Current Protocols Research Articles

Nuxcell Neo® improves vaccine efficacy in antibody response.

Current vaccination protocols raise concerns about the efficacy of immunization. There is evidence that changes in the gut microbiota can impact immune response. The formation of the gut microbiota in newborns plays a crucial role in immunity. Probiotic bacteria and prebiotics present important health-promoting and immunomodulatory properties. Thus, we hypothesize that pro and prebiotic supplementation can improve the efficacy of vaccination in newborns. In this protocol, newborn mice were used and treated with a single-dose rabies vaccine combined with Nuxcell Neo® (2 g/animal/week) for 3 weeks. Samples were collected on days 7, 14, and 21 after vaccination for analysis of cytokines and concentration of circulating antibodies. Our results show an increased concentration of antibodies in animals vaccinated against rabies and simultaneously treated with Nuxcell Neo® on days 14 and 21 when compared to the group receiving only the vaccine. In the cytokine levels analysis, it was possible to observe that there weren't relevant and significant changes between the groups, which demonstrates that the health of the animal remains stable. The results of our study confirm the promising impact of the use of Nuxcell Neo® on the immune response after vaccination.

Guidelines for the development, performance evaluation and validation of new sleep technologies (DEVSleepTech guidelines) - a protocol for a Delphi consensus study.

New sleep technologies are being developed, refined and delivered at a fast pace. However, there are serious concerns about the validation and accuracy of new sleep-related technologies being made available, as many of them, especially consumer-sleep technologies, have not been tested in comparison with gold-standard methods or have been approved by health regulatory agencies. The importance of proper validation and performance evaluation of new sleep technologies has already been discussed in previous studies and some recommendations have already been published, but most of them do not employ standardized methodology and are not able to cover all aspects of new sleep technologies. The current protocol describes the methods of a Delphi consensus study to create guidelines for the development, performance evaluation and validation of new sleep devices and technologies. The resulting recommendations are not intended to be used as a quality assessment tool to evaluate individual articles, but rather to evaluate the overall procedures, studies and experiments performed to develop, evaluate performance and validate new technologies. We hope these guidelines can be helpful for researchers who work with new sleep technologies on the appraisal of their reliability and validation, for companies who are working on the development and refinement of new sleep technologies, and by regulatory agencies to evaluate new technologies that are looking for registration, approval or inclusion on health systems.

Factors Associated with Early Mortality in Acute Type A Aortic Dissection-A Single-Centre Experience.

Acute aortic dissection type A (AADA) is a surgical emergency with relevant mortality and morbidity despite improvements in current management protocols. Identifying patients at risk of a fatal outcome and controlling the factors associated with mortality remain of paramount importance. In this retrospective observational study, we reviewed the medical records of 117 patients with AADA, who were referred to our centre and operated on between 2005 and 2021. Preoperative, intraoperative, and postoperative variables were analysed and tested for their correlation with in-hospital mortality. The overall survival rate was 83%. Preoperatively, factors associated with mortality were age (p = 0.02), chronic hypertension (p = 0.02), any grade of aortic valve stenosis in the patient's medical history (p = 0.03), atrial fibrillation (p = 0.04), and oral anticoagulation (p = 0.04). Non-survivors had significantly longer operative times (p = 0.002). During the postoperative phase, mortality was strongly associated with acute kidney injury (AKI) (p < 0.001), acute heart failure (p < 0.001), stroke (p = 0.02), focal neurological deficits (p = 0.02), and sepsis (p = 0.001). In the multivariate regression analysis, the onset of postoperative focal neurological deficits was the best predictor of a fatal outcome after adjusting for ARDS (odds ratio: 5.8, 95%-CI: 1.2-41.7, p = 0.04). In this retrospective analysis, atrial fibrillation, oral anticoagulation, hypertension, and age were significantly correlated with mortality. Postoperatively, acute kidney injury, acute heart failure, sepsis, and focal neurological deficits were correlated with in-hospital mortality, and focal neurological deficit has been identified as a significant predictor of fatal outcomes. Early detection and interdisciplinary management of at-risk patients remain crucial throughout the postoperative phase.

Breast cancer detection using enhanced IRI-numerical engine and inverse heat transfer modeling: model description and clinical validation

Effective treatment of breast cancer relies heavily on early detection. Routine annual mammography is a widely accepted screening technique that has resulted in significantly improving the survival rate. However, it suffers from low sensitivity resulting in high false positives from screening. To overcome this problem, adjunctive technologies such as ultrasound are employed on about 10% of women recalled for additional screening following mammography. These adjunctive techniques still result in a significant number of women, about 1.6%, who undergo biopsy while only 0.4% of women screened have cancers. The main reason for missing cancers during mammography screening arises from the masking effect of dense breast tissue. The presence of a tumor results in the alteration of temperature field in the breast, which is not influenced by the tissue density. In the present paper, the IRI-Numerical Engine is presented as an adjunct for detecting cancer from the surface temperature data. It uses a computerized inverse heat transfer approach based on Pennes’s bioheat transfer equations. Validation of this enhanced algorithm is conducted on twenty-three biopsy-proven breast cancer patients after obtaining informed consent under IRB protocol. The algorithm correctly predicted the size and location of cancerous tumors in twenty-four breasts, while twenty-two contralateral breasts were also correctly predicted to have no cancer (one woman had bilateral breast cancer). The tumors are seen as highly perfused and metabolically active heat sources that alter the surface temperatures that are used in heat transfer modeling. Furthermore, the results from this study with twenty-four biopsy-proven cancer cases indicate that the detection of breast cancer is not affected by breast density. This study indicates the potential of the IRI-Numerical Engine as an effective adjunct to mammography. A large scale clinical study in a statistically significant sample size is needed before integrating this approach in the current protocol.

Modeling Fetal Alcohol Spectrum Disorders in Zebrafish to Characterize the Impact of an Adverse Embryonic Environment on Adult Social Behavior.

Fetal alcohol spectrum disorders (FASD) describe all alcohol-induced birth defects. Birth defects such as growth deficiencies, craniofacial, behavioral, and cognitive abnormalities are associated with FASD. Social difficulties are common behavioral abnormalities associated with FASD and often result in serious health issues. Animal models are critical to understanding the mechanisms responsible for ethanol-induced social defects. Zebrafish are social vertebrates that produce externally fertilized transparent eggs; these characteristics provide researchers with a precise yet simple procedure for creating the FASD phenotype and an innate behavior that can be leveraged to model the social deficits associated with FASD. Thus, zebrafish are ideal for characterizing the social deficits of FASD. The goal of the current protocol is to provide the user with a simple behavioral assay that can be used to characterize the consequences of a negative environment early during development and the effects it can have on social behavior in adulthood. The protocol can be used to characterize the effect mutations or teratogens have on adult social behavior. The protocol outlined here demonstrates how to characterize the social behavior of individual fish during a 20-min social assay. Furthermore, the data obtained using the current protocol provides evidence that the protocol can be used to characterize the effects of embryonic ethanol-induced social defects in adult zebrafish.

Impacts of systemic treatments on health-related quality of life for patients with metastatic colorectal cancer: a systematic review and network meta-analysis

ObjectiveThere is limited evidence of comparative results among different treatments regarding impacts of Health-Related Quality of Life (HRQoL) for patients with metastatic colorectal cancer (mCRC). We aimed to compare efficacy of systemic treatments on HRQoL among patients with mCRC.MethodsWe collected randomized controlled trials (RCTs) reported in English up until July 2023, from databases including PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and prominent conference databases, for this Bayesian network meta-analysis. Phase 2 or 3 trials that evaluated at least two therapeutic regimens were included. Primary outcomes were short-term and long-term mean changes in EORTC QLQ-C30 global health status/quality of life (GHS/QoL) scores. Secondary outcome was mean change in EQ-5D health utility scores. Mean differences (MDs) with 95% confidence intervals (CIs) were used as effect size. Subgroup analysis was performed based on whether patients received systemic treatments before. We conducted various sensitivity analyses, including differentiating between chemotherapy types, and analyzed patient cohorts with non-specified gene expression levels as well as those with target KRAS expression statuses. The current systematic review protocol was registered on PROSPERO (CRD42023453315 and CRD42023420498).ResultsImmunotherapy and targeted therapy significantly improved HRQoL over chemotherapy, with MDs of 9.27 (95% CI: 3.96 to 14.6) and 4.04 (95% CI: 0.11 to 7.94), respectively. Monotherapy significantly outperformed both combination therapy (MD 5.71, 95%CI 0.78 to 10.63) and no active treatment (MD 3.7, 95%CI 1.41 to 6.01) regarding GHS/QoL in the short-term. Combining targeted therapy with chemotherapy did not improve HRQoL. Focusing on HRQoL, cetuximab excelled when gene expression baselines were unspecified. Subgroup and sensitivity analyses upheld these robust findings, unaffected by model or patient baseline characteristics. Evidence from clinical trials without specific gene level data suggested that monotherapies, especially targeted therapies such as cetuximab, demonstrated superiority in HRQoL. For KRAS wild-type patients, no significant HRQoL differences emerged between chemotherapy, targeted therapy, or their combination..ConclusionsTargeted therapies and immunotherapy demonstrate superior HRQoL benefits, monotherapy such as cetuximab is associated with significant improvements as compared to combination therapy. However, tailoring these results to individual gene expression profiles requires more evidence.

Efficient Synthesis and HPLC-Based Characterization for Developing Vanadium-48-Labeled Vanadyl Acetylacetonate as a Novel Cancer Radiotracer for PET Imaging.

Bis(acetylacetonato)oxidovanadium(IV) [(VO(acac)2], generally known as vanadyl acetylacetonate, has been shown to be preferentially sequestered in malignant tissue. Vanadium-48 (48V) generated with a compact medical cyclotron has been used to label VO(acac)2 as a potential radiotracer in positron emission tomography (PET) imaging for the detection of cancer, but requires lengthy synthesis. Current literature protocols for the characterization of VO(acac)2 require macroscale quantities of reactants and solvents to identify products by color and to enable crystallization that are not readily adaptable to the needs of radiotracer synthesis. We present an improved method to produce vanadium-48-labeled VO(acac)2, [48V]VO(acac)2, and characterize it using high-performance liquid chromatography (HPLC) with radiation detection in combination with UV detection. The approach is suitable for radiotracer-level quantities of material. These methods are readily applicable for production of [48V]VO(acac)2. Preliminary results of preclinical, small-animal PET studies are presented.

Towards good practices for research on Acheta domesticus, the house cricket

Abstract Several alternative approaches have been proposed to address the need for sustainable protein sources within our existing food and feed systems. Insects are regarded as a promising alternative, which has led to increased attention from researchers worldwide. Acheta domesticus, the house cricket, is considered a potential insect species for industrial production and various applications due to its high nutritious value. Since it is expected that A. domesticus and its applications will continue to rise as an important field of study, the standardisation of production techniques are needed. Nowadays, variation in the measurement of parameters and differences in experimental design limit the comparison among studies and, therefore, the ability to build upon existing knowledge. By identifying gaps in current protocols and providing suggestions on rearing practices and reporting, this paper aims to take the first step towards standardisation of the production and characterisation of Acheta domesticus for research purposes. This initiative primarily focusses on research practices evaluating the impact of feed and environmental conditions on the performance of house crickets.

High SNR full brain relaxometry at 7T by accelerated MR-STAT.

To demonstrate the feasibility and robustness of the Magnetic Resonance Spin TomogrAphy in Time-domain (MR-STAT) framework for fast, high SNR relaxometry at 7T. To deploy MR-STAT on 7T-systems, we designed optimized flip-angles using the BLAKJac-framework that incorporates the SAR-constraints. Transmit RF-inhomogeneities were mitigated by including a measured -map in the reconstruction. Experiments were performed on a gel-phantom and on five volunteers to explore the robustness of the sequence and its sensitivity to inhomogeneities. The SNR-gain at 7T was explored by comparing phantom and in vivo results to MR-STAT at 3T in terms of SNR-efficiency. The higher SNR at 7T enabled two-fold acceleration with respect to current 2D MR-STAT protocols at lower field strengths. The resulting scan had whole-brain coverage, with 1 x 1 x 3 mm3 resolution (1.5 mm slice-gap) and was acquired within 3 min including the -mapping. After -correction, the estimated T1 and T2 in a phantom showed a mean relative error of, respectively, 1.7% and 4.4%. In vivo, the estimated T1 and T2 in gray and white matter corresponded to the range of values reported in literature with a variation over the subjects of 1.0%-2.1% (WM-GM) for T1 and 4.3%-5.3% (WM-GM) for T2. We measured a higher SNR-efficiency at 7T (R = 2) than at 3T for both T1 and T2 with, respectively, a 4.1 and 2.3 times increase in SNR-efficiency. We presented an accelerated version of MR-STAT tailored to high field (7T) MRI using a low-SAR flip-angle train and showed high quality parameter maps with an increased SNR-efficiency compared to MR-STAT at 3T.

Thiuram Disulfide Mediated Cu-Catalyzed Amidation of Terminal Alkynes: An Efficient Synthesis of Alkynyl Amides.

Terminal alkynes undergo a CO-free aminocarbonylation reaction mediated by thiuram disulfides. Thiuram disulfide acts as the source of the carbamoyl group in the amidation of terminal alkynes in the presence of copper-based reagent and catalyst. A series of alkynyl amides has been prepared with several structural variations following the current one-pot two-step protocol. The reaction proceeds through a mixed disulfide intermediate, which has been isolated and characterized by single-crystal XRD analysis.

Comparison of EV Fast Charging Protocols and Impact of Sinusoidal Half-Wave Fast Charging Methods on Lithium-Ion Cells

In electric vehicle fast charging systems, it is important to minimize the effect of fast charging on the grid and it is also important to operate the charging system at high efficiencies. In order to achieve these objectives, in this paper, a sinusoidal half-wave DC current charging protocol and a sinusoidal half-wave pulsed current charging protocol are proposed for the fast charging of Li-ion batteries. A detailed procedure is presented for implementing the following proposed methods: (a) a pre-defined half-sine wave current function and (b) a pulsed half-sine wave current method. Unlike the conventional full-wave sinusoidal ripple current charging protocols, the proposed study does not utilize any sinusoidal full-wave ripple. The performance of these new charging methods on Ni-Co-Al-type Li-cells is studied and compared with the existing constant current and positive pulsed current charging protocols, which have been discussed in the existing literature. In addition, the changes in the electrochemical impedance spectrograph of each cell are examined to study the effects of the applied charging methods on the internal resistance of the Li cell. Finally, the test results are presented for 250 life cycles of charging at 2C (C: charging rate) and the degradation in cell capacities are compared among the four different methods for the Ni-Co-Al-type Li cell.

Short-term hypercaloric carbohydrate loading increases surgical stress resilience by inducing FGF21

Dietary restriction promotes resistance to surgical stress in multiple organisms. Counterintuitively, current medical protocols recommend short-term carbohydrate-rich drinks (carbohydrate loading) prior to surgery, part of a multimodal perioperative care pathway designed to enhance surgical recovery. Despite widespread clinical use, preclinical and mechanistic studies on carbohydrate loading in surgical contexts are lacking. Here we demonstrate in ad libitum-fed mice that liquid carbohydrate loading for one week drives reductions in solid food intake, while nearly doubling total caloric intake. Similarly, in humans, simple carbohydrate intake is inversely correlated with dietary protein intake. Carbohydrate loading-induced protein dilution increases expression of hepatic fibroblast growth factor 21 (FGF21) independent of caloric intake, resulting in protection in two models of surgical stress: renal and hepatic ischemia-reperfusion injury. The protection is consistent across male, female, and aged mice. In vivo, amino acid add-back or genetic FGF21 deletion blocks carbohydrate loading-mediated protection from ischemia-reperfusion injury. Finally, carbohydrate loading induction of FGF21 is associated with the induction of the canonical integrated stress response (ATF3/4, NF-kB), and oxidative metabolism (PPARγ). Together, these data support carbohydrate loading drinks prior to surgery and reveal an essential role of protein dilution via FGF21.

Abstract TMP14: Population-Based Intracranial Vascular Imaging for Acute Ischemic Stroke is Suboptimal

Introduction: Endovascular thrombectomy (EVT) is the standard of care for patients with ischemic stroke and large vessel occlusion (LVO). Intracranial vascular imaging is required to determine the presence of an LVO. Although patients can be eligible for EVT up to 24h after last seen normal (LSN), current imaging protocols focus on the first 6h from LSN. We evaluated the use of intracranial vascular imaging in patients with ischemic stroke as a function of time since LSN in Ontario, Canada. Methods: We analyzed data from the Ontario Stroke Registry which performed primary data collection evaluating care and outcomes in 13,828 patients hospitalized with stroke across Ontario in the fiscal year 2019/20. This sampling strategy included 93.3% of all strokes in a province of 14.5 million residents. We used modified Poisson regression models to evaluate the association between time from LSN to first hospital presentation (&lt;6h, 6-12h, 12-24h) and receipt of intracranial vascular imaging with computed tomographic angiography or magnetic resonance angiography. We adjusted for baseline differences and estimated the adjusted relative risk (aRR) of imaging. Results: Data collection is &gt;75% completed and full results will be presented at the ISC. Of 8,482 patients with ischemic stroke, 6,345 (74.8%) presented within 24h of LSN (n=3,811 &lt;6h; n=1,368 6-12h; n=1,166 12-24h). Median age was 76 years (IQR 66-85) and 3,002 (47.3%) were women. Overall, 5,196 (81.9%) patients had intracranial vascular imaging, but compared to those within 6h of LSN (86.8% imaged), patients presenting later were less likely to receive vascular imaging (77.2% for 6-12h, aRR 0.91 95%CI [0.88, 0.94] and 71.4% for 12-24h, aRR 0.85 95%CI [0.82, 0.88]). Of those imaged, 895 (17.2%) had an LVO (18.5% &lt;6h; 16.4% 6-12h, 13.3% 12-24h, p&lt;0.01) and 492 (55.0%) patients with LVO underwent EVT. Conclusions: On a population basis, over 80% of patients with ischemic stroke had intracranial vascular imaging, but gaps in care exist for those presenting in the later time window. Up to one in three patients presenting beyond 6h from LSN did not have vascular imaging. Systems of care must be optimized to support LVO identification and EVT access in later time windows.

Is a mix - A fix? "A microscopic analysis of depth of penetration of three combinations of irrigants".

The aim of the study is to evaluate the penetration depth of irrigants mixed with NaOCl into dentinal tubules at the apical third of the root canal using a confocal laser scanning microscope (CLSM). Thirty-six single-rooted teeth were selected, decoronated, and straight-line access established. Then, the canal was enlarged with hand Protaper till size F3. The samples were divided randomly into three groups: Group 1 was irrigated with 3% NaOCl mixed with 1% phytic acid; Group 2 was irrigated with 3% NaOCl mixed with 18% etidronic acid; and Group 3 was irrigated with 3% NaOCl mixed with chitosan. The samples were subjected to CLSM evaluation. One-way analysis of variance with Tukey's post hoc was used for statistical analysis. Group 3 (NaOCl with chitosan) showed a greater depth of penetration in comparison to Groups 1 and 2. Within limitations, it can be concluded that chitosan, in combination with NaOCl can be used as an alternative to the current irrigation protocol.

Handling Patient Emergencies During Radiopharmaceutical Therapy

BackgroundRadiopharmaceutical therapy (RPT) is a rapidly growing treatment modality. Though uncommon, patients may experience complications during their RPT treatment, which may trigger a rapid response from the hospital team. However, members of this team are typically not familiar with precautions for radiation safety. During these events, it is important to prioritize the patient's health over all else. However, there are some practices that can help minimize the risk of radiation contamination spread and exposure to staff while tending to the patient. MethodsWe formed a team to develop a standard protocol for handling patient emergencies during RPT treatment. This team consisted of an authorized user, radiation safety officer, medical physicist, nurse, RPT administration staff, and a quality/safety coordinator. The focus for developing this standardized protocol for RPT patient emergencies was three-fold: (1) stabilize the patient, (2) reduce radiation exposure to staff, and (3) limit the spread of radiation contamination. ResultsWe modified our hospital's existing rapid response protocol to account for the additional staff and tasks needed to accomplish all three of these goals. Each team member was assigned specific responsibilities, which include serving as a gatekeeper to restrict traffic, managing the crash cart, performing chest compressions, timing chest compressions, documenting the situation, and monitoring/managing radiation safety in the area. We developed a small, easy-to-read card for rapid response staff to read while they are en route to the area so they can be aware of and prepare for the unique circumstances that RPT treatments present. ConclusionsThough rapid response events with RPT patients are uncommon, it is important to have a standardized protocol for how to handle these situations beforehand rather than improvise in the moment. We have provided an example of how our team adapted our hospital's current rapid response protocol to accommodate RPT patients.

Abstract PR001: Learning to adapt: Rational personalization of adaptive therapy using deep reinforcement learning

Abstract Standard-of-care treatment regimens have long been designed for maximal cell kill, yet these strategies often fail when applied to metastatic cancers due to the emergence of drug resistance. Adaptive treatment strategies have been developed as an alternative approach, dynamically adjusting treatment to suppress the growth of treatment-resistant populations, delaying, or even preventing, tumor progression. Promising clinical results in prostate cancer indicate the potential to optimize adaptive treatment protocols. We propose the application of deep reinforcement learning (DRL) to guide adaptive drug scheduling, and demonstrate that these treatment schedules can outperform the current adaptive protocols in a mathematical model calibrated to prostate cancer dynamics, more than doubling the time to progression. We show that the DRL strategies are robust to patient variability, including both tumor dynamics and clinical monitoring schedules. We demonstrate that the DRL framework can produce interpretable, adaptive strategies based on a single tumor burden threshold, replicating and informing optimal treatment strategies. Given the DRL framework has no knowledge of the underlying mathematical tumor model, this demonstrates the capability of DRL to help develop treatment strategies in novel or complex settings. Finally, we propose a five-step pathway combining mechanistic modeling with the DRL framework to translate this approach to the clinic with limited information for a given patient. Integrating conventional tools to ensure the interpretability of traditionally `black-box' DRL models, we generate personalized treatment schedules that consistently outperform clinical standard-of-care protocols. Citation Format: Kit Gallagher, Maximilian Strobl, Robert Gatenby, Philip Maini, Alexander Anderson. Learning to adapt: Rational personalization of adaptive therapy using deep reinforcement learning [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Cancer Evolution and Data Science: The Next Frontier; 2023 Dec 3-6; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_2):Abstract nr PR001.

Pericervical Dentin Metrics in Mandibular First Molars Determined with Digital Periapical Radiography and Cone-beam Computed Tomography

IntroductionPericervical root dentin is decisive for the long-term mechanical integrity of root-filled teeth. Current treatment protocol does not include a customized step to determine the pretreatment residual pericervical root dentin. ObjectiveTo determine and compare the residual root dentin and canal width using digital periapical radiography (DPR) and cone-beam computed tomography (CBCT) at the apical limit of the pericervical area (PCA) in mandibular first molars. MethodsDPR and CBCT images of 60 patients with age between 22 and 76 years were used to determine (a) the mesiodistal widths of the root canal (pericervical dimensions [PCL]-C) and the root (PCL-R) of mandibular first molars at the apical limit of the PCA and (b) the intracanal distance from the apical limit of the PCA to the radiographic apex (intracanal distance [ICD]). The correlation between the PCL and ICD measurements obtained from DPR and CBCT were evaluated. ResultsValues between 0.10–0.80 mm and 0.00–1.10 mm were obtained for PCL-C using DPR and CBCT respectively (95% CI). The PCL values between 0.90–2.30 mm and 0.00–2.30 mm were obtained from DPR and CBCT respectively (95% CI). The ICD ranged between 4.6–12.3 mm in DPR and 4.40–12.0 mm in CBCT (95% CI). The comparative analysis showed differences from −0.9 to 0.5 mms for PCL and −2.00 to 1.5 mms for ICD between DPR and CBCT techniques respectively. ConclusionThe PCL and ICD determined from DPR and CBCT provided the pericervical dentin metrics that could be utilized clinically as a guideline for decision-making in endodontic treatment.

Brain Tumor Imaging without Gadolinium-based Contrast Agents: Feasible or Fantasy?

Gadolinium-based contrast agents (GBCAs) form the cornerstone of current primary brain tumor MRI protocols at all stages of the patient journey. Though an imperfect measure of tumor grade, GBCAs are repeatedly used for diagnosis and monitoring. In practice, however, radiologists will encounter situations where GBCA injection is not needed or of doubtful benefit. Reducing GBCA administration could improve the patient burden of (repeated) imaging (especially in vulnerable patient groups, such as children), minimize risks of putative side effects, and benefit costs, logistics, and the environmental footprint. On the basis of the current literature, imaging strategies to reduce GBCA exposure for pediatric and adult patients with primary brain tumors will be reviewed. Early postoperative MRI and fixed-interval imaging of gliomas are examples of GBCA exposure with uncertain survival benefits. Half-dose GBCAs for gliomas and T2-weighted imaging alone for meningiomas are among options to reduce GBCA use. While most imaging guidelines recommend using GBCAs at all stages of diagnosis and treatment, non-contrast-enhanced sequences, such as the arterial spin labeling, have shown a great potential. Artificial intelligence methods to generate synthetic postcontrast images from decreased-dose or non-GBCA scans have shown promise to replace GBCA-dependent approaches. This review is focused on pediatric and adult gliomas and meningiomas. Special attention is paid to the quality and real-life applicability of the reviewed literature.

Improving Venous Thromboembolism Prophylaxis Through Service Integration, Policy Enhancement, and Health Informatics.

Venous thromboembolism (VTE) prevention and management are susceptible issues that require specific rules to sustain and oversee their functioning, as preventing VTE is a vital patient safety priority. This paper aims to investigate and provide recommendations for VTE assessment and reassessment through policy enhancement and development. We reviewed different papers and policies to propose recommendations and theme analysis for policy modifications and enhancements to improve VTE prophylaxis and management. Recommendations were set to enhance the overall work of VTE prophylaxis, where the current VTE protocols and policies must ensure high levels of patient safety and satisfaction. The recommendations included working through a well-organized multidisciplinary team and staff engagement to support and enhance VTE's work. Nurses', pharmacists', and physical therapists' involvement in setting up the plan and prevention is the way to share the knowledge and paradigm of experience to standardize the management. Promoting policies regarding VTE prophylaxis assessment and reassessment using electronic modules as a part of the digital health process was proposed. A deep understanding of the underlying issues and the incorporation of generic policy recommendations were set. This article presents recommendations for stakeholders, social media platforms, and healthcare practitioners to enhance VTE prophylaxis and management.

Methods for the Design and Analysis of Analytical Ultracentrifugation Experiments.

Analytical ultracentrifugation experiments play an integral role in the solution-phase characterization of biological macromolecules and their interactions. This unit discusses the design of sedimentation velocity and sedimentation equilibrium experiments performed with a Beckman Proteomelab XL-A or XL-I analytical ultracentrifuge and with a Beckman Optima AUC. Instrument settings and experimental design considerations are explained, and strategies for the analysis of experimental data with the UltraScan data analysis software package are presented. Special attention is paid to the strengths and weaknesses of the available detectors, and guidance is provided on how to extract maximum information from analytical ultracentrifugation experiments. © 2024 The Authors. Current Protocols published by Wiley Periodicals LLC.