Common Categories Research Articles

Therapeutic Drug Monitoring (TDM) Implementation in Public Hospitals in Greece in 2003 and 2021: A Comparative Analysis of TDM Evolution over the Years.

Therapeutic drug monitoring (TDM) is the clinical practice of measuring drug concentrations. TDM can be used to determine treatment efficacy and to prevent the occurrence or reduce the risk of drug-induced side effects, being, thus, a tool of personalized medicine. Drugs for which TDM is applied should have a narrow therapeutic range and exhibit both significant pharmacokinetic variability and a predefined target concentration range. The aim of our study was to assess the current status of TDM in Greek public hospitals and estimate its progress over the last 20 years. All Greek public hospitals were contacted to provide data and details on the clinical uptake of TDM in Greece for the years 2003 and 2021 through a structured questionnaire. Data from 113 out of 132 Greek hospitals were collected in 2003, whereas for 2021, we have collected data from 98 out of 122 hospitals. Among these, in 2003 and 2021, 64 and 51 hospitals, respectively, performed TDM. Antiepileptics and antibiotics were the most common drug categories monitored in both years. The total number of drug measurement assays decreased from 2003 to 2021 (153,313 ± 7794 vs. 90,065 ± 5698; p = 0.043). In direct comparisons between hospitals where TDM was performed both in 2003 and 2021 (n = 35), the mean number of measurements was found to decrease for most drugs, including carbamazepine (198.8 ± 46.6 vs. 46.6 ± 10.1, p < 0.001), phenytoin (253.6 ± 59 vs. 120 ± 34.3; p = 0.001), amikacin (147.3 ± 65.2 vs. 91.1 ± 71.4; p = 0.033), digoxin (783.2 ± 226.70 vs. 165.9 ± 28.9; p < 0.001), and theophylline (71.5 ± 28.7 vs. 11.9 ± 6.4; p = 0.004). Only for vancomycin, a significant increase in measurements was recorded (206.1 ± 96.1 vs. 789.1 ± 282.8; p = 0.012). In conclusion, our findings show that TDM clinical implementation is losing ground in Greek hospitals. Efforts and initiatives to reverse this trend are urgently needed.

Understanding tourists’ experiences at war heritage sites in Ho Chi Minh city, Vietnam: a netnographic analysis of TripAdvisor reviews

ABSTRACT This article examines tourists’ experiences based on a content analysis of 23,640 online TripAdvisor reviews on the Cu Chi tunnels, one of the most well-known dark tourist sites in Vietnam. Using the netnography approach, we found that most online reviews are from inbound tourists. We identified several factors that impact tourists’ perceptions, including tourists’ underground experience, the content of war history, the tour guide’s narrative talents, tourists’ experience shooting weapons on-site, and the relative size of the crowd. Both positive and negative experiences were grouped into a few common categories. Based on our analysis, we observed that the current improvement of service quality, programmes, and presentations is not enough to transform tourists’ experiences at the site. Rather, we discovered that the tourist also needs to be a co-creator of the experience. We draw out the findings to delineate their theoretical value and make inferences for the site management before concluding with a discussion of the study’s limitations and suggestions for future research.

Opsoclonus and ocular flutter: evaluation and management.

Opsoclonus and ocular flutter are saccadic intrusions characterized by spontaneous, back-to-back, fast eye movements (saccades) that oscillate about the midline of central visual fixation without intervening inter-saccadic intervals. When this type of movement occurs exclusively in the horizontal plane, it is called ocular flutter. When it occurs in multiple planes (i.e. horizontal, vertical, and torsional) it is called opsoclonus. The most common etiologic categories are parainfectious and paraneoplastic diseases. Less common are toxic-metabolic, traumatic, or idiopathic origins. The mechanism of these movements relates to dysfunction of brainstem and cerebellar machinery involved in the generation of saccades. In this review, we discuss the characteristics of opsoclonus and ocular flutter, describe approaches to clinical evaluation and management of the patient with opsoclonus and ocular flutter, and review approaches to therapeutic intervention. Recent publications demonstrated eye position-dependent opsoclonus present only in left gaze, which may be related to dysfunction of frontal eye fields or structures in the cerebellar vermis. Opsoclonus and ocular flutter originate from a broad array of neuropathologies and have value from both a neuroanatomic and etiologic perspective.

THTP3.4 Performances measures in Robotic-Assisted Surgery- A Systematic Review

Abstract Background Robotic-Assisted Surgery (RAS) has seen a global rise in the past 30 years. Despite the increased adoption, there is no current standardised training curricula or measure of performance. The aim of this systematic review was to define the RAS metrics used to assess technical performance across the surgical specialities. Methods Using the PRISMA 2020 guidelines, Pubmed, Embase and the Cochrane Library were searched systematically for full texts published 31st January 2020 – 31st January 2022. All randomised controlled trials (RCTs) and observational studies were considered. Review articles and systematic reviews were excluded. The papers’ quality and bias score were assessed using the Newcastle Ottawa Score for the observational studies and Cochrane Risk Tool for the RCTs. Results The initial search yielded 1189 papers of which 74 were eligible. The majority were published in urology (45% n=33). 27 unique metrics were identified and categorised as “task based”, “procedural based”, “cognitive assessments” and “global assessments”. Global assessments were the most common category of assessment (n=12); the most frequently used was GEARs (Global Evaluative Assessment of Robotic Skills). Only 4 metrics (automated, Proficiency Based Progression (PBP), pupillary measures and time to completion) used quantitative measures to assess performance whilst the remaining relied upon Likert scales thereby creating variability amongst users. Conclusion There is wide variation in tools used to assess performance in RAS. The majority of tools are subjective which increases the risk of bias amongst users and therefore accuracy in the measure of performance. A validated, objective global assessment tool that utilises quantitative measures is required.

Subsequent risky driving behaviors, recidivism and crashes among drivers with a traffic violation: A scoping review

PurposeDrivers who have committed a traffic violation are a particularly high-risk group, yet studies conducted among this group are scarce. We analyzed and synthesized the current literature concerning subsequent risky driving behaviors, recidivism, and crashes among drivers with a traffic violation. MethodsWe searched PubMed, Education Resources Information Center (ERIC), Academic Search Complete, Web of Science, and Scopus for articles published in English between January 1, 1999, and May 31, 2023. A total of 25 articles met the selection criteria and were included in the final analysis. Two coders independently extracted and analyzed the selected articles to identify common categories across the articles, including study design, study population, type of traffic violation, and study outcomes including subsequent driving behaviors, recidivism, and crash risks. ResultsOf the 25 selected articles, 19 (76%) involved both male and female participants. Fourteen (56%) studies were interventions/evaluation studies, with the other 11 (44%) being observational. Nineteen (76%) studies included alcohol-impaired driving violations, and 23 (92%) studies examined recidivism as an outcome measure. Over half of the observational studies demonstrated that traffic offenders were more likely to commit a subsequent traffic violation or had elevated risk of crashes. Most of the intervention/evaluation studies demonstrated a significant reduction in driving under the influence (DUI) of alcohol among the study participants. However, such positive effects observed during the active intervention period were not always sustained. ConclusionsTraffic offenders are a high-risk group for subsequent violations and crashes. Evidence from this review calls for more effective interventions implemented following a traffic violation to prevent recidivism, crashes, and crash-related injuries and deaths.

SFA-Net: A Selective Features Absorption Network for Object Detection in Rainy Weather Conditions.

In recent years, object detection approaches using deep convolutional neural networks (CNNs) have derived major advances in normal images. However, such success is hardly achieved with rainy images due to lack of visibility. Aiming to bridge this gap, in this article, we present a novel selective features absorption network (SFA-Net) to improve the performance of object detection not only in rainy weather conditions but also in favorable weather conditions. SFA-Net accomplishes this objective by utilizing three subnetworks, where the feature selection subnetwork is concatenated with the object detection subnetwork through the feature absorption subnetwork to form a unified model. To promote further advancement in object detection impaired by rain, we propose a large-scale rainy image dataset, named srRain, which contains both synthetic rainy images and real-world rainy images for training and testing purposes. srRain is comprised of 25 900 rainy images depicting diverse driving scenarios in the presence of rain with a total of 181 164 instances interpreting five common object categories. Experimental results display that our SFA-Net reaches the highest mean average precision (mAP) of 77.53% on a normal image set, 62.52% on a synthetic rainy image set, 37.34% on a collected natural rainy image set, and 32.86% on a published real rainy image set, surpassing current state-of-the-art object detectors and the combination of image deraining and object detection models while retaining a high speed.

About some problems of law enforcement activities in the field of state social assistance and support to poor citizens in Russia

The subject of the study is the most common conflict situations that are resolved, mainly in court, in the field of providing state social assistance and support to the poor citizens. The author analyzes the existing, rather extensive judicial practice in this area, focusing on the most socially significant aspects of law enforcement that need further improvement. The methodological basis of the study was a set of general scientific methods of cognition, based on a dialectical general philosophical basis, and, in turn, determining the use of certain private scientific methods, primarily statistical methods in the law enforcement sphere. The article was prepared as part of the state assignment to the Financial University under the Government of the Russian Federation in 2023. The sphere of assistance to low-income citizens and families is extremely conflictual from the point of view of law enforcement. The most common categories include legal disputes related to: contradictions between federal legislation and regulatory acts of the regions of the Russian Federation; imperfection of federal and regional legislation; improper application of the norms of substantive and procedural law; violation of the terms of the social contract; recovery of funds unreasonably paid to recipients of social assistance; bringing to administrative responsibility for misuse budget funds; challenging the refusal to provide social services, in the form of vouchers for sanatorium treatment.

Technologies for Treatment of Landfill Leachate: A Brief Review

Abstract: Landfill leachate contains organic compounds like amines, ketones, carboxylic acid, alcohols, aldehydes, phenols, phosphates and inorganic pollutants such as ammonia, phosphorous, sulphate, emerging contaminants like per-and polyfluoroalkyl substances (PFAS) and also the toxic heavy metals like Mn, Cd, Pb, Fe, Ni, Zn and As. In young landfill leachate, the concentration of volatile acid and simply degraded organic matter is high while pH is low. However, in mature landfills, there is more leachate production with high pH. The age of landfill and determination of parameters like BOD, COD, COD/BOD ratio are important to know the appropriate treatment methods. Physicochemical, biological and combined methods are the most reported landfill leachate treatment methods. Advanced oxidation process, adsorption, coagulation-flocculation, bioremediation, phytoremediation, bioreactor, membrane process and air striping are some of the common categories of effective treatment of landfill leachate. For better apprehension, it has been reviewed that treatment efficiencies of different kinds of leachate depend on their composition and method adopted. Studies related to the removal of organic matter and heavy metals are predominant which reported excellent removal efficiency ranging from 80-100%. In addition, physical parameters like color and turbidity can also be removed effectively using appropriate treatment methods. The present article deals with a concise review of existing literature on sustainable landfill leachate treatment technologies which include physical, chemical, biological and combined techniques.

A province-wide childhood malignancy profiles in Indonesia (2010-2019): Yogyakarta Pediatric Cancer Registry

Background The global burden of childhood cancer is poorly quantified, but it is estimated that 80% of all children with cancer live in low- and middle-income countries with cure rates of childhood cancer far lower than in high-income nations.&#x0D; Objective To describe the Yogyakarta Region pediatric cancer profile from 2010-2019 and compare it to that of a 2000-2009 study in the same setting.&#x0D; Methods This retrospective study of childhood cancer was conducted in patients aged £18 years and diagnosed in Dr. Sardjito General Hospital from 2010 to 2019. Pediatric cancer patient data were collected from hospital hardcopy and electronic medical records. An estimated annual average incidence rate of childhood cancer was calculated and the number of patients by their regions of origin were visualized. The number of childhood malignancies recorded is also compared by the number found in 2000-2009 study.&#x0D; Results There were 1,839 new cases registered in Yogyakarta Pediatric Cancer Registry during the study period. The mean age at diagnosis was 6.3 years and male-to-female ratio was 1.4: 1.0. Fifty-six% of cancers were diagnosed in the 0-5-years age group. The most common diagnosis category was leukemia, which accounted for 60% of all childhood malignancies. The three most common diagnoses were acute lymphoblastic leukemia (44%), acute myeloid leukemia (12%), and retinoblastoma (7%). The annual average incidence rates of leukemia and solid tumors were 26.8 and 17.5 per million, respectively. The number of patients registered in 2000-2009 study was 1,124 case. Therefore, there was an increase of 63.6% in the number of childhood malignancies registered in 2010-2019 compared to the 2000-2009 study.&#x0D; Conclusion There is an increase in the number of childhood malignancies registered in 2010-2019 compared to the 2000-2009 study. The number of patients referred to our hospital increased, indicating a more inclusive registry, better referral system, and better access to health care facility.

Is Breast Magnetic Resonance Imaging Superior to Sonography in Gynecomastia Evaluation and Surgery Planning.

Data on the value of magnetic resonance imaging (MRI) in the preoperative evaluation and surgery planning of gynecomastia are limited. The purpose of this study is to reveal MRI features and categories of gynecomastia and compare surgical outcomes following MRI and sonography as well as their diagnostic accuracy. The area of the gland and the whole breast on the transverse plane via nipple of MRI were measured to calculate the ratio between them. Areola, mass and branch patterns were categorized to represent three different gynecomastia type on MRI. 183 patients were included, with 38 in MRI group and 145 in sonography group. Diagnostic accuracy was assessed by the level of agreement between preoperative imaging findings and intraoperative observations. Surgical data, patients' satisfaction and complications were compared between the two groups. MRI in 75 gynecomastic breasts demonstrated the average ratio of the gland to the whole breast was 10.6%±13.3%. The most common MRI categories were branch patterns (45.3%). The diagnostic concordance rate of MRI was higher than sonography (100% vs. 86.8%, p = 0.001). Among those junior surgeons, the length of surgery was reduced in MRI group (100 min vs. 115 min, p = 0.048). There was no difference in terms of patient's satisfaction and complication rate between MRI and sonography. MRI was superior to sonography in diagnostic accuracy to assess the tissue components of gynecomastia and provided informative guidance especially for junior surgeons. Surgical outcomes were comparable regardless of the use of MRI or sonography for evaluation. IThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Laryngeal symptoms related to motor phenotypes in Parkinson's disease: A systematic review.

This study aimed to systematically review the associations between motor clinical phenotypes in Parkinson's disease (PD) and laryngeal disease symptoms. Laryngeal dysfunctions such as dysphonia and dysphagia are ubiquitous in people with Parkinson's disease (PwPD). Similar to other disease symptoms, they manifest variably across PwPD. Some of the variability within PD has been explained by clinical phenotypes. However, it is unclear how laryngeal symptoms of PD express themselves across these phenotypes. Five databases were searched (MEDLINE, CINAHL, Web of Science, Embase, Scopus) in May 2022. After the removal of duplicates, all retrieved records were screened. Cohort, case-control, and cross-sectional studies in English discussing laryngeal symptoms and clinical PD phenotypes were included. Data were extracted, tabulated, and assessed using Moola et al.'s (2021) appraisal tool for systematic reviews of risk and etiology. The search retrieved 2370 records, representing 540 PwPD. After the removal of duplicates and screening, eight articles were included for review. The most common phenotype categories were tremor-dominant and postural-instability gait disordered (PIGD). Five studies addressed vocal characteristics, while four considered swallowing. Differences and lack of rigor in methodology across studies complicated conclusions, but a tendency for tremor-dominant phenotypes to present with less severe laryngeal symptoms was found. Some minor differences in laryngeal function were found between tremor-dominant and PIGD phenotypes in PD. However, there is a need for more standardized and high-quality studies when comparing motor phenotypes for laryngeal function.

Inborn Errors of Immunity-the Sri Lankan Experience 2010-2022.

Inborn errors of immunity (IEI) are typically monogenic. Data from the Indian subcontinent are relatively scarce. This paper evaluates IEI diagnosed in Sri Lanka. Data of patients diagnosed with IEI from 2010 to 2022 at the Department of Immunology, Medical Research Institute, Colombo, Sri Lanka, were retrospectively analyzed. Two hundred and six patients were diagnosed with IEI, with a prevalence of 0.94per 100,000. The onset of disease was below 12years in 84.9%, whereas in 10.9%, it was after 18years. The male: female ratio was 1.78:1. Consanguinity was identified in 26.6%. IEI were found in all but one (bone marrow failure) of the 10 IUIS categories. Predominantly antibody deficiencies were the most common category among the nine identified (30.1%), followed by combined immune deficiencies with syndromic features (21.3%), immunodeficiencies affecting cellular and humoral immunity (19.9%), congenital defects of phagocyte number or function (13.1%), and defects in intrinsic and innate immunity (8.2%). Severe combined immune deficiency (SCID) was the commonest disease (14.6%), followed by chronic granulomatous disease (CGD) (10.6%) and X linked agammaglobulinemia (8.7%). Of the patients with a known outcome (n = 184), 51 died (27.7%). Mortality rates were high in SCID (83.3%), Omenn syndrome (OS) (100%), and CGD (31.8%) patients. IEI in Sri Lanka are diagnosed mainly in childhood. The low diagnosis rates suggest a need for educating clinicians regarding IEI in adulthood. The high mortality rates associated with some IEI indicate the need of transplant services in the country.

Association of working hours with accelerometer-based sleep duration and sleep quality on the following night among older employees

This study examined the association between daily working hours and accelerometer-based sleep duration, sleep efficiency, and number of awakenings per hour of sleep on the following night among 800 older public sector employees in Finland (mean age 63 years in the first measurement they participated in, 87% women) with 4,818 measurement nights in total. Information on working hours was derived from daily logs and categorized into: 1) 6 h, 2) 7, hours 3) 8 h, 4) 9 h, and 5) 10 or more hours of work. The most common category (i.e. workdays with 8 h of work) was used as the reference category in the analyses. Nights followed by a workday and a free day were analyzed separately. No differences were observed in sleep duration between the reference group and the other working hour categories when the next day was a workday nor when the next day was a free day. After a 6-hour workday, sleep efficiency was on average 1.0 percentage points higher and there were on average 0.13 less awakenings per hour of sleep when compared with the reference category. When the next day was a free day, no differences in sleep quality were observed. Thus, no clear indication of a dose-response relationship between working hours and either duration or quality of sleep was found. Furthermore, future research should further examine the possibility that the association between working hours and sleep is somewhat different depending on whether the workday is followed by another workday or a free day.

Towards Less Plastic in Food Contact Materials: An In-Depth Overview of the Belgian Market.

The food contact materials (FCMs) industry is forced to develop substitute materials due to constant pressure from consumers and authorities to reduce fossil-based plastic. Several alternatives are available on the market. However, market share, trends, and consumer preferences are still unclear. Therefore, this study aims to provide an overview of the Belgian FCMs market, the available substitute materials, and their uses. The market analysis was performed with an integrated web-based approach. Fifty-two sources were investigated, covering e-shops selling materials intended to replace disposable plastic materials or being advertised as environmentally friendly and websites describing homemade FCMs. The first screening identified 10,523 articles. The following data cleaning process resulted in a homogeneous dataset containing 2688 unique entries, systematically categorised into fifteen material categories and seven utilisation classes. Paper and board was the most popular material category (i.e., 37% of the entries), followed by bagasse, accounting for 9% of the entries. Takeaway and food serving (44.4% and 22.8% of the entries) were the most common usage categories. The study pursued to provide insights into current trends and consumer preferences, highlighting priorities for safety assessment and future policy making.

Herbal Products Sold in Sikkim Himalaya Region – India: A Mini Survey

Objective: The present survey aimed to interact with the vendors, analyze, examine, and document the herbal medicinal products sold in retail stores, pharmacies, AYUSH stores, generally closed and open markets in the local area of Sikkim, mainly rural towns – Gangtok, Ranipool, Singtam, and Rangpo. It was a first of its kind study on the selected topic in Sikkim – India. Material and Methods: The methodology followed during the survey was a cross-sectional study, open ended semi-structured questionnaire, and survey data collection tools were employed; descriptive and inferential statistics were done. Results: The results were summarized in the different tables. From, it was found that old age (46+) uses most of the herbal products (66.6%), adult (20–45 years) uses 42.6% of herbal products, adolescent (13–19) uses 16.6%, and child (1–12) uses 14.5%. Females use more herbal products than males at 57%, and males at 43%. It was found that a large number of herbal products in Sikkim are manufactured outside Sikkim (98%) and 2% of the products were manufactured in Sikkim. Herbal product packaging is mostly secondary (66%), followed by primary (28%) and tertiary packaging (6%). It was found that a large number of solid dosage (47%) form of herbal products is available in the market followed by liquid dosage form (38%). According to brand wise or company wise, Patanjali (41%) products accounted for a big share on the market followed by Baidyanath (19%), other brands (15%), AYUSH (11%), Himalaya (8%), and Dabur (6%). Based on diseases treated, digestion, and metabolism (21%) followed by bone and joint pain (17%), diabetes mellitus (14%), cough and cold (12%), piles (11%), hypertension (7%), thyroid (3%), and other other common diseases categories represents about 15%. Highlights the situation after the COVID-19 pandemic indicating drastic increases in market value (in Lakhs) and the sale of herbal products in Sikkim. Conclusion: The data highlighted above were the first of its kind in a study done in Sikkim – India; no data were available in any scientific repositories to date.

Biomedical Amplifiers Design Based on Pseudo-Resistors: A Review

The demand for efficient, robust, and cost-effective Brain-Machine Interface (BMI) systems continues to increase in the last decade. One of the fundamental design blocks in such systems is the signal amplification and filtering. Generally, biomedical signals are characterized by low amplitude and low frequency in a noisy environment. Therefore they need to be amplified and filtered before passing the signal to the next processing stage. In this review paper, a comprehensive survey is conducted in existing literature of two-stage biomedical amplifiers, focusing on the impact of the pseudo-resistor non-linearity on the system’s performance. First, the common categories of pseudo-resistors are presented and discussed. Then, different amplifier designs, targeted for biomedical applications, are identified and studied considering the influence of the pseudo-resistors on the performance. A special focus was given to the impact of the Process, Voltage, and Temperature variations where experiments are conducted to test the performance under different variation tests. Different two-stage biomedical amplifiers, used in bio-detection systems, with programmable gain and bandwidth features based on pseudo-resistors are implemented. The designs are realized and simulated using LTspice utilizing 90nm process technology, BSIM4, version 4.3, level 54.

Physician-staffed prehospital units: a retrospective follow-up from an urban area in Scandinavia

BackgroundThe aim of this study was to determine when and how rapid response vehicles (RRVs) make a difference in prehospital care by investigating the number and kinds of RRV assignment dispatches and the prehospital characteristics and interventions involved.MethodsThis retrospective cohort study was based on data from a quality assurance system where all assignments are registered. RRV staff register every assignment directly at the site, using a smartphone, tablet, or computer. There is no mandatory information requirement or time limit for registration. The study includes data for all RRVs operating in Region Stockholm, three during daytime hours and one at night – from January 1, 2021 to December 31, 2021.ResultsIn 2021, RRVs in Stockholm were dispatched on 11,283 occasions, of which 3,571 (31.6%) resulted in stand-downs. In general, stand-downs were less common for older patients. The most common dispatch category was blunt trauma (1,584 or 14.0%), which accounted for the highest frequency of stand-downs (676 or 6.0%). The second most common category was cardiac arrest (1,086 or 9.6%), followed by shortness of breath (691 or 6.1%), medical not specified (N/S) (596 or 5.3%), and seizures (572 or 5.1%).ConclusionThe study findings confirm that RRVs provide valuable assistance to the ambulance service in Stockholm, especially for cardiac arrest and trauma patients. In particular, RRV personnel have more advanced medical knowledge and can administer medications and perform interventions that the regular ambulance service cannot provide.

Cognitive and adaptive behaviors associated with disease severity and genotype in patients with mucopolysaccharidosis II

BackgroundMucopolysaccharidosis II (MPS II) is a rare, X-linked lysosomal storage disease caused by pathogenic variants of the iduronate-2-sulfatase gene (IDS) and is characterized by a highly variable disease spectrum. MPS II severity is difficult to predict based on IDS variants alone; while some genotypes are associated with specific phenotypes, the disease course of most genotypes remains unknown. This study aims to refine the genotype–phenotype categorization by combining information from the scientific literature with data from two clinical studies in MPS II. MethodsGenotype, cognitive, and behavioral data from 88 patients in two clinical studies (NCT01822184, NCT02055118) in MPS II were analyzed post hoc in combination with published information on IDS variants from the biomedical literature through a semi-automated multi-stage review process. The Differential Ability Scales, second edition (DAS-II) and the Vineland Adaptive Behavior Scales™, second edition (VABS-II) were used to measure cognitive function and adaptive behavior. ResultsThe most common category of IDS variant was missense (47/88, 53.4% of total variants). The mean (standard deviation [SD]) baseline DAS-II General Conceptual Ability (GCA) and VABS-II Adaptive Behavior Composite (ABC) scores were 74.0 (16.4) and 82.6 (14.7), respectively. All identified IDS complete deletions/large rearrangements (n = 7) and large deletions (n = 1) were associated with a published ‘severe’ or ‘predicted severe’ progressive neuronopathic phenotype, characterized by central nervous system involvement. In categories comprising more than one participant, mean baseline DAS-II GCA scores (SD) were lowest among individuals with complete deletions/large rearrangements 64.0 (9.1, n = 4) and highest among those with splice site variants 83.8 (14.2, n = 4). Mean baseline VABS-II ABC scores (SD) were lowest among patients with unclassifiable variants 79.3 (4.9, n = 3) and highest among those with a splice site variant 87.2 (16.1, n = 5), in variant categories with more than one participant. ConclusionsMost patients in the studies had an MPS II phenotype categorized as ‘severe’ or ‘predicted severe’ according to classifications, as reported in the literature. Patients with IDS complete deletion/large rearrangement variants had lower mean DAS-II GCA scores than those with other variants, as well as low VABS-II ABC, confirming an association with the early progressive ‘severe’ (neuronopathic) disease. These data provide a starting point to improve the classification of MPS II phenotypes and the characterization of the genotype–phenotype relationship.

Appraisals of Social Trauma and Their Role in the Development of Post-Traumatic Stress Disorder and Social Anxiety Disorder.

Cognitive theories of post-traumatic stress disorder (PTSD) feature appraisal of trauma as a critical factor in the development and maintenance of the disorder. Here we explored appraisals of social trauma (severe rejection or humiliation). Participants were outpatients with social anxiety disorder (SAD) and clinically significant PTSD symptoms (PTSS) after social trauma (n = 15); two clinical control groups of either SAD (n = 32) or obsessive-compulsive disorder (OCD; n = 13); and a control group with no diagnoses (n = 38). Measures included a clinical interview to assess social trauma and related open-ended appraisals and the Posttraumatic Cognitions Inventory (PTCI). Raters blind to group assignment performed content analyses of appraisals. Results showed that the PTSS group scored significantly higher than either clinical group on the PTCI SELF subscale. Only the SELF subscale predicted a diagnosis of both PTSS and SAD. All but one PTSS participant reported primarily negative beliefs about their social trauma, and the most common categories were flawed self and others are critical or cruel. Post-traumatic appraisals implicated in the course of PTSD are significant in how individuals respond to social trauma, with negative self-cognitions linked to both PTSS and SAD.

Sustainability of bio-mediated and bio-inspired ground improvement techniques for geologic hazard mitigation: a systematic literature review

This is a systematic literature review of quantitative sustainability assessments, focusing on life cycle sustainability assessment (LCSA), of bio-mediated and bio-inspired ground improvement technologies applied to geologic hazard mitigation. The aims of the systematic review are to 1) compare the sustainability of various ground improvement techniques and, 2) to evaluate the rigor and consistency of sustainability assessment methods applied to these techniques. The literature review considers studies identified through keyword searches of bibliographic databases. After selection criteria were applied to ensure identified articles were within scope, a total of 8 articles were found which assessed bio-mediated and bio-inspired ground improvement technologies. The technologies represented in the literature include enzyme induced carbonate precipitation (EICP), microbially induced carbonate precipitation (MICP), and microbially induced desaturation and carbonate precipitation (MIDP). While sustainability is typically conceived to include environmental, economic and social impacts, most studies examined only life cycle environmental impacts, three included life cycle cost accounting, and none included social impacts. Analysis of the studies’ system boundaries show inconsistencies across studies, making comparison of results inaccurate. The most common environmental impact categories included in the identified studies are global warming and eutrophication. Raw materials production and field emissions from the biogeochemical reactions that drive the technologies are the largest contributors to these impacts. Based on the review, it is clear that a set of LCSA guidelines is needed to produce high-quality LCSAs that can be used in comparative assessments and to confidently identify processes where the impacts of bio-mediated and bioinspired technologies can be reduced.