bluuebunny/crossref_metadata_2025 huggingface dataset:
Pollution Credit Certificates Theory: An Analysis on the Quality of Solid Waste Management in Brazil
Authors: Jardim Faria de Araujo Marina , Faria de Araújo Marcus Vinícius , De Araujo Jr Antonio Henriques , Medeiros de Barros José Glenio , De Almeida Maria da Glória , Bastos da Fonseca Bernardo , Da Motta Reis José Salvador , Ferreira Motta Barbosa Luís César , Santos Gilberto , De Souza Sampaio Nilo Antonio
Published: December 2021

Purpose: This paper aims to introduce an economic instrument called Theory of Pollution Credit Certificates in the management of municipal solid waste in Brazil, in order to create opportunities to achieve the goal established in the above mentioned policy at lowest possible social costs.       
Methodology/Approach: The methodology adopted has as a starting point the “constructo” of a scenario in which a city comprised of five brazilian districts produces its urban solid waste made up of 50% organic material. In the proposed scenario, similar to what happens in practice, a fee for collection and treatment of organic material would be charged for two different situations.
Findings: The result showed that the use of Pollution Credit Certificates Theory has a better cost-effectiveness for solid waste management because it allows reaching the environmental goal at a lower cost to society.
Research Limitation/Implication: Subjectivity of the analysis, due to the “constructo” proposition in the studies.
Originality/Value of paper: From the results obtained, we inferred that the use of the Pollution Certificates Theory for the management of brazilian municipal solid waste benefits from economies of scale as it allows in the scenario determined, that districts sell their spaces at the landfill and parallel to this, to promote the practice of composting organic waste in the municipality.
Eduardo Frei Montalva y las históricas y globales exigencias cívicas del Estado de Derecho
Authors: San Miguel Pérez Enrique
Published: December 2021

La rotunda personalidad política de Eduardo Frei Montalva, presidente cristiano-demócrata de Chile entre 1964 y 1970, y líder de la oposición democrática tras la violenta instalación de la dictadura del general Augusto Pinochet en 1973, incluye, ya en su tiempo, un poderoso pensamiento sobre la democracia, el Estado de Derecho y la ciudadanía global, así como el origen y significado de la Historia. Y sus análisis y propuestas conservan plena vigencia política y jurídica.La rotunda personalidad política de Eduardo Frei Montalva, presidente cristiano-demócrata de Chile entre 1964 y 1970, y líder de la oposición democrática tras la violenta instalación de la dictadura del general Augusto Pinochet en 1973, incluye, ya en su tiempo, un poderoso pensamiento sobre la democracia, el Estado de Derecho y la ciudadanía global, así como el origen y significado de la Historia. Y sus análisis y propuestas conservan plena vigencia política y jurídica.
A Comparative Empirical Study of Discrete Choice Models in Retail Operations
Authors: Berbeglia Gerardo , Garassino Agustín , Vulcano Gustavo
Published: December 2021

Choice-based demand estimation is a fundamental task in retail operations and revenue management, providing necessary input data for inventory control, assortment, and price-optimization models. The task is particularly difficult in operational contexts where product availability varies over time and customers may substitute into the available options. In addition to the classical multinomial logit (MNL) model and extensions (e.g., nested logit, mixed logit, and latent-class MNL), new demand models have been proposed (e.g., the Markov chain model), and others have been recently revisited (e.g., the rank list-based and exponomial models). At the same time, new computational approaches were developed to ease the estimation function (e.g., column-generation and expectation-maximization (EM) algorithms). In this paper, we conduct a systematic, empirical study of different choice-based demand models and estimation algorithms, including both maximum-likelihood and least-squares criteria. Through an exhaustive set of numerical experiments on synthetic, semisynthetic, and real data, we provide comparative statistics of the predictive power and derived revenue performance of an ample collection of choice models and characterize operational environments suitable for different model/estimation implementations. We also provide a survey of all the discrete choice models evaluated and share all our estimation codes and data sets as part of the online appendix.

This paper was accepted by Vishal Gaur, operations management.
Stochastic Knapsack Revisited: The Service Level Perspective
Authors: Lyu Guodong , Chou Mabel C. , Teo Chung-Piaw , Zheng Zhichao , Zhong Yuanguang
Published: December 2021

A key challenge in the resource allocation problem is to find near-optimal policies to serve different customers with random demands/revenues, using a fixed pool of capacity (properly configured). Three classes of allocation policies, responsive (with perfect hindsight), adaptive (with information updates), and anticipative (with forecast information) policies, are widely used in practice. We analyze and compare the performances of these policies for both capacity minimization and revenue maximization models. In both models, the performance gaps between optimal anticipative policies and adaptive policies are shown to be bounded when the demand and revenue of each item are independently generated. In contrast, the gaps between the optimal adaptive policies and responsive policies can be arbitrarily large. More importantly, we show that the techniques developed, and the persistency values obtained from the optimal responsive policies can be used to design good adaptive and anticipative policies for the other two variants of resource allocation problems.
A hard winter ahead
Authors: Halliwell Amanda
Published: December 2021

The Care Quality Commission's annual report on the state of care in England gives cause for concern for the foreseeable future, starting with the immediate issue of winter pressures. Amanda Halliwell reports.
Changes and thresholds in the Forgotten Joint Score after total hip arthroplasty
Authors: Robinson Patrick G. , MacDonald Deborah J. , Macpherson Gavin J. , Patton James T. , Clement Nick D.
Published: December 2021

Aims

The aim of this study was to identify the minimal clinically important difference (MCID), minimal important change (MIC), minimal detectable change (MDC), and patient-acceptable symptom state (PASS) in the Forgotten Joint Score (FJS) according to patient satisfaction six months following total hip arthroplasty (THA) in a UK population.

Methods

During a one-year period, 461 patients underwent a primary THA and completed preoperative and six-month FJS, with a mean age of 67.2 years (22 to 93). At six months, patient satisfaction was recorded as very satisfied, satisfied, neutral, dissatisfied, or very dissatisfied. The difference between patients recording neutral (n = 31) and satisfied (n = 101) was used to define the MCID. MIC for a cohort was defined as the change in the FJS for those patients declaring their outcome as satisfied, whereas receiver operating characteristic curve analysis was used to determine the MIC for an individual and the PASS. Distribution-based methodology was used to calculate the MDC.

Results

Using satisfaction as the anchor, the MCID for the FJS was 8.1 (95% confidence interval (CI) 3.7 to 15.9; p = 0.040), which was affirmed when adjusting for confounding. The MIC for the FJS for a cohort of patients was 17.7 (95% CI 13.7 to 21.7) and for an individual patient was 18. The MDC90 for the FJS was eight, meaning that 90% of patients scoring more than this will have experienced a real change that is beyond measurement error. The PASS threshold for the FJS was defined as 29.

Conclusion

The MCID and MIC can be used respectively to assess whether there is a clinical difference between two groups, or whether a cohort or patient has had a meaningful change in their FJS. Both values were greater than measurement error (MDC90), suggesting a real change. The PASS threshold for the postoperative FJS can be used as a marker of achieving patient satisfaction following THA. Cite this article: Bone Joint J 2021;103-B(12):1759–1765.
Noncritical phasematching behavior in thin-film lithium niobate frequency converters
Authors: Kuo Paulina S.
Published: December 2021

We present a study of noncritical phasematching behavior in thin-film, periodically poled lithium niobate (PPLN) waveguides. Noncritical phasematching refers to designing waveguides so that the phasematching is insensitive to variations in waveguide thickness, width, or other parameters. For waveguide thickness (the dimension with greatest nonuniformity due to fabrication), we found that phasematching sensitivity can be minimized but not eliminated. We estimate limits on the acceptable thickness variation and discuss scaling with device length for second-harmonic generation and sum-frequency generation in thin-film PPLN frequency converters.
Monolithic topological honeycomb lens for achromatic focusing and imaging
Authors: Zhu Wule , Duan Fang , Tatsumi Kazuya , Beaucamp Anthony
Published: December 2021

Wavelength dispersion is a universal phenomenon in refractive optics that degrades optical performances. Current mitigation methods are being greatly challenged by the demanding requirements of miniaturization, low aberrations, high throughput, and accurate manufacture. Here, we propose an unconventional monolithic honeycomb-like lens concept with topological degrees of design freedom, capable of near diffraction-limited achromatic performance. To automate the design process, a methodological framework is presented that directly evolves the honeycomb lens from a flat window, instead of a knowledge-based starting geometry. The honeycomb lens performance at the full field of view is remarkably better than either traditional aspheric lenses or commercial cascaded lenses. It also overcomes limitations of flat metalenses, which have extremely small aperture sizes and suffer from multi-order aberrations. This topological honeycomb lens concept may pave the way to inexpensive and compact achromatic optics for focusing and imaging applications in consumer cameras, wearable optics, virtual reality, etc.
Entwicklung eines Konzepts zur Managementbewertung nach DIN EN ISO 9001
Authors: Liedtke Patrick , Feuersenger Hannes , Arndt Hans-Knud
Published: December 2021

Um wettbewerbsfähig zu bleiben, streben viele Organisationen eine kontinuierliche Verbesserung mithilfe eines Qualitätsmanagementsystems an. Die Zertifizierung spielt dabei zunehmend eine größere Rolle. Für den Bereich der Qualitätsmanagementsysteme besteht die Möglichkeit, sich nach der DIN EN ISO 9001 zertifizieren zu lassen. Um die Zertifizierung zu erreichen, muss eine sogenannte Managementbewertung durch die oberste Leitung vorgenommen werden, in der die relevanten Bereiche der Organisation evaluiert werden. Ziel ist es, Verbesserungspotenziale rechtzeitig zu erkennen und Korrekturmaßnahmen einzuleiten. Das Vorhaben birgt Schwierigkeiten, da es verschiedene Vorlagen und Definitionen gibt, welche unterschiedliche Inhalte und Ziele aufweisen. Dadurch ist oftmals unklar, welche Aspekte innerhalb der Managementbewertung beziehungsweise zu welchen Detaillierungsgrad diese abgebildet werden sollen. Aus diesem Grund stellt dieser Beitrag ein Konzept vor, um die Managementbewertung einheitlich und normgerecht abzubilden. Das Konzept soll Organisationen eine Hilfestellung für die Erstellung der Managementbewertung bieten. Dabei wurde für die Evaluation eine Befragung in einem mittelständischen Unternehmen durchgeführt.
The Lyme and Tickborne Disease Dashboard: A map-based resource to promote public health awareness and research collaboration
Authors: Curriero Frank C. , Wychgram Cara , Rebman Alison W. , Corrigan Anne E. , Kvit Anton , Shields Timothy , Aucott John N.
Published: December 2021

With the incidence of Lyme and other tickborne diseases on the rise in the US and globally, there is a critical need for data-driven tools that communicate the magnitude of this problem and help guide public health responses. We present the Johns Hopkins Lyme and Tickborne Disease Dashboard (https://www.hopkinslymetracker.org/), a new tool that harnesses the power of geography to raise awareness and fuel research and scientific collaboration. The dashboard is unique in applying a geographic lens to tickborne diseases, aiming not only to become a global tracker of tickborne diseases but also to contextualize their complicated geography with a comprehensive set of maps and spatial data sets representing a One Health approach. We share our experience designing and implementing the dashboard, describe the main features, and discuss current limitations and future directions.
Downregulation of SFRP2 facilitates cancer stemness and radioresistance of glioma cells via activating Wnt/β-catenin signaling
Authors: Wu Quansheng , Yin Xiaofeng , Zhao Wenbo , Xu Wenli , Chen Laizhao
Published: December 2021

Secreted frizzled-related protein 2 (SFRP2) is a glycoprotein with frizzled-like cysteine-rich domain that binds with Wnt ligands or frizzled receptors to regulate Wnt signaling. SFRP2 is frequently hypermethylated in glioma patients, and analysis of TCGA data indicates that SFRP2 is one of the most downregulated genes in radiotherapy treated glioma patients. In the present study, we aimed to explore the potential function of SFRP2 in tumorigenesis and radioresistance of glioma. The RNA sequencing data of TCGA glioma samples were downloaded and analyzed. SFRP2 expression in 166 glioma patients was evaluated by qRT-PCR. The potential functions of SFRP2 in glioma were evaluated by loss-of-function assays and gain-of-function assays in glioma cell lines. We found that SFRP2 was downregulated in radiotherapy-treated glioma patients, and low SFRP2 expression was correlated with advanced tumor stage and poor prognosis. CRISP/Cas9-meidated SFRP2 knockdown promoted soft agar colony formation, cancer stemness and radioresistance of glioma cells, while enforced SFRP2 expression exhibited opposite effects. Moreover, Wnt/β-catenin signaling was activated in radiotherapy treated glioma patients. SFRP2 knockdown activated Wnt/β-catenin signaling in glioma cell lines, while overexpression of SFRP2 inhibited Wnt/β-catenin activation. Besides, pharmacological inhibition of Wnt/β-catenin signaling by XAV-939 abrogated the effects of SFRP2 knockdown on cancer stemness and radioresistance of glioma cells. Our data for the first time demonstrated a role of SFRP2 in radioresistance of glioma cells, and suggested that inhibition of Wnt/β-catenin signaling might be a potential strategy for increasing radiosensitivity of glioma patients.
(Don’t) just screenshot it: Ethics of archiving fan misbehaviours
Authors: Drouin Renee Ann
Published: December 2021

Despite the field of fandom studies’ interest in fan archives and fan behaviours, little work currently discusses how a fan archivist may approach the curation of a fan behaviour-focused archive. While such an archive may be fraught with ethical dilemmas of documenting others without consent, the archival efforts remark on broader cultural ramifications outside of individual works for a more encompassing view of the fandom itself. This article explores the ethics and understandings of such archives, in which fans have, without institutional training or sponsorship, curated archives dedicated to the misbehaviours and harassment of other fans. I conclude with what academics can learn from their ethical approaches.
P007 The Frequency of Anxiety and Depression in Patients With Inflammatory Bowel Diseases in the Moscow Clinical Scientific Center
Authors: Knyazev Oleg , Babayan Anait , Kagramanova Anna , Lishchinskaya Albina , Zvyaglova Mariya , Bodunova Natalya , Firsova Lyudmila , Ogarev Valeriy , Li Irina , Parfenov Asfold
Published: December 2021

BACKGROUND:

Anxiety and depression occur in a significant number of patients with inflammatory bowel diseases (IBD). The prevalence of anxiety and / or depression is 13-44.4% in patients with IBD compared to 4.4% among the world population.

OBJECTIVE:

To identify the frequency of anxiety and depression in patients with inflammatory bowel diseases in the Moscow Clinical Scientific Center named after A. S. Loginov.

METHODS:

A questionnaire was conducted on the Hospital Anxiety and Depression Scale (HADS) questionnaire for 370 patients with moderate to severe UC during the period of exacerbation of the disease.

RESULTS:

Of the 370 patients with UC, 283 (76.48%) had clinical and subclinical signs of anxiety and depression. Subclinical depression was noted in 76 (26.8%), clinically pronounced depression - 11 (3.4%), signs of anxiety had higher indicators-subclinical anxiety was found in 172 (60.8%) of the surveyed patients, pronounced clinical anxiety – in 24 (8.4%) patients with UC. Statistically significant correlations of average strength between the indicators of adherence according to the Morisky - Green questionnaire with scores on the HADS scale, both for anxiety and depression (p < 0.001, r - 0.6299) were revealed Among patients with anxiety and depression, the ratio of patients with high adherence to therapy (HAT) and low adherence to therapy (LAT) was 204 (55,1%) 79 (21,4%), accordingly. When comparing the degree of adherence depending on the presence of anxiety and depression, we found that HAT was associated with anxiety and depression in patients with UC (OR = 0.024; 95% CI 0.003-0.186; p < 0.001).

CONCLUSION:

The prevalence of anxiety and/or depression is 77% in patients with IBD during an exacerbation in the Moscow Clinical Scientific Center named after A. S. Loginov.
P013 Resolution of Infliximab Associated Infusion Hypersensitivity After Switching to Biosimilar Infliximab-dyyb
Authors: Irani Malcolm , Bryant Rosalind , Lofton Heather , Abraham Bincy
Published: December 2021

CASE:

Background: Administration of infliximab for the treatment of inflammatory bowel disease has a well-recognized risk of infusion-related (IR) adverse events. The recent introduction of the biosimilar infliximab-dyyb (Inflectra®) has been shown to have similar efficacy with comparable safety profile when compared to infliximab; however, although the active ingredients are similar, the inactive ingredients are different. We present a case of a 26-year-old female with ulcerative colitis who had resolution of her IR hypersensitivity when switched from infliximab to infliximab-dyyb.

CASE DESCRIPTION:

A 26-year-old female with a past medical history of ulcerative pancolitis presented to our clinic with the chief complaint of rash associated with her infliximab infusions. She described pruritic raised lesions which would occur on her upper and lower extremities during her infusions. She denied any shortness of breath or wheezing, and her symptoms were well controlled with methylprednisolone 40mg IV prior to her infusions. Previously, she had been treated for her UC with oral mesalamine, azathioprine and intermittent prednisone and did not have any adverse reactions to these medications. She has no known allergies to other medications and her peripheral eosinophil count was 1.6%. She was initially started on infliximab 5mg/kg every 8 weeks since 2013 and had achieved clinical as well as endoscopic remission with her most recent colonoscopy graded as Mayo 0. On account of her infusion reaction, drug antibodies were checked but were not detected. Infliximab level was 8.8 μg/ml. Due to insurance she was required to switch to infliximab-dyyb. After switching to the biosimilar, she has not had any infusion related reactions and no longer requires premedication with methylprednisolone with her infusions.

DISCUSSION:

Immediate IR reactions have been reported in 5-23% of IBD patients receiving infliximab and those who develop antibodies towards infliximab have a 2-fold risk of acute IR events. Side effects have been reported to be the primary reason for discontinuation of infliximab, and studies have shown that discontinuation can lead to an increased risk of relapse of inflammatory bowel disease. Although infliximab and infliximab-dyyb have analogous active ingredients, the inactive ingredients differ. Specifically, infliximab-dyyb lacks monobasic sodium phosphate and dibasic sodium phosphate, which acts as an emulsifier which we believe contributed to her IR with originator biologic infliximab. It is important to recognize these differences as IR hypersensitivities may be attributed to inactive ingredients; especially when antibodies are negative. Our case report suggests that a switch to biosimilar infliximab in patients may provide added benefit especially in those that have reactions occurring from inactive ingredients in the originator biologic.
P020 Proton Pump Inhibitor Therapy: Providing “Acid” Outcomes in Patients With Inflammatory Bowel Disease Under Infliximab Treatment
Authors: Macedo Silva Vítor , Lima Capela Tiago , Freitas Marta , Curdia Gonçalves Tiago , Boal Carvalho Pedro , Dias de Castro Francisca , Moreira Maria João , Cotter José
Published: December 2021

BACKGROUND:

A recent meta-analysis has suggested that proton pump inhibitor (PPI) therapy is associated with lower clinical remission rates and a higher number of hospitalizations in patients with inflammatory bowel disease (IBD) under infliximab therapy. We aimed to assess if these differences kept their significance when adjusted for other possible confounders.

METHODS:

Cohort study of consecutive patients with Crohn’s disease (CD) and Ulcerative Colitis (UC) under infliximab therapy. A minimum follow-up of 54 weeks after introduction of infliximab treatment was required. The analyzed outcomes were deep remission at week 54 and the need of IBD-related hospitalization, corticosteroid treatment or abdominal surgery under infliximab treatment. Collected possible confounders were age, gender, smoking habits, perianal disease, extra-intestinal manifestations, familiar history of IBD and concomitant use of immunomodulators.

RESULTS:

Our final sample included 104 patients, 56 (53.8%) of them females, with a mean age of 38.2±13.1 years. From these, 77 (74.0%) had CD and 27 (26.0%) had UC. PPI therapy was described in 21 (20.2%) of the patients under infliximab treatment. On univariate analysis, PPI users were found to have significantly lower rates of deep remission at week 54 (7.7 vs 28.3%; p = 0.034) and higher IBD-related hospitalization rates (47.6 vs 21.7%; p = 0.034). No differences were found regarding the need of corticosteroid therapy (4.8 vs 10.8%; p = 0.398) or abdominal surgery (33.7 vs 21.7; p = 0.201). When adjusted for the collected confounders by multivariate analysis, while not significantly influencing deep remission at week 54 (OR = 0.16; 95%CI = 0.02-1.63; p = 0.121), concomitant PPI therapy was a significant independent risk factor for IBD-related hospitalization (OR = 3.22; 95%CI = 1.11-9.34; p = 0.04).

CONCLUSION:

Despite not conducting to significantly different deep remission rates, concomitant PPI therapy was associated with a three-fold increase in hospitalization rates in IBD patients under infliximab treatment, even when adjusted for classical risk factors for adverse outcomes in IBD. These findings emphasize the importance of restricting PPI treatment to those with a clear clinical indication, especially in this set of patients.
P057 How Distance Between Residence and Treatment Center Impact the Outcome of Patients With Inflammatory Bowel Disease at CMN 20
Authors: Paredes Amenabar Carlos , Cortes Espinosa Tomas , López Goméz Jesús , Trujillo de la Fuente Korely , Romero Lozania Jose , Perez-Cabeza de Vaca Rebeca , Gerrard Christian Navarro , Narvaéz Mendez Maddy , Christian Navarro Gerrard , Guzmán-Cárcamo Ana , Ramos Gómez Mayra , Suarez Cuenca Juan
Published: December 2021

BACKGROUND:

Inflammatory bowel disease (IBD) affects an estimated 1.6 million people in the United States with at least 70,000 new cases per year. In the last 15 years an increase in frequency of IBD cases from 0.30 cases per 100,000 person-years to 1.83 cases per 100,000 person-years has been reported in Mexico. Variables such as early hospitalization at diagnosis, low hemoglobin levels, high values of C-reactive protein (CRP), fecal calprotectin concentration and absence of mucosal healing during evolution define the prognosis of these patients. However, the distance a patient must travel in order to reach a specialized treatment center can become an impediment for a correct diagnosis and treatment, severely impacting the clinical outcome of such patients.

METHODS:

Observational, cross-sectional, retrospective study. Objective: In patients with IBD, determine the impact of distance between the residence and specialized treatment center on the general clinical outcome. Variables analyzed: sex, age, disease duration, average travel time, distance in kilometers between place of residence and specialized treatment center, Crohn´s Disease (CD) or Ulcerative Colitis (UC), and their respective severity classification scores, as well as number of hospital readmissions per year. The results were evaluated with ANOVA tests, univariate analysis had a 95% confidence index and a significant “p” determined as p < 0.05.

RESULTS:

The study included 66 patients (45 UC and 21 CD). Mean age 51.15± 17.5 years. The distance between residence and hospital was calculated and classified into 3 quartiles based on proximity: 750km (quartile 3). There was a higher risk among patients in the most distant quartile for the use of biological therapy (OR, 2.20; 95% CI, 0.23- 20.55) and surgery (OR, 2.76, 95% CI 0.49- 15.48). We observed a clear relationship between the number of hospital readmission and the distance quartiles with a p = 0.0047.

CONCLUSION:

We observed an impact between the distance of residence and specialized treatment center over the patient’s clinical outcome. More readmissions, greater disease activity scores, more use of biological therapy and surgery were observed in patients who had to travel more than 750km from their home to their specialized treatment center compared to the other travel quartiles, this with a p = 0.0047.
P061 Impact of Inflammatory Bowel Disease on sleep quality in a Mexican population attended in a referral center
Authors: Trujillo de la Fuente Korely , López Goméz Jesús , Cortes Espinosa Tomas , Perez-Cabeza de Vaca Rebeca , Paredes Amenabar Carlos , Romero Lozania Jose , Navarro-Gerrard Megan , Mateos Viramontes Ana Luisa , Ramos Gómez Mayra
Published: December 2021

BACKGROUND:

Sleep disorders occur recurrently in patients with inflammatory bowel disease (IBD). The relationship between poor sleep quality and IBD activity has been subject to scarce attention. Poor sleep quality could be considered a relevant extraintestinal manifestation and a potential marker of subclinical inflammation, which could increase the severity of inflammation and the risk of relapse, however, we do not have enough information to confirm this hypothesis. Objective: Describe the impact of IBD on the quality of sleep, in patients treated in a referral hospital.

METHODS:

Observational, analytical, and cross-sectional study. Patients with diagnosis of IBD treated at Centro Médico Nacional "20 de Noviembre" were evaluated. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. IBD activity was measured using the Harvey-Bradshaw index for Crohn's disease (CD) and the Mayo scale for Ulcerative Colitis (UC).

RESULTS:

A total of 51 patients were included, the Pittsburgh Sleep Index Questionnaire (PSQI) was performed, after informed consent was signed. Patients had a mean age of 52. Fifty five percent were female, 65% had UC. Biological therapy was administered to 70.5%. In CD 89% were in remission and 11% in moderate activity. In UC 48.5% were in remission, 45.5% had mild activity and 6% had moderate activity. Eighty percent of the patients did not use hypnotic drugs. Patients with UC in remission had a bad perception of sleep quality in 68%, quite good sleep quality in 18% and very good sleep quality in 12% with a PSQI of 10.5 ± 3.2. In patients with mild activity, the perception of sleep quality was very good in 6%, quite good in 46%, quite bad in 40% and very bad in 6%, with a PSQI of 8 ± 3.7. In patients with moderate activity, 100% had a rather bad perception of sleep quality with a PSQI of 11 ± 1.4. For CD in remission the perception of sleep was quite bad in 43%, quite good in 43%, very bad in 6% and very good in 6% with a PSQI of 9 ± 4.3. In patients with moderate activity 50% had a very bad sleep quality perception and 50% a fairly good sleep quality perception with a PSQI of 14 ± 4.2.

CONCLUSION:

In this study a statistically significant association was obtained between PSQI and the perception of sleep reported by the patients, with a p < 0.005. Further research is still needed to better characterize sleep disturbances in this population. Due to the sample size, a prospective, randomized study is required to confirm these findings. The present analysis has no conflict of interest.
P076 The Role of Dual Biologic Therapy in Inflammatory Bowel Disease
Authors: Stone Molly , Morrison Margaret , Forster Erin
Published: December 2021

BACKGROUND:

As the prevalence of complex inflammatory bowel disease and extraintestinal manifestations continue to rise, more patients are requiring complex treatment regimens. In some cases, patients may require more than one biologic agent to target different areas in the inflammatory cascade. Although a body of data is emerging, there is currently no consensus on patient and agent selection for dual therapy or adverse outcomes of therapy.

METHODS:

A retrospective chart review of all patients receiving dual biologic therapy for IBD at a single tertiary care center was conducted. This was exempted by the IRB. Data regarding the patient and disease course, indication for dual biologic use, other concurrent therapies, infections and any adverse events was collected from the EMR.

RESULTS:

Ten patients (9 Crohn’s Disease, 1 Ulcerative Colitis) were identified as receiving dual biologic therapy. The most common combination therapy was ustekinumab with vedolizumab (5) or an anti-TNF (4); one patient was receiving adalimumab with vedolizumab. Nine patients were also on an immunomodulator (6 methotrexate, 2 6-mercaptopurine, 1 azathioprine) and three required steroids in addition to dual biologic therapy. The majority (8) of the patients were started on dual biologic therapy due to refractory GI symptoms, the others were due to extraintestinal manifestations (EIMs) with psoriatic arthritis and ankylosing spondylitis. Nine patients had significant symptomatic improvement on dual biologic regimen and all six patients with follow-up endoscopy demonstrated improvement. Two patients developed infectious diarrhea (C.difficile and e. coli), no other significant infections were noted. No patients were found to have malignancy or any other adverse effects of treatment during the reviewed period.

CONCLUSION:

Dual biologic therapy can be used with improvement in symptomatic and endoscopic findings of IBD. The combination use of two biologic agents does not appear to have additional infectious risk compared to single agent and no other adverse events were described. Longer follow-up and larger patient populations are needed to verify the combination of biologic mechanisms for therapy of refractory IBD and EIMs.
P075 Urgency and its Association with Quality of Life and Clinical Outcomes in Ulcerative Colitis Patients
Authors: Sninsky Jared , Barnes Edward , Zhang Xian , Long Millie
Published: December 2021

BACKGROUND:

Urgency, the immediate need to defecate, is common in ulcerative colitis (UC). The frequently used patient reported outcome (PRO)-2 for UC includes only rectal bleeding and stool frequency. We sought to investigate the association of urgency in UC patients with 1) quality of life (QoL) domains and 2) future UC hospitalizations, steroid prescriptions, and colectomy.

METHODS:

We conducted a cross-sectional and then a subsequent longitudinal study within IBD Partners, a patient-powered research network. We described associations of levels of urgency in UC patients with PROMIS QoL domains (depression, anxiety, social satisfaction, fatigue, sleep, and pain). Next, a longitudinal cohort determined associations between baseline urgency and subsequent clinical outcomes including UC hospitalization, steroid prescription, or colectomy within 12 months. We used bivariate statistics and logistic regression models to describe independent associations.

RESULTS:

A total of 632 UC patients were included in the cross-sectional study. After adjusting for clinical variables, rectal bleeding, and stool frequency, “hurry”, “immediately” and “incontinence” increased the odds of social impairment by 2.05 [1.24-3.4] (p = 0.005), 2.76 [1.1-6.74] (p = 0.028), and 7.7 [1.66-38.3] (p = 0.009) respectively compared to “no hurry”. Urgency also significantly increased the odds of depression, anxiety, and fatigue. In the multivariate pooled logistic regression of the longitudinal cohort, Urgency was associated with a significant stepwise increase in risk of hospitalizations, steroids, and colectomy. “Hurry”, “immediately” and “incontinence” increased the odds of colectomy within 12 months by 1.41 [1.15-1.72] (p < 0001), and 3.29 [2.13-5.09] (p < 0001).

CONCLUSION:

We demonstrate that urgency is a PRO independently associated with compromised QoL in patients with UC. Urgency is associated with future risk of hospitalizations, steroid prescription, and colectomy. Our findings support the consideration of urgency as a UC-specific PRO and its use as an outcome in clinical trials to capture QoL and risk of clinical decompensation.
Rapid reviews as an emerging approach to evidence synthesis in education
Authors: Wollscheid Sabine , Tripney Janice
Published: December 2021

Rapid reviews using abbreviated systematic review methods are of increasing importance for evidence-informed decision-making in education, although there is little guidance about the most suitable approach. Three recently completed rapid review reports are compared to inform discussions on the utility of this type of review in education and to highlight appropriate methods for producing evidence syntheses in a limited time frame. Rapid review methods need to be chosen to fit the needs of the review, which involves: thinking broadly about different kinds of team experience and expertise; estimating the size and nature of the literature to be reviewed; considering the review purpose and nature of the topic; choosing an appropriate synthesis method for the review purpose, evidence base and reviewers’ expertise; fully describing the review approach, and discussing the potential limitations of chosen methods; and understanding the anticipated audiences and tailoring outputs accordingly. Rapid reviews to address urgent and high-priority questions provide the benefits of timeliness and reduced resource requirements. However, it is crucial to understand caveats and limitations to the rapid conduct of evidence syntheses for decision-making purposes. This article offers guidance to support researchers, postgraduate students and commissioners who wish to conduct rapid reviews in a transparent and systematic way, addressing complex questions of relevance to evidence-informed decision-making in education.
Familias ante la diversidad
Authors: Serrano Fernández Laura
Published: December 2021

El propósito de este artículo es el de reflejar la realidad de familias que, actualmente, se encuentran viviendo la discapacidad intelectual de sus hijos. Para ello, se profundiza en la experiencia de vida de nueve familias con hijos con discapacidad intelectual de entre 7 y 26 años. A través de sus historias de vida se abordan los hitos fundamentales del recibimiento de la discapacidad intelectual de un hijo en el sistema familiar, así como los principales desafíos.
Poseidón: agua, aprendizaje y salud
Authors: Blanco Barrero Rocío , Álvarez Hernando Susana , Rodríguez Carrión Sara , Martín Berbel Lorena , Navarro Meléndez Ana
Published: December 2021

El programa Poseidón, iniciado en el año 2015, está dirigido tanto a niños como adolescentes con daño cerebral, discapacidad intelectual y física, que además, presentan un amplio espectro de secuelas cognitivas, sensoriales y funcionales, dependiendo de la localización e intensidad de la lesión. La metodología del programa consiste en realizar intervenciones transdisciplinares en el medio acuático uniendo 4 disciplinas: fisioterapia, terapia ocupacional, logopedia y pedagogía terapéutica. Gracias a una evaluación conjunta y bajo el marco de referencia de la CIF-IA, se desarrollan acciones de mejora para la consecución de objetivos terapéuticos y pedagógicos, con un único fin: mejorar la calidad de vida y el bienestar de personas con discapacidad.
Diálogo con el cuerpo
Authors: Pedraza Díaz Esperanza María , Pérez Rubio-Iglesias Agustín
Published: December 2021

En ocasiones nos empeñamos en hacer uso de un lenguaje oral creyendo que es la mejor vía de comunicación en las aulas. A lo largo de 6 meses una maestra y un educador teatral hemos podido colaborar juntos haciendo de la comunicación no verbal y la estimulación sensorial herramientas del desarrollo cognitivo y psicomotriz en alumnos con pluridiversidad funcional. Durante este tiempo hemos generado dinámicas que han favorecido las capacidades expresivas de alumnos, educadores y familias.
Welche Rolle spielt die EU‑Agrarpolitik?
Authors: Grohmann Pascal , Kliem Lea , Birkenstock Maren
Published: December 2021

Fast die Hälfte der Fläche der EU wird landwirtschaftlich genutzt. Daraus ergeben sich vielfältigeWechselwirkungen zwischen Landwirtschaft und Umwelt. Die EU‑Agrarpolitik hat großen Einfluss auf die Nutzung der Flächen, trägt bislang jedoch wenig dazu bei, negative Umweltwirkungen zu vermindern. Mit dem richtigen Policy-Mix könnte sich dies zukünftig ändern.
Fördermaßnahmen aus Agrarumweltprogrammen
Authors: Böhner Hannah G. S. , Joormann Ineke
Published: December 2021

Agrarumweltprogramme sind ein Instrument der europäischen Agrarpolitik, um die Biodiversität in Agrarlandschaften zu fördern. Die Gestaltung der Fördermaßnahmen wird zur Herausforderung, wenn sie unter Wahrung administrativer Notwendigkeiten ökologisch wirksam und von der Landwirtschaft akzeptiert sein sollen.
Aprendizaje organizacional y liderazgo como variables relacionadas con el cambio organizacional
Authors: Rodríguez Urrea Yuly Rosalba , García-Rubiano Mónica
Published: December 2021

El objetivo de este estudio fue hallar la relación entre el aprendizaje organizacional y
liderazgo en el contexto de cambio organizacional en 264 trabajadores de nueve empresas
del sector económico terciario de Bogotá. Se realizó bajo un diseño transversal/
correlacional, utilizando el modelo de ecuaciones estructurales, mediante la aplicación
del cuestionario multifactorial de liderazgo (MLQ) forma 5x corta adaptado
(82 ítems), forma líder y forma del clasificador, adaptado por Vega y Zabala (2004);
el instrumento de Castañeda y Ríos (2007) de aprendizaje organizacional, y el instrumento
de cambio organizacional (IMC) de García y Forero (2010). Los resultados
sugieren relaciones entre cambio organizacional y aprendizaje organizacional.
Success story of controlling COVID-19 in East Asia: lessons for South Asia
Authors: Majumder Shapan Chandra , Karim Mohammad Razaul , Miah Md. Mamun
Published: December 2021

The novel coronavirus is an issue of life and death. The main purpose of the study is to know the East Asian success story of controlling Covid-19 and identify which strategies could be a lesson for South Asia and to examine the influence of good governance on controlling COVID-19. Total daily cases of COVID-19 are collected from March 10 to June 15 for East Asian and March 4 to June 15 for South Asian countries. ARIMA forecasting, ADF test, stability test, and diagnostic tests are applied. The minimum value of AIC and BIC shows the appropriate model is ARIMA (0, 1, 1) for both regions. In the East and South Asian model, the coefficients of the constant term are -0.759451 and 198.0155, and coefficients of MA (1) are -0.715686 and -0.339701 respectively for both regions. It's significant at a 1% significance level and support our hypotheses that the total daily cases of COVID-19 decreasing into East Asia but increasing into South Asia and prove that the South Asia region has faced a lot of difficulties to tackle COVID-19 as most of the countries have not enough government capacity, weak institutions, limited resources, narrow government reaches to the vulnerable people and corruption compare to East Asian region and no actual strategies are yet noticeable from the governments of South Asia as a result transmission increases day by day. That is why; we think that South Asian countries could take lessons from East Asian countries as these countries are more successful to control COVID-19.
Effect of monetary policy on economic growth in nigeria in the post structural adjustment programme
Authors: Ani Kelechi Johnmary , Onu Chigozie
Published: December 2021

The study investigated the effect of monetary policy on economic growth during post structural adjustment programmer in Nigeria. It used the expo-facto design. Secondary data for the period of 1985-2015 were utilized. The data were extracted from the Central Bank of Nigeria (CBN) Statistical Bulletin and the National Bureau of Statistics (NBS). The linear regression with the application of Ordinary least Squares (OLS) technique was employed to estimate the parameters of the model numerically. Finding revealed that broad money supply had a positive and significant effect on economic growth in Nigeria during post structural adjustment programmer from 1986-2015. Interest rate had a negative and significant effect on economic growth in Nigeria during the same period and inflation rate had a positive and insignificant effect on economic growth in Nigeria at the same time. The study recommended that Central Bank of Nigeria should facilitate the emergence of market based interest rate that would attract both domestic and foreign investments, as well as create jobs, and promote non-oil export, while reviving industries that are currently operational, far below installed capacity. In order to strengthen the financial sector, the Central Bank has to encourage the introduction of more financial instruments that are flexible enough to meet the risk preferences and sophistication of operators in the financial sector.
Agricultural engineering based on system analysis and elctronic imaging
Authors: Lakhoua Mohamed Najeh , Ben Salem Jamel , Battikh Tahar , Jabri Imed
Published: December 2021

In this paper, we present the need for system analysis and electronic imaging for the study of Agricultural Engineering.  In fact, the system analysis aims to structure the analysis of agricultural systems. In fact, we present a literature review of system analysis and the need for electronic imaging. Then, two applications of Agricultural Engineering are presented. In fact, the basic principle of the application of stock management of a grain weighing system is presented. An application of the identification of the behavioral criteria of dairy cattle through electronic imaging is presented. Finally, the different results obtained from these applications are discussed.
Evaluation of occupational safety conditions in a waste plastic recycling plant in Brazil
Authors: Borges Soares Bruna , Farias de Sousa Lucas , Aguiar dos Santos Mariana
Published: December 2021

The adequacy of working conditions to safety standards has a fundamental importance in the company's environment. The efficient implementation of an Occupational Health and Safety Management System allows the reduction of risks associated with accidents; reduce costs to the employer and a strong ally in the competitive market when the safety indicator is a decisive factor in the choice of suppliers. The aim of this study was to evaluate occupational safety and health (OSH) practices at work in a plastic recycling plant located in northeastern Brazil, as well as to identify opportunities for improvement. Data collection was carried out from on-site visits and control measures were proposed for the risk factors identified. The evaluation made it possible to identify that the recycling activity is characterized by several occupational hazards, which are aggravated by inadequate working conditions. The non-conformity of jobs, the use of obsolete equipment and the lack of specific training to perform certain functions were identified as the most relevant aspects. For these, opportunities for improvement and adequation were connected. The study results can help other companies that perform the same activities to improve their performance in OSH based on the points of improvement presented.
Afamin predicts the prevalence and incidence of nonalcoholic fatty liver disease
Authors: Pitkänen Niina , Finkenstedt Armin , Lamina Claudia , Juonala Markus , Kähönen Mika , Mäkelä Kari-Matti , Dieplinger Benjamin , Viveiros Andre , Melmer Andreas , Leitner Isabella , Kedenko Ludmilla , Seppälä Ilkka , Viikari Jorma S.A. , Mueller Thomas , Kronenberg Florian , Paulweber Bernhard , Lehtimäki Terho , Zoller Heinz , Raitakari Olli T. , Dieplinger Hans
Published: December 2021

Objectives

In the general population, increased afamin concentrations are associated with the prevalence and incidence of metabolic syndrome as well as type 2 diabetes. Although metabolic syndrome is commonly associated with nonalcoholic fatty liver disease (NAFLD), there exist no information on afamin and NAFLD.

Methods

Afamin concentrations were cross-sectionally measured in 146 Austrian patients with NAFLD, in 45 patients without NAFLD, and in 292 age- and sex-matched healthy controls. Furthermore, the feasibility of afamin to predict incident NAFLD was evaluated in 1,434 adult participants in the population-based Cardiovascular Risk in Young Finns Study during a 10-year follow-up.

Results

Median afamin concentrations were significantly higher in NAFLD patients (83.6 mg/L) than in patients without NAFLD (61.6 mg/L, p<0.0001) or in healthy controls (63.9 mg/L, p<0.0001). In age- and sex-adjusted logistic regression analyses a 10 mg/L increase of afamin was associated with a 1.5-fold increase of having NAFLD as compared with patients without NAFLD and the risk was even two-fold when compared with healthy controls. In the population-based cohort, afamin concentrations at baseline were significantly lower in participants without NAFLD (n=1,195) than in 239 participants who developed NAFLD (56.5 vs. 66.9 mg/L, p<0.0001) during the 10-year follow up, with highest afamin values observed in individuals developing severe forms of NAFLD. After adjustment for several potentially confounding parameters, afamin remained an independent predictor for the development of NAFLD (OR=1.37 [95% CI 1.23–1.54] per 10 mg/L increase, p<0.0001).

Conclusions

Afamin concentrations are increased in patients with NAFLD and independently predict the development of NAFLD in a population-based cohort.