The correlation between conspiracy mentality and vaccine intentions is moderated by social events: Evidence from longitudinal data during COVID-19 pandemic in the UK

Social events may provide important cues that influence the sense of reality, including the perception that conspiracy theories are plausible. Using longitudinal panel data collected in the UK from March 2020 to December 2021, this study aims to identify whether social events influenced the strength of the association between conspiracy mentality and vaccine intentions during the COVID-19 pandemic. Consistent with previous research, the conspiracy mentality was a significant predictor of vaccine intentions across three-time points, but also that conspiracy mentality measured in March 2020 predicted that participants were more hesitant to the vaccines in December 2020. The primary finding was that different social events moderated the strength of the correlation between conspiracy mentality and vaccine intentions within similar participants. Conspiracy mentality became more vital to evaluate COVID-19 vaccines in December 2020, when the vaccination program was about to commence.

Diagnostic utility of prolonged ambulatory video-electroencephalography monitoring

OBJECTIVES

Ambulatory video-electroencephalography (video-EEG) represents a low-cost, convenient and accessible alternative to inpatient video-EEG monitoring, however few studies have examined their diagnostic yield. In this large-scale retrospective study conducted in Australia, we evaluated the efficacy of prolonged ambulatory video-EEG recordings in capturing diagnostic events and resolving the referring question.

METHODS

Sequential adult and paediatric ambulatory video-EEG reports from April 2020 to June 2021 were reviewed retrospectively. Data collection included patient demographics, clinical information, and details of events and EEG abnormalities. Clinical utility was assessed by examining i) time to first diagnostic event, and ii) ability to resolve the referring questions - seizure localisation, quantification, classification, and differentiation (differentiating seizures from non-epileptic events).

RESULTS

Of the 600 reports analysed, 49 % captured at least one event, and 45 % captured interictal abnormalities (epileptiform or non-epileptiform). Seizures, probable psychogenic events (mostly non-convulsive), and other non-epileptic events occurred in 13 %, 23 % and 21 % of recordings respectively, with overlap. Unreported events were captured in 53 (9 %) recordings, and unreported seizures represented more than half of all seizures captured (51 %, 392/773). Nine percent of events were missing clinical, video or electrographic data. A diagnostic event occurred in 244 (41 %) recordings, of which 14 % were captured between the fifth and eighth day of recording. Reported event frequency ≥ 1/week was the only significant predictor of diagnostic event capture. In recordings with both seizures and psychogenic events, unrecognized seizures were frequent, and seizures may be missed if recording is terminated early. The referring question was resolved in 85 % of reports with at least one event, and 53 % of all reports. Specifically, this represented 46 % of reports (235/512) for differentiation of events, and 75 % of reports (27/36) for classification of seizures.

CONCLUSION

Ambulatory video-EEG recordings are of high diagnostic value in capturing clinically relevant events and resolving the referring clinical questions.

OPTImized coronary interventions eXplaIn the bEst cliNical outcomEs (OPTI-XIENCE) study. Rationale and study design

INTRODUCTION

Clinical events may occur after percutaneous coronary intervention (PCI), particularly in complex lesions and complex patients. The optimization of PCI result, using pressure guidewire and intracoronary imaging techniques, may reduce the risk of these events. The hypothesis of the present study is that the clinical outcome of patients with indication of PCI and coronary stent implantation that are at high risk of events can be improved with an unrestricted use of intracoronary tools that allow PCI optimization.

METHODS AND ANALYSIS

Observational prospective multicenter international study, with a follow-up of 12 months, including 1064 patients treated with a cobalt‑chromium everolimus-eluting stent. Inclusion criteria include any of the following: Lesion length > 28 mm; Reference vessel diameter < 2.5 mm or > 4.25 mm; Chronic total occlusion; Bifurcation with side branch ≥2.0 mm;Ostial lesion; Left main lesion; In-stent restenosis; >2 lesions stented in the same vessel; Treatment of >2 vessels; Acute myocardial infarction; Renal insufficiency; Left ventricular ejection fraction <30 %; Staged procedure. The control group will be comprised by a similar number of matched patients included in the "extended risk" cohort of the XIENCE V USA study. The primary endpoint will be the 1-year rate of target lesion failure (TLF) (composite of ischemia-driven TLR, myocardial infarction (MI) related to the target vessel, or cardiac death related to the target vessel). Secondary endpoints will include overall mortality, cardiovascular mortality, acute myocardial infarction, TVR, TLR, target vessel failure, and definitive or probable stent thrombosis at 1 year.

IMPLICATIONS

The ongoing OPTI-XIENCE study will contribute to the growing evidence supporting the use of intra-coronary imaging techniques for stent optimization in patients with complex coronary lesions.

Spatiotemporal characteristics of the neural representation of event concepts

Events are a fundamentally important part of our understanding of the world. How lexical concepts denoting events are represented in the brain remains controversial. We conducted two experiments using event and object nouns matched on a range of psycholinguistic variables, including concreteness, to examine spatial and temporal characteristics of event concepts. Both experiments used magnitude and valence tasks on event and object nouns. The fMRI experiment revealed a distributed set of regions for events, including the angular gyrus, anterior temporal lobe, and posterior cingulate across tasks. In the EEG experiment, events and objects differed in amplitude within the 300-500 ms window. Together these results shed light into the spatiotemporal characteristics of event concept representation and show that event concepts are represented in the putative hubs of the semantic system. While these hubs are typically associated with object semantics, they also represent events, and have a likely role in temporal integration.

High blood pressure with elevated resting heart rate: a high risk "Sympathetic" clinical phenotype

Epidemiological studies have unequivocally shown that elevated heart rate values measured at rest have an adverse prognostic impact in the hypertensive patient, being associated with an increased risk of cardiovascular events and complications. In recent years new data have been collected on this issue, strengthening the clinical relevance of elevated heart rate as a specific hypertensive phenotype. The present paper will review old and new data on the prognostic importance of resting tachycardia in the hypertensive patient. It will also examine the role of the sympathetic nervous system in the development of this alteration as well as its therapeutic implications. The different approaches to dynamically assess heart rate values in the clinical setting will be finally discussed.

Benchmarking of medication incidents reporting and medication error rates in a JCI accredited university teaching hospital at a GCC country

Introduction

The benchmarking for medication incidents rate is not regarded as a recognized key performance measure or indicator in national or international organizations. The absence of benchmarking the medication incidents results in the loss of a self-governing perception of how well we performed compared to other peers.

Methodology and settings

This 600-bed tertiary, Joint Commission International (JCI) accredited hospital retrospective analysis looked at all medication management-related events from January-2018 to December-2021. The study design follows descriptive, cross-sectional, retrospective prevalence research.

Results

The rate of medication incidents that resulted in harm declined from Q3-2019 to Q4-2021. A significant increase in Pharmacy interventions/clarifications was recorded. Additionally, a significant increase in incidents reported with no-harm coupled with a significant reduction in incidences of serious events from 2019 to 2020. Finally, no-harm events were significantly reduced from 2020 to 2021.

Discussion

The Pharmacy's study analyzed every medication incident documented from 2019 to 2021. 99.7% of reported incidents were classified as no-harm (near misses). There was an exponential decrease from Q1-2020 to Q1-202. A significant increase in incidents fell in the category of (near misses) with no-harm and a significant reduction in serious events. Pharmacy interventions/clarifications saw a massive increase and impact from Q3-2018 to Q2-2019, compared to the same period in 2018. By preventing medical incidents, benchmarking, and analyzing incidents and the reporting system, the use of information technology could dramatically reduce the rate of drug incidents.

Conclusion

This study found that benchmarking medication incidents is valuable, as it can help identify areas where improvements can be made, implement strategies to improve safety, and track progress over time. The benchmark was recommended to be below 100 incidents for every 10,000 prescriptions/orders processed, and for E-I categories, below one incident for every 10,000 prescriptions/orders processed. This will help develop a worldwide standard with an absolved culture with non-punitive consequences.

Paediatric harmful adverse drug events (PHADE)

Background and Objectives

It is well established that adverse drug events are frequent in paediatric hospital practice. The objective of this study is to systematically quantify and report the incidence of harmful adverse drug events across our institution and to identify predominant medications and error types.

Methods

We prospectively compiled a validated medication safety database for paediatric inpatients within our institution over a three-and-a-half-year period. All incidences of apparent patient harm relating to medication error were investigated and analyzed to determine veracity, severity of harm, phase of medication process, error type, causative medication, and contributory factors enabling each event.

Results

We identified 59 harmful adverse drug events, with an overall rate of 15.5 per 105 patient bed days. Most events occurred during administration (n = 27) and prescribing (n = 26) phases. Almost half of all harm (49%) was associated with opioids; a broad range of medication classes accounted for other harm. Harmful events occurred in 7.3 per 105 administrations of morphine and 13.3 per 105 administrations of hydromorphone. Wrong dose was the most frequently encountered error type.

Conclusions

This is the first study to quantify harmful adverse drug events in paediatric hospital practice. Our prospective analysis and compilation of harmful medication errors in paediatric hospital practice, reported with denominators of opioid administrations, and patient bed days, is a new standard for comparison in the long-discussed problem of paediatric harmful adverse drug events. By focusing on identified problematic drugs, error types, and contributory factors, we identify opportunities for interventions, error prevention and harm reduction.

National Joint Registry recorded untoward intraoperative events during primary total hip arthroplasty: an investigation into the data accuracy, causal mechanisms and attributability

INTRODUCTION

Untoward intraoperative events occurring during total hip arthroplasty are recorded by the National Joint Registry through Minimum Data Set (MDS) forms. This data may be used to assess the safety of implants. The aim of this study is to evaluate the accuracy of the untoward intraoperative events, assess the mechanism and ascertain whether these events were attributable to the implants inserted.

METHODS

A retrospective analysis was undertaken of primary total hip arthroplasties performed between 2005 and 2018 in which an untoward intraoperative event was recorded.

RESULTS

Of 12,802 primary hip replacements, 64 patients (0.5%) had untoward intraoperative events recorded on the MDS form. In 43 of 64 cases, the intraoperative untoward event recorded on the MDS form matched the operation notes. Among these 43 cases, in 30 (69%) patients the intraoperative event could be attributed to the implant recorded. In the remaining 13 (31%) cases, the events recorded could not be attributed to the implant. In six cases, the untoward events were attributed to implants used to manage the events rather than the implants which caused them. In seven cases, the untoward events were related to surgical technique rather than to the implant or instrumentation.

CONCLUSIONS

Our analysis highlights that all untoward intraoperative events recorded on the NJR form are not implant related or attributable to the implant inserted. Provision should be made on the MDS form to clarify whether a particular untoward intraoperative event was related to the implant inserted.

Fatty liver index and cardiovascular outcomes in never-treated hypertensive patients: a prospective cohort

The prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing rapidly worldwide, affecting 25-30% of the population. Fatty liver index (FLI) is a validated marker of NAFLD and can be used as a screening tool for hepatic steatosis. The purpose of the study was to evaluate the relationship between FLI and the risk of major cardiovascular events in never treated hypertensive patients. We included 903 hypertensive patients without a history of cardiovascular disease (mean age 52.7 ± 11.4 years; men 55%; baseline clinic BP 149.8 ± 15.2/95.5 ± 10.1 mmHg). Participants were prospectively evaluated for a mean follow-up period of 5.2 ± 3.2 years with at least one annual visit. Patients were also categorized into two groups using an FLI of 60 units. The incidence of cardiovascular events during follow-up was 8.5% (n = 77). Patients with FLI < 60 (n = 625) had a better BP control compared to their counterparts with FLI ≥ 60 (n = 278) during follow up (43% vs 33%, p = 0.02). Cox-regression analysis indicated that FLI (Hazard Ratio [HR], 1.05; 95% Confidence Interval [CI], 1.03-1.07, p < 0.001), FLI z-scores (HR, 3.66; 95% CI, 2.22-6.04) and high-risk FLI (HR, 7.5; 95% CI, 3.12-18.04) were independent determinants of the outcome after adjustment for baseline and follow-up variables. Stratification by diabetes mellitus indicated that FLI predicted the outcome to a greater extent in those with than those without diabetes (P-interaction < 0.001). In conclusion, FLI has an independent prognostic value for the incidence of cardiovascular events in newly diagnosed, never-treated hypertensive patients. Therefore, FLI might identify higher-risk patients in the primary prevention of hypertension.

Knowledge of the temporal structure of events in relation to autistic traits and social ability

Event knowledge, a person's understanding of patterns of activities in the world, is crucial for everyday social interactions. Social communication differences are prominent in autism, which may be related to atypical event knowledge, such as atypical knowledge of the sequences of activities that comprise the temporal structure of events. Previous research has found that autistic individuals have atypical event knowledge, but research in this area is minimal, particularly regarding autistic individuals' knowledge of the temporal structure of events. Furthermore, no studies have investigated the link between event knowledge and autistic traits in a non-clinical sample. We investigated relationships between event knowledge and autistic traits in individuals from the general population with varying degrees of autistic traits. We predicted that atypical ordering of event activities is related to autistic traits, particularly social communication abilities, but not other clinical traits. In Study 1, atypical ordering of event activities correlated with social ability, but not with most measures of repetitive behaviours and restricted interests. In Study 2, the typicality of activity ordering varied by participants' social ability and the social nature of the events. Relationships were not found between event activity ordering and other clinical traits. These findings suggest a relationship between autistic traits, specifically social abilities, and knowledge of the temporal structure of events in a general population sample.

Network Science-based Urban Forecast Dashboard

The urban environment is a highly dynamic and complex system. Urban dynamics in this complex system is largely reflected by the movement of people to and from Places of Interest (POIs) in the urban area. To better understand and plan for the city's various scenarios, there is a need to forecast urban dynamic conditions in terms of the possible movements of people across POIs. However, such predictions are not easy because an interdependent and living system is hard to forecast. In addition, the commuting and shopping of individuals in urban environments will show distinct patterns at various stages of disasters as compared to normal situations. This paper presents a network science-based urban forecast dashboard, in order to monitor urban events and identify the interdependencies that characterize urban dynamics. Behind the dashboard is a deep learning model that incorporates the network dynamics between POIs. The dashboard powers the prediction of urban dynamics from a network science perspective. This research calls for a unified framework to model the flow and network in the city. The dashboard visualizes how network science and urban science can mutually benefit from each other.

Environmental noise reduction for tunable resistive pulse sensing of extracellular vesicles

Extracellular vesicles (EVs) bearing biomolecules from parental cells can represent a novel source of disease biomarkers and are under intensive study for their clinical potential. Tunable resistive pulse sensing (TRPS) quantifies the magnitude of a small ionic resistive pulse current to determine the size, concentration, and zeta potential of EVs. Environmental noise is a common limiting factor that affects the precision of sensing devices. TRPS is particularly vulnerable to environmental noise, including both mechanical and electrical. The upper detection limit of the TRPS relies on the physical size of the elastomeric tunable nanopore. The lower limit relies on the electrical signal-to-noise ratio. Guided by simulation, we designed an external device to suppress environmental noise for TRPS measurement. Both mechanical and electrical environmental noise reductions were observed after using the shield. The study also validated the noise reduction function of the shield by quantifying EVs from different cell origins. Detection of EVs smaller than 200 nm was improved by using the shield; which was reported challenging for conventional quantification methods. The study highlighted a feasible approach to solve environmental noise challenges for TRPS based EV quantification.

BOLD cofluctuation 'events' are predicted from static functional connectivity

Recent work identified single time points ("events") of high regional cofluctuation in functional Magnetic Resonance Imaging (fMRI) which contain more large-scale brain network information than other, low cofluctuation time points. This suggested that events might be a discrete, temporally sparse signal which drives functional connectivity (FC) over the timeseries. However, a different, not yet explored possibility is that network information differences between time points are driven by sampling variability on a constant, static, noisy signal. Using a combination of real and simulated data, we examined the relationship between cofluctuation and network structure and asked if this relationship was unique, or if it could arise from sampling variability alone. First, we show that events are not discrete - there is a gradually increasing relationship between network structure and cofluctuation; ∼50% of samples show very strong network structure. Second, using simulations we show that this relationship is predicted from sampling variability on static FC. Finally, we show that randomly selected points can capture network structure about as well as events, largely because of their temporal spacing. Together, these results suggest that, while events exhibit particularly strong representations of static FC, there is little evidence that events are unique timepoints that drive FC structure. Instead, a parsimonious explanation for the data is that events arise from a single static, but noisy, FC structure.

The wide variety of reasons for feeling guilty in adults: findings from a large cross-sectional web-based survey

BACKGROUND

Experiencing some sort of guilt is a common phenomenon in adulthood. As feeling guilty is usually unpleasant and may even lead to further negative psychological consequences like depression, the aim of this study was to provide comprehensive information on the reasons for such feelings in adults.

METHODS

A cross-sectional web-based survey was conducted between May 2019 and April 2020, collecting qualitative information on reasons for feeling guilty in n = 604 adults (mean/SD age = 45.3/16.4 years; n = 346/57.3% women, n = 255/42.2% men and n = 3/0.5% adults without identification with a particular gender). Stated reasons were inductively classified into (super-)/categories, and information on frequency and percentage (total, gender- and age-specific) for each of these (super-)/categories was provided.

RESULTS

Participants altogether stated 1515 reasons for feeling guilty that were classified into 12 supercategories and 49 categories. "Telling lies/withholding truth/information" followed by "Not spending (enough) time with family (members)/Not taking (enough) care of family (members)/not being there for family (members)" were the most frequent categories of reasons for feeling guilty in the sample. Guilt feelings explicitly referring to "religious beliefs" or a "subjectively perceived more general responsibility'" (e.g., for society, humankind, problems of the world), by contrast, were of minor importance. Male and female participants as well as participants of different ages showed similarities but also several differences in stated reasons for feeling guilty. Female participants, for example, more often experienced feelings of guilt related to family members, children and to some kind of general responsibility for the wellbeing of others, whereas male participants felt guilty more often because of some kind of misconduct/mistakes being made or because of difficulties in marriage/relationship.

CONCLUSIONS

Adults can feel guilty for a wide variety of different reasons. Most reasons seem to be rather concrete (e.g., related to concrete negative self-attributions/flaws or to concrete social situations with concrete individuals). There also seem to be some age- and gender-related differences in reasons for feeling guilty.

Automatic gait event detection in pathologic gait using an auto-selection approach among concurrent methods

BACKGROUND

Accurate gait event detection is crucial to analyze pathological gait data. Existing methods relying on marker trajectories were reported to be sensitive to different gait patterns, which is an inherent characteristic of pathologic gait.

RESEARCH QUESTION

We propose a new approach based on auto-selection among different methods, original and taken from the literature.

METHODS

The auto-selection approach evaluates the accuracy of the implemented methods for both foot-strike and foot-off on all available events detected by the force platforms, independently, and automatically selects the most accurate one to be used on the whole gait session. Pathological gait data from 272 patients with cerebral palsy and idiopathic toe walking were used retrospectively to evaluate the accuracy of this approach. Three methods previously reported in literature together with original methods developed based on auto-correlation were implemented and constituted our auto-selection approach. The accuracy and precision were compared to a recently reported method based on deep events as it is the method that showed the best performance in literature.

RESULTS

Results showed that the proposed approach outperformed all implemented methods used alone, with an accuracy of - 2.0 ms and - 0.9 ms for foot strike and foot-off, respectively. Additionally, more than 99% and 93% of events detected were detected within 20 ms and 10 ms of accuracy, respectively.

SIGNIFICANCE

The proposed methodology has demonstrated to improve the accuracy and precision of gait event detection in gait analysis.

Perceived importance of pandemic interventions for attending cultural events - findings from Germany

BACKGROUND

During the first waves of the COVID-19 pandemic, many cultural and sporting events were held without spectators or had to be cancelled. Therefore, several containment strategies to provide requirements for safe events were developed and tested. Nonetheless, every second (50.7%) is afraid of becoming infected on an event. We therefore investigated which hygiene and containment measures are perceived to be important from the visitor's point of view and thus might increase subjective sense of safety.

METHODS

This online study was carried out in November 2020. A total of 1,004 persons, who regularly attended events before the pandemic, took part in the study. The importance of different hygiene and containment measures was evaluated using a 5-point Likert-scale (1 "unimportant" to 5 "extremely important"). Potential statistical differences in socio-demographical aspects (age, gender, net disposable income for leisure activities) and attendance on events were tested with analyses of variance.

RESULTS

Participants perceived the use of disinfectant (M = 4.10) as the most important element of containment strategies, followed by transparent information on the hygiene strategy (M = 4.00), reduced occupancy (M = 3.98), and optimized ventilation (M = 3.97). Body temperature measurement at the entrance (M = 3.27), a negative SARS-CoV-2 test (M = 3.11), completion of a health questionnaire (M = 3.05), and abandoning breaks and catering (M = 2.98) were considered as less important. Analyses of group differences in socio-demographical aspects found abandoning breaks and catering to be more important to men than to women. This strategy is also more important to people aged 66 and above than to younger age groups (e.g., age 20-40). For women, the use of disinfectant is considerably more important. No other significant differences exist.

CONCLUSION

Combining relevant measures appears to be important to provide a safe containment strategy. Measures aimed at positively influencing people's sense of safety do not fully correspond to researched knowledge of effectiveness. There are also target group-specific differences in the rating of measures, which should be considered while preparing containment strategies. To describe the dynamic development of changes in subjective rating of containment strategies, continuing research is needed.

Capturing the nature of events and event context using hierarchical event descriptors (HED)

Event-related data analysis plays a central role in EEG and MEG (MEEG) and other neuroimaging modalities including fMRI. Choices about which events to report and how to annotate their full natures significantly influence the value, reliability, and reproducibility of neuroimaging datasets for further analysis and meta- or mega-analysis. A powerful annotation strategy using the new third-generation formulation of the Hierarchical Event Descriptors (HED) framework and tools (hedtags.org) combines robust event description with details of experiment design and metadata in a human-readable as well as machine-actionable form, making event annotation relevant to the full range of neuroimaging and other time series data. This paper considers the event design and annotation process using as a case study the well-known multi-subject, multimodal dataset of Wakeman and Henson made available by its authors as a Brain Imaging Data Structure (BIDS) dataset (bids.neuroimaging.io). We propose a set of best practices and guidelines for event annotation integrated in a natural way into the BIDS metadata file architecture, examine the impact of event design decisions, and provide a working example of organizing events in MEEG and other neuroimaging data. We demonstrate how annotations using HED can document events occurring during neuroimaging experiments as well as their interrelationships, providing machine-actionable annotation enabling automated within- and across-experiment analysis and comparisons. We discuss the evolution of HED software tools and have made available an accompanying HED-annotated BIDS-formated edition of the MEEG data of the Wakeman and Henson dataset (openneuro.org, ds003645).

Factors which predict adverse events following surgery in adults with cervical spinal deformity

AIMS

The aim of this study was to identify the risk factors for adverse events following the surgical correction of cervical spinal deformities in adults.

METHODS

We identified adult patients who underwent corrective cervical spinal surgery between 1 January 2007 and 31 December 2015 from the MarketScan database. The baseline comorbidities and characteristics of the operation were recorded. Adverse events were defined as the development of a complication, an unanticipated deleterious postoperative event, or further surgery. Patients aged < 18 years and those with a previous history of tumour or trauma were excluded from the study.

RESULTS

A total of 13,549 adults in the database underwent primary corrective surgery for a cervical spinal deformity during the study period. A total of 3,785 (27.9%) had a complication within 90 days of the procedure, and 3,893 (28.7%) required further surgery within two years. In multivariate analysis, male sex (odds ratio (OR) 0.90 (95% confidence interval (CI) 0.8 to 0.9); p = 0.019) and a posterior approach (compared with a combined surgical approach, OR 0.66 (95% CI 0.5 to 0.8); p < 0.001) significantly decreased the risk of complications. Osteoporosis (OR 1.41 (95% CI 1.3 to 1.6); p < 0.001), dyspnoea (OR 1.48 (95% CI 1.3 to 1.6); p < 0.001), cerebrovascular accident (OR 1.81 (95% CI 1.6 to 2.0); p < 0.001), a posterior approach (compared with an anterior approach, OR 1.23 (95% CI 1.1 to 1.4); p < 0.001), and the use of bone morphogenic protein (BMP) (OR 1.22 (95% CI 1.1 to 1.4); p = 0.003) significantly increased the risks of 90-day complications. In multivariate regression analysis, preoperative dyspnoea (OR 1.50 (95% CI 1.3 to 1.7); p < 0.001), a posterior approach (compared with an anterior approach, OR 2.80 (95% CI 2.4 to 3.2; p < 0.001), and postoperative dysphagia (OR 2.50 (95% CI 1.8 to 3.4); p < 0.001) were associated with a significantly increased risk of further surgery two years postoperatively. A posterior approach (compared with a combined approach, OR 0.32 (95% CI 0.3 to 0.4); p < 0.001), the use of BMP (OR 0.48 (95% CI 0.4 to 0.5); p < 0.001) were associated with a significantly decreased risk of further surgery at this time.

CONCLUSION

The surgical approach and intraoperative use of BMP strongly influence the risk of further surgery, whereas the comorbidity burden and the characteristics of the operation influence the rates of early complications in adult patients undergoing corrective cervical spinal surgery. These data may aid surgeons in patient selection and surgical planning. Cite this article: Bone Joint J 2021;103-B(4):734-738.

[COVID-19, routine dynamics and reflexivity of structure. On the eventful change of Fridays for Future's protest forms]

This contribution focuses on the dis/continuity of routines at the onset of the COVID-19 pandemic. The pandemic is conceived as a nexus of multiple, intertwined crises of action and interaction (ÖZS special issue 2016, 41/1). Instead of understanding crisis as an external facticity, i.e., external cause of change, we argue that actors negotiate crisis in sociomaterial processes within historically specific contexts. Taking up the debate in organizational studies on the conception and description of intentional change, this article adds a reflection on intentional routine changes in times of crises. In methodological terms, the article connects routine dynamics with the perspective of eventful sociology. Eventful sociology emphasizes that sociomaterial negotiations of routines can unfold to more far-reaching structural changes and therefore calls for a rigorous temporal description along paths. Based on the results of a process-oriented ethnographic study of Fridays for Future Vienna, the article identifies two conditional moments (normative-discursive and material-bodily) through which structure is made reflexive. Finally, the pursued understanding of reflexivity is embedded in the debate on the (world)risk society.

Increasing anaphylaxis events in Western Australia identified using four linked administrative datasets

Background

Anaphylaxis events are increasing worldwide, based on studies of single administrative datasets including hospital admissions, emergency room presentations, and prescription and medical claims data. Linking multiple administrative datasets may provide better epidemiological estimates, by capturing a greater number of anaphylaxis events occurring at the individual level. In this linked data study in Western Australia, we combined 4 population-based datasets to identify anaphylaxis events, factors influencing occurrence, and change in event rates from 2002 to 2013.

Methods

Four linked administrative datasets from the Western Australian Data Linkage System were used, representing ambulance attendances, emergency department presentations, hospital inpatient admissions and death registrations. An anaphylaxis cohort was identified using ICD-9-CM, ICD-10-AM and additional anaphylaxis diagnosis codes, with event rates calculated. We explored the impact of age, gender, cause, Indigenous status and socioeconomic index on event rates. Standard Poisson regression models were used to examine the significance of the change in anaphylaxis event rates over time.

Results

A total 12,637 individuals (mean age 31.8 years, 49.6% female) experienced 15,462 anaphylaxis events between 2002 and 2013 (97.5% in non-Indigenous patients and 59.5% residing in the area of greatest socioeconomic advantage). Anaphylaxis event rates increased from 15.4 to 82.5/10⁵ population between 2002 and 2013. The greatest increase in anaphylaxis events was seen in those coded as unspecified anaphylaxis (all ages, males and females combined, p < 0.001), with the highest rates of unspecified anaphylaxis in males 0–4 years (171.9/10⁵ population in 2013), and females 15–19 years (104.0/10⁵ in 2013). The average annual percent increase (95% CI) for food-related anaphylaxis was 9.2% (6.6–12.0); for medication-related anaphylaxis was 5.8% (4.5–7.1); and for unspecified anaphylaxis was 10.4% (9.8–11.0); all p < 0.001. There was a significant increase in ambulance attendance, emergency presentations and inpatient admissions for anaphylaxis between 2002 and 2013, with emergency presentations (56.0/10⁵ population), inpatient admissions (43.2/10⁵), and ambulance attendance (21.6/10⁵) highest in 2013. Only 25 anaphylaxis-related deaths were recorded in the mortality register with no significant change in rates over time.

Conclusion

Using multiple linked administrative datasets, we identified significantly higher rates of total anaphylaxis than previously reported, with more than 5-fold increases in anaphylaxis events between 2002 and 2013. While the combination of 4 population-level datasets provides a more comprehensive capture of cases, even at the individual dataset level, admission rates for anaphylaxis in Western Australia are substantially higher than those previously reported for similar time periods, both in Australia and worldwide.

Development and validation of a follow-up methodology for a randomised controlled trial, utilising routine clinical data as an alternative to traditional designs: a pilot study to assess the feasibility of use for the BladderPath trial

Background

Bladder cancer outcomes have not changed significantly in 30 years; the BladderPath trial (Image Directed Redesign of Bladder Cancer Treatment Pathway, ISRCTN35296862) proposes to evaluate a modified pathway for diagnosis and treatment ensuring appropriate pathways are undertaken earlier to improve outcomes. We are piloting a novel data collection technique based on routine National Health Service (NHS) data, with no traditional patient-Health Care Professional contact after recruitment, where trial data are traditionally collected on case report forms. Data will be collected from routine administrative sources and validated via data queries to sites. We report here the feasibility and pre-trial methodological development and validation of the schema proposed for BladderPath.

Methods

Locally treated patient cohorts were utilised for routine data validation (hospital interactions data (HID) and administrative radiotherapy department data (RTD)). Single site events of interest were algorithmically extracted from the 2008–2018 HID and validated against reference datasets to determine detection sensitivity. Survival analysis was performed using RTD and HID data. Hazard ratios and survival statistics were calculated estimating treatment effects and further validating and assessing the scope of routine data.

Results

Overall, 829/1042 (sensitivity 0.80) events of interest were identified in the HID, with varying levels of sensitivity; identifying, 202/206 (sensitivity 0.98; PPV 0.96) surgical events but only 391/568 (sensitivity 0.69; PPV 0.95) radiotherapy regimens. An overall temporal quality improvement trend was present: detecting 41/117 events (35%) in 2011 to 104/109 (95%) in 2017 (all event types). Using the RTD, 5-year survival rates were 43% (95% CI 25–59%) in the chemoradiotherapy group and 30% (95% CI 23–36%) in the radiotherapy group; using the HID, the 5-year radical cystectomy survival rate was 57% (95% CI 50–63%).

Conclusions

Routine data are a feasible method for trial data collection. As long as events of interest are pre-validated, very high sensitivities for trial conduct can be achieved and further improved with targeted data queries. Outcomes can also be produced comparable to clinical trial and national dataset results. Given the real-time, obligatory nature of the HID, which forms the Hospital Episode Statistics (HES) data, alongside other datasets, we believe routine data extraction and validation is a robust way of rapidly collecting datasets for trials.

Supplementary Information

Supplementary information accompanies this paper at 10.1186/s40814-020-00713-y.

[Scholia about the pandemia urbi et orbi et orbe generate by de COVID-19 disease.]

The Goddess of Health had two daughters, Panacea and Higinia, the fruit of the first is diagnosis, prognosis and treatment, and the fruit of the second is health management, prevention, and statistics. Humanbeings are unexpectedly subjected to:1. Happenings: they belong to the plane of the personality, crisis, the Age of the virus appears that had already been announced. The ideological support is not sustained, causing a bankruptcy in the system of our life. The subject acts unconsciously, does not believe in the advent of the catastrophe, does not follow logical rules, is unable to transcend, fear-anguish appears and this requires a lot of protection. Those who remain free from personal decomposition skewer him and put a project called "person" with his sense of life, his lifestyle and life project, which is the conjunction of body and spirit, which with the agony struggles against life itself.2. Events: they belong to the plane of nature, catastrophes. The use of the word catastrophe is not synonymou swith unavoidable natural disaster, accident, although it is used by the health authorities this can have a great impact on those affected by the virus. This word has the final nuance of Greek tragedies. False arrogance appears, true madness. In the case of the Covid-19 there is something else, a dialectical position with oneself. They lived and we lived on a volcano. The example of the Apocalypse and its three plagues, epidemics and post-war neuroses, etc. The most striking neuropsychiatricsymptomatology is the appearance of "ageusia" and "anosmia", abruptly and totally, which disappears slowly, as well as sleep disturbances with ignagogic images post-traumatic stress charts appear.

Events, Event Prediction, and Predictive Processing

Events and event prediction are pivotal concepts across much of cognitive science, as demonstrated by the papers in this special issue. We first discuss how the study of events and the predictive processing framework may fruitfully inform each other. We then briefly point to some links to broader philosophical questions about events.