Working Group Research Articles

Employee engagement and retention in multicultural work groups: The interplay of employee and supervisory cultural intelligence

Given the rise in cultural diversity in workplaces due to increased globalization and hyperconnectivity, organizations worldwide are seeking effective ways to attract and retain multicultural talent. This research probes the interaction between an employee’s cultural intelligence (CQ) and a supervisor’s CQ, investigating how this interaction impacts work engagement and the intention to stay within multicultural work groups. Drawing on work engagement literature and leader-member exchange (LMX) theory, we conducted two empirical studies. Study 1 (170 matched data) reveals that employee’s CQ positively influences work engagement, with this relationship moderated by the supervisor’s CQ. Study 2 (161 matched data) validates these findings while also demonstrating how work engagement influences employee’s intention to stay. Taken collectively, our research advances theory and practice by elucidating the synergistic value of fostering both employees’ and supervisors’ CQ—i.e., the “double CQ”—for enhancing engagement and retention in multicultural work groups.

10 Optimizing implementation and continuous monitoring of a newborn screening program for severe combined immunodeficiency

Abstract Background Severe Combined Immunodeficiency (SCID) is an inborn error of immunity characterized by severely low T cell levels and function. Early diagnosis is essential to prevent serious infections and improve outcomes. Newborn screening (NBS) for SCID provides a way to detect SCID and other conditions associated with T cell lymphopenia in the neonatal period. Objectives 1) Optimize the implementation of a NBS program for SCID in British Columbia (BC), Canada; and 2) create a systematic method for monitoring the diagnoses and outcomes of infants with a positive screen to facilitate continuous improvement of the NBS program. Design/Methods An interdisciplinary working group comprised of immunologists, biochemical geneticists, and hematopathologists met at regular intervals prior to and after implementing NBS for SCID in BC. We developed an algorithm for the evaluation and initial management of infants with an abnormal NBS for SCID based on literature review and local expert consensus. Using a REDCap database, we tracked the prevalence, evaluation, diagnoses and outcomes of infants with a positive NBS. The database also monitored diagnoses and outcomes of children referred to Immunology outside of the NBS program. Plan-do-study-act cycles included creation of clinical and educational guidelines on SCID, optimization of abnormal NBS cut-off values, and reflex chromosomal microarray (CMA) testing of infants with confirmed T cell lymphopenia. Results Between October 3, 2022 and June 16, 2023, 28,816 initial samples were tested, and 30 infants had a positive screen for SCID. Of the 30 infants, 10 were ultimately diagnosed with conditions associated with T cell lymphopenia. Diagnosis led to avoidance of live viral vaccines and implementation of infection precaution measures. No infants experienced complications related to live viral vaccine administration, compared to 1 case in the preceding 12 months prior to NBS implementation. In February 2023, the threshold for an abnormal NBS was adjusted to achieve the goal positive screen frequency of 0.1%. Performing reflex CMA testing on infants with confirmed T cell lymphopenia led to rapid diagnosis of chromosomal microdeletion syndromes, avoiding unnecessary second tier testing. Since implementing NBS for SCID in BC, there have been no cases of SCID diagnosed outside of the NBS program. Conclusion Establishing an interdisciplinary working group and clinical database facilitated the smooth integration and continuous improvement of NBS for SCID in BC. This model can be applied to other healthcare systems to support teams and ensure the best possible outcomes for affected patients.

Machine learning-based prediction of sarcopenia in community-dwelling middle-aged and older adults: findings from the CHARLS.

Sarcopenia is a prominent issue among aging populations and associated with poor health outcomes. This study aimed to examine the predictive value of questionnaire and biomarker data for sarcopenia, and to further develop a user-friendly calculator for community-dwelling middle-aged and older adults. We used two waves (2011 and 2013) of the China Health and Retirement Longitudinal Study (CHARLS) to predict sarcopenia, defined by the Asian Working Group for Sarcopenia 2019 criteria. We restricted the analytical sample to adults aged 45 or above (N = 2934). Five machine learning models were used to construct Q-based (only questionnaire variables), Bio-based (only biomarker variables), and combined (questionnaire plus biomarker variables) models. Area under the receiver operating characteristic curve (AUROC) was used for performance assessment. Temporal external validation was performed based on two datasets from CHARLS. Important predictors were identified by Shapley values and coefficients. Extreme gradient boosting (XGBoost), considering both questionnaire and biomarker characteristics, emerged as the optimal model, and its AUROC was 0.759 (95% CI: 0.747-0.771) at a decision threshold of 0.20 on the test set. Models also performed well on the external datasets. We found that cognitive function was the most important predictor in both Q-based and combined models, and blood urea nitrogen was the most important predictor in the Bio-based model. Other key predictors included education, haematocrit, total cholesterol, drinking, number of chronic diseases, and instrumental activities of daily living score. Our findings offer a potential for early screening and targeted prevention of sarcopenia among middle-aged and older adults in the community setting.

Simultaneous Quantification of Serum Symmetric Dimethylarginine, Asymmetric Dimethylarginine and Creatinine for Use in a Routine Clinical Laboratory.

Background Symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA) are naturally occurring amino acids classed as uremic toxins by the EUTOX working group. SDMA is principally excreted through the kidneys and is a well-known renal function marker, ADMA is a potent inhibitor of nitric oxide production. Here, we describe the development of a rapid and sensitive liquid chromatography tandem mass spectrometry method for simultaneous measurement of SDMA, ADMA and creatinine. Method Serum samples were prepared by protein precipitation and dilution with acetonitrile prior to injection onto a Waters TQS-Micro. Multiple reaction monitoring was used to detect SDMA, ADMA, creatinine, and their corresponding internal standard transitions after separation with a HILIC analytical column. Sample stability and intra-individual variation studies were also assessed following ethical approval. Results The retention time for creatinine was 0.43, SDMA 1.10 and ADMA 1.14 minutes. Mean recovery for creatinine was 103%, SDMA was 100% and ADMA was 103%, matrix effects were minimal (<6%). Lower limit of quantitation for creatinine and SDMA/ADMA was 17.5 µmol/L and 0.1 µmol/L respectively. Analytical imprecision showed a coefficient of variation <10% for all analytes across the working range of the assays. Intra-individual variation for creatinine was 4.7%, SDMA 7.5% and ADMA 7.6%. Discussion We have developed a rapid assay for LC-MS/MS measurement of SDMA, ADMA and creatinine in a routine clinical laboratory. It is simple, reproducible, and easy to perform. The stability of SDMA and ADMA pre- and post-centrifugation allows for their routine use without any special sample handling requirements.

From Traditional to Challenge-Based Learning: A Case Study

The rapid evolution of the information technology sector necessitates innovative educational methods not only addressing current industry needs but also anticipating future challenges. This study aims to explore the transition from traditional pedagogical approaches to challenge-based learning (CBL) within the context of an undergraduate course, "Ethical, Social and Professional Aspects of IT" (120 participants). It investigates how this methodological shift influences the development strategies of the course and the pedagogical outcomes for students, particularly first-year IT administration and development students engaging in practical group work. Employing a mixed research design, the study gathers data through reflections of the course staff, empirical study with students and analysis of the didactic changes within the course. It evaluates the effectiveness of problem-based learning (PBL) and CBL methodologies in addressing real-world IT ethics, social, and professional challenges with a focus on fostering creativity, problem-solving skills, and interdisciplinary collaboration. Preliminary findings suggest that CBL not only enhances students' engagement and learning outcomes but also bridges the gap between academic knowledge and practical application in the IT sector. The collaboration students provided insights into real-world challenges, improving students’ learning and administrative experiences at the university. Furthermore, the study highlights the advantages of integrating both PBL and CBL to cultivate a more dynamic and responsive educational environment. The shift towards CBL in the "Ethical, Social and Professional Aspects of IT" course at Tallinn University of Technology represents a significant step forward in aligning educational practices with the needs of the contemporary and future IT industry, preparing students for the complexities of the modern workforce, and contributing to a sustainable, innovative, and resilient economy. Further research is needed to fully understand the long-term impacts of this pedagogical shift and to refine the methodologies for broader application.

Student-led discussions of landmark discovery articles: a foothold in teaching primary virology literature.

Introducing students to primary scientific literature is essential for establishing scientific literacy; however, students can feel overwhelmed by the amount of information within a research article. In our virology discussion courses, we address this issue by creating a student-centered and active learning environment. Students present and guide discussions on the rationales, background, methods, results, and conclusions from research literature in class. This approach has been applied in both undergraduate and graduate settings for students studying microbiology, with different expectations and criteria between the two groups. Student evaluations collected from three semesters were positive toward the teaching methods. Students praised the inclusion of "landmark discovery" articles, which examined paradigm-shifting concepts in virology. Undergraduates expressed their increased confidence in comprehending scientific literature and highlighted the impact of group work. In a critique of the course, students suggested more variety in the topics covered and inclusion of recent publications. Overall, our enhanced approach and methods improved student experiences with primary scientific literature and promoted student learning.

Analysis of Effectiveness of Collaborative Pedagogy Practices

This study analyzes the effectiveness of collaborative teaching and learning strategies to enhance student's educational experience and learning results. Collaborative pedagogy converts the traditional teacher-centered paradigm into a more participatory, student-centered approach, promoting active participation via group work, debates, and collective problem-solving. This study examines existing literature, case studies, and empirical evidence to evaluate the impact of collaborative approaches on student accomplishment, motivation, and the development of fundamental abilities such as critical thinking, communication, and cooperation. The study found that collaborative teaching and learning approaches are essential for strengthening comprehension, increasing information retention, and cultivating superior social skills. The benefits of peer learning, active engagement, and instructor facilitation are highlighted in cultivating a dynamic classroom atmosphere. The study underscores other problems linked to implementing collaborative pedagogy, including resource constraints, dominant teacher-centered cultural norms, and substantial class sizes, especially in poor countries such as Nepal. The acceptance of collaborative pedagogy in Nepal is increasing owing to continuing educational reforms and curricular modifications; nonetheless, many obstacles hinder its extensive implementation. The document emphasizes the need for augmented teacher training, greater infrastructural support, and customized teaching methodologies to use the benefits of collaborative learning properly. The results demonstrate that, when properly implemented, collaborative teaching-learning methodology may substantially improve educational quality and prepare students to confront real-world difficulties.

The Effect of Isometric Exercise Position on the Effectiveness of Isolated Work of the Thigh Flexor Muscles Based on the Results of the sEMG Study.

The main function of the hamstring muscles is to bend the knee joint and support the function of the hip extensors. Their frequent injuries are the result of overload related to, among others, dynamic running or jumping, and inadequate preparation for athletics activities. The asymmetry of the work of individual flexor muscle groups is clearly marked in the case of valgus or varus of the knee joint, i.e., in different positions of the lower limb. The aim of the study was to determine the position and form of a rehabilitation exercise in which an isolated group of muscles flexing the knee joint will show the greatest bioelectrical activity. The study involved 25 students of the Jagiellonian University Medical College. The students were aged 20-26. The average age was 22.9 (±1.4). The study participants included 17 women with an average age of 23.0 (±1.1) and 8 men with an average age of 22.6 (±1.9). Women constituted 68% and men 32% of all respondents. All participants agreed to participate in the study. Surface electromyography measurements in both lower limbs provided an initial number of 50 cases. The activity of the knee flexor muscles during isometric contraction with resistance was measured in correlation with three foot and lower leg settings: internal rotation, neutral position, and external rotation. The bioelectrical activity of the semitendinosus muscle is significantly higher (p < 0.01) in the internal rotation position than in the neutral position of the lower leg, while the bioelectrical activity of the biceps femoris muscle is inversely higher (p < 0.01) in the external rotation position than in the neutral position. The results are significant for both average and maximum values of muscle stimulation. During isometric contraction with resistance, the semitendinosus muscle shows the greatest bioelectrical activity in the internal rotation position of the lower leg and foot, and the biceps femoris muscle in the external rotation position of the lower leg and foot. The above information has important implicational applications when improving isolated groups of hamstrings. In the future, this may contribute to more effective rehabilitation of patients with injuries of the muscles described in the article.

The essential role of combined calcium and vitamin D supplementation in the osteoporosis scenario in italy: Expert opinion paper

SummaryAn Italian multidisciplinary working group discussed the current Italian scenario of osteoporosis management during a meeting and highlighted the essential role of calcium and vitamin D supplementation in the prevention of fragility fractures.PurposeThis paper aims to review and discuss data on calcium and vitamin D requirements and the role of combined calcium and vitamin D supplementation in the treatment of patients with osteoporosis.MethodsThe discussion of the experts covered literature data on calcium and vitamin D supplementation, gaps in the diagnosis and treatment of osteoporosis, and the role of the primary care physician in identifying and treating patients with osteoporosis. Articles for consideration were identified through PubMed searches using different combinations of pertinent keywords.ResultsThe discussion highlighted that insufficient calcium or vitamin D intake increases the risk of fragility fractures. The experts also drew attention to the essential role of calcium and vitamin D supplementation in achieving an anti-fracture effect and supporting the efficacy of anti-osteoporotic agents without increasing nephrolithiasis and cardiovascular risks. In addition, the discussion underlined the role of the primary care physician in the initial clinical approach to patients with osteoporosis.ConclusionsThe experts believe that efficient treatment for patients with osteoporosis should include calcium and vitamin D supplementation to achieve adequate levels that are able to inhibit the parathyroid hormone and bone resorption.

Incidence of Self-Reported Bothersome Tinnitus Versus Tinnitus Diagnosis Among U.S. Army Soldiers.

U.S. Army Soldiers undergo annual audiometric surveillance to facilitate prevention of auditory injury. Soldiers are screened for bothersome tinnitus and subsequently referred for a clinical audiological evaluation as warranted. Presumably, most Soldiers seen in the clinic for bothersome tinnitus receive a tinnitus diagnosis. The incidence of self-reported bothersome tinnitus at the time of annual audiometric surveillance and subsequent diagnosis of tinnitus in the medical record has not been examined to date. This study estimated the incidence of tinnitus diagnosis in a population of Soldiers who reported new onset bothersome tinnitus and explored trends associated with tinnitus diagnosis to refine hearing health education. A subset of hearing conservation records retrieved for a previous study were selected based on change in self-reporting of bothersome tinnitus. Corresponding medical records were retrieved for this sample of Active Duty (AD) Soldiers. The data were retrospectively examined, and analyses were conducted to identify statistically significant differences between Soldiers with and Soldiers without a tinnitus diagnosis. In addition, trend patterns of bothersome tinnitus and significant threshold shift (STS) were examined. Of the sample of 730,350 AD Soldiers, 16.7% self-reported new onset bothersome tinnitus and 7.1% of those recorded as having bothersome tinnitus had a diagnosis of tinnitus in their medical record. Soldiers with a tinnitus diagnosis were older and had higher pure-tone averages than Soldiers without a tinnitus diagnosis. Counterintuitively, overall trend percentages of bothersome tinnitus increased per calendar year, while the percentages of STS decreased throughout the study period. The rate of tinnitus diagnosis in the medical record is vastly lower than the prevalence of bothersome tinnitus recorded in the annual surveillance system. Steps should be taken to screen, refer, and diagnose tinnitus more consistently. Based on the outcome of the study analysis, we recommend that screening for bothersome tinnitus more closely follows procedure recommendations from the Department of Veterans Affairs and Department of Defense (VA/DOD) Tinnitus Working Group, which may reduce the rate at which Soldiers report bothersome tinnitus.

Understanding Tinnitus Clinical Care in the Veterans Health Administration and Department of Defense: Overview of Survey Results.

In 2021, the Veterans Health Administration (VHA) and Department of Defense (DOD) Tinnitus Working Group conducted a survey of DOD and VHA clinicians to evaluate clinical services provided for tinnitus. The online survey included a mix of multiple-choice and open-ended questions. Respondents included VHA and DOD health care providers in audiology, otolaryngology, mental health, and primary care, as well as DOD hearing conservation technicians. Quantitative and qualitative methods were used to analyze the data. A total of 669 providers responded to this combined survey. Results indicated that compared to DOD and VHA providers in other fields, audiologists tended to be more confident and more aware of their role in tinnitus management. In terms of confidence and scope of practice, DOD mental health care providers were the group least familiar with tinnitus care. Other results explored herein include barriers to tinnitus care, facilitators for progressive tinnitus management programs, interventions and patient materials offered, new patient materials wanted, and respondents' preferred information sources and training methods. Survey results indicated that more directed education and support are needed to increase DOD and VHA clinicians' awareness of the need for tinnitus services and their roles in providing that care. https://doi.org/10.23641/asha.27229215.

Examining the Causal and Heterogeneous Influence of Three-Dimensional Urban Forms on CO2 Emissions in 285 Chinese Cities

Despite the efforts to examine the influence of urban forms on CO2 emissions, most studies have mainly measured urban forms from a two-dimensional perspective, with relatively little attention given to three-dimensional urban forms and their causal relationships. Utilizing the built-up area dataset from the Global Human Settlement Layer (GHSL) project and the carbon emission dataset from the China City Greenhouse Gas Working Group (CCG), we examine a causal and heterogeneous effect of three-dimensional urban forms on CO2 emissions—specifically urban height, density, and intensity—in 285 Chinese cities. The empirical results reveal a robust and positive causal effect of 3D urban forms on carbon emissions. Even when incorporating the spatial spillover effect, the positive effect of 3D urban forms remains. Moreover, GDP per capita and total population have a greater impact on urban CO2 emissions. Additionally, we find that the influence of 3D urban forms on CO2 emissions is U-shaped, with total population serving as a moderating factor in this effect. Importantly, there is significant geographic and sectoral heterogeneity in the influence of 3D urban forms on CO2 emissions. Specifically, the influence of 3D urban forms is greater in eastern cities than in non-eastern cities. Furthermore, 3D urban forms primarily influence household carbon emissions rather than industrial and transportation carbon emissions. Therefore, in response to the growing challenges of global climate change and environmental issues, urban governments should adopt various strategies to develop more rational three-dimensional urban forms to reduce CO2 emissions.

Prevention of Trafficking in Organs, Tissues, and Cells.

Trafficking in human organs, cells, and tissues has long been a source of concern for health authorities and professionals, and several international ethical guidance documents and national laws have affirmed the prohibition of trade in these substances of human origin (SoHOs). However, despite considerable attention to the issue of organ trafficking, this remains a substantial and widespread problem internationally. In contrast, trafficking in cells, tissues, and medical products derived from SoHOs has received comparatively little attention, and the extent and nature of such trafficking remain largely unknown. Consequently, as part of the 2023 Global Summit on Convergence in Transplantation held in Santander, Spain, an ethics working group was assigned the task of formulating actionable recommendations to support the prevention of trafficking in all SoHOs. In reporting on this work, we review factors that may influence the persistent trafficking of SoHOs, explore the potential difficulties associated with the collection and reporting of data about suspected trafficking activities, and argue that more practical and consistent guidance, training, and regulatory frameworks are needed internationally to support effective reporting, sharing of data, and collaborative responses to suspected trafficking cases. We also discuss the importance of psychosocial evaluation of living donors as a strategy to detect and prevent organ trafficking and strive to advance the implementation of this well-established recommendation by outlining minimum standards for psychosocial evaluation of living donors.

Do gravity data justify a rifted “Liguro-Provençal Basin”?

The geodynamic evolution of the Liguro-Provençal Basin and its crust and upper mantle structure remain debated, especially regarding the role of rifting in continental break-up and seafloor spreading. Our study incorporates updated datasets, including new gravity maps from the AlpArray Gravity Working Group (complete Bouguer, free air, and isostatic anomalies) for 3D modeling and gravity field analysis, seismic data from Lobster offshore campaigns for direct comparison, and geodynamic models, supplemented by seismic profiles from previous French and Italian campaigns to constrain the interpretation. We used GFZ’s IGMAS + software for interactive 3D modeling, creating a density model extending to 300 km depth that includes crustal and upper mantle inhomogeneities based on prior geodynamic models. This hybrid approach, with polygonal structures for the crust and voxels for the upper mantle, clarifies individual contributions to the gravity field. Extending initial gravity modeling from the SPP MB4D project INTEGRATE, our work provides a consistent 3D density model for the Alps and Ligurian Basin. The constrained 3D modeling and numerical analyses (terracing, clustering, filtering, curvature), along with vertical stress and gravitational potential energy calculations, suggest that rifting has significantly influenced the basin’s geological evolution.

The presence of oligoclonal bands predicts conversion to multiple sclerosis in isolated myelitis

Acute transverse myelitis (ATM) is a disease characterized by inflammation of the spinal cord and may have various causes. In the context of this work, the distinction between isolated ATM and initial manifestation of autoimmune-mediated diseases of the central nervous system such as multiple sclerosis (MS) is crucial. Hence, the aim of this work was to identify predictive factors associated with the conversion to definite MS in a collective of individuals after their initial episode of isolated ATM (no initial identified cause). In this retrospective data analysis from the Vienna MS Database, all patients from Jan. 1, 1999, to Dec. 31, 2019, with a diagnosis of isolated ATM (according to the criteria of the Transverse Myelitis Consortium Working Group) who underwent lumbar puncture were extracted. Electronic medical records were reviewed on the availability of clinical data including therapy and follow-up, laboratory results including cerebrospinal fluid (CSF) analysis, evoked potentials (EP) as well as magnetic resonance imaging data. Among 42 patients with the diagnosis of isolated ATM, 12 (29%) were subsequently diagnosed with MS over a median follow-up period of 7.7 years. Univariately, MS converters were younger (32 years [25–39] vs. 42 years [31–50], p = 0.032), had a lower CSF/serum albumin ratio (29 [24–35] vs 37 [27–52], p = 0.037), lower CSF total protein (4.5 [2.8–4.8] vs. 5.5 [3.4–8.5], p = 0.023) and a higher proportion of CSF-specific oligoclonal bands (OCB; 83% vs. 30%, p = 0.002). In the multivariate regression analysis, the presence of CSF-specific OCB emerged as the sole predictive factor of subsequent MS diagnosis (OR: 14.42, 95% CI 1.39 to 149.48, p = 0.03). In a collective of 42 patients with isolated ATM and an MS conversion rate of nearly 30%, the only but highly predictive factor were CSF-specific OCB. This emphasizes the significance of conducting timely CSF analysis in such patients and underscores the need for tailored monitoring and follow-up strategies in this specific group.

The effect of sarcopenic obesity on glycaemic status based on fasting plasma glucose and glycated haemoglobin: A prospective cohort study.

To investigate the effect of sarcopenic obesity on the progression of glycaemic status in middle-aged and older adults without diabetes. This research involved 4637 participants without diabetes from the China Health and Retirement Longitudinal Study 2011-2015. Sarcopenic obesity at baseline was evaluated based on the Asian Working Group for Sarcopenia 2019 criteria. According to the American Diabetes Association criteria, we used fasting plasma glucose and glycated haemoglobin to define glycaemic status. Cox proportional hazard models were applied to obtain adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). The mean age of included participants was 58.98 ± 8.82 years, and 45.35% were men. During 18,497 person-years of follow-up, 1743 (37.59%) cases with glycaemic status progression were identified. Compared with participants without sarcopenia and obesity, participants with sarcopenic obesity, but not sarcopenia only or obesity only, exhibited a higher risk of progression from normoglycaemia to diabetes (HR = 2.11; 95% CI: 1.10-4.04). Moreover, participants with sarcopenic obesity (HR = 1.65; 95% CI: 1.04-2.63), sarcopenia only (HR = 1.78; 95% CI: 1.11-2.86), or obesity only (HR = 2.00; 95% CI: 1.29-3.12) had increased the risk of progression from prediabetes to diabetes. The effect of sarcopenic obesity on the progression of glycaemic status based on fasting plasma glucose and glycated haemoglobin may be more pronounced than that of sarcopenia only or obesity only.

The European Broadcasting Union: corporate management and voluntary work

Information as a public good is not a thing of nature, but a purposeful action. In my contribution, I explore an international association that got institutionalised around the idea of information as a public good by means of lucrative cooperation between public service broadcasters. It emerged after the Second World War, in a world where public services would become the norm rather than the exception, and has continued to a time when priorities switched fundamentally towards profit and liberalisation. The object of study is the European Broadcasting Union, the largest association of public service media providers in Europe and beyond, servicing more than one billion people as audiences via its members. In order to understand whether EBU's institutional practices still prioritise information as a public good or have moved towards a more neo-lib focus, I undertook an institutional analysis based on secondary data. The research shows that the combination of a neo-lib corporate layer with voluntary working groups from national PSMs makes EBU particularly successful; it looks like a new public management dream come true, except that EBU is not an accountable public organisation. Through the NGO structure, corporate management and voluntary work, it opens large avenues of cooperation for professionals to innovate together, at the end of the day enhancing information as a public good.

Navigating ethical and legal challenges in the HEALthy Brain and Child Development Study: Lessons learned from the ethics, law, policy working group

The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. The HBCD study has faced several ethical and legal challenges due to its goal of enrolling pregnant people (including those with substance use disorder) and their newborns. Challenges not fully anticipated at the outset emerged from the rapidly changing legal landscape around reproductive rights in the United States. By embedding scholars in bioethics and law within research teams and engaging them in conversation with each other and other study personnel, we were able to address many challenges proactively and respond promptly to unanticipated challenges. In this paper, we highlight several important ethical and legal challenges that arose from the first phase of funding through the beginning of participant enrollment. We explain the methods used to address these challenges, the ethical and legal tradeoffs that arose, and the resolution of challenges through the design of the study. Based on this experience, we provide recommendations for research teams, sponsors, and reviewers to address legal risks and promote the ethical conduct of studies with pregnant people and caregivers. We highlight the importance of collaboration with bioethics and legal scholars in studies involving complex and evolving legal risks, as well as the necessity of designing robust approaches to informed consent and maintaining participant trust while navigating ethical challenges in research.

Comparative analysis of SARC-F-EBM, Ishii test, and six other screening tools for sarcopenia in Chinese community-dwelling older adults: a cross-sectional diagnostic study

To assess the relative performance of simple screening methods for sarcopenia in Chinese community-dwelling older adults. Data of older adults aged ≥ 60 were collected through a cross-sectional investigation. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. The accuracy of screening methods was evaluated using sensitivity, specificity, receiver operating characteristic (ROC) curves and area under the ROC curves (AUC). The AUC value greater than 0.8 represented the good screening ability. A total of 918 older adults (44.3% men, mean age 70.4 ± 6.5 years) were included in this study. The overall prevalence rates of possible sarcopenia, confirmed sarcopenia, and severe sarcopenia were 59.5%, 12.8%, and 5.9%, respectively. In men, the SARC-F-EBM and Ishii tests indicated good screening capabilities for confirmed sarcopenia, with an AUC of 0.81 (95% CI: 0.77–0.85) and 0.80 (95% CI: 0.76–0.84), respectively. In women, the highest AUC was also achieved using the SARC-F-EBM at 0.79 (95% CI: 0.75–0.82), followed by the Ishii test at 0.77 (95% CI: 0.74–0.81), showing the moderate efficacy. A ranking diagram showed that SARC-F-EBM was most likely to be considered the best method for diagnosing sarcopenia in terms of AUC and sensitivity, regardless of sex. We recommend the SARC-F-EBM for sarcopenia screening in community-dwelling Chinese older adults when respondents are able to answer the questionnaire accurately; otherwise, the Ishii test consisting entirely of objective measures could be used.

The Symptoms-Varices-Pathophysiology Classification of Pelvic Venous Disorders: A Report of the American Vein &amp; Lymphatic Society International Working Group on Pelvic Venous Disorders

The Symptoms-Varices-Pathophysiology Classification of Pelvic Venous Disorders: A Report of the American Vein &amp; Lymphatic Society International Working Group on Pelvic Venous Disorders