Daniel B. Reed integrates individual stories with the study of performance to understand the forces of diaspora and mobility in the lives of musicians, dancers, and mask performers originally from ...Côte d'Ivoire who now live in the United States. Through the lives of four Ivorian performers, Reed finds that dance and music, being transportable media, serve as effective ways to understand individual migrants in the world today. As members of an immigrant community who are geographically dispersed, these performers are unmoored from their place of origin and yet deeply engaged in presenting their symbolic roots to North American audiences. By looking at performance, Reed shows how translocation has led to transformations on stage, but he is also sensitive to how performance acts as a way to reinforce and maintain community. Abidjan USA provides a multifaceted view of community that is at once local, national, and international, and where identity is central, but transportable, fluid, and adaptable.
In an interview conducted in 2020, ethnomusicologist Ruth M. Stone looks back on a career that began with field research in Liberia in the Kpelle communities where she grew up and continues, despite ...her retirement, to this day. In her reflections, Dr. Stone emphasizes the people in her life—students she has taught; families with whom she has lived, conducted research, and maintained long-term relationships; and colleagues with whom she has worked across disciplinary lines to foster rich understandings of expressive cultural dimensions of African life. She discusses her commitment to administration and service, including her efforts to institutionalize ethnomusicology and the study of African music in North America, Africa, and beyond.
This first-in-man imaging study evaluated the safety and feasibility of hyperpolarized 1-¹³Cpyruvate as an agent for noninvasively characterizing alterations in tumor metabolism for patients with ...prostate cancer. Imaging living systems with hyperpolarized agents can result in more than 10,000-fold enhancement in signal relative to conventional magnetic resonance (MR) imaging. When combined with the rapid acquisition of in vivo ¹³C MR data, it is possible to evaluate the distribution of agents such as 1-¹³Cpyruvate and its metabolic products lactate, alanine, and bicarbonate in a matter of seconds. Preclinical studies in cancer models have detected elevated levels of hyperpolarized 1-¹³Clactate in tumor, with the ratio of 1-¹³Clactate/1-¹³Cpyruvate being increased in high-grade tumors and decreased after successful treatment. Translation of this technology into humans was achieved by modifying the instrument that generates the hyperpolarized agent, constructing specialized radio frequency coils to detect ¹³C nuclei, and developing new pulse sequences to efficiently capture the signal. The study population comprised patients with biopsy-proven prostate cancer, with 31 subjects being injected with hyperpolarized 1-¹³Cpyruvate. The median time to deliver the agent was 66 s, and uptake was observed about 20 s after injection. No dose-limiting toxicities were observed, and the highest dose (0.43 ml/kg of 230 mM agent) gave the best signal-to-noise ratio for hyperpolarized 1-¹³Cpyruvate. The results were extremely promising in not only confirming the safety of the agent but also showing elevated 1-¹³Clactate/1-¹³Cpyruvate in regions of biopsy-proven cancer. These findings will be valuable for noninvasive cancer diagnosis and treatment monitoring in future clinical trials.
Semiconducting nanowires have the potential to function as highly sensitive and selective sensors for the label-free detection of low concentrations of pathogenic microorganisms. Successful ...solution-phase nanowire sensing has been demonstrated for ions, small molecules, proteins, DNA and viruses; however, 'bottom-up' nanowires (or similarly configured carbon nanotubes) used for these demonstrations require hybrid fabrication schemes, which result in severe integration issues that have hindered widespread application. Alternative 'top-down' fabrication methods of nanowire-like devices produce disappointing performance because of process-induced material and device degradation. Here we report an approach that uses complementary metal oxide semiconductor (CMOS) field effect transistor compatible technology and hence demonstrate the specific label-free detection of below 100 femtomolar concentrations of antibodies as well as real-time monitoring of the cellular immune response. This approach eliminates the need for hybrid methods and enables system-scale integration of these sensors with signal processing and information systems. Additionally, the ability to monitor antibody binding and sense the cellular immune response in real time with readily available technology should facilitate widespread diagnostic applications.
The effects of influenza on a population are attributable to the clinical severity of illness and the number of persons infected, which can vary greatly between seasons or pandemics. To create a ...systematic framework for assessing the public health effects of an emerging pandemic, we reviewed data from past influenza seasons and pandemics to characterize severity and transmissibility (based on ranges of these measures in the United States) and outlined a formal assessment of the potential effects of a novel virus. The assessment was divided into 2 periods. Because early in a pandemic, measurement of severity and transmissibility is uncertain, we used a broad dichotomous scale in the initial assessment to divide the range of historic values. In the refined assessment, as more data became available, we categorized those values more precisely. By organizing and prioritizing data collection, this approach may inform an evidence-based assessment of pandemic effects and guide decision making.
To demonstrate simultaneous hyperpolarization and imaging of three (13)C-labeled perfusion MRI contrast agents with dissimilar molecular structures ((13)Curea, (13)Chydroxymethyl cyclopropane, and ...(13)Ct-butanol) and correspondingly variable chemical shifts and physiological characteristics, and to exploit their varying diffusibility for simultaneous measurement of vascular permeability and perfusion in initial preclinical studies.
Rapid and efficient dynamic multislice imaging was enabled by a novel pulse sequence incorporating balanced steady state free precession excitation and spectral-spatial readout by multiband frequency encoding, designed for the wide, regular spectral separation of these compounds. We exploited the varying bilayer permeability of these tracers to quantify vascular permeability and perfusion parameters simultaneously, using perfusion modeling methods that were investigated in simulations. "Tripolarized" perfusion MRI methods were applied to initial preclinical studies with differential conditions of vascular permeability, in normal mouse tissues and advanced transgenic mouse prostate tumors.
Dynamic imaging revealed clear differences among the individual tracer distributions. Computed permeability maps demonstrated differential permeability of brain tissue among the tracers, and tumor perfusion and permeability were both elevated over values expected for normal tissues.
Tripolarized perfusion MRI provides new molecular imaging measures for specifically monitoring permeability, perfusion, and transport simultaneously in vivo.
Introduction: Screening for previously undiagnosed diabetes in the emergency department (ED) can enhance early detection, which may particularly benefit patients with barriers to accessing primary ...care. To optimize use of limited ED resources, there is a need to identify ED patients who are at high risk.
Objectives: To improve identification of ED patients with undiagnosed diabetes using machine learning (ML) .
Methods: Diabetes screening by HbA1c was implemented in four EDs at an academic medical center. Patients aged 40 or older, with BMI > 25, no history of diabetes and no HbA1c result within 6 months were eligible for screening. Patients were stratified by screening result and compared across demographic and clinical characteristics, and local geographic measures of health and socioeconomic variables. ML classifier models predicting a positive screening result were trained, and were validated on a prospectively withheld subset of the cohort.
Results: In the first weeks after implementation, 2423 eligible patients were identified, and 1518 (62.6%) were screened, with 114 (7.5% of those screened) found to have previously undiagnosed diabetes. Patients with diabetes more often identified as male, Hispanic or Latino, Black, or Asian, had higher BMIs and blood pressures at triage, resided in neighborhoods with higher diabetes prevalence and poverty rates, and had less prior healthcare utilization, especially in the outpatient setting. The best performing classifier models were logistic regression with elastic net regularization (AUC 0.81) and gradient-boosted trees (AUC 0.77) . These models identified a high-risk subgroup consisting of 30% of eligible patients who accounted for over 80% of newly detected cases of diabetes.
Conclusions: ML models can reliably identify ED patients at high risk of having undiagnosed diabetes based on demographic, clinical, and local geographic risk factors, and could form the basis of a selective screening program.
Disclosure
I.Bohart: None. J.Caldwell: None. J.Swartz: None. P.E.Rosen: None. N.Genes: None. C.A.Koziatek: None. D.B.Neill: None. D.C.Lee: None.
To compare transcatheter aortic valve replacement (TAVR) outcomes during the period when public health emergency (PHE) flexibilities were in place with outcomes during a period before they were ...introduced.
Patients who received a native TAVR with either a SAPIEN 3 or SAPIEN 3 Ultra valve from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry between June 22, 2019, and August 30, 2022, were placed into one of two cohorts: (1) pre-PHE cohort, and (2) peri-PHE cohort. Outcomes included in-hospital events and events occurring 30 days post-TAVR. Patients were matched 1:1 on their propensity of receiving a TAVR during the pre- or peri-PHE periods. After matching, relative risk was calculated for each in-hospital outcome and HRs for outcomes 30 days post-TAVR.
In this study, 173,434 patients met inclusion criteria; after 1:1 matching, there were 37,063 patients in each cohort. There was no difference between cohorts in in-hospital outcomes, including all-cause mortality, stroke, composite of mortality and stroke, pacemaker, or major vascular complications. Similarly, there was no statistically significant difference in 30-day outcomes between the cohorts.
In this large-scale retrospective study of 74,126 patients undergoing TAVR procedures from 2019 to 2022, no significant differences existed in TAVR outcomes during the PHE period.
The combined hyperpolarized (HP)
C pyruvate and urea MRI has provided a simultaneous assessment of glycolytic metabolism and tissue perfusion for improved cancer diagnosis and therapeutic evaluation ...in preclinical studies. This work aims to translate this dual-probe HP imaging technique to clinical research.
A co-polarization system was developed where 1-
Cpyruvic acid (PA) and
C,
N
urea in water solution were homogeneously mixed and polarized on a 5T SPINlab system. Physical and chemical characterizations and toxicology studies of the combined probe were performed. Simultaneous metabolic and perfusion imaging was performed on a 3T clinical MR scanner by alternatively applying a multi-slice 2D spiral sequence for 1-
Cpyruvate and its downstream metabolites and a 3D balanced steady-state free precession (bSSFP) sequence for
C,
N
urea.
The combined PA/urea probe has a glass-formation ability similar to neat PA and can generate nearly 40% liquid-state
C polarization for both pyruvate and urea in 3-4 h. A standard operating procedure for routine on-site production was developed and validated to produce 40 mL injection product of approximately 150 mM pyruvate and 35 mM urea. The toxicology study demonstrated the safety profile of the combined probe. Dynamic metabolite-specific imaging of 1-
Cpyruvate, 1-
Clactate, 1-
Calanine, and
C,
N
urea was achieved with adequate spatial (2.6 mm × 2.6 mm) and temporal resolution (4.2 s), and urea images showed reduced off-resonance artifacts due to the J
coupling.
The reported technical development and translational studies will lead to the first-in-human dual-agent HP MRI study and mark the clinical translation of the first HP
C MRI probe after pyruvate.
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