Systematic Recording Research Articles

Allergen immunotherapy adverse events in adults with respiratory allergies-data from ADER: An EAACI task force report.

Registries can yield important insights on allergen immunotherapy (AIT) outcomes in daily clinical practice. However, systematic recordings of adverse events (AE) due to AIT in real-life are lacking. The Allergen Immunotherapy Adverse Events Registry (ADER) is a prospective, multicenter registry on real-life AIT safety. Data on adults (>18 years old) with respiratory allergies receiving AIT with mites, pollens, epithelia, and/or molds were retrieved and analyzed from ADER. The frequency, characteristics and risk factors of AE were investigated. The MedDRA terminology was used to record AE. A total of 1545 individuals with a mean age of 33 ± 10 years receiving 1815 AIT courses (n = 1060 sublingual (SLIT); n = 755 subcutaneous (SCIT)) in centers from eight countries were included. Patients had allergic rhinitis (65%) or, asthma only (3.7%) or rhinitis with asthma (31.2%). Grass was the most frequent specific sensitizer (60.7%), followed by mites (45.5%), birch pollen (20.6%), epithelia (16.1%), and molds (8%). There were 296 AE recorded in 115 patients (7.4%). A higher frequency of AE occurred during up-dosing (59%) compared to maintenance. Severe reactions were rare (0.2%), all in the context of SCIT. After 6 weeks of maintenance only one moderate AE was recorded. The most frequently reported symptoms were from the respiratory system and the skin. Having asthma, doing SCIT, AIT with mugwort, cat, or birch were associated with higher risk for AE while the use of allergoids induced lower risk. In real life clinical practice, AIT-associated AE occur in a minority of patients, while severe reactions are rare. The presence of asthma and use of SCIT are risk factors, while the use of modified allergens lowers the risk.

Has genomic selection fulfilled its promise?

Abstract Genomic selection has been increasingly implemented since its initial description in 2001. The initial focus of activity was in the dairy industry in the developed world but it has now been adopted in all major livestock species, and adoption is underway in most agronomically important plants. The promise of genomic selection includes increased accuracy of estimation of genetic merit, earlier estimation of genetic merit, the capacity to make improvements in traits previously less tractable to genetic change, and the capacity to estimate genetic merit in animals without phenotypic records. Each of these benefits has been realised in practice, with the significance of the opportunity varying with species. At the same time, ease of adoption and realisation of benefits has varied, based on three broad parameters: the availability of suitable (and sufficiently cheap) genotyping tools, the prior extent of systematic recording of phenotypes, and the use of estimates of genetic merit in selection. The effectiveness of genomic selection depends on the existence and composition of a genomic reference population, and this is the most significant challenge for any industry, breed or breeding program seeking to achieve the available benefits. The challenge is two-fold: first, to ensure that sufficient of the right phenotypes are recorded on the right animals, and second, flowing directly from the first, is to fund the phenotyping effort – and challenges aspects are ongoing. “Right” in the context of both phenotypes and animals means most informative, or relevant to the breeding objective or goal. No standard approach has been outlined for addressing these challenges, but the review presents some simple conceptual thinking that can assist. Genomic selection also heightens the importance of ensuring maintenance of genetic diversity, and of monitoring changes in both selected and non-selected traits. Genomic selection has fulfilled its promise where applied effectively and is increasing scope for genetic improvement both in rate of progress and trait coverage. At the same time, its dependencies must be addressed in order to the potential benefits to be realised, and this will likely require new organisational and funding arrangements in many situations.

Plants and their uses in dermatological recipes of the Receptarium of Burkhard III von Hallwyl from 16th century Switzerland – Data mining a historical text and preliminary in vitro screening

Ethnopharmacological relevanceHistorical texts on materia medica can be an attractive source of ethnopharmacological information. Various research groups have investigated corresponding resources from Europe and the Mediterranean region, pursuing different objectives. Regardless of the method used, the indexing of textual information and its conversion into data sets useful for further investigations represents a significant challenge. Aim of the studyFirst, this study aims to systematically catalogue pharmaco-botanical information in the Receptarium of Burkhard von Hallwyl (RBH) in order to identify candidate plants in a targeted manner. Secondly, the potential of RBH as a resource for pharmacological investigations will be assessed by means of a preliminary in vitro screening. Materials and methodsWe developed a relational database for the systematic recording of parameters composing the medical recipes contained in the historical text. Focusing on dermatological recipes, we explored the mentioned plants and their uses by drawing on specific literature. The botanical identities (candidate species) suggested in the literature for the historical plant names were rated based on their plausibility of being the correct attribution. The historical uses were interpreted by consulting medical-historical and modern clinical literature. For the subsequent in vitro screening, we selected candidate species used in recipes directed at the treatment of inflammatory or infectious skin disorders and wounds. Plants were collected in Switzerland and their hydroethanolic crude extracts tested for possible cytotoxic effects and for their potential to modulate the release of IL-6 and TNF in PS-stimulated whole blood and PBMCs. ResultsThe historical text analysis points up the challenges associated with the assessment of historical plant names. Often two or more plant species are available as candidates for each of the 161 historical plant names counted in the 200 dermatological recipes in RBH. On the other hand, our method enabled to draw conclusions about the diseases underlying the 56 medical applications mentioned in the text. On this basis, 11 candidate species were selected for in vitro screening, four of which were used in RBH in herbal simple recipes and seven in a herbal compound formulation. None of the extracts tested showed a noteworthy effect on cell viability except for the sample of Sanicula europaea L. Extracts were tested at 50 μg/mL in the whole blood assay, where especially Vincetoxicum hirundinaria Medik. or Solanum nigrum L. showed inhibitory or stimulatory activities. In the PBMC assay, the root of Vincetoxicum hirundinaria revealed a distinct inhibitory effect on IL-6 release (IC50 of 3.6 μg/mL). ConclusionsUsing the example of RBH, this study illustrates a possible ethnopharmacological path from unlocking the historical text and its subsequent analysis, through the selection and collection of plant candidates to their in vitro investigation. Fully documenting our approach to the analysis of historical texts, we hope to contribute to the discussion on solutions for the digital indexing of premodern information on the use of plants or other natural products.

Do MCH prisms change asthenopic complaints when reading?

Purpose. Asthenopic symptoms mostly occur during demanding near-sighted tasks and are related to binocular symptoms (e. g. heterophoria), among others. Correction of symptomatic heterophoria with prismatic glasses is one way to treat the symptoms. This study investigates the effect of wearing a horizontal prismatic correction for 6 months. Material and Methods. A total of 87 subjects were assigned to a heterophoric prism group (N = 32), a heterophoric control group (N = 31) or an orthophoric control group (N = 24) according to their MCH heterophoria. In the heterophoric prism group, the subjects were prescribed glasses with a prismatic correction for 6 months according to their distance correction; in contrast, the subjects in the heterophoric control group had to wear glasses without prismatic correction for the same period. The effect of the prisms on complaints due to asthenopic symptoms was investigated by comparing the total sum obtained in the CISS questionnaire at the beginning of the study and after 6 months (before and after wearing glasses) for the 3 groups. Results. A (long-term) prism effect was not apparent in the CISS total score. In both the heterophoric prism group and in the heterophoric control group, the CISS total score increased slightly and non-significantly after 6 months. When considering the heterophoric subjects with an increased CISS score at baseline, a nevertheless slight but non-significant decrease of symptoms was observed. All changes were observed in both the heterophoric prism group and the heterophoric control group. An additional analysis using binocular profiles showed a reduction in symptoms by numbers and specifically for subjects with reduced vergence flexibility. Conclusion. Wearing an individual, horizontal prismatic correction had no effect on the overall CISS-score for our test subjects. Further methods that allow a systematic recording of symptoms and optometric parameters are probably necessary to observe an effect. These could be binocular profiles that classify individuals according to their binocular parameters. Keywords horizontal heterophoria, asthenopic symptoms, prismatic correction, binocular vision

Physical Activity, Bleedings and Quality of Life in Subjects with Haemophilia A without Inhibitors-A Multicenter, Observational Italian Study with a Wearable Device.

Background: This study aimed to gather data on physical activity (PA), bleeding, health-related quality of life, and health status, using a wearable device and an electronic patient-reported outcome (ePRO) app, in individuals with moderate or severe hemophilia A (HA) without inhibitors receiving treatment according to the clinical practice. Methods: This is a 12-month multicenter cohort study conducted in Italy. The primary outcomes included the description of PA by type and intensity, adherence to World Health Organization guidelines, bleeding, and health-related quality of life by EQ-5D questionnaire. PA data were collected continuously through a fitness tracker worn by the patient; all the other variables were collected through ePRO questionnaires. Results: Only 54 of the 103 enrolled subjects (52.4%) used their fitness tracker for the defined valid period; adolescents were the least compliant age group. PA was performed at low rates and intensity. Approximately 52% of the subjects had sedentary behavior. The mean EQ-5D values did not change over time. At least one bleeding was reported in 43.7% of the subjects, mostly with sedentary behavior. The PA in the 2 days preceding the bleeding was comparable to the one observed in the overall observational period. Conclusions: The systematic recording of data through a fitness tracker and ePRO app shows that subjects with HA without inhibitors have lower-than-expected PA and that they still experience issues related to bleeding.

TAILR (Nursing-Sensitive Events and Their Association With Individual Nurse Staffing Levels) Project: Protocol for an International Longitudinal Multicenter Study.

Nursing-sensitive events (NSEs) are common, accounting for up to 77% of adverse events in hospitalized patients (eg, fall-related harm, pressure ulcers, and health care-associated infections). NSEs lead to adverse patient outcomes and impose an economic burden on hospitals due to increased medical costs through a prolonged hospital stay and additional medical procedures. To reduce NSEs and ensure high-quality nursing care, appropriate nurse staffing levels are needed. Although the link between nurse staffing and NSEs has been described in many studies, appropriate nurse staffing levels are lacking. Existing studies describe constant staffing exposure at the unit or hospital level without assessing patient-level exposure to nurse staffing during the hospital stay. Few studies have assessed nurse staffing and patient outcomes using a single-center longitudinal design, with limited generalizability. There is a need for multicenter longitudinal studies with improved potential for generalizing the association between individual nurse staffing levels and NSEs. This study aimed (1) to determine the prevalence, preventability, type, and severity of NSEs; (2) to describe individual patient-level nurse staffing exposure across hospitals; (3) to assess the effect of nurse staffing on NSEs in patients; and (4) to identify thresholds of safe nurse staffing levels and test them against NSEs in hospitalized patients. This international multicenter study uses a longitudinal and observational research design; it involves 4 countries (Switzerland, Sweden, Germany, and Iran), with participation from 14 hospitals and 61 medical, surgery, and mixed units. The 16-week observation period will collect NSEs using systematic retrospective record reviews. A total of 3680 patient admissions will be reviewed, with 60 randomly selected admissions per unit. To be included, patients must have been hospitalized for at least 48 hours. Nurse staffing data (ie, the number of nurses and their education level) will be collected daily for each shift to assess the association between NSEs and individual nurse staffing levels. Additionally, hospital data (ie, type, teaching status, and ownership) and unit data (ie, service line and number of beds) will be collected. As of January 2024, the verification process for the plausibility and comprehensibility of patients' and nurse staffing data is underway across all 4 countries. Data analyses are planned to be completed by spring 2024, with the first results expected to be published in late 2024. This study will provide comprehensive information on NSEs, including their prevalence, preventability, type, and severity, across countries. Moreover, it seeks to enhance understanding of NSE mechanisms and the potential impact of nurse staffing on these events. We will evaluate within- and between-hospital variability to identify productive strategies to ensure safe nurse staffing levels, thereby reducing NSEs in hospitalized patients. The TAILR (Nursing-Sensitive Events and Their Association With Individual Nurse Staffing Levels) study will focus on the optimization of scarce staffing resources. DERR1-10.2196/56262.

Randomized, Placebo-controlled Homeopathic Drug-proving of SARS CoV-2 nosode (BiosimCovex) in healthy volunteers

Introduction
 The Homeopathic Pathogenetic Trial (HPT, Drug-proving) is a systematic examination and recording of the symptoms experienced by healthy volunteers after an administration of an investigational medicinal substance. Randomized, placebo-controlled HPT was conducted using BiosimCovex (SARS CoV-2 nosode) in healthy volunteers. 
 Materials and methods
 BiosimCovex 30c was given orally in a randomized, placebo-controlled trial to examine the safety and pathogenetic effects of 30 volunteers (18- 65 years of age and both genders). Volunteers were administered a dose of 6 pills of the nosode once a day for two weeks followed by 30 days observation period. Pre and post-examination (physical), vital signs, and laboratory investigations were done with a run-in period of 7 days. Symptoms experienced by the volunteers were recorded and analyzed, and Qualitative and Quantitative indices per volunteer were reported. Trial registered at http://ctri.nic.in (CTRI/2022/06/043392).
 Results
 BiosimCovex nosode exhibited quantitatively distinct symptoms, which can be applied in clinical practice. The number of symptoms reported in the verum arm was 73 (placebo 11). The incidence of the Pathogenetic effect per volunteer in the verum group was 8.1 vs that of the placebo 5.5. The Qualitative Pathogenetic Index was 0.295 in the verum group as compared to the placebo 0.193. The symptoms observed matched with the symptoms produced in an open-label Phase 1 study conducted during the COVID-19 pandemic and also with that of the viral infection. There were no serious/fatal adverse events during the study. Safe use was documented.
 Conclusion
 BiosimCovex nosode developed during a pandemic condition produced specific symptoms in the homeopathic pathogenetic trial which could be used in clinical practice.

Menganalisis Neraca Pembayaran Sebagai Tolak Ukur Kemampuan Perekonomian Nasional dalam Menopang Transaksi - Transaksi Internasional

The Indonesian economy is currently experiencing significant growth, which can be measured through its balance of payments. The balance of payments is a systematic record of international economic transactions between the residents of a country and those of other countries over a specific period of time. The development of the balance of payments is closely related to the growth of the real, fiscal, and monetary sectors. The balance of payments can be considered an indicator of a country's economic condition because it allows a country to measure the size of the flow of funds from abroad, both incoming and outgoing. The balance of payments also serves as an important tool, as it records all economic transactions involving the exchange of goods, services, and financial assets between the residents of a country and those of other countries.

Stakeholders’ Views on Strategies, Measures and Policies Implemented in Education of Students with Disabilities during the COVID-19 Pandemic in Greece

PURPOSE. The pandemic crisis outbreak had a severe impact on all aspects of people’s lives worldwide. Educational systems applied across the globe, were forced to adapt to new, restricting conditions overnight changing abruptly the educational landscape, especially for students with disabilities (SwDs). The lack of central preparedness strategy and the unprecedented conditions called upon the experts, administrators, teachers and parents/carers to interpret and implement strategies, policies, and measures challenging progress conquered in the past years in inclusive education. The aim of the present study was to investigate the experiences and views of key-stakeholders in special and inclusive education in Greece (experts-regional coordinators, administrators, parents/carers) on strategies, measures and policies implemented in education of SwDs during the COVID-19 pandemic crisis and to explore potential perspectives emerged in safeguarding the special and inclusive education in crisis times. METHODS. An exploratory qualitative study using semi-structured interviews was applied. The participants of the study were 31 key-stakeholders in total (11 experts-regional coordinators, 10 administrators, and 10 parents/carers who have children with disabilities). Interviews were conducted via video conferencing platforms using three different interview protocols designed by the research team for the purposes of the study. Qualitative data were collected and analyzed using content analysis. RESULTS. The findings reveal both similar and diverging approaches among the stakeholders regarding the strategies, measures and policies as well as concerning the surfaced challenges and proposed recommendations. Emphasis by the stakeholders is given to the lack of systematic recording of needs and preparedness plan before the pandemic outbreak. The lack of central guidance and support is identified as a major aggravating factor regardless of the initiatives taken at individual or local level to promote learning of SwDs. All stakeholders acknowledged the need to develop and use an applicable preparedness plan for schools during crisis, in order to maintain and promote further equal access to education for all students. CONCLUSION. The key-stakeholders of the special and inclusive education in Greece have similar and diverging views on how the special education challenges were addressed during the pandemic crisis. However, all parties concurred on the pressing need for a preparedness plan to be applied to all schools in case of a future crisis. Points of Interest The present paper presents the views of key-stakeholders regarding the strategies, policies, programs implemented for the education of SwDs during the pandemic crisis in Greece. The importance of the study lies in the fact that primary data were collected from the full range of key-stakeholders (teachers/professionals, administrators as well as parents/carers) in inclusive education. The results show views on the following central themes: preparation and operation of schools, educational practices and material, measures, services, educational programs, interventions, emerging needs of SwDs, as well as challenges, recommendations, and feedback. The results reflect an interesting canvas of similar and diverging views across the involved key stakeholders in the education of SwDs during the pandemic crisis.

A Work Study for Upgradation of Plastic Product Manufacturing Unit

Abstract: This paper discusses about the project on work study of plastic product manufacturing unit.The factory is well renowned for its plastic products .This unit is present at Electronic Zone, Hingna MIDC ,Nagpur .This factory has plastic injection molding machine for product manufacturing .In the project ,we will study examine ,investigate about the existing ways of doing work. We are going to do systematic recording and critical examination of existing working structure ,plant layout ,management ,allocation of work to workers ,way of completion of work from taking delivery of raw materials upto delivering finished products. We are using principles of Industrial Engineering which comprises work study,method study ,work measurement ,plant layout, material handling ,ergonomics to study the existing ways of production in the industry. Our purpose of studying the existing way is to find out loopholes in the current process and to eliminate all unnecessary operations and waste .Again, We are identifying non-value adding operations while investigating all operations processes .This study will guide us to discover new ways of doing work with developing and applying more effective methods to reduce cost, increase overall productivity and efficiency.

What are the main symptoms of urticaria and how are they systematically recorded?

Wheals or angioedema or both are the main symptoms of urticaria. The small number of the symptoms usually makes diagnosis easy. What is not trivial, however, is the comprehensive systematic recording and assessment of these symptoms and, above all, their sequelae, which affect many areas of the patient's life. Disease activity, quality of life and disease control can and should be measured before and during treatment in order to optimally adapt therapeutic measures. The instruments developed for this purpose have become easier and more convenient to use in recent years thanks to user-friendly platforms such as mobile health apps.

Considering Uncertainty of Historical Ice Jam Flood Records in a Bayesian Frequency Analysis for the Peace‐Athabasca Delta

AbstractThe Peace‐Athabasca Delta in Alberta, Canada has numerous perched basins that are primarily recharged after large ice jams cause floods (an ecological benefit). Previous studies have estimated that such large floods are likely to decrease in frequency under various climate projections. However, there is a sizable uncertainty range in these predicted flood probabilities, in part due to the short 60‐year systematic record that contained few large ice jam floods. An additional 50 years of historical data are available from various sources, with expert‐interpreted flood categories; however, these categorizations are uncertain in magnitude and occurrence. We developed a Bayesian framework that considers magnitude and occurrence uncertainties within a logistic regression model that predicts the annual probability of a large flood. The Bayesian regression estimates the joint distribution of parameters describing the effects of climatic factors and parameters that describe the probability that historical flood magnitudes were recorded as large (or not) when a truly large (or not) flood occurred. We compare four models for hindcasting and projecting large ice jam flood probabilities in future climates. The models consider: (a) historical data uncertainty, (b) no historical data uncertainty, (c) only the systematic record, and (d) the systematic record with a different model. Neglecting historical data uncertainty provides inaccurate estimates, while using only the systematic record provides wider prediction intervals than considering the full record with uncertain historical data. Thus, we demonstrate that including uncertain historical information can effectively extend the record length and make flood frequency analyses more accurate and precise.

Prospective observational study iron deficiency anemia clinical profile in children with sickle cell disease: a study protocol

Background Sickle cell disease, a hereditary hemoglobinopathy, presents complex clinical challenges including increased susceptibility to iron deficiency anemia (IDA). However, the clinical profile of IDA in pediatric patients with sickle cell disease still needs to be adequately characterized. This study aims to comprehensively investigate the prevalence, severity, associated risk factors, and potential impact of IDA on morbidity and mortality in this vulnerable population. Methods A prospective observational study will be conducted on 303 children from January 2024 to December 2024 at the Department of Pediatrics, Jawaharlal Nehru Medical College and AVBR Hospital, Sawangi, Wardha. Participants will include pediatric patients diagnosed with sickle cell disease, with informed consent from their parents or legal guardians. Data will be collected through clinical assessments, blood sample analyses for hematological parameters, and systematic recording of relevant clinical information. Statistical analyses, including Fisher’s exact test, Chi-square test, and Student’s t-test, will be used to assess the data, with a significance level set at p < 0.05. Expected outcomes This study aims to provide critical insights into the prevalence and clinical profile of IDA in children with sickle cell disease, shedding light on potential risk factors and correlations with comorbid conditions. Furthermore, it seeks to explore the relationship between IDA and disease-related morbidity and mortality.

Assessing Workplace Violence: Methodological Considerations.

The risk of violence is present in all workplaces. It must be accurately assessed to establish prevention and protection measures tailored to the features of each situation. The risk management process requires compliance in a sequential order: 1) risk identification, 2) quantitative risk assessment, and 3) impact assessment. Gathering workers' experiences using lists, focus groups, or participatory ergonomics groups is necessary to identify the phenomenon. For risk assessment, spontaneous reporting of events is often insufficient. It may be complemented with two methods: systematic recording of violent events that occurred in the past year during periodic medical examinations of workers and targeted surveys. The epidemiological analysis of data from individual interviews and surveys provides the phenomenon's prevalence, incidence, and evolution. Moreover, reporting the harm suffered by victims of violence allows constructing impact matrices to allocate resources where they are most needed.

Predicting the duration of motorway incidents using machine learning

AbstractMotorway incidents are frequent & varied in nature. Incident management on motorways is critical for both driver safety & road network operation. The expected duration of an incident is a key parameter in the decision-making process for control room operators, however, the actual duration for which an incident will impact the network is never known with true certainty. This paper presents a study which compares the ability of different machine learning algorithms to estimate the duration of motorway incidents on Ireland’s M50 motorway, using an extensive historical incident database. Results show that the support vector machine has the best performance in most cases, but a different method may need to be used to improve accuracy in some situations. Results highlight the main challenges in accurately forecasting incident durations in real time & recommendations are made for improving prediction accuracy through systematic recording of various additional incident details.

Two new species of Hyalella (Amphipoda, Dogielinotidae) from the Humid Chaco ecoregion of Paraguay.

The freshwater amphipod genus Hyalella Smith, 1874 is widely distributed in the Neotropics, with several biogeographically restricted species and a high cryptic diversity throughout South America. Tens of species of Hyalella have been documented from nearby Brazil and Argentina, but no systematic record of the genus exists for Paraguay. Here we describe two new species of Hyalella: H.mboituisp. nov. and H.juliasp. nov. from the Ñeembucú wetlands of southwestern Paraguay. Hyalellamboituisp. nov. and H.juliasp. nov. are characterised by a dorsally smooth body, pigmented eyes, uropod 1 endopod with a curved seta, the dorsal margin of uropod 3 ramus without setae, and uropod 3 peduncle longer than wide and with six setae apically. The two species are distinguished by their diagnostic mouthparts, with a median serrated edge on the lacinia mobilis in H.mboituisp. nov. and two elongated lateral denticles with a serrated edge in H.juliasp. nov., and by the presence of a pronounced cup for the dactylus on gnathopod 2 in H.mboituisp. nov. In addition, they show differences in the number of articles on antennae 1 and 2, in the relative length of the pereiopods, and in the numbers and types of setae on their gnathopods and uropods 1-3. Hyalellamboituisp. nov. and H.juliasp. nov. represent the first taxonomically documented occurrence of Paraguayan freshwater amphipods. These new taxa attest to the largely unmapped species richness of freshwater invertebrates in the Humid Chaco of Paraguay. This potential biodiversity hotspot is currently under threat from land conversion, highlighting the need for more systematic studies and effective conservation of the local invertebrate biodiversity.

Emerging trends in the blood spinal-cord barrier: A bibliometric analysis.

The blood-spinal cord barrier (BSCB) is a unique protective barrier located between the circulatory system and the central nervous system. BSCB plays a vital role in various diseases. However, there is little systematic research and recording in this field by bibliometrics analysis. We aim to visualize this field through bibliometrics to analyze the hotspots and trends of BSCB and in order to facilitate an understanding of future developments in basic and clinical research. To conduct a bibliometric study of original publications and their references, the keywords Blood Spinal-Cord Barrier and BSCB are searched and filtered from the Web of Science database (2000-2022), focusing on citations, authors, journals, and countries/regions. Additionally, clustering of the references and co-citation analysis was completed, including a total of 1926 articles and comments. From the results, 193 authors were identified, among which Sharma Hs played a key role. As far as the analysis result of the clustering of the references is concerned, the most common type in cluster analysis is spinal cord injury (SCI) which is a current and developing research field. The keywords are also the specific content under these clusters. The most influential organization is Univ Calif San Francisco, and "Proceedings of The National Academy of Sciences of The United States of America" magazine is the most cited magazine. The research on BSCB is booming focusing mainly on "BSCB in SCI" including "activation," "pathway," and "drug delivery" which is also the trend of future research.

What to do when the unwanted happens? Negative event management in studies on internet- and mobile-based interventions for youths and adults with two case reports

BackgroundDespite severely burdened individuals, often being excluded from research studies on internet- and mobile-based interventions (IMIs), negative events (NEs) including suicidal thoughts and behaviors (STBs) can still occur during a trial. NEs require monitoring and adequate safety measures. However, study protocols frequently lack comprehensive descriptions of procedures for managing NEs. AimsThis study aimed to illustrate the assessment, monitoring, and procedures for addressing NEs in two studies on IMIs in adults and youth using case reports, to identify strengths and weaknesses of the NE management approaches, and to derive key learnings and recommendations. MethodsTwo case reports were drawn from two distinct IMI studies. The first study, PSYCHOnlineTHERAPY, evaluates the combination of an IMI with on-site psychotherapy for anxiety and depressive disorders in adults (adult blended study). The second study evaluates a standalone, therapist-guided IMI for post-traumatic stress disorder (PTSD) in youth (youth standalone study). Potential NEs were predefined depending on the study sample. The case studies thoroughly document the systematic recording and ongoing monitoring of NEs through self-report and observer-based assessments during the interventions. The cases illustrate a variety of NE management strategies, including automated and personalized approaches, adapted to the specific nature and severity of the NEs. The NE management approaches are visualized using decision trees. ResultsIn the adult blended case study, online questionnaires detected STBs and triggered automated support information. As on-site therapy had already ended, a telephone consultation session allowed for the identification and discussion of the heightened intensity of suicidal thoughts, along with the development of specific additional help options. In the youth standalone case study, heightened tension in an adolescent with PTSD during trauma processing could be addressed in a telephone therapeutic session focusing on resource activation and emotion regulation. The referral to on-site treatment was supported. Overall, advantages of the NE management included automated procedures, multimodal assessment of a wide range of NEs, and standardized procedures tailored to different severity levels. Weaknesses included the use of single-item assessments for STBs and lack of procedures in case of deterioration or nonresponse to treatment. ConclusionThis study provides practical insights and derives key learnings and recommendations regarding the management of NEs in different IMI contexts for both adults and youth.

Development and Internal Validation of a Clinical and Genetic Risk Score for Rheumatoid Arthritis-Associated Interstitial Lung Disease.

Although clinical and genetic risk factors have been identified for rheumatoid arthritis-associated interstitial lung disease (RA-ILD), there are no current tools allowing for risk stratification. We sought to develop and validate an ILD risk model in a large, multicentre, prospective RA cohort. Participants in the Veterans Affairs RA (VARA) registry were genotyped for 12 single nucleotide polymorphisms (SNPs) associated with idiopathic pulmonary fibrosis. ILD was validated through systematic record review. A genetic risk score (GRS) was computed from minor alleles weighted by effect size with ILD, using backward selection. The GRS was combined with clinical risk factors within a logistic regression model. Internal validation was completed using bootstrapping, and model performance was assessed by the area under the receiver operating curve (AUC). Of 2,386 participants (89% male, mean age 69.5 years), 9.4% had ILD. Following backward selection, five SNPs contributed to the GRS. The GRS and clinical factors outperformed clinical factors alone in discriminating ILD (AUC 0.675 vs 0.635, p< 0.001). The shrinkage-corrected performance for combined and clinical-only models was 0.667 (95% CI 0.628, 0.712) and 0.623 (95% CI 0.584, 0.651), respectively. Twenty percent of the cohort had a combined risk score below a cut-point with >90% sensitivity. A clinical and genetic risk model discriminated ILD in a large, multicentre RA cohort better than a clinical-only model, excluding 20% of the cohort from low-yield testing. These results demonstrate the potential utility of a GRS in RA-ILD and support further investigation into individualized risk stratification and screening.

Invasive Bacterial Infections of the Musculoskeletal and Central Nervous System during Pig Rearing: Detection Frequencies of Different Pathogens and Specific Streptococcus suis Genotypes.

Locomotor and central nervous system disorders occur during pig rearing, but there is no systematic recording of the different causative agents in Germany. Joint and meningeal swabs, kidneys, lungs, and eight different lymph nodes per pig were cultured, and isolated pathogens were identified using polymerase chain reactions (PCRs). The cps and pathotype of Streptococcus suis (S. suis) isolates were determined using multiplex-PCR. S. suis was the most important pathogen in the infected joints (70.8%) and meningeal swabs (85.4%) and was most frequently detected in both sites in suckling and weaning piglets. To elucidate the possible portal of entry of S. suis, eight different lymph nodes from 201 pigs were examined in a prospective study. S. suis was detected in all examined lymph nodes (n = 1569), including the mesenteric lymph nodes (15.8%; n = 121/765), with cps 9 (37.2%; n = 147) and cps 2 (24.3%; n = 96) being the most dominating cps types. In piglets with a systemic S. suis infection, different lymph nodes are frequently infected with the invasive S. suis strain, which does not help clarify the portal of entry for S. suis.