bluuebunny/crossref_metadata_2025 huggingface dataset:
Generative transfer learning for measuring plausibility of EHR diagnosis records
Authors: Estiri Hossein , Vasey Sebastien , Murphy Shawn N
Published: August 2020

Objective

Due to a complex set of processes involved with the recording of health information in the Electronic Health Records (EHRs), the truthfulness of EHR diagnosis records is questionable. We present a computational approach to estimate the probability that a single diagnosis record in the EHR reflects the true disease.

Materials and Methods

Using EHR data on 18 diseases from the Mass General Brigham (MGB) Biobank, we develop generative classifiers on a small set of disease-agnostic features from EHRs that aim to represent Patients, pRoviders, and their Interactions within the healthcare SysteM (PRISM features).

Results

We demonstrate that PRISM features and the generative PRISM classifiers are potent for estimating disease probabilities and exhibit generalizable and transferable distributional characteristics across diseases and patient populations. The joint probabilities we learn about diseases through the PRISM features via PRISM generative models are transferable and generalizable to multiple diseases.

Discussion

The Generative Transfer Learning (GTL) approach with PRISM classifiers enables the scalable validation of computable phenotypes in EHRs without the need for domain-specific knowledge about specific disease processes.

Conclusion

Probabilities computed from the generative PRISM classifier can enhance and accelerate applied Machine Learning research and discoveries with EHR data.
Five-year follow-up results from phase II studies of nivolumab in Japanese patients with previously treated advanced non-small cell lung cancer: pooled analysis of the ONO-4538-05 and ONO-4538-06 studies
Authors: Saka Hideo , Nishio Makoto , Hida Toyoaki , Nakagawa Kazuhiko , Sakai Hiroshi , Nogami Naoyuki , Atagi Shinji , Takahashi Toshiaki , Horinouchi Hidehito , Takenoyama Mitsuhiro , Katakami Nobuyuki , Tanaka Hiroshi , Takeda Koji , Satouchi Miyako , Isobe Hiroshi , Maemondo Makoto , Goto Koichi , Hirashima Tomonori , Minato Koichi , Yada Nobumichi , Tamura Tomohide
Published: August 2020

Background

Two phase II studies in Japan examined the efficacy and safety of nivolumab, a programmed cell death 1 receptor inhibitor, in patients with advanced squamous and non-squamous non-small cell lung cancer (ONO-4538-05 and ONO-4538-06). We examined the long-term efficacy and safety of nivolumab in these patients treated for up to 5 years.

Methods

Patients with squamous (N = 35) or non-squamous (N = 76) non-small cell lung cancer received nivolumab (3 mg/kg every 2 weeks) until disease progression/death. Overall survival and progression-free survival were assessed at 5 years after starting treatment in separate and pooled analyses. Safety was evaluated in terms of treatment-related adverse events.

Results

A total of 17 patients were alive at the database lock (26 July 2019). The median overall survival (95% confidence interval) and 5-year survival rate were 16.3 (12.4–25.2) months and 14.3% in squamous patients, 17.1 (13.3–23.0) months and 19.4% in non-squamous patients and 17.1 (14.2–20.6) months and 17.8% in the pooled analysis, respectively. Programmed death ligand-1 expression tended to be greater among 5-year survivors than in non-survivors (P = 0.0703). Overall survival prolonged with increasing programmed death ligand-1 expression, with 5-year survival rates of 11.8, 21.8 and 41.7% in patients with programmed death ligand-1 expression of <1, ≥1–<50 and ≥50%, respectively. Treatment-related adverse events in ≥10% of patients (pooled analysis) included rash (15.3%), malaise (14.4%), decreased appetite (14.4%), pyrexia (14.4%) and nausea (10.8%).

Conclusions

Long-term survival with nivolumab was observed in patients with squamous or non-squamous non-small cell lung cancer. No new safety signals were reported after ≥5 years of follow-up.
Dynamics of Equity Factor Returns and Asset Pricing
Authors: Stoyanov Stoyan V , Fabozzi Francesco A
Published: August 2020

In empirical equity asset pricing, the stochastic discount factor (SDF) is implicitly modeled as a linear function of equity factors and is influenced by the empirical properties of the factor returns. We investigate the pricing error introduced by a misspecified SDF which ignores each of the following established empirical phenomena: autocorrelation, dynamics of covariances, dynamics of correlations, and heavy tails for the conditional factor return distribution. We consider near-linear SDFs and nonlinear specifications characterized by a high degree of risk aversion. We find that assuming constant covariances or constant correlations can significantly overprice certain equity portfolios at all risk-aversion levels and that ignoring fat tails can lead to large pricing errors for some derivative assets for highly nonlinear SDFs.
Sand Fly (Diptera: Psychodidae: Phlebotominae) Population Dynamics and Natural Leishmania Infections in Attica Region, Greece
Authors: Giantsis Ioannis A , Beleri Stavroula , Balatsos Georgios , Karras Vasileios , Patsoula Eleni , Papachristos Dimitrios , Michaelakis Antonios , Chaskopoulou Alexandra
Published: August 2020

A 2-yr sand fly (Diptera: Psychodidae) seasonality study was performed in Attica Region, Greece, from June 2017 until November 2018, aiming also to detect the presence of Leishmania infection in the collected sand flies. In total, 701 sand flies were collected from urban areas within the Attica Region using BG-Sentinel traps, set weekly in eight fixed sites. Five species were identified morphologically and molecularly, namely Phlebotomus tobbi (Adler and Theodor), which was most the most commonly collected species, followed by P. Neglectus (Tonnoir), P. papatasi (Scopoli), P. simici (Theodor), and Sergentomyia minuta (Rondani). During both survey years sand fly populations peaked in late August to early September. Fifty-nine monospecific pools were examined for Leishmania detection by analyzing the ITS1 nuclear region using both RFLPs and sequencing, seven of which were found positive. Leishmania DNA was identified as L. infantum in six pools (five P. papatasi and one P. tobbi), whereas in one P. papatasi pool Leishmania DNA was identified as L. tropica. This is the first time that L. tropica has been detected in naturally infected sand flies from the Attica Region as well as in central Greece, while previously it has only been detected in sand flies collected from Central Macedonia (Northern Greece).
A Pediatric Infectious Diseases Perspective of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Novel Coronavirus Disease 2019 (COVID-19) in Children
Authors: Shane Andi L , Sato Alice I , Kao Carol , Adler-Shohet Felice C , Vora Surabhi B , Auletta Jeffery J , Nachman Sharon , Raabe Vanessa N , Inagaki Kengo , Akinboyo Ibukunoluwa C , Woods Charles , Alsulami Abdulsalam O , Kainth Mundeep K , Santos Roberto Parulan , Espinosa Claudia M , Burns Julianne E , Cunningham Coleen K , Dominguez Samuel R , Martinez Beatriz Larru , Zhu Frank , Crews Jonathan , Kitano Taito , Saiman Lisa , Kotloff Karen
Published: August 2020

Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2, responsible for coronavirus disease 2019 (COVID-19) infections, is emerging. While the severe manifestations and acute clinical burden of COVID-19 have largely spared children compared with adults, understanding the epidemiology, clinical presentation, diagnostics, management, and prevention opportunities and the social and behavioral impacts on child health is vital. Foremost is clarifying the contribution of asymptomatic and mild infections to transmission within the household and community and the clinical and epidemiologic significance of uncommon severe post-infectious complications. Here, we summarize the current knowledge, identify resources, and outline research opportunities. Pediatric infectious diseases clinicians have a unique opportunity to advocate for the inclusion of children in epidemiological, clinical, treatment, and prevention studies to optimize their care as well as to represent children in the development of guidance and policy during pandemic response.
The Medicago truncatula Yellow Stripe1-Like3 gene is involved in vascular delivery of transition metals to root nodules
Authors: Castro-Rodríguez Rosario , Abreu Isidro , Reguera María , Novoa-Aponte Lorena , Mijovilovich Ana , Escudero Viviana , Jiménez-Pastor Francisco J , Abadía Javier , Wen Jiangqi , Mysore Kirankumar S , Álvarez-Fernández Ana , Küpper Hendrik , Imperial Juan , González-Guerrero Manuel
Published: August 2020

Symbiotic nitrogen fixation carried out in legume root nodules requires transition metals. These nutrients are delivered by the host plant to the endosymbiotic nitrogen-fixing bacteria living within the nodule cells, a process in which vascular transport is essential. As members of the Yellow Stripe-Like (YSL) family of metal transporters are involved in root to shoot transport, they should also be required for root to nodule metal delivery. The genome of the model legume Medicago truncatula encodes eight YSL proteins, four of them with a high degree of similarity to Arabidopsis thaliana YSLs involved in long-distance metal trafficking. Among them, MtYSL3 is a plasma membrane protein expressed by vascular cells in roots and nodules and by cortical nodule cells. Reducing the expression level of this gene had no major effect on plant physiology when assimilable nitrogen was provided in the nutrient solution. However, nodule functioning was severely impaired, with a significant reduction of nitrogen fixation capabilities. Further, iron and zinc accumulation and distribution changed. Iron was retained in the apical region of the nodule, while zinc became strongly accumulated in the nodule veins in the ysl3 mutant. These data suggest a role for MtYSL3 in vascular delivery of iron and zinc to symbiotic nitrogen fixation.
Antifungal activity of deferiprone and EDTA against Sporothrix spp.: Effect on planktonic growth and biofilm formation
Authors: Brilhante Raimunda Sâmia Nogueira , Costa Anderson da Cunha , Pereira Vandbergue Santos , Fernandes Mirele Rodrigues , de Oliveira Jonathas Sales , Rodrigues Anderson Messias , Camargo Zoilo Pires , Pereira-Neto Waldemiro de Aquino , Sidrim José Júlio Costa , Rocha Marcos Fábio Gadelha
Published: August 2020

The present study evaluated the antifungal activity of the chelators deferiprone (DFP) and ethylenediaminetetraacetic acid (EDTA) and their effect on biofilm formation of the S. schenckii complex. Eighteen strains of Sporothrix spp. (seven S. brasiliensis, three S. globosa, three S. mexicana and five Sporothrix schenckii sensu stricto) were used. Minimum inhibitory concentration (MIC) values for EDTA and DFP against filamentous forms of Sporothrix spp. ranged from 32 to 128 μg/ml. For antifungal drugs, MIC values ranged from 0.25 to 4 μg/ml for amphotericin B, from 0.25 to 4 μg/ml for itraconazole, and from 0.03 to 0.25 μg/ml for terbinafine. The chelators caused inhibition of Sporothrix spp. in yeast form at concentrations ranging from 16 to 64 μg/ml (for EDTA) and 8 to 32 μg/ml (for DFP). For antifungal drugs, MIC values observed against the yeast varied from 0.03 to 0.5 μg/ml for AMB, 0.03 to 1 μg/ml for ITC, and 0.03 to 0.13 μg/ml for TRB. Both DFP and EDTA presented synergistic interaction with antifungals against Sporothrix spp. in both filamentous and yeast form. Biofilms formed in the presence of the chelators (512 μg/ml) showed a reduction of 47% in biomass and 45% in metabolic activity. Our data reveal that DFP and EDTA reduced the growth of planktonic cells of Sporothrix spp., had synergistic interaction with antifungal drugs against this pathogen, and reduced biofilm formation of Sporothrix spp.
Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients
Authors: Vehreschild Jörg Janne , Koehler Philipp , Lamoth Frédéric , Prattes Juergen , Rieger Christina , Rijnders Bart J A , Teschner Daniel
Published: August 2020

Diagnosis, treatment, and management of invasive mould infections (IMI) are challenged by several risk factors, including local epidemiological characteristics, the emergence of fungal resistance and the innate resistance of emerging pathogens, the use of new immunosuppressants, as well as off-target effects of new oncological drugs. The presence of specific host genetic variants and the patient's immune system status may also influence the establishment of an IMI and the outcome of its therapy. Immunological components can thus be expected to play a pivotal role not only in the risk assessment and diagnosis, but also in the treatment of IMI. Cytokines could improve the reliability of an invasive aspergillosis diagnosis by serving as biomarkers as do serological and molecular assays, since they can be easily measured, and the turnaround time is short. The use of immunological markers in the assessment of treatment response could be helpful to reduce overtreatment in high risk patients and allow prompt escalation of antifungal treatment. Mould-active prophylaxis could be better targeted to individual host needs, leading to a targeted prophylaxis in patients with known immunological profiles associated with high susceptibility for IMI, in particular invasive aspergillosis. The alteration of cellular antifungal immune response through oncological drugs and immunosuppressants heavily influences the outcome and may be even more important than the choice of the antifungal treatment. There is a need for the development of new antifungal strategies, including individualized approaches for prevention and treatment of IMI that consider genetic traits of the patients.

Lay Abstract

Anticancer and immunosuppressive drugs may alter the ability of the immune system to fight invasive mould infections and may be more important than the choice of the antifungal treatment. Individualized approaches for prevention and treatment of invasive mold infections are needed.
Simulating gas kinematic studies of high-redshift galaxies with the HARMONI integral field spectrograph
Authors: Richardson Mark L A , Routledge Laurence , Thatte Niranjan , Tecza Matthias , Houghton Ryan C W , Pereira-Santaella Miguel , Rigopoulou Dimitra
Published: August 2020

We present simulated observations of gas kinematics in a galaxy formed in a 10 pc resolution cosmological simulation with the hydrodynamical +   N-body code ramses, using the new ramses2hsim pipeline with the simulated observing pipeline (hsim) for the Extremely Large Telescope High Angular Resolution Monolithic Optical and Near-infrared Integral field spectrograph (HARMONI IFS). We post-process the galaxy's gas kinematics and Hα line emission for each simulation cell, and integrate the emission to produce an extinction-corrected input cube. We then simulate observations of the input cube with HARMONI, for a range of exposure times, spatial sampling, and spectral resolution. We analyse the mock observations to recover galaxy properties such as its kinematics and compare with the known simulation values. We investigate the cause of biases between the ‘real’ and ‘observed’ kinematic values, demonstrating the sensitivity of the inferred rotation curve to knowledge of the instrument’s point spread function.
HP Cet and Swift J0820.6–2805: two candidate intermediate polars observed by XMM–Newton
Authors: Nucita A A , De Paolis F , Strafella F , Licchelli D
Published: August 2020

We report on the XMM–Newton observation of HP Cet and Swift J0820.6–2805, two X-ray photon sources that are candidates to be members of the intermediate polar class of cataclysmic variables. If the historical optical light curve of HP Cet shows a periodic feature at ≃96 min, a clear identification of such a signature in the high energy band (apart for a variability on a time-scale of ≃8 min as detected by the ROSAT satellite) is lacking. By using XMM–Newton archive data, we clearly identify a feature (at ≃88 min) which is marginally consistent with one of the binary system orbital periods reported in the literature. We also found a signature of a periodic features on the time-scale of ≃5.6 min. In the case of Swift J0820.6–2805, the intermediate polar nature was previously unclear and the orbital and the white dwarf spin periods were unknown. Here, the 0.3–10 keV data undoubtedly reveal an orbital period and a white dwarf spin of ≃87.5 and ≃27.9 min, respectively. The spectral analysis showed that both HP Cet and Swift J0820.6–280 are members of the underluminous IP subclass since their luminosity in the 0.3–10 keV band is estimated to be ≃5 × 1030 and ≃3.8 × 1029 erg s−1, respectively.
The globular cluster system mass–halo mass relation in the E-MOSAICS simulations
Authors: Bastian Nate , Pfeffer Joel , Kruijssen J M Diederik , Crain Robert A , Trujillo-Gomez Sebastian , Reina-Campos Marta
Published: August 2020

Linking globular clusters (GCs) to the assembly of their host galaxies is an overarching goal in GC studies. The inference of tight scaling relations between GC system properties and the mass of both the stellar and dark halo components of their host galaxies are indicative of an intimate physical connection, yet have also raised fundamental questions about how and when GCs form. Specifically, the inferred correlation between the mass of a GC system (MGC) and the dark matter halo mass (Mhalo) of a galaxy has been posited as a consequence of a causal relation between the formation of dark matter mini-haloes and GC formation during the early epochs of galaxy assembly. We present the first results from a new simulation of a cosmological volume (L = 34.4 cMpc on a side) from the E-MOSAICS suite, which includes treatments of the formation and evolution of GCs within the framework of a detailed galaxy formation model. The simulated MGC–Mhalo relation is linear for halo masses >5 × 1011 M⊙, and is driven by the hierarchical assembly of galaxies. Below this halo mass, the simulated relation features a downturn, which we show is consistent with observations, and is driven by the underlying stellar mass–halo mass relation of galaxies. Our fiducial model reproduces the observed MGC–M⋆ relation across the full mass range, which we argue is more physically relevant than the MGC–Mhalo relation. We also explore the physical processes driving the observed constant value of $\hbox{$M_{\rm GC}$}/ \hbox{$M_{\rm halo}$}\sim 5\times 10^{-5}$ and find that it is the result of a combination of cluster formation physics and cluster disruption.
Bow shocks, nova shells, disc winds and tilted discs: the nova-like V341 Ara has it all
Authors: Castro Segura N , Knigge C , Acosta-Pulido J A , Altamirano D , del Palacio S , Hernandez Santisteban J V , Pahari M , Rodriguez-Gil P , Belardi C , Buckley D A H , Burleigh M R , Childress M , Fender R P , Hewitt D M , James D J , Kuhn R B , Kuin N P M , Pepper J , Ponomareva A A , Pretorius M L , Rodríguez J E , Stassun K G , Williams D R A , Woudt P A
Published: August 2020

V341 Ara was recently recognized as one of the closest (d ≃ 150 pc) and brightest (V ≃ 10) nova-like cataclysmic variables. This unique system is surrounded by a bright emission nebula, likely to be the remnant of a recent nova eruption. Embedded within this nebula is a prominent bow shock, where the system’s accretion disc wind runs into its own nova shell. In order to establish its fundamental properties, we present the first comprehensive multiwavelength study of the system. Long-term photometry reveals quasi-periodic, super-orbital variations with a characteristic time-scale of 10–16 d and typical amplitude of ≃1 mag. High-cadence photometry from theTransiting Exoplanet Survey Satellite (TESS) reveals for the first time both the orbital period and a ‘negative superhump’ period. The latter is usually interpreted as the signature of a tilted accretion disc. We propose a recently developed disc instability model as a plausible explanation for the photometric behaviour. In our spectroscopic data, we clearly detect antiphased absorption and emission-line components. Their radial velocities suggest a high mass ratio, which in turn implies an unusually low white-dwarf mass. We also constrain the wind mass-loss rate of the system from the spatially resolved [O iii] emission produced in the bow shock; this can be used to test and calibrate accretion disc wind models. We suggest a possible association between V341 Ara and a ‘guest star’ mentioned in Chinese historical records in AD 1240. If this marks the date of the system’s nova eruption, V341 Ara would be the oldest recovered nova of its class and an excellent laboratory for testing nova theory.
Recovering variable stars in large surveys: EAup Algol-type class in the Catalina Survey
Authors: Carmo A , Ferreira Lopes C E , Papageorgiou A , Jablonski F J , Rodrigues C V , Drake A J , Cross N J G , Catelan M
Published: August 2020

The discovery and characterization of Algol eclipsing binaries (EAs) provide an opportunity to contribute for a better picture of the structure and evolution of low-mass stars. However, the cadence of most current photometric surveys hinders the detection of EAs since the separation between observations is usually larger than the eclipse(s) duration and hence few measurements are found at the eclipses. Even when those objects are detected as variable, their periods can be missed if an appropriate oversampling factor is not used in the search tools. In this paper, we apply this approach to find the periods of stars catalogued in the Catalina Real-Time Transient Survey (CRTS) as EAs having unknown period (EAup). As a result, the periods of ${\sim} 56{\rm {per \, cent}}$ of them were determined. Eight objects were identified as low-mass binary systems and modelled with the Wilson & Devinney synthesis code combined with a Markov chain Monte Carlo optimization procedure. The computed masses and radii are in agreement with theoretical models and show no evidence of inflated radii. This paper is the first of a series aiming to identify suspected binary systems in large surveys.
A 4 per cent measurement of H0 using the cumulative distribution of strong lensing time delays in doubly imaged quasars
Authors: Harvey David
Published: August 2020

In the advent of large-scale surveys, individually modelling strong gravitational lenses and their counterpart time delays in order to precisely measure H0 will become computationally expensive and highly complex. A complimentary approach is to study the cumulative distribution function (CDF) of time delays where the global population of lenses is modelled along with H0. In this paper, we use a suite of hydrodynamical simulations to estimate the CDF of time delays from doubly imaged quasars for a realistic distribution of lenses. We find that the CDFs exhibit large amounts of halo–halo variance, regulated by the density profile inner slope and the total mass within 5 kpc. With the objective of fitting to data, we compress the CDFs using principal component analysis and fit a Gaussian processes regressor consisting of three physical features: the redshift of the lens, $z$L; the power-law index of the halo, α, and the mass within 5 kpc, plus four cosmological features. Assuming a flat Universe, we fit our model to 27 doubly imaged quasars finding $H_0=71^{+2}_{-3}$ km s−1 Mpc−1, $z_{\rm L}= 0.36_{-0.09}^{+0.2}$, $\alpha =-1.8_{-0.1}^{+0.1}$, log (M(< 5 kpc$)/M_\odot)=11.1_{-0.1}^{+0.1}$, $\Omega _{\rm M} = 0.3_{-0.04}^{+0.04}$, and $\Omega _{\rm \Lambda }=0.7_{-0.04}^{+0.04}$. We compare our estimates of $z$L and log (M(< 5 kpc)/M⊙) to the data and find that within the sensitivity of the data, they are not systematically biased. We generate mock CDFs and find with that the Vera Rubin Observatory (VRO) could measure σ/H0 to ${\lt}3{\rm {per \, cent}}$, limited by the precision of the model. If we are to exploit fully VRO, we require simulations that sample a larger proportion of the lens population, with a variety of feedback models, exploring all possible systematics.
A Magic Bullet? The Potential Impact of E-Cigarettes on the Toll of Cigarette Smoking
Authors: Mendez David , Warner Kenneth E
Published: August 2020

Introduction

We examine the proportion of US smoking-produced mortality that e-cigarettes might eliminate under assumptions regarding vaping’s ability to increase smoking cessation, vaping’s health risks, and the possibility that vaping will increase smoking among young people.

Methods

We employ a dynamic population simulation model that tracks individuals from ages 0 to 110, differentiated by gender and smoking status. Using data from the US Census, the National Vital Statistics Reports, Cancer Prevention Study II, and the National Health Interview Survey, we estimate the number of smoking-related life-years lost (LYL) from 2018 to 2100 in a no-vaping scenario. We then compare results for model runs that assess the impact of vaping under a variety of assumptions.

Results

The combination of assumptions produces 360 possible scenarios. 357 (99%) yield positive estimates of life-years saved (LYS) due to vaping by 2100, from 143 000 to 65 million. Most scenarios result in millions of individuals quitting smoking due to vaping. On average, vaping-induced quitters gain an extra 1.2–2.0 years of life compared to smokers who quit without vaping. The impact of vaping is greatest when it most helps smokers who otherwise have the greatest difficulty quitting smoking. While the numbers of LYS are generally large across all scenarios, they often represent a small fraction of the toll of smoking.

Conclusions

Vaping is highly likely to reduce smoking-produced mortality. Still, vaping is not “the” answer to the public health crisis created by smoking. Rather, it may well be a tool to add to the armamentarium of effective tobacco control measures.

Implications

E-cigarettes hold the potential to reduce cigarette smoking’s enormous toll. By itself, however, tobacco harm reduction, as embodied in vaping, is no magic bullet. Going forward, tobacco control will require vigilant application of the evidence-based measures that have brought us so much success in combatting smoking. It will require, as well, the search for and adoption of novel means of attacking the remaining problem. Harm reduction can, and many would say should, be a part of the complex formula that will eventually bring about the demise of smoking.
Heathrow and the Making of Neoliberal Britain
Authors: Vernon James
Published: August 2020

How might we understand neoliberalism and its history differently if we trace its emergence and operation in a particular place? As the first airport in the world to be privatized in 1986 Heathrow is a paradigmatic neoliberal space. And yet for decades before it was sold the airport’s services — catering, cleaning, retail and security — had been steadily deregulated and outsourced in ways that force us to reconsider neoliberalism as discrete from, or emerging from a rupture with, welfare capitalism. The precarious and cheap outsourced forms of labour at Heathrow were performed by Commonwealth citizens of colour, often women, who had paradoxically arrived in Britain through an increasingly hostile immigration regime at the airport. The racialized forms of neoliberal capitalism at the airport depended upon and reproduced a post-imperial social formation that was no less marked by postcolonial crises and a new biopolitics of immigration control designed to restrict their diasporas in the metropole. Seen from Heathrow, neoliberalism is less about the global flow of ideas and capital than the local social formations and labour regimes engendered by changing forms of accumulation.
Oral Opioid Prescribing Trends in the United States, 2002–2018
Authors: Kern David M , Cepeda M Soledad , Sena Anthony G
Published: August 2020

Objective

To conduct a retrospective analysis of sequential cross-sectional data of opioid prescribing practices in patients with no prior history of opioid use.

Methods

Individuals filling an oral opioid prescription who had 1 year of prior observation were identified from four different administrative claims databases for the period between January 1, 2002, and December 31, 2018: IBM MarketScan® Commercial Database (CCAE), Multi-State Medicaid Database (MDCD), Medicare Supplemental Database (MDCR), and Optum© De-Identified Clinformatics® Data Mart Database. Outcomes included incidence of new opioid use and characteristics of patients’ first opioid prescription, including dispensed morphine milligram equivalent (MME) per day, total MME dispensed, total MME ≥300, and days’ supply of prescription for ≤3 or ≥30 days.

Results

There were 40,600,696 new opioid users identified. The incidence of new opioid use in the past 17 years ranged from 6% to 11% within the two commercially insured databases. Incidence decreased over time in MDCD and was consistently higher in MDCR. Total MME dispensed decreased in MDCD and increased in CCAE, with no major changes in the other databases. The proportion of patients receiving ≥30-day prescriptions decreased and the proportion of patients receiving ≤3-day prescriptions increased in MDCD, while ≥30-day prescriptions in the Optum database dramatically increased (low of 3.0% in 2003 to peak of 16.9% in 2017).

Conclusions

Opioid prescribing practices varied across different populations of insured individuals during the past 17 years. The most substantial changes in opioid prescriptions over time have occurred in MDCD, with reductions in use across multiple metrics.
Risk of severe coronavirus disease in imported and secondary cases in Zhejiang province, China
Authors: He Fan , Shang Xiaopeng , Fu Tiehong , Lin Junfen , Li Fudong , Qiu Yinwei , Wu Chen , Wang Zhen
Published: August 2020

Background

To our knowledge, no previous studies have focused on determining whether the virulence and case fatality rate of the severe acute respiratory coronavirus 2 (SARS-CoV-2) decreases as the virus continues to spread. Hence, our aim was to retrospectively explore the differences in the risk of severe or critical COVID-19 among imported, secondary and tertiary cases in Zhejiang, China.

Methods

We categorized COVID-19 cases reported by hospitals in Zhejiang as first-, second- and third-generation cases. Univariate and multivariate logistic regression analyses were performed to compare disease severity and case generation.

Results

Of 1187 COVID-19 cases, 227 (19.1%, 95% CI: 16.9–21.4) manifested severe or critical illness. The adjusted risk difference for severe or critical illness was lower for second- (odds ratio (OR) = 0.84, 95% confidence interval (CI): 0.52–1.36) and third-generation (OR = 0.55, 95% CI: 0.37–0.83) cases than for first-generation cases. Compared with hospitalized patients, cases identified at centralized isolation locations (OR = 0.62, 95% CI: 0.40–0.97) and those identified through active search or gateway screening (OR = 0.28, 95% CI: 0.08–1.04) were at a lower risk of severe or critical illness.

Conclusions

Second- and third-generation cases of COVID-19 have a lower risk of developing severe or critical illness than first-generation cases.
Quality of media reporting following a celebrity suicide in India
Authors: Menon Vikas , Kar Sujita Kumar , Varadharajan Natarajan , Kaliamoorthy Charanya , Pattnaik Jigyansa Ipsita , Sharma Ginni , Mukherjee Srijeeta , Shirahatti Nikhilesh B , Ransing Ramdas , Padhy Susanta Kumar , Arafat S M Yasir
Published: August 2020

Background

Celebrity suicides have the potential to trigger suicide contagion, particularly when media reporting is detailed and imbalanced. We aimed to assess the quality of media reporting of suicide of a popular Indian entertainment celebrity against the World Health Organization (WHO) suicide reporting guidelines.

Methods

Relevant news articles that reported the actor’s suicide were retrieved from online news portals of regional and English language newspapers and television channels in the immediate week following the event. Deductive content analysis of these articles was done using a pre-designed data extraction form.

Results

A total of 573 news articles were analyzed. Several breaches of reporting were noted in relation to mentioning the word ‘celebrity’ in the title of report (14.7%), inclusion of the deceased’s photograph (88.5%), detailed descriptions of the method (50.4%) and location of suicide (70.6%); local language newspapers were more culpable than English newspapers. Helpful reporting characteristics such as mentioning warning signs (4.1%), including educational information (2.7%) and suicide support line details (14.0%) were rarely practiced.

Conclusion

Media reporting of celebrity suicide in India is imbalanced and poorly adherent to suicide reporting recommendations. Local language news reports display more frequent and serious violations in reporting as opposed to English news articles.
Nothing Wrong with the Analysis of Clades in Comparative Evolutionary Studies: A Reply to Poe et al
Authors: Baker Joanna , Meade Andrew , Pagel Mark , Venditti Chris
Published: August 2020

In a recent paper, Poe et al. assert that scientists should abandon clade-based approaches, particularly those using named taxonomic ranks. Poe et al. attempt to demonstrate that clade selection can have effects on the results of evolutionary analyses but unfortunately fall short of making any robust conclusions. Here, we demonstrate that the assertions made by Poe et al. have two important flaws: (i) an erroneous view of modern phylogenetic comparative methods; and (ii) a lack of statistical rigor in their analyses. We repeat Poe et al.’s analysis but using appropriate phylogenetic comparative approaches. We demonstrate that results remain consistent regardless of the clade definition. We go on to discuss the value of taxonomic groupings and how they can provide meaningful units of comparison in evolutionary study. Unlike the disheartening suggestion to abandon the use of clades, scientists can instead continue to use phylogenetic “ corrections” that are already the standard for most comparative evolutionary analyses. [Comparative methods; evolution; phylogeny; taxonomy.]
Broadscale phage therapy is unlikely to select for widespread evolution of bacterial resistance to virus infection
Authors: Cohan Frederick M , Zandi Matthew , Turner Paul E
Published: August 2020

Multi-drug resistant bacterial pathogens are alarmingly on the rise, signaling that the golden age of antibiotics may be over. Phage therapy is a classic approach that often employs strictly lytic bacteriophages (bacteria-specific viruses that kill cells) to combat infections. Recent success in using phages in patient treatment stimulates greater interest in phage therapy among Western physicians. But there is concern that widespread use of phage therapy would eventually lead to global spread of phage-resistant bacteria and widespread failure of the approach. Here, we argue that various mechanisms of horizontal genetic transfer (HGT) have largely contributed to broad acquisition of antibiotic resistance in bacterial populations and species, whereas similar evolution of broad resistance to therapeutic phages is unlikely. The tendency for phages to infect only particular bacterial genotypes limits their broad use in therapy, in turn reducing the likelihood that bacteria could acquire beneficial resistance genes from distant relatives via HGT. We additionally consider whether HGT of clustered regularly interspaced short palindromic repeats (CRISPR) immunity would thwart generalized use of phages in therapy, and argue that phage-specific CRISPR spacer regions from one taxon are unlikely to provide adaptive value if horizontally-transferred to other taxa. For these reasons, we conclude that broadscale phage therapy efforts are unlikely to produce widespread selection for evolution of bacterial resistance.
Novel hepaci- and pegi-like viruses in native Australian wildlife and non-human primates
Authors: Porter Ashleigh F , Pettersson John H -O , Chang Wei-Shan , Harvey Erin , Rose Karrie , Shi Mang , Eden John-Sebastian , Buchmann Jan , Moritz Craig , Holmes Edward C
Published: August 2020

The Flaviviridae family of positive-sense RNA viruses contains important pathogens of humans and other animals, including Zika virus, dengue virus, and hepatitis C virus. The Flaviviridae are currently divided into four genera—Hepacivirus, Pegivirus, Pestivirus, and Flavivirus—each with a diverse host range. Members of the genus Hepacivirus are associated with an array of animal species, including humans, non-human primates, other mammalian species, as well as birds and fish, while the closely related pegiviruses have been identified in a variety of mammalian taxa, also including humans. Using a combination of total RNA and whole-genome sequencing we identified four novel hepaci-like viruses and one novel variant of a known hepacivirus in five species of Australian wildlife. The hosts infected comprised native Australian marsupials and birds, as well as a native gecko (Gehyra lauta). From these data we identified a distinct marsupial clade of hepaci-like viruses that also included an engorged Ixodes holocyclus tick collected while feeding on Australian long-nosed bandicoots (Perameles nasuta). Distinct lineages of hepaci-like viruses associated with geckos and birds were also identified. By mining the SRA database we similarly identified three new hepaci-like viruses from avian and primate hosts, as well as two novel pegi-like viruses associated with primates. The phylogenetic history of the hepaci- and pegi-like viruses as a whole, combined with co-phylogenetic analysis, provided support for virus-host co-divergence over the course of vertebrate evolution, although with frequent cross-species virus transmission. Overall, our work highlights the diversity of the Hepacivirus and Pegivirus genera as well as the uncertain phylogenetic distinction between.
Reciprocal Mentoring: An Innovative Clinical Exercise for Nursing Education
Authors: Friday Vivienne Evet
Published: August 2020

The growing population of older adults requires that nursing programs provide nursing students with the skills and knowledge needed to provide gerontological nursing care. This article describes a reciprocal mentoring exercise used for the clinical practice experience in a new 16-week stand-alone gerontology nursing course. Reflective journaling and responses to a survey revealed positive outcomes for students and mentors.
Diagnosis methods and treatment strategy for primary thyroid lymphoma: a retrospective analysis of 41 cases in China
Authors: Wang Yicheng , Wang Shirui , Liu Ziwen , Liao Quan , Chen Ge , Xu Xiequn
Published: August 2020

Primary thyroid lymphoma (PTL) is a rare malignant tumor. It can manifest as a rapidly growing mass and produce various compression symptoms. However, PTL is easily missed or misdiagnosed for the lack of standardized diagnostic methods. Therefore, it is very necessary to analyze the diagnosis methods and treatment strategy of PTL to clarify the guide of diagnosis and treatment. In this study, we retrospectively analyzed PTL patients to determine their clinical, ultrasound and histological features. Forty-one PTL cases were analyzed. The pathological results of all cases were B-cell-derived non-Hodgkin’s lymphoma. In these patients, 12 were mucosa-associated lymphoid tissue lymphomas, and 24 were diffuse large B-cell lymphomas. Through the analysis of the clinical, ultrasonographic and histological features of 41 patients with PTL, and the discussion of treatment strategies, we support that middle-aged women with a history of Hashimoto’s thyroiditis should pay more attention to the possibility of PTL if they have a swelling neck. Thyroid function tests and neck ultrasound are routine examinations. Core biopsy is an important diagnostic method. PTL treatment is mainly based on radiotherapy and chemotherapy, and surgery is not the first choice.
Oral contrast agents lead to underestimation of dose calculation in volumetric-modulated arc therapy planning for pelvic irradiation
Authors: Jing Hao , Tian Yuan , Tang Yu , Wang Shu-Lian , Jin Jing , Song Yong-Wen , Liu Yue-Ping , Fang Hui , Chen Bo , Qi Shu-Nan , Tang Yuan , Lu Ning-Ning , Yang Yong , Li Ning , Li Ye-Xiong
Published: August 2020

Background

The effects of oral contrast agents (OCAs) on dosimetry have not been studied in detail. Therefore, this study aimed to examine the influence of OCAs on dose calculation in volumetric-modulated arc therapy plans for rectal cancer.

Methods

From 2008 to 2016, computed tomography (CT) images were obtained from 33 rectal cancer patients administered OCA with or without intravenous contrast agent (ICA) and 14 patients who received no contrast agent. CT numbers of organs at risk were recorded and converted to electronic densities. Volumetric-modulated arc therapy plans were designed before and after the original densities were replaced with non-enhanced densities. Doses to the planned target volume (PTV) and organs at risk were compared between the plans.

Results

OCA significantly increased the mean and maximum densities of the bowels, while the effects of ICA on these parameters depended on the blood supply of the organs. With OCA, the actual doses for PTV were significantly higher than planned and doses to the bowel increased significantly although moderately. However, the increase in the volume receiving a high-range doses was substantial (the absolute change of intestine volume receiving ≥52 Gy: 1.46 [0.05−3.99, cubic centimeter range: −6.74 to 128.12], the absolute change of colon volume receiving ≥50 Gy: 0.34 [0.01−1.53 cc, range: −0.08 to 3.80 cc]. Dose changes due to ICA were insignificant. Pearson correlation showed that dose changes were significantly correlated with a high intestinal volume within or near the PTV (ρ> 0.5,P < 0.05) and with the density of enhanced intestine (ρ> 0.3,P < 0.05).

Conclusions

Contrast agents applied in simulation cause underestimation of doses in actual treatment. The overdose due to ICA was slight, while that due to OCA was moderate. The bowel volume receiving ≥50Gy was dramatically increased when OCA within the bowel was absent. Physicians should be aware of these issues if the original plan is barely within clinical tolerance or if a considerable volume of enhanced intestine is within or near the PTV.
A Systematic Review of Cochlear Implantation in Temporal Bone Fractures and the Significance of Otic Capsule Involvement
Authors: Cowan Brandon , Oska Sandra , Arianpour Khashayar , Svider Peter F. , Bojrab Dennis , Hong Robert S.
Published: August 2020

Objective:

Head trauma can cause deafness in cases with and without a skull base fracture. Anatomic disruption can occur with skull base fractures, but inner ear structures can also be damaged by the concussive forces of the trauma even without fracture. It is thought that negative prognostic indicators for successful cochlear implantation (CI) for hearing rehabilitation include fractures involving the otic capsule or ossification of the cochlea. This review evaluates success of CI in posttrauma patients.

Data Sources:

PubMed/MEDLINE, Cochrane, and Embase.

Study Selection:

Search terms used were “cochlear implant” AND (“trauma” OR “fracture”). Studies including preoperative computed tomography or magnetic resonance imaging and patient-level outcome data were included.

Data Extraction:

Study design, perioperative and postoperative outcomes, and complications were reported. Success rates of CI were compared using χ
2 analysis.

Data Synthesis:

Twenty-three studies encompassing 88 patients who experienced posttraumatic deafness and received subsequent CI were included. CI was reported as successful for 28 of 34 patients (82%) with otic capsule-involving fracture, as compared with 17 of 22 (77%) in those who had an otic capsule-sparing temporal bone fracture, and 15 of 17 (88%) of patients without evidence of fracture (i.e., concussive inner ear injury).

Conclusions:

In patients with posttraumatic hearing loss, success rates do not significantly differ between cases that do or do not involve fractures of the otic capsule. CI for posttraumatic hearing loss is generally successful.
Cochlear Implant Outcomes Following Vestibular Schwannoma Resection: Systematic Review
Authors: Wick Cameron C. , Butler Margaret J. , Yeager Lauren H. , Kallogjeri Dorina , Durakovic Nedim , McJunkin Jonathan L. , Shew Matthew A. , Herzog Jacques A. , Buchman Craig A.
Published: August 2020

Objective:

Hearing loss remains a significant morbidity for patients with vestibular schwannomas (VS). A growing number of reports suggest audibility with cochlear implantation following VS resection; however, there is little consensus on preferred timing and cochlear implant (CI) performance.

Data Sources:

A systematic literature search of the Ovid Medline, Embase, Scopus, and clinicaltrails.gov databases was performed on 9/7/2018. PRISMA reporting guidelines were followed.

Study Selection:

Included studies reported CI outcomes in an ear that underwent a VS resection. Untreated VSs, radiated VSs, and CIs in the contralateral ear were excluded.

Data Extraction:

Primary outcomes were daily CI use and attainment of open-set speech. Baseline tumor and patient characteristics were recorded. Subjects were divided into two groups: simultaneous CI placement with VS resection (Group 1) versus delayed CI placement after VS resection (Group 2).

Data Synthesis:

Twenty-nine articles with 93 patients met inclusion criteria. Most studies were poor quality due to their small, retrospective design. Group 1 had 46 patients, of whom 80.4% used their CI on a daily basis and 50.0% achieved open-set speech. Group 2 had 47 patients, of whom 87.2% used their CI on a daily basis and 59.6% achieved open-set speech. Group 2 had more NF2 patients and larger tumors. CI timing did not significantly impact outcomes.

Conclusions:

Audibility with CI after VS resection is feasible. Timing of CI placement (simultaneous versus delayed) did not significantly affect performance. Overall, 83.9% used their CI on a daily basis and 54.8% achieved open-set speech.
Effect of Aging and Direction of Impulse in Suppression Head Impulse Test
Authors: Lee Jung-Yup , Kim Min-Beom
Published: August 2020

Objective:

To identify differences in the vestibulo-ocular reflex (VOR) gain value and the peak saccade velocity in the suppression video head impulse test paradigms according to the age of the subject and the direction of the impulse.

Study Design:

Retrospective chart analysis.

Setting:

Tertiary referral hospital.

Patients/Interventions:

Between October 2017 and May 2019, we enrolled subjects who had previous histories of dizziness but no dizziness over the last 1 month.

Main Outcome Measure:

We conducted cervical vestibular-evoked myogenic potential and caloric tests, as well as video head impulse tests. We excluded the subjects who had abnormal cervical vestibular-evoked myogenic potential results (asymmetry ratio of greater than 30%) and abnormal caloric test results (caloric paresis of greater than 25%).

Results:

We included 647 subjects aged 10 to 87 years. The mean VOR gain and peak saccade velocity were maintained in subjects less than 70 years old (VOR gain, 0.991 ± 0.08, peak saccade velocity, 348.47 ± 142.32). However, the decreases in VOR gain and peak saccade velocity were significant in subjects over 70 years old (VOR gain, 0.928 ± 0.09, peak saccade velocity, 315.51 ± 0.09; p < 0.001). The mean VOR gain of the rightward impulse (1.00 ± 0.09) was higher than the leftward impulse (0.96 ± 0.08, p < 0.001).

Conclusions:

Both the VOR gain and peak saccade velocity of suppression video head impulse test paradigms declined with increasing age over 70 years. In addition, the VOR gain of the rightward impulse was higher than the leftward impulse in the right-eye recordings.