From Things to Services: A Social IoT Approach for Tourist Service Management

In the context of Internet of Things (IoT), the cooperation and synergy between varied and disparate communicating objects is strained by trustworthiness, confidentiality and interoperability concerns. These restrictions can limit the development of IoT-based applications especially considering the emergent boost in the number of communicating objects and their growing itinerant nature in a collective service context. A new perspective arises with the paradigm of Social Internet of Things (SIoT), that relies on the implementation of semi-independent communicating objects with cooperation assessed by social relations and social feed-back. In this article, we present the development and expansion of the IoT concept towards SIoT in the context of the interactions between tourist services as communicating objects. As a proof-of-concept we propose a composition of services as virtualized social objects and the interaction between them, by taking into consideration the balance, trustworthiness, cooperation and synergy of services. Furthermore we present a solution to integrate also accessibility in SIoT services. The presented concept is presented using a demonstrator build for tourist services

Coping with physical and psychological symptoms: a qualitative study of advanced lung cancer patients and their family caregivers

PURPOSE: Advanced lung cancer patients have high rates of multiple physical and psychological symptoms, and many of their family caregivers experience significant distress. However, little is known about strategies that these patients and their family caregivers employ to cope with physical and psychological symptoms. This study aimed to identify strategies for coping with various physical and psychological symptoms among advanced, symptomatic lung cancer patients and their primary family caregivers. METHODS: Patients identified their primary family caregiver. Individual semi-structured qualitative interviews were conducted with 21 advanced, symptomatic lung cancer patients and primary family caregivers. Thematic analysis of interview data was framed by stress and coping theory. RESULTS: Patients and caregivers reported maintaining a normal routine and turning to family and friends for support with symptom management, which often varied in its effectiveness. Whereas support from health-care professionals and complementary and alternative medicine were viewed favorably, reactions to Internet and in-person support groups were mixed due to the tragic nature of participants' stories. Several cognitive coping strategies were frequently reported (i.e., changing expectations, maintaining positivity, and avoiding illness-related thoughts) as well as religious coping strategies. CONCLUSIONS: Results suggest that advanced lung cancer patients and caregivers may be more receptive to cognitive and religious approaches to symptom management and less receptive to peer support. Interventions should address the perceived effectiveness of support from family and friends

Development of a Symptom Management Intervention: Qualitative Feedback from Advanced Lung Cancer Patients and their Family Caregivers

Background: Little is known about cancer patient and family caregiver preferences for the content and format of nonpharmacologic interventions. Revising interventions based on patient and caregiver feedback before implementation may improve intervention feasibility and acceptability, especially in the context of advanced-stage cancer. Objectives: The aim of the study was to obtain feedback from patients with advanced-stage, symptomatic lung cancer and their family caregivers on the content and format of a nonpharmacologic symptom management intervention under development. The intervention blended evidence-based cognitive-behavioral and emotion-focused strategies to reduce physical and psychological symptoms. Methods: Semistructured qualitative interviews were conducted with 21 patients with advanced-stage, symptomatic lung cancer and caregivers. Participants reviewed handouts regarding intervention components and provided feedback. Results: Patients and caregivers desired intervention components that addressed the patient's high symptom burden such as education regarding treatment adverse effects and the provision of various coping tools. Offering interventions with a brief or flexible length and delivering them via telephone were other suggestions for enhancing intervention acceptability. Participants also preferred an equal focus on patient and caregiver concerns and a more positive intervention framework. Conclusions: Intervention preferences of patients with advanced-stage lung cancer and caregivers underscore the severity of the disease and treatment process and the need to adapt interventions to patients with high symptom burden. These preferences may be incorporated into future intervention trials to improve participant recruitment and retention. Implications for Practice: Nurses can modify interventions to meet the needs of patients with advanced-stage, symptomatic lung cancer and caregivers. For example, flexibility regarding intervention content and length may accommodate those with significant symptoms

OpenFraming: we brought the ML; you bring the data. Interact with your data and discover its frames

When journalists cover a news story, they can cover the story from multiple angles or perspectives. A news article written about COVID-19 for example, might focus on personal preventative actions such as mask-wearing, while another might focus on COVID-19's impact on the economy. These perspectives are called "frames," which when used may influence public perception and opinion of the issue. We introduce a Web-based system for analyzing and classifying frames in text documents. Our goal is to make effective tools for automatic frame discovery and labeling based on topic modeling and deep learning widely accessible to researchers from a diverse array of disciplines. To this end, we provide both state-of-the-art pre-trained frame classification models on various issues as well as a user-friendly pipeline for training novel classification models on user-provided corpora. Researchers can submit their documents and obtain frames of the documents. The degree of user involvement is flexible: they can run models that have been pre-trained on select issues; submit labeled documents and train a new model for frame classification; or submit unlabeled documents and obtain potential frames of the documents. The code making up our system is also open-sourced and well-documented, making the system transparent and expandable. The system is available on-line at http://www.openframing.org and via our GitHub page https://github.com/davidatbu/openFraming .Published versio

Stents in pediatric and adult congenital cardiac catheterization in France in 2013

Stents have contributed to the development of the interventional catheterization for congenital heart diseases (CHD). The aim of this study was to describe indications, results and adverse events in current practice.MethodsThe participation to this study was proposed to all catheterization laboratories specialized in CHD in France (M3C network). All cases with stents implantation in 2013 in pediatric and adult CHD were retrospectively included. Adverse events were assessed using the Bergersen classification.Results174 stents were implanted during 132 procedures in 127 patients by 6 main operators in 9 centers. Patients were aged 15.7±15.1years old (min 5day-old - max 70years old). Sixteen types of procedures were identified. Main indications were transcatheter pulmonary valve replacement (29 patients, 23.0%), pulmonary artery branches angioplasty (34 patients, 27.0%), aortic (re)coarctation stenting (37 patients, 29.4%) and ductus arteriosus stenting (11 patients, 8.7%). 18 patients (14.3%) were under one y.o and 35 (27.8%) were over 18y.o. Main pathologies were tetralogy of Fallot and variants (ACC-CHD 8.3, n=45, 35.7%), and aortic coarctation (ACC-CHD 9.2, n=36, 28.6%). More than 1 stent was implanted in 32 procedures (24.4%, max. 5 stents). Main stents implanted were the CP stent (33.0%), EV3 LD max (22.0%), Valeo (16.2%) and valved stents (15.0%). 98.5% procedures were considered as successful. Serious adverse events were observed in 12.9%. After multivariate adjustment, only procedure type was related to the risk of total adverse events (OR: 3.0, 95%CI 1.1–7.9) but not to stent related adverse events. Age, weight, center, operator, type of stents, stent diameter, genetic disorder and type of CHD were not significantly related to the risk of adverse events.ConclusionStents are used in various CHD catheterization procedures, from infancy to adult age. Adverse events rate is significant and seems related to the type of procedure

Social correlates of mental health in gastrointestinal cancer patients and their family caregivers: Exploring the role of loneliness

Purpose The present study examined the degree to which loneliness mediated the influence of negative (social constraints) and positive (emotional support) relationship qualities on the global mental health of advanced gastrointestinal (GI) cancer patients and their family caregivers. Methods Fifty patient-caregiver dyads completed measures assessing social constraints (e.g., avoidance, criticism) from the other dyad members, emotional support from others, loneliness, and global mental health. Structural equation modeling was used to examine individual models, and Actor-Partner Interdependence Mediation Modeling was used to examine dyadic associations. Results Individual path analyses for patients and caregivers demonstrated that emotional support had a significant indirect effect on mental health through loneliness (Bs = 0.32 and 0.30, respectively), but no associations were found between social constraints and mental health. In dyadic analyses, participants’ loneliness and mental health were not significantly related to their partner’s emotional support, loneliness, or mental health (Bs = − 0.18 to 0.18). Conclusions Findings suggest that for advanced GI cancer patients and caregivers, emotional support from others alleviates feelings of loneliness, which may lead to better mental health. However, the benefits of emotional support appear to be primarily intrapersonal rather than interpersonal in nature. Additionally, participants endorsed low levels of social constraints, which might explain their lack of relation to loneliness and mental health. Continued examination of interdependence in social processes between cancer patients and caregivers will inform intervention development

SYNERGISTIC ANTIOSTEOPOROTIC EFFECT OF LEPIDIUM SATIVUM AND ALENDRONATE IN GLUCOCORTICOID-INDUCED OSTEOPOROSIS IN WISTAR RATS

Bisphosphonates (BP) therapy is a vital option to reduce the risk of bone fracture in people who have osteoporosis. However, Bisphosphonate have displayed several side effects. Lepidium sativum (LS) plant and seeds has been used in traditional folk medicine as a mediator for bone fractures. Therefore, we aimed to compare the biochemical effects of LS alone (2% LS in diet, n=8), BP (Alendronate, 70 mg/kg s.c.; n=8) alone, or LS and BP combined in a rat model of glucocorticoid-induced osteoporosis (GIO) by injecting methylprednisolone 3.5 mg/kg per day for 4 weeks. Serum calcium (Ca), albumin, phosphorus (PO4), bone-specific alkaline phosphatase (b-ALP), and tartrate-resistant acid phosphatase (TRAP) were measured 4 weeks after induction of GIO. GIO-group showed significantly increased serum TRAP and decreased b-ALP. GIO-group also showed significantly decreased serum PO4 and unaltered Ca concentrations. Histological examination of GIO-group tibia bones indicates an osteoporotic changes and a concomitant decrease in percentage of trabecular area/bone marrow area (PTB) in the proximal femoral epiphysis. Treatment with either LS and/or BP ameliorated the above mentioned changes with variable degrees; with a net results of enhanced serum calcium, bone architecture, PTB, b-ALP and decreased TRAP in LS and LS+BP groups compared to that of animals treated with Alendronate alone. In conclusion, our findings present evidence supporting the potential benefits of LS in reducing the burden of GCs on bone health

Pembrolizumab in Combination with Ipilimumab as Second-Line or Later Therapy for Advanced Non–Small-Cell Lung Cancer: KEYNOTE-021 Cohorts D and H

Objectives Combination immunotherapy may result in improved antitumor activity compared with single-agent treatment. We report results from dose-finding and dose-expansion cohorts of the phase 1/2 KEYNOTE-021 study that evaluated combination therapy with anti‒programmed death 1 (PD-1) antibody pembrolizumab plus anti‒cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibody ipilimumab in patients with previously treated advanced non–small-cell lung cancer (NSCLC). Materials and Methods Eligibility criteria stipulated histologically/cytologically confirmed advanced NSCLC and treatment failure on ≥1 prior systemic therapy (platinum-based chemotherapy or targeted therapy for patients with EGFR/ALK aberrations). In the dose-finding cohort, patients initially received pembrolizumab 10 mg/kg plus ipilimumab 1 or 3 mg/kg once every 3 weeks for 4 cycles followed by pembrolizumab 10 mg/kg monotherapy for up to 2 years. Based on emerging published data, subsequent patients received pembrolizumab 2 mg/kg plus ipilimumab 1 mg/kg. Objective response rate (ORR; primary efficacy endpoint) was assessed per RECIST version 1.1 by blinded, independent central review. Phase 2 hypothesis that ORR would be greater than the 20% rate for historical controls was evaluated using the exact binomial test. Results Fifty-one patients were enrolled; 71% received ≥2 prior lines of therapy. No dose-limiting toxicities occurred at any dose level. Among patients who received pembrolizumab 2 mg/kg plus ipilimumab 1 mg/kg (n = 44), ORR was 30% (95% CI, 17%–45%), but not statistically significantly >20% (P = 0.0858). Median progression-free survival in this group was 4.1 (95% CI, 1.4–5.8) months; median overall survival was 10.9 (95% CI, 6.1–23.7) months. With pembrolizumab 2 mg/kg plus ipilimumab 1 mg/kg, incidences of treatment-related adverse events, grade 3–5 treatment-related adverse events, and immune-mediated adverse events and infusion reactions were 64%, 29% and 42%, respectively. Conclusions In patients with heavily pretreated advanced NSCLC, pembrolizumab plus ipilimumab showed evidence of antitumor activity, but was associated with meaningful toxicity

Acceptance and Commitment Therapy for Symptom Interference in Advanced Lung Cancer and Caregiver Distress: A Pilot Randomized Trial

Context Advanced lung cancer patients typically have a poor prognosis and many symptoms that interfere with functioning, contributing to high rates of emotional distress in both patients and family caregivers. There remains a need for evidence-based interventions to improve functional outcomes and distress in this population. Objectives This pilot trial examined the feasibility and preliminary efficacy of telephone-based Acceptance and Commitment Therapy (ACT) for symptomatic, advanced lung cancer patients and their distressed family caregivers. Primary outcomes were patient symptom interference with functioning and patient and caregiver distress. Methods Symptomatic, advanced lung cancer patients and distressed caregivers (n = 50 dyads) were randomly assigned to six sessions of ACT or an education/support condition. Patients completed measures of symptom interference and measures assessing the severity of fatigue, pain, sleep disturbance, and breathlessness. Patients and caregivers completed measures of distress and illness acceptance and struggle. Results The eligibility screening rate (51%) and retention rate (76% at six weeks postintervention) demonstrated feasibility. No group differences were found with respect to patient and caregiver outcomes. Both groups showed a small, significant decrease in struggle with the illness over the study period, but did not show meaningful change in other outcomes. Conclusion Findings suggest that telephone-based ACT is feasible for many advanced lung cancer patients and caregivers, but may not substantially reduce symptom interference and distress. Low baseline levels of certain symptoms may have contributed to null findings. Next steps include applying ACT to specific, clinically meaningful symptom interference and varying intervention dose and modality