bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of HIV Partner Services in the Modern Biomedical HIV Prevention Era: A Network Modeling Study
Authors: Jenness Samuel M. , Le Guillou Adrien , Lyles Cynthia , Bernstein Kyle T. , Krupinsky Kathryn , Enns Eva A. , Sullivan Patrick S. , Delaney Kevin P.
Published: October 2022

Background

HIV partner services can accelerate the use of antiretroviral-based HIV prevention tools (ART and PrEP), but its population impact on long-term HIV incidence reduction is challenging to quantify with traditional PS metrics of partner identified or HIV-screened. Understanding the role of partner services within the portfolio of HIV prevention interventions, including using it to efficiently deliver antiretrovirals, is needed to achieve HIV prevention targets.

Methods

We used a stochastic network model of HIV/STI transmission for men who have sex with men (MSM), calibrated to surveillance-based estimates in the Atlanta area, a jurisdiction with high HIV burden and suboptimal partner services uptake. Model scenarios varied successful delivery of partner services cascade steps (newly diagnosed “index” patient and partner identification, partner HIV screening, and linkage or reengagement of partners in PrEP or ART care) individually and jointly.

Results

At current levels observed in Atlanta, removal of HIV partner services had minimal impact on 10-year cumulative HIV incidence, as did improving a single partner services step while holding the others constant. These changes did not sufficiently impact overall PrEP or ART coverage to reduce HIV transmission. If all index patients and partners were identified, maximizing partner HIV screening, partner PrEP provision, partner ART linkage, and partner ART reengagement would avert 6%, 11%, 5%, and 18% of infections, respectively. Realistic improvements in partner identification and service delivery were estimated to avert 2–8% of infections, depending on the combination of improvements.

Conclusions

Achieving optimal HIV prevention with partner services depends on pairing improvements in index patient and partner identification with maximal delivery of HIV screening, ART, and PrEP to partners if indicated. Improving the identification steps without improvement to antiretroviral service delivery steps, or vice versa, is projected to result in negligible population HIV prevention benefit.
Presumptive and Follow-Up Treatment Associated With Gonorrhea and Chlamydia Testing Episodes in Sexually Transmitted Disease Clinics: Impact of Changing Treatment Guidelines for Gonorrhea, Sexually Transmitted Disease Surveillance Network, 2015–2018
Authors: Llata Eloisa , Braxton Jim , Asbel Lenore , Huspeni Dawn , Tourdot Laura , Kerani Roxanne P. , Cohen Stephanie , Kohn Robert , Schumacher Christina , Toevs Kim , Torrone Elizabeth , Kreisel Kristen
Published: October 2022

Background

Centers for Disease Control and Prevention recommendation for treatment of uncomplicated gonorrhea (NG) were revised in December 2020 and include ceftriaxone monotherapy when chlamydial infection was excluded. We evaluated the impact of these revised treatment recommendations using data from a network of sexually transmitted disease (STD) clinics before the change in guidelines.

Methods

We performed a cross-sectional analysis from 8 STD clinics participating in the STD Surveillance Network from January 2015 to June 2018 assessing NG/chlamydia (CT) testing episodes, nucleic acid amplification test results, CT only and NG/CT treatment records, and timing of treatment. We describe the frequency of NG and CT treatment practices and what proportion of patients treated would not have had to receive an antichlamydial agent.

Results

Of 190,589 episodes that occurred during the study period, 67,895 (35.6%) episodes were associated with a treatment record consistent with NG or chlamydia (CT only [n = 37,530] or NG/CT [n = 30,365]), most (~86%) were prescribed on the same-day as initial testing. Of the 67,895 episodes with corresponding treatment record(s), 42.1% were positive for either NG or CT compared with 3.7% were positive for NG or CT for those not associated with treatment records (n = 122,694 episodes). Among 30,365 episodes associated with NG/CT treatment records, monotherapy would only have been indicated for 10.1% (3081/30,365) of the episodes as they were treated on follow-up and were NG positive and CT negative.

Conclusions

Treatment was prescribed in one-third of NG/CT testing episodes, with the majority provided same day. Despite changes in NG treatment guidelines to ceftriaxone monotherapy, majority of patients would continue to receive an antichlamydia agent when treated for NG in these settings.
Comparing Practices Used in Overdose Fatality Review Teams to Recommended Implementation Guidelines
Authors: Ray Bradley , Bailey Katie , Dunnigan Megan , Aalsma Matthew C. , Bell Lauren , O'Brien Mallory
Published: October 2022

Objectives:

Overdose fatality review teams are a public health and public safety collaboration that reviews fatality cases using a multidisciplinary team to provide recommendations for overdose prevention. No research exists on the case review practices currently being used in these programs.

Design:

We administered a cross-sectional survey measuring case review practices and perceptions to a convenience sample of overdose fatality review teams.

Setting:

We administered the online survey to participants at a national virtual forum on overdose fatality review.

Participants:

In this study, we examined 30 county-level overdose fatality review teams from 6 states who completed the survey.

Main Outcome Measures:

We developed measures of case review practices from an overdose fatality review implementation guide. We provided descriptive statistics on the survey items used to measure these practices and examined how practice uptake varied by overdose fatality review team characteristics.

Results:

Most overdose fatality review teams had adequate representation and membership, but none adhered to all of the practices measured from the implementation guide. The largest gap was in perceived effectiveness and implementation of case review recommendations. In addition, teams that had been reviewing cases for longer reported more adherence to recommended practices.

Conclusions:

Overdose fatality case review is a collaboration between local public health and public safety agencies that holds great promise. However, these teams will require additional training and technical assistance with local community support to ensure that recommendations are actionable.
A Data-Driven Response to the Addiction Crisis in Hamilton County, Ohio
Authors: Manchak Sarah M. , Gosney Meagan E. , Haberman Cory , Firesheets Kelly C.
Published: October 2022

Context:

For more than a decade, the state of Ohio has been an epicenter of the opioid crisis. Multiple interventions have been deployed to address this crisis and reduce opioid overdoses and overdose deaths in the state. The Hamilton County Addiction Response Coalition (HC ARC) and its strategic, countywide prearrest diversion (LEAD) and deflection (QRT) programs have been at the forefront of this effort in Cincinnati, Ohio. Operating since April 2018, these programs have continued to grow and improve and have been successful in connecting hundreds of citizens to needed treatment and other social services.

Program:

HC ARC combats overdoses and overdose deaths by utilizing cross-sector planning and collaboration to operate 2 countywide programs: Quick Response Team (QRT) and Law Enforcement Assisted Diversion (LEAD).

Implementation:

The QRT and LEAD programs leverage partnerships with law enforcement, public health, addiction and mental health services, reentry services, and trained peer supporters. The QRT emphasizes triage, assessment, and connection to appropriate services for people with recent nonfatal drug overdoses and provides outreach and education in hot spot communities. LEAD provides diversion from the criminal justice system into long-term case management for nonviolent individuals with low-level offenses who also struggle with substance use disorder, mental health, homelessness, and/or poverty.

Evaluation:

QRT and LEAD team members routinely track and record client contacts and outcomes using a centralized electronic case management platform. Data are extracted and analyzed by the evaluation team to examine indices of program success and provide ongoing feedback to the QRT and LEAD teams.

Discussion:

HC ARC has implemented, tested, expanded, and now standardized its prearrest diversion programming. It has built a sustainable model to improve health and health equity for marginalized individuals whose needs intersect across health care, public health, community-based social services, and the criminal-legal system. Collectively, this work offers a guide for implementation and best practices for the following: detailed planning, policy, and procedure development; identification of key leaders and community partners; and methods to evaluate program operations to make data-driven decisions and real-time program adjustments.
Naloxone Plus, Plus Some: Examining Ohio's Quick Response Teams Through the Lens of Deflection
Authors: Firesheets Kelly , Juarez Sophia , Kopak Albert , Ross Jon , Sperber Kimberly , Reichert Jessica
Published: October 2022

There were nearly 50 000 opioid-related deaths in 2019 in the United States.* The dramatic frequency of opioid overdoses and fatalities has led to strained community resources, especially among hospitals and first responders (law enforcement, fire, and emergency medical services). In response to rising overdose rates, many first responders have implemented programs that align public health and public safety responses to overdoses. Often called “Quick Response Teams” (QRTs), these programs leverage a collaborative team to respond to those at risk of overdose, or who have survived an overdose. The initial QRT was implemented in Colerain Township, Ohio, in 2015.† Today, QRTs are a widely accepted “model” overdose response program.‡ Despite the popularity of QRTs, research on the model is limited. In this article, the authors use existing qualitative and quantitative data from QRTs across the state of Ohio to examine QRTs. Using the lens of the Police, Treatment and Community Collaborative's 5 deflection pathways, the authors answer four key questions: (1) What is the scale of QRTs in Ohio, and how are QRTs in our sample structured? (2) Whom are the QRTs serving? (3) How many pathways of deflection are reflected in Ohio's QRTs? (4) What can these data teach us about the context of the QRT work and (more generally) collaborative overdose response? After examining the QRTs and their data, the authors provide suggestions to help researchers, practitioners, and funders better understand QRTs and similar public health/public safety partnerships.
The Overdose Response Strategy: Reducing Drug Overdose Deaths Through Strategic Partnership Between Public Health and Public Safety
Authors: Wolff Jessica , Gitukui Stephanie , O'Brien Mallory , Mital Sasha , Noonan Rita K.
Published: October 2022

Context:

Public health and public safety collaborations can strengthen and improve efforts to address the worsening drug overdose crisis.

Program:

The Overdose Response Strategy is addressing this need through a national public health and public safety program designed to foster the cross-sector sharing of timely data, pertinent intelligence, and evidence-based and innovative strategies to prevent and respond to drug overdose.

Implementation:

Since 2015, the Overdose Response Strategy has been implemented by state-based public health and public safety teams who work together to prevent and respond to drug overdoses within and across sectors, states, and territories. The public health and public safety teams share data systems to inform rapid and effective community overdose prevention efforts; support immediate, evidence-based response efforts that can directly reduce overdose deaths; design and use promising strategies at the intersection of public health and public safety; and use effective and efficient primary prevention strategies that can reduce substance use and overdose long term. Implementation of the Overdose Response Strategy aligns with the US Centers for Disease Control and Prevention's Strategic Partnering Framework.

Evaluation:

The evaluation of the Overdose Response Strategy, which is currently underway, is based on 2 evaluation approaches: Collective Impact and Organizational Network Analysis. These approaches provide a way to look at the strength of the relationship between public health and public safety and the way the relationship is leveraged to advance program goals and objectives.

Discussion:

The Overdose Response Strategy serves as a strategic partnership model that can potentially be applied to other issues, such as gun violence, that may benefit from public health and public safety collaboration.
Implementation and Uptake of the Massachusetts Drug Supply Data Stream: A Statewide Public Health-Public Safety Partnership Drug Checking Program
Authors: Green Traci C. , Olson Rebecca , Jarczyk Cole , Erowid Earth , Erowid Fire , Thyssen Sylvia , Wightman Rachel , del Pozo Brandon , Michelson Laura , Consigli Amanda , Reilly Brittni , Ruiz Sarah
Published: October 2022

Context:

The illicit drug supply is rapidly evolving. Equally important to gathering drug supply data for monitoring is timely sharing of information with people who use drugs, the providers who care for them, law enforcement partners, and public health stakeholders so that efforts to avoid harmful substances, take preventive actions, and better target interventions can occur.

Program:

The Massachusetts Drug Supply Data Stream (MADDS) is the country's first statewide community drug checking program. Founded on public health-public safety partnerships, MADDS collects remnant drug packaging and paraphernalia with residue from people who use drugs and noncriminal samples from partnering police departments. MADDS tests samples using simultaneous immunoassay fentanyl test strips, Fourier-transform infrared spectrometry (FTIR), and off-site laboratory testing by gas chromatography-mass spectrometry (GC/MS). Results are accessible to community programs and municipalities, while trend analyses inform public health for cross-site alerts and informational bulletins.

Implementation:

MADDS was launched statewide in 2020 and rapidly expanded to a multisite program. Program staff approached communities and met with municipal police and community partners to secure written agreements to host drug checking. Community partners designed sample collection consistent with their pandemic era workflows. Consultations with stakeholders gathered feedback on design and deliverables.

Evaluation:

The program tests sample donations on-site from community agencies and police departments, incorporates review by a medical toxicologist for health and safety concerns, crafts stakeholder-specific communications, and disseminates English, Spanish, and Portuguese language materials. For 2020, a total of 427 samples were tested, of which 47.1% were positive for fentanyl. By early 2021, MADDS detected shifts in cocaine purity, alerted communities of a new toxic fentanyl analogue and a synthetic cannabinoid contaminant, and confirmed the increase of xylazine (a veterinary sedative) in Massachusetts.

Discussion:

Community drug checking programs can be collaboratively designed with public health and public safety to generate critical health and safety information for people who use drugs and the communities where they live.
Linking Public Health and Public Safety Data on Co-occurring Disorders Among Adults in Hawaii's Criminal Justice System
Authors: Fontanilla Tiana , Kim Sunja , Bowen Kristy , Choi Ho Suk , Talagi Deveraux , Fan Victoria Y. , Borja Vincent , Smith Tammie , Curtis Amy
Published: October 2022

To better understand the behavioral health treatment needs of adults involved in the criminal justice system and to improve the continuum of services provided to this vulnerable population, Hawaii initiated a data linkage project that connects substance use and mental health data from the state Department of Public Safety with behavioral health treatment data from the state Department of Health for the State of Hawaii. Specifically, this linkage project begins to examine behavioral health treatment levels recommended by the criminal justice system and Hawaii State Hospital inpatient psychiatric admissions. We provide a preliminary summary on individuals who were both involved in the criminal justice system and received court-ordered inpatient psychiatric treatment and outline data governance procedures, future directions, and practice recommendations.
Tenant-Based Housing Voucher Programs: A Community Guide Systematic Review
Authors: Finnie Ramona K. C. , Peng Yinan , Hahn Robert A. , Schwartz Alex , Emmons Karen , Montgomery Ann Elizabeth , Muntaner Carles , Garrison Veronica Helms , Truman Benedict I. , Johnson Robert L. , Fullilove Mindy T. , Cobb Jamaicia , Williams Samantha P. , Jones Camara , Bravo Pablo , Buchanan Sharunda ,   The Community Preventive Services Task Force
Published: October 2022

Context:

Unaffordable or insecure housing is associated with poor health in children and adults. Tenant-based housing voucher programs (voucher programs) limit rent to 30% or less of household income to help households with low income obtain safe and affordable housing.

Objective:

To determine the effectiveness of voucher programs in improving housing, health, and other health-related outcomes for households with low income.

Design:

Community Guide systematic review methods were used to assess intervention effectiveness and threats to validity. An updated systematic search based on a previous Community Guide review was conducted for literature published from 1999 to July 2019 using electronic databases. Reference lists of included studies were also searched.

Eligibility Criteria:

Studies were included if they assessed voucher programs in the United States, had concurrent comparison populations, assessed outcomes of interest, were written in English, and published in peer-reviewed journals or government reports.

Main Outcome Measures:

Housing quality and stability, neighborhood opportunity (safety and poverty), education, income, employment, physical and mental health, health care use, and risky health behavior.

Results:

Seven studies met inclusion criteria. Compared with low-income households not offered vouchers, voucher-using households reported increased housing quality (7.9 percentage points [pct pts]), decreased housing insecurity or homelessness (−22.4 pct pts), and decreased neighborhood poverty (−5.2 pct pts).

Adults in voucher-using households had improved health care access and physical and mental health. Female youth experienced better physical and mental health but not male youth. Children who entered the voucher programs under 13 years of age had improved educational attainment, employment, and income in their adulthood; children's gains in these outcomes were inversely related to their age at program entry.

Conclusion:

Voucher programs improved health and several health-related outcomes for voucher-using households, particularly young children. Research is still needed to better understand household's experiences and contextual factors that influence achievement of desired outcomes.
Successful Hepatitis C Birth Cohort Screening and Linkage to Care in a US Community Health System
Authors: Zijlstra Michael K. , Fidel Nague Kristine , Louie Patrick , Imas Polina , Sonnenberg Amnon , Fimmel Claus J.
Published: October 2022

Context:

Birth cohort (“baby boomer”) screening represents a well-validated strategy for the identification of asymptomatic hepatitis C–infected patients. However, successful linkage of newly diagnosed patients to antiviral therapy has been more difficult to accomplish.

Objective:

To analyze the results of a systemwide birth cohort screening program in a US community health care system.

Design:

We analyzed the data from an ongoing hepatitis C virus (HCV) screening and treatment program that was established at NorthShore University Health System in 2015. Hepatitis C virus screening by primary care providers was prompted through automated Best Practice and Health Maintenance alerts. Patient visits and screening orders were tracked using a customized HCV dashboard. Virologic, demographic, and treatment data were assessed and compared with those of a cohort of patients with previously established HCV infection.

Results:

Since program inception, 61 8161 (64.3%) of the entire NorthShore baby boomer population of 96 001 patients have completed HCV antibody testing, and 160 patients (0.26%) were antibody positive. Of 152 antibody-positive patients who underwent HCV RNA testing, 53 (34.2%) were viremic. A total of 39 of 53 patients (73.6%) underwent antiviral therapy and achieved a sustained virologic response. Compared with patients identified through screening, a comparison cohort of patients with previously established HCV had more advanced fibrosis and significantly lower dropout rates. The COVID-19 pandemic was associated with a decrease in the number of outpatient visits of screening-eligible patients and with a reduction in HCV screening rates.

Conclusion:

Our data demonstrate the electronic medical records–assisted systemwide implementation of HCV birth cohort screening and successful linkage to antiviral therapy in a community-based US multihospital system.
Assessment of Practices Affecting Racial and Ethnic COVID-19 Vaccination Equity in 10 Large US Cities
Authors: Honeycutt Christopher Cole , Contento Jacqueline , Kim Joanne , Patil Ankita , Balu Suresh , Sendak Mark
Published: October 2022

Context:

In the United States, COVID-19 vaccines have been unequally distributed between different racial and ethnic groups. Public reporting of race and ethnicity data for COVID-19 vaccination has the potential to help guide public health responses aimed at promoting vaccination equity. However, there is evidence that such data are not readily available.

Objectives:

This study sought to assess gaps and discrepancies in COVID-19 vaccination reporting in 10 large US cities in July 2021.

Design, Setting, and Participants:

For the 10 cities selected, we collected COVID-19 vaccination and population data using publicly available resources, such as state health department Web sites and the US Census Bureau American Community Survey. We examined vaccination plans and news sources to identify initial proposals and evidence of implementation of COVID-19 vaccination best practices.

Main Outcome Measure:

We performed quantitative assessment of associations of the number of vaccination best practices implemented with COVID-19 racial and ethnic vaccination equity. We additionally assessed gaps and discrepancies in COVID-19 vaccination reporting between states.

Results:

Our analysis did not show that COVID-19 vaccination inequity was associated with the number of vaccination best practices implemented. However, gaps and variation in reporting of racial and ethnic demographic vaccination data inhibited our ability to effectively assess whether vaccination programs were reaching minority populations.

Conclusions:

Lack of consistent public reporting and transparency of COVID-19 vaccination data has likely hindered public health responses by impeding the ability to track the effectiveness of strategies that target vaccine equity.
The lumbar artery perforator flap in breast reconstruction
Authors: Stillaert Filip BJL , Opsomer Dries , Blondeel Phillip N , Van Landuyt Koenraad
Published: October 2022

The lumbar artery perforator flap is a valuable alternative in breast reconstruction whenever the DIEP flap is not feasible because of insufficient or unavailable abdominal tissue.

The advantage is the ideal shape and consistency of the flap as well as the option to perform a nerve anastomosis with the cluneal nerve. The anatomy is consistent but there are some technical issues related to the short perforator and difficult surgical exposure in the lower back region.

The inclusion of a vascular interposition graft improved our results and facilitated our technical challenges and final inset of the flap. These videos guide you through the different steps involved in a breast reconstruction with the lumbar artery perforator flap.
Direct Comparison of Diagnostic Accuracy of Fast Kilovoltage Switching Dual-Energy Computed Tomography and Magnetic Resonance Imaging for Detection of Enhancement in Renal Masses
Authors: McGrath Trevor A. , Ahmad Faraz , Sathiadoss Paul , Haroon Mohammad , McInnes Matthew DF , Bossuyt Patrick MM , Schieda Nicola
Published: October 2022

Purpose

The aim of the study was to compare diagnostic accuracy of dual-energy computed tomography (DECT) and magnetic resonance imaging (MRI) to detect enhancement in renal masses.

Methods

Adults renal masses of 10 mm or greater with both fast kilovoltage potential switching DECT and contrast-enhanced MRI performed within 12 months were retrospectively included. Two blinded radiologists independently evaluated for enhancement subjectively (5-point Likert scales) and quantitatively (signal intensity ratio ≥15% for MRI, iodine concentration ≥1.2 or ≥2.0 mg/mL for DECT). Per-lesion diagnostic accuracy, with histologic reference standard for solid masses, was expressed as the area under the receiver operator curve (AUC) for each index test. Differences were evaluated for statistical significance using the DeLong test.

Results

We included 24 patients with 41 masses: 17 solid renal masses and 24 Bosniak 1 or 2 cysts. There was no significant difference in diagnostic accuracy comparing subjective enhancement by MRI and using iodine overlay DECT for reader 1 (AUC 0.99 vs 0.99, P = 0.38) or reader 2 (AUC 1.00 vs 0.94, P = 0.12) Interobserver agreement was κ = 0.61 for DECT and κ = 0.71 for MRI. There was no significant difference either in accuracy between quantitative assessment using signal intensity ratio or iodine concentration for reader 1 (AUC 0.94 vs 0.94, P = 0.88) or reader 2 (AUC 0.97 vs 0.92, P = 0.16). False-negative results in both subjective and quantitative assessment were nearly exclusively seen in papillary renal cell carcinoma, occurring with both DECT and MRI.

Conclusions

We detected no significant differences in accuracy for detecting enhancement in renal masses comparing MRI and DECT. Our results require further investigation in larger sample sizes, but suggest that DECT may be comparable to MRI for detection of enhancement in renal masses.
Changes in the Transcriptome-Associated Co-Expression Profile of Embryonic External Ear Development After the BMP5 Gene Mutation
Authors: Liu Wei , Lin Lin , Yang Qinghua , Jin Shengyang , Jiang Haiyue
Published: October 2022

This study aimed to perform an association analysis of the full transcriptome in Bmp5 short-ear mice during the development of the external ear in mouse embryos using advanced sequencing techniques. To understand the changes in gene regulation and expression of BMP5 gene mutations involved in the external ear embryonic development of mice, external ear tissues of mouse embryos developed to E15.5 and E17.5 were obtained using a BMP5 short-ear mouse model. The association analysis of the full transcriptome mainly involved the analysis of lncRNA and mRNA associations, the analysis of lncRNA and miRNA associations, the analysis of miRNA and mRNA associations, the analysis of circRNA and mRNA associations and circRNA, miRNA, and mRNA associations. The results showed that regulation of the full transcriptome is associated with external ear development in BMP5 short-ear mouse embryos, and some key regulatory changes in full transcriptome after BMP5 gene point mutation are different. This study will provide a new clue to investigate the mechanism underlying the regulation of mouse external ear development by the full transcriptome.
Development and Validation of a Hybrid Bronchoscopy Trainer Using Three-Dimensional Printing
Authors: Shaylor Ruth , Golden Eran , Goren Or , Verenkin Vladimir , Cohen Barak
Published: October 2022

Introduction

Simulation is an essential component of medical education. Commercially available intubation simulators often lack anatomical fidelity of the lower airway and are therefore not suitable for teaching bronchoscopy or lung isolation. By using a desktop 3-dimensional (3D) printer, we aimed to create and validate a hybrid simulator from an existing mannequin with a 3D-printed lower airway that has anatomical fidelity and is financially affordable compared with commercially available models.

Methods

Using an anonymized computed tomography scan of an adult male patient, we developed a 3D model of the airway from below the larynx to the 3rd generation bronchi, which was then printed on a desktop 3D printer. The printed airway was attached to an existing mannequin below the larynx via a universal adaptor. Ten anesthesiology attendings performed a blinded comparison of the hybrid mannequin with a commercially available mannequin for tactile and visual fidelity when performing intubation, bronchoscopy, and lung isolation. They were also asked to assess the models for educational suitability.

Results

The 3D printed model was judged more suitable for teaching double-lumen tube insertion to novice physicians compared with the commercial model, with median (interquartile range) scores of 5 (4–5) versus 3 (2–4), P = 0.017. Similar results were found for bronchial blocker insertion and bronchoscopy. The visual fidelity of the bronchial anatomy was scored as 5 (4–5) and 2 (1–3) for the 3D-printed and the commercial models, respectively (P = 0.007).

Conclusion

By creating a hybrid model combining an existing commercially available mannequin with a 3D-printed trachea and bronchial tree, we have created an affordable training simulator suitable for teaching lung isolation and bronchoscopy. Enhancing existing mannequins with 3D-printed parts may be of particular interest to institutions that do not have the funds to buy models with anatomical fidelity but do have access to a 3D printer.
Validation of a 3-Dimensional-Printed Infant Tibia for Intraosseous Needle Insertion Training
Authors: Manshadi Keya , Chang Todd P. , Schmidt Anita , Lau Jennifer , Rake Alyssa , Pham Phung , Illingworth Kenneth , Song Joo Lee
Published: October 2022

Introduction

Current bone models used for pediatric intraosseous (IO) placement training are expensive or lack anatomic and/or functional fidelity. This technical report describes the development and validation of a 3-dimensional printed (3DP) tibia from a pediatric lower extremity computed tomography scan for IO procedural training.

Methods

Multiple 3DP tibia models were printed using a dual-extrusion fused-filament fabrication printer. Models underwent iterative optimization until 2 final models, one of polypropylene (3DP clear) and the other of polylactic acid/polypropylene (3DP white), were selected. Using an exploratory sequential mixed-methods design, a novel IO bone model assessment tool was generated. Physicians then used the assessment tool to evaluate and compare common IO bone models to the novel 3DP models during IO needle insertion.

Results

Thirty physicians evaluated the provided pediatric IO bone models. Compared with a chicken bone as a reference, the 3DP white bone had statistically significantly higher mean scores of anatomy, heft, sense of being anchored in the bone, quality of bone resistance, and “give” when interfaced with an IO needle. Twenty-two of the 30 participants ranked the 3DP white bone as either 1st or 2nd in terms of ranked preference of pediatric IO bone model. A 3DP white bone costs $1.10 to make.

Conclusions

The 3DP IO tibia models created from real-life computed tomography images have high degrees of anatomic and functional realism. These IO training models are easily replicable, highly appraised, and can be printed at a fraction of the cost of commercially available plastic models.
Recipient and Graft Outcomes in Simultaneous Kidney and Pancreas Transplantation With Steroid Avoidance in the United States
Authors: Cerise Adam , Shaker Tamer , LeNguyen Phuoc , Dinesh Anant , Jackson Scott , Kandaswamy Raja , Riad Samy
Published: October 2022

Background.

Steroid avoidance in kidney transplantation has been proven noninferior. Long-term outcome data on steroid avoidance in simultaneous pancreas-kidney (SPK) remains scant.

Methods.

Utilizing the Scientific Registry of Transplant Recipients between 2000 and 2020, we studied all primary crossmatch negative SPK recipients (N = 5683) who received antithymocyte globulin induction and were discharged alive with functioning grafts on tacrolimus and mycophenolate ± steroid maintenance. Recipients were grouped according to steroid use into 2 groups: steroid maintenance (n = 4191) and steroid avoidance (n = 1492). Kaplan-Meier curves censored at 10 y were generated for recipient and allograft survival by steroid maintenance. Predictors for recipient and graft survival were examined using Cox Proportional Hazards. Models were adjusted for age, body mass index, ethnicity, diabetes type, human leukocyte-antigen mismatches, cold ischemia time, transplant era, preemptive transplantation, and pancreas donor risk index with the transplant center included as a random effect.

Results.

Steroid avoidance gained popularity over time, accounting for over one-fourth of the studied cohort. One-year acute rejection rates by steroid avoidance were comparable for kidney (8.6% versus 9%, P = 0.783); however, the pancreas rejection rate was lower in the steroid avoidance group (7.9% versus 10%; P = 0.035). After adjustment, steroid avoidance did not influence recipient survival (lower level of confidence interval, adjusted hazard ratio, upper level of confidence interval: 0.94, 1.15, 1.39), pancreas (0.75, 0.93, 1.16), or kidney (0.95, 1.18, 1.45) death-censored survival, compared with steroid maintenance.

Conclusions.

Accounting for the recipient and graft characteristics, steroid avoidance is associated with similar recipient, pancreas, and kidney graft outcomes compared with steroid maintenance in SPK recipients after antithymocyte globulin induction with tacrolimus and mycophenolate maintenance.
The motor Wisdom of the Crowd
Authors: Madirolas Gabriel , Zaghi-Lara Regina , Gomez-Marin Alex , Pérez-Escudero Alfonso
Published: October 2022

Wisdom of the Crowd is the aggregation of many individual estimates to obtain a better collective one. Because of its enormous social potential, this effect has been thoroughly investigated, but predominantly on tasks that involve rational thinking (such as estimating a number). Here we tested this effect in the context of drawing geometrical shapes, which still enacts cognitive processes but mainly involves visuomotor control. We asked more than 700 school students to trace five patterns shown on a touchscreen and then aggregated their individual trajectories to improve the match with the original pattern. Our results show the characteristics of the strongest examples of Wisdom of the Crowd. First, the aggregate trajectory can be up to 5 times more accurate than the individual ones. Second, this great improvement requires aggregating trajectories from different individuals (rather than trials from the same individual). Third, the aggregate trajectory outperforms more than 99% of individual trajectories. Fourth, while older individuals outperform younger ones, a crowd of young individuals outperforms the average older one. These results demonstrate for the first time Wisdom of the Crowd in the realm of motor control, opening the door to further studies of human and also animal behavioural trajectories and their mechanistic underpinnings.
Local IL-17 orchestrates skin aging
Authors: Solá Paloma , Mereu Elisabetta , Bonjoch Júlia , Casado Marta , Reina Oscar , Blanco Enrique , Esteller Manel , DiCroce Luciano , Heyn Holger , Solanas Guiomar , Benitah Salvador Aznar
Published: October 2022

Skin aging is characterized by structural and functional changes that lead
to slower wound healing and higher rate of infections, which contribute to
age-associated frailty. This likely depends on synergy between alterations in
the local microenvironment and stem cell–intrinsic changes, underscored by
pro-inflammatory microenvironments that drive pleotropic changes. To date,
little is known about the precise nature and origin of the proposed
age-associated inflammatory cues, or how they affect different tissue resident
cell types. Based on deep single-cell RNA-sequencing of the entire dermal
compartment, we now provide a comprehensive understanding of the age-associated
changes in all skin cell types. We show a previously unreported skew towards an
IL-17–expressing phenotype of Th cells, γδ T cells and innate lymphoid cells in
aged skin. Aberrant IL-17 signaling is common to many autoimmune (e.g.,
rheumatoid arthritis and psoriasis) and chronic inflammatory diseases.
Importantly, in vivo blockade of IL-17–triggered
signaling during the aging process reduces the pro-inflammatory state by
affecting immune and non-immune skin cells of both dermis and epidermis.
Strikingly, IL-17 neutralization significantly delays the appearance of
age-related traits, such as decreased epidermal thickness, increased cornified
layer thickness and ameliorated hair follicle stem cell activation and hair
shaft regeneration. Our results indicate that the aged skin shows chronic and
persistent signs of inflammation, and that age-associated increased IL-17
signaling could be targeted as a strategy to prevent age-associated skin
ailments in elderly.
Mutual inhibition of airway epithelial responses supports viral and fungal
co-pathogenesis during coinfection
Authors: Dancer Patrick , Pickard Adam , Potocka Wiktoria , Earle Kayleigh , Fortune-Grant Rachael , Kadler Karl , Bertuzzi Margherita , Gago Sara
Published: October 2022

Awareness that fungal coinfection complicates viral respiratory infections
causing worse disease outcome has recently emerged. The environmental fungus
Aspergillus fumigatus
(Af) has been reported as the main driver of
fungal coinfection in patients suffering from viral infections caused by
Cytomegalovirus, Influenza or more recently SARS-CoV2. The airway epithelium is
the first common point of contact between inhaled pathogens and the host.
Aberrant airway epithelial cell (AEC) responses against fungal challenge have
been described in patients susceptible to aspergillosis. Therefore, it is likely
that a dysregulation of AEC responses during fungal-viral coinfection represents
a potent driver for the development of fungal disease. Here we used an
in vitro model of
Af-viral infection of AECs to determine outcomes of
spore internalisation, killing and viral replication during coinfection. Our
data indicate that viral stimulation, while boosting
Af uptake by AECs, limits
Af spore killing by those cells, favouring fungal
persistence and growth. Type I viral-induced interferon release was
significantly decreased in the presence of Af hyphal
forms suggesting a possible role of Af secreted
factors in modulating viral pathogenicity. We next explored the impact of
Af challenge in SARS-CoV2 replication within
airway epithelial cells using nano-luciferase as a measure of viral replication.
We found that Af increased SARS-CoV2 pathogenicity in
a strain-dependent manner. Collectively, our findings demonstrate a mutual
inhibition of antifungal and antiviral AEC responses during
Af-viral coinfection and also suggest that some
fungal factors might be key regulators of co-pathogenicity during in lung
infection.
A di-arginine additive for dissociation of gold nanoparticle aggregates: A matrix-insensitive approach with applications in protease detection
Authors: Retout Maurice , Jin Zhicheng , Tsujimoto Jason , Mantri Yash , Borum Raina , Creyer Matthew N. , Yim Wonjun , He Tengyu , Chang Yu-Ci , Jokerst Jesse V.
Published: October 2022

We report the reversible aggregation of gold nanoparticle (AuNPs) assemblies via a diarginine peptide additive and thiolated PEGs (HS-PEGs). The AuNPs were first aggregated by attractive forces between the citrate-capped surface and the arginine side chains. We found that HS-PEG thiol group has higher affinity for the AuNPs surface, thus leading to redispersion and colloidal stability. In turn, there was a robust and obvious color change due to on/off plasmonic coupling. The assemblies’ dissociation was directly related to the HS-PEG structural properties such as their size or charge. As an example, HS-PEGs with a molecular weight below 1 kDa could dissociate 100% of the assemblies and restore the exact optical properties of the initial AuNPs suspension (prior to the assembly). Surprisingly, the dissociation capacity of HS-PEGs was not affected by the composition of the operating medium and could be performed in complex matrices such as plasma, saliva, bile, urine, cell lysates or even sea water. The high affinity of thiols for the gold surface encompasses by far the one of endogenous molecules and is thus favorized. Moreover, starting with AuNPs already aggregated ensured the absence of background signal as the dissociation of the assemblies was far from spontaneous. Remarkably, it was possible to dry the AuNPs assemblies and to solubilize them back with HS-PEGs, improving the colorimetric signal generation. We used this system for protease sensing in biological fluid. Trypsin was chosen as model enzyme and highly positively charged peptides were conjugated to HS-PEG molecules as cleavage substrate. The increase of positive charge of the HS-PEG-peptide conjugate quenched the dissociation capacity of the HS-PEG molecules which could only be restored by the proteolytic cleavage. Picomolar limit of detection was obtained as well as the detection in saliva or urine.

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Emulating clinical pressure waveforms in cell culture using an Arduino-controlled 3D-printed platform for 96-well plates
Authors: Szmelter Adam H. , Venturini Giulia , Abbed Rana J. , Acheampong Manny O. , Eddington David T.
Published: October 2022

High blood pressure is the primary risk factor for heart disease, the leading cause of death globally. Despite this, current methods to replicate physiological pressures in-vitro remain limited in sophistication and throughput. Single-chamber exposure systems allow for only one pressure condition to be studied at a time and the application of dynamic pressure waveforms is currently limited to simple sine, triangular, or square waves. Here, we introduce a high-throughput hydrostatic pressure exposure system for 96-well plates. The platform can deliver a fully-customizable pressure waveform to each column of the plate, for a total of 12 simultaneous conditions. Using clinical waveform data, we are able to replicate real patients’ blood pressures as well as other medically-relevant pressures within the body and have assembled a small patient-derived waveform library of some key physiological locations. As a proof of concept, human umbilical vein endothelial cells (HUVECs) survived and proliferated under pressure for 3 days under a wide range of static and dynamic blood pressures ranging from 10 mm Hg to 400 mm Hg. Interestingly, pathologic and supraphysiologic pressure exposures did not inhibit cell proliferation. By integrating with, rather than replacing, ubiquitous lab cultureware it is our hope that this device will facilitate the incorporation of hydrostatic pressure into standard cell culture practice.
Effect of victim relatedness on cannibalistic behaviour of ladybird beetle,Menochilus sexmaculatusFabricius (Coleoptera: Coccinellidae)
Authors: Yadav Tripti , Omkar  , Mishra Geetanjali
Published: October 2022

Cannibalism is taxonomically widespread and has a large impact on the individuals’ fitness and population dynamics. Thus, identifying how the rates of cannibalism are affected by different ecological cues is crucial for predicting species evolution and population dynamics. In current experiment, we investigated how victim relatedness affects the cannibalistic tendencies of different life stages of ladybird,Menochilus sexmaculatus, which is highly cannibalistic. We provided larval instars and newly emerged adults ofM. sexmaculatuswith a choice of sibling, half-sibling and non-sibling conspecific eggs as victim of cannibalism. First victim cannibalised and latency to cannibalise were observed along with total number of victims cannibalised after 24 hours. First preference of victim did not differ with life stages of the cannibals though the number of victims cannibalized did increase with advancement in stage. Percentage of total eggs cannibalised also varied significantly with life stage and victim relatedness. First and second instars tend to cannibalise more percentage of siblings and non-sibling eggs while third instars cannibalised more percentage of non-sibling eggs; fourth instars and adults on the other hand cannibalised highest percentage of eggs irrespective of their relatedness. Insignificant effect of victim relatedness was observed on latency to cannibalise eggs, though it varied significantly with the cannibal’s life stage. Shortest latency to cannibalise was recorded for first instars and longest for adults and second instars. In conclusion, kin recognition and its avoidance is stage-specific, with fourth instar and newly emerged adults being less discriminatory as compared to early stages owing to increased evolutionary survival pressure.
Minor intron containing genes: Achilles’ heel of viruses?
Authors: Wuchty Stefan , White Alisa K. , Olthof Anouk M. , Drake Kyle , Hume Adam J. , Olejnik Judith , Mühlberger Elke , Aguiar-Pulido Vanessa , Kanadia Rahul N.
Published: October 2022

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) revealed the world’s unpreparedness to deal with the emergence of novel pathogenic viruses, pointing to the urgent need to identify targets for broad-spectrum antiviral strategies. Here, we report that proteins encoded by Minor Intron-containing Genes (MIGs) are significantly enriched in datasets of cellular proteins that are leveraged by SARS-CoV-2 and other viruses. Pointing to a general gateway for viruses to tap cellular machinery, MIG-encoded proteins (MIG-Ps) that react to the disruption of the minor spliceosome are most important points of viral attack, suggesting that MIG-Ps may pan-viral drug targets. While contemporary anti-viral drugs shun MIG-Ps, we surprisingly found that anti-cancer drugs that have been repurposed to combat SARS-CoV-2, indeed target MIG-Ps, suggesting that such genes can potentially be tapped to efficiently fight viruses.