bluuebunny/crossref_metadata_2025 huggingface dataset:
Language & Coding Creativity
Authors: Murati Ermira
Published: April 2022

Machines are gaining understanding of language at a very rapid pace. This achievement has given rise to a host of creative and business applications using natural language processing (NLP) engines, such as OpenAIs GPT-3. NLP applications do not simply change commerce and literature. They raise new questions about how human beings relate to machines and how that symbiosis of communication will evolve as the future rushes toward us.
Automation, Augmentation, Value Creation & the Distribution of Income
& Wealth
Authors: Spence Michael
Published: April 2022

Digital technologies are transforming the economy and society. The dimensionality and scope of the impacts are bewildering and too numerous to cover in a single essay. But of all the concerns around digital technology (and there are many), perhaps none has attracted more attention, and generated deeper anxiety, than the impact of various types of automation on work and on the structure of the economy. I focus on the ways in which the digitization of virtually all data, information, and content is transforming economies. And more specifically, I look at the impacts of automation, augmentation, AI, machine learning, and advanced robotics on economic transformations, on work, and on the distribution of income and wealth.
The Moral Dimension of AI-Assisted Decision-Making: Some Practical
Perspectives from the Front Lines
Authors: Carter Ash
Published: April 2022

This essay takes an engineering approach to ensuring that the deployment of artificial intelligence does not confound ethical principles, even in sensitive applications like national security. There are design techniques in all three parts of the AI architecture-algorithms, data sets, and applications-that can be used to incorporate important moral considerations. The newness and complexity of AI cannot therefore serve as an excuse for immoral outcomes of deployment by companies or governments.
What to Do If N Is Two?
Authors: Fries Pascal , Maris Eric
Published: April 2022

The field of in vivo neurophysiology currently uses statistical standards that are based on tradition rather than formal analysis. Typically, data from two (or few) animals are pooled for one statistical test, or a significant test in a first animal is replicated in one (or few) further animals. The use of more than one animal is widely believed to allow an inference on the population. Here, we explain that a useful inference on the population would require larger numbers and a different statistical approach. The field should consider to perform studies at that standard, potentially through coordinated multicenter efforts, for selected questions of exceptional importance. Yet, for many questions, this is ethically and/or economically not justifiable. We explain why in those studies with two (or few) animals, any useful inference is limited to the sample of investigated animals, irrespective of whether it is based on few animals, two animals, or a single animal.
Strategies to Improve the Rural Surgical Workforce
Authors: Sarap Michael D.
Published: April 2022

The rural surgical workforce is in crisis, resulting in significant health care access issues for the 60 million rural Americans. Rural surgeons encounter unique barriers to providing care for patients that are different than their urban counterparts. Rural hospitals are failing at an alarming rate. The American College of Surgeons (ACS) and the ACS Advisory Council for Rural Surgery have worked to improve communication among isolated rural surgeons and to bring recognition to rural surgeons as a distinct group. The rural workforce is aging at a rapid rate and multiple factors prevent newly trained surgeons from replacing those that retire. Loss of a surgeon in a small community leads to significant economic losses and possibly even closure of the local hospital. Changes in surgical training, subspecialization, demographic trends, and economic issues all lead to less numbers of young surgeons choosing to practice in small communities. Increasing the numbers of trainees will not reverse the trend unless it is combined with a change in the training paradigm for surgeons with a rural interest, additional funding for more rural training programs and financial support for surgeons to work in rural areas, and collaboration with urban and academic health care systems and their surgeons.
Prevalence, Predictors, and Impact of Coronary Artery Ectasia in Patients With Atherosclerotic Heart Disease
Authors: Xi Ziwei , Qiu Hong , Guo Tingting , Wang Yong , Dou Kefei , Xu Bo , Wu Yongjian , Qiao Shubin , Yang Weixian , Yang Yuejin , Gao Runlin
Published: April 2022

The clinical relevance of coronary artery ectasia (CAE) is poorly understood. We investigated the prevalence, potential predictors, and prognostic significance of CAE in patients with atherosclerotic coronary artery disease. Consecutive patients undergoing percutaneous coronary intervention (PCI) from January 2016 to December 2018 were included and followed up for 1 year. CAE was diagnosed as an abnormal dilation >1.5-fold the diameter of adjacent normal segments on angiography. A total of 590 patients with CAE were identified from 36 790 patients undergoing PCI (overall rate of CAE: 1.6%). In multivariate analysis, variables including body mass index >30 kg/m2 (risk ratio, RR: 2.413, P = .018), ever-smoking (RR: 1.669, P < .001), hypertension (RR: 1.221, P = .025), acute myocardial infarction at admission (RR: 1.343, P = .004), no diabetes (RR: .810, P = .023), previous myocardial infarction (RR: 1.545, P < .001), no left main disease (RR: .632, P = .008) and multiple-vessel disease (RR: 1.326, P = .001), increased C-reactive protein (RR: 1.006, P = .012) were predictors of CAE. The incidence of adverse cardiovascular outcomes did not differ significantly between patients with or without CAE ( P = .203). CAE is not uncommon among patients undergoing PCI in this cohort study. The presence of CAE vs its absence had no significant impact on 1-year clinical outcomes after PCI.
Delinquent by the Dozen: Youth From Larger Families Engage in More Delinquency—Fact or Myth?
Authors: Collier Nicole L. , Mears Daniel P.
Published: April 2022

Studies suggest that there is a linear and positive relationship between family size and delinquency. However, questions exist about this assessment. Drawing on prior scholarship and analyses, we revisit and test the family size-delinquency relationship. We also test whether the effect varies by sibling relatedness. Results indicate no consistent or large criminogenic effect of larger families on delinquency and that the relationship is considerably more complicated than what prior work has identified. Some beneficial effects are identified for children in full biological households, some criminogenic effects are identified for children from non-full biological households, and the relationships are curvilinear. Findings underscore the need to revisit research on family size and delinquency and to take into account sibling relatedness.
Gaon Panchayat, Tribal Women and Their Participation: A Case of Tiwas of Assam
Authors: Kakati Bhaskar Kumar
Published: April 2022

Panchayati Raj Institutions, the three-tier institutions of local self-governing institutions that stand at the bottom, are found in rural areas in all states of India except in the Sixth Schedule areas formed under the Indian Constitution. The genesis of India’s local governance can be traced back to ancient times. However, these institutions got their present shape and structure after a series of reform studies resulted in several Acts and constitutional amendments. In this article, an attempt has been made to understand and analyse the impact of tribal women’s participation in the local governing institutions among the Tiwas of Assam.
Influence of Career Decision Ambiguity Tolerance Preference on Career Adaptability: The Role of Individual and Organizational Career Management
Authors: Zhou Jie
Published: April 2022

Drawing on the career construction and cognitive appraisal theory, this study constructs a moderated mediation model to explore the mechanism of career decision ambiguity tolerance preference (CDAT-P) on career adaptability via challenge appraisal, as well as the interactive effect of individual and organizational career management. Participants comprised 1023 Chinese university students who completed questionnaires with a three-wave design. The results show that CDAT-P positively predicts career adaptability, and challenge appraisal mediates the direct effect. Moreover, individual career management and organizational career management have an interactive effect on the direct relationship between CDAT-P and challenge appraisal and the first stage of the mediating effect. Specifically, when individual and organizational career management are high, the positive direct effect of CDAT-P on challenge appraisal and the mediating effect are stronger.
The Use of Discord Servers to Buy and Sell Drugs
Authors: van der Sanden Robin , Wilkins Chris , Rychert Marta , Barratt Monica J.
Published: April 2022

The focus of current research on social media drug markets is the use of mainstream platforms such as Facebook, Snapchat and Instagram. No research currently exists examining how lesser-known social media platforms may facilitate online drug supply. This paper presents the first analysis of the use of the social media platform Discord to buy and sell illegal drugs. The study utilizes observational data and qualitative interviews with Discord drug market participants in New Zealand, including sellers and a drug server administrator ( n = 12). Our findings demonstrate that the Discord platform, which was initially established for gaming, is also being used to facilitate drug transactions. Discord is used to establish local drug selling groups called “servers,” which can be joined by accessing an “invite-link.” The advantages of Discord drug servers cited by interviewees included competitive prices and the ability to greatly expand local seller and customer bases beyond pre-existing personal networks. However, accessibility, server size and management varied considerably between drug servers, giving rise to a range of issues and concerns. We use drug market typologies based on theory of “open” and “closed” markets to understand how “lower tier” and “higher tier” Discord drug servers provided different buying and selling environments. “Lower tier” drug servers were generally characterized by greater ease of entry, larger size, higher rates of opportunism among participants and variable server management. Conversely, “higher tier” drug servers typically involved tighter market entry controls, more active server management and were generally smaller in size. The emergence of Discord drug servers illustrates how the evolution of social media platforms presents their users with new spaces that can be adapted to function as drug markets and the tensions that may emerge during the process of learning to buy and sell in a new social media space.
Experiences of Civic Participation Among Older African American and Latinx Immigrant Adults in the Context of an Ageist and Racist Society
Authors: Reyes Laurent
Published: April 2022

In the past 20 years, older adults’ civic participation has received considerable attention. Current literature shows that rates of voting and volunteering have been consistently lower among African Americans and Latinx older adults compared to White older adults. However, little research has explored civic participation in the context of historical structures of inequality that influence how Black and Latinx populations participate in civic life. I draw from an intersectional life course perspective and phenomenological methods to examine experiences of civic participation through participants’ lens. Findings draw our attention to how race/racism and age/ageism shape how, where, and with whom participants participate. Findings demonstrate how civic participation is embedded within systems of inequality that inform individual behavior as well as available opportunities for engagement. These findings call attention to the need to re-conceptualize and support civic participation that centers the experiences of historically ethnoracially oppressed populations.
Black Lives Matter to media (finally): A content analysis of news coverage during summer 2020
Authors: Cox Jennifer Brannock
Published: April 2022

This study examined 286 stories posted about the Black Lives Matter movement and protests following George Floyd’s death by the six most-viewed U.S. news outlets on Facebook during summer 2020. These organizations published a significant amount of content, though the frequency declined throughout the summer. Stories mostly framed protesters positively and police negatively. Organizations regularly used law/crime spot news to frame protests. The findings may signal a potential shift away from the media’s protest paradigm.
Nature-derived epoxy resins: Synthesis, allergenicity, and thermosetting properties of pinoresinol diglycidyl ether
Authors: O’Boyle Niamh M , Niklasson Ida B , Ponting David J , Ortega Miguel A , Seifert Tina , Natsch Andreas , Luthman Kristina , Karlberg Ann-Therese
Published: April 2022

We describe a novel nature-derived epoxy resin monomer (ERM) derived from the plant lignan pinoresinol. Epoxy resins are thermosetting materials in global usage owing to their excellent technical properties such as flexibility and durability. However, their adverse health effects are often not considered and affect users of epoxy resins worldwide. Components of epoxy resin systems are strong skin sensitizers and cause allergic contact dermatitis. The reported prevalence attributable to epoxy chemicals is between 11.7 and 12.5% of all cases of occupational allergic contact dermatitis. We are committed to developing epoxy resins with reduced allergenic effect, while maintaining their excellent properties. The novel ERM, pinoresinol diglycidyl ether (PinoDGE), was synthesized in one step from pinoresinol and epichlorohydrin in 88% yield. It was not classified as a skin sensitizer in the in vivo local lymph node assay, at concentrations up to 0.17 m, as it did not cause a stimulation index >3 compared to control. Pinoresinol diglycidyl ether reacted with the model peptide AcPHCKRM in a reactivity assay and was predicted to be a skin sensitizer in the KeratinoSens assay. Preliminary cross-linking studies indicate that it has promising properties compared to commercially used ERMs. Pinoresinol diglycidyl ether could be seen as a lead compound for further development of alternative ERMs with a better safety profile based on natural and renewable sources for construction of epoxy resin polymers.
In vitro and In vivo assessment of a novel organ perfusion stent for successful flow separation in donation after cardiac death
Authors: Elsisy Moataz , Tillman Bryan , Chau Lynn , Go Catherine , Cho Sung Kwon , Chun Youngjae
Published: April 2022

Shortage of healthy donors’ organs has appeared as one of the main challenges for organ transplantation. This study focuses on the novel endovascular device development to increase the number of available organs from cardiac death donors. The primary objective of this study is the design validation of a newly developed stent graft for the abdominal organ perfusion with cardiac blood flow isolation. In this paper, the effectiveness of the device design has been validated via the assessment of the device performance both in vitro and in vivo. The radial force of stent structure was first numerically analyzed using finite element method, then was quantified experimentally. The blood perfusion parameters were investigated to demonstrate their effect on the blood delivered to the abdominal organs, maintaining the organs healthy for donation. In vitro flow leakage was measured using a 3-D printing-based silicone aortic model to evaluate the isolation between cardiac flow and perfusion flow with minimum values. Following the design validation process, a functional prototype stent graft has been successfully fabricated using optimized laser welding conditions and subsequent joining processes. In vivo porcine study results have demonstrated smooth delivery and successful placement of the device showing complete cardiac flow separation isolating abdominal regions only with the oxygenated blood flow.
Reconciliation policies in COVID times: what role for trade unions in Spain and Italy?
Authors: Pavolini Emmanuele , Luque Balbona David , Guillén Ana M.
Published: April 2022

This article aims to interpret trade unions’ role in reconciliation policies during the current pandemic in Italy and Spain. Questions to be answered include whether and to what degree unions have been present in the public debate, have participated in the policy-making process, have acted as policy reform protagonists or have consented to it, and to what extent they have been able to influence the direction of reform. The study proposes a three-level analytical framework of general applicability, signalling the variables that may affect the role played by unions at the micro-, meso- and macro-levels, together with the indicators that could be used. Research results for the Italian and Spanish cases indicate that the most relevant level to explain the role played by unions is the macro one. Unions tended to acquiesce to government policies in both countries, although that does not preclude action or involvement. The article also argues that a better and more nuanced categorisation of union roles should be developed.
A paradigm shift in guiding the operations of open schools in Tanzania: Praxis of emerging controversies and dynamics
Authors: Shirima Gennes Hendry
Published: April 2022

This paper reports the findings of a study that had examined the operations of open schools for out-of-secondary-school youth and adults in Tanzania. Its objective was to establish the practicality of the policy guidelines in guiding the operations of open schools and the emerging controversies and dynamics in their daily operations. This qualitative study collected data using documentary review and interviews, which was later subjected to thematic analysis. The study found contradictory and incongruous policy guidelines for open schools that largely rendered them impractical. Moreover, misinterpretations, varying understandings and inconsistencies in practices among open schools were common occurrences. There also emerged several dynamics in guiding the operations of open schools such as un-standardised practices, erratic registrations and persistence of uncontrolled open schools in the black market. In consequence, it was difficult to rationally manage their practices. Overall, the rather misplaced policy priority governing the operations of open schools calls for a special attention and impetus to bring about the desired positive change in this education sub-sector.
Sexual and Reproductive Health Counseling: The Sooner the Better
Authors: Becker Danielle A.
Published: April 2022

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A Comparison of Dynamical Perceptual-Motor Primitives and Deep Reinforcement Learning for Human-Artificial Agent Training Systems
Authors: Rigoli Lillian , Patil Gaurav , Nalepka Patrick , Kallen Rachel W. , Hosking Simon , Best Christopher , Richardson Michael J.
Published: April 2022

Effective team performance often requires that individuals engage in team training exercises. However, organizing team-training scenarios presents economic and logistical challenges and can be prone to trainer bias and fatigue. Accordingly, a growing body of research is investigating the effectiveness of employing artificial agents (AAs) as synthetic teammates in team training simulations, and, relatedly, how to best develop AAs capable of robust, human-like behavioral interaction. Motivated by these challenges, the current study examined whether task dynamical models of expert human herding behavior could be embedded in the control architecture of AAs to train novice actors to perform a complex multiagent herding task. Training outcomes were compared to human-expert trainers, novice baseline performance, and AAs developed using deep reinforcement learning (DRL). Participants’ subjective preferences for the AAs developed using DRL or dynamical models of human performance were also investigated. The results revealed that AAs controlled by dynamical models of human expert performance could train novice actors at levels equivalent to expert human trainers and were also preferred over AAs developed using DRL. The implications for the development of AAs for robust human-AA interaction and training are discussed, including the potential benefits of employing hybrid Dynamical-DRL techniques for AA development.
An alternative reduced dose regimen of ticagrelor for neuroendovascular patients
Authors: Kass-Hout Omar , Stern Joseph , D Tangonan Ruth , Morsi Rami Z , Thind Sonam , Kass-Hout Tareq , Guterman Lee
Published: April 2022

Objective

There is a growing use of ticagrelor in patients undergoing neuroendovascular procedures, especially those who demonstrate clopidogrel resistance. While multiple dosages are studied in the cardiology literature, the optimal dose for patients with neurological pathology has yet to be established. Here, we describe a single center experience involving 39 patients who underwent neuroendovascular procedures that then received an adjusted lower dose of ticagrelor.

Methods

A retrospective chart review was performed between 2013 and 2017 for patients on dual anti-platelet therapy (DAPT) for either cervical or intracranial vascular pathologies, as well as stenting of the neurovasculature, including carotid arteries. Patients were placed on ticagrelor if their measured P2Y12 reaction units (PRU) responses to clopidogrel were outside the expected range in our center using the VerifyNow™ P2Y12 test. All patients were maintained on a dose of 45 mg twice daily except for one patient who received 22.5 mg twice daily. Responsiveness to ticagrelor were measured utilizing the VerifyNow™ P2Y12 test.

Results

The mean number of days for follow-up post treatment initiation was 532 days. A total of 39 patients were included in the analysis. Of these, 8 patients (21%) received implantation of intracranial stents (5 patients received pipeline embolization devices, 1 patient received stent-assisted coiling, and 2 patients received intracranial stents for atherosclerotic disease). Fourteen patients (35%) received carotid angioplasty and stenting. Seventeen patients (44%) did not receive permanent implantation of a stent. All patients on the lower dose ticagrelor of 45 mg twice daily achieved responsiveness (i.e., PRU < 194). Hemorrhagic transformation of ischemic stroke occurred in one patient (2.5%). No other hemorrhagic complications were encountered. No thromboembolic events were recorded aside from one patient (2.5%) with intracranial atherosclerotic disease who had an ischemic event.

Conclusions

A lower dose of ticagrelor (45 mg twice daily) appears to be safe and effective in this small cohort of patients who are resistant to clopidogrel per P2Y12 testing and who have increased risk of ischemic or hemorrhagic strokes due to neurovascular pathologies and implants. Further randomized studies are required to confirm these findings.
A rare case of granuloma faciale presenting with ulceration: A case report
Authors: Mahmood Farhan , Teo Iris YH , Glassman Steven J
Published: April 2022

Granuloma faciale is an uncommon inflammatory dermatosis characterized by persistent dermal plaques, typically on the face, that mimic granulomatous disorders like sarcoidosis. Ulceration of granuloma faciale has very rarely been reported, and the plaques are usually asymptomatic and of cosmetic impact. We present a case of an 83-year-old male with recurrent granuloma faciale with spontaneous ulceration and monoclonal gammopathy of undetermined significance. Intralesional triamcinolone, 10 mg/mL monthly for 5 months, with pimecrolimus cream twice daily resolved the ulceration and the lesion continues to flatten and lighten. Ulceration is rare and atypical in granuloma faciale lesions which can be treated.
Sociospatial Disparities in “Third Place” Availability in the United States
Authors: Rhubart Danielle , Sun Yue , Pendergrast Claire , Monnat Shannon
Published: April 2022

Tertiary to home and work, “third places” serve as opportunity structures that transmit information and facilitate social capital and upward mobility. However, third places may be inequitably distributed, thereby exacerbating disparities in social capital and mobility. The authors use tract-level data from the National Neighborhood Data Archive to examine the distribution of third places across the United States. There were significant disparities in the availability of third places. Higher poverty rates were associated with fewer third places. Tracts with the smallest shares of Black and Hispanic populations had comparatively more third places. However, this racial disadvantage was not linear, suggesting potential buffering effects in places with the largest shares of Black and Hispanic populations. There was also a rural disadvantage, except in the most isolated rural tracts. This study demonstrates the value of conceptualizing and measuring third places to understand sociospatial disparities in the availability of these understudied opportunity structures.
U.S. State Policy Contexts and Physical Health among Midlife Adults
Authors: Kemp Blakelee R. , Grumbach Jacob M. , Montez Jennifer Karas
Published: April 2022

The authors examine how state policy contexts may have contributed to unfavorable adult health in recent decades, using merged individual-level data from the 1993–2016 Behavioral Risk Factor Surveillance System ( n = 2,166,835) and 15 state-level policy domains measured annually on a conservative-to-liberal continuum. The authors examine associations between policy domains and health among adults 45 to 64 years old and assess how much of the associations are accounted for by adults’ socioeconomic, behavioral and lifestyle, and family factors. A more liberal version of the civil rights domain was associated with better health. It was disproportionately important for less educated adults and women, and its association with adult health was partly accounted for by educational attainment, employment, and income. Environment, gun safety, and marijuana policy domains were, to a lesser degree, predictors of health in some model specifications. In sum, health improvements require a greater focus on macro-level factors that shape the conditions in which people live.
Using Panel Discussions to Enhance Ethical Learning
Authors: Baldo Carlos M. , Wareham Justin D. , Seidel Julie P.
Published: April 2022

This article describes an exercise that develops students’ capacity to identify ethical dilemmas, apply ethical frameworks, and consider ethical issues from multiple perspectives. The exercise consists of five interrelated activities that take place over the course of several weeks, with the central activity being a panel discussion featuring businesspeople from the local community. The exercise provides opportunities for students to work as a class, in small groups, and individually, and its culmination is a reflective essay that helps students internalize core concepts about business ethics. The exercise can be executed in a face-to-face class or a synchronous online environment.
Population Impact of Sugar-Sweetened Beverages on Dental Caries and Overweight/Obesity in Australian Children
Authors: Ha D.H. , Arora A. , Harford J. , Luzzi L. , Chrisopoulos S. , Do L.G.
Published: April 2022

This study investigated population impact of sugar-sweetened beverage (SSB) intake on overweight and obesity and dental caries in Australian children. The National Child Oral Health Study collected parent-completed data (socioeconomic status, health behaviors, SSB consumption) and dental caries in the primary dentition of children aged 5 to 8 years. The outcomes (prevalence of caries and overweight and obesity) were assessed in multivariable regression models to estimate prevalence ratios (PRs) with SSB intake as the main exposure. Population attributable fraction (PAF) was calculated using population distribution of the exposure and adjusted PRs. Among 7,021 children, some 15.2% children consumed 2+ SSBs per day. Prevalence of caries and overweight and obesity was 35.8% and 28.7%, respectively, and strongly associated with SSB consumption. Adjusted PRs for 2+ SSB intake/d for having dental caries and overweight and obesity was 1.45 (95% confidence interval [CI], 1.27–1.66) and 1.49 (95% CI, 1.28–1.74), respectively. PAF of SSB consumption was 11% (95% CI, 18–35) for dental caries and 9% (95% CI, 11–34) for overweight and obesity. The reported findings consolidated evidence of detrimental effects of sugars intake on population health. Public health policy and advocacy initiatives such as a sugar tax and banning junk food advertisements should be prioritized to potentially reduce a significant proportion of cases with either condition.

Knowledge Transfer Statement:

The reported findings greatly consolidated evidence of detrimental effects of sugars intake on child oral health and overweight and obesity, some of the most prevalent chronic conditions in children. Evidence on population impact of sugars intake is directly informative to policy makers and the public about the potential impact of population-based programs targeting sugars intake to prevent dental caries and overweight and obesity.
Dalit Entrepreneurship Hard Nut to Crack: Empirical Evidence
Authors: Nashier Seema , Vij Sanket
Published: April 2022

The life of people born in Dalit families is more challenging than others and the challenges upturn manifold if a downtrodden seek a livelihood in the field of entrepreneurship. Although, entrepreneurship is a risky affair for everyone it discommodes the Dalit community more. The paucity of societal support and resources, and above all lower caste label makes it highly troublesome for Dalit to cross the threshold of entrepreneurship and stay therein. Government and a few other organizations assure to provide all possible facilities and assistance to the Dalit aspirants through diverse schemes but many times these assurances are found outlying from reality. This empirical research article aims to provide qualitative insight into the previously published articles, research papers, and reports allied to the challenges of Dalit entrepreneurship. The thematic analysis technique has been applied for literature review using NVivo Software. The upshots of the study clearly depict that Dalit entrepreneurs are frequently confronted with severe difficulties, particularly due to the unfair conduct of various stakeholders. This research study will make a considerable contribution to the Dalit literature and outcomes will assist the policymakers to enhance the efficiency of entrepreneurial schemes to the expected level.
Inflammation and myeloid malignancy: quenching the flame
Authors: Stubbins Ryan J. , Platzbecker Uwe , Karsan Aly
Published: April 2022

Chronic inflammation with aging (“inflammaging”) plays a prominent role in the pathogenesis of myeloid malignancies. Aberrant inflammatory activity affects many different cells in the marrow, including normal blood and stromal marrow elements and leukemic cells, in unique and distinct ways. Inflammation can promote selective clonal expansion through differential immune-mediated suppression of normal hematopoietic cells and malignant clones. We review these complex roles, how they can be understood by separating cell-intrinsic from extrinsic effects, and how this informs future clinical trials.
Bioinspired Functional Surfaces for Medical Devices
Authors: Zhang Liwen , Liu Guang , Guo Yurun , Wang Yan , Zhang Deyuan , Chen Huawei
Published: April 2022

Medical devices are a major component of precision medicine and play a key role in medical treatment, particularly with the rapid development of minimally invasive surgery and wearable devices. Their tissue contact properties strongly affect device performance and patient health (e.g., heat coagulation and slipperiness on surgical graspers). However, the design and optimization of these device surfaces are still indistinct and have no supporting principles. Under such conditions, natural surfaces with various unique functions can provide solutions. This review summarizes the current progress in natural functional surfaces for medical devices, including ultra-slipperiness and strong wet attachment. The underlying mechanisms of these surfaces are attributed to their coupling effects and featured micro-nano structures. Depending on various medical requirements, adaptable designs and fabrication methods have been developed. Additionally, various medical device surfaces have been validated to achieve enhanced contact properties. Based on these studies, a more promising future for medical devices can be achieved for enhanced precision medicine and human health.
Delivery of CXCL9/10/11 plasmid DNAs promotes the tumor-infiltration of T cells and synergizes with PD1 antibody for treating lung cancer
Authors: Ma Yuxia , Liu Yi , Zhi Ying , Wang Haibin , Yang Mei , Niu Jieting , Zhao Li , Wang Pengsheng
Published: April 2022

Background

Immune checkpoint blockade (ICB)-based cancer immunotherapy presents promising efficacy in cancer treatment. However, only a small portion of patients show responsiveness to the treatment, which is partially caused by limited tumor infiltration of T cells. Chemokines CXCL9, CXCL10 and CXCL11 bind to their receptor CXCR3 to regulate T cell invasion.

Methods

We delivered plasmids encoding CXCL9, CXCL10 and CXCL11 to tumor cells and tumor tissues using nanoparticles and investigated their effect on T cell invasion and infiltration. In addition, we applied these nanoparticles together with anti-PD-1 antibody, which is known to activate T cells and restore immune function against tumor cells. The anti-tumor effects were evaluated.

Results

Delivering plasmids encoding CXCL9, CXCL10 and CXCL11 by nanoparticles resulted in expression of these chemokines in both LLC cells and tumors. Expressing CXCL9, CXCL10 and CXCL11 promoted the infiltration of T cells in vitro and in vivo, as well as decreased the tumor size. Nanoparticles together with anti-PD-1 displayed the best anti-tumor effects.

Conclusions

Delivery of CXCL9/10/11 plasmids by nanoparticles promoted T cell infiltration in tumors and synergizes with the activity of anti-PD1 antibody.
AutoCoV: tracking the early spread of COVID-19 in terms of the spatial and temporal patterns from embedding space by K-mer based deep learning
Authors: Sung Inyoung , Lee Sangseon , Pak Minwoo , Shin Yunyol , Kim Sun
Published: April 2022

Background

The widely spreading coronavirus disease (COVID-19) has three major spreading properties: pathogenic mutations, spatial, and temporal propagation patterns. We know the spread of the virus geographically and temporally in terms of statistics, i.e., the number of patients. However, we are yet to understand the spread at the level of individual patients. As of March 2021, COVID-19 is wide-spread all over the world with new genetic variants. One important question is to track the early spreading patterns of COVID-19 until the virus has got spread all over the world.

Results

In this work, we proposed AutoCoV, a deep learning method with multiple loss object, that can track the early spread of COVID-19 in terms of spatial and temporal patterns until the disease is fully spread over the world in July 2020. Performances in learning spatial or temporal patterns were measured with two clustering measures and one classification measure. For annotated SARS-CoV-2 sequences from the National Center for Biotechnology Information (NCBI), AutoCoV outperformed seven baseline methods in our experiments for learning either spatial or temporal patterns. For spatial patterns, AutoCoV had at least 1.7-fold higher clustering performances and an F1 score of 88.1%. For temporal patterns, AutoCoV had at least 1.6-fold higher clustering performances and an F1 score of 76.1%. Furthermore, AutoCoV demonstrated the robustness of the embedding space with an independent dataset, Global Initiative for Sharing All Influenza Data (GISAID).

Conclusions

In summary, AutoCoV learns geographic and temporal spreading patterns successfully in experiments on NCBI and GISAID datasets and is the first of its kind that learns virus spreading patterns from the genome sequences, to the best of our knowledge. We expect that this type of embedding method will be helpful in characterizing fast-evolving pandemics.
Bias amplification in the g-computation algorithm for time-varying treatments: a case study of industry payments and prescription of opioid products
Authors: Inoue Kosuke , Goto Atsushi , Kondo Naoki , Shinozaki Tomohiro
Published: April 2022

Background

It is often challenging to determine which variables need to be included in the g-computation algorithm under the time-varying setting. Conditioning on instrumental variables (IVs) is known to introduce greater bias when there is unmeasured confounding in the point-treatment settings, and this is also true for near-IVs which are weakly associated with the outcome not through the treatment. However, it is unknown whether adjusting for (near-)IVs amplifies bias in the g-computation algorithm estimators for time-varying treatments compared to the estimators ignoring such variables. We thus aimed to compare the magnitude of bias by adjusting for (near-)IVs across their different relationships with treatments in the time-varying settings.

Methods

After showing a case study of the association between the receipt of industry payments and physicians’ opioid prescribing rate in the US, we demonstrated Monte Carlo simulation to investigate the extent to which the bias due to unmeasured confounders is amplified by adjusting for (near-)IV across several g-computation algorithms.

Results

In our simulation study, adjusting for a perfect IV of time-varying treatments in the g-computation algorithm increased bias due to unmeasured confounding, particularly when the IV had a strong relationship with the treatment. We also found the increase in bias even adjusting for near-IV when such variable had a very weak association with unmeasured confounders between the treatment and the outcome compared to its association with the time-varying treatments. Instead, this bias amplifying feature was not observed (i.e., bias due to unmeasured confounders decreased) by adjusting for near-IV when it had a stronger association with the unmeasured confounders (≥0.1 correlation coefficient in our multivariate normal setting).

Conclusion

It would be recommended to avoid adjusting for perfect IV in the g-computation algorithm to obtain a less biased estimate of the time-varying treatment effect. On the other hand, it may be recommended to include near-IV in the algorithm unless their association with unmeasured confounders is very weak. These findings would help researchers to consider the magnitude of bias when adjusting for (near-)IVs and select variables in the g-computation algorithm for the time-varying setting when they are aware of the presence of unmeasured confounding.
Pentavalent vaccination in Kenya: coverage and geographical accessibility to health facilities using data from a community demographic and health surveillance system in Kilifi County
Authors: Ogero Morris , Orwa James , Odhiambo Rachael , Agoi Felix , Lusambili Adelaide , Obure Jerim , Temmerman Marleen , Luchters Stanley , Ngugi Anthony
Published: April 2022

Background

There is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The third dose of pentavalent vaccine for children is an important indicator for assessing performance of the immunisation programme because it mirrors the completeness of a child’s immunisation schedule. Spatial access to an immunizing health facility, especially in sub-Sahara African (SSA) countries, is a significant determinant of Pentavalent 3 vaccination coverage, as the vaccine is mainly administered during routine immunisation schedules at health facilities. Rural areas and densely populated informal settlements are most affected by poor access to healthcare services. We therefore sought to determine vaccination coverage of Pentavalent 3, estimate the travel time to health facilities offering immunisation services, and explore its effect on immunisation coverage in one of the predominantly rural counties on the coast of Kenya.

Methods

We used longitudinal survey data from the health demographic surveillance system implemented in Kaloleni and Rabai Sub-counties in Kenya. To compute the geographical accessibility, we used coordinates of health facilities offering immunisation services, information on land cover, digital elevation models, and road networks of the study area. We then fitted a hierarchical Bayesian multivariable model to explore the effect of travel time on pentavalent vaccine coverage adjusting for confounding factors identified a priori.

Results

Overall coverage of pentavalent vaccine was at 77.3%. The median travel time to a health facility was 41 min (IQR = 18–65) and a total of 1266 (28.5%) children lived more than one-hour of travel-time to a health facility. Geographical access to health facilities significantly affected pentavalent vaccination coverage, with travel times of more than one hour being significantly associated with reduced odds of vaccination (AOR = 0.84 (95% CI 0.74 – 0.94).

Conclusion

Increased travel time significantly affects immunization in this rural community. Improving road networks, establishing new health centres and/or stepping up health outreach activities that include vaccinations in hard-to-reach areas within the county could improve immunisation coverage. These data may be useful in guiding the local department of health on appropriate location of planned immunization centres.
Do motorcycle helmets reduce road traffic injuries, hospitalizations and mortalities in low and lower-middle income countries in Africa? A systematic review and meta-analysis
Authors: Abdi Nadifa , Robertson Tara , Petrucka Pammla , Crizzle Alexander M.
Published: April 2022

Background

Studies in Africa have examined the association between helmet use and injury prevention, however, there has been no systematic review to synthesize the literature within an African context nor has there been any meta-analysis examining the effect of helmet use on injury prevention.

Methods

The review was performed in accordance with the Joanna Briggs Institute for Systematic Reviews. Articles were searched using several databases (e.g. CINAHL, OVID Medline) and select gray literature (e.g. TRID) sources. Articles were included if they were quantitative studies published in English between 2000 and 2019 and examined the association between motorcycle helmet use with head injuries, hospitalizations, and deaths in low- and lower-middle income countries in Africa with comprehensive motorcycle helmet laws. A meta-analysis was performed using pooled effect sizes assessing the impact of helmet use on reducing head injuries.

Results

After screening 491 articles, eight studies met the inclusion criteria. Helmet use ranged from 0 to 43%. The mean age of being involved in a crash was 30 years with males being two times more likely to be involved in motorcycle crashes than females. Drivers (riders) were more likely to be involved in a crash, followed by passengers and then pedestrians. Helmet use reduced injury severity and provided an 88% reduction in serious head injuries (OR 0.118, 95% CI: 0.014–0.968, p = 0.049).

Conclusions

In our study, helmet usage significantly reduced the likelihood of fatal head injuries. African countries with no helmet laws should consider adopting helmet use policies to reduce severe head related injuries from motorcycle crashes.
Health risk associated with residential relocation among people who inject drugs in Los Angeles and San Francisco, CA: a cross sectional study
Authors: Chiang Joey C. , Bluthenthal Ricky N. , Wenger Lynn D. , Auerswald Colette L. , Henwood Benjamin F. , Kral Alex H.
Published: April 2022

Background

Given the housing instability and frequent residential relocation (both volitional and hegemonic) of people who inject drugs, we sought to determine whether residential relocation (defined as sleeping in a different place in the past 30 days) is associated with health outcomes in a sample of people who inject drugs (PWID).

Methods

We recruited 601 PWID using targeted sampling and interviewed them between 2016 and 2018 in San Francisco and Los Angeles, CA about housing, drug use practices, and service utilization. We then developed multivariable regression models to investigate how residential relocation is associated with violence, health outcomes, and social service access. We analyzed our data between June 2018 and October 2019.

Results

Participants who relocated in the past 30 days had lower odds of being in substance use treatment (Adjusted Odds Ratio [AOR] = 0.62, 95% Confidence Interval [CI] = 0.42, 0.89) and higher odds of nonfatal overdose (AOR = 2.50, CI = 1.28, 4.90), receptive syringe sharing (AOR = 2.26, CI = 1.18, 4.32), severe food insecurity (AOR = 1.69, CI = 1.14, 2.50), having belongings stolen (AOR = 2.14, CI = 1.42, 3.21), experiencing physical assault (AOR = 1.58, CI = 1.03, 2.43), arrest (AOR = 1.64, CI = 1.02, 2.65), and jail (AOR = 1.90, CI = 1.16, 3.13) in the past 6 months when compared to those who did not relocate.

Conclusions

PWID who have relocated in the past 30 days have higher odds of experiencing violence and life- threatening adverse outcomes, and policies that disrupt living circumstances of PWID should be ended in favor of those that support housing stability.
Point-of-care prediction model of loop gain in patients with obstructive sleep apnea: development and validation
Authors: Schmickl Christopher N. , Orr Jeremy E. , Kim Paul , Nokes Brandon , Sands Scott , Manoharan Sreeganesh , McGinnis Lana , Parra Gabriela , DeYoung Pamela , Owens Robert L. , Malhotra Atul
Published: April 2022

Background

High loop gain (unstable ventilatory control) is an important—but difficult to measure—contributor to obstructive sleep apnea (OSA) pathogenesis, predicting OSA sequelae and/or treatment response. Our objective was to develop and validate a clinical prediction tool of loop gain.

Methods

A retrospective cohort of consecutive adults with OSA (apnea–hypopnea index, AHI > 5/hour) based on in-laboratory polysomnography 01/2017–12/2018 was randomly split into a training and test-set (3:1-ratio). Using a customized algorithm (“reference standard”) loop gain was quantified from raw polysomnography signals on a continuous scale and additionally dichotomized (high > 0.7). Candidate predictors included general patient characteristics and routine polysomnography data. The model was developed (training-set) using linear regression with backward selection (tenfold cross-validated mean square errors); the predicted loop gain of the final linear regression model was used to predict loop gain class. More complex, alternative models including lasso regression or random forests were considered but did not meet pre-specified superiority-criteria. Final model performance was validated on the test-set.

Results

The total cohort included 1055 patients (33% high loop gain). Based on the final model, higher AHI (beta = 0.0016; P < .001) and lower hypopnea-percentage (beta = −0.0019; P < .001) predicted higher loop gain values. The predicted loop gain showed moderate-to-high correlation with the reference loop gain (r = 0.48; 95% CI 0.38–0.57) and moderate discrimination of patients with high versus low loop gain (area under the curve = 0.73; 95% CI 0.67–0.80).

Conclusion

To our knowledge this is the first prediction model of loop gain based on readily-available clinical data, which may facilitate retrospective analyses of existing datasets, better patient selection for clinical trials and eventually clinical practice.