weight, and height and waist circumference) and vital signs (blood pressure) were taken. Blood samples were drawn after 8 10 hours over-night fasting to measure lipid panel, fasting plasma glucose and serum insulin concentrations. The homeostatic model assessment, version 2 (HOMA2) computer model was used to calculate beta cell function. Depression was assessed using the Beck Depression Inventory-II (BDI-II) and stress levels were assessed using the Perceived Stress Scale (PSS). Results: Moderate to severe depressive symptoms were more likely for persons with diabetes (p = 0.030). There were no differences in perceived stress between ethnicity and diabetes status (p = 0.283). General linear models for participants with and without type 2 diabetes using beta cell function as the dependent variable showed no association with depressive symptoms and perceived stress; however, Haitian Americans had significantly lower beta cell function than African Americans both with and without diabetes and adjusting for age, gender, waist circumference and smoking. Further research is needed to compare these risk factors in other race/ethnic groups.

An interactive environmental site assessment audit for Wagner Creek river basin clean up project

The primary purpose of this thesis was to design and create an Interactive Audit to conduct Environmental Site Assessments according to American Society of Testing Material's (ASTM) Phase I Standards at the Wagner Creek study area. ArcPad and ArcIMS are the major software that were used to create the model and ArcGIS Desktop was used for data analysis and to export shapefile symbology to ArcPad. Geographic Information Systems (GIS) is an effective tool to deploy these purposes. This technology was utilized to carry out data collection, data analysis and to display data interactively on the Internet. Electronic forms, customized for mobile devices were used to survey sites. This is an easy and fast way to collect and modify field data. New data such as land use, recognized environmental conditions, and underground storage tanks can be added into existing datasets. An updated map is then generated and uploaded to the Internet using ArcIMS technology. The field investigator has the option to generate and view the Inspection Form at the end of his survey on site, or print a hardcopy at base. The mobile device also automatically generates preliminary editable Executive Reports for any inspected site.

Calcium carbonate global LGM Burial rate data

Global databases of calcium carbonate concentrations and mass accumulation rates in Holocene and last glacial maximum sediments were used to estimate the deep-sea sedimentary calcium carbonate burial rate during these two time intervals. Sparse calcite mass accumulation rate data were extrapolated across regions of varying calcium carbonate concentration using a gridded map of calcium carbonate concentrations and the assumption that accumulation of noncarbonate material is uncorrelated with calcite concentration within some geographical region. Mean noncarbonate accumulation rates were estimated within each of nine regions, determined by the distribution and nature of the accumulation rate data. For core-top sediments the regions of reasonable data coverage encompass 67% of the high-calcite (>75%) sediments globally, and within these regions we estimate an accumulation rate of 55.9 ± 3.6 x 10**11 mol/yr. The same regions cover 48% of glacial high-CaCO3 sediments (the smaller fraction is due to a shift of calcite deposition to the poorly sampled South Pacific) and total 44.1 ± 6.0 x 10**11 mol/yr. Projecting both estimates to 100 % coverage yields accumulation estimates of 8.3 x 10**12 mol/yr today and 9.2 x 10**12 mol/yr during glacial time. This is little better than a guess given the incomplete data coverage, but it suggests that glacial deep sea calcite burial rate was probably not considerably faster than today in spite of a presumed decrease in shallow water burial during glacial time.

Avaliação do planejamento de prótese parcial removível em modelos recebidos por laboratórios de João Pessoa-PB

Objective: To evaluate the planning and quality of plaster models for fabricati on of removable parti al dentures received from three commercial prosthodonti c laboratories located in the city of João Pessoa, PB, Brazil, which perform the casting procedures in their facilities. Methods: Forty 40 plaster models were photographed per laboratory, totalizing 120 models. The evaluation was performed using two questi onnaires, one designed for the dental prosthesis technicians, and another applied by the investigator for the visual evaluati on of the models. Data were analyzed using the SPSS soft ware version 13.0. Results: Ninety-two (76.7%) models did not present planning. In addition, no model presented references of insertion plane or guide pins. Calculati on of the mouth preparati on index (MPI) to evaluate the distribution of the oclusal and cingulum abutments or rests showed that 86 (71.7%) models were classifi ed as poor, 23 (19.2%) models as good and only 11 (9,.2%) models as acceptable. Defects were found in 102 (85%) models. Conclusion: The prosthodontists are not preparing the mouth of their pati ents, neglecti ng the planning of removable partial dentures, and passing this responsibility to the dental prosthesis technicians. In addition, the quality of the models sent to the laboratories was unsatisfactory.