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Aim. Fibromyalgia (FM) is a noninflammatory disorder of the nervous system characterized by widespread musculoskeletal pain and somatic complaints of at least 3 months duration. There are no current diagnostic criteria for fibromyalgia in children to guide clinicians in recognition, thus leading to many subspecialty referrals and extensive imaging and tests. The purpose of this retrospective review is to compare two diagnostic criteria for juvenile fibromyalgia. Methods. A retrospective chart review of 20 children diagnosed with juvenile fibromyalgia from a singular pain physician practice was performed. Both the Yunus diagnostic criteria and the 2016 American College of Rheumatology (ACR) diagnostic criteria were applied and compared. Results. 85% of patients met criteria for fibromyalgia under both criteria. 15% of patients met only ACR criteria as the Yunus criteria excluded those with underlying conditions. Of the children who fulfilled criteria with use of both diagnostic tools, this cohort reported a high somatic symptom burden as demonstrated by the ACR symptom severity scales of 12 and satisfaction of at least 4 Yunus and Masi minor criteria on average. Widespread pain was noted with an ACR Widespread Pain Index (WPI) of 7, and tender points were 4.8 on average across the cohort. Effective therapeutic regimens among patients varied widely from medical monotherapy to multimodal treatment. Patients presented with pain for 1.8 yrs on average prior to a diagnosis. All of the cohort had a normal laboratory evaluation; half the cohort received additional imaging and testing. Conclusion. This case series suggests the need for an updated diagnostic tool for pediatric fibromyalgia to facilitate recognition and treatment. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze acute care utilization of sickle cell disease (SCD) and sickle cell trait (SCT) in children and identify trends in emergency department (ED) visits and inpatient admissions over a 10-year period. This is a retrospective population-based study of SCD- and SCT-related ED visits and admissions from 2006 to 2015. Data were acquired from the Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), and National Emergency Department Sample (NEDS) database. Cost-to-charge and estimated professional fee ratios were applied to approximate costs. Over 80% of medical expenditure on HbSS is through ED-based admissions. There is a statistically significant increase from 2006 to 2015 in the direct hospital admissions associated with patients less than 18 years of age who have been diagnosed with SCT.Conclusion: Among patients less than 18 years of age with HbSS, inpatient admissions through the emergency department accounted for the largest medical expenditure of the SCD subtypes. What is Known: • There are currently no multi-year, nationwide analyses of acute care utilization in sickle cell disease and sickle cell trait (SCT) in the pediatric population. • SCT is more common than SCD, affecting 1.5% of all infants born in the USA. What is New: • Comprehensive annual costs of acute care utilization of patients less than 18 years of age with SCD and SCT in the USA which includes aggregated demographical patient care data and to illustrate temporal trends of acute care utilization in children less than 18 years of age with SCD and SCT • Among patients less than 18 years of age with HbSS, inpatient admissions through the emergency department accounted for the largest medical expenditure of the sickle cell disease subtypes. [ABSTRACT FROM AUTHOR]

This article describes how the author used a wiki-based website in a real analysis course, and assesses its effectiveness. The wiki was used to post course materials, maintain a forum, enable students to write collaborative projects, and enable students to develop a glossary of important terms. The wiki proved to be very successful; it facilitated student collaboration, exposed students to LaTeX, and even helped them to study for examinations. [ABSTRACT FROM AUTHOR]

We prove the following conjecture of Atanassov (Studia Sci. Math. Hungar.32 (1996), 71–74). Let T be a triangulation of a d-dimensional polytope P with n vertices v1, v2,…,vn. Label the vertices of T by 1,2,…,n in such a way that a vertex of T belonging to the interior of a face F of P can only be labelled by j if vj is on F. Then there are at least n−d full dimensional simplices of T, each labelled with d+1 different labels. We provide two proofs of this result: a non-constructive proof introducing the notion of a pebble set of a polytope, and a constructive proof using a path-following argument. Our non-constructive proof has interesting relations to minimal simplicial covers of convex polyhedra and their chamber complexes, as in Alekseyevskaya (Discrete Math.157 (1996), 15–37) and Billera et al. (J. Combin. Theory Ser. B57 (1993), 258–268). [Copyright &y& Elsevier]

Hairball buster (HB) (also called node-neighbor centrality or NNC) is an approach to graph analytic triage that uses simple calculations and visualization to quickly understand and compare graphs. Rather than displaying highly interconnected graphs as 'hairballs' that are difficult to understand, HB provides a simple standard visual representation of a graph and its metrics, combining a monotonically decreasing curve of node metrics with indicators of each node's neighbors' metrics. The HB visual is canonical, in the sense that it provides a standard output for each node-link graph. It helps analysts quickly identify areas for further investigation, and also allows for easy comparison between graphs of different data sets. The calculations required for creating an HB display is order M plus N log N, where N is the number of nodes and M is the number of edges. This paper includes examples of the HB approach applied to four real-world data sets. It also compares HB to similar visual approaches such as degree histograms, adjacency matrices, blockmodeling, and force-based layout techniques. HB presents greater information density than other algorithms at lower or equal calculation cost, efficiently presenting information in a single display that is not available in any other single display. [ABSTRACT FROM AUTHOR]

The article informs that SARS-CoV-2 B.1.1.529 (Omicron) variant became predominant in the U.S. by late December 2021, leading to a surge in COVID-19 cases and associated emergency department visits and hospitalizations. It is noted that being up to date on vaccinations and following other recommended prevention strategies are critical to preventing infections, severe illness, or death from COVID-19.

The geographic areas in the United States most affected by the coronavirus disease 2019 (COVID-19) pandemic have changed over time. On May 7, 2020, CDC, with other federal agencies, began identifying counties with increasing COVID-19 incidence (hotspots) to better understand transmission dynamics and offer targeted support to health departments in affected communities. Data for January 22-July 15, 2020, were analyzed retrospectively (January 22-May 6) and prospectively (May 7-July 15) to detect hotspot counties. No counties met hotspot criteria during January 22-March 7, 2020. During March 8-July 15, 2020, 818 counties met hotspot criteria for ≥1 day; these counties included 80% of the U.S. population. The daily number of counties meeting hotspot criteria peaked in early April, decreased and stabilized during mid-April-early June, then increased again during late June-early July. The percentage of counties in the South and West Census regions* meeting hotspot criteria increased from 10% and 13%, respectively, during March-April to 28% and 22%, respectively, during June-July. Identification of community transmission as a contributing factor increased over time, whereas identification of outbreaks in long-term care facilities, food processing facilities, correctional facilities, or other workplaces as contributing factors decreased. Identification of hotspot counties and understanding how they change over time can help prioritize and target implementation of U.S. public health response activities. [ABSTRACT FROM AUTHOR]