Capturing contact in mitral valve dynamic closure with fluid-structure interaction simulation

PURPOSE

Realistic fluid-structure interaction (FSI) simulation of the mitral valve opens the way toward planning for surgical repair. In the literature, blood leakage is identified by measuring the flow rate, but detailed information about closure efficiency is missing. We present in this paper an FSI model that improves the detection of blood leakage by building a map of contact.

METHODS

Our model is based on the immersed boundary method that captures a map of contact and perfect closure of the mitral valve, without the presence of orifice holes, which often appear with existing methods. We also identified important factors influencing convergence issues.

RESULTS

The method is demonstrated in three typical clinical situations: mitral valve with leakage, bulging, and healthy. In addition to the classical ways of evaluating MV closure, such as stress distribution and flow rate, the contact map provides easy detection of leakage with identification of the sources of leakage and a quality assessment of the closure.

CONCLUSIONS

Our method significantly improves the quality of the simulation and allows the identification of regurgitation as well as a spatial evaluation of the quality of valve closure. Comparably fast simulation, ability to simulate large deformation, and capturing detailed contact are the main aspects of the study.

How should the government treat asylum seekers? The role of labour market vulnerability and migration in Europe

Is labour market vulnerability associated with harsher preferences on asylum-seeking policy? If so, how might the size of the existing foreign-born population condition this effect? We unpack these dynamics across 20 European countries using 2014 ESS and EU-SILC data. In doing so, we examine the relevance of labour market vulnerability both directly and in combination with: individual-level exposure to people of a different race or ethnicity; and the perceived or actual size of the foreign-born population. Results suggest that exposure to labour market risk is associated with a preference for harsher treatment, but that this relationship is driven by respondents with little to no interactions with the existing minority population. We also find that labour market vulnerability is associated with higher (lower) preferred severity in countries with a large (small) presumed foreign-born population. The actual size of the foreign-born population, by contrast, does not appear to matter.

The Impact of Contact and Fame on Changing the Public Stigma of Mental Illness

Many famous people have disclosed their mental illness to erase the harmful effects of stigma. This study examines the relative impact of disclosure stories from people who are or are not celebrities. We expected noncelebrities would be viewed as more similar and likeable and therefore have greater effects on stigma change. Research participants from an MTurk panel viewed self-disclosure stories from celebrity, Mariah Carey, or noncelebrity, Malia Fontecchio. Participants completed the Difference and Disdain Scale prior to reviewing the vignettes and immediately after each one. Participants also completed scales representing perceptions of fame, dissimilarity, and likeability of the person in each story. Results supported hypotheses: Mariah Carey was perceived as more famous, more dissimilar, and less likeable than Malia Fontecchio. Reading the Malia Fontecchio story led to greater improvement in disdain stigma than the Mariah Carey story. Implications for the varied role of celebrity status in stigma change are discussed.

Infection Risk in Sexual Contacts of Syphilis: A Systematic Review and Meta-analysis

OBJECTIVES

Current guidelines recommend offering epidemiological treatment to asymptomatic contacts of early syphilis. This is on the expectation that up to 60% of sexual contacts of patients with syphilis will be infected. However, the evidence for this figure is sparse. We performed a systematic review and meta-analysis, to estimate the proportion of sexual contacts of syphilis that are infected with syphilis.

METHODS

Two electronic databases (Medline and Embase) were reviewed in March 2021, to identify studies that reported rates of infection in sexual contacts of syphilis.

RESULTS

Of 3,051 Embase and 1,828 Medline articles identified, 32 were included in the meta-analysis. In total 36,397 contacts were tested. The proportion of contacts infected varied across the studies, ranging from 10.7% to 97.5%, resulting in considerable heterogeneity (I²=98.5%). Pooling the studies gave an estimated proportion of infected contacts of 32.6% (95% confidence interval: 26.2% - 39.7%).

CONCLUSIONS

The risk of infection in sexual contacts of syphilis reported in the literature is highly variable, with a pooled estimate of 32.6%. This will help guide decisions regarding epidemiological treatment of sexual contacts of patients with syphilis. These decisions are increasingly important in this era of antibiotic resistance, with increasing emphasis being placed on antimicrobial stewardship.

Knowledge, contact and stigma of mental illness: Comparing three stakeholder groups in Hong Kong

BACKGROUND

It remains unknown what the impacts of multiple dimensions of contact (e.g. level, quantity and quality) are on the stigma of mental illness.

AIMS

To explore the relationship between the multiple dimensions of contact and stigma of mental illness among family members (FM), mental health workers (MHW) and community residents (CR) in Hong Kong.

METHODS

The stigma, contact and knowledge were measured in FM, MHW and CR in Hong Kong. Multiple regression analyses were used.

RESULTS

MHW (n = 141) had higher knowledge, more contact and lower stigma of mental illness than CR (n = 95) or FM (n = 62). Knowledge and contact quality were significantly associated with lower stigma of mental illness in the three groups. However, contact level and contact quantity were not significantly associated with most stigma components. The contact level was positively associated with stigma of mental illness among FM and CR.

CONCLUSIONS

The results of this study highlight the differences in knowledge, contact and stigma of mental illness among different stakeholder groups. This study suggests that positive contact (e.g. equal, supportive, voluntary and pleasant contact) reduces stigma of mental illness, while negative contact (e.g. unfriendly, unsupportive, unpleasant contact) may increase stigma. The Enhancing Contact Model (ECM) should be tested in future anti-stigma interventions.

Revisiting the relationship between contact and physician attitudes toward patients with opioid use disorder

INTRODUCTION

Prior research suggests that some physicians hold negative attitudes toward patients who misuse opioids and that this serves as a barrier which limits the availability and effectiveness of health care services. Interventions which improve physicians' attitudes have thus garnered attention, many of which have focused on increasing contact between physicians and patients who misuse opioids. However, drawing on recent literature on intergroup contact, the current paper argues that contact may not have uniformly positive effects on prejudice.

METHODS

We surveyed 408 board-certified physicians in the state of Ohio where many opioid overdose deaths have been concentrated. We used regression to test for interactions between contact and three focal variables, bias, burnout, and stress, on physician willingness to work with patients who misuse opioids.

RESULTS

The negative relationships between bias, physician burnout, and stress induced by working with patients who misuse opioids and physicians' willingness to work with this patient population are each exacerbated when contact with patients who misuse opioids is high.

CONCLUSIONS

Although intervention studies have shown promise for the role that increased contact may have in reducing stigma toward patients who misuse opioids, these interventions may not be appropriate for physicians who are experiencing strain or who hold preexisting negative attitudes toward this patient population. Future interventions may need to target bias, burnout, and stress, in addition to facilitating contact, to increase physician willingness to work with these patients.

The mediating role of knowledge on the contact and stigma of mental illness in Hong Kong

BACKGROUND

Although knowledge is a crucial component in contact theory delineating how prejudice changes toward out-groups with stigmatized conditions, little is known about the mediating role of knowledge on contact, stigmatizing attitudes, and behaviors toward mental illness.

AIM

This study aimed to examine the mechanism underlie contact and stigma change by knowledge.

METHODS

A total of 366 participants including family members (FM), mental health providers (MHP), and community residents (CR) recruited across communities in Hong Kong and completed measures of contact level, contact quantity, contact quality, mental health related knowledge, prejudice, and discriminatory behaviors. Structural equation modeling was adopted to test the association among the key variables.

RESULTS

Higher level of contact was significantly correlated with better knowledge, less prejudice, and less discriminatory behaviors. Knowledge was directly and negatively correlated with prejudicial attitudes but was not significantly related to discriminatory behaviors. Furthermore, lower levels of prejudice were associated with less discriminatory behaviors.

CONCLUSION

Enhancement of contact may increase understanding toward people with mental illness (PMI) and diminish stigmatizing attitudes and behaviors. Although prejudicial attitudes may be reduced by broadening mental health knowledge, increasing knowledge only might not ameliorate discriminatory behaviors. Future research should test mediators on contact and stigma by using longitudinal data.

Increased urbanization reduced the effectiveness of school closures on seasonal influenza epidemics in China

BACKGROUND

School closure is a common mitigation strategy during severe influenza epidemics and pandemics. However, the effectiveness of this strategy remains controversial. In this study, we aimed to explore the effectiveness of school closure on seasonal influenza epidemics in provincial-level administrative divisions (PLADs) with varying urbanization rates in China.

METHODS

This study analyzed influenza surveillance data between 2010 and 2019 provided by the Chinese National Influenza Center. Taking into consideration the climate, this study included a region with 3 adjacent PLADs in Northern China and another region with 4 adjacent PLADs in Southern China. The effect of school closure on influenza transmission was evaluated by the reduction of the effective reproductive number of seasonal influenza during school winter breaks compared with that before school winter breaks. An age-structured Susceptible-Infected-Recovered-Susceptible (SIRS) model was built to model influenza transmission in different levels of urbanization. Parameters were determined using the surveillance data via robust Bayesian method.

RESULTS

Between 2010 and 2019, in the less urbanized provinces: Hebei, Zhejiang, Jiangsu and Anhui, during school winter breaks, the effective reproductive number of seasonal influenza epidemics reduced 14.6% [95% confidential interval (CI): 6.2-22.9%], 9.6% (95% CI: 2.5-16.6%), 7.3% (95% CI: 0.1-14.4%) and 8.2% (95% CI: 1.1-15.3%) respectively. However, in the highly urbanized cities: Beijing, Tianjin and Shanghai, it reduced only 5.2% (95% CI: -0.7-11.2%), 4.1% (95% CI: -0.9-9.1%) and 3.9% (95% CI: -1.6-9.4%) respectively. In China, urbanization is associated with decreased proportion of children and increased social contact. According to the SIRS model, both factors could reduce the impact of school closure on seasonal influenza epidemics, and the proportion of children in the population is thought to be the dominant influencing factor.

CONCLUSIONS

Effectiveness of school closure on the epidemics varies with the age structure in the population and social contact patterns. School closure should be recommended in the low urbanized regions in China in the influenza seasons.

Nutritionally induced nanoscale variations in spider silk structural and mechanical properties

Spider major ampullate (MA) silk is characterized by high strength and toughness and is adaptable across environments. Experiments depriving spiders of protein have enabled researchers to examine nutritionally induced changes in gene expression, protein structures, and bulk properties of MA silk. However, it has not been elucidated if it varies in a similar way at a nanoscale. Here we used Atomic Force Microscopy (AFM) to simultaneously examine the topographic, structural, and mechanical properties of silks spun by two species of spider, Argiope keyserlingi and Latrodectus hasselti, at a nanoscale when protein fed or deprived. We found height, a measure of localized width, to substantially vary across species and treatments. We also found that Young's modulus, which may be used as an estimate of localized stiffness, decreased with protein deprivation in both species' silk. Our results suggest that nanoscale skin-core structures of A. keyserlingi's MA silk varied significantly across treatments, whereas only slight structural and functional variability was found for L. hasselti's silk. These results largely agreed with examinations of the bulk properties of each species' silk. However, we could not directly attribute the decoupling between protein structures and bulk mechanics in L. hasselti's silk to nanoscale features. Our results advance the understanding of processes inducing skin and core structural variations in spider silks at a nanoscale, which serves to enhance the prospect of developing biomimetic engineering programs.

Age-of-actor effects in body expression recognition of children

Investigations of developmental trajectories for emotion recognition suggest that both face- and body expression recognition increases rapidly in early childhood and reaches adult levels of performance near the age of ten. So far, little is known about whether children's ability to recognise body expressions is influenced by the age of the person they are observing. This question is investigated here by presenting 119 children and 42 young adults with videos of children, young adults and older adults expressing emotions with their whole body. The results revealed an own-age advantage for children, reflected in adult-level accuracy for videos of children for most expressions but reduced accuracy for videos of older adults. Children's recognition of older adults' expressions was not correlated with children's estimated amount of contact with older adults. Support for potential influences of social biases on performance measures was minimal. The own-age advantage was explained in terms of children's reduced familiarity with body expressions of older adults due to aging related changes in the kinematics characteristics of movements and potentially due to stronger embodiment of other children's bodily movements.

Collision with opponents-but not foul play-dominates injury mechanism in professional men's basketball

Background

To identify injury patterns and mechanisms in professional men’s basketball by means of video match analysis.

Methods

In Germany, injuries are registered with the statutory accident insurance for professional athletes (VBG) by clubs or club physicians as part of occupational accident reporting. Moderate and severe injuries (absence of > 7 days) sustained during basketball competition in one of four seasons (2014–2017 and 2018–2019) in the first or second national men’s league in Germany were prospectively analyzed using a newly developed standardized observation form. Season 2017–2018 was excluded because of missing video material.

Results

Video analysis included 175 (53%) of 329 moderate and severe match injuries. Contact patterns categorized according to the different body sites yielded eight groups of typical injury patterns: one each for the head, shoulders, and ankles, two for the thighs, and three for the knees. Injuries to the head (92%), ankles (76%), shoulders (70%), knees (47%), and thighs (32%) were mainly caused by direct contact. The injury proportion of foul play was 19%. Most injuries (61%) occurred in the central zone below the basket. More injuries occurred during the second (OR 1.8, p = 0.018) and fourth quarter (OR 1.8, p = 0.022) than during the first and third quarter of the match.

Conclusion

The eight identified injury patterns differed substantially in their mechanisms. Moderate and severe match injuries to the head, shoulders, knees, and ankles were mainly caused by collision with opponents and teammates. Thus, stricter rule enforcement is unlikely to facilitate safer match play.

Mediating effects of stigma on the relationship between contact and willingness to care for people with mental illness among nursing students

BACKGROUND

Previous studies have demonstrated that contact positively impacts nursing students' willingness to care for people with mental illness. However, studies that have explored the mechanism of such a relationship between contact and willingness remain few.

OBJECTIVES

To examine the direct relationship between contact and nursing students' willingness to care for people with mental illness and to explore the potential mediating roles of stigma.

DESIGN

This was a cross-sectional study design.

SETTINGS

The study was conducted in a nursing school in Nanjing city, China.

PARTICIPANTS

A total of 839 nursing students were recruited in the study through convenience sampling.

METHODS

Nursing students' stigma, contact, and willingness to care for people with mental illness were measured online through the Stigma toward People with Mental Illness Scale (SPMI), the Level of Contact Report, and one item of "which degree indicates your willingness to provide care for people with mental illness," respectively. The structural equation model was applied to explore the potential mediating roles of stigma.

RESULTS

Contact with people suffering from mental illness directly affected nursing students' willingness to care for them (β = 0.076, p < 0.05). Meanwhile, stigma partly mediated the effect of students' contact on willingness to care for people with mental illness (β = 0.048, p < 0.05).

CONCLUSIONS

High level of contact can improve nursing students' willingness to care and the relationship is partly mediated by stigma. Measures to improve the level of contact and reduce stigmatizing attitudes of nursing students are accordingly essential in influencing them to have more willingness to care for people with mental illness.

Spatial and temporal variation in proximity networks of commercial dairy cattle in Great Britain

The nature of contacts between hosts can be important in facilitating or impeding the spread of pathogens within a population. Networks constructed from contacts between hosts allow examination of how individual variation might influence the spread of infections. Studying the contact networks of livestock species managed under different conditions can additionally provide insight into their influence on these contact structures. We collected high-resolution proximity and GPS location data from nine groups of domestic cattle (mean group size = 85) in seven dairy herds employing a range of grazing and housing regimes. Networks were constructed from cattle contacts (defined by proximity) aggregated by different temporal windows (2 h, 24 h, and approximately 1 week) and by location within the farm. Networks of contacts aggregated over the whole study were highly saturated but dividing contacts by space and time revealed substantial variation in cattle interactions. Cows showed statistically significant variation in the frequency of their contacts and in the number of cows with which they were in contact. When cows were in buildings, compared to being on pasture, contact durations were longer and cows contacted more other cows. A small number of cows showed evidence of consistent relationships but the majority of cattle did not. In one group where management allowed free access to all farm areas, cows showed asynchronous space use and, while at pasture, contacted fewer other cows and showed substantially greater between-individual variation in contacts than other groups. We highlight the degree to which variations in management (e.g. grazing access, milking routine) substantially alter cattle contact patterns, with potentially major implications for infection transmission and social interactions. In particular, where individual cows have free choice of their environment, the resulting contact networks may have a less-risky structure that could reduce the likelihood of direct transmission of infections.

Transmission of infectious laryngotracheitis virus vaccine and field strains: the role of degree of contact and transmission by whole blood, plasma and poultry dust

Understanding the mechanisms of transmission of infectious laryngotracheitis virus (ILTV) is critical to proper control as both vaccine and wild-type strains circulate within chicken flocks with potential adverse consequences. The relative efficiency of transmission by direct contact between chickens and airborne transmission has not been investigated. Furthermore, relatively high levels of ILTV DNA have been detected in poultry dust and blood but the infectivity of these is unknown. In this study, comparison of in-contact and airborne transmission of two vaccine and one field strain of ILTV revealed that all transmitted to 100% of in-contact birds by 6 days post-exposure (dpe). Airborne transmission without contact resulted in 100% transmission by 14 and 17 dpe for the wild-type and Serva vaccine virus but only 27% transmission by 21 dpe for the A20 vaccine virus. The infectivity of dust or extracts of dust and blood or plasma from infected chickens at various stages of infection was assessed by inoculation into susceptible chickens. There was no transmission by any of these materials. In conclusion, direct contact facilitated efficient ILTV transmission but the virus was unable to be transmitted by dust from infected chickens suggestive of a limited role in the epidemiology of ILTV.

Hospital-based prospective study of pertussis in infants and close contacts in Tehran, Iran

Background

Pertussis remain a global health concern, especially in infants too young to initiate their vaccination. Effective vaccination and high coverage limit the circulation of the pathogen, yet duration of protection is limited and boosters are recommended during a lifetime. In Iran, boosters are given at 18 months and 6 years old using whole pertussis vaccines for which efficacy is not known, and pertussis surveillance is scant with only sporadic biological diagnosis. Burden of pertussis is not well understood and local data are needed.

Methods

Hospital-based prospective study implementing molecular laboratory testing in infants aged ≤6 months and presenting ≥5 days of cough associated to one pertussis-like symptom in Tehran. Household and non-household contact cases of positive infants were evaluated by comprehensive pertussis diagnosis (molecular testing and serology) regardless of clinical signs. Clinical evaluation and source of infection were described.

Results

A total of 247 infants and 130 contact cases were enrolled. Pertussis diagnosis result was obtained for 199 infants and 104 contact cases. Infant population was mostly < 3 months old (79.9%; 157/199) and unvaccinated (62.3%; 124/199), 20.1% (40/199) of them were confirmed having B. pertussis infection. Greater cough duration and lymphocyte counts were the only symptoms associated to positivity. Half of the contact cases (51.0%; 53/104) had a B. pertussis infection, median age was 31 years old. A proportion of 28.3% (15/53) positive contacts did not report any symptom. However, 67.9% (36/53) and 3.8% (2/53) of them reported cough at inclusion or during the study, including 20.8% (11/53) who started coughing ≥7 days before infant cough onset. Overall, only five samples were successfully cultured.

Conclusion

These data evidenced the significant prevalence of pertussis infection among paucy or poorly symptomatic contacts of infants with pertussis infection. Widespread usage of molecular testing should be implemented to identify B. pertussis infections.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-06266-6.

In vivo articular contact pattern of a total wrist arthroplasty design

Total wrist arthroplasty (TWA) designs suffer from relatively high complication rates when compared to other arthroplasties. Understanding the contact pattern of hip and knee replacement has improved their design and function; however, the in vivo contact pattern of TWA has not yet been examined and is thus the aim of this study. We hypothesized that the center of contact (CoC) is located at the geometric centers of the carpal component and radial component in the neutral posture and that the CoC moves along the principal arcs of curvature throughout primary anatomical motions. Wrist motion and implant kinematics of six patients with the Freedom® total wrist implant were studied during various tasks using biplanar videoradiography. The location of the CoC of the components was investigated by calculating distance fields between the articular surfaces. We found the CoC at the neutral posture was not at the geometric centers but was located 3.5 mm radially on the carpal component and 1.2 mm ulnarly on the radial component. From extension to flexion, the CoC moved 10.8 mm from dorsal to volar side on the carpal component (p < 0.0001) and 7.2 mm from volar to dorsal on the radial component (p = 0.0009). From radial to ulnar deviation, the CoC moved 12.4 mm from radial to ulnar on the carpal component (p < 0.0001), and 5.6 mm from ulnar to radial on the radial component (p = 0.009). The findings of this study may eventually improve TWA success by advancing future designs through a more accurate understating of their kinematic performance in vivo.

Delivery room cuddles for extremely preterm babies and parents: concept, practice, safety, parental feedback

Aim

Following extreme preterm birth, there has traditionally been felt an imperative to rush baby to the neonatal unit for ongoing intensive care. Immediate needs of parents to bond with their babies through direct early physical contact have often been overlooked; many weeks can pass before parents get to hold their babies for the first time. Recognition of the importance of early contact is growing. We aimed to review the safety and value of routinely practising delivery room cuddles for extremely preterm babies.

Methods

We reviewed delivery room cuddles in babies born <27 weeks’ gestation in our centre between 2006 and 2017 via case‐control. We also conducted a questionnaire survey of mothers who experienced a delivery room cuddle to gain their feedback and perspectives.

Results

We found no difference in age or temperatures on neonatal unit admission. There was no case of inadvertent extubation associated with cuddles. Parental feedback was very positive.

Conclusion

With appropriate safeguards, delivery room cuddles are feasible and achievable for extremely preterm babies irrespective of birth gestation. Facilitation of the cuddle is an early and very important family‐centred care practice which seems much appreciated by parents and which may improve bonding, lactation, and maternal mental health.

"Permission to Touch": Nurses' Perspectives of Interpersonal Contact during Patient Care

The purpose of this study was to describe nurses' perceptions about the use of interpersonal touch in their clinical practice. A qualitative descriptive approach with content analysis method was used to identify common themes. Registered nurses (N = 22) participated in focus groups and individual interviews. Three themes emerged from the analysis: (a) touch and massage as a resource, (b) individualized boundaries, and (c) professional role conflict. While the approach to touch varied, stories about the positive impacts that touch can have on patient care were consistently evident throughout the data. Implications for practice include incorporating areas from the themes into the development of educational programs focusing on how to integrate touch into practice as a comforting resource, while keeping individual's preferences in mind.

Fathers' Involvement with Their Children Before and After Separation

Changes in fathering over the last decades have led to substantially more involvement of fathers in their children's upbringing. At the same time, high rates of parental separation and subsequent loss of contact fuel concern about separated fathers' role in their children's lives. Underlying such concern is the assumption that separation represents a discontinuity in fathers' parenting. This paper investigates whether fathers' pre- and post-separation paternal involvement is linked: are fathers with lower levels of contact after separation those who were less involved fathers when co-resident? To answer this question, we draw on a nationally representative UK longitudinal study of children born in 2000-2001 to interrogate the links between fathering before and after separation for 2107 fathers, who separated from their child's mother before the child was age 11. We show that fathers who were more involved parents prior to separation tend to have more frequent contact after separation, adjusting for other paternal and family characteristics. The size of this association between pre- and post-separation fathering is, however, modest, and even among more involved fathers, intensity of contact declines over time.

Empathy and Close Social Ties in Late Life

OBJECTIVES

Older adults with stronger social ties often lead longer, healthier, and happier lives, but these ties may differ based on older adults' ability to share and understand others' emotions (i.e., empathy). This study asked how empathy was associated with the way that older adults construct and engage in their social worlds.

METHOD

We drew on the Daily Experiences and Well-being Study to examine how older adults' empathy was associated with the structure (e.g., network size and contact), function (e.g., support), and quality (e.g., affection and conflict) of their close social ties. Participants (N = 333) self-rated empathy and listed their social partners using three concentric convoy circles.

RESULTS

Empathy was not associated with older adults' social network structure, but more empathic older adults exchanged support with more social partners and reported greater affection for their social partners. We did not observe a significant link between older adults' empathy and conflict with social partners.

DISCUSSION

Examining empathy advances our understanding of individual differences in older adults' close social ties. This study suggests that empathy may play a promising role with regard to promoting older adults' social experiences and strengthening their close ties.

Database of epidemic trends and control measures during the first wave of COVID-19 in mainland China

OBJECTIVES

In this data collation study, we aimed to provide a comprehensive database describing the epidemic trends and responses during the first wave of coronavirus disease 2019 (COVID-19) throughout the main provinces in China.

METHODS

From mid-January to March 2020, we extracted publicly available data regarding the spread and control of COVID-19 from 31 provincial health authorities and major media outlets in mainland China. Based on these data, we conducted descriptive analyses of the epidemic in the six most-affected provinces.

RESULTS

School closures, travel restrictions, community-level lockdown, and contact tracing were introduced concurrently around late January but subsequent epidemic trends differed among provinces. Compared with Hubei, the other five most-affected provinces reported a lower crude case fatality ratio and proportion of critical and severe hospitalised cases. From March 2020, as the local transmission of COVID-19 declined, switching the focus of measures to the testing and quarantine of inbound travellers may have helped to sustain the control of the epidemic.

CONCLUSIONS

Aggregated indicators of case notifications and severity distributions are essential for monitoring an epidemic. A publicly available database containing these indicators and information regarding control measures is a useful resource for further research and policy planning in response to the COVID-19 epidemic.

A cross-sectional survey of stigma towards people with a mental illness in the general public. The role of employment, domestic noise disturbance and age

INTRODUCTION

Stigmatization impedes the social integration of persons recovering from mental illnesses. Little is known about characteristics of the stigmatized person that lessen or aggravate public stigma.

PURPOSE

This study investigates which characteristics of persons with mental illnesses (i.e. with a depression or a psychotic disorder) might increase or decrease the likelihood of public stigma.

METHODS

Over 2,000 adults read one of sixteen vignettes describing a person with a depressive disorder or a psychotic disorder and answered a set of items measuring social distance.

RESULTS

The person who was employed (vs. unemployed), or whose neighbors did not experience domestic noise disturbance (vs. disturbance) elicited significantly less social distance. Also persons with a depressive disorder elicited less social distance, vs. persons with a psychotic disorder.

CONCLUSION

Employment and good housing circumstances may destigmatize persons coping with mental illnesses. Mental health and social services should encourage paid employment, quality housing and other paths to community integration.

The Longest-Lasting Relationship: Patterns of Contact and Well-Being Among Mid- to Later-Life Siblings

OBJECTIVES

Adults in mid to later life experience shrinking social networks, which may hinder well-being. Siblings may be important sources of social contact. Yet, little is known about adults' patterns of contact with siblings and how contact is linked to well-being.

METHOD

Participants included 491 adults from across the United States (M age = 58.96, SD = 6.25; 68% female) recruited online via Amazon Mechanical Turk; they reported on their contact with their sibling in person, over the phone, via email, texting, and social media.

RESULTS

Latent class analysis found evidence for four patterns of contact (classes) among siblings: low, medium, high, and traditional. Those with high contact reported greater life satisfaction than those in the other groups. Those in the high group reported lower self-rated health when they recalled being treated less favorably, relative to their sibling, by their mother as children.

DISCUSSION

These findings suggest that differing patterns of sibling contact exist among older adults. In some cases, contact may promote well-being. In other cases, more contact may serve as a reminder of hurtful or painful past family experiences related to mothers' differential treatment, in which case more contact may be linked to poorer health.

Acute corneal edema decades after penetrating keratoplasty for keratoconus in eyes wearing scleral contact lenses

PURPOSE

To report three cases of acute corneal edema occurring decades after penetrating keratoplasty (PK) for keratoconus in eyes wearing scleral contact lenses (ScCLs) with previously clear corneal grafts.

METHODS

Retrospective chart review of three ScCL wearers presenting for sudden onset pain and blurred vision. Data extracted included clinical presentation, year and reason for PK, ocular medications and comorbidities, contact lens wearing history, results of any ancillary testing available including corneal topography, anterior segment optical coherence tomography (OCT), and specular microscopy surrounding the event, treatment and outcomes of intervention. The number of PK eyes fit with ScCLs in the author's practice was determined to estimate the prevalence of this event.

RESULTS

The three patients each had a longstanding PK for keratoconus performed between 33-35 years prior to presentation and recurrent ectasia. Each patient presented with an acute, painful eye and reduced vision either 3 days, 4 months or 9 years after refitting into ScCLs. Each eye had well demarcated focal microcystic epithelial and stromal edema within the graft and crossing the wound margin onto the host cornea. Although a definitive break or detachment of Descemet's membrane was not visualized, the presentations suggest these were episodes of acute hydrops.

CONCLUSIONS

Longstanding PKs with recurrent ectasia and acute focal edema suggestive of corneal hydrops is demonstrated in this case series of ScCL wearers. Although similar events have occurred as part of the natural history of post-PK corneas for keratoconus, the proximity of ScCL refitting to two of the events suggests some association.