Relationships Among Physical Activity, Daylight Exposure, and Rest-Activity Circadian Rhythm in Patients With Esophageal and Gastric Cancer: An Exploratory Study.

BACKGROUND: Although rest-activity circadian rhythm (RACR) disruption is associated with mortality in patients with cancer, few studies have examined the effect of RACR on patients with esophageal and gastric cancer. OBJECTIVE: The aim of this study was to identify the predictors of RACR. METHODS: This cross-sectional, single-site study included 276 patients with esophageal and gastric cancer recruited from chest-surgery and general-surgery outpatient departments. Actigraphy was used to assess objective physical activity (PA), daylight exposure, and RACR, and 3-day PA was used to indicate the subjective amount of PA. The parameter of objective PA was the up activity mean; the parameter of daylight exposure was >500 lx, and the parameters of RACR were the 24-hour correlation coefficient, in-bed less than out-of-bed dichotomy index, midline estimating statistic of rhythm, and amplitude. The subjective amount of PA was calculated as the sum of mild, moderate, and vigorous PA. RESULTS: The up activity mean predicted 24-hour correlation coefficient. The PA amount and up activity mean predicted in-bed less than out-of-bed dichotomy index. The up activity mean and >500-lx daylight exposure predicted midline estimating statistic of rhythm. Finally, the PA amount and up activity mean predicted the amplitude. CONCLUSIONS: Increased PA and daylight exposure may improve RACR. IMPLICATIONS FOR PRACTICE: Patients with esophageal and gastric cancer should be encouraged to engage in outdoor PA during the daytime as part of their regular lifestyle to maintain a robust circadian rhythm.

Barriers to blockchain adoption in the seaport industry: A fuzzy DEMATEL analysis.

Blockchain technology, marked as a disruptive force across various sectors, including seaport logistics, faces challenges and obstacles that impede its effective adoption. We aim to empirically identify the significant barriers impeding blockchain adoption in the seaport industry and elucidate the interconnected relationships between these impediments. Utilizing the Fuzzy Decision-Making Trial and Evaluation Laboratory Analysis (Fuzzy DEMATEL) technique, we quantify the cause-and-effect relationships between various barriers to blockchain adoption. Structured interviews involving 18 experts were conducted, collecting both qualitative interview data and quantitative data. The nature of ports and the maritime industry did not seem to be accurately reflected in the literature about blockchain adoption, presenting several new findings in this study. Four primary obstacles were identified: 1) Lack of management support and commitment. 2) Issues in supply chain collaboration, communication and coordination. 3) Resistance from and lack of involvement of external stakeholders. 4) The high cost. Furthermore, cost was reaffirmed as a significant factor influencing blockchain adoption. We enhance existing literature by revealing the interdependencies among identified barriers and offers insights for policymakers and industry practitioners. We aim to foster successful blockchain integration in the seaport industry, improving its sustainability performance. During this research, it has been acknowledged by the business sector that the effective employment of business process re-engineering (BPR) and the strategic implementation of blockchain technology are crucial strategies to surmount the obstacles that have impeded the extensive integration of blockchain within port operations.

Modeling the longitudinal changes of ancestry diversity in the Million Veteran Program.

BACKGROUND: The Million Veteran Program (MVP) participants represent 100 years of US history, including significant social and demographic changes over time. Our study assessed two aspects of the MVP: (i) longitudinal changes in population diversity and (ii) how these changes can be accounted for in genome-wide association studies (GWAS). To investigate these aspects, we divided MVP participants into five birth cohorts (N-range = 123,888 [born from 1943 to 1947] to 136,699 [born from 1948 to 1953]). RESULTS: Ancestry groups were defined by (i) HARE (harmonized ancestry and race/ethnicity) and (ii) a random-forest clustering approach using the 1000 Genomes Project and the Human Genome Diversity Project (1kGP + HGDP) reference panels (77 world populations representing six continental groups). In these groups, we performed GWASs of height, a trait potentially affected by population stratification. Birth cohorts demonstrate important trends in ancestry diversity over time. More recent HARE-assigned Europeans, Africans, and Hispanics had lower European ancestry proportions than older birth cohorts (0.010 < Cohen's d < 0.259, p < 7.80 × 10-4). Conversely, HARE-assigned East Asians showed an increase in European ancestry proportion over time. In GWAS of height using HARE assignments, genomic inflation due to population stratification was prevalent across all birth cohorts (linkage disequilibrium score regression intercept = 1.08 ± 0.042). The 1kGP + HGDP-based ancestry assignment significantly reduced the population stratification (mean intercept reduction = 0.045 ± 0.007, p < 0.05) confounding in the GWAS statistics. CONCLUSIONS: This study provides a characterization of ancestry diversity of the MVP cohort over time and compares two strategies to infer genetically defined ancestry groups by assessing differences in controlling population stratification in genome-wide association studies.

Anxiety and associated factors among Vietnamese students during COVID-19 pandemic: A cross-sectional study.

Mental health care for students in general, particularly anxiety, is a significant problem that needs more attention, especially during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to describe the prevalence of anxiety and examine the associated factors among students during the COVID-19 pandemic in Vietnam. A cross-sectional study was conducted from August to September 2021 among 5730 students. An online survey was used to collect sociodemographic information, and the generalized anxiety disorder questionnaire (GAD-7) was used to assess anxiety symptoms among Vietnamese students. Results showed that the prevalence of anxiety among study participants was 16.2% (95% confidence interval [CI]: 15.3%-17.2%). Factors related to anxiety among students were gender, type of housemate, COVID-19 exposure/infection status, vaccination status, health status, academic performance, and social relationships during the COVID-19 pandemic. A significant number of students experienced anxiety during COVID-19, and this rate was related to several factors. Psychological interventions are required to support students during and after the COVID-19 pandemic and other health crises. Further studies are required to confirm our findings.

Automatic detection of Covid-19 from chest X-ray and lung computed tomography images using deep neural networks and transfer learning.

The world has been undergoing the most ever unprecedented circumstances caused by the coronavirus pandemic, which is having a devastating global effect in different aspects of life. Since there are not effective antiviral treatments for Covid-19 yet, it is crucial to early detect and monitor the progression of the disease, thereby helping to reduce mortality. While different measures are being used to combat the virus, medical imaging techniques have been examined to support doctors in diagnosing the disease. In this paper, we present a practical solution for the detection of Covid-19 from chest X-ray (CXR) and lung computed tomography (LCT) images, exploiting cutting-edge Machine Learning techniques. As the main classification engine, we make use of EfficientNet and MixNet, two recently developed families of deep neural networks. Furthermore, to make the training more effective and efficient, we apply three transfer learning algorithms. The ultimate aim is to build a reliable expert system to detect Covid-19 from different sources of images, making it be a multi-purpose AI diagnosing system. We validated our proposed approach using four real-world datasets. The first two are CXR datasets consist of 15,000 and 17,905 images, respectively. The other two are LCT datasets with 2,482 and 411,528 images, respectively. The five-fold cross-validation methodology was used to evaluate the approach, where the dataset is split into five parts, and accordingly the evaluation is conducted in five rounds. By each evaluation, four parts are combined to form the training data, and the remaining one is used for testing. We obtained an encouraging prediction performance for all the considered datasets. In all the configurations, the obtained accuracy is always larger than 95.0%. Compared to various existing studies, our approach yields a substantial performance gain. Moreover, such an improvement is statistically significant.

Sorption of cosmetic and personal care polymer ingredients to iron oxides, clay minerals and soil clays: An environmental perspective.

The increasing daily use of cosmetic and personal care ingredients (CPCIs) requires improved understanding of the fate and impacts of CPCIs in environmental systems. Effects of CPCIs on colloidal properties of various geocolloids such as iron oxides (goethite, haematite), clay minerals (kaolinite, bentonite) and soil clays (kaolinitic-, illitic- and lateritic soil clays) were studied by tracking time-resolved changes in zeta potential (ζ) and observing suspended particle density. Two polymers representing anionic CPCIs, i.e., polyacrylate crosspolymer-11 (PC11) and cationic CPCIs, i.e., polyDADMAC (PD) show contrast effects on ζ and colloidal properties of the selected materials. While PC11 tended to associate with Fe oxides, PD can be adsorbed by clay minerals and soil clays. The neutralization due to the sorption of either PC11 or PD onto opposite-charge sign surface sites can lower the net surface charge of the materials, thereby enhancing electrostatic attraction, stimulating particle size growth, and eventually intensifying co-aggregation. The observed colloidal properties of iron oxides, clay minerals and soil clays under the presence of PC11 and PD may reflect what are happening in many aquatic environments where CPCIs co-exist with various mineral colloids. Therein, CPCIs likely delay the transport of the opposite-charge sign colloids, while they increase the dispersibility and transportability of the same-charge sign colloids. This implies that intensifying presence of a given CPCI could have selective effects on colloid systems. As a whole, CPCIs can change the fate and the final destination of mineral colloids and themselves; therefore, their effects and relevant treatment techniques need to be included into the future agenda.

The Russia-Ukraine Conflict: Its Implications for the Global Food Supply Chains.

Food is one of the most traded goods, and the conflict in Ukraine, one of the European breadbaskets, has triggered a significant additional disruption in the global food supply chains after the COVID-19 impact. The disruption to food output, supply chains, availability, and affordability could have a long-standing impact. As a result, the availability and supply of a wide range of food raw materials and finished food products are under threat, and global markets have seen recent increases in food prices. Furthermore, the Russian-Ukrainian conflict has adversely affected food supply chains, with significant effects on production, sourcing, manufacturing, processing, logistics, and significant shifts in demand between nations reliant on imports from Ukraine. This paper aims to analyze the impacts of the conflict between Russia and Ukraine on the effectiveness and responsiveness of the global food supply chains. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, including grey literature, was deployed to investigate six key areas of the food supply chains that would be impacted most due to the ongoing war. Findings include solutions and strategies to mitigate supply chain impacts such as alternative food raw materials, suppliers and supply chain partners supported by technological innovations to ensure food safety and quality in warlike situations.

Predictors of adherence, contamination and dropout in home-based walking by lung and oesophageal cancer patients from two randomised control trials: An exploratory study.

OBJECTIVES: In this study, we examined predictors of exercise adherence, contamination and dropout in lung and oesophageal cancer patients who participated in two randomised controlled trials. METHODS: We used data on 188 lung and oesophageal cancer patients from two previous studies (intervention: moderate-intensity walking for 12 weeks). Baseline measurements included demographic variables, disease characteristics, Hospital Anxiety and Depression Scale and Bouchard 3-day physical activity (PA) record. We used multiple linear and logistic regressions to analyse predictors of exercise adherence in the walking group, contamination in the control group and dropout in both groups. RESULTS: Pre-intervention exercise habits and baseline depression scores predicted adherence, with an explanatory power of 16.7% (p < 0.0001). Pre-intervention exercise habits (odds ratio [OR] 19.65, 95% confidence interval [CI] 2.76-139.97), baseline moderate PA (min/day) (OR 1.03, 95% CI 1.01-1.05) and baseline vigorous PA (min/day) (OR 1.09, 95% CI 1.01-1.18) predicted contamination. Baseline mild PA (10 min/day) (OR 0.94, 95% CI 0.89-0.99) predicted dropout. CONCLUSIONS: Pre-intervention exercise habits and baseline depression levels predicted exercise adherence in the walking group. In the control group, pre-intervention exercise habits and baseline moderate and vigorous PA predicted contamination. Baseline mild PA predicted dropout rates in both groups.

Association of Gulf War Illness with Characteristics in Deployed vs. Non-Deployed Gulf War Era Veterans in the Cooperative Studies Program 2006/Million Veteran Program 029 Cohort: A Cross-Sectional Analysis.

Gulf War Illness (GWI), a chronic multisymptom illness with a complex and uncertain etiology and pathophysiology, is highly prevalent among veterans deployed to the 1990-1991 GW. We examined how GWI phenotypes varied by demographic and military characteristics among GW-era veterans. Data were from the VA's Cooperative Studies Program 2006/Million Veteran Program (MVP) 029 cohort, Genomics of GWI. From June 2018 to March 2019, 109,976 MVP enrollees (out of a total of over 676,000) were contacted to participate in the 1990-1991 GW-era Survey. Of 109,976 eligible participants, 45,169 (41.1%) responded to the 2018-2019 survey, 35,902 respondents met study inclusion criteria, 13,107 deployed to the GW theater. GWI phenotypes were derived from Kansas (KS) and Centers for Disease Control and Prevention (CDC) GWI definitions: (a) KS Symptoms (KS Sym+), (b) KS GWI (met symptom criteria and without exclusionary health conditions) [KS GWI: Sym+/Dx-], (c) CDC GWI and (d) CDC GWI Severe. The prevalence of each phenotype was 67.1% KS Sym+, 21.5% KS Sym+/Dx-, 81.1% CDC GWI, and 18.6% CDC GWI severe. These findings affirm the persistent presence of GWI among GW veterans providing a foundation for further exploration of biological and environmental underpinnings of this condition.

Adaptation and validation of the Van Rie tuberculosis stigma scale in Vietnam.

OBJECTIVES: Tuberculosis (TB) stigma contributes to diagnostic delay, disease concealment, and reduced wellbeing for affected individuals. Despite the availability of several TB stigma scales, most high-TB burden countries do not have a culturally validated version available. This study evaluated the Van Rie TB stigma scale (VTSS) among people with TB in Vietnam. METHODS: This study consisted of two phases. In phase 1, the VTSS was culturally and linguistically adapted to the Vietnamese context. In phase 2, people with TB were invited to complete a survey containing the VTSS, a depression scale, and a quality of life scale. The data analysis included confirmatory factor analysis (CFA), exploratory factor analysis (EFA), construct validity, and floor or ceiling effects. RESULTS: In phase 1, items were reworded from the third person to the first person. The TB/HIV co-infection items (items 7 and 11) were the least relevant for people with TB (62% and 73% relevance, respectively). In phase 2, the CFA demonstrated adequate goodness-of-fit indices (GFI = 0.88, CFI = 0.96, RMSEA = 0.058); however several of the item factor loadings were low. The EFA demonstrated good internal consistency (α = 0.85) and revealed one dominant factor. Construct validity was low. CONCLUSIONS: The VTSS demonstrated good psychometric properties in Vietnam. Depending on the purpose of the scale, the HIV co-infection items and item 10 could be considered for removal.

Outcomes of robotic-assisted liver surgery versus laparoscopic liver surgery for treatment of stage I hepatocellular carcinoma.

BACKGROUND: This article investigated whether robotic-assisted liver surgery versus laparoscopic liver surgical treatment of hepatocellular carcinoma (HCC) has similar or different short- and long-term clinical outcomes. METHODS: A total of 3049 patients from the National Cancer Database who received minimally invasive surgery (ie, robotic or laparoscopic surgery) for stage I HCC cancers between 2010 to 2015, of which 123 had robotic and 2926 had laparoscopic surgeries performed, were identified. Logistic regression was applied to evaluate short-term outcomes. Cox proportional hazards models were applied to estimate all-cause mortality at 1-year, 3-years, and 5-years after surgery, adjusting for potential confounders. Propensity score-matched analyses were conducted to compare long-term outcomes between robotic and laparoscopic surgeries. RESULTS: Robotic surgery was associated with improved overall survival, with 1-, 3-, and 5-year survival rates (SRs) of 0.92, 0.75, and 0.63 compared with laparoscopic surgery SRs of 0.86, 0.60, and 0.45, respectively (P value <.01). Multivariate analyses showed that robotic compared with laparoscopic surgery had significantly lower 5-year total mortality (hazard ratio [HR], 0.64 and 95% confidence interval [CI], 0.45%-0.93% for intent-to-treat; HR, 0.62 and 95% CI, 0.42%-0.91% for end-treatment analyses). Similar results were found in propensity score matched analyses; robotic surgery was associated with improved overall survival compared with laparoscopic surgery (HR, 0.64 and 95% CI, 0.43%-0.96% for intent-to-treat; HR, 0.59 and 95% CI, 0.39%-0.90% for end-treatment). CONCLUSIONS: Robotic surgery is not inferior to laparoscopic surgery in treating early-stage HCC and may be associated with improved long-term survival.

Codesign of Food System and Circular Economy Approaches for the Development of Livestock Feeds from Insect Larvae.

Processes that utilise low-value wastes and convert them to high-value food ingredients systemically add value across commercial operations. Current common disposal options include use as animal feed, anaerobic digestion, composting, incineration, and the worst-case options of landfill and wastewater disposal. The pressure is acute with food manufacturers needing to align with the UN Sustainable Development Goals and reach targets of zero waste to landfill. This research identifies black soldier fly larvae as a bioreactor that converts most food waste into high-value feed materials. Production of larvae and the regulatory framework for their use as animal feed is being assessed in several nations. The requirement to understand the availability of feedstocks for larvae production and the capability to establish feedstock supply chains was tested in this study using geographical information system and life cycle assessment methodologies, providing new research insights for resource utilisation in a circular economy.

Discovery of new genetic determinants of morphological plasticity in rice roots and shoots under phosphate starvation using GWAS.

Phosphorus is an essential nutrient for plants that is often in short supply. In rice (Oryza sativa L.), inorganic phosphate (Pi) deficiency leads to various physiological disorders that consequently affect plant productivity. In this study, a large-scale phenotyping experiment using 160 Vietnamese rice landraces was performed under greenhouse conditions, by employing an alpha lattice design with three replicates, to identify quantitative trait loci (QTLs) associated with plant growth inhibition caused by Pi deficiency. Rice plantlets were grown for six weeks in the PVC sand column (16 cm diameter × 80 cm height) supplied with Pi-deficient medium (10 µM P) or full-Pi Yoshida medium (320 µM P). The effects of Pi deficiency on the number of crown roots, root length, shoot length, root weight, shoot weight and total weight were studied. From 36 significant markers identified using a genome-wide association study, 21 QTLs associated with plant growth inhibition under Pi starvation were defined. In total, 158 candidate genes co-located with the defined QTLs were identified. Interestingly, one QTL (qRST9.14) was associated with all three weight-traits. The co-located gene GLYCEROPHOSPHODIESTER PHOSPHODIESTERASE 13 was found to be potentially involved in Pi transport. Understanding the molecular mechanisms of Pi-starvation responses, and identifying the potential QTLs responsible for low-Pi stress tolerance, will provide valuable information for developing new varieties tolerant of low-Pi conditions.

A genome-wide association study reveals the quantitative trait locus and candidate genes that regulate phosphate efficiency in a Vietnamese rice collection.

The crucial role of phosphate (Pi) for plant alongside the expected depletion of non-renewable phosphate rock have created an urgent need for phosphate-efficient rice varieties. In this study, 157 greenhouse-grown Vietnamese rice landraces were treated under Pi-deficient conditions to discover the genotypic variation among biochemical traits, including relative efficiency of phosphorus use (REP), relative root to shoot weight ratio (RRSR), relative physiological phosphate use efficiency (RPPUE), and relative phosphate uptake efficiency (RPUpE). Plants were grown in Yoshida nutrient media with either a full (320 µM) or a low Pi supply (10 µM) over six weeks. This genome-wide association study led to the discovery of 31 significant single nucleotide polymorphisms, 18 quantitative trait loci (QTLs), and 85 candidate genes. A common QTL named qRPUUE9.16 was found among the three investigated traits. Some interesting candidate genes, such as PLASMA MEMBRANE PROTEIN1 (OsPM1), CALMODULIN-RELATED CALCIUM SENSOR PROTEIN 15 (OsCML15), phosphatases 2C (PP2C), STRESS-ACTIVATED PROTEIN KINASE (OsSAPK2), and GLYCEROPHOSPHORYL DIESTER PHOSPHODIESTERASES (GDPD13), were found strongly correlated to the Pi starvation. RNA sequencing transcriptomes revealed that 45 out of 85 candidate genes were significantly regulated under Pi starvation. Furthermore, nearly two-thirds of genotypes did not possess the OsPsTOL1 gene; however, no significant difference was observed in response to Pi deficiency between genotypes with or without this gene, suggesting that other QTLs in rice may resist Pi starvation. These results provide new information on the genetics of nutrient use efficiency in rice and may potentially assist with developing more phosphate-efficient rice plants.

Factors affecting mammography screening behaviour among rural Vietnamese women.

OBJECTIVES: To identify factors associated with mammography screening behaviour and its predictors among rural Vietnamese women. METHOD: A predictive correlational study involving 120 women aged ≥ 40 years was conducted in the suburbs of Hanoi, Vietnam, in July 2018 by using Breast Cancer Awareness Measurement and the Champion Health Beliefs Model Scale. Mammography screening behaviour was assessed by asking participants about their previous mammography experience. RESULTS: Only 16.7% of participants had undergone mammography screening. High education levels, high monthly family income, having family members or friends with breast cancer, and receiving physicians' recommendations increased the likelihood of participants screening for breast cancer. Mean scores on perceived susceptibility and perceived barriers differed significantly between participants who had and those who had not undergone screening (t = 4.31; p < .001; t = -5.05; p < .001, respectively). Perceived susceptibility and perceived barriers significantly increased the predictive power of the hierarchical logistic model (critical value = 6.16; [df = 2]; p = .046). Perceived barriers were the most significant predictors of screening behaviour (odds ratio 0.84; 95% CI, 0.71-0.99; p = .039). CONCLUSION: Efforts are necessary to increase mammography awareness in the community and promote screening rates in Vietnam.

Testing the data platforms required for the 21st century food system using an industry ecosystem approach.

Testing the planning of resource utilisation across food supply chains provides sustainability and security reporting that can resonate with consumer requirements. The research reported here demonstrates this approach for fast throughput convenience foods that have short shelf life and whose product development must be agile enough to meet changing consumer demand. The higher-level outputs of these conditions are the responsible reporting of nutritional, greenhouse gas emission and packaging impact assessments. Together with the food safety requirements of this food category, it means that manufacturing operations are in some of the most challenging arenas for sustainability assessment. The analysis presented here shows that food production systems can no longer focus on one or two core conditions, such as food safety or quality. This is a strategy of least resistance that has previously worked but it continues to displace risks elsewhere within the food and beverage meta-system, rather than attempting to reconcile complexities and address intra-system root causes. By taking a holistic view the food ecosystem approach can inter-connect requirements using digital and externally linked platforms that will fundamentally change the way future food systems operate. The integration and streaming of these platforms are only achieved through innovation, with the end-user providing development and balance in emergent business ecosystems.

Patterns of Anticoagulation Use in Patients With Cancer With Atrial Fibrillation and/or Atrial Flutter.

BACKGROUND: Atrial fibrillation (AF) is a common cardiovascular complication affecting patients with cancer, but management strategies are not well established. OBJECTIVES: The purpose of this retrospective cohort study was to evaluate cross-sectional patterns of anticoagulation (AC) use in patients with cancer with AF or atrial flutter (AFL) on the basis of their risk for stroke and bleeding. METHODS: Patients with cancer and electrocardiograms showing AF or AFL performed at Moffitt Cancer Center in either the inpatient or outpatient setting were included in this retrospective analysis. We described percentages of AC prescription by stroke and bleeding risk, as determined by individual CHA2DS2-VASc and HAS-BLED scores, respectively. Multivariable logistic regression evaluated clinical variables independently associated with anticoagulant prescription. RESULTS: The prevalence of electrocardiography-documented AF or AFL was 4.8% (n = 472). The mean CHA2DS2-VASc score was 2.8 ± 1.4. Among patients with CHA2DS2-VASc scores ≥2 and HAS-BLED scores <3, 44.3% did not receive AC, and of these, only 18.3% had platelet values <50,000/µl. In multivariable analysis, older age, hypertension, prior stroke, and history of venous thromboembolism were each directly associated with AC use, while current chemotherapy use, prior bleeding, renal disease, and thrombocytopenia were each inversely associated with AC use. CONCLUSIONS: Nearly one-half of patients with cancer, the majority with normal platelet counts, had an elevated risk for stroke but did not receive AC. In addition to known predictors, current chemotherapy use was independently associated with a lower odds of AC use. This study highlights the need to improve the application of AF treatment algorithms to cancer populations.

Iron Hack - A symposium/hackathon focused on porphyrias, Friedreich's ataxia, and other rare iron-related diseases.

Background: Basic and clinical scientific research at the University of South Florida (USF) have intersected to support a multi-faceted approach around a common focus on rare iron-related diseases. We proposed a modified version of the National Center for Biotechnology Information's (NCBI) Hackathon-model to take full advantage of local expertise in building "Iron Hack", a rare disease-focused hackathon. As the collaborative, problem-solving nature of hackathons tends to attract participants of highly-diverse backgrounds, organizers facilitated a symposium on rare iron-related diseases, specifically porphyrias and Friedreich's ataxia, pitched at general audiences. Methods: The hackathon was structured to begin each day with presentations by expert clinicians, genetic counselors, researchers focused on molecular and cellular biology, public health/global health, genetics/genomics, computational biology, bioinformatics, biomolecular science, bioengineering, and computer science, as well as guest speakers from the American Porphyria Foundation (APF) and Friedreich's Ataxia Research Alliance (FARA) to inform participants as to the human impact of these diseases. Results: As a result of this hackathon, we developed resources that are relevant not only to these specific disease-models, but also to other rare diseases and general bioinformatics problems. Within two and a half days, "Iron Hack" participants successfully built collaborative projects to visualize data, build databases, improve rare disease diagnosis, and study rare-disease inheritance. Conclusions: The purpose of this manuscript is to demonstrate the utility of a hackathon model to generate prototypes of generalizable tools for a given disease and train clinicians and data scientists to interact more effectively.

DNA-HPV transition rate and related factors in HPV-infected women in Can Tho city, Vietnam.

OBJECTIVES: To determine DNA-HPV transition rates and related factors in HPV-infected women 18-69 years of age in Can Tho City from 2013 to 2018. METHODS: Both a retrospective and a prospective cohort study were done. Interviews, gynaecological examinations and HPV testing by PCR (cervical fluid) were used to collect data. The results were recorded and compared with those of HPV in 2013 to assess the development of HPV over time. Transition was defined as conversion to HPV-positive state in 2018 from a negative state in 2013. No transition was defined as clearance of HPV when the positive 2013 result was negative in 2018 or when the result remained negative or positive in 2013 and 2018. Factors related to the change were analysed. RESULTS: Among a sample size of 204 cases, the average age of participants was 48.9 ± 10.4 years. Women >45 comprised 63.2% of participants; 82.8% lived with their husbands, 6.4% were divorced, and 2.9% lived apart from their husbands due to work. After 5 years of observation, 16.2% of DNA-HPV cases had converted to HPV-positive state and 66.2% of DNA-HPV cases had cleared to HPV-negative state. Factors related to conversion to HPV-positive state were age ≤ 45 years (3.14 times higher risk of transition than in the >45 age group (95% CI: 1.12-8.8)); change of sexual partner (OR = 3.75 (95% CI: 1.15-12.2)); change of sexual partner by husband (OR = 3.69 (95% CI: 1.20-11.3); sexually transmitted diseases (OR = 5.19 (95% CI: 1.09-24.8)); and a history of vacuum aspiration or dilation and evacuation abortion (OR = 1.4 (95% CI: 0.29-6.4)). CONCLUSIONS: 16.2% of women with DNA-HPV transition converted to HPV-positive state. Changes in sexual habits increase the risk of developing HPV positivity.

TAUX DE TRANSITION ADN-VPH ET FACTEURS CONNEXES CHEZ LES FEMMES INFECTÉES PAR LE VPH À CAN THO CITY, VIETNAM: OBJECTIFS: Déterminer les taux de transition ADN-VPH et les facteurs connexes chez les femmes infectées par le VPH, âgées de 18 à 69 ans à Can Tho City de 2013 à 2018. MÉTHODES: Une étude de cohorte rétrospective et une prospective ont été effectuées. Des entretiens, des examens gynécologiques et des tests pour le VPH par PCR (liquide cervical) ont été utilisés pour collecter des données. Les résultats ont été enregistrés et comparés à ceux du VPH en 2013 afin d'évaluer l'évolution du VPH au fil du temps. La transition a été définie comme étant la conversion d'un état négatif au VPH en 2013 à un état positif en 2018. Aucune transition n'a été définie comme une élimination du VPH lorsque le résultat positif de 2013 était négatif en 2018 ou lorsque le résultat est resté négatif ou positif en 2013 et 2018. Les facteurs liés au changement ont été analysés. RÉSULTATS: Sur un échantillon de 204 cas, l'âge moyen des participantes était de 48,9 ± 10,4 ans. Les femmes > 45 ans représentaient 63,2% des participantes; 82,8% vivaient avec leur mari, 6,4% étaient divorcées et 2,9% vivaient séparées de leur mari à cause de leur travail. Après 5 ans d'observation, 16,2% des cas d'ADN-VPH étaient passés à l'état VPH positif et 66,2% des cas d'ADN-VPH avaient tout éliminé et étaient passés à l'état HPV négatif. Les facteurs liés à la conversion à l'état positif au VPH étaient les suivants: âge ≤ 45 ans (risque de transition de 3,14 fois supérieur à celui du groupe d'âge > 45 ans (IC95%: 1,12 à 8,8)), changement de partenaire sexuel (OR = 3,75 (IC95%: 1,15-12,2)), changement de partenaire sexuel par le mari (OR = 3,69 (IC95%: 1,20-11,3), maladies sexuellement transmissibles (OR = 5,19 (IC95%: 1,09-24,8)) et antécédents d'aspiration ou de dilatation et d'évacuation d'avortement (OR = 1,4 (IC95%: 0,29 à 6,4)). CONCLUSIONS: 16,2% des femmes présentant une transition ADN-VPH sont devenues positives au VPH. Les changements d'habitudes sexuelles augmentent le risque de développer une positivité au VPH.

Electronic medical record-verified hepatitis C virus screening in a large health system.

BACKGROUND: Baby boomers are at increased risk for hepatitis C virus (HCV) infection and related cancer; therefore, one-time HCV screening is recommended. METHODS: To assess prevalence of, and factors associated with providers ordering HCV screening, we examined a retrospective cohort of electronic medical records for patient visits from 01 August 2015 until 31 July 2017 in a large health system. HCV screening ordered was examined by patient age, gender, race/ethnicity, provider specialty, and number of clinical visits, stratified by birth cohort: born ≤1945, 1945-1965 (baby boomers), 1966-1985, and ≥1985. Multivariable regression identified factors independently associated with HCV screening ordered among average risk baby boomers. RESULTS: A total of 65 114 patients ages ≥18 years were evaluated. Among baby boomers HCV screening test order increased threefold between the two study years (4.0%-12.9%). Odds of screening test ordered were significantly higher for non-Hispanic Blacks (multivariable adjusted odds ratio [aOR]=1.36; 95% CI = 1.19-1.55), males (aOR = 1.44; 95% CI = 1.33-1.57), and having a clinic visit with a primary care provider alone or with specialty care (aOR = 3.25-4.16). Medicare (aOR = 0.89; 95% CI = 0.80-0.99), Medicaid (aOR 0.89; 95% CI 0.80-0.99), and an unknown provider type (aOR = 0.16; 95% CI = 0.08-0.33), were associated with lower odds of screening tests ordered. CONCLUSIONS: While the proportion of baby boomers with an HCV screening test ordered increased during the study, the rate of screening remains far below national goals. Data from this study indicate that providers are not ordering HCV screening universally for all of their baby boomer patients. Continued efforts to increase HCV screening are needed to reduce the incidence of HCV-related morbidity and mortality.