City, University of London

Purpose: Defocus Incorporated Multiple Segments (DIMS) lenses and atropine have proven standalone efficacy in controlling myopia progression in children. However, there is a scarcity of evidence of their efficacy when used in combination. This randomized controlled trial (RCT) aims to evaluate the efficacy of combination treatment using 0.025% atropine and DIMS spectacle lenses compared to 0.025% atropine and single vision (SV) lenses in slowing myopia progression in European myopic children. Methods: RCT conducted on children aged 4‐16 years with myopia between ‐1.00 and ‐6.00D and astigmatism ≤2.00D. Children were randomly assigned to the 0.025% atropine and SV lenses treatment group (group A) or 0.025% atropine and DIMS lenses treatment group (group B). Cycloplegic spherical equivalent refraction (SER) and axial length (AL) were measured at baseline, 6 and 12 months. Statistical analyses (Mann‐Whitney U‐test or Chi‐squared test) were performed to test for significance between the two groups. Results: 79 patients completed the 12 month‐follow‐up: n = 38 (48.1%) in group A (47.4% female), mean age 9.00 ± 2.74 years; n = 41 (51. 9%) in group B (46.3% female), mean age 9.68 ± 2.65 years. There was no significant association between group and sex ( p = 0.93) or age difference between the groups ( p = 0.26). At 12 months, mean AL ± SD change was 0.16 ± 0.13mm in group A and 0.09 ± 0.16mm in group B, mean difference 0.07 ± 0.02 mm (95%CI 0.03‐0.12, p < 0.001). Mean SER ± SD progression was ‐0.16 ± 0.31D and ‐0.16 ± 0.36D in group A and B, respectively ( p = 0.61). 39.5% of the children in Group B had no axial elongation over 12 months, compared to 14.5% of the children in group A ( p < 0.001). Conclusions: Combination treatment with 0.025% atropine and DIMS spectacle lenses is more effective in controlling axial elongation than 0.025% atropine with SV lenses in European children. The differences in SER between the groups were not significant. The AL increase in group B was less than that previously reported with DIMS lenses alone in Asian and European children over 12 months, suggesting that other factors, such as pupil size, may enhance the DIMS lens efficacy in controlling axial elongation.

Purpose: To assess vision‐related quality of life (VR‐QoL) in children undergoing myopia control treatment with atropine compared to children treated with combination treatment of atropine and Defocus incorporated multiple segments (DIMS) spectacle lenses. Methods: Longitudinal study that included myopic children aged 4 to 16 years undergoing myopia control treatment. Group A included children on 0.025% atropine eyedrops and single‐vision lenses, and group B included children on combined treatment of 0.025% atropine and DIMS lenses. Demographic and clinical data, including cycloplegic spherical equivalent refraction (SER) and axial length (AL), were noted. VR‐QoL was assessed using the Children's Visual Function questionnaire (CVFQ) and the Pediatric Eye Questionnaire (PedEyeQ) before initiating and after 6 months of treatment. Statistical analyses (Mann‐Whitney U‐test or t‐test) were performed. Results: 95 patients were included: 50 children in group A, mean age 8.94 ±2.50 years and 45 children in group B, mean age 9.51 ±2.46 years ( p = 0.266). No significant differences were found in the overall VR‐QoL between both groups with PedEyeQ. Functional Vision and Social item scores (PedEyeQ) significantly improved at the 6M follow‐up in group A ( p = 0.03 and p = 0.016, respectively) and group B (all p = 0.01). Scores on the Eye Condition item (PedEyeQ) at baseline and at 6M follow‐up were reversed; a decrease in group A, 89.73 [69.86‐89.73] and 64.98 [50.02‐74.99] ( p < 0.01), and an increase in group B, 69.96 [69.96‐89.72] and 74.97 [43.62‐85] ( p = 0.039). For the CVFQ, only Group B showed an improvement in General Vision ( p = 0.049) and Competence ( p = 0.031) scores. Conclusions: Myopic children treated with atropine and those using combination treatment (atropine and DIMS) do not seem to have significant differences in overall VR‐QoL following 6 months of treatment. General Vision (CVFQ), Competence (CVFQ) and Eye Condition (PedEyeQ) scores improve significantly for children on combination treatment.

Aims/Purpose: Scotland's child vision screening by orthoptists at 3.5‐5.5 years is taken up by ~85% (40,000‐50,000 annually). Screening failures are referred for eye examinations, including cycloplegic refraction. Aim 1: report refractive error data from these examinations (5,000‐7,000 annually) for 3 years pre‐ and 2 years post‐COVID. Aims 2 and 3: investigate correlations between myopia and socio‐economic deprivation and urban/rural dwellings. Methods: Right eye spherical equivalent refraction (SER) data from 10 Health Boards (HB) were compared. Population proportions within each deprivation index quintile (DIQ) and living in different dwelling types are known for each HB. Associations were investigated between these variables and proportions of children in each HB who failed screening and were found to have myopia. Results: Frequency distributions revealed a myopic shift in SER post‐COVID. Median SER (IQR) was in 2013‐14 +1.25D (+0.50 to +2.63); 2014‐15 +1.38D (+0.38 to +2.50); 2015‐16 +1.38D (+0.50 to +2.63); 2020‐21 +1.13D (+0.25 to +2.25); 2021‐22 +1.25D (+0.37 to +2.25). Statistically significant findings: overall difference between years (Kruskal‐Wallis, p < 0.0005); pairwise comparisons ( p < 0.0005) between each of the first 3 years and each of the last 2 years; but not ( p > 0.66) in pairwise comparisons of 2013‐16 or of 2020‐22. The proportion of children with myopia (≤‐0.50D): < 8% annually 2013‐16, 12% in 2020‐21, 11% in 2021‐22. There was a linear trend for an increasing proportion with myopia (r ² = 0.94, p = 0.006). Correlations between the proportions of children in each HB with myopia and who fell within each DIQ were low (r ² < 0.33). There was a high positive correlation (r ² = 0.83, p = 0.002) between the proportion with myopia and proportion of dwellings that were flats/apartments. Conclusions: The proportion with myopia has increased post‐COVID. A strong association exists between living in flats/apartments and myopia, but no strong correlation with a deprivation index.

Retinal mechanisms evolved to extract and code efficiently the most important information present in retinal images. Luminance contrast, ‘red/green’, ‘yellow/blue’, ‘white‐black’, and ‘light‐flux’ channels extract the signals needed to account for most attributes of our visual perception, including the ability to judge the level of ambient lighting. By employing two types of photoreceptors, rods and cones, the visual system achieves an extraordinarily large, dynamic range of useful vision, but this involves extensive compromises. The spatial, temporal and chromatic properties of the signals extracted from the retinal image very greatly with the level of ambient illumination. Visual acuity, contrast sensitivity, red/green and yellow/blue colour vision and motion and rapid flicker sensitivity, all worsen with decreasing light level. The extent to which visual performance is compromised in the mesopic range is also affected by normal aging and retinal disease. In this lecture I shall describe a number of advanced vision and optometric tests designed to reduce within subject variability, to account for normal age‐related changes, to isolate selectively red/green and yellow/blue colour mechanisms and most importantly, to test specifically for the rate of loss of visual sensitivity in the mesopic range. Results from extensive investigations in patients with diabetes, age‐related macular degeneration and glaucoma will be used to illustrate the usefulness of these tests in the early detection of retinal disease. Unique results from single patient studies will also be presented to illustrate some visual consequences of abnormal interaction of rod and cone signals in the mesopic range.

Aims/Purpose: Scotland, with a population of ~5.5 million, has a comprehensive vision screening programme by orthoptists for children aged 3.5‐5.5 years, taken up by ~85% (40,000‐50,000 annually). Tests include presenting vision, cover test, and other orthoptic evaluations. Screening failures are referred for an eye examination, including cycloplegic refraction, by an optometrist or, infrequently, an ophthalmologist. Our aim is to report the prevalence of amblyogenic risk factors (ARF), in children who failed screening and completed an eye examination. Methods: Based on AAPOS criteria, the following ARF were applied: constant manifest strabismus or any of the following refractive states: hyperopia (spherical equivalent refraction, SER) > 4.00D (in one/both eyes), astigmatism > 1.75DC (in one/both eyes), anisometropia > 1.25DC for astigmatism and > 1.25D (SER) for hyperopic or mixed (one eye hyperopic, the other myopic) anisometropia. 2021/22 school year data, from Scottish Health Boards containing 87% of Scotland's population, are reported. Results: 36,270 children completed vision screening, 78.9% of all eligible children. 8,130 (22.4%) children failed screening and were referred for eye examination, with data returned and analysed for 5,310 (65.3%). The overall prevalence (95% CI) of children having at least one ARF was 5.06% (4.84‐5.29), and for at least two, three and four ARFs was 1.62% (1.49‐1.76), 0.27% (0.22‐0.33) and 0.04% (0.03‐0.07) respectively. Among children with an ARF, 35.1% had hyperopia > 4.00D, 48.2% had astigmatism > 1.75D, 26.6% had hyperopic anisometropia, 12.6% had astigmatic anisometropia, 2.0% had mixed anisometropia, and 13.7% had constant manifest strabismus. Conclusions: In this predominantly Caucasian population 5.06% (95% CI: 4.84‐5.29%) of Scottish children (3.5 – 5.5 years) have at least one ARF. The high prevalence of ARFs validates the importance of carrying out a universal vision screening programme.

Purpose: To assess vision‐related quality of life (VR‐QoL) in children undergoing myopia control treatment with atropine compared to children treated with combination treatment of atropine and Defocus incorporated multiple segments (DIMS) spectacle lenses. Methods: Longitudinal study that included myopic children aged 4 to 16 years undergoing myopia control treatment. Group A included children on 0.025% atropine eyedrops and single‐vision lenses, and group B included children on combined treatment of 0.025% atropine and DIMS lenses. Demographic and clinical data, including cycloplegic spherical equivalent refraction (SER) and axial length (AL), were noted. VR‐QoL was assessed using the Children's Visual Function questionnaire (CVFQ) and the Pediatric Eye Questionnaire (PedEyeQ) before initiating and after 6 months of treatment. Statistical analyses (Mann‐Whitney U‐test or t‐test) were performed. Results: 95 patients were included: 50 children in group A, mean age 8.94 ±2.50 years and 45 children in group B, mean age 9.51 ±2.46 years ( p = 0.266). No significant differences were found in the overall VR‐QoL between both groups with PedEyeQ. Functional Vision and Social item scores (PedEyeQ) significantly improved at the 6M follow‐up in group A ( p = 0.03 and p = 0.016, respectively) and group B (all p = 0.01). Scores on the Eye Condition item (PedEyeQ) at baseline and at 6M follow‐up were reversed; a decrease in group A, 89.73 [69.86‐89.73] and 64.98 [50.02‐74.99] ( p < 0.01), and an increase in group B, 69.96 [69.96‐89.72] and 74.97 [43.62‐85] ( p = 0.039). For the CVFQ, only Group B showed an improvement in General Vision ( p = 0.049) and Competence ( p = 0.031) scores. Conclusions: Myopic children treated with atropine and those using combination treatment (atropine and DIMS) do not seem to have significant differences in overall VR‐QoL following 6 months of treatment. General Vision (CVFQ), Competence (CVFQ) and Eye Condition (PedEyeQ) scores improve significantly for children on combination treatment.

Assurance cases offer a structured way to present arguments and evidence for certification of systems where safety and security are critical. However, creating and evaluating these assurance cases can be complex and challenging, even for systems of moderate complexity. Therefore, there is a growing need to develop new automation methods for these tasks. While most existing assurance case tools focus on automating structural aspects, they lack the ability to fully assess the semantic coherence and correctness of the assurance arguments. In prior work, we introduced the Assurance 2.0 framework that prioritizes the reasoning process, evidence utilization, and explicit delineation of counter-claims (defeaters) and counter-evidence. In this paper, we present our approach to enhancing Assurance 2.0 with semantic rule-based analysis capabilities using common-sense reasoning and answer set programming solvers, specifically s(CASP). By employing these analysis techniques, we examine the unique semantic aspects of assurance cases, such as logical consistency, adequacy, indefeasibility, etc. The application of these analyses provides both system developers and evaluators with increased confidence about the assurance case.

Introduction Information on care home residents in England is captured in numerous data sets (care home records, General Practitioner records, community nursing, etc.) but little of this information is currently analysed in a way that is useful for care providers, current or future residents and families or that realises the potential of data to enhance care provision. The DACHA study aimed to develop and test a minimum data set (MDS) which would bring together data that is useful to support and improve care and facilitate research. It is that utility that underscores the importance of meaningful public involvement (PI) with the range of groups of people affected. This paper analyses the involvement of family members of care home residents and care home staff through a PI Panel. Objectives The objective for the PI activities was to consistently bring the knowledge and perspectives of family members and care home staff to influence the ongoing design and conduct of the DACHA study. Methods The bespoke methods of PI included a dedicated PI team and a PI Panel of public contributors. Meetings were recorded and minutes agreed, resulting actions were tracked and reflections on the PI recorded. A democratic, social relations approach was used to frame the analysis. Results A PI panel met 17 times. All meetings included both family members and care home staff. Analysis of the records and reflections developed the following themes about the operation of the PI: deepened understanding of the data environment in care homes; Influence on the pilot MDS; aiming for best research practices with care homes; personal/professional development for PI members; expectations of the project. Learning points for future research projects are developed. Conclusions PI shaped the design and conduct of the DACHA study, grounding it in the needs and perspectives of people using and providing social care. Data research has a huge responsibility to accurately incorporate relevant public perspectives. There is an implicit assumption that records and data are objective and ‘speak for themselves’ however there can be unintended consequences from introduction of new data requirements in practice. Patient or Public Contribution Public contributors to this manuscript include family members of older people living in care homes and staff of care homes. The wider study also involved as the public, older people living in care homes. Public contributors helped develop the project, contributed throughout the conduct of the study and some chose to be involved in preparing this manuscript.

Background Subcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Exercise is a potentially effective intervention for SIVCI. However, the mechanisms through which exercise promotes brain health and cognitive function are not well understood. Telomere length restoration and an increased capacity for cellular proliferation may provide a putative mechanism. Therefore, in this exploratory study we aimed to 1) assess the effect of a resistance training program on leukocyte telomere length; and 2) determine whether telomere length and/or change in telomere length is related to intervention response (i.e., change in cognitive function and/or brain structure). Method The sample consists of a subset of participants from a 12‐month single‐blinded, randomized controlled trial (ClinicalTrials.gov Identifier: NCT02669394). Participants (N = 91) were randomized to twice‐weekly resistance training (RT) or an active control group (balance and tone exercises; BAT). Study eligibility included: 1) age 55 years and older; 2) magnetic resonance imaging (MRI) evidence of cerebral small vessel disease; 3) mild cognitive impairment; and 4) the absence of dementia. We measured participants’ leukocyte (blood) telomere length at baseline, 6 months, and 12 months, using a qPCR‐based method. The intervention outcomes include cognitive function measured by the Alzheimer’s Disease Assessment Scale‐Cognitive‐Plus (ADAS‐Cog‐13 with additional cognitive tests) and structural brain magnetic resonance imaging (MRI) markers of SIVCI (e.g., white matter hyperintensities). Result We have generated telomere length data, demonstrating very good reproducibility with an intraclass correlation coefficient (ICC) of 0.853 [0.772, 0.907]. We will present findings that provide novel insights into the usefulness of telomere length as a predictive biomarker for intervention response. Furthermore, our work will contribute to the mechanistic understanding of exercise‐induced benefits for cognitive and brain health in SIVCI. Conclusion To our knowledge, this is the first study to investigate the role of telomere length in the efficacy of an exercise intervention for vascular cognitive impairment. This could inform the development of personalised interventions and aid the discovery of novel therapeutic targets.

As artificial intelligence (AI) systems begin to take on social roles traditionally filled by humans, it will be crucial to understand how this affects people’s cooperative expectations. In the case of human–human dyads, different relationships are governed by different norms: For example, how two strangers—versus two friends or colleagues—should interact when faced with a similar coordination problem often differs. How will the rise of ‘social’ artificial intelligence (and ultimately, superintelligent AI) complicate people’s expectations about the cooperative norms that should govern different types of relationships, whether human–human or human–AI? Do people expect AI to adhere to the same cooperative dynamics as humans when in a given social role? Conversely, will they begin to expect humans in certain types of relationships to act more like AI? Here, we consider how people’s cooperative expectations may pull apart between human–human and human–AI relationships, detailing an empirical proposal for mapping these distinctions across relationship types. We see the data resulting from our proposal as relevant for understanding people’s relationship–specific cooperative expectations in an age of social AI, which may also forecast potential resistance towards AI systems occupying certain social roles. Finally, these data can form the basis for ethical evaluations: What relationship–specific cooperative norms we should adopt for human–AI interactions, or reinforce through responsible AI design, depends partly on empirical facts about what norms people find intuitive for such interactions (along with the costs and benefits of maintaining these). Toward the end of the paper, we discuss how these relational norms may change over time and consider the implications of this for the proposed research program.

When TikTok started as a youth-oriented platform, it was mostly used for light entertainment, including music, songs and dance clips. Today, however, it is often relied upon as a hub for social and political activism. Hashtags are an important affordance to create visibility and attract attention. Using a qualitative multimodal thematic analysis, this study examines the shifting patterns in TikTok’s nature as a social media platform and investigates its various affordances in the realm of activism, in general, and feminist activism, in particular. Adopting a comprehensive approach, which takes into account various dynamics, including the overall political and social context, the various actors and the deployed tools and tactics, this study investigates why and how some feminist TikTok campaigns, such as #MahsaAmini which erupted in Iran to resist the imposition of the hijab following the murder of Mahsa Amini, are more likely to go viral and gain more international visibility than other TikTok feminist campaigns, such as #HandsOffMyHijab which erupted in France to resist the hijab and niqab ban. Findings revealed how various factors contributed to increasing the virality and international visibility of the Iranian Mahsa Amini’s #WomanLifeFreedom campaign, including the used online tactics, the support of media and political actors, the power of celebrities and social media influencers, and the online and offline support by male figures. The undertaken thematic analysis identified different dominant themes and representations of hijab in the two online social movements, reflecting varying expressions of feminisms, activisms and resistance. In so doing, the study offers a conceptual model for understanding these online dynamics within the appropriate socio-political and cultural contexts.

How are consent and the rule of law possible in post-Enlightenment societies? The rule of law is necessary. But a rule of law based upon secular principles exposes various problems of relativism that compromise its validity. Leszek Kolakowski is a neglected social theorist in the West. One of his striking arguments on the question of the integration of society is that no valid moral principles exist in experience or logic. It is a position founded on his personal history which rejects both Marxism and capitalism. Kolakowski concludes that the moral integration of society requires a faith-based foundation. This article situates Kolakowski's position by identifying three stages in the development of his thought. It goes on to examine the role of phenomenological sociology in his outlook, especially the work of Husserl and Bergson. The faith-based conclusion that Kolakowski draws will be indigestible to many readers. Yet the questions that it raises about purposeful being and secure identity are especially pertinent in the fake news/post-truth climate of the present day.

A refractive index (RI) and temperature dual-parameter sensor, based on a side-polished hole-assisted dual-core fiber (HADCF), has been proposed. In this sensor, SnO2 film has been deposited on the suspended core of HADCF by RF sputtering to produce loss mode resonance (LMR). The energy of the center core has been shown to be able to be coupled into the suspended core, taking advantage of the small distance involved and phase matching between two cores. The 10 mm long HADCF can be used to form a directional coupler. LMR and the directional coupler are integrated in parallel on the same section of HADCF, which realizes the high integration of sensing measurement. The sensor achieves simultaneous measurement of both RI and temperature through measuring both the LMR dip and coupling dip. The RI and temperature sensitivities achieved were 3812.5 nm/RIU and 521.4 pm/°C, respectively. The sensor discussed shows important advantages of high sensitivity, simple fabrication, high integration, and the ability to make measurements of two key parameters.

This study investigates the effectiveness of porous casing treatments in reducing noise in axial flow fans, using various triply periodic minimum surface (TPMS) configurations. All TPMS-based casings outperform solid casings in minimizing radial fan noise and enhancing the casing's sound absorption capabilities. Among the structures, the primitive type is less effective compared to the diamond and gyroid designs. Experimental results demonstrate that the gyroid and diamond casings reduce overall sound pressure levels by 6 dB (11%) and 8 dB (14%), respectively. They also decrease accumulated sound energy by 36% and 60%, respectively. Additionally, increasing porosity from 20% to 50% further enhances accumulated sound energy reduction by 27%. TPMS structures significantly lower sound pressure levels at blade passing frequencies (BPF), with maximum noise reductions observed at BPF4 and BPF10, where noise drops by 6 and 7 dB, respectively. This innovative casing treatment has a marked impact on the aeroacoustic performance of axial flow fans, and the findings offer valuable insights for future noise reduction strategies using TPMS-based porous casings.

Background We developed a prototype minimum data set (MDS) for English care homes, assessing feasibility of extracting data directly from digital care records (DCRs) with linkage to health and social care data. Methods Through stakeholder development workshops, literature reviews, surveys and public consultation, we developed an aspirational MDS. We identified ways to extract this from existing sources, including DCRs and routine health and social care datasets. To address gaps, we added validated measures of delirium, cognitive impairment, functional independence and quality of life to DCR software. Following routine health and social care data linkage to DCRs, we compared variables recorded across multiple data sources, using a hierarchical approach to reduce missingness where appropriate. We reported proportions of missingness, mean and standard deviation (SD) or frequencies (%) for all variables. Results We recruited 996 residents from 45 care homes in three English Integrated Care Systems. 727 residents had data included in the MDS. Additional data were well completed (<35% missingness at wave 1). Competition for staff time, staff attrition and software-related implementation issues contributed to missing DCR data. Following data linkage and combining variables where appropriate, missingness was reduced (≤4% where applicable). Discussion Integration of health and social care is predicated on access to data and interoperability. Despite governance challenges we safely linked care home DCRs to statutory health and social care datasets to create a viable prototype MDS for English care homes. We identified issues around data quality, governance, data plurality and data completion essential to MDS implementation going forward.

Aims : The study aimed to examine the relationship between several risk factors as well as prevention and control programs with Diabetes prevalence at district level in Indonesia. Methods : This study used a cross-sectional study design and performing descriptive, Pearson Correlation, and multivariate linear regression analysis. Secondary data was collected from the Ministry of Health and National Insurance Body involving 241 districts aggregate data. The risk factors included in the study were overweight, obesity, central obesity, sweet food consumption, sweet beverage consumption, fatty food consumption, lack of fruit and vegetable consumption, lack of physical activity, smoking, and hypertension. The prevention and control programs included NCD Post (Posbindu), village running Posbindu, examination of Posbindu, Pandu PHC, chronic disease program (Prolanis), routine checking blood glucose, Minimum standard service (SPM) of Diabetes services and adult screening. Results : There was a difference in the prevalence of Diabetes between districts and cities (p-value <0.001) and difference across seven regions in Indonesia (p-value <0.001). There were 15 variables associated with Diabetes prevalence (R ² 0.606), 5 of which had significant association, namely central obesity (p 0,018; Beta 0.027), fatty food consumption (p 0.015; Beta 0.006), smoking (p 0.002; Beta -0.034), Prolanis (p 0.001; Beta 0.899), and routine of blood glucose checking (p 0,000; Beta 0.279). Conclusions : Several risk factors and programs associated with Diabetes prevalence at district level in Indonesia.

The study aimed to analyze the use of complementary and integrative health practices (CIHPs) during labor and birth in a freestanding birth center. A total of 28 different CIHPs were applied with or used by laboring women. The most adopted CIHPs were mind-body practices (99.9%) and natural products (35.5%), mostly used by primiparous women (P <.05). Adopting CIHPs can increase care quality, increase positive experiences during childbirth, and promote evidence-based choices.