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Purpose: This study aimed to explore the practices of optometrists in Hong Kong towards diagnosing and managing dry eye disease (DED)., Methods: From September 2021 to March 2022, an online questionnaire was distributed to optometrists in Hong Kong through several professional associations. The questionnaire included questions about the importance and usefulness of various diagnostic tests, as well as inquiries about management strategies and recommended follow-up schedules for DED. Responses were compared between optometrists who were more or less proactive in continuing education to identify potential differences., Results: The analysis included 68 valid responses. Sixty-one of them were Part 1 optometrists that represents 5.5 % of registered Part 1 optometrists back in 2022. Assessment of clinical symptoms was the most commonly performed investigation (93 %) and considered the most important (75 %) procedure in DED assessments, followed by corneal staining and fluorescein tear break-up time. Traditional diagnostic tests were preferred over newer methods, such as osmolarity, which were not yet commonly used. Unpreserved lubricants (90 %) and lid hygiene (63 %) were the primary treatments recommended for mild DED. Optometrists who had more experience and frequent participation in continuing education were more confident in diagnosing and managing DED, and more likely to recommend omega-3 supplements for moderate DED., Conclusion: The diagnostic and management strategies of optometrists in Hong Kong were generally consistent with the recommendations of the Dry Eye Workshop II report. However, standardized DED questionnaires and newer diagnostic tools were not commonly used. Evidence-based optometric care for dry eye management should be encouraged in Hong Kong optometric practice., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

The etiology of myopia remains unclear. This study investigated whether retinal ganglion cells (RGCs) in the myopic retina encode visual information differently from the normal retina and to determine the role of Connexin (Cx) 36 in this process. Generalized linear models (GLMs), which can capture stimulus-dependent changes in real neurons with spike timing precision and reliability, were used to predict RGCs responses to focused and defocused images in the retinas of wild-type (normal) and Lens-Induced Myopia (LIM) mice. As the predominant subunit of gap junctions in the mouse retina and a plausible modulator in myopia development, Cx36 knockout (KO) mice were used as a control for an intact retinal circuit. The kinetics of excitatory postsynaptic currents (EPSCs) of a single αRGC could reflect projection of both focused and defocused images in the retinas of normal and LIM, but not in the Cx36 knockout mice. Poisson GLMs revealed that RGC encoding of visual stimuli in the LIM retina was similar to that of the normal retina. In the LIM retinas, the linear-Gaussian GLM model with offset was a better fit for predicting the spike count under a focused image than the defocused image. Akaike information criterion (AIC) indicated that nonparametric GLM (np-GLM) model predicted focused/defocused images better in both LIM and normal retinas. However, the spike counts in 33% of αRGCs in LIM retinas were better fitted by exponential GLM (exp-GLM) under defocus, compared to only 13% αRGCs in normal retinas. The differences in encoding performance between LIM and normal retinas indicated the possible amendment and plasticity of the retinal circuit in myopic retinas. The absence of a similar response between Cx36 KO mice and normal/LIM mice might suggest that Cx36, which is associated with myopia development, plays a role in encoding focused and defocused images., Competing Interests: Declaration of competing interest The authors declare no competing financial interests., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Due to excessive elongation of the eyeball, myopia-related vascular abnormalities are frequently observed in the central retinal artery (CRA) and its intraretinal branches. In addition to inconsistency in previously reported findings, hemodynamic (reduced flow velocity, increased vascular resistance) and morphological changes (narrower vessel diameter) were usually studied separately. This cross-sectional study evaluated the hemodynamic and morphological characteristics concurrently in a large sample of healthy myopes, by using the color Doppler ultrasound and adaptive optics retinal camera. Results showed that the retrobulbar segment of CRA had a tendency of slightly reduced flow velocity in eyeballs with longer axial length, but the correlation was not significant after adjusting for the multiple correlations. Vascular resistance was not affected by the axial elongation. With respect to the intraretinal branches, no significant changes in longer eyes of total diameter or lumen diameter were observed, while both the wall thickness and the wall cross-sectional area were significantly increased, but only a marginally increase in the wall to lumen ratio was found with increasing axial length. This implies some potential small artery remodeling in the intraretinal CRA branches. Overall, blood supply of the inner retina in healthy young myopes is likely to be maintained. Additionally, morphological parameters of vascular microstructure could be potential biomarkers to monitor myopia progression and understand myopia-related vascular abnormalities in future studies., (© 2022. The Author(s).)

The high prevalence of myopia has become a global concern, especially in East and Southeast Asia. Alarmingly, the prevalence of high myopia is increasing. Mechanical stretching caused by excessive eyeball elongation leads to various anatomical changes in the fundus. This stretching force may also lead to the development of vascular abnormalities, which tend to be subtle and easily overlooked. A healthy ocular vasculature is a prerequisite of adequate oxygen supply for normal retinal functions. This review summarises previous findings on structural and haemodynamic aspects of myopia-related vascular changes.

Kenaf seed oil-in-water nanoemulsions (NANO) stabilized by sodium caseinate (SC), beta-cyclodextrin (β-CD), and Tween 20 (T20) have been optimized and shown to improve in vitro bioaccessibility and physicochemical stability in the previous study. The main objective of this study was to evaluate the stability of bioactive compounds and antioxidants in the NANO during storage at different temperatures (4 °C, 25 °C, and 40 °C). An evaluation of the antioxidant activities of each emulsifier showed that SC had good scavenging capability with 97.6% ABTS radical scavenging activity. Therefore, SC which was used as one of the main emulsifiers could further enhanced the antioxidant activity of NANO. At week 8 of storage, NANO that stored at 4 °C had maintained the best bioactive compounds stability and antioxidant activities with 90% retention of vitamin E and 65% retention of phytosterols. These results suggested that 4 °C would be the most suitable storage temperature for NANO containing naturally present vitamin E and phytosterols. From the accelerated storage results at 40 °C, NANO containing vitamin E and phytosterols had maintained half of its initial concentration until week 4 and week 2 of storage, which is equivalent to 16 weeks and 8 weeks of storage at room temperature, respectively., Practical Application: The results of this study provide a better understanding on the stability of bioactive compounds and antioxidant activities in oil-in-water nanoemulsions that stabilized by similar ternary emulsifiers during storage at different temperatures. In addition, this study could be used as a predictive model to estimate the shelf life of bioactive compounds encapsulated in the form of nanoemulsions., (© 2018 Institute of Food Technologists®.)

Inflammatory bowel disease (IBD) is a chronic inflammatory disease, in which the intestinal epithelium loses its barrier function. Given the existence of the oxygen gradient in the intestinal epithelium and that inflammation further contributes to the tissue hypoxia, we investigated the role of hypoxia-inducible factor (HIF), a transcription factor activated under hypoxic conditions in myeloid cells, in the progression of IBD. To do this, we utilized myeloid-specific knockout (KO) mice targeting HIF pathways, created by a Cre-loxP system with human MRP8 (hMRP8), an intracellular calcium-binding protein, as the myeloid promoter. By feeding 5% dextran sodium sulfate (DSS) to hMRP8 von Hippel Lindau ( Vhl ) KO mice, in which HIF-1α and HIF-2α are constitutively activated in myeloid cells, we found that these mice were highly susceptible to DSS-induced colitis, demonstrating greater body weight loss, increased mortality, faster onset of rectal bleeding, shortened colon length, and increased CD11b- or Gr-1-positive myeloid cells in the colon compared with wild-type (WT) mice. These parameters were restored to, if not better than, the WT levels when we examined hMRP8 Hif-1a KO mice upon 5% DSS feeding. hMRP8 Hif-2a KO mice, on the other hand, exhibited a similar degree of DSS-induced colitis to that of WT mice. Lastly, when DSS was given together with azoxymethane to induce tumorigenesis in the colon, we found that hMRP8 Hif-1a KO mice exhibited comparable levels of colorectal tumors to those of WT mice, indicating that HIF-1α in myeloid cells is dispensable for tumorigenesis. Collectively, our results suggest that HIF-1α activation in myeloid cells critically regulates IBD progression., Competing Interests: Competing interestsThe authors declare no competing or financial interests., (© 2018. Published by The Company of Biologists Ltd.)

Kenaf ( Hibiscus cannabinus L.) seed oil has been proven for its multi-pharmacological benefits; however, its poor water solubility and stability have limited its industrial applications. This study was aimed to further improve the stability of pre-developed kenaf seed oil-in-water nanoemulsions by using food-grade ternary emulsifiers. The effects of emulsifier concentration (1, 5, 10, 15% w/w), homogenisation pressure (16,000, 22,000, 28,000 psi), and homogenisation cycles (three, four, five cycles) were studied to produce high stability of kenaf seed oil-in-water nanoemulsions using high pressure homogeniser. Generally, results showed that the emulsifier concentration and homogenisation conditions had great effect ( p < 0.05) on the particle sizes, polydispersity index and hence the physical stability of nanoemulsions. Homogenisation parameters at 28,000 psi for three cycles produced the most stable homogeneous nanoemulsions that were below 130 nm, below 0.16, and above -40 mV of particle size, polydispersity index, and zeta potential, respectively. Field emission scanning electron microscopy micrograph showed that the optimised nanoemulsions had a good distribution within nano-range. The optimised nanoemulsions were proved to be physically stable for up to six weeks of storage at room temperature. The results from this study also provided valuable information in producing stable kenaf seed oil nanoemulsions for the future application in food and nutraceutical industries.

Kenaf (Hibiscus cannabinus L.) seed oil-in-water nanoemulsions stabilized by complexation of beta-cyclodextrin with sodium caseinate and Tween 20 have been shown to have higher bioaccessibility of vitamin E and total phenolic content than nonemulsified kenaf seed oil in the previous in vitro gastrointestinal digestion study. However, its oral bioavailability was unknown. Therefore, the aim of this study was to evaluate the rate of in vivo oral bioavailability of kenaf seed oil-in-water nanoemulsions in comparison with nonemulsified kenaf seed oil and kenaf seed oil macroemulsions during the 180 min of gastrointestinal digestion. Kenaf seed oil macroemulsions were produced by using conventional method. Kenaf seed oil-in-water nanoemulsions had shown improvement in the rate of absorption. At 180 min of digestion time, the total α-tocopherol bioavailability of kenaf seed oil nanoemulsions was increased by 1.7- and 1.4-fold, compared to kenaf seed oil and macroemulsion, respectively. Kenaf seed oil-in-water nanoemulsions were stable in considerably wide range of pH (>5 and <3), suggesting that it can be fortified into beverages within this pH range PRACTICAL APPLICATION: The production of kenaf seed oil-in-water nanoemulsions had provided a delivery system to encapsulate the kenaf seed oil, as well as enhanced the bioaccessibility and bioavailability of kenaf seed oil. Therefore, kenaf seed oil-in-water nanoemulsions exhibit a great potential application in nutraceutical fields., (© 2018 Institute of Food Technologists®.)

Kenaf seed oil-in-water nanoemulsions (KSON) and kenaf seed oil-in-water macroemulsions were produced to access their gastroprotective effect against indomethacin- and ethanol-induced ulcers in comparison with non-emulsified kenaf seed oil (KSO). Emulsifier mixture (EM) that used to emulsify KSO was also included in the study. Ulcer index, stomach tissue oxidative status, and histopathological changes in indomethacin-induced and ethanol-induced ulcer models were both evaluated. KSON had demonstrated good gastroprotective effect against both ulcer models than non-emulsified KSO and KSOM. In addition, the gastroprotective effect of KSON was comparable to the standard drug, Omeprazole. EM also exhibited gastroprotective effect, especially in indomethacin-induced ulcers. This may be attributed to its high antioxidant activity and cytoprotective effect of sodium caseinate contained in the EM. Results supported that KSON enhanced the bioavailability of native KSO; therefore it offers gastroprotective effect for the prevention of gastric ulceration as a natural alternative to the synthetic drug., Competing Interests: Compliance with ethical standardsThe authors have declared no conflict of interest.

This study aimed to evaluate the effect of kenaf seed oil (KSO), kenaf seed oil-in-water macroemulsion (KSOM), kenaf seed oil-in-water nanoemulsions (KSON), and emulsifier mixtures (EM) on serum lipid profile, liver oxidative status, and histopathological changes in high-cholesterol fed rats. Stability and characteristic of KSOM and KSON were carried out prior to in vivo study. Forty-two Sprague-Dawley rats were divided into 7 groups (6 rats each) and induced hypercholesterolemia by feeding high cholesterol diet (HCD) for 14 days prior to treatments. Different treatments were introduced on day 15 to 29 while supplemented with HCD and removal of HCD during treatment on day 30 to 43, except for HCD group. Body weight and serum lipid profiles were measured at 3 different points: after hypercholesterolemia was induced, on day 29, and at the end of the experiment. Relative liver weight, atherogenic index, coronary risk index, and fecal total bile acids were also determined at the end of experiment. KSON showed significantly higher stability than KSOM and FTIR exhibited good encapsulation of KSO after 1.5 years of storage. Serum total cholesterol, low density lipoprotein cholesterol, lipid peroxidation levels in HCD group without treatment were significantly higher compared to normal control group and all treatment groups. All samples demonstrated hypocholesterolemic effect, but KSON exhibited higher efficiency in cholesterol-lowering properties, weight control and decreased liver fat as confirmed by histopathological evaluation. The overall results revealed that the efficacy of different treatments was in descending order of KSON, KSO, KSOM, and EM., Practical Application: Kenaf seed oil-in-water nanoemulsion (KSON) has the potential to be used as a natural alternative to the synthetic hypocholesterolemic drug in the future. However, larger sample size and clinical trial are needed to confirm on this potential application. In addition, treatment with KSON was suggested to prevent cardiovascular disease and fatty liver., (© 2018 Institute of Food Technologists®.)

This study was conducted to compare 3D-printed polycaprolactone (PCL) and polycaprolactone/β-tricalcium phosphate (PCL/β-TCP) membranes with a conventional commercial collagen membrane in terms of their abilities to facilitate guided bone regeneration (GBR). Fabricated membranes were tested for dry and wet mechanical properties. Fibroblasts and preosteoblasts were seeded into the membranes and rates and patterns of proliferation were analyzed using a kit-8 assay and by scanning electron microscopy. Osteogenic differentiation was verified by alizarin red S and alkaline phosphatase (ALP) staining. An in vivo experiment was performed using an alveolar bone defect beagle model, in which defects in three dogs were covered with different membranes. CT and histological analyses at eight weeks after surgery revealed that 3D-printed PCL/β-TCP membranes were more effective than 3D-printed PCL, and substantially better than conventional collagen membranes in terms of biocompatibility and bone regeneration and, thus, at facilitating GBR.

The implantation of cell-seeded large-sized scaffold often results in insufficient tissue regeneration, which is still a challenge for successful grafting. Excess hydrogen peroxide (H 2 O 2 ) released by cells propagates oxidative stress, which is the primary cause of tissue injury leading to failure in tissue regeneration. Hence, preventing tissue from oxidative damage becomes imperative. For the first time, we entrapped catalase, an antioxidant in a scaffold as a novel approach in bioengineering to prevent tissue from H 2 O 2 -induced damage. The gel prepared from the mixture of decellularized adipose tissue and high viscous sodium alginate was used to entrap the catalase, and was coated to 3D polycaprolactone porous scaffolds. This study showed that our 3D design would regulate the release of catalase in a sustained and efficient manner protecting human turbinate mesenchymal stem cells cultured in 2D/3D in vitro oxidative microenvironment provided by H 2 O 2 , and supporting their robust growth. Interestingly, in vivo study revealed that our design was successful in tissue engineering by both an increase in tissue growth (≥45%) throughout the large-sized scaffold with substantial reduction in inflammation (≥40%), and an increase in the induction of angiogenesis (≥40%). This novel design, therefore, would be highly applicable for successful grafting to replace a damaged tissue in future.

Purpose: The continuous-text reading-acuity test MNREAD is designed to measure the reading performance of people with normal and low vision. This test is used to estimate maximum reading speed (MRS), critical print size (CPS), reading acuity (RA), and the reading accessibility index (ACC). Here we report the age dependence of these measures for normally sighted individuals, providing baseline data for MNREAD testing., Methods: We analyzed MNREAD data from 645 normally sighted participants ranging in age from 8 to 81 years. The data were collected in several studies conducted by different testers and at different sites in our research program, enabling evaluation of robustness of the test., Results: Maximum reading speed and reading accessibility index showed a trilinear dependence on age: first increasing from 8 to 16 years (MRS: 140-200 words per minute [wpm]; ACC: 0.7-1.0); then stabilizing in the range of 16 to 40 years (MRS: 200 ± 25 wpm; ACC: 1.0 ± 0.14); and decreasing to 175 wpm and 0.88 by 81 years. Critical print size was constant from 8 to 23 years (0.08 logMAR), increased slowly until 68 years (0.21 logMAR), and then more rapidly until 81 years (0.34 logMAR). logMAR reading acuity improved from -0.1 at 8 years to -0.18 at 16 years, then gradually worsened to -0.05 at 81 years., Conclusions: We found a weak dependence of the MNREAD parameters on age in normal vision. In broad terms, MNREAD performance exhibits differences between three age groups: children 8 to 16 years, young adults 16 to 40 years, and middle-aged to older adults >40 years.

Aim: The short-form Physiological Profile Assessment (PPA) is increasingly used in clinical practice for assessing fall risk in older people. However, a normative database is only available for Caucasian populations. The purpose of the present study was to develop a normative database for Hong Kong Chinese older people and examine the fall risk profile of this population., Methods: A total of 622 participants aged 60-95 years were recruited. Participants underwent the PPA (containing tests of contrast sensitivity, proprioception, quadriceps strength, reaction time and sway), and composite fall risk scores were computed. Participants were then followed up for falls for 1 year., Results: Quadriceps strength and lower limb proprioception scores were comparable with those reported for Caucasian populations. However, contrast sensitivity, simple reaction time and postural sway scores were relatively poor. The average composite fall risk score was 1.7 ± 1.5, showing a "moderate" fall risk when compared with the Caucasian norms. Despite the relatively poor physical performances and moderately high fall risk scores, the incidence of one plus falls in the 1-year follow-up period was just 16.4%, with just 2.6% reporting two plus falls. The area under the curve for composite fall risk scores in discriminating fallers from non-fallers was 0.53 (95% CI 0.45-0.60)., Conclusions: Despite poorer performance in PPA tests, the incidence of prospective falls in a Hong Kong Chinese population was low. In consequence, the PPA could not discriminate well between fallers and non-fallers. The present study provided normality data for short-form PPA measures for older Chinese people as a reference for further studies., (© 2015 Japan Geriatrics Society.)

Engineered adipose tissue constructs that are capable of reconstructing soft tissue with adequate volume would be worthwhile in plastic and reconstructive surgery. Tissue printing offers the possibility of fabricating anatomically relevant tissue constructs by delivering suitable matrix materials and living cells. Here, we devise a biomimetic approach for printing adipose tissue constructs employing decellularized adipose tissue (DAT) matrix bioink encapsulating human adipose tissue-derived mesenchymal stem cells (hASCs). We designed and printed precisely-defined and flexible dome-shaped structures with engineered porosity using DAT bioink that facilitated high cell viability over 2 weeks and induced expression of standard adipogenic genes without any supplemented adipogenic factors. The printed DAT constructs expressed adipogenic genes more intensely than did non-printed DAT gel. To evaluate the efficacy of our printed tissue constructs for adipose tissue regeneration, we implanted them subcutaneously in mice. The constructs did not induce chronic inflammation or cytotoxicity postimplantation, but supported positive tissue infiltration, constructive tissue remodeling, and adipose tissue formation. This study demonstrates that direct printing of spatially on-demand customized tissue analogs is a promising approach to soft tissue regeneration., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Purpose: This study aimed to develop and validate a new Chinese reading chart for children. The characteristics of reading profiles among Hong Kong children were also investigated., Methods: A new reading chart was developed using the design principles of the MNREAD chart. Children (N = 169) aged seven to 11 years with normal vision and no developmental or reading difficulties were recruited from four local Hong Kong primary schools located in four different districts. Reading performance was measured using three versions of the new Chinese reading chart for children as well as six short passages. Repeated reading measures were conducted for 79 participants 4-8 weeks later. A linear mixed-model analysis was performed for the reading measures to identify the contribution of each source of variation (individual participant, among-charts within-session and between-sessions, and error) to the total variance., Results: Three reading parameters were derived from the Chinese reading chart for children - maximum reading speed (MRS), critical print size (CPS) and reading acuity (RA). Results from the linear mixed-model and Bland and Altman analyses revealed that all three versions of the chart were reproducible, with little variability among-charts and between-sessions (p < 0.001). The coefficient of repeatability for the MRS, CPS and RA was 0.08 logWPM, 0.16 logMAR and 0.14 logMAR respectively. The strong correlation between reading speed measured by the chart and ordinary children's reading passages confirmed the usefulness of the chart for assessing children's reading performance (Rc = 0.67, 95% CI of 0.60-0.73)., Conclusions: We developed and validated a new Chinese reading chart for children for quantifying reading performance in Chinese children with normal reading ability. This standardised clinical test can be reliably used to measure the MRS, CPS and RA in Chinese-speaking children. Further research is needed to evaluate the validity of this chart for assessing reading performance in Chinese children with reading difficulties, dyslexia or low vision., (© 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.)

Purpose: Although superior performance in visual motor and visual perceptual skills of preschool children has been documented in the Chinese population, a normative database is only available for the US population. This study aimed to determine the normative values for these visuomotor and visual perceptual tests for preschool children in the Hong Kong Chinese population and to investigate the effect of fundamental visual functions on visuomotor and visual perceptual skills., Methods: One hundred seventy-four children from six different kindergartens in Hong Kong were recruited. Distance visual acuity, near visual acuity, and stereopsis were tested, along with two measures of visual perception (VP): Visual-Motor Integration (VMI) and Test of Visual-Perceptual Skills (TVPS). Raw VMI and TVPS scores were converted into standard/scaled scores. The impact of basic visual functions on VP (VMI and TVPS) was examined using multiple regression., Results: Visual functions were generally good: only 9.2 and 4.6% of subjects had unilateral and bilateral reduced habitual vision, respectively (distance visual acuity in the better eye >0.3 logMAR [logarithm of the minimum angle of resolution]). Performance in the VMI and in the visual memory and spatial relationships subtests of the TVPS exceeded that reported for age-matched children from the United States. Multiple regression analysis provided evidence that age had the strongest predictive value for the VMI and VP skills. In addition, near visual acuity was weakly associated with performance in the VMI and the visual discrimination and spatial relationships subtests of the TVPS, accounting for a limited proportion of the intersubject variability (R < 3%; p < 0.001)., Conclusions: Hong Kong preschoolers outperformed their US peers in the VMI and visual memory/spatial relationships of TVPS subtests, perhaps attributed to greater exposure to such material during their preschool home education. This study provided normality data for VMI and four subtests of the TVPS for Hong Kong Chinese preschool children as a reference for future studies.

Background: There is currently limited information about ethnic differences in myopia prevalence within mainland China, especially in rural or semi-rural areas. We examined the prevalence of refractive errors, visual impairment and spectacle coverage in school children of varying ethnicity in Turpan, Xinjiang province., Methods: A community eye care service was provided for five schools. Presenting monocular distance and near visual acuity (VA), and ocular alignment were assessed. Retinoscopy and cycloplegic subjective refraction were performed for participants with presenting visual impairment (distance VA worse than 0.3 logMAR; Snellen 6/12 or 20/40) or abnormal binocular vision. Questionnaires administered prior to the eye examinations were used to collect information regarding personal lifestyle and parental myopia., Results: A total of 646 out of 690 (94%) subjects aged four to 19 years (11.9 ± 2.6; mean ± S.D.) completed the eye examination. Three hundred and eighty-two (59%) of participants were of Uyghur ethnicity, followed by Han, 176 (27%) and Hui, 74 (12%). The mean age of Uyghur, Han and Hui students was 12.3 ± 2.7, 11.4 ± 2.6 and 11.4 ± 2.3 years respectively, in which the Uyghur students were significantly older than the Han and Hui students (F(3,631) = 5.58 p < 0.001). In total, 170 (27%) and 85 (13%) subjects failed the screening examination for one eye or both eyes, respectively. The prevalence of presenting visual impairment was not significantly different among the ethnic groups (p = 0.26). After cycloplegic refraction, most subjects' VA (98%) improved to better than 0.3 logMAR (Snellen 6/12 or 20/40). The prevalence of "clinically-significant myopia" (≤-0.50 dioptres) was 27%, 18% and 13% in Han, Hui and Uyghur children, respectively (p < 0.001). In contrast, Uyghur students had the highest prevalence of astigmatism (Uyghur 12%, Han 5%, Hui 4%). The overall spectacle coverage was 36%, while spectacle coverage among ethnic groups were similar (Han, 41%; Uyghur, 32%; Hui, 41%; χ(2) = 2.23, df = 2, p = 0.33)., Conclusion: The prevalence of clinically significant myopia varied markedly with ethnicity in school children sampled from a semi-rural region of mainland China (Han > Hui > Uyghur). As reported previously, uncorrected/under-corrected refractive error was the main cause of presenting visual impairment., (© 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.)

The electrical response of the retina was examined as a function of retinal region, using stimuli of various spatial frequencies in the first experiment. In the second experiment, the regional response of the retina to defocus at high and low spatial frequencies was investigated. Twenty three subjects were recruited for global flash multifocal electroretinogram (mfERG) in experiment 1. Black and white gratings (printed on plastic transparent sheets) of four spatial frequencies (SF), 0.24, 1.2, 2.4 and 4.8 cycle per degree were presented in front of the mfERG stimulation. The amplitudes and implicit times of the direct (DC) and induced (IC) components of mfERG responses were pooled into six concentric rings for analysis. There was low amplitude DC at low SF, which increased with increasing SF, and which decreased with increasing eccentricity. The IC was high in amplitude at all SF and reduced in amplitude with increasing eccentricity. Our findings suggested that outer and inner retina had different characteristics in processing spatial details. In experiment 2, Twenty-three young adults were recruited for mfERG measurement. The retinal electrical responses for low (0.24cpd) and high (4.8cpd) SF under fully corrected conditions of short-term negative defocus (-2D) and short term positive defocus (+2D) conditions were measured. There was a sign-dependent response to defocus in the DC response, mainly in peripheral regions. The sign dependent response at low SF was more obvious than that at high SF, and was located more peripherally. The IC response showed no clear trends for either defocus condition. The human retina seems to have a decoding system for optical defocus, which was tuned for low spatial frequency, and was located in the retinal near periphery.

Bioprinting has exciting prospects for printing three-dimensional (3-D) tissue constructs by delivering living cells with appropriate matrix materials. However, progress in this field is currently extremely slow due to limited choices of bioink for cell encapsulation and cytocompatible gelation mechanisms. Here we report the development of clinically relevant sized tissue analogs by 3-D bioprinting, delivering human nasal inferior turbinate tissue-derived mesenchymal progenitor cells encapsulated in silk fibroin-gelatin (SF-G) bioink. Gelation in this bioink was induced via in situ cytocompatible gelation mechanisms, namely enzymatic crosslinking by mushroom tyrosinase and physical crosslinking via sonication. Mechanistically, tyrosinases oxidize the accessible tyrosine residues of silk and/or gelatin into reactive o-quinone moieties that can either condense with each other or undergo nonenzymatic reactions with available amines of both silk and gelatin. Sonication alters the hydrophobic interaction and accelerates self-assembly of silk fibroin macromolecules to form β-sheet crystals, which physically crosslink the hydrogel. However, sonication has no effect on the conformation of gelatin. The effect of optimized rheology, secondary conformations of silk-gelatin bioink, temporally controllable gelation strategies and printing parameters were assessed to achieve maximum cell viability and multilineage differentiation of the encapsulated human nasal inferior turbinate tissue-derived mesenchymal progenitor cells. This strategy offers a unique path forward in the direction of direct printing of spatially customized anatomical architecture in a patient-specific manner., (Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Background: Stroke, a common cerebrovascular accident, usually results in various extents of functional disability. Extensive studies have shown that ocular and visual problems are common in patients with stroke. Unfortunately, current stroke rehabilitation programs rarely address stroke-related ocular and visual problems in Hong Kong., Methods: To examine how visual impairment (for example, deterioration in visual acuity and restriction in visual field) affects the stroke population in Hong Kong, vision screening was conducted for post-stroke patients attending in-patient and out-patient stroke clinics at two hospitals., Results: One hundred and thirteen stroke patients were recruited. The percentage of various aspects of visual problems in Hong Kong post-stroke patients was generally lower than that reported in Western countries; however, a high percentage of patients had deficits in oculomotor (53.1 per cent) and vergence functions (11.5 per cent), restrictions in binocular visual field (11.5 per cent) and impairment in visual acuity (worse than 0.30 logMAR, 29.8 per cent). Conversely, only a small proportion of patients noticed problems with their vision (for example, diplopia and blurry vision) through subjective reports. This revealed that many post-stroke patients had undetected or undiagnosed ocular and visual problems. Appropriate referral was given to patients with visual problems for further evaluation and treatment., Conclusion: Neglecting visual problems may impose deteriorating effect on patients' stroke rehabilitation and functional independence and lead to increased incidents of injury. To address this potential hindrance in rehabilitation, formal screening for visual problems in stroke patients in a rehabilitation setting is essential., (© 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometrists Association Australia.)

Effects of context on the perception of, and incidental memory for, real-world objects have predominantly been investigated in younger individuals, under conditions involving a single static viewpoint. We examined the effects of prior object context and object familiarity on both older and younger adults' incidental memory for real objects encountered while they traversed a conference room. Recognition memory for context-typical and context-atypical objects was compared with a third group of unfamiliar objects that were not readily named and that had no strongly associated context. Both older and younger adults demonstrated a typicality effect, showing significantly lower 2-alternative-forced-choice recognition of context-typical than context-atypical objects; for these objects, the recognition of older adults either significantly exceeded, or numerically surpassed, that of younger adults. Testing-awareness elevated recognition but did not interact with age or with object type. Older adults showed significantly higher recognition for context-atypical objects than for unfamiliar objects that had no prior strongly associated context. The observation of a typicality effect in both age groups is consistent with preserved semantic schemata processing in aging. The incidental recognition advantage of older over younger adults for the context-typical and context-atypical objects may reflect aging-related differences in goal-related processing, with older adults under comparatively more novel circumstances being more likely to direct their attention to the external environment, or age-related differences in top-down effortful distraction regulation, with older individuals' attention more readily captured by salient objects in the environment. Older adults' reduced recognition of unfamiliar objects compared to context-atypical objects may reflect possible age differences in contextually driven expectancy violations. The latter finding underscores the theoretical and methodological value of including a third type of objects--that are comparatively neutral with respect to their contextual associations--to help differentiate between contextual integration effects (for schema-consistent objects) and expectancy violations (for schema-inconsistent objects).

How does prolonged reduction in retinal-image contrast affect visual-contrast coding? Recent evidence indicates that some forms of long-term visual deprivation result in compensatory perceptual and neural changes in the adult visual pathway. It has not been established whether changes due to contrast adaptation are best characterized as "contrast gain" or "response gain." We present a theoretical rationale for predicting that adaptation to long-term contrast reduction should result in response gain. To test this hypothesis, normally sighted subjects adapted for four hours by viewing their environment through contrast-reducing goggles. During the adaptation period, the subjects went about their usual daily activities. Subjects' contrast-discrimination thresholds and fMRI BOLD responses in cortical areas V1 and V2 were obtained before and after adaptation. Following adaptation, we observed a significant decrease in contrast-discrimination thresholds, and significant increase in BOLD responses in V1 and V2. The observed interocular transfer of the adaptation effect suggests that the adaptation has a cortical origin. These results reveal a new kind of adaptability of the adult visual cortex, an adjustment in the gain of the contrast-response in the presence of a reduced range of stimulus contrasts, which is consistent with a response-gain mechanism. The adaptation appears to be compensatory, such that the precision of contrast coding is improved for low retinal-image contrasts.

Previous studies of tactile acuity on the fingertip, using passive touch, have demonstrated an age-related decline in spatial resolution for both sighted and blind subjects. We have reexamined this age dependence with two newly designed tactile-acuity charts that require active exploration of the test symbols. One chart used dot patterns similar to braille, and the other used embossed Landolt rings. Groups of blind braille readers and sighted subjects ranging from 12 to 85 years old were tested in two experiments. We replicated previous findings for sighted subjects by showing an age-related decrease in tactile acuity by nearly 1% per year. Surprisingly, the blind subjects retained high acuity into old age, showing no age-related decline. For the blind subjects, tactile acuity did not correlate with braille reading speed, the amount of daily reading, or the age at which braille was learned. We conclude that when measured with active touch, blind subjects retain high tactile acuity into old age, unlike their aging sighted peers. We propose that blind people's use of active touch in daily activities, not specifically braille reading, results in preservation of tactile acuity across the life span.

Purpose: It is often difficult to estimate parameters from individual clinical data because of noisy or incomplete measurements. Nonlinear mixed-effects (NLME) modeling provides a statistical framework for analyzing population parameters and the associated variations, even when individual data sets are incomplete. The authors demonstrate the application of NLME by analyzing data from the MNREAD, a continuous-text reading-acuity chart., Methods: The authors analyzed MNREAD data (measurements of reading speed vs. print size) for two groups: 42 adult observers with normal vision and 14 patients with age-related macular degeneration (AMD). Truncated sets of MNREAD data were generated from the individual observers with normal vision. The MNREAD data were fitted with a two-limb function and an exponential-decay function using an individual curve-fitting approach and an NLME modeling approach., Results: The exponential-decay function provided slightly better fits than the two-limb function. When the parameter estimates from the truncated data sets were used to predict the missing data, NLME modeling gave better predictions than individual fitting. NLME modeling gave reasonable parameter estimates for AMD patients even when individual fitting returned unrealistic estimates., Conclusions: These analyses showed that (1) an exponential-decay function fits MNREAD data very well, (2) NLME modeling provides a statistical framework for analyzing MNREAD data, and (3) NLME analysis provides a way of estimating MNREAD parameters even for incomplete data sets. The present results demonstrate the potential value of NLME modeling for clinical vision data.

Purpose: Visual-span profiles are plots of letter-recognition accuracy as a function of letter position left and right of the point of fixation. Legge, Mansfield, and Chung [Legge, G. E., Mansfield, J. S., & Chung, S. T. L. (2001). Psychophysics of reading-XX. Linking letter recognition to reading speed in central and peripheral vision. Vision Research, 41(6), 725-743] proposed that reduced size of the visual span is a spatial factor limiting reading speed in patients with age-related macular degeneration (AMD). We have recently shown that a temporal property of letter recognition--the exposure time required for a high level of accuracy--is also a factor limiting reading speed in AMD [Cheong, A. M. Y., Legge, G. E., Lawrence, M. G., Cheung, S. H., & Ruff, M. (2007). Relationship between slow visual processing and reading speed in people with macular degeneration. Vision Research, 47, 2943-2965]. We measured the visual-span profiles of AMD subjects and assessed the relationship of the spatial and temporal properties of these profiles to reading speed., Methods: Thirteen AMD subjects and 11 age-matched normals were tested. Visual-span profiles were measured by using the trigram letter-recognition method described by Legge et al. (2001). Each individual's temporal threshold for letter recognition (80% accuracy criterion) was used as the exposure time for measuring the visual-span profile. Size of the visual span was computed as the area under the profile in bits of information transmitted. The information transfer rate in bits per second was defined as the visual-span size in bits divided by the exposure time in sec., Results: AMD visual-span sizes were substantially smaller (median of 23.9 bits) than normal visual-span sizes in central vision (median of 40.8 bits, p<.01). For the nine AMD subjects with eccentric fixation, the visual-span sizes (median of 20.6 bits) were also significantly smaller than visual spans of normal controls at 10 degrees below fixation in peripheral vision (median of 29.0 bits, p=.01). Information transfer rate for the AMD subjects (median of 29.5 bits/s) was significantly slower than that for the age-matched normals at both central and peripheral vision (median of 411.7 and 290.5 bits/s respectively, ps<.01). Information transfer rates were more strongly correlated with reading speed than the size of the visual span, and explained 36% of the variance in AMD reading speed., Conclusion: Both visual-span size and information transfer rate were significantly impaired in the AMD subjects compared with age-matched normals. Information transfer rate, representing the combined effects of a reduced visual span and slower temporal processing of letters, was a better predictor of reading speed in AMD subjects than was the size of the visual span.

Purpose: Subjects with significant peripheral field loss (PFL) self report difficulty in street crossing. In this study, we compared the traffic gap judgment ability of fully sighted and PFL subjects to determine whether accuracy in identifying crossable gaps was adversely affected because of field loss. Moreover, we explored the contribution of visual and nonvisual factors to traffic gap judgment ability., Methods: Eight subjects with significant PFL as a result of advanced retinitis pigmentosa or glaucoma with binocular visual field <20 degrees and five age-matched normals (NV) were recruited. All subjects were required to judge when they perceived it was safe to cross at a 2-way 4-lane street while they stood on the curb. Eye movements were recorded by an eye tracker as the subjects performed the decision task. Movies of the eye-on-scene were made offline and fixation patterns were classified into either relevant or irrelevant. Subjects' street-crossing behavior, habitual approach to street crossing, and perceived difficulties were assessed., Results: Compared with normal vision (NV) subjects, the PFL subjects identified 12% fewer crossable gaps while making 23% more errors by identifying a gap as crossable when it was too short (p < 0.05). The differences in traffic gap judgment ability of the PFL subjects might be explained by the significantly smaller fixation area (p = 0.006) and fewer fixations distributed to the relevant tasks (p = 0.001). The subjects' habitual approach to street crossing and perceived difficulties in street crossing (r > 0.60) were significantly correlated with traffic gap judgment performance., Conclusions: As a consequence of significant field loss, limited visual information about the traffic environment can be acquired, resulting in significantly reduced performance in judging safe crossable gaps. This poor traffic gap judgment ability in the PFL subjects raises important concerns for their safety when attempting to cross the street.

Purpose: People with macular degeneration (MD) often read slowly even with adequate magnification to compensate for acuity loss. Oculomotor deficits may affect reading in MD, but cannot fully explain the substantial reduction in reading speed. Central-field loss (CFL) is often a consequence of macular degeneration, necessitating the use of peripheral vision for reading. We hypothesized that slower temporal processing of visual patterns in peripheral vision is a factor contributing to slow reading performance in MD patients., Methods: Fifteen subjects with MD, including 12 with CFL, and five age-matched control subjects were recruited. Maximum reading speed and critical print size were measured with rapid serial visual presentation (RSVP). Temporal processing speed was studied by measuring letter-recognition accuracy for strings of three randomly selected letters centered at fixation for a range of exposure times. Temporal threshold was defined as the exposure time yielding 80% recognition accuracy for the central letter., Results: Temporal thresholds for the MD subjects ranged from 159 to 5881 ms, much longer than values for age-matched controls in central vision (13 ms, p<0.01). The mean temporal threshold for the 11 MD subjects who used eccentric fixation (1555.8 +/- 1708.4 ms) was much longer than the mean temporal threshold (97.0 +/- 34.2 ms, p<0.01) for the age-matched controls at 10 degrees in the lower visual field. Individual temporal thresholds accounted for 30% of the variance in reading speed (p<0.05)., Conclusion: The significant association between increased temporal threshold for letter recognition and reduced reading speed is consistent with the hypothesis that slower visual processing of letter recognition is one of the factors limiting reading speed in MD subjects.

Purpose: To read efficiently with a simple hand or stand magnifier, people with visual impairment have to move (navigate) the device along each line (forward phase) and back to the correct position at the start of the next line (retrace phase). Page navigation difficulties have been implicated as limiting factors when reading with hand and stand magnifiers, but have not been objectively measured., Methods: Magnifier movements were recorded using a 3SPACE Isotrak system for 43 participants with age-related macular degeneration (AMD) who read two short stories using their habitual hand or stand magnifier. Page navigation was quantified in terms of magnifier movements and navigation errors for the forward and retrace phases. Visual acuities and visual fields were measured, and magnifier usage and page navigation difficulties were surveyed., Results: During the forward phase, participants primarily used either a straight (47%) or diagonal downward (46%) movement, whereas during the retrace phase, the majority (56%) used a downward movement. On average, forward navigation time was four times longer than retrace navigation time (p<0.001). The most common navigation error was incorrect positioning of the magnifier at the end of the retrace movement. Near word acuity correlated strongly with forward time (r=0.78), and moderately with retrace time (r=0.53) and forward errors (r=0.50). Vertical field of view correlated with retrace errors (r=-0.53). Participants' estimates of page navigation difficulties were not predictive of objective measures of performance., Conclusions: We quantified page navigation strategies and difficulties of people with AMD reading with magnifiers. Retrace, which presents the most common difficulty, is not well predicted by vision measures or magnifier characteristics; future studies should investigate the relationship between motor skills and navigation performance, and the impact of training or devices on reducing retrace navigation difficulties.

Purpose: People with low vision often use optical low vision aids to assist reading. There have been numerous training programs recommended to train people using magnifiers for reading. However, most of the programs are time consuming and labor intensive. In this study, we investigated the effects of home-based large print reading practice on reading performance when stand magnifiers (STM's) are first prescribed., Methods: Thirty-two subjects with age-related macular degeneration (AMD) and with minimal experience in using magnifiers for reading were recruited. They were divided into three groups: control, practice 1 (P1), and practice 2 (P2). Before the prescription of STM's, all the subjects were given the same amount of in-office practice with the STM (weeks 0 to 2). In addition, in these 2 weeks, P1 and P2 subjects were given large print books to read daily at home. P2 subjects were required to read the large print books through a reduced field of view. The control group subjects received no additional reading practice. Reading rates with and without STM's on passages of text were assessed for all the subjects regularly for 20 weeks., Results: There were no significant differences between the control, P1, and P2 groups in the increase in reading rate with STM (p = 0.29). At week 0, reading rate for small print with STM was significantly slower than reading rate on the equivalent-sized large print (p = 0.004); however, as time went on, reading rate with STM's increased significantly (p = 0.02). After 2 weeks of in-office magnifier practice and repeated measures of reading rate with STM, reading rate with STM had improved such that it was not significantly different from reading rate on large print (p = 0.11)., Conclusion: Supervised, short-term, in-office practice with the magnifier was effective in improving magnifier reading performance to achieve maximum reading rate. Additional large print reading practice did not result in any greater improvement in reading rate than in-office magnifier practice alone.