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IntroductionHereditary angioedema (HAE) due to C1 inhibitor (C1-INH) deficiency is an ultra-rare autosomal dominant inherited disease that affects 1 in 67,000 people in the world. The attacks are based on subcutaneous and submucosal edema that can lead to death if not properly managed. Considering the lack of information on the clinical management of Brazilian patients with HAE, this study aimed to identify and characterize patients with HAE-C1-INH that used danazol prophylactic treatment in the Brazilian Public Health System (SUS) and the healthcare resource utilization (HCRU).MethodsThis was an observational retrospective database study with patients treated with danazol from January 2011 until December 2021 within the SUS. The HAE cohort included patients with 12 years or older with at least one record for ICD-10 D84.1, one claim for danazol record, and at least 6 months of available history in the database.ResultsOur study included 799 patients treated in the SUS, with a mean (SD) age at danazol initiation of 40 years (16). The number of patients with HAE showed a similar distribution over this 10-year period analyzed with the highest number of patients in 2015 (n = 509) and 2016 (n = 480). A total of 253 (32%) patients had a record of at least one attack. Of those, 45 (17.8%) had at least one procedure HAE-related hospital admission, and 128 (50.6%) had at least one HAE-related hospital admission. The mean (SD) hospitalization length of stay was 5 (8) days. Over 14% (n = 36) of HAE patients with attack (n = 253) had at least one HAE-related ICU admission.ConclusionThis database study is the strategy used to allow us to find and describe the characteristics of patients with HAE who use danazol for long-term prophylaxis in the SUS and identify HCRU outcomes of interest such as hospitalizations, inpatient, and outpatient settings. The high rate of attacks, hospitalizations, and general resource uses highlights the necessity to increase awareness of new strategies and accurate approaches to treat HAE patients. Therefore, our findings are important indicators that our health system and guidelines need to be revised and improved to properly diagnose, treat, and assist patients with HAE.

Abstract Background To improve the availability and accessibility of healthier food and drinks in schools, sports and worksites canteens, national Guidelines for Healthier Canteens were developed by the Netherlands Nutrition Centre. Until now, no tool was available to monitor implementation of these guidelines. This study developed and assessed the content validity and usability of an online tool (the ‘Canteen Scan’) that provides insight into and directions for improvement of healthier food products in canteens. Methods The Canteen Scan was developed using a three-step iterative process. First, preliminary measures and items to evaluate adherence to the guidelines were developed based on literature, and on discussions and pre-tests with end-users and experts from science, policy and practice. Second, content validity of a paper version of the Canteen Scan was assessed among five end-users. Third, the online Canteen Scan was pilot tested among end-users representing school canteens. Usability was measured by comprehensibility, user-friendliness, feasibility, time investment, and satisfaction. Results The content validity of the Canteen Scan was ensured by reaching agreement between stakeholders representing science, policy and practice. The scan consists of five elements: 1) basic conditions (e.g. encouragement to drink water and availability of policy regarding the guidelines), 2) product availability offered on displays (counter, shelf) and 3) in vending machines, 4) product accessibility (e.g. promotion and placement of products), and 5) an overall score based on the former elements and tailored feedback for creating a healthier canteen. The scan automatically classifies products into healthier or less healthy products. Pilot tests indicated good usability of the tool, with mean scores of 4.0–4.6 (5-point Likert scale) on the concepts comprehensibility, user-friendliness and feasibility. Conclusion The Canteen Scan provides insight into the extent to which canteens meet the Dutch Guidelines for Healthier Canteens. It also provides tailored feedback to support adjustments towards a healthier canteen and with the scan changes over time can be monitored. Pilot tests show this tool to be usable in practice.

Accurate and efficient prediction of mobile network traffic in a public setting with changing flow of people can not only ensure a stable network but also help operators make resource scheduling decisions before reasonably allocating resources. Therefore, this paper proposes a method based on kernel extreme learning machine (kELM) for traffic data prediction. Particle swarm optimization (PSO), multiverse optimizer (MVO), and moth–flame optimization (MFO) were adopted to optimize kELM parameters for finding the best solution. To verify the predictive performance of the kernel ELM model, backpropagation (BP) neural network, v-support vector regression (vSVR), and ELM were also applied to traffic prediction, and the results were compared with kELM. Experimental results showed that the smallest mean absolute percentage error in the test (11.150%) was achieved when kELM was optimized by MFO with Gaussian as the kernel function, that is, the prediction result of MFO-kELM was the best. This study can provide significant guidance for network stability and resource conservation. [ABSTRACT FROM AUTHOR]

Accurate and efficient prediction of mobile network traffic in a public setting with changing flow of people can not only ensure a stable network but also help operators make resource scheduling decisions before reasonably allocating resources. Therefore, this paper proposes a method based on kernel extreme learning machine (kELM) for traffic data prediction. Particle swarm optimization (PSO), multiverse optimizer (MVO), and moth–flame optimization (MFO) were adopted to optimize kELM parameters for finding the best solution. To verify the predictive performance of the kernel ELM model, backpropagation (BP) neural network, v-support vector regression (vSVR), and ELM were also applied to traffic prediction, and the results were compared with kELM. Experimental results showed that the smallest mean absolute percentage error in the test (11.150%) was achieved when kELM was optimized by MFO with Gaussian as the kernel function, that is, the prediction result of MFO-kELM was the best. This study can provide significant guidance for network stability and resource conservation.

Highlights • Free-access psychiatric community services need a specific efficient triage method. • A new 6-item SCL-90 factor predicts early suicide attempts and hospitalizations. • SCL-6 score≥ 7.5 identified adverse outcomes with good sensitivity and specificity. • This simple, rapid screening tool may identify patients needing urgent treatments. Abstract To increase access to treatment, Italy made assessment at community mental health centers (CMHCs) independent of medical referral, resulting in increased numbers of patients to be triaged efficiently. To support this process, we evaluated SCL-90-R item-ratings to identify factors that best predicted adverse early outcomes among persons seeking first-time CMHC care in a 24-month period in Rome. A psychiatric nurse screened subjects with a brief interview and self-administered SCL-90-R and psychiatrists provided CGI ratings and ICD-9 diagnosis. Of 832 screened subjects, 32 (3.85%) were hospitalized or attempted suicide within 90 days. Six SCL-90 items (15,41,55,57,78,88) scored much higher with than without such adverse outcomes; their sum is proposed as a predictive measure (“SCL-6″). In binary multivariable logistic modeling, this factor, but not age, sex, diagnosis, or other SCL-90-derived subscales strongly predicted adverse outcomes. A ROC curve for SCL-6 reflected a strong separation between subjects with versus without adverse outcomes (AUC = 0.76). This simple screening tool may support timely identification of patients at risk of early adverse clinical outcome who require especially close follow-up. [ABSTRACT FROM AUTHOR]

Abstract: The adoption and deployment of 3DTV can be seen as a major step in the history of television, comparable to the transition from analogue to digital and standard to high definition TV. Although 3D is expected to emerge from the cinema to peoples’ home, there is still a lack of knowledge on how people (future end users) perceive 3DTV and how this influences their viewing experience as well as their acceptance of 3DTV. Within this paper, findings from a three-day field evaluation study on people’s 3DTV experiences, focusing on the feeling of sickness and presence, are presented. Contrary to the traditional controlled laboratory setting, the study was conducted in the public setting of a shopping center and involved 700 participants. The study revealed initial insights on users’ feeling of presence and sickness when watching 3DTV content. Results from this explorative study show that most of the participants reported symptoms of sickness after watching 3DTV with an effect of gender and age on the reported feeling of sickness. Our results further suggest that the users’ previous experience with 3D content has an influence on how realistic people rate the viewing experience and how involved they feel. The particularities of the study environment, a shopping mall, are reflected in our findings and future research directions and action points for investigating people’s viewing experiences of 3DTV are summarized. [Copyright &y& Elsevier]

We examined differences in male and female caregivers' behavioral styles, and their use of negative or positive touch in noncompliance episodes with preschoolaged children that occurred in public settings. Coders reliably coded adult caregiver behavioral style (authoritarian-type, authoritative-type, and permissive-type), positive and negative touch, and children's latency to comply, as well as the child's demeanor at the end of the noncompliance event. Surprisingly, almost a quarter of all children were touched negatively by adults during these public episodes. Contrary to expectations based on self-report and laboratory studies, male caregivers were more likely to use touch in noncompliance episodes with children, and more likely to use positive touch, than female caregivers. Adult caregiver behavioral style, and positive versus negative touch were each related to children's responses in the noncompliance episodes. This work extends the findings of earlier studies about adult caregiver behavioral styles and highlights the use of positive versus negative touch as an important behavioral context for compliance requests of young children. Further, child demeanor is a crucial measure of the success of parenting behavior in noncompliance episodes because it indexes behavior occurring after compliance occurs, but which has the potential to be a significant influence on family harmony. The use of naturalistic observational methodology is suggested as a critical step in validating findings on harsh discipline and corporal punishment that rely on methods in which social desirability may be a confound. [ABSTRACT FROM AUTHOR]

In England recently the Anglican, Methodist, United Reformed and Baptist Churches hoped to move from an "inspection" towards an "audit" system of reviewing theological training institutions. They have had only limited success. This paper explores the nature of the "formation" the churches are seeking in candidates for their public representative ministries. It suggests that there is a need for theological educators and trainers to produce benchmark statements to stand alongside the already published criteria. In the light of both, reviewers and inspectors may assess the validity of institutional and student performance. The article illustrates the challenge of ministerial formation with reference to critical audiences in the church and academic context, and in the public arena. [ABSTRACT FROM AUTHOR]

The study examined student evaluations (N = 221) of frequency and impact of negative interpersonal behaviors by academic faculty and other students. As expected, negative behaviors by faculty was rated as less frequent but as more upsetting than those carried out by fellow students. The impact of such behaviors was not affected by the setting in which they occurred. However, students with a strong power motivation perceived negative behaviors by faculty as more upsetting than did students with a weak power motivation. The findings highlight the importance of covert restrictions on the exploitation of the potential power intrinsic in paternalistic relationships. [ABSTRACT FROM AUTHOR]

Background: To assess the time-efficiency of a designated operating room (OR) workflow in the introduction of femtosecond laser-assisted cataract surgery (FLACS, LenSx, Alcon®). The study was carried out in a public hospital a with high-volume of procedures., Methods: We performed this prospective, controlled, surgical intervention study in the ophthalmology department of a Spanish tertiary referral public hospital. A total of 167 eyes were enrolled, including 62 eyes undergoing conventional phacoemulsification surgery. In phase I, patients were assigned either to FLACS-I (n=63) or conventional phacoemulsification surgery (n=62). One surgeon operated the femtosecond laser, and another completed the procedure, while a third performed conventional phacoemulsification. In the second phase (FLACS-II), all the surgeries were FLACS (n=42). One surgeon performed the FLACS procedure, and two different surgeons completed the surgeries in separate ORs. Surgical and turnover times of all the patients were recorded., Results: Preparation time was statistically significantly lower in FLACS-I and FLACS-II (P<0.001), whereas the duration of the cataract procedure per se was higher in FLACS-II compared to conventional phacoemulsification (P=0.03). Phacoemulsification energy was higher in FLACS-II compared to FLACS-I (P=0.01), whereas laser-related surgical time was lower (P=0.001). Surgical complications and total surgical time showed no statistically significant differences between any of the three groups., Conclusions: This study suggests a time-efficient and suitable workflow model for FLACS, considering the specific requirements and restrictions of a fully booked public hospital. Even so, we have shown that the FLACS procedure does not take longer than conventional phacoemulsification when following a detailed plan for OR workflow. In addition, our data reflect an improvement in FLACS surgical times with ongoing experience., Trial Registration: NCT03931629 (retrospectively registered)., (Copyright © 2021. Published by Elsevier Masson SAS.)

Alcohol use is a persisting social and health problem in Spain that often takes place within the recreational context. This study aims to analyze objective and self-reported measures of alcohol use and to assess the potential role of social factors on alcohol intake in open-air public settings. A total of 1475 participants (47.4% women), including 27.8% adolescents organized into 355 natural groups of friends, were interviewed while they were socializing at night in the streets of Palma (Spain). Breath alcohol concentration (BrAC), self-reported measures of alcohol use, and social variables were assessed. Men showed statistically higher scores in BrAC than women. However, adolescents' Alcohol Use Disorders Identification Test (AUDIT) scores were not statistically different by gender. Correlation between objective and self-reported measures was low. Interestingly, BrAC of drinkers was lower when some friends in the group were sober. Moreover, especially in young adults, variables related to the social environment were statistically significant factors to predict BrAC. In conclusion, we found a high prevalence of alcohol intake in young people in open-air public settings, low relationship of objective and self-reported measures, and social factors linked to alcohol use, although differences by age and gender must be considered.