A preliminary assessment of indirect impacts on aquaculture species health and welfare in Scotland during COVID-19 lockdown.

COVID-19 led to sudden changes in human activities, mainly due to restrictive measures required to supress the virus. We assess the preliminary evidence for impacts on animal health and welfare in Scottish aquaculture, a key economic activity in remoter areas of the country. We summarise the industry structure, explore pathways of vulnerability to aquatic animal disease within a One Health framework that may be accentuated by impacts of COVID-19, and use basic routine data collection on the key welfare indicators of salmon mortality and parasitic sea lice counts. The indicators were published on schedule and provide no evidence of gross impact on health and welfare, at least for salmon, during the period of intensive lockdown restrictions in Scotland. Longer term effects cannot be ruled out and we do not assess impacts on the economic or social aspects of aquaculture production.

Late-onset, snowstorm-like appearance of calcium deposits coating a poly(methyl methacrylate) posterior chamber intraocular lens.

UNLABELLED: An 81-year-old man developed decreased vision associated with diffuse precipitates on his poly(methyl methacrylate) (PMMA) posterior chamber intraocular lens (IOL), on his corneal endothelium, and in his anterior chamber approximately 35 years after IOL implantation. Slitlamp evaluation showed diffuse white material on the surface of the IOL, white precipitates on the corneal endothelium, and visible debris in the anterior chamber. The patient had IOL exchange, and pathological analysis showed numerous calcium deposits within the Soemmerring ring that diffusely spread to the anterior surface of the PMMA IOL. This case of diffuse calcium precipitates on the IOL and the corneal endothelium and in the anterior chamber 35 years after implantation shows that even long after IOL implantation, lens epithelium proliferation and metabolism can result in sequestered material that can be released many years later. FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.

Evaluating teaching methods: validation of an evaluation tool for hydrodissection and phacoemulsification portions of cataract surgery.

PURPOSE: To develop and assess the validity of an evaluation tool to assess quantitatively the hydrodissection and phacoemulsification portions of cataract surgery performed by residents. DESIGN: Case series. SETTING: Jules Stein Eye Institute, Olive View-UCLA Medical Center, and Veterans Administration Medical Center, Los Angeles, California, USA. METHODS: The UCLA ophthalmology faculty members were surveyed and the literature was reviewed to develop a grading tool consisting of 15 questions to evaluate surgical technique, including questions from the Global Rating Assessment of Skills in Intraocular Surgery and from the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric. Video clips of the hydrodissection and phacoemulsification portions of cataract surgery performed by 1 postgraduate year 2 (PGY2) resident, 1 PGY3 resident, 2 PGY4 residents, and an advanced surgeon were independently graded in a masked fashion by an 8-member faculty panel. RESULTS: Eleven of the 15 questions had a significant association with surgical experience level (P<.05, analysis of variance). Interobserver variability in grading yielded intraclass correlation coefficients between 0.28 and 0.72. The questions with the lowest interobserver variability were hydrodissection questions on instrument handling, flow of operation, and nucleus rotation. Nucleus cracking also had low variability. Less directly visible tasks, especially 3-dimensional tasks, had wider interobserver variability. CONCLUSIONS: Surgical performance can be validly measured using an evaluation tool. Improved videography and studies to identify the best questions for evaluating each step of cataract surgery may help ophthalmic educators more precisely measure training outcomes for improving teaching interventions. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Evaluating teaching methods of cataract surgery: validation of an evaluation tool for assessing surgical technique of capsulorhexis.

PURPOSE: To develop and assess the validity of an evaluation tool to quantitatively assess the capsulorhexis portion of cataract surgery performed by residents. SETTING: University of California at Los Angeles (UCLA), Department of Ophthalmology, Jules Stein Eye Institute, Los Angeles, California, USA. DESIGN: Masked prospective case series. METHODS: Ophthalmology faculty members at UCLA were surveyed and literature was reviewed to develop a grading tool comprising 12 questions to evaluate surgical technique, including 4 from the Global Rating Assessment of Skills in Intraocular Surgery and 2 from the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric. Video clips of continuous curvilinear capsulorhexis (CCC) performed by 2 postgraduate year (PGY) 3 residents, 2 PGY 4 residents, and 2 advanced surgeons were independently graded in a masked fashion by a 7-member faculty panel. RESULTS: Four questions had low interobserver variability and a significant correlation with surgical skill level (intraclass correlation coefficient >0.75; P<.05, analysis of variance; 42 observations). The 4 questions were visual Likert-scale questions grading flow of operation, set up for regrasp, commencement of flap and formation, and circular completion of the CCC. CONCLUSIONS: Surgical performance can be validly measured using an evaluation tool. However, not all evaluation questions produced reliable results. The reliability and accuracy of the measurements appear to depend on the form and content of the question. Studies to optimize assessment tools identifying the best questions for evaluating each step of cataract surgery may help ophthalmic educators more precisely measure outcomes for improving teaching interventions. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Forensic continuum of care with Assertive Community Treatment (ACT) for persons recovering from co-occurring disabilities: long-term outcomes.

This study presents the long-term outcomes of a continuum of care program for co-occurring psychiatric disabilities and chemical dependency that has been recognized as a best practice model by the American Psychological Association's Committee for the Advancement of Professional Practice's Task Force on Serious Mental Illness and Severe Emotional Disturbance (APA/CAPP, 2007). Since publication of the initial positive outcomes for 18 men in 2002, this innovative recovery program continued to successfully reintegrate a total of 91 men and women with severe co-occurring disabilities who had been acquitted of violent crimes by reason of insanity (NGRI). This follow-up study showed continued positive outcomes for an additional 73 program graduates in terms of non-reoffending, psychiatric stability, substance abuse abstinence, stable housing and meaningful activity. In contrast to other studies that have applied Assertive Community Treatment and Intensive Case Management to populations with forensic issues and failed to reduce criminal recidivism, this continuum of care recovery model had strong results in preventing criminal recidivism in addition to achieving improved mental health, abstinence and quality of life.

Transformations of mathematical and stimulus functions.

Following a pretest, 8 participants who were unfamiliar with algebraic and trigonometric functions received a brief presentation on the rectangular coordinate system. Next, they participated in a computer-interactive matching-to-sample procedure that trained formula-to-formula and formula-to-graph relations. Then, they were exposed to 40 novel formula-to-graph tests and 10 novel graph-to-formula tests. Seven of the 8 participants showed substantial improvement in identifying formula-to-graph relations; however, in the test of novel graph-to-formula relations, participants tended to select equations in their factored form. Next, we manipulated contextual cues in the form of rules regarding mathematical preferences. First, we informed participants that standard forms of equations were preferred over factored forms. In a subsequent test of 10 additional novel graph-to-formula relations, participants shifted their selections to favor equations in their standard form. This preference reversed during 10 more tests when financial reward was made contingent on correct identification of formulas in factored form. Formula preferences and transformation of novel mathematical and stimulus functions are discussed.

Laser in situ keratomileusis in patients with autoimmune diseases.

PURPOSE: To evaluate the safety of laser in situ keratomileusis (LASIK) in patients with autoimmune diseases. SETTING: Private clinical practice. METHODS: In this retrospective case series, the records of patients who had LASIK at the Maloney Vision Institute between June 1, 1998, and October 1, 2004, were reviewed for a history of autoimmune disease including systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis, scleroderma, inflammatory bowel disease, Graves' disease, Reiter's syndrome, and Hashimoto's disease. The records were reviewed for corneal and scleral complications of autoimmune disease after LASIK. RESULTS: Forty-nine eyes of 26 patients with inactive or stable autoimmune disease were identified. No eye developed corneal thinning, melting, persistent epithelial defect, persistent keratitis, scleral thinning, scleritis, or scleromalacia. CONCLUSION: Laser in situ keratomileusis may be a reasonable option in patients with well-controlled or inactive autoimmune disease.

Lens opacities after posterior chamber phakic intraocular lens implantation.

PURPOSE: To describe a case series to determine the incidence of lens opacities after posterior chamber phakic intraocular lens (IOL) implantation (STAAR Surgical, Monrovia, CA) for very high ametropias. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Fourteen eyes of 170 consecutive eyes with high ametropias in whom lens opacities developed after posterior chamber phakic IOL implant (PCPIOL). INTERVENTION: Posterior chamber phakic intraocular lens implant. MAIN OUTCOME MEASURES: Lens opacity appearance, localization, and clinical course. RESULTS: Fourteen eyes developed lens opacities 125 +/- 116 days after phakic IOL implant. All eyes had anterior subcapsular opacities, and two eyes also developed nuclear sclerosis. The anterior opacities did not extend posteriorly within the lens, and there were no posterior subcapsular cataracts. Seventy-one percent of opacities were first seen

Predictability and outcomes of photoastigmatic keratectomy using the Nidek EC-5000 excimer laser.

PURPOSE: To evaluate the effect of astigmatic correction on the accuracy of the myopic and astigmatic correction in patients having photorefractive astigmatic keratectomy (PARK) and in those having photorefractive keratectomy (PRK). SETTING: Specialist excimer laser refractive clinic. METHODS: This prospective consecutive case series comprised 6097 eyes with a preoperative mean spherical equivalent (MSE) of -4.63 diopters (D) +/- 1.95 (SD) (range -0.75 to -13.00 D) and a mean cylinder of -1.13 +/- 0.73 D (range -0.50 to -6.00 D) having PARK with a Nidek EC-5000 excimer laser. Visual and refractive outcomes were assessed 12 months postoperatively and compared with those in 3004 eyes that had spherical PRK. RESULTS: At 12 months, the MSE was -0.02 +/- 0.79 D and the mean cylinder was -0.49 +/- 0.47 D in the PARK group; the MSE was -0.07 +/- 0.66 D in the PRK group. An MSE within +/-0.05 D of emmetropia was achieved by 69.8% and within +/-1.00 D, by 87.9%. The uncorrected visual acuity (UCVA) was 20/20 or better in 42.6% and 20/40 or better in 91.2%. Statistical significance (P <.001, analysis of variance) was achieved for MSE, sphere, cylinder, haze, and visual acuity (best corrected [BCVA] and UCVA) based on the preoperative cylinder. The loss of BCVA varied from 1.1% to 5.8% depending on the degree of astigmatism treated. Accuracy varied with the attempted myopic correction and the attempted astigmatic correction. CONCLUSIONS: Excimer laser PARK was an effective treatment for compound myopic astigmatism, but predictability decreased and complications increased as the attempted astigmatic correction increased.

Shipping and the spread of infectious salmon anemia in Scottish aquaculture.

Long-distance transport of pathogens plays a critical role in the emergence of novel diseases. Shipping is a major contributor to such transport, and the role of ships in spreading disease has been recognized for centuries. However, statistical confirmation of pathogen spread by shipping is usually impractical. We present evidence of invasive spread of infectious salmon anemia in the salmon farms of Scotland and demonstrate a link between vessel visits and farm contamination. The link is associated with vessels moving fish between sites and transporting harvest, but not with vessels delivering food or involved in other work.