Average Mean Deviation Research Articles

Biomechanics-Function in Glaucoma: Improved Visual Field Predictions from IOP-Induced Neural Strains

Purpose(1) To assess whether neural tissue structure and biomechanics could predict functional loss in glaucoma; (2) To evaluate the importance of biomechanics in making such predictions. DesignClinic-based cross-sectional study. MethodsWe recruited 238 glaucoma subjects (Chinese ethnicity, more than 50 years old). For one eye of each subject, we imaged the optic nerve head (ONH) using spectral-domain OCT under the following conditions: (1) primary gaze and (2) primary gaze with acute IOP elevation (to approximately 35 mmHg) achieved through ophthalmo-dynamometry. We utilized automatic segmentation of optic nerve head (ONH) tissues and digital volume correlation (DVC) analysis to compute intraocular pressure (IOP)-induced neural tissue strains. A robust geometric deep learning approach, known as Point-Net, was employed to predict the full Humphrey 24-2 pattern standard deviation (PSD) maps from ONH structural and biomechanical information. For each point in each PSD map, we predicted whether it exhibited no defect or a PSD value of less than 5%. Predictive performance was evaluated using 5-fold cross-validation and the F1-score. We compared the model's performance with and without the inclusion of IOP-induced strains to assess the impact of biomechanics on prediction accuracy. ResultsIntegrating biomechanical (IOP-induced neural tissue strains) and structural (tissue morphology and neural tissues thickness) information yielded a significantly better predictive model (F1-score: 0.76 ± 0.02) across validation subjects, as opposed to relying only on structural information, which resulted in a significantly lower F1-score of 0.71 ± 0.02 (p < 0.05). Our subjects had a mean age of 69±5 years. Among them, 88 were female. The cohort included a wide range of glaucoma severity, with Mean Deviation (MD) values ranging from -1.8 (mild) to -25.2 (severe), and an average MD value of -7.25±5.05. ConclusionOur study has shown that the integration of biomechanical data can significantly improve the accuracy of visual field loss predictions and highlights the importance of the biomechanics-function relationship in glaucoma.

Social Determinants of Health and US Health Care Expenditures by Insurer

US health expenditures have been growing at an unsustainable rate, while health inequities and poor outcomes persist. Targeting social determinants of health (SDOH) may contribute to identifying and controlling health care expenditures. To determine whether SDOH are associated with US health care expenditures by Medicare, Medicaid, and private insurers. Cross-sectional study of adults, representing the US civilian, noninstitutionalized population with Medicare, Medicaid, or private coverage, from the 2021 Medical Expenditure Panel SDOH Survey. Data analysis was conducted from October 2023 to April 2024. SDOH as individual-level, health-related social needs categorized by Healthy People 2030 domains: (1) educational access and quality, (2) health care access and quality, (3) neighborhood and built environment,(4) economic stability, and (5) social and community context. The primary outcome was health care expenditures (US dollars) by Medicare, Medicaid, and private insurers. A 2-part econometric model (probit regression model and generalized linear model with gamma distribution) was used. Among the 14 918 insured adults in the analytic sample (mean [SD] age, 52.5 [17.9] years; 8471 female [56.8%]), the majority had middle to high family income (10 524 participants [70.5%]) and were privately insured (10 227 participants [68.5%]). Annual median (IQR) expenditure was $1648 ($389-$7126) for Medicaid, $3643 ($1321-$10 519) for Medicare, and $1369 ($456-$4078) for private insurers. Educational attainment and social isolation were associated with Medicaid expenditures. Medicaid beneficiaries with a high school diploma or general educational development certificate had on average (mean difference) $2245.39 lower annual Medicaid expenditures (95% CI, -$3700.97 to -$789.80) compared with beneficiaries with less than high school attainment. Compared with those who never felt isolated, Medicaid beneficiaries who often felt isolated had on average $2706.94 (95% CI, $1339.06-$4074.82) higher annual Medicaid expenditures. Health care access, built environment, and economic stability were associated with Medicare expenditures. Medicare beneficiaries living in neighborhoods with lower availability of parks had on average $5959.27 (95% CI, $1679.99 to $10 238.55) higher annual Medicare expenditures. Medicare beneficiaries who were very confident in covering unexpected expenses had on average $3743.98 lower annual Medicare expenditures (95% CI, -$6500.68 to -$987.28) compared with those who were not confident. Medical discrimination and economic stability were associated with private expenditures. Private insurance beneficiaries who experienced medical discrimination had on average $2599.93 (95% CI, $863.71-$4336.15) higher annual private expenditures compared with those who did not. Private beneficiaries who were contacted by debt collections in the past year had on average $2033.34 (95% CI, $896.82 to $3169.86) higher annual private expenditures compared with those who were not contacted. In this cross-sectional study of 14 918 insured adults, individual-level SDOH were significantly associated with US health care expenditures by Medicare, Medicaid, and private insurers. These findings may inform health insurers and policymakers to incorporate SDOH in their decision-making practices to identify and control health care expenditures, advancing health equity.

Sleep disturbances in anorexia nervosa.

Sleep is crucial for physical and psychological health, and disturbances are closely linked to psychiatric disorders, making their management essential for improving treatment outcomes and preventing relapse. Although sleep disturbances are implicated in psychopathology of eating disorders, its role in anorexia nervosa (AN) remains unclear. This review aimed to characterise sleep in AN. A systematic search was conducted in four scientific databases, including papers from inception to 25 May 2024. A machine learning algorithm (ASReview) was utilised to screen titles and abstracts for eligibility. Sleep quantity, architecture, and quality were investigated. Meta-analyses were conducted to investigate the difference between patients with AN and healthy controls (HC) in total sleep time (TST), wake after sleep onset (WASO), sleep onset latency (SOL), sleep efficiency, Sleep Stage 1, 2, slow wave sleep, rapid eye movement (REM) sleep and REM latency. Certainty of evidence was assessed using the GRADE approach. Out of 67 potentially eligible papers, 31 were included in this review, with 15 in the meta-analyses. Statistically significant average mean differences were found for TST (-32.1min [95% CI: -50.9, -13.4]), WASO (19.0min [95% CI: -2.4, 40.3]), and sleep efficiency (-4.4% [95% CI: -7.9, -0.9]). Additionally, Sleep stage 1 was significantly increased (2.4% [95%-CI: 0.05, 4.7]), while REM sleep was reduced (-2.1% [95%-CI: -4.2, -0.02]). Subgroup analysis showed that TST and WASO did not improve significantly after weight restoration. Sleep in patients with AN is impaired, with lower TST and sleep efficiency, higher WASO, more time in stage 1 sleep, and less in REM. Weight restoration alone may not improve sleep. While more research is needed, substantial accompanying sleep disturbances in AN justifies addressing these in current treatment practice, also because of the chronic character of AN and importance of sleep for long term (mental) health.

Phenotypic Heterogeneity of Patients With Marfan Syndrome in Puerto Rico: A Case Series.

Previous studies have reported on the cardiovascular, ocular, and musculoskeletal findings in patients with Marfan syndrome (MFS). This study aims to report the ocular and genotypic findings in patients with the syndrome in Puerto Rico. A chart review of a cohort of patients with the syndrome from Puerto Rico was done. Patients were examined by at least one of the authors (NJI). Fibrillin-1 (FBN1) full gene sequencing was done to all patients (Laboratory for Molecular Medicine, Center for Genetics and Genomics, Cambridge, MA). This study was approved by the Institutional Review Board of the Universidad Central del Caribe (approval number: 2024-07). Results: Six patients aged 28-79 years were examined. There were seven female and three male patients. The average visual acuity was 0.49 and 0.52 in the right eye (OD) and left eye (OS), respectively. The average refraction (spherical equivalent) was -1.28 sph OD and -1.07 sph OS. The average intraocular pressure was 14 mmHg in both eyes (OU). A patient had a dislocated lens OD; a patient had lens dislocation OU; and a patient had prosthesis OD and aphakia OS. Upon optical coherence tomography (OCT), the retinal nerve fiber layer (RNFL) average was 75.86 µm OD and 81.85 ​​µm OS; the average cup-to-disc (C/D) ratio was 0.41 and 0.35 in the right and left eye, respectively. Upon visual field testing, the average mean deviation (MD) was -6.27 dB OD and -8.55 dB OS. Our findings underscore the significant phenotypic and genotypic heterogeneity of patients with MFS in Puerto Rico. The identification of several mutations in the FBN1 gene in the Puerto Rican population demonstrates the need for an up-to-date approach to diagnose and co-manage patients with the syndrome. This study contributes to a deeper understanding of the genetic heritage of patients with the syndrome and highlights the potential for personalized therapeutic interventions.

O25 ARE COMMUNITY HEALTH WORKERS EFFECTIVE IN MANAGING HYPERTENSION AND DIABETES SIMULTANEOUSLY? A SYSTEMATIC REVIEW AND META-ANALYSIS

Background and objective: To evaluate and summarise the effectiveness of community health worker (CHW)-led interventions to manage risk factors for NCDs. We further assessed whether CHWs could simultaneously manage hypertension and diabetes. Methods: We searched six different databases for randomised controlled trials and cluster randomised trials. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. We used random effects models to assess the sample average mean difference between intervention and control groups. The primary outcomes for this review were net mean differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose (HbA1c and fasting blood glucose), blood lipids (low-density lipoprotein (LDL) and triglycerides) and obesity (body mass index (BMI) ≥ 25 kg/m2). Results: Among 10,508 potential articles identified, 68 were included in the systematic review, and 43 for meta-analysis (11223 participants) after excluding studies not meeting the inclusion criteria. Interventions undertaken by CHWs were effective in reducing SBP [-2.94 mmHg (95% CI, -4.28 to -1.59); I2=73%], DBP [-1.63 mmHg (95% CI, -2.60 to -0.66); I2=81%], HbA1c% [-0.30 (95% CI, -0.45 to -0.16), I2=54%], and triglycerides [-8.32 mg/dl (95%. CI, -13.54 to -3.10)]. Greater reductions in SBP were observed in low- and middle-income countries (LMICs) than in high-income countries (HICs). No detectable difference was observed in the change in HbA1c% in LMICs (only three studies). Interventions targeting diabetes as the primary outcome not only reduced HbA1c% but were also effective in reducing SBP by -2.03 mmHg (95% CI, -3.85 to -0.21). There was no evidence that these interventions improved body mass index or LDL Conclusions: We demonstrate that CHW-led interventions are effective in reducing SBP, DBP, HbA1c% and triglycerides, thus reinforcing the importance of engaging CHWs in the management of NCDs. This study represents an important step towards expanding the role of CHWs in addressing multiple risk factors in LMICs and marginalised groups in HICs. Figure 1: Effect of CHW-delivered intervention on primary and secondary outcomes of systolic blood pressure

Demand analysis of cayenne chilli pepper in Surakarta City

Background: This study aims to analyze the factors that affect the cayenne chilli pepper demand, to know its elasticity and to forecast its demand for 2019 up to 2023. Findings: By using time series data of 1993-2017, this study applies multiple regresiion analysis. Methods: The method used for demand foreasting analysis is Least Squares Method and for the error estimator is used Mean Average Deviation. Conclusion: The results show that cayenne chilli pepper price, red chilli pepper price, onion price, the population and income per influence the cayenne chilli pepper demand in Surakarta City. The price elasticity of demand is inelastic and the pruduct categorized as normal goods. Cross elasticity indicates that cayenne chilli pepper subsituted with red chilli with the value of cross elasticity 0,137 and complementered with onion which the value of cross elasticity is -0,094. The result of cayenne chilli pepper demand forecasting for 2019 up to 2023 shows that the potential demand will always increas every year. The value of demand forecast on 2019 is 852.350,24 kg; the value of demand forecast on 2020 is 854.291,99 kg; the value of demand forecast on 2021 is 856.233,74 kg; the value of demand forecast on 2022 is 858.175,49 kg and the value of demand forecast on 2023 is 860. 117,24 kg with the value of error estimator is 0,0048 kg.

Investigating Approaches Utilized by Instructors to Navigate Classroom Organization Issues in Higher Education Environments

The primary goal of the study was to investigate the perspectives of instructors regarding strategies for managing classroom organization challenges in a higher education setting. The researcher selected a sample of 478 respondents by using a simple random sampling technique from six universities operating in Multan district. The study employs a quantitative approach, collecting data through a questionnaire. 348 questionnaires from the 478 instructors were collected. The response rate was 73.23%, which was acceptable for survey research. For the analysis of data, the researcher applied both descriptive and inferential statistics. Average mean and standard deviations were employed to examine the opinion of higher education institution instructors about the frequency of use of approaches and effectiveness of these approaches. A t-test was employed from inferential statistics for finding the opinion of higher education institution instructors on the basis of gender. Percentage analysis was conducted for the analysis of approaches through rank-order. Thematic analysis method was used for the examination of open-ended questions. The study found that higher education institution instructors often use clear voice, question-answer strategies, and active student-instructor interaction to address classroom organization issues. Other approaches include planning lessons, treating all learners equally, arranging the classroom well, improving familiarity, and practicing instructional techniques. However, the use of rules based on conditions, time-out approaches for violent behavior, and rules for penance and penalties was rare.

Glaucoma Home Self-Testing Using VR Visual Fields and Rebound Tonometry Versus In-Clinic Perimetry and Goldmann Applanation Tonometry: A Pilot Study.

This pilot study aimed to assess the feasibility, accuracy, and repeatability of unsupervised, at-home, multi-day glaucoma testing using the Olleyes VisuALL Virtual Reality Platform (VRP) and the iCare HOME handheld self-tonometer. Participants were trained to use two U.S. Food and Drug Administration-registered or approved devices before conducting self-tests at home over 3 consecutive days. The iCare HOME intraocular pressure (IOP) measurements were collected four times daily per eye, and VRP visual field tests were performed once daily. The results were compared with one in-clinic Humphrey Field Analyzer (HFA) visual field test performed on the day of device training, iCare HOME measurements by the trainer, and the last five Goldmann applanation tonometer (GAT) results. Of 15 enrolled participants, nine of them (60%) completed the study. The six excluded participants could not self-measure using iCare HOME. There was significant correlation between the average mean deviation (MD) values of the at-home VRP tests and in-clinic HFA test (r2 = 0.8793, P < 0.001). Additionally, the average of the sensitivities in five of six Garway-Heath sectors were significantly correlated. VRP test duration was also shorter than in-clinic HFA testing (P < 0.001). Finally, at-home tonometry yielded statistically similar values compared to trainer-obtained iCare HOME values. The mean and range of at-home tonometry were also statistically similar to those for in-clinic GAT, but at-home tonometry demonstrated higher maximum IOP values (P = 0.0429). Unsupervised, at-home, multi-day glaucoma testing using two devices resulted in the capture of higher maximum IOPs than in the clinic and good MD correlation of VRP with HFA. However, 40% of participants could not self-measure IOP using iCare HOME. The study findings suggest that at-home remote glaucoma monitoring correlates with in-office testing and could provide additional information for glaucoma management, although patients had more difficulty with the iCare HOME than the VRP.

Investigating phase changes in cyanide-containing organic compounds with high melting points based on Quantitative Structure-Property Relationship modelling

Cyanide-containing organic compounds exhibit heat-resistant properties due to their high melting points, which can exceed 250 °C. These compounds find widespread applications in various industries. To predict their thermal decomposition temperatures, a straightforward model is introduced in this study. Unlike complex descriptors and computer codes, this model relies on structural parameters specific to cyanide-containing organic compounds. The investigation revealed that certain structural variables significantly influence the onset decomposition temperature. Among these, the number and type of rings play a crucial role. The model was developed and tested using a dataset of 77 experimental thermal decomposition onset temperatures for cyanide-containing organic compounds. For training and test sets comprising 62 and 15 compounds, respectively, the predicted values demonstrated good agreement with experimental data. Specifically, the coefficient of determination (R2) was 0.922 for the training set and 0.897 for the test set. The root mean square deviation (RMSD) and average absolute deviation (AAD) were 14.37 and 17.11 K for the training set, and 11.10 and 13.80 K for the test set. Furthermore, the proposed model outperformed a more complex existing model when applied to 13 cyanide-containing organic compounds. Additionally, this method can be utilized for designing cyanide-containing organic compounds with desired decomposition temperatures.

Improved fusion model for generating hourly fine scale land surface temperature data under all-weather condition

Existing Land Surface Temperature (LST) fusion models encounter some challenges due to missing data, complex weather areas, and rapid land cover changes. To overcome these limitations, we proposed the Integrated SpatioTemporal Fusion Algorithm (ISFAT). ISFAT is developed based on contemporary fusion models but in addition incorporates data from partially contaminated LSTs using the masked weight function. This helps to predict fine-scale LST on prediction date while considering error resulting from landcover changes between the base and prediction date. This algorithm also factors in the calculation of model residuals, which are distributed back to the predicted fine-scale LST using the thin-plate spline function. The fine-scale LST on prediction can thereafter employed for predicting hourly fine-scale LST images by integrating a coarse resolution LST with hourly temporal resolution. Compared to contemporary LST fusion models, ISFAT demonstrates superior performance, with mean average differences of 0.1 K and 0.27 K over SADFAT and STITFM, respectively. Additionally, diurnal LST predictions from ISFAT compare well with air temperatures from automatic weather stations. Notably, on February 18, 2020, ISFAT effectively optimized fine-scale LST for Hong Kong, achieving an RMSE of 3.33 K, despite the limitation of cloud cover in the base date. The newly developed ISFAT could facilitate better LST retrieval over a large spatial coverage under different degrees of cloud contamination.

Assessment of the estimation methods of Tmrt in semi-outdoor spaces in humid sub-tropical climates: An empirical study in Wuhan, China

Studies have been conducted on the mean radiant temperature (Tmrt) estimation methods using globe thermometers for measuring outdoor thermal environments in various climate regions. Yet, given the unique thermal environments of semi-outdoor spaces, these Tmrt estimation methods may not be appropriate for the spaces with shading effects. This study aims to assess the thermometric and radiative methods for Tmrt estimation in semi-outdoor spaces in humid sub-tropical climates, taking data from six-directional radiation measurements as validations. During the typical summer and winter days in Wuhan, China, the measurements were carried out in semi-outdoor spaces facing south and west, with an open square for comparison, including air temperature, humidity, wind velocity, black-globe temperature, and long- and short-wavelength radiation fluxes obtained from four-component net radiometers. It was found the maximum mean deviation of diurnal Tmrt values estimated by the black-globe thermometer method in semi-outdoor spaces was 7.1 °C, which exceeded the threshold required by ISO7726, where the shortwave radiation was regarded as the dominant interference factor. To improve the accuracy and cost-effectiveness of Tmrt estimation, we proposed linear empirical equations to calibrate the Tmrt estimated by black-global thermometer method that the root mean square error (RMSE) of the Tmrt deviations can generally vary from 2.22 to 2.72 °C. Contributing to the thermal comfort research, this study proposed an empirical method for estimating Tmrt in semi-outdoor spaces in humid subtropical climates, which can generate satisfactory results in accordance with ISO7726 standards with cost-effective instrumentation.

Total Shoulder Arthroplasty Versus Reverse Shoulder Arthroplasty in Primary Glenohumeral Osteoarthritis With Intact Rotator Cuffs: A Meta-Analyses.

Traditional practice favors total shoulder arthroplasty (TSA) for the treatment of primary glenohumeral osteoarthritis (PGHO) with an intact rotator cuff; however, the indications for reverse shoulder arthroplasty (RSA) have expanded to include PGHO. The purpose of this systematic review is to compare the mean differences in the range of motion and patient-reported outcomes between the TSA and RSA with an intact rotator cuff and to analyze the subgroup of the Walch type B2 glenoid. This IRB-exempt, PROSPERO-registered systematic review strictly followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. A literature search of five databases revealed 493 articles, of which 10 were included for quantitative synthesis. Level III evidence studies with the diagnosis of PGHO and ≥2 years of follow-up were included. Studies without preoperative and postoperative data were excluded. The Newcastle-Ottawa scale was used to evaluate the methodologic quality of the included studies. Preoperative and postoperative range of motion and patient-reported outcomes were collected. The random-effects model was employed, and p < 0.05 was considered statistically significant. There were a total of 544 and 329 studies in the TSA group and RSA group, respectively. The mean age in the TSA group and RSA groups were 65.36 ± 7.06 and 73.12 ± 2.40, respectively (p = 0.008). The percentages of males in the TSA and RSA groups were 73.2% and 51.1%, respectively (p = 0.02). The mean differences in forward elevation, external rotation in adduction, internal rotation scale, visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and Single AssessmentNumericEvaluation (SANE) scores were improved for both groups with no significant differences between the two. There were 9.6 times the revisions in the TSA group (8.8% vs. 0.91%; p = 0.014) and 1.5 times the complications in the TSA group (3.68% vs. 2.4%; p = 0.0096). Two hundred and forty-two glenoids were identified as Walch type B2 (126 in the TSA groupand 116 in the RSA group). The mean ages in the B2 subgroup were 68.20 ± 3.25 and 73.03 ± 1.49 for the TSA and RSA, respectively (p = 0.25). The percentages of males in the B2 subgroup were 74.6% and 46.5% for the TSA and RSA groups, respectively (p = 0.0003). The ASES, SANE, forward elevation, and external rotation in the adduction results were descriptively summarized for this subgroup, with average mean differences of 49.0 and 51.2, 45.7 and 66.1, 77.6° and 58.6°, and 38.6° and 34.1° for the TSA and RSA groups, respectively. In the setting of primary glenohumeral osteoarthritis with an intact rotator cuff, the RSA has a similar range of motion and clinical outcomesbut lower complication and revision rates as compared to the TSA. This may hold true in the setting of the B2 glenoid, although a high-powered study on this subgroup is required. Anatomic shoulder arthroplasty maintains an important role in select patients. Further studies are required to better elucidate the role of glenoid bone loss and posterior humeral head subluxation with regard to implant choice.

Flow field and particle dispersion in a naturally ventilated model building: Application of large eddy simulation based on parallel lattice Boltzmann method

Flow field analysis and pollutant particles tracking in a natural ventilation flow are computationally intensive due to the coupled outdoor and indoor airflow, as well as the existence of different turbulence scales, and large numbers of particles. As a breakthrough approach, an explicit and parallel algorithm based on lattice Boltzmann method (LBM) solver is developed to simulate transient particulate flow indoor and outdoor of a model building. Since flow analysis in natural ventilation requires high-order CFD methods, large eddy simulation (LES) by the wall-adapting local eddy-viscosity (WALE) sub-grid scales model is employed. Also, one-step collision for reduction of memory usage, domain decomposition method for parallel processing of both flow and particles, and Lagrangian tracking for following particles are implemented into the developed algorithm. Investigation of grid independency shows that medium lattice resolution provides an average mean deviation equal to 18% and 34% for horizontal and vertical centerline of model building, respectively. In addition, when compared to finite volume method (FVM), LBM requires 2.7 times higher lattice resolution to achieve acceptable accuracy. However, it approximately speeds simulation duration up to 3 times. Moreover, 100 seconds of parallel particle tracking lasts almost 800 minutes on a simple desktop.

Visual Field Outcomes in the Primary Tube Versus Trabeculectomy Study

PurposeTo describe visual field outcomes in the Primary Tube Versus Trabeculectomy (PTVT) Study. DesignCohort analysis of a prospective multicenter randomized clinical trial. SubjectsA total of 155 eyes from 155 subjects randomly assigned to treatment with tube shunt surgery (n=84) or trabeculectomy with mitomycin C (n=71). MethodsThe PTVT Study was a multicenter randomized clinical trial comparing the safety and efficacy of trabeculectomy and tube shunt surgery in eyes without prior intraocular surgery. Subjects underwent standard automated perimetry (SAP) at baseline and annually for five years. SAP tests were deemed reliable if the false positive rate was ≤15%. Tests were excluded if visual acuity was ≤20/400 or loss of ≥2 Snellen lines from baseline were attributed to a non-glaucomatous etiology. Linear mixed-effects models were used to compare rates of change in SAP mean deviation (MD) between the two treatment groups. Intraocular pressure (IOP) control was assessed by percentage of visits with IOP <18 mmHg and mean IOP. Outcome MeasuresRate of change in SAP MD during follow-up. ResultsA total of 730 SAP tests were evaluated, with an average of 4.7 tests per eye. The average SAP MD at baseline was -12.8±8.3 dB in the tube group and -12.0±8.4 dB in the trabeculectomy group (p=0.57). The mean rate of change in SAP MD was -0.32±0.39 dB/year in the trabeculectomy group and -0.47±0.43 dB/year in the tube group (p=0.23). Eyes with mean IOP 14-17.5 mmHg had significantly faster rates of SAP MD loss compared to eyes with mean IOP <14 mmHg (-0.59±0.13 vs. -0.27±0.08 dB/year, p=0.012) and eyes with only 50-75% of visits with IOP <18 mmHg had faster rates than those with 100% of visits with IOP <18 mmHg (-0.90±0.16 vs. -0.29±0.08 dB/year, p<0.001). Multivariable analysis identified older age and worse IOP control as risk factors for faster progression in both treatment groups. ConclusionsNo statistically significant difference in mean rates of visual field change was observed between trabeculectomy and tube shunt surgery in the PTVT Study. Worse IOP control was significantly associated with faster rates of SAP MD loss during follow-up. Older patients were also at risk for faster progression.

An insight into the Application of AI in maritime and Logistics toward Sustainable Transportation

This review article looks at the developing field of artificial intelligence and machine learning in maritime and marine environment management. The marine industry is increasingly interested in applying advanced AI and ML technologies to solve sustainability, efficiency, and regulatory compliance issues. This paper examines maritime and marine AI and ML applications using a deep literature review and case study analysis. Modeling ship fuel consumption, which impacts the environment and operating expenses, is a top responsibility. The study demonstrates that ML approaches such as Random Forest and Tweedie models can estimate ship fuel use. Statistical analysis demonstrates that the Random Forest model beats the Tweedie model regarding accuracy and consistency. For the training and testing datasets, the Random Forest model has high R2 values of 0.9997 and 0.9926, indicating a solid match. Low Root Mean Square Error (RMSE) and average absolute relative deviation (AARD) suggest that the model accurately reflects fuel use variability. While still performing well, the Tweedie model has lower R2 values and higher RMSE and AARD values, suggesting reduced accuracy and precision in fuel consumption prediction. These findings provide light on the potential applications of artificial intelligence and machine learning in maritime and marine environment management. Advanced analytics enables decision-makers to analyze fuel consumption patterns better, increase operational efficiency, and decrease environmental impact, thus improving maritime sustainability.

Design and Performance Analysis of a Mecanum-Built Perturbation-Based Balance Training Device.

This study proposes a mecanum-built perturbation-based balance training device aimed at improving motor adaptive skills for fall prevention in individuals with neurological disorders or the elderly. Incorporating multidirectional fall simulations in line with modified constraint-induced movement therapy, the device's efficacy was evaluated by measuring the distance traveled and peak acceleration under different static loads (20, 30, and 40 kg) and input accelerations (1, 2, and 3 m/s2). A pilot study with 10 subjects was conducted to assess device performance, utilizing repeated measures analysis of variance and Bonferroni's post hoc analysis. Results indicated a load-dependent reduction in distance traveled, with an average mean difference of 0.74-1.23 cm between the 20 and 40 kg loads for trials of 9 and 18 cm, respectively. Despite varying loads, the device consistently achieved near-anticipated peak accelerations, suggesting its capability to induce effective perturbations. The study also observed a significant lateral movement preference, suggesting adjustments to pulse width modulation and time period may optimize lateral movement performance.

Development of a new criterion for predicting critical heat flux in rod bundles with supercritical water flowing upward

Investigations of heat transfer characteristics in channels with supercritical fluids are crucial for power cycle applications, such as supercritical water-cooled reactors. To ensure the safety of the system, heat transfer deterioration (HTD) should be avoided. The criteria to identify the onset of HTD in heated rod bundles are still not determined. This study summarizes indicators for the onset of HTD in a rod bundle with supercritical water flowing upward based on observations from experimental data. Existing criteria for the tube flow are assessed by comparing predicted critical heat flux (CHF) values with experimentally identified values. Considering effects of different operating parameters, a new criterion for predicting HTD behavior in rod bundles is developed. The results indicate that the new criterion has a better performance than all existing criteria, with a mean average relative deviation of 0.26 %. Predicted CHF values are within ± 20 % of the respective experimentally identified CHF values.

The Relationship between Subclinical Hypothyroidism and Carotid Intima-Media Thickness as a Potential Marker of Cardiovascular Risk: A Systematic Review and a Meta-Analysis.

Thyroid dysfunction is known to have significant consequences on the cardiovascular system. The correlation between carotid intima-media thickness (CIMT) and subclinical hypothyroidism (SCH) has been frequently evaluated in clinical studies in recent years. This study aimed to evaluate the significance of this association through a meta-analysis. We conducted a systematic search of PubMed, MedLine, Scopus, and Web of Science databases using the keywords 'subclinical hypothyroidism and carotid intima-media thickness', from the beginning of each database until January 2023. We established the inclusion and exclusion criteria and considered studies that met the inclusion criteria. We used Jamovi for statistical analysis of the data. We identified 39 observational studies that met the inclusion criteria, with 3430 subjects: 1545 SCH and 1885 EU. Compared to euthyroid subjects (EU), subjects with subclinical hypothyroidism (SCH) had significantly increased carotid intima-media thickness (CIMT) values; the estimated average mean difference was 0.08 (95% CI 0.05 to 0.10), p < 0.01, I2 = 93.82%. After the sensitivity analysis, a total of 19 from the 39 abovementioned studies were analyzed, with most studies showing a positive association between SCH and thickening of the carotid wall; the estimated average mean difference was 0.04 (95% CI 0.02 to 0.07), p = 0.03, I2 = 77.7. In addition, female sex, advanced age, and high cholesterol levels statistically significantly influenced this association. Our meta-analysis indicates a significant positive association between SCH and increased CIMT, but with some limitations.

Comparison of Executive Function Skills between Patients with Cerebral Palsy and Typically Developing Populations: A Systematic Review and Meta-Analysis.

Background: Children with CP show deficits in executive function compared to their typically developing peers, based on the majority of the available evidence. However, the magnitude of these deficits, as well as the proportions of the shortfalls in the three main components, have not yet been examined. This is the first meta-analysis to synthesize evidence on the magnitude of differences between patients with cerebral palsy (CP) and typically developing populations in different components of executive function skills (working memory, inhibitory control and cognitive flexibility), and thus makes recommendations on which areas of executive functioning are in greatest need of intervention. Methods: We conducted a systematic literature search of four databases for studies that measured executive functions in these two groups until 31 August 2023. We calculated the standardized mean difference (Hedges' g), an average effect size overall, and for the three components of executive function skills separately, we used several moderator analyses, including methodological differences between the primary studies. Results: Fifteen articles were included in the meta-analysis. The average mean difference in executive functioning overall was large (g+ = -0.82). Furthermore, large significant differences were found in working memory (g+ = -0.92) and inhibitory control (g+ = -0.82) and a moderate difference was identified in cognitive flexibility (g+ = -0.57). In addition, results of moderator analyses reveal the importance of a rigorous matching of control group participants and CP patients. Conclusions: The results demonstrate a severe impairment in all executive functions among CP patients compared to typically developing peers, which do not decrease over time.

Chinese herbal medicine for post-viral fatigue: A systematic review of randomized controlled trials.

Fatigue is a common symptom after viral infection. Chinese herbal medicine (CHM) is thought to be a potential effective intervention in relieving fatigue. To assess the effectiveness and safety of CHM for the treatment of post-viral fatigue. Systematic review and meta-analysis of randomized controlled trials (RCTs). The protocol of this systematic review was registered on PROSPERO (CRD42022380356). Trials reported changes of fatigue symptom, which compared CHM to no treatment, placebo or drugs, were included. Six electronic databases and three clinical trial registration platforms were searched from inception to November 2023. Literature screening, data extraction, and risk bias assessment were independently carried out by two reviewers. Quality of the included trials was evaluated using Cochrane risk of bias tool, and the certainty of the evidence was evaluated using GRADE. The meta-analysis was performed using Review Manager 5.4, mean difference (MD) and its 95% confidence interval (CI) was used for estimate effect of continuous data. Heterogeneity among trials was assessed through I2 value. Overall, nineteen studies with 1921 patients were included. Results of individual trial or meta-analysis showed that CHM was better than no treatment (MD = -0.80 scores, 95%CI -1.43 to -0.17 scores, P = 0.01, 60 participants, 1 trial), placebo (MD = -1.90 scores, 95%CI -2.38 to -1.42 scores, P<0.00001, 184 participants, 1 trial), placebo on basis of rehabilitation therapy (MD = -14.90 scores, 95%CI -24.53 to -5.27 scores, P = 0.02, 118 participants, 1 trial) or drugs (MD = -0.38 scores, 95%CI -0.48 to -0.27 scores, I2 = 0%, P<0.00001, 498 participants, 4 trials) on relieving fatigue symptoms assessing by Traditional Chinese Medicine fatigue scores. Trials compared CHM plus drugs to drugs alone also showed better effect of combination therapy (average MD = -0.56 scores). In addition, CHM may improve the percentage of CD4 T lymphocytes and reduce the level of serum IL-6 (MD = -14.64 scores, 95%CI 18.36 to -10.91 scores, I2 = 0%, P<0.00001, 146 participants, 2 trials). Current systematic review found that the participation of CHM can improve the symptoms of post-viral fatigue and some immune indicators. However, the safety of CHM remains unknown and large sample, high quality multicenter RCTs are still needed in the future.