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1.
Nat Microbiol ; 9(4): 1021-1035, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38553608

RESUMEN

Gas vesicles (GVs) are microbial protein organelles that support cellular buoyancy. GV engineering has multiple applications, including reporter gene imaging, acoustic control and payload delivery. GVs often cluster into a honeycomb pattern to minimize occupancy of the cytosol. The underlying molecular mechanism and the influence on cellular physiology remain unknown. Using genetic, biochemical and imaging approaches, here we identify GvpU from Priestia megaterium as a protein that regulates GV clustering in vitro and upon expression in Escherichia coli. GvpU binds to the C-terminal tail of the core GV shell protein and undergoes a phase transition to form clusters in subsaturated solution. These properties of GvpU tune GV clustering and directly modulate bacterial fitness. GV variants can be designed with controllable sensitivity to GvpU-mediated clustering, enabling design of genetically tunable biosensors. Our findings elucidate the molecular mechanisms and functional roles of GV clustering, enabling its programmability for biomedical applications.


Asunto(s)
Orgánulos , Proteínas , Bacterias
2.
Evolution ; 78(1): 195-208, 2024 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-37996091

RESUMEN

In males of many vertebrate species, sexual selection has led to the evolution of sexually dimorphic traits, which are often developmentally controlled by androgen signaling involving androgen response elements (AREs). Evolutionary changes in the number and genomic locations of AREs can modify patterns of receptor regulation and potentially alter gene expression. Here, we use recently sequenced primate genomes to evaluate the hypothesis that the strength of sexual selection is related to the genome-wide number of AREs in a diversifying lineage. In humans, we find a higher incidence of AREs near male-biased genes and androgen-responsive genes when compared with randomly selected genes from the genome. In a set of primates, we find that gains or losses of AREs proximal to genes are correlated with changes in male expression levels and the degree of sex-biased expression of those genes. In a larger set of primates, we find that an increase in one indicator of sexual selection, canine size sexual dimorphism, is correlated with genome-wide ARE counts. Our results suggest that the responsiveness of the genome to androgens in humans and their close relatives has been shaped by sexual selection that arises from competition among males for mating access to females.


Asunto(s)
Andrógenos , Caracteres Sexuales , Femenino , Humanos , Masculino , Animales , Perros , Primates/genética , Elementos de Respuesta , Proliferación Celular
3.
Artículo en Inglés | MEDLINE | ID: mdl-38100649

RESUMEN

Trust is vital to public confidence in health and science, yet there is no consensus on the most useful way to conceptualize, define, measure, or intervene on trust and its related constructs (e.g., mistrust, distrust, and trustworthiness). In this review, we synthesize literature from this wide-ranging field that has conceptual roots in racism, marginalization, and other forms of oppression. We summarize key definitions and conceptual frameworks and offer guidance to scholars aiming to measure these constructs. We also review how trust-related constructs are associated with health outcomes, describe interventions in this field, and provide recommendations for building trust and institutional trustworthiness and advancing health equity. We ultimately call for future efforts to focus on improving the trustworthiness of public health professionals, scientists, health care providers, and systems instead of aiming to increase trust in these entities as they currently exist and behave. Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

4.
Cogn Sci ; 47(12): e13388, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-38103208

RESUMEN

The meaning of most words in language depends on their context. Understanding how the human brain extracts contextualized meaning, and identifying where in the brain this takes place, remain important scientific challenges. But technological and computational advances in neuroscience and artificial intelligence now provide unprecedented opportunities to study the human brain in action as language is read and understood. Recent contextualized language models seem to be able to capture homonymic meaning variation ("bat", in a baseball vs. a vampire context), as well as more nuanced differences of meaning-for example, polysemous words such as "book", which can be interpreted in distinct but related senses ("explain a book", information, vs. "open a book", object) whose differences are fine-grained. We study these subtle differences in lexical meaning along the concrete/abstract dimension, as they are triggered by verb-noun semantic composition. We analyze functional magnetic resonance imaging (fMRI) activations elicited by Italian verb phrases containing nouns whose interpretation is affected by the verb to different degrees. By using a contextualized language model and human concreteness ratings, we shed light on where in the brain such fine-grained meaning variation takes place and how it is coded. Our results show that phrase concreteness judgments and the contextualized model can predict BOLD activation associated with semantic composition within the language network. Importantly, representations derived from a complex, nonlinear composition process consistently outperform simpler composition approaches. This is compatible with a holistic view of semantic composition in the brain, where semantic representations are modified by the process of composition itself. When looking at individual brain areas, we find that encoding performance is statistically significant, although with differing patterns of results, suggesting differential involvement, in the posterior superior temporal sulcus, inferior frontal gyrus and anterior temporal lobe, and in motor areas previously associated with processing of concreteness/abstractness.


Asunto(s)
Inteligencia Artificial , Mapeo Encefálico , Humanos , Mapeo Encefálico/métodos , Encéfalo/fisiología , Lenguaje , Semántica
5.
Genome Res ; 2023 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-37989601

RESUMEN

Sex chromosome dosage compensation is a model to understand the coordinated evolution of transcription; however, the advanced age of the sex chromosomes in model systems makes it difficult to study how the complex regulatory mechanisms underlying chromosome-wide dosage compensation can evolve. The sex chromosomes of Poecilia picta have undergone recent and rapid divergence, resulting in widespread gene loss on the male Y, coupled with complete X Chromosome dosage compensation, the first case reported in a fish. The recent de novo origin of dosage compensation presents a unique opportunity to understand the genetic and evolutionary basis of coordinated chromosomal gene regulation. By combining a new chromosome-level assembly of P. picta with whole-genome bisulfite sequencing and RNA-seq data, we determine that the YY1 transcription factor (YY1) DNA binding motif is associated with male-specific hypomethylated regions on the X, but not the autosomes. These YY1 motifs are the result of a recent and rapid repetitive element expansion on the P. picta X Chromosome, which is absent in closely related species that lack dosage compensation. Taken together, our results present compelling support that a disruptive wave of repetitive element insertions carrying YY1 motifs resulted in the remodeling of the X Chromosome epigenomic landscape and the rapid de novo origin of a dosage compensation system.

6.
Ophthalmic Physiol Opt ; 43(6): 1326-1336, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37622450

RESUMEN

PURPOSE: To determine whether a typical vision therapy (VT) programme designed to improve visual information processing (VIP) skills is effective in improving these skills and/or academic performance. METHODS: We used a double-blind, randomised clinical trial to compare VIP VT to placebo training. Participating schools referred a sample of 579 early primary school children identified as being within the lower third of their class for literacy. From the referred sample, we identified 247 children eligible to participate (passed visions and auditory processing screening, and VIP performance <34th percentile), 94 of whom participated. Matching IQ, school grade and sex was achieved by sorting hierarchically on these values and then alternately allocating to VT or placebo groups. Both programmes ran for 10 weeks and consisted of 33 h working at home and 4 h working in office. The VT programme was indicative of that employed in Australian paediatric optometry practices, with the placebo programme containing similar activities, except targeting skills within a child's competencies and with specific VIP development activities removed. The main outcome measures were score change on three standardised educational tests (reading comprehension, spelling and mathematics) and six VIP tests, both immediately post-intervention (PI) and 6 months later. RESULTS: Sixty-nine children completed the programmes. The VT programme produced no significant improvement in the three educational tests or in five of the six VIP tests compared to the control. The VT programme improved visual sequential memory (VSM) by a moderate amount compared to the control (Cohen's d = 0.57 and 0.52, immediately PI and at 6 months, respectively: p < 0.03 and p < 0.02). CONCLUSIONS: The VIP and academic performance benefits from a VT programme were largely identical to those from a control programme, both immediately and 6-month PI. Placebo effects and general effects such as improvements in executive function and/or regression-to-the-mean could be mistaken for specific programme effectiveness.

7.
Integr Comp Biol ; 63(4): 960-967, 2023 10 10.
Artículo en Inglés | MEDLINE | ID: mdl-37591671

RESUMEN

What are the implications of misunderstanding sex as a binary, and why is it essential for scientists to incorporate a more expansive view of biological sex in our teaching and research? This roundtable will include many of our symposium speakers, including biologists and intersex advocates, to discuss these topics and visibilize the link between ongoing reification of dyadic sex within scientific communities and the social, political, and medical oppression faced by queer, transgender, and especially intersex communities. As with the symposium as a whole, this conversation is designed to bring together empirical research and implementation of equity, inclusion, and justice principles, which are often siloed into separate rooms and conversations at academic conferences. Given the local and national attacks on the rights of intersex individuals and access to medical care and bodily autonomy, this interdisciplinary discussion is both timely and urgent.


Asunto(s)
Trastornos del Desarrollo Sexual , Personas Transgénero , Animales , Humanos , Biología
8.
Am Nat ; 202(3): 241-259, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37606950

RESUMEN

AbstractAcross the animal kingdom there are myriad forms within a sex across, and even within, species, rendering concepts of universal sex traits moot. The mechanisms that regulate the development of these trait differences are varied, although in vertebrates, common pathways involve gonadal steroid hormones. Gonadal steroids are often associated with heteromorphic trait development, where the steroid found at higher circulating levels is the one involved in trait development for that sex. Occasionally, there are situations in which a gonadal steroid associated with heteromorphic trait development in one sex is involved in heteromorphic or monomorphic trait development in another sex. We propose a verbal hypothesis, the ancestral modulation hypothesis (AMH), that uses the evolutionary history of the trait-particularly which sex ancestrally possessed higher trait values-to predict the regulatory pathway that governs trait expression. The AMH predicts that the genomic architecture appears first to resolve sexual conflict in an initially monomorphic trait. This architecture takes advantage of existing sex-biased signals, the gonadal steroid pathway, to generate trait heteromorphism. In cases where the other sex experiences evolutionary pressure for the new phenotype, that sex will co-opt the existing architecture by altering its signal to match that of the original high-trait-value sex. We describe the integrated levels needed to produce this pattern and what the expected outcomes will be given the evolutionary history of the trait. We present this framework as a testable hypothesis for the scientific community to investigate and to create further engagement and analysis of both ultimate and proximate approaches to sexual heteromorphism.


Asunto(s)
Evolución Biológica , Genómica , Animales , Fenotipo , Sexismo
9.
Ophthalmic Physiol Opt ; 43(5): 1211-1222, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37306319

RESUMEN

INTRODUCTION: Vision standards for driving are typically based on visual acuity, despite evidence that it is a poor predictor of driving safety and performance. However, visual motion perception is potentially relevant for driving, as the vehicle and surroundings are in motion. This study explored whether tests of central and mid-peripheral motion perception better predict performance on a hazard perception test (HPT), which is related to driving performance and crash risk, than visual acuity. Additionally, we explored whether age influences these associations, as healthy ageing impairs performance on some motion sensitivity tests. METHODS: Sixty-five visually healthy drivers (35 younger, mean age: 25.5; SD 4.3 years; 30 older adults, mean age: 71.0; SD 5.4 years) underwent a computer-based HPT, plus four different motion sensitivity tests both centrally and at 15° eccentricity. Motion tests included minimum displacement to identify motion direction (Dmin ), contrast detection threshold for a drifting Gabor (motion contrast), coherence threshold for a translational global motion stimulus and direction discrimination for a biological motion stimulus in the presence of noise. RESULTS: Overall, HPT reaction times were not significantly different between age groups (p = 0.40) nor were maximum HPT reaction times (p = 0.34). HPT response time was associated with motion contrast and Dmin centrally (r = 0.30, p = 0.02 and r = 0.28, p = 0.02, respectively) and with Dmin peripherally (r = 0.34, p = 0.005); these associations were not affected by age group. There was no significant association between binocular visual acuity and HPT response times (r = 0.02, p = 0.29). CONCLUSIONS: Some measures of motion sensitivity in central and mid-peripheral vision were associated with HPT response times, whereas binocular visual acuity was not. Peripheral testing did not show an advantage over central testing for visually healthy older drivers. Our findings add to the growing body of evidence that the ability to detect small motion changes may have potential to identify unsafe road users.


Asunto(s)
Conducción de Automóvil , Percepción de Movimiento , Humanos , Anciano , Adulto , Percepción de Movimiento/fisiología , Agudeza Visual , Percepción Visual/fisiología , Visión Ocular , Tiempo de Reacción/fisiología
10.
Health Serv Res ; 58 Suppl 2: 218-228, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37279782

RESUMEN

OBJECTIVE: To assess whether knowledge of Tuskegee, the U.S. Immigration and Customs Enforcement (ICE) agency's detainment of children, and satisfaction with the George Floyd death investigation were associated with trust in actors involved in the development and distribution of coronavirus vaccines. DATA SOURCES AND STUDY SETTING: National survey with a convenience sample of Black (n = 1019) and Hispanic (n = 994) adults between July 1 and 26, 2021. STUDY DESIGN: Observational study using stratified adjusted logistic regression models to measure the association between ratings of the trustworthiness of actors involved in the development and distribution of coronavirus vaccines. PRINCIPAL FINDINGS: Among Black respondents, lower satisfaction with the George Floyd death investigation was associated with lower trustworthiness ratings of pharmaceutical companies (ME: -0.09; CI: -0.15, 0.02), the FDA (ME: -0.07; CI: -0.14, -0.00), the Trump Administration (ME: -0.09; CI: -0.16, -0.02), the Biden Administration (ME: -0.07, CI: -0.10, 0.04), and elected officials (ME: -0.10, CI: -0.18, -0.03). Among Hispanic respondents, lower satisfaction was associated with lower trustworthiness ratings of the Trump Administration (ME: -0.14, CI: -0.22, -0.06) and elected officials (ME: -0.11; CI: -0.19, -0.02). Greater knowledge of ICE's detainment of children and families among Hispanic respondents was associated with lower trustworthiness ratings of state elected officials (ME: -0.09, CI: -0.16, 0.01). Greater knowledge of the US Public Health Service Study of Syphilis in Tuskegee was associated with higher trustworthiness ratings of their usual source of care (ME: 0.09; CI: 0.28, 0.15) among Black respondents (ME: 0.09; CI: 0.01, 0.16). CONCLUSIONS: Among Black respondents, lower satisfaction with the George Floyd death investigation was associated with lowered levels of trust in pharmaceutical companies, some government officials, and administrators; it was not associated with the erosion of trust in direct sources of health care delivery, information, or regulation. Among Hispanic respondents, greater knowledge of the ICE detainments was associated with lower trustworthiness ratings of elected state officials. Paradoxically, higher knowledge of the Study of Syphilis in Tuskegee was associated with higher trustworthiness ratings in usual sources of care.


Asunto(s)
COVID-19 , Sífilis , Vacunas , Adulto , Niño , Humanos , Confianza , Pandemias/prevención & control , Preparaciones Farmacéuticas
11.
Ann Biomed Eng ; 51(10): 2289-2300, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37357248

RESUMEN

Methods for statistically analyzing patient-specific data that vary both spatially and over time are currently either limited to summary statistics or require elaborate surface registration. We propose a new method, called correspondence-based network analysis, which leverages particle-based shape modeling to establish correspondence across a population and preserve patient-specific measurements and predictions through statistical analysis. Herein, we evaluated this method using three published datasets of the hip describing cortical bone thickness of the proximal femur, cartilage contact stress, and dynamic joint space between control and patient cohorts to evaluate activity- and group-based differences, as applicable, using traditional statistical parametric mapping (SPM) and our proposed spatially considerate correspondence-based network analysis approach. The network approach was insensitive to correspondence density, while the traditional application of SPM showed decreasing area of the region of significance with increasing correspondence density. In comparison to SPM, the network approach identified broader and more connected regions of significance for all three datasets. The correspondence-based network analysis approach identified differences between groups and activities without loss of subject and spatial specificity which could improve clinical interpretation of results.


Asunto(s)
Hueso Cortical , Fémur , Humanos , Extremidad Inferior , Articulaciones
12.
JAMA ; 329(19): 1682-1692, 2023 05 16.
Artículo en Inglés | MEDLINE | ID: mdl-37191700

RESUMEN

Importance: Health inequities exist for racial and ethnic minorities and persons with lower educational attainment due to differential exposure to economic, social, structural, and environmental health risks and limited access to health care. Objective: To estimate the economic burden of health inequities for racial and ethnic minority populations (American Indian and Alaska Native, Asian, Black, Latino, and Native Hawaiian and Other Pacific Islander) and adults 25 years and older with less than a 4-year college degree in the US. Outcomes include the sum of excess medical care expenditures, lost labor market productivity, and the value of excess premature death (younger than 78 years) by race and ethnicity and the highest level of educational attainment compared with health equity goals. Evidence Review: Analysis of 2016-2019 data from the Medical Expenditure Panel Survey (MEPS) and state-level Behavioral Risk Factor Surveillance System (BRFSS) and 2016-2018 mortality data from the National Vital Statistics System and 2018 IPUMS American Community Survey. There were 87 855 survey respondents to MEPS, 1 792 023 survey respondents to the BRFSS, and 8 416 203 death records from the National Vital Statistics System. Findings: In 2018, the estimated economic burden of racial and ethnic health inequities was $421 billion (using MEPS) or $451 billion (using BRFSS data) and the estimated burden of education-related health inequities was $940 billion (using MEPS) or $978 billion (using BRFSS). Most of the economic burden was attributable to the poor health of the Black population; however, the burden attributable to American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander populations was disproportionately greater than their share of the population. Most of the education-related economic burden was incurred by adults with a high school diploma or General Educational Development equivalency credential. However, adults with less than a high school diploma accounted for a disproportionate share of the burden. Although they make up only 9% of the population, they bore 26% of the costs. Conclusions and Relevance: The economic burden of racial and ethnic and educational health inequities is unacceptably high. Federal, state, and local policy makers should continue to invest resources to develop research, policies, and practices to eliminate health inequities in the US.


Asunto(s)
Escolaridad , Estrés Financiero , Inequidades en Salud , Accesibilidad a los Servicios de Salud , Determinantes Sociales de la Salud , Adulto , Humanos , Etnicidad/estadística & datos numéricos , Estrés Financiero/epidemiología , Estrés Financiero/etnología , Estrés Financiero/etiología , Grupos Minoritarios/estadística & datos numéricos , Estados Unidos/epidemiología , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Determinantes Sociales de la Salud/economía , Determinantes Sociales de la Salud/etnología , Determinantes Sociales de la Salud/estadística & datos numéricos , Costo de Enfermedad , Indio Americano o Nativo de Alaska/estadística & datos numéricos , Asiático Americano Nativo Hawáiano y de las Islas del Pacífico/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Negro o Afroamericano/estadística & datos numéricos
13.
Health Aff (Millwood) ; 42(5): 693-701, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37126750

RESUMEN

Black Americans in the US South have high rates of preventable heart failure hospitalizations, which reflects systemic inequities that also produce economic costs. We measured the direct medical costs of disparities in preventable heart failure admissions (that is, excess admissions) among Medicare beneficiaries living in six states in the US South (Kentucky, Arkansas, Florida, Georgia, Mississippi, and North Carolina). We used 2015-17 data from the Healthcare Cost and Utilization Project and constructed negative binomial models with state-level fixed effects to calculate adjusted admission rates with heart failure as the principal diagnosis. We calculated the number of these admissions that would have been avoided if Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native Medicare beneficiaries had the same admission rates as White beneficiaries. We found 28,213 excess admissions (48 percent excess) with $60,845,855 annual costs among Black beneficiaries, 3,499 (14 percent excess) with $8,179,381 annual costs among Hispanic beneficiaries, and 550 (51 percent excess) with $1,093,472 in annual costs among American Indian/Alaska Native beneficiaries. Failure to address heart failure treatment inequities in the community has a high opportunity cost.


Asunto(s)
Insuficiencia Cardíaca , Medicare , Anciano , Humanos , Estados Unidos , Hospitalización , Hispánicos o Latinos , Negro o Afroamericano , Disparidades en Atención de Salud
14.
Integr Comp Biol ; 63(4): 936-945, 2023 10 10.
Artículo en Inglés | MEDLINE | ID: mdl-37147027

RESUMEN

In her influential book "Developmental Plasticity and Evolution," Mary Jane West-Eberhard introduced the concept of cross-sexual transfer, where traits expressed in one sex in an ancestral species become expressed in the other sex. Despite its potential ubiquity, we find that cross-sexual transfer has been under-studied and under-cited in the literature, with only a few experimental papers that have invoked the concept. Here, we aim to reintroduce cross-sexual transfer as a powerful framework for explaining sex variation and highlight its relevance in current studies on the evolution of sexual heteromorphism (different means or modes in trait values between the sexes). We discuss several exemplary studies of cross-sexual transfer that have been published in the past two decades, further building on West-Eberhard's extensive review. We emphasize two scenarios as potential avenues of study, within-sex polymorphic and sex-role reversed species, and discuss the evolutionary and adaptive implications. Lastly, we propose future questions to expand our understanding of cross-sexual transfer, from nonhormonal mechanisms to the identification of broad taxonomic patterns. As evolutionary biologists increasingly recognize the nonbinary and often continuous nature of sexual heteromorphism, the cross-sexual framework has important utility for generating novel insights and perspectives on the evolution of sexual phenotypes across diverse taxa.


Asunto(s)
Evolución Biológica , Caracteres Sexuales , Femenino , Animales , Fenotipo
15.
J Med Internet Res ; 25: e46123, 2023 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-37099371

RESUMEN

BACKGROUND: Limited availability of in-person health care services and fear of contracting COVID-19 during the pandemic promoted an increased reliance on telemedicine. However, long-standing inequities in telemedicine due to unequal levels of digital literacy and internet connectivity among different age groups raise concerns about whether the uptake of telemedicine has exacerbated or alleviated those inequities. OBJECTIVE: The aim of this study is to examine changes in telemedicine and in-person health service use during the COVID-19 pandemic across age groups for Medicaid beneficiaries in the state of Louisiana. METHODS: Interrupted time series models were used on Louisiana Medicaid claims data to estimate trends in total, in-person, and telemedicine monthly office visit claims per 1000 Medicaid beneficiaries between January 2018 and December 2020. Changes in care pattern trends and levels were estimated around the infection peaks (April 2020 and July 2020) and for an end-of-year infection leveling off period (December 2020). Four mutually exclusive age categories (0 to 17, 18 to 34, 35 to 49, and 50 to 64 years) were used to compare the differences. RESULTS: Prior to the COVID-19 pandemic, telemedicine services accounted for less than 1% of total office visit claim volume across the age groups. Each age group followed similar patterns of sharp increases in April 2020, downward trends until sharp increases again in July 2020, followed by flat trends thereafter until December 2020. These sharp increases were most pronounced for older patients, with those aged 50 to 64 years seeing increases of 184.09 telemedicine claims per 1000 Medicaid beneficiaries in April 2020 (95% CI 172.19 to 195.99) and 120.81 in July 2020 (95% CI 101.32 to 140.31) compared with those aged 18 to 34 years, seeing increases of 84.47 (95% CI 78.64 to 90.31) and 57.00 (95% CI 48.21 to 65.79), respectively. This resulted in overall changes from baseline to December 2020 levels of 123.65 (95% CI 112.79 to 134.51) for those aged 50 to 64 years compared with 59.07 (95% CI 53.89 to 64.24) for those aged 18 to 34 years. CONCLUSIONS: Older Medicaid beneficiaries in Louisiana had higher rates of telemedicine claim volume during the COVID-19 pandemic compared with younger beneficiaries.


Asunto(s)
COVID-19 , Telemedicina , Estados Unidos/epidemiología , Humanos , Medicaid , COVID-19/epidemiología , Pandemias , Louisiana/epidemiología
16.
Front Bioeng Biotechnol ; 11: 1089113, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36873362

RESUMEN

Statistical shape modeling is an indispensable tool in the quantitative analysis of anatomies. Particle-based shape modeling (PSM) is a state-of-the-art approach that enables the learning of population-level shape representation from medical imaging data (e.g., CT, MRI) and the associated 3D models of anatomy generated from them. PSM optimizes the placement of a dense set of landmarks (i.e., correspondence points) on a given shape cohort. PSM supports multi-organ modeling as a particular case of the conventional single-organ framework via a global statistical model, where multi-structure anatomy is considered as a single structure. However, global multi-organ models are not scalable for many organs, induce anatomical inconsistencies, and result in entangled shape statistics where modes of shape variation reflect both within- and between-organ variations. Hence, there is a need for an efficient modeling approach that can capture the inter-organ relations (i.e., pose variations) of the complex anatomy while simultaneously optimizing the morphological changes of each organ and capturing the population-level statistics. This paper leverages the PSM approach and proposes a new approach for correspondence-point optimization of multiple organs that overcomes these limitations. The central idea of multilevel component analysis, is that the shape statistics consists of two mutually orthogonal subspaces: the within-organ subspace and the between-organ subspace. We formulate the correspondence optimization objective using this generative model. We evaluate the proposed method using synthetic shape data and clinical data for articulated joint structures of the spine, foot and ankle, and hip joint.

17.
Med Care ; 61(Suppl 1): S70-S76, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36893421

RESUMEN

BACKGROUND: The COVID-19 pandemic led to an increased reliance on telemedicine. Whether this exacerbated existing disparities within vulnerable populations is not yet known. OBJECTIVES: Characterize changes in outpatient telemedicine evaluation and management (E&M) services for Louisiana Medicaid beneficiaries by race, ethnicity, and rurality during the COVID-19 pandemic. RESEARCH DESIGN: Interrupted time series regression models estimated pre-COVID-19 trends and changes in E&M service use at the April and July 2020 peaks in COVID-19 infections in Louisiana and in December 2020 after those peaks had subsided. SUBJECTS: Louisiana Medicaid beneficiaries continuously enrolled between January 2018 and December 2020 who were not also enrolled in Medicare. MEASURES: Monthly outpatient E&M claims per 1000 beneficiaries. RESULTS: Prepandemic differences in service use between non-Hispanic White and non-Hispanic Black beneficiaries narrowed by 34% through December 2020 (95% CI: 17.6%-50.6%), while differences between non-Hispanic White and Hispanic beneficiaries increased by 10.5% (95% CI: 0.1%-20.7%). Non-Hispanic White beneficiaries used telemedicine at higher rates than non-Hispanic Black (difference=24.9 claims per 1000 beneficiaries, 95% CI: 22.3-27.4) and Hispanic beneficiaries (difference=42.3 claims per 1000 beneficiaries, 95% CI: 39.1-45.5) during the first wave of COVID-19 infections in Louisiana. Telemedicine use increased slightly for rural beneficiaries compared with urban beneficiaries (difference=5.3 claims per 1000 beneficiaries, 95% CI: 4.0-6.6). CONCLUSIONS: The COVID-19 pandemic narrowed gaps in outpatient E&M service use between non-Hispanic White and non-Hispanic Black Louisiana Medicaid beneficiaries, though gaps in telemedicine use emerged. Hispanic beneficiaries experienced large reductions in service use and relatively small increases in telemedicine use.


Asunto(s)
COVID-19 , Telemedicina , Anciano , Humanos , Estados Unidos/epidemiología , COVID-19/epidemiología , Medicaid , Medicare , Pandemias , Louisiana/epidemiología
18.
Optom Vis Sci ; 100(3): 201-206, 2023 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-36728337

RESUMEN

SIGNIFICANCE: In the real word, visual tasks may be concurrent with other activity that imposes mental load. Although the brain's capacity to process information is limited, attention can improve visual performance by selectively allocating processing resources. Therefore, measuring visual performance under such circumstances can reflect patients' vision more accurately. PURPOSE: The aim of this study was to evaluate the effect of nonvisual task-induced mental load on visual performance at both attended and unattended locations in stimulus-driven captured attention. METHODS: Visual function was measured with an orientation discrimination task for Gabor patches with contrasts of 10, 15, 30, 50, and 80%. Three attentional conditions (valid-cue, invalid-cue, and neutral-cue) were randomly interleaved within runs. To modulate mental load, the visual task was performed either with or without a simultaneous auditory n-back task (two-back for maximum mental load and zero-back to control for the effect of having to perform a simultaneous task). RESULTS: Our result showed that the effect of mental load on correct responses was significant ( P = .02). Correct responses decreased significantly during the two-back task when compared with the baseline condition ( P = .03), but there was no significant difference between baseline and zero-back conditions ( P = .06). The effect of attention and spatial frequencies on the percentage of correct responses was significant ( P < .001). There was no significant interaction between mental load and spatial frequency, contrast level, or attention ( P > .05). CONCLUSIONS: Mental load had a similar decreasing effect on attended and unattended visual stimuli. This may be due to a generalized effect on processing resources upstream to where spatial attention is allocated.


Asunto(s)
Atención , Cognición , Humanos , Atención/fisiología , Estimulación Luminosa , Percepción Visual/fisiología
19.
J Biomech ; 146: 111424, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36603366

RESUMEN

Femoroacetabular impingement syndrome (FAIS) is a motion-related pathology of the hip characterized by pain, morphological abnormalities of the proximal femur, and an elevated risk of joint deterioration and hip osteoarthritis. Activities that require deep flexion are understood to induce impingement in cam FAIS patients, however, less demanding activities such as walking and pivoting may induce pain as well as alterations in kinematics and joint stability. Still, the paucity of quantitative descriptions of cam FAIS has hindered understanding underlying hip joint mechanics during such activities. Previous in silico studies have employed generalized model geometry or kinematics to simulate impingement between the femur and acetabulum, which may not accurately capture the interplay between morphology and motion. In this study, we utilized models with participant-specific bone and articular soft tissue anatomy and kinematics measured by dual-fluoroscopy to compare hip contact mechanics of cam FAIS patients to controls during four activities of daily living (internal/external pivoting and level/incline walking). Averaged across the gait cycle during incline walking, patients displayed increased strain in the anterior joint (labrum strain: p-value = 0.038, patients: 11.7 ± 6.7 %, controls: 5.0 ± 3.6 %; cartilage strain: p-value = 0.029, patients: 9.1 ± 3.3 %, controls: 4.2 ± 2.3). Patients also exhibited increased average anterior cartilage strains during external pivoting (p-value = 0.039; patients: 13.0 ± 9.2 %, controls: 3.9 ± 3.2 %]). No significant differences between patient and control contact area and strain were found for level walking and internal pivoting. Our study provides new insights into the biomechanics of cam FAIS, including spatiotemporal hip joint contact mechanics during activities of daily living.


Asunto(s)
Pinzamiento Femoroacetabular , Humanos , Actividades Cotidianas , Articulación de la Cadera , Acetábulo , Caminata , Cartílago , Dolor
20.
JAMA Netw Open ; 6(1): e2251687, 2023 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-36656586

RESUMEN

This cohort study investigates differences in screening mammography before vs during the COVID-19 pandemic by race and ethnicity among Medicaid beneficiaries in Louisiana.


Asunto(s)
COVID-19 , Medicaid , Estados Unidos/epidemiología , Humanos , Pandemias , Louisiana , Medicare
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