Search

BackgroundCommonly offered as supportive care, therapist-led online support groups (OSGs) are a cost-effective way to provide support to individuals affected by cancer. One important indicator of a successful OSG session is group cohesion; however, monitoring group cohesion can be challenging due to the lack of nonverbal cues and in-person interactions in text-based OSGs. The Artificial Intelligence–based Co-Facilitator (AICF) was designed to contextually identify therapeutic outcomes from conversations and produce real-time analytics. ObjectiveThe aim of this study was to develop a method to train and evaluate AICF’s capacity to monitor group cohesion. MethodsAICF used a text classification approach to extract the mentions of group cohesion within conversations. A sample of data was annotated by human scorers, which was used as the training data to build the classification model. The annotations were further supported by finding contextually similar group cohesion expressions using word embedding models as well. AICF performance was also compared against the natural language processing software Linguistic Inquiry Word Count (LIWC). ResultsAICF was trained on 80,000 messages obtained from Cancer Chat Canada. We tested AICF on 34,048 messages. Human experts scored 6797 (20%) of the messages to evaluate the ability of AICF to classify group cohesion. Results showed that machine learning algorithms combined with human input could detect group cohesion, a clinically meaningful indicator of effective OSGs. After retraining with human input, AICF reached an F1-score of 0.82. AICF performed slightly better at identifying group cohesion compared to LIWC. ConclusionsAICF has the potential to assist therapists by detecting discord in the group amenable to real-time intervention. Overall, AICF presents a unique opportunity to strengthen patient-centered care in web-based settings by attending to individual needs. International Registered Report Identifier (IRRID)RR2-10.2196/21453

BackgroundThe recent onset of the COVID-19 pandemic and the social distancing requirement have created an increased demand for virtual support programs. Advances in artificial intelligence (AI) may offer novel solutions to management challenges such as the lack of emotional connections within virtual group interventions. Using typed text from online support groups, AI can help identify the potential risk of mental health concerns, alert group facilitator(s), and automatically recommend tailored resources while monitoring patient outcomes. ObjectiveThe aim of this mixed methods, single-arm study was to evaluate the feasibility, acceptability, validity, and reliability of an AI-based co-facilitator (AICF) among CancerChatCanada therapists and participants to monitor online support group participants’ distress through a real-time analysis of texts posted during the support group sessions. Specifically, AICF (1) generated participant profiles with discussion topic summaries and emotion trajectories for each session, (2) identified participant(s) at risk for increased emotional distress and alerted the therapist for follow-up, and (3) automatically suggested tailored recommendations based on participant needs. Online support group participants consisted of patients with various types of cancer, and the therapists were clinically trained social workers. MethodsOur study reports on the mixed methods evaluation of AICF, including therapists’ opinions as well as quantitative measures. AICF’s ability to detect distress was evaluated by the patient's real-time emoji check-in, the Linguistic Inquiry and Word Count software, and the Impact of Event Scale-Revised. ResultsAlthough quantitative results showed only some validity of AICF’s ability in detecting distress, the qualitative results showed that AICF was able to detect real-time issues that are amenable to treatment, thus allowing therapists to be more proactive in supporting every group member on an individual basis. However, therapists are concerned about the ethical liability of AICF’s distress detection function. ConclusionsFuture works will look into wearable sensors and facial cues by using videoconferencing to overcome the barriers associated with text-based online support groups. International Registered Report Identifier (IRRID)RR2-10.2196/21453

Abstract Erythroblastic sarcoma (ES) (previously called chloroma or granulocytic sarcoma) are rare hematological neoplams characterized by the proliferation of myeloid blasts at extramedullary sites, and primarily involve the skin and soft tissue of middle-aged adults. ES may be concomitant with or secondary to myeloid neoplasms (mostly acute myeloid leukemia (AML)) or in isolated cases (de novo) without infiltration of the bone marrow by blasts. ES share cytogenetic and molecular abnormalities with AML, including RUNX1T1 fusions. Some of these alterations seem to be correlated with particular sites of involvement. Herein, we report an isolated erythroblastic sarcoma with NFIA::RUNX1T1 located in the central nervous system (CNS) of a 3-year-old boy. Recently, two pediatric cases of CNS MS with complete molecular characterization have been documented. Like the current case, they concerned infants (2 and 3 years-old) presenting a brain tumor (pineal involvement) with leptomeningeal dissemination. Both cases also harbored a NFIA::RUNX1T3 fusion. ES constitutes a diagnostic challenge for neuropathologists because it does not express differentiation markers such as CD45, and may express CD99 which could be confused with CNS Ewing sarcoma. CD43 is the earliest pan-hematopoietic marker and CD45 is not expressed by erythroid lineage cells. E-cadherin (also a marker of erythroid precursors) and CD117 (expressed on the surface of erythroid lineage cells) constitute other immunhistochemical hallmarks of ES. The prognosis of patients with ES is similar to that of other patients with AML but de novo forms seem to have a poorer prognosis, like the current case. To conclude, pediatric ES with NFIA::RUNX1T1/3 fusions seem to have a tropism for the CNS and thus constitute a potential pitfall for neuropathologists. Due to the absence of circulating blasts and a DNA-methylation signature, the diagnosis must currently be made by highlighting the translocation and expression of erythroid markers.

IntroductionFollicular Lymphoma (FL) results from the malignant transformation of germinal center (GC) B cells. FL B cells display recurrent and diverse genetic alterations, some of them favoring their direct interaction with their cell microenvironment, including follicular helper T cells (Tfh). Although FL-Tfh key role is well-documented, the impact of their regulatory counterpart, the follicular regulatory T cell (Tfr) compartment, is still sparse.MethodsThe aim of this study was to characterize FL-Tfr phenotype by cytometry, gene expression profile, FL-Tfr origin by transcriptomic analysis, and functionality by in vitro assays.ResultsCD4+CXCR5+CD25hiICOS+ FL-Tfr displayed a regulatory program that is close to classical regulatory T cell (Treg) program, at the transcriptomic and methylome levels. Accordingly, Tfr imprinting stigmata were found on FL-Tfh and FL-B cells, compared to their physiological counterparts. In addition, FL-Tfr co-culture with autologous FL-Tfh or cytotoxic FL-CD8+ T cells inhibited their proliferation in vitro. Finally, although FL-Tfr shared many characteristics with Treg, TCR sequencing analyses demonstrated that part of them derived from precursors shared with FL-Tfh. DiscussionAltogether, these findings uncover the role and origin of a Tfr subset in FL niche and may be useful for lymphomagenesis knowledge and therapeutic management.

Abstract Background Over the past decade, the United States (US) has seen a spike in migration across the US-Mexico border with an increase in hospital admissions of migrants and asylum-seekers under the custody of immigration law enforcement (ILE). This study aimed to determine how the presence of ILE officials affects patient care and provider experience in a teaching hospital setting. Methods This cross-sectional online survey solicited quantitative and qualitative feedback from medical students, residents, and attending physicians (n = 1364) at a teaching hospital system with two campuses in Arizona. The survey included participant demographics and addressed participants’ experience caring for patients in ILE custody, including the perception of respect, violations of patients’ privacy and autonomy, and the comfort level with understanding hospital policies and patient rights. Thematic analyses were also performed based on respondent comments. Results 332 individuals (24%) responded to the survey. Quantitative analyses revealed that 14% of participants described disrespectful behaviors of ILE officials, mainly toward detained patients. Qualitative thematic analyses of respondent comments revealed details on such disrespectful encounters including ILE officers violating the Health Insurance Portability and Accountability Act (HIPAA) and using intimidation tactics with patients. Nearly half of the respondents did not have knowledge of policies about ILE detainees’ medical care, detainees’ privacy rights, or ILE’s authority in patient care. Conclusions This study points out the complexities, challenges, and ethical considerations of caring for patients in ILE custody in the hospital setting and the need to educate healthcare professionals on both patient and provider rights. It describes the lived experiences and difficulties that providers on the border face in trying to achieve equity in the care they provide to detained migrant patients.

The territorial scale is increasingly recognised as a relevant scale for analysing, conceiving and supporting the ecological transitions of agri-food systems. France and Italy have both been pioneer countries for the valorisation of territorially-based food identity and more recently experimented innovative forms of collective and public action to support transitions to sustainable territorial food systems. In Italy, the biodistrict frame has progressively been legitimised and recently adopted as a legal framework, while in France, despite many regional experiences focused on organic agriculture, the legal framework recently established with the territorial food system policy, officially driven by the agroecological transition paradigm, leaves a very variable place to organic agriculture and its principles, depending on local features and power configurations. Our objective in this paper is to understand these processes of institutionalisation. Based on a focused review of the French and Italian literature on this issue and on the analysis of the relative place of organics in policies, experiences and debates in France and Italy over the five last decades, we show that these processes of institutionalisation result from specific interplays between science, policy and experience, where the related actors take a different role, leading to different configurations and favouring different framings.

Abstract Background Investigations of participant retention in longitudinal health and medical research, document strategies that work best but overlook social marketing’s capacity to influence participant retention. After applying the social marketing framework: the idea that determining what longitudinal participants ‘buy’ (product), at what cost (price), in what location (place) and through which communication channels (promotion), this paper aims to inform and enhance retention efforts. Methods This qualitative study was conducted through in-depth interviews with participants from the Raine Study that began in Western Australia in 1989. The Generation 2 participants, initially enrolled into the Raine Study as babies by their parents (Generation 1), are now young adults invited to attend follow-up studies and tests every few years. Our study defined ‘active’ participants (n = 17) as those who agreed to attend their 27 year follow-up, and ‘inactive’ (n = 12) participants as those who had attended neither of the past two follow-ups (22 and 27 years). Results Raine Study participants experienced core, actual and augmented product benefits. Inactive participants focused on the costs (price) associated with participation, and were more likely to suggest tele-health (place) strategies to overcome barriers to follow-up attendance. Both active and inactive participants found professional processes and friendly staff made the Raine Study environment appealing, suggested that social media (promotion) was underutilised, and offered novel ideas to enhance engagement. Conclusions Social marketing can support the development of differentiated strategies addressing the unique needs and wants of active and inactive participants. Sophisticated cohort segmentation can reach participants in a more meaningful way, reinforce the study ‘brand’ and guard against attrition.

IntroductionEmotion regulation is altered in many psychiatric disorders in adolescence, but the understanding of mechanisms that underlie this alteration is still poor.MethodsThe PERCEPT study explores alexithymia, empathy, facial emotion recognition (FER) and defence mechanisms in a sample of adolescents in psychiatric care (n = 61, 74% of girls, mean age = 15.03 y.o.), in relation with participants’ attachment styles.ResultsResults revealed correlations between attachment dimensions and all of the emotion regulation variables, suggesting that attachment modalities have functional links with emotional regulation at its different levels: FER accuracy was inversely correlated with avoidant attachment, while affective empathy, difficulty in identifying feelings (alexithymia) and immature as well as neurotic defence mechanisms were positively correlated with anxious attachment. Moreover, attachment categories delineated distinct emotional perception profiles. In particular, preoccupied attachment included adolescents with the highest levels of facial emotion perception (sensitivity and accuracy) and of affective empathy, whereas detached attachment included adolescents with the lowest levels of these variables. Neurotic defence mechanisms and difficulty to identify feelings were correlated with preoccupied attachment; immature defence mechanisms and difficulty to describe feelings to others characterized fearful attachment.DiscussionThese results suggest that attachment categories underlie emotion regulation processes in psychiatric disorders in adolescence. Theoretical and clinical implications are discussed.

Cet article interroge la place accordée aux dimensions sensibles (au sens d’attachement, de ce qui « fait sens », ce à quoi l’on tient) ainsi que leur rôle au sein des dispositifs et expérimentations qui visent la transition écologique dans et par les systèmes alimentaires, à travers six cas situés dans différentes régions de France. Plus précisément, il sonde ces attachements afin de voir ce qu’ils peuvent apporter à la participation de publics à première vue éloignés des enjeux de transition écologique, et en explore la portée en matière de politisation. Il montre que la prise en compte de ces attachements offre un contrepoint aux approches technicistes et normatives de la transition écologique, tout en permettant de traiter les enjeux de la démocratie et de la justice alimentaires. Il identifie trois voies de politisation, diversement combinées dans les six expérimentations étudiées : la capacitation/l’augmentation du pouvoir d’agir (empowerment), la valorisation des pratiques et/ou des savoirs, et la formation de collectifs. Il suggère, enfin, qu’en dépit des limites que nous identifions, la prise en compte de ces dimensions sensibles favorise, sous certaines conditions, l’inclusion et la participation de ces publics. Cette prise en compte offre en outre une voie privilégiée pour l’articulation des enjeux de justice et de démocratie alimentaires aux enjeux environnementaux, ce qui mériterait d’être davantage considéré ou du moins discuté dans le cadre des politiques de transition écologique.

This study explores how a state-based franchisee association of a multinational quick-service restaurant franchisor introduced three world-first innovations through the activation of the five dimensions of entrepreneurial orientation (EO). The antecedents to this activation were also explored. A historical extended case study focusing on a revelatory case was undertaken. In-depth analysis using a rigorous qualitative methodology was facilitated by the triangulation of informant interviews, publicly available data, archival data, and artefacts. The three innovations explored involved the apparent activation of all five dimensions of EO by the franchisee association. The franchisee association’s structure and the provenance of its franchisee members, in being either externally recruited or internally recruited, appeared to have a bearing on whether product or process innovations were pursued. Five antecedents that enhance the propensity of franchisee associations to activate the dimensions of EO were also identified, and a preliminary model was constructed. Whilst the EO of franchisors and franchisees has previously been examined, this study is the first to explore franchisee associations as a vehicle for EO. With around 75% of franchisors incorporating some form of franchisee association, better understanding how to harness their innovative potential could bestow a competitive advantage upon those franchise systems able to do so.

In this study, we focus on the eruption of Mount Etna on Christmas 2018, which emitted great amounts of SO2 from 24th to 30th December into the free troposphere. Simulations based on two different estimations of SO2 emission fluxes are conducted with the chemistry-transport model MOCAGE in order to study the impact of these estimations on the volcanic plume modeling. The two flux emissions used are retrieved (1) from the ground-based network FLAME, located on the flank of the volcano, and (2) from the spaceborne instrument SEVIRI onboard the geostationary satellite MSG. Multiple spaceborne observations, in the infrared and ultraviolet bands, are used to evaluate the model results. Overall, the model results match well with the plume location over the period of the eruption showing the good transport of the volcanic plume by the model, which is linked to the use of a realistic estimation of the altitude of injection of the emissions. However, there are some discrepancies in the plume concentrations of SO2 between the two simulations, which are due to the differences between the two emission flux estimations used that are large on some of the days. These differences are linked to uncertainties in the retrieval methods and observations used to derive SO2 volcanic fluxes. We find that the uncertainties in the satellite-retrieved column of SO2 used for the evaluation of the simulations, linked to the instrument sensitivity and/or the retrieval algorithm, are sometimes nearly as large as the differences between the two simulations. This shows a limitation of the use of satellite retrievals of SO2 concentrations to quantitatively validate modeled volcanic plumes. In the paper, we also discuss approaches to improve the simulation of SO2 concentrations in volcanic plumes through model improvements and also via more advanced methods to more effectively use satellite-derived products.

B cell affinity maturation occurs in the germinal center (GC). Light-zone (LZ) GC B cells (BGC-cells) interact with follicular dendritic cells (FDCs) and compete for the limited, sequential help from T follicular helper cells needed to escape from apoptosis and complete their differentiation. The highest-affinity LZ BGC-cells enter the cell cycle and differentiate into PCs, following a dramatic epigenetic reorganization that induces transcriptome changes in general and the expression of the PRDM1 gene in particular. Human PC precursors are characterized by the loss of IL-4/STAT6 signaling and the absence of CD23 expression. Here, we studied the fate of human LZ BGC-cells as a function of their CD23 expression. We first showed that CD23 expression was restricted to the GC LZ, where it was primarily expressed by FDCs; less than 10% of tonsil LZ BGC-cells were positive. Sorted LZ BGC-cells left in culture and stimulated upregulated CD23 expression but were unable to differentiate into PCs – in contrast to cells that did not upregulate CD23 expression. An in-depth analysis (including single-cell gene expression) showed that stimulated CD23-negative LZ BGC-cells differentiated into plasmablasts and time course of gene expression changes delineates the transcriptional program that sustains PC differentiation. In particular, we identified a B cell proliferation signature supported by a transient MYC gene expression. Overall, the CD23 marker might be of value in answering questions about the differentiation of normal BGC-cells and allowed us to propose an instructive LZ BGC-cells maturation and fate model.

Four field seasons of snow leopard (Panthera uncia) camera trapping inside Naryn State Nature Reserve, Kyrgyzstan, performed thanks to citizen science expeditions, allowed detecting a minimal population of five adults, caught every year with an equilibrated sex ratio (1.5:1) and reproduction: five cubs or subadults have been identified from three litters of two different females. Crossings were observed one to three times a year, in front of most camera traps, and several times a month in front of one of them. Overlap of adults’ minimal territories was observed in front of several camera traps, regardless of their sex. Significant snow leopard presence was detected in the buffer area and at Ulan area which is situated at the reserve border. To avoid poaching on this apex predator and its preys, extending the more stringent protection measures of the core zone to both the Southern buffer area and land adjacent to Ulan is recommended.

Individuals applying for asylum must demonstrate a well-founded fear of persecution. By documenting signs of torture and other forms of abuse, medical evaluations can provide forensic evidence to support asylum claims. The backlog of pending immigration cases in the United States recently exceeded one million. Student-run asylum medicine clinics conduct forensic evaluations to assist in the asylum adjudication process. The Physicians for Human Rights National Student Advisory Board administered surveys to student-run clinics in the US in 2017 and 2018. Retrospective analysis evaluated the completion rates of forensic evaluations, caseload capacities, and training frequencies. Student-run asylum clinics completed 38.8% more forensic evaluations in 2017 than in 2016. In 2016, 33% of clinics received forensic evaluation requests that exceeded their capacity, a figure that rose to 50% in 2017. The number of clinicians trained by asylum clinics increased nearly fourfold between 2016 and 2017, and the number of students trained grew by 81%. A recent surge in armed conflict has contributed to record numbers of asylum applications in the US. The results of this survey reveal the burgeoning capability of student-run asylum clinics to provide evaluations, a trend that underscores medical students’ ability to significantly impact human rights issues. Student-run asylum clinics are poised to fill an increasingly important role in supporting victims of torture and persecution.

Abstract In recent years, a growing number of actors and institutions, in different countries, have begun using the notion of Agroecology, which has led to an expansion of its polysemy and its controversies. Taking this into account, this paper analyzes, based on the Brazilian and French experiences, the peculiarities of Agroecology in four different fields: science, social movements, government policies, and education. It also discusses three other issues: the analytical, programmatic and normative discourses; the different definitions, in the fields of science and education, of the object of study of Agroecology; and the different formulations regarding its fundamental principles. It is argued that, in this new context, recognition of this pluralism and the controversies acquires a central role in the construction of knowledge in the various fields linked to Agroecology.

Abstract This paper presents an analysis about agroecological alternative food networks and new producer-consumer relationships in France and Brazil. The investigation method is based on descriptive and qualitative research about 20 cases (qualitative interviews), selected with stakeholders (farmers, traders, consumers and food experts) in France and Southern Brazil. A typology about the characteristics and organization to short circuits trade is provided. The results show that alternative food networks are very diverse and dynamic, being a social, economic and environmental option to family farming, strengthening local markets and reconnecting producers and consumers. In these countries, the successful initiatives of alternative networks occur in places where there is coordination between food networks stakholders such as the government, NGOs, private enterprises, farmers and consumers' organizations.

In this paper we describe the evolution of AMAP institution (french CSA) when the revision process of the Charter took place (2013) - a text that has to be signed to be allowed to use the name AMAP. Analyzing the evolution of contents of the documents as well as the innovative revision process, we show that a constitutional level was added. This resolved some tensions, but also completed the system of rules of the institution (Ostrom, 1990), and thus must have made this exchange system more durable.

Transitioning toward more sustainable agricultural development paths requires extensive change and not simply marginal technical adjustments, as suggested by a strong conception of agroecology. To deal with transition, we believe that agroecology can be enriched by a deep analysis of sustainability transition frameworks and, conversely, that preexisting theories can be questioned in light of the specificities of agroecological transitions (AET). We first examine some of the main sustainability transition frameworks (resilience of social-ecological systems, institutional analysis and development of social-ecological systems, and socio-technical transition). We identify their ontologies to question their ability to be combined without deep adjustments. In a second step, we analyze how these frameworks have been used and questioned by researchers from the life sciences or social sciences in four AET studies. We find that each framework is relevant in its systemic and dynamic approach to change, but also that there are limits concerning the balance between the various dimensions. The scales and processes linked to AET must be taken into account, as well as the way to jointly consider ecological, socioeconomic, and technological aspects. Moreover, it is clear that problems in dealing with agency are common to these approaches, which influences the way to model change. More broadly, sustainability transition frameworks need to account better for ecological and technological materialities and processes, the importance of emergent organizations in singular situations, and learning processes and the diversity of knowledge dynamics. Doing so is challenging because it requires regrounding theories in empirical observations as well as questioning disciplinary frontiers and ontologies.

O resumo deste artigo não está diponível.

Neste artigo, exploramos a relação entre Agroecologia e Agricultura Orgânica. O debate na comunidade científica em alguns países e a análise das posições ou discursos de pesquisadores e artigos apontam para distintas combinações, trocas e interações entre a Agricultura Orgânica e Agroecologia. Nesse sentido, primeiramente, com base na revisão de literatura, mostramos distintas interações entre esses estilos de agricultura. Além disto, analisamos as controvérsias das agriculturas em foco, bem como apresentamos uma síntese de dois estudos de caso para ilustrar a aplicação prática de princípios da agroecologia, avaliando práticas e valores éticos, relacionando-as com as lógicas familiares ou patronais de funcionamento da produção. Concluímos que as relações entre os estilos de agricultura não podem ser reduzidas a uma simples oposição entre um campo científico e um domínio prático. Diversos elementos devem ser tomados em conta, entre os quais o grau de integração sociocultural (valores) à sociedade, as práticas e a inserção no mercado. Estudos no território brasileiro exemplificam a diversidade de relações existentes, seja inclusiva ou exclusiva, observando-se uma fluidez entre conceitos de agroecologia e agricultura orgânica.