bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of proton beam range in phantom with metals based on monochromatic energy CT images
Authors: Meng Qianqian , Li Jing , Jiang Wei , Hu Birong , Xu Feng , Shi Xiaomeng , Zhong Renming
Published: September 2022

The purpose of the study was to evaluate the accuracy of monochromatic energy (MonoE) computed tomography (CT) images reconstructed by spectral CT in predicting the stopping power ratio $( SP{R}_w)$ of materials in the presence of metal. The CIRS062 phantom was scanned three times using spectral CT. In the first scan, a solid water insert was placed at the center of the phantom $(C{T}_{no\ metal})$. In the second scan, the solid water insert was replaced with a titanium alloy femoral head $(C{T}_{metal})$. The metal artifact reduction (MAR) algorithm was used in the last scan $(C{T}_{metal+ MAR})$. The MonoE-CT images of 40 keV and 80 keV were reconstructed. Finally, the single-energy CT method (SECT) and the dual-energy CT method (DECT) were used to calculate the $SP{R}_w$. The mean absolute error (MAE) of the $SP{R}_w$ of the inner layer inserts calculated by the SECT method were 3.19%, 13.88% and 2.71%, corresponding to $C{T}_{no\ metal}$, $C{T}_{metal}$ and $C{T}_{metal+ MAR}$, respectively. For the outer layer inserts, the MAE of $SP{R}_w$ were 3.43%, 5.42% and 2.99%, respectively. Using the DECT method, the MAE of the $SP{R}_w$ of the inner layer inserts was 1.30%, 3.69% and 1.46% and the MAE of the outer layer inserts– was 1.34%, 1.36% and 1.05%. The studies shows that, compared with the SECT method, the accuracy of the DECT method in predicting the $SP{R}_w$ of a material is more robust to the presence of metal. Using the MAR algorithm when performing CT scans can further improve the accuracy of predicting the SPR of materials in the presence of metal.
Immediate Accidents and Lingering Trauma: Railwaymen Poets, Danger, and Emotive Verse
Authors: Betts Oliver
Published: September 2022

This paper examines the work of a group of Railwaymen Poets, whose verse has been collected as part of the Piston, Pen and Press project. It explores their writings both as part of an emerging theme of accident and loss poetry surrounding the railways in Victorian culture but also more specifically as interrelated texts produced by workers sharing common experiences. Whilst many wrote about all manner of subjects, not just the railway accident, public fascination with accident reporting allowed them to both pursue their literary endeavours and also to use poetry as a form of catharsis. Their poetry, this paper argues, should be read as a collective expression of emotion around the dangerous and loss-ridden nature of their work.
Probing the Galactic halo with RR lyrae stars − III. The chemical and kinematic properties of the stellar halo
Authors: Liu Gaochao , Huang Yang , Bird Sarah Ann , Zhang Huawei , Wang Fei , Tian Haijun
Published: September 2022

Based on a large spectroscopic sample of ∼4300 RR Lyrae stars with metallicity, systemic radial velocity, and distance measurements, we present a detailed analysis of the chemical and kinematic properties of the Galactic halo. Using this sample, the metallicity distribution function (MDF) as a function of r and the velocity anisotropy parameter β profiles (for different metallicity populations) are derived for the stellar halo. Both the chemical and kinematic results suggest that the Galactic halo is composed of two distinct parts, the inner halo and outer halo. The cutoff radius (∼30 kpc) is similar to the previous break radius found in the density distribution of the stellar halo. We find that the inner part is dominated by a metal-rich population with extremely radial anisotropy (β ∼ 0.9). These features are in accordance with those of ‘Gaia-Enceladus-Sausage’ (GES) and we attribute this inner halo component as being dominantly composed of stars deposited from this ancient merged satellite. We find that GES probably has a slightly negative metallicity gradient. The metal-poor populations in the inner halo are characterized as a long tail in MDF with an anisotropy of β ∼ 0.5, which is similar to that of the outer part. The MDF for the outer halo is very broad with several weak peaks and the value of β is around 0.5 for all metallicities.
Lepton masses and mixings, and muon anomalous magnetic moment in an extended B − L model with the type-I seesaw mechanism
Authors: Vien V V , Long Hoang Ngoc , Hernández A E Cárcamo
Published: September 2022

We propose a B − L model combined with the S4 × Z3 × Z4 discrete symmetry that successfully explains the recent 3+1 sterile–active neutrino data. The smallness of the neutrino mass is obtained through the type-I seesaw mechanism. The active–active and sterile–active neutrino mixing angles are predicted to be consistent with the recent constraints in which $0.3401\, (0.3402) \le \sin ^2\theta _{12}\le 0.3415\, (0.3416), \, 0.456\, (0.433) \le \sin ^2\theta _{23}\le 0.544\, (0.545), \, 2.00\, (2.018) \le 10^2\times \sin ^2\theta _{13}\le 2.405\, (2.424),\, \, 156 \, (140.8) \le \delta ^{(\circ )}_{CP}\le 172\, (167.2)$ for normal (inverted) ordering of the three-neutrino scenario, and $0.015 \, (0.022) \le s^2_{14}\le 0.045 \, (0.029), \, 0.005 (0.0095)\le s^2_{24}\le 0.012\, (0.012), \, 0.003 \, (0.009)\le s^2_{34} \le 0.011$ for normal (inverted) ordering of the 3+1 neutrino scenario. Our model predicts flavor-conserving leptonic neutral scalar interactions and successfully explains the muon g − 2 anomaly.
Integrating Ambulatory Addiction Consultation Service Into a Community Mental Health Center
Authors: Jegede Oluwole , Muvvala Srinivas , Cahill John , Wade Ryan , Jordan Ayana
Published: September 2022

Despite the escalation in substance related overdose mortality—culminating in more than 100,000 deaths in each of the first 2 years of the COVID-19 pandemic—healthcare systems have not kept up with the demands for care among people who use drugs. There remains a significant gap in access to evidence-based treatment. The addiction consult services has served to address this gap, as a critical intervention that engages mostly hospitalized patients and initiate addiction treatment in acute settings, but little is known about addiction consult services in ambulatory settings. This model of care could potentially serve to scale up the care for people who use drugs in the community by embedding the limited number of addiction professionals within existing ambulatory systems, thus extending their reach. We describe here an innovative, yet simple and potentially replicable model for an ambulatory addiction consultation service in a large, advanced community mental health center.
Guided Participation for Clinical Practice
Authors: Pridham Karen , Limbo Rana
Published: September 2022

Theory of guided participation for clinical practice presents teaching and learning in the context of the teacher and learner relationship. The teacher functions as a guide bringing the learner as a participant into a reciprocal, dynamic process that addresses issues learners are working on, acknowledging and directing learning activity to personal and clinical goals. Outcomes of this process are competencies in health-related functions. The process proceeds with understanding of the learner's internal working model (IWM) of self, other, and relationships. The IWM goals, intentions, and expectations formulate guided participation processes for development of competencies specific to the learner's cultural and personal situation and health need.
The COVID-19 Pandemic: Effects on Pediatric Fracture Patterns in the Emergency Department and Subspecialty Follow-up Care
Authors: Lapsa Julianne , Bukola Badaki Oluwakemi , Xu Amy , Eaton Cyd , Lee R. Jay , Ryan Leticia
Published: September 2022

Purpose:

The COVID-19 pandemic affected pediatric fracture injury patterns and volume. There is a paucity of research evaluating this trend throughout the pandemic and also follow-up to orthopaedic subspecialty care after emergency fracture management.

Methods:

This retrospective cohort study reviewed patients 2 to 18 years of age presenting for fracture care to an urban pediatric emergency department. We assessed patient demographics, clinical care, and follow-up to surgical subspecialist. Time periods investigated included March 30 to September 4, 2020 (pandemic), March 30 to September 4, 2019, and March 30 to September 4, 2018 (prepandemic). Subanalysis within the pandemic was during the “stay-at-home order” verses the phased re-opening of the state. Descriptive statistical analysis, Pearson’s χ2 or Fisher exact tests, and Mann-Whitney U tests were performed.

Results:

In this population, fractures overall declined by 40% (n=211) during the pandemic compared with 2019 (n=349) and 28% compared with 2018 (n=292). Lower extremity fractures accounted for a greater percentage of injuries during the pandemic compared with prepandemic. Time to surgical subspecialty follow-up was shortest during the 2020 pandemic peak at 9 days and was significantly longer during phased reopening (phase 1: 18 d, P=0.001; phase 2: 14 d, P=0.005). These patterns were also consistent for days to repeat imaging.

Conclusions:

We found differences in fracture prevalence, mechanisms, and follow-up care during the pandemic. Time to subspecialty follow-up care was longer during pandemic phased reopening despite overall fewer fractures. Plans to absorb postponed visits and efficiently engage redeployed staff may be necessary to address difficulties in follow-up orthopaedic management during public health crises.

Level of Evidence:

Level II.
Is There an Inherited Contribution to Risk for Sporadic Unilateral Vestibular Schwannoma? Evidence of Familial Clustering
Authors: Gurgel Richard K. , Couldwell William T. , Patel Neil S. , Cannon-Albright Lisa A.
Published: September 2022

Object

Unlike the autosomal dominant inheritance of neurofibromatosis 2, there are no known inherited risk factors for sporadic, unilateral vestibular schwannoma (VS), which comprise most VS cases. The authors tested a hypothesis positing a genetic contribution to predisposition to these lesions by analyzing familial clustering of cases.

Methods

Familial clustering of individuals with unilateral VS was analyzed in two independent genealogical resources with linked diagnosis data: the Veterans Health Administration Genealogy Resource and the Utah Population Database. Tests for excess relatedness, estimation of relative risks (RRs) in close and distant relatives, and identification of pedigrees with a significant excess of unilateral VS among descendants were performed.

Results

The average pairwise relatedness of the Veterans Health Administration Genealogy Resource VS cases significantly exceeded the expected relatedness (p = 0.016), even when close relationships were ignored (p = 0.002). RR for third- and fifth-degree relatives developing VS were significantly elevated (RR, 60.83; p = 0.0005; 95% confidence interval [CI], 7.37–219.73) and (RR, 11.88; p = 0.013; 95% CI, 1.44–42.90), respectively. No VS-affected first-, second-, or fourth-degree relatives were observed. In the Utah Population Database population, no first- or second-degree relatives with VS were observed. RR for fifth-degree relatives developing VS was significantly elevated (RR, 2.23; p = 0.009; 95% CI, 1.15–3.90).

Conclusion

These results provide strong evidence for an inherited predisposition to sporadic, unilateral VS. This study exhibits the value of genealogical resources with linked medical data for examining hypotheses regarding inherited predisposition. The high-risk unilateral VS pedigrees identified in two independent resources provide a powerful means of pursuing predisposition gene identification.
Factors Associated with Prolonged Extubation after Total Intravenous Anesthesia in Patients Undergoing Vestibular Schwannoma Resection
Authors: Xia Junming , Ran Guo , Chen Kaizheng , Shen Xia
Published: September 2022

Objective

To identify factors associated with prolonged tracheal extubation after vestibular schwannoma resection in patients receiving propofol-remifentanil–based total intravenous anesthesia (TIVA).

Study Design

Single-center retrospective study of vestibular schwannoma resection performed by a single neurosurgeon between July 2018 and September 2021.

Setting

Tertiary academic medical center.

Patients

Adults receiving TIVA for vestibular schwannoma resection, classified according to extubation time: non-prolonged extubation (<15 min) and prolonged extubation (≥15 min).

Main Outcome Measures

Time from end of surgery to extubation, demographic parameters, intraoperative variables, and familiarity between the anesthesia provider and the neurosurgeon were analyzed. Predictors for prolonged extubation were analyzed via multivariate analysis. The primary outcome was the incidence of prolonged extubation. The secondary outcome was factors associated with prolonged tracheal extubation.

Results

A total of 234 cases were analyzed. The median (interquartile range) extubation time was 9.4 minutes (7.2, 12.2 min). Extubation was prolonged in 39 patients (16.7%). Factors predicting prolonged extubation were significant blood loss (odds ratio [OR], 12.8; 95% confidence interval [CI], 2.6–61.7; p = 0.002), intraoperative neuromuscular blocking drug infusion (OR, 6.6; 95% CI, 2.8–15.7; p < 0.001), and lack of familiarity between the anesthesia provider and neurosurgeon (OR, 4.4; 95% CI, 1.5–12.3; p = 0.005).

Conclusion

Significant blood loss, intraoperative neuromuscular blocking drug infusion, and lack of familiarity between anesthesia provider and neurosurgeon were associated with prolonged extubation following TIVA for vestibular schwannoma resection.
Glymphatic MRI techniques in sleep and neurodegenerative diseases
Authors: Lee Hyochul , Choi Seung Hong , Anzai Yoshimi
Published: September 2022

Purpose of review

The purpose of this review article is to summarize the current in-vivo imaging techniques for the evaluation of the glymphatic function and discuss the factors influencing the glymphatic function and research directions in the future.

Recent findings

The glymphatic system allows the clearance of metabolic waste from the central nervous system (CNS). The glymphatic pathway has been investigated using intrathecal or intravenous injection of a gadolinium-based contrast agent (GBCA) on MRI, so-called glymphatic MRI. The glymphatic MRI indirectly visualizes the dynamic CSF flow and evaluated the glymphatic function in the animal and human models. Several clinical and preclinical studies using glymphatic MRI have confirmed that the glymphatic function is impaired in neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, and idiopathic normal pressure hydrocephalus. Furthermore, physiologic process such as sleep facilitates the glymphatic clearance, thus clearing accumulation of protein deposition, such as amyloid or tau, potentially delaying the progression of neurodegenerative diseases.

The glymphatic system plays a crucial role in clearing metabolic wastes in the brain. Glymphatic MR imaging using GBCA administration serves as a functional imaging tool to measure the glymphatic function and investigate various pathophysiologies of neurodegenerative diseases.
Counseling Tobacco Smoke Exposure Reduction Measures in Pediatrics: A Quality Improvement Project
Authors: Ferguson Kevin , Krishnan Sankaran , Sullivan Emily , Bhela Shyall , Dozor Allen J. , Welter John J.
Published: September 2022

Introduction:

With over 40% of children in the USA exposed to tobacco smoke, the AAP recommends tobacco smoke exposure (TSE) assessment during clinic visits. We aimed to increase the rates of TSE screening and provider counseling regarding TSE reduction using an evidence-based approach.

Methods:

We conducted the project at a large pediatric pulmonology practice. Baseline caregiver surveys and medical record review of TSE documentation took place in July/August, 2019. From September 2019 to July 2021, PDSA cycles were conducted to increase TSE screening and reduce counseling.

Results:

Before starting the project, 18% of smoking caregivers acknowledged smoking in the home and 41% in the car. While caregivers strongly desired to decrease TSE (median 9.4/10 on Likert scale), physician counseling of TSE reduction was offered only to 44%. PDSA cycles led to refining our patient passport, a document used during patient intake, which increased screening of TSE from 46% to 85%. Creating an educational handout in our electronic record addressing TSE increased TSE reduction counseling from 44% to 80% of children with smokers in the home.

Conclusions:

Incorporating TSE screening into established nursing documentation of vital signs led to the sustained screening of TSE among children in a pediatric pulmonology practice. Embedding educational material in our electronic record and changes in clinic processes increased TSE reduction counseling. Similar changes could improve rates of counseling caregivers of other guidelines aimed to improve the children’s health.
Facial Scars: Do Position and Orientation Matter?
Authors: Zapatero Zachary D. , Workman Clifford I. , Kalmar Christopher L. , Humphries Stacey , Kosyk Mychajlo S. , Carlson Anna R. , Swanson Jordan W. , Chatterjee Anjan , Taylor Jesse A.
Published: September 2022

Purpose

This study tested the core tenets of how facial scars are perceived by characterizing layperson response to faces with scars. We predicted that scars closer to highly viewed structures of the face (i.e., upper lip and lower lid), scars aligned against resting facial tension lines, and scars in the middle of anatomic subunits of the face would be rated less favorably.

Methods

Voluntee s aged 18 and older from the United States were recruited through Amazon's Mechanical Turk to complete a face rating survey. Scars were digitally added in different locations and orientations for a total of 14 unique scars added to each face.

Each participant rated 50 different faces on confidence, friendliness, and attractiveness. Data were analyzed using linear mixed effects models (LMEMs).

Results

A total of 88,850 ratings (82,990 scarred, 93.4%) for attractiveness, friendliness, and confidence were analyzed. In univariate LMEMs, the presence of a facial scar did not significantly impact attractiveness (β=0.016, SE=0.014, z=1.089, p=0.276). A second set of LMEMs identified interactions between location, subunit placement, and orientation to facial tension lines. Scars located on the lower lid mid subunit perpendicular to facial tension lines were rated less attractive (β=-0.065, SE=0.028, z=-2.293, p=0.022).

Conclusions

On average, a single well-healed facial scar does not negatively affect first impressions of attractiveness, confidence, or friendliness. Specific scar location and orientation combinations, however, such as a perpendicular scar at the mid-lower eyelid, may result in lower perceived attractiveness, confidence, and friendliness.
Using Community Detection Techniques to Identify Themes in COVID-19–Related Patient Safety Event Reports
Authors: Boxley Christian , Krevat Seth , Sengupta Srijan , Ratwani Raj , Fong Allan
Published: September 2022

Objectives

The COVID-19 pandemic has transformed how healthcare is delivered to patients. As the pandemic progresses and healthcare systems continue to adapt, it is important to understand how these changes in care have changed patient care. This study aims to use community detection techniques to identify and facilitate analysis of themes in patient safety event (PSE) reports to better understand COVID-19 pandemic’s impact on patient safety. With this approach, we also seek to understand how community detection techniques can be used to better identify themes and extract information from PSE reports.

Methods

We used community detection techniques to group 2082 PSE reports from January 1, 2020, to January 31, 2021, that mentioned COVID-19 into 65 communities. We then grouped these communities into 8 clinically relevant themes for analysis.

Results

We found the COVID-19 pandemic is associated with the following clinically relevant themes: (1) errors due to new and unknown COVID-19 protocols/workflows; (2) COVID-19 patients developing pressure ulcers; (3) unsuccessful/incomplete COVID-19 testing; (4) inadequate isolation of COVID-19 patients; (5) inappropriate/inadequate care for COVID-19 patients; (6) COVID-19 patient falls; (7) delays or errors communicating COVID-19 test results; and (8) COVID-19 patients developing venous thromboembolism.

Conclusions

Our study begins the long process of understanding new challenges created by the pandemic and highlights how machine learning methods can be used to understand these and similar challenges. Using community detection techniques to analyze PSE reports and identify themes within them can help give healthcare systems the necessary information to improve patient safety and the quality of care they deliver.
Contrast Enhancement Patterns in Pediatric Glioblastomas
Authors: Pokhylevych Halyna , Khose Swapnil , Gule-Monroe Maria K. , Chen Melissa M. , Fuller Greg , Gruschkus Stephen K. , Sadighi Zsila , Zaky Wafik , Sandberg David I. , McGovern Susan L. , Johnson Jason M.
Published: September 2022

Background and Purpose

Brain tumors are the most common cause of cancer-related deaths among the pediatric population. Among these, pediatric glioblastomas (GBMs) comprise 2.9% of all central nervous system tumors and have a poor prognosis. The purpose of this study is to determine whether the imaging findings can be a prognostic factor for survival in children with GBMs.

Materials and Methods

The imaging studies and clinical data from 64 pediatric patients with pathology-proven GBMs were evaluated. Contrast enhancement patterns were classified into focal, ring-like, and diffuse, based on preoperative postcontrast T1-weighted magnetic resonance images. We used the Kaplan-Meier method and Cox proportional hazard regression to evaluate the prognostic value of imaging findings.

Results

Patients with ring-enhanced GBMs who underwent gross total resection or subtotal resection were found to have a significantly shorter progression-free survival (P = 0.03) comparing with other enhancing and nonenhancing glioblastomas.

Conclusions

In this study, we analyzed survival factors in children with pediatric glioblastomas. In the group of patients who underwent gross total resection or subtotal resection, those patients with focal-enhanced GBMs had significantly longer progression-free survival (P = 0.03) than did those with other types of enhancing GBMs (diffuse and ring-like).
The Impact of Virtual Monoenergetic Imaging on Visualization of the Cervical Spinal Canal
Authors: McComiskey David , Erdenebold Undrakh-Erdene , McInnes Matthew D.F. , Salameh Jean-Paul , Chatelain Robert , Torres Carlos , Chakraborty Santanu , Zakhari Nader
Published: September 2022

Rationale and Objectives

Our purpose is to explore the role of dual-energy computed tomography (DECT) and virtual monoenergetic energy levels in reducing shoulder artifact to improve visualization of the cervical spinal canal.

Materials and Methods

A retrospective review of 171 consecutive DECT scans of the neck (95 male, 65 female; mean age, 60.9 years, ranging from 18 to 88 years; with 11 excluded because of nondiagnostic image quality) during an 8-month period was performed with postprocessing of monoenergetic images at 50, 70, 100, and 140 keV. Subjective comparisons and objective image noise between the monoenergetic images and standard computed tomography (CT) were analyzed by 1-way analysis of variance to determine the optimal DECT energy level with the highest image quality.

Results

Subjectively, 100-keV DECT best visualizes the spinal canal relative to standard CT, 50 and 70 keV (P < 0.01), and was superior to 140 keV for reader 1 (P < 0.01). Objectively, 100 keV demonstrated less noise relative to 50 keV (72.02; P < 0.01). There was no difference in noise between 100 keV and 70 keV, or between 100 keV and standard CT, which also demonstrated lower noise relative to 50-, 70-, and 140-keV levels (91.53, P < 0.01; 29.84, P < 0.01; and 22.66, P < 0.03).

Conclusion

Dual-energy CT at 100 keV may be the preferred DECT monoenergetic level for soft tissue assessment. Increasing energy level is associated with reduction in shoulder artifact, with no difference in noise between 100 keV and standard CT, although 100-keV images may be subjectively better.
Development of a Rubric to Evaluate Implementation Quality of Simulation-Based Courses
Authors: Nayahangan Leizl Joy , Konge Lars , Park Christine , Dubrowski Adam , Yudkowsky Rachel
Published: September 2022

Introduction

Simulation-based education is a recognized way of developing medical competencies, and there is overwhelming scientific evidence to support its efficacy. However, it is still underused, which can often be related to poor implementation process. In addition, best practices for implementation of simulation-based courses based on implementation science are not widely known nor applied. The purpose of this study was to develop a rubric, the Implementation Quality Rubric for Simulation (IQR-SIM), to evaluate the implementation quality of simulation-based courses.

Methods

A 3-round, modified Delphi process involving international simulation and implementation experts was initiated to gather and converge opinions regarding criteria for evaluating the implementation quality of simulation-based courses. Candidate items for Round 1 were developed based on the Adapted Implementation Model for Simulation. Items were revised and expanded to include descriptive anchors for evaluation in Round 2. Criterion for inclusion was 70% of respondents selecting an importance rating of 4 or 5/5. Round 3 provided refinement and final approval of items and anchors.

Results

Thirty-three experts from 9 countries participated. The initial rubric of 32 items was reduced to 18 items after 3 Delphi rounds, resulting in the IQR-SIM: a 3-point rating scale, with nonscored options “Don't know/can't assess” and “Not applicable,” and a comments section.

Conclusions

The IQR-SIM is an operational tool that can be used to evaluate the implementation quality of simulation-based courses and aid in the implementation process to identify gaps, monitor the process, and promote the achievement of desired implementation and learning outcomes.
Video Messaging to Increase Vascularized Composite Allograft Donation Willingness in United States Military Veterans
Authors: Rodrigue James R. , Shenkel Jessica , Boger Matthew , Pomahac Bohdan , Fleishman Aaron
Published: September 2022

Background.

Expansion of vascularized composite allograft (VCA) transplantation depends on the public’s willingness to donate VCA organs, including face, extremities, and genitourinary organs. This study evaluated the effectiveness of video messaging on VCA donation willingness in US military veterans, a key stakeholder in VCA transplantation.

Methods.

Participants (n = 556) were randomized to 1 of 3 VCA video messaging interventions (informational, testimonial, or blended), a general (non-VCA) organ donation video message, or a control (nondonation) video message. Questionnaires were completed at pre- and postintervention and at 3-wk follow-up.

Results.

Veterans exposed to any VCA video messaging were more likely to express VCA donation willingness (69%, n = 203/296) than those exposed to general donation messaging (53%, n = 47 of 89; P = 0.006) or No Donation Messaging (37%, n = 36 of 97; P < 0.001). A significantly higher proportion of participants who received Blended VCA Messaging were willing to be VCA donors, compared with the Informational VCA Messaging group (79% versus 61%, P = 0.006). Each VCA messaging video resulted in a significant pre- to postintervention increase in the proportion of participants willing to donate their own face, hands, and legs (P < 0.03).

Conclusions.

Brief educational videos focused on VCA transplantation can have a demonstrable and verifiable impact on rates of VCA donation willingness in veterans.
Determining Clinical Thresholds for Donor HLA Eplet Compatibility to Predict Best Outcomes Following Lung Transplantation
Authors: Hiho Steven J. , Walton Duncan C. , Paraskeva Miranda A. , Levvey Bronwyn J. , Diviney Mary B. , Snell Gregory I. , Sullivan Lucy C. , Westall Glen P.
Published: September 2022

Background.

Currently, the assessment of immunological risk in lung transplantation (LTx) does not completely consider HLA compatibility at the molecular level. We have previously demonstrated the association of HLA eplets in predicting chronic lung allograft dysfunction following LTx; however, the associations between HLA eplet mismatch (epMM) loads and overall survival are unknown.

Methods.

In this retrospective, single-center study, 277 LTx donor-recipient pairs were high resolution HLA typed and analyzed for HLA epMMs using HLAMatchmaker (version 3.1). LTx pairs were also assessed for the presence of the previously described risk epitope mismatches DQ2-DQA1*05 and DQ7-DQA1*05.

Results.

HLA class I epMMs were not associated with deleterious outcomes; however, lower HLA class II (≤19), DQA1 (≤2), and combined HLA class I and II (≤29) epMM demonstrated an association with increased time to chronic lung allograft dysfunction and improved overall survival. The presence of a risk epitope mismatch was not associated with worse clinical outcomes.

Conclusions.

HLA epMM can risk-stratify LTx recipients and potentially guide donor-recipient matching and immunosuppression strategies.
LIM Homeobox Transcription Factor 1-β Expression is Upregulated in Patients with Osteolysis after Total Ankle Arthroplasty and Inhibits Receptor Activator of Nuclear Factor-κB Ligand-Induced Osteoclast Differentiation in Vitro
Authors: Kim Kabsun , Han Jeong Eun , Lee Keun-Bae , Kim Nacksung
Published: September 2022

Background: Osteolysis is one of the most common problems that occurs after total hip and knee arthroplasty and has recently become a significant problem after total ankle arthroplasty (TAA). In this study, we investigated the role of LIM homeobox transcription factor 1-β (Lmx1b) in osteoclast differentiation. By evaluating the expression profiles associated with osteolysis following TAA treatment, Lmx1b was found to be differentially expressed in patients with osteolysis after TAA.Methods: To identify the important genes associated with osteolysis after TAA, RNA sequencing was performed by analyzing 8 patient samples: 5 primary TAA samples (control group) and 3 TAA samples revised for flexion instability (osteolysis group). By analyzing the differentially expressed genes and gene ontologies, Lmx1b expression was found to be upregulated in the osteolysis group compared to that in the control group. Focusing on the role of Lmx1b in bone cells, Lmx1b was overexpressed by a retrovirus in osteoclast precursor cells. The cultured cells were stained with tartrate-resistant acid phosphatase, and the expression of osteoclast-related genes was analyzed using real-time polymerase chain reaction.Results: Lmx1b overexpression in osteoclast precursors suppresses osteoclast formation and resorptive activity. The expression of osteoclast marker genes was significantly reduced during osteoclast differentiation by Lmx1b overexpression. Furthermore, Lmx1b is associated with nuclear factor of activated T cells 1 (NFATc1) and inhibited NFATc1 translocation into the nucleus.Conclusions: These results provide novel insights into the anti-bone resorptive effect of Lmx1b on osteolysis after TAA and may lead to the development of effective preventative and therapeutic strategies for peri-implant osteolysis.
Retropharyngeal Ectopic Parathyroid Adenoma Localized by 18F-Fluorocholine Positron Emission Tomography/Computed Tomography: A Case Report
Authors: Jang Hyeokjoo , Lee Seunghyun , Kim Dahee , Hong Namki
Published: September 2022

Ectopic parathyroid adenomas of the retropharyngeal space are relatively rare. Herein, we report a case of primary hyperparathyroidism (PHPT) secondary to a retropharyngeal parathyroid adenoma. A 22-year-old woman presented with elevated serum calcium and parathyroid hormone (PTH) levels, revealed during a medical check-up. The patient had a history of ureteral stones and a confirmed low bone mass. Neck 99mTechnetium-sestamibi singlephoton emission computed tomography (CT) and ultrasonography did not reveal any suspicious lesions. There was no evidence of hereditary PHPT based on the results of targeted gene sequencing. Surgical exploration was unsuccessful, and the PHPT persisted after the first surgery. Approximately a year after the failed operation, 18F-fluorocholine (FCH) positron emission tomography/CT (PET-CT) became available, and when performed, it revealed increased uptake in the retropharyngeal space of the right side of the neck. The results of parathyroid venous sampling were concordant with a >2-fold elevation of PTH level in the veins on the right side of the neck compared to the peripheral veins. The 1.8 cm-diameter mass was successfully removed resulting in an 87% reduction in intraoperative PTH level (198.0-26.5 pg/mL). Subsequently, normalizations of calcium and PTH levels were achieved. In summary, ectopic parathyroid adenomas, including retropharyngeal lesions, should also be suspected when investigating an elusive case of PHPT. 18F-FCH PET-CT can be a useful complementary modality for detecting culprit lesions.
Association between oral health and swallowing function
Authors: Yamano Takafumi , Nishi Kensuke , Omori Fumitaka , Wada Kaori , Yamaguchi Masahiro , Naito Toru
Published: September 2022

Objective

Oral care is effective for preventing pneumonia, but objective evaluation of its effect on swallowing is lacking. Oral assessment scores, such as the Oral Health Assessment Tool (OHAT), are used to evaluate the oral environment to monitor oral care. Methods: We investigated the relationship between OHAT score and swallowing function in 24 patients aged 64–97 years.

Results

The OHAT score did not correlate with the video endoscopy (VE) or video fluorography (VF) scores. Furthermore, the OHAT score was not significantly different between the multiple and no or single pneumonia episode groups. The group with multiple episodes of pneumonia had lower VE and VF scores than that with no or a single episode of pneumonia (p < 0.01).

Conclusions

Oral assessment, VE, and VF scores are necessary to evaluate swallowing in patients with suspected dysphagia. In addition, recurrent pneumonia among patients with a good oral environment has multiple contributing factors, including subclinical aspiration, pharyngeal clearance, and delayed activation of the gag reflex.
Mapping and modeling human colorectal carcinoma interactions with the tumor microenvironment
Authors: Li Ning , Zhu Qin , Tian Yuhua , Ahn Kyung Jin , Wang Xin , Cramer Zvi , Folkert Ian W. , Yu Pengfei , Jou Justine , Adams-Tzivelekidis Stephanie , Sehgal Priyanka , Mahmoud Najia N. , Aarons Cary B. , Roses Robert E. , Thomas-Tikhonenko Andrei , Furth Emma E. , Stanger Ben Z. , Rustgi Anil , Haldar Malay , Katona Bryson W. , Tan Kai , Lengner Christopher J.
Published: September 2022

The initiation and progression of cancer are inextricably linked to the tumor microenvironment (TME). Understanding the function of specific cancer-TME interactions poses a major challenge due in part to the complexity of the in vivo microenvironment. Here we predict cancer-TME interactions from single cell transcriptomic maps of both human colorectal cancers (CRCs) and mouse CRC models, ask how these interactions are altered in established, long-term human tumor organoid (tumoroid) cultures, and functionally recapitulate human myeloid-carcinoma interactions in vitro. Tumoroid cultures suppress gene expression programs involved in promoting inflammation and immune cell migration through receptor-ligand interactions, providing a reductive platform for re-establishing carcinoma-immune cell interactions in vitro. Introduction of human monocyte-derived macrophages into tumoroid cultures instructs macrophages to acquire pro-tumorigenic gene expression programs similar to those observed in vivo. This includes hallmark induction of SPP1, encoding Osteopontin, an extracellular CD44 ligand with established oncogenic effects. Taken together, these findings offer a framework for understanding CRC-TME interactions and provide a reductionist tool for modeling specific aspects of these interactions.
Molecular landscape and functional characterization of centrosome amplification in ovarian cancer
Authors: Sauer Carolin M. , Hall James A. , Couturier Dominique-Laurent , Bradley Thomas , Piskorz Anna M. , Griffiths Jacob , Sawle Ashley , Eldridge Matthew D. , Smith Philip , Hosking Karen , Reinius Marika A.V. , Gavarró Lena Morrill , Mes-Masson Anne-Marie , Ennis Darren , Millan David , Hoyle Aoisha , McNeish Iain A. , Jimenez-Linan Mercedes , Martins Filipe Correia , Tischer Julia , Vias Maria , Brenton James D.
Published: September 2022

High grade serous ovarian carcinoma (HGSOC) is characterised by poor outcome and extreme chromosome instability (CIN). Therapies targeting centrosome amplification (CA), a key mediator of chromosome missegregation and CIN, may have significant clinical utility in HGSOC. However, the prevalence of CA in HGSOC, its relationship to genomic biomarkers of CIN and its potential impact on therapeutic response have not been defined. Using high-throughput multi-regional microscopy on 287 clinical HGSOC tumour tissues and 73 ovarian cancer cell lines, we show that CA through centriole overduplication is a highly recurrent and heterogeneous feature of HGSOC and is strongly associated with CIN and genome subclonality. Cell-based studies showed that high prevalence CA is phenocopied in ovarian cancer cell lines, and that high CA is associated with increased multi-treatment resistance; most notably to paclitaxel which is the most common treatment used in HGSOC. CA in HGSOC may therefore present a potential driver of tumour evolution and a powerful biomarker for response to standard-of-care treatment.
European scenarios for future biological invasions
Authors: Pérez-Granados Cristian , Lenzner Bernd , Golivets Marina , Saul Wolf-Christian , Jeschke Jonathan M. , Essl Franz , Peterson Garry D. , Rutting Lucas , Latombe Guillaume , Adriaens Tim , Aldridge David C. , Bacher Sven , Bernardo-Madrid Rubén , Brotons Lluís , Díaz François , Gallardo Belinda , Genovesi Piero , González-Moreno Pablo , Kühn Ingolf , Kutleša Petra , Leung Brian , Liu Chunlong , Pagitz Konrad , Pastor Teresa , Pauchard Aníbal , Rabitsch Wolfgang , Roy Helen E. , Robertson Peter , Seebens Hanno , Solarz Wojciech , Starfinger Uwe , Tanner Rob , Vilà Montserrat , Roura-Pascual Núria
Published: September 2022

Invasive alien species are one of the major threats to global biodiversity, ecosystem integrity, nature’s contribution to people and human health. While scenarios about potential future developments have been available for other global change drivers for quite some time, we largely lack an understanding of how biological invasions might unfold in the future across spatial scales.

Based on previous work on global invasion scenarios, we developed a workflow to downscale global scenarios to a regional and policy-relevant context. We applied this workflow at the European scale to create four European scenarios of biological invasions until 2050 that consider different environmental, socio-economic and socio-cultural trajectories, namely the European Alien Species Narratives (Eur-ASNs).

We compared the Eur-ASNs with their previously published global counterparts (Global-ASNs), assessing changes in 26 scenario variables. This assessment showed a high consistency between global and European scenarios in the logic and assumptions of the scenario variables. However, several discrepancies in scenario variable trends were detected that could be attributed to scale differences. This suggests that the workflow is able to capture scale-dependent differences across scenarios.

We also compared the Global- and Eur-ASNs with the widely used Global and European Shared Socioeconomic Pathways (SSPs), a set of scenarios developed in the context of climate change to capture different future socio-economic trends. Our comparison showed considerable divergences in the scenario space occupied by the different scenarios, with overall larger differences between the ASNs and SSPs than across scales (global vs. European) within the scenario initiatives.

Given the differences between the ASNs and SSPs, it seems that the SSPs do not adequately capture the scenario space relevant to understanding the complex future of biological invasions. This underlines the importance of developing independent, but complementary, scenarios focused on biological invasions. The downscaling workflow we presented and implemented here provides a tool to develop such scenarios across different regions and contexts. This is a major step towards an improved understanding of all major drivers of global change including biological invasions.
Socially transmitted innovations in dynamic predator-prey systems
Authors: Kikuchi David W. , Simon Margaret W.
Published: September 2022

Individual behavioral variation is common, yet often we do not know how it is maintained. A potential explanation is that some behaviors must be acquired rather than genetically inherited. We investigate the social transmission of behavioral innovations, which can be key for the success of predator species, especially in contexts where environmental changes take place. We examine innovation in two classic predator-prey models. We assume that innovations increase predator attack rates or conversion efficiencies, or that innovations reduce predator mortality or prey handling time. We find that a common outcome of innovations is the destabilization of the system. Destabilizing effects include increasing oscillations or limit cycles. If either of these outcomes increases the risk of extinction, innovations that benefit individual predators may not have positive long-term effects on predator populations. Furthermore, as populations cycle, innovative individuals can be nearly eliminated, maintaining temporal behavioral variability. The destabilizing effects of behavioral innovations on predator-prey dynamics could have implications for biological invasions, urban populations, endangered species, and, more broadly, the maintenance of behavioral polymorphisms.
Phenotypic switch and reduced the growth of melanoma spheroids in the presence of mast cell-conditioned medium: potential impact of nutrient starvation effects
Authors: Grujic Mirjana , Nguyen Thanh , Héchard Tifaine , Wang Helen , Lampinen Maria , Paivandy Aida , Pejler Gunnar
Published: September 2022

Mast cells are abundant in melanoma tumors, and studies suggest that they can be either detrimental or protective for melanoma growth. However, the underlying mechanisms are not fully understood. Here, we adopted a hanging drop-established spheroid system to investigate how mast cells can influence melanoma growth and phenotype in a 3-D context. In the presence of mast cells or mast cell-conditioned medium, melanoma spheroid growth was profoundly reduced. To address the underlying mechanism, we conducted a transcriptomic analysis, which revealed that mast cell-conditioned medium had extensive effects on the melanoma gene expression patterns. Pathway analyses revealed profound effects on the expression of genes related to amino acid and protein metabolism. The conditioned medium also induced an upregulated expression of cancer-related genes, including adhesion molecules implicated in metastatic spreading. In line with this, after transfer to a Matrigel extracellular matrix milieu, spheroids that had been developed in the presence of mast cell-conditioned medium displayed enhanced elevated growth and adhesive properties. However, when assessing for possible effects of nutrient starvation, i.e., reduced nutrient content in mast cell-conditioned medium, we found that the observed effects on melanoma spheroid growth potentially could be explained by such effects. Hence, it cannot be excluded that the observed phenotypic alterations of melanoma spheroids grown in the presence of mast cells or mast cell-conditioned media are, at least partly, due to nutrient starvation rather than to the action of factors secreted by mast cells. Instead, our findings may provide insight into the effects on gene expression events that occur in melanoma tumors under nutrient stress.
Infant antibody repertoires during the first two years of influenza vaccination
Authors: Kuraoka Masayuki , Curtis Nicholas C. , Watanabe Akiko , Tanno Hidetaka , Shin Seungmin , Ye Kevin , Macdonald Elizabeth , Lavidor Olivia , Kong Susan , Holle Tarra Von , Windsor Ian , Ippolito Gregory C. , Georgiou George , Walter Emmanuel B. , Kelsoe Garnett H. , Harrison Stephen C. , Moody M. Anthony , Bajic Goran , Lee Jiwon
Published: September 2022

The first encounter with influenza virus biases later immune responses. This “immune imprinting”, formerly from infection within a few years of birth, is in the U.S. now largely from immunization with a quadrivalent, split vaccine (IIV4). In a pilot study of IIV4 imprinting, we characterized, by single-B-cell cultures, NextGen sequencing, and plasma antibody proteomics, the primary antibody responses to influenza in two infants during their first two years of seasonal influenza vaccination. One infant, who received only a single vaccination in Year 1, contracted an influenza B (IBV) infection between the two years, allowing us to compare imprinting by infection and vaccination. That infant had a shift in hemagglutinin (HA)-reactive B-cell specificity from largely influenza A (IAV)-specific in Year 1 to IBV-specific in Year 2, both before and after vaccination. HA-reactive B cells from the other infant maintained a more evenly distributed specificity. In Year 2, class-switched HA-specific B cell IGHV somatic hypermutation (SHM) levels reached average levels seen in adults. The HA-reactive plasma antibody repertoires of both infants comprised a relatively small number of antibody clonotypes, with one or two very abundant clonotypes. Thus, after the Year 2 boost, both infants had overall B cell profiles that resembled those of adult controls.

Importance

Influenza virus is a moving target for the immune system. Variants emerge that escape protection from antibodies elicited by a previously circulating variant (“antigenic drift”). The immune system usually responds to a drifted influenza virus by mutating existing antibodies rather than by producting entirely new ones. Thus, immune memory of the earliest influenza exposure has a major influence on later responses to infection or vaccination (“immune imprinting”). In the many studies of influenza immunity in adult subjects, imprinting has been from an early infection, since only in the past two decades have infants received influenza immunizations. The work reported in this paper is a pilot study of imprinting in two infants by the flu vaccine, which they received before experiencing an influenza infection. The results suggest that a quadrivalent (four-subtype) vaccine may provide an immune imprint less dominated by one subtype than does a monovalent infection.