Are Individual Differences in Reading Speed Related to Extrafoveal Visual Acuity and Crowding?

PubMed Central

Frömer, Romy; Dimigen, Olaf; Niefind, Florian; Krause, Niels; Kliegl, Reinhold; Sommer, Werner

2015-01-01

Readers differ considerably in their speed of self-paced reading. One factor known to influence fixation durations in reading is the preprocessing of words in parafoveal vision. Here we investigated whether individual differences in reading speed or the amount of information extracted from upcoming words (the preview benefit) can be explained by basic differences in extrafoveal vision—i.e., the ability to recognize peripheral letters with or without the presence of flanking letters. Forty participants were given an adaptive test to determine their eccentricity thresholds for the identification of letters presented either in isolation (extrafoveal acuity) or flanked by other letters (crowded letter recognition). In a separate eye-tracking experiment, the same participants read lists of words from left to right, while the preview of the upcoming words was manipulated with the gaze-contingent moving window technique. Relationships between dependent measures were analyzed on the observational level and with linear mixed models. We obtained highly reliable estimates both for extrafoveal letter identification (acuity and crowding) and measures of reading speed (overall reading speed, size of preview benefit). Reading speed was higher in participants with larger uncrowded windows. However, the strength of this relationship was moderate and it was only observed if other sources of variance in reading speed (e.g., the occurrence of regressive saccades) were eliminated. Moreover, the size of the preview benefit—an important factor in normal reading—was larger in participants with better extrafoveal acuity. Together, these results indicate a significant albeit moderate contribution of extrafoveal vision to individual differences in reading speed. PMID:25789812

Effects of Milk vs Dark Chocolate Consumption on Visual Acuity and Contrast Sensitivity Within 2 Hours: A Randomized Clinical Trial.

PubMed

Rabin, Jeff C; Karunathilake, Nirmani; Patrizi, Korey

2018-04-26

Consumption of dark chocolate can improve blood flow, mood, and cognition in the short term, but little is known about the possible effects of dark chocolate on visual performance. To compare the short-term effects of consumption of dark chocolate with those of milk chocolate on visual acuity and large- and small-letter contrast sensitivity. A randomized, single-masked crossover design was used to assess short-term visual performance after consumption of a dark or a milk chocolate bar. Thirty participants without pathologic eye disease each consumed dark and milk chocolate in separate sessions, and within-participant paired comparisons were used to assess outcomes. Testing was conducted at the Rosenberg School of Optometry from June 25 to August 15, 2017. Visual acuity (in logMAR units) and large- and small-letter contrast sensitivity (in the log of the inverse of the minimum detectable contrast [logCS units]) were measured 1.75 hours after consumption of dark and milk chocolate bars. Among the 30 participants (9 men and 21 women; mean [SD] age, 26 [5] years), small-letter contrast sensitivity was significantly higher after consumption of dark chocolate (mean [SE], 1.45 [0.04] logCS) vs milk chocolate (mean [SE], 1.30 [0.05] logCS; mean improvement, 0.15 logCS [95% CI, 0.08-0.22 logCS]; P < .001). Large-letter contrast sensitivity was slightly higher after consumption of dark chocolate (mean [SE], 2.05 [0.02] logCS) vs milk chocolate (mean [SE], 2.00 [0.02] logCS; mean improvement, 0.05 logCS [95% CI, 0.00-0.10 logCS]; P = .07). Visual acuity improved slightly after consumption of dark chocolate (mean [SE], -0.22 [0.01] logMAR; visual acuity, approximately 20/12) and milk chocolate (mean [SE], -0.18 [0.01] logMAR; visual acuity, approximately 20/15; mean improvement, 0.04 logMAR [95% CI, 0.02-0.06 logMAR]; P = .05). Composite scores combining results from all tests showed significant improvement after consumption of dark compared with milk chocolate

Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study.

PubMed

Holz, Frank G; Tadayoni, Ramin; Beatty, Stephen; Berger, Alan; Cereda, Matteo Giuseppe; Hykin, Philip; Staurenghi, Giovanni; Wittrup-Jensen, Kim; Altemark, Andreas; Nilsson, Jonas; Kim, Kun; Sivaprasad, Sobha

2016-12-01

To identify predictive markers for the outcomes of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration (nAMD). AURA was a retrospective, observational, multicentre study that monitored the 2-year outcomes following intravitreal ranibizumab treatment in patients with nAMD. Using stepwise regression analysis, we evaluated the association between visual acuity outcomes, baseline characteristics and resource utilisation in order to determine which variables are significantly linked to outcomes in AURA. We also examined the relationship between visual acuity outcomes and number of injections received. Analyses were performed using data from year 1 (n=1695) and year 2 completers (n=1184). Logistic analysis showed that baseline visual acuity score, age at start of therapy, number of ophthalmoscopies and optical coherence tomography (OCT) (combined) and number of injections (ranibizumab) were significant (p<0.05) prognostic factors for vision maintenance (loss <15 letters) or vision gain (≥15 letters). Patients who received >7 injections (in 1 year) or >14 injections (over 2 years) gained more letters and demonstrated greater vision maintenance (loss of <15 letters) than patients who received fewer injections. There was a significant (p<0.05) association between number of injections and national reimbursement schemes and OCT. A number of factors that are predictive of treatment outcomes in a real-life setting were identified. Notably, the decline of treatment benefits may be linked to number of injections and a failure to visit clinicians and receive OCT as required. These findings may be helpful in guiding ophthalmologist treatment decisions under limited time and financial constraints. NCT01447043. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Repeatability of Monocular Acuity Testing in Adults with and without Down Syndrome.

PubMed

Ravikumar, Ayeswarya; Benoit, Julia S; Morrison, Kelsie B; Marsack, Jason D; Anderson, Heather A

2018-03-01

Individuals with Down syndrome may experience greater difficulty reliably performing visual acuity (VA) tests because of intellectual disability and limitations in visual quality. This study evaluated the repeatability of acuity (Bailey-Lovie [BL] and HOTV) in subjects with and without Down syndrome. High-contrast VA was measured in both eyes of 30 subjects with Down syndrome (mean, 30 years; range, 18 to 50 years) and 24 control subjects without Down syndrome (mean, 29 years; range, 18 to 50 years). In the Down syndrome group, 23 subjects performed BL, and 7 subjects performed HOTV. All control subjects performed both BL and HOTV, but for HOTV analysis, only seven age-matched control subjects were included. For each eye, subjects performed VA three times on different charts (computer controlled, single-line display) until five total letters were missed on each chart. A repeated-measure ANOVA was used to compare the acuity measures between groups. The average logMAR VA for subjects with Down syndrome was approximately six lines worse than the control subjects (BL: Down syndrome = right eye: 0.51 ± 0.16, left eye: 0.53 ± 0.18; control = right eye: -0.06 ± 0.06, left eye: -0.06 ± 0.08, P < .0001; HOTV: Down syndrome = right eye: 0.47 ± 0.19, left eye: 0.46 ± 0.16; control: right eye = -0.11 ± 0.09, left eye: -0.07 ± 0.07, P < .001). Bailey-Lovie VA repeatability (1.96 * Sw * √2) was 0.13 logMAR (6.5 letters) for Down syndrome and 0.09 logMAR (4.5 letters) for control subjects. HOTV VA repeatability was 0.16 logMAR (eight letters) for both Down syndrome and control subjects. Despite poorer acuity in individuals with Down syndrome, repeatability of VA measurements was comparable to control subjects for both BL and HOTV techniques.

PROSPECTIVE EVALUATION OF VISUAL ACUITY AGREEMENT BETWEEN STANDARD EARLY TREATMENT DIABETIC RETINOPATHY STUDY CHART AND A HANDHELD EQUIVALENT IN EYES WITH RETINAL PATHOLOGY.

PubMed

Rahimy, Ehsan; Reddy, Sahitya; DeCroos, Francis Char; Khan, M Ali; Boyer, David S; Gupta, Omesh P; Regillo, Carl D; Haller, Julia A

2015-08-01

To evaluate the visual acuity agreement between a standard back-illuminated Early Treatment Diabetic Retinopathy Study (ETDRS) chart and a handheld internally illuminated ETDRS chart. Two-center prospective study. Seventy patients (134 eyes) with retinal pathology were enrolled between October 2012 and August 2013. Visual acuity was measured using both the ETDRS chart and the handheld device by masked independent examiners after best protocol refraction. Examination was performed in the same room under identical illumination and testing conditions. The mean number of letters seen was 63.0 (standard deviation: 19.8 letters) and 61.2 letters (standard deviation: 19.1 letters) for the ETDRS chart and handheld device, respectively. Mean difference per eye between the ETDRS and handheld device was 1.8 letters. A correlation coefficient (r) of 0.95 demonstrated a positive linear correlation between ETDRS chart and handheld device measured acuities. Intraclass correlation coefficient was performed to assess the reproducibility of the measurements made by different observers measuring the same quantity and was calculated to be 0.95 (95% confidence interval: 0.93-0.96). Agreement was independent of retinal disease. The strong correlation between measured visual acuity using the ETDRS and handheld equivalent suggests that they may be used interchangeably, with accurate measurements. Potential benefits of this device include convenience and portability, as well as the ability to assess ETDRS visual acuity without a dedicated testing lane.

Visual acuity measured with luminance-modulated and contrast-modulated noise letter stimuli in young adults and adults above 50 years old

PubMed Central

Woi, Pui Juan; Kaur, Sharanjeet; Waugh, Sarah J.; Hairol, Mohd Izzuddin

2016-01-01

The human visual system is sensitive in detecting objects that have different luminance level from their background, known as first-order or luminance-modulated (LM) stimuli. We are also able to detect objects that have the same mean luminance as their background, only differing in contrast (or other attributes). Such objects are known as second-order or contrast-modulated (CM), stimuli. CM stimuli are thought to be processed in higher visual areas compared to LM stimuli, and may be more susceptible to ageing. We compared visual acuities (VA) of five healthy older adults (54.0±1.83 years old) and five healthy younger adults (25.4±1.29 years old) with LM and CM letters under monocular and binocular viewing. For monocular viewing, age had no effect on VA [F(1, 8)= 2.50, p> 0.05]. However, there was a significant main effect of age on VA under binocular viewing [F(1, 8)= 5.67, p< 0.05].  Binocular VA with CM letters in younger adults was approximately two lines better than that in older adults. For LM, binocular summation ratios were similar for older (1.16±0.21) and younger (1.15±0.06) adults. For CM, younger adults had higher binocular summation ratio (1.39±0.08) compared to older adults (1.12±0.09). Binocular viewing improved VA with LM letters for both groups similarly. However, in older adults, binocular viewing did not improve VA with CM letters as much as in younger adults. This could reflect a decline of higher visual areas due to ageing process, most likely higher than V1, which may be missed if measured with luminance-based stimuli alone. PMID:28184281

[Pilot study to resolve problems of visual acuity assessment in grading vision of the physically handicapped--visual acuity and difficulties in daily life of age-related macular degeneration-].

PubMed

Yuzawa, Mitsuko; Ishibashi, Tatsuro; Honda, Yoshihito; Kubota, Nobue

2010-09-01

To resolve the problems of visual acuity assessment in grading the vision of the physically handicapped as proposed by the Subcommittee for Promoting the Realization of a Cohesive Society with the Visually Disabled, Science Council of Japan, a method suitable for assessing visual disturbances, and the relationship between the degree of visual disturbances and the degree of difficulty in activities of daily life are clarified. 151 persons with age-related macular degeneration were studied. Examination methods for measuring visual acuity and reading performance were studied, and interviews using the daily living task dependent on vision (DLTV) questionnaire were performed. The correlations between total DLTV score and each examination method were analyzed. The median total DLTV score for each grade of visual acuity of the better eye was calculated. Spearman's correlation coefficient between distance corrected visual acuity of the better eye and total DLTV score was 0.76. Median DLTV scores for visual acuities (better eye) of 0.2, 0.3, 0.4, 0.5 were 65, 73.5, 62, 79 respectively. Visual acuity can be assessed by measuring distant corrected visual acuity of the better eye and setting the upper limit of visual disturbance at either 0.3 or 0.4.

Desktop publishing and validation of custom near visual acuity charts.

PubMed

Marran, Lynn; Liu, Lei; Lau, George

2008-11-01

Customized visual acuity (VA) assessment is an important part of basic and clinical vision research. Desktop computer based distance VA measurements have been utilized, and shown to be accurate and reliable, but computer based near VA measurements have not been attempted, mainly due to the limited spatial resolution of computer monitors. In this paper, we demonstrate how to use desktop publishing to create printed custom near VA charts. We created a set of six near VA charts in a logarithmic progression, 20/20 through 20/63, with multiple lines of the same acuity level, different letter arrangements in each line and a random noise background. This design allowed repeated measures of subjective accommodative amplitude without the potential artifact of familiarity of the optotypes. The background maintained a constant and spatial frequency rich peripheral stimulus for accommodation across the six different acuity levels. The paper describes in detail how pixel-wise accurate black and white bitmaps of Sloan optotypes were used to create the printed custom VA charts. At all acuity levels, the physical sizes of the printed custom optotypes deviated no more than 0.034 log units from that of the standard, satisfying the 0.05 log unit ISO criterion we used to demonstrate physical equivalence. Also, at all acuity levels, log unit differences in the mean target distance for which reliable recognition of letters first occurred for the printed custom optotypes compared to the standard were found to be below 0.05, satisfying the 0.05 log unit ISO criterion we used to demonstrate functional equivalence. It is possible to use desktop publishing to create custom near VA charts that are physically and functionally equivalent to standard VA charts produced by a commercial printing process.

Sensory factors limiting horizontal and vertical visual span for letter recognition

PubMed Central

Yu, Deyue; Legge, Gordon E.; Wagoner, Gunther; Chung, Susana T. L.

2014-01-01

Reading speed for English text is slower for text oriented vertically than horizontally. Yu, Park, Gerold, and Legge (2010) showed that slower reading of vertical text is associated with a smaller visual span (the number of letters recognized with high accuracy without moving the eyes). Three possible sensory determinants of the size of the visual span are: resolution (decreasing acuity at letter positions farther from the midline), mislocations (uncertainty about the relative position of letters in strings), and crowding (interference from flanking letters in recognizing the target letter). In the present study, we asked which of these factors is most important in determining the size of the visual span, and likely in turn in determining the horizontal/vertical difference in reading when letter size is above the critical print size for reading. We used a decomposition analysis to represent constraints due to resolution, mislocations, and crowding as losses in information transmitted (in bits) about letter recognition. Across vertical and horizontal conditions, crowding accounted for 75% of the loss in information, mislocations accounted for 19% of the loss, and declining acuity away from fixation accounted for only 6%. We conclude that crowding is the major factor limiting the size of the visual span, and that the horizontal/vertical difference in the size of the visual span is associated with stronger crowding along the vertical midline. PMID:25187253

Sensory factors limiting horizontal and vertical visual span for letter recognition

PubMed Central

Yu, Deyue; Legge, Gordon E.; Wagoner, Gunther; Chung, Susana T. L.

2014-01-01

Reading speed for English text is slower for text oriented vertically than horizontally. Yu, Park, Gerold, and Legge (2010) showed that slower reading of vertical text is associated with a smaller visual span (the number of letters recognized with high accuracy without moving the eyes). Three possible sensory determinants of the size of the visual span are: resolution (decreasing acuity at letter positions farther from the midline), mislocations (uncertainty about the relative position of letters in strings), and crowding (interference from flanking letters in recognizing the target letter). In the present study, we asked which of these factors is most important in determining the size of the visual span, and likely in turn in determining the horizontal/vertical difference in reading when letter size is above the critical print size for reading. We used a decomposition analysis to represent constraints due to resolution, mislocations, and crowding as losses in information transmitted (in bits) about letter recognition. Across vertical and horizontal conditions, crowding accounted for 75% of the loss in information, mislocations accounted for 19% of the loss, and declining acuity away from fixation accounted for only 6%. We conclude that crowding is the major factor limiting the size of the visual span, and that the horizontal/vertical difference in the size of the visual span is associated with stronger crowding along the vertical midline.

Nurse-patient assignment models considering patient acuity metrics and nurses' perceived workload.

PubMed

Sir, Mustafa Y; Dundar, Bayram; Barker Steege, Linsey M; Pasupathy, Kalyan S

2015-06-01

Patient classification systems (PCSs) are commonly used in nursing units to assess how many nursing care hours are needed to care for patients. These systems then provide staffing and nurse-patient assignment recommendations for a given patient census based on these acuity scores. Our hypothesis is that such systems do not accurately capture workload and we conduct an experiment to test this hypothesis. Specifically, we conducted a survey study to capture nurses' perception of workload in an inpatient unit. Forty five nurses from oncology and surgery units completed the survey and rated the impact of patient acuity indicators on their perceived workload using a six-point Likert scale. These ratings were used to calculate a workload score for an individual nurse given a set of patient acuity indicators. The approach offers optimization models (prescriptive analytics), which use patient acuity indicators from a commercial PCS as well as a survey-based nurse workload score. The models assign patients to nurses in a balanced manner by distributing acuity scores from the PCS and survey-based perceived workload. Numerical results suggest that the proposed nurse-patient assignment models achieve a balanced assignment and lower overall survey-based perceived workload compared to the assignment based solely on acuity scores from the PCS. This results in an improvement of perceived workload that is upwards of five percent. Copyright © 2015 Elsevier Inc. All rights reserved.

Developmental Changes during Childhood in Single-Letter Acuity and Its Crowding by Surrounding Contours

ERIC Educational Resources Information Center

Jeon, Seong Taek; Hamid, Joshua; Maurer, Daphne; Lewis, Terri L.

2010-01-01

Crowding refers to impaired target recognition caused by surrounding contours. We investigated the development of crowding in central vision by comparing single-letter and crowding thresholds in groups of 5-year-olds, 8-year-olds, 11-year-olds, and adults. The task was to discriminate the orientation of a Sloan letter E. Single-letter thresholds,…

Reliability of visual acuity measurements taken with a notebook and a tablet computer in participants who were illiterate to Roman characters.

PubMed

Ruamviboonsuk, Paisan; Sudsakorn, Napitchareeya; Somkijrungroj, Thanapong; Engkagul, Chayanee; Tiensuwan, Montip

2012-03-01

Electronic measurement of visual acuity (VA) has been proposed and adopted as a method of determining VA scores in clinical research. Characters (optotypes) are displayed on a monitor screen and the examinee selects a match and inputs his choice to another electronic device. Unfortunately, the optotypes, called Sloan letters, in the standard protocol are 10 Roman characters. This limits their practicabilityfor measuring VA of patients who are illiterate to these characters. The authors introduced a method of displaying the Sloan letters one by one on a notebook and all 10 Sloan letters on a tablet computer screen. The former is for testing the patients whereas the latter is for them to input their responses by tapping on a letter that matches the one on the notebook screen. To assess test-retest reliability of VA scores determined with this method. Participants without ocular abnormality were recruited to have their right eyes measured with the same VA measurement method twice, one week apart. Those who were illiterate to Roman characters were enrolled for the aforementioned method for measuring their VA (Tablet group). A 15-inch display notebook computer and a 9-inch display tablet computer (iPad) communicated via a local wireless data network provided by a Wi-Fi router. Those who understood Roman characters were enrolled to have measurements with a 17-inch desktop computer and an infrared wireless keyboard (Keyboard group). Both methods used the same protocols and software for VA measurements. Reliability of VA scores obtained from each group was assessed by the confidence interval (CI) of the difference of the scores from the test and retest. The t test was used to analyze differences in mean VA scores between the test and retest in each group with p < 0.05 determined as statistically significant. There were 49 and 50 participants in the Tablet and Keyboard group respectively. The 95% CI of the difference between the scores from the test and retest in each group

Evaluation of visual acuity measurements after autorefraction vs manual refraction in eyes with and without diabetic macular edema.

PubMed

Sun, Jennifer K; Qin, Haijing; Aiello, Lloyd Paul; Melia, Michele; Beck, Roy W; Andreoli, Christopher M; Edwards, Paul A; Glassman, Adam R; Pavlica, Michael R

2012-04-01

To compare visual acuity (VA) scores after autorefraction vs manual refraction in eyes of patients with diabetes mellitus and a wide range of VAs. The letter score from the Electronic Visual Acuity (EVA) test from the electronic Early Treatment Diabetic Retinopathy Study was measured after autorefraction (AR-EVA score) and after manual refraction (MR-EVA score), which is the research protocol of the Diabetic Retinopathy Clinical Research Network. Testing order was randomized, study participants and VA examiners were masked to refraction source, and a second EVA test using an identical supplemental manual refraction (MR-EVAsuppl score) was performed to determine test-retest variability. In 878 eyes of 456 study participants, the median MR-EVA score was 74 (Snellen equivalent, approximately 20/32). The spherical equivalent was often similar for manual refraction and autorefraction (median difference, 0.00; 5th-95th percentile range, -1.75 to 1.13 diopters). However, on average, the MR-EVA scores were slightly better than the AR-EVA scores, across the entire VA range. Furthermore, the variability between the AR-EVA scores and the MR-EVA scores was substantially greater than the test-retest variability of the MR-EVA scores (P < .001). The variability of differences was highly dependent on the autorefractor model. Across a wide range of VAs at multiple sites using a variety of autorefractors, VA measurements tend to be worse with autorefraction than manual refraction. Differences between individual autorefractor models were identified. However, even among autorefractor models that compare most favorably with manual refraction, VA variability between autorefraction and manual refraction is higher than the test-retest variability of manual refraction. The results suggest that, with current instruments, autorefraction is not an acceptable substitute for manual refraction for most clinical trials with primary outcomes dependent on best-corrected VA.

Simulating visibility under reduced acuity and contrast sensitivity.

PubMed

Thompson, William B; Legge, Gordon E; Kersten, Daniel J; Shakespeare, Robert A; Lei, Quan

2017-04-01

Architects and lighting designers have difficulty designing spaces that are accessible to those with low vision, since the complex nature of most architectural spaces requires a site-specific analysis of the visibility of mobility hazards and key landmarks needed for navigation. We describe a method that can be utilized in the architectural design process for simulating the effects of reduced acuity and contrast on visibility. The key contribution is the development of a way to parameterize the simulation using standard clinical measures of acuity and contrast sensitivity. While these measures are known to be imperfect predictors of visual function, they provide a way of characterizing general levels of visual performance that is familiar to both those working in low vision and our target end-users in the architectural and lighting-design communities. We validate the simulation using a letter-recognition task.

Simulating Visibility Under Reduced Acuity and Contrast Sensitivity

PubMed Central

Thompson, William B.; Legge, Gordon E.; Kersten, Daniel J.; Shakespeare, Robert A.; Lei, Quan

2017-01-01

Architects and lighting designers have difficulty designing spaces that are accessible to those with low vision, since the complex nature of most architectural spaces requires a site-specific analysis of the visibility of mobility hazards and key landmarks needed for navigation. We describe a method that can be utilized in the architectural design process for simulating the effects of reduced acuity and contrast on visibility. The key contribution is the development of a way to parameterize the simulation using standard clinical measures of acuity and contrast sensitivity. While these measures are known to be imperfect predictors of visual function, they provide a way of characterizing general levels of visual performance that is familiar to both those working in low vision and our target end-users in the architectural and lighting design communities. We validate the simulation using a letter recognition task. PMID:28375328

Automated Measurement of Visual Acuity in Pediatric Ophthalmic Patients Using Principles of Game Design and Tablet Computers.

PubMed

Aslam, Tariq M; Tahir, Humza J; Parry, Neil R A; Murray, Ian J; Kwak, Kun; Heyes, Richard; Salleh, Mahani M; Czanner, Gabriela; Ashworth, Jane

2016-10-01

To report on the utility of a computer tablet-based method for automated testing of visual acuity in children based on the principles of game design. We describe the testing procedure and present repeatability as well as agreement of the score with accepted visual acuity measures. Reliability and validity study. Setting: Manchester Royal Eye Hospital Pediatric Ophthalmology Outpatients Department. Total of 112 sequentially recruited patients. For each patient 1 eye was tested with the Mobile Assessment of Vision by intERactIve Computer for Children (MAVERIC-C) system, consisting of a software application running on a computer tablet, housed in a bespoke viewing chamber. The application elicited touch screen responses using a game design to encourage compliance and automatically acquire visual acuity scores of participating patients. Acuity was then assessed by an examiner with a standard chart-based near ETDRS acuity test before the MAVERIC-C assessment was repeated. Reliability of MAVERIC-C near visual acuity score and agreement of MAVERIC-C score with near ETDRS chart for visual acuity. Altogether, 106 children (95%) completed the MAVERIC-C system without assistance. The vision scores demonstrated satisfactory reliability, with test-retest VA scores having a mean difference of 0.001 (SD ±0.136) and limits of agreement of 2 SD (LOA) of ±0.267. Comparison with the near EDTRS chart showed agreement with a mean difference of -0.0879 (±0.106) with LOA of ±0.208. This study demonstrates promising utility for software using a game design to enable automated testing of acuity in children with ophthalmic disease in an objective and accurate manner. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of the American Optical Vision Tester and the Armed Forces Far Visual Acuity Test. B-6-133-13

DTIC Science & Technology

1954-01-01

THE AMERICAN OPTICAL VISION TESTER AND THE ARMED FORCES FAR VISUAL ACUITY TEST Comparisons were made of the visual acuity scores of 100 enlisted men on ...the American Optical Vision Tester (with Sloan plates) and on the Armed Forces Far Visual Acuity test. Order of presentation was: AO-left eye, AO...right eye, AFFVAT-left, AFVTAT-right. Correlation coefficients between AO and AFFVAT were around .89. Dispersion of acuity scores was about the same on

Resolution acuity versus recognition acuity with Landolt-style optotypes.

PubMed

Heinrich, Sven P; Bach, Michael

2013-09-01

International standards define acuity as the reciprocal of the threshold gap size of a Landolt C optotype. However, the literature is inconsistent as to what type of acuity is measured with Landolt Cs. The present study addresses this question more directly than previous studies by quantifying the effect of an inherent luminance artifact in Landolt-style optotypes. Two groups of modified optotypes were used. In the first group, each optotype had a single gap structure with the same average luminance. Between optotypes, the gap structures differed in their degree of fineness. In the second group of optotypes, a standard gap was always present, defining the orientation of the optotype. Additional gap structures of the same average luminance, but different fineness, were inserted at the remaining potential gap locations, thereby balancing luminance across potential gap locations. Visual acuity measures were obtained for each optotype variant, using a computer-based test employing a staircase procedure. Similar acuity values were obtained for all optotypes of the first group, and for standard Landolt Cs, irrespective of the fineness of the gap structure. With luminance-balanced optotypes of the second group, measured acuity was halved, compared to standard optotypes. The results support the view that it is recognition acuity, rather than resolution acuity, which is measured with standard Landolt-style optotypes, with the imbalanced luminance distribution serving as a cue. Luminance-balanced optotypes may help to obtain a more veridical estimate of resolution acuity, although recognition acuity may be more relevant in daily living.

Perceptual learning improves contrast sensitivity, visual acuity, and foveal crowding in amblyopia.

PubMed

Barollo, Michele; Contemori, Giulio; Battaglini, Luca; Pavan, Andrea; Casco, Clara

2017-01-01

Amblyopic observers present abnormal spatial interactions between a low-contrast sinusoidal target and high-contrast collinear flankers. It has been demonstrated that perceptual learning (PL) can modulate these low-level lateral interactions, resulting in improved visual acuity and contrast sensitivity. We measured the extent and duration of generalization effects to various spatial tasks (i.e., visual acuity, Vernier acuity, and foveal crowding) through PL on the target's contrast detection. Amblyopic observers were trained on a contrast-detection task for a central target (i.e., a Gabor patch) flanked above and below by two high-contrast Gabor patches. The pre- and post-learning tasks included lateral interactions at different target-to-flankers separations (i.e., 2, 3, 4, 8λ) and included a range of spatial frequencies and stimulus durations as well as visual acuity, Vernier acuity, contrast-sensitivity function, and foveal crowding. The results showed that perceptual training reduced the target's contrast-detection thresholds more for the longest target-to-flanker separation (i.e., 8λ). We also found generalization of PL to different stimuli and tasks: contrast sensitivity for both trained and untrained spatial frequencies, visual acuity for Sloan letters, and foveal crowding, and partially for Vernier acuity. Follow-ups after 5-7 months showed not only complete maintenance of PL effects on visual acuity and contrast sensitivity function but also further improvement in these tasks. These results suggest that PL improves facilitatory lateral interactions in amblyopic observers, which usually extend over larger separations than in typical foveal vision. The improvement in these basic visual spatial operations leads to a more efficient capability of performing spatial tasks involving high levels of visual processing, possibly due to the refinement of bottom-up and top-down networks of visual areas.

SKread predicts handwriting performance in patients with low vision.

PubMed

Downes, Ken; Walker, Laura L; Fletcher, Donald C

2015-06-01

To assess whether performance on the Smith-Kettlewell Reading (SKread) test is a reliable predictor of handwriting performance in patients with low vision. Cross-sectional study. Sixty-six patients at their initial low-vision rehabilitation evaluation. The patients completed all components of a routine low-vision appointment including logMAR acuity, performed the SKread test, and performed a handwriting task. Patients were timed while performing each task and their accuracy was recorded. The handwriting task was performed by having patients write 5 5-letter words into sets of boxes where each letter is separated by a box. The boxes were 15 × 15 mm, and accuracy was scored with 50 points possible from 25 letters: 1 point for each letter within the confines of a box and 1 point if the letter was legible. Correlation analysis was then performed. Median age of participants was 84 (range 54-97) years. Fifty-seven patients (86%) had age-related macular degeneration or some other maculopathy, whereas 9 patients (14%) had visual impairment from media opacity or neurologic impairment. Median Early Treatment Diabetic Retinopathy Study acuity was 20/133 (range 20/22 to 20/1000), and median logMAR acuity was 0.82 (range 0.04-1.70). SKread errors per block correlated with logMAR acuity (r = 0.6), and SKread time per block correlated with logMAR acuity (r = 0.51). SKread errors per block correlated with handwriting task time/accuracy ratio (r = 0.61). SKread time per block correlated with handwriting task time/accuracy ratio (r = 0.7). LogMAR acuity score correlated with handwriting task time/accuracy ratio (r = 0.42). All p values were < 0.01. SKread scores predict handwriting performance in patients with low vision better than logMAR acuity. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Associations among visual acuity and vision- and health-related quality of life among patients in the multicenter uveitis steroid treatment trial.

PubMed

Frick, Kevin D; Drye, Lea T; Kempen, John H; Dunn, James P; Holland, Gary N; Latkany, Paul; Rao, Narsing A; Sen, H Nida; Sugar, Elizabeth A; Thorne, Jennifer E; Wang, Robert C; Holbrook, Janet T

2012-03-01

To evaluate the associations between visual acuity and self-reported visual function; visual acuity and health-related quality of life (QoL) metrics; a summary measure of self-reported visual function and health-related QoL; and individual domains of self-reported visual function and health-related QoL in patients with uveitis. Best-corrected visual acuity, vision-related functioning as assessed by the NEI VFQ-25, and health-related QoL as assessed by the SF-36 and EuroQoL EQ-5D questionnaires were obtained at enrollment in a clinical trial of uveitis treatments. Multivariate regression and Spearman correlations were used to evaluate associations between visual acuity, vision-related function, and health-related QoL. Among the 255 patients, median visual acuity in the better-seeing eyes was 20/25, the vision-related function score indicated impairment (median, 60), and health-related QoL scores were within the normal population range. Better visual acuity was predictive of higher visual function scores (P ≤ 0.001), a higher SF-36 physical component score, and a higher EQ-5D health utility score (P < 0.001). The vision-specific function score was predictive of all general health-related QoL (P < 0.001). The correlations between visual function score and general quality of life measures were moderate (ρ = 0.29-0.52). The vision-related function score correlated positively with visual acuity and moderately positively with general QoL measures. Cost-utility analyses relying on changes in generic healthy utility measures will be more likely to detect changes when there are clinically meaningful changes in vision-related function, rather than when there are only changes in visual acuity. (ClinicalTrials.gov number, NCT00132691.).

Dynamic visual acuity using "far" and "near" targets

NASA Technical Reports Server (NTRS)

Peters, Brian T.; Bloomberg, Jacob J.

2005-01-01

CONCLUSIONS: DVA may be useful for assessing the functional consequences of an impaired gaze stabilization mechanism or for testing the effectiveness of a rehabilitation paradigm. Because target distance influences the relative contributions of canal and otolith inputs, the ability to measure DVA at near and far viewing distances may also lead to tests that will independently assess canal and otolith function. OBJECTIVE: To present and test a methodology that uses dynamic visual acuity (DVA) to assess the efficacy of compensatory gaze mechanisms during a functionally relevant activity that differentially measures canal and otolith function. MATERIAL AND METHODS: The effect of treadmill walking at a velocity of 1.79 m/s on subjects' visual acuity was assessed at each of two viewing distances. A custom-written threshold determination program was used to display Landolt C optotypes on a laptop computer screen during a "far" (4 m) target condition and on a micro-display for a "near" (50 cm) target condition. The walking acuity scores for each target distance were normalized by subtracting a corresponding acuity measure obtained while standing still on the treadmill belt. RESULTS: As predicted by subjective reports of relative target motion, the decrease in visual acuity was significantly greater (p < 0.00001) for the near compared to the far condition.

Simulation of thalamic prosthetic vision: reading accuracy, speed, and acuity in sighted humans.

PubMed

Vurro, Milena; Crowell, Anne Marie; Pezaris, John S

2014-01-01

The psychophysics of reading with artificial sight has received increasing attention as visual prostheses are becoming a real possibility to restore useful function to the blind through the coarse, pseudo-pixelized vision they generate. Studies to date have focused on simulating retinal and cortical prostheses; here we extend that work to report on thalamic designs. This study examined the reading performance of normally sighted human subjects using a simulation of three thalamic visual prostheses that varied in phosphene count, to help understand the level of functional ability afforded by thalamic designs in a task of daily living. Reading accuracy, reading speed, and reading acuity of 20 subjects were measured as a function of letter size, using a task based on the MNREAD chart. Results showed that fluid reading was feasible with appropriate combinations of letter size and phosphene count, and performance degraded smoothly as font size was decreased, with an approximate doubling of phosphene count resulting in an increase of 0.2 logMAR in acuity. Results here were consistent with previous results from our laboratory. Results were also consistent with those from the literature, despite using naive subjects who were not trained on the simulator, in contrast to other reports.

Improving the quality of outpatient clinic letters using the Sheffield Assessment Instrument for Letters (SAIL).

PubMed

Fox, Adam T; Palmer, Roger D; Crossley, James G M; Sekaran, Devanitha; Trewavas, Eira S; Davies, Helena A

2004-08-01

To improve the quality of outpatient letters used as communication between hospital and primary care doctors. On 2 separate occasions, 15 unselected outpatient letters written by each of 7 hospital practitioners were rated by another hospital doctor and a general practitioner (GP) using the Sheffield Assessment Instrument for Letters (SAIL). Individualised feedback was provided to participants following the rating of the first set of letters. The audit cycle was completed 3 months later without forewarning by repeat assessment by the same hospital and GP assessors using the SAIL tool to see if there was any improvement in correspondence. Single centre: general paediatric outpatient department in a large district general hospital. All 7 doctors available for reassessment completed the audit loop, each providing 15 outpatient letters per assessment. The mean of the quality scores, derived for each letter from the summation of a 20-point checklist and a global score, improved from 23.3 (95% CI 22.1-24.4) to 26.6 (95% CI 25.8-27.4) (P = 0.001). The SAIL provides a feasible and reliable method of assessing the quality and content of outpatient clinic letters. This study demonstrates that it can also provide feedback with a powerful educational impact. This approach holds real potential for appraisal and revalidation, providing an effective means for the quality improvement required by clinical governance.

Response Classification Images in Vernier Acuity

NASA Technical Reports Server (NTRS)

Ahumada, Albert J., Jr.; Beard, B. L.; Ellis, Stephen R. (Technical Monitor)

1997-01-01

Orientation selective and local sign mechanisms have been proposed as the basis for vernier acuity judgments. Linear image features contributing to discrimination can be determined for a two choice task by adding external noise to the images and then averaging the noises separately for the four types of stimulus/response trials. This method is applied to a vernier acuity task with different spatial separations to compare the predictions of the two theories. Three well-practiced observers were presented around 5000 trials of a vernier stimulus consisting of two dark horizontal lines (5 min by 0.3 min) within additive low-contrast white noise. Two spatial separations were tested, abutting and a 10 min horizontal separation. The task was to determine whether the target lines were aligned or vertically offset. The noises were averaged separately for the four stimulus/response trial types (e.g., stimulus = offset, response = aligned). The sum of the two 'not aligned' images was then subtracted from the sum of the 'aligned' images to obtain an overall image. Spatially smoothed images were quantized according to expected variability in the smoothed images to allow estimation of the statistical significance of image features. The response images from the 10 min separation condition are consistent with the local sign theory, having the appearance of two linear operators measuring vertical position with opposite sign. The images from the abutting stimulus have the same appearance with the two operators closer together. The image predicted by an oriented filter model is similar, but has its greatest weight in the abutting region, while the response images fall to nonsignificance there. The response correlation image method, previously demonstrated for letter discrimination, clarifies the features used in vernier acuity.

Exploration of a Preflight Acuity Scale for Fixed Wing Air Ambulance Transport.

PubMed

Phipps, Marcy; Conley, Virginia; Constantine, William H

Despite the prevalence of fixed wing medical flights for specialized care and repatriation, few acuity rating scales exist aimed at the prediction of adverse in-flight medical events. An acuity scoring system can provide information to flight crews, allowing for staffing enhancements, protocol modifications, and flight planning, with the aim of improving patient care, outcomes, and preventing losses to providers because of costly diversions. Our medical crew developed an acuity scale, which was applied retrospectively to 296 patients transported between January 2016 and March 2017. Patients received scores based on conditions identified during the preflight medical report, the initial patient assessment, demographics, and flight factors. Five patients were identified as high-risk transports based on our scale. Three patients suffered adverse events according to our defined criteria, 2 of which occurred before transport and 1 during transport. The 3 patients suffering adverse events did not receive a score that indicated adverse events in flight. Our scale was not predictive of adverse events in flight. However, it did illuminate factors worthy of consideration. Consideration of these factors may have prevented adverse events. Published by Elsevier Inc.

The Relationship between OCT-measured Central Retinal Thickness and Visual Acuity in Diabetic Macular Edema

PubMed Central

2008-01-01

Objective To compare optical coherence tomography (OCT)-measured retinal thickness and visual acuity in eyes with diabetic macular edema (DME) both before and after macular laser photocoagulation. Design Cross-sectional and longitudinal study. Participants 210 subjects (251 eyes) with DME enrolled in a randomized clinical trial of laser techniques. Methods Retinal thickness was measured with OCT and visual acuity was measured with the electronic-ETDRS procedure. Main Outcome Measures OCT-measured center point thickness and visual acuity Results The correlation coefficients for visual acuity versus OCT center point thickness were 0.52 at baseline and 0.49, 0.36, and 0.38 at 3.5, 8, and 12 months post-laser photocoagulation. The slope of the best fit line to the baseline data was approximately 4.4 letters (95% C.I.: 3.5, 5.3) better visual acuity for every 100 microns decrease in center point thickness at baseline with no important difference at follow-up visits. Approximately one-third of the variation in visual acuity could be predicted by a linear regression model that incorporated OCT center point thickness, age, hemoglobin A1C, and severity of fluorescein leakage in the center and inner subfields. The correlation between change in visual acuity and change in OCT center point thickening 3.5 months after laser treatment was 0.44 with no important difference at the other follow-up times. A subset of eyes showed paradoxical improvements in visual acuity with increased center point thickening (7–17% at the three time points) or paradoxical worsening of visual acuity with a decrease in center point thickening (18%–26% at the three time points). Conclusions There is modest correlation between OCT-measured center point thickness and visual acuity, and modest correlation of changes in retinal thickening and visual acuity following focal laser treatment for DME. However, a wide range of visual acuity may be observed for a given degree of retinal edema and paradoxical

The Fuzzy Scarlet Letter

ERIC Educational Resources Information Center

Pallas, Aaron M.

2012-01-01

Critics of the public release of teacher evaluation scores sometimes liken these ratings to the scarlet letter worn by Hester Prynne in Nathaniel Hawthorne's classic novel. The comparison is apt. But public school teachers who are subjected to public shaming because of their students' test scores can rarely expect the opportunities for redemption…

CORRELATION OF CLINICAL AND STRUCTURAL PROGRESSION WITH VISUAL ACUITY LOSS IN MACULAR TELANGIECTASIA TYPE 2: MacTel Project Report No. 6-The MacTel Research Group.

PubMed

Peto, Tunde; Heeren, Tjebo F C; Clemons, Traci E; Sallo, Ferenc B; Leung, Irene; Chew, Emily Y; Bird, Alan C

2018-01-01

To evaluate progression of macular telangiectasia Type 2 lesions and their correlation with visual acuity. An international multicenter prospective study with annual examinations including best-corrected visual acuity (BCVA), fundus photography, fluorescein angiography, and optical coherence tomography images graded centrally. Mixed models were used to estimate progression rates, and a generalized linear model to compute the relative risk of BCVA loss, loss of ellipsoid zone (EZ) reflectivity, development of pigment plaques, or neovascularization. One thousand and fourteen eyes of 507 participants were followed for 4.2 ± 1.6 years. Best-corrected visual acuity decreased 1.07 ± 0.05 letters (mean ± SE) per year. Of all eyes, 15% lost ≥15 letters after 5 years. Of the eyes without EZ loss, 76% developed a noncentral loss. Of the eyes with noncentral loss, 45% progressed to central EZ loss. The rate of BCVA loss in eyes with noncentral EZ loss at baseline was similar to eyes without EZ loss. The rate of BCVA loss was significantly higher in eyes with central EZ loss at baseline (-1.40 ± 0.14 letters, P < 0.001). Ellipsoid zone loss is frequently found in macular telangiectasia Type 2 and is an important structural component reflecting visual function. Its presence in the fovea significantly correlates with worse visual prognosis.

A comparison of static near stereo acuity in youth baseball/softball players and non-ball players.

PubMed

Boden, Lauren M; Rosengren, Kenneth J; Martin, Daniel F; Boden, Scott D

2009-03-01

Although many aspects of vision have been investigated in professional baseball players, few studies have been performed in developing athletes. The issue of whether youth baseball players have superior stereopsis to nonplayers has not been addressed specifically. The purpose of this study was to determine if youth baseball/softball players have better stereo acuity than non-ball players. Informed consent was obtained from 51 baseball/softball players and 52 non-ball players (ages 10 to 18 years). Subjects completed a questionnaire, and their static near stereo acuity was measured using the Randot Stereotest (Stereo Optical Company, Chicago, Illinois). Stereo acuity was measured as the seconds of arc between the last pair of images correctly distinguished by the subject. The mean stereo acuity score was 25.5 +/- 1.7 seconds of arc in the baseball/softball players and 56.2 +/- 8.4 seconds of arc in the non-ball players. This difference was statistically significant (P < 0.00001). In addition, a perfect stereo acuity score of 20 seconds of arc was seen in 61% of the ball players and only 23% of the non-ball players (P = 0.0001). Youth baseball/softball players had significantly better static stereo acuity than non-ball players, comparable to professional ball players.

Fluctuation in visual acuity during soft toric contact lens wear.

PubMed

Chamberlain, Paul; Morgan, Philip B; Moody, Kurt J; Maldonado-Codina, Carole

2011-04-01

To quantify changes in visual acuity (VA) with soft toric contact lenses as a result of lens movement and/or rotational instability caused by versional eye movements. A novel chart for vision assessment at near (40 cm) for soft toric contact lenses (VANT chart),consisting of a central, color-coded logMAR panel and eight peripheral letter targets set on a white background measuring 60 × 40 cm was constructed. In the developmental phase of the work, 10 subjects (20 eyes) wore 2 toric lenses in random order, and the impact of rapid and delayed eye versions in 8 directions of gaze on VANT acuity was investigated. In phase 2, 35 subjects (68 eyes) wore 4 toric lenses in random order, and a streamlined clinical protocol using the VANT chart was implemented. Standard assessments of toric lens fit and distance VA were also performed. Testing in the first phase showed no difference for change in VA for rapid vs. delayed version movements, (p = 0.17) but acuity reduction was greater for diagonal compared with horizontal/vertical versions (p = 0.06). As such, testing in phase 2 proceeded using rapid, diagonal versions only. In this second phase, there were differences for low-contrast distance VA measures between lens types (p = 0.02) and for both VANT baseline acuity (p = 0.03) and postversion acuity (p = 0.04), but no differences were found between lenses for magnitude of vision loss (p = 0.91), which was about one line. No relationship was established between the magnitude of vision loss and measured rotational stability (p = 0.75). This work has demonstrated that conventional approaches to measuring VA do not fully replicate the "real world" experience of soft toric lens wearers. The VANT chart has shown that VA is reduced immediately after versional eye movements and suggests that more dynamic methods of assessing visual performance should be considered for soft toric contact lens wearers, especially given the apparent inability of lens stability measurements to predict

The dishonest dean's letter: an analysis of 532 dean's letters from 99 U.S. medical schools.

PubMed

Edmond, M; Roberson, M; Hasan, N

1999-09-01

To quantify the censure of potentially negative information in dean's letters. Concordance between 532 dean's letters and the corresponding transcripts was determined for six variables (failing grade in a preclinical course, marginal preclinical course grade, failing grade for a clinical rotation, marginal clinical rotation grade, leave of absence, and requirement to repeat an entire year of medical school). The evaluated variables were not found in the dean's letters 27% to 50% of the time that they were present on the transcripts. In three of nine instances (33%), a failing grade in a clinical rotation was not included. Four students had been required to repeat an entire year, but this was noted in only two cases. In toto, 35 of 104 (34%) of the variables identified on the transcripts were not reported. In addition, deans were significantly less likely to report a student's USMLE 1 score if the score was at or below the 20th percentile (p = .03). Some deans suppress negative information in their letters and potentially obfuscate the residency selection process.

Learning to Identify Near-Threshold Luminance-Defined and Contrast-Defined Letters in Observers with Amblyopia

PubMed Central

Chung, Susana T.L.; Li, Roger W.; Levi, Dennis M.

2008-01-01

We assessed whether or not the sensitivity for identifying luminance-defined and contrast-defined letters improved with training in a group of amblyopic observers who have passed the critical period of development. In Experiment 1, we tracked the contrast threshold for identifying luminance-defined letters with training in a group of 11 amblyopic observers. Following training, six observers showed a reduction in thresholds, averaging 20%, for identifying luminance-defined letters. This improvement transferred extremely well to the untrained task of identifying contrast-defined letters (average improvement = 38%) but did not transfer to an acuity measurement. Seven of the 11 observers were subsequently trained on identifying contrast-defined letters in Experiment 2. Following training, five of these seven observers demonstrated a further improvement, averaging 17%, for identifying contrast-defined letters. This improvement did not transfer to the untrained task of identifying luminance-defined letters. Our findings are consistent with predictions based on the locus of learning for first- and second-order stimuli according to the filter-rectifier-filter model for second-order visual processing. PMID:18824189

Functional Multijoint Position Reproduction Acuity in Overhead-Throwing Athletes

PubMed Central

Tripp, Brady L; Uhl, Timothy L; Mattacola, Carl G; Srinivasan, Cidambi; Shapiro, Robert

2006-01-01

Context: Baseball players rely on the sensorimotor system to uphold the balance between upper extremity stability and mobility while maintaining athletic performance. However, few researchers have studied functional multijoint measures of sensorimotor acuity in overhead-throwing athletes. Objective: To compare sensorimotor acuity between 2 high-demand functional positions and among planes of motion within individual joints and to describe a novel method of measuring sensorimotor function. Design: Single-session, repeated-measures design. Setting: University musculoskeletal research laboratory. Patients or Other Participants: Twenty-one National Collegiate Athletic Association Division I baseball players (age = 20.8 ± 1.5 years, height = 181.3 ± 5.1 cm, mass = 87.8 ± 9.1 kg) with no history of upper extremity injury or central nervous system disorder. Main Outcome Measure(s): We measured active multijoint position reproduction acuity in multiple planes using an electromagnetic tracking device. Subjects reproduced 2 positions: arm cock and ball release. We calculated absolute and variable error for individual motions at the scapulothoracic, glenohumeral, elbow, and wrist joints and calculated overall joint acuity with 3-dimensional variable error. Results: Acuity was significantly better in the arm-cock position compared with ball release at the scapulothoracic and glenohumeral joints. We observed significant differences among planes of motion within the scapulothoracic and glenohumeral joints at ball release. Scapulothoracic internal rotation and glenohumeral horizontal abduction and rotation displayed less acuity than other motions. Conclusions: We established the reliability of a functional measure of upper extremity sensorimotor system acuity in baseball players. Using this technique, we observed differences in acuity between 2 test positions and among planes of motion within the glenohumeral and scapulothoracic joints. Clinicians may consider these

Writing more informative letters of reference.

PubMed

Wright, Scott M; Ziegelstein, Roy C

2004-05-01

Writing a meaningful and valuable letter of reference is not an easy task. Several factors influence the quality of any letter of reference. First, the accuracy and reliability of the writer's impressions and judgment depend on how well he knows the individual being described. Second, the writer's frame of reference, which is determined by the number of persons at the same level that he has worked with, will impact the context and significance of his beliefs and estimations. Third, the letter-writing skills of the person composing the letter will naturally affect the letter. To support the other components of a candidate's application, a letter of reference should provide specific examples of how an individual's behavior or attitude compares to a reference group and should assess "intangibles" that are hard to glean from a curriculum vitae or from test scores. This report offers suggestions that should help physicians write more informative letters of reference.

Writing More Informative Letters of Reference

PubMed Central

Wright, Scott M; Ziegelstein, Roy C

2004-01-01

Writing a meaningful and valuable letter of reference is not an easy task. Several factors influence the quality of any letter of reference. First, the accuracy and reliability of the writer's impressions and judgment depend on how well he knows the individual being described. Second, the writer's frame of reference, which is determined by the number of persons at the same level that he has worked with, will impact the context and significance of his beliefs and estimations. Third, the letter-writing skills of the person composing the letter will naturally affect the letter. To support the other components of a candidate's application, a letter of reference should provide specific examples of how an individual's behavior or attitude compares to a reference group and should assess “intangibles” that are hard to glean from a curriculum vitae or from test scores. This report offers suggestions that should help physicians write more informative letters of reference. PMID:15109330

Visual acuity testing in diabetic subjects: the decimal progression chart versus the Freiburg visual acuity test.

PubMed

Loumann Knudsen, Lars

2003-08-01

To study reproducibility and biological variation of visual acuity in diabetic maculopathy, using two different visual acuity tests, the decimal progression chart and the Freiburg visual acuity test. Twenty-two eyes in 11 diabetic subjects were examined several times within a 12-month period using both visual acuity tests. The most commonly used visual acuity test in Denmark (the decimal progression chart) was compared to the Freiburg visual acuity test (automated testing) in a paired study. Correlation analysis revealed agreement between the two methods (r(2)=0.79; slope=0.82; y-axis intercept=0.01). The mean visual acuity was found to be 15% higher (P<0.0001) with the decimal progression chart than with the Freiburg visual acuity test. The reproducibility was the same in both tests (coefficient of variation: 12% for each test); however, the variation within the 12-month examination period differed significantly. The coefficient of variation was 17% using the decimal progression chart, 35% with the Freiburg visual acuity test. The reproducibility of the two visual acuity tests is comparable under optimal testing conditions in diabetic subjects with macular oedema. However, it appears that the Freiburg visual acuity test is significantly better for detection of biological variation.

Letter Imperfect

ERIC Educational Resources Information Center

Kramer, Stephen

2003-01-01

In this essay, the author, a 5th-grade teacher, questions how well a standardized test can measure his students. This article presents a letter he wrote for the Washington state science test scorer regarding his students' test scores. He shares stories about some of the students in his class. He points out that tests can turn out to be more like…

Functional visual acuity in patients with successfully treated amblyopia: a pilot study.

PubMed

Hoshi, Sujin; Hiraoka, Takahiro; Kotsuka, Junko; Sato, Yumiko; Izumida, Shinya; Kato, Atsuko; Ueno, Yuta; Fukuda, Shinichi; Oshika, Tetsuro

2017-06-01

The aim of this study was to use conventional visual acuity measurements to quantify the functional visual acuity (FVA) in eyes with successfully treated amblyopia, and to compare the findings with those for contralateral normal eyes. Nineteen patients (7 boys, 12 girls; age 7.5 ± 2.2 years) with successfully treated unilateral amblyopia and the same conventional decimal visual acuity in both eyes (better than 1.0) were enrolled. FVA, the visual maintenance ratio (VMR), maximum and minimum visual acuity, and the average response time were recorded for both eyes of all patients using an FVA measurement system. The differences in FVA values between eyes were analyzed. The mean LogMAR FVA scores, VMR (p < 0.001 for both), and the LogMAR maximum (p < 0.005) and minimum visual acuity (p < 0.001) were significantly poorer for the eyes with treated amblyopia than for the contralateral normal eyes. There was no significant difference in the average response time. Our results indicate that FVA and VMR were poorer for eyes with treated amblyopia than for normal eyes, even though the treatment for amblyopia was considered successful on the basis of conventional visual acuity measurements. These results suggest that visual function is impaired in eyes with amblyopia, regardless of treatment success, and that FVA measurements can provide highly valuable diagnosis and treatment information that is not readily provided by conventional visual acuity measurements.

Effect of Bevacizumab vs Aflibercept on Visual Acuity Among Patients With Macular Edema Due to Central Retinal Vein Occlusion

PubMed Central

Scott, Ingrid U.; Ip, Michael S.; Blodi, Barbara A.; Oden, Neal L.; Awh, Carl C.; Kunimoto, Derek Y.; Marcus, Dennis M.; Wroblewski, John J.; King, Jacqueline

2017-01-01

Importance Studies have established the efficacy and safety of aflibercept for the treatment of macular edema due to central retinal vein occlusion. Bevacizumab is used off-label to treat this condition despite the absence of supporting data. Objective To investigate whether bevacizumab is noninferior to aflibercept for the treatment of macular edema secondary to central retinal or hemiretinal vein occlusion. Design, Setting, and Participants The SCORE2 randomized noninferiority clinical trial was conducted at 66 private practice or academic centers in the United States, and included 362 patients with macular edema due to central retinal or hemiretinal vein occlusion who were randomized 1:1 to receive aflibercept or bevacizumab. The first participant was randomized on September 17, 2014, and the last month 6 visit occurred on May 6, 2016. Analyses included data available as of December 30, 2016. Interventions Eyes were randomized to receive intravitreal injection of bevacizumab (1.25 mg; n = 182) or aflibercept (2.0 mg; n = 180) every 4 weeks through month 6. Main Outcomes and Measures The primary outcome was mean change in visual acuity (VA) letter score (VALS) from the randomization visit to the 6-month follow-up visit, based on the best-corrected electronic Early Treatment Diabetic Retinopathy Study VALS (scores range from 0-100; higher scores indicate better VA). The noninferiority margin was 5 letters, and statistical testing for noninferiority was based on a 1-sided 97.5% confidence interval. Results Among 362 randomized participants (mean [SD] age, 69 [12] years; 157 [43.4%] women; mean [SD] VALS at baseline, 50.3 [15.2] [approximate Snellen VA 20/100]), 348 (96.1%) completed the month 6 follow-up visit. At month 6, the mean VALS was 69.3 (a mean increase from baseline of 18.6) in the bevacizumab group and 69.3 (a mean increase from baseline of 18.9) in the aflibercept group (model-based estimate of between-group difference, −0.14; 97.5% CI, −3

Visual acuity and legal visual requirement to drive a passenger vehicle.

PubMed

Kiel, A W; Butler, T; Alwitry, A

2003-07-01

(1). To test the consistency and ease with which number-plates of different component figures can be read under DVLA driving test conditions; (2). to test the relative difficulty of reading corresponding figures on registration plates of white and yellow backgrounds.Design Prospective study of consecutive eligible clinic patients. Ophthalmology outpatients. 210 individuals with a corrected visual acuity with both eyes open of between 6/9 and 6/12. The ability to read three different number-plates under standard DVLA driving-test conditions (ie at 20.5 m in good daylight with glasses if worn) and the ability to read identical number-plates against a white and a yellow background. There is a significant difference between the ease with which three different number-plates can be read depending on their letter and numeral composition, although this did not seem to be significantly affected by whether they were printed on a yellow or white background. Only 92.3% of subjects could read all the number-plates at the legal distance, 96.7% could read at least one number-plate at the legal distance and 3.3% of the test subjects could not read any of the number-plates at 20.5 m. The current test protocol used to obtain a driving licence and, moreover, the test the police will employ to assess visual competence to drive, is highly variable and is unlikely to give consistent repeatable results. The performance of those with equally good visual acuity is unpredictable and is highly dependent on the number-plate they are asked to read. This variability could exclude some who would otherwise pass the test or pass an individual with a visual acuity below accepted standards. The forthcoming changes in the regulations for design of number-plates is an ideal opportunity to standardise the whole testing procedure for driving visual acuity.

Factors affecting development of motor skills in extremely low birth weight children.

PubMed

O'Connor, Anna R; Birch, Eileen E; Spencer, Rand

2009-01-01

The aim of this study is to analyze the impact of ophthalmic and neonatal factors on motor development in extremely low birth weight (ELBW) children. Sixty-four ELBW children at least 3 years of age were recruited. Visual acuity (VA) was assessed using the Teller acuity cards (TACs) and a letter test, if possible. A validated questionnaire assessing 25 fine (part A) and 20 gross motor (part B) skills was administered to the parents. Data were collected on retinopathy of prematurity (ROP) zone, intraventricular haemorrhage (IVH), length of stay in hospital, and number of days on oxygen. Abnormal TAC acuity was associated with significantly lower scores on both parts A and B (part A: 21.5 versus 11.8, p < 0.001; part B: 17.5 versus 13.2, p < 0.001). Linear regression demonstrates a significant direct relationship between letter acuity and score A only (p = 0.03, r(2) = 0.179). Neither length of hospital stay, number of days ventilated, nor a history of IVH were associated with score A or B. However, the presence of ROP zone 1 was associated with a lower score A (p = 0.03). In this ELBW cohort VA and ophthalmic factors were the only factors associated with scores of development, particularly fine motor development.

How well do you see what you hear? The acuity of visual-to-auditory sensory substitution

PubMed Central

Haigh, Alastair; Brown, David J.; Meijer, Peter; Proulx, Michael J.

2013-01-01

Sensory substitution devices (SSDs) aim to compensate for the loss of a sensory modality, typically vision, by converting information from the lost modality into stimuli in a remaining modality. “The vOICe” is a visual-to-auditory SSD which encodes images taken by a camera worn by the user into “soundscapes” such that experienced users can extract information about their surroundings. Here we investigated how much detail was resolvable during the early induction stages by testing the acuity of blindfolded sighted, naïve vOICe users. Initial performance was well above chance. Participants who took the test twice as a form of minimal training showed a marked improvement on the second test. Acuity was slightly but not significantly impaired when participants wore a camera and judged letter orientations “live”. A positive correlation was found between participants' musical training and their acuity. The relationship between auditory expertise via musical training and the lack of a relationship with visual imagery, suggests that early use of a SSD draws primarily on the mechanisms of the sensory modality being used rather than the one being substituted. If vision is lost, audition represents the sensory channel of highest bandwidth of those remaining. The level of acuity found here, and the fact it was achieved with very little experience in sensory substitution by naïve users is promising. PMID:23785345

[Application of Ocular Trauma Score in Mechanical Ocular Injury in Forensic Medicine].

PubMed

Xiang, Jian; Guo, Zhao-ming; Wang, Xu; Yu, Li-li; Liu, Hui

2015-10-01

To evaluate the application value for the prognosis of mechanical ocular injury cases using ocular trauma score (OTS). Four hundred and eleven cases of mechanical ocular trauma were retrospectively reviewed. Of the 449 eyes, there were 317 closed globe injury and 132 open globe injury. OTS variables included numerical values as initial visual acuity, rupture, endophthalmitis, perforat- ing or penetrating injury, retinal detachment and relative afferent pupillary block. The differences be- tween the distribution of the final visual acuity and the probability of standard final visual acuity were compared to analyze the correlation between OTS category and final visual acuity. The different types of ocular trauma were compared. Compared with the distribution of final visual acuity in standard OTS score, the ratio in OTS-3 category was statistically different in present study, and no differences were found in other categories. Final visual acuity showed a great linear correlation with OTS category (r = 0.71) and total score (r = 0.73). Compared with closed globe injury, open globe injury was generally associated with lower total score and poorer prognosis. Rupture injury had poorer prognosis compared with penetrating injury. The use of OTS for the patients with ocular trauma can provide re- liable information for the evaluation of prognosis in forensic medicine.

Assessment of Grating Acuity in Infants and Toddlers Using an Electronic Acuity Card: The Dobson Card.

PubMed

Mohan, Kathleen M; Miller, Joseph M; Harvey, Erin M; Gerhart, Kimberly D; Apple, Howard P; Apple, Deborah; Smith, Jordana M; Davis, Amy L; Leonard-Green, Tina; Campus, Irene; Dennis, Leslie K

2016-01-01

To determine if testing binocular visual acuity in infants and toddlers using the Acuity Card Procedure (ACP) with electronic grating stimuli yields clinically useful data. Participants were infants and toddlers ages 5 to 36.7 months referred by pediatricians due to failed automated vision screening. The ACP was used to test binocular grating acuity. Stimuli were presented on the Dobson Card. The Dobson Card consists of a handheld matte-black plexiglass frame with two flush-mounted tablet computers and is similar in size and form to commercially available printed grating acuity testing stimuli (Teller Acuity Cards II [TACII]; Stereo Optical, Inc., Chicago, IL). On each trial, one tablet displayed a square-wave grating and the other displayed a luminance-matched uniform gray patch. Stimuli were roughly equivalent to the stimuli available in the printed TACII stimuli. After acuity testing, each child received a cycloplegic eye examination. Based on cycloplegic retinoscopy, patients were categorized as having high or low refractive error per American Association for Pediatric Ophthalmology and Strabismus vision screening referral criteria. Mean acuities for high and low refractive error groups were compared using analysis of covariance, controlling for age. Mean visual acuity was significantly poorer in children with high refractive error than in those with low refractive error (P = .015). Electronic stimuli presented using the ACP can yield clinically useful measurements of grating acuity in infants and toddlers. Further research is needed to determine the optimal conditions and procedures for obtaining accurate and clinically useful automated measurements of visual acuity in infants and toddlers. Copyright 2016, SLACK Incorporated.

Readability of "Dear Patient" device advisory notification letters created by a device manufacturer.

PubMed

Mueller, Luke A; Sharma, Arjun; Ottenberg, Abigale L; Mueller, Paul S

2013-04-01

In 2006, the Heart Rhythm Society (HRS) recommended that cardiovascular implantable electronic device (CIED) manufacturers use advisory notification letters to communicate with affected patients. To evaluate the readability of the HRS sample "patient device advisory notification" letter and those created by 1 CIED manufacturer. The HRS sample letter and 25 Boston Scientific Corporation letters dated from 2005 through 2011 were evaluated by using 6 readability tests. Readability (Flesch-Kincaid score) of the HRS sample letter was grade level 12.5, and median readability of the device manufacturer letters was grade level 12.8 (range 10.8-18.9). Similar results were obtained by using other readability scales. No letters had readability scores at the National Work Group on Literacy and Health's recommended reading level-fifth grade; the letters' readability exceeded this recommended level by an average of 7.7 grades (95% confidence interval 6.9-8.5; P<.001). Likewise, no letters had readability scores at the average reading level of US adults-eighth grade; the letters' readability exceeded this level by an average of 4.7 grades (95% confidence interval 3.9-5.5; P< .001). The readability of the HRS sample letter and those created by a CIED manufacturer significantly exceeded the recommended and average US adults' reading skill levels. Such letters are unlikely to be informative to many patients. CIED manufacturers should ensure that advisory letters are comprehensible to most affected patients. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Visual acuity at 10 years in Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) study eyes: effect of retinal residua of retinopathy of prematurity.

PubMed

Dobson, Velma; Quinn, Graham E; Summers, C Gail; Hardy, Robert J; Tung, Betty

2006-02-01

To describe recognition (letter) acuity at age 10 years in eyes with and without retinal residua of retinopathy of prematurity (ROP). Presence and severity of ROP residua were documented by a study ophthalmologist. Masked testers measured monocular recognition visual acuity (Early Treatment of Diabetic Retinopathy Study) when the children were 10 years old. Two hundred forty-seven of 255 surviving Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) randomized trial patients participated. A reference group of 102 of 104 Philadelphia-based CRYO-ROP study participants who did not develop ROP was also tested. More severe retinal residua were associated with worse visual acuity, regardless of whether retinal ablation was performed to treat the severe acute-phase ROP. However, within each ROP residua category, there was a wide range of visual acuity results. This is the first report of the relation between visual acuity (Early Treatment of Diabetic Retinopathy Study charts) and structural abnormalities related to ROP in a large group of eyes that developed threshold ROP in the perinatal period. Visual deficits are greater in eyes with more severe retinal residua than in eyes with mild or no residua. However, severity of ROP residua does not predict the visual acuity of an individual eye because within a single residua category, acuity may range from near normal to blind.

OPTICAL COHERENCE TOMOGRAPHY BASELINE PREDICTORS FOR INITIAL BEST-CORRECTED VISUAL ACUITY RESPONSE TO INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT IN EYES WITH DIABETIC MACULAR EDEMA: The CHARTRES Study.

PubMed

Santos, Ana R; Costa, Miguel Â; Schwartz, Christian; Alves, Dalila; Figueira, João; Silva, Rufino; Cunha-Vaz, Jose G

2018-06-01

To identify baseline optical coherence tomography morphologic characteristics predicting the visual response to anti-vascular endothelial growth factor therapy in diabetic macular edema. Sixty-seven patients with diabetic macular edema completed a prospective, observational study (NCT01947881-CHARTRES). All patients received monthly intravitreal injections of Lucentis for 3 months followed by PRN treatment and underwent best-corrected visual acuity measurements and spectral domain optical coherence tomography at Baseline, Months 1, 2, 3, and 6. Visual treatment response was characterized as good (≥10 letters), moderate (5-10 letters), and poor (<5 or letters loss). Spectral domain optical coherence tomography images were graded before and after treatment by a certified Reading Center. One month after loading dose, 26 patients (38.80%) were identified as good responders, 19 (28.35%) as Moderate and 22 (32.83%) as poor responders. There were no significant best-corrected visual acuity and central retinal thickness differences at baseline (P = 0.176; P = 0.573, respectively). Ellipsoid zone disruption and disorganization of retinal inner layers were good predictors for treatment response, representing a significant risk for poor visual recovery to anti-vascular endothelial growth factor therapy (odds ratio = 10.96; P < 0.001 for ellipsoid zone disruption and odds ratio = 7.05; P = 0.034 for disorganization of retinal inner layers). Damage of ellipsoid zone, higher values of disorganization of retinal inner layers, and central retinal thickness decrease are good predictors of best-corrected visual acuity response to anti-vascular endothelial growth factor therapy.

A Retrospective Analysis Comparing the New Standardized Letter of Recommendation in Dermatology with the Classic Narrative Letter of Recommendation

PubMed Central

Mosser, Joy; Lee, Grace; Pootrakul, Llana; Harfmann, Katya; Fabbro, Stephanie; Faith, Esteban Fernandez; Carr, David; Plotner, Alisha; Zirwas, Matthew; Kaffenberger, Benjamin H.

2016-01-01

Background: In an effort to avoid numerous problems associated with narrative letters of recommendation, a dermatology standardized letter of recommendation was utilized in the 2014–2015 resident application cycle. Objective: A comparison of the standardized letter of recommendation and narrative letters of recommendation from a single institution and application cycle to determine if the standardized letter of recommendation met its original goals of efficiency, applicant stratification, and validity. Methods: Eight dermatologists assessed all standardized letters of recommendation/narrative letters of recommendation pairs received during the 2014–2015 application cycle. Five readers repeated the analysis two months later. Each letter of recommendation was evaluated based on a seven question survey. Letter analysis and survey completion for each letter was timed. Results: Compared to the narrative letters of recommendation, the standardized letter of recommendation is easier to interpret (p<0.0001), has less exaggeration of applicants’ positive traits (p<0.001), and has higher inter-rater and intrarater reliability for determining applicant traits including personality, reliability, work-ethic, and global score. Standardized letters of recommendation are also faster to interpret (p<0.0001) and provide more information about the writer’s background or writer-applicant relationship than narrative letters of recommendation (p<0.001). Limitations: This study was completed at a single institution. Conclusions: The standardized letter of recommendation appears to be meeting its initial goals of 1) efficiency, 2) applicant stratification, and 3) validity. (J Clin Aesthet Dermatol. 2016;9(9):36–2.) PMID:27878060

The relation of functional visual acuity measurement methodology to tear functions and ocular surface status.

PubMed

Kaido, Minako; Ishida, Reiko; Dogru, Murat; Tsubota, Kazuo

2011-09-01

To investigate the relation of functional visual acuity (FVA) measurements with dry eye test parameters and to compare the testing methods with and without blink suppression and anesthetic instillation. A prospective comparative case series. Thirty right eyes of 30 dry eye patients and 25 right eyes of 25 normal subjects seen at Keio University School of Medicine, Department of Ophthalmology were studied. FVA testing was performed using a FVA measurement system with two different approaches, one in which measurements were made under natural blinking conditions without topical anesthesia (FVA-N) and the other in which the measurements were made under the blink suppression condition with topical anesthetic eye drops (FVA-BS). Tear function examinations, such as the Schirmer test, tear film break-up time, and fluorescein and Rose Bengal vital staining as ocular surface evaluation, were performed. The mean logMAR FVA-N scores and logMAR Landolt visual acuity scores were significantly lower in the dry eye subjects than in the healthy controls (p < 0.05), while there were no statistical differences between the logMAR FVA-BS scores of the dry eye subjects and those of the healthy controls. There was a significant correlation between the logMAR Landolt visual acuities and the logMAR FVA-N and logMAR FVA-BS scores. The FVA-N scores correlated significantly with tear quantities, tear stability and, especially, the ocular surface vital staining scores. FVA measurements performed under natural blinking significantly reflected the tear functions and ocular surface status of the eye and would appear to be a reliable method of FVA testing. FVA measurement is also an accurate predictor of dry eye status.

Enhanced visual acuity and image perception following correction of highly aberrated eyes using an adaptive optics visual simulator.

PubMed

Rocha, Karolinne Maia; Vabre, Laurent; Chateau, Nicolas; Krueger, Ronald R

2010-01-01

To evaluate the changes in visual acuity and visual perception generated by correcting higher order aberrations in highly aberrated eyes using a large-stroke adaptive optics visual simulator. A crx1 Adaptive Optics Visual Simulator (Imagine Eyes) was used to correct and modify the wavefront aberrations in 12 keratoconic eyes and 8 symptomatic postoperative refractive surgery (LASIK) eyes. After measuring ocular aberrations, the device was programmed to compensate for the eye's wavefront error from the second order to the fifth order (6-mm pupil). Visual acuity was assessed through the adaptive optics system using computer-generated ETDRS opto-types and the Freiburg Visual Acuity and Contrast Test. Mean higher order aberration root-mean-square (RMS) errors in the keratoconus and symptomatic LASIK eyes were 1.88+/-0.99 microm and 1.62+/-0.79 microm (6-mm pupil), respectively. The visual simulator correction of the higher order aberrations present in the keratoconus eyes improved their visual acuity by a mean of 2 lines when compared to their best spherocylinder correction (mean decimal visual acuity with spherocylindrical correction was 0.31+/-0.18 and improved to 0.44+/-0.23 with higher order aberration correction). In the symptomatic LASIK eyes, the mean decimal visual acuity with spherocylindrical correction improved from 0.54+/-0.16 to 0.71+/-0.13 with higher order aberration correction. The visual perception of ETDRS letters was improved when correcting higher order aberrations. The adaptive optics visual simulator can effectively measure and compensate for higher order aberrations (second to fifth order), which are associated with diminished visual acuity and perception in highly aberrated eyes. The adaptive optics technology may be of clinical benefit when counseling patients with highly aberrated eyes regarding their maximum subjective potential for vision correction. Copyright 2010, SLACK Incorporated.

The advanced glaucoma intervention study, 6: effect of cataract on visual field and visual acuity. The AGIS Investigators.

PubMed

2000-12-01

To investigate the effect of cataract on visual function and the role of cataract in explaining a race-treatment interaction in outcomes of glaucoma surgery. The Advanced Glaucoma Intervention Study (AGIS) enrolled 332 black patients (451 eyes) and 249 white patients (325 eyes) with advanced glaucoma. Eyes were randomly assigned to an argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy sequence or a trabeculectomy-ALT-trabeculectomy sequence. From the AGIS experience with cataract surgery during follow-up, we estimated the expected change in visual function scores from before cataract surgery to after cataract surgery. Then, for eyes with cataract not removed, we used these estimates of expected change to adjust visual function scores for the presumed effects of cataract. In turn, we used the adjusted scores to obtain cataract-adjusted main outcome measures. Average percent of eyes with decrease of visual field (APDVF) and average percent of eyes with decrease of visual acuity (APDVA). Within the 2 months before cataract surgery, visual acuity was better in eyes of white patients than of black patients by an average of approximately 2 lines on the visual acuity test chart. Cataract surgery improved visual acuity and visual field defect scores, with the amounts of improvement greater when preoperative visual acuity was lower. Adjustments for cataract brought about the following relative reductions: for APDVF, a relative reduction of 5% to 11% in black patients and 9% to 11% in white patients; for APDVA, a relative reduction of 45% to 49% in black patients and 31% to 38% in white patients; and for the APDVF and APDVA race-treatment interactions, relative reductions of 25% and 45%, respectively. On average, visual function scores improved after cataract surgery. The findings of reduced race-treatment interactions after adjustment for cataract do not alter our earlier conclusion that the AGIS 7-year results support use of the ALT

Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study.

PubMed

Mine, Masashi; Miyata, Kimie; Morikawa, Masayuki; Nishi, Tomo; Okamoto, Nozomi; Kawasaki, Ryo; Yamashita, Hidetoshi; Kurumatani, Norio; Ogata, Nahoko

2016-01-01

Both visual impairment and cognitive impairment are essential factors that determine the quality of life in the aged population. The aim of this study was to determine if a correlation existed between visual acuity and cognitive impairment in an elderly Japanese population. The Fujiwara-kyo Eye Study was a cross-sectional study of individuals aged ≥68 years who lived in Nara Prefecture of Japan. Participants underwent ophthalmological examinations and cognitive function test. A mild visual impairment was defined as having a best corrected visual acuity (BCVA) >0.2 logarithm of the minimum angle of resolution (logMAR) units in the better eye. Cognitive impairment was defined as having a Mini-Mental State Examination (MMSE) score of ≤23 points. A total to 2818 individuals completed the examinations. The mean age of the participants was 76.3 ± 4.8 years (mean ± standard deviation). The mean BCVA of the better eye was -0.02 ± 0.13 logMAR units and 6.6% subjects were classified as being mildly visually impaired. The mean MMSE score was 27.3 ± 2.3 and 5.7% subjects were classified as being cognitively impaired. The proportion of subjects with cognitive or moderate visual impairment increased with age, and there was a significant correlation between the visual acuity and MMSE score (r = -0.10, p < 0.0001). Subjects with mild visual impairments had 2.4 times higher odds of having cognitive impairment than those without visual impairment (odds ratio 2.4, 95% confidence interval, 1.5-3.8, p < 0.001) after adjusting for age, sex, and length of education. We conclude that it may be important to maintain good visual acuity to reduce the risk of having cognitive impairment.

Association of Visual Acuity and Cognitive Impairment in Older Individuals: Fujiwara-kyo Eye Study

PubMed Central

Mine, Masashi; Miyata, Kimie; Morikawa, Masayuki; Nishi, Tomo; Okamoto, Nozomi; Kawasaki, Ryo; Yamashita, Hidetoshi; Kurumatani, Norio; Ogata, Nahoko

2016-01-01

Abstract Both visual impairment and cognitive impairment are essential factors that determine the quality of life in the aged population. The aim of this study was to determine if a correlation existed between visual acuity and cognitive impairment in an elderly Japanese population. The Fujiwara-kyo Eye Study was a cross-sectional study of individuals aged ≥68 years who lived in Nara Prefecture of Japan. Participants underwent ophthalmological examinations and cognitive function test. A mild visual impairment was defined as having a best corrected visual acuity (BCVA) >0.2 logarithm of the minimum angle of resolution (logMAR) units in the better eye. Cognitive impairment was defined as having a Mini-Mental State Examination (MMSE) score of ≤23 points. A total to 2818 individuals completed the examinations. The mean age of the participants was 76.3 ± 4.8 years (mean ± standard deviation). The mean BCVA of the better eye was −0.02 ± 0.13 logMAR units and 6.6% subjects were classified as being mildly visually impaired. The mean MMSE score was 27.3 ± 2.3 and 5.7% subjects were classified as being cognitively impaired. The proportion of subjects with cognitive or moderate visual impairment increased with age, and there was a significant correlation between the visual acuity and MMSE score (r = −0.10, p < 0.0001). Subjects with mild visual impairments had 2.4 times higher odds of having cognitive impairment than those without visual impairment (odds ratio 2.4, 95% confidence interval, 1.5–3.8, p < 0.001) after adjusting for age, sex, and length of education. We conclude that it may be important to maintain good visual acuity to reduce the risk of having cognitive impairment. PMID:27610269

The validity of visual acuity assessment using mobile technology devices in the primary care setting.

PubMed

O'Neill, Samuel; McAndrew, Darryl J

2016-04-01

The assessment of visual acuity is indicated in a number of clinical circumstances. It is commonly conducted through the use of a Snellen wall chart. Mobile technology developments and adoption rates by clinicians may potentially provide more convenient methods of assessing visual acuity. Limited data exist on the validity of these devices and applications. The objective of this study was to evaluate the assessment of distance visual acuity using mobile technology devices against the commonly used 3-metre Snellen chart in a primary care setting. A prospective quantitative comparative study was conducted at a regional medical practice. The visual acuity of 60 participants was assessed on a Snellen wall chart and two mobile technology devices (iPhone, iPad). Visual acuity intervals were converted to logarithm of minimum angle of resolution (logMAR) scores and subjected to intraclass correlation coefficient (ICC) assessment. The results show a high level of general agreement between testing modality (ICC 0.917 with a 95% confidence interval of 0.887-0.940). The high level of agreement of visual acuity results between the Snellen wall chart and both mobile technology devices suggests that clinicians can use this technology with confidence in the primary care setting.

Three-year safety and visual acuity results of epimacular 90 strontium/90 yttrium brachytherapy with bevacizumab for the treatment of subfoveal choroidal neovascularization secondary to age-related macular degeneration.

PubMed

Avila, Marcos P; Farah, Michael E; Santos, Arturo; Carla, Livia; Fuji, Gildo; Rossi, Juliana; Nau, Jeffrey

2012-01-01

To evaluate the long-term safety and visual acuity outcomes associated with epimacular strontium 90 brachytherapy combined with intravitreal bevacizumab for the treatment of subfoveal choroidal neovascularization because of age-related macular degeneration. Thirty-four treatment-naive patients with predominantly classic, minimally classic, and occult subfoveal choroidal neovascularization lesions participated in this prospective, 2-year, nonrandomized multicenter study. Subjects from 1 center (n = 19) were reconsented and followed-up for 3 years. Each subject received a single 24-Gy beta irradiation treatment via an intraocular delivery device and 2 planned injections of bevacizumab at treatment and 1 month later. Additional bevacizumab therapy was permitted based on prespecified retreatment criteria. Adverse events were observed, and best-corrected visual acuity was measured using Early Treatment Diabetic Retinopathy Study vision charts. Subjects were evaluated every 3 months during the first year of follow-up and every 6 months during Years 2 and 3 of follow-up. All 34 subjects were followed-up for 24 months and 19 were followed-up through 36 months. With up to 24 months of follow-up, 12 of 24 phakic patients (50%) exhibited ≥ 2 grades of progression in Lens Opacification Classification System (LOCS) II lens classification; 5 eyes underwent cataract extraction before the Month 36 visit. There was 1 case of nonproliferative retinopathy identified at 36 months of follow-up that did not have an adverse effect on visual acuity, was stable at 43 months of follow-up, and was isolated to the parafoveal region. Mean best-corrected visual acuity demonstrated an average gain of +15.0 and -4.9 letters at 12 months and 24 months, respectively; the drop in mean gain at Month 24 was largely attributable to cataract formation. At 36 months (n = 19), the mean best-corrected visual acuity was +3.9, 90% (17 of 19) of eyes had lost <15 letters from baseline, 53% (10 of 19) had

Overcoming the effect of letter confusability in letter-by-letter reading: a rehabilitation study.

PubMed

Harris, Lara; Olson, Andrew; Humphreys, Glyn

2013-01-01

Patients who read in a letter-by-letter manner can demonstrate effects of lexical variables when reading words comprised of low confusability letters, suggesting the capacity to process low-confusability words in parallel across the letters (Fiset, Arguin, & McCabe, 2006). Here a series of experiments is presented investigating letter confusability effects in MAH, a patient with expressive and receptive aphasia who shows reduced reading accuracy with longer words, and DM, a relatively "pure" alexic patient. Two rehabilitation studies were employed: (i) a word-level therapy and (ii) a letter-level therapy designed to improve discrimination of individual letters. The word-level treatment produced generalised improvement to low-confusability words only, but the serial processing treatment produced improvement on both high and low confusability words. The results add support to the hypothesis that letter confusability plays a key role in letter-by-letter reading, and suggest that a rehabilitation method aimed at reducing ambiguities in letter identification may be particularly effective for treating letter-by-letter reading.

Substituted-letter and transposed-letter effects in a masked priming paradigm with French developing readers and dyslexics.

PubMed

Lété, Bernard; Fayol, Michel

2013-01-01

The aim of the study was to undertake a behavioral investigation of the development of automatic orthographic processing during reading acquisition in French. Following Castles and colleagues' 2007 study (Journal of Experimental Child Psychology, 97, 165-182) and their lexical tuning hypothesis framework, substituted-letter and transposed-letter primes were used in a masked priming paradigm with third graders, fifth graders, adults, and phonological dyslexics matched on reading level with the third graders. No priming effect was found in third graders. In adults, only a transposed-letter priming effect was found; there was no substituted-letter priming effect. Finally, fifth graders and dyslexics showed both substituted-letter and transposed-letter priming effects. Priming effects between the two groups were of the same magnitude after response time (RT) z-score transformation. Taken together, our results show that the pattern of priming effects found by Castles and colleagues in English normal readers emerges later in French normal readers. In other words, language orthographies seem to constrain the tuning of the orthographic system, with an opaque orthography producing faster tuning of orthographic processing than more transparent orthographies because of the high level of reliance on phonological decoding while learning to read. Copyright © 2012 Elsevier Inc. All rights reserved.

A New Font, Specifically Designed for Peripheral Vision, Improves Peripheral Letter and Word Recognition, but Not Eye-Mediated Reading Performance.

PubMed

Bernard, Jean-Baptiste; Aguilar, Carlos; Castet, Eric

2016-01-01

Reading speed is dramatically reduced when readers cannot use their central vision. This is because low visual acuity and crowding negatively impact letter recognition in the periphery. In this study, we designed a new font (referred to as the Eido font) in order to reduce inter-letter similarity and consequently to increase peripheral letter recognition performance. We tested this font by running five experiments that compared the Eido font with the standard Courier font. Letter spacing and x-height were identical for the two monospaced fonts. Six normally-sighted subjects used exclusively their peripheral vision to run two aloud reading tasks (with eye movements), a letter recognition task (without eye movements), a word recognition task (without eye movements) and a lexical decision task. Results show that reading speed was not significantly different between the Eido and the Courier font when subjects had to read single sentences with a round simulated gaze-contingent central scotoma (10° diameter). In contrast, Eido significantly decreased perceptual errors in peripheral crowded letter recognition (-30% errors on average for letters briefly presented at 6° eccentricity) and in peripheral word recognition (-32% errors on average for words briefly presented at 6° eccentricity).

Retrospective, controlled observational case study of patients with central retinal vein occlusion and initially low visual acuity treated with an intravitreal dexamethasone implant.

PubMed

Winterhalter, Sibylle; Vom Brocke, Gerrit Alexander; Pilger, Daniel; Eckert, Annabelle; Schlomberg, Juliane; Rübsam, Anne; Klamann, Matthias Karl; Gundlach, Enken; Dietrich-Ntoukas, Tina; Joussen, Antonia Maria

2016-10-27

Patients with initially low visual acuity were excluded from the therapy approval studies for retinal vein occlusion. But up to 28 % of patients presenting with central retinal vein occlusion have a baseline BCVA of less than 34 ETDRS letters (0.1). The purpose of our study was to assess visual acuity and central retinal thickness in patients suffering from central retinal vein occlusion and low visual acuity (<0.1) in comparison to patients with visual acuity (≥0.1) treated with Dexamethasone implant 0.7 mg for macular edema. Retrospective, controlled observational case study of 30 eyes with macular edema secondary to central retinal vein occlusion, which were treated with a dexamethasone implantation. Visual acuity, central retinal thickness and intraocular pressure were measured monthly. Analyses were performed separately for eyes with visual acuity <0.1 and ≥0.1. Two months post intervention, visual acuity improved only marginally from 0.05 to 0.07 (1 month; p = 0,065) and to 0.08 (2 months; p = 0,2) in patients with low visual acuity as compared to patients with visual acuity ≥0.1 with an improvement from 0.33 to 0.47 (1 month; p = 0,005) and to 0.49 (2 months; p = 0,003). The central retinal thickness, however, was reduced in both groups, falling from 694 to 344 μm (1 month; p = 0.003,) to 361 μm (2 months; p = 0,002) and to 415 μm (3 months; p = 0,004) in the low visual acuity group and from 634 to 315 μm (1 month; p < 0,001) and to 343 μm (2 months; p = 0,001) in the visual acuity group ≥0.1. Absence of visual acuity improvement was related to macular ischemia. In patients with central retinal vein occlusion and initially low visual acuity, a dexamethasone implantation can lead to an important reduction of central retinal thickness but may be of limited use to increase visual acuity.

Longitudinal Changes in Visual Acuity and Health Related Quality of Life. The Los Angeles Latino Eye Study

PubMed Central

McKean-Cowdin, Roberta; Varma, Rohit; Hays, Ron D.; Wu, Joanne; Choudhury, Farzana; Azen, Stanley P.

2010-01-01

Purpose To examine the association between longitudinal changes in visual acuity (VA) and Health Related Quality of Life (HRQOL) in a population-based sample of adult Latinos. Design A population-based cohort study of eye disease in Latinos. Participants 3,169 adult Latino participants who live in the city of La Puente, California. Methods Data for these analyses were collected for the Los Angeles Latino Eye Study (LALES). Distance visual acuity (VA) was measured during a detailed ophthalmologic examination using the standard Early Treatment Diabetic Retinopathy Study protocol at baseline and a 4 year follow-up examination. HRQOL was assessed by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-Item Short-Form Health Survey version 1 (SF-12 v.1). Main Outcome Measures Mean differences in HRQOL composite and subscale scores between baseline and follow-up were calculated for 3,169 participants with complete clinical examination and HRQOL data at both time points. Mean differences and effect sizes (ES) for NEI-VFQ and SF-12 v.1 scores were calculated for 3 categories of VA change over the 4 year follow-up period (VA improved ≥ 2 lines, no change in VA or −2score; with the largest score changes found for the driving difficulties, vision related mental health, and vision related dependency subscales (−12.7, −11.5, and −11.3 respectively). For participants with a 2 line improvement in VA we also noted an approximate 5 point gain in the NEI-VFQ-25 composite score. The largest change (ES = 0.80) was observed for the driving difficulties subscale. No measurable differences in HRQOL were observed for individuals without change in VA from baseline to follow-up. Conclusions Clinically important, longitudinal changes in visual acuity (2 line changes or greater) were

Visual acuity, endothelial cell density and polymegathism after iris-fixated lens implantation.

PubMed

Nassiri, Nader; Ghorbanhosseini, Saeedeh; Jafarzadehpur, Ebrahim; Kavousnezhad, Sara; Nassiri, Nariman; Sheibani, Kourosh

2018-01-01

The purpose of this study was to evaluate the visual acuity as well as endothelial cell density (ECD) and polymegathism after iris-fixated lens (Artiflex ® AC 401) implantation for correction of moderate to high myopia. In this retrospective cross-sectional study, 55 eyes from 29 patients undergoing iris-fixated lens implantation for correction of myopia (-5.00 to -15.00 D) from 2007 to 2014 were evaluated. Uncorrected visual acuity, best spectacle-corrected visual acuity, refraction, ECD and polymegathism (coefficient of variation [CV] in the sizes of endothelial cells) were measured preoperatively and 6 months postoperatively. In the sixth month of follow-up, the uncorrected vision acuity was 20/25 or better in 81.5% of the eyes. The best-corrected visual acuity was 20/30 or better in 96.3% of the eyes, and more than 92% of the eyes had a refraction score of ±1 D from the target refraction. The mean corneal ECD of patients before surgery was 2,803±339 cells/mm 2 , which changed to 2,744±369 cells/mm 2 six months after surgery ( p =0.142). CV in the sizes of endothelial cells before the surgery was 25.7%±7.1% and six months after surgery it was 25.9%±5.4% ( p =0.857). Artiflex iris-fixated lens implantation is a suitable and predictable method for correction of moderate to high myopia. There was no statistically significant change in ECD and polymegathism (CV in the sizes of endothelial cells) after 6 months of follow-up.

Reliability of Snellen charts for testing visual acuity for driving: prospective study and postal questionnaire

PubMed Central

Currie, Zanna; Bhan, Archana; Pepper, Irene

2000-01-01

Objectives To assess the ability of patients with binocular 6/9 or 6/12 vision on the Snellen chart (Snellen acuity) to read a number plate at 20.5 m (the required standard for driving) and to determine how health professionals advise such patients about driving. Design Prospective study of patients and postal questionnaire to healthcare professionals. Subjects 50 patients with 6/9 vision and 50 with 6/12 vision and 100 general practitioners, 100 optometrists or opticians, and 100 ophthalmologists. Setting Ophthalmology outpatient clinics in Sheffield. Main outcome measures Ability to read a number plate at 20.5 m and health professionals' advice about driving on the basis of visual acuity. Results 26% of patients with 6/9 vision failed the number plate test, and 34% with 6/12 vision passed it. Of the general practitioners advising patients with 6/9 vision, 76% said the patients could drive, 13% said they should not drive, and 11% were unsure. Of the general practitioners advising patients with 6/12 vision, 21% said the patients could drive, 54% said they should not drive, and 25% were unsure. The level of acuity at which optometrists, opticians, and ophthalmologists would advise drivers against driving ranged from 6/9−2 (ability to read all except two letters on the 6/9 line of the Snellen chart) to less than 6/18. Conclusions Snellen acuity is a poor predictor of an individual's ability to meet the required visual standard for driving. Patients with 6/9 vision or less should be warned that they may fail to meet this standard, but those with 6/12 vision should not be assumed to be below the standard. PMID:11039964

Letter Names, Letter Sounds and Phonological Awareness: An Examination of Kindergarten Children across Letters and of Letters across Children

ERIC Educational Resources Information Center

Evans, Mary Ann; Bell, Michelle; Shaw, Deborah; Moretti, Shelley; Page, Jodi

2006-01-01

In this study 149 kindergarten children were assessed for knowledge of letter names and letter sounds, phonological awareness, and cognitive abilities. Through this it examined child and letter characteristics influencing the acquisition of alphabetic knowledge in a naturalistic context, the relationship between letter-sound knowledge and…

Learning to Write Letters: Examination of Student and Letter Factors

PubMed Central

Puranik, Cynthia S.; Petscher, Yaacov; Lonigan, Christopher J.

2016-01-01

Learning to write the letters of the alphabet is an important part of learning how to write conventionally. In this study, we investigated critical factors in the development of letter-writing skills using exploratory item response models to simultaneously account for variance in responses due to differences between students and between letters. Letter-writing skills were assessed in 415 preschool children aged 3 to 5 years. At the student level, we examined the contribution of letter-name knowledge, letter-sound knowledge, and phonological awareness to letter-writing skills. At the letter level, we examined seven intrinsic and extrinsic factors in understanding how preschool children learn to write alphabet letters: first letter of name, letters in name, letter order, textual frequency, number of strokes, symmetry, and letter type. Results indicated that variation in letter-writing skills was accounted for more by differences between students rather than by differences between letters, with most of the variability accounted for by letter-name knowledge and age. Although significant, the contribution of letter-sound knowledge and phonological awareness was relatively small. Student-level mechanisms underlying the acquisition of letter-writing skills are similar to the mechanisms underlying the learning of letter sounds. However, letter characteristics, which appear to play a major role in the learning of letter names and letter sounds, did not appear to influence learning how to write letters in a substantial way. The exception was if the letter was in the child’s name. PMID:25181463

Stereopsis and positional acuity under dark adaptation.

PubMed

Livingstone, M S; Hubel, D H

1994-03-01

Though experience tells us we can perceive depth in dim light, it is not so obvious that one of the chief mechanisms for depth perception, stereopsis, is possible under scotopic conditions. The only studies on human stereopsis in the dark adapted state seem to be those of Nagel [(1902) Zeitschrift für Psychologie, 27, 264-266] and Mueller and Lloyd [(1948) Proceedings of the National Academy of Science, U.S.A., 34, 223-227], both of which used real objects or line stereograms. We tested stereopsis using both random-dot and line stereograms and, in agreement with these studies, found that stereopsis is indeed possible in dark adaptation. We also measured stereo acuity and positional acuity (both of which are examples of hyperacuity) and compared these with grating acuity at several levels of light and dark adaptation. At all illumination levels tested, acuities for stereopsis and relative line position were both higher than for grating acuity. As light levels decreased, positional and grating acuity declined in parallel fashion, whereas stereoacuity declined more steeply.

The flex track: flexible partitioning between low- and high-acuity areas of an emergency department.

PubMed

Laker, Lauren F; Froehle, Craig M; Lindsell, Christopher J; Ward, Michael J

2014-12-01

Emergency departments (EDs) with both low- and high-acuity treatment areas often have fixed allocation of resources, regardless of demand. We demonstrate the utility of discrete-event simulation to evaluate flexible partitioning between low- and high-acuity ED areas to identify the best operational strategy for subsequent implementation. A discrete-event simulation was used to model patient flow through a 50-bed, urban, teaching ED that handles 85,000 patient visits annually. The ED has historically allocated 10 beds to a fast track for low-acuity patients. We estimated the effect of a flex track policy, which involved switching up to 5 of these fast track beds to serving both low- and high-acuity patients, on patient waiting times. When the high-acuity beds were not at capacity, low-acuity patients were given priority access to flexible beds. Otherwise, high-acuity patients were given priority access to flexible beds. Wait times were estimated for patients by disposition and Emergency Severity Index score. A flex track policy using 3 flexible beds produced the lowest mean patient waiting time of 30.9 minutes (95% confidence interval [CI] 30.6 to 31.2 minutes). The typical fast track approach of rigidly separating high- and low-acuity beds produced a mean patient wait time of 40.6 minutes (95% CI 40.2 to 50.0 minutes), 31% higher than that of the 3-bed flex track. A completely flexible ED, in which all beds can accommodate any patient, produced mean wait times of 35.1 minutes (95% CI 34.8 to 35.4 minutes). The results from the 3-bed flex track scenario were robust, performing well across a range of scenarios involving higher and lower patient volumes and care durations. Using discrete-event simulation, we have shown that adding some flexibility into bed allocation between low and high acuity can provide substantial reductions in overall patient waiting and a more efficient ED. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc

The Flex Track: Flexible Partitioning between Low- and High-Acuity Areas of an Emergency Department

PubMed Central

Laker, Lauren F.; Froehle, Craig M.; Lindsell, Christopher J.; Ward, Michael J.

2014-01-01

Study Objective EDs with both low- and high-acuity treatment areas often have fixed allocation of resources, regardless of demand. We demonstrate the utility of discrete-event simulation to evaluate flexible partitioning between low- and high-acuity ED areas to identify the best operational strategy for subsequent implementation. Methods A discrete-event simulation was used to model patient flow through a 50-bed, urban, teaching ED that handles 85,000 patient visits annually. The ED has historically allocated ten beds to a Fast Track for low-acuity patients. We estimated the effect of a Flex Track policy, which involved switching up to five of these Fast Track beds to serving both low- and high-acuity patients, on patient waiting times. When the high-acuity beds were not at capacity, low-acuity patients were given priority access to flexible beds. Otherwise, high-acuity patients were given priority access to flexible beds. Wait times were estimated for patients by disposition and emergency severity index (ESI) score. Results A Flex Track policy using three flexible beds produced the lowest mean patient waiting of 30.9 (95% CI 30.6–31.2) minutes. The typical Fast Track approach of rigidly separating high- and low–acuity beds produced a mean patient wait time of 40.6 (95% CI 40.2–50.0) minutes, 31% higher than the three-bed Flex Track. A completely flexible ED, where all beds can accommodate any patient, produced mean wait times of 35.1 (95% CI 34.8–35.4) minutes. The results from the three-bed Flex Track scenario were robust, performing well across a range of scenarios involving higher and lower patient volumes and care durations. Conclusion Using discrete-event simulation, we have shown that adding some flexibility into bed allocation between low- and high-acuity can provide substantial reductions in overall patient waiting and a more efficient ED. PMID:24954578

Distance versus near visual acuity in amblyopia

PubMed Central

Christoff, Alex; Repka, Michael X.; Kaminski, Brett M.; Holmes, Jonathan M.; Ch, B

2011-01-01

Purpose There are conflicting reports about whether distance and near visual acuity are similar in eyes with amblyopia. The purpose of this study is to compare monocular distance visual acuity with near visual acuity in amblyopic eyes of children. Methods Subjects 2 to 6 years of age were evaluated in a randomized trial of amblyopia therapy for moderate amblyopia (20/40 to 20/80) due to anisometropia, strabismus, or both. Prior to initiating the protocol-prescribed therapy, subjects had best-corrected visual acuity measured with standardized protocols at 3 meters and 0.4 meters using single-surrounded HOTV optotypes. Results A total of 129 subjects were included. The mean amblyopic eye visual acuity was similar at distance and near (mean, 0.45 logMAR at distance versus 0.45 logMAR at near; mean difference, +0.00, 95% CI, −0.03 to 0.03). Of the 129 subjects, 86 (67%) tested within one line at distance and near, 19 (15%) tested more than one logMAR line better at distance, and 24 (19%) tested more than one logMAR line better at near. The mean visual acuity difference between distance and near did not differ by cause of amblyopia, age, or spherical equivalent refractive error. Conclusions We found no systematic difference between distance and near visual acuity in 2- to 6-year-old children with moderate amblyopia associated with strabismus and/or anisometropia. Individual differences between distance and near visual acuity are likely due to test–retest variability. PMID:21907115

A New Font, Specifically Designed for Peripheral Vision, Improves Peripheral Letter and Word Recognition, but Not Eye-Mediated Reading Performance

PubMed Central

Bernard, Jean-Baptiste; Aguilar, Carlos; Castet, Eric

2016-01-01

Reading speed is dramatically reduced when readers cannot use their central vision. This is because low visual acuity and crowding negatively impact letter recognition in the periphery. In this study, we designed a new font (referred to as the Eido font) in order to reduce inter-letter similarity and consequently to increase peripheral letter recognition performance. We tested this font by running five experiments that compared the Eido font with the standard Courier font. Letter spacing and x-height were identical for the two monospaced fonts. Six normally-sighted subjects used exclusively their peripheral vision to run two aloud reading tasks (with eye movements), a letter recognition task (without eye movements), a word recognition task (without eye movements) and a lexical decision task. Results show that reading speed was not significantly different between the Eido and the Courier font when subjects had to read single sentences with a round simulated gaze-contingent central scotoma (10° diameter). In contrast, Eido significantly decreased perceptual errors in peripheral crowded letter recognition (-30% errors on average for letters briefly presented at 6° eccentricity) and in peripheral word recognition (-32% errors on average for words briefly presented at 6° eccentricity). PMID:27074013

Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema.

PubMed

Wells, John A; Glassman, Adam R; Ayala, Allison R; Jampol, Lee M; Aiello, Lloyd Paul; Antoszyk, Andrew N; Arnold-Bush, Bambi; Baker, Carl W; Bressler, Neil M; Browning, David J; Elman, Michael J; Ferris, Frederick L; Friedman, Scott M; Melia, Michele; Pieramici, Dante J; Sun, Jennifer K; Beck, Roy W

2015-03-26

The relative efficacy and safety of intravitreous aflibercept, bevacizumab, and ranibizumab in the treatment of diabetic macular edema are unknown. At 89 clinical sites, we randomly assigned 660 adults (mean age, 61±10 years) with diabetic macular edema involving the macular center to receive intravitreous aflibercept at a dose of 2.0 mg (224 participants), bevacizumab at a dose of 1.25 mg (218 participants), or ranibizumab at a dose of 0.3 mg (218 participants). The study drugs were administered as often as every 4 weeks, according to a protocol-specified algorithm. The primary outcome was the mean change in visual acuity at 1 year. From baseline to 1 year, the mean visual-acuity letter score (range, 0 to 100, with higher scores indicating better visual acuity; a score of 85 is approximately 20/20) improved by 13.3 with aflibercept, by 9.7 with bevacizumab, and by 11.2 with ranibizumab. Although the improvement was greater with aflibercept than with the other two drugs (P<0.001 for aflibercept vs. bevacizumab and P=0.03 for aflibercept vs. ranibizumab), it was not clinically meaningful, because the difference was driven by the eyes with worse visual acuity at baseline (P<0.001 for interaction). When the initial visual-acuity letter score was 78 to 69 (equivalent to approximately 20/32 to 20/40) (51% of participants), the mean improvement was 8.0 with aflibercept, 7.5 with bevacizumab, and 8.3 with ranibizumab (P>0.50 for each pairwise comparison). When the initial letter score was less than 69 (approximately 20/50 or worse), the mean improvement was 18.9 with aflibercept, 11.8 with bevacizumab, and 14.2 with ranibizumab (P<0.001 for aflibercept vs. bevacizumab, P=0.003 for aflibercept vs. ranibizumab, and P=0.21 for ranibizumab vs. bevacizumab). There were no significant differences among the study groups in the rates of serious adverse events (P=0.40), hospitalization (P=0.51), death (P=0.72), or major cardiovascular events (P=0.56). Intravitreous aflibercept

Photometric Compliance of Tablet Screens and Retro-Illuminated Acuity Charts As Visual Acuity Measurement Devices.

PubMed

Livingstone, I A T; Tarbert, C M; Giardini, M E; Bastawrous, A; Middleton, D; Hamilton, R

2016-01-01

Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc.) and three ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off) exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2) providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90%) regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%). Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off) had adequate mean luminance (≥ 120 cd/m2) and Weber contrast (≥ 90%), but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%). Two charts were operating beyond manufacturer's recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was >50%. Overall, iPad tablets matched or marginally out

Photometric Compliance of Tablet Screens and Retro-Illuminated Acuity Charts As Visual Acuity Measurement Devices

PubMed Central

Livingstone, I. A. T.; Tarbert, C. M.; Giardini, M. E.; Bastawrous, A.; Middleton, D.; Hamilton, R.

2016-01-01

Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc.) and three ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off) exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2) providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90%) regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%). Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off) had adequate mean luminance (≥ 120 cd/m2) and Weber contrast (≥ 90%), but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%). Two charts were operating beyond manufacturer’s recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was >50%. Overall, iPad tablets matched or marginally out

Letter-Sound Knowledge: Exploring Gender Differences in Children When They Start School Regarding Knowledge of Large Letters, Small Letters, Sound Large Letters, and Sound Small Letters

PubMed Central

Sigmundsson, Hermundur; Eriksen, Adrian D.; Ofteland, Greta Storm; Haga, Monika

2017-01-01

This study explored whether there is a gender difference in letter-sound knowledge when children start at school. 485 children aged 5–6 years completed assessment of letter-sound knowledge, i.e., large letters; sound of large letters; small letters; sound of small letters. The findings indicate a significant difference between girls and boys in all four factors tested in this study in favor of the girls. There are still no clear explanations to the basis of a presumed gender difference in letter-sound knowledge. That the findings have origin in neuro-biological factors cannot be excluded, however, the fact that girls probably have been exposed to more language experience/stimulation compared to boys, lends support to explanations derived from environmental aspects. PMID:28951726

Olympic Scoring of English Compositions

ERIC Educational Resources Information Center

Follman, John; Panther, Edward

1974-01-01

Examines empirically the efficacy of utilizing Olympic diving and gymnastic scoring systems for grading graduate students' English compositions. Results indicated that such scoring rules do not produce ratings different in reliability or in level from conventional letter grades. (ED)

[Schoolchildren's visual acuity in the dynamics of learning].

PubMed

Bezrukikh, M M; Voinov, V B; Kul'ba, S N; Shurygina, I P

2014-12-01

The results of the screening study of the acuity of schoolchildren between 7 and 17 years old living in Rostov Region of the Russian Federation are discussed in the article. The method of computer optometry was used to measure acuity. 93772 pupils, 48621 girls and 45151 boys, from 150 schools participated in this examination. It was found that there is sustained growth of those with low acuity (0,2 and less) among children of both sexes from junior group (7 years) to the senior (17). The signs of the decline in visual acuity among girls (14%) are manifested earlier than in boys (8%). The decline in visual acuity among 7-8-year-old children is about 3%. While comparing children from rural areas with those from big cities a true dependence of the parameter (acuity) on the factors (city and sex) was found.

Assessing physician leadership styles: application of the situational leadership model to transitions in patient acuity.

PubMed

Skog, Alexander; Peyre, Sarah E; Pozner, Charles N; Thorndike, Mary; Hicks, Gloria; Dellaripa, Paul F

2012-01-01

The situational leadership model suggests that an effective leader adapts leadership style depending on the followers' level of competency. We assessed the applicability and reliability of the situational leadership model when observing residents in simulated hospital floor-based scenarios. Resident teams engaged in clinical simulated scenarios. Video recordings were divided into clips based on Emergency Severity Index v4 acuity scores. Situational leadership styles were identified in clips by two physicians. Interrater reliability was determined through descriptive statistical data analysis. There were 114 participants recorded in 20 sessions, and 109 clips were reviewed and scored. There was a high level of interrater reliability (weighted kappa r = .81) supporting situational leadership model's applicability to medical teams. A suggestive correlation was found between frequency of changes in leadership style and the ability to effectively lead a medical team. The situational leadership model represents a unique tool to assess medical leadership performance in the context of acuity changes.

Learning to recognize letters in the periphery: Effects of repeated exposure, letter frequency, and letter complexity

PubMed Central

Husk, Jesse S.; Yu, Deyue

2017-01-01

Patients with central vision loss must rely on their peripheral vision for reading. Unfortunately, limitations of peripheral vision, such as crowding, pose significant challenges to letter recognition. As a result, there is a need for developing effective training methods for improving crowded letter recognition in the periphery. Several studies have shown that extensive practice with letter stimuli is beneficial to peripheral letter recognition. Here, we explore stimulus-related factors that might influence the effectiveness of peripheral letter recognition training. Specifically, we examined letter exposure (number of letter occurrences), frequency of letter use in English print, and letter complexity and evaluated their contributions to the amount of improvement observed in crowded letter recognition following training. We analyzed data collected across a range of training protocols. Using linear regression, we identified the best-fitting model and observed that all three stimulus-related factors contributed to improvement in peripheral letter recognition with letter exposure being the most important factor. As an important explanatory variable, pretest accuracy was included in the model as well to avoid estimate biases and was shown to have influence on the relationship between training improvement and letter exposure. When developing training protocols for peripheral letter recognition, it may be beneficial to not only consider the overall length of training, but also to tailor the number of stimulus occurrences for each letter according to its initial performance level, frequency, and complexity. PMID:28265651

Relationship between umami taste acuity with sweet or bitter taste acuity and food selection in Japanese women university students.

PubMed

Kubota, Masaru; Toda, Chikako; Nagai-Moriyama, Ayako

2018-01-01

Although there are many studies on the umami receptor and its signaling pathway, literature on the effect of umami taste acuity on dietary choices in healthy subjects is limited. The current study aims to clarify the relationship between umami taste acuity with sweet or bitter taste acuity, food preference and intake. Forty-two healthy Japanese female university students were enrolled. The acuity for umami, sweet, and bitter tastes was evaluated using the filter-paper disc method. The study population was divided into 32 umami normal tasters and 10 hypo-tasters based on the taste acuity at the posterior part of the tongue using monosodium glutamate. Umami hypo-tasters exhibited a significantly lower sensitivity to sweet tastes than normal tasters. However, the sensitivity to bitter taste was comparable between the two groups. Food preference was examined by the food preference checklist consisted of 81 food items. Among them, umami tasters preferred shellfish, tomato, carrot, milk, low fat milk, cheese, dried shiitake, and kombu significantly more than umami hypo-tasters did. A self-reported food frequency questionnaire revealed no significant differences in the intake of calories and three macronutrients between the two groups; however, umami tasters were found to eat more seaweeds and less sugar than umami hypo-tasters. These data together may indicate the possibility that umami taste acuity has an effect on a dietary life. Therefore, training umami taste acuity from early childhood is important for a healthy diet later in life.

Factors Predicting Visual Acuity Outcome in Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial.

PubMed

Kempen, John H; Van Natta, Mark L; Altaweel, Michael M; Dunn, James P; Jabs, Douglas A; Lightman, Susan L; Thorne, Jennifer E; Holbrook, Janet T

2015-12-01

To identify factors associated with best-corrected visual acuity (BCVA) presentation and 2-year outcome in 479 intermediate, posterior, and panuveitic eyes. Cohort study using randomized controlled trial data. Multicenter Uveitis Steroid Treatment (MUST) Trial masked BCVA measurements at baseline and at 2 years follow-up used gold-standard methods. Twenty-three clinical centers documented characteristics per protocol, which were evaluated as potential predictive factors for baseline BCVA and 2-year change in BCVA. Baseline factors significantly associated with reduced BCVA included age ≥50 vs <50 years; posterior vs intermediate uveitis; uveitis duration >10 vs <6 years; anterior chamber (AC) flare >grade 0; cataract; macular thickening; and exudative retinal detachment. Over 2 years, eyes better than 20/50 and 20/50 or worse at baseline improved, on average, by 1 letter (P = .52) and 10 letters (P < .001), respectively. Both treatment groups and all sites of uveitis improved similarly. Factors associated with improved BCVA included resolution of active AC cells, resolution of macular thickening, and cataract surgery in an initially cataractous eye. Factors associated with worsening BCVA included longer duration of uveitis (6-10 or >10 vs <6 years), incident AC flare, cataract at both baseline and follow-up, pseudophakia at baseline, persistence or incidence of vitreous haze, and incidence of macular thickening. Intermediate, posterior, and panuveitis have a similarly favorable prognosis with both systemic and fluocinolone acetonide implant treatment. Eyes with more prolonged/severe inflammatory damage and/or inflammatory findings initially or during follow-up have a worse visual acuity prognosis. The results indicate the value of implementing best practices in managing inflammation. Copyright © 2015 Elsevier Inc. All rights reserved.

Writing letters to patients as an educational tool for medical students.

PubMed

Mrduljaš Đujić, Nataša; Žitnik, Edi; Pavelin, Ljubica; Bačić, Dubravka; Boljat, Mia; Vrdoljak, Davorka; Pavličević, Ivančica; Dvornik, Ana; Marušić, Ana; Marušić, Matko

2013-08-23

Despite rapid growth and development of medical technology, personal relationship between the patient and physician remains the basis of high quality treatment. The aim of our study was to develop, implement and evaluate patient therapeutic letters written by students as a tool in teaching family medicine. The study included all 6th year students attending their rounds in family medicine, structured into two 10-day cycles, one in urban offices and one in offices on the Adriatic islands (rural). After receiving detailed instructions, students wrote letters to two patients after a consultation in the office. The letters were audited by patients and 3 family medicine experts who used a grading instrument (scale 0 - poor, 1 - medium, 2 - good) for 1) adequacy and clarity of description of patients' disease/state, 2) knowledge, 3) adequacy of recommendations, 4) courtesy and respect and 5) language and style. Patients and experts were also asked to underline phrases they thought would be difficult to understand; the underlined text was subjected to content analysis. Both the patients and the experts gave high scores for the value and quality of the letters in terms of the description of the problem, adequacy of recommendations given, and courtesy and respect (mean (±standard deviation) 5.65 ± 0.79 for patients vs. 4.87 ± 0.79 for experts out of maximum score of 6). Family medicine experts were stricter than patients in their evaluation of the content of the letters (adequacy and clarity of disease description (P < 0.001) and adequacy of recommendations (P < 0.001). Both the patients and the experts seemed to like longer letters as the length of the letter showed significant positive correlation with the quality summary score (correlation r = 0.492 vs. r = 0.338, respectively, P < 0.010). Overlapping of the text underlined as difficult to understand by patients and experts was found in 10 (11.6%) out of 86 letters. The highest overlap (20

Are blind people more likely to accept free cataract surgery? A study of vision-related quality of life and visual acuity in Kenya.

PubMed

Briesen, Sebastian; Roberts, Helen; Ilako, Dunera; Karimurio, Jefitha; Courtright, Paul

2010-01-01

To determine possible differences in visual acuity, socio-demographic factors and vision-related Quality of Life (QoL) between people accepting and people refusing sponsored cataract surgery. Three hundred and fifty seven local residents with visually impairing cataract, presenting at screening sites in Kwale District, Kenya were clinically assessed and interviewed. The World Health Organization (WHO) QoL-questionnaire WHO/Prevention of Blindness and Deafness Visual Functioning Questionnaire 20 (PBD-VFQ20) was used to determine the vision-related QoL. A standardized questionnaire asked for socio-demographic data and prior cataract surgery in one eye. After interview, patients were offered free surgery. Primary outcome was the mean QoL-score between acceptors and non-acceptors. Secondary outcomes were visual acuity and socio-demographic factors and their contribution to QoL-scores and the decision on acceptance or refusal. Fifty nine people (16.5%) refused and 298 accepted cataract surgery. Vision-related QoL was poorer in people accepting than in those refusing (mean score 51.54 and 43.12 respectively). People with poor visual acuity were only slightly more likely to accept surgery than people with better vision; the strongest predictors of acceptance were the QoL-score and gender. Men were twice as likely to accept compared to women. Of people who accepted surgery, 73.8% had best eye vision of 20/200 or better. In this population, visual acuity was of limited use to predict a person's decision to accept or refuse cataract surgery. QoL-scores provide further insight into which individuals will agree to surgery and it might be useful to adapt the QoL-questions for field use. Gender inequities remain a matter of concern with men being more likely to get sight-restoring surgery.

Second-year visual acuity outcomes of nAMD patients treated with aflibercept: data analysis from the UK Aflibercept Users Group.

PubMed

Almuhtaseb, H; Johnston, R L; Talks, J S; Lotery, A J

2017-11-01

PurposeTo audit the visual acuity (VA) outcomes achieved at the end of year two in 17 UK centres, which followed the year 1 VIEW protocol in year 1, but a variable approach in year 2 for aflibercept for neovascular macular degeneration (nAMD).Patients and methodsRetrospective data analysis, from an electronic medical record, of a consecutive series of treatment-naive nAMD patients who received aflibercept for 2 consecutive years, having followed the VIEW protocol in year one, defined as eyes having received 7 or 8 injections from baseline.ResultsThe mean number of intravitreal injections (IVI)s during year 2 was 3.7 in 1180 eyes (1083 patients). The mean baseline VA of the whole cohort was 56.3 ETDRS letters, improving to 61.3 at 1 year (+5) and 59.1 (+2.8) at the end of year 2. The mean VA letter score at the end of year 2, stratified by number of IVIs into three groups was as follows: group A, 57.3 (gain of +1.7) (44% of eyes (/=6 IVIs)). Even though there were VA gains in the three groups over the 2-years, there was a drop in VA in year one to two. Eyes that received >/=6 IVIs (group C) had a smaller reduction of VA during year 2 than those which received

38 CFR 4.76 - Visual acuity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... distance and near vision using Snellen's test type or its equivalent. (b) Evaluation of visual acuity. (1) Evaluate central visual acuity on the basis of corrected distance vision with central fixation, even if a central scotoma is present. However, when the lens required to correct distance vision in the poorer eye...

38 CFR 4.76 - Visual acuity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... distance and near vision using Snellen's test type or its equivalent. (b) Evaluation of visual acuity. (1) Evaluate central visual acuity on the basis of corrected distance vision with central fixation, even if a central scotoma is present. However, when the lens required to correct distance vision in the poorer eye...

Motor imagery performance and tactile acuity in patients with complaints of arms, neck and shoulder.

PubMed

Heerkens, Renée J; Köke, Albère Ja; Lötters, Freek Jb; Smeets, Rob Jem

2018-07-01

This study aims to gain more knowledge of the sensorimotor incongruence in patients with chronic nonspecific complaints of arm, neck and shoulder. Seven patients and seven healthy controls performed a left/right judgment task, and tactile acuity was assessed by the two-point discrimination threshold at fingers and shoulders. The results suggest a decreased tactile acuity in patients with chronic nonspecific complaints of arm, neck and shoulder and a faster reaction time at the painful arm, which might imply disturbed information processing of sensory and motor feedback. Due to the small sample size and low scores on the pain and disability questionnaires, these conclusions should be interpreted with care. Further research is recommended.

Defining lactation acuity to improve patient safety and outcomes.

PubMed

Mannel, Rebecca

2011-05-01

While substantial evidence exists identifying risks factors associated with premature weaning from breastfeeding, there are no previously published definitions of patient acuity in the lactation field. This article defines evidence-based levels of lactation acuity based on maternal and infant characteristics. Patient acuity, matching severity of illness to intensity of care required, is an important determinant of patient safety and outcomes. It is often used as part of a patient classification system to determine staffing needs and acceptable workloads in health care settings. As acuity increases, more resources, including more skilled clinicians, are needed to provide optimal care. Developing an evidence-based definition of lactation acuity can help to standardize terminology, more effectively distribute health care staff resources, encourage research to verify the validity and reliability of lactation acuity, and potentially improve breastfeeding initiation and duration rates.

Prehospital severity scoring at major rock concert events.

PubMed

Erickson, T B; Koenigsberg, M; Bunney, E B; Schurgin, B; Levy, P; Willens, J; Tanner, L

1997-01-01

Rock and contemporary music concerts are popular, recurrent events requiring on-site medical staffing. To describe a novel severity score used to stratify the level of acuity of patients presenting to first-aid stations at these events. Retrospective review of charts generated at the first-aid stations of five major rock concerts within a 60,000 spectator capacity, outdoor, professional sports stadium. Participants included all concert patrons presenting to the stadium's first-aid stations as patients. Data were collected on patient demographics, history of drug or ethanol usage while at the concert event, first-aid station time, treatment rendered, diagnosis, and disposition. All patients evaluated were retrospectively assigned a "DRUG-ROCK" Injury Severity Score (DRISS) to stratify their level of acuity. Individual concert events and patient dispositions were compared statistically using chi-square, Fisher's exact, and the ANOVA Mean tests. Approximately 250,000 spectators attended the five concert events. First-aid stations evaluated 308 patients (utilization rate of 1.2 per 1,000 patrons). The most common diagnosis was minor trauma (130; 42%), followed in frequency by ethanol/illicit drug intoxication (98; 32%). The average time in the first-aid station was 23.5 +/- 22.5 minutes (+/- standard deviation; range: 5-150 minutes). Disposition of patients included 100 (32.5%) who were treated and released; 98 (32%) were transported by paramedics to emergency departments (EDs); and 110 (35.5%) signed-out against medical advise (AMA), refusing transport. The mean DRISS was 4.1 (+/- 2.65). Two-thirds (67%) of the study population were ranked as mild by DRISS criteria (score = 1-4), with 27% rated as moderate (score = 5-9), and 6% severe (score > 10). The average of severity scores was highest (6.5) for patients transported to hospitals, and statistically different from the scores of the average of the treated and released and AMA groups (p < 0.005). The DRISS was useful

[Analysis of characteristics shown in self introduction letter and professor's recommendation letter].

PubMed

Kim, Sang Hyun

2013-09-01

The purpose of this study was to investigate applicants' behavioral characteristics based on the evaluation of cognitive, affective and social domain shown in self introduction letter and professor's recommendation letter. Self introduction letters and professor's recommendation letters of 109 applicants students who applied to medical school were collected. Frequency analysis and simple correlation were done in self introduction letter and professor's recommendation letter. Frequency analysis showed affective characteristics were most often mentioned in self introduction letter, and cognitive characteristics were most frequently described in professor's recommendation letter. There was a strong correlation between cognitive domains of self introduction letter and cognitive domain of professor's recommendation letter. There was a strong correlation between affective domain of self introduction letter and cognitive domain professor's recommendation letter. It is very important to make full use of self introduction letter and professor's recommendation letter for selecting medical students. Through the frequency analysis and simple correlation, more specific guidelines need to be suggested in order to secure fairness and objectivity in the evaluation of self-introduction letter and professor's recommendation letter.

Effects of Letter-Identification Training on Letter Naming in Prereading Children

ERIC Educational Resources Information Center

Hayashi, Yusuke; Schmidt, Anna C.; Saunders, Kathryn J.

2013-01-01

Three prereading children who named 0 to 3 of 20 targeted letters were taught to select the 20 printed letters when they heard spoken letter names. For all participants, letter-identification training resulted in naming for the majority of letters.

Composing chaotic music from the letter m

NASA Astrophysics Data System (ADS)

Sotiropoulos, Anastasios D.

Chaotic music is composed from a proposed iterative map depicting the letter m, relating the pitch, duration and loudness of successive steps. Each of the two curves of the letter m is based on the classical logistic map. Thus, the generating map is xn+1 = r xn(1/2 - xn) for xn between 0 and 1/2 defining the first curve, and xn+1 = r (xn - 1/2)(1 - xn) for xn between 1/2 and 1 representing the second curve. The parameter r which determines the height(s) of the letter m varies from 2 to 16, the latter value ensuring fully developed chaotic solutions for the whole letter m; r = 8 yielding full chaotic solutions only for its first curve. The m-model yields fixed points, bifurcation points and chaotic regions for each separate curve, as well as values of the parameter r greater than 8 which produce inter-fixed points, inter-bifurcation points and inter-chaotic regions from the interplay of the two curves. Based on this, music is composed from mapping the m- recurrence model solutions onto actual notes. The resulting musical score strongly depends on the sequence of notes chosen by the composer to define the musical range corresponding to the range of the chaotic mathematical solutions x from 0 to 1. Here, two musical ranges are used; one is the middle chromatic scale and the other is the seven- octaves range. At the composer's will and, for aesthetics, within the same composition, notes can be the outcome of different values of r and/or shifted in any octave. Compositions with endings of non-repeating note patterns result from values of r in the m-model that do not produce bifurcations. Scores of chaotic music composed from the m-model and the classical logistic model are presented.

The e-CRABEL score: an updated method for auditing medical records.

PubMed

Myuran, Tharsika; Turner, Oliver; Ben Doostdar, Bijan; Lovett, Bryony

2017-01-01

In 2001 the CRABEL score was devised in order to obtain a numerical score of the standard of medical note keeping. With the advent of electronic discharge letters, many components of the CRABEL score are now redundant as computers automatically include some documentation. The CRABEL score was modified to form the e-CRABEL score. "Patient details on discharge letter" and "Admission and discharge dates on discharge letter" were replaced with "Summary of investigations on discharge letter" and "Documentation of VTE prophylaxis on the drug chart". The new e-CRABEL score has been used as a monthly audit tool in a busy surgical unit to monitor long-term standards of medical note keeping, with interventions of presenting in the departmental audit meeting, and giving a teaching session to a group of junior doctors at two points. Following discussion with stakeholders: junior doctors, consultants, and the audit department; it was decided that the e-CRABEL tool was sufficiently compact to be completed on a monthly basis. Critique and interventions included using photographic examples, case note selection and clarification of the e-CRABEL criteria in a teaching session. Tools used for audit need to be updated in order to accurately represent what they measure, hence the modification of the CRABEL score to make the new e-CRABEL score. Preliminary acquisition and presentation of data using the e-CRABEL score has shown promise in improving the quality of medical record keeping. The tool is sufficiently compact as to conduct on a monthly basis, maintaining standards to a high level and also provides data on VTE documentation.

Dimensionality and Reliability of Letter Writing in 3- to 5-Year-Old Preschool Children

PubMed Central

Puranik, Cynthia S.; Petscher, Yaacov; Lonigan, Christopher J.

2015-01-01

The primary purpose of this study was to examine the dimensionality and reliability of letter writing skills in preschool children with the aim of determining whether a sequence existed in how children learn to write the letters of the alphabet. Additionally, we examined gender differences in the development of letter writing skills. 471 children aged 3 to 5 years old completed a letter writing task. Results from factor analyses indicated that letter writing represented a unidimensional skill. Similar to research findings that the development of letter-names and letter-sound knowledge varies in acquisition, our findings indicate that the ability to write some letters is acquired earlier than the ability to write other letters. Although there appears to be an approximate sequence for the easiest and most difficult letters, there appears to be a less clear sequence for letters in the middle stages of development. Overall, girls had higher letter writing scores compared to boys. Gender differences regarding difficulty writing specific letters was less conclusive; however, results indicated that when controlling for ability level, girls had a higher probability of writing a letter correctly than boys. Implications of these findings for the assessment and instruction of letter writing are discussed. PMID:26346443

Letter names and phonological awareness help children to learn letter-sound relations.

PubMed

Cardoso-Martins, Cláudia; Mesquita, Tereza Cristina Lara; Ehri, Linnea

2011-05-01

Two experimental training studies with Portuguese-speaking preschoolers in Brazil were conducted to investigate whether children benefit from letter name knowledge and phonological awareness in learning letter-sound relations. In Experiment 1, two groups of children were compared. The experimental group was taught the names of letters whose sounds occur either at the beginning (e.g., the letter /be/) or in the middle (e.g., the letter /'eli/) of the letter name. The control group was taught the shapes of the letters but not their names. Then both groups were taught the sounds of the letters. Results showed an advantage for the experimental group, but only for beginning-sound letters. Experiment 2 investigated whether training in phonological awareness could boost the learning of letter sounds, particularly middle-sound letters. In addition to learning the names of beginning- and middle-sound letters, children in the experimental group were taught to categorize words according to rhyme and alliteration, whereas controls were taught to categorize the same words semantically. All children were then taught the sounds of the letters. Results showed that children who were given phonological awareness training found it easier to learn letter sounds than controls. This was true for both types of letters, but especially for middle-sound letters. Copyright © 2011. Published by Elsevier Inc.

21 CFR 886.1150 - Visual acuity chart.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Visual acuity chart. 886.1150 Section 886.1150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1150 Visual acuity chart. (a) Identification...

Evaluation of Visual Acuity Measurements after Autorefraction versus Manual Refraction in Eyes with and without Diabetic Macular Edema

PubMed Central

Sun, Jennifer K.; Qin, Haijing; Aiello, Lloyd Paul; Melia, Michele; Beck, Roy W.; Andreoli, Christopher M.; Edwards, Paul A.; Glassman, Adam R.; Pavlica, Michael R.

2012-01-01

Objective To compare visual acuity (VA) scores after autorefraction versus research protocol manual refraction in eyes of patients with diabetes and a wide range of VA. Methods Electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS) VA Test© letter score (EVA) was measured after autorefraction (AR-EVA) and after Diabetic Retinopathy Clinical Research Network (DRCR.net) protocol manual refraction (MR-EVA). Testing order was randomized, study participants and VA examiners were masked to refraction source, and a second EVA utilizing an identical manual refraction (MR-EVAsupl) was performed to determine test-retest variability. Results In 878 eyes of 456 study participants, median MR-EVA was 74 (Snellen equivalent approximately 20/32). Spherical equivalent was often similar for manual and autorefraction (median difference: 0.00, 5th and 95th percentiles −1.75 to +1.13 Diopters). However, on average, MR-EVA results were slightly better than AR-EVA results across the entire VA range. Furthermore, variability between AR-EVA and MR-EVA was substantially greater than the test-retest variability of MR-EVA (P<0.001). Variability of differences was highly dependent on autorefractor model. Conclusions Across a wide range of VA at multiple sites using a variety of autorefractors, VA measurements tend to be worse with autorefraction than manual refraction. Differences between individual autorefractor models were identified. However, even among autorefractor models comparing most favorably to manual refraction, VA variability between autorefraction and manual refraction is higher than the test-retest variability of manual refraction. The results suggest that with current instruments, autorefraction is not an acceptable substitute for manual refraction for most clinical trials with primary outcomes dependent on best-corrected VA. PMID:22159173

Reliability and Normative Data for the Dynamic Visual Acuity Test for Vestibular Screening.

PubMed

Riska, Kristal M; Hall, Courtney D

2016-06-01

The purpose of this study was to determine reliability of computerized dynamic visual acuity (DVA) testing and to determine reference values for younger and older adults. A primary function of the vestibular system is to maintain gaze stability during head motion. The DVA test quantifies gaze stabilization with the head moving versus stationary. Commercially available computerized systems allow clinicians to incorporate DVA into their assessment; however, information regarding reliability and normative values of these systems is sparse. Forty-six healthy adults, grouped by age, with normal vestibular function were recruited. Each participant completed computerized DVA testing including static visual acuity, minimum perception time, and DVA using the NeuroCom inVision System. Testing was performed by two examiners in the same session and then repeated at a follow-up session 3 to 14 days later. Intraclass correlation coefficients (ICCs) were used to determine inter-rater and test-retest reliability. ICCs for inter-rater reliability ranged from 0.323 to 0.937 and from 0.434 to 0.909 for horizontal and vertical head movements, respectively. ICCs for test-retest reliability ranged from 0.154 to 0.856 and from 0.377 to 0.9062 for horizontal and vertical head movements, respectively. Overall, raw scores (left/right DVA and up/down DVA) were more reliable than DVA loss scores. Reliability of a commercially available DVA system has poor-to-fair reliability for DVA loss scores. The use of a convergence paradigm and not incorporating the forced choice paradigm may contribute to poor reliability.

Understanding Course Content through Letter Writing: Do Informal Writing Assignments Improve Grades?

ERIC Educational Resources Information Center

Bersamin, Melina; Zamboanga, Byron L.; Orsak-Neff, Natalie

2013-01-01

Using an experimental study design (N = 41), we examined whether participation in an informal writing assignment, specifically writing a letter to a friend about course content, improved exam scores in an undergraduate child development course. Findings indicated that participating in the writing assignment significantly improved scores on an exam…

Re-Audit of the Contents of GP Referral letters to General Adult Community Psychiatrists.

PubMed

Odelola, Catherine; Jabbar, Farid

2017-09-01

The quality of information provided by referring general practitioners to secondary care mental health services are crucial elements in the effective management of patients. In order to establish effective communication, both primary and secondary care health professionals should contribute to planning and organising this process taking into account their different opinions and views. Anonymous questionnaire was designed to collect information on items that GPs and psychiatrist rated as most important items in GP referral letters to psychiatrists. The questionnaires were sent out electronically. Each item was scored using a rating scale where 0 was least important and 10 was most important. Items that scored 8 and above were agreed by all as the most important items. 76 GP letters were audited using a devised checklist of the identified most important items. Data was collected and analysed using a devised data collection tool. A re-audit was done 6months later. A response rate of 70% was obtained for both psychiatrists and GPs. Reasons for referral were described in almost all GP referral letters (95%). Only 24% referral letters had details about current physical health which improved to 59%. Concerns about risk were described in only 47% of letters and treatment provided by GP in 50% of letters. These improved in 79% and 71% of letters respectively in the re-audit. The involvement of professionals in devising a standardised approach for referral letters has improved communication in this re-audit between GPs and Psychiatrists. This is evident in the improvement in key aspects of the referral letters: past medical history, past psychiatric history, current physical health, treatment provided by GP. Efficient communication between GPs and psychiatrists improves the quality of health care for patients.

Impact of referral letters on scheduling of hospital appointments: a randomised control trial

PubMed Central

Jiwa, Moyez; Meng, Xingqiong; O’Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita

2014-01-01

Background Communication is essential for triage, but intervention trials to improve it are scarce. Referral Writer (RW), a referral letter software program, enables documentation of clinical data and extracts relevant patient details from clinical software. Aim To evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters. Design and setting Single-blind, parallel-groups, controlled design with a 1:1 randomisation. Australian GPs watched video vignettes virtually. Method GPs wrote referral letters after watching vignettes of patients with cancer symptoms. Letter content was scored against a benchmark. The proportions of referral letters triagable by a specialist with confidence, and in which the specialist was confident the patient had potentially life-limiting pathology were determined. Categorical outcomes were tested with χ2 and continuous outcomes with t-tests. A random-effects logistic model assessed the influence of group randomisation (RW versus control), GP demographics, clinical specialty, and specialist referral assessor on specialist confidence in the information provided. Results The intervention (RW) group referred more patients and scored significantly higher on information relayed (mean difference 21.6 [95% confidence intervals {CI} = 20.1 to 23.2]). There was no difference in the proportion of letters for which specialists were confident they had sufficient information for appointment scheduling (RW 77.7% versus control 80.6%, P = 0.16). In the logistic model, limited agreement among specialists contributed substantially to the observed differences in appointment scheduling (P = 35% [95% CI 16% to 59%]). Conclusion In isolation, referral letter templates are unlikely to improve the scheduling of specialist appointments, even when more information is relayed. PMID:24982494

Impact of referral letters on scheduling of hospital appointments: a randomised control trial.

PubMed

Jiwa, Moyez; Meng, Xingqiong; O'Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita

2014-07-01

Communication is essential for triage, but intervention trials to improve it are scarce. Referral Writer (RW), a referral letter software program, enables documentation of clinical data and extracts relevant patient details from clinical software. To evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters. Single-blind, parallel-groups, controlled design with a 1:1 randomisation. Australian GPs watched video vignettes virtually. GPs wrote referral letters after watching vignettes of patients with cancer symptoms. Letter content was scored against a benchmark. The proportions of referral letters triagable by a specialist with confidence, and in which the specialist was confident the patient had potentially life-limiting pathology were determined. Categorical outcomes were tested with χ(2) and continuous outcomes with t-tests. A random-effects logistic model assessed the influence of group randomisation (RW versus control), GP demographics, clinical specialty, and specialist referral assessor on specialist confidence in the information provided. The intervention (RW) group referred more patients and scored significantly higher on information relayed (mean difference 21.6 [95% confidence intervals {CI} = 20.1 to 23.2]). There was no difference in the proportion of letters for which specialists were confident they had sufficient information for appointment scheduling (RW 77.7% versus control 80.6%, P = 0.16). In the logistic model, limited agreement among specialists contributed substantially to the observed differences in appointment scheduling (P = 35% [95% CI 16% to 59%]). In isolation, referral letter templates are unlikely to improve the scheduling of specialist appointments, even when more information is relayed. © British Journal of General Practice 2014.

Olfactory acuity in theropods: palaeobiological and evolutionary implications.

PubMed

Zelenitsky, Darla K; Therrien, François; Kobayashi, Yoshitsugu

2009-02-22

This research presents the first quantitative evaluation of the olfactory acuity in extinct theropod dinosaurs. Olfactory ratios (i.e. the ratio of the greatest diameter of the olfactory bulb to the greatest diameter of the cerebral hemisphere) are analysed in order to infer the olfactory acuity and behavioural traits in theropods, as well as to identify phylogenetic trends in olfaction within Theropoda. A phylogenetically corrected regression of olfactory ratio to body mass reveals that, relative to predicted values, the olfactory bulbs of (i) tyrannosaurids and dromaeosaurids are significantly larger, (ii) ornithomimosaurs and oviraptorids are significantly smaller, and (iii) ceratosaurians, allosauroids, basal tyrannosauroids, troodontids and basal birds are within the 95% CI. Relative to other theropods, olfactory acuity was high in tyrannosaurids and dromaeosaurids and therefore olfaction would have played an important role in their ecology, possibly for activities in low-light conditions, locating food, or for navigation within large home ranges. Olfactory acuity was the lowest in ornithomimosaurs and oviraptorids, suggesting a reduced reliance on olfaction and perhaps an omnivorous diet in these theropods. Phylogenetic trends in olfaction among theropods reveal that olfactory acuity did not decrease in the ancestry of birds, as troodontids, dromaeosaurids and primitive birds possessed typical or high olfactory acuity. Thus, the sense of smell must have remained important in primitive birds and its presumed decrease associated with the increased importance of sight did not occur until later among more derived birds.

Olfactory acuity in theropods: palaeobiological and evolutionary implications

PubMed Central

Zelenitsky, Darla K.; Therrien, François; Kobayashi, Yoshitsugu

2008-01-01

This research presents the first quantitative evaluation of the olfactory acuity in extinct theropod dinosaurs. Olfactory ratios (i.e. the ratio of the greatest diameter of the olfactory bulb to the greatest diameter of the cerebral hemisphere) are analysed in order to infer the olfactory acuity and behavioural traits in theropods, as well as to identify phylogenetic trends in olfaction within Theropoda. A phylogenetically corrected regression of olfactory ratio to body mass reveals that, relative to predicted values, the olfactory bulbs of (i) tyrannosaurids and dromaeosaurids are significantly larger, (ii) ornithomimosaurs and oviraptorids are significantly smaller, and (iii) ceratosaurians, allosauroids, basal tyrannosauroids, troodontids and basal birds are within the 95% CI. Relative to other theropods, olfactory acuity was high in tyrannosaurids and dromaeosaurids and therefore olfaction would have played an important role in their ecology, possibly for activities in low-light conditions, locating food, or for navigation within large home ranges. Olfactory acuity was the lowest in ornithomimosaurs and oviraptorids, suggesting a reduced reliance on olfaction and perhaps an omnivorous diet in these theropods. Phylogenetic trends in olfaction among theropods reveal that olfactory acuity did not decrease in the ancestry of birds, as troodontids, dromaeosaurids and primitive birds possessed typical or high olfactory acuity. Thus, the sense of smell must have remained important in primitive birds and its presumed decrease associated with the increased importance of sight did not occur until later among more derived birds. PMID:18957367

Higher-order aberrations and best-corrected visual acuity in Native American children with a high prevalence of astigmatism

PubMed Central

Miller, Joseph M.; Harvey, Erin M.; Schwiegerling, Jim

2016-01-01

Purpose To determine whether higher-order aberrations (HOAs) in children from a highly astigmatic population differ from population norms and whether HOAs are associated with astigmatism and reduced best-corrected visual acuity. Methods Subjects were 218 Tohono O’odham Native American children 5–9 years of age. Noncycloplegic HOA measurements were obtained with a handheld Shack-Hartmann sensor (SHS). Signed (z06s to z14s) and unsigned (z06u to z14u) wavefront aberration Zernike coefficients Z(3,−3) to Z(4,4) were rescaled for a 4 mm diameter pupil and compared to adult population norms. Cycloplegic refraction and best-corrected logMAR letter visual acuity (BCVA) were also measured. Regression analyses assessed the contribution of astigmatism (J0) and HOAs to BCVA. Results The mean root-mean-square (RMS) HOA of 0.191 ± 0.072 μm was significantly greater than population norms (0.100 ± 0.044 μm. All unsigned HOA coefficients (z06u to z14u) and all signed coefficients except z09s, z10s, and z11s were significantly larger than population norms. Decreased BCVA was associated with astigmatism (J0) and spherical aberration (z12u) but not RMS coma, with the effect of J0 about 4 times as great as z12u. Conclusions Tohono O’odham children show elevated HOAs compared to population norms. Astigmatism and unsigned spherical aberration are associated with decreased acuity, but the effects of spherical aberration are minimal and not clinically significant. PMID:26239206

Improving Visual Acuity of Myopes through Operant Training: The Evaluation of Psychological and Physiological Mechanisms Facilitating Acuity Enhancement

DTIC Science & Technology

1988-12-01

Suiek. M. ( 1987 ). Voice and Manual Control in Dual Task Situations. Proceedings o* the Human Pactors Society. (31st Annual Meeting): 419-423. FIELDS OF...aberration. Trachtman ( 1987 ) found that a reduction in pupil size alone may improve acuity although accommodation remains unchanged. 18 One means of...that facilitate behaviorally trained visual acuity improvement (Gallaway, Pearl, Winkelstein, & Scheiman, 1987 ). Relatively few eye care practitioners

[The relationship between eyeball structure and visual acuity in high myopia].

PubMed

Liu, Yi-Chang; Xia, Wen-Tao; Zhu, Guang-You; Zhou, Xing-Tao; Fan, Li-Hua; Liu, Rui-Jue; Chen, Jie-Min

2010-06-01

To explore the relationship between eyeball structure and visual acuity in high myopia. Totally, 152 people (283 eyeballs) with different levels of myopia were tested for visual acuity, axial length, and fundus. All cases were classified according to diopter, axial length, and fundus. The relationships between diopter, axial length, fundus and visual acuity were studied. The mathematical models were established for visual acuity and eyeball structure markers. The visual acuity showed a moderate correlation with fundus class, comus, axial length and diopter ([r] > 0.4, P < 0.000 1). The visual acuity in people with the axial length longer than 30.00 mm, diopter above -20.00 D and fundus in 4th class were mostly below 0.5. The mathematical models were established by visual acuity and eyeball structure markers. The visual acuity should decline with axial length extension, diopter deepening and pathological deterioration of fundus. To detect the structure changes by combining different kinds of objective methods can help to assess and to judge the vision in high myopia.

RETENTION OF HIGH TACTILE ACUITY THROUGHOUT THE LIFESPAN IN BLINDNESS

PubMed Central

Legge, Gordon E.; Madison, Cindee; Vaughn, Brenna N.; Cheong, Allen M.Y.; Miller, Joseph C.

2009-01-01

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 re-examined this age dependence with two newly designed tactile-acuity charts requiring 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 in age from 12 to 85 years, 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 lifespan. PMID:19064491

Individual differences in non-verbal number acuity correlate with maths achievement.

PubMed

Halberda, Justin; Mazzocco, Michèle M M; Feigenson, Lisa

2008-10-02

Human mathematical competence emerges from two representational systems. Competence in some domains of mathematics, such as calculus, relies on symbolic representations that are unique to humans who have undergone explicit teaching. More basic numerical intuitions are supported by an evolutionarily ancient approximate number system that is shared by adults, infants and non-human animals-these groups can all represent the approximate number of items in visual or auditory arrays without verbally counting, and use this capacity to guide everyday behaviour such as foraging. Despite the widespread nature of the approximate number system both across species and across development, it is not known whether some individuals have a more precise non-verbal 'number sense' than others. Furthermore, the extent to which this system interfaces with the formal, symbolic maths abilities that humans acquire by explicit instruction remains unknown. Here we show that there are large individual differences in the non-verbal approximation abilities of 14-year-old children, and that these individual differences in the present correlate with children's past scores on standardized maths achievement tests, extending all the way back to kindergarten. Moreover, this correlation remains significant when controlling for individual differences in other cognitive and performance factors. Our results show that individual differences in achievement in school mathematics are related to individual differences in the acuity of an evolutionarily ancient, unlearned approximate number sense. Further research will determine whether early differences in number sense acuity affect later maths learning, whether maths education enhances number sense acuity, and the extent to which tertiary factors can affect both.

An Attempt to Simulate Letter-by-Letter Dyslexia in Normal Readers

ERIC Educational Resources Information Center

Fiset, Stephanie; Arguin, Martin; Fiset, Daniel

2006-01-01

We attempted to simulate the main features of letter-by-letter (LBL) dyslexia in normal readers through stimulus degradation (i.e. contrast reduction and removal of high spatial frequencies). The results showed the word length and the letter confusability effects characteristic of LBL dyslexia. However, the interaction of letter confusability and…

Spatial acuity of the body surface over the life span.

PubMed

Stevens, J C; Choo, K K

1996-01-01

Spatial acuity over 13 regions of the body was assessed cross-sectionally in 122 male and female subjects between 8 and 87 years of age. Of two measures, the primary one was a threshold for detecting a gap between two points (a refinement of the conventional two-point threshold). The secondary one was a threshold of point localization in 7 of these 13 body regions. The two measures yielded similar pictures of body acuity and age-related changes in acuity, and they agreed in essentials with an early acuity map dating back to Weber in 1835, as cited and confirmed experimentally by Weinstein (1968). To this acuity map, the present study added the dimension of age. The main finding was that aging is much harder on some body regions than on others. Declining acuity with age was found to characterize all regions to one degree or another, but the hands and feet turned out to be far more vulnerable than the more central regions, including the very acute lip and tongue. Deterioration of acuity in the great toe (averaging 400% between youth and advanced age) and fingertip (averaging 130%) may adversely affect such diverse activities as braille reading, grasping, and maintaining balance. The acuity map determined by gap discrimination was essentially the same for males and females; however, males gave significantly smaller localization thresholds than females. In two body regions tested (fingertip and upper lip), children significantly outperformed young adults at gap discrimination.

Empiric determination of corrected visual acuity standards for train crews.

PubMed

Schwartz, Steven H; Swanson, William H

2005-08-01

Probably the most common visual standard for employment in the transportation industry is best-corrected, high-contrast visual acuity. Because such standards were often established absent empiric linkage to job performance, it is possible that a job applicant or employee who has visual acuity less than the standard may be able to satisfactorily perform the required job activities. For the transportation system that we examined, the train crew is required to inspect visually the length of the train before and during the time it leaves the station. The purpose of the inspection is to determine if an individual is in a hazardous position with respect to the train. In this article, we determine the extent to which high-contrast visual acuity can predict performance on a simulated task. Performance at discriminating hazardous from safe conditions, as depicted in projected photographic slides, was determined as a function of visual acuity. For different levels of visual acuity, which was varied through the use of optical defocus, a subject was required to label scenes as hazardous or safe. Task performance was highly correlated with visual acuity as measured under conditions normally used for vision screenings (high-illumination and high-contrast): as the acuity decreases, performance at discriminating hazardous from safe scenes worsens. This empirically based methodology can be used to establish a corrected high-contrast visual acuity standard for safety-sensitive work in transportation that is linked to the performance of a job-critical task.

Reliability of Slope Scores for Individuals.

DTIC Science & Technology

1983-04-01

RD-Ai3I 252 RELIABILITY OF SLOPE SCORES FOR XNDIVIDUALS( U ) NAVAL i/ BIODYNAMICS LAB*NE&I ORLEANS LA R C CARTER ET AL. APR 83 NBDL-93RS UNCLASSIFIED F... Neisser , 1963), search for typographical errors in prose (Schindler, 1978), and choice reaction time (Teichner, 1978) were studied with respect to the...17 Experiment 4: Letter Search Method A letter-search task was administered to 23 subjects in the manner of Neisser (1963). Subjects were presented

Contributing factors to VEP grating acuity deficit and inter-ocular acuity difference in children with cerebral visual impairment.

PubMed

Cavascan, Nívea Nunes; Salomão, Solange Rios; Sacai, Paula Yuri; Pereira, Josenilson Martins; Rocha, Daniel Martins; Berezovsky, Adriana

2014-04-01

To investigate contributing factors to visual evoked potential (VEP) grating acuity deficit (GAD) and inter-ocular acuity difference (IAD) measured by sweep-VEPs in children with cerebral visual impairment (CVI). VEP GAD was calculated for the better acuity eye by subtracting acuity thresholds from mean normal VEP grating acuity according to norms from our own laboratory. Deficits were categorized as mild (0.17 ≤ deficit < 0.40 log units), moderate (0.40 ≤ deficit < 0.70 log units) or severe (deficit ≥0.70 log units). Maximum acceptable IAD was 0.10 log units. A group of 115 children (66 males-57 %) with ages ranging from 1.2 to 166.5 months (median = 17.7) was examined. VEP GAD ranged from 0.17 to 1.28 log units (mean = 0.68 ± 0.27; median = 0.71), and it was mild in 23 (20 %) children, moderate in 32 (28 %) and severe in 60 (52 %). Severe deficit was significantly associated with older age and anti-seizure drug therapy. IAD ranged from 0 to 0.49 log units (mean = 0.06 ± 0.08; median = 0.04) and was acceptable in 96 (83 %) children. Children with strabismus and nystagmus had IAD significantly larger compared to children with orthoposition. In a large cohort of children with CVI, variable severity of VEP GAD was found, with more than half of the children with severe deficits. Older children and those under anti-seizure therapy were at higher risk for larger deficits. Strabismus and nystagmus provided larger IADs. These results should be taken into account on the clinical management of children with this leading cause of bilateral visual impairment.

A study to assess the quality of information in referral letters to the orthodontic department at Kingston Hospital, Surrey.

PubMed

Izadi, Maryam; Gill, Daljit S; Naini, Farhad B

2010-04-01

To assess the quality of information included in referral letters sent to the orthodontic department at Kingston Hospital, Surrey, UK. Referral letters sent by both general dental practitioners (GDPs) and specialist orthodontists were analysed retrospectively in order to ascertain the percentage meeting the inclusion criteria as suggested by Mossey (2006) and the British Orthodontic Society (2008) for the quality of information included in an ideal orthodontic referral letter. Thirty-five consecutive letters sent between May and September 2005 and 206 letters sent in the same period in 2008 were collected by hand and analysed against the inclusion criteria. The numbers of referral letters received from GDPs, specialist orthodontists, and others sources were also determined. Most of the referrals sent in 2005 and 2008 included 40-50% of the referral inclusion points. This was despite an almost twofold increase in the number of referral letters received from specialist orthodontic practitioners in 2008. The majority of the letters, from both GDPs and specialists, did not include details of the oral hygiene or caries status of the patient, or an indication of their motivation towards treatment. None of the referral letters included a plaque score. The main weaknesses in the quality of information provided in referral letters were that in more than 80% of the letters there was no mention of the patient's medical history and no comment on caries status, the standard of oral hygiene, patient motivation for treatment, or an Index of Orthodontic Treatment Need score. The quality of information included in referral letters sent to Kingston Hospital orthodontic department needs to be improved.

Iris pigmentation and photopic visual acuity: a preliminary study.

PubMed

Short, G B

1975-11-01

Visual acuity under varying conditions of light stress was tested in four human populations. It was found that the density of iris pigmentation had no significant effect on visual acuity under conditions of bright light. While some acclimatization to local light levels was observed, significant population differences in visual acuity were obtained. A hypothesis is advanced at to the adaptive value of varying densities of pigmentation of the iris based on the known heat absorption properties of melanin granules.

Knowledge about writing influences reading: Dynamic visual information about letter production facilitates letter identification.

PubMed

Schubert, Teresa; Reilhac, Caroline; McCloskey, Michael

2018-06-01

How are reading and writing related? In this study, we address the relationship between letter identification and letter production, uncovering a link in which production information can be used to identify letters presented dynamically. By testing an individual with a deficit in letter identification, we identified a benefit which would be masked by ceiling effects in unimpaired readers. In Experiment 1 we found that letter stimuli defined by the direction of dot motion (tiny dots within letter move leftward, background dots move rightward) provided no advantage over static letters. In Experiment 2, we tested dynamic stimuli in which the letter shapes emerged over time: drawn as they would be written, drawn in reverse, or with the letter shape filled in randomly. Improved identification was observed only for letters drawn as they are typically written. These results demonstrate that information about letter production can be integrated into letter identification, and point to bi-directional connections between stored letter production information (used for writing) and abstract letter identity representations (used in both reading and writing). The links from stored production information to abstract letter identities allow the former to activate the latter. We also consider the implications of our results for remediation of acquired letter identification deficits, including letter-drawing treatments and the underlying cause of their efficacy. Copyright © 2018 Elsevier Ltd. All rights reserved.

Allen figure and broken wheel visual acuity measurement in preschool children.

PubMed

Schmidt, P P

1992-02-01

In a masked investigation, 34 preschool children (n = 34, 19 females and 15 males) between the ages of 3 and 5 years (mean age = 4.1 years) enrolled in Project Headstart had their monocular and binocular visual acuity measured using the Broken Wheel and Allen figure methods. The results showed that 1) a greater range in acuity values was found with the Allen figure than Broken Wheel test, despite the identical Snellen equivalent acuity levels and similar probability of guessing criteria used for both Broken Wheel and Allen figure acuity measurement e.g., no strong statistical correlation (rOD = +0.22, rOS = -0.11 and rOU = +0.04; rho OD = +0.22, rho OS = -0.11, rho OU = 0.00) for the two tests was found; and 2) the Broken Wheel test appeared to discriminate between 20/30 and 20/40 acuity performance more consistently than did Allen figure and in a way not attributable to chance (p less than or equal to 0.003). In a separate evaluation, the Broken Wheel test showed consistency in the acuity measured. Broken Wheel acuity measurement, even with an average variation of +/- 5.6 percent from the corresponding Snellen standard, appears to be a valuable clinical tool to measure acuity in young children.

The association between higher education and approximate number system acuity

PubMed Central

Lindskog, Marcus; Winman, Anders; Juslin, Peter

2014-01-01

Humans are equipped with an approximate number system (ANS) supporting non-symbolic numerosity representation. Studies indicate a relationship between ANS-precision (acuity) and math achievement. Whether the ANS is a prerequisite for learning mathematics or if mathematics education enhances the ANS remains an open question. We investigated the association between higher education and ANS acuity with university students majoring in subjects with varying amounts of mathematics (mathematics, business, and humanities), measured either early (First year) or late (Third year) in their studies. The results suggested a non-significant trend where students taking more mathematics had better ANS acuity and a significant improvement in ANS acuity as a function of study length that was mainly confined to the business students. The results provide partial support for the hypothesis that education in mathematics can enhance the ANS acuity. PMID:24904478

The association between higher education and approximate number system acuity.

PubMed

Lindskog, Marcus; Winman, Anders; Juslin, Peter

2014-01-01

Humans are equipped with an approximate number system (ANS) supporting non-symbolic numerosity representation. Studies indicate a relationship between ANS-precision (acuity) and math achievement. Whether the ANS is a prerequisite for learning mathematics or if mathematics education enhances the ANS remains an open question. We investigated the association between higher education and ANS acuity with university students majoring in subjects with varying amounts of mathematics (mathematics, business, and humanities), measured either early (First year) or late (Third year) in their studies. The results suggested a non-significant trend where students taking more mathematics had better ANS acuity and a significant improvement in ANS acuity as a function of study length that was mainly confined to the business students. The results provide partial support for the hypothesis that education in mathematics can enhance the ANS acuity.

RED-LETTER DAYS

EPA Science Inventory

The word "red-letter" is an adjective meaning "of special significance." It's origin is from the practice of marking Christian holy days in red letters on calendars. The "red-letter days" to which I refer occurred while I was a graduate student of ...

Letter and symbol identification: No evidence for letter-specific crowding mechanisms.

PubMed

Castet, Eric; Descamps, Marine; Denis-Noël, Ambre; Colé, Pascale

2017-09-01

It has been proposed that letters, as opposed to symbols, trigger specialized crowding processes, boosting identification of the first and last letters of words. This hypothesis is based on evidence that single-letter accuracy as a function of within-string position has a W shape (the classic serial position function [SPF] in psycholinguistics) whereas an inverted V shape is obtained when measured with symbols. Our main goal was to test the robustness of the latter result. Our hypothesis was that any letter/symbol difference might result from short-term visual memory processes (due to the partial report [PR] procedures used in SPF studies) rather than from crowding. We therefore removed the involvement of short-term memory by precueing target-item position and compared SPFs with precueing and postcueing. Perimetric complexity was stringently matched between letters and symbols. In postcueing conditions similar to previous studies, we did not reproduce the inverted V shape for symbols: Clear-cut W shapes were observed with an overall smaller accuracy for symbols compared to letters. This letter/symbol difference was dramatically reduced in precueing conditions in keeping with our prediction. Our results are not consistent with the claim that letter strings trigger specialized crowding processes. We argue that PR procedures are not fit to isolate crowding processes.

The effect of letter string length and report condition on letter recognition accuracy.

PubMed

Raghunandan, Avesh; Karmazinaite, Berta; Rossow, Andrea S

Letter sequence recognition accuracy has been postulated to be limited primarily by low-level visual factors. The influence of high level factors such as visual memory (load and decay) has been largely overlooked. This study provides insight into the role of these factors by investigating the interaction between letter sequence recognition accuracy, letter string length and report condition. Letter sequence recognition accuracy for trigrams and pentagrams were measured in 10 adult subjects for two report conditions. In the complete report condition subjects reported all 3 or all 5 letters comprising trigrams and pentagrams, respectively. In the partial report condition, subjects reported only a single letter in the trigram or pentagram. Letters were presented for 100ms and rendered in high contrast, using black lowercase Courier font that subtended 0.4° at the fixation distance of 0.57m. Letter sequence recognition accuracy was consistently higher for trigrams compared to pentagrams especially for letter positions away from fixation. While partial report increased recognition accuracy in both string length conditions, the effect was larger for pentagrams, and most evident for the final letter positions within trigrams and pentagrams. The effect of partial report on recognition accuracy for the final letter positions increased as eccentricity increased away from fixation, and was independent of the inner/outer position of a letter. Higher-level visual memory functions (memory load and decay) play a role in letter sequence recognition accuracy. There is also suggestion of additional delays imposed on memory encoding by crowded letter elements. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Effect of Orthographic Processes on Letter Identity and Letter-Position Encoding in Dyslexic Children

PubMed Central

Reilhac, Caroline; Jucla, Mélanie; Iannuzzi, Stéphanie; Valdois, Sylviane; Démonet, Jean-François

2012-01-01

The ability to identify letters and encode their position is a crucial step of the word recognition process. However and despite their word identification problem, the ability of dyslexic children to encode letter identity and letter-position within strings was not systematically investigated. This study aimed at filling this gap and further explored how letter identity and letter-position encoding is modulated by letter context in developmental dyslexia. For this purpose, a letter-string comparison task was administered to French dyslexic children and two chronological age (CA) and reading age (RA)-matched control groups. Children had to judge whether two successively and briefly presented four-letter strings were identical or different. Letter-position and letter identity were manipulated through the transposition (e.g., RTGM vs. RMGT) or substitution of two letters (e.g., TSHF vs. TGHD). Non-words, pseudo-words, and words were used as stimuli to investigate sub-lexical and lexical effects on letter encoding. Dyslexic children showed both substitution and transposition detection problems relative to CA-controls. A substitution advantage over transpositions was only found for words in dyslexic children whereas it extended to pseudo-words in RA-controls and to all type of items in CA-controls. Letters were better identified in the dyslexic group when belonging to orthographically familiar strings. Letter-position encoding was very impaired in dyslexic children who did not show any word context effect in contrast to CA-controls. Overall, the current findings point to a strong letter identity and letter-position encoding disorder in developmental dyslexia. PMID:22661961

Sporadic Visual Acuity Loss in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)

PubMed Central

Kim, Benjamin J.; Ying, Gui-Shuang; Huang, Jiayan; Levy, Nicole E.; Maguire, Maureen G.

2014-01-01

Purpose To evaluate transient, large visual acuity (VA) decreases, termed sporadic vision loss, during anti-vascular endothelial growth factor treatment for neovascular age-related macular degeneration (AMD). Design Cohort within a randomized clinical trial. Methods Setting Comparison of AMD Treatments Trials (CATT). Study Population 1185 CATT patients. Main Outcome Measures incidence of sporadic vision loss and odds ratio (OR) for association with patient and ocular factors. Sporadic vision loss was a decline of ≥ 15 letters from the previous visit, followed by a return at the next visit to no more than 5 letters worse than the visit before the VA loss. Results There were 143 sporadic vision loss events in 122/1185 (10.3%) patients. Mean VA at two years for those with and without sporadic vision loss was 58.5 (~20/63) and 68.4 (~20/40) letters, respectively (P < 0.001). Among patients treated pro re nata, no injection was given for 27.6% (27/98) of sporadic vision loss events. Multivariate analysis demonstrated that baseline predictors for sporadic vision loss included worse baseline VA (OR 2.92, 95%CI:1.65–5.17 for ≤ 20/200 compared with ≥ 20/40), scar (OR 2.21, 95%CI:1.22–4.01), intraretinal foveal fluid on optical coherence tomography (OR 1.80, 95%CI:1.11–2.91), and medical history of anxiety (OR 1.90, 95%CI:1.12–3.24) and syncope (OR 2.75, 95%CI:1.45–5.22). Refraction decreased the likelihood of sporadic vision loss (OR 0.62, 95%CI:0.42–0.91). Conclusions Approximately 10% of CATT patients had sporadic vision loss. Baseline predictors included AMD-related factors and factors independent of AMD. These data are relevant for clinicians in practice and those involved in clinical trials. PMID:24727261

Sporadic visual acuity loss in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT).

PubMed

Kim, Benjamin J; Ying, Gui-Shuang; Huang, Jiayan; Levy, Nicole E; Maguire, Maureen G

2014-07-01

To evaluate transient, large visual acuity (VA) decreases, termed sporadic vision loss, during anti-vascular endothelial growth factor treatment for neovascular age-related macular degeneration (AMD). Cohort within a randomized clinical trial. setting: Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). study population: Total of 1185 CATT patients. main outcome measures: Incidence of sporadic vision loss and odds ratio (OR) for association with patient and ocular factors. Sporadic vision loss was a decline of ≥15 letters from the previous visit, followed by a return at the next visit to no more than 5 letters worse than the visit before the VA loss. There were 143 sporadic vision loss events in 122 of 1185 patients (10.3%). Mean VA at 2 years for those with and without sporadic vision loss was 58.5 (∼20/63) and 68.4 (∼20/40) letters, respectively (P < .001). Among patients treated pro re nata, no injection was given for 27.6% (27/98) of sporadic vision loss events. Multivariate analysis demonstrated that baseline predictors for sporadic vision loss included worse baseline VA (OR 2.92, 95% confidence interval [CI]:1.65-5.17 for ≤20/200 compared with ≥20/40), scar (OR 2.21, 95% CI:1.22-4.01), intraretinal foveal fluid on optical coherence tomography (OR 1.80, 95% CI:1.11-2.91), and medical history of anxiety (OR 1.90, 95% CI:1.12-3.24) and syncope (OR 2.75, 95% CI:1.45-5.22). Refraction decreased the likelihood of sporadic vision loss (OR 0.62, 95%CI: 0.42-0.91). Approximately 10% of CATT patients had sporadic vision loss. Baseline predictors included AMD-related factors and factors independent of AMD. These data are relevant for clinicians in practice and those involved in clinical trials. Copyright © 2014 Elsevier Inc. All rights reserved.

Navigated macular laser decreases retreatment rate for diabetic macular edema: a comparison with conventional macular laser.

PubMed

Neubauer, Aljoscha S; Langer, Julian; Liegl, Raffael; Haritoglou, Christos; Wolf, Armin; Kozak, Igor; Seidensticker, Florian; Ulbig, Michael; Freeman, William R; Kampik, Anselm; Kernt, Marcus

2013-01-01

The purpose of this study was to evaluate and compare clinical outcomes and retreatment rates using navigated macular laser versus conventional laser for the treatment of diabetic macular edema (DME). In this prospective, interventional pilot study, 46 eyes from 46 consecutive patients with DME were allocated to receive macular laser photocoagulation using navigated laser. Best corrected visual acuity and retreatment rate were evaluated for up to 12 months after treatment. The control group was drawn based on chart review of 119 patients treated by conventional laser at the same institutions during the same time period. Propensity score matching was performed with Stata, based on the nearest-neighbor method. Propensity score matching for age, gender, baseline visual acuity, and number of laser spots yielded 28 matched patients for the control group. Visual acuity after navigated macular laser improved from a mean 0.48 ± 0.37 logMAR by a mean +2.9 letters after 3 months, while the control group showed a mean -4.0 letters (P = 0.03). After 6 months, navigated laser maintained a mean visual gain of +3.3 letters, and the conventional laser group showed a slower mean increase to +1.9 letters versus baseline. Using Kaplan-Meier analysis, the laser retreatment rate showed separation of the survival curves after 2 months, with fewer retreatments in the navigated group than in the conventional laser group during the first 8 months (18% versus 31%, respectively, P = 0.02). The short-term results of this pilot study suggest that navigated macular photocoagulation is an effective technique and could be considered as a valid alternative to conventional slit-lamp laser for DME when focal laser photocoagulation is indicated. The observed lower retreatment rates with navigated retinal laser therapy in the first 8 months suggest a more durable treatment effect.

Numerical distance effect size is a poor metric of approximate number system acuity.

PubMed

Chesney, Dana

2018-04-12

Individual differences in the ability to compare and evaluate nonsymbolic numerical magnitudes-approximate number system (ANS) acuity-are emerging as an important predictor in many research areas. Unfortunately, recent empirical studies have called into question whether a historically common ANS-acuity metric-the size of the numerical distance effect (NDE size)-is an effective measure of ANS acuity. NDE size has been shown to frequently yield divergent results from other ANS-acuity metrics. Given these concerns and the measure's past popularity, it behooves us to question whether the use of NDE size as an ANS-acuity metric is theoretically supported. This study seeks to address this gap in the literature by using modeling to test the basic assumption underpinning use of NDE size as an ANS-acuity metric: that larger NDE size indicates poorer ANS acuity. This assumption did not hold up under test. Results demonstrate that the theoretically ideal relationship between NDE size and ANS acuity is not linear, but rather resembles an inverted J-shaped distribution, with the inflection points varying based on precise NDE task methodology. Thus, depending on specific methodology and the distribution of ANS acuity in the tested population, positive, negative, or null correlations between NDE size and ANS acuity could be predicted. Moreover, peak NDE sizes would be found for near-average ANS acuities on common NDE tasks. This indicates that NDE size has limited and inconsistent utility as an ANS-acuity metric. Past results should be interpreted on a case-by-case basis, considering both specifics of the NDE task and expected ANS acuity of the sampled population.

Distinct Circuits for Recovery of Eye Dominance and Acuity in Murine Amblyopia.

PubMed

Stephany, Céleste-Élise; Ma, Xiaokuang; Dorton, Hilary M; Wu, Jie; Solomon, Alexander M; Frantz, Michael G; Qiu, Shenfeng; McGee, Aaron W

2018-05-24

Degrading vision by one eye during a developmental critical period yields enduring deficits in both eye dominance and visual acuity. A predominant model is that "reactivating" ocular dominance (OD) plasticity after the critical period is required to improve acuity in amblyopic adults. However, here we demonstrate that plasticity of eye dominance and acuity are independent and restricted by the nogo-66 receptor (ngr1) in distinct neuronal populations. Ngr1 mutant mice display greater excitatory synaptic input onto both inhibitory and excitatory neurons with restoration of normal vision. Deleting ngr1 in excitatory cortical neurons permits recovery of eye dominance but not acuity. Reciprocally, deleting ngr1 in thalamus is insufficient to rectify eye dominance but yields improvement of acuity to normal. Abolishing ngr1 expression in adult mice also promotes recovery of acuity. Together, these findings challenge the notion that mechanisms for OD plasticity contribute to the alterations in circuitry that restore acuity in amblyopia. Copyright © 2018 Elsevier Ltd. All rights reserved.

Visual acuity and visual field impairment in Usher syndrome.

PubMed

Edwards, A; Fishman, G A; Anderson, R J; Grover, S; Derlacki, D J

1998-02-01

To determine the extent of visual acuity and visual field impairment in patients with types 1 and 2 Usher syndrome. The records of 53 patients with type 1 and 120 patients with type 2 Usher syndrome were reviewed for visual acuity and visual field area at their most recent visit. Visual field areas were determined by planimetry of the II4e and V4e isopters obtained with a Goldmann perimeter. Both ordinary and logistic regression models were used to evaluate differences in visual acuity and visual field impairment between patients with type 1 and type 2 Usher syndrome. The difference in visual acuity of the better eye between patients with type 1 and type 2 varied by patient age (P=.01, based on a multiple regression model). The maximum difference in visual acuity between the 2 groups occurred during the third and fourth decades of life (with the type 1 patients being more impaired), while more similar acuities were seen in both younger and older patients. Fifty-one percent (n=27) of the type 1 patients had a visual acuity of 20/40 or better in at least 1 eye compared with 72% (n=87) of the type 2 patients (age-adjusted odds ratio, 3.9). Visual field area to both the II4e (P=.001) and V4e (P<.001) targets was more impaired in the better eye of type 1 patients than type 2 patients. A concentric central visual field greater than 20 degrees in at least 1 eye was present in 20 (59%) of the available 34 visual fields of type 1 patients compared with 70 (67%) of the available 104 visual fields of type 2 patients (age-adjusted odds ratio, 2.9) with the V4e target and in 6 (21%) of the available 29 visual fields of type 1 patients compared with 36 (38%) of the available 94 visual fields of type 2 patients (age-adjusted odds ratio, 4.9) with the II4e target. The fraction of patients who had a visual acuity of 20/40 or better and a concentric central visual field greater than 20 degrees to the II4e target in at least 1 eye was 17% (n=5) in the type 1 patients and 35% (n=33

An acuity cards cookbook.

PubMed

Vital-Durand, F

1996-01-01

Acuity cards are being more commonly used in clinical and screening practice. The author describes his experience from over 6000 infants tested with the method, using two commercially available sets of cards to provide users with comprehensive guidelines to allow them to get the most out of this useful test.

All About Letters.

ERIC Educational Resources Information Center

Post Office Dept., Washington, DC.

This booklet, designed to promote the letter writing habit, provides information about writing letters in a variety of situations. It is divided into several short sections with illustrations. Reasons to write letters and postcards are offered by several authors and celebrites including Stevie Wonder, Darryl Stingley, and "Dear Abby." Addresses…

A preliminary investigation of lumbar tactile acuity in yoga practitioners.

PubMed

Flaherty, Mary; Connolly, Martin

2014-01-01

Tactile acuity in the back relates to voluntary lumbo-pelvic control and is lower in chronic low back pain (CLBP) patients. Two-point discrimination (TPD) thresholds are higher, indicating decreased tactile acuity in patients with CLBP. Yoga has been shown to help relieve CLBP. This study investigated the hypothesis that regular practitioners of yoga have increased tactile acuity (i.e., lower TPD thresholds) when compared to matched controls who regularly perform gym-based (resistance training or aerobic-type) exercise. Tactile acuity in the low back was assessed using TPD in 16 long-term practitioners of yoga (5 Ashtanga, 5 Bikram, and 6 Iyengar practitioners) and 16 age- and gender-matched healthy controls who exercise (with weights and aerobic exercise). The yoga practitioners' TPD was lower than that of the exercisers, indicating greater tactile acuity in the low back. While there was no difference between the TPD of the practitioners of different yoga styles, the TPD of the Ashtanga yoga participants were significantly lower than those of the exercisers. The yogis whose main reasons to practice yoga were for "meditation or increased mindfulness" and for "well-being" showed a nonsignificant trend of higher tactile acuity than those who did yoga for "physical exercise." There was no association between TPD threshold and cumulative amount of yoga practice in terms of hours per week and years of experience. However, increased hours of exercise per week correlated with higher TPD. The findings suggest that there may be a relationship between yoga practice and enhanced tactile acuity in the low back.

Letters

NASA Astrophysics Data System (ADS)

2008-07-01

Confused or incorrect? J Khan Reply to the above letter from the authors of 'Aerodynamics experiments with an observable airflow: a fog-wind-tunnel' B Priemer A misleading explanation H Fricker Reply to the above letter from the authors of 'Demonstrate Lenz's law with an aluminium ring' Lyna, C T Chee, C L Sai, G N Khang and T A Ling The heart of the problem B Marshall

Effects of Reduced Acuity and Stereo Acuity on Saccades and Reaching Movements in Adults With Amblyopia and Strabismus.

PubMed

Niechwiej-Szwedo, Ewa; Goltz, Herbert C; Colpa, Linda; Chandrakumar, Manokaraananthan; Wong, Agnes M F

2017-02-01

Our previous work has shown that amblyopia disrupts the planning and execution of visually-guided saccadic and reaching movements. We investigated the association between the clinical features of amblyopia and aspects of visuomotor behavior that are disrupted by amblyopia. A total of 55 adults with amblyopia (22 anisometropic, 18 strabismic, 15 mixed mechanism), 14 adults with strabismus without amblyopia, and 22 visually-normal control participants completed a visuomotor task while their eye and hand movements were recorded. Univariate and multivariate analyses were performed to assess the association between three clinical predictors of amblyopia (amblyopic eye [AE] acuity, stereo sensitivity, and eye deviation) and seven kinematic outcomes, including saccadic and reach latency, interocular saccadic and reach latency difference, saccadic and reach precision, and PA/We ratio (an index of reach control strategy efficacy using online feedback correction). Amblyopic eye acuity explained 28% of the variance in saccadic latency, and 48% of the variance in mean saccadic latency difference between the amblyopic and fellow eyes (i.e., interocular latency difference). In contrast, for reach latency, AE acuity explained only 10% of the variance. Amblyopic eye acuity was associated with reduced endpoint saccadic (23% of variance) and reach (22% of variance) precision in the amblyopic group. In the strabismus without amblyopia group, stereo sensitivity and eye deviation did not explain any significant variance in saccadic and reach latency or precision. Stereo sensitivity was the best clinical predictor of deficits in reach control strategy, explaining 23% of total variance of PA/We ratio in the amblyopic group and 12% of variance in the strabismus without amblyopia group when viewing with the amblyopic/nondominant eye. Deficits in eye and limb movement initiation (latency) and target localization (precision) were associated with amblyopic acuity deficit, whereas changes in

Dynamic Visual Acuity and Landing Sickness in Crewmembers Returning from Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Rosenberg, M.J.F; Peters, B.T.; Reschke, M. F.

2016-01-01

Long-term exposure to microgravity causes sensorimotor adaptations that result in functional deficits upon returning to a gravitational environment. At landing the vestibular system and the central nervous system, responsible for coordinating head and eye movements, are adapted to microgravity and must re-adapt to the gravitational environment. This re-adaptation causes decrements in gaze control and dynamic visual acuity, with astronauts reporting oscillopsia and blurred vision. Dynamic visual acuity (DVA) is assessed using an oscillating chair developed in the Neuroscience Laboratory at JSC. This chair is lightweight and easily portable for quick deployment in the field. The base of the chair is spring-loaded and allows for manual oscillation of the subject. Using a metronome, the chair is vertically oscillated plus or minus 2 cm at 2 Hz by an operator, to simulate walking. While the subject is being oscillated, they are asked to discern the direction of Landolt-C optotypes of varying sizes and record their direction using a gamepad. The visual acuity thresholds are determined using an algorithm that alters the size of the optotype based on the previous response of the subject using a forced-choice best parameter estimation that is able to rapidly converge on the threshold value. Visual acuity thresholds were determined both for static (seated) and dynamic (oscillating) conditions. Dynamic visual acuity is defined as the difference between the dynamic and static conditions. Dynamic visual acuity measures will be taken prior to flight (typically L-180, L-90, and L-60) and up to eight times after landing, including up to 3 times on R plus 0. Follow up measurements will be taken at R plus 1 (approximately 36 hours after landing). Long-duration International Space Station crewmembers will be tested once at the refueling stop in Europe and once again upon return to Johnson Space Center. In addition to DVA, subjective ratings of motion sickness will be recorded

Visual Acuity Change over 12 Months in the Prospective Progression of Atrophy Secondary to Stargardt Disease (ProgStar) Study: ProgStar Report Number 6.

PubMed

Kong, Xiangrong; Strauss, Rupert W; Cideciyan, Artur V; Michaelides, Michel; Sahel, José-Alain; Munoz, Beatriz; Ahmed, Mohamed; Ervin, Ann M; West, Sheila K; Cheetham, Janet K; Scholl, Hendrik P N

2017-11-01

To estimate the yearly rate of change of best-corrected visual acuity (BCVA) and the risk of loss 1 line or more over 1 year and to identify risk factors for BCVA loss in patients with Stargardt disease (STGD1). Multicenter, prospective cohort study. Two hundred fifty-nine patients (489 eyes) with molecularly confirmed STGD1 enrolled at 9 centers in the United States and Europe. Participants were followed up every 6 months, and data at the baseline and 6- and 12-month visits were analyzed. Best-corrected visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Standardized reporting forms were used to collect participants' characteristics and clinical observations. Linear mixed effects models were used to estimate the rate of BCVA loss. Linear models with generalized estimating equations were used to identify risk factors for BCVA loss of 1 line or more over 1 year. Change in BCVA over 1 year. Cross-sectional analysis at baseline showed that earlier symptom onset and longer duration since onset was associated with worse BCVA. Longitudinal analysis showed no overall significant change of BCVA within 12 months, but the rate of BCVA change was significantly different by baseline BCVA (P < 0.001). The BCVA of eyes with baseline BCVA of 20/25 or better declined at a rate of 2.8 ETDRS letters per year (P = 0.10), eyes with baseline BCVA between 20/25 and 20/70 declined at a rate of 2.3 ETDRS letters per year (P = 0.002), eyes with baseline BCVA between 20/70 and 20/200 declined at a rate of 0.8 ETDRS letters per year (P = 0.08), and eyes with baseline BCVA worse than 20/200 showed a significant improvement of 2.3 ETDRS letters per year (P < 0.001). Overall, 12.9% of eyes lost 1 line or more, and the risk of such BCVA loss was different by baseline BCVA level (P = 0.016). Smoking and vitamin A use was not associated significantly with baseline BCVA, nor with rate of BCVA loss over 1 year. Change in BCVA in STGD1 patients over a

Acuity systems dialogue and patient classification system essentials.

PubMed

Harper, Kelle; McCully, Crystal

2007-01-01

Obtaining resources for quality patient care is a major responsibility of nurse leaders and requires accurate information in the political world of budgeting. Patient classification systems (PCS) assist nurse managers in controlling cost and improving patient care while appropriately using financial resources. This paper communicates acuity systems development, background, flaws, and components while discussing a few tools currently available. It also disseminates the development of a new acuity tool, the Patient Classification System. The PCS tool, developed in a small rural hospital, uses 5 broad concepts: (1) medications, (2) complicated procedures, (3) education, (4) psychosocial issues, and (5) complicated intravenous medications. These concepts embrace a 4-tiered scale that differentiates significant patient characteristics and assists in staffing measures for equality in patient staffing and improving quality of care and performance. Data obtained through use of the PCS can be used by nurse leaders to effectively and objectively lobby for appropriate patient care resources. Two questionnaires distributed to registered nurses on a medical-surgical unit evaluated the nurses' opinion of the 5 concepts and the importance for establishing patient acuity for in-patient care. Interrater reliability among nurses was 87% with the author's acuity tool.

Extending the Administration Time of the Letter Fluency Test Increases Sensitivity to Cognitive Status in Aging

PubMed Central

Holtzer, R.; Goldin, Y.; Donovick, P.J.

2010-01-01

We examined whether extending the administration time of letter fluency from one minute per letter trial (standard administration) to two minutes increased the sensitivity of this test to cognitive status in aging. Participants (mean age = 84.6) were assigned to cognitive impairment (n=20) and control (n=40) groups. Pearson correlations and scatter plot analyses showed that associations between the Dementia Rating Scale scores and letter fluency were higher and less variable when performance on the latter was extended to two minutes. ANOVA showed that the cognitive impairment group generated fewer words in the second minute of the letter fluency task compared to the control group. Finally, discriminant function analyses revealed that extending the letter fluency trials to two minutes increased discrimination between the control and cognitive impairment groups. PMID:19449244

Human locognosic acuity on the arm varies with explicit and implicit manipulations of attention: implications for interpreting elevated tactile acuity on an amputation stump.

PubMed

O'Boyle, D J; Moore, C E; Poliakoff, E; Butterworth, R; Sutton, A; Cody, F W

2001-06-01

In Experiment 1, normal subjects' ability to localize tactile stimuli (locognosia) delivered to the upper arm was significantly higher when they were instructed explicitly to direct their attention selectively to that segment than when they were instructed explicitly to distribute their attention across the whole arm. This elevation of acuity was eliminated when subjects' attentional resources were divided by superimposition of an effortful, secondary task during stimulation. In Experiment 2, in the absence of explicit attentional instruction, subjects' locognosic acuity on one of three arm segments was significantly higher when stimulation of that segment was 2.5 times more probable than that of stimulation of the other two segments. We surmise that the attentional mechanisms responsible for such modulations of locognosic acuity in normal subjects may contribute to the elevated sensory acuity observed on the stumps of amputees.

Spatial Acuity and Prey Detection in Weakly Electric Fish

PubMed Central

Babineau, David; Lewis, John E; Longtin, André

2007-01-01

It is well-known that weakly electric fish can exhibit extreme temporal acuity at the behavioral level, discriminating time intervals in the submicrosecond range. However, relatively little is known about the spatial acuity of the electrosense. Here we use a recently developed model of the electric field generated by Apteronotus leptorhynchus to study spatial acuity and small signal extraction. We show that the quality of sensory information available on the lateral body surface is highest for objects close to the fish's midbody, suggesting that spatial acuity should be highest at this location. Overall, however, this information is relatively blurry and the electrosense exhibits relatively poor acuity. Despite this apparent limitation, weakly electric fish are able to extract the minute signals generated by small prey, even in the presence of large background signals. In fact, we show that the fish's poor spatial acuity may actually enhance prey detection under some conditions. This occurs because the electric image produced by a spatially dense background is relatively “blurred” or spatially uniform. Hence, the small spatially localized prey signal “pops out” when fish motion is simulated. This shows explicitly how the back-and-forth swimming, characteristic of these fish, can be used to generate motion cues that, as in other animals, assist in the extraction of sensory information when signal-to-noise ratios are low. Our study also reveals the importance of the structure of complex electrosensory backgrounds. Whereas large-object spacing is favorable for discriminating the individual elements of a scene, small spacing can increase the fish's ability to resolve a single target object against this background. PMID:17335346

Connections are not enough for membership: Letter/non-letter distinction persists through phonological association learning.

PubMed

Schmitt, Andreas; van Leeuwen, Cees; Lachmann, Thomas

2017-05-01

In compound, hierarchical stimuli (also known as Navon figures), a Global Precedence Effect (GPE) can reliably be observed for both letters and non-letters. However, when presentation conditions sufficiently resemble those of reading, the GPE for letters has occasionally been found to disappear. We corroborate this effect in a study with a large group of participants. In addition, in-between two sessions, participants were trained in associating the non-letters with either phonological or non-phonological sounds. We reasoned that learning distinctive phonological associations might be akin to the acquisition of letter knowledge. This might eliminate the GPE also for the non-letters. However, the GPE persisted for the trained non-letters in both conditions. The large number of participants in this study revealed additional effects in the letter condition, which enabled further insights in the processing dissociation between letters and non-letter shapes. Copyright © 2017. Published by Elsevier B.V.

Military readiness: an exploration of the relationship between marksmanship and visual acuity.

PubMed

Wells, Kenney H; Wagner, Heidi; Reich, Lewis N; Hardigan, Patrick C

2009-04-01

The United States military relies on visual acuity standards to assess enlistment induction and military occupational specialty eligibility, as well as to monitor soldiers' combat vision readiness. However, these vision standards are not evidence based and may not accurately reflect appropriate standards for military readiness or reflect a correlation between visual acuity and occupational performance. The aim of this study was to investigate the relationship between visual acuity and marksmanship performance using a single blind trial with the Engagement Skills Trainer 2000. Marksmanship performance was evaluated in 28 subjects under simulated day and night conditions with habitual spectacle prescription and contact lenses that created visual blur. Panel Poisson regression using an independent correlation structure revealed significant differences (p < 0.001) as visual acuity decreased from 20/25 to 20/50. We conclude that marksmanship performance decreases as visual acuity decreases. We believe that this relationship supports the use of a visual acuity requirement.

Visual Acuity Change Over 24 Months and its Association With Foveal Phenotype and Genotype in Individuals With Stargardt Disease: ProgStar Study Report No. 10.

PubMed

Kong, Xiangrong; Fujinami, Kaoru; Strauss, Rupert W; Munoz, Beatriz; West, Sheila K; Cideciyan, Artur V; Michaelides, Michel; Ahmed, Mohamed; Ervin, Ann-Margret; Schönbach, Etienne; Cheetham, Janet K; Scholl, Hendrik P N

2018-06-14

Limited data from prospective studies are available to understand the natural history of ABCA4-related Stargardt disease (STGD1). Such data are important for determining appropriate outcome measures for future STGD1 trials. To estimate the rate of loss of best-corrected visual acuity (BCVA) during 2 years and to estimate the associations of BCVA loss with foveal phenotype and genotype in patients with STGD1. This multicenter prospective cohort study included 259 participants (489 study eyes) with molecularly confirmed STGD1 who were 6 years or older. The participants were enrolled at 9 centers in the United States and Europe and were followed up every 6 months for 2 years. Baseline BCVA and presence and type of foveal lesion (determined via fundus autofluorescence images) and genotype (classified into 4 groups based on the number and pathogenicity of ABCA4 mutations). Rate of BCVA change per year. The mean (SD) age was 33 (15) years. Of 259 the participants, 141 (54%) were female, and 222 (85%) were white. The overall rate of BCVA loss was 0.55 (95% CI, 0.20-0.90) letters per year during the 2 years. Eyes with baseline BCVA worse than 20/200 showed an improvement of 0.65 (95% CI, 0.1-1.2) letters per year. At baseline, the mean BCVA for eyes without foveal lesion was 20/32, and their BCVA change rate over time was 0.1 (95% CI, -1.2 to 1.35) letters per year (P = .89). Eyes with a foveal lesion but having BCVA of 20/70 or better at baseline lost BCVA at a rate of 3 (95% CI, 1.5-4.4) letters per year (P < .001). Genotype was neither associated with baseline BCVA nor with the rate of BCVA change during the follow-up. A clinically small BCVA loss was observed during 2 years, and the change rate varied depending on baseline BCVA. Eyes without lesion in the fovea had better BCVA at baseline and showed minimal change of BCVA throughout 2 years. Eyes with no or modest acuity impairment but with a foveal lesion at baseline had the fastest loss rate. For trials of

Impact of baseline Diabetic Retinopathy Severity Scale scores on visual outcomes in the VIVID-DME and VISTA-DME studies.

PubMed

Staurenghi, Giovanni; Feltgen, Nicolas; Arnold, Jennifer J; Katz, Todd A; Metzig, Carola; Lu, Chengxing; Holz, Frank G

2017-10-19

To evaluate intravitreal aflibercept versus laser in subgroups of patients with baseline Diabetic Retinopathy Severity Scale (DRSS) scores ≤43, 47, and ≥53 in VIVID-DME and VISTA-DME. Patients with diabetic macular oedema were randomised to receive intravitreal aflibercept 2 mg every 4 weeks (2q4), intravitreal aflibercept 2 mg every 8 weeks after five initial monthly doses (2q8), or macular laser photocoagulation at baseline with sham injections at every visit. These post hoc analyses evaluate outcomes based on baseline DRSS scores in patients in the integrated dataset. The 2q4 and 2q8 treatment groups were also pooled. 748 patients had a baseline DRSS score based on fundus photographs (≤43, n=301; 47, n=153; ≥53, n=294). At week 100, the least squares mean difference between treatment groups (effect of intravitreal aflibercept above that of laser, adjusting for baseline best-corrected visual acuity) was 8.9 (95% CI 5.99 to 11.81), 9.7 (95% CI 5.54 to 13.91), and 11.0 (95% CI 7.96 to 14.1) letters in those with baseline DRSS scores ≤43, 47, and ≥53, respectively. The proportions of patients with ≥2 step DRSS score improvement were greater in the intravitreal aflibercept group versus laser, respectively, for those with baseline DRSS scores of ≤43 (13% vs 5.9%), 47 (25.8% vs 4.5%), and ≥53 (64.5% vs 28.4%). Regardless of baseline DRSS score, functional outcomes were superior in intravitreal aflibercept-treated patients, demonstrating consistent treatment benefit across various baseline levels of retinopathy. NCT01331681 and NCT01363440, Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular Edema secondary to branch retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 6.

PubMed

Scott, Ingrid U; Ip, Michael S; VanVeldhuisen, Paul C; Oden, Neal L; Blodi, Barbara A; Fisher, Marian; Chan, Clement K; Gonzalez, Victor H; Singerman, Lawrence J; Tolentino, Michael

2009-09-01

To compare the efficacy and safety of 1-mg and 4-mg doses of preservative-free intravitreal triamcinolone with standard care (grid photocoagulation in eyes without dense macular hemorrhage and deferral of photocoagulation until hemorrhage clears in eyes with dense macular hemorrhage) for eyes with vision loss associated with macular edema secondary to branch retinal vein occlusion (BRVO). Multicenter, randomized clinical trial of 411 participants. Main Outcome Measure Gain in visual acuity letter score of 15 or more from baseline to month 12. Twenty-nine percent, 26%, and 27% of participants achieved the primary outcome in the standard care, 1-mg, and 4-mg groups, respectively. None of the pairwise comparisons between the 3 groups was statistically significant at month 12. The rates of elevated intraocular pressure and cataract were similar for the standard care and 1-mg groups, but higher in the 4-mg group. There was no difference identified in visual acuity at 12 months for the standard care group compared with the triamcinolone groups; however, rates of adverse events (particularly elevated intraocular pressure and cataract) were highest in the 4-mg group. Application to Clinical Practice Grid photocoagulation as applied in the SCORE Study remains the standard care for patients with vision loss associated with macular edema secondary to BRVO who have characteristics similar to participants in the SCORE-BRVO trial. Grid photocoagulation should remain the benchmark against which other treatments are compared in clinical trials for eyes with vision loss associated with macular edema secondary to BRVO. Trial Registration clinicaltrials.gov Identifier: NCT00105027.

Visual acuity in young elite motorsport athletes: a preliminary report.

PubMed

Schneiders, Anthony G; Sullivan, S John; Rathbone, Emma J; Louise Thayer, A; Wallis, Laura M; Wilson, Alexandra E

2010-05-01

To determine whether elite motorsport athletes demonstrate superior levels of Visual Acuity than age and sex-matched controls. A cross-sectional observational study. A University vision and balance laboratory. Young male motorsport athletes from the New Zealand Elite Motorsport Academy and healthy age and sex-matched controls. Vision performance tests comprising; Static Visual Acuity (SVA), Dynamic Visual Acuity (DVA), Gaze Stabilization Test (GST), and the Perception Time Test (PTT). Motorsport athletes demonstrated superior visual acuity compared to age and sex-matched controls for all measures, and while this was not statistically significant for SVA, GST and DVA, it reached statistical significance for the PTT (pacuity and perception time may not only act to increase performance, but may also reduce the risk of potential injury. This study highlights the need for further research into the area of visual performance, particularly in motorsport and other high-speed sports, where such skills might be integral to performance and injury reduction.

An investigation of the relation between sibilant production and somatosensory and auditory acuity

PubMed Central

Ghosh, Satrajit S.; Matthies, Melanie L.; Maas, Edwin; Hanson, Alexandra; Tiede, Mark; Ménard, Lucie; Guenther, Frank H.; Lane, Harlan; Perkell, Joseph S.

2010-01-01

The relation between auditory acuity, somatosensory acuity and the magnitude of produced sibilant contrast was investigated with data from 18 participants. To measure auditory acuity, stimuli from a synthetic sibilant continuum ([s]-[ʃ]) were used in a four-interval, two-alternative forced choice adaptive-staircase discrimination task. To measure somatosensory acuity, small plastic domes with grooves of different spacing were pressed against each participant’s tongue tip and the participant was asked to identify one of four possible orientations of the grooves. Sibilant contrast magnitudes were estimated from productions of the words ‘said,’ ‘shed,’ ‘sid,’ and ‘shid’. Multiple linear regression revealed a significant relation indicating that a combination of somatosensory and auditory acuity measures predicts produced acoustic contrast. When the participants were divided into high- and low-acuity groups based on their median somatosensory and auditory acuity measures, separate ANOVA analyses with sibilant contrast as the dependent variable yielded a significant main effect for each acuity group. These results provide evidence that sibilant productions have auditory as well as somatosensory goals and are consistent with prior results and the theoretical framework underlying the DIVA model of speech production. PMID:21110603

Visual functions and disability in diabetic retinopathy patients.

PubMed

Shrestha, Gauri Shankar; Kaiti, Raju

2014-01-01

This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. A cross-sectional study was carried out among 38 visually impaired diabetic retinopathy subjects at the Low Vision Clinic of B.P. Koirala Lions Centre for Ophthalmic Studies, Kathmandu. The subjects underwent assessment of distance and near visual acuity, objective and subjective refraction, contrast sensitivity, color vision, and central and peripheral visual fields. The visual disabilities of each subject in their daily lives were evaluated using a standard questionnaire. Multiple regression analysis between visual functions and visual disabilities index was assessed. The majority of subjects (42.1%) were of the age group 60-70 years. Best corrected visual acuity was found to be 0.73±0.2 in the better eye and 0.93±0.27 in the worse eye, which was significantly different at p=0.002. Visual disability scores were significantly higher for legibility of letters (1.2±0.3) and sentences (1.4±0.4), and least for clothing (0.7±0.3). Visual disability index for legibility of letters and sentences was significantly correlated with near visual acuity and peripheral visual field. Contrast sensitivity was also significantly correlated with the visual disability index, and total scores. Impairment of near visual acuity, contrast sensitivity, and peripheral visual field correlated significantly with different types of visual disability. Hence, these clinical tests should be an integral part of the visual assessment of diabetic eyes. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

What Do Letter Migration Errors Reveal About Letter Position Coding in Visual Word Recognition?

ERIC Educational Resources Information Center

Davis, Colin J.; Bowers, Jeffrey S.

2004-01-01

Dividing attention across multiple words occasionally results in misidentifications whereby letters apparently migrate between words. Previous studies have found that letter migrations preserve within-word letter position, which has been interpreted as support for position-specific letter coding. To investigate this issue, the authors used word…

Letter Names and Phonological Awareness Help Children to Learn Letter-Sound Relations

ERIC Educational Resources Information Center

Cardoso-Martins, Claudia; Mesquita, Tereza Cristina Lara; Ehri, Linnea

2011-01-01

Two experimental training studies with Portuguese-speaking preschoolers in Brazil were conducted to investigate whether children benefit from letter name knowledge and phonological awareness in learning letter-sound relations. In Experiment 1, two groups of children were compared. The experimental group was taught the names of letters whose sounds…

Effects of retinal eccentricity and acuity on global motion processing

PubMed Central

Bower, Jeffrey D.; Bian, Zheng; Andersen, George J.

2012-01-01

The present study assessed direction discrimination of moving random dot cinematograms (RDCs) at retinal eccentricities of 0, 8, 22 and 40 deg. In addition, Landolt C acuity was assessed at these eccentricities to determine whether changes in motion discrimination performance covaried with acuity in the retinal periphery. The results of the experiment indicated that discrimination thresholds increased with retinal eccentricity and directional variance (noise) independent of acuity. Psychophysical modeling indicated that the results of eccentricity and noise could be explained by an increase in channel bandwidth and an increase in internal multiplicative noise. PMID:22382583

What Can Reduce Letter Migrations in Letter Position Dyslexia?

ERIC Educational Resources Information Center

Friedmann, Naama; Rahamim, Einav

2014-01-01

Letter position dyslexia (LPD) is a peripheral dyslexia that causes errors of letter position within words, such as reading "cloud" as "could." In this study, we assessed the effect of various display manipulations and reading methods on the reading of 10 Hebrew readers with developmental LPD. These manipulations included…

Cumulative sum analysis score and phacoemulsification competency learning curve.

PubMed

Vedana, Gustavo; Cardoso, Filipe G; Marcon, Alexandre S; Araújo, Licio E K; Zanon, Matheus; Birriel, Daniella C; Watte, Guilherme; Jun, Albert S

2017-01-01

To use the cumulative sum analysis score (CUSUM) to construct objectively the learning curve of phacoemulsification competency. Three second-year residents and an experienced consultant were monitored for a series of 70 phacoemulsification cases each and had their series analysed by CUSUM regarding posterior capsule rupture (PCR) and best-corrected visual acuity. The acceptable rate for PCR was <5% (lower limit h) and the unacceptable rate was >10% (upper limit h). The acceptable rate for best-corrected visual acuity worse than 20/40 was <10% (lower limit h) and the unacceptable rate was >20% (upper limit h). The area between lower limit h and upper limit h is called the decision interval. There was no statistically significant difference in the mean age, sex or cataract grades between groups. The first trainee achieved PCR CUSUM competency at his 22 nd case. His best-corrected visual acuity CUSUM was in the decision interval from his third case and stayed there until the end, never reaching competency. The second trainee achieved PCR CUSUM competency at his 39 th case. He could reach best-corrected visual acuity CUSUM competency at his 22 nd case. The third trainee achieved PCR CUSUM competency at his 41 st case. He reached best-corrected visual acuity CUSUM competency at his 14 th case. The learning curve of competency in phacoemulsification is constructed by CUSUM and in average took 38 cases for each trainee to achieve it.

First quality score for referral letters in gastroenterology—a validation study

PubMed Central

Eskeland, Sigrun Losada; Brunborg, Cathrine; Seip, Birgitte; Wiencke, Kristine; Hovde, Øistein; Owen, Tanja; Skogestad, Erik; Huppertz-Hauss, Gert; Halvorsen, Fred-Arne; Garborg, Kjetil; Aabakken, Lars; de Lange, Thomas

2016-01-01

Objective To create and validate an objective and reliable score to assess referral quality in gastroenterology. Design An observational multicentre study. Setting and participants 25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist. Main outcome measure Correlation between the TPS and a visual analogue scale (VAS) for referral quality. Results The 327 referrals had an average TPS of 13.2 (range 1–25) and an average VAS of 4.7 (range 0.2–9.5). The reliability of the score was excellent, with an intra-rater intraclass correlation coefficient (ICC) of 0.87 and inter-rater ICC of 0.91. The overall correlation between the TPS and the VAS was moderate (r=0.42), and ranged from fair to substantial for the various indications. Mean agreement was good (ICC=0.47, 95% CI (0.34 to 0.57)), ranging from poor to good. Conclusions The TPS is reliable, objective and shows good agreement with the subjective VAS. The score may be a useful tool for assessing referral quality in gastroenterology, particularly important when evaluating the effect of interventions to improve referral quality. PMID:27855107

Transillumination of iris and subnormal visual acuity--ocular albinism?

PubMed Central

Sjödell, L.; Sjöström, A.; Abrahamsson, M.

1996-01-01

BACKGROUND: A common clinical sign in children with subnormal visual acuity or slow visual development was iris transillumination. This was used as the inclusion criterion in a study of children shown to have a subnormal visual acuity in a general health examination at age 4 years. METHODS: Refraction values, stereopsis, fundus photography, macular and nerve head appearance, and visual evoked response (VER) recordings were studied in 18 children. The clinical results were compared with 64 controls referred to the eye clinic because of subnormal vision from the general health examination or from school health care. RESULTS: Eight children had VERs showing asymmetry typical for albinism. Another four had only small asymmetries on the VER, indicating a lower degree of decussation abnormality. No simple correlation of visual acuity, degree of iris transillumination, stereopsis, or macular pathology and VER asymmetries were found. However, marked iris transillumination in all four quadrants, absence of a foveal reflex, and low visual acuity were weakly correlated. CONCLUSIONS: In a rather homogeneous group of children with iris transillumination and subnormal visual acuity eight of 18 had typical albino VERs. The findings of small atypical VER asymmetries in four children and no asymmetry in six children suggest that albinism may be considered as a description of a heterogeneous group of conditions including maximal decussation rate (100%) in the chiasma to a condition with almost normal (> or = 50%) decussation rate. Images PMID:8795373

Improvement of visual acuity by refraction in a low-vision population.

PubMed

Sunness, Janet S; El Annan, Jaafar

2010-07-01

Refraction often may be overlooked in low-vision patients, because the main cause of vision decrease is not refractive, but rather is the result of underlying ocular disease. This retrospective study was carried out to determine how frequently and to what extent visual acuity is improved by refraction in a low-vision population. Cross-sectional study. Seven hundred thirty-nine low-vision patients seen for the first time. A database with all new low-vision patients seen from November 2005 through June 2008 recorded presenting visual acuity using an Early Treatment Diabetic Retinopathy Study chart; it also recorded the best-corrected visual acuity (BCVA) if it was 2 lines or more better than the presenting visual acuity. Retinoscopy was carried out on all patients, followed by manifest refraction. Improvement in visual acuity. Median presenting acuity was 20/80(-2) (interquartile range, 20/50-20/200). There was an improvement of 2 lines or more of visual acuity in 81 patients (11% of all patients), with 22 patients (3% of all patients) improving by 4 lines or more. There was no significant difference in age or in presenting visual acuity between the group that did not improve by refraction and the group that did improve. When stratified by diagnosis, the only 2 diagnoses with a significantly higher rate of improvement than the age-related macular degeneration group were myopic degeneration and progressive myopia (odds ratio, 4.8; 95% confidence interval [CI], 3.0-6.7) and status post-retinal detachment (odds ratio, 7.1; 95% CI, 5.2-9.0). For 5 patients (6% of those with improvement), the eye that was 1 line or more worse than the fellow eye at presentation became the eye that was 1 line or more better than the fellow eye after refraction. A significant improvement in visual acuity was attained by refraction in 11% of the new low-vision patients. Improvement was seen across diagnoses and the range of presenting visual acuity. The worse-seeing eye at presentation may

A half-mile walk decreases visual acuity in active older people.

PubMed

De Oliveira Filho, Ciro Winckler; Dias, Roges Ghidini; Tavares, Graziela Morgana Silva; Santos, Gilmar Moraes; Mazo, Giovana Zarpellon

2010-06-01

The influence of a half-mile walk on the visual acuity of older people who engaged in physical activity was examined. 91 elderly people of both sexes (20 men, 71 women; M age = 69 yr., SD = 6) participated. All were assessed before and after the half-mile walking test for visual acuity (Snellen Optotype Scale) and heart rate. The data indicated a significant decrease in visual acuity as a result of the half-mile test.

Visual acuity of commercial motor drivers in Ogun State of Nigeria.

PubMed

Onabolu, O O; Bodunde, O T; Otulana, T O; Ajibode, H A; Awodein, O G; Onadipe, O J; Jagun, O A

2012-12-01

To objectively assess the visual acuity of commercial motor drivers (CMD) in 3 Local Government Areas (LGA) of Ogun State of Nigeria in order to determine their eligibility to drive. The visual acuities of CMDs in 3 LGAS of Ogun state in Nigeria (selected using a multistage sampling technique) were tested with Snellens acuity charts and the eyes examined with bright pen torches and ophthamoscopes. Visual acuity 6/12 or better in the worse eye was taken as adequate to obtain a driving license. The drivers with worse visual acuities were further examined to find the cause of decreased vision. The visual acuities of 524 drivers were determined and analyzed. Their ages ranged from 19-66 years with a mean of 46.8 ±7.2 years. Two hundred and twenty (41.9%) of the drivers were between 40 and 49 years old. Four hundred and four (77.1%) did not have any form of eye test prior to this study. Four hundred and sixty three drivers (88.4%) were eligible to drive while 61 drivers (11.6%) were not eligible. Decreased visual acuity was caused by refractive error in 22(36.1%), cataract in 19(31.2%), glaucoma in 12(19.7%), corneal scar in 5(8.2%) and posterior segment lesions in 3(4.9%). Objective assessment of vision should be an essential component of licensure. Middle aged and elderly drivers are prone to age related ocular diseases and require reassessment of visual status every 3 years when licenses are renewed.

Letter Names: Effect on Letter Saying, Spelling, and Word Recognition in Hebrew.

ERIC Educational Resources Information Center

Levin, Iris; Patel, Sigal; Margalit, Tamar; Barad, Noa

2002-01-01

Examined whether letter names, which bridge the gap between oral and written language among English speaking children, have a similar function in Hebrew. In findings from studies of Israeli kindergartners and first graders, children were found to rely on letter names in performing a number of letter saying, spelling, and word recognition tasks.…

Dynamic Visual Acuity: a Functionally Relevant Research Tool

NASA Technical Reports Server (NTRS)

Peters, Brian T.; Brady, Rachel A.; Miller, Chris A.; Mulavara, Ajitkumar P.; Wood, Scott J.; Cohen, Helen S.; Bloomberg, Jacob J.

2010-01-01

Coordinated movements between the eyes and head are required to maintain a stable retinal image during head and body motion. The vestibulo-ocular reflex (VOR) plays a significant role in this gaze control system that functions well for most daily activities. However, certain environmental conditions or interruptions in normal VOR function can lead to inadequate ocular compensation, resulting in oscillopsia, or blurred vision. It is therefore possible to use acuity to determine when the environmental conditions, VOR function, or the combination of the two is not conductive for maintaining clear vision. Over several years we have designed and tested several tests of dynamic visual acuity (DVA). Early tests used the difference between standing and walking acuity to assess decrements in the gaze stabilization system after spaceflight. Supporting ground-based studies measured the responses from patients with bilateral vestibular dysfunction and explored the effects of visual target viewing distance and gait cycle events on walking acuity. Results from these studies show that DVA is affected by spaceflight, is degraded in patients with vestibular dysfunction, changes with target distance, and is not consistent across the gait cycle. We have recently expanded our research to include studies in which seated subjects are translated or rotated passively. Preliminary results from this work indicate that gaze stabilization ability may differ between similar active and passive conditions, may change with age, and can be affected by the location of the visual target with respect to the axis of motion. Use of DVA as a diagnostic tool is becoming more popular but the functional nature of the acuity outcome measure also makes it ideal for identifying conditions that could lead to degraded vision. By doing so, steps can be taken to alter the problematic environments to improve the man-machine interface and optimize performance.

Implementing an obstetric triage acuity scale: interrater reliability and patient flow analysis.

PubMed

Smithson, David S; Twohey, Rachel; Rice, Tim; Watts, Nancy; Fernandes, Christopher M; Gratton, Robert J

2013-10-01

A 5-category Obstetric Triage Acuity Scale (OTAS) was developed with a comprehensive set of obstetrical determinants. The objectives of this study were as follows: (1) to test the interrater reliability of OTAS and (2) to determine the distribution of patient acuity and flow by OTAS level. To test the interrater reliability, 110 triage charts were used to generate vignettes and the consistency of the OTAS level assigned by 8 triage nurses was measured. OTAS performed with substantial (Kappa, 0.61 - 0.77, OTAS 1-4) and near perfect correlation (0.87, OTAS 5). To assess patient flow, the times to primary and secondary health care provider assessments and lengths of stay stratified by acuity were abstracted from the patient management system. Two-thirds of triage visits were low acuity (OTAS 4, 5). There was a decrease in length of stay (median [interquartile range], minutes) as acuity decreased from OTAS 1 (120.0 [156.0] minutes) to OTAS 3 (75.0 [120.8]). The major contributor to length of stay was time to secondary health care provider assessment and this did not change with acuity. The percentage of patients admitted to the antenatal or birthing unit decreased from 80% (OTAS 1) to 12% (OTAS 5). OTAS provides a reliable assessment of acuity and its implementation has allowed for triaging of obstetric patients based on acuity, and a more in-depth assessment of the patient flow. By standardizing assessment, OTAS allows for opportunities to improve performance and make comparisons of patient care and flow across organizations. Copyright © 2013 Mosby, Inc. All rights reserved.

Phenomenological model of visual acuity

NASA Astrophysics Data System (ADS)

Gómez-Pedrero, José A.; Alonso, José

2016-12-01

We propose in this work a model for describing visual acuity (V) as a function of defocus and pupil diameter. Although the model is mainly based on geometrical optics, it also incorporates nongeometrical effects phenomenologically. Compared to similar visual acuity models, the proposed one considers the effect of astigmatism and the variability of best corrected V among individuals; it also takes into account the accommodation and the "tolerance to defocus," the latter through a phenomenological parameter. We have fitted the model to the V data provided in the works of Holladay et al. and Peters, showing the ability of this model to accurately describe the variation of V against blur and pupil diameter. We have also performed a comparison between the proposed model and others previously published in the literature. The model is mainly intended for use in the design of ophthalmic compensations, but it can also be useful in other fields such as visual ergonomics, design of visual tests, and optical instrumentation.

First quality score for referral letters in gastroenterology-a validation study.

PubMed

Eskeland, Sigrun Losada; Brunborg, Cathrine; Seip, Birgitte; Wiencke, Kristine; Hovde, Øistein; Owen, Tanja; Skogestad, Erik; Huppertz-Hauss, Gert; Halvorsen, Fred-Arne; Garborg, Kjetil; Aabakken, Lars; de Lange, Thomas

2016-10-08

To create and validate an objective and reliable score to assess referral quality in gastroenterology. An observational multicentre study. 25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist. Correlation between the TPS and a visual analogue scale (VAS) for referral quality. The 327 referrals had an average TPS of 13.2 (range 1-25) and an average VAS of 4.7 (range 0.2-9.5). The reliability of the score was excellent, with an intra-rater intraclass correlation coefficient (ICC) of 0.87 and inter-rater ICC of 0.91. The overall correlation between the TPS and the VAS was moderate (r=0.42), and ranged from fair to substantial for the various indications. Mean agreement was good (ICC=0.47, 95% CI (0.34 to 0.57)), ranging from poor to good. The TPS is reliable, objective and shows good agreement with the subjective VAS. The score may be a useful tool for assessing referral quality in gastroenterology, particularly important when evaluating the effect of interventions to improve referral quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Disentangling the developmental trajectories of letter position and letter identity coding using masked priming.

PubMed

Kezilas, Yvette; McKague, Meredith; Kohnen, Saskia; Badcock, Nicholas A; Castles, Anne

2017-02-01

Masked transposed-letter (TL) priming effects have been used to index letter position processing over the course of reading development. Whereas some studies have reported an increase in TL priming over development, others have reported a decrease. These findings have led to the development of 2 somewhat contradictory accounts of letter position development: the lexical tuning hypothesis and the multiple-route model. One factor that may be contributing to these discrepancies is the use of baseline primes that substitute letters in the target word, which may confound the effect of changes in letter position processing over development with those of letter identity. The present study included an identity prime (e.g., listen-LISTEN), in addition to the standard two-substituted-letter (2SL; e.g., lidfen-LISTEN) and all-letter-different (ALD; e.g., rodfup-LISTEN) baselines, to remove the potential confound between letter position and letter identity information in determining the effect of the TL prime. Priming effects were measured in a lexical decision task administered to children aged 7-12 and a group of university students. Using inverse transformed response times, targets preceded by a TL prime were responded to significantly faster than those preceded by 2SL and ALD primes, and priming remained stable across development. In contrast, targets preceded by a TL prime were responded to significantly slower than those preceded by an ID prime, and this reaction-time cost increased significantly over development, with adults showing the largest cost. These findings are consistent with a lexical tuning account of letter position development, and are inconsistent with the multiple-route model. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Modelling the training effects of kinaesthetic acuity measurement in children.

PubMed

Sims, K; Morton, J

1998-07-01

In previous papers (Sims, Henderson, Hulme, & Morton, 1996a; Sims, Henderson, Morton, & Hulme, 1996b) we have found that the motor skills of clumsy children are capable of significant improvement following relatively brief interventions. Most remarkably, this included a 10-minute intervention while testing the kinaesthetic acuity of the children using a staircase method (Pest). In this paper, we show that Pest testing improves the kinaesthetic acuity of normal children as well. We analyse the available data on the development and improvement of motor skills and kinaesthetic acuity and derive a causal model for the underlying skills. We show that at least three independent cognitive/biological components are required to account for the data. These three components are affected differently by the various interventions that have been tried. We deduce that improvement on a general test of motor impairment can be found as a result of training in kinaesthetic acuity or through other, independent factors.

[Examinations with the Cardiff Acuity Test].

PubMed

Gräf, M; Becker, R; Neff, A; Kaufmann, H

1996-08-01

Recently, a new preferential looking (PL) test has been presented for measuring visual acuity in infants and young children (Cardiff Acuity Test, CAT). The PL target is a schematic vanishing picture composed of isoluminant lines with different spatial orientations. Fifty-three healthy children (4-34 months, group 1), 28 (4-35 months) children at risk for amblyopia due to strabismus (group 2), 19 healthy subjects, and 157 patients (group 3) were tested with the CAT. In group 2 the CAT was compared with the fixation preference test. In group 3 the CAT was compared with a recognition test (Landolt C test). In group 1 the interocular difference of the CAT data was a maximum of 1 dB (70% 0 dB, 30% 1 dB, 1/3 so-called octave). Thus, an interocular difference of > 1 dB was considered to be suggestive of monocular or asymmetrical visual impairment. The maximum value 6/6 was frequently achieved (RE 44%, LE 36%, > 18 months RE 57%, LE 46%). In group 2 only 20% of the monolateral strabismic children showed an interocular difference > 1 dB in the CAT. In group 3 we found significant correlations between the CAT and Landolt acuity. A ratio of about 1.7/1 between CAT and Landolt acuity remained constant in cataract eyes as compared to healthy eyes. In amblyopic eyes due to strabismus this ratio was 3.7/1. Thus, amblyopia was underestimated with the CAT. Without limiting the examination distance, interocular differences > 1 dB in the CAT occurred in 52% of the strabismic amblyopic patients (potential sensitivity). At a distance of 1 m this rate decreased to 22% (real sensitivity). In conclusion, the CAT definitely lacks sensitivity for strabismic amblyopia. The data suggest that the real sensitivity could be improved by using higher spatial frequencies. The use of familiar shapes instead of gratings such as PL targets affects cooperation favorably in 12- to 36-month-old children.

The Two Sides of Sensory–Cognitive Interactions: Effects of Age, Hearing Acuity, and Working Memory Span on Sentence Comprehension

PubMed Central

DeCaro, Renee; Peelle, Jonathan E.; Grossman, Murray; Wingfield, Arthur

2016-01-01

Reduced hearing acuity is among the most prevalent of chronic medical conditions among older adults. An experiment is reported in which comprehension of spoken sentences was tested for older adults with good hearing acuity or with a mild-to-moderate hearing loss, and young adults with age-normal hearing. Comprehension was measured by participants’ ability to determine the agent of an action in sentences that expressed this relation with a syntactically less complex subject-relative construction or a syntactically more complex object-relative construction. Agency determination was further challenged by inserting a prepositional phrase into sentences between the person performing an action and the action being performed. As a control, prepositional phrases of equivalent length were also inserted into sentences in a non-disruptive position. Effects on sentence comprehension of age, hearing acuity, prepositional phrase placement and sound level of stimulus presentations appeared only for comprehension of sentences with the more syntactically complex object-relative structures. Working memory as tested by reading span scores accounted for a significant amount of the variance in comprehension accuracy. Once working memory capacity and hearing acuity were taken into account, chronological age among the older adults contributed no further variance to comprehension accuracy. Results are discussed in terms of the positive and negative effects of sensory–cognitive interactions in comprehension of spoken sentences and lend support to a framework in which domain-general executive resources, notably verbal working memory, play a role in both linguistic and perceptual processing. PMID:26973557

The Two Sides of Sensory-Cognitive Interactions: Effects of Age, Hearing Acuity, and Working Memory Span on Sentence Comprehension.

PubMed

DeCaro, Renee; Peelle, Jonathan E; Grossman, Murray; Wingfield, Arthur

2016-01-01

Reduced hearing acuity is among the most prevalent of chronic medical conditions among older adults. An experiment is reported in which comprehension of spoken sentences was tested for older adults with good hearing acuity or with a mild-to-moderate hearing loss, and young adults with age-normal hearing. Comprehension was measured by participants' ability to determine the agent of an action in sentences that expressed this relation with a syntactically less complex subject-relative construction or a syntactically more complex object-relative construction. Agency determination was further challenged by inserting a prepositional phrase into sentences between the person performing an action and the action being performed. As a control, prepositional phrases of equivalent length were also inserted into sentences in a non-disruptive position. Effects on sentence comprehension of age, hearing acuity, prepositional phrase placement and sound level of stimulus presentations appeared only for comprehension of sentences with the more syntactically complex object-relative structures. Working memory as tested by reading span scores accounted for a significant amount of the variance in comprehension accuracy. Once working memory capacity and hearing acuity were taken into account, chronological age among the older adults contributed no further variance to comprehension accuracy. Results are discussed in terms of the positive and negative effects of sensory-cognitive interactions in comprehension of spoken sentences and lend support to a framework in which domain-general executive resources, notably verbal working memory, play a role in both linguistic and perceptual processing.

47 CFR 61.15 - Letters of transmittal and cover letters.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 61.15 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS Rules for Electronic Filing § 61.15 Letters of transmittal and cover letters. (a) All... pursuant to the notice requirements of section 204(a)(3) of the Communications Act shall display...

When approximate number acuity predicts math performance: The moderating role of math anxiety

PubMed Central

Libertus, Melissa E.

2018-01-01

Separate lines of research suggest that people who are better at estimating numerical quantities using the approximate number system (ANS) have better math performance, and that people with high levels of math anxiety have worse math performance. Only a handful of studies have examined both ANS acuity and math anxiety in the same participants and those studies report contradictory results. To address these inconsistencies, in the current study 87 undergraduate students completed assessments of ANS acuity, math anxiety, and three different measures of math. We considered moderation models to examine the interplay of ANS acuity and math anxiety on different aspects of math performance. Math anxiety and ANS acuity were both unique significant predictors of the ability to automatically recall basic number facts. ANS acuity was also a unique significant predictor of the ability to solve applied math problems, and this relation was further qualified by a significant interaction with math anxiety: the positive association between ANS acuity and applied problem solving was only present in students with high math anxiety. Our findings suggest that ANS acuity and math anxiety are differentially related to various aspects of math and should be considered together when examining their respective influences on math ability. Our findings also raise the possibility that good ANS acuity serves as a protective factor for highly math-anxious students on certain types of math assessments. PMID:29718939

When approximate number acuity predicts math performance: The moderating role of math anxiety.

PubMed

Braham, Emily J; Libertus, Melissa E

2018-01-01

Separate lines of research suggest that people who are better at estimating numerical quantities using the approximate number system (ANS) have better math performance, and that people with high levels of math anxiety have worse math performance. Only a handful of studies have examined both ANS acuity and math anxiety in the same participants and those studies report contradictory results. To address these inconsistencies, in the current study 87 undergraduate students completed assessments of ANS acuity, math anxiety, and three different measures of math. We considered moderation models to examine the interplay of ANS acuity and math anxiety on different aspects of math performance. Math anxiety and ANS acuity were both unique significant predictors of the ability to automatically recall basic number facts. ANS acuity was also a unique significant predictor of the ability to solve applied math problems, and this relation was further qualified by a significant interaction with math anxiety: the positive association between ANS acuity and applied problem solving was only present in students with high math anxiety. Our findings suggest that ANS acuity and math anxiety are differentially related to various aspects of math and should be considered together when examining their respective influences on math ability. Our findings also raise the possibility that good ANS acuity serves as a protective factor for highly math-anxious students on certain types of math assessments.

Experience-dependent central vision deficits: Neurobiology and visual acuity.

PubMed

Williams, Kate; Balsor, Justin L; Beshara, Simon; Beston, Brett R; Jones, David G; Murphy, Kathryn M

2015-09-01

Abnormal visual experience during childhood often leads to amblyopia, with strong links to binocular dysfunction that can include poor acuity in both eyes, especially in central vision. In animal models of amblyopia, the non-deprived eye is often considered normal and what limits binocular acuity. This leaves open the question whether monocular deprivation (MD) induces binocular dysfunction similar to what is found in amblyopia. In previous studies of MD cats, we found a loss of excitatory receptors restricted to the central visual field representation in visual cortex (V1), including both eyes' columns. This led us to ask two questions about the effects of MD: how quickly are receptors lost in V1? and is there an impact on binocular acuity? We found that just a few hours of MD caused a rapid loss of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor proteins across all of V1. But after a few days of MD, there was recovery in the visual periphery, leaving a loss of AMPA receptors only in the central region of V1. We reared animals with early MD followed by a long period of binocular vision and found binocular acuity deficits that were greatest in the central visual field. Our results suggest that the greater binocular acuity deficits in the central visual field are driven in part by the long-term loss of AMPA receptors in the central region of V1. Copyright © 2014 Elsevier Ltd. All rights reserved.

Local and non-local deficits in amblyopia: acuity and spatial interactions.

PubMed

Bonneh, Yoram S; Sagi, Dov; Polat, Uri

2004-12-01

Amblyopic vision is thought to be limited by abnormal long-range spatial interactions, but their exact mode of action and relationship to the main amblyopic deficit in visual acuity is largely unknown. We studied this relationship in a group (N=59) of anisometropic (N=21) and strabismic (or combined, N=38) subjects, using (1) a single and multi-pattern (crowded) computerized static Tumbling-E test with scaled spacing of two pattern widths (TeVA), in addition to an optotype (ETDRS chart) acuity test (VA) and (2) contrast detection of Gabor patches with lateral flankers (lateral masking) along the horizontal and vertical axes as well as in collinear and parallel configurations. By correlating the different measures of visual acuity and contrast suppression, we found that (1) the VA of the strabismic subjects could be decomposed into two uncorrelated components measured in TeVA: acuity for isolated patterns and acuity reduction due to flanking patterns. The latter comprised over 60% of the VA magnitude, on the average and accounted for over 50% of its variance. In contrast, a slight reduction in acuity was found in the anisometropic subjects, and the acuity for a single pattern could account for 70% of the VA variance. (2) The lateral suppression (contrast threshold elevation) in a parallel configuration along the horizontal axis was correlated with the VA (R2=0.7), as well as with the crowding effect (TeVA elevation, R2=0.5) for the strabismic group. Some correlation with the VA was also found for the collinear configuration in the anisometropic group, but less suppression and no correlation were found for all the vertical configurations in all the groups. The results indicate the existence of a specific non-local component of the strabismic deficit, in addition to the local acuity deficit in all amblyopia types. This deficit might reflect long-range lateral inhibition, or alternatively, an inaccurate and scattered top-down attentional selection mechanism.

Improved Mental Acuity Forecasting with an Individualized Quantitative Sleep Model.

PubMed

Winslow, Brent D; Nguyen, Nam; Venta, Kimberly E

2017-01-01

Sleep impairment significantly alters human brain structure and cognitive function, but available evidence suggests that adults in developed nations are sleeping less. A growing body of research has sought to use sleep to forecast cognitive performance by modeling the relationship between the two, but has generally focused on vigilance rather than other cognitive constructs affected by sleep, such as reaction time, executive function, and working memory. Previous modeling efforts have also utilized subjective, self-reported sleep durations and were restricted to laboratory environments. In the current effort, we addressed these limitations by employing wearable systems and mobile applications to gather objective sleep information, assess multi-construct cognitive performance, and model/predict changes to mental acuity. Thirty participants were recruited for participation in the study, which lasted 1 week. Using the Fitbit Charge HR and a mobile version of the automated neuropsychological assessment metric called CogGauge, we gathered a series of features and utilized the unified model of performance to predict mental acuity based on sleep records. Our results suggest that individuals poorly rate their sleep duration, supporting the need for objective sleep metrics to model circadian changes to mental acuity. Participant compliance in using the wearable throughout the week and responding to the CogGauge assessments was 80%. Specific biases were identified in temporal metrics across mobile devices and operating systems and were excluded from the mental acuity metric development. Individualized prediction of mental acuity consistently outperformed group modeling. This effort indicates the feasibility of creating an individualized, mobile assessment and prediction of mental acuity, compatible with the majority of current mobile devices.

Cataract Surgery Outcomes in Uveitis: The Multicenter Uveitis Steroid Treatment Trial.

PubMed

Sen, H Nida; Abreu, Francis M; Louis, Thomas A; Sugar, Elizabeth A; Altaweel, Michael M; Elner, Susan G; Holbrook, Janet T; Jabs, Douglas A; Kim, Rosa Y; Kempen, John H

2016-01-01

To assess the visual outcomes of cataract surgery in eyes that received fluocinolone acetonide implant or systemic therapy with oral corticosteroids and immunosuppression during the Multicenter Uveitis Steroid Treatment (MUST) Trial. Nested prospective cohort study of patients enrolled in a randomized clinical trial. Patients that underwent cataract surgery during the first 2 years of follow-up in the MUST Trial. Visual outcomes of cataract surgery were evaluated 3, 6, and 9 months after surgery using logarithmic visual acuity charts. Change in visual acuity over time was assessed using a mixed-effects model. Best-corrected visual acuity. After excluding eyes that underwent cataract surgery simultaneously with implant surgery, among the 479 eyes in the MUST Trial, 117 eyes (28 eyes in the systemic, 89 in the implant group) in 82 patients underwent cataract surgery during the first 2 years of follow-up. Overall, visual acuity increased by 23 letters from the preoperative visit to the 3-month visit (95% confidence interval [CI], 17-29 letters; P < 0.001) and was stable through 9 months of follow-up. Eyes presumed to have a more severe cataract, as measured by inability to grade vitreous haze, gained an additional 42 letters (95% CI, 34-56 letters; P < 0.001) beyond the 13-letter gain in eyes that had gradable vitreous haze before surgery (95% CI, 9-18 letters; P < 0.001) 3 months after surgery, making up for an initial difference of -45 letters at the preoperative visit (95% CI, -56 to -34 letters; P < 0.001). Black race, longer time from uveitis onset, and hypotony were associated with worse preoperative visual acuity (P < 0.05), but did not affect postsurgical recovery (P > 0.05, test of interaction). After adjusting for other risk factors, there was no significant difference in the improvement in visual acuity between the 2 treatment groups (implant vs. systemic therapy, 2 letters; 95% CI, -10 to 15 letters; P = 0.70). Cataract surgery resulted in substantial

Parafoveal letter-position coding in reading.

PubMed

Snell, Joshua; Bertrand, Daisy; Grainger, Jonathan

2018-05-01

The masked-priming lexical decision task has been the paradigm of choice for investigating how readers code for letter identity and position. Insight into the temporal integration of information between prime and target words has pointed out, among other things, that readers do not code for the absolute position of letters. This conception has spurred various accounts of the word recognition process, but the results at present do not favor one account in particular. Thus, employing a new strategy, the present study moves out of the arena of temporal- and into the arena of spatial information integration. We present two lexical decision experiments that tested how the processing of six-letter target words is influenced by simultaneously presented flanking stimuli (each stimulus was presented for 150 ms). We manipulated the orthographic relatedness between the targets and flankers, in terms of both letter identity (same/different letters based on the target's outer/inner letters) and letter position (intact/reversed order of letters and of flankers, contiguous/noncontiguous flankers). Target processing was strongly facilitated by same-letter flankers, and this facilitatory effect was modulated by both letter/flanker order and contiguity. However, when the flankers consisted of the target's inner-positioned letters alone, letter order no longer mattered. These findings suggest that readers may code for the relative position of letters using words' edges as spatial points of reference. We conclude that the flanker paradigm provides a fruitful means to investigate letter-position coding in the fovea and parafovea.

Night vision in barn owls: visual acuity and contrast sensitivity under dark adaptation.

PubMed

Orlowski, Julius; Harmening, Wolf; Wagner, Hermann

2012-12-06

Barn owls are effective nocturnal predators. We tested their visual performance at low light levels and determined visual acuity and contrast sensitivity of three barn owls by their behavior at stimulus luminances ranging from photopic to fully scotopic levels (23.5 to 1.5 × 10⁻⁶). Contrast sensitivity and visual acuity decreased only slightly from photopic to scotopic conditions. Peak grating acuity was at mesopic (4 × 10⁻² cd/m²) conditions. Barn owls retained a quarter of their maximal acuity when luminance decreased by 5.5 log units. We argue that the visual system of barn owls is designed to yield as much visual acuity under low light conditions as possible, thereby sacrificing resolution at photopic conditions.

Visual acuity deficits in the fellow eyes of children with unilateral amblyopia.

PubMed

Varadharajan, Srinivasa; Hussaindeen, Jameel Rizwana

2012-02-01

To study the visual acuity deficits and maturation in the fellow eyes of children with unilateral amblyopia who were treated with patching. Medical records of patients aged 4-13 years visiting a tertiary eye care center between January 2003 and December 2007 who were diagnosed for the first time with unilateral amblyopia were reviewed. Subjects included in the study were followed through April 2009. The baseline visual acuity in the fellow eye of amblyopic subjects was compared with that of age-matched healthy subjects. Changes in visual acuity in the amblyopic and fellow eyes during subsequent visits were analyzed. A total of 112 children with amblyopia were included (strabismic, 14; anisometropic, 51; combined mechanism, 47). Baseline visual acuity in the fellow eye of these children differed significantly from that of age-matched controls up to 8 years of age. Average logMAR acuity reached 0.0 at age 5 years in controls versus age 9 years in patients. Although the mean visual acuity of the fellow eyes improved during treatment, 21% developed temporary occlusion amblyopia. Full-time patching had no additional benefit when compared with part-time patching. Visual acuity in the fellow eye of children with unilateral amblyopia is reduced at baseline and matures more slowly than in healthy control patients. The risk for temporary occlusion amblyopia in the fellow eye is similar what has been previously reported. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

Analysis of reliability of professor recommendation letters based on concordance with self-introduction letter.

PubMed

Kim, Sang Hyun

2013-12-01

The purpose of this study was to examine the concordance between a checklist's categories of professor recommendation letters and characteristics of the self-introduction letter. Checklists of professor recommendation letters were analyzed and classified into cognitive, social, and affective domains. Simple correlation was performed to determine whether the characteristics of the checklists were concordant with those of the self-introduction letter. The difference in ratings of the checklists by pass or fail grades was analyzed by independent sample t-test. Logistic regression analysis was performed to determine whether a pass or fail grade was influenced by ratings on the checklists. The Cronbach alpha value of the checklists was 0.854. Initiative, as an affective domain, in the professor's recommendation letter was highly ranked among the six checklist categories. Self-directed learning in the self-introduction letter was influenced by a pass or fail grade by logistic regression analysis (p<0.05). Successful applicants received higher ratings than those who failed in every checklist category, particularly in problem-solving ability, communication skills, initiative, and morality (p<0.05). There was a strong correlation between cognitive and affective characteristics in the professor recommendation letters and the sum of all characteristics in the self-introduction letter.

Van: An Open Letter

ERIC Educational Resources Information Center

Tieman, John Samuel

2011-01-01

This essay is an open letter from a classroom teacher to a concerned citizen. The letter lists a variety of problems caused largely by standardization and the more corrosive effects of positivism. Many of these problems are unknown to those outside the immediate school setting. While the letter focuses on a specific setting, an inner city school…

Brief Report: Visual Acuity in Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Albrecht, Matthew A.; Stuart, Geoffrey W.; Falkmer, Marita; Ordqvist, Anna; Leung, Denise; Foster, Jonathan K.; Falkmer, Torbjorn

2014-01-01

Recently, there has been heightened interest in suggestions of enhanced visual acuity in autism spectrum disorders (ASD) which was sparked by evidence that was later accepted to be methodologically flawed. However, a recent study that claimed children with ASD have enhanced visual acuity (Brosnan et al. in "J Autism Dev Disord"…

The effect of state medicaid case-mix payment on nursing home resident acuity.

PubMed

Feng, Zhanlian; Grabowski, David C; Intrator, Orna; Mor, Vincent

2006-08-01

To examine the relationship between Medicaid case-mix payment and nursing home resident acuity. Longitudinal Minimum Data Set (MDS) resident assessments from 1999 to 2002 and Online Survey Certification and Reporting (OSCAR) data from 1996 to 2002, for all freestanding nursing homes in the 48 contiguous U.S. states. We used a facility fixed-effects model to examine the effect of introducing state case-mix payment on changes in nursing home case-mix acuity. Facility acuity was measured by aggregating the nursing case-mix index (NCMI) from the MDS using the Resource Utilization Group (Version III) resident classification system, separately for new admits and long-stay residents, and by an OSCAR-derived index combining a range of activity of daily living dependencies and special treatment measures. We followed facilities over the study period to create a longitudinal data file based on the MDS and OSCAR, respectively, and linked facilities with longitudinal data on state case-mix payment policies for the same period. Across three acuity measures and two data sources, we found that states shifting to case-mix payment increased nursing home acuity levels over the study period. Specifically, we observed a 2.5 percent increase in the average acuity of new admits and a 1.3 to 1.4 percent increase in the acuity of long-stay residents, following the introduction of case-mix payment. The adoption of case-mix payment increased access to care for higher acuity Medicaid residents.

Outcome progress letter types

PubMed Central

Lingley-Pottie, Patricia; Janz, Teresa; McGrath, Patrick J.; Cunningham, Charles; MacLean, Cathy

2011-01-01

Abstract Objective To determine health care professional and parental preferences for receiving progress letters from a pediatric mental health program between a traditional text-only format and a version in which information was presented using graphs and tables with limited text. Design Mailed survey. Setting Nova Scotia. Participants Parents (n = 98) of children who received treatment from and health care professionals (n = 74) who referred patients to the Strongest Families Program (formerly the Family Help Program) were eligible. Most of the health care professionals were family practitioners (83.8%). Main outcome measures Preference between 2 letters that contained the same content (including progress in the program, results from a questionnaire, and resolved and ongoing problems) in different formats—one using text only, the other using graphs as well as text. Results In total, 83.8% of health professionals and 76.5% of parents indicated that they preferred to receive feedback in letters containing information in graphical format. Background and demographic information did not predict preferences. Parents preferred to receive progress letters at the beginning, midway through, and at the end of treatment, and health professionals preferred to receive progress letters at the beginning and end of treatment. Conclusion When receiving progress letters from a pediatric mental health program, health care professionals and parents preferred to receive letters that used graphs to help convey information. PMID:22170209

Small fruit flies sacrifice temporal acuity to maintain contrast sensitivity.

PubMed

Currea, John P; Smith, Joshua L; Theobald, Jamie C

2018-06-05

Holometabolous insects, like fruit flies, grow primarily during larval development. Scarce larval feeding is common in nature and generates smaller adults. Despite the importance of vision to flies, eye size scales proportionately with body size, and smaller eyes confer poorer vision due to smaller optics. Variable larval feeding, therefore, causes within-species differences in visual processing, which have gone largely unnoticed due to ad libitum feeding in the lab that results in generally large adults. Do smaller eyes have smaller ommatidial lenses, reducing sensitivity, or broader inter-ommatidial angles, reducing acuity? And to what extent might neural processes adapt to these optical challenges with temporal and spatial summation? To understand this in the fruit fly, we generated a distribution of body lengths (1.67-2.34 mm; n = 24) and eye lengths (0.33-0.44 mm; n = 24), resembling the distribution of wild-caught flies, by removing larvae from food during their third instar. We find smaller eyes (0.19 vs.0.07 mm 2 ) have substantially fewer (978 vs. 540, n = 45) and smaller ommatidia (222 vs. 121 μm 2 ;n = 45) separated by slightly wider inter-ommatidial angles (4.5 vs.5.5°; n = 34). This corresponds to a greater loss in contrast sensitivity (<50%) than spatial acuity (<20%). Using a flight arena and psychophysics paradigm, we find that smaller flies lose little spatial acuity (0.126 vs. 0.118CPD; n = 45), and recover contrast sensitivity (2.22 for both; n = 65) by sacrificing temporal acuity (26.3 vs. 10.8Hz; n = 112) at the neural level. Therefore, smaller flies sacrifice contrast sensitivity to maintain spatial acuity optically, but recover contrast sensitivity, almost completely, by sacrificing temporal acuity neurally. Copyright © 2018. Published by Elsevier Ltd.

Visual Acuity does not Moderate Effect Sizes of Higher-Level Cognitive Tasks

PubMed Central

Houston, James R.; Bennett, Ilana J.; Allen, Philip A.; Madden, David J.

2016-01-01

Background Declining visual capacities in older adults have been posited as a driving force behind adult age differences in higher-order cognitive functions (e.g., the “common cause” hypothesis of Lindenberger & Baltes, 1994). McGowan, Patterson and Jordan (2013) also found that a surprisingly large number of published cognitive aging studies failed to include adequate measures of visual acuity. However, a recent meta-analysis of three studies (LaFleur & Salthouse, 2014) failed to find evidence that visual acuity moderated or mediated age differences in higher-level cognitive processes. In order to provide a more extensive test of whether visual acuity moderates age differences in higher-level cognitive processes, we conducted a more extensive meta-analysis of topic. Methods Using results from 456 studies, we calculated effect sizes for the main effect of age across four cognitive domains (attention, executive function, memory, and perception/language) separately for five levels of visual acuity criteria (no criteria, undisclosed criteria, self-reported acuity, 20/80-20/31, and 20/30 or better). Results As expected, age had a significant effect on each cognitive domain. However, these age effects did not further differ as a function of visual acuity criteria. Conclusion The current meta-analytic, cross-sectional results suggest that visual acuity is not significantly related to age group differences in higher-level cognitive performance—thereby replicating LaFleur and Salthouse (2014). Further efforts are needed to determine whether other measures of visual functioning (e.g. contrast sensitivity, luminance) affect age differences in cognitive functioning. PMID:27070044

Visual functions and disability in diabetic retinopathy patients

PubMed Central

Shrestha, Gauri Shankar; Kaiti, Raju

2013-01-01

Purpose This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. Method A cross-sectional study was carried out among 38 visually impaired diabetic retinopathy subjects at the Low Vision Clinic of B.P. Koirala Lions Centre for Ophthalmic Studies, Kathmandu. The subjects underwent assessment of distance and near visual acuity, objective and subjective refraction, contrast sensitivity, color vision, and central and peripheral visual fields. The visual disabilities of each subject in their daily lives were evaluated using a standard questionnaire. Multiple regression analysis between visual functions and visual disabilities index was assessed. Result The majority of subjects (42.1%) were of the age group 60–70 years. Best corrected visual acuity was found to be 0.73 ± 0.2 in the better eye and 0.93 ± 0.27 in the worse eye, which was significantly different at p = 0.002. Visual disability scores were significantly higher for legibility of letters (1.2 ± 0.3) and sentences (1.4 ± 0.4), and least for clothing (0.7 ± 0.3). Visual disability index for legibility of letters and sentences was significantly correlated with near visual acuity and peripheral visual field. Contrast sensitivity was also significantly correlated with the visual disability index, and total scores. Conclusion Impairment of near visual acuity, contrast sensitivity, and peripheral visual field correlated significantly with different types of visual disability. Hence, these clinical tests should be an integral part of the visual assessment of diabetic eyes. PMID:24646899

Amblyopia: The Thalamus Is a No-Go Area for Visual Acuity.

PubMed

Seignette, Koen; Levelt, Christiaan N

2018-06-18

When one eye does not function well during development, the visual cortex becomes less responsive to it and visual acuity declines. New research suggests that reduced response strength and deteriorating acuity occur in separate circuits. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Effect of State Medicaid Case-Mix Payment on Nursing Home Resident Acuity

PubMed Central

Feng, Zhanlian; Grabowski, David C; Intrator, Orna; Mor, Vincent

2006-01-01

Objective To examine the relationship between Medicaid case-mix payment and nursing home resident acuity. Data Sources Longitudinal Minimum Data Set (MDS) resident assessments from 1999 to 2002 and Online Survey Certification and Reporting (OSCAR) data from 1996 to 2002, for all freestanding nursing homes in the 48 contiguous U.S. states. Study Design We used a facility fixed-effects model to examine the effect of introducing state case-mix payment on changes in nursing home case-mix acuity. Facility acuity was measured by aggregating the nursing case-mix index (NCMI) from the MDS using the Resource Utilization Group (Version III) resident classification system, separately for new admits and long-stay residents, and by an OSCAR-derived index combining a range of activity of daily living dependencies and special treatment measures. Data Collection/Extraction Methods We followed facilities over the study period to create a longitudinal data file based on the MDS and OSCAR, respectively, and linked facilities with longitudinal data on state case-mix payment policies for the same period. Principal Findings Across three acuity measures and two data sources, we found that states shifting to case-mix payment increased nursing home acuity levels over the study period. Specifically, we observed a 2.5 percent increase in the average acuity of new admits and a 1.3 to 1.4 percent increase in the acuity of long-stay residents, following the introduction of case-mix payment. Conclusions The adoption of case-mix payment increased access to care for higher acuity Medicaid residents. PMID:16899009

Grating visual acuity results in the early treatment for retinopathy of prematurity study.

PubMed

Dobson, Velma; Quinn, Graham E; Summers, C Gail; Hardy, Robert J; Tung, Betty; Good, William V

2011-07-01

To compare grating (resolution) visual acuity at 6 years of age in eyes that received early treatment (ET) for high-risk prethreshold retinopathy of prematurity (ROP) with that in eyes that underwent conventional management (CM). In a randomized clinical trial, infants with bilateral, high-risk prethreshold ROP (n = 317) had one eye undergo ET and the other eye undergo CM, with treatment only if ROP progressed to threshold severity. For asymmetric cases (n = 84), the high-risk prethreshold eye was randomized to ET or CM. Grating visual acuity measured at 6 years of age by masked testers using Teller acuity cards. Monocular grating acuity results were obtained from 317 of 370 surviving children (85.6%). Analysis of grating acuity results for all study participants with high-risk prethreshold ROP showed no statistically significant overall benefit of ET (18.1% vs 22.8% unfavorable outcomes; P = .08). When the 6-year grating acuity results were analyzed according to a clinical algorithm (high-risk types 1 and 2 prethreshold ROP), a benefit was seen in type 1 eyes (16.4% vs 25.2%; P = .004) undergoing ET, but not in type 2 eyes (21.3% vs 15.9%; P = .29). Early treatment of eyes with type 1 ROP improves grating acuity outcomes, but ET for eyes with type 2 ROP does not. APPLICATION TO CLINICAL MEDICINE: Type 1 eyes should be treated early; however, based on acuity results at 6 years of age, type 2 eyes should be cautiously monitored for progression to type 1 ROP. Trial Registration clinicaltrials.gov Identifier: NCT00027222.

Fresnel prisms and their effects on visual acuity and binocularity.

PubMed Central

Véronneau-Troutman, S

1978-01-01

1. The visual acuity with the Fresnel membrane prism is significantly less than that with the conventional prism of the same power for all prism powers from 12 delta through 30 delata at distance and from 15 delta through 30 delta at near. 2. The difference in the visual acuity between base up and base down, and between base in and base out, is not significantly different for either the Fresnel membrane prism or for the conventional prism. 3. For both Fresnel membrane prism and the conventional prism, the visual acuity when looking straight ahead. 4. Using Fresnel membrane prisms of the same power from different lots, the visual acuity varied significantly. The 30 delta prism caused the widest range in visual acuity. 5. When normal subjects are fitted with the higher powers of the Fresnel membrane prism, fusion and stereopsis are disrupted to such an extent that the use of this device to restore or to improve binocular vision in cases with large-angle deviations is seriously questioned. 6. Moreover, the disruption of fusion and stereopsis is abrupt and severe and does not parallel the decrease in visual acuity. The severely reduced ability to maintain fusion may be related to the optical aberrations, which, in turn, may be due to the molding process and the polyvinyl chloride molding material. 7. Through the flexibility of the membrane prism is a definite advantage, because of its proclivity to reduce visual acuity and increase aberrations its prescription for adults often must be limited to only one eye. 8. For the same reasons in the young child with binocular vision problems, the membrane prism presently available should be prescribed over both eyes only in powers less than 20 delta. When the membrane prism is to be used as a partial occluder (over one eye only), any power can be used. 9. The new Fresnel "hard" prism reduces visual acuity minimally and rarely disrupts binocularity, thus increasing the potential for prismotherapy to establish binocularity. This

Variable acuity remote viewing system flight demonstration

NASA Technical Reports Server (NTRS)

Fisher, R. W.

1983-01-01

The Variable Acuity Remote Viewing System (VARVS), originally developed under contract to the Navy (ONR) as a laboratory brassboard, was modified for flight demonstration. The VARVS system was originally conceived as a technique which could circumvent the acuity/field of view/bandwidth tradeoffs that exists in remote viewing to provide a nearly eye limited display in both field of view (160 deg) and resolution (2 min arc) while utilizing conventional TV sensing, transmission, and display equipment. The modifications for flight demonstration consisted of modifying the sensor so it could be installed and flow in a Piper PA20 aircraft, equipped for remote control and modifying the display equipment so it could be integrated with the NASA Research RPB (RPRV) remote control cockpit.

Visual Acuity Using Head-fixed Displays During Passive Self and Surround Motion

NASA Technical Reports Server (NTRS)

Wood, Scott J.; Black, F. Owen; Stallings, Valerie; Peters, Brian

2007-01-01

The ability to read head-fixed displays on various motion platforms requires the suppression of vestibulo-ocular reflexes. This study examined dynamic visual acuity while viewing a head-fixed display during different self and surround rotation conditions. Twelve healthy subjects were asked to report the orientation of Landolt C optotypes presented on a micro-display fixed to a rotating chair at 50 cm distance. Acuity thresholds were determined by the lowest size at which the subjects correctly identified 3 of 5 optotype orientations at peak velocity. Visual acuity was compared across four different conditions, each tested at 0.05 and 0.4 Hz (peak amplitude of 57 deg/s). The four conditions included: subject rotated in semi-darkness (i.e., limited to background illumination of the display), subject stationary while visual scene rotated, subject rotated around a stationary visual background, and both subject and visual scene rotated together. Visual acuity performance was greatest when the subject rotated around a stationary visual background; i.e., when both vestibular and visual inputs provided concordant information about the motion. Visual acuity performance was most reduced when the subject and visual scene rotated together; i.e., when the visual scene provided discordant information about the motion. Ranges of 4-5 logMAR step sizes across the conditions indicated the acuity task was sufficient to discriminate visual performance levels. The background visual scene can influence the ability to read head-fixed displays during passive motion disturbances. Dynamic visual acuity using head-fixed displays can provide an operationally relevant screening tool for visual performance during exposure to novel acceleration environments.

Clinical vision characteristics of the congenital achromatopsias. I. Visual acuity, refractive error, and binocular status.

PubMed

Haegerstrom-Portnoy, G; Schneck, M E; Verdon, W A; Hewlett, S E

1996-07-01

Visual acuity, refractive error, and binocular status were determined in 43 autosomal recessive (AR) and 15 X-linked (XL) congenital achromats. The achromats were classified by color matching and spectral sensitivity data. Large interindividual variation in refractive error and visual acuity was present within each achromat group (complete AR, incomplete AR, and XL). However, the number of individuals with significant interocular acuity differences is very small. Most XLs are myopic; ARs show a wide range of refractive error from high myopia to high hyperopia. Acuity of the AR and XL groups was very similar. With-the-rule astigmatism of large amount is very common in achromats, particularly ARs. There is a close association between strabismus and interocular acuity differences in the ARs, with the fixating eye having better than average acuity. The large overlap of acuity and refractive error of XL and AR achromats suggests that these measures are less useful for differential diagnosis than generally indicated by the clinical literature.

Disentangling the Developmental Trajectories of Letter Position and Letter Identity Coding Using Masked Priming

ERIC Educational Resources Information Center

Kezilas, Yvette; McKague, Meredith; Kohnen, Saskia; Badcock, Nicholas A.; Castles, Anne

2017-01-01

Masked transposed-letter (TL) priming effects have been used to index letter position processing over the course of reading development. Whereas some studies have reported an increase in TL priming over development, others have reported a decrease. These findings have led to the development of 2 somewhat contradictory accounts of letter position…

Perceptions of interprofessional teamwork in low-acuity settings: a qualitative analysis.

PubMed

van Schaik, Sandrijn M; O'Brien, Bridget C; Almeida, Sandra A; Adler, Shelley R

2014-06-01

Working effectively in interprofessional teams is a core competency for all health care professionals, yet there is a paucity of instruments with which to assess the associated skills. Published medical teamwork skills assessment tools focus primarily on high-acuity situations, such as cardiopulmonary arrests and crisis events in operating rooms, and may not generalise to non-high-acuity environments, such as in-patient wards and out-patient clinics. We undertook the current study to explore the constructs underlying interprofessional teamwork in non-high-acuity settings and team members' perspectives of essential teamwork attributes. We used an ethnographic approach to study four interprofessional teams in two different low-acuity settings: women's HIV (human immunodeficiency virus) clinics and in-patient paediatric wards. Over a period of 17 months, we collected qualitative data through direct observations, focus groups and individual interviews. We analysed the data using qualitative thematic analysis, following an iterative process: data from our observations (20 hours in total) informed the focus group guide and focus group data informed the interview guide. To enhance the integrity of our analysis, we triangulated data sources and verified themes through member checking. We conducted seven focus groups and 27 individual interviews with a total of 39 study participants representing eight professions. Participants emphasised shared leadership and collaborative decision making, mutual respect, recognition of one's own and others' limitations and strengths, and the need to nurture relationships. Team members also discussed tensions around hierarchy and questioned whether doctor leadership is appropriate for interprofessional teams. Our findings indicate that there are differences in teamwork between low-acuity and high-acuity settings, and also provide insights into potential barriers to effective interprofessional teamwork. Our study delineates essential

Letter Knowledge in Parent–Child Conversations

PubMed Central

Robins, Sarah; Treiman, Rebecca; Rosales, Nicole

2014-01-01

Learning about letters is an important component of emergent literacy. We explored the possibility that parent speech provides information about letters, and also that children’s speech reflects their own letter knowledge. By studying conversations transcribed in CHILDES (MacWhinney, 2000) between parents and children aged one to five, we found that alphabetic order influenced use of individual letters and letter sequences. The frequency of letters in children’s books influenced parent utterances throughout the age range studied, but children’s utterances only after age two. Conversations emphasized some literacy-relevant features of letters, such as their shapes and association with words, but not letters’ sounds. Describing these patterns and how they change over the preschool years offers important insight into the home literacy environment. PMID:25598577

easyCBM[R] Slope Reliability: Letter Names, Word Reading Fluency, and Passage Reading Fluency. Technical Report #1111

ERIC Educational Resources Information Center

Patarapichayatham, Chalie; Anderson, Daniel; Irvin, P. Shawn; Kamata, Akhito; Alonzo, Julie; Tindal, Gerald

2011-01-01

Within a response to intervention (RTI) framework, students are administered multiple tests of equivalent difficulty. Changes in students' scores over time are then attributed to changes in learning. In the current study, we evaluated the reliability of score changes (i.e., slope) for the easyCBM[R] letter names, word reading fluency, and passage…

Visual acuity outcomes in eyes with flat corneas after PRK.

PubMed

Varssano, David; Waisbourd, Michael; Minkev, Liza; Sela, Tzahi; Neudorfer, Meira; Binder, Perry S

2013-06-01

To evaluate the impact of corneal curvatures less than 35 diopters (D) after photorefractive keratectomy (PRK) on visual acuity outcomes. Visual acuity outcomes of 5,410 eyes that underwent PRK from January 2006 to November 2010 were retrospectively analyzed for the impact of postoperative corneal curvatures on visual outcomes. All procedures were performed on a single platform (Allegretto 200Hz excimer laser; Alcon Laboratories, Inc., Irvine, CA). Main outcome measures were postoperative corrected distance visual acuity (CDVA) and loss of CDVA. Corneas with a measured or a calculated postoperative flat meridian less than 35 D and those with a measured postoperative steep meridian less than 35 D had worse postoperative CDVA than corneas with meridians of either 35 D or more (P ≤ .021). However, the preoperative CDVA was worse in the flatter curvatures in all comparisons performed (P ≤ .024). Consequently, the measured or calculated meridian curvature had no effect on CDVA loss (P ≥ .074). Postoperative corneal keratometry values (flat and steep meridians) less than 35 D did not have a predictive effect on the risk of losing visual acuity following myopic PRK performed on the Allegretto 200Hz excimer laser. Copyright 2013, SLACK Incorporated.

The Eye Phone Study: reliability and accuracy of assessing Snellen visual acuity using smartphone technology

PubMed Central

Perera, C; Chakrabarti, R; Islam, F M A; Crowston, J

2015-01-01

Purpose Smartphone-based Snellen visual acuity charts has become popularized; however, their accuracy has not been established. This study aimed to evaluate the equivalence of a smartphone-based visual acuity chart with a standard 6-m Snellen visual acuity (6SVA) chart. Methods First, a review of available Snellen chart applications on iPhone was performed to determine the most accurate application based on optotype size. Subsequently, a prospective comparative study was performed by measuring conventional 6SVA and then iPhone visual acuity using the ‘Snellen' application on an Apple iPhone 4. Results Eleven applications were identified, with accuracy of optotype size ranging from 4.4–39.9%. Eighty-eight patients from general medical and surgical wards in a tertiary hospital took part in the second part of the study. The mean difference in logMAR visual acuity between the two charts was 0.02 logMAR (95% limit of agreement −0.332, 0.372 logMAR). The largest mean difference in logMAR acuity was noted in the subgroup of patients with 6SVA worse than 6/18 (n=5), who had a mean difference of two Snellen visual acuity lines between the charts (0.276 logMAR). Conclusion We did not identify a Snellen visual acuity app at the time of study, which could predict a patients standard Snellen visual acuity within one line. There was considerable variability in the optotype accuracy of apps. Further validation is required for assessment of acuity in patients with severe vision impairment. PMID:25931170

Letter-transposition effects are not universal: The impact of transposing letters in Hebrew

PubMed Central

Velan, Hadas; Frost, Ram

2009-01-01

We examined the effects of letter transposition in Hebrew in three masked-priming experiments. Hebrew, like English has an alphabetic orthography where sequential and contiguous letter strings represent phonemes. However, being a Semitic language it has a non-concatenated morphology that is based on root derivations. Experiment 1 showed that transposed-letter (TL) root primes inhibited responses to targets derived from the non-transposed root letters, and that this inhibition was unrelated to relative root frequency. Experiment 2 replicated this result and showed that if the transposed letters of the root created a nonsense-root that had no lexical representation, then no inhibition and no facilitation were obtained. Finally, Experiment 3 demonstrated that in contrast to English, French, or Spanish, TL nonword primes did not facilitate recognition of targets, and when the root letters embedded in them consisted of a legal root morpheme, they produced inhibition. These results suggest that lexical space in alphabetic orthographies may be structured very differently in different languages if their morphological structure diverges qualitatively. In Hebrew, lexical space is organized according to root families rather than simple orthographic structure, so that all words derived from the same root are interconnected or clustered together, independent of overall orthographic similarity. PMID:20161017

Supplementing cross-cover communication with the patient acuity rating.

PubMed

Phillips, Andrew W; Yuen, Trevor C; Retzer, Elizabeth; Woodruff, James; Arora, Vineet; Edelson, Dana P

2013-03-01

Patient hand-offs at physician shift changes have limited ability to convey the primary team's longitudinal insight. The Patient Acuity Rating (PAR) is a previously validated, 7-point scale that quantifies physician judgment of patient stability, where a higher score indicates a greater risk of clinical deterioration. Its impact on cross-covering physician understanding of patients is not known. To determine PAR contribution to sign-outs. Cross-sectional survey. Intern physicians at a university teaching hospital. Subjects were surveyed using randomly chosen, de-identified patient sign-outs, previously assigned PAR scores by their primary teams. For each sign-out, subjects assigned a PAR score, then responded to hypothetical cross-cover scenarios before and after being informed of the primary team's PAR. Changes in intern assessment of the scenario before and after being informed of the primary team's PAR were measured. In addition, responses between novice and experienced interns were compared. Between May and July 2008, 23 of 39 (59 %) experienced interns and 25 of 42 (60 %) novice interns responded to 480 patient scenarios from ten distinct sign-outs. The mean PAR score assigned by subjects was 4.2 ± 1.6 vs. 3.8 ± 1.8 by the primary teams (p < 0.001). After viewing the primary team's PAR score, interns changed their level of concern in 47.9 % of cases, their assessment of the importance of immediate bedside evaluation in 48.7 % of cases, and confidence in their assessment in 43.2 % of cases. For all three assessments, novice interns changed their responses more frequently than experienced interns (p = 0.03, 0.009, and <0.001, respectively). Overall interns reported the PAR score to be theoretically helpful in 70.8 % of the cases, but this was more pronounced in novice interns (81.2 % vs 59.6 %, p < 0.001). The PAR adds valuable information to sign-outs that could impact cross-cover decision-making and potentially benefit patients

Predicting through-focus visual acuity with the eye's natural aberrations.

PubMed

Kingston, Amanda C; Cox, Ian G

2013-10-01

To develop a predictive optical modeling process that utilizes individual computer eye models along with a novel through-focus image quality metric. Individual eye models were implemented in optical design software (Zemax, Bellevue, WA) based on evaluation of ocular aberrations, pupil diameter, visual acuity, and accommodative response of 90 subjects (180 eyes; 24-63 years of age). Monocular high-contrast minimum angle of resolution (logMAR) acuity was assessed at 6 m, 2 m, 1 m, 67 cm, 50 cm, 40 cm, 33 cm, 28 cm, and 25 cm. While the subject fixated on the lowest readable line of acuity, total ocular aberrations and pupil diameter were measured three times each using the Complete Ophthalmic Analysis System (COAS HD VR) at each distance. A subset of 64 mature presbyopic eyes was used to predict the clinical logMAR acuity performance of five novel multifocal contact lens designs. To validate predictability of the design process, designs were manufactured and tested clinically on a population of 24 mature presbyopes (having at least +1.50 D spectacle add at 40 cm). Seven object distances were used in the validation study (6 m, 2 m, 1 m, 67 cm, 50 cm, 40 cm, and 25 cm) to measure monocular high-contrast logMAR acuity. Baseline clinical through-focus logMAR was shown to correlate highly (R² = 0.85) with predicted logMAR from individual eye models. At all object distances, each of the five multifocal lenses showed less than one line difference, on average, between predicted and clinical normalized logMAR acuity. Correlation showed R² between 0.90 and 0.97 for all multifocal designs. Computer-based models that account for patient's aberrations, pupil diameter changes, and accommodative amplitude can be used to predict the performance of contact lens designs. With this high correlation (R² ≥ 0.90) and high level of predictability, more design options can be explored in the computer to optimize performance before a lens is manufactured and tested clinically.

The pigeon's distant visual acuity as a function of viewing angle.

PubMed

Uhlrich, D J; Blough, P M; Blough, D S

1982-01-01

Distant visual acuity was determined for several viewing angles in two restrained White Carneaux pigeons. The behavioral technique was a classical conditioning procedure that paired presentation of sinusoidal gratings with shock. A conditioned heart rate acceleration during the grating presentation indicated resolution of the grating. The bird's acuity was fairly uniform across a large range of their lateral visual field; performance decreased slightly for posterior stimulus placement and sharply for frontal placements. The data suggest that foveal viewing is relatively less advantageous for acuity in pigeons than in humans. The data are also consistent with the current view that pigeons are myopic in frontal vision.

Visual acuity loss and OCT changes as initial signs of leukaemia

PubMed Central

Ortiz, Jose M; Ruiz-Moreno, Jose M; Pozo-Martos, Paola; Montero, Javier A

2010-01-01

AIM To report two cases where decreased visual acuity was the first symptom of leukaemia and optical coherence tomography (OCT) allowed identification and localization of the retinal lesions. METHODS Retrospective, interventional, case reports. RESULTS One case of lymphoblastic acute leukaemia and chronic lymphoid leukaemia were diagnosed following decreased visual acuity. OCT showed macular serous detachment in the first case. The second case presented hypo fluorescent retinal infiltrates which appeared as hyper reflective lesions by OCT. Retinal changes disappeared and visual acuity was recovered following complete remission of the neoplasm. CONCLUSION OCT is a valuable, non invasive diagnostic tool permitting detection, localization and follow-up of ocular dissemination of neoplasms. PMID:22553573

Should we add visual acuity ratios to referral criteria for potential cerebral visual impairment?

PubMed

van der Zee, Ymie J; Stiers, Peter; Evenhuis, Heleen M

To determine whether the assessment of visual acuity ratios might improve the referral of children with (sub)normal visual acuity but at risk of cerebral visual impairment. In an exploratory study, we assessed visual acuity, crowding ratio and the ratios between grating acuity (Teller Acuity Cards-II) and optotype acuity (Cambridge Crowding Cards) in 60 typically developing school children (mean age 5y8m±1y1m), 21 children with ocular abnormalities only (5y7m±1y9m) and 26 children with (suspected) brain damage (5y7m±1y11m). Sensitivities and specificities were calculated for targets and controls from the perspective of different groups of diagnosticians: youth health care professionals (target: children with any visual abnormalities), ophthalmologists and low vision experts (target: children at risk of cerebral visual impairment). For youth health care professionals subnormal visual acuity had the best sensitivity (76%) and specificity (70%). For ophthalmologists and low vision experts the crowding ratio had the best sensitivity (67%) and specificity (79 and 86%). Youth health care professionals best continue applying subnormal visual acuity for screening, whereas ophthalmologists and low vision experts best add the crowding ratio to their routine diagnostics, to distinguish children at risk of visual impairment in the context of brain damage from children with ocular pathology only. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

49 CFR 240.121 - Criteria for vision and hearing acuity data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Criteria for vision and hearing acuity data. 240... ENGINEERS Component Elements of the Certification Process § 240.121 Criteria for vision and hearing acuity... paragraph (e) of this section, a person's vision and hearing shall meet or exceed the standards prescribed...

49 CFR 240.121 - Criteria for vision and hearing acuity data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Criteria for vision and hearing acuity data. 240... ENGINEERS Component Elements of the Certification Process § 240.121 Criteria for vision and hearing acuity... paragraph (e) of this section, a person's vision and hearing shall meet or exceed the standards prescribed...

Association of Baseline Visual Acuity and Retinal Thickness With 1-Year Efficacy of Aflibercept, Bevacizumab, and Ranibizumab for Diabetic Macular Edema.

PubMed

Wells, John A; Glassman, Adam R; Jampol, Lee M; Aiello, Lloyd Paul; Antoszyk, Andrew N; Baker, Carl W; Bressler, Neil M; Browning, David J; Connor, Crystal G; Elman, Michael J; Ferris, Frederick L; Friedman, Scott M; Melia, Michele; Pieramici, Dante J; Sun, Jennifer K; Beck, Roy W

2016-02-01

Comparisons of the relative effect of 3 anti-vascular endothelial growth factor agents to treat diabetic macular edema warrant further assessment. To provide additional outcomes from a randomized trial evaluating 3 anti-vascular endothelial growth factor agents for diabetic macular edema within subgroups based on baseline visual acuity (VA) and central subfield thickness (CST) as evaluated on optical coherence tomography. Post hoc exploratory analyses were conducted of randomized trial data on 660 adults with diabetic macular edema and decreased VA (Snellen equivalent, approximately 20/32 to 20/320). The original study was conducted between August 22, 2012, and August 28, 2013. Analysis was conducted from January 7 to June 2, 2015. Repeated 0.05-mL intravitreous injections of 2.0 mg of aflibercept (224 eyes), 1.25 mg of bevacizumab (218 eyes), or 0.3 mg of ranibizumab (218 eyes) as needed per protocol. One-year VA and CST outcomes within prespecified subgroups based on both baseline VA and CST thresholds, defined as worse (20/50 or worse) or better (20/32 to 20/40) VA and thicker (≥400 µm) or thinner (250 to 399 µm) CST. In the subgroup with worse baseline VA (n = 305), irrespective of baseline CST, aflibercept showed greater improvement than bevacizumab or ranibizumab for several VA outcomes. In the subgroup with better VA and thinner CST at baseline (61-73 eyes across 3 treatment groups), VA outcomes showed little difference between groups; mean change was +7.2, +8.4, and +7.6 letters in the aflibercept, bevacizumab, and ranibizumab groups, respectively. However, in the subgroup with better VA and thicker CST at baseline (31-43 eyes), there was a suggestion of worse VA outcomes in the bevacizumab group; mean change from baseline to 1 year was +9.5, +5.4, and +9.5 letters in the aflibercept, bevacizumab, and ranibizumab groups, respectively, and VA letter score was greater than 84 (approximately 20/20) in 21 of 33 (64%), 7 of 31 (23%), and 21 of 43 (49

Liability and Letters of Recommendation.

ERIC Educational Resources Information Center

Sendor, Benjamin

1997-01-01

Analyzes the California Supreme Court case "Randi W. v. Muroc Joint Unified School District." The court determined that letters of recommendation, which had omitted mentioning allegations of improper sexual conduct with students, were deceptively incomplete. Writers of letters have three choices: refuse to write a letter, write a fully…

Geographic Variation in the Use of Low-Acuity Pediatric Emergency Medical Services.

PubMed

Gregory, Emily F; Chamberlain, James M; Teach, Stephen J; Engstrom, Ryan; Mathison, David J

2017-02-01

The aim of this study was to examine geographic variation in pediatric low-acuity emergency medical services (EMS) use in Washington, DC. This cross-sectional analysis of low-acuity EMS transports evaluated arrivals at 2 emergency departments and included 93% of pediatric transports in Washington, DC, during the study period. Low-acuity classification was defined as a triage emergency severity index of 4 or 5 not resulting in transfer, admission, or death. Logistic regression compared low-acuity visits arriving via EMS with all other low-acuity visits. Home zip code represented geographic location. Covariates included patient age, sex, race/ethnicity, hour of emergency department arrival, and insurance status. There were 45,454 low-acuity visits among children aged 0 to 17 years. Of these, 3304 (7.3%) arrived via EMS. The mean age was 5.6 (±5.0) years. Most were African American (84.3%) and had Medicaid insurance (87.3%). Geographic variation predicted EMS use. Adjusted odds ratios (ORs) of using EMS varied from 1.11 to 2.54 when compared with the lowest EMS use zip code. Odds of EMS use were higher among those with public insurance (adjusted OR [adj OR], 1.71; 95% confidence interval [CI], 1.46-2.00) and those with evening and overnight arrivals (evening arrival, adj OR of 1.65 and 95% CI of 1.47-1.86; overnight arrival, adj OR of 2.98 and 95% CI of 2.43-3.65). After adjusting for known covariates, residential zip code was associated with low-acuity EMS activation, stressing the importance of geographic variation in EMS use. Providing alternate means of transportation, or targeted education to certain residential areas, may decrease unnecessary EMS activation.

Embedded Picture Mnemonics to Learn Letters

ERIC Educational Resources Information Center

Shmidman, Adina; Ehri, Linnea

2010-01-01

Can embedded mnemonics ease the task of learning a foreign alphabet? English-speaking preschoolers (N = 36, M = 5;2 years) were taught 10 Hebrew letter-sound relations. Experimental letters were learned with mnemonics that embedded letter shapes in drawings of objects whose shapes resembled the letters and whose English names began with the…

Randomized trial of a home monitoring system for early detection of choroidal neovascularization home monitoring of the Eye (HOME) study.

PubMed

Chew, Emily Y; Clemons, Traci E; Bressler, Susan B; Elman, Michael J; Danis, Ronald P; Domalpally, Amitha; Heier, Jeffrey S; Kim, Judy E; Garfinkel, Richard

2014-02-01

To determine whether home monitoring with the ForeseeHome device (Notal Vision Ltd, Tel Aviv, Israel), using macular visual field testing with hyperacuity techniques and telemonitoring, results in earlier detection of age-related macular degeneration-associated choroidal neovascularization (CNV), reflected in better visual acuity, when compared with standard care. The main predictor of treatment outcome from anti-vascular endothelial growth factor (VEGF) agents is the visual acuity at the time of CNV treatment. Unmasked, controlled, randomized clinical trial. One thousand nine hundred and seventy participants 53 to 90 years of age at high risk of CNV developing were screened. Of these, 1520 participants with a mean age of 72.5 years were enrolled in the Home Monitoring of the Eye study at 44 Age-Related Eye Disease Study 2 clinical centers. In the standard care and device arms arm, investigator-specific instructions were provided for self-monitoring vision at home followed by report of new symptoms to the clinic. In the device arm, the device was provided with recommendations for daily testing. The device monitoring center received test results and reported changes to the clinical centers, which contacted participants for examination. The main outcome measure was the difference in best-corrected visual acuity scores between baseline and detection of CNV. The event was determined by investigators based on clinical examination, color fundus photography, fluorescein angiography, and optical coherence tomography findings. Masked graders at a central reading center evaluated the images using standardized protocols. Seven hundred sixty-three participants were randomized to device monitoring and 757 participants were randomized to standard care and were followed up for a mean of 1.4 years between July 2010 and April 2013. At the prespecified interim analysis, 82 participants progressed to CNV, 51 in the device arm and 31 in the standard care arm. The primary analysis

A prospective, observational, open-label, multicentre study to investigate the daily treatment practice of ranibizumab in patients with neovascular age-related macular degeneration.

PubMed

van Asten, Freekje; Evers-Birkenkamp, Kim U; van Lith-Verhoeven, Janneke J C; de Jong-Hesse, Yvonne; Hoppenreijs, Vincent P T; Hommersom, Richard F; Scholten, Agnes M; Hoyng, Carel B; Klaver, Johannes H J

2015-03-01

The HELIOS (Health Economics with Lucentis in Observational Settings) study was designed on request of the Dutch Health Authority for an observational study to assess the effectiveness and safety of ranibizumab for neovascular age-related macular degeneration (wet AMD) in daily practice. The HELIOS study was a 2-year prospective, observational, open-label, multicentre study involving 14 sites. Patients with wet AMD were enrolled and observed for a period of 24 months. The data were collected at baseline and at the visits closest around the time-points 3, 6, 12, 18 and 24 months after inclusion. Treatment with ranibizumab resulted in prevention of vision loss. The mean ETDRS score increased from 45.1 letters at baseline to 48.5 letters at 24 months. This was achieved with a mean of 7.8 injections over 24 months. Stabilization of visual acuity was also reflected by the scores on the quality of life EQ-5D questionnaire, which did not significantly change over the study period. The more subjective EQ-VAS questionnaire showed an overall improvement. The VFQ-25 questionnaire was also mostly stable over time. After 24 months, 32.2% of the patients gained ≥1 letter and 17.1% gained >15 letters. Patients completing the loading phase were better responders, as demonstrated by increased long-term visual acuity. In addition, ranibizumab was well tolerated and had a safety profile commonly seen in routine clinical practice. This study demonstrates that also in daily practice ranibizumab was effective in preventing vision loss over a period of 24 months. No new safety findings were identified. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Acuity-adaptable nursing care: exploring its place in designing the future patient room.

PubMed

Kwan, Melissa A

2011-01-01

To substantiate the anticipated benefits of the original acuity-adaptable care delivery model as defined by innovator Ann Hendrich. In today's conveyor belt approach to healthcare, upon admission and through discharge, patients are commonly transferred based on changing acuity needs. Wasted time and money and inefficiencies in hospital operations often result-in addition to jeopardizing patient safety. In the last decade, a handful of hospitals pioneered the implementation of the acuity-adaptable care delivery model. Built on the concept of eliminating patient transfers, the projected outcomes of acuity-adaptable units-decreased average lengths of stay, increased patient safety and satisfaction, and increased nurses' satisfaction from reduced walking distances-make a good case for a model patient room. Although some hospitals experienced the projected benefits of the acuity-adaptable care delivery model, sustaining the outcomes proved to be difficult; hence, the original definition of acuity-adaptable units has not fared well. Variations on the original concept demonstrate that eliminating patient transfers has not been completely abandoned in healthcare redesign and construction initiatives. Terms such as flex-up, flex-down, universal room, and single-stay unit have since emerged. These variations convolute the search for empirical evidence to support the anticipated benefits of the original concept. To determine the future of this concept and its variants, a significant amount of outcome data must be generated by piloting the concept in different hospital settings. As further refinements and adjustments to the concept emerge, the acuity-adaptable room may find a place in future hospitals.

Overt use of a tactile-kinesthetic strategy shifts to covert processing in rehabilitation of letter-by-letter reading.

PubMed

Lott, Susan Nitzberg; Carney, Aimee Syms; Glezer, Laurie S; Friedman, Rhonda B

2010-11-01

BACKGROUND: Letter-by-letter readers identify each letter of the word they are reading serially in left to right order before recognizing the word. When their letter naming is also impaired, letter-by-letter reading is inaccurate and can render even single word reading very poor. Tactile and/or kinesthetic strategies have been reported to improve reading in these patients, but only under certain conditions or for a limited set of stimuli. AIMS: The primary aim of the current study was to determine whether a tactile/kinesthetic treatment could significantly improve reading specifically under normal reading conditions, i.e. reading untrained words presented in free vision and read without overt use of the strategy. METHODS #ENTITYSTARTX00026; PROCEDURES: Three chronic letter-by-letter readers participated in a tactile/kinesthetic treatment aimed at first improving letter naming accuracy (phase 1) and then letter-by-letter reading speed (phase 2). In a multiple case series design, accuracy and speed of reading untrained words without overt use of the trained tactile/kinesthetic strategy was assessed before phase 1, after phase 1 and again after phase 2. OUTCOMES #ENTITYSTARTX00026; RESULTS: All three patients significantly improved both their speed and accuracy reading untrained words without overt use of the trained tactile/kinesthetic strategy. All three patients required the additional practice in phase 2 to achieve significant improvement. Treatment did not target sentence level reading, yet two of the three patients became so adept that they could read entire sentences. CONCLUSIONS: This study replicates previous findings on the efficacy of tactile/kinesthetic treatment for letter-by-letter readers with poor letter naming. It further demonstrates that this treatment can alter cognitive processing such that words never specifically trained can be read in free vision without overtly using the trained strategy. The data suggest that an important element in achieving

Overt use of a tactile-kinesthetic strategy shifts to covert processing in rehabilitation of letter-by-letter reading

PubMed Central

Lott, Susan Nitzberg; Carney, Aimee Syms; Glezer, Laurie S.; Friedman, Rhonda B.

2010-01-01

Background Letter-by-letter readers identify each letter of the word they are reading serially in left to right order before recognizing the word. When their letter naming is also impaired, letter-by-letter reading is inaccurate and can render even single word reading very poor. Tactile and/or kinesthetic strategies have been reported to improve reading in these patients, but only under certain conditions or for a limited set of stimuli. Aims The primary aim of the current study was to determine whether a tactile/kinesthetic treatment could significantly improve reading specifically under normal reading conditions, i.e. reading untrained words presented in free vision and read without overt use of the strategy. Methods & Procedures Three chronic letter-by-letter readers participated in a tactile/kinesthetic treatment aimed at first improving letter naming accuracy (phase 1) and then letter-by-letter reading speed (phase 2). In a multiple case series design, accuracy and speed of reading untrained words without overt use of the trained tactile/kinesthetic strategy was assessed before phase 1, after phase 1 and again after phase 2. Outcomes & Results All three patients significantly improved both their speed and accuracy reading untrained words without overt use of the trained tactile/kinesthetic strategy. All three patients required the additional practice in phase 2 to achieve significant improvement. Treatment did not target sentence level reading, yet two of the three patients became so adept that they could read entire sentences. Conclusions This study replicates previous findings on the efficacy of tactile/kinesthetic treatment for letter-by-letter readers with poor letter naming. It further demonstrates that this treatment can alter cognitive processing such that words never specifically trained can be read in free vision without overtly using the trained strategy. The data suggest that an important element in achieving this level of generalization is

Letters from the Future: The Use of Therapeutic Letter Writing in Counseling Sexual Abuse Survivors

ERIC Educational Resources Information Center

Kress, Victoria E.; Hoffman, Rachel; Thomas, Amanda M.

2008-01-01

In the context of counseling sexual abuse survivors, the creative counseling technique of having clients write letters--to themselves or others--from a future context is described. A theoretical framework for writing letters to oneself from the future is presented. Specific types of letters from the future are explained, and case examples and…

Early development of letter specialization in left fusiform is associated with better word reading and smaller fusiform face area.

PubMed

Centanni, Tracy M; Norton, Elizabeth S; Park, Anne; Beach, Sara D; Halverson, Kelly; Ozernov-Palchik, Ola; Gaab, Nadine; Gabrieli, John DE

2018-03-05

A functional region of left fusiform gyrus termed "the visual word form area" (VWFA) develops during reading acquisition to respond more strongly to printed words than to other visual stimuli. Here, we examined responses to letters among 5- and 6-year-old early kindergarten children (N = 48) with little or no school-based reading instruction who varied in their reading ability. We used functional magnetic resonance imaging (fMRI) to measure responses to individual letters, false fonts, and faces in left and right fusiform gyri. We then evaluated whether signal change and size (spatial extent) of letter-sensitive cortex (greater activation for letters versus faces) and letter-specific cortex (greater activation for letters versus false fonts) in these regions related to (a) standardized measures of word-reading ability and (b) signal change and size of face-sensitive cortex (fusiform face area or FFA; greater activation for faces versus letters). Greater letter specificity, but not letter sensitivity, in left fusiform gyrus correlated positively with word reading scores. Across children, in the left fusiform gyrus, greater size of letter-sensitive cortex correlated with lesser size of FFA. These findings are the first to suggest that in beginning readers, development of letter responsivity in left fusiform cortex is associated with both better reading ability and also a reduction of the size of left FFA that may result in right-hemisphere dominance for face perception. © 2018 John Wiley & Sons Ltd.

Statistical mechanics of letters in words

PubMed Central

Stephens, Greg J.; Bialek, William

2013-01-01

We consider words as a network of interacting letters, and approximate the probability distribution of states taken on by this network. Despite the intuition that the rules of English spelling are highly combinatorial and arbitrary, we find that maximum entropy models consistent with pairwise correlations among letters provide a surprisingly good approximation to the full statistics of words, capturing ~92% of the multi-information in four-letter words and even “discovering” words that were not represented in the data. These maximum entropy models incorporate letter interactions through a set of pairwise potentials and thus define an energy landscape on the space of possible words. Guided by the large letter redundancy we seek a lower-dimensional encoding of the letter distribution and show that distinctions between local minima in the landscape account for ~68% of the four-letter entropy. We suggest that these states provide an effective vocabulary which is matched to the frequency of word use and much smaller than the full lexicon. PMID:20866490

Letters From Peplau.

PubMed

Peden, Ann R

2018-03-01

Dr. Hildegard Peplau, considered to be our first modern Nurse theorist and the Mother of Psychiatric Nursing, was a prolific writer, engaging in correspondence with colleagues and students who sought her professional and theoretical expertise. Through these letters, she influenced psychiatric nursing while maintaining a broad international network of professional colleagues. An analysis of letters, written between 1990 and 1998, provides insights into Peplau's last decade of professional life and a model of how to support the next generation of nurse scholars. Using content analysis, 24 letters received between 1990 and 1998 were read, reread, and coded. Recurring themes were identified. Three themes were identified. These include Peplau, the Person: Living a Life of Professional Balance; Lighting a Spark: Investing in the Next Generation; and Work in the Vineyards of Nursing: Maintaining a Life of Scholarship. The letters depict Peplau's keen intellect, her wide professional network, her leisure time spent with family and friends, and her own work to assure that her theoretical legacy continued. Peplau's insights continue to be relevant as psychiatric mental health nursing leaders engage in activities to support the next generation of scholars and leaders.

Resource Letter FR-1: Fractals

NASA Astrophysics Data System (ADS)

Hurd, Alan J.

1988-11-01

This Resource Letter provides a guide to the literature on fractals. Although ``fractal'' is a relatively new term in science, unifying many new ideas with established ones, its wide application and general popularity have made it one of the fastest growing fields in statistical physics. The letter E after an item indicates elementary level or material of general interest to persons becoming informed in the field; the letter I, for intermediate level, indicates material of somewhat more specialized nature; and the letter A indicates rather specialized or advanced material. An asterisk (*) indicates those articles to be included in an accompanying Reprint Book.

Measuring the Influence of Galilean Loupe System on Near Visual Acuity of Dentists under Simulated Clinical Conditions

PubMed Central

Urlic, Iris; Verzak, Željko; Vranic, Dubravka Negovetic

2016-01-01

Aim The purpose of this study was to compare near visual acuity of dentists without optical aids (VSC) with near visual acuity of those using the Galilean telescope system (VGA2) with magnification of x 2.5, and the distance of 350 mm in simulated clinical conditions. Methods The study included 46 dentists (visual acuity 1.0 without correction). A visual acuity testing was carried out using a miniaturized Snellen visual acuity chart which was placed in the cavity of molar teeth mounted in a phantom head in simulated clinical conditions. Near visual acuity for the vicinity was examined: 1) without correction at a distance of 300-400 mm (VSC); 2) with Galilean loupes with magnification of x2.5, focal length of 350mm. Results The distributions of near visual acuity recorded using VSC and VGA2, 5 systems were compared by the Wilcoxon Signed Rank test. The results obtained by Wilcoxon Signed Rank test pointed to a statistically significant difference in the distribution of recorded visual acuity between the VSC and VGA2 optical systems (W = - 403.5; p <0.001). Conclusion If using the VGA2, 5 systems, higher values of the near visual acuity were recorded and subsequently compared to near visual acuity without magnifying aids (VSC). PMID:27847397

Measuring the Influence of Galilean Loupe System on Near Visual Acuity of Dentists under Simulated Clinical Conditions.

PubMed

Urlic, Iris; Verzak, Željko; Vranic, Dubravka Negovetic

2016-09-01

The purpose of this study was to compare near visual acuity of dentists without optical aids (VSC) with near visual acuity of those using the Galilean telescope system (VGA2) with magnification of x 2.5, and the distance of 350 mm in simulated clinical conditions. The study included 46 dentists (visual acuity 1.0 without correction). A visual acuity testing was carried out using a miniaturized Snellen visual acuity chart which was placed in the cavity of molar teeth mounted in a phantom head in simulated clinical conditions. Near visual acuity for the vicinity was examined: 1) without correction at a distance of 300-400 mm (VSC); 2) with Galilean loupes with magnification of x2.5, focal length of 350mm. The distributions of near visual acuity recorded using VSC and VGA2, 5 systems were compared by the Wilcoxon Signed Rank test. The results obtained by Wilcoxon Signed Rank test pointed to a statistically significant difference in the distribution of recorded visual acuity between the VSC and VGA2 optical systems (W = - 403.5; p <0.001). If using the VGA2, 5 systems, higher values of the near visual acuity were recorded and subsequently compared to near visual acuity without magnifying aids (VSC).

ANS acuity and mathematics ability in preschoolers from low-income homes: contributions of inhibitory control.

PubMed

Fuhs, Mary Wagner; McNeil, Nicole M

2013-01-01

Recent findings by Libertus, Feigenson, and Halberda (2011) suggest that there is an association between the acuity of young children's approximate number system (ANS) and their mathematics ability before exposure to instruction in formal schooling. The present study examined the generalizability and validity of these findings in a sample of preschoolers from low-income homes. Children attending Head Start (N = 103) completed measures to assess ANS acuity, mathematics ability, receptive vocabulary, and inhibitory control. Results showed only a weak association between ANS acuity and mathematics ability that was reduced to non-significance when controlling for a direct measure of receptive vocabulary. Results also revealed that inhibitory control plays an important role in the relation between ANS acuity and mathematics ability. Specifically, ANS acuity accounted for significant variance in mathematics ability over and above receptive vocabulary, but only for ANS acuity trials in which surface area conflicted with numerosity. Moreover, this association became non-significant when controlling for inhibitory control. These results suggest that early mathematical experiences prior to formal schooling may influence the strength of the association between ANS acuity and mathematics ability and that inhibitory control may drive that association in young children. © 2012 Blackwell Publishing Ltd.

The neural correlates of learned motor acuity

PubMed Central

Yang, Juemin; Caffo, Brian; Mazzoni, Pietro; Krakauer, John W.

2014-01-01

We recently defined a component of motor skill learning as “motor acuity,” quantified as a shift in the speed-accuracy trade-off function for a task. These shifts are primarily driven by reductions in movement variability. To determine the neural correlates of improvement in motor acuity, we devised a motor task compatible with magnetic resonance brain imaging that required subjects to make finely controlled wrist movements under visual guidance. Subjects were imaged on day 1 and day 5 while they performed this task and were trained outside the scanner on intervening days 2, 3, and 4. The potential confound of performance changes between days 1 and 5 was avoided by constraining movement time to a fixed duration. After training, subjects showed a marked increase in success rate and a reduction in trial-by-trial variability for the trained task but not for an untrained control task, without changes in mean trajectory. The decrease in variability for the trained task was associated with increased activation in contralateral primary motor and premotor cortical areas and in ipsilateral cerebellum. A global nonlocalizing multivariate analysis confirmed that learning was associated with increased overall brain activation. We suggest that motor acuity is acquired through increases in the number of neurons recruited in contralateral motor cortical areas and in ipsilateral cerebellum, which could reflect increased signal-to-noise ratio in motor output and improved state estimation for feedback corrections, respectively. PMID:24848466

Visual acuity in adults with Asperger's syndrome: no evidence for "eagle-eyed" vision.

PubMed

Falkmer, Marita; Stuart, Geoffrey W; Danielsson, Henrik; Bram, Staffan; Lönebrink, Mikael; Falkmer, Torbjörn

2011-11-01

Autism spectrum conditions (ASC) are defined by criteria comprising impairments in social interaction and communication. Altered visual perception is one possible and often discussed cause of difficulties in social interaction and social communication. Recently, Ashwin et al. suggested that enhanced ability in local visual processing in ASC was due to superior visual acuity, but that study has been the subject of methodological criticism, placing the findings in doubt. The present study investigated visual acuity thresholds in 24 adults with Asperger's syndrome and compared their results with 25 control subjects with the 2 Meter 2000 Series Revised ETDRS Chart. The distribution of visual acuities within the two groups was highly similar, and none of the participants had superior visual acuity. Superior visual acuity in individuals with Asperger's syndrome could not be established, suggesting that differences in visual perception in ASC are not explained by this factor. A continued search for explanations of superior ability in local visual processing in persons with ASC is therefore warranted. Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Robot-Aided Mapping of Wrist Proprioceptive Acuity across a 3D Workspace

PubMed Central

Marini, Francesca; Squeri, Valentina; Morasso, Pietro; Konczak, Jürgen; Masia, Lorenzo

2016-01-01

Proprioceptive signals from peripheral mechanoreceptors form the basis for bodily perception and are known to be essential for motor control. However we still have an incomplete understanding of how proprioception differs between joints, whether it differs among the various degrees-of-freedom (DoFs) within a particular joint, and how such differences affect motor control and learning. We here introduce a robot-aided method to objectively measure proprioceptive function: specifically, we systematically mapped wrist proprioceptive acuity across the three DoFs of the wrist/hand complex with the aim to characterize the wrist position sense. Thirty healthy young adults performed an ipsilateral active joint position matching task with their dominant wrist using a haptic robotic exoskeleton. Our results indicate that the active wrist position sense acuity is anisotropic across the joint, with the abduction/adduction DoF having the highest acuity (the error of acuity for flexion/extension is 4.64 ± 0.24°; abduction/adduction: 3.68 ± 0.32°; supination/pronation: 5.15 ± 0.37°) and they also revealed that proprioceptive acuity decreases for smaller joint displacements. We believe this knowledge is imperative in a clinical scenario when assessing proprioceptive deficits and for understanding how such sensory deficits relate to observable motor impairments. PMID:27536882

Making acuity-adaptable units work: lessons from the field.

PubMed

Zimring, Craig; Seo, Hyun-Bo

2012-01-01

Because there have been no clear directions on how to implement acuity-adaptable units (AAUs), this paper describes actual tactics and strategies that have worked in multiple institutions. AAUs have been used in hospitals for the past decade, but reports in the literature have indicated both successes and difficulties in meeting operational goals and objectives. Despite various views regarding acuity adaptability, there is little in the literature that suggests why it works in some hospitals and not in others. As part of a larger construction project, this project team interviewed the leaders of six hospitals to determine what was associated with the successful implementation of AAUs. This paper reports on themes that emerged from these interviews, namely: choose the right specialty for medical centers; adopt the AAU model for the entire facility in community hospitals; bring in and train the right people; change culture through communication; and use acuity-adaptable unit clusters. Main themes, predictable patient progress, and culture change are further discussed and key recommendations are described.

Predictors of Sensitivity to Perceptual Learning in Children With Infantile Nystagmus.

PubMed

Huurneman, Bianca; Boonstra, F Nienke; Goossens, Jeroen

2017-08-01

To identify predictors of sensitivity to perceptual learning on a computerized, near-threshold letter discrimination task in children with infantile nystagmus (idiopathic IN: n = 18; oculocutaneous albinism accompanied by IN: n = 18). Children were divided into two age-, acuity-, and diagnosis-matched training groups: a crowded (n = 18) and an uncrowded training group (n = 18). Training consisted of 10 sessions spread out over 5 weeks (grand total of 3500 trials). Baseline performance, age, diagnosis, training condition, and perceived pleasantness of training (training joy) were entered as linear regression predictors of training-induced changes on a single- and a crowded-letter task. An impressive 57% of the variability in improvements of single-letter visual acuity was explained by age, training condition, and training joy. Being older and training with uncrowded letters were associated with larger single-letter visual acuity improvements. More training joy was associated with a larger gain from the uncrowded training and a smaller gain from the crowded training. Fifty-six percent of the variability in crowded-letter task improvements was explained by baseline performance, age, diagnosis, and training condition. After regressing out the variability induced by training condition, baseline performance, and age, perceptual learning proved more effective for children with idiopathic IN than for children with albinism accompanied by IN. Training gains increased with poorer baseline performance in idiopaths, but not in children with albinism accompanied by IN. Age and baseline performance, but not training joy, are important prognostic factors for the effect of perceptual learning in children with IN. However, their predictive value for achieving improvements in single-letter acuity and crowded letter acuity, respectively, differs between diagnostic subgroups and training condition. These findings may help with personalized treatment of individuals likely to benefit

Recovery in a letter-by-letter reader: more efficiency at the expense of normal reading strategy.

PubMed

Ablinger, Irene; Huber, Walter; Schattka, Kerstin I; Radach, Ralph

2013-01-01

Although changes in reading performance of recovering letter-by-letter readers have been described in some detail, no prior research has provided an in-depth analysis of the underlying adaptive word processing strategies. Our work examined the reading performance of a letter-by-letter reader, FH, over a period of 15 months, using eye movement methodology to delineate the recovery process at two different time points (T1, T2). A central question is whether recovery is characterized either by moving back towards normal word processing or by refinement and possibly automatization of an existing pathological strategy that was developed in response to the impairment. More specifically, we hypothesized that letter-by-letter reading may be executed with at least four different strategies and our work sought to distinguish between these alternatives. During recovery significant improvements in reading performance were achieved. A shift of fixation positions from the far left to the extreme right of target words was combined with many small and very few longer regressive saccades. Apparently, 'letter-by-letter reading' took the form of local clustering, most likely corresponding to the formation of sublexical units of analysis. This pattern was more pronounced at T2, suggesting that improvements in reading efficiency may come at the expense of making it harder to eventually return to normal reading.

The (lack of) relation between straylight and visual acuity. Two domains of the point-spread-function.

PubMed

van den Berg, Thomas J T P

2017-05-01

The effect of cataract and other media opacities on functional vision is typically assessed clinically using visual acuity. In both clinical and basic research, straylight (the functional result of light scattering in the eye) is commonly measured. The purpose of the present study was to determine the link between these two measures: is visual acuity in cataract and other media opacities related to straylight? Interdependence between acuity and straylight is addressed from three different points of view: (1) Methodological: can acuity differences affect the measurement value of straylight, and vice versa? (2) Basic optics: does the optical process of light scattering in the human eye affect both straylight and visual acuity? (3) Statistical: how strongly are acuity and straylight correlated in the practice of important clinical conditions? Experimental and theoretical aspects will be considered, with a focus on normal ageing and cataract formation. (1) Methodological: testing potential effects of acuity, artificially manipulated with positive trial lenses, showed no effect on measured straylight values. Since light scattering in the eye involves a low percentage of the light and has large angular spreading, contrast reduction due to straylight is limited, resulting in virtually absent acuity effects. (2) Basic optics: light scattering from the human donor eye lens is found to have virtually no effect in the centre of the point-spread-function, also for cataractous lenses, resulting in virtually absent acuity effects. (3) Statistical: literature data on straylight and visual acuity show a weak correlation for the important groups of normal ageing and cataract populations. The point-spread-function of the normal ageing and cataractous human eye is built upon two rather independent basic parts. Aberrations control the central peak. Light scattering controls the periphery from about 1° onwards. The way acuity and straylight are measured ensures no confounding between

Can "CANISO" Activate "CASINO"? Transposed-Letter Similarity Effects with Nonadjacent Letter Positions

ERIC Educational Resources Information Center

Perea, Manuel; Lupker, Stephen J.

2004-01-01

Nonwords created by transposing two "adjacent" letters (i.e., transposed-letter (TL) nonwords like "jugde") are very effective at activating the lexical representation of their base words. This fact poses problems for most computational models of word recognition (e.g., the interactive-activation model and its extensions), which assume that exact…

Eagle-eyed visual acuity: an experimental investigation of enhanced perception in autism.

PubMed

Ashwin, Emma; Ashwin, Chris; Rhydderch, Danielle; Howells, Jessica; Baron-Cohen, Simon

2009-01-01

Anecdotal accounts of sensory hypersensitivity in individuals with autism spectrum conditions (ASC) have been noted since the first reports of the condition. Over time, empirical evidence has supported the notion that those with ASC have superior visual abilities compared with control subjects. However, it remains unclear whether these abilities are specifically the result of differences in sensory thresholds (low-level processing), rather than higher-level cognitive processes. This study investigates visual threshold in n = 15 individuals with ASC and n = 15 individuals without ASC, using a standardized optometric test, the Freiburg Visual Acuity and Contrast Test, to investigate basic low-level visual acuity. Individuals with ASC have significantly better visual acuity (20:7) compared with control subjects (20:13)-acuity so superior that it lies in the region reported for birds of prey. The results of this study suggest that inclusion of sensory hypersensitivity in the diagnostic criteria for ASC may be warranted and that basic standardized tests of sensory thresholds may inform causal theories of ASC.

Effect of Target Location on Dynamic Visual Acuity During Passive Horizontal Rotation

NASA Technical Reports Server (NTRS)

Appelbaum, Meghan; DeDios, Yiri; Kulecz, Walter; Peters, Brian; Wood, Scott

2010-01-01

The vestibulo-ocular reflex (VOR) generates eye rotation to compensate for potential retinal slip in the specific plane of head movement. Dynamic visual acuity (DVA) has been utilized as a functional measure of the VOR. The purpose of this study was to examine changes in accuracy and reaction time when performing a DVA task with targets offset from the plane of rotation, e.g. offset vertically during horizontal rotation. Visual acuity was measured in 12 healthy subjects as they moved a hand-held joystick to indicate the orientation of a computer-generated Landolt C "as quickly and accurately as possible." Acuity thresholds were established with optotypes presented centrally on a wall-mounted LCD screen at 1.3 m distance, first without motion (static condition) and then while oscillating at 0.8 Hz (DVA, peak velocity 60 deg/s). The effect of target location was then measured during horizontal rotation with the optotypes randomly presented in one of nine different locations on the screen (offset up to 10 deg). The optotype size (logMar 0, 0.2 or 0.4, corresponding to Snellen range 20/20 to 20/50) and presentation duration (150, 300 and 450 ms) were counter-balanced across five trials, each utilizing horizontal rotation at 0.8 Hz. Dynamic acuity was reduced relative to static acuity in 7 of 12 subjects by one step size. During the random target trials, both accuracy and reaction time improved proportional to optotype size. Accuracy and reaction time also improved between 150 ms and 300 ms presentation durations. The main finding was that both accuracy and reaction time varied as a function of target location, with greater performance decrements when acquiring vertical targets. We conclude that dynamic visual acuity varies with target location, with acuity optimized for targets in the plane of motion. Both reaction time and accuracy are functionally relevant DVA parameters of VOR function.

Visual evoked potential measurement of contrast sensitivity in a case of retinal laser injury reveals visual function loss despite normal acuity

NASA Astrophysics Data System (ADS)

Glickman, Randolph D.; Harrison, Joseph M.; Zwick, Harry; Longbotham, Harold G.; Ballentine, Charles S.; Pierce, Bennie

1996-04-01

Although visual function following retinal laser injuries has traditionally been assessed by measuring visual acuity, this measure only indicates the highest spatial frequency resolvable under high-contrast viewing conditions. Another visual psychophysical parameter is contrast sensitivity (CS), which measures the minimum contrast required for detection of targets over a range of spatial frequencies, and may evaluate visual mechanisms that do not directly subserve acuity. We used the visual evoked potential (VEP) to measure CS in a population of normal subjects and in patients with ophthalmic conditions affecting retinal function, including one patient with a laser injury in the macula. In this patient, the acuity had recovered from scored as the reciprocal of the lowest contrast within the sweep which elicited a response synchronized to the counterphase frequency. We found a CS deficit that appeared for a 3 degree(s) test field but not for larger test fields. These data indicated that contrast sensitivity measurements may reveal alterations in visual neural processing mechanisms not detected with standard clinical tests of acuity.

Impact of a letter-grade program on restaurant sanitary conditions and diner behavior in New York City.

PubMed

Wong, Melissa R; McKelvey, Wendy; Ito, Kazuhiko; Schiff, Corinne; Jacobson, J Bryan; Kass, Daniel

2015-03-01

We evaluated the impact of the New York City restaurant letter-grading program on restaurant hygiene, food safety practices, and public awareness. We analyzed data from 43,448 restaurants inspected between 2007 and 2013 to measure changes in inspection score and violation citations since program launch in July 2010. We used binomial regression to assess probability of scoring 0 to 13 points (A-range score). Two population-based random-digit-dial telephone surveys assessed public perceptions of the program. After we controlled for repeated restaurant observations, season of inspection, and chain restaurant status, the probability of scoring 0 to 13 points on an unannounced inspection increased 35% (95% confidence interval [CI]=31%, 40%) 3 years after compared with 3 years before grading. There were notable improvements in compliance with some specific requirements, including having a certified kitchen manager on site and being pest-free. More than 91% (95% CI=88%, 94%) of New Yorkers approved of the program and 88% (95% CI=85%, 92%) considered grades in dining decisions in 2012. Restaurant letter grading in New York City has resulted in improved sanitary conditions on unannounced inspection, suggesting that the program is an effective regulatory tool.

Human Time-Frequency Acuity Beats the Fourier Uncertainty Principle

NASA Astrophysics Data System (ADS)

Oppenheim, Jacob N.; Magnasco, Marcelo O.

2013-01-01

The time-frequency uncertainty principle states that the product of the temporal and frequency extents of a signal cannot be smaller than 1/(4π). We study human ability to simultaneously judge the frequency and the timing of a sound. Our subjects often exceeded the uncertainty limit, sometimes by more than tenfold, mostly through remarkable timing acuity. Our results establish a lower bound for the nonlinearity and complexity of the algorithms employed by our brains in parsing transient sounds, rule out simple “linear filter” models of early auditory processing, and highlight timing acuity as a central feature in auditory object processing.

Impacting patient outcomes through design: acuity adaptable care/universal room design.

PubMed

Brown, Katherine Kay; Gallant, Dennis

2006-01-01

To succeed in today's challenging healthcare environment, hospitals must examine their impact on customers--patients and families--staff and physicians. By using competitive facility design and incorporating evidence-based concepts such as the acuity adaptable care delivery model and the universal room, the hospital will realize an impact on patient satisfaction that will enhance market share, on physician satisfaction that will foster loyalty, and on staff satisfaction that will decrease turnover. At the same time, clinical outcomes such as a reduction in mortality and complications and efficiencies such as a reduction in length of stay and minimization of hospital costs through the elimination of transfers can be gained. The results achieved are dependent on the principles used in designing the patient room that should focus on maximizing patient safety and improving healing. This article will review key design elements that support the success of an acuity adaptable unit such as the use of a private room with zones dedicated to patients, families, and staff, healing environment, technology, and decentralized nursing stations that support the success of the acuity adaptable unit. Outcomes of institutions currently utilizing the acuity adaptable concept will be reviewed.

Audience Mail: Letters to an Anchorman

ERIC Educational Resources Information Center

Gans, Herbert J.

1977-01-01

Analyzes letters sent to John Chancellor and NBC Nightly News in October of 1975 in an attempt to identify writer characteristics, letter types, stories and issues to which the writers reacted and the reasons for writing the letters. (MH)

Visual acuity with simulated and real astigmatic defocus.

PubMed

Ohlendorf, Arne; Tabernero, Juan; Schaeffel, Frank

2011-05-01

To compare the effects of "simulated" and "real" spherical and astigmatic defocus on visual acuity (VA). VA was determined with letter charts that were blurred by calculated spherical or astigmatic defocus (simulated defocus) or were seen through spherical or astigmatic trial lenses (real defocus). Defocus was simulated using ZEMAX and the Liou-Brennan eye model. Nine subjects participated [mean age, 27.2 ± 1.8 years; logarithm of the minimum angle of resolution (logMAR), -0.1]. Three different experiments were conducted in which VA was reduced by 20% (logMAR 0.0), 50% (logMAR 0.2), or 75% (logMAR 0.5) by either (1) imposing positive spherical defocus, (2) imposing positive and negative astigmatic defocus in three axes (0, 45, and 90°), and (3) imposing cross-cylinder defocus in the same three axes as in (2). Experiment (1): there were only minor differences in VA with simulated and real positive spherical defocus. Experiment (2): simulated astigmatic defocus reduced VA twice as much as real astigmatic defocus in all tested axes (p < 0.01 in all cases). Experiment (3): simulated cross-cylinder defocus reduced VA much more than real cross-cylinder defocus (p < 0.01 in all cases), similarly for all three tested axes. The visual system appears more tolerant against "real" spherical, astigmatic, and cross-cylinder defocus than against "simulated" blur. Possible reasons could be (1) limitations in the modeling procedures to simulate defocus, (2) higher ocular aberrations, and (3) fluctuations of accommodation. However, the two optical explanations (2) and (3) cannot account for the magnitude of the effect, and (1) was carefully analyzed. It is proposed that something may be special about the visual processing of real astigmatic and cross-cylinder defocus-because they have less effect on VA than simulations predict.

Warning letters to sponsor-investigators at academic health centres - the regulatory "canaries in a coal mine".

PubMed

O'Reilly, Erin K; Blair Holbein, M E; Berglund, Jelena P; Parrish, Amanda B; Roth, Mary-Tara; Burnett, Bruce K

2013-12-01

This study highlights Warning Letter (WL) findings issued to sponsor-investigators (S-Is) by the Food and Drug Administration (FDA). The online index of WLs issued from October 1, 2007 through September 30, 2012 was reviewed [1]. Through a manual screening process, letters were evaluated if specifically issued to 'clinical investigators', 'sponsors' or 'sponsor-investigators'. A particular focus was given to S-Is at Academic Health Centres (AHCs). Each letter was scored for the presence of violations in 40 general regulatory categories. A review of FDA WLs issued over a five-year period (FDA Fiscal Years 2008-2012) revealed that WLs to S-Is represent half of the WLs issued to all sponsors (16 of 32 letters). A review of these letters indicates that S-Is are not aware of, or simply do not meet, their regulatory responsibilities as either investigators or sponsors. In comparing total sponsor letters to those of S-Is, the most cited violation was the same: a lack of monitoring. A review of publicly available inspection data indicates that these 16 letters merely represent the tip of the iceberg. This review of the WL database reveals the potential for serious regulatory violations among S-Is at AHCs. Recent translational funding initiatives may serve to increase the number of S-Is, especially among Academic Health Centres (AHCs) [2]; thus, AHCs must become aware of this S-I role and work to support investigators who assume both roles in the course of their research.

Temporal order and processing acuity of visual, auditory, and tactile perception in developmentally dyslexic young adults.

PubMed

Laasonen, M; Service, E; Virsu, V

2001-12-01

We studied the temporal acuity of 16 developmentally dyslexic young adults in three perceptual modalities. The control group consisted of 16 age- and IQ-matched normal readers. Two methods were used. In the temporal order judgment (TOJ) method, the stimuli were spatially separate fingertip indentations in the tactile system, tone bursts of different pitches in audition, and light flashes in vision. Participants indicated which one of two stimuli appeared first. To test temporal processing acuity (TPA), the same 8-msec nonspeech stimuli were presented as two parallel sequences of three stimulus pulses. Participants indicated, without order judgments, whether the pulses of the two sequences were simultaneous or nonsimultaneous. The dyslexic readers were somewhat inferior to the normal readers in all six temporal acuity tasks on average. Thus, our results agreed with the existence of a pansensory temporal processing deficit associated with dyslexia in a language with shallow orthography (Finnish) and in well-educated adults. The dyslexic and normal readers' temporal acuities overlapped so much, however, that acuity deficits alone would not allow dyslexia diagnoses. It was irrelevant whether or not the acuity task required order judgments. The groups did not differ in the nontemporal aspects of our experiments. Correlations between temporal acuity and reading-related tasks suggested that temporal acuity is associated with phonological awareness.

Artificial Intelligence Can Predict Daily Trauma Volume and Average Acuity.

PubMed

Stonko, David P; Dennis, Bradley M; Betzold, Richard D; Peetz, Allan B; Gunter, Oliver L; Guillamondegui, Oscar D

2018-04-19

The goal of this study was to integrate temporal and weather data in order to create an artificial neural network (ANN) to predict trauma volume, the number of emergent operative cases, and average daily acuity at a level 1 trauma center. Trauma admission data from TRACS and weather data from the National Oceanic and Atmospheric Administration (NOAA) was collected for all adult trauma patients from July 2013-June 2016. The ANN was constructed using temporal (time, day of week), and weather factors (daily high, active precipitation) to predict four points of daily trauma activity: number of traumas, number of penetrating traumas, average ISS, and number of immediate OR cases per day. We trained a two-layer feed-forward network with 10 sigmoid hidden neurons via the Levenberg-Marquardt backpropagation algorithm, and performed k-fold cross validation and accuracy calculations on 100 randomly generated partitions. 10,612 patients over 1,096 days were identified. The ANN accurately predicted the daily trauma distribution in terms of number of traumas, number of penetrating traumas, number of OR cases, and average daily ISS (combined training correlation coefficient r = 0.9018+/-0.002; validation r = 0.8899+/- 0.005; testing r = 0.8940+/-0.006). We were able to successfully predict trauma and emergent operative volume, and acuity using an ANN by integrating local weather and trauma admission data from a level 1 center. As an example, for June 30, 2016, it predicted 9.93 traumas (actual: 10), and a mean ISS score of 15.99 (actual: 13.12); see figure 3. This may prove useful for predicting trauma needs across the system and hospital administration when allocating limited resources. Level III STUDY TYPE: Prognostic/Epidemiological.

Maturation of Binocular, Monocular Grating Acuity and of the Visual Interocular Difference in the First 2 Years of Life.

PubMed

Costa, Marcelo Fernandes; de Cássia Rodrigues Matos França, Valtenice; Barboni, Mirella Teles Salgueiro; Ventura, Dora Fix

2018-05-01

The sweep visual evoked potential method (sVEP) is a powerful tool for measurement of visual acuity in infants. Despite the applicability and reliability of the technique in measuring visual functions the understanding of sVEP acuity maturation and how interocular difference of acuity develops in early infancy, as well as the availability of normality ranges, are rare in the literature. We measured binocular and monocular sVEPS acuities in 481 healthy infants aged from birth to 24 months without ophthalmological diseases. Binocular sVEP acuity was significantly higher than monocular visual acuities for almost all ages. Maturation of monocular sVEP acuity showed 2 longer critical periods while binocular acuity showed three maturation periods in the same age range. We found a systematic variation of the mean interocular acuity difference (IAD) range according to age from 1.45 cpd at birth to 0.31 cpd at 24 months. An additional contribution was the determination of sVEP acuity norms for the entire age range. We conclude that binocular and monocular sVEP acuities have distinct growth curves reflecting different maturation profiles for each function. Differences in IAD range shorten according to age and they should be considered in using the sVEP acuity measurements for clinical diagnosis as amblyopia.

Tactile acuity and lumbopelvic motor control in patients with back pain and healthy controls.

PubMed

Luomajoki, H; Moseley, G L

2011-04-01

Voluntary lumbopelvic control is compromised in patients with back pain. Loss of proprioceptive acuity is one contributor to decreased control. Several reasons for decreased proprioceptive acuity have been proposed, but the integrity of cortical body maps has been overlooked. We investigated whether tactile acuity, a clear clinical signature of primary sensory cortex organisation, relates to lumbopelvic control in people with back pain. Forty-five patients with back pain and 45 age- and sex-matched healthy controls participated in this cross-sectional study. Tactile acuity at the back was assessed using two-point discrimination (TPD) threshold in vertical and horizontal directions. Voluntary motor control was assessed using an established battery of clinical tests. Patients performed worse on the voluntary lumbopelvic tasks than healthy controls did (p<0.001). TPD threshold was larger in patients (mean (SD)=61 (13) mm) than in healthy controls (44 (10) mm). Moreover, larger TPD threshold was positively related to worse performance on the voluntary lumbopelvic tasks (Pearson's r=0.49; p<0.001). Tactile acuity, a clear clinical signature of primary sensory cortex organisation, relates to voluntary lumbopelvic control. This relationship raises the possibility that the former contributes to the latter, in which case training tactile acuity may aid recovery and assist in achieving normal motor performance after back injury.

Wavefront coherence area for predicting visual acuity of post-PRK and post-PARK refractive surgery patients

NASA Astrophysics Data System (ADS)

Garcia, Daniel D.; van de Pol, Corina; Barsky, Brian A.; Klein, Stanley A.

1999-06-01

Many current corneal topography instruments (called videokeratographs) provide an `acuity index' based on corneal smoothness to analyze expected visual acuity. However, post-refractive surgery patients often exhibit better acuity than is predicted by such indices. One reason for this is that visual acuity may not necessarily be determined by overall corneal smoothness but rather by having some part of the cornea able to focus light coherently onto the fovea. We present a new method of representing visual acuity by measuring the wavefront aberration, using principles from both ray and wave optics. For each point P on the cornea, we measure the size of the associated coherence area whose optical path length (OPL), from a reference plane to P's focus, is within a certain tolerance of the OPL for P. We measured the topographies and vision of 62 eyes of patients who had undergone the corneal refractive surgery procedures of photorefractive keratectomy (PRK) and photorefractive astigmatic keratectomy (PARK). In addition to high contrast visual acuity, our vision tests included low contrast and low luminance to test the contribution of the PRK transition zone. We found our metric for visual acuity to be better than all other metrics at predicting the acuity of low contrast and low luminance. However, high contrast visual acuity was poorly predicted by all of the indices we studied, including our own. The indices provided by current videokeratographs sometimes fail for corneas whose shape differs from simple ellipsoidal models. This is the case with post-PRK and post-PARK refractive surgery patients. Our alternative representation that displays the coherence area of the wavefront has considerable advantages, and promises to be a better predictor of low contrast and low luminance visual acuity than current shape measures.

ERP correlates of letter identity and letter position are modulated by lexical frequency

PubMed Central

Vergara-Martínez, Marta; Perea, Manuel; Gómez, Pablo; Swaab, Tamara Y.

2013-01-01

The encoding of letter position is a key aspect in all recently proposed models of visual-word recognition. We analyzed the impact of lexical frequency on letter position assignment by examining the temporal dynamics of lexical activation induced by pseudowords extracted from words of different frequencies. For each word (e.g., BRIDGE), we created two pseudowords: A transposed-letter (TL: BRIGDE) and a replaced-letter pseudoword (RL: BRITGE). ERPs were recorded while participants read words and pseudowords in two tasks: Semantic categorization (Experiment 1) and lexical decision (Experiment 2). For high-frequency stimuli, similar ERPs were obtained for words and TL-pseudowords, but the N400 component to words was reduced relative to RL-pseudowords, indicating less lexical/semantic activation. In contrast, TL- and RL-pseudowords created from low-frequency stimuli elicited similar ERPs. Behavioral responses in the lexical decision task paralleled this asymmetry. The present findings impose constraints on computational and neural models of visual-word recognition. PMID:23454070

Resource Letter MA-2: Musical acoustics

NASA Astrophysics Data System (ADS)

Rossing, Thomas D.

1987-07-01

This Resource Letter provides a guide to the literature on musical acoustics. The letter E after an item indicates elementary level or material of general interest to persons becoming informed in the field. The letter I, for intermediate level, indicates material of a somewhat more specialized nature; and the letter A indicates rather specialized or advanced material. An asterisk (*) indicates articles that are especially useful or interesting; a double asterisk (**) indicates those articles to be included in an accompanying Reprint Book.

The letter knowledge assessment tool.

PubMed

Pedro, Cassandra; Lousada, Marisa; Pereira, Rita; Hall, Andreia; Jesus, Luis M T

2017-10-10

There is a need to develop letter knowledge assessment tools to characterise the letter knowledge in Portuguese pre-schoolers and to compare it with pre-schoolers from other countries, but there are no tools for this purpose in Portugal. The aim of this paper is to describe the development and validation procedures of the Prova de Avaliação de Competências de Pré-Literacia (PACPL), which assesses letter knowledge. This study includes data that has been gathered in two phases: pilot and main study. In the pilot study, an expert panel of six speech and language pathologists analysed the instrument. Children (n = 216) aged 5;0-7;11 participated in the main study that reports data related to the psychometric characteristics of the PACPL. Content validity, internal consistency, reliability and contributing factors to performance were examined statistically. A modified Bland-Altman method revealed good agreement amongst evaluators. The main study showed that the PACPL has a very good internal consistency and high inter-rater (96.2% of agreement and a Cohen's k value of 0.92) and intra-rater (95.6% of agreement and a Cohen's k value of 0.91) agreement. Construct validity of the PCAPL was also assured (Cronbach's α of 0.982). Significant differences were found between age groups with children increasing their letter knowledge with age. In addition, they were better at identifying than at producing both letter names and letter sounds. The PACPL is a valid and reliable instrument to assess letter knowledge in Portuguese children.

49 CFR 107.309 - Warning letters.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Warning letters. 107.309 Section 107.309... PROGRAM PROCEDURES Enforcement Compliance Orders and Civil Penalties § 107.309 Warning letters. (a) The Associate Administrator may issue a warning letter to any person whom the Associate Administrator believes...

49 CFR 107.309 - Warning letters.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Warning letters. 107.309 Section 107.309... PROGRAM PROCEDURES Enforcement Compliance Orders and Civil Penalties § 107.309 Warning letters. (a) The Associate Administrator may issue a warning letter to any person whom the Associate Administrator believes...

49 CFR 107.309 - Warning letters.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Warning letters. 107.309 Section 107.309... PROGRAM PROCEDURES Enforcement Compliance Orders and Civil Penalties § 107.309 Warning letters. (a) The Associate Administrator may issue a warning letter to any person whom the Associate Administrator believes...

49 CFR 107.309 - Warning letters.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Warning letters. 107.309 Section 107.309... PROGRAM PROCEDURES Enforcement Compliance Orders and Civil Penalties § 107.309 Warning letters. (a) The Associate Administrator may issue a warning letter to any person whom the Associate Administrator believes...

49 CFR 107.309 - Warning letters.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 2 2014-10-01 2014-10-01 false Warning letters. 107.309 Section 107.309... PROGRAM PROCEDURES Enforcement Compliance Orders and Civil Penalties § 107.309 Warning letters. (a) The Associate Administrator may issue a warning letter to any person whom the Associate Administrator believes...

Retinal Thickness and Visual Acuity in Diabetic Macular Edema: An Optical Coherence Tomography-Based Study.

PubMed

Islam, Farrah

2016-07-01

To determine the relationship between foveal (retinal) thickness and visual acuity in diabetic macular edema through optical coherence tomography (OCT) mapping software. Cross-sectional descriptive study. The Retina Clinic of Al-Shifa Trust Eye Hospital, Rawalpindi, from August 2011 to August 2012. Eighty eyes of 68 patients with clinical diagnosis of diabetic macular edema, based on complete ophthalmic examination, were enrolled. The best-corrected visual acuity was recorded on logMar scale. OCTimaging was performed through dilated pupil by experienced operator. Foveal thickness was determined. OCTparameters of macular thickness were analysed with baseline variables including age, duration since diagnosed with diabetes, and visual acuity. The mean visual acuity was 0.81 (0.2 - 1.8) logMar units. The average foveal thickness was 395.09 ±142.26 (183 - 825 µm). There was moderate correlation between foveal thickness and visual acuity (rs= 0.574, p < 0.001), absent in those who had visual acuity worse than 1 logMar. There was a weak positive association between foveal thickness and the duration of diabetes (rs=0.249, p < 0.05). There was, however, no correlation between foveal thickness and age (rs= 0.012, p=0.919). There is a moderate correlation between visual acuity and degree of foveal thickening in diabetic macular edema, hence two cannot be used interchangeably in clinical practice.

Relationship between photoreceptor outer segment length and visual acuity in diabetic macular edema.

PubMed

Forooghian, Farzin; Stetson, Paul F; Meyer, Scott A; Chew, Emily Y; Wong, Wai T; Cukras, Catherine; Meyerle, Catherine B; Ferris, Frederick L

2010-01-01

The purpose of this study was to quantify photoreceptor outer segment (PROS) length in 27 consecutive patients (30 eyes) with diabetic macular edema using spectral domain optical coherence tomography and to describe the correlation between PROS length and visual acuity. Three spectral domain-optical coherence tomography scans were performed on all eyes during each session using Cirrus HD-OCT. A prototype algorithm was developed for quantitative assessment of PROS length. Retinal thicknesses and PROS lengths were calculated for 3 parameters: macular grid (6 x 6 mm), central subfield (1 mm), and center foveal point (0.33 mm). Intrasession repeatability was assessed using coefficient of variation and intraclass correlation coefficient. The association between retinal thickness and PROS length with visual acuity was assessed using linear regression and Pearson correlation analyses. The main outcome measures include intrasession repeatability of macular parameters and correlation of these parameters with visual acuity. Mean retinal thickness and PROS length were 298 mum to 381 microm and 30 microm to 32 mum, respectively, for macular parameters assessed in this study. Coefficient of variation values were 0.75% to 4.13% for retinal thickness and 1.97% to 14.01% for PROS length. Intraclass correlation coefficient values were 0.96 to 0.99 and 0.73 to 0.98 for retinal thickness and PROS length, respectively. Slopes from linear regression analyses assessing the association of retinal thickness and visual acuity were not significantly different from 0 (P > 0.20), whereas the slopes of PROS length and visual acuity were significantly different from 0 (P < 0.0005). Correlation coefficients for macular thickness and visual acuity ranged from 0.13 to 0.22, whereas coefficients for PROS length and visual acuity ranged from -0.61 to -0.81. Photoreceptor outer segment length can be quantitatively assessed using Cirrus HD-OCT. Although the intrasession repeatability of PROS

49 CFR 190.205 - Warning letters.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Warning letters. 190.205 Section 190.205... REGULATORY PROCEDURES Enforcement § 190.205 Warning letters. Link to an amendment published at 78 FR 58909... or order issued thereunder has occurred, the Associate Administrator, OPS, may issue a Warning Letter...

7 CFR 1773.33 - Management letter.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Management letter. 1773.33 Section 1773.33... AGRICULTURE (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Reporting Requirements § 1773.33 Management letter. The CPA must prepare a management letter that includes, at a minimum, comments on: (a) Audit...

Effect of water turbidity on the visual acuity of harbor seals (Phoca vitulina).

PubMed

Weiffen, Michael; Möller, Bettina; Mauck, Björn; Dehnhardt, Guido

2006-05-01

The underwater visual acuity (the angle subtended by the minimal resolvable line width of high contrast square wave gratings at a viewing distance of 2m) of two male harbor seals was determined at different levels of water turbidity. Starting with visual acuity angles of 5.5' and 12.7' in clear water we found visual acuity to decrease rapidly with increasing turbidity at rates of 7.4' and 6.0' per formazin nephelometric unit (FNU). Besides the individual differences in visual performance of the harbor seals tested, our results reveal a dramatic loss of visual acuity even at moderate levels of turbidity. At sites in the German Wadden Sea, where harbor seals are known to roam and forage, we measured turbidity levels exceeding 40FNU. These data suggest that turbidity has to be considered as an important factor in the sensory ecology of pinnipeds.

Reduction in Dynamic Visual Acuity Reveals Gaze Control Changes Following Spaceflight

NASA Technical Reports Server (NTRS)

Peters, Brian T.; Brady, Rachel A.; Miller, Chris; Lawrence, Emily L.; Mulavara Ajitkumar P.; Bloomberg, Jacob J.

2010-01-01

INTRODUCTION: Exposure to microgravity causes adaptive changes in eye-head coordination that can lead to altered gaze control. This could affect postflight visual acuity during head and body motion. The goal of this study was to characterize changes in dynamic visual acuity after long-duration spaceflight. METHODS: Dynamic Visual Acuity (DVA) data from 14 astro/cosmonauts were collected after long-duration (6 months) spaceflight. The difference in acuity between seated and walking conditions provided a metric of change in the subjects ability to maintain gaze fixation during self-motion. In each condition, a psychophysical threshold detection algorithm was used to display Landolt ring optotypes at a size that was near each subject s acuity threshold. Verbal responses regarding the orientation of the gap were recorded as the optotypes appeared sequentially on a computer display 4 meters away. During the walking trials, subjects walked at 6.4 km/h on a motorized treadmill. RESULTS: A decrement in mean postflight DVA was found, with mean values returning to baseline within 1 week. The population mean showed a consistent improvement in DVA performance, but it was accompanied by high variability. A closer examination of the individual subject s recovery curves revealed that many did not follow a pattern of continuous improvement with each passing day. When adjusted on the basis of previous long-duration flight experience, the population mean shows a "bounce" in the re-adaptation curve. CONCLUSION: Gaze control during self-motion is altered following long-duration spaceflight and changes in postflight DVA performance indicate that vestibular re-adaptation may be more complex than a gradual return to normal.

Low-acuity presentations to regional emergency departments: What is the issue?

PubMed

Cheek, Colleen; Allen, Penny; Shires, Lizzi; Parry, Denise; Ruigrok, Marielle

2016-04-01

To explore GP-referrals and self-referrals to EDs and factors associated with patients seeking low-acuity care at ED. Retrospective analysis of all ED presentations to Mersey Community Hospital and North West Regional Hospital (Tasmania) between 1 January 2009 and 31 December 2013. Cross-sectional survey of patients presenting to the EDs for care triaged as low-acuity. There were 255,365 ED presentations in the retrospective data: 11,252 (4.4%) GP-referrals and 218,205 (85.4%) self-referrals. At ED 49% of GP-referrals were triaged ATS 4 or 5 and 35% of self-referrals were triaged ATS 1-3. There were 138 (84.2%) low-acuity patients who completed the survey; predominantly, all attended for acute injury or illness. Single point-of-care convenience was most commonly selected (71%) as a reason for attending ED. Over 85% of patients who seek emergency care in this region self-refer, so understanding health-seeking behaviour is important. Most low-acuity patients are acutely injured or unwell, and the decision to go to ED is based on their perception of accessibility of expertise aligned with their need. The term 'GP-type' is misleading in this context and should not be used. Providing low-acuity care in parallel with providing a specialised emergency service meets the needs of the local community and is likely to be the lowest cost model in a regional and rural area. Funding models must reflect the actual cost of delivering this important service rather than presentation types. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Neural Correlates of Top-Down Letter Processing

ERIC Educational Resources Information Center

Liu, Jiangang; Li, Jun; Zhang, Hongchuan; Rieth, Cory A.; Huber, David E.; Li, Wu; Lee, Kang; Tian, Jie

2010-01-01

This fMRI study investigated top-down letter processing with an illusory letter detection task. Participants responded whether one of a number of different possible letters was present in a very noisy image. After initial training that became increasingly difficult, they continued to detect letters even though the images consisted of pure noise,…

VISUAL ACUITY IN PSEUDOXANTHOMA ELASTICUM.

PubMed

Risseeuw, Sara; Ossewaarde-van Norel, Jeannette; Klaver, Caroline C W; Colijn, Johanna M; Imhof, Saskia M; van Leeuwen, Redmer

2018-04-12

To assess the age-specific proportion of visual impairment in patients with pseudoxanthoma elasticum (PXE) and to compare this with foveal abnormality and similar data of late age-related macular degeneration patients. Cross-sectional data of 195 patients with PXE were reviewed, including best-corrected visual acuity and imaging. The World Health Organisation criteria were used to categorize bilateral visual impairment. These results were compared with similar data of 131 patients with late age-related macular degeneration from the Rotterdam study. Overall, 50 PXE patients (26.0%) were visually impaired, including 21 (11%) with legal blindness. Visual functioning declined with increasing age. In patients older than 50 years, 37% was visually impaired and 15% legally blind. Foveal choroidal neovascularization was found in 84% of eyes with a best-corrected visual acuity lower than 20/70 (0.30) and macular atrophy in the fovea in 16%. In late age-related macular degeneration patients, 40% were visually impaired and 13% legally blind. Visual impairment started approximately 20 years later as compared with PXE patients. Visual impairment and blindness are frequent in PXE, particularly in patients older than 50 years. Although choroidal neovascularization is associated with the majority of vision loss, macular atrophy is also common. The proportion of visual impairment in PXE is comparable with late age-related macular degeneration but manifests earlier in life.

Patching vs Atropine to Treat Amblyopia in Children Aged 7 to 12 Years: A Randomized Trial

PubMed Central

2008-01-01

Objective To compare patching with atropine eye drops in the treatment of moderate amblyopia (20/40 -20/100) in children age 7 to 12 years. Methods In a randomized multi-center clinical trial, 193 children with amblyopia were randomized to weekend atropine or patching 2 hours per day of the sound eye. Main Outcome Measure Masked assessment of amblyopic eye visual acuity using the EETDRS testing protocol at 17 weeks. Results At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference (patching minus atropine) between groups adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95% confidence intervals for noninferiority = -0.7 and +3.1 letters). Based on the confidence intervals this difference met the pre-specified definition for equivalence (ends of confidence intervals <5 letters). Amblyopic eye visual acuity was 20/25 or better in 15 subjects (17%) in the atropine group and 20 subjects (24%) in the patching group (difference = 7%, 95% confidence interval = -3% to 17%). Conclusions Treatment with atropine or patching leads to similar degrees of improvement in 7 to 12 year old children with moderate amblyopia. About 1 in 5 achieves 20/25 or better visual acuity in the amblyopic eye. Application to Clinical Practice Treatment of older children with unilateral amblyopia. PMID:19064841

Factors associated with visual acuity in patients with cystoid macular oedema and Retinitis Pigmentosa.

PubMed

Liew, Gerald; Moore, Anthony T; Bradley, Patrick D; Webster, Andrew R; Michaelides, Michel

2018-06-01

Retinitis pigmentosa is the most common inherited retinal dystrophy. The factors associated with visual acuity in patients with other retinal diseases are well known, but are poorly understood in patients with retinitis pigmentosa. This knowledge is useful for prognosis and to support secondary endpoints in clinical trials. We conducted a cross-sectional study of consecutive patients recruited from the inherited retinal disease service from January 2012 to December 2012. Central macular thickness (CMT) was measured using spectral domain optical coherence tomography. Data were available for 81 patients and 162 eyes. After multivariable analyses, older age, earlier age of onset of symptoms, and thicker CMT were associated with lower visual acuity. Gender and inheritance pattern were not associated with visual acuity. Each decade older age, younger age of onset, and thicker CMT was associated with 0.12, 0.10, and 0.11 worse logarithm of the minimal angle of resolution units of visual acuity, respectively (p < 0.05 for all). Age, age of onset, and CMT are associated with visual acuity and important factors to measure in studies of retinitis pigmentosa.

Vernier But Not Grating Acuity Contributes to an Early Stage of Visual Word Processing.

PubMed

Tan, Yufei; Tong, Xiuhong; Chen, Wei; Weng, Xuchu; He, Sheng; Zhao, Jing

2018-03-28

The process of reading words depends heavily on efficient visual skills, including analyzing and decomposing basic visual features. Surprisingly, previous reading-related studies have almost exclusively focused on gross aspects of visual skills, while only very few have investigated the role of finer skills. The present study filled this gap and examined the relations of two finer visual skills measured by grating acuity (the ability to resolve periodic luminance variations across space) and Vernier acuity (the ability to detect/discriminate relative locations of features) to Chinese character-processing as measured by character form-matching and lexical decision tasks in skilled adult readers. The results showed that Vernier acuity was significantly correlated with performance in character form-matching but not visual symbol form-matching, while no correlation was found between grating acuity and character processing. Interestingly, we found no correlation of the two visual skills with lexical decision performance. These findings provide for the first time empirical evidence that the finer visual skills, particularly as reflected in Vernier acuity, may directly contribute to an early stage of hierarchical word processing.

33 CFR 127.009 - Letter of recommendation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Letter of recommendation. 127.009... General § 127.009 Letter of recommendation. After the COTP receives the Letter of Intent under § 127.007(a) or (b), the COTP issues a Letter of Recommendation as to the suitability of the waterway for LNG or...

33 CFR 127.009 - Letter of recommendation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Letter of recommendation. 127.009... General § 127.009 Letter of recommendation. After the COTP receives the Letter of Intent under § 127.007(a) or (b), the COTP issues a Letter of Recommendation as to the suitability of the waterway for LNG or...

Using On-scene EMS Responders' Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers.

PubMed

Scott, Greg; Clawson, Jeff; Fivaz, Mark C; McQueen, Jennie; Gardett, Marie I; Schultz, Bryon; Youngquist, Scott; Olola, Christopher H O

2016-02-01

Using the Medical Priority Dispatch System (MPDS) - a systematic 911 triage process - to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews. The primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews' patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN). In this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a "hot" (lights-and-siren) transport. Out of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren. With the exception of the low-acuity, ALPHA

Relation between Approximate Number System Acuity and Mathematical Achievement: The Influence of Fluency

PubMed Central

Wang, Li; Sun, Yuhua; Zhou, Xinlin

2016-01-01

Previous studies have observed inconsistent relations between the acuity of the Approximate Number System (ANS) and mathematical achievement. In this paper, we hypothesize that the relation between ANS acuity and mathematical achievement is influenced by fluency; that is, the mathematical achievement test covering a greater expanse of mathematical fluency may better reflect the relation between ANS acuity and mathematics skills. We explored three types of mathematical achievement tests utilized in this study: Subtraction, graded, and semester-final examination. The subtraction test was designed to measure the mathematical fluency. The graded test was more fluency-based than the semester-final examination, but both involved the same mathematical knowledge from the class curriculum. A total of 219 fifth graders from primary schools were asked to perform all three tests, then given a numerosity comparison task, a visual form perception task (figure matching), and a series of other tasks to assess general cognitive processes (mental rotation, non-verbal matrix reasoning, and choice reaction time). The findings were consistent with our expectations. The relation between ANS acuity and mathematical achievement was particularly clearly reflected in the participants’ performance on the visual form perception task, which supports the domain-general explanations for the underlying mechanisms of the relation between ANS acuity and math achievement. PMID:28066291

24 CFR 200.1505 - Warning letter.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Warning letter. 200.1505 Section... Lender Quality Assurance Enforcement § 200.1505 Warning letter. (a) In general. HUD may issue a warning letter, which specifies problems or violations identified by HUD, to a MAP lender. (b) Effect of warning...

49 CFR 190.205 - Warning letters.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Warning letters. 190.205 Section 190.205... PROCEDURES Enforcement § 190.205 Warning letters. Upon determining that a probable violation of 49 U.S.C..., OPS, may issue a Warning Letter notifying the owner or operator of the probable violation and advising...

17 CFR 38.711 - Warning letters.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Warning letters. 38.711... MARKETS Disciplinary Procedures § 38.711 Warning letters. Where a rule violation is found to have occurred, no more than one warning letter may be issued per rolling 12-month period for the same violation. ...

17 CFR 38.711 - Warning letters.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Warning letters. 38.711... MARKETS Disciplinary Procedures § 38.711 Warning letters. Where a rule violation is found to have occurred, no more than one warning letter may be issued per rolling 12-month period for the same violation. ...

24 CFR 200.1505 - Warning letter.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Warning letter. 200.1505 Section... Lender Quality Assurance Enforcement § 200.1505 Warning letter. (a) In general. HUD may issue a warning letter, which specifies problems or violations identified by HUD, to a MAP lender. (b) Effect of warning...

49 CFR 190.205 - Warning letters.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Warning letters. 190.205 Section 190.205... PROCEDURES Enforcement § 190.205 Warning letters. Upon determining that a probable violation of 49 U.S.C..., OPS, may issue a Warning Letter notifying the owner or operator of the probable violation and advising...

24 CFR 200.1505 - Warning letter.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Warning letter. 200.1505 Section... Lender Quality Assurance Enforcement § 200.1505 Warning letter. (a) In general. HUD may issue a warning letter, which specifies problems or violations identified by HUD, to a MAP lender. (b) Effect of warning...

24 CFR 200.1505 - Warning letter.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Warning letter. 200.1505 Section... Lender Quality Assurance Enforcement § 200.1505 Warning letter. (a) In general. HUD may issue a warning letter, which specifies problems or violations identified by HUD, to a MAP lender. (b) Effect of warning...

24 CFR 200.1505 - Warning letter.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Warning letter. 200.1505 Section... Lender Quality Assurance Enforcement § 200.1505 Warning letter. (a) In general. HUD may issue a warning letter, which specifies problems or violations identified by HUD, to a MAP lender. (b) Effect of warning...

49 CFR 190.205 - Warning letters.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Warning letters. 190.205 Section 190.205... PROCEDURES Enforcement § 190.205 Warning letters. Upon determining that a probable violation of 49 U.S.C..., OPS, may issue a Warning Letter notifying the owner or operator of the probable violation and advising...

Visual acuity estimation from simulated images

NASA Astrophysics Data System (ADS)

Duncan, William J.

Simulated images can provide insight into the performance of optical systems, especially those with complicated features. Many modern solutions for presbyopia and cataracts feature sophisticated power geometries or diffractive elements. Some intraocular lenses (IOLs) arrive at multifocality through the use of a diffractive surface and multifocal contact lenses have a radially varying power profile. These type of elements induce simultaneous vision as well as affecting vision much differently than a monofocal ophthalmic appliance. With myriad multifocal ophthalmics available on the market it is difficult to compare or assess performance in ways that effect wearers of such appliances. Here we present software and algorithmic metrics that can be used to qualitatively and quantitatively compare ophthalmic element performance, with specific examples of bifocal intraocular lenses (IOLs) and multifocal contact lenses. We anticipate this study, methods, and results to serve as a starting point for more complex models of vision and visual acuity in a setting where modeling is advantageous. Generating simulated images of real- scene scenarios is useful for patients in assessing vision quality with a certain appliance. Visual acuity estimation can serve as an important tool for manufacturing and design of ophthalmic appliances.

The letters of John Dastin.

PubMed

Thiesen, Wilfred

2008-07-01

John Dastin, a noted alchemist who lived ca. 1300, followed the lead of many of his contemporaries and predecessors in using letters to propagate his views on alchemy. This article identifies a number of letters that Dastin wrote, and includes one text addressed to a cardinal of the city of Naples. This letter is virtually a copy of a work by Arnold of Villanova. I believe that other works ascribed to Dastin will also show a great dependence on Arnold's works.

Identifying a clinically meaningful threshold for change in uveitic macular edema evaluated by optical coherence tomography.

PubMed

Sugar, Elizabeth A; Jabs, Douglas A; Altaweel, Michael M; Lightman, Sue; Acharya, Nisha; Vitale, Albert T; Thorne, Jennifer E

2011-12-01

To identify a clinically meaningful threshold for change in retinal thickness measured by optical coherence tomography for patients with uveitic macular edema using correlation with change in visual acuity. Cross-sectional and longitudinal study. One hundred twenty-eight eyes (101 individuals) with macular edema enrolled in the Multicenter Uveitis Steroid Treatment (MUST) trial. At enrollment and after 6 months of follow-up, retinal thickness was measured at the central subfield with time-domain optical coherence tomography and visual acuity was measured with logarithmic (Early Treatment Diabetic Retinopathy Study) visual acuity charts. Participants were classified as having macular edema if the retinal thickness was 260 μm or more. A threshold for change in retinal center subfield thickness of 20% balanced the percentage of false positives and false negatives for predicting more than a 10-letter change in visual acuity with a sensitivity of 77% and a specificity of 75%. The results were similar for more than 5-letter changes and for 15-letter or more changes. Those with a 20% or more reduction in retinal thickness had a mean 11.0-letter improvement (95% confidence interval, 7.7 to 14.3) as compared with a -0.4-letter change (95% confidence interval, -4.1 to 3.3) in visual acuity for those without a 20% reduction (P < .01). In addition to being above the level of measurement uncertainty, a 20% change in retinal thickness in patients with macular edema seems to be optimal for clinically important changes in visual acuity and may be considered as an outcome for clinical trials of treatments for uveitic macular edema. Copyright © 2011 Elsevier Inc. All rights reserved.

Context-dependent similarity effects in letter recognition.

PubMed

Kinoshita, Sachiko; Robidoux, Serje; Guilbert, Daniel; Norris, Dennis

2015-10-01

In visual word recognition tasks, digit primes that are visually similar to letter string targets (e.g., 4/A, 8/B) are known to facilitate letter identification relative to visually dissimilar digits (e.g., 6/A, 7/B); in contrast, with letter primes, visual similarity effects have been elusive. In the present study we show that the visual similarity effect with letter primes can be made to come and go, depending on whether it is necessary to discriminate between visually similar letters. The results support a Bayesian view which regards letter recognition not as a passive activation process driven by the fixed stimulus properties, but as a dynamic evidence accumulation process for a decision that is guided by the task context.

Impact of a Letter-Grade Program on Restaurant Sanitary Conditions and Diner Behavior in New York City

PubMed Central

McKelvey, Wendy; Ito, Kazuhiko; Schiff, Corinne; Jacobson, J. Bryan; Kass, Daniel

2015-01-01

Objectives. We evaluated the impact of the New York City restaurant letter-grading program on restaurant hygiene, food safety practices, and public awareness. Methods. We analyzed data from 43 448 restaurants inspected between 2007 and 2013 to measure changes in inspection score and violation citations since program launch in July 2010. We used binomial regression to assess probability of scoring 0 to 13 points (A-range score). Two population-based random-digit-dial telephone surveys assessed public perceptions of the program. Results. After we controlled for repeated restaurant observations, season of inspection, and chain restaurant status, the probability of scoring 0 to 13 points on an unannounced inspection increased 35% (95% confidence interval [CI] = 31%, 40%) 3 years after compared with 3 years before grading. There were notable improvements in compliance with some specific requirements, including having a certified kitchen manager on site and being pest-free. More than 91% (95% CI = 88%, 94%) of New Yorkers approved of the program and 88% (95% CI = 85%, 92%) considered grades in dining decisions in 2012. Conclusions. Restaurant letter grading in New York City has resulted in improved sanitary conditions on unannounced inspection, suggesting that the program is an effective regulatory tool. PMID:25602861

Vision Outcomes Following Anti-Vascular Endothelial Growth Factor Treatment of Diabetic Macular Edema in Clinical Practice.

PubMed

Holekamp, Nancy M; Campbell, Joanna; Almony, Arghavan; Ingraham, Herbert; Marks, Steven; Chandwani, Hitesh; Cole, Ashley L; Kiss, Szilárd

2018-04-20

To determine monitoring and treatment patterns, and vision outcomes in real-world patients initiating anti-vascular endothelial growth factor (anti-VEGF) therapy for diabetic macular edema (DME). Retrospective interventional cohort study. SETTING: Electronic medical record analysis of Geisinger Health System data. 110 patients (121 study eyes) initiating intravitreal ranibizumab or bevacizumab for DME during January 2007‒May 2012, with baseline corrected visual acuity of 20/40‒20/320, and ≥1 ophthalmologist visits during follow-up. Intravitreal injections per study eye during the first 12 months; corrected visual acuity, change in corrected visual acuity from baseline, proportions of eyes with ≥10 or ≥15 approxEarly Treatment Diabetic Retinopathy Study letter gain/loss at 12 months; number of ophthalmologist visits. Over 12 months, mean number of ophthalmologist visits was 9.2; mean number of intravitreal injections was 3.1 (range, 1-12), with most eyes (68.6%) receiving ≤3 injections. At 12 months, mean corrected visual acuity change was +4.7 letters (mean 56.9 letters at baseline); proportions of eyes gaining ≥10 or ≥15 letters were 31.4% and 24.0%, respectively; proportions of eyes losing ≥10 or ≥15 letters were 10.8% and 8.3%, respectively. Eyes receiving adjunctive laser during the first 6 months (n = 33) showed similar change in corrected visual acuity to non-laser-treated eyes (n = 88) (+3.1 vs +5.3 letters at 12 months). DME patients receiving anti-VEGF therapy in clinical practice undergo less frequent monitoring and intravitreal injections, and achieve inferior vision outcomes to patients in landmark clinical trials. Copyright © 2018. Published by Elsevier Inc.

Impact of Target Distance, Target Size, and Visual Acuity on the Video Head Impulse Test.

PubMed

Judge, Paul D; Rodriguez, Amanda I; Barin, Kamran; Janky, Kristen L

2018-05-01

The video head impulse test (vHIT) assesses the vestibulo-ocular reflex. Few have evaluated whether environmental factors or visual acuity influence the vHIT. The purpose of this study was to evaluate the influence of target distance, target size, and visual acuity on vHIT outcomes. Thirty-eight normal controls and 8 subjects with vestibular loss (VL) participated. vHIT was completed at 3 distances and with 3 target sizes. Normal controls were subdivided on the basis of visual acuity. Corrective saccade frequency, corrective saccade amplitude, and gain were tabulated. In the normal control group, there were no significant effects of target size or visual acuity for any vHIT outcome parameters; however, gain increased as target distance decreased. The VL group demonstrated higher corrective saccade frequency and amplitude and lower gain as compared with controls. In conclusion, decreasing target distance increases gain for normal controls but not subjects with VL. Preliminarily, visual acuity does not affect vHIT outcomes.

EDUCATION ENHANCES THE ACUITY OF THE NON-VERBAL APPROXIMATE NUMBER SYSTEM

PubMed Central

Piazza, Manuela; Pica, Pierre; Izard, Véronique; Spelke, Elizabeth; Dehaene, Stanislas

2015-01-01

All humans share a universal, evolutionarily ancient approximate number system (ANS) that estimates and combines the number of objects in sets with ratio-limited precision. Inter-individual variability in the acuity of the ANS correlates with mathematical achievement, but the causes of this correlation have never been established. We acquired psychophysical measures of ANS acuity in child and adult members of an indigene group in the Amazon, the Mundurucu, who have a very restricted numerical lexicon and highly variable access to mathematical education. By comparing Mundurucu subjects with or without access to schooling, we demonstrate that education significantly enhances the acuity with which sets of concrete objects are estimated. These results speak in favor of an important effect of culture and education on basic number perception. We hypothesize that symbolic and non-symbolic numerical thinking mutually enhance one another over the course of mathematics instruction. PMID:23625879

Recommended care adherence: improved by patient reminder letters but with potential attenuation by the healthcare process complexity.

PubMed

Zhang, Zhou; Fish, Jason

2012-01-01

American adults receive the recommended care just over half of the time for all recommended services. Many patient reminder strategies have attempted to increase the adherence rates for preventative and chronic disease management. However, there is a lack of data available in relation to adherence rates for symptom-specific recommended services and a lack of data identifying any contributions from the organisational structures to these adherence rates. To identify the efficacy and differences in patient reminder letter strategies on various categories of recommended services, as well as to analyse the relationship between a novel quantification of a healthcare system's process complexity with adherence rates. Retrospective cohort study analysing pilot data collected from an urban, academic healthcare provider utilising patient reminder letters. Adults attending one academic medical centre's outpatient practice from 2008 to 2009. Two reminder letters sent chronologically if the recommended care was not completed in the appropriate time frame. Adherence rates of each recommended service at baseline, after first and second reminder letters, and non-adherence rates despite the reminder letter intervention. Process flow complexity was calculated as a composite score combining elements of fastest time to complete routine order, number of different steps in routine order, number of departments involved, and number of sites patients visit. Patient adherence rates increased for all the recommended services after the first reminder letter. Preventative and Chronic Disease Management recommendations demonstrated additional moderate increases after the second reminder letter. Referrals and Radiologogy and Diagnostic Testing (acute, symptom specific) and Labs (acute and nonacute) demonstrated additional minimal adherence rate increases after the second reminder letter. Comparison of the process flow complexity demonstrated an inverse relationship between process complexity and

Effect of astigmatism on visual acuity in eyes with a diffractive multifocal intraocular lens.

PubMed

Hayashi, Ken; Manabe, Shin-Ichi; Yoshida, Motoaki; Hayashi, Hideyuki

2010-08-01

To examine the effect of astigmatism on visual acuity at various distances in eyes with a diffractive multifocal intraocular lens (IOL). Hayashi Eye Hospital, Fukuoka, Japan. In this study, eyes had implantation of a diffractive multifocal IOL with a +3.00 diopter (D) addition (add) (AcrySof ReSTOR SN6AD1), a diffractive multifocal IOL with a +4.00 D add (AcrySof ReSTOR SN6AD3), or a monofocal IOL (AcrySof SN60WF). Astigmatism was simulated by adding cylindrical lenses of various diopters (0.00, 0.50, 1.00, 1.50, 2.00), after which distance-corrected acuity was measured at various distances. At most distances, the mean visual acuity in the multifocal IOL groups decreased in proportion to the added astigmatism. With astigmatism of 0.00 D and 0.50 D, distance-corrected near visual acuity (DCNVA) in the +4.00 D group and distance-corrected intermediate visual acuity (DCIVA) and DCNVA in the +3.00 D group were significantly better than in the monofocal group; the corrected distance visual acuity (CDVA) was similar. The DCNVA with astigmatism of 1.00 D was better in 2 multifocal groups; however, with astigmatism of 1.50 D and 2.00 D, the CDVA and DCIVA at 0.5m in the multifocal groups were significantly worse than in the monofocal group, although the DCNVA was similar. With astigmatism of 1.00 D or greater, the mean CDVA and DCNVA in the multifocal groups reached useful levels (20/40). The presence of astigmatism in eyes with a diffractive multifocal IOL compromised all distance visual acuities, suggesting the need to correct astigmatism of greater than 1.00 D. No author has a financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Short-Term Visual Deprivation, Tactile Acuity, and Haptic Solid Shape Discrimination

PubMed Central

Crabtree, Charles E.; Norman, J. Farley

2014-01-01

Previous psychophysical studies have reported conflicting results concerning the effects of short-term visual deprivation upon tactile acuity. Some studies have found that 45 to 90 minutes of total light deprivation produce significant improvements in participants' tactile acuity as measured with a grating orientation discrimination task. In contrast, a single 2011 study found no such improvement while attempting to replicate these earlier findings. A primary goal of the current experiment was to resolve this discrepancy in the literature by evaluating the effects of a 90-minute period of total light deprivation upon tactile grating orientation discrimination. We also evaluated the potential effect of short-term deprivation upon haptic 3-D shape discrimination using a set of naturally-shaped solid objects. According to previous research, short-term deprivation enhances performance in a tactile 2-D shape discrimination task – perhaps a similar improvement also occurs for haptic 3-D shape discrimination. The results of the current investigation demonstrate that not only does short-term visual deprivation not enhance tactile acuity, it additionally has no effect upon haptic 3-D shape discrimination. While visual deprivation had no effect in our study, there was a significant effect of experience and learning for the grating orientation task – the participants' tactile acuity improved over time, independent of whether they had, or had not, experienced visual deprivation. PMID:25397327

Short-term visual deprivation, tactile acuity, and haptic solid shape discrimination.

PubMed

Crabtree, Charles E; Norman, J Farley

2014-01-01

Previous psychophysical studies have reported conflicting results concerning the effects of short-term visual deprivation upon tactile acuity. Some studies have found that 45 to 90 minutes of total light deprivation produce significant improvements in participants' tactile acuity as measured with a grating orientation discrimination task. In contrast, a single 2011 study found no such improvement while attempting to replicate these earlier findings. A primary goal of the current experiment was to resolve this discrepancy in the literature by evaluating the effects of a 90-minute period of total light deprivation upon tactile grating orientation discrimination. We also evaluated the potential effect of short-term deprivation upon haptic 3-D shape discrimination using a set of naturally-shaped solid objects. According to previous research, short-term deprivation enhances performance in a tactile 2-D shape discrimination task - perhaps a similar improvement also occurs for haptic 3-D shape discrimination. The results of the current investigation demonstrate that not only does short-term visual deprivation not enhance tactile acuity, it additionally has no effect upon haptic 3-D shape discrimination. While visual deprivation had no effect in our study, there was a significant effect of experience and learning for the grating orientation task - the participants' tactile acuity improved over time, independent of whether they had, or had not, experienced visual deprivation.

Relationship between socioeconomic deprivation 
or urban/rural residence and visual acuity before cataract surgery in Northern Scotland.

PubMed

Chua, Paul Y; Mustafa, Mohammed S; Scott, Neil W; Kumarasamy, Manjula; Azuara-Blanco, Augusto

2013-01-01

To evaluate the influence of socioeconomic factors on visual acuity before cataract surgery. 
 The medical case notes of 240 consecutive patients listed for cataract surgery from January 1, 2010, at Grampian University Hospital, Aberdeen, were reviewed retrospectively. Patients with ocular comorbidity were excluded. Demographics, postal codes, and visual acuity were recorded. Scottish Index of Multiple Deprivation was used to determine the deprivation rank. Home location was classified as urban or rural. The effect of these parameters on preoperative visual acuity was investigated using chi-square tests or Fisher exact test as appropriate. 
 A total of 184 patients (mean 75 years) were included. A total of 127 (69%) patients had visual acuity of 6/12 or better. An association was found between affluence and preoperative visual acuity of 6/12 or better (χ2trend = 4.97, p = 0.03), with a significant rising trend across quintile of deprivation. There was no evidence to suggest association between geographical region and preoperative visual acuity (p = 0.63). 
 Affluence was associated with good visual acuity (6/12 or better) before cataract surgery. There was no difference in preoperative visual acuity between rural and urban populations.

Does proprioceptive acuity during active knee rotation in the transverse plane vary at different ranges?

PubMed

Muaidi, Qassim I

2016-11-21

Knee proprioception in the sagittal plane has been widely investigated in prospective studies, however limited information is known about proprioceptive acuity during active knee rotation and the way most commonly injured. To investigate whether proprioceptive acuity during active internal and external knee rotation varies at different ranges in the transverse plane. Healthy volunteers (N: 26) without previous injury or surgery of the knee joint participated in the study.Knee rotation proprioceptive acuity was measured using a custom-designed device. The measure of proprioceptive acuity used in this study was the just-noticeable-difference (JND). Participants actively rotated the knee at different intervals(initial, mid, and terminal internal or external rotation range) to one of four movement blocks and the magnitude of the permitted motion was judged. The means of the JND for proprioceptive acuity at initial internal rotation (0.80° ± 0.06) were significantly (p< 0.002) lower than for mid (1.62° ± 0.18), and terminal (2.08° ± 0.35) internal rotation. The means of the JND for proprioceptive acuity at initial external rotation (1.16° ± 0.10) were significantly (p< 0.04) lower than for mid (1.95° ± 0.30), and terminal (1.97° ± 0.24) internal rotation. Participants perceived smaller differences between active internal and external rotation movements at initial rotation range than at the mid and terminal rotation range of movement. This suggests better proprioceptive acuity at the initial rotation range of movement in the transverse plane.

[Prevalence of low visual acuity and ophthalmological disorders in six-year-old children from Santa Fe city].

PubMed

Verrone, Pablo J; Simi, Marcelo R

2008-08-01

Changes in children visual acuity that are not treated carry a high risk of irreversible consequences. To determine the prevalence of low visual acuity and to diagnose the ophthalmologic diseases that cause it in six-year-old children from Santa Fe City, Argentina. Observational, descriptive and transversal design. Visual acuity is defined as the eye's capacity to distinguish separate points and to recognize shapes. It was determined using the Snellen table for farsighted vision on 177 six-year-old children who attended four elementary schools in Santa Fe City. An ophthalmologic examination was performed on those who had low visual acuity and their mothers were interviewed to ascertain the pathological background of their children. The prevalence of low visual acuity was 10.7% (n= 19). The prevalence of amblyopia was 3.9%. Refraction errors were the only cause of low visual acuity. Astigmatism was predominantly frequent. The most frequent pathological backgrounds were: ocular infections, premature birth, history of malnutrition and maternal use of tobacco. The prevalence of low visual acuity found in this study is lower than the one informed in most other studies. This data require confirmation by further studies.

Resource Letter: GW-1: Global warming

NASA Astrophysics Data System (ADS)

Firor, John W.

1994-06-01

This Resource Letter provides a guide to the literature on the possibility of a human-induced climate change—a global warming. Journal articles and books are cited for the following topics: the Greenhouse Effect, sources of infrared-trapping gases, climate models and their uncertainties, verification of climate models, past climate changes, and economics, ethics, and politics of policy responses to climate change. [The letter E after an item indicates elementary level or material of general interest to persons becoming informed in the field. The letter I, for intermediate level, indicates material of somewhat more specialized nature, and the letter A indicates rather specialized or advanced material.

Implied reading direction and prioritization of letter encoding.

PubMed

Holcombe, Alex O; Nguyen, Elizabeth H L; Goodbourn, Patrick T

2017-10-01

Capacity limits hinder processing of multiple stimuli, contributing to poorer performance for identifying two briefly presented letters than for identifying a single letter. Higher accuracy is typically found for identifying the letter on the left, which has been attributed to a right-hemisphere dominance for selective attention. Here, we use rapid serial visual presentation (RSVP) of letters in two locations at once. The letters to be identified are simultaneous and cued by rings. In the first experiment, we manipulated implied reading direction by rotating or mirror-reversing the letters to face to the left rather than to the right. The left-side performance advantage was eliminated. In the second experiment, letters were positioned above and below fixation, oriented such that they appeared to face downward (90° clockwise rotation) or upward (90° counterclockwise rotation). Again consistent with an effect of implied reading direction, performance was better for the top position in the downward condition, but not in the upward condition. In both experiments, mixture modeling of participants' report errors revealed that attentional sampling from the two locations was approximately simultaneous, ruling out the theory that the letter on one side was processed first, followed by a shift of attention to sample the other letter. Thus, the orientation of the letters apparently controls not when the letters are sampled from the scene, but rather the dynamics of a subsequent process, such as tokenization or memory consolidation. Implied reading direction appears to determine the letter prioritized at a high-level processing bottleneck. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Visual acuity and quality of life in dry eye disease: Proceedings of the OCEAN group meeting.

PubMed

Benítez-Del-Castillo, José; Labetoulle, Marc; Baudouin, Christophe; Rolando, Maurizio; Akova, Yonca A; Aragona, Pasquale; Geerling, Gerd; Merayo-Lloves, Jesús; Messmer, Elisabeth M; Boboridis, Kostas

2017-04-01

Dry eye disease (DED) results in tear film instability and hyperosmolarity, inflammation of the ocular surface and, ultimately, visual disturbance that can significantly impact a patient's quality of life. The effects on visual acuity result in difficulties with driving, reading and computer use and negatively impact psychological health. These effects also extend to the workplace, with a loss of productivity and quality of work causing substantial economic losses. The effects of DED and the impact on vision experienced by patients may not be given sufficient importance by ophthalmologists. Functional visual acuity (FVA) is a measure of visual acuity after sustained eye opening without blinking for at least 10 s and mimics the sustained visual acuity of daily life. Measuring dynamic FVA allows the detection of impaired visual function in patients with DED who may display normal conventional visual acuity. There are currently several tests and methods that can be used to measure dynamic visual function: the SSC-350 FVA measurement system, assessment of best-corrected visual acuity decay using the interblink visual acuity decay test, serial measurements of ocular and corneal higher order aberrations, and measurement of dynamic vision quality using the Optical Quality Analysis System. Although the equipment for these methods may be too large or unaffordable for use in clinical practice, FVA testing is an important assessment for DED. Copyright © 2016 Elsevier Inc. All rights reserved.

The use of acuity and frailty measures for district nursing workforce plans.

PubMed

David, Ami; Saunders, Mary

2018-02-02

This article discusses the use of Quest acuity and frailty measures for community nursing interventions to quantify and qualify the contributions of district nursing teams. It describes the use of a suite of acuity and frailty tools tested in 8 UK community service trusts over the past 5years. In addition, a competency assessment tool was used to gauge both capacity and capability of individual nurses. The consistency of the results obtained from the Quest audits offer significant evidence and potential for realigning community nursing services to offer improvements in efficiency and cost-effectiveness. The National Quality Board (NQB) improvement resource for the district nursing services ( NQB, 2017 ) recommends a robust method for classifying patient acuity/frailty/dependency. It is contended the Quest tools and their usage articulated here offer a suitable methodology.

Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials.

PubMed

Sharma, Sumit; Toth, Cynthia A; Daniel, Ebenezer; Grunwald, Juan E; Maguire, Maureen G; Ying, Gui-Shuang; Huang, Jiayan; Martin, Daniel F; Jaffe, Glenn J

2016-04-01

To describe the association between morphologic features on fundus photography (FP), fluorescein angiography (FA), and optical coherence tomography (OCT) and visual acuity (VA) in the second year of the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Prospective cohort study within a randomized clinical trial. Participants in the CATT. Study eye eligibility required angiographic and OCT evidence of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) and VA between 20/25 and 20/320. Treatment was assigned randomly to ranibizumab or bevacizumab with 3 different dosing regimens over a 2-year period. Fluid type, location, and thickness; retina and subretinal tissue complex thickness on OCT; size and lesion composition on FP and FA; and VA. Among 1185 CATT participants, 993 (84%) had fluid on OCT at baseline and completed 2 years of follow-up. At 2 years, intraretinal fluid (IRF), subretinal fluid (SRF), sub-retinal pigment epithelium (RPE) fluid, and subretinal tissue complex thickness decreased in all treatment groups. Ranibizumab monthly was best able to resolve each type of fluid. Eyes with SRF in the foveal center on OCT had better mean VA than eyes with no SRF (72.8 vs. 66.6 letters; P = 0.006). Eyes with IRF in the foveal center had worse mean VA than eyes without IRF (59.9 vs. 70.9 letters; P < 0.0001). Eyes with retinal thickness <120 μm had worse VA compared with eyes with retinal thickness 120 to 212 and >212 μm (59.4 vs. 71.3 vs. 70.3 letters; P < 0.0001). At 2 years, the mean VA (letters) of eyes varied substantially by the type of subfoveal pathology on FP and FA: 70.6 for no pathology; 74.1 for fluid only; 73.3 for CNV or pigment epithelial (RPE) detachment; 68.4 for nongeographic atrophy; and 62.9 for geographic atrophy, hemorrhage, RPE tear, or scar (P < 0.0001). The associations between VA and morphologic features identified through year 1 were maintained or strengthened during year 2. Eyes

Letter order is not coded by open bigrams

PubMed Central

Kinoshita, Sachiko; Norris, Dennis

2013-01-01

Open bigram (OB) models (e.g., SERIOL: Whitney, 2001, 2008; Binary OB, Grainger & van Heuven, 2003; Overlap OB, Grainger et al., 2006; Local combination detector model, Dehaene et al., 2005) posit that letter order in a word is coded by a set of ordered letter pairs. We report three experiments using bigram primes in the same-different match task, investigating the effects of order reversal and the number of letters intervening between the letters in the target. Reversed bigrams (e.g., fo-OF, ob-ABOLISH) produced robust priming, in direct contradiction to the assumption that letter order is coded by the presence of ordered letter pairs. Also in contradiction to the core assumption of current open bigram models, non-contiguous bigrams spanning three letters in the target (e.g., bs-ABOLISH) showed robust priming effects, equivalent in size to contiguous bigrams (e.g., bo-ABOLISH). These results question the role of open bigrams in coding letter order. PMID:23914048

Visual acuity from far to near and contrast sensitivity in eyes with a diffractive multifocal intraocular lens with a low addition power.

PubMed

Hayashi, Ken; Manabe, Shin-Ichi; Hayashi, Hideyuki

2009-12-01

To compare visual acuity from far to near, contrast visual acuity, and acuity in the presence of glare (glare visual acuity) between an aspheric diffractive multifocal intraocular lens (IOL) with a low addition (add) power (+3.0 diopters) and a monofocal IOL. Hayashi Eye Hospital, Fukuoka, Japan. This prospective study comprised patients having implantation of an aspheric diffractive multifocal ReSTOR SN6AD1 IOL with a +3.0 D add (multifocal group) or a monofocal AcrySof IQ SN60WF IOL (monofocal group). Visual acuity from far to near distances, contrast acuity, and glare acuity were evaluated 3 months postoperatively. Each IOL group comprised 64 eyes of 32 patients. For monocular and binocular visual acuity, the mean uncorrected and distance-corrected intermediate acuity at 0.5 m and the near acuity at 0.3 m were significantly better in the multifocal group than in the monofocal group (Pacuity at 0.7 m and 1.0 m were similar between the 2 groups. No significant differences were observed between groups in contrast acuity and glare acuity under photopic and mesopic conditions. Furthermore, no significant correlation was found between all-distance acuity and pupil diameter or between visual acuity and IOL decentration and tilt. The diffractive multifocal IOL with a low add power provided significantly better intermediate and near visual acuity than the monofocal IOL. Contrast sensitivity with and without glare was reduced with the multifocal IOL, and all-distance visual acuity was independent of pupil diameter and IOL displacement.

Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits.

PubMed

Martsolf, Grant; Fingar, Kathryn R; Coffey, Rosanna; Kandrack, Ryan; Charland, Tom; Eibner, Christine; Elixhauser, Anne; Steiner, Claudia; Mehrotra, Ateev

2017-04-01

We assess whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions. We used data from the Healthcare Cost and Utilization Project State Emergency Department Databases for 2,053 EDs in 23 states from 2007 to 2012. We used Poisson regression models to examine the association between retail clinic penetration and the rate of ED visits for 11 low-acuity conditions. Retail clinic "penetration" was measured as the percentage of the ED catchment area that overlapped with the 10-minute drive radius of a retail clinic. Rate ratios were calculated for a 10-percentage-point increase in retail clinic penetration per quarter. During the course of a year, this represents the effect of an increase in retail clinic penetration rate from 0% to 40%, which was approximately the average penetration rate observed in 2012. Among all patients, retail clinic penetration was not associated with a reduced rate of low-acuity ED visits (rate ratio=0.999; 95% confidence interval=0.997 to 1.000). Among patients with private insurance, there was a slight decrease in low-acuity ED visits (rate ratio=0.997; 95% confidence interval=0.994 to 0.999). For the average ED in a given quarter, this would equal a 0.3% reduction (95% confidence interval 0.1% to 0.6%) in low-acuity ED visits among the privately insured if retail clinic penetration rate increased by 10 percentage points per quarter. With increased patient demand resulting from the expansion of health insurance coverage, retail clinics may emerge as an important care location, but to date, they have not been associated with a meaningful reduction in low-acuity ED visits. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

High visual acuity revealed in dogs

PubMed Central

Lind, Olle; Milton, Ida; Andersson, Elin; Jensen, Per

2017-01-01

Humans have selectively bred and used dogs over a period of thousands of years, and more recently the dog has become an important model animal for studies in ethology, cognition and genetics. These broad interests warrant careful descriptions of the senses of dogs. Still there is little known about dog vision, especially what dogs can discriminate in different light conditions. We trained and tested whippets, pugs, and a Shetland sheepdog in a two-choice discrimination set-up and show that dogs can discriminate patterns with spatial frequencies between 5.5 and 19.5 cycle per degree (cpd) in the bright light condition (43 cd m-2). This is a higher spatial resolution than has been previously reported although the individual variation in our tests was large. Humans tested in the same set-up reached acuities corresponding to earlier studies, ranging between 32.1 and 44.2 cpd. In the dim light condition (0.0087 cd m-2) the acuity of dogs ranged between 1.8 and 3.5 cpd while in humans, between 5.9 and 9.9 cpd. Thus, humans make visual discrimination of objects from roughly a threefold distance compared to dogs in both bright and dim light. PMID:29206864

High visual acuity revealed in dogs.

PubMed

Lind, Olle; Milton, Ida; Andersson, Elin; Jensen, Per; Roth, Lina S V

2017-01-01

Humans have selectively bred and used dogs over a period of thousands of years, and more recently the dog has become an important model animal for studies in ethology, cognition and genetics. These broad interests warrant careful descriptions of the senses of dogs. Still there is little known about dog vision, especially what dogs can discriminate in different light conditions. We trained and tested whippets, pugs, and a Shetland sheepdog in a two-choice discrimination set-up and show that dogs can discriminate patterns with spatial frequencies between 5.5 and 19.5 cycle per degree (cpd) in the bright light condition (43 cd m-2). This is a higher spatial resolution than has been previously reported although the individual variation in our tests was large. Humans tested in the same set-up reached acuities corresponding to earlier studies, ranging between 32.1 and 44.2 cpd. In the dim light condition (0.0087 cd m-2) the acuity of dogs ranged between 1.8 and 3.5 cpd while in humans, between 5.9 and 9.9 cpd. Thus, humans make visual discrimination of objects from roughly a threefold distance compared to dogs in both bright and dim light.

Intra- and interpattern relations in letter recognition.

PubMed

Sanocki, T

1991-11-01

Strings of 4 unrelated letters were backward masked at varying durations to examine 3 major issues. (a) One issue concerned relational features. Letters with abnormal relations but normal elements were created by interchanging elements between large and small normal letters. Overall accuracy was higher for letters with normal relations, consistent with the idea that relational features are important in recognition. (b) Interpattern relations were examined by mixing large and small letters within strings. Relative to pure strings, accuracy was reduced, but only for small letters and only when in mixed strings. This effect can be attributed to attentional priority for larger forms over smaller forms, which also explains global precedence with hierarchical forms. (c) Forced-choice alternatives were manipulated in Experiments 2 and 3 to test feature integration theory. Relational information was found to be processed at least as early as feature presence or absence.

49 CFR 240.207 - Procedures for making the determination on vision and hearing acuity.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Procedures for making the determination on vision and hearing acuity. 240.207 Section 240.207 Transportation Other Regulations Relating to... making the determination on vision and hearing acuity. (a) Each railroad, prior to initially certifying...

49 CFR 240.207 - Procedures for making the determination on vision and hearing acuity.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Procedures for making the determination on vision and hearing acuity. 240.207 Section 240.207 Transportation Other Regulations Relating to... making the determination on vision and hearing acuity. (a) Each railroad, prior to initially certifying...

Multi-country real-life experience of anti-vascular endothelial growth factor therapy for wet age-related macular degeneration

PubMed Central

Holz, Frank G; Tadayoni, Ramin; Beatty, Stephen; Berger, Alan; Cereda, Matteo G; Cortez, Rafael; Hoyng, Carel B; Hykin, Philip; Staurenghi, Giovanni; Heldner, Stephanie; Bogumil, Timon; Heah, Theresa; Sivaprasad, Sobha

2015-01-01

Background/aims Real-life anti-vascular endothelial growth factor (VEGF) therapy use in patients with wet age-related macular degeneration (wAMD) was assessed in a retrospective, observational study in Canada, France, Germany, Ireland, Italy, the Netherlands, UK and Venezuela. Methods Medical records of patients with wAMD, who started ranibizumab treatment between 1 January 2009 and 31 August 2009, were evaluated. Data were collected until the end of treatment and/or monitoring or until 31 August 2011. Results 2227 patients who received ≥1 anti-VEGF injection with a baseline visual acuity assessment and ≥1 postbaseline visual acuity assessment for the treated eye were evaluated. Visual acuity improved until about day 120; thereafter, visual acuity gains were not maintained. Mean change in visual acuity score from baseline to years 1 and 2 was +2.4 and +0.6 letters, respectively. Patients received a mean of 5.0 and 2.2 injections in the first and second year, respectively. There were substantial differences in visual outcomes and injection frequency between countries. More frequent visits and injections were associated with greater improvements in visual acuity. Conclusions In clinical practice, fewer injections are administered than in clinical trials. Anti-VEGF treatment resulted in an initial improvement in visual acuity; however, this was not maintained over time. Trial registration number NCT01447043. PMID:25193672

Eye size and visual acuity influence vestibular anatomy in mammals.

PubMed

Kemp, Addison D; Christopher Kirk, E

2014-04-01

The semicircular canals of the inner ear detect head rotations and trigger compensatory movements that stabilize gaze and help maintain visual fixation. Mammals with large eyes and high visual acuity require precise gaze stabilization mechanisms because they experience diminished visual functionality at low thresholds of uncompensated motion. Because semicircular canal radius of curvature is a primary determinant of canal sensitivity, species with large canal radii are expected to be capable of more precise gaze stabilization than species with small canal radii. Here, we examine the relationship between mean semicircular canal radius of curvature, eye size, and visual acuity in a large sample of mammals. Our results demonstrate that eye size and visual acuity both explain a significant proportion of the variance in mean canal radius of curvature after statistically controlling for the effects of body mass and phylogeny. These findings suggest that variation in mean semicircular canal radius of curvature among mammals is partly the result of selection for improved gaze stabilization in species with large eyes and acute vision. Our results also provide a possible functional explanation for the small semicircular canal radii of fossorial mammals and plesiadapiforms. Copyright © 2014 Wiley Periodicals, Inc.

Effect of Yogic Breathing on Accommodate Braille Version of Six-letter Cancellation Test in Students with Visual Impairment.

PubMed

Pradhan, Balaram; Mohanty, Soubhagyalaxmi; Hankey, Alex

2018-01-01

Attentional processes tend to be less well developed in the visually impaired, who require special training to develop them fully. Yogic breathing which alters the patterns of respiration has been shown to enhance attention skills. Letter cancellation tests are well-established tools to measure attention and attention span. Here, a modified Braille version of the six-letter cancellation test (SLCT) was used for students with visual impairment (VI). This study aimed to assess the immediate effects of Bhramari Pranayama (BhPr) and breath awareness (BA) on students with VI. This study was a self-as-control study held on 2 consecutive days, on 19 participants (8 males, 11 females), with a mean age of 15.89 ± 1.59 years, randomized into two groups. On the 1 st day, Group 1 performed 10 min breath awareness and Group 2 performed Bhramari ; on the 2 nd day, practices were reversed. Assessments used a SLCT specially adapted for the visually impaired before and after each session. The Braille letter cancellation test was successfully taken by 19 students. Scores significantly improved after both techniques for each student following practices on both days ( P < 0.001). BhPr may have more effect on attention performance than BA as wrong scores significantly increased following BA ( P < 0.05), but the increase in the score after Bhramari was not significant. Despite the small sample size improvement in attentional processes by both yoga breathing techniques was robust. Attentional skills were definitely enhanced. Long-term practice should be studied.

Effect of Yogic Breathing on Accommodate Braille Version of Six-letter Cancellation Test in Students with Visual Impairment

PubMed Central

Pradhan, Balaram; Mohanty, Soubhagyalaxmi; Hankey, Alex

2018-01-01

Context: Attentional processes tend to be less well developed in the visually impaired, who require special training to develop them fully. Yogic breathing which alters the patterns of respiration has been shown to enhance attention skills. Letter cancellation tests are well-established tools to measure attention and attention span. Here, a modified Braille version of the six-letter cancellation test (SLCT) was used for students with visual impairment (VI). Aim: This study aimed to assess the immediate effects of Bhramari Pranayama (BhPr) and breath awareness (BA) on students with VI. Methods: This study was a self-as-control study held on 2 consecutive days, on 19 participants (8 males, 11 females), with a mean age of 15.89 ± 1.59 years, randomized into two groups. On the 1st day, Group 1 performed 10 min breath awareness and Group 2 performed Bhramari; on the 2nd day, practices were reversed. Assessments used a SLCT specially adapted for the visually impaired before and after each session. Results: The Braille letter cancellation test was successfully taken by 19 students. Scores significantly improved after both techniques for each student following practices on both days (P < 0.001). BhPr may have more effect on attention performance than BA as wrong scores significantly increased following BA (P < 0.05), but the increase in the score after Bhramari was not significant. Conclusions: Despite the small sample size improvement in attentional processes by both yoga breathing techniques was robust. Attentional skills were definitely enhanced. Long-term practice should be studied. PMID:29755219

Models of Discourse in the Letter of Complaint

ERIC Educational Resources Information Center

Hartford, Beverly; Mahboob, Ahmar

2004-01-01

In both the Outer Circle and the Expanding Circle countries, books which provide examples of letters written in English and guidelines for writing these letters are available for students, business people, and any others who have an interest or need for writing such letters. These model letters are not only for business correspondence, but also…

15 CFR 700.63 - Letters of Understanding.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Letters of Understanding. 700.63... DEFENSE PRIORITIES AND ALLOCATIONS SYSTEM Official Actions § 700.63 Letters of Understanding. (a) A Letter of Understanding is an official action which may be issued in resolving special priorities assistance...

50 CFR 216.188 - Letters of Authorization.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Letters of Authorization. 216.188 Section 216.188 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC... Low Frequency Active (SURTASS LFA sonar) Sonar § 216.188 Letters of Authorization. (a) A Letter of...

50 CFR 216.188 - Letters of Authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Letters of Authorization. 216.188 Section 216.188 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC... Low Frequency Active (SURTASS LFA sonar) Sonar § 216.188 Letters of Authorization. (a) A Letter of...

33 CFR 401.68 - Explosives Permission Letter.

Code of Federal Regulations, 2010 CFR

2010-07-01

... granted and the vessel shall not transit. (c) A written application for a Seaway Explosives Permission... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Explosives Permission Letter. 401... Permission Letter. (a) A Seaway Explosives Permission Letter is required for an explosive vessel in the...

Photobiomodulation reduces drusen volume and improves visual acuity and contrast sensitivity in dry age-related macular degeneration.

PubMed

Merry, Graham F; Munk, Marion R; Dotson, Robert S; Walker, Michael G; Devenyi, Robert G

2017-06-01

To evaluate the efficacy of photobiomodulation (PBM) treatment for patients with dry age-related macular degeneration (AMD). Assessments on 42 eyes with dry AMD (age related eye disease study (AREDS) 2-4) were conducted. Multiwavelength light emitting diode (LED) light comprising of yellow (590 nm), red (670 nm) and near-infrared (790 nm) bandwidths was applied to subjects' eyes for a treatment course of 3 weeks. Outcome measures were changes in best-corrected visual acuity (BCVA), contrast sensitivity (CS), drusen volume and central drusen thickness. Significant improvement in mean BCVA of 5.90 letters (p < 0.001) was seen on completion of the 3-week treatment and 5.14 letters (p < 0.001) after 3 months. Contrast sensitivity improved significantly (log unit improvement of 0.11 (p = 0.02) at 3 weeks and 3 months (log unit improvement of 0.16 (p = 0.02) at three cycles per degree. Drusen volume decreased by 0.024 mm 3 (p < 0.001) and central drusen thickness was significantly reduced by a mean of 3.78 μm (p < 0.001), while overall central retinal thickness and retinal volume remained stable. This is the first study demonstrating improvements in functional and anatomical outcomes in dry AMD subjects with PBM therapy. These findings corroborate an earlier pilot study that looked at functional outcome measures. The addition of anatomical evidence contributes to the basis for further development of a non-invasive PBM treatment for dry AMD. © 2016 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

Identifying a Clinically Meaningful Threshold for Change in Uveitic Macular Edema Evaluated by Optical Coherence Tomography

PubMed Central

Sugar, Elizabeth A.; Jabs, Douglas A.; Altaweel, Michael M.; Lightman, Sue; Acharya, Nisha; Vitale, Albert T.; Thorne, Jennifer E.

2011-01-01

Purpose To identify a clinically meaningful threshold for change in retinal thickness measured by optical coherence tomography (OCT) for patients with uveitic macular edema, using correlation with change in visual acuity. Design Cross-sectional and longitudinal study. Methods 128 eyes (101 individuals) with macular edema enrolled in the Multicenter Uveitis Steroid Treatment (MUST) trial. At enrollment and after six months of follow-up, retinal thickness was measured at the central subfield with time domain OCT and visual acuity was measured with logarithmic (ETDRS) visual acuity charts. Participants were classified as having macular edema if the retinal thickness was ≥260μm. Results A threshold for change in retinal center subfield thickness of 20% balanced the percentage of false positives and negatives for predicting greater than 10-letter change in visual acuity with sensitivity of 77% and a specificity of 75%. The results were similar for greater than 5 or 15 or greater letter changes. Those with a 20% or greater reduction in retinal thickness had a mean 11.0 letter improvement (95% CI: 7.7 to 14.3) as compared to a -0.4 letter change (95% CI: -4.1 to 3.3) in visual acuity for those without a 20% reduction (p < 0.01). Conclusions In addition to being above the level of measurement uncertainty, a 20% change in retinal thickness in patients with macular edema appears to be optimal for clinically important changes in visual acuity and may be considered as an outcome for clinical trials of treatments for uveitic macular edema. PMID:21861971

A Stimulus Sampling Theory of Letter Identity and Order

ERIC Educational Resources Information Center

Norris, Dennis; Kinoshita, Sachiko; van Casteren, Maarten

2010-01-01

Early on during word recognition, letter positions are not accurately coded. Evidence for this comes from transposed-letter (TL) priming effects, in which letter strings generated by transposing two adjacent letters (e.g., "jugde") produce large priming effects, more than primes with the letters replaced in the corresponding position (e.g.,…

Launch of Zoological Letters.

PubMed

Fukatsu, Takema; Kuratani, Shigeru

2016-02-01

A new open-access journal, Zoological Letters, was launched as a sister journal to Zoological Science, in January 2015. The new journal aims at publishing topical papers of high quality from a wide range of basic zoological research fields. This review highlights the notable reviews and research articles that have been published in the first year of Zoological Letters, providing an overview on the current achievements and future directions of the journal.

Reasons for Letter Contracts.

DTIC Science & Technology

1980-09-01

accelerated Initial Operational Capability (IOC). The TOW-DRAGON PM reacted accordingly. This also is a good example of a letter contract award to permit...Government. Good pricing depends pri- marily upon the exercise of sound judgement by all personnel concerned with the procurement. I: 3-801.2...Contracts. (a) The written determination required by DAR 3-408(c)(1) shall in- clude an outline of the reaons for a letter contract and the alternatives

Learning to identify contrast-defined letters in peripheral vision

PubMed Central

Chung, Susana T.L.; Levi, Dennis M.; Li, Roger W.

2009-01-01

Performance for identifying luminance-defined letters in peripheral vision improves with training. The purpose of the present study was to examine whether performance for identifying contrast-defined letters also improves with training in peripheral vision, and whether any improvement transfers to luminance-defined letters. Eight observers were trained to identify contrast-defined letters presented singly at 10° eccentricity in the inferior visual field. Before and after training, we measured observers’ thresholds for identifying luminance-defined and contrast-defined letters, embedded within a field of white luminance noise (maximum luminance contrast = 0, 0.25, and 0.5), at the same eccentric location. Each training session consisted of 10 blocks (100 trials per block) of identifying contrast-defined letters at a background noise contrast of 0.5. Letters (x-height = 4.2°) were the 26 lowercase letters of the Times-Roman alphabet. Luminance-defined letters were generated by introducing a luminance difference between the stimulus letter and its mid-gray background. The background noise covered both the letter and its background. Contrast-defined letters were generated by introducing a differential noise contrast between the group of pixels that made up the stimulus letter and the group of pixels that made up the background. Following training, observers showed a significant reduction in threshold for identifying contrast-defined letters (p < 0.0001). Averaged across observers and background noise contrasts, the reduction was 25.8%, with the greatest reduction (32%) occurring at the trained background noise contrast. There was virtually no transfer of improvement to luminance-defined letters, or to an untrained letter size (2× original), or an untrained retinal location (10° superior field). In contrast, learning transferred completely to the untrained contralateral eye. Our results show that training improves performance for identifying contrast

Creation of an Accurate Algorithm to Detect Snellen Best Documented Visual Acuity from Ophthalmology Electronic Health Record Notes.

PubMed

Mbagwu, Michael; French, Dustin D; Gill, Manjot; Mitchell, Christopher; Jackson, Kathryn; Kho, Abel; Bryar, Paul J

2016-05-04

Visual acuity is the primary measure used in ophthalmology to determine how well a patient can see. Visual acuity for a single eye may be recorded in multiple ways for a single patient visit (eg, Snellen vs. Jäger units vs. font print size), and be recorded for either distance or near vision. Capturing the best documented visual acuity (BDVA) of each eye in an individual patient visit is an important step for making electronic ophthalmology clinical notes useful in research. Currently, there is limited methodology for capturing BDVA in an efficient and accurate manner from electronic health record (EHR) notes. We developed an algorithm to detect BDVA for right and left eyes from defined fields within electronic ophthalmology clinical notes. We designed an algorithm to detect the BDVA from defined fields within 295,218 ophthalmology clinical notes with visual acuity data present. About 5668 unique responses were identified and an algorithm was developed to map all of the unique responses to a structured list of Snellen visual acuities. Visual acuity was captured from a total of 295,218 ophthalmology clinical notes during the study dates. The algorithm identified all visual acuities in the defined visual acuity section for each eye and returned a single BDVA for each eye. A clinician chart review of 100 random patient notes showed a 99% accuracy detecting BDVA from these records and 1% observed error. Our algorithm successfully captures best documented Snellen distance visual acuity from ophthalmology clinical notes and transforms a variety of inputs into a structured Snellen equivalent list. Our work, to the best of our knowledge, represents the first attempt at capturing visual acuity accurately from large numbers of electronic ophthalmology notes. Use of this algorithm can benefit research groups interested in assessing visual acuity for patient centered outcome. All codes used for this study are currently available, and will be made available online at https://phekb.org.

Creation of an Accurate Algorithm to Detect Snellen Best Documented Visual Acuity from Ophthalmology Electronic Health Record Notes

PubMed Central

French, Dustin D; Gill, Manjot; Mitchell, Christopher; Jackson, Kathryn; Kho, Abel; Bryar, Paul J

2016-01-01

Background Visual acuity is the primary measure used in ophthalmology to determine how well a patient can see. Visual acuity for a single eye may be recorded in multiple ways for a single patient visit (eg, Snellen vs. Jäger units vs. font print size), and be recorded for either distance or near vision. Capturing the best documented visual acuity (BDVA) of each eye in an individual patient visit is an important step for making electronic ophthalmology clinical notes useful in research. Objective Currently, there is limited methodology for capturing BDVA in an efficient and accurate manner from electronic health record (EHR) notes. We developed an algorithm to detect BDVA for right and left eyes from defined fields within electronic ophthalmology clinical notes. Methods We designed an algorithm to detect the BDVA from defined fields within 295,218 ophthalmology clinical notes with visual acuity data present. About 5668 unique responses were identified and an algorithm was developed to map all of the unique responses to a structured list of Snellen visual acuities. Results Visual acuity was captured from a total of 295,218 ophthalmology clinical notes during the study dates. The algorithm identified all visual acuities in the defined visual acuity section for each eye and returned a single BDVA for each eye. A clinician chart review of 100 random patient notes showed a 99% accuracy detecting BDVA from these records and 1% observed error. Conclusions Our algorithm successfully captures best documented Snellen distance visual acuity from ophthalmology clinical notes and transforms a variety of inputs into a structured Snellen equivalent list. Our work, to the best of our knowledge, represents the first attempt at capturing visual acuity accurately from large numbers of electronic ophthalmology notes. Use of this algorithm can benefit research groups interested in assessing visual acuity for patient centered outcome. All codes used for this study are currently

Resource Letter ETC-1: extraterrestrial civilization.

PubMed

Kuiper, T B; Brin, G D

1989-01-01

This Resource Letter provides a guide to the literature about intelligent life beyond the human sphere of exploration. It offers a starting point for professionals and academics interested in participating in the debate about the existence of other technological civilizations or in the search for extraterrestrial intelligence (SETI). It can also serve as a reference for teaching. This Letter is not intended as an exhaustive bibliography, but several extensive bibliographies have been cited. The letter E after an item indicates elementary, nontechnical material of general interest to persons becoming informed in the field. Intermediate level material, of a somewhat more specialized nature, is indicated by the Letter I. The annotation A indicates advanced, technical material. An asterisk (*) precedes items to be included in an accompanying Reprint Book.

Educators' Liability for Negative Letters of Recommendation.

ERIC Educational Resources Information Center

Tidwell, James A.

1986-01-01

Discusses the protection of "qualified privilege" provided by the law to teachers writing letters of recommendation for students. The letter must be written in good faith and with a belief that it contains no inaccurate information. Reviews some related court decisions and provides seven recommendations for writing such letters. (MD)

50 CFR 216.277 - Letters of Authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MAMMALS Taking Marine Mammals Incidental to U.S. Navy Training in the Southern California Range Complex (SOCAL Range Complex) § 216.277 Letters of Authorization. (a) A Letter of Authorization, unless suspended... and renewal of the Letter of Authorization will be based on a determination that the total number of...

50 CFR 218.7 - Letters of Authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MAMMALS Taking Marine Mammals Incidental to U.S. Navy Training in the Virginia Capes Range Complex (VACAPES Range Complex) § 218.7 Letters of Authorization. (a) A Letter of Authorization, unless suspended... and renewal of the Letter of Authorization will be based on a determination that the total number of...

50 CFR 218.16 - Letters of Authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MAMMALS Taking Marine Mammals Incidental to U.S. Navy Training in the Jacksonville Range Complex (JAX Range Complex) § 218.16 Letters of Authorization. (a) A Letter of Authorization, unless suspended or... and renewal of the Letter of Authorization will be based on a determination that the total number of...

Formation of automatic letter-colour associations in non-synaesthetes through likelihood manipulation of letter-colour pairings.

PubMed

Kusnir, Flor; Thut, Gregor

2012-12-01

Grapheme-colour synaesthesia is a well-characterized phenomenon in which achromatic letters and/or digits automatically and systematically trigger specific colour sensations. Models of its underlying mechanisms diverge on a central question: whether triggered sensations reflect (1) an overdeveloped capacity in normal cross-modal processing (i.e., sharing characteristics with the general population), or rather (2) qualitatively deviant processing (i.e., unique to a few individuals). To test to what extent synaesthesia-like (automatic) letter-colour associations may be learned by non-synaesthetes into adulthood, implied by (1), we developed a learning paradigm that aimed to implicitly train such associations via a visual search task that employed statistical probability learning of specific letter-colour pairs. In contrast to previous synaesthesia-training studies (Cohen Kadosh, Henik, Catena, Walsh, & Fuentes, 2009; Meier & Rothen, 2009), here all participants were naïve as to the end-goal of the experiment (i.e., the formation of letter-colour associations), mimicking the learning conditions of acquired grapheme-colour synaesthesia (Hancock, 2006; Witthoft & Winawer, 2006). In two experiments, we found evidence for significant binding of colours to letters by non-synaesthetes. These newly-formed associations showed synaesthesia-like characteristics, because they correlated in strength with performance on individual synaesthetic Stroop-tasks (experiment 1), and because interference between the learned (associated) colour and the real colour during letter processing depended on their relative positions in colour space (opponent vs. non-opponent colours, experiment 2) suggesting automatic formation on a perceptual rather than conceptual level, analogous to synaesthesia. Although not evoking conscious colour percepts, these learned, synaesthesia-like associations in non-synaesthetes support that common mechanisms may underlie letter-colour associations in synaesthetes

Measuring value for low-acuity care across settings.

PubMed

Morgan, Sofie Rahman; Smith, Meaghan A; Pitts, Stephen R; Shesser, Robert; Uscher-Pines, Lori; Ward, Michael J; Pines, Jesse M

2012-09-01

Increasing healthcare costs have created an emphasis on improving value, defined as how invested time, money, and resources improve health. The role of emergency departments (EDs) within value-driven health systems is still undetermined. Often questioned is the value of an ED visit for conditions that could be reasonably treated elsewhere such as office-based, urgent, and retail clinics. This paper presents a conceptual approach to assess the value of these low-acuity visits. It adapts an existing analytic model to highlight specific factors that impact key stakeholders' (patients, insurers, and society) assessments of the value of ED-based care compared with care in alternative settings. These factors are presented in 3 equations, 1 for each stakeholder, emphasizing how tangible and intangible benefits of care weigh against direct and indirect costs and how each perspective influences value. Aligning value among groups could allow stakeholders to influence each other and could guide rational change in the delivery of acute medical care for low-acuity conditions.

Written Communications Simulation: Write Me a Letter.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh. Div. of Vocational Education.

This simulation is intended for use as a culminating activity after students have been exposed to personal and/or business letter writing, use of reference manuals, typing of letters, mailing procedures, typing of numbers, punctuation practice, and filing procedures. Stated objectives are to enable students to type a mailable letter; to inspect,…

Validation of the ocular trauma score for intraocular foreign bodies in deadly weapon-related open-globe injuries.

PubMed

Unal, Melih H; Aydin, Ali; Sonmez, Murat; Ayata, Ali; Ersanli, Dilaver

2008-01-01

To evaluate the prognostic value of the Ocular Trauma Score (OTS) in cases of deadly weapon-related open-globe injuries with intraocular foreign bodies. A retrospective, interventional case series included 20 eyes of 20 patients who had deadly weapon-related open-globe injuries with intraocular foreign bodies. The OTS was calculated for each patient by adding the determined numbers of OTS variables at presentation (initial visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect). Patients were categorized based on their score (category 1 through 5). Final visual acuities in the OTS categories were calculated and compared to those in OTS study group. No statistically significant difference was found between the categorical distributions of the study patients and those in the OTS study group. No patient in the study was in category 5. The OTS, which was designed to predict visual outcomes of general ocular trauma, may also provide reliable information about the prognosis of deadly weapon-related open-globe injuries with intraocular foreign bodies.

Lawn mower injuries as a cause of serious visual acuity impairment - Case reports.

PubMed

Jasielska, Monika; Winiarczyk, Mateusz; Bieliński, Paweł; Mackiewicz, Jerzy

2017-05-11

[b]Abstract Objective.[/b] The aim of the study is to present four cases of lawn mowers injuries as a cause of serious visual acuity impairment. [b]Materials and Method[/b]. A retrospective study of four patients admitted in 2013-2015 to the Department of Vitreoretinal Surgery in Lublin with severe open or closed globe injury, one with an intraocular foreign body (IOFB). The presence of eye protective equipment was assessed, as well as visual acuity, eye tissue condition before and after treatment, and applied therapy. In all cases an improvement was achieved in local conditions. The intraocular foreign body was removed, wounds sutured and damaged tissues placed in position. All eyeballs were saved. In three cases, visual acuity was improved to a usable level. Three patients underwent pars plana vitrectomy, one with IOFB removal from the vitreous cavity. [b]Conclusions[/b]. Lawn mower induced eye injuries are a significant cause of serious visual acuity impairment or blindness. The presented study shows that lawn mower eye injuries are still a therapeutic, social and economic problem, yet are very preventable with proper eye protection and patients' education. Current prevention strategies are inadequate, and therefore should be updated.

Visual Acuity Outcomes of the Boston Keratoprosthesis Type 1: Multicenter Study Results.

PubMed

Rudnisky, Christopher J; Belin, Michael W; Guo, Rong; Ciolino, Joseph B

2016-02-01

To report logarithm of the minimal angle of resolution (logMAR) visual outcomes of the Boston keratoprosthesis type 1. Prospective cohort study. Preoperative, intraoperative, and postoperative parameters of 300 eyes of 300 patients who underwent implantation of a Boston keratoprosthesis type 1 device between January 2003 and July 2008 by 1 of 19 surgeons at 18 medical centers were collected. After an average of 17.1 ± 14.8 months, visual acuity improved significantly (P < .0001) to a mean final value of 0.89 ± 0.64 (20/150). There were also significantly fewer eyes with light perception (6.7%; n = 19; P < .0001), although 3.1% (n = 9) progressed to no light perception. There was no association between age (P = .08), sex (P = .959), operative side (P = .167), or failure (P = .494) and final visual acuity. The median time to achieve 20/200 visual acuity was 1 month (95% confidence interval 1.0-6.0) and it was retained for an average of 47.8 months. Multivariate analysis, controlling for preoperative visual acuity, demonstrated 2 factors associated with final visual outcome: chemical injury was associated with better final vision (P = .007), whereas age-related macular degeneration was associated with poorer vision (P < .0001). The Boston keratoprosthesis type 1 is an effective device for rehabilitation in advanced ocular surface disease, resulting in a significant improvement in visual acuity. Eyes achieved a mean value of 20/150 (0.89 ± 0.64 logMAR units) after 6 months and this was relatively stable thereafter. The best visual prognosis is observed in chemical injury eyes, whereas the worst prognosis is in aniridia, although the latter has limited visual potential. Copyright © 2016 Elsevier Inc. All rights reserved.

Are Letter Detection and Proofreading Tasks Equivalent?

ERIC Educational Resources Information Center

Saint-Aubin, Jean; Losier, Marie-Claire; Roy, Macha; Lawrence, Mike

2015-01-01

When readers search for misspellings in a proofreading task or for a letter in a letter detection task, they are more likely to omit function words than content words. However, with misspelled words, previous findings for the letter detection task were mixed. In two experiments, the authors tested the functional equivalence of both tasks. Results…

The Intentions of Letter Writers for Applicants to a Baccalaureate-M.D. Program: Self-Report and Content Analyses of Letters of Reference.

PubMed

Mavis, Brian E; Shafer, Christine L; Magallanes, Belinda M

2006-12-01

The purpose of this study was to determine how individuals providing reference letters framed the task and the specific attributes used to describe applicants. Participants were letter writers (N=106) for accepted or alternate applicants. Participants received a brief anonymous survey and a return postcard to release their past letter for content analysis. Seventy-six percent of letter writers (N=81) returned a survey. Most (64%) intended to describe applicants' positive accomplishments. According to respondents' they were most likely to write about academic accomplishments (85%), work ethic (78%), dependability (70%) and motivation (70%). Seventy-four respondents (70%) released their letter for content analysis. Academic accomplishments (77%), motivation (41%) and leadership (41%) were the attributes most frequently mentioned in the letters. Most letter writers see their role as supportive rather than evaluative. Academic accomplishments, though often mentioned, are available from other sources. Many non-cognitive attributes of most interest to admissions committees are least likely to appear in reference letters.

On Using Vernier Acuity to Assess Magnocellular Sensitivity

ERIC Educational Resources Information Center

Skottun, Bernt C.; Skoyles, John R.

2010-01-01

A recent study [Keri, S., & Benedek, G. (2009). Visual pathway deficit in female fragile x premutation carriers: A potential endophenotype. "Brain and Cognition", 69, 291-295] has found Vernier acuity deficiencies together with contrast sensitivity defects consistent with a magnocellular deficit in female fragile x premutation carriers. This may…

Assessing Suppression in Amblyopic Children With a Dichoptic Eye Chart.

PubMed

Birch, Eileen E; Morale, Sarah E; Jost, Reed M; De La Cruz, Angie; Kelly, Krista R; Wang, Yi-Zhong; Bex, Peter J

2016-10-01

Suppression has a key role in the etiology of amblyopia, and contrast-balanced binocular treatment can overcome suppression and improve visual acuity. Quantitative assessment of suppression could have a role in managing amblyopia. We describe a novel eye chart to assess suppression in children. We enrolled 100 children (7-12 years; 63 amblyopic, 25 nonamblyopic with strabismus or anisometropia, 12 controls) in the primary cohort and 22 children (3-6 years; 13 amblyopic, 9 nonamblyopic) in a secondary cohort. Letters were presented on a dichoptic display (5 letters per line). Children wore polarized glasses so that each eye saw a different letter chart. At each position, the identity of the letter and its contrast on each eye's chart differed. Children read 8 lines of letters for each of 3 letter sizes. The contrast balance ratio was the ratio at which 50% of letters seen by the amblyopic eye were reported. Amblyopic children had significantly higher contrast balance ratios for all letter sizes compared to nonamblyopic children and controls, requiring 4.6 to 5.6 times more contrast in the amblyopic eye compared to the fellow eye (P < 0.0001). Amblyopic eye visual acuity was correlated with contrast balance ratio (r ranged from 0.49-0.57 for the 3 letter sizes). Change in visual acuity with amblyopia treatment was correlated with change in contrast balance ratio (r ranged from 0.43-0.62 for the 3 letter sizes). Severity of suppression can be monitored as part of a routine clinical exam in the management of amblyopia in children.

The United Kingdom Diabetic Retinopathy Electronic Medical Record Users Group, Report 1: baseline characteristics and visual acuity outcomes in eyes treated with intravitreal injections of ranibizumab for diabetic macular oedema.

PubMed

Egan, Catherine; Zhu, Haogang; Lee, Aaron; Sim, Dawn; Mitry, Danny; Bailey, Clare; Johnston, Robert; Chakravarthy, Usha; Denniston, Alastair; Tufail, Adnan; Khan, Rehna; Mahmood, Sajjad; Menon, Geeta; Akerele, Toks; Downey, Louise; McKibbin, Martin; Varma, Atul; Lobo, Aires; Wilkinson, Elizabeth; Fitt, Alan; Brand, Christopher; Tsaloumas, Marie; Mandal, Kaveri; Kumar, Vineeth; Natha, Salim; Crabb, David

2017-01-01

To describe baseline characteristics and visual outcome for eyes treated with ranibizumab for diabetic macular oedema (DMO) from a multicentre database. Structured clinical data were anonymised and extracted from an electronic medical record from 19 participating UK centres: age at first injection, ETDRS visual acuity (VA), number of injections, ETDRS diabetic retinopathy (DR) and maculopathy grade at baseline and visits. The main outcomes were change in mean VA from baseline, number of injections and clinic visits and characteristics affecting VA change and DR grade. Data from 12 989 clinic visits was collated from baseline and follow-up for 3103 eyes. Mean age at first treatment was 66 years. Mean VA (letters) for eyes followed at least 2 years was 51.1 (SD=19.3) at baseline, 54.2 (SD: 18.6) and 52.5 (SD: 19.4) at 1 and 2 years, respectively. Mean visual gain was five letters. The proportion of eyes with VA of 72 letters or better was 25% (baseline) and 33% (1 year) for treatment naïve eyes. Eyes followed for at least 6 months received a mean of 3.3 injections over a mean of 6.9 outpatient visits in 1 year. In a large cohort of eyes with DMO treated with ranibizumab injections in the UK, 33% of patients achieved better than or equal to 6/12 in the treated eye at 12 months compared with 25% at baseline. The mean visual gain was five letters. Eyes with excellent VA at baseline maintain good vision at 18 months. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Are All Letters Really Processed Equally and in Parallel? Further Evidence of a Robust First Letter Advantage

PubMed Central

Scaltritti, Michele; Balota, David A.

2013-01-01

This present study examined accuracy and response latency of letter processing as a function of position within a horizontal array. In a series of 4 Experiments, target-strings were briefly (33 ms for Experiment 1 to 3, 83 ms for Experiment 4) displayed and both forward and backward masked. Participants then made a two alternative forced choice. The two alternative responses differed just in one element of the string, and position of mismatch was systematically manipulated. In Experiment 1, words of different lengths (from 3 to 6 letters) were presented in separate blocks. Across different lengths, there was a robust advantage in performance when the alternative response was different for the letter occurring at the first position, compared to when the difference occurred at any other position. Experiment 2 replicated this finding with the same materials used in Experiment 1, but with words of different lengths randomly intermixed within blocks. Experiment 3 provided evidence of the first position advantage with legal nonwords and strings of consonants, but did not provide any first position advantage for non-alphabetic symbols. The lack of a first position advantage for symbols was replicated in Experiment 4, where target-strings were displayed for a longer duration (83 ms). Taken together these results suggest that the first position advantage is a phenomenon that occurs specifically and selectively for letters, independent of lexical constraints. We argue that the results are consistent with models that assume a processing advantage for coding letters in the first position, and are inconsistent with the commonly held assumption in visual word recognition models that letters are equally processed in parallel independent of letter position. PMID:24012723

Effects of Horizontal Acceleration on Human Visual Acuity and Stereopsis

PubMed Central

Horng, Chi-Ting; Hsieh, Yih-Shou; Tsai, Ming-Ling; Chang, Wei-Kang; Yang, Tzu-Hung; Yauan, Chien-Han; Wang, Chih-Hung; Kuo, Wu-Hsien; Wu, Yi-Chang

2015-01-01

The effect of horizontal acceleration on human visual acuity and stereopsis is demonstrated in this study. Twenty participants (mean age 22.6 years) were enrolled in the experiment. Acceleration from two different directions was performed at the Taiwan High-Speed Rail Laboratory. Gx and Gy (< and >0.1 g) were produced on an accelerating platform where the subjects stood. The visual acuity and stereopsis of the right eye were measured before and during the acceleration. Acceleration <0.1 g in the X- or Y-axis did not affect dynamic vision and stereopsis. Vision decreased (mean from 0.02 logMAR to 0.25 logMAR) and stereopsis declined significantly (mean from 40 s to 60.2 s of arc) when Gx > 0.1 g. Visual acuity worsened (mean from 0.02 logMAR to 0.19 logMAR) and poor stereopsis was noted (mean from 40 s to 50.2 s of arc) when Gy > 0.1 g. The effect of acceleration from the X-axis on the visual system was higher than that from the Y-axis. During acceleration, most subjects complained of ocular strain when reading. To our knowledge, this study is the first to report the exact levels of visual function loss during Gx and Gy. PMID:25607601

Depth Acuity Methodology for Electronic 3D Displays: eJames (eJ)

DTIC Science & Technology

2016-07-01

AFRL-RH-WP-TR-2016-0060 Depth Acuity Methodology for Electronic 3D Displays: eJames (eJ) Eric L. Heft, John McIntire...AND SUBTITLE Depth Acuity Methodology for Electronic 3D Displays: eJames (eJ) 5a. CONTRACT NUMBER FA8650-08-D-6801-0050 5b. GRANT NUMBER...of 3D electronic displays: one active-eyewear Stereo 3D (S3D) and two non-eyewear full parallax Field-of-Light Display (FoLD) systems. The two FoLD

Navon letters affect face learning and face retrieval.

PubMed

Lewis, Michael B; Mills, Claire; Hills, Peter J; Weston, Nicola

2009-01-01

Identifying the local letters of a Navon letter (a large letter made up of smaller different letters) prior to recognition causes impairment in accuracy, while identifying the global letters of a Navon letter causes an enhancement in recognition accuracy (Macrae & Lewis, 2002). This effect may result from a transfer-inappropriate processing shift (TIPS) (Schooler, 2002). The present experiment extends research on the underlying mechanism of this effect by exploring this Navon effect on face learning as well as face recognition. The results of the two experiments revealed that when the Navon task used at retrieval was the same as that used at encoding then the performance accuracy is enhanced, whereas when the processing operations mismatch at retrieval and at encoding, this impairs recognition accuracy. These results provide support for the TIPS explanation of the Navon effect.

When writing impairs reading: letter perception's susceptibility to motor interference.

PubMed

James, Karin H; Gauthier, Isabel

2009-08-01

The effect of writing on the concurrent visual perception of letters was investigated in a series of studies using an interference paradigm. Participants drew shapes and letters while simultaneously visually identifying letters and shapes embedded in noise. Experiments 1-3 demonstrated that letter perception, but not the perception of shapes, was affected by motor interference. This suggests a strong link between the perception of letters and the neural substrates engaged during writing. The overlap both in category (letter vs. shape) and in the perceptual similarity of the features (straight vs. curvy) of the seen and drawn items determined the amount of interference. Experiment 4 demonstrated that intentional production of letters is not necessary for the interference to occur, because passive movement of the hand in the shape of letters also interfered with letter perception. When passive movements were used, however, only the category of the drawn items (letters vs. shapes), but not the perceptual similarity, had an influence, suggesting that motor representations for letters may selectively influence visual perception of letters through proprioceptive feedback, with an additional influence of perceptual similarity that depends on motor programs.

Neural Correlates of Letter Reversal in Children and Adults

PubMed Central

Kalra, Priya; Yee, Debbie; Sinha, Pawan; Gabrieli, John D. E.

2014-01-01

Children often make letter reversal errors when first learning to read and write, even for letters whose reversed forms do not appear in normal print. However, the brain basis of such letter reversal in children learning to read is unknown. The present study compared the neuroanatomical correlates (via functional magnetic resonance imaging) and the electrophysiological correlates (via event-related potentials or ERPs) of this phenomenon in children, ages 5–12, relative to young adults. When viewing reversed letters relative to typically oriented letters, adults exhibited widespread occipital, parietal, and temporal lobe activations, including activation in the functionally localized visual word form area (VWFA) in left occipito-temporal cortex. Adults exhibited significantly greater activation than children in all of these regions; children only exhibited such activation in a limited frontal region. Similarly, on the P1 and N170 ERP components, adults exhibited significantly greater differences between typical and reversed letters than children, who failed to exhibit significant differences between typical and reversed letters. These findings indicate that adults distinguish typical and reversed letters in the early stages of specialized brain processing of print, but that children do not recognize this distinction during the early stages of processing. Specialized brain processes responsible for early stages of letter perception that distinguish between typical and reversed letters may develop slowly and remain immature even in older children who no longer produce letter reversals in their writing. PMID:24859328

The role of sensorimotor learning in the perception of letter-like forms: tracking the causes of neural specialization for letters.

PubMed

James, Karin H; Atwood, Thea P

2009-02-01

Functional specialization in the brain is considered a hallmark of efficient processing. It is therefore not surprising that there are brain areas specialized for processing letters. To better understand the causes of functional specialization for letters, we explore the emergence of this pattern of response in the ventral processing stream through a training paradigm. Previously, we hypothesized that the specialized response pattern seen during letter perception may be due in part to our experience in writing letters. The work presented here investigates whether or not this aspect of letter processing-the integration of sensorimotor systems through writing-leads to functional specialization in the visual system. To test this idea, we investigated whether or not different types of experiences with letter-like stimuli ("pseudoletters") led to functional specialization similar to that which exists for letters. Neural activation patterns were measured using functional magnetic resonance imaging (fMRI) before and after three different types of training sessions. Participants were trained to recognize pseudoletters by writing, typing, or purely visual practice. Results suggested that only after writing practice did neural activation patterns to pseudoletters resemble patterns seen for letters. That is, neural activation in the left fusiform and dorsal precentral gyrus was greater when participants viewed pseudoletters than other, similar stimuli but only after writing experience. Neural activation also increased after typing practice in the right fusiform and left precentral gyrus, suggesting that in some areas, any motor experience may change visual processing. The results of this experiment suggest an intimate interaction among perceptual and motor systems during pseudoletter perception that may be extended to everyday letter perception.

Natural history of drusenoid pigment epithelial detachment in age-related macular degeneration: Age-Related Eye Disease Study Report No. 28.

PubMed

Cukras, Catherine; Agrón, Elvira; Klein, Michael L; Ferris, Frederick L; Chew, Emily Y; Gensler, Gary; Wong, Wai T

2010-03-01

To describe the natural history of eyes with drusenoid pigment epithelial detachments (DPEDs) associated with age-related macular degeneration (AMD). Multicenter, clinic-based, prospective cohort study. Among 4757 participants enrolled in the Age-Related Eye Disease Study (AREDS), 255 were identified as having DPED in at least 1 eye and having 5 or more years of follow-up after the initial detection of the DPED. Baseline and annual fundus photographs were evaluated for the evolution of the fundus features and the development of advanced AMD in the forms of central geographic atrophy (CGA) or neovascular (NV) AMD. Kaplan-Meier analyses of progression to advanced AMD and of moderate vision loss (> or =15 letters compared with baseline) were performed. Rate of progression to advanced AMD and change in visual acuity from baseline (in terms of mean letters lost and proportion losing > or =15 letters). A total of 311 eyes (from 255 participants) with DPED were followed for a median follow-up time of 8 years subsequent to the initial detection of a DPED. Of the 282 eyes that did not have advanced AMD at baseline, advanced AMD developed within 5 years in 119 eyes (42%) (19% progressing to CGA and 23% progressing to NV-AMD). In the remaining eyes that did not develop advanced AMD (n=163), progressive fundus changes, typified by the development of calcified drusen and pigmentary changes, were detected. Visual decline was prominent among study eyes, with approximately 40% of all eyes decreasing in visual acuity by > or =15 letters at 5 years follow-up. Mean visual acuity decreased from 76 letters ( approximately 20/30) at baseline to 61 letters ( approximately 20/60) at 5 years. Five-year decreases in mean visual acuity averaged 26 letters for eyes progressing to advanced AMD and 8 letters for non-progressing eyes. The natural history of eyes containing DPED is characterized by a high rate of progression to both CGA and NV-AMD. Among eyes not progressing to advanced AMD

Does letter rotation slow down orthographic processing in word recognition?

PubMed

Perea, Manuel; Marcet, Ana; Fernández-López, María

2018-02-01

Leading neural models of visual word recognition assume that letter rotation slows down the conversion of the visual input to a stable orthographic representation (e.g., local detectors combination model; Dehaene, Cohen, Sigman, & Vinckier, 2005, Trends in Cognitive Sciences, 9, 335-341). If this premise is true, briefly presented rotated primes should be less effective at activating word representations than those primes with upright letters. To test this question, we conducted a masked priming lexical decision experiment with vertically presented words either rotated 90° or in marquee format (i.e., vertically but with upright letters). We examined the impact of the format on both letter identity (masked identity priming: identity vs. unrelated) and letter position (masked transposed-letter priming: transposed-letter prime vs. replacement-letter prime). Results revealed sizeable masked identity and transposed-letter priming effects that were similar in magnitude for rotated and marquee words. Therefore, the reading cost from letter rotation does not arise in the initial access to orthographic/lexical representations.

48 CFR 42.504 - Postaward letters.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Postaward letters. 42.504 Section 42.504 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Postaward Orientation 42.504 Postaward letters. In some...

Radiation-induced changes in taste acuity in cancer patients. [. gamma. rays

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mossman, K.L.; Henkin, R.I.

1978-01-01

Changes in taste acuity were measured in 27 patients with various forms of cancer who received radiation to the head and neck region. In 9 of these patients (group I), measurements of taste acuity were made more than 1 year after completion of radiation therapy. In the other 18 patients (group II), taste measurements were made before, during, and approximately 1 month after radiation therapy. Taste acuity was measured for four taste qualities (salt, sweet, sour, and bitter) by a forced choice-three stimulus drop technique which measured detection and recognition thresholds and by a forced scaling technique which measured tastemore » intensity responsiveness. In group II patients, impaired acuity, as indicated by elevated detection and recognition thresholds, was observed approximately 3 weeks after initiation of radiotherapy. The bitter and salt qualities showed the earliest and greatest impairment and the sweet quality the least. Taste intensity responsiveness also was impaired in group II patients. As for thresholds, scaling impairment was most severe for bitter and salt taste qualities. Scaling impairment occurred before changes in either detection or recognition thresholds. Detection and recognition thresholds determined in group I patients also showed salt and bitter qualities were affected more severely than either sweet or sour qualities. Zinc administration to group I patients in an uncontrolled study suggested that zinc therapy may be useful in ameliorating taste impairment in some patients. These results suggest that taste loss may be a factor in the anorexia and weight loss that is observed commonly in patients who have undergone radiation treatment. Correction of this abnormality may be useful in aiding the nutritional status of these patients.« less

[Evaluation of visual acuity in a historical cohort of 137 patients treated for amblyopia by occlusion 30-35 years ago].

PubMed

Simonsz-Tóth, B; Loudon, S E; van Kempen-du Saar, H; van de Graaf, E S; Groenewoud, J H; Simonsz, H J

2007-01-01

Opinions differ on the course of the visual acuity in the amblyopic eye after cessation of occlusion therapy. This study evaluated visual acuity in a historical cohort treated for amblyopia with occlusion therapy 30-35 years ago. Between 1968 and 1975, 1250 patients had been treated by the orthoptist in the Waterland Hospital in Purmerend, The Netherlands. Of these, 471 received occlusion treatment for amblyopia (prevalence 5.0%, after comparison with the local birth rate). We were able to contact 203 of these patients, 137 were orthoptically re-examined in 2003. We correlated the current visual acuity with the cause of amblyopia, the age at start and end of treatment, the visual acuity at start and end of treatment, fixation, binocular vision and refractive errors. Mean age at the start of treatment was 5.4 +/- 1.9 years, 7.4 +/- 1.7 years at the end and 37 +/- 2.7 years at follow-up. Current visual acuity in the amblyopic eye was correlated with a low visual acuity at the start (p < 0.0001) and end (p < 0.0001) of occlusion therapy, an eccentric fixation (p < 0.0001), and the cause of amblyopia (p = 0.005). At the end of the treatment, patients with a strabismic amblyopia (n = 98) had a visual acuity in the amblyopic eye of 0.29 logMAR +/- 0.3, and in 2003 0.27 +/- 0.3 logMAR. In patients with an anisometropic amblyopia (> 1 D, n = 16) visual acuity had decreased from 0.17 +/- 0.23 logMAR to 0.21 logMAR +/- 0.23. In patients with both strabismic and anisometropic amblyopia (n = 23), visual acuity had decreased from 0.52 logMAR +/- 0.54 to 0.65 logMAR +/- 0.54. Overall, acuity had decreased in 54 patients (39%) after cessation of treatment. Of these, 18 patients had an acuity decrease to less than 50% of their acuity at the end of treatment. In 15 of these 18 patients anisohypermetropia had increased. A decrease in visual acuity after cessation of occlusion therapy occurred in patients with a combined cause of amblyopia or with an increase in anisohypermetropia.

Astronaut Charles Conrad during visual acuity experiments over Laredo

NASA Technical Reports Server (NTRS)

1965-01-01

Astronaut Charles Conrad Jr., pilot for the prime crew on the Gemini 5 space flight, takes pictures of predetermined land areas during visual acuity experiments over Laredo, Texas. The experiments will aid in learning to identify known terrestrial features under controlled conditions.

Teaching Complaint and Adjustment Letters--And Tact (My Favorite Assignment).

ERIC Educational Resources Information Center

Deimling, Paula

1992-01-01

Describes a three-part assignment in which each student writes a complaint letter and an adjustment letter responding to another student's complaint letter. Discusses how the third part of the assignment--journal entries--allows students to formulate their own criteria for excellent letters based upon their reactions to the letters they receive.…

Portable acuity screening for any school: validation of patched HOTV with amblyopic patients and Bangerter normals.

PubMed

Tsao Wu, Maya; Armitage, M Diane; Trujillo, Claire; Trujillo, Anna; Arnold, Laura E; Tsao Wu, Lauren; Arnold, Robert W

2017-12-04

We needed to validate and calibrate our portable acuity screening tools so amblyopia could be detected quickly and effectively at school entry. Spiral-bound flip cards and download pdf surround HOTV acuity test box with critical lines were combined with a matching card. Amblyopic patients performed critical line, then threshold acuity which was then compared to patched E-ETDRS acuity. 5 normal subjects wore Bangerter foil goggles to simulate blur for comparative validation. The 31 treated amblyopic eyes showed: logMAR HOTV = 0.97(logMAR E-ETDRS)-0.04 r2 = 0.88. All but two (6%) fell less than 2 lines difference. The five showed logMAR HOTV = 1.09 ((logMAR E-ETDRS) + .15 r2 = 0.63. The critical-line, test box was 98% efficient at screening within one line of 20/40. These tools reliably detected acuity in treated amblyopic patients and Bangerter blurred normal subjects. These free and affordable tools provide sensitive screening for amblyopia in children from public, private and home schools. Changing "pass" criteria to 4 out of 5 would improve sensitivity with somewhat slower testing for all students.

The processing of consonants and vowels during letter identity and letter position assignment in visual-word recognition: an ERP study.

PubMed

Vergara-Martínez, Marta; Perea, Manuel; Marín, Alejandro; Carreiras, Manuel

2011-09-01

Recent research suggests that there is a processing distinction between consonants and vowels in visual-word recognition. Here we conjointly examine the time course of consonants and vowels in processes of letter identity and letter position assignment. Event related potentials (ERPs) were recorded while participants read words and pseudowords in a lexical decision task. The stimuli were displayed under different conditions in a masked priming paradigm with a 50-ms SOA: (i) identity/baseline condition e.g., chocolate-CHOCOLATE); (ii) vowels-delayed condition (e.g., choc_l_te-CHOCOLATE); (iii) consonants-delayed condition (cho_o_ate-CHOCOLATE); (iv) consonants-transposed condition (cholocate-CHOCOLATE); (v) vowels-transposed condition (chocalote-CHOCOLATE), and (vi) unrelated condition (editorial-CHOCOLATE). Results showed earlier ERP effects and longer reaction times for the delayed-letter compared to the transposed-letter conditions. Furthermore, at early stages of processing, consonants may play a greater role during letter identity processing. Differences between vowels and consonants regarding letter position assignment are discussed in terms of a later phonological level involved in lexical retrieval. Copyright © 2010 Elsevier Inc. All rights reserved.

Transposed-Letter and Laterality Effects in Lexical Decision

ERIC Educational Resources Information Center

Perea, Manuel; Fraga, Isabel

2006-01-01

Two divided visual field lexical decision experiments were conducted to examine the role of the cerebral hemispheres in transposed-letter similarity effects. In Experiment 1, we created two types of nonwords: nonadjacent transposed-letter nonwords ("TRADEGIA"; the base word was "TRAGEDIA," the Spanish for "TRAGEDY") and two-letter different…

From Numbers to Letters: Feedback Regularization in Visual Word Recognition

ERIC Educational Resources Information Center

Molinaro, Nicola; Dunabeitia, Jon Andoni; Marin-Gutierrez, Alejandro; Carreiras, Manuel

2010-01-01

Word reading in alphabetic languages involves letter identification, independently of the format in which these letters are written. This process of letter "regularization" is sensitive to word context, leading to the recognition of a word even when numbers that resemble letters are inserted among other real letters (e.g., M4TERI4L). The present…

IRTs of the ABCs: Children's Letter Name Acquisition

PubMed Central

Piasta, Shayne B.; Anthony, Jason L.; Lonigan, Christopher J.; Francis, David J.

2015-01-01

We examined the developmental sequence of letter name knowledge acquisition by children from 2 to five years of age. Data from 2 samples representing diverse regions, ethnicity, and socioeconomic backgrounds (ns = 1074 & 500) were analyzed using item response theory (IRT) and differential item functioning techniques. Results from factor analyses indicated that letter name knowledge represented a unidimensional skill; IRT results yielded significant differences between letters in both difficulty and discrimination. Results also indicated an approximate developmental sequence in letter name learning for the simplest and most challenging to learn letters -- but with no clear sequence between these extremes. Findings also suggested that children were most likely to first learn their first initial. We discuss implications for assessment and instruction. PMID:22710016

Assessing Suppression in Amblyopic Children With a Dichoptic Eye Chart

PubMed Central

Birch, Eileen E.; Morale, Sarah E.; Jost, Reed M.; De La Cruz, Angie; Kelly, Krista R.; Wang, Yi-Zhong; Bex, Peter J.

2016-01-01

Purpose Suppression has a key role in the etiology of amblyopia, and contrast-balanced binocular treatment can overcome suppression and improve visual acuity. Quantitative assessment of suppression could have a role in managing amblyopia. We describe a novel eye chart to assess suppression in children. Methods We enrolled 100 children (7–12 years; 63 amblyopic, 25 nonamblyopic with strabismus or anisometropia, 12 controls) in the primary cohort and 22 children (3–6 years; 13 amblyopic, 9 nonamblyopic) in a secondary cohort. Letters were presented on a dichoptic display (5 letters per line). Children wore polarized glasses so that each eye saw a different letter chart. At each position, the identity of the letter and its contrast on each eye's chart differed. Children read 8 lines of letters for each of 3 letter sizes. The contrast balance ratio was the ratio at which 50% of letters seen by the amblyopic eye were reported. Results Amblyopic children had significantly higher contrast balance ratios for all letter sizes compared to nonamblyopic children and controls, requiring 4.6 to 5.6 times more contrast in the amblyopic eye compared to the fellow eye (P < 0.0001). Amblyopic eye visual acuity was correlated with contrast balance ratio (r ranged from 0.49–0.57 for the 3 letter sizes). Change in visual acuity with amblyopia treatment was correlated with change in contrast balance ratio (r ranged from 0.43–0.62 for the 3 letter sizes). Conclusions Severity of suppression can be monitored as part of a routine clinical exam in the management of amblyopia in children. PMID:27784068

Baseline predictors for one-year visual outcomes with ranibizumab or bevacizumab for neovascular age-related macular degeneration.

PubMed

Ying, Gui-shuang; Huang, Jiayan; Maguire, Maureen G; Jaffe, Glenn J; Grunwald, Juan E; Toth, Cynthia; Daniel, Ebenezer; Klein, Michael; Pieramici, Dante; Wells, John; Martin, Daniel F

2013-01-01

To determine the baseline predictors of visual acuity (VA) outcomes 1 year after treatment with ranibizumab or bevacizumab for neovascular age-related macular degeneration (AMD). Cohort study within the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). A total of 1105 participants with neovascular AMD, baseline VA 20/25 to 20/320, and VA measured at 1 year. Participants were randomly assigned to ranibizumab or bevacizumab on a monthly or as-needed schedule. Masked readers evaluated fundus morphology and features on optical coherence tomography (OCT). Visual acuity was measured using electronic VA testing. Independent predictors were identified using regression techniques. The VA score, VA score change from baseline, and ≥3-line gain at 1 year. At 1 year, the mean VA score was 68 letters, mean improvement from baseline was 7 letters, and 28% of participants gained ≥3 lines. Older age, larger area of choroidal neovascularization (CNV), and elevation of retinal pigment epithelium (RPE) were associated with worse VA (all P<0.005), less gain in VA (all P<0.02), and a lower proportion gaining ≥3 lines (all P<0.04). Better baseline VA was associated with better VA at 1 year, less gain in VA, and a lower proportion gaining ≥3 lines (all P<0.0001). Predominantly or minimally classic lesions were associated with worse VA than occult lesions (66 vs. 69 letters; P=0.0003). Retinal angiomatous proliferans (RAP) lesions were associated with more gain in VA (10 vs. 7 letters; P=0.03) and a higher proportion gaining ≥3 lines (odds ratio, 1.9; 95% confidence interval, 1.2-3.1). Geographic atrophy (GA) was associated with worse VA (64 vs. 68 letters; P=0.02). Eyes with total foveal thickness in the second quartile (325-425 μm) had the best VA (P=0.01) and were most likely to gain ≥3 lines (P=0.004). Predictors did not vary by treatment group. For all treatment groups, older age, better baseline VA, larger CNV area, predominantly or minimally

Representation of Letter Position in Spelling: Evidence from Acquired Dysgraphia

PubMed Central

Fischer-Baum, Simon; McCloskey, Michael; Rapp, Brenda

2010-01-01

The graphemic representations that underlie spelling performance must encode not only the identities of the letters in a word, but also the positions of the letters. This study investigates how letter position information is represented. We present evidence from two dysgraphic individuals, CM and LSS, who perseverate letters when spelling: that is, letters from previous spelling responses intrude into subsequent responses. The perseverated letters appear more often than expected by chance in the same position in the previous and subsequent responses. We used these errors to address the question of how letter position is represented in spelling. In a series of analyses we determined how often the perseveration errors produced maintain position as defined by a number of alternative theories of letter position encoding proposed in the literature. The analyses provide strong evidence that the grapheme representations used in spelling encode letter position such that position is represented in a graded manner based on distance from both edges of the word. PMID:20378104

A crowdful of letters: disentangling the role of similarity, eccentricity and spatial frequencies in letter crowding.

PubMed

Zahabi, Sacha; Arguin, Martin

2014-04-01

The present study investigated the joint impact of target-flanker similarity and of spatial frequency content on the crowding effect in letter identification. We presented spatial frequency filtered letters to neurologically intact non-dyslexic readers while manipulating target-flanker distance, target eccentricity and target-flanker confusability (letter similarity metric based on published letter confusion matrices). The results show that high target-flanker confusability magnifies crowding. They also reveal an intricate pattern of interactions of the spatial frequency content of the stimuli with target eccentricity, flanker distance and similarity. The findings are congruent with the notion that crowding results from the inappropriate pooling of target and flanker features and that this integration is more likely to match a response template at a subsequent decision stage with similar than dissimilar flankers. In addition, the evidence suggests that crowding from similar flankers is biased towards relatively high spatial frequencies and that crowding shifts towards lower spatial frequencies as target eccentricity is increased. Copyright © 2014 Elsevier B.V. All rights reserved.

Exploring Corporate Rhetoric: Metadiscourse in the CEO's Letter.

ERIC Educational Resources Information Center

Hyland, Ken

1998-01-01

Examines how metadiscourse is used to create a positive corporate image in 137 CEOs' letters, showing how CEOs use nonpropositional material to realize rational, credible, and affective appeals. Reveals the essentially rhetorical nature of CEOs' letters by comparing the frequency and distribution of metadiscourse in their letters and directors'…

Correlation Between Near-Vision Acuity and the Incidence of Peritoneal Dialysis-Related Infections.

PubMed

Kojima, Shigeki; Sakurada, Tsutomu; Koitabashi, Kenichiro; Kojima, Kaori; Watanabe, Shiika; Uchida, Daisuke; Kaneshiro, Nagayuki; Konno, Yusuke; Shibagaki, Yugo

Peritoneal dialysis (PD)-related infections (PDIs) such as peritonitis, exit-site infection, and tunnel infection are serious complications affecting patients on PD. Because patients with diabetes (DM) and of older age have increased in number in Japan, the number of patients with visual impairment is estimated also to have increased. Near vision is necessary for performing proper PD daily care. However, no studies have reported whether visual impairment is likely to increase the risk of PDIs.Our study included 31 PD patients (16 men, 15 women; mean age: 61.5 ± 11.8 years; mean PD duration: 27.3 ± 20.3 months; 38.7% with DM; 54.8% wearing glasses) who performed their own PD care. At our facility and related facilities, we used a standard near-vision test chart, which classifies vision into 12 grades, from 0.1 (poor) to 1.5 (clear), to assess near-vision binocular visual acuity in those patients between March 2015 and September 2015. In addition, we retrospectively examined the medical records of the patients to determine their history of PDIs. We then evaluated the correlation between near-vision acuity and the incidence of PDIs.Mean measured near-vision acuity was 0.61 ± 0.29, and we observed no significant difference in the visual acuity of patients with and without DM (0.55 ± 0.31 vs. 0.63 ± 0.26 respectively, p = 0.477). In addition, we observed no significant difference in the incidence of PDIs between patients with and without DM (1.298 ± 1.609 per year vs. 1.164 ± 0.908 per year respectively, p = 0.804). We did not find a correlation between near-vision acuity and the incidence of PDIs (r = -0.071, p = 0.795).

Development of Early Handwriting: Visual-Motor Control During Letter Copying

PubMed Central

Maldarelli, Jennifer E.; Kahrs, Björn A.; Hunt, Sarah C.; Lockman, Jeffrey J.

2015-01-01

Despite the importance of handwriting for school readiness and early academic progress, prior research on the development of handwriting has focused primarily on the product rather than the process by which young children write letters. In contrast, in the present work, early handwriting is viewed as involving a suite of perceptual, motor and cognitive abilities, which must work in unison if children are to write letters efficiently. To study such coordination, head-mounted eye-tracking technology was used to investigate the process of visual-motor coordination while kindergarten children (N=23) and adults (N=11) copied individual letters and strings of letters that differed in terms of their phonemic properties. Results indicated that kindergarten children were able to copy single letters efficiently, as did adults. When the cognitive demands of the task increased and children were presented with strings of letters, however, their ability to copy letters efficiently was compromised: children frequently interrupted their writing mid-letter, whereas they did not do so on single letter trials. Yet, with increasing age, children became more efficient in copying letter strings, in part by using vision more prospectively when writing. Taken together, the results illustrate how the coordination of perceptual, motor and cognitive processes contributes to advances in the development of letter writing skill. PMID:26029821

An Acuity Tool for Heart Failure Case Management: Quantifying Workload, Service Utilization, and Disease Severity.

PubMed

Kilgore, Matthew D

The cardiology service line director at a health maintenance organization (HMO) in Washington State required a valid, reliable, and practical means for measuring workloads and other productivity factors for six heart failure (HF) registered nurse case managers located across three geographical regions. The Kilgore Heart Failure Case Management (KHFCM) Acuity Tool was systematically designed, developed, and validated to measure workload as a dependent function of the number of heart failure case management (HFCM) services rendered and the duration of times spent on various care duties. Research and development occurred at various HMO-affiliated internal medicine and cardiology offices throughout Western Washington. The concepts, methods, and principles used to develop the KHFCM Acuity Tool are applicable for any type of health care professional aiming to quantify workload using a high-quality objective tool. The content matter, scaling, and language on the KHFCM Acuity Tool are specific to HFCM settings. The content matter and numeric scales for the KHFCM Acuity Tool were developed and validated using a mixed-method participant action research method applied to a group of six outpatient HF case managers and their respective caseloads. The participant action research method was selected, because the application of this method requires research participants to become directly involved in the diagnosis of research problems, the planning and execution of actions taken to address those problems, and the implementation of progressive strategies throughout the course of the study, as necessary, to produce the most credible and practical practice improvements (; ; ; ). Heart failure case managers served clients with New York Heart Association Functional Class III-IV HF (), and encounters were conducted primarily by telephone or in-office consultation. A mix of qualitative and quantitative results demonstrated a variety of quality improvement outcomes achieved by the design

33 CFR 181.17 - Label numbers and letters.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Label numbers and letters. 181.17...) BOATING SAFETY MANUFACTURER REQUIREMENTS Manufacturer Certification of Compliance § 181.17 Label numbers and letters. Letters and numbers on each label must: (a) Be no less than one-eighth of an inch in...

33 CFR 181.17 - Label numbers and letters.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Label numbers and letters. 181.17...) BOATING SAFETY MANUFACTURER REQUIREMENTS Manufacturer Certification of Compliance § 181.17 Label numbers and letters. Letters and numbers on each label must: (a) Be no less than one-eighth of an inch in...

The effects of a flexible visual acuity-driven ranibizumab treatment regimen in age-related macular degeneration: outcomes of a drug and disease model.

PubMed

Holz, Frank G; Korobelnik, Jean-François; Lanzetta, Paolo; Mitchell, Paul; Schmidt-Erfurth, Ursula; Wolf, Sebastian; Markabi, Sabri; Schmidli, Heinz; Weichselberger, Andreas

2010-01-01

Differences in treatment responses to ranibizumab injections observed within trials involving monthly (MARINA and ANCHOR studies) and quarterly (PIER study) treatment suggest that an individualized treatment regimen may be effective in neovascular age-related macular degeneration. In the present study, a drug and disease model was used to evaluate the impact of an individualized, flexible treatment regimen on disease progression. For visual acuity (VA), a model was developed on the 12-month data from ANCHOR, MARINA, and PIER. Data from untreated patients were used to model patient-specific disease progression in terms of VA loss. Data from treated patients from the period after the three initial injections were used to model the effect of predicted ranibizumab vitreous concentration on VA loss. The model was checked by comparing simulations of VA outcomes after monthly and quarterly injections during this period with trial data. A flexible VA-guided regimen (after the three initial injections) in which treatment is initiated by loss of >5 letters from best previously observed VA scores was simulated. Simulated monthly and quarterly VA-guided regimens showed good agreement with trial data. Simulation of VA-driven individualized treatment suggests that this regimen, on average, sustains the initial gains in VA seen in clinical trials at month 3. The model predicted that, on average, to maintain initial VA gains, an estimated 5.1 ranibizumab injections are needed during the 9 months after the three initial monthly injections, which amounts to a total of 8.1 injections during the first year. A flexible, individualized VA-guided regimen after the three initial injections may sustain vision improvement with ranibizumab and could improve cost-effectiveness and convenience and reduce drug administration-associated risks.

50 CFR 216.257 - Letters of Authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MAMMALS Taking Marine Mammals Incidental to Conducting Precision Strike Weapon Missions in the Gulf of Mexico § 216.257 Letters of Authorization. (a) A Letter of Authorization, unless suspended or revoked...

Teaching Letter Formation.

ERIC Educational Resources Information Center

Graham, Steve; Madan, Avi J.

1981-01-01

The authors describe a remedial technique for teaching letter formation to students with handwriting difficulties. The approach blends traditional procedures (modeling, physical prompts, tracing, self correction, etc.) with cognitive behavior modification principles. (CL)

Left cortical specialization for visual letter strings predicts rudimentary knowledge of letter-sound association in preschoolers

PubMed Central

Lochy, Aliette; Van Reybroeck, Marie; Rossion, Bruno

2016-01-01

Reading, one of the most important cultural inventions of human society, critically depends on posterior brain areas of the left hemisphere in proficient adult readers. In children, this left hemispheric cortical specialization for letter strings is typically detected only after approximately 1 y of formal schooling and reading acquisition. Here, we recorded scalp electrophysiological (EEG) brain responses in 5-y-old (n = 40) prereaders presented with letter strings appearing every five items in rapid streams of pseudofonts (6 items per second). Within 2 min of recording only, letter strings evoked a robust specific response over the left occipito-temporal cortex at the predefined frequency of 1.2 Hz (i.e., 6 Hz/5). Interindividual differences in the amplitude of this electrophysiological response are significantly related to letter knowledge, a preschool predictor of later reading ability. These results point to the high potential of this rapidly collected behavior-free measure to assess reading ability in developmental populations. These findings were replicated in a second experiment (n = 26 preschool children), where familiar symbols and line drawings of objects evoked right-lateralized and bilaterally specific responses, respectively, showing the specificity of the early left hemispheric dominance for letter strings. Collectively, these findings indicate that limited knowledge of print in young children, before formal education, is sufficient to develop specialized left lateralized neuronal circuits, thereby pointing to an early onset and rapid impact of left hemispheric reentrant sound mapping on posterior cortical development. PMID:27402739

7 CFR 1773.33 - Management letter.

Code of Federal Regulations, 2013 CFR

2013-01-01

... letter. The CPA must prepare a management letter that includes, at a minimum, comments on: (a) Audit... condition and operations. For borrowers with a December 31 year end, the CPA must state whether the... other than December 31, the CPA must state whether the information appears reasonable based upon the...

7 CFR 1773.33 - Management letter.

Code of Federal Regulations, 2012 CFR

2012-01-01

... letter. The CPA must prepare a management letter that includes, at a minimum, comments on: (a) Audit... condition and operations. For borrowers with a December 31 year end, the CPA must state whether the... other than December 31, the CPA must state whether the information appears reasonable based upon the...

7 CFR 1773.33 - Management letter.

Code of Federal Regulations, 2011 CFR

2011-01-01

... letter. The CPA must prepare a management letter that includes, at a minimum, comments on: (a) Audit... condition and operations. For borrowers with a December 31 year end, the CPA must state whether the... other than December 31, the CPA must state whether the information appears reasonable based upon the...

Cognitive Determinants of Early Letter Knowledge

ERIC Educational Resources Information Center

Helal, Suha; Weil-Barais, Annick

2015-01-01

The present study investigated the general cognitive determinants of alphabetic letter knowledge. It involved 60 French kindergarten children (mean age: five years six months). Two test batteries were used: the CMS to evaluate general cognitive abilities (memory, attention, and learning), and the LKT to assess letter knowledge and its various…

Developing a Standardized Letter of Recommendation

ERIC Educational Resources Information Center

Walters, Alyssa M.; Kyllonen, Patrick C.; Plante, Janice W.

2006-01-01

The Standardized Letter of Recommendation (SLR) is a Web-based admission tool designed to replace traditional, narrative letters of recommendation with a more systematic and equitable source of information about applicants to institutions of higher education. The SLR includes a rating scale and open-ended response space that prompt evaluators to…

Influence of Passive Joint Stiffness on Proprioceptive Acuity in Individuals With Functional Instability of the Ankle.

PubMed

Marinho, Hellen Veloso Rocha; Amaral, Giovanna Mendes; de Souza Moreira, Bruno; Araújo, Vanessa Lara; Souza, Thales Rezende; Ocarino, Juliana Melo; da Fonseca, Sérgio Teixeira

2017-12-01

Study Design Controlled laboratory study, cross-sectional. Background Deficits in ankle proprioceptive acuity have been reported in persons with functional instability of the ankle. Passive stiffness has been proposed as a possible mechanism underlying proprioceptive acuity. Objective To compare proprioceptive acuity and passive ankle stiffness in persons with and without functional ankle instability, and to assess the influence of passive joint stiffness on proprioceptive acuity in persons with functional ankle instability. Methods A sample of 18 subjects with and 18 without complaints of functional ankle instability following lateral ankle sprain participated. An isokinetic dynamometer was used to compare motion perception threshold, passive position sense, and passive ankle stiffness between groups. To evaluate the influence of passive stiffness on proprioceptive acuity, individuals in the lateral functional ankle instability group were divided into 2 subgroups: "high" and "low" passive ankle stiffness. Results The functional ankle instability group exhibited increased motion perception threshold when compared with the corresponding limb of the control group. Between-group differences were not found for passive position sense and passive ankle stiffness. Those in the functional ankle instability group with higher passive ankle stiffness had smaller motion perception thresholds than those with lower passive ankle stiffness. Conclusion Unlike motion perception threshold, passive position sense is not affected by the presence of functional ankle instability. Passive ankle stiffness appears to influence proprioceptive acuity in persons with functional ankle instability. J Orthop Sports Phys Ther 2017;47(12):899-905. Epub 7 Oct 2017. doi:10.2519/jospt.2017.7030.

Safety and Effectiveness of Cataract Surgery with Simultaneous Intravitreal Anti-VEGF in Patients with Previously Treated Exudative Age-Related Macular Degeneration.

PubMed

Falcão, Manuel Sousa; Freitas-Costa, Paulo; Beato, João Nuno; Pinheiro-Costa, João; Rocha-Sousa, Amândio; Carneiro, Ângela; Brandão, Elisete Maria; Falcão-Reis, Fernando

2017-02-27

To evaluate the safety and impact on visual acuity, retinal and choroidal morphology of simultaneous cataract surgery and intravitreal anti-vascular endothelial growth factor on patients with visually significant cataracts and previously treated exudative age-related macular degeneration. Prospective study, which included 21 eyes of 20 patients with exudative age-related macular degeneration submitted to simultaneous phacoemulsification and intravitreal ranibizumab or bevacizumab. The patients were followed for 12 months after surgery using a pro re nata strategy. Visual acuity, foveal and choroidal thickness changes were evaluated 1, 6 and 12 months post-operatively. There was a statistically significant increase in mean visual acuity at one (13.4 letters, p < 0.05), six (11.5 letters, p < 0.05) and twelve months (11.3 letters, p < 0.05) without significant changes in retinal or choroidal morphology. At 12 months, 86% of eyes were able to maintain visual acuity improvement. There were no significant differences between the two anti-vascular endothelial growth factor drugs and no complications developed during follow-up. Simultaneous phacoemulsification and intravitreal anti- vascular endothelial growth factor is safe and allows improvement in visual acuity in patients with visually significant cataracts and exudative age-related macular degeneration. Visual acuity gains were maintained with a pro re nata strategy showing that in this subset of patients, phacoemulsification may be beneficial. Cataract surgery and simultaneous anti-vascular endothelial growth factor therapy improves visual acuity in patients with exudative age-related macular degeneration.

Age Changes in the Missing-Letter Effect Revisited

ERIC Educational Resources Information Center

Saint-Aubin, J.; Klein, R.M.; Landry, T.

2005-01-01

When participants search for a target letter while reading, they make more omissions if the target letter is embedded in frequent function words than in less frequent content words. Reflecting developmental changes in component language and literacy skills, the size of this effect increases with age. With adults, the missing-letter effect is due…

Gender differences in recommendation letters for postdoctoral fellowships in geoscience

NASA Astrophysics Data System (ADS)

Dutt, Kuheli; Pfaff, Danielle L.; Bernstein, Ariel F.; Dillard, Joseph S.; Block, Caryn J.

2016-11-01

Gender disparities in the fields of science, technology, engineering and mathematics, including the geosciences, are well documented and widely discussed. In the geosciences, despite receiving 40% of doctoral degrees, women hold less than 10% of full professorial positions. A significant leak in the pipeline occurs during postdoctoral years, so biases embedded in postdoctoral processes, such as biases in recommendation letters, may be deterrents to careers in geoscience for women. Here we present an analysis of an international data set of 1,224 recommendation letters, submitted by recommenders from 54 countries, for postdoctoral fellowships in the geosciences over the period 2007-2012. We examine the relationship between applicant gender and two outcomes of interest: letter length and letter tone. Our results reveal that female applicants are only half as likely to receive excellent letters versus good letters compared to male applicants. We also find no evidence that male and female recommenders differ in their likelihood to write stronger letters for male applicants over female applicants. Our analysis also reveals significant regional differences in letter length, with letters from the Americas being significantly longer than any other region, whereas letter tone appears to be distributed equivalently across all world regions. These results suggest that women are significantly less likely to receive excellent recommendation letters than their male counterparts at a critical juncture in their career.

[The role of external letter positions in visual word recognition].

PubMed

Perea, Manuel; Lupker, Sthephen J

2007-11-01

A key issue for any computational model of visual word recognition is the choice of an input coding schema, which is responsible for assigning letter positions. Such a schema must reflect the fact that, according to recent research, nonwords created by transposing letters (e.g., caniso for CASINO ), typically, appear to be more similar to the word than nonwords created by replacing letters (e.g., caviro ). In the present research, we initially carried out a computational analysis examining the degree to which the position of the transposition influences transposed-letter similarity effects. We next conducted a masked priming experiment with the lexical decision task to determine whether a transposed-letter priming advantage occurs when the first letter position is involved. Primes were created by either transposing the first and third letters (démula-MEDULA ) or replacing the first and third letters (bérula-MEDULA). Results showed that there was no transposed-letter priming advantage in this situation. We discuss the implications of these results for models of visual word recognition.

Sixty-Minute Review of Letter Writing

ERIC Educational Resources Information Center

Cunningham, Donald H.; Graham, Louise

1974-01-01

The article describes a one-hour presentation which provides a basic stereotyped pattern of letter organization for the four types of letters (order, request, claim, and reply) the business of secretarial student is most likely to have to write. The four paragraphs of the pattern are: purpose, explanation, optional, and closing. (AG)

Effect of stimulus configuration on crowding in strabismic amblyopia.

PubMed

Norgett, Yvonne; Siderov, John

2017-11-01

Foveal vision in strabismic amblyopia can show increased levels of crowding, akin to typical peripheral vision. Target-flanker similarity and visual-acuity test configuration may cause the magnitude of crowding to vary in strabismic amblyopia. We used custom-designed visual acuity tests to investigate crowding in observers with strabismic amblyopia. LogMAR was measured monocularly in both eyes of 11 adults with strabismic or mixed strabismic/anisometropic amblyopia using custom-designed letter tests. The tests used single-letter and linear formats with either bar or letter flankers to introduce crowding. Tests were presented monocularly on a high-resolution display at a test distance of 4 m, using standardized instructions. For each condition, five letters of each size were shown; testing continued until three letters of a given size were named incorrectly. Uncrowded logMAR was subtracted from logMAR in each of the crowded tests to highlight the crowding effect. Repeated-measures ANOVA showed that letter flankers and linear presentation individually resulted in poorer performance in the amblyopic eyes (respectively, mean normalized logMAR = 0.29, SE = 0.07, mean normalized logMAR = 0.27, SE = 0.07; p < 0.05) and together had an additive effect (mean = 0.42, SE = 0.09, p < 0.001). There was no difference across the tests in the fellow eyes (p > 0.05). Both linear presentation and letter rather than bar flankers increase crowding in the amblyopic eyes of people with strabismic amblyopia. These results suggest the influence of more than one mechanism contributing to crowding in linear visual-acuity charts with letter flankers.

Calibration-free gaze tracking for automatic measurement of visual acuity in human infants.

PubMed

Xiong, Chunshui; Huang, Lei; Liu, Changping

2014-01-01

Most existing vision-based methods for gaze tracking need a tedious calibration process. In this process, subjects are required to fixate on a specific point or several specific points in space. However, it is hard to cooperate, especially for children and human infants. In this paper, a new calibration-free gaze tracking system and method is presented for automatic measurement of visual acuity in human infants. As far as I know, it is the first time to apply the vision-based gaze tracking in the measurement of visual acuity. Firstly, a polynomial of pupil center-cornea reflections (PCCR) vector is presented to be used as the gaze feature. Then, Gaussian mixture models (GMM) is employed for gaze behavior classification, which is trained offline using labeled data from subjects with healthy eyes. Experimental results on several subjects show that the proposed method is accurate, robust and sufficient for the application of measurement of visual acuity in human infants.

Copying referral letters to patients: prepare for change.

PubMed

White, Philip

2004-08-01

The National Health Service (NHS) Plan for England has directed that from April 2004 clinicians will offer patients the opportunity to receive copies of letters that are written about them. Patients like to have more information and patients who have received copies of letters have found them useful. It is hoped that copying letters will improve relationships between doctors and patients, encourage patients to be better informed, and improve the quality of information provided to patients. Relatively little empirical research has been performed in this area but what exists is generally supportive. Attention will need to be paid to issues of confidentiality, the language and content of letters, and individuals who may have difficulty obtaining information from letters. This initiative is one of many that the NHS has introduced to enhance openness, honesty and the quality of information provided to patients.

[Visual acuity in anti-VEGF therapy for AMD : Can specific characteristics in the SD-OCT help?

PubMed

Book, B; Ziegler, M; Heimes, B; Gutfleisch, M; Spital, G; Pauleikhoff, D; Lommatzsch, A

2017-01-01

The efficacy of anti-VEGF therapy in exudative AMD has been established in several large clinical trials using a fixed injection regimen as well as a SD-OCT-based PRN regimen. In these studies, after the first three injections, an increase of the mean visual acuity was observed, which could be stabilized with constant treatment for up to 24 months. However, the specific course of the visual acuity is very different between individuals. The aim of the present study was to correlate specific initial SD-OCT parameters with the course of visual acuity in order to characterize factors that may be important for the individual visual prognosis. In a prospective case study, the visual course and SD-OCT changes of 156 patients with minimum follow-up of 12 months (mean 80.1 months) were analysed. Visual acuity (LogMar) was investigated at regular intervals and correlated with specific SD-OCT parameters (foveal thickness, height of sub-retinal fluid or presence of associated PED, presence of intra-retinal cysts, length of IS/OS break, choroidal thickness). The initial increase in visual acuity could be stabilized over time. This effect was associated with a decrease in foveal retinal thickness, which also persisted over time. While sub-retinal fluid, presence of PED, and choroidal thickness showed no prognostic relevance for the change in visual acuity, the presence of more advanced central retinal thickness, of intra-retinal cysts or a longer break in the IS/OS junction were associated with a less favourable development of visual acuity. In the present study, the presence of more advanced central retinal thickness, of intra-retinal cysts or a larger IS/OS break correlated significantly with a worse visual prognosis. These might be clinical signs for more extensive pre-existing intra-retinal changes. Further analysis and new diagnostic tools may prove this and may result in specific additive neuroprotective or regenerative therapeutic approaches in exudative AMD.

Record bid for Einstein letter

NASA Astrophysics Data System (ADS)

Jeandron, Michelle

2008-06-01

A letter written by Albert Einstein the year before his death has sold for the staggering amount of £170 000 at an auction in London last month. The previously unrecorded letter, which has spent the past 50 years in a private collection, includes a discussion of Einstein's views on religion, bringing new material to the debate about whether or not he believed in God. The lot had been expected to fetch between £6000-£8000.

Distinct eye movement patterns enhance dynamic visual acuity.

PubMed

Palidis, Dimitrios J; Wyder-Hodge, Pearson A; Fooken, Jolande; Spering, Miriam

2017-01-01

Dynamic visual acuity (DVA) is the ability to resolve fine spatial detail in dynamic objects during head fixation, or in static objects during head or body rotation. This ability is important for many activities such as ball sports, and a close relation has been shown between DVA and sports expertise. DVA tasks involve eye movements, yet, it is unclear which aspects of eye movements contribute to successful performance. Here we examined the relation between DVA and the kinematics of smooth pursuit and saccadic eye movements in a cohort of 23 varsity baseball players. In a computerized dynamic-object DVA test, observers reported the location of the gap in a small Landolt-C ring moving at various speeds while eye movements were recorded. Smooth pursuit kinematics-eye latency, acceleration, velocity gain, position error-and the direction and amplitude of saccadic eye movements were linked to perceptual performance. Results reveal that distinct eye movement patterns-minimizing eye position error, tracking smoothly, and inhibiting reverse saccades-were related to dynamic visual acuity. The close link between eye movement quality and DVA performance has important implications for the development of perceptual training programs to improve DVA.

Distinct eye movement patterns enhance dynamic visual acuity

PubMed Central

Palidis, Dimitrios J.; Wyder-Hodge, Pearson A.; Fooken, Jolande; Spering, Miriam

2017-01-01

Dynamic visual acuity (DVA) is the ability to resolve fine spatial detail in dynamic objects during head fixation, or in static objects during head or body rotation. This ability is important for many activities such as ball sports, and a close relation has been shown between DVA and sports expertise. DVA tasks involve eye movements, yet, it is unclear which aspects of eye movements contribute to successful performance. Here we examined the relation between DVA and the kinematics of smooth pursuit and saccadic eye movements in a cohort of 23 varsity baseball players. In a computerized dynamic-object DVA test, observers reported the location of the gap in a small Landolt-C ring moving at various speeds while eye movements were recorded. Smooth pursuit kinematics—eye latency, acceleration, velocity gain, position error—and the direction and amplitude of saccadic eye movements were linked to perceptual performance. Results reveal that distinct eye movement patterns—minimizing eye position error, tracking smoothly, and inhibiting reverse saccades—were related to dynamic visual acuity. The close link between eye movement quality and DVA performance has important implications for the development of perceptual training programs to improve DVA. PMID:28187157

Evaluating the construct of triage acuity against a set of reference vignettes developed via modified Delphi method.

PubMed

Twomey, Michèle; Wallis, Lee A; Myers, Jonathan E

2014-07-01

To evaluate the construct of triage acuity as measured by the South African Triage Scale (SATS) against a set of reference vignettes. A modified Delphi method was used to develop a set of reference vignettes. Delphi participants completed a 2-round consensus-building process, and independently assigned triage acuity ratings to 100 written vignettes unaware of the ratings given by others. Triage acuity ratings were summarised for all vignettes, and only those that reached 80% consensus during round 2 were included in the reference set. Triage ratings for the reference vignettes given by two independent experts using the SATS were compared with the ratings given by the international Delphi panel. Measures of sensitivity, specificity, associated percentages for over-triage/under-triage were used to evaluate the construct of triage acuity (as measured by the SATS) by examining the association between the ratings by the two experts and the international panel. On completion of the Delphi process, 42 of the 100 vignettes reached 80% consensus on their acuity rating and made up the reference set. On average, over all acuity levels, sensitivity was 74% (CI 64% to 82%), specificity 92% (CI 87% to 94%), under-triage occurred 14% (CI 8% to 23%) and over-triage 12% (CI 8% to 23%) of the time. The results of this study provide an alternative to evaluating triage scales against the construct of acuity as measured with the SATS. This method of using 80% consensus vignettes may, however, systematically bias the validity estimate towards better performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Case of the Purloined Letter.

ERIC Educational Resources Information Center

Zirkel, Perry A.

2003-01-01

Analyzes Arkansas case wherein the Eighth Circuit held 6-5 that letter written by seventh-grade student threatening violence against his former girl friend was not protected by the First Amendment even though a friend took the letter from student's home without his knowledge and gave it to the girl. Upheld board's decision to expel student.…

Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome

PubMed Central

Duke, Roseline E.; Adio, Adedayo; Oparah, Sidney K.; Odey, Friday; Eyo, Okon A.

2016-01-01

Purpose: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. Materials and Method: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. Results: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit. PMID:27347247

CHANGES IN CENTRAL CHOROIDAL THICKNESS AFTER TREATMENT OF DIABETIC MACULAR EDEMA WITH INTRAVITREAL BEVACIZUMAB CORRELATION WITH CENTRAL MACULAR THICKNESS AND BEST-CORRECTED VISUAL ACUITY.

PubMed

Nourinia, Ramin; Ahmadieh, Hamid; Nekoei, Elnaz; Malekifar, Parviz; Tofighi, Zahra

2018-05-01

To assess the effect of intravitreal injection of bevacizumab on central choroidal thickness (CCT) and its relationship with central macular thickness (CMT) and best-corrected visual acuity (BCVA) changes in eyes with center-involving diabetic macular edema. This prospective interventional case series included 20 eyes of 20 patients with center-involving diabetic macular edema naive to treatment. The BCVA assessment, complete eye examination, enhanced depth optical coherence tomography, and fluorescein angiography were performed at baseline followed by 3 monthly intravitreal injection of bevacizumab. The treated eyes underwent BCVA evaluation and enhanced depth optical coherence tomography at Months 1, 2, 3, and 6 after the first injection. Change of the CCT was the primary outcome measure. Secondary outcome measures included BCVA and CMT changes and their relationship with CCT changes. Mean age of patients was 63.1 ± 8.0 (range, 52-75) years. Mean baseline CCT was 265 ± 79 μm, which reduced to 251 ± 81 μm and 232 ± 82 μm at Months 3 and 6, respectively (P < 0.001). Corresponding values for CMT were 470 ± 107 μm, 392 ± 104 μm, and 324 ± 122 μm, respectively (P < 0.001). The BCVA improved from 20/60 at baseline to 20/50 at Month 3 and 20/40 at Month 6 (P = 0.007). Each 1 μm decrease in CCT was associated with 2.74 μm reduction in CMT and 0.1 Early Treatment Diabetic Retinopathy Study letter score improvement in BCVA (P < 0.001 and P = 0.001, respectively). After treatment of diabetic macular edema with intravitreal injection of bevacizumab, CCT decreased and this reduction significantly correlated with CMT reduction and vision improvement.

Development of early handwriting: Visual-motor control during letter copying.

PubMed

Maldarelli, Jennifer E; Kahrs, Björn A; Hunt, Sarah C; Lockman, Jeffrey J

2015-07-01

Despite the importance of handwriting for school readiness and early academic progress, prior research on the development of handwriting has focused primarily on the product rather than the process by which young children write letters. In contrast, in the present work, early handwriting is viewed as involving a suite of perceptual, motor, and cognitive abilities, which must work in unison if children are to write letters efficiently. To study such coordination, head-mounted eye-tracking technology was used to investigate the process of visual-motor coordination while kindergarten children (N = 23) and adults (N = 11) copied individual letters and strings of letters that differed in terms of their phonemic properties. Results indicated that kindergarten children were able to copy single letters efficiently, as did adults. When the cognitive demands of the task increased and children were presented with strings of letters, however, their ability to copy letters efficiently was compromised: Children frequently interrupted their writing midletter, whereas they did not do so on single letter trials. Yet, with increasing age, children became more efficient in copying letter strings, in part by using vision more prospectively when writing. Taken together, the results illustrate how the coordination of perceptual, motor, and cognitive processes contributes to advances in the development of letter writing skill. (c) 2015 APA, all rights reserved).

Near visual acuity for everyday activities with accommodative and monofocal intraocular lenses.

PubMed

Sanders, Donald R; Sanders, Monica L

2007-10-01

To determine the levels of functional near visual acuity required for everyday social reading activities and to compare the levels to those attained with accommodative and monofocal intraocular lenses (LOLs). Font size equivalencies of an Early Treatment Diabetic Retinopathy Study near chart and a variety of commonly read print objects were determined and correlated to the findings of distance-corrected near vision measurements with 2 accommodative (Tetraflex, 1CU) and 1 monofocal (Acrysof MA30) IOLs. The smallest print objects studied were sweetener packets with type between 20/40 (Jaeger [J] 5) and 20/50 (J6). Type in classified ads, stock quotations, and pocket bibles was 20/50 (J6), type in a telephone directory was 20/63 (J8), and type in standard newspapers, journals, and magazines was 20/80 (J9). Tested monocularly, 88% of Tetraflex, 40% of ICU, and 7% of Acrysof MA30 eyes had distance-corrected near vision sufficient to read newspaper and telephone directory print, and 63% of Tetraflex, 30% of 1CU, and 0% of Acrysof MA30 eyes could read classified ads, stock quotations, and pocket bibles, respectively. Tested binocularly after bilateral implantation, 96% of Tetraflex patients could read telephone directory print and 89% could read ads, stock quotations, and pocket bibles. Functional near visual acuity is not equivalent to the bottom-line objective at 20/20 (J1) near visual acuity. No print size was found at or smaller than 20/40 (J5), indicating that a requirement of nearly perfect near visual acuity, while desirable, may not be necessary for patients' social reading needs for accommodative IOLs.

A Comparison of Patched HOTV Visual Acuity and Photoscreening

ERIC Educational Resources Information Center

Leman, Rachel; Clausen, Michelle M.; Bates, Janice; Stark, Lee; Arnold, Koni K.; Arnold, Robert W.

2006-01-01

Early detection of significant vision problems in children is a high priority for pediatricians and school nurses. Routine vision screening is a necessary part of that detection and has traditionally involved acuity charts. However, photoscreening in which "red eye" is elicited to show whether each eye is focusing may outperform routine acuity…

Visual Acuity is Related to Parafoveal Retinal Thickness in Patients with Retinitis Pigmentosa and Macular Cysts

PubMed Central

Brockhurst, Robert J.; Gaudio, Alexander R.; Berson, Eliot L.

2008-01-01

Purpose To quantify the prevalence and effect on visual acuity of macular cysts in a large cohort of patients with retinitis pigmentosa. Methods In 316 patients with typical forms of retinitis pigmentosa, we measured visual acuities with Early Treatment Diabetic Retinopathy Study (ETDRS) charts, detected macular cysts with optical coherence tomography (OCT), and quantified retinal thicknesses by OCT. We used the FREQ, LOGISTIC, and GENMOD procedures of SAS to evaluate possible risk factors for cyst prevalence and the MIXED procedure to quantify the relationships of visual acuity to retinal thickness measured at different locations within the macula. Results We found macular cysts in 28% of the patients, 40% of whom had cysts in only one eye. Macular cysts were seen most often in patients with dominant disease and not at all in patients with X-linked disease (p = 0.006). In eyes with macular cysts, multiple regression analysis revealed that visual acuity was inversely and independently related to retinal thickness at the foveal center (p = 0.038) and within a ring spanning an eccentricity of 5° to 10° from the foveal center (p = 0.004). Conclusions Macular cysts are a common occurrence in retinitis pigmentosa, especially among patients with dominantly-inherited disease. Visual acuity is influenced by edema in the parafovea, as well as in the fovea. PMID:18552390

Letter position coding across modalities: the case of Braille readers.

PubMed

Perea, Manuel; García-Chamorro, Cristina; Martín-Suesta, Miguel; Gómez, Pablo

2012-01-01

The question of how the brain encodes letter position in written words has attracted increasing attention in recent years. A number of models have recently been proposed to accommodate the fact that transposed-letter stimuli like jugde or caniso are perceptually very close to their base words. Here we examined how letter position coding is attained in the tactile modality via Braille reading. The idea is that Braille word recognition may provide more serial processing than the visual modality, and this may produce differences in the input coding schemes employed to encode letters in written words. To that end, we conducted a lexical decision experiment with adult Braille readers in which the pseudowords were created by transposing/replacing two letters. We found a word-frequency effect for words. In addition, unlike parallel experiments in the visual modality, we failed to find any clear signs of transposed-letter confusability effects. This dissociation highlights the differences between modalities. The present data argue against models of letter position coding that assume that transposed-letter effects (in the visual modality) occur at a relatively late, abstract locus.

Letter-Sound Reading: Teaching Preschool Children Print-to-Sound Processing

PubMed Central

2015-01-01

This intervention study investigated the growth of letter sound reading and growth of consonant–vowel–consonant (CVC) word decoding abilities for a representative sample of 41 US children in preschool settings. Specifically, the study evaluated the effectiveness of a 3-step letter-sound teaching intervention in teaching pre-school children to decode, or read, single letters. The study compared a control group, which received the preschool’s standard letter-sound instruction, to an intervention group which received a 3-step letter-sound instruction intervention. The children’s growth in letter-sound reading and CVC word decoding abilities were assessed at baseline and 2, 4, 6 and 8 weeks. When compared to the control group, the growth of letter-sound reading ability was slightly higher for the intervention group. The rate of increase in letter-sound reading was significantly faster for the intervention group. In both groups, too few children learned to decode any CVC words to allow for analysis. Results of this study support the use of the intervention strategy in preschools for teaching children print-to-sound processing. PMID:26839494

The Effectiveness of Pictured Letters Mnemonics Strategy in Learning Similar English Language Letters among Students with Learning Disabilities

ERIC Educational Resources Information Center

Dakhiel, Maysoon A.; Al Rub, Mohammed O. Abu

2017-01-01

The present study aims to investigate the effectiveness of pictured letters mnemonics strategy in learning similar English language letters among students with learning disabilities in Saudi Arabia according to experimental group (1) and (2), control group, gender, and interaction between them. The study sample comprised (90) students with…

Learning of Letter Names and Sounds and Their Contribution to Word Recognition

ERIC Educational Resources Information Center

Levin, Iris; Shatil-Carmon, Sivan; Asif-Rave, Ornit

2006-01-01

This study investigated knowledge of letter names and letter sounds, their learning, and their contributions to word recognition. Of 123 preschoolers examined on letter knowledge, 65 underwent training on both letter names and letter sounds in a counterbalanced order. Prior to training, children were more advanced in associating letters with their…

The effects of alphabet and expertise on letter perception

PubMed Central

Wiley, Robert W.; Wilson, Colin; Rapp, Brenda

2016-01-01

Long-standing questions in human perception concern the nature of the visual features that underlie letter recognition and the extent to which the visual processing of letters is affected by differences in alphabets and levels of viewer expertise. We examined these issues in a novel approach using a same-different judgment task on pairs of letters from the Arabic alphabet with two participant groups—one with no prior exposure to Arabic and one with reading proficiency. Hierarchical clustering and linear mixed-effects modeling of reaction times and accuracy provide evidence that both the specific characteristics of the alphabet and observers’ previous experience with it affect how letters are perceived and visually processed. The findings of this research further our understanding of the multiple factors that affect letter perception and support the view of a visual system that dynamically adjusts its weighting of visual features as expert readers come to more efficiently and effectively discriminate the letters of the specific alphabet they are viewing. PMID:26913778

The Indirect Empathic Approach to Claim Letters.

ERIC Educational Resources Information Center

Bell, James D.

1985-01-01

In discussing letter-writing methods for business communication classes, the article explains that claim letter formats other than the direct approach are not only legitimate, but also effective, and suggests that the approach selected should depend upon the circumstances surrounding the claim. (CT)

Association between individual differences in non-symbolic number acuity and math performance: a meta-analysis.

PubMed

Chen, Qixuan; Li, Jingguang

2014-05-01

Many recent studies have examined the association between number acuity, which is the ability to rapidly and non-symbolically estimate the quantity of items appearing in a scene, and symbolic math performance. However, various contradictory results have been reported. To comprehensively evaluate the association between number acuity and symbolic math performance, we conduct a meta-analysis to synthesize the results observed in previous studies. First, a meta-analysis of cross-sectional studies (36 samples, N = 4705) revealed a significant positive correlation between these skills (r = 0.20, 95% CI = [0.14, 0.26]); the association remained after considering other potential moderators (e.g., whether general cognitive abilities were controlled). Moreover, a meta-analysis of longitudinal studies revealed 1) that number acuity may prospectively predict later math performance (r = 0.24, 95% CI = [0.11, 0.37]; 6 samples) and 2) that number acuity is retrospectively correlated to early math performance as well (r = 0.17, 95% CI = [0.07, 0.26]; 5 samples). In summary, these pieces of evidence demonstrate a moderate but statistically significant association between number acuity and math performance. Based on the estimated effect sizes, power analyses were conducted, which suggested that many previous studies were underpowered due to small sample sizes. This may account for the disparity between findings in the literature, at least in part. Finally, the theoretical and practical implications of our meta-analytic findings are presented, and future research questions are discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

Statewide retrospective study of low acuity emergency presentations in New South Wales, Australia: who, what, where and why?

PubMed Central

Dinh, Michael M; Berendsen Russell, Saartje; Bein, Kendall J; Chalkley, Dane R; Muscatello, David; Paoloni, Richard; Ivers, Rebecca

2016-01-01

Objective The present study aims to use a statewide population-based registry to assess the prevalence of low acuity emergency department (ED) presentations, describe the trend in presentation rates and to determine whether they were associated with various presentation characteristics such as the type of hospital as well as clinical and demographic variables. Design and setting This was a retrospective analysis of a population-based registry of ED presentations in New South Wales (NSW). Generalised estimating equations with log links were used to determine factors associated with low acuity presentations to account for repeat presentations and the possibility of clustering of outcomes. Participants Patients were included in this analysis if they presented to an ED between January 2010 and December 2014. The outcomes of interest were low acuity presentation, defined as those who self-presented (were not transported by ambulance), were assigned a triage category of 4 or 5 (semiurgent or non-urgent) and discharged back to usual residence from ED. Results There were 10.7 million ED presentations analysed. Of these, 45% were classified as a low acuity presentation. There was no discernible increase in the rate of low acuity presentations across NSW between 2010 and 2014. The strongest predictors of low acuity ED presentation were age <40 years of age (OR 1.77); injury or musculoskeletal administrative and non-urgent procedures (OR 2.96); ear, nose and throat, eye or oral (OR 5.53); skin or allergy-type presenting problems (OR 2.84). Conclusions Low acuity ED presentations comprise almost half of all ED presentations. Alternative emergency models of care may help meet the needs of these patients. PMID:27165649

Comparative effectiveness of mailed reminder letters on mammography screening compliance.

PubMed

Romaire, Melissa A; Bowles, Erin J Aiello; Anderson, Melissa L; Buist, Diana S M

2012-08-01

Reminder letters are effective at prompting women to schedule mammograms. Less well studied are reminders addressing multiple preventive service recommendations. We compared the effectiveness of a mammogram-specific reminder sent when a woman was due for a mammogram to a reminder letter addressing multiple preventive services and sent on a woman's birthday on mammography receipt. The study included 48,583 women 52-74 years enrolled in Group Health Cooperative, a health plan in Washington State. From 2005 to 2009, women were mailed 88,605 mammogram-specific or birthday letters. In this one group pretest-posttest study, we modeled the odds of obtaining a screening mammogram after receiving a letter by reminder type using logistic regression, controlling for demographic and healthcare use characteristics and stratifying by whether women were overdue or up-to-date with mammography at the mailing. Among women up-to-date with screening, birthday letters were negatively associated with mammography receipt compared to mammogram-specific letters (birthday letters with 1-2 recommendations: OR=0.73; 95% CI:0.68-0.79; 3 recommendations: OR=0.74; 95% CI:0.69-0.78; 4-8 recommendations: OR=0.62 95% CI:0.55-0.68) after. Among overdue women, birthday letters with 4-8 recommendations were negatively associated with mammography receipt. Transitioning from mammogram-specific reminder letters to multiple preventive service birthday letters was associated with decreased mammography receipt. Copyright © 2012 Elsevier Inc. All rights reserved.

Evaluation of visual acuity with Gen 3 night vision goggles

NASA Technical Reports Server (NTRS)

Bradley, Arthur; Kaiser, Mary K.

1994-01-01

Using laboratory simulations, visual performance was measured at luminance and night vision imaging system (NVIS) radiance levels typically encountered in the natural nocturnal environment. Comparisons were made between visual performance with unaided vision and that observed with subjects using image intensification. An Amplified Night Vision Imaging System (ANVIS6) binocular image intensifier was used. Light levels available in the experiments (using video display technology and filters) were matched to those of reflecting objects illuminated by representative night-sky conditions (e.g., full moon, starlight). Results show that as expected, the precipitous decline in foveal acuity experienced with decreasing mesopic luminance levels is effectively shifted to much lower light levels by use of an image intensification system. The benefits of intensification are most pronounced foveally, but still observable at 20 deg eccentricity. Binocularity provides a small improvement in visual acuity under both intensified and unintensified conditions.

Blindness enhances tactile acuity and haptic 3-D shape discrimination.

PubMed

Norman, J Farley; Bartholomew, Ashley N

2011-10-01

This study compared the sensory and perceptual abilities of the blind and sighted. The 32 participants were required to perform two tasks: tactile grating orientation discrimination (to determine tactile acuity) and haptic three-dimensional (3-D) shape discrimination. The results indicated that the blind outperformed their sighted counterparts (individually matched for both age and sex) on both tactile tasks. The improvements in tactile acuity that accompanied blindness occurred for all blind groups (congenital, early, and late). However, the improvements in haptic 3-D shape discrimination only occurred for the early-onset and late-onset blindness groups; the performance of the congenitally blind was no better than that of the sighted controls. The results of the present study demonstrate that blindness does lead to an enhancement of tactile abilities, but they also suggest that early visual experience may play a role in facilitating haptic 3-D shape discrimination.

46 CFR 169.219 - Renewal of letter of designation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Renewal of letter of designation. 169.219 Section 169.219 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Inspection and Certification Letter of Designation § 169.219 Renewal of letter of designation. At...