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A Simplified, Combined Protocol Versus Standard Treatment For Acute Malnutrition In Children 6-59 Months (Compas Trial): A Cluster-Randomized Controlled Non-Inferiority Trial In Kenya And South Sudan, Jeanette Bailey, Charles Opondo, Natasha Lelijveld, Bethany Marron, Pamela Onyo, Eunice N. Musyoki, Susan W. Adongo, Mark Manary, André Briend, Marko Kerac

Open Access Publications

BACKGROUND: Malnutrition underlies 3 million child deaths worldwide. Current treatments differentiate severe acute malnutrition (SAM) from moderate acute malnutrition (MAM) with different products and programs. This differentiation is complex and costly. The Combined Protocol for Acute Malnutrition Study (ComPAS) assessed the effectiveness of a simplified, unified SAM/MAM protocol for children aged 6-59 months. Eliminating the need for separate products and protocols could improve the impact of programs by treating children more easily and cost-effectively, reaching more children globally.

METHODS AND FINDINGS: A cluster-randomized non-inferiority trial compared a combined protocol against standard care in Kenya and South Sudan. Randomization was stratified …

Statistics Of Heart Failure And Mechanical Circulatory Support In 2020, Robert E. S. Bowen, Thomas J. Graetz, Daniel A. Emmert, Michael S. Avidan

Open Access Publications

Heart failure is increasing in prevalence, with approximately 26 million patients affected worldwide. This represents a significant cause of morbidity and mortality. Statistics regarding heart failure patient age, hospitalization likelihood, and mortality differ significantly by country. Heart failure patients are typically classified by ejection fraction, with distinct phenotypes associated with reduced ejection fraction (rEF) or preserved ejection fraction (pEF). Heart failure has a significant financial impact related to hospitalization, medication, and procedural expenses. The costs of heart failure also extend to the reduced quality of life conferred by heart failure symptoms. Management of heart failure includes a variety of interventions, …

Driving Factors Of Preterm Birth Risk In Adolescents, Marta J. Perez, Jen J. Chang, Lorene A. Temming, Ebony B. Carter, Julia D. López, Methodius G. Tuuli, George A. Macones, Molly J. Stout

Open Access Publications

No abstract provided.

Comparative Genomics And Transcriptomics Of 4 Paragonimus Species Provide Insights Into Lung Fluke Parasitism And Pathogenesis, Bruce A. Rosa, Young-Jun Choi, Samantha N. Mcnulty, Hyeim Jung, John Martin, Takeshi Agatsuma, Hiromu Sugiyama, Thanh Hoa Le, Pham Ngoc Doanh, Wanchai Maleewong, David Blair, Paul J. Brindley, Peter U. Fischer, Makedonka Mitreva

Open Access Publications

BACKGROUND: Paragonimus spp. (lung flukes) are among the most injurious foodborne helminths, infecting ∼23 million people and subjecting ∼292 million to infection risk. Paragonimiasis is acquired from infected undercooked crustaceans and primarily affects the lungs but often causes lesions elsewhere including the brain. The disease is easily mistaken for tuberculosis owing to similar pulmonary symptoms, and accordingly, diagnostics are in demand.

RESULTS: We assembled, annotated, and compared draft genomes of 4 prevalent and distinct Paragonimus species: Paragonimus miyazakii, Paragonimus westermani, Paragonimus kellicotti, and Paragonimus heterotremus. Genomes ranged from 697 to 923 Mb, included 12,072-12,853 genes, and were 71.6-90.1% complete according …

Lathosterol Oxidase (Sterol C-5 Desaturase) Deletion Confers Resistance To Amphotericin B And Sensitivity To Acidic Stress In Leishmania Major, Yu Ning, Cheryl Frankfater, Fong-Fu Hsu, Rodrigo P Soares, Camila A Cardoso, Paula M Nogueira, Noelia Marina Lander, Roberto Docampo, Kai Zhang

Open Access Publications

Lathosterol oxidase (LSO) catalyzes the formation of the C-5-C-6 double bond in the synthesis of various types of sterols in mammals, fungi, plants, and protozoa. In

The Endosymbiont Wolbachia Rebounds Following Antibiotic Treatment, Emma L. Gunderson, Young-Jun Choi, Makedonka Mitreva, Et Al.

Open Access Publications

Antibiotic treatment has emerged as a promising strategy to sterilize and kill filarial nematodes due to their dependence on their endosymbiotic bacteria, Wolbachia. Several studies have shown that novel and FDA-approved antibiotics are efficacious at depleting the filarial nematodes of their endosymbiont, thus reducing female fecundity. However, it remains unclear if antibiotics can permanently deplete Wolbachia and cause sterility for the lifespan of the adult worms. Concerns about resistance arising from mass drug administration necessitate a careful exploration of potential Wolbachia recrudescence. In the present study, we investigated the long-term effects of the FDA-approved antibiotic, rifampicin, in the Brugia pahangi …

Switching Warfarin To Direct Oral Anticoagulants In Atrial Fibrillation: Insights From The Ncdr Pinnacle Registry, Christopher T Sciria, Thomas M Maddox, Et Al

Open Access Publications

BACKGROUND: Previous studies examining the use of direct oral anticoagulants (DOACs) in atrial fibrillation (AF) have largely focused on patients newly initiating therapy. Little is known about the prevalence/patterns of switching to DOACs among AF patients initially treated with warfarin.

HYPOTHESIS: To examine patterns of anticoagulation among patients chronically managed with warfarin upon the availability of DOACs and identify patient/practice-level factors associated with switching from chronic warfarin therapy to a DOAC.

METHODS: Prospective cohort study of AF patients in the NCDR PINNACLE registry prescribed warfarin between May 1, 2008 and May 1, 2015. Patients were followed at least 1 year …

The Effect Of Thermal Therapy On The Blood-Brain Barrier And Blood-Tumor Barrier, Bhuvic Patel, Peter H Yang, Albert H Kim

Open Access Publications

The blood-brain and blood-tumor barriers represent highly specialized structures responsible for tight regulation of molecular transit into the central nervous system. Under normal circumstances, the relative impermeability of the blood-brain barrier (BBB) protects the brain from circulating toxins and contributes to a brain microenvironment necessary for optimal neuronal function. However, in the context of tumors and other diseases of central nervous system, the BBB and the more recently appreciated blood-tumor barrier (BTB) represent barriers that prevent effective drug delivery. Overcoming both barriers to optimize treatment of central nervous system diseases remains the subject of intense scientific investigation. Although many newer …

Maternal Knowledge Of The Risk Of Vertical Transmission And Offspring Acquisition Of Hepatitis B., Mauricio Lisker-Melman, Mandana Khalili, Steven H Belle, Norah A Terrault, Hsing-Hua S Lin, Coleman I Smith, Raymond T Chung, Naoky Tsai, Natalie H Bzowej, Tram T Tran, Sarah Jane Schwarzenberg, Hepatitis B Research Network (Hbrn)

Open Access Publications

INTRODUCTION AND OBJECTIVES: Universal vaccination at birth and in infancy is key to the elimination of chronic hepatitis B infection. We aimed to assess hepatitis B immune-prophylaxis and perinatal transmission knowledge, in a large and ethnically diverse cohort of previously pregnant North American women, chronically infected with hepatitis B.

MATERIALS AND METHODS: The Hepatitis B Research Network (HBRN) is comprised of 28 Clinical Centers in the United States and Canada. Female cohort participants were administered a questionnaire to assess: (1) their assertion of knowledge regarding HBV prophylaxis at birth, testing, and diagnosis of hepatitis B in their children, and (2) …

Brain Connectivity And Socioeconomic Status At Birth And Externalizing Symptoms At Age 2 Years, Bruce Ramphal, Diana J Whalen, Jeanette K Kenley, Qiongru Yu, Christopher D Smyser, Cynthia E Rogers, Chad M Sylvester

Open Access Publications

Low childhood socioeconomic status (SES) predisposes individuals to altered trajectories of brain development and increased rates of mental illness. Brain connectivity at birth is associated with psychiatric outcomes. We sought to investigate whether SES at birth is associated with neonatal brain connectivity and if these differences account for socioeconomic disparities in infant symptoms at age 2 years that are predictive of psychopathology. Resting state functional MRI was performed on 75 full-term and 37 term-equivalent preterm newborns (n = 112). SES was characterized by insurance type, the Area Deprivation Index, and a composite score. Seed-based voxelwise linear regression related SES to …

Robust Principal Component Analysis For Accurate Outlier Sample Detection In Rna-Seq Data, Xiaoying Chen, Bo Zhang, Ting Wang, Azad Bonni, Guoyan Zhao

Open Access Publications

BACKGROUND: High throughput RNA sequencing is a powerful approach to study gene expression. Due to the complex multiple-steps protocols in data acquisition, extreme deviation of a sample from samples of the same treatment group may occur due to technical variation or true biological differences. The high-dimensionality of the data with few biological replicates make it challenging to accurately detect those samples, and this issue is not well studied in the literature currently. Robust statistics is a family of theories and techniques aim to detect the outliers by first fitting the majority of the data and then flagging data points that …

Parkinson Disease Clinical Subtypes: Key Features & Clinical Milestones, Meghan C Campbell, Peter S Myers, Alexandra J Weigand, Erin R Foster, Nigel J Cairns, Joshua J Jackson, Christina N Lessov-Schlaggar, Joel S Perlmutter

Open Access Publications

OBJECTIVES: Based on multi-domain classification of Parkinson disease (PD) subtypes, we sought to determine the key features that best differentiate subtypes and the utility of PD subtypes to predict clinical milestones.

METHODS: Prospective cohort of 162 PD participants with ongoing, longitudinal follow-up. Latent class analysis (LCA) delineated subtypes based on score patterns across baseline motor, cognitive, and psychiatric measures. Discriminant analyses identified key features that distinguish subtypes at baseline. Cox regression models tested PD subtype differences in longitudinal conversion to clinical milestones, including deep brain stimulation (DBS), dementia, and mortality.

RESULTS: LCA identified distinct subtypes: "motor only" (N = 63) …

Phenotypic Profiling In Subjects Heterozygous For 1 Of 2 Rare Variants In The Hypophosphatasia Gene (Alpl), Daniel R Tilden, Jonathan H Sheehan, John H Newman, Jens Meiler, John A Capra, Andrea Ramirez, Jill Simmons, Kathryn Dahir

Open Access Publications

CONTEXT: Hypophosphatasia (HPP) is a syndrome marked by low serum alkaline phosphatase (AlkP) activity as well as musculoskeletal and/or dental disease. While the majority of subjects with HPP carry a pathogenic variant in the

METHODS: Through BioVU, a DNA biobank that pairs individuals' genetic information with their de-identified medical records, we identified subjects with 2 rare variants with distinct reported clinical phenotypes (p.D294A and p.T273M). We then performed a manual review of these subjects' de-identified medical records along with computational modeling of protein structure to construct a genetic, biochemical and clinical phenotype for each subject and variant.

RESULTS: Twenty subjects …

Evaluation Of Ng-Test Carba 5 For Rapid Phenotypic Detection And Differentiation Of Five Common Carbapenemase Families: Results Of A Multicenter Clinical Evaluation, Stephen Jenkins, Carey-Ann D. Burnham, Meghan A Wallace, Et Al

Open Access Publications

NG-Test Carba 5 is a rapid

Evaluation Of The Biofire Filmarray Pneumonia Panel For Detection Of Viral And Bacterial Pathogens In Lower Respiratory Tract Specimens In The Setting Of A Tertiary Care Academic Medical Center, Daniel M Webber, Meghan A Wallace, C A Burnham, Neil W Anderson

Open Access Publications

Our objective was to evaluate the diagnostic yield and accuracy of the BioFire FilmArray pneumonia panel (BFPP) for identification of pathogens in lower respiratory tract specimens (

Behavioral And Neural Signatures Of Working Memory In Childhood, Monica D. Rosenberg, Deanna M. Barch, Et Al

Open Access Publications

Working memory function changes across development and varies across individuals. The patterns of behavior and brain function that track individual differences in working memory during human development, however, are not well understood. Here, we establish associations between working memory, other cognitive abilities, and functional MRI (fMRI) activation in data from over 11,500 9- to 10-year-old children (both sexes) enrolled in the Adolescent Brain Cognitive Development (ABCD) Study, an ongoing longitudinal study in the United States. Behavioral analyses reveal robust relationships between working memory, short-term memory, language skills, and fluid intelligence. Analyses relating out-of-scanner working memory performance to memory-related fMRI activation …

An Agonistic Anti-Cd137 Antibody Disrupts Lymphoid Follicle Structure And T-Cell-Dependent Antibody Responses, Jun P Hong, Glennys V Reynoso, Prabhakar S Andhey, Amanda Swain, Jackson S Turner, Adrianus C M Boon, Florian Krammer, Ali H Ellebedy, Fabio Zanini, Maxim Artyomov, Heather D Hickman, Michael S Diamond

Open Access Publications

CD137 is a costimulatory receptor expressed on natural killer cells, T cells, and subsets of dendritic cells. An agonistic monoclonal antibody (mAb) against CD137 has been used to reduce tumor burden or reverse autoimmunity in animal models and clinical trials. Here, we show that mice treated with an agonistic anti-CD137 mAb have reduced numbers of germinal center (GC) B cells and follicular dendritic cells (FDCs) in lymphoid tissues, which impair antibody responses to multiple T-cell-dependent antigens, including infectious virus, viral proteins, and conjugated haptens. These effects are not due to enhanced apoptosis or impaired proliferation of B cells but instead …

Development Of A Single-Stranded Dna-Binding Protein Fluorescent Fusion Toolbox, Katarzyna Dubiel, Camille Henry, Lisanne M. Spenkelink, Alexander G. Kozlov, Elizabeth A. Wood, Slobodan Jergic, Nicholas E. Dixon, Antoine M. Van Oijen, Michael M. Cox, Timothy M. Lohman, Steven J. Sandler, James L. Keck

Open Access Publications

Bacterial single-stranded DNA-binding proteins (SSBs) bind single-stranded DNA and help to recruit heterologous proteins to their sites of action. SSBs perform these essential functions through a modular structural architecture: the N-terminal domain comprises a DNA binding/tetramerization element whereas the C-terminus forms an intrinsically disordered linker (IDL) capped by a protein-interacting SSB-Ct motif. Here we examine the activities of SSB-IDL fusion proteins in which fluorescent domains are inserted within the IDL of Escherichia coli SSB. The SSB-IDL fusions maintain DNA and protein binding activities in vitro, although cooperative DNA binding is impaired. In contrast, an SSB variant with a fluorescent protein …

Pet Radiopharmaceuticals For Imaging Chemotherapy-Induced Cardiotoxicity, Jothilingam Sivapackiam, Monica Sharma, Thomas H Schindler, Vijay Sharma

Open Access Publications

PURPOSE OF REVIEW: Currently, cardiotoxicity is monitored through echocardiography or multigated acquisition scanning and is defined as 10% or higher LVEF reduction. The latter stage may represent irreversible myocardium injury and limits modification of therapeutic paradigms at earliest stages. To stratify patients for anthracycline-related heart failure, highly sensitive and molecularly specific probes capable of interrogating cardiac damage at the subcellular levels have been sought.

RECENT FINDINGS: PET tracers may provide noninvasive assessment of earliest changes within myocardium. These tracers are at nascent stages of development and belong primarily to (a) mitochondrial potential-targeted and (b) general ROS (reactive oxygen species)-targeted radiotracers. …

Cumulative Exposure To Long Working Hours And Occurrence Of Ischemic Heart Disease: Evidence From The Constances Cohort At Inception, Marc Fadel, Jian Li, Grace Sembajwe, Diana Gagliardi, Fernando Pico, Anna Ozguler, Bradley A Evanoff, Michel Baer, Akizumi Tsutsumi, Sergio Iavicoli, Annette Leclerc, Yves Roquelaure, Johannes Siegrist, Alexis Descatha

Open Access Publications

Background Long-working hours (LWH) are a probable risk factor for ischemic heart diseases (IHD); however, no previous study has considered duration of exposure to LWH when addressing this topic. We aimed to determine the association between cumulative exposure to LWH and IHD while accounting for relevant confounders. Methods and Results In this retrospective study, we included all baseline participants from the French population-based cohort CONSTANCES. Part-time employees and those who reported a cardiac event in the 5 years before LWH exposure were excluded. From self-administered questionnaires and clinical examinations, we obtained participants' age, sex, body mass index, occupational status, smoking …

Validation Of Parkinson's Disease-Related Questionnaires In South Africa, Gill Nelson, Ntombizodwa Ndlovu, Nicola Christofides, Tintswalo M Hlungwani, Irene Faust, Brad A Racette

Open Access Publications

Background: There are very few epidemiological studies investigating Parkinson's disease (PD) in Africa. The hundreds of local languages and dialects make traditional screening and clinical evaluation tools difficult to use.

Objective: The objective of the study was to validate two commonly used PD questionnaires in an African population.

Methods: The PD Screening Questionnaire (PDSQ) and Parkinson's Disease Questionnaire (PDQ-39) were modified and translated into Afrikaans, Setswana, and isiZulu and administered to a sample of healthy local residents. We assessed the internal consistencies and cluster characteristics of the questionnaires, using a Cronbach's alpha test and exploratory factor analysis. The questionnaires were …

Replication Of Associations With Psychotic-Like Experiences In Middle Childhood From The Adolescent Brain Cognitive Development (Abcd) Study, Nicole R Karcher, Rachel L Loewy, Mark Savill, Shelli Avenevoli, Rebekah S Huber, Tony J Simon, Ingrid N Leckliter, Kenneth J Sher, Deanna M Barch

Open Access Publications

The fields of psychology and psychiatry are increasingly recognizing the importance of replication efforts. The current study aimed to replicate previous findings examining the construct validity and psychometric properties of a psychotic-like experiences (PLEs) measure in middle childhood using an independent subset of the baseline Adolescent Brain Cognitive Development (ABCD) sample. Using a remainder baseline sample of 7013 nine- to eleven-year-old children with complete data, we examined measurement invariance across race/ethnicity and sex, and examined the associations between the Prodromal Questionnaire Brief-Child Version (PQ-BC) and other measures of PLEs, internalizing symptoms, neuropsychological test performance, and developmental milestones, to determine whether …

A Survey-Based Analysis Of The Academic Job Market, Jason D. Fernandes, Sarvenaz Sarabipour, Christopher T. Smith, Natalie M. Niemi, Nafisa M. Jadavji, Ariangela J. Kozik, Alex S. Holehouse, Vikas Pejaver, Orsolya Symmons, Alexandre W. Bisson Filho, Amanda Haage

Open Access Publications

Many postdoctoral researchers apply for faculty positions knowing relatively little about the hiring process or what is needed to secure a job offer. To address this lack of knowledge about the hiring process we conducted a survey of applicants for faculty positions: the survey ran between May 2018 and May 2019, and received 317 responses. We analyzed the responses to explore the interplay between various scholarly metrics and hiring outcomes. We concluded that, above a certain threshold, the benchmarks traditionally used to measure research success - including funding, number of publications or journals published in - were unable to completely …

The Neurons That Mistook A Hat For A Face, Michael J. Arcaro, Carlos Ponce, Margaret Livingstone

Open Access Publications

Despite evidence that context promotes the visual recognition of objects, decades of research have led to the pervasive notion that the object processing pathway in primate cortex consists of multiple areas that each process the intrinsic features of a few particular categories (e.g. faces, bodies, hands, objects, and scenes). Here we report that such category-selective neurons do not in fact code individual categories in isolation but are also sensitive to object relationships that reflect statistical regularities of the experienced environment. We show by direct neuronal recording that face-selective neurons respond not just to an image of a face, but also …

Radiological Society Of North America (Rsna) 3d Printing Special Interest Group (Sig) Clinical Situations For Which 3d Printing Is Considered An Appropriate Representation Or Extension Of Data Contained In A Medical Imaging Examination: Abdominal, Hepatobiliary, And Gastrointestinal Conditions, David H Ballard, Et Al

Open Access Publications

BACKGROUND: Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D printing indications.

METHODS: A literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of abdominal pathologic processes. Each included study was graded according to published guidelines.

RESULTS: Evidence-based appropriateness guidelines are provided for the following areas: intra-hepatic masses, hilar cholangiocarcinoma, biliary stenosis, biliary stones, gallbladder pathology, pancreatic cancer, …

Safety And Efficacy Of Co-Administered Diethylcarbamazine, Albendazole And Ivermectin During Mass Drug Administration For Lymphatic Filariasis In Haiti: Results From A Two-Armed, Open-Label, Cluster-Randomized, Community Study, Christine Dubray, Anita Sircar, Madsen Beau De Rochars, Joshua Bogus, Abdel N. Direny, Jean Romuald Ernest, Carl Fayette, Charles W. Goss, Marisa Hast, Katiuscia O'Brian, Guy Emmanuel Pavilus, Daniel Frantz Sabin, Ryan Wiegand, Gary J. Weil, Jean Frantz Lemoine

Open Access Publications

No abstract provided.

Cd56 Regulates Human Nk Cell Cytotoxicity Through Pyk2, Justin T. Gunesch, Amera L. Dixon, Tasneem A.M. Ebrahim, Melissa M. Berrien-Elliott, Swetha Tatineni, Tejas Kumar, Everardo Hegewisch-Solloa, Todd A. Fehniger, Emily M. Mace

Open Access Publications

Human natural killer (NK) cells are defined as CD56

Assessment Of Antibiotic-Resistant Organism Transmission Among Rooms Of Hospitalized Patients, Healthcare Personnel, And The Hospital Environment Utilizing Surrogate Markers And Selective Bacterial Cultures, Jennie H Kwon, Kimberly Reske, Caroline A O'Neil, Candice Cass, Sondra Seiler, Meghan A Wallace, Tiffany Hink, Stephen Y Liang, Victoria J Fraser, Carey-Ann D Burnham, Erik R Dubberke

Open Access Publications

OBJECTIVE: To assess potential transmission of antibiotic-resistant organisms (AROs) using surrogate markers and bacterial cultures.

DESIGN: Pilot study.

SETTING: A 1,260-bed tertiary-care academic medical center.

PARTICIPANTS: The study included 25 patients (17 of whom were on contact precautions for AROs) and 77 healthcare personnel (HCP).

METHODS: Fluorescent powder (FP) and MS2 bacteriophage were applied in patient rooms. HCP visits to each room were observed for 2-4 hours; hand hygiene (HH) compliance was recorded. Surfaces inside and outside the room and HCP skin and clothing were assessed for fluorescence, and swabs were collected for MS2 detection by polymerase chain reaction (PCR) …

Efficacy Of Bezlotoxumab In Participants Receiving Metronidazole, Vancomycin, Or Fidaxomicin For Treatment Of Clostridioides (Clostridium) Difficile Infection, Erik R. Dubberke, Dale N. Gerding, Ciarán P. Kelly, Kevin W. Garey, Galia Rahav, Audrey Mosley, Robert Tipping, Mary Beth Dorr

Open Access Publications

Background: In phase 3 MODIFY I/II trials, bezlotoxumab significantly reduced recurrence of

Methods: In MODIFY I/II (NCT01241552/NCT01513239), participants received a single infusion of bezlotoxumab (10 mg/kg) or placebo during anti-CDI treatment. Using pooled data from MODIFY I/II, initial clinical cure (ICC) and rCDI were assessed in metronidazole-, vancomycin-, and fidaxomicin-treated subgroups.

Results: Of 1554 participants in MODIFY I/II, 753 (48.5%) received metronidazole, 745 (47.9%) vancomycin, and 56 (3.6%) fidaxomicin. Fewer participants receiving metronidazole had a prior CDI episode in the previous 6 months (12.9%) or ≥1 risk factor for rCDI (66.0%) vs participants receiving vancomycin (41.2% and 83.6%, respectively) and …

Update On T Cells In The Virally Infected Brain: Friends And Foes, Shenjian Ai, Robyn S Klein

Open Access Publications

PURPOSE OF REVIEW: The present review will outline neuroprotective and neurotoxic effects of central nervous system (CNS) infiltrating T cells during viral infections. Evidence demonstrating differential roles for antiviral effector and resident memory T-cell subsets in virologic control and immunopathology in the CNS will be discussed. Potential therapeutic targets emanating from a growing understanding of T-cell-initiated neuropathology that impacts learning and memory will also be delineated.

RECENT FINDINGS: The critical role for T cells in preventing and clearing CNS infections became incontrovertible during the era of acquired immunodeficiency syndrome. Recent studies have further defined differential roles of T-cell subsets, including …