Moral foundations theory and the narrative self: towards an improved concept of moral selfhood for the empirical study of morality.

Within the empirical study of moral decision making, people's morality is often identified by measuring general moral values through a questionnaire, such as the Moral Foundations Questionnaire provided by Moral Foundations Theory (MFT). However, the success of these moral values in predicting people's behaviour has been disappointing. The general and context-free manner in which such approaches measure moral values and people's moral identity seems crucial in this respect. Yet, little research has been done into the underlying notion of self. This article aims to fill this gap. Taking a phenomenological approach and focusing on MFT, we examine the concept of moral self that MFT assumes and present an improved concept of moral self for the empirical study of morality. First, we show that MFT adopts an essentialist concept of moral self, consisting of stable moral traits. Then, we argue that such a notion is unable to grasp the dynamical and context sensitive aspects of the moral self. We submit that Ricoeur's narrative notion of identity, a self that reinterprets itself in every decision situation through self-narrative, is a viable alternative since it is able to incorporate context sensitivity and change, while maintaining a persisting moral identity. Finally, we argue that this narrative concept of moral self implies measuring people's morality in a more exploratory fashion within a delineated context.

Why Are General Moral Values Poor Predictors of Concrete Moral Behavior in Everyday Life? A Conceptual Analysis and Empirical Study.

Within moral psychology, theories focusing on the conceptualization and empirical measurement of people's morality in terms of general moral values -such as Moral Foundation Theory- (implicitly) assume general moral values to be relevant concepts for the explanation and prediction of behavior in everyday life. However, a solid theoretical and empirical foundation for this idea remains work in progress. In this study we explore this relationship between general moral values and daily life behavior through a conceptual analysis and an empirical study. Our conceptual analysis of the moral value-moral behavior relationship suggests that the effect of a generally endorsed moral value on moral behavior is highly context dependent. It requires the manifestation of several phases of moral decision-making, each influenced by many contextual factors. We expect that this renders the empirical relationship between generic moral values and people's concrete moral behavior indeterminate. Subsequently, we empirically investigate this relationship in three different studies. We relate two different measures of general moral values -the Moral Foundation Questionnaire and the Morality As Cooperation Questionnaire- to a broad set of self-reported morally relevant daily life behaviors (including adherence to COVID-19 measures and participation in voluntary work). Our empirical results are in line with the expectations derived from our conceptual analysis: the considered general moral values are poor predictors of the selected daily life behaviors. Furthermore, moral values that were tailored to the specific context of the behavior showed to be somewhat stronger predictors. Together with the insights derived from our conceptual analysis, this indicates the relevance of the contextual nature of moral decision-making as a possible explanation for the poor predictive value of general moral values. Our findings suggest that the investigation of morality's influence on behavior by expressing and measuring it in terms of general moral values may need revision.

Validation of LC-MS/MS methods for the determination of mirabegron and eight metabolites in human plasma in a paediatric population.

Mirabegron is the first registered ß3-adrenoceptor agonist for treatment of overactive bladder as an alternative to antimuscarinics. Previously four liquid chromatography-tandem mass spectrometry assays were published to determine mirabegron and eight metabolites (M5, M8, M11-M16) in human plasma. In order to support paediatric development, the assays were further optimized to reduce the required blood volume and increase the sensitivity. The assays were miniaturized by using 96-well supported liquid extraction plates (mirabegron, M5, M16) or 96-well mixed-mode cation exchange solid phase extraction plates (M8, M11-M15) and a more sensitive MS-system was used. For the analytes, up to fivefold increase in assay sensitivity was achieved. The required blood sample volume was reduced from 10 to 2 mL for each timepoint. Validation demonstrated that the assays were accurate, precise and selective in the determination of mirabegron and metabolites. The assays were successfully applied to evaluate the pharmacokinetics of mirabegron in a paediatric population.

Molecular Dynamics of Photosystem II Embedded in the Thylakoid Membrane.

Photosystem II (PSII) is one of the key protein complexes in photosynthesis. We introduce a coarse grained model of PSII and present the analysis of 60 µs molecular dynamics simulations of PSII in both monomeric and dimeric form, embedded in a thylakoid membrane model that reflects its native lipid composition. We describe in detail the setup of the protein complex and the many natural cofactors and characterize their mobility. Overall we find that the protein subunits and cofactors are more flexible toward the periphery of the complex as well as near the PLQ exchange cavity and at the dimer interface. Of all cofactors, ß-carotenes show the highest mobility. Some of the ß-carotenes diffuse in and out of the protein complex via the thylakoid membrane. In contrast with the PSII dimer, the monomeric form adopts a tilted conformation in the membrane, with strong interactions between the soluble PsbO subunit and the glycolipid headgroups. Interestingly, the tilted conformation causes buckling of the membrane. Together, our results provide an unprecedented view of PSII dynamics on a microsecond time scale. Our data may be used as basis for the interpretation of experimental data as well as for theoretical models describing exciton energy transfer.

Straylight Measurements in Two Different Apodized Diffractive Multifocal Intraocular Lenses.

PURPOSE: To evaluate differences in straylight between eyes implanted with a hydrophilic multifocal IOL (Seelens MF; Hanita Lenses, Hanita, Israel) and a hydrophobic multifocal IOL (SN6AD1; Alcon Laboratories, Inc., Fort Worth, TX). METHODS: In a prospective cohort study, routinely obtained straylight measurements (C-Quant; Oculus Optikgeräte, Wetzlar, Germany) 3 months after standard phacoemulsification for either cataract or refractive lens procedures were compared. Patients were implanted with either the SeeLens MF IOL or the SN6AD1 IOL. Postoperative straylight values, visual acuity, and refractive outcomes were compared. RESULTS: The SeeLens MF IOL was implanted in 84 eyes and the SN6AD1 IOL in 79 eyes. The difference in straylight was 0.08 (P = .01), with the SeeLens MF IOL having less straylight. Postoperative CDVA was logMAR -0.03 ± 0.06 in the SeeLens MF group, and logMAR -0.02 ± 0.08 in the SN6AD1 group. Mean postoperative refraction was +0.01 ± 0.43 and +0.06 ± 0.35 D, respectively. CONCLUSIONS: The Seelens MF IOL showed a stray-light of log(s) 0.08 lower than the SN6AD1 IOL. In terms of spherical equivalent and visual acuity the lenses performed equally. More study will aid in understanding the causes and clinical impact of this difference.

Atomistic and Coarse Grain Topologies for the Cofactors Associated with the Photosystem II Core Complex.

Electron transfers within and between protein complexes are core processes of the electron transport chains occurring in thylakoid (chloroplast), mitochondrial, and bacterial membranes. These electron transfers involve a number of cofactors. Here we describe the derivation of molecular mechanics parameters for the cofactors associated with the function of the photosystem II core complex: plastoquinone, plastoquinol, heme b, chlorophyll A, pheophytin, and ß-carotene. Parameters were also obtained for ubiquinol and ubiquinone, related cofactors involved in the respiratory chain. Parameters were derived at both atomistic and coarse grain (CG) resolutions, compatible with the building blocks of the GROMOS united-atom and Martini CG force fields, respectively. Structural and thermodynamic properties of the cofactors were compared to experimental values when available. The topologies were further tested in molecular dynamics simulations of the cofactors in their physiological environment, e.g., either in a lipid membrane environment or in complex with the heme binding protein bacterioferritin.

Effect of vitreous opacities on straylight measurements.

PURPOSE: To evaluate the effect of vitreous floaters on intraocular straylight. METHODS: Records of bilaterally phakic patients with unilateral complaint of floaters as the main symptom were identified from an electronic database. Patients who underwent straylight measurements on both affected and unaffected eyes using a C-Quant straylight meter were selected. Data were collected on age, sex, visual acuity, straylight measurements, and optical coherence tomography. The unaffected eye served as a control. RESULTS: Fifteen cases were included (7 women and 8 men; mean age, 54.3 years; age range, 24-71 years). Visual acuity was not correlated with the complaint of floaters. Average straylight value in eyes with floaters was 1.426 log(s) (±0.23 SD) with a median value of 1.52 log(s). The mean value for fellow eyes was 1.275 (±0.23 SD) with a median of 1.25 log(s). The differences between both groups using a Wilcoxon matched-pair signed-rank test was statistically significant at P = 0.0009. On optical coherence tomography, most patients had a confirmed or probable posterior vitreous detachment. However, in four patients, a posterior vitreous detachment was absent in the affected eyes. Vitreous floaters were inconsistently imaged by optical coherence tomography, with only a few patients presenting appreciable condensations close to the retinal surface. These were present in both affected and unaffected eyes. CONCLUSION: Intraocular straylight is significantly increased in eyes affected by floaters. No correlation was seen with vision or optical coherence tomography appearance. Straylight is an independent objective measure of visual perception that seems to be closely correlated to complaints expressed by patients experiencing floaters.

Quality of vision after femtosecond laser-assisted descemet stripping endothelial keratoplasty and penetrating keratoplasty: a randomized, multicenter clinical trial.

PURPOSE: To compare the quality of vision (straylight and contrast sensitivity) after femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS DSEK) and penetrating keratoplasty (PK). DESIGN: Prospective, randomized clinical trial. METHODS: setting: Multicenter (5 ophthalmic centers in The Netherlands). study population: Eighty eyes of 80 patients with corneal endothelial dysfunction were included and were randomized to FS DSEK or PK. observation procedures: FS DSEK and PK. main outcome measures: Straylight, contrast sensitivity, astigmatism, uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), and visual symptom score. RESULTS: Straylight at 12 months was 1.37 ± 0.2 logarithm of straylight for FS DSEK and 1.46 ± 0.2 logarithm of straylight for PK (P = .151). During 12 months of follow-up, there was a significant improvement of straylight and contrast sensitivity after FS DSEK (P < .001) and PK (P < .001). The change of straylight and contrast sensitivity correlated significantly with the change of BSCVA after FS DSEK (r = -0.645; r = 0.580) and PK (r = -0.370; r = 0.659). The visual symptom score was comparable between the 2 groups during the 12 months of follow-up. CONCLUSIONS: Improvement of straylight and contrast sensitivity was significantly correlated with an improvement of BSCVA. Straylight and contrast sensitivity were improved significantly after FS DSEK and were comparable with those after PK, although BSCVA was slightly better in the PK group.

Combining in vitro test methods for measuring light scatter in intraocular lenses.

Intraocular lenses (IOLs) are designed for implantation for vision correction following cataract removal. The IOL typically replaces a cataractous natural lens that exhibits very high levels of light scattering. The amount of scattering is significantly reduced with an IOL, though it is rarely quantified and both the surface and the bulk of the intraocular lens may contribute to light scatter at some level, and in some cases potentially affecting patients' post-operative quality of vision. The purpose of this paper is to describe two complementary in-vitro quantitative methods for measuring light scatter caused by IOLs. The first method directly measures light scatter from the lens in one plane for angles larger than two degrees. The second method measures light scatter in an eye model including the focal point out to three degrees in the image plane. The measured amount of light scatter from an IOL is typically lower than that found in healthy donor crystalline lenses of various ages that are used as a basis for comparison.

Alleviating debilitating photophobia and secondary exotropia caused by increased straylight by widening a small posterior capsulotomy.

In a patient with complaints of photophobia and an ocular deviation, straylight was found to be increased to 1.61 (log[s]), which is 5 times the normal value. The only relative clinical finding was the edge of a too small posterior capsulotomy. Visual acuity was normal. Six weeks after the posterior capsulotomy was widened to a diameter of 6.0 mm with a neodymium:YAG laser, the symptoms were resolved and the patient was satisfied. Straylight may manifest clinically as complaints of photophobia. Straylight increase, which can be related to slitlamp findings, may lead to an interventional decision. Our clinical decision-making was also guided by straylight measurements and proved to be crucial in resolving the patient's complaints. More study of clinical situations in which straylight measurement can be used is needed.

Straylight measurements in laser in situ keratomileusis and laser-assisted subepithelial keratectomy for myopia.

PURPOSE: To compare straylight values before and 3 months after laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) and to analyze the causes of any change. SETTING: Private refractive surgery clinic, Driebergen, The Netherlands. METHODS: Straylight was measured before and after LASIK or LASEK with a C-Quant straylight meter; values were recorded as the straylight parameter log(s). Main outcome measures were the difference between postoperative and preoperative straylight values and factors causing a difference between the values. RESULTS: The study evaluated 102 eyes having LASIK and 137 eyes having LASEK. On average, there was significant improvement in straylight values postoperatively in both groups. The mean decrease was -0.016 log(s) in the LASIK group and -0.026 log(s) in the LASEK group. Nonparametric testing (sign test) showed that the improvement in straylight was statistically significant in more than 50% of eyes in both groups. Straylight improved in 62 eyes in the LASIK group (P<.001) and 78 eyes in the LASEK group (P<.02) and deteriorated in 35 eyes and 58 eyes, respectively. There was an increase in straylight in 17 eyes (7.1%). Clinical correlations were found in some eyes that had increased postoperative straylight values. CONCLUSION: On average, straylight values 3 months after LASIK and LASEK were slightly decreased from baseline values.

Straylight measurements before and after removal of epithelial ingrowth.

In 3 eyes with epithelial ingrowth after laser in situ keratomileusis, straylight was measured before and after the ingrowth was removed. In 2 eyes of 1 patient, epithelial ingrowth reached the pupillary axis. Straylight decreased (improved) significantly after ingrowth removal: a 3.6-fold decrease in the right eye and a 10-fold decrease in the left eye. The uncorrected distance visual acuity (UDVA) improved from 0.25 (20/80) in both eyes to 1.0 (20/20) and 0.8 (20/25), respectively. In 1 eye of another patient, from which epithelial ingrowth was removed to prevent flap melting and distortion, the pupillary opening was not obscured and no significant change in straylight was found. The UDVA improved from 0.32 (20/60) to 1.0 (20/20) after the ingrowth was removed. An increase in straylight can be a significant complication of epithelial ingrowth. After the interlamellar space is cleared, the improvement in straylight is several factors larger than the gain in UDVA.

Randomised controlled trial of the effects of two rigid gas permeable (RGP) contact lens materials and two surface cleaners on straylight values.

PURPOSE: In a double-masked randomized controlled crossover study we investigated both the retinal responses to straylight, and the effects of lens cleaners on straylight values, in two different RGP contact lens materials. METHODS: Thirty patients (20-59 years) wearing RGP lenses were refitted with new lenses made of Boston XO material in one eye and made of Comfort O2 (ONSI-56) material in the other eye. Reported wetting angles for the Boston XO material (103 degrees ) and for the ONSI-56 material (7.2 degrees ) were obtained by sessile drop measurements. After refitting, the study comprised three 5-week trial periods. In Period 1 half of the participants (Group A) wore Boston XO lenses in their right eye and Comfort O2 (ONSI-56) lenses in their left eye, and the other half (Group B) vice versa. In Period 2 Group A wore Comfort O2 (ONSI-56) lenses in their right eye and Boston XO lenses in their left, and Group B vice versa. All participants used Miraflow cleaner during periods 1 and 2. In Period 3, during which all participants used Boston cleaner, Group A wore Boston XO lenses in their right eye and Comfort O2 (ONSI-56) lenses in their left eye and Group B vice versa. Straylight data (log S) were obtained with and without contact lenses using the Oculus C-Quant straylight meter in all three periods. Central corneal thickness (CCT) was measured in the second and third periods. RESULTS: When not wearing lenses (n = 60 eyes) at the end of the second 5 week trial period straylight was measured twice with averages of 1.07 log S, and the corrected CCT measurements averaged 546 mum. Straylight values with Comfort O2 (ONSI-56) reached 1.15 log S at the end of both the second (n = 25 eyes) and third periods (n = 23 eyes). Straylight values with Boston XO were 1.17 log S (n = 26 eyes) at the end of the second period, and 1.16 log S (n = 25 eyes) at the end of the third period. CONCLUSIONS: Existing RGP lens wearers refitted with new lenses with different contact angles, made of Boston XO and Comfort O2 (ONSI-56) showed, over three 5 week periods, relatively small increases in straylight, which were functionally comparable, irrespective of the type of lens material or lens cleaner used. At every visit, straylight values and CCTs returned to baseline levels after RGP lens removal, confirming that the straylight fluctuations were mainly due to scattering from the RGP lenses; or tear film interaction; or a combination of both.

Intraocular straylight after implantation of the multifocal AcrySof ReSTOR SA60D3 diffractive intraocular lens.

PURPOSE: To measure intraocular straylight (as a measure of glare) after cataract surgery and implantation of an AcrySof ReSTOR SA60D3 multifocal or AcrySof SA60AT monofocal intraocular lens (IOL) (both Alcon Laboratories). SETTING: University Hospital Maastricht, Maastricht; Isala Clinics, Zwolle; Netherlands Institute for Neurosciences, Amsterdam, The Netherlands. METHODS: In a prospective open observational case series, a newly developed straylight meter was used to objectively measure straylight 6 months postoperatively in 66 eyes with a diffractive AcrySof ReSTOR SA60D3 IOL (multifocal group) and 40 eyes with a monofocal AcrySof SA60AT IOL (monofocal group). A comparison of straylight levels in an age-matched population without cataract (control group) was performed. RESULTS: The straylight level was 1.20 log units +/- 0.16 (SD) in the multifocal group and 1.10 +/- 0.19 log units in the monofocal group. When the difference in mean level of straylight was adjusted for age, mean straylight levels were 0.078 log units lower in the monofocal group than in the multifocal group (P = .026). Straylight levels in both pseudophakic groups were lower than in the control group without cataract (P< .0001). CONCLUSIONS: Levels of intraocular straylight log(s) were significantly lower for both types of IOL than in age-matched subjects from the normal population. The mean level of intraocular straylight 6 months postoperatively was higher in patients with an AcrySof ReSTOR SA60D3 IOL than in patients with a monofocal AcrySof SA60AT IOL. Implantation of the former IOL would therefore result in a smaller gain in contrast sensitivity and a smaller reduction in glare and halos than implantation of the latter IOL.

Corneal surface reconstruction algorithm that uses Zernike polynomial representation.

We developed an algorithm that directly determines Zernike coefficients for the corneal anterior surface derived from the reflection image of a stimulus with pseudorandom encoding. This algorithm does not need to include calculation of corneal height maps. The numerical performance of the algorithm is good. It has the potential of determining corneal shape with submicrometer accuracy in obtaining Zernike coefficients. When applied to real eye measurements the accuracy of the procedure will be limited by the topographer that is used.