Repository Of Evidence Research Articles

Portfolio practices in the principal evaluation process: A qualitative case study

BackgroundThe portfolio is a vital component of the evaluation of principals and serves as a repository of evidence of achievements, skills, and capabilities. It facilitates the meticulous recording and documentation of experiences undertaken. Furthermore, the portfolio is instrumental in the refinement of conceptual ideas over time, while simultaneously offering a panoramic vista of a school's operational ethos and its alignment with professional benchmarks. ObjectiveThis study delves into the practices surrounding the principal portfolio and the formative and summative evaluation of principals by their evaluating supervisors. It aims to uncover principals’ perceptions regarding the obligatory nature of portfolios and other evaluative methodologies throughout both assessments. In light of the pivotal role that portfolios occupy in the realm of professional development and evaluation for school principals, the Abu Dhabi Education Council has mandated the compilation of principal portfolios within public schools. This mandate requires a detailed accounting of principals' proficiencies, achievements, and developmental trajectories. Markedly, this exploration stands as one of a scant number of inquiries probing the application of portfolios by school principals, with a particular focus on the context of the United Arab Emirates. It is poised to enrich the discourse on the utility of portfolios as instrumental tools for fostering leadership acumen and evaluative competency within the spheres of educator and principal preparation over the preceding two decades. The critical examination of these practices is vital for a nuanced understanding of their operational dynamics, the efficacy and challenges of e-portfolios, the array of opportunities they unveil, the identities of the involved stakeholders, and their ultimate objectives. MethodsThis study adopted a qualitative research approach to gather and analyze non-numerical data in the form of concepts, opinions, and experiences presented by principals and their supervisors within the Al-Ain School District (overseen by the Abu Dhabi Education Council). The cohort of participants comprised nine individuals endowed with extensive portfolio experience, six principals and three cluster managers. All worked in public educational institutions and were meticulously selected based on predefined criteria. This study relied on several data collection methods to obtain participants’ perspectives on their experiences with portfolio practices, including face-to-face interviews and documents from their portfolios. ResultsA thematic analysis of the participant data yielded five salient themes reflecting the experiences of the principals: (1) inconsistent expectations for portfolio evidence; (2) portfolios summoned in response to rising tensions at the summative evaluation; (3) portfolios promoting reflective practices in formative evaluation; (4) portfolios susceptible to manipulation or falsification; and (5) excessive time spent building and developing portfolios. In order to maximize the utility of portfolios, this result invites school principals to unleash the latent potential inherent in their actions by leveraging portfolios as mirrors for reflective leadership and ongoing self-assessment. ConclusionsThis research delineates both practical and theoretical ramifications for the application of professional portfolios. It elucidates the nature of evidence principals ought to incorporate within their portfolios. Furthermore, it endeavors to better inform principals of the evidence collection process, including what artifacts and documentation to gather and how to do so.

Functional characterization of 2,832 JAG1 variants supports reclassification for Alagille syndrome and improves guidance for clinical variant interpretation

Pathogenic variants in the JAG1 gene are a primary cause of the multi-system disorder Alagille syndrome. Although variant detection rates are high for this disease, there is uncertainty associated with the classification of missense variants that leads to reduced diagnostic yield. Consequently, up to 85% of reported JAG1 missense variants have uncertain or conflicting classifications. We generated a library of 2,832 JAG1 nucleotide variants within exons 1-7, a region with a high number of reported missense variants, and designed a high-throughput assay to measure JAG1 membrane expression, a requirement for normal function. After calibration using a set of 175 known or predicted pathogenic and benign variants included within the variant library, 486 variants were characterized as functionally abnormal (n= 277 abnormal and n= 209 likely abnormal), of which 439 (90.3%) were missense. We identified divergent membrane expression occurring at specific residues, indicating that loss of the wild-type residue itself does not drive pathogenicity, a finding supported by structural modeling data and with broad implications for clinical variant classification both for Alagille syndrome and globally across other disease genes. Of 144 uncertain variants reported in patients undergoing clinical or research testing, 27 had functionally abnormal membrane expression, and inclusion of our data resulted in the reclassification of 26 to likely pathogenic. Functional evidence augments the classification of genomic variants, reducing uncertainty and improving diagnostics. Inclusion of this repository of functional evidence during JAG1 variant reclassification will significantly affect resolution of variant pathogenicity, making a critical impact on the molecular diagnosis of Alagille syndrome.

The Quaternary sequence of the Nahr el Kebir, NW Syria: An important repository for evidence of Palaeolithic occupation and landscape evolution in the eastern Mediterranean

The third largest river in Syria, the Nahr el Kebir has a well-preserved record of river-terrace deposits that have produced substantial Palaeolithic artefact assemblages both from within the terrace deposits and from the land surfaces above and around them. At the Mediterranean coastline, the fluvial gravels interdigitate with raised shoreline terrace deposits, providing an insight into the temporal and climatic relations of both of these important geomorphological and morphostratigraphical archives, as well as their relationship with each other. New research is reported here on the Pleistocene geology and geomorphology of the Nahr el Kebir and the associated Palaeolithic archaeology, the latter having been reinterpreted based on reassessment of museum collections arising from earlier detailed work. Field visits revealed an additional, hitherto unrecognized low-level river terrace, whereas one of the previously recognized Palaeolithic levels can be shown to coincide with slope deposits that armour hilltops rather than representing a genuine fluvial formation. The new understanding of these geomorphological and sedimentary archives supports ideas that this corner of the Mediterranean has experienced unusually rapid uplift during the recent Quaternary, as a result of which the local rivers, including the Kebir, have deepened their valleys rapidly. Consequently, only the recent part of the Quaternary is recorded in the Kebir system and the ages envisaged previously for the terrace deposits and the Palaeolithic artefact assemblages were considerable overestimates in many cases, a finding that has significance for their correlation with those from the wider region. Reassessment of the Palaeolithic archaeology suggests a settlement history initially dominated by groups using handaxes, alongside simple core working (0.5–0.3 Ma), followed by a major change with the appearance of Levallois core working alongside handaxes, marking the transition to the early Middle Palaeolithic.

The effects of public health and social measures (PHSM) implemented during the COVID‐19 pandemic: An overview of systematic reviews

AbstractIntroductionTo systematically review the effectiveness and unintended health and socioeconomic consequences of public health and social measures (PHSM) aimed at reducing the scale and risk of transmission of coronavirus disease 2019 (COVID‐19).MethodsThis review followed guidance about overviews of reviews in the Cochrane handbook for systematic reviews of interventions and used the Epistemonikos database's COVID‐19 Living Overview of Evidence repository as a primary search source. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR 2) checklist.ResultsA total of 94 reviews were included, of which eight (9%) had “moderate” to “high” confidence ratings on the AMSTAR 2. Of 16 reviews (17%) reporting applying the GRADE framework, none found high certainty evidence for any of our outcomes of interest. Across the 94 reviews, the most frequently examined PHSM were personal protection (n = 18, 19%). Within multicomponent interventions, so‐called “lockdown” was the most frequently examined component (n = 39, 41%). The most frequently reported outcome category was non‐COVID‐19‐related health outcomes (n = 58, 62%). Only five (5%) reviews reported on socioeconomic outcomes. Findings from the eight reviews with moderate or high confidence ratings on AMSTAR 2 are narratively summarized. There is low‐certainty evidence that multicomponent interventions may reduce the transmission of COVID‐19 in different settings. For active surveillance and response measures, low‐certainty evidence suggests that routine testing of residents and staff in long‐term care facilities may reduce the number of infections, hospitalizations, and deaths among residents. We found very low‐certainty evidence about the effectiveness of personal protection measures, travel‐related control measures, and environmental measures. Unintended consequences were rarely examined by those eight reviews.ConclusionWe found predominantly low‐ to very low‐certainty evidence regarding the effectiveness and unintended consequences of PHSM in controlling the risk and scale of COVID‐19 transmission. There is a need to improve the conduct and reporting of systematic reviews.

Genebe.net: Implementation and validation of an automatic ACMG variant pathogenicity criteria assignment.

We present GeneBe, an online platform streamlining the automated application of American College of Medical Genetics and Genomics (ACMG), Association for Molecular Pathology (AMP), and the College of American Pathologists (CAP) criteria for assessment of pathogenicity of genetic variants. GeneBe utilizes automated algorithms that evaluate 17 criteria from 28, closely aligning with current guidelines and leveraging data from diverse sources, including ClinVar. The user-friendly web interface enables manual refinement of assignments for specific criteria based on site-collected data. Our algorithm demonstrates a high correlation (r = 0.90) of assigned pathogenicity scores compared to expert assessments from the ClinGen Evidence Repository and substantial concordance with ClinVar verdict assignments (κ = 0.69). Comparative analysis with other published tools reveals that GeneBe performs similarly to VarSome while being superior over TAPES and InterVar. In contrast to some other tools, GeneBe's web implementation is tracker-free and third-party request-free, safeguarding user privacy. Additionally, GeneBe offers an Application Programming Interface (API) for enhanced flexibility and integration into existing workflows and is provided free of charge for research purposes. GeneBe is available at https://genebe.net.

Real-world analyses of mortality risk after androgen deprivation therapy initiation in Black vs. White patients with prostate cancer.

84 Background: 2 studies found significantly longer overall survival in Black vs. White patients with metastatic castration-resistant prostate cancer (PCa): a 2019 meta-analysis of 9 phase III trials and a 2020 registry study. Our real-world data study compared all-cause mortality risk for Black vs. White PCa patients. Compared to the prior studies, our study encompasses a broader scope and is not exclusive to men with castration-resistant PCa. Methods: Data were collected from the Decision Resources Group Real World Evidence repository, which links medical and prescription claims, and US Electronic Healthcare Records. The analysis set included PCa patients who received ≥1 androgen deprivation therapy (ADT) injection between 1991-2020. Cox regression was used to compare all-cause mortality rates between White and Black patients. Multivariable regression model accounted for the following variables: baseline metastasis, BMI, oncology vs. urology setting, antagonist vs. agonist, personal major adverse cardiovascular event (MACE) history, tobacco history, baseline PSA (>4 vs. ≤4 ng/mL), race (White vs. Black), statin use, increasing age per year, ethnicity (non-Hispanic vs. Hispanic), increasing ADT exposure per year, diabetes, hypertension, and family MACE history. Results: 44,439 patients were included for the all-patient analyses. 34,762 patients were included in the Black vs White analyses: 5,817 and 28,945 were Black and White, respectively. Overall, mortality risk was 2.6% and 17% at 1 and 4 years after ADT initiation, respectively. Mortality risk after ADT initiation was 1.6% and 2.6% at 1 year and 11.7% and 18.1% at 4 years for Black and White patients, respectively. Both unadjusted (HR=1.66, 95% CI 1.53-1.80, p<0.05) and adjusted (HR=1.24, 95% CI 1.01-1.52, p<0.05) mortality risks were higher for White vs. Black patients. Conclusions: All-cause mortality incidence was higher in White vs. Black patients. Adding to the body of evidence, our research also reveals that Black race is associated with a protective effect on survival for all-cause mortality in men undergoing ADT. Potential hypotheses for higher mortality in White vs. Black patients include survival bias to MACE (i.e., Black patients may have died from PCa before having MACE), survival bias to be diagnosed with PCa (i.e., Black patients may have higher rate of CV death and kidney failure prior to PCa diagnosis), and protective effects of higher BMI in Black patients against cancer cachexia. The large size (~45,000 patients from a database with >300 million patients), long follow-up (10 years for some patients), recent clinical experience (99% from 2010-2020), and diversity of the dataset give weight to the results being an accurate representation of current clinical experience. Future studies should confirm our findings that White PCa patients have higher mortality risk and investigate the above hypotheses.

Patient Demographics and Major Adverse Cardiovascular Events after Androgen Deprivation Therapy for Prostate Cancer.

The association between patient demographics and CV events after ADT using real-world data was evaluated. In addition to encompassing >30 times more patients than all previous MACE studies, this is the first study, to the best of our knowledge, to include a comprehensive listing of many demographic factors from one large, recent US dataset over a long period of time. The retrospective analysis of data in the Decision Resources Group (now Clarivate) Real World Evidence repository, representing >300M US patients from 1991 to 2020 across all US regions, was performed. Patients with PCa receiving ≥1 ADT injection were included. MACE risk after ADT initiation was evaluated for demographic and potential PCa-related risk factors. Kaplan-Meier survival curves were constructed, and Cox regression was used to evaluate the association between MACE risk and demographic/PCa-related risk factors. Overall, MACE risk was slightly lower in the first year after ADT initiation (3.9%) vs. years 2-4 (∼5.2%). In a multivariate Cox model, MACE risk after ADT initiation was significantly higher for older vs. younger patients (adjusted HR per increasing year = 1.08, 95% CI: 1.07-1.09), men with a history of MACE vs. without (HR = 2.22, 95% CI: 1.72-2.88), men with very low BMI vs. normal or high BMI (HR for decreasing BMI per kg/m2 = 1.02, 95% CI: 1.01-1.03), White vs. Black patients (HR = 1.30, 95% CI: 1.08-1.55), and patients who did not use statins vs. those who did (HR = 1.13, 95% CI: 1.00-1.27). Of the PCa-related risk factors, MACE risk after ADT initiation was significantly higher for oncology vs. urology treatment setting (HR = 2.47, 95% CI: 2.12-2.88), patients with baseline metastasis vs. those without (HR = 2.30, 95% CI: 1.72-3.07), and patients treated with antagonists vs. agonists (HR = 1.62, 95% CI: 1.25-2.10). Demographic factors are important contributors to increased MACE risk for men with PCa on ADT. Clinicians should monitor risk factors and modify if possible.

Between science and art

Abstract Professor Irene Manton (1904–1988) was in the vanguard of technical advances in botany through the use of electron microscopy. As well as new techniques and discoveries communicated through a considerable body of scientific publications, she left behind a collection of antiquities spanning a broad range of cultures and dates. Through these objects, Manton investigated intellectual problems in the history of science and communicated her findings with a highly original and idiosyncratic approach. At first sight a disparate group of unprovenanced antiquities, through the lens of Manton’s archives this collection can be understood as a rich repository of material evidence. This critical examination of Manton’s collecting practices and the uses she made of her ancient objects provides new evidence for the variety of approaches to collecting and interpreting antiquities, spanning disciplinary boundaries, over the course of the twentieth century.

Cardiovascular Risk in Prostate Cancer Patients Using Luteinizing Hormone-Releasing Hormone Agonists or a Gonadotropin-Releasing Hormone Antagonist.

Luteinizing hormone-releasing hormone (LHRH) agonists are believed to have higher cardiovascular risk relative to gonadotropin-releasing hormone (GnRH) antagonists. However, previous studies have not consistently demonstrated this. We used real-world clinical practice data to evaluate differences in major adverse cardiovascular events (MACE) risk between LHRH agonists compared to a GnRH antagonist following androgen deprivation therapy (ADT) initiation. We performed a retrospective analysis of data in the Decision Resources Group (now Clarivate) Real World Evidence repository, which represents >300 million US patients from 1991 to 2020 across all US regions. Patients with prostate cancer who received at least 1 injection of ADT were included. The risks of MACE and all-cause mortality as independent endpoints were evaluated, Kaplan-Meier curves were constructed, and associations between MACE and all available confounding risk factors were evaluated by Cox regression analysis using Statistical Package for the Social Sciences. A total of 45,059 men with prostate cancer treated with ADT were analyzed. Overall, the risks of MACE and all-cause mortality were slightly lower in the first year after ADT initiation compared to subsequent years. MACE risk was higher for the GnRH antagonist compared to LHRH agonists (HR=1.62; 95% CI 1.21-2.18, P = .001). The risk of all-cause mortality was also higher for the GnRH antagonist vs LHRH agonists (HR=1.87; 95% CI 1.39-2.51, P < .001). The adjusted incidence of MACE was higher for men treated with the GnRH antagonist compared to the LHRH agonists. The demographic and risk factors with the greatest impact on MACE risk were higher age, baseline metastasis, oncology (vs urology) setting, personal MACE history, antagonist (vs agonist), tobacco history, White (vs Black) race, and lower BMI.

Causal mapping for evaluators

Evaluators are interested in capturing how things causally influence one another. They are also interested in capturing how stakeholders think things causally influence one another. Causal mapping – the collection, coding and visualisation of interconnected causal claims – has been used widely for several decades across many disciplines for this purpose. It makes the provenance or source of such claims explicit and provides tools for gathering and dealing with this kind of data and for managing its Janus-like double-life: on the one hand, providing information about what people believe causes what, and on the other hand, preparing this information for possible evaluative judgements about what causes what. Specific reference to causal mapping in the evaluation literature is sparse, which we aim to redress here. In particular, the authors address the Janus dilemma by suggesting that causal maps can be understood neither as models of beliefs about causal pathways nor as models of causal pathways per se but as repositories of evidence for those pathways.

Variant Classification for Pompe disease; ACMG/AMP specifications from the ClinGen Lysosomal Diseases Variant Curation Expert Panel

Accurate determination of the clinical significance of genetic variants is critical to the integration of genomics in medicine. To facilitate this process, the NIH-funded Clinical Genome Resource (ClinGen) has assembled Variant Curation Expert Panels (VCEPs), groups of experts and biocurators which provide gene- and disease- specifications to the American College of Medical Genetics & Genomics and Association for Molecular Pathology's (ACMG/AMP) variation classification guidelines. With the goal of classifying the clinical significance of GAA variants in Pompe disease (Glycogen storage disease, type II), the ClinGen Lysosomal Diseases (LD) VCEP has specified the ACMG/AMP criteria for GAA. Variant classification can play an important role in confirming the diagnosis of Pompe disease as well as in the identification of carriers. Furthermore, since the inclusion of Pompe disease on the Recommended Uniform Screening Panel (RUSP) for newborns in the USA in 2015, the addition of molecular genetic testing has become an important component in the interpretation of newborn screening results, particularly for asymptomatic individuals. To date, the LD VCEP has submitted classifications and supporting data on 243 GAA variants to public databases, specifically ClinVar and the ClinGen Evidence Repository. Here, we describe the ACMG/AMP criteria specification process for GAA, an update of the GAA-specific variant classification guidelines, and comparison of the ClinGen LD VCEP's GAA variant classifications with variant classifications submitted to ClinVar. The LD VCEP has added to the publicly available knowledge on the pathogenicity of variants in GAA by increasing the number of expert-curated GAA variants present in ClinVar, and aids in resolving conflicting classifications and variants of uncertain clinical significance.

Toward a Value-Based Therapy Recommendation Model.

Patient value is an important factor in clinical decision making, but conventionally, it is not incorporated in the decision processes. Clinical decision making has some clinical guidelines as a reference. There are very few value-based clinical guidelines, but knowledge about how values affect decision making is mentioned in some scattered studies in the literature. We use a literature review method to extract evidence and integrate it as part of the decision-making model. In this paper, a value-based therapy recommendation comprehensive model is proposed. A literature analysis is conducted to collect value-based evidence. The patients' values are defined and classified with fine granularity. Categorized values and candidate therapies are used in combination as filtering keywords to build this literature database. The literature analysis method generates a literature database used as a source of arguments for influencing decision making based on values. Then, a formalism model is put forward to integrate the value-based evidence with clinical evidence, and the literature databases and clinical guidelines are collected and analyzed to populate the evidence repository. During the decision-making processes, the evidence repository is utilized to match patients' clinical information and values. Decision-makers can dynamically adjust the relative importance of the two pieces of evidence to obtain a treatment plan that is more suitable for the patient. A prototype system was implemented using a case study for breast cancer and validated for feasibility and effectiveness through controlled experiments.

Exploring Large Digital Bodies for the Study of Human Behavior.

Internet access has become a fundamental component of contemporary society, with major impacts in many areas that offer opportunities for new research insights. The search and deposition of information in digital media form large sets of data known as digital corpora, which can be used to generate structured data, representing repositories of knowledge and evidence of human culture. This information offers opportunities for scientific investigations that contribute to the understanding of human behavior on a large scale, reaching human populations/individuals that would normally be difficult to access. These tools can help access social and cultural varieties worldwide. In this article, we briefly review the potential of these corpora in the study of human behavior. Therefore, we propose Culturomics of Human Behavior as an approach to understand, explain, and predict human behavior using digital corpora.

Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field.

Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field.

Tracing Absence

Zār is the complex of healing rituals connected to belief in spirit winds that afflict the body with physical and psychic pain. Linked, by anthropologists, to the movement of enslaved Africans from East Africa to Southwest Asia, zār is sometimes considered a trace of Indian Ocean slavery—a history for which archival evidence is scattered, imprecise, at times hardly available. Zār thus calls into being an alternative archive, one predicated on kinesis, self-disintegration, and the active use of the senses. (Rapture through scent is integral to the zār ceremony and is why those associated with the ritual are sometimes called ibn or bint bukhūr, “born into incense”).1The archive, as a repository of information, documentation, and evidence, is the dominant mode through which scholars produce knowledge about the past. What does it mean to consider a practice like zār a historical trace? What does it mean to approach healing rituals through the lens of the archive? In my writings on fascination with zār in Iranian cinema, I have been interested in how the phenomenon of zār defies anthropological, historical, and even political desire: the desire to record it, contextualize it, to capture its referent, to formulate its proper meaning. For inasmuch as zār registers a history of enslavement that has been blotted out of traditional, nation-based historiography, zār’s resistances to recording and inscription seem just as significant as its empirical, anthropological “content.” Zār’s resistances reflect the intransigent facticity—the ambivalent structure of our facts—regarding African enslavement in the Indian Ocean and point us toward models of historical memory that are more challenging than familiar oppositions like commemoration and denial, truth and nontruth.Forgetting, absence, loss, dissolution, emptiness. These are different ways one might describe what I take to be the most significant aspect of the zār ritual: loosely translatable as an entry into trance. Every component of the ceremony (the loud, thumping drums, the strong burning gums, the inscrutable cantations) directs the zārī toward her own self-dissolution. Participants sometimes describe a feeling of being emptied, of amnesia. Incomprehensible in their “speech and acts,” they are “no longer themselves.”2 At the climax of zār, consciousness lapses. A white cloth is thrown upon this disappearing person, protecting the dissolving self from the gaze of others. The cloth shield is tautological. Something of zār—its most curious and impenetrable facet—resists empirical observation. A discontinuity in the subject troubles the continuity of the observer who wants-to-know.In film and media studies, the “archival turn” of the nineteenth century has been compellingly linked to theories of technology.3 The proliferation of archives, as well as the proliferation of the archive’s “processes of subjectification,” can be read alongside an increasing precision of registration, the technoscientific evolution of which film is one of modernity’s most exemplary achievements.4 Both the growth of archives and the orthographic rectitude of audiovisual recording supports and supplements modernity’s increasing demand for and obsession with facts, facticity, and objectivity. This is as true in the human sciences as in the natural sciences, as well as in everything that falls between, including modern historiography, which is modeled upon, and views itself—despite its own, sometimes critical, caveats—as a science of the past.Film is a technology with the potential to supply us with reality, to attest to the being-there of the having-been-there.5 (This is why continuity filming has been equally central to the production of scientific knowledge, as to the political realism of counter-cinema aesthetics.6) But in zār, the certitude of the having-been-there flickers. Trance is a “being away,” a going absent; yghīb; a suspension.7 If zār is a trace of slavery, filmed zār is a trace of a trace. But attenuation, erosion of reality, is less the cause for the disappointments of zār’s cinematic recordings than the protrusion of an absence that undermines the goals of epistemological orientation. In place of information, what the phenomenology of zār offers is an absence at the heart of experience.How does one reconcile the demands of knowledge accumulation (the drive for facticity) with an absence that is not merely incurable but that is itself the cure? The force of this question continues to shape the way I think about African enslavement in the Indian Ocean. Which is to say, there is a power internal to this absence that stalls, diverts, and transforms how we might produce knowledge about it.

The UN General Assembly as a Security Actor: Appraising the Investigative Mechanism for Syria

This article analyses the role of the United Nations General Assembly (UNGA) as a security actor. With the creation of the ‘International, Impartial and Independent Mechanism to Assist in the Investigation and Prosecution of Persons Responsible for the Most Serious Crimes under International Law Committed in the Syrian Arab Republic since March 2011’ (IIIM), through UNGA Resolution 71/ 2481 in 2016, the General Assembly creatively used its powers to strengthen international criminal justice. Although investigative or fact-finding missions itself are nothing new to the UN system, Resolution 71/ 248 is qualitatively different to any other mission before it. The IIIM was established without Syrian consent, which is a historic first for the General Assembly. It is also the first time that such a body is tasked with investigations that fulfil prosecution standards, that serves as an evidence repository as well as a connecting hub between different justice actors. The UN General Assembly filled a void where the UN Security Council found itself in a stalemate over Syria. The IIIM has since served as a blueprint for a new generation of investigative mechanisms that emerged in the UN system. Looking beyond the appraisal of the IIIM, the article argues that the UN General Assembly practice in maintaining peace and security has significantly evolved over time. The early UN General Assembly practice through Uniting for Peace allowed it to assert its proactive role in parallel to the Security Council, yet it failed in its claim of authority to recommend forceful, collective measures. The practice subsequently evolved towards the diverse use of non-forceful measures, of which the IIIM provides a recent example. Creative boundary pushing in the UNGA through non-forcible measures will hopefully contribute to peace and security beyond war.

Genetic epidemiology of human neutrophil antigen variants suggests significant global variability.

Human neutrophil antigens possess significant clinical implications especially in the fields of transfusion and transplantation medicine. Efforts to estimate the prevalence of genetic variations underpinning the antigenic expression are emerging. However, there lacks a precise capture of the global frequency profiles. Our article emphasizes the potential utility of maintaining an organized online repository of evidence on neutrophil antigen-associated genetic variants from published literature and reports. This, in our opinion, is an emerging area and would significantly benefit from the awareness and understanding of population-level diversities.

75-LB: Use of Continuous Glucose Monitoring (CGM) and Its Association with Economic Outcomes in the Real-World Setting

Background: CGM is increasingly used as tool in the management of diabetes, supporting improvements in glycemic control and quality of life. Objectives: The aim of this retrospective study was to evaluate the association between CGM use and healthcare resource utilization (HCRU) and cost. Methods: Using medical claims from Clarivate™ Real-World Evidence repository and CGM data from Glooko®, US people with diabetes (≥18 years) (PwD) and on insulin were assigned to mutually exclusive cohorts based on CGM usage status and matched in terms of age, gender, and diabetes type. First CGM use (index) was required to occur within January 1, 2015 - July 30, 2019. HCRU and costs were assessed 12 months post-index. Results: After matching, 3,918 PwD were assigned into each cohort. Significantly more CGM vs. non CGM users (p&amp;lt;0.0001) were on insulin pump, treated with bolus insulin only, and commercially insured. Mean pre-index Charlson Comorbidity Index (CCI) scores were lower (p&amp;lt;0.00001) and most diabetes-related comorbidities were less prevalent (p&amp;lt;0.01) in the CGM vs. non-CGM cohort. After adjusting for demographics, diabetes type, CCI, and insurance, the use of CGM vs. no CGM was associated with a 27-70% and 32-76% reduction in HCRU and costs (p&amp;lt;0.0001) , respectively. Conclusion: The use of CGM (vs. no CGM use) was associated with lower HCRU and costs, which may result in lower healthcare burden for PwD and payers. Disclosure M. Perez-nieves: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. E. R. Hankosky: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. L. Fan: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. F. Gelsey: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. E. L. Eby: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. T. J. Sims: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. E. Umeh: None. R. Juneja: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. Funding Eli Lilly and Company

COVID-19 Living Overview of Evidence repository is highly comprehensive and can be used as a single source for COVID-19 studies

Background and ObjectiveThe coronavirus disease 2019 Living OVerview of Evidence (COVID-19 L·OVE) is a public repository and classification platform for COVID-19 articles. The repository contains more than 430,000 articles as of September 20, 2021 and intends to provide a one-stop shop for COVID-19 evidence. Considering that systematic reviews conduct high-quality searches, this study assesses the comprehensiveness and currency of the repository against the total number of studies in a representative sample of COVID-19 systematic reviews. MethodsOur sample was generated from all the studies included in the systematic reviews of COVID-19 published during April 2021. We estimated the comprehensiveness of COVID-19 L·OVE repository by determining how many of the individual studies in the sample were included in the COVID-19 L·OVE repository. We estimated the currency as the percentage of studies that was available in the COVID-19 L·OVE repository at the time the systematic reviews conducted their own search. ResultsWe identified 83 eligible systematic reviews that included 2,132 studies. COVID-19 L·OVE had an overall comprehensiveness of 99.67% (2,125/2,132). The overall currency of the repository, that is, the proportion of articles that would have been obtained if the search of the reviews was conducted in COVID-19 L·OVE instead of searching the original sources, was 96.48% (2,057/2,132). Both the comprehensiveness and the currency were 100% for randomized trials (82/82). ConclusionThe COVID-19 L·OVE repository is highly comprehensive and current. Using this repository instead of traditional manual searches in multiple databases can save a great amount of work to people conducting systematic reviews and would improve the comprehensiveness and timeliness of evidence syntheses. This tool is particularly important for supporting living evidence synthesis processes.

BiSHM: Evidence detection and preservation model for cloud forensics

Abstract The cloud market is growing every day. So are cloud crimes. To investigate crimes that happen in a cloud environment, an investigation is carried out adhering to the court of law. Forensics investigations require evidence from the cloud. Evidence acquisition in the cloud requires formidable efforts because of physical inaccessibility and the lack of cloud forensics tools. Time is very crucial in any forensic investigation. If the evidence is preserved before the cloud forensic investigation, it can give the investigators a head start. To identify and preserve such potential evidence in the cloud, we propose a system with an artificial intelligence (AI)-based agent, equipped for binary classification that monitors and profiles the virtual machine (VM) from hypervisor level activities. The proposed system classifies and preserves evidence data generated in the cloud. The evidence repository module of the system uses a novel blockchain model approach to maintain the data provenance. The proposed system works at the hypervisor level, which makes it robust for anti-forensics techniques in the cloud. The proposed system identifies potential evidence reducing the effective storage space requirement of the evidence repository. Data provenance incorporated in the proposed system reduces trust dependencies on the cloud service provider (CSP).