Patterns of SARS-CoV-2 Testing Preferences in a National Cohort in the United States: Latent Class Analysis of a Discrete Choice Experiment

BACKGROUND

Inadequate screening and diagnostic testing in the United States throughout the first several months of the COVID-19 pandemic led to undetected cases transmitting disease in the community and an underestimation of cases. Though testing supply has increased, maintaining testing uptake remains a public health priority in the efforts to control community transmission considering the availability of vaccinations and threats from variants.

OBJECTIVE

This study aimed to identify patterns of preferences for SARS-CoV-2 screening and diagnostic testing prior to widespread vaccine availability and uptake.

METHODS

We conducted a discrete choice experiment (DCE) among participants in the national, prospective CHASING COVID (Communities, Households, and SARS-CoV-2 Epidemiology) Cohort Study from July 30 to September 8, 2020. The DCE elicited preferences for SARS-CoV-2 test type, specimen type, testing venue, and result turnaround time. We used latent class multinomial logit to identify distinct patterns of preferences related to testing as measured by attribute-level part-worth utilities and conducted a simulation based on the utility estimates to predict testing uptake if additional testing scenarios were offered.

RESULTS

Of the 5098 invited cohort participants, 4793 (94.0%) completed the DCE. Five distinct patterns of SARS-CoV-2 testing emerged. Noninvasive home testers (n=920, 19.2% of participants) were most influenced by specimen type and favored less invasive specimen collection methods, with saliva being most preferred; this group was the least likely to opt out of testing. Fast-track testers (n=1235, 25.8%) were most influenced by result turnaround time and favored immediate and same-day turnaround time. Among dual testers (n=889, 18.5%), test type was the most important attribute, and preference was given to both antibody and viral tests. Noninvasive dual testers (n=1578, 32.9%) were most strongly influenced by specimen type and test type, preferring saliva and cheek swab specimens and both antibody and viral tests. Among hesitant home testers (n=171, 3.6%), the venue was the most important attribute; notably, this group was the most likely to opt out of testing. In addition to variability in preferences for testing features, heterogeneity was observed in the distribution of certain demographic characteristics (age, race/ethnicity, education, and employment), history of SARS-CoV-2 testing, COVID-19 diagnosis, and concern about the pandemic. Simulation models predicted that testing uptake would increase from 81.6% (with a status quo scenario of polymerase chain reaction by nasal swab in a provider's office and a turnaround time of several days) to 98.1% by offering additional scenarios using less invasive specimens, both viral and antibody tests from a single specimen, faster turnaround time, and at-home testing.

CONCLUSIONS

We identified substantial differences in preferences for SARS-CoV-2 testing and found that offering additional testing options would likely increase testing uptake in line with public health goals. Additional studies may be warranted to understand if preferences for testing have changed since the availability and widespread uptake of vaccines.

Patterns of Injury in the Spanish Football League Players

BACKGROUND

The study of football injuries is a subject that concerns the scientific community. The problem of most of the available research is that it is mainly descriptive. The objective of this study is to discover and analyse the patterns of injury in the Spanish Football League (2016-2017 season).

METHODS

The sample data consisted of 136 given injuries identified by the official physicians of the football clubs. The analysis was performed by using traditional statistic tests, T-pattern detection and polar coordinate analysis.

RESULTS

The analysis revealed several patterns of injury: (a) The defender suffered a rupture of the hamstring muscles after a sprint, (b) knee sprains happened due to a received tackle, (c) fibrillar adductor rupture appeared mostly among defenders and (d) fibrillar ruptures took place mostly throughout the first part.

CONCLUSIONS

There is a marked shift in the tendency regarding the player who gets more injured, from the midfielder to the defender. The most common injury was fibrillar rupture. The most common scenario in which this injury occurred was that in which the player injured himself after a sprint (24%). A week without competing seems to be insufficient as a prevention mechanism for injuries.

Tracking Private WhatsApp Discourse About COVID-19 in Singapore: Longitudinal Infodemiology Study

BACKGROUND

Worldwide, social media traffic increased following the onset of the COVID-19 pandemic. Although the spread of COVID-19 content has been described for several social media platforms (eg, Twitter and Facebook), little is known about how such content is spread via private messaging platforms, such as WhatsApp (WhatsApp LLC).

OBJECTIVE

In this study, we documented (1) how WhatsApp is used to transmit COVID-19 content, (2) the characteristics of WhatsApp users based on their usage patterns, and (3) how usage patterns link to COVID-19 concerns.

METHODS

We used the experience sampling method to track day-to-day WhatsApp usage during the COVID-19 pandemic. For 1 week, participants reported each day the extent to which they had received, forwarded, or discussed COVID-19 content. The final data set comprised 924 data points, which were collected from 151 participants.

RESULTS

During the weeklong monitoring process, most participants (143/151, 94.7%) reported at least 1 COVID-19-related use of WhatsApp. When a taxonomy was generated based on usage patterns, around 1 in 10 participants (21/151, 13.9%) were found to have received and shared a high volume of forwarded COVID-19 content, akin to super-spreaders identified on other social media platforms. Finally, those who engaged with more COVID-19 content in their personal chats were more likely to report having COVID-19-related thoughts throughout the day.

CONCLUSIONS

Our findings provide a rare window into discourse on private messaging platforms. Such data can be used to inform risk communication strategies during the pandemic.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04367363; https://clinicaltrials.gov/ct2/show/NCT04367363.

Drinking and Social Media Use Among Workers During COVID-19 Pandemic Restrictions: Five-Wave Longitudinal Study

Background

The COVID-19 pandemic restricted everyday life during 2020-2021 for many people worldwide. It also affected alcohol consumption patterns and leisure activities, including the use of social media.

Objective

The aim of this study was to analyze whether social media use predicts increased risky drinking over time and during the COVID-19 pandemic restrictions in particular.

Methods

This 5-wave longitudinal survey study, based on a nationwide sample of workers, was conducted in Finland in 2019-2021. A total of 840 respondents (male: 473/840, 56.31%; age range 18-64 years; mean age 43.90, SD 11.14 years) participated in all 5 waves of the study. The outcome variable was risky drinking, measured using the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). Multilevel linear hybrid modeling enabled the investigation of both within-person and between-person effects. Predictors included social media use and communication, involvement in social media identity bubbles, psychological distress, and remote working. Controls included sociodemographic factors and the Big Five personality traits.

Results

Increased involvement in social media identity bubbles was associated with an increase in risky drinking behavior. Of all social media platforms examined, online dating app use was associated with riskier use of alcohol over time during the COVID-19 crisis. Daily social media communication with colleagues about nonwork topics was associated with risky drinking. Female gender, younger age, university education, nonindustrial occupational field, conscientiousness, agreeableness, and neuroticism were associated with lower levels of risky drinking.

Conclusions

Social media use during a pandemic carries some risks for alcohol consumption. Involvement in social media identity bubbles and online dating are risk factors for excessive drinking during the COVID-19 pandemic.

Generalizing Boltzmann Configurational Entropy to Surfaces, Point Patterns and Landscape Mosaics

Several methods have been recently proposed to calculate configurational entropy, based on Boltzmann entropy. Some of these methods appear to be fully thermodynamically consistent in their application to landscape patch mosaics, but none have been shown to be fully generalizable to all kinds of landscape patterns, such as point patterns, surfaces, and patch mosaics. The goal of this paper is to evaluate if the direct application of the Boltzmann relation is fully generalizable to surfaces, point patterns, and landscape mosaics. I simulated surfaces and point patterns with a fractal neutral model to control their degree of aggregation. I used spatial permutation analysis to produce distributions of microstates and fit functions to predict the distributions of microstates and the shape of the entropy function. The results confirmed that the direct application of the Boltzmann relation is generalizable across surfaces, point patterns, and landscape mosaics, providing a useful general approach to calculating landscape entropy.

The Impact of COVID-19 Pandemic on Orthopedic Trauma Practice: An Experience at a Tertiary Care Center in Northern India

The Impact of Covid -19 Pandemic on Orthopedic trauma practice: An experience at a tertiary care center in Northern India Introduction: COVID-19 pandemic and associated lockdown have had drastic effects on the health care system. To dedicate all the staff, residents, interns to covid care and accommodate the escalated inflow of infected persons, most hospitals had to restructure their departments. The orthopedic department was no exception. The present study aimed to evaluate trends in orthopedic trauma cases during two waves of the Covid -19 pandemic.

MATERIAL AND METHODS

In this retrospective observational study, the period of lockdown during the first wave of Covid (March 24, 2020, to May 31, 2020 (Period 2)) and the second wave in 2021 was compared with a similar nine weeks interval in 2019 before COVID -19 (Period 1). Demographic details and epidemiological parameters of trauma were collected and compared.

OBSERVATIONS

The number of admissions declined from 8.2 admissions/day to 2.3/day and 2.71/day in periods 2 and 3, respectively. Roadside accidents in 73.37% of patients in period 1 reduced to 30.43% and 59 36.2% in period 2 and 3, respectively. After soft tissue injuries, fractures around the hip joint dominated the pattern of injury during the lockdown, while polytrauma significantly decreased compared to the pre-covid era. More than 80% of patients during lockdown were treated conservatively.

CONCLUSION

Evaluation of differences in injury patterns and method of treatment during distinctive situations arising due to the COVID-19 pandemic will help to judicially plan and formulate protocols for more effective management of patients if similar events arise again.

Entropy in Landscape Ecology: A Quantitative Textual Multivariate Review

This paper presents a multivariate textual analysis of more than 1300 papers on entropy in ecology. There are six main insights that emerged. First, there is a large body of literature that has addressed some aspect of entropy in ecology, most of which has been published in the last 5-10 years. Second, the vast majority of these papers focus on species distribution, species richness, relative abundance or trophic structure and not landscape-scale patterns or processes, pe se. Third, there have been few papers addressing landscape-level questions related to entropy. Fourth, the quantitative analysis with hierarchical clustering identified a strongly nested structure among papers that addressed entropy in ecology. Fifth, there is clear differentiation of papers focused on landscape-level applications of entropy from other papers, with landscape focused papers clustered together at each level of the hierarchy in a relatively small and closely associated group. Sixth, this group of landscape-focused papers was substructured between papers that explicitly adopted entropy measures to quantify the spatial pattern of landscape mosaics, often using variations on Boltzmann entropy, versus those that utilize Shannon entropy measures from information theory, which are not generally explicit in their assessment of spatial configuration. This review provides a comprehensive, quantitative assessment of the scope, trends and relationships among a large body of literature related to entropy in ecology and for the first time puts landscape ecological research on entropy into that context.

Exploring the Relation between Atopic Diseases and Lifestyle Patterns among Adolescents Living in Greece: Evidence from the Greek Global Asthma Network (GAN) Cross-Sectional Study

Introduction: Diet and physical activity might be associated with the risk of allergic diseases in childhood. However, evidence in literature is sparse and diverse. We aim to examine the associations between four healthy dietary consumption pattern drinks, plus the adherence to a physically active lifestyle with atopic diseases (asthma, allergic rhinitis and eczema) in adolescence and their relative importance. Methods: A total of 1934 adolescents (921 boys, 47.5%) and their parents completed a validated questionnaire assessing atopic diseases’ symptoms prevalence in the past 12 months, as well as nutritional and physical activity information. Four healthy dietary and one physical active lifestyle patterns were identified and logistic regression was applied to assess their relation with allergic diseases. Results: A high weekly consumption of fruits, vegetables and pulses and low consumption of unhealthy foods was negatively associated with all atopic symptoms while adherence to a physical active lifestyle was inversely associated with asthma and allergic rhinitis symptoms and dairy products with asthma and eczema symptoms in the past 12 months after adjustment for several confounders (all p < 0.05). Fruits, vegetables and pulses consumption per week emerged as the most important lifestyle pattern negatively associated for all atopic diseases, after the adjustment for all the remaining lifestyle patterns and confounders (all p < 0.05) Conclusions: Our findings suggest that a high fruit, vegetable and pulse intake should be the first lifestyle intervention every clinician and public health care worker evolving in the management of atopic adolescents should encourage and promote.

Different Primary Sites of Hypopharyngeal Cancer Have Different Lymph Node Metastasis Patterns: A Retrospective Analysis From Multi-Center Data

Background

Most hypopharyngeal cancers (HPCs) develop lymph node metastasis (LNM) at initial diagnosis. Understanding the pattern of LNM in HPC could help both surgeons and radiologists make decisions in the management of cervical lymph nodes.

Methods

A total of 244 newly diagnosed HPC patients between January 2010 and December 2018 were recruited from three specialized cancer hospitals in mainland China. All patients received pre-treatment magnetic resonance imaging (MRI), and definitive radiotherapy with or without concurrent chemotherapy. We reassessed the features of the primary tumor (tumor size, primary location, and extent of invasion) and the involvement of lymph nodes at each level. According to the incidence of LNM, these levels were sequenced and sorted into drainage stations. Univariate and multivariate analyses were used to determine the risk factors for bilateral and regional lymph node metastasis.

Results

The cohort consisted of 195 piriform sinus cancers (PSC), 47 posterior wall cancers (PWC), and 2 post-cricoid cancers (PCC). A total of 176 patients (72.1%) presented with MRI-detectable LNMs. The overall LNM rates for level II-VI and retropharyngeal lymph nodes (RPLNs) were 59.0%, 52.9%, 14.3%, 1.6%, 2.9%, and 16.4%, respectively. Based on the prevalence of LNM at each level, we hypothesize that the lymphatic drainage of PSC was carried out in sequence along three stations: Level II and III (61.0% and 55.4%), Level IV and RPLN (15.9% and 11.3%), and Level V and VI (1.5% and 3.1%). For PWCs, lymphatic drainage is carried out at two stations: Level II, III, and RPLN (48.9%, 40.4%, and 34.0%) and Level IV-VI (6.4%, 0%, and 2.1%). According to univariate and multivariate analyses, posterior wall invasion was significantly correlated with bilateral LNM (P = 0.030, HR = 2.853 95%CI, 1.110-7.338) and RPLN metastasis (P = 0.017, HR = 2.880 95%CI, 1.209-6.862). However, pyriform sinus invasion was less likely to present with bilateral LNM (P = 0.027, HR = 0.311, 95%CI, 0.111-0.875) and RPLN metastasis (P = 0.028, HR = 0.346, 95%CI, 0.134-0.891).

Conclusions and Relevance

The primary tumor site and extent of invasion are related to the pattern of lymph node metastasis. That is, the metastasis would drainage station by station along different directions.

Enhanced H2 Evolution at Patterned MoSx-Modified Si-Based Photocathodes by Incorporating the Interfacial 3D Nanostructure of Ag

Photoelectrochemical cells represent one of the promising ways to renewably produce hydrogen (H₂) as a future chemical fuel. The design of a catalyst/semiconductor junction for the hydrogen evolution reaction (HER) requires various factors for high performance. In catalytic materials, an intrinsic activity with fast charge-transfer kinetics is important. Additionally, their thermodynamic property and physical adhesion should be compatible with the underlying semiconductor for favorable band alignment and stability during vigorous H₂ bubble formation. Moreover, catalysts, especially non-noble materials that demand a large amount of loading, should be adequately dispersed on the semiconductor surface to allow sufficient light absorption to generate excitons. One of the methods to simultaneously satisfy these conditions is to adopt an interfacial layer between the semiconductor and active materials in HER. The interfacial layer efficiently extracts the electrons from the semiconductor and conveys those to the catalytically active surface. We demonstrate Ag as a 3D interfacial nanostructure of patterned MoS_x catalysts for photoelectrochemical HER. The nanostructured porous Ag layer was introduced by a simple chemical process, followed by photoelectrochemical deposition of MoS_x to form MoS_x/Ag nanostructures in cross-shaped catalyst pattern arrays. Ag modulated the surface electronic property of MoS_x to improve the reaction kinetics as well as helped a charge transport at the Ag|p-Si(100) junction. The physically stable adhesion of catalysts was also achieved despite the ∼40 nm thick catalysts owing to the interfacial Ag nanostructure. This work contributes to further understand the complex multistep HER from light absorption to charge transfer to protons, helping to develop cost-effective and efficient photocathodes.

The relationship between mean platelet volume and reverse dipping blood pressure pattern in patients with essential hypertension

OBJECTIVE

An association between increased mean platelet volume (MPV) and cardiovascular events is well established. Recent studies suggest that a nondipper blood pressure pattern is closely related to increased MPV. Because little information has been revealed about the relationship between reverse dipper hypertension (RDHT) and MPV, we aimed to investigate this relation.

METHODS

A total of 317 patients were retrospectively evaluated by analyzing the records of ambulatory blood pressure monitoring (ABPM). Patients were categorized into three groups according to their ABPM values as RDHT (n = 63), non-dipper hypertension (NDHT) (n = 95), and dipper hypertension (DHT) groups (n = 159). MPV and biochemical analyses were recorded from the hospital database.

RESULTS

The largest MPV was found in patients with RDHT, followed by patients with NDHT and DHT group (9.1 ± 0.4 fl, 8.8 ± 0.6 fl, and 8.6 ± 0.5 fl, respectively, for all p < .05). MPV was positively correlated with mean 24-hour systolic blood pressure (SBP), mean 24-hour diastolic blood pressure (DBP), mean daytime SBP, mean nighttime SBP and mean nighttime DBP. In multivariate logistic regression analysis, MPV (OR 1.761, 95% CI 1.329 to 2.334, p = .001) and age (OR 1.065, 95% CI 1.019 to 1.113, p = .001) were found to be associated with RDHT. ROC curve analysis of MPV for prediction of RDHT showed that at the cutoff value of >9,1 fl with a sensitivity of 60% and specificity of 69%, respectively (AUC = 0.696 ± 0.035, 95% CI: 0.627-0.764). Our data show that the RDHT pattern is associated with increased MPV values in patients with essential hypertension.

Patterns of Injuries Among Children Diagnosed With Attention Deficit Hyperactivity Disorder in Aseer Region, Southwestern Saudi Arabia

Background

Globally, attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder that affects children. In 2011, there was an ADHD diagnosis prevalence of around 8% among children (4-17 years) in the US. ADHD-affected children are more prone to physical injuries such as physical trauma, accidental poisoning, burns, etc. This study was aimed to evaluate the association of ADHD with severe injuries, the influence of age and gender on this association, and the impact of ADHD medications on the frequency of such injuries.

Methodology

This study was conducted in three governmental and three private settings in Aseer region. The files of children who were diagnosed with ADHD in the study settings were reviewed for a 12-month time period. Data were extracted from the medical files using a pre-structured data extraction sheet to avoid errors and inter-rater bias. The extracted data included child gender, age, duration of disease, and injury-related data. A brief questionnaire had been applied to mothers regarding mothers' attitudes towards injuries among their children, adherence to medications, as well as the reasons for non-adherence to medications and clinical visits in a non-adherent group during the clinic visit.

Results

One hundred and sixty-three children with a diagnosis of ADHD completed the study. The affected children were aged between two and 15 years (mean: 7.8 ± 2.9 years). An exact of 116 (71.2%) children were males. An exact of 70 (42.9%) affected children had trauma. The most-reported traumas were superficial injuries (84.3%), burns (48.6%), fractures (37.1%), deep injuries (31.4%), and broken or lost teeth (28.6%). About 52% of the children were adherent to medications and their clinical visits. Among the non-adherent group, the most reported reasons were parents’ care and attention (20.5%), followed by the COVID-19 pandemic and delay in visits times (16.7%). Regarding mothers' attitudes towards injuries among children with ADHD, 49.1% of the mothers agreed that there is an association between a child with ADHD and being traumatized while 22.7% said there was no relation.

Conclusions

In our cohort, the majority of the children with ADHD were boys at primary school age. Association of the history of the disease with trauma was not uncommon, and most injuries were not severe, but burns and deep injuries were reported among considered portions.

Effect of Mechanical Properties on Multicomponent Shell Patterning

Self-organized shells are fundamental in biological compartmentalization. They protect genomic material or enclose enzymes to aid the metabolic process. Studies of crystalline shells have shown the importance of the mechanical properties of building units in the shell morphology. However, the mechanism underlying the morphology of multicomponent assemblies is still poorly understood. Here, we analyze multicomponent closed shells that have different mechanical properties. By minimizing elastic energy, we show that heterogeneous bending rigidities regulate the surface pattern into circular, spikes, and ridge shapes. Interestingly, our continuum elasticity model recovers the patterns that have been proposed in bacterial microcompartments (BMCs), which are self-organized protein shells that aid the breakdown of complex molecules and allow bacteria to survive in hostile environments. In addition, our work elucidates the principles of pattern formation that can be used to design and engineer multicomponent microcompartments with a specific surface distribution of the components.

Pattern of extranodal involvement and its impact on survival in diffuse large B-cell lymphoma from a tertiary cancer center in rural India

Introduction

Extranodal (EN) involvement in diffuse large B-cell lymphoma (DLBCL) carries poor prognosis. Both the number and the specific sites of EN involvement are important in predicting prognosis. Given that the epidemiologic pattern of DLBCL in India is different from the rest of the world and such data correlations are scarce from developing countries, we aimed to find out if specific site and number of EN involvement could predict survival in DLBCL.

Methods

Patients with DLBCL treated with combination chemotherapy plus rituximab were included. Site and number of EN involvement were noted. Univariate analysis for survival was performed for EN involvement or not, specific site of involvement, and number of EN involvement (0/1 vs. ≥2).

Results

Among a total of 177 patients, 92 (52%) patients had EN disease. When patients with 2 or more EN sites were compared against patients with 0 or 1 site, there was significant reduction in both progression-free survival (PFS) and overall survival (OS) (3-year OS of 55% vs. 79%, P = 0.001, 3-year PFS of 42% vs. 65%, P = 0.001). When specific EN sites were studied for correlation with survival, involvement of skin/soft tissue, and serosa were associated with significant reduction in 3-year OS (33% vs. 74%, P = 0.011, and 63% vs. 75%, P = 0.03, respectively) and 3-year PFS (25% vs. 62%, P < 0.001, and 46% vs. 62%, P = 0.01, respectively).

Conclusion

Two or more EN sites in DLBCL predicted inferior survival. Serosal and skin/soft tissue involvement also predicted poor survival.

Recognizing Pattern and Rule of Mutation Signatures Corresponding to Cancer Types

Cancer has been generally defined as a cluster of systematic malignant pathogenesis involving abnormal cell growth. Genetic mutations derived from environmental factors and inherited genetics trigger the initiation and progression of cancers. Although several well-known factors affect cancer, mutation features and rules that affect cancers are relatively unknown due to limited related studies. In this study, a computational investigation on mutation profiles of cancer samples in 27 types was given. These profiles were first analyzed by the Monte Carlo Feature Selection (MCFS) method. A feature list was thus obtained. Then, the incremental feature selection (IFS) method adopted such list to extract essential mutation features related to 27 cancer types, find out 207 mutation rules and construct efficient classifiers. The top 37 mutation features corresponding to different cancer types were discussed. All the qualitatively analyzed gene mutation features contribute to the distinction of different types of cancers, and most of such mutation rules are supported by recent literature. Therefore, our computational investigation could identify potential biomarkers and prediction rules for cancers in the mutation signature level.

Superhydrophobic Polymer Composite Surfaces Developed via Photopolymerization

Fabrication of superhydrophobic materials using incumbent techniques involves several processing steps and is therefore either quite complex, not scalable, or often both. Here, the development of superhydrophobic surface-patterned polymer-TiO₂ composite materials using a simple, single-step photopolymerization-based approach is reported. The synergistic combination of concurrent, periodic bump-like pattern formation created using irradiation through a photomask and photopolymerization-induced nanoparticle (NP) phase separation enables the development of surface textures with dual-scale roughness (micrometer-sized bumps and NPs) that demonstrate high water contact angles, low roll-off angles, and desirable postprocessability such as flexibility, peel-and-stick capability, and self-cleaning capability. The effect of nanoparticle concentration on surface porosity and consequently nonwetting properties is discussed. Large-area fabrication over an area of 20 cm², which is important for practical applications, is also demonstrated. This work demonstrates the capability of polymerizable systems to aid in the organization of functional polymer-nanoparticle surface structures.

Assessment of Habits of Tobacco Use among Dental and Nondental Students of Indian Population: A Cross-sectional Study

Background

Tobacco usage can be equated to an unending progressive pandemic which continues to spread globally at an alarming unhindered pace. Dental surgeons have a key role in initiating reduction and even cessation of tobacco habits. Hence, the present study was undertaken for analyzing the habits of tobacco use among dental and nondental students of Indian population.

Materials and Methods

A total of 500 dental students and 500 nondental students were enrolled in the present study. Among dental students, only interns were enrolled across different dental colleges of India. A questionnaire was framed and was sent to all the students in the form of Google Forms. The questionnaire contained questions pertaining to the assessment of prevalence of tobacco use and type of tobacco use habit. All the results were recorded and analyzed.

Results

Five hundred dental students and 500 nondental students were enrolled. Among the dental group, tobacco use habits were present in 23.8% of the students, whereas in the nondental group, tobacco use habits were present in 43.6% of the students. While comparing the prevalence of tobacco use habits among the dental and nondental groups, significant results were obtained. In the dental group, smoking habit and chewing habit were present in 44.54% and 32.77% of the students, respectively. In the nondental group, smoking habit and chewing habit were present in 52.29% and 29.82% of the students, respectively. While comparing the pattern of tobacco use among students of the two study groups, nonsignificant results were obtained.

Conclusion

There is an urgent need of tobacco cessation programs in the community to decrease the morbidity and mortality associated with it.

Introgression of ASIP and TYRP1 Alleles Explains Coat Color Variation in Valais Goats

The Valais Blackneck goat is a Swiss goat breed with a characteristic coat color phenotype. Before the revision of the breed standard in 1938, 4 different color varieties of Valais goats were known. Besides Blackneck animals resembling the modern breed standard, the brown and white Copperneck goat, the white Capra Sempione, and the greyish Grüenochte comprised the historic Valais goats. The brown pigmentation of Copperneck goats had previously been traced back to an introgression of a mutant TYRP1 allele from Toggenburg goats. In the present study, we identified additional introgression events of distinct ASIP alleles causing the remaining 2 rare coat color patterns within the Valais Blackneck goat breed. We identified the introgression of the AWt allele from Appenzell or Saanen goats in white Capra Sempione goats. Similarly, introgression of the Apc allele from Peacock goats resulted in the greyish Grüenochte phenotype. These results demonstrate past hybridization events between breeds that are separated today. A perfect genotype-phenotype association in 393 Valais goats supported the causality of the genotyped variants for the different coat color phenotypes. Our study gives insights into the introgression of functionally relevant copy number variant (CNV) alleles controlling pigmentation between goat breeds with strikingly different coat color patterns.

Pattern and Outcomes of Fall Injuries and Associated Factors in Emergency Department at Addis Ababa Burn, Emergency and Trauma Hospital

INTRODUCTION

Fall injuries are an important public health concern and remain a growing health problem globally. Falls are predicted to rise in rank compared to other causes of death, to become the 17th leading cause of death by 2030 unless necessary intervention is given.

PURPOSE

This study was aimed to assess the pattern, outcomes of fall injuries, and associated factors.

METHODS

A cross-sectional study design was employed to review a patient's registration chart from January 1, 2019 to December 31, 2019. Data were collected using a structured checklist developed from previous similar studies. The checked data were entered into Epi data 4.1 versions. Then, it was exported to SPSS 25 versions for analysis. Data were analyzed using descriptive statistics and logistic regression. In the multivariate logistic regression predictors having a P-value < 0.05 were considered to be statistically associated.

RESULTS

A total of 331 patients' charts were reviewed. The most common outcome of falling injury was alive 284 (85.8%) while death accounts for 47 (14.2%). Among injured body parts, extremity accounts for around one-fourth, 88 (26.6%), followed by head injury 68 (20.5%). In multivariate logistic regression, those patients aged ≥65 years had 6.15 times more likely to die than those patients aged between 15 and 30 years (AOR 6.15; 95% CI 2.82-14.37, P=0.015), and participants with comorbidity were 1.6 times more likely to die than to be discharged (AOR 1.60; 95% CI, 1.01-5.09, P=0.005) due to falling injury, whereas patient's occupation, marital status, and sex had no significant association with outcomes of a fall injury.

CONCLUSION

The most common outcomes of fall injury were discharged with improvement even though there was a high death rate. Extremity injuries were the most common pattern of injury. Fall is high-risk mortality in the older age group. Furthermore, patient with comorbidity, fall from height and injury to spinal cord and poly-trauma is more likely to die relative to other patients.

Pterygium in Onitsha, Nigeria

Objective

To determine the pattern and risk factors of pterygium in adults at the Guinness Eye Centre Onitsha, Nigeria.

Materials and Methods

Consecutive adults aged ≥30 years with pterygium were studied. Each patient had comprehensive ocular examination including visual acuity, anterior segment, and adnexal assessment and fundoscopy. The pterygium was graded in terms of severity and type.

Results

A total of 156 patients with pterygium participated; 92 (59%) females versus 64 (41%) males (F:M =3:2). The age range was 30-65 years; mean: 43.9 ± 8.4 years. The majority of the study population (36.5%) was of the age group 40-49 years. The subjects were predominately traders 78 (50%) and 93 (59.6%) of the pterygium patients were outdoor workers. Bivariate analysis indicated that those involved in outdoor work were six times at greater risk of developing pterygium than indoor workers (P = 0.001; OR = 6.2). Out of the 156 pterygium patients seen, 107 (68.6%) of them complained of associated symptoms. Redness of the eye was the commonest symptom reported by 79 (50.9%) cases while 8 (5.1%) cases complained of burning sensation. There was a preponderance of nasal pterygia with temporal pterygia being the least. Blinding pterygium was seen in three eyes (1.3%).

Conclusion

Pterygium is a common disorder presenting at eye clinics. Outdoor workers are at a greater risk of developing pterygium. Thus, health education is of great importance.

Lessons learned from post-COVID-19 vaccination PET/CT studies

Vaccination against coronavirus 2019 (COVID-19) has created new challenges. Lymphadenopathy with increased uptake in patients undergoing PET/CT may mislead to unnecessary further evaluation. We have analyzed routinely performed PET/CT studies after Pfizer-BioNTech vaccination to familiarize ourselves with the PET/CT appearance of various PET tracers and to prevent the consequences of misinterpretation. Methods: We analyzed 1,018 PET/CT studies performed between January 1, 2021, and February 15, 2021. Information about the dates and sites of vaccination was collected. Visual and semiquantitative analysis of axillary–neck lymphadenopathy and arm uptake was correlated with immunization data. Results: Increased uptake in axillary lymphadenopathy was observed unilaterally in 66% of vaccinated patients, in 55% of patients vaccinated once, and in 69% of those vaccinated twice. The intensity of uptake decreased over time. Fifty-four of 274 patients (20%) had simultaneous increased activity in the posterior arm and ipsilateral axillary lymphadenopathy (double sign [DS]). The sensitivity, specificity, positive predictive value, and negative predictive value were 55.4%, 83.6%, 86.7%, 49.2%, respectively, for axillary lymphadenopathy and 38.6%, 100%, 100%, and 66.1%, respectively, for DS. No DS was observed later than 10 and 21 d after the first and the second vaccinations, respectively. None of the nonvaccinated patients had arm uptake or DS. Conclusion: Vaccination against COVID-19 frequently causes nonspecific axillary lymphadenopathy with increased PET tracer activity. In one fifth of our study population, this lymphadenopathy was associated with increased uptake at the vaccination site, DS. DS was 100% specific, with a 100% positive predictive value for postvaccination lymphadenopathy, hence enabling avoidance of misinterpretation of PET/CT studies and further unnecessary evaluation.

Online Interactive Platform for COVID-19 Literature Visual Analytics: Platform Development Study

BACKGROUND

Papers on COVID-19 are being published at a high rate and concern many different topics. Innovative tools are needed to aid researchers to find patterns in this vast amount of literature to identify subsets of interest in an automated fashion.

OBJECTIVE

We present a new online software resource with a friendly user interface that allows users to query and interact with visual representations of relationships between publications.

METHODS

We publicly released an application called PLATIPUS (Publication Literature Analysis and Text Interaction Platform for User Studies) that allows researchers to interact with literature supplied by COVIDScholar via a visual analytics platform. This tool contains standard filtering capabilities based on authors, journals, high-level categories, and various research-specific details via natural language processing and dozens of customizable visualizations that dynamically update from a researcher's query.

RESULTS

PLATIPUS is available online and currently links to over 100,000 publications and is still growing. This application has the potential to transform how COVID-19 researchers use public literature to enable their research.

CONCLUSIONS

The PLATIPUS application provides the end user with a variety of ways to search, filter, and visualize over 100,00 COVID-19 publications.

COVID-19 Pandemic as a Traumatic Event and Its Associations with Fear and Mental Health: A Cognitive-Activation Approach

The COVID-19 global pandemic still represents a major threat with detrimental health consequences. Analyzing the psychological outcomes, COVID-19 could be interpreted as a collective traumatic event that can generate symptoms related to post-traumatic stress disorder (PTSD). Considering this, the purpose of this paper is twofold: first, to investigate the relationship between intrusive thoughts and fear related to the COVID-19 pandemic and between intrusive thoughts and mental health; second, to test the mediating role of hyperarousal and avoidance in these two relationships. In order to reach these aims, the present study investigated these relationships and tested a mediation model in two cross-sectional studies in Italy. Altogether, 627 individuals and 495 workers completed an online survey for study 1 and study 2, respectively. Mediation analyses were performed via the SPSS macro PROCESS; the significance of total, direct, and indirect effect was tested via bootstrapping. The results showed that within the PTSD framework, hyperarousal compared with avoidance mediated the relationship between intrusion and the analyzed outcomes. In conclusion, the present study provided empirical evidence for the influence of hyperarousal on individual consequences such as fear of COVID-19 and mental health. Research, as well as theoretical and practical implications, are discussed.

Patterns and compound specific stable carbon isotope analysis (δ13 C) of capsaicinoids in Cayenne chilli fruits of different ripening stages

INTRODUCTION

Capsaicinoids are alkaloids of high pungency which are exclusively formed by fruits of the genus Capsicum. Capsaicinoid content and composition of Capsicum fruits are influenced by ripening.

OBJECTIVE

Determination of changes in content and pattern of individual capsaicinoids in chilli pods with fruit ripening. Compound specific stable carbon isotope analysis (δ¹³ C values (‰), CSIA) was used for a better understanding of capsaicinoid development during fruit ripening.

METHODOLOGY

Cayenne chillies (Capsicum annuum) were grown in a glasshouse and harvested from different plants at four ripening stages (unripe, semi-ripe, ripe, overripe). Nine capsaicinoids (one verified by synthesis) were quantified by gas chromatography with mass spectrometry (GC-MS). For CSIA, an acetylation method for derivatising capsaicinoids was developed.

RESULTS

Variations in the patterns of the nine capsaicinoids were not relatable to a distinct ripening stage and also total contents varied extensively from plant to plant. However, changes in total capsaicinoid concentrations were systematic. In almost all plants, maximum values were reached in unripe fruits, then decreased to semi-ripe samples and increased again in the following ripening process. Likewise, δ¹³ C values of individual capsaicinoids were always by ~2‰ heavier in unripe than in semi-ripe or ripe fruits. However, direction of changes in sum-δ¹³ C values (‰) (taking contributions of all capsaicinoids together) could not be explained by corresponding variations in capsaicinoid concentrations.

CONCLUSIONS

Both quantification and δ¹³ C values (‰) verified the presence of ripening-related changes in the capsaicinoid content which may be caused by simultaneously proceeding reactions like synthesis, storage and degradation of capsaicinoids.

Estimating the COVID-19 Spread Through Real-time Population Mobility Patterns: Surveillance in Low- and Middle-Income Countries

Background

On January 21, 2020, the World Health Organization reported the first case of severe acute respiratory syndrome coronavirus 2, which rapidly evolved to the COVID-19 pandemic. Since then, the virus has also rapidly spread among Latin American, Caribbean, and African countries.

Objective

The first aim of this study is to identify new emerging COVID-19 clusters over time and space (from January 21 to mid-May 2020) in Latin American, Caribbean, and African regions, using a prospective space–time scan measurement approach. The second aim is to assess the impact of real-time population mobility patterns between January 21 and May 18, 2020, under the implemented government interventions, measurements, and policy restrictions on COVID-19 spread among those regions and worldwide.

Methods

We created a global COVID-19 database, of 218 countries and territories, merging the World Health Organization daily case reports with other measures such as population density and country income levels for January 21 to May 18, 2020. A score of government policy interventions was created for low, intermediate, high, and very high interventions. The population’s mobility patterns at the country level were obtained from Google community mobility reports. The prospective space–time scan statistic method was applied in five time periods between January and May 2020, and a regression mixed model analysis was used.

Results

We found that COVID-19 emerging clusters within these five periods of time increased from 7 emerging clusters to 28 by mid-May 2020. We also detected various increasing and decreasing relative risk estimates of COVID-19 spread among Latin American, Caribbean, and African countries within the period of analysis. Globally, population mobility to parks and similar leisure areas during at least a minimum of implemented intermediate-level control policies (when compared to low-level control policies) was related to accelerated COVID-19 spread. Results were almost consistent when regional stratified analysis was applied. In addition, worldwide population mobility due to working during high implemented control policies and very high implemented control policies, when compared to low-level control policies, was related to positive COVID-19 spread.

Conclusions

The prospective space–time scan is an approach that low-income and middle-income countries could use to detect emerging clusters in a timely manner and implement specific control policies and interventions to slow down COVID-19 transmission. In addition, real-time population mobility obtained from crowdsourced digital data could be useful for current and future targeted public health and mitigation policies at a global and regional level.

Therapeutic Properties of Edible Mushrooms and Herbal Teas in Gut Microbiota Modulation

Edible mushrooms are functional foods and valuable but less exploited sources of biologically active compounds. Herbal teas are a range of products widely used due to the therapeutic properties that have been demonstrated by traditional medicine and a supplement in conventional therapies. Their interaction with the human microbiota is an aspect that must be researched, the therapeutic properties depending on the interaction with the microbiota and the consequent fermentative activity. Modulation processes result from the activity of, for example, phenolic acids, which are a major component and which have already demonstrated activity in combating oxidative stress. The aim of this mini-review is to highlight the essential aspects of modulating the microbiota using edible mushrooms and herbal teas. Although the phenolic pattern is different for edible mushrooms and herbal teas, certain non-phenolic compounds (polysaccharides and/or caffeine) are important in alleviating chronic diseases. These specific functional compounds have modulatory properties against oxidative stress, demonstrating health-beneficial effects in vitro and/or In vivo. Moreover, recent advances in improving human health via gut microbiota are presented. Plant-derived miRNAs from mushrooms and herbal teas were highlighted as a potential strategy for new therapeutic effects.

Basal cell carcinoma of the eyelid margin: Dermoscopic clues in a case series

Basal cell carcinoma (BCC) can sometimes affect the eyelids and in particular the eyelid margin, where it can often be misdiagnosed, mimicking other benign, more common diseases. Dermoscopy may provide additional diagnostic criteria for an earlier diagnosis of eyelid margin BCC, although the dermoscopic features of BCC affecting this anatomical site have seldom been reported. We highlight the peculiar presence of linear vessels perpendicular to the eyelid margin in BCCs of the eyelid margin. Our article represents the first report of these dermoscopic findings in a series of BCCs of the eyelid margin.

Typical Pain Patterns in Unhappy Patients After Total Knee Arthroplasty

BACKGROUND

The primary aim of this study is to assess characteristics of pain in patients with ongoing pain after total knee arthroplasty (TKA). The secondary aim of this study is to identify specific pain patterns and link these to underlying pathologies.

METHODS

A prospectively collected cohort of 97 painful primary TKA patients was retrospectively evaluated. All patients followed a standardized diagnostic algorithm, which led to a diagnosis that set the indication for revision surgery. Character, location, dynamics, and radiation of pain were systematically assessed and correlated with the underlying pathologies.

RESULTS

Most frequent pain characters were pricking/lancinating (45.7%), pinching/crushing, and dull/heavy (38.6%); 89.5% of all patients localized their knee pain anteriorly; 48.1% reported pain aggravations by descending stairs. Radiating pain was reported in 14% of the patients. Patella-related problems (56.7%) and instability (52.6%) were the most frequent pathologies. Based on correlations between the characteristics 6 specific pain patterns were identified. The most outstanding ones include the following: pattern 1, instability is associated with jumping/shooting, pricking/lancinating and tugging/wrenching pain, and aggravated by chair raising and starting; pattern 6, pain aggravation by descending stairs is associated with anterior and lateral jumping/shooting, tingling/stinging and sharp/lacerating pain character, and TKA positioning and patella baja.

CONCLUSION

The assessment of painful TKA patients involving specific pain patterns help to further differentiate and define the clinical picture and ultimately the cause of a painful TKA. If the causes of the described complaints are known, a decision for a therapy can be made reliably and sustainably at an early stage before the state of pain becomes chronic.

Relationship Between Different Risk Factor Patterns and Follow-Up Outcomes in Patients With ST-Segment Elevation Myocardial Infarction

Objective: Few studies have been concerned with the combined influences of the presence of multiple risk factors on follow-up outcomes in AMI patients. Our study aimed to identify risk factor patterns that may be associated with 1-year survival in male patients with ST-segment elevation myocardial infarction (STEMI). Methods: Data were from the China STEMI Care Project Phase 2 (CSCAP-2) collected between 2015 and 2018. A total of 15,675 male STEMI patients were enrolled in this study. Risk factor patterns were characterized using latent class analysis (LCA) according to seven risk factors. Associations between risk factor patterns and follow-up outcomes, including the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause death, were investigated by Cox proportional hazard regression analysis. Results: We obtained four risk factor patterns as "young and middle-aged with low levels of multimorbidity," "middle-aged with overweight," "middle-aged and elderly with normal weight," and "elderly with high multimorbidity." Four patterns had significant differences in event-free survival (P < 0.001). As compared with the patients of "young and middle-aged with low levels of multimorbidity" pattern, the risk of incidence of MACCE and all-cause death were increased in patients of "middle-aged with overweight" pattern (All-cause death: HR = 1.70, 95% CI:1.29~2.23; MACCE: HR = 1.49, 95% CI:1.29~1.72), "middle-aged and elderly with normal weight" pattern (All-cause death: HR = 3.04, 95% CI: 2.33~3.98; MACCE: HR = 1.82, 95% CI: 1.56~2.12), and "elderly with high multimorbidity" pattern (All-cause death: HR = 5.78, 95% CI: 4.49~7.42; MACCE: HR = 2.67, 95% CI: 2.31~3.10). Conclusions: By adopting a Latent Class Analysis Approach, STEMI patients can be characterized into four risk factor patterns with significantly different prognosis. The data is useful for the improvement of community health management in each specific subgroup of patients, which indicates a particular risk factor pattern.

Discrimination and Quantitation of Biologically Relevant Carboxylate Anions Using A [Dye•PAMAM] Complex

Carboxylate anions are analytical targets with environmental and biological relevance, whose detection is often challenging in aqueous solutions. We describe a method for discrimination and quantitation of carboxylates in water buffered to pH 7.4 based on their differential interaction with a supramolecular fluorescent sensor, self-assembled from readily available building blocks. A fifth-generation poly(amidoamine) dendrimer (PAMAM G5), bound to organic fluorophores (calcein or pyranine) through noncovalent interactions, forms a [dye•PAMAM] complex responsive to interaction with carboxylates. The observed changes in absorbance, and in fluorescence emission and anisotropy, were interpreted through linear discriminant analysis (LDA) and principal component analysis (PCA) to differentiate 10 structurally similar carboxylates with a limit of discrimination around 100 μM. The relationship between the analytes’ chemical structures and the system’s response was also elucidated. This insight allowed us to extend the system’s capabilities to the simultaneous identification of the nature and concentration of unknown analytes, with excellent structural identification results and good concentration recovery, an uncommon feat for a pattern-based sensing system.

The Great Mime: Three Cases of Melanoma with Carcinoid-Like and Paraganglioma-Like Pattern with Emphasis on Differential Diagnosis

Melanoma is among the most aggressive tumors, with different histological patterns of presentation ranging from the usual and easily diagnosable pictures to complex patterns of difficult diagnostic interpretation. Here, we present three cases of a very rare melanoma variant described as "carcinoid-like" and "paraganglioma-like" in the literature, and a brief review of the current literature of the very few cases described to date.

Identification of Epidemiological Traits by Analysis of SARS-CoV-2 Sequences

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the ongoing global COVID-19 pandemic that began in late December 2019. The rapid spread of SARS-CoV-2 is primarily due to person-to-person transmission. To understand the epidemiological traits of SARS-CoV-2 transmission, we conducted phylogenetic analysis on genome sequences from >54K SARS-CoV-2 cases obtained from two public databases. Hierarchical clustering analysis on geographic patterns in the resulting phylogenetic trees revealed a co-expansion tendency of the virus among neighboring countries with diverse sources and transmission routes for SARS-CoV-2. Pairwise sequence similarity analysis demonstrated that SARS-CoV-2 is transmitted locally and evolves during transmission. However, no significant differences were seen among SARS-CoV-2 genomes grouped by host age or sex. Here, our identified epidemiological traits provide information to better prevent transmission of SARS-CoV-2 and to facilitate the development of effective vaccines and therapeutics against the virus.

Deep Learning Prediction of Metastasis in Locally Advanced Colon Cancer Using Binary Histologic Tumor Images

In this study, we developed the Binary ImaGe Colon Metastasis classifier (BIg-CoMet), a semi-guided approach for the stratification of colon cancer patients into two risk groups for the occurrence of distant metastasis, using an InceptionResNetV2-based deep learning model trained on binary images. We enrolled 291 colon cancer patients with pT3 and pT4 adenocarcinomas and converted one cytokeratin-stained representative tumor section per case into a binary image. Image augmentation and dropout layers were incorporated to avoid overfitting. In a validation collective (n = 128), BIg-CoMet was able to discriminate well between patients with and without metastasis (AUC: 0.842, 95% CI: 0.774-0.911). Further, the Kaplan-Meier curves of the metastasis-free survival showed a highly significant worse clinical course for the high-risk group (log-rank test: p < 0.001), and we demonstrated superiority over other established risk factors. A multivariable Cox regression analysis adjusted for confounders supported the use of risk groups as a prognostic factor for the occurrence of metastasis (hazard ratio (HR): 5.4, 95% CI: 2.5-11.7, p < 0.001). BIg-CoMet achieved good performance for both UICC subgroups, especially for UICC III (n = 53), with a positive predictive value of 80%. Our study demonstrates the ability to stratify colon cancer patients via a semi-guided process on images that primarily reflect tumor architecture.

Secular Trends in Physical Activity Among Immigrants in the United States, 2009-2018

BACKGROUND

The objective of this study was to evaluate secular trends in domain-specific physical activity in the immigrant population in the US between 2009 and 2018.

METHOD

A secondary data analysis from the 2009-2018 National Health and Nutrition Examination Survey; a total of 7282 immigrants in the US were included in this analysis. All domain-specific physical activity was assessed by a self-reported questionnaire. Tests for linear trends were performed to examine the trends of each physical activity time using orthogonal polynomial coefficients. Physical activity trends were assessed by the whole group and the various subgroups.

RESULTS

Total physical activity showed an upward linear trend in female (Ptrend = .04) and young adult (Ptrend = .009) immigrants. Work-related physical activity showed an upward linear trend in young adult immigrants (Ptrend = .01). Recreational physical activity showed an upward linear trend in young adult (Ptrend = .03) and Mexican American (Ptrend < .001) immigrants and in immigrants living in the US for 15-29 years (Ptrend = .02). In contrast, we observed downward linear trends in transit-related physical activity for immigrants across male (Ptrend = .04), middle-aged adult (Ptrend = .01), and non-Hispanic black groups (Ptrend = .004) and in immigrants living in the US for 15-29 years (Ptrend = .03).

CONCLUSION

There were no significant linear trends in the 4 domains of physical activity in the overall US immigrant population; however, trends in domain-specific physical activity in the US immigrant population differed by gender, age, race/ethnicity, and length of residence. These findings may inform physical activity promotion strategies targeting US immigrant populations with diverse sociocultural backgrounds.

Methods of Generating Dielectrophoretic Force for Microfluidic Manipulation of Bioparticles

Manipulation of microscale bioparticles including living cells is of great significance to the broad bioengineering and biotechnology fields. Dielectrophoresis (DEP), which is defined as the interactions between dielectric particles and the electric field, is one of the most widely used techniques for the manipulation of bioparticles including cell separation, sorting, and trapping. Bioparticles experience a DEP force if they have a different polarization from the surrounding media in an electric field that is nonuniform in terms of the intensity and/or phase of the electric field. A comprehensive literature survey shows that the DEP-based microfluidic devices for manipulating bioparticles can be categorized according to the methods of creating the nonuniformity via patterned microchannels, electrodes, and media to generate the DEP force. These methods together with the theory of DEP force generation are described in this review, to provide a summary of the methods and materials that have been used to manipulate various bioparticles for various specific biological outcomes. Further developments of DEP-based technologies include identifying materials that better integrate with electrodes than current popular materials (silicone/glass) and improving the performance of DEP manipulation of bioparticles by combining it with other methods of handling bioparticles. Collectively, DEP-based microfluidic manipulation of bioparticles holds great potential for various biomedical applications.

Characterizing the Anticancer Treatment Trajectory and Pattern in Patients Receiving Chemotherapy for Cancer Using Harmonized Observational Databases: Retrospective Study

BACKGROUND

Accurate and rapid clinical decisions based on real-world evidence are essential for patients with cancer. However, the complexity of chemotherapy regimens for cancer impedes retrospective research that uses observational health databases.

OBJECTIVE

The aim of this study is to compare the anticancer treatment trajectories and patterns of clinical events according to regimen type using the chemotherapy episodes determined by an algorithm.

METHODS

We developed an algorithm to extract the regimen-level abstracted chemotherapy episodes from medication records in a conventional Observational Medical Outcomes Partnership (OMOP) common data model (CDM) database. The algorithm was validated on the Ajou University School Of Medicine (AUSOM) database by manual review of clinical notes. Using the algorithm, we extracted episodes of chemotherapy from patients in the EHR database and the claims database. We also developed an application software for visualizing the chemotherapy treatment patterns based on the treatment episodes in the OMOP-CDM database. Using this software, we generated the trends in the types of regimen used in the institutions, the patterns of the iterative chemotherapy use, and the trajectories of cancer treatment in two EHR-based OMOP-CDM databases. As a pilot study, the time of onset of chemotherapy-induced neutropenia according to regimen was measured using the AUSOM database. The anticancer treatment trajectories for patients with COVID-19 were also visualized based on the nationwide claims database.

RESULTS

We generated 178,360 treatment episodes for patients with colorectal, breast, and lung cancer for 85 different regimens. The algorithm precisely identified the type of chemotherapy regimen in 400 patients (average positive predictive value >98%). The trends in the use of routine clinical chemotherapy regimens from 2008-2018 were identified for 8236 patients. For a total of 12 regimens (those administered to the largest proportion of patients), the number of repeated treatments was concordant with the protocols for standard chemotherapy regimens for certain cases. In addition, the anticancer treatment trajectories for 8315 patients were shown, including 62 patients with COVID-19. A comparative analysis of neutropenia showed that its onset in colorectal cancer regimens tended to cluster between days 9-15, whereas it tended to cluster between days 2-8 for certain regimens for breast cancer or lung cancer.

CONCLUSIONS

We propose a method for generating chemotherapy episodes for introduction into the oncology extension module of the OMOP-CDM databases. These proof-of-concept studies demonstrated the usability, scalability, and interoperability of the proposed framework through a distributed research network.

Exploring epigenetic biomarkers of universal specificities and commonalities among pan-cancer cohorts in The Cancer Genome Atlas

Aim: To explore the mechanism of cancer by employing a comprehensive analysis of DNA methylation patterns and variations among pan-cancer cohorts. Materials & methods: This research focused on the discovery of universally specific or common biomarkers by mathematical statistics and machine learning methods in The Cancer Genome Atlas. Results: We found 138 differently methylated CpGs (DMCs) with a common methylation trend and eight common differently methylated regions in different cancer cohorts. Additionally, we found 99 DMCs to distinguish 32 different cancer cohorts in random forest analysis because of the specificity mechanism, but each DMC still had high instability. Conclusion: Our results could facilitate the development of biomarkers that are universally specific and common features across pan-cancer cohorts.

Deep Segmentation of Point Clouds of Wheat

The 3D analysis of plants has become increasingly effective in modeling the relative structure of organs and other traits of interest. In this paper, we introduce a novel pattern-based deep neural network, Pattern-Net, for segmentation of point clouds of wheat. This study is the first to segment the point clouds of wheat into defined organs and to analyse their traits directly in 3D space. Point clouds have no regular grid and thus their segmentation is challenging. Pattern-Net creates a dynamic link among neighbors to seek stable patterns from a 3D point set across several levels of abstraction using the K-nearest neighbor algorithm. To this end, different layers are connected to each other to create complex patterns from the simple ones, strengthen dynamic link propagation, alleviate the vanishing-gradient problem, encourage link reuse and substantially reduce the number of parameters. The proposed deep network is capable of analysing and decomposing unstructured complex point clouds into semantically meaningful parts. Experiments on a wheat dataset verify the effectiveness of our approach for segmentation of wheat in 3D space.

Plug Regime Flow Velocity Measurement Problem Based on Correlability Notion and Twin Plane Electrical Capacitance Tomography: Use Case

In this paper, the authors present the flow velocity measurement based on twin plane sensor electrical capacitance tomography and the cross-correlation method. It is shown that such a technique has a significant restriction for its use, particularly for the plug regime of a flow. The major issue is with the irregular regime of the flow when portions of propagated material appear in different time moments. Thus, the requirement of correlability of analyzed input signal patterns should be met. Therefore, the checking of the correlability should be considered by such a technique. The article presents a study of the efficiency of the original algorithm of automatic extraction of the suitable signal patterns which has been recently proposed, to calculate flow velocity. The obtained results allow for choosing in practice the required parameters of the algorithm to correct the extraction of signal patterns in a proper and accurate way. Various examples of the application of the discussed algorithm were presented, along with the analysis of the influence of the parameters used on the quality of plugs identification and determination of material flow.

In Vitro Modulatory Effect of Stevioside, as a Partial Sugar Replacer in Sweeteners, on Human Child Microbiota

The effect of stevioside on human health is still insufficiently highlighted by recent research. The total or partial replacement of sugar with sweeteners influences the general state of health, especially the human microbiota's response as a determining factor in the onset of type 2 diabetes. The present study aimed to present the long-term (one-year) in vitro effect that regular stevioside consumption had on children's pattern microbiota. A metabolomic response was established by determining the synthesis of organic acids and a correlation with antioxidant status. An increase in the number of bacterial strains and the variation of amount of butyrate and propionate to the detriment of lactic acid was observed. The effect was evidenced by the progressive pH increasing, the reduction of acetic acid, and the proliferation of Escherichia coli strains during the simulations. Synthesis of the main short-chain fatty acids (SCFAs) was interpreted as a response (adaptation) of the microbiota to the stevioside, without a corresponding increase in antioxidant status. This study demonstrated the modulatory role of stevioside on the human microbiota and on the fermentation processes that determine the essential SCFA synthesis in maintaining homeostasis. The protection of the microbiota against oxidative stress was also an essential aspect of reducing microbial diversity.

Pattern of Ocular Involvement in Midface Injuries Seen at a Tertiary Care Hospital in Northern Nigeria

Aim:

The aim of the study was to report the etiology, pattern, and spectrum of ocular injuries in patients with maxillofacial injuries seen at a tertiary care hospital in northern Nigeria.

Patients and Methods:

This is a retrospective evaluation of the etiology, spectrum, and treatment of ocular injures seen in patients with midfacial fractures, who presented at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria, a tertiary care hospital in northern Nigeria. Cases were seen at the oral and maxillofacial clinic for those presenting with midfacial fractures, whereas those presenting with ocular injuries due to midfacial injuries were referred from the ophthalmology department. Data were collected on their demographics, etiology of injuries, body part(s) involved, and treatment.

Results:

A total of 256 patients had midfacial injuries during the period, of which 219 patients had 357 associated ocular injuries. The age range was between 3 and 76 years. There were more males (83.8%) than females (16.2%), giving a male-to-female ratio of 5.2:1; the 21–30 years' age bracket was most frequently affected (38.4%). The predominant etiology of injuries was road traffic accidents (RTAs) (90.1%), followed by assault (4.9%). Zygomatic complex fractures (38.6%) and orbital wall fractures (24.7%) were the common midfacial injuries. There were 357 ocular injuries, giving a patient: injury ratio of 1:1.6, with subconjunctival hemorrhage (32.5%) and ruptured globe (20.0%) being common. Treatments performed were reduction and immobilization of midfacial fractures plus evisceration (32.0%), followed by reduction and immobilization of fractures alone (23.9%) and reduction and immobilization plus grafting of soft tissues (21.2%).

Conclusion:

Ocular injuries are quite common in patients with midfacial injuries, with a ratio of 1.6:1. RTA was the most common etiology, with zygomatic complex fractures as the most common midfacial injury. Subconjunctival hemorrhage was the most common ocular injury manifestation, with young adults (21–30 years of age) being most affected. Treatment often involved reduction and immobilization of midface fractures with evisceration and grafting of ocular tissues.

PlantLayout pipeline to model tissue patterning

To study the mechanisms underlying developmental pattern formation in a tissue, one needs to analyze the dynamics of the regulators in time and space across the tissue of a specific architecture. This problem is essential for the developmental regulators (morphogens) that distribute over the tissues anisotropically, forming there maxima and gradients and guiding cellular processes in a dose-dependent manner. Here we present the PlantLayout pipeline for MATLAB software, which facilitates the computational studies of tissue patterning. With its help, one can build a structural model of a two-dimensional tissue, embed it into a mathematical model in ODEs, perform numerical simulations, and visualize the obtained results - everything on the same platform. As a result, one can study the concentration dynamics of developmental regulators over the cell layout reconstructed from the real tissue. PlantLayout allows studying the dynamics and the output of gene networks guided by the developmental regulator in specific cells. The gene networks could be different for different cell types. One of the obstacles that PlantLayout removes semi-automatically is the determination of the cell wall orientation which is relevant when cells in the tissue have a polarity. Additionally, PlantLayout allows automatically extracting other quantitative and qualitative features of the cells and the cell walls, which might help in the modeling of a developmental pattern, such as the length and the width of the cell walls, the set of the neighboring cells, cell volume and cell perimeter. We demonstrate PlantLayout performance on the model of phytohormone auxin distribution over the plant root tip.

Prevalence, pattern and predictors of sexual abuse among young female hawkers in Kano metropolis, Nigeria

Context

Sexual abuse of young female hawkers is a subject of public health importance with resultant long-lasting physical and mental consequences.

Aims

This study assessed the prevalence, pattern and predictors of sexual abuse among female hawkers in Kano State, Nigeria.

Settings and Design

Using a descriptive cross-sectional design and two-stage sampling technique, female hawkers in Kano metropolis were studied.

Subjects and Methods

An adapted and pre-tested semi-structured interviewer-administered questionnaire was used to obtain information from 236 female hawkers. Data were analysed with SPSS Statistics, version 24.0 software. Prevalence and pattern of sexual abuse was determined and adjusted odds ratios of predictors derived from binary logistic regression models.

Results

The prevalence of sexual abuse was 68.6%. Forms of sexual abuse reported included verbal abuse (38.1%), inappropriate touch (64.0%) and rape (25.8%). Predictors of sexual abuse included respondents' age (adjusted odds ratio [aOR] = 10.65, 95% confidence interval [CI] [2.92-38.84]), ethnicity (aOR = 4.26, 95% CI [1.30-14.00]), highest educational attainment (aOR = 0.38, 95% CI [0.15-0.99]), residence with parent (s) (aOR = 0.07, 95%CI [0.01-0.54]) and parents being alive (aOR = 6.79, 95%CI [1.41-32.62]).

Conclusions

Sexual abuse is prevalent among female hawkers and the forms experienced ranged from verbal abuse to inappropriate touch and rape. Interventions that delay age at the commencement of hawking, ensure the education of the girl child and support parental care could foster more matured and smart female hawkers who can avoid sexual abuse.

The Relationship Between the Global Burden of Influenza From 2017 to 2019 and COVID-19: Descriptive Epidemiological Assessment

BACKGROUND

SARS-CoV-2 and influenza are lipid-enveloped viruses with differential morbidity and mortality but shared modes of transmission.

OBJECTIVE

With a descriptive epidemiological framing, we assessed whether recent historical patterns of regional influenza burden are reflected in the observed heterogeneity in COVID-19 cases across regions of the world.

METHODS

Weekly surveillance data reported by the World Health Organization from January 2017 to December 2019 for influenza and from January 1, 2020 through October 31, 2020, for COVID-19 were used to assess seasonal and temporal trends for influenza and COVID-19 cases across the seven World Bank regions.

RESULTS

In regions with more pronounced influenza seasonality, COVID-19 epidemics have largely followed trends similar to those seen for influenza from 2017 to 2019. COVID-19 epidemics in countries across Europe, Central Asia, and North America have been marked by a first peak during the spring, followed by significant reductions in COVID-19 cases in the summer months and a second wave in the fall. In Latin America and the Caribbean, COVID-19 epidemics in several countries peaked in the summer, corresponding to months with the highest influenza activity in the region. Countries from regions with less pronounced influenza activity, including South Asia and sub-Saharan Africa, showed more heterogeneity in COVID-19 epidemics seen to date. However, similarities in COVID-19 and influenza trends were evident within select countries irrespective of region.

CONCLUSIONS

Ecological consistency in COVID-19 trends seen to date with influenza trends suggests the potential for shared individual, structural, and environmental determinants of transmission. Using a descriptive epidemiological framework to assess shared regional trends for rapidly emerging respiratory pathogens with better studied respiratory infections may provide further insights into the differential impacts of nonpharmacologic interventions and intersections with environmental conditions. Ultimately, forecasting trends and informing interventions for novel respiratory pathogens like COVID-19 should leverage epidemiologic patterns in the relative burden of past respiratory pathogens as prior information.

The Silva Pattern-based Classification for HPV-associated Invasive Endocervical Adenocarcinoma and the Distinction Between In Situ and Invasive Adenocarcinoma: Relevant Issues and Recommendations From the International Society of Gynecological Pathologists

The Silva pattern-based classification for human papilloma virus-associated invasive adenocarcinoma has emerged as a reliable system to predict risk of lymph node metastasis and recurrences. Although not a part of any staging system yet, it has been incorporated in synoptic reports as established by the College of American Pathologists (CAP) and the International Collaboration on Cancer Reporting (ICCR). Moreover, the current National Comprehensive Cancer Network (NCCN) guidelines include this classification as an "emergent concept." In order to facilitate the understating and application of this new classification by all pathologists, the ISGyP Endocervical Adenocarcinoma Project Working Group presents herein all the current evidence on the Silva classification and aims to provide recommendations for its implementation in practice, including interpretation, reporting, and application to biopsy and resection specimens. In addition, this article addresses the distinction of human papilloma virus-associated adenocarcinoma in situ and gastric type adenocarcinoma in situ from their invasive counterparts.

Lexicon Development for COVID-19-related Concepts Using Open-source Word Embedding Sources: An Intrinsic and Extrinsic Evaluation

BACKGROUND

Scientists are developing new computational methods and prediction models to better clinically understand COVID-19 prevalence, treatment efficacy, and patient outcomes. These efforts could be improved by leveraging documented COVID-19-related symptoms, findings, and disorders from clinical text sources in an electronic health record. Word embeddings can identify terms related to these clinical concepts from both the biomedical and nonbiomedical domains, and are being shared with the open-source community at large. However, it's unclear how useful openly available word embeddings are for developing lexicons for COVID-19-related concepts.

OBJECTIVE

Given an initial lexicon of COVID-19-related terms, this study aims to characterize the returned terms by similarity across various open-source word embeddings and determine common semantic and syntactic patterns between the COVID-19 queried terms and returned terms specific to the word embedding source.

METHODS

We compared seven openly available word embedding sources. Using a series of COVID-19-related terms for associated symptoms, findings, and disorders, we conducted an interannotator agreement study to determine how accurately the most similar returned terms could be classified according to semantic types by three annotators. We conducted a qualitative study of COVID-19 queried terms and their returned terms to detect informative patterns for constructing lexicons. We demonstrated the utility of applying such learned synonyms to discharge summaries by reporting the proportion of patients identified by concept among three patient cohorts: pneumonia (n=6410), acute respiratory distress syndrome (n=8647), and COVID-19 (n=2397).

RESULTS

We observed high pairwise interannotator agreement (Cohen kappa) for symptoms (0.86-0.99), findings (0.93-0.99), and disorders (0.93-0.99). Word embedding sources generated based on characters tend to return more synonyms (mean count of 7.2 synonyms) compared to token-based embedding sources (mean counts range from 2.0 to 3.4). Word embedding sources queried using a qualifier term (eg, dry cough or muscle pain) more often returned qualifiers of the similar semantic type (eg, "dry" returns consistency qualifiers like "wet" and "runny") compared to a single term (eg, cough or pain) queries. A higher proportion of patients had documented fever (0.61-0.84), cough (0.41-0.55), shortness of breath (0.40-0.59), and hypoxia (0.51-0.56) retrieved than other clinical features. Terms for dry cough returned a higher proportion of patients with COVID-19 (0.07) than the pneumonia (0.05) and acute respiratory distress syndrome (0.03) populations.

CONCLUSIONS

Word embeddings are valuable technology for learning related terms, including synonyms. When leveraging openly available word embedding sources, choices made for the construction of the word embeddings can significantly influence the words learned.

Pattern Unifies Autism

Autism is a highly heterogeneous condition, genetically and phenotypically. This diversity of causation and presentation has impeded its definition, recognition, assessment, and treatment. Current diagnostic criteria for autism involve two domains, restricted interests and repetitive behavior (RRBs) and social deficits, whose relationship remains unclear. I suggest that the large suite of traits associated with autism can be usefully conceptualized under the single rubric of "pattern," a term that connects autism with basic brain and cognitive functions and structures its phenotypes within a single theoretical framework. Autism thus involves increases and enhancements to pattern perception, pattern recognition, pattern maintenance, pattern generation, pattern processing, and pattern seeking. RRBs result from increased and imbalanced pattern-related perception and cognition, and social alterations result in part from the usual lack of clear pattern in social interactions, combined with the interference of RRBs with social development. This framework has strong implications for assessment of social and non-social autism-related traits, personalized therapy, and priorities for research.

Diagnosis of tuberculosis pleurisy with three endoscopic features via pleuroscopy

Background:

Tuberculosis (TB) is a constant threat even with a worldwide active public health campaign. Diagnosis of TB pleurisy is challenging in the case of pleural effusion of unknown origin after aspiration analysis. The study was designed to demonstrate a simple image interpretation technique to differentiate TB pleurisy from non-TB pleurisy using semi-rigid pleuroscopy.

Methods:

The study retrospectively enrolled 117 patients who underwent semi-rigid pleuroscopy from April 2016 to August 2018 in a tertiary hospital. We analyzed the possibility of TB pleurisy using three simple pleuroscopic images via semi-rigid pleuroscopy.

Results:

Among 117 patients, 28 patients (23.9%) were diagnosed with TB pleurisy. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 20 (71.4%), 20 (71.4%), and 19 (67.9%) patients with TB pleurisy, respectively. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in six (6.7%), 37 (41.6%), and no (0.0%) patients with non-TB pleurisy, respectively. The positive and negative predictive values of any two out of three pleuroscopic patterns for TB pleurisy were 100.0% and 93.7%, respectively.

Conclusions:

A high positive predictive value for TB pleurisy was demonstrated by the presence of any two out of the three characteristic features. Absence of all three features had an excellent negative predictive value for TB pleurisy. Our diagnostic criteria reconfirm that pleuroscopic images can be used as predictors for TB pleurisy in patients with undiagnosed pleural effusion.

The reviews of this paper are available via the supplementary material section.

Physical Activity Behavior Before, During, and After COVID-19 Restrictions: Longitudinal Smartphone-Tracking Study of Adults in the United Kingdom

BACKGROUND

The COVID-19 pandemic led to the implementation of worldwide restrictive measures to reduce social contact and viral spread. These measures have been reported to have a negative effect on physical activity (PA). Studies of PA during the pandemic have primarily used self-reported data. The single academic study that used tracked data did not report on demographics.

OBJECTIVE

This study aimed to explore patterns of smartphone-tracked activity before, during, and immediately after lockdown in the United Kingdom, and examine differences by sociodemographic characteristics and prior levels of PA.

METHODS

Tracked longitudinal weekly minutes of PA were captured using the BetterPoints smartphone app between January and June 2020. Data were plotted by week, demographics, and activity levels at baseline. Nonparametric tests of difference were used to assess mean and median weekly minutes of activity at significant points before and during the lockdown, and as the lockdown was eased. Changes over time by demographics (age, gender, Index of Multiple Deprivation, baseline activity levels) were examined using generalized estimating equations (GEEs).

RESULTS

There were 5395 users with a mean age of 41 years (SD 12) and 61% (n=3274) were female. At baseline, 26% (n=1422) of users were inactive, 23% (n=1240) were fairly active, and 51% (n=2733) were active. There was a relatively even spread across deprivation deciles (31% [n=1693] in the least deprived deciles and 23% in the most [n=1261]). We found significant changes in PA from the week before the first case of COVID-19 was announced (baseline) to the week that social distancing restrictions were relaxed (Friedman test: χ22=2331, P<.001). By the first full week of lockdown, the median change in PA was 57 minutes less than baseline. This represents a 37% reduction in weekly minutes of PA. Overall, 63% of people decreased their level of activity between baseline and the first week of COVID-19 restrictions. Younger people showed more PA before lockdown but the least PA after lockdown. In contrast, those aged >65 years appeared to remain more active throughout and increased their activity levels as soon as lockdown was eased. Levels of PA among those classed as active at baseline showed a larger drop compared with those considered to be fairly active or inactive. Socioeconomic group and gender did not appear to be associated with changes in PA.

CONCLUSIONS

Our tracked PA data suggests a significant drop in PA during the United Kingdom's COVID-19 lockdown. Significant differences by age group and prior PA levels suggests that the government's response to COVID-19 needs to be sensitive to these individual differences and the government should react accordingly. Specifically, it should consider the impact on younger age groups, encourage everyone to increase their PA, and not assume that people will recover prior levels of PA on their own.