bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome scans reveal extensive population structure in three neritic tuna and tuna-like species in the Indian Ocean
Authors: Feutry Pierre , Foster Scott , Grewe Peter M , Aulich Jorden , Lansdell Matt , Clear Naomi , Cooper Scott , Williams Ashley , Johnson Grant , Dilrukshi Thilini , Wudianto  , Shahid Umair , Ahusan Mohamed , Lestari Pratiwi , Taufik Muhammad , Priatna Asep , Zamroni Achmad , Usmani Hamid Badar , Farley Jessica , Murua Hilario , Marsac Francis , Davies Campbell R
Published: December 2024

Neritic tunas and tuna-like species are an important resource for many coastal nations1 worldwide supporting both commercial and artisanal fisheries, but little is known about their population structure at a spatial scale required for effective fisheries management. In this study, we use Next Generation Sequencing methods to investigate the genetic connectivity of three major neritic tuna and tuna-like species in the Indian Ocean: Longtail Tuna (Thunnus tonggol), Kawakawa (Euthynnus affinis), and narrow-barred Spanish mackerel (Scomberomorus commerson). We sampled 293 Longtail Tuna from three locations, 362 Kawakawa from seven locations, and 210 narrow-barred Spanish mackerel from six locations. Genetic data showed clear evidence of heterogeneity in all three species, and patterns of isolation-by-distance were detected in Kawakawa and narrow-barred Spanish mackerel. Pairwise FST estimates of population differentiation and model-based grouping (mixture models) revealed that (i) individuals of Longtail Tuna from each sampling location belonged to a distinct genetic group, (ii) at least two different groups of Kawakawa were identified, and (iii) at least four groups of narrow-barred Spanish mackerel were identified across the sampled range within the north and eastern Indian Ocean. These results demonstrate that neritic tunas exhibit genetic structuring at small to medium spatial scales that need to be considered in the design of monitoring and assessment systems for fisheries management purposes in the northern and eastern parts of their range in the Indian Ocean. Further sampling, at a finer spatial resolution within the range of the current study, and across the north-western and western parts of their range of the Indian Ocean that were not covered in the current study, is required to provide a comprehensive understanding of the number of populations present and the spatial extent of individual populations in the Indian Ocean and adjacent seas.
Impact of aetiology on short- and long-term outcomes in open descending and thoracoabdominal aneurysm repair
Authors: Chen Joshua R , Pritting Christopher , Shah Vishal N , King Colin , McGee Jacqueline , Plestis Konstadinos A
Published: December 2024

OBJECTIVES

We analysed the impact of chronic type B aortic dissection (cTBAD) and degenerative aneurysm (DA) on the short- and long-term outcomes of patients undergoing open descending thoracic aortic aneurysm and thoracoabdominal aortic aneurysm repair.

METHODS

We performed a retrospective analysis of a prospectively maintained aortic database. From 1999 to 2023, 245 patients underwent open descending thoracic aortic aneurysm or thoracoabdominal aortic aneurysm repair. We compared preoperative comorbidities, postoperative complications and operative and long-term mortality for patients with cTBAD (120 patients, 49%) and DA (125 patients, 51%).

RESULTS

Patients with cTBAD were significantly younger, more likely to be male and less likely to have comorbidities including diabetes, chronic obstructive pulmonary disease and coronary artery disease. There were no statistically significant differences in the incidence of operative mortality between cTBAD (7.5%) and DA patients (11.2%) (P = 0.44). Survival at 1, 5, 10 and 15 years for cTBAD versus DA patients was 90% versus 76%, 79% versus 59%, 59% versus 42% and 50% versus 29%, respectively (P < 0.01); however, this lost statistical significance in the Cox regression (P = 0.86). Following multivariable analysis, older age, female gender, coronary artery disease, urgent or emergent procedure and descending thoracic aortic aneurysm were independent predictors of long-term outcomes.

CONCLUSIONS

There were no statistically significant differences in the incidence of postoperative complications, operative deaths and long-term survival between cTBAD and DA patients.

IRB number

(#20D.802), Obtained: 1/31/23.
Risk Stratification of Metabolic Risk Factors and Statin Use Associated With Liver and Nonliver Outcomes in Chronic Hepatitis B
Authors: Zhang Xinrong , Nguyen Vy H , Kam Leslie Yeeman , Barnett Scott D , Henry Linda , Cheung Ramsey , Nguyen Mindie H
Published: December 2024

Background

We investigated the association of metabolic risk factors (MRFs) and statin use with liver and nonliver outcomes in a nationwide cohort of patients with chronic hepatitis B (CHB) in the United States.

Methods

We conducted a retrospective cohort study of adult patients with CHB using the MarketScan Databases (January 2007–December 2021). Incidence of liver and nonliver outcomes (cardiovascular disease, chronic kidney disease, and extrahepatic cancer) was analyzed. MRFs included diabetes mellitus (DM), hypertension, hyperlipidemia, and obesity.

Results

The study included 52 277 patients with CHB, and 1:1 propensity score matching yielded 16 696 pairs of matched patients with and without MRFs for analysis. When compared with those without MRFs, patients with DM and all 3 other MRFs had the highest adjusted hazard ratio (95% CI) for any liver outcome at 2.08 (1.22–3.52), followed by 12.98 (7.73–21.80) for cardiovascular disease, 9.25 (5.46–15.66) for chronic kidney disease, and 2.01 (1.00–4.04) for extrahepatic cancer. Increased metabolic burden was associated with liver and nonliver outcomes except for comparison between patients without MRFs and those with MRFs but no DM (P > .2 for all liver outcomes). Among lower metabolic burden (≤2 MRFs), statin use was associated with a 15% lower risk of any liver outcomes, 35% reduced risk of HCC, and 15% lower risk of cirrhosis but not among those with higher metabolic burden (≥3 MRFs).

Conclusions

Higher metabolic burden was associated with a greater risk for liver and nonliver complications in patients with CHB, with DM having the highest impact among other MRFs. Statin use was associated with a reduced risk of liver outcomes among lower metabolic burden.
Direct-Acting Antivirals Quickly Eradicate Hepatitis C Virus From the Liver in People With Human Immunodeficiency Virus but Do Not Fully Reverse Immune Activation
Authors: Sachithanandham Jaiprasath , Leep-Lazar Julia , Quinn Jeffrey , Bowden Kenneth , Balasubramaniam Prasanthy , Ward Kathleen , Ribeiro Ruy M , Sulkowski Mark S , Balagopal Ashwin
Published: December 2024

Background

Hepatitis C virus (HCV) infects nearly one-fourth of people with human immunodeficiency virus (HIV). The role of direct-acting antivirals (DAAs) on immune activation in people with HIV (PWH) and HCV is poorly understood.

Methods

We quantified plasma HCV RNA and CXCL10 in persons with HCV monoinfection versus HIV/HCV coinfection receiving sofosbuvir-velpatasvir. Single-cell laser capture microdissection was applied to liver biopsies obtained before and within 4–7 days of DAA initiation to estimate HCV clearance and changes in interferon-stimulated genes (ISGs).

Results

We enrolled 10 people with chronic genotype 1a HCV: 5 were PWH with ART-suppressed viremia and CD4+ T cell counts >200 cells/µL. First- and second-phase plasma HCV RNA kinetics were not different between groups. Median (min–max) proportions of infected hepatocytes at biopsy 1 were 0.06 (0.01–0.59) in HCV monoinfection and 0.21 (0.04–0.87) in HIV/HCV coinfection and did not differ. Participants had lower intracellular HCV RNA levels at biopsy 2. CXCL10 levels declined in both groups but were higher in coinfection than in monoinfection even at the end of treatment. The proportion of cells expressing ISGs diminished in monoinfection but increased in coinfection.

Conclusions

Whereas DAAs rapidly cleared intrahepatic HCV in both groups, immune activation was slower to diminish in PWH. Residual immune activation in PWH warrants further exploration.

Clinical Trials Registration. NCT02938013.
IL-5-producing Group 2 innate lymphoid cells promote T cell-independent IgA production in cooperation with eosinophils
Authors: Yanagibashi Tsutomu , Ikutani Masashi , Nagai Terumi , Arita Makoto , Watanabe Yasuharu , Nagai Yoshinori , Takatsu Kiyoshi
Published: December 2024

Intestinal bacteria play a critical role in the regulation of the host immune system and an imbalance in the intestinal bacterial composition induces various host diseases. Therefore, maintaining a balance in the intestinal bacterial composition is crucial for health. Immunoglobulin A (IgA), produced through T cell-dependent and T cell-independent (TI) pathways, is essential for host defense against pathogen invasion and maintaining the balance of intestinal symbiotic bacteria. Interleukin (IL)-5 is constitutively produced by Group 2 innate lymphoid cells (ILC2s) and plays a critical role in the survival and proliferation of B cells and eosinophils. Here, we show the role of IL-5-producing ILC2s in intestinal TI IgA production at steady state using T cell receptor α deficient mice. In this mouse model, ILC2s increased fecal TI IgA levels in a non-inflammatory state in an IL-5-dependent manner. The administration of recombinant IL-33 (rIL-33) increased the amount of TI IgA production, accompanied by an increase in the number of IL-5-producing ILC2s in the large intestine. In addition, rIL-33 treatment increased IL-5-dependent IgA+ cells in isolated lymphoid follicles, the site of TI IgA production. Furthermore, eosinophils recruited by ILC2s were required for the maximal production of IgA in the TI pathway. Moreover, IL-5 increased the frequency of TI IgA-binding intestinal bacteria and was involved in the maintenance of intestinal bacterial composition. These findings indicate that IL-5-producing ILC2s together with eosinophils contribute to TI IgA production. In addition to their role in TI IgA production, IL-5-producing ILC2s may contribute to the homeostasis of intestinal commensal bacteria.
Tracing active members in microbial communities by BONCAT and click chemistry-based enrichment of newly synthesized proteins
Authors: Hellwig Patrick , Kautzner Daniel , Heyer Robert , Dittrich Anna , Wibberg Daniel , Busche Tobias , Winkler Anika , Reichl Udo , Benndorf Dirk
Published: December 2024

A comprehensive understanding of microbial community dynamics is fundamental to the advancement of environmental microbiology, human health, and biotechnology. Metaproteomics, defined as the analysis of all proteins present within a microbial community, provides insights into these complex systems. Microbial adaptation and activity depend to an important extent on newly synthesized proteins (nP), however, the distinction between nP and bulk proteins is challenging. The application of BONCAT with click chemistry has demonstrated efficacy in the enrichment of nP in pure cultures for proteomics. However, the transfer of this technique to microbial communities and metaproteomics has proven challenging and thus it has not not been used on microbial communities before. To address this, a new workflow with efficient and specific nP enrichment was developed using a laboratory-scale mixture of labelled Escherichia coli and unlabeled yeast. This workflow was then successfully applied to an anaerobic microbial community with initially low bioorthogonal non-canonical amino acid tagging efficiency. A substrate shift from glucose to ethanol selectively enriched nP with minimal background. The identification of bifunctional alcohol dehydrogenase and a syntrophic interaction between an ethanol-utilizing bacterium and two methanogens (hydrogenotrophic and acetoclastic) demonstrates the potential of metaproteomics targeting nP to trace microbial activity in complex microbial communities.
UrbanBus: a fine-grained dataset for bus ridership analysis
Authors: Ke Liwen , Guo Xiangyu , Li Tianrui , Li Chongshou
Published: December 2024

Bus ridership analysis plays a critical role in intelligent transportation systems. Numerous methods have been proposed for this purpose. However, compared to other public transportation modes (e.g. metro, taxi), there is a lack of public datasets for bus ridership analysis, including forecasting, scheduling, and clustering. To address this issue, this note presents a novel bus ridership dataset, UrbanBus, consisting of approximately 727 million automatic fare collection transactions collected over six months from the intelligent transportation system in a major Asian city. The unique characteristic of the dataset is its fine granularity at the transaction level. The time granularity is at the second level, allowing for various aggregation operations for high-level analysis. Additionally, the bus routes and pairwise distances between stops are provided. This dataset is expected to benefit the intelligent transportation research community and is publicly available at: https://github.com/ableyyyx/UrbanBus.
Clearance of archived integrase strand transfer inhibitors resistance mutations in people with virologically suppressed HIV infection
Authors: Abdi Basma , Palich Romain , Seang Sophie , Fauchois Antoine , Cocherie Théophile , Faycal Antoine , Sayon Sophie , Teyssou Elisa , Saliba Sanaa , Soulie Cathia , Valantin Marc Antoine , Pourcher Valérie , Katlama Christine , Calvez Vincent , Marcelin Anne-Geneviève , Wirden Marc
Published: December 2024

Introduction

We assessed the kinetics of the clearance of integrase strand transfer inhibitors resistance mutations (INSTIs-RMs) and associated factors from people living with HIV (PWH) displaying suppressed viral replication after virological failure (VF) on an INSTI regimen.

Patients and methods

We included PWH with HIV-RNA viral loads ≤20 copies/mL for at least 5 years in whom INSTIs-RM had been identified at least once in a prior RNA resistance genotyping test. HIV DNAs were sequenced by Sanger sequencing (SS) and ultra-deep sequencing (UDS; detection threshold: 5%) every year over the preceding 5 years.

Results

We included 39 PWH in the study. Most (95%) had experienced VF on a raltegravir-containing regimen. The past INSTIs-RMs were not detected in the peripheral blood mononuclear cells of 35 of the 39 (90%) PWH by SS at the end of follow-up. In a longitudinal analysis (2017–21) based on UDS, the previously detected INSTIs-RMs were not detected in 29 of the 35 (83%) PWH. In multivariable analysis, the duration of viral replication and the level of HIV-RNA during prior VF were significantly associated with the persistence of INSTIs-RM, with odds ratios of 1.05 per week of replication (95% CI, 1.00–1.11; P = 0.024) and 8.26 per log10 copies/mL (95% CI, 1.46–46.59; P = 0.017).

Conclusions

We observed a clear trend towards the clearance of archived INSTIs-RM after a long period of virological control leading to changes in the resistance profile in cellular DNA, raising the possibility of studies assessing the recycling of INSTI classes even in the presence of a history of resistance.
Do electronic health records used by primary care practices support recommended alcohol-related care?
Authors: Bradley Katharine , McCormack James , Addis Megan , Hamilton Leah K , Lapham Gwen T , Jonas Daniel , Bishop Dawn , Parsons Darla , Budimir Cheryl , Sanchez Victoria , Bannon Jennifer , Villalobos Gabriela , Krist Alex H , Walunas Theresa , Day Anya
Published: December 2024

Objective

The quality of alcohol-related prevention and treatment in US primary care is poor. The purpose of this study was to describe the extent to which Electronic Health Records (EHRs) used by 167 primary care practices across 7 states currently include the necessary prompts, clinical support, and performance reporting essential for improving alcohol-related prevention and treatment in primary care.

Materials and Methods

Experts from five regional quality improvement programs identified basic EHR features needed to support evidence-based alcohol-related prevention (ie, screening and brief intervention) and treatment of alcohol use disorders (AUD). Data were collected regarding whether EHRs included these features.

Results

EHRs from 21 vendors were used by the primary care practices. For prevention, 62% of the 167 practices’ EHRs included a validated screening questionnaire, 46% automatically scored the screening instrument, 62% could report the percent screened, and 37% could report the percent screening positive. Only 7% could report the percent offered brief intervention. For alcohol treatment, 49% of practices could report the percent diagnosed with AUD, 58% and 91% allowed documentation of referral and treatment with AUD medication, respectively. Only 3% could report the percent of patients diagnosed with AUD who received treatment.

Discussion

Most EHRs observed across 167 primary care practices across 7 US states lacked basic functionality necessary to support evidence-based alcohol-related prevention and AUD treatment. Only 3% and 7% of EHRs, respectively, included the ability to report widely recommended quality measures needed to improve the quality of recommended alcohol-related prevention and treatment in primary care.

Conclusion

Improving EHR functionality is likely necessary before alcohol-related primary care can be improved.
Minimizing energy usage in multi-point manufacturing: a dimensional transfer learning strategy
Authors: Liu Jie , Yap Hwa Jen , Khairuddin Anis Salwa Mohd
Published: December 2024

With the increasing complexity of industrial manufacturing tasks, optimizing Multi-Point Manufacturing (MPF) operations, such as drilling and spot welding, has become essential for improving energy efficiency and execution speed. These tasks can be formulated as multi-dimensional Traveling Salesman Problems (TSPs), where robotic manipulators must traverse multiple points optimally while minimizing energy consumption. However, traditional heuristic algorithms, such as Genetic Algorithm (GA) and Ant Colony Optimization (ACO), face significant limitations. Their iterative nature leads to long computation times, and their performance heavily relies on precise parameter tuning to achieve high-quality solutions. To address these challenges, this study proposes a novel minimum energy consumption scheduling strategy for MPF problems, utilizing a Graph Neural Network (GNN)-based approach enhanced by Transfer Learning. The method employs Self-Adjusting Multi-modal Artificial Neural Networks (SAMANN) to reduce the 6D task nodes into a 2D representation, enabling the reuse of pre-trained 2D TSP models. Fine-tuning is then applied to further optimize performance. Compared with traditional heuristic algorithms, the proposed method significantly reduces computation time while maintaining solution quality. It is also found that the new approach surpasses the performance of the current state-of-the-art (SOTA) neural model in terms of both solution quality and training time across multi-dimensional TSPs and MPF problem domains, offering a robust and efficient solution for real-world MPF applications.
Deaf adult insights into elements of classroom discourse altered in interpretation
Authors: Crume Peter Kirk , Langer Elizabeth Caldwell
Published: December 2024

In this study, 19 college-educated deaf adults with experience using interpreters in educational settings provided insights into how successfully various elements of classroom discourse were preserved through interpretation. The deaf adults, fluent in American Sign Language (ASL) and experienced at using interpreters, watched educational interpreters’ renditions of an elementary school art lesson, and answered questions, providing information about the clarity, completeness, and coherence of the message. Next, the deaf adults were asked to compare what they saw in the first interpretation of the lesson to what was conveyed in a second iteration by a highly experienced interpreter familiar with the lesson whose first language is ASL. A control group of 16 hearing adults accessing the lesson directly from the teacher answered the same questions. For the elements of classroom discourse studied—main ideas, project instructions, mental state references, and relevance strategies—results showed a substantial difference between what the hearing participants in the direct presentation condition received and what the deaf adults accessing the message through the educational interpreters received. Qualitative analyses of the differences—between the direct versus interpreted versions and between the deaf participants’ responses to the two interpretations—revealed tendencies for, and ramifications of, alterations and omissions in classroom discourse.
Sexual function and pregnancy outcomes after periacetabular osteotomy: a systematic review
Authors: Hutchinson Katie , Baig Khurram , Smith Christian , Malviya Ajay
Published: December 2024

Periacetabular osteotomy (PAO) is a surgical treatment of developmental dysplasia of the hip (DDH). This systematic review investigates the impact PAO has on sexual function and pregnancy through changes in patient-reported outcomes. A literature search of Medline, PubMed, EMBASE, and the Cochrane Library from 1996 to November 2023 was performed. Search terms included: ‘periacetabular osteotomy’, ‘pelvic osteotomy’, ‘outcomes’, ‘sexual function’, ‘pregnancy’, and ‘childbirth’. Assessment of methodological quality was performed using the methodological index for nonrandomized studies (MINORS) criteria and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. The search returned 560 papers, with 5 meeting the inclusion criteria. Sexual function improved over both short- and longer-term follow-up periods. 48.2% of patients had improved sexual function following PAO. Female patients reported greater improvement than males, who had a higher baseline score. No complications were documented in pregnancy or delivery compared to patients who had not had a PAO. Increased rates of caesarean sections (CSs) were seen in all studies (37.4%) compared to the European average. All five papers were calculated to be of low quality according to the MINORS criteria and low certainty according to the GRADE level of evidence. Patients receiving a PAO due to symptomatic DDH had improved sexual dysfunction due to a reduction in hip pain, but almost half of these patients may not appreciate any benefit. There is an increased likelihood of CS in patients post-PAO, with no reliable evidence for its necessity. Limitations of this review included poor quality and availability of evidence, as all studies were retrospective cohort studies. Further larger powered studies are required to assess the full impact of PAO on both sexual function and pregnancy.
Assessment and management of periacetabular aneurysmal bone cysts—a series of four cases
Authors: Beyer Reagan S H , Steiner Quinn , Hennessy David W , Rosas Humberto G , Goodspeed David C , Spiker Andrea M
Published: December 2024

Aneurysmal bone cysts (ABCs) in the periacetabular region can be challenging to treat because they create unique problems, given their proximity to articular cartilage and a significant weight bearing surface. This case series details the assessment and treatment of four periacetabular ABCs with a review of pertinent current literature. Treatment approaches used include curettage with 6% phenol chemical adjuvant, type III hemipelvectomy, serial image-guided sclerotherapy injections, and in one case, an exostotic lesion was treated with hip arthroscopy.
Justification, margin values, and analysis populations for oncologic noninferiority and equivalence trials: a meta-epidemiological study
Authors: Kleber Troy J , Sherry Alexander D , Arifin Andrew J , Kupferman Gabrielle S , Kouzy Ramez , Abi Jaoude Joseph , Lin Timothy A , Beck Esther J , Miller Avital M , Passy Adina H , McCaw Zachary R , Msaouel Pavlos , Ludmir Ethan B
Published: December 2024

Background

Noninferiority and equivalence trials evaluate whether an experimental therapy’s effect on the primary endpoint is contained within an acceptable margin compared with standard of care. The reliability and impact of this conclusion, however, is largely dependent on the justification for this design, the choice of margin, and the analysis population used.

Methods

A meta-epidemiological study was performed of phase 3 randomized noninferiority and equivalence oncologic trials registered at ClinicalTrials.gov. Data were extracted from each trial’s registration page and primary manuscript.

Results

We identified 65 noninferiority and 10 equivalence trials that collectively enrolled 61 632 patients. Of these, 61 (81%) trials demonstrated noninferiority or equivalence. A total of 65 (87%) trials were justified in the use of a noninferiority or equivalence design either because of an inherent advantage (53 trials), a statistically significant quality-of-life improvement (6 trials), or a statistically significant toxicity improvement (6 trials) of the interventional treatment relative to the control arm. Additionally, 69 (92.0%) trials reported a prespecified noninferiority or equivalence margin of which only 23 (33.3%) provided justification for this margin based on prior literature. For trials with time-to-event primary endpoints, the median noninferiority margin was a hazard ratio of 1.22 (range = 1.08-1.52). Investigators reported a per-protocol analysis for the primary endpoint in only 28 (37%) trials.

Conclusions

Although most published noninferiority and equivalence trials have clear justification for their design, few provide rationale for the chosen margin or report a per-protocol analysis. These findings underscore the need for rigorous standards in trial design and reporting.
Spotlight on identity construction among professionals transitioning to an emerging occupation
Authors: Courtois Cynthia , Picard Claire-France , Gendron Yves
Published: December 2024

The contemporary work environment is characterized by frequent transitions throughout an individual’s career. A relatively recent trend concerns established professionals relocating in newly emerging occupations. Despite the extensive research conducted on the construction of professional identity, there is still a dearth of knowledge regarding how occupational identity is formed. The aim of this study is to gain a deeper understanding of the process through which professionals (re)construct their occupational identity when making a career transition to an emerging occupation. Drawing on twenty-seven interviews with professionals in the accounting and law enforcement fields who have transitioned to the emerging antifraud occupation, we explore how they navigate tensions between different aspirational, professional, and expected identities, and how they employ strategies to establish or blur boundaries to define their emerging occupational identity. This study offers a deeper understanding of the process by which a coherent occupational identity is constructed and shaped by interaction between multiple identities. This research contributes to the literature on career transitions by developing a more nuanced understanding of the occupational boundary strategies that professionals employ to construct a coherent occupational identity during a career transition. Further, our study underscores a pivotal concern regarding the maintenance of professionalism as professionals move into nascent occupational roles. In such circumstances, the definition of occupational identity may be less clearly delineated, and the establishment of rule-setting may be primarily determined by the organization’s management, thus curtailing the autonomy traditionally associated with professionalism.
A statistical assessment of influenza intensity thresholds from the moving epidemic and WHO methods
Authors: Bracher Johannes , Littek Jonas M
Published: December 2024

Monitoring influenza activity is a key task of public health agencies worldwide. Intensity thresholds serve to retrospectively classify season peak intensity and to compare current influenza activity to past peak values. The resulting classifications into low, medium, high, or very high intensity inform national-level risk assessment and planning. Moreover, they feed into international summary reports. Two common thresholding approaches, recommended in dedicated WHO guidelines, are the moving epidemic method (MEM) and the WHO method. In both approaches, thresholds correspond to quantiles of a normal distribution fitted to a set of historical observations. While an extensive literature on applications of these methods exists, their statistical properties have not been assessed systematically. In this article, we study them analytically and in a simulation study based on re-sampling of French influenza surveillance data. Moreover, extensions to account for small sample sizes and secular trends are described. Under the default settings, both the MEM and WHO method on average classify more seasons than intended as high or very high intensity. Combining characteristics of both and adding a small-sample correction, better-calibrated thresholds can be achieved. Even these, however, have modest sensitivity and positive predictive values. This concerns especially thresholds for very high intensity.
Bidimensional latent regression item response models for the assessment of financial knowledge in the presence of ‘Don’t Know’ responses
Authors: Aristei David , Bacci Silvia , Gallo Manuela , Iannario Maria
Published: December 2024

Increasing attention has been recently paid to assessing individuals’ financial competence. Financial knowledge appears as a complex and not directly observable phenomenon, whose measurement is usually based on answers to a set of multiple-choice items. The option ‘Don’t Know’ (DK) is usually included among the possible answers to capture uncertainty or lack of knowledge. Its presence represents an element of noise that can affect the measurement of financial knowledge. DK responses are usually considered as incorrect answers or missing values; however, these naive approaches may lead to biased financial knowledge measures. In this study, we address the issue of estimating the latent knowledge construct accounting for the DK option, through a bidimensional latent dregression two-parameter logistic model. The model at issue relies on the assumption that the response process may be disentangled in two consecutive steps driven by two latent variables: propensity to provide a substantive answer and financial knowledge. In the first step, both latent variables affect the probability of providing a substantive response. In the second step, conditionally on the selection of a substantive response, financial knowledge affects the probability of a correct answer vs. an incorrect one. Individual characteristics are also considered to explain the two latent traits.
Rare appendicular anomaly of horseshoe appendix diagnosed intra-operatively during laparoscopic appendectomy: case report
Authors: Almalki Ahmed , Alotaibi Ahad , Alzamel Heythem , Albuthi Saud
Published: December 2024

Acute appendicitis is the most common cause of lower abdominal pain among patients presented to the Emergency Department. Appendicular anomalies in general are rare, and the horseshoe appendix is considered the rarest, with few reported cases in the literature. We are presenting a young female patient, medically and surgically free, who presented to the Emergency Department with persistent right lower quadrant, associated with vomiting for 2 days. Vitally was stable, and labs were remarkable for leukocytosis and neutrophil shift. Abdomen CT scan showed a dilated appendix up to 1 cm with mural edema and hyperenhancement surrounded by mild fat stranding, minimal free fluid, and thickened adjacent peritoneal reflection. In conclusion, routinely performed surgeries can surprise the surgeon with unusual findings. Knowing the anatomy and possible associated anomalies is a cornerstone for any surgery. Even with the rarity of these anomalies, a high index of suspicion and careful recognition are required.
Utilizing a surgical sabermetrics framework to evaluate the impact of simulated operative crises on trainee cognitive load and non-technical skills
Authors: Norton Joel , Geraghty Alistair , Howie Emma , Boyle Connor , Yule Steven , Tambyraja Andrew
Published: December 2024

Intraoperative crisis events, such as haemorrhage or iatrogenic perforation, can cause considerable stress in the operating surgeon. Little standardized training exists for managing such events, especially for surgical trainees. Cognitive load (CogL) is the extent to which a task places demands on cognitive resources. Such resources are finite, and when overwhelmed, can lead to stress, which in turn can negatively affect intraoperative technical and non-technical performance. Surgical sabermetrics is a novel field that involves advanced analysis of data obtained from non-invasive physiological sensors measuring surgeon CogL, as well as audiovisual recordings of surgical procedures capturing surgeon technical and non-technical skills. This data-driven approach enhances understanding of factors that can improve, or worsen, surgical performance. ‘Managing Surgical Crises’ is a high-fidelity simulation course which exposes surgical trainees to standardized intraoperative crises with no risk to patient safety. This study aims to apply a sabermetrics framework to the ‘Managing Surgical Crises’ course to gain insight into trainee surgeon CogL and non-technical skills during the introduction and response to crisis events. Surgical trainees will be allocated to a simulated surgical crisis event and tasked with managing the scenario utilizing the Team, Environment, Assess/Analyse/Anticipate, Manage resources (TEAM) algorithm. A sabermetrics framework will be employed to collect quantitative data regarding CogL and non-technical performance. Full ethical approval has been obtained for this study. Dissemination of the results will be through conferences and publications in peer-reviewed journals.
(133) ORAL TESTOSTERONE UNDECANOATE QUICKLY AND EFFECTIVELY ACHIEVES SERUM TESTOSTERONE ≥ 300 NG/DL IN MOST HYPOGONADAL MEN WITHOUT DOSE TITRATIONS
Authors: Miner M , Boldt-Houle DM , Atkinson SN
Published: December 2024

Introduction

Over 2.4 million US men have hypogonadism, defined as serum testosterone (T) levels <300 ng/dL and/or symptoms of T deficiency. Negative effects associated with hypogonadism include development of metabolic syndrome, increased risk of coronary artery disease, decreased libido, low bone mineral density, and muscle loss. Oral T replacement therapies provide a route of administration that may be more appropriate for some patients’ needs.

Objective

We present secondary analyses of T data from a phase 3 study of oral testosterone undecanoate (TU) which is approved in 158, 198, 237, 316, and 396 mg doses, with the goal of demonstrating that the starting oral TU dose quickly and effective achieves normal serum T concentrations in a large proportion of men.

Methods

A phase 3, randomized, active controlled, open-label study was conducted to assess the safety and efficacy of oral TU in 222 hypogonadal men. Men ≥18 to ≤75 years with morning serum T ≤ 300 ng/dL twice in one week were eligible. Eligible patients were randomized to oral TU or transdermal T-gel from Days 0 to 42. The initial oral TU dose was 237 mg TU twice a day (BID). For men treated with the initial oral TU dose, serum T concentrations were evaluated at Day 21, 4 hours after the dose.

Results

165 men had serum T data. 85% of men achieved serum T concentrations ≥300 ng/dL on Day 21 at 4 hours after the first oral TU dose with no dose titrations. (Figure 1) For these 85%, the mean T concentration was 679 ng/dL.

Conclusions

Overall, the starting dose of 237 mg TU BID quickly and effectively increased serum T concentrations ≥300 ng/dL in 85% of hypogonadal men. The wide distribution of serum T concentrations for the same dose (e.g., 15% <300 ng/d and 12% ≥1000 ng/dL) suggests that men likely respond differently to T replacement therapy. Therefore, an oral T replacement therapy that allows for dose titration would likely be preferable to a fixed dose. Future studies and investigations should evaluate patient factors that impact the magnitude of T increases allowing for more individualized titrations.

Disclosure

Yes, this is sponsored by industry/sponsor: Tolmar, Inc.

Clarification: Industry initiated, executed and funded study.

Any of the authors act as a consultant, employee or shareholder of an industry for: Tolmar, Inc.
(148) INFLUENCE OF INDUSTRY PAYMENTS ON PRESCRIPTION BEHAVIOR PATTERN OF TESTOSTERONE MEDICATIONS AMONG PHYSICIANS IN THE UNITED STATES: NATIONAL CLAIM DATABASE ANALYSIS
Authors: Kalidoss S , Venishetty N , Hussain Z , Bajic P , Raheem O
Published: December 2024

Introduction

Testosterone medications is commonly used to treat adult-onset hypogonadism worldwide including the United States. Physicians pattern of medication's prescription may be influenced by specific factors including pharmaceutical industry and financial relationships.

Objective

To determine the impact of physicians’ financial relationships with the pharmaceutical industry on prescribing marketed Testosterone medications ie, prescription behavior pattern.

Methods

We identified prescribers from the 2021 Medicare Part D Prescribers – by Provider and Drug dataset and the CMS General Open Payment Data Prescriber public use file. This file contains prescriber identifying information (name and practice address) and claim counts for all pharmaceuticals prescribed to beneficiaries with Medicare Part D coverage. We sorted the prescribers based on three categories, (All Providers, “Urologists”, and “Non-Urologists”). We included all prescription drugs labeled “testosterone”. We recorded the total number of prescriptions of “testosterone” drugs for each prescribing provider. We recorded the total number of financial payments each prescriber received for the generic-named “testosterone” drugs. Both the number of payments and the total value of payments were included.

Results

We identified 387,452 prescribers (273,978 urologists and 113,474 non-urologists) in Open Payment Data and Medicare Part D databases. Providers who received payment had a statistically significant higher number of prescriptions of testosterone medications compared to providers who did not receive a payment when prescribed testosterone medications. In 2021, the average number of prescriptions was 1.495 among all providers who received payment vs. 1.22 among all providers who did not receive payment (p < 0.001). The average number of prescriptions was 1.499 among all “urologists” who received payment vs. 1.218 among all “urologists” who did not receive payment (p < 0.001). The average number of prescriptions was 1.480 among all “non-urologists” who received payment vs. 1.226 among all “non-urologists” who did not receive payment (p < 0.001) (Table 1).

Conclusions

There is a consistent association between receipt of industry payment and prescribing marketed Testosterone medications particularly among urologists providers. This database analysis does indicate that prescription pattern for testosterone is primarily influenced by industry payments particularly among urologists providers.

Disclosure

No.
Power, futuristic framings, and the problem of techno-fideism or How climate change breaks the promise of progress
Authors: Oreskes Naomi
Published: December 2024

Previous work has addressed industry disinformation in blocking climate action. This paper focuses on three additional matters. The first is political power. The second is anchoring effects and futuristic framing. The third is ‘techno-fideism’—an unreasonable faith in technology to solve social and political problems—and its relation to narratives of progress.
“Quality Women’s Healthcare Should Be A Top Priority”: Service Women’s Experiences With the Health Care Provided by the Netherlands Armed Forces
Authors: Verstegen Mohan K , van Baarle Eva M
Published: December 2024

Introduction

Fit and healthy military personnel are the basis for a strong organization and good health care is essential to ensure service people’s deployability. This applies equally to female-specific health care (FSH). Quality health care can help not only to recruit but also retain more women in the military. However, as there is a lack of empirical studies focusing on service women’s experiences with FSH, this study explores female military personnel’s experiences with FSH in the Netherlands Armed Forces (NAF), including conditions such as menstruation, pregnancy, and menopause in order to find ways of improving these women’s health care and self-care.

Methods

We carried out a qualitative study involving 4 focus groups of service women (n = 17) from all military branches of the NAF (Navy, Air Force, Army, and Military Police).

Results

Using inductive thematic analysis, we ascertained 4 key themes: inadequate knowledge and experience among military primary care providers; a perceived lack of gynecologists in the military health care system; difficulties around FSH-related self-care; and inadequate (and inadequately provided) information on menstruation, pregnancy, and menopause. Our findings imply several recommendations to foster good FSH. Changes are needed on four fronts: agenda setting, information, normalization, and implementation. Leaders and role models can bring the topic FSH to the chain of command’s attention.

Conclusion

The NAF are currently not focusing sufficiently on FSH. In order to provide their female personnel with a high quality of care, this will require changes in policy, implementation, and supervision as well as fostering the development of an open culture that enables discussions on FSH.
Impact of SARS-CoV-2 Infection on Physical Fitness in Air Force Basic Trainees
Authors: Crouch Elena , Marcus Joseph E , Yun Heather C , Casey Teresa M , Kieffer John , Winkler Erin , Osuna Angela B , Kasper Korey , Aden James , Kiley John L
Published: December 2024

Introduction

The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on physical fitness in previously healthy adults is not well understood. In this study, we assess the impact of SARS-CoV-2 infection on the physical fitness test (PT) scores of Air Force basic trainees.

Materials and Methods

SARS-CoV-2 testing data and trainee fitness test scores for the calendar year 2021 were obtained from U.S. Air Force basic military trainees. Trainees perform a standardized fitness test including push-ups, sit-ups, and a 2.4 kilometer run at the beginning and end of their training. For this study, basic trainees who performed 2 fitness tests in 2021 and also tested positive for SARS-CoV-2 were defined as the infected cohort. These were 1:1 matched by sex to an uninfected control group of basic trainees. Changes in fitness test scores and pass–fail rates were then compared across the infected and control groups.

Results

A total of 23,450 basic trainees performed a PT in calendar year 2021, 975 (4%) of whom tested positive for SARS-CoV-2. A total of 621 (64%) had completed 2 fitness tests during the defined study period and were included in the infected cohort. There were 96 females (15.5%) in each group and 525 males (84.5%) in each group. There was no difference in body mass index between the infected and the control groups (24.0 [Interquartile range (IQR) 21.8 to 36.0] vs. 24.3 [IQR 21.7–36.9], P = .253). The infected group had a higher rate of failing their PT at the end of training when compared to control (15.7% vs. 4.3%, P < .001). When comparing those who passed their first fitness test and went on to fail their second fitness test, this occurred more frequently in the infected group (2.3% vs. 0.81%, P = .037). When comparing trainees who failed their first fitness test and went on to pass their second fitness test, this occurred more frequently in the control group (46.3% vs. 39.6%, P = .016). Among the infected group, there were no differences in second test failure rates when comparing symptomatic to asymptomatic trainees (16.9% vs. 11.8%, P = .143).

Conclusions

SARS-CoV-2 infection was associated with an increased risk of PT failure as well as conversion from a passing to failing test score. There were no differences in second test failure rates in symptomatic compared to asymptomatic trainees. A key confounder to the data was the effect deconditioning had on fitness during isolation.
Monitoring observations of SMC X-1’s excursions (moose) III. X-ray spectroscopy of a warped, precessing accretion disc
Authors: Karam Rawan , Dage Kristen C , Tetarenko Bailey E , Brumback McKinley C , Haggard Daryl , Bahramian Arash , Hu Chin-Ping , Neilsen Joey , Altamirano Diego , Athukoralalage Wasundara , Charles Philip A , Clarkson William I , Hickox Ryan C , Kennea Jamie
Published: December 2024

The moose (Monitoring Observations of SMC X-1’s Excursions) program uses the Neutron Star Interior Composition Explorer Mission (NICER) to monitor the high-mass X-ray binary SMC X-1 during its superorbital period excursions. Here, we perform X-ray spectral analyses of 26 NICER observations of SMC X-1, taken at the tail-end of the excursion between 2021-04-01 and 2022-01-05. We use a single spectral model to fit spectra observed in high, intermediate, and low states, using a combination of a partial covering fraction model, a blackbody disc, and a power-law component. We find that the partial covering fraction varies significantly with the superorbital state during superorbital excursion. Our findings suggest that the low/high state in SMC X-1 is caused by a very high obscuration of the accretion disc.
Reionization relics in the cross-correlation between the Lyα forest and 21 cm intensity mapping in the post-reionization era
Authors: Montero-Camacho Paulo , Morales-Gutiérrez Catalina , Zhang Yao , Long Heyang , Mao Yi
Published: December 2024

The tumultuous effects of ultraviolet photons that source cosmic reionization, the subsequent compression and shock-heating of low-density regions, and the modulation of baryons in shallow potential wells induced by the passage of ionization fronts, collectively introduce perturbations to the evolution of the intergalactic medium in the post-reionization era. These enduring fluctuations persist deep into the post-reionization era, casting a challenge upon precision cosmology endeavours targeting tracers in this cosmic era. Simultaneously, these relics from reionization also present a unique opportunity to glean insights into the astrophysics that govern the epoch of reionization. In this work, we propose a first study of the cross-correlation of Ly$\alpha$ forest and 21 cm intensity mapping, accounting for the repercussions of inhomogeneous reionization in the post-reionization era. We investigate the ability of Square Kilometre Array (SKA) $\times$ Dark Energy Spectroscopic Instrument (DESI)-like, SKA $\times$ MUltiplexed Survey Telescope (MUST)-like, and Packed Ultra-wideband Mapping Array (PUMA) $\times$ MUST-like instrumental set-ups to achieve a high-signal-to-noise ratio (SNR) in the redshift range $3.5 \le z \le 4$. Moreover, we assess how alterations in integration time, survey area, and reionization scenarios impact the SNR. Furthermore, we forecast the cross-correlation’s potential to constrain cosmological parameters under varying assumptions: considering or disregarding reionization relics, marginalizing over reionization astrophysics, and assuming perfect knowledge of reionization. Notably, our findings underscore the remarkable capability of a futuristic PUMA $\times$ MUST-like set-up, with a modest 100-h integration time over a 100 deg2 survey, to constrain the ionization efficiency error to $\sigma _\zeta = 3.42$.