bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural networks for separation of cosmic gamma rays and hadronic cosmic rays in air shower observation with a large area surface detector array
Authors: Okukawa Sousuke , Hara Kazuyuki , Hibino Kinya , Katayose Yusaku , Kawata Kazumasa , Ohnishi Munehiro , Sako Takashi , Sako Takashi K , Shibata Makio , Shiomi Atsushi , Takita Masato
Published: April 2024

The Tibet ASγ experiment has been observing cosmic gamma rays and cosmic rays in the energy range from teraelectron volts to several tens of petaelectron volts with a surface detector array since 1990. The derivation of cosmic gamma-ray flux is made by finding the excess distribution of the arrival direction of air showers above background cosmic rays. In 2014, the underground water Cherenkov muon detector (MD) was added to separate cosmic gamma rays from the background on the basis of the muon-less feature of the air showers of gamma-ray origin; hybrid observations using these two detectors were started at this time. In the present study, we developed methods to separate gamma-ray-induced air showers and hadronic cosmic-ray-induced ones using the measured particle number density distribution to improve the sensitivity of cosmic gamma-ray measurements using the Tibet air shower array data alone before the installation of the MD. We tested two approaches based on neural networks. The first method used feature values representing the lateral spread of the secondary particles, and the second method used the shower image data. To compare the separation performance of each method, we analyzed Monte Carlo air shower events in the vertically incident direction with mono-initial-energy gamma rays and protons. When discriminated by a single feature, the feature with the highest separation performance has an area under the curve (AUC) value of 0.701 for a gamma-ray energy of 10 TeV and 0.808 for 100 TeV. A separation method with a multilayer perceptron (MLP) based on multiple features has AUC values of 0.761 for a gamma-ray energy of 10 TeV and 0.854 for 100 TeV, which represents an improvement of approximately 5% in the AUC value compared with the single-feature case. We also found that the feature values that effectively contribute to the separation vary depending on the energy. A separation method with a convolutional neural network (CNN) using the shower image data has AUC values of 0.781 for a gamma-ray energy of 10 TeV and 0.901 for 100 TeV, which are approximately 5% higher than those of the MLP method. We applied the CNN separation method to Monte Carlo gamma-ray and cosmic-ray events from the Crab Nebula in the energy range 10–100 TeV. The AUC values range from 0.753 to 0.879, and the significance of the observed gamma-ray excess is improved by 1.3 to 1.8 times compared with the case without the separation procedure.
Contributions of atmospheric forcing and ocean preconditioning in the 2016 Antarctic sea ice extent drop
Authors: Mezzina Bianca , Goosse Hugues , Huot Pierre-Vincent , Marchi Sylvain , Van Lipzig Nicole
Published: April 2024

The 2016 Antarctic sea ice extent (SIE) drop was a rapid decrease that led to persistent low sea ice conditions. The event was triggered by atmospheric anomalies, but the potential preconditioning role of the ocean is unsettled. Here, we use sensitivity experiments with a fully-coupled regional climate model to elucidate the impact of the ocean conditions on the drop and on the persistence of the negative SIE anomalies during 2017. In particular, we re-initialize the model in January 2016 using different ocean and sea ice conditions, keeping lateral boundary forcings in the atmosphere and ocean unchanged. We find that the state of the Southern Ocean in early 2016 does not determine whether the drop occurs or not, but indeed has an impact on its amplitude and regional characteristics. Our results also indicate that the ocean initialization affects the sea ice recovery after the drop in the short term (one year), especially in the Weddell sector. The ocean’s influence appears not to be linked to the ocean surface and sea-ice initialization, but rather to the sub-surface conditions (between 50 m and 150 m) and heat exchange fluctuations at the regional scale, while the atmospheric forcing triggering the drop is driven by the large-scale circulation.
Exploiting a variational auto-encoder to represent the evolution of sudden stratospheric warmings
Authors: Chen Yi-Chang , Liang Yu-Chiao , Wu Chien-Ming , Huang Jin-De , Lee Simon H , Wang Yih , Zeng Yi-Jhen
Published: April 2024

Sudden stratospheric warmings (SSWs) are the most dramatic events in the wintertime stratosphere. Such extreme events are characterized by substantial disruption to the stratospheric polar vortex, which can be categorized into displacement and splitting types depending on the morphology of the disrupted vortex. Moreover, SSWs are usually followed by anomalous tropospheric circulation regimes that are important for subseasonal-to-seasonal prediction. Thus, monitoring the genesis and evolution of SSWs is crucial and deserves further advancement. Despite several analysis methods that have been used to study the evolution of SSWs, the ability of deep learning methods has not yet been explored, mainly due to the relative scarcity of observed events. To overcome the limited observational sample size, we use data from historical simulations of the Whole Atmosphere Community Climate Model version 6 to identify thousands of simulated SSWs, and use their spatial patterns to train the deep learning model. We utilize a convolutional neural network combined with a variational auto-encoder (VAE)—a generative deep learning model—to construct a phase diagram that characterizes the SSW evolution. This approach not only allows us to create a latent space that encapsulates the essential features of the vortex structure during SSWs, but also offers new insights into its spatiotemporal evolution mapping onto the phase diagram. The constructed phase diagram depicts a continuous transition of the vortex pattern during SSWs. Notably, it provides a new perspective for discussing the evolutionary paths of SSWs: the VAE gives a better-reconstructed vortex morphology and more clearly organized vortex regimes for both displacement-type and split-type events than those obtained from principal component analysis. Our results provide an innovative phase diagram to portray the evolution of SSWs, in which particularly the splitting SSWs are better characterized. Our findings support the future use of deep learning techniques to study the underlying dynamics of extreme stratospheric vortex phenomena, and to establish a benchmark to evaluate model performance in simulating SSWs.
Divergent future change in South Atlantic Ocean Dipole impacts on regional rainfall in CMIP6 models
Authors: Nworgu Uzoma C , Nnamchi Hyacinth C , Rosário Nilton E
Published: April 2024

The South Atlantic Ocean Dipole (SAOD) exerts strong influence on climate variability in parts of Africa and South America. Here we assess the ability of an ensemble of 35 state-of-the-art coupled global climate models to simulate the SAOD impacts on regional rainfall for the historical period (1950–2014), and their future projections (2015–2079). For both periods we consider the peak phase of the dipole in austral winter. Observational analysis reveals four regions with spatially coherent SAOD impacts on rainfall; Northern Amazon, Guinea Coast, Central Africa, and Southeast Brazil. The observed rainfall response to the SAOD over Northern Amazon (0.31 mm d−1), Guinea Coast (0.38 mm d−1), and Southeast Brazil (0.12 mm d−1) are significantly underestimated by the modeled ensemble-mean response of 0.10 ± 0.15 mm d−1, 0.05 ± 0.15 mm d−1, −0.01 ± 0.04 mm d−1, respectively. A too southerly rain belt in the ensemble, associated with warmer-than-observed Atlantic cold tongue, leads to better performance of models over Central Africa (46% simulate observations-consistent SAOD-rainfall correlations) and poor performance over the Guinea Coast (only 5.7% simulate observations-consistent SAOD-rainfall correlations). We also find divergent responses among the projections of ensemble members precluding a categorical statement on the future strength of the SAOD-rainfall relationship in a high-emissions scenario. Our results highlight key uncertainties that must be addressed to enhance the value of SAOD-rainfall projections for the affected African and South American countries.
Assessing canopy height measurements from ICESat-2 and GEDI orbiting LiDAR across six different biomes with G-LiHT LiDAR
Authors: Yu Qiuyan , Ryan Michael G , Ji Wenjie , Prihodko Lara , Anchang Julius Y , Kahiu Njoki , Nazir Abid , Dai Jingyu , Hanan Niall P
Published: April 2024

The height of woody plants is a defining characteristic of forest and shrubland ecosystems because height responds to climate, soil and disturbance history. Orbiting LiDAR instruments, Ice, Cloud and land Elevation Satellite-2 (ICESat-2) and Global Ecosystem Dynamics Investigation LiDAR (GEDI), can provide near-global datasets of plant height at plot-level resolution. We evaluate canopy height measurements from ICESat-2 and GEDI with high resolution airborne LiDAR in six study sites in different biomes from dryland shrub to tall forests, with mean canopy height across sites of 0.5–40 m. ICESat-2 and GEDI provide reliable estimates for the relative height with RMSE and mean absolute error (MAE) of 7.49 and 4.64 m (all measurements ICESat-2) and 6.52 and 4.08 m (all measurements GEDI) for 98th percentile relative heights. Both datasets slightly overestimate the height of short shrubs (1–2 m at 5 m reference height), underestimate that of tall trees (by 6–7 m at 40 m reference height) and are highly biased (>3 m) for reference height <5 m, perhaps because of the difficulty of distinguishing canopy from ground signals. Both ICESat-2 and GEDI height estimates were only weakly sensitive to canopy cover and terrain slope (R
2 < 0.06) and had lower error for night compared to day samples (ICESat-2 RMSE night: 5.57 m, day: 6.82 m; GEDI RMSE night: 5.94 m, day: 7.03 m). For GEDI, the day versus night differences varied with differences in mean sample heights for the day and night samples and had little effect on bias. Accuracy of ICESat-2 and GEDI canopy heights varies among biomes, and the highest MAE was observed in the tallest, densest forest (GEDI: 7.85 m; ICESat-2: 7.84 m (night) and 12.83 m (day)). Improvements in canopy height estimation would come from better discrimination of canopy photons from background noise for ICESat-2 and improvements in the algorithm for decomposing ground and canopy returns for GEDI. Both would benefit from methods to distinguish outlier samples.
The MBO2/FAP58 heterodimer stabilizes assembly of inner arm dynein b and reveals axoneme asymmetries involved in ciliary waveform
Authors: Fu Gang , Augspurger Katherine , Sakizadeh Jason , Reck Jaimee , Bower Raqual , Tritschler Douglas , Gui Long , Nicastro Daniela , Porter Mary E.
Published: April 2024

Cilia generate three-dimensional waveforms required for cell motility and transport of fluid, mucus, and particles over the cell surface. This movement is driven by multiple dynein motors attached to nine outer doublet microtubules that form the axoneme. The outer and inner arm dyneins are organized into 96-nm repeats tandemly arrayed along the length of the doublets. Motility is regulated in part by projections from the two central pair microtubules that contact radial spokes located near the base of the inner dynein arms in each repeat. Although much is known about the structures and protein complexes within the axoneme, many questions remain about the regulatory mechanisms that allow the cilia to modify their waveforms in response to internal or external stimuli. Here, we used Chlamydomonas mbo (move backwards only) mutants with altered waveforms to identify at least two conserved proteins, MBO2/CCDC146 and FAP58/CCDC147, that form part of a L-shaped structure that varies between doublet microtubules. Comparative proteomics identified additional missing proteins that are altered in other motility mutants, revealing overlapping protein defects. Cryo-electron tomography and epitope tagging revealed that the L-shaped, MBO2/FAP58 structure interconnects inner dynein arms with multiple regulatory complexes, consistent with its function in modifying the ciliary waveform.
A Multicenter, Randomized, Evaluator-Blinded Study to Examine the Safety and Effectiveness of Hyaluronic Acid Filler in the Correction of Infraorbital Hollows
Authors: Biesman Brian S , Green Jeremy B , George Rosalyn , Jacob Carolyn , Palm Melanie , Jones Derek H , Grunebaum Lisa , Beer Kenneth , Cho Young , Joseph John H , Almegård Birgitta , Weinberg Felipe , Bromée Torun
Published: April 2024

Background

Hyaluronic acid injections are increasingly administered for correction of infraorbital hollows (IOHs).

Objectives

The objective of this study was to examine the effectiveness (IOH correction) and safety of Restylane Eyelight hyaluronic acid (HAEYE) injections.

Methods

Patients with moderate/severe IOHs, assessed with the Galderma infraorbital hollows scale (GIHS), were randomized to HAEYE injections (by needle/cannula) (Day 1 + optional Month 1 touch-up) or no-treatment control. The primary endpoint was blinded evaluator–reported Month 3 response, defined as ≥1-point GIHS improvement from baseline (both sides, concurrently). Other endpoints examined investigator-reported aesthetic improvement on the Global Aesthetic Improvement Scale (GAIS), patient-reported satisfaction (FACE-Q satisfaction with outcome; satisfaction questionnaire), and adverse events.

Results

Overall, 333 patients were randomized. Month 3 GIHS responder rate was significantly higher for HA­EYE (87.4%) vs control (17.7%; P < .001), and comparable between HA­EYE-needle and HA­EYE-cannula groups (P = .967). HAEYE GAIS responder rate was 87.5-97.7% (Months 3-12). Mean FACE-Q Rasch-transformed scores were 64.3-73.5 (HAEYE) vs 14.1-16.2 (control) through Month 12. Patients reported looking younger (≥71%) and less tired (≥79%) with reduced undereye shadows (≥76%) and recovered within 3-5 hours posttreatment. Efficacy was maintained through Month 12 (63.5% GIHS responders) and through Month 18, after Month 12 retreatment (80.3% GIHS responders; 99.4% GAIS responders; FACE-Q scores 72.5-72.8). Forty patients (12.7%) reported typically mild adverse events (4.9% HAEYE-needle; 20.9% HAEYE-cannula).

Conclusions

HAEYE treatment was effective in correcting moderate/severe IOHs at the primary endpoint (Month 3). Efficacy was sustained through Month 12 after first treatment for 63.5% and through Month 18 for 80.3% (after 1 retreatment) with needle or cannula administration. Safety outcomes were reassuring.

Level of Evidence: 1
Regional analysis to delineate intrasample heterogeneity with RegionalST
Authors: Lyu Yue , Wu Chong , Sun Wei , Li Ziyi
Published: April 2024

Motivation

Spatial transcriptomics has greatly contributed to our understanding of spatial and intra-sample heterogeneity, which could be crucial for deciphering the molecular basis of human diseases. Intra-tumor heterogeneity, e.g. may be associated with cancer treatment responses. However, the lack of computational tools for exploiting cross-regional information and the limited spatial resolution of current technologies present major obstacles to elucidating tissue heterogeneity.

Results

To address these challenges, we introduce RegionalST, an efficient computational method that enables users to quantify cell type mixture and interactions, identify sub-regions of interest, and perform cross-region cell type-specific differential analysis for the first time. Our simulations and real data applications demonstrate that RegionalST is an efficient tool for visualizing and analyzing diverse spatial transcriptomics data, thereby enabling accurate and flexible exploration of tissue heterogeneity. Overall, RegionalST provides a one-stop destination for researchers seeking to delve deeper into the intricacies of spatial transcriptomics data.

Availability and implementation

The implementation of our method is available as an open-source R/Bioconductor package with a user-friendly manual available at https://bioconductor.org/packages/release/bioc/html/RegionalST.html.
High-dimensional multisubject time series transition matrix inference with application to brain connectivity analysis
Authors: Lyu Xiang , Kang Jian , Li Lexin
Published: April 2024

ASTRACT

Brain-effective connectivity analysis quantifies directed influence of one neural element or region over another, and it is of great scientific interest to understand how effective connectivity pattern is affected by variations of subject conditions. Vector autoregression (VAR) is a useful tool for this type of problems. However, there is a paucity of solutions when there is measurement error, when there are multiple subjects, and when the focus is the inference of the transition matrix. In this article, we study the problem of transition matrix inference under the high-dimensional VAR model with measurement error and multiple subjects. We propose a simultaneous testing procedure, with three key components: a modified expectation-maximization (EM) algorithm, a test statistic based on the tensor regression of a bias-corrected estimator of the lagged auto-covariance given the covariates, and a properly thresholded simultaneous test. We establish the uniform consistency for the estimators of our modified EM, and show that the subsequent test achieves both a consistent false discovery control, and its power approaches one asymptotically. We demonstrate the efficacy of our method through both simulations and a brain connectivity study of task-evoked functional magnetic resonance imaging.
Revisiting the Bond between Social Work and Ethnography
Authors: Sinai-Glazer H
Published: April 2024

Ethnographic research in social work is extremely valuable, yet not very commonly applied. In this theoretical article, I delineate the historical bond and ethical alliance between ethnography and social work, as well as highlight the empirical value that ethnography can offer the social work profession. By so doing I render visible the affinity between ethnographic research and the discipline of social work. I conclude by examining the relations between slow scholarship and ethnographic research as a means of resistance to the corporate neo-liberal university setting, encouraging social work scholars to do more ethnographic work. Such work can make a potentially significant contribution to social work practitioners, service users, policy makers, educators and scholars and encourage social science with meaning.
Two-point connected complex of zinc aminoporphyrin with histidine protected at α-amino and imidazolyl-π nitrogen atoms
Authors: Yuasa Mio , Nakamura Soichi , Tamiaki Hitoshi
Published: April 2024

Zinc porphyrins possessing an (N,N-dialkylamino)methyl group at the peripheral position were prepared from β-octaethylporphyrin. The synthetic zinc aminoporphyrins were complexed with an Nα,Nim(τ)-protected histidine through the coordination of the histidyl imidazolyl-τ nitrogen atom with the central zinc atom and the concomitant hydrogen bonding of the histidyl carboxy group with the peripheral amino group. The 1:1 complexation in the chloroform was dependent on the size of the alkyl groups on the peripheral aminomethyl nitrogen atom. The diethyl substitute complexed more strongly than the dimethyl and dipropyl counterparts. The complexation of zinc (diethylamino)methyl-porphyrin with an Nα,Nim(π)-protected histidine was 260-fold stronger than that with the above Nα,Nim(τ)-protected histidine to exhibit the association constant of 2.6 × 106 M−1. The significant enhancement was ascribable to the less sterically demanding and more coordinating Nim(τ)-atom compared with the Nim(π)-atom. The achiral zinc aminoporphyrin was complexed with the chiral Nα,Nim(π)-protected histidine to give a circular dichroism active species in a visible Soret region.
Functional brain networks in Developmental Topographical Disorientation
Authors: Faryadras Mahsa , Burles Ford , Iaria Giuseppe , Davidsen Jörn
Published: April 2024

Despite a decade-long study on Developmental Topographical Disorientation, the underlying mechanism behind this neurological condition remains unknown. This lifelong selective inability in orientation, which causes these individuals to get lost even in familiar surroundings, is present in the absence of any other neurological disorder or acquired brain damage. Herein, we report an analysis of the functional brain network of individuals with Developmental Topographical Disorientation ($n = 19$) compared against that of healthy controls ($n = 21$), all of whom underwent resting-state functional magnetic resonance imaging, to identify if and how their underlying functional brain network is altered. While the established resting-state networks (RSNs) are confirmed in both groups, there is, on average, a greater connectivity and connectivity strength, in addition to increased global and local efficiency in the overall functional network of the Developmental Topographical Disorientation group. In particular, there is an enhanced connectivity between some RSNs facilitated through indirect functional paths. We identify a handful of nodes that encode part of these differences. Overall, our findings provide strong evidence that the brain networks of individuals suffering from Developmental Topographical Disorientation are modified by compensatory mechanisms, which might open the door for new diagnostic tools.
The causal relationship between physical activity, sedentary behavior and brain cortical structure: a Mendelian randomization study
Authors: Sun Yulin , Ma Di , Jiang Zhenping , Han Qifeng , Liu Yining , Chen Guoyang
Published: April 2024

Physical activity and sedentary behavior, both distinct lifestyle behaviors associated with brain health, have an unclear potential relationship with brain cortical structure. This study aimed to determine the causal link between physical activity, sedentary behavior, and brain cortical structure (cortical surface area and thickness) through Mendelian randomization analysis. The inverse-variance weighted method was primarily utilized, accompanied by sensitivity analyses, to confirm the results’ robustness and accuracy. Analysis revealed nominally significant findings, indicating a potential positive influence of physical activity on cortical thickness in the bankssts (β = 0.002 mm, P = 0.043) and the fusiform (β = 0.002 mm, P = 0.018), and a potential negative association of sedentary behavior with cortical surface area in the caudal middle frontal (β = −34.181 mm2, P = 0.038) and the pars opercularis (β = −33.069 mm2, P = 0.002), alongside a nominally positive correlation with the cortical surface area of the inferior parietal (β = 58.332 mm2, P = 0.035). Additionally, a nominally significant negative correlation was observed between sedentary behavior and cortical thickness in the paracentral (β = −0.014 mm, P = 0.042). These findings offer insights into how lifestyle behaviors may influence brain cortical structures, advancing our understanding of their interaction with brain health.
Limited but specific engagement of the mature language network during linguistic statistical learning
Authors: Schneider Julie M , Scott Terri L , Legault Jennifer , Qi Zhenghan
Published: April 2024

Statistical learning (SL) is the ability to detect and learn regularities from input and is foundational to language acquisition. Despite the dominant role of SL as a theoretical construct for language development, there is a lack of direct evidence supporting the shared neural substrates underlying language processing and SL. It is also not clear whether the similarities, if any, are related to linguistic processing, or statistical regularities in general. The current study tests whether the brain regions involved in natural language processing are similarly recruited during auditory, linguistic SL. Twenty-two adults performed an auditory linguistic SL task, an auditory nonlinguistic SL task, and a passive story listening task as their neural activation was monitored. Within the language network, the left posterior temporal gyrus showed sensitivity to embedded speech regularities during auditory, linguistic SL, but not auditory, nonlinguistic SL. Using a multivoxel pattern similarity analysis, we uncovered similarities between the neural representation of auditory, linguistic SL, and language processing within the left posterior temporal gyrus. No other brain regions showed similarities between linguistic SL and language comprehension, suggesting that a shared neurocomputational process for auditory SL and natural language processing within the left posterior temporal gyrus is specific to linguistic stimuli.
Neural alignment during outgroup intervention predicts future change of affect towards outgroup
Authors: Kluge Annika , Somila Niko , Lankinen Kaisu , Levy Jonathan
Published: April 2024

While social psychology studies have shown that paradoxical thinking intervention has a moderating effect on negative attitudes toward members from rival social groups (i.e. outgroup), the neural underpinnings of the intervention have not been studied. Here, we investigate this by examining neural alignment across individuals at different phases during the intervention regarding Covid-19 vaccine-supporters’ attitudes against vaccine-opposers. We raise two questions: Whether neural alignment varies during the intervention, and whether it predicts a change in outgroup attitudes measured via a survey 2 days after the intervention and compared to baseline. We test the neural alignment using magnetoencephalography-recorded neural oscillations and multiset canonical correlation analysis. We find a build-up of neural alignment which emerges at the final phase of the paradoxical thinking intervention in the precuneus—a hub of mentalizing; there was no such effect in the control conditions. In parallel, we find a behavioral build-up of dissent to the interventional stimuli. These neural and behavioral patterns predict a prosocial future change in affect and actions toward the outgroup. Together, these findings reveal a new operational pattern of mentalizing on the outgroup, which can change the way individuals may feel and behave toward members of that outgroup.
Tuberculosis Disease in Immunocompromised Children and Adolescents: A Pediatric Tuberculosis Network European Trials Group Multicenter Case-control Study
Authors: Rodríguez-Molino Paula , Tebruegge Marc , Noguera-Julian Antoni , Neth Olaf , Fidler Katy , Brinkmann Folke , Sainz Talia , Ivaskeviciene Inga , Ritz Nicole , Brito Maria Joao , Milheiro Silva Tiago , Chechenieva Vira , Serdiuk Maryna , Lancella Laura , Russo Cristina , Soler-García Aleix , Navarro Maria Luisa , Krueger Renate , Feiterna-Sperling Cornelia , Starshinova Anna , Hiteva Antonina , Hoffmann Anna , Kalibatas Paulius , Lo Vecchio Andrea , Scarano Sara Maria , Bustillo Matilde , Blázquez Gamero Daniel , Espiau María , Buonsenso Danilo , Falcón Lola , Turnbull Louise , Colino Elena , Rueda Santiago , Buxbaum Charlotte , Carazo Begoña , Alvarez Cristina , Dapena Marta , Piqueras Anabel , Velizarova Svetlana , Ozere Iveta , Götzinger Florian , Pareja Marta , Garrote Llanos Maria Isabel , Soto Beatriz , Rodríguez Martín Sonia , Korta Jose Javier , Pérez-Gorricho Beatriz , Herranz Mercedes , Hernández-Bartolomé Ángel , Díaz-Almirón Mariana , Kohns Vasconcelos Malte , Ferreras-Antolín Laura , Santiago-García Begoña
Published: April 2024

Background

In high-resource settings, the survival of children with immunocompromise (IC) has increased and immunosuppressive therapies are increasingly being used. This study aimed to determine the clinical characteristics, performance of diagnostic tools, and outcome of IC children with tuberculosis (TB) in Europe.

Methods

Multicenter, matched case-control study within the Pediatric Tuberculosis Network European Trials Group, capturing TB cases <18 years diagnosed 2000–2020.

Results

A total of 417 TB cases were included, comprising 139 children who are IC (human immunodeficiency virus, inborn errors of immunity, drug-induced immunosuppression, and other immunocompromising conditions) and 278 non-IC children as controls. Nonrespiratory TB was more frequent among cases than controls (32.4% vs 21.2%; P = .013). Patients with IC had an increased likelihood of presenting with severe disease (57.6% vs 38.5%; P < .001; odds ratio [95% confidence interval], 2.073 [1.37–3.13]). Children with IC had higher rates of false-negative tuberculin skin test (31.9% vs 6.0%; P < .001) and QuantiFERON-TB Gold assay (30.0% vs 7.3%; P < .001) results at diagnosis. Overall, the microbiological confirmation rate was similar in IC and non-IC cases (58.3% vs 49.3%; P = .083). Although the mortality in children with IC was <1%, the rate of long-term sequelae was significantly higher than in non-IC cases (14.8% vs 6.1%; P = .004).

Conclusions

Children with IC and TB in Europe have increased rates of nonrespiratory TB, severe disease, and long-term sequelae. Immune-based TB tests have poor sensitivity in those children. Future research should focus on developing improved immunological TB tests that perform better in patients with IC, and determining the reasons for the increased risk of long-term sequelae, with the aim to design preventive management strategies.
Incidence of Influenza-related Medical Encounters and the Associated Healthcare Resource Use and Complications Across Adult Age Groups in the United States During the 2015–2020 Influenza Seasons
Authors: McGovern Ian , Cappell Katherine , Bogdanov Alina N , Haag Mendel D M
Published: April 2024

Background

Research on influenza burden in adults has focused on crude subgroups with cut-points at 65 years, limiting insight into how burden varies with increasing age. This study describes the incidence of influenza-related outpatient visits, emergency room visits, and hospitalizations, along with healthcare resource use and complications in the aging adult population.

Methods

Individuals aged ≥18 years in the United States were evaluated retrospectively in 5 seasonal cohorts (2015–2020 seasons) in strata of age with 5-year increments. Person-level electronic medical records linked to pharmacy and medical claims were used to ascertain patient characteristics and outcomes. Influenza-related medical encounters were identified based on diagnostic codes (International Classification of Diseases, 10th Edition, codes J09*–J11*).

Results

Incidence of influenza-related outpatient visits was highest among people aged 18–34 years and declined with increasing age. For emergency room visits, incidence tended to be elevated for people aged 18–34 years, relatively stable from 35 through 60, and increased rapidly after age 60 years. Hospitalization incidence remained relatively stable until about 50 years of age and then increased with age. One in 3 patients was diagnosed with pneumonia after hospitalization, regardless of age. Across seasons, age groups, and clinical settings, on average, 40.8% of individuals were prescribed antivirals and 17.2% antibiotics.

Conclusions

Incidence of influenza-related hospitalizations begins to increase around age 50 years rather than the more common cut-point of 65, whereas incidence of outpatient visits was highest among younger adults. Influenza infections frequently led to antiviral and antibiotic prescriptions, underscoring the role influenza vaccination can play in combating antimicrobial resistance.
Investigation of an Mpox Outbreak Affecting Many Vaccinated Persons in Chicago, Illinois—March 2023–June 2023
Authors: Faherty Emily A G , Holly Taylor , Ogale Yasmin P , Spencer Hillary , Becht Ashley M , Crisler Gordon , Wasz Michael , Stonehouse Patrick , Barbian Hannah J , Zelinski Christy , Kittner Alyse , Foulkes Dorothy , Anderson Kendall W , Evans Tiffany , Nicolae Lavinia , Staton Amber , Hardnett Carla , Townsend Michael B , Carson William C , Satheshkumar Panayampalli S , Hutson Christina L , Gigante Crystal M , Quilter Laura A S , Gorman Susan , Borah Brian , Black Stephanie R , Pacilli Massimo , Kern David , Kerins Janna , McCollum Andrea M , Rao Agam K , Tabidze Irina
Published: April 2024

Background

After months of few mpox cases, an increase in cases was reported in Chicago during May 2023, predominantly among fully vaccinated (FV) patients. We investigated the outbreak scope, differences between vaccinated and unvaccinated patients, and hypotheses for monkeypox virus (MPXV) infection after vaccination.

Methods

We interviewed patients and reviewed medical records to assess demographic, behavioral, and clinical characteristics; mpox vaccine status; and vaccine administration routes. We evaluated serum antibody levels after infection and compared patient viral genomes with MPXV sequences in available databases. We discussed potential vaccine compromise with partners who manufactured, handled, and administered the vaccine associated with breakthrough infections.

Results

During 18 March–27 June 2023, we identified 49 mpox cases; 57% of these mpox patients were FV. FV patients received both JYNNEOS doses subcutaneously (57%), intradermally (7%), or via heterologous administration (36%). FV patients had more median sex partners (3; interquartile range [IQR] = 1–4) versus not fully vaccinated patients (1; IQR = 1–2). Thirty-six of 37 sequenced specimens belonged to lineage B.1.20 of clade IIb MPXV, which did not demonstrate any amino acid changes relative to B.1, the predominant lineage from May 2022. Vaccinated patients demonstrated expected humoral antibody responses; none were hospitalized. No vaccine storage excursions were identified. Approximately 63% of people at risk for mpox in Chicago were FV during this period.

Conclusions

Our investigation indicated that cases were likely due to frequent behaviors associated with mpox transmission, even with relatively high vaccine effectiveness and vaccine coverage. Cases after vaccination might occur in similar populations.
Twice-Daily Dolutegravir–Based Antiretroviral Therapy With 1 Month of Daily Rifapentine and Isoniazid for Tuberculosis Prevention
Authors: Podany Anthony T , Cramer Yoninah , Imperial Marjorie , Rosenkranz Susan L , Avihingsanon Anchalee , Arduino Roberto , Samaneka Wadzanai , Gelmanova Irina , Savic Rada , Swindells Susan , Dawson Rodney , Luetkemeyer Anne F
Published: April 2024

Background

One month of daily rifapentine + isoniazid (1HP) is an effective, ultrashort option for tuberculosis prevention in people with human immunodeficiency virus (HIV). However, rifapentine may decrease antiretroviral drug concentrations and increase the risk of virologic failure. AIDS Clinical Trials Group A5372 evaluated the effect of 1HP on the pharmacokinetics of twice-daily dolutegravir.

Methods

A5372 was a multicenter, pharmacokinetic study in people with HIV (≥18 years) already on dolutegravir-containing antiretroviral therapy with HIV RNA <50 copies/mL. Participants received daily rifapentine/isoniazid (600 mg/300 mg) for 28 days as part of 1HP. Dolutegravir was increased to 50 mg twice daily during 1HP, and intensive pharmacokinetic sampling was performed on day 0 (before 1HP) and on the final day of 1HP treatment.

Results

Thirty-two participants (41% female; 66% Black/African; median [Q1, Q3] age, 42 [34, 49] years) were included in the pharmacokinetic analysis; 31 had HIV RNA <50 copies/mL at the end of 1HP dosing. One participant had an HIV RNA of 160 copies/mL at day 28, with HIV RNA <50 copies/mL upon repeat testing on day 42. The median (Q1, Q3) dolutegravir trough concentration was 1751 ng/mL (1195, 2542) on day 0 versus 1987 ng/mL (1331, 2278) on day 28 (day 28:day 0 geometric mean ratio, 1.05 [90% confidence interval, .93–1.2]; P = .43). No serious adverse events were reported.

Conclusions

Dolutegravir trough concentrations with 50 mg twice-daily dosing during 1HP treatment were greater than those with standard-dose dolutegravir once daily without 1HP. These pharmacokinetic, virologic, and safety data provide support for twice-daily dolutegravir use in combination with 1HP for tuberculosis prevention.

Clinical Trials Registration

NCT04272242.
Differentiation of radicular cysts and radicular granulomas via texture analysis of multi-slice computed tomography images
Authors: Yomtako Supasith , Watanabe Hiroshi , Kuribayashi Ami , Sakamoto Junichiro , Miura Masahiko
Published: April 2024

Objectives

This study aimed to establish a method for differentiating radicular cysts from granulomas via texture analysis (TA) of multi-slice computed tomography (CT) images.

Methods

A total of 222 lesions with multi-slice computed tomography images acquired at our hospital between 2013 and 2022 that were pathologically diagnosed were included in this study. Cases of contrast-enhanced images, severe metallic artefacts, and lesions that were not sufficiently large to be analysed were excluded. The images were chronologically divided into a training group and a validation group. The radiological characteristics were determined. Subsequently, a TA was performed. Pyradiomics software was used for the TA of three-dimensionally segmented volumes extracted from 2 mm slice thickness images with a soft-tissue algorithm. Features that differed significantly between the two lesions in the training group were extracted and used to create machine-learning models. The discriminative ability of these models was evaluated in the validation group using receiver operating characteristic curve analysis.

Results

A total of 131 lesions, comprising 28 radicular cysts and 103 granulomas, were analysed. Forty-three texture features that exhibited significant variations were extracted. A support vector machine and decision tree model, with areas under the curves of 0.829 and 0.803, respectively, were created. These models showed high discriminative abilities, even for the validation group, with areas under the curve of 0.727 and 0.701, respectively. Both models showed superior performance compared with that of the models based on radiographic findings.

Conclusion

Discriminatory models were established for the TA of radicular cysts and granulomas using CT images.
Faecal Microbiota Transplantation Engraftment After Budesonide or Placebo in Patients With Active Ulcerative Colitis Using Pre-selected Donors: A Randomized Pilot Study
Authors: van Lingen Emilie , Nooij Sam , Terveer Elisabeth M , Crossette Emily , Prince Amanda L , Bhattarai Shakti K , Watson Andrea , Galazzo Gianluca , Menon Rajita , Szabady Rose L , Bucci Vanni , Norman Jason M , van der Woude C Janneke , van der Marel Sander , Verspaget Hein W , van der Meulen-de Jong Andrea E , Keller Josbert J
Published: April 2024

Background

Faecal microbiota transplantation [FMT] shows some efficacy in treating patients with ulcerative colitis [UC], although variability has been observed among donors and treatment regimens. We investigated the effect of FMT using rationally selected donors after pretreatment with budesonide or placebo in active UC.

Methods

Patients ≥18 years old with mild to moderate active UC were randomly assigned to 3 weeks of budesonide [9 mg] or placebo followed by 4-weekly infusions of a donor faeces suspension. Two donors were selected based on microbiota composition, regulatory T cell induction and short-chain fatty acid production in mice. The primary endpoint was engraftment of donor microbiota after FMT. In addition, clinical efficacy was assessed.

Results

In total, 24 patients were enrolled. Pretreatment with budesonide did not increase donor microbiota engraftment [p = 0.56] nor clinical response, and engraftment was not associated with clinical response. At week 14, 10/24 [42%] patients achieved [partial] remission. Remarkably, patients treated with FMT suspensions from one donor were associated with clinical response [80% of responders, p < 0.05] but had lower overall engraftment of donor microbiota. Furthermore, differences in the taxonomic composition of the donors and the engraftment of certain taxa were associated with clinical response.

Conclusion

In this small study, pretreatment with budesonide did not significantly influence engraftment or clinical response after FMT. However, clinical response appeared to be donor-dependent. Response to FMT may be related to transfer of specific strains instead of overall engraftment, demonstrating the need to characterize mechanisms of actions of strains that maximize therapeutic benefit in UC.
Statistical primer: individual patient data meta-analysis and meta-analytic approaches in case of non-proportional hazards
Authors: An Kevin R , Di Franco Antonino , Rahouma Mohamed , Biondi-Zoccai Giuseppe , Redfors Björn , Gaudino Mario
Published: April 2024

Individual patient data (IPD) meta-analyses build upon traditional (aggregate data) meta-analyses by collecting IPD from the individual studies rather than using aggregated summary data. Although both traditional and IPD meta-analyses produce a summary effect estimate, IPD meta-analyses allow for the analysis of data to be performed as a single dataset. This allows for standardization of exposure, outcomes, and analytic methods across individual studies. IPD meta-analyses also allow the utilization of statistical methods typically used in cohort studies, such as multivariable regression, survival analysis, propensity score matching, uniform subgroup and sensitivity analyses, better management of missing data, and incorporation of unpublished data. However, they are more time-intensive, costly, and subject to participation bias. A separate issue relates to the meta-analytic challenges when the proportional hazards assumption is violated. In these instances, alternative methods of reporting time-to-event estimates, such as restricted mean survival time should be used. This statistical primer summarizes key concepts in both scenarios and provides pertinent examples.
Geophysical modelling of the Bjerkreim–Lobe, southern Norway
Authors: Lee Madeline Dana , Pastore Zeudia , McEnroe Suzanne A
Published: April 2024

The Bjerkreim–Sokndal (BKS) intrusion in southern Norway has been studied for decades due to the presence of magnetic remanence creating anomalies 12 000 nT below background as measured by airborne magnetic surveys. The strong magnetic remanence also makes the BKS intrusion a good Earth analogue for remote studies of planets that have prominent magnetic signatures, such as Martian geological environments. Although numerous geophysical surveys and samples have been collected in the area, there are limited 3-D geological interpretations of the subsurface. Here, we used existing geophysical data to conduct forward and inversion modelling of the Bjerkreim lobe to investigate the subsurface geometry of the BKS intrusion. An extensive petrophysical property compilation was used as input data for the models, in combination with airborne magnetics and digital elevation models. This petrophysical compilation was initially analysed using principal component analysis to understand which variables would have the greatest impact on the models. Forward and inversion modelling show that cross-cutting jotunite bodies, and small anorthosite blocks within the Bjerkreim lobe have a limited depth extent of 1 km. Massive and foliated anorthosites to the west of the Bjerkreim lobe extend to depths greater than 4 km indicating that the BKS intruded into these anorthosites. Complications in magnetic field fitting during the forward modelling of megacyclic units with strong magnetic remanence and the results from a new ground magnetic survey support the need to revisit mapped contacts of the cyclical units.
Climate crisis risks to elderly health: strategies for effective promotion and response
Authors: Madani Hosseini Mahsa , Zargoush Manaf , Ghazalbash Somayeh
Published: April 2024

The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country’s rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis.
‘You are making it sound like you are talking to a child’: exploring community sentiment on developing and disseminating tailored sexual health education resources for migrants
Authors: Gray Corie , Crawford Gemma , Roberts Meagan , Vujcich Daniel
Published: April 2024

Health communication is a critical component of public health, which includes health education resources. Resource effectiveness is improved where health literacy demands, including the cultural appropriateness of resources, match the intended audience. International guidelines support the tailoring of resources for migrants from culturally and linguistically diverse backgrounds (CaLD). Five focus groups (n = 18) and interviews (n = 9) with people from CaLD migrant backgrounds explored community perspectives on sexual health resources developed by a state department of health, specifically clarity, comprehensiveness, cultural appropriateness and strategies for dissemination. We identified three major thematic areas relating to simplicity, cultural norms and beliefs and dissemination. Participants recommended resource delivery in different formats as part of a broader intervention. Generally, sexual health information was deemed appropriate and easily understood. However, the resources used simplified language that participants reported was vague and inaccurate at times, potentially contributing to misinformation and reinforcing stigma relating both to the status of being a migrant and sexual health. Findings suggest the need for more nuanced health resource development beyond translation and language simplification. Resources developed in different formats, including different health literacy demands, using approaches that engage the target group in design and dissemination and contextualized within a comprehensive health promotion project, are likely to be more effective.
Minerals and trace elements
Authors: Elliott Ruan , Sharp Paul
Published: April 2024

This chapter discusses key minerals and trace elements essential to several important biochemical and physiological functions in the body. It primarily focuses on dietary sources of the various minerals and their homeostatic regulation in the body. Calcium and phosphorus are correlated due to their close interrelationship in maintaining bone health, while iron, zinc, iodine, and selenium hold essential roles in human metabolism. The chapter explains the major metabolic functions of the minerals and trace elements and the consequences of deficiency and excess of individual elements. It then looks into current methodologies used to assess the body status of minerals and trace elements and the basis of the current dietary recommendations for intakes of micronutrients.