The Hemianopia Reading Questionnaire (HRQ): Development and Psychometric Qualities in a Large Community Sample.

The ability to read is important for daily life functioning. Individuals with homonymous visual field defects (iwHs) after brain injury experience frequent reading difficulties. The current study presents a novel self-report questionnaire aimed at measuring the wide variety of reading difficulties iwHs can experience: the Hemianopia Reading Questionnaire (HRQ). The 24-item HRQ was developed with help from clinical experts and experts by experience and was inspired by existing reading questionnaires for adults. The three tested subscales of the HRQ assess the relationship to reading, reading skills and daily life functional reading. The factor structure, reliability, convergent validity and divergent validity were examined in a large community sample (i.e., individuals without homonymous visual field defects) with a comparable distribution of age, gender and level of education to those who have suffered a stroke (N = 998). Two competing hypothesized models were tested and a good fit was found for a three-bifactor model of the HRQ. The reliability of the three subscales was found to be good (ω range 0.93-0.99), as well as the convergent and divergent validity (9 out of 12 Spearman's correlations, according to expectations). The results support further use of the HRQ in iwHs, especially in the context of reading rehabilitation. Suggestions for clinical and scientific use and future psychometric research on the HRQ are provided.

ACE-DNV: Automatic classification of gaze events in dynamic natural viewing.

Eye movements offer valuable insights for clinical interventions, diagnostics, and understanding visual perception. The process usually involves recording a participant's eye movements and analyzing them in terms of various gaze events. Manual identification of these events is extremely time-consuming. Although the field has seen the development of automatic event detection and classification methods, these methods have primarily focused on distinguishing events when participants remain stationary. With increasing interest in studying gaze behavior in freely moving participants, such as during daily activities like walking, new methods are required to automatically classify events in data collected under unrestricted conditions. Existing methods often rely on additional information from depth cameras or inertial measurement units (IMUs), which are not typically integrated into mobile eye trackers. To address this challenge, we present a framework for classifying gaze events based solely on eye-movement signals and scene video footage. Our approach, the Automatic Classification of gaze Events in Dynamic and Natural Viewing (ACE-DNV), analyzes eye movements in terms of velocity and direction and leverages visual odometry to capture head and body motion. Additionally, ACE-DNV assesses changes in image content surrounding the point of gaze. We evaluate the performance of ACE-DNV using a publicly available dataset and showcased its ability to discriminate between gaze fixation, gaze pursuit, gaze following, and gaze shifting (saccade) events. ACE-DNV exhibited comparable performance to previous methods, while eliminating the necessity for additional devices such as IMUs and depth cameras. In summary, ACE-DNV simplifies the automatic classification of gaze events in natural and dynamic environments. The source code is accessible at https://github.com/arnejad/ACE-DNV .

Reading Difficulties in Parkinson's Disease: A Stepped Care Model for Neurovisual Rehabilitation.

BACKGROUND: People with Parkinson's disease (PD) frequently experience reading difficulties. Little is known about what functional impairments distinguish people with PD with and without reading difficulties and how these should guide rehabilitation. OBJECTIVE: To provide concrete advice for an efficient stepped care model for reading difficulties in PD, based on extensive functional assessments. METHODS: This study included 74 people with PD in a neurovisual rehabilitation setting who underwent assessment of visual, visuoperceptual, and cognitive functions. Outcomes were compared between those with frequent (RD+; N = 55) and infrequent reading difficulties (RD-; N = 19). Aids and advice provided during rehabilitation were registered. RESULTS: Only a few functions appeared to distinguish RD+ and RD-. Visual functions (i.e., contrast sensitivity, g = 0.76; reading acuity, g = 0.66; visual acuity, g = 0.54) and visuoperceptual functions (i.e., visual attention, g = 0.58, visual motor speed, g = 0.56) showed significant worse scores in RD+ compared to RD-. Aids and advice applied consisted mainly of optimizing refraction, improving lighting, and optimizing text size and spacing. CONCLUSION: The test battery showed significant differences between RD+ and RD-on only a few tests on visual and visuoperceptual functions. The applied aids and advice matched well with these impairments. Therefore, we recommend a stepped care model, starting with a short test battery on these functions. If this battery indicates functional impairments, this can be followed by standard aids and advice to improve reading. Only in case of insufficient effect additional testing should take place.

A systematic review on visual scanning behaviour in hemianopia considering task specificity, performance improvement, spontaneous and training-induced adaptations.

PURPOSE: People with homonymous hemianopia (HH) benefit from applying compensatory scanning behaviour that limits the consequences of HH in a specific task. The aim of the study is to (i) review the current literature on task-specific scanning behaviour that improves performance and (ii) identify differences between this performance-enhancing scanning behaviour and scanning behaviour that is spontaneously adopted or acquired through training. MATERIALS AND METHODS: The databases PsycInfo, Medline, and Web of Science were searched for articles on scanning behaviour in people with HH. RESULTS: The final sample contained 60 articles, reporting on three main tasks, i.e., search (N = 17), reading (N = 16) and mobility (N = 14), and other tasks (N = 18). Five articles reported on two different tasks. Specific scanning behaviour related to task performance in search, reading, and mobility tasks. In search and reading tasks, spontaneous adaptations differed from this performance-enhancing scanning behaviour. Training could induce adaptations in scanning behaviour, enhancing performance in these two tasks. For mobility tasks, limited to no information was found on spontaneous and training-induced adaptations to scanning behaviour. CONCLUSIONS: Performance-enhancing scanning behaviour is mainly task-specific. Spontaneous development of such scanning behaviour is rare. Luckily, current compensatory scanning training programs can induce such scanning behaviour, which confirms that providing scanning training is important.IMPLICATIONS FOR REHABILITATIONScanning behaviour that improves performance in people with homonymous hemianopia (HH) is task-specific.Most people with HH do not spontaneously adopt scanning behaviour that improves performance.Compensatory scanning training can induce performance-enhancing scanning behaviour.

Prevalence and nature of self-reported visual complaints in people with Parkinson's disease-Outcome of the Screening Visual Complaints questionnaire.

INTRODUCTION: Visual complaints can have a vast impact on the quality of life of people with Parkinson's disease (PD). In clinical practice however, visual complaints often remain undetected. A better understanding of visual complaints is necessary to optimize care for people with PD and visual complaints. This study aims at determining the prevalence of visual complaints experienced by a large outpatient cohort of people with PD compared to a control group. In addition, relations between visual complaints and demographic and disease-related variables are investigated. METHODS: The Screening Visual Complaints questionnaire (SVCq) screened for 19 visual complaints in a cohort of people with idiopathic PD (n = 581) and an age-matched control group without PD (n = 583). RESULTS: People with PD experienced significantly more complaints than controls, and a greater impact of visual complaints on their daily lives. Complaints that were most common ('often/always') were unclear vision (21.7%), difficulty reading (21.6%), trouble focusing (17.1%), and blinded by bright light (16.8%). Largest differences with controls were found for double vision, needing more time to see and having trouble with traffic participation due to visual complaints. Age, disease duration, disease severity, and the amount of antiparkinsonian medication related positively to the prevalence and severity of visual complaints. CONCLUSION: Visual complaints are highly prevalent and occur in great variety in people with PD. These complaints progress with the disease and have a large impact on the daily lives of these people. Standardized questioning is advised for timely recognition and treatment of these complaints.

The Multiple Mitotic Roles of the ASPM Orthologous Proteins: Insight into the Etiology of ASPM-Dependent Microcephaly.

The Drosophila abnormal spindle (asp) gene was discovered about 40 years ago and shown to be required for both mitotic and meiotic cell division. Subsequent studies showed that asp is highly conserved and that mutations in its human ortholog ASPM (Abnormal Spindle-like Microcephaly-associated; or MCPH5) are the most common cause of autosomal recessive primary microcephaly. This finding greatly stimulated research on ASPM and its fly and mouse (Aspm) orthologs. The three Asp orthologous proteins bind the microtubules (MTs) minus ends during cell division and also function in interphase nuclei. Investigations on different cell types showed that Asp/Aspm/ASPM depletion disrupts one or more of the following mitotic processes: aster formation, spindle pole focusing, centrosome-spindle coupling, spindle orientation, metaphase-to-anaphase progression, chromosome segregation, and cytokinesis. In addition, ASPM physically interacts with components of the DNA repair and replication machineries and is required for the maintenance of chromosomal DNA stability. We propose the working hypothesis that the asp/Aspm/ASPM genes play the same conserved functions in Drosophila, mouse, and human cells. Human microcephaly is a genetically heterogeneous disorder caused by mutations in 30 different genes that play a variety of functions required for cell division and chromosomal DNA integrity. Our hypothesis postulates that ASPM recapitulates the functions of most human microcephaly genes and provides a justification for why ASPM is the most frequently mutated gene in autosomal recessive primary microcephaly.

Correction: The Screening Visual Complaints questionnaire (SVCq) in people with Parkinson's disease-Confirmatory factor analysis and advice for its use in clinical practice.

[This corrects the article DOI: 10.1371/journal.pone.0272559.].

The Screening Visual Complaints questionnaire (SVCq) in people with Parkinson's disease-Confirmatory factor analysis and advice for its use in clinical practice.

BACKGROUND: The Screening Visual Complaints questionnaire (SVCq) is a short questionnaire to screen for visual complaints in people with Parkinson's disease (PD). OBJECTIVE: The current study aims to investigate the factor structure of the SVCq to increase the usability of this measure in clinical practice and facilitate the interpretation of visual complaints in people with PD. METHODS: We performed a confirmatory factor analysis using the 19 items of the SVCq of 581 people with PD, investigating the fit of three models previously found in a community sample: a one-factor model including all items, and models where items are distributed across either three or five factors. The clinical value of derived subscales was explored by comparing scores with age-matched controls (N = 583), and by investigating relationships to demographic and disease related characteristics. RESULTS: All three models showed a good fit in people with PD, with the five-factor model outperforming the three-factor and one-factor model. Five factors were distinguished: 'Diminished visual perception-Function related' (5 items), 'Diminished visual perception-Luminance related' (3 items), 'Diminished visual perception-Task related' (3 items), 'Altered visual perception' (6 items), and 'Ocular discomfort' (2 items). On each subscale, people with PD reported more complaints than controls, even when there was no ophthalmological condition present. Furthermore, subscales were sensitive to relevant clinical characteristics, like age, disease duration, severity, and medication use. CONCLUSIONS: The five-factor model showed a good fit in people with PD and has clinical relevance. Each subscale provides a solid basis for individualized visual care.

Genetic Control of Kinetochore-Driven Microtubule Growth in Drosophila Mitosis.

Centrosome-containing cells assemble their spindles exploiting three main classes of microtubules (MTs): MTs nucleated by the centrosomes, MTs generated near the chromosomes/kinetochores, and MTs nucleated within the spindle by the augmin-dependent pathway. Mammalian and Drosophila cells lacking the centrosomes generate MTs at kinetochores and eventually form functional bipolar spindles. However, the mechanisms underlying kinetochore-driven MT formation are poorly understood. One of the ways to elucidate these mechanisms is the analysis of spindle reassembly following MT depolymerization. Here, we used an RNA interference (RNAi)-based reverse genetics approach to dissect the process of kinetochore-driven MT regrowth (KDMTR) after colcemid-induced MT depolymerization. This MT depolymerization procedure allows a clear assessment of KDMTR, as colcemid disrupts centrosome-driven MT regrowth but not KDMTR. We examined KDMTR in normal Drosophila S2 cells and in S2 cells subjected to RNAi against conserved genes involved in mitotic spindle assembly: mast/orbit/chb (CLASP1), mei-38 (TPX2), mars (HURP), dgt6 (HAUS6), Eb1 (MAPRE1/EB1), Patronin (CAMSAP2), asp (ASPM), and Klp10A (KIF2A). RNAi-mediated depletion of Mast/Orbit, Mei-38, Mars, Dgt6, and Eb1 caused a significant delay in KDMTR, while loss of Patronin had a milder negative effect on this process. In contrast, Asp or Klp10A deficiency increased the rate of KDMTR. These results coupled with the analysis of GFP-tagged proteins (Mast/Orbit, Mei-38, Mars, Eb1, Patronin, and Asp) localization during KDMTR suggested a model for kinetochore-dependent spindle reassembly. We propose that kinetochores capture the plus ends of MTs nucleated in their vicinity and that these MTs elongate at kinetochores through the action of Mast/Orbit. The Asp protein binds the MT minus ends since the beginning of KDMTR, preventing excessive and disorganized MT regrowth. Mei-38, Mars, Dgt6, Eb1, and Patronin positively regulate polymerization, bundling, and stabilization of regrowing MTs until a bipolar spindle is reformed.

Electronic health record implementation and healthcare workers' work characteristics and autonomous motivation-a before-and-after study.

BACKGROUND: Technological innovation in healthcare is often assumed to contribute to the quality of care. However, the question how technology implementation impacts healthcare workers has received little empirical attention. This study investigates the consequences of Electronic Health Record (EHR) implementation for healthcare workers' autonomous work motivation. These effects are further hypothesized to be mediated by changes in perceived work characteristics (job autonomy and interdependence). Additionally, a moderating effect of profession on the relationship between EHR implementation and work characteristics is explored. METHODS: A quantitative uncontrolled before-and-after study was performed among employees from a large university medical centre in the Netherlands. Data were analysed following the component approach for testing a first stage moderated mediation model, using Generalized Estimating Equations (GEE). RESULTS: A total of 456 healthcare workers (75 physicians, 154 nurses, 145 allied healthcare professionals, and 82 administrative workers) finished both the baseline and the follow-up survey. After EHR implementation, perceived job autonomy decreased, whereas interdependence increased. In line with our hypothesis, job autonomy was positively associated with autonomous motivation. In contrast to our expectations, interdependence also showed a positive association with autonomous motivation. Autonomous motivation was stable over the course of EHR implementation. This study did not provide support for a moderating effect of profession: no differences were observed between the various professions regarding the changes in their experienced job autonomy and interdependence after EHR implementation. CONCLUSIONS: Our study showed that healthcare professionals' perceptions of their work characteristics, but not their autonomous motivation, were changed after EHR implementation, and that these experiences were relatively similar for physicians, nurses, and allied healthcare professionals. The stability of healthcare workers' autonomous motivation may be explained by the opposite effects of decreased job autonomy and increased interdependence, and by the EHR being in line with healthcare workers' values. The changes in job autonomy and interdependence may have consequences beyond motivation, for example by affecting clinical decision-making, proactive behaviour, and the quality of teamwork. These potential consequences of EHR implementation warrant further research.

Confirmatory factor analysis of the Dutch Screening Visual Complaints questionnaire in people with multiple sclerosis.

BACKGROUND: Visual complaints among people with multiple sclerosis (pwMS) are common, but often difficult to recognize. The Screening Visual Complaints questionnaire (SVCq) has been developed to screen for visual complaints in people with a neurodegenerative disease, including multiple sclerosis (MS). A previous study performed a factor analysis in a normal population which revealed an acceptable one-factor model, a three-factor model and a five-factor model within the SVCq. To increase the usability of the SVCq in people with MS, the purpose of the current study was to investigate the fit of the three models in a cohort of pwMS. RESULTS: The confirmatory factor analysis on the SVCq in 493 people with MS showed good fit for all the models. The three-factor model (diminished visual perception, altered visual perception and ocular discomfort) outperformed the one-factor model. The five-factor model outperformed both models, which showed that dividing the first factor (diminished visual perception) into three more factors (function-related, luminance-related and task-related) has merit. CONCLUSIONS: All models may be useful in clinical care for pwMS. The one-factor model may give a quick overview of the presence and severity of visual complaints in general. The individual factors, of either the three- or the five factor models, may contribute to a better recognition of the nature of visual complaints in pwMS and may guide further steps in rehabilitation for pwMS with visual complaints.

Experiences of patients and health care professionals on the quality of telephone follow-up care during the COVID-19 pandemic: a large qualitative study in a multidisciplinary academic setting.

OBJECTIVE: To evaluate the perceived quality of follow-up telephone consultations (TCs) from the perspective of patients and healthcare professionals (HCPs) of multiple medical disciplines during the COVID-19 pandemic. DESIGN: A qualitative study using semi-structured interviews and reflexive thematic analysis. SETTING: Seven medical disciplines (general dermatology, dermato-oncology, head and neck oncology, internal medicine, medical oncology, gynaecological oncology and surgical oncology) at a large university hospital in the Netherlands. PARTICIPANTS: Patients who received and HCPs who provided TCs as a substitute for outpatient follow-up appointments during the COVID-19 pandemic. RESULTS: Eighty-two patients and 58 HCPs were interviewed. Predominantly, patients and HCPs were satisfied with the quality of care by TCs. They regarded TCs as efficient, accessible and of acceptable quality, provided there was an established patient-HCP relationship, medical complaints were absent and physical examination was not indicated. However, most patients were worried about the accuracy of their health assessment in the absence of physical examination and non-verbal communication. Both patients and HCPs wish to use TCs in the future alternatively with face-to-face consultations. CONCLUSION: This study concludes that TCs seem a valuable contribution to the context of follow-up care and could partially replace face-to-face consultations. TCs can be performed in stable, chronic patients with whom a doctor-patient relationship has already been established. Face-to-face consultations are considered more appropriate in the case of new patients, challenging or emotionally charged consultations and when clinically relevant physical examination is indicated. Due to the context-dependent nature of experiences of patients and HCPs, TCs should be used with an individually customised approach based on patient and disease specifics, in which shared decision-making plays an extensive role. Before major implementation is considered, sufficient data on the safety regarding missed diagnoses or cancer recurrences should be assembled first.

Self-Reported Visual Complaints in People with Parkinson's Disease: A Systematic Review.

BACKGROUND: Scientific research increasingly focuses on visual symptoms of people with Parkinson's disease (PD). However, this mostly involves functional measures, whereas self-reported data are equally important for guiding clinical care. OBJECTIVE: This review provides an overview of the nature and prevalence of self-reported visual complaints by people with PD, compared to healthy controls. METHODS: A systematic literature search was performed. Studies from three databases (PubMed, PsycInfo, and Web of Science) were screened for eligibility. Only studies that reported results of visual self-reports in people with idiopathic PD were included. RESULTS: One hundred and thirty-nine eligible articles were analyzed. Visual complaints ranged from function-related complaints (e.g., blurred vision, double vision, increased sensitivity to light or changes in contrast sensitivity) to activity-related complaints (e.g., difficulty reading, reaching, or driving). Visual complaints were more prevalent in people with PD compared to healthy controls. The presence of visual complaints leads to a reduced quality of life (QoL). Increased prevalence and severity of visual complaints in people with PD are related to longer disease duration, higher disease severity, and off-state. CONCLUSION: A large proportion of people with PD have visual complaints, which negatively affect QoL. Complaints are diverse in nature, and specific and active questioning by clinicians is advised to foster timely recognition, acknowledgement, and management of these complaints.

Health care professionals' motivation, their behaviors, and the quality of hospital care: A mixed-methods systematic review.

BACKGROUND: Health care professionals' work motivation is assumed to be crucial for the quality of hospital care, but it is unclear which type of motivation ought to be stimulated to improve quality. Motivation and similar concepts are aligned along a motivational continuum that ranges from (intrinsic) autonomous motivation to (extrinsic) controlled motivation to provide a framework for this mixed-methods systematic review. PURPOSE: This mixed-methods systematic review aims to link various types of health care professionals' motivation directly and through their work-related behaviors to quality of care. METHODS: Six databases were searched from January 1990 to August 2016. Qualitative and quantitative studies were included if they reported on work motivation in relationship to work behavior and/or quality, and study participants were health care professionals working in hospitals in high-income countries. Study bias was evaluated using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. The review protocol was registered in the PROSPERO database (CRD42016043284). RESULTS: A total of 84 out of 6,525 unique records met the inclusion criteria. Results show that health care professionals' autonomous motivation improves their quality perceptions and work-related behaviors. Controlled motivation inhibits voicing behavior, but when balanced with autonomous motivation, it stimulates core task and proactive behavior. Proactivity is associated with increased quality of care perceptions. PRACTICE IMPLICATIONS: To improve quality of care, policy makers and managers need to support health care professionals' autonomous motivation and recognize and facilitate proactivity as an essential part of health care professionals' jobs. Incentive-based quality improvements need to be complemented with aspects that stimulate autonomous motivation.

Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study.

BACKGROUND: Quality indicators are registered to monitor and improve the quality of care. However, the number and effectiveness of quality indicators is under debate, and may influence the joy in work of physicians and nurses. Empirical data on the nature and consequences of the registration burden are lacking. The aim of this study was to identify and explore healthcare professionals' perceived burden due to quality registrations in hospitals, and the effect of this burden on their joy in work. METHODS: A mixed methods observational study, including participative observations, a survey and semi-structured interviews in two academic hospitals and one teaching hospital in the Netherlands. Study participants were 371 healthcare professionals from an intensive care unit (ICU), a haematology department and others involved in the care of elderly patients and patients with prostate or gastrointestinal cancer. RESULTS: On average, healthcare professionals spend 52.3 minutes per working day on quality registrations. The average number of quality measures per department is 91, with 1380 underlying variables. Overall, 57% are primarily registered for accountability purposes, 19% for institutional governance and 25% for quality improvement objectives. Only 36% were perceived as useful for improving quality in everyday practice. Eight types of registration burden were identified, such as an excessive number of quality registrations, and the lack of usefulness for improving quality and inefficiencies in the registration process. The time healthcare professionals spent on quality registrations was not correlated with any measure of joy in work. Perceived unreasonable registrations were negatively associated with healthcare professionals' joy in work (intrinsic motivation and autonomy). Healthcare professionals experienced quality registrations as diverting time from patient care and from actually improving quality. CONCLUSION: Registering fewer quality indicators, but more of what really matters to healthcare professionals, is key to increasing the effectiveness of registrations for quality improvement and governance. Also the efficiency of quality registrations should be increased through staffing and information and communications technology solutions to reduce the registration burden experienced by nurses and physicians.

The impact of early information concerning the surgical operations on anxiety in patients with burns.

AIMS: Stress has been linked to poor coping with health-related issues, poor adaptation, a decrease of quality of life, poor recovery and poor wound healing. Therefore, it is important to address patients' uncertainty and feelings of anxiety. The aim of this study was to examine the effect of providing early treatment information based on an LDI-scan to patients with burns on their feelings of anxiety. DESIGN: An observational prospective pre-test post-test study. METHODS: Patients with intermediate burns (n = 59) admitted to our burn centre in 2016 were evaluated for anxiety using a visual analogue scale (VAS-A) before and after an LDI-scan was made. Two groups were compared: a group that heard whether surgery would or would not be recommended for wound closure (certain group) versus a group that heard to wait and see whether an operation was determined to be helpful (uncertain group). RESULTS: Before the LDI-scan was made, both groups showed clinically high levels of anxiety (median VAS scores above 5). After the information gathered with the LDI was discussed with the patient, anxiety dropped significantly (median VAS below 3; p = .001). No significant differences between the groups were observed (p > .05). CONCLUSION: In contrast to other studies, anxiety was significantly reduced in all our study groups after information was shared. Early communication of knowledge by health care professionals is important regardless whether it includes treatment uncertainty.

Moonlighting in Mitosis: Analysis of the Mitotic Functions of Transcription and Splicing Factors.

Moonlighting proteins can perform one or more additional functions besides their primary role. It has been posited that a protein can acquire a moonlighting function through a gradual evolutionary process, which is favored when the primary and secondary functions are exerted in different cellular compartments. Transcription factors (TFs) and splicing factors (SFs) control processes that occur in interphase nuclei and are strongly reduced during cell division, and are therefore in a favorable situation to evolve moonlighting mitotic functions. However, recently published moonlighting protein databases, which comprise almost 400 proteins, do not include TFs and SFs with secondary mitotic functions. We searched the literature and found several TFs and SFs with bona fide moonlighting mitotic functions, namely they localize to specific mitotic structure(s), interact with proteins enriched in the same structure(s), and are required for proper morphology and functioning of the structure(s). In addition, we describe TFs and SFs that localize to mitotic structures but cannot be classified as moonlighting proteins due to insufficient data on their biochemical interactions and mitotic roles. Nevertheless, we hypothesize that most TFs and SFs with specific mitotic localizations have either minor or redundant moonlighting functions, or are evolving towards the acquisition of these functions.

The development of the Screening of Visual Complaints questionnaire for patients with neurodegenerative disorders: Evaluation of psychometric features in a community sample.

BACKGROUND AND OBJECTIVES: Patients with neurodegenerative disorders often experience impairments in visual function. In research and clinical care, visual problems are primarily understood as objective visual impairments. Subjective complaints, referring to complaints from a patient's perspective, receive less attention, while they are of utmost clinical importance to guide assessment and rehabilitation. A 21-item Screening of Visual Complaints questionnaire (SVC) was developed for the assessment of subjective visual complaints in patients with neurodegenerative disorders. This prospective study aims to evaluate the psychometric properties of the SVC in a large community sample. METHODS: A stratified convenience sample of 1,461 healthy Dutch participants (18-95 years) without severe self-reported neurological, ophthalmological or psychiatric conditions completed the SVC, Cerebral Visual Complaints questionnaire (CVC-q), National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25), Behavior Rating Inventory of Executive Function-A (BRIEF-A), Questionnaire for Experiences of Attention Deficits (Fragebogen erlebter Defizite der Aufmerkzamkeit; FEDA), Depression Anxiety Stress Scale-21 (DASS-21) and the Structured Inventory for Malingered Symptomatology (SIMS) online. After two weeks, 66 participants completed the SVC again. We evaluated the factor structure, internal consistency, convergent and divergent validity, and test-retest reliability of the SVC. RESULTS: The sample was split in two subsamples to perform exploratory and confirmatory factor analyses. In the first subsample, the exploratory factor analysis extracted three factors from the SVC: diminished visual perception, altered visual perception and ocular discomfort. The confirmatory factor analysis showed this model to be valid in the second subsample. The SVC showed satisfactory convergent validity (NEI-VFQ-25: r = -0.71; CVC-q: r = 0.84) and divergent validity (SIMS: r = 0.26; BRIEF-A: r = 0.29; FEDA: r = 0.40; DASS-21: r = 0.34) and good internal consistency (Cronbach's alpha = 0.85) and test-retest reliability (ICC = 0.82). CONCLUSIONS: The SVC is a valid and reliable tool for the assessment of subjective visual complaints in a community sample and appears promising for clinical use in patients with neurodegenerative disorders.

Effects of low visual acuity on neuropsychological test scores: A simulation study.

Objective: To systematically examine the effect of low visual acuity (LVA) on a number of commonly used neuropsychological tests.Method: In this study, the influence of LVA on a number of commonly used neuropsychological tests was examined in 238 healthy older adults (aged 50-80) without visual or neurological impairment. LVA was simulated using simulation glasses.Results: It was found that a simulated LVA of ∼0.2 (decimal acuity; Snellen 6/30 or 20/100, LogMAR 0.7) had a negative impact on test performance for the Trail Making Test, Complex Figure of Rey (copy score), and Visual Object and Space Perception battery subtest 3, but not for the Mini Mental State Examination and Balloons test. For some tests, the negative impact of LVA increased with age.Conclusions: These results have important implications for the use of neuropsychological tests in the visually impaired population. More specifically, when administering the Trail Making Test, Complex Figure of Rey (copy score), and Visual Object and Space Perception Battery subtest 3 to older people with LVA, low test scores should be interpreted with great caution. Low test scores on the Mini Mental State Examination and Balloons Test are not likely to be caused by LVA and are more likely to reflect actual cognitive impairment. The results contribute to the validity of neuropsychological assessment of older people with visual impairment, leading to more effective and more patient-based rehabilitation.

RNAi-mediated depletion of the NSL complex subunits leads to abnormal chromosome segregation and defective centrosome duplication in Drosophila mitosis.

The Drosophila Nonspecific Lethal (NSL) complex is a major transcriptional regulator of housekeeping genes. It contains at least seven subunits that are conserved in the human KANSL complex: Nsl1/Wah (KANSL1), Dgt1/Nsl2 (KANSL2), Rcd1/Nsl3 (KANSL3), Rcd5 (MCRS1), MBD-R2 (PHF20), Wds (WDR5) and Mof (MOF/KAT8). Previous studies have shown that Dgt1, Rcd1 and Rcd5 are implicated in centrosome maintenance. Here, we analyzed the mitotic phenotypes caused by RNAi-mediated depletion of Rcd1, Rcd5, MBD-R2 or Wds in greater detail. Depletion of any of these proteins in Drosophila S2 cells led to defects in chromosome segregation. Consistent with these findings, Rcd1, Rcd5 and MBD-R2 RNAi cells showed reduced levels of both Cid/CENP-A and the kinetochore component Ndc80. In addition, RNAi against any of the four genes negatively affected centriole duplication. In Wds-depleted cells, the mitotic phenotypes were similar but milder than those observed in Rcd1-, Rcd5- or MBD-R2-deficient cells. RT-qPCR experiments and interrogation of published datasets revealed that transcription of many genes encoding centromere/kinetochore proteins (e.g., cid, Mis12 and Nnf1b), or involved in centriole duplication (e.g., Sas-6, Sas-4 and asl) is substantially reduced in Rcd1, Rcd5 and MBD-R2 RNAi cells, and to a lesser extent in wds RNAi cells. During mitosis, both Rcd1-GFP and Rcd5-GFP accumulate at the centrosomes and the telophase midbody, MBD-R2-GFP is enriched only at the chromosomes, while Wds-GFP accumulates at the centrosomes, the kinetochores, the midbody, and on a specific chromosome region. Collectively, our results suggest that the mitotic phenotypes caused by Rcd1, Rcd5, MBD-R2 or Wds depletion are primarily due to reduced transcription of genes involved in kinetochore assembly and centriole duplication. The differences in the subcellular localizations of the NSL components may reflect direct mitotic functions that are difficult to detect at the phenotypic level, because they are masked by the transcription-dependent deficiency of kinetochore and centriolar proteins.