bluuebunny/crossref_metadata_2025_split huggingface dataset:
Operationalizing Community Assessment Results to Enhance Preparedness for a Radiological Emergency
Authors: Ferguson Rennie W. , Barnett Daniel J. , Kennedy Ryan David , Sell Tara Kirk , Wieder Jessica S. , Spannhake Ernst W. 
Published: February 2022

Objective:
A radiological emergency such as the detonation of a radiological dispersal device would have catastrophic health, environmental, and economic consequences. Community assessments can provide useful information about radiological and other emergency preparedness at the household level. Tools such as logic models can be applied to link data collected in a community assessment to planned activities and targeted outcomes. This study sought to answer how public health departments can use the results of a community assessment to improve preparedness for radiological and other types of emergencies and to present a sample logic model demonstrating how questions asked in a community assessment can be used to drive intended outcomes.

Design:
Surveys were fielded in 2019 to professionals with experience in radiological emergency preparedness, state and local health and emergency management, and journalism. Questions included the role of health departments in radiological emergency preparedness, the operationalization of results from a community assessment for preparedness, and information sharing in a radiological emergency. Descriptive statistics and a modified framework approach were used for open-ended questions.

Results:
Nearly three-fourths of state/local officials reported that it would be at least somewhat difficult (73%; 11 of 15 state/local officials) for a local health department to operationalize the results of a community health assessment for radiological emergency preparedness. Potential barriers included competing priorities, lack of funds, and limited staff. Resources such as pretested communication materials, tailored messaging, and technical tools and training can assist health departments and emergency management agencies in using the information collected from a community assessment.

Conclusions:
To address implementation challenges in operationalizing the results of a community assessment, officials can use tools such as logic models to illustrate how the information gathered from a community health assessment will create an intended preparedness outcome and to advocate for funds for this type of assessment.
Lack of Consistent Investment in Federal Insurance Navigator Program Undermines Navigators' Equity Work in Vulnerable Communities
Authors: van Eijk Marieke S. , Kett Paula M. , Prueher Lillian , Frogner Bianca K. , Guenther Grace A. 
Published: February 2022

Context:
Navigators in the federal Insurance Navigator Program (“Navigator Program”), who are employed by organizations in states with Federally Facilitated Marketplaces, provide enrollment assistance, outreach, and education to individuals who are eligible for health insurance coverage. Such work is central to public health efforts to address inequities but continues to be poorly understood and undervalued. More information is needed to understand the components of navigators' equity work and how decreases in program funding have affected their service provision.

Objective:
To examine navigators' labor at a granular level to better understand and highlight the equity work they do, the training and skills required for this work, and the Navigator Program–based challenges they face.

Design:
This was a descriptive qualitative study using data collected from interviews conducted in February-May 2021. We used a thematic analysis approach to develop major themes and subthemes.

Setting:
This was a national study.

Participants:
We conducted 18 semistructured interviews with 24 directors, navigators, and other professionals at organizations funded as federally certified Navigator Programs.

Main Outcome Measures:
Components of navigators' work; required training and skills; and challenges faced in accomplishing the work.

Results:
We identified 3 major themes: (1) navigators' health equity work goes beyond required responsibilities; (2) equity skills are built on the job; and (3) financial instabilities challenge navigators' health equity work.

Conclusion:
Navigators bring specialized and essential skills and services to underserved communities. They are trusted sources of information, advocates, resource connectors, and, most significantly, health equity workers. However, the Navigator Program fails to support navigators' work and the communities they serve in the long term. To facilitate organizations' capacities to train, keep, and support navigators in this health equity work and to guarantee long-term enrollment assistance for underserved communities, efforts to stabilize funding are needed.
Communication During Interhospital Transfers of Emergency General Surgery Patients: A Qualitative Study of Challenges and Opportunities
Authors: Alagoz Esra , Saucke Megan , Arroyo Natalia , Fernandez Taylor Sara , Ingraham Angela 
Published: February 2022

Objectives
Transferred emergency general surgery (EGS) patients experience worse outcomes than directly admitted patients. Improving communication during transfers may improve patient care. We sought to understand the nature of and challenges to communication between referring (RP) and accepting (AP) providers transferring EGS patients from the transfer center nurse’s (TCN) perspective.

Methods
Guided by the Relational Coordination Framework, we interviewed 17 TCNs at an academic medical center regarding (in)efficient and (in)effective communication between RPs and APs. In-person interviews were recorded, transcribed, and managed in NVivo. Four researchers developed a codebook, cocoded transcripts, and met regularly to build consensus and discuss emergent themes. We used data matrices to perform constant comparisons and arrive at higher-level concepts.

Results
Challenges to ideal communication centered on the appropriateness and completeness of information, efficiency of the conversation, and degree of consensus. Transfer center nurses described that RPs provided incomplete information because of a lack of necessary infrastructure, personnel, or technical knowledge; competing clinical demands; or a fear of the transfer request being rejected. Inefficient communication resulted from RPs being unfamiliar with the information APs expected and the lack of a structured process to share information. Communication also failed when providers disagreed about the necessity of the transfer. Accepting providers diffused tension and facilitated communication by embracing the role of a “coach,” negotiating “wait-and-see” agreements, and providing explanations of why transfers were unnecessary.

Conclusions
Transfer center nurses described numerous challenges to provider communication. Opportunities for improvement include sharing appropriate and complete information, ensuring efficient communication, and reaching consensus about the course of action.
Recent Trends in Adult and Pediatric Antiretroviral Therapy Monitoring and Failure
Authors: Boettiger David C. , An Vu Thien , Kumarasamy Nagalingeswaran , Azwa Iskandar , Sudjaritruk Tavitiya , Truong Khanh Huu , Avihingsanon Anchalee , Ross Jeremy , Kariminia Azar ,   for the International Epidemiology Databases to Evaluate AIDS—Asia-Pacific
Published: February 2022

Objective:
To assess recent trends in the monitoring of antiretroviral therapy (ART) and detection of ART failure in adult and pediatric HIV clinics.

Methods:
We used data collected from 21 adult and 17 pediatric sites (across 13 and 6 countries/territories, respectively) in the International Epidemiology Databases to Evaluate AIDS - Asia-Pacific cohort. ART failure was defined as viral, immune, or clinical consistent with WHO guidelines.

Results:
A total of 8567 adults and 6149 children contributed data. Frequency of CD4 count monitoring declined between 2010 and 2019 among adult sites (from 1.93 to 1.06 tests/person per year, a 45.1% decline) and pediatric sites (from 2.16 to 0.86 testsperson per year, a 60.2% decline), whereas rates of viral load monitoring remained relatively stable. The proportion of adult and pediatric treatment failure detected as immune failure declined (from 73.4% to 50.0% and from 45.8% to 23.1%, respectively), whereas the proportion of failure detected as viral failure increased (from 7.8% to 25.0% and from 45.8% to 76.9%, respectively). The proportion of ART failure detected as clinical failure remained stable among adult and pediatric sites. The largest shifts in ART monitoring and failure type occurred in lower middle-income countries.

Conclusions:
Although viral failure in our Asian cohort now comprises a larger portion of ART failure than in prior years, the diagnostic characteristics of immune and clinical failure, and recommendations on their management, remain important inclusions for regional ART guidelines.
Extending Inherited Metabolic Disorder diagnostics with Biomarker Interaction Visualizations
Authors: Slenter Denise N. , Hemel Irene M.G.M. , Evelo Chris T. , Bierau Jörgen , Willighagen Egon L. , Steinbusch Laura K.M. 
Published: February 2022

AbstractBackgroundInherited Metabolic Disorders (IMDs) are rare diseases where one impaired protein leads to a cascade of changes in the adjacent chemical conversions. IMDs often present with non-specific symptoms, a lack of a clear genotype-phenotype correlation, andde novomutations, complicating diagnosis. Furthermore, products of one metabolic conversion can be the substrate of another pathway obscuring biomarker identification and causing overlapping biomarkers for different disorders. Visualization of the connections between metabolic biomarkers and the enzymes involved might aid in the diagnostic process. The goal of this study was to provide a proof-of-concept framework for integrating knowledge of metabolic interactions with real-life patient data before scaling up this approach. This framework was tested on two groups of well-studied and related metabolic pathways (the urea cycle and pyrimidine de-novo synthesis). The lessons learned from our approach will help to scale up the framework and support the diagnosis of other less understood IMDs.MethodsOur framework integrates literature and expert knowledge into machine-readable pathway models, including relevant urine biomarkers and their interactions. The clinical data of 16 previously diagnosed patients with various pyrimidine and urea cycle disorders were visualized on the top 3 relevant pathways. Two expert laboratory scientists evaluated the resulting visualizations to derive a diagnosis.ResultsThe proof-of-concept platform resulted in varying numbers of relevant biomarkers (five to 48), pathways and pathway interactions for each patient. The two experts reached the same conclusions for all samples with our proposed framework as with the current metabolic diagnostic pipeline. For nine patient samples the diagnosis was made without knowledge about clinical symptoms or sex. For the remaining seven cases, four interpretations pointed in the direction of a subset of disorders, while three cases were found to be undiagnosable with the available data. Diagnosing these patients would require additional testing besides biochemical analysis.ConclusionThe presented framework shows how metabolic interaction knowledge can be integrated with clinical data in one visualization, which can be relevant for future analysis of difficult patient cases and untargeted metabolomics data. Several challenges were identified during the development of this framework, which should be resolved before this approach can be scaled up and implemented to support the diagnosis of other (less understood) IMDs. The framework could be extended with other OMICS data (e.g. genomics, transcriptomics), phenotypic data, as well as linked to other knowledge captured as Linked Open Data.
Plasma ST6Gal1 is Dispensable for IgG Sialylation
Authors: Oswald Douglas M , Lehoux Sylvain D , Zhou Julie Y , Glendenning Leandre M , Cummings Richard D , Cobb Brian A 
Published: February 2022

AbstractThe glycosylation of IgG has attracted increased attention due to the impact of N-glycan modifications at N297 on IgG function, acting primarily through modulation of Fc domain conformation and Fcγ receptor binding affinities and signaling. However, the mechanisms regulating IgG glycosylation and especially α2,6-sialylation of its N-glycan remain poorly understood. We observed previously that IgG is normally sialylated in mice with B cells lacking the sialyltransferase ST6Gal1. This supported the hypothesis that IgG may be sialylated outside of B cells, perhaps through the action of hepatocyte-released plasma ST6Gal1. Here we demonstrate that this model is incorrect. Animals lacking hepatocyte expressed ST6Gal1 retain normal IgG α2,6-sialylation, despite the lack of detectable ST6Gal1 in plasma. Moreover, we confirmed that B cells were not a redundant source of IgG sialylation. Thus, while α2,6-sialylation is lacking in IgG from mice with germline ablation of ST6Gal1, IgG α2,6-sialylation is normal in mice lacking ST6Gal1 in either hepatocytes or B cells. These results indicate that IgG α2,6-sialylation arises after release from a B cell, but is not dependent on plasma-localized ST6Gal1 activity.
Artificial soils reveal individual factor controls on microbial processes
Authors: Valle Ilenne Del , Gao Xiaodong , Ghezzehei Teamrat A. , Silberg Jonathan J. , Masiello Caroline A. 
Published: February 2022

ABSTRACTSoil matrix properties influence microbial behaviors that underlie nutrient cycling, greenhouse gas production, and soil formation. However, the dynamic and heterogeneous nature of soils makes it challenging to untangle the effects of different matrix properties on microbial behaviors. To address this challenge, we developed a tunable artificial soil recipe and used these materials to study the abiotic mechanisms driving soil microbial growth and communication. When we used standardized matrices with varying textures to culture gas-reporting biosensors, we found that Gram-negative bacteria grew best in synthetic silt soils, remaining active over a wide range of soil matric potentials, while Gram-positive bacteria preferred sandy soils, sporulating at a low water potentials. Soil texture, mineralogy, and alkalinity all attenuated the bioavailability of an acyl-homoserine lactone (AHL) signaling molecule that controls community-level microbial behaviors. Texture controlled the timing of AHL sensing, while AHL bioavailability was decreased ∼105-fold by mineralogy and ∼103-fold by alkalinity. Finally, we built artificial soils with a range of complexities that converge on the properties of one Mollisol. As artificial soil complexity increased to more closely resemble the Mollisol, microbial behaviors approached those occurring in the natural soil, with the notable exception of organic matter. Properties that behaved additively were soil texture, pH, and mineralogy, while organic matter did not, suggesting that its soil behavior is an emergent property.IMPORTANCEUnderstanding environmental controls on soil microbes is difficult because many abiotic parameters vary simultaneously and uncontrollably when different natural soils are compared, preventing mechanistic determination of any individual soil parameter’s effect on microbial behaviors. We describe how soil texture, mineralogy, pH, and organic matter content can be varied individually within artificial soils to study their effects on soil microbes. Using microbial biosensors that report by producing a rare indicator gas, we identify soil properties that control microbial growth and attenuate the bioavailability of a diffusible chemical used to control community-level behaviors. We find that artificial soils differentially affect signal bioavailability and the growth of Gram-negative and Gram-positive microbes. We show that some soil properties have additive effects on signal bioavailability, while others exhibit emergent properties. These artificial soils are useful for studying the mechanisms that underlie soil controls on microbial fitness, signaling, and gene transfer.
Accurate and robust inference of genetic ancestry from cancer-derived molecular data across genomic platforms
Authors: Belleau Pascal , Deschênes Astrid , Tuveson David A. , Krasnitz Alexander 
Published: February 2022

AbstractGenetic ancestry-oriented cancer research requires the ability to perform accurate and robust genetic ancestry inference from existing cancer-derived data, including whole exomes, transcriptomes and targeted gene panels, very often in the absence of matching cancer-free genomic data. Here we examine the feasibility and accuracy of such computation. In order to optimize and assess the performance of the ancestry inference for any given input cancer-derived molecular profile, we have developed a data synthesis framework. In its core procedure, the ancestral background of the profiled patient is replaced with one of any number of individuals with known ancestry. Data synthesis is applicable to multiple profiling platforms and makes it possible to assess the performance of inference specifically for a given molecular profile, and separately for each continental-level ancestry. This ability extends to all ancestries, including those without statistically sufficient representation in the existing cancer data. We further show that our inference procedure is accurate and robust in a wide range of sequencing depths. Testing our approach for three representative cancer types, and across three molecular profiling modalities, we demonstrate that global, continental-level ancestry of the patient can be inferred with high accuracy, as quantified by its agreement with the golden standard of the ancestry derived from matching cancer-free molecular data. Our study demonstrates that vast amounts of existing cancer-derived molecular data potentially are amenable to ancestry-oriented studies of the disease, without recourse to matching cancer-free genomes or patients’ self-identification by ancestry.
Why Are Alzheimer’s Disease Patients Unaware of their Memory Deficits?
Authors: Razafimahatratra Solofo , Guieysse Thomas , Lejeune François-Xavier , Houot Marion , Medani Takfarinas , Dreyfus Gérard , Klarsfeld André , Villain Nicolas , Pereira Filipa Raposo , La Corte Valentina , George Nathalie , Pantazis Dimitrios , Andrade Katia 
Published: February 2022

ABSTRACTAnosognosia, or the lack of awareness of one’s own impairment, is frequent for memory deficits in patients with Alzheimer’s disease (AD). Although often related to frontal dysfunctions, the neural mechanisms of anosognosia remain largely unknown. We hypothesized that anosognosia in AD may result from a failure in the error-monitoring system, thus preventing patients from being aware of and learning from their own errors. We therefore investigated the event-related potentials evoked by erroneous responses during a memory task in two groups of amyloid positive individuals who had only subjective memory complaints at study entry: 1) those who progressed to AD; and 2) those who remained cognitively normal after five years of follow-up. Our findings revealed direct evidence of a failure in the error-monitoring system at early stages of AD, suggesting that it may be the critical neural substrate of anosognosia in this neurodegenerative disorder.
Using a Computational Cognitive Model to Simulate the Effects of Personal and Social Network Experiences on Seasonal Influenza Vaccination Decisions
Authors: Walsh Matthew M. , Parker Andrew M. , Vardavas Raffaele , Nowak Sarah A. , Kennedy David P. , Gidengil Courtney A. 
Published: February 2022

AbstractThe substantial societal costs of seasonal influenza include illness, loss of lives, and loss of work productivity. Vaccination is the most effective means for averting the disease, yet fewer than half of adults in the United States are vaccinated annually. In this research, we focus on how personal experience and the experiences of close social contacts contribute to vaccination decisions. The results of a multi-year longitudinal survey study revealed the significant effects of personal and social network experiences on vaccination. We develop a memory-based model of vaccination decisions using the Adaptive Control of Thought – Rational (ACT-R) integrated cognitive architecture. The model accounts for the effects of personal and social experience on vaccination, and suggests interventions that may be effective in increasing vaccination uptake.
Inference of causal relationships based on the genetics of cardiometabolic traits and conditions unique to females in >50,000 participants
Authors: Xiao Brenda , Velez Edwards Digna R. , Lucas Anastasia , Drivas Theodore , Gray Kathryn , Keating Brendan , Weng Chunhua , Jarvik Gail P. , Hakonarson Hakon , Kottyan Leah , Elhadad Noemie ,   Regeneron Genetics Center, Wei Wei-Qi , Luo Yuan , Kim Dokyoon , Ritchie Marylyn , Verma Shefali Setia 
Published: February 2022

AbstractBackgroundCardiometabolic diseases are highly comorbid and associated with poor health outcomes. However, the investigation of the relationship between the genetic predisposition to cardiometabolic diseases with the risk of conditions unique to females such as breast cancer, endometriosis and pregnancy-related complications is highly understudied. This study aimed to estimate the cross-trait genetic overlap and influence of genetic burden of cardiometabolic traits on health conditions unique to females.MethodsWe obtained data for female participants in the Penn Medicine BioBank (PMBB; 21,837 samples) and the electronic MEdical Records and GEnomics (eMERGE; 49,171 samples) network. We examined the relationship between four cardiometabolic phenotypes (body mass index (BMI), coronary artery disease (CAD), type 2 diabetes (T2D) and hypertension (through blood pressure measurements)) and 23 female health conditions by performing four analyses: 1) Cross-trait genetic correlation analyses to compare genetic architecture. 2) Polygenic risk scores (PRS)-based association tests to characterize shared genetic effects on disease risk. 3) Mendelian randomization (MR) for significant associations to assess cross-trait causal relationships. 4) Chronology analyses to visualize the timeline of events unique to groups of females with high and low genetic burden for cardiometabolic traits and highlight the disease prevalence in risk groups by age.ResultsWe observed high genetic correlation among cardiometabolic and female health conditions. PRS meta-analysis identified 29 significant associations reflecting potential shared biology among common cardiometabolic phenotypes and female health conditions. Significant associations include PRSBMIwith endometrial cancer and polycystic ovarian syndrome (PCOS), PRSCADwith breast cancer, and the PRST2Dwith gestational diabetes and PCOS. Mendelian randomization provided additional evidence of independent causal effects between T2D and gestational diabetes and CAD and with breast cancer. Our results reflected inverse association between PRSCADand breast cancer. Lastly, as visualized from chronology analyses, individuals with high PRS are also more likely to develop conditions such as PCOS and gestational hypertension at earlier ages.ConclusionsPolygenic susceptibility to cardiometabolic traits is associated with conditions unique to females. Several of these associations are likely to result from the complex pathophysiology of cardiometabolic risk, and others may reflect potential pleiotropic effects that go beyond cardiometabolic health in females.