bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of an app-based bedside clinical decision-making tool for mechanical cardiocirculatory support in patients with cardiogenic shock: the MCS-Aid app
Authors: Giustino G , Serrao G W , Melarcode-Krishnamoorty P , Vengrenyuk A , Kyaw H , Gidwani U , Sharma S K , Kini A
Published: December 2022

Background

Patients presenting with cardiogenic shock remain at high risk of morbidity and mortality. Several mechanical cardiocirculatory support (MCS) devices have been developed and their use is rapidly increase in clinical practice. However, there is significant heterogeneity in patient selection, timing of implantation, and post-implantation management across centers and operators.

Purpose

We sought to develop and smartphone app-based clinical decision-making tool to help bedside selection and post-implantation management of MCS devices in patients presenting with cardiogenic shock or cardiac arrest.

Methods

The MCS-Aid app will consistent of 3 major sections: (i) initial device selection based on clinical presentation (patients with cardiogenic shock or cardiac arrest post-ROSC); (ii) guide for escalation or addition of MCS based on the individual hemodynamic scenario; (iii) guide for weaning after implantation of MCS device. The app will have an interactive interface that will allow the user to select the most appropriate next step in management based on the clinical information being entered. A calculator to derive key hemodynamic parameters (e.g. cardiac power output or pulmonary artery pulsatility index) will be incorporated in the App to inform clinical decision-making when appropriate. An example of an algorithm that will be part of the MCS-Aid app is illustrated in the figure.

Conclusions

The MCS-Aid app is an user-friendly bedside clinical decision tool that could help fellows-in-training, early-career interventionalist and interventional cardiologist to select the appropriate MCS device according to the individual clinical and hemodynamic scenario.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Abiomed
Implementation of a clinical trial recruitment support system based on fast healthcare interoperability resources (FHIR) in a cardiology department
Authors: Scherer C , Endres S , Orban M , Kaeaeb S , Massberg S , Winter A , Loebe M
Published: December 2022

Background

Clinical Trial Recruitment Support Systems can booster patient inclusion of clinical trials by automatically analyzing eligibility criteria based on electronic health records. However, missing interoperability has hindered introduction of those systems on a broader scale.

Purpose

Our aim was to develop a recruitment support system based on FHIR R4 and evaluate its usage and features in a cardiology department.

Methods/Implementation

Clinical conditions, anamnesis, examinations, allergies, medication, laboratory data and echocardiography results were imported as FHIR resources. Trial study nurses and physicians were enabled to add new and edit trial information and input inclusion and exclusion criteria using a web-browser user interface in the hospital intranet. All information were recorded on the server side as the FHIR resources “ResearchStudy” and “Group”. Eligibility criteria linked by the logical operation “OR” were represented by using multiple FHIR Group resources for enrollment. On the client side, eligibility criteria were transformed to a tree-like structure (see Figure 1). Upon user demand, all hospitalized and ambulatory patients in the cardiology department were instantly screened for trial eligibility using the FHIR eligibility criteria on the existing patients' FHIR resources. Furthermore, study personal was able to manually edit trial status (i.e. ineligible, on-study, ...) of patients, which was implemented using the FHIR resource “ResearchSubject”.

Results

This implementation of a CTRSS based on FHIR R4 was evaluated in clinical practice: Beginning from 1st April 2021 the application was used as an additional patient screening tool for the four trials CLOSURE-AF, FAIR-HF2, SPRIRIT-HF and TORCH-PLUS of the German Centre for Cardiovascular Research. As the COVID-19 pandemic is prohibiting any proper comparison of patient inclusion rates, efficacy of the recruitment support system was tested by comparing the numbers of patients identified by the recruitment support system and enrolled in a trial to the actual number of enrolled patients irrespective of the screening method from 1st April 2021 to 23rd November 2021. The system was able to identify 52 of 55 patients included in those four clinical trials.

Conclusion

Use of FHIR for defining eligibility criteria of clinical trials may facilitate interoperability and allow automatic screening for eligible patients at multiple sites of different healthcare providers in the future. Upcoming changes in FHIR should allow easier description of “OR”-linked eligibility criteria.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Deutsche Forschungsgemeinschaft
Insights into diurnal variations of advanced hemodynamic parameters in ambulatory individuals enabled by a photoplethysmography-based wearable monitor
Authors: Nachman D , Kolben Y , Carmon E , Hazan E , Goldstein N , Eisenkraft A , Fons M , Amir O , Asleh R , Gepner Y
Published: December 2022

Background

Recent technological developments enable non-invasive monitoring of advanced hemodynamic parameters, allowing big data-driven insights on diurnal changes for the first time. This study aimed to describe the trends of multiple advanced cardiovascular parameters among ambulatory individuals using a medical grade wearable monitor.

Methods

Common and advanced cardio-respiratory parameters were monitored for 24 hours in ambulatory volunteers using a photoplethysmography-based wearable monitor. The multi vital ambulatory monitoring (MVAM) included stroke volume (SV), cardiac index (CI), systemic vascular resistance (SVR), blood oxygen saturation (SpO2), respiratory rate (RR), systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and heart rate (HR). Diurnal variations were evaluated among all participants, and analyses were stratified based on sex, age, and body-mass index (BMI).

Results

A total of 256 participants were included in the analysis. All measured parameters showed significant (p<0.001) diurnal changes. Nighttime values were lower excluding RR and SVR, reaching the nadir at 5 am, and then increasing to a maximum at 10 am, plateauing, and then gradually declining from 7 to 8 pm. CI demonstrated a reduction of 0.6 L/min/m2 (20%), while SVR demonstrated the opposite trend and was higher during the night increasing by up to 212 dynes/sec/cm5 (16%). Females demonstrated higher HR and CI with lower SVR during daytime and nighttime. Obese participants (BMI >30 kg/m2) had a higher SBP and DBP, and lower SV and CI. SVR was higher among the elderly.

Conclusions

Diurnal changes using MVAM corresponding with awake-sleep hours were noticed in the monitored parameters and differed between sex, age, and BMI groups. This suggests that wearable monitoring platforms could shed more light on hemodynamic changes in subgroups, and might help with future efforts to provide tailored personalized medicine and pre-symptomatic diagnosis and prevention.

Funding Acknowledgement

Type of funding sources: None.
Appendicular Lean Mass, Grip Strength, and the Incidence of Dementia Among Older Adults in the Health ABC Study
Authors: Andrews James S , Gold Laura S , Reed May J , Hough Catherine L , Garcia Jose M , McClelland Robyn L , Fitzpatrick Annette L , Covinsky Ken E , Crane Paul K , Yaffe Kristine , Cawthon Peggy M
Published: December 2022

Background

Identification of novel risk factors for dementia in older adults could facilitate development of methods to identify patients most at risk and improve their cognitive outcomes. We aimed to determine whether lower appendicular lean mass (ALM), assessed by dual-energy x-ray absorptiometry (DXA), and lower grip strength are associated with a greater likelihood of incident dementia among older adults in the Health Aging and Body Composition Study (Health ABC).

Methods

Health ABC data from 1997 to 2008 were analyzed (n = 2 704). Baseline ALM to body mass index (BMI) ratio (ALMBMI) was assessed by DXA. Baseline grip strength was assessed by hand-held dynamometry. Incident dementia diagnosis was defined as either (i) dementia-related hospitalization plus a Modified Mini-Mental State Examination (3MS) score of ≤ 90; or (ii) record of prescription for anti-dementia medication; or (iii) decline of at least 1.5 SDs on the 3MS score compared to baseline. Cox proportional hazard models estimated associations of ALMBMI and grip strength with incident dementia over follow-up with and without adjusting for covariates, stratified by sex.

Results

Among older men, each standard deviation decrement in ALMBMI (adjusted hazard ratio [aHR]: 1.33; 95% confidence interval [CI]: 1.07, 1.65) or grip strength (aHR 1.22; 95% CI: 1.06, 1.41) was associated with increased likelihood of incident dementia.

Conclusions

Lower ALMBMI and grip strength may be important risk factors for the development of dementia among older men. How these factors may belong to a causal pathway of dementia must be elucidated in future work.
Introducing HL7 FHIR Genomics Operations: a developer-friendly approach to genomics-EHR integration
Authors: Dolin Robert H , Heale Bret S E , Alterovitz Gil , Gupta Rohan , Aronson Justin , Boxwala Aziz , Gothi Shaileshbhai R , Haines David , Hermann Arthur , Hongsermeier Tonya , Husami Ammar , Jones James , Naeymi-Rad Frank , Rapchak Barbara , Ravishankar Chandan , Shalaby James , Terry May , Xie Ning , Zhang Powell , Chamala Srikar
Published: December 2022

Objective

Enabling clinicians to formulate individualized clinical management strategies from the sea of molecular data remains a fundamentally important but daunting task. Here, we describe efforts towards a new paradigm in genomics-electronic health record (HER) integration, using a standardized suite of FHIR Genomics Operations that encapsulates the complexity of molecular data so that precision medicine solution developers can focus on building applications.

Materials and Methods

FHIR Genomics Operations essentially “wrap” a genomics data repository, presenting a uniform interface to applications. More importantly, operations encapsulate the complexity of data within a repository and normalize redundant data representations—particularly relevant in genomics, where a tremendous amount of raw data exists in often-complex non-FHIR formats.

Results

Fifteen FHIR Genomics Operations have been developed, designed to support a wide range of clinical scenarios, such as variant discovery; clinical trial matching; hereditary condition and pharmacogenomic screening; and variant reanalysis. Operations are being matured through the HL7 balloting process, connectathons, pilots, and the HL7 FHIR Accelerator program.

Discussion

Next-generation sequencing can identify thousands to millions of variants, whose clinical significance can change over time as our knowledge evolves. To manage such a large volume of dynamic and complex data, new models of genomics-EHR integration are needed. Qualitative observations to date suggest that freeing application developers from the need to understand the nuances of genomic data, and instead base applications on standardized APIs can not only accelerate integration but also dramatically expand the applications of Omic data in driving precision care at scale for all.
Effects of genotype, sex, and feed restriction on the biochemical composition of chicken preen gland secretions and their implications for commercial poultry production
Authors: Gvoždíková Javůrková Veronika , Doležal Petr , Fraňková Adéla , Horák Monika , Chodová Darina , Langrová Iva , Tůmová Eva
Published: December 2022

Preen gland secretions spread on the feathers contain various chemical compounds dominated by fatty acids (FAs) and volatile organic compounds (VOCs). These chemicals may significantly affect plumage condition, microbial and ectoparasitic load on feathers, and chemical communication of birds. However, how chemical composition of preen secretions varies in commercially produced chickens with respect to their genotype, sex, and feeding regime remain largely unknown, as well as the welfare implications for farmed poultry. We found that while polyunsaturated fatty acids in chicken preen secretions differed significantly with genotype (P << 0.001), saturated fatty acids and monounsaturated fatty acids varied with genotype-dependent preen gland volume (P < 0.01). Chickens of meat-type fast-growing Ross 308 genotype had reduced preen gland volume and lower proportions of all FA categories in their preen secretions compared with dual-purpose slow-growing ISA Dual chickens. A total of 34 FAs and 77 VOCs with tens of unique FAs were detected in preen secretions of both genotypes. While differences in the relative proportion of 6 of the 10 most dominant VOCs in chicken preen gland secretions were related to genotype (P < 0.001), only 1 of the 10 most dominant VOCs showed a sex effect (P < 0.01), and only 2 of the 10 most dominant VOCs showed a genotype-dependent effect of feed restriction (P < 0.05). Feed restriction had no effect on the relative proportion of any of the FAs in chicken preen gland secretions. Moreover, we found that meat-type Ross 308 preen secretions were dominated by VOCs, which are proven attractants for poultry red mite and may also increase infestation with other ectoparasites and negatively influence overall odor-mediated intraspecific communication and welfare. This study shows that no feeding management, but long-term genetic selection in commercial breeding may be the main cause of the differences in the biochemistry and function of chicken preen secretions. This might have negative consequences for chemosignaling, antiparasitic, and antimicrobial potential of preen secretions and can lead to increased susceptibility to ectoparasites, plumage care disorders, and can affect the overall condition, welfare, and productivity of commercially bred chickens. Selection-induced preen gland impairments must therefore be considered and compensated by proper management of the chicken farm and increased care about animal well-being.
C/EBPα promotes triacylglycerol synthesis via regulating PPARG promoter activity in goat mammary epithelial cells
Authors: Tian Huibin , Luo Jun , Guo Peng , Li Chun , Zhang Xueying
Published: December 2022

CCAAT/enhancer binding protein α (C/EBPα) is the key transcription factor involved in lipid metabolism, however, the role of C/EBPα in milk fat synthesis of dairy goats remains unknown. The objective of the present research was to clarify the function of C/EBPα in goat mammary epithelial cells (GMECs) and its impact on peroxisome proliferator-activated receptor gamma (PPARG) promoter activity. In this study, C/EBPα overexpression increased its mRNA and protein levels by 42-fold and 6-fold, respectively. In contrast, transfecting siRNA targeting C/EBPα decreased its mRNA level to 20% and protein abundance to 80% of the basal level. The contents of lipid droplets, triacylglycerol (TAG), and cholesterol were increased (P < 0.05) in C/EBPα-overexpressing GMECs, and knockdown of C/EBPα led to the opposite results. Overexpression of C/EBPα significantly increased the expression levels of genes involved in TAG synthesis (AGPAT6, DGAT2, P < 0.01), lipid droplet formation (PLIN2, P < 0.01), and fatty acid synthesis (FADS2, P < 0.05; ELOVL6, P < 0.01). Knockdown of C/EBPα decreased (P < 0.05) the expression levels of AGPAT6, DGAT1, DGAT2, PLIN2, FADS2, and ELOVL6. C/EBPα upregulated the expression level of PPARG (P < 0.05), and four C/EBPα binding regions were identified in the PPARG promoter at −1,112 to −1,102 bp, −734 to −724 bp, −248 to −238 bp, and −119 to −109 bp. Knockdown of C/EBPα reduced (P < 0.05) the PPARG promoter activity when the C/EBPα binding regions were mutated at −1,112 to −1,102 bp, −734 to −724 bp, and −248 to −238 bp locations of the promoter. However, the promoter activity did not change when the mutation was located at −119 bp. In conclusion, our results suggest that C/EBPα can promote TAG synthesis in GMECs through its effects on mRNA abundance of genes related to lipid metabolism and regulation of the PPARG promoter activity via C/EBPα binding regions.
Glassy-Winged Sharpshooters Cease Feeding and Avoid Plants Treated With Sub-Lethal Doses of the Neonicotinoid Insecticide Imidacloprid
Authors: Sisterson Mark S , Uchima Sean Y , Wallis Christopher M , Krugner Rodrigo
Published: December 2022

Insecticides are a primary means for suppressing populations of insects that transmit plant pathogens. Application of insecticides for limiting the spread of insect-transmitted plant pathogens is often most effective when applied on an area-wide scale. The glassy-winged sharpshooter is a vector of the bacterial pathogen Xylella fastidiosa, which causes numerous plant diseases including Pierce’s disease of grapevine. The glassy-winged sharpshooter has been the subject of an area-wide suppression program in California for nearly two decades. Overreliance on a limited number of active ingredients including the neonicotinoid imidacloprid has resulted in increased levels of resistance to commonly applied products. In California, glassy-winged sharpshooters move between citrus, an important overwintering host, and vineyards. Accordingly, imidacloprid is routinely applied via the irrigation system in vineyards and citrus orchards. For soil applied applications, it may take days to weeks for concentrations in plants to increase to lethal doses. Further, as the dose of imidacloprid required to kill sharpshooters increases due to resistance, so too does the period that sharpshooters are exposed to sub-lethal doses. Response of glassy-winged sharpshooter to cowpea plants treated with sub-lethal doses of imidacloprid was evaluated by conducting no-choice and choice tests. In no-choice feeding assays, glassy-winged sharpshooters caged on plants treated with sub-lethal doses of imidacloprid ceased feeding and produced little excreta. Further, sub-lethal exposure to a range of doses over a 4-d period did not affect viability over a 9-wk post-exposure holding period on untreated plants. In choice-tests, glassy-winged sharpshooters avoided treated plants and were observed predominately on untreated plants. Results suggest that application of imidacloprid to vineyards and citrus orchards may push glassy-winged sharpshooters out of treated habitats rather than kill them.
Morphology and genetics of grasshopper mice revisited in a paleontological framework: reinstatement of Onychomyini (Rodentia, Cricetidae)
Authors: Kelly Thomas S , Martin Robert A , Ronez Christophe , Cañón Carola , Pardiñas Ulyses F J
Published: December 2022

Grasshopper mice of the genus Onychomys, represented by three living species in North America, have a long and controversial taxonomic history. Usually allocated to either the cricetine or neotomine cricetids, they also have been considered to represent a distinct tribe. Since the discovery and description of the extinct grasshopper mouse relative Acrolophomys rhodopetros from the late Miocene of the upper Dove Spring Formation of California, dated at 9.3–8.8 Ma, it has become apparent that the grasshopper mouse clade has a long, distinct evolutionary history. Using a combination of morphological (including paleontological material) and molecular data, we reassessed the phylogenetic position of grasshopper mice. A morphological phylogenetic analysis was done on fossil and modern specimens of all recognized neotomine tribes, including craniodental, phallic, and soft tissue characters. A DNA-based matrix was constructed including 72 species representing all known living genera of Neotominae and 13 outgroup taxa belonging mostly to cricetid subfamilies. DNA sampling covered the mitochondrial protein-coding gene cytochrome-b (Cytb), and seven nuclear loci. The morphological analysis yielded a single most parsimonious tree of 42 steps, placing Ochrotomys (Ochrotomyini), Baiomys (Baiomyini), Reithrodontomys (Reithrodontomyini), and an Onychomys–Acrolophomys clade as successive sister clades to a Peromyscus clade, respectively. The molecular phylogenetic analyses recovered seven major clades: (1) a clade including Habromys, Megadontomys, Neotomodon, Osgoodomys, Podomys, and a paraphyletic Peromyscus clade, sister to (2) a second clade containing extant Onychomys species, (3) a Reithrodontomys clade, (4) an Isthmomys clade, (5) a clade including Baiomys and Scotinomys, (6) an Ochrotomys clade, and (7) a well-­supported clade containing Hodomys, Neotoma, and Xenomys. A Bayesian combined morphological and molecular analysis recovered the same major phylogenetic associations as the molecular analyses. The sum of molecular markers and morphological traits expressed by Acrolophomys and Onychomys leads to a phylogenetic position supporting their recognition as a distinct tribe.
Carbon-concentrating mechanisms in pods are key elements for terminal drought resistance inPhaseolus vulgaris
Authors: González-Lemes Ingrid , Acosta-Maspons Alexis , Cetz-Chel José E , Polania José A , Acosta-Gallegos Jorge A , Herrera-Estrella Alfredo , Covarrubias Alejandra A
Published: December 2022

Common bean (Phaseolus vulgaris L.) is one of the most consumed legumes in the human diet and a substantial source of dietary protein. A major problem for this rainfed crop is the decrease in grain yield caused by prolonged drought periods during the reproductive stage of plant development (terminal drought). Terminal drought remains a prevailing threat to the farming of this staple, with losses reaching >80%. Based on the high correlation between the resistance of common bean to terminal drought and efficient photoassimilate mobilization and biomass accumulation in seeds, we aimed to identify mechanisms implicated in its resistance to this stress. We used two representative Durango race common bean cultivars with contrasting yields under terminal drought, grown under well-watered or terminal drought conditions. Using comparative transcriptomic analysis focused on source leaves, pods, and seeds from both cultivars, we provide evidence indicating that under terminal drought the resistant cultivar promotes the build-up of transcripts involved in recycling carbon through photosynthesis, photorespiration, and CO2-concentrating mechanisms in pod walls, while in seeds, the induced transcripts participate in sink strength and respiration. Physiological data support this conclusion, implicating their relevance as key processes in the plant response to terminal drought.
Some Biographical Notes on Richard Bradock (and Others)
Authors: Blayney Peter W M
Published: December 2022

Because the printer Richard Bradock began his apprenticeship during the five-year gap in the Stationers’ early records, his origins have remained unknown. Tracing the life and career of his second known master (Henry Middleton), and of Middleton’s own wider connections in the trade, has led to a record of a man who turns out to have been Bradock’s father. Moreover, in his Stationers’ Company Apprentices, 1605–1640 (1961), D. F. McKenzie wrongly supposed that some records of a Richard ‘Bradde’ (or ‘Bradd’, or ‘Brad’) were simply using an abbreviated form of ‘Bradock’. Consequently, half the apprentices credited to Bradock should be reassigned to the Stationer Richard ‘Brad’, the son of Stationer John ‘Bread’ or ‘Bred’.
Evaluating the Challenges and Potential Complications of Breastfeeding in Naval Aviation
Authors: Ajuzie Stephanie
Published: December 2022

Introduction

Active duty flight crew plays a critical role in military operations. The occupational demands of the flying environment require a certain level of medical suitability. Additionally, such an environment could be more hazardous for certain populations. While the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the World Health Organization strongly support exclusive breastfeeding for the health benefit of both the mother and the child in the first 6 months of life, the aeromedical implications of lactating are not widely discussed. Breastfeeding is inherently challenging for many women, in part because of the frequent emptying required to maintain breastmilk supply and avoid complications such as engorgement, clogged ducts, and mastitis. This pilot study evaluated the experiences of individuals concurrently breastfeeding while on active duty Naval flying status to (1) assess whether these individuals experience frequent challenges or complications associated with lactating and (2) establish the need for future expanded studies.

Materials and Methods

This survey-based, retrospective, descriptive study evaluated the experiences of 17 lactating individuals on active duty Naval flying status. Women were recruited using word of mouth and social media platforms. Responses were tabulated and summarized from the survey, which included yes/no questions and free-response sections regarding flying position, breastfeeding history, and breastfeeding challenges. This trial was approved by the Naval Air Warfare Center Aircraft Division (NAWCAD) Institutional Review Board (Protocol Number NAWCAD.2021.0004-IR-EP7).

Results

Of the 27 women who received study materials after expression of interest, 17 individuals completed the informed consent and survey protocols. Although limited by sample size and the demographics of respondents, the results highlight that the active duty flying environment did impact the breastfeeding experiences of the participants, with 88% of respondents reporting some difficulty or complication associated with breastfeeding and the operational flying environment. Difficulty in maintaining breastmilk supply, engorgement, and the need for supplementation were some of the concerns discussed.

Conclusions

This study hypothesizes that occupational demands associated with aviation result in a decreased ability to maintain exclusive breastfeeding, an increased risk for engorgement and clogged ducts, and a higher likelihood of early weaning among Naval aviators. It included only the perspectives of Naval officers, thereby lacking the input of enlisted aircrew on flight status, who comprise a large population of active duty flyers. The responses, although limited by a lack of controls and survey limitations, indicate that a future study to expand understanding of the aeromedical implications on lactating individuals would be valuable for improving workplace support and the ultimate success of lactating women in meeting their breastfeeding goals.
Enrichment of Hard Sweeps on the X Chromosome in Drosophila melanogaster
Authors: Harris Mariana , Garud Nandita R
Published: December 2022

The characteristic properties of the X chromosome, such as male hemizygosity and its unique inheritance pattern, expose it to natural selection in a way that can be different from the autosomes. Here, we investigate the differences in the tempo and mode of adaptation on the X chromosome and autosomes in a population of Drosophila melanogaster. Specifically, we test the hypothesis that due to hemizygosity and a lower effective population size on the X, the relative proportion of hard sweeps, which are expected when adaptation is gradual, compared with soft sweeps, which are expected when adaptation is rapid, is greater on the X than on the autosomes. We quantify the incidence of hard versus soft sweeps in North American D. melanogaster population genomic data with haplotype homozygosity statistics and find an enrichment of the proportion of hard versus soft sweeps on the X chromosome compared with the autosomes, confirming predictions we make from simulations. Understanding these differences may enable a deeper understanding of how important phenotypes arise as well as the impact of fundamental evolutionary parameters on adaptation, such as dominance, sex-specific selection, and sex-biased demography.
Real-World Outcomes Associated With Letermovir Use for Cytomegalovirus Primary Prophylaxis in Allogeneic Hematopoietic Cell Transplant Recipients: A Systematic Review and Meta-analysis of Observational Studies
Authors: Vyas Ami , Raval Amit D , Kamat Shweta , LaPlante Kerry , Tang Yuexin , Chemaly Roy F
Published: December 2022

Background

A systematic review and meta-analysis of real-world observational studies was conducted to summarize the impact of letermovir cytomegalovirus (CMV) primary prophylaxis (PP) among adult allogeneic hematopoietic cell transplant (allo-HCT) recipients.

Methods

Systematic searches in Medline/PubMed, Embase, and conferences (from database inception to October 2021) were conducted to identify studies for inclusion. Random-effects models were used to derive pooled estimates on the relative effectiveness of letermovir PP compared to controls.

Results

Forty-eight unique studies (N = 7104 patients) were included, most of which were comparative, single-center, and conducted in the United States. Letermovir PP was associated with statistically significant reduction in odds of CMV reactivation (pooled odds ratio [pOR], 0.13 and 0.24; P < .05), clinically significant CMV infection (pOR, 0.09 and 0.19; P < .05), and CMV disease (pOR, 0.31 and 0.35; P < .05) by day +100 and day +200 after allo-HCT, respectively. Letermovir PP was associated with significantly lower odds of all-cause (pOR, 0.73; P < .01) and nonrelapse mortality (pOR, 0.65; P = .01) beyond day 200 after allo-HCT.

Conclusions

Letermovir for CMV PP was effective in reducing the risk of CMV-related complications overall and mortality beyond day 200 among adult allo-HCT recipients.
The Margin of Appreciation in Freedom of Thought, Conscience, and Religion under Article 9 of ECHR
Authors: Alexopoulou Konstantina
Published: December 2022

This article analyses the manner in which the margin of appreciation has been developed by the European Court of Human Rights in Article 9 cases. As a principle of subsidiarity European Convention States Parties enjoy a margin of appreciation but its scope varies according to particular principles. It is generally certain, when a proportionality test applies (eg concerning proselytism, places and buildings of worship, legal recognition of religious communities, prisoners’ rights), narrow, when the Court has already formulated specific interpretational criteria (eg concerning State’s interference with the internal affairs/dissolution of a religious community or restrictions sought by religious employers), or wide, when there is no widespread consensus and State authorities are in a better place to determine on the matter (eg levying of church taxes, freedom of religion in workplace, public places, and educational institutions). This article appraises the rationale and circumstances which produce particular outcomes with a view to increasing predictability and consistent practice by States.
Reaction-Induced Porosity in an Eclogite-Facies Vein Selvage (Monviso Ophiolite, W. Alps): Textural Evidence and In Situ Trace Elements and Sr Isotopes in Apatite.
Authors: Hoover William F , Penniston-Dorland Sarah , Piccoli Philip , Kylander-Clark Andrew
Published: December 2022

Porosity generated during fluid–rock reaction can facilitate fluid transport and metasomatism in low permeability high-pressure metamorphic rocks. Evidence for reaction-induced porosity is found in an eclogite-facies clinopyroxene + apatite vein in an undeformed eclogitized Fe–Ti metagabbro from the Monviso Ophiolite (W. Alps) with a distinct garnet-rich selvage. Vein-forming fluids were sourced from adjacent metagabbros and reaction with the host rock removed Ca and P from the selvage and added Fe, REE, Pb and Cr. Textures at the selvage–host rock interface and in the host rock record local heterogeneity in reactivity and porosity during metasomatism linked to variable initial lawsonite abundance. These features reflect a hierarchy of pervasive-to-channelized porosity structures that facilitated widespread metasomatism of the host rock. Development of this metasomatic system in response to locally derived fluids suggests large-scale externally derived fluid transport is not required to drive extensive fluid–rock exchange. The production of porosity during metasomatic reactions could be important in facilitating further fluid–rock reaction and fluid transport in subducting slabs where permeability is low.
How Large Are Bequest Motives? Estimates Based on Health Shocks
Authors: Kvaerner Jens Soerlie
Published: December 2022

I analyze the inter vivo transfers and bequest decisions of 700,000 individuals during a period when the decision maker receives negative news regarding their life expectancy. The event that initiates the news is a health outcome. Expected mortality increases both the likelihood of transferring wealth to the next generation and the amount transferred. The size of the inter vivo transfer and bequest are positively related to the wealth of the parent and the severity of the diagnosis, regardless of diagnosis-specific demand for informal care. Using a structural life cycle model, I estimate the bequest parameters that are consistent with the causal effect estimates.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Do Corporations Retain Too Much Cash? Evidence from a Natural Experiment
Authors: Kim Hwanki Brian , Kim Woojin , Kronlund Mathias
Published: December 2022

Corporations have accumulated record amounts of cash. We study whether firms’ cash retention has been excessive by examining a Korean reform that introduced a new tax on earnings retained as cash. Difference-in-differences tests show that treated firms reduce cash retention and instead increase payouts and investments. Market participants react favorably to the reform, consistent with excessive cash retention. The valuation effects and the alternative uses of the cash are associated with behavioral and agency frictions. Firms that are more subject to behavioral biases increase payouts and experience higher valuations, while poorly governed firms allocate more to investment and experience relatively lower valuations.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
A Prospective Cohort Study on the Intergenerational Transmission of Childhood Adversity and Subsequent Risk of Psychotic Experiences in Adolescence
Authors: Bolhuis Koen , Steenkamp Lisa R , Tiemeier Henning , Blanken Laura , Pingault Jean-Baptiste , Cecil Charlotte A M , El Marroun Hanan
Published: December 2022

Background and Hypothesis

Previous studies have shown a robust relationship between childhood adversity and subsequent psychotic symptoms. However, the role of familial risk factors underlying this relationship remains largely unclear. Here, we tested whether offspring childhood adversity and postnatal maternal psychopathology mediated the relationship between maternal childhood adversity and offspring psychotic experiences.

Study Design

N = 3068 mother-offspring dyads were included. Maternal history of childhood adversity was retrospectively assessed using the Childhood Trauma Questionnaire during pregnancy. Maternal psychopathology was assessed during and after pregnancy. Twenty-four offspring childhood adversities were assessed by maternal interview when the child was 10 years old. Offspring psychotic experiences were examined using self-report at 14 years. Structural equation mediation models were conducted to explore whether maternal postnatal psychopathology and offspring childhood adversities sequentially mediated the relationship between maternal childhood adversity and offspring psychotic experiences. Analyses were adjusted for sociodemographic confounders.

Study Results

Maternal history of childhood adversity was associated with offspring childhood adversities (β = 0.12, 95% CI: 0.09 to 0.16). Offspring childhood adversity mediated the association of maternal childhood adversity with offspring hallucinations (βindirect effect = 0.008, 95% CI: 0.002 to 0.014, proportion mediated = 16.3%) and delusions (βindirect effect = 0.006, 95% CI: 0.000 to 0.012, proportion mediated = 13.1%).

Conclusions

Intergenerational transmission of childhood adversity can be considered of relevance in the etiology of psychosis vulnerability and can potentially serve as a modifiable risk factor.
Retirement Is Not an Option for the Undocumented: Undocumented Latinx Older Adults’ Perceptions of Financial (In)security in the United States
Authors: Ayón Cecilia , Deniz-Zaragoza Mirella , Marshall Gillian , Hernandez Javier
Published: December 2022

This study examines undocumented Latinx older adults’ perceptions and experiences regarding their economic security in the United States. In-depth semistructured interviews were used to facilitate dialogue with older undocumented adults about their economic security in the United States (N = 25). Participants were on average 61 years old (SD = 4.52), Latinx, and had resided in the United States an average of 23 years (SD = 7.05). More than 70% of the participants were employed; the remaining participants were not working due to poor health (n = 5), advanced age (n = 1), or being in between jobs (n = 1). Authors present a model to illustrate participants’ narratives on their economic (in)security in the United States. Some participants discussed having long-term security in their jobs while others described a cycle of job insecurity due to their status. Their precarious status limited their employment opportunities and earning potential. Their savings capacity is narrow; many did not have savings for emergencies, and less so for a time when they are no longer able to work. Many participants believe they will work until they are physically unable to continue working; others believe their children will be a source of support. Practitioners can engage undocumented immigrants in economic empowerment interventions and advocacy efforts to eliminate exploitation in the workplace. Policy change is needed to provide undocumented older adults the opportunity to achieve financial security.
Research on text fault recognition for on-board equipment of a C3 train control system based on an integrated XGBoost algorithm
Authors: Yue Lili , Liu Luyue , Li Maoqing , Xiao Baodi , Wu Xiaochun
Published: December 2022

The robust guarantee of train control on-board equipment is inextricably linked to the safe functioning of a high-speed train. A fault diagnostic model of on-board equipment is built utilizing the integrated learning XGBoost (eXtreme Gradient Boosting) algorithm to help technicians assess the malfunction category of high-speed train control on-board equipment accurately and rapidly. The XGBoost algorithm iterates multiple decision tree models to improve the accuracy of fault diagnosis by lifting the predicted residual and adding regular terms. To begin, the text features were extracted using the improved TF-IDF (Term Frequency–Inverse Document Frequency) approach, and 24 fault feature words were chosen and converted into weight word vectors. Secondly, considering the imbalanced fault categories in the data set, the ADASYN (Adaptive Synthetic sampling) adaptive synthetically oversampling technique was used to synthesize a few category fault samples. Finally, the data samples were split into training and test sets based on the fault text data of CTCS-3 train control on-board equipment recorded by Guangzhou Railway Group maintenance personnel. The XGBoost model was utilized to realize the automatic fault location of the test set after optimized parameter tuning through grid search. Compared with other methods, the evaluation index of the XGBoost model was significantly improved. The diagnostic accuracy reached 95.43%, which verifies the effectiveness of the method in text fault diagnosis.
Occurrence and Distribution of Major Viruses Infecting Passion Fruit in Guizhou Province, China, and Molecular Characterization of Two Potyviruses
Authors: Fu Xiaodong , Jiang Junmei , Yang Qian , Niu Lili , Wang Ye , Long Xiuqin , Malichan Srihunsa , Xie Xin
Published: December 2022

The planting of passion fruit (Passiflora edulis) in Guizhou Province has gradually increased, and the area under cultivation ranks third in China. However, the cultivation and production of passion fruit is severely affected by viral diseases. In 2021 and 2022, we investigated the occurrence of multiple viral diseases in major cultivation areas, identified the main viruses and conducted field surveys in different growing areas of passion fruit in Guizhou Province, China. In total, 308 samples were randomly collected from 10 different passion fruit cultivation areas, and seven viral diseases were identified using electron microscopy, small RNA sequencing, and reverse-transcription polymerase chain reaction. Among them, the infection rate of Telosma mosaic virus (TeMV) was the highest (50%), followed by East Asian Passiflora virus (EAPV) (19%), and cucumber mosaic virus (CMV) (15%). The detection rates of the other four viruses were lower: Passiflora latent virus (PLV) (1%), turnip mosaic virus (TuMV) (0.6%), Passiflora virus Y (PaVY) (0.3%), and Euphorbia leaf curl virus (ELCV) (6%). In addition, high rates of mixed TeMV + CMV + EAPV infections were found in the province. Notably, 79% of EAPV-infected plants were also infected with TeMV. Finally, the molecular characteristics of the two highly detected potyviruses, TeMV and EAPV, were analyzed. To our knowledge, this study is the first systematic survey of viral diseases of passion fruit in Guizhou Province, China.
Infusion Nursing
Authors: Miller Crystal
Published: December 2022

With a focus on safety, these nurses manage all infusion needs.
New Drug Approved For ALS
Authors: Aschenbrenner Diane S.
Published: December 2022

Sodium phenylbutyrate–taurursodiol (Relyvrio) has been approved to treat amyotrophic lateral sclerosis.

The drug was approved despite the absence of phase 3 clinical trial data. Data from a small phase 2 trial indicated that patients receiving Relyvrio had a slower loss of functioning than those taking placebo.

Relyvrio poses a risk to patients who are sensitive to salt intake and to those with pancreatic, intestinal, and enterohepatic circulation disorders.
Teaching Empathic Communication at the End of Life: A Virtual Simulation for Nursing Students
Authors: Chidume Tiffani
Published: December 2022

There is a gap in the literature regarding prelicensure nursing students’ knowledge/communication regarding death and dying. A virtual telecommunication pilot simulation-based experience (SBE) was designed to address the gap in learner experiences communicating with the family of a dying loved one. Learners had to provide the family member, a role portrayed by a simulated patient, an update on the patient’s rapidly declining condition. The course leaders noticed the value in learners having personalized conversations and empathetic emotion with family members. This virtual SBE will replace an older face-to-face end-of-life SBE going forward.
Preoperative assessment of cutaneous melanoma thickness by multispectral dermoscopy
Authors: Janssen Laudine , Van Kelst Sofie , De Smedt Julie , Terrasson Julie , Diricx Bart , Kimpe Tom , Papeleu Jorien , Verhaeghe Evelien , Brochez Lieve , Garmyn Marjan
Published: December 2022

Preoperative assessment of Breslow thickness by means of sonography and clinical and dermoscopic criteria in white light dermoscopy has been reported, but up until now, the use of multispectral dermoscopy has not been investigated. Aim of this research is to determine whether multispectral dermoscopy and more specifically pigment maps can be used as a predictive marker for Breslow thickness in melanoma. Pigment maps are generated in real time from multispectral dermoscopic images and help to visualize the presence of pigment in a lesion. Multispectral images of 110 melanomas were collected, using a digital handheld multispectral dermatoscope, and assessed independently by five observers for the presence or absence of deep pigment compared with the surrounding skin. According to histopathological examination, the mean Breslow thickness of all 110 melanomas was 1.04 mm (ranging from 0.1 to 14 mm). The group of melanomas where deep pigment was visualized on the multispectral image (n = 78) had a significantly higher Breslow thickness (1.19 mm) than the group where no deep pigment was observed (n = 32, mean Breslow 0.68 mm) (P = 0.025). This study is unique in preoperative assessment of tumour thickness by means of multispectral dermoscopy. Our data indicate that the presence of deep pigment as visualized in digital dermoscopic skin parameter maps identifies a group of thicker melanomas. Further prospective research is needed to validate these pigment maps, generated by multispectral dermoscopy as a measure to predict invasiveness in melanoma.
Immune-related adverse events are associated with therapeutic efficacy of immunotherapy in patients with melanoma brain metastases
Authors: Huo Cecilia W. , Gunadasa Indika , Gkolia Panagiota , Shackleton Mark , Hunn Martin
Published: December 2022

Immunotherapy with T-cell checkpoint inhibitors have changed the treatment landscape for patients with melanoma brain metastases (MBMs), offering increased survival compared with historical outcomes. We sought to identify clinical features associated with intracranial tumour responses or progression-free survival (PFS) in patients with MBMs treated with immunotherapy. Patients with MBMs treated with immunotherapy from August 2013 to March 2020 were identified through local databases. Melanoma disease burdens and immune-related adverse events (irAEs) were assessed retrospectively by review of patient medical records. Efficacy was evaluated by determining objective response rates (ORRs) in brain metastases using immune-Response Evaluation Criteria in Solid Tumours criteria, MBM-specific survival and overall PFS. Twenty-six patients were identified as eligible for this study. The presence and volume of extracranial metastases (ECM) were associated with a non-significant trend of reduced intracranial ORRs and PFS. Patients with irAEs, on the other hand, had significantly increased intracranial ORRs and PFS compared to those without irAEs. Severe, grade ≥3 irAEs and co-occurrence of ≥2 irAEs were also significantly associated with longer PFS. The presence and volume of ECM correlated inversely with development and severity of irAEs. We report a strong association between the development of irAEs and favourable melanoma-specific outcomes in patients with MBMs receiving immunotherapy. Contrary to previous studies, we found that co-occurrence of ECM in these patients was associated with fewer irAEs and reduced treatment efficacy.