Association between tumor necrosis factor inhibitors and the risk of hospitalization or death among patients with immune-mediated inflammatory disease and covid-19

IMPORTANCE: Although tumor necrosis factor (TNF) inhibitors are widely prescribed globally because of their ability to ameliorate shared immune pathways across immune-mediated inflammatory diseases (IMIDs), the impact of COVID-19 among individuals with IMIDs who are receiving TNF inhibitors remains insufficiently understood. OBJECTIVE: To examine the association between the receipt of TNF inhibitor monotherapy and the risk of COVID-19–associated hospitalization or death compared with other commonly prescribed immunomodulatory treatment regimens among adult patients with IMIDs. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a pooled analysis of data from 3 international COVID-19 registries comprising individuals with rheumatic diseases, inflammatory bowel disease, and psoriasis from March 12, 2020, to February 1, 2021. Clinicians directly reported COVID-19 outcomes as well as demographic and clinical characteristics of individuals with IMIDs and confirmed or suspected COVID-19 using online data entry portals. Adults (age 18 years) with a diagnosis of inflammatory arthritis, inflammatory bowel disease, or psoriasis were included. EXPOSURES: Treatment exposure categories included TNF inhibitor monotherapy (reference treatment), TNF inhibitors in combination with methotrexate therapy, TNF inhibitors in combination with azathioprine/6-mercaptopurine therapy, methotrexate monotherapy, azathioprine/6- mercaptopurine monotherapy, and Janus kinase (Jak) inhibitor monotherapy. MAIN OUTCOMES AND MEASURES: The main outcome was COVID-19–associated hospitalization or death. Registry-level analyses and a pooled analysis of data across the 3 registries were conducted using multilevel multivariable logistic regression models, adjusting for demographic and clinical characteristics and accounting for country, calendar month, and registry-level correlations. RESULTS: A total of 6077 patients from 74 countries were included in the analyses; of those, 3215 individuals (52.9%)were from Europe, 3563 individuals (58.6%)were female, and the mean (SD) age was 48.8 (16.5) years. The most common IMID diagnoses were rheumatoid arthritis (2146 patients [35.3%]) and Crohn disease (1537 patients [25.3%]). A total of 1297 patients (21.3%) were hospitalized, and 189 patients (3.1%) died. In the pooled analysis, compared with patients who received TNF inhibitor monotherapy, higher odds of hospitalization or death were observed among those who received a TNF inhibitor in combination with azathioprine/6-mercaptopurine therapy (odds ratio [OR], 1.74; 95%CI, 1.17-2.58; P = .006), azathioprine/6-mercaptopurine monotherapy (OR, 1.84; 95%CI, 1.30-2.61; P = .001), methotrexate monotherapy (OR, 2.00; 95%CI, 1.57-2.56; P < .001), and Jak inhibitor monotherapy (OR, 1.82; 95%CI, 1.21-2.73; P = .004) but not among those who received a TNF inhibitor in combination with methotrexate therapy (OR, 1.18; 95%CI, 0.85-1.63; P = .33). Similar findings were obtained in analyses that accounted for potential reporting bias and sensitivity analyses that excluded patients with a COVID-19 diagnosis based on symptoms alone. CONCLUSIONS AND RELEVANCE: In this cohort study, TNF inhibitor monotherapy was associated with a lower risk of adverse COVID-19 outcomes compared with other commonly prescribed immunomodulatory treatment regimens among individuals with IMIDs

It’s the talk: A study of involvement initiatives in secure mental health settings

Background: A study of involvement initiatives within secure mental health services across one UK region, where these have been organised to reflect alliances between staff and service users. There is little previous relevant international research, but constraints upon effective involvement have been noted. Objective: To explore and evaluate involvement initiatives in secure mental health settings. Design: A case study design with thematic analysis of qualitative interviews and focus groups. Setting and participants: Data collection was carried out between October 2011 and February 2012 with 139 staff and service users drawn from a variety of secure mental health settings. Findings: Our analysis offers four broad themes, titled: safety and security first?; bringing it all back home; it picks you up; it’s the talk. The quality of dialogue between staff and services users was deemed of prime importance. Features of secure environments could constrain communication, and the best examples of empowerment took place in non-secure settings. Discussion: Key aspects of communication and setting sustain involvement. These features are discussed with reference to Jurgen Habermas's work on communicative action and deliberative democracy. Conclusions: Involvement initiatives with service users resident in secure hospitals can be organized to good effect and the active role of commissioners is crucial. Positive outcomes are optimized when care is taken over the social space where involvement takes place and the process of involvement is appreciated by participants. Concerns over risk management are influential in staff support. This is germane to innovative thinking about practice and policy in this field

Automated Attendance System

The Automated Attendance System will automatically capture students’ attendance using RFID and face recognition technology. The system is consisted of a camera, a RFID reader and tags, as well as a software system. The camera will capture the image of the user when he/she passes the RFID card by the reader. The RFID reader will collect the information from the tag, digitize it, and transmit it to the computer. The software will then retrieve the student information associated with the RFID tag, check whether the student is enrolled in the class and compare the student’s photo with the image captured by the camera. With our Automated Attendance System, the lecturer can easily and automatically keep track of student attendance and can check that the student themselves are taking the exam

AGENDA: Best Management Practices (BMPs): What? How? And Why?

The Environmentally Friendly Drilling Systems (EFD) Program, managed by the Houston Advanced Research Center, works to identify, develop and transfer critical, cost effective, new technologies that can provide policy makers and industry with the ability to develop natural gas reserves in a safe and environmentally friendly manner. Funding for the EFD Program is through a grant from the Research Partnership to Secure Energy for America, established under the 2005 Energy Act. Within the EFD Program, some projects focus on technologies for developing energy sources in environmentally sensitive areas; others (like the NRLC’s BMP Project) seek ways to reduce the environmental footprint in all types of environments. The EFD Program currently provides the majority of funding for the Intermountain Oil and Gas BMP project. The EFD Program holds quarterly workshops to share ideas among the program partners, sponsors, and with the broader community. The NRLC hosted the EFD\u27s quarterly meeting in a workshop on May 26, 2011 at the Wolf Law Building on the University of Colorado campus. With presentations from EFD project researchers and perspectives invited from all participants, the May, 2011 EFD workshop explored the value of different methods for incorporating BMPs into a development as well as the benefits and cost of implementing BMPs. See the NRLC\u27s Intermountain Oil and Gas BMP Project for more information on BMPs and how they can be implemented in oil and gas development

AGENDA: Best Management Practices (BMPs): What? How? And Why?

The Environmentally Friendly Drilling Systems (EFD) Program, managed by the Houston Advanced Research Center, works to identify, develop and transfer critical, cost effective, new technologies that can provide policy makers and industry with the ability to develop natural gas reserves in a safe and environmentally friendly manner. Funding for the EFD Program is through a grant from the Research Partnership to Secure Energy for America, established under the 2005 Energy Act. Within the EFD Program, some projects focus on technologies for developing energy sources in environmentally sensitive areas; others (like the NRLC’s BMP Project) seek ways to reduce the environmental footprint in all types of environments. The EFD Program currently provides the majority of funding for the Intermountain Oil and Gas BMP project. The EFD Program holds quarterly workshops to share ideas among the program partners, sponsors, and with the broader community. The NRLC hosted the EFD\u27s quarterly meeting in a workshop on May 26, 2011 at the Wolf Law Building on the University of Colorado campus. With presentations from EFD project researchers and perspectives invited from all participants, the May, 2011 EFD workshop explored the value of different methods for incorporating BMPs into a development as well as the benefits and cost of implementing BMPs. See the NRLC\u27s Intermountain Oil and Gas BMP Project for more information on BMPs and how they can be implemented in oil and gas development

The lived experience of working with female patients in a high secure hospital

Women’s secure hospitals are often considered to be stressful and demanding places to work, with these environments characterised as challenging and violent. The staff experience of working in this environment is however not well represented in the literature. This study is the first to examine the ‘lived experience’ of seven nurses working in the National High Secure Healthcare Service for Women. Interview transcripts were analysed with the use of Interpretative Phenomenological Analysis, and the findings presented within four superordinate themes ‘horror’, ‘balancing acts’, ‘emotional hard labour’, and ‘the ward as a community’. These themes all depict the challenges that participants experience in their work, the ways in which they cope with these challenges and how they make sense of these experiences. A meta-theme of ‘making sense by understanding why’ is also presented, which represents the importance for participants to attempt to make sense of the tensions and challenges by formulating a fuller meaning. The findings suggest the importance of workforce development, in terms of allowing sufficient protected time for reflection and formulation (for example within the format of group supervision or reflective practice), and for staff support mechanisms (e.g. clinical supervision, counselling, debriefs) to be inbuilt into the ethos of a service, so as to provide proactive support for staff ‘on the frontline’

PPAndroid-Benchmarker: Benchmarking Privacy Protection Systems on Android Devices

Mobile devices are ubiquitous in today's digital world. While people enjoy the convenience brought by mobile devices, it has been proven that many mobile apps leak personal information without user consent or even awareness. That can occur due to many reasons, such as careless programming errors, intention of developers to collect private information, infection of innocent apps by malware, etc. Thus, the research community has proposed many methods and systems to detect privacy leakage and prevent such detected leakage on mobile devices. This is a to do note at margin While it is obviously essential to evaluate the accuracy and effectiveness of privacy protection systems, we are not aware of any automated system that can benchmark performance of privacy protection systems on Android devices. In this paper, we report PPAndroid-Benchmarker, the first system of this kind, which can fairly benchmark any privacy protection systems dynamically (i.e., in run time) or statically. PPAndroid-Benchmarker has been released as an open-source tool and we believe that it will help the research community, developers and even end users to analyze, improve, and choose privacy protection systems on Android devices. We applied PPAndroid-Benchmarker in dynamic mode to 165 Android apps with some privacy protection features, selected from variant app markets and the research community, and showed effectiveness of the tool. We also illustrate two components of PPAndroid-Benchmarker on the design level, which are Automatic Test Apps Generator for benchmarking static analysis based tools and Reconfigurability Engine that allows any instance of PPAndroid-Benchmarker to be reconfigured including but not limited to adding and removing information sources and sinks. Furthermore, we give some insights about current status of mobile privacy protection and prevention in app markets based upon our analysis

Probing for proof, plausibility, principle and possibility: a new approach to assessing evidence in a systematic evidence review

This article proposes a new approach to assessing evidence during a systematic evidence review aiming to inform international development policy. Drawing lessons from a number of social science systematic evidence reviews, the paper identifies how the method’s limiting perspective on evidence (including the exclusive focus on ‘golden standard’ empirical information) has serious disadvantages for the usability of evidence reviews for policy. This article aims to provide an alternative framework that allows for a less exclusionary, yet policy-practical way of assessing evidence. We propose four perspectives on evidence, appropriate for different stages in the policy process: principle when setting or prioritising broad policy goals, plausibility when assessing specific future policies, proof when evaluating past policies and possibility when striving for innovation and allowing exchange of ideas