The use of self-disclosure to build rapport with mock covert human intelligence sources (CHIS)

The use of covert human intelligence sources for the protection of national security is an important but under-researched area. In light of increased globalisation, and technological developments, examining covert intelligence gathering online may have operational relevance. This study examined the use of similarities in self disclosure to develop rapport with mock covert human intelligence sources online. A sample of 66 participants were asked to assume the role of a CHIS, listen to an audio recording of a meeting of the criminal network they are part of, and strike a balance between being forthcoming to their handler while at the same time not revealing all information they possessed. They were then interviewed online by a mock handler who opened the conversation in one of three ways: self-disclosing information that highlighted similarities between herself and the CHIS, self disclosing information that highlighted dissimilarities, or control (no disclosure). Participants completed a follow-up rapport questionnaire based on their interaction with the handler. The study found that mock sources rated rapport higher in the similarities condition in comparison with other conditions; however, it did not translate into a significant difference in the intelligence reported. The findings of this research and its policy and practice implications are discussed

DESIGN AND PRODUCTION OF A DEVICE FOR BASING AND FIXING CONIC DETAILS IN SINE BAR MEASUREMENTS

The geometric features of the conical parts measured by a sine bar requires special devices for basing and fastening. Basing and fixing conical parts on a sine bar is a problem that can lead to deviations in measurements. In the presented study, a fixture for fixing and basing conical details when measuring with a sine bar is designed and manufactured. The device is designed to facilitate the work of the operator in fixing the workpiece during the measurement, which increases the accuracy of the measurements. The developed structure is designed using SolidWorks. After the completion of the 3D model, a choice of material and technology for 3D printing is made. After that, a 3D printer is used for its production. The manufactured device is tested in laboratory studies. The designed device is installed on the sine bar without changing the measurement methodology. The conducted experiments prove its workability and applicability

Colorectal neoplastic emergencies in immunocompromised patients: preliminary result from the Web-based International Register of Emergency Surgery and Trauma (WIRES-T trial)

Association of advanced age, neoplastic disease and immunocompromission (IC) may lead to surgical emergencies. Few data exist about this topic. Present study reports the preliminary data from the WIRES-T trial about patients managed for colorectal neoplastic emergencies in immunocompromised patients. The required data were taken from a prospective observational international register. The study was approved by the Ethical Committee with approval n. 17575; ClinicalTrials.gov Identifier: NCT03643718. 839 patients were collected; 753 (80.7%) with mild-moderate IC and 86 (10.3%) with severe. Median age was 71.9 years and 73 years, respectively, in the two groups. The causes of mild-moderate IC were reported such malignancy (753-100%), diabetes (103-13.7%), malnutrition (26-3.5%) and uremia (1-0.1%), while severe IC causes were steroids treatment (14-16.3%); neutropenia (7-8.1%), malignancy on chemotherapy (71-82.6%). Preoperative risk classification were reported as follow: mild-moderate: ASA 1-14 (1.9%); ASA 2-202 (26.8%); ASA 3-341 (45.3%); ASA 4-84 (11.2%); ASA 5-7 (0.9%); severe group: ASA 1-1 patient (1.2%); ASA 2-16 patients (18.6%); ASA 3-41 patients (47.7%); ASA 4-19 patients (22.1%); ASA 5-3 patients (3.5%); lastly, ASA score was unavailable for 105 cases (13.9%) in mild-moderate group and in 6 cases (6.9%) in severe group. All the patients enrolled underwent urgent/emergency surgery Damage control approach with open abdomen was adopted in 18 patients. Mortality was 5.1% and 12.8%, respectively, in mild-moderate and severe groups. Long-term survival data: in mild-moderate disease-free survival (median, IQR) is 28 (10-91) and in severe IC, it is 21 (10-94). Overall survival (median, IQR) is 44 (18-99) and 26 (20-90) in mild-moderate and severe, respectively; the same is for post-progression survival (median, IQR) 29 (16-81) and 28, respectively. Univariate and multivariate analyses showed as the only factor influencing mortality in mild-moderate and severe IC is the ASA score. Colorectal neoplastic emergencies in immunocompromised patients are more frequent in elderly. Sigmoid and right colon are the most involved. Emergency surgery is at higher risk of complication and mortality; however, management in dedicated emergency surgery units is necessary to reduce disease burden and to optimize results by combining oncological and acute care principles. This approach may improve outcomes to obtain clinical advantages for patients like those observed in elective scenario. Lastly, damage control approach seems feasible and safe in selected patients

Chronic Oral Anticoagulation Therapy and Prognosis of Patients Admitted to Hospital for COVID-19: Insights from the HOPE COVID-19 Registry

BackgroundMost evidence regarding anticoagulation and COVID-19 refers to the hospitalization setting, but the role of oral anticoagulation (OAC) before hospital admission has not been well explored. We compared clinical outcomes and short-term prognosis between patients with and without prior OAC therapy who were hospitalized for COVID-19.MethodsAnalysis of the whole cohort of the HOPE COVID-19 Registry which included patients discharged (deceased or alive) after hospital admission for COVID-19 in 9 countries. All-cause mortality was the primary endpoint. Study outcomes were compared after adjusting variables using propensity score matching (PSM) analyses.Results7698 patients were suitable for the present analysis (675 (8.8%) on OAC at admission: 427 (5.6%) on VKAs and 248 (3.2%) on DOACs). After PSM, 1276 patients were analyzed (638 with OAC; 638 without OAC), without significant differences regarding the risk of thromboembolic events (OR 1.11, 95% CI 0.59-2.08). The risk of clinically relevant bleeding (OR 3.04, 95% CI 1.92-4.83), as well as the risk of mortality (HR 1.22, 95% CI 1.01-1.47; log-rank p value = 0.041), was significantly increased in previous OAC users. Amongst patients on prior OAC only, there were no differences in the risk of clinically relevant bleeding, thromboembolic events, or mortality when comparing previous VKA or DOAC users, after PSM.ConclusionHospitalized COVID-19 patients on prior OAC therapy had a higher risk of mortality and worse clinical outcomes compared to patients without prior OAC therapy, even after adjusting for comorbidities using a PSM. There were no differences in clinical outcomes in patients previously taking VKAs or DOACs. This trial is registered with NCT04334291/EUPAS34399

Trypanocidal drugs for chronic asymptomatic Trypanosoma cruzi infection

Fil: Villar, Juan Carlos. Department of Medicine, Universidad Autónoma de Bucaramanga; Colombia.Fil: Perez, Juan Guillermo. Fundación Cardioinfantil Instituto de Cardiología, Bogota; Colombia.Fil: Cortes, Olga Lucia. Fundación Cardioinfantil Instituto de Cardiología, Bogota; ColombiaFil: Riarte, Adelina. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología; Argentina.Fil: Pepper, Micah. School of Public Health, Boston University, Boston; Estados Unidos.Fil: Marin-Neto, José Antônio. Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto; Brasil.Fil: Guyatt, Gordon H. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton; Canada.Prevention of chronic chagasic cardiomyopathy (CCC) by treating infected populations with trypanocidal therapy (TT) remains a challenge. Despite a renewed enthusiasm for TT, uncertainty regarding its efficacy, concerns about its safety and limited availability remain barriers for a wider use of conventional drugs. We have updated a previous version of this review