Incidence Of Crises Research Articles

US Clinical Practice Experience with Eculizumab in Myasthenia Gravis: Acute Clinical Events and Healthcare Resource Utilization.

The terminal complement inhibitor eculizumab is approved in the USA for the treatment of patients with acetylcholine receptor antibody-positive generalized myasthenia gravis (MG). The ELEVATE study aimed to examine clinical-practice outcome data on eculizumab effectiveness in US adults with MG (generalized or ocular). This paper reports the findings on MG exacerbations and crises and associated healthcare resource utilization, and the use of rescue therapy. A retrospective chart review was conducted of US adults with MG who initiated eculizumab. Outcomes assessed for up to 2 years before and after eculizumab initiation included percentages and rates per patient per year (PPPY) of exacerbations and crises (the latter defined as intubation/impending intubation), healthcare resource utilization, and rescue therapy administration. A total of 119 patients diagnosed with MG were enrolled in the study; 92 patients had ≥3 months of data both before and during eculizumab therapy and were included in the analyses. The mean rate of MG exacerbations decreased from 0.385 PPPY before eculizumab initiation to 0.152 PPPY during eculizumab treatment (p = 0.0034); the mean rate of MG crises decreased from 0.411 to 0.056 PPPY (p = 0.0018). Rates of healthcare resource utilization and rescue therapy use also decreased significantly during eculizumab treatment. This retrospective chart review analysis provides evidence for a beneficial impact of eculizumab treatment on the incidence of MG exacerbations and crises and associated healthcare resource utilization in clinical practice, and on rescue therapy use. These data further support the therapeutic benefits of eculizumab in patients with MG.

7061 Incidence of Adrenal Crisis In Congenital Adrenal Hyperplasia (CAH) Patients During A Prospective Monitored Long-Term Study Of Modified-Release Hydrocortisone (MRHC) Capsules, (Efmody)

Abstract Disclosure: R.J. Ross: Consulting Fee; Self; Diurnal. D.P. Merke: Research Investigator; Self; Diurnal. A. Mallappa: Research Investigator; Self; Diurnal. W. Arlt: Research Investigator; Self; Diurnal. A. Brac de la Perriere: Research Investigator; Self; Diurnal. A.L. Hirschberg: Research Investigator; Self; Diurnal. J.D. Newell-Price: Research Investigator; Self; Diurnal. A. Prete: Research Investigator; Self; Diurnal. A. Rees: Research Investigator; Self; Diurnal. N. Reisch: Research Investigator; Self; Diurnal. M. Quinkler: Research Investigator; Self; Diurnal. P.A. Touraine: Research Investigator; Self; Diurnal. K. Maltby: Employee; Self; Diurnal. J. Quirke: Employee; Self; Diurnal. N. Aslam: Employee; Self; Diurnal. H. Coope: Employee; Self; Diurnal. J. Porter: Employee; Self; Diurnal. Background: Adrenal crisis is the leading cause of excess mortality in patients with CAH[1]. Retrospective studies report an adrenal crisis incidence of 5-10/100 patient years (PY), with mortality 0.5/100 PY2. Modified-release hydrocortisone (MRHC) capsules, (Efmody), replicate cortisol diurnal rhythm and improve androgen control in CAH compared to standard glucocorticoid therapy2. Here, we report the incidence of adrenal crisis in CAH patients from a prospective study of MRHC in CAH patients. Methods: Patients completing MRHC Ph2 and Ph3 studies were eligible to enter a single-arm, open-label extension study. Study visits occurred at baseline, weeks 4, 12, 24 and 6-monthly thereafter. The primary endpoint was the safety of MRHC over time. Adrenal crisis was defined according to Allolio 20153. MRHC doses were adjusted on the basis of an adrenal insufficiency checklist, and measurement of androstenedione (A4) and 17-hydroxyprogesterone (17-OHP) at 9am and 1pm. Results: 91 patients entered the study, mean age 37 years, 68% female, 32% male. 22 discontinued; 11 at patient request, 5 due to pregnancy, 2 undergoing fertility treatment, 2 at physician/sponsor request, 1 due to an AE (carpal tunnel syndrome), and 1 due to death (myocardial infarction). Median treatment duration was 1500 days, range 0.2 to 5.8 years. Median MRHC dose at study entry was 30mg/day, reducing to 20mg/day from 24-weeks until end of study. Signs and symptoms of adrenal insufficiency due to under-treatment were reported for 41 (45.1%) participants, most frequently fatigue which was reported at some point by 41.8% of all participants. Signs and symptoms of overtreatment were reported for 25 (27.5%) participants, most frequently sudden weight gain which was reported at some point by 16.5% of all participants. Signs and symptoms of both over- and undertreatment occurred predominantly during the first 24 weeks. The study encompassed 357 participant years, and 18 adverse events considered indicative of adrenal crisis occurred in 7 participants, giving an incidence rate of 5.043 adrenal crises / 100 PY. Conclusions: Data from this longest prospectively monitored study in CAH suggest that the incidence of adrenal crisis on MRHC is at the low end of that reported in retrospective studies and the safety profile of MRHC is otherwise similar to immediate release hydrocortisone.

7966 Long-Term Safety and Efficacy of a Hydrocortisone Oral Granules in a Young Child with Congenital Adrenal Hypertrophy

Abstract Disclosure: M. Bertossi: None. C. Lowe: None. Q.L. Van Meter: Consulting Fee; Self; Eton Pharmaceuticals. Speaker; Self; Eton Pharmaceuticals. Introduction: Congenital adrenal hyperplasia (CAH) is the most common cause of pediatric adrenal insufficiency. Children diagnosed with CAH need exogenous glucocorticoid therapy throughout their lifetime. Because low dose hydrocortisone (HC) tablets are not available, patients and their caregivers must either split/crush hydrocortisone tablets or rely on HC that has been compounded from adult medications. In late 2020, a pediatric specific HC formulation, an oral granule, became available with doses as low as 0.5 mg. There are minimal data concerning the long-term use of this novel HC formulation. Subject and Method: This case study is a girl (DOB 11/2016) with CAH who has been administered the HC oral granule formulation for over 3 years. Results: The subject is a 7-year-old female who was diagnosed at birth with CAH. At an outside institution, she administered 6.25 mg HC, divided into three doses of 2.5 mg in the morning, 1.25 mg in the afternoon, and 2.5 mg in the evening (2.5/1.25/2.5; 9 mg/m2). She was also administered 0.15 mg fludrocortisone qd. Her dose was increased to a total dose of 7.5 mg, administered 2.5 mg three times/day (10 mg/m2) because of a high 17-OHP concentration, 1048 mg/dL. Other hormone levels were unremarkable. Her 17-OHP levels increased to 2662 mg/dL after 3 months of the increased dose. Because of the development of Cushing’s symptoms, she was switched to the 7.0 mg HC granules (2.5/2.0/2.5; 9.5 mg/m2 total dose). After the switch to the HC granules, her 17-OHP levels was 293 ng/dL. Because of rising 17-OHP levels, her dose needed to be increased twice over the past 2 yrs. Her current dose is 12 mg HC granules (4/4/4; 11 mg/m2 total dose), and her three most recent 17-OHP levels were 73, 101, and 89 ng/dL, respectively. She is also taking 0.2 mg fludrocortisone po, q am. Throughout HC granule therapy, she had no incidence of adrenal crisis. Her most recent calculated bone age was 8 yr 10 mo, with her chronological age was 6 yr, 8 mo with no evidence of virilization. Growth curves suggest that she is neither under- nor over-dosed on her HC therapy. Conclusion: This case may be the longest, continuous administration of the novel HC granules in US for a child with CAH. The results show the potential to better titrate HC dosing, especially with the narrow therapeutic window of HC in children with CAH. Her daily dose was adjusted by titrating in small increments to result in good outcomes, such as better hormonal control, the lack of virilization and continuous growth. Further evaluations of the long-term use of HC granules are needed to occur to establish the long-term risks and benefits of this novel HC granule. Presentation: 6/3/2024

Carcinoid crisis in Lutetium-177-Dotatate therapy of neuroendocrine tumors: an overview of pathophysiology, risk factors, recognition, and treatment

PurposeLutetium-177-Dotatate (Lutathera®) is a combined radionuclide-peptide that is FDA-approved for the treatment of well-differentiated, somatostatin receptor-positive, gastroenteropancreatic neuroendocrine tumors. Carcinoid crisis is a rare, but potentially life-threatening risk of this radiopharmaceutical, of which prompt recognition and treatment is essential to reducing morbidity. This manuscript provides an overview of the topic to promote awareness of this adverse event, with emphasis on early recognition and management. In addition, we present our institution’s experience with Lutetium-177-Dotatate-associated complications across a five-year period.MethodsA literature review of lutetium-177-dotatate therapy and its potential implication of carcinoid crisis was performed. Additionally, a review of our institution’s experience is presented.ResultsThe incidence of carcinoid crisis induced by Lutetium-177-Dotatate therapy is estimated to range between 1 and 2% of treatment recipients. Those who have tumors located within the midgut, higher tumor burden, and the presence of metastasis have an increased risk of developing carcinoid crisis, among other risk factors. Carcinoid crisis is most often encountered within 12–48 h of receiving the first treatment dose, with the most common symptoms being nausea/vomiting, flushing, and diarrhea.ConclusionCarcinoid crisis is a rare but potentially life-threatening complication of Lutetium-177-Dotatate therapy. Knowledge of risk factors and prompt recognition of symptoms is essential to successful treatment, with early initiation of intravenous octreotide serving a critical step in reducing morbidity of this adverse event.

Cardiovascular risks of Asian patients on androgen-receptor-targeted agents for prostate cancer: a systematic review and meta-analysis

BackgroundProstate cancer is now one of the most prevalent cancers in men in Asia. As the average life expectancy of Asian males with prostate cancer increases with the availability of treatment options, the possible risk of cardiac-related adverse effects arising from androgen-receptor-targeted agents (ARTAs) may be increased due to the greater exposure. We aim to perform a meta-analysis on the incidence of cardiac-related adverse events in Asian patients with prostate cancer treated with ARTAs. Materials and methodsDatabases were thoroughly searched for relevant articles. The Patient Intervention Comparison Outcome Study type model was used to frame our clinical question, and 2 independent authors went through several rounds of screening to select the final included studies. A meta-analysis was conducted using the Cochran–Mantel–Haenszel method. Quality assessment was carried out with the Cochrane risk-of-bias tool RoB 2. ResultsSeven randomized controlled trials were included for the final meta-analysis. Use of ARTA in Asian men did not show any significant increase in the total number of cardiac-related adverse events (risk ratio [RR]: 1.66 [0.84–3.26], p = 0.14). However, there was increase in incidence of hypertension (RR: 2.30 [1.41–3.73], p = 0.0008) and hypertension crises (RR: 16.87 [2.13–133.34], p = 0.007). A subgroup analysis of the type of ARTA used showed enzalutamide having the highest risk of hypertension (RR: 5.86 [2.10–16.38], p = 0.0008). Conclusion:Although ARTAs did not show any significant increase in incidence of cardiac-related adverse events, there is an increased risk of hypertension especially with the use of enzalutamide. With this knowledge, closer blood pressure monitoring is needed for patients started on ARTA, especially enzalutamide.

Climatic oscillations and sovereign debt crises

I present the case for the relationship between climatic oscillations and sovereign debt crisis between 1970 and 2018. I find strong empirical evidence of a relationship between the Antarctic Oscillation, the Madden-Julian Oscillation, the North Atlantic Oscillation, the Pacific North American Pattern, and the Pacific Decadal Oscillation and the incidence of Sovereign Debt Crises. Additionally, the combination of the El Nino Oscillation with the Indian Dipole, the North Atlantic Oscillation and the Pacific North American Pattern are associated with droughts that contributed to Sovereign Debt Crises.

Prophylactic exchange transfusion in sickle cell disease pregnancy: a TAPS2 feasibility randomized controlled trial

AbstractSerial prophylactic exchange blood transfusion (SPEBT) is increasingly used in sickle cell disease (SCD) pregnancy, despite a lack of robust evidence. The Transfusion Antenatally in Pregnant Women with Sickle Cell Disease (TAPS2) study assessed the feasibility and acceptability of conducting a definitive randomized controlled trial of SPEBT (intervention) vs standard care (control) in this population. Women aged ≥18 years with SCD, between 6+0 and 18+6 weeks of singleton gestation, were randomized 1:1 every 6 -10 weeks throughout pregnancy in 7 hospitals in England. The main outcomes were recruitment rate (primary outcome), acceptability, and retention. Secondary outcomes were safety and maternal/infant outcomes. In total, 194 women were screened over 42 months (extended because of the pandemic), 88 were eligible, and 35 (39.8%) consented to participate; 18 participants were randomized to intervention, and 17 to control. Follow-up data were collected on all participants. Twelve patients in the intervention group received at least 1 SPEBT, of these, 11 received ≥3. The remaining patient was withdrawn from SPEBT because of transfusion reaction. Sixteen control participants required at least 1 transfusion. There were no statistically significant differences in maternal, infant, and postnatal outcomes. A trend toward a lower incidence of vaso-occlusive crisis, preterm delivery, and improved birthweight was observed in the intervention. The study achieved satisfactory recruitment and retention, confirming its acceptability to participants. TAPS2 demonstrates that it is feasible to perform a definitive international trial of SPEBT in SCD pregnancy. These trials were registered at www.ClinicalTrials.gov as #NCT03975894 and International Standard Randomized Controlled Trial Number (www.isrctn.com; #ISRCTN52684446).

D3 Interim results for Myasthenia Gravis-resource utilization, epidemiology, survival & treatment patterns (MG-REST) study in Ontario, Canada

Background: Reliable real-world data on the burden of MG is needed to inform Canadian clinical and policy decisions in the era of new MG therapeutics, including FcRn inhibitors. Given the lack of recent Canadian data on MG disease burden, the MG-REST Study aims to estimate the clinical burden of MG in Ontario. Methods: Ontario administrative data from ICES were utilized for a retrospective population-based cohort study of adults with MG identified through a validated algorithm (April 2013-March 2019) and followed for up to seven years (March 2020) to determine myasthenic crisis characteristics and overall survival (OS). Results: The MG cohort (n=2,601) had an average age of 65.7 years and 53.3% were males. Incidence of first myasthenic crisis was 9%, with 87% of events occurring at/after diagnosis. MG OS was 89%, 85% and 75% at 1-year, 2-years and 5-years, respectively, while OS after first crisis was 60%, 52%, and 39% for the same years. Conclusions: Despite the availability of conventional therapies throughout the study, MG crisis remains a serious, common complication of MG, with decreased survival at 1-year post-crisis (29% difference versus 1-year OS following MG diagnosis). Study highlights MG burden and unmet need for new effective therapies for MG treatment.

Partnership to tackle MH crisis for people with disabilities launched

The United Health Foundation, the philanthropic foundation of the UnitedHealth Group has awarded the nonprofit disability rights advocacy organization, The Arc of the United States, a three‐year, $2.5 million grant to improve mental health care for people with intellectual and developmental disabilities (IDD), a news release by The Arc stated. Up to 40% of people with IDD have co‐occurring mental health conditions, and this critical funding will help address their unmet mental health needs. Currently, only 1 in 10 children and adolescents with IDD and mental health disorders receive specialized services. These statistics highlight the need for training and awareness to ensure providers and caregivers are equipped to support the mental health needs of people with disabilities. This includes expanding access to quality mental health care services, improving coordination between disability and health systems, training over 2,000 providers and caregivers to recognize mental health needs in people with IDD, and launching public awareness campaigns to counteract stigma and misconceptions. A key component of the grant is partnering with the National Council for Mental Wellbeing to adapt its evidence‐based Mental Health First Aid program with information on IDD. Over three years, the United Health Foundation grant will help train caregivers, health care professionals, first responders, educators and family members to recognize the mental health needs of people with IDD and decrease the number of mental health crisis incidents experienced by this population.

Incidence and features of adrenal crisis in patients with Addison's Disease

Incidence and features of adrenal crisis in patients with Addison's Disease

Incidence of adrenal crisis in Congenital Adrenal Hyperplasia (CAH) patients during a prospective monitored long-term study of modified-release hydrocortisone (MRHC) capsules, (Efmody)

Incidence of adrenal crisis in Congenital Adrenal Hyperplasia (CAH) patients during a prospective monitored long-term study of modified-release hydrocortisone (MRHC) capsules, (Efmody)

Enhancing outcome prediction by applying the 2019 WHO DM classification to adults with hyperglycemic crises: A single-center cohort in Thailand

Background and aimsHyperglycemic crisis is a metabolic catastrophe which can occur in any type of diabetes. In 2019, the World Health Organization (WHO) revised the classification of diabetes mellitus (DM) and established two new hybrid forms, latent autoimmune diabetes in adults (LADA) and ketosis-prone type 2 diabetes (T2D). This study aimed to determine clinical outcomes after a hyperglycemic crisis event in people with diabetes classified subtypes by 2019 WHO DM classification. MethodsA five-year (2015–2019) retrospective study of adult patients admitted with hyperglycemic crises was conducted. Types of diabetes were recategorized based on the 2019 WHO DM classification. Clinical characteristics, in-admission treatment and complications, long-term follow-up outcomes, and mortality were collected, analyzed, and compared. ResultsA total of 185 admissions occurred in 136 patients. The mean age was 50.6 ± 18.4 years (49.3 % men). The annual average incidence of hyperglycemic crises was 5.2 events/1000 persons. The proportion of type 1 diabetes, T2D, LADA, ketosis-prone T2D, and pancreatic DM were 15.4 %, 69.1 %, 2.2 %, 11 %, and 2.2 %, respectively. In-hospital mortality was 3.7 % while cumulative mortality totaled 19.1 %. During the 24-month follow-up, ketosis-prone T2D had the highest success of insulin discontinuation (HR 6.59; 95 % CI 6.69–319.4; p < 0.001), while T2D demonstrated the highest mortality compared to others (HR, 2.89; 95%CI 1.15–6.27; p = 0.02). ConclusionThe reclassification of diabetes based on 2019 WHO DM classification helped elucidate differences in long-term outcomes and mortality among DM types. The new classification, which separates ketosis-prone T2D from standard T2D, should be encouraged in clinical practice for precise and individualized management.

How can we detect news surrounding community safety crisis incidents in the internet? Experiments using attention-based Bi-LSTM models

Reports related to community safety crisis incidents are being escalated and shared on social media and other online digital platforms. These reports must be addressed quickly to concerned organizations to provide welfare support to individuals and communities in crisis, to protect their lives, and to obtain justice. To achieve this, we proposed a framework termed detection of Community Safety Crisis Incidents (CSCI) reports using an attention-based Bidirectional Long Short-term Memory (att-Bi-LSTM). Amharic reports in Ethiopia were selected as the object of study for the implementation of the detection model due to the high CSCI report rate in the region. We gathered the textual data and spoken speech content reports from famous worldwide media websites, Twitter, and YouTube platforms utilizing data crawling techniques. The proposed model achieved 90.93 % accuracy for the text test dataset and 82.10 % accuracy for the voice test dataset on the text-based pre-training model. The model was also tested on English news, yielding an accuracy of 85.92 %.

Clinical features of patients with connective tissue disease with anti-human upstream binding factor antibodies: A single-center retrospective study.

Anti-human upstream-binding factor (anti-hUBF) antibodies have been reported predominantly in patients with connective tissue diseases (CTDs); these have also been reported in patients without CTDs such as hepatocellular carcinoma. Because of the low frequency of expression and few case reports, there is no consensus on the clinical significance of these antibodies. Thus, we aimed to examine the clinical features of patients with anti-hUBF antibodies and analyzed 1042 patients with clinically suspected CTDs. The presence of anti-hUBF antibodies was screened using immunoprecipitation assays. Of the 1042 patients, 19 (1.82%) tested positive for anti-hUBF antibodies; among them, 10 (56%) were diagnosed with undifferentiated CTD (UCTD), six with systemic sclerosis (SSc) and three with other diseases. Five of the 10 patients with UCTD were referred to our hospital with suspected SSc. None of the five patients fulfilled the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria, but three scored seven points, a relatively high score. Six anti-hUBF-positive patients with SSc had a significantly lower modified Rodnan skin score (mRSS) than that of anti-hUBF-negative patients with SSc (2 [0-2] vs 7 [0-49], p < 0.01). Compared with anti-topoisomerase I-positive patients, anti-hUBF-positive patients had a significantly lower mRSS (2 [0-2] vs 13 [0-42], p < 0.01) and lower incidence of scleroderma renal crisis (0 of 6 vs 8 of 184, p < 0.01). Compared with anti-centromere-positive patients, anti-hUBF-positive patients had a higher incidence of interstitial lung disease (ILD), but the difference was not statistically significant (4 of 6 vs 19 of 239). In conclusion, anti-hUBF antibodies were predominantly detected in patients with CTDs and UCTD. In patients with CTDs, SSc exhibited a high ratio, displaying a lower mRSS and higher incidence of ILD. In patients with UCTD, careful follow-up is recommended as they may develop CTDs in the future.

Social valuation of biodiversity relative to other types of assets at risk in wildfire.

Environmental crises, such as wildfires, can cause major losses of human life, infrastructure, biodiversity, and cultural values. In many such situations, incident controllers must make fateful choices about what to protect-and hence what to abandon. With an online representative survey of >2000 adult Australians, we investigated social attitudes to this dilemma. We used best-worst scaling to assess preferences across a set of 11 assets representing human life, infrastructure, biodiversity, and cultural values. Survey respondents overwhelmingly prioritized a single human life (best-worst score of 6647 out of possible score ranging from -10695 to 10695), even if that choice resulted in extinction of other species. Inanimate (replaceable) objects were accorded lowest priority (best-worst scores of -4655 for a shed and -3242 for a house). Among biodiversity assets, respondents prioritized protecting a population of the iconic koala (Phascolarctos cinereus) (best-worst score of 1913) ahead of preventing the extinction of a snail (score -329) and a plant species (-226). These results variably support current policy in that they emphasize the importance the community places on protection of human life, but results diverged from conventional practice in rating some biodiversity assets ahead of infrastructure. The preference for protecting a population of koalas ahead of action taken to prevent the extinction of an invertebrate and plant species corroborates previous research reporting biases in the way people value nature. If noncharismatic species are not to be treated as expendable, then the case for preventing their extinction needs to be better made to the community. Given the increasing global incidence of high-severity wildfires, further sampling of societal preferences among diverse asset types is needed to inform planning, policy, and practice relating to wildfire. Other preemptive targeted management actions (such as translocations) are needed to conserve biodiversity, especially noniconic species, likely to be imperiled by catastrophic events.

Incidence and risk factors of pain crisis after hematopoietic cell transplantation for sickle cell disease

AbstractVaso-occlusive episodes (VOC) or pain crises are the most common indications for hematopoietic cell transplantation (HCT) for sickle cell disease (SCD). Elimination of pain crisis after HCT is an important patient-centered outcome and may improve understanding of the natural history of pain syndromes in SCD. We examined deidentified records of 763 patients followed-up for a median of 36.7 months (range, 0.3-168.6 months), with 69.6% patient's age <18 years at HCT, 83.3% patient's Karnofsky-Lansky performance score (KPS) ≥90, overall survival 92.9%, event-free survival 72.4%, graft failure (GF) 22.4%, AGVHD 21.4%, CGVHD 27%, and pain crisis 8.65%. On unadjusted logistic regression, increased risk of pain crisis after HCT was observed in patient's aged >10 years at HCT (range, 11-17 years; OR, 9.43; 95% CI, 3.20-27.79; P < .0001), in age ≥18 years (OR, 16.62; 95% CI, 5.85-47.16; P < .0001), in those with history of pain crisis 2 years before HCT (OR, 13.16; 95% CI, 4.08-42.42; P < .0001), alternate donors (haploidentical [OR, 4.80; 95% CI, 2.48-9.31; P < .0001], unrelated matched [OR, 2.71; 95% CI, 1.23-5.97; P = .0132], and mismatched unrelated [OR, 3.19; 95% CI, 1.44-7.05; P = .0041], and those with GF (n = 41 [5.37%]; OR, 7.15; 95% CI, 4.20-12.18; P < .0001). Pain crisis was less frequent with KPS of ≥90 (OR, 0.31; 95% CI, 0.18-0.55; P < .0001). Multivariable logistic regression models confirmed age at HCT, KPS, graft type, donor type, history of VOC 2 years before HCT, and GF as independent predictors of pain crisis after HCT and generated predictive models and nomograms for pain crisis after HCT for SCD, which can support shared decision making.

Robust Training of Social Media Image Classification Models

Images shared on social media help crisis managers gain situational awareness and assess incurred damages, among other response tasks. As the volume and velocity of such content are typically high, real-time image classification has become an urgent need for faster disaster response. Recent advances in computer vision and deep neural networks have enabled the development of models for image classification for a number of tasks, including detecting crisis incidents, filtering irrelevant images, classifying images into specific humanitarian categories, and assessing the severity of the damage. To develop robust models, it is necessary to understand the capability of the publicly available pretrained models for these tasks, which remains to be underexplored in the crisis informatics literature. In this study, we address such limitations by investigating ten different network architectures for four different tasks using the largest publicly available datasets for these tasks. We also explore various data augmentation strategies, semisupervised techniques, and a multitask learning setup. In our extensive experiments, we achieve promising results.

Assessment of Stakeholders’ and Universities’ Goal Congruence

This study was with the view of providing information on goals integration that could mitigate the incidence of crises in the universities. It delineated the individual goals of the stakeholders and the institutional goals; also examined the relationship between the individual goals of the stakeholders and goals of public universities in Osun State. The study adopted a correlational survey design. The population comprised students, academic staff members, non-teaching staff members and parents of public university in Osun State. Data collected were analysed using frequency count, percentages, graph and Spearman’s rank order correlation statistic. From the findings, the institutional goals were intellectual development, research among others. The individual goals of the stakeholders of the public universities in Osun State were earning for livelihood, production of independent minded citizens among others. The study showed that there was a moderate correlation between undergraduate education (university goal) and impartation of values into students (individual staff goal), (rs = 0.429**, n = 216, p &lt; 0.05), besides 0.429 &gt; 0.264, so the null hypothesis was rejected. There was also a moderate correlation between student scholarship and scientific research (university goal) and scholarship (individual student goal), (rs= 0.444**, n=2023, p &lt; 0.05), besides 0.444 &gt; 0.264, so the null hypothesis was rejected. The study concluded that aligning personal goals of the stakeholders with the goal of universities through creation of interactive atmosphere between stakeholders and the university management and creating peaceful environment for workers and students would boost industrial peace in universities.

Percutaneous ablation for adrenal metastasis from non-small-cell lung cancer: comparison between cryoablation and microwave ablation.

While cryoablation (CA) and microwave ablation (MWA) have both been implemented as approaches to the treatment of adrenal metastasis (AM), the outcomes associated with these two therapeutic strategies remain unclear. To compare the safety and efficacy of CA and MWA as treatments for AM in patients with non-small-cell lung cancer (NSCLC). Consecutive patients with AM secondary to NSCLC from January 2015 to December 2020 underwent CA or MWA. Treatment-related outcomes and complications were retrospectively compared between these groups. In total, 68 NSCLC patients with isolated AM were enrolled in this study, of whom 35 and 33 underwent treatment with CA and MWA, respectively. Primary complete ablation rates in the CA and MWA groups were 91.4% (32/35) and 93.9% (31/33) respectively (p = 1.000), while a 100% secondary complete ablation rate was observed for both groups. Hypertensive crisis incidence affected 11.4% (4/35) and 9.1% (3/33) of patients in the CA and MWA groups (p = 1.000), respectively, while 8 (22.9%) and 8 (24.2%) patients in these corresponding groups experienced local progression after ablation that was detected during the follow-up period (p = 0.893). Patients in the CA and MWA groups exhibited a median progression-free survival of 18 and 22 months, respectively (p = 0.411), while the corresponding median overall survival of patients in these groups was 25 and 29 months (p = 0.786). CT-guided CA and MWA appear to exhibit similar safety and efficacy profiles when employed to treat isolated AM in NSCLC patients.

防范应对高校校园危机事端的措施

防范应对高校校园危机事端的措施