Original Rainbow Research Articles

Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): five-year outcomes of a randomised trial

Concerns remain over the long-term safety of vascular endothelial growth factor (VEGF) inhibitors to treat retinopathy of prematurity (ROP). RAINBOW is an open label randomised trial comparing intravitreal ranibizumab (in 0.2mg and 0.1mg doses) with laser therapy in very low birthweight infants (<1500g) with ROP. Of 201 infants completing RAINBOW, 180 were enrolled in the RAINBOW Extension Study. At 5 years, children underwent ophthalmic, development and health assessments. The primary outcome was visual acuity in the better-seeing eye. The study is registered with ClinicalTrial.gov, NCT02640664. Between 16-6-2016 and 21-4-2022, 156 children (87%) were evaluated at 5 years. Of 32 children with no acuity test result, 25 had a preferential looking test, for 4 children investigators reported low vision for each eye, and in 3 further children no vision measurement was obtained. 124 children completed the acuity assessment, the least square mean (95% CI) letter score in the better seeing eye was similar in the three trial arms-66.8 (62.9-70.7) following ranibizumab 0.2mg, 64.6 (60.6-68.5) following ranibizumab 0.1mg and 62.1 (57.8-66.4) following laser therapy; differences in means: ranibizumab 0.2mg v laser: 4.7 (95% CI:-1.1, 10.5); 0.1mg v laser: 2.5 (-3.4, 8.3); 0.2mg v 0.1mg: 2.2 (-3.3, 7.8). High myopia (worse than-5 dioptres) in at least one eye occurred in 4/52 (8%) children following ranibizumab 0.2mg, 8/55 (15%) following ranibizumab 0.1mg and 11/45 (24%) following laser therapy (0.2mg versus laser: odds ratio: 3.99 (1.16-13.72)). Ocular and systemic secondary outcomes and adverse events were distributed similarly in each trial arm. 5-year outcomes confirm the findings of the original RAINBOW trial and a planned interim analysis at 2 years, including a reduced frequency of high myopia following ranibizumab treatment. No effects of treatment on non-ocular outcomes were detected. Novartis Pharma AG.

2-year outcomes of ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW extension study): prospective follow-up of an open label, randomised controlled trial

Intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors is increasingly used to treat retinopathy of prematurity (ROP) in the absence of evidence about long-term efficacy or safety. In this prespecified interim analysis of the RAINBOW extension study, we aimed to prospectively assess outcomes at age 2 years. RAINBOW was an open-label, randomised trial that compared intravitreal ranibizumab (at 0·1 mg and 0·2 mg doses) with laser therapy for the treatment of ROP in very low birthweight infants (<1500 g). Families of the 201 infants that completed the RAINBOW core study were approached for consent to enter the extension study, which evaluates treatment outcomes prospectively through to 5 years of age. At age 20-28 months corrected for prematurity, participants had ophthalmic, development, and health assessments. The primary outcome was the absence of structural ocular abnormalities; secondary outcomes included vision-related quality of life (reported by parents using the Children's Visual Function Questionnaire), development (assessed with the Mullen Scales of Early Learning), motor function, and health status. Investigator-determined ocular and non-ocular serious and other adverse events were recorded. This study is registered with ClinicalTrials.gov, NCT02640664. Between June 16, 2016, and Jan 22, 2018, 180 infants were enrolled in the RAINBOW extension study, and 153 (85%) were evaluated at 20-28 months of age. No child developed new ocular structural abnormalities. Structural abnormalities were present in one (2%) of 56 infants in the ranibizumab 0·2 mg group, one (2%) of 51 infants in the 0·1 mg group, and four (9%) of 44 infants in the laser therapy group. The odds ratio of no structural abnormality was 5·68 (95% CI 0·60-54·0; p=0·10) for ranibizumab 0·2 mg versus laser therapy, 4·82 (0·52-45·0; p=0·14) for ranibizumab 0·1 mg versus laser therapy, and 1·21 (0·07-20; p=0·90) for ranibizumab 0·2 mg vs 0·1 mg. High myopia (-5 dioptres or worse) was less frequent after 0·2 mg ranibizumab (five [5%] of 110 eyes) than with laser therapy (16 [20%] of 82; odds ratio 0·19, 95% CI 0·05-0·69; p=0·012). Composite vision-related quality of life scores seemed higher among the ranibizumab 0·2 mg group (mean 84, 95% CI 80-88) compared with laser therapy (77, 72-83; p=0·063). Mullen Scales T-scores for visual reception, receptive and expressive language were distributed similarly between the three trial groups and there were similar proportions of infants with motor and hearing problems among treatment groups. The proportion of infants with respiratory symptoms and Z scores of standing height, weight, and head circumference were similarly distributed in the treatment groups. There were no adverse events considered by the investigator to be related to the study intervention. 2-year outcomes following ranibizumab 0·2 mg for the treatment of ROP confirm the ocular outcomes of the original RAINBOW trial and show reduced high myopia, with possibly better vision-related quality of life. This treatment did not appear to affect non-ocular infant development. Novartis Pharma AG.

A Validation Study of the Rainbow Model of Integrated Care-Measurement Tool for Patients in China.

Introduction:The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. The aim of this paper is to modify the original patient version of the RMIC-MT for the Chinese primary care context and validate its psychometric properties.Methods:The translation and adaptation processes were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 386 patients with diabetes attending one of 20 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method was used to assess the construct validity. Confirmation factor analysis was used to evaluate model fit of the modified version. Cronbach’s alpha was used to ascertain the internal consistency reliability.Results:During the translation and adaptation process, all 24 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Five factors (person-centeredness, clinical integration, professional integration, team-based coordination, organizational integration) with 15 items were determined by exploratory factor analysis, accounting for 53.51% of the total variance. Good internal consistency was achieved with each item correlated the highest on an assigned subscale and Cronbach’s alpha score of 0.890. Moderately positive associations (r≥ 0.4, p<0.01) between the score of the scale and these correlations indicate good construct validity.Conclusions:The results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT patient version. Its application in China will promote the development of people-centered integrated primary care. However, future studies with diverse samples crossing regions would be needed to test its psychometric properties for the various Chinese primary care contexts.

Validation of the care providers version of the Rainbow Model of Integrated Care-measurement tool in Chinese primary care systems

BackgroundThe original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. To translate and adapt the original care provider version of the RMIC-MT and evaluate its psychometric properties by a pilot study in Chinese primary care systems.MethodsThe translation and adaptation process were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 1610 community care professionals in all 79 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method and promax rotation was used to assess the construct validity. Cronbach’s alpha was utilized to ascertain the internal consistency reliability. Lastly, confirmation factor analysis was used to evaluate the exploratory factor analysis model fit.ResultsDuring the translation and adaptation process, all 48 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Six factors (person- & community-centeredness, care integration, professional integration, organizational integration, cultural competence and technical competence) with 45 items were determined by exploratory factor analysis, accounting for 61.46% of the total variance. A standard Cronbach’s alpha of 0.940 and significant correlation among all items in the scale (> 0.4) showed good internal consistency reliability of the tool. And, the model passed the majority of goodness-to-fit test by confirmation factor analysis.ConclusionsThe results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT provider version. Its application in China will promote the development of people-centered integrated primary care. However, further psychometric testing is needed in multiple primary care settings with both public and private community institutes.

“We Know What the Pigs Don’t Like”: the Formation and Solidarity of the Original Rainbow Coalition

The Original Rainbow Coalition is often revered as an “inter-racial” alliance that included the Black Panthers, Young Lords, and Young Patriots. Re-contextualizing the formation of the coalition in relation to population violence in Chicago, this article documents the Rainbow Coalition as a political strategy that opposed the economization of poverty. Led by Fred Hampton, the Rainbow Coalition practiced an unconventional solidarity that also challenged the anti-racism strategies proposed by civil rights, cultural nationalist, and New Left organizations, alike.

From Radicalism to Representation: Jose “Cha Cha“ Jimenez’s Journey into Electoral Politics

This article examines Jose “Cha Cha” Jimenez’s 1975 aldermanic campaign and his work toward the successful election of the first African American mayor of Chicago. Several progressive politicians who cut their political teeth on Jimenez’s city council campaign used the skills they acquired in the mid-1970s to break through the political glass ceiling that for decades kept Latinos from actualizing their potential. This article provides a lens through which to see how Jimenez and the Young Lords laid the groundwork for an anti-Daley machine that was a continuation of the original Rainbow Coalition.

Rainbows without unicorns: metric structures in theories with modified dispersion relations

Rainbow metrics are a widely used approach to the metric formalism for theories with modified dispersion relations. They have had a huge success in the quantum gravity phenomenology literature, since they allow one to introduce momentum-dependent space-time metrics into the description of systems with a modified dispersion relation. In this paper, we introduce the reader to some realizations of this general idea: the original rainbow metrics proposal, the momentum-space-inspired metric and a Finsler geometry approach. As the main result of this work we also present an alternative definition of a four-velocity dependent metric which allows one to handle the massless limit. This paper aims to highlight some of their properties and how to properly describe their relativistic realizations.

Circulant Rainbow: A New Rainbow Variant With Shorter Private Key and Faster Signature Generation

Rainbow is one of the most important signature schemes in multivariate public key cryptography. It enjoys a strong security guarantee and is a promising signature scheme in Post-Quantum Cryptography. However, it suffers from large key size. In this paper, we propose Circulant Rainbow with shorter private key and higher signing efficiency. In Circulant Rainbow, we introduce rotating relations into parts of Rainbow private key to speed up the signing procedure and reduce the private key size. We carefully choose security parameters so that our Circulant Rainbow is secure against all known attacks. In our experiment, Circulant Rainbow is about three times faster than original Rainbow and it can reduce the private key size by about 45%. We also make a comparison of Circulant Rainbow with some traditional signature schemes, the results show that Circulant Rainbow is a promising candidate in Post-Quantum Cryptography.

Cryptanalysis of the Quaternion Rainbow

Rainbow is one of signature schemes based on the problem solving a set of multivariate quadratic equations. While its signature generation and verification are fast and the security is presently sufficient under suitable parameter selections, the key size is relatively large. Recently, Quaternion Rainbow — Rainbow over a quaternion ring — was proposed by Yasuda, Sakurai and Takagi (CT-RSA'12) to reduce the key size of Rainbow without impairing the security. However, a new vulnerability emerges from the structure of quaternion ring; in fact, Thomae (SCN'12) found that Quaternion Rainbow is less secure than the same-size original Rainbow. In the present paper, we further study the structure of Quaternion Rainbow and show that Quaternion Rainbow is one of sparse versions of the Rainbow. Its sparse structure causes a vulnerability of Quaternion Rainbow. Especially, we find that Quaternion Rainbow over even characteristic field, whose security level is estimated as about the original Rainbow of at most 3/4 by Thomae's analysis, is almost as secure as the original Rainbow of at most 1/4-size.

Security of Multivariate Signature Scheme Using Non-commutative Rings

Multivariate Public Key Cryptosystems (MPKC) are candidates for post-quantum cryptography. Rainbow is a digital signature scheme in MPKC, whose signature generation and verification are relatively efficient. However, the security of MPKC depends on the difficulty in solving a system of multivariate polynomials, and the key length of MPKC becomes substantially large compared with that of RSA cryptosystems for the same level of security. The size of the secret and public keys in MPKC has been reduced in previous research. The NC-Rainbow is a signature scheme in MPKC, which was proposed in order to reduce the size of secret key of Rainbow. So far, several attacks against NC-Rainbow have been proposed. In this paper, we summarize attacks against NC-Rainbow, containing attacks against the original Rainbow, and analyze the total security of NC-Rainbow. Based on the cryptanalysis, we estimate the security parameter of NC-Rainbow at the several security level.

Analysis of the Perfect Table Fuzzy Rainbow Tradeoff

Cryptanalytic time memory tradeoff algorithms are tools for inverting one-way functions, and they are used in practice to recover passwords that restrict access to digital documents. This work provides an accurate complexity analysis of the perfect table fuzzy rainbow tradeoff algorithm. Based on the analysis results, we show that the lesser known fuzzy rainbow tradeoff performs better than the original rainbow tradeoff, which is widely believed to be the best tradeoff algorithm. The fuzzy rainbow tradeoff can attain higher online efficiency than the rainbow tradeoff and do so at a lower precomputation cost.

From the bullet to the ballot: the Illinois Chapter of the Black Panther Party and racial coalition politics in Chicago

In this comprehensive history of the Illinois Chapter of the Black Panther Party (ILBPP), Chicago native Jakobi Williams demonstrates that the city's Black Power movement was both a response to and an extension of the city's civil rights movement. Williams focuses on the life and violent death of Fred Hampton, a charismatic leader who served as president of the NAACP Youth Council and continued to pursue a civil rights agenda when he became chairman of the revolutionary Chicago-based Black Panther Party. Framing the story of Hampton and the ILBPP as a social and political history and using, for the first time, sealed secret police files in Chicago and interviews conducted with often reticent former members of the ILBPP, Williams explores how Hampton helped develop racial coalitions between the ILBPP and other local activists and organizations. Williams also recounts the history of the original Rainbow Coalition, created in response to Richard J. Daley's Democratic machine, to show how the Panthers worked to create an antiracist, anticlass coalition to fight urban renewal, political corruption, and police brutality.

Black Radicalism, Marxism, and Collective Memory: An Interview with Robin D. G. Kelley

Black Radicalism, Marxism, and Collective Memory: An Interview with Robin D. G. Kelley Jordan T. Camp (bio) This interview was occasioned by the twentieth anniversary of Robin D. G. Kelley’s Hammer and Hoe: Alabama Communists during the Great Depression (Chapel Hill: University of North Carolina Press, 1990), an anniversary that fell amid the worst economic crisis since the Great Depression. Conducted in Los Angeles during 2011, it has been since edited and revised. It aims to clarify the historical lessons of the black freedom and radical labor struggles in the 1930s for confronting the current crisis. Jordan T. Camp 2010 marked the twentieth anniversary of the publication of Hammer and Hoe. It began as your dissertation in the history department at UCLA, which you completed in 1987. Can you talk about how the conjuncture shaped your study? Robin D. G. Kelley The timing is really important. The project was conceived in the early 1980s. My interest was in southern Africa, specifically the South African Left. At the same time, the Jesse Jackson campaign and the Rainbow Coalition was taking off, as was the idea of multiracial and multiethnic organizing actually led by people of color. I was involved in campaigns at UCLA and was simultaneously trying to write about an original rainbow coalition. My dissertation began as a comparative study of radicalism in South Africa and the US South. I ended up dropping the South Africa piece because I was denied access to the country. Yet with a South African framing of what became a US story I was forced to think hard about things like intraracial class tensions and conflicts. I had to look at Alabama differently. I couldn’t look at the black working class as a kind of solid whole, nor could I look at the white working class in the same way. Part of what Hammer and Hoe tried to do was look at Alabama society as whole, not just black workers. [End Page 215] Camp How have you felt about its reception over the past two decades? Kelley It’s been interesting. I am really happy with that book. Looking over it again, I am not sure what I would do differently because I said what I needed to say. The reviews over all have been great, but more importantly the way a number of activists and organizers on the Left have talked about that book has been very heartening. For many readers, the book does three things. First, it demonstrates that substantial, effective organizing can occur under the worst of circumstances; that immense poverty, depression, and violence weren’t successful deterrents to movement building. Second, that even the most ardent racists are not fixed in their ideology. People can be transformed in the struggle. Racism is definitely a fetter to multiracial organizing, but Hammer and Hoe shows how people built a movement across the color line in the most racist place of all. Anyone watching footage of Bull Connor in Ingram Park in 1963 could not believe that thirty years before that there had been an interracial group of five thousand people in Birmingham standing on the street demanding relief, jobs, and an end to police brutality. Third, that class politics are alive and well. But any class politics that pretend that race and also gender get in the way of class organizing miss the point altogether. You can actually build white support for antiracism, male support for antisexism, and black support for white working-class justice. People can and do cross the boundaries that historians and scholars impose on people. The levels of empathy that many of the people in Hammer and Hoe showed—the fact that people were willing to be beaten or die for others—is an extremely important lesson. We spend so much time theorizing race, class, and gender and wondering whether or not you can get people of a particular identity to move, but we don’t even ask the question “Can you get Steve to risk his life for Hosea Hudson?” It is not that Steve is supporting Hosea Hudson because he is black and male; Steve is supporting Hosea Hudson because he is part of a...

Réticulum sarcoplasmique et tachycardies ventriculaires catécholergiques (1re partie)

Intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors is increasingly used to treat retinopathy of prematurity (ROP) in the absence of evidence about long-term efficacy or safety. In this prespecified interim analysis of the RAINBOW extension study, we aimed to prospectively assess outcomes at age 2 years.RAINBOW was an open-label, randomised trial that compared intravitreal ranibizumab (at 0·1 mg and 0·2 mg doses) with laser therapy for the treatment of ROP in very low birthweight infants (<1500 g). Families of the 201 infants that completed the RAINBOW core study were approached for consent to enter the extension study, which evaluates treatment outcomes prospectively through to 5 years of age. At age 20–28 months corrected for prematurity, participants had ophthalmic, development, and health assessments. The primary outcome was the absence of structural ocular abnormalities; secondary outcomes included vision-related quality of life (reported by parents using the Children's Visual Function Questionnaire), development (assessed with the Mullen Scales of Early Learning), motor function, and health status. Investigator-determined ocular and non-ocular serious and other adverse events were recorded. This study is registered with ClinicalTrials.gov, NCT02640664.Between June 16, 2016, and Jan 22, 2018, 180 infants were enrolled in the RAINBOW extension study, and 153 (85%) were evaluated at 20–28 months of age. No child developed new ocular structural abnormalities. Structural abnormalities were present in one (2%) of 56 infants in the ranibizumab 0·2 mg group, one (2%) of 51 infants in the 0·1 mg group, and four (9%) of 44 infants in the laser therapy group. The odds ratio of no structural abnormality was 5·68 (95% CI 0·60–54·0; p=0·10) for ranibizumab 0·2 mg versus laser therapy, 4·82 (0·52–45·0; p=0·14) for ranibizumab 0·1 mg versus laser therapy, and 1·21 (0·07–20; p=0·90) for ranibizumab 0·2 mg vs 0·1 mg. High myopia (–5 dioptres or worse) was less frequent after 0·2 mg ranibizumab (five [5%] of 110 eyes) than with laser therapy (16 [20%] of 82; odds ratio 0·19, 95% CI 0·05–0·69; p=0·012). Composite vision-related quality of life scores seemed higher among the ranibizumab 0·2 mg group (mean 84, 95% CI 80–88) compared with laser therapy (77, 72–83; p=0·063). Mullen Scales T-scores for visual reception, receptive and expressive language were distributed similarly between the three trial groups and there were similar proportions of infants with motor and hearing problems among treatment groups. The proportion of infants with respiratory symptoms and Z scores of standing height, weight, and head circumference were similarly distributed in the treatment groups. There were no adverse events considered by the investigator to be related to the study intervention.2-year outcomes following ranibizumab 0·2 mg for the treatment of ROP confirm the ocular outcomes of the original RAINBOW trial and show reduced high myopia, with possibly better vision-related quality of life. This treatment did not appear to affect non-ocular infant development.Novartis Pharma AG.

Commentary

Intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors is increasingly used to treat retinopathy of prematurity (ROP) in the absence of evidence about long-term efficacy or safety. In this prespecified interim analysis of the RAINBOW extension study, we aimed to prospectively assess outcomes at age 2 years.RAINBOW was an open-label, randomised trial that compared intravitreal ranibizumab (at 0·1 mg and 0·2 mg doses) with laser therapy for the treatment of ROP in very low birthweight infants (<1500 g). Families of the 201 infants that completed the RAINBOW core study were approached for consent to enter the extension study, which evaluates treatment outcomes prospectively through to 5 years of age. At age 20–28 months corrected for prematurity, participants had ophthalmic, development, and health assessments. The primary outcome was the absence of structural ocular abnormalities; secondary outcomes included vision-related quality of life (reported by parents using the Children's Visual Function Questionnaire), development (assessed with the Mullen Scales of Early Learning), motor function, and health status. Investigator-determined ocular and non-ocular serious and other adverse events were recorded. This study is registered with ClinicalTrials.gov, NCT02640664.Between June 16, 2016, and Jan 22, 2018, 180 infants were enrolled in the RAINBOW extension study, and 153 (85%) were evaluated at 20–28 months of age. No child developed new ocular structural abnormalities. Structural abnormalities were present in one (2%) of 56 infants in the ranibizumab 0·2 mg group, one (2%) of 51 infants in the 0·1 mg group, and four (9%) of 44 infants in the laser therapy group. The odds ratio of no structural abnormality was 5·68 (95% CI 0·60–54·0; p=0·10) for ranibizumab 0·2 mg versus laser therapy, 4·82 (0·52–45·0; p=0·14) for ranibizumab 0·1 mg versus laser therapy, and 1·21 (0·07–20; p=0·90) for ranibizumab 0·2 mg vs 0·1 mg. High myopia (–5 dioptres or worse) was less frequent after 0·2 mg ranibizumab (five [5%] of 110 eyes) than with laser therapy (16 [20%] of 82; odds ratio 0·19, 95% CI 0·05–0·69; p=0·012). Composite vision-related quality of life scores seemed higher among the ranibizumab 0·2 mg group (mean 84, 95% CI 80–88) compared with laser therapy (77, 72–83; p=0·063). Mullen Scales T-scores for visual reception, receptive and expressive language were distributed similarly between the three trial groups and there were similar proportions of infants with motor and hearing problems among treatment groups. The proportion of infants with respiratory symptoms and Z scores of standing height, weight, and head circumference were similarly distributed in the treatment groups. There were no adverse events considered by the investigator to be related to the study intervention.2-year outcomes following ranibizumab 0·2 mg for the treatment of ROP confirm the ocular outcomes of the original RAINBOW trial and show reduced high myopia, with possibly better vision-related quality of life. This treatment did not appear to affect non-ocular infant development.Novartis Pharma AG.

Displacement, stiffness and load behaviour of laser-cut RAINBOW actuators

Commercial piezoceramic PZT 5A discs were reduced in air at 750 °C to produce RAINBOW actuators using graphite as the reduction substrate and ZrO 2 powder for protection. After the reduction process, the RAINBOW actuators were cut to desired shapes with a Nd–YAG laser. The effect of the laser cutting on the load, displacement, stiffness and dielectric constant characteristics of the actuators was studied for different sizes. Load capabilities of the actuators reduced as the amount of active material decreased but almost 30% of the active material could be removed without significant change in load properties. Results showed the possibilities to shape and decrease the size of the actuators and perform application specific modifications in load, displacement and stiffness properties. The effect of the laser cutting on the dielectric constant was insignificant compared with the de-poling effect of high electric field driving. Manufactured actuators were modelled with the ATILA program. Modelling gave accurate results with the original RAINBOW actuator and with sliced actuators 15 and 10 mm in width.