bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating reduction in medical costs associated with pharmacists’ presence in the emergency department using a novel cost avoidance framework
Authors: Poremba Matthew , Champa Kelsey , Reichert Erin
Published: December 2022

Purpose

The purpose of this study was to evaluate the cost avoidance associated with emergency medicine pharmacist (EMP) presence in the emergency department (ED) using a novel cost avoidance framework.

This single-center, retrospective, observational study examined EMP interventions from November 1, 2021, through March 31, 2022. EMPs prospectively selected up to 10 shifts in which to log interventions during the study period. Interventions were categorized into 25 cost avoidance categories, 10 of which incorporated recently proposed probability variables. All categories were organized into 4 broad cost avoidance domains, including resource utilization, individualization of patient care, adverse drug event prevention, and hands-on care. During the study period, 894 interventions were logged, which accounted for $143,132 in cost avoidance (lower probability value of $124,186, upper probability value of $168,858), with a median cost avoidance per shift of $1,671 (interquartile range, $1,025 to $2,451). On the basis of 240 shifts, the estimated annual total cost avoidance per pharmacist was extrapolated to be $401,040.

Conclusion

While the mean cost avoidance of $161.10 per intervention observed in our study was less than that in prior cost avoidance studies due to the conservative and potentially more realistic estimates used, implementation of this cost avoidance framework still showed substantial cost avoidance associated with EMP presence in the ED.
DMPPred: a tool for identification of antigenic regions responsible for inducing type 1 diabetes mellitus
Authors: Kumar Nishant , Patiyal Sumeet , Choudhury Shubham , Tomer Ritu , Dhall Anjali , Raghava Gajendra P S
Published: December 2022

There are a number of antigens that induce autoimmune response against β-cells, leading to type 1 diabetes mellitus (T1DM). Recently, several antigen-specific immunotherapies have been developed to treat T1DM. Thus, identification of T1DM associated peptides with antigenic regions or epitopes is important for peptide based-therapeutics (e.g. immunotherapeutic). In this study, for the first time, an attempt has been made to develop a method for predicting, designing, and scanning of T1DM associated peptides with high precision. We analysed 815 T1DM associated peptides and observed that these peptides are not associated with a specific class of HLA alleles. Thus, HLA binder prediction methods are not suitable for predicting T1DM associated peptides. First, we developed a similarity/alignment based method using Basic Local Alignment Search Tool and achieved a high probability of correct hits with poor coverage. Second, we developed an alignment-free method using machine learning techniques and got a maximum AUROC of 0.89 using dipeptide composition. Finally, we developed a hybrid method that combines the strength of both alignment free and alignment-based methods and achieves maximum area under the receiver operating characteristic of 0.95 with Matthew’s correlation coefficient of 0.81 on an independent dataset. We developed a web server ‘DMPPred’ and stand-alone server for predicting, designing and scanning T1DM associated peptides (https://webs.iiitd.edu.in/raghava/dmppred/).
YaHS: yet another Hi-C scaffolding tool
Authors: Zhou Chenxi , McCarthy Shane A , Durbin Richard
Published: December 2022

We present YaHS, a user-friendly command-line tool for the construction of chromosome-scale scaffolds from Hi-C data. It can be run with a single-line command, requires minimal input from users (an assembly file and an alignment file) which is compatible with similar tools and provides assembly results in multiple formats, thereby enabling rapid, robust and scalable construction of high-quality genome assemblies with high accuracy and contiguity.

Availability and implementation

YaHS is implemented in C and licensed under the MIT License. The source code, documentation and tutorial are available at https://github.com/sanger-tol/yahs.

Supplementary information

Supplementary data are available at Bioinformatics online.
Hedgehog signaling regulates Wolffian duct development through the primary cilium
Authors: Alves Maíra Bianchi Rodrigues , Girardet Laura , Augière Céline , Moon Kyeong Hye , Lavoie-Ouellet Camille , Bernet Agathe , Soulet Denis , Calvo Ezequiel , Teves Maria E , Beauparlant Charles Joly , Droit Arnaud , Bastien Alexandre , Robert Claude , Bok Jinwoong , Hinton Barry T , Belleannée Clémence
Published: December 2022

Primary cilia play pivotal roles in embryonic patterning and organogenesis through transduction of the Hedgehog signaling pathway (Hh). Although mutations in Hh morphogens impair the development of the gonads and trigger male infertility, the contribution of Hh and primary cilia in the development of male reproductive ductules, including the epididymis, remains unknown. From a Pax2Cre; IFT88fl/fl knock-out mouse model, we found that primary cilia deletion is associated with imbalanced Hh signaling and morphometric changes in the Wolffian duct (WD), the embryonic precursor of the epididymis. Similar effects were observed following pharmacological blockade of primary cilia formation and Hh modulation on WD organotypic cultures. The expression of genes involved in extracellular matrix, mesenchymal-epithelial transition, canonical Hh and WD development was significantly altered after treatments. Altogether, we identified the primary cilia-dependent Hh signaling as a master regulator of genes involved in WD development. This provides new insights regarding the etiology of sexual differentiation and male infertility issues.
Trends in treatment and outcomes of atrial fibrillation during 2007–17 in Finland
Authors: Teppo Konsta , Airaksinen K E Juhani , Jaakkola Jussi , Halminen Olli , Linna Miika , Haukka Jari , Putaala Jukka , Mustonen Pirjo , Kinnunen Janne , Hartikainen Juha , Aro Aapo L , Lehto Mika
Published: December 2022

Aims

Guidelines on the management of atrial fibrillation (AF) have evolved significantly during the past two decades, but the concurrent developments in real-life management and prognosis of AF are unknown. We assessed trends in the treatment and outcomes of patients with incident AF between 2007 and 2017.

Methods and results

The registry-based nationwide FinACAF (Finnish AntiCoagulation in Atrial Fibrillation) cohort covers all patients with AF in Finland from all levels of care. We determined the proportion of patients who were treated with oral anticoagulants (OACs) or rhythm control therapies, experienced an ischaemic stroke or bleeding event requiring hospitalization, or died within 1-year follow-up after AF diagnosis. We identified 206 909 patients (mean age 72.6 years) with incident AF. During the study period, use of OACs increased from 43.6 to 76.3%, and the increase was most evident in patients with at least moderate stroke risk. One-year mortality decreased from 13.3 to 10.6%, and the ischaemic stroke rate from 5.3 to 2.2%. The prognosis especially improved in patients over 75 years of age. Concurrently, a small increase in major bleeding events was observed. Use of catheter ablation increased continuously over the study period, but use of other rhythm-control therapies decreased after 2013.

Conclusion

Stroke prevention with OACs in patients with incident AF improved considerably from 2007 to 2017 in Finland. This development was accompanied by decreasing 1-year mortality and the reduction of the ischaemic stroke rate by more than half, particularly among elderly patients, whereas there was only slight increase in severe bleeding events.
Driving under the Influence of Amphetamine: Analytical Evaluation of Illegal or Prescription Drug Intake Using Chiral UHPLC–MS-MS
Authors: Nielsen Marie Katrine Klose , Andersen Nina Zacho , Rasmussen Brian Schou , Johansen Sys Stybe
Published: December 2022

Differentiation between consumption of illegal and prescription drugs remains an important aspect in forensic toxicology. While illicit amphetamine is most often racemic, the medicinal drugs marketed in Denmark for the treatment of attention-deficit hyperactivity disorder contain the pure (S)-enantiomer or a prodrug thereof. In this study, we present a simple and efficient analytical workflow to provide information about the origin of amphetamine consumed in forensic cases concerning driving under the influence of drugs (DUID). Following quantification of amphetamine and methamphetamine using our conventional multi-target ultra-high performance liquid chromatography–tandem mass spectrometry method, determination of (R)- and (S)-amphetamine was performed by reinjecting the sample extract on a Phenomenex LUX® AMP chiral column using the same analytical instrument and mobile phases. Chiral separation was performed isocratic within a run time of 6 min. The analytical workflow was applied to blood samples from 5,248 suspected DUID cases within a 2-year period. Amphetamine was detected in 18.7% of the samples, of which both enantiomers were detected in 89.5% of the cases, indicating the consumption of illegal racemic amphetamine. In 6.1% of the positive cases, both amphetamine and methamphetamine were detected, indicating either co-consumption of both amphetamines or consumption of methamphetamine. In the remaining 4.4%, only (S)-amphetamine was detected indicating the consumption of prescription drugs containing (S)-amphetamine or a prodrug thereof. Implementation of a simple and rapid chiral method in the conventional analytical workflow for routine forensic casework proved to be an efficient way to elucidate whether a positive amphetamine result originates from illegal or prescription drug consumption, without increasing turnaround time nor costs to any significant extent, as no additional sample preparation was required.
Velocity-coherent substructure in TMC-1: inflow and fragmentation
Authors: Smith Simon E T , Friesen Rachel , Marchal Antoine , Pineda Jaime E , Caselli Paola , Chen Michael Chun-Yuan , Choudhury Spandan , Di Francesco James , Ginsburg Adam , Kirk Helen , Matzner Chris , Punanova Anna , Scibelli Samantha , Shirley Yancy
Published: December 2022

Filamentary structures have been found nearly ubiquitously in molecular clouds and yet their formation and evolution is still poorly understood. We examine a segment of Taurus Molecular Cloud 1 (TMC-1) that appears as a single, narrow filament in continuum emission from dust. We use the Regularized Optimization for Hyper-Spectral Analysis (ROHSA), a Gaussian decomposition algorithm that enforces spatial coherence when fitting multiple velocity components simultaneously over a data cube. We analyse HC5N (9–8) line emission as part of the Green Bank Ammonia Survey and identify three velocity-coherent components with ROHSA. The two brightest components extend the length of the filament, while the third component is fainter and clumpier. The brightest component has a prominent transverse velocity gradient of 2.7 ± 0.1 km s−1 pc−1 that we show to be indicative of gravitationally induced inflow. In the second component, we identify regularly spaced emission peaks along its length. We show that the local minima between pairs of adjacent HC5N peaks line up closely with submillimetre continuum emission peaks, which we argue is evidence for fragmentation along the spine of TMC-1. While coherent velocity components have been described as separate physical structures in other star-forming filaments, we argue that the two bright components identified in HC5N emission in TMC-1 are tracing two layers in one filament: a lower density outer layer whose material is flowing under gravity towards the higher density inner layer of the filament.
A theoretical study of the time lags due to Comptonization and the constraints on the X-ray corona in AGNs
Authors: Zhang W , Papadakis I E , Dovčiak M , Bursa M , Karas V
Published: December 2022

We study the Fourier time lags due to the Comptonization of disc-emitted photons in a spherical, uniform, and stationary X-ray corona, which located on the rotational axis of the black hole. We use monk, a general relativistic Monte Carlo radiative transfer code, to calculate Compton scattering of photons emitted by a thin disc with a Novikov–Thorne temperature profile. We find that the model time lags due to Comptonization remain constant up to a characteristic frequency and then rapidly decrease to zero at higher frequencies. We provide equations that can be used to determine the time lags and cross-spectra for a wide range of values for the corona radius, temperature, optical depth, height, and for various accretion rates and black hole masses. We also provide an equation for the X-ray luminosity of a single corona, as a function of its characteristics and location above the disc. Remarkably, the observed X-ray time lags of nearby, bright active galaxies can be successfully reproduced by inverse Comptonization process of multiple dynamic coronae.
The role of the drag force in the gravitational stability of dusty planet forming disc – I. Analytical theory
Authors: Longarini Cristiano , Lodato Giuseppe , Bertin Giuseppe , Armitage Philip J
Published: December 2022

Recent observations show that planet formation is already underway in young systems, when the protostar is still embedded into the molecular cloud and the accretion disc is massive. In such environments, the role of self-gravity (SG) and gravitational instability (GI) is crucial in determining the dynamical evolution of the disc. In this work, we study the dynamical role of drag force in self-gravitating discs as a way to form planetesimals in early protoplanetary stages. We obtain the dispersion relation for density-wave perturbations on a fluid composed of two phases (gas and dust) interacting through the common gravitation field and the mutual drag force, and we find that the stability threshold is determined by three parameters: the local dust-to-gas density ratio, the dust relative temperature, and the relevant Stokes number. In a region of parameters space, where young protoplanetary discs are likely to be found, the instability can be dust driven, occurring at small wavelengths. In this regime, the Jeans mass is much smaller than the one predicted by the standard GI model. This mechanism can be a viable way to form planetary cores in protostellar discs, since their predicted mass is about ∼10 M⊕.
Impact of HAC evolution on the formation of small hydrocarbons in the Orion Bar and the Horsehead PDRs
Authors: Murga M S , Vasyunin A I , Kirsanova M S
Published: December 2022

We study evolution of hydrogenated amorphous carbon (HAC) grains under harsh UV radiation in photodissociation regions (PDRs) near young massive stars. Our aim is to evaluate the impact of the HAC grains on formation of observed small hydrocarbons: C2H, C2H2, C3H+, C3H, C3H2, C4H, in PDRs. We developed a microscopic model of the HAC grains based on available experimental results. The model includes processes of photo and thermo-desorption, accretion of hydrogen and carbon atoms and subsequent formation of carbonaceous mantle on dust surface. H2, CH4, C2H2, C2H4, C2H6, C3H4, C3H6, C3H8 are considered as the main fragments of the HAC photodestruction. We simulated evolution of the HAC grains under the physical conditions of two PDRs, the Orion Bar and the Horsehead nebula. We estimated the production rates of the HAC’ fragments in gas phase chemical reactions and compared them with the production rates of fragments due to the HAC destruction. The latter rates may dominate under some conditions, namely, at AV = 0.1 in both PDRs. We coupled our model with the gas-grain chemical model MONACO and calculated abundances of observed small hydrocarbons. We conclude that the contribution of the HAC destruction fragments to chemistry is not enough to match the observed abundances, although it increases the abundances by several orders of magnitude in the Orion Bar at AV = 0.1. Additionally, we found that the process of carbonaceous mantle formation on dust surface can be an inhibitor for the formation of observed small hydrocarbons in PDRs.
Baryon pasting algorithm: halo-based and particle-based pasting methods
Authors: Osato Ken , Nagai Daisuke
Published: December 2022

We present a fast methodology to produce mock observations of the thermal and kinetic Sunyaev–Zel’dovich (SZ) effects based on the dark matter only N-body simulations coupled with the analytic intracluster medium model. The methods employ two different approaches: halo-based pasting (HP) and particle-based pasting (PP). The former pastes gas density and pressure on to haloes and requires only a halo catalogue, and the latter considers the contribution from field particles as well, i.e. particles that do not belong to any haloes and thus utilize the full particle information. Therefore, the PP algorithm incorporates secondary effects beyond the HP algorithm: asphericity of haloes and contribution from diffuse gas. In particular, such a diffuse component is the dominant source of the kinetic SZ effect. As validation of our methods, we have produced 108 all-sky maps with HP and 108 flat-sky maps, which cover $5 \times 5 \, \mathrm{deg}^2$ with both HP and PP, and measured power spectra of the maps. Our method can produce a mock map within a few hours, even for all-sky coverage with a parallel computational environment. The power spectra of HP maps are consistent with the halo model prediction of the thermal SZ effect. On the other hand, the power spectra of PP maps are suppressed due to the halo asphericity but can reproduce better the theoretical prediction for the kinetic SZ effect. We discuss the utility of baryon-pasted mock SZ maps for estimating the covariance matrix of SZ statistics and modelling the selection and projection effects for cluster cosmology.
Radial velocity confirmation of a hot super-Neptune discovered by TESS with a warm Saturn–mass companion
Authors: Knudstrup E , Gandolfi D , Nowak G , Persson C M , Furlan E , Livingston J , Matthews E , Lundkvist M S , Winther M L , Rørsted J L , Albrecht S H , Goffo E , Carleo I , Deeg H J , Collins K A , Narita N , Isaacson H , Redfield S , Dai F , Hirano T , Akana Murphy J M , Beard C , Buchhave L A , Cary S , Chontos A , Crossfield I , Cochran W D , Conti D , Dalba P A , Esposito M , Fajardo-Acosta S , Giacalone S , Grunblatt S K , Guerra P , Hatzes A P , Holcomb R , Horta F G , Howard A W , Huber D , Jenkins J M , Kabáth P , Kane S , Korth J , Lam K W F , Lester K V , Matson R , McLeod K K , Orell-Miquel J , Murgas F , Palle E , Polanski A S , Ricker G , Robertson P , Rubenzahl R , Schlieder J E , Seager S , Smith A M S , Tenenbaum P , Turtelboom E , Vanderspek R , Weiss L , Winn J
Published: December 2022

We report the discovery and confirmation of the planetary system TOI-1288. This late G dwarf harbours two planets: TOI-1288 b and TOI-1288 c. We combine TESS space-borne and ground-based transit photometry with HARPS-N and HIRES high-precision Doppler measurements, which we use to constrain the masses of both planets in the system and the radius of planet b. TOI-1288 b has a period of $2.699835^{+0.000004}_{-0.000003}$ d, a radius of 5.24 ± 0.09 R⊕, and a mass of 42 ± 3 M⊕, making this planet a hot transiting super-Neptune situated right in the Neptunian desert. This desert refers to a paucity of Neptune-sized planets on short period orbits. Our 2.4-yr-long Doppler monitoring of TOI-1288 revealed the presence of a Saturn–mass planet on a moderately eccentric orbit ($0.13^{+0.07}_{-0.09}$) with a minimum mass of 84 ± 7 M⊕ and a period of $443^{+11}_{-13}$ d. The five sectors worth of TESS data do not cover our expected mid-transit time for TOI-1288 c, and we do not detect a transit for this planet in these sectors.
Living without pain. Case series of patients with hereditary sensory and autonomic neuropathies in a Canadian tertiary care centre
Authors: Reddi Renitha , Horvath Gabriella A
Published: December 2022

Background

Hereditary sensory and autonomic neuropathies (HSANs) are a group of heterogeneous genetic disorders presenting predominantly with sensory and autonomic dysfunction. They are a diverse group of diseases of the peripheral nervous system characterized by profound distal sensory loss and various autonomic and motor disturbances.

Objectives

The primary objective of this study was to describe the clinical presentation of children with HSAN to paediatricians. We present clinical features and genetic etiology of patients with HSAN followed in a Canadian tertiary paediatric centre, including suggestions for their monitoring, management, and long-term follow-up.

Methods

A retrospective chart review of all patients with HSAN followed from the years 2000 through 2021 was performed. Collected data consisted of patients’ demographics, clinical characteristics, imaging, and management.

Results

Eight patients were included. The average age at diagnosis was 3.19 ± 2.83 years. Insensitivity to pain (100%), dysautonomia (100%), global development delay (87.5%), emesis (62.5%), and self-injury (62.5%) were the most prevalent manifestations of HSAN. The most common co-morbidities were gastroesophageal reflux disease (50%), obstructive sleep apnea (37.5%), attention-deficit hyperactivity disorder (37.5%), and iron deficiency (37.5%). Management was multi-disciplinary, involving neurologists, orthopeds, developmental paediatricians, sleep specialists, and psychiatrists.

Conclusion

HSANs are a diverse group of diseases, characterized by profound distal sensory loss, acral mutilations, and variable autonomic disturbances. It is important to recognize the diagnosis in the paediatrician’s office in order to set up surveillance and prevent complications.
FEASIBILITY STUDY OF LOW TUBE VOLTAGE COMPUTER TOMOGRAPHY ANGIOGRAPHY (CTA) FOR BRONCHIAL ARTERY IMAGING IN PATIENTS WITH HEMOPTYSIS
Authors: An Jianli , Dong Yanchao , Niu Hongtao
Published: December 2022

Objective

To investigate the application of low tube voltage computer tomography angiography (CTA) in bronchial artery (BA) imaging in hemoptysis patients.

Methods

Between January 2017 and December 2021, 119 patients were studied, including 31 in the 80-kV group, 39 in the 100-kV group and 49 in the control group (120 kV). The CT dose index-volume (CTDIvol) (mGy) and effective dose (ED) (mSv) of each group were comparatively analysed. Image quality evaluation included the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and subjective 5-scores.

Results

Statistically significant differences were noted in CTDIvol, ED, SNR, CNR and image quality scores of the groups (P < 0.05). Comparative analysis showed no statistical difference in CTDIvol, ED and image quality scores between the 80- and 100-kV groups.

Conclusion

Low tube voltage CTA is useful in BA imaging for hemoptysis patients. Tube voltages of 100 kV have better image quality and lower radiation dose.
Discovery of genomic loci associated with sleep apnea risk through multi-trait GWAS analysis with snoring
Authors: Campos Adrian I , Ingold Nathan , Huang Yunru , Mitchell Brittany L , Kho Pik-Fang , Han Xikun , García-Marín Luis M , Ong Jue-Sheng ,   23andMe Research Team, Agee Michelle , Aslibekyan Stella , Auton Adam , Babalola Elizabeth , Bell Robert K , Bielenberg Jessica , Bryc Katarzyna , Bullis Emily , Cameron Briana , Coker Daniella , Dhamija Devika , Das Sayantan , Elson Sarah L , Filshtein Teresa , Fletez-Brant Kipper , Fontanillas Pierre , Freyman Will , Gandhi Pooja M , Heilbron Karl , Hicks Barry , Hinds David A , Huber Karen E , Jewett Ethan M , Jiang Yunxuan , Kleinman Aaron , Kukar Katelyn , Lin Keng-Han , Lowe Maya , Luff Marie K , McCreight Jennifer C , McIntyre Matthew H , McManus Kimberly F , Micheletti Steven J , Moreno Meghan E , Mountain Joanna L , Mozaffari Sahar V , Nandakumar Priyanka , Noblin Elizabeth S , O’Connell Jared , Petrakovitz Aaron A , Poznik G David , Shastri Anjali J , Shelton Janie F , Shi Jingchunzi , Shringarpure Suyash , Tian Chao , Tran Vinh , Tung Joyce Y , Wang Xin , Wang Wei , Weldon Catherine H , Wilton Peter , Law Matthew H , Yokoyama Jennifer S , Martin Nicholas G , Dong Xianjun , Cuellar-Partida Gabriel , MacGregor Stuart , Aslibekyan Stella , Rentería Miguel E
Published: December 2022

Study Objectives

Despite its association with severe health conditions, the etiology of sleep apnea (SA) remains understudied. This study sought to identify genetic variants robustly associated with SA risk.

Methods

We performed a genome-wide association study (GWAS) meta-analysis of SA across five cohorts (NTotal = 523 366), followed by a multi-trait analysis of GWAS (multi-trait analysis of genome-wide association summary statistics [MTAG]) to boost power, leveraging the high genetic correlation between SA and snoring. We then adjusted our results for the genetic effects of body mass index (BMI) using multi-trait-based conditional and joint analysis (mtCOJO) and sought replication of lead hits in a large cohort of participants from 23andMe, Inc (NTotal = 1 477 352; Ncases = 175 522). We also explored genetic correlations with other complex traits and performed a phenome-wide screen for causally associated phenotypes using the latent causal variable method.

Results

Our SA meta-analysis identified five independent variants with evidence of association beyond genome-wide significance. After adjustment for BMI, only one genome-wide significant variant was identified. MTAG analyses uncovered 49 significant independent loci associated with SA risk. Twenty-nine variants were replicated in the 23andMe GWAS adjusting for BMI. We observed genetic correlations with several complex traits, including multisite chronic pain, diabetes, eye disorders, high blood pressure, osteoarthritis, chronic obstructive pulmonary disease, and BMI-associated conditions.

Conclusion

Our study uncovered multiple genetic loci associated with SA risk, thus increasing our understanding of the etiology of this condition and its relationship with other complex traits.
The beneficiary principle in the 21st century
Authors: Chandler Sam
Published: December 2022

This article examines the development of the beneficiary principle in recent times. It examines how modern trust drafting has stretched the principle to its limit, especially with the preponderance of “massively discretionary trusts” offshore.
Effect of using crochet octopus in reducing the pain: a randomized controlled study
Authors: Çövener Özçelik Çağrı , Eren Özge , Sabaz Nagihan , Bulut Muhammet
Published: December 2022

Aims

The study aimed to determine the effect of using a crochet octopus to reduce acute pain and maintain optimal physiological measurements that develops during procedural pain in neonates.

Materials and methods

This was a parallel design randomized controlled study. During the procedure of heel lance, experimental groups were delivered a crochet octopus 10 min before the process and let them touch the octopus during and for up to 10 min after the procedure. Control group experienced the process without any intervention. SpO2, duration of crying of neonates and pain they experienced were evaluated.

Results

The study was completed with 100 (50 for the experimental group and 50 for the control group) term neonates. SpO2 of neonates, touching the crochet octopus during and after in second minute of the process was found higher and also the duration of crying was shorter during whole the process, and the pain they experienced due to the process was lower than the control group.

Conclusions

Crochet octopus affected physiological measurements of the neonates positively and reduced the procedural pain as well.
Are Ecological Momentary Assessments of Pain Valid and Reliable? A Systematic Review and Meta-analysis
Authors: Overton Mark , Ward Sarah , Swain Nicola , Falling Carrie , Gwynne-Jones David , Fillingim Roger , Mani Ramakrishnan
Published: December 2022

Objectives:

This systematic review and meta-analysis aimed to determine the level of evidence for the psychometric properties of Ecological Momentary Assessment (EMA) in populations with persistent pain.

Materials and Methods:

Five databases were searched from 1980 to December 2021. Two reviewers independently screened the titles, abstracts, and full text, extracted data, and assessed adherence to reporting standards and methodological rigor before evaluating the quality of evidence. A meta-analysis, including the pooling of correlations for the relevant EMA pain outcomes, was completed.

Results:

Overall, 3270 studies were identified, with 14 studies meeting inclusion criteria. Meta-analyses confirmed good to excellent relationships demonstrated between EMA and recalled pain intensity and interference across different timeframes. Many of the included studies did not fully adhere to recommended reporting standards, and the quality of included studies was either doubtful or inadequate due to methodological flaws. The level of evidence for measurement properties of pain outcomes was low for the criterion validity of pain intensity and interference and very low for reliability and construct validity of pain intensity and interference.

Discussion:

Ecological momentary assessment of pain experience appears both valid and reliable. Although the levels of evidence were low or very low, these findings provide preliminary support for the use of EMA in clinical practice and research settings. Potential strengths of EMA include providing measures with greater ecological validity while also reducing recall bias, both pertinent in pain outcome measurement. More research, including higher-quality studies, is needed to demonstrate further support for EMA, including the need for establishing other types of validity.
Central Sensitization and Small-fiber Neuropathy Are Associated in Patients With Fibromyalgia
Authors: Dumolard Anne , Lefaucheur Jean-Pascal , Hodaj Enkelejda , Liateni Zaki , Payen Jean-François , Hodaj Hasan
Published: December 2022

Objective:

To study the prevalence of small-fiber neuropathy (SFN) in a large cohort of patients with fibromyalgia (FM) and to better characterize the subset of patients with both FM and SFN.

Methods:

This 1-year, retrospective, observational cohort study included 265 patients with FM. They all performed electrochemical skin conductance (ESC) using the Sudoscan device, 1 of the simplest and most reliable technique to assess the distal autonomic nerve fibers. They completed 4 self-assessment questionnaires: (1) the Central Sensitization Inventory (CSI), (2) the Neuropathic Pain Symptom Inventory (NPSI), and (3) the Hospital Anxiety and Depression Scale (HADS), the Fibromyalgia Impact Questionnaire (FIQ).

Results:

Fifty-three patients (20%) had reduced ESC values. These patients had higher CSI and HADS scores, and a larger intake of analgesic drugs compared with patients with no ESC abnormalities. Central sensitization, which was extreme in 69% of the patients (CSI score ≥60), was 1 of the main determinants of ESC abnormalities and was associated with a higher NPSI score, even though these 2 factors were not correlated.

Conclusion:

Over the past 10 years, studies have shown that a significant proportion of patients with FM have signs of small nerve fiber impairment. The possible involvement of SFN, in the occurrence and presentation of clinical symptoms in FM patients, remains however unclear. This is the first study that showed an association between central sensitization and both small nerve fiber impairment and neuropathic pain features in FM patients, rather than a direct association between SFN and neuropathic pain.
New perspectives on ferroptosis and its role in hepatocellular carcinoma
Authors: Cong Tianhao , Luo Yingen , Fu Yan , Liu Yu , Li Yujie , Li Xiao
Published: December 2022

For a long time, the morbidity and mortality rates of hepatocellular carcinoma (HCC) have remained high. Since the concept of ferroptosis was introduced in 2012, researchers’ perspectives have shifted toward finding novel ferroptosis-related treatment strategies, especially for tumors that are resistant to apoptosis. In recent years, there have been an increasing number of studies on ferroptosis, and these studies have found that ferroptosis has great potential and promise for cancer treatment. Ferroptosis is a kind of regulated cell death (RCD); unlike apoptosis, ferroptosis is an iron-dependent type of RCD driven by lipid peroxidation. The whole process of ferroptosis mainly revolves around three pathways (system xc
−/ glutathione peroxidase 4 [GPX4]), lipid peroxidation, and iron metabolism), which are also regulated by various metabolic factors. This review will attempt to analyze the relationship between the system xc
−/GPX4 pathway, lipid peroxidation, iron metabolism, and ferroptosis from three aspects (triggering, execution, and regulation), and the regulatory factors for ferroptosis will be summarized. In this review, we will also illustrate the relationship between ferroptosis and tumors as well as its application in tumors from the perspective of HCC. Finally, we will summarize the current limitations and needs and provide perspectives related to the focus of development in the future.
Sex differences in systemic lupus erythematosus (SLE): an inception cohort of the Chinese SLE Treatment and Research Group (CSTAR) registry XVII
Authors: Gui Yinli , Bai Wei , Xu Jian , Duan Xinwang , Zhan Feng , Zhao Chen , Jiang Zhenyu , Li Zhijun , Wu Lijun , Liu Shengyun , Yang Min , Wei Wei , Wang Ziqian , Zhao Jiuliang , Wang Qian , Leng Xiaomei , Tian Xinping , Li Mengtao , Zhao Yan , Zeng Xiaofeng
Published: December 2022

Background:

The onset and clinical presentation of systemic lupus erythematosus (SLE) are sex-related. Few studies have investigated the distinctions in clinical characteristics and treatment preferences in male and female SLE patients in the initial cohort. This study aimed to improve the understanding of Chinese SLE patients by characterizing the different sexes of SLE patients in the inception cohort.

Methods:

Based on the initial patient cohort established by the Chinese SLE Treatment and Research Group, a total of 8713 patients (795 men and 7918 women) with newly diagnosed SLE were enrolled between April 2009 and March 2021. Of these, 2900 patients (347 men and 2553 women) were eligible for lupus nephritis (LN). A cross-sectional analysis of the baseline demographic characteristics, clinical manifestations, laboratory parameters, organ damage, initial treatment regimens, and renal pathology classification was performed according to sex.

Results:

In the SLE group, as compared to female patients, male patients had a later age of onset (male vs. female: 37.0 ± 15.8 years vs. 35.1 ± 13.7 years, P 
= 0.006) and a higher SLE International Collaborative Clinic/American College of Rheumatology damage index score (male vs. female: 0.47 ± 1.13 vs. 0.34 ± 0.81, P 
= 0.015), LN (male vs. female: 43.6% vs. 32.2%, P < 0.001), fever (male vs. female: 18.0% vs. 14.6%, P 
= 0.010), thrombocytopenia (male vs. female: 21.4% vs. 18.5%, P 
= 0.050), serositis (male vs. female: 14.7% vs. 11.7%, P 
= 0.013), renal damage (male vs. female: 11.1% vs. 7.4%, P < 0.001), and treatment with cyclophosphamide (CYC) (P < 0.001). The frequency of leukopenia (male vs. female: 20.5% vs. 25.4%, P 
= 0.002) and arthritis (male vs. female: 22.0% vs. 29.9%, P < 0.001) was less in male patients with SLE. In LN, no differences were observed in disease duration, SLE Disease Activity Index score, renal biopsy pathological typing, or 24-h urine protein quantification among the sexes. In comparisons with female patients with LN, male patients had later onset ages (P 
= 0.026), high serum creatinine (P < 0.001), higher end-stage renal failure rates (P 
= 0.002), musculoskeletal damage (P 
= 0.023), cardiovascular impairment (P 
= 0.009), and CYC use (P 
= 0.001); while leukopenia (P 
= 0.017), arthritis (P 
= 0.014), and mycophenolate usage (P 
= 0.013) rates were lower.

Conclusions:

Male SLE patients had more severe organ damage and a higher LN incidence compared with female SLE patients; therefore, they may require more aggressive initial treatment compared to female patients.
Associations of polygenic risk scores for preeclampsia and blood pressure with hypertensive disorders of pregnancy
Authors: Nurkkala Jouko , Kauko Anni , FinnGen  , Laivuori Hannele , Saarela Tanja , Tyrmi Jaakko S. , Vaura Felix , Cheng Susan , Bello Natalie A. , Aittokallio Jenni , Niiranen Teemu
Published: December 2022

Background:

Preexisting hypertension increases risk for preeclampsia. We examined whether a generic blood pressure polygenic risk score (BP-PRS), compared with a preeclampsia-specific polygenic risk score (PE-PRS), could better predict hypertensive disorders of pregnancy.

Methods:

Our study sample included 141 298 genotyped FinnGen study participants with at least one childbirth and followed from 1969 to 2021. We calculated PRSs for SBP and preeclampsia using summary statistics for greater than 1.1 million single nucleotide polymorphisms.

Results:

We observed 8488 cases of gestational hypertension (GHT) and 6643 cases of preeclampsia. BP-PRS was associated with GHT [multivariable-adjusted hazard ratio for 1SD increase in PRS (hazard ratio 1.38; 95% CI 1.35–1.41)] and preeclampsia (1.26, 1.23–1.29), respectively. The PE-PRS was also associated with GHT (1.16; 1.14–1.19) and preeclampsia (1.21, 1.18–1.24), but with statistically more modest magnitudes of effect (P = 0.01). The model c-statistic for preeclampsia improved when PE-PRS was added to clinical risk factors (P = 4.6 × 10–15). Additional increment in the c-statistic was observed when BP-PRS was added to a model already including both clinical risk factors and PE-PRS (P = 1.1 × 10–14).

Conclusion:

BP-PRS is strongly associated with hypertensive disorders of pregnancy. Our current observations suggest that the BP-PRS could capture the genetic architecture of preeclampsia better than the current PE-PRSs. These findings also emphasize the common pathways in the development of all BP disorders. The clinical utility of a BP-PRS for preeclampsia prediction warrants further investigation.
(In)Equality and Beyond: Achieving Justice in Gender-Affirming Hormone Initiation
Authors: Macenski Christina L. , Keuroghlian Alex S. , AhnAllen Christopher G. , Beemyn Genny , Erlick Eli , Gill-Peterson Jules , Harper Joanna Marie , Ramos Rebeca , Stroumsa Daphna , Benetti Fernando J. , Fromson John A.
Published: December 2022

The World Professional Association for Transgender Health (WPATH) is an international organization that aims to advocate for transgender and gender-diverse (TGD) people by promoting safe and effective ways to access and deliver healthcare to maximize psychological health and well-being. One way this is achieved is through the WPATH’s published Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, a set of guidelines for gender-affirming care that is based on the available science and expert consensus. In anticipation of the release of updated guidelines (Standards of Care Version 8) in 2022 the Radcliffe Institute for Advanced Study at Harvard University hosted an Exploratory Seminar in December 2021 that brought together experts from the United States, Mexico, and the United Kingdom to share knowledge across disciplines in order to propose revisions to the WPATH’s updated guidelines. This article shares the workgroup’s high-level consensus and recommendations.
Opioid dose and pain effects of an online pain self-management program to augment usual care in adults with chronic pain: a multisite randomized clinical trial
Authors: Wilson Marian , Dolor Rowena J. , Lewis Daniel , Regan Saundra L. , Vonder Meulen Mary Beth , Winhusen T. John
Published: December 2022

Readily accessible nonpharmacological interventions that can assist in opioid dose reduction while managing pain is a priority for adults receiving long-term opioid therapy (LOT). Few large-scale evaluations of online pain self-management programs exist that capture effects on reducing morphine equivalent dose (MED) simultaneously with pain outcomes. An open-label, intent-to-treat, randomized clinical trial recruited adults (n = 402) with mixed chronic pain conditions from primary care and pain clinics of 2 U.S. academic healthcare systems. All participants received LOT-prescriber-provided treatment of MED ≥ 20 mg while receiving either E-health (a 4-month subscription to the online Goalistics Chronic Pain Management Program), or treatment as usual (TAU). Among 402 participants (279 women [69.4%]; mean [SD] age, 56.7 [11.0] years), 200 were randomized to E-health and 202 to TAU. Of 196 E-heath participants, 105 (53.6%) achieved a ≥15% reduction in daily MED compared with 85 (42.3%) of 201 TAU participants (odds ratio, 1.6 [95% CI, 1.1-2.3]; P = 0.02); number-needed-to-treat was 8.9 (95% CI, 4.8, 66.0). Of 166 E-health participants, 24 (14.5%) achieved a ≥2 point decrease in pain intensity vs 13 (6.8%) of 192 TAU participants (odds ratio, 2.4 [95% CI, 1.2-4.9]; P = 0.02). Benefits were also observed in pain knowledge, pain self-efficacy, and pain coping. The findings suggest that for adults on LOT for chronic pain, use of E-health, compared with TAU, significantly increased participants' likelihood of clinically meaningful decreases in MED and pain. This low-burden online intervention could assist adults on LOT in reducing daily opioid use while self-managing pain symptom burdens.
Predicting placebo analgesia in patients with chronic pain using natural language processing: a preliminary validation study
Authors: Branco Paulo , Berger Sara , Abdullah Taha , Vachon-Presseau Etienne , Cecchi Guillermo , Apkarian A. Vania
Published: December 2022

Patients with chronic pain show large placebo effects in clinical trials, and inert pills can lead to clinically meaningful analgesia that can last from days to weeks. Whether the placebo response can be predicted reliably, and how to best predict it, is still unknown. We have shown previously that placebo responders can be identified through the language content of patients because they speak about their life, and their pain, after a placebo treatment. In this study, we examine whether these language properties are present before placebo treatment and are thus predictive of placebo response and whether a placebo prediction model can also dissociate between placebo and drug responders. We report the fine-tuning of a language model built based on a longitudinal treatment study where patients with chronic back pain received a placebo (study 1) and its validation on an independent study where patients received a placebo or drug (study 2). A model built on language features from an exit interview from study 1 was able to predict, a priori, the placebo response of patients in study 2 (area under the curve = 0.71). Furthermore, the model predicted as placebo responders exhibited an average of 30% pain relief from an inert pill, compared with 3% for those predicted as nonresponders. The model was not able to predict who responded to naproxen nor spontaneous recovery in a no-treatment arm, suggesting specificity of the prediction to placebo. Taken together, our initial findings suggest that placebo response is predictable using ecological and quick measures such as language use.
The Omicron variant wave: Where are we now and what are the prospects?
Authors: Wang Mong-Lien , Lin Yang , Hou Ju-Fen , Yang Yi-Ping , Chien Yueh , Sun Yi-Chen , Liang Kung-Hao , Yang De-Ming , Chang Tai-Jay , Wu Cheng-Hsien , Kao Shou-Yen , Hung Kai-Feng
Published: December 2022

The Omicron variant BA.2 is the dominant form of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in many countries, including those that have already implemented the strictest quarantine mandates that effectively contained the spread of the previous variants. Although many individuals were partially or fully vaccinated, confirmed Omicron infections have far surpassed all other variants combined in just a couple of months since the Omicron variant emerged. The ChAdOx1-S (AstraZeneca), BNT162b2 (Pfizer-BioNTech), and mRNA-1273 (Moderna) vaccines offer protection against the severe illness of SARS-CoV-2 infection; however, these currently available vaccines are less effective in terms of preventing Omicron infections. As a result, a booster dose of BNT162b2 or mRNA-1273 is recommended for individuals >12 years old who had received their second dose of the approved vaccines for >5 months. Herein, we review the studies that assessed the clinical benefits of the booster dose of vaccines against Omicron infections. We also analyzed public data to address whether early booster vaccination effectively prevented the surge of the Omicron infections. Finally, we discuss the consideration of a fourth dose of vaccine as a way to prevent possible upcoming infections.
Using American College of Gastroenterology Guidelines to provide effective health maintenance for patients with inflammatory bowel disease
Authors: Benjamin Lynne E. , Gianelis Kristin A.
Published: December 2022

Background:

Patients with inflammatory bowel disease (IBD) are at increased risk for infections, malignancies, and osteoporosis, related to both the disease state and medical therapy. Identification and treatment of depression and anxiety is crucial for disease management. Guidelines developed by the American College of Gastroenterology include recommendations for preventive health maintenance in patients with IBD to guide quality care.

Local Problem:

Chart audits in a private gastroenterology practice revealed that only 20% of patients with IBD were receiving recommended health maintenance. The aim was to increase effective preventive care of patients with inflammatory bowel disease by 50% by the end of 8 weeks.

Methods:

The quality improvement project consisted of four rapid Plan-Do-Study-Act cycles.

Interventions:

The interventions implemented for this quality improvement project included a patient questionnaire, an order sheet/order set, a case management log, and team engagement.

Results:

Providers identified deficiencies and ordered needed health maintenance for 100% of patients with IBD. While effective preventive care orders increased, order completion rates were unchanged during the project.

Conclusions:

Patient questionnaires, order sheets, a case management log, and teamwork were successfully used by providers in a private gastroenterology practice to increase orders placed for preventive care in patients with IBD. The project tools could easily be modified and implemented in other specialty practices who care for patients with specialized health maintenance needs.