bluuebunny/crossref_metadata_2025 huggingface dataset:
Yield prediction through integration of genetic, environment, and management data through deep learning
Authors: Kick Daniel R , Wallace Jason G , Schnable James C , Kolkman Judith M , Alaca Barış , Beissinger Timothy M , Edwards Jode , Ertl David , Flint-Garcia Sherry , Gage Joseph L , Hirsch Candice N , Knoll Joseph E , de Leon Natalia , Lima Dayane C , Moreta Danilo E , Singh Maninder P , Thompson Addie , Weldekidan Teclemariam , Washburn Jacob D
Published: January 2023

Accurate prediction of the phenotypic outcomes produced by different combinations of genotypes, environments, and management interventions remains a key goal in biology with direct applications to agriculture, research, and conservation. The past decades have seen an expansion of new methods applied toward this goal. Here we predict maize yield using deep neural networks, compare the efficacy of 2 model development methods, and contextualize model performance using conventional linear and machine learning models. We examine the usefulness of incorporating interactions between disparate data types. We find deep learning and best linear unbiased predictor (BLUP) models with interactions had the best overall performance. BLUP models achieved the lowest average error, but deep learning models performed more consistently with similar average error. Optimizing deep neural network submodules for each data type improved model performance relative to optimizing the whole model for all data types at once. Examining the effect of interactions in the best-performing model revealed that including interactions altered the model's sensitivity to weather and management features, including a reduction of the importance scores for timepoints expected to have a limited physiological basis for influencing yield—those at the extreme end of the season, nearly 200 days post planting. Based on these results, deep learning provides a promising avenue for the phenotypic prediction of complex traits in complex environments and a potential mechanism to better understand the influence of environmental and genetic factors.
Transition in availability of improved sanitation facilities and its effect on diarrhoeal disease in India: evidence from longitudinal data
Authors: Brahmanandam N , Bharambe Milind Sadashiv
Published: January 2023

Background

Poor sanitation, such as open defecation, is a major public health concern in India, causing diarrhoea and other infectious diseases. So far, few studies have linked poor sanitation with diarrhoea using longitudinal data. In this context, this study assesses the transition in availability of household sanitation facilities and its effect on diarrhoeal morbidity.

Methods

We used two waves of longitudinal data from the India Human Development Survey, conducted in 2004–2005 and 2011–2012, and based on 34 131 followed-up households using a two-stage stratified random sampling method. In the first stage, multinomial logistic regression was used to assess socio-economic factors contributing to the transition in the availability of household sanitation facilities. In the second stage, multivariate linear regression was performed to examine the effect of the change in the availability of household sanitation facilities on the prevalence of diarrhoeal morbidity. All the analysis in this study was carried out by using Stata version 13 software.

Results

The findings reveal that the practice of open defecation was continued to be higher among lower socio-economic households than better-off socio-economic households in both 2004–2005 and 2011–2012. The proportion of household members who fell sick due to diarrhoea morbidity has decreased significantly (β=−0.06, p<0.04) among households that switched from open defecation in 2004–2005 to improved sanitation facilities in 2011–12, compared to households that continued to practice open defecation in both periods (2004–2005 and 2011–2012). The share of household members who fell sick due to diarrhoeal morbidity was significantly lower (β=−0.09, p<0.001) among the households who adopted improved toilet facilities in both periods (2004–2005 and 2011–2012) as compared with the households who continued to defecate openly in both periods, net of other covariates.

Conclusions

Our findings show that there is a need to strengthen existing policies focusing on lower socio-economic groups to improve sanitation and eliminate its related diseases. In particular, the ongoing ‘Clean India Mission’ should play a critical role in promoting sanitation for all.
Leukocyte surface expression of the endoplasmic reticulum chaperone GRP78 is increased in severe COVID-19
Authors: Angeles-Floriano Tania , Sanjuan-Méndez Adriana , Rivera-Torruco Guadalupe , Parra-Ortega Israel , Lopez-Martinez Briceida , Martinez-Castro Jesús , Marin-Santiago Sergio , Alcántara-Hernández Carolina , Martínez-Martínez Araceli , Márquez-González Horacio , Klünder-Klünder Miguel , Olivar-López Victor , Zaragoza-Ojeda Montserrat , Arenas-Huertero Francisco , Torres-Aguilar Honorio , Medina-Contreras Oscar , Zlotnik Albert , Valle-Rios Ricardo
Published: January 2023

Hyperinflammation present in individuals with severe COVID-19 has been associated with an exacerbated cytokine production and hyperactivated immune cells. Endoplasmic reticulum stress leading to the unfolded protein response has been recently reported as an active player in inducing inflammatory responses. Once unfolded protein response is activated, GRP78, an endoplasmic reticulum–resident chaperone, is translocated to the cell surface (sGRP78), where it is considered a cell stress marker; however, its presence has not been evaluated in immune cells during disease. Here we assessed the presence of sGRP78 on different cell subsets in blood samples from severe or convalescent COVID-19 patients. The frequency of CD45+sGRP78+ cells was higher in patients with the disease compared to convalescent patients. The latter showed similar frequencies to healthy controls. In patients with COVID-19, the lymphoid compartment showed the highest presence of sGRP78+ cells versus the myeloid compartment. CCL2, TNF-α, C-reactive protein, and international normalized ratio measurements showed a positive correlation with the frequency of CD45+sGRP78+ cells. Finally, gene expression microarray data showed that activated T and B cells increased the expression of GRP78, and peripheral blood mononuclear cells from healthy donors acquired sGRP78 upon activation with ionomycin and PMA. Thus, our data highlight the association of sGRP78 on immune cells in patients with severe COVID-19.
Prognostic analysis of radiotherapy for cervical lymph node recurrence after curative resection of thoracic esophageal squamous cell carcinoma
Authors: Chu Jinjin , Wang Fan
Published: January 2023

To identify efficacy and prognosis of radiotherapy (RT) for cervical lymph node recurrence (CLNR) in thoracic esophageal squamous cell carcinoma (TESCC) after curative resection. The clinical data from 65 patients were retrospectively analyzed. The Kaplan–Meier method was employed to analyze the survival of patients. The Cox proportional hazards model was then exploited for multivariate analysis. The median overall survival (OS) was 20 months; one-year, two-year, three-year and five-year survival rates were 68.3%, 47.3%, 33.4% and 10.6%. The median progression-free survival (PFS) was 14 months. Univariate analysis indicated that time from surgery to recurrence, number of recurrent lymph nodes and dose of RT were significant prognostic factors, whereas multivariate analysis showed that number of recurrent lymph nodes and radiation dose were independent factors. RT was an effective salvage treatment for patients with CLNR after surgery. Those patients who showed single lymph node recurrence and who were exposed to ≥60 Gy of RT experienced a favorable prognosis.
The ampulla of Vater: A potential target for metastatic melanoma?
Authors: Armany David , Gosal Preet , Adams Stuart
Published: January 2023

Malignant melanomas are aggressive cancers that can prove to be fatal, with Australia harbouring the highest incidence of skin cancers worldwide. Surprisingly, as little as 13.4% of patients undergoing surgical resection of high-risk melanomas remain disease-free after 2 years, with 31.6% showing evidence of distant spread. Although rare, secondary tumours of the ampulla of Vater have been documented, with the most common primaries involving breast, renal and melanoma cancers. We report the case of a malignant melanoma of the ampulla of Vater occurring in a patient 4-year post-surgical resection of a Stage II melanoma manifesting as acute pancreatitis with obstructive jaundice. Given the rarity of secondary ampullary tumours, metastatic melanoma should always be considered in patients with obstructive jaundice and a history of melanoma resection. In the absence of distant disease, surgery may be considered after consensus at multidisciplinary team meetings and after consideration of the patient preference.
Chylothorax following transsternal total thymectomy: a case report
Authors: Kato Fumiaki , Tomita Masaki , Shimmura Kohei , Yoshizumi Hideyuki , Sato Toshihiko
Published: January 2023

Herein, we report a case of chylothorax following total thymectomy. A 46-year-old woman having an anterior mediastinal tumor underwent a thymectomy via median sternotomy. Seven days after surgery, there was no massive pleural effusion. However, on post-operative day 17, a right massive pleural effusion was detected, and it was diagnosed as chylothorax. She was successfully treated with conservative therapy. Chylothorax following thymectomy is a very rare complication.
Elucidating the unknown transcriptional responses and PHR1-mediated biotic and abiotic stress tolerance during phosphorus limitation
Authors: Scheible Wolf-Rűdiger , Pant Pooja , Pant Bikram D , Krom Nick , Allen Randy D , Mysore Kirankumar S
Published: January 2023

Phosphorus (P) limitation in the majority of world soils is a major constraint for plant growth and crop productivity. RNA sequencing was used to discover novel P-responsive gene transcripts (PRGTs) in leaves and roots of Arabidopsis. Hisat StringTie and the Cufflinks TopHat transcript assembler were used to analyze reads and identify 1074 PRGTs with a >5-fold altered abundance during P limitation. Interestingly, 60% of these transcripts were not previously reported. Among the novel PRGTs, 106 were from unannotated genes, and some were among the most P-responsive, including At2g36727 which encodes a novel miRNA. Annotated novel PRGTs encode transcription factors, miRNAs, small signaling peptides, long non-coding RNAs, defense-related proteins, and transporters, along with proteins involved in many biological processes. We identified several genes that undergo alternative splicing during P limitation, including a novel miR399-resistant splice variant of PHOSPHATE2 (PHO2.2). Several novel P-responsive genes were regulated by PHOSPHATE STARVATION RESPONSE1 (PHR1), PHR1-LIKE 1 (PHL1), and PHO2. We discovered that P-limited plants show increased resistance to pathogens and drought stress mediated by PHR1–PHL1. Identification of novel P-responsive transcripts and the discovery of the influence of P limitation on biotic and abiotic stress adds a significant component to our understanding of plant P signaling.
What is ‘good’ domestic violence lawyering?: views from specialist legal services in Australia
Authors: Wangmann Jane , Bartlett Francesca , Batagol Becky , Booth Tracey , Douglas Heather , Kaye Miranda , Seear Kate
Published: January 2023

There is increasing recognition that many lawyers, regardless of their practice area, will represent people who have both used and experienced violence in their intimate relationships. This suggests that being informed about domestic and family violence (DFV) is an important attribute of competent lawyering. Despite repeated reports and research drawing attention to poor practices, many lawyers lack DFV training. There is limited research about what it means to be a ‘good’ DFV lawyer. To explore this, we conducted focus groups with lawyers employed in specialist women’s legal services in Australia. Much work undertaken in these services involves working with clients who have experienced DFV, so these lawyers are well placed to identify features of ‘good’ DFV lawyering. The attributes for competent lawyering with people who have experienced DFV, include being knowledgeable about DFV, being trauma-informed/responsive, being knowledgeable about the law and the relevance of violence, adopting a safety lens and providing a holistic service. Our study identifies a number of areas that require further research including understanding the difference between DFV-informed lawyering and trauma-informed/responsive lawyering, and whether specific competencies are required when representing people who experience DFV or have used DFV. Despite years of research and various inquiries pointing to inadequacies and making recommendations for improvement, this article draws attention to continuing gaps in this area.
Identification and characterization of RNA pentaloop sequence families
Authors: Saon Md Sharear , Kirkpatrick Charles C , Znosko Brent M
Published: January 2023

One of the current methods for predicting RNA tertiary structure is fragment-based homology, which predicts tertiary structure from secondary structure. For a successful prediction, this method requires a library of the tertiary structures of small motifs clipped from previously solved RNA 3D structures. Because of the limited number of available tertiary structures, it is not practical to find structures for all sequences of all motifs. Identifying sequence families for motifs can fill the gaps because all sequences within a family are expected to have similar structural features. Currently, a collection of well-characterized sequence families has been identified for tetraloops. Because of their prevalence and biological functions, pentaloop structures should also be well-characterized. In this study, 10 pentaloop sequence families are identified. For each family, the common and distinguishing structural features are highlighted. These sequence families can be used to predict the tertiary structure of pentaloop sequences for which a solved structure is not available.
Genomic markers of recurrence risk in atypical meningioma following gross total resection
Authors: Vaubel Rachael A , Kumar Rahul , Weiskittel Taylor M , Jenkins Sarah , Dasari Surendra , Uhm Joon H , Lachance Daniel H , Brown Paul D , Van Gompel Jamie J , Jenkins Robert B , Kipp Benjamin R , Sukov William R , Giannini Caterina , Johnson Derek R , Raghunathan Aditya
Published: January 2023

Background

Meningiomas are the most common primary central nervous system (CNS) tumor in adults and CNS World Health Organization grade 2 (atypical) meningiomas show an intermediate risk of recurrence/progression. Molecular parameters are needed to better inform management following gross total resection (GTR).

Methods

We performed comprehensive genomic analysis of tumor tissue from 63 patients who underwent radiologically confirmed GTR of a primary grade 2 meningioma, including a CLIA-certified target next-generation sequencing panel (n = 61), chromosomal microarray (n = 63), genome-wide methylation profiling (n = 62), H3K27me3 immunohistochemistry (n = 62), and RNA-sequencing (n = 19). Genomic features were correlated with long-term clinical outcomes (median follow-up: 10 years) using Cox proportional hazards regression modeling and published molecular prognostic signatures were evaluated.

Results

The presence of specific copy number variants (CNVs), including -1p, -10q, -7p, and -4p, was the strongest predictor of decreased recurrence-free survival (RFS) within our cohort (P < .05). NF2 mutations were frequent (51%) but did not show a significant association with RFS. DNA methylation-based classification assigned tumors to DKFZ Heidelberg benign (52%) or intermediate (47%) meningioma subclasses and was not associated with RFS. H3K27 trimethylation (H3K27me3) was unequivocally lost in 4 tumors, insufficient for RFS analysis. Application of published integrated histologic/molecular grading systems did not improve prediction of recurrence risk over the presence of -1p or -10q alone.

Conclusions

CNVs are strong predictors of RFS in grade 2 meningiomas following GTR. Our study supports incorporation of CNV profiling into clinical evaluation to better guide postoperative patient management, which can be readily implemented using existing, clinically validated technologies.
In pursuit of reconstructing missing human hands
Authors: Gong Xuan , Sun Bai-Yang , Wang Qi-Ning , Xiong Cai-Hua
Published: January 2023

Exploring bio-intelligence of human limbs could provide a new perspective for reconstructing missing limbs.
Swedish Religion Education in Public Schools—Objective and Neutral or a Marination into Lutheran Protestantism?
Authors: Berglund Jenny
Published: January 2023

This article takes its point of departure in the recommendations by the Council of Europe, and Organization for Security and Co-operation in Europe (OSCE) that recommend that European states should offer education about religions for all school students, regardless of religious or non-religious background. Sweden is one of the countries that provides such education through a compulsory non-denominational religion education (RE) school subject. The compulsory nature of the school subject is possible as long as the teaching is both ‘objective and pluralistic’. In this article, the concept of objectivity but also neutrality is discussed, using the Swedish school subject as an example. The argument pursued is that RE in Sweden, although presented as objective and neutral, also can be understood as ‘marinated’ in Lutheran Protestantism. In the end, the protestant taste of the Swedish non-denominational and compulsory RE is used as a call for further awareness of how the religious history of a given country affects not only education but also the way people perceive the phenomena called religion. These are important perspectives not only for RE teachers who are demanded to teach in a neutral and objective manner, but perhaps also for lawyers?
Enrichment of Incompatible Elements in Alkaline Syenites in Large Igneous Provinces Due to Magma Replenishment and Reactive Porous Flow in a Mush Reservoir
Authors: Zhu Sheng-Zhu , Huang Xiao-Long , Yu Yang , Yang Fan , Wang Christina Yan , He Peng-Li , Cao Jun
Published: January 2023

Understanding the petrogenesis of alkaline syenites is important for constraining the mechanisms of rare earth element (REE) and rare-metal mineralization. Here we report a detailed petrological and geochemical study of early Permian syenitic rocks from the southwestern Tarim large igneous province (TLIP) in the Wajilitag area (China). We use these data to investigate the complex magmatic processes responsible for the enrichment of incompatible elements (e.g. REEs and rare metals) in these rocks. The Wajilitag syenitic rocks comprise early hornblende syenite (281 Ma) and later nepheline syenite (278 Ma), both of which are spatially and temporally associated with mafic intrusions (i.e. gabbro and diabase). These syenitic rocks show continuous variations in major elements with the mafic rocks. They also have similar Sr–Nd–Hf isotopic compositions with the nearby mafic rocks, denoting that the Wajilitag syenitic rocks should be derived from the melts represented by these mafic rocks. However, these syenitic rocks, particularly the nepheline syenites, are typically characterized by extreme enrichment of incompatible elements, which is hard to be accounted by simple fractional crystallization of mafic magmas. Some clinopyroxene phenocrysts in the Wajilitag nepheline syenites show oscillatory zoning with strikingly increasing and then gradually decreasing MgO contents, which recorded replenishment of mafic magma at the interval. Low-MgO clinopyroxene mantles and/or rims have much higher incompatible element contents (e.g. Nb, Ce, and Zr) and ratios (e.g. Ce/Y) than their cores, which could reflect melt injection controlled by reactive porous flow in a mush reservoir of a crustal magma chamber. Such processes may also cause the high Ce and/or Nb contents of the mantles and/or rims of zoned titanite and apatite phenocrysts. The injection of reactive porous flow melts is the key process that produces the extreme enrichment of incompatible elements in the alkaline syenites from the western TLIP, as well as other plume-related alkaline syenites that host world-class REE and rare-metal deposits.
Histone H3K4 methyltransferase DcATX1 promotes ethylene induced petal senescence in carnation
Authors: Feng Shan , Jiang Xinyu , Wang Ruiming , Tan Hualiang , Zhong Linlin , Cheng Yunjiang , Bao Manzhu , Qiao Hong , Zhang Fan
Published: January 2023

Petal senescence is controlled by a complex regulatory network. Epigenetic regulation like histone modification influences chromatin state and gene expression. However, the involvement of histone methylation in regulating petal senescence remains poorly understood. Here, we found that the trimethylation of histone H3 at Lysine 4 (H3K4me3) is increased during ethylene-induced petal senescence in carnation (Dianthus caryophyllus L.). H3K4me3 levels were positively associated with the expression of transcription factor DcWRKY75, ethylene biosynthetic genes 1-aminocyclopropane-1-carboxylic acid (ACC) synthase (DcACS1), and ACC oxidase (DcACO1), and senescence associated genes (SAGs) DcSAG12 and DcSAG29. Further, we identified that carnation ARABIDOPSIS HOMOLOG OF TRITHORAX1 (DcATX1) encodes a histone lysine methyltransferase which can methylate H3K4. Knockdown of DcATX1 delayed ethylene-induced petal senescence in carnation, which was associated with the down-regulated expression of DcWRKY75, DcACO1, and DcSAG12, whereas overexpression of DcATX1 exhibited the opposite effects. DcATX1 promoted the transcription of DcWRKY75, DcACO1, and DcSAG12 by elevating the H3K4me3 levels within their promoters. Overall, our results demonstrate that DcATX1 is a H3K4 methyltransferase that promotes the expression of DcWRKY75, DcACO1, DcSAG12 and potentially other downstream target genes by regulating H3K4me3 levels, thereby accelerating ethylene-induced petal senescence in carnation. This study further indicates that epigenetic regulation is important for plant senescence processes.
The Fractured-Land Hypothesis
Authors: Fernández-Villaverde Jesús , Koyama Mark , Lin Youhong , Sng Tuan-Hwee
Published: January 2023

Patterns of state formation have crucial implications for comparative economic development. Diamond (1997) famously argued that “fractured land” was responsible for China’s tendency toward political unification and Europe’s protracted polycentrism. We build a dynamic model with granular geographical information in terms of topographical features and the location of productive agricultural land to quantitatively gauge the effects of fractured land on state formation in Eurasia. We find that topography alone is sufficient but not necessary to explain polycentrism in Europe and unification in China. Differences in land productivity, in particular the existence of a core region of high land productivity in northern China, deliver the same result. We discuss how our results map into observed historical outcomes, assess how robust our findings are, and analyze the differences between theory and data in Africa and the Americas.
Filtrations on the representation ring of an affine algebraic group
Authors: Karpenko Nikita A
Published: January 2023

Let G be an affine algebraic group over a field. The representation ring $\mathrm{R}(G)$ has three standard filtrations, defining the same topology on $\mathrm{R}(G)$: augmentation, Chern and Chow, each of which contained in the next one. For split reductive G, motivated by potential applications related to spin groups, we introduce and study one more filtration, containing the previous ones, which we call induced because it is induced by any of the filtrations on the representation ring of a maximal split torus of G. In the case of semisimple simply connected G, this fourth filtration turns out to be equivalent (in the above topological sense) to the previous three. However, for the spin group $G=\operatorname{\mathrm{Spin}}(d)$ over the complex numbers with $d=7,8$, the new filtration is shown to be strictly larger than the others. It is also shown that for $G=\operatorname{\mathrm{Spin}}(d)$ over an arbitrary field and with any $d\geq7$, the Chern and Chow filtrations on $\mathrm{R}(G)$ are not the same, giving new counter-examples to an extension of Atiyah’s conjecture.
Testing the Production Approach to Markup Estimation
Authors: Raval Devesh
Published: January 2023

Under the production approach to markup estimation, any flexible input should recover the markup. I test this implication using manufacturing datasets from Chile, Colombia, India, Indonesia, the U.S., and Southern Europe, as well as store-level data from a major U.S. retailer, and overwhelmingly reject that markups estimated using labour and materials have the same distribution. For every dataset, markups estimated using labour are negatively correlated with markups estimated using materials, exhibit greater dispersion, and have opposite time trends. I continue to find stark differences in markups estimated using energy and non-energy raw materials. Non-neutral productivity differences across firms can explain these findings.
Fears and Tears: Should More People Be Moving within and from Developing Countries, and What Stops this Movement?
Authors: McKenzie David
Published: January 2023

Only one in seven of the world's population have ever migrated, despite the enormous gains in income possible through international and internal movement. I examine the evidence for different explanations given in the economics literature for this lack of movement and their implications for policy. Incorrect information about the gains to migrating, liquidity constraints that prevent poor people paying the costs of moving, and high costs of movement arising from both physical transportation costs and policy barriers all inhibit movement and offer scope for policy efforts to inform, provide credit, and lower moving costs. However, the economics literature has paid less attention to the fears people have when faced with the uncertainty of moving to a new place, and to the reasons behind the tears they shed when moving. While these tears reveal the attachment people have to particular places, this attachment is not fixed, but itself changes with migration experiences. Psychological factors such as a bias toward the status quo and the inability to picture what one is giving up by not migrating can result in people not moving, even when they would benefit from movement and are not constrained by finances or policy barriers from doing so. This suggests new avenues for policy interventions that can help individuals better visualize the opportunity costs of not moving, alleviate their uncertainties, and help shift their default behavior from not migrating.
Plant Disease Models and Forecasting: Changes in Principles and Applications over the Last 50 Years
Authors: González-Domínguez Elisa , Caffi Tito , Rossi Vittorio , Salotti Irene , Fedele Giorgia
Published: January 2023

This review gives a perspective of selected advances made since the middle of the 20th century in plant disease modeling, and the associated increase in the number of models published during that time frame. This progress can be mainly attributed to advances in (i) sensors and automatic environmental data collection technology, (ii) instrumentation and methods for studying botanical epidemiology, and (iii) data analytics and computer science. We review the evolution of techniques for developing data-based (empirical) models and process-based (mechanistic) models using the wheat rusts as a case study. We also describe the increased importance of knowledge about biological processes for plant disease modeling by using apple scab as a second case study. For both wheat rusts and apple scab, we describe how the models have evolved over the last 50 years by considering certain milestones that have been achieved in disease modeling. Finally, we describe how plant disease models are used as part of a multi-modeling approach to develop decision-making tools in the application of integrated pest management.
Use of exogenous hormones in those at increased risk for breast cancer: contraceptive and menopausal hormones in gene carriers and other high-risk patients
Authors: Pederson Holly J. , Batur Pelin
Published: January 2023

Importance and Objective

Addressing the hormonal needs of individuals at increased risk of breast cancer (BC) can be a challenge. Observational, prospective, and case-control data support the safety of hormonal contraception in women, often with the added benefits of ovarian and endometrial cancer risk reduction. The majority of data on menopausal hormone therapy (HT) in the highest-risk patients comes from studies of patients with pathogenic variants in BRCA1 and BRCA2 who undergo early surgical menopause. The benefits of risk-reducing salpingo-oophorectomy are not minimized by HT, whereas its use mitigates accelerated osteoporosis and cardiovascular disease. In other patients at increased risk, such as with family history, studies have shown little risk with significant benefit.

Methods

We review evidence to help women's health practitioners aid patients in making choices. The paper is divided into four parts: 1, contraception in the very high-risk patient (ie, with a highly penetrant BC predisposition gene); 2, contraception in other patients at increased risk; 3, menopausal HT in the gene carrier; and 4, HT in other high-risk patients.

Discussion and Conclusion

Women at increased risk for BC both early and later in life should be offered reassurance around the use of premenopausal and postmenopausal hormone therapies. The absolute risks associated with these therapies are low, even in the very high-risk patient, and the benefits are often substantial. Shared decision making is key in presenting options, and knowledge of the data in this area is fundamental to these discussions.
The History of the Linear No-Threshold Model and Recommendations for a Path Forward
Authors: Cardarelli John , Hamrick Barbara , Sowers Dan , Burk Brett
Published: January 2023

The intent of this paper and the accompanying video series is to inform the scientific community about the historical foundations that underpin the linear no-threshold (LNT) model’s use for cancer risk assessment. There is a clear distinction here: this effort is about the history of how LNT came to be the regulatory paradigm and model for cancer risk assessment that it is today and not a discussion of the pros and cons of the LNT model. The overarching goal of this effort is to reframe the conversation around low-dose response models in light of this history and to determine how this history influences the scientific understanding of low-dose radiation responses. The timing of this series is intentional, as the International Commission on Radiological Protection (ICRP) has embarked on a mission to review the entire system of radiation protection. This effort necessarily requires rigorous scientific debate that must be based in fact. The history of the LNT model is paramount to this discussion, and it warrants consideration. Unfortunately, rather than engendering respectful debate, the topic of cancer risks associated with low dose radiation exposures has forged two disparate and sometimes contentious camps: (1) low doses, no matter how low, present some form of health risk and (2) an alternative model better represents the actual risks. The video series, conceived by John Cardarelli II, current President of the Health Physics Society (HPS), features Edward Calabrese, professor of toxicology in the School of Public Health and Health Sciences at the University of Massachusetts at Amherst, being interviewed by HPS Past-President Barbara Hamrick, CHP, JD, with support from Daniel Sowers, the Chair of the HPS Public Information Committee, and HPS Executive Director Brett Burk. Emily Caffrey, the Chief Editor of our Ask-the-Experts website (https://hps.org/publicinformation/ate/), was invited to watch the completed series as an independent peer reviewer. Further, an email address, factcheck@hps.org, was created to allow for peer-review by the scientific community to facilitate ongoing discussion and allow for corrections to the record as necessary. It is the sincere hope of this team that this work inspires new discussions about the system of radiological protection. We encourage everyone in this field to watch all 22 episodes to be informed about the underpinnings of current regulatory policy in the US.
Effect of Head Position and Magnetic Resonance Sequence on Cochlear Implant–Related Artifact Size and Internal Auditory Canal Visibility
Authors: Kalmanson Olivia A. , Talmage Garrick D. , Honce Justin M. , Gubbels Samuel P.
Published: January 2023

Hypothesis

To assess whether cochlear implant (CI)–related magnetic resonance imaging (MRI) artifact and visibility of the internal auditory canal (IAC) can be improved with head positioning and select MRI sequences.

Background

CI-related MRI artifact limits the use of CIs in otherwise good candidates because of the need for serial MRIs for monitoring of pathology. This most notably impacts patients with tumors of the cerebellopontine angle and IAC.

Methods

Two cadaver heads were implanted with either a Med-El CONCERT (fixed magnet) or SYNCHRONY (rotating magnet) device. Each head was imaged in a 1.5T scanner in 11 different positions. The SYNCHRONY-implanted head was also imaged in a 3.0T scanner in seven positions. Artifact size and IAC visibility (graded on a Likert scale) were measured for each head position by a neuroradiologist.

Results

The CONCERT CI produced significantly smaller artifact than the SYNCHRONY CI (effect size, 14.65 mm; p < 0.001). There was no significant difference between CI models in regard to IAC visibility. No head positions were statistically significantly better than neutral position for minimizing artifact size or IAC visibility, although some positions resulted in significantly larger artifact (effect sizes, 2.1–14.3 mm; p < 0.05) or significantly poorer IAC visibility (effect size, 1.4; p < 0.01). The T2 three-dimensional (CISS/FIESTA) sequence demonstrated significantly smaller artifact than T1 sequences, whereas T1 sequences demonstrated significantly better IAC visibility than T2 sequences.

Conclusion

Head positioning and magnetic resonance sequence selection impact CI-related artifact size and IAC visibility.
Is Gestational COVID-19 a Risk Factor for Congenital Hearing Loss?
Authors: Tanyeri Toker Gokce , Kumbul Yusuf Cagdas , Cetinkol Ali Emre , Aslan Hale , Baba Pinar , Oncel Mehmet Yekta
Published: January 2023

Objective

The aim of this study was to investigate whether COVID-19 during pregnancy is a risk factor for congenital hearing loss.

Study Design

Retrospective cohort.

Setting

Tertiary referral center.

Patients

Hearing screening test results of 60,223 newborns between March 2020 and May 2021 were screened using the national database. Newborn babies of 570 pregnant women with positive COVID-19 PCR test during pregnancy who met the study criteria were included in the gestational COVID-19 group, and 570 healthy newborns born in the same period were included in the control group.

Intervention

Diagnostic.

Main Outcome Measure

Results of up to three automatic auditory brainstem response tests in the first 30 days of life were used for newborn hearing screening.

Results

When the gestational COVID-19 and control groups were compared in terms of demographic data, there was no statistically significant difference for any of the variables (maternal age, gestational age, birth weight, neonate gender, mode of delivery, p > 0.05 for all variables). Of the mothers in the gestational COVID-19 group, 62 (10.9%) had COVID-19 in the first trimester, 181 (31.8%) in the second trimester, and 327 (57.3%) in the third trimester. When the first and second test results of newborn hearing screening were compared between the groups, the number of babies with hearing loss was higher in the gestational COVID-19 group than in the control group (p = 0.025; odds ratio, 1.357; 95% confidence interval, 1.039–1.774; p = 0.006; odds ratio, 4.924; 95% confidence interval, 1.410–17.193, respectively). For the third test results, hearing loss was detected in only one baby in both groups (p = 0.284). When the first, second, and third test results for newborn hearing screening were compared according to the trimesters when COVID-19 positivity was identified, the difference between trimesters was not found to be statistically significant (p > 0.05).

Conclusion

To the best of our knowledge, this is the largest study in the literature of the impact of COVID-19 on newborn hearing. The findings in the study suggest that gestational COVID-19 is not a risk factor for permanent congenital hearing loss. However, because the risk of detecting hearing loss is high in the first 15 days, we emphasize the importance of the third screening test.
Vestibular Implantation Can Work Even After More Than 20 Years of Bilateral Vestibular Hypofunction
Authors: Schoo Desi P. , Ayiotis Andrianna I. , Fernandez Brillet Celia , Chow Margaret R. , Lane Kelly E. , Ward Bryan K. , Carey John P. , Della Santina Charles C.
Published: January 2023

Objective

To determine whether prosthetic stimulation delivered via a vestibular implant can elicit artificial sensation of head movement despite long (23-yr) duration adult-onset ototoxic bilateral vestibular hypofunction (BVH).

Study Design

Case report.

Setting

Tertiary care center as part of a first-in-human clinical trial.

Patients

One.

Interventions

Unilateral vestibular implantation with an investigational multichannel vestibular implant in a 55-year-old man with a well-documented 23-year history of aminoglycoside-induced BVH.

Main Outcome Measures

Electrically evoked vestibulo-ocular reflexes (eeVOR).

Results

Vestibular implant stimulation can drive stimulus-aligned eeVOR and elicit a vestibular percept 23 years after the onset of bilateral vestibulopathy. Prosthetic stimulation targeting individual semicircular canals elicited eye movements that approximately aligned with each targeted canal's axis. The magnitude of the eeVOR response increased with increasing stimulus current amplitude. Response alignment and magnitude were similar to those observed for implant recipients who underwent vestibular implantation less than 10 years after BVH onset. Responses were approximately stable for 18 months of continuous device use (24 h/d except during sleep).

Conclusions

Vestibular implantation and prosthetic electrical stimulation of semicircular canal afferent nerves can drive canal-specific eye movement responses more than 20 years after the onset of ototoxic vestibular hypofunction.
The Prevalence of Symptom Reporting for Benign Paroxysmal Positional Vertigo in a Traumatic Brain Injury Population
Authors: Harrell Regan , Manetta Chelsea , Guthrie Michael , Enam Nabela
Published: January 2023

Objective

To assess the prevalence of benign paroxysmal positional vertigo (BPPV) in traumatic brain injury population.

Study Design

In this cross-sectional design, each subject completed screening for BPPV, which included subjective questioning and positional testing. Subjects were asked if they experienced dizziness with bed mobility. All were tested with the Dix-Hallpike and the roll test to determine if nystagmus consistent with BPPV was present.

Setting

Brain injury inpatient rehabilitation unit.

Participants

Subjects admitted to the rehabilitation unit during a 6-month time frame who had a traumatic mechanism of brain injury or experienced a fall resulting from a neurologic event.

Interventions

Diagnostic interventions included the Dix-Hallpike and roll tests.

Main Measures

The primary outcomes of this study were the prevalence of BPPV and symptom reports.

Results

Seventy-six subjects met the inclusion criteria. Three subjects were transferred to acute care before screening for BPPV could be completed. Of the 73 subjects who completed the screening process, 42 (58%) tested positive for BPPV, of which only 7 (10%) reported subjective symptoms of dizziness and/or vertigo. χ
2 Analysis of the two screening methods demonstrated a statistically significant difference in the positivity rate between tests (χ
2
1 = 5.715, p = 0.017, Cohen's W = 0.279). If subjects responded yes to both screening questions, they were significantly more likely to test positive for BPPV with a moderate effect size of 0.279.

Conclusion

There was a high prevalence of BPPV within an inpatient rehabilitation facility in subjects with traumatic brain injury, with a small percentage of patients reporting dizziness with subjective questioning.
Ossicular Chain Reconstruction With Titanium Prostheses: A Systematic Review and Meta-Analysis
Authors: Kortebein Sarah , Russomando Alessandra Cataldo , Greda Dominik , Cooper Matthew , Ledbetter Leila , Kaylie David
Published: January 2023

Objectives

This review sought to establish expectations for hearing improvement with specifically titanium partial (PORP) and total ossicular replacement prostheses (TORP) to give surgeons an acceptable goal for postoperative hearing results and to counsel patients on their expected results.

Databases Reviewed

MEDLINE/PubMed, EMBASE, and Cochrane Library.

Methods

A systematic review of the literature was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three databases (MEDLINE/PubMed, EMBASE, Cochrane library) were searched using relevant key search terms to identify studies evaluating outcomes of titanium prostheses. A title/abstract and full article review was then done, and the results from the remaining studies were analyzed with Review Manager 5.4 Software to perform a meta-analysis using a random-effects model.

Results

Forty articles were analyzed after full article review based on the inclusion and exclusion criteria. For PORPs, the average improvement in air-bone gap (ABG) and pure-tone average were 12.1 and 13.5 dB, respectively. For TORPs, the average improvements in ABG and pure-tone average were 16.7 and 17.0 dB, respectively. Preoperatively, the average ABG was 7.0 dB better for PORP than TORP patients, and postoperatively, the ABG improved an average of 4.9 dB more for the PORP cohort. Seventy percent of PORPs and 57% of TORPs subjects had a postoperative ABG less than 20 dB.

Conclusions

Overall, reconstruction of the ossicular chain with titanium prostheses reliably improves patients' hearing outcomes, and this study gives relevant information for counseling patients preoperatively on realistic hearing outcomes.
Vestibular Complaints Impact on the Long-Term Quality of Life of Vestibular Schwannoma Patients
Authors: Fuentealba-Bassaletti Constanza , Neve Olaf M. , van Esch Babette F. , Jansen Jeroen C. , Koot Radboud W. , van Benthem Peter Paul G. , Hensen Erik F.
Published: January 2023

Objective

To analyze the effect of dizziness-related symptoms on the long-term quality of life (QoL) of patients with unilateral vestibular schwannoma.

Methods

In this cross-sectional study, patients with a unilateral vestibular schwannoma diagnosed between 2004 and 2013 completed a disease-specific QoL questionnaire (Penn Acoustic Neuroma Quality of Life [PANQOL]) and the Dizziness Handicap Inventory (DHI) in 2020. Linear regression was performed to assess the correlation between QoL and the DHI total score, and the scores of the DHI functional, emotional, and physical subdomains. Potential confounders such as age, sex, tumor size at baseline, and treatment modality (active surveillance, surgery, or radiotherapy) were included in the model.

Results

In total, 287 of 479 patients (59%) experienced dizziness with a median follow-up of 10 years. The DHI total score was significantly associated with the PANQOL total score. On average, we found a reduction of 0.7 points on the PANQOL for each additional point on the DHI. The DHI emotional subdomain was the most prominent determinant of poorer QoL. Each point on the DHI emotional subscale was associated with a reduction of 1.3 on the PANQOL score. Treatment modality did not have a clinically relevant effect on dizziness-related QoL.

Conclusions

Even mild dizziness can have a significant and clinically relevant effect on the QoL of patients with unilateral vestibular schwannoma in the long term. This holds true for all treatment modalities. Addressing the vestibular problems may improve QoL in vestibular schwannoma patients, and DHI subscale analysis may help tailor the optimal vestibular intervention.
Audiometry-Confirmed Sudden Sensorineural Hearing Loss Incidence among COVID-19 Patients and BNT162b2 Vaccine Recipients
Authors: Cohen Michael Ori , Tamir Sharon Ovnat , O'Rourke Norm , Marom Tal
Published: January 2023

Objective

To compare sudden sensorineural hearing loss (SSNHL) incidence rates over the coronavirus disease 2019 (COVID-19) outbreak and the COVID-19 vaccination campaign periods to pre-COVID-19 periods.

Study Design

Retrospective cohort.

Setting

Secondary hospital.

Patients

Patients >12 years with auditory-confirmed SSNHL were enrolled. COVID-19 status and BNT162 inoculation records ≤28 days before SSNHL diagnosis were retrieved. Patients were categorized according to their date of presentation over four equal periods: 1) July 2018–April 2019 (first prepandemic period), 2) May 2019–February 2020 (second prepandemic period), 3) March 2020–December 2020 (COVID-19 outbreak), and 4) January 2021–October 2021 (BNT162b2 vaccinations campaign).

Interventions

Pre- and post-COVID-19 emergence; BNT162b2 vaccine.

Main Outcome Measures

Incidence rate ratios (IRRs) were calculated to compare SSNHL cases during the COVID-19 and vaccination periods with pre-COVID-19 periods.

Results

Of the 100 patients with SSNHL over the four periods, 1 had COVID-19 and 8 were vaccinated. The annual SSNHL incidence was 12.87, 12.28, 13.45, and 19.89 per 100,000 over periods 1 to 4, respectively. SSNHL incidence over the third period was not significantly different than the first/second periods (IRR = 1.045, 95% confidence interval [CI] = 0.629–1.85, ρ = 0.788, and IRR = 1.095, 95% CI = 0.651–1.936, ρ = 0.683, respectively), whereas SSNHL incidence rate over the fourth period was higher (IRR = 1.545, 95% CI = 0.967–2.607, ρ = 0.068, and IRR = 1.619, 95% CI = 1–2.73, ρ = 0.05, respectively). SSNHL incidence in vaccine recipients was lower than prepandemic unvaccinated patients (IRR = 0.584, 95% CI =0.464–1.67, ρ = 0.984, and IRR = 0.612, 95% CI =0.48–1.744, ρ = 0.92, respectively).

Conclusion

There were fewer SSNHL cases during the first COVID-19 months. Although the SSNHL rate over the COVID-19 vaccination campaign increased, it was not higher for patients who received the BNT162b2 vaccine.