Cross-Cultural Comparisons with Japan

Paper by Richard K. Beardsle

Comparison of Outcomes between Endoscopic and Transcleral Cyclophotocoagulation.

Importance: Traditionally cyclophotocoagulation has been reserved as a treatment of last resort for eyes with advanced stage glaucoma, but increasingly it is offered to eyes with less severe disease. Endoscopic approaches in particular are utilized in increasing numbers of patients despite only a small number of publications on its results. Objective: The purpose of this study was to compare the efficacy and safety of endoscopic and transcleral cyclophotocoagulation (ECP and TCP) procedures in eyes with refractory glaucomas. Design, Setting, and Participants: A chart review was performed on consecutive patients who underwent ECP and TCP at a tertiary ophthalmology care center between January 2000 and December 2010. Cases with fewer than 3 months of follow-up or that had concurrent pressure reducing procedures were excluded. The main outcome measures examined were intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA), additional glaucoma procedure required, and complications. Main Outcomes and Measures: Forty-two eyes (42 patients) that underwent ECP and forty-four eyes (44 patients) that underwent TCP were identified. The TCP group had a statistically higher mean age (71.2 ± 16.7 vs. 58.1 ± 22.9 years, respectively), larger proportion of neovascular glaucoma (40.9% vs. 16.7%), worse initial BCVA (logMAR 2.86 vs. 1.81), and higher preoperative IOP (45.3 vs. 26.6 mmHg) than the ECP group. At 12 months follow-up, the mean IOP difference between groups was not statistically significant, although the change in IOP from baseline to 12 months was greater for the TCP group (p = 0.006). The rates of progression to no light perception (NLP) and phthisis bulbi were significantly higher amongst TCP eyes than ECP eyes (27.2% vs. 4.8%, p = 0.017, and 20.5% vs. 0%, p = 0.003, respectively). Of these eyes that progressed, a majority had neovascular glaucoma (NVG). Corneal decompensation was the most frequent complication following ECP (11.9%). Conclusions and Relevance: In patients with preoperative BCVA of 20/400 or better, overall complication rates (cystoid macular edema, exudative retinal detachment, inflammation, cornea decompensation) were higher after ECP than with TCP. In refractory glaucomas in a real world setting (not a trial), TCP was more frequently used in ischemic eyes. TCP was associated with a higher rate of progression to phthisis bulbi and loss of light perception than ECP. However, ECP was associated with a clinically significant rate of corneal decompensation. These outcomes likely were related to the severity of underlying ocular diseases found in these eyes

“Rational” Observational Systems of Educational Accountability and Reform

There is something incalculable about teacher expertise and whether it can be observed, detected, quantified, and as per current educational policies, used as an accountability tool to hold America’s public school teachers accountable for that which they do (or do not do well). In this commentary, authors (all of whom are former public school teachers) argue that rubric-based teacher observational systems, developed to assess the extent to which teachers adapt and follow sets of rubric-based rules, might actually constrain teacher expertise. Moreover, authors frame their comments using the Dreyfus Model (1980, 1986) to illustrate how observational systems and the rational conceptions on which they are based might be stifling educational progress and reform. Accessed 4,702 times on https://pareonline.net from August 20, 2015 to December 31, 2019. For downloads from January 1, 2020 forward, please click on the PlumX Metrics link to the right

Measurements of one-point statistics in 21 cm intensity maps via foreground avoidance strategy

Measurements of the one-point probability distribution function and higher-order moments (variance, skewness, and kurtosis) of the high-redshift 21 cm fluctuations are among the most direct statistical probes of the non-Gaussian nature of structure formation and evolution during reionization. However, contamination from astrophysical foregrounds and instrument systematics pose significant challenges in measuring these statistics in real observations. In this work, we use forward modelling to investigate the feasibility of measuring 21 cm one-point statistics through a foreground avoidance strategy. Leveraging the well-known characteristic of foreground contamination in which it occupies a wedge-shape region in k-space, we apply a foreground wedge-cut filter that removes the contaminated modes from a mock data set based on the Hydrogen Epoch of Reionization Array (HERA) instrument, and measure the one-point statistics from the image-space representation of the remaining non-contaminated modes. We experiment with wedge-cutting over different frequency bandwidths and varying degrees of removal that correspond to different assumptions on the extent of the foreground sources on the sky and leakage from the Fourier Transform window function. We find that the centre of the band is the least biased from wedge-cutting while the edges of the band are unusable due to being highly down-weighted by the window function. Based on this finding, we introduce a rolling filter method that allows reconstruction of an optimal wedge-cut 21~cm intensity map over the full bandwidth using outputs from wedge-cutting over multiple sub-bands. We perform Monte Carlo simulations to show that HERA should be able to measure the rise in skewness and kurtosis near the end of reionization with the rolling wedge-cut method if foreground leakage from the Fourier transform window function can be controlled.Comment: 12 pages, 8 figures, submitted to MNRA

A Spectroscopic Study of Field and Runaway OB Stars

Identifying binaries among runaway O- and B-type stars offers valuable insight into the evolution of open clusters and close binary stars. Here we present a spectroscopic investigation of 12 known or suspected binaries among field and runaway OB stars. We find new orbital solutions for five single-lined spectroscopic binaries (HD 1976, HD 14633, HD 15137, HD 37737, and HD 52533), and we classify two stars thought to be binaries (HD 30614 and HD 188001) as single stars. In addition, we reinvestigate their runaway status using our new radial velocity data with the UCAC2 proper motion catalogs. Seven stars in our study appear to have been ejected from their birthplaces, and at least three of these runaways are spectroscopic binaries and are of great interest for future study.Comment: 21 pages, 1 figure, 7 tables; Accepted to Ap

Wnt4 and LAP2alpha as pacemakers of Thymic Epithelial Senescence

Age-associated thymic involution has considerable physiological impact by inhibiting de novo T-cell selection. This impaired T-cell production leads to weakened immune responses. Yet the molecular mechanisms of thymic stromal adipose involution are not clear. Age-related alterations also occur in the murine thymus providing an excellent model system. In the present work structural and molecular changes of the murine thymic stroma were investigated during aging. We show that thymic epithelial senescence correlates with significant destruction of epithelial network followed by adipose involution. We also show in purified thymic epithelial cells the age-related down-regulation of Wnt4 (and subsequently FoxN1), and the prominent increase in LAP2α expression. These senescence-related changes of gene expression are strikingly similar to those observed during mesenchymal to pre-adipocyte differentiation of fibroblast cells suggesting similar molecular background in epithelial cells. For molecular level proof-of-principle stable LAP2α and Wnt4-over-expressing thymic epithelial cell lines were established. LAP2α over-expression provoked a surge of PPARγ expression, a transcription factor expressed in pre-adipocytes. In contrast, additional Wnt4 decreased the mRNA level of ADRP, a target gene of PPARγ. Murine embryonic thymic lobes have also been transfected with LAP2α- or Wnt4-encoding lentiviral vectors. As expected LAP2α over-expression increased, while additional Wnt4 secretion suppressed PPARγ expression. Based on these pioneer experiments we propose that decreased Wnt activity and increased LAP2α expression provide the molecular basis during thymic senescence. We suggest that these molecular changes trigger thymic epithelial senescence accompanied by adipose involution. This process may either occur directly where epithelium can trans-differentiate into pre-adipocytes; or indirectly where first epithelial to mesenchymal transition (EMT) occurs followed by subsequent pre-adipocyte differentiation. The latter version fits better with literature data and is supported by the observed histological and molecular level changes

The impact of mental health recovery narratives on recipients experiencing mental health problems: Qualitative analysis and change model.

BACKGROUND: Mental health recovery narratives are stories of recovery from mental health problems. Narratives may impact in helpful and harmful ways on those who receive them. The objective of this paper is to develop a change model identifying the range of possible impacts and how they occur. METHOD: Semi-structured interviews were conducted with adults with experience of mental health problems and recovery (n = 77). Participants were asked to share a mental health recovery narrative and to describe the impact of other people's recovery narratives on their own recovery. A change model was generated through iterative thematic analysis of transcripts. RESULTS: Change is initiated when a recipient develops a connection to a narrator or to the events descripted in their narrative. Change is mediated by the recipient recognising experiences shared with the narrator, noticing the achievements or difficulties of the narrator, learning how recovery happens, or experiencing emotional release. Helpful outcomes of receiving recovery narratives are connectedness, validation, hope, empowerment, appreciation, reference shift and stigma reduction. Harmful outcomes are a sense of inadequacy, disconnection, pessimism and burden. Impact is positively moderated by the perceived authenticity of the narrative, and can be reduced if the recipient is experiencing a crisis. CONCLUSIONS: Interventions that incorporate the use of recovery narratives, such as peer support, anti-stigma campaigns and bibliotherapy, can use the change model to maximise benefit and minimise harms from narratives. Interventions should incorporate a diverse range of narratives available through different mediums to enable a range of recipients to connect with and benefit from this material. Service providers using recovery narratives should preserve authenticity so as to maximise impact, for example by avoiding excessive editing