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251. Equal Access to Telemedicine during COVID‐19 Pandemic: A Pediatric Otolaryngology Perspective

Author

Jiang, Wen, Magit, Anthony E, and Carvalho, Daniela

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Health Services, Clinical Research, Rural Health, Networking and Information Technology R&D (NITRD), Good Health and Well Being, COVID-19, California, Child, Child, Preschool, Female, Health Services Accessibility, Humans, Male, Otolaryngology, Retrospective Studies, SARS-CoV-2, Telemedicine, United States, access, Otorhinolaryngology, Clinical sciences
Abstract

Objectives/hypothesisDuring the current COVID-19 pandemic, the demand for direct-to-home telemedicine services has risen to an unprecedented level. Equal access to specialty care was assessed to identify potential barriers that may negatively impact telemedicine utilization.Study designRetrospective case series.MethodsWe examined the 6-week period between March and May 2020 when the only access to nonurgent pediatric otolaryngology service was through telemedicine and compared it to in-person visits during the same period in 2019. We compared patient demographics, including age, gender, preferred language, zip code of residence, and primary insurance plan.ResultsA total of 1,495 visits were conducted through telemedicine from March 23, 2020 to May 1, 2020, and 1983 in-person visits were completed in 2019. There was no difference in patient age and gender. The proportions of Spanish-speaking families were similar (15.8% in 2019 vs. 14.4% in 2020, P = .96). The percentage of Medi-Cal-insured patients (51.4% in 2019 vs. 49.8% in 2020, P = .73) and the mean poverty level (12.6% in 2019 vs. 12.2% in 2020, P = .38) also remained the same. Spanish-speaking families were statistically more likely to require rescheduling of their telemedicine visits (17.2%) when compared to the overall rescheduling rate of 11.9% (P = .0083).ConclusionsWe were able to successfully provide access to telemedicine services to our vulnerable populations during the current COVID-19 pandemic. Telemedicine is likely to remain an essential mode of delivering patient care going forward. It is important to evaluate and identify potential disparities to telemedicine access and proactively implement changes to address these barriers.Level of evidence4. Laryngoscope, 131:1175-1179, 2021.

Published
2021

252. Undifferentiated recurrent fevers in pediatrics are clinically distinct from PFAPA syndrome but retain an IL-1 signature

Author

Luu, Irene, Nation, Javan, Page, Nathan, Carvalho, Daniela, Magit, Anthony, Jiang, Wen, Leuin, Shelby, Bliss, Morgan, Bothwell, Marcella, Brigger, Matthew, Kearns, Donald, Pransky, Seth, and Broderick, Lori

Subjects
Digestive Diseases, Pediatric, Dental/Oral and Craniofacial Disease, Pain Research, CD3 Complex, Child, Preschool, Female, Fever, Gastrointestinal Diseases, Hereditary Autoinflammatory Diseases, Humans, Inflammation, Interleukin-1, Lymphadenitis, Male, Palatine Tonsil, Pediatrics, Pharyngitis, Stomatitis, Aphthous, Syndrome, T-Lymphocytes, Tonsillectomy, Recurrent fever, Periodic fever, Autoinflammation, Immunology
Abstract

Autoinflammatory disorders of the innate immune system present with recurrent episodes of inflammation often beginning in early childhood. While there are now more than 30 genetically-defined hereditary fever disorders, many patients lack a clear diagnosis. Many pediatric patients are often grouped with patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome despite failing to meet diagnostic criteria. Here, we categorize these patients as syndrome of undifferentiated recurrent fever (SURF), and identify the unique features which distinguish them from the PFAPA syndrome. SURF patients were more likely to report gastrointestinal symptoms of nausea, vomiting and abdominal pain, and experienced inconsistent responses to on-demand steroid therapy compared to PFAPA patients. For this previously undefined cohort, an optimal course of therapy remains uncertain, with medical and surgical therapies largely driven by parental preference. A subset of patients with SURF underwent tonsillectomy with complete resolution. Flow cytometric evaluation demonstrates leukocytic populations distinct from PFAPA patients, with reduced CD3+ T cell numbers. SURF patient tonsils were predominantly characterized by an IL-1 signature compared to PFAPA, even during the afebrile period. Peripheral blood signatures were similar between groups suggesting that PFAPA and SURF patient tonsils have localized, persistent inflammation, without clinical symptoms. These data suggest that SURF is a heterogenous syndrome on the autoinflammatory disease spectrum.

Published
2021

253. Diagnostic utility of fine needle aspiration cytology in pediatric thyroid nodules based on Bethesda Classification

Author

Jiang, Wen, Phillips, Susan A, Newbury, Robert O, Naheedy, John H, and Newfield, Ron S

Subjects
Pediatric, Cancer, Clinical Research, Pediatric Research Initiative, Prevention, Biomedical Imaging, Adolescent, Biopsy, Fine-Needle, Child, Cytodiagnosis, Female, Humans, Male, Reproducibility of Results, Retrospective Studies, Thyroid Neoplasms, Thyroid Nodule, Ultrasonography, Interventional, cytology, fine needle aspiration, pediatrics, TBSRTC, thyroid nodules, Paediatrics and Reproductive Medicine, Endocrinology & Metabolism
Abstract

ObjectivesThe Bethesda system for reporting cytopathology (TBSRTC) has been widely adopted in the management of thyroid nodules. Based on the limited pediatric data available, the implied malignancy risk for each of the categories may be significantly different in pediatrics vs. adults, especially in the indeterminate categories (Bethesda Class III or IV). We report the diagnostic utility of fine needle aspiration (FNA) biopsy at our institution based on the Bethesda system and the risk of malignancy in each category.MethodsWe retrospectively reviewed all patients who underwent a thyroid FNA at our tertiary pediatric hospital from 12/1/2002 to 11/30/2018. FNA results were classified according to TBSRTC. Patient demographics, cytology, histopathology, radiological and clinical follow-ups were examined.ResultsA total of 171 patients were included with 203 cytological samples. Average age at initial FNA was 14.7 years (range 6.9-18.6 years). The numbers of nodules reported for Bethesda categories I-VI were 29, 106, 22, 14, 6 and 26, respectively, and the rate of malignancy was: 13.8, 4.7, 22.7, 35.7, 83.3 and 100%, respectively. Use of ultrasound guidance reduced the non-diagnostic rate from 38.1 to 11.5%. Introduction of on-site adequacy testing further reduced the non-diagnostic rate to 6.5% since 2014.ConclusionsThe risk of malignancy for thyroid nodules in this pediatric cohort is higher than reported in adults. However, rates described here are much closer to adult ranges than previously published pediatric cohorts. The addition of adequacy testing improved the non-diagnostic rate of FNA procedures performed with ultrasound guidance.

Published
2021

254. Line Drawings of Natural Scenes Guide Visual Attention

Author

Yang, Kai-Fu, Jiang, Wen-Wen, Zhan, Teng-Fei, and Li, Yong-Jie

Subjects
Computer Science - Computer Vision and Pattern Recognition
Abstract

Visual search is an important strategy of the human visual system for fast scene perception. The guided search theory suggests that the global layout or other top-down sources of scenes play a crucial role in guiding object searching. In order to verify the specific roles of scene layout and regional cues in guiding visual attention, we executed a psychophysical experiment to record the human fixations on line drawings of natural scenes with an eye-tracking system in this work. We collected the human fixations of ten subjects from 498 natural images and of another ten subjects from the corresponding 996 human-marked line drawings of boundaries (two boundary maps per image) under free-viewing condition. The experimental results show that with the absence of some basic features like color and luminance, the distribution of the fixations on the line drawings has a high correlation with that on the natural images. Moreover, compared to the basic cues of regions, subjects pay more attention to the closed regions of line drawings which are usually related to the dominant objects of the scenes. Finally, we built a computational model to demonstrate that the fixation information on the line drawings can be used to significantly improve the performances of classical bottom-up models for fixation prediction in natural scenes. These results support that Gestalt features and scene layout are important cues for guiding fast visual object searching., Comment: 12 pages, 10 figures

Published
2019

255. Depth penetration and scope extension of failures in the cascading of multilayer networks

Author

Jiang, Wen-Jun, Liu, Run-Ran, and Jia, Chun-Xiao

Subjects
Physics - Physics and Society, Nonlinear Sciences - Adaptation and Self-Organizing Systems
Abstract

Real-world complex systems always interact with each other, which causes these systems to collapse in an avalanche or cascading manner in the case of random failures or malicious attacks. The robustness of multilayer networks has attracted great interest, where the modeling and theoretical studies of which always rely on the concept of multilayer networks and percolation methods. A straightforward and tacit assumption is that the interdependence across network layers is strong, which means that a node will fail entirely with the removal of all links if one of its interdependent neighbours fails. However, this oversimplification cannot describe the general form of interactions across the network layers in a real-world multilayer system. In this paper, we reveal the nature of the avalanche disintegration of general multilayer networks with arbitrary interdependency strength across network layers. Specifically, we identify that the avalanche process of the whole system can essentially be decomposed into two microscopic cascading dynamics in terms of the propagation direction of the failures: depth penetration and scope extension. In the process of depth penetration, the failures propagate from layer to layer, where the greater the number of failed nodes is, the greater the destructive power that will emerge in an interdependency group. In the process of scope extension, failures propagate with the removal of connections in each network layer. Under the synergy of the two processes, we find that the percolation transition of the system can be discontinuous or continuous with changes in the interdependency strength across network layers, which means that sudden system-wide collapse can be avoided by controlling the interdependency strength across network layers.

Published
2019

286. COVID-19 vaccination for patients with epilepsy: A Chinese expert consensus

Author

Liu, Xuewu, Wang, Qun, Ren, Liankun, Fang, Xiqin, He, Zhiyi, Ding, Jing, Wang, Kang, Xu, Huiqin, Zhang, Hua, Song, Yijun, Lu, Qiang, Sun, Meizhen, Han, Xiong, Cao, Lili, Lin, Weihong, Li, Xiaoyi, Zhang, Qing, Ding, Yao, Wang, Furong, Wang, Tiancheng, Wang, Jiwen, Liu, Xiaorong, Wu, Yuan, Chen, Yangmei, Feng, Zhanhui, Wang, Shoulei, Wang, Xiangqing, Guan, Yuguang, Xie, Xufang, Huang, Huapin, Zhang, Ming, Wang, Xiaoshan, Hong, Zhen, Jiang, Wen, Han, Yanbing, Deng, Yulei, Zhao, Jiangming, Liao, Jianxiang, Wang, Yu, and Lian, Yajun

Published
2023
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289. Investigation of the Preparation of Steel-Based Superamphiphobic Surface by Ni-nSiO2 Nanocomposite Electroplating

Author

CHENG Hong, WEI Zhi-yuan, WANG Yong, JIANG Wen-xuan

Subjects
superamphiphobic surface, nanocomposite electrodeposition, steel substrate surface, preparation process parameters, Materials of engineering and construction. Mechanics of materials, TA401-492, Technology
Abstract

In order to realize the preparation of a superamphiphobic surface on the steel substrate and simultaneously avoid damage to the physical properties of the steel substrate surface， a preparation process for preparing superamphiphobic surface on marine Q235 steel was proposed on the basis of Ni-nSiO2 nanocomposite electrodeposition technology. Firstly， a micro-nano double-roughness structure suitable for superamphiphobic properties was constructed on the surface of the steel substrate by nanocomposite electroplating and liquid phase deposition，and then the surface was modified with heptadecafluorodecyl trimethoxysilane. By designing a three - factor orthogonal experiment， the preparation process parameters that could realize superamphiphobic surface were obtained by changing the electroplating parameters (temperature， time， current) and analyzing the influence of each parameter on the surface wettability. Additionally， the microscopic morphology of the as-prepared superamphiphobic surface was analyzed by scanning electron microscopy. Results showed that when the current density was 12.5 A/dm2， the magnetic stirring speed was 200 r/min， the electroplating time was 50 min， and the temperature was 60 ℃， the as-prepared steel-based superamphiphobic surface presented a contact angle of 154° with water and a contact angle of 151° with oil. Under the above parameters， the combination of micro-nano rough morphology obtained through the composite electrodeposition process and low surface energy modification made the surface exhibited superamphiphobic properties.

Published
2023
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291. Deep learning integrates histopathology and proteogenomics at a pan-cancer level

Author

Aguet, François, Akiyama, Yo, Anand, Shankara, Anurag, Meenakshi, Babur, Özgün, Bavarva, Jasmin, Birger, Chet, Birrer, Michael J., Cantley, Lewis C., Cao, Song, Carr, Steven A., Ceccarelli, Michele, Chan, Daniel W., Chinnaiyan, Arul M., Cho, Hanbyul, Chowdhury, Shrabanti, Cieslik, Marcin P., Clauser, Karl R., Colaprico, Antonio, Zhou, Daniel Cui, da Veiga Leprevost, Felipe, Day, Corbin, Dhanasekaran, Saravana M., Domagalski, Marcin J., Dou, Yongchao, Druker, Brian J., Edwards, Nathan, Ellis, Matthew J., Selvan, Myvizhi Esai, Foltz, Steven M., Francis, Alicia, Geffen, Yifat, Getz, Gad, Gonzalez Robles, Tania J., Gosline, Sara J.C., Gümüş, Zeynep H., Heiman, David I., Hiltke, Tara, Hostetter, Galen, Hu, Yingwei, Huang, Chen, Huntsman, Emily, Iavarone, Antonio, Jaehnig, Eric J., Jewell, Scott D., Ji, Jiayi, Jiang, Wen, Johnson, Jared L., Katsnelson, Lizabeth, Ketchum, Karen A., Kolodziejczak, Iga, Krug, Karsten, Kumar-Sinha, Chandan, Lei, Jonathan T., Liang, Wen-Wei, Liao, Yuxing, Lindgren, Caleb M., Liu, Tao, Ma, Weiping, Rodrigues, Fernanda Martins, McKerrow, Wilson, Mesri, Mehdi, Nesvizhskii, Alexey I., Newton, Chelsea J., Oldroyd, Robert, Paulovich, Amanda G., Payne, Samuel H., Petralia, Francesca, Pugliese, Pietro, Reva, Boris, Rykunov, Dmitry, Satpathy, Shankha, Savage, Sara R., Schadt, Eric E., Schnaubelt, Michael, Schürer, Stephan, Shi, Zhiao, Smith, Richard D., Song, Xiaoyu, Song, Yizhe, Stathias, Vasileios, Storrs, Erik P., Terekhanova, Nadezhda V., Thangudu, Ratna R., Thiagarajan, Mathangi, Tignor, Nicole, Wang, Liang-Bo, Wang, Pei, Wang, Ying, Wen, Bo, Wiznerowicz, Maciej, Wu, Yige, Wyczalkowski, Matthew A., Yao, Lijun, Yaron, Tomer M., Yi, Xinpei, Zhang, Bing, Zhang, Hui, Zhang, Qing, Zhang, Xu, Zhang, Zhen, Wang, Joshua M., Hong, Runyu, Demicco, Elizabeth G., Tan, Jimin, Lazcano, Rossana, Moreira, Andre L., Li, Yize, Calinawan, Anna, Razavian, Narges, Schraink, Tobias, Gillette, Michael A., Omenn, Gilbert S., An, Eunkyung, Rodriguez, Henry, Tsirigos, Aristotelis, Ruggles, Kelly V., Ding, Li, Robles, Ana I., Mani, D.R., Rodland, Karin D., Lazar, Alexander J., Liu, Wenke, and Fenyö, David

Published
2023
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292. Integrative multi-omic cancer profiling reveals DNA methylation patterns associated with therapeutic vulnerability and cell-of-origin

Author

Aguet, François, Akiyama, Yo, An, Eunkyung, Anand, Shankara, Anurag, Meenakshi, Babur, Ozgun, Bavarva, Jasmin, Birger, Chet, Birrer, Michael, Calinawan, Anna, Cantley, Lewis C., Cao, Song, Carr, Steve, Ceccarelli, Michele, Chan, Daniel, Chinnaiyan, Arul, Cho, Hanbyul, Chowdhury, Shrabanti, Cieslik, Marcin, Clauser, Karl, Colaprico, Antonio, Zhou, Daniel Cui, da Veiga Leprevost, Felipe, Day, Corbin, Dhanasekaran, Mohan, Domagalski, Marcin, Dou, Yongchao, Druker, Brian, Edwards, Nathan, Ellis, Matthew, Selvan, Myvizhi Esai, Francis, Alicia, Getz, Gad, Gillette, Michael A., Robles, Tania Gonzalez, Gosline, Sara, Gümüş, Zeynep, Heiman, David, Hiltke, Tara, Hong, Runyu, Hostetter, Galen, Hu, Yingwei, Huang, Chen, Huntsman, Emily, Iavarone, Antonio, Jaehnig, Eric, Jewel, Scott, Ji, Jiayi, Jiang, Wen, Lee Johnson, Jared, Katsnelson, Lizabeth, Ketchum, Karen, Krug, Karsten, Kumar-Sinha, Chandan, Lei, Jonathan, Liao, Yuxing, Lindgren, Caleb, Liu, Tao, Liu, Wenke, Ma, Weiping, Rodrigues, Fernanda Martins, McKerrow, Wilson, Mesri, Mehdi, Nesvizhskii, Alexey I., Newton, Chelsea, Oldroyd, Robert, Omenn, Gilbert, Paulovich, Amanda, Petralia, Francesca, Pugliese, Pietro, Reva, Boris, Ruggles, Kelly, Rykunov, Dmitry, Satpathy, Shankha, Savage, Sara, Schadt, Eric, Schnaubelt, Michael, Schraink, Tobias, Shi, Zhiao, Smith, Dick, Song, Xiaoyu, Stathias, Vasileios, Storrs, Erik, Tan, Jimin, Terekhanova, Nadezhda, Thangudu, Ratna, Thiagarajan, Mathangi, Tignor, Nicole, Wang, Joshua, Wang, Liang-Bo, Wang, Pei, Wang, Ying (Cindy), Wen, Bo, Wu, Yige, Yao, Lijun, Yaron, Tomer M., Yi, Xinpei, Zhang, Bing, Zhang, Hui, Zhang, Qing, Zhang, Xu, Zhang, Zhen, Chan, Daniel W., Dhanasekaran, Saravana M., Schürer, Stephan, Smith, Richard D., Wyczalkowski, Matthew A., Liang, Wen-Wei, Lu, Rita Jui-Hsien, Jayasinghe, Reyka G., Foltz, Steven M., Porta-Pardo, Eduard, Geffen, Yifat, Wendl, Michael C., Lazcano, Rossana, Kolodziejczak, Iga, Song, Yizhe, Govindan, Akshay, Demicco, Elizabeth G., Li, Xiang, Li, Yize, Sethuraman, Sunantha, Payne, Samuel H., Fenyö, David, Rodriguez, Henry, Wiznerowicz, Maciej, Shen, Hui, Mani, D.R., Rodland, Karin D., Lazar, Alexander J., Robles, Ana I., and Ding, Li

Published
2023
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