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Article ; Online: Dual-Boarded Physicians and Consultation-Liaison Psychiatrists: Striving Together Toward Common Goals.

Heinrich, Thomas W / DeMoss, Dustin S

Journal of the Academy of Consultation-Liaison Psychiatry

2024 Volume 65, Issue 2, Page(s) 123–125

MeSH term(s)	Humans ; Goals ; Psychiatrists ; Psychiatry ; Physicians ; Referral and Consultation
Language	English
Publishing date	2024-03-07
Publishing country	Netherlands
Document type	Editorial
ISSN	2667-2960
ISSN (online)	2667-2960
DOI	10.1016/j.jaclp.2024.03.002
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Article ; Online: Borna disease in an adult free-ranging Eurasian beaver (Castor fiber albicus).

Ellenberger, Christin / Heenemann, Kristin / Vahlenkamp, Thomas W / Grothmann, Pierre / Herden, Christiane / Heinrich, Anja

Journal of comparative pathology

2024 Volume 209, Page(s) 31–35

Abstract: Borna disease (BD) associated with a peracute bacterial septicaemia with Escherichia coli was diagnosed in an adult female, naturally infected, free-ranging Eurasian beaver of the subspecies Castor fiber albicus, clinically characterized by weight loss, ... ...

Abstract	Borna disease (BD) associated with a peracute bacterial septicaemia with Escherichia coli was diagnosed in an adult female, naturally infected, free-ranging Eurasian beaver of the subspecies Castor fiber albicus, clinically characterized by weight loss, depression, weakness and gurgled peristaltic sounds. The beaver was euthanized humanely. Necropsy and light microscopy revealed a non-purulent meningoencephalitis with typical mononuclear perivascular cuffs and parenchymal infiltrates. The diagnosis of BD was confirmed by detection of viral antigen and RNA by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). The PCR product was sequenced and cluster analysis revealed a close relationship between endemic clusters in Saxony-Anhalt. This is the first report of naturally occurring BD in a free-ranging Eurasian beaver.
MeSH term(s)	Female ; Animals ; Borna Disease ; Antigens, Viral ; Autopsy/veterinary ; Meningoencephalitis/veterinary ; Sepsis/veterinary
Chemical Substances	Antigens, Viral
Language	English
Publishing date	2024-02-12
Publishing country	England
Document type	Journal Article
ZDB-ID	390920-7
ISSN	1532-3129 ; 0021-9975
ISSN (online)	1532-3129
ISSN	0021-9975
DOI	10.1016/j.jcpa.2024.01.003
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Article ; Online: Association Between COVID-19 and Delirium Development in the General Medical Units at an Academic Medical Center.

Dong, Yilu / Hanson, Ryan / Penlesky, Annie C / Nattinger, Ann B / Heinrich, Thomas W / Pezzin, Liliana E

WMJ : official publication of the State Medical Society of Wisconsin

2024 Volume 122, Issue 5, Page(s) 319–324

Abstract: Introduction: Evidence suggests that inpatients who develop delirium experience worse outcomes. Although there is reason to believe that COVID-positive patients may be at a higher risk for developing delirium, little is known about the association ... ...

Abstract	Introduction: Evidence suggests that inpatients who develop delirium experience worse outcomes. Although there is reason to believe that COVID-positive patients may be at a higher risk for developing delirium, little is known about the association between COVID-19 and delirium among hospitalized patients outside the intensive care unit (ICU). This study aimed to examine (1) the independent association between COVID-19 infection and the development of delirium among all non-ICU patients and (2) the risk factors associated with developing delirium among patients admitted with COVID-19, with a special focus on presenting symptoms. Methods: Using electronic health record (EHR) data of adults admitted to any general medical unit at a large academic medical center from July 2020 through February 2021, we used a cross-sectional multivariable logistic regression to estimate the associations, while adjusting for patients' sociodemographic, clinical characteristics, delirium-free length of stay, as well as time fixed effects. Results: Multivariable regression estimates applied to 20 509 patients hospitalized during the study period indicate that COVID-19-positive patients had 72% higher relative risk (odds ratio 1.72; 95% CI, 1.31 - 2.26; Conclusions: COVID-19 positivity was associated with higher odds of developing delirium among patients during their non-ICU hospitalization. These findings may be helpful in targeting the use of delirium prevention strategies among non-ICU patients.
MeSH term(s)	Adult ; Humans ; COVID-19/epidemiology ; Cross-Sectional Studies ; Inpatients ; Academic Medical Centers ; Delirium/epidemiology
Language	English
Publishing date	2024-01-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	441051-8
ISSN	2379-3961 ; 0043-6542 ; 1098-1861
ISSN (online)	2379-3961
ISSN	0043-6542 ; 1098-1861
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Article ; Online: Exact Shapley values for local and model-true explanations of decision tree ensembles

Thomas W. Campbell / Heinrich Roder / Robert W. Georgantas III / Joanna Roder

Machine Learning with Applications, Vol 9, Iss , Pp 100345- (2022)

2022

Abstract: Additive feature explanations using Shapley values have become popular for providing transparency into the relative importance of each feature to an individual prediction of a machine learning model. While Shapley values provide a unique additive feature ...

Abstract	Additive feature explanations using Shapley values have become popular for providing transparency into the relative importance of each feature to an individual prediction of a machine learning model. While Shapley values provide a unique additive feature attribution in cooperative game theory, the Shapley values that can be generated for even a single machine learning model are far from unique, with theoretical and implementational decisions affecting the resulting attributions. Here, we consider the application of Shapley values for explaining decision tree ensembles and present a novel approach to Shapley value-based feature attribution that can be applied to random forests and boosted decision trees. This new method provides attributions that accurately reflect details of the model prediction algorithm for individual instances, while being computationally competitive with one of the most widely used current methods. We explain the theoretical differences between the standard and novel approaches and compare their performance using synthetic and real data.
Keywords	Explainability ; Shapley values ; Machine learning ; Interpretability ; Decision trees ; Cybernetics ; Q300-390 ; Electronic computers. Computer science ; QA75.5-76.95
Subject code	006
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A 10-Year Follow-up Survey of Psychiatry Resident Education in Consultation-Liaison Psychiatry.

Beach, Scott R / Ernst, Carrie L / Lavakumar, Mallika / Greenstein, Samuel P / Fipps, David C / Soeprono, Thomas M / Heinrich, Thomas W / Schwartz, Ann C

Journal of the Academy of Consultation-Liaison Psychiatry

2022 Volume 64, Issue 3, Page(s) 199–208

Abstract: Background: In 2010, the Academy of Consultation-Liaison (then Academy of Psychosomatic Medicine) surveyed US residency programs to understand training in consultation-liaison (CL) psychiatry, leading to recommendations in 2014. Since then, residency ... ...

Abstract	Background: In 2010, the Academy of Consultation-Liaison (then Academy of Psychosomatic Medicine) surveyed US residency programs to understand training in consultation-liaison (CL) psychiatry, leading to recommendations in 2014. Since then, residency training in CL has evolved in the context of competing training demands, increased prioritization of electives, and reactions to coronavirus 2019. Objective: To determine the current state of residency training in CL across the United States, including the structure of core and elective resident rotations in CL, attending physician staffing, presence of fellows and other trainees, didactic curriculum, and impact of coronavirus 2019. Methods: Members of the Academy of Consultation-Liaison Residency Education Subcommittee designed and piloted an 81-question survey tool that was sent to program directors of 269 US general psychiatry training programs for voluntary completion. Results: One hundred three of 269 programs responded to the survey, yielding a response rate of 38.3%. Responding programs were larger and more likely to have a CL fellowship than nonresponding programs. Of the 103 responding programs, 82.5% have more than the minimally required time on CL, with 46.6% reporting an increase in total CL time in the past decade. Since 2010, 18.4% of responding programs changed the placement of the CL rotation, with 43.7% now adherent to the 2014 Academy of Psychosomatic Medicine recommendation to include core CL training in the second half of residency. Thirty-five percent of responding programs require residents to rotate on more than 1 CL service, and 19.4% have a required outpatient CL component. Faculty full-time equivalent varies widely. Of all services included, 33.8% report that all CL faculty are board-certified in CL psychiatry, whereas 18.7% have no board-certified faculty. Of the 103 responding programs, 36.9% offer a CL fellowship, but 31.1% report no residency graduates pursuing CL fellowships in the past 5 years. Of the included programs, 77.7% have a formal CL curriculum for residents, with 34.0% reporting a separate didactic series during the CL rotation. Conclusions: Among the responding programs, the amount of time spent on core CL rotations has increased in the past decade, but programs have also shifted CL training earlier in the course of residency. Residency programs are increasingly challenged to provide an optimal CL experience, and updated guidance from Academy of Consultation-Liaison may be appreciated.
MeSH term(s)	United States ; Internship and Residency ; Follow-Up Studies ; Psychiatry/education ; Curriculum ; Referral and Consultation
Language	English
Publishing date	2022-12-12
Publishing country	Netherlands
Document type	Journal Article
ISSN	2667-2960
ISSN (online)	2667-2960
DOI	10.1016/j.jaclp.2022.12.003
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Article ; Online: Monoclonal antibody therapy demonstrates increased virulence of a lineage VII strain of Lassa virus in nonhuman primates.

Woolsey, Courtney / Cross, Robert W / Prasad, Abhishek N / Agans, Krystle N / Borisevich, Viktoriya / Deer, Daniel J / Dobias, Natalie S / Fears, Alyssa C / Harrison, Mack B / Heinrich, Megan L / Fenton, Karla A / Garry, Robert F / Branco, Luis M / Geisbert, Thomas W

Emerging microbes & infections

2024 Volume 13, Issue 1, Page(s) 2301061

Abstract: Lassa virus (LASV) is a World Health Organization (WHO) priority pathogen that causes high morbidity and mortality. Recently, we showed that a combination of three broadly neutralizing human monoclonal antibodies known as Arevirumab-3 (8.9F, 12.1F, 37.2D) ...

Abstract	Lassa virus (LASV) is a World Health Organization (WHO) priority pathogen that causes high morbidity and mortality. Recently, we showed that a combination of three broadly neutralizing human monoclonal antibodies known as Arevirumab-3 (8.9F, 12.1F, 37.2D) based on the lineage IV Josiah strain protected 100% of cynomolgus macaques against heterologous challenge with lineage II and III strains of LASV when therapy was initiated beginning at day 8 after challenge. LASV strains from Benin and Togo represent a new lineage VII that are more genetically diverse from lineage IV than strains from lineages II and III. Here, we tested the ability of Arevirumab-3 to protect macaques against a LASV lineage VII Togo isolate when treatment was administered beginning 8 days after exposure. Unexpectedly, only 40% of treated animals survived challenge. In a subsequent study we showed that Arevirumab-3 protected 100% of macaques from lethal challenge when treatment was initiated 7 days after LASV Togo exposure. Based on our transcriptomics data, successful Arevirumab-3 treatment correlated with diminished neutrophil signatures and the predicted development of T cell responses. As the
MeSH term(s)	Humans ; Animals ; Lassa virus ; Lassa Fever ; Virulence ; Macaca fascicularis ; Antibodies, Monoclonal/pharmacology
Chemical Substances	Antibodies, Monoclonal
Language	English
Publishing date	2024-01-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2681359-2
ISSN	2222-1751 ; 2222-1751
ISSN (online)	2222-1751
ISSN	2222-1751
DOI	10.1080/22221751.2023.2301061
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Article ; Online: Monoclonal antibody therapy protects nonhuman primates against mucosal exposure to Lassa virus.

Cross, Robert W / Fenton, Karla A / Woolsey, Courtney / Prasad, Abhishek N / Borisevich, Viktoriya / Agans, Krystle N / Deer, Daniel J / Dobias, Natalie S / Fears, Alyssa C / Heinrich, Megan L / Geisbert, Joan B / Garry, Robert F / Branco, Luis M / Geisbert, Thomas W

Cell reports. Medicine

2024 Volume 5, Issue 2, Page(s) 101392

Abstract: Lassa fever (LF) is an acute viral illness that causes thousands of deaths annually in West Africa. There are currently no Lassa virus (LASV) vaccines or antivirals approved for human use. Recently, we showed that combinations of broadly neutralizing ... ...

Abstract	Lassa fever (LF) is an acute viral illness that causes thousands of deaths annually in West Africa. There are currently no Lassa virus (LASV) vaccines or antivirals approved for human use. Recently, we showed that combinations of broadly neutralizing human monoclonal antibodies (BNhuMAbs) known as Arevirumab-2 or Arevirumab-3 protected up to 100% of cynomolgus macaques against challenge with diverse lineages of LASV when treatment was initiated at advanced stages of disease. This previous work assessed efficacy against parenteral exposure. However, transmission of LASV to humans occurs primarily by mucosal exposure to virus shed from Mastomys rodents. Here, we describe the development of a lethal intranasal exposure macaque model of LF. This model is employed to show that Arevirumab cocktails rescue 100% of macaques from lethal LASV infection when treatment is initiated 8 days after LASV exposure. Our work demonstrates BNhuMAbs have utility in treating LASV infection acquired through mucosal exposure.
MeSH term(s)	Animals ; Humans ; Lassa virus ; Lassa Fever/drug therapy ; Lassa Fever/prevention & control ; Macaca fascicularis ; Immunotherapy ; Antibodies, Monoclonal/pharmacology ; Antibodies, Monoclonal/therapeutic use
Chemical Substances	Antibodies, Monoclonal
Language	English
Publishing date	2024-01-26
Publishing country	United States
Document type	Journal Article
ISSN	2666-3791
ISSN (online)	2666-3791
DOI	10.1016/j.xcrm.2024.101392
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Article ; Online: Assessment of a host-guest interaction in a bilayer membrane model.

Kumari, Harshita / Negin, Saeedeh / Eisenhart, Andrew / Patel, Mohit B / Beck, Thomas L / Heinrich, Frank / Spikes, Helena J / Gokel, George W

RSC advances

2022 Volume 12, Issue 49, Page(s) 32046–32055

Abstract: Supramolecular interactions are well recognized and many of them have been extensively studied in chemistry. The formation of supramolecular complexes that rely on weak force interactions are less well studied in bilayer membranes. Herein, a supported ... ...

Abstract	Supramolecular interactions are well recognized and many of them have been extensively studied in chemistry. The formation of supramolecular complexes that rely on weak force interactions are less well studied in bilayer membranes. Herein, a supported bilayer membrane is used to probe the penetration of a complex between tetracycline and a macrocyclic polyether. In a number of bacterial systems, the presence of the macrocycle has been found to significantly enhance the potency of the antimicrobial
Language	English
Publishing date	2022-11-10
Publishing country	England
Document type	Journal Article
ISSN	2046-2069
ISSN (online)	2046-2069
DOI	10.1039/d2ra03851j
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Article ; Online: Central Neuromodulators for Treating Functional GI Disorders: A Primer.

Sobin, W Harley / Heinrich, Thomas W / Drossman, Douglas A

The American journal of gastroenterology

2017 Volume 112, Issue 5, Page(s) 693–702

Abstract: Patients with functional GI disorders (FGIDs) are commonplace in the gastroenterologist's practice. A number of these patients may be refractory to peripherally acting agents, yet respond to central neuromodulators. There are benefits and potential ... ...

Abstract	Patients with functional GI disorders (FGIDs) are commonplace in the gastroenterologist's practice. A number of these patients may be refractory to peripherally acting agents, yet respond to central neuromodulators. There are benefits and potential adverse effects to using TCAs, SSRIs, SNRIs, atypical antipsychotics, and miscellaneous central neuromodulators in these patients. These agents can benefit mood, pain, diarrhea, constipation, nausea, sleep, and depression. The mechanisms by which they work, the differences between classes and individual agents, and the various adverse effects are outlined. Dosing, augmentation strategies, and treatment scenarios specifically for painful FGIDs, FD with PDS, and chronic nausea and vomiting syndrome are outlined.
MeSH term(s)	Antidepressive Agents, Tricyclic/pharmacology ; Antidepressive Agents, Tricyclic/therapeutic use ; Antipsychotic Agents/therapeutic use ; Clinical Competence ; Defecation/drug effects ; Gastrointestinal Diseases/drug therapy ; Gastrointestinal Hemorrhage/chemically induced ; Humans ; Nausea/chemically induced ; Nausea/drug therapy ; Neurotransmitter Agents/pharmacology ; Neurotransmitter Agents/therapeutic use ; Serotonin Syndrome/chemically induced ; Serotonin Uptake Inhibitors/pharmacology ; Serotonin Uptake Inhibitors/therapeutic use ; Serotonin and Noradrenaline Reuptake Inhibitors/pharmacology ; Serotonin and Noradrenaline Reuptake Inhibitors/therapeutic use ; Sexual Dysfunction, Physiological/chemically induced ; Vomiting/chemically induced
Chemical Substances	Antidepressive Agents, Tricyclic ; Antipsychotic Agents ; Neurotransmitter Agents ; Serotonin Uptake Inhibitors ; Serotonin and Noradrenaline Reuptake Inhibitors
Language	English
Publishing date	2017-03-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.1038/ajg.2017.57
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Article ; Online: Toxicities of CAR T-Cell Therapy and the Role of the Consultation-Liaison Psychiatrist.

Pawar, Deepa S / Molinaro, Jessica R / Knight, Jennifer M / Heinrich, Thomas W

Psychosomatics

2018 Volume 60, Issue 5, Page(s) 519–523

MeSH term(s)	Cytokine Release Syndrome/diagnosis ; Cytokine Release Syndrome/etiology ; Cytokine Release Syndrome/psychology ; Female ; Humans ; Immunotherapy, Adoptive/adverse effects ; Lymphoma, Large B-Cell, Diffuse/therapy ; Middle Aged ; Neurotoxicity Syndromes/diagnosis ; Neurotoxicity Syndromes/etiology ; Neurotoxicity Syndromes/psychology ; Psychiatry ; Referral and Consultation
Language	English
Publishing date	2018-11-13
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	209487-3
ISSN	1545-7206 ; 0033-3182
ISSN (online)	1545-7206
ISSN	0033-3182
DOI	10.1016/j.psym.2018.10.006
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