UK-South Asian patients' experiences of and satisfaction toward receiving information about biologics in rheumatoid arthritis

Background: Rheumatoid arthritis (RA) causes painful joint inflammation and is incurable, but treatments control RA. Drug regimens are complex, and patients often do not take their medication as expected. Poor medication adherence can lead to poorly controlled disease and worse patient outcomes. Biologics treatments are expensive and require full engagement from patients. We have previously shown that patients from Black ethnic minority backgrounds do not fully engage into treatment plan. This study explored the patients’ experiences in and satisfaction toward receiving information about biologics and future support preferences in South Asian patients with RA. Methods: Twenty South Asian patients with RA from Royal Wolverhampton Hospitals NHS Trust and Central Manchester University Hospitals NHS Foundation Trust participated in individual semi-structured interviews. Interviews were transcribed and data were analyzed by using thematic analysis approach. Results: Four overarching themes describe the patients’ experience in and satisfaction toward receiving information on biologics: 1) current provision of information regarding the “biologics journey” and understanding of RA: in this theme, non-English-speaking patients expressed heightened anxiety about stepping up to biologics; 2) experience and perceptions of biologics: many patients were positive about the biologic experience; however, there were patient-perceived delays in getting on to the biologics; 3) factors influencing willingness to try biologics: in this theme, a number of factors were identified including seeking advice from doctors abroad; and 4) recommendations on the desired information to fully understand the use of biologics: some patients valued group discussions, while others suggested receiving RA and biologic information through a video interaction. Conclusion: This novel study provides insight into South Asian RA patients’ experiences in and satisfaction toward receiving information about biologics. South Asian patients with RA reported a range of perceptions about biologics and support preferences, many of which may not be shared with the non-South Asian population

Cross-referencing and Thesaurus maintenance

The development of thesauri in science and technology is briefly discussed. The important aspects of the structure and format of a thesaurus are mentioned. The need for revising a thesaurus, the structural changes that may occur in course of time, and the problems of maintaining a thesaurus are indicated. It is the need that should determine the frequency of revision, rather than any other exigency. The types of relations implied in the cross-reference structures in thesauri are briefly discus- sed. The cross-reference structures in TEST, Thesaurofacet, INIS The Stresses the point that the policy regarding saurus etc, are examined. the cross-referencing in thesauri should be stated explicitly, if proper and useful studies are to be undertaken regarding the cross-reference structures, and points out that such a policy statement is of help in the maintenance of thesauri and usable form. The two types of approaches suggested Kochen and others for the study of properties of cross-reference of structures are mentioned

Degradation of cysts of Havtmannella culbertsoni by culture filtrates of Alternaria sp.

This article does not have an abstract

Roadblocks in the Grammaticalization Highway: When Phonology Gets in the Way

In lieu of an abstract, here is a brief excerpt:In light of recent proposals that question the unidirectionality of grammaticalization and the necessity of phonetic erosion (or more broadly autonomy), the third person pronominal suffix -nye in Besemah, a little-known Malay language of southwest Sumatra, presents an interesting puzzle. In the majority of constructions -nye attaches directly to the root and has undergone phonetic erosion (i.e., -nye > -e): anak-nye > anak-e ‘their child’. In deverbal noun constructions suffixed with -an, or circumfixed with peN- -an, however, the -nye is separated from the root and surfaces as a separate phonological word (i.e., -nye > anye): langkah-an-nye > langkah-an anye ‘his stride’ (from the root langkah ‘to step’). One might expect that the most phonetically robust and prosodically independent form (anye) is the oldest, but there is strong evidence going back to Proto-Austronesian that it is not. Therefore, what do we make of a case where a suffix by all other accounts is grammaticalizing, but in some constructions is phonetically strengthened and phonologically less bound (i.e., suffix > word)? Arguably, such a case should be added to the growing list of examples of degrammaticalization because -nye is apparently climbing up the cline. However, what is more interesting than this taxonomy is determining the conditions, pressures, and/or motivations by which this change emerged. It turns out that this unexpected alternation between –e, –nye, and anye can be attributed to a morphophonological (or more specifically morpho-prosodic) preference in Besemah for no more than one suffix per word. This preference alongside restrictions on phonological words and routinization has resulted in a number of unusual patterns, most importantly the alternations resulting from the suffix -nye attaching to other suffixes.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India

Background Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. Methods This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. Results In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Conclusion Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold

SARS-CoV-2 Infections and ACE2: Clinical Outcomes Linked With Increased Morbidity and Mortality in Individuals With Diabetes

Individuals with diabetes suffering from coronavirus disease 2019 (COVID-19) exhibit increased morbidity and mortality compared with individuals without diabetes. In this Perspective, we critically evaluate and argue that this is due to a dysregulated renin-angiotensin system (RAS). Previously, we have shown that loss of angiotensin-I converting enzyme 2 (ACE2) promotes the ACE/angiotensin-II (Ang-II)/angiotensin type 1 receptor (AT1R) axis, a deleterious arm of RAS, unleashing its detrimental effects in diabetes. As suggested by the recent reports regarding the pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), upon entry into the host, this virus binds to the extracellular domain of ACE2 in nasal, lung, and gut epithelial cells through its spike glycoprotein subunit S1. We put forth the hypothesis that during this process, reduced ACE2 could result in clinical deterioration in COVID-19 patients with diabetes via aggravating Ang-II–dependent pathways and partly driving not only lung but also bone marrow and gastrointestinal pathology. In addition to systemic RAS, the pathophysiological response of the local RAS within the intestinal epithelium involves mechanisms distinct from that of RAS in the lung; however, both lung and gut are impacted by diabetes-induced bone marrow dysfunction. Careful targeting of the systemic and tissue RAS may optimize clinical outcomes in subjects with diabetes infected with SARS-CoV-2.This study was supported by National Institutes of Health grants R01EY025383, R01EY012601, R01EY028858, and R01EY028037 to M.B.G. A.G.O. was supported in part by R01NS10241

Questionnaire study to gain an insight into the manufacturing and fitting process of artificial eyes in children: an ocularist perspective

Purpose To gain an insight into the manufacturing and fitting of artificial eyes in children and potential improvements to the process. Method An online qualitative survey was distributed to 39 ocularists/prosthetists in Europe and Canada. Participants were recruited through purposive sampling, specifically maximum variation sampling from the researcher’s contacts and an online search. Results The findings highlighted the current impression technique as being the most difficult yet most important part of the current process for both the ocularist and child patient. Negatively affecting obtaining a good impression, the child patients distress can be reduced by their parents by providing encouragement, reassurance, practicing the insertion and removal of the artificial eye and being matter of fact. Whilst improvements to the current process provided mixed views, the incorporation of current technology was perceived as not being able to meet the requirements to produce aesthetically pleasing artificial eyes. Conclusion The current artificial eye process can be seen as an interaction with its success being dependent on the child patient’s acceptance and adjustment which is dependent on the factors associated to the process. Investigation into the needs of the patient and whether technology can improve the process are the next steps in its advancement

What should a quantitative model of masking look like and why would we want it?

Quantitative models of backward masking appeared almost as soon as computing technology was available to simulate them; and continued interest in masking has lead to the development of new models. Despite this long history, the impact of the models on the field has been limited because they have fundamental shortcomings. This paper discusses these shortcomings and outlines what future quantitative models should look like. It also discusses several issues about modeling and how a model could be used by researchers to better explore masking and other aspects of cognition

The relationship between socioeconomic status and white matter microstructure in pre-reading children: A longitudinal investigation

Reading is a learned skill crucial for educational attainment. Children from families of lower socioeconomic status (SES) tend to have poorer reading performance and this gap widens across years of schooling. Reading relies on the orchestration of multiple neural systems integrated via specific white-matter pathways, but there is limited understanding about whether these pathways relate differentially to reading performance depending on SES background. Kindergarten white-matter FA and second-grade reading outcomes were investigated in an SES-diverse sample of 125 children. The three left-hemisphere white-matter tracts most associated with reading, and their right-hemisphere homologs, were examined: arcuate fasciculus (AF), superior longitudinal fasciculus (SLF), and inferior longitudinal fasciculus (ILF). There was a significant and positive association between SES and fractional anisotropy (FA) in the bilateral ILF in kindergarten. SES moderated the association between kindergarten ILF and second grade reading performance, such that it was positive in lower-SES children, but not significant in higher-SES children. These results have implications for understanding the role of the environment in the development of the neural pathways that support reading