Giant cell arteritis (GCA) is a disease that relapses often, and some patients run a refractory course. Although prompt recognition of resistant GCA is a major issue, there is no well-recognized, ...baseline risk factor for poor response to glucocorticoid (GC) treatment.
We included all patients consecutively diagnosed with GCA and homogeneously treated since 1976 in a single department and regularly followed-up for at least 18 months. Using a set of customized criteria defining response to GCs, we separated patients into highly responsive, usually responsive, dependent on GCs, and resistant to GCs. We determined which of the baseline variables were associated with GC-resistance and conducted factor analyses of mixed data and decision tree analyses. We also determined whether being GC-resistant was associated with poorer tolerance to GCs and higher death rates.
In all, 455 patients were followed for 93.4 ± 67.6 (standard deviation) months; 41 (9%) and 21 (4.6%) patients developed GC-dependent and GC-resistant disease, respectively. Factor analyses suggested an association between clinical pattern and degree of responsiveness to GCs; The decision tree analyses, built on an age at GCA onset 〈 66 years and body weight 〉 71 kg, delineated a high risk profile (44% of the patients who featured both characteristics were GC-resistant vs. less than 3% who featured neither, p < 0.001). Infections were more prevalent in the GC-resistant or GC-dependent patients, but without decreasing their survival.
Extra-cranial, large-vessel GCA may be associated with prolonged GC requirements. A simple combination of age and body weight defined a subgroup of patients at high risk for developing GC resistance. Our findings need confirmation in prospective controlled studies.
In this study the Vignettes Parenting Interactions in the Neighbourhood (V-PIN) was validated. These vignettes can be used to gain insight into and reflect on interactions in the neighbourhood ...between parents and nonparental adults. A correlational design (N = 134) was used to assess the reliability (i.e. internal consistency, test-retest), convergent and discriminant validity and relations with background variables of the V-PIN. Reliability (both internal consistency and test-retest) proved good. Positive, significant correlations provided evidence for convergent validity. The measure did not correlate with non-related constructs or background characteristics, which was an indication for discriminant validity. The newly developed measure seems useful to explore the perspectives of nonparental adults in parent-child interactions in neighbourhoods with a wide group of stakeholders with diverse cultural backgrounds and can (complemented with visualisations), be used to stimulate supportive interactions and inclusion in social work practices and the community.
We provide program managers insight into considerations for launching and running a large-scale, long-term citizen science project, using the Snapshot Wisconsin trail-camera project as a case study. ...Many citizen science projects are undertaken with a “learn as you go” approach, so there is room to better prepare program managers from the outset. We provide a comprehensive list of components making up citizen science projects, and discuss capacity needs for each component. We then quantify staff time needed throughout the project, based on our own experiences managing a long-term citizen science project with >1,000 participants. We show that total staff time and staff time devoted to certain project components vary markedly among 3 project phases: planning, growth, and maintenance. We recommend planning for 5.5 staff positions to maintain a long-term project serving a few hundred volunteers or more. The illustrated concepts can be applied by any person or group developing a volunteer-based project to prepare for logistic and funding needs across a project’s lifespan. Program managers must remember that people form the backbone of any citizen science project, and the success or failure of such projects depend in large part on the user experience of volunteers.
The book, Conformity of COVID-19 responses in Africa through the prism of international human rights law, provides useful insights into the subject-matter of COVID-19 from African perspectives on ...international law, human rights and democracy through detailed analyses of data, instruments, documents and events connected with the pandemic. The cutting-edge analyses by the contributors help to provide useful information on the human rights preparedness of African states to deal with pandemics, the limitations or restrictions imposed on human rights by African governments and the violations of human rights that took place during the pandemic; and whether the continent has learnt any useful lessons based on past experiences.
In Dual Active Bridge (DAB) converters, there can be transformer current ringing, especially when the transformer turns ratio is high. It is induced by high dv/dt generated by fast switching as well ...as the low impedance of the magnetic tank at the high-frequency range. To quantify the influence of the magnetic tank, its impedance model is thoroughly modeled by considering all the parasitic components. It is found that the parasitic capacitors of the magnetics do not equally affect the current ringing, and thereby the critical one is addressed. On top of that, the design guide of the inductor is provided for mitigation of the current ringing. Additionally, the impact of dv/dt is also studied. The models and analyses are verified on a 2.5 kW DAB prototype.
Abstract This study investigates how privileged petitioners applying for “green cards” for foreign national spouses uphold the US gender order and gender project when navigating the spousal ...reunification process. This work troubles the dichotomy within the literature between the all-empowered state and the wholly disempowered petitioners. Using content analysis of an online forum where petitioners exchange advice with others, I show the privileged petitioners enthusiastically engage in upholding the racialized gender hierarchy of the United States. Ultimately, as privileged petitioners broker immigration policy, they engage in state-building and nation-building practices that reaffirm their own privilege, which they feel is fleeting and must be re-established. Unlike less-privileged petitioners who discipline themselves to align with the state’s ideal of what a proper future nation should look like, these petitioners try to discipline others’ by constructing gendered subjectivities and forging racialized femininities that serve to uphold and legitimate the petitioners’ place in within the social hierarchy and the household.
EPDF and EPUB available Open Access under CC-BY-NC-ND licence. This book examines the unique implications of the pandemic in the Global South. With international contributors from a variety of ...disciplines, it investigates the pandemic’s effects on development, medicine, gender (in)equality and human rights among other issues. The book’s assessment offers a discourse on the ways in which the impact of COVID-19 can be mitigated in some of the most challenging socio-economic contexts in the world.
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