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We study the adiabatic connection that has as weak-coupling expansion the Møller-Plesset perturbation series, generalizing to the open-shell case previous closed-shell results for the large-coupling limit. We first focus on the hydrogen atom with fractional spins, providing results along the adiabatic connection from small to large coupling strengths. We reveal an intriguing phase diagram and an equation for the large-coupling leading order that has closed-form solutions for specific choices of its relevant quantum numbers. We then show that the hydrogen atom results provide variational estimates for the large-coupling leading terms for the general many-electron open-shell case in terms of functionals of the Hartree–Fock α-spin and β-spin densities.

Purpose To present the outcomes of a patient with anterior chamber intraocular lens (ACIOL) related endothelial decompensation who underwent Descemet membrane endothelial keratoplasty (DMEK) and cataract surgery with intraocular lens (IOL) implantation in the capsular bag (so-called tripleDMEK) combined with ACIOL removal (quadrupleDMEK) in both eyes.Methods Case reportResults A 58-year-old female patient was referred due to decreased visual acuity within the last 18 months. She had a history of iris-claw ACIOL implantation 17 years before. The corrected distance visual acuity (CDVA) was 20/40 in both eyes. Due to low endothelial cell density and increased corneal thickness, ACIOL removal combined with tripleDMEK (as quadrupleDMEK) was performed for both eyes. Despite a graft detachment that was successfully managed with re-bubbling in the first eye, both eyes showed an increase in the CDVA (20/25 and 20/32, respectively) without any other significant complications in the follow-up of the patient. The corneas of both eyes were clear postoperatively.Conclusion This case report demonstrated that quadrupleDMEK may provide feasible management for chronic endothelial cell decompensation secondary to iris-claw ACIOL implantation.

A statistical classification model was developed to identify online platform organizations based on the texts on their website. The model was subsequently used to identify all (potential) platform organizations with a website included in the Dutch Business Register. The empirical outcomes of the statistical model were plausible in terms of the words and the bimodal distribution of fitted probabilities, but the results indicated an overestimation of the number of platform organizations. Next, the external validity of the outcomes was investigated through a survey of the organizations that were identified as a platform organization by the statistical classification model. The response by the organizations to the survey confirmed a substantial number of type-I errors. Furthermore, it revealed a positive association between the fitted probability of the text-based classification model and the organization’s response to the survey question on being an online platform organization. The survey results indicated that the text-based classification model can be used to obtain a subpopulation of potential platform organizations from the entire population of businesses with a website. This subpopulation may form a good starting point to study platform organizations in more detail.

Hintergrund: Die Excimerlaser-assistierte phototherapeutische Keratektomie (PTK) hat sich in der Behandlung der Epithel-Basalmembran-Dystrophie (EBMD) – auch Map-Dot-Fingerprint-Dystrophie (MDF) – als Goldstandard etabliert. An der Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS in Homburg/Saar, kamen Systeme von Zeiss und Schwind zum Einsatz, die wir in dieser Studie bezüglich der postoperativen Ergebnisse verglichen haben. Patienten und Methoden: In die retrospektive Studie eingeschlossen wurden Patienten, die im Zeitraum 2007 bis 2017 mit der Diagnose MDF mittels PTK behandelt wurden. Es erfolgten 170 Operationen mittels des Lasersystems Zeiss Meditec MEL-70 (Carl Zeiss Meditec AG, Jena, Deutschland) und 98 mittels Schwind eye-tech-solutions Amaris 750S (Schwind eye-tech-solutions GmbH, Kleinostheim, Deutschland). Erhoben wurden prä- und postoperative Werte zu Visus, Refraktion, Astigmatismus sowie Krümmungsdaten aus der Pentacam und Endothelzellcount. Der betrachtete Follow-up-Zeitraum betrug im Mittel 8 Monate. Ergebnisse: In beiden Lasergruppen zeigten Patienten postoperativ eine signifikant bessere Sehschärfe (Zeiss: p< 0,001, Schwind p< 0,004). In der Schwind-Gruppe fiel diese jedoch geringer aus, wodurch ein signifikanter Unterschied zwischen den Lasersystemen mit Vorteil für die Zeiss-Gruppe bestand (p< 0,017). Zu signifikanten Veränderungen des sphärischen Äquivalents kam es weder im prä-/postoperativen Vergleich noch zwischen den Lasergruppen. Der Astigmatismus nahm postoperativ in der Zeiss-Gruppe ab (p< 0,042), während sich dieser bei Schwind-Patienten nicht signifikant änderte (p< 0,217). Dies führte postoperativ zu einem signifikanten Unterschied zwischen beiden Systemen (p< 0,014). Schlussfolgerung: In Zusammenschau aller Ergebnisse kann die PTK im Einklang mit der bisherigen Literatur und unabhängig von den untersuchten Lasersystemen als eine effektive Behandlungsmethode bei EBMD empfohlen werden. Patienten profitieren von einer langen Rezidivfreiheit bei gebessertem oder gleichbleibendem Visus und stabiler Refraktion.

Reliable personal identification is crucial. This study explores an ECG-based system using spectrograms and involutional neural networks (INNs) for accurate person identification. The system first preprocesses ECG signals with a Butterworth filter and segments them using the Pan-Tompkins++ algorithm. Each segment, representing a heartbeat, is then converted into a spectrogram using the short-time Fourier transform (STFT). Finally, an INN classifies the spectrograms for identification. Tested on the MIT-BIH Arrhythmia and Physikalisch-Technische Bundesanstalt (PTB) databases, the system achieved accuracies of 97.93% and 97.63%, respectively, surpassing conventional methods like convolutional neural networks (CNNs). This improvement is attributed to INNs' ability to better capture both local and temporal patterns in the spectrogram data.

AimsTo create and assess the performance of an artificial intelligence-based image analysis tool for the measurement and quantification of the corneal neovascularisation (CoNV) area.MethodsSlit lamp images of patients with CoNV were exported from the electronic medical records and included in the study. An experienced ophthalmologist made manual annotations of the CoNV areas, which were then used to create, train and evaluate an automated image analysis tool that uses deep learning to segment and detect CoNV areas. A pretrained neural network (U-Net) was used and fine-tuned on the annotated images. Sixfold cross-validation was used to evaluate the performance of the algorithm on each subset of 20 images. The main metric for our evaluation was intersection over union (IoU).ResultsThe slit lamp images of 120 eyes of 120 patients with CoNV were included in the analysis. Detections of the total corneal area achieved IoU between 90.0% and 95.5% in each fold and those of the non-vascularised area achieved IoU between 76.6% and 82.2%. The specificity for the detection was between 96.4% and 98.6% for the total corneal area and 96.6% and 98.0% for the non-vascularised area.ConclusionThe proposed algorithm showed a high accuracy compared with the measurement made by an ophthalmologist. The study suggests that an automated tool using artificial intelligence may be used for the calculation of the CoNV area from the slit-lamp images of patients with CoNV.

This study examines whether classroom ethnic diversity is related to citizenship outcomes of ethnic minority and majority students. Hypotheses, derived from the social capital literature, are tested using the Dutch nationally representative data of the International Civic and Citizenship Education Study of 2016 (2812 students, from 123 classrooms at secondary schools). The association between classroom ethnic diversity and five aspects of citizenship are examined: citizenship knowledge, support for gender equality, support for ethnic equality, institutional trust, and voting intentions. Results of multilevel analyses show that classroom diversity is related to stronger support for gender equality as well as support for ethnic equality, but negatively related to institutional trust, and not related to citizenship knowledge and voting intentions. These effects remain when controlling for socio-economic aspects of the school environment (educational track, classroom SES, urbanization, classroom climate) and are the same for both ethnic minority and majority students.

Israel’s Mental Health Rehabilitation Law (Israel Ministry of Health, 2000) provided the foundation for intensive development of rehabilitation services for people coping with mental illness. At the same time, emphasis was placed on the need for an officially recognized training system that would be structured, methodical, and available to professionals from diverse backgrounds. In 2011, the National School for Training in Rehabilitation and Recovery in Mental Health was established, under the auspices of the Ministry of Health and in collaboration with Ono Academic College. The current article describes the development of global and Israeli training programs for professionals in the mental health rehabilitation field, focusing on the unique working model of the program offered at the National School for Training in Mental Health Rehabilitation.

Previous studies suggest that secondary school students in vocational tracks receive fewer opportunities to practice with critical-democratic citizenship than students in academic tracks. Less is known about the role of critical-democratic citizenship education in tertiary vocational education and training (VET). Utilizing questionnaire data collected in 2021 amongst 350 Dutch VET students, a structural equation model was constructed in which we conjointly studied to what extent differences in students’ attitudes towards societal awareness and sound opinion forming are associated with 1) students’ experiences regarding the curriculum content, 2) openness of the classroom climate for discussion, 3) autonomy and structure provided by the teacher and 4) intrinsic value of the experienced citizenship education. This latter element was found to be especially relevant, as it was associated with both societal awareness and sound opinion forming, whereas classroom climate played only a minor role. Students’ societal awareness was also associated with both the experienced curriculum content and the autonomy and structure offered by the teacher. These results offer important practical implications to further improve opportunities for critical-democratic citizenship in VET.

Liquefied petroleum gas (LPG) storage fires and explosions occur due to uncontrolled gas leaks and the gradual breakdown of associated safety barriers. By installing an effective safety barrier, these accidents can be greatly reduced. However, this study assesses the probability of failure of emergency safety barriers (ESBs) to help decision makers understand how they can support decisions to reduce the risks associated with LPG storage. In this context, an extension of the event tree analysis is proposed named emergency event tree analysis (EETA). The aim of this paper is to develop an integrated approach that uses interval type‐2 fuzzy sets and Analytic Hierarchy Process (AHP) method and emergency event tree analysis to handle uncertainty in the failure probability assessment of emergency safety barriers (ESBs). In addition, a case study on the failure probability assessment of the emergency safety barriers of the LPG plant in Algeria based on the proposed methodology is provided and carried out to illustrate its effectiveness and feasibility. The results demonstrated the ability of interval type‐2 fuzzy sets and the AHP method to provide highly reliable results and to evaluate the failure probability of emergency safety barriers in emergencies situations. However, the classical event tree analysis (CETA) does not take into account the possibility of assessing the emergency consequences of different accident scenarios. Consequently, it only allows you to estimate the occurrence probability of accident scenarios. The results of this study show that the value of the probability of failure of the emergency safety barriers can be used to estimate the probability of occurrence of emergency consequences under different accident scenarios, improved the reliability and help prioritize emergency improvement measures. The study provides scientific and operational references for analyzing emergency consequences of the various accident scenarios in all fields such as petrochemical, maritime industry, and health occupational.

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Background/Objectives: To measure the endothelial cell density (ECD) of the in toto pre-stripped endothelial Descemet membrane lamellae (EDML) and to describe the impact of pre- and intraoperative endothelial cell loss (ECL) on postoperative midterm clinical outcome. Subjects/Methods: The ECD of 56 Corneoscleral Donor Discs (CDD) was first measured with an inverted specular microscope (t0pre). The measurement was then repeated non-invasively after the preparation of the EDML (t0post). DMEK was performed the next day using these grafts. Follow-up examinations took place 6 weeks, 6 months and 1 year postoperatively where the ECD was assessed. In addition, the impact of ECL 1 (during preparation) and ECL 2 (during surgery) on the ECD, visual acuity (VA) and pachymetry at 6 months and 1 year was investigated. Results: The average ECD (in cells/mm²) at time points t0pre, t0post, 6 weeks, 6 months & 1 year was 2584 ± 200, 2355 ± 207, 1366 ± 345, 1091 ± 564 and 939 ± 352. The average logMAR VA and pachymetry (in µm) was 0.50 ± 0.27 and 597 ± 63, 0.23 ± 0.17 and 535 ± 54, 0.16 ± 0.12 and 535 ± 54, 0.06 ± 0.08 and 512 ± 37, respectively The ECL 1 (9% on average) had no significant impact on the main outcome measures after 6 months and 1 year (p > 0.11). The ECL 2 correlated significantly with the ECD and the pachymetry at 1 year postop (p< 0.02). Conclusion: Our results indicate that the non-invasive ECD measurement of the prestripped EDML roll before its transplantation is feasible. Despite significantly decreasing ECD up to 6 months postoperatively, visual acuity further improved and thickness further decreased up to 1 year postoperatively.

There is limited literature on Arab American mental health, particularly among youth. This chapter will provide an overview of the Arab American/MENA population, their migration to the United States, traditional Arab culture and values, Arab American youth identity, acculturation and acculturation stress, the impact of discrimination on Arab American youth, mental illness in Arab American youth, and cultural variables to consider in seeking help. This chapter will provide recommendations and cultural considerations when working with Arab American youth.

Community engagement is important for inclusive HIV cure development. This study evaluates current engagement in HIV cure research among affected communities in the Netherlands by analyzing awareness, interest, and information-seeking behavior. It also identifies participant characteristics and HIV-related illness perceptions linked to each engagement stage.

To investigate the relationship between long-term condition (LTC) status and adherence to protective behaviours against infectious disease (face covering, physical distancing, hand hygiene).

Purpose To evaluate the effectiveness of epithelium-off (epi-off) accelerated corneal crosslinking (A-CXL, 9 mW/cm2, 10 min) in adult keratoconus (KC) patients.Methods The study included 151 KC corneas (124 patients) after A-CXL. The parameters best corrected visual acuity (BCVA) and the tomographic readings (Pentacam HR, Oculus, Germany) were analysed at 24, 12 and 6 months preoperatively, prior to surgery; and 6 weeks, 6 months, 1, 2 and >2 years postoperatively. The demarcation line was assessed by anterior segment optical coherence tomography (Tomey SS-1000, CASIA 2 (Tomey, Nagoya, Japan)).Results Comparing pre- to postoperative findings 6 weeks after A-CXL with paired t-test, the anterior steep (46.8 ± 4.0|47.1 ± 4.1), flat (50.2 ± 4.3|50.6 ± 4.6) and maximal keratometry (57.6 ± 6.8|58.3 ± 6.8) increased (p < 0.05), while the thinnest pachymetry decreased significantly (459 ± 39|444 ± 42, p < 0.05). Lateron, however, there was a decreasing anterior flat (1, 2 and >2 years; p < 0.0001), mean (1 year; p = 0.01 and 2 years; p = 0.03) and maximal keratometry (1, 2 and >2 years; p < 0.0001). The posterior corneal keratometry readings did not change significantly until >2 years after A-CXL (MANOVA; steep, p = 0.008; flat, p = 0.027; mean, p = 0.007). The mean depth of the demarcation line was 242 ± 62 µm (53.6%). The preoperative logMAR BCVA (0.35 ± 0.02) decreased 6 weeks after A-CXL (0.39 ± 0.03) followed by a continuous improvement until the latest follow-up (0.18 ± 0.04).Conclusion A-CXL constitutes a successful method for KC stabilization. Signs of KC progression occur within the first 6 weeks postoperatively (“pseudoprogression”), but this is not indicative of the long-term effect.

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To improve the performance of organophilic clay in water treatment, it was treated with a neutral amine and a source of silica tetraethyl orthosilicate with formula Si(OC2H5)4. The obtained materials were called PCHs (porous clay heterostructures). To allow us to better appreciate their properties, PCHs samples were subjected to different characterizations as Fourier-transform infrared spectroscopy, X-ray diffraction and Brunauer–Emmett–Teller analysis, then they were applied in batch reactor adsorption of the model cationic dye methylene blue (MB). The prepared PCHs adsorbents have high affinity towards MB. The most known Langmuir and Freundlich models were applied to analyze experimental isotherm data. The maximum adsorption capacity founded was of 274 and 361 mg/g for the prepared samples. The adsorption mechanism was based on the hydrophobic–hydrophobic interactions. These results are important in selecting the most effective and suitable adsorbent for cationic dyes removal from polluted environments.

Hintergrund: Ziel der Studie war es, den Einfluss einer simultanen Amnionmembrantransplantation (AMT), des Hornhaut(HH)-Status (eigene HH vs. Transplantat [TPL]) und der Grunderkrankung auf die Erfolgs- und Rezidivraten des autologen Serums (AS) bei therapieresistenten Epitheldefekten zu evaluieren. Patienten und Methoden: Von 2007 bis 2019 wurden 990 Therapien mit AS an 703 Augen von 645 Patienten retrospektiv untersucht. Erfasst wurden das Vorliegen einer Erosio oder Ulkus, die Anwendung einer AMT, der HH-Status und die Grunderkrankung. Zielgrößen waren die Epithelschlussrate innerhalb 4 Wochen und die Rezidivrate nach Epithelschluss. Die mediane Beobachtungszeit betrug 50 Monate. Ergebnisse: Ein Epithelschluss zeigte sich bei 73,6 % und ein Rezidiv bei 27,4 %. Eine AMT wurde signifikant häufiger bei Ulzera (p&lt; 0,001) und Rezidiven (p= 0,048) angewandt. Ohne AMT ergab sich eine signifikant höhere Epithelschlussrate (p&lt; 0,001) und schnellere Heilungstendenz (p&lt; 0,001). Es bestand kein Unterschied zwischen der eigenen HH und dem TPL in der Epithelschlussrate (p= 0,47). Auf dem TPL zeigte sich eine signifikant höhere Rezidivrate (p= 0,004) und ein schnelleres Rezidivauftreten (p= 0,03), v. a. ≤6 Monate nach Epithelschluss. Die Grunderkrankungen zeigten einen signifikanten Unterschied in der Epithelschluss- (p= 0,02) und Rezidivrate (p&lt; 0,001) mit höchstem Erfolg bei HH-Dystrophien und geringstem bei kongenitaler Aniridie. Schlussfolgerungen: Das AS stellt eine effektive Therapieoption bei therapieresistenten Epitheldefekten dar. Es zeigt auf dem TPL eine hohe Erfolgsrate bei zugleich höherer Rezidivneigung. Bei simultaner AMT ist wegen der erhöhten Komplexität des zugrunde liegenden Problems mit geringeren Erfolgsraten zu rechnen. Das AS ist bei verschiedenen Grunderkrankungen erfolgreich einsetzbar, mit Limitationen bei der kongenitalen Aniridie.

Objectives:Pre-exposure prophylaxis (PrEP) use may influence sexual behaviour and transmission of STIs among men who have sex with men (MSM). We aimed to quantify the distribution of STI diagnoses among MSM in the Netherlands based on their sexual behaviour before and after the introduction of PrEP.Methods:HIV-negative MSM participating in a prospective cohort study (Amsterdam Cohort Studies) completed questionnaires about sexual behaviour and were tested for STI/HIV during biannual visits (2009–2019). We developed a sexual behaviour risk score predictive of STI diagnosis and used it to calculate Gini coefficients for gonorrhoea, chlamydia and syphilis diagnoses in the period before (2009 to mid-2015) and after PrEP (mid-2015 to 2019). Gini coefficients close to zero indicate that STI diagnoses are homogeneously distributed over the population, and close to one indicate that STI diagnoses are concentrated in individuals with a higher risk score.Results:The sexual behaviour risk score (n=630, n visits=10 677) ranged between 0.00 (low risk) and 3.61 (high risk), and the mean risk score increased from 0.70 (SD=0.66) before to 0.93 (SD=0.80) after PrEP. Positivity rates for chlamydia (4%) and syphilis (1%) remained relatively stable, but the positivity rate for gonorrhoea increased from 4% before to 6% after PrEP. Gini coefficients increased from 0.37 (95% CI 0.30 to 0.43) to 0.43 (95% CI 0.36 to 0.49) for chlamydia, and from 0.37 (95% CI 0.19 to 0.52) to 0.50 (95% CI 0.32 to 0.66) for syphilis comparing before to after PrEP. The Gini coefficient for gonorrhoea remained stable at 0.46 (95% CI 0.40 to 0.52) before and after PrEP.Conclusions:MSM engaged in more high-risk sexual behaviour and gonorrhoea diagnoses increased after PrEP was introduced. Chlamydia and syphilis diagnoses have become more concentrated in a high-risk subgroup. Monitoring the impact of increasing PrEP coverage on sexual behaviour and STI incidence is important. Improved STI prevention is needed, especially for high-risk MSM.

Abstract:Aside from certain food taboos, most people in the Middle Ages, whether Christian, Muslim, or Jewish, ate a similar diet, based on their economic status. Yet, as early as the thirteenth century in Spain, rules were being established to prohibit commensality. Medieval Iberian legal codes and religious ordinances against commensality use a rhetoric of impurity and vice that have its roots in classical and ancient traditions. In this article, I will examine the history of the rhetoric of impurity as it relates to food and its impact on the diets of Christians, Muslims, and Jews in the Iberian Middle Ages. I explain how religious authorities used food restrictions to advance their vision of the proper social order. I will also show how the conflation of racial prejudice and food practices created nationalistic discourses that continue to this day.

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