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Background Mutations in the L/M cone opsin gene array cause abnormally high perceived retinal contrast and the development of myopia. Environmental factors may also lead to high visual contrast and cause myopia. Diffusion optics technology (DOT) lenses are designed to reduce contrast signalling in the retina and slow myopia progression. Methods The Control of Myopia Using Peripheral Diffusion Lenses Efficacy and Safety Study (CYPRESS, NCT03623074) is a 36-month, multicentre, randomised, controlled, double-masked trial evaluating two investigational spectacle lenses versus control lenses in myopic children aged 6–10, with a planned interim analysis at 12 months. The primary endpoints are change from baseline in axial length (AL) and spherical equivalent refraction (SER). Results 256 children (58% female; mean age at screening, 8.1 years) were dispensed spectacles. Across all groups, baseline averages were AL 24.02 mm (SD±0.77 mm), SER −2.01 D (SD±0.9 D) using manifest refraction, and SER −1.94 D (SD±1.0 D) using cycloplegic autorefraction. At 12 months, mean difference in SER progression for test 1 versus control was −0.40 D (p<0.0001), representing a 74% reduction and −0.32 D for Test 2 (p<0.0001), representing a 59% reduction. The difference in AL progression for test 1 versus control was 0.15 mm (p<0.0001) and test 2 versus control was 0.10 mm (p=0.0018). Conclusion 12-month results from this ongoing trial demonstrate the safety and effectiveness of DOT spectacles for reducing myopic progression. [ABSTRACT FROM AUTHOR]

The transition from a centrally planned economy to a market economy with socialist characteristics has had a profound effect on China's cultural industries. This paper adopts a case study approach to illustrate the challenges that have shaped the administration of public museums as a consequence of China's economic reforms. By drawing upon an example of cross-cultural collaboration between Western cultural institutions and China's Nanjing Museum (南京博物院: nanjing bowuyuan), we uncover the tensions that exist between China's cultural policy preferences and the encroaching values of the market economy. In doing so, this article contributes towards a richer exposition of the local practices guiding cultural management, reflecting the broader challenges endemic among China's cultural industries. Primarily, we seek to illustrate how market imperatives have influenced local practices, creating a context unique to China that deviates from the central tenets of neoliberal development and market management. [ABSTRACT FROM AUTHOR]

This paper draws upon an extensive evidence base to analyze Chinese perceptions of Western cultural heritage and capture dominant reflections on an overseas destination as portrayed through selected images and artifacts. The dataset derives from an integrated methodological approach utilized to interpret visitor perceptions of an exhibition—hosted by Nanjing Museum, China—that focused on Scotland's cultural heritage. The analysis of the data revealed insight into the importance of the experiential qualities of heritage tourism—specifically those aligned to the natural environment—and a desire to achieve an emotive and sensual engagement with key signifiers of both tangible and intangible cultural heritage through potential leisure experiences. The results provide detailed insights into the contemporary values motivating Chinese outbound tourists to visit and experience overseas heritage, the importance and potential of innovative 'experience research methodologies' and practical guidance for destination organizations that seek to position and promote Western cultural heritage to a Chinese audience. [ABSTRACT FROM AUTHOR]

In this paper we consider why students in poor and rural regions of China are dropping out of school in numbers that may be greater than official statistics admit. With questions about education quality among the most intractable in Education for All initiatives across the developing world, we sketch a portrait of education in a remote mountain village community as it might be painted from the perspective of a primary school dropout: a portrait in which education quality is well in the shadows. We indicate the limits of the view that commonly relates the phenomenon of school dropout primarily with poverty, a lack of school resources and inequities in resource distribution, suggesting that the picture is more nuanced and subtly shaded at local levels. Our research indicates that the education system in the radically transitional society that China is today brings with it values that clash with those of its citizens, particularly those who are marginalized and cannot easily adjust, perhaps because of their disadvantaged socio-economic, cultural and geographic location. In an ethnographic study in a poor, rural area in Yunnan province, we found significant disjunctions in values: between those of the school system and those of parents with regard to the aims and purposes of education; between those of the curriculum and those of teachers with regard to their role in the classroom vis-a-vis knowledge as represented in textbooks; between those of government education policy and the concerns of the remote rural poor with regard to resource distribution; and between those of a newly market-oriented society and educational ideals about teachers' and students' abilities. We also offer some insight into the scale and complexity of the problems associated with a lack of education quality and students' dropping out of school as a consequence, which cannot be revealed by the official 1% dropout rate.

Background As recommended in the current prescribing information, rituximab infusions in patients with rheumatoid arthritis (RA) take 4.25 hours for the first infusion and 3.25 hours for subsequent infusions, which is a burden on patients and the health care system. We therefore evaluated the safety of infusing rituximab at a faster rate for an infusion period of 2 hours in patients with RA. Methods Patients with an inadequate response to anti-TNF who were rituximab-naive or -experienced received 2 courses of rituximab: Infusion 1 (Day 1) was administered over the standard 4.25 hours, and Infusions 2 (Day 15), 3 (Day 168) and 4 (Day 182) were administered over a faster 2-hour period. The primary endpoint was incidence of infusion-related reactions (IRRs) associated with Infusion 2. Results Of the 351 patients enrolled, 87% and 13% were rituximab-naive and -experienced, respectively. The incidence (95% CI) of IRRs associated with Infusion 1 was 16.2% (12.5%, 20.5%) and consistent with weighted historical incidence of 20.7% (19.4%, 22.1%). The incidence (95% CI) of IRRs associated with Infusions 2, 3, and 4 compared with respective weighted historical incidences at the standard infusion rate was 6.5% (4.1%, 9.7%) vs 8.1% (7.2%, 9.1%); 5.9% (3.5%, 9.3%) vs 11.5% (10.3%, 12.8%); and 0.7 (0.1%, 2.6%) vs 5.0% (4.2%, 6.0%), respectively. All IRRs were grade 1 or 2, except for 3 grade 3 IRRs associated with Infusion 1 and 2 grade 3 IRRs associated with Infusion 2. Four patients experienced a total of 5 grade 3 IRRs; 3 of these patients continued on to received subsequent infusions at the faster rate. There were no serious IRRs. Conclusion This study demonstrated that rituximab can be administered at the faster infusion rate at the second and subsequent infusions without increasing the rate or severity of IRRs. [ABSTRACT FROM AUTHOR]

Within recent years, China has experienced growth in the construction and development of museums. Encouraged by financial and cultural policy measures, China’s public museums have opened to the world with the aim of introducing Chinese culture to a broad audience and connecting with the global cultural marketplace. Cross-cultural collaboration has formed a prominent part of this strategy, functioning as a diplomatic tool to nurture mutual understanding between nations. Using empirical data from a research project that examined the production and consumption of an overseas exhibition hosted by Nanjing Museum (南京博物院: nanjing bowuyuan), this paper explores the processes of negotiation and avenues of innovation that emerged from the production of the exhibition and collaborative research project. By reflecting on the lessons learned from this partnership, practical solutions are offered to help inform future strategies and ways of working that may promote sustainable engagement and collaboration between UK and Chinese cultural institutions. [ABSTRACT FROM AUTHOR]

Background: Ranibizumab--a recombinant, humanized, monoclonal antibody Fab that neutralizes all active forms of vascular endothelial growth factor A--has been evaluated for the treatment of neovascular age-related macular degeneration. Methods: In this multicenter, 2-year, double-blind, sham-controlled study, we randomly assigned patients with age-related macular degeneration with either minimally classic or occult (with no classic lesions) choroidal neovascularization to receive 24 monthly intravitreal injections of ranibizumab (either 0.3 mg or 0.5 mg) or sham injections. The primary end point was the proportion of patients losing fewer than 15 letters from baseline visual acuity at 12 months. Results: We enrolled 716 patients in the study. At 12 months, 94.5% of the group given 0.3 mg of ranibizumab and 94.6% of those given 0.5 mg lost fewer than 15 letters, as compared with 62.2% of patients receiving sham injections (P < .001 for both comparisons). Visual acuity improved by 15 or more letters in 24.8% of the 0.3-mg group and 33.8% of the 0.5-mg group, as compared with 5.0% of the sham-injection group (P<.001 for both doses). Mean increases in visual acuity were 6.5 letters in the 0.3-mg group and 7.2 letters in the 0.5-mg group, as compared with a decrease of 10.4 letters in the shaminjection group (P<.001 for both comparisons). The benefit in visual acuity was maintained at 24 months. During 24 months, presumed endophthalmitis was identified in five patients (1.0%) and serious uveitis in six patients (1.3%) given ranibizumab. Conclusions: Intravitreal administration of ranibizumab for 2 years prevented vision loss and improved mean visual acuity, with low rates of serious adverse events, in patients with minimally classic or occult (with no classic lesions) choroidal neovascularization secondary to age-related macular degeneration. [ABSTRACT FROM AUTHOR]

Psychological issues following hematopoietic cell transplantation (HCT) are unfortunately common. Literature specific to the transplant experience for the needs of adolescents and young adults (AYA) is lacking. The purpose of this article is to (1) describe the allogeneic transplant experience for AYA transplant patients during the first year following transplantation including demographic and treatment characteristics, (2) present AYA data obtained during and following a six-part posttransplant discharge study, (3) illustrate typical AYA experiences using case studies, and (4) propose AYA intervention strategies within Erickson's stages of psychosocial development. A quality of life model provided the research conceptual framework, and the content analysis framework for the qualitative research. Themes that emerged within each domain were the following: sexuality/fertility, fatigue, depression/poor coping/habits,adherence issues, use of technology, dependency issues, changes in roles/relationships, issues with school/education, financial issues, family problems/issues, miscellaneous, religion/spirituality, fear of future, uncertainty, life, death, more life appreciation. These data guide us for providing targeted interventions for the needs of this AYA population. This paper has presented literature and developmental theory, qualitative and qualitative data from an intervention study, and clinical cases in order to propose a developmental treatment model for AYA transplant patients. A coordinated and multidisciplinary approach is needed for the HCT patient who is an AYA.