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Commemoration and Bloody Sunday : pathways of memory
\"In this wide-ranging study of the politics of memory in Northern Ireland, Brian Conway examines the 'career' of the commemoration of Bloody Sunday, and looks at how and why the way this historic event is remembered has undergone change over time. Drawing on original empirical data, he provides new insights into the debate on collective memory\"--Provided by publisher.
Book
Land subsidence and earth fissures in south-central and southern Arizona, USA
Land subsidence due to groundwater overdraft has been an ongoing problem in south-central and southern Arizona (USA) since the 1940s. The first earth fissure attributed to excessive groundwater withdrawal was discovered in the early 1950s near Picacho. In some areas of the state, groundwater-level declines of more than 150 m have resulted in extensive land subsidence and earth fissuring. Land subsidence in excess of 5.7 m has been documented in both western metropolitan Phoenix and Eloy. The Arizona Department of Water Resources (ADWR) has been monitoring land subsidence since 2002 using interferometric synthetic aperture radar (InSAR) and since 1998 using a global navigation satellite system (GNSS). The ADWR InSAR program has identified more than 25 individual land subsidence features that cover an area of more than 7,300 km
2
. Using InSAR data in conjunction with groundwater-level datasets, ADWR is able to monitor land subsidence areas as well as identify areas that may require additional monitoring. One area of particular concern is the Willcox groundwater basin in southeastern Arizona, which is the focus of this paper. The area is experiencing rapid groundwater declines, as much as 32.1 m during 2005–2014 (the largest land subsidence rate in Arizona State—up to 12 cm/year), and a large number of earth fissures. The declining groundwater levels in Arizona are a challenge for both future groundwater availability and mitigating land subsidence associated with these declines. ADWR’s InSAR program will continue to be a critical tool for monitoring land subsidence due to excessive groundwater withdrawal.
Journal Article
Synchronization of kinetic and kinematic hand tasks with electrocorticography and cortical stimulation during awake craniotomies
Awake craniotomies provide unique and invaluable scientific opportunities for neurophysiological experimentation in consenting human subjects. While such experimentation carries a long history, rigorous reporting of methodologies focusing on synchronizing data across multiple platforms is not universally reported and often not translatable to across operating rooms, facilities, or behavioral tasks. Therefore, here we detail an intraoperative data synchronization methodology designed to work across multiple commercially available platforms to collect behavioral and surgical field videos, electrocorticography, brain stimulation timing, continuous finger joint angles, and continuous finger force production. Our technique was developed to be nonobstructive to operating room (OR) staff and generalizable to a variety of hand-based tasks. We hope that the detailed reporting of our methods will support the scientific rigor and reproducibility of future studies, as well as aid other groups interested in performing related experiments.
Journal Article
Quantifying Hand Strength and Isometric Pinch Individuation Using a Flexible Pressure Sensor Grid
Modulating force between the thumb and another digit, or isometric pinch individuation, is critical for daily tasks and can be impaired due to central or peripheral nervous system injury. Because surgical and rehabilitative efforts often focus on regaining this dexterous ability, we need to be able to consistently quantify pinch individuation across time and facilities. Currently, a standardized metric for such an assessment does not exist. Therefore, we tested whether we could use a commercially available flexible pressure sensor grid (Tekscan F-Socket [Tekscan Inc., Norwood, MA, USA]) to repeatedly measure isometric pinch individuation and maximum voluntary contraction (MVC) in twenty right-handed healthy volunteers at two visits. We developed a novel equation informed by the prior literature to calculate isometric individuation scores that quantified percentage of force on the grid generated by the indicated digit. MVC intra-class correlation coefficients (ICCs) for the left and right hands were 0.86 (p < 0.0001) and 0.88 (p < 0.0001), respectively, suggesting MVC measurements were consistent over time. However, individuation score ICCs, were poorer (left index ICC 0.41, p = 0.28; right index ICC −0.02, p = 0.51), indicating that this protocol did not provide a sufficiently repeatable individuation assessment. These data support the need to develop novel platforms specifically for repeatable and objective isometric hand dexterity assessments.
Journal Article
Quantitative assessments of finger individuation with an instrumented glove
Background
In clinical and research settings, hand dexterity is often assessed as finger individuation, or the ability to move one finger at a time. Despite its clinical importance, there is currently no standardized, sufficiently sensitive, or fully objective platform for these evaluations.
Methods
Here we developed two novel individuation scores and tested them against a previously developed score using a commercially available instrumented glove and data collected from 20 healthy adults. Participants performed individuation for each finger of each hand as well as whole hand open-close at two study visits separated by several weeks. Using the three individuation scores, intra-class correlation coefficients (ICC) and minimal detectable changes (MDC) were calculated. Individuation scores were further correlated with subjective assessments to assess validity.
Results
We found that each score emphasized different aspects of individuation performance while generating scores on the same scale (0 [poor] to 1 [ideal]). These scores were repeatable, but the quality of the metrics varied by both equation and finger of interest. For example, index finger intra-class correlation coefficients (ICC’s) were 0.90 (< 0.0001), 0.77 (< 0.001), and 0.83 (p < 0.0001), while pinky finger ICC’s were 0.96 (p < 0.0001), 0.88 (p < 0.0001), and 0.81 (p < 0.001) for each score. Similarly, MDCs also varied by both finger and equation. In particular, thumb MDCs were 0.068, 0.14, and 0.045, while index MDCs were 0.041, 0.066, and 0.078. Furthermore, objective measurements correlated with subjective assessments of finger individuation quality for all three equations (ρ = − 0.45, p < 0.0001; ρ = − 0.53, p < 0.0001; ρ = − 0.40, p < 0.0001).
Conclusions
Here we provide a set of normative values for three separate finger individuation scores in healthy adults with a commercially available instrumented glove. Each score emphasizes a different aspect of finger individuation performance and may be more uniquely applicable to certain clinical scenarios. We hope for this platform to be used within and across centers wishing to share objective data in the physiological study of hand dexterity. In sum, this work represents the first healthy participant data set for this platform and may inform future translational applications into motor physiology and rehabilitation labs, orthopedic hand and neurosurgery clinics, and even operating rooms.
Journal Article
Addressing digital exclusion to improve access to HIV and viral hepatitis care for people who experience criminalization: a mixed methods evaluation of a quality improvement project
Background
People who experience criminalization, such as those who use drugs, are incarcerated, and are affected by homelessness, have a high prevalence of HIV and/or hepatitis C virus (HCV) infection and low treatment uptake in British Columbia. Barriers to care include unreliable means of maintaining contact with healthcare providers. To reduce these barriers, the Test, Link, Call (TLC) Project provides cell phones and peer health mentors to support access to HIV and/or HCV care. This study aims to determine the outcomes and acceptability of TLC and its impact on care engagement.
Methods
A mixed-methods evaluation was conducted over the first 29 months (October 2021–March 2024) of the TLC Project. Data were collected concurrently in two rounds: the first after one year and the second two years after launch. Qualitative data were collected using semi-structured interviews conducted with healthcare providers (
n
= 8), peer health mentors (
n
= 6), and program participants (
n
= 20). Quantitative data, including demographic and clinical information, were gathered through program records and cross-sectional clinical chart reviews. Factors associated with HCV treatment uptake were assessed among HCV RNA positive participants (
n
= 245) using multivariate logistic regression. Data from both rounds were integrated for comprehensive analysis.
Results
273 participants were enrolled in HCV care, and 26 in HIV care. Interviewees found TLC highly acceptable and effective. Positive outcomes included increased access to health and social services, connection to loved ones, independence, and safety. Challenges included phone theft and digital literacy issues. Overall, 57% of TLC participants enrolled for HCV care initiated curative treatment, compared to 40% among people who currently inject drugs in the provincial administrative database in 2020. The multivariate logistic regression analysis suggested that gender, housing stability, safer supply prescriptions, and length of involvement in the TLC program are predictive factors influencing treatment initiation.
Conclusions
The provision of cell phones and peer health mentors effectively increased engagement in HIV and HCV care, demonstrating substantial benefits despite some challenges. This cost-effective intervention could be expanded to support people who experience criminalization in other geographic locations and addressing other health conditions, such as syphilis and substance use disorder.
Journal Article
Multidecadal drought impacts on the Lower Colorado Basin with implications for future management
Overallocation of Colorado River water and groundwater alongside multidecadal drought underscore the need to understand water-resource dynamics. Here we assess water-storage variations using satellites, regional modeling, and monitoring to inform future management. Total water storage loss from Gravity Recovery and Climate Experiment (GRACE) satellites was dominated by Lower Basin declines (80% of total), exceeding Lake Mead capacity by 40%. These Lower Basin storage declines were dominated by groundwater depletion (60% of total), with cumulative depletion hotspots ≤11 m (2002–2023) and subsidence ≤1 m (2010–2024). Regional groundwater modeling shows intensive depletion (1940s–1970s) followed by partial recovery since the early 1980s from irrigation reduction, wet climate cycles (early 1980s–1990s), and Colorado River water transfers to Central Arizona. Managed aquifer recharge and incidental recharge from imported surface-water irrigation led to a 3-m average groundwater-level rise in Central Arizona Active Management Areas (2000–2023). Projected declines in Colorado River water transfers to Central Arizona could lead to further depletion and subsidence. Water transfers from agricultural to municipal/industrial sectors would improve future management. Understanding system dynamics related to climate and human drivers is essential for developing future conjunctive surface-water and groundwater management strategies.
Intense droughts and irrigation over the past century in the lower Colorado Basin have driven groundwater depletion and subsidence that has been partially alleviated by transfers from the Colorado River, according to analysis of satellite, groundwater modelling, and monitoring data.
Journal Article
Reported adverse events related to use of hepatitis C virus direct-acting antivirals with opioids: 2017–2021
Introduction
Due to concerns over potential interactions between some hepatitis C direct-acting antivirals (DAAs) and opioids, we describe adverse event (AE) reports of concomitant use of opioids and DAAs.
Methods
AEs reported (July 28, 2017–December 31, 2021) with the administration of the DAAs glecaprevir/pibrentasvir, sofosbuvir/velpatasvir, ledipasvir/sofosbuvir, sofosbuvir/velpatasvir/voxilaprevir, and elbasvir/grazoprevir as suspect products were downloaded from the US Food and Drug Administration AE Reporting System Public Dashboard. The number of AE reports containing opioids (fentanyl, hydrocodone, oxycodone) as co-suspect products/concomitant products were counted and summarized by severity, reporting country and whether an outcome of death was reported. Overdose AEs were counted irrespective of opioid use, and changes over time were assessed.
Results
In total, 40 AEs were reported for DAAs and concomitant fentanyl use, 25 (62.5%) were in the USA, 35 (87.5%) were considered serious, and 14 (35.0%) resulted in death; and 626 were reported with concomitant oxycodone/hydrocodone use, 596 (95.2%) were in the USA, 296 (47.3%) were considered serious, and 28 (4.5%) resulted in death. There were 196 overdose AEs (32 [16%] deaths) declining from 2018 (
N
= 56) to 2021 (
N
= 29).
Conclusions
Treating people with hepatitis C virus (HCV) infection who use drugs is key to achieving HCV elimination. Low numbers of DAA AE reports with opioids may provide reassurance to prioritize HCV treatment in this population. These data contribute to evidence supporting the continued scale-up of DAA treatment among people who use drugs to achieve HCV elimination goals.
Journal Article
A randomized control trial of high-dose micronutrient-antioxidant supplementation in healthy persons with untreated HIV infection
Although micronutrient and antioxidant supplementation are widely used by persons with human immunodeficiency virus (HIV), a therapeutic role beyond recommended daily allowances (RDA) remains unproven. An oral high-dose micronutrient and antioxidant supplement (Treatment) was compared to an RDA supplement (Control) for time to progressive immunodeficiency or initiation of antiretroviral therapy (ART) in people living with HIV (PLWH). This study was a randomized, double-blind, placebo-controlled multicenter clinical trial. PLWH were recruited from Canadian HIV Trials Network sites, and followed quarterly for two years. Eligible participants were asymptomatic, antiretroviral treatment (ART)-naïve, HIV-seropositive adults with a CD4 T lymphocyte count (CD4 count) between 375-750 cells/[mu]L. Participants were randomly allocated 1:1 to receive Treatment or Control supplements. The primary outcome was a composite of time-to-first of confirmed CD4 count below 350 cells/[mu]L, initiation of ART, AIDS-defining illness or death. Primary analysis was by intention-to-treat. Secondary outcomes included CD4 count trajectory from baseline to ART initiation or two years. A Data and Safety Monitoring Board reviewed the study for safety, recruitment and protocol adherence every six months. Of 171 enrolled participants: 66 (38.6%) experienced a primary outcome: 27 reached a CD4 count below 350 cells/[mu]L, and 57 started ART. There was no significant difference in time-to-first outcome between groups (Hazard Ratio = 1.05; 95%CI: 0.65, 1.70), or in time to any component outcome. Using intent-to-treat censoring, mean annualized rates of CD4 count decline were -42.703 cells/[mu]L and -79.763 cells/[mu]L for Treatment and Control groups, with no statistical difference in the mean change between groups (-37.06 cells/[mu]L/52 weeks, 95%CI: (-93.59, 19.47); p = 0.1993). Accrual was stopped at 171 of the 212 intended participants after an interim analysis for futility, although participant follow-up was completed. In ART-naïve PLWH, high-dose antioxidant, micronutrient supplementation compared to RDA supplementation had no significant effect on disease progression or ART initiation.
Journal Article