bluuebunny/crossref_metadata_2025 huggingface dataset:
ASHP National Survey of Health-System Specialty Pharmacy Practice—2020
Authors: Stubbings JoAnn , Pedersen Craig A , Low Karly , Chen David
Published: August 2021

Purpose

Results of the first ASHP National Survey of Health-System Specialty Pharmacy Practice are presented.

Methods

A sample of 230 leaders in health-system specialty pharmacies were contacted by email and invited to participate in a survey hosted using an online survey application. The survey sample was compiled from ASHP member lists, through review of data from other ASHP surveys indicating the presence of specialty pharmacies, and by outreach to ASHP member organizational leaders.

Results

The response rate was 53.0%. Most health-system specialty pharmacies dispense 30,000 or fewer specialty prescriptions per year, have an annual revenue of $100 million or less, are part of an entity eligible to participate in the 340B Drug Pricing Program, operate 1 specialty pharmacy location, have at least 1 specialty pharmacy accreditation, dispense nonspecialty medications in addition to specialty medications, and employ an average of 13 pharmacists and 15 technicians. More than two-thirds of health-system specialty pharmacies (68.8%) dispense no more than half of the prescriptions written by their providers due to payer network restrictions or limited distribution drugs. The health-system specialty pharmacy practice model includes access to the electronic health record (100% of respondents), pharmacists and technicians dedicated to specific clinics (64.9% and 57.7%, respectively), specialty pharmacist involvement in treatment decisions and drug therapy selection prior to the prescription being written (64.9%), and documenting recommendations and progress notes in patients’ electronic health record (93.4%). Most health-system specialty pharmacies (83.3%) offer experiential or formal education in specialty pharmacy. Top challenges that survey respondents expected to face in the next year included restricted access to payer networks and limited distribution drugs, 340B Drug Pricing Program changes, and shrinking reimbursement from payers.

Conclusion

The health-system specialty pharmacy represents an integrated advanced practice model that incorporates specialty medication-use management across the continuum of care.
Detecting quantitative trait loci and exploring chromosomal pairing in autopolyploids using polyqtlR
Authors: Bourke Peter M , Voorrips Roeland E , Hackett Christine A , van Geest Geert , Willemsen Johan H , Arens Paul , Smulders Marinus J M , Visser Richard G F , Maliepaard Chris
Published: August 2021

Motivation

The investigation of quantitative trait loci (QTL) is an essential component in our understanding of how organisms vary phenotypically. However, many important crop species are polyploid (carrying more than two copies of each chromosome), requiring specialized tools for such analyses. Moreover, deciphering meiotic processes at higher ploidy levels is not straightforward, but is necessary to understand the reproductive dynamics of these species, or uncover potential barriers to their genetic improvement.

Results

Here, we present polyqtlR, a novel software tool to facilitate such analyses in (auto)polyploid crops. It performs QTL interval mapping in F1 populations of outcrossing polyploids of any ploidy level using identity-by-descent probabilities. The allelic composition of discovered QTL can be explored, enabling favourable alleles to be identified and tracked in the population. Visualization tools within the package facilitate this process, and options to include genetic co-factors and experimental factors are included. Detailed information on polyploid meiosis including prediction of multivalent pairing structures, detection of preferential chromosomal pairing and location of double reduction events can be performed.

Availabilityand implementation

polyqtlR is freely available from the Comprehensive R Archive Network (CRAN) at http://cran.r-project.org/package=polyqtlR.

Supplementary information

Supplementary data are available at Bioinformatics online.
Outcomes of robot-assisted versus conventional laparoscopic low anterior resection in patients with rectal cancer: propensity-matched analysis of the National Clinical Database in Japan
Authors: Matsuyama T , Endo H , Yamamoto H , Takemasa I , Uehara K , Hanai T , Miyata H , Kimura T , Hasegawa H , Kakeji Y , Inomata M , Kitagawa Y , Kinugasa Y
Published: August 2021

Background

Robot-assisted laparoscopic surgery has several advantages over conventional laparoscopy. However, population-based comparative studies for low anterior resection are limited. This article aimed to compare peri-operative results of robot-assisted low anterior resection (RALAR) and laparoscopy

Methods

This retrospective cohort study used data from patients treated with RALAR or conventional laparoscopic low anterior resection (CLLAR) between October 2018 and December 2019, as recorded in the Japanese National Clinical Database, a data set registering clinical information, perioperative outcomes, and mortality. Of note, the registry does not include information on the tumour location (centimetres from the anal verge) and diverting stoma creation. Perioperative outcomes, including rate of conversion to open surgery, were compared between RALAR and CLLAR groups. Confounding factors were adjusted for using propensity score matching.

Results

Of 21 415 patients treated during the study interval, 20 220 were reviewed. Two homogeneous groups of 2843 patients were created by propensity score matching. The conversion rate to open surgery was significantly lower in the RALAR group than in the CLLAR group (0.7 versus 2.0 per cent; P < 0.001). The RALAR group had a longer operating time (median: 352 versus 283 min; P < 0.001), less intraoperative blood loss (15 versus 20 ml; P < 0.001), a lower in-hospital mortality rate (0.1 versus 0.5 per cent; P = 0.007), and a shorter postoperative hospital stay (median: 13 versus 14 days; P < 0.001) compared with the CLLAR group. The CLLAR group had a lower rate of readmission within 30 days (2.4 versus 3.3 per cent; P = 0.045).

Conclusion

These data highlight the reduced conversion rate, in-hospital mortality rate, intraoperative blood loss, and length of postoperative hospital stay for rectal cancer surgery in patients treated using robot-assisted laparoscopic surgery compared with laparoscopic low anterior resection.
Reach and Power of Physician-Initiated Tweets in a Twitter Inflammatory Bowel Disease Community
Authors: Kesavarapu Keerthana , Zelenkauskaite Asta , Nandi Neilanjan
Published: August 2021

Background

Inflammatory bowel disease (IBD) specialist Twitter engagement and thematic content was assessed.

Methods

The nature of interaction between IBD specialists and users who responded to them was analyzed based on (1) content analysis of stakeholders who responded to them; (2) nature of interaction through a manual thematic content analysis of IBD specialist tweets and responses; (3) prominence of interaction by employing descriptive analysis and statistical inferences relative to the number of replies, likes, and retweets. Analyzed samples included of tweets (n = 320) compiled from 16 IBD specialists, and associated replies (n = 299), retweets (n = 869), and likes (n = 4068).

Results

Healthcare professionals (HCPs) more often engaged with peer-HCPs, compared to other stakeholders. When it comes to the nature of exchanges, of original tweets, the most common content was for knowledge sharing (58%) and endorsement (28%). In the knowledge sharing category, research accounted for more than half of those tweets (53%). Of replies, knowledge sharing occurred most frequently with a subtheme of IBD management (62%).

Conclusions

HCP–HCP Twitter engagement was more frequent than HCP–other Twitter stakeholder interaction. The primary purpose for this engagement was found to obtain real-time information, professionally network, and disseminate research.
Recurrent stroke secondary to late patent foramen ovale-closure device thrombus: a case report
Authors: Jerzyna Lennox , Prashar Abhisheik , Youssef George , Sader Mark
Published: August 2021

Background

Percutaneous patent foramen ovale (PFO) closure has been well established in the secondary prevention of cryptogenic stroke with overall low rates of procedural complications. One such complication is PFO closure device thrombus formation which is now rarely reported with newer generation devices.

Case summary

We present the unusual case of a 59-year-old woman with myelofibrosis who developed late-onset recurrent embolic strokes related to Amplatzer PFO closure device thrombus whilst therapeutically anticoagulated on Warfarin. Surgical management was deemed too high risk and our patient was conservatively managed with enoxaparin. Serial transthoracic echocardiography demonstrated a reduction in thrombus size and the patient had no further neurological events.

Discussion

Overall, the risk of serious complications following percutaneous PFO closure, such as device-associated thrombus, remains low. The risk of thrombus formation in patients with hypercoagulable states is not well characterized. Despite good evidence for the efficacy in preventing recurrent cryptogenic stroke, the role of PFO closure in addition to anticoagulation is unclear. Given this uncertain benefit of PFO closure in anticoagulated patients and the unclear risk profile, patient selection, and thorough pre-procedural evaluation are vital when assessing the appropriateness of percutaneous PFO closure.
Successful staged management of a spontaneous iliac vein rupture associated with May–Thurner syndrome: a case report
Authors: Nishimoto Yuji , Toma Masanao , Iwasa Kohei , Sato Yukihito
Published: August 2021

Background

Spontaneous iliac vein ruptures have only been reported in approximately 50 cases. An accurate preoperative diagnosis is difficult even with contrast-enhanced computed tomography (CT), and the operative mortality and morbidity rates are quite high. The cause of spontaneous iliac vein ruptures and their optimal diagnosis and management remain unclear.

Case summary

A 69-year-old woman without a history of prior trauma presented with low back pain, left lower limb swelling, and hypovolaemic shock. An initial contrast-enhanced CT revealed a large retroperitoneal haematoma without arterial extravasation. Her blood pressure dropped again under a noradrenaline administration. A second venous phase contrast-enhanced CT revealed venous extravasation in the external iliac vein with a suspected compression of the common iliac vein (May–Thurner syndrome) and deep vein thrombosis (DVT). Her haemodynamics were stabilized whilst a laparotomy was arranged. An inferior vena cava (IVC) filter was placed due to concerns about rebleeding with initiating anticoagulation therapy. Given the failed conservative management, elective endovascular treatment (EVT) was performed including percutaneous Fogarty venous thrombectomy and placement of self-expanding and covered stents. After the intervention, the lower limb swelling significantly improved under oral anticoagulation therapy, and the IVC filter was retrieved. At the 3-month follow-up, the lower limb swelling completely disappeared, and the contrast-enhanced CT demonstrated the complete disappearance of the retroperitoneal haematoma and DVT.

Discussion

This case provided not only the potential value of the venous phase contrast-enhanced CT in diagnosing a spontaneous iliac vein rupture but also the potential benefit of conservative management followed by elective EVT.
Patient-reported outcome measures in cardiovascular disease
Authors: Kornowski Ran
Published: August 2021

In today's medical ecosystem, it is vital to measure the outcomes that are most important to the patients. As such, patient-reported outcome measures (PROMS) can be an essential metric to deliver high-quality cardiovascular care, particularly in the subset of patients who remain disappointed with their outcomes.

PROMS should be a reproducible and reflective report of what is fundamental to a patient over time and across treatments with proper standards in the analysis, interpretation, and reporting of the collected data. These reports can also be sensitive to changes, whether improvements or deteriorations in the quality of care and medical attitude, but a lack of standardization makes it difficult to draw robust conclusions and compare findings across treatments.

As a research tool, PROMS can have a significant prognostic prominence, offering a powerful instrument of comparison between different treatment modalities. With the information technology (IT) abilities of today, we can leverage mobile tools and powerful computer systems to perform sophisticated data analysis using patient-derived data and randomization. This may eliminate guesswork and generate impactful metrics to better inform the decision-making process. PROMS analysed by proper standardized algorithms can avoid physician bias and be integrated into the hospital teamwork.

Therefore, there is a strong need for integration of PROMS into the evaluation of cardiovascular interventions and procedures, and establishment of international standards in the analyses of patient-reported outcomes and quality of life data to address this need and develop therapeutic recommendations.
Pulmonary vein pseudoaneurysm secondary to oesophageal stent displacement
Authors: Muñoz-Molina Gemma-María , Gorospe-Sarasúa Luis , Galindo-Álvarez Julio , Cabañero-Sánchez Alberto
Published: August 2021

Oesophageal stents allow endoscopic treatment of several oesophageal disorders. Although oesophageal stents are generally safe, early and late adverse events may occur. We present a previously unpublished complication consisting of a pulmonary vein pseudoaneurysm secondary to an oesophageal stent displacement.
The impact of a COVID-19 lockdown on work productivity under good and poor compliance
Authors: Ohrnberger Julius , Segal Alexa Blair , Forchini Giovanni , Miraldo Marisa , Skarp Janetta , Nedjati-Gilani Gemma , Laydon Daniel J , Ghani Azra , Ferguson Neil M , Hauck Katharina
Published: August 2021

Background

In response to the COVID-19 pandemic, governments across the globe have imposed strict social distancing measures. Public compliance to such measures is essential for their success, yet the economic consequences of compliance are unknown. This is the first study to analyze the effects of good compliance compared with poor compliance to a COVID-19 suppression strategy (i.e. lockdown) on work productivity.

Methods

We estimate the differences in work productivity comparing a scenario of good compliance with one of poor compliance to the UK government COVID-19 suppression strategy. We use projections of the impact of the UK suppression strategy on mortality and morbidity from an individual-based epidemiological model combined with an economic model representative of the labour force in Wales and England.

Results

We find that productivity effects of good compliance significantly exceed those of poor compliance and increase with the duration of the lockdown. After 3 months of the lockdown, work productivity in good compliance is £398.58 million higher compared with that of poor compliance; 75% of the differences is explained by productivity effects due to morbidity and non-health reasons and 25% attributed to avoided losses due to pre-mature mortality.

Conclusion

Good compliance to social distancing measures exceeds positive economic effects, in addition to health benefits. This is an important finding for current economic and health policy. It highlights the importance to set clear guidelines for the public, to build trust and support for the rules and if necessary, to enforce good compliance to social distancing measures.
Effects of Wood Ash Application on Tree Nutrition and Soil Dynamics in a Pinus taeda System
Authors: de Quadros Leonardo Packer , Ducheiko Henrique Almeida Santos , Maeda Shizuo , Prior Stephen Arthur , Araújo Eloá Moura , Gomes João Bosco Vasconcelos , Bognola Itamar Antonio , Soares Marcia Toffani Simão , Magri Ederlan , Frigo Cleiton , Kawasaki Alberto , Motta Antônio Carlos Vargas
Published: August 2021

Many Brazilian forest industries use wood biomass as a sustainable energy source that generates a wood ash by-product. This residue is typically discarded in nearby planted forests. To evaluate the effects of wood ash rates on Pinus taeda L. growth, a study was established on a high clay soil in 2006. Five rates of wood ash (0, 10, 20, 40, and 80 T ha−1) were applied to a P. taeda system. Soil chemical properties were evaluated three times at different depths. Tree growth (i.e., height, diameter at breast height, and commercial volume) and nutrition (needle elemental composition) were determined. After 11 years, litter accumulation and soil mobilization (bioturbation) were also evaluated. Ash application did not affect tree growth/yield or litter accumulation. A small reduction in soil acidity and increased bases in the upper soil layer were observed two years after ash application; this effect reached deeper layers after six years but retreated to shallower depths at 11 years. A soil amount of 14.6 m3 ha−1 year−1 was relocated closer to the soil surface due to bioturbation by edaphic fauna. The application of wood ash to forest soils appears to be an ecologically sound alternative for disposal of this industrial by-product.
A new tightly coupled method for high-rate seismogeodesy: a shake table experiment and application to the 2016 Mw 6.6 central Italy earthquake
Authors: Fang Rongxin , Zheng Jiawei , Shu Yuanming , Lv Huanghui , Shi Chuang , Liu Jingnan
Published: August 2021

High-rate global navigation satellite system (GNSS) has emerged as an effective method to recover seismic waveforms without saturation and drifts, but it has the limitation of relatively lower sampling rate and higher noise level compared to seismic instruments. In this study, we present a new seismogeodetic method by integrating GNSS and accelerometer data to obtain optimal real-time seismic waveforms. Unlike traditional integration methods based on GNSS techniques of relative positioning or precise point positioning, the new method uses a GNSS time difference technique and inherits its unique advantage in real-time and high-accuracy velocity solutions. Furthermore, by incorporating the tightly coupled structure, it can overcome the cascading problem and provide more accurate and robust waveforms compared to its loosely coupled counterpart. The performance of this method is first compared with the traditional loosely coupled approach in challenging environments through a set of shake table experiments. With three GNSS satellites, this approach method can improve the accuracy of velocities and displacements by 42 and 87 per cent, respectively. With four or more GNSS satellites, the average improvements of the method reach 25 and 41 per cent for the velocities and displacements, respectively. We then validate the full performances of the method through simulated shake table experiments and collocated GNSS and accelerometer data during the 2016 Mw 6.6 central Italy earthquake. The simulated and real-event analyses demonstrate that the new integration method can take full advantage of the complementary characteristics of GNSS and accelerometer sensors. By providing more accurate and broad-band velocity and displacement waveforms in a real-time or near-real-time manner, this method is quite promising in earthquake early warning and rapid source inversion.
Investigating the subsurface in a shallow water environment using array and single-station ambient vibration techniques
Authors: Shynkarenko A , Lontsi A M , Kremer K , Bergamo P , Hobiger M , Hallo M , Fäh D
Published: August 2021

Single-station and array ambient vibration techniques are widely used in onshore environments, in particular to retrieve the subsurface structure and shear-wave velocity profiles. We apply these techniques offshore in Lake Lucerne (Switzerland) using single-station and array Ocean Bottom Seismometer (OBS) data. This lake has experienced tsunamigenic subaquatic slope failures in the past and still has sediment-charged slopes that might fail in the presence of a seismic or aseismic trigger. The application of traditional onshore methods offshore brings additional challenges related to the processing of recorded data. To overcome these challenges, we perform multibeam bathymetry surveys to precisely locate the OBS on the lake floor and airgun shootings to determine the orientation of the horizontal components of the seismometer and to correct the time drift of the recorder. Then we obtain surface-wave phase velocity dispersion curves of Scholte and Love waves, and Scholte wave ellipticity curves at six subaquatic slopes. After the estimation of the dispersion curves, we deal with their modal identification using mode attribution analysis. The shear-wave velocity and thickness of the sedimentary layers at the investigated slopes are inferred using a transdimensional Bayesian inversion algorithm. The resolved velocity profiles show very low shear-wave velocities in shallow lake sediments and allow us to improve the understanding of the local stratigraphy. This research contributes to the assessment of stability and tsunamigenic potential of subaquatic slopes in Lake Lucerne.
Probabilistic inversion of seafloor compliance for oceanic crustal shear velocity structure using mixture density neural networks
Authors: Mosher S G , Eilon Z , Janiszewski H , Audet P
Published: August 2021

Measurements of various physical properties of oceanic sediment and crustal structures provide insight into a number of geological and geophysical processes. In particular, knowledge of the shear wave velocity (VS) structure of marine sediments and oceanic crust has wide ranging implications from geotechnical engineering projects to seismic mantle tomography studies. In this study, we propose a novel approach to nonlinearly invert compliance signals recorded by colocated ocean-bottom seismometers and high-sample-rate pressure gauges for shallow oceanic shear wave velocity structure. The inversion method is based on a type of machine learning neural network known as a mixture density neural network (MDN). We demonstrate the effectiveness of the MDN method on synthetic models with a fixed deployment depth of 2015 m and show that among 30 000 test models, the inverted shear wave velocity profiles achieve an average error of 0.025 km s−1. We then apply the method to observed data recorded by a broad-band ocean-bottom station in the Lau basin, for which a VS profile was estimated using Monte Carlo sampling methods. Using the mixture density network approach, we validate the method by showing that our VS profile is in excellent agreement with the previous result. Finally, we argue that the mixture density network approach to compliance inversion is advantageous over other compliance inversion methods because it is faster and allows for standardized measurements.
Gay and Lesbian Liberation in the Low Countries: From Stonewall to Pink Pillar
Authors: Dupont Wannes
Published: August 2021

This article examines the legacy of Stonewall in the Netherlands and Belgium, exploring how the gay and lesbian liberation movement resonated with pre-existing activism, national political cultures, and the peculiar structure of civil society in the Low Countries. American influences were real but limited until the later 1970s when the emergence of anti-gay politics in the US fuelled international solidarity under the flag of Stonewall and Gay Pride. The Dutch and Flemish authorities’ willingness to accommodate the mainstream movements early on limited the appeal and effectiveness of confrontational liberationism.
Safety and Efficacy of Tofacitinib in Combination With Biologic Therapy for Refractory Crohn’s Disease
Authors: Lee Scott David , Singla Anand , Harper Jason , Barahimi Mitra , Jacobs Jeffrey , Kamp Kendra J , Clark-Snustad Kindra Dawn
Published: August 2021

Background

The majority of patients with Crohn’s disease (CD) will not achieve endoscopic remission on current therapy. Addition of tofacitinib to biologics may improve remission rates.

Methods

We retrospectively assessed safety and clinical and endoscopic effectiveness of off-label tofacitinib and biologics for CD.

Results

We identified 19 patients treated with tofacitinib and a biologic for refractory CD between 2017 and 2019. Tofacitinib was added for luminal disease on colonoscopy (n = 13), luminal disease on capsule (n = 3), and pyoderma gangrenosum (n = 3). The mean age was 41.2 years (28–62), mean disease was duration 16.9 years (6–36), and prior exposure to biologics was a median of 4 (1–6). Mean treatment duration was 9.6 months (SD, 3.3). Adverse events (AEs) were reported in 36.8% of patients, most commonly minor infection or CD flare, and no patients had a serious AE; 80.0% (n = 8) achieved clinical response, and 60.0% (n = 6) achieved clinical remission based on Harvey-Bradshaw Index. Endoscopic improvement occurred in 54.5% (n = 6), endoscopic remission in 18.2% (n = 2), and endoscopic healing in 18.2% (n = 2) of patients. Mean Simple Endoscopic Score in CD significantly improved from 13.6 ± 5.2 to 6.5 ± 4.0 after treatment (P < .01).

Conclusions

In patients treated with tofacitinib in combination with a biologic, no new safety signals were observed. Combination tofacitinib and a biologic was effective in achieving clinical and endoscopic improvement in some patients with severe, refractory CD, although a larger sample size is needed to further assess the efficacy and long-term safety of this treatment strategy.
Implementation of a mHealth solution to remotely monitor patients on a cardiac surgical waiting list: service evaluation
Authors: Obika Bernard Dillon , Dolezova Nikola , Ponzo Sonia , Valentine Sophie , Shah Sachin , Gledhill Jonathan , Plans David , Nicholson Conor , Walters Cathy , Stephen Laura , Ng Serena , Ayres Janet , Petrou Mario , Bhudia Sunil , Denny Clare , Schrauwers Hillary , Markides Vias
Published: August 2021

Background

The emergence of COVID-19 resulted in postponement of nonemergent surgical procedures for cardiac patients in London. mHealth represented a potentially viable mechanism for highlighting deteriorating patients on the lengthened cardiac surgical waiting lists.

Objective

To evaluate the deployment of a digital health solution to support continuous triaging of patients on a cardiac surgical waiting list.

Method

An NHS trust utilized an app-based mHealth solution (Huma Therapeutics) to help gather vital information on patients awaiting cardiac surgery (valvular and coronary surgery). Patients at a tertiary cardiac center on a waiting list for elective surgery were given the option to be monitored remotely via a mobile app until their date of surgery. Patients were asked to enter their symptoms once a week. The clinical team monitored this information remotely, prompting intervention for those patients who needed it.

Results

Five hundred and twenty-five patients were on boarded onto the app. Of the 525 patients using the solution, 51 (9.71%) were identified as at risk of deteriorating based on data captured via the remote patient monitoring platform and subsequently escalated to their respective consultant. 81.7% of patients input at least one symptom after they were on boarded on the platform.

Discussion

Although not a generalizable study, this change in practice clearly demonstrates the feasibility and potential benefit digital remote patient monitoring can have in triaging large surgical wait lists, ensuring those that need care urgently receive it. We recommend further study into the potential beneficial outcomes from preoperative cardiac mHealth solutions.
The nucleolus from a liquid droplet perspective
Authors: Yoneda Mitsuhiro , Nakagawa Takeya , Hattori Naoko , Ito Takashi
Published: August 2021

The nucleolus is a membrane-less organelle sequestered from the nucleus by liquid droplet formation through a liquid–liquid phase separation (LLPS). It plays important roles in cell homoeostasis through its internal thermodynamic changes. Reversible nucleolar transitions between coalescence and dispersion are dependent on the concentrations, conformations and interactions of its molecular liquid droplet-forming components, including DNA, RNA and protein. The liquid droplet-like properties of the nucleolus enable its diverse dynamic roles. The liquid droplet formation mechanism, by which the nucleolus is sequestered from the nucleoplasm despite the absence of a membrane, explains a number of complex nucleolar functions.
Urethral functional reconstruction using a pedicled thigh flap for urethral cutaneous fistula after vulvar necrotizing fasciitis
Authors: Hihara Masakatsu , Kihara Masashi , Mitsui Toshihito , Kakudo Natsuko , Kuro Atsuyuki , Kusumoto Kenji
Published: August 2021

The penile and scrotal skin are often resected after vulvar necrotizing fasciitis, so functional and aesthetic vulvar reconstruction is extremely challenging. With widespread and deepened infections, urethral fistulas can develop, forcing penis and scrotal amputations. In cases complicated with a urethral fistula, the wound cannot be treated by simple skin graft surgery, and complicated flap surgery is required. We verified that urethral functional reconstruction using a pedicled thigh flap is a useful technique for managing urethral cutaneous fistulas that develop after necrotizing fasciitis.
Using Smartphones to Capture and Combine Self-Reports and Passively Measured Behavior in Social Research
Authors: Keusch Florian , Conrad Frederick G
Published: August 2021

With the ubiquity of smartphones, it is possible to collect self-reports as well as to passively measure behaviors and states (e.g., locations, movement, activity, and sleep) with native sensors and the smartphone’s operating system, both on a single device that usually accompanies participants throughout the day. This research synthesis brings structure to a rapidly expanding body of literature on the combined collection of self-reports and passive measurement using smartphones, pointing out how and why researchers have combined these two types of data and where more work is needed. We distinguish between five reasons why researchers might want to integrate the two data sources and how this has been helpful: (1) verification, for example, confirming start and end of passively detected trips, (2) contextualization, for example, asking about the purpose of a passively detected trip, (3) quantifying relationships, for example, quantifying the association between self-reported stress and passively measured sleep duration, (4) building composite measures, for example, measuring components of stress that participants are aware of through self-reports and those they are not through passively measured speech attributes, and (5) triggering measurement, for example, asking survey questions contingent on certain passively measured events or participant locations. We discuss challenges of collecting self-reports and passively tracking participants’ behavior with smartphones from the perspective of representation (e.g., who owns a smartphone and who is willing to share their data), measurement (e.g., different levels of temporal granularity in self-reports and passively collected data), and privacy considerations (e.g., the greater intrusiveness of passive measurement than self-reports). While we see real potential in this approach it is not yet clear if its impact will be incremental or will revolutionize the field.
Latent Factor Analysis of the PROMIS and Single Assessment Numeric Evaluation in Patients Undergoing Shoulder Surgery
Authors: Anderson Ashley B , Tenan Matthew S , Dickens Jonathan F
Published: August 2021

Introduction

Patient-reported outcomes (PROs) are reporting tools that quantify patients’ perceptions of their mental and physical health. Many PROs may inadvertently measure the same or overlapping theoretical constructs (e.g., pain, function, depression, etc.), which is both inefficient and a patient burden. The purpose of this study was to examine the functional relationship of the Single Assessment Numeric Evaluation (SANE) score and general constructs measured with the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) in young patients undergoing shoulder surgery.

Material and Methods

This study was an institutional review board approved retrospective case control of the Military Orthopaedics Tracking Injuries and Outcomes Network using 805 patients and 1,373 observations. All patients underwent shoulder surgery and had multiple observations ranging from 28 days pre-surgery to 428 days post-surgery. Correlation matrices and exploratory factor analysis were used to examine how each of the measured variables (PROMIS physical function, PROMIS pain interference, PROMIS sleep disturbance, PROMIS anxiety, PROMIS depression, and SANE surveys) contribute or “weigh” on latent factors, which are then mapped to a theoretical construct. This statistical method helps uncover structural relationships between measured variables.

Results

The PROMIS and SANE surveys collectively weigh on two latent factors: psychological health (measured variables: PROMIS anxiety [0.95] and PROMIS depression [0.86]) and physical capabilities (measured variables: PROMIS physical function [0.81], PROMIS pain interference [−0.82], PROMIS sleep disturbance [−0.51], and SANE [0.68]). Although the physical capability construct is functionally related to psychological health (−0.45), there is no direct relation between SANE and measures of depression or anxiety.

Conclusions

This study supports the use of the SANE as a valid single question to assess physical function providing similar information to the PROMIS in regard to measuring physical capabilities. Its simplicity makes it easy to use and implement with minimal uplift or change in workflow.
A fast radio burst in a globular cluster: why is this neutron star different from (almost) all other neutron stars?
Authors: Katz J I
Published: August 2021

Most fast radio burst (FRB) models are built from comparatively common astronomical objects: neutron stars, black holes, and supernova remnants. Yet FRB sources are rare, and most of these objects, found in the Galaxy, do not make FRB. Special and rare circumstances may be required for these common objects to be sources of FRB. The recent discovery of a repeating FRB in a globular cluster belonging to the galaxy M81 suggests a model involving a neutron star and a close binary companion, likely a white dwarf; both neutron stars and close binaries are superabundant in globular clusters. Magnetic interaction is a plausible, though unproven, mechanism of acceleration of relativistic particles that may radiate coherently as FRB. In such a model, the energy source is the orbital kinetic energy, and not limited by the magnetostatic energy of a neutron star. Double neutron star binaries cannot be the observed long-lived repeating FRB sources, but might make much shorter lived sources, and perhaps non-repeating FRB.
Spontaneous perception: a framework for task-free, self-paced perception
Authors: Baror Shira , He Biyu J
Published: August 2021

Flipping through social media feeds, viewing exhibitions in a museum, or walking through the botanical gardens, people consistently choose to engage with and disengage from visual content. Yet, in most laboratory settings, the visual stimuli, their presentation duration, and the task at hand are all controlled by the researcher. Such settings largely overlook the spontaneous nature of human visual experience, in which perception takes place independently from specific task constraints and its time course is determined by the observer as a self-governing agent. Currently, much remains unknown about how spontaneous perceptual experiences unfold in the brain. Are all perceptual categories extracted during spontaneous perception? Does spontaneous perception inherently involve volition? Is spontaneous perception segmented into discrete episodes? How do different neural networks interact over time during spontaneous perception? These questions are imperative to understand our conscious visual experience in daily life. In this article we propose a framework for spontaneous perception. We first define spontaneous perception as a task-free and self-paced experience. We propose that spontaneous perception is guided by four organizing principles that grant it temporal and spatial structures. These principles include coarse-to-fine processing, continuity and segmentation, agency and volition, and associative processing. We provide key suggestions illustrating how these principles may interact with one another in guiding the multifaceted experience of spontaneous perception. We point to testable predictions derived from this framework, including (but not limited to) the roles of the default-mode network and slow cortical potentials in underlying spontaneous perception. We conclude by suggesting several outstanding questions for future research, extending the relevance of this framework to consciousness and spontaneous brain activity. In conclusion, the spontaneous perception framework proposed herein integrates components in human perception and cognition, which have been traditionally studied in isolation, and opens the door to understand how visual perception unfolds in its most natural context.
Understanding the effect of categorization of a continuous predictor with application to neuro-oncology
Authors: Gupta Ruchi , Day Courtney N , Tobin Wlliam O , Crowson Cynthia S
Published: August 2021

Many neuro-oncology studies commonly assess the association between a prognostic factor (predictor) and disease or outcome, such as the association between age and glioma. Predictors can be continuous (eg, age) or categorical (eg, race/ethnicity). Effects of categorical predictors are frequently easier to visualize and interpret than effects of continuous variables. This makes it an attractive, and seemingly justifiable, option to subdivide the continuous predictors into categories (eg, age <50 years vs age ≥50 years). However, this approach results in loss of information (and power) compared to the continuous version. This review outlines the use cases for continuous and categorized predictors and provides tips and pitfalls for interpretation of these approaches.
CXCL13 expression in mouse 4T1 breast cancer microenvironment elicits antitumor immune response by regulating immune cell infiltration
Authors: Ma Qizhi , Chen Yue , Qin Qing , Guo Fuchun , Wang Yong-sheng , Li Dan
Published: August 2021

Breast cancer is the most commonly diagnosed cancer type and the leading cause of cancer-related deaths among women worldwide. Previous studies have reported contradictory performance of chemokine CXC motif ligand 13 (CXCL13) in breast cancer. In this study, The Cancer Genome Atlas database analysis revealed that CXCL13 was overexpressed in various human cancers including breast carcinoma, and associated with good clinical prognosis in breast cancer. Flow cytometry detection also found upregulated intracellular CXCL13 expression in human breast cancer cell lines. To explore the possible role of CXCL13 in the breast cancer microenvironment, mouse triple negative breast cancer (TNBC) was lentivirally transfected to stably overexpress mouse CXCL13 (4T1-CXCL13). Both parental 4T1 and 4T1-CXCL13 strains showed no in vitro or in vivo endogenous cell surface CXCR5 expression. In immune-competent BALB/c mice, the in vivo tumor growth of 4T1-CXCL13 was significantly inhibited and even completely eradicated, accompanied with increased infiltrations of CD4+, CD8+ T lymphocytes and CD11b+CD11c+ DCs. Further investigations showed that CXCL13 expression in the 4T1 tumor microenvironment elicited long-term antitumor immune memory, and rejection of distal parental tumor. The antitumor activity of CXCL13 was remarkedly impaired in BALB/cA-nu nude mice, or in BALB/c mice with CD8+ T lymphocyte or NK cell depletion. Our investigation indicated that CXCL13 expression in TNBC triggered effective antitumor immunity by chemoattracting immune cell infiltrations and could be considered as a novel prognostic marker for TNBC.
The Cross-Section of Bank Value
Authors: Egan Mark , Lewellen Stefan , Sunderam Adi
Published: August 2021

We study the determinants of value creation in U.S. commercial banks. We develop novel measures of individual banks’ productivities at collecting deposits and making loans that we relate to bank market values. We find that deposit productivity is responsible for two-thirds of the value of the median bank and most variation in value across banks. Variation in productivity is driven by differences across banks in technology, customer demographics, and market power. We also find evidence of synergies between deposit-taking and lending. Our findings suggest that there is significant heterogeneity in banks’ ability to capture value by manufacturing safe assets.
Being a NEET before and after the Great Recession: persistence by gender in Southern Europe
Authors: Malo Miguel Á , Mussida Chiara , Cueto Begoña , Baussola Maurizio
Published: August 2021

This article adds to the scant literature on the time persistence of being a young Not in Employment, Education or Training (NEET) by including four main novelties: we distinguish short- and long-term persistence; we use estimations before (2004–2007) and after the Great Recession (2013–2016); we analyse four Southern European countries that are relatively similar and were significantly affected by the Great Recession (Greece, Italy, Portugal and Spain); and all analyses are disaggregated by gender. The descriptive analysis shows a convergence in NEET rates by gender in the four countries due to a worsening of the male NEET rate and no improvement among young females. The econometric estimations show that long-term persistence is smaller than short-term persistence and that the latter increased after the Great Recession, especially for male NEETs. Policy implications for the design of the Youth Guarantee and lessons from the coronavirus pandemic are also discussed.
The Four Domain Food Insecurity Scale (4D-FIS): development and evaluation of a complementary food insecurity measure
Authors: Johnson Cassandra M , Ammerman Alice S , Adair Linda S , Aiello Allison E , Flax Valerie L , Elliott Sinikka , Hardison-Moody Annie , Bowen Sarah K
Published: August 2021

The U.S. Department of Agriculture (USDA) Food Security Survey Module (FSSM) is a valuable tool for measuring food insecurity, but it has limitations for capturing experiences of less severe food insecurity. To develop and test the Four Domain Food Insecurity Scale (4D-FIS), a complementary measure designed to assess all four domains of the food access dimension of food insecurity (quantitative, qualitative, psychological, and social).Low-income Black, Latina, and White women (n = 109) completed semi-structured (qualitative) and structured (quantitative) interviews. Interviewers separately administered two food insecurity scales, including the 4D-FIS and the USDA FSSM adult scale. A scoring protocol was developed to determine food insecurity status with the 4D-FIS. Analyses included a confirmatory factor analysis to examine the hypothesized structure of the 4D-FIS and an initial evaluation of reliability and validity. A four-factor model fit the data reasonably well as judged with fit indices. Results showed relatively high factor loadings and inter-factor correlations indicated that factors were distinct. Cronbach’s alpha (ɑ) for the overall scale was 0.90 (subscale ɑ ranged from 0.69 to 0.91) and provided support for the scale’s internal consistency reliability. There was fair overall agreement between the 4D-FIS and USDA FSSM adult scale, but agreement varied by category. Findings provide preliminary support for the 4D-FIS as a complementary measure of food insecurity, with implications for researchers, practitioners, and policymakers working in U.S. communities.
Uplifting the voices of rural American Indian older adults to improve understanding of physical activity behavior
Authors: Pedersen Maja , Harris Kari Jo , Lewis Jordan , Grant Mattea , Kleinmeyer Chelsea , Glass Ashley , Graham Niki , Brown Blakely , King Diane
Published: August 2021

American Indian (AI) older adults experience pronounced health disparities and demonstrate one of the lowest levels of physical activity (PA) among racial and ethnic groups. Nearly half of AI older adults live in rural areas, indicating distinct challenges to participation in PA. Research to identify factors influencing PA in this population is missing from the literature, yet is critical to informing culturally relevant PA intervention development and implementation. The purpose was to identify barriers to and facilitators of PA among rural AI older adults using the ecological model and qualitative methods. A community-based approach was used to conduct semi-structured interviews with rural AI older adults. Interview questions were based on a multi-level ecological model. Content analysis was performed, using an iterative coding process to identify findings. The mean age of participants (n = 21) was 66 years. Barriers to and facilitators of PA were identified across ecological model levels. Barriers included factors such as caregiving and community responsibilities, lack of acceptable areas for walking, and overall lack of community-level support for older adult health. Facilitators included a personal connection to the land and ancestors through PA, multigenerational participation, and supportive tribal policies. This study addressed a gap in the literature by identifying barriers to and facilitators of PA among rural AI older adults, which can inform PA intervention development. With barriers and facilitators identified by AI older adults themselves, the voices of those directly affected are uplifted to shape efforts toward addressing longstanding health disparities through relevant public health interventions.
Dictyostelium discoideum:An Alternative Nonanimal Model for Developmental Toxicity Testing
Authors: Baines Robert P , Wolton Kathryn , Thompson Christopher R L
Published: August 2021

A critical aspect of toxicity evaluation is developmental and reproductive toxicity (DART) testing. Traditionally, DART testing has been conducted in vivo in mammalian model systems. New legislation aimed at reducing animal use and the prohibitive costs associated with DART testing, together with a need to understand the genetic pathways underlying developmental toxicity means there is a growing demand for alternative model systems for toxicity evaluation. Here we explore the potential of the eukaryotic social amoeba Dictyostelium discoideum, which is already widely used as a simple model system for cell and developmental biology, as a potential nonanimal model for DART testing. We developed assays for high-throughput screening of toxicity during D. discoideum growth and development. This allowed the toxicity of a broad range of test compounds to be characterized, which revealed that D. discoideum can broadly predict mammalian toxicity. In addition, we show that this system can be used to perform functional genomic screens to compare the molecular modes of action of different compounds. For example, genome-wide screens for mutations that affect lithium and valproic acid toxicity allowed common and unique biological targets and molecular processes mediating their toxicity to be identified. These studies illustrate that D. discoideum could represent a predictive nonanimal model for DART testing due to its amenability to high-throughput approaches and molecular genetic tractability.