Divergent functions for airway epithelial matrix metalloproteinase 7 and retinoic acid in experimental asthma

The innate immune response of airway epithelial cells to aeroallergen initiates the development of T cell responses that are central to allergic inflammation. Although proteinase allergens induce the expression of interleukin 25 we show that epithelial matrix metalloproteinase 7 (MMP7) was expressed in asthma and was required for maximal activity of IL-25 in promoting T helper type 2 cell differentiation. Allergen-challenged Mmp7^−/− mice showed reduced airway hyperreactivity, allergic inflammatory cytokine production and increased expression of retinal dehydrogenase (RALDH)-1. Inhibition of RALDH-1 restored the asthma phenotype in Mmp7^−/− mice and inhibited lung T regulatory cell responses while exogenous administration of retinoic acid attenuated the asthma phenotype. Thus, MMP7 coordinates allergic lung inflammation by activating IL-25 while simultaneously inhibiting retinoid-dependent T regulatory cell development.

Integrative modelling for One Health: pattern, process and participation

This paper argues for an integrative modelling approach for understanding zoonoses disease dynamics, combining process, pattern and participatory models. Each type of modelling provides important insights, but all are limited. Combining these in a '3P' approach offers the opportunity for a productive conversation between modelling efforts, contributing to a 'One Health' agenda. The aim is not to come up with a composite model, but seek synergies between perspectives, encouraging cross-disciplinary interactions. We illustrate our argument with cases from Africa, and in particular from our work on Ebola virus and Lassa fever virus. Combining process-based compartmental models with macroecological data offers a spatial perspective on potential disease impacts. However, without insights from the ground, the 'black box' of transmission dynamics, so crucial to model assumptions, may not be fully understood. We show how participatory modelling and ethnographic research of Ebola and Lassa fever can reveal social roles, unsafe practices, mobility and movement and temporal changes in livelihoods. Together with longer-term dynamics of change in societies and ecologies, all can be important in explaining disease transmission, and provide important complementary insights to other modelling efforts. An integrative modelling approach therefore can offer help to improve disease control efforts and public health responses.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'.

Limits on gravitational-wave emission from selected pulsars using LIGO data

We place direct upper limits on the amplitude of gravitational waves from 28 isolated radio pulsars by a coherent multidetector analysis of the data collected during the second science run of the LIGO interferometric detectors. These are the first direct upper limits for 26 of the 28 pulsars. We use coordinated radio observations for the first time to build radio-guided phase templates for the expected gravitational-wave signals. The unprecedented sensitivity of the detectors allows us to set strain upper limits as low as a few times 10(-24). These strain limits translate into limits on the equatorial ellipticities of the pulsars, which are smaller than 10(-5) for the four closest pulsars.

Hubble Space Telescope prescription retrieval

Prescription retrieval is a technique for directly estimating optical prescription parameters from images. We apply it to estimate the value of the Hubble Space Telescope primary mirror conic constant. Our results agree with other studies that examined primary-mirror test fixtures and results. In addition they show that small aberrations exist on the planetary-camera repeater optics.

Technology gap assessment for a future large-aperture ultraviolet-optical-infrared space telescope

The Advanced Technology Large Aperture Space Telescope (ATLAST) team identified five key technology areas to enable candidate architectures for a future large-aperture ultraviolet/optical/infrared (LUVOIR) space observatory envisioned by the NASA Astrophysics 30-year roadmap, "Enduring Quests, Daring Visions." The science goals of ATLAST address a broad range of astrophysical questions from early galaxy and star formation to the processes that contributed to the formation of life on Earth, combining general astrophysics with direct-imaging and spectroscopy of habitable exoplanets. The key technology areas are internal coronagraphs, starshades (or external occulters), ultra-stable large-aperture telescope systems, detectors, and mirror coatings. For each technology area, we define best estimates of required capabilities, current state-of-the-art performance, and current technology readiness level (TRL), thus identifying the current technology gap. We also report on current, planned, or recommended efforts to develop each technology to TRL 5.

A Pilot Study on the Effects of Nut Consumption on Cardiovascular Biomarkers

BACKGROUND

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in the United States and changes in lifestyle can minimize the likelihood of succumbing to heart disease. Anti-inflammatory agents are commonly used to reduce the chronic inflammatory state behind the pathogenesis of CVD. Multiple studies have been published correlating nut consumption with a reduction in both heart attacks and strokes. The goal of this study is to determine to what extent the consumption of almonds, hazelnuts, and walnuts have on the blood markers associated with cardiac disease and inflammation.

METHODS

This was a six-week study in which subject's baseline values act as controls. Fasting blood draws occurred at week 0, week 2, and after four weeks of intervention (week 6). All participants had undesirable lipid profiles and no medications related to heart disease.

RESULTS

Total cholesterol (TC): high-density lipoprotein (HDL-C) ratio was lowered a statistically significant amount at the six-week time point (3.89 ± 0.74) compared to both the zero-week (4.93 ± 1.16, p < 0.01) and two-week (4.63 ± 1.20, p < 0.5) timepoints. Low-density lipoprotein (LDL) measurements were lowered a statistically significant amount at the six-week time point (135.6 ± 15.0 mg/dL) compared to the zero-week (159.7 ± 12.3 mg/dL, p < 0.01). Erythrocyte sedimentation rate (ESR) was lowered a statistically significant amount at six-week time point (10.44 ± 5.05 mm/h) compared to the zero-week (14.44 ± 5.12 mm/h, p < 0.01).

CONCLUSIONS

Blood markers associated with CVD specifically and the general marker for inflammation associated with many chronic diseases can be favorably modified with the consumption of specific nuts as demonstrated by this study.

An osteopathic orientation to interprofessional education

CONTEXT

The osteopathic tenets may serve as a useful guideline for an interprofessional program. There is an alignment between the osteopathic tenets and the concept of interprofessional education (IPE). IPE occurs when students from two or more professions work with each other to collaborate or improve healthcare outcomes. Holistic treatment is fundamental in both instances, and the interrelatedness of structure and function requires acknowledgment of all healthcare professionals' roles in treating a patient. IPE allows students to gain a better understanding of their own professional roles and the roles of their fellow healthcare providers in treating patients more effectively.

OBJECTIVES

The objectives of this analysis are to evaluate the ability of an interprofessional summer workshop/lecture utilizing an osteopathic focus to educate students from different healthcare colleges about the interconnectedness of the systems of the human body and how working with a team-based approach will ultimately benefit their collective patients. A secondary objective was to determine the students' perceptions before and after the lecture/workshop to see if there were any perceived differences among students in different healthcare professions at either time.

METHODS

This was a retrospective data analysis conducted on pretest/posttest surveys completed by 73 incoming students from six different healthcare colleges participating in the Summer Preparedness and Readiness Course (SPaRC), held annually at Western University of Health Sciences (WUHS) in Pomona, California. Analysis was conducted on responses collected during the SPaRC programs of 2013, 2016, and 2019. Participants were given surveys containing five questions scored on a five-point Likert scale. The surveys were given before and after an integrated lecture/hands-on workshop presented at SPaRC that reviewed multiple studies showing the utility of connecting the healthcare professions to best treat a patient.

RESULTS

A total of 73 students responded to both the prelecture and postlecture surveys. When the number of positive scores were totaled from students from all colleges, there was an increase in positive responses from 190 (52.2 %) in prelecture surveys when compared to 336 (92.3 %) in postlecture surveys. A Wilcoxon signed-rank test suggested that the lecture workshop elicited a significant improvement in scores from prelecture to postlecture for all students (Z=-6.976, p=0.000). Median scores improved from 3.60 at baseline to 4.40 after the lecture/workshop. Secondary analysis conducted utilizing Kruskal-Wallis H to examine the differences between the responses of the different colleges prelecture and postlecture showed no significant differences prelecture (H [6]=7.58, p=0.271) and a significant difference between postlecture answers (H [6]=14.04, p=0.029). A series of post hoc independent Kruskal-Wallis H analyses was conducted to identify where differences were, and the only identifiable difference after Bonferroni corrections was between students from the Doctor of Osteopathic Medicine college and the Physician Assistant's college after the lecture/survey (p=0.041).

CONCLUSIONS

An interprofessional program with the osteopathic principles of focusing on body unity and relatedness of structure and function may serve as a helpful tool for uniting healthcare professionals in their ultimate goal of better serving their patients.

Drivers and potential distribution of anthrax occurrence and incidence at national and sub-county levels across Kenya from 2006 to 2020 using INLA

Anthrax is caused by, Bacillus anthracis, a soil-borne bacterium that infects grazing animals. Kenya reported a sharp increase in livestock anthrax cases from 2005, with only 12% of the sub-counties (decentralised administrative units used by Kenyan county governments to facilitate service provision) accounting for almost a third of the livestock cases. Recent studies of the spatial extent of B. anthracis suitability across Kenya have used approaches that cannot capture the underlying spatial and temporal dependencies in the surveillance data. To address these limitations, we apply the first Bayesian approach using R-INLA to analyse a long-term dataset of livestock anthrax case data, collected from 2006 to 2020 in Kenya. We develop a spatial and a spatiotemporal model to investigate the distribution and socio-economic drivers of anthrax occurrence and incidence at the national and sub-county level. The spatial model was robust to geographically based cross validation and had a sensitivity of 75% (95% CI 65-75) against withheld data. Alarmingly, the spatial model predicted high intensity of anthrax across the Northern counties (Turkana, Samburu, and Marsabit) comprising pastoralists who are often economically and politically marginalized, and highly predisposed to a greater risk of anthrax. The spatiotemporal model showed a positive link between livestock anthrax risk and the total human population and the number of exotic dairy cattle, and a negative association with the human population density, livestock producing households, and agricultural land area. Public health programs aimed at reducing human-animal contact, improving access to healthcare, and increasing anthrax awareness, should prioritize these endemic regions.

Accuracy of Anterior Superior Iliac Spine Symmetry Assessment by Routine Structural Examination

Context: Assessment of the anterior superior iliac spine (ASIS) is a key component in generating the pelvic diagnosis of somatic dysfunction, but studies have shown poor reliability between examiners.

Objective: To assess the influence of homogeneous training, years of experience, and eye dominance on the percentage of correctness, sensitivity, and specificity of ASIS evaluation.

Methods: Osteopathic physicians, predoctoral teaching fellows, and first- and second-year osteopathic medical students from a single teaching institute assessed 3 plastic pelvic models with ASIS anatomic landmarks set at different levels: even and 5- and 10-mm descrepancies. Dominant and nondominant eyes were used independently to assess ASIS levels.

Results: A total of 147 examiners (participants) participated in this study (66 first-year and 61 second-year medical students, 15 fellows, and 5 osteopathic physicians). The overall percentages of correct results were 31.0% (even levels), 82.8% (5-mm discrepancy), and 91.7% (10-mm discrepancy). Differences by level of training were statistically significant only for the 5-mm ASIS discrepancy, where participants with more experience performed better. The overall sensitivity was 82.8% (5-mm discrepancy) and 91.7% (10-mm discrepancy), and the specificity was 31.0%. No statistically significant differences were found in the percentage of correct results by eye dominance.

Conclusion: Assessment of ASIS is sensitive but not specific at discrepancies of 5 mm or greater. Length of experience positively influences the percentage of correct results, and eye dominance does not significantly change this outcome. This form of assessment can be used to screen for ASIS asymmetry.

Dynamic models of Fabry-Perot interferometers

Long-baseline, high-finesse Fabry-Perot interferometers can be used to make distance measurements that are precise enough to detect gravity waves. This level of sensitivity is achieved in part when the interferometer mirrors are isolated dynamically, with pendulum mounts and high-bandwidth cavity length control servos to reduce the effects of seismic noise. We present dynamical models of the cavity fields and signals of Fabry-Perot interferometers for use in the design and evaluation of length control systems for gravity-wave detectors. Models are described and compared with experimental data.

Verification imaging in prostate MR-only radiotherapy: Are fiducial markers necessary?

PURPOSE/OBJECTIVE

MR-only radiotherapy planning exploits the benefits of MRI soft-tissue delineation, whilst negating the registration inaccuracies caused by MRI CT fusion. Fiducial markers have conventionally been used in prostate radiotherapy to reduce on-treatment image matching variability. However, this is an invasive procedure for the patient, and presents technical difficulties in an MR-only pathway as fiducial markers are difficult to visualise on MRI. This study compares MR-CBCT soft-tissue matching to fiducial matching in an MR-only prostate pathway.

MATERIAL/METHODS

Four therapeutic radiographers reviewed first fraction CBCTs for 25 patients. The CBCT was compared to the planning MRI, a T2 weighted sequence for the soft-tissue match and compared to a T1 weighted MRI sequence for the fiducial match. Inter-observer variability was quantified using the inter-observer error and 95 % limits of agreement from a modified Bland-Altman analysis. Accuracy of the soft-tissue match was quantified by calculating the difference from the fiducial match.

RESULTS

Limits of agreement on the MR soft-tissue match were 1.5 mm, 4.0 mm, 3.5 mm and fiducial match 2.5 mm, 3.6 mm, 2.5 mm (lateral, longitudinal, vertical). Inter-observer error (±standard deviation) on the MR soft-tissue match were 0.6(±0.5) mm, 1.8(±1.1) mm, 1.7(±0.7) mm and fiducial match 0.7(±1.1) mm, 1.1(±1.5) mm, 0.8(±0.7) mm (lateral, longitudinal, vertical). The difference of the soft-tissue match from the fiducial match was 0.3(±1.1) mm, -0.1(±2.7) mm, 0.1(±1.9) mm (lateral, longitudinal, vertical).

CONCLUSION

MR-CBCT soft-tissue matching has similar accuracy and inter-observer variability as fiducial matching. This suggests fiducial markers are not necessary in an MR-only prostate radiotherapy pathway.

IMPLICATIONS FOR PRACTICE

MR-only prostate radiotherapy does not require fiducial markers since MR-CBCT soft tissue matching can be used for IGRT.