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International survey of treatment practices for atopic dermatitis in pregnant and breastfeeding women: Physician perspectives
No full textBackground and Objectives
Systemic treatment of pregnant/breastfeeding atopic dermatitis (AD) patients is challenging due to limited safety data. We explored treatment practices with systemic agents, including the guideline-recommended cyclosporine as the first systemic choice as well as emerging therapies, in this vulnerable population.
Patients and Methods
The Global Allergy and Asthma Excellence Network (GA2LEN) ADCARE initiative collected data from physicians worldwide who treat pregnant women with AD. Physicians completed an electronic questionnaire on the use of systemic agents in pregnant/breastfeeding AD patients.
Results
103 physicians from 32 countries completed the survey, primarily dermatologists (n = 48) or allergologists (n = 43). Antihistamines were the systemic drug most often considered to be used during pregnancy/breastfeeding (n = 73/81, 90.1%), with fewer physicians considering the use of systemic agents for the first trimester compared to later stages of pregnancy. For acute flares, systemic corticosteroids (n = 34/80, 42.5%) were preferred, followed by biologics and antihistamines (each n = 15/80, 18.8%). Although the guideline-recommended cyclosporine is sometimes considered for AD during pregnancy (n = 38/81, 46.9%), it was rarely considered as the preferred drug by physicians (n = 1/80, 1.25%).
Conclusions
Our study shows a misalignment between guideline recommendations and prescription patterns and highlights an unmet need for knowing and using the existing recommendations
Fiction writing workshops to explore staff perceptions of artificial intelligence (AI) in higher education
No full textThis study explores perceptions of artificial intelligence (AI) in the higher education workplace through innovative use of fiction writing workshops. Twenty-three participants took part in three workshops, imagining the application of AI assistants and chatbots to their roles. Key themes were identified, including perceived benefits and challenges of AI implementation, interface design implications, and factors influencing task delegation to AI. Participants envisioned AI primarily as a tool to enhance task efficiency rather than fundamentally transform job roles. This research contributes insights into the desires and concerns of educational users regarding AI adoption, highlighting potential barriers such as value alignment
What makes online political ads unacceptable? Interrogating public attitudes to inform regulatory responses
No full textOnline political advertising is often portrayed negatively, yet there is limited evidence regarding what exactly the public deems unacceptable. This paper provides new insights into public attitudes based on an online survey conducted in 2022, in which 1881 respondents evaluated political ads placed on Facebook during the 2019 UK General Election. We find that citizens do not inherently view political ads as unacceptable, and that perceptions of acceptability are influenced by partisan and demographic factors. We also find that ads deemed compliant with existing regulatory protocols for non-political advertising are considered more acceptable, suggesting a case for extending the existing regulatory regime to political ads. Delving deeper into our survey data, we explore the drivers behind these perceptions of acceptability and find that concerns about the content and tone of ads play a significant role. These findings provide valuable insights for those seeking to develop codes of conduct to govern practices in this space. Overall, our study offers a nuanced understanding of public attitudes toward online political advertising and identifies possible pathways for regulatory reform
Changes in corticosteroid and non-steroidal immunosuppressive therapy with long-term zilucoplan treatment in generalized myasthenia gravis
No full textBackground
The efficacy and safety of complement component 5 inhibitor zilucoplan in patients with anti-acetylcholine receptor antibody-positive generalized myasthenia gravis (gMG) were assessed in two double-blind studies (NCT03315130/NCT04115293 [RAISE]). During these studies and the first 12 weeks of the open-label extension study, RAISE-XT, corticosteroid and non-steroidal immunosuppressive therapy (NSIST) doses were kept stable; thereafter doses could be changed at the investigator’s discretion. We evaluated corticosteroid and NSIST dose changes in patients with gMG during zilucoplan treatment in RAISE-XT.
Methods
In RAISE-XT, patients who completed a qualifying double-blind study self-administered once-daily subcutaneous zilucoplan 0.3mg/kg. We assessed (post hoc) patients who changed their corticosteroid or NSIST dose relative to double-blind baseline at Week 120 (data cutoff: November 11, 2023).
Results
Overall, 200 patients enrolled. At Week 120, 61.1% (n = 33/54) of patients who were on corticosteroids at double-blind baseline had reduced or discontinued corticosteroids (mean 15.5mg dose reduction); mean change from baseline (CFB) in Myasthenia Gravis Activities of Daily Living (MG-ADL) score:−6.55 (standard deviation [SD] 3.65). Of patients on NSIST at double-blind baseline, 29.8% (n = 14/47) reduced or discontinued ≥ 1 NSIST; mean CFB in MG-ADL score:−7.57 (SD 4.69). Among all patients at Week 120, 9.3% (n = 8/86) had increased or started corticosteroids; 2.4% of patients (n = 2/85) had increased NSIST, including one who started a new NSIST. Zilucoplan was well tolerated.
Conclusions
Treatment with zilucoplan allowed for reduction or discontinuation of corticosteroids in the majority of patients and NSIST in about a third of patients, while maintaining efficacy.
Trial registration
NCT04225871; October 2, 2019
Biochar production, activation, and applications: A comprehensive technical review
No full textOur planet has been facing critical challenges since the late 20th century, including climate change, resource shortages, environmental degradation and pollution, demanding urgent and sustainable solutions. Biochar, a carbon-rich material produced via biomass pyrolysis, has gained attention for its great potentials in environmental remediation, pollutant removals, carbon neutrality, soil amendment, building materials, and etc. The performance of biochar in these applications is closely linked to its physicochemical properties, which are influenced by the feedstock and the preparation/activation methods. This paper reviews a wide range of biochar produced from various feedstocks, and the associated performance in different applications. Advanced characterisations are discussed to unveil the fundamental mechanisms and provide insights for further improvement and optimization. The techno-economic analysis evaluates the feasibility, challenges, and opportunities for scaling up and adopting biochar in potential applications. By focusing on biochar's multifunctionality and sustainability, this paper provides a reference for future research on developing biochar as a green technology with environmental and economic benefits
Framing divestment:A decade of media discourse on fossil fuel divestment in higher education
No full textThe fossil fuel divestment movement has emerged as a significant force in climate activism. This study presents a comprehensive analysis of public discourse on fossil fuel divestment in higher education, offering novel insights into the complex interplay between key actors, drivers, and actions that shape institutional responses. Drawing on a dataset of 3,474 news articles spanning a decade, we employ a mixed-methods approach combining quantitative content analysis with qualitative interpretation. Our findings reveal distinct framing patterns across stakeholder groups, highlighting a notable disconnect between student demands and institutional responses. We identify how higher education institutions strategically reframe fossil fuel divestment demands through alternative narratives, illuminating the challenges of implementing sustainability in higher education. Theoretically, this work extends social movement and sustainability transitions literature by demonstrating how competing narratives influence institutional change processes. We contribute to these theories by elucidating the role of media framing in legitimizing or delegitimizing climate activism strategies. Practically, our analysis offers actionable insights for activists and decision makers navigating the complex landscape of institutional responses to climate action. Our findings have notable implications for understanding how framing strategies can be leveraged to drive sustainability transitions in higher education and beyond, offering a timely contribution to debates on the role of institutional change for sustainability
The orbit of WASP-4 b is in decay
No full textWASP-4 b is a hot Jupiter exhibiting a decreasing orbital period, prompting investigations into potential mechanisms driving its
evolution. We analysed 173 transit light curves, including 37 new observations, and derived mid-transit timings with EXOFAST,
forming the most extensive transit timing variation (TTV) data set for this system. Adding 58 literature timings and removing
unreliable data, we constructed a TTV diagram with 216 points. Our analysis considered linear, quadratic, and apsidal motion
models, with the quadratic model proving to be significantly superior in all model comparison statistics. We found no significant
periodic signals in the data. The quadratic model allows us to infer a tidal quality factor of Q
∼ 80 000 from the orbital decay
rate if this is due to stellar tides. Theoretical considerations indicate that such efficient dissipation is possible due to internal
gravity waves in the radiative core of WASP-4, but only in our models with a more evolved host star, possibly near the end of
its main-sequence lifetime, and with a larger radius than the observed one. Our main-sequence models produce only about a
third of the required dissipation (Q
∼ 2 − 5 × 105). Therefore, the observed orbital decay can only be explained by a slightly
larger or more evolved host, resembling the case for WASP-12. Our findings highlight the need for further stellar modelling
and improvement in our current understanding of tidal dissipation mechanisms driving orbital decay in close-in exoplanetary
systems
Does a Citizen Science Approach Enhance the Effectiveness of Flood Early Warning Systems? Evidence from the Akaki Catchment, Ethiopia
No full textFlooding has emerged as a significant concern in the Akaki catchment area of Ethiopia, affecting settlements and properties. Early warning systems (EWSs) are implemented to reduce flood risks, but power dynamics among at-risk communities and stakeholders have raised concerns about the reliable accessibility of warning information. We integrated a citizen science approach into existing flood EWSs to promote inclusivity, local perspectives, and equitable expertise distribution in flood early warning. It draws on primary data collected through diverse methods, alongside an extensive review of documents from the years 2021 to 2022. The analysis of qualitative data indicates the integration of citizen science into a flood EWSs delivers dependable early warning information and encourages the establishment of networks. This approach reduces dependence on external entities, enhances local decision-making capabilities, and promotes a sense of ownership, empowerment, and trust. This can transform the dynamics and responsibilities linked to flood management. However, the longer-term participation of citizen scientists in flood EWSs is challenging due to the disparity between commitment levels and benefits, lack of legal frameworks, and insufficient recognition of community diversity within policy frameworks. The research herein emphasizes the significance of understanding power dynamics and institutional capacities in integrating citizen science into flood EWSs. It offers valuable perspectives for policymakers, practitioners, and communities on participatory governance, social equity, and the resilience of communities in the face of environmental challenges
A glossary of signs and symptoms of giant cell arteritis
No full textObjectives
This study seeks to create consensus-based definitions of signs and symptoms of giant cell arteritis (GCA) for use by health care professionals, primarily in research settings.
Methods
Core definitions of signs and symptoms of GCA were extracted from 11 randomised controlled trials of GCA previously reviewed in a systematic literature review conducted in the context of the development of response criteria for GCA. This information was supplemented by definitions from other sources, such as rheumatology textbooks. A 2-round Delphi was performed within an international task force (32 members from 11 countries). The first round aimed to obtain consensus on the descriptive terms defining each sign or symptom, and round 2 rated the importance of these terms. Based on the Delphi study method, preliminary definitions were developed. In 4 online meetings, results of the Delphi were reviewed, and a consensus was achieved on final definitions.
Results
Twenty-nine signs and symptoms of GCA were reviewed. Six signs or symptoms of GCA had previously been defined in the literature. A high level of agreement was reached on the definition of 23 signs and symptoms with the following 12 considered characteristic of GCA: headache, temporal artery abnormalities, scalp tenderness, scalp necrosis, jaw claudication, tongue claudication, tongue necrosis, amaurosis fugax, permanent vision loss, fever, limb claudication, and blood pressure inequality.
Conclusions
A glossary of definitions for 23 signs and symptoms of GCA was developed through a consensus process involving international experts