Mailing Lists Research Articles

Management of inflammatory bowel disease in the emergency setting: the MIBODI international survey and evidence-based practices.

This study aimed to evaluate the impact of the WSES-AAST guidelines in clinical practice and to investigate the knowledge, attitudes, and practices of emergency surgeons in managing the complications of ulcerative colitis (UC) and Crohn's disease (CD). The MIBODI survey is a cross-sectional study among WSES members designed as an international web-based survey, according to the Checklist for Reporting Results of Internet E-Surveys, to collect data on emergency surgeons' knowledge, attitudes, and practices concerning the management of patients presenting with acute complications of CD and UC. The questionnaire was composed of 30 questions divided into five sections: (1) demographic data, (2) primary evaluation, (3) non-operative management, (4) operative management, and (5) perianal sepsis management. Two hundred and forty-two surgeons from 48 countries agreed to participate in the survey. The response rate was 24.2% (242/1000 members on WSES mail list). Emergency surgeons showed high adherence to recommendations for 6 of the 21 assessed items, with a "correct" response rate greater than or equal to 60%, according to WSES-AAST recommendations. Nine critical issues were highlighted, with correct answers at a rate of less than 50%. Inflammatory bowel disease is a complex disease that requires a multidisciplinary approach with close collaboration between gastroenterologists and surgeons. Emergency surgeons play a crucial role in managing complications related to IBD. One year after publication, the MIBODI study showed significant global implementation of the WSES-AAST guidelines in clinical practice, offering an imperative tool in the improved management of IBD in emergency and urgent settings.

P093 What’s in a name? Misnaming and renaming of Juvenile Idiopathic Arthritis has long-term impacts

Abstract Background/Aims Juvenile Idiopathic Arthritis (JIA) is a heterogenous group of disorders characterised by chronic joint inflammation of unknown aetiology lasting 6+ weeks, with onset before the age of 16. Historically, some patients with JIA have been labelled as having adult-onset disorders such as Rheumatoid Arthritis (RA) in order to facilitate access to medication. Some have also been incorrectly reclassified at age 16 (with their JIA being relabelled as RA) due to lack of understanding by some healthcare professionals in adult clinics that children and young people get arthritis too. Whilst treatments for RA and JIA are broadly similar, important differences in treatment, management, prognosis and extra-articular manifestations remain. This collaborative study between three patient organisations investigated the extent of the issues arising from misnaming and/or renaming of JIA in a UK population. Methods Adults in the UK aged 18+ who had any diagnosis of a musculoskeletal or rheumatic condition (RMD) were invited to complete a voluntary online survey. Surveys were disseminated through webpages, social media and email mailing lists, enabled by the patient organisations Juvenile Arthritis Research, Arthur’s Place and The Wren Project. Respondents provided information about their diagnosis, experiences, and attitudes across a range of themes and topics. Results In total, 532 respondents with any form of arthritis, and/or other rheumatic or musculoskeletal condition completed the survey (64% female; 68% White ethnicity; median age 35.5 years), covering a primary diagnosis of different rheumatic conditions; 185 (35%) had a second or subsequent additional rheumatic disease. Of 169 respondents with a primary diagnosis of JIA and symptom onset prior to age sixteen, 87 (52%) reported that a doctor or healthcare professional has subsequently told them (whilst under adult services) that their condition is now called something other than Juvenile Arthritis once they reached adulthood. In addition, 134 (25%) respondents reported a primary diagnosis of RA; of these 15 (11%) had symptom onset prior to age 16, indicating their diagnosis should have been JIA. Conclusion Given the importance of accurate diagnosis for patients, both for a patient’s sense of identity and for treatment, care and prognosis reasons, the name given to a disease matters. With 11% of patients with a diagnosis of RA having paediatric-onset JIA, and 52% with JIA being incorrectly told their diagnosis has changed post-16, there are important implications for patients and caregivers. Improved awareness and understanding of the importance of correct labelling of RMDs may help reduce confusion and uncertainty and improve access to appropriate care. Disclosure R.P. Beesley: None. R.M. Beesley: None. K. Middleton: None. A. McBride: None. E.M.D. Smith: None. M.W. Beresford: None.

Жизнь и прозябание

<p>For several years, A.V. Suvorov has been doing mailing lists for like-minded colleagues and friends. Each of the letters is a scientific and journalistic text on philosophical, psychological, pedagogical, and life topics. A.V. Suvorov signed his letters "Hedgehog" - that's how he called himself, meaning not only prickly, but also the desire to isolate himself for a while, shrink, withdraw into himself from the world, so that he could then turn to him with something important. We bring to your attention his latest essay, or rather, the last revision of the text that he wrote almost a quarter of a century ago. The author reflects on how to overcome universal, collective and individual, personal nonsense as a way of existence. In his opinion, didactics is intended to provide a means of understanding existence.</p>

The First Blockchain: Bitcoin, Entropy, Religion

Bitcoin did not suddenly appear in November 2008, at the heart of the subprime crisis. It has matured over a decade, notably through the exchanges of Nick Szabo, Hal Finney, and others, with key moments such as the publication of “The God Protocols” by Szabo in 1997. The theological analogy developed in the introduction to that text, which theorizes smart contracts, raises the question: simple facetiousness, geek irony, or a clue to religious references? By analysing not only the founding texts but also the discussions in the Extropian or cryptography mailing lists in which Szabo and Finney took part, this article seeks to answer whether religious references (vocabulary, imagination, symbolism, structure) may have played a role in the genesis of Bitcoin.

Healthcare practitioners’ experiences and perspectives of music in perinatal care in Ireland: An exploratory survey

IntroductionEvidence shows that music can promote the wellbeing of women and infants in the perinatal period. Ireland's National Maternity Strategy (2016–2026) suggests a holistic approach to woman's healthcare needs and music interventions are ideally placed as a non-pharmacological and cost-effective intervention to improve the quality of care offered to women and infants. This cross-sectional survey aimed to explore the healthcare practitioners’ personal and professional experiences of using music therapeutically and its impact and barriers in practice. The survey also investigated practitioners’ knowledge and attitudes towards the use of music as a therapeutic tool in perinatal care. MethodsA novel online survey was developed and distributed through healthcare practitioners’ electronic mailing lists, social media, Perinatal Mental Health staff App, and posters at the regional maternity hospital during 26th June and 26th October 2020. Survey items included demographics, personal and professional use of music, and perspectives on music intervention in perinatal care. ResultsForty-six healthcare practitioners from across 11 professions were recruited and 42 were included in this study. 98 % of perinatal practitioners used music intentionally to support their wellbeing and 75 % referred to using music in their work. While 90 % found music beneficial in their practice, 15 % reported some negative effect. Around two-thirds of the respondents were familiar with the evidence on music and perinatal wellbeing and 95 % thought there was not enough guidance. 40 % considered music therapy an evidence-based practice and 81 % saw a role for music therapy in standard maternity service in Ireland. The qualitative feedback on how music was used personally and professionally, its’ reported benefits, negative effects, and barriers are discussed. DiscussionThis study offers insights into how healthcare practitioners viewed and applied music in perinatal practice. The findings indicate high interest and positive experiences in using music as a therapeutic tool in perinatal care which highlights the need for more evidence and guidance.

Health Fatalism Does Not Predict Body Mass Index but Is Associated with Diet Quality in Healthy Adults: A Cross-Sectional Study

Objective Obesity as assessed by body mass index (BMI) is associated with increased risk of chronic disease. Health fatalism, defined as the belief that health outcomes are outside of one’s control, is also associated with chronic disease risk. The purpose of this cross-sectional study was to understand the relationship between health fatalism and BMI in healthy adults. Secondary outcomes assessed the relationships between health fatalism and diet quality and health fatalism and physical activity. Method Healthy individuals aged 18 to 65 years were recruited via ResearchMatch, electronic mailing lists, and social media. Participants completed online questionnaires on demographic characteristics, diet quality, physical activity, and degree of health fatalism. Regression models were used to assess the primary and secondary outcomes. For the primary outcome, the model of health fatalism (predictor) and BMI (outcome) was also adjusted for diet quality, physical activity, and demographic characteristics. Results Participants (n = 496) were 38.7 ± 14.3 years old and primarily female (76%) and White (81%), with a BMI of 25.1 ± 5.2 kg/m2. Most participants had a college or post-college education (74%), stated that they always had sufficient income to live comfortably (90%), and were moderately to highly active (91%). There was no relationship between health fatalism and BMI (p > 0.05) or health fatalism and physical activity (p > 0.05); however, there was a significant relationship between health fatalism and diet quality (beta coefficient: −0.046; 95% confidence interval, −0.086 to −0.0058; p = 0.025), such that a higher degree of fatalism predicted a slight decrease in diet quality. Conclusions Although health fatalism did not predict BMI in this population, fatalistic beliefs were associated with poorer diet quality.

Irritability across adolescence: Examining longitudinal trajectory, stability, and associations with psychopathology and functioning at age 18

BackgroundIrritability, marked by diminished frustration tolerance, holds significant implications for youth mental health treatment. Despite prior research on irritability trajectories, understanding of individual differences during adolescence remains limited. This study examines the stability and trajectory of irritability across ages 12–18, investigating associations with psychopathology and functioning at age 18. MethodsA community sample of families with 3-year-old children (N = 518) was recruited via commercial mailing lists. Irritability was assessed at ages 12, 15, and 18 using the Affective Reactivity Index. Psychopathology at age 18 was evaluated with the Kiddie Schedule for Affective Disorders and Schizophrenia, and functioning was assessed through the UCLA Life Stress Interview. Measurement invariance analyses and latent growth curve modeling were conducted within a structural equation modeling (SEM) framework. ResultsConfigural, metric, and scalar invariance models were supported. Elevated irritability at age 12 predicted adverse outcomes at age 18, including increased psychotropic medication use, mental health treatment, suicidal ideation, self-injury, and psychiatric disorders. Importantly, these associations persisted even after accounting for corresponding variables at age 12. The trajectory of irritability during early adolescence significantly predicted heightened risks for various outcomes at age 18, including suicidal ideation, depression, anxiety, disruptive behavior disorders, and impaired interpersonal functioning. DiscussionLimitations include using only youth-reported data at age 18, limited generalizability from a mostly White, middle-class sample, and insufficient exploration of the broader developmental trajectory of irritability. Nevertheless, the findings emphasize the crucial role of irritability's trajectory in influencing various psychopathological and functional outcomes in late adolescence.

Opinion, uptake and current practice of robot-assisted upper gastrointestinal and oesophagogastric surgery in the UK: AUGIS national survey results.

The uptake of upper gastrointestinal (GI) robotic surgery in the United Kingdom (UK), and Europe more widely, is expanding rapidly. This study aims to present a current snapshot of the practice and opinions of the upper GI community with reference to robotic surgery, with an emphasis on tertiary cancer (oesophagogastric) resection centres. An electronic survey was circulated to the UK upper GI surgical community via national mailing lists, social media and at an open-invitation conference on robotic upper GI surgery in January 2023. The survey included questions on surgeons' current practice or planned adoption (if any) of robotics at individual and unit level, and their opinions on robotic upper GI surgery in general. Priority ranking and Likert-scale response options were used. In total, 81 respondents from 43 hospitals were included. Thirty-four resectional centres responded, including 30 of 31 (97%) recognised upper GI cancer centres in England. Respondents reported performing robotic surgery in 21 of 34 (61.8%) resectional centres, with a median of 65 procedures per centre performed at the time of the survey (range 0-500, interquartile range 93.75). Every centre without a robotic programme expressed a desire or had active plans to implement one. Respondents ranked surgeon ergonomics as the most important reason for pursuing robotics, followed by improvements in patient outcomes and oncological efficacy. Robotic upper GI practice is nascent but rapidly growing in the UK with plans for uptake in almost all tertiary centres. There is growing opinion that this is likely to become the predominant surgical approach in future with benefits to both patients and surgeons. This snapshot offers a point of reference to all stakeholders in upper GI surgery.

Antimicrobial Prescription Behavior in Equine Asthma Cases: An International Survey

Equine asthma is considered a non-infectious respiratory disease characterized by inflammation and hypersensitivity. Given the importance of antimicrobial stewardship, an international survey was designed to investigate the use of antimicrobials in asthmatic horses and the factors influencing prescription behavior. An online survey was distributed in six languages by international mailing lists and social media from December 2020 to January 2022. Of the 434 responses recorded, 249 veterinarians working in 25 countries finished the survey. These included 79 ECEIM/ACVIM diplomats. A total of 204 respondents confirmed national regulations concerning antimicrobial use in their country. Knowledge of the asthma definitions as presented in the revised ACVIM consensus statement was greater in veterinarians treating over 95% of equine patients compared to veterinarians treating more species, based on 10 questions (answers consistent with the consensus statement in 7 (IQR 5–9) and 4 (IQR 3–6) questions, respectively, (p < 0.001)). A total of 131 respondents stated to use antimicrobials (at least ‘sometimes’) in at least one of the three presented cases consistent with equine asthma. Trimethoprim-Sulfa combinations, penicillin(s), and tetracyclines were prescribed most (by 105, 53 and 38 veterinarians, respectively). Aminoglycosides, cephalosporins and fluoroquinolones were also selected (22, 15, 9 veterinarians respectively). Tetracyclines and cephalosporins are prescribed more often by veterinarians working without national regulations (p 0.019 and p 0.035, respectively). The most selected factors influencing prescription behavior were: ‘tracheal wash culture’ (62% of 131 veterinarians using antimicrobials in these cases), ‘whether other horses in the barn have similar complaints’ (60%), and ‘response to other forms of therapy’ (53%). In conclusion, insight into prescription behavior is the first step towards minimizing and optimizing antimicrobial use.

Endoscopist experience with pediatric recurrent and intentional foreign body ingestion (RIFBI): Management considerations and future directions.

Accidental foreign body ingestion (FBI) is a common pediatric referral concern. In contrast, recurrent and intentional FBI (RIFBI) is infrequent and associated with greater endoscopic and surgical intervention in adults. Although pediatric guidelines exist for FBI, the risk and therapeutic implications of RIFBI are not addressed. An anonymous international survey on pediatric gastroenterologist experience with RIFBI was distributed. A 33-item REDCap© survey was distributed via email to pediatric gastroenterologists identified through mailing and email lists obtained from pediatric gastroenterology professional organizations. During 9-12/2021 we accrued 202 completed surveys. Respondents were from 27 countries and across the career span. Eighty percent reported experience with RIFBI; 74% reported seeing ≤ 3 patients with RIFBI within the past 24 months and 4% reported seeing ≥ 6. Of those who treated RIFBI, 38% reported an average number of annual ingestions per patient was ≥5. Frequent morbidity but not mortality was reported. Half reported adherence to FBI guidelines. Later-career endoscopists treated RIFBI more aggressively than accidental ingestion. Ninety-six percent noted that patients with RIFBI had psychiatric comorbidities. Providers at academic medical centers reported referring to behavioral health more than those in other settings. Most gastroenterologists surveyed reported encountering RFBI several times a year and in patients with psychiatric comorbidities. Greater likelihood of adverse outcomes associated with endoscopy was reported. Most reported referral to behavioral health and few had RIFBI management protocols. A broader spectrum of psychologic comorbidities in the pediatric population with RIFBI, notably depression and autism spectrum disorder, were reported.

A Smartphone use in Medical Photography

The modern era is becoming more and more digital. The use of smartphones for taking photos is widespread in the medical field. Most often, these photos are used for patient care, but also these photographs are used for educational and teaching purposes. Through a survey carried out among our university hospital doctors (HU), we wanted to establish an inventory of current practices in terms of taking but also using and storing medical photos and/or videos. Methods Prospective cross-sectional study, carried out among 1400 HU teaching doctors affiliated with the Faculty of Medicine of Tunis, via a Google Forms questionnaire pre-established by the digital pedagogy committee, and sent by email through institutional mailing lists. Results We received 223 (15.9%) survey participants, divided into 52 specialties. Only 2.7% did not use their “smartphones” to take medical photos. Smartphones were used for taking photos and/or videos of patients (76.7%), medical records (70.9%), and slides, samples or radiological images (72.2%). Twenty-two percent of respondents were reluctant to use a smartphone for taking medical photos, due to the risk of loss or theft of the phone (69.2%) and a question of confidentiality and ethics (59. 3%). The taking of medical photos and/or videos was for patient care (81.6%), for educational purposes or for research (90.6%), for personal reference (39.5%), for entertainment or for social networks (0.9%). The smartphone would be the most accessible and the easiest to use (non-accessibility of a traditional camera (58.7%)). The classic camera, on the other hand, is considered the most secure. Nearly half of doctors (48.4%) stored their medical photos in a dedicated database, 21.5% with their personal photos and 42.2% on their personal computer. An inter-colleague exchange of medical photos via instant messaging on social networks in 47.3% of cases. The patient’s oral consent is always requested in 58.3% (46% however consider this to be insufficient). Written consent is obtained in 4.5%. However, 7.6% do not request any. The need to establish legal procedures for taking these photos, by establishing standardized consent forms, was mentioned by most of the responses. Conclusions The use of smartphones for taking medical photos and/or videos is widespread, easy and useful. However, consent must be detailed. Standardized procedures must be put in place to protect patients but also doctors.

Ansiedade em Profissionais dos Cuidados de Saúde Primários na Primeira Vaga da Pandemia COVID-19

Introduction The COVID-19 pandemic led to the adoption of paramount measures to detect SARS-CoV-2 infection and prevent its spread, causing anxiety in the general population. Health professionals have been considered one of the most vulnerable groups for mental health problems, as observed in past epidemics. The present study aimed to assess the anxiety in primary healthcare professionals during the COVID-19 pandemic and identify the factors that influenced it. Methodology This cross-sectional study was performed via an online anonymous survey, disseminated primarily through social networks and institutional mailing lists, between March 29th and April 5th 2020, applied to primary healthcare professionals in mainland Portugal. Anxiety levels were obtained by applying the Beck Anxiety Inventory. Logistic regression analyses were conducted to identify factors associated with anxiety levels. Results The study included 696 participants, of which 61.9% were physicians, 84.8% were women and 43.8% presented mild to severe levels of anxiety. Factors such as personal history of previous mental health disorders (p<0.001), having a family member with risk factors for SARS-CoV-2 complications (p=0.012) and being an administrative clerk (p=0.014), showed to relate with higher levels of anxiety. On the other hand, the existence of a workspace contingency plan was associated with lower anxiety levels (p=0.048); nevertheless, 6.9% considered it inadequate, mainly due to inappropriate protective equipment for professionals (79.6%). Conclusion This study highlights a high prevalence of anxiety among health professionals and reinforces the need of, in future pandemics, promoting the adoption of adequate measures to protect their mental health and, ultimately, safeguard the quality of patient care. Keywords: COVID-19, pandemic, anxiety, health personnel, occupational health, occupational medicine.

The use of eye-tracking technology as a tool to evaluate social cognition in people with an intellectual disability: a systematic review and meta-analysis

BackgroundRelatively little is known about social cognition in people with intellectual disability (ID), and how this may support understanding of co-occurring autism. A limitation of previous research is that traditional social-cognitive tasks place a demand on domain-general cognition and language abilities. These tasks are not suitable for people with ID and lack the sensitivity to detect subtle social-cognitive processes. In autism research, eye-tracking technology has offered an effective method of evaluating social cognition—indicating associations between visual social attention and autism characteristics. The present systematic review synthesised research which has used eye-tracking technology to study social cognition in ID. A meta-analysis was used to explore whether visual attention on socially salient regions (SSRs) of stimuli during these tasks correlated with degree of autism characteristics presented on clinical assessment tools.MethodSearches were conducted using four databases, research mailing lists, and citation tracking. Following in-depth screening and exclusion of studies with low methodological quality, 49 articles were included in the review. A correlational meta-analysis was run on Pearson’s r values obtained from twelve studies, reporting the relationship between visual attention on SSRs and autism characteristics.Results and conclusionsEye-tracking technology was used to measure different social-cognitive abilities across a range of syndromic and non-syndromic ID groups. Restricted scan paths and eye-region avoidance appeared to impact people’s ability to make explicit inferences about mental states and social cues. Readiness to attend to social stimuli also varied depending on social content and degree of familiarity. A meta-analysis using a random effects model revealed a significant negative correlation (r = −.28, [95% CI −.47, −.08]) between visual attention on SSRs and autism characteristics across ID groups. Together, these findings highlight how eye-tracking can be used as an accessible tool to measure more subtle social-cognitive processes, which appear to reflect variability in observable behaviour. Further research is needed to be able to explore additional covariates (e.g. ID severity, ADHD, anxiety) which may be related to visual attention on SSRs, to different degrees within syndromic and non-syndromic ID groups, in order to determine the specificity of the association with autism characteristics.

Attitudes towards artificial intelligence in emergency medicine.

To assess Australian and New Zealand emergency clinicians' attitudes towards the use of artificial intelligence (AI) in emergency medicine. We undertook a qualitative interview-based study based on grounded theory. Participants were recruited through ED internal mailing lists, the Australasian College for Emergency Medicine Bulletin, and the research teams' personal networks. Interviews were transcribed, coded and themes presented. Twenty-five interviews were conducted between July 2021 and May 2022. Thematic saturation was achieved after 22 interviews. Most participants were from either Western Australia (52%) or Victoria (16%) and were consultants (96%). More participants reported feeling optimistic (10/25) than neutral (6/25), pessimistic (2/25) or mixed (7/25) towards the use of AI in the ED. A minority expressed scepticism regarding the feasibility or value of implementing AI into the ED. Multiple potential risks and ethical issues were discussed by participants including skill loss from overreliance on AI, algorithmic bias, patient privacy and concerns over liability. Participants also discussed perceived inadequacies in existing information technology systems. Participants felt that AI technologies would be used as decision support tools and not replace the roles of emergency clinicians. Participants were not concerned about the impact of AI on their job security. Most (17/25) participants thought that AI would impact emergency medicine within the next 10 years. Emergency clinicians interviewed were generally optimistic about the use of AI in emergency medicine, so long as it is used as a decision support tool and they maintain the ability to override its recommendations.

Unmet Needs of Immune Thrombotic Thrombocytopenic Purpura (iTTP)-Specific Pregnancy Counseling, Care and Outcomes in Women with Ittp

Unmet needs of iTTP-specific pregnancy counseling, care and outcomes in women with iTTP INTRODUCTION: Pregnancy is a known trigger for an initial episode or relapse of immune thrombotic thrombocytopenic purpura (iTTP) and outcomes of pregnancy in women with iTTP have historically been suboptimal with high rates of recurrent iTTP, fetal loss, preeclampsia and HELLP syndrome. More recent data suggest that prophylactic immunosuppression to normalize ADAMTS13 levels before conception, and ADAMTS13 monitoring and prophylactic steroids or plasma exchange during pregnancy can improve maternal and fetal outcomes. However, it is not clear whether women with iTTP are routinely counseled regarding these options. We conducted this study to understand the experiences of women with iTTP with reproductive healthcare, how iTTP has impacted their reproductive decisions, and outcomes of pregnancy. METHODS: We developed a web-based (RedCap) survey focused on the reproductive healthcare experiences of women with iTTP with in three major sections: (1) counseling and education around pregnancy that was provided to them, (2) the impact of iTTP on their reproductive decisions, and (3) outcomes of any pregnancies they had experienced. The survey was distributed through social media and email mailing lists of a patient advocacy organization and was kept open for one month (January 2023). Survey data were summarized using counts and percentages. The focus of the analysis was to identify gaps in patient education and care where efforts could be focused on educating clinicians or providing information to patients though patient advocacy groups. RESULTS: Seventy-five females with iTTP responded to the survey. The median age of the respondents was 44 years (range 23 - 65). Sixty-five (74.7%) identified as White, 13 (14.9%) as Black, 6 (6.9%) as Asian and 3 (3.4%) identified as other/prefer not to say. Nearly all (94.6%) were followed by a hematologist or hematologist-oncologist and 82.9% reported being monitored regularly for iTTP. Only 26.7% (20 of 75) reported that their doctor talked to them about measures that may help achieve a successful pregnancy. These included ADAMTS13 monitoring (n=15), plasma exchange treatments (n=10), rituximab (n=10), and aspirin (n=3) (options are not mutually exclusive so total is > 20). Moreover, 30.0% (21 of 70) reported that they were advised by their doctor to not get pregnant due to their iTTP. Some patients (36.0%) avoided pregnancy out of fear of the consequences of iTTP and 28.4% (21 of 74) responded that their iTTP diagnosis has affected their ability to get into a relationship, which impacts their quality of life (Figure 1). Fifty-three patients reported that they had had at least one pregnancy. Of these, 35 had pregnancies before iTTP diagnosis, 10 with the initial presentation of iTTP, and 8 women had a total of 11 pregnancies following the diagnosis of iTTP. Consistent with prior reports, there was a high rate of maternal and fetal complications in pregnancies that occurred in the setting of a first iTTP episode complicating pregnancy, or pregnancies after an iTTP diagnosis (Table 1). iTTP relapse occurred in 27.3% (3 of 11) pregnancies in women with prior iTTP. Fetal loss occurred in 30% of pregnancies with first TTP diagnosis and 9% of pregnancies after iTTP. In both groups, approximately 20% were small for gestational age. Preeclampsia or HELLP syndrome occurred in 50% and 18.2% of pregnancies complicated by initial TTP diagnosis or after iTTP diagnosis, respectively. CONCLUSION: Though pregnancy in women with iTTP is high risk, close monitoring and prophylactic interventions can improve outcomes. While many women with iTTP are counseled regarding the risks of pregnancy, few receive counseling regarding their options to potentially improve pregnancy outcomes. This limits their reproductive choices and impacts their relationships. Educating clinicians and providing information to patients though patient advocacy groups may help address these healthcare gaps.

Characterizing a collaboration by its communication structure

I present first results of my analysis of a collection of about 24,000 email messages from internal mailing lists of the ATLAS collaboration, at CERN, the particle physics laboratory, during the years 2010–2013. I represent the communication on these mailing lists as a network in which the members of the collaboration are connected if they reply to each other’s messages. Such a network allows me to characterize the collaboration from a bird’s eye view of its communication structure in epistemically relevant terms. I propose to interpret established measures such as the density of the network as indicators for the degree of “collaborativeness” of the collaboration and the presence of “communities” as a sign of cognitive division of labor. Similar methods have been used in philosophical and historical studies of collective knowledge generation but mostly at the level of information exchange, cooperation and competition between individual researchers or small groups. The present article aims to take initial steps towards a transfer of these methods and bring them to bear on the processes of collaboration inside a “collective author.”

A snapshot of equality and diversity among UK vascular surgery trainees

INTRODUCTION Increasing equality and diversity, widening access and maintaining a work–life balance are important aims for the future surgical workforce. The executive committee of the Rouleaux Club (the trainee association of vascular surgeons in the UK) sought to ensure that it represented its members fairly by establishing the diversity of the vascular surgery training workforce. METHODS The Rouleaux Club committee devised an anonymous online survey covering an extensive topic range (including sex and gender identity, ethnicity, less than full-time working and children). The link to the questionnaire was distributed via email to all members, via social media and via pre-existing mailing lists. The survey was open for four weeks (26 September to 23 October 2020). RESULTS A total of 117 vascular trainees participated in our survey (55% of 213 known with a national training number). There were 48 female (41%) and 69 male respondents (59%). This ratio is better than the national average in surgical specialties (35% female trainees) but lower than that in medical specialties (57%). One respondent’s gender identity did not align with their biological sex. Almost two-thirds (60%) of the respondents were White. The ethnic backgrounds of the remaining trainees were Asian (24%), Arab (5%), Black (4%) and mixed (5%). Two trainees preferred not to state their ethnicity. The majority of the respondents (n=101, 86%) were heterosexual/straight, three (3%) identified as bisexual and two (2%) as gay. Eleven participants (9%) indicated that they preferred not to answer this question. Ten trainees (10/101, 10%) stated that they had worked less than full time at some point during their training. Three of these continue to work less than full time. CONCLUSIONS This study is the first of its kind to assess the equality and diversity of the vascular trainee workforce; improvements can only be made if baseline data are known. The Rouleaux Club confirms that it represents its members fairly.

Bodily maps of emotions and pain: tactile and hedonic sensitivity in healthy controls and patients experiencing chronic pain.

Pain is an unpleasant sensory and emotional experience. Both pain and emotions are warning signals against outside harm. Interoception, bodily sensations of emotions can be assessed with the emBODY tool where participants colour the body parts where they feel different emotions. Bodily maps of emotions (BMoE) have been shown to be similar between healthy individuals independent of age, sex, cultural background, and language. We used this tool to analyze how these body maps may differ between healthy controls and patients with persistent pain. We recruited 118 patients with chronic pain. An algorithm-selected matched controls from 2348 individuals who were recruited through social media, message boards, and student mailing lists. After providing background information, the participants completed the bodily topography colouring tasks with the emBODY tool using tablets (patients) and online using their own devices (controls), for pain, sensitivity for tactile, nociceptive and hedonic stimuli, and for the 6 basic emotions and a neutral state. Patients with pain coloured significantly larger areas for pain and more negative emotions. On the whole, their BMoEs were dampened compared with healthy controls. They also coloured more areas for nociceptive but not for tactile or hedonic sensitivity. Patients and controls marked different body areas as sensitive to nociceptive and tactile stimulation, but there was no difference in sensitivity to hedonic touch. Our findings suggest that emotional processing changes when pain persists, and this can be assessed with these colouring tasks. BMoEs may offer a new approach to assessing pain.

Survey on public acceptance of insects as novel food in a non-EU country: a case study of Serbia

Abstract The present study aimed to evaluate the state of public perceptions and acceptance of insects as food in Serbia. The data was gathered via an online survey involving 1102 participants who completed Google Forms questionnaire shared through mailing lists and social media channels. The findings indicate that, while 85.3% of the respondents were aware of the use of insects in human diet, only 12.5% had previously consumed edible insects. The results of the chi-square tests further revealed that both familiarity and experience significantly affected willingness to buy insect-based food, whereas age and educational level did not. Men were more open to purchasing edible insects than women. Twice as many participants (49.4%) responded positively to eating insect-based food in which insects were not visible than to consuming recognisable insects (25.4%). Crisis (shortage of conventional sources of protein), curiosity, nutrition, and health benefits were the most frequently chosen reasons for including insect-based products in a diet, whereas disgust was the main reason against. Multiple correspondence analysis resulted in two dimensions that accounted for the largest amount of variance. The first dimension referred to familiarity with entomophagy, experience of eating edible insects, and willingness to buy insect-based products, whereby sustainability, affordability, taste, nutrition, and curiosity were the reasons for including insect-based products in a diet, while high price was a reason against. The second dimension indicated lack of familiarity, experience, or willingness to buy, with crisis as the most common motivating reason, and the perception of insects as pests and socio-cultural unacceptance as the main reasons against. Although almost half of the respondents reported willingness to consume processed insect-based products, the actual acceptance is possibly lower. Therefore, future research should focus on the provision of tasting opportunities as well as information on the benefits associated with the production and consumption of insects.

Knowledge and worries on motherhood choice in multiple sclerosis - a cross-sectional study on patient-reported outcome measures.

Since multiple sclerosis (MS) is often diagnosed in young women, pregnancy is a common topic for women with MS (wwMS). The study aimed to assess the measurement properties of two patient-reported outcome measures on motherhood choice in MS, and to explore the information and support needs of wwMS concerning motherhood. We conducted an anonymous web-based survey to validate the motherhood/pregnancy choice and worries questionnaire (MPWQ, 31 items plus up to 3 additional items) and the motherhood choice knowledge questionnaire (MCKQ, 16 items). We used mailing lists and social media for nationwide recruitment in Germany, and included women of childbearing age with relapsing-remitting MS, clinically isolated syndrome or suspected MS who were considering pregnancy or were pregnant. For the MPWQ, we assessed item difficulty, discriminatory power, and internal consistency (Cronbach's alpha; CA). We analysed construct validity using the Leipzig Questionnaire of Motives to have a Child, the Decisional Conflict Scale, the Hospital Anxiety and Depression Scale, and the Pregnancy-Related Anxiety Questionnaire-revised2. We studied the structural validity using exploratory factor analysis (EFA). The MCKQ was evaluated descriptively. We explored the information and support needs of wwMS on motherhood descriptively. We examined correlations between MCKQ, MPWQ and clinical characteristics and performed exploratory group comparisons considering the following binary variables: having children and being pregnant. 325 wwMS started the survey; 232 wwMS met our inclusion criteria and were analysed. Their mean age was 30 years (SD 5). Most women had relapsing-remitting MS (n=218; 94%), 186 (80%) had no children, and 38 (16%) were pregnant. Internal consistency was good for the worries subscale (CA>0.8), while it was unsatisfactory for the attitude and coping subscales (CA<0.7). The EFA did not support the three-scale structure (coping, attitude, and worries). Due to these findings, we decided to keep the worries scale without any subscale. The items from the coping scale and attitude scale could be assessed as additional descriptive items. Convergent and divergent construct validity of the MPWQ was satisfactory. 206 wwMS (89%) completed the MCKQ. On average, 9 of 16 (56%) items were answered correctly (range 2-15), and the questionnaire showed a good balance between easy and difficult items. Questions on immunotherapy, disease activity, and breastfeeding were the most challenging. WwMS were confident in getting pregnant and raising a child (n=222; 96%). Most wwMS were worried about postpartum relapses (n=200; 86%) and the long-term effects of pregnancy on disease evolution (n=149; 64%). About half of the wwMS (n=124; 54%) did not know where to find professional help and 127 (55%) had no strategies to cope with future impairments so that they could take care of a child. Our results support the suitability and acceptability of both questionnaires as potential patient-reported measures for assessment of knowledge and worries around motherhood/pregnancy in MS. The survey results highlight the need for evidence-based information on motherhood in MS to increase knowledge, reduce worries and support wwMS in making informed decisions.