Nuances In Terms Research Articles

Adalimumab Persistence and Its Biosimilar in Inflammatory Bowel Disease: A Real-World Study.

Adalimumab biosimilar experience is still recent. Interchangeability differences could reduce persistence times. Our goal was to compare biosimilar persistence differences with a reference. A retrospective observational study was performed in three groups divided according to the adalimumab received. The primary outcome measure was persistence, represented with Kaplan-Meier analysis, and we secondarily evaluated security, efficacy, and biomarkers. We obtained approval from the regional ethical committee, and the study was conducted following the Helsinki Declaration as revised in 2013. Data from 104 patients were collected: 50 received the biosimilar, 29 received the reference, and 25 switched from the original to the biosimilar. After a follow-up of 12 months, the biosimilar's persistence was higher, without differences in mild adverse events per group. In contrast, there were differences in severe events, with the switched group's frequency being higher. Biomarkers were reduced at similar proportions in all groups, and 43% had a clinical response at week 20 without differences. Adalimumab biosimilars are a valuable option for IBD based on clinical equivalence that are less expensive than the original drug. Their use does not have a detrimental influence on disease, although there are a few nuances in terms of interchangeability. These results support increasing confidence in using biosimilars, thus promoting the better sustainability of health systems.

Role of Immunotherapy in Gastroesophageal Cancers-Advances, Challenges and Future Strategies.

Gastroesophageal cancers (GECs) carry considerable morbidity and mortality, and demonstrate geographical histological variances in addition to molecular heterogeneity. Consequently, the immunogenicity of the different subtypes, which can predict the likelihood of immunotherapy response, can vary. Immune checkpoint inhibitor (ICI) therapy has transformed the treatment of many cancer types over the past decade but has been slower to gain a foothold in the treatment paradigm of GECs. This article reviews the existing evidence and use approvals for immunotherapies and immune-based treatments in GECs, in the neoadjuvant, adjuvant and metastatic disease settings. The challenges of and limitations to ICI application in current clinical practice are examined. Ongoing clinical trials and future directions of research are also considered. ICI therapy has become an established treatment option within GECs, both perioperatively and in advanced disease. However, nuances in terms of its use are not yet fully understood. Ongoing research proposes to broaden the application of immunotherapies in GECs with the potential to continue to improve outcomes.

A Study of Assessment of Casinos’ Risk of Ruin in Casino Games with Poisson Distribution

Gambling, as an uncertain business involving risks confronting casinos, is commonly analysed using the risk of ruin (ROR) formula. However, due to its brevity, the ROR does not provide any implication of nuances in terms of the distribution of wins/losses, thus causing the potential failure of unravelling exceptional and extreme cases. This paper discusses the mathematical model of ROR using Poisson distribution theory with the consideration of house advantage (a) and the law of large numbers in order to compensate for the insufficiency mentioned above. In this discussion, we explore the relationship between cash flow and max bet limits in the model and examine how these factors interact in influencing the risk of casino bankruptcy. In their business nature, casinos operate gambling businesses and capitalize on the house advantage favouring them. The house advantage of the games signifies casinos’ profitability, and in addition, the uncertainty inevitably poses a certain risk of bankruptcy to them even though the house advantage favours them. In this paper, the house advantage is incorporated into our model for a few popular casino games. Furthermore, a set of full-range scales is defined to facilitate effective judgment on the levels of risk confronted by casinos in certain settings. Some wagers of popular casino games are also exemplified with our proposed model.

The Evolving Facets and Nuances of the English Language in the Digital Era

This article focuses on the changing roles of English language and literature with the onset of 21st century. There has been a massive revolution in the world of digitization with the rapid advancement of technology. This paper explores how, in this scenario, English language has paved its way into various nuances in terms of its identity and thematic centrality in both the aspects of the uses of English language and literature. This article explores the complexities of the evolving word adaptations in language and literature over technological uses, where brief interactions, suppression, and reliability serve to define the era of next generation???s online presence. English language has served since ages to overcome the barriers of communication even before the invent of technology. This paper examines how the common English language nuances are rapidly coming into use of everyday life. This paper seeks to understand how English language can continually affect our sense of self-growth, and how this can mould our identity. The paper proposes that English language is not merely serving as a tool for communication worldwide in the present scenario but also constitutes a complex narrative at various contextual sources representing our culture and society. It argues that the various interpretations of the English language and literature can have a powerful impact on shaping our personality as individuals and as a community as a whole in this digital era.

Effect of eco-innovation on green supply chain management, circular economy capability, and performance of small and medium enterprises

The social structures in organisations constitute essential enablers for the betterment of small and medium enterprises’ (SMEs) performance. Our paper explores such enablers in the context of SMEs’ contribution to the Circular Economy (CE), through the lens of institutional and dynamic capability view theories. We focus on the relationships between institutional pressures, eco-innovation, green supply chain management (GSCM) practices, CE capability, big data driven supply chains (BDSC), and performance for CE supply chains. We used a survey to collect data (n = 240) from people working in SMEs in the manufacturing sector in South Africa. Drawing from institutional theory, we find that coercive, normative, and mimetic pressures have a positive relationship with eco-innovation. Furthermore, eco-innovation is positively associated with GSCM, with these two concepts significantly related to the building of CE capability. The final element in our framework shows a positive relationship between GSCM and CE capability. Our findings reveal some nuances in terms of the relationships between the concepts. For example, whilst BDSCs have a moderating influence on the relationship between CE capability and firm performance for the CE supply chain, no such influence is evident for the relationship between GSCM practices and performance. Further work needs to focus on explaining this and other findings and on validating our theoretical framework.

PERANCANGAN BACKDROP UNTUK PERNIKAHAN MENGGUNAKAN TEKNIK MAKRAME

Mukhlisa Sabilla. C0915029. 2019. Backdrop Design for Wedding using the Macrame Technique. Final Project: Textile Craft Study Program, Faculty of Arts and Design, Sebelas Maret University. “Designing backdrop for wedding using the macrame technique” aims to explore the makame knots made into wedding decorations. The design results into an innovative product and has product differentiation. The realization of the product can add to the visual wealth of macrames that function aswedding decorations. The result of the design is a backdrop for wedding made with macrame techniques by taking the idea of the shape of flora sirih gading leaves and lotus flowers, the form of fauna butterflies, kawung motifs, wjikan, ukel/besusulan, tumpal/sorot and tassels. Backdrop consists of 3 parts, the main part is in themiddle, the complement is on the left and right. Laying the backdrop on a wooden frame inspired by the basic shape of the house. Backdrop with macrame technique offers different nuances in terms of aesthetics and visual appearance.

Consumption of Non-nutritive Sweeteners and Risk for Type 2 Diabetes: What Do We Know, and Not?

The article explores the relationship between non-nutritive sweetener consumption and the risk of developing type 2 diabetes through reviewing meta-analyses and systematic reviews, as well as clinical trials and observational studies. The data overall has yet to show a strong and clear link between consumption of non-nutritive sweeteners and the development of type 2 diabetes. However, several observational studies have shown a positive relationship between these two variables, with a stronger association found among women. Regarding non-nutritive sweeteners that are currently commercially available, there is not one specific non-nutritive sweetener that appears to be more strongly associated with the development of type 2 diabetes than other non-nutritive sweeteners. There is still much to be learned regarding non-nutritive sweeteners and their potential link to metabolic disorders. Further research is needed to identify the long-term impacts of non-nutritive sweetener consumption and identify the nuances in terms of risk of developing type 2 diabetes concerning specific non-nutritive sweeteners.

FEMALE FORM OF MALE DOMINANT STRUCTURE IN ARTISTIC CONTEXT

Women have always been the subject of art in terms of their biological and physiological characteristics. The compositions that are shaped in accordance with contents have different nuances in terms of form according to the cultural structure in the arts of civilizations with functional practices and sub-meaning interpretations. Despite this, they have common characteristics in terms of woman/body/sexuality on social duty and classification. Such that male domination social gender roles, gender discrimination based on biology bring along some restrictions and exclusion, and that degrades women to the subject of scopophilic. Gender structure in art is exposed with unfair visual codes, disadvantageous images, improper female circumstances and erotic nudity in many compositions. Women body that is turned into a theatrical material, their identity and gender are abstracted, their image, representation, symbol and government connetion shows the demands of male dominant structure. In this frame, the aim of this study is to analyze the affect of gender roles, patterns, the woman themed art pieces in historical process that is oriented towards structuring, building a sustainable woman perception in male dominant systems of societies on art history. Accordingly, the study is important in terms of showing the systematical dominances on woman identity, body, sexuality created by male dominant sense of art and art literature research in terms of turning femininity into a different construction other than its natural positions and clarifying the problem of re-naming and re-structuring the position of woman and body today. Literature research and descriptive research methods are used in this study. Related visuals and written resources are analyzed and the parts that are related to the content of this article are handled in a manner that creates meaningful unity. Keywords: Masculinity/femininity, male statement and work of art, social gender and art

The Nudge to Finish Up: A National Study of Community College Near-Completion Students

Community college near-completion students are community college starters who have accumulated a considerable number of credits but left college without any postsecondary educational credential. This quantitative study examined a nationally representative sample and intended to reveal significant predictors of becoming a community college near-completion student. We adopted Bean and Metzner’s (1985) framework to focus on characteristics of nontraditional college students and Bahr’s (2013) approach to emphasize students’ course-taking patterns. We conducted a latent class analysis to explore students’ course-taking patterns and examined whether different course-taking patterns would predict the likelihood of being a near-completion student using a logistic regression model. Findings indicated the significant role of course-taking patterns in predicting the likelihood of being a community college near completion student. Community college students who have taken and passed a large number of remedial courses are more likely to leave college without a credential. Additional interaction terms in the regression model further revealed the nuances in terms of the influences of course-taking patterns among various student sub-groups. Implications for practice and future research are discussed.

De urbanistas a planificadores

La presente entrevista indaga en la transformación del rol de los profesionales avocados a la disciplina regional y urbana, en el período comprendido entre mediados de la década del cuarenta y finales de los años sesenta. Centrando la conversación en la comprensión del pasaje de la figura del urbanista a la de planificador, se proponen iluminar nuevas aristas del debate que, sobre la base de la comprensión histórica del devenir disciplinar, posibilitan una lectura minuciosa de este desplazamiento de orden teórico y práctico. La estrategia de una mirada en clave latinoamericana de los trabajos de investigación de Arturo Almandoz Marte lo convierten en un interlocutor clave para la comprensión de los matices que adquiere la disciplina en lo referido a las ideas, los actores, los referentes y las indagaciones sobre la formación de profesionales vinculados a las necesidades del Estado en el período de estudio.

The second concert of powers: managing US-China competition on the Korean peninsula conflict in terms of international communication perspective

The conflict in the Korean peninsula is an issue that becoming a most major concern in the region other than the case of the South China Sea. Struggle for influence between the United States and China give new nuances in terms of supremacy competition and political status as a superpower. The war that occurred between two Koreans ensure that the balance of power will become the most dominant issue of the United States and China put forward in the future. Profits will be more felt by those who are disputing (South Korea and North Korea), compared to the United States and China. Paradigm to see that the conditions of the Cold War will happen again in the East Asia region should focus on the dominant form of economic compensation provided by each country (US and China). Conflict,ntherefore, require efforts to fight the influence by managing it well, so that it will give more benefits than losses for all affected countries. In this case, a diplomatic approach is needed in the form of conflict management communication to prevent armed contact between the two countries to fight for influence on the Korean peninsula.

PSYCHIATRY AND THE NOBEL PRIZE: EMIL KRAEPELIN’S NOBELIBILITY

1. Introduction In 1910, Kraepelin was invited to nominate a scholar for the Nobel Prize in physiology or medicine. He replied to the Nobel Committee: After receiving the invitation, I contacted colleagues in other medical fields for advice, because as it seems, researcher in my field can possibly for such an honourable award (Nobel archive (NA), Kraepelin yearbook 1910). It is speculative whether Kraepelin implied that no other researcher in my field but me should resonate in the mind of the readers, but his reply reveals three aspects of medicine and science associated with questions of personal achievements and reputation which will be investigated further in this paper. First, the staging of excellence in medicine with the help of the Nobel Prize; second, the role of psychiatry in the cast of the medical disciplines; and third, Kraepelin's story as a Nobel Prize runner-up. Given the focus of this journal, we will not discuss the prize-worthiness of Kraepelin's scientific work or his legacy in detail. It is in this context sufficient to mention that Kraepelin's name still stands for excellence in psychiatry: Established in 1928, the Golden Kraepelin Medal (awarded by the German Research Institute of Psychiatry) is one of the world's most renowned awards in psychiatry. Reflecting upon this reputation, it is perhaps not surprising that Kraepelin was nominated several times for the Nobel Prize in physiology or medicine. In this paper we demonstrate the ambivalence of excellence and failure preserved in the Nobel Prize archive by tracing the nominations for Kraepelin, one of the founders of modern scientific psychiatry. A few of the arguments presented here were also highlighted in a recent correspondence piece for World Psychiatry (Hansson and Fangerau 2016). Taking Kraepelin's case as an example, we try to deconstruct the aura surrounding the Nobel Prize, arguably--at least nowadays--the strongest symbol of scientific excellence worldwide. The key questions concern how and why particular scientists have been acknowledged as the greatest in their respective fields. We do that by analyzing Nobel Prize nominations collected in the archive of the Nobel Committee for physiology or medicine in Sweden. These files offer new perspectives on reward mechanisms in medicine and on how excellence has been attributed within particular scientific communities during the 20th century. Moreover, the nominations can help to reconstruct networks in medicine and science, and even more so if--where applicable--personal letters between nominator and nominee and comments in the daily press are added to the analysis. Bo S. Lindberg, for example, combined such sources and presented new nuances in terms of international reputation of the strong Nobel Prize candidate and renowned Swedish neurologist Salomon Henschen during the first decades of the 20th century (Lindberg 2013). Following this approach, we are interested in why some often nominated candidates fail in the end. To understand Kraepelin's Nobel Prize candidacy--or Nobelibility, Juri Allik coined this neologism at the Tartu conference Emil Kraepelin 160/30 in February 2016, meaning the eligibility for winning a Nobel Prize--better, we will first have a brief look at the Nobel Prize nomination procedure and zoom in on the rather few prizes for psychiatrists. Second, the nominations for Kraepelin will be reconstructed in order to understand why he as one of the most important psychiatrist of his time was never awarded the prize. In the end, Kraepelin could not, to use his own words: compete for such an honourable award. Thus, we finally have to ask, why he was only a second best option for the Nobel Prize committee. The focus will be on Kraepelin as a nominee, although he also acted as a nominator himself on several occasions. From 1901 to 1921 he nominated in chronological order, according to the official Nobel Prize nomination database, scholars of different nationalities working in various fields of medicine: Robert Koch (1901, 1905), Jules Bordet (1910, 1912, 1914), Bernhard Naunyn (1910), Felix Marchand (1911, 1912), Franz Nissl (1919), and August von Wassermann (1920, 1921) (https://www. …

Managing Patients With Psoriasis in the Busy Clinic: Practical Tips for Health Care Practitioners.

Psoriasis is a common inflammatory disease with significant comorbidities, whose management can be challenging given the variety of treatment options. It is critical for nurse practitioners, physician assistants, general practitioners, and dermatology trainees to have useful information about the treatment and monitoring of patients with psoriasis. Although certain aspects of care apply to all patients, each therapeutic agent has its own nuances in terms of assessments, dosing, and monitoring. The most appropriate treatment is based not only on disease severity but also on comorbid conditions and concomitant medications. These practitioners are vital in facilitating patient care by thorough understanding of systemic agents, selection criteria, dosing, and recommended monitoring. This article provides high-yield practical pearls on managing patients with moderate to severe psoriasis. It includes case-based discussions illustrating considerations for special populations, such as pregnant women, children, and patients with comorbidities (eg, human immunodeficiency virus infection, hepatitis C, hepatitis B, and history of malignancy).

Talking About Sexual Consent

Sexual consent is an increasingly important concept for sexual violence prevention. Practitioners of bondage/discipline, dominance/submission, sadomasochism (hereafter BDSM) advocate strong community standards of active sexual consent to ensure that their practices are clearly differentiated from abuse. In this article, we explore the ways in which heterosexual female BDSM practitioners understand the meaning of and communicate sexual consent within their relationships. Their accounts of sexual consent within their BDSM relationships present sexual consent as synonymous with safe play. Yet, even within a context that demands explicit consent, there are complexities and nuances in terms of how sexual consent is communicated during play. We explore how explicit forms of consent found in descriptions of BDSM sit uncomfortably next to feminist analyses of how heteronormativity can undermine women's autonomy during heterosex.

Les juifs courtiers parmi les chrétiens : l’échange sans la religion ?

In the Crown of Aragon, where usury was permitted through regulation, especially in Catalonia and Mallorca, brokers were not all Jews who were usually seen as being the specialists in monetary transactions. Jews were certainly over-represented in trade but it is also now known that they could hold a wide variety of jobs. There are in fact few traders or lenders among the Jewish community from the 14th century, such roles tending instead to belong to members of urban and intellectual elites. This paper compares two social networks: that of Pons de Gualba, bishop of Barcelona, and that of Bartomeu de Mans, magistrate/provost of Vilafranca del Pénedes, who had links with Berenger de Finestres, a money-changer of Barcelona. The networks of these two eminent men were interlinked, in the sense that the roles played by Jews and Christians in the trading process were neither strictly segregated nor exactly the same, the precise distribution of these roles depending on the subtlest of nuances in terms of how the members of the two religions related to each other. The trade associations of Jews and Christians were different, as were the insults used to deprecate rivals. It is thus not that trade took no account of religion but rather that religious difference could be used as a means to colour the expression of the normal love-hate relationships between men who were involved in the business of trade.

Strained Metallocenophanes and Related Organometallic Rings Containing π‐Hydrocarbon Ligands and Transition‐Metal Centers

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Strained Metallocenophanes and Related Organometallic Rings Containing π‐Hydrocarbon Ligands and Transition‐Metal Centers

The structures, bonding, and ring-opening reactions of strained cyclic carbon-based molecules form a key component of standard textbooks. In contrast, the study of strained organometallic molecules containing transition metals is a much more recent development. A wealth of recent research has revealed fascinating nuances in terms of structure, bonding, and reactivity. Building on initial work on strained ferrocenophanes, a broad range of strained organometallic rings composed of a variety of different metals, pi-hydrocarbon ligands, and bridging elements has now been developed. Such strained species can potentially undergo ring-opening reactions to functionalize surfaces and ring-opening polymerization to form easily processed metallopolymers with properties determined by the presence of the metal and spacer. This Review summarizes the current state of knowledge on the preparation, structural characterization, electronic structure, and reactivity of strained organometallic rings with pi-hydrocarbon ligands and d-block metals.

The Language of Evaluation Theory: Insights Gained from an Empirical Study of Evaluation Theory and Practice

Abstract: Broad concern for language issues in evaluation has been limited in comparison to other social science disciplines. In this article, some occasions of definitional or conceptual confusion with evaluation theory language are identified that emerged during a study conducted by Christie. We suggest that much of the language we use to describe evaluation practice is steeped in theoretical terminology, which may limit the utility of the language. We also argue that theoretical language ought to be used with great care, with attention to the subtleties and nuances of terms, for there may be unexpected confusion or ambiguity in the field about the terms we routinely use. A research agenda is offered, suggesting that it would be both an informative as well as a useful task for us to learn more about the everyday “folk theories” of the field and the vernacular used to describe them.