Predicting intraocular pressure using systemic variables or fundus photography with deep learning in a health examination cohort

The purpose of the current study was to predict intraocular pressure (IOP) using color fundus photography with a deep learning (DL) model, or, systemic variables with a multivariate linear regression model (MLM), along with least absolute shrinkage and selection operator regression (LASSO), support vector machine (SVM), and Random Forest: (RF). Training dataset included 3883 examinations from 3883 eyes of 1945 subjects and testing dataset 289 examinations from 289 eyes from 146 subjects. With the training dataset, MLM was constructed to predict IOP using 35 systemic variables and 25 blood measurements. A DL model was developed to predict IOP from color fundus photographs. The prediction accuracy of each model was evaluated through the absolute error and the marginal R-squared (mR2), using the testing dataset. The mean absolute error with MLM was 2.29 mmHg, which was significantly smaller than that with DL (2.70 dB). The mR2 with MLM was 0.15, whereas that with DL was 0.0066. The mean absolute error (between 2.24 and 2.30 mmHg) and mR2 (between 0.11 and 0.15) with LASSO, SVM and RF were similar to or poorer than MLM. A DL model to predict IOP using color fundus photography proved far less accurate than MLM using systemic variables.

Promoting Online Transparency to Help Achieve the Sustainable Development Goals: An Empirical Study of Local Governments in Latin America

Although transparency on the sustainability of public services is an issue of urgent interest to both governments and academics, previous research in this area has mainly focused on developed European countries, and has paid insufficient attention to areas that are still developing, such as many Latin American countries. The aim of this study is to identify factors that promote transparency on sustainability by local governments in Latin America, in the view that greater transparency will help them meet the goals of the 2030 Agenda for Sustainable Development. Therefore, using content analysis and following the GRI guidelines, we analyze the economic, social and environmental information published on the websites of 200 large local governments in 18 Latin American countries. In addition, using linear regression and calculating the corresponding Spearman coefficients, we analyze the influence of idiosyncratic and systemic variables on the volume of information disclosed. Our findings show that certain factors—population size, education level, unemployment, the quality of legislation and political corruption—affect transparency on sustainability. The conclusions drawn from this analysis enable us to identify useful measures for enhancing transparency on sustainability, including the reform of transparency laws and the analysis and disclosure of citizens’ information demands.

Is Oral Health All About Tooth Brushing? A Longitudinal Study in Individuals With Brain Injury in A Neurorehabilitation Setting

Objective: To investigate oral health changes and its associated factors during hospitalization in individuals with acquired brain injury (ABI).Material and Methods: Sixty-one individuals were recruited to evaluate the acute changes in oral health by performing plaque, calculus, bleeding on probing (BOP) and bedside oral examination (BOE) at week 1 and week 5. Individuals’ brushing habits, eating difficulties, onset of pneumonia etc. were retrieved from e-journal. Association between oral-health outcomes to systemic variables were investigated through multilevel regression models.Results: Dental plaque (P=0.01) and total BOE score (P<0.05) decreased over time but not the calculus (P=0.30), BOP (P=0.06) and increase in tooth brushing frequency (P=0.06). Reduction in plaque, and BOE over time were negatively associated with higher score of periodontitis at baseline (coef. -6.8; -1.0, respectively), which in turn were associated with an increased proportion of BOP (coef. ≈ 15.0). Increased proportion of calculus was associated with eating difficulties (coef. 2.3) and onset of pneumonia (coef. 6.2).Conclusions: Nursing care has been fundamental in improving oral health but non-significant improvement in calculus, BOP and brushing frequency indicates a need for development in existing oral care program through academic-clinical partnership keeping eating difficulties and patients’ vegetative and cognitive state in consideration.

Making Management (More) Relevant: Breaking Down Disciplinary Walls and Pursuing Neglected Independent Variables

The Walls Project encourages educators to broaden management teaching beyond individual and organizational variables and outcomes to systemic variables and outcomes. Its focus is on discovering independent variables that have social and environmental impacts and are currently neglected. Founded by six individuals who met at a RMLE UnConference in 2017, the Project decided to share pedagogical materials, examine them for commonalities, and present their findings at the MOBTC conference in 2019. This article summarizes these materials with an eye to revealing several variables of consequence, such as socioeconomic status and belief in economic growth, which are studied and taught infrequently in business schools. We suggest that researchers examine business curricula for similar neglected variables, study their impact across systems levels, and then develop them pedagogically to enhance management education that has a social and environmental impact.

Innovating business processes in public administrations: towards a systemic approach

PurposeThe purpose of this paper is to study the credit collection process in public administrations in order to develop a conceptual model which goes beyond the traditional logic of linearity, adopting system thinking approaches.Design/methodology/approachThis study analyses the case of an Italian local government-owned enterprise. Data collection through semi-structured interviews and document analysis has enabled the development of propositions, the identification of systemic variables, and the development of an explanatory modeling process based on the system dynamics approach.FindingsThis paper shows that public administrations can effectively involve external actors, especially citizens, as knowledge and public value co-creators only when considering systemic, unintended, and delayed implications of decision-making activities related to the provision of sensitive public services such as credit collection.Originality/valueBusiness process modelling should address some key fragilities of traditional modeling processes, especially in the public sector. This paper develops a novel systemic conceptual model which lays the groundwork for empirically testing business process innovation in public administrations.

A blend of essential oils improved feed efficiency and affected ruminal and systemic variables of dairy cows

This experiment evaluated the effect of a blend of essential oils (BEO) on intake, lactation performance, diet digestibility, ruminal fermentation profile, eating behavior, body thermoregulation, blood acid–base balance, and milk fatty acid profile of lactating cows. Twenty-eight Holstein cows were individually fed a standard diet for 14 d and treatments control or BEO (a microencapsulated blend of pepper extract containing capsaicin and pure forms of carvacrol, cinnamaldehyde, and eugenol; 150 mg/kg of diet dry matter) for 56 d. Significance was declared at P ≤ 0.05 and trends at 0.05 &lt; P ≤ 0.10. Dry matter intake (DMI) was reduced (19.5 vs. 20.1 kg/d) and milk yield was increased (30.1 vs. 30.8 kg/d) by BEO, inducing improved milk to DMI ratio (1.53 vs. 1.62). Milk fat concentration tended to be increased by BEO, but total solids yield did not differ. There was a trend for increased total tract non-neutral detergent fiber organic matter digestibility with BEO. The molar proportion of acetate in ruminal fluid was reduced (51.4 vs. 57.8%) and that of propionate was increased (26.1 vs. 31.3%) by BEO. Ruminal microbial yield and total protozoa count in ruminal fluid did not differ. Cows fed BEO ingested a greater proportion of the daily intake in the morning (30.6 vs. 36.6%) and tended to ingest a lower proportion at night, tended to have longer meals, and had fewer meals per day (11.9 vs. 13.7) and larger meal size (1.5 vs. 1.7 kg of dry matter per meal). Blood urea-N and glucose concentrations did not differ. The BEO increased jugular blood oxygenation. The sweating rate on a hot and dry day was increased (160 vs. 221 g/m2/h) by BEO. The mean rectal and skin temperatures and respiration rate did not differ, but the proportion of rectal temperature measurements ≥39.2 °C was reduced by BEO at 1400 h (17.8 vs. 28.5%) and 2000 h (23.2 vs. 34.8%). The BEO increased the secretion (g/d) of 18:2 trans-10, cis-12 and the concentration of 18:0 iso fatty acids in milk fat. When one sample of milk from BEO cows was offered with two samples of milk from control, 59% of regular consumers of milk (n = 63) identified the odd sample correctly. The gain in feed efficiency induced by BEO was associated with reduced acetate-to-propionate ratio in ruminal fluid, altered eating behavior, lower frequency of high rectal temperature, and increased blood oxygenation. Essential oils had positive effects on ruminal fermentation and systemic variables of dairy cows.

Neoclassical Realist Theory, Alliance Politics, and Nonproliferation

Chapter 2 develops neoclassical realist theory. It explicates how the two systemic variables—the current distribution of power in a region and the time horizons for threats to the hegemon’s interests in that region—can create incentives for US presidential administrations to favor coercive or accommodative strategies toward a vulnerable ally seeking nuclear weapons. When confronted with such high domestic mobilization hurdles to their preferred strategies, however, administrations will pursue hybrid strategies—ones that combine accommodative and coercive elements—toward an ally. This chapter unpacks the measurement of the variables and the types of empirical evidence that might confirm or disconfirm the hypotheses. It also outlines three alternative explanations (nuclear domino theory, security commitment theory, and credible sanctions theory) and the types of evidence that might confirm or disconfirm their hypotheses.

Institutional change and accountability: procedural ecology and defiance of the Brazilian case

This article analyzes the process of institutional change, focusing on endogenous, exogenous and systemic processes. Scholars usually analyze institutional change considering endogenous and exogenous explanatory factors to talk about the direction and outcomes of the changes. In addition to these two factors, this paper proposes a third one. This paper proposes that the process of institutional change should be understood in terms of systemic variables and should take into account the interactions between institutions as a relevant factor in explaining the veto or promotion of institutional change. Based on qualitative evidence gathered from interviews with key accountability actors in Brazil, the paper discusses the incremental changes that occurred in the Brazilian accountability institutions. We demonstrate that, despite these incremental changes, the final result in terms of institutional change was not a broader systemic change with greater cooperation and coordination of control activities between accountability institutions. Accountability processes are understood as part of a dynamic system, under which competition and cooperation are part of the action repertoire of accountability actors and used differently depending on the situation.