Global Production of Active Pharmaceutical Ingredients for US Generic Drugs Experiencing Shortages.

This study evaluates the characteristics of generic active pharmaceutical ingredients (APIs) used to manufacture drugs with shortages in the US and facilities producing APIs worldwide.

Revealing the Pressure-Induced Phase Transformation of Xenotime TbPO4 via In Situ Photoluminescence Spectroscopy.

The pressure-induced phase transformations of certain rare earth (RE) orthophosphates have attracted broad interest from geoscience to structural ceramics. Studying these transformations has required in situ Raman spectroscopy or synchrotron X-ray diffraction (XRD), each of which suffers from poor signal or limited accessibility, respectively. This study exploits the photoluminescence (PL) of Tb3+ ions and the unique sensitivity of PL to the local bonding environment to interrogate the symmetry-reducing xenotime-monazite phase transformation of TbPO4. At pressures consistent with the XRD-based phase transformation onset pressure of 8.7(6) GPa, PL spectra show new peaks emerging as well as trend changes in the centroids and intensity ratios of certain PL bands. Furthermore, PL spectra of recovered samples show transformation is irreversible. Hysteresis in certain PL band intensity ratios also reveals the stress history in TbPO4. This in situ PL approach can be applied to probe pressure-induced transformations and crystal field distortions in other RE-based oxide compounds.

Mortality Due to Hyperglycemic Crises in the US, 1999-2022.

This study analyzes trends in US mortality attributed to both diabetic ketoacidosis and hyperosmolar hyperglycemic state from 1999-2022.

Change in Epidemiology of Creutzfeldt-Jakob Disease in the US, 2007-2020.

This cross-sectional study uses Centers for Disease Control and Prevention multiple cause of death data to examine recent US trends in Creutzfeldt-Jakob disease.

False or Misleading Claims in Online Direct-to-Consumer Ketamine Advertising in Maryland.

This cross-sectional study evaluates the prevalence of false or misleading information in online direct-to-consumer advertising for off-label and unapproved ketamine in Maryland.

Developing Prioritization Criteria to Identify Target Drugs for CalRx, the California Generic Drugs Initiative.

OBJECTIVES: This study aimed to establish criteria to identify priority drugs for CalRx, a California-sponsored initiative to support the manufacture and distribution of affordable generic drugs. METHODS: A web-based ranking exercise was implemented with key stakeholders in August 2020, using pricing, spending, and public health criteria identified through a review of academic literature and public health agency reports. A total of 39 of 40 invited stakeholders in 4 different categories-patient advocates, healthcare providers, health insurers, and health policy and economic experts-participated in this study (98% response rate). RESULTS: Drugs that treat large populations, drugs that represent high cost to payors, and drugs that represent high cost to consumers were ranked a priority, receiving > 10% of ranking weights. Drugs that treat conditions with high morbidity or mortality, drugs without therapeutic alternatives, and drugs treating vulnerable populations represented criteria of further interest (9%-10% of weights). Shortage risk and curative effect (8%-9% of the weights), high price increases, communicable disease treatments, and high unit prices (< 8% of the weights) represented the bottom of the priority distribution. CONCLUSIONS: This study suggests that drugs that treat large populations, drugs that represent large costs to payors, and drugs that represent large costs to consumers should be the priority for California's CalRx generic drug initiative. A prioritizing algorithm will assist California in determining top drugs to target from a public health and spending perspective as it plans the rollout of the CalRx initiative and negotiates with drug manufacturers.

See the wind: Wind scale estimation with optical flow and VisualWind dataset.

Wind sensing by learning from video clips could empower cameras to sense the wind scale and significantly improve the spatiotemporal resolution of existing professional weather records that are often at the city scale. Humans can interpret the wind scale from the motion of surrounding environment objects, especially the moving dynamics of trees in the wind. The goal of this paper is to train cameras to sense the wind by capturing such motion information using optical flow and machine learning models. To this end, we introduce a novel video dataset of over 6000 labeled video clips, covering eleven wind classes of the Beaufort scale. The videos are collected from social media, pubic cameras, and self-recording with varying numbers of clips in each class. Every video clip has a length of 10 s with varied frame rates, and contains scenes of various trees swaying in different scales of wind from an approximately fixed viewpoint. The variation in scene over the course of a single video is minimal. We propose a dual-branch model to estimate the wind scale including a motion branch, which uses optical flow to extract the tree movement dynamics, and a visual branch, to provide visual complementary clues for wind scale estimation. The two branches are fused adaptively in the end of the network, achieving 86.69 % accuracy which confirms the effectiveness of the proposed method. We have conducted experiments compared with a two-stage baseline model and a model only consisting of the motion branch, achieving the best accuracy with the potential to significantly improve the efficiency in time and storage. The dataset and the code are publicly accessible online.

Stress-Induced (Takotsubo) Cardiomyopathy After Liver Transplant Rescued with Venoarterial Extracorporeal Membrane Oxygenation.

Here, we report the case of a 55 year old male patient without significant preexisting cardiovascular disease who received a deceased donor liver transplant. Intraoperatively, the patient developed cardiogenic shock secondary to stress-induced cardiomyopathy or Takotsubo syndrome (TTS), which was refractory to high-dose vasoactive, inotropic medical therapy. The patient was successfully managed with venoarterial extracorporeal membrane oxygenation (VA-ECMO) for 7 days, with complete recovery of cardiac function and maintenance of the hepatic graft. Given the anticipated need for only a short period of support and the expectation of full myocardial recovery, such patients may represent excellent candidates for the use of VA-ECMO.

Mortality Rates Among U.S. Women of Reproductive Age, 1999-2019.

INTRODUCTION: High and increasing levels of pregnancy-related mortality and morbidity in the U.S. indicate that the underlying health status of reproductive-aged women may be far from optimal, yet few studies have examined mortality trends and disparities exclusively among this population. METHODS: All-cause and cause-specific mortality data for 1999-2019 were obtained from the Centers for Disease Control and Prevention WONDER Underlying Cause of Death database. Levels and trends in mortality between 1999 and 2019 for women aged 15-44 years stratified by age, race/ethnicity, and state were examined. Given the urgent need to address pregnancy-related health disparities, the correlation between all-cause and pregnancy-related mortality rates across states for the years 2015-2019 was also examined. RESULTS: Age-adjusted, all-cause mortality rates among women aged 15-44 years improved between 2003 and 2011 but worsened between 2011 and 2019. The recent increase in mortality among this age group was not driven solely by increases in external causes of death. Patterns differed by age, race/ethnicity, and geography, with non-Hispanic American Indian and Alaskan Native women having 2.3 and non-Hispanic Black women having 1.4 times the risk of all-cause mortality in 2019 compared with that of non-Hispanic White women. Age-adjusted all-cause mortality rates and pregnancy-related mortality rates were strongly correlated at the state level (r=0.75). CONCLUSIONS: Increasing mortality among reproductive-aged women has substantial implications for maternal, women's, and children's health. Given the high correlation between pregnancy-related mortality and all-cause mortality at the state level, addressing the structural factors that shape mortality risks may have the greatest likelihood of improving women's health outcomes across the life course.

Ferromagnetism and Spin-Polarized Luminescence in Lead-Free CsEuCl3 Perovskite Nanocrystals and Thin Films.

The emergence of next-generation spintronic and spin-photonic technologies will be aided by the development of materials showing strongly coupled magnetic, electronic, and optical properties. Through a combination of magneto-photoluminescence and magnetic circular dichroism spectroscopies we demonstrate strong magneto-optical responses from CsEuCl3 perovskite nanocrystals and thin films in the near-UV/visible region, stemming from the f-d transitions centered at the B-site Eu2+ cations. We show that this material undergoes a ferromagnetic phase transition at ∼3 K in both the nanocrystal and thin-film samples, resulting in complete spin alignment and indicating intrinsic ferromagnetism. We also report the observation of spin-polarized photoluminescence in the presence of a magnetic field at cryogenic temperatures, saturating with a large polarization ratio (ΔI/I = (IL - IR)/(IL + IR)) of nearly 30% at modest magnetic fields (∼2 T). These results highlight CsEuCl3 as an intrinsically ferromagnetic, luminescent metal-halide perovskite with potentially interesting implications for future spin-based technologies using perovskites.

Reporting of Infectious Diseases in the United States During the Coronavirus Disease 2019 (COVID-19) Pandemic.

Reporting of infectious diseases other than COVID-19 has been greatly decreased throughout the COVID-19 pandemic. We find this decrease varies by routes of transmission, reporting state, and COVID-19 incidence at the time of reporting. These results underscore the need for continual investment in routine surveillance efforts despite pandemic conditions.

Disparities In County COVID-19 Vaccination Rates Linked To Disadvantage And Hesitancy.

We analyzed trends in adult COVID-19 vaccine coverage over time based on COVID-19 vaccine hesitancy and social vulnerability. We found that each of these variables carries an independent association with disparities across counties in COVID-19 vaccine coverage. Counties that score high on both hesitancy and vulnerability are especially likely to have lower COVID-19 vaccination rates compared with the rest of the country.

Lots of movement, little progress: a review of reptile home range literature.

Reptiles are the most species-rich terrestrial vertebrate group with a broad diversity of life history traits. Biotelemetry is an essential methodology for studying reptiles as it compensates for several limitations when studying their natural history. We evaluated trends in terrestrial reptile spatial ecology studies focusing upon quantifying home ranges for the past twenty years. We assessed 290 English-language reptile home range studies published from 2000-2019 via a structured literature review investigating publications' study location, taxonomic group, methodology, reporting, and analytical techniques. Substantial biases remain in both location and taxonomic groups in the literature, with nearly half of all studies (45%) originating from the USA. Snakes were most often studied, and crocodiles were least often studied, while testudines tended to have the greatest within study sample sizes. More than half of all studies lacked critical methodological details, limiting the number of studies for inclusion in future meta-analyses (55% of studies lacked information on individual tracking durations, and 51% lacked sufficient information on the number of times researchers recorded positions). Studies continue to rely on outdated methods to quantify space-use (including Minimum Convex Polygons and Kernel Density Estimators), often failing to report subtleties regarding decisions that have substantial impact on home range area estimates. Moving forward researchers can select a suite of appropriate analytical techniques tailored to their research question (dynamic Brownian Bridge Movement Models for within sample interpolation, and autocorrelated Kernel Density Estimators for beyond sample extrapolation). Only 1.4% of all evaluated studies linked to available and usable telemetry data, further hindering scientific consensus. We ultimately implore herpetologists to adopt transparent reporting practices and make liberal use of open data platforms to maximize progress in the field of reptile spatial ecology.

Laser-Driven Growth of Semiconductor Nanowires from Colloidal Nanocrystals.

Semiconductor nanowire production through vapor- and solution-based processes has propelled nanowire systems toward a wide range of technological applications. Although vapor-based nanowire syntheses enable precise control over nanowire composition and phase, they typically employ batch processes with specialized pressure management systems, limiting throughput. Solution-based nanowire growth processes have improved scalability but can require even more extensive pressure and temperature management systems. Here, we demonstrate a solution-based nanowire growth process that utilizes the large Young-Laplace interfacial surface pressures and collective heating effects of colloidal metal nanocrystals under irradiation to drive nanowire growth photothermally. Laser irradiation of a solution containing metal nanocrystals and semiconductor precursors facilitates rapid heating, precursor decomposition, and nanowire growth on a benchtop in simple glassware under standard conditions, potentially enabling a range of solution-based experiments including in-line combinatorial identification of optimized reaction parameters, in situ measurements, and the production of nanowires with complex compositions.

Association between exenatide use and incidence of Alzheimer's disease.

INTRODUCTION: Recent developments suggest that insulin-sensitizing agents used to treat type II diabetes (T2DM) may also prove useful in reducing the risk of Alzheimer's disease (AD). The objective of this study is to analyze the association between exenatide use among Medicare beneficiaries with T2DM and the incidence of AD. METHODS: We performed a retrospective cohort analysis on claims data from a 20% random sample of Medicare beneficiaries with T2DM from 2007 to 2013 (n = 342,608). We compared rates of incident AD between 2009 and 2013 according to exenatide use in 2007-2008, measured by the number of 30-day-equivalent fills. We adjusted for demographics, comorbidities, and use of other drugs. Unmeasured confounding was assessed with an instrumental variables approach. RESULTS: The sample was mostly female (65%), White (76%), and 74 years old on average. Exenatide users were more likely to be male (38% vs. 35%), White (87% vs. 76%), and younger (by 4.2 years) than non-users. Each additional 30-day-equivalent claim was associated with a 2.4% relative reduction in incidence (odds ratio 0.976; 95% confidence interval 0.963-0.989; P < .001). There was no evidence of unmeasured confounding. DISCUSSION: Exenatide use is associated with a reduced incidence of AD among Medicare beneficiaries aged 65 years or older with T2DM. The association shown in this study warrants consideration by clinicians prescribing insulin sensitizing agents to patients.