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Introduction: The aim of this study was to assess the long‐term effects of topical azithromycin on signs, symptoms and self‐management of meibomian gland dysfunction (MGD). Methods: Forty participants were assessed for MGD and its effect on the fluorescein tear break‐up time (FTBUT). Participants were treated with topical azithromycin twice daily for 2 weeks and then once daily for a further 2 weeks. One year after treatment, 31 participants completed a survey assessing pre‐ and post‐treatment effect on symptoms, lifestyle and self‐treatment methods. Results: Following treatment, there was a significant reduction in MGD grading from a median of grade 2 to grade 0 (z = 4.40, p < 0.0001) and an increase in FTBUT from a median of 3–8 s (z = 4.75, p < 0.0001). One year afterwards, the survey showed a significant improvement in symptoms (sensitivity to light, grittiness, burning, blurred vision, all p < 0.03) and reduction in required self‐treatments (lid wipes, tear substitutes, both p < 0.03). There was also a reduced impact on lifestyle (reading, night driving, computer use and watching television, all p < 0.0001) and in all environmental conditions (all p < 0.0001). Conclusions: This study confirms the positive effect of topical azithromycin on MGD and shows it has a long‐term impact on symptoms, self‐treatment methods and lifestyle. This has implications for both chair time and healthcare costs when managing patients with MGD. Pending further clinical trials in a larger population with different demographics, topical azithromycin should be considered by all eyecare practitioners as a viable pharmacological treatment when managing MGD. [ABSTRACT FROM AUTHOR]

A nonrandom national sample of 16 familicides, which involved 19 offenders (ages 14 to 21 years) who either killed or made a serious attempt to kill their families, was studied. The majority of offenders were Caucasian (78.91 %) males (84.21 %) with interpersonal family conflicts due to parental control, substance use, or physical violence. Prior to the murders, 50 % of the offenders reported to others their intent to kill their families. All of the 42 reported victims were specifically targeted and most of the homicides were planned shooting attacks (75 %) rather than spontaneous eruptions. Immediately following the homicides, 75 % of the offenders stole money from their families, and in 50 % of the cases they either called their friends to report the murders or to plan leisure activities. All offenders were immediate suspects and 81.25 % confessed to the homicides. Implications for furthering our understanding of this group of young offenders are offered., Author(s): Rosa Viñas-Racionero [sup.1] , Louis B. Schlesinger [sup.2] , Mario J. Scalora [sup.1] , John P. Jarvis [sup.3] Author Affiliations: (1) 0000 0004 1937 0060grid.24434.35Department of Psychology, University of [...]

This article analyzes a group of Gambian-American college writers creating an alternative public to challenge the patronizing norms operating in prevailing "aid-to-Africa" rhetorics. These young rhetors evoked performative genres and hybrid discourses so that members of their local public (the African nationals, African American professionals, white educators, fellow students, Muslim elders, conservative Christian community leaders) might themselves embody more productive self-other relations as they considered together the issue that drew them together publicly: the often hidden and insidious ways that cultural gender norms limit young African women's ability to thrive, whether in the U.S. or in the Gambia. (Contains 9 endnotes.)

Introduction: The objective of this study was to evaluate the impact of preoperative bowel stimulation on the development of postoperative ileus (POI) after loop ileostomy closure. Methods: This was a multicenter, randomized controlled trial (NCT025596350) including adult (≥ 18 years old) patients who underwent elective loop ileostomy closure at 7 participating hospitals. Participants were randomly assigned (1:1) using a centralized computer-generated sequence with block randomization to either preoperative bowel stimulation or no stimulation (control group). Bowel stimulation consisted of 10 outpatient sessions within the 3 weeks prior to ileostomy closure and was performed by trained Enterostomal Therapy nurses. The primary outcome was POI, defined as an intolerance to oral food in the absence of clinical or radiological signs of obstruction, on or after postoperative day 3, that either (a) required nasogastric tube insertion; or (b) was associated with two of the following: nausea/vomiting, abdominal distension, or the absence of flatus. Results: Between January 2017 and November 2020, 101 patients were randomized, and 5 patients never underwent ileostomy closure; thus, 96 patients (47 stimulated vs. 49 control) were analyzed according to a modified intention-to-treat protocol. Baseline characteristics were well balanced in both groups. The incidence of POI was lower among patients randomized to stimulation (6.4% vs. 24.5%, p = 0.034; unadjusted RR: 0.26, 95% CI 0.078–0.87). Stimulated patients also had earlier median time to first flatus (2.0 days (1.0–2.0) vs. 2.0 days (2.0–3.0), p = 0.025), were more likely to pass flatus on postoperative day 1 (46.8% vs. 22.4%, p = 0.022), and had a shorter median postoperative hospital stay (3.0 days (2.0–3.5) vs. 4.0 days (2.0–6.0), p = 0.003). Conclusions: Preoperative bowel stimulation via the efferent limb of the ileostomy reduced POI after elective loop ileostomy closure. [ABSTRACT FROM AUTHOR]

As journalists, we Know the power of words. The phrase 'the pen is mightier than the sword' was coined for a reason--and when the words we employ are backed up [...]

This study uses data from the National Incident-Based Reporting System (NIBRS) to explore the impact of model selection on determining the association of victim-level and incident-level factors to the likelihood of homicide clearance. We compare both traditional operationalizations of clearance rates as well as the time to clearance as dependent variables in examinations of correlates of solvability in homicide cases. Using a different approach than most other analyses of this problem, the results affirm the consistency of some effects but also reveal some important differences when the aspect of time is factored into the model. Implications for analyses of efficiency and effectiveness of police response to homicide, cold-case analyses, and other strategies for solving crime are discussed. Keywords: clearance rates: homicide: NIBRS

The peeling stress near the free edge of a bimaterial beam under uniform temperature change creates a moment which causes both layers to have identical curvatures at the interface. A new formula from beam theory is given for this Peeling Moment. A beam with a negative Peeling Moment resists delamination at the free edge. A physical explanation for the moment is developed; the sign of the Peeling Moment is also the determinant of the location of the equivalent centroid of the bimaterial beam. This provides a valuable new rule for designing resistance to thermomechanical delamination of a bimaterial structure. [DOI: 10.1115/1.1649240]