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, parental myopia was not associated with the age-related trends of refractive error (regression coefficient for children without parental myopeia, 0.08; for children with 2 parents with myopia, 0.04; P = .31 for interaction) and ratio of axial length to corneal curvature radius (regression coefficient for children without parental myopeia, 0.031; for children with 2 parents with myopia, 0.032; P = .89 for interaction) beyond infancy. Conclusions and Relevance Parental myopia, especially childhood-onset parental myopia, was associated with a greater risk of early-onset myopia in Asian, Hispanic, non-Hispanic white, and African American children. The observed associations of parental myopia in children as early as 1 year of age and in children without myopia suggests that genetic susceptibility may play a more important role in early-onset myopia and that parental myopia may contribute to myopia in children by setting up a more myopic baseline before school age.Bone being a hierarchical composite material has a structure varying from macro to nano scale. The arrangement of the components of bone material and the bonding between fibers and matrix gives rise to its unique material properties. In the present study, the micro-mechanisms of cortical bone failure were examined under different loading conditions using scanning electron microscopy. The experimental tests were conducted in longitudinal and transverse directions of bone diaphysis under tensile as well as compressive loadings. The results show that bone material has maximum stiffness under longitudinal tensile loading, while the strength is higher under transverse compressive loading. A reverse trend of compressive mechanical properties of bone is observed for longitudinal and transverse loading as compared to trends reported in the previous studies. Therefore, micro-mechanisms of cortical bone failure were analyzed for different loading conditions to reveal such type of behavior of cortical bone and to correlate bone microstructure with mechanical response of bone. Copyright (c) 2020 by ASME.Importance Clinical assessment of vision-related disability is hampered by the lack of instruments to assess visual performance in real-world situations. Interactive virtual reality (VR) environments displayed in a binocular stereoscopic VR headset have been designed, presumably simulating day-to-day activities to evaluate vision-related disability. Objective To investigate the application of VR to identify vision-related disability in patients with glaucoma. Design, Setting, and Participants In a cross-sectional study, 98 patients with glaucoma and 50 healthy individuals were consecutively recruited from a university eye clinic; all participants were Chinese. The study was conducted between August 30, 2016, and July 31, 2017; data analysis was performed from December 1, 2017, to October 30, 2018. Exposures Measurements of visual acuity, contrast sensitivity, visual field (VF), National Eye Institute 25-item Visual Function Questionnaire Rasch score, and VR disability scores determined from 5 VR simulations sEye Institute 25-item Visual Function Questionnaire Rasch score (R2 = 0.207). Conclusions and Relevance These findings suggest that vision-related disability is associated with lighting condition and task in patients with glaucoma. Virtual reality may allow eye care professionals to understand the patients' perspectives on how visual impairment imparts disability in daily living and provide a new paradigm to augment the assessment of vision-related disability.Detailed knowledge of strain rate-dependent viscoelastic properties of bony materials is necessary to understand the mechanisms of bone fracture under impact loading conditions (e.g. falls, traffic accidents and military environments, etc.). Although the mechanical properties of bones have been studied for several decades, the high strain rate data and corresponding material parameters of the rate-dependent constitutive models are still limited. In the present study, Split Hopkinson Pressure Bar (SHPB) technique was used to test bovine cortical bones to obtain the rate-dependent stress-strain curves in two directions (along and perpendicular to the bone fibers). A constitutive relationship comprising two terms was then presented to identify the material constants with strain rate effect and viscoelastic properties. In this model, the quasi-static elasticity and nonlinear viscoelasticity components were used to show the nonlinear strain rate dependence. The presented data give strong experimental evidence and basis for further development of biomechanical models for human cortical bone. Copyright (c) 2020 by ASME.Importance Risk factors for in-hospital mortality of patients with head and neck cancer (HNC) are multilevel. Studies have examined the effect of patient-level characteristics on in-hospital mortality; however, there is a paucity of data on multilevel correlates of in-hospital mortality. Objective To examine the multilevel associations of patient- and hospital-level factors with in-hospital mortality and develop a nomogram to predict the risk of in-hospital mortality among patients diagnosed with HNC. Design, Setting, and Participants This cross-sectional study used the 2008-2013 National Inpatient Sample database. Rapamycin in vitro Hospitalized patients 18 years and older diagnosed (both primary and secondary diagnosis) as having HNC using the International Classification of Diseases, Ninth Revision, Clinical Modification codes were included. Analysis began December 2018. Main Outcomes and Measures The primary outcome of interest was in-hospital mortality. A weighted multivariable hierarchical logistic regression model estimain-hospital mortality discrimination (area under the curve of 72%). Conclusions and Relevance This cross-sectional study found that both patient- and hospital-level factors were associated with in-hospital mortality, and the nomogram estimated with fair accuracy the probability of in-hospital death among patients with HNC. These multilevel factors are critical indicators of survivorship and should thus be considered when planning programs or interventions aimed to improve survival among this unique population.
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