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Summary: Background: While many patients seem to recover from SARS-CoV-2 infections, many patients report experiencing SARS-CoV-2 symptoms for weeks or months after their acute COVID-19 ends, even developing new symptoms weeks after infection. These long-term effects are called post-acute sequelae of SARS-CoV-2 (PASC) or, more commonly, Long COVID. The overall prevalence of Long COVID is currently unknown, and tools are needed to help identify patients at risk for developing long COVID. Methods: A working group of the Rapid Acceleration of Diagnostics-radical (RADx-rad) program, comprised of individuals from various NIH institutes and centers, in collaboration with REsearching COVID to Enhance Recovery (RECOVER) developed and organized the Long COVID Computational Challenge (L3C), a community challenge aimed at incentivizing the broader scientific community to develop interpretable and accurate methods for identifying patients at risk of developing Long COVID. From August 2022 to December 2022, participants developed Long COVID risk prediction algorithms using the National COVID Cohort Collaborative (N3C) data enclave, a harmonized data repository from over 75 healthcare institutions from across the United States (U.S.). Findings: Over the course of the challenge, 74 teams designed and built 35 Long COVID prediction models using the N3C data enclave. The top 10 teams all scored above a 0.80 Area Under the Receiver Operator Curve (AUROC) with the highest scoring model achieving a mean AUROC of 0.895. Included in the top submission was a visualization dashboard that built timelines for each patient, updating the risk of a patient developing Long COVID in response to clinical events. Interpretation: As a result of L3C, federal reviewers identified multiple machine learning models that can be used to identify patients at risk for developing Long COVID. Many of the teams used approaches in their submissions which can be applied to future clinical prediction questions. Funding: Research reported in this RADx® Rad publication was supported by the National Institutes of Health. Timothy Bergquist, Johanna Loomba, and Emily Pfaff were supported by Axle Subcontract: NCATS-STSS-P00438.

The National Clinical Cohort Collaborative (N3C) uses privacy-preserving record linkage (PPRL) to formulate longitudinal patient histories and for de-duplication across disparate data including electronic health records, administrative claims, and mortality data. The N3C employs a linkage honest broker implementation model which separates the entity holding de-identified PPRL tokens, from the entity holding the substantive data payloads. As a result of this data governance structure, linkage quality assessments are necessarily distributed into 2 distinct processes: 1) Linkage Honest Broker receipt and processing of linkages, 2) Data Aggregation entity assembling data based on received linkage crosswalks. Data is released on a weekly basis. This presentation will focus on Step 2 for the Mortality data linkages where the downstream data linkage pipelines must assess linkage quality across several dimensions of quality, focused on plausibility. There are 4 types of mortality data spanning the electronic health record, government Social Security Administration death master files, third-party obituary data, and administrative claims. Each of these sources has different levels of authoritativeness and data latency, compounding the challenges of reconciling fact of death including accurate death reporting dates. To address these challenges, we implemented an automated linkage quality pipeline which generates reports that assess linkage plausibility across the various data types, classifying concordance and discordance between data sources including age, dates of death, surfacing plausible and non-plausible activities post-death. Sharing our real-world implementation will aid conference attendees in understanding how to plan for such activities when considering specific implementation models for privacy-preserving linkages.

Data centralization is increasingly non-viable in the changing landscape of data privacy and data governance. New models of data sharing are needed, in particular when privacy-preserving record linkages (PPRL) are being used to connect data within restricted data enclaves and public open enclaves. We share a privacy-preserving data-sharing infrastructure that employs a linkage honest broker implementation of PPRL connecting structured electronic health record data between the National Center for Advancing Translational Science (NCATS) National Clinical Cohort Collaborative (N3C), a restricted data enclave, with the National Cancer Institute (NCI) Cancer Imaging Archive (TCIA), a public open enclave. In particular we will address: • Data governance models needed when linking data from restricted vs. public enclaves • Specific privacy-preserving consideration when linking to imaging data which contain specific structured data and imaging considerations • Privacy-preserving data aggregation when combining multi-modal data from restricted data enclaves with publicly discoverable imaging data

Transepithelial electrical resistance (TEER) is a widely used technique for quantifying the permeability of epithelial and endothelial cell layers. However, traditional methods of measuring TEER are limited to single timepoint measurements and can subject cells to an altered environment during the measurement. Here, we assessed the validity of TEER measurements by the ECIS TEER96 device, which is designed to take continuous TEER measurements of a cell culture system in a standard laboratory incubator. We found that the instrument accurately measures TEER across TEER values ranging from 10 to 2050 Ω*cm2 and is more accurate than the manual epithelial voltohmmeter electrode at high TEER values. Furthermore, the high-resolution measurements provided by the device allowed for a unique insight into the mechanisms and kinetics of cells in vitro. To demonstrate the continuous measurement capability of the device, we tracked the formation of an MDCKI cell monolayer until TEER plateaued. Furthermore, we treated Caco-2 monolayers with different concentrations of DMSO and the antimicrobial and surfactant compound benzethonium chloride to measure disruptions to barrier integrity. Treatment of both compounds resulted in concentration-dependent loss of barrier integrity. Our results suggest that the ECIS TEER96 device is a reliable and convenient option for measuring TEER in cell cultures and can provide valuable insights into the behavior of cells in vitro. This technology will be especially useful for increasing throughput of drug permeability assays, inflammation studies, and gaining better understanding of disease states in a cell culture system.

Athlete maltreatment has become 'one of the greatest concerns faced by governing bodies, authorities and practitioners in sport' (Stirling 2009, p. 1901). Its causes broadly stem from: (1) the culture and authority structures in organised sport; (2) the limited legal rights of athletes; and (3) a fragmented system of organisational oversight. Cutting across these causes is the distinct 'policy mix' within the elite sport system itself. Drawing upon a theoretical framework located within 'new institutionalism' and an interpretive qualitative approach using document analysis and semi-structured interviews, this investigation focuses on how policy instruments (e.g. programmes, rules, budgets, etc.) combine to shape/reinforce the behaviour and views of athletes, coaches, and administrators. Findings show that the policy instruments within the existing hierarchical structure of the elite sport system are interconnected and complement each other to mutually facilitate the attainment of elite sport success. Overall, this study suggests that the mix of policy instruments aimed at achieving the state's sport/political objectives may sustain and reinforce maltreatment. [ABSTRACT FROM AUTHOR]

Wellbeing has firmly established itself within contemporary practice, politics and policy. Indeed, the cultural, commercial, and terrestrial landscape of the concept is staggering and manifests within popular discourse and across global organisations and institutions, national governments, workplaces, and consumer lifestyle products and services. Notably, the field of sport, exercise, and physical activity has been identified by the World Health Organisation (WHO), the United Nations, and the OECD as a key sector with the potential to contribute to people's wellbeing. This should not be surprising given that there is a large body of literature espousing the benefits of regular physical activity (in myriad forms) as part of a healthy lifestyle. However, there are increasing concerns that wellbeing's global ubiquity may be leading to a range of unintended consequences and/or unscrupulous practices within both international organisations and nation-states. This largely conceptual essay focuses on the concept and process of wellbeing washing by (1) tracing the historical roots and evolution of wellbeing; (2) exploring its reconceptualization within the framework of neoliberalism; (3) offering a preliminary outline of the concept of wellbeing washing; and (4) briefly describing how wellbeing washing is manifesting within the context of sport in Aotearoa/New Zealand. Overall, this analysis explores wellbeing as a contested terrain of interests marked by a range of complexities and contradictions. [ABSTRACT FROM AUTHOR]

Athlete maltreatment in organized sport has attracted considerable attention from governing bodies, stakeholders and the general public. Despite numerous studies and policy proposals from various countries, the problem remains unresolved due to its inherent complexity. Drawing upon the concept of 'a wicked problem' widely utilized in policy analysis, this study first identifies the wicked features of maltreatment, focusing on: (1) the difficulty of establishing a definition of maltreatment; (2) the challenges of identifying its causes; and (3) the impediments to identifying solutions in a context of embedded stakeholders and unintended consequences. To provide further analysis, we compare athlete maltreatment with other issues in sport such as doping and match-fixing, to suggest that lessons can be drawn from other wicked problems in the same contested terrain. Overall, given the complex interplay between maltreatment and the maintenance/legitimization of sport systems, this paper calls for continuing attention and evaluation of existing research/policies and advocates for a more multidimensional view that acknowledges maltreatment as a wicked problem. [ABSTRACT FROM AUTHOR]

On 17th May 2020, the New Zealand Government announced a $265 million investment to support sport and recreation amid the country's first COVID-19 lockdown. The Sport NZ Recovery Package (RP) focused on three investment outcomes for the sector: 'Reset and Rebuild', 'Strengthen and Adapt', and [become] 'Different and Better' (Sport NZ 2020a). This study examines the overall design features and funding initiatives of the RP as a novel policy response to 'turbulence'. Of particular interest is whether this instrument was 'system changing' (McDonnell and Elmore 1987) and how it might enable future transformation or stability in the sports sector. Drawing from documents and interviews with officials from Sport NZ, one National Sports Organisation (NSO), and six Regional Sports Trusts (RSTs), three key findings relate to 1) the characteristics of the RP as policy instrument; 2) the novelty of Tū Manawa relative to Sport NZ's shifting strategy; and 3) the way in which organisations coped with the administration of new funds. The findings suggest that Sport NZ's funding strategies were multidimensional (targeting a wider array of activities and organisations than those pre-COVID-19) and could themselves be 'turbulent-inducing'. Future studies should examine the long-term legacy of the package and its associated goals to interpret if Sport NZ's initiatives are sustained for the [promised] readjustment and strengthening of the New Zealand sports sector. [ABSTRACT FROM AUTHOR]

The concern for athlete maltreatment in elite sport emerged in response to a wide range of high-profile cases. While diverse theories and concepts have been used to explore the subject, there is a need for non-Western analyses that can attend to the cultures, practices and narratives of Asian states. Drawing on the case of South Korea's elite sport system, this paper scrutinises the mix of institutional practices and narratives that may variously converge to enable maltreatment or diverge, to prompt calls for systemic change. Grounded in ‘new institutionalism’ and a qualitative approach that incorporates document analysis and semi-structured interviews, this research examines maltreatment within a unique Korean Confucian hierarchical socio-cultural context. The results indicate that complementary practices and narratives enable maltreatment and facilitate the continuation of the system. Conversely, this study also investigated instances of divergence highlighting the impetus for change. However, there is some evidence to suggest that accommodating reforms, which remain essentially shaped by existing practices and narratives, often lead to resistance against substantial change. In sum, the combination of convergent and divergent practices and narratives, within the complex and unique cultural and structural context of Korea, signals that while policy changes to address athlete maltreatment are emerging, barriers to fundamental, sustained change remain. [ABSTRACT FROM AUTHOR]