bluuebunny/crossref_metadata_2025 huggingface dataset:
Research progress on friction and wear properties of powder metallurgy brake pad
Authors: Yu Chunyu , Chen Jiawei , Zhang Qinghai , Li Weipu
Published: December 2022

The terrain of China is relatively complex, which leads to the complex and changeable working conditions of high-speed trains during braking. Studying the influence under different braking conditions on the performance of train brake pads is a problem worthy of in-depth discussion. In order to explore the performance changes of powder metallurgy brake pads during train braking, this paper summarizes the friction and wear properties and wear mechanism of powder metallurgy brake pads under different braking conditions; combined with the research status of powder metallurgy brake pad materials, it provides directions for the research of new powder metallurgy materials. Provide reference for the improvement of brake pads of high-speed train in the future.
Identification of potential biomarkers and immune infiltration in pediatric sepsis via multiple-microarray analysis
Authors: Yao Yinhui , Zhao Jingyi , Hu Junhui , Song Hong , Wang Sizhu , Ying Wang
Published: December 2022

Immune adjustment has become a sepsis occurring in the development of an important mechanism that cannot be ignored. This article from the perspective of immune infiltration of pediatric sepsis screening markers, and promote the understanding of disease mechanisms. Bioinformatics integrated six data sets of pediatric sepsis by using the surrogate variable analysis package and then analyzed differentially expressed genes (DEGs), immune infiltration and weighted gene co-expression network analysis of characteristics (WGCNA) of immune infiltration between pediatric sepsis and the control. Common genes of WGCNA and DEGs were used to functional annotation, pathway enrichment analysis and protein-protein interaction network. Support vector machine (SVM), least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to confirm the key genes for the diagnosis of pediatric sepsis. Receiver operating characteristic (ROC) curve, C index, principal component analysis (PCA) and GiViTi calibration band were used to evaluate the diagnostic performance of key genes. Decision curve analysis (DCA) was used to evaluate the clinical application value of key genes. Lastly, the correlation between key genes and immune cells was analyze. NK cells Resting and NK cell activated in pediatric sepsis during immune infiltration were significantly lower than those in the control group, while M1 Macrophages were higher than those in the control group. ROC, C-index, PCA, GiViTi calibration band and DCA indicated that MCEMP1, CD177, MMP8 and OLFM4 had high diagnostic performance for pediatric sepsis. There is a negative correlation between 4 key genes and NK cells resting, NK cells activated. Except for MCEMP1, the other 3 genes were positively correlated with M1 Macrophages. This study revealed differences in immune responses in pediatric sepsis and identified four key genes as potential biomarkers. Pediatric sepsis in pathology maybe understood better by learning about how it develops.
Mortality risk prediction with ILD-GAP index in a fibrotic hypersensitivity pneumonitis cohort
Authors: Mendonça Almeida Leonor , Fernandes Ana Luísa , Gouveia Cardoso Catarina , Lima Bruno , Neves Inês , Novais-Bastos Hélder , Caetano Mota Patrícia , Melo Natália , Souto Moura Conceição , Guimarães Susana , Carvalho André , Cunha Rui , Pereira José Miguel , Morais António
Published: December 2022

Background:

Fibrotic hypersensitivity pneumonitis (fHP) is associated with significant morbidity and mortality. Interstitial lung disease–gender-age-physiology (ILD-GAP) performance in fHP outside the initial cohort was never performed.

Aim:

To assess the ILD-GAP index’s ability to predict mortality in a Portuguese cohort of patients with fHP and analyse whether other clinical variables add value.

Methods:

Retrospective analysis of fHP cohort in two Portuguese ILD centres. The baseline ILD-GAP index was calculated. Survival was analysed in months; mortality was the primary outcome. Univariate and multivariate analyses to identify mortality risk factors were performed.

Results:

A total of 141 patients were included. Fifty-three patients (37.6%) died during the follow-up. The usual interstitial pneumonia (UIP) pattern was found in 49.6%, and their survival was inferior to non-UIP [32 months (interquartile range, IQR = 19, 60) versus 52 months (IQR = 28, 98), p = 0.048]. Patients with an ILD-GAP index higher than three double their risk of mortality [hazard ratio (HR) = 6.48, 95% confidence interval (CI) = (3.03–13.96)] when compared with the patients with an index between 2 and 3 [HR = 3.04, 95% CI = (1.62–5.71)] adjusting for acute exacerbation history. Even though UIP patients had worse survival, it did not reach statistical significance when UIP pattern was added to this model. Acute exacerbation history was an independent risk factor for mortality; however, ILD-GAP still predicted mortality after adjusting for this factor. PaO2 and 6-minute walk test desaturation were not significant risk factors.

Conclusion:

ILD-GAP index is a good predictor for mortality in fHP, even after adjusting for other mortality risk factors.
Impact of recurrent hospitalization for Clostridioides difficile on longitudinal outcomes in patients with inflammatory bowel diseases: a nationally representative cohort
Authors: Venkat Preethi G. , Nguyen Nghia H. , Luo Jiyu , Qian Alexander S. , Khanna Sahil , Singh Siddharth
Published: December 2022

Background:

Clostridioides difficile infection (CDI) is associated with poor outcomes in patients with inflammatory bowel diseases (IBD).

Objectives:

We conducted a nationally representative cohort study to evaluate the impact of recurrent CDI (rCDI)-related hospitalization on longitudinal unplanned healthcare utilization in patients with IBD.

Design:

This was a retrospective cohort study that utilized the 2017 Nationwide Readmissions Database (NRD).

Methods:

We identified 13,446 patients with IBD, hospitalized at least twice from January to June 2017 and followed through December 2017; of these, 1,148 had CDI-related hospitalizations. We compared the annual burden of hospitalization and IBD-related surgery in IBD patients with rCDI-related admission versus single CDI-related admission (primary reference), and those with one or more CDI-related admission versus no CDI-related admission (secondary reference).

Results:

There were no significant differences in risk and burden of unplanned healthcare utilization (time spent in-hospital, 27 days versus 27 days, p = 0.62), 6-month readmission (63% versus 64.3%, p = 0.8) or IBD-related surgery in patients with recurrent (two or more) CDI-related hospitalizations versus single CDI-related admission. However, patients with ⩾1 CDI-related admission versus no CDI admissions experienced higher rate of 6-month readmission (61.1% versus 55.7%, p<.001), total days spent in the hospital per year (median: 26 days versus 21 days, p<.001), total cost across all hospitalizations per year ($212,524 versus $184,384, p < 0.01), and inpatient mortality (3.28% versus 1.81%, p = 0.01), without an increase in risk of IBD-related surgery (6.7% versus 6.4%, p = 0.79).

Conclusion:

While patients with IBD hospitalized for CDI have poor longitudinal inpatient outcomes, recurrent admissions for CDI may not increase risk of adverse outcomes compared to one-time admission.
The N-brace trial: Does arm position during immobilisation of proximal humerus fractures influence outcome - A preliminary study
Authors: Gokaraju Kishan , Ahrens Philip , Boileau Pascal , Baring Tobias
Published: December 2022

Background

Traditional initial management of proximal humerus fractures (PHF) involves arm immobilisation in a simple sling (SS) in an internally rotated position. We believe this risks fracture displacement and imbalance of soft tissues, encouraging malunion and stiffness. A neutral-rotation brace (NRB) maintains an arm position which may prevent this, leading to quicker and superior recovery.

Methods

We randomised patients with two- to four-part PHF into 4 weeks of immobilisation with either a SS or NRB, independent of surgery. Range of motion (ROM), subjective shoulder value (SSV), DASH, Constant–Murley (CMS) and Oxford Shoulder (OSS) scores were assessed at 6-weeks, 3-months and 1-year post-injury.

Results

The SS group included 11 patients vs 9 in the NRB group. At final follow-up, the SS and NRB groups had mean DASH scores of 42 vs 35, OSS 42 vs 46, CMS 71 vs 86, SSV 84% vs 92%, respectively. ROM was superior with the NRB (elevation 159°, ER 47° and IR score 8 vs 140°, 37° and 7 with SS).

Conclusions

Despite being a small series, our results demonstrate a trend towards NRB providing better outcomes. This feasibility study supports the need for a larger multi-centre randomised controlled trial comparing these immobilisation methods for PHF.
Quasi-civilian defence minister and civilian authority: The case study of Indonesia's Ministry of Defence during Joko Widodo’s presidency
Authors: Haripin Muhamad , Priamarizki Adhi , Nugroho Sigit S.
Published: December 2022

The President of the Republic of Indonesia, Joko Widodo, appointed two former military generals, Ryamizard Ryacudu (2014–2019) and Prabowo Subianto (2019–present), for the first- and second-term defence minister positions consecutively. The appointment of military officers – either retired or active – as defence ministers has been perceived as a recipe for potential democratic setbacks. Current studies on the quasi-civilian defence minister mainly focused on explaining the logic behind such appointments. On the other hand, our study attempts to test the argument about whether the decision to select former military figures to lead the Ministry of Defence undermines civilian control. This article examines: (1) the institutional arrangement of the defence establishment; (2) the composition of the Indonesian Ministry of Defence's leadership structure; and (3) the leadership activities and key initiatives. The findings are that military officers have indeed dominated the ministry's organisational structure. Nevertheless, such domination did not automatically translate into the deterioration of civilian supremacy as the institutional arrangement limits those quasi-civilian defence ministers’ manoeuvres.
Alzheimer Disease Biomarkers in Clinical Practice: A Blood-Based Diagnostic Revolution
Authors: Paczynski Madeline M. , Day Gregory S.
Published: December 2022

An estimated 6.1 million Americans live with cognitive impairment—a number that is expected to triple by 2050. Alzheimer disease (AD) is the most common cause of impairment. The development of blood-based biomarkers capable of detecting pathological changes of AD in living patients has the potential to revolutionize the diagnostic approach to cognitive impairment by enabling screening for AD using accessible, non-invasive measures of amyloid and tau neuropathology, with accuracy that increasingly approaches that seen with “gold standard” positron emission tomography and cerebrospinal fluid measures. Demand for biomarker testing is expected to intensify with the emergence of effective treatments for AD and related dementias. Clinicians in all fields must prepare to meet this demand. Primary care practitioners are well positioned to support dementia diagnosis and management, including the application and interpretation of biomarkers. This article reviews the current uses of AD biomarkers and the potential applications of emerging blood-based AD biomarkers in clinical practice.
Social Determinants of Health and Hypertension Control in Adults with Medicaid
Authors: Sonnenblick Ross , Reilly Alexa , Roye Karina , McCurley Jessica L. , Levy Douglas E. , Fung Vicki , McGovern Sydney Howard , Clark Cheryl R. , Thorndike Anne N.
Published: December 2022

Background:

Social determinants of health (SDOH) are associated with cardiovascular disease, but little is known about mechanisms underlying those relationships. We hypothesized that SDOH would be associated with uncontrolled hypertension (HTN) in adults with Medicaid.

Methods:

This was a retrospective analysis of adults in a Medicaid accountable care organization who had HTN diagnoses, received regular care at community health centers, and enrolled in a cohort study between December 2019 and December 2020. Baseline surveys collected demographics and SDOH, including food insecurity, unstable housing, cost-related medication underuse, and financial stress. Blood pressure (BP) measurements over 12 months after survey completion were obtained from the electronic health record. Participants were categorized as: uncontrolled HTN (mean systolic BP ≥ 140 mm Hg and/or mean diastolic BP ≥ 90 mm Hg), controlled HTN, or unknown HTN control (no BP documented). We examined the association of individual and cumulative (count, 0-4) SDOH with uncontrolled HTN and unknown HTN control using multivariable logistic regression adjusting for demographics, smoking, diabetes, and HTN medication.

Results:

Participants (n = 245) were mean (SD) age 51.3 (8.6) years, 66.1% female, 43.7% Hispanic, 34.3% White, and 18.0% Black. Overall, 58.0% had food insecurity, 38.0% had unstable housing, 29.4% had financial stress, and 20.0% reported cost-related medication underuse. BP was documented for 180 participants; 44 (24.4%) had uncontrolled HTN. In multivariable models, neither individual nor cumulative SDOH were associated with uncontrolled HTN or unknown HTN control.

Conclusions:

In a Medicaid-insured population receiving care at community health centers, adverse SDOH were prevalent but were not associated with HTN control.
Patient Safety Culture: The Impact on Workplace Violence and Health Worker Burnout
Authors: Kim Sinhye , Kitzmiller Rebecca , Baernholdt Marianne , Lynn Mary R. , Jones Cheryl B.
Published: December 2022

Background:

Patient and health care worker safety is an interconnected phenomenon. To date, few studies have examined the relationship between patient and worker safety, specifically with respect to work safety culture. Therefore, we examined patient safety culture, workplace violence (WPV), and burnout in health care workers to identify whether patient safety culture factors influence worker burnout and WPV.

Methods:

This cross-sectional study used secondary survey data sent to approximately 7,100 health care workers at a large academic medical center in the United States. Instruments included the Hospital Survey on Patient Safety Culture, a WPV scale measuring physical and verbal violence perpetrated by patients or visitors, and the Emotional Exhaustion scale from the Maslach Burnout Inventory.

Findings:

These analyses included 3,312 (47%) hospital staff who directly interacted with patients. Over half of nurse (62%), physician (53%), and allied health professional respondents (52%) reported experiencing verbal violence from a patient, and 39% of nurses and 14% of physicians reported experiencing physical violence from a patient. Burnout levels for nurses (2.67 ± 1.02) and physicians (2.65 ± 0.93) were higher than the overall average for all staff (2.61 ± 1.0). Higher levels of worker-reported patient safety culture were associated with lower odds of WPV (0.47) and lower burnout scores among workers ( B = −1.02). Teamwork across units, handoffs, and transitions were dimensions of patient safety culture that also influenced WPV and burnout.

Conclusions/Application to Practice:

Our findings suggest that improvements in hospital strategies aimed at patient safety culture, including team cohesion with handoffs and transitions, could positively influence a reduction in WPV and burnout among health care workers.
The Importance of Independent Empirical Evidence and Why We Disagree With Multmeier et al. (2021)
Authors: Brand Sebastian , Jungmann Stefanie M. , Kolb Johanna , Witthöft Michael
Published: December 2022

For the first time, Jungmann et al. (2020) showed in a randomized controlled trial that using a health app to request health-related information can lead to similar negative emotional and behavioral effects as searching online for health-related information. In 2021, Multmeier and colleagues published a Letter to the Editor referring to these findings. In our response, we critically evaluate their major comments and ask for empirical evidence supporting their claims. We provide an outlook on how we envision the scientific discourse regarding the findings and why further peer-reviewed (at best, open science oriented) publications are essential.
Reflections on the Personality and Psychopathology Interface in Honor of Scott O. Lilienfeld: Toward Illuminating the Nature of the Processes Underlying Personality Disturbances
Authors: Lenzenweger Mark F. , Patrick Christopher J. , Watts Ashley L. , Latzman Robert D. , Depue Richard A.
Published: December 2022

Scott O. Lilienfeld maintained an intense and probing interest in the interface of personality and psychopathology. He was especially intrigued by the personality systems subserving the clinical construct/disorder of psychopathy. Each of us knew Lilienfeld at various junctures in his academic career, and here we celebrate his scientific interest in this substantive area of clinical psychological science. We share our intellectual and theoretical forays in the challenging terrain of the personality–psychopathology interface through brief overviews of our respective contributions and models on this topic. We share our perspectives, which at times are overlapping and at times divergent, with reference to the corpus of published work that each of us has produced through our respective research programs. We invite the reader to sample our different perspectives, to engage with this fascinating area, and, in doing so, to implicitly embrace Lilienfeld’s scientific passion for this developing area of personality and psychopathology science.
Book review: Shekhar Pathak, The Chipko Movement: A People’s History
Authors: Singh Pushpa
Published: December 2022

Shekhar Pathak, The Chipko Movement: A People’s History. India: Permanent Black. 2021. 371 pages. ₹895. ISBN: 9788178245553.
Institutional ‘Presence’ and the Indian State: The Long Narrative
Authors: Roy Anupama
Published: December 2022

The long durée narrative of the state in independent India is one of accumulation of incremental and aggregate power relations arrayed in and through political institutions inhabiting a field of power. These relationships are protean, exhibiting conflicts and contestations among institutions that compete for power within the domain of the state. The ‘ebbs’ and ‘flows’ in power are visible in the state-space represented by institutional arrangements and the patterns of relationship among them. While institutions perform the function of legitimation for the state, they also manifest the crisis that besets the state, reflecting dissonance between its moral–political goals of bringing about socio-economic transformation and its ability to achieve them through ‘state-bureaucratic’ practices. The constitutional state in India can be seen as the setting where the state-idea as limited by law and as an ‘instrument’ for bringing about transformative change was situated. Institutional crises during the emergency and the uneven trajectories of institutional presence in the ensuing period show the marginalization of institutions such as Parliament and the ambivalence of the judiciary in articulating the principles underlying the constitutional consensus. A dominative presence of the executive corroding deliberative spaces making them sites of adversarial combat and the populist appeal of the ‘leader’ drawing upon communitarian emotions has paved the way for a majoritarian state.
Scheduled, Simultaneous Dosing of Pregabalin, Celecoxib, and Acetaminophen Markedly Reduces or Eliminates Opioid Use After ACL Reconstruction Using Allograft or Hamstring Tendon Autograft: A Randomized Clinical Trial
Authors: Swenson Jeffrey D. , Conrad Kevin M. , Pace Nathan L. , Phillips Kathleen , Saltzman Charles L.
Published: December 2022

Background:

Opioid analgesics continue to be prescribed after ambulatory surgery despite untoward adverse effects, risk of overdose, and association with substance use disorder.

Purpose/Hypothesis:

The purpose was to investigate the use of a novel system to provide scheduled and simultaneous dosing of acetaminophen, celecoxib, and pregabalin after anterior cruciate ligament reconstruction (ACLR). It was hypothesized that this system would markedly reduce pain and opioid use compared with existing best practice.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

Included were 100 patients scheduled for elective, primary ACLR using allograft or hamstring tendon autograft. Selection criteria included age between 18 and 65 years and weight between 65 and 120 kg. Exclusion criteria were a known allergy to any drug used in the study or the use of opioid analgesics before surgery. Patients in the intervention group received a blister pack with scheduled, simultaneous doses of acetaminophen, celecoxib, and pregabalin; patients were also given oxycodone 5 mg as needed for breakthrough pain. Patients in the control group were prescribed ibuprofen and oxycodone 5 mg/acetaminophen 325 mg as needed for pain. The primary outcome measure was pain. Secondary outcomes were nausea, itching, and daily oxycodone use. Patients were asked to quantify their average pain at rest, nausea, and itching on an 11-point verbal scale (from 0 to 10). These data were recorded for 6 days during daily telephone contacts with patients after hospital discharge.

Results:

Cumulative results for 6 days showed significantly lower values in the intervention group compared with the control group for pain (median [interquartile range], 28 [14-35] vs 35 [28-41], respectively; P = .009) and oxycodone use (median [interquartile range] number of tablets, 0 [0-2] vs 8 [1.25-16], respectively; P < .001). Based on these data, the upper tolerance limits for the number of oxycodone tablets required by 90% of patients in the intervention and control groups were 8 tablets and 30 tablets, respectively. Cumulative results for nausea and itching were also significantly lower for the intervention group. Most patients in the intervention group used no opioids during recovery.

Conclusion:

Simultaneous dosing of 3 nonopioid analgesics resulted in reduced postoperative pain and markedly lower opioid use.

Registration:

NCT04015908 ( ClinicalTrials.gov identifier).
Establishment of Reference Values for Early Auditory Preverbal Skills of Children with Cochlear Implants
Authors: Yidi Liu , Yue Long , Xinyu Wang , Jiaying Hu , Xin Ni , Haihong Liu
Published: December 2022

Auditory and verbal abilities of children with early cochlear implant (CI) surgery usually take some time to develop, and a reference index of early development for horizontal comparisons is urgently needed to guide the mapping process and adjust rehabilitation programs. Therefore, the aim of this study was to establish a reference value for early auditory preverbal skills development in children with CI and investigate the developmental curve and influencing factors for these children. The LittlEARS® Auditory Questionnaire (LEAQ) scores of 287 eligible Chinese participants were obtained at 1, 2, 3, 6, 9, 12, 18, 24, 28, and 36 months interval after CI activation. The median and standard deviation of the LEAQ score of each hearing stage for these children with different activation ages were calculated to establish the reference values. Quadratic regression was conducted to fit the expected developmental curve of the LEAQ score ([Formula: see text] [0 to 20 months]). With a linear mixed-effects model, we found that the receptive auditory behavior increased rapidly after CI activation, while expressive language skills developed at a steady rate. We also found that the following factors all significantly influenced the LEAQ: the duration of CI use, the development quotient, age of implantation and activation, and the presence of large vestibular aqueduct syndrome or auditory neuropathy spectrum disorder. The reference values and the expected developmental curve for the LEAQ in children with CI established by the present study provides guidance to clinicians and parents as well as realistic expectations regarding language and speech outcomes.
The Resident VIEW in Community-Based Care Residential Settings
Authors: White Diana L. , Tunalilar Ozcan , Hasworth Serena , Winfree Jaclyn
Published: December 2022

The Resident VIEW is a measure of person-centered care (PCC) from residents’ perspectives and was previously studied in nursing homes. The current study presents descriptive data for the Resident VIEW in community-based care settings including assisted living, residential care (AL/RC), and adult foster homes (AFH). Using a two-stage sampling design, we recruited 31 AL/RC and 119 AFH in Oregon and completed face-to-face structured interviews with 227 and 195 residents, respectively. Residents provided ratings for both the importance of and their experience with 66 items that tapped into PCC practices in eight domains. Results are provided for each item, many of which are significantly associated with greater quality of life, better resident satisfaction, and fewer depressive symptoms, especially in the domains of personalized care and being treated like a person. Incongruence between importance and experience ratings indicate many residents experience unmet needs across multiple domains. The Resident VIEW performed well in different types of settings, providing an important tool for researchers and providers who wish to learn about the PCC experience from residents’ points of view.
Developing the Breast Utility Instrument to Measure Health-Related Quality-of-Life Preferences in Patients with Breast Cancer: Selecting the Item for Each Dimension
Authors: Tsui Teresa C. O. , Trudeau Maureen E. , Mitsakakis Nicholas , Krahn Murray D. , Davis Aileen M.
Published: December 2022

Introduction. Generic preference-based instruments inadequately measure breast cancer (BrC) health-related quality-of-life preferences given advances in therapy. Our overall purpose is to develop the Breast Utility Instrument (BUI), a BrC-specific preference-based instrument. This study describes the selection of the BUI items. Methods. A total of 408 patients from diverse BrC health states completed the EORTC QLQ-C30 and BR45 (breast module). For each of 10 dimensions previously assessed with confirmatory factor analysis, we evaluated data fit to the Rasch model based on global model and item fit, including threshold ordering, item residuals, infit and outfit, differential item functioning (age), and unidimensionality. Misfitting items were removed iteratively, and the model fit was reassessed. From items fitting the Rasch model, we selected 1 item per dimension based on high patient- and clinician-rated item importance, breadth of item thresholds, and clinical relevance. Results. Global model fit was good in 7 and borderline in 3 dimensions. Separation index was acceptable in 4 dimensions. Item selection criteria were maximized for the following items: 1) physical functioning (trouble taking a long walk), 2) emotional functioning (worry), 3) social functioning (interfering with social activities), 4) pain (having pain), 5) fatigue (tired), 6) body image (dissatisfied with your body), 7) systemic therapy side effects (hair loss), 8) sexual functioning (interest in sex), 9) breast symptoms (oversensitive breast), and 10) endocrine therapy symptoms (problems with your joints). Conclusions. We propose 10 items for the BUI. Our next steps include assessing the measurement properties prior to eliciting preference weights of the BUI.

Highlights

A previous confirmatory factor analysis established 10 dimensions of the European Organisation for Research and Treatment of Cancer (EORTC) core quality of life questionnaire (QLQ-C30) and its breast module (BR45). In this study, we selected 1 item per dimension based on fit to the Rasch model, patient- and clinician-rated item importance, breadth of item thresholds, and clinical relevance. These items form the core of the future Breast Utility Instrument (BUI). The future BUI will be a novel breast cancer–specific preference-based instrument that potentially will better reflect women’s preferences in clinical decision making and cost utility analyses.
Deploying geospatial visualization dashboards to combat the socioeconomic impacts of COVID-19
Authors: Praharaj Sarbeswar , Solis Patricia , Wentz Elizabeth A
Published: December 2022

COVID-19 dashboards with geospatial data visualization have become ubiquitous. There is a growing sense of responsibility to report public health data pushing governments and community organizations to develop and share web-based dashboards. While a substantial body of literature exists on how these GIS technologies and urban analytics approaches support COVID-19 monitoring, their level of social embeddedness, quality and accessibility of user interface, and overall decision-making capabilities has not been rigorously assessed. In this paper, we survey 68 public web-based COVID-19 dashboards using a nominal group technique to find that most dashboards report a wealth of epidemiologic data at the state and county levels. However, these dashboards have limited emphasis on providing granular data (city and neighborhood level) broken down by population sub-groups. We found severe inadequacy in reporting social, behavioral, and economic indicators that shape the trajectory of the pandemic and vice versa. Our survey reveals that most COVID-19 dashboards ignore the provision of metadata, data download options, and narratives around visualizations explaining the data’s background, source, and purpose. Based on these lessons, we illustrate an empirical experiment of building a dashboard prototype—the COVID-19 Economic Resilience Dashboard in Arizona. Our dashboard project demonstrates a model that can inform decision-making (beyond plain information sharing) while being accessible by design. To achieve this, we provide localized data, drill-down options by geography and sub-population, visualization narratives, open access to the data source, and accessible features on the interface. We exhibited the value of linking pandemic-related information with socioeconomic data. Our findings suggest a pathway forward for researchers and governments to incorporate more action-oriented data and easy-to-use interfaces as they refine existing and develop new information systems and data analytics dashboards.
Distal Biceps Repair: 2-Volar Incision Technique for Acute and Chronic Retracted Tears
Authors: Singh Suvleen K. , Pike J. Mattison , Bennfors Grace , Welsh Megan E. , Friedman Richard J. , Eichinger Josef K.
Published: December 2022

Background:

A distal biceps repair is performed after a rupture of the distal biceps tendon, an injury that typically affects the dominant arm of middle-aged men, resulting in weakness in supination and elbow flexion. A volar 2-incision technique minimizes skin incision length while optimizing exposure to anatomical structures through proper incision placement for acute repair and chronic reconstruction with graft.

Indications:

Retraction of the distal biceps away from its insertion on the proximal radius in the chronic setting can require a more extensile incision. Two transverse incisions are strategically placed on either side of the antecubital fossa to optimize exposure of the radial insertion site and proximally to retrieve the retracted tendon for either acute or chronic retracted distal biceps tears with or without graft reconstruction.

Technique Description:

A transverse incision is made in the forearm directly over the radial tuberosity. This facilitates direct exposure and drilling of a socket for placement of the distal biceps’ tendon with suture button and interference screw construct. A second proximal transverse incision is made to identify and retrieve the retracted tendon. The tendon is retrieved and prepared or reconstructed with graft for chronic cases with suture. The tendon and graft are tunneled under the skin bridge between the 2 incisions. The sutures are then loaded onto a titanium button, which is deployed onto the far cortex. The tendon is advanced into the tunnel, an interference screw is placed, and the sutures are tied.

Results:

Restoration of anatomy and correct placement of the 2 incisions is facilitated with this approach, restoring distal biceps function without requiring extensile volar exposure of the entirety of the length of the distal biceps tendon.

Discussion/Conclusion:

This technique mitigates the need for extensive dissection. It also facilitates improved visualization of relevant structures for cases with substantial tendon retraction, even in the case of chronic retracted tears requiring allograft reconstruction. The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Stable and durable factor IX levels in patients with hemophilia B over 3 years after etranacogene dezaparvovec gene therapy
Authors: von Drygalski Annette , Gomez Esteban , Giermasz Adam , Castaman Giancarlo , Key Nigel S. , Lattimore Susan U. , Leebeek Frank W. G. , Miesbach Wolfgang A. , Recht Michael , Gut Robert , Dolmetsch Ricardo , Monahan Paul E. , Le Quellec Sandra , Pipe Steven W.
Published: December 2022

Etranacogene dezaparvovec (AMT-061) is a recombinant adeno-associated virus serotype 5 (AAV5) vector containing a codon-optimized Padua variant human factor IX (FIX) transgene with a liver-specific promoter. Here, we report 3-year outcomes from a phase 2b, open-label, single-dose, single-arm, multicenter trial conducted among adults with severe or moderately severe hemophilia B (FIX ≤2%). All participants (n = 3) received a single intravenous dose (2 × 1013 gene copies per kg) and will be followed up for 5 years. The primary end point of FIX activity ≥5% at 6 weeks was met. Secondary end points included bleed frequency, FIX concentrate use, joint health, and adverse events (AEs). All participants required routine FIX prophylaxis and had neutralizing antibodies to AAV5 before etranacogene dezaparvovec treatment. After administration, FIX activity rose to a mean of 40.8% in year 1 and was sustained in year 3 at 36.9%. All participants discontinued FIX prophylaxis. Bleeding was completely eliminated in 2 out of 3 participants. One participant required on-demand FIX replacement therapy per protocol because of elective surgical procedures, for 2 reported bleeding episodes, and twice for a single self-administered infusion because of an unreported reason. One participant experienced 2 mild, self-limiting AEs shortly after dosing. During the 3-year study period, there were no clinically significant elevations in liver enzymes, no requirement for steroids, no FIX inhibitor development, and no late-emergent safety events in any participant. Etranacogene dezaparvovec was safe and effective in adults with hemophilia B over 3 years after administration. This trial was registered at www.clinicaltrials.gov as #NCT03489291.
Selecting initial therapy in CLL
Authors: Ahn Inhye E. , Brown Jennifer R.
Published: December 2022

Targeted therapy is a powerful treatment option in chronic lymphocytic leukemia (CLL) that has outperformed conventional chemoimmunotherapy in most clinical settings. Except for selected young, fit patients with a mutated immunoglobulin heavy chain variable region gene, most patients benefit from targeted therapy with either a continuous BTK inhibitor or 1-year fixed-duration venetoclax-obinutuzumab as first-line treatment of CLL. Treatment selection is driven by patient-, treatment-, and disease-related factors, encompassing patient preference, concomitant medications, comorbidities, safety profile of the regimen, and TP53 aberration. Clinical trials are actively investigating the simultaneous inhibition of Bruton’s tyrosine kinase (BTK) and B-cell lymphoma 2 (BCL-2) proteins with or without a CD20 monoclonal antibody, which can achieve deep response in most patients (52%-89% undetectable minimal residual disease in bone marrow).
Fitness and frailty in myeloma
Authors: Pawlyn Charlotte , Khan Abdullah M. , Freeman Ciara L.
Published: December 2022

As the aging population grows, so too does the number of well-tolerated antimyeloma therapies. Physicians will see an increasing volume of patients for subsequent lines of therapy, which could now extend this relationship for over a decade. For younger patients, treatment choices are infrequently impacted by concerns of fitness, but instead about effecting the deepest, most durable response. Older adults, in contrast, are more likely to experience under- than overtreatment, and therefore more objective (and ideally straightforward) ways to evaluate their fitness and ability to tolerate therapy will increasingly assist in decision-making. Post hoc analyses categorizing the fitness of trial patients in the modern treatment era globally demonstrate that even in highly selected populations, those that are recategorized as less fit or frail are consistently at higher risk of inferior outcomes and increased toxicities. Real-world data are comparatively lacking but do demonstrate that most patients with myeloma are not representative of those enrolled on clinical trials, generally more heavily burdened by comorbidities and more likely to be categorized as “less than fit.” Simultaneously, the number of therapeutic options open to patients in the relapsed setting continues to grow, now including T-cell engagers and cellular therapies, with their unique toxicity profiles. The aim of this review is to summarize the available data, highlight some of the approaches possible to easily assess fitness and how results might inform treatment selection, and illustrate ways that patients' condition can be optimized rather than lead to exclusion from the more complex therapies newly available.
Approach to the patient with suspected hypereosinophilic syndrome
Authors: Klion Amy D.
Published: December 2022

Hypereosinophilic syndromes (HES) are a heterogenous group of rare disorders with clinical manifestations ranging from fatigue to life-threatening endomyocardial fibrosis and thromboembolic events. Given the broad differential diagnosis of HES, a comprehensive approach is needed to identify potential secondary (treatable) causes and define end-organ manifestations. Classification by clinical HES subtype is also useful in terms of assessing prognosis and guiding therapy. Corticosteroids remain the mainstay of initial therapy in the setting of acute, life-threatening PDGFR mutation-negative HES. Whereas the recent availability of eosinophil-targeted therapies with extraordinary efficacy and little apparent toxicity is changing the treatment paradigm, especially for idiopathic HES and overlap syndromes, questions remain unanswered regarding the choice of agent, impact of combination therapies, and long-term effects of eosinophil depletion. This review provides a case-based discussion of the differential diagnosis of HES, including the classification by clinical HES subtype. Treatment options are reviewed, including novel eosinophil-targeted agents recently approved for the treatment of HES and/or other eosinophil-associated disorders. Primary (myeloid) disorders associated with hypereosinophilia are not be addressed in depth in this review.
Roles of real-world evidence in severe asthma treatment: challenges and opportunities
Authors: Lee Youngsoo , Lee Ji-Hyang , Park So Young , Lee Ji-Ho , Kim Joo-Hee , Kim Hyun Jung , Kim Sang-Heon , Chung Kian Fan , Song Woo-Jung
Published: December 2022

Recent advances in asthma research have led to the development of novel biologicals that hinder the pathological actions of key molecules in severe asthma. Traditional randomised controlled studies (RCTs), the gold standard for evaluating the efficacy and safety of medical interventions with excellent internal validity, have proven the clinical benefits and favourable safety profiles of type 2 biologicals in severe asthma. However, RCTs are not always ideal because of shortcomings such as limited external validity and practical issues in the management of severe asthma that cannot be solved through strictly designed clinical trials. Thus, the applicability of their findings may be questioned because treatment adherence is frequently poor in the real world. Real-world evidence includes a wide range of real-world data (RWD) collected from multiple sources in clinical practice, such as electronic medical records, healthcare insurance claims and retrospective or prospective patient registries. RWD may help clinicians decide how to manage patients with severe asthma. Real-world evidence is also gaining attention in addressing clinical questions not answered by traditional RCTs. Because there are various types of RWD with different possibilities and limitations, it is important to decide which type of RWD could be “fit for purpose” to address a specific question. This narrative review discusses the challenges and opportunities of RWD for evaluating the effectiveness and clinical outcomes of biological treatments for severe asthma.
At-home noninvasive ventilation initiation with telemonitoring in amyotrophic lateral sclerosis patients: a retrospective study
Authors: Réginault Thomas , Bouteleux Benoit , Wibart Philippe , Mathis Stéphane , Le Masson Gwendal , Pillet Odile , Grassion Léo
Published: December 2022

Background

Noninvasive ventilation (NIV) improves survival and quality of life in amyotrophic lateral sclerosis (ALS) patients. NIV initiation is mostly conducted at hospital, but a recurrent lack of hospital beds led to the necessity of exploring an at-home initiation process. Here, we report data from our NIV initiation cohort of ALS patients. Could our at-home NIV initiation process with telemonitoring in ALS patients be an efficient solution for adherence and nocturnal hypoxaemia correction?

Methods

We performed a retrospective analysis of data collected from 265 ALS patients treated at the Bordeaux ALS Centre for whom NIV initiation was carried out between September 2017 and June 2021, with two modalities: at-home initiation or in-hospital initiation. The primary outcome was adherence to NIV at 30 days. The secondary outcome was at-home NIV initiation process efficiency of nocturnal hypoxaemia correction.

Results

At 30 days, NIV adherence (mean >4 h·day−1) was 66% of the total population, 70% of the at-home NIV initiation subgroup and 52% of the in-hospital NIV initiation subgroup. Nocturnal hypoxaemia correction was observed in 79% of adherent patients in the at-home NIV initiation subgroup. Mean delay of NIV prescription and at-home NIV initiation was 8.7 days (+/−6.5)versus29.5 days in hospital.

Conclusion

Our study shows that our at-home NIV initiation process in ALS patients is a good option to provide rapid access to NIV with good adherence and efficiency. Further literature on the benefits of at-home NIV initiation is welcomed, especially to evaluate long-term efficiency and global cost analysis.
A Poisson reduced-rank regression model for association mapping in sequencing data
Authors: Fitzgerald Tiana , Jones Andrew , Engelhardt Barbara E.
Published: December 2022

Background

Single-cell RNA-sequencing (scRNA-seq) technologies allow for the study of gene expression in individual cells. Often, it is of interest to understand how transcriptional activity is associated with cell-specific covariates, such as cell type, genotype, or measures of cell health. Traditional approaches for this type of association mapping assume independence between the outcome variables (or genes), and perform a separate regression for each. However, these methods are computationally costly and ignore the substantial correlation structure of gene expression. Furthermore, count-based scRNA-seq data pose challenges for traditional models based on Gaussian assumptions.

Results

We aim to resolve these issues by developing a reduced-rank regression model that identifies low-dimensional linear associations between a large number of cell-specific covariates and high-dimensional gene expression readouts. Our probabilistic model uses a Poisson likelihood in order to account for the unique structure of scRNA-seq counts. We demonstrate the performance of our model using simulations, and we apply our model to a scRNA-seq dataset, a spatial gene expression dataset, and a bulk RNA-seq dataset to show its behavior in three distinct analyses.

Conclusion

We show that our statistical modeling approach, which is based on reduced-rank regression, captures associations between gene expression and cell- and sample-specific covariates by leveraging low-dimensional representations of transcriptional states.
Pattern recognition of topologically associating domains using deep learning
Authors: Yang Jhen Yuan , Chang Jia-Ming
Published: December 2022

Background

Recent increasing evidence indicates that three-dimensional chromosome structure plays an important role in genomic function. Topologically associating domains (TADs) are self-interacting regions that have been shown to be a chromosomal structural unit. During evolution, these are conserved based on checking synteny block cross species. Are there common TAD patterns across species or cell lines?

Results

To address the above question, we propose a novel task—TAD recognition—as opposed to traditional TAD identification. Specifically, we treat Hi-C maps as images, thus re-casting TAD recognition as image pattern recognition, for which we use a convolutional neural network and a residual neural network. In addition, we propose an elegant way to generate non-TAD data for binary classification. We demonstrate deep learning performance which is quite promising, AUC > 0.80, through cross-species and cell-type validation.

Conclusions

TADs have been shown to be conserved during evolution. Interestingly, our results confirm that the TAD recognition model is practical across species, which indicates that TADs between human and mouse show common patterns from an image classification point of view. Our approach could be a new way to identify TAD variations or patterns among Hi-C maps. For example, TADs of two Hi-C maps are conserved if the two classification models are exchangeable.