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ARCADIA reveals spatially dependent transcriptional programs through integration of scRNA-seq and spatial proteomics.

MOTIVATION: Cellular states are strongly influenced by spatial context, but single-cell RNA sequencing (scRNA-seq) loses information about local tissue organization, while spatial proteomic assays capture limited marker panels that constrain transcriptomic inference. Integrating these modalities can elucidate how spatial niches shape transcriptional programs, yet existing approaches depend on either feature-level correspondence such as gene-protein linkage or cell-level barcode pairing, which is often unavailable. RESULTS: We present ARCADIA (ARchetype-based Clustering and Alignment with Dual Integrative Autoencoders), a generative framework for cross-modal integration that operates without cell barcode pairing and does not assume direct feature-to-feature correspondence. ARCADIA identifies modality-specific archetypes, that is, convex combinations of cells representing extreme phenotypic states, and aligns these anchors across modalities by minimizing the discrepancy between their cell-type composition profiles. The aligned archetypes define a shared coordinate system that anchors dual variational autoencoders (VAEs) trained with cross-modal geometric regularization, preserving archetype structure and spatial neighborhood information while enabling bidirectional translation between modalities. On semi-synthetic CITE-seq data, ARCADIA outperforms existing weak-linkage methods. Applied to independent human tonsil scRNA-seq and CODEX data, ARCADIA reconstructs known tissue architecture and reveals spatially dependent transcriptional programs linking B-cell maturation and T-cell activation or exhaustion to microenvironmental niches. AVAILABILITY AND IMPLEMENTATION: Source code is accessible at https://github.com/azizilab/ARCADIA_public. Reproducibility scripts and data are available at https://github.com/azizilab/arcadia_reproducibility.

Proteomics↗

Assessing the success of the WomanKind program: an integrated model of 24-hour health care response to domestic violence.

PURPOSE: The WomanKind program, a non-profit health care based program for for victims of domestic/intimate partner violence (IPV), seeks to enable and motivate health care providers to identify victims of such violence and refer them to WomanKind's in-house services. An evaluation designed to assess client referral to WomanKind services and the impact of health care provider training was carried out. METHODS: Data were collected at three intervals over a 2-year period at 3 intervention and 2 comparison hospitals located in Minneapolis, MN. The focus of data collection efforts was to assess the providers' knowledge, attitudes, beliefs, and behaviors (KABB) concerning identification and referral of victims of IPV. Hospital staff and volunteer advocate training programs also were evaluated. Chart reviews were conducted and client referrals assessed. RESULTS: Providers at WomanKind hospitals demonstrated significantly higher knowledge, attitudes, beliefs and behaviors than those at comparison hospitals throughout the study. During the data collection period, 1719 IPV victims were identified and referred to the WomanKind program, while only 27 IPV victims were referred to trained social workers at the comparison hospitals. Chart reviews indicated that emergency staff at the intervention sites provide documentation of IPV in patient records twice as frequently as emergency staff at the comparison sites. CONCLUSION: This research underscores the efficacy of a well-structured, multidisciplinary effort to deliver services to IPV victims. The results demonstrate that specialized training and on-site client services create a significant positive impact on the KABB of health care providers.

Attitude of Health Personnel↗

IAEA/EPA international climatic test program for integrating radon detectors. International Atomic Energy Agency/Environmental Protection Agency.

As an element of the joint IAEA-EPA International Radon Metrology Evaluation Program, a climatic test of long-term integrating radon detectors was conducted at the U.S. EPA Radiation and Indoor Environments National Laboratory. The objective of this study was to test the performance of commonly used commercially available long-term 222Rn detector systems under extreme climatological conditions using filtered polycarbonate CR-39 plastic analyzed by the manufacturer using the track-etch method, unfiltered LR-115 film analyzed by the manufacturer, and Teflon based electrets analyzed in the field by EPA using the manufacturer's equipment. The EPA environmental radon chambers were used to expose detectors to extreme cold and dry (less than 4.0 degrees C air temperature and 25% relative humidity) and hot and humid (greater than 35 degrees C air temperature and 85% relative humidity) climatic conditions. During phase I detectors were exposed to low temperatures and low humidities, and during phase II detectors were exposed to high temperatures and high humidities. Typical indoor equilibrium fractions (near 50%) and radon concentrations of about 150 Bq m(-3) were maintained for each phase, which lasted 90 d. The results indicated that the optimal detector for extreme climatic conditions is dependent on the relative importance of bias and precision. Overall, however, the filtered track-etch type detector produced the most reliable results under the extreme conditions.

Air Microbiology↗

The impact of a multidisciplinary breast cancer center on recommendations for patient management: the University of Pennsylvania experience.

BACKGROUND: Advances in the diagnosis and treatment of breast carcinoma have led to a multidisciplinary approach to management for patients with breast carcinoma. To assess the effect of this approach, the authors performed an evaluation for a cohort of patients examined in a multidisciplinary breast cancer center. METHODS: An analysis was performed for the records of 75 consecutive women with 77 breast lesions examined in consultation in a multidisciplinary breast cancer center between January and June 1998. Each patient's case was evaluated by a panel consisting of a medical oncologist, surgical oncologist, radiation oncologist, pathologist, diagnostic radiologist, and, when indicated, plastic surgeon. A comprehensive history and physical examination was performed, and the relevant mammograms, pathology slides, and medical records were reviewed. Treatment recommendations made before this evaluation were compared with the consensus recommendations made by the panel. RESULTS: For the 75 patients, the multidisciplinary panel disagreed with the treatment recommendations from the outside physicians in 32 cases (43%), and agreed in 41 cases (55%). Two patients (3%) had no treatment recommendation before consultation. For the 32 patients with a disagreement, the treatment recommendations were breast-conservation treatment instead of mastectomy (n = 13; 41%) or reexcision (n = 2; 6%); further workup instead of immediate definitive treatment (n = 10; 31%); treatment based on major change in diagnosis on pathology review (n = 3; 9%); addition of postmastectomy radiation treatment (n = 3; 9%); or addition of hormonal therapy (n = 1; 3%). CONCLUSIONS: The multidisciplinary breast cancer evaluation program provided an integrated program in which individual patients were evaluated by a team of physicians and led to a change in treatment recommendation for 43% (32 of 75) of the patients examined. This multidisciplinary program provided important second opinions for many patients with breast carcinoma.

Adult↗

The evolution of a health hazard assessment database management system for military weapons, equipment, and materiel.

During the 1970s, the Army health hazard assessment (HHA) process developed as a medical program to minimize hazards in military materiel during the development process. The HHA Program characterizes health hazards that soldiers and civilians may encounter as they interact with military weapons and equipment. Thus, it is a resource for medical planners and advisors to use that can identify and estimate potential hazards that soldiers may encounter as they train and conduct missions. The U.S. Army Center for Health Promotion and Preventive Medicine administers the program, which is integrated with the Army's Manpower and Personnel Integration program. As the HHA Program has matured, an electronic database has been developed to record and monitor the health hazards associated with military equipment and systems. The current database tracks the results of HHAs and provides reporting designed to assist the HHA Program manager in daily activities.

Databases, Factual↗

Integrating the Jewish Dietary Laws into a dietetics program. Kashruth in a dietetics curriculum.

A clinical and community dietetics program integrates Kashruth, the Jewish Dietary Laws, into its curriculum. Simply defined, kosher means fit for consumption. Emblems used throughout the United States and Canada to indicate a program of rabbinic endoresment and supervision of canned, boxed, and bottled products are included. An existing kosher unit is described, and guidelines for establishing a kosher food science laboratory unit are offered. Suggestions for instituting kosher foodservice in health care facilities are given. Therapeutic applications of Kashruth are suggested, and approved therapeutic food products are listed.

Cooking↗

The ASH HematOmics Program supports integrative analysis of genomic and clinical data in hematologic diseases.

The increasing availability of genomic and transcriptomic sequencing has uncovered diverse genomic alterations and distinct gene expression profiles driving hematologic diseases, yet a data integration and sharing platform dedicated to hematology remains lacking. We developed the American Society of Hematology (ASH) HematOmics Program (ASHOP; ashop.hematology.org), a resource for exploring somatic alterations and gene fusions, transcriptomic results, and clinical data from 5960 patients spanning B-cell precursor and T-cell acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndromes, and chronic lymphocytic leukemia. Users can explore genomic alteration landscapes and comutation patterns via lollipop and matrix plots and analyze significantly altered genes in user-defined subcohorts. Transcriptomes can be explored through interactive uniform manifold approximation and projections, clustering, differential expression, and pathway enrichment. Genomic, transcriptomic features, and clinical outcomes can be correlated in a user-driven manner or combined to precisely define study cohorts. We illustrate the following 4 use cases of ASHOP: (1) stratification of DUX4-rearranged B-cell leukemias into Early/Multipotent and Committed subgroups with distinct outcomes, (2) characterization of HOXA/HOXB expression patterns in acute myeloid leukemias, (3) correlating mutational burden with mismatch repair deficiency and mutational signatures, and (4) investigation of TP53 alteration landscape. ASHOP is an open-access resource to inform genomic and transcriptomic data interpretation for hematologic malignancies and will expand to support additional diseases and data modalities from the ASH community.

Humans↗

The residents' viewpoint of the matching process, factors influencing their program selection, and satisfaction with the results.

PURPOSE: The purpose of this study was to determine the factors considered by oral and maxillofacial surgery residents in selecting residency programs, to estimate the level of their satisfaction with the selection and matching processes, and to analyze the relationship between these factors and overall satisfaction with their match. MATERIALS AND METHODS: A questionnaire was sent to 675 residents listed as members of the American Association of Oral and Maxillofacial Surgeons, and 208 responded to the survey. Of these residents, 56.7% were in an MD integrated program, 30.3% were in a 4-year certificate program, 10.6% were in an MD optional program, and 2.4% were in a combined PhD program. RESULTS: There were no differences between the program types and the number of resident applications or the number of interviews. Residents in the MD integrated programs had significantly higher board scores than both the MD optional residents and the 4-year certificate residents. The most important factors that residents considered when making their match list were as follows: good relationships between residents, good relationships between residents and attendings, training in orthognathic surgery, training in implant surgery, and training in dentoalveolar surgery. When residents were asked whether they were satisfied with the program in which they were currently enrolled, MD integrated residents were significantly more satisfied than were those residents in the MD optional and 4-year certificate program. Additional predictors of residence satisfaction were satisfied with the results of the match process, accuracy of the program in representing itself during the interview process, and less importance placed on orthognathic surgery training. Although generally satisfied, 25% would want to go to a different program if they could go through the match again. CONCLUSIONS: The majority of residents seem to be satisfied with the program in which they matched. Among the important factors determining satisfaction are the degree of honesty during the interview process, good relations among residents and between residents and attending doctors, the scope of clinical training, and the didactic/academic content of the program.

Analysis of Variance↗

Charting a course for the future of women's health in the United States: concepts, findings and recommendations.

The JHU Women's and Children's Health Policy Center, with the federal Maternal and Child Health Bureau, undertook a review of the health of women in the United States and invited experts to develop recommendations on health policy, programs, practices and research. The review included published research, program reviews, and policy reports on women's physical health, mental health, and health behaviors, and on the effects of health services, systems and financing on their health. Based on trends in age, ethnic background, education, labor-force participation, marriage and childbearing among women, the results of the reviews, and the experts' consultation, several recommendations were made for a forward looking agenda. They included the need: (1) to focus broadly on women's health, not just during pregnancy; (2) for comprehensive, integrated programs and services addressing women's unique needs; (3) for integrated programs and services across the lifespan; (4) for better provider training about women's unique health needs, the differential effects of particular problems on them, and the consequences of chronic health problems heretofore considered primarily male problems; (5) to eliminate social policies that single out women, particularly pregnant women, for punitive actions; (6) to promote social policies that ensure economic security for women; and (7) for vigorous public health leadership to shape the women's health agenda, recognizing the social and economic context of their lives. The social and economic trends among women in the US and the recommendations for a women's health agenda have relevance to other developed countries as well.

Developed Countries↗

Managing the Brisbane River and Moreton Bay: an integrated research/management program to reduce impacts on an Australian estuary.

The Brisbane River and Moreton Bay Study, an interdisciplinary study of Moreton Bay and its major tributaries, was initiated to address water quality issues which link sewage and diffuse loading with environmental degradation. Runoff and deposition of fine-grained sediments into Moreton Bay, followed by resuspension, have been linked with increased turbidity and significant loss of seagrass habitat. Sewage-derived nutrient enrichment, particularly nitrogen (N), has been linked to algal blooms by sewage plume maps. Blooms of a marine cyanobacterium, Lyngbya majuscula, in Moreton Bay have resulted in significant impacts on human health (e.g., contact dermatitis) and ecological health (e.g., seagrass loss), and the availability of dissolved iron from acid sulfate soil runoff has been hypothesised. The impacts of catchment activities resulting in runoff of sediments, nutrients and dissolved iron on the health of the Moreton Bay waterways are addressed. The Study, established by 6 local councils in association with two state departments in 1994, forms a regional component of a national and state program to achieve ecologically sustainable use of the waterways by protecting and enhancing their health, while maintaining economic and social development. The Study framework illustrates a unique integrated approach to water quality management whereby scientific research, community participation and the strategy development were done in parallel with each other. This collaborative effort resulted in a water quality management strategy which focuses on the integration of socioeconomic and ecological values of the waterways. This work has led to significant cost savings in infrastructure by providing a clear focus on initiatives towards achieving healthy waterways. The Study's Stage 2 initiatives form the basis for this paper.

Australia↗

Integrated residency training in family medicine and general practice dentistry.

General practice dental training and family practice medical training can be combined into one effective integrated program. This combination benefits the patients in a family practice model unit, enhances family practice resident education, and will ultimately benefit patient care delivery. This paper describes the experience of such an integrated program which is now well established.

Education, Dental↗

Monitoring of antimicrobial therapy by an integrated computer program.

OBJECTIVE: To assess the impact of the setting-up of a computer program designed by the Hospital Pharmacy Department as a tool that provides information for the antimicrobial therapy monitoring. To assess its influence on pharmaceutical costs. MATERIAL AND METHOD: The computer application for the follow-up of antimicrobial treatments integrates information from the Pharmacy Department and the Microbiology Laboratory and selects all patients to whom some controlled antibiotic has been prescribed. The pharmacist reviews all the controlled antibiotic treatments, suggests any change to the physician if needed and quantifies the economic impact of the accepted interventions. RESULTS: On average, 12.5% of controlled antibiotic treatments warranted a pharmaceutical intervention, and 92% of them were accepted. The most frequent interventions related to prescriptions were change of dosage and administration route and related to the disease were in respiratory and urinary tract infections. From the economic point of view, the accepted interventions represented a saving of 12,087,029 pesetas (83,359 $)/year, on average. CONCLUSION: The applied computer program resulted a useful tool for a clinical pharmacist to reach more correct antibiotical therapeutics and better cost-effectiveness relation. It also helped to achieve favorable clinical outcomes.

Anti-Bacterial Agents↗

25 years of an integrated vaccination program in Chile.

Various problems and subjects related to the long Chilean experience in vaccination programmes are reported. Emphasis is placed on proper administrative and planning steps in order to obtain the right epidemiological diagnosis, to develop the infrastructure of health, to support financially, to manage resources, to train personnel, to apply techniques and to evaluate periodically. The advantages of the integration of the programme in primary services are commented on. Epidemiological evaluation and surveillance are considered highly important in the successes obtained. The particular structure of health services in Chile has played a meaningful role in meeting public health requirements for the past 25 years, specifically with respect to vaccination programmes.

Chile↗

[Development of an integrated software program to analyze statistically the results of complex investigations in space biology and medicine].

A concept of implementing the problem-oriented statistical software based on an application of expert systems is presented. The shortcomings of existing statistical software for personal computers and trends of their improvements are analyzed. Recommendations on designing of statistical expert systems can be used by the statisticians, mathematicians, programmers and users not being professionals in these fields. Integrated statistical software will make it possible to perform additional retrospective analysis and to check up the large arrays of previously gained data and to obtain supplementary scientific information and to find new regularities in the previous experimental findings.

Aerospace Medicine↗

New trend by states is to integrate HIV programs. Collaboration saves some resources.

Until recently, a typical model for providing HIV services has been to separate prevention and testing programs from treatment and care programs. While many states still adhere to this model, there's a new trend in which state health departments are encouraging the two groups to collaborate and even merge their boards. The goal is to increase efficiencies, save board members' time, and improve communication.

Cooperative Behavior↗