Ten principles for data sharing and commercialization Cole, Curtis L; Sengupta, Soumitra; Rossetti (née Collins), Sarah ...
Journal of the American Medical Informatics Association : JAMIA,
03/2021, Letnik:
28, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Abstract
Digital medical records have enabled us to employ clinical data in many new and innovative ways. However, these advances have brought with them a complex set of demands for healthcare ...institutions regarding data sharing with topics such as data ownership, the loss of privacy, and the protection of the intellectual property. The lack of clear guidance from government entities often creates conflicting messages about data policy, leaving institutions to develop guidelines themselves. Through discussions with multiple stakeholders at various institutions, we have generated a set of guidelines with 10 key principles to guide the responsible and appropriate use and sharing of clinical data for the purposes of care and discovery. Industry, universities, and healthcare institutions can build upon these guidelines toward creating a responsible, ethical, and practical response to data sharing.
Vaccination is one of the essential measures in reducing transmission, morbidity, and mortality rates of a disease. However, the COVID-19 vaccination is facing hesitancy across the globe, Malawi ...included. A population-based cross-sectional study was conducted in Malawi to document knowledge, attitudes, and practices on COVID-19 vaccination. The study targeted the general adult population and employed a multi-stage sampling technique. The Census Enumeration Areas within the 16 selected districts served as a primary sampling unit. Among the total 3068 participants, 1947 (63.6%) were female. About 1039 (34.1%) participants had primary education, while only 169 (5.5%) had college education. A total of 2936 (95.7%) participants knew about the COVID-19 vaccine, and 2063 (68.4%) felt that the COVID-19 vaccine was effective. A total of 1180 (38.7%) got vaccinated. Knowledge of the COVID-19 vaccination was significantly associated with participants' education levels, location, occupation, marital status, household family income, and whether they were suffering from chronic illness or not. Overall, the level of knowledge and attitudes about the COVID-19 vaccination was good. This study has also established that different population groups have statistically different levels of knowledge and attitudes regarding COVID-19 vaccination. This study has also indicated a significant relationship between the rate of vaccination and several factors. Therefore, this calls for stakeholders to continue awareness and group-targeted tailored campaigns so as to increase COVID-19 vaccination.
This pilot study presents an environmental DNA (eDNA) assay for sea lamprey Petromyzon marinus and brown trout Salmo trutta, two species of economic and conservation importance in the Republic of ...Ireland. The results demonstrate the effectiveness of eDNA for assessing presence of low‐abundance taxa (here, P. marinus) for environmental managers, and they highlight the potential for assessing relative abundance of rare or invasive freshwater species.
Left Ventricular Tachycardia in Pediatrics
Introduction
The aim of this study was to evaluate the clinical presentation and outcomes of pediatric patients with ventricular tachycardia (VT) ...originating from left heart structures.
Methods and Results
This international multicenter retrospective study including 152 patients (age 10.0 ± 5.1 years, 62% male), divided into those with fascicular VT (85%, 129/152) and nonfascicular LV VT (15%, 23/152). All patients had a normal heart structure or only a minor cardiac abnormality. Adenosine was largely ineffective in both groups (tachycardia termination in 4/74 of fascicular VT and 0/5 of nonfascicular LV VT). In fascicular VT, calcium channel blockers were effective in 80% (74/92); however, when administered orally, there was a 21% (13/62) recurrence rate. In nonfascicular LV VT, a variety of antiarrhythmic therapies were used with no one predominating. Ablation procedures were successful in 71% (72/102) of fascicular VT and 67% (12/18) of nonfascicular LV VT on an intention to treat analysis. Major complications occurred in 5 patients with fascicular VT and 1 patient with nonfascicular LV VT. After a follow‐up period of 2 years (1 day to 15 years), 72% of all patients with fascicular VT were off medications with no tachycardia recurrence. One patient died of noncardiac causes. In nonfascicular LV VT, follow‐up was 3.5 years (0.5–15 years), P = 0.38. A total of 65% of these patients were free from arrhythmias. Two patients died suddenly (P < 0.01).
Conclusion
The clinical course and outcomes of pediatric patients with fascicular VT and nonfascicular LV VT are varied. Catheter ablation procedures can be curative.
Introduction
This study aimed to examine the relationship between gender, apolipoprotein E (APOE) genotype, and mesial temporal atrophy in mild cognitive impairment (MCI) with and without progression ...to Alzheimer’s disease (AD).
Methods
We evaluated 236 MCI patients with (
n
= 121) and without (
n
= 115) AD progression. Longitudinal MRI-based hippocampal volumes (HV) and entorhinal cortex (ERC) thickness were obtained. The Clinical Dementia Rating Sum of Boxes (CDR-SB) score was used to assess disease severity.
Results
We found a significant effect of APOE, gender, and clinical course (stable MCI versus MCI-AD progression) on HV. There was a significant effect of clinical course and APOE, but not gender, on ERC. Baseline HV and APOE4 status predicted MCI-AD progression in women. Baseline ERC and APOE4 status predicted MCI-AD progression in men. There were significant differences in CDR-SB scores between patients with and without MCI-AD progression, but not between males and females, or APOE4 carriers and non-carriers.
Conclusions
HV, but not ERC, is strongly influenced by gender in MCI. The effects of gender and APOE4 on neuroimaging biomarkers have potentially important implications in the prediction of MCI-AD progression and should be taken into account in clinical trials.
Background
Acute myeloid leukemia (AML) with monocytic differentiation (M‐AML) remains a diagnostic challenge largely due to lack of sensitive and specific markers for immature monocytes. The ...immunoglobulin‐like inhibitory receptors, LILRB1 and LILRB4, are expressed on monocytes but have not yet been systematically evaluated in the clinical setting.
Methods
We evaluated the diagnostic performance of LILRB1 and LILRB4 as monocytic markers for both immature and mature monocytes in comparison to other myelomonocytic markers including CD14, CD15, CD33, CD36, and CD64 in eight cases of control bone marrow (BM, 5) and peripheral blood (PB, 3), 64 cases of (M‐AML), and 57 cases of AML without monocytic differentiation (NM‐AML) by flow cytometric immunophenotyping.
Results
In control BM, LILRB1 and LILRB4 were consistently expressed on monocytes at all stages of maturation, from CD34+/CD14− monocytic precursors to CD14−/dim+ maturing and CD14+ mature monocytes. In M‐AML, LILRB1 and LILRB4 were consistently expressed on monocytes, regardless of the degree of maturity, from CD14−/dim+ monoblasts/promonocytes to CD14+ mature monocytes but were not expressed on myeloblasts. The diagnostic performances as a monocytic marker assessed by sensitivity/specificity were 100%/100% for LILRB1/LILRB4, 100%/82% for CD11b, 80%/100% for CD14, 100%/81% for CD64, 100%/58% for CD15/CD33, and 89%/97% for CD36/CD64.
Conclusion
The co‐expression of LILRB1/LILRB4 outperformed other myelomonocytic markers as a highly sensitive and specific marker for monocytes at all stages of maturation and could reliably distinguish M‐AML from NM‐AML. LILRB4 additionally represents a novel therapeutic target for treating M‐AML.
•A matched 1:2 retrospective case-control study design was used to characterize COVID-19 patients with hypertension comorbidity.•COVID-19 deaths varied with hypertensive condition, with more ...registered in hypertensive patients.•Signs and symptoms varied between hypertensive and non-hypertensive COVID-19 patients.•Risk of death due to COVID-19 among hypertensive patients increased with age.•Death among COVID-19 hypertensives was associated with underlying comorbidities.
The aim of this study was to characterize COVID-19 cases and explore the risk factors associated with mortality among hypertensive patients with COVID-19 across Malawi.
A retrospective case-control study design was used to provide a detailed account of cases and to explore the risk factors associated with mortality among hypertensive patients with COVID-19. In total, 441 patients were included in the study in a ratio of one case to two controls (1:2), matched by age.
Deaths due to COVID-19 varied with hypertensive condition, with more deaths registered in hypertensive patients. Clinical signs and symptoms varied greatly between hypertensive and non-hypertensive COVID-19 patients, tending to be milder in the latter group. The risk of death due to COVID-19 among hypertensive patients increased with age, and was meaningfully associated with underlining comorbidities, such as HIV, TB, cardiovascular disease, and liver disease.
Our study revealed predictive factors for mortality in hypertensive COVID-19 patients, which can be used by policy makers and healthcare practitioners to identify those at a higher risk, and to determine the appropriate treatment approach to achieve the best possible clinical outcomes.
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