Digital Commons Network^™

A Rare Case Of Idiopathic Painful Nervus Intermedius Neuropathy In A 13-Year-Old Female: A Case Report And Discussion In The Context Of The Literature, Diego Fernandez-Vial, Linda Sangalli, Christina Perez

Oral Health Science Faculty Publications

(1) Background: Painful nervus intermedius neuropathy involves continuous or near-continuous pain affecting the distribution of the intermedius nerve(s). The diagnosis of this entity is challenging, particularly when the clinical and demographic features do not resemble the typical presentation of this condition. To the best of our knowledge, only three case reports have described the occurrence of nervus intermedius neuropathy in young patients. (2) Case Description: A 13-year-old female referred to the orofacial pain clinic with a complaint of pain located deep in the right ear and mastoid area. The pain was described as constant, throbbing and dull, with an intensity …

Maternal Proximity To Mountain-Top Removal Mining And Birth Defects In Appalachian Kentucky, 1997–2003, Daniel B. Cooper, Courtney J. Walker, W. Jay Christian

Epidemiology and Environmental Health Faculty Publications

Extraction of coal through mountaintop removal mining (MTR) alters many dimensions of the landscape. Explosive blasts, exposed rock, and coal washing have the potential to pollute air and water. Previous research suggests that infants born to mothers living in areas with MTR have a higher prevalence of birth defects. In this cross-sectional study, we further examine the relationship between MTR activity and several types of birth defects. Maternal exposure to MTR was assessed using remote sensing data from Skytruth, which captures MTR activity in the Central Appalachian region of the United States. Active MTR area was quantified within a five-kilometer …

Characterization And Comparison Of Human Glioblastoma Models, Julia A. Schulz, Louis T. Rogers, Richard J. Kryscio, Anika M. S. Hartz, Björn Bauer

Sanders-Brown Center on Aging Faculty Publications

Abstract
Glioblastoma (GBM) is one of the deadliest cancers. Treatment options are limited, and median patient survival is only several months. Translation of new therapies is hindered by a lack of GBM models that fully recapitulate disease heterogeneity. Here, we characterize two human GBM models (U87-luc2, U251-RedFLuc). In vitro, both cell lines express similar levels of luciferase and show comparable sensitivity to temozolomide and lapatinib exposure. In vivo, however, the two GBM models recapitulate diferent aspects of the disease. U87-luc2 cells quickly grow into large, well-demarcated tumors; U251-RedFLuc cells form small, highly invasive tumors. Using a new method to assess …

Alcohol Use, Sleep, And Depression Among Family Caregivers In The Time Of Covid-19, Ashley M. Strzelecki, Mairead E. Moloney, Alyssa T. Brooks, Jessica Weafer

Psychology Faculty Publications

The COVID-19 pandemic has substantially altered daily life around the world, resulting in significant impacts on health behaviors. The additional burdens imposed by family caregiving (i.e., providing unpaid care for children and/or adults) may further exacerbate negative effects of the pandemic on health and health behaviors, including increased alcohol consumption, poor sleep, and increased depressive symptoms. The current study examined this possibility. Participants (N = 320, mean age = 35.11 years) completed an online questionnaire assessing alcohol use, sleep, and depression during the COVID-19 pandemic (June–August 2020) and retrospectively assessed the same health behaviors in the months prior to the …

Characteristics And Health Effects Of Particulate Matter Emitted From A Waste Sorting Plant, Abdullah Barkhordari, Marcelo I. Guzman, Gholamreza Ebrahimzadeh, Armin Sorooshian, Mahdieh Delikhoon, Mehdi Jamshidi Rastani, Somayeh Golbaz, Mehdi Fazlzadeh, Ramin Nabizadeh, Abbas Norouzian Baghani

Chemistry Faculty Publications

Solid waste components can be recycled in waste paper and cardboard sorting plants (WPCSP) through a multistep process. This work collected 15 samples every six days from each of the 9 points selected to study the processes taking place in a WPCSP (135 particulate matter samples total). Examining the concentration and size fraction of particulate matter (i.e., PM1, PM2.5 and PM10) in WPCSP is an essential issue to notify policy makers about the health impacts on exposed workers. The major activities for increasing of the concentration of PM in various processing units in the WPCSP, especially in hand-picking routes I …

Evaluating Social Support And T2d Risk Factors Among Members Of Rural-Dwelling Grandparent-Headed Households, Brittany L. Smalls, Abebola Adegboyega, Kelly Nb Palmer, Jennifer Hatcher

Journal of Appalachian Health

Purpose: This study examines the associations of social support and type 2 diabetes (T2D) risk factors among members of rural-dwelling, grandparent-headed households (GHH).

Methods: Prospective data were collected from rural-dwelling members of GHH with no known diagnosis of T2D. Data collected on family characteristics, T2D clinical risk factors, and social support were assessed.

Results: Sixty-six grandparents and 72 grandchildren participated in the study. The average age and HbA1Cs were 59.4 years and 6.2% ± 1.4 for grandparents and 11.8 years and 4.9% ± 0.6 for grandchildren. Most grandparents were found to have prediabetes or undiagnosed diabetes. The number of people …

Exploration Of Vaccination Attitudes Among Parents And Caregivers In A Rural Appalachian Health Clinic, Radwa Omar, Karen Hande, Natasha Mcclure

Journal of Appalachian Health

At a rural Appalachian health clinic in Kentucky, 20% of patients under 18 years were not up to date with the CDC-recommended immunization schedule. Reasons parents or caregivers chose to delay or refuse their child’s immunizations were explored using the Caregiver Vaccination Attitude Scale. High levels of trust in the healthcare provider and self-reported vaccine knowledge highlight opportunities for rural healthcare providers to apply evidence-based communication strategies to address vaccine hesitancy and promote the safety and health of the entire community.

On We Go, With Hope: Remembering Our Founding Editor-In-Chief, Dr. F. Douglas Scutchfield, Rachel E. Dixon, Randolph F. Wykoff

Journal of Appalachian Health

With the passing of our founding Editor-in-Chief, Dr. F. Douglas Scutchfield, the Journal of Appalachian Health team reflects on a life well lived and a monumental public legacy left behind. We thank "Scutch" for enriching the lives of so many, and we commit to growing the Journal in his honor.

Covid-19 Pandemic Impact On Essential Public Health Services And Online Health Communication—Appalachian Kentucky, March–December 2020, Margaret A. Riggs, Kenny Ortiz-Jurado, Keith Klein

Journal of Appalachian Health

Introduction: The COVID-19 pandemic posed many challenges for local health departments (LHDs). This study examines how stay-at-home orders impacted the provision of essential public health services and subsequent increased use of online health communication by LHDs for rural populations in Appalachian Kentucky during the first year of the COVID-19 pandemic.

Methods: A survey to gather information about provision of essential public health services was administered to five LHDs representing 13 counties between June 2020 and December 2020. Additionally, demographic and health-outcome data from LHD, state health department, and CDC websites were reviewed, alongside health communications posted on LHD social media …

A Love Rooted Deep In The Appalachian Mountains: One Part Of The Legacy Of Doug Scutchfield, Charlotte S. Seidman

Journal of Appalachian Health

F. Douglas Scutchfield, MD, died on Monday, May 23, 2022 in Lexington KY.

I have known and worked with Doug for over 40 years and share my personal insights into how he created the Journal of Appalachian Health, one of his last great career adventures and a lasting legacy to his deep investment in the health and vitality of Appalachia and its people.

Sars-Cov-2 (Covid-19) Vaccine Intentions In Kentucky, Kevin A. Pearce Md, Mph, Emily Messerli Dnp, Aprn, Mary E. Lacy, Brittany L. Smalls, Diane B. Francis, Sukruthi Yerramreddy, Marc Kiviniemi

Journal of Appalachian Health

Background: At the time of our writing, the COVID-19 pandemic continues to cause significant disruption to daily lives. In Kentucky, the burdens from this disease are higher, and vaccination rates for COVID-19 are lower, in comparison to the U.S. as a whole. Understanding vaccine intentions across key subpopulations is critical to increasing vaccination rates.

Purpose: This study explores COVID-19 vaccine intentions in Kentucky across demographic subpopulations and also investigates the influences on vaccine intention of attitudes and beliefs about COVID-19.

Methods: A population-based survey of 1,459 Kentucky adults was conducted between January 26 and March 20, 2021, with over-sampling of …

Assessing The Intention, Attitudes, And Social Influences On Covid-19 Preventive Behaviors Among Non-Rural Black And Rural Appalachian White Populations: A Faith-Based Community Study, Maria L. Gomez, Tofial Azam, Jean Edward, Hannah Bowman, Lovoria B. Williams

Journal of Appalachian Health

Introduction: The COVID-19 pandemic has had detrimental impacts in non-rural Black and rural Appalachian populations. Yet despite the pandemic’s magnitude, there is a scarcity of research exploring potential influences of attitudes and social influences within these populations on their adherence to COVID-19 public health preventive behaviors.

Purpose: This study examines the intention, attitudes, and social influences to adhere to COVID-19 preventive behaviors among non-rural Black and rural Appalachian congregants in Kentucky by integrating the Theory of Planned Behavior (TPB).

Methods: Secondary analysis of cross-sectional data was used to assess the association between the TPB constructs and four key public health …

An Il1rl1 Genetic Variant Lowers Soluble St2 Levels And The Risk Effects Of Apoe-Ε4 In Female Patients With Alzheimer’S Disease, Yuanbing Jiang, Xiaopu Zhou, Hui Yi Wong, Li Ouyang, Fanny C. F. Ip, Vicky M. N. Chau, Shun-Fat Lau, Wei Wu, Daniel Y. K. Wong, Heukjin Seo, Wing-Yu Fu, Nicole C. H. Lai, Yuewen Chen, Alzheimer’S Disease Neuroimaging Initiative, Charles D. Smith, Gregory A. Jicha, Peter A. Hardy, Partha Sinha, Elizabeth Oates, Gary Conrad

Sanders-Brown Center on Aging Faculty Publications

Changes in the levels of circulating proteins are associated with Alzheimer’s disease (AD), whereas their pathogenic roles in AD are unclear. Here, we identified soluble ST2 (sST2), a decoy receptor of interleukin-33–ST2 signaling, as a new disease-causing factor in AD. Increased circulating sST2 level is associated with more severe pathological changes in female individuals with AD. Genome-wide association analysis and CRISPR–Cas9 genome editing identified rs1921622, a genetic variant in an enhancer element of IL1RL1, which downregulates gene and protein levels of sST2. Mendelian randomization analysis using genetic variants, including rs1921622, demonstrated that decreased sST2 levels lower AD …

Exogenous Short Chain Fatty Acid Effects In App/Ps1 Mice, Diana J. Zajac, Benjamin C. Shaw, David J. Braun, Stefan J. Green, Joshua M. Morganti, Steven Estus

Sanders-Brown Center on Aging Faculty Publications

Elucidating the impact of the gut microbiome on Alzheimer’s Disease (AD) is an area of intense interest. Short chain fatty acids (SCFAs) are major microbiota metabolites that have been implicated as a mediator of gut microbiome effects in the brain. Here, we tested the effects of SCFA-treated water vs. saline-treated water on APPswe/PSEN1dE9 mice maintained under standard laboratory conditions. Mice were treated with SCFAs from five months of age until ten months of age, when they were evaluated for microbiome profile, impaired spatial memory as evaluated with the radial arm water maze, astrocyte activation as measured by Gfap expression and …

Increased Rates Of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, And Non-Metropolitan Communities, Lindsey R. Hammerslag, Jeffery Talbert, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Living in a nonmetropolitan area is associated with an increase in the age-adjusted death rate from unintentional injuries, from 46.2 in metropolitan areas to 59.2 in nonmetropolitan areas in 2018, with all races/ethnicity groups affected except for non-Hispanic Black.
• The ratio of unintentional injury deaths in nonmetropolitan areas, compared to metropolitan areas, was 1.28 overall, ranging from 1.05 to 1.56 depending on race and ethnicity.
• American Indians and Alaska Natives have the highest rate of living in nonmetropolitan areas (39.5%), and this group has the greatest increase in death from unintentional injury associated with living in …

Southeastern Law Librarian Summer 2022 Special Annual Meeting Issue, Seaall

Newsletters

No abstract provided.

Moral Distress During Covid-19: The Importance Of Perceived Organizational Support For Hospital Nurses, Abigail Latimer, Melanie D. Otis, Gia Mudd-Martin, Debra K. Moser

UK CARES Faculty Publications

Moral distress, or the inability to act congruent with moral beliefs, has been of concern for healthcare professionals especially since the COVID-19 pandemic. Hospital nurses are particularly affected in their roles with mounting administrative pressures and demands. We examined whether general and COVID- specific support in employing healthcare organizations predicted moral distress in a sample of inpatient hospital nurses. A total of 248 nurses completed the Measure of Moral Distress for Healthcare Professionals, Survey of Perceived Organizational Support, COVID Organizational Support survey, and the Hospital Ethical Climate Scale. We found that general and COVID-related organizational support were predictors of moral …

Enlarged Perivascular Spaces Are Negatively Associated With Montreal Cognitive Assessment Scores In Older Adults, Timothy J. Libecap, Valentinos Zachariou, Christopher E. Bauer, Donna M. Wilcock, Gregory A. Jicha, Flavius D. Raslau, Brian T. Gold

Sanders-Brown Center on Aging Faculty Publications

Emerging evidence suggests that enlarged perivascular spaces (ePVS) may be a clinically significant neuroimaging marker of global cognitive function related to cerebral small vessel disease (cSVD). We tested this possibility by assessing the relationship between ePVS and both a standardized measure of global cognitive function, the Montreal Cognitive Assessment (MoCA), and an established marker of cSVD, white matter hyperintensity volume (WMH) volume. One hundred and eleven community-dwelling older adults (56–86) underwent neuroimaging and MoCA testing. Quantification of region-specific ePVS burden was performed using a previously validated visual rating method and WMH volumes were computed using the standard ADNI pipeline. Separate …

Impact Of The Covid-19 Pandemic On Daily Life, Mood, And Behavior Of Adults With Down Syndrome, Sigan L. Hartley, Victoria Fleming, Brianna Piro-Gambetti, Annie Cohen, Beau M. Ances, Michael A. Yassa, Adam M. Brickman, Benjamin L. Handen, Elizabeth Head, Mark Mapstone, Bradley T. Christian, Ira T. Lott, Eric Doran, Shahid Zaman, Sharon Krinsky-Mchale, Frederick A. Schmitt, Christy L. Hom, Nicole Schupf

Sanders-Brown Center on Aging Faculty Publications

Background: The Down syndrome population has been disproportionately affected by Coronavirus 2019 (COVID-19) in terms of experiencing severe illness and death. Societal efforts to curb the spread of COVID-19 may also have taken a heavy toll on the daily lives of individuals with Down syndrome.

Objective/hypothesis: The goal of the study was to understand how the COVID-19 pandemic has altered daily life (including residence, employment, and participation in adult disability day programs) and influenced the mood and behavior of adults with Down syndrome.

Methods: Between September 2020 and February 2021, caregivers of 171 adults with Down syndrome (aged …

Effect Of Pitching Restrictions And Mound Distance On Youth Baseball Pitch Counts., Hailey Mair, Nicholas A Kenney, Timothy L Uhl, L Robert Ullery, Robert G Hosey

Physical Therapy Faculty Publications

BACKGROUND: Studies have shown that higher pitch counts are directly related to a greater incidence of elbow and shoulder pain among youth baseball pitchers.

PURPOSE/HYPOTHESIS: The purpose of this study was to examine the effect of different pitching restriction rules on the number of pitches thrown in youth baseball leagues. We hypothesized that more pitches would be thrown in leagues with inning restrictions versus leagues with pitch count restrictions as well as in leagues with a longer mound distance (from pitching mound to home plate).

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: Pitch count data were collected for …

Sex Differences In The Genetic Architecture Of Cognitive Resilience To Alzheimer’S Disease, Jaclyn M. Eissman, Logan Dumitrescu, Emily R. Mahoney, Alexandra N. Smith, Shubhabrata Mukherjee, Michael L. Lee, Phoebe Scollard, Seo Eun Choi, William S. Bush, Corinne D. Engelman, Qiongshi Lu, David W. Fardo, Emily H. Trittschuh, Jesse Mez, Catherine C. Kaczorowski, Hector Hernandez Saucedo, Keith F. Widaman, Rachel F. Buckley, Michael J. Properzi, Elizabeth C. Mormino, Hyun Sik Yang, Theresa M. Harrison, Trey Hedden, Kwangsik Nho, Shea J. Andrews, Douglas Tommet, Niran Hadad, R. Elizabeth Sanders, Douglas M. Ruderfer, Katherine A. Gifford, Xiaoyuan Zhong, Neha S. Raghavan, Badri Vardarajan, Margaret A. Pericak-Vance, Lindsay A. Farrer, Li San Wang, Carlos Cruchaga, Gerard D. Schellenberg, Nancy J. Cox, Jonathan L. Haines, C. Dirk Keene, Andrew J. Saykin, Eric B. Larson, Reisa A. Sperling, Richard Mayeux, Michael L. Cuccaro, David A. Bennett, Julie A. Schneider, Paul K. Crane, Angela L. Jefferson, Timothy J. Hohman

Sanders-Brown Center on Aging Faculty Publications

Approximately 30% of elderly adults are cognitively unimpaired at time of death despite the presence of Alzheimer's disease neuropathology at autopsy. Studying individuals who are resilient to the cognitive consequences of Alzheimer's disease neuropathology may uncover novel therapeutic targets to treat Alzheimer's disease. It is well established that there are sex differences in response to Alzheimer's disease pathology, and growing evidence suggests that genetic factors may contribute to these differences. Taken together, we sought to elucidate sex-specific genetic drivers of resilience.

We extended our recent large scale genomic analysis of resilience in which we harmonized cognitive data across four cohorts …

Non-Solvent Induced Phase Separation (Nips) For Fabricating High Filtration Efficiency (Fe) Polymeric Membranes For Face Mask And Air Filtration Applications, Ebuka A. Ogbuoji, Lauren Stephens, Amber Haycraft, Eric Woodridge, C. Escobar

Chemical and Materials Engineering Faculty Publications

Protection against airborne viruses has become very relevant since the outbreak of SARSCoV-2. Nonwoven face masks along with heating, ventilation, and air conditioning (HVAC) filters have been used extensively to reduce infection rates; however, some of these filter materials provide inadequate protection due to insufficient initial filtration efficiency (FE) and FE decrease with time. Flat sheet porous membranes, which have been used extensively to filter waterborne microbes and particulate matter due to their high FE have the potential to filter air pollutants without compromising its FE over time. Therefore, in this study, single layer polysulfone (PSf) membranes were fabricated via …

A Simplified Model For The Intermediate Structure Of Strong Fire Whirls, Forman A. Williams

Progress in Scale Modeling, an International Journal

A model is described for the overall structure of intense fire whirls, based on a spatially evolving vortex, with circulation enhancement driven by the axial acceleration of low-density gas in the core through the axial pressure gradient. The axial acceleration increases the entrainment rate into the core which, through mass conservation, increases the circulation if the angle between the tangential and radial velocity components remains fixed. The two-zone model employs general balance equations for regions inside and outside a cylinder of fixed radius, each inviscid, the inside region being presumed to have a constant density small compared with the (constant) …

Reduced-Scale Experiments And Numerical Simulations Of Informal Settlement Dwelling Fires, Vigneshwaran Narayanan, Antonio Cicicone, Ayden D. Botha, Richard Shaun Walls

Progress in Scale Modeling, an International Journal

Informal settlement dwellings (ISDs) house approximately one billion people in the developing world and this number is expected to double by the year 2030. Contemporary research on ISD fires has focused on understanding the fire dynamics within individual dwellings (micro-scale) and fire spread in settlements consisting of multiple dwellings (macro-scale). This paper aims to do two primary things: investigate if scaling methods that were derived for compartments with thermally thick boundaries can be applied to ISDs (compartments with thermally thin boundaries), and if they can adequately represent the most important phenomena associated with full-scale ISD fires; and demonstrate Fire Dynamics …

Specialized Safety Training And Tracking For Kytc Construction And Maintenance Personnel, Gabriel Dadi, Ashtarout Ammar, Seth Atkins, Martha Horseman

Kentucky Transportation Center Research Report

High-quality safety training is critical for educating employees in the highway construction and maintenance industry about workplace hazards and giving them tools to remove and/or minimize associated risks. But researchers and state transportation agencies have not committed enough resources to develop safety trainings that address the unique needs of this sector. This report fills in this gap for the Kentucky Transportation Cabinet (KYTC) by cataloguing safety training resources available through other state and federal transportation agencies, documenting trainings available to Cabinet staff, identifying and prioritizing training gaps, and critically evaluating the content, quality, and duration of training resources. A web-based …

Bridge Project Prioritization, Bryan Gibson, Christopher Van Dyke, Sudhir Palle, Ryan Griffith, Doug Kreis

Kentucky Transportation Center Research Report

Kentucky’s 14,000+ bridges are key nodes within the state’s surface transportation network. They facilitate the movement of freight, commercial vehicles, and personal vehicles alike. Historically, the Kentucky Transportation Cabinet (KYTC) has prioritized bridge maintenance projects using sufficiency ratings. These ratings are based on three factors — structural adequacy and safety, design obsolescence, and an asset’s importance within the roadway network. Although useful, sufficiency ratings do not account for factors that should be considered during the prioritization process (e.g., condition factors, risk). To address the shortcomings associated with using sufficiency ratings, KYTC — with the assistance of the Kentucky Transportation Center …

Risk-Based Project Development, Steve Waddle, Ying Li, Christopher Van Dyke

Kentucky Transportation Center Research Report

Risk management is integral to highway project development. Managing risk entails identifying uncertainties which could influence project activities, understanding how they can be mitigated or eliminated, and monitoring risk during project development. Many state transportation agencies have introduced methods for identifying risks, determining whether risks are high impact or low impact, and generating response strategies. These methods are often qualitative or semi-quantitative in nature due to the challenge of quantifying the likelihood of a risk and its effects. These approaches are nonetheless valuable for helping designers and project development teams remain mindful of negative risks which could pose significant hurdles. …

Non-Metropolitan And Metropolitan Trends In Mental Health Treatment Availability In Community Health And Community Mental Health Centers, Tyrone F. Borders, Timothy Williams, Katherine Youngen, Julia Cecil

Rural & Underserved Health Research Center Publications

Key Findings

The supply of community mental health centers (CMHCs) decreased substantially from 2000 to 2019 and became nearly non-existent in non-metropolitan counties.

• The number of CMHCs in non-metropolitan counties declined from 182 to 15.
• The number of CMHCs in metropolitan counties declined from 582 to 104.

The supply of community health centers (CHCs) offering mental health services increased substantially over the same time period, or from 2000 to 2019.

• The number of CHCs in non-metropolitan counties increased from 184 to 573.
• The number of CHCs in metropolitan counties increased from 126 to 797.

The Effect Of Reduced Cp, Synthetic Amino Acid Supplemented Diets On Growth Performance And Nutrient Excretion In Wean To Finish Swine, Caitlin E. Vonderohe, Kayla M. Mills, Shule Liu, Matthew D. Asmus, Emily R. Otto-Tice, Brian T. Richert, Ji-Qin Ni, John Scott Radcliffe

Animal and Food Sciences Faculty Publications

Mixed sex pigs (n = 720) were placed in 12 rooms (Purdue Swine Environmental Research Building) to measure the effect of reduced crude protein (CP), amino acid (AA)-supplemented diets on growth and the carcass. Pigs were blocked by body weight (BW) and gender and allotted to room and pen (10 mixed-sex pigs/pen). Pigs were fed a nine-phase, wean-finish program. Control pigs consumed corn-soybean meal-distiller’s dried grains with solubles (DDGS) diets containing no to minimal (Met) synthetic AA. The 2X diet was formulated to meet the seventh most-limiting AA, and balanced using synthetic AAs to meet all AA needs. The 1X …

Ethanol Exposure Up-Regulates Pd-L1/Pd-1 Immune Checkpoint Pathway And Promotes Mammary Tumor Development, Wenhua Xu, Linqing Wu, Mei Xu, Jia Luo, Gang Chen

Pharmacology and Nutritional Sciences Faculty Publications

Alcohol consumption in women enhances breast cancer incidence and ethanol is the main causal factor. Compromised host immunity through immunosuppression facilitates the development of many types of cancer, including breast cancer. Immune cells in breast tissues, particularly tumor-infiltrating CD8 cytotoxic T cells, play a critical role in the host anti-tumor immunity against breast tumorigenesis. These cytotoxic T cells are the major immune cells to carry out anti-tumor immunity through their cytotoxic effector function, which can be regulated by immune checkpoint pathways. The PD-1/PD-L1 pathway (the interaction between programmed death-1, PD-1, and its ligand, programmed deathligand 1, PD-L1) is the best …