Artificial intelligence improves accuracy, efficiency, and reliability of a handheld infrared eccentric autorefractor for adult refractometry.

AIM: To evaluate the accuracy, efficiency, and reliability of a handheld infrared eccentric autorefractor (hICA) with artificial intelligence (AI) by comparing its refraction measurements to those recorded using hICA and a clinical table-mounted automatic refractor (TAR). METHODS: A cross-sectional study using three optometers, including hICA with or without AI and TAR, for refractometry of adults (aged 19-49 years old) with no signs of ocular disease or trauma in the absence of cycloplegia. Right and left eye refraction data were recorded, including the spherical equivalent (SE), diopter of spherical power (DS), diopter of cylindrical power (DC) decomposed into vectors J0 and J45, and measurement times. To avoid analytical difficulties associated with the interdependence of observations between eyes from the same individual, the Generalized Estimation Equation was used to compare the SE, DS, J0 and J45 measurements, and the times thereof, among the different groups. The intraclass correlation coefficient (ICC) and Spearman's rank correlation coefficient were used to evaluate correlations among the measurements recorded by the three different instruments. Bland-Altman were used to analyze the precision of the equipment by the agreement. RESULTS: A total of 70 patients (140 eyes; mean age: 31.37y; range: 19-49y) were assessed using refractometry. In a brightly lit environment, there was no significant difference between the mean SE recorded using TAR and that recorded using hICA with AI or without AI (both P>0.05). In an intense-light environment, hICA equipped with AI showed a better detection rate than without AI. Light intensity had a greater effect on dioptric measurements recorded using hICA without AI (P<0.001) than on those recorded using the one equipped with AI (P<0.05). Measurement times varied significantly between the different light intensities and instruments (P<0.05). CONCLUSION: For the normal human eyes, AI may improve the accuracy, efficiency, and reliability of measurements recorded using hICA in various light environments.

Comparative Efficacy of Methylphenidate and Atomoxetine on Social Adjustment in Youths with Attention-Deficit/Hyperactivity Disorder.

Objective: Although methylphenidate and atomoxetine have positive effects in reducing core symptoms and emotional/behavioral problems of attention-deficit/hyperactivity disorder (ADHD), little is known about their efficacy in improving social adjustment problems among youths with ADHD. Methods: A total of 168 drug-naive youths, 7-16 years of age, with DSM-IV-defined ADHD, were recruited and randomly assigned to osmotic-release oral system methylphenidate (n = 83) and atomoxetine (n = 85) in a 24-week, open-label, head-to-head clinical trial. Efficacy measurement was based on the parent-rated and self-rated Social Adjustment Inventory for Children and Adolescents (SAICA). Evaluation time points were set at baseline and weeks 8, 16, and 24. Results: At week 24, methylphenidate was associated with improvement in school functions (parent report: Cohen d = -0.82; self-report: Cohen d = -0.66) and peer relationships (parent report: Cohen d = -0.50; self-report: Cohen d = -0.25); and atomoxetine was associated with improvement in school functions (parent report: Cohen d = -0.62; self-report: Cohen d = -0.34) and peer relationships (parent report: Cohen d = -0.33; self-report: Cohen d = -0.65). In terms of parent-reported and self-reported ratings, there were no significant differences between the two treatment groups in mean reduction in the severity of school dysfunctions, impaired peer relationships, and behavioral problems at home at week 24. Conclusions: Our findings lend evidence to support that both methylphenidate and atomoxetine were comparably effective in improving social adjustment in youths with ADHD, including school functions and peer relationships.

An Open-Label, Randomized Trial of Methylphenidate and Atomoxetine Treatment in Children with Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: The efficacy of both methylphenidate and atomoxetine has been established in placebo-controlled trials. The present study aimed to directly compare the efficacy of methylphenidate and atomoxetine in improving symptoms among children with attention-deficit/hyperactivity disorder (ADHD). METHODS: The study sample included 160 drug-naïve children and adolescents 7-16 years of age, with DSM-IV-defined ADHD, randomly assigned to osmotic-release oral system methylphenidate (OROS-methylphenidate) (n=80) and atomoxetine (n=80) in a 24 week, open-label, head-to-head clinical trial. The primary efficacy measure was the score of the ADHD Rating Scale-IV Parents Version: Investigator Administered and Scored (ADHD-RS-IV). The secondary efficacy measures included the Clinical Global Impressions-ADHD-Severity (CGI-ADHD-S) and Chinese Swanson, Nolan, and Pelham IV scale (SNAP-IV), based on the ratings of investigators, parents, teachers, and subjects. RESULTS: At week 24, mean changes in ADHD-RS-IV Inattention scores were 13.58 points (Cohen's d, -3.08) for OROS-methylphenidate and 12.65 points (Cohen's d, -3.05) for atomoxetine; and mean changes in ADHD-RS-IV Hyperactivity-Impulsivity scores were 10.16 points (Cohen's d, -1.75) for OROS-methylphenidate and 10.68 points (Cohen's d, -1.87) for atomoxetine. In terms of parent-, teacher-, and self-ratings on behavioral symptoms, both of the two treatment groups significantly decreased on the SNAP-IV scores at the end-point, with effect sizes ranging from 0.9 to 0.96 on the Inattention subscale and from 0.61 to 0.8 on the Hyperactivity/Impulsivity subscale for OROS-methylphenidate; and from 0.51 to 0.88 on the Inattention subscale and from 0.29 to 0.57 on the Hyperactivity/Impulsivity subscale for atomoxetine. No statistically significant differences between treatment groups were observed on the outcome measures. Vomiting, somnolence, and dizziness were reported more often for atomoxetine than for OROS-methylphenidate, whereas insomnia was reported more often for OROS-methylphenidate than for atomoxetine. CONCLUSIONS: After 24 weeks of treatment, OROS-methylphenidate and atomoxetine had comparable efficacy in reducing core ADHD symptoms in drug-naïve children and adolescents with ADHD.

[Comparison of contrast sensitivity and wavefront analysis after implantation of AcrySof IQ aspherical intraocular lens].

OBJECTIVE: To determine vision quality when testing two acrylic intraocular lenses, AcrySof IQ and AcrySof Natural, after routine cataract extraction and IOL implantation. METHOD: Prospective, randomized, double-masked study that 260 eyes of patients who underwent cataract extraction and IOL implantation was performed. Patients were randomly divided into 2 groups: AcrySof IQ or AcrySof Natural. One week, one and three month postoperative evaluations included contrast sensitivity and wavefront analysis. The independent-samples T test was used. P < 0.05 was considered statistically significant. RESULT: The AcrySof IQ group has significantly higher and middle spatial frequency of contrast sensitivity. The difference in low spatial frequency was getting significant along with time. Patients with AcrySof IQ had a reduction in total high-order aberrations and spherical aberration. There were no difference in coma between two groups. CONCLUSION: The use of aspheric acrylic AcrySof IQ IOL may improve the quality of vision as a result of the reduction of contrast sensitivity and spherical aberration.