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A benchmarking study of SARS-CoV-2 whole-genome sequencing protocols using COVID-19 patient samples.

iScience 2021 Jul 21:102892. Epub 2021 Jul 21.

Center for Genomics, School of Medicine, Loma Linda University, Loma Linda, California, United States of America.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging new type of coronavirus that is responsible for the COVID-19 pandemic and the unprecedented global health emergency. Whole-genome sequencing (WGS) of SARS-CoV-2 plays a critical role in understanding the disease. Performance variation exists across SARS-CoV-2 viral WGS technologies, but there is currently no benchmarking study comparing different WGS sequencing protocols. Read More

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Cost-Effectiveness of Population Level and Individual Level Interventions to Combat Non-communicable Disease in Eastern Sub-Saharan Africa and South East Asia: A WHO-CHOICE Analysis.

Int J Health Policy Manag 2021 Jun 7. Epub 2021 Jun 7.

Department of Management of Non Communicable Diseases, Violence and Injury, World Health Organization, Geneva, Switzerland.

Background: To determine the health system costs and health-related benefits of interventions for the prevention and control of non-communicable diseases (NCDs), including mental health disorders, for the purpose of identifying the most cost-effective intervention options in support of global normative guidance on the best-buy interventions for NCDs. In addition, tools are developed to allow country contextualisation of the analyses to support local priority setting exercises.

Methods: This analysis follows the standard WHO-CHOICE (World Health Organization-Choosing Interventions that are Cost-Effective) approach to generalized cost-effectiveness analysis applied to two regions, Eastern sub-Saharan Africa and South-East Asia. Read More

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Virtual Care: Choosing the Right Tool, at the Right Time.

Ann Fam Med 2021 Jul-Aug;19(4):365-367

Kaiser Permanente of Washington, Burien, Washington

When the immediate threat of COVID-19 subsides, the future of health care will involve more virtual care. Before the pandemic, patient choice rather than clinician guidance determined which medium (telephone visits, video visits, electronic messaging) was used to receive care. Two media synchronicity theory principles-conveyance and convergence-can create a framework for determining how to choose the right medium of care for the patient. Read More

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Management algorithms and artificial intelligence systems for cardiopulmonary bypass.

Perfusion 2021 Jul 12:2676591211030762. Epub 2021 Jul 12.

Department of Cardiac Surgery, Anthea Hospital - GVM Care & Research, Bari, Italy.

This article introduces management algorithms to support operators in choosing the best strategy for metabolic management during cardiopulmonary bypass using artificial intelligence systems. We developed algorithms for the identification of the optimal way for assessing metabolic parameters. Different management algorithms for extracorporeal procedures interfaced with metabolic monitoring systems already exist on the market and are applied in clinical practice. Read More

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Perioperative Anaphylaxis: Evaluation and Management.

Clin Rev Allergy Immunol 2021 Jul 10. Epub 2021 Jul 10.

Division of Allergic Diseases, Mayo Clinic, Rochester, MN, 55905, USA.

Perioperative anaphylaxis (PA) is a rare but life-threatening condition that poses diagnostic and management challenges in the operating room. The incidence of severe perioperative reactions is estimated to be approximately 1:7000-10,000. Management involves both immediate stabilization of the patient and identifying the culprit agent. Read More

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Show Me Your Face: Towards an Automated Method to Provide Timely Guidance in Visual Analytics.

IEEE Trans Vis Comput Graph 2021 Jul 7;PP. Epub 2021 Jul 7.

Providing guidance during a Visual Analytics session can support analysts in pursuing their goals more efficiently. However, the effectiveness of guidance depends on many factors: Determining the right timing to provide it is one of them. Although in complex analysis scenarios choosing the right timing could make the difference between a dependable and a superfluous guidance, an analysis of the literature suggests that this problem did not receive enough attention. Read More

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Development of an integrated model of care for allogeneic stem cell transplantation facilitated by eHealth-the SMILe study.

Support Care Cancer 2021 Jul 5. Epub 2021 Jul 5.

Institute of Nursing Science, Department Public Health, University of Basel, Basel, Switzerland.

Purpose: Allogeneic stem cell transplantation would benefit from re-engineering care towards an integrated eHealth-facilitated care model. With this paper we aim to: (1) describe the development of an integrated care model (ICM) in allogeneic SteM-cell-transplantatIon faciLitated by eHealth (SMILe) by combining implementation, behavioral, and computer science methods (e.g. Read More

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Unsupervised Learning of Non-Hermitian Topological Phases.

Phys Rev Lett 2021 Jun;126(24):240402

Center for Quantum Information, IIIS, Tsinghua University, Beijing 100084, People's Republic of China.

Non-Hermitian topological phases bear a number of exotic properties, such as the non-Hermitian skin effect and the breakdown of conventional bulk-boundary correspondence. In this Letter, we introduce an unsupervised machine learning approach to classify non-Hermitian topological phases based on diffusion maps, which are widely used in manifold learning. We find that the non-Hermitian skin effect will pose a notable obstacle, rendering the straightforward extension of unsupervised learning approaches to topological phases for Hermitian systems ineffective in clustering non-Hermitian topological phases. Read More

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Exploring Factors Impacting on the Lane Choice of Riders of Non-Motorized Vehicles at Exit Legs of Signalized At-Grade Intersections.

Int J Environ Res Public Health 2021 06 11;18(12). Epub 2021 Jun 11.

School of Transportation, Southeast University, Nanjing 210096, China.

For most signalized at-grade intersections, exclusive lanes for non-motorized vehicles have been applied to improve the level of service, capacity and safety of both motorized vehicles and non-motorized vehicles. However, because of various factors, riders of non-motorized vehicles have been observed using lanes for motorized vehicles instead of lanes for non-motorized vehicles, which usually negatively influences the performance of signalized intersections and sometimes may cause serious problems such as traffic congestion and accidents. The objective of this paper is to explore factors influencing the lane choice of riders of non-motorized vehicles at exit legs of signalized at-grade intersections and develop a prediction model for riders' lane choice. Read More

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A Six Sigma DMAIC methodology as a support tool for Health Technology Assessment of two antibiotics.

Math Biosci Eng 2021 Apr;18(4):3469-3490

Department of Electrical Engineering and Information Technology (DIETI), University of Naples "Federico II", Naples, Italy.

Health Technology Assessment (HTA) and Six Sigma (SS) have largely proved their reliability in the healthcare context. The former focuses on the assessment of health technologies to be introduced in a healthcare system. The latter deals with the improvement of the quality of services, reducing errors and variability in the healthcare processes. Read More

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Substandard and falsified medicines: proposed methods for case finding and sentinel surveillance.

JMIR Public Health Surveill 2021 Jun 27. Epub 2021 Jun 27.

Faculty of Pharmacy, Universitas Pancasila, Jakarta, ID.

Unstructured: Background: The World Health Organization and others warn that substandard and falsified medicines harm health and waste money, especially in low and middle income countries. However, no country has measured the extent of the problem market-wide, and no agreed methods exist to estimate prevalence of either substandard or falsified medicines. This is in part because the task seems overwhelming; medicine markets are huge and diverse, and testing medicines is expensive. Read More

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Analysis of steady-state carbon tracer experiments using akaike information criteria.

Metabolomics 2021 Jun 19;17(7):61. Epub 2021 Jun 19.

Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Introduction: Carbon isotope tracers have been used to determine relative rates of tricarboxylic acid cycle (TCA) cycle pathways since the 1950s. Steady-state experimental data are typically fit to a single mathematical model of metabolism to determine metabolic fluxes. Whether the chosen model is appropriate for the biological system has generally not been evaluated systematically. Read More

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Cambridge Protocol for Management of Segmental Bone Loss.

J Orthop Case Rep 2021 ;11(1):45-50

Department of Trauma and Orthopaedic Surgery, Cambridge University Hospital, Cambridge, United Kingdom.

Introduction: Segmental long bone defects are some of the most challenging to surgically reconstruct; however, there is no clear guidance on which of the myriad of techniques is superior in a given clinical context. We describe three cases of segmental bone loss presenting to a major trauma center and have use these to develop a treatment algorithm for the sub-acute management of such fractures.

Case Report: Case 1 - Acute shortening and delayed lengthening using lengthening intramedullary (IM) nail to treat diaphyseal non-union of the femur with associated 3 cm shortening. Read More

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January 2021

Real-world outcomes with extended-release buprenorphine (XR-BUP) in a low threshold bridge clinic: A retrospective case series.

J Subst Abuse Treat 2021 Jul 2;126:108316. Epub 2021 Feb 2.

Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, United States of America. Electronic address:

Background: In clinical trial settings, extended-release buprenorphine (XR-BUP) is noninferior to sublingual buprenorphine and may offer some advantages. However, real-world experiences of XR-BUP are limited and outcomes are unknown for low-threshold clinics with high-risk populations. Practical guidance is lacking on overcoming treatment challenges, such as inability for some to stabilize on sublingual (SL) BUP for seven days prior to XR-BUP and ongoing craving/withdrawal symptoms during treatment. Read More

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Experimental Design of Preclinical Experiments: Number of PDX Lines versus Subsampling within PDX Lines.

Neuro Oncol 2021 Jun 9. Epub 2021 Jun 9.

Department of Radiation Oncology, Mayo Clinic, Rochester, MN.

Background: Appropriately designed preclinical patient-derived xenograft (PDX) experiments are important to accurately inform human clinical trials. There is little experimental design guidance regarding choosing the number of PDX lines to study, and the number of mice within each PDX line.

Methods: Retrospective data from IDH-wildtype glioblastoma preclinical experiments evaluating a uniform regimen of fractionated radiation (RT), temozolomide (TMZ) chemotherapy, and concurrent RT/TMZ across 27 PDX lines were used to evaluate experimental designs and empirically estimate statistical power for analysis of variance (ANOVA) and Cox regression. Read More

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Choosing a Metamodel of a Simulation Model for Uncertainty Quantification.

Med Decis Making 2021 Jun 8:272989X211016307. Epub 2021 Jun 8.

Department of Epidemiology and Biostatistics, Amsterdam UMC, Location VUMC, Amsterdam, the Netherlands.

Background: Metamodeling may substantially reduce the computational expense of individual-level state transition simulation models (IL-STM) for calibration, uncertainty quantification, and health policy evaluation. However, because of the lack of guidance and readily available computer code, metamodels are still not widely used in health economics and public health. In this study, we provide guidance on how to choose a metamodel for uncertainty quantification. Read More

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Embracing informed learner self-assessment during debriefing: the art of plus-delta.

Adv Simul (Lond) 2021 Jun 5;6(1):22. Epub 2021 Jun 5.

KidSIM Simulation Program, Alberta Children's Hospital, Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, T3B 6A8, Canada.

The healthcare simulation field has no shortage of debriefing options. Some demand considerable skill which serves as a barrier to more widespread implementation. The plus-delta approach to debriefing offers the advantages of conceptual simplicity and ease of implementation. Read More

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Effects of fasting on patients with chronic kidney disease during Ramadan and practical guidance for healthcare professionals.

Clin Kidney J 2021 Jun 5;14(6):1524-1534. Epub 2021 Feb 5.

University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, Scotland.

There are an estimated 1.8 billion Muslims worldwide, with the majority of them choosing to fast during the month of Ramadan. Fasting, which requires abstinence from food and drink from dawn to sunset can be up to 20 h per day during the summer months in temperate regions. Read More

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Promoting healthy foods among urban school children in Bangladesh: a qualitative inquiry of the challenges and opportunities.

BMC Public Health 2021 06 1;21(1):1029. Epub 2021 Jun 1.

Universal Health Coverage, Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.

Background: In Bangladesh overweight and obesity among urban school children are on the rise. Urban school children tend to consume foods dense in calories and few fruits and vegetables which is associated with overweight and obesity. The current study explored the barriers and opportunities for promoting healthy diets among school children from the perspective of teachers and parents in Dhaka, Bangladesh. Read More

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Patient-reported outcomes and patient-reported outcome measures in interstitial lung disease: where to go from here?

Eur Respir Rev 2021 Jun 25;30(160). Epub 2021 May 25.

Dept of Respiratory Diseases and Allergy, Centre for Rare Lung Diseases, Aarhus University Hospital, Aarhus N, Denmark.

Patient-reported outcome measures (PROMs), tools to assess patient self-report of health status, are now increasingly used in research, care and policymaking. While there are two well-developed disease-specific PROMs for interstitial lung diseases (ILD) and idiopathic pulmonary fibrosis (IPF), many unmet and urgent needs remain. In December 2019, 64 international ILD experts convened in Erice, Italy to deliberate on many topics, including PROMs in ILD. Read More

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Clinical effects of different anesthesia methods in lateral episiotomy.

Ann Ital Chir 2021 ;92:190-195

Objectives: To investigate the clinical effects of different anesthesia methods in lateral episiotomy. Providing the guidance of choosing the appropriate anesthesia method in clinical operation.

Methods: A total of 300 primiparas with vaginal delivery were enrolled into this study. Read More

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January 2021

The detailed clinical objectives approach to designing clinical trials and choosing estimands.

Pharm Stat 2021 May 20. Epub 2021 May 20.

Global Biostatistics and Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany.

Objective setting is a necessary early step in the development of a clinical trial. ICH E9(R1) notes that the clinical objectives of a trial lead directly to the choice of estimands but barely discusses objectives themselves. Indeed, there is very little guidance anywhere in literature about objectives in clinical trials. Read More

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Practical Recommendations for the Management of Patients with ITP During the COVID-19 Pandemic.

Mediterr J Hematol Infect Dis 2021 1;13(1):e2021032. Epub 2021 May 1.

Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

The current COVID-19 pandemic requires revisiting our current approach to major blood disorders, including ITP (Immune Thrombocytopenia), stirring up the production of several disease-specific practical guidelines. This report describes an updated version of consensus-based practical guidelines on the management of ITP, adapted to the Italian health system and social context. It highlights the role of the hematologist in offering guidance for choosing differentiated approaches in relation to specific circumstances and is intended to provide them with a useful tool for sharing the decision-making process with their patients. Read More

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Addressing Fairness, Bias, and Appropriate Use of Artificial Intelligence and Machine Learning in Global Health.

Front Artif Intell 2020 15;3:561802. Epub 2021 Apr 15.

Massachusetts Institute of Technology, Cambridge, MA, United States.

In Low- and Middle- Income Countries (LMICs), machine learning (ML) and artificial intelligence (AI) offer attractive solutions to address the shortage of health care resources and improve the capacity of the local health care infrastructure. However, AI and ML should also be used cautiously, due to potential issues of fairness and algorithmic bias that may arise if not applied properly. Furthermore, populations in LMICs can be particularly vulnerable to bias and fairness in AI algorithms, due to a lack of technical capacity, existing social bias against minority groups, and a lack of legal protections. Read More

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Telemedicine consultations with physicians in Swedish primary care: a mixed methods study of users' experiences and care patterns.

Scand J Prim Health Care 2021 Jun 11;39(2):204-213. Epub 2021 May 11.

School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.

Objective: The study aimed to explore users' experiences and care patterns concerning telemedicine consultations with physicians in Swedish primary care from 2017 to 2019.: A mixed methods study involving 26 qualitative interviews with users of telemedicine consultations from a national sample, complemented by a quantitative registry study of data from 10,400 users in a Swedish region.

Results: Users mainly described telemedicine consultations as a positive experience and perceived that the service met their current health care needs. Read More

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Two Small Molecule Inhibitors Promote Reprogramming of Guangxi Bama Mini-Pig Mesenchymal Stem Cells Into Naive-Like State Induced Pluripotent Stem Cells.

Cell Reprogram 2021 Jun 5;23(3):158-167. Epub 2021 May 5.

Animal Reproduction Institute, State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, Guangxi University, Nanning, P.R. China.

Past researches have shown that pluripotency maintenance of naive and primed-state pluripotent stem cells (PSCs) depends on different signaling pathways, and naive-state PSCs possess the ability to produce chimeras when they are introduced into a blastocyst. Considering porcine is an attractive model for preclinical studies, many researches about pig induced pluripotent stem cells (piPSCs) have been reported. Some cytokines and small molecule compounds could transform primed piPSCs into naive state. Read More

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Updated guidance on the management of cancer treatment-induced bone loss (CTIBL) in pre- and postmenopausal women with early-stage breast cancer.

J Bone Oncol 2021 Jun 18;28:100355. Epub 2021 Mar 18.

Bone Centre, Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands.

Introduction: Adjuvant endocrine therapy induces bone loss and increases fracture risk in women with hormone-receptor positive, early-stage breast cancer (EBC). We aimed to update a previous position statement on the management of aromatase inhibitors (AIs) induced bone loss and now included premenopausal women.

Methods: We conducted a systematic literature search of the medical databases from January 2017 to May 2020 and assessed 144 new studies. Read More

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Variable selection methods for identifying predictor interactions in data with repeatedly measured binary outcomes.

J Clin Transl Sci 2020 Nov 16;5(1):e59. Epub 2020 Nov 16.

Department of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA.

Introduction: Identifying predictors of patient outcomes evaluated over time may require modeling interactions among variables while addressing within-subject correlation. Generalized linear mixed models (GLMMs) and generalized estimating equations (GEEs) address within-subject correlation, but identifying interactions can be difficult if not hypothesized . We evaluate the performance of several variable selection approaches for clustered binary outcomes to provide guidance for choosing between the methods. Read More

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November 2020

Systematic THz study of the substrate effect in limiting the mobility of graphene.

Sci Rep 2021 Apr 22;11(1):8729. Epub 2021 Apr 22.

Department of Physics, University of Ottawa, Ottawa, Canada.

We explore the substrate-dependent charge carrier dynamics of large area graphene films using contact-free non-invasive terahertz spectroscopy. The graphene samples are deposited on seven distinct substrates relevant to semiconductor technologies and flexible/photodetection devices. Using a Drude model for Dirac fermions in graphene and a fitting method based on statistical signal analysis, we extract transport properties such as the charge carrier density and carrier mobility. Read More

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