bluuebunny/crossref_metadata_2025 huggingface dataset:
The Fate of Resectable Pancreatic Adenocarcinoma After Neoadjuvant Chemotherapy
Authors: Irfan Ahmer , Rose J. Bart , Wang Thomas N. , Vickers Selwyn M. , Dudeja Vikas , Gbolahan Olumide , Reddy Sushanth
Published: February 2022

Objectives

Pancreatic cancer continues to be a major cause of cancer-related mortality. There has been a greater implementation of up-front chemotherapy for pancreatic adenocarcinoma patients. Although there are many theoretical benefits to neoadjuvant chemotherapy, its clinical impact is uncertain. We sought to understand the outcomes of patients with resectable and borderline-resectable pancreatic adenocarcinoma who underwent neoadjuvant chemotherapy.

Methods

Patients were collected in a secure database from September 2018 to May 2020. Patients were excluded if they presented with locally advanced or metastatic disease, inability to complete chemotherapy, or if they were not a surgical candidate.

Results

Sixty-six patients with resectable disease underwent chemotherapy. Folinic acid/5-fluorouracil/irinotecan/oxaliplatin was used in 41 patients (62.1%) and gemcitabine-based regimens in 28 patients (42.4%, greater than 100% as some patients underwent both regimens). After restaging, 47 patients (71.2%) were thought to have resectable disease. Of these patients, 36 have been successfully resected to date. Metastatic disease was found in 12 patients (18.2%) and 6 patients (9.1%) had locally advanced disease.

Conclusions

Most patients with resectable pancreatic cancer are resected after neoadjuvant chemotherapy, but a subset will develop local or distant progression. Further studies will be needed to determine which patients will progress locally and may benefit from an up-front surgical approach.
Surgery-First Orthognathic Approach to Correct Facial Asymmetry: Artificial Intelligence–Based Cephalometric Analysis
Authors: Choi Jong Woo , Park Hojin , Kim, B.S. In-Hwan , Kim Namkug , Kwon Soon-Man , Lee Jang Yeol
Published: February 2022

Background:

The surgery-first orthognathic approach has been applied at our institution since 2007. However, its indications remain debated. The aim of this study was to investigate the reliability of the surgery-first approach to correct facial asymmetry compared to the traditional orthodontics-first approach using a novel artificial intelligence–based cephalometric analysis.

Methods:

Intervention outcomes of surgery-first (n = 33) and orthodontics-first (n = 26) approaches to correct facial asymmetry were examined. Patients with facial asymmetry who had undergone orthognathic surgery from January of 2006 to January of 2019 were included in the study. In the surgery-first approach, the novel preoperative simulation process on the dental model was performed to determine the final occlusion without presurgical orthodontic treatment. Changes in cephalometric landmarks were compared using the supervised deep learning process developed at our institution.

Results:

The surgery-first approach without presurgical orthodontic treatment corrected facial asymmetry and yielded results similar to those of the traditional orthognathic approach. The statistical analysis revealed that changes in skeletal cephalometric landmarks were similar in the two groups.

Conclusions:

The surgery-first orthognathic approach without presurgical orthodontic treatment treated facial asymmetry, possibly suggesting a possible paradigm shift in treatment. In addition, artificial intelligence–based cephalometric analysis was an effective tool.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
A Novel Technique for Muscle Flap Preservation in Posterolateral Muscle-Sparing Thoracotomy
Authors: O’Neill Rebecca C. , Mentz James A. , Reece Edward , Ripley Taylor , Coster Jenalee , Winocour Sebastian J.
Published: February 2022

The muscle-sparing thoracotomy offers several benefits over the traditional posterolateral thoracotomy approach for surgically accessing the chest cavity. Some of the potential advantages of preserving the latissimus dorsi and serratus anterior muscles include both functional benefits and potential use of these muscles for future flap reconstruction. Nevertheless, the muscle-sparing thoracotomy technique has traditionally been described with a wide exposure and, as a result, a theoretically higher risk of seroma and hematoma formation due to the increased dead space. The authors propose a new approach to muscle-sparing thoracotomy to avoid the disadvantages of each technique. By defining two subcutaneous anatomical triangles that can be safely lifted without disrupting the latissimus dorsi and serratus anterior muscles’ blood supply, this novel approach provides good exposure, preserves muscle flaps for future use, and minimizes dead space. As a result, this novel muscle-sparing thoracotomy technique has the potential to minimize postoperative complications and maximize patient outcomes.
Training Surgery Residents to be Leaders: Construction of a Resident Leadership Curriculum
Authors: Stein Matthew K. , Kelly John D. , Useem Michael , Donegan Derek J. , Levin L. Scott
Published: February 2022

Historically, the traditional pathways into plastic surgery required board eligibility in a surgical specialty such as general surgery, orthopedics, urology, neurosurgery, otolaryngology, or ophthalmology. This requirement resulted in plastic surgery residents who had served as chief residents before plastic surgery training. Their maturity emotionally and surgically allowed them to immediately concentrate on the new language and principles of plastic surgery. They had led others and were capable of leading themselves in a new surgical discipline. Today, medical students typically match into surgical specialties directly out of medical school and need to spend their time learning basic surgical skills and patient care because of the contracted time afforded to them. Formal leadership training has historically been limited in surgical training. The authors set out to delineate the creation, implementation, and perceptions of a leadership program within a surgical residency and provide guideposts for the development of engaged, conscious, and dedicated leaders within the residencies they lead.
Vein Grafts in Free Flap Reconstruction: Review of Indications and Institutional Pearls
Authors: Langdell Hannah C. , Shammas Ronnie L. , Atia Andrew , Chang Edward I. , Matros Evan , Phillips Brett T.
Published: February 2022

Vein grafts enable soft-tissue reconstruction in cases of insufficient pedicle length, a lack of nearby recipient vessels, and a wide zone of injury caused by trauma or radiation therapy. The purpose of this article is to provide a comprehensive review of vein grafts in free flap reconstruction focusing on the timing of arteriovenous loops, complications, and surgical technique. Vein graft indications, types of vein grafts, and location-specific considerations are also reviewed. Three reconstructive microsurgeons at high-volume centers were asked to offer institutional pearls on the order of anastomosis, selection of donor veins, and timing of arteriovenous loops. In terms of gap length, vessel gaps less than 10 cm may be reconstructed with an interposition or transposition vein graft. For longer gaps, surgeons should consider the use of arteriovenous loops, transposition arteriovenous loops, or flow-through flaps. Both one and two-stage arteriovenous loops are used, depending on patient comorbidities, potential exposure of critical structures, and surgeon preference. Although one-stage arteriovenous loops expedite the reconstructive process, two-stage arteriovenous loops require shorter operations and help identify patients at risk of flap failure. Although whether the use of vein grafts increases flap failure rates is controversial, complications are highest in lower extremity reconstruction, cases of a prolonged interval between stages in two-stage arteriovenous loops, and unplanned vein grafts.
Liporeduction: A Faster and Safer Breast Remodeling Technique
Authors: Auersvald André , Botti Chiara , Botti Giovanni , Pascali Michele
Published: February 2022

Background:

Breast reduction is a time-consuming procedure with a relatively high complication rate. Furthermore, recurrent breast enlargement can occur in case of postoperative weight gain. The authors describe a breast reduction technique based on liposuction, followed mostly by skin resection alone, which makes this operation easier, faster, and safer, with more stable results.

Methods:

Two hundred thirty-three patients were treated by breast liporeduction between 2006 and 2017, with an age range of 18 to 70 years (average age, 42 years). The patients were selected after careful clinical and instrumental assessment among those in whose breasts the fat component was prevalent over the gland. Most of the soft-tissue reduction consisted of fat aspiration. The follow-up ranged from 12 months to 9 years (average, 4.5 years).

Results:

The results of this study have been extremely satisfactory. Most of the patients healed uneventfully and were happy with the final outcome. Very few complications were encountered, among which were small steatonecroses and partial nipple-areola complex necroses.

Conclusions:

For the past 15 years, all four authors have preferred this breast reduction technique over others. Fat only is selectively removed by aspiration with a blunt cannula, sparing the vascular network and easily mobilizing the nipple-areola complex. Liporeduction provides a good stable result because any postoperative weight variation will not change the volume of a breast consisting mainly of glandular and fibrous tissue.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Multiple High-Risk HPV Types Contribute to Cervical Dysplasia in Ugandan Women Living With HIV on Antiretroviral Therapy
Authors: Nakisige Carol , Adams Scott V. , Namirembe Constance , Okoche Lazarus , Ferrenberg James , Towlerton Andrea , Larsen Anna , Orem Jackson , Casper Corey , Frenkel Lisa , Uldrick Thomas S.
Published: February 2022

Background:

Cervical cancer mortality remains high in sub-Saharan Africa, especially among women living with HIV (WLWH). Characterization of prevalent high-risk human papillomavirus (hrHPV) types and immune function in WLWH with cervical abnormalities despite antiretroviral therapy (ART) can inform prevention strategies.

Setting:

Kampala, Uganda.

Methods:

From 2017 to 2020, we enrolled Ugandan women with cervical dysplasia detected with visual inspection with acetic acid (VIA). WLWH were required to be on ART >3 months with plasma HIV RNA <1000 copies/mL. Biopsies from VIA-positive lesions underwent histopathologic grading and cervical swab specimens were tested for hrHPV. Clinical correlations were evaluated with Poisson regression to estimate adjusted prevalence ratios (aPR).

Results:

One hundred eighty-eight WLWH and 116 HIV-seronegative women participated. Among WLWH, median ART duration was 6 years and median CD4 667 cells/µL. Cervical intraepithelial neoplasia (CIN) grade 2/3 was found in 29% of WLWH versus 9% of HIV-seronegative women. In women with CIN1 or without histopathology-confirmed dysplasia, hrHPV (aPR [95% confidence interval]: 2.17 [1.43 to 3.29]) and multiple hrHPV (aPR 3.73 [1.07 to 13.1]) were more common in WLWH, as were vaccine-targeted and vaccine-untargeted hrHPVtypes. Differences in hrHPV prevalence by HIV serostatus were not observed in women with CIN2/3 (interaction P < 0.01). Among WLWH, low CD4/8 ratio was associated with hrHPV while detectable plasma HIV RNA (20–1000 copies/mL) was associated with CIN2/3 or invasive cancer.

Conclusion:

Despite ART, WLWH with cervical VIA abnormalities remain at elevated risk for multiple hrHPV and high-grade dysplasia. Cervical cancer prevention and research tailored for WLWH are warranted in the ART era.
SARS-CoV-2 Testing and Positivity Among Persons With and Without HIV in 6 US Cohorts
Authors: Park Lesley S. , McGinnis Kathleen A. , Gordon Kirsha S. , Justice Amy C. , Leyden Wendy , Silverberg Michael J. , Skarbinski Jacek , Jefferson Celeena , Horberg Michael , Certa Julia , Napravnik Sonia , Edwards Jessie K. , Westreich Daniel , Bastarache Lisa , Gangireddy Srushti , Benning Lorie , D'Souza Gypsyamber , Williams Carolyn , Althoff Keri N. ,   on behalf of the CIVET Collaboration of the NA-ACCORD of IeDEA
Published: February 2022

Background:

It is not definitively known if persons with HIV (PWH) are more likely to be SARS-CoV-2 tested or test positive than persons without HIV (PWoH). We describe SARS-CoV-2 testing and positivity in 6 large geographically and demographically diverse cohorts of PWH and PWoH in the United States.

Setting:

The Corona Infectious Virus Epidemiology Team comprises 5 clinical cohorts within a health system (Kaiser Permanente Northern California, Oakland, CA; Kaiser Permanente Mid-Atlantic States, Rockville, MD; University of North Carolina Health, Chapel Hill, NC; Vanderbilt University Medical Center, Nashville, TN; and Veterans Aging Cohort Study) and 1 interval cohort (Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study).

Methods:

We calculated the proportion of patients SARS-CoV-2 tested and the test positivity proportion by HIV status from March 1 to December 31, 2020.

Results:

The cohorts ranged in size from 1675 to 31,304 PWH and 1430 to 3,742,604 PWoH. The proportion of PWH who were tested for SARS-CoV-2 (19.6%–40.5% across sites) was significantly higher than PWoH (14.8%–29.4%) in the clinical cohorts. However, among those tested, the proportion of patients with positive SARS-CoV-2 tests was comparable by HIV status; the difference in proportion of SARS-CoV-2 positivity ranged from 4.7% lower to 1.4% higher.

Conclusions:

Although PWH had higher testing proportions compared with PWoH, we did not find evidence of increased positivity in 6 large, diverse populations across the United States. Ongoing monitoring of testing, positivity, and COVID-19–related outcomes in PWH are needed, given availability, response, and durability of COVID-19 vaccines; emergence of SARS-CoV-2 variants; and latest therapeutic options.
Modeling the Probability of COVID-19 Based on Symptom Screening and Prevalence of Influenza and Influenza-Like Illnesses
Authors: Alemi Farrokh , Vang Jee , Guralnik Elina , Roess Amira
Published: February 2022

Background:

The importance of various patient-reported signs and symptoms to the diagnosis of coronavirus disease 2019 (COVID-19) changes during, and outside, of the flu season. None of the current published studies, which focus on diagnosis of COVID-19, have taken this seasonality into account.

Objective:

To develop predictive algorithm, which estimates the probability of having COVID-19 based on symptoms, and which incorporates the seasonality and prevalence of influenza and influenza-like illness data.

Methods:

Differential diagnosis of COVID-19 and influenza relies on demographic characteristics (age, race, and gender), and respiratory (eg, fever, cough, and runny nose), gastrointestinal (eg, diarrhea, nausea, and loss of appetite), and neurological (eg, anosmia and headache) signs and symptoms. The analysis was based on the symptoms reported by COVID-19 patients, 774 patients in China and 273 patients in the United States. The analysis also included 2885 influenza and 884 influenza-like illnesses in US patients. Accuracy of the predictions was calculated using the average area under the receiver operating characteristic (AROC) curves.

Results:

The likelihood ratio for symptoms, such as cough, depended on the flu season—sometimes indicating COVID-19 and other times indicating the reverse. In 30-fold cross-validated data, the symptoms accurately predicted COVID-19 (AROC of 0.79), showing that symptoms can be used to screen patients in the community and prior to testing.

Conclusion:

Community-based health care providers should follow different signs and symptoms for diagnosing COVID-19 during, and outside of, influenza season.
Liquid-Liver Phantom
Authors: Morr Anna S. , Herthum Helge , Schrank Felix , Görner Steffen , Anders Matthias S. , Lerchbaumer Markus , Müller Hans-Peter , Fischer Thomas , Jenderka Klaus-Vitold , Hansen Hendrik H.G. , Janmey Paul A. , Braun Jürgen , Sack Ingolf , Tzschätzsch Heiko
Published: February 2022

Objectives

Tissue stiffness can guide medical diagnoses and is exploited as an imaging contrast in elastography. However, different elastography devices show different liver stiffness values in the same subject, hindering comparison of values and establishment of system-independent thresholds for disease detection. There is a need for standardized phantoms that specifically address the viscosity-related dispersion of stiffness over frequency. To improve standardization of clinical elastography across devices and platforms including ultrasound and magnetic resonance imaging (MRI), a comprehensively characterized phantom is introduced that mimics the dispersion of stiffness of the human liver and can be generated reproducibly.

Materials and Methods

The phantom was made of linear polymerized polyacrylamide (PAAm) calibrated to the viscoelastic properties of healthy human liver in vivo as reported in the literature. Stiffness dispersion was analyzed using the 2-parameter springpot model fitted to the dispersion of shear wave speed of PAAm, which was measured by shear rheometry, ultrasound-based time-harmonic elastography, clinical magnetic resonance elastography (MRE), and tabletop MRE in the frequency range of 5 to 3000 Hz. Imaging parameters for ultrasound and MRI, reproducibility, aging behavior, and temperature dependency were assessed. In addition, the frequency bandwidth of shear wave speed of clinical elastography methods (Aplio i900, Canon; Acuson Sequoia, Siemens; FibroScan, EchoSense) was characterized.

Results

Within the entire frequency range analyzed in this study, the PAAm phantom reproduced well the stiffness dispersion of human liver in vivo despite its fluid properties under static loading (springpot stiffness parameter, 2.14 [95% confidence interval, 2.08–2.19] kPa; springpot powerlaw exponent, 0.367 [95% confidence interval, 0.362–0.373]). Imaging parameters were close to those of liver in vivo with only slight variability in stiffness values of 0.5% (0.4%, 0.6%), 4.1% (3.9%, 4.5%), and −0.63% (−0.67%, −0.58%), respectively, between batches, over a 6-month period, and per °C increase in temperature.

Conclusions

The liquid-liver phantom has useful properties for standardization and development of liver elastography. First, it can be used across clinical and experimental elastography devices in ultrasound and MRI. Second, being a liquid, it can easily be adapted in size and shape to specific technical requirements, and by adding inclusions and scatterers. Finally, because the phantom is based on noncrosslinked linear PAAm constituents, it is easy to produce, indicating potential widespread use among researchers and vendors to standardize liver stiffness measurements.
Cardiopulmonary Resuscitation During Simulated Pediatric Interhospital Transport: Lessons Learned From Implementation of an Institutional Curriculum
Authors: Noje Corina , Duval-Arnould Jordan , Costabile Philomena M. , Henderson Eric , Perretta Julianne , Sorcher Jill L. , Shilkofski Nicole , Hunt Elizabeth A.
Published: February 2022

Introduction

Little is known about cardiopulmonary resuscitation (CPR) quality during pediatric interhospital transport; hence, our aim was to investigate its feasibility.

Methods

After implementing an institutional education curriculum on pediatric resuscitation during ambulance transport, we conducted a 4-year prospective observational study involving simulation events. Simulated scenarios were (1) interhospital transport of a child retrieved in cardiac arrest (Sim1) and (2) unanticipated cardiac arrest of a child during transport (Sim2). Cardiopulmonary resuscitation data were collected via Zoll RSeries defibrillators. Performance was evaluated using age-appropriate American Heart Association (AHA) Guidelines. Video recordings were reviewed for qualitative thematic analysis.

Results

Twenty-six simulations were included: 16 Sim1 [mannequins: Laerdal SimMan 3G (n = 13); Gaumard 5-year-old HAL (n = 3)] and 10 Sim2 [Gaumard 1-year-old HAL (n = 8); Laerdal SimBaby (n = 2)]. Median (IQR) CPR duration was 18 minutes 23 seconds (14–22 minutes), chest compression rate was 112 per minute (106–118), and fraction (CCF) was 1 (0.9–1). Five hundred eight 60-second resuscitation epochs were evaluated (Sim1: 356; Sim2: 152); 73% were AHA compliant for rate and 87.8% for CCF. Twenty-four minutes (4.7%) had pauses more than 10 seconds. One hundred fifty seven Sim1 epochs (44.1%) met criteria for excellent CPR (AHA-compliant for rate, depth, and CCF). Rates of excellent CPR were higher for learner groups with increased simulation and transport experience (59.1% vs. 35.3%, P < 0.001). Thematic analysis identified performance-enhancing strategies, stemming from anticipating challenges, planning solutions, and ensuring team's shared mental model.

Conclusions

High-quality CPR may be achievable during pediatric interhospital transport. Certain transport-specific strategies may enhance resuscitation quality. Learners' performance improved with simulation and transport experience, highlighting ongoing education's role.
Relating free will beliefs and attitudes
Authors: Wisniewski David , Cracco Emiel , González-García Carlos , Brass Marcel
Published: February 2022

Most people believe in free will, which is foundational for our sense of agency and responsibility. Past research demonstrated that such beliefs are dynamic, and can be manipulated experimentally. Much less is known about free will attitudes (FWAs; do you value free will?), whether they are equally dynamic, and about their relation to free will beliefs (FWBs). If FWAs were strongly positive, people might be reluctant to revise their beliefs even in the face of strong evidence to do so. In this registered report, we developed a novel measure of FWAs and directly related FWBs and attitudes for the first time. We found FWBs and attitudes to be positively related, although to a lesser degree than determinism or dualism beliefs/attitudes. Nevertheless, an experimental manipulation technique aimed at reducing FWBs (Crick text) showed remarkably specific effects on FWBs only, and no effects on FWAs. Overall, these results provide valuable new insights into laypeople's views on free will by including a novel measure of FWAs. They also provide evidence for the validity of a common experimental technique that has been rightfully criticized in the literature lately.
Proxyeconomics, a theory and model of proxy-based competition and cultural evolution
Authors: Braganza Oliver
Published: February 2022

Competitive societal systems by necessity rely on imperfect proxy measures. For instance, profit is used to measure value to consumers, patient volumes to measure hospital performance, or the journal impact factor to measure scientific value. While there are numerous reasons why proxies will deviate from the underlying societal goals, they will nevertheless determine the selection of cultural practices and guide individual decisions. These considerations suggest that the study of proxy-based competition requires the integration of cultural evolution theory and economics or decision theory. Here, we attempt such an integration in two ways. First, we describe an agent-based simulation model, combining methods and insights from these disciplines. The model suggests that an individual intrinsic incentive can constrain a cultural evolutionary pressure, which would otherwise enforce fully proxy-oriented practices. The emergent outcome is distinct from that with either the isolated economic or evolutionary mechanism. It reflects what we termlock-in, where competitive pressure can undermine the ability of agents to pursue the shared social goal. Second, we elaborate the broader context, outlining the system-theoretic foundations as well as some philosophical and practical implications, towards a broader theory. Overall, we suggest such a theory may offer an explanatory and predictive framework for diverse subjects, ranging from scientific replicability to climate inaction, and outlining strategies for diagnosis and mitigation.
Emergence of splits and collective turns in pigeon flocks under predation
Authors: Papadopoulou Marina , Hildenbrandt Hanno , Sankey Daniel W. E. , Portugal Steven J. , Hemelrijk Charlotte K.
Published: February 2022

Complex patterns of collective behaviour may emerge through self-organization, from local interactions among individuals in a group. To understand what behavioural rules underlie these patterns, computational models are often necessary. These rules have not yet been systematically studied for bird flocks under predation. Here, we study airborne flocks of homing pigeons attacked by a robotic falcon, combining empirical data with a species-specific computational model of collective escape. By analysing GPS trajectories of flocking individuals, we identify two new patterns of collective escape: early splits and collective turns, occurring even at large distances from the predator. To examine their formation, we extend an agent-based model of pigeons with a ‘discrete’ escape manoeuvre by a single initiator, namely a sudden turn interrupting the continuous coordinated motion of the group. Both splits and collective turns emerge from this rule. Their relative frequency depends on the angular velocity and position of the initiator in the flock: sharp turns by individuals at the periphery lead to more splits than collective turns. We confirm this association in the empirical data. Our study highlights the importance of discrete and uncoordinated manoeuvres in the collective escape of bird flocks and advocates the systematic study of their patterns across species.
Population viability assessment of an endangered raptor using detection/non-detection data reveals susceptibility to anthropogenic impacts
Authors: Cervantes Francisco , Martins Marlei , Simmons Robert E.
Published: February 2022

As the demand for carbon-neutral energy sources increases, so does the need to understand the impacts that these technologies have on the environment. Here, we assess the potential consequences of additional mortality on an Endangered raptor recently exposed to wind farms for the first time, the Black HarrierCircus maurus, one of the world’s rarest harriers. We conduct a population viability assessment using a Bayesian model integrating life-history information and annual reporting rates from detection/non-detection surveys from the South African Bird Atlas Project. Our model estimates a global population of approximately 1300 birds currently declining at 2.3% per year, and one that could collapse in under 100 years, if an average of three to five adult birds are killed annually. This level of mortality may soon exist, given the current rate of fatalities and the number of wind farms planned within the species’ distribution. In addition, we find that the population is sensitive to changes in climate. Our results highlight the critical need for appropriate placement, and adaptive management of wind farms and other infrastructure causing harrier mortality. We also show how detection/non-detection data may be used to infer population dynamics and viability, when population counts are unavailable.
Scattering of surface waves by a vertical truncated structured cylinder
Authors: Porter R. , Zheng S. , Liang H.
Published: February 2022

This paper describes the solution to the problem of scattering of plane incident waves on water of constant depth by a bottom mounted circular cylinder, extending partially through the depth, which has an internal structure comprised of closely spaced thin vertical barriers between which fluid is allowed to flow. The problem is solved under full depth-dependent linearized water wave theory using an effective medium equation to describe the fluid motion in cylinder and effective boundary conditions to match that flow to the fluid region outside the cylinder. The interest in this problem lies in the development of novel solution methods for fully three-dimensional water wave interaction with bathymetric plate arrays. Results computed using this theory are compared with a shallow water approximation based on the recent work of Marangos & Porter (2021 Shallow water theory for structured bathymetry.
Proc. R. Soc. A
477
, 20210421.) and with accurate computations of an exact representation of the geometry using a discrete set of plates. Other results highlight the resonant directional lensing effects of this type of cylindrical plate array device.
Self-organization and information transfer in Antarctic krill swarms
Authors: Burns Alicia L. , Schaerf Timothy M. , Lizier Joseph , Kawaguchi So , Cox Martin , King Rob , Krause Jens , Ward Ashley J. W.
Published: February 2022

Antarctic krill swarms are one of the largest known animal aggregations, and yet, despite being the keystone species of the Southern Ocean, little is known about how swarms are formed and maintained. Understanding the local interactions between individuals that provide the basis for these swarms is fundamental to knowing how swarms arise in nature, and what potential factors might lead to their breakdown. Here, we analysed the trajectories of captive, wild-caught krill in 3D to determine individual-level interaction rules and quantify patterns of information flow. Our results demonstrate that krill align with near neighbours and that they regulate both their direction and speed relative to the positions of groupmates. These results suggest that social factors are vital to the formation and maintenance of swarms. Furthermore, krill operate a novel form of collective organization, with measures of information flow and individual movement adjustments expressed most strongly in the vertical dimension, a finding not seen in other swarming species. This research represents a vital step in understanding the fundamentally important swarming behaviour of krill.
Interaction capacity as a potential driver of community diversity
Authors: Ushio Masayuki
Published: February 2022

How patterns in community diversity emerge is a long-standing question in ecology. Studies suggested that community diversity and interspecific interactions are interdependent. However, evidence from high-diversity ecological communities is lacking because of practical challenges in characterizing speciose communities and their interactions. Here, I analysed time-varying interaction networks that were reconstructed using 1197 species, DNA-based ecological time series taken from experimental rice plots and empirical dynamic modelling, and introduced ‘interaction capacity', namely, the sum of interaction strength that a single species gives and receives, as a potential driver of community diversity. As community diversity increases, the number of interactions increases exponentially but the mean interaction capacity of a community becomes saturated, weakening interspecific interactions. These patterns are modelled with simple mathematical equations, based on which I propose the ‘interaction capacity hypothesis': that interaction capacity and network connectance can be two fundamental properties that influence community diversity. Furthermore, I show that total DNA abundance and temperature influence interaction capacity and connectance nonlinearly, explaining a large proportion of diversity patterns observed in various systems. The interaction capacity hypothesis enables mechanistic explanations of community diversity. Therefore, analysing ecological community data from the viewpoint of interaction capacity would provide new insight into community diversity.
Accurate Non-invasive Mass and Temperature Quantifications with Spectral CT
Authors: Liu Leening P. , Hwang Matthew , Hung Matthew , Soulen Michael C. , Schaer Thomas P. , Shapira Nadav , Noël Peter B.
Published: February 2022

Spectral CT has been increasingly implemented clinically for its better characterization and quantification of materials through its multi-energy results. It also facilitates calculation of physical density utilizing the Alvarez-Macovski model without approximations. These spectral physical density quantifications allow for non-invasive mass measurements and temperature evaluations by manipulating the definition of physical density and thermal volumetric expansion, respectively. To develop the model, original and parametrized versions of the Alvarez-Macovski model and electron density-physical density model were validated with a phantom. The best physical density model was then implemented on clinical spectral CT scans of ex vivo bovine muscle to determine the accuracy and effect of acquisition parameters on mass measurements. In addition, the relationship between physical density and changes in temperature was evaluated by scanning and subjecting the tissue to a range of temperatures. A linear fit utilizing the thermal volumetric expansion was performed to assess the correlation. The parametrized Alvarez-Macovski model performed best in both model development and validation with errors within ±0.02 g/mL. As observed with muscle, physical density was not significantly affected by dose and acquisition mode but was slightly affected by collimation. These effects were also reflected in mass measurements, which demonstrated accuracy with a maximum percent error of 0.34%, further validating the physical density model. Furthermore, physical density was strongly correlated (R of 0.9781) to temperature changes through thermal volumetric expansion. Accurate and precise spectral physical density quantifications enable non-invasive mass measurements for pathological detection and temperature evaluation for thermal therapy monitoring in interventional oncology.
SENSOR TECHNOLOGY FOR OPENING NEW PATHWAYS IN DIAGNOSIS AND THERAPEUTICS OF BREAST, LUNG, COLORECTAL AND PROSTATE CANCER
Authors: Roshani Saeed , Coccia Mario , Mosleh Melika
Published: February 2022

This study analyzes the interaction between sensor research and technology and different types of cancer (breast, lung, colorectal and prostate) that generates a high mortality in society with the goals of detecting new directions for improving diagnosis and therapeutics. This study develops an approach of computational scientometrics based on data of the Web of Science from 1991 to 2021 period. The results of this analysis show the vital role of biosensor and electrochemical biosensor applied in breast cancer, lung cancer, and prostate cancer research, except colorectal cancer for latter one. Instead, research of optical sensors is developing mainly in the directions of breast, prostate, and colorectal cancer for improving diagnostics. Finally, oxygen sensor research is developing for breast and lung cancer for applications in breath analysis in new treatment processes. Preliminary results presented here clearly illustrate the evolutionary paths of main sensor technologies that have a great potential in future diagnosis of cancer, but we also need additional examinations of other aspects and factors for supporting appropriate strategies of management of technology to foster the technology transfer of sensor technologies in cancer research for improving diagnosis and, whenever possible, reduce world-wide mortality of cancer ins society.
Distribution of the National Science Foundation’s Advancing Informal STEM Learning Awards (AISL) between 2006-21
Authors: Houzenga Heidi M. , Muindi Fanuel J.
Published: February 2022

The COVID-19 pandemic tested many fundamental connections between science and society. A growing field working to strengthen those connections exists within the informal STEM learning (ISL) community which provides diverse learning and engagement environments outside the formal classroom. One of the largest funders of ISL initiatives is the National Science Foundation (NSF) which runs the Advanced Informal STEM Learning (AISL) program in the United States. The AISL program supports initiatives through six categories that include pilots and feasibility studies, research in service to practice, innovations in development, broad implementation, literature reviews, syntheses, or meta-analyses, and conferences. However, a number of questions remain unanswered with respect to the distribution and ultimately the broad impact of the awards. In this study, we analyzed publicly available awardee information across a 15-year period (2006-2021) to provide a preliminary analysis of how the AISL grants are distributed across individual states, organizations, and the principal investigators. Several states, organizations, and principal investigators stood out as prolific awardees. Massachusetts and California represented the largest share of awards at 14% and 13% respectively during that time. WGBH Educational Foundation located in Massachusetts and the Exploratorium located in California, received the largest number of awards during the 15 year period. Notably, 67% of the AISL awards list at least one co-principal investigator. Our report brings to light a number of new questions and charts new paths of exploration for future studies.
An Ethogram Identifies Behavioural Markers of Attention to Humans in European Herring Gulls (Larus argentatus)
Authors: Feist Franziska , Graham Paul
Published: February 2022

Herring gulls are one of few species thriving in anthropogenic landscapes. Their history of urbanisation and familiarity with people makes them a good target for studies of human-wildlife interactions. Previous research highlights a connection between food-stealing behaviour, success in anthropogenic areas, and increased attention towards humans, raising questions about the exact extent of a gull’s knowledge of human food cues. To explore these, behavioural responses to human cues in a food-related context were investigated and presented in a systematic ethogram, which identified three distinct markers of attention. Head turns, approaches, and angular body position all differed significantly between control and food conditions, showing that attention towards humans in a food-related context was upregulated and reflected in behaviour. In food condition trials, head turns occurred more often and gulls faced towards the experimenter with occasional approaches that were never seen in control conditions. Additionally, juvenile gulls exhibited less head turns, indicating lower vigilance, while neither approaches nor pecks differed between age groups. Interestingly, no group effects on attentional markers were found. Acoustic and behavioural human food-like cues alone seemed insufficient to elicit these responses, indicating that gulls specifically paid attention to the details of human behaviour. These results show situation-dependent attentional modulation in gulls and provide a description of attentive behaviours that can be used in further study.

Urbanised herring gulls successfully benefited from anthropogenic food sources. We showed that human food-centred behaviours directly modulated the attentional states of gulls.
Favourable vaccine-induced SARS-CoV-2 specific T cell response profile in patients undergoing immune-modifying therapies
Authors: Qui Martin , Bert Nina Le , Chan Webber Pak Wo , Tan Malcolm , Hang Shou Kit , Hariharaputran Smrithi , Sim Jean Xiang Ying , Low Jenny Guek Hong , Ng Wei Ling , Wan Wei Yee , Ang Tiing Leong , Bertoletti Antonio , Salazar Ennaliza
Published: February 2022

Patients undergoing immune-modifying therapies demonstrate a reduced humoral response after COVID-19 vaccination, but we lack a proper evaluation of the impact of such therapies on vaccine-induced T cell responses. Here, we longitudinally characterised humoral and Spike-specific T cell responses in inflammatory bowel disease (IBD) patients who are on antimetabolite therapy (azathioprine or methotrexate), TNF inhibitors and/or other biologic treatment (anti-integrin or anti-p40) after mRNA vaccination up to 3 months after completing two vaccine doses. We demonstrated that a Spike-specific T cell response is not only induced in treated IBD patients at levels similar to healthy individuals, but also sustained at higher magnitude, particularly in those treated with TNF inhibitor therapy. Furthermore, the Spike-specific T cell response in these patients is mainly preserved against mutations present in SARS-CoV-2 B.1.1.529 (Omicron) and characterized by a Th1/IL-10 cytokine profile. Thus, despite the humoral response defects, the favourable profile of vaccine-induced T cell responses might still provide a layer of COVID-19 protection to patients under immune-modifying therapies.
Interoperability Assessment of Emergency Department Processes Based on Multicriteria Decision-Making Methods
Authors: Laus Fernanda Wanka , Pegoraro Fábio , Loures Eduardo de Freitas Rocha , Santos Eduardo Alves Portela
Published: February 2022

It is noticeable that, because of the amount and quality of information exchanged and the criticality of the decisions guided by them, hospitals are considered as some of the most complex organizations in modern society. Evidencing it, emergency departments in hospitals are examples of such complex environments that need perfect integration among systems, people, departments, and data. The processes behind the Emergency Department (ED) routine cause a set of critical and time-dependent decision-making, which must consider several criteria related to organizational and clinical attributes. Based on the literature and worldwide initiatives related to managing complex organizations, an ED can be interpreted through the enterprise interoperability (EI) lens, a concept related to the capability of different systems to work collaboratively within and throughout the organization. Thus, this paper proposes a framework focusing on interoperability assessment in ED processes, where different actors need to interoperate. The proposed framework for Enterprise Interoperability Assessment (EIA) is based on multicriteria decision analysis (MCDA) methods, considering organizational and clinical attributes of the ED. The Analytic Hierarchy Process (AHP) and Preference Ranking Organization Method for Enrichment Evaluation II (PROMETHEE II), in an integrated approach, were elected as the most appropriate multicriteria methods to support, respectively, diagnostic (interoperability assessment) and decisional (interoperability improvements) processes in this background. Last, to validate the framework proposed, a case study was carried out at a stroke unit in a University Hospital (UH) in the south of Brazil. The outcome inferred that the UH achieved the intermediate level of enterprise interoperability in stroke treatment, and Business and Information Technology concerns were found to be the priorities, which deserved greater efforts, to enhance interoperability.
Effectiveness of Covid-19 vaccines against symptomatic and asymptomatic SARS-CoV-2 infections in an urgent care setting
Authors: Rane Madhura S. , Robertson McKaylee , Kulkarni Sarah , Frogel Daniel , Gainus Chris , Nash Denis
Published: February 2022

Background

It is critical to monitor changes in vaccine effectiveness against COVID-19 outcomes for various vaccine products in different population subgroups.

Methods

We conducted a retrospective study in patients ≥12 years who underwent testing for the SARS-CoV-2 virus from April 1 - October 25, 2021 at urgent care centers in the New York City metropolitan area. Patients self-reported vaccination status at the time of testing. We used a test-negative design to estimate vaccine effectiveness (VE) by comparing odds of a positive test for SARS-CoV-2 infection among vaccinated (n=484,468), partially vaccinated (n=107,573), and unvaccinated (n=466,452) patients, adjusted for demographic factors and calendar time.

Results

VE against symptomatic infection after 2 doses of mRNA vaccines was 96% (95% Confidence Interval [CI]: 95%, 97%) in the pre-delta period and reduced to 79% (95% CI: 77%, 81%) in the delta period. In the delta period, VE for 12–15-year-olds (85%; [95% CI: 81%, 89%]) was higher compared to older age groups (<65% for all other age groups). VE estimates did not differ by sex, race/ethnicity, and comorbidity. VE against symptomatic infection was the highest for individuals with a prior infection followed by full vaccination. VE against symptomatic infection after the mRNA-1273 vaccine (83% [95% CI: 81%, 84%]) was higher compared to the BNT162b2 vaccine (76% [95% CI: 74%, 78%]) in the delta period. VE after the single-dose Ad26.COV2.S vaccine was the lowest compared to other vaccines (29% [95% CI: 26%, 32%]) in the delta period.

Conclusions

VE against infection after two doses of the mRNA vaccine was high initially, but significantly reduced against the delta variant for all three FDA-approved vaccines.
LARisk: An R package for lifetime attributable risk from radiation exposure
Authors: Lee Juhee , Kim Young Min , Park Yeongwoo , Jang Eunjin , Yoo Jinkyung , Seo Songwon , Cha Eun Shil , Lee Won Jin
Published: February 2022

The lifetime radiation associated risk of cancer incidence has been of interest at least seventy years after atomic bombings of Hiroshima and Nagasaki in 1945. Since most of radiation epidemiological studies are retrospective, it is important to assess the potential magnitude of radiation-related cancer risk. The R-package so-call LARisk implements to easily calculate lifetime attributable risks (LAR) of radiation associated cancer incidence presenting bootstrap-based confidence intervals of the estimated risks. The main characteristics of the LARisk package are to flexibly compute the LAR-associated risks, effectively summarize large data, and promptly update domain-knowledge such as new regression coefficients for excess relative risk or excess absolute risk models, population information, etc. The manuscript provides a complete guide for usage of the LARisk package, which will enable to contribute the prospective studies in radiation epidemiology.
Knowledge, Attitude, and Practices of Health Professionals Working in A Major Health Care System Regarding Social Determinants of Health (SDOH) and Community Health Workers (CHW’s)
Authors: Khan Muhammad Nausherwan , Azhar Erum , Zain Areeba , Bowman Meredith Root , Ahmed Natasha Tahir , Khan Muhammad Arslan , Caswell Leigh , Waheed Abdul
Published: February 2022

Introduction

Social Determinants of Health (SDOH) play a key role in impacting the health outcomes of any population. Community Health Workers (CHW’s) play an important role in health promotion, disease prevention, and management of chronic illnesses. This study aims at exploring the knowledge, attitude, and practices of health care professionals towards CHWs to fully integrate in them for mitigation of SDOH.

Materials and Methods

A cross-sectional study utilizing an anonymous survey questionnaire across 4 clinical sites was carried out from June 2016 to November 2017 in a major healthcare system (Presbyterian) in Albuquerque, New Mexico. Descriptive statistics (means, standard deviations, and proportions) were collected. Categorical variables were analyzed using Chi-squared and Fisher’s exact test; a p-value of <0.05 was considered statistically significant, using SAS 9.4 statistical software.

Results

Almost half of the health professionals had no knowledge about the social determinants of health. Almost a quarter of the health professionals did not know the role of CHWs in healthcare, however, 100% of the respondents across all clinic and practice locations and regardless of their role or scope of the practice believed that greater involvement of CHWs would improve patient outcomes.

Conclusion

There is a knowledge deficit among health care providers about the social determinants of health (SDOH).More educational and teaching opportunities on SDOH and CHWs to all health professionals should be provided to all health professionals so the clinical team can help manage SDOH in addition to providing clinical care.