bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of platelet concentrations and evaluation of risk factors for thrombocytopenia following traumatic injury
Authors: Farrar Julie E , Naik Kushal , Van Matre Edward T , Martin Katelyn G , Magnotti Louis J , Wood G Christopher , Swanson Joseph M
Published: April 2022

Introduction

Thrombocytopenia is common in critically ill trauma patients and can lead to potentially broad differentials, including major bleeding, hemodilution, extracorporeal circuit losses, heparin-induced thrombocytopenia, and more. Understanding the normal time course of platelet decline and recovery may delineate thrombocytopenia(HIT) secondary to traumatic injury versus other inciting factors.

Methods

This retrospective study included trauma patients admitted over a 1-year period. The primary aim was characterizing the effect of trauma on platelet concentration and thrombocytopenia incidence in the first 30 days following injury. Thrombocytopenia was defined as platelet concentration <150 × 109/L. A secondary aim was evaluating significant factors contributing to thrombocytopenia.

Results

A total of 225 patients were included. Thrombocytopenia occurred in 67.3% of patients, and a platelet decline of 50% or greater occurred in 44%. Decrease in platelet concentration was significant from day 1 to day 4 (mean ± SD, 232 ± 86 vs 142 ± 76 × 109/L; p = .001). Platelets recovered to baseline on day 8 and peaked on day 16. Packed red blood cell or platelet transfusion, continuous renal replacement therapy, and acute liver injury independently predicted a ≥50% platelet decrease. HIT was not diagnosed in any patients.

Conclusion

Platelet nadir likely occurs approximately 4 days after injury and recovers relatively quickly thereafter. More studies are needed to evaluate the magnitude of effect on thrombocytopenia by factors beyond trauma.
Due process in police-led prosecutions: Views of Ghanaian police prosecutors
Authors: Amagnya Moses Agaawena
Published: April 2022

Criminal prosecutions led by police officers are integral to justice delivery in some common-law countries. The cooperation and participation of interested parties, particularly victims and witnesses, are important for successful prosecutions because most police prosecutors are not lawyers. Prosecutors adherence to due process when handling cases can secure parties’ willing cooperation and participation. However, is due processes followed during police-led prosecutions of criminal cases? This study uses interview data from police prosecutors to explore police-led prosecutions in Ghana. Results show that police prosecutors do not pay significant attention to pre-trial conferencing with disputed parties. In addition, prosecutors non-adherence to due process is aggravated by irregular training and professional development, inadequate professional competence, and lack of pre-trial procedural uniformity and clarity. Finally, the article discusses the implication of the results for theory and police prosecution policies.
4D structures for the short-time building of emergency shelters
Authors: Costa L Alice , Rangel Carvalho Bárbara , Lino Alves Jorge , Marques António T , da Silva André Filipe BM , Esfandiari Puria , da Silva João Francisco MG , Rita Silva Ana , Parente Marco
Published: April 2022

The increasing number of internal displaced people due to conflicts or natural disasters over the years represents the need to create structural solutions for first emergency shelter, which are currently supplied in tarpaulin and structures improvised by the locals. Innovative technologies like 4D printing could present an alternative, being possible to develop 3D structures with smart materials that react with environmental stimulus, such as water, light, heat and others. Unlike 3D printing, which is static, the factor ‘time’ adds a dimension to the 4D, making the structures self-assembling, multifunctional or self-repairing. Given this, the aim of this paper is to present research for the application of 4D-printed structures, for crises, to speed up and ease the assembly process, replacing the structures currently used with one that integrates the emergency kit. It also presents a review on emergency shelters, as well as on 3D and 4D printing processes, clarifying its definition and introducing a case study demonstrative of the process, by printing with shape memory filaments, specifically poly lactic acid and shape memory polymers. A concept was developed and validated, evaluating the possibility of applying 4D printing process in the development of structures that are easy to transport and assemble in emergencies, using the beneficial characteristics of shape memory polymer material. Therefore, the simulation of the concept and the improvement of material properties in terms of specific strength and toughness, which can be achieved using composite materials, are indicated as future recommendations. Moreover, the concept must be evaluated from a structural point of view.
Perceiving Freedom: Civil Liberties and COVID-19 Vaccinations
Authors: Munir Hayley , Munir Syed Rashid
Published: April 2022

Why have some countries been more successful in their COVID-19 vaccine rollouts than others? Despite efforts by governments to vaccinate their adult populations against COVID-19, vaccination rates remain irregularly low in some countries. We suggest that a crucial piece of this puzzle lies in resistance against government directives from the public due to civil liberty protections. Countries with greater protections for civil liberties can be expected to have lower vaccinations administered than countries with fewer protections, as the public enjoys a sense of freedom regarding their private lives. In such countries, de jure constraints on government policies are complemented by the fear of public backlash, even in crises; consequently, beyond structural limitations, governments with high levels of civil liberty protections face an additional hurdle in managing the COVID-19 crisis. Evidence for this hypothesis is presented for 153 countries by combining civil liberty scores with newly available data on COVID-19 vaccinations.
Fostering Greater Persistence Among Underserved Computer Science Undergraduates: A Descriptive Study of the I-PASS Project
Authors: Mickelson Roslyn Arlin , Mikkelsen Ian , Dorodchi Mohsen , Cukic Bojan , Horn Tytianna
Published: April 2022

Female, Black, Latinx, Native American, low-income, and rural students remain underrepresented among computer science undergraduate degree recipients. Along with student, family, and secondary school characteristics, college organizational climate, curricula, and instructional practices shape undergraduates’ experiences that foster persistence until graduation. Our quasi-experimental project, Improving the Persistence and Success of Students from Underrepresented Populations in Computer Science (I-PASS), is designed to augment students’ persistence until they earn their computer science degree. Drawing on prior research, including Tinto's model of effective institutional actions for retention, I-PASS Scholars—all low-income, female and/or members of underserved demographics groups— receive a four-year scholarship; mentoring, tutoring, advising; and opportunities to integrate into the academic and social life of the campus. Students’ written reflections and attitude surveys suggest I-PASS's components foster their retention by, among other mechanisms, enhancing their computer science identity development and sense of belonging in the major.
An Intervention Trial for Strengthening Medical Adherence after Heart Transplantation
Authors: Tigges-Limmer K. , Stock Gissendanner S S. , Schmid-Ott G. , Wlost S. , Gummert J.F. , Zittermann A.
Published: April 2022

Introduction

In heart transplant recipients, nonadherence is associated with higher risk of morbidity and mortality.

Research Question

Can a psychoeducational intervention enhance adherence to medical recommendations?

Design

We randomized 200 patients awaiting heart transplantation on the high urgency wait list to a manualized psychoeducational intervention or standard care. Follow-up continued to three years after transplantation. Primary endpoint was adherence to immunosuppressive medication, assessed at 3, 6, 12, 24, and 36 months posttransplant. Secondary endpoints were barriers to adherence during follow-up and clinical outcomes, including cardiac rejection within the first postoperative year and postoperative 3-year mortality.

Results

Fifty patients died before or within the first 3 months of transplantation. The primary endpoint was analyzed in 66 patients in the intervention group and 66 in the control group. Both study groups showed almost maximal adherence to immunosuppressive medication throughout follow-up, with no significant time x treatment interaction (P>0.99). Likewise, there was no significant time x treatment interaction ( P=0.41) on barriers to adherence. The percentage of patients with International Society for Heart and Lung Transplantation standard grade 1 and 2 rejection was in the intervention and control groups 82.5% and 78.7%, respectively, and 8.8% and 13.1%, respectively, without significant differences between study groups ( P=0.75). Considering all randomized and transplanted patients in the intervention group (N=85) and control group (N=87), postoperative 3-year mortality was 29.4% and 27.6%, respectively ( P=0.82).

Conclusions

Adherence to immunosuppressive medication was high, even without a complex, manualized psychoeducational intervention. The intervention had no significant positive impact on cardiac rejection and mortality.
Thoracic Endovascular Aneurysm Repair and Tracheal Stenting for Respiratory Failure due to a Thoracic Aortic Aneurysm: A Case Report
Authors: Hakkenbrak Nadia A.G. , Truijers Maarten , Thomassen Irene
Published: April 2022

An 82-year-old male was referred to the emergency department for severe respiratory distress. Computed tomography angiography showed tracheal compression due to a large ruptured saccular aneurysm of the descending thoracic aorta. Emergency Thoracic Endovascular Aneurysm Repair (TEVAR) was performed. To reduce tracheal compression, an endotracheal stent was placed (silicone Dumon©). Following surgery, respiratory function improved. Two days after the surgery, the patient refused further invasive treatment, including mechanical mucus aspiration from the endotracheal stent, and palliative sedation was initiated. Conventional treatment to reduce tracheal compression by a saccular aortic aneurysm is open surgical aneurysm repair. If open repair is contraindicated because of patient age, comorbidity, or in case of severe hemodynamic instability following aneurysm rupture, TEVAR with endotracheal stent placement may serve as a bridge to definite surgery to reduce tracheal compression.
“Beyond Their Actual Limits”: Immersion, Interactivity, and the Virtual Sublime in Burke and Video Games
Authors: Kim Yaeri
Published: April 2022

This article examines the experience of the sublime engendered by video games and the function of immersion and interactivity in producing this effect. A close inspection of the history of the sublime as an aesthetic principle and related cultural practices reveals that the elements of immersion, interactivity, and virtuality were already integral to Burke’s seminal conceptualization, as well as in architecture and visual media, before the emergence of digital media. The techniques and technologies of the immersive sublime deployed by preexisting spatial and visual art forms are inherited, revised, and enhanced in video games, as demonstrated by the analysis of the undersea exploration game ABZÛ. In this sense, the video game simultaneously marks the continuation of and new developments in the interlinked histories of the sublime and technology.
Deployment of low-profile flow-diverter through a double lumen balloon catheter (remo-diversion technique) to treat recurrent middle cerebral artery bifurcation aneurysm: A technical note
Authors: Pagano Paolo , Calvão Pires Pedro , Paiusan Laurentiu , Soize Sebastien , Manceau Pierre François , Pierot Laurent
Published: April 2022

Wide neck intracranial aneurysms are often difficult to treat with coiling alone, and sophisticated techniques such as balloon-assisted coiling, stent-assisted coiling, flow-diversion, or intrasaccular flow-disruption are sometimes required.

This technical note reports the endovascular treatment of a recurrent middle cerebral bifurcation aneurysm by remodeling technique followed by flow-diverter (Silk Vista Baby) deployment through a remodeling balloon (double lumen balloon Eclipse 2L).
How Implementation of Cognitive Assistive Technology in Home-Based Services for Young Adults with Intellectual Disabilities Influences Support Staff`s Professional Practice
Authors: Söderström Sylvia , Bakken Hege , Østby May , Ellingsen Karl E.
Published: April 2022

The implementation of technology in home-based services takes place in contextualised socio-material practices negotiated through interactions between a diversity of actors. Prerequisites for succeeding in this process are time and competence, and that use of the technology is experienced as meaningful, for both the support staff and the resident. In this article, we investigate how implementation of cognitive assistive technology (CAT) in home-based services for young adults with intellectual disabilities influences the support staff`s professional practice. The participants are eight support staff members, five women and three men. Data were collected through two group interviews, the second one 8 months after the first one. The data were analysed according to a systematic text condensation (STC) approach. Implementation of CAT is a demanding process, revealing different perspectives on professionalism and changing power relations, and entails a new way of working for the support staff.
Does interpersonal liking lead to interpersonal synchrony in musical contexts?
Authors: Melton Zachary J , Chaffin Roger , Kangas-Dick Kayleigh , Marsh Kerry L , Demos Alexander P
Published: April 2022

The causal relationship of interpersonal liking affecting interpersonal synchrony is inconsistently documented. This study tests whether (a) interpersonal liking increases both behavioural and perceived synchrony and (b) people will synchronise with an agreeable partner over a competing musical stimulus. We had college students ( N = 25) shake an egg-shaker with an agreeable or disagreeable confederate without music, with music, and with specific instruction to synchronise. Participants reported liking the agreeable confederate more than the disagreeable confederate and rated their relationship more positively; however, both behavioural and perceived synchrony were unaffected by the agreeableness of the confederate. Thus, we failed to replicate previous findings in an auditory only context. Furthermore, participants who believed they were more synchronised with the confederate liked the confederate more and felt more like a team, but the degree of behavioural synchrony was unrelated to these social perceptions. Perception of synchrony appears to be more important for social bonding than behavioural synchrony.
Skipping the structural particle de (的) in reading Chinese: The role of word frequency and sentential fit
Authors: Yang Jinmian , Zhang Tianyu , Xue Yangxin
Published: April 2022

Previous studies suggested that readers were more likely to skip a word when it was previewed by a very-high-frequency word, like “the” in English and “ de (的)” in Chinese, and they suggested that readers based skipping decisions on parafoveal word information rather than on sentence context. However, in these studies, the very-high-frequency preview word ( the or de) was always implausible given the sentence context. It is an open question whether parafoveal word information interacts with sentence context to influence skipping decisions. Therefore, the current experiment orthogonally manipulated the preview information of the target character (identical or de preview) and the plausibility of de (plausible or implausible) to examine this question. The major results indicated that readers were more likely to skip the target character and made longer outgoing saccade length across the boundary in the de preview condition than in the identical preview condition. What is more important, the interaction between the plausibility of de and preview condition was significant: Readers’ higher probability of skipping the target character and longer outgoing saccade length in the de preview condition than in the identical preview condition was only significant when de was plausible, suggesting that parafoveal word information and context information can act as a joint constraint on skipping decision in reading Chinese.
Bayesian approximations to the theory of visual attention (TVA) in a foraging task
Authors: Le Sofia Tkhan Tin , Kristjánsson Árni , MacInnes W Joseph
Published: April 2022

Foraging as a natural visual search for multiple targets has increasingly been studied in humans in recent years. Here, we aimed to model the differences in foraging strategies between feature and conjunction foraging tasks found by Á. Kristjánsson et al. Bundesen proposed the theory of visual attention (TVA) as a computational model of attentional function that divides the selection process into filtering and pigeonholing. The theory describes a mechanism by which the strength of sensory evidence serves to categorise elements. We combined these ideas to train augmented Naïve Bayesian classifiers using data from Á. Kristjánsson et al. as input. Specifically, we attempted to answer whether it is possible to predict how frequently observers switch between different target types during consecutive selections (switches) during feature and conjunction foraging using Bayesian classifiers. We formulated 11 new parameters that represent key sensory and bias information that could be used for each selection during the foraging task and tested them with multiple Bayesian models. Separate Bayesian networks were trained on feature and conjunction foraging data, and parameters that had no impact on the model’s predictability were pruned away. We report high accuracy for switch prediction in both tasks from the classifiers, although the model for conjunction foraging was more accurate. We also report our Bayesian parameters in terms of their theoretical associations with TVA parameters, [Formula: see text] (denoting the pertinence value), and [Formula: see text] (denoting the decision-making bias).
Fight INflammation to Improve outcome after aneurysmal Subarachnoid HEmorRhage (FINISHER) trial: Study protocol for a randomized controlled trial
Authors: Güresir Erdem , Lampmann Tim , Bele Sylvia , Czabanka Marcus , Czorlich Patrick , Gempt Jens , Goldbrunner Roland , Hurth Helene , Hermann Elvis , Jabbarli Ramazan , Krauthausen Marius , König Ralph , Lindner Dirk , Malinova Vesna , Meixensberger Jürgen , Mielke Dorothee , Németh Robert , Darkwah Oppong Marvin , Pala Andrej , Prinz Vincent , Rashidi Ali , Roder Constantin , Sandalcioglu Ibrahim Erol , Sauvigny Thomas , Schebesch Karl-Michael , Timmer Marco , Vajkoczy Peter , Wessels Lars , Wild Florian , Wilhelm Christoph , Wostrack Maria , Vatter Hartmut , Coch Christoph
Published: April 2022

Rationale:

Aneurysmal subarachnoid hemorrhage (SAH) has high morbidity and mortality. While the primary injury results from the initial bleeding cannot currently be influenced, secondary injury through vasospasm and delayed cerebral ischemia worsens outcome and might be a target for interventions to improve outcome. To date, beside the aneurysm treatment to prevent re-bleeding and the administration of oral nimodipine, there is no therapy available, so novel treatment concepts are needed. Evidence suggests that inflammation contributes to delayed cerebral ischemia and poor outcome in SAH. Some studies suggest a beneficial effect of anti-inflammatory glucocorticoids, but there are no data from randomized controlled trials examining the efficacy of glucocorticoids. Therefore, current guidelines do not recommend the use of glucocorticoids in SAH.

Aim:

The Fight INflammation to Improve outcome after aneurysmal Subarachnoid HEmorRhage (FINISHER) trial aims to determine whether dexamethasone improves outcome in a clinically relevant endpoint in SAH patients.

Methods and design:

FINISHER is a multicenter, prospective, randomized, double-blinded, placebo-controlled clinical phase III trial which is testing the outcome and safety of anti-inflammatory treatment with dexamethasone in SAH patients.

Sample size estimates:

In all, 334 patients will be randomized to either dexamethasone or placebo within 48 h after SAH. The dexamethasone dose is 8 mg tds for days 1–7 and then 8 mg od for days 8–21.

Study outcome:

The primary outcome is the modified Rankin Scale (mRS) at 6 months, which is dichotomized to favorable (mRS 0–3) versus unfavorable (mRS 4–6).

Discussion:

The results of this study will provide the first phase III evidence as to whether dexamethasone improves outcome in SAH.
Changes in physical activity and risk of ischemic stroke: The ARIC study
Authors: Cowan Logan T , Tome Joana , Mallhi Arshpreet Kaur , Tarasenko Yelena N , Palta Priya , Evenson Kelly R , Lakshminarayan Kamakshi
Published: April 2022

Background:

Limited data exist regarding the impact of changes in physical activity (PA) over time on ischemic stroke risk. Exploring this understudied area could help improve stroke prevention strategies and promote PA during the lifespan.

Methods:

We evaluated 11,089 Atherosclerosis Risk in Communities (ARIC) participants recruited in 1987–1989 who completed Visit 3 (1993–1995). We classified PA as meeting recommendations, not meeting recommendations, or no PA. Categories of increased, decreased, stable high, and stable low PA and a continuous PA variable were also evaluated. Crude and adjusted Cox regression models were used to characterize the association of 6-year changes in PA and ischemic stroke risk.

Results:

Participants had a mean age of 60 years. During a median of 21 years, 762 ischemic stroke events occurred. Compared to the participants with recommended PA at both visits, those with no PA had 46% higher hazards of ischemic stroke (hazard ratio (HR) = 1.46 (95% confidence interval (CI) = 1.17, 1.82)), and those with recommended PA at Visit 1 and no PA at Visit 3 also had 37% higher hazards (HR = 1.37 (95% CI = 1.02, 1.83)). Participants who increased their PA from Visit 1 to Visit 3 had 23% lower hazard than those with stable low PA at both visits (HR = 0.77 (95% CI = 0.63, 0.94)), while those who decreased their PA had 25% higher hazards compared to those with stable high PA at both visits (HR = 1.25 (95% CI = 1.01, 1.54)).

Conclusion:

Physical inactivity during midlife increases ischemic stroke risk, while meeting PA recommendations reduces it.
Sabotage in dynamic tournaments with heterogeneous contestants: Evidence from European football
Authors: Zhao Yangqing , Zhang Hui
Published: April 2022

This paper analyses how sabotage, measured as the number of fouls and yellow and red cards, is affected by the relative performance of and asymmetries between teams, determined based on score margin and the odds gap between one team and its opponent. By applying detailed controls for within-match dynamics and differences in team quality, we first observe that badly losing favourites are more willing than losing underdogs to increase their unsporting behaviour in heterogeneous contests. There are more yellow cards and fouls as the game progresses. We further find that most sabotage (yellow cards) can be observed when the (absolute) goal difference is equal to 1. Teams decrease their level of sabotage (fouls) by increasing the number of goals of lead or trail. In addition, weaker teams have an incentive to engage in more unfair and destructive strategies, such as committing more fouls, including those penalized with yellow cards. However, the incidence of red cards is not influenced by the score margin or strength gap.
Effects of repeated-sprint training in hypoxia induced by voluntary hypoventilation on performance during ice hockey off-season
Authors: Brocherie Franck , Cantamessi Gregory , Millet Grégoire P. , Woorons Xavier
Published: April 2022

This study aimed to assess the effects of an off-season period of repeated-sprint training in hypoxia induced by voluntary hypoventilation at low lung volume (RSH-VHL) on off-ice repeated-sprint ability (RSA) in ice hockey players. Thirty-five high-level youth ice hockey players completed 10 sessions of running repeated sprints over a 5-week period, either with RSH-VHL (n = 16) or with unrestricted breathing (RSN, n = 19). Before (Pre) and after (Post) the training period, subjects performed two 40-m single sprints (to obtain the reference velocity (Vref)) followed by a running RSA test (12 × 40 m all-out sprints with departure every 30 s). From Pre to Post, there was no change in Vref or in the maximal velocity reached in the RSA test in both groups. In RSH-VHL, the mean velocity of the RSA test was higher (88.9 ± 5.4 vs. 92.9 ± 3.2% of Vref; p < 0.01) and the percentage decrement score lower (11.1 ± 5.2 vs. 7.1 ± 3.3; p < 0.01) at Post than at Pre whereas no significant change occurred in the RSN group (89.6 ± 3.3 vs. 91.3 ± 1.9% of Vref, p = 0.11; 10.4 ± 3.2 vs. 8.7 ± 2.3%; p = 0.13). In conclusion, five weeks of off-ice RSH-VHL intervention led to a significant 4% improvement in off-ice RSA performance. Based on previous findings showing larger effects after shorter intervention time, the dose-response dependent effect of this innovative approach remains to be investigated.
Diagnosing the direction of shoulder instability in rugby players
Authors: Clarke Ciaran John , Torrance Emma , Gibson Jo , Brownson Peter , Funk Lennard
Published: April 2022

The muscular characteristics of rugby players may make diagnosing the direction of shoulder instability and labral pathology challenging. This study aimed to assess the accuracy of clinical examination and specifically instability tests, in diagnosing the direction of shoulder instability in rugby players. One-hundred-and-forty rugby players, who had undergone a shoulder stabilization procedure, over a 55-month period, were included in this study. The mean age was 21.5 years with 137 males. Data collected included clinical examination and intraoperative findings. The two were compared to calculate the diagnostic accuracy of special tests for instability. The Anterior Apprehension Test had good sensitivity (82.7%), specificity (100%) and PPV (100%) but poor NPV (55.8%). All posterior instability tests demonstrated a sensitivity of over 85%, but all had a specificity of 25% or less. In 83.6% of cases the direction of instability was correctly identified from history and examination. Anterior instability was correctly diagnosed in 78.9% of cases and posterior in 100.0%. The poor NPV of the anterior apprehension test suggests that clinicians should be suspicious of anterior instability in rugby shoulders even in the light of negative examination findings. Positive posterior instability tests are highly suggestive of posterior instability in rugby players.
Time of arrival as a diagnostic for far-field high explosive blast waves
Authors: Farrimond Dain G. , Rigby Sam E. , Clarke Sam D. , Tyas Andy
Published: April 2022

The ability to accurately determine blast loading parameters will enable more fundamental studies on the sources of blast parameter variability and their influence on the magnitude and form of the loading itself. This will ultimately lead to a better fundamental understanding of blast wave behaviour, and will result in more efficient and effective protective systems and enhanced resilience of critical infrastructure. This article presents a study on time of arrival as a diagnostic for far-field high explosive blasts, and makes use of the results from a large number of historic tests and newly performed experiments where the propagating shock front was filmed using a high-speed video (HSV) camera. A new method for optical shock tracking of far-field blast tests is developed and validated, and full-field arrival time results are compared against those determined from the historic data recorded using traditional pressure gauges. Arrival time variability is shown to be considerably lower than peak pressure and peak specific impulse, and is shown to decrease exponentially with increasing scaled distance. Further, the method presented in this article using HSV cameras to determine arrival time yields further reductions in variability. Finally, it is demonstrated that the method can be used to accurately determine far-field TNT equivalence of high explosives.
Automated clinical pathway standardization using SNOMED CT- based semantic relatedness
Authors: Alahmar Ayman , AlMousa Mohannad , Benlamri Rachid
Published: April 2022

The increasing number of patients and heavy workload drive health care institutions to search for efficient and cost-effective methods to deliver optimal care. Clinical pathways are promising care plans that proved to be efficient in reducing costs and optimizing resource usage. However, most clinical pathways are circulated in paper-based formats. Clinical pathway computerization is an emerging research field that aims to integrate clinical pathways with health information systems. A key process in clinical pathway computerization is the standardization of clinical pathway terminology to comply with digital terminology systems. Since clinical pathways include sensitive medical terms, clinical pathway standardization is performed manually and is difficult to automate using machines. The objective of this research is to introduce automation to clinical pathway standardization. The proposed approach utilizes a semantic score-based algorithm that automates the search for SNOMED CT terms. The algorithm was implemented in a software system with a graphical user interface component that physicians can use to standardize clinical pathways by searching for and comparing relevant SNOMED CT retrieved automatically by the algorithm. The system has been tested and validated on SNOMED CT ontology. The experimental results show that the system reached a maximum search space reduction of 98.9% within any single iteration of the algorithm and an overall average of 71.3%. The system enables physicians to locate the proper terms precisely, quickly, and more efficiently. This is demonstrated using case studies, and the results show that human-guided automation is a promising methodology in the field of clinical pathway standardization and computerization.
Financing Whole-Person Health
Authors: Hecht Madison , Marzolf James , Castle Ryan D.
Published: April 2022

Background

Current payment models in the U.S. healthcare system are neither sustainable nor desirable. Expenses outpace revenue for most healthcare providers, while patients experience rising prices contrasted with inadequate health outcomes.

Objective

There is not a single, small adjustment that can remedy these issues; systemic problems require systemic solutions. One such solution involves whole-person care, an approach that emphasizes using diverse healthcare resources to align care with a patient’s values and goals as well as treat a patient’s physical, behavioral, emotional, and social risk factors.

Methods

In order to be most effective, whole-person care must be paired with a viable payment system that prioritizes positive outcomes and efficiency. The predominant fee-for-service payment system is not conducive to whole-person strategies.

Results

This paper examines the role of capitated payments, risk adjustments, social and structural determinants of health, and expense trends in an interdependent approach to healthcare industry system reform.

Conclusion

The Whole Health paradigm is optimized to improve both the financial performance of healthcare providers and the healthcare results of patients. Phased implementation is both feasible and sustainable.
Constructing Corequisites: How Community Colleges Structure Corequisite Math Coursework and the Implications for Student Success
Authors: Ryu Wonsun , Schudde Lauren , Pack Kim
Published: April 2022

States and broad-access colleges are rapidly scaling corequisite coursework—a model where students concurrently enroll in college-level and developmental coursework—in response to dismal completion rates in traditional “developmental” sequences. At community colleges, evidence suggests that corequisite reforms can dramatically improve students’ completion of required college-level courses, but colleges often implement new programing and sequences with limited information. We analyzed administrative data from Texas community colleges implementing a statewide corequisite mandate. Our results illustrate (a) how colleges structured corequisite courses in response to the statewide mandate and (b) how corequisite coursework characteristics predicted student outcomes. Our results suggest that some corequisite coursework elements—including mixed-ability college-level classes, higher credits for the developmental education (dev-ed) corequisite support course, and using the same instructor across both the college-level and dev-ed course—improve students’ probability of passing college-level math, though these course design elements do not appear to predict long-term outcomes like persistence in college.
COVID-19 and the Vulnerabilities of Community-Dwelling Older Adults: Findings From a Statewide Survey of Home-Delivered Meals Recipients*
Authors: Masters Julie L. , Wilkinson Lindsay R. , Kelly Christopher M. , McKelvey Miechelle , Ghazi Saidi Ladan , Hill Toni L. , Drozd David , Wu Heng , O’Brien Taylor
Published: April 2022

COVID-19’s impact on community-dwelling older adults, especially those in rural and underserved areas, as well as those who are homebound, is of interest to policy makers and clinicians, now and in the future. This study aims to examine the consequences of the COVID-19 pandemic on community-dwelling older adults with the greatest social and economic needs residing in a mostly rural state. Using a self-administered survey, we collected data from 1852 home-delivered meal recipients, age 60 years and older, served by Nebraska’s eight Area Agencies on Aging. Results highlight three areas of importance: social connections, healthcare access and utilization, and technology. We found that while most older adults maintained social interaction, despite the restrictions imposed by the pandemic, feelings of loneliness persisted or even increased, with 35% of respondents feeling lonelier because of the pandemic. Our findings further reveal that 42% of older adults skipped or postponed healthcare visits during the pandemic, although the majority expressed interest in using telehealth. Finally, the rural‐urban divide was evident in our data, with less than one-half of respondents (45%) having access to reliable internet. Suggestions on how to prepare the most vulnerable people for similar crises are included.
Human mobility data and analysis for urban resilience: A systematic review
Authors: Haraguchi Masahiko , Nishino Akihiko , Kodaka Akira , Allaire Maura , Lall Upmanu , Kuei-Hsien Liao , Onda Kaya , Tsubouchi Kota , Kohtake Naohiko
Published: April 2022

The impacts of disasters are increasing due to climate change and unplanned urbanization. Big and open data offer considerable potential for analyzing and predicting human mobility during disaster events, including the COVID-19 pandemic, leading to better disaster risk reduction (DRR) planning. However, the value of human mobility data and analysis (HMDA) in urban resilience research is poorly understood. This review highlights key opportunities for and challenges hindering the use of HMDA in DRR in urban planning and risk science, as well as insights from practitioners. A gap in research on HMDA for data-driven DRR planning was identified. By examining human mobility studies and their respective analytical and planning tools, this paper offers deeper insights into the challenges that must be addressed to improve the development of effective data-driven DRR planning, from data collection to implementation. In future work on HMDA, (i) the human mobility of vulnerable populations should be targeted, (ii) research should focus on disaster mitigation and prevention, (iii) analytical methods for evidence-based disaster planning should be developed, (iv) different types of data should be integrated into analyses to overcome methodological challenges, and (v) a decision-making framework should be developed for evidence-based urban planning through transdisciplinary knowledge co-production.
A longitudinal analysis of travel demand and its determinants in the Greater Toronto-Hamilton Area
Authors: Kasraian Dena , Raghav Shivani , Yusuf Bilal , Miller Eric J
Published: April 2022

This study provides a unique long-term investigation of regional travel demand that addresses several gaps in the existing longitudinal literature. Firstly, it investigates the development of travel demand in terms of both vehicle kilometres travelled (VKT) and passenger kilometres travelled (PKT), based on actual demand, congestion and equilibrium distances, using road and multi-modal transit networks in the Greater Toronto-Hamilton Area (GTHA). Secondly, it identifies influential travel demand determinants after testing an extensive set of variables including longitudinal gravity-based transport accessibility measures. Thirdly, it investigates to what extent the determinants’ influence changes over time and various locations within the study area, providing new insights into the temporal and intra-regional variations of travel demand and its determinants. The findings show that VKT and PKT have grown in absolute and per trip terms, mainly due to substantial population growth, especially in the suburban areas. Whilst average potential travel times by transit have decreased, they are substantially longer than auto travel times. Furthermore, travel demand determinants vary significantly across space by degrees of urbanity, especially for VKT. The findings call for area- and population segment-specific land use and transportation policies across the GTHA.
Introduction: Refugee camps as carceral junctions
Authors: Turner Simon , Whyte Zachary
Published: April 2022

Carceral junctions are confining structures, where people wait in situations of pressure and possibility before they move or are moved elsewhere. They are sites of interface and contestation. Conceptualizing camps as carceral junctions means examining the double sense of ‘moving camps’: On the one hand, camps shape, detain and enable particular forms of movement for residents as they move between camps and cultivate networks in hopes of viable futures. On the other hand, camps themselves are also mobile in the sense that models of encampment travel and shift within and between states, just as individual camp staff careers may span multiple camps. Bringing these senses together, the contributions in the special issue develop the concept of the carceral junction as a way of grasping the paradoxical work and consequences of camps. By proposing the concept of carceral junctions we intend to draw on but also critique conceptualizations and theories that either reify the confining nature of camps as places of exception or overly celebrate the agency of migrant mobility. The term is coined to grasp the mobilities of knowledge, power and bodies that characterize asylum camps, as well as their interfaces and connectedness in a context where states adopt increasingly restrictive refugee policies.
Both G protein–coupled and immunoreceptor tyrosine-based activation motif receptors mediate venous thrombosis in mice
Authors: Mwiza Jean Marie N. , Lee Robert H. , Paul David S. , Holle Lori A. , Cooley Brian C. , Nieswandt Bernhard , Schug Wyatt J. , Kawano Tomohiro , Mackman Nigel , Wolberg Alisa S. , Bergmeier Wolfgang
Published: April 2022

Platelets are critical in hemostasis and a major contributor to arterial thrombosis (AT). (Pre)clinical studies suggest platelets also contribute to venous thrombosis (VT), but the mechanisms are largely unknown. We hypothesized that in VT, platelets use signaling machinery distinct from AT. Here we aimed to characterize the contributions of platelet G protein–coupled (GPCR) and immunoreceptor tyrosine-based activation motif (ITAM) receptor signaling to VT. Wild-type (WT) and transgenic mice were treated with inhibitors to selectively inhibit platelet-signaling pathways: ITAM-CLEC2 (Clec2mKO), glycoprotein VI (JAQ1 antibody), and Bruton’s tyrosine kinase (ibrutinib); GPCR-cyclooxygenase 1 (aspirin); and P2Y12 (clopidogrel). VT was induced by inferior vena cava stenosis. Thrombin generation in platelet-rich plasma and whole-blood clot formation were studied ex vivo. Intravital microscopy was used to study platelet–leukocyte interactions after flow restriction. Thrombus weights were reduced in WT mice treated with high-dose aspirin + clopidogrel (dual antiplatelet therapy [DAPT]) but not in mice treated with either inhibitor alone or low-dose DAPT. Similarly, thrombus weights were reduced in mice with impaired ITAM signaling (Clec2mKO + JAQ1; WT + ibrutinib) but not in Clec2mKO or WT + JAQ1 mice. Both aspirin and clopidogrel, but not ibrutinib, protected mice from FeCl3-induced AT. Thrombin generation and clot formation were normal in blood from high-dose DAPT- or ibrutinib-treated mice; however, platelet adhesion and platelet–neutrophil aggregate formation at the vein wall were reduced in mice treated with high-dose DAPT or ibrutinib. In summary, VT initiation requires platelet activation via GPCRs and ITAM receptors. Strong inhibition of either signaling pathway reduces VT in mice.
Safety and efficacy of atezolizumab with obinutuzumab and bendamustine in previously untreated follicular lymphoma
Authors: Younes Anas , Burke John M. , Diefenbach Catherine , Ferrari Silvia , Khan Cyrus , Sharman Jeff P. , Tani Monica , Ujjani Chaitra , Vitolo Umberto , Yuen Sam , Raval Aparna , Shivhare Mahesh , Nielsen Tina G. , Sellam Gila , Gilbertson Michael
Published: April 2022

Obinutuzumab (G) chemoimmunotherapy demonstrated improved progression-free survival (PFS) vs rituximab-based chemoimmunotherapy in patients with previously untreated follicular lymphoma (FL) in the GALLIUM trial. Atezolizumab (atezo) is a programmed death-ligand 1 inhibitor with a complementary mechanism of action to G by restoring cytotoxic T-cell function. We evaluated the safety and efficacy of atezo-G-bendamustine in patients with previously untreated FL in a phase Ib/II trial (#NCT02596971). A safety run-in phase was followed by an expansion phase with atezo-G-bendamustine induction and atezo-G maintenance for ≤24 months. Forty patients with previously untreated FL were enrolled and treated with atezo-G-bendamustine. The primary endpoint, complete response (CR) rate, assessed by an independent review committee (IRC; modified Lugano 2014 criteria) was 75.0% (95% confidence interval [CI], 61.3% to 85.8%). Three-year investigator-assessed PFS and overall survival rates were 80.9% (95% CI, 63.9% to 90.5%) and 89.3% (95% CI, 73.9% to 95.9%), respectively. At baseline, 21/40 patients had circulating lymphoma-specific clonotypes and underwent repeat testing at end of induction; all were minimal residual disease negative (10−5 sensitivity), with 16 (76.2%) CRs, 3 (14.3%) partial responses, and 2 (9.5%) with stable disease (IRC assessed). Grade 5 (fatal) adverse events (AEs) were reported in 5 patients. The efficacy of atezo-G-bendamustine in previously untreated FL did not appear superior to G-bendamustine efficacy as seen in the GALLIUM trial, and the addition of atezo to G-bendamustine was associated with an increased risk of AEs. Particularly due to the unfavorable safety profile, this regimen cannot be recommended in patients with previously untreated FL. This trial was registered at www.clinicaltrials.gov as #NCT02596971.
Autophagy-mediated expression clusters are involved in immunity regulation of coronary artery disease
Authors: Lv Jin , Wang Dong , Li Tian
Published: April 2022

Background

The association between autophagy and immunity, including infiltrating immunocytes, immune reaction gene-sets, and HLAs (human leukocyte antigen) gene, remains unclear. The present study aimed to provide a valid diagnostic tool for coronary artery disease (CAD), and explore the pathological mechanisms of CAD based on the association between autophagy and immunity.

Methods

First, the overlap between differentially expressed genes (DEGs) and autophagy-related genes (ARGs) was identified. Subsequently, machine learning was conducted to screen risk genes closely related to CAD. Diverse autophagy phenotype-related clusters were identified using unsupervised clustering. The connections between different clusters and immune characteristics were evaluated as well.

Results

The present study identified 27 differentially expressed autophagy-related genes (DEAGRs) in CAD samples compared with healthy conrtrols. A classifier constructing by 9 DEARGs was regarded as an effective diagnostic tool for CAD. Furthermore, three distinct autophagy phenotype - related clusters were identified, each cluster exhibited different immune characteristics. Finally, the gene ontology (GO) analysis of 901 autophagy phenotype-related genes showed that immune response, protein phosphorylation, and innate immune response were remarkable enrichment components.

Conclusions

This study identified an effective classifier constituted by 9-DEARGs that has good diagnostic performance for CAD, and revealed that autophagy and the immunity may be common critical factors in the occurrence and development of CAD.
Gene-coexpression network analysis identifies specific modules and hub genes related to cold stress in rice
Authors: Zeng Zhichi , Zhang Sichen , Li Wenyan , Chen Baoshan , Li Wenlan
Published: April 2022

Background

When plants are subjected to cold stress, they undergo a series of molecular and physiological changes to protect themselves from injury. Indica cultivars can usually withstand only mild cold stress in a relatively short period. Hormone-mediated defence response plays an important role in cold stress. Weighted gene co-expression network analysis (WGCNA) is a very useful tool for studying the correlation between genes, identifying modules with high phenotype correlation, and identifying Hub genes in different modules. Many studies have elucidated the molecular mechanisms of cold tolerance in different plants, but little information about the recovery process after cold stress is available.

Results

To understand the molecular mechanism of cold tolerance in rice, we performed comprehensive transcriptome analyses during cold treatment and recovery stage in two cultivars of near-isogenic lines (9311 and DC907). Twelve transcriptomes in two rice cultivars were determined. A total of 2509 new genes were predicted by fragment splicing and assembly, and 7506 differentially expressed genes were identified by pairwise comparison. A total of 26 modules were obtained by expression-network analysis, 12 of which were highly correlated with cold stress or recovery treatment. We further identified candidate Hub genes associated with specific modules and analysed their regulatory relationships based on coexpression data. Results showed that various plant-hormone regulatory genes acted together to protect plants from physiological damage under short-term low-temperature stress. We speculated that this may be common in rice. Under long-term cold stress, rice improved the tolerance to low-temperature stress by promoting autophagy, sugar synthesis, and metabolism.

Conclusion

Through WGCNA analysis at the transcriptome level, we provided a potential regulatory mechanism for the cold stress and recovery of rice cultivars and identified candidate central genes. Our findings provided an important reference for the future cultivation of rice strains with good tolerance.