bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of glucose‐lowering medications for the treatment of type 2 diabetes mellitus during pregnancy in the United States
Authors: Wood Mollie E. , Patorno Elisabetta , Huybrechts Krista F. , Bateman Brian T. , Gray Kathryn J. , Seely Ellen W. , Vine Seanna , Hernández‐Díaz Sonia
Published: December 2021

Introduction

Some guidelines allow for the use of either insulin or noninsulin antidiabetic agents for gestational diabetes, but only insulin is recommended for pregnant women with preexisting type 2 diabetes mellitus (T2DM). We aimed to document treatment patterns in routine care for women with preexisting T2DM.

Methods

We identified pregnancy cohorts within 2 US claims databases for publicly and privately insured individuals: the Medicaid Analytical eXtract (2000–2014) and OptumClinformatics (2004–2014). T2DM was classified with a validated algorithm using ICD‐9‐CM and CPT codes. We assessed medication usage over the years of the study, and changes in medication use before and after the beginning of pregnancy, using prescription fills as a proxy for the use of insulin, metformin, sulphonylureas and other noninsulin antidiabetic agents before pregnancy and during each trimester.

Results

Among 12,631 women with T2DM, insulin use in pregnancy was stable over the study years (55%–60% in the 2nd trimester), but 2nd trimester use of metformin increased from <5% to 20%. Over the study period, 41% of women filled a prescription for metformin before pregnancy, 37% in the 1st trimester and 17% in the 2nd trimester. By the 2nd trimester, few women used sulphonylureas (11%) or other noninsulin antidiabetic agents (1%). Of the women on metformin only before pregnancy, 36% switched to insulin only by 2nd trimester, 11% added insulin and 16% continued on metformin only. Of the women on metformin and insulin before pregnancy, 61% switched to insulin only by 2nd trimester, 22% continued with metformin and insulin and <5% used only metformin.

Conclusion

The use of insulin‐metformin combinations and other noninsulin antidiabetic drugs during pregnancy has increased. Safety studies for these medication regimens are needed.
Heart failure with recovered ejection fraction and the utility of defibrillator therapy: a review
Authors: Devgun Jasneet K. , Kennedy Samuel , Slivnick Jeremy , Garrett Zachary , Dodd Katherine , Derbala Mohamed H. , Ortiz Cristina , Smith Sakima A.
Published: December 2021

Heart failure with recovered ejection fraction (HFrecEF) involves those who have previously had reduced cardiac function that has subsequently improved. However, there is not a single definition of this phenomenon and recovery of cardiac function in terms of left ventricular ejection fraction (LVEF) itself does not necessarily correlate with remission from the detrimental physiology of heart failure (HF) and its consequences. There is also the question of the utility of defibrillators in these patients, and whether they should be replaced at the time of battery depletion. To address this, several studies have shown specific predictors of ensuing LVEF recovery, including patient demographics, co‐morbidities, and medication use, as well as predictors of ventricular arrhythmias (VA) following LVEF recovery. Recent studies have also shown novel imaging parameters that may aid in predicting which patients would have a higher risk of these arrhythmias. Additional data describe a small, yet appreciable risk of VA, in addition to appropriate shocks as well. In this review, we describe predictors of LVEF recovery, carefully analyse and characterize the continued risk for VA and appropriate shocks following LVEF recovery, and explore additional novel modalities that may aid in decision‐making.
Prevalence of food addiction determined by the Yale Food Addiction Scale and associated factors: A systematic review with meta‐analysis
Authors: Praxedes Dafiny R. S. , Silva‐Júnior André E. , Macena Mateus L. , Oliveira Ana Débora , Cardoso Kamyla S. , Nunes Lara O. , Monteiro Maíra B. , Melo Ingrid Sofia V. , Gearhardt Ashley N. , Bueno Nassib Bezerra
Published: December 2021

Objective

To determine, through a systematic review with meta‐analysis, the prevalence of food addiction (FA) using the Yale Food Addiction Scale (YFAS) and its derivatives exploring possible factors associated with the prevalence of FA in several contexts.

Methods

The following databases were searched: MEDLINE, ScienceDirect, LILACS, PsycArticles, CENTRAL, Greylit.org, and OpenGrey.eu. Studies that assessed FA using YFAS were included. Two independent reviewers assessed the eligibility of each report. Random‐effects meta‐analysis was performed to calculate the weighted prevalence of FA. Subgroup analyses and meta‐regression were conducted to explore sources of heterogeneity.

Results

Of the 6425 abstracts reviewed, 272 studies were included. The weighted mean prevalence of FA diagnosis was 20% (95% CI: 18%; 21%). The prevalence of FA was higher in individuals with clinical diagnosis of binge eating (55%; 95% CI 34%; 75%). The prevalence in clinical samples was higher compared to non‐clinical samples. Two studies included children only and no studies included only elderly people.

Conclusions

Food addiction is a topic in which there has been a significant growth in studies. The highest prevalence was found in the group of participants with eating disorders and weight disorders. More studies with children and the elderly are needed.
Transaction search engine of distributed electricity market trading platform based on blockchain technology
Authors: Xie Jingdong , Zhou Xuemei , Wang Shiyao , Sun Xin , Sun Bo
Published: December 2021

Currently, it is difficult for China's electricity trading platform to handle large amounts of data during centralized clearing, achieve cross‐regional sharing of transaction information, and realize the optimized allocation of resources. The previous research has proposed establishing a new distributed electricity market trading platform based on blockchain technology to solve the aforementioned problems; however, transaction nodes on the platform have difficulty determining the final delisting plan in the face of numerous choices. Therefore, in this study, a search engine was designed according to the demands of the delisting node. The developed algorithm is run with a programmed script through a smart contract and can provide the best delisting plan for delisting nodes, ensuring that the delisting plan is selected intelligently and publicly. Overall, seven delisting strategies were designed. Additionally, the improved Critic‐G1 method based on the coefficient of variation was used to establish a smart contract for the comprehensive evaluation of listing nodes. Finally, the example analysis verified that calling the smart contract can help the delisting node quickly obtain the best delisting strategy, increase the enthusiasm of the transaction subject, and facilitate the promotion and application of the transaction platform based on blockchain technology, confirming the effectiveness of the proposed method.
Performance evaluation of flexible CIGS modules based on operational data under outdoor conditions
Authors: Lee Ruda , Lee Hyomun , Kim Dongsu , Yoon Jongho
Published: December 2021

As a major driver to achieve feasible long‐term goals of the Korean Green New Deal policy, a renewable system application in a building, such as the building‐integrated photovoltaics (BIPV) system, has been expedited by raising a BIPV installation subsidy to 70%. Among the technology of BIPV modules, the CuInGaSe2 (CIGS) type module has been drawing attention and considered as one of the effective alternatives because of its benefits, including its flexibility, lightweights, and relative ease to use as a building material. However, the lack of information understanding of its real application to buildings has still existed under various outdoor experimental conditions. In response to this gap, this study analyzed the power generation performance of flexible CIGS modules under outdoor exposure conditions to evaluate their applicability to BIPV buildings. To conduct the test, the CIGS module was installed on an inclined plane (30°) and vertical plane (90°) using a mock‐up installed facing the south. In particular, this study assessed performance ratio (PR) values to analyze the power generation performance behaviors under direct/diffuse irradiance conditions along with diverse cloud cover conditions. Results from this experimental case study indicated that the power generation performance of the vertical CIGS module decreased compared with that of the inclined CIGS module during all analysis periods, except for the February period. This phenomenon became more distinct as the solar altitude angle increased, and the power generation performance of the vertical module became similar to that of the inclined module as the altitude angle decreased. By experimenting with the diffuse irradiance condition depending on the change in cloud cover, the PR decreased by approximately 12%.
Numerical simulation of the stress field and fault sealing of complex fault combinations in Changning area, Southern Sichuan Basin, China
Authors: Li Jiajie , Qin Qirong , Li Hu , Wan Yuanfei
Published: December 2021

In order to quantitatively study the impact of faults on shale gas productivity, taking Changning area in the south of Sichuan Basin as an example, this study analyzes the impact of fault scale and strike on shale gas productivity under complex structural environment. The typical well profile is selected to establish a three‐dimensional numerical model, and the structural stress distribution characteristics of common structural combinations in this area are analyzed by finite‐element numerical simulation. If, IFT, and IC parameters are selected to quantitatively calculate the sealing of faults. It is found that NE‐trending faults and faults with fault drop grade of 1 in the study area have the greatest damage to shale preservation. The combination of wide and gentle syncline and small fault, low‐angle anticline, and large fault is a typical structural style in this area. The structural combination styles of well N216 and well N217 are similar, but well N216 is subjected to large compressive stress. The calculation shows that the fault plugging performance of well N216 is better than that of well N217.
Age-specific survivorship and fecundity shape genetic diversity in marine fishes
Authors: Barry Pierre , Broquet Thomas , Gagnaire Pierre-Alexandre
Published: December 2021

Genetic diversity varies among species due to a range of eco-evolutionary processes that are not fully understood. The neutral theory predicts that the amount of variation in the genome sequence between different individuals of the same species should increase with its effective population size (Ne). In real populations, multiple factors that modulate the variance in reproductive success among individuals cause Ne to differ from the total number of individuals (N). Among these, age-specific mortality and fecundity rates are known to have a direct impact on the Ne/N ratio. However, the extent to which vital rates account for differences in genetic diversity among species remains unknown. Here, we addressed this question by comparing genome-wide genetic diversity across 16 marine fish species with similar geographic distributions but contrasted lifespan and age-specific survivorship and fecundity curves. We sequenced the whole genome of 300 individuals to high coverage and assessed their genome-wide heterozygosity with a reference-free approach. Genetic diversity varied from 0.2% to 1.4% among species, and showed a negative correlation with adult lifespan, with a large negative effect (slope=−0.089 per additional year of lifespan) that was further increased when brooding species providing intense parental care were removed from the dataset (slope=−0.129 per additional year of lifespan). Using published vital rates for each species, we showed that the Ne/N ratio resulting simply from life tables parameters can predict the observed differences in genetic diversity among species. Using simulations, we further found that the extent of reduction in Ne/N with increasing adult lifespan is particularly strong under Type III survivorship curves (high juvenile and low adult mortality) and increasing fecundity with age, a typical characteristic of marine fishes. Our study highlights the importance of vital rates as key determinants of species genetic diversity levels in nature.
Drought and heat affect common bean minerals and human diet—What we know and where to go
Authors: Losa Alessia , Vorster Juan , Cominelli Eleonora , Sparvoli Francesca , Paolo Dario , Sala Tea , Ferrari Marika , Carbonaro Marina , Marconi Stefania , Camilli Emanuela , Reboul Emmanuelle , Waswa Boaz , Ekesa Beatrice , Aragão Francisco , Kunert Karl
Published: December 2021

Global climate change, causing large parts of the world to become drier with longer drought periods, severely affects production of common beans (Phaseolus vulgaris L.). The bean is worldwide the most produced and consumed food grain legume in the human diet. In common beans, adapted to moderate climates, exposure to drought/heat stress not only results in significant reduction of bean yield but also the nutritional value. This review explores the contribution of common beans to food and nutrient security as well as health. Also discussed is the existing knowledge of the impact of drought/heat stress, associated with a changing climate, specifically on iron (Fe) and phytic acid (PA) that are both among the most important mineral and anti‐nutritional compounds found in common beans. Further discussed is how the application of modern “omics” tools contributes in common beans to higher drought/heat tolerance as well as to higher Fe and reduced PA content. Finally, possible future actions are discussed to develop new common bean varieties with both improved drought/heat tolerance and higher mineral (Fe) content.
On the edge‐based smoothed finite element approximation of viscoelastic fluid flows
Authors: He Tao
Published: December 2021

This article discusses the numerical simulation of viscoelastic fluid flows using the edge‐based smoothed finite element method (ESFEM). The incompressible Navier–Stokes equations coupled with the Oldroyd‐B constitutive relation are decoupled via the characteristic‐based split scheme that enables the use of equal‐order interpolation for the triple primitive variables. For this reason, the spatial discretization is implemented with linear three‐node triangular elements which work very well with the ESFEM. Edge‐based smoothing cells (SCs) are constructed on grounds of existing elements, directly underpinning the essential gradient smoothing procedure. New integration points are proposed within local SCs since the ESFEM enjoys the tremendous flexibility of the smoothed Galerkin weak‐form integral. The discrete viscoelastic system is entirely formulated in the edge‐based notion such that all gradient‐related terms are readily smoothed cell‐by‐cell. Finally, several numerical examples are presented to demonstrate the desirable capability of the ESFEM.
Mulberry (Morus alba L.) leaf polysaccharide ameliorates insulin resistance‐ and adipose deposition‐associated gut microbiota and lipid metabolites in high‐fat diet‐induced obese mice
Authors: Zhao Xin , Fu Zhifei , Yao Minghe , Cao Yu , Zhu Tongtong , Mao Rui , Huang Ming , Pang Yafen , Meng Xianghui , Li Lin , Zhang Boli , Li Yuhong , Zhang Han
Published: December 2021

Dietary supplements are currently being used to ameliorate metabolic alterations via maintaining gut microflora balance. Mulberry leaf is known as medicine homologous food for its glucose‐ and lipid‐modulating properties. However, the effects of mulberry leaf polysaccharide (MP) on metabolic dysbiosis and gut microbiota are still poorly understood. After extraction and characterization, the beneficial effects of water‐soluble MP were evaluated in high‐fat diet‐induced obese mice. MP treatment could reduce adipose tissue, improve insulin resistance, and alleviate the pathological lesions in colon. Investigation of the underlying mechanism showed that MP modulated gut microbial community by 16S rRNA analysis and reversed the elevation of lipid indexes by plasma lipidomics analysis. Correlation analysis indicated that the abundance of seven key bacterial species and six lipids were closely associated with the metabolic traits, respectively. Overall, MP could ameliorate metabolic disorders, and modify the gut microbiota and lipids. This would greatly facilitate the utilization of MP as a functional food.
Development and psychometric evaluation of the Dementia Public Stigma Scale
Authors: Kim Sarang , Eccleston Claire , Klekociuk Shannon , Cook Peta S. , Doherty Kathleen
Published: December 2021

Objectives

Dementia is a stigmatised condition and dementia‐related stigma is associated with low self‐esteem, poor psychological wellbeing, social isolation and poor quality of life in people living with dementia and their families. There is, however, a lack of valid measures that accurately quantify dementia‐related stigma in the general public. This study reports the initial psychometric evaluation of a new tool designed to measure dementia‐related public stigma amongst community dwelling adults.

Methods

A sample of 3250 individuals aged 18 and over completed an online survey on their beliefs and feelings regarding dementia and people living with dementia, and their behavioural intentions towards people living with dementia. Exploratory factor analysis (EFA) using Maximum Likelihood with oblique rotation was performed to extract factors. Confirmatory factor analysis (CFA) was used to confirm the factor structure using goodness‐of‐fit index (GFI), the comparative fit index (CFI), and the root mean square error of approximation (RMSEA) to evaluate the model fit. Internal consistency was measured for the final scale version.

Results

EFA resulted in a 16‐item, 5‐factor model (Fear and discomfort, Negative perceptions, Positive perceptions, Burden, and Exclusion) that explained 50.43% of the total variance. The CFA‐estimated model demonstrated a good fit; all fit indices were larger than 0.95 (GFI = 0.967, CFI = 0.959) and smaller than 0.05 (RMSEA = 0.048). The final scale showed moderate to high reliability scores ranging from α = 0.738 to 0.805.

Conclusions

The Dementia Public Stigma Scale is a tool with reliability, and some demonstrated validity. This scale can be used to measure the public stigma of dementia amongst adults and may be used in the development and evaluation of interventions aimed at dementia‐related stigma reduction.
The anxiety‐specific hippocampus–prefrontal cortex pathways links to procrastination through self‐control
Authors: Zhang Rong , Chen Zhiyi , Hu Bowen , Zhou Feng , Feng Tingyong
Published: December 2021

Procrastination, which is defined as delaying an intended course of action despite negative outcomes, is demonstrated to have a deal with negative emotion including trait anxiety. Although highly anxious individuals showed impoverished control ability, no studies have indicated the role of self‐control in the relationship between trait anxiety and procrastination, and its neural correlates. To this end, we used the sliding window method to calculate the temporal deviation of dynamic functional connectivity (FC) in 312 healthy participants who underwent the resting‐state functional magnetic resonance imaging (fMRI) scanning. In line with our hypothesis, higher trait anxiety is linked to more procrastination via poorer self‐control. Besides, the dynamic FC analyses showed that trait anxiety was positively correlated with dynamic FC variability in hippocampus–prefrontal cortex (HPC–PFC) pathways, including left rostral hippocampus–left superior frontal gyrus (left rHPC–left SFG), and left rHPC–right middle frontal gyrus (left rHPC–‐MFG). Furthermore, the structural equation modeling (SEM) uncovered a mediated role of self‐control in the association between the anxiety‐specific brain connectivity and procrastination. These findings suggest that the HPC–PFC pathways may reflect impoverished regulatory ability over the negative thoughts for anxious individuals, and thereby incurs more procrastination, which enhances our understanding of how trait anxiety links to procrastination.
Rapid processing and quantitative evaluation of structural brain scans for adaptive multimodal imaging
Authors: Váša František , Hobday Harriet , Stanyard Ryan A. , Daws Richard E. , Giampietro Vincent , O'Daly Owen , Lythgoe David J. , Seidlitz Jakob , Skare Stefan , Williams Steven C. R. , Marquand Andre F. , Leech Robert , Cole James H.
Published: December 2021

Current neuroimaging acquisition and processing approaches tend to be optimised for quality rather than speed. However, rapid acquisition and processing of neuroimaging data can lead to novel neuroimaging paradigms, such as adaptive acquisition, where rapidly processed data is used to inform subsequent image acquisition steps. Here we first evaluate the impact of several processing steps on the processing time and quality of registration of manually labelled T1‐weighted MRI scans. Subsequently, we apply the selected rapid processing pipeline both to rapidly acquired multicontrast EPImix scans of 95 participants (which include T1‐FLAIR, T2, T2*, T2‐FLAIR, DWI and ADC contrasts, acquired in ~1 min), as well as to slower, more standard single‐contrast T1‐weighted scans of a subset of 66 participants. We quantify the correspondence between EPImix T1‐FLAIR and single‐contrast T1‐weighted scans, using correlations between voxels and regions of interest across participants, measures of within‐ and between‐participant identifiability as well as regional structural covariance networks. Furthermore, we explore the use of EPImix for the rapid construction of morphometric similarity networks. Finally, we quantify the reliability of EPImix‐derived data using test–retest scans of 10 participants. Our results demonstrate that quantitative information can be derived from a neuroimaging scan acquired and processed within minutes, which could further be used to implement adaptive multimodal imaging and tailor neuroimaging examinations to individual patients.
Simultaneous modeling of reaction times and brain dynamics in a spatial cueing task
Authors: Steinkamp Simon R. , Fink Gereon R. , Vossel Simone , Weidner Ralph
Published: December 2021

Understanding how brain activity translates into behavior is a grand challenge in neuroscientific research. Simultaneous computational modeling of both measures offers to address this question. The extension of the dynamic causal modeling (DCM) framework for blood oxygenation level‐dependent (BOLD) responses to behavior (bDCM) constitutes such a modeling approach. However, only very few studies have employed and evaluated bDCM, and its application has been restricted to binary behavioral responses, limiting more general statements about its validity. This study used bDCM to model reaction times in a spatial attention task, which involved two separate runs with either horizontal or vertical stimulus configurations. We recorded fMRI data and reaction times (n= 26) and compared bDCM with classical DCM and a behavioral Rescorla–Wagner model using Bayesian model selection and goodness of fit statistics. Results indicate that bDCM performed equally well as classical DCM when modeling BOLD responses and as good as the Rescorla–Wagner model when modeling reaction times. Although our data revealed practical limitations of the current bDCM approach that warrant further investigation, we conclude that bDCM constitutes a promising method for investigating the link between brain activity and behavior.
Patterns of change in cortical morphometry following traumatic brain injury in adults
Authors: Mazaharally Maria , Stojanovski Sonja , Trossman Rebecca , Szulc‐Lerch Kamila , Chakravarty M Mallar , Colella Brenda , Glazer Joanna , E. Green Robin , Wheeler Anne L.
Published: December 2021

Progressive cortical volumetric loss following moderate–severe traumatic brain injury (TBI) has been observed; however, regionally specific changes in the structural determinants of cortical volume, namely, cortical thickness (CT) and cortical surface area (CSA), are unknown and may inform the patterns and neural substrates of neurodegeneration and plasticity following injury. We aimed to (a) assess differences in CT and CSA between TBI participants and controls in the early chronic stage post‐injury, (b) describe longitudinal changes in cortical morphometry following TBI, and (c) examine how regional changes in CT and CSA are associated. We acquired magnetic resonance images for 67 participants with TBI at up to 4 time‐points spanning 5 months to 7 years post‐injury, and 18 controls at 2 time‐points. In the early chronic stage, TBI participants displayed thinner cortices than controls, predominantly in frontal regions, but no CSA differences. Throughout the chronic period, TBI participants showed widespread CT reductions in posterior cingulate/precuneus regions and moderate CT increase in frontal regions. Additionally, CSA showed a significant decrease in the orbitofrontal cortex and circumscribed increase in posterior regions. No changes were identified in controls. Relationships between regional cortical changes in the same morphological measure revealed coordinated patterns within participants, whereas correlations between regions with CT and CSA change yielded bi‐directional relationships. This suggests that these measures may be differentially affected by neurodegenerative mechanisms such as transneuronal degeneration following TBI and that degeneration may be localized to the depths of cortical sulci. These findings emphasize the importance of dissecting morphometric contributions to cortical volume change.
Use of power analysis to determine the number of samples needed to assess water quality in lakes and flowing waters
Authors: Conine Andrea L. , Rickard Sarah E. , Onion Alene M. , Wiegert Eric J. , Smith Alexander J.
Published: December 2021

The Clean Water Act requires states to develop methods for assessing water quality. Assessment methods serve as decision-making procedures for including waterbodies on the Section 303(d) List of Impaired Waters. We used 17 years of ambient water quality data to explore statistical analyses for assessment methods that represent New York's waterbodies. Power analyses were performed to determine how many samples are needed to evaluate exceedances of water quality criteria using one-sample t-tests in lakes and flowing waters. Results suggest six samples for lakes and eight samples for flowing waters are needed to obtain at least 80% power, which is fewer samples than most other types of statistical assessment methodologies. This smaller number was possible because the power analysis was applied to the actual variability found in monitoring data to calculate the effect size as opposed to more conservative statistical estimates based on random data. Water quality criteria can have different analysis requirements such as single samples or means above the threshold, so we compared how many impairments would occur in the dataset if the six or eight samples were assessed as two single exceedances or a mean above the water quality criteria. Because the power analysis gives no indication of the time frame of when samples should be collected, the intra- and interannual variability of the data was assessed to determine whether sampling over a growing season in one year or sampling over multiple years is more representative of the water quality status. Results demonstrated that data collected over the growing season captured more variability in water quality data than data collected over multiple years in both waterbody types. With the prevalence of regulatory agencies having large, historical datasets rising, it would be possible for other agencies to apply these types of analyses to their assessment methodologies. Integr Environ Assess Manag 2022;18:1621–1628. © 2021 SETAC

KEY POINTS

Use of power analysis on historical water quality datasets was a successful method for statistically determining how many samples are needed to perform regulatory assessments for impairment of lakes and flowing waters. In New York State, six samples for lakes and eight samples for flowing waters were found to be sufficient for performing regulatory assessments for impairment of waterbodies.
PARP mediated DNA damage response, genomic stability and immune responses
Authors: Zong Chunyan , Zhu Tianyu , He Jie , Huang Rui , Jia Renbing , Shen Jianfeng
Published: December 2021

Poly(ADP‐ribose) polymerase (PARP) enzymes, especially PARP1, play important roles in the DNA damage response and in the maintenance of genome stability, which makes PARPis a classic synthetic lethal therapy for BRCA‐deficient tumors. Conventional mechanisms suggest that PARPis exert their effects via catalytic inhibition and PARP‐DNA trapping. Recently, PARP1 has been found to play a role in the immune modulation of tumors. The blockade of PARP1 is able to induce innate immunity through a series of molecular mechanisms, thus allowing the prediction of the feasibility of PARPis combined with immune agents in the treatment of tumors. PARPis combined with immunomodulators may have a stronger tumor suppressive effect on inhibiting tumor growth and blocking immune escape.
A hybrid feature fusion strategy for early fusion and majority voting for late fusion towards melanocytic skin lesion detection
Authors: Singh Lokesh , Janghel Rekh Ram , Sahu Satya Prakash
Published: December 2021

A computer‐aided‐diagnostic system for diagnosing melanoma often uses distinct kinds of features for characterizing the lesions. Extracting distinct features from melanocytic images represents the various characteristics of pigmented lesions. Concatenating such features distinguishes extracted feature's information effectively while eliminating the redundant information amid them, which aids in discriminating the cancerous and noncancerous lesions. This article proposes a framework comprising segmentation, feature extraction, feature fusion, and classification to differentiate benign lesions from melanoma. The proposed framework is four‐fold: beginning with the extraction of ROI from an image, the SLICACO method is used for segmentation. Thereafter, ABCD rule‐based global and local features are extracted for effective melanoma detection. Further, we develop a new hybrid feature fusion strategy, PCAFA, leveraging the benefits of principal component analysis and factor analysis. The method performs early fusion by combining all extracted features within an individual feature vector and fed to a learning model for the prediction. While late fusion is performed using majority voting by combining the outputs of machine learning models. After that, gradient tree boosting, support vector machine, and decision tree models are trained to utilize distinct features of skin lesions for their classification as benign or malignant. The effectiveness of the designed framework is validated on the ISIC2017 benchmark skin lesion dataset based on specificity, sensitivity, and accuracy. The generalizability of the designed framework is gauged by conducting a fair comparison with conventional methods. Evaluated results reveal the potential of the proposed fused feature‐set in discriminating malignant and nonmalignant lesions with an accuracy of 96.8%.
Infants’ and toddlers’ digital media use and mothers’ mental health: A comparative study before and during the COVID‐19 pandemic
Authors: Pedrotti Bruna Gabriella , Mallmann Manoela Yustas , Almeida Carla Regina Santos , Marques Fernanda Martins , Vescovi Gabriela , Riter Helena da Silveira , Almeida Maíra Lopes , Pieta Maria Adélia Minghelli , Frizzo Giana Bitencourt
Published: December 2021

This study compared children's and mothers’ digital media use and mothers’ mental health in two samples: one accessed before (Group 1; N = 257; M = 33.18 years; SD = 4.79) and the other accessed during (Group 2; N = 256; M = 33.51 years; SD = 4.96) the COVID‐19 pandemic in Brazil. Mothers of children up to 3 years old (Group 1: M = 17.95 months, SD = 9.85; Group 2: M = 16.48 months, SD = 10.15) answered an online survey. Bivariate analysis, factorial ANOVA tests, and multiple linear regression were performed. Results suggest that mothers’ and children's media use duration was higher during the pandemic only among children over 12 months. Mothers’ media use duration (β = .18) and mothers’ intention to offer media (β = .23) contributed to the explanation of children's media use duration (F(4, 474) = 16.81; p < .001; R2 = .12; R2 adjusted = .117). Higher mothers’ common mental disorders symptoms were also positively correlated to mothers’ intention to offer media to children both before and during the pandemic. Results suggest that interventions focusing on infants and toddlers screen time reduction should target maternal aspects such as mental health, maternal screen time, and intention to offer media, taking into account the mothers’ needs when planning these actions.
Transitions to virtual early childhood home visitation during COVID‐19
Authors: Traube Dorian , Gozalians Sharlene , Duan Lei
Published: December 2021

COVID‐19 has disrupted many of the preventive service sectors designed to promote infant mental health. The purpose of this study is to examine provider and supervisor transition strategies as well as maternal‐child outcomes during the transition from in‐person to virtual early childhood home visitation services in Los Angeles County. Los Angeles County is one of the largest home visitation sectors in the U.S. and disproportionately impacted by the COVID‐19 pandemic. Transitioning from in‐person to virtual home visitation was an important step in ensuring the continuity of infant mental health services. Home visitors reported relative ease in transitioning to virtual services themselves but noted that families encountered greater difficulty. The most helpful strategies to support this transition included training, ongoing reflective supervision, and provision of technology. Family level analysis revealed that positive screening rates for anxiety and depression decreased during the pandemic as did referrals for most support services. These findings likely highlight challenges in delivering virtual home visitation. Understanding how transitions in a key infant serving sector were managed serves an important role in forecasting for the future and preparing for future public heath emergencies.
Telehealth adaptation of perinatal mental health mother–infant group programming for the COVID‐19 pandemic
Authors: Paul Jennifer J. , Dardar Shaleah , River Laura M. , St. John‐Larkin Celeste
Published: December 2021

The COVID‐19 pandemic and ensuing isolation stressed pregnant and postpartum women and their families pervasively. This necessitated addressing young families’ mental health needs while protecting both patients and providers from COVID‐19 exposure. Our experience of rapidly adapting Pregnancy, Maternal Postpartum Peer Support, and Mother–Infant Postpartum Group interventions to high‐quality telehealth modalities elucidates benefits and challenges of mother–infant dyadic treatment amidst the pandemic. This study compares 2019 in‐person and 2020 telehealth services during the period from mid‐March through mid‐December in each year. Initial program Warmline contacts were similar across years despite pandemic‐related restrictions, with 2020 program contacts surpassing the 147 unique patient outreaches during the commensurate 2019 period. Pregnancy Group enrollment remained consistent. Maternal Postpartum Peer Support Group participation increased with transition to telehealth with 27 individuals with over 100 group‐based visits in 2020. Twenty‐five mother–infant Postpartum pairs initially enrolled in the 12‐week multicomponent Mother–Infant Therapy Group (M‐ITG) during 2019 in‐person services, and 16 completed the program (36% non‐completion rate). During 2020 telehealth, 15 of 18 mother–infant pairs completed the program (17% non‐completion rate); a greater than 50% reduction in non‐completion. We further compare pre‐/post‐pandemic onset M‐ITG participant demographics, enrollment, and Edinburgh Postnatal Depression Scale (EPDS) scores.
Evaluation of pediatric electives and core pediatric topics offered at United States schools and colleges of pharmacy
Authors: Chung Allison M. , Padgett Elizabeth , Eiland Lea S.
Published: December 2021

Introduction

Pediatric patients are an important population in every community, and providing patient‐centered care to this population relies on fundamental knowledge of pediatric care.

Objectives

To describe the availability of pediatric electives and depth of pediatric topics taught throughout the curricula offered at Doctor of Pharmacy (Pharm.D.) programs in the United States.

Methods

This was a quantitative/qualitative survey study assessment. A 21‐question survey was created, reviewed, and pilot‐tested prior to full distribution. The electronic survey was administered and distributed via email to relevant faculty at 145 identified Pharm.D. programs.

Results

The survey achieved a 65% response rate with 69.2% of responding programs reported offering at least one pediatric elective. Pharmacy schools that responded represented all areas of the United States. The majority, 57.5% (n = 54), of responding programs employed at least one full‐time pediatric faculty member, and 14.9% (n = 2) had two pediatric faculty members.

The most common topics taught in pharmacy curricula without a pediatric elective (>80%) were cystic fibrosis, asthma, attention‐deficit/hyperactivity disorder, immunizations, otitis media, and calculations. Pediatric topics that were not offered anywhere in these curriculum (>40%) were cardiology, congenital heart disease, hypersensitivity reactions, child abuse, neonatal intensive care, and health disparities in children. However, topics that were most commonly covered within a pediatric elective (>50%) consisted of cardiology, congenital heart disease, cystic fibrosis, growth and development, neonatal intensive care unit foundations, medication errors/safety, and calculations.

The most common type of assessments utilized in the pediatric electives were exams or quizzes (n = 53). Case‐based learning was the most common teaching method.

Conclusion

This study demonstrates a growth in pediatric education, the extent of pediatric topics taught throughout curricula, and an increase in pediatric faculty members in pharmacy programs. There remains a need for all programs to teach pediatric patient‐centered care and for more pediatric pharmacists leading this education in pharmacy curricula.
Characterization and evaluation of a pharmacy morbidity, mortality, and improvement case conference for drug safety optimization: An 8‐year experience
Authors: Droege Molly Elizabeth , Stacy Elizabeth Sue , Guido Maria Rose , Alhayani Taha , Keegan Shaun Patrick , Miller Angela Margaret , McKinney Kathryn Clark , Morris Patricia Ann , Parrish Nicholas John , Reinstatler Kristina Marie , Takieddine Sheila Cohara , Vora Alisha Mahesh , Warner Alexandra Rachel , Waters Geralyn Elizabeth , Mueller Eric William
Published: December 2021

Introduction

Traditional morbidity and mortality conferences focus on clinical decision‐making rather than process improvement (PI) and patient safety. A local pharmacy morbidity, mortality, and improvement (MMI) program evolved didactic clinical case presentations into an action‐oriented, resident‐led, case‐based PI learning experience to enhance the institutional patient safety culture.

Objectives

The purpose of this report is to describe a pharmacy‐led MMI program including the overall MMI process, characterization of drug errors evaluated, and review of drug use process optimizations.

Methods

A narrative review of the MMI process was performed including retrospective characterization of errors and PIs identified from patient safety events presented between June 2013 and August 2021. Errors were classified per the American Society of Health‐System Pharmacists (ASHP) Guidelines on Preventing Medication Errors in Hospitals and the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Medication Error Index. PI strategies were qualitatively and quantitatively described.

Results

Implementation and evolution of MMI over 8 years resulted in consistent error classification, PI interventions across the drug use process, and numerous patient safety continuing education (CE) offerings. Ninety‐seven (80.3%) events completed all MMI components. The majority of events occurred in the emergency department/intensive care unit (42 [43%]) or medical‐surgical floor (36 [37%]). A median of two (interquartile range [IQR] 1‐3) steps in the drug use process contributed to the event. ASHP level 4 (32 [33%]) and NCC MERP category D (22 [21%]) were the most common classifications; NCC MERP error without harm (51 [53%]) had the highest incidence. A total of 163 PI initiatives were identified (median 2 [IQR 1‐2] per case) with 76 (78%) including high‐impact areas such as high‐alert drugs and transitions of care. A total of 606.5 CE hours were awarded.

Conclusion

The pharmacy‐led MMI program is an effective and innovative opportunity to enhance patient safety and improve the drug use process.
Opioid prescribing and prescription monitoring program use after buprenorphine discontinuation
Authors: Varisco Tyler J. , Abughosh Susan , Chen Hua , Fleming Marc L. , Ziedonis Douglas , Wanat Matthew , Thornton Douglas
Published: December 2021

Introduction

Prescription opioid use is not recommended in individuals with a history of opioid use disorder. Still, patients often experience pain or craving after buprenorphine discontinuation leading to opioid use. As complete, accessible, patient level records of controlled substance use, prescription monitoring programs (PMPs) may offer a useful tool to recognize recent treatment with buprenorphine and prevent new opioid use.

Objective

The objective of this study was to estimate the incidence of new opioid use after buprenorphine discontinuation and to measure the rate of provider and pharmacist PMP query prior to dispensing opioid analgesics to individuals with a recent history of buprenorphine treatment.

Methods

A cohort of patients who initiated and discontinued a buprenorphine product between June 30, 2016 and July 4, 2018 was identified from the Texas PMP. Eligible participants were then followed for an additional 180 days to determine if they filled a prescription for an opioid medication after discontinuation. Records of PMP query were then used to measure the frequency with which prescribers and pharmacists queried the PMP prior to dispensing an opioid prescription after buprenorphine discontinuation.

Results

Of the 7081 eligible participants, 16.5% filled an opioid prescription after treatment discontinuation. Pharmacists or prescribers checked the PMP prior to prescribing or dispensing in only 116 of these 1169 instances (9.9%). Of those who filled an opioid prescription after discontinuation, 36.8% did so at a pharmacy where they previously filled a buprenorphine prescription.

Conclusions

A considerable number of patients filled an opioid prescription after buprenorphine discontinuation. Despite the availability of the PMP, prescribers and pharmacists rarely use it when deciding whether to dispense an opioid prescription to an individual who recently discontinued buprenorphine. Reform focused on PMP workflow integration and usability may be a useful tool to reduce opioid use after buprenorphine discontinuation.
Osteosarcoma cells in early and late stages as cancer in vitro progression model for assessing the responsiveness of cells to silver nanoparticles
Authors: Sokołowska Paulina , Siatkowska Małgorzata , Białkowska Kamila , Rosowski Marcin , Komorowski Piotr , Walkowiak Bogdan
Published: December 2021

Understanding of biology of osteosarcoma malignant progression is indispensable for enhancement of conventional chemotherapy by the use of silver nanoparticles (AgNPs). We presented an in vitro model of cancer progression closely resembling processes occurring in vivo in terms of protein profile. A comparison of cytotoxic and genotoxic potential of AgNPs in Saos‐2 cells in early stages of cancerous progression (early passages) with the cells in advanced stages (late passages) demonstrated significantly reduced responsiveness of the late passage cells to nanoparticles toxicity. It was also confirmed by proteome analysis as we identified considerably higher number of differentially expressed proteins in Saos‐2 cells in early passages compared to the late passage cells. Our studies showed that the ability of AgNPs as potential drug carriers to deliver a medication and/or to evoke toxic effects might be significantly diminished in advanced stages of cancer progression.
Treatment of comatose patient from cyclobenzaprine overdose with therapeutic plasma exchange
Authors: Buyukgoz Cihangir , Gangu Shantaveer , Gowani Faaria , Kimura Dai
Published: December 2021

We present a case of a 15‐year‐old female who was admitted in a comatose state with no spontaneous respiratory effort and absence of brainstem reflexes after cyclobenzaprine ingestion. Due to severe presentation and recent ingestion of high plasma protein binding medication with long half‐life, therapeutic plasma exchange (TPE) was performed and resulted in full neurological recovery. This case explores the role of TPE as an effective treatment option for life‐threatening cyclobenzaprine overdose. TPE is generally beneficial for drugs that have a low volume of distribution and high plasma protein binding. Cyclobenzaprine is known to have a relatively high volume of distribution. However, in the case of drug intoxication with relatively high‐volume distribution, high protein binding, and long half‐life, TPE could be effective if it is conducted promptly.
Autologous hematopoietic stem cell product contaminated with Salmonella due to occult salmonellosis in an asymptomatic donor
Authors: Jacobs Jeremy W. , Guarente Juliana , Hendrickson Jeanne E. , Tormey Christopher A. , Bar Noffar
Published: December 2021

Recent advancements in infectious disease testing methods and pathogen reduction technologies have greatly reduced the incidence of microbial contamination of allogeneic blood products. Despite this significant reduction, contamination of autologous cellular therapy products remains a challenging issue, as many of these mitigation strategies are not feasible for such products. Most microorganisms isolated from cellular therapy products are Gram‐positive normal skin flora, and studies have demonstrated that adverse effects are infrequent when these contaminated products are infused. However, no prior report has documented an autologous hematopoietic stem cell (HSC) or other cellular therapy product contaminated with Salmonella bacteria—a pathogenic Gram‐negative organism. We present the first known case of Salmonella contaminating an HSC product secondary to occult salmonellosis in the donor, and discuss the implications of this contaminating organism and the therapeutic dilemma posed by this scenario.