The association between refractive cutoffs for spectacle provision and visual improvement among school-aged children in South Africa.

OBJECTIVES: To evaluate different refractive cutoffs for spectacle provision with regards to their impact on visual improvement and spectacle compliance. DESIGN: Prospective study of visual improvement and spectacle compliance. PARTICIPANTS: South African school children aged 6-19 years receiving free spectacles in a programme supported by Helen Keller International. METHODS: Refractive error, age, gender, urban versus rural residence, presenting and best-corrected vision were recorded for participants. Spectacle wear was observed directly at an unannounced follow-up examination 4-11 months after initial provision of spectacles. The association between five proposed refractive cutoff protocols and visual improvement and spectacle compliance were examined in separate multivariate models. MAIN OUTCOMES: Refractive cutoffs for spectacle distribution which would effectively identify children with improved vision, and those more likely to comply with spectacle wear. RESULTS: Among 8520 children screened, 810 (9.5%) received spectacles, of whom 636 (79%) were aged 10-14 years, 530 (65%) were girls, 324 (40%) had vision improvement > or = 3 lines, and 483 (60%) were examined 6.4+/-1.5 (range 4.6 to 10.9) months after spectacle dispensing. Among examined children, 149 (31%) were wearing or carrying their glasses. Children meeting cutoffs < or = -0.75 D of myopia, > or = +1.00 D of hyperopia and > or = +0.75 D of astigmatism had significantly greater improvement in vision than children failing to meet these criteria, when adjusting for age, gender and urban versus rural residence. None of the proposed refractive protocols discriminated between children wearing and not wearing spectacles. Presenting vision and improvement in vision were unassociated with subsequent spectacle wear, but girls (p < or = 0.0006 for all models) were more likely to be wearing glasses than were boys. CONCLUSIONS: To the best of our knowledge, this is the first suggested refractive cutoff for glasses dispensing validated with respect to key programme outcomes. The lack of association between spectacle retention and either refractive error or vision may have been due to the relatively modest degree of refractive error in this African population.

Performance of body fat and body mass index cutoffs in elevated blood pressure screening among male children and adolescents

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Nutrition screening and risk factors prior to chemotherapy in cancer patients 65 years and older

Background The largest proportion of cancer patients are aged 65 years and over. Increasing age is also associated with nutritional risk and multi-morbidities—factors which complicate the cancer treatment decision-making process in older patients. Objectives To determine whether malnutrition risk and Body Mass Index (BMI) are associated with key oncogeriatric variables as potential predictors of chemotherapy outcomes in geriatric oncology patients with solid tumours. Methods In this longitudinal study, geriatric oncology patients (aged ≥65 years) received a Comprehensive Geriatric Assessment (CGA) for baseline data collection prior to the commencement of chemotherapy treatment. Malnutrition risk was assessed using the Malnutrition Screening Tool (MST) and BMI was calculated using anthropometric data. Nutritional risk was compared with other variables collected as part of standard CGA. Associations were determined by chi-square tests and correlations. Results Over half of the 175 geriatric oncology patients were at risk of malnutrition (53.1%) according to MST. BMI ranged from 15.5–50.9kg/m2, with 35.4% of the cohort overweight when compared to geriatric cutoffs. Malnutrition risk was more prevalent in those who were underweight (70%) although many overweight participants presented as at risk (34%). Malnutrition risk was associated with a diagnosis of colorectal or lung cancer (p=0.001), dependence in activities of daily living (p=0.015) and impaired cognition (p=0.049). Malnutrition risk was positively associated with vulnerability to intensive cancer therapy (rho=0.16, p=0.038). Larger BMI was associated with a greater number of multi-morbidities (rho =.27, p=0.001. Conclusions Malnutrition risk is prevalent among geriatric patients undergoing chemotherapy, is more common in colorectal and lung cancer diagnoses, is associated with impaired functionality and cognition and negatively influences ability to complete planned intensive chemotherapy.

A comparative analysis of risk stratification tools for emergency department patients with chest pain

Background: Appropriate disposition of emergency department (ED) patients with chest pain is dependent on clinical evaluation of risk. A number of chest pain risk stratification tools have been proposed. The aim of this study was to compare the predictive performance for major adverse cardiac events (MACE) using risk assessment tools from the National Heart Foundation of Australia (HFA), the Goldman risk score and the Thrombolysis in Myocardial Infarction risk score (TIMI RS). Methods: This prospective observational study evaluated ED patients aged ≥30 years with non-traumatic chest pain for which no definitive non-ischemic cause was found. Data collected included demographic and clinical information, investigation findings and occurrence of MACE by 30 days. The outcome of interest was the comparative predictive performance of the risk tools for MACE at 30 days, as analyzed by receiver operator curves (ROC). Results: Two hundred eighty-one patients were studied; the rate of MACE was 14.1%. Area under the curve (AUC) of the HFA, TIMI RS and Goldman tools for the endpoint of MACE was 0.54, 0.71 and 0.67, respectively, with the difference between the tools in predictive ability for MACE being highly significant [chi2 (3) = 67.21, N = 276, p < 0.0001]. Conclusion: The TIMI RS and Goldman tools performed better than the HFA in this undifferentiated ED chest pain population, but selection of cutoffs balancing sensitivity and specificity was problematic. There is an urgent need for validated risk stratification tools specific for the ED chest pain population.

Calibration and evaluation of an objective measure of physical activity in pre-school children

Background The purposes of this study were 1) to establish accelerometer count cutoffs to categorize activity intensity of 3 to 5-y old-children and 2) to evaluate the accelerometer as a measure of children’s physical activity in preschool settings. Methods While wearing an ActiGraph accelerometer, 16 preschool children performed five, 3-min structured activities. Receiver Operating Characteristic (ROC) curve analyses identified count cutoffs for four physical activity intensities. In 9 preschools, 281 children wore an ActiGraph during observations performed by three trained observers (interobserver reli-ability = 0.91 to 0.98). Results Separate count cutoffs for 3, 4, and 5-y olds were established. Sensitivity and specificity for the count cutoffs ranged from 86.7% to 100.0% and 66.7% to 100.0%, respectively. ActiGraph counts/15 s were different among all activities (P < 0.05) except the two sitting activities. Correlations between observed and ActiGraph intensity categorizations at the preschools ranged from 0.46 to 0.70 (P < 0.001). Conclusions The ActiGraph count cutoffs established and validated in this study can be used to objectively categorize the time that preschool-age children spend in different physical activity intensity levels.

Using Lifespan developmental theory and methods as a viable alternative to the study of generational differences at work

I agree with Costanza and Finkelstein (2015) that it is futile to further invest in the study of generational differences in the work context due to a lack of appropriate theory and methods. The key problem with the generations concept is that splitting continuous variables such as age or time into a few discrete units involves arbitrary cutoffs and atheoretical groupings of individuals (e.g., stating that all people born between the early 1960s and early 1980s belong to Generation X). As noted by methodologists, this procedure leads to a loss of information about individuals and reduced statistical power (MacCallum, Zhang, Preacher, & Rucker, 2002). Due to these conceptual and methodological limitations, I regard it as very difficult if not impossible to develop a “comprehensive theory of generations” (Costanza & Finkelstein, p. 20) and to rigorously examine generational differences at work in empirical studies.

A network representation of protein structures: Implications for protein stability

This study views each protein structure as a network of noncovalent connections between amino acid side chains. Each amino acid in a protein structure is a node, and the strength of the noncovalent interactions between two amino acids is evaluated for edge determination. The protein structure graphs (PSGs) for 232 proteins have been constructed as a function of the cutoff of the amino acid interaction strength at a few carefully chosen values. Analysis of such PSGs constructed on the basis of edge weights has shown the following: 1), The PSGs exhibit a complex topological network behavior, which is dependent on the interaction cutoff chosen for PSG construction. 2), A transition is observed at a critical interaction cutoff, in all the proteins, as monitored by the size of the largest cluster (giant component) in the graph. Amazingly, this transition occurs within a narrow range of interaction cutoff for all the proteins, irrespective of the size or the fold topology. And 3), the amino acid preferences to be highly connected (hub frequency) have been evaluated as a function of the interaction cutoff. We observe that the aromatic residues along with arginine, histidine, and methionine act as strong hubs at high interaction cutoffs, whereas the hydrophobic leucine and isoleucine residues get added to these hubs at low interaction cutoffs, forming weak hubs. The hubs identified are found to play a role in bringing together different secondary structural elements in the tertiary structure of the proteins. They are also found to contribute to the additional stability of the thermophilic proteins when compared to their mesophilic counterparts and hence could be crucial for the folding and stability of the unique three-dimensional structure of proteins. Based on these results, we also predict a few residues in the thermophilic and mesophilic proteins that can be mutated to alter their thermal stability.

Optimal pulse spacing for dynamical decoupling in the presence of a purely dephasing spin bath

Maintaining quantum coherence is a crucial requirement for quantum computation; hence protecting quantum systems against their irreversible corruption due to environmental noise is an important open problem. Dynamical decoupling (DD) is an effective method for reducing decoherence with a low control overhead. It also plays an important role in quantum metrology, where, for instance, it is employed in multiparameter estimation. While a sequence of equidistant control pulses the Carr-Purcell-Meiboom-Gill (CPMG) sequence] has been ubiquitously used for decoupling, Uhrig recently proposed that a nonequidistant pulse sequence the Uhrig dynamic decoupling (UDD) sequence] may enhance DD performance, especially for systems where the spectral density of the environment has a sharp frequency cutoff. On the other hand, equidistant sequences outperform UDD for soft cutoffs. The relative advantage provided by UDD for intermediate regimes is not clear. In this paper, we analyze the relative DD performance in this regime experimentally, using solid-state nuclear magnetic resonance. Our system qubits are C-13 nuclear spins and the environment consists of a H-1 nuclear spin bath whose spectral density is close to a normal (Gaussian) distribution. We find that in the presence of such a bath, the CPMG sequence outperforms the UDD sequence. An analogy between dynamical decoupling and interference effects in optics provides an intuitive explanation as to why the CPMG sequence performs better than any nonequidistant DD sequence in the presence of this kind of environmental noise.

Case Study: Influence Of Morphological Changes On Flooding In Jingjiang River

The middle reach of the Yangtze River, customarily called the Jingjiang River, together with its diversion channels and Dongting Lake, form a large complicated drainage system. In the last five decades, significant geomorphological changes have occurred in the drainage system, including the shrinkage of diversion channels, contraction of Dongting Lake, changes in the rating curve at the Luoshan station, and cutoffs of the lower Jingjiang River. These changes are believed to be the cause of the occurrence of abnormal floods in the Jingjiang River. Qualitative analyses suggest that the first three factors aggravate the flood situation in the lower Jingjiang River, while the last factor seems beneficial for flood prevention. To quantitatively evaluate these conclusions, a finite-volume numerical model was constructed. A series of numerical simulations were carried out to test the individual and combined effects of the aforementioned four factors, and these simulations showed that high flood stages in the Jingjiang River clearly are related to the geomorphological changes.

Relativistic mean field theory: methods and applications

We develop a method for performing one-loop calculations in finite systems that is based on using the WKB approximation for the high energy states. This approximation allows us to absorb all the counterterms analytically and thereby avoids the need for extreme numerical precision that was required by previous methods. In addition, the local approximation makes this method well suited for self-consistent calculations. We then discuss the application of relativistic mean field methods to the atomic nucleus. Self-consistent, one loop calculations in the Walecka model are performed and the role of the vacuum in this model is analyzed. This model predicts that vacuum polarization effects are responsible for up to five percent of the local nucleon density. Within this framework the possible role of strangeness degrees of freedom is studied. We find that strangeness polarization can increase the kaon-nucleus scattering cross section by ten percent. By introducing a cutoff into the model, the dependence of the model on short-distance physics, where its validity is doubtful, is calculated. The model is very sensitive to cutoffs around one GeV.

Desenvolvimento e validação de modelo preditivo e avaliação de testes de diagnóstico por classe latente para o parasitismo por L. chagasi em cães atendidos no Hospital Veterinário Universitário da UFPI, Teresina

A leishmaniose visceral americana (LVA) é uma doença em expansão no Brasil, para a qual se dispõem de poucas, e aparentemente ineficientes, estratégias de controle. Um dos grandes problemas para a contenção da leishmaniose visceral americana é a falta de um método acurado de identificação dos cães infectados, considerados os principais reservatórios da doença no meio urbano. Neste sentido, a caracterização de marcadores clínico-laboratoriais da infecção neste reservatório e a avaliação mais adequada do desempenho de testes para diagnóstico da infecção podem contribuir para aumentar a efetividade das estratégias de controle da LVA. Com isso, o presente estudo tem dois objetivos principais: (1) desenvolver e validar um modelo de predição para o parasitismo por Leishmania chagasi em cães, baseado em resultados de testes sorológicos e sinais clínicos e (2) avaliar a sensibilidade e especificidade de critérios clínicos, sorológicos e parasitológicos para detecção de infecção canina por L. chagasi mediante análise de classe latente. O primeiro objetivo foi desenvolvido a partir de estudo em que foram obtidos dados de exames clínico, sorológico e parasitológico de todos os cães, suspeitos ou não de LVA, atendidos no Hospital Veterinário Universitário da Universidade Federal do Piauí (HVU-UFPI), em Teresina, nos anos de 2003 e 2004, totalizando 1412 animais. Modelos de regressão logística foram construídos com os animais atendidos em 2003 com a finalidade de desenvolver um modelo preditivo para o parasitismo com base nos sinais clínicos e resultados de sorologia por Imunofluorescência Indireta (IFI). Este modelo foi validado nos cães atendidos no hospital em 2004. Para a avaliação da área abaixo da curva ROC (auROC), sensibilidade, especificidade, valores preditivos positivo (VPP), valores preditivos negativo (VPN) e acurácia global, foram criados três modelos: um somente baseado nas variáveis clínicas, outro considerando somente o resultado sorológico e um último considerando conjuntamente a clínica e a sorologia. Dentre os três, o último modelo apresentou o melhor desempenho (auROC=90,1%, sensibilidade=82,4%, especificidade=81,6%, VPP=73,4%, VPN=88,2% e acurácia global=81,9%). Conclui-se que o uso de modelos preditivos baseados em critérios clínicos e sorológicos para o diagnóstico da leishmaniose visceral canina pode ser de utilidade no processo de avaliação da infecção canina, promovendo maior agilidade na contenção destes animais com a finalidade de reduzir os níveis de transmissão. O segundo objetivo foi desenvolvido por meio de um estudo transversal com 715 cães de idade entre 1 mês e 13 anos, com raça variada avaliados por clínicos veterinários no HVU-UFPI, no período de janeiro a dezembro de 2003. As sensibilidades e especificidades de critérios clínicos, sorológicos e parasitológicos para detecção de infecção canina por Leishmania chagasi foram estimadas por meio de análise de classe latente, considerando quatro modelos de testes e diferentes pontos de corte. As melhores sensibilidades estimadas para os critérios clínico, sorológico e parasitológico foram de 60%, 95% e 66%, respectivamente. Já as melhores especificidades estimadas para os critérios clínico, sorológico e parasitológico foram de 77%, 90% e 100%, respectivamente. Conclui-se que o uso do exame parasitológico como padrão-ouro para validação de testes diagnósticos não é apropriado e que os indicadores de acurácia dos testes avaliados são insuficientes e não justificam que eles sejam usados isoladamente para diagnóstico da infecção com a finalidade de controle da doença.

SiO2 对Bi2O3-B2O3 玻璃体系光学、热学及结构的 影响

Glasses with compositions 50Bi2O3-xB2O3- (50-x)SiO2(x=0, 10, 20, 30, 40, 50) in mol% have been prepared by using a normal melt-quench technique. The effect of SiO2 addition on thermal stability, optical properties and structural characteristic on Bi2O3-B2O3 glass were systematically investigated by using XRD, DTA, ultraviolet-visible transmittance spectra, midinfrared transmittance spectra and Raman spectra. The experimental results demonstrate that, with the addition of SiO2, thermal stability of glass samples has been obviously improved. Once the amount of SiO2 is too much, the glass samples tend to be phase seperation which results in the decrease of thermal stability. With increasing SiO2 content, the UV cutoff edge firstly shifts to short-wave band and then shifts to long-wave band, and the transmittance of mid-infrared has been greatly improved. With substitution of SiO2 for B2O3, the [BO3] triangles and [BO4] tetrahedral groups are gradually replaced by [SiO4]. [BiO6] octahedral and [SiO4] tetrahedral units are connected forming a vibrational mode of Bi-O-Si. The physical chemistry and optical performance of Bi2O3-B2O3 glass were greatly improved by addition of SiO2.

Sensitivity of angler benefit estimates from a model of recreational demand to the definition of the substitute sites considered by the angler

Fishery managers are mandated to understand the effects that environmental damage, fishery regulations, and habitat improvement projects have on the net benefits that recreational anglers derive from their sport. Since 1994, the National Marine Fisheries Service (NMFS) has worked to develop a consistent method for estimating net benefits through site choice models of recreational trip demand. In estimating net benefits with these models, there is a tradeoff between computational efficiency and angler behavior in reality. This article examines this tradeoff by considering the sensitivity of angler-welfare estimates for an increase in striped bass (Morone saxatalis) angling quality across choice sets with five travel distance cutoffs and compares those estimates to a model with an unrestricted choice set. This article shows that 95% confidence intervals for welfare estimates of an increase in the striped bass catch and keep rate overlap for all distance-based choice sets specified here.

Influence of Mg content on molecular-beam-epitaxy-grown ZnMgS ultraviolet photodetectors

Zn1-xMgxS-based Schottky barrier ultraviolet (UV) photodetectors were fabricated using the molecular-beam-epitaxy (MBE) technique. The influence of Mg content on MBE-grown Zn1-xMgxS-based UV photodetectors has been investigated in details with a variety of experimental techniques, including photoresponse (PR), capacitance-voltage, deep level transient Fourier spectroscopy (DLTFS) and photoluminescence (PL). The room-temperature PR results show that the abrupt long-wavelength cutoffs covering 325, 305 295. and 270 nm with Mg contents of 16%, 44%, 57%, and 75% in the Zn1-xMgxS active layers, respectively, were achieved. But the responsivity and the external quantum efficiency exhibited a slight decrease with the Mg content increasing. In good agreement with the PR results, both of the integrated intensity of the PL spectra obtained from Zn1-xMgxS thin films with different Mg compositions (x = 31% and 52%, respectively) and the DLTFS spectra obtained from Zn1-xMgxS-based (x = 5% and 45%, respectively) UV photodetector samples clearly revealed a significant concentration increase of the non-radiative deep traps with increasing Mg containing in the ZnMgS active layers. Our experimental results also indicate that the MBE-grown ZnMgS-based photodetectors can offer the promising characteristics for the detection of short-wavelength UV radiation. (C) 2004 Elsevier B.V. All rights reserved.