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This study aims at evaluating the relationship between visual impairment and health-related quality of life (QoL) by identifying factors that affect the EQ-5D index score and Visual Functioning Questionnaire (VFQ) global score, and determining whether the VFQ-25 scores and the European Quality of Life-5 Dimensions (EQ-5D) scores are correlated. Methods: This cross-sectional study comprised 318 patients aged 40 years or more presenting with best corrected visual acuity (BCVA) of 20/40 or worse in the better eye.Patients received comprehensive ophthalmologic examinations, and were administered the National Eye Institute VFQ-25 and the EQ-5D instruments. A higher VFQ-25 score indicates a better QoL and, after conversion of the EQ-5D scores to an index score, a higher EQ-5D index score indicates a better QoL. Results: On multivariate analysis of the EQ-5D index scores, women and those with arthritis were found to have significantly worse QoL, and the EQ-5D index score was increased by every unit increase in BCVA or mean deviation. Multivariate analysis of the VFQ-25 scores revealed that a history of heart disease, arthritis, and eye diseases, such as age-related macular degeneration or diabetic retinopathy, had significant negative effects on patients' QoL, and VFQ-25 global score was decreased by every unit increase in logMAR. According to this analysis, patients' QoL was improved by each unit increase in BCVA or mean deviation. The correlation between the two questionnaires was only weak to moderate. Conclusion: Visual impairment was associated with lower QoL, as assessed by either questionnaire in Taiwanese patients.

We report an all-solution, simple process (DC plating with single additive) for metallizing high aspect ratio (AR = 5 and AR~12) through vias in ultrathin glass (thickness ~100 um). Highly uniform and continuous Cu seed layer is first achieved by a simple surface modification, Sn/Pd catalyst adsorption and Cu electroless plating. Subsequently, the vias are filled by DC plating in the presence of a single additive nitrotetrazolium blue chloride (NBT). The strong inhibition effect of NBT is exploited to first bridge the center of the vias followed by filling of two blind vias. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to conduct a cost-effectiveness analysis (CEA) of monofocal and multifocal intraocular lenses (IOLs) for cataract patients in Taiwan. Methods: This prospective nonrandomized study was designed to evaluate the effectiveness of monofocal and multifocal IOLs by means of visual performance, visual quality, vision-related quality of life, and spectacle-independence rates. The direct costs were calculated using the payment points of the fee schedule for medical services multiplied by the treatment items. The concept of incremental cost effectiveness ratios was used to evaluate the costs of different types of IOLs in cataract surgery and postoperative outcomes in patients. Findings: A total of 61 patients from the monofocal IOL group (n = 21), multifocal IOL group 1 (n = 22), and multifocal IOL group 2 (n = 18) who completed the study were included in the analysis. No significant differences were observed in mean ages or patient to eye ratio. Significant differences in effectiveness after the implantations of monofocal and multifocal IOLs were observed for spectacle-free rate and monocular contrast sensitivity under glare conditions only. The incremental cost-effectiveness ratios of monofocal versus multifocal IOLs indicated that it cost an additional $57 to $58 (US dollars) to increase each 1% of the spectacle-independence rate. Implications: This study's results indicated that multifocal IOLs provided better effectiveness on vision-related indicators like the incremental cost effectiveness ratios of postoperative spectacle-independence rate and binocular best-corrected visual acuity measurements at near vision. Our findings suggest that multifocal IOLs can be highly cost effective for patients who prefer to be spectacle free, so it is important to ensure that patients have realistic expectations when making choices between monofocal and multifocal IOLs. [ABSTRACT FROM AUTHOR]

Purpose: Long-acting insulin analogues were developed to facilitate consistent glycemic control without excessive hypoglycemia. However, structural modifications of the insulin molecule can alter biological responses and binding characteristics with specific receptors. The aim of this study was to estimate the risk of sight-threatening diabetic retinopathy (STDR) associated with treatment using long-acting insulin analogues compared with intermediate-acting insulin in patients with type 2 diabetes mellitus (T2DM). Methods: A retrospective cohort consisting of patients with T2DM aged 20 years of age and older with newly initiated treatment with long-acting insulin analogues (glargine and detemir) and intermediate-acting human insulin was identified from the National Health Insurance database between January 2004 and December 2006 and was subdivided into different cohorts. The risk of the development of STDR was determined by Cox regression models and compared between different cohorts. Findings: Of the 46,739 eligible patients, initiators of insulin glargine, insulin detemir, and neutral protamine Hagedorn (NPH) insulin were identified for comparison using propensity-score matching methods. Long-acting insulin analogues were not associated with changed risk for STDR by intention-to-treat and time-varying use approaches between either matched or unmatched cohorts. Implications: The strategies that aim at preventing diabetic retinopathy by treating T2DM patients with long-acting insulin analogues remain further prospective studies with longer follow-up period to validate our observations within an appropriate dosage range and to further evaluate the safety of long-acting insulin analogues on reducing the progression of diabetic retinopathy. [ABSTRACT FROM AUTHOR]

Background: The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients' decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. Methods: This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one's own expense, overall patient satisfaction and postoperative visual clarity. Results: The results showed that the patient's gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Conclusions: Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients. [ABSTRACT FROM AUTHOR]

Novel sub-micro sized hexagonal clubs of ZnO (HC-ZnO), which are coated as a scattering layer (SL) for the photoanode of a DSSC, are synthesized. X-ray diffraction (XRD) patterns of the ZnO clubs show clear peaks corresponding to wurtzite crystal phase of ZnO. Scanning electron microscopic (SEM) images show that each club has two opposite hexagonal faces (parts) of unequal dimensions. High resolution transmission electron microscopic (HR-TEM) image of a single ZnO club reveals that the ZnO is single crystalline and has wurtzite crystal structure; the image indicates a lattice spacing (d) of 0.26 nm; this is ascribed to the (002) planar spacing of the hexagonal ZnO. A solar-to-electricity conversion efficiency (η) of 3.36% is achieved for the cell with the double layer (DL) film, which is 16% higher than that of the cell with only transparent layer (TL) of commercial ZnO (2.89%) and far higher than that of the cell with SL (0.05%). The ηof the cell with the DL (3.36%) could further be improved to 4.28% through the modification of the DL surface with TiOx. Incident photo-to-current conversion efficiency (IPCE) curves, UV–vis absorption spectra, energy dispersive X-ray (EDX) spectra, and electrochemical impedance spectra (EIS) are also used to substantiate the results. [ABSTRACT FROM AUTHOR]