27941 research outputs found
Sort by
Artificial Intelligence Education in Radiology Training: A Systematic Review of Effectiveness, Barriers, and Future Directions
Get PDFRationale and objectives: The purpose of this systematic review study was to characterize the current landscape of various artificial intelligence (AI) education in radiology, summarizing existing curricula, outcomes, challenges, and future directions for effective integration into residency training.
Materials and methods: A comprehensive search of PubMed, Web of Science, Embase, and Google Scholar identified relevant published studies up to June 19, 2025.
Results: Of the 2646 studies screened, 14 studies evaluated the performance of AI-based training programs for radiology trainees; among these, 92.9% (13/14) reported improvements in trainees' performance, including better diagnostic precision and interpretation (57.2%, 8/14), greater trainee confidence (57.2%, 8/14), hands-on experience with AI platforms (85.7%, 12/14), increased AI knowledge (85.7%, 12/14), engagement with AI-based case learning (35.7%, 5/14), understanding of AI ethics and bias (7.1%, 1/14), and acceptance of AI-assisted learning (78.6%, 11/14), whereas one study (7.1%, 1/14) found no significant benefit. Performance evaluation metrics varied across studies, with 35.7% (5/14) reporting a higher median of sensitivity, specificity, and accuracy (72%, 80%, and 81.3%) after AI training compared to before AI training (62.2%, 78.9%, and 76.5%, respectively), and 28.6% (4/14) showing improved AI knowledge scores. Hands-on simulations and didactic lectures were the most common AI training formats (78.6% and 71.4%). Risks and concerns included over-reliance on AI, limited exposure to complex or rare cases, and a lack of feedback. Recommendations highlighted the need for AI-faculty teaching, broader content coverage, and standardized multi-center AI-training programs to facilitate wider adoption.
Conclusion: 92.9% of studies showed that AI-based training can enhance radiology trainees' knowledge, interpretive skills, or diagnostic performance, especially for junior trainees; however, its safe adoption requires standardized curricula with diverse cases, mentorship, workflow integration, and robust evaluation, with larger studies needed to confirm generalizability.No embarg
tRNA-derived RNA processing in sperm transmits non-genetically inherited phenotypes to offspring in C. elegans [preprint]
Get PDFThis article is a preprint. Preprints are preliminary reports of work that have not been certified by peer review.The environment encountered by an organism can modulate epigenetic information in gametes to transmit non-genetically inherited phenotypes to offspring. In mouse models, the diet of males regulates specific tRNA-derived RNAs (tDRs) in sperm. After fertilization, tDRs regulate embryonic gene expression and generate metabolic phenotypes in adult offspring through uncharacterized changes during development. Here we demonstrate that in C. elegans, tDRs also accumulate in sperm and can similarly transmit epigenetically inherited phenotypes to offspring. We identify the RNaseT2 enzyme, rnst-2, as a regulator of C. elegans tDR accumulation. RNST-2 processes or degrades tRNA-halves, leading to short <30 nt fragments. This rnst-2 dependent regulation of tDR length distribution modulates specific tDRs in sperm which, after fertilization, regulate early embryonic and developmental gene expression, leading to adaptive phenotypes in progeny. Our findings establish tDRs as a deeply conserved carrier of intergenerational epigenetic information and position the worm as a model for dissecting paternal non-genetic inheritance mechanistically.No embarg
A Pilot Pragmatic Cluster Randomized Trial of School-Supervised Therapy to Improve Pediatric Asthma Control
No full textBackground: Although school-supervised inhaled corticosteroid administration has potential to improve asthma morbidity, there has yet to be an evaluation of the pediatric practice as a setting to identify children with asthma and connect them to school-supervised asthma therapy.
Objective: Conduct a pragmatic pilot trial of Asthma Link, a model that connects children with asthma seen in pediatric practice to supervised asthma therapy in the school setting.
Methods: Four pediatric practices were pair-matched and randomized to (1) Asthma Link plus an asthma educational workbook or (2) Enhanced Usual Care, the same workbook alone. We recruited children 6 to 17 years old with poorly controlled asthma, prescribed a daily inhaled corticosteroid. Parent-child dyads completed surveys at baseline and 3, 6, and 12 months.
Primary outcomes: recruitment/retention of pediatric practices and parent-child dyads and intervention fidelity.
Secondary outcomes: asthma symptoms, medication adherence, emergency room visits, hospital admissions, oral steroid use, missed schooldays.
Results: Four pediatric practices and 66 parent-child dyads were recruited (average child age 9 y, 44% female, 65% Hispanic, 23% Black, 62% low income). All (4 of 4) practices were retained throughout the study and retention of parent-child dyads was 95%, 91%, and 89% at 3, 6, and 12 months, respectively. All (31 of 31) Asthma Link families brought their child's preventive inhaler into school; children received school health staff-supervised therapy on more than 95% of schooldays over 12 months. Children in the Asthma Link group had greater improvement in Asthma Control Test scores, longer time to first asthma exacerbation, less oral steroid use, and better medication adherence compared with the Enhanced Usual Care group.
Conclusions: Extending the reach of pediatric practices to facilitate the delivery of daily asthma prevention medication at school was feasible and improved pediatric asthma morbidity.No embarg
TDP-43 dysfunction leads to impaired proteostasis and predisposes mice to worse neurological outcomes after brain injury [preprint]
No full textThis article is a preprint. Preprints are preliminary reports of work that have not been certified by peer review.Background: Pathological TAR DNA-binding protein 43 (TDP-43) dysfunction is associated with multiple neurodegenerative disorders. However, the mechanistic link between TDP-43 dysfunction and neurodegeneration is poorly understood and likely involves a combination of genetic and environmental risk factors. A major risk factor for neurodegenerative disease is exposure to traumatic brain injury (TBI). Here, we investigated the synergistic interplay between TDP-43 dysfunction and TBI in a murine model of amyotrophic lateral sclerosis (ALS)/frontotemporal dementia (FTD).
Methods: A model of TDP-43 dysfunction caused by a knock-in Q331K mutation in Tardbp was combined with a mild model of TBI. Control conditions included both WT mice and mice with sham surgery. Animals were evaluated for behavioral deficits at timepoints pre- and post-surgery. Additionally, post-mortem brain tissues were examined using RNA sequencing and mass spectrometry-based quantitative proteomics together with histological and biochemical analyses.
Results: Expression of dysfunctional TDP-43 in vivo caused deficits in multiple branches of the proteostasis network, including protein folding, protein synthesis, and protein turnover. Examples include mis-expression of chaperones and genes within the ubiquitin-proteosome pathway in mutant TDP-43 versus WT mice. Further, mutant TDP-43 expression correlated with reduced thermostability of proteins associated with the ribosome and the chaperonin containing TCP-1 complex. In response to TBI, mutant TDP-43 mice exhibited significantly worse neurological outcomes relative to WT animals. Heightened neurological deficits in mutant TDP-43 mice following TBI coincided with a robust upregulation of proteostasis- and stress-related genes at the transcript level. However, this upregulation was not detected at the protein level.
Conclusions: Our data demonstrate that expression of dysfunctional TDP-43 leads to deficits within the proteostasis network in vivo at baseline. Despite an upregulation of proteostasis-related genes at the transcript level in mutant TDP-43 mice after TBI, mutant TDP-43 mice exhibit an impaired response to, and recovery from, brain trauma relative to their WT counterparts. Restoring proteostasis is expected to protect against the detrimental effects of TDP-43 dysfunction, especially under stress conditions that promote neurodegenerative disease.No embarg
Prevalent Diagnosed Depression in Relation to Contextual Isolation Among Nursing Home Residents in the United States: A Cross-Sectional Study
No full textNursing home residents commonly experience depression. This study examined the relationship between contextual isolation (having a socially salient characteristic in a nursing home where few other residents share that characteristic) and diagnosed depression. Using a cross-sectional design, we identified 1,033,485 long-stay nursing home residents from the 2010-2019 national Minimum Data Set 3.0 (a resident-centered assessment) 1 year from admission. Sixteen percent were contextually isolated on multiple characteristics. Males who were multiply contextually isolated had diagnosed depression more than males without contextual isolation (adjusted prevalence ratio: 1.09; 95% Confidence interval: 1.08-1.10). Resident groups defined by racial group who were contextually isolated on multiple characteristics had a higher prevalence of diagnosed depression than those without contextual isolation. Interventions targeting the impact of contextual isolation may reduce the prevalence of diagnosed depression among long-stay nursing home residents.No embarg
Whole-brain chemosensory responses of both C. elegans sexes [preprint]
Get PDFThis article is a preprint. Preprints are preliminary reports of work that have not been certified by peer review.Sexually-dimorphic neural circuits play a critical role in shaping sex-specific animal behaviors. Maps of the structural dimorphisms in these circuits have been explored by analyzing "synaptic connectomes", electron micrograph reconstructions of synaptic connectivity. Nevertheless, recent studies in the model organism have shown little to no correlation between the synaptic connectome and dynamic neural activity. Therefore, the extent of sexual dimorphism in functional neural activity remains unknown. To determine the extent of functional sexual-dimorphisms in we compared activity, neuron-by-neuron, across all neurons in the heads of both sexes. To sample a broad view of responses to different sensory modalities, we tested a diverse panel of ethologically-relevant olfactory, gustatory, and chemical stimuli, representing both attractive and aversive cues. We found that nearly every sensory neuron responded dimorphically to at least one cue and monomorphically to other cues, indicating that sexually-dimorphic circuits are pervasive and stimulus dependent. This dimorphic and monomorphic activity was present to a lesser extent in downstream interneurons and even less so in motoneurons, implicating sensory neurons as the primary source and location of sexually-dimorphic activity. Comparing the functional activity we measured to the published synaptic connectomes of both sexes revealed that sexual dimorphism in functional connectivity was distinct from and complementary to sexual dimorphism in synaptic connectivity. Our results provide a first-of-its-kind comparison of whole-brain dynamics between sexes at the level of single neurons, serving as an extensive resource for further investigations of functional sex differences.No embarg
Examining the Acceptability and Feasibility of a Doula Intervention Program for Veterans Receiving VA Maternity Care Benefits
No full textObjective: We aimed to assess the feasibility and acceptability of a community-based doula care pilot program for pregnant veterans receiving Department of Veterans Affairs (VA)-purchased obstetric care.
Methods: This study was conducted at two VA medical centers (Durham, North Carolina, and New Orleans, Louisiana) in partnership with local community-based doula agencies. Certified doulas provided prenatal education as well as continuous labor support and postpartum follow-up. Telephone-based surveys were administered at baseline (∼20 weeks' gestation) and ∼4 weeks postpartum. Acceptability was assessed using the validated 4-item Acceptability of Intervention Measure (AIM; 5-point Likert scale) and participant-reported experiences. Maternal and infant health outcomes were assessed following childbirth.
Results: Of the 39 veterans referred, 74% (n = 29) enrolled, and 59% (n = 23) completed both assessments, comprising the final analytic sample. Participants were predominantly Black (74%) and multiparous (61%), with high rates of service-connected disability (91%), military sexual trauma (70%), and elevated prenatal depressive symptoms (44%). All veterans received prenatal doula support; 61% received intrapartum support and 57% received postpartum support. The overall cesarean birth rate was 17%, and 87% of participants rated their childbirth experience positively. The mean AIM score was 4.3 (SD = 1.2), indicating a high level of perceived acceptability and feasibility of the doula intervention. Most participants (70%) expressed interest in using doula services in future pregnancies.
Conclusions: Community-based doula care was feasible and highly acceptable among perinatal veterans, particularly those with elevated psychosocial and obstetric risk. These findings support integrating doula services into VA maternity care to enhance culturally responsive, trauma-informed support for veterans of color.No embarg
Awake Prone Positioning in Adults With COVID-19: An Individual Participant Data Meta-Analysis
No full textImportance: The impact of awake prone positioning (APP) on clinical outcomes in patients with COVID-19 and acute hypoxemic respiratory failure (AHRF) remains uncertain.
Objective: To assess the association of APP with improved clinical outcomes among patients with COVID-19 and AHRF, and to identify potential effect modifiers.
Data sources: PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov were searched through August 1, 2024.
Study selection: Randomized clinical trials (RCTs) examining APP in adults with COVID-19 and AHRF that reported intubation rate or mortality were included.
Data extraction and synthesis: Individual participant data (IPD) were extracted according to PRISMA-IPD guidelines. For binary outcomes, logistic regression was used and odds ratio (OR) and 95% CIs were reported, while for continuous outcomes, linear regression was used and mean difference (MD) and 95% CIs were reported.
Main outcomes and measures: The primary outcome was survival without intubation. Secondary outcomes included intubation, mortality, death without intubation, death after intubation, escalation of respiratory support, intensive care unit (ICU) admission, time from enrollment to intubation and death, duration of invasive mechanical ventilation, and hospital and ICU lengths of stay.
Results: A total of 14 RCTs involving 3019 patients were included; 1542 patients in the APP group (mean [SD] age, 59.3 [14.1] years; 1048 male [68.0%]) and 1477 in the control group (mean [SD] age, 59.9 [14.1] years; 979 male [66.3%]). APP improved survival without intubation (OR, 1.42; 95% CI, 1.20-1.68), and it reduced the risk of intubation (OR, 0.70; 95% CI, 0.59-0.84) and hospital mortality (OR, 0.77; 95% CI, 0.63-0.95). APP also extended the time from enrollment to intubation (MD, 0.93 days; 95% CI, 0.43 to 1.42 days). In exploratory subgroup analyses, improved survival without intubation was observed in patients younger than age 68 years, as well as in patients with a body mass index of 26 to 30, early implementation of APP (ie, less than 1 day from hospitalization), a pulse saturation to inhaled oxygen fraction ratio of 155 to 232, respiratory rate of 20 to 26 breaths per minute (bpm), and those receiving advanced respiratory support at enrollment. However, none of the subgroups had significant interaction with APP treatment. APP duration 10 or more hours/d within the first 3 days was associated with increased survival without intubation (OR, 1.85; 95% CI, 1.37-2.49).
Conclusions and relevance: This IPD meta-analysis found that in adults with COVID-19 and AHRF, APP was associated with increased survival without intubation and with reduced risks of intubation and mortality, including death after intubation. Prolonged APP duration (10 or more hours/d) was associated with better outcomes.No embarg
Biofilm Heterogeneity in Bacillus subtilis
Get PDFBacteria are found throughout the world, in environments ranging from water to soil to the human gut. One survival mechanism common to all these environments is the formation of biofilms – communities of microorganisms encased in self-produced extracellular matrices. Biofilms are important because they provide a protective, extracellular structure that allows cells to specialize. Specialization can be either inter-species, where a certain species fills a niche; or intra-species, where genetically identical cells metabolically differentiate to fill niches within the biofilm community. To study intra-species differentiation, I use the model organism Bacillus subtilis, a soil-borne bacterium known to differentiate into numerous, phenotypically distinct cell types. In this thesis, I characterize the spatial-, temporal- and media-specific differences of gene expression in B. subtilis NCIB3610 using fluorescent transcriptional reporters, top-down colony images, biofilm cross-sectioning, and flow cytometry. As part of this work, I extended the use of Gaussian mixture models to analyze bacterial flow cytometry data and show how this approach provides insights into expression patterns that are obscured when simple on-off gates are applied. Altogether, these data demonstrate that cellular transcriptional heterogeneity within these biofilms is even more extensive than previously understood. My data provide a framework for generating hypotheses about how this heterogeneity is established and maintained. In addition, I propose and test whether DNA methylation acts as a control mechanism for driving biofilm heterogeneity in B. subtilis biofilms. My data indicate that although there are phenotypic differences between strains where putative DNA methyltransferases have been deleted, none appear to drive differences in detectable DNA methylation. Overall, my work extends our understanding of bacterial cellular heterogeneity and provides analysis tools and new hypotheses for future work.Systems, Computational, and Quantitative BiologyNo embarg
Association between parent-perceived neighborhood support on food insufficiency and public benefit participation among US children
Get PDFObjectives: Food insufficiency leads to significant negative health outcomes among children. A neighborhood's social environment (including social cohesion and support) could be associated with participation in federal nutrition programs that reduce food insufficiency through sharing of information related to how to enroll. We sought to examine the association of parent-perceived neighborhood support with food insufficiency and participation in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) among US children.
Methods: Cross-sectional data from the 2022 National Survey of Children's Health, a nationally representative survey of US children aged 0-17, were used (n = 49,907). Weighted ordinal logistic regression models estimated the adjusted odds ratio (aOR) for the relationship between caregiver-perceived neighborhood support and food insufficiency and weighted logistic regression models for the association between neighborhood support and SNAP and WIC participation.
Results: In 2022, 44 % of children lived in non-supportive neighborhoods. After controlling for covariates and accounting for sampling weights, children in non-supportive neighborhoods had 2.41 times the odds of food insufficiency (aOR: 2.39; 95 % CI: 2.19-2.65) and 1.18 times the odds of participating in SNAP (95 % CI 1.01-1.37), but there was no significant association with WIC participation (aOR: 1.04, 95 % CI 0.84-1.29).
Conclusions: Despite low neighborhood social support being significantly associated with food insufficiency, it is associated with only slightly higher odds of participation in SNAP and is not associated with WIC participation. Further research is needed to understand whether social networks can be leveraged to improve uptake of these programs.No embarg