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Tissue clay: an experimental model to evaluate its performance in soft tissue augmentation and its biologic fate.

Tissue clay (a mixture of autologous whole blood and microfibrillar collagen--Avitene) has been proposed as a medium for reconstruction in cosmetic and reconstructive deformities of the face. Its performance and biologic fate has not been evaluated experimentally. The current study employs a model using the rabbit pinna to determine, histologically, the fate of a tissue clay implant.

Animals↗

Predicting bandwidth in the high-performance liquid chromatographic separation of large biomolecules. II. A general model for the four common high-performance liquid chromatography methods.

A general model for describing gradient elution separations of peptides and proteins by reversed-phase high-performance liquid chromatography (HPLC) has been presented previously. This model has now been modified so that it can be applied to any of the four HPLC methods used for separating biological macromolecules: reversed-phase, ion-exchange, hydrophobic-interaction and size-exclusion chromatography, carried out in either an isocratic or gradient elution mode. The role of sample molecule structure and the particular column used has been further studied, so that previous empirical parameters for different column/sample choices can now be estimated from three physical properties of the sample and the column: sample molecular weight, native vs. denatured sample, column packing pore diameter. This eliminates much of the empiricism of our preceding model, and minimizes the number of experimental runs now required in order to apply the model in practice. The final model has been tested for several hundred runs involving peptides and proteins in the molecular weight range 600-162,000, all four of these HPLC methods, in both isocratic and gradient elution modes, and using data from several different laboratories (including our own). The model is able to predict bandwidth in HPLC separations of proteins and peptides with an accuracy of +/- 17% (1 standard deviation), for the case of "well-behaved" separations. Separations that are not "well-behaved" will give wider bands than predicted by the model.

Chemical Phenomena↗

Toward a model of dichotic listening performance.

Dichotic listening performance for different classes of speech sounds was examined under conditions of controlled attention. Consideration of the complex of target item and competing item demonstrated that, in general, targets were more accurately identified when the competing item shared no relevant features with it and less accurately identified when the competing item shared place, voice, or manner with the target item. Nasals as well as stops demonstrated a significant right-ear advantage (REA). False alarm rates were very similar for left and right attentional conditions, whereas intrusions from the right ear while attending to the left were far more common than intrusions from the left while attending to the right. Attention is viewed as serving to select the stimuli that will be reported, but at a late stage, and only after the right ear perceptual advantage has had its effect. A model of dichotic listening performance is proposed in which both the ease of localizing the item and the strength of evidence for the presence of the item are relevant factors.

Adult↗

Mesenchymal stem cells are superior to angiogenic growth factor genes for improving myocardial performance in the mouse model of acute myocardial infarction.

Both cell therapy and angiogenic growth factor gene therapy have been applied to animal studies and clinical trials. Little is known about the direct comparison between cell therapy and angiogenic growth factor gene therapy. The goal of this study was to compare the effects of human bone marrow-derived mesenchymal stem cells (hMSCs) transplantation and injection of angiogenic growth factor genes in a model of acute myocardial infarction in mice. The hMSCs were obtained from adult human bone marrow and expanded in vitro. The purity and characteristics of hMSCs were identified by flow cytometry and immunophenotyping. Immediately after ligation of the left anterior descending coronary artery in male severe combined immunodeficient (SCID) mice, culture-expanded hMSCs or angiogenic growth factor genes were injected intramuscularly at the left anterior free wall. The engrafted hMSCs were positive for cardiac marker, desmin. Infarct size was significantly smaller in the hMSCs-treated group than in the angiopoietin-1 (Ang-1) or vascular endothelial growth factor (VEGF)-treated group at day 28 after infarction. hMSCs transplantation was better in decreasing left ventricular end-diastolic dimension and increasing fractional shortening than Ang1 or VEGF gene therapy. Capillary density was markedly increased after hMSCs transplantation than Ang1 and VEGF gene therapy. In conclusion, intramyocardial transplantation of hMSCs improves cardiac function after acute myocardial infarction through enhancement of angiogenesis and myogenesis in the ischemic myocardium. hMSCs are superior to angiogenic growth factor genes for improving myocardial performance in the mouse model of acute myocardial infarction. Transplantation of MSCs may become the future therapy for acute myocardial infarction for myocardial regeneration.

Angiopoietin-1↗

A comparison of three techniques for rapid model development: an application in patient risk-stratification.

Accurately risk-stratifying patients is a key component of health care outcomes assessment. And, many health care organizations increasingly are relying upon automated means for assistance in making patient risk-stratification decisions. Unfortunately, the process of outcome model development, as it is currently practiced, is both time consuming and difficult. We investigated the relative abilities of three modeling techniques (logistic regression, artificial neural network (ANN), and Bayesian) to rapidly develop models for risk-stratifying patients. Our results demonstrated that all three modeling techniques perform equally well in certain situations. However, the Bayesian model with conditional independence had the best overall performance. Unfortunately, none of the models were able to achieve the degree of accuracy which would be required in a medical setting.

APACHE↗

TLINKAGE-IMPRINT: a model-based approach to performing two-locus genetic imprinting analysis.

OBJECTIVES: Imprinting refers to the expression of only one copy of a gene pair, which is determined by the parental origin of the copy. Imprinted genes play a role in the development of several complex diseases, including cancers and mental disorders. In certain situations, two-trait-loci models are shown to be more powerful than one-trait-locus models. However, no current methods use pedigree structure efficiently and perform two-locus imprinting analyses. In this paper, we apply the Elston-Stewart algorithm to the parametric two-trait-loci imprinting model used by Strauch et al. [2000] to obtain a method for qualitative trait linkage analyses that explicitly models imprinting and can be applied to large pedigrees. METHODS: We considered a parametric approach based on 4 x 4 penetrance matrix to account for imprinting and modified TLINKAGE software to implement this approach. We performed simulation studies using a small and a large pedigree under dominant and imprinted and dominant or imprinted scenarios. Furthermore, we developed a likelihood ratio-based test for imprinting that compares the logarithm of odds (LOD) score obtained using the two-locus imprinting model with that obtained using the standard two-locus model that does not allow for imprinting. RESULTS: In simulation studies of three scenarios where the true mode of inheritance included imprinting, accurate modeling through the proposed approach yielded higher LOD scores and better recombination fraction estimates than the traditional two-locus model that does not allow for imprinting. CONCLUSIONS: This imprinting model will be useful in identifying the genes responsible for several complex disorders that are potentially caused by a combination of imprinted and non-imprinted genes.

Algorithms↗

Detection of cytokine release syndrome using wearables and cytokine profiling following CAR-T therapy for myeloma.

BACKGROUNDChimeric antigen receptor T-cell (CAR-T) therapies have revolutionized treatment for relapsed/refractory multiple myeloma (RRMM). However, cytokine release syndrome (CRS), a common and potentially severe complication, requires inpatient monitoring, limiting access and increasing costs. Wearable devices could support outpatient CAR-T delivery, but feasibility for CRS detection versus standard care remains unproven.METHODSWe conducted a prospective, single-center observational pilot study to assess the feasibility of using wearable devices for monitoring vital signs and detecting CRS. Thirty patients receiving idecabtagene vicleucel (ide-cel) or ciltacabtagene autoleucel (cilta-cel) were enrolled; 25 with sufficient monitoring data were evaluable. Sensors collected skin and axillary temperature, oxygen saturation, respiratory and heart rate, and motion. Peripheral blood cytokines were analyzed pre- and postinfusion using a multiplex proteomic platform. The primary outcome was feasibility, assessed by CRS detection sensitivity and specificity; secondary outcomes included adherence, lead time, and performance of models integrating wearable and cytokine data.RESULTSCRS occurred in 20 of 25 patients. The best-performing wearable model detected 18 or 20 CRS episodes with a sensitivity of 0.72 (mean 0.75; 95% CI 0.60-0.91) and a specificity of 0.80 (mean 0.76; 95% CI 0.68-0.84), and a median lead time of 7:00 hours before nursing recognition. Median adherence during high-risk periods was 71%. Cytokine changes paralleled temperature elevations, and IFN-γ emerged as a consistent biomarker.CONCLUSIONWearable devices are feasible for early CRS detection and may support outpatient CAR-T care. Larger outpatient studies are warranted.TRIAL REGISTRATIONThis study did not meet the criteria for ClinicalTrials.gov registration.

Humans↗

Performance contracting: the Colorado model.

Through a process of negotiation between a community mental health centers association (CMHCA) and the state division of mental health (DMH), a performance contracting system has created entrepreneurial freedom for the mental health centers while still providing adequate controls by the DMH.

Colorado↗

Identification of a novel human gut microbes and microbial metabolites related genes signature for prognostic implication in head and neck squamous carcinomas.

BACKGROUND: The gut microbiota acts as a critical driver influencing the pathogenesis, therapeutic response, and clinical outcomes across various cancer types. This study aimed to investigate the prognostic value of human gut microbes and microbial metabolites related genes (HGMMMRGs) in head and neck squamous cell carcinoma (HNSCC). METHODS: We constructed a prognostic risk model comprising 19 core HGMMMRGs using LASSO penalized regression and a multivariate Cox proportional hazards model. The predictive performance of the model was evaluated through Kaplan-Meier analysis, receiver operating characteristic (ROC) curves, nomograms, and concordance index. In addition, functional enrichment analysis was performed on the differentially expressed risk genes. Furthermore, the relationship between the immune microenvironment of HNSCC and the risk diagnostic model was examined. Western blot analysis was used to assess the expression levels of IL10 in both HNSCC tissues and adjacent normal tissues. Finally, the correlation between IL10 and the gut microbiota was explored. RESULTS: This study developed a risk score model integrating 19 HGMMMRG genes, which can serve as a tool to guide prognosis and immune microenvironment assessment in HNSCC patients. Survival analysis showed that patients in the high-risk group had significantly worse outcomes (P&#x2009;<&#x2009;0.05). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed significant enrichment of differentially expressed genes (DRLs) and immune-related pathways. Western blot analysis further confirmed that IL10 was highly expressed in HNSCC, and the abundance of Faecalibacterium prausnitzii and Enterococcus durans colonies was correlated with IL10 expression. CONCLUSION: We developed a prognostic model for HGMMMRGs that can be effectively used to predict OS in patients with HNSCC. Second, Faecalibacterium prausnitzii and Enterococcus durans can influence the prognosis of patients with HNSCC by mediating the expression IL10 and thereby affecting the prognosis of HNSCC patients. Thus, human gut microbes and microbial metabolite-related genes may be another promising strategy for the treatment of patients with HNSCC.

HNSCC↗

Research on identification of key genes and immune-metabolic mechanisms in atrial fibrillation through integrated multi-cohort transcriptomic analysis and machine learning.

This study aimed to integrate multiple datasets for the identification of atrial fibrillation (AF)-related differentially expressed genes (DEGs), analyze their underlying mechanisms through functional enrichment and machine learning, construct diagnostic models, and explore immune-metabolic interactions to provide novel biomarkers and theoretical foundations. Gene expression datasets were integrated and normalized, with batch effects removed using principal component analysis. Differential expression analysis, functional enrichment analysis (Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways), and machine learning-based feature gene selection and model construction were performed. Shapley additive explanations analysis was utilized to interpret the constructed models, while gene set enrichment analysis, gene set variation analysis, and immune cell infiltration analysis were conducted to investigate the associations between feature genes and immune infiltration. After integrating and normalizing gene expression data and eliminating batch effects via principal component analysis, 6 DEGs were identified, including 4 upregulated and 2 down-regulated ones. Functional enrichment analysis showed these DEGs were significantly enriched in neuro-related biological processes and pathways, indicating their key roles in AF pathogenesis. Five key feature genes were selected using LASSO, random forest, and support vector machine-recursive feature elimination algorithms. They had significant expression differences between the AF and control groups (P&#x2005;<&#x2005;.001) and were located on distinct chromosomes. The constructed random forest and support vector machine models performed excellently (area under the curve&#x2005;&#x2265;&#x2005;0.85). Shapley additive explanations analysis revealed TNNI1 contributed most to model prediction, with its expression significantly positively correlated with immune cell infiltration. Gene set enrichment analysis and gene set variation analysis analyses further showed feature genes participated in AF pathogenesis by regulating immune modulation, metabolic pathways, and autophagy. Immune cell infiltration analysis found altered proportions of T-cell subsets and M0 macrophages in the AF group, along with complex links between feature gene expression and immune cell function. This study systematically elucidated the unique gene expression patterns and key regulatory pathways associated with AF, clarifying the crucial roles of feature genes in immune regulation, metabolic imbalance, and cellular dysfunction. These findings provide a theoretical basis and potential therapeutic targets for understanding AF pathogenesis and developing targeted treatment strategies.

Atrial Fibrillation↗

A three-gene radioresistance signature predicts tumor progression in cervical cancer.

BACKGROUND: As a primary curative treatment for locally advanced cervical cancer, radiotherapy is frequently undermined by radioresistant tumor cells that evade cell death and subsequently drive post-treatment tumor progression. This study aimed to identify candidate genes associated with radioresistance in cervical cancer and to explore their potential in predicting unfavorable outcomes among radioresistant patients, thereby providing a reference for future research. METHODS: We screened for co-expressed genes using transcriptomic data from radiation non-complete response (NCR) cervical cancer patients in Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Cox regression analyses were conducted to identify the most significant radioresistance-associated genes for constructing a prognostic model. The predictive performance of this model was further validated through logistic regression, weighted gene co-expression network analysis (WGCNA), and pan-cancer analyses. Quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) was performed to quantify the expression levels of key genes in cervical cancer tissue samples from radiosensitive and radioresistant patients. RESULTS: The resulting prognostic model comprised three genes: MTMR11, VANGL1, and CD46. This gene panel was significantly associated with the prognosis of cervical cancer patients receiving radiotherapy and showed acceptable predictive performance across multiple cancer types. qRT-PCR analysis revealed that the expression patterns of MTMR11 and VANGL1 were generally consistent with radioresistance of cervical cancer, whereas CD46 exhibited an unexpected expression trend. CONCLUSIONS: Our findings indicate that MTMR11, VANGL1, and CD46 are associated with radioresistance and prognosis in cervical cancer. Their potential clinical utility, especially in predicting radiotherapy response at the individual patient level, requires further validation in larger, independent, and prospective cohorts.

Cervical cancer↗

Assessment of basic human performance resources predicts performance of ureteroscopy.

BACKGROUND: Our objective was to predict endoscopic performance in a cadaver model using basic performance resources (BPRs) measurements. METHODS: Medical students (n = 16) underwent intense ureteroscopic training on a virtual reality ureteroscopy trainer and were rated on performing ureteroscopy on a cadaver. The medical students also underwent 13 validated BPR measurements. Urology residents also performed cadaveric ureteroscopy and BPRs. A predictive model built from urology residents' (n = 16) BPRs and performance assessment was used to predict medical student cadaveric ureteroscopy performance based on their BPRs alone. RESULTS: The predictive model built with urology residents predicted the ureteroscopic performance of 10 of 16 medical students within 15% of their rated ureteroscopic performance on the cadaver. CONCLUSIONS: A predictive model built with urology residents can moderately predict the ureteroscopic performance of medical students from BPRs. Additional in vivo evaluation is required.

Adult↗

The role of knowledge of results frequency in learning through observation.

The authors examined whether reduced knowledge of results (KR) frequency during observation of a model's performance enhances learning. As they viewed a timing task, observers (n = 54) received KR about the model's performance on each trial (100% KR) or on 1 out of 3 trials (33% KR). Controls (n = 18) received only physical practice; they did not take part in the observation session. The authors also wanted to dissociate the guidance effect of KR during physical practice from the guidance role played by the representation acquired during observation. Therefore, following the observation phase, participants physically performed the task with either the same or a different KR frequency than that experienced during observation. The effects of observation and physical practice on learning were assessed in delayed retention tests. The beneficial effect of reduced KR frequency during observation continued for the following physical practice phases. Possible explanations as to why KR influences observational learning are discussed.

Adult↗

Observational learning: effects of bandwidth knowledge of results.

The authors investigated whether bandwidth knowledge of results (KR) during observation of a model's performance enhances motor skill learning. Following a pretest, 2 groups of participants (N = 28) observed a model practicing a timing task. The bandwidth group received KR about the model's performance only when his performance fell outside the criteria for a correct response. The yoked group received KR on the same trials as the bandwidth group did but were not told that the KR was only about incorrect performances. In that way, the authors avoided a confound between bandwidth and relative frequency effects on performance and learning. Following the observation phase, both groups of participants performed 10-min and 24-hr retention tests. Bandwidth KR enabled that group to reduce its performance variability and, to a lesser extent, to enhance its performance accuracy. The authors discuss the results with respect to the powerful effect of qualitative KR through observation.

Adult↗

Aging performance of a compliant layer bearing acetabular prosthesis in an ovine hip arthroplasty model.

The wear performance of a polyurethane compliant layer (CL) material formed into an acetabular component and implanted into a sheep model of cemented total hip arthroplasty was assessed at 6, 12, 24, and 48 months. Four (11%) of 36 acetabular components debonded from the cement and one component was slightly loose at the cement-bone interface. There was no macroscopic evidence of fracture, wear, or deformation of the CL material on the articular surface of the acetabular components. Small numbers of polymeric wear particles was found in the hip synovial tissues of 10 sheep, most commonly in the early time groups, and were likely associated with initial wear of surface asperities. The wear performance of the CL was unchanged during a 48-month implantation period.

Acetabulum↗

Confidence interval estimates of an index of quality performance based on logistic regression models.

This paper considers an index of hospital quality performance defined as the ratio of the observed number deaths to the number predicted by a fitted logistic regression model. We study tests and confidence intervals under two different scenarios depending on the availability of an estimate of the covariance matrix of the coefficients from the fitted logistic regression model. We propose parametric as well as bootstrap-based confidence intervals. We apply the methods to an analysis of the performance of 27 intensive care units.

Aged↗