Real-life Observations Research Articles

COVID-19 Vaccine: A Potential Risk Factor for Accelerating the Onset of Bullous Pemphigoid.

Bullous pemphigoid (BP) is the most common autoimmune bullous disease, whose main autoantigens are hemidesmosomal components BP180 and BP230. Although recent studies found no association between COVID-19 vaccines and BP, since mass vaccinations started, more than 90 vaccine-associated BP cases have been reported. To find an agreement among real-life clinical observations and recent epidemiologic data, we further investigated this topic. A total of 64 patients with BP onset in 2021 were demographically, clinically, and serologically characterized: 14 (21.9%) vaccine-associated patients (VA) developed BP within 5 weeks from the first/second vaccine dose. VA and vaccine-non-associated (VNA) patients had similar demographics and clinical and immunological characteristics. Noteworthy, the monthly distribution of BP onset during mass vaccinations paralleled vaccine administration to the elderly in the same catchment area. Additionally, in 2021, BP onsets in April-May and June-July significantly increased (p = 0.004) and declined (p = 0.027), respectively, compared to the three years before vaccination campaigns (2018-2020). Interestingly, VA and VNA patients showed statistically significant differences in the use of inhalers and diuretics. Our findings suggest that the COVID-19 vaccine may constitute an accelerating factor that, together with other triggering factors, could act in genetically predisposed individuals with possible sub-clinical autoreactivity against BP antigens, slightly accelerating BP onset.

The use of biologics in patients suffering from chronic rhinosinusitis with nasal polyps - a 4-year real life observation.

Antibody therapy for chronic rhinosinusitis with nasal polyps (CRSwNP) has been established in Germany since 2019. With limited long-term data on biologic treatment for CRSwNP, we conducted a comprehensive evaluation of our 4-year data. This monocentric study aims to assess the real-world effects of this treatment on clinical course, quality of life, treatment adherence, biologic switching, dual therapy, and comorbidities. We retrospectively analysed biologic therapy data in patients with severe chronic rhinosinusitis with nasal polyps. 191 patients with CRSwNP treated with Dupilumab, Mepolizumab, or Omalizumab were observed for up to 4 years in a real-life setting. We observed clear symptom improvements with few side effects. No loss of efficacy or tolerability was noted during the 4-year period. Patients reported high satisfaction compared to previous therapies, with overall improved quality of life. Revision surgery or oral steroid use during biologic therapy was rare. Some patients prolonged injection intervals or discontinued steroid nasal spray. Biologic switching occurred infrequently due to side effects or inadequate response and was generally well tolerated. Many patients reported additional positive effects such as asthma or allergy symptom improvement and reduced medication intake. In summary, this study confirms the potency and tolerability of biologics for CRSwNP treatment, with sustained efficacy over 4 years. Biologic switching is a viable option for inadequate response or intolerable side effects. Therapy positively impacts Th2 comorbidities, corticosteroid requirements, surgery need, and overall compliance remains high. Project No.: 22-0802. Registry name: Biologika bei Patient*innen mit chronischer Sinusitis mit Nasenpolypen.

Understanding the AI Integrity in Academic Excellence: Bangladesh Perspective

Artificial Intelligence (AI) and Machine Learning (ML) are revolutionary tools that have opened up a new technology-driven horizon in academic learning to enhance and accelerate the higher education journey. This article describes and discusses the convergence of academic integrity and AI, both of which are fundamental to our intellectual environment. An effective approach to AI-integrated learning can balance the use of AI-generated tools and techniques to stimulate students' creativity, analytical thinking, and real-life observation. As we strive for academic excellence, it is essential to integrate AI in academics and all other spheres of development with balance and rationality, through appropriate policies and regulated ethical and value-based use. Educational institutes should have many open platforms to discuss, debate, and smoothly integrate AI technology into academic practices while maintaining the integrity that underpins our scholarly pursuits. Investing in academic and policy debates and discussions regarding the ethicality of AI applications can create a brighter future for academia. This will allow us to leverage the power of AI to advance our knowledge and understanding and to build a stronger nation with greater impact.

What Is Ailing Oncology Clinical Trials? Can We Fix Them?

Evidence from phase three clinical trials helps shape clinical practice. However, a very small minority of patients with cancer participate in clinical trials and many trials are not completed on time due to slow accrual. Issues with restrictive eligibility criteria can severely limit the patients who can access trials, without any convincing evidence that these restrictions impact patient safety. Similarly, regulatory, organizational, and institutional hurdles can delay trial activation, ultimately making some studies irrelevant. Additional issues during trial conduct (e.g., mandatory in-person visits, central confirmation of standard biomarkers, and inflexible drug dosage modification) contribute to making trials non-patient-centric. These real-life observations from experienced clinical trialists can seem nonsensical to investigators and patients alike, who are trying to bring effective drugs to patients with cancer. In this review, we delve into these issues in detail, and discuss potential solutions to make clinical trials more accessible to patients.

Engaging in language therapy to enhance the proficiency of simultaneous bilingualism: A case study of a multilingual child

Bilingualism and multilingualism are no longer exceptional occurrences on today’s globe; instead, they have become the prevailing standards in cultures worldwide. Individuals can become bilingual by either simultaneous acquisition of two languages from childhood or sequential acquisition over time as bilinguals. The primary objective of this study is to determine the role of language therapists in assisting parents and teachers in optimizing the dual-language proficiency of young children. This case study was conducted to investigate this matter, and it was determined that a balanced utilization of both languages, coupled with guidance from language professionals to parents and teachers, dramatically enhances a child’s performance. In addition, parents consistently strive for their child to become multilingual, as they perceive it as a beneficial factor for their child’s future. The data was gathered through a semi-structured interview session with parents and real-life scenario observations. This case study illustrates the advantages and disadvantages of being bilingual or multilingual. The study findings will assist parents and early childhood educators in dealing with children coping with different language encounters at home and school.

A new approach to the evaluation and solution of the relativistic kinetic dispersion relation and verification with continuum kinetic simulation

The present work describes a new approach to evaluation and root finding for the kinetic dispersion relation of Langmuir waves, which is central to the analytical understanding of collisionless damping in plasmas. The plasma dispersion function is solved to machine precision using direct integration in the complex plane in combination with an analytic evaluation of the residue to account for the deformation along the Landau contour. To efficiently attain machine precision, the contour is displaced in the complex plane prior to integration, and numerical subtleties related to the placement of the contour are discussed. The approach is generic in that it applies to arbitrary distribution functions, with the present manuscript focused on relativistic cases. Detailed verification of results via direct kinetic simulation in a variety of configuration space dimensions is also presented. Finally, the technique is applied to the challenging case of highly relativistic (i.e. extremely hot) plasmas. Here we show both qualitative agreement with prior work, as well as the disappearance of the Landau root which would have significant implication for real-life observation or experiment.

Wayfinding in immersive virtual environments as social activity supported by virtual agents

Effective navigation and interaction within immersive virtual environments (IVEs) rely on thorough scene exploration. Therefore, wayfinding is essential, assisting users in comprehending their surroundings, planning routes, and making informed decisions. Based on real-life observations, wayfinding is, thereby, not only a cognitive process but also a social activity profoundly influenced by the presence and behaviors of others. In virtual environments, these “others” are virtual agents (VAs), defined as anthropomorphic computer-controlled characters, who enliven the environment and can serve as background characters or direct interaction partners. However, less research has been conducted to explore how to efficiently use VAs as social wayfinding support. In this paper, we aim to assess and contrast user experience, user comfort, and acquisition of scene knowledge through a between-subjects study involving n = 60 participants across three distinct wayfinding conditions in one slightly populated urban environment: (i) unsupported wayfinding, (ii) strong social wayfinding using a virtual supporter who incorporates guiding and accompanying elements while directly impacting the participants’ wayfinding decisions, and (iii) weak social wayfinding using flows of VAs that subtly influence the participants’ wayfinding decisions by their locomotion behavior. Our work is the first to compare the impact of VAs’ behavior in virtual reality on users’ scene exploration, including spatial awareness, scene comprehension, and comfort. The results show the general utility of social wayfinding support, while underscoring the superiority of the strong type. Nevertheless, further exploration of weak social wayfinding as a promising technique is needed. Thus, our work contributes to the enhancement of VAs as advanced user interfaces, increasing user acceptance and usability.

Efficacy of risankizumab after intra-class switching between anti IL-23 antagonists: a multi-center, retrospective, real-life observation.

Efficacy of risankizumab after intra-class switching between anti IL-23 antagonists: a multi-center, retrospective, real-life observation.

Mathematical model of osteophyte development with the first attempt to identify a biomechanical parameter

The paper presents research on identifying a biomechanical parameter from a theoretical model of changes during osteoarthritis. In vitro experiments were carried out on quasi-3D chondrocyte cultures seeded on corn-starch hydrogel materials and subjected to mechanical stress on a designed and constructed stand. The results were adapted to a mathematical model and calculated on a simplified two-dimensional specimen. Numerical simulations have been performed to illustrate the growth of bone spurs. The observed changes of variables which determine osteophytes are qualitative and more correlated to the real-life observations.

Anti‐VEGF for wet AMD ‐ Which drug and how often?

Introduction of anti‐VEGF agents as a treatment option of neovascular AMD (ex AMD) in 2004 have brought dramatic progression in the treatment of that disease and until now it is a gold standard for ex AMD management. In that course we will present following subjects concerning ex AMD treatment with the use of anti‐VEGF drugs. We will present a variety of anti‐VEGF agents used now for ex AMD treatment: ranibizumab, aflibercept, brolucizumab, faricimab. We will discuss the differences between these drugs, in terms of efficacy and safety. Results from clinical trials and real life observations will be presented. Novel drug‐faricimab will be presented as bispecific antibody‐which inhibits both angiopoietin‐2 and VEGF‐A which possesses superior therapeutic action in reducing vascular leaking and inflammatory responses. The rules of different regiments of anti‐VEGF treatment will be discussed‐ fixed, PRN (pro re nata), TREX (treat and extend). We will discuss as well two important problems: When to switch to the other drug in ex AMD treatment and which were the results of the treatment of patients with ex AMD during the COVID‐19 pandemic. New therapeutic strategies in ex AMD will be presented as research in under way to develop novel anti‐VEGF agents with longer duration of action and to identify new methods of delivery with long‐ term release of anti‐VEGF medication as intraocular implants.

A stochastic differential equation model for predator-avoidance fish schooling

This paper presents a mathematical model based on stochastic differential equations (SDEs) to depict the dynamics of a predator–prey system in an aquatic environment characterized by schooling behavior among the prey. The model employs a particle-like approach, incorporating attractive and repulsive forces, akin to phenomena observed in molecular physics, to capture the interactions among the constituent units. Two hunting tactics of the predator, center-attacking and nearest-attacking strategies, are integrated into the model. Numerical simulations of this model unveil four distinct predator-avoidance patterns exhibited by schooling prey: Split and Reunion, Split and Separate into Two Groups, Scattered, and Maintain Formation and Distance. Our results also confirm the effectiveness of large groups of schooling prey in mitigating predation risk, consistent with real-life observations in natural aquatic ecosystems. These findings validate the accuracy and applicability of our model.

Beyond Linguistics: Exploring the Cognitive and Motivational Barriers to Essay Writing for Tertiary Students

In higher education, developing strong writing skills is crucial for students' academic and career success. Unfortunately, this important aspect of education has been somewhat neglected in the context of Maluku province. Therefore, this study, serves the crucial purpose of shedding light on the multifaceted factors that underpin the deficiencies in writing skills. The primary aim of this study is to explore the fundamental factors contributing to the deficiencies in tertiary students' writing skills. To accomplish this, we conducted a quantitative survey, selecting a random sample of 70 Moluccan local students out of 120 who were enrolled in an essay writing class. Results indicate that cognitive factors play the most pivotal role in contributing to deficiencies in writing skills, boasting a remarkably high path coefficient value of 0.846. Linguistic factors and motivational aspects closely follow, with values of 0.556 and 0.528, respectively. The deficiency in writing skills among students can be attributed to a lack of internal motivation for learning, and inadequate opportunities provided by teachers for real-life observation and learning. For effective improvement in writing abilities, students need both an intrinsic motivation to learn and consistent guidance and stimulation from educators. The process of writing not only involves linguistic capability but also a deep cognitive understanding, emphasizing the need for students to process and present their thoughts comprehensively and appealingly. Improving tertiary students' writing skills require a comprehensive approach that addresses cognitive, linguistic, and motivational factors. Implementing these implications can result in more effective teaching methods and improved writing outcomes for students.

Membina Keahlian Pertambangan: Pembelajaran Aktif dan Pelatihan Laboratorium di PT Bukit Asam Tanjung Enim untuk Mahasiswa Universitas Sriwijaya

Since the outbreak of the COVID-19 pandemic in early 2020, many processes in teaching and learning have experienced significant disruption, hindering implementation as originally planned. The impact of this is that some learning materials are not provided adequately, resulting in reduced student skills. Therefore, measures of field observations and practical participation have been designed and implemented with the aim of encouraging students to improve their skills. In this initiative, the observation method is used in conjunction with practical training sessions. The holistic approach allows students to learn holistically through real-life observations and real-world applications. The results of this activity are carefully evaluated, focusing on comparing the students' initial ability before participating in the program and their achievements after participating in this series of activities. Analysis of these assessments showed that mastery of the theoretical material has increased significantly, with an average increase of 42%. In addition, in terms of actual application there is a more pronounced increase, with an average actual capacity increase of 97.625%. These results clearly reflect the effectiveness of field observations and practical practices in enhancing students' skills, both in theory and in practical application.

Safe mobility: Analysis of drivers' behavior at the stop bar of signalized intersections using mixed-effects modeling

Transportation safety continues to be a daily challenge as it results in enormous losses to human life and to the economy. This research targets safe mobility at intersections in an urban setting by analyzing drivers' behavior at the stop bar during red-light phases with an unprecedented focus on drivers' psychological and demographic attributes. To do so, three main scenarios are utilized to test drivers' responses using a state-of-the-art driving simulator, which include pedestrians crossing the crosswalk, police enforcement personnel and adjacent driver encroaching on the stop bar promoting the imitation behavior. A survey assessing demographics, including standardized questionnaires for individual psychological traits and driving rituals is used to complement the simulator experience for a total of 178 participants. Real life observations and monitoring at intersections are conducted to confirm drivers' behaviors with respect to stopping at the stop bar in the presence of various triggers. Our results show that younger males with a history of at least one severe accident are more likely to exhibit aggressive behavior such as speeding and committing violations. Participants scoring high on the Attitudes Towards Traffic Safety and Driving Behavior Survey scales are safer drivers who show more concern about traffic laws. High scores on mindfulness and agreeableness (Big Five Personality Inventory) are associated with less violations whereas extraversion and neuroticism linked with impulsivity and frustration are associated with higher acceleration rates and overall speed. Taken together, driving scenarios and psychological variables better profile differential safe driving behaviors. Thus, it could be highly effective to include trainings for mindfulness and emotional management in addition to driving risk-awareness to enhance safe driving behavior and focus on improving the existing driving education system by focusing on young drivers' attitudes towards safety as it has shown to impact their actual driving behavior.

P247 ETI reduces antibiotic treatment days in people with cystic fibrosis – a real-life observation

Since its approval, Elexacaftor/Tezacaftor/Ivacaftor (ETI) has improved lung function and decreased the number of pulmonary exacerbations in people with cystic fibrosis (pwCF). Here, we investigated the influence of ETI on the amount of oral and intravenous (iv) antibiotic therapies in pwCF since the initiation of ETI therapy.

Should I stay or should I go now? Empirical and real-life observations of the effect of uniform colour on inhibitory control

ABSTRACT We asked whether inhibitory control during sport is influenced by uniform colour. Participants were instructed to pass to the larger side of an opponent wearing red, green, or grey (control) uniforms, but not when that side was defended. Correct inhibition of responses was lower when opponents wore uniforms that were green compared to grey, but not red compared to grey, suggesting that perceiving green impaired inhibition. We therefore interrogated archival data to examine the association between green uniforms and intercepted passes–if green impairs an opponent’s inhibitory control, more ill-chosen passes should occur. Netball teams wearing predominantly green uniforms completed significantly more intercepts than teams wearing other-coloured (control) uniforms, suggesting that the colour of their uniform may have promoted a higher proportion of ill-chosen passes by opponents. Colour may influence inhibition in sport due to a colour-meaning association–green is “go”.

Investigating Language Ego as an Affective Factor Influencing Second Language Acquisition in the Learning Process

ABSTRACT: Real-life observation has shown that second language (L2) learners differ in their L2 learning process in which this individual difference is virtually related to the factors influencing second language acquisition. Many researchers have been interested in finding those factors, yet there is still a little study examining the impact of language ego as the affective factor. Thus, this paper aims to elaborate on how the language ego influences second language acquisition. By having a thorough understanding of language ego in L2 learning, it is expected that it can give some enlightenment to a better learning process for L2 learners.To provide an adequate explanation of language ego, this paper uses a literature review. This method is used to aggregate empirical findings related to a narrow research question which is the language ego as one of the affective factors influencing second language acquisition. Some previous studies that discuss a similar topic are collected, and the data is analyzed in accordance with the objective of this paper.As one of the affective factors, language ego is a psychological state of a learner in which it refers to the identity that a person develops in reference to the language. In this paper, it is hypothesized that the language ego influences second language acquisition in positive correlation when the focus is the permeability of the language ego. The permeability shows how the ego can be flexible and adaptable to the second language. The higher the learner’s language ego permeability is, the higher the learner’s chance of successful second language acquisition is.

Safety and effectiveness of vaccines against COVID-19 in children aged 5–11 years: a systematic review and meta-analysis

To date, more than 761 million confirmed SARS-CoV-2 infections have been recorded globally, and more than half of all children are estimated to be seropositive. Despite high SARS-CoV-2 infection incidences, the rate of severe COVID-19 in children is low. We aimed to assess the safety and efficacy or effectiveness of COVID-19 vaccines approved in the EU for children aged 5-11 years. In this systematic review and meta-analysis, we included studies of any design identified through searching the COVID-19 L·OVE (living overview of evidence) platform up to Jan 23, 2023. We included studies with participants aged 5-11 years, with any COVID-19 vaccine approved by the European Medicines Agency-ie, mRNA vaccines BNT162b2 (Pfizer-BioNTech), BNT162b2 Bivalent (against original strain and omicron [BA.4 or BA.5]), mRNA-1273 (Moderna), or mRNA-1273.214 (against original strain and omicron BA.1). Efficacy and effectiveness outcomes were SARS-CoV-2 infection (PCR-confirmed or antigen-test confirmed), symptomatic COVID-19, hospital admission due to COVID-19, COVID-19-related mortality, multisystem inflammatory syndrome in children (MIS-C), and long-term effects of COVID-19 (long COVID or post-COVID-19 condition as defined by study investigators or per WHO definition). Safety outcomes of interest were serious adverse events, adverse events of special interest (eg, myocarditis), solicited local and systemic events, and unsolicited adverse events. We assessed risk of bias and rated the certainty of evidence (CoE) using the Grading of Recommendations Assessment, Development and Evaluation approach. This study was prospectively registered with PROSPERO, CRD42022306822. Of 5272 screened records, we included 51 (1·0%) studies (n=17 [33%] in quantitative synthesis). Vaccine effectiveness after two doses against omicron infections was 41·6% (95% CI 28·1-52·6; eight non-randomised studies of interventions [NRSIs]; CoE low), 36·2% (21·5-48·2; six NRSIs; CoE low) against symptomatic COVID-19, 75·3% (68·0-81·0; six NRSIs; CoE moderate) against COVID-19-related hospitalisations, and 78% (48-90, one NRSI; CoE very low) against MIS-C. Vaccine effectiveness against COVID-19-related mortality was not estimable. Crude event rates for deaths in unvaccinated children were less than one case per 100 000 children, and no events were reported for vaccinated children (four NRSIs; CoE low). No study on vaccine effectiveness against long-term effects was identified. Vaccine effectiveness after three doses was 55% (50-60; one NRSI; CoE moderate) against omicron infections, and 61% (55-67; one NRSI; CoE moderate) against symptomatic COVID-19. No study reported vaccine efficacy or effectiveness against hospitalisation following a third dose. Safety data suggested no increased risk of serious adverse events (risk ratio [RR] 0·83 [95% CI 0·21-3·33]; two randomised controlled trials; CoE low), with approximately 0·23-1·2 events per 100 000 administered vaccines reported in real-life observations. Evidence on the risk of myocarditis was uncertain (RR 4·6 [0·1-156·1]; one NRSI; CoE low), with 0·13-1·04 observed events per 100 000 administered vaccines. The risk of solicited local reactions was 2·07 (1·80-2·39; two RCTs; CoE moderate) after one dose and 2·06 (1·70-2·49; two RCTs; CoE moderate) after two doses. The risk of solicited systemic reactions was 1·09 (1·04-1·16; two RCTs; CoE moderate) after one dose and 1·49 (1·34-1·65; two RCTs; CoE moderate) after two doses. The risk of unsolicited adverse events after two doses (RR 1·21 [1·07-1·38]; CoE moderate) was higher among mRNA-vaccinated compared with unvaccinated children. In children aged 5-11 years, mRNA vaccines are moderately effective against infections with the omicron variant, but probably protect well against COVID-19 hospitalisations. Vaccines were reactogenic but probably safe. Findings of this systematic review can serve as a basis for public health policy and individual decision making on COVID-19 vaccination in children aged 5-11 years. German Federal Joint Committee.

Improved Imagery Throughput via Cascaded Uncertainty Pruning on U-Net++

The extensive use of machine learning inferences in real-life earth observation and remote sensing cases has grown over recent years. Network pruning has been carefully studied in various applications to speed up the machine learning workflow, but mainstream pruning strategies often focus on specific connection significancy rather than the sample difficulty. U-Net++ as a well-versed and capable semantic segmentation deep convolutional neural network architecture, as well as its equivalents, are all facing the challenge of overconfidence, which will create barriers for a robust uncertainty-based pruning strategy to be designed. In the following study, we analyzed the efficiency of deep neural networks and semantic segmentation in satellite imagery analysis, and proposed a new tailored workf low of dynamic pruning for U-Net++ by combining the ideas of network calibration and uncertainty and defining the inference complexity of network input samples. We tested and illustrated the capability of this new workflow and delivered a successful comparative study on its effectiveness on the DeepGlobe satellite imagery road extraction dataset and how it can greatly reduce the computational cost with little performance drop.

A new intervention strategy for an HIV/AIDS transmission by a general fractional modeling and an optimal control approach

This study proposes a new mathematical model in a generalized fractional framework for the investigation of an HIV/AIDS transmission dynamics. An auxiliary parameter further prevents the fractional equations from mismatching in the dimension. In order to analyze the general model, the non-negativity of the solution and the stability of the equilibrium points are examined. The model is also implemented by a powerful numerical scheme based on the quadrature rules and the repeated Trapezoidal method; as well, the error discussion and the convergence analysis are established. In addition, an efficient intervention strategy is developed and examined based on the optimal control theories in terms of optimality necessary conditions. Real-life clinical observations from Cape Verde Islands show that the new fractional model outperforms the classical one with ordinary time-derivatives, and enhances the modeling output compared to the previous fractional mathematical results. Further, numerical simulations demonstrate that the proposed optimal control measure leads to a significant reduction in the disease spread. As a result, the general fractional model offers a degree-of-freedom, an efficient tool which is helpful to illustrate the fundamental features of the disease transmission and to increase the efficiency of the proposed treatment strategy.