bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric patients’ experience in receiving services provided by non-specialist community nurses, southern Thailand
Authors: Aekwarangkoon Saifon , Noonil Naiyana
Published: April 2021

Background:

Psychiatric problems have been a growing and significant public health challenge. Community-based psychiatric services have been shown to contribute to the improvement of health and social-related outcomes, but with limited specialists in this field. Consequently, Thailand has integrated these services into the primary care system delivered by community nurses working in primary care units (PCUs).

Aim:

To describe the experiences of psychiatric patients in receiving services provided by non-specialist community nurses.

Method:

A phenomenological approach was used. Eleven psychiatric patients with 10 major depressive disorders and 1 with schizophrenia were interviewed. The results were evaluated using thematic content analysis.

Results:

The results revealed two main themes as barriers and facilitators experienced in receiving services from community nurses.

Conclusion:

Community-based services should be concerned about developing psychiatric nursing competency for community nurses to extend basic services to patients in communities and to assist family members.
FoxO1 as a Regulator of Aquaporin 5 Expression in the Salivary Gland
Authors: Lee S.M. , Lee S.W. , Kang M. , Choi J.K. , Park K. , Byun J.S. , Kim D.Y.
Published: April 2021

Forkhead box O1 (FoxO1) is a multifunctional initiator, mediator, and repressor of autoimmune diseases in an organ- or disease-specific manner. However, the role of FoxO1 in the salivary gland has not yet been elucidated. In this study, we discovered that FoxO1 and aquaporin 5 (AQP5) are both significantly downregulated in the patients with primary Sjögren syndrome, an autoimmune disease accompanying salivary gland dysfunction. Pharmacologic or genetic perturbation of FoxO1 in the rat salivary gland acinar cell line, SMG-C6, induced a significant downregulation of AQP5 expression, as observed in clinical specimens. There was a strong correlation between FoxO1 and AQP5 expression because FoxO1 is a direct regulator of AQP5 expression in salivary gland acinar cells through its interaction with the promoter region of AQP5. Serial injection of a FoxO1 inhibitor into mice induced a reduction of AQP5 expression in submandibular glands and, consequently, hyposalivation, which is one of the major clinical symptoms of primary Sjögren syndrome. However, there was no sign of inflammation or cell damage in the submandibular glands harvested from mice treated with the FoxO1 inhibitor. In conclusion, our findings indicate that FoxO1 in salivary gland tissue acts as a direct regulator of AQP5 expression. Thus, downregulation of FoxO1 observed in primary Sjögren syndrome is a putative mechanism for hyposalivation without the involvement of previously reported soluble factors in primary Sjögren syndrome patient sera.
The Effects of Cyberbullying Victimization and Personality Characteristics on Adolescent Mental Health: An Application of the Stress Process Model
Authors: Wang Lin
Published: April 2021

Although a considerable body of research has documented the association between victimization experience and adolescent mental health, previous studies have not investigated the mediating effects of personality characteristics such as social competence and self-mastery on the associations between cyberbullying victimization and mental health. This study aims to fill in this research gap. Random group sampling based on grade was employed, and a total of 607 adolescents (51.07% females, Mage = 15.04) were recruited to participate in the study. The findings of the present study partially supported the hypotheses. Specifically, the results showed that cyberbullying victimization was positively associated with social anxiety and depression. Self-mastery was found to mediate the relationship between cyberbullying victimization and symptoms of depression and social anxiety. Social competence was found to be negatively related to social anxiety, but no mediating effect was found between cyberbullying victimization and symptoms of mental health. Theoretical and practical implications were discussed.
A Neglected Problem: Understanding the Effects of Personal and Vicarious Trauma on African Americans’ Attitudes Toward the Police
Authors: Pryce Daniel K. , Olaghere Ajima , Brown Robert A. , Davis Vondell M.
Published: April 2021

The relationship between the police and African Americans has had a contentious history for decades. To explore this topic further, we interviewed 77 African Americans in the City of Durham, NC, about the declining relationship between their community and the police. We find that African Americans’ perceptions of the police are nuanced and complicated by personal experiences, vicarious experiences of relatives and friends, and news from social media and television regarding policing practices and treatment, including police harassment and/or brutality. We characterize these direct and vicarious experiences as the transmission of trauma. Even for the proportion of African Americans who had positive perceptions and interactions with the police, their views of the police seemed to be further complicated by broader concerns of discriminatory treatment. We proffer solutions to improve the relationship between the police and African Americans. The implications of our findings for future research are also discussed.
Introduction to the Special Series on Behavioral Disorders and Juvenile Justice: Facilitating Effective Reentry Into School and Community
Authors: Griller Clark Heather , Mathur Sarup R.
Published: April 2021

This introduction to the special series on facilitating effective reentry into school and community for youth from the juvenile justice (JJ) system highlights several important issues for educators and others serving youth with emotional and behavioral disorders (EBD). The articles within this special series focus on key factors in programming and professional development that promote reentry success. Central to this discussion are protective factors, like self-determination and engagement, facility programming and climate, provision of person-centered supports, prioritization of youth development and mental health, increased communication and capacity building among stakeholders, and shifting to the use of positive youth outcomes in addition to recidivism as measure of reentry success. Findings and discussion provide a critical reference point for professionals and scholars interested in promoting reentry success and may improve interventions and services for JJ-involved youth, especially those with EBD.
Demagogic populism and media system: A preliminary articulation
Authors: Jones Paul K
Published: April 2021

Political communication studies has a long tradition of ‘crisis talk’ regarding the fate of public communication. Now, however, the field itself faces a kind of existential crisis as its core assumptions of ‘normal’ political communication are daily undermined. This ‘liberal normalcy’ shares much with orthodoxies in populism studies, most notably a tendency to bracket out demagogic communication, both in historical fascist regimes and democracies. Yet correcting these failings is not simply a matter of rejecting liberal models for left-populist ones. Rather, both fields need to broaden their historical parameters and deepen their theoretical frameworks. The article draws on the Weberian conception of modern demagogy and its revision in the wake of 'modern media' by Shils and Adorno. It further argues that a critical reworking of Hallin and Mancini’s media systems approach could benefit both fields. For Hallin and Mancini’s socio-historical use of Weberian ideal-typification complements Worsley’s never-completed plan for an ideal-typification of modes of populism and demagogic leadership.
Stop Sign Gap Assist Application in a Connected Vehicle Simulation Environment
Authors: Arafat Mahmoud , Hadi Mohammed , Hunsanon Thodsapon , Amine Kamar
Published: April 2021

Assessment of the safety and mobility impacts of connected vehicles (CVs) and cooperative automated vehicle applications is critical to the success of these applications. In many cases, there may be trade-offs in the mobility and safety impacts depending on the setting of the parameters of the applications. This study developed a method to evaluate the safety and mobility benefits of the Stop Sign Gap Assist (SSGA) system, a CV-based application at unsignalized intersections, which utilizes a calibrated microscopic simulation tool. The study results confirmed that it was critical to calibrate the drivers’ gap acceptance probability distributions in the utilized simulation model to reflect real-world driver behaviors when assessing SSGA impacts. The simulation models with the calibrated gap parameters were then used to assess the impacts of the SSGA. The results showed that SSGA can potentially improve overall minor approach capacity at unsignalized intersections by approximately 35.5% when SSGA utilization reaches 100%. However, this increase in capacity depended on the setting of the minimum gap time in the SSGA and there was a clear trade-off between capacity and safety. The analysis indicated that as the minimum gap time used in the SSGA increased, the safety of the intersection increased, showing for example that with the utilization of an 8-s gap at a 750 vph main street flow rate, the number of conflicts could decrease by 30% as the SSGA utilization rate increased from 0% to 100%.
Detection of Pavement Maintenance Treatments using Deep-Learning Network
Authors: Gao Lu , Yu Yao , Hao Ren Yi , Lu Pan
Published: April 2021

Pavement maintenance and rehabilitation (M&R) records are important as they provide documentation that M&R treatment is being performed and completed appropriately. Moreover, the development of pavement performance models relies heavily on the quality of the condition data collected and on the M&R records. However, the history of pavement M&R activities is often missing or unavailable to highway agencies for many reasons. Without accurate M&R records, it is difficult to determine if a condition change between two consecutive inspections is the result of M&R intervention, deterioration, or measurement errors. In this paper, we employed deep-learning networks of a convolutional neural network (CNN) model, a long short-term memory (LSTM) model, and a CNN-LSTM combination model to automatically detect if an M&R treatment was applied to a pavement section during a given time period. Unlike conventional analysis methods so far followed, deep-learning techniques do not require any feature extraction. The maximum accuracy obtained for test data is 87.5% using CNN-LSTM.
Indicators and ICTs application for municipal waste management
Authors: Singh Ajay
Published: April 2021

The worldwide populace is rising steadily. Urbanization is likewise expanding quickly with the rising populace. Fast urbanization has considerably increased the generation of municipal solid waste (MSW). The MSW management issues have recently been analyzed through various assessment indicators and information and communication technologies (ICTs). This article provides an overview of applications of assessment indicators and ICTs for addressing the environmental issues of waste disposal and management in municipalities. The selection of indicators mainly depends on the stakeholders’ specific requirements, such as waste management strategies, urban planning and development, human health, and energy generation. The literature analysis revealed that collection, sorting, recycling, cost efficiency, and environmental aspect were the leading indicators used in waste management studies. And these indicators reduce the complexity of systems and formulate evaluations easier for the decision-maker. Moreover, these are also helpful in assessing the improvement and reporting the waste condition to the expert. These analysis further revealed that information and communication technology is a requirement in the planning and managing of current solid waste disposal problems. The use of ICTs in waste management systems mitigates possible constraints regarding spot selection, inept waste disposal, waste collection monitoring, and proper recycling.
Bridging the Gap: A Qualitative Analysis of What It Takes to Inspire Youth to Engage in Volunteering
Authors: Nordstrom Onnolee , Tulibaski Katherine L. G. , Peterson Tim O.
Published: April 2021

This article explores how to inspire youth to volunteer. Drawing on ideas of inspiration and motivational framing, we develop insight into how constructing and cultivating a sense of efficacy and obligation pushes a young individual passively inspired by the good deeds and acts being performed in the third sector into becoming someone who is inspired to take action and volunteer. Getting out into the real world of practice allowed us to explore the situated practices carried out in a youth summer internship program. We find that five program practices—authorizing, creating safe relational spaces, reflecting, revealing privilege, and simplifying—fostered an emergent action-oriented set of beliefs that supplied the impetus youth needed to become inspired to volunteer. This has implications for our understanding of the inspirational process as well as for philanthropic foundations looking to design effective programs. Limitations and directions for future research are also discussed.
A multi-particle abrasive model for investigation of residual stress in belt grinding of titanium alloys
Authors: Xiao Guijian , Song Kangkang , Zhou Huawei , He Yi , Dai Wentao
Published: April 2021

The titanium alloy blade is a key part of an aero-engine, but its high surface efficiency and precision machining present technical problems. Belt grinding can effectively prolong the fatigue life of the blade and enhance the service performance of the aero-engine. However, the residual stress of the workpiece after belt grinding directly affects its service performance and life. The traditional single particle abrasive model simulation is limited in exploring the influence of grinding process parameters on surface residual stress. In this study, an ABAQUS simulation model of multi-particle belt grinding is established for titanium alloy material, a finite element (FE) simulation is conducted with different technological parameters, and the results are analysed. The critical belt grinding experiment is conducted on thin-walled titanium alloy parts, and the distribution characteristics of surface residual stress after grinding are studied to understand the influence of grinding parameters on the formation of surface residual stress. Comparing the results of the FE simulation and the grinding experiment, the common law of stress change and the prediction model are obtained. The results show that the multi-particle belt grinding simulation is consistent with the belt grinding experiment in terms of the influence of grinding parameters on residual stress. The simulation can serve as a guide in actual belt grinding to some extent. Directions for improving the multi-particle abrasive simulation model are discussed.
Effect of jet flow on cooling performance and thermal stress of a radial turbine back disc
Authors: Ma Chao , Su Yilong , Zhu Guangqian , Zhang Jianjian
Published: April 2021

In view of the development status of high-reliability and low-cost cooling technology for radial turbine of micro-gas turbine or vehicle turbocharger, the impingement cooling technology of the radial turbine back disc was proposed, and the improvement of the cooling efficiency and thermal stress of the turbine back disc was numerically simulated. The results show that the impingement cooling technology can greatly improve the cooling efficiency of the turbine back disc and reduce the stress level. When the relative cooling flow is 1.0%–3.0%, the average cooling efficiency of the lower part of the turbine back disc is increased by 258%–486% compared with no cooling, which can reduce the thermal stress at the fillet of the back disc by 140–216 MPa. Both the average cooling efficiency and the fillet stress of the back disc increase slightly as the relative position of the jet hole moves outward. When the relative cooling flow is controlled within 2.0%, the effect of this cooling technology on the performance of the turbine can be ignored.
Source-to-sink and evolutionary processes of the East China Sea inner-shelf mud belt and its response to environmental changes since the Holocene: New evidence from the distal mud belt
Authors: Cong Jingyi , Hu Gang , Jonell Tara N , Zhang Yong , Li Yuting , Bi Shipu
Published: April 2021

During the past decades, the elongated mud belt, 1000 km length, in the inner shelf of the East China Sea (ECS), has been extensively studied. Previous studies mainly focused on the northern part of the mud belt. There are still many arguments on various issues of the mud belt, including the provenance discrimination, the formation mechanism, and its evolution response to climate and environmental changes. In this paper, a borehole acquired from the distal southern mud belt which penetrated the Holocene strata with the collected data was analyzed. According to the parameters of (La/Sm)UCC versus (Gd/Yb)UCC and the ternary diagram of smectite-illite-(kaolinite + chlorite), sediments from the top section of Core ECS1601 originated from the Yangtze River since 13.7 ka. Sediments from upper and lower reaches of the Yangtze River can be clearly distinguished by (Gd/Yb)UCC value. The provenance of the distal mud belt shifted from upper reaches to lower valley since 5 ka and returned to the upper reaches again since 2.5 ka, which was related to the asynchronous evolution of Asian monsoon system and anthropogenic activities. The high sedimentation rates occurring in the distal mud belt between 5 and 2.5 ka were related to the decreased sediment supply of the upper reaches and the strengthened Zhejiang-Fujian Coastal Current (ZFCC) caused by the intensified East Asian Winter Monsoon (EAWM).
A desire for authoritative science? How citizens’ informational needs and epistemic beliefs shaped their views of science, news, and policymaking in the COVID-19 pandemic
Authors: Post Senja , Bienzeisler Nils , Lohöfener Mareike
Published: April 2021

The coronavirus pandemic created a situation in which virological and epidemiological science became highly politically relevant but was uncertain and fragmented. This raises the question as to how science could inform policymaking and public debate on societal crisis management. Based on an online survey of Germans ( N = 1513) representative for age, gender, education, and place of residence, we investigate citizens’ prescriptive views of the relationships between science, policymaking, and the media. Views differ depending on their informational needs and epistemic beliefs. People with a need for definite information and a view of scientific knowledge as static wanted scientists to dominate policymaking and journalists to deliver definite information about the coronavirus. People with an informational need to construct their own opinions wanted journalists to question policy and scientific advice. Furthermore, they rejected the idea of scientists dominating policymaking. Results are discussed with reference to theories of science and democracy.
Large Shareholders and Stock Price Synchronicity: Evidence from Vietnam
Authors: To Anh Tho , Le Trung Dao , Tran Quoc Tuan , Nguyen Thanh Lam , Ho Thi Thu Hong
Published: April 2021

This article aims to investigate how large shareholders affect the information environment, as measured by stock price synchronicity, of listed firms in the Vietnam stock exchanges. Upon applying fixed effects and instrumental variables fixed effects with firm-level clustered standard errors for a sample of 160 listed firms in the Vietnam stock exchanges over the period 2008–2017, the results show that stock price synchronicity is negatively associated with the two largest shareholders’ ownership and positively related to state ownership. The findings support that non-state large ownership plays an important role in improving the information environment in emerging markets where investor protection laws are relatively weak.
Has Indian Anthropology Withered Away?
Authors: Vaid Naresh
Published: April 2021

Anthropology is a dynamic discipline that has a cut-out task to provide solutions to the challenges faced by the world societies. While contribution of Anthropology is recognized in most parts of the world, India, particularly after the mid-1980s, has shown its reluctance to respond to various problems and, subsequently, ignored by planners, policymakers, administrators, and even other sister disciplines. Anthropologists have the vast knowledge of human societies, methodology, experience, and communicative skills to provide solutions to those problems. Therefore, there is an urgent need to revive the zeal of anthropologists to respond to all sorts of problems being faced by India and take the lead in providing solutions to those problems. Otherwise, anthropology may be marginalized further, and it may be suicidal for the discipline as also for its practitioners.
Faith struggles in science: Academic schools as religious sects
Authors: Follert Florian , Daumann Frank
Published: April 2021

Particularly in the social sciences, scientific debates can be understood as a special expression of academic discourse and ideally support the progress of knowledge within a discipline. Very often, there are competing academic schools with greatly differing theoretical foundations, as we have seen, for example, in social sciences-especially by the “Methodenstreit” in economics, or the “Positivismusstreit” in Sociology. This paper aims to introduce a new approach to study academic schools and would like to contribute to the literature on the economics of science. To this end, the paper uses the economic theory of religion in general and the economics of sects in particular by transferring the approach to academic schools for the first time. Our results can help to extend the understanding of scientific decision-making and to explain the membership to an academic school. Although the model is presented in relationship to social sciences in general and economics in particular, the basic model of academic schools is generally transferable.

JEL Classification: A12, B13, B21, B40, B53, Z12
Did the COVID-19 Lock-Down Make Us Better at Working in Virtual Teams?
Authors: Klonek Florian E. , Kanse Lisette , Wee Serena , Runneboom Cecilia , Parker Sharon K.
Published: April 2021

The COVID-19 pandemic was a key event forcing an increase in virtual work. Drawing on event system theory, we examined whether virtual teams showed enhanced processes in later stages of the pandemic compared to the early stages of the pandemic. We collected data from 54 virtual teams ( N = 152 individuals) who worked on a 30-minute task. We measured team processes and performance. Virtual teams during the post-transition phase (June–August 2020) showed better levels of team action processes and conflict management compared to teams working in the immediate transition phase (March–May 2020), indicative of an adaptation effect.
Müller-Weiss Disease: The Descriptive Factors of Failure Conservative Treatment
Authors: Harnroongroj Thos , Tharmviboonsri Theerawoot , Chuckpaiwong Bavornrit
Published: April 2021

Background:

Conservative treatment is the first-line approach for Müller-Weiss disease (MWD). However, factors associated with the failure of conservative treatment have never been reported. Our objectives were to compare the differences in demographic and radiographic parameters between “successful” and “failure” conservative treatment in patients with MWD and identify descriptive factors associated with failure conservative treatment.

Methods:

We retrospectively reviewed 68 patients with MWD divided into 29 “failure” and 39 “successful” conservative treatment groups. Demographic characteristics, Foot and Ankle Outcome Score (FAOS), visual analog scale (VAS) scores for pain and walking disability, and radiographic parameters such as calcaneal pitch, lateral Meary, anteroposterior (AP) Meary angle, and talonavicular-naviculocuneiform arthritis were compared. Logistic regression analysis was performed to identify descriptive factors of failure conservative treatment. A P value <.05 was considered a statistically significant difference.

Results:

We found more severe VAS pain and walking disability scores and FAOS for the pain, activities of daily living, and quality of life subscales in the failure group ( P < .05). Regression analysis demonstrated 2 significant descriptive factors associated with failure conservative treatment: abducted AP Meary angle >13.0 degrees and radiographic talonavicular arthritis. No demographic characteristics were found to be associated with failure conservative treatment.

Conclusion:

Midfoot abduction (AP Meary angle, >13 degrees) and radiographic talonavicular arthritis were factors associated with failure conservative treatment in MWD and should be determined concurrently with the clinical severity. Classification systems for MWD should include these factors.

Level of evidence:

Level III, retrospective comparative study.
Communication Campaigns to Support the Use of Nutritional Warnings: Different Messages for Different People?
Authors: Ares Gastón , Vidal Leticia , Otterbring Tobias , Aschemann-Witzel Jessica , Curutchet María Rosa , Giménez Ana , Bove Isabel
Published: April 2021

Communication campaigns are expected to contribute to increase the efficacy of nutritional warnings. In this context, the aims of the present work were (a) to evaluate how citizens perceive different types of messages for a communication campaign and (b) to determine if personal characteristics such as gender, age, and educational level, as well socioeconomic and nutritional status, moderate how citizens perceive such campaign messages. A series of graphic pieces were designed for each of the following three types of messages: promotion of informed food choices; raising awareness of the negative health consequences of excessive consumption of sugar, fat, and sodium; and promotion of healthy food choices. An online study was conducted with 774 participants, who were randomly assigned to one of the three types of messages. The participants’ self-reported perception of the graphic pieces was evaluated using 7-point Likert-type scales. After completing the evaluation task, the participants proceeded to a series of choices. This was implemented to evaluate whether exposure to different types of messages affected hypothetical food choices. Results revealed that messages related to the promotion of healthy eating were perceived as the most adequate as part of a communication campaign and had the potential to encourage more healthful hypothetical choices in the experimental task. However, gender, age, and nutritional status moderated the influence of the type of message on the participants’ perception, meaning that different groups perceived different types of messages as the most adequate. The results from the present work stress the need to include different types of messages in a communication campaign to target individuals with different motivations and characteristics.
Netarsudil: A new ophthalmic drug in the treatment of chronic primary open angle glaucoma and ocular hypertension
Authors: Batra Mansi , Gupta Sumeet , Nair Anroop B , Dhanawat Meenakshi , Sandal Suraj , Morsy Mohamed Aly
Published: April 2021

Background:

Vision impairment remains a major health problem worldwide. Elevated intraocular pressure is a prime risk factor for blindness in the elderly. Netarsudil is a Rho-associated protein kinase (ROCK) inhibitor, which also inhibits norepinephrine transport. This narrative review summarizes the properties and clinical significance of netarsudil, a promising drug in topical glaucoma therapy.

Methods:

We searched PubMed, Medline and Scopus databases using relevant keywords to retrieve information on the physicochemical properties, formulation, mechanism of action, clinical pharmacokinetics, dose and toxicity of netarsudil.

Results:

Netarsudil showed promising effects in lowering the elevated intraocular pressure by two mechanisms. The US FDA approved netarsudil for clinical use in 2017 under the trademark of Rhopressa® while European Medicines Agency approved Rhokiinsa® in 2019. This drug is available as a 0.02% ophthalmic solution for once-daily topical application.

Conclusion:

The discovery of netarsudil is a breakthrough in the therapy of glaucoma with proven efficacy in a wide range of eye pressures and is well tolerated in cases with ocular hypertension and chronic glaucoma.
Leber’s hereditary optic neuropathy: Diagnostic pitfalls in genetic testing
Authors: Mariacher Siegfried , Bolz Matthias , Mojon Daniel Stéphane
Published: April 2021

Purpose:

To investigate the possibility and consequences of false positive testing for Leber’s hereditary optic neuropathy (LHON) using repeated testing.

Methods:

In three cases of suspected LHON, initial mutation analysis using restriction fragment length polymorphism (RFLP) and direct sequencing showed rare mtDNA mutations at nt 14482 in two cases and a mutation in nt 14484 in the third case which has been associated with a mild variant of LHON. All three patients consulted a specialized neuro-ophthalmology center for a second opinion. During the examinations the clinical diagnosis of LHON was questioned. Therefore the initial DNA samples were reevaluated again using the same probes.

Results:

The reevaluation by the testing laboratory of the DNA samples of the three patients revealed misinterpreted initial results and could show that there were no LHON typical mutations in none of the three patients.

Conclusion:

A high level of suspicion is important when an accumulation of rare mutations occurs. It is only because of the attentiveness of a specialized neuro-ophthalmologist and the testing laboratory that the diagnosis of LHON was averted. Every laboratory testing can produce false positive results. Therefore, we emphasize that a positive test should be confirmed by a second independent laboratory, at least if the clinical findings seem not to be typical for LHON.
Impression cytology and meibomian glands in conjunctivochalasis
Authors: Muhafiz Ersin , Bozkurt Erdinç , Erten Remzi
Published: April 2021

Purpose:

To evaluate the tear parameters, meibomian glands and lid margin and tarsal conjunctival impression cytology in patients with conjunctivochalasis (CCH).

Methods:

The study included 57 patients diagnosed with CCH and 35 healthy volunteers. Tear break-up time (TBUT) was measured and Schirmer test was performed. Meibomian gland morphologies, dropout rates, and meiboscores were evaluated using meibography. Finally, impression cytology samples were taken by pressing the impression filters on the lower lid margin and lower tarsal conjunctiva. The samples were evaluated according to the Nelson grading system.

Results:

Schirmer test was longer and TBUT was shorter in the study group ( p = 0.035 and p < 0.001, respectively). The median of meibomian gland dropout rate was 33.45% (Interquartile range [IQR]; 23.17%–49.75%) and 18.80% (IQR; 12.35%–26.50%) in the study and control groups, respectively ( p < 0.001). There was no significant difference in terms of lid-margin cytology between the two groups ( p = 0.481). In tarsal conjunctiva cytology, the median value of Nelson grade of the study group was 2 (IQR; 1–2) and that of the control group was 1 (IQR; 1–2) ( p = 0.040). When Nelson grade-2 and above was accepted as the pathological limit, it was found that 27.5% of the study group and 15.2% of the control group showed pathological findings ( p = 0.204).

Conclusions:

In patients with CCH, damage occurs in the tarsal conjunctiva with the effects of redundant conjunctival folds. In these patients, atrophy occurs in the meibomian glands and tear stability is impaired. Therefore, CCH should not be overlooked in clinical practice.
Outcome of cataract surgery in children affected by malignancies other than retinoblastoma with eye-lens radiation exposure
Authors: Lo Giudice Giuseppe , Angelini Edoardo , Bini Silvia , Candian Tommaso , Crudeli Clorinda , Galan Alessandro
Published: April 2021

Purpose:

To describe, retrospectively, the visual outcome, feasibility, and safety of cataract surgery in a pediatric population affected by iatrogenic cataract, secondary to systemic oncological treatment for malignancies other than retinoblastoma.

Methods:

Young patients, affected by radiation-induced cataract, who were referred to the San Paolo Ophthalmic Center in Padova between 2010 and 2017, were included in the study. All patients had previously received radiotherapy and/or chemotherapy treatment for malignancies, between 2004 and 2013. All medical records of infants who underwent cataract surgery were accurately reviewed.

Results:

Eighteen eyes out of 11 patients included in the study underwent cataract surgery. The mean age at surgery was 9.7 ± 3.6 years. The interval between tumor diagnosis and cataract development was around 3 years. Mean follow-up after surgery was 15.4 ± 6.3 months. All eyes underwent posterior chamber intraocular lens implantation, posterior capsulotomy, and anterior vitrectomy in one time surgery. No intraoperative complications were shown. Post-operatively, only one eye received laser capsulotomy due to posterior capsule opacification. At the end of follow up, best-corrected visual acuity was 20/20 (LogMAR 0) in all eyes and significantly improved ( p < 0.01) compared to baseline.

Conclusions:

Iatrogenic-cataract surgery in pediatric oncological patients is a safe and effective way to improve visual acuity. Posterior capsulotomy and anterior vitrectomy at the time of surgery reduce the rate of posterior lens opacification and guarantee an excellent visual acuity in these patients.
Rhino-orbital mucormycosis during steroid therapy in COVID-19 patients: A case report
Authors: Veisi Amirreza , Bagheri Abbas , Eshaghi Mohammad , Rikhtehgar Mohamad Hasan , Rezaei Kanavi Mozhgan , Farjad Reza
Published: April 2021

Purpose:

To report two cases of COVID-19 under treatment with a corticosteroid; in one case rhino-orbitocerebral mucormycosis and in another one rhino-orbital mucormycosis developed.

Case presentation:

A 40-year old woman and a 54-year old man with severe COVID-19 underwent corticosteroid therapy for immune-related lung injuries. The first case presented with a bilateral visual loss and complete ophthalmoplegia of the right eye. The second case presented with vision loss, proptosis, orbital inflammation, and complete ophthalmoplegia on the left side. Histopathologic, nasal endoscopic examinations, and radiologic findings confirmed mucormycosis in both patients. The patients denied orbital exenteration and were managed with systemic amphotericin B and daily endoscopic sinus debridement and irrigation with diluted amphotericin B. Because of the intracranial space involvement, the first case died. The second case was successfully managed surgically and medically.

Conclusion:

Rhino-orbital/cerebral mucormycosis may be developed in COVID-19 patients under treatment with corticosteroid, and requires prompt diagnosis and management.
To compare corneal confocal microscopy of eyes with Fuchs’ endothelial corneal dystrophy after two different endothelial surgeries
Authors: Schiano-Lomoriello Domenico , Abicca Irene , Bono Valeria , Giannini Daniela , Colabelli-Gisoldi Rossella Annamaria , Boni Nicoletta , Komaiha Chiara , Pocobelli Augusto
Published: April 2021

Purpose:

To study the features of corneal confocal microscopy of eyes with Fuchs’ endothelial corneal dystrophy (FECD) after successful Descemet stripping automated endothelial keratoplasty (DSAEK) versus Descemet membrane endothelial keratoplasty (DMEK).

Methods:

Thirty-two eyes affected by FECD with corneal oedema requiring a corneal graft were treated with DSAEK (15 eyes) or DMEK (17 eyes). All patients underwent in vivo corneal confocal microscopy (IVCCM) at 6 months postoperatively. We evaluated preoperative and postoperative corrected distance visual acuity (CDVA) and the correlation with IVCCM characteristics.

Results:

Using IVCCM, Z-scan curve analysis showed similar subepithelial reflectivity peaks between the two groups (DSAEK 1256 SU ± 514 vs DMEK 1118 SU ± 408, p = 0.411), while the interface reflectivity was significantly higher in the DMEK group (1511 SU ± 357) than in the DSAEK group (1029 SU ± 413, p = 0.002).

Conclusion:

Comparing the corneal confocal microscopic characteristics after DMEK with those after DSAEK and their correlation with visual outcome at 6 months, we hypothesized that the presence of a third reflectivity peak in the Z-scan curves of DSAEK patients could justify the poorer visual outcome with this endothelial surgery than with DMEK.
Three Cases of Aphasic Status Epilepticus: Clinical and Electrographic Characteristics
Authors: Lee Jung-Ju , Park Jong-Moo , Kang Kyusik , Kwon Ohyun , Lee Woong-Woo , Kim Byung-Kun
Published: April 2021

Aphasic status epilepticus (ASE) is unusual and has clinical characteristics similar to those of other disorders. Herein, we report 3 cases of ASE. A left-handed man (patient 1) showed continuous aphasia after the administration of flumazenil. He had underlying alcoholic liver cirrhosis and traumatic brain lesions in the right hemisphere. Electroencephalography (EEG) revealed periodic epileptiform discharges in the right frontotemporal area, which were intervened by rhythmic activity with spatiotemporal evolutions. A right-handed woman (patient 2) showed recurrent aphasia. Blood tests revealed a high blood glucose level (546 mg/dL) and high serum osmolality (309 mMol/L). Her EEG showed rhythmic activity in the left frontotemporal area with spatiotemporal evolutions on a normal background rhythm. She became seizure-free after the administration of an antiepileptic drug and strict glucose regulation. A right-handed woman (patient 3) developed subacute aphasia a week before hospital admission. She had a gradual decline of cognition 1 year before. Her EEG showed intermittent quasi-rhythmic fast activity in the frontotemporal area bilaterally, with fluctuating frequency and amplitude. The patient became seizure-free after the administration of an antiepileptic drug. Brain single-photon emission tomography performed after seizure control showed decreased perfusion in the left frontotemporal area. After discharge, her cognitive function gradually declined to a severe state of dementia. ASE can be caused by diverse etiologies; it is usually caused by cerebral lesions and less frequently by non-lesional etiologies or degenerative disorders. Adequate treatment of underlying disorders and seizures is critical for curing the symptoms of ASE.
Factors affecting the manual linking of clinical progress notes to problems in daily clinical practice: A retrospective quantitative analysis and cross sectional survey
Authors: Cillessen Felix , de Vries Robbé Pieter , Bor Hans , Biermans Marion
Published: April 2021

This cross sectional study examines how patient characteristics, doctor characteristics, and doctors’ education and attitudes affect the extent to which doctors link progress notes to clinical problems. The independent effects of patient characteristics on the linking of notes was examined with a mixed model logistic regression. The effects of doctor characteristics and doctors’ education and attitudes on the link ratio was analyzed with univariate analysis of variance. A survey was used to obtain arguments and attitudes on linking notes. For “patient characteristics”, the odds of linking increased with an increase in the number of problems or hospital days, decreased, with an increase in the number of involved doctors, medical specialties or the number of notes. For “doctor characteristics”, the link ratio increased with more work experience. For “doctors’ education and attitudes”, the link ratio increased with more familiarity in linking notes and belief in the added value of problem oriented charting. “Overview” was the most cited reason for linking; “I don’t know how” the most cited reason for not linking. There is a huge variation within and between all disciplines. Important arguments, for and against, are found. Recommendations for policymakers and medical leadership are given to maximize the benefits.
Optimal multi-kernel local fisher discriminant analysis for feature dimensionality reduction and fault diagnosis
Authors: Zhang Qing , Li Heng , Zhang Xiaolong , Wang Haifeng
Published: April 2021

To achieve a more desirable fault diagnosis accuracy by applying multi-domain features of vibration signals, it is significative and challenging to refine the most representative and intrinsic feature components from the original high dimensional feature space. A novel dimensionality reduction method for fault diagnosis is proposed based on local Fisher discriminant analysis (LFDA) which takes both label information and local geometric structure of the high dimensional features into consideration. Multi-kernel trick is introduced into the LFDA to improve its performance in dealing with the nonlinearity of mapping high dimensional feature space into a lower one. To obtain an optimal diagnosis accuracy by the reduced features of low dimensionality, binary particle swarm optimization (BPSO) algorithm is utilized to search for the most appropriate parameters of kernels and K-nearest neighbor (kNN) recognition model. Samples with labels are used to train the optimal multi-kernel LFDA and kNN (OMKLFDA-kNN) fault diagnosis model to obtain the optimal transformation matrix. Consequently, the trained fault diagnosis model implements the recognition of machinery health condition with the most representative feature space of vibration signals. A bearing fault diagnosis experiment is conducted to verify the effectiveness of proposed diagnostic approach. Performance comparison with some other methods are investigated, and the improvement for fault diagnosis of the proposed method are confirmed in different aspects.
On the global politics of “decency” and “restraint”
Authors: Peys Christopher
Published: April 2021

This essay offers a review of both Roach’s Decency and Difference: Humanity and the Global Challenge of Identity Politics and Steele’s Restraint in International Politics. Exploring the concept-driven modes of analysis employed in each of these two texts, this essay investigates how Roach and Steele theorize the moral, socio-psychological, and political struggles inherent to the notions of decency and restraint. This review is not only devoted to understanding Roach’s and Steele’s respective arguments about how global politics has been conditioned by the tensions inherent to decency and restraint but, also, to reflecting on how these two scholars suggest we deal—theoretically and practically—with the complexities of these two notions in today’s world. At a time when various forces of indecent, unrestrained behavior have arguably led to an exclusionary politics of identity, rancor, and enmity, Roach’s and Steele’s books demonstrate—conceptually, empirically, and normatively—how we can understand the global politics of decency and restraint, as well as how people(s) around the world can begin to take more dignified steps in a just, democratic direction.
Cost-effectiveness analysis of alternative colorectal cancer screening strategies in high-risk individuals
Authors: Benamouzig Robert , Barré Stéphanie , Saurin Jean-Christophe , Leleu Henri , Vimont Alexandre , Taleb Sabrine , De Bels Frédéric
Published: April 2021

Background and aims:

Current guidelines recommend colonoscopy every 3–5 years for colorectal cancer (CRC) screening of individuals with a familial history of CRC. The objective of this study was to compare the cost effectiveness of screening alternatives in this population.

Methods:

Eight screening strategies were compared with no screening: fecal immunochemical test (FIT), Stool DNA and blood-based screening every 2 years, colonoscopy, computed tomography colonography, colon capsules, and sigmoidoscopy every 5 years, and colonoscopy at 45 years followed, if negative, by FIT every 2 years. Screening test and procedures performance were obtained from the literature. A microsimulation model reproducing the natural history of CRC was used to estimate the cost (€2018) and effectiveness [quality-adjusted life-years (QALYs)] of each strategy. A lifetime horizon was used. Costs and effectiveness were discounted at 3.5% annually.

Results:

Compared with no screening, colonoscopy and sigmoidoscopy at a 30% uptake were the most effective strategy (46.3 and 43.9 QALY/1000). FIT at a 30 µg/g threshold with 30% uptake was only half as effective (25.7 QALY). Colonoscopy was associated with a cost of €484,000 per 1000 individuals whereas sigmoidoscopy and FIT were associated with much lower costs (€123,610 and €66,860). Incremental cost-effectiveness rate for FIT and sigmoidoscopy were €2600/QALY ( versus no screening) and €3100/QALY ( versus FIT), respectively, whereas it was €150,000/QALY for colonoscopy ( versus sigmoidoscopy). With a lower threshold (10 µg/g) and a higher uptake of 45%, FIT was more effective and less costly than colonoscopy at a 30% uptake and was associated with an incremental cost–effectiveness ratio (ICER) of €4240/QALY versus no screening.

Conclusion:

At 30% uptake, current screening is the most effective screening strategy for high-risk individuals but is associated with a high ICER. Sigmoidoscopy and FIT at lower thresholds (10 µg/g) and a higher uptake should be given consideration as cost-effective alternatives.

Plain Language Summary

Cost-effectiveness analysis of colorectal cancer screening strategies in high-risk individuals Fecal occult blood testing with an immunochemical test (FIT) is generally considered as the most cost-effective alternative in colorectal cancer screening programs for average risk individuals without family history. Current screening guidelines for high-risk individuals with familial history recommend colonoscopy every 3–5 years. Colonoscopy every 3–5 years for individuals with familial history is the most effective strategy but is associated with a high incremental cost–effectiveness ratio. Compared with colonoscopy, if screening based on FIT is associated with a higher participation rate, it can achieve a similar effectiveness at a lower cost.