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Abstract Polyvinyl pyrrolidone capped Zn1-x Mn x S (0 ≤ x ≤ 0.1) nanocrystals have been synthesized using wet chemical co-precipitation method. Crystallographic and morphological characterization of the synthesized materials have been done using X-ray diffraction and transmission electron microscope. Crystallographic studies show the zinc blende crystals having average crystallite size approx. 3 nm, which is almost similar to the average particle size calculated from electron micrographs. Atomic absorption spectrometer has been used for qualitative and quantitative analysis of synthesized nanomaterials. Photo-catalytic activity has been studied using methylene blue dye as a test contaminant. Energy resolved luminescence spectra have been recorded for the detailed description of radiative and non-radiative recombination mechanisms. Photo-catalytic activity dependence on dopant concentration and luminescence quantum yield has been studied in detail.

The yak (Bos grunniens), renowned for its adaptability to extreme cold and hypoxic conditions, stands as a remarkable domestic animal crucial for sustaining livelihoods in harsh climates. We conducted a comprehensive analysis of the whole genome sequence data from three distinct Indian yak populations: Arunachali yak (n = 10), Himachali yak (n = 10), and Ladakhi yak (n = 10). The genomic data for Indian yaks were meticulously generated by our laboratory and compared with their Chinese counterpart, the Jinchuan yak (n = 8), for a more nuanced understanding. Our investigation revealed a total of 37,437 runs of homozygosity (ROH) segments in 34 animals representing four distinct yak populations. The Jinchuan yak population exhibited the highest proportion, constituting 80.8 % of total ROHs, predominantly as small segments (<0.1 Mb), accounting for 63 % of the overall ROHs. Further analysis uncovered a significantly higher degree of inbreeding in Chinese yaks compared to their Indian counterparts. The Indian yak populations, in contrast, demonstrated relatively lower and consistent levels of inbreeding. Moreover, we identified ROH hotspots that covered at least 60 % of individuals in our study, indicating their pivotal role in environmental adaptation. A total of five hotspot regions were detected, housing genes such as ENSBGRG00000015023 (WNT2), YIPF4, SPAST, TLN2, and DSG4. These genes are associated with traits including hair follicle initiation, nutrient stress response, microtubule assembly, development of cardiac muscle, hair follicle, and coat color. This observation strongly suggests that there is substantial selection acting on these genes, emphasizing their important role in environmental adaptation among yak populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Seasonal variations significantly impact buffalo bull semen production and quality, particularly during the summer months. Understanding the genetic basis of these changes is important for managing bull fertility and improving sperm quality. The present study focused on characterizing and identifying polymorphisms in chromatin remodeling genes, protamines (PRMs) and Transition Nuclear Proteins (TNPs) in Murrah buffalo bulls with varying semen quality due to seasonal effects. Our findings revealed none of the coding region variation in PRM1, PRM2, TNP1, and TNP2, these genes are highly conserved in buffalo. Two intronic variants were identified, including G16C in PRM1 intron 1 and intronic SNP in PRM2 intron 1 (G96A). The complete CDS of consensus sequence of bubaline PRM1 was 86.3% identical and 94.1% similar to the bovine PRM1. Whereas the complete CDS of consensus sequence of bubaline TNP2 was 78.2% identical and 91.0% similar to bovine TNP2. Further, no statistically significant differences in the fold change of TNP1, TNP2, PRM1, and PRM2 levels between the hot summer SNA and SA groups and the winter SNA and SA groups This study represents the first comprehensive report on the characterization of bubaline PRM1 (complete CDS), PRM2 (partial CDS), TNP1 (partial CDS), and TNP2 (complete CDS) genes in buffalo sperm cells. Results of the study, clearly indicate that the genes associated with protamine (PRM1 and TNP2) are highly conserved in Bubalus bubalis. Understanding these genetic underpinnings can have implications for improving buffalo bull fertility and semen quality., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Goat milk is gaining popularity as a superior alternative to bovine milk due to its closer resemblance to human milk. Understanding the molecular processes underlying lactation is crucial for improving milk quality and production in goats. However, the genetic mechanisms governing lactation in goats, particularly in indigenous breeds like the Jakhrana, remain largely unexplored., Results: In this study, we performed a comprehensive transcriptomic analysis of Jakhrana goat mammary glands during early and late lactation stages. We isolated milk somatic cells and conducted RNA sequencing, followed by transcript quantification and mapping against the ARS1.2 Capra hircus reference assembly. Our analysis identified differentially expressed genes (DEGs) and commonly expressed genes (CEGs) across the lactation phases. Early lactation showed enrichment of genes encoding antimicrobial peptides and lubrication proteins, while late lactation exhibited heightened expression of genes encoding major milk proteins. Additionally, DEG analysis revealed upregulation of pivotal genes, such as the ABC transporter gene MRP4, implicated in modulating milk composition and quality., Conclusion: Our findings provide insights into the genetic mechanisms underlying lactation dynamics in the Jakhrana goat. Understanding these mechanisms could help in improving milk production and quality in goats, benefiting both the dairy industry and consumers., (© 2024. The Author(s).)

Selection of the most stably expressed reference genes is key to monitoring accurate target gene expression across any tissue or cell type. The mRNA in spermatozoa stores valuable information related to changes in spermatogenesis due to variations in environmental conditions, especially during heat stress, which affects various sperm functions. Semen quality in buffalo bulls is significantly influenced by the seasons. In the study, a panel of nine genes was evaluated to identify the most stably expressed internal control gene (ICG) for the normalization of real-time gene expression data generated across various seasons for Murrah buffalo bulls' spermatozoa. Sperm cells were purified from the semen samples collected during different seasons, with temperature-humidity index (THI) ranging from 80.80 ± 1.47 (hot summer) to 55.88 ± 1.98 (winter), using the BoviPure™ gradient purification method. The RNA isolated from the purified spermatozoa fraction was quality checked prior to reverse transcription and subjected to qPCR (quantitative real-time PCR) based expression analysis. An automated 'endoGene' pipeline was employed to apply the geNorm, NormFinder, and BestKeeper algorithms for data analysis. The result indicated that GAPDH and PP1A were the most stably expressed among the gene panel, whereas ATPSF1 and ACTB were the two least stable expressed reference genes. Further, the most suitable ICGs identified were validated by normalization of real time expression data of heat stress and sperm quality genes, HSFY2 and AKAP4, respectively. The genes identified would help in generating the most reliable results for the expression profiling of the genes dictating sperm quality and heat stress cope-up mechanism in buffalo spermatozoa, collected during different seasons., (© 2024. The Author(s) under exclusive licence to International Society of Biometeorology.)

Semen production and quality are closely correlated with different environmental factors in bovines, particularly for the buffalo (Bubalus bubalis) bulls reared under tropical and sub-tropical conditions. Factors including DNA methylation patterns, an intricate process in sperm cells, have an impact on the production of quality semen in buffalo bulls under abiotic stress conditions. The present study was conducted to identify DNA methylome signatures for semen quality in Murrah buffalo bulls, acclaimed as a major dairy breed globally, under summer heat stress. Based on semen quality parameters that significantly varied between the two groups over the seasons, the breeding bulls were classified into seasonally affected (SA = 6) and seasonally non-affected (SNA = 6) categories. DNA was isolated from purified sperm cells and sequenced using the RRBS (Reduced Representation Bisulfite Sequencing) technique for genome-wide methylome data generation. During the hot summer months, the physiological parameters such as scrotal surface temperature, rectal temperature, and respiration rate for both the SA and SNA bulls were significantly higher in the afternoon than in the morning. Whereas, the global CpG% of SA bulls was positively correlated with the afternoon's scrotal surface and rectal temperature. The RRBS results conveyed differentially methylated cytosines in the promoter region of the genes encoding the channels responsible for Ca 2+ exchange, NPTN, Ca 2+ activated chloride channels, ANO1, and a few structure-related units such as septins (SEPT4 and SEPT6), SPATA, etc. Additionally, the hypermethylated set of genes in SA was significantly enriched for pathways such as the FOXO signaling pathway and oocyte meiosis. The methylation patterns suggest promoter methylation in the genes regulating the sperm structure as well as surface transporters, which could contribute to the reduced semen quality in the Murrah buffalo bulls during the season-related heat stress., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This study employed various experimental techniques to produce graphene oxide (GO) under different conditions, such as the inclusion or exclusion of NaNO 3 , and reduced graphene oxide (RGO) with or without the catalyst CaCl 2 . The procedure of decreasing RGO was carried out using the reducing agent NaBH 4 . Moreover, the prepared mixtures were utilized in the degradation process of methylene blue (MB) dye using photo-catalysis, with exposure to both ultraviolet (UV) light and sunlight. When exposed to UV and sunlight irradiation, WN-GO showed rapid and ecologically friendly breakdown of MB dye in comparison to N-GO. WN-GO exhibited exceptional adsorption capabilities, surpassing other tested materials like N-GO, WN-C-RGO and C-RGO. Although WN-C-RGO has demonstrated satisfactory performance in terms of photo-catalytic degradation, as the concentration-time graph of the MB dye revealed significant degradation, with a reduction of up to 90% and 62.5% under UV light and sunlight exposure, respectively. These results offer insightful information on the potential of graphene-based materials to address other environmental issues, particularly in the areas of water treatment., Competing Interests: The authors hereby declare that we have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (This journal is © The Royal Society of Chemistry.)

This study presents a comprehensive image analysis of the SnO 2 nanoparticles synthesised through calcination at diverse temperatures, which enables an estimation of grain size distribution (GSD) from field-emission scanning electron microscopy (FE-SEM) images. Even though FE-SEM images could provide us with a lot of information about sample differences, we can learn more and perform a more accurate analysis of them by using quantitative data obtained by our image processing application. The digital image processing techniques used in this research provide a detailed analysis of the nanoparticles' size and shape, enabling a deeper understanding of their unique characteristics. The results reveal the significant impact of calcination temperature on the morphology of the nanoparticles, with changes in grain size and grain size distribution observed at varying temperatures., (© 2023 Royal Microscopical Society.)

Background: Few studies have been published about specialty-specific fourth-year medical student leadership in any discipline. This paper provides insight from pediatric educators about the current status and recommendations for pediatric-specific fourth-year leaders., Objective: To identify the prevalence of pediatric fourth-year medical student directors across the US and Canada and to compare current and ideal responsibilities for this role., Methods: Five multi-part questions were written and submitted for the 2019 Council on Medical Student Education in Pediatrics (COMSEP) Annual Survey and subsequently disseminated to all COMSEP member physicians. Anonymous responses were collected and results analyzed. The study was IRB exempt., Results: The program-level survey response rate was 79%. Of 115 respondent medical schools, 37% reported having a pediatric fourth-year director separate from the clerkship director, with an average of 9.8% full-time equivalent (FTE) protected time for the role. In contrast, individuals indicated 20% FTE would be ideal for fourth-year director responsibilities. The most common role identified for pediatric fourth-year directors was directing sub-internships. Respondents indicated it would be ideal for pediatric fourth-year directors to have an increased level of involvement in all areas queried in the survey, especially directing a pediatric residency preparatory course/boot camp, faculty development for educators of fourth-year students, and remediating fourth-year students., Conclusions: As specialty-specific experiences have grown in the fourth year of medical school, there is an increasing demand for faculty leadership separate from direction of the pediatric clerkship. In this national survey, pediatric educators expressed a need for additional protected time to lead fourth-year specific activities. Similar findings in other disciplines would support advocating for more protected time and expanded roles for specialty-specific fourth-year directors nationally.

Background: Large scale implementation of new strategies and healthcare delivery standards in academic medical centers (AMCs) requires training of healthcare workforce at different stages of their medical career. The patient-centered medical home (PCMH) model for healthcare delivery involves adoption by all members of the healthcare workforce, including seasoned professionals and trainees. Though widely known, the PCMH model has been implemented sporadically at large AMCs and methods to implement the model across healthcare workforce have not been well-documented., Methods: To meet all PCMH standards and achieve sustainable level 3 recognition, the authors implemented in 2014-2015 a multi-pronged approach that capitalized on existing educational infrastructure among faculty, residents, and medical students. Within 18 months, the authors applied new interdisciplinary practices and policies, redesigned residency training in continuity practices and extensively modified medical school curricula., Results: These innovative transformational education efforts addressed the six PCMH standards for faculty, residents, and undergraduate medical students. Faculty played a major role as system change agents and facilitators of learning. Residents learned to better understand patients' cultural needs, identify 'at-risk' patients, ensure continuity of care, and assess and improve quality of care. Medical students were exposed to PCMH core standards throughout their training via simulations, training in the community and with patients, and evaluation tasks. By implementing these changes across the healthcare workforce, the AMC achieved PCMH status in a short time, changed practice culture and improved care for patients and the community. Since then, the AMC has been able to maintain PCMH recognition annually with minimal effort., Conclusions: Successful strategies that capitalize on existing strengths in infrastructure complemented by innovative educational offerings and inter-professional partnerships can be adapted by other organizations pursuing similar transformation efforts. This widespread transformation across the healthcare workforce facilitate a deep-rooted change that enabled our academic medical center to sustain PCMH recognition.

Purpose: Contribution of radiation doses from medical X-ray examination to collective dose is significant. Unusually, high doses may increase the risk of stochastic effects of radiations. Therefore, radiation dose assessment was performed in 241 digital X-ray examinations in the study and was compared with published dose reference levels (DRLs)., Methods: Entrance surface air kerma (ESAK) was calculated in chest PA, cervical AP/Lat, abdomen AP, lumbar AP/Lat and pelvis AP digital radiographic examinations (119 male and 122 female) following the International Atomic Energy Agency recommended protocol. Initially, 270 digital examinations were selected, reject analysis was performed and final 241 examinations were enrolled in the study for dose calculations. The exposure parameters and X-ray tube output were used for dose calculations. Effective doses were estimated with the help of conversion coefficients from ICRP 103., Results: Median ESAK (mGy) and associated effective doses obtained were cervical spine AP (1.30 mGy, 0.045 mSv), cervical spine Lat (0.25 mGy, 0.005 mSv), chest PA (0.11 mGy, 0.014 mSv), abdomen AP (0.90 mGy, 0.118 mSv), lumbar spine AP (1.52 mGy, 0.177 mSv), lumbar spine Lat (7.76 mGy, 0.209 mSv) and pelvis AP (0.82 mGy, 0.081 mSv). Results were compared with the studies of UK, Oman, India and Canada., Conclusion: The calculated ESAK and effective dose values were less than or close to previously published literature except for cervical spine AP and lumbar spine Lat. The results reinforce the need for radiation protection optimization, improving examination techniques and appropriate use of automatic exposure control in digital radiography. ESAK values reported in this study could further contribute to establishing local DRLs, regional DRLs and national DRLs., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Objective: To assess for a difference in the characteriza - tion of rotator cuff (RC) muscle fatty infiltration (FI) between the sagittal and coronal planes in the setting of a large or massive RC tear., Materials and Methods: Retrospective review of pa - tients with MRIs demonstrating large or massive RC tears (study group-SG) and no tearing (control group-CG) was conducted. Sagittal T1W and coronal PD images of the supraspinatus and infraspinatus muscles from each patient were selected, separated, and placed in random order. Three MSK readers reviewed the images blindly and independently and qualified the FI based on the Goutallier classification., Results: The SG included 15 men and 15 women (mean age: 65; range: 45 to 87 years); CG included 10 men and 10 women (mean age: 60; range 45 to 76 years). Statistically significant (SS) discrepancies in the assessment of the FI between the sagittal and coronal images occurred 62% in SG and 33% in CG, (p < 0.001). In SG, each reader demon - strated a SS tendency (p < 0.04) to assign a higher value to each muscle when grading the sagittal images compared to coronal images. In SG, 33% of the time (37% supraspinatus, 29% infraspinatus), there was a grade greater than or equal to 3 assigned on the sagittal images but less than 3 grade on corresponding coronal images., Conclusion: There was a statistically significant differ - ence in the characterization of RC FI between the sagittal and coronal planes in the setting of a large or massive tear, likely related to incomplete visualization of the musculature on sagittal imaging secondary to muscle and tendon retrac - tion and more complete visualization on coronal imaging. Awareness of this difference may allow for a more accurate characterization of the degree of fatty infiltration.

In the setting of acute central nervous system (CNS) emergencies, computed tomography (CT) and conventional magnetic resonance imaging (MRI) play an important role in the identification of life-threatening intracranial injury. However, the full extent or even presence of brain damage frequently escapes detection by conventional CT and MRI. Advanced MRI techniques such as diffusion tensor imaging (DTI) are emerging as important adjuncts in the diagnosis of microstructural white matter injury in the acute and postacute brain-injured patient. Although DTI aids in detection of brain injury pathology, which has been repeatedly associated with typical adverse clinical outcomes, the evolution of acute changes and their long-term prognostic implications are less clear and the subject of much active research. A major aim of current research is to identify imaging-based biomarkers that can identify the subset of TBI patients who are at risk for adverse outcome and can therefore most benefit from ongoing care and rehabilitation as well as future therapeutic interventions.The aim of this study is to introduce the current methods used to obtain DTI in the clinical setting, describe a set of common interpretation strategies with their associated advantages and pitfalls, as well as illustrate the clinical utility of DTI through a set of specific patient scenarios. We conclude with a discussion of future potential for the management of TBI.

Objective: The article reviews a select group of traumatic upper extremity injuries that can be easily misinterpreted on radiographs., Conclusion: The awareness of these specific injuries and an understanding of their underlying pathophysiology and the role that radiographs can play in their evaluation will give the reader the best opportunity to make the important imaging findings and guide appropriate treatment.

Retroperitoneal hemangioma is a rare but clinically significant condition that can be challenging to diagnose and characterize on anatomical imaging alone. We present a case of an 80-year-old woman with diabetes and hypertension, who was found to have an abdominal mass diagnosed first on CT abdomen and pelvis in March 2011 and demonstrated to be stable on subsequent MRI study performed 16 months later in July 2012. The mass was later confirmed to be a hemangioma on a 99mTc-red cell study.

Medical residents are a distinct group of health sciences library users that need detailed instruction in literature searching. Core residency competencies from the Accreditation Council for Graduate Medical Education require that all residents be competent in finding, critically appraising, and incorporating the latest clinical evidence into their daily practice with patients. With the collaboration of the library and a clinical department of pediatrics, a program was developed that teaches residents the basic elements of EBM searching and then reinforces this learning over the course of three years.

Nanolabeling is an invaluable novel technique in biology to detect and characterize different parts of biological systems including microscopic entities, viz., cells inside the living systems. Stem cells (SCs) are multipotent cells with the potential to differentiate into bone, cartilage, fat, muscle cells, and neurons and are being investigated for their utility in cell-based transplantation therapy. Yet, adequate methods to track transplanted SCs in vivo are limited, precluding functional studies. Nanoparticles (quantum dots) offer an alternative to organic dyes and fluorescent proteins to label and track cells in vitro and in vivo. These nanoparticles are resistant to chemical and metabolic degradation, demonstrating long-term photo stability. Here, we describe the technology of labeling the stem cells with silver nitrate nanoparticles in an in vitro coculture model. This is followed by defining the procedure of administering these cells in vivo and studying the distribution pattern and resultant regenerative effects of the "tagged" stem cells.

In a retrospective study of 71 voxels of benign peripheral zone tissue from 3 men who underwent endorectal magnetic resonance (MR) spectroscopic imaging of the prostate at both 1.5 and 3 T, 21 voxels that appeared more malignant at 3 T to either of two readers demonstrated significantly higher levels of choline and polyamines at 3 T compared to 1.5 T using a Wilcoxon ranked-sum test; awareness of this selective amplification of these metabolic signals at high field strength may help avoid overdiagnosis of prostate cancer., (Copyright © 2011. Published by Elsevier Inc.)

Polyvinyl pyrrolidone capped Zn1-xMnxS (0 ≤ x ≤ 0.1) nanocrystals have been synthesized using wet chemical co-precipitation method. Crystallographic and morphological characterization of the synthesized materials have been done using X-ray diffraction and transmission electron microscope. Crystallographic studies show the zinc blende crystals having average crystallite size approx. 3 nm, which is almost similar to the average particle size calculated from electron micrographs. Atomic absorption spectrometer has been used for qualitative and quantitative analysis of synthesized nanomaterials. Photo-catalytic activity has been studied using methylene blue dye as a test contaminant. Energy resolved luminescence spectra have been recorded for the detailed description of radiative and non-radiative recombination mechanisms. Photo-catalytic activity dependence on dopant concentration and luminescence quantum yield has been studied in detail.

Purpose: The aim was to compare vision correction wearing time between myopic children and teenagers in a clinical trial of contact lenses and spectacles., Methods: Parents of subjects in the Adolescent and Child Health Initiative for Vision Empowerment (ACHIEVE) study provided wearing times for spectacle and contact lens wear. Hours wearing primary correction and total correction were compared between the two treatment groups. Other factors hypothesised to be associated with wearing time were analysed., Results: The average wearing time of the primary correction differed significantly with the wearing time for the spectacles group being 91.5 hours per week compared to 80.3 hours per week for the contact lens wearers (p < 0.0001). Total correction time was slightly higher for the contact lens wearers, 97.5 hours per week, after accounting for time wearing spectacles. Higher refractive error was strongly related to longer wearing times (p < 0.0002). Age and treatment group were associated with wearing time (p = 0.005). Young contact lens wearers wore their lenses less than young spectacle wearers and older contact lens wearers. Low scores on an appearance quality-of-life scale were associated with longer wearing time in spectacle wearers compared to the low- and high-scoring contact lens wearers. Gender, spectacle satisfaction and activities were not related to wearing time., Conclusions: While contact lens wearers, on average, wear their contact lenses less than spectacle wearers, they spend roughly the same amount of time wearing a refractive correction. Higher refractive error resulted in longer wearing times for both spectacle and contact lens wearers. Younger contact lens wearers wore their contact lenses for shorter periods than the spectacle wearers, but still wore them, on average, 74.4 hours per week (about 10 hours per day), suggesting that contact lenses are a viable alternative mode of correction for children.

Background: The rate and reasons for discontinuation of contact lens wear by young patients are not well known. The Contact Lenses in Pediatrics (CLIP) Study surveyed participants 3 months after the final study visit to determine the percentage of participants who continued to wear contact lenses after study conclusion. The factors associated with continued contact lens wear and differences in behaviors between the children and teens were also determined to provide insights to practitioners who provide refractive correction for patients in those age groups., Methods: Three months after the CLIP Study completion, participants and parents returned mailed surveys that assessed post-study lens purchase and symptoms related to contact lens wear if contact lenses wear had been continued. Responses were compared between the children and teens using chi(2) or Fisher's exact test., Results: Almost 92% of the surveys were returned. Eighty percent of teens' parents reported purchasing lenses after the study, vs. 63% of the children's parents (p=0.02). Symptoms reported at the last study visit were not significantly associated with future purchase, though there was a trend towards more light sensitivity in those who did not purchase more contact lenses (23.1% vs. 11.8%). Satisfaction with contact lenses was high among both those purchasing additional contact lenses and those who did not. Both children and teens reported similar frequencies of symptoms such as burning, itching or tearing eyes 3 months following study completion. Teens reported having contact-lens-related dry eyes more frequently than children., Conclusions: A large proportion of children and an even higher proportion of teens continued wearing their lenses 3 months after completing the CLIP Study. Children and teens reported similar contact lens comfort and low frequencies of most symptoms, though teens experienced more dry-eye symptoms. Overall, reports of symptoms in this sample were lower than had been reported in adult populations by other investigators.

Purpose: Soft contact lenses have been reported to increase the progression of myopia. The purpose of this study was to determine whether soft contact lenses affect the progression of myopia in children., Methods: Children between the ages of 8 and 11 years with -1.00 to -6.00 D myopia and less than 1.00 D astigmatism were randomly assigned to wear soft contact lenses (n = 247) or spectacles (n = 237) for 3 years. Refractive error and corneal curvatures were measured annually by cycloplegic autorefraction, and axial length was measured annually by A-scan ultrasound. Multilevel modeling was used to compare the rate of change of refractive error, corneal curvature, and axial length between spectacle and contact lens wearers., Results: There was a statistically significant interaction between time and treatment for myopia progression (P = 0.002); the average rate of change was 0.06 D per year greater for contact lens wearers than spectacle wearers. After 3 years, the adjusted difference between contact lens wearers and spectacle wearers was not statistically significant (95% confidence interval [CI] = -0.46 to 0.02). There was no difference between the two treatment groups with respect to change in axial length (ANCOVA, P = 0.37) or change in the steepest corneal curvature (ANCOVA, P = 0.72)., Conclusions: These data provide reassurance to eye care practitioners concerned with the phenomenon of "myopic creep." Soft contact lens wear by children does not cause a clinically relevant increase in axial length, corneal curvature, or myopia relative to spectacle lens wear. (ClinicalTrials.gov, NCT00522288.).

Purpose: Children are not offered elective contact lenses as a treatment option for refractive error nearly as often as teens are. The purpose of this report was to examine the benefits of contact lens wear for children and teens to determine whether children benefit as much as teens. If they do, children should routinely be offered contact lens wear as a treatment for refractive error., Methods: Neophyte contact lens wearers were categorized as children (8-12 years of age) or teens (13-17 years of age). They completed the Pediatric Refractive Error Profile (PREP), a pediatric quality-of-life survey for subjects affected only by refractive error, while wearing glasses; then they were fitted with silicone hydrogel contact lenses. One week, 1 month, and 3 months after receiving contact lenses, the subjects completed the same PREP survey. Subjects also completed questions regarding wearing time and satisfaction with contact lenses during specific activities., Results: The study enrolled 169 subjects at three clinical centers. Ninety-three (55%) of the subjects were girls; 78 (46%) were white; and 44 (26%) were Hispanic. After wearing contact lenses for 3 months, the overall PREP score increased from 64.4 for children and 61.8 for teens while wearing glasses to 79.2 for children and 76.5 for teens. The improvement from baseline to 3 months was significant for children and teens (P<0.0001 for both groups), but there was not a significant difference in improvement between children and teens (P>0.05). The areas of most improvement were satisfaction with correction, activities, and appearance., Conclusions: Contact lenses significantly improved the quality of life, as reported by children and teens using the PREP, and there was not a difference in improvement between children and teens. Contact lens wear dramatically improves how children and teens feel about their appearance and participation in activities, leading to greater satisfaction with their refractive error correction. The improvement in quality of life after contact lens wear indicates that children should be offered contact lenses as a treatment for refractive error as routinely as teens.

Purpose: Despite several studies that show 8- to 11-year-old children are capable of wearing a various contact lens modalities, parents often report that their eye care practitioner would not fit their child with contact lenses until the child was about 13 years old. We conducted the Contact Lenses in Pediatrics (CLIP) Study to compare contact lens fitting and follow-up between 8- to 12-year-old children and 13- to 17-year-old teenagers., Methods: At the baseline visit, all subjects underwent a contact lens fitting, including visual acuity, a manifest refraction, autorefraction, and biomicroscopy. Subjects then underwent contact lens insertion and removal training, which consisted of talking about contact lens care as well as inserting and removing a contact lens three times. Subjects returned for follow-up visits at 1 week, 1 month, and 3 months, and visual acuity, contact lens fit assessment, and biomicroscopy were performed. The time of the fitting, the insertion and removal training, and each follow-up visit were measured individually and added for a total chair time. Biomicroscopy examinations were conducted according to a standardized protocol., Results: We enrolled 84 children and 85 teens in the study. Of the 169 subjects, 93 (55.0%) were female, 78 (46.2%) were white, 44 (23.3%) were Hispanic, and 28 (17.6%) were black. The mean (+/- SD) total chair time for children was 110.6 +/- 39.2 min, significantly more than 95.3 +/- 25.2 min for teens (Student's t-test, p = 0.003). Most of the difference was caused by insertion and removal training, which lasted 41.9 +/- 32.0 min for children and 30.3 +/- 20.2 min for teens (Student's t-test, p = 0.01). The presence of conjunctival staining increased from 7.1% of the subjects at baseline to 19.9% of the subjects at 3 months (chi2, p = 0.0006), but the changes were similar between children and teens. No other biomicroscopy signs increased significantly over the 3-month period., Conclusions: The total chair time for children is approximately 15 min longer than teens, but most of that difference is explained by longer time spent teaching children insertion and removal. Because insertion and removal is generally taught by staff members, the eye care practitioner's time with the patient is similar between children and teens. Furthermore, neither children nor teens experienced problems related to contact lens wear during the study. Eye care practitioners should consider routinely offering contact lenses as a treatment option, even for children 8 years old.

Purpose: The purpose of this study was to describe the baseline characteristics of subjects and methods for a multicenter, randomized clinical trial to compare the effects of contact lens wear and spectacle wear on children's self-perception., Methods: Eligible subjects are randomly assigned to wear glasses or contact lenses throughout the 3-year study. Self-perceptions are measured 1 month after randomization and every 6 months using the Self-Perception Profile for Children (SPPC). Children's satisfaction with spectacles and refractive error-related visual quality of life are also measured using surveys developed for the study. Visual acuity, cycloplegic autorefraction, corneal curvature, and axial dimensions are measured annually., Results: Five clinical sites enrolled 484 subjects with a mean (+/- standard deviation [SD]) age of 10.4 +/- 1.1 years. Approximately three-fifths of the subjects are girls, 47.1% of the subjects are white, 21.5% are black, and 21.5% are Hispanic. The mean (+/- SD) cycloplegic spherical equivalent autorefraction of the right eye is -2.38 +/- 1.04 D, and the average (+/- SD) axial length of the right eye is 24.32 +/- 0.77 mm. The average (+/- SD) Global Self-Worth score on the SPPC is 3.20 +/- 0.62 on a scale from one (low perceived competence) to 4 (high perceived competence). The average (+/- SD) spectacle satisfaction is 59.1 +/- 26.6 on a scale from zero (no satisfaction) to 100 (perfect satisfaction). The average refractive error-related quality of life score is 63.5 +/- 12.8 on a scale from zero (poor quality of life) to 100 (excellent quality of life)., Conclusions: Subjects enrolling in the ACHIEVE Study are an ethnically diverse group of young myopic children. Ocular characteristics of the sample are consistent with data presented in other randomized clinical trials evaluating treatments for myopic children. The data reported here represent the baseline data for a 3-year randomized clinical trial to investigate the effects of contact lens vs. spectacle wear on children's self-perceptions.