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Temporal trends in vascular medication use in 8079 patients with systemic sclerosis: insights to inform future trials and therapeutic strategies from the EUSTAR cohort
No full textObjectives
Systemic sclerosis (SSc) is characterized by widespread vascular damage resulting in digital and systemic vasculopathic sequelae. Although there are effective treatments available, vascular disease remains a significant cause of morbidity and mortality in SSc. Our aim was to describe patterns of vascular medication use in SSc, including examination for potential changes over time.
Methods
A cross-sectional study of SSc patients enrolled in the EUSTAR database meeting 2013 ACR/EULAR SSc criteria. Patients were divided into two time periods: 2012–2017 and 2018–2022. We analysed the prescription patterns of endothelin receptor antagonists (ERA), phosphodiesterase type-5 inhibitors (PDE5i), calcium channel blockers (CCB), intravenous iloprost, and antiplatelet therapies. Logistic regression was used to evaluate temporal trends and interaction effects.
Results
A total of 8079 patients were included. Significant increases over time were observed in the use of ERA (7% to 12%, P < 0.001), PDE5i (5.4% to 7.2%, P = 0.064), CCB (20% to 32%, P < 0.001) and anti-platelet therapies (15% to 20%, P < 0.001). There was a notable decrease in iloprost use (3.1% to 0.3%, P < 0.001). The prevalence of active digital ulcers (DU) decreased (16% to 13%, P = 0.040), while a history of DU (24% to 30%, P < 0.001) increased. Year-by-year and non-linear increases were noted for ERA and CCB whereas non-linear increase was observed for PDE5i. Year-by-year and non-linear decrease was observed for Iloprost prescription.
Conclusion
A significant change has occurred over time in vascular medication use in SSc patients, with increased utilization of ERA, PDE5i, CCB and anti-platelet therapies suggesting the adoption of more proactive and/or preventive treatment strategies
OP0081 Anti-Ro/SSA+/RF+ double seropositivity in systemic sclerosis is associated with more severe interstitial lung disease: A study from the EUSTAR database
No full textBetween Ship and Library:Global Knowledge and Spaces of Exchange at the Middle Temple, 1586–1636
No full textDisruptions as catalysts to sustainability? Long-term responses in bike-sharing demand to disruptions during the pandemic
Get PDFUnderstanding the implications of large-scale, prolonged disruptions on travel demand is important for informing the future design of resilient, efficient, and sustainable transport systems. Major disruptions during the COVID-19 pandemic provide an opportunity to shed light on this issue. While contemporaneous responses in such demand amidst these disruptions have been well documented, insights into long-term post-disruption responses remain limited. This research gap challenges the development of a transport policy agenda capable of adapting to and mitigating the enduring consequences of disruptions. This research contributes to this topic by scrutinising long-term responses in bike-sharing demand to major disruptions during the pandemic. It investigates (1) the characteristics of these long-term responses; (2) the discrepancies between the long-term and contemporaneous responses to these disruptions; and (3) the associations of the long-term responses with docking stations’ contextual characteristics. We use 57-month bike-sharing demand data from London, spanning the pre-, amidst-, and post-disruption phases. Utilising pre-disruption data as a baseline and data in subsequent phases as comparisons, we apply Bayesian time-series models for counterfactual analysis to assess bike-sharing demand’s responses.
We find that major disruptions during the pandemic contribute, in the long term, to a more than 20% rise in bike-sharing demand in the post-disruption phase, compared to a counterfactual scenario absent such disruptions. The increase in off-peak hour demand is greater than in peak hour demand. Demand for short- and medium-duration trips increases, whilst that for long-duration trips decreases slightly. However, despite the overall increase in demand post-disruption, the magnitude of this increase flattens over time. Moreover, bike-sharing demand’s long-term responses surpass its contemporaneous responses. Finally, docking stations located in areas with a more diverse land-use mix, higher intersection density, better accessibility to public transport, and a lower percentage of minority population show a larger long-term response in demand. Our findings remain robust while accounting for the confounding impacts of COVID-19 cases post-disruption and the implementation of active travel interventions during the pandemic. We suggest that prolonged disruptions like those during the pandemic may have functioned as catalysts for the uptake of sustainable transport, such as bike-sharing. Yet, our evidence of a diminishing long-term response over time underscores a need for persistent, proactive actions to support sustainable transport after disruptions subside, if the positive response is to be sustained
Conceptualizing supply- and demand-side climate change mitigation: A typology and new research directions
Get PDFTuning Into Affect and Appetite in Caregivers, and Its Association With Recognising and Responding to Infant Appetite Cues
Get PDFPositive mealtime interactions shape infant eating patterns potentially promoting appetite regulation. This study investigated whether caregivers who “tune-in” to their own internal affect and appetite cues, can also recognise and respond to their infant's appetite cues via responsive feeding (RF). Caregivers (N = 445; mean age: 33.5 ± 4.7 years) with children aged 5–28 m participated in an online survey in August 2023. Caregivers' RF practices, mealtime emotions, eating traits, alexithymia (impaired capacity to identify and express emotions) and their infant's eating traits were administered using validated questionnaires. Recent mealtime experiences were described through an open-ended question. Caregivers who relied on interoceptive cues in eating scored high on recognising infant appetite cues (R² = 0.11, F(1, 396) = 5.40, p < 0.001). Whereas caregivers with alexithymia reported poorer ability to recognise infant appetite cues (R² = 0.12, F(7, 399) = 7.53, p < 0.001) and less positive mealtime emotions (R² = 0.12, F(7, 399) = 7.49, p < 0.001) compared to those without alexithymia. Caregivers' capacity to “tune-in” to their own internal satiation cues inversely mediated the relationship between caregivers' alexithymia and their recognition of infant mealtime appetite cues. Infant eating traits (Food Responsiveness and Satiety Responsiveness) were associated with parental use of food to calm. Overall, RF was associated with mealtime emotions, parental ability to “tune-in” to their own affect (alexithymia) and appetite, and child's appetitive traits. Developing caregiver's awareness and responsiveness to their own and their child's affect and appetite cues may promote RF practices
Bridging the gap: exploring the impact of bootcamp on non-technical skills and professional development in early-career orthopaedic trainees
Get PDFBackground
Surgical education faces numerous challenges, including reduced training opportunities and the need for both technical and non-technical skills development. This study explores how a surgical bootcamp for new Trauma and Orthopaedic (T&O) trainees can facilitate the development of Non-Technical Skills for Surgeons (NOTSS) and form a foundation for ongoing professional development during the critical transition to specialty training.
Methods
Using a mixed-methods approach, we examined the impact of a two-day bootcamp for T&O ST3 trainees (n = 15) in the Yorkshire region. Data collection included pre/post-bootcamp questionnaires (100% response rate) and semi-structured interviews at two weeks (n = 11, 73%) and six months (n = 6, 40%) post-bootcamp. Analysis followed Braun and Clarke’s thematic approach to identify patterns across participants’ experiences.
Results
Four major themes were identified: Integration & Expectations, Perception and Application of NOTSS, Psychological Safety & Learning Culture, and Building Relationships. The bootcamp functioned as a transitional space facilitating adaptation across social, psychological, and professional domains. Trainees progressed from initial skepticism about NOTSS to recognizing their importance in clinical practice. However, a notable disconnect persisted between their conscious recognition of these skills’ value and their predominantly unconscious application in daily practice, suggesting that awareness alone did not automatically translate to deliberate practice. The bootcamp provided foundations for professional socialization through peer networks, senior mentorship, and creating psychological safety, which collectively contributed to professional development.
Conclusions
Even brief surgical bootcamps can serve as valuable experiences that support trainees’ integration into specialty training through multiple adaptation processes. The early introduction of NOTSS plants important concepts that trainees apply in practice, even without explicit recognition. By addressing social and psychological aspects of training alongside technical and non-technical competencies, bootcamps can be conceptualized as foundations for ongoing professional development rather than isolated skills workshops. Future educational interventions should consider integrating structured follow-up to help trainees consciously identify and develop non-technical competencies
Unprecedented? How COVID-19 Revealed the Politics of Our Economy by William Davies, Sahil Jai Dutta, Nick Taylor, and Martina Tazzioli, Cambridge, MA, MIT Press, 2022, 320 pp., $24.95 T (paper)
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