Making their mark?:How protest sparks, surfs, and sustains media issue attention

Media attention is both an important outcome and a resource for protest groups. This paper examines media-movement dynamics using television news coverage of 1,277 protests in Belgium (2003-2019). We situate protest coverage in media issue attention cycles and scrutinize whether features of protest or rather media issue attention fluctuations are key for protest's agenda-setting effect. Our results show that while most protests fail to alter the attention cycle, a considerable share of protests is followed by a significant increase in media issue attention, especially when surfing issue attention already on the rise. Overall, media issue attention cycles rather than protest features affect protest's agenda-setting effect, suggesting that protest agenda-setting is more a matter of exploiting discursive opportunities than of forcing one's issue on the media agenda by signaling newsworthiness. These findings have serious implications for our understanding of protest group agency in news making and agenda-setting

Cost management and cross-functional communication through product architectures

Product architecture decisions regarding, for example, product modularity, component commonality, and design re-use, are important for balancing costs, responsiveness, quality, and other important business objectives. Firms are challenged with complex tradeoffs between competing design priorities, face the need to facilitate communication between functional silos, and want to learn from past experiences. In this paper, we present a qualitative approach for systematically evaluating the product architecture of a product family, comparing the original architecture objectives and actual experiences. The intended contribution of our research is threefold: (1) to present a framework that brings together a diverse set of product architecture-related decisions and business performance; (2) to provide a set of metrics that operationalise the variables in the framework, and (3) to provide a workshop protocol that is based on the framework and the metrics. This workshop aims to improve cross-functional communication about the product architecture of an existing product family, and it results in practical improvement actions for future architecture design projects. Experiences with this approach are reported in pilots with Philips Domestic Appliances and Personal Care, and Philips Consumer Electronics

Does recovery from submaximal exercise predict response to cardiac resynchronisation therapy?

BACKGROUND: Exercise parameters are not routinely incorporated in decision making for cardiac resynchronisation therapy (CRT). Submaximal exercise parameters better reflect daily functional capacity of heart failure patients than parameters measured at maximal exertion, and may therefore better predict response to CRT. We compared various exercise parameters, and sought to establish which best predict CRT response. METHODS: In 31 patients with chronic heart failure (61% male; age 68±7 years), submaximal and maximal cycling testing was performed before and 3 months after CRT. Submaximal oxygen onset (τVO(2) onset) and recovery kinetics (τVO(2) recovery), peak oxygen uptake (VO(2) peak) and oxygen uptake efficiency slope (OUES) where measured. Response was defined as ≥15% relative reduction in end-systolic volume. RESULTS: After controlling for age, New York Heart Association and VO(2) peak, fast submaximal VO(2) kinetics were significantly associated with response to CRT, measured either during onset or recovery of submaximal exercise (area under the curve, AUC=0.719 for both; p<0.05). By contrast, VO(2) peak (AUC=0.632; p=0.199) and OUES (AUC=0.577; p=0.469) were not associated with response. Among patients with fast onset and recovery kinetics, below 60 s, a significantly higher percentage of responders was observed (91% and 92% vs 43% and 40%, respectively). CONCLUSIONS: Impaired VO(2) kinetics may serve as an objective marker of submaximal exercise capacity that is age-independently associated with non-response following CRT, whereas maximal exercise parameters are not. Assessment of VO(2) kinetics is feasible and easy to perform, but larger studies should confirm their clinical utility

alpha II-spectrin and beta II-spectrin do not affect TGF beta 1-induced myofibroblast differentiation

Mechanosensing of fibroblasts plays a key role in the development of fibrosis. So far, no effective treatments are available to treat this devastating disorder. Spectrins regulate cell morphology and are potential mechanosensors in a variety of non-erythroid cells, but little is known about the role of spectrins in fibroblasts. We investigate whether II- and II-spectrin are required for the phenotypic properties of adult human dermal (myo)fibroblasts. Knockdown of II- or II-spectrin in fibroblasts did not affect cell adhesion, cell size and YAP nuclear/cytosolic localization. We further investigated whether II- and II-spectrin play a role in the phenotypical switch from fibroblasts to myofibroblasts under the influence of the pro-fibrotic cytokine TGF1. Knockdown of spectrins did not affect myofibroblast formation, nor did we observe changes in the organization of SMA stress fibers. Focal adhesion assembly was unaffected by spectrin deficiency, as was collagen type I mRNA expression and protein deposition. Wound closure was unaffected as well, showing that important functional properties of myofibroblasts are unchanged without II- or II-spectrin. In fact, fibroblasts stimulated with TGF1 demonstrated significantly lower endogenous mRNA levels of II- and II-spectrin. Taken together, despite the diverse roles of spectrins in a variety of other cells, II- and II-spectrin do not regulate cell adhesion, cell size and YAP localization in human dermal fibroblasts and are not required for the dermal myofibroblast phenotypical switch

Lokaal middenveld & lokale besturen: focusgroepen : CSI Spotlightpaper 20

Dit rapport geeft de bevindingen weer van focusgroepen die in 5 kleinere gemeenten georganiseerd werden. In elke gemeente was er een bijeenkomst met mensen uit het lokale verenigingsleven en eentje met lokale bestuurders. Deze resultaten zijn niet per se representatief maar wel indicatief voor wat er gaande is bij het lokale middenveld in kleinere gemeenten. Het rapport gaat in op zeven deelaspecten van de gesprekken die in elke gemeente gevoerd werden. 1. Op zoek naar de nieuwe, jonge vrijwilliger? 2.De verzuiling voorbij? 3. De relatie tussen 'koepels' en 'afdelingen': andere werelden? 4. Het belang van de deelgemeenten 5. Het ontsluiten van etnisch-culturele diversiteit: "wij" en "zij"? 6. Lokaal bestuur en middenveld: een LAT-relatie? 7. Naar nieuwe impulsen? Vernieuwing en innovatieve praktijken

Double CEBPA mutations, but not single CEBPA mutations, define a subgroup of acute myeloid leukemia with a distinctive gene expression profile that is uniquely associated with a favorable outcome

Mutations in CCAAT/enhancer binding protein α (CEBPA) are seen in 5% to 14% of acute myeloid leukemia (AML) and have been associated with a favorable clinical outcome. Most AMLs with CEBPA mutations simultaneously carry 2 mutations (CEBPAdouble-mut), usually biallelic, whereas single heterozygous mutations (CEBPAsingle-mut) are less frequently seen. Using denaturing high-performance liquid chromatography and nucleotide sequencing, we identified among a cohort of 598 newly diagnosed AMLs a subset of 41 CEBPA mutant cases (28 CEBPAdouble-mut and 13 CEBPA single-mut cases) CEBPAdouble-mut associated with a unique gene expression profile as well as favorable overall and event-free survival, retained in multi-variable analysis that included cytoge-netic risk, FZT3-ITD and NPM1 mutation, white blood cell count, and age. In contrast, CEBPA single-mut AMLs did not express a discriminating signature and could not be distinguished from wild-type cases as regards clinical outcome. These results demonstrate significant underlying heterogeneity within CEBPA mutation-positive AML with prognostic relevance

Explaining Personalized Activity Limitations in Patients With Hand and Wrist Disorders:Insights from Sociodemographic, Clinical, and Mindset Characteristics

Objectives: To investigate the association of sociodemographic, clinical, and mindset characteristics on outcomes measured with a patient-specific patient-reported outcome measure (PROM); the Patient Specific Functional Scale (PSFS). Secondly, we examined whether these factors differ when a fixed-item PROM, the Michigan Hand Outcome Questionnaire (MHQ), is used as an outcome. Design:Cohort study, using the aforementioned groups of factors in a hierarchical linear regression. Setting: Twenty-six clinics for hand and wrist conditions in the Netherlands. Participants: Two samples of patients with various hand and wrist conditions and treatments: n=7111 (PSFS) and n=5872 (MHQ). Interventions: NA. Main Outcome Measures:The PSFS and MHQ at 3 months. Results:The PSFS exhibited greater between-subject variability in baseline, follow-up, and change scores than the MHQ. Better PSFS outcomes were associated with: no involvement in litigation (β[95% confidence interval=-0.40[-0.54;-0.25]), better treatment expectations (0.09[0.06;0.13]), light workload (0.08[0.03;0.14]), not smoking (-0.07[-0.13;-0.01]), men sex (0.07[0.02;0.12]), better quality of life (0.07[0.05;0.10]), moderate workload (0.06[0.00;0.13]), better hand satisfaction (0.05[0.02; 0.07]), less concern (-0.05[-0.08;-0.02]), less pain at rest (-0.04[-0.08;-0.00]), younger age (-0.04[-0.07;-0.01]), better comprehensibility (0.03[0.01;0.06]), better timeline perception (-0.03[-0.06;-0.01]), and better control (-0.02[-0.04;-0.00]). The MHQ model was highly similar but showed a higher R2 than the PSFS model (0.41 vs 0.15), largely due to the R2 of the baseline scores (0.23 for MHQ vs 0.01 for PSFS). Conclusions:Health care professionals can improve personalized activity limitations by addressing treatment expectations and illness perceptions, which affect PSFS outcomes. Similar factors affect the MHQ, but the baseline MHQ score has a stronger association with the outcome score than the PSFS. While the PSFS is better for individual patient evaluation, we found that it is difficult to explain PSFS outcomes based on baseline characteristics compared with the MHQ. Using both patient-specific and fixed-item instruments helps health care professionals develop personalized treatment plans that meet individual needs and goals.</p

The Ultrashort Mental Health Screening Tool Is a Valid and Reliable Measure With Added Value to Support Decision-making

BACKGROUND: Mental health influences symptoms, outcomes, and decision-making in musculoskeletal healthcare. Implementing measures of mental health in clinical practice can be challenging. An ultrashort screening tool for mental health with a low burden is currently unavailable but could be used as a conversation starter, expectation management tool, or decision support tool.QUESTIONS/PURPOSES: (1) Which items of the Pain Catastrophizing Scale (PCS), Patient Health Questionnaire (PHQ-4), and Brief Illness Perception Questionnaire (B-IPQ) are the most discriminative and yield a high correlation with the total scores of these questionnaires? (2) What is the construct validity and added clinical value (explained variance for pain and hand function) of an ultrashort four-item mental health screening tool? (3) What is the test-retest reliability of the screening tool? (4) What is the response time for the ultrashort screening tool?METHODS: This was a prospective cohort study. Data collection was part of usual care at Xpert Clinics, the Netherlands, but prospective measurements were added to this study. Between September 2017 and January 2022, we included 19,156 patients with hand and wrist conditions. We subdivided these into four samples: a test set to select the screener items (n = 18,034), a validation set to determine whether the selected items were solid (n = 1017), a sample to determine the added clinical value (explained variance for pain and hand function, n = 13,061), and a sample to assess the test-retest reliability (n = 105). Patients were eligible for either sample if they completed all relevant measurements of interest for that particular sample. To create an ultrashort screening tool that is valid, reliable, and has added value, we began by picking the most discriminatory items (that is, the items that were most influential for determining the total score) from the PCS, PHQ-4, and B-IPQ using chi-square automated interaction detection (a machine-learning algorithm). To assess construct validity (how well our screening tool assesses the constructs of interest), we correlated these items with the associated sum score of the full questionnaire in the test and validation sets. We compared the explained variance of linear models for pain and function using the screening tool items or the original sum scores of the PCS, PHQ-4, and B-IPQ to further assess the screening tool's construct validity and added value. We evaluated test-retest reliability by calculating weighted kappas, ICCs, and the standard error of measurement.RESULTS: We identified four items and used these in the screening tool. The screening tool items were highly correlated with the PCS (Pearson coefficient = 0.82; p &lt; 0.001), PHQ-4 (0.87; p &lt; 0.001), and B-IPQ (0.85; p &lt; 0.001) sum scores, indicating high construct validity. The full questionnaires explained only slightly more variance in pain and function (10% to 22%) than the screening tool did (9% to 17%), again indicating high construct validity and much added clinical value of the screening tool. Test-retest reliability was high for the PCS (ICC 0.75, weighted kappa 0.75) and B-IPQ (ICC 0.70 to 0.75, standard error of measurement 1.3 to 1.4) items and moderate for the PHQ-4 item (ICC 0.54, weighted kappa 0.54). The median response time was 43 seconds, against more than 4 minutes for the full questionnaires.CONCLUSION: Our ultrashort, valid, and reliable screening tool for pain catastrophizing, psychologic distress, and illness perception can be used before clinician consultation and may serve as a conversation starter, an expectation management tool, or a decision support tool. The clinical utility of the screening tool is that it can indicate that further testing is warranted, guide a clinician when considering a consultation with a mental health specialist, or support a clinician in choosing between more invasive and less invasive treatments. Future studies could investigate how the tool can be used optimally and whether using the screening tool affects daily clinic decisions.LEVEL OF EVIDENCE: Level II, diagnostic study.</p