Facilitative Moderation for Online Participation in eRulemaking

This paper describes the use of facilitative moderation strategies in an online rulemaking public participation system. Rulemaking is one of the U.S. government\u27s most important policymaking methods. Although broad transparency and participation rights are part of its legal structure, significant barriers prevent effective engagement by many groups of interested citizens. Regulation Room, an experimental open-government partnership between academic researchers and government agencies, is a socio-technical participation system that uses multiple methods to lower potential barriers to broader participation. To encourage effective individual comments and productive group discussion in Regulation Room, we adapt strategies for facilitative human moderation originating from social science research in deliberative democracy and alternative dispute resolution [24, 1, 18, 14] for use in the demanding online participation setting of eRulemaking. We develop a moderation protocol, deploy it in live Department of Transportation (DOT) rulemakings, and provide an initial analysis of its use through a manual coding of all moderator interventions with respect to the protocol. We then investigate the feasibility of automating the moderation protocol: we employ annotated data from the coding project to train machine learning-based classifers to identify places in the online discussion where human moderator intervention is required. Though the trained classifiers only marginally outperform the baseline, the improvement is statistically signifcant in spite of limited data and a very basic feature set, which is a promising result

Facilitative Moderation for Online Participation in eRulemaking

This paper describes the use of facilitative moderation strategies in an online rulemaking public participation system. Rulemaking is one of the U.S. government\u27s most important policymaking methods. Although broad transparency and participation rights are part of its legal structure, significant barriers prevent effective engagement by many groups of interested citizens. Regulation Room, an experimental open-government partnership between academic researchers and government agencies, is a socio-technical participation system that uses multiple methods to lower potential barriers to broader participation. To encourage effective individual comments and productive group discussion in Regulation Room, we adapt strategies for facilitative human moderation originating from social science research in deliberative democracy and alternative dispute resolution [24, 1, 18, 14] for use in the demanding online participation setting of eRulemaking. We develop a moderation protocol, deploy it in live Department of Transportation (DOT) rulemakings, and provide an initial analysis of its use through a manual coding of all moderator interventions with respect to the protocol. We then investigate the feasibility of automating the moderation protocol: we employ annotated data from the coding project to train machine learning-based classifers to identify places in the online discussion where human moderator intervention is required. Though the trained classifiers only marginally outperform the baseline, the improvement is statistically signifcant in spite of limited data and a very basic feature set, which is a promising result

Association of Complement and MAPK Activation With SARS-CoV-2-Associated Myocardial Inflammation

IMPORTANCE Myocardial injury is a common feature of patients with SARS-CoV-2 infection. However, the cardiac inflammatory processes associated with SARS-CoV-2 infection are not completely understood. OBJECTIVE To investigate the inflammatory cardiac phenotype associated with SARS-CoV-2 infection compared with viralmyocarditis, immune-mediatedmyocarditis, and noninflammatory cardiomyopathy by integrating histologic, transcriptomic, and proteomic profiling. DESIGN, SETTING, AND PARTICIPANTS This case serieswas a cooperative study between the Ludwig Maximilian University Hospital Munich and the Cardiopathology Referral Center at the University of Tubingen in Germany. A cohort of 19 patients with suspectedmyocarditis was examined; of those, 5 patients were hospitalized with SARS-CoV-2 infection between March and May 2020. Cardiac tissue specimens from those 5 patients were compared with specimens from 5 patients with immune-mediatedmyocarditis, 4 patients with non-SARS-CoV-2 viralmyocarditis, and 5 patients with noninflammatory cardiomyopathy, collected from January to August 2019. EXPOSURES Endomyocardial biopsy. MAIN OUTCOMES AND MEASURES The inflammatory cardiac phenotypeswere measured by immunohistologic analysis, RNA exome capture sequencing, and mass spectrometry-based proteomic analysis of endomyocardial biopsy specimens. RESULTS Among 19 participants, the median age was 58 years (range, 37-76 years), and 15 individuals (79%) were male. Data on race and ethnicity were not collected. The abundance of CD163+ macrophages was generally higher in the cardiac tissue of patients with myocarditis, whereas lymphocyte counts were lower in the tissue of patients with SARS-CoV-2 infection vs patients with non-SARS-CoV-2 virus-associated and immune-mediatedmyocarditis. Among those with SARS-CoV-2 infection, components of the complement cascade, including C1q subunits (transcriptomic analysis: 2.5-fold to 3.6-fold increase; proteomic analysis: 2.0-fold to 3.4-fold increase) and serine/cysteine proteinase inhibitor clade G member 1 (transcriptomic analysis: 1.7-fold increase; proteomic analysis: 2.6-fold increase), belonged to the most commonly upregulated transcripts and differentially abundant proteins. In cardiac macrophages, the abundance of C1q was highest in SARS-CoV-2 infection. Assessment of important signaling cascades identified an upregulation of the serine/threonine mitogen-activated protein kinase pathways. CONCLUSIONS AND RELEVANCE This case series found that the cardiac immune signature varied in inflammatory conditions with different etiologic characteristics. Future studies are needed to examine the role of these immune pathways inmyocardial inflammation

EquiFACS: the Equine Facial Action Coding System

Although previous studies of horses have investigated their facial expressions in specific contexts, e.g. pain, until now there has been no methodology available that documents all the possible facial movements of the horse and provides a way to record all potential facial configurations. This is essential for an objective description of horse facial expressions across a range of contexts that reflect different emotional states. Facial Action Coding Systems (FACS) provide a systematic methodology of identifying and coding facial expressions on the basis of underlying facial musculature and muscle movement. FACS are anatomically based and document all possible facial movements rather than a configuration of movements associated with a particular situation. Consequently, FACS can be applied as a tool for a wide range of research questions. We developed FACS for the domestic horse (Equus caballus) through anatomical investigation of the underlying musculature and subsequent analysis of naturally occurring behaviour captured on high quality video. Discrete facial movements were identified and described in terms of the underlying muscle contractions, in correspondence with previous FACS systems. The reliability of others to be able to learn this system (EquiFACS) and consistently code behavioural sequences was high—and this included people with no previous experience of horses. A wide range of facial movements were identified, including many that are also seen in primates and other domestic animals (dogs and cats). EquiFACS provides a method that can now be used to document the facial movements associated with different social contexts and thus to address questions relevant to understanding social cognition and comparative psychology, as well as informing current veterinary and animal welfare practices

Case Report: Sudden very late-onset near fatal PD1 inhibitor-associated myocarditis with out-of-hospital cardiac arrest after >2.5 years of pembrolizumab treatment

IntroductionImmune checkpoint inhibitors have advanced the outcomes of many different types of cancer. A rare but extraordinarily severe complication of these agents resembles immune checkpoint inhibitor-related myocarditis, which typically occurs within the first few weeks after treatment initiation with a mortality of 25%–50%.Case reportA 57-year-old woman had uneventfully received pembrolizumab for metastatic non-small cell lung cancer for over 2.5 years and was admitted after an out-of-hospital cardiac arrest due to ventricular fibrillation. After successful cardiopulmonary resuscitation, the initial diagnostic work-up showed elevated cardiac enzymes and a limited left-ventricular ejection fraction, while coronary angiography did not show relevant stenosis. Despite cardiac MRI being unsuggestive of myocarditis, myocardial biopsies were obtained and histologically confirmed anti-PD-1 antibody-associated myocarditis. After the initiation of prednisone at 1 mg/kg body weight, the patient gradually recovered and was discharged three weeks later with markedly improved cardiac function.ConclusionThis case resembles the first description of a very late onset irMyocarditis, occurring over 2.5 years after the start of treatment. It demonstrates the importance of contemplating that severe immune-related toxicities with a sudden onset clinical presentation may occur even after long uneventful periods of anti-PD-1 immune checkpoint inhibitor treatment. Furthermore, it underlines the critical importance of myocardial biopsies in this setting, especially when cardiac MRI remains inconclusive. Moreover, it demonstrates the necessity and benefits of early immunosuppressive treatment if immune-related myocarditis is considered a differential diagnosis

Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice: a position statement of the ESC working group on myocardial and pericardial diseases

In this paper the Working Group on Myocardial and Pericardial Disease proposes a revised definition of dilated cardiomyopathy (DCM) in an attempt to bridge the gap between our recent understanding of the disease spectrum and its clinical presentation in relatives, which is key for early diagnosis and the institution of potential preventative measures. We also provide practical hints to identify subsets of the DCM syndrome where aetiology directed management has great clinical relevance

Myocarditis following COVID-19 vaccine: incidence, presentation, diagnosis, pathophysiology, therapy, and outcomes put into perspective. A clinical consensus document supported by the Heart Failure Association of the European Society of Cardiology (ESC) and the ESC Working Group on Myocardial and Pericardial Diseases

Over 10 million doses of COVID-19 vaccines based on RNA technology, viral vectors, recombinant protein, and inactivated virus have been administered worldwide. Although generally very safe, post-vaccine myocarditis can result from adaptive humoral and cellular, cardiac-specific inflammation within days and weeks of vaccination. Rates of vaccine-associated myocarditis vary by age and sex with the highest rates in males between 12 and 39 years. The clinical course is generally mild with rare cases of left ventricular dysfunction, heart failure and arrhythmias. Mild cases are likely underdiagnosed as cardiac magnetic resonance imaging (CMR) is not commonly performed even in suspected cases and not at all in asymptomatic and mildly symptomatic patients. Hospitalization of symptomatic patients with electrocardiographic changes and increased plasma troponin levels is considered necessary in the acute phase to monitor for arrhythmias and potential decline in left ventricular function. In addition to evaluation for symptoms, electrocardiographic changes and elevated troponin levels, CMR is the best non-invasive diagnostic tool with endomyocardial biopsy being restricted to severe cases with heart failure and/or arrhythmias. The management beyond. guideline-directed treatment of heart failure and arrhythmias includes non-specific measures to control pain. Anti-inflammatory drugs such as non-steroidal anti-inflammatory drugs, and corticosteroids have been used in more severe cases, with only anecdotal evidence for their effectiveness. In all age groups studied, the overall risks of SARS-CoV-2 infection-related hospitalization and death are hugely greater than the risks from post-vaccine myocarditis. This consensus statement serves as a practical resource for physicians in their clinical practice, to understand, diagnose, and manage affected patients. Furthermore, it is intended to stimulate research in this area

Teacher unionism in changing times: is this the real “new unionism”?

This article provides a case study of union change in an environment in which radical school restructuring is taking place, and active strategies to weaken and marginalize organized teachers are being pursued by the state. The case study union is the National Union of Teachers in England. The article explores a number of different strategies open to teacher unions, utilizing a framework provided by Turner (2004). Drawing on data collected at a national level, and in three local authority areas, I argue that the National Union of Teachers’ response to the erosion of collective bargaining is best presented as an amalgam of strategies focused on workplace organizing, political campaigning, and coalition building. The data demonstrate considerable congruence between national and local strategies, although local data reveal considerable challenges in implementation and consequently considerable unevenness in local experiences