Prospective machine learning CT quantitative evaluation of idiopathic pulmonary fibrosis in patients undergoing anti-fibrotic treatment using low- and ultra-low-dose CT.

AIM: To compare the machine learning computed tomography (CT) quantification tool, Computer-Aided Lung Informatics for Pathology Evaluation and Ratings (CALIPER) to pulmonary function testing (PFT) in assessing idiopathic pulmonary fibrosis (IPF) for patients undergoing treatment and determine the effects of limited (LD) and ultra-low dose (ULD) CT on CALIPER performance. MATERIALS AND METHODS: Thirty-eight IPF patients underwent PFT and standard, LD, and ULD CT. CALIPER classified each CT voxel into either vessel-related structures (VRS), normal, reticular (R), honeycomb (HC) or ground-glass (GG) features. CALIPER-derived interstitial lung disease (ILD) extent represented the sum of GG, R and HC values. Repeated-measures correlation coefficient (ρrm) and 95% confidence interval (CI) evaluated CALIPER features correlation with PFT. Lin's concordance correlation coefficient (CCC) assessed concordance of CALIPER parameters across different CT dosages. RESULTS: Twenty patients completed 12 months of follow-up. CALIPER ILD correlated significantly with percent predicted (%) forced vital capacity (FVC) and forced expiratory volume in 1 second (%FEV1; p=0.004, ρrm -0.343, 95% CI [-0.547, -0.108] and 0.008, -0.321, [-0.518, -0.07], respectively). VRS significantly correlated with %FVC and %FEV1 (p=0.000, ρrm -0.491, 95% CI [-0.685, -0.251] and -0.478, 0.000, [-0.653, -0.231], respectively). There was near perfect LD and moderate ULD concordance with standard dose CT for both ILD (CCC 0.995, 95% CI 0.988-0.999 and 0.9, 0.795-0.983, respectively) and VRS (CCC 0.989, 95% CI 0.963-0.997 and 0.915, 0.806-0.956, respectively). CONCLUSIONS: CALIPER parameters correlate well with PFTs for evaluation of IPF in patients undergoing anti-fibrotic treatment without being influenced by dose variation. CALIPER may serve as a robust, objective adjunct to PFTs in assessing anti-fibrotic treatment related changes.

Padres Preparados, Jóvenes Saludables: intervention impact of a randomized controlled trial on Latino father and adolescent energy balance-related behaviors.

BACKGROUND: Studies have shown associations among food and activity behaviors and body weight of Latino fathers and adolescents. However, few Latino father-focused interventions have been designed to improve energy balance-related behaviors (EBRBs) and weight status among early adolescents. Thus, this efficacy study aims to evaluate the Padres Preparados, Jóvenes Saludables (Padres) youth obesity prevention program for positive changes in EBRBs (fruit, vegetable, sugar-sweetened beverage (SSB), sweet/salty snack, and fast-food consumption, physical activity, and screen time) and weight status among low-income Latino fathers and adolescents (10-14 years). METHODS: A two-arm (treatment versus delayed-treatment control group) randomized controlled trial was conducted to evaluate the efficacy of 8 weekly experiential learning sessions (2.5 hours each) based on social cognitive theory. The sessions included food preparation, parenting skills, nutrition, and physical activity. The program was delivered to father-adolescent dyads (mothers were encouraged to attend) in trusted community-based settings in a Midwest metropolitan area between 2017 and 2019. In March 2020, in-person implementation was discontinued due to COVID-19 pandemic restrictions, which limited the sample size. Father/adolescent dyads were randomized to treatment or control group within each site. Surveys and measurements were completed by fathers and adolescents to assess changes in food and activity behaviors from baseline to post-intervention. Adolescents also completed 24-hour dietary recall interviews at baseline and post-intervention. Intervention effects were assessed using linear regression mixed models adjusted for covariates and accounting for clustering of participants within sites. RESULTS: Data from 147 father/adolescent dyads who completed at least the baseline data collection were used. No significant differences were observed for baseline to post-intervention changes in adolescents' and fathers' EBRBs or weight status between treatment and control groups. Fathers' SSB and fast food intakes were not statistically significant (p = 0.067 and p = 0.090, respectively). CONCLUSIONS: The Padres program resulted in no significant improvements in adolescent and father EBRBs and weight status. Additional Latino father-focused interventions are needed to examine intervention effects on EBRBs among Latino adolescents. TRIAL REGISTRATION: The Padres Preparados, Jóvenes Saludables study is registered with the U.S. National Library of Medicine, ClinicalTrials.gov Identifier: NCT03469752 (19/03/2018).

Does adherence to child care nutrition and physical activity best practices differ by child care provider's participation in support programs and training?

INTRODUCTION: To date, gaps exist in our understanding of how child care provider participation in various support programs is associated with the reported implementation of nutrition and physical activity best practices by child care providers. Thus, the purpose of the current study was to compare implementation of nutrition and physical activity best practices among child care providers engaged in the Child and Adult Food Care Program (CACFP), Parent AWARE, and other training opportunities, to implementation among providers who do not participate in each of these opportunities. METHODS: Cross-sectional analysis of survey data collected from a stratified-random sample of licensed family-home and center-based child care settings (Family-homes n=394; Centers n= 224) in XXX from Month-Month 20XX. Descriptive statistics and multiple regression models were used to characterize differences in adherence to best practices based on program participation (CACFP, Parent AWARE, training) and type of child care setting (center versus family-home). Surveys measured self-reported engagement in nutrition and PA best practices as well as participation in CACFP, Parent Aware, and training opportunities. RESULTS: Center-based child care providers participating in CACFP adhered to more nutrition and PA best practices than those not involved in CACFP. Further, with one exception, participating in Parent AWARE and engagement in training were positively associated with adherence to nutrition practices in center and family-home setting, and with adherence to PA practices in family homes. CONCLUSIONS: Child care providers should be encouraged to participate in available support programs; advocates should work to identify and remove barriers to support program participation.

Is the childhood home food environment a confounder of the association between child maltreatment exposure and adult body mass index?

Childhood maltreatment is consistently associated with adult obesity, leading to calls for tailored weight interventions for people with maltreatment histories. However, it is possible that the maltreatment-obesity association is spurious and driven by unmeasured confounding, in which case such interventions would be misplaced. The home food environment in childhood is a potential confounder, but its role in the association of maltreatment with obesity has not been examined. We used a longitudinal dataset (Project EAT) to examine the association of adult retrospective reports of maltreatment history in childhood (1+ types of maltreatment before age 18 years) with previously-collected prospective childhood reports of home food environment characteristics (availability of healthy foods, availability of sweet/salty snack food, family meal frequency, and food insufficiency). We then estimated the association between maltreatment and adult body mass index (BMI, kg/m2) with and without adjustment for these home food environment factors. After adjustment for sociodemographics, maltreatment had a 0.84 kg/m2 (95% CI: 0.28, 1.41) higher BMI at age 24-39 years, compared to those with no maltreatment, after adjustment for sociodemographics, parenting style, and BMI in childhood. Additional adjustment for home food environment factors had little effect on this association (ß = 0.78 kg/m2; 95% CI: 0.21,1.35), suggesting limited confounding influence of the home food environment factors. Findings provide additional robust evidence that childhood maltreatment is a risk factor for obesity that may warrant tailored interventions.

Isospin Mixing Reveals

The thermonuclear ^{30}P(p,γ)^{31}S reaction rate is critical for modeling the final elemental and isotopic abundances of ONe nova nucleosynthesis, which affect the calibration of proposed nova thermometers and the identification of presolar nova grains, respectively. Unfortunately, the rate of this reaction is essentially unconstrained experimentally, because the strengths of key ^{31}S proton capture resonance states are not known, largely due to uncertainties in their spins and parities. Using the ß decay of ^{31}Cl, we have observed the ß-delayed γ decay of a ^{31}S state at E_{x}=6390.2(7) keV, with a ^{30}P(p,γ)^{31}S resonance energy of E_{r}=259.3(8) keV, in the middle of the ^{30}P(p,γ)^{31}S Gamow window for peak nova temperatures. This state exhibits isospin mixing with the nearby isobaric analog state at E_{x}=6279.0(6) keV, giving it an unambiguous spin and parity of 3/2^{+} and making it an important l=0 resonance for proton capture on ^{30}P.

Circulating cellular adhesion molecules and risk of diabetes: the Multi-Ethnic Study of Atherosclerosis (MESA).

AIMS: To test the hypothesis that soluble cellular adhesion molecules would be positively and independently associated with risk of diabetes. METHODS: Soluble levels of six cellular adhesion molecules (ICAM-1, E-selectin, VCAM-1, E-cadherin, L-selectin and P-selectin) were measured in participants in the Multi-Ethnic Study of Atherosclerosis, a prospective cohort study. Participants were then followed for up to 10 years to ascertain incident diabetes. RESULTS: Sample sizes ranged from 826 to 2185. After adjusting for age, sex, race/ethnicity, BMI and fasting glucose or HbA1c , four cellular adhesion molecules (ICAM-1, E-selectin, VCAM-1 and E-cadherin) were positively associated with incident diabetes and there was a statistically significant trend across quartiles. Comparing the incidence of diabetes in the highest and lowest quartiles of each cellular adhesion molecule, the magnitude of association was largest for E-selectin (hazard ratio 2.49; 95% CI 1.26-4.93) and ICAM-1 (hazard ratio 1.76; 95% CI 1.22-2.55) in fully adjusted models. Tests of effect modification by racial/ethnic group and sex were not statistically significant for any of the cellular adhesion molecules (P > 0.05). CONCLUSIONS: The finding of significant associations between multiple cellular adhesion molecules and incident diabetes may lend further support to the hypothesis that microvascular endothelial dysfunction contributes to risk of diabetes.

Mediators involved in the relation between depressive symptoms and weight status in female adolescents and young adults.

Depression may be a risk factor for overweight status, but mechanisms involved in this relationship are unclear. This study explored behavioral factors involved in the relationship between adolescent depression symptoms and adult overweight status. A population-based cohort of female participants in Project EAT (n=1035) was followed over 10 years and reported on psychological functioning, weight status and eating and activity patterns in early/middle adolescence (1999=Time 1; T1), middle adolescence/early young adulthood (2004=Time 2; T2) and early/middle young adulthood (2009=Time 3; T3). Structural equation models were fit which included T1 depression scores predicting overweight status at T3, with T2 fruit and vegetable consumption, moderate-to-vigorous physical activity and binge eating examined as mediators. There were small but significant effects of T1 depression scores predicting an increased likelihood of T3 overweight status (standardized estimate=0.038; P=0.007), and of T2 binge eating mediating the relation between T1 depression and T3 overweight status (standardized indirect effect estimate=0.036; P=0.009). Binge eating may be one pathway to overweight among depressed females, suggesting that recognition and treatment of eating pathology in individuals with depression may help prevent overweight. Examination of other behavioral (and non-behavioral) factors explaining the relationship between depression and overweight is warranted.

Split isobaric analog state in 55Ni: case of strong isospin mixing.

Study of ß+ decay of the exotic Tz=-3/2 nucleus 55Cu, via delayed γ rays, has revealed a strongly isospin mixed doublet (4599-4579 keV) in 55Ni, which represents the fragmented and previously unknown isobaric analog of the ground state of 55Cu. The observed small log ft values to both states in the doublet confirm the superallowed Fermi ß decay. The near degeneracy of a pair of 3/2- levels in 55Ni results in the strong isospin mixing. The isospin mixing matrix element between the T=3/2 and T=1/2 levels is inferred from the experiment to be 9(1) keV, which agrees well with the matrix element of the charge symmetry breaking shell model Hamiltonian of Ormand and Brown. A precise value of the half-life of 55Cu at 57(3) ms was also obtained.

A New Frontier in Temporal Bone Imaging: Photon-Counting Detector CT Demonstrates Superior Visualization of Critical Anatomic Structures at Reduced Radiation Dose.

BACKGROUND AND PURPOSE: Photon-counting detector CT is a new technology with a limiting spatial resolution of ≤150 µm. In vivo comparisons between photon-counting detector CT and conventional energy-integrating detector CT are needed to determine the clinical impact of photon counting-detector CT in temporal bone imaging. MATERIALS AND METHODS: Prospectively recruited patients underwent temporal bone CT examinations on an investigational photon-counting detector CT system after clinically indicated temporal bone energy-integrating detector CT. Photon-counting detector CT images were obtained at an average 31% lower dose compared with those obtained on the energy-integrating detector CT scanner. Reconstructed images were evaluated in axial, coronal, and Pöschl planes using the smallest available section thickness on each system (0.4 mm on energy-integrating detector CT; 0.2 mm on photon-counting detector CT). Two blinded neuroradiologists compared images side-by-side and scored them using a 5-point Likert scale. A post hoc reassignment of readers' scores was performed so that the scores reflected photon-counting detector CT performance relative to energy-integrating detector CT. RESULTS: Thirteen patients were enrolled, resulting in 26 image sets (left and right sides). The average patient age was 63.6 [SD, 13.4] years; 7 were women. Images from the photon-counting detector CT scanner were significantly preferred by the readers in all reconstructed planes (P < .001). Photon-counting detector CT was rated superior for the evaluation of all individual anatomic structures, with the oval window (4.79) and incudostapedial joint (4.75) receiving the highest scores on a Likert scale of 1-5. CONCLUSIONS: Temporal bone CT images obtained on a photon-counting detector CT scanner were rated as having superior spatial resolution and better critical structure visualization than those obtained on a conventional energy-integrating detector scanner, even with a substantial dose reduction.

Comparison of [18F] FDG-PET/MRI and Clinical Findings for Assessment of Suspected Lumbar Facet Joint Pain: A Prospective Study to Characterize Candidate Nonanatomic Imaging Biomarkers and Potential Impact on Management.

BACKGROUND AND PURPOSE: Prior retrospective studies have suggested that both T2 hyperintensity and gadolinium enhancement on fat-suppressed MR imaging are associated with lumbar facet joint pain, but prospective evaluation of FDG-PET/MR imaging with a standardized protocol and correlation to clinical findings are lacking. The primary aim was to prospectively assess a standardized FDG-PET/MRI protocol in patients with suspected facetogenic low back pain, with determination of the concordance of imaging and clinical findings. MATERIALS AND METHODS: Ten patients with clinically suspected facetogenic low back pain were prospectively recruited with a designation of specific facet joints implicated clinically. Subsequently, patients underwent an FDG-PET/MR imaging examination with gadolinium. Each facet joint was graded for perifacet signal change on MR imaging and FDG activity. The frequency and correlation of MR imaging, FDG-PET, and clinical findings were determined. RESULTS: FDG activity showed high concordance with high overall MR imaging scores (concordance correlation coefficient = 0.79). There was concordance of the clinical side of pain with the side of high overall MR imaging scores and increased FDG activity on 12/20 (60%) sides. Both a high overall MR imaging score (concordance correlation coefficient = 0.12) and FDG-PET findings positive for increased activity (concordance correlation coefficient = 0.10) had low concordance with the specific clinically implicated facet joints. Increased FDG activity or high MR imaging scores or both were present in only 10/29 (34%) facet joints that had been clinically selected for percutaneous intervention. Eleven (11%) facet joints that had not been selected for treatment demonstrated these imaging findings. CONCLUSIONS: There was low concordance of perifacet signal change and FDG activity with clinically implicated facet joints. This could indicate either the potential to change patient management or a lack of biomarker accuracy. Therefore, additional larger randomized studies with the use of comparative medial branch blocks would be useful to further investigate the clinical utility of these findings.

Covariance and sensitivity data generation at ORNL.

Covariance data are required to assess uncertainties in design parameters in several nuclear applications. The error estimation of calculated quantities relies on the nuclear data uncertainty information available in the basic nuclear data libraries, such as the US Evaluated Nuclear Data Library, ENDF/B. The uncertainty files in the ENDF/B library are obtained from the analysis of experimental data and are stored as variance and covariance data. In this paper we address the generation of covariance data in the resonance region done with the computer code SAMMY. SAMMY is used in the evaluation of the experimental data in the resolved and unresolved resonance energy regions. The data fitting of cross sections is based on the generalised least-squares formalism (Bayesian theory) together with the resonance formalism described by R-matrix theory. Two approaches are used in SAMMY for the generation of resonance parameter covariance data. In the evaluation process SAMMY generates a set of resonance parameters that fit the data, and, it provides the resonance parameter covariances. For resonance parameter evaluations where there are no resonance parameter covariance data available, the alternative is to use an approach called the 'retroactive' resonance parameter covariance generation. In this paper, we describe the application of the retroactive covariance generation approach for the gadolinium isotopes.

Evaluation of silicon neutron resonance parameters in the thermal to 1800 keV energy range.

Because silicon is a major constituent of concrete and soil, neutron and gamma ray information on silicon is important for reactor shielding and criticality safety calculations. Therefore, much effort was put into the ENDF/B-VI evaluation for the three stable isotopes of silicon. The neutron capture cross section of natural silicon was recently measured at the Oak Ridge Electron Linear Accelerator (ORELA) in the energy range 1-700 keV. Using the ENDF/B-VI evaluation for initial values, a new evaluation of the resonance parameters was performed by adding the results of the ORELA capture measurements to the experimental database. The computer code SAMMY was used for the analysis of the experimental data; the new version of SAMMY allows accurate calculations of the self-shielding and multiple scattering effects in the capture measurements. The accuracy of the radiative capture widths of the resonances was improved by this analysis. Accurate values of the s-, p- and d-wave neutron strength functions were also obtained. Although the resonance capture component of the present evaluation is 2-3 times smaller than that in ENDF/B-VI, the total capture cross section is much larger, at least for energies >250 keV, because the direct capture component contributes values of the same order of magnitude as the resonance component. The direct component was not taken into account in the ENDF/B-VI evaluation and was calculated for the first time in the present evaluation.

Identification of candidate genes for prostate cancer-risk SNPs utilizing a normal prostate tissue eQTL data set.

Multiple studies have identified loci associated with the risk of developing prostate cancer but the associated genes are not well studied. Here we create a normal prostate tissue-specific eQTL data set and apply this data set to previously identified prostate cancer (PrCa)-risk SNPs in an effort to identify candidate target genes. The eQTL data set is constructed by the genotyping and RNA sequencing of 471 samples. We focus on 146 PrCa-risk SNPs, including all SNPs in linkage disequilibrium with each risk SNP, resulting in 100 unique risk intervals. We analyse cis-acting associations where the transcript is located within 2 Mb (±1 Mb) of the risk SNP interval. Of all SNP-gene combinations tested, 41.7% of SNPs demonstrate a significant eQTL signal after adjustment for sample histology and 14 expression principal component covariates. Of the 100 PrCa-risk intervals, 51 have a significant eQTL signal and these are associated with 88 genes. This study provides a rich resource to study biological mechanisms underlying genetic risk to PrCa.

Lack of association of 3 functional gene variants with hypertension in African Americans.

African Americans are a critical population in which to study the impact of physiologically important candidate gene mutations on the occurrence of hypertension. African Americans not only have a higher prevalence of hypertension, but the disease strikes earlier, with greater severity, and often results in death at an earlier age compared with whites in the United States. In this study, 3 physiologically important candidate gene mutations (angiotensinogen A[-6], alpha-Adducin Gly460Trp, and G-Protein beta(3)-subunit C825T) were examined for their association with hypertension status in a sample of 904 African Americans from Jackson, Mississippi. Tests of simple association and multivariate logistic regression analyses revealed no association between hypertension status and any of the studied polymorphisms. This lack of association persisted after stratification of the sample by gender and body size. These data indicate that these polymorphisms do not contribute in a significant way to interindividual variation in the risk of hypertension in this sample of African Americans, and further genome-wide studies should be performed to identify genes that may influence blood pressure levels in this population.

Spontaneous orbital hemorrhage during general anesthesia and arthroplasty.

A 72-year-old woman who had a history of arthritis and cerebral vascular accident 4 years earlier underwent hand surgery. Because regional anesthesia was not successful, general anesthesia was administered. Shortly before extubation, proptosis developed in her left eye, and she was unable to open it. The condition was due to spontaneous orbital hemorrhage and resolved with conservative treatment.

Childhood experiences of abuse, later substance use, and parenting outcomes among low-income mothers.

Relationships among childhood abuse, subsequent adult functioning (with a focus on severity of substance abuse), and child placement were explored in an urban sample of low-income, African-American mothers. Childhood sexual trauma and age were found to be correlated with severity of later drug use; history of physical or sexual abuse was significantly related to psychological distress in adulthood; and addiction was highly correlated with child placement. Implications of the findings are discussed, with particular reference to collaborations between child welfare and substance abuse treatment.

Clinical characteristics of ovarian cancer classified by BRCA1, BRCA2, and RAD51C status.

We evaluated homologous recombination deficient (HRD) phenotypes in epithelial ovarian cancer (EOC) considering BRCA1, BRCA2, and RAD51C in a large well-annotated patient set. We evaluated EOC patients for germline deleterious mutations (n = 899), somatic mutations (n = 279) and epigenetic alterations (n = 482) in these genes using NGS and genome-wide methylation arrays. Deleterious germline mutations were identified in 32 (3.6%) patients for BRCA1, in 28 (3.1%) for BRCA2 and in 26 (2.9%) for RAD51C. Ten somatically sequenced patients had deleterious alterations, six (2.1%) in BRCA1 and four (1.4%) in BRCA2. Fifty two patients (10.8%) had methylated BRCA1 or RAD51C. HRD patients with germline or somatic alterations in any gene were more likely to be high grade serous, have an earlier diagnosis age and have ovarian and/or breast cancer family history. The HRD phenotype was most common in high grade serous EOC. Identification of EOC patients with an HRD phenotype may help tailor specific therapies.

Home/family, peer, school, and neighborhood correlates of obesity in adolescents.

OBJECTIVE: This study was designed to (1) identify the most important home/family, peer, school, and neighborhood environmental characteristics associated with weight status and (2) determine the overall contribution of these contexts to explaining weight status among an ethnically/racially diverse sample of adolescents. DESIGN AND METHODS: Surveys and anthropometric measures were completed in 2009-2010 by 2,793 adolescents (53.2% girls, mean age = 14.4 ± 2.0, 81.1% non-white) in Minneapolis/St. Paul, Minnesota schools. Data representing characteristics of adolescents' environments were collected from parents/caregivers, friends, school personnel, and Geographic Information System sources. Multiple regression models controlled for adolescent age, ethnicity/race, and socioeconomic status. RESULTS: The variance in body mass index (BMI) z-scores explained by 51 multicontextual characteristics was 24% for boys and 22% for girls. Across models, several characteristics of home/family (e.g., infrequent family meals) and peer environments (e.g., higher proportion of male friends who were overweight) were consistently associated with higher BMI z-scores among both boys and girls. Among girls, additional peer (e.g., lower physical activity among female friends) and neighborhood (e.g., perceived lack of safety) characteristics were consistently associated with higher BMI z-scores. CONCLUSIONS: Results underscore the importance of addressing the home/family and peer environments in future research and intervention efforts designed to reduce adolescent obesity.

30 years of ergonomics at 3M: a case study.

The added value of the Ergonomics Program at 3M was found to be improved employee safety, compliance with regulations and reduction of work-related illness, increases in productivity, and quality and operating efficiency. This paper describes the thirty years of existence of this program. For the first twenty years, the program objectives were to: respond to requests for assistance related to work-related musculoskeletal disorder (WMSD) concerns, raise employee awareness of MSDs and ergonomics; educate engineers in ergonomics design; and develop ergonomics teams at manufacturing locations. Since the year 2000, 3M's Ergonomics Program has been in transition from a US-centric and corporate-based technical-expertled program to a global program applying participatory ergonomics strategies within a macroergonomics framework. During that transition, the existing program requirements were revised, new methods and program tools were created, and expectations for implementation at the manufacturing locations clarified. This paper focuses on the company's manufacturing ergonomics program activities during the past ten years and includes specifics of the program's objectives, risk assessment reduction process, and ergonomics technical expertise development. The main benefit achieved throughout the company is reducing employee injury while also increasing productivity and operating efficiency.