Evaluation of fatigability measurement: Integrative review

Fatigability is defined as the extent of fatigue in the context of activity and differs from the term used in exercise literature to describe muscle endurance characteristics. Many fatigability measures are available, but no studies have thoroughly evaluated them for adequate incorporation of fatigability concepts. This integrative review provides an overall assessment of existing fatigability measures and then evaluates each in depth. A database search and hand search produced 14 studies for review. Fatigability measurement took three forms: self-reported fatigability, perceived fatigability (self-reported fatigue following a defined performance test), and performance fatigability (performance deterioration). Of 17 measures identified, validity and/or reliability was reported for six (35.3%), and no measure was used in more than one study. Fatigability measures have been correlated with clinical measures, indicating that fatigability should be measured during routine clinical health screening. Refinement of measures and additional fatigability data collection will improve understanding and treatment of fatigue.     

Mental Health of Nurses Working at a Government-designated Hospital During a MERS-CoV Outbreak: A Cross-sectional Study

BACKGROUND

During an epidemic of a novel infectious disease, many healthcare workers suffer from mental health problems.

A Comparison of the Accuracy of Clinician Prediction of Survival Versus the Palliative Prognostic Index

Context

Survival predictions for advanced cancer patients impact many aspects of care, but the accuracy of clinician prediction of survival (CPS) is low. Prognostic tools such as the Palliative Prognostic Index (PPI) have been proposed to improve accuracy of predictions. However, it is not known if PPI is better than CPS at discriminating survival.

Optical coherence tomography shows early loss of the inferior temporal quadrant retinal nerve fiber layer in autosomal dominant optic atrophy

Purpose

The aim of the study was to evaluate the relationship between visual function and retinal nerve fiber layer thickness (RNFLT) determined using Stratus optical coherence tomography (OCT) in patients with autosomal dominant optic atrophy (ADOA).

Methods

The study was a retrospective, institutional, and comparative case series. Thirty-six consecutive patients with ADOA and 72 age-matched normal controls were compared with regard to RNFLT, best-corrected visual acuity (BCVA), and visual field.

Results

The relative reduction of RNFLT of ADOA patients was most evident in the temporal quadrant (56.8 %), followed by the inferior (35.5 %), superior (27.2 %), and nasal quadrants (26.4 %). In ADOA patients, BCVA decreased with RNFL thinning (p?<?0.001), and was not related to age (p?=?0.210). Papillomacular bundle RNFLT decreased with age throughout the study period of 3.7?±?2.3 years (?3.83?±?9.96 μm, p?=?0.017). The presence of a superotemporal central scotoma (61.1 %) was related to decreased inferotemporal RNFLT (7 and 8 o’clock, p?=?0.016 and p?=?0.036, respectively).

Conclusions

The papillomacular bundle RNFL of ADOA is most vulnerable and progressively damaged with age, despite early temporal RNFL loss. Early loss of inferior temporal RNFL in ADOA is related to superotemporal central scotoma.

     

Correlation between depth and area of retinal nerve fiber layer defect as measured by spectral domain optical coherence tomography

Background

To evaluate the correlation between the depth and area of retinal nerve fiber layer (RNFL) defect, as measured on an RNFL map of spectral-domain optical coherence tomography (SD-OCT).

Methods

The RNFL of 472 glaucoma subjects and of 217 healthy subjects was imaged by an SD-OCT. RNFL defect depth and area on the RNFL map were expressed as an RNFL defect depth percentage index (RDPI) and an RNFL defect area index (RDAI), respectively, according to the following two formulas: 100×[1–{summation of thicknesses of RNFL defects/summation of thicknesses of upper 95th percentile range of age-matched healthy subjects in areas corresponding to defects}]; 100×[number of superpixels of RNFL defects/(46?×?46–superpixels inside optic disc or β zone parapapillary atrophy)]. The best-fitting model describing the relationship between the two parameters was derived by fractional polynomial analysis.

Results

Logarithmic fit was determined to be the best-fitting model in describing the relationship of the RDPI against the RDAI (y?=?53.4?+?3.7 ln(x) and y?=?50.9?+?5.9 ln(x) in superior and inferior hemifields, respectively). The expected RDAIs at the point where the RDPI and RDAI rates of change were the same were 3.7 and 5.9 %; the corresponding upper 95 % confidence interval limits of the RDPI 59.0 and 61.8 % in the superior and inferior hemifields, respectively.

Conclusions

The correlation between the RNFL defect depth and area, as derived from the RNFL map, was best described by the logarithmic fit. Changes were more marked in depth than in area, especially for mild localized defects.

     

Peripheral lamina cribrosa depth in primary open-angle glaucoma: a swept-source optical coherence tomography study of lamina cribrosa

Purpose

To investigate peripheral lamina cribrosa depth (PLCD) and its vertical-horizontal difference in eyes with primary open-angle glaucoma (POAG).

Methods

Patients with POAG (n=90 eyes) and age-matched healthy individuals (n=90 eyes) underwent swept-source optical coherence tomography (SS-OCT) scans centered at the optic discs. The PLCD was defined as the vertical distance between the most peripheral visible end of anterior lamina cribrosa (LC) surface and the reference plane connecting the Bruch''s membrane openings. The PLCD in each quadrant region and the vertical-horizontal PLCD difference were compared between the POAG and healthy eyes. The clinical factors associated with increased PLCD were evaluated.

Results

The PLCD was significantly larger in the POAG eyes than the control eyes at the horizontal (P=0.034) and vertical (P=0.001) meridians. The vertical PLCD was significantly larger than the horizontal PLCD, both in the POAG eyes (P<0.001) and in the control eyes (P=0.003). However, the vertical-horizontal PLCD difference was significantly larger in the POAG eyes (47±60 μm) than in the control eyes (18±54 μm, P=0.001). Multivariate regression showed a significant association of male gender (P=0.005), increased baseline IOP (P=0.043), and decreased MD of VF (P=0.025) with increased PLCD.

Conclusions

The peripheral LC was displaced more posteriorly in the POAG eyes compared with the age-matched healthy eyes. In the POAG eyes, the peripheral LC was displaced more posteriorly at the vertical meridian than at the horizontal meridian. The peripheral LC in the vertical meridian might have increased IOP-related strain (deformation) compared with horizontal meridian in glaucomatous eyes.     

Formamidinium-based planar heterojunction perovskite solar cells with alkali carbonate-doped zinc oxide layer

We herein demonstrate n-i-p-type planar heterojunction perovskite solar cells employing spin-coated ZnO nanoparticles modified with various alkali metal carbonates including Li₂CO₃, Na₂CO₃, K₂CO₃ and Cs₂CO₃, which can tune the energy band structure of ZnO ETLs. Since these metal carbonates doped on ZnO ETLs lead to deeper conduction bands in the ZnO ETLs, electrons are easily transported from the perovskite active layer to the cathode electrode. The power conversion efficiency of about 27% is improved due to the incorporation of alkali carbonates in ETLs. As alternatives to TiO₂ and n-type metal oxides, electron transport materials consisting of doped ZnO nanoparticles are viable ETLs for efficient n-i-p planar heterojunction solar cells, and they can be used on flexible substrates via roll-to-roll processing.

Planar formamidinium perovskite solar cells have been fabricated with an alkali carbonate-doped zinc oxide layer.