Vitrectomy for Vitreous Opacities

Pars plana vitrectomy (PPV) surgery in vitreous opacities is an effective treatment method that increases patient satisfaction. However, due to the risks associated with PPV surgery, its application in vitreous floaters is controversial. Instead, performing sutureless, minimally invasive PPV surgery with 25 gauge trocars on floaters may reduce the risks. For surgical treatment, it is important to select appropriate patients, evaluation of the risk and benefit balance of PPV, and application the treatment.

Balancing benefits and potential risks of vaccination: the precautionary principle and the law of unintended consequences

Vaccination is a life-saving endeavour, yet risk and uncertainty are unavoidable in science and medicine. Vaccination remains contentious in the public mind, and vaccine hesitancy is a serious public health issue. This has recently been reignited in the discussion over potential side effects of COVID-19 vaccines, and the decision by several countries to suspend measures such as the AstraZeneca vaccine. In these instances, the precautionary principle has often been invoked as a rationale, yet such heuristics do not adequately weigh potential harms against real benefits. How we analyse, communicate and react to potential harms is absolutely paramount to ensure the best decisions and outcomes for societal health, and maintaining public confidence. While balancing benefits and risks is an essential undertaking, it cannot be achieved without due consideration of several other pertinent factors, especially in the context of vaccination, where misguided or exaggerated fears have in the past imperilled public health. While well meaning, over reactions to potential hazards of vaccination and other health interventions can have unintended consequences, and cause lingering damage to public trust. In this analysis, we explore the challenges of assessing risk and benefit, and the limitations of the precautionary principle in these endeavours. When risk is unclear, cautious vigilance might be a more pragmatic and useful policy than reactionary suspensions.

Biologics for Psoriasis During the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19), a new form of acute infectious respiratory syndrome first reported in 2019, has rapidly spread worldwide and has been recognized as a pandemic by the WHO. It raised widespread concern about the treatment of psoriasis in this COVID-19 pandemic era, especially on the biologics use for patients with psoriasis. This review will summarize key information that is currently known about the relationship between psoriasis, biological treatments, and COVID-19, and vaccination-related issues. We also provide references for dermatologists and patients when they need to make clinical decisions. Currently, there is no consensus on whether biological agents increase the risk of coronavirus infection; however, current research shows that biological agents have no adverse effects on the prognosis of patients with COVID-19 with psoriasis. In short, it is not recommended to stop biological treatment in patients with psoriasis to prevent the infection risk, and for those patients who tested positive for SARS-CoV-2, the decision to pause biologic therapy should be considered on a case-by-case basis, and individual risk and benefit should be taken into account. Vaccine immunization against SARS-CoV-2 is strictly recommendable in patients with psoriasis without discontinuation of their biologics but evaluating the risk-benefit ratio of maintaining biologics before vaccination is mandatory at the moment.

Glucocorticoid therapy in assisted reproduction

As glucocorticoids are well-known as important regulators of stress and the immune system, their function and clinical use have elicited substantial interest in the field of reproduction. In particular, the effect of glucocorticoid therapy on endometrial receptivity during assisted reproduction, including in vitro fertilization (IVF) cycles, has led to a great deal of interest and controversy. However, previous studies have not been able to provide consistent and reliable evidence due to their small, non-controlled designs and use of different criteria. Considering the potential risk of exposure to glucocorticoids for mothers and fetuses in early pregnancy, the use of glucocorticoids in IVF cycles should be carefully evaluated, including the balance between risk and benefit. To date, there is no conclusive evidence that the use of glucocorticoids improves the pregnancy rate in IVF cycles with unselected subjects, and a further investigation should be considered with a proper study design.

Acceptance of Main Power Generation Sources among Japan’s Undergraduate Students: The Roles of Knowledge, Experience, Trust, and Perceived Risk and Benefit

In Japan, graduates who become independent professionals in society have the right to choose energy providers given the liberalization of the electricity market in the country. This issue renders student perceptions regarding various types of energy generation a critical factor for decision making. Accordingly, we explored the risk and benefit perceptions of undergraduates regarding Japan’s main energy resources, namely, liquid natural gas (LNG), coal, hydropower, solar and nuclear resources, and petroleum. We also assessed energy acceptance among the target population and its influencing factors, such as student age and gender, school department, hometown, knowledge and experience of main power sources in Japan, and trust in government and power plant operation. These objectives were accomplished through field surveys and empirical characterizations of energy acceptance determinants. Compared with risk perception, benefit perception regarding all kinds of power generation was significantly predicted by knowledge. Experience explained only the perception of benefit from coal power generation, and benefit perception more strongly predicted energy acceptance than did risk perception. The findings suggested the necessity of university energy education programs for increased student knowledge of energy sources. Energy companies should increase energy benefits from economic, environmental, and energy security and safety perspectives to enhance energy acceptance among students. On the basis of the results, we classified energy sources in Japan into obscure (LNG and petroleum), well-known (coal and nuclear), and exploratory (hydropower and solar) resources—a first in the energy field and contributory to energy education design.

Should children be vaccinated against COVID-19?

Whether all children under 12 years of age should be vaccinated against COVID-19 remains an ongoing debate. The relatively low risk posed by acute COVID-19 in children, and uncertainty about the relative harms from vaccination and disease mean that the balance of risk and benefit of vaccination in this age group is more complex. One of the key arguments for vaccinating healthy children is to protect them from long-term consequences. Other considerations include population-level factors, such as reducing community transmission, vaccine supply, cost, and the avoidance of quarantine, school closures and other lockdown measures. The emergence of new variants of concern necessitates continual re-evaluation of the risks and benefits. In this review, we do not argue for or against vaccinating children against COVID-19 but rather outline the points to consider and highlight the complexity of policy decisions on COVID-19 vaccination in this age group.