A novel survey of raptor collections in Europe and their potential to provide samples for pan-European contaminant monitoring

This paper provides a novel survey of current collections of frozen raptor carcasses and tissue samples in natural history museums (NHMs), environmental specimen banks (ESBs) and other research collections (ORCs e.g. at universities and research institutes) across Europe and assesses the extent to which collections might support pan-European raptor biomonitoring through the provision of samples for contaminant analyses. The paper is based on questionnaire responses received in late 2018 and early 2019 from 116 institutions. Issues covered include the number of raptor carcasses and diversity of raptor species arriving annually at collections, the number of carcasses stored in freezers, the extent to which collections retain frozen tissue samples, what records are kept of carcasses and tissue samples, constraints to expanding collections of frozen carcasses and tissues and the extent to which collections currently engage in ecotoxicological research and monitoring. Our findings show that collections in Europe receive well over 5000 raptor carcasses per annum, and that NHMs are the key recipients of raptor carcasses for most countries. Collections in Europe probably hold well over 10,000 raptor carcasses in their freezers, offering a substantial resource of frozen raptor carcasses and tissues from recent years. Moreover, these carcasses include good specimen numbers for species that have been prioritized for pan-European contaminant monitoring. Collections are becoming digitized aiding access to samples. However, freezer capacity is a key constraint to retention of carcasses, and contaminant biomonitoring is novel for most NHMs. Our findings on the repository and availability of frozen raptor carcasses and tissues held by collections in Europe can enable greater use of these specimens for pan-European contaminant monitoring in support of better chemicals management. We highlight opportunities to further optimize raptor collections for pan-European contaminant monitoring.

AED applied, not recommending defibrillation - A validation study of the new variable “AED” in the Danish Cardiac Arrest Registry

Background: to design and implement a new variable, in accordance with the Utstein style – namely the variable “AED” - considering the challenges of reporting cases in which the AED did not recommend an electrical shock after analyzing cardiac arrhythmias, for use in the Danish Cardiac Arrest Registry.Participants: Patients with out-of-hospital cardiac arrest for which resuscitation was attempted between 2016 and 2019, identified in the nationwide Danish Cardiac Arrest Registry. Their medical records were reviewed to establish a positive variable in “AED”.Methods: Data from the national Danish Cardiac Arrest Registry were used to identify core features of out-of-hospital cardiac arrests medical recording in Denmark and its possible improvement. Results: Among n= 1080 cases, summary statistics on core recording variables of interest were collected. We found statistically significant differences in the two cohorts of cardiac arrests where an AED was present on the scene and recorded in the Danish Cardiac Arrest Registry, regarding age, location, emeregency medical service response time, witnesses, bystander cardiopulmonary resuscitation, first monitored rhythm, direct current cardioversion shock delivered by the medical staff and survival outcomes such as return of spontaneous circulation at any time, status at arrival at hospital and 30-day survival. Conclusions: This validation study showed an improved completeness of registration of out-of-hospital cardiac arrests when implementing the new AED-variable, in accordance with the Utstein style. Thus, the new AED-variable is a valid and substantial resource for future epidemiological studies. However, a future effort to improve registration completeness along with continuous improvement of the Danish Cardiac Arrest Registry is needed.

The MURAL collection of prostate cancer patient-derived xenografts enables discovery through preclinical models of uro-oncology

Preclinical testing is a crucial step in evaluating cancer therapeutics. We aimed to establish a significant resource of patient-derived xenografts (PDXs) of prostate cancer for rapid and systematic evaluation of candidate therapies. The PDX collection comprises 59 tumors collected from 30 patients between 2012–2020, coinciding with availability of abiraterone and enzalutamide. The PDXs represent the clinico-pathological and genomic spectrum of prostate cancer, from treatment-naïve primary tumors to castration-resistant metastases. Inter- and intra-tumor heterogeneity in adenocarcinoma and neuroendocrine phenotypes is evident from bulk and single-cell RNA sequencing data. Organoids can be cultured from PDXs, providing further capabilities for preclinical studies. Using a 1 x 1 x 1 design, we rapidly identify tumors with exceptional responses to combination treatments. To govern the distribution of PDXs, we formed the Melbourne Urological Research Alliance (MURAL). This PDX collection is a substantial resource, expanding the capacity to test and prioritize effective treatments for prospective clinical trials in prostate cancer.

Resonant quantum principal component analysis

Principal component analysis (PCA) has been widely adopted to reduce the dimension of data while preserving the information. The quantum version of PCA (qPCA) can be used to analyze an unknown low-rank density matrix by rapidly revealing the principal components of it, i.e., the eigenvectors of the density matrix with the largest eigenvalues. However, because of the substantial resource requirement, its experimental implementation remains challenging. Here, we develop a resonant analysis algorithm with minimal resource for ancillary qubits, in which only one frequency-scanning probe qubit is required to extract the principal components. In the experiment, we demonstrate the distillation of the first principal component of a 4 × 4 density matrix, with an efficiency of 86.0% and a fidelity of 0.90. This work shows the speedup ability of quantum algorithm in dimension reduction of data and thus could be used as part of quantum artificial intelligence algorithms in the future.

Neurodevelopmental conditions, neuroconstuctivism, and reproducible research; challenges and future directions.

With growing awareness of problems with reproducibility within the field of neurodevelopmental conditions, we outline why and how, as a field, we can collectively reform our practice with the goal of research improvement. We advocate that our research is of most impact when researchers investigate how developmental pathways and phenotypic profiles unfold. However, this neuroconstructivist approach and more traditional approaches bring many challenges, not least the problem of statistical power. Here, we outline the challenges to research in our field, and suggest solutions. In recognition that solutions can require substantial resource, we have also included less resource-intensive solutions where possible. The challenges and solutions discussed include sample size, individual differences, cross-disorder comparisons, multi-disciplinary expertise, measurement sensitivity and longitudinal data. Key recommendations include transparency and collaboration. For our field to produce rigorous, replicable research, researchers should strive to present protocols and data transparently (where possible) and collaborate to collect (multi-disciplinary) data as a collective effort.

Healthcare Utilization and Costs in Patients with Migraine Who Have Failed Previous Preventive Treatments

ABSTRACTObjective:To characterize healthcare utilization (HCU) and associated costs among patients with migraine categorized by the number of preventive treatment failures (TFs; 1TF, 2TFs, 3+TFs) using real-world data.Methods:This retrospective analysis identified adults with incident migraine diagnosis in the IBM MarketScan® Commercial and Medicare Supplemental database between January 1, 2011, and June 30, 2015. TF was defined in the 2 years after the first migraine diagnosis period. 1TF, 2TFs, and 3+TFs were defined as patients who had received only two preventive treatments (PTs), three PTs, and 4+ PTs in the 2-year period, respectively. A negative binomial model was used to analyze HCU data, and a two-part model was used for cost data controlling for the pre-index Deyo-Charlson Comorbidity Index.Results:Overall, 24,282 patients with incident migraine who had failed at least one PT were included in the analysis. Of these, 72.7% (n=17,653) had 1TF, 20.2% (n=4,900) had 2TFs, and 7.1% (n=1,729) had 3+TFs. Adjusted annualized rates of all-cause and migraine-specific HCU increased with an increase in the number of TFs (1.4–4 times higher; all p < 0.0001 vs 1TF). The mean total all-cause healthcare costs were higher by $3,732 (95% confidence interval [CI]: $2,708–$4,588) in patients with 2TFs and by $8,912 (95% CI: $7,141–$10,822) in patients with 3+TFs vs those with 1TF. Outpatient costs were the key drivers of differences in healthcare costs.Conclusions:TF in patients with migraine was associated with a substantial resource and cost burden, which increased with the number of TFs.

HYPER: Group testing via hypergraph factorization applied to COVID-19

Large scale screening is a critical tool in the life sciences, but is often limited by reagents, samples, or cost. An important challenge in screening has recently manifested in the ongoing effort to achieve widespread testing for individuals with SARS-CoV-2 infection in the face of substantial resource constraints. Group testing methods utilize constrained testing resources more efficiently by pooling specimens together, potentially allowing larger populations to be screened with fewer tests. A key challenge in group testing is to design an effective pooling strategy. The global nature of the ongoing pandemic calls for something simple (to aid implementation) and flexible (to tailor for settings with differing needs) that remains efficient. Here we propose HYPER, a new group testing method based on hypergraph factorizations. We provide characterizations under a general theoretical model, and exhaustively evaluate HYPER and proposed alternatives for SARS-CoV-2 screening under realistic simulations of epidemic spread and within-host viral kinetics. We demonstrate that HYPER performs at least as well as other methods in scenarios that are well-suited to each method, while outperforming those methods across a broad range of resource-constrained environments, and being more flexible and simple in design, and taking no expertise to implement. An online tool to implement these designs in the lab is available at http://hyper.covid19-analysis.org.

Veterans’ response to an automated text messaging protocol during the COVID-19 pandemic

The US Department of Veterans Affairs (VA) is using an automated short message service application named “Annie” as part of its coronavirus disease 2019 (COVID-19) response with a protocol for coronavirus precautions, which can help the veteran monitor symptoms and can advise the veteran when to contact his or her VA care team or a nurse triage line. We surveyed 1134 veterans on their use of the Annie application and coronavirus precautions protocol. Survey results support what is likely a substantial resource savings for the VA, as well as non-VA community healthcare. Moreover, the majority of veterans reported at least 1 positive sentiment (felt more connected to VA, confident, or educated and/or felt less anxious) by receiving the protocol messages. The findings from this study have implications for other healthcare systems to help manage a patient population during the coronavirus pandemic.

Abstract 339: Urban and Rural Patients Receive Different Care for Atrial Fibrillation

Background: Atrial fibrillation (AF) accounts for substantial resource utilization that is expected to increase as the US population ages. Management strategies for AF vary widely based on patient preference, physician specialty training, available resources, and other factors, but the impact that geography has on treatment variations for AF is unknown. Objective: We seek to evaluate differences in AF patient characteristics and management between urban and non-urban Medicare beneficiaries. Methods: Our cohort included all Medicare fee-for-service beneficiaries meeting the CMS chronic conditions warehouse definition of AF from 2013-2017. Beneficiaries were designated as urban and non-urban by rural-urban commuting area codes. AF procedures were tabulated based on CPT codes. The use of AF related medications was tabulated based on prescriptions for drugs of interest in Medicare Part D. Results: During our period of interest, Medicare AF patients were average age 79 yrs, and 52% were female. Urban patients were more likely to be black and have chronic kidney disease, diabetes, and ischemic heart disease. The average CHADS2VA2SC score was high (4.90 SD 1.71) and not meaningfully different between urban and non-urban groups. Most advanced interventions for AF increased over time driven mostly by increases in AF ablation (Figure). However, compared with non-urban patients, urban patients were more likely to undergo AF ablation (1.81 vs 1.42%, p<0.001), Watchman implantation (0.15 vs 0.11%, p<0.001), and cardioversion (0.06 vs 0.05%, p=0.015). Non-urban patients were more likely to be prescribed amiodarone (7.08 vs 6.09%, p=0.002) and warfarin (8.84 vs 7.40%, p<0.001) compared with urban patients and were less likely to be prescribed a direct oral anticoagulant. Conclusions: Despite urban and non-urban Medicare patients with AF being similar with regard to demographic and clinical characteristics, treatment of AF varied in important ways between these groups. In general, urban patients were more likely to receive interventional care for AF which, in some cases, has known associated benefits with regard to quality of life, morbidity, and mortality. Further work is needed to understand differences in outcomes between these two groups and to develop policy solutions to reduce treatment disparities.

Public Health Implementation Considerations for State-Level Ebola Monitoring and Movement Restrictions

ABSTRACT Objective: This article describes implementation considerations for Ebola-related monitoring and movement restriction policies in the United States during the 2013–2016 West Africa Ebola epidemic. Methods: Semi-structured interviews were conducted between January and May 2017 with 30 individuals with direct knowledge of state-level Ebola policy development and implementation processes. Individuals represented 17 jurisdictions with variation in adherence to US Centers for Disease Control and Prevention (CDC) guidelines, census region, predominant state political affiliation, and public health governance structures, as well as the CDC. Results: Interviewees reported substantial resource commitments required to implement Ebola monitoring and movement restriction policies. Movement restriction policies, including for quarantine, varied from voluntary to mandatory programs, and, occasionally, quarantine enforcement procedures lacked clarity. Conclusions: Efforts to improve future monitoring and movement restriction policies may include addressing surge capacity to implement these programs, protocols for providing support to affected individuals, coordination with law enforcement, and guidance on varying approaches to movement restrictions.