Advancing the care of individuals with cancer through innovation & technology: Proceedings from the cardiology oncology innovation summit 2020 and 2021.

As cancer therapies increase in effectiveness and patients' life expectancies improve, balancing oncologic efficacy while reducing acute and long-term cardiovascular toxicities has become of paramount importance. To address this pressing need, the Cardiology Oncology Innovation Network (COIN) was formed to bring together domain experts with the overarching goal of collaboratively investigating, applying, and educating widely on various forms of innovation to improve the quality of life and cardiovascular healthcare of patients undergoing and surviving cancer therapies. The COIN mission pillars of innovation, collaboration, and education have been implemented with cross-collaboration among academic institutions, private and public establishments, and industry and technology companies. In this report, we summarize proceedings from the first two annual COIN summits (inaugural in 2020 and subsequent in 2021) including educational sessions on technological innovations for establishing best practices and aligning resources. Herein, we highlight emerging areas for innovation and defining unmet needs to further improve the outcome for cancer patients and survivors of all ages. Additionally, we provide actionable suggestions for advancing innovation, collaboration, and education in cardio-oncology in the digital era.

Representation of Women in Published Articles at 3 Academic Pediatric Journals: 2001 to 2022.

OBJECTIVE: To evaluate the representation of women authors and editorial board members at 3 pediatric journals. METHODS: We conducted a retrospective review of original research articles published in Pediatrics, The Journal of Pediatrics, and JAMA Pediatrics from 2001 to 2022. We analyzed five 1-year intervals and inferred the binary gender of authors by first name. Cochran-Armitage tests evaluated trends in gender proportion of authorship and editorial board membership over time. Pearson's χ2 tests compared United States (US) authorship position and faculty rank as determined by Association of American Medical Colleges' data. RESULTS: From 2001 to 2022, 4426 original research articles were studied (exclusion rate <1%). There was a 23.7%, 15.9%, and 28.8% increase in proportion of women as first authors, senior authors, and editorial board members globally, with all trends significant over time (P < .01). In 2022, US women were 67.3% of first authors, only slightly lower than the 68.6% of women junior faculty (P = .01). US women were 48.0% of US senior authors, equivalent to the 47.5% of US women senior faculty (P = .18). US women represented 47.4% of US editorial board members, equivalent to their percentage as senior faculty (P = .98). CONCLUSIONS: The percentage of US and international women authorship and editorial board membership has steadily increased. The percentage of US women as junior faculty and first authors is almost equivalent. The percentage of US women as senior faculty, senior authors, and editorial board members is equivalent but significantly reduced from their junior faculty representation.

How Race, Ethnicity, and Social Determinants of Health Are Reported in Three European Pediatric Journals.

OBJECTIVES: To evaluate how geography, ethnicity, ancestry, and race or religion (GEAR) and social determinants of health (SDOH) data are reported and discussed in 3 European pediatric journals and to compare practices between European and American journals. STUDY DESIGN: A retrospective analysis of all original articles that enrolled children (<18 years old) published from January through June 2021 in 3 European pediatric journals: Archives of Disease in Childhood, European Journal of Pediatrics, and Acta Paediatrica. We categorized SDOH using the 5 domains as outlined by the US Healthy People 2030 framework. For each article, we recorded whether GEAR and SDOH were reported in the results and interpreted in the discussion sections. We then compared these European data by χ2 tests with data from 3 US pediatric journals. RESULTS: Of the 320 studied articles, 64 (20%) and 80 (25%) reported GEAR and SDOH data in the results sections, respectively. Of those articles, 32 (50%) and 53 (66.3%) studies interpreted the GEAR and SDOH data in their discussion sections, respectively. On average, articles reported factors from 1.2 GEAR and 1.9 SDOH categories with great variability in the variables collected and data groupings. Articles published in European journals were less likely to report GEAR and SDOH than articles published in US journals (P < .001 for both). CONCLUSIONS: Articles published in European pediatric journals did not commonly report either GEAR or SDOH, and there was wide variation in how data were collected and reported. Harmonization of categories will allow for more accurate interstudy comparisons.

The Use of Race, Ethnicity, and Social Determinants of Health in Three Pediatrics Journals.

OBJECTIVE: To evaluate how race, ethnicity, and social determinants of health (SDOH) are reported and discussed in 3 pediatrics journals. STUDY DESIGN: Bibliometric analysis of original articles that enrolled children as participants between January-June 2021 published in The Journal of Pediatrics, Pediatrics, and JAMA Pediatrics. We recorded in aggregate the inclusion of race, ethnicity, and SDOH data from the methods, results, and discussion sections of each article. We then used χ2 analyses and t tests to compare recording and use of race, ethnicity, and SDOH data on a number of factors. RESULTS: A total of 317 original articles were included with 200 (63.1%) conducted in the US. Researchers presented 116 unique race and ethnicity categories. US studies reported race significantly more frequently than international studies (166/200, 83.0% vs 29/117, 24.8% P < .001), yet only 24.7% (41/166) of US and 10.3% (3/29) of international studies that reported these data interpreted their significance and linked such to their study findings. US federal funding influenced reporting of race and ethnicity but not interpretation. Less than one-half of all studies reported SDOH (147/317, 46.4%), and very few that reported SDOH interpreted the data to study findings in both the US (18/106, 17.0%) and internationally (3/41, 7.3%). CONCLUSION: Race, ethnicity, and SDOH data are reported without consistent categories, and their significance is not often explained in both US and international articles. Researchers should be more intentional about how and why they collect, report, and interpret these data to help identify health disparities and highlight health inequities.

Analyzing Trends in the Global Surge of Coronavirus Disease 2019 Pandemic Submissions to The Journal of Pediatrics.

During February to December 2020, there were 498 coronavirus disease 2019 (COVID-19) pandemic-focused brief report and original article submissions to The Journal of Pediatrics. The majority were from international authors (68.1%). Early in the pandemic, geographic origin of the corresponding author paralleled the path of COVID-19 infection both within the US and around the globe.

Fractional re-distribution among cell motility states during ageing.

Ageing in humans is associated with the decreased capacity to regulate cell physiology. Cellular properties, such as cell morphology and mechanics, encode ageing information, and can therefore be used as robust biomarkers of ageing. Using a panel of dermal fibroblasts derived from healthy donors spanning a wide age range, we observe an age-associated decrease in cell motility. By taking advantage of the single-cell nature of our motility data, we classified cells based on spatial and activity patterns to define age-dependent motility states. We show that the age-dependent decrease in cell motility is not due to the reduced motility of all cells, but results from the fractional re-distribution among motility states. These findings highlight an important feature of ageing cells characterized by a reduction of cellular heterogeneity in older adults relative to post-adolescent/adults. Furthermore, these results point to a mechanistic framework of ageing, with potential applications in deciphering emergent ageing phenotypes and biomarker development.

Preferences for disclosing adverse childhood experiences for children and adults with cystic fibrosis.

INTRODUCTION: The 2017-2018 National Survey of Children's Health estimates that 30 million (42%) US children have experienced at least one adverse childhood experience (ACE), including abuse, neglect, and household dysfunction. ACEs negatively impact long-term health, and there has been no study of ACEs in cystic fibrosis (CF). We assessed willingness to disclose ACEs experienced by children with CF by surveying their parents and adults with CF. METHODS: We anonymously surveyed parents of children with CF and adults with CF at the Northwestern University/Lurie Children's CF Center to determine their willingness to disclose ACEs. RESULTS: The survey was completed by 46/157 (29%) parents and 36/105 (34%) adults with CF. Few parents (22%) and adults (17%) were willing to discuss most or all specific ACEs, more were willing to disclose the number of ACEs experienced in a category (57% parents, 47% adults), and the majority were willing to participate in anonymous research about ACEs (76% parents, 67% adults). Most parents (63%) and adults (50%) would prefer to have ACEs screened separately from their CF appointment, and most parents (63%) and adults (56%) wanted to learn more about ACEs from a member of their care team. CONCLUSIONS: Participants preferred to disclose the number of categorical ACEs rather than specific ACEs and most were open to participating in anonymous ACEs research. More research is needed before implementing screening. Educating patients, parents, and providers about ACEs and appropriate interventions when ACES are identified is needed for both research and clinical applications of ACEs screening.

Impact of the Coronavirus Disease 2019 Pandemic on Authorship Gender in The Journal of Pediatrics: Disproportionate Productivity by International Male Researchers.

OBJECTIVE: To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on authorship gender in articles submitted to The Journal of Pediatrics. STUDY DESIGN: Using gender-labeling algorithms and human inspection, we inferred the gender of corresponding authors of original articles submitted in January-February and April-May of 2019 and 2020 noting those articles related to the COVID-19 pandemic. We used Pearson χ2 tests to determine differences in gender proportions during the selected periods in the US and internationally. RESULTS: We analyzed 1521 original articles. Submissions increased 10.9% from January-February 2019 to January-February 2020 and 61.6% from April-May 2019 to April-May 2020. Women accounted for 56.0% of original articles in April-May 2019 but only 49.8% of original articles in April-May 2020. Original articles focused on COVID-19 represented a small percentage of additional articles submitted in January-February 2020 (1/33 or 3.0%) and (53/199 or 26.6%) in April-May 2020 compared with the number of submissions in the same months in 2019. International male corresponding authors submitted a significantly larger proportion of original articles compared with international female corresponding authors in April-May 2020 compared to April-May 2019 (P = .043). There was no difference in corresponding author gender proportion in the US (US in April-May of 2020 vs April-May of 2019; P = .95). There was no significant difference in final dispositions based on corresponding author gender for original articles from 2019 and 2020 (P = .17). CONCLUSIONS: Original article submissions to The Journal increased in April-May 2020, with the greatest increase by international male corresponding authors. The majority of the submission growth was not related to COVID-19.

The demographics of adverse outcomes in cystic fibrosis.

Understanding variability in cystic fibrosis (CF) health outcomes requires an understanding of factors that go far beyond Cystic Fibrosis Transmembrane Receptor (CFTR) function caused by different gene mutations. Social and environmental factors that influence health have a significant influence on the trajectory of health in CF and in other chronic diseases. In this article, we review demographic factors associated with poorer health outcomes in CF, known and postulated biological mechanisms of these outcomes, and interventions that healthcare teams can implement that may reduce outcome disparities.

Missed Opportunities in the Preparticipation Physical Examination for High School Athletes.

The preparticipation sports examination (PPE) is required for US high school athletes. We queried members of the Illinois Chapter of the American Academy of Pediatrics (ICAAP) about what they actually include in a PPE, allotted PPE time, and counseling about full contact sports participation. Of 2300 ICAAP members contacted electronically, 228 (10%) responded, yielding 205 usable surveys. When performing a PPE, 34 (25%) always complete all of 6 selected AAP-recommended PPE components and 102 (74%) always get a concussion history. In contrast, 29 (21%) always complete all of the 6 selected AAP PPE components and 70 (49%) always get a concussion history as part of well-child checkup. Main interferences with clinician proficiency are lack of time and training cited by 49% and 37%, respectively. Pediatricians were evenly divided about whether or not to counsel against full contact sports, but were more likely to do so after the athlete sustained a first concussion.

The Role of Gender in Publication in The Journal of Pediatrics 2015-2016: Equal Reviews, Unequal Opportunities.

OBJECTIVES: To examine whether the gender of corresponding authors, reviewers, and editors led to differential publication recommendations and outcomes for original research articles and invited editorials submitted to The Journal of Pediatrics in 2015 and 2016. STUDY DESIGN: Names of corresponding authors, reviewers, editors, and editorial writers in The Journal of Pediatrics databases for 2015-2016 were analyzed to determine gender using computer algorithms and Internet searches. Reviewer recommendations and final editor dispositions were stratified by their gender and the gender of the corresponding authors. RESULTS: Of 3729 original manuscripts, 54.3% had female corresponding authors. Women were the associate editor (40.2% of submissions), guest editor (34.8%), or primary reviewer (37.4%), with no gender difference in editor or reviewer assignments for submissions by female vs male corresponding authors. There were no outcome differences by author gender for manuscripts overseen by female (P = .71) or male (P = .62) editors nor recommendation differences by female (P = .18) or male (P = .71) reviewers. Female editors had a lower acceptance rate overall than male editors (20.1% vs 25.6%; P < .001). Women were statistically less likely to accept and complete the invitation to peer review original articles (34.0%; 2295 of 6743) compared with men (40.0%; 3930 of 9823; P < .001). Women wrote 33 of 107 editorials (30.8%). CONCLUSIONS: There were no differences in reviewer recommendations or editor decisions for original research articles based on corresponding author gender. However, women had fewer opportunities to serve as peer reviewers and editorial writers than would be expected given their representation as academic pediatric faculty.

Gender Differences in the Authorship of Original Research in Pediatric Journals, 2001-2016.

OBJECTIVES: To examine the gender of authors of original research in 3 high-impact pediatric journals between 2001 and 2016, given the importance of publishing on academic promotion, and to compare authorship gender with the percentage of women on editorial boards and with academic faculty composition. STUDY DESIGN: We assessed the prevalence of female first and senior (last-listed) authorship of original research articles published in 3 pediatric-focused journals Pediatrics, JAMA Pediatrics (entitled Archives of Pediatric and Adolescent Medicine until 2013), and The Journal of Pediatrics. We also examined the gender breakdown of the main editors and the broader editorial boards of these journals. In addition, we examined whether junior female faculty co-authored with male or female senior faculty. RESULTS: Of 3895 original articles, 22 were excluded because the gender of either the first or senior author could not be determined from the name. An analysis of authorship by year showed increasing female representation across the selected journals in both first (39.8% in 2001, 57.7% in 2016) and senior (28.6% in 2001, 38.1% in 2016) authors, respectively. Editorial boards also showed increasing female representation (17.8% in 2001 to 39.8% in 2016). Junior female faculty were more likely to co-author with senior female women (female first and last author); the gap remained unchanged despite the increasing number of women entering pediatrics. CONCLUSIONS: Women are underrepresented as authors and editors, although the gap is closing. Junior women are less likely to co-author with senior men, which may be a disservice given current gender disparities in promotion and leadership.

Biophysical and biomolecular determination of cellular age in humans.

Ageing research has focused either on assessing organ- and tissue-based changes, such as lung capacity and cardiac function, or on changes at the molecular scale such as gene expression, epigenetic modifications and metabolism. Here, by using a cohort of 32 samples of primary dermal fibroblasts collected from individuals between 2 and 96 years of age, we show that the degradation of functional cellular biophysical features-including cell mechanics, traction strength, morphology and migratory potential-and associated descriptors of cellular heterogeneity predict cellular age with higher accuracy than conventional biomolecular markers. We also demonstrate the use of high-throughput single-cell technologies, together with a deterministic model based on cellular features, to compute the cellular age of apparently healthy males and females, and to explore these relationships in cells from individuals with Werner syndrome and Hutchinson-Gilford progeria syndrome, two rare genetic conditions that result in phenotypes that show aspects of premature ageing. Our findings suggest that the quantification of cellular age may be used to stratify individuals on the basis of cellular phenotypes and serve as a biological proxy of healthspan.