bluuebunny/crossref_metadata_2025 huggingface dataset:
Prescriptions of Psychotropic Medications by Providers Treating Children of Military Service Members
Authors: Kucera Alexandria , Koehlmoos Tracey , Grunwald Lindsay , Banaag Amanda , Schvey Natasha A , Quinlan Jeffrey , Tanofsky-Kraff Marian
Published: March 2022

Introduction

There are approximately 1.5 million U.S. military-dependent children. However, little is known about mental health referrals for these youths. This study sought to examine the type of mental health treatment referrals made by primary care providers for child military-dependent beneficiaries receiving care in the direct (within Military Treatment Facilities) and private care (civilian-fee-for service facilities) sectors of the Military Health System.

Materials and Methods

A between-subjects, cross-sectional study was performed on children aged 5–18 years old in fiscal years 2011–2015 and enrolled in TRICARE Prime. Study analyses examined specialty (“talk therapy”) mental health care and psychotropic medication referrals from TRICARE Prime (the Defense Health Agency-managed health care program) providers for beneficiary children diagnosed with attention-, mood-, anxiety-, or behavior-related disorders in direct versus private sector care.

Results

Of 1,533,630 children enrolled in TRICARE Prime (50.03% female), 8.6% (n = 131,393) were diagnosed with a psychological disorder during FY 2011–2015. Most were attention-related (5.2%, n = 79,770), followed by mood (1.7%, n = 25,314), anxiety (1.1%, n = 16,155), and conduct-related diagnoses (0.7%, n = 10,154). Adjusting for age, sex, and sponsor rank, children within direct care diagnosed with attention-related disorders were 1.7 times more likely to receive a prescription for psychotropic medication than those in private sector care, odds ratio (OR) = 1.72, 95% confidence interval (CI): [1.66, 1.77]. Children diagnosed with mood-related disorders in direct care were 2.1 times more likely to receive a prescription for psychotropic medication than those in private sector care, OR = 2.08, 95% CI: [1.96, 2.21]. Across disorders, children who received private sector care were more likely to have a referral specialty mental health (“talk therapy”) follow-up (ps < 0.0001).

Conclusions

For attention- and mood-related disorders, but not anxiety- or conduct-related disorders, direct care providers were more likely than private sector care providers to prescribe psychotropic medications. Inconsistencies of provider referrals within and outside of the Military Health System should be elucidated to determine the impact on outcomes.
Low Rates of Contraception Use in Women With Human Immunodeficiency Virus
Authors: Bhatta Manasa , Bian Aihua , Norwood Jamison , Shepherd Bryan E , Ransby Imani , Nelson Jeffrey , Turner Megan , Sterling Timothy R , Castilho Jessica L
Published: March 2022

Background

Women with human immunodeficiency virus (WWH) have low rates of hormonal or long-acting contraceptive use. Few studies have described contraception use among WWH over time.

Methods

We examined contraception (including all forms of hormonal contraception, intrauterine devices, and bilateral tubal ligations) use among cisgender women aged 18–45 years in care at Vanderbilt’s human immunodeficiency virus (HIV) clinic in Nashville, Tennessee, from 1998 through 2018. Weighted annual prevalence estimates of contraception use were described. Cox proportional hazards models examined factors associated with incident contraception use and pregnancy.

Results

Of the 737 women included, median age at clinic entry was 31 years; average follow-up was 4.1 years. At clinic entry, 47 (6%) women were on contraception and 164 (22%) were pregnant. The median annual percentage of time on any contraception use among nonpregnant women was 31.7% and remained stable throughout the study period. Younger age was associated with increased risk of pregnancy and contraceptive use. Psychiatric comorbidity decreased likelihood of contraception (adjusted hazard ratio [aHR], 0.52 [95% CI {confidence interval}, .29–.93]) and increased likelihood of pregnancy (aHR, 1.77 [95% CI, .97–3.25]). While not associated with contraceptive use, more recent year of clinic entry was associated with higher pregnancy risk. Race, substance use, CD4 cell count, HIV RNA, smoking, and antiretroviral therapy were not associated with contraception use nor pregnancy.

Conclusions

Most WWH did not use contraception at baseline nor during follow-up. Likelihood of pregnancy increased with recent clinic entry while contraception use remained stable over time. Continued efforts to ensure access to effective contraception options are needed in HIV clinics.
Kap1 Regulates the Stability of Lin28A in Embryonic Stem Cells
Authors: Moon Hye Ji , Lee Na Yeon , Do Eun Kyoung , Lee Seo Yul , Park Gyu Tae , Lim Jae Kyong , Seo Jeong Kon , Kim Jae Ho
Published: March 2022

Lin28A is an RNA-binding protein that controls mammalian development and maintenance of the pluripotency of embryonic stem cells (ESCs) via regulating the processing of the microRNA let-7. Lin28A is highly expressed in ESCs, and ectopic expression of this protein facilitates reprogramming of somatic cells to induced pluripotent stem cells. However, the mechanisms underlying the post-translational regulation of Lin28A protein stability in ESCs remain unclear. In the present study, we identified Kap1 (KRAB-associated protein 1) as a novel Lin28A-binding protein using affinity purification and mass spectrometry. Kap1 specifically interacted with the N-terminal region of Lin28A through its coiled-coil domain. Kap1 overexpression significantly attenuated Lin28A ubiquitination and increased its stability. However, small interfering RNA-mediated knockdown of Kap1 promoted the ubiquitination of Lin28A, leading to its proteasomal degradation. Trim71, an E3 ubiquitin ligase, induced Lin28A degradation and Kap1 knockdown accelerated the Trim71-dependent degradation of Lin28A. Mutation of the lysine 177 residue of Lin28A to arginine abrogated the ubiquitination and degradation of Lin28A which were accelerated by Kap1 silencing. Moreover, Kap1 overexpression led to the accumulation of Lin28A in the cytoplasm, but not in the nucleus, and reduced the levels of let-7 subtypes. These results suggest that Kap1 plays a key role in regulation of the stability of Lin28A by modulating the Trim71-mediated ubiquitination and subsequent degradation of Lin28A, thus playing a pivotal role in the regulation of ESC self-renewal and pluripotency.
Distribution, Ecological Factors, Molecular Diversity, and Specific PCR for Major Species of Pin Nematodes (Paratylenchus spp.) in Prunus Plantations in Spain
Authors: Clavero-Camacho Ilenia , Cantalapiedra-Navarrete Carolina , Archidona-Yuste Antonio , Castillo Pablo , Palomares-Rius Juan E.
Published: March 2022

This study aimed to evaluate the prevalence and distribution of Paratylenchus species in the main areas of Prunus spp. production in Spain, their ecological constraints, and new molecular tools for the specific identification of major species. Pin nematodes are recognized as plant-parasitic nematodes with a wide host range and global distribution. Therefore, understanding the environmental and agronomic factors involved in their distribution is critical to design environmental and sustainable management strategies to reduce plant damage. A total of 219 sampling sites were surveyed and 12 Paratylenchus species were identified based on an integrative taxonomic approach (P. baldaccii, P. enigmaticus, P. goodeyi, P. hamatus, P. holdemani, P. indalus, P. israelensis, P. pedrami, P. tateae, P. tenuicaudatus, P. veruculatus, and P. zurgenerus). The most common pin nematode was P. hamatus, followed by P. tenuicaudatus. Nematode abundance was influenced by climatic characteristics, soil chemical properties, and agronomic management practices. Nine explanatory variables were selected as the most strongly associated with Paratylenchus distribution. Specifically, P. tenuicaudatus was significantly correlated with soil chemical characteristics, such as pH and carbon, sulfur, and sodium content, whereas P. goodeyi was closely related to fields with <10 years of almond cultivation. Species-specific PCRs were developed for P. hamatus and P. tenuicaudatus and their validity was evaluated studying the molecular variability of these species and against other Paratylenchus species.
The Pursuit in Nepal of Native Trichoderma spp. for Plant Disease Biocontrol
Authors: Khadka Ram B. , Rotondo Francesca , Miller Sally A.
Published: March 2022

The characteristics of 41 native Trichoderma isolates collected from diverse microclimatic domains in Nepal and two Ohio isolates and their efficacy in biocontrol of plant diseases were assessed. Species assignment was based on a maximum likelihood phylogenetic analysis constructed on a concatenated dataset using the internal transcribed spacer region ( ITS), translocation elongation factor ( tef1), and RNA polymerase II subunit ( rpb2). Most of the Nepal isolates ( n = 37) were assigned to the Viride clade and identified as T. asperellum or T. asperelloides, whereas a minority ( n = 4) were assigned to the Harzianum clade and identified as T. lixii or T. rugulosum. One of the Ohio isolates belonged to the Hamatum clade and was closely related to the T. hamatum reference strain, whereas the other Ohio strain was closely related to T. ghanense (Longibrachiatum clade). Confrontation assays conducted to evaluate mycelial growth reduction of Rhizoctonia solani indicated that mechanisms of action included competition, mycoparasitism, and antibiosis. Trichoderma asperellum isolates NT22, NT8, NT24, and NT25 and T. asperelloides isolates NT1 and NT30 reduced Rhizoctonia root rot severity in greenhouse assays by more than 50% compared with the nontreated controls. Trichoderma asperellum isolates NT4, NT25, NT28, and NT17 and T. asperelloides NT8 suppressed clubroot severity in greenhouse assays by more than 75% compared with the nontreated controls. A significant negative correlation was observed between the percentage of mycelial growth reduction in vitro (confrontation assay) of R. solani and root rot severity. This study provides a basis for additional investigations of Trichoderma diversity and biocontrol potential in Nepal.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Reliability of radiographic measurements for hip dysplasia using a reduced radiation technique
Authors: Lawing Cheryl R. , Gorbe Rebecca L. , Maciel Maureen J. , Greene Travis C. , Khoury Joseph G.
Published: March 2022

The purpose of this study was to examine whether measurement accuracy is impacted with a low radiation radiograph technique. Treatment decisions for hip dysplasia require serial radiographs to monitor acetabular anatomy. However, radiation use creates concern for future malignancy. Standard radiograph technique utilizes a grid to enhance clarity, but requires a larger X-ray dose. We hypothesized grid removal would lower radiation exposure without decreasing measurement accuracy. This is a retrospective cohort study of patients with idiopathic DDH and neuromuscular hip displacement at a single institution from 2019 to 2020 receiving surveillance radiographs. A cohort receiving modified technique radiographs (grid removed) was compared to an age-matched cohort receiving standard technique radiographs. Four examiners measured radiographs on two separate occasions, a minimum of 2 weeks apart. Migration percentage (MP) was measured for neuromuscular patients and acetabular index (AI) for idiopathic DDH. Intraclass correlation coefficient (ICC) with a 95% confidence interval (CI) was used to evaluate inter-observer and intra-observer agreement for measurements. Average radiation dose for both techniques. A total of 134 age-matched patients were included for measurement of MP. Thirty age-matched patients were included for AI measurements. Inter and intra-rater reliability of MP and AI were not different with or without use of the grid. There was a 50–75% decrease in radiation dose per radiograph following grid removal, dependent on patient size. The adjusted radiograph technique showed no significant difference in MP or AI reliability. A slight decrease in picture contrast did not jeopardize measurement reliability and decreased radiation exposure for the patient significantly. This simple technique can be useful for patients requiring multiple radiographs over time.
Image-guided surgery in oral cancer: toward improved margin control
Authors: Noorlag Rob , de Bree Remco , Witjes Max J.H.
Published: March 2022

Purpose of review

The aim of this review is to discuss recent studies on the assessment of tumor extension and resection margins by different intraoperative techniques allowing for image-guided surgery of oral cancer.

Recent findings

There are different in-vivo and ex-vivo intraoperative techniques to improve margin control of which intraoperative ultrasound and targeted fluorescence-guided resections have high potential clinical value and are closest to clinical implementation.

In oral cancer surgery, resection margins, particularly deep margins, are often inadequate. Intraoperative frozen section does not improve resection margin control sufficiently. Specimen-driven intraoperative assessment for gross analysis of suspected margins reduces the amount of positive resection margins substantially but leaves still room for improvement. Mucosal staining methods, optical coherence tomography and narrow band imaging can only be used for superficial (mucosal) resection margin control. Spectroscopy is under investigation, but clinical data are scarce. Intraoperative ex-vivo imaging of the resection specimen by magnetic resonance and PET/computed tomography may be used to assess resection margins but needs more research. Intraoperative in-vivo ad ex-vivo ultrasound and targeted fluorescence imaging have high potential clinical value to guide oral cancer resections and are closest to clinical implementation for improved margin control.
Real-world data on melanoma brain metastases and survival outcome
Authors: Pedersen Sidsel , Møller Søren , Donia Marco , Persson Gitte Fredberg , Svane Inge Marie , Ellebaek Eva
Published: March 2022

Novel medical therapies have revolutionized outcome for patients with melanoma. However, patients with melanoma brain metastases (MBM) still have poor survival. Data are limited as these patients are generally excluded from clinical trials, wherefore real-world data on clinical outcome may support evidence-based treatment choices for patients with MBM. Patients diagnosed with MBM between 2008 and 2020 were included retrospectively. Patient characteristics, treatment, and outcome data were recorded from The Danish Metastatic Melanoma Database, pathology registries, electronic patient files, and radiation plans. Anti-programmed cell death protein 1 antibodies and the combination of BRAF/MEK-inhibitors were introduced in Denmark in 2015, and the cohort was split accordingly for comparison. A total of 527 patients were identified; 148 underwent surgical excision of MBM, 167 had stereotactic radiosurgery (SRS), 270 received whole-brain radiation therapy (WBRT), and 343 received systemic therapies. Median overall survival (mOS) for patients diagnosed with MBM before and after 2015 was 4.4 and 7.6 months, respectively. Patients receiving surgical excision as first choice of treatment had the best mOS of 10.9 months, whereas patients receiving WBRT had the worst outcome (mOS, 3.4 months). Postoperative SRS did not improve survival or local control after surgical excision of brain metastases. Of the 40 patients alive >3 years after diagnosis of MBM, 80% received immunotherapy at some point after diagnosis. Patients with meningeal carcinosis did not benefit from treatment with CPI. Outcome for patients with MBM has significantly improved after 2015, but long-term survivors are rare. Most patients alive >3 years after diagnosis of MBM received immunotherapy.
Pharmacological activation of kappa opioid receptors in the nucleus accumbens core and ventral tegmental area increases the aversive effects of nicotine
Authors: Pham Han , Seeley Sarah L. , D’Souza Manoranjan S.
Published: March 2022

Aversive effects of nicotine play an important role in the development of nicotine dependence. However, neural substrates and/or brain regions that play a role in the aversive effects of nicotine have not been fully identified. Previous work done in our laboratory showed that systemic administration of kappa opioid receptors (KORs) agonist ±U50488 increased the aversive effects of nicotine. In this study, we assessed the effects of KOR activation in specific brain regions, namely, the nucleus accumbens (NAcc) core and ventral tegmental area (VTA) on the aversive effects of nicotine using the conditioned taste aversion model. Separate groups of Wistar rats were implanted with cannulae above either the NAcc core or the VTA. KOR agonist (±U50488) was bilaterally infused in the NAcc core (0, 0.3, and 3 ug/0.5 ul/side) or VTA (0, 0.3, 1.5, and 3 ug/0.5 ul/side) prior to receiving nicotine (0.4 mg/kg, base; s.c.) during conditioning. Bilateral infusion of the KOR agonist (3 ug/0.5 ul/side) in the NAcc core or the VTA increased the aversive effects of nicotine compared with respective saline controls. Together, these results suggest that pharmacological activation of the KORs in the NAcc core and VTA dose dependently modulate the aversive effects of nicotine. Because aversive effects of nicotine determine susceptibility to development of nicotine dependence, we can conclude that KOR activity in the NAcc and VTA after administration of nicotine may determine susceptibility to the development of nicotine dependence.
Superficial Temporal Vein and Alternative Middle Temporal Vein as Recipient Veins for Free-flap Reconstruction
Authors: Kagaya Yu , Arikawa Masaki , Akazawa Satoshi
Published: March 2022

The superficial and middle temporal veins (STV and MTV) have been used as recipient veins for free-flap reconstruction; however, the STV is sometimes small and cannot be used, while the MTV is not fully recognized or utilized as a recipient vein. The purpose of the present study was to evaluate the reliability of the STV/MTV as recipient veins and to verify the utility and availability of the MTV by comparing the two veins. Thirty-five consecutive cases of free-flap reconstruction utilizing recipient vessels in the temporal region were retrospectively reviewed. Regarding recipient veins, the STV was the only option in the first 18 cases; the MTV was included among the options in the latter 17 cases. The calibers of the STV/MTV were evaluated at two level points (1: zygomatic arch, 2: palpebral fissure) using the results of preoperative dynamic-enhanced computed tomography (CT). Two cases of severe venous congestion were identified among the first 18 patients. After the adoption of the MTV, the MTV was used in 10 of the 17 cases, and no vascular complication occurred. On CT imaging evaluation, the caliber of the MTV (Point 2) (2.94 ± 0.55 mm) was significantly larger than the calibers of the STV (Point 1) (2.40 ± 0.48 mm) and MTV (Point 1) (2.49 ± 0.43 mm) (both P < 0.001). Regarding the recipient veins in the temporal area, the MTV can offer an option with a larger caliber or for additional venous anastomosis when the condition of the STV is inadequate.
Metastatic Neoplasms to the Vulva—A Review
Authors: Heller Alexis , Breitner Daniel , Cracchiolo Bernadette , Heller Debra S.
Published: March 2022

Introduction

Metastatic neoplasms to the vulva are rare and can pose a diagnostic dilemma. As identification of the primary site can influence patient treatment and prognosis, correct diagnosis is important.

Methods

PubMed was searched for applicable publications using the terms vulva, vulvar neoplasms, metastasis, and vulvar metastasis.

Results

Most neoplasms metastatic to the vulva originate from other genital sources; however, extragenital primary neoplasms can also metastasize to the vulva. Vulvar metastases often occur in the setting of widespread disease.

Conclusions

It is important to consider biopsy for appropriate histologic and immunohistochemical studies, as well as consider patient history to establish the primary site of metastatic lesions to the vulva, allowing optimal therapy.
Does adding neuromuscular electrical stimulation to rehabilitation following total knee arthroplasty lead to a better quadriceps muscle strength recovery? A systematic review
Authors: Labanca Luciana , Bonsanto Fabio , Raffa Debora , Orlandi Magli Antonella , Benedetti Maria Grazia
Published: March 2022

Patients undergoing total knee arthroplasty (TKA) show postsurgical quadriceps weakness. Neuromuscular electrical stimulation (NMES) has been shown to be an effective treatment for muscle strength recovery in a number of orthopaedic conditions. The aim of this review is to investigate whether adding NMES to TKA rehabilitation leads to a better quadriceps strength recovery in comparison with standardized rehabilitation. A second aim is to investigate which are the most commonly used NMES pulse settings and their effectiveness. A systematic review of literature was conducted on PubMed, Cochrane, Scopus and Web-of-Science. Intervention studies evaluating the effects of a rehabilitation intervention based on quadriceps NMES in patients undergoing TKA were retrieved. Methodological quality was assessed using the risk of bias-2 Cochrane tool. Features of NMES rehabilitation and technical data on NMES settings were extracted from the studies. Four studies met the inclusion criteria. Due to the limited number and the heterogeneity of the selected studies, it was not appropriate to carry out a meta-analysis. All the studies reported higher quadriceps strength in patients undergoing quadriceps NMES, particularly early after TKA. The addition of NMES or traditional strength training shows similar long-term effects. Short duration and low-intensity NMES have limited effects on quadriceps strength. Heterogeneity was found on NMES methodologies and pulse settings. In conclusion, NMES is effective for quadriceps strength recovery following TKA. NMES intensity and duration are essential for good NMES outcomes on quadriceps strength. Further studies on NMES methodologies, pulse features and settings are required to address the gaps in knowledge on NMES following TKA.
Clinicopathologic and Molecular Study of Hybrid Nerve Sheath Tumors Reveals Their Common Association With Fusions Involving VGLL3
Authors: Nihous Hugo , Baud Jessica , Azmani Rihab , Michot Audrey , Perret Raul , Mayeur Laetitia , de Pinieux Gonzague , Milin Serge , Angot Emilie , Duquenne Sébastien , Geneste Damien , Lucchesi Carlo , Le Loarer Francois , Bouvier Corinne
Published: March 2022

A subset of benign peripheral nerve sheath tumors are “hybrid” combining several lines of differentiation, most often schwannian and perineurial features. The pathogenesis of these tumors was poorly described until the recent discovery of recurrent VGLL3 rearrangements in hybrid schwannoma/perineuriomas, supporting the hypothesis that this entity represents a distinct subgroup of tumors and not only a morphologic variation of other peripheral nerve sheath tumors. Following this finding, we investigated 10 cases of hybrid peripheral nerve sheath tumors with immunohistochemistry, RNA sequencing, and array comparative genomic hybridization. By light microscopy, 7 tumors were hybrid schwannoma/perineurioma tumors, and 3 were hybrid schwannoma/neurofibroma. Most cases of hybrid schwannoma/perineuriomas displayed VGLL3 rearrangements fused in 5′ either to CHD7 or CHD9 (n=6/7) and had simple diploid genetic profiles with few copy number alterations. Compared with a control group composed of 28 tumors associated with varied neural phenotypes, all VGLL3-fused tumors clustered together by transcriptomic analysis. In contrast, 1 case of hybrid schwannoma/perineurioma tumor harbored a CDH9-ZFHX3 fusion, a prominent perineurial component identified by immunohistochemistry and clustered with perineuriomas. No recurrent genetic alteration was seen in the 3 hybrid schwannoma/neurofibromas. To summarize, this study confirms and expands the recent findings on hybrid schwannoma/perineurioma, highlighting the predominance of VGLL3 fusions in these tumors.
Radiofrequency Heating and High-Intensity Focused Electromagnetic Treatment Delivered Simultaneously: The First Sham-Controlled Randomized Trial
Authors: Samuels Julene B. , Katz Bruce , Weiss Robert A.
Published: March 2022

Background:

Radiofrequency-based and high-intensity focused electromagnetic (HIFEM)-based devices have proved effective and safe for abdominal body shaping. Radiofrequency is known to reduce adipose tissue, whereas HIFEM treatment is effective for muscle definition. The authors investigated the efficacy of a novel device delivering synchronized radiofrequency and HIFEM treatment simultaneously for abdominal toning and fat reduction.

Methods:

Seventy-two patients were enrolled and randomly divided into active (n = 48; age, 45.5 ± 13.0 years) and sham groups (n = 24; age, 44.6 ± 12.3 years). Both groups received three treatments on the abdomen once a week. The intensity in the active group was set to maximum tolerable level; in the sham group, the intensities were set to 5 percent. Ultrasound images were taken before treatment and at 1, 3, and 6 months after treatment to examine changes in subcutaneous fat and rectus abdominis muscle thickness. Digital photographs were taken, and satisfaction and therapy comfort were assessed.

Results:

Ultrasound images of the active group at 1 month showed significant (p < 0.05) reduction in adipose tissue thickness by 20.5 percent (4.8 ± 2.6 mm), whereas rectus abdominis muscle thickness increased by 21.5 percent (2.0 ± 0.8 mm). Results at 3 months improved to 28.3 percent (7.6 ± 3.7 mm) and 24.2 percent (2.3 ± 0.9 mm), respectively. Improvements were maintained at 6 months after treatment in the active group, whereas the sham group showed no significant changes. Treatments were found to be comfortable. The active group showed higher satisfaction with outcomes.

Conclusion:

Active treatment utilizing simultaneous application of radiofrequency and HIFEM therapy resulted in a significant increase in rectus abdominis thickness and subcutaneous fat reduction, exceeding previously published results for separate HIFEM and radiofrequency treatments.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
Outcomes of Combined Liposuction/Laser Skin Tightening versus Open Suction-Assisted Brachioplasty in Moderate Arm Ptosis
Authors: Fayek Mina , Rizk Ibrahem N. , Hashem Ahmed M. , El Sharkawy Omar A.
Published: March 2022

Background:

Only a few studies have directly compared outcomes of different arm contouring techniques across matched cohorts of patients. In this study, the authors present preliminary data comparing outcomes of conventional open suction-assisted brachioplasty (using the Pascal and Le Louarn procedure) versus combined liposuction/laser skin tightening in (grade 2b arm ptosis per El Khatib classification).

Methods:

Thirty patients (60 arms) (28 women, two men) with moderate brachial ptosis (severe upper arm adiposity and a moderate degree of skin laxity) (grade 2b arm ptosis per El Khatib classification) were included. Objective and subjective measures were used in the assessment of results.

Results:

There were no statistically significant differences in objective measurements (arm circumference reduction ratio and percentage of ptosis elimination) between the groups. Patient satisfaction scores were higher with liposuction/laser skin tightening and found to be statistically significant (p < 0.05). Patients in this latter cohort reported less pain and earlier return to work (mean less than a week) (p < 0.05). Four patients complained of residual ptosis in each group.

Conclusions:

Liposuction/laser skin tightening is a safe and effective alternative to open suction-assisted brachioplasty (using the Pascal and Le Louarn technique) in patients with severe arm adiposity and moderate brachial ptosis (grade 2b arm ptosis as described by El Khatib classification). Proper patient selection remains critical for the success of this treatment strategy and requires precise clinical analysis as described.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
High Rates of Pre-exposure Prophylaxis Eligibility and Associated HIV Incidence in a Population With a Generalized HIV Epidemic in Rakai, Uganda
Authors: Ssempijja Victor , Nakigozi Gertrude , Ssekubugu Robert , Kagaayi Joseph , Kigozi Godfrey , Nalugoda Fred , Nantume Betty , Batte James , Kigozi Grace , Yeh Ping Teresa , Nakawooya Hadijja , Serwadda David , Quinn Thomas C. , Gray Ronald H. , Wawer Maria J. , Grabowski Kate M. , Chang Larry W. , van't Hoog Anja , Cobelens Frank , Reynolds Steven J.
Published: March 2022

Background:

The utility of using pre-exposure prophylaxis (PrEP) eligibility assessments to identify eligibility in general populations has not been well studied in sub-Saharan Africa. We used the Rakai Community Cohort Study to conduct a cross-sectional analysis to estimate PrEP eligibility and a cohort analysis to estimate HIV incidence associated with PrEP eligibility.

Methods:

Based on Uganda's national PrEP eligibility tool, we defined eligibility as reporting at least one of the following HIV risks in the past 12 months: sexual intercourse with more than one partner of unknown HIV status; nonmarital sex act without a condom; sex engagement in exchange for money, goods, or services; or experiencing genital ulcers. We used log-binomial and modified Poisson models to estimate prevalence ratios for PrEP eligibility and HIV incidence, respectively.

Findings:

We identified 12,764 participants among whom to estimate PrEP eligibility prevalence and 11,363 participants with 17,381 follow-up visits and 30,721 person-years (pys) of observation to estimate HIV incidence. Overall, 29% met at least one of the eligibility criteria. HIV incidence was significantly higher in PrEP-eligible versus non–PrEP-eligible participants (0.91/100 pys versus 0.41/100 pys; P < 0.001) and independently higher in PrEP-eligible versus non–PrEP-eligible female participants (1.18/100 pys versus 0.50/100 pys; P < 0.001). Among uncircumcised male participants, HIV incidence was significantly higher in PrEP-eligible versus non–PrEP-eligible participants (1.07/100 pys versus 0.27/100 pys; P = 0.001), but there was no significant difference for circumcised male participants.

Interpretation:

Implementing PrEP as a standard HIV prevention tool in generalized HIV epidemics beyond currently recognized high-risk key populations could further reduce HIV acquisition and aid epidemic control efforts.
Accurate Mandible Reconstruction by Mixed Reality, 3D Printing, and Robotic-Assisted Navigation Integration
Authors: Lin Quan-quan , Wang Feng , Sun Jin-long , Zhang Hai-zhong , Xi Qing
Published: March 2022

Mandibular reconstruction is one of the most complex procedures concerning the patient’s postoperative facial shape and occlusion condition. In this study, the authors integrated mixed reality, three-dimensional (3D) printing, and robotic-assisted navigation technology to complete the mandibular reconstruction in a novel and more accurate way. Mixed reality can visualize the significant anatomical structures of the operative area, but only be used in simulated operation by now. Three-dimensional printing surgical guide plate makes it easy to separate tissue, while imprecision often occurs due to the potential of displacement and deformation. In recent years, most robotic-assisted navigation surgery technology can only achieve precise position by 2D view on the screen but not realistic 3D navigation. in this study, the integrated 3 technologies were used in mandibular reconstruction. Preoperative imaging examination was performed, and the data were imported into the digital workstation before operation. First, the original data was edited and optimized to reconstruct the digital model and formulate the surgical plan. Then MR was used to output the visualized project and matched the 3D reconstruction model in reality. The 3D plate was printed for surgical guidance. Last, robotic-assisted navigation was used to guide and position the vascularized fibula autograft and the immediate dental implantation. In conclusion, the authors integrated the 3 technologies and constructed a new digital surgical procedure to improve surgical accuracy and simplify the procedure comparing with traditional surgery.
Characterizing the Impact of Socioeconomic Status on Orbital Floor Reconstruction: A National Inpatient Sample (NIS) Analysis
Authors: Perla Krissia M. Rivera , Zeyl Victoria G. , Lopez Christopher D. , Lopez Joseph , Redett Richard J. , Manson Paul N. , Yang Robin
Published: March 2022

Orbital floor fractures result in posterior globe displacement known as enophthalmos, and diplopia due to extraorbital soft tissue impingement. Surgical repair may involve the use of autolo-gous or synthetic materials. Previous studies have demonstrated a higher prevalence of orbital floor fractures among lower socioeconomic status (SES) populations. The authors aimed to characterize the impact of socioeconomic status on surgical management, outcomes, and use of synthetic orbital implant. The authors conducted a cross-sectional study of adult orbital floor fracture patients from 2002 to 2017 using the National Inpatient Sample. Among patients who underwent surgical treatment, our study found decreased synthetic orbital implant use among uninsured and Black patients and decreased home discharge among Medicare patients. There were no differences in orbital reconstruction. Further research is needed to elucidate possible mechanisms driving these findings.
Liver Transplantation Outcomes From Controlled Circulatory Death Donors
Authors: Gaurav Rohit , Butler Andrew J. , Kosmoliaptsis Vasilis , Mumford Lisa , Fear Corrina , Swift Lisa , Fedotovs Arturs , Upponi Sara , Khwaja Samir , Richards James , Allison Michael , Watson Christopher J. E.
Published: March 2022

Objective:

To compare the outcomes of livers donated after circulatory death (DCD) and undergoing either in situ normothermic regional perfusion (NRP) or ex situ normothermic machine perfusion (NMP) with livers undergoing static cold storage (SCS).

Summary of Background Data:

DCD livers are associated with increased risk of primary nonfunction, poor function, and nonanastomotic strictures (NAS), leading to underutilization.

Methods:

A single center, retrospective analysis of prospectively collected data on 233 DCD liver transplants performed using SCS, NRP, or NMP between January 2013 and October 2020.

Results:

Ninety-seven SCS, 69 NRP, and 67 NMP DCD liver transplants were performed, with 6-month and 3-year transplant survival (graft survival non-censored for death) rates of 87%, 94%, 90%, and 76%, 90%, and 76%, respectively. NRP livers had a lower 6-month risk-adjusted Cox proportional hazard for transplant failure compared to SCS (hazard ratio 0.30, 95% Confidence Interval 0.08–1.05, P = 0.06). NRP and NMP livers had a risk-adjusted estimated reduction in the mean model for early allograft function score of 1.52 (P < 0.0001) and 1.19 (P < 0.001) respectively compared to SCS. Acute kidney injury was more common with SCS (55% vs 39% NRP vs 40% NMP; P = 0.08), with a lower risk-adjusted peak-to-baseline creatinine ratio in the NRP (P = 0.02). No NRP liver had clinically significant NAS in contrast to SCS (14%) and NMP (11%, P = 0.009), with lower risk-adjusted odds of overall NAS development compared to SCS (odds ratio = 0.2, 95%CI 0.06–0.72, P = 0.01).

Conclusion:

NRP and NMP were associated with better early liver function compared to SCS, whereas NRP was associated with superior preservation of the biliary system.
Psychopharmacology: past, present and future
Authors: Serretti Alessandro
Published: March 2022

The origin of modern psychopharmacology dates to the 50s, with the discovery of imipramine and chlorpromazine. At present, we can choose among over 100 different compounds, which are effective in many psychiatric disturbances but are far from perfect in terms of efficacy and tolerability. The main limitation of available treatments is their lack in specificity, both in terms of pharmacologic targets and regional brain specificity. Several new compounds with innovative mechanisms of action have been recently approved; however, pharmacologic treatments targeted for specific tissues are still not available. Recent imaging and genetic findings suggest that we may be close to discovering the regional pathophysiologic mechanisms of psychiatric disorders. Targeted treatment to specific proteins or even genes may be possible using monoclonal antibodies, RNA silencing, gene editing or drug repurposing. We may be therefore close to a shift of paradigm in the treatment of psychiatric disorders, with innovative and targeted treatments.
Characterization of Streptomyces nymphaeiformis sp. nov., and its taxonomic relatedness to other polyhydroxybutyrate-degrading streptomycetes
Authors: Hix Gary R. , Khan Muhammad S. , Miller Mikayla T. , Napier Elisha C. , O'Brien Allison L. , White Roger P. , Baron Stephen F.
Published: March 2022

A polyhydroxybutyrate (PHB)-degrading actinomycete, strain SFB5AT, was identified as a species of

Streptomyces

based on its membrane fatty acid profile and the presence of ll-diaminopimelic acid in the cell wall. It formed sporulating mycelia on most agar media, but flat or wrinkled, moist colonies on trypticase soy agar. Spores were smooth, cylindrical, and borne on long, straight to flexuous chains. It produced a light brown diffusible pigment, but not melanin. Comparison of genomic digital DNA–DNA hybridization (dDDH) and average nucleotide identity (ANI) values indicated that strain SFB5AT was related to

Streptomyces litmocidini

JCM 4394T,

Streptomyces vietnamensis

GIMV4.0001T,

Streptomyces nashvillensis

JCM 4498T and

Streptomyces tanashiensis

JCM 4086T, plus 11 other species. However, the dDDH and ANI values were well below the species differentiation thresholds of <70 and <95 %, respectively; also, multilocus sequence analysis distances exceeded the species threshold of 0.007. Moreover, strain SFB5AT differed from the other species in pigmentation and its ability to catabolize arabinose. Strain SFB5AT and 11 of its 15 closest relatives degraded PHB and have genes for extracellular, short-chain-length denatured polyhydroxyalkanoate depolymerases. These enzymes from strain SFB5AT and its closest relatives had a type 1 catalytic domain structure, while those from other relatives had a type 2 structure, which differs from type one in the position of a consensus histidine in the active site. Thus, phenotypic and genotypic differences suggest that strain SFB5AT represents a new species of Streptomyces, for which we propose the name Streptomyces nymphaeiformis sp. nov. The type strain is SFB5AT (=NRRL B-65520T=DSM 112030T).
Novel viral RNA genomes of the vine mealybug Planococcus ficus
Authors: Martinez-Mercado Miguel A. , de Jesús José Luis Duarte , Galindo-Sánchez Clara E. , Saavedra-Flores Anaid , Carrillo-Tripp Jimena
Published: March 2022

The vine mealybug, Planococcus ficus (Signoret, 1875), is the most important insect pest in growing areas of the grapevine Vitis vinifera L. in several countries, including Mexico. In Mexico, Baja California (B.C.) is the region with the highest production of V. vinifera L. grapes for industrial purposes. Recently, the diversity of viruses infecting insects only (insect-specific viruses) has been broadly explored to elucidate further ecological viral–host interactions in many insect species, which in some cases has resulted in the application of virus-based biological control agents for insect pests. However, a survey of the Pl. ficus virome has not been done yet. In the present study, we pooled Pl. ficus individuals collected through different vineyards of Ensenada, B.C., Mexico and analysed them by meta-transcriptomics. Novel nearly complete genomes of five RNA viruses were retrieved. These viruses were related to the Iflaviridae and Reoviridae families, and to the Picornavirales and Tolivirales orders. A new isolate belonging to the Dicistroviridae family was also found. Phylogenetic analyses showed that these putative viral genomes group with viruses having hemipteran (including a mealybug species) or other insect hosts, or with viruses associated with insects. Our results suggest that the identified novel RNA viruses could be insect-specific viruses of Pl. ficus. This work is the first insight into the Pl. ficus virome; it guarantees further studies aimed to characterize those viruses with potential for application in biological control of this economically important insect.
Placental transcription profiling in 6-23 weeks’ gestation reveals differential transcript usage in early development
Authors: Bogias K. Justin , Pederson Stephen M , Leemaqz Shalem , Smith Melanie D , McAninch Dale , Jankovic-Karasoulos Tanja , McCullough Dylan , Wan Qianhui , Bianco-Miotto Tina , Breen James , Roberts Claire T
Published: March 2022

The human placenta is a rapidly developing transient organ that is key to pregnancy success. Early development of the conceptus occurs in a low oxygen environment before oxygenated maternal blood begins to flow into the placenta at ∼10-12 weeks’ gestation. This process is likely to substantially affect overall placental gene expression. Transcript variability underlying gene expression has yet to be profiled. In this study, accurate transcript expression profiles were identified for 84 human placental chorionic villus tissue samples collected across 6-23 weeks’ gestation. Differential gene expression (DGE), differential transcript expression (DTE) and differential transcript usage (DTU) between 6-10 weeks’ and 11-23 weeks’ gestation groups were assessed. In total, 229 genes had significant DTE yet no significant DGE. Integration of DGE and DTE analyses found that differential expression patterns of individual transcripts were commonly masked upon aggregation to the gene-level. Of the 611 genes that exhibited DTU, 534 had no significant DGE or DTE. The four most significant DTU genes ADAM10, VMP1, GPR126, and ASAH1, were associated with hypoxia-responsive pathways. Transcript usage is a likely regulatory mechanism in early placentation. Identification of functional roles will facilitate new insight in understanding the origins of pregnancy complications.
The association between plasma chemokines and breast cancer risk and prognosis: A Mendelian randomization study
Authors: Yu Xingxing , Zhang Yanyu , Lin Yuxiang , Zou Shuqing , Zhu Pingxiu , Song Mengjie , Fu Fangmeng , Yang Haomin
Published: March 2022

Background

Despite the potential role of several chemokines in the migration of cytotoxic immune cells to prohibit breast cancer cell proliferation, a comprehensive view of chemokines and the risk and prognosis of breast cancer is scarce, and little is known about their causal associations.

Methods

With a two-sample Mendelian randomization (MR) approach, genetic instruments associated with 30 plasma chemokines were created. Their genetic associations with breast cancer risk and survival were extracted from the recent genome-wide association study, with available survival information for 96,661 patients. We further tested the associations between the polygenetic risk score (PRS) for chemokines and breast cancer in the UK Biobank cohort using logistic regression models. The association between chemokine expression in tumors and breast cancer survival was analyzed in the TCGA cohort with Cox regression models.

Results

Plasma CCL5 was causally associated with the risk of breast cancer in the MR analysis, which was significant in the luminal and HER-2 enriched subtypes and further confirmed using PRS analysis (OR=0.94, 95% CI=0.89-1.00). A potential causal association with breast cancer survival was only found for plasma CCL19, especially for ER-positive patients. In addition, we also found an inverse association between CCL19 expression in tumors and breast cancer overall and relapse-free survival (HR=0.58, 95% CI=0.35-0.95).

Conclusion

We observed an inverse association between genetic predisposition to CCL5 and the risk of breast cancer, while CCL19 was associated with breast cancer survival. These associations suggested the potential of these chemokines as tools for breast cancer prevention and treatment.
A systematic review about skin lesions in children affected by Coronavirus Disease 2019 (excluding multisystem inflammatory syndrome in children): study protocol
Authors: Dondi Arianna , Sperti Giacomo , Gori Davide , Montalti Marco , Parini Lorenza , Guaraldi Federica , Lanari Marcello , Neri Iria
Published: March 2022

COVID-19 disease can give a range of skin manifestations, some of which specific to children and young patients. Given the different nature of the lesions in specific stages of the disease and the fact that they may be the only or predominant symptom of the disease, it is of great importance for the pediatrician and dermatologist to be familiar with COVID-19 skin lesions. The aim of this systematic review, conducted according to the PRISMA statement, is to investigate COVID-19-associated cutaneous involvement in children in terms of type of skin lesions, frequency, and time of onset, with the exclusion of those associated with multisystem inflammatory syndrome in children. A comprehensive literature search will be performed through PubMed between December 2019 and December 2021. The quality of each study will be assessed according to the STROBE tool for observational studies. This systematic review will provide evidence about the dermatological manifestations of COVID-19 disease in children published up to the end of year 2021. Recognizing skin symptoms as potential manifestations of COVID-19 in children is important for a non-delayed diagnosis, with prompt activation of the adequate tracing, isolation, and hygienic measures, and for timely treatment of unlikely but possible serious complications.
Discovery of small molecule inhibitors of Plasmodium falciparum apicoplast DNA polymerase
Authors: Kaur Supreet , Nieto Nicholas , McDonald Peter , Beck Josh R. , Honzatko Richard B. , Roy Anuradha , Nelson Scott W
Published: March 2022

Malaria is caused by infection with protozoan parasites of the Plasmodium genus, which is part of the phylum Apicomplexa. Most organisms in this phylum contain a relic plastid called the apicoplast. The apicoplast genome is replicated by a single DNA polymerase (apPOL), which is an attractive target for anti-malarial drugs. We screened small-molecule libraries (206,504 compounds) using a fluorescence-based high-throughput DNA polymerase assay. Dose/response analysis and counter-screening identified 186 specific apPOL inhibitors. Toxicity screening against human HepaRG human cells removed 84 compounds and the remaining were subjected to parasite killing assays using chloroquine resistant P. falciparum parasites. Nine compounds were potent inhibitors of parasite growth and may serve as lead compounds in efforts to discover novel malaria drugs.