AUTOANTIBODIES RELATED TO RHEUMATIC DISEASES AFTER COVID-19 INFECTION

BackgroundSARS-CoV-2(Severe acute respiratory syndrome coronavirus 2) has been circulating worldwide for three years. It mainly causes upper respiratory tract infection, which can manifest as pulmonary infection and even respiratory distress syndrome in severe cases. Different autoantibodies can be detected in patients infected with COVID-19.ObjectivesTo explore autoantibodies related to rheumatic diseases after COVID-19 infection.MethodsNinety-eight inpatients were tested for antinuclear antibodies (ANA), antibodies to extractable nuclear antigens(ENA), anti-neutrophil cytoplasmic antibodies（ANCA), anticardiolipin antibodies,a-β2GPI (IgG/IgM). They were from a tertiary hospital in Guangzhou during the COVID-19 epidemic. Data were described statistically.ResultsNinety-eight hospitalized patients were tested for relevant antibodies. The average age was 50.64±19.54;67 (68.4%) were male, 64 (65.3%) were COVID-19 positive, 90 (90.9%) had rheumatic diseases, and 56 of them were COVID-19 positive patients with rheumatic diseases.There were 76 patients tested for antinuclear antibodies;29 （38.16%）were negative, 18 （23.68%）had a 1/80 titre, and 29（28.16%） had a titre greater than 1:80. The 31 covid patients were positive for ANA. In the high-titer group, 19 patients with rheumatic diseases were positive for COVID-19, and 12 patients had an exacerbation of the rheumatic diseases (6 of whom had previously had pulmonary fibrosis). Of 31 covid patients, only two were non-rheumatic patients, and both were elderly, aged 85 and 100, respectively.Fifty-six patients had ENA results, and 29 for positive antibodies, 8 for ds-DNA antibodies, 2 for anti-Sm antibodies, 6 for anti-nucleosome antibodies, 12 for anti-U1RNP antibodies, 2 for anti-Scl-70 antibodies, 12 for anti-SS-A antibodies, 3 for anti-mitochondrial M2 antibodies, 2 for anti-centromere antibodies, 1 for anti-Po antibodies, and one for anti-Jo-1 antibody. All 56 patients had rheumatic diseases, and no new patients were found.There were 62 patients with ANCA data. P-ANCA was positive in 12 cases(19.35%), and MPO-ANCA was positive in 2 cases. An 85-year-old non-rheumatic COVID-19 patient was P-ANCA positive. She had a history of hypertension, colon cancer, CKD3, coronary heart disease, and atrial flutter.In the anticardiolipin antibodies group, there were 62 patients;only 6 were positive, and 2 were rheumatic patients infected with COVID-19. Antiphospholipid antibodies were detected in 33 patients, and a-β2GPI was tested in one patient, an 82-year-old COVID-19 patient with gout, diabetes, and cerebral infarction in the past. We did not find a statistical difference in the above results.ConclusionWe have not found a correlation between SARS-CoV-2 and serum autoantibodies of rheumatic immune diseases. It needs large samples and an extended follow-up to research.AcknowledgementsThis work was supported by Scientific and Technological Planning Project of Guangzhou City [202102020150], Guangdong Provincial Basic and Applied Basic Research Fund Project [2021A1515111172], National Natural Science Foundation of China Youth Fund [82201998] and Third Affiliated Hospital of Sun Yat-Sen University Cultivating Special Fund Project for National Natural Science Foundation of China [2022GZRPYQN01].Disclosure of Interestsone declared.

Monitoring and Early Warning of SMEs' Shutdown Risk under the Impact of Global Pandemic Shock

The COVID-19 outbreak devastated business operations and the world economy, especially for small and medium-sized enterprises (SMEs). With limited capital, poorer risk tolerance, and difficulty in withstanding prolonged crises, SMEs are more vulnerable to pandemics and face a higher risk of shutdown. This research sought to establish a model response to shutdown risk by investigating two questions: How do you measure SMEs' shutdown risk due to pandemics? How do SMEs reduce shutdown risk? To the best of our knowledge, existing studies only analyzed the impact of the pandemic on SMEs through statistical surveys and trivial recommendations. Particularly, there is no case study focusing on an elaboration of SMEs' shutdown risk. We developed a model to reduce cognitive uncertainty and differences in opinion among experts on COVID-19. The model was built by integrating the improved Dempster's rule of combination and a Bayesian network, where the former is based on the method of weight assignment and matrix analysis. The model was first applied to a representative SME with basic characteristics for survival analysis during the pandemic. The results show that this SME has a probability of 79% on a lower risk of shutdown, 15% on a medium risk of shutdown, and 6% of high risk of shutdown. SMEs solving the capital chain problem and changing external conditions such as market demand are more difficult during a pandemic. Based on the counterfactual elaboration of the inferred results, the probability of occurrence of each risk factor was obtained by simulating the interventions. The most likely causal chain analysis based on counterfactual elaboration revealed that it is simpler to solve employee health problems. For the SMEs in the study, this approach can reduce the probability of being at high risk of shutdown by 16%. The results of the model are consistent with those identified by the SME respondents, which validates the model.

Investigation of demographic implicit discrimination and disparate impact in chest radiography image-based AI for COVID-19 severity prediction

It is important to evaluate medical imaging artificial intelligence (AI) models for possible implicit discrimination (ability to distinguish between subgroups not related to the specific clinical task of the AI model) and disparate impact (difference in outcome rate between subgroups). We studied potential implicit discrimination and disparate impact of a published deep learning/AI model for the prediction of ICU admission for COVID-19 within 24 hours of imaging. The IRB-approved, HIPAA-compliant dataset contained 8,357 chest radiography exams from February 2020-January 2022 (12% ICU admission within 24 hours) and was separated by patient into training, validation, and test sets (64%, 16%, 20% split). The AI output was evaluated in two demographic categories: sex assigned at birth (subgroups male and female) and self-reported race (subgroups Black/African-American and White). We failed to show statistical evidence that the model could implicitly discriminate between members of subgroups categorized by race based on prediction scores (area under the receiver operating characteristic curve, AUC: median [95% confidence interval, CI]: 0.53 [0.48, 0.57]) but there was some marginal evidence of implicit discrimination between members of subgroups categorized by sex (AUC: 0.54 [0.51, 0.57]). No statistical evidence for disparate impact (DI) was observed between the race subgroups (i.e. the 95% CI of the ratio of the favorable outcome rate between two subgroups included one) for the example operating point of the maximized Youden index but some evidence of disparate impact to the male subgroup based on sex was observed. These results help develop evaluation of implicit discrimination and disparate impact of AI models in the context of decision thresholds © COPYRIGHT SPIE. Downloading of the is permitted for personal use only.

THE PREVALENCE AND INCIDENCE OF PSORIASIS AND PSORIATIC ARTHRITIS IN ENGLAND FROM 2009-2019: AN OBSERVATIONAL STUDY USING PRIMARY CARE DATA

BackgroundPsoriasis (PsO) and psoriatic arthritis (PsA) can greatly impact quality of life and result in substantial personal and societal costs. Complete and up to date data on the prevalence and incidence of these conditions and whether these change over time and vary by age is important for healthcare service planning so that specialist care and funding can be appropriately allocated.ObjectivesTo determine the prevalence and incidence of PsO and PsA in males and females from 2009-2019 across all age groups in England.MethodsWe used Clinical Practice Research Datalink AURUM, a primary care electronic health record database, including 20% of the English population. The codes used to identify patients with PsO and PsA were selected by rheumatologists and dermatologists and cross-checked with published code lists from other studies to ensure inclusion of all relevant codes. All included patients must have data for at least 1 year before their diagnosis. The annual incidence and point prevalence were calculated from 2009-2019 and stratified by age/sex. The study period ended in 2019 to avoid COVID-19 pandemic affecting results.ResultsThe prevalence of PsO and PsA in males and females increased annually, peaking in 2019 (PsO males 2.41% [95% confidence interval (CI) 2.40, 2.42];PsO females 2.60% [95% CI 2.59-2.61];PsA males 0.20% [95% CI 0.20-0.20];PsA females 0.21% [95% CI 0.21- 0.22]), as illustrated in Table 1. In 2019, the prevalence of PsO and PsA was highest in the over 65 years age group;PsO 4.25% [95% CI 4.22-4.28] and PsA 0.38% [95% CI 0.37-0.38]. The annual incidence (per 100,000 person years) of PsO has gradually decreased in males (from 168 (164-171) in 2009 to 148 (145-151) in 2019) but in females it has been stable with a slight annual decrease (from 180 (177-184) in 2009 to 173 (170-176) in 2019). The annual incidence for PsA has increased in both males and females (13 (12-14) in 2009 and 15 (14-16) in 2019 for males and 12 (11-13) in 2009 and 18 (17-19) in 2019 for females).ConclusionThe increasing prevalence of PsO and PsA highlights the importance of organising healthcare services to meet this need, particularly in the elderly population.ReferencesNIL.Table 1.Prevalence of PsO and PsA from 2009-2019 in EnglandYear20092010201120122013201420152016201720182019Population (n)1073383110910802110318501118036711343299112249341137842211657996119336261223432512420998PsO (n)216841229106239819250667259988268032276804286499295712304568311104PsO prevalence (%, 95%CI)-Male1.98 (1.96-1.99)2.06 (2.05- 2.07)2.13 (2.12-2.14)2.19 (2.18-2.20)2.24 (2.23- 2.25)2.33 (2.32- 2.34)2.37 (2.36- 2.38)2.39 (2.38- 2.40)2.40 (2.39- 2.41)2.40 (2.39- 2.42)2.41 (2.40- 2.42)-Female2.07 (2.05- 2.08)2.14 (2.13- 2.16)2.22 (2.21- 2.23)2.29 (2.28- 2.31)2.35 (2.33- 2.36)2.45 (2.43- 2.46)2.50 (2.49- 2.51)2.53 (2.52- 2.54)2.56 (2.54- 2.57)2.58 (2.56- 2.59)2.60 (2.59- 2.61)PsO incidence (100,000 person years)-Male168 (164-171)158 (155- 162)161 (158-165)153 (150-157)161 (157- 164)156 (153- 159)155 (152- 159)154 (151- 157)153 (150-156)150 (147-153)148 (145-151)-Female180 (177-184)176 (172-179)181 (177-184)171 (167-174)175 (171-178)176 (172-180)179 (176-183)178 (174-181)177 (174-181)174 (170-177)173 (170-176)PsA (n)1444515443164681752218545196182072021994232572451425683PsA prevalence (%, 95%CI)-Male0.14 (0.14- 0.14)0.15 (0.14- 0.15)0.15 (0.15- 0.16)0.16 (0.16- 0.16)0.17 (0.16- 0.17)0.18 (0.17- 0.18)0.18 (0.18- 0.19)0.19 (0.18- 0.19)0.19 (0.19- 0.20)0.20 (0.19- 0.20)0.20 (0.20- 0.20)-Female0.13 (0.13- 0.13)0.14 (0.13- 0.14)0.15 (0.14- 0.15)0.15 (0.15- 0.16)0.16 (0.16- 0.16)0.17 (0.17- 0.18)0.18 (0.18- 0.18)0.19 (0.19- 0.19)0.20 (0.19- 0.20)0.20 (0.20- 0.21)0.21 (0.21- 0.22)PsA incidence (100,000 person years)-Male13 (12- 14)12 (11- 13)13 (12- 14)12 (11- 13)13 (12-14)14 (13- 15)14 (13- 15)14 (13-15)1514-16)14(13- 15)15 (14-16)-Female12 (11- 13)13 (12- 14)13 (12- 14)14 (13-15)14 (13-15)15 (14-16)17 (16- 18)16 (15- 17)17 (16- 18)18 (17-19)18 (17-19)Acknowledgements:NIL.Disclosure of InterestsArani Vivekanantham: None declared, Edward Burn: None dec ared, Marta Pineda-Moncusí: None declared, Sara Khalid Grant/research support from: SK has received research grant funding from the UKRI and Alan Turing Institute outside this work. SK's research group has received grant support from Amgen and UCB Biopharma., Daniel Prieto-Alhambra Grant/research support from: DPA's department has received grant/s from Amgen, Chiesi-Taylor, Lilly, Janssen, Novartis, and UCB Biopharma. His research group has received consultancy fees from Astra Zeneca and UCB Biopharma. Amgen, Astellas, Janssen, Synapse Management Partners and UCB Biopharma have funded or supported training programmes organised by DPA's department., Laura Coates Speakers bureau: LC has been paid as a speaker for AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Medac, Novartis, Pfizer and UCB., Consultant of: LC has worked as a paid consultant for AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Galapagos, Janssen, Novartis, Pfizer and UCB., Grant/research support from: LC has received grants/research support from AbbVie, Amgen, Celgene, Eli Lilly, Novartis and Pfizer.

SAFETY OUTCOMES IN PATIENTS (PTS) WITH RHEUMATOID ARTHRITIS (RA) TREATED WITH FILGOTINIB (FIL) IN FILOSOPHY: INTERIM RESULTS FROM A PROSPECTIVE OBSERVATIONAL STUDY

BackgroundConsideration is needed when using Janus kinase (JAK) inhibitors to treat RA in pts aged ≥65 years or those with cardiovascular (CV) risk factors. The JAK1 preferential inhibitor FIL was generally well tolerated in clinical trials[1];safety has not been determined in a real-world setting.ObjectivesTo report baseline characteristics and up to 6-month safety data from the first 480 pts treated with FIL in the FILOSOPHY study (NCT04871919), and in two mutually exclusive subgroups based on age and CV risk.MethodsFILOSOPHY is an ongoing, phase 4, non-interventional, European study of pts with RA who have been prescribed FIL for the first time and in accordance with the product label in daily practice. Baseline characteristics and the incidence of select adverse events (AEs) are assessed in pts aged ≥65 years and/or with ≥1 CV risk factor (Table 1), and in those aged <65 years with no CV risk factors.ResultsAs of the end of June 2022, 480 pts had been treated: 441 received FIL 200 mg and 39 received FIL 100 mg. Of the 480 pts, 148 (30.8%) were aged ≥65 years;332 (69.2%) were aged <65 years. In total, 86 (17.9%) were former smokers, 81 (16.9%) were current smokers and 203 (42.3%) were non-smokers (data were missing for 110 pts [22.9%]). In addition to smoking, the most frequent CV risk factors included a history of hypertension (32.3%), a history of dyslipidemia (10.2%) and a family history of myocardial infarction (8.5%;Table 1).23 pts (4.8%) discontinued treatment due to AEs. Of the 354 pts aged ≥65 years or with ≥1 CV risk factor, infections affected 64 pts (18.1%), 34 (9.6%) had COVID-19, 2 (0.6%) had herpes zoster, and cardiac disorders (angina pectoris, atrial fibrillation, palpitations and tachycardia) affected 5 pts (1.4%);no cases of malignancies were observed. In the subgroup aged <65 years and with no CV risk factors (n=126), infections occurred in 18 pts (14.3%) (9 [7.1%] had COVID-19;3 [2.4%] had herpes zoster) and malignancies (myeloproliferative neoplasm) affected 1 pt (0.8%);no pts had cardiac disorders. There were no cases of deep vein thrombosis or pulmonary embolism in either subgroup.ConclusionIn this interim analysis of FILOSOPHY, no unexpected safety signals emerged at up to 6 months. Although infections and cardiac disorders affected a numerically greater proportion of pts aged ≥65 years or with ≥1 CV risk vs those aged <65 years with no CV risk, longer follow-up on a broader cohort is necessary to further characterize the safety of FIL in different groups of pts with RA.Reference[1]Winthrop K, et al. Ann Rheum Dis 2022;81:184–92Table 1.Baseline characteristics and CV risk factorsBaseline demographics/CV risk factorsAll FIL-treated pts (N=480)≥65 years or with ≥1 CV risk factor (n=354)<65 years and no CV risk factor (n=126)*Female sex, n (%)351 (73.1)252 (71.2)99 (78.6)Age, years, mean (SD)57.6 (11.5)60.4 (10.8)49.6 (9.6)Rheumatoid factor positive, n (%)†228 (47.5)167 (47.2)61 (48.4)Anti-citrullinated protein antibody positive, n (%)‡243 (50.6)176 (49.7)67 (53. 2)Body mass index, kg/m2, mean (SD)27.6 (5.7) n=43728.0 (5.4) n=33126.3 (6.4) n=106RA disease duration, years, mean (SD)10.4 (9.4) n=47810.5 (9.5) n=35310.0 (8.8) n=125Tender joint count 28, mean (SD)8.6 (6.9) n=4578.7 (7.1) n=3408.3 (6.3) n=117Swollen joint count 28, mean (SD)5.6 (5.2) n=4525.7 (5.4) n=3365.4 (4.4) n=116Former smoker, n (%)§86 (17.9)86 (24.3)0Current smoker, n (%)§81 (16.9)81 (22.9)0Non-smoker, n (%)§203 (42.3)130 (36.7)73 (57.9)Family history of myocardial infarction, n (%)41 (8.5)41 (11.6)0Medical history of: n (%) CV disease33 (6.9)33 (9.3)0 Diabetes35 (7.3)35 (9.9)0 Dyslipidemia49 (10.2)49 (13.8)0 Hypertension155 (32.3)155 (43.8)0 Ischemic CNS  vascular disorders11 (2.3)11 (3.1)0 Peripheral vascular disease17 (3.5)17 (4.8)0*Includes 53 pts with missing smoking status data who were aged <65 years with no other CV risk factors.†Missing/unknown in 154 pts;‡Missing in 153 pts;§Smoking status data missing in 110 pts (22.9%).AcknowledgementsWe thank the physicia s and patients who participated in this study. The study was funded by Galapagos NV, Mechelen, Belgium. Publication coordination was provided by Fabien Debailleul, PhD, of Galapagos NV. Medical writing support was provided by Debbie Sherwood, BSc, CMPP (Aspire Scientific, Bollington, UK), and funded by Galapagos NV.Disclosure of InterestsPatrick Verschueren Speakers bureau: AbbVie, Eli Lilly, Galapagos, Roularta, Consultant of: Celltrion, Eli Lilly, Galapagos, Gilead, Nordic Pharma, Sidekick Health, Grant/research support from: Galapagos, Pfizer, Jérôme Avouac Speakers bureau: AbbVie, AstraZeneca, BMS, Eli Lilly, Galapagos, MSD, Novartis, Pfizer, Sandoz, Sanofi, Consultant of: AbbVie, Fresenius Kabi, Galapagos, Sanofi, Grant/research support from: BMS, Fresenius Kabi, Novartis, Pfizer, Karen Bevers Grant/research support from: Galapagos, Susana Romero-Yuste Speakers bureau: AbbVie, Biogen, BMS, Lilly, Pfizer, Consultant of: Sanofi, Lilly, Grant/research support from: Lilly, MSD, Roberto Caporali Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Sandoz, UCB, Consultant of: AbbVie, Amgen, BMS, Celltrion, Eli Lilly, Fresenius Kabi, Galapagos, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Thomas Debray Consultant of: Biogen, Galapagos, Gilead, Francesco De Leonardis Employee of: Galapagos, James Galloway Speakers bureau: AbbVie, Biogen, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Roche, UCB, Consultant of: AbbVie, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Grant/research support from: AstraZeneca, Celgene, Gilead, Janssen, Medicago, Novavax, Pfizer, Monia Zignani Shareholder of: Galapagos, Employee of: Galapagos, Gerd Rüdiger Burmester Speakers bureau: AbbVie, Amgen, BMS, Chugai, Galapagos, Lilly, Pfizer, Sanofi, Consultant of: AbbVie, Amgen, BMS, Galapagos, Lilly, Pfizer, Sanofi.

AI and ICU Monitoring on the Wake of the COVID-19 Pandemic

The Intensive Care Unit (ICU) is a paradigmatic example of the potential reach of data-centred knowledge discovery. This is because the contemporary ICU heavily depends on medical devices for patient monitoring through electronic data acquisition. This poses a unique opportunity for multivariate data analysis to support evidence-based medicine (EBM), particularly in the form of Artificial Intelligence (AI) approaches. The COVID-19 pandemic has tested the limits of critical care management, often overwhelming ICUs. In this brief chapter, we sketch the role of AI, especially in the form of Machine Learning (ML), at the ICU and discuss what can it offer to address COVID-19 disruption in this environment. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Telehealth and its impact on the management of type 2 diabetes

The recent Covid-19 pandemic has created many challenges and barriers in healthcare, which includes the treatment and management of patients with type 2 diabetes (Robson & Hosseinzadeh, 2021). The purpose of this Evidence-Based Project (EBP) project is to evaluate the effectiveness of type 2 diabetes management through telehealth and answers the following PICOT question: In patients with diabetes type 2 who have difficulties with medical visit compliance (P), will the telehealth platform (I), compared to patient's previous visit HbA1c (C) improve the Hemoglobin A1c (HbA1c) diagnostic marker (O) over a 12-week period(T)? An extensive literature search of five databases was performed, citation chasing, and a hand search yielded fourteen pieces of evidence ranging from level I to VI (Melnyk & Fineout-Overholt, 2019). The pieces of evidence selected for this project support the evidence that telehealth implementation is as effective as the "usual care" or in-person visits to treat type 2 diabetes. The John Hopkins Nursing Evidence-Based Practice (JHNEBP) model was selected. Patients with a HbA1c of greater than 6.7% have been asked to schedule two six-week telehealth visits. During the live video visit, a review of medications, and diabetes self-management education (DSME) will be conducted. Participants will be provided with education to promote lifestyle modifications. The visits will be conducted through an Electronic Medical Record (EMR) system that is Health Insurance Portability and Accountability Act (HIPAA) compliant. A paired t-Test will be used with the data collected from the pre-and post-HbA1c. Improve the management of type 2 diabetes with the incorporation of telemedicine in primary care. Research supports the need to further expand the use of telehealth in primary care, to improve patient outcomes and decrease co-morbidities related to type 2 diabetes.

Distributed records in the Rohingya refugee diaspora: Arweave and the R-Archive

Purpose: This article delineates the pilot implementation of the Rohingya Archive (R-Archive). The R-Archive seeks to both confront and exploit the roles of documentation and recordkeeping in forced displacement of Rohingya people through targeted physical and bureaucratic violence in Myanmar. This grassroots activist intervention is located at the intersection of technology, rights, records, jurisdictions and economics. Using Arweave's blockweave, the R-Archive secures copies of records, such as identity documentation, land deeds and personal papers, carried into diaspora by Rohingya refugees against unauthorised alteration, deletion and loss, providing a trust infrastructure for accumulating available evidence in support of rights claims and cultural preservation. Design/methodology/approach: Iterative development of functional requirements, data collection processes and identification of a technological solution for the community-based, post-custodial, blockchain-inspired R-Archive;design and testing of the R-Archive pilot;and analysis of trust and economic concerns arising. Findings: A complex set of interconnecting considerations is raised by this use of emerging technologies in service to a vulnerable and diasporic community. Hostile governments and volatile cryptocurrencies are both threats to the distributed post-custodial R-Archive. However, the strength of the community bonds that form the archive and articulated in its records speak to the possibility of perdurance for a global Rohingya archive, and working through the challenges surfaced by its development offers the possibility to serve as a model that might be adaptable for other grassroots archival activist projects initiated by oppressed, marginalised and diasporic communities. Research limitations/implications: Personal and community safety and accessibility concerns, especially in refugee camps and under Covid-19 restrictions, presented particular challenges to carrying out the research and development that are addressed in the research design and future research plans. Practical implications: The goal of this pilot was to collect and store examples of a range of documents that demonstrate different aspects of Rohingya culture and links to the homeland as well as those that record formal evidentiary relationships between members of the Rohingya community now in diaspora and the Burmese state (e.g. acknowledgements of citizenship). The pilot was intended to demonstrate the viability of using a blockchain-inspired decentralised archival system combined with a community-driven approach to data collection and then to evaluate the results for potential to scale. Social implications: The R-Archive is a community-centred and driven effort to identify and preserve, under as secure and trusted conditions as possible, digital copies of documents that are of juridical, cultural and personal value to the Rohingya people and also of significance as primary documentary evidence that might be used by international legal institutions in investigating genocide taking place in Burma and by academic researchers studying the history of Burma. Originality/value: The R-Archive is novel in terms of its technological application (Arweave), the economic concerns of a vulnerable stateless population it is trying to address, and its functional complexity, in that its goal is simultaneously to serve both legal evidentiary and community archive functions. The R-Archive is also an important addition to other notable efforts in the diasporic Rohingya community that have attempted to employ the tools of technology for cultural preservation. [ FROM AUTHOR] Copyright of Journal of Documentation is the property of Emerald Publishing Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Cutting through the noise during crisis by enhancing the relevance of research to policymakers

Background:It is widely recognised that policymakers use research deemed relevant, yet little is understood about ways to enhance perceived relevance of research evidence. Observing policymakers' access of research online provides a pragmatic way to investigate predictors of relevance.Aims and objectives:This study investigates a range of relevance indicators including committee assignments, public statements, issue prevalence, or the policymaker's name or district.Methods:In a series of four rapid-cycle randomised control trials (RCTs), the present work systematically explores science communication strategies by studying indicators of perceived relevance. State legislators, state staffers, and federal staffers were emailed fact sheets on issues of COVID (Trial 1, N = 3403), exploitation (Trial 2, N = 6846), police violence (Trial 3, N = 3488), and domestic violence (Trial 4, N = 3888).Findings:Across these trials, personalising the subject line to the legislator's name or district and targeting recipients based on committee assignment consistently improved engagement. Mentions of subject matter in public statements was inconsistently associated, and state-level prevalence of the issue was largely not associated with email engagement behaviour.Discussion and conclusions:Together, these results indicate a benefit of targeting legislators based on committee assignments and of personalising the subject line with legislator information. This work further operationalises practical indicators of personal relevance and demonstrates a novel method of how to test science communication strategies among policymakers. Building enduring capacity for testing science communication will improve tactics to cut through the noise during times of political crisis.

Working capital and firm performance: role of COVID-19 disruption

PurposeThis study examines the performance effect of working capital for a large sample of Indian manufacturing firms in light of supply chain disruption, i.e. the COVID-19 pandemic.Design/methodology/approachThis study is based on secondary data collected from the Prowess database on Indian manufacturing firms listed on the Bombay Stock Exchange (BSE) 500. Panel data regression analyses are used to estimate all models. Moreover, this study has employed robust standard errors to consider for heteroscedasticity concerns.FindingsThe results challenge the current notion of working capital investment and reveal that higher working capital has a positive and significant impact on firm performance. Further, it highlights that Indian manufacturing firms suffered financially post-COVID-19 as they significantly lack the working capital to run day-to-day operations.Originality/valueThis research contributes to the scant literature by examining the association between working capital financing and firm performance in light of the COVID-19 pandemic, representing typical developing economies like India.

Introduction to Climate Change Mitigation and Adaptation

Since the first edition of the handbook, important new research findings on climate change have been gathered. The evidence has further solidified, and the effects have become more visible. Both mitigation and adaptation of climate change are more important than ever before. The handbook in its presently third edition was completely updated and extended in coverage. Climate change is a fact, and aspects of "doing business in climate change” were included alongside scientific evidence on climate change, mitigation technologies – both established and novel – and adaptation measures to provide maximum benefit to its readers. The impacts of climate change have made it into our daily lives. All human beings, in turn, can contribute to the mitigation and adaptation of climate change. Consequently, these topics are discussed in schools, in private settings, in research, and in the business world. We can see solid implications of climate change. The 2020 COVID-19 crisis has paralyzed the entire world almost instantly. Climate change is slower and subtler, but even more severe in its potential and factual consequences, where no "fix” like a vaccination exists to return to the previous state. This handbook is more necessary than ever before. Over the last several million years, there have been warmer and colder periods on Earth, and the climate fluctuates for a variety of natural reasons, as data from tree rings, pollen, and ice core samples have shown. However, human activities on Earth have reached an extent that they impact the globe in potentially catastrophic ways, in terms of magnitude and irreversibility. Mitigation and adaptation are the two principal routes of our responses to climate change, and they, in fact, can be best achieved collectively by world citizens, scientists and nonscientists, in our daily lives. This chapter is an introduction to climate change and the handbook in its third edition. Current state of the arts of climate change mitigation and adaptation approaches are discussed. © Springer Nature Switzerland AG 2022. All rights are reserved.

The spatial concentration, stability, and specialization of mental health calls for service: Evidence in support of proactive, place-based interventions

For many decades the police have been the de facto responders to persons with perceived mental illness (PwPMI). However, having the police in this role has come with negative repercussions for PwPMI, such as disproportionately experiencing criminalization and use of force. In recognizing these issues, the police-and more recently, the community-have developed responses that either seek to improve interactions between the police and PwPMI or remove the police from this role altogether. However, in either case, these efforts are reactivein nature, responding to crises that arguably could have been prevented had a timelier intervention taken place. Further, evidence on certain police responses to PwPMI, such as Crisis Intervention Teams (CIT) and co-response teams, suggests that they endure deployment-related challenges, thus limiting their reach to PwPMI.Drawing from the Criminology of Place and existing place-based policing strategies, the present dissertation argues that efforts focused on respondingto PwPMI should instead be proactively deployed, targeting areas where interactions between police and PwPMI concentrate spatially. Doing so would not only result in efficient deployment of scarce resources but would permit police- and community-based efforts to have a greater reach to PwPMI and thus prevent future interactions with police. To-date, however, there have been few empirical and theoretical investigations into the spatial patterns of PwPMI calls for service that could inform such proactive, place-based efforts. Specifically, we do not currently understand: (1) the degree to which PwPMI calls for service concentrate within certain geographical contexts (such as a small city);(2) whether the degree of PwPMI call concentration and the location of these calls remain stable over time;and (3) what theoretical frameworks explain why PwPMI calls for service occur where they do. Drawing on seven years (2014-2020) of calls for service data from the Barrie Police Service and data from the 2016 Canadian Census, the present dissertation employs various methods of spatial analysis to fills these specific knowledge gaps.Although the theoretical investigation confirmed the findings of previous work that found no association between social disorganization theory and the spatial patterns of PwPMI calls for service, the present dissertation revealed: (1) PwPMI calls for service are highly concentrated within the context of a small city, even more so than what has previously been uncovered in larger jurisdictions;(2) the degree of PwPMI call concentration is stable over time, falling within a narrow proportional bandwidth of spatial units;and (3) PwPMI calls for service, and their concentrations, occur in the same places over time-even during the COVID-19 pandemic-and are thus spatially stable. As such, though more scholarship is needed on theories that might help explain why PwPMI calls occur where they do, the findings of the present dissertation strongly support the proactive, place-based deployment of resources to PwPMI. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID-19 IN PATIENTS WITH RHEUMATIC IMMUNE-MEDIATED INFLAMMATORY DISEASES IN AMERICA: DIFFERENCES AND SIMILARITIES BETWEEN MEXICO AND ARGENTINA

BackgroundPatients with immune-mediated rheumatic diseases (IRD) have poorer outcomes of SARS-CoV-2 infection compared to the general population.ObjectivesTo assess and compare clinical course, severity and complications of SARS-CoV-2 infection in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) from Mexico and Argentina.MethodsData from both national registries, CMR-COVID (Mexico) and SAR-COVID (Argentina), were combined. Briefly, adult IRD patients with SARS-CoV-2 infection were recruited between 08.2020 and 09.2022 in SAR-COVID and between 04.2020 and 06.2022 in CMR-COVID. Sociodemographic data, comorbidities, and DMARDs were recorded, as well as clinical characteristics, complications, and treatment for SARS-CoV-2 infection. Descriptive analysis. Chi square, Fisher, Student T, Mann Whitney U tests and multiple logistic regression analyses were performed.ResultsA total of 3709 patients were included, 1167 (31.5%) from the CMR-COVID registry and 2542 (68.5%) from the SAR-COVID registry. The majority (82.3%) were women, with a mean age of 50.4 years (SD 14.4). The most frequent IRD were rheumatoid arthritis (47.5%) and systemic lupus erythematosus (18.9%). Mexican patients were significantly older, had a higher female predominance and had higher prevalence of rheumatoid arthritis, antiphospholipid syndrome, and axial spondyloarthritis, while the Argentine patients had more frequently psoriatic arthritis and ANCA-associated vasculitis. In both cohorts, approximately 80% were in remission or low disease activity at the time of infection. Mexicans took glucocorticoids (43% vs 37%, p<0.001) and rituximab (6% vs 3%, p<0.001) more frequently. They also reported more comorbidities (48% vs 43%, p=0.012).More than 90% of patients presented symptoms related to SARS-CoV-2 infection. The frequency of hospitalization was comparable between the groups (23.4%), however, the Mexicans had more severe disease (Figure 1) and a higher mortality rate (9.4% vs 4.0%, p<0.0001). After adjusting for risk factors, Mexicans were more likely to die due to COVID-19 (OR 2.2, 95%CI 1.5-3.1).ConclusionIn this cohort of patients with IRD from Mexico and Argentina with SARS-CoV-2 infection, the majority presented symptoms, a quarter were hospitalized and 6% died due to COVID-19. Mexicans presented more severe disease, and after considering risk factors they were two times more likely to die.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsCarolina Ayelen Isnardi Grant/research support from: SAR-COVID is a multi- sponsor registry, where Pfizer, Abbvie, and Elea Phoenix provided unrestricted grants. None of them participated or infuenced the development of the project, data collection, analysis, interpretation, or writing the report. They do not have access to the information collected in the database, Deshire Alpizar-Rodriguez: None declared, Marco Ulises Martínez-Martínez: None declared, Rosana Quintana: None declared, Ingrid Eleonora Petkovic: None declared, Sofia Ornella: None declared, Vanessa Viviana Castro Coello: None declared, Edson Velozo: None declared, David Zelaya: None declared, María Severina: None declared, Adriana Karina Cogo: None declared, Romina Nieto: None declared, Dora Aida Pereira: None declared, Iris Jazmin Colunga-Pedraza: None declared, Fedra Irazoque-Palazuelos: None declared, GRETA CRISTINA REYES CORDERO: None declared, Tatiana Sofía Rodriguez-Reyne: None declared, JOSE ANTONIO VELOZ ARANDA: None declared, Cassandra Michele Skinner Taylor: None declared, INGRID MARIBEL JUAREZ MORA: None declared, Beatriz Elena Zazueta Montiel: None declared, Atzintli Martínez: None declared, Cesar Francisco Pacheco Tena: None declared, Guillermo Pons-Estel: None declared.

The role of 'non-knowledge' in crisis policymaking: a proposal and agenda for future research

Background: Recent complex and cross-boundary policy problems, such as climate change, pandemics, and financial crises, have recentred debates about state capacity, democratic discontent and the 'crisis of expertise'. These problems are contested and open to redefinition, misunderstanding, spin, and deception, challenging the ability of policymakers to locate, discriminate, comprehend, and respond to competing sources of knowledge and expertise. We argue that 'non-knowledge' is an under-explored aspect of responses to major policy crises. Key points: While discussed in recent work in sociology and other social sciences, non-knowledge has been given less explicit attention in policy studies, and is not fully captured by orthodox understandings of knowledge and evidence use. We outline three main forms of non-knowledge that challenge public agencies: amnesia, ignorance and misinformation. In each case, 'non-knowledge' is not simply the absence of policy-relevant knowledge. Amnesia refers to what is forgotten, reinvented or 'unlearned', while claims of ignorance involve obscuring or casting aside of relevant knowledge that could (or even should) be available. To be misinformed is to actively believe false or misleading information. In each instance, non-knowledge may have strategic value for policy actors or aid the pursuit of self-interest. Conclusions and implications: We demonstrate the relevance of non-knowledge through a brief case study, emerging from the inquiry into the COVID-19 hotel quarantine programme in the Australian state of Victoria. We argue that both amnesia and 'practical' forms of ignorance contributed to failures during the early part of the programme. © Policy Press 2023.

Economic Policy Uncertainty and Emerging Stock Market Volatility

This research examines the effect of economic policy uncertainty (EPU) indices on Pakistan's stock market volatility. Particularly, we examine the impact of the economic policy uncertainty index for Pakistan and bilateral global trading partner countries, the US, China, and the UK. We employ the GARCH-MIDAS model and combination forecast approach to evaluate the performance of economic uncertainty indices. The empirical findings show that the US economic policy uncertainty index is a more powerful predictor of Pakistan stock market volatility. In addition, the EPU index for the UK also provides valuable information for equity market volatility prediction. Surprisingly, Pakistan and China EPU indices have no significant predictive information for volatility forecasting during the sample period. Lastly, we find evidence of all uncertainty indices during economic upheaval from the COVID-19 pandemic. We obtained identical results even during the Covid-19. Our findings are robust in various evaluation methods, like MCS tests and other forecasting windows.

A Systematic Review Identifying Adverse Health Outcomes and Mortality Rates Associated with Telehealth

Background: The literature supporting telehealth management is growing accelerated by the COVID-pandemic. We hypothesize that there are risks of adverse events associated with telehealth interventions. Methods: A review of PubMed (including MEDLINE), Embase, ISI (Web of Science), VHL/GHL, Scopus, Science Direct, and PsycINFO was conducted for all adverse events associated with telehealth from January 1, 1960 to March 1, 2021. This systematic review and meta-analyses were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Of 5,144 citations 78 published studies met criteria for quality evaluation and underwent full text ion including the qualitative synthesis. Of the 78 included studies 8 were included in the quantitative synthesis resulting in 2 meta-analyses. The results of the meta-analysis suggest that monitoring patients using telehealth techniques is associated with 40% lower mortality risks among patients suffering from heart failure, compared to those who received traditional care. The results of the random-effects meta-analysis showed the pooled relative risk of mortality to be 0.60, indicating that patients that underwent telemonitoring had a lower mortality risk compared with the patients that underwent usual care. Among patients with heart implants, patients who received telemonitoring had a 35% lower mortality risk compared to patients receiving traditional care. Conclusions: While RCTs of telehealth interventions demonstrate enhanced patient outcomes in a number of studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggest an important need for more complementary studies with consistent outcome assessments.

Envisioning innovative post-COVID approaches toward LTCF design in dense urban areas: Exploring an evidence-based design prototype

The COVID-19 (coronavirus disease 2019) pandemic has posed greater challenges to older adults, especially those who live in congregated long-term care facilities (LTCFs) in dense urban settings. These facilities struggle with high rates of COVID-19 infections and other challenges that undermine LTCF residents' well-being. These challenges, including social isolation and limited access to nature and community, have been exacerbated by the pressures of the pandemic. This has led to feelings of loneliness, depression, and other mental health issues among residents and a higher risk of psychological stress and infection among nurses. The pandemic has challenged the existing built environment of LTCFs. Issues regarding physical and mental health, quality of life (QoL), infection control, and pandemic resiliency have been shown to be increasingly interwoven. This chapter envisions innovative approaches toward a post-COVID-19 environment for older adults and their caregivers. This chapter provides an extensive review and synthesis of the lessons learned from LTCFs during the pandemic, with a focus on how their experience was impacted by design. The authors also draw from current design trends to identify their potential to support residents', staff, and visitors' needs during and after pandemics. From these learnings, the following design principles were developed: (1) small household model, (2) biophilic design, (3) intergenerational community, and (4) multi-tier infection control strategies. These design principles were then translated to a prototype through a graduate capstone studio project, which provides a visual illustration of how these evidence-based design solutions can be applied within a dense urban environment. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

HIGH DOSE INTRAVENOUS ANAKINRA TREATMENT IS SAFE AND EFFECTIVE IN SEVERE AND CRITICAL COVID-19 PATIENTS: A PROPENSITY SCORE MATCHED STUDY IN A SINGLE CENTER

BackgroundIn COVID-19 severe disease course such as need of intensive care unit (ICU) as well as development of mortality is mainly due to cytokine storm.ObjectivesIn this study, we aimed to evaluate the high dose intravenous anakinra treatment response and outcome in patients with severe and critical COVID-19 compared to standard of care.MethodsThis retrospective observational study was carried out at a tertiary referral center. The study population consisted of two groups as follows;the patients receiving high dose intravenous anakinra (anakinra group) between 01.09.2021 and 01.02.2022 and the patients treated with standard of care (SoC, control group) as historical control group who were hospitalized between 01.07.2021 and 01.09.2021.ResultsAfter the propensity score 1:1 matching 79 patients in anakinra and 79 patients in SoC matched and included into the analysis. Mean±SD patient age was 67.4±16.7 and 67.1±16.3 years in anakinra and SoC group, respectively (p=0.9). Male gender was 38 (48.7 %) in anakinra and 36 (46.2 %) SoC (p=0.8). Overall, ICU admission was in 14.1 % (n=11) and 30.8 % (n=24) (p=0.013;OR: 6.2), intubation in 12.8 % (n=10) and 16.7 % (n=13) patients (p=0.5), 14.1 % (n=11) and 32.1 % (n=25) patients died in anakinra and control group, respectively (p=0.008;OR: 7.1)ConclusionIn our study mortality was lower in patients receiving anakinra compared to SoC. Intravenous high dose anakinra is safe and effective treatment in patients with severe and critical COVID-19.Table 1.Baseline clinical and laboratory features of patients receiving standard of care (SoC) and Anakinra before and after propensity score (PS) matchingBefore PS matchingAfter PS matchingVariablesAnakinra (n=148)SoC (n=114)p value (OR)Anakinra (n=78)SoC (n=78)p value (OR)Age (years) (mean±SD)66.8±1763.1±170.0967.4±16.767.1±16.30.9Gender, male (n, %)78 (52.7)45 (39.5)0.033 (4.5)38 (48.7)36 (46.2)0.8Duration of hospitalization (days) (median, IQR)11 (12)9 (7.3)0.027.5 (9)11 (8)0.01Comorbidities (n, %) Diabetes mellitus41/146 (28.1)39 (34.2)0.318 (23)31 (39.7)0.025 (5) Hypertension84/143 (58.7)64 (56)0.730 (61.5)50 (64)0.7 Coronary heart disease27/143 (19)24 (21)0.718 (23)20 (25.6)0.7 Heart failure18/143 (12.6)23 (20)0.114 (18)20 (25.6)0.24 Chronic renal failure31 (21)6 (5.3)<0.001 (13.06)15 (19)6 (7.7)0.035 (4.5) Chronic obstructive lung disease23/144 (16)19 (16.7)0.914 (18)15 (19)0.8 Dementia15/117 (12.8)2 (1.8)0.001 (10.4)3/61 (5)2 (2.6)0.5 Malignancy16/146 (11)8 (7)0.39 (11.5)6 (7.7)0.4 Immunosuppressive usage18/146 (12.3)2 (1.8)0.001 (10.08)5 (6.5)2 (2.6)0.2Disease severity (n, %) NIH score 3 (severe)57 (38.5)68 (59.6)0.001 (11.5)48 (61.5)44 (56.4)0.5 NIH score 4 (critical)91 (61.5)46 (40.4)30 (38.5)34 (43.6) mcHIS score (mean±SD)3.4±1.22.64±1.5<0.0012.9±13.1±1.30.2PS: Propensity score, SoC: Standard of care, OR: Odds ratio, SD: Standard deviation, IQR: Interquartile range, mcHIS: Modified Covid hyperinflammatory syndrome score, NIH: National Institute Health, ALT: Alanin aminotransferase, AST: Aspartate aminotransferaseTable 2.Outcomes of patients receiving SoC and Anakinra before and after PS matchingBefore PS matchingAfter PS matchingVariables (n, %)Anakinra (n=148)SoC (n=114)p value (OR)Anakinra (n=78)SoC (n=78)p value (OR)Pneumothorax3/134 (2.2)00.25*2/73 (2.7)00.5*Myocardial infarction3/132 (2.3)6 (5.3)0.32/72 (2.8)2/56 (3.6)1Pulmonary embolism4/134 (3)11 (9.6)0.034 (4.8)*3/73 (4.1)7 (9)0.3*Intensive care unit60 (40.5)25 (22)0.001 (10.2)11 (14.1)24 (30.8)0.013 (6.2)Intubation54 (36.5)13 (11.4)<0.001 (21.3)10 (12.8)13 (16.7)0.5Mortality56 (37.8)27 (23.7)0.015 (5.96)11 (14.1)25 (32.1)0.008 (7.1)PS: Propensity score, SoC: Standard of care, OR: Odds ratioREFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Artificial intelligence and machine learning in clinical trial design and application

In 2020, COVID-19 changed how health care was approached both in the United States and globally. In the early phases, the vast majority of energy and attention was devoted to containing the pandemic and treating the infected. Toward the end of 2020, that attention expanded to vaccinating people across the globe. What was not being considered at the time were challenges to future health and clinical trials that power new treatments for COVID-19 and non-COVID-19 treatments. © 2023 Elsevier Inc. All rights reserved.

Remote and digitally delivered mental health support for care-experienced young people: Some practice-based reflections in response to cummings (2023)

In a recent contribution to this journal, Cummings (2023) reports findings from a preliminary qualitative study of practitioner viewpoints regarding digitally delivered mental health support to care-experienced young people. Cummings' study highlights the need to engage with professional experiences of using digital methods with this group, both during and outside of the COVID-19 pandemic. A response to - and commentary on - Cummings' contribution is provided, to advance discussion of issues identified by the research. We reflect on our experience as practitioners and researchers working in and alongside specialist child and adolescent mental health service teams serving care-experienced children and young people. We focus on workspaces in remote working, therapeutic technique in online and telephone-based care, and virtues and challenges of remote care delivery. (PsycInfo Database Record (c) 2023 APA, all rights reserved)