On Care-fulness: Critical Creative Expressions of Care in a Feminist Theatre Research Project

In early 2020, as the first of many COVID lockdowns began across Australia, a collective of feminist and queer performance scholars and artists embarked on the research project Staging Australian Women’s Lives: Theatre, Feminism and Socially Engaged Art. Our aim was to document contributions of womxn theatre makers, while conducting a feminist analysis of strategies used to deal with gender inequality and oppression, on stage and off. While pivoting to the digital and the virtual, we recognised a need to support womxn theatre makers whose lives and livelihoods are thrown into further precarity by the pandemic. This paper speaks to our commitment to bringing together critical theory, arts practices and everyday life in ethical forms and encounters that make visible, recognise and express care for one another and for the work

Continuous glucose monitors and virtual care in high-risk, racial and ethnic minority populations: Toward promoting health equity

Continuous glucose monitors (CGMs) have become an important tool to aid self-management of blood glucose for many patients with diabetes in the U.S., and the benefits of CGM use are well-documented. However, disparities in CGM use exist, with lower use in certain marginalized racial and ethnic groups. CGM may be an important and underutilized tool to help reduce inequities. Evidence supporting the use of CGMs as a part of virtual care is discussed, with an emphasis on designing virtual diabetes care programs to promote health equity. Recommendations for clinical practice and research are presented. In clinical practice, CGM should be an option for all people with diabetes who qualify based on clinical practice guidelines, regardless of race, ethnicity, or other individual characteristics. Future research should characterize the use of, benefit from, and preferences for CGM among individuals from racial and ethnic groups to guide interventions at the health system, clinic, provider, and patient levels to promote equitable, evidence-based, and guideline-directed CGM use in marginalized racial and ethnic groups with diabetes

Stepping out of Flatland: Discovering Behavior Patterns as Topological Structures in Cyber Hypergraphs

Data breaches and ransomware attacks occur so often that they have become part of our daily news cycle. This is due to a myriad of factors, including the increasing number of internet-of-things devices, shift to remote work during the pandemic, and advancement in adversarial techniques, which all contribute to the increase in both the complexity of data captured and the challenge of protecting our networks. At the same time, cyber research has made strides, leveraging advances in machine learning and natural language processing to focus on identifying sophisticated attacks that are known to evade conventional measures. While successful, the shortcomings of these methods, particularly the lack of interpretability, are inherent and difficult to overcome. Consequently, there is an ever-increasing need to develop new tools for analyzing cyber data to enable more effective attack detection. In this paper, we present a novel framework based in the theory of hypergraphs and topology to understand data from cyber networks through topological signatures, which are both flexible and can be traced back to the log data. While our approach's mathematical grounding requires some technical development, this pays off in interpretability, which we will demonstrate with concrete examples in a large-scale cyber network dataset. These examples are an introduction to the broader possibilities that lie ahead; our goal is to demonstrate the value of applying methods from the burgeoning fields of hypernetwork science and applied topology to understand relationships among behaviors in cyber data.Comment: 18 pages, 11 figures. This paper is written for a general audienc

Associations of microvascular complications with all-cause death in patients with diabetes and COVID-19:the CORONADO, ABCD Covid-19 audit and AMERICADO study groups

AIM: To provide a detailled analysis of the microvascular burden in patients with diabetes hopitalized for COVD‐19. MATERIALS AND METHODS: We analysed data from the French CORONADO initiative and the UK Association of British Clinical Diabetologists (ABCD) COVID‐19 audit, two nationwide multicentre studies, and the AMERICADO, a multicentre study conducted in New York area. We assessed the association between risk of all‐cause death during hospital stay and the following microvascular complications in patients with diabetes hospitalized for COVID‐19: diabetic retinopathy and/or diabetic kidney disease and/or history of diabetic foot ulcer. RESULTS: Among 2951 CORONADO, 3387 ABCD COVID‐19 audit and 9327 AMERICADO participants, microvascular diabetic complications status was ascertained for 1314 (44.5%), 1809 (53.4%) and 7367 (79.0%) patients, respectively: 1010, 1059 and 1800, respectively, had ≥1 severe microvascular complication(s) and 304, 750 and 5567, respectively, were free of any complications. The patients with isolated diabetic kidney disease had an increased risk of all‐cause death during hospital stay: odds ratio [OR] 2.53 (95% confidence interval [CI] 1.66‐3.83), OR 1.24 (95% CI 1.00‐1.56) and OR 1.66 (95% CI 1.40‐1.95) in the CORONADO, the ABCD COVID‐19 national audit and the AMERICADO studies, respectively. After adjustment for age, sex, hypertension and cardiovascular disease (CVD), compared to those without microvascular complications, patients with microvascular complications had an increased risk of all‐cause death during hospital stay in the CORONADO, the ABCD COVID‐19 diabetes national audit and the AMERICADO studies: adjusted OR ((adj)OR) 2.57 (95% CI 1.69‐3.92), (adj)OR 1.22 (95% CI 1.00‐1.52) and (adj)OR 1.33 (95% CI 1.15‐1.53), respectively. In meta‐analysis of the three studies, compared to patients free of complications, those with microvascular complications had an unadjusted OR for all‐cause death during hospital stay of 2.05 (95% CI 1.42‐2.97), which decreased to 1.62 (95% CI 1.19‐2.119) after adjustment for age and sex, and to 1.50 (1.12‐2.02) after hypertension and CVD were further added to the model. CONCLUSION: Microvascular burden is associated with an increased risk of death in patients hospitalized for COVID‐19

Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes

BackgroundThe Hispanic/Latino population has greater risk (estimated >50%) of developing type 2 diabetes (T2D) and developing it at a younger age. The American Diabetes Association estimates costs of diagnosed diabetes in 2017 was $327 billion; with medical costs 2.3x higher than patients without diabetes. The purpose of this manuscript is to describe the methodology utilized in a randomized controlled trial aimed at evaluating the efficacy of a diabetes telemanagement (DTM) program for Hispanic/Latino patients with T2D. The intent is to provide information for future investigators to ensure that this study can be accurately replicated.MethodsThis study was a randomized controlled trial with 240 participants. Eligible patients (Hispanic/Latino, aged 18+, living with T2D) were randomized to Comprehensive Outpatient Management (COM) or DTM. DTM was comprised of usual care, including routine clinic visits every three months, as well as: Biometrics (a tablet, blood glucose meter, blood pressure monitor, and scale); Weekly Video Visits (facilitated in the patient’s preferred language); and Educational Videos (including culturally congruent diabetes self-management education and quizzes). COM consisted of usual care including routine clinic visits every three months. For this study, COM patients received a glucometer, glucose test strips, and lancets. Establishing a therapeutic nurse-patient relationship was a fundamental component of our study for both groups. First contact (post-enrollment) centered on ensuring that patients and caregivers understood the program, building trust and rapport, creating a non-judgmental environment, determining language preference, and establishing scheduling availability (including evenings and weekends). DTM were provided with a tablet which allowed for self-paced education through videos and weekly video visits. The research team and Community Advisory Board identified appropriate educational video content, which was incorporated in diabetes educational topics. Video visits allowed us to assess patient involvement, motivation, and nonverbal communication. Communicating in Spanish, and awareness of diverse Hispanic/Latino backgrounds was critical, as using relevant and commonly-used terms can increase adherence and improve outcomes. Shared decision-making was encouraged to make realistic health care choices.ConclusionKey elements discussed above provide a framework for future dissemination of an evidence-based DTM intervention to meet the needs of underserved Hispanic/Latino people living with T2D

Macroalgae Farming: A Strategy for Economic Growth and Nutrient Mitigation

Macroalgae Farming: A Strategy for Economic Growth and Nutrient Mitigation Executive Summary Alyson Myers April 2015 Email: [email protected] The estuarine system of the Chesapeake Bay has experienced a “tragedy of the commons” through nutrient loading, degraded oxygen levels for marine life and a decrease in system function for the Bay watersheds’ inhabitants. The US government has called for the restoration of the Chesapeake Bay. This paper proposes an aquaculture practice that may assist that goal, macroalgae (seaweed) farming, which can convert excess nutrients to biomass for harvest and conversion to economic goods. While this practice cannot fix our nutrient problem--nutrients should be stopped at their sources, like farm fields, hardscape, power plants and automobile tailpipes--it can quantitatively reduce nutrients in the waterway. This paper examines macroalgae farming for the practice’s production capability per square meter (tissue contains 3-5% Nitrogen, .01% Phosphorus, and 30% Carbon) in the waterway and as a method to meet regulatory goals of the Environmental Protection Agency (EPA). EPA calls for the “development of non-traditional Best Management Practices like algal scrubbers.” Similarly, NOAA refers to Ecosystem-based Management as a national priority and the “potential for aquaculture of shellfish and seaweed (algae) to mitigate impacts of climate change (e.g., sequestering carbon, bioextraction).” The farming process extracts nutrients through harvest and is sustainable by growing a biomass in waterways rather than relying, like agriculture, on fresh water (irrigation currently uses 60% of global fresh water which is not sustainable). Further, the practice does not use arable land, which is increasingly under pressure from growing populations and energy crops. Macroalgae farming is an established 6 billion dollar industry worldwide. The biggest use is human consumption followed by markets such as cosmetics, aquaculture feed, agar and carrageenan, iodine, fertilizers and more. The global production of farmed seaweed doubled between 2000 and 2012. This paper recommends several niche markets that can make the enterprise profitable in the US. Nutrient trading also provides a revenue stream with current prices for nitrogen removal at $8/lb to$20/lb. It compares this price to other methods of nitrogen removal including Wastewater Treatment upgrades and agricultural practices (cover crops, etc). Production costs of macroalgae biomass, according to the literature and this author in the field, vary between $6.60/lb and$42/lb for nitrogen removal. Nutrient trading can probably not cover the cost of the practice, and therefore we must look to the private sector to monetize the biomass. The government could decide to engage in a Public-Private Partnership to fund the strategy initially until the private sector undertakes the business enterprise with no further funding necessary. The paper explores one scenario under which a Bay state, Virginia, may mitigate its atmospheric nutrient load (1%, or 578,001 pounds of Nitrogen), for which there are no Best Management Practices, by dedicating 3.8 square miles to the enterprise. The practice would result in 107, 037, 222 lbs of wet biomass available for use by markets. The government spends approximately $.5 billion/yr to restore the Chesapeake Bay with only modest success. A dedication of 5$25,000,000, would initiate the enterprise and, within two to three years could possibly be self-sustaining, with an increase in jobs and sustainable biomass for the economy. Such a project would provide a model for Restoration of the Commons, or restorative commerce, and could be implemented in eutrophic waterways around the globe. Conclusions: 1. Macroalgae farming provides a way to harvest nutrients in eutrophic waterways 2. Atmospheric deposition has no Best Management Practice for mitigation 3. Macroalgae farming can mitigate, as an example, 1% of Virginia’s TMDL (atmospheric) through dedication of 3.8 sq mi of Chesapeake Bay 4. The harvested biomass can provide material for markets, like cosmetics, consumer fertilizer, and specialty papers. 5. Macroalgae farming cannot “fix” the nutrient problem of eutrophic waterways (too much marine space would be required), but it can positively impact the problem 6. Macroalgae outcompete microalgae, the cause of dead zones, and farming operations should be located close to nutrient hotspots, but beyond Submerged Aquatic Vegetation (which provides oxygen) 7. Biomass harvest must be timed to take advantage of oxygen production and avoid decomposition 8. A macroalgae farm can potentially lead to a profitable business venture and a productive public-private partnership

Energy imbalance: obesity, associated comorbidities, prevention, management and public health implications

The prevalence of obesity has been continually increasing, as have its associated comorbidities and health care costs. Effective management of obesity and early intervention measures are necessary to overcome this global issue. The responsibility for preventing and managing this global epidemic does not lie solely on an individual, but also on the entire health care system. Policy makers—nationally and globally—must play their roles to solve the issue. In this review article, we examine methods of controlling and managing obesity through interventions, such as a low caloric diet, physical exercise, pharmacological guidance, and bariatric surgical procedures. While health care professionals should educate patients about all available treatment options for severe obesity, bariatric surgical procedures have increased in popularity and are considered very beneficial with outcomes fruitful in managing severe obesity

Sensitivities of cloud radiative effects to large-scale meteorology and aerosols from global observations

The radiative effects of clouds make a large contribution to the Earth's energy balance, and changes in clouds constitute the dominant source of uncertainty in the global warming response to carbon dioxide forcing. To characterize and constrain this uncertainty, cloud controlling factor (CCF) analyses have been suggested that estimate sensitivities of clouds to large-scale environmental changes, typically in cloud-regime specific multiple linear regression frameworks. Here, local sensitivities of cloud radiative effects to a large number of controlling factors are estimated in a regime-independent framework from 20 years of near-global satellite observations and reanalysis data using statistical learning. A regularized linear regression (ridge regression) is shown to skillfully predict anomalies of shortwave (R² = 0.63) and longwave CRE (R² = 0.72) in independent test data on the basis of 28 CCFs, including aerosol proxies. The sensitivity of CRE to selected CCFs is quantified and analyzed. CRE sensitivities to sea-surface temperature and estimated inversion strength are particularly pronounced in low-cloud regions and generally in agreement with previous studies. The analysis of CRE sensitivities to three-dimensional wind field anomalies reflects that CREs in tropical ascent regions are mainly driven by variability of large-scale vertical velocity in the upper troposphere. In the subtropics, CRE is sensitive to free-tropospheric zonal and meridional wind anomalies, which are likely to encapsulate information on synoptic variability that influences subtropical cloud systems by modifying wind shear and thus turbulence and dry-air entrainment in stratocumulus clouds, as well as variability related to midlatitude cyclones. Different proxies for aerosols are analyzed as CCFs, with satellite-derived aerosol proxies showing a larger CRE sensitivity than a proxy from an aerosol reanalysis, likely pointing to satellite aerosol retrieval biases close to clouds leading to overestimated aerosol sensitivities. Sensitivities of shortwave CRE to all aerosol proxies indicate a pronounced cooling effect from aerosols in stratocumulus regions that is counteracted to a varying degree by a longwave warming effect. The analysis may guide the selection of CCFs in future sensitivity analyses aimed at constraining cloud feedback and climate forcings from aerosol-cloud interactions, using both data from observations and global climate models