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1.
J Agric Food Chem ; 2024 Sep 03.
Article in English | MEDLINE | ID: mdl-39226040

ABSTRACT

Transposon mutagenesis screening of Bacillus subtilis YB-1471, a novel rhizosphere biocontrol agent of Fusarium crown rot (FCR) of wheat, resulted in the identification of orf04391, linked to reduced biofilm formation. The gene encodes a protein possessing a putative tertiary structure of a "double-wing" DNA-binding domain. Expression of orf04391 increased during biofilm development in stationary cultures and during rapid growth in shaking cultures. An orf04391 deletion strain showed reduced biofilm production related to lower levels of the extracellular matrix, and the mutant also had reduced sporulation, adhesion, root colonization, and FCR biocontrol efficiency. Transcriptome analysis of YB-1471 and Δorf04391 in stationary culture showed that the loss of orf04391 resulted in altered expression of numerous genes, including sinI, an initiator of biofilm formation. DNA binding was shown with his-tagged Orf04391 binding to the sinIR operon in vivo and in vitro. Orf04391 appears to be a transcriptional regulator of biofilm formation in B. subtilis through the Spo0A-SinI/SinR pathway.

2.
Article in English | MEDLINE | ID: mdl-39230540

ABSTRACT

Point-of-care ultrasound (POCUS) involves the acquisition, interpretation, and immediate clinical integration of ultrasonographic imaging performed by a treating clinician. The current state of cardiac POCUS terminology is heterogeneous and ambiguous, in part because it evolved through siloed specialty practices. In particular, the medical literature and colloquial medical conversation contain a wide variety of terms that equate to cardiac POCUS. While diverse terminology aided in the development and dissemination of cardiac POCUS throughout multiple specialties, it also contributes to confusion and raises patient safety concerns. This statement is the product of a diverse and inclusive Writing Group from multiple specialties, including medical linguistics, that employed an iterative process to contextualize and standardize a nomenclature for cardiac POCUS. We sought to establish a deliberate vocabulary that is sufficiently unrelated to any specialty, ultrasound equipment, or clinical setting to enhance consistency throughout the academic literature and patient care settings. This statement (1) reviews the evolution of cardiac POCUS-related terms; (2) outlines specific recommendations, distinguishing between intrinsic and practical differences in terminology; (3) addresses the implications of these recommendations for current practice; and (4) discusses the implications for novel technologies and future research.

3.
Eur J Cancer ; 210: 114271, 2024 Aug 08.
Article in English | MEDLINE | ID: mdl-39232428

ABSTRACT

INTRODUCTION: Coordinated medical evacuations represent an important strategy for emergency response when healthcare systems are impaired by armed conflict, particularly for patients diagnosed with life-threatening conditions such as cancer. In this study, we compare the experiences of two parallel medical evacuation systems developed to meet the medical needs of Ukrainians affected by war. METHODS: This retrospective study compared outcomes of two medical evacuation systems, developed by the European Union Emergency Response Coordination Centre (ERCC) and Supporting Action for Emergency Response in Ukraine (SAFER Ukraine) collaborative, in the first 10 months after the war's intensification in Ukraine (February 24 to December 21, 2022). Each groups' respective registries served as data sources. Patient demographics and allocation data were summarized descriptively. Median time for patient referral were analyzed statistically. RESULTS: The ERCC pathway evacuated 1385 patients (median age: 36 [0 - 85] years) to 16 European countries; 78.7 % (n = 1091) suffered from trauma-related injuries and 13.4 % (n = 185) from cancer. SAFER Ukraine evacuated 550 patients (median age: 9 [0 - 22] years) to 14 European and North American countries; 97.1 % (n = 534) were children diagnosed with cancer or blood disorders. The median evacuation time for the SAFER Ukraine cohort was shorter than the ERCC cohort (p < 0.001), though comparable (six versus seven days). CONCLUSION: The ERCC and SAFER Ukraine collaborative successfully developed medical evacuation pathways to meet the needs of Ukrainian patients impacted by war. System comparison provides opportunity to identify strategies for parallel system harmonization and a pragmatic example of how to anticipate support of these patients in future armed conflicts.

4.
Obes Surg ; 2024 Sep 05.
Article in English | MEDLINE | ID: mdl-39235685

ABSTRACT

PURPOSE: Besides lifestyle interventions, medication, and surgery, endoscopic options are becoming part of the current treatment landscape for people with obesity. With the POSE (Primary Obesity Surgery Endoscopic) procedure, endoluminal folds are created in the stomach with full-thickness sutures. Recently, the modified version, POSE-2, was introduced in clinical practice. This study aims to evaluate the safety and effectiveness of the POSE-2 procedure after one year in patients with obesity. MATERIALS AND METHODS: All patients treated with the POSE-2 procedure between March 2019 and November 2022 in the Zuyderland Medical Center and the Dutch Obesity Clinic were included in this retrospective data study. Inclusion criteria are as follows: age between 18 and 65 years and a BMI > 30 kg/m2. All patients with contraindications for the POSE-2 procedure were excluded. RESULTS: Forty-nine patients were included of which 86% were female, with a mean age of 46 years and mean BMI of 34.6 kg/m2. Total weight loss was evaluated at 3, 6, and 12 months and was 11.5%, 13.2%, and 14.8%, respectively. A median of 14 anchor sutures was used in a median procedure time of 50 min. All patients except one had same day discharge. Postprocedural complaints were mild and consisted of nausea and vomiting (36.7%) and pain (54.2%). No complications were recorded in this group. One week postprocedure, most patients (95.9%) reported feeling satisfied between meals. CONCLUSION: The POSE-2 procedure can be applied as a safe and effective treatment for people with obesity. This study presents a positive effect on weight reduction and no complications after 1 year of follow-up.

5.
JAMA Ophthalmol ; 2024 Sep 05.
Article in English | MEDLINE | ID: mdl-39235786

ABSTRACT

Importance: Racial, ethnic, and sex disparities exist in US clinical study enrollment, and the prevalence of these disparities in Pediatric Eye Disease Investigator Group (PEDIG) clinical studies has not been thoroughly assessed. Objective: To evaluate racial, ethnic, and sex representation in PEDIG clinical studies compared with the 2010 US Census pediatric population. Design, Setting, and Participants: This cross-sectional analysis examined PEDIG clinical studies based in the US from December 1, 1997 to September 12, 2022, 41 of which met inclusion criteria of a completed study, a study population younger than 18 years, and 1 or more accompanying publication. Data analysis was performed between November 2023 and February 2024. Exposure: Study participant race, ethnicity, and sex for each clinical study, as collected from peer-reviewed publications, patient-enrollment datasets, and ClinicalTrials.gov. Main Outcomes and Measures: Median enrollment percentages of female, White, Black, Hispanic, Asian, and other race participants were calculated and compared with the 2010 US Census pediatric population using a 1-sample Wilcoxon rank test. Proportionate enrollment was defined as no difference on a 1-sample Wilcoxon rank test if P ≥ .05. If P < .05, we determined if the median enrollment percentage was greater than or less than 2010 US Census proportion to determine if enrollees were underrepresented or overrepresented. To calculate the magnitude of overrepresentation or underrepresentation, enrollment-census difference (ECD) was defined as the difference between groups' median enrollment percentage and percentage representation in the 2010 US Census. Compound annual growth rate (CAGR) was used to measure temporal trends in enrollment, and logistic regression analysis was used to analyze factors that may have contributed to proportionate representation outcomes. Results: A total of 11 658 study participants in 41 clinical studies were included; mean (SD) participant age was 5.9 (2.8) years and 5918 study participants (50.8%) were female. In clinical studies meeting inclusion criteria, White participants were overrepresented (ECD, 0.19; 95% CI, 0.10-0.28; P < .001). Black participants (ECD, -0.07; 95% CI, -0.10 to -0.03; P < .001), Asian participants (ECD, -0.03; 95% CI, -0.04 to -0.02; P < .001), and Hispanic participants (ECD, -0.09; 95% CI, -0.13 to -0.05; P < .001) were underrepresented. Female participants were represented proportionately (ECD, 0.004; 95% CI, -0.036 to 0.045; P = .21). White and Asian participants demonstrated a decreasing trend in study enrollment from 1997 to 2022 (White: CAGR, -1.5%; 95% CI, -2.3% to -0.6%; Asian: CAGR, -1.7%; 95% CI, -2.0% to -1.4%), while Hispanic participants demonstrated an increasing enrollment trend (CAGR, 7.2%; 95% CI, 3.7%-10.7%). Conclusions and Relevance: In this retrospective cross-sectional study of PEDIG clinical studies from December 1, 1997 to September 12, 2022, Black, Hispanic, and Asian participants were underrepresented, White participants were overrepresented, and female participants were represented proportionally. Trends suggested increasing enrollment of Hispanic participants and decreasing enrollment of White participants over time. This study demonstrates an opportunity to advocate for increased enrollment of underrepresented groups in pediatric ophthalmology clinical studies.

7.
J Imaging Inform Med ; 2024 Aug 13.
Article in English | MEDLINE | ID: mdl-39138749

ABSTRACT

Segmentation of infarcts is clinically important in ischemic stroke management and prognostication. It is unclear what role the combination of DWI, ADC, and FLAIR MRI sequences provide for deep learning in infarct segmentation. Recent technologies in model self-configuration have promised greater performance and generalizability through automated optimization. We assessed the utility of DWI, ADC, and FLAIR sequences on ischemic stroke segmentation, compared self-configuring nnU-Net models to conventional U-Net models without manual optimization, and evaluated the generalizability of results on an external clinical dataset. 3D self-configuring nnU-Net models and standard 3D U-Net models with MONAI were trained on 200 infarcts using DWI, ADC, and FLAIR sequences separately and in all combinations. Segmentation results were compared between models using paired t-test comparison on a hold-out test set of 50 cases. The highest performing model was externally validated on a clinical dataset of 50 MRIs. nnU-Net with DWI sequences attained a Dice score of 0.810 ± 0.155. There was no statistically significant difference when DWI sequences were supplemented with ADC and FLAIR images (Dice score of 0.813 ± 0.150; p = 0.15). nnU-Net models significantly outperformed standard U-Net models for all sequence combinations (p < 0.001). On the external dataset, Dice scores measured 0.704 ± 0.199 for positive cases with false positives with intracranial hemorrhage. Highly optimized neural networks such as nnU-Net provide excellent stroke segmentation even when only provided DWI images, without significant improvement from other sequences. This differs from-and significantly outperforms-standard U-Net architectures. Results translated well to the external clinical environment and provide the groundwork for optimized acute stroke segmentation on MRI.

8.
J Surg Oncol ; 2024 Aug 19.
Article in English | MEDLINE | ID: mdl-39155668

ABSTRACT

BACKGROUND AND OBJECTIVES: The American Joint Committee on Cancer (AJCC) TNM staging system defines atypical parathyroid neoplasia (APN) as tumor in situ (Tis) and reserves the definition of parathyroid carcinoma (PC) to parathyroid tumor with invasion into surrounding structures. Because the parathyroid gland has no true capsule, "extension" with APN versus microscopic "invasion" of surrounding soft tissue can be difficult and confusing for clinicians. We aimed to determine the clinical course of atypical parathyroid neoplasm with and without soft tissue extension and parathyroid carcinoma with only soft tissue invasion (pT1) and to report the outcomes. METHODS: Following an IRB-approved protocol, we identified all patients treated for parathyroid neoplasm or cancer at our single tertiary care cancer center from 1990 to 2021. We excluded all patients with evidence of clinical or pathologic gross invasion into surrounding structures (pT2 or higher), lymph node involvement, or metastatic disease. By definition, this excluded all cases where the distinction was clinically evident to the surgeon at the time of the operation based on finding a hard, firm, sticky, or discolored parathyroid gland. Only patients with pathologic T1 (pT1) parathyroid carcinoma or APN were included. All pathologic examinations were independently re-reviewed by a single designated expert senior endocrine pathologist. The definition of APN strictly followed the WHO definition of a clinically worrisome lesion having features including fibrous bands or increased mitotic rate, necrosis, or trabecular growth that did not meet robust criteria for frank invasion. Pathologic T1 disease was defined as invasion limited to soft tissue. Analyses were performed using R version 4.0.2 and Jamovi. RESULTS: Of all PC patients at our institution, only 71 met the strict inclusion criteria of APN or pT1. Forty-four patients had pT1 disease and 27 had APN: 12 of the APN had soft tissue extension, and 15 had no soft tissue extension. The groups were similar with regard to age at diagnosis (p = 0.328). The average follow-up duration was 84 months from initial surgical intervention. Of the 12 with APN, one patient (1/12; 8%) with soft tissue extension recurred, developed distant metastases, and subsequently died during follow up. Of the 44 patients with pT1 PC, six developed distant metastases and 13 (13/44; 30%) died during the follow-up period. One patient with APN and soft tissue extension recurred and died and no patient with APN and no soft tissue extension died. CONCLUSIONS: Patients with APN and extension into soft tissue have a clinical course similar to that of APN without soft tissue extension. APN with soft tissue extension is a different disease from pT1 disease with invasion of soft tissue. The pTis classification appears justified for APN with and without soft tissue extension.

9.
Science ; 385(6709): 651-656, 2024 Aug 09.
Article in English | MEDLINE | ID: mdl-39116250

ABSTRACT

The energetic disorder induced by fluctuating liquid environments acts in opposition to the precise control required for coherence-based sensing. Overcoming fluctuations requires a protected quantum subspace that only weakly interacts with the local environment. We report a ytterbium complex that exhibited an ultranarrow absorption linewidth in solution at room temperature with a full width at half maximum of 0.625 milli-electron volts. Using spectral hole burning, we measured an even narrower linewidth of 410 pico-electron volts at 77 kelvin. Narrow linewidths allowed low-field magnetic circular dichroism at room temperature, used to sense Earth-scale magnetic fields. These results demonstrated that ligand protection in lanthanide complexes could substantially diminish electronic state fluctuations. We have termed this system an "atomlike molecular sensor" (ALMS) and proposed approaches to improve its performance.

10.
Microbiol Resour Announc ; : e0026624, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39088317

ABSTRACT

Cladosporium and Epicoccum are cosmopolitan fungi of the class Dothideomycetes with few cultured and genomic representatives. Here, we report draft reference genome sequences of Epicoccum sp. F181 (GenBank accession number JAJSLS01), Cladosporium sp. F165 (JAJSLR01), and F190 (JAJSLT01) isolated from recycling and waste management facilities in New Zealand.

11.
Transl Vis Sci Technol ; 13(8): 30, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39163016

ABSTRACT

Purpose: Central retinal artery occlusion (CRAO) is an ocular emergency that results from acute blockage of the blood supply to the retina and leads to a sudden vision loss. Other forms of ischemic retinopathies include diabetic retinopathy (DR), which involves chronic retinal ischemia and remains the leading cause of blindness in working-age adults. This study is the first to conduct a proteomic analysis of aqueous humor (AH) from patients with CRAO with a comparative analysis using vitreous humor (VH) samples from patients with DR. Methods: AH samples were collected from 10 patients with CRAO undergoing paracentesis and 10 controls undergoing cataract surgery. VH samples were collected from 10 patients with DR and 10 non-diabetic controls undergoing pars plana vitrectomy (PPV). Samples were analyzed using mass spectrometry. Results: Compared with controls, AH levels of 36 differentially expressed proteins (DEPs) were identified in patients with CRAO. Qiagen Ingenuity Pathway Analysis (IPA) revealed 11 proteins linked to ophthalmic diseases. Notably, enolase 2, a glycolysis enzyme isoform primarily expressed in neurons, was upregulated, suggesting neuronal injury and enzyme release. Additionally, clusterin, a protective glycoprotein, was downregulated. ELISA was conducted to confirm proteomics data. VH samples from patients with DR exhibited changes in a distinct set of proteins, including ones previously reported in the literature. Conclusions: The study provides novel insights into CRAO pathophysiology with multiple hits identified. Proteomic results differed between DR and CRAO studies, likely due to the different pathophysiology and disease duration. Translational Relevance: This is the first proteomic analysis of CRAO AH, with the potential to identify future therapeutic targets.


Subject(s)
Aqueous Humor , Proteomics , Retinal Artery Occlusion , Humans , Aqueous Humor/metabolism , Aqueous Humor/chemistry , Proteomics/methods , Retinal Artery Occlusion/metabolism , Male , Female , Aged , Middle Aged , Eye Proteins/metabolism , Vitreous Body/metabolism , Vitrectomy , Phosphopyruvate Hydratase/metabolism , Paracentesis , Mass Spectrometry
12.
Hear Res ; 451: 109093, 2024 Sep 15.
Article in English | MEDLINE | ID: mdl-39094370

ABSTRACT

The discovery and development of electrocochleography (ECochG) in animal models has been fundamental for its implementation in clinical audiology and neurotology. In our laboratory, the use of round-window ECochG recordings in chinchillas has allowed a better understanding of auditory efferent functioning. In previous works, we gave evidence of the corticofugal modulation of auditory-nerve and cochlear responses during visual attention and working memory. However, whether these cognitive top-down mechanisms to the most peripheral structures of the auditory pathway are also active during audiovisual crossmodal stimulation is unknown. Here, we introduce a new technique, wireless ECochG to record compound-action potentials of the auditory nerve (CAP), cochlear microphonics (CM), and round-window noise (RWN) in awake chinchillas during a paradigm of crossmodal (visual and auditory) stimulation. We compared ECochG data obtained from four awake chinchillas recorded with a wireless ECochG system with wired ECochG recordings from six anesthetized animals. Although ECochG experiments with the wireless system had a lower signal-to-noise ratio than wired recordings, their quality was sufficient to compare ECochG potentials in awake crossmodal conditions. We found non-significant differences in CAP and CM amplitudes in response to audiovisual stimulation compared to auditory stimulation alone (clicks and tones). On the other hand, spontaneous auditory-nerve activity (RWN) was modulated by visual crossmodal stimulation, suggesting that visual crossmodal simulation can modulate spontaneous but not evoked auditory-nerve activity. However, given the limited sample of 10 animals (4 wireless and 6 wired), these results should be interpreted cautiously. Future experiments are required to substantiate these conclusions. In addition, we introduce the use of wireless ECochG in animal models as a useful tool for translational research.


Subject(s)
Acoustic Stimulation , Audiometry, Evoked Response , Auditory Pathways , Chinchilla , Cochlear Nerve , Photic Stimulation , Wakefulness , Wireless Technology , Animals , Cochlear Nerve/physiology , Wakefulness/physiology , Wireless Technology/instrumentation , Auditory Pathways/physiology , Audiometry, Evoked Response/methods , Models, Animal , Auditory Perception/physiology , Cochlea/physiology , Visual Perception , Time Factors
13.
Clin Cancer Res ; 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39087941

ABSTRACT

The optimal medical treatment of chemotherapy-ineligible patients affected by advanced soft tissue sarcomas is unclear. In this population, tyrosine kinase inhibitors (TKIs) represent an appealing alternative treatment strategy. First-line use of the TKI anlotinib in chemotherapy-ineligible soft tissue sarcoma patients showed promising activity across multiple histologies.

14.
Hip Int ; : 11207000241269285, 2024 Aug 11.
Article in English | MEDLINE | ID: mdl-39129272

ABSTRACT

BACKGROUND: Objective and subjective outcomes in the direct anterior approach (DAA) and posterior approach (PA) in total hip arthroplasty (THA) were assessed in this study, using the Oxford Hip Score (OHS) as primary outcome. Pain, 3 objective performance-based tests, surgical time, blood loss and length of stay were assessed as secondary outcomes. METHODS: Patients with primary end-stage osteoarthritis were prospectively enrolled by shared decision making for the DAA (32 patients) or PA (26 patients). Baseline data were collected preoperatively and outcomes postoperatively at 2-, 6-, 9- and 12-month follow-up. RESULTS: There is no significant difference (p < 0.05) between the DAA and PA on primary outcome (OHS). There was a main effect of time which indicated an increase of OHS over time independent of group (p < 0.01). CONCLUSIONS: In the current study, no significant differences in postoperative functional outcome were found between DAA and PA in all follow-up moments.

15.
Neurosurgery ; 2024 Aug 26.
Article in English | MEDLINE | ID: mdl-39185894

ABSTRACT

Global neurosurgery seeks to provide quality neurosurgical health care worldwide and faces challenges because of historical, socioeconomic, and political factors. To address the shortfall of essential neurosurgical procedures worldwide, dyads between established neurosurgical and developing centers have been established. Concerns have been raised about their effectiveness and ability to sustain capacity development. Successful partnerships involve multiple stakeholders, extended timelines, and twinning programs. This article outlines current initiatives and challenges within the neurosurgical community. This narrative review aims to provide a practical tool for colleagues embarking on clinical partnerships, the Engagements and assets, Capacity, Operative autonomy, Sustainability, and scalability (ECOSystem) of care. To create the ECOSystem of care in global neurosurgery, the authors had multiple online discussions regarding important points in the practical tool. All developed tiers were expanded based on logistics, clinical, and educational aspects. An online search was performed from August to November 2023 to highlight global neurosurgery partnerships and link them to tiers of the ECOSystem. The ECOSystem of care involves 5 tiers: Tiers 0 (foundation), 1 (essential), 2 (complexity), 3 (autonomy), and 4 (final). A nonexhaustive list of 16 neurosurgical partnerships was created and serves as a reference for using the ECOSystem. Personal experiences from the authors through their partnerships were also captured. We propose a tiered approach for capacity building that provides structured guidance for establishing neurosurgical partnerships with the ECOSystem of care. Clinical partnerships in global neurosurgery aim to build autonomy, enabling independent provision of quality healthcare services.

16.
J Control Release ; 374: 425-440, 2024 Aug 26.
Article in English | MEDLINE | ID: mdl-39103056

ABSTRACT

For medical emergencies, such as acute ischemic stroke, rapid drug delivery to the target site is essential. For many small molecule drugs, this goal is unachievable due to poor solubility that prevents intravenous administration, and less obviously, by extensive partitioning to plasma proteins and red blood cells (RBCs), which greatly slows delivery to the target. Here we study these effects and how they can be solved by loading into nanoscale drug carriers. We focus on fingolimod, a small molecule drug that is FDA-approved for treatment of multiple sclerosis, which has also shown promise in the treatment of stroke. Unfortunately, fingolimod has poor solubility and very extensive partitioning to plasma proteins and RBCs (in whole blood, 86% partitions to RBCs, 13.96% to plasma proteins, and 0.04% is free). We develop a liposomal formulation that slows the partitioning of fingolimod to RBCs and plasma proteins, enables intravenous delivery, and additionally prevents fingolimod toxicity to RBCs. The liposomal formulation nearly completely prevented fingolimod adsorption to plasma proteins (association with plasma proteins was 98.4 ± 0.4% for the free drug vs. 5.6 ± 0.4% for liposome-loaded drug). When incubated with whole blood in vitro, the liposomal formulation greatly slowed partitioning of fingolimod to RBCs and also eliminated deleterious effects of fingolimod on RBC rigidity, morphology, and hemolysis. In vivo, the liposomal formulation delayed fingolimod partitioning to RBCs for over 30 min, a critical time window for stroke. Fingolimod-loaded liposomes showed improved efficacy in a mouse model of post-stroke neuroinflammation, completely sealing the leaky blood-brain barrier (114 ± 11.5% reduction in albumin leak into the brain for targeted liposomes vs. 38 ± 16.5% reduction for free drug). This effect was only seen for liposomes modified with antibodies to enable targeted delivery to the site of action, and not in unmodified, long-circulating liposomes. Thus, loading fingolimod into liposomes prevented partitioning to RBCs and associated toxicities and enabled targeted delivery. This paradigm can be used for tuning the blood distribution of small molecule drugs for the treatment of acute illnesses requiring rapid pharmacologic intervention.

17.
Radiology ; 312(2): e240320, 2024 08.
Article in English | MEDLINE | ID: mdl-39189909

ABSTRACT

Background Large language models (LLMs) for medical applications use unknown amounts of energy, which contribute to the overall carbon footprint of the health care system. Purpose To investigate the tradeoffs between accuracy and energy use when using different LLM types and sizes for medical applications. Materials and Methods This retrospective study evaluated five different billion (B)-parameter sizes of two open-source LLMs (Meta's Llama 2, a general-purpose model, and LMSYS Org's Vicuna 1.5, a specialized fine-tuned model) using chest radiograph reports from the National Library of Medicine's Indiana University Chest X-ray Collection. Reports with missing demographic information and missing or blank files were excluded. Models were run on local compute clusters with visual computing graphic processing units. A single-task prompt explained clinical terminology and instructed each model to confirm the presence or absence of each of the 13 CheXpert disease labels. Energy use (in kilowatt-hours) was measured using an open-source tool. Accuracy was assessed with 13 CheXpert reference standard labels for diagnostic findings on chest radiographs, where overall accuracy was the mean of individual accuracies of all 13 labels. Efficiency ratios (accuracy per kilowatt-hour) were calculated for each model type and size. Results A total of 3665 chest radiograph reports were evaluated. The Vicuna 1.5 7B and 13B models had higher efficiency ratios (737.28 and 331.40, respectively) and higher overall labeling accuracy (93.83% [3438.69 of 3665 reports] and 93.65% [3432.38 of 3665 reports], respectively) than that of the Llama 2 models (7B: efficiency ratio of 13.39, accuracy of 7.91% [289.76 of 3665 reports]; 13B: efficiency ratio of 40.90, accuracy of 74.08% [2715.15 of 3665 reports]; 70B: efficiency ratio of 22.30, accuracy of 92.70% [3397.38 of 3665 reports]). Vicuna 1.5 7B had the highest efficiency ratio (737.28 vs 13.39 for Llama 2 7B). The larger Llama 2 70B model used more than seven times the energy of its 7B counterpart (4.16 kWh vs 0.59 kWh) with low overall accuracy, resulting in an efficiency ratio of only 22.30. Conclusion Smaller fine-tuned LLMs were more sustainable than larger general-purpose LLMs, using less energy without compromising accuracy, highlighting the importance of LLM selection for medical applications. © RSNA, 2024 Supplemental material is available for this article.


Subject(s)
Radiography, Thoracic , Retrospective Studies , Humans , Radiography, Thoracic/methods
18.
Insects ; 15(8)2024 Jul 30.
Article in English | MEDLINE | ID: mdl-39194783

ABSTRACT

Honey bees (Apis mellifera) provide a useful model for studying aging because of the differences in longevity between the relatively short-lived summer and long-lived winter bees, as well as bees lacking signs of cognitive senescence as they age. Bee brains were dissected from newly emerged, 14-day-, and 28-day- old bees in mid- and late summer, as well as brood nest bees in fall, winter, and spring, before, during, and after overwintering, respectively. Brains were examined with nuclear magnetic resonance (NMR) spectroscopy to analyze their metabolome. Nine variable importance in projection (VIP) variables were identified, primarily amino acids and choline derivatives. Differences in metabolite concentrations were found with different ages of summer bees, mostly between newly emerged and 14-day- old bees, such as a decrease in phenylalanine and an increase in ß-alanine, but there were also changes in older adults, such as o-phosphocholine that declined in 28-day- old bees. Differences in brood nest bees were observed, including a decline in tryptophan and an increase in ß-alanine. These may provide distinct metabolomic signatures with age and season. Such research holds promise for a better understanding of the complex interplays between bee physiology, development, and aging, which has implications for improving bee health and management.

19.
Mol Ecol ; : e17520, 2024 Aug 28.
Article in English | MEDLINE | ID: mdl-39205506

ABSTRACT

Animal gut microbiomes are critical to host physiology and fitness. The gut microbiomes of fishes-the most abundant and diverse vertebrate clade-have received little attention relative to other clades. Coral reef fishes, in particular, make up a wide range of evolutionary histories and feeding ecologies that are likely associated with gut microbiome diversity. The repeated evolution of herbivory in fishes and mammals also allows us to examine microbiome similarity in relationship to diet across the entire vertebrate tree of life. Here, we generate a large coral reef fish gut microbiome dataset (n = 499 samples, 19 species) and combine it with a diverse aggregation of public microbiome data (n = 447) to show that host diet drives significant convergence between coral reef fish and mammalian gut microbiomes. We demonstrate that this similarity is largely driven by carnivory and herbivory and that herbivorous and carnivorous hosts exhibit distinct microbial compositions across fish and mammals. We also show that fish and mammal gut microbiomes share prominent microbial taxa, including Ruminoccocus spp. and Akkermansia spp., and predicted metabolic pathways. Despite the major evolutionary and ecological differences between fishes and mammals, our results reveal that their gut microbiomes undergo similar dietary selective pressures. Thus, diet, in addition to phylosymbiosis must be considered even when comparing the gut microbiomes of distantly related hosts.

20.
Adapt Phys Activ Q ; : 1-20, 2024 Aug 28.
Article in English | MEDLINE | ID: mdl-39209293

ABSTRACT

This study examined doctoral students' occupational socialization experiences in U.S. adapted physical activity doctoral programs. Twenty-eight doctoral students were recruited and participated in semistructured, in-depth interviews. Interview transcripts were analyzed through a collaborative qualitative analysis, which resulted in the construction of four themes: (a) early socialization experiences foster a positive, but limited impression of physical education and physical activity; (b) doctoral education is pursued to have a greater impact on the disability community; (c) relationships with socializing agents provide support during doctoral education; and (d) coursework and learning in the community facilitate preparation for faculty roles. The findings indicate that there are several similarities between doctoral students and their peers in other doctoral degree programs. Some of these similarities point to issues that may concern prospective doctoral students and faculty members in adapted physical activity terminal degree programs.

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