Inhalation Lenalidomide-Loaded Liposome for Bleomycin-Induced Pulmonary Fibrosis Improvement.

Idiopathic pulmonary fibrosis (IPF) is a progressive, fibrotic interstitial lung disease with unclear etiology and increasing prevalence. Pulmonary administration can make the drug directly reach the lung lesion location and reduce systemic toxic and side effects. The effectiveness of lenalidomide (Len) liposomal lung delivery in idiopathic pulmonary fibrosis was investigated. Len liposomes (Len-Lip) were prepared from soybean lecithin, cholesterol (Chol), and medicine in different weight ratios by thin film hydration method. The Len-Lip were spherical in shape with an average size of 226.7 ± 1.389 nm. The liposomes with a higher negative zeta potential of around - 34 mV, which was conducive to improving stability by repelling each other. The drug loading and encapsulation rate were 2.42 ± 0.07% and 85.47 ± 2.42%. Len-Lip had little toxicity at the cellular level and were well taken up by cells. At bleomycin-induced pulmonary fibrosis model mice, inhalation Len-Lip could improve lung function and decrease lung hydroxyproline contents, and alleviate pulmonary fibrosis state. Inhalation Len-Lip provided a reference for the treatment of idiopathic pulmonary fibrosis.

The Association Between the Special Subsidy for Families Practicing Family Planning and the Mental Health of Loss/Disability-of-Single-Child Parents: Evidence from China.

This study evaluated the association between the special subsidy policy and the mental health of loss/disability-of-single-child parents (LCPs/DCPs) in China and found that accepting the special subsidy is inversely related to the mental health of LCPs and DCPs. In addition, accepting the subsidy is more inversely related to the mental health of LCPs than DCPs, of rural parents than urban parents, of male parents than female parents, and of loss/disability-of-single-son parents than loss/disability-of-single-daughter parents. According to taboo trade-off theory, we proposed several explanations for the finding and put forward some policy recommendations.

Gender Differences in Mental Health of Bereaved Parents in an Only-Child Society: Evidence From China.

This study examined gender differences in mental health of bereaved parents related to the gender of deceased only child in China, an only-child society with traditional culture of son preference, using data drawn from the China Family Planning Survey on Vulnerable Households in 2017. The findings indicated that parents with deceased only child suffered from more negative mental health symptoms than nonbereaved parents. For only-child-death families, there were no statistically significant gender differences in mental health of parents, and the gender of the deceased only child was basically unrelated to maternal/paternal mental health. Due to the implementation of one-child policy in China, both sons and daughters are highly prized and equally relied on by aging parents owing to the irreplaceability of the only child, which might moderate the effects of traditional culture of son preference on bereaved parental mental health.

Discovery of cyanopyridine scaffold as novel indoleamine-2,3-dioxygenase 1 (IDO1) inhibitors through virtual screening and preliminary hit optimisation.

With the aim of discovering novel IDO1 inhibitors, a combined similarity search and molecular docking approach was employed to the discovery of 32 hit compounds. Testing the screened hit compounds has led to several novel submicromolar inhibitors. Especially for compounds LVS-019 with cyanopyridine scaffold, showed good IDO1 inhibitory activity. To discover more compounds with similar structures to LVS-019, a shape-based model was then generated on the basis of it and the second-round virtual screening was carried out leading to 23 derivatives. Molecular docking studies suggested a possible binding mode of LVS-019, which provides a good starting point for the development of cyanopyridine scaffold compounds as potent IDO1 inhibitor. To improve potency of these hits, we further designed and synthesised another 14 derivatives of LVS-019. Among these compounds, LBJ-10 showed improved potency compared to the hits and displayed comparable potency to the control GDC-0919 analogue. LBJ-10 can serve as ideal leads for further modifications as IDO1 inhibitors for cancer treatment.

Retinal sensitivity is a valuable complementary measurement to visual acuity--a microperimetry study in patients with maculopathies.

PURPOSE: To evaluate changes in macular sensitivity, as measured with microperimetry, among patients with maculopathy and stable visual acuity (VA). METHODS: Macular sensitivity was assessed using the Spectral OCT/SLO™ microperimetry (OCT/SLO, Optos Plc., Dunfermline, UK) in 25 eyes (16 patients) with maculopathy and stable VA (<5 letters change in ETDRS score) at two consecutive clinic visits. To take the limits of the test-retest repeatability of the OCT/SLO into account, coefficient of repeatability (CoR) was employed to estimate the probability of the sensitivity changes being secondary to measurement noise. RESULTS: The point sensitivity changes were statistically significant (Wilcoxon signed-rank test, P < 0.001). Seventy-seven points (11 %) out of a total of 700 sensitivity points had a genuine sensitivity change, with a mean increase of 8.6 ± 2.6 dB in 35 points and a mean decrease of 7.9 ± 2.2 dB in 42 points. CONCLUSIONS: Point-to-point change in macular sensitivity can be used as a biomarker of changes in disease activity in patients with maculopathy, and can be more accurate than either mean sensitivity or BCVA in detection of changes in macular function. The measurement variability should be considered when observing the local sensitivity changes.

Prevalence of high astigmatism in children aged 3 to 6 years in Guangxi, China.

PURPOSE: To investigate the prevalence and type of high astigmatism among children aged 3 to 6 years in Guangxi, a relatively undeveloped province in western China, and to examine the correlation between astigmatism and visual acuity. METHODS: Children aged 3 to 6 years in Nanning, the capital of Guangxi Province, participated in a population-based survey using a cluster random sampling technique. Eye examinations included autorefraction, visual acuity measurements, and assessments of the external eye, anterior segment, media, and fundus. Data for the right eyes were analyzed. RESULTS: Among the 2304 children examined, the overall prevalence of high astigmatism (≥1.25 diopters by noncycloplegic SureSight autorefraction) was 12.7% (95% confidence interval, 11.3 to 14.0%). The age-specific prevalences of high astigmatism in 3-, 4-, 5-, and 6-year-old children were 13.8, 13.2, 12.9, and 8.1%, respectively. The prevalence of high astigmatism did not vary with age or gender (p > 0.05). The majority of cases of high astigmatism were with-the-rule astigmatism (82.9%), followed by against-the-rule (12.6%) and oblique (4.5%) astigmatism. A linear correlation was found between astigmatism magnitude and visual acuity (logMAR acuity = 0.068 + 0.055 × astigmatism) in all participants. Multiple linear regression analysis further showed that the correlation of astigmatism with visual acuity was magnitude dependent (ß = 0.240). When with-the-rule astigmatism was used as a reference group, against-the-rule astigmatism (ß = 0.137) and oblique astigmatism (ß = 0.154) were closely correlated with visual acuity. CONCLUSIONS: High astigmatism was moderately prevalent among children aged 3 to 6 years in Guangxi Province. With-the-rule astigmatism was the dominant form of astigmatism. Magnitude- and orientation-dependent correlations of astigmatism with visual acuity were confirmed.

Association of retinal sensitivity to integrity of photoreceptor inner/outer segment junction in patients with diabetic macular edema.

PURPOSE: To evaluate the relationship between retinal sensitivity and the photoreceptor inner segment/outer segment (IS/OS) layer status in patients with diabetic macular edema (DME). DESIGN: Cross-sectional study. PARTICIPANTS: Twenty-five adult patients (37 eyes) diagnosed with DME and managed at the Wilmer Eye Institute, Johns Hopkins University (Baltimore, MD). METHODS: We obtained simultaneous fundus microperimetry (MP) and optical coherence tomography (OCT) of patients with DME using a combined MP/OCT system. The device recorded retinal sensitivity and retinal thickness on a 3-dimensional tomography map, and we performed a point-by-point analysis of the IS/OS layer integrity at every MP point. We also reviewed OCT scans to determine the type of DME, cystoid macular edema, or diffuse macular edema (absence of any cysts). In addition, fixation stability and fixation location were analyzed. MAIN OUTCOME MEASURES: Retinal point sensitivity measured by MP. RESULTS: Twenty-five patients (37 eyes: 29 male and 8 female; mean age, 64.16 years) with DME were enrolled. Fixation was centric in 30 eyes (81%), paracentric in 3 eyes (8%), and eccentric in 4 eyes (11%). Twenty-seven eyes had cystoid macular edema, and 10 eyes had diffuse macular edema. Mean central subfield thickness was 325 µm. We analyzed a total of 1036 individual MP points. Mean point sensitivity was 10.51 dB. A total of 793 points (76.5%) had IS/OS layer present, and 243 points (23.5%) had IS/OS layer disrupted. A mixed linear model, constructed to adjust for potential confounders and account for dependence between retinal points, revealed that the absence of the IS/OS junction was significantly associated with a 3.28-dB decrease in retinal point sensitivity (P<0.001). CONCLUSIONS: This novel index study demonstrates that disruption of the IS/OS junction is correlated with a significant decrease in point sensitivity in eyes with DME. Further studies are indicated to confirm and validate this relationship. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

Duration of immunogenicity of high-dose and prolonged-schedule hepatitis B vaccine among patients with chronic kidney disease: A one year follow-up study in China.

BACKGROUND: Patients with chronic kidney disease (CKD) have immunological defects that result in reduced production and faster decay of anti-HBs after hepatitis B vaccination. We assessed the duration of the immunogenicity after four-standard-dose and four-triple-dose regimens among patients with CKD. METHODS: A randomized controlled trial was conducted between May 2019 and February 2020. Patients were randomly allocated to receive three or four doses of 20 µg    , or four doses of 60 µg   of hepatitis B vaccine. Immunogenicity was assessed for 18 months till February 2021. RESULTS: Between months 7 and 18, the seroconversion rate decreased from 81.7% (58/71) to 64.3% (36/56) in IM20 × 3 group, from 93.0% (66/71) to 77.4% (41/53) in IM20 × 4 group, and from 93.2% (68/73) to 90.7% (49/54) in IM60 × 4 group. Seroconversion was higher in IM60 × 4 group than in IM20 × 3 group at month 18 (P < 0.05). In multivariate analysis, CKD patients without immune suppression or hormone therapy or patients with IM60 × 4 were more likely to have durable immunogenicity at month 18. CONCLUSIONS: Patients receiving four-triple-dose regimen of hepatitis B vaccine showed improved duration of immunogenicity at the one-year follow-up. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT03962881).

Sex-specific differences in sleep-disordered breathing and nocturnal hypoxemia in chronic thromboembolic pulmonary hypertension and chronic thromboembolic pulmonary disease.

Objective: Although chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease (CTEPD) are known to be accompanied by symptoms associated with sleep-disordered breathing (SDB) and nocturnal hypoxemia, the sex-specific differences of SDB and nocturnal hypoxemia in patients with CTEPH and CTEPD remain unknown. Methods: Between July 2020 and August 2022, data were retrieved from 57 males and 63 female patients with CTEPH and CTEPD who underwent sleep study at Shanghai Pulmonary Hospital. Nocturnal mean SpO2 (mean SpO2) < 90% was defined as nocturnal hypoxemia. Logistic and linear regression analysis was performed to assess the predictive value of sleep study indices to hemodynamic parameters. Receiver operating characteristic (ROC) curve was applied to analyze the specific parameters to predict the risk of CTEPH. Results: SDB was similarly present in males and females, and both sexes predominantly had obstructive sleep apnea (OSA); more women were diagnosed with nocturnal hypoxemia (32 vs. 7%, p = 0.002). SaO2 was negatively associated with mean pulmonary arterial pressure (mPAP) in men (p < 0.001), whereas the ratio of nocturnal SpO2 < 90% of the total monitoring time (T90%) was positively correlated with mPAP. Mean SpO2 was an independent predictor for pulmonary vascular resistance and cardiac output in women (p = 0.001, p < 0.001, p = 0.001, respectively). T90%, SaO2, and minimal SpO2 were combined to develop a new composite parameter: hypoxemia scoring index (HSI). ROC curve analysis indicated that HSI levels of 0.55 could discriminate CTEPH from CTEPD with a sensitivity of 92.3% and specificity of 87.5% in female patients (an area under the curve, 0.937; 95% CI: 0.879-0.995, p < 0.001). Conclusion: Sex-specific nocturnal hypoxemia was present in patients with CTEPH or CTEPD. In female patients, the HSI showed high capacity for predicting the risk of CTEPH. Clinical trials registration: Registry: chictr.org.cn; Identifier: ChiCTR-DDD-16009406.

Long-term outcomes in health-related quality of life influence chronic disease management in patients with pulmonary hypertension.

Background: Significantly improved survival in patients with pulmonary hypertension (PH) has raised interest in maintaining a good quality of long-term survivorship. In this study, health-related quality of life (HRQOL) measurement was used to assess the long-term changes of physical and mental outcomes. Methods: A total of 559 consecutive inpatients with PH completed generic HRQOL (Short Form-36) who were diagnosed with PH by right heart catheterization. Assessments were carried out at short-term (1 year), midterm (3 years), and long-term (5 years) follow-ups. Results: Patients with PH suffered more severe impairments in both physical and emotional domains than the U.S. population normative values. Patients with PH due to chronic lung disease had the worst physical component summary (PCS) score, but there was no difference in mental component summary (MCS) score among different PH types. A reduced PCS score was correlated with WHO FC severity and pulmonary vascular resistance (PVR). The Z score showed that the changing trend of mental conditions continuously declined from baseline to midterm and long-term follow-ups, but the PCS score seemed to be stable or improved. Cox regression analysis indicated increased baseline PVR and WHO FC III and IV, and decreased physical subscale of role physical, mental subscale of social functioning, and the MCS score have increased risk of mortality in the long-term follow-up. Conclusion: Patients with PH have poor HRQOL. The long-term change of physical status seemed to be stable, but the mental state was continuously worse. These suggested identifying and intervening mental health progresses is a noteworthy issue in PH chronic management.

Preparation of 3D Printed Chitosan/Polyvinyl Alcohol Double Network Hydrogel Scaffolds.

In this work, a 3D printed double-network (DN) hydrogel scaffold is designed with chitosan (CS) and polyvinyl alcohol (PVA) as the framework matrix. The addition of PVA into the CS-based hydrogel clearly enhances the mechanical properties and lowers the swelling behaviors of the hydrogels. The crosslinking of CS with genipin can perform the pre-crosslinking to improve the viscosity and 3D printability of the hydrogel precursor, while increasing the PVA content results in lowering the viscosity and 3D printability of the pre-crosslinked hydrogel. The antibacterial property results of the DN hydrogel display that the hydrogel have favorable long-lasting antibacterial ability. The appropriate pre-crosslinked hydrogel with the CS/PVA mass ratio of 3:10 and pre-crosslinking time of 7 h is used for 3D printing to prepare the 3D printed porous DN hydrogels. Moreover, the anti-tumor drug doxorubicin (DOX) is loaded into the 3D printed porous DN hydrogels and the in vitro release study displays the sustainable drug release behavior. And the DOX release from hydrogel scaffold can be adjusted by the pH value of release environment. All of the results indicate that the porous DN CS/PVA hydrogel scaffolds have great application potential for tissue regeneration.

Immunogenicity and safety of a high-dose and prolonged-schedule hepatitis B vaccine among chronic kidney disease patients: a randomized, parallel-controlled trial.

Background: The immunogenicity against hepatitis B vaccine is unsatisfactory in the chronic kidney disease (CKD) patients, and studies evaluating augmented vaccine regimens to enhance immunogenicity have been inconclusive.Objectives: To evaluate the immunogenicity and safety of four-standard-dose and four-triple-dose regimens hepatitis B vaccine among CKD patients in China.Research design and methods: We conducted a multicenter, randomized, parallel-controlled trial including 273 patients with CKD who were randomly allocated to receive 3 or 4 doses of 20 or 60 µg of recombinant hepatitis B vaccine.Main outcome measures: Seroconversion rates, high-level response rates, and geometric mean concentrations (GMCs) of anti-HBs at months 3 and 7.Results: The seroconversion rates and high-level responses in the IM20 × 4 group and the IM60 × 4 group were higher than those in the IM20 × 3 group at months 3 and 7 (P < 0.05). The IM60 × 4 group had better immune responses than the IM20 × 4 group at month 3 (P < 0.05); however, no significant difference was noted at month 7 (P > 0.05).Conclusions: Both the four-standard-dose and four-triple-dose regimens improved immune response compared to the three-standard-dose regimen of hepatitis B vaccination in CKD patients, and the additional effect of higher dose was minimal.Trial registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT03962881).

Predicting related factors of immunological response to hepatitis B vaccine in hemodialysis patients based on integration of decision tree classification and logistic regression.

The non/hypo-response rate of the hepatitis B vaccine among hemodialysis (HD) patients is still high, it is of great significance to explore the influencing factors and their relationships. To study the related factors and their relationships using logistic regression model and Chi-squared Automatic Interaction Detection (CHAID) decision tree model. A randomized controlled trial was conducted between February 2014 and May 2015 in China. HD patients being serologically negative for HBsAg and anti-HBs were randomly assigned to receive three intramuscular injections of the standard dose (20 µg) or high dose (60 µg) of recombinant hepatitis B vaccine at months 0, 1, and 6. Those with anti-HBs concentrations <100 mIU/mL, and ≥100 mIU/mL at month 7 were considered as non/hypo-response and high-level response, respectively. The non/hypo-response was 31.34% (89/284). After adjustment for confounders, logistic analysis showed that males (OR = 2.203, 95%CI: 1.109-4.367) and those with higher dialysis frequency (>4 times per 2 weeks) (OR = 1.918, 95%CI: 1.015-3.626) had a significant risk of non/hypo-response. While the CHAID analysis showed that gender, dose, and dialysis frequency were influencing factors of non/hypo-response, and gender is most important. The interaction between gender and dialysis frequency had the greatest effect on immunization, and followed by the interaction between dialysis frequency and vaccine dose. Taken together, gender, dose and dialysis frequency were influencing factors of hepatitis B vaccine in HD patients.

Long-term persistent immunogenicity after successful standard and triple-dosed hepatitis B vaccine in hemodialysis patients: A 3-year follow-up study in China.

BACKGROUND: Although the efficacy of hepatitis B vaccines among hemodialysis patients has been documented, the long-term persistence of immunogenicity in this population remains largely unknown. We explored the long-term persistence of immunogenicity induced by different hepatitis B vaccine regimens in hemodialysis patients. METHODS: In initial study, we conducted a randomized, multicenter, double-blind, parallel-controlled trial among hemodialysis patients in 13 hospitals in Shanxi Province, China. A total of 352 hemodialysis patients were allocated to receive 3-dose 20 µg (IM20 group) and 3-dose 60 µg (IM60 group) recombinant hepatitis B vaccine at months 0, 1, and 6. Vaccine-induced immune responses were measured at month 7. In this study, the responders (anti-HBs ≥ 10 mIU/mL) were followed up at months 18, 24, 30, 36 and 42, respectively. We used the generalized log-rank test and generalized estimating equations (GEE) to analyze the long-term durability of responses and the kinetics of anti-HBs levels, respectively. RESULTS: A total of 284 patients were involved in the extended follow-up period. The duration of vaccine-induced response with 75% of patients maintained protective antibody were 12 months and 18 months in the IM20 group and IM60 group, respectively (P = 0.291). The long-term persistent immunogenicity induced by 3-dose 60 µg was more satisfactory than that by 3-dose 20 µg hepatitis B vaccine in patients with hemodialysis duration ≥ five years (P = 0.023). The peak anti-HBs levels in 100-1000 mIU/mL or ≥ 1000 mIU/mL were more likely to maintain long-term protective antibody compared to anti-HBs levels in 10-100 mIU/mL (P ＜ 0.05). The kinetic profile was similar between the two groups (P = 0.334). CONCLUSION: High-dose 60 µg hepatitis B vaccine could lead a satisfactory long-term durability of immunogenicity among patients with hemodialysis duration of five years or more. Peak anti-HBs level after vaccination was associated with the long-term persistence of immunogenicity.

The Influence of Intrinsic Motivation on Pay Satisfaction Among Caregivers in Residential Home for the Elderly in China: The Mediating Role of Job Burnout.

BACKGROUND: According to the theory of compensating differentials, caregivers with high levels of intrinsic motivation should exhibit a higher-than-average satisfaction with their pay. Whereas studies conducted in Western countries have provided empirical evidence for the theory of compensating differentials in various care settings, few studies have been conducted in China that focus on caregivers employed in residential homes for the elderly (RHE). The sociodemographic characteristics of caregivers in China different significantly from their counterparts in Western countries. PURPOSE: This study was developed to analyze the mediating role of job burnout to assess the influence of intrinsic motivation on pay satisfaction among caregivers in RHE. METHODS: Structural equation modeling was used to examine the influences of intrinsic motivation on pay satisfaction in a sample of 1,212 caregivers employed in RHE in China by analyzing the mediating role of job burnout. RESULTS: Intrinsic motivation was found to relate positively to pay satisfaction (ß = .11, p < .05). Negative relationships were identified between intrinsic motivation and job burnout (ß = -.46, p < .01) and between job burnout and pay satisfaction (ß = -.13, p < .01). Job burnout was found to have a significant mediating effect on the relationship between intrinsic motivation and pay satisfaction (ß = .06, p < .01). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: A significant relationship was found between intrinsic motivation and pay satisfaction, with job burnout playing a mediating role in caregivers employed in RHE in China. This research has profound implications for nursing education, practice, and research. First, greater efforts should be focused on instilling nursing values in nursing students to foster intrinsic motivation. Second, nonpecuniary rewards may be offered to caregivers to acknowledge the values of care work and strengthen intrinsic motivation. Third, a supportive working climate should be fostered to reduce job burnout. Fourth, caregivers should be informed of their rights to decent pay and their right to bargain collectively through unions. Fifth, appropriate public policies should be implemented to provide pay for caregivers at levels that recognize and appreciate their intrinsic motivation.

The Modulation of Laser Refractive Surgery on Sensory Eye Dominance of Anisometropia.

PURPOSE: To evaluate the effect of laser refractive surgery on sensory eye dominance of anisometropia. METHODS: A total of 156 subjects with nonanisometropic myopia and 70 subjects with anisometropic myopia were enrolled in the first part of the study. The dichoptic motion coherence threshold technique was applied to collect the normal dataset and distribution of sensory eye dominance. The second part of the study included 40 subjects with nonanisometropic myopia and 40 subjects with anisometropic myopia who received the femtosecond laser-assisted in situ keratomileusis (Fs-LASIK). A comprehensive ophthalmologic evaluation was performed with particular attention to sensory eye dominance preoperatively and one-week and one-month postoperatively. The ocular dominance index (ODI) was applied to evaluate the subject's overall degree of sensory ocular dominance. Visual acuity, sighting eye dominance, and stereo acuity were also accessed. RESULTS: In experiment one, the mean ODI in the nonanisometropic group and the anisometropic group was 1.48 ± 0.63 and 1.95 ± 1.07, respectively. The ODI values of the anisometropic group were significantly higher than those of the nonanisometropic group (Mann-Whitney U test, P < 0.001). The demographics information and the distribution of ODI values in both groups are summarized in tables and figures. In experiment two, all LASIK procedures were uneventful and no postoperative complications were observed during the postoperative follow-up. Preoperatively, the ODI values of the anisometropic LASIK group were significantly higher than those of the nonanisometropic LASIK group, which was consistent with the results of part 1. However, one week after operation, the mean ODI values of the anisometropic LASIK group had significantly decreased from 1.89 ± 1.09 to 1.39 ± 0.44. And, the mean ODI values slightly increased to 1.65 ± 0.61 one-month postoperatively. In the nonanisometropic LASIK group, there were no statistically significant differences of ODI changes among preoperative, post-one-week and post-one-month visits. The demographics information and the changes of ODI of both LASIK groups are summarized in tables and figures. CONCLUSION: Stronger sensory eye dominance is seen in the subjects with anisometropic myopia compared to subjects with nonanisometropic myopia. The strong sensory dominance of anisometropia becomes more balanced at one week of postoperation but returns to the preoperative level after one month. Laser refractive surgery had a short-term modulation of sensory eye dominance.

Intrinsic motivation and turnover intention among geriatric nurses employed in nursing homes: the roles of job burnout and pay satisfaction.

Background: Few studies have examined intrinsic motivation that is related to turnover intention among geriatric nurses employed in nursing homes in China. Objectives: This study aims at investigating the relationship between intrinsic motivation and turnover intention among geriatric nurses employed in nursing homes in China by analyzing the mediating roles of job burnout and pay satisfaction. Methods: Based on multistage stratified random sampling, a total of 1212 geriatric nurses was investigated by a questionnaire in China. Structural equation models were employed to test the hypotheses. Results: Intrinsic motivation was negatively related to turnover intention (ß = -0.063), and job burnout (ß = -0.072) and pay satisfaction (ß = -0.014) played significant mediating roles in the relationship between intrinsic motivation and turnover intention. Conclusions: Findings revealed that intrinsic motivation, pay satisfaction and job burnout were strong predicators of turnover intention. The results may provide implications to lessen turnover intention among geriatric nurses employed in nursing homes.

Comparison of optical quality after implantable collamer lens implantation and wavefront-guided laser in situ keratomileusis.

AIM: To compare the optical quality after implantation of implantable collamer lens (ICL) and wavefront-guided laser in situ keratomileusis (WG-LASIK). METHODS: The study included 40 eyes of 22 patients with myopia who accepted ICL implantation and 40 eyes of 20 patients with myopia who received WG-LASIK. Before surgery and three months after surgery, the objective scattering index (OSI), the values of modulation transfer function (MTF) cutoff frequency, Strehl ratio, and the Optical Quality Analysis System (OQAS) values (OVs) were accessed. The higher order aberrations (HOAs) data including coma, trefoil, spherical, 2nd astigmatism and tetrafoil were also obtained. For patients with pupil size <6 mm, HOAs data were analyzed for 4 mm-pupil diameter. For patients with pupil size ≥6 mm, HOAs data were calculated for 6 mm-pupil diameter. Visual acuity, refraction, pupil size and intraocular pressures were also recorded. RESULTS: In both ICL and WG-LASIK group, significant improvements in visual acuities were found postoperatively, with a significant reduction in spherical equivalent (P< 0.001). After the ICL implantation, the OSI decreased slightly from 2.34±1.92 to 2.24±1.18 with no statistical significance (P=0.62). While in WG-LASIK group, the OSI significantly increased from 0.68±0.43 preoperatively to 0.91±0.53 postoperatively (Wilcoxon signed ranks test, P=0.000). None of the mean MTF cutoff frequency, Strehl ratio, OVs showed statistically significant changes in both ICL and WG-LASIK groups. In the ICL group, there were no statistical differences in the total HOAs for either 4 mm-pupil or 6 mm-pupil. In the WG-LASIK group, the HOA parameters increased significantly at 4 mm-pupil. The total ocular HOAs, coma, spherical and 2nd astigmatism were 0.12±0.06, 0.06±0.03, 0.00±0.03, 0.02±0.01, respectively. After the operation, these values were increased into 0.16±0.07, 0.08±0.05, -0.04±0.04, 0.03±0.01 respectively (Wilcoxon signed ranks test, all P<0.05). At 6 mm-pupil, the induction of total HOAs was not statistically significant in the WG-LASIK group. CONCLUSION: ICL implantation has a less disturbance to optical quality than WG-LASIK. The OQAS is a valuable complementary measurement to the wavefront aberrometers in evaluating the optical quality.

Fixation Stability Measurement Using Two Types of Microperimetry Devices.

PURPOSE: We compared the fixation stability measurements obtained with two microperimeters, the Micro Perimeter 1 (MP-1) and the Spectral OCT/SLO (OCT/SLO), in subjects with and without maculopathies. METHODS: A total of 41 eyes with no known ocular diseases and 45 eyes with maculopathies were enrolled in the study. Both eyes of each participant had a 20-second fixation test using the MP-1 and OCT/SLO. The bivariate contour ellipse area (BCEA) was used for fixation stability evaluation. RESULTS: In the normal group, BCEA was 2.93 ± 0.32 log minarc2 on OCT/SLO and 2.89 ± 0.30 log minarc2 on MP-1. In the maculopathy group, BCEA was 3.05 ± 0.41 log minarc2 on OCT/SLO and 3.15 ± 0.46 log minarc2 on MP-1. There was no statistically significant difference between the BCEA measured by OCT/SLO and by MP-1 in both groups. A moderate correlation was found between the two devices (r = 0.45, P < 0.001). The sample size during the fixation test was 535.5 ± 14.6 pairs of coordinates in the normal group and 530.7 ± 14.9 pairs in the maculopathy group with MP-1, while it was 72.3 ± 6.9 and 59.9 ± 10.1, respectively, with OCT/SLO. This was due to different tracking frequencies between the two microperimeters. CONCLUSION: Fixation stability assessment yields similar results using the OCT/SLO and MP-1. A major difference in sampling rate between the two microperimeters does not significantly affect BCEA measurements. TRANSLATIONAL RELEVANCE: Fixation stability assessments are comparable and interchangeable between the OCT/SLO and the MP-1.