bluuebunny/crossref_metadata_2025 huggingface dataset:
Rising to the Gender Challenge in Scotland: Women's Embodiment of the Disposition to be Mountaineers
Authors: Tulle Emmanuelle
Published: March 2022

Mountains have long been dominated by men and hypermasculine practices. Women have worked hard to find a legitimate space in them. This paper is drawn from a qualitative study which explores the experiences of 10 women, based in Scotland, who have dedicated part of their lives to mountains. It adds to existing insights on women who have made inroads into mountaineering. Conceptualising mountaineering as a social field structured by masculine domination, the paper seeks to understand the conditions which have enabled the women to successfully embody a disposition to mountaineering over time and interrogates how the women's practices represent a challenge to the continuing dominance of men and hypermasculine narratives that prevail in this field. The paper shows that a number of structural changes in wider society and in mountaineering have enabled women to claim a mountaineering identity but that the field continues to be inflected by narratives of exclusion.
Prediction of air compressor condition using vibration signals and machine learning algorithms
Authors: S Aravinth , V Sugumaran
Published: March 2022

Air compressors are widely used equipment in the modern world for their tremendous utilization in applications of both domestic and industrial sectors. The inbuilt mechanical parts are often prone to various failures due to the complexity in the construction of air compressors that affects the overall system process. Hence, it is essential to devise a methodology to identify the failures at the early stages of its operation to avoid the major causalities due to process breakdown and system seizure. In this study, a single-acting single-stage reciprocating air compressor was chosen. The fault conditions like inlet valve fluttering, outlet valve fluttering, valve plate leakage, and check valve fault were considered. The statistical, histogram and autoregressive moving average features were extracted from the raw vibration signals. The most dominating features were selected using a decision tree algorithm and those features were classified using machine learning classifiers like Lazy K Star, Decorate, and radial basis function networks. The classifier Lazy K Star on autoregressive moving average feature exhibits the highest fault classification rate of 99.67% in classifying various compressor conditions and the results were compared and presented.
Practical Considerations in Determining Adversity and the No-Observed-Adverse-Effect-Level (NOAEL) in Nonclinical Safety Studies: Challenges, Perspectives and Case Studies
Authors: Kale Vijay P. , Bebenek Ilona , Ghantous Hanan , Kapeghian John , Singh Bhanu P. , Thomas Lawrence J.
Published: March 2022

Determining the adverse nature of findings from nonclinical safety studies often poses a challenge for the key stakeholders responsible for interpreting the results of definitive toxicity studies in support of pharmaceutical product development. Although there are instances in which responses to treatment clearly indicate intolerability or tissue injury associated with dysfunction; in practice, more often there is uncertainty in characterizing an effect of drug treatment as adverse or not. This is due to the inherent variability in responses of biological test systems to toxicological insults, leaving the ultimate analyses of adversity to individual interpretation and subjectivity. This article is a follow-up to the workshop entitled, “Adverse or Not Adverse?: Thinking process behind adversity determination during nonclinical drug development,” conducted at the 58th Annual Meeting of the Society of Toxicology, March 2019 in Baltimore, MD. In this paper, we further discuss and incorporate the perspectives of authors representing different roles, such as Study Director, Study Pathologist, Pharmacology/Toxicology Reviewer (U.S. Food and Drug Administration), and Sponsor in the determination and use of adversity. We also present a practical stepwise approach as an aid in this assessment, and further apply these principles to discuss 10 case studies with different therapeutic modalities and unique challenges.
Fatal Pediatric Streptococcal Infection: A Clinico—Pathological Study
Authors: Nagy Anita , Reyes Jeanette A. , Chiasson David. A.
Published: March 2022

Purpose and Context

Streptococcal Infection (SI) is an important cause of pediatric death in children, yet limited reports exist on autopsy findings in fatal SI cases.

Method

Case records (1997–2019) of SI with no pre-existing risk factors were reviewed and selected. Their clinical and pathological findings in the autopsy reports were analyzed.

Results

In our cohort of 38 cases based on bacterial culture results, SI was most commonly caused by Streptococcus pneumoniae (SPn; 45%) and Streptococcus pyogenes (SPy; 37%). 92% of decedents had some prodromal symptoms prior to terminal presentation. The clinical course was often rapid, with 89% found unresponsive, suddenly collapsing, or dying within 24 hours of hospital admission. 64% of deaths were attributed to sepsis, more frequently diagnosed in the SPy group than in the SPn group (71% vs 48%). Pneumonia was found in both SPn and SPy groups, whereas meningitis was exclusively associated with SPn.

Conclusion

Our study shows fatal SI is most commonly caused by either SPn or SPy, both of which are frequently associated with prodromal symptoms, rapid terminal clinical course, and evidence of sepsis. Postmortem diagnosis of sepsis is challenging and should be correlated with clinical features, bacterial culture results, and autopsy findings.
The efficacy and safety profile of cataract procedures performed with a sensor-embedded handpiece and a new hybrid phaco tip
Authors: Sabur Huri , Unsal Ugur
Published: March 2022

Objective

To evaluate the efficacy and safety of the new Intrepid Hybrid tip and Active Sentry handpiece in comparison to the Intrepid Balanced tip and Centurion Ozil handpiece.

Methods

One hundred sixty-eight eyes were included in the study and randomized into Group 1 (Active Sentry handpiece + Intrepid Hybrid tip, n = 86) and Group 2 (Centurion Ozil handpiece + Intrepid Balanced tip, n = 82). Data were collected from the phaco device, including total U/S time, cumulative dissipated energy (CDE), the total number of active surge mitigation actuations (ASM actuations), torsional amplitude, torsional amplitude on time, estimated fluid of aspirated, and aspiration time. Endothelial cell count (ECC) and central corneal thickness (CCT) were assessed. A correlation analysis was performed between ASM actuations, phaco metrics, and patient characteristics in Group 1.

Results

The CDE, torsional amplitude measured in Group 1 (8.8 ± 3.9, 51.2 ± 13.3, respectively) were significantly lower than those of Group 2 (10.4 ± 4.2, 65.2 ± 9.3, respectively). While no complications were observed in group 1, there were posterior capsule rupture in 2 eyes and iris damage in 1 eye in group 2. The mean ECC and CCT were similar at 1 month. The ASM actuations were more engaged in the eyes with pseudoexfoliation and small pupils.

Conclusion

The combination of the new Intrepid Hybrid tip and Active Sentry handpiece enables safer cataract procedures without compromising efficacy due to its surge prevention mechanisms and special tip design. It could be a good option for residents in training.
Problems to Consider Before Determining the Regimen of the Treatment for Juvenile Systemic Sclerosis Treatment: A Case Report Where Tocilizumab Monotherapy Succeeded Efficiently and Safely
Authors: Funauchi Masanori , Kinoshita Koji
Published: March 2022

Juvenile systemic sclerosis (SSc) is a rare condition that results in various disorders, including growth retardation and learning disabilities in addition to impaired quality of life due to fibrosis and microvascular disorders in multiple organs. Recently, efficacies of immunosuppressants such as cyclophosphamide and mycophenolate mofetil, as well as biological agents, have been reported in adult patients with SSc. However, there has been no consensus in the treatment of juvenile SSc due to its rarity and the fact that skin sclerosis may be self-limiting in some patients. Here, we present a case of 13-year-onset SSc with growth retardation and learning disabilities, in addition to skin sclerosis, interstitial lung disease, and possible myocardial fibrosis that was successfully treated with tocilizumab monotherapy without remarkable adverse reactions. As careful case-by-case management of patient’s growth and education along with standard treatment is needed, the documentation of such case is important for the evaluation of the efficient and safe therapy for juvenile SSc.
Safety experience with continued exposure to ofatumumab in patients with relapsing forms of multiple sclerosis for up to 3.5 years
Authors: Hauser Stephen L , Cross Anne H , Winthrop Kevin , Wiendl Heinz , Nicholas Jacqueline , Meuth Sven G , Giacomini Paul S , Saccà Francesco , Mancione Linda , Zielman Ronald , Bagger Morten , Das Gupta Ayan , Häring Dieter A , Jehl Valentine , Kieseier Bernd C , Pingili Ratnakar , Stoneman Dee , Su Wendy , Willi Roman , Kappos Ludwig
Published: March 2022

Background:

Ofatumumab is approved for the treatment of relapsing multiple sclerosis (RMS). Ongoing safety reporting is crucial to understand its long-term benefit–risk profile.

Objective:

Report the safety and tolerability of ofatumumab in RMS after extended treatment up to 3.5 years.

Methods:

Patients completing ASCLEPIOS I/II (phase 3), APLIOS, or APOLITOS (phase 2) trials could enter ALITHIOS, a phase 3b, open-label, long-term safety study. We analyzed cumulative data of continuous ofatumumab treatment and of patients newly switched from teriflunomide.

Results:

The safety population had 1969 patients: 1292 continuously treated with ofatumumab (median time-at-risk 35.5 months, 3253 patient-years) and 677 newly switched (median time-at-risk 18.3 months, 986 patient-years). A total of 1650 patients (83.8%) had ⩾1 adverse events and 191 (9.7%) had ⩾1 serious adverse events. No opportunistic infections or progressive multifocal leukoencephalopathy events were identified; the risk of malignancies was low. Mean serum immunoglobulin (Ig) G levels remained stable. Mean IgM levels decreased but remained above the lower limit of normal in most. Serious infection incidence was low; decreased Ig levels were not associated with serious infections.

Conclusion:

In patients with up to 3.5 years’ exposure, ofatumumab was well tolerated, with no new safety risks identified. These findings, with its established effectiveness, support a favorable benefit–risk profile of ofatumumab in RMS.
Identifying clinical and psychological correlates of persistent negative symptoms in early-onset psychotic disorders
Authors: Karakuş Oğuz Bilal , Ermiş Çağatay , Tunçtürk Mustafa , Yüksel Ayşe Sena , Alarslan Sezen , Sağlam Yeşim , Görmez Vahdet , Karaçetin Gül
Published: March 2022

Persistent negative symptoms (PNS) contribute to impairment in psychosis. The characteristics of PNS seen in youth remained under-investigated. We aimed to demonstrate clinical, treatment-related, and psychosocial characteristics of PNS in early-onset schizophrenia-spectrum disorders (EOSD). 132 patients with EOSD were assessed with Positive and Negative Symptom Scale, Brief Negative Symptom Scale, Calgary Depression Scale for Schizophrenia, and Simpson-Angus Scale. Parenting skills and resilience were evaluated using Parental Attitude Research Instrument and Child and Youth Resilience Measure-12. Longer duration of untreated psychosis (DUP) and prodromal phase were found in primary and secondary PNS groups, compared to the non-PNS group. The primary PNS group was characterized by earlier age-onset, lower smoking rates, and more common clozapine use. Resilience and egalitarian/democratic parenting were negatively correlated with symptoms related to motivation/pleasure and blunted expression. More blunted expression-related symptoms and longer DUP in the first episode significantly predicted primary/secondary PNS at follow-up. Using the data from total negative symptom scores and DUP, Receiver Operating Characteristic analyses significantly differentiated primary/secondary PNS groups from the non-PNS counterparts. PNS associated with blunted expression and low motivation/pleasure in the first episode could persist into clinical follow-up. Effective pharmacological treatment and psychosocial interventions are needed in youth.
Adefovir for lamivudine-resistant hepatitis B
Authors: Roediger Rebecca , Smyth Elizabeth Kula , Dieterich Douglas
Published: March 2022

Adefovir, a nucleotide analog developed by John Martin, was a major breakthrough in the treatment of chronic Hepatitis B. Prior to adefovir, Hepatitis B treatment was limited to two therapeutic modalities, either interferon, which carried significant side effects and was efficacious in a minority of patients, or lamivudine which showed no durable effects with short-term use and a high rate of resistance with long-term use. Adefovir was found to be effective in suppressing viral replication and in resolving the hepatic inflammation associated with hepatitis B with only rare instances of resistance. In this article, we appreciate John Martin’s contribution to science and medicine as we review the landmark trials of adefovir that brought forth a new era of treatment of Hepatitis B.
Efficacy of second-line dolutegravir plus 2 nucleoside reverse transcriptase inhibitors by baseline nucleoside reverse transcriptase inhibitor resistance and nucleoside reverse transcriptase inhibitor use in the DAWNING study
Authors: Brown Dannae , Kaplan Richard , Losso Marcelo , Brites Carlos , Wang Ruolan , Underwood Mark , Hopking Judy , Aboud Michael , Sievers Jörg
Published: March 2022

Background

In the DAWNING study, dolutegravir + 2 nucleoside reverse transcriptase inhibitors (NRTIs) demonstrated superior efficacy at Week 48 and a favourable safety profile compared with lopinavir/ritonavir + 2 NRTIs in adults with HIV-1 failing first-line therapy of a non-nucleoside reverse transcriptase inhibitor + 2 NRTIs.

Methods

Participants at 58 centres in 13 countries were randomised (1:1) to 52 weeks of open-label treatment with dolutegravir or lopinavir/ritonavir combined with 2 investigator-selected NRTIs, including at least one fully active NRTI based on screening resistance testing. The primary endpoint was the proportion of participants achieving HIV-1 RNA <50 copies/ml at Week 48 (Snapshot algorithm). Post-hoc efficacy analyses were performed based on baseline NRTI resistance profile and second-line NRTI use.

Results

Of 624 participants randomised and treated, 499 (80%) received <2 active NRTIs at Baseline. NRTI resistance was present in 561 participants (90%). Among participants receiving lamivudine or emtricitabine in the presence of M184V/I, 85% (187/220) of participants on dolutegravir versus 72% (152/210) on lopinavir/ritonavir had HIV-1 RNA <50 copies/ml at Week 48 (difference, 12.6%; 95% CI: 4.9–20.3%). High responses were also observed in the dolutegravir group, when zidovudine or tenofovir disoproxil fumarate were included in the background regimen in the presence of thymidine analogue mutations or K65R, respectively; however, participant numbers in these subgroups were small.

Conclusions

Response rates were high in participants receiving dolutegravir + 2 NRTIs as second-line treatment regardless of pre-existing resistance to one of the NRTIs, including in participants using lamivudine or emtricitabine in the presence of M184V/I.
Ethnographic (dis) locations: An approach for studying marginalisation in the context of socio-economic change
Authors: Islam Asiya
Published: March 2022

This paper revisits discussions about the pursuit of a singular location for ethnographic research. Citing challenges to the fixity of location, from circulation of people to the impossibility of containing digital worlds, scholars have proposed multi-sited, multi-scalar, multi-modal and multi-sensorial ethnographies, advocating that the researcher ‘follow the actor’. Drawing upon these innovations, this paper traces the affects generated in the process of following the actors as well as the consequent blurring of the division between the researcher and the researched so that they together constitute the category of ‘actors’ who co-produce the field. Using the example of an ethnography with young lower middle class women in Delhi, this paper deploys the researcher’s experience of dislocation or unexpected shuttling in the field to develop ‘dislocation’ as a methodological and analytical strategy for studying marginalisation in the context of socio-economic change by embracing intersubjective relations, affects and partiality of knowledge in ethnographic research.
Adaptive RBF with hyperparameter optimisation for aeroacoustic applications
Authors: Burghignoli Lorenzo , Rossetti Monica , Centracchio Francesco , Palma Giorgio , Iemma Umberto
Published: March 2022

The present work reports an investigation on the use of adaptive metamodels based on radial basis functions (RBFs) for aeroacoustic applications of highly innovative configurations. The relevance of the topic lies on the paramount importance of metamodelling techniques within the design optimisation process of disruptive aircraft layouts. Indeed, the air traffic growth, consequently the hard environmental constraints imposed by regulations, will make a technological breakthrough, an imperative need within few years. As a consequence, the engineering community is paying particular attention to the development of innovative techniques for the design of unconventional configurations. For this class of applications, the designer cannot successfully rely on historical data or low-fidelity models, and the expensive direct simulations remain the only valuable design strategy. In this regard, it can be demonstrated that the use of surrogate models, i.e., metamodels, significantly reduces the computing costs, especially in view of a robust approach to the optimised design. In order to further improve the efficiency of metamodel-based techniques, dynamic approaches based on hyperparameter optimisation and adaptive sampling procedures have been recently developed. The case study presented here pertains the exploiting of dynamic RBF-based metamodels for noise shielding applications. The analysis of the metamodel performances and its convergence properties shows how the final number of direct simulations is significantly reduced by the hyperparameter optimisation algorithm, still strongly depending on the choice of the RBF kernel function.
A new quantitative acoustic emission model for damage characterization of composite laminates using original waveforms
Authors: Xu Dong , Liu Pengfei , Chen Zhiping , Wu Tao
Published: March 2022

The correlation between acoustic characteristics and mechanical behaviors shows great significance for health monitoring and characterization. This paper develops a new quantitative model based on the modified Mel-frequency cepstral analysis and statistical methods so as to link acoustic emission (AE) features with mechanical behaviors of end-notched flexure (ENF) composite laminates. First, the Mel-frequency cepstral analysis in automatic speech recognition is modified to adapt to AE sensors and signals. Second, the modified Mel-frequency cepstral coefficients (MFCCs) are extracted from original waveforms of AE hits for damage characterization of composites. MFCC0 is taken as an effective feature to qualitatively discriminate damage stages and to identify the pre-failure critical point. The decreasing patterns of MFCC1 and MFCC2 for ENF specimens can be clearly observed with the loading time by using the simple moving average method. Third, pencil lead breaks are repeatedly conducted on the healthy specimen to verify the pattern in the degraded specimen. Finally, a further investigation based on the cumulative moving average method demonstrates that MFCC1 and MFCC2 are quadratic and linear functions of the load ratio or the deflection ratio, respectively. In addition, the latter is more suitable to be an indicator of damage accumulation of composite laminates.
A Case Study of Prolonged Exposure for Posttraumatic Stress Disorder With a Latino Male with Polysubstance Use, Severe Depression, and Anger in a Residential Substance Use Treatment Program
Authors: Doerfler Leonard A. , Twigden Alec
Published: March 2022

Substance use disorders and post-traumatic stress disorder (PTSD) often co-occur, along with depression and anger. Despite evidence that Prolonged Exposure Therapy is effective for individuals with co-occurring PTSD and SUD when PE is implemented alongside SUD treatment, clinicians have been reluctant to offer PE or other trauma-focused therapies to individuals with co-occurring PTSD and SUD because of the belief that increased emotional distress would be counter-therapeutic for individuals in early recovery. A widely held explanation for the high degree of comorbidity is that individuals with PTSD use substances to reduce or avoid painful and disturbing PTSD symptoms. This case study describes the implementation and outcome of PE therapy with a 32-year-old man who had been admitted to a residential substance use treatment program for Latino males. The client had a long history of polysubstance use and severe PTSD. The client was homeless and reported significant depressive and anger symptoms. Assessment of PTSD revealed that he was using heroin and cocaine to avoid painful memories of a traumatic event that had occurred several years prior to his admission to this treatment program. Because the client reported using these substances to reduce emotional distress, PE was chosen as the PTSD intervention. During PE Therapy the client reported no thoughts or urges to use substances and at discharge from residential treatment he reported no problems with PTSD or depression. The client maintained all gains at 1-year follow-up, when he also reported that he was working full time and had remained abstinent since he completed treatment.
Using Human–Machine Interfaces to Convey Feedback in Automated Driving
Authors: Shull Emily M. , Gaspar John G. , McGehee Daniel V. , Schmitt Rose
Published: March 2022

The next decade will see a rapid increase in the prevalence of partial vehicle automation, specifically conditional automation (i.e., SAE level 3; SAE, 2018 ). In conditional automation, the expectation is that the user is still receptive to takeover and can disengage while the automation is active, but as the automation approaches its operational limits, or the end of its operational design domain, it issues a request to intervene and the user is expected to retake control. A human–machine interface (HMI) that can safely and effectively transition control is therefore very important. This simulator study investigated how features of the HMI design, specifically feedback about the confidence (i.e., current capability) of the automation influenced transition of control. Participants were assigned to one of three conditions, which received varying amounts of visual and auditory feedback regarding the automation’s confidence. Findings suggest 3-stage auditory-visual feedback about the automation’s confidence may improve subsequent takeover performance compared to 3-stage visual and a control group without feedback. This research demonstrates the potential value of providing more insight into automated feature performance in conditional automation.
Sequential Research to Evaluate the Impact of Patient and Public Involvement on Cancer Research Outcomes: Using Interviews, Stimulus Material and a Modified Delphi Technique
Authors: Pandya-Wood Raksha
Published: March 2022

Evaluating patient and public involvement (PPI) in healthcare research continues to attract international interest. This article discusses how one exemplar study evaluated the impact of PPI on cancer research outcomes, with user involvement sewn into the design. The research aligned to interpretivist and pragmatist paradigms and resulted in a mixed methods sequential design. Phase 1 involved 23 in-depth interviews to explore perceptions of impact of PPI on cancer research outcomes with patients, researchers and stakeholders. Analysis from Phase 1 formed the basis of a ‘stimulus paper’ to use in Phase 2. Phase 2 adopted the modified Delphi technique with a virtual panel of 35 experts. This research found several factors shaped the impact of PPI on cancer research outcomes. However, the data itself are not the foci of this article, the methodological process, theoretical decisions, limitations and lessons learned across the research are.
Outcome and technical evolution of type 2 endoleak embolization with ethylene-vinyl-alcohol copolymer
Authors: Vance Ansar Z , Graif Assaf , Patel Ramkrishna , Chedrawy Christelle , Chohan Omar , Garcia Mark J , Kimbiris George , Leung Daniel A
Published: March 2022

Purpose

This study aims to evaluate the safety and efficacy of novel approaches to type 2 endoleak access for the purpose of embolization using ethylene-vinyl-alcohol copolymer (EVOH) in patients with abdominal aortic aneurysm (AAA) sac expansion post endovascular abdominal aortic repair (EVAR).

Methods

A retrospective review of 43 consecutive patients (mean age = 80.2 ± 6.7 years) who underwent 52 embolization procedures for type 2 endoleaks using EVOH was performed at a single institution. Catheterization of the endoleaks was achieved using the transarterial (TA) and direct translumbar approaches (DTL), in addition to the novel direct transabdominal (DTA) and perigraft (PG) approaches. Endpoints included technical success of endoleak catheterization, technical success of endoleak embolization, endoleak persistence, endoleak recurrence, AAA sac area change, and adverse events.

Results

The TA, DTL, DTA, and PG approaches were used 25, 2, 14, and 19 times respectively, including nine procedures where a combination of approaches was used. The technical success rate of endoleak embolization was 98%. Five patients developed recurrent type 2 endoleaks, while five patients developed a type 1 endoleak. The persistent endoleak rate at a mean initial follow-up of 3 months was 34%. At a mean follow-up of 18 months, 58% of patients demonstrated absence of an endoleak, and 71% showed freedom from AAA sac enlargement. No major adverse events were recorded.

Conclusion

The DTA and PG approaches were safe and effective in this cohort of patients undergoing embolization of type 2 endoleaks with EVOH.
Designing and implementing methodology for double-blind, placebo-controlled clinical trials using blood products within the Department of Veterans Affairs
Authors: Miller Elliott K , Goldberg Alexa M , Janoff Edward N , Brown Sheldon T , Curtis Jeffrey L , Bonomo Robert A , Shih Mei-Chiung , Gleason Theresa C
Published: March 2022

Background:

Success in conducting clinical trials during the coronavirus disease of 2019 pandemic requires the ability to innovate and adapt. There are well-established procedures for the blinding of investigational agents, especially medications, in placebo-controlled randomized clinical trials within the Veterans Health Administration. However, these procedures, managed by research pharmacists, may not apply to investigational agents that are not exclusively managed by pharmacy, such as blood products, including coronavirus disease of 2019 convalescent plasma (plasma). In the absence of established blinding procedures, such studies require special design considerations to minimize uncertainty or bias.

Methods:

We describe the processes and procedures developed for blinding of plasma in “Veterans Affairs CoronavirUs Research and Efficacy Studies-1” as a prototypical study using this class of investigational therapeutic agents. Veterans Affairs CoronavirUs Research and Efficacy Studies-1 is an ongoing multicenter randomized clinical trial testing the efficacy of plasma added to conventional therapy for severe acute respiratory syndrome coronavirus-2 infection.

Results:

We report the design of procedures to supply investigational blood products or 0.9% normal saline (saline) control while ensuring the integrity of the blind. Key aspects include workflow considerations, physical blinding strategies, and methods for engaging stakeholders. These procedures leverage the well-established Veterans Affairs research pharmacist’s research infrastructure, and Blood Bank Services, which is responsible for blood-based investigational products.

Conclusion:

By describing the methods used to deliver blood products in a blinded manner in Veterans Affairs CoronavirUs Research and Efficacy Studies-1, we strive both to educate and to increase awareness to improve the implementation of these biological therapeutics for future, high-quality research studies.
Keeping it simple: mental health assessment in the Gastroenterology Department – using the Hospital Anxiety and Depression Scale (HADS) for IBD patients in Israel
Authors: Avinir Asia , Dar Shira , Taler Michal , Haj Ola , Gothelf Doron , Kopylov Uri , Ben-Horin Shomron , Mekori-Domachevsky Ehud
Published: March 2022

Background:

Depression and anxiety are common among inflammatory bowel disease (IBD) patients. Not only do they worsen quality of life, but also worsen the prognosis of the IBD. Yet, there are no widely accepted guidelines for screening for depression or anxiety in this population. The Hospital Anxiety and Depression Scale (HADS) is a self-administered questionnaire designed to measure anxiety and depression in the physically ill. The purpose of this study was to establish the utility of the HADS as a screening tool in IBD patients.

Methods:

Seventy-nine IBD patients (age 29.86 ± 8.36, 51.9% female, 77.2% Crohn’s disease) were recruited consecutively at the day treatment unit, Gastroenterology Department, Sheba Medical Center. They were asked to complete the HADS, the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). The scores of the HADS depression and anxiety subscales were correlated with the BDI and STAI scores, and the rates of above-threshold scores were calculated and compared between the three questionnaires and findings from previous studies.

Results:

The two HADS subscales significantly correlated with and the BDI ( rs = .69, p < 0.001) and STAI state and trait anxiety ( rs = .853, p < 0.001; rs = .744, p < 0.001, respectively). The usual HADS cut-off scores yielded adequate rate of anxiety but lower than expected depression rates.

Conclusions:

Our findings suggest the HADS as a valid screening tool for anxiety and depression in IBD patients. We recommend administering it routinely in gastrointestinal (GI) follow-ups using a lower cut-off score for depression than anxiety (greater than 7 vs greater than 11, respectively).
The Pendulum of Non-Alignment: Charting Myanmar's Great Power Diplomacy (2011–2021)
Authors: Passeri Andrea , Marston Hunter
Published: March 2022

Since independence, Myanmar has prioritised a non-aligned foreign policy to preserve autonomy in the international arena. Yet, it has done so in contrasting and sometimes opposite ways. Historically, Myanmar's great power diplomacy has resembled a pendulum swinging between two ideal types: ‘positive non-alignment’ and ‘negative neutralism’. The former represents a proactive blend of non-aligned behaviour that seeks to assert independence by achieving a diversified range of international partnerships, whereas the latter endeavours to accomplish the same goal through diplomatic disengagement and self-aloofness. This article analyses Myanmar's shifting recourse to opposite archetypes of alignment by examining its foreign policy between 2011 and 2021. Building upon a comprehensive theoretical classification of different forms of non-alignment, the analysis contends that Myanmar's evolving great power diplomacy is ultimately rooted in oscillating degrees of political legitimation held by its leaders, which pushed them to alternatively tilt towards positive non-alignment or negative neutralism.
Role of Telemedicine in Diabetes Management
Authors: Dhediya Rajnish , Chadha Manoj , Bhattacharya Arpan D. , Godbole Shreerang , Godbole Shreeharsh
Published: March 2022

Introduction:

Telemedicine is a growing arena that may increase access to care for patients with diabetes. It has more relevance for rural populations or those with limited physical access to health care, for improving diabetes care. Telemedicine can also be used to offer diabetes self-education and transportation barriers for patients living in under-resourced areas or with disabilities.

Method

"This review explores the landscape of telemedicine approaches and evidence for incorporation into general practice.

Results & Discussion:

Telehealth platforms have been shown to be both feasible and effective for health care delivery in diabetes, although there are many caveats that require tailoring to the institution, clinician, and patient population. Research in diabetes telehealth should focus next on how to increase access to patients who are known to be marginalized from traditional models of health care.
Evaluation of a New Clinical Tool to Enhance Clinical Care of Control-IQ Users
Authors: Messer Laurel H. , Berget Cari , Centi Sophia , Mcnair Bryan , Forlenza Gregory P.
Published: March 2022

Background:

The purpose of this study was to develop and test a new Clinic Tool to assist health care professionals with clinical care of persons with diabetes using the Control-IQ system.

Methods:

A Clinic Tool was iteratively developed with input from diabetes clinicians, which outlined a systematic process for assessing data, reviewing insulin settings, providing education, and documenting the encounter. Diabetes clinicians were recruited to trial the Clinical Tool in up to five clinical encounters (in-person, telehealth, or telephone). Quantitative surveys and free-text responses, including a knowledge quiz and the System Usability Scale (SUS), were administered to determine clinician satisfaction, confidence, knowledge, and implications for practice.

Results:

Twenty-nine clinicians (43% endocrinologists, mean 10.7 years in practice) enrolled in the study and completed 89 encounters using the Control-IQ Clinic Tool. Participants spent an average of 10 minutes using the Tool and reported excellent SUS scores within the 90%-95% percentile for usability. Knowledge quiz scores increased in 42% of participants. Both familiarity with Control-IQ and confidence providing clinical care to Control-IQ users significantly improved ( P = .009 and P < .001 respectively). Ninety percent of participants agreed that the Tool will change their clinical care going forward.

Conclusion:

The Control-IQ Clinical Tool is highly usable and impacted clinical care delivery to Control-IQ users. Tools that serve to improve clinician confidence in delivery of care to diabetes device users should be expanded, leveraged, and studied to assess the impact on adherence and glycemic control for persons with diabetes.
Discursive Toolkits of Anti-Muslim Disinformation on Twitter
Authors: Bhatia Kiran Vinod , Arora Payal
Published: March 2022

In this article, we investigate the socio-technical ecology of Twitter, including the technological affordances of the platform and the user-generated discursive strategies used to create and circulate anti-Muslim disinformation online. During the first wave of Covid-19, right-wing followers claimed that Muslims were spreading the virus to perform Jihad. We analyzed a sample of 7000 tweets using Critical Discourse Analysis to examine how the online disinformation accusing Muslims in India was initiated and sustained. We identify three critical discourse strategies used on Twitter to spread and sustain the anti-Muslim (dis)information: (1) creating mediatized hate solidarities, (2) appropriating instruments of legitimacy, and (3) practicing Internet Hindu vigilantism. Each strategy consists of a subset of discursive toolkits, highlighting the central routes of discursive engagement to produce disinformation online. We argue that understanding how the technical affordances of Social Networking Sites are leveraged in quotidian online practices to produce and sustain the phenomenon of online disinformation will prove to be a novel contribution to the field of disinformation studies and Internet research.
Artificial Learning and Machine Learning Applications in Spine Surgery: A Systematic Review
Authors: Lopez Cesar D. , Boddapati Venkat , Lombardi Joseph M. , Lee Nathan J. , Mathew Justin , Danford Nicholas C. , Iyer Rajiv R. , Dyrszka Marc D. , Sardar Zeeshan M. , Lenke Lawrence G. , Lehman Ronald A.
Published: March 2022

Objectives

This current systematic review sought to identify and evaluate all current research-based spine surgery applications of AI/ML in optimizing preoperative patient selection, as well as predicting and managing postoperative outcomes and complications.

Methods

A comprehensive search of publications was conducted through the EMBASE, Medline, and PubMed databases using relevant keywords to maximize the sensitivity of the search. No limits were placed on level of evidence or timing of the study. Findings were reported according to the PRISMA guidelines

Results

After application of inclusion and exclusion criteria, 41 studies were included in this review. Bayesian networks had the highest average AUC (.80), and neural networks had the best accuracy (83.0%), sensitivity (81.5%), and specificity (71.8%). Preoperative planning/cost prediction models (.89,82.2%) and discharge/length of stay models (.80,78.0%) each reported significantly higher average AUC and accuracy compared to readmissions/reoperation prediction models (.67,70.2%) ( P < .001, P = .005, respectively). Model performance also significantly varied across postoperative management applications for average AUC and accuracy values ( P < .001, P < .027, respectively).

Conclusions

Generally, authors of the reviewed studies concluded that AI/ML offers a potentially beneficial tool for providers to optimize patient care and improve cost-efficiency. More specifically, AI/ML models performed best, on average, when optimizing preoperative patient selection and planning and predicting costs, hospital discharge, and length of stay. However, models were not as accurate in predicting postoperative complications, adverse events, and readmissions and reoperations. An understanding of AI/ML-based applications is becoming increasingly important, particularly in spine surgery, as the volume of reported literature, technology accessibility, and clinical applications continue to rapidly expand.
The Text4HealthyAging Program: An Evidence-Based Text Messaging Innovation to Support Healthy Urban Aging in Canada and Australia
Authors: Eboreime Ejemai , Ohinmaa Arto , Rusak Benjamin , Cassidy Keri-Leigh , Morrison Jason , McGrath Patrick , Uher Rudolf , Meier Sandra , Fleury Marie-Josee , Iyer Srividya N. , Rej Soham , Batchelor Frances , Levinger Pazit , Dang Christa , Hopwood Malcolm , Acquah Francis N. L. , Dzator Janet , Tomblin Murphy Gail , Warford Jordan , Wozney Lori , Vedel Isabelle , Gahagan Jacqueline , Theou Olga , Koto Prosper , Sampalli Tara , Kirkland Susan , Watters Nicholas , Agyapong Vincent I. O.
Published: March 2022

Age-friendly cities are crucial to achieve the WHO goal of healthy aging. Such cities promote opportunities for health, participation, and security, thus enhancing quality of life as people age. Older people commonly experience psychosocial challenges such as anxiety, depression, substance abuse, loss of autonomy, grief, fear, and loneliness. Australian and Canadian cities continue to seek innovation to improve healthy urban aging and create more age-friendly environments for older adults. There is increasing evidence on the effectiveness and feasibility of mobile technology in health promotion and closing psychological treatment gaps. Older adults have been demonstrated to engage frequently with mobile devices, particularly text messaging. In this article, we conceptualize the Text4HealthyAging, an evidence-based text messaging innovation to support healthy urban aging in Canadian and Australian cities.
Relationship-based practice and digital technology in child and family social work: Learning from practice during the COVID-19 pandemic
Authors: Copson Ruth , Murphy Anne M , Cook Laura , Neil Elsbeth , Sorensen Pernille
Published: March 2022

Vital services provided by social workers to children in care or on the edge of care were largely delivered “online” during the COVID-19 pandemic. This paper explores the potential impact of these changes on vulnerable children and their families. Relationship-based practice is integral to social work and the shift to digital communication during the COVID-19 pandemic has led to accelerated practice changes and implications for relationship building both with and between service users. Going forward, social workers and other professionals are likely to move to an increasingly hybrid model of communication, combining both digital and face-to-face methods. This article identifies the impact of digital communication on relationships in professional practice, drawing on three studies of digital communication in the UK carried out at the University of East Anglia. The first considered how child protection social workers responded to the challenges of COVID-19, the second looked at how children in care were keeping in touch with their birth families and the third focused on the approaches being taken to moving children from foster care to adoptive families. Five themes related to relationships were identified across all three studies: the significance of the age and developmental stage of the child; the frequency of contact and communication; digital literacy/exclusion; the impact of the lack of sensory experience; and the importance of the relationship history. The article concludes with implications for utilising digital methods in building and maintaining relationships in practice and highlights the need to consider both the inner and outer worlds of those involved.
People as Our Most Important Asset: A Critical Exploration of Agility and Employee Commitment
Authors: Dupret Katia , Pultz Sabina
Published: March 2022

In this article, we examine how employees experience different types of work commitment at an IT consultancy company using agility to give staff greater autonomy and decision-making latitude. We analyze its agile practices through an in-depth case study comprising interviews and non-participative observation of managers and employees, concluding that the company aims to increase autonomy and decision-making latitude by introducing agile approaches to project management, but thereby risks eroding its employees’ commitment. Indeed, the new social dynamics engender new professional insecurities and decision-making passivity and appear to lack a clear organizational purpose, thus challenging certain aspects of employee commitment.
Structural insights into the non-inhibitory mechanism of the anti-EGFR EgB4 nanobody
Authors: Zeronian Matthieu R. , Doulkeridou Sofia , van Bergen en Henegouwen Paul M. P. , Janssen Bert J. C.
Published: March 2022

Background

The epidermal growth factor receptor (EGFR) is involved in various developmental processes, and alterations of its extracellular segment are associated with several types of cancers, in particular glioblastoma multiforme (GBM). The EGFR extracellular region is therefore a primary target for therapeutic agents, such as monoclonal antibodies and variable domains of heavy chain antibodies (VHH), also called nanobodies. Nanobodies have been previously shown to bind to EGFR, and to inhibit ligand-mediated EGFR activation.

Results

Here we present the X-ray crystal structures of the EgB4 nanobody, alone (to 1.48 Å resolution) and bound to the full extracellular EGFR-EGF complex in its active conformation (to 6.0 Å resolution). We show that EgB4 binds to a new epitope located on EGFR domains I and II, and we describe the molecular mechanism by which EgB4 plays a non-inhibitory role in EGFR signaling.

Conclusion

This work provides the structural basis for the application of EgB4 as a tool for research, for targeted therapy, or as a biomarker to locate EGFR-associated tumors, all without affecting EGFR activation.
Contrasting effects of plant inter- and intraspecific variation on community trait responses to nitrogen addition and drought in typical and meadow steppes
Authors: Guo Aixia , Zuo Xiaoan , Zhang Senxi , Hu Ya , Yue Ping , Lv Peng , Li Xiangyun , Zhao Shenglong , Yu Qiang
Published: March 2022

Background

Inter- and intraspecific variation in plant traits play an important role in grassland community assembly under global change scenarios. However, explorations of how these variations contribute to the responses of community traits to nitrogen (N) addition and drought in different grassland types are lacking. We measured the plant height, leaf area (LA), specific leaf area (SLA), leaf dry matter content (LDMC), leaf N content (LNC) and the ratio of leaf carbon (C) to leaf N (C:N) in a typical and a meadow steppe after three years of N addition, drought and their interaction. We determined the community-weighted means (CWMs) of the six traits to quantify the relative contribution of inter- and intraspecific variation to the responses of community traits to N addition and drought in the two steppes.

Results

The communities in the two steppes responded to N addition and the interaction by increasing the CWM of LNC and decreasing C:N. The community in the meadow steppe responded to drought through increased CWM of LNC and reduced C:N. Significant differences were observed in SLA, LDMC, LNC and C:N between the two steppes under different treatments. The SLA and LNC of the community in the meadow steppe were greater than those of the typical steppe, and the LDMC and C:N exhibited the opposite results. Moreover, variation in community traits in the typical steppe in response to N addition and drought was caused by intraspecific variation. In contrast, the shifts in community traits in the meadow steppe in response to N addition and drought were influenced by both inter- and intraspecific variation.

Conclusions

The results demonstrate that intraspecific variation contributed more to community functional shifts in the typical steppe than in the meadow steppe. Intraspecific variation should be considered to understand better and predict the response of typical steppe communities to global changes. The minor effects of interspecific variation on meadow steppe communities in response to environmental changes also should not be neglected.