bluuebunny/crossref_metadata_2025 huggingface dataset:
Equivalence of quantum barren plateaus to cost concentration and narrow gorges
Authors: Arrasmith Andrew , Holmes Zoë , Cerezo M , Coles Patrick J
Published: June 2022

Optimizing parameterized quantum circuits (PQCs) is the leading approach to make use of near-term quantum computers. However, very little is known about the cost function landscape for PQCs, which hinders progress towards quantum-aware optimizers. In this work, we investigate the connection between three different landscape features that have been observed for PQCs: (1) exponentially vanishing gradients (called barren plateaus (BPs)), (2) exponential cost concentration about the mean, and (3) the exponential narrowness of minima (called narrow gorges). We analytically prove that these three phenomena occur together, i.e., when one occurs then so do the other two. A key implication of this result is that one can numerically diagnose BPs via cost differences rather than via the computationally more expensive gradients. More broadly, our work shows that quantum mechanics rules out certain cost landscapes (which otherwise would be mathematically possible), and hence our results could be interesting from a quantum foundations perspective.
External magnetic effect for the security of practical quantum key distribution
Authors: Tan Hao , Zhang Wei-Yang , Zhang Likang , Li Wei , Liao Sheng-Kai , Xu Feihu
Published: June 2022

Quantum key distribution (QKD) allows remote parties to share secret keys with proven security. To guarantee the security of practical QKD, the imperfections in realistic devices need to be characterized and considered in practical security analysis. Particularly, a standard QKD system normally uses optical isolator or optical circulator in the transmitter to prevent the injection from external light. Here we find that the optical isolators and circulators, commonly based on the Faraday effect, are subject to the perturbation from external magnetic fields. With this, we provide a comprehensive analysis of the security for practical QKD due to external magnetic effect. We experimentally demonstrate the influence of magnetic fields on both the transmittance and the isolation of standard optical isolators and circulators. We analyze the security risks caused by the potential magnetic attacks, together with the corresponding countermeasures.
Wadge-like degrees of Borel bqo-valued functions
Authors: Kihara Takayuki , Selivanov Victor
Published: June 2022

We unite two well known generalisations of the Wadge theory. The first one considers more general reducing functions than the continuous functions in the classical case, and the second one extends Wadge reducibility from sets (i.e.,

{
0
,
1
}

\{0,1\}

-valued functions) to

Q
Q

-valued functions, for a better quasiorder

Q
Q

. In this article, we consider more general reducibilities on the

Q
Q

-valued functions and generalise some results of L. Motto Ros [J. Symbolic Logic 74 (2009), pp. 27–49] in the first direction and of T. Kihara and A. Montalbán [Trans. Amer. Math. Soc. 370 (2018), pp. 9025–9044] in the second direction: Our main result states that the structure of the

Δ

α
0

\mathbf {\Delta }^0_\alpha

-degrees of

Δ

α
+
γ

0

\mathbf {\Delta }^0_{\alpha +\gamma }

-measurable

Q
Q

-valued functions is isomorphic to the

Δ

β
0

\mathbf {\Delta }^0_\beta

-degrees of

Δ

β
+
γ

0

\mathbf {\Delta }^0_{\beta +\gamma }

-measurable

Q
Q

-valued functions, and these are isomorphic to the generalized homomorphism order on the

γ
\gamma

-th iterated

Q
Q

-labeled forests.
Data-Driven Commentary on SARS-CoV-2 Infection, Vaccination, and Fertility
Authors: Klipstein Sigal , Dionne Jodie A , Feinberg Eve C , Kawwass Jennifer F , Pfeifer Samantha M , Schlegel Peter N , Racowsky Catherine
Published: June 2022

A recent study by Wesselink et al. (Am J Epidemiol. 2022;191(8):1383–1395) adds to the growing body of research finding that vaccination for coronavirus disease 2019 (COVID-19) is safe for individuals either seeking pregnancy or who are pregnant. The study’s authors found no effect of COVID-19 vaccination on fecundity in a population of individuals with no known infertility who were attempting conception. The finding reinforces the messaging of the American Society for Reproductive Medicine COVID-19 Task Force, the aim of which is to provide data-driven recommendations to individuals contemplating pregnancy in the face of the COVID-19 pandemic. As safe and effective COVID-19 vaccines became available, and with an increasing number of studies showing a heightened risk of severe disease during pregnancy, an important role of the Task Force is to encourage vaccination during the preconceptual window and in early pregnancy. The Task Force supports ongoing research to address gaps in knowledge about safe and effective therapies and preventive measures for individuals contemplating pregnancy and during pregnancy. Such research will help optimize care for reproductive-age individuals in the face of current and future health crises.
Primary Aldosteronism: State-of-the-Art Review
Authors: Vaidya Anand , Hundemer Gregory L , Nanba Kazutaka , Parksook Wasita W , Brown Jenifer M
Published: June 2022

We are witnessing a revolution in our understanding of primary aldosteronism (PA). In the past 2 decades, we have learned that PA is a highly prevalent syndrome that is largely attributable to pathogenic somatic mutations, that contributes to cardiovascular, metabolic, and kidney disease, and that when recognized, can be adequately treated with widely available mineralocorticoid receptor antagonists and/or surgical adrenalectomy. Unfortunately, PA is rarely diagnosed, or adequately treated, mainly because of a lack of awareness and education. Most clinicians still possess an outdated understanding of PA; from primary care physicians to hypertension specialists, there is an urgent need to redefine and reintroduce PA to clinicians with a modern and practical approach. In this state-of-the-art review, we provide readers with the most updated knowledge on the pathogenesis, prevalence, diagnosis, and treatment of PA. In particular, we underscore the public health importance of promptly recognizing and treating PA and provide pragmatic solutions to modify clinical practices to achieve this.
Development of a New Dislodgeable Foliar Residue Analytical Laboratory Method for Pesticides
Authors: Badawy Mohamed H , Murnane Darragh , Lewis Kathleen A , Morgan Neil
Published: June 2022

The dislodgeable foliar residue (DFR) is the amount of pesticide that exists on foliage after the pesticide has dried and which could dislodge to the skin or clothes of workers and is a key parameter for non-dietary risk assessments required to demonstrate safe use for pesticide registration. DFR data in the literature are described as insufficiently reliable, limited, and encompasses considerable statistical uncertainties. The purpose of this article is to describe a newly developed laboratory method for the quantification of DFR with an illustrative example. The laboratory method reflected available field DFR methodology but involved controlled application of droplets to leaves and validation of the wash-off process used to remove the residue from the leaf surface before the analytical quantification. A very high level of accuracy (99.7–102.1%) and precision (±1.5%) was achieved. Residue data generated from the illustrated application of the method showed a robust normal distribution, unlike field studies. The method is deemed to be controllable, cost-efficient, and time-saving, taking hours rather than days. This enables the generation of more data to allow extrapolation between the generated data by investigating multiple factors that may influence DFR. An improved understanding of DFR could save time, money, and resources.
Enzymatic synthesis of non-natural flavonoids by combining geranyl pyrophosphate C6-methyltransferase and aromatic prenyltransferase
Authors: Tsutsumi Hayama , Urano Naoki , Katsuyama Yohei , Ohnishi Yasuo
Published: June 2022

Terpenoids are the largest class of natural products and are derived from C5 isoprene units. Recent discoveries of modification enzymes in native isoprene units before cyclization or transfer reactions have revealed that C5 units with additional carbon atoms are also used to produce terpenoids. These reports indicate that the utilization of these modification enzymes is useful for the enzymatic production of non-natural terpenoids. In this study, we have attempted to produce methylgeranyl polyphenols, which are not observed in nature, by combining a geranyl pyrophosphate C6 methyltransferase, BezA, which was discovered from the benzastatin biosynthetic pathway, and the promiscuous prenyltransferase NphB, which catalyzes prenylation of various flavonoids. We successfully synthesized five methylgeranylated flavonoids from naringenin, apigenin, and genistein. This result demonstrates that BezA is a powerful tool for the synthesis of novel non-natural terpenoids.
Ten-Eleven Translocation-3 CXXC domain is critical for postfertilization demethylation and expression of pluripotency genes in pig embryos
Authors: Uh Kyungjun , Lee Kiho
Published: June 2022

Enzymes of the ten-eleven translocation family are considered to play an important role in the regulation of DNA methylation patterns by converting 5-methylcytosine to 5-hydroxymethylcytosine. Known as a maternal transcript enriched in mature oocytes, ten-eleven translocation-3 (TET3) has been suggested to initiate DNA demethylation of the paternal genome in zygotes. Previous studies in mouse cells indicate that the N-terminal CXXC domain of TET3 is important in catalyzing the oxidation of 5-methylcytosine through its potential DNA binding ability; however, it is not clear whether the DNA binding capacity of CXXC domain is required for the 5-hydroxymethylcytosine conversion in mammalian embryos. Here, we identified TET3 isoforms in porcine oocytes and investigated the role of the oocyte specific TET3 isoform (pTET3L) in controlling postfertilization demethylation in porcine embryos. The pTET3L possessed sequences representing a known DNA binding domain, the CXXC, and injection of the TET3 CXXC fused with GFP into mature porcine oocytes resulted in exclusive localization of the GFP-CXXC in the pronuclei. The CXXC overexpression reduced the 5-methylcytosine level in zygotes and enhanced the DNA demethylation of the NANOG promoter in 2-cell stage embryos. Furthermore, there was an increase in the transcript abundance of NANOG and ESRRB in blastocysts developed from GFP-CXXC injected oocytes. Targeted knockdown of pTET3L resulted in the downregulation of pluripotency genes in subsequently developed blastocysts. The findings indicate that the CXXC domain of TET3 serves as a critical component for the postfertilization demethylation of porcine embryos and coordinates proper expression of pluripotency related genes in blastocysts.
In vitro- and in vivo-produced male dairy calves show molecular differences in the hepatic and muscular energy regulation
Authors: Rabaglino María B , Secher Jan Bojsen-Møller , Hyttel Poul , Kadarmideen Haja N
Published: June 2022

In cattle, the in vitro production (IVP) of embryos is becoming more relevant than embryos produced in vivo, i.e. after multiple ovulation and embryo transfer (MOET). However, the effects of IVP on the developmental programming of specific organs in the postnatal calves are yet unknown. Previously, we reported an epigenomic and transcriptomic profile of the hypothalamus–pituitary–testicular axis compatible with its earlier activation in IVP calves compared to MOET animals. Here, we studied the hepatic and muscular epigenome and transcriptome of those same male dairy calves (n = 4 per group). Tissue samples from liver and semitendinosus muscle were obtained at 3 months of age, and the extracted gDNA and RNA were sequenced through whole-genome bisulfite sequencing and RNA-sequencing, respectively. Next, bioinformatic analyses determined differentially methylated cytosines or differentially expressed genes [false discovery rate (FDR) < 0.05] for each Omic dataset; and nonparametrically combined genes (NPCG) for both integrated omics (P < 0.05). KEGG pathways enrichment analysis showed that NPCG upregulated in the liver and the muscle of the IVP calves were involved in oxidative phosphorylation and the tricarboxylic acid cycle. In contrast, ribosome and translation were upregulated in the liver but downregulated in the muscle of the IVP calves compared to the MOET calves (FDR < 0.05). A model considering the effect of the methylation levels and the group on the expression of all the genes involved in these pathways confirmed these findings. In conclusion, the multiomics data integration approach indicated an altered hepatic and muscular energy regulation in phenotypically normal IVP calves compared to MOET calves.
Trust- and reputation-based opinion dynamics modelling over temporal networks
Authors: Jain Eeti , Singh Anurag
Published: June 2022

Trust and reputation are a person’s belief over another person and are essential factors while opinion values are shared among online social platforms. Both the values are calculated using past shared opinions and the structure of the network. Further, a credibility score is calculated using the trust and reputation of the nodes, which is helpful to share the opinion values more accurately. In this work, an opinion dynamics temporal network is modelled using the credibility score of the nodes in the network. The addition and deletion of the edges and the opinion evolution occur on the basis of the credibility score of the nodes. Results are analysed over scale-free networks generated using Bollabas et al. model. Such scale-free networks are evolved over time termed as temporal network using the proposed model. It is analysed how the different threshold values on the credibility score of the nodes affect the opinion values convergence on the proposed model.
Epidemiology and management of right ventricular-predominant heart failure and shock in the cardiac intensive care unit
Authors: Kanwar Manreet K , Everett Kay D , Gulati Gaurav , Brener Michael I , Kapur Navin K
Published: June 2022

Cardiogenic shock from left ventricular failure is a common presentation in the intensive care unit. In contrast, right ventricular (RV)-predominant heart failure (HF) causing shock is less well recognized. We review the epidemiology and mechanisms of RV-predominant HF and discuss pharmacologic and device-based approaches for the management of this challenging clinical problem.
Visualizing and quantifying molecular and cellular processes in Caenorhabditis elegans using light microscopy
Authors: Shah Pavak , Bao Zhirong , Zaidel-Bar Ronen
Published: June 2022

Light microscopes are the cell and developmental biologists’ “best friend,” providing a means to see structures and follow dynamics from the protein to the organism level. A huge advantage of Caenorhabditis elegans as a model organism is its transparency, which coupled with its small size means that nearly every biological process can be observed and measured with the appropriate probe and light microscope. Continuous improvement in microscope technologies along with novel genome editing techniques to create transgenic probes have facilitated the development and implementation of a dizzying array of methods for imaging worm embryos, larvae, and adults. In this review, we provide an overview of the molecular and cellular processes that can be visualized in living worms using light microscopy. A partial inventory of fluorescent probes and techniques successfully used in worms to image the dynamics of cells, organelles, DNA, and protein localization and activity is followed by a practical guide to choosing between various imaging modalities, including widefield, confocal, lightsheet, and structured illumination microscopy. Finally, we discuss the available tools and approaches, including machine learning, for quantitative image analysis tasks, such as colocalization, segmentation, object tracking, and lineage tracing. Hopefully, this review will inspire worm researchers who have not yet imaged their worms to begin, and push those who are imaging to go faster, finer, and longer.
Rethinking Communication in the Era of Artificial Intelligence
Authors: Sundar S Shyam , Lee Eun-Ju
Published: June 2022

This article introduces the special issue of Human Communication Research (HCR) exploring the role of artificial intelligence (AI) in communication. It situates the six articles in this issue along conceptual dimensions drawn from human–computer interaction (HCI) and computer-mediated communication (CMC) research. It also underscores the importance of typologizing AI’s involvement in human communication by building on traditional distinctions such as mass versus interpersonal communication. In doing so, it describes how AI can fulfill analogous roles as either communicator or mediator in both contexts. This article also discusses the six articles and draws out common themes, most notably the tension between human agency and machine agency caused by the arrival of AI. It concludes by expressing optimism for the discovery of new concepts, frameworks and issues as we study both the positive and negative influences of AI on the process and effects of human communication.
The Effect of Pregnancy On Metabolic Scaling and Population Energy Demand in the Viviparous Fish Gambusia affinis
Authors: Moffett Emma R , Fryxell David C , Benavente J N , Kinnison M T , Palkovacs E P , Symons C C , Simon K S
Published: June 2022

Synopsis

Metabolism is a fundamental attribute of all organisms that influences how species affect and are affected by their natural environment. Differences between sexes in ectothermic species may substantially alter metabolic scaling patterns, particularly in viviparous or live-bearing species where females must support their basal metabolic costs and that of their embryos. Indeed, if pregnancy is associated with marked increases in metabolic demand and alters scaling patterns between sexes, this could in turn interact with natural sex ratio variation in nature to affect population-level energy demand. Here, we aimed to understand how sex and pregnancy influence metabolic scaling and how differences between sexes affect energy demand in Gambusia affinis (Western mosquitofish). Using the same method, we measured routine metabolic rate in the field on reproductively active fish and in the laboratory on virgin fish. Our data suggest that changes in energy expenditure related to pregnancy may lead to steeper scaling coefficients in females (b = 0.750) compared to males (b = 0.595). In contrast, virgin females and males had similar scaling coefficients, suggesting negligible sex differences in metabolic costs in reproductively inactive fish. Further, our data suggest that incorporating sex differences in allometric scaling may alter population-level energy demand by as much as 20–28%, with the most pronounced changes apparent in male-biased populations due to the lower scaling coefficient of males. Overall, our data suggest that differences in energy investment in reproduction between sexes driven by pregnancy may alter allometric scaling and population-level energy demand.
Marine mammal consumption and fisheries removals in the Nordic and Barents Seas
Authors: Skern-Mauritzen Mette , Lindstrøm Ulf , Biuw Martin , Elvarsson Bjarki , Gunnlaugsson Thorvaldur , Haug Tore , Kovacs Kit M , Lydersen Christian , McBride Margaret M , Mikkelsen Bjarni , Øien Nils , Víkingsson Gísli
Published: June 2022

In this study, we assess prey consumption by the marine mammal community in the northeast Atlantic [including 21 taxa, across three regions: (I) the Icelandic shelf, Denmark Strait, and Iceland Sea (ICE); (II) the Greenland and Norwegian Seas (GN); and (III) the Barents Sea (BS)], and compare mammal requirements with removals by fisheries. To determine prey needs, estimates of energetic requirements were combined with diet and abundance information for parameterizing simple allometric scaling models, taking uncertainties into account through bootstrapping procedures. In total, marine mammals in the ICE, GN, and BS consumed 13.4 [Confidence Interval (CI): 5.6–25.0], 4.6 (CI: 1.9–8.6), and 7.1 (CI: 2.8–13.8) million tonnes of prey year–1. Fisheries removed 1.55, 1.45, and 1.16 million tonnes year–1 from these three areas, respectively. While fisheries generally operate at significantly higher trophic levels than marine mammals, we find that the potential for direct competition between marine mammals and fisheries is strongest in the GN and weakest in the BS. Furthermore, our results also demonstrate significant changes in mammal consumption compared to previous and more focused studies over the last decades. These changes likely reflect both ongoing population recoveries from historic whaling and the current rapid physical and biological changes of these high-latitude systems. We argue that changing distributions and abundances of mammals should be considered when establishing fisheries harvesting strategies, to ensure effective fisheries management and good conservation practices of top predators in such rapidly changing systems.
Last mile logistics: Research trends and needs
Authors: Demir Emrah , Syntetos Aris , van Woensel Tom
Published: June 2022

Aspiring green agendas in conjunction with tremendous economic pressures are resulting in an increased attention to the environment and technological innovations for improving existing logistics systems. Last mile logistics, in particular, are becoming much more than a consumer convenience necessity and a transportation optimization exercise. Rather, this area presents a true opportunity to foster both financial and environmental sustainability. This paper investigates recent technological advancements and pending needs related to business and social innovations, emphasizing green logistics and city logistics concepts. We discuss various pertinent aspects, including drones, delivery robots, truck platooning, collection and pickup points, collaborative logistics, integrated transportation, decarbonization and advanced transport analytics. From a mathematical perspective, we focus on the basic features of the vehicle routing problem and some of its variants. We provide recommendations around strategies that may facilitate the adoption of new effective technologies and innovations.
Minimal degrees and downwards density in some strong positive reducibilities and quasi-reducibilities
Authors: Chitaia Irakli , Ng Keng Meng , Sorbi Andrea , Yang Yue
Published: June 2022

We consider three strong reducibilities, $s_{1}, s_{2}, Q_{1}$ (where we identify a reducibility $\leqslant _r$ with its index $r$). The first two reducibilities can be viewed as injective versions of $s$-reducibility, whereas $Q_1$-reducibility can be viewed as an injective version of $Q$-reducibility. We have, with proper inclusions, $s_{1} \subset s_{2} \subset s$. It is well known that there is no minimal $s$-degree, and there is no minimal $Q$-degree. We show on the contrary that there exist minimal $\varDelta ^{0}_{2}$$s_{2}$-degrees and minimal $\varDelta ^{0}_{2}$$s_{1}$-degrees. On the other hand, both the $\varPi ^{0}_{1}$$s_{2}$-degrees and the $\varPi ^{0}_{1}$$s_{1}$-degrees are downwards dense. By the isomorphism of the $s_1$-degrees with the $Q_1$-degrees induced by complementation of sets, it follows that there exist minimal $\varDelta ^0_2$$Q_1$-degrees, but the c.e. $Q_{1}$-degrees are downwards dense.
Characterization of an autonomous pathway complex that promotes flowering in Arabidopsis
Authors: Qi Pei-Lin , Zhou Hao-Ran , Zhao Qiang-Qiang , Feng Chao , Ning Yong-Qiang , Su Yin-Na , Cai Xue-Wei , Yuan Dan-Yang , Zhang Zhao-Chen , Su Xiao-Min , Chen Shan-Shan , Li Lin , Chen She , He Xin-Jian
Published: June 2022

Although previous studies have identified several autonomous pathway components that are required for the promotion of flowering, little is known about how these components cooperate. Here, we identified an autonomous pathway complex (AuPC) containing both known components (FLD, LD and SDG26) and previously unknown components (EFL2, EFL4 and APRF1). Loss-of-function mutations of all of these components result in increased FLC expression and delayed flowering. The delayed-flowering phenotype is independent of photoperiod and can be overcome by vernalization, confirming that the complex specifically functions in the autonomous pathway. Chromatin immunoprecipitation combined with sequencing indicated that, in the AuPC mutants, the histone modifications (H3Ac, H3K4me3 and H3K36me3) associated with transcriptional activation are increased, and the histone modification (H3K27me3) associated with transcriptional repression is reduced, suggesting that the AuPC suppresses FLC expression at least partially by regulating these histone modifications. Moreover, we found that the AuPC component SDG26 associates with FLC chromatin via a previously uncharacterized DNA-binding domain and regulates FLC expression and flowering time independently of its histone methyltransferase activity. Together, these results provide a framework for understanding the molecular mechanism by which the autonomous pathway regulates flowering time.
Melanoma-Specific Clinical Outcomes of Inpatient Immune Checkpoint Blockade Treatment
Authors: Loo Kimberly , Kalvin Hannah L , Panageas Katherine S , Park Vivian , Postow Michael A
Published: June 2022

Background

Little is known about patient outcomes with advanced melanoma following inpatient initiation or continuation of immune checkpoint blockade (ICB).

Methods and Results

We conducted a single institution retrospective case series of advanced melanoma patients who initiated ICB as an inpatient (initial inpatient cohort, n = 9), or continued ICB as an inpatient after previously starting as an outpatient (outpatient then inpatient cohort, n = 5). One patient had a partial response to ICB initiated as an inpatient, but ultimately died of melanoma after 13.5 months. Median overall survival for initial inpatient cohort was 1.0 month (95% CI: 0.2-11.2), and 1.4 months (95% CI: 0.4-58.0) for the outpatient then inpatient cohort. Three patients were alive >6 months after inpatient ICB administration.

Conclusion

Despite overall poor outcomes, some patients may benefit from inpatient ICB. This study provides additional information for clinicians to appropriately counsel patients on expectations following inpatient ICB.
A Risk-based Theory of Exchange Rate Stabilization
Authors: Hassan Tarek A , Mertens Thomas M , Zhang Tony
Published: June 2022

We develop a novel, risk-based theory of the effects of exchange rate stabilization. In our model, the choice of exchange rate regime allows policymakers to make their currency, and by extension, the firms in their country, a safer investment for international investors. Policies that induce a country’s currency to appreciate when the marginal utility of international investors is high lower the required rate of return on the country’s currency and increase the world-market value of domestic firms. Applying this logic to exchange rate stabilizations, we find a small economy stabilizing its bilateral exchange rate relative to a larger economy can increase domestic capital accumulation, domestic wages, and even its share in world wealth. In the absence of policy coordination, small countries optimally choose to stabilize their exchange rates relative to the currency of the largest economy in the world, which endogenously emerges as the world’s “anchor currency”, Larger economies instead optimally choose to float their exchange rates. The model therefore predicts an equilibrium pattern of exchange rate arrangements that is remarkably similar to the one in the data.
Guselkumab provides sustained domain-specific and comprehensive efficacy using composite indices in patients with active psoriatic arthritis
Authors: Coates Laura C , Ritchlin Christopher T , Gossec Laure , Helliwell Philip S , Rahman Proton , Kollmeier Alexa P , Xu Xie L , Shawi May , Karyekar Chetan S , Contré Christine , Noël Wim , Sheng Shihong , Wang Yanli , Xu Stephen , Mease Philip J
Published: June 2022

Objectives

To evaluate the efficacy of guselkumab for the treatment of active PsA utilizing composite indices.

Methods

Data were pooled from the phase 3 DISCOVER-1 (n = 381) and DISCOVER-2 (n = 739) studies. In both studies, patients were randomized 1:1:1 to subcutaneous guselkumab 100 mg every 4 weeks (Q4W); guselkumab 100 mg at week 0, week 4, then Q8W; or placebo Q4W with crossover to guselkumab 100 mg Q4W at week 24. Composite indices used to assess efficacy through week 52 included Disease Activity Index for Psoriatic Arthritis (DAPSA), Psoriatic Arthritis Disease Activity Score (PASDAS), minimal disease activity (MDA), and very low disease activity (VLDA). Through week 24, treatment failure rules were applied. Through week 52, non-responder imputation was used for missing data.

Results

Greater proportions of guselkumab- than placebo-treated patients achieved DAPSA low disease activity (LDA) and remission, PASDAS LDA and VLDA, MDA, and VLDA at week 24 vs placebo (all unadjusted P < 0.05). At week 52, in the guselkumab Q4W and Q8W groups, respectively, response rates were as follows: DAPSA LDA, 54.2% and 52.5%; DAPSA remission, 18.2% and 17.6%; PASDAS LDA, 45.3% and 41.9%; PASDAS VLDA, 16.9% and 19.5%; MDA, 35.9% and 30.7%; and VLDA, 13.1% and 14.4%. In the placebo-crossover-to-guselkumab group, response rates for all composite indices increased after patients switched to guselkumab, from week 24 through week 52.

Conclusion

Treatment with guselkumab provided robust and sustained benefits across multiple PsA domains through 1 year, indicating that guselkumab is an effective therapy for the diverse manifestations of PsA.

Trial registration

NCT03162796; NCT03158285
Clinical Value of Histologic Endometrial Dating in Women With Thin Endometrial Lining During Frozen-Thawed Blastocyst—Stage Embryo Transfer: A Retrospective Case Series [A348]
Authors: Jayakumaran Jayapriya , Maldonado Kiara , Trolice Mark
Published: June 2022

INTRODUCTION:

To evaluate the pregnancy outcome of frozen embryo transfer (FET) cycles from patients with inadequate endometrium (IE) but “in-phase” histologic endometrial dating.

METHODS:

This is a retrospective pilot study of patients between the years of 2014 and 2020 who underwent a standard hormonal endometrial preparation for FET that had been canceled due to IE defined as a maximum thickness <8 mm following up to 35 days of estradiol supplementation. Endometrial biopsy was performed for histologic dating using the criteria of Noyes et al after 9–11 days of progesterone supplementation. Women who were determined to have “in-phase” endometrium underwent a subsequent FET cycle in the following month, utilizing the same endometrial proliferation method and transferred of at least one good-quality blastocyst. The EMT goal was determined from the previous cycle. The primary outcome was the live birth rate. Descriptive statistics and Pearson Correlation was calculated using SPSS software v23.

RESULTS:

A total of 21 women were included. The mean age was 38.2±6.7 years. The mean endometrial thickness was 6.4±0.5 mm. Seventeen women (81%) demonstrated endometria that were “in-phase” on histological dating and underwent a subsequent FET cycle: The mean number of embryos transferred was 1.47±0.6, the live birth rate was 35.3% (6/17); clinical pregnancy rate was 47% (8/17); miscarriage rate was 11.8%. There was no correlation between age and endometrial thickness (Pearson Correlation Coefficient R=0.08, P=.7).

CONCLUSION:

Histologic dating in women with a prior canceled FET due to IE is a potentially reliable method to allow the opportunity for a successful FET with comparable outcomes to the National Average (SART National Summary Report for 2018).
Profile Matching for the Generalization and Personalization of Causal Inferences
Authors: Cohn Eric R. , Zubizarreta José R.
Published: June 2022

We introduce profile matching, a multivariate matching method for randomized experiments and observational studies that finds the largest possible unweighted samples across multiple treatment groups that are balanced relative to a covariate profile. This covariate profile can represent a specific population or a target individual, facilitating the generalization and personalization of causal inferences. For generalization, because the profile often amounts to summary statistics for a target population, profile matching does not always require accessing individual-level data, which may be unavailable for confidentiality reasons. For personalization, the profile comprises the characteristics of a single individual. Profile matching achieves covariate balance by construction, but unlike existing approaches to matching, it does not require specifying a matching ratio, as this is implicitly optimized for the data. The method can also be used for the selection of units for study follow-up, and it readily applies to multivalued treatments with many treatment categories. We evaluate the performance of profile matching in a simulation study of the generalization of a randomized trial to a target population. We further illustrate this method in an exploratory observational study of the relationship between opioid use and mental health outcomes. We analyze these relationships for three covariate profiles representing: (i) sexual minorities, (ii) the Appalachian United States, and (iii) the characteristics of a hypothetical vulnerable patient. The method can be implemented via the new function profmatch in the designmatch package for R, for which we provide a step-by-step tutorial.
Latent growth trajectories of county-level diabetes prevalence in the United States, 2004–2017, and associations with overall environmental quality
Authors: McAlexander Tara P. , Jagai Jyotsna S. , McClure Leslie A.
Published: June 2022

Background:

The prevalence of type 2 diabetes (T2D) has increased in the United States, and recent studies suggest that environmental factors contribute to T2D risk. We sought to understand if environmental factors were associated with the rate and magnitude of increase in diabetes prevalence at the county level.

Methods:

We obtained age-adjusted diabetes prevalence estimates from the CDC for 3,137 US counties from 2004 to 2017. We applied latent growth mixture models to these data to identify classes of counties with similar trends in diabetes prevalence over time, stratified by Rural Urban Continuum Codes (RUCC). We then compared mean values of the US EPA Environmental Quality Index (EQI) 2006–2010, overall and for each of the five domain indices (air, water, land, sociodemographic, and built), with RUCC-specific latent class to examine associations of environmental factors and class of diabetes prevalence trajectory.

Results:

Overall diabetes prevalence trends between 2004 and 2017 were similar across all RUCC strata. We identified two classes among metropolitan urbanized (RUCC 1) counties; four classes among non-metro urbanized (RUCC 2) counties; and three classes among less urbanized (RUCC 3) and thinly populated (RUCC 4) counties. Associations with overall EQI values and class of diabetes prevalence trends differed by RUCC strata, with the clearest association between poor air EQI and steeper increases in diabetes prevalence among rural counties (RUCC 3 and 4).

Conclusions:

Similarities in county-level diabetes prevalence trends between 2004 and 2017 were identified for each RUCC strata, although associations with environmental factors varied by rurality.
REPAIR OF THE EXIT WOUND OF A PERFORATING GLOBE INJURY WITH THE AMNIOTIC MEMBRANE: A SURGICAL ADJUVANT FOR EARLY VITRECTOMY
Authors: Hondur Ahmet M.
Published: June 2022

Purpose:

To describe the use of the amniotic membrane for the repair of the exit wound of a perforating injury involving the retina and the choroid.

Methods:

Case report.

Results:

A 46-year-old man presented one day after a perforating ocular injury with an exit wound close to the inferior temporal retinal vascular arcade. The next day, the patient underwent a combined vitrectomy and phacoemulsification with intraocular lens implantation. During vitrectomy, a retinochoroidectomy was performed at the exit wound and the internal limiting membrane was peeled over the macula and up to the exit wound. Laser retinopexy was followed by plugging of a piece of the amniotic membrane to the exit wound. A second piece of the amniotic membrane was used to cover the bare retinochoroidectomy area. The surgery was concluded with a silicone exchange. Postoperatively, no sign of proliferative vitreoretinopathy was observed, and at 3 months, the silicone oil was removed. The follow-up was uneventful, and the eye achieved a final visual acuity of 20/30.

Conclusion:

The amniotic membrane may offer a simple and safe solution for the repair of the exit wounds of perforating injuries involving the retina and the choroid. The use of the amniotic membrane for this purpose may afford the opportunity for early vitrectomy in the management of perforating ocular injuries.
Twenty Four Hour Intraocular Pressure Indicators Distinguish Normal Tension Glaucoma from Healthy Eyes Measured with a Contact Lens Sensor
Authors: Tojo Naoki , Hayashi Atsushi
Published: June 2022

Précis:

The cut-off values of CLS

Purpose:

We conducted the present study to determine (1) the best factor for distinguishing normal tension glaucoma (NTG) and non-glaucoma subjects based on the intraocular pressure (IOP) values measured by a contact lens sensor (CLS) and (2) the optimal cut-off values of that factor.

Subjects and Methods:

The eyes of 18 non-glaucoma subjects and 26 NTG patients were examined. We evaluated five indicators: maximum IOP value, standard deviation (SD), IOP fluctuation range, the cosine-fit curve amplitude, and the amplitude of dual-harmonic regression values. We determined the indicators’ cut-off values to distinguish between non-glaucoma subjects and NTG patients with the area under the curve (AUC).

Results:

The mean IOP values were 12.3±2.7 mmHg in the non-glaucoma eyes and 12.5±3.1 mmHg in the NTG eyes (P=0.824). All five indicators were significantly higher in the NTG group. The best factor to distinguish the non-glaucoma subjects and NTG patients was the IOP fluctuation range (P<0.0001, AUC=0.844); the cut-off level value was 436.5 millivolt equivalents.

Conclusions:

24 hour IOP measurements with a CLS showed that among IOP indicators studied, the range of IOP fluctuation was most important and significantly larger in NTG eyes compared to non-glaucoma eyes.
The Diagnosis of Burnout
Authors: Parker Gordon , Tavella Gabriela
Published: June 2022

Burnout is a topic of high public and research interest, but debate remains as to how the syndrome should best be defined, measured, and diagnosed. In this article, we overview how issues relating to burnout's definition and measurement as well as the debate surrounding its overlap with depression have led to ambiguity surrounding its diagnostic status. We argue for a broader conceptualization of burnout and detail why we position it as distinct from depression, before providing recommendations for clinicians when considering a burnout diagnosis. We highlight that all measures of burnout risk “false-positive” diagnoses and that they should more be viewed as screening strategies with a definitive diagnosis (of “burning out” or “being burnt out”) requiring close clinical assessment and exclusion of alternate psychological and physical conditions.
COVID-19 Survivors' Intensive Care Unit Experiences and Their Possible Effects on Mental Health
Authors: Telatar Tahsin Gökhan , Telatar Ayça , Hocaoğlu Çiçek , Hızal Ayşe , Sakın Mustafa , Üner Sarp
Published: June 2022

It is known that being hospitalized in the intensive care unit (ICU) for any reason is a risk factor for future psychiatric problems. This qualitative study aims to identify the experiences of coronavirus disease 2019 (COVID-19) ICU survivors and provide insights for relevant mental health problems after being discharged. Participants were COVID-19 patients discharged from ICUs of a secondary care hospital. The experiences of 21 ICU survivors were evaluated using Colaizzi's 7-step approach, which were determined by the purposeful sampling method. There were three themes generated from the interviews as “emotions on COVID-19 diagnosis,” “feelings about ICU stay and health care providers,” and “life in the shadow of COVID-19.” Two subthemes for every single theme were generated, and a total of 19 codes were extracted. It is essential to understand the individual's unique experiences in designing preventive interventions and apply individual preventive mental health interventions during ICU stay.
Risk Factors of Serious Bacterial Infection in Previously Healthy Children Older Than 90 Days Old With Fever and Neutropenia
Authors: Mora-Capín Andrea , Lorente-Romero Jorge , Hernanz-Lobo Alicia , Rivas-García Arístides , Vázquez-López Paula , Carrascosa-García Paula , González-Hermosa Andrés , Mena-Huarte Juncal , Pérez-Saez María Amalia , Nadal Gemma , García-de-Diego Irene , Marañón-Pardillo Rafael ,   Research Network of the Spanish Society of Pediatric Emergencies (RISeuP-SPERG)
Published: June 2022

Background

The main objective was to determine the clinical or analytical factors that independently predict risk of serious bacterial infection (RSBI) in immunocompetent patients older than 90 days given a diagnosis of fever and for whom neutropenia was an incidental finding. The secondary objective was to describe the prevalence of serious bacterial infections (SBIs).

Methods

This is a 3-year-long, multicenter, prospective analytical and observational study carried out at 6 pediatric emergency departments. Data for epidemiological, clinical, and analytical variables were collected.

Results

One hundred forty patients with febrile neutropenia (60.7% mild, 39.3% moderate to severe) were recruited. Serious bacterial infection incidence was 15.0% (95% confidence interval [CI], 9–21): 1 Invasive Bacterial Infection (Staphylococcus epidermidis bacteremia), 10 urinary tract infections, 8 pneumonias, and 2 cellulitis. Median total neutrophil counts per microliter showed no statistically significant differences (P = 0.512; 1000 [750–1200] in SBI patients vs 1100 [800–1300] in non-SBI patients). Higher RSBI was observed in patients with neutrophils less than 20% relative to total leukocytes (SBI, 15, 26.3%) than in those with neutrophils of 20% or greater (SBI, 6, 7.2%) (odds ratio, 4.6; 95% CI, 1.7–12.7). In patients with greater than 5000 leukocytes/μL, a percentage of neutrophils less than 20% was related to a greater RSBI with a trend toward statistical significance (odds ratio, 6.1; 95% CI, 0.7–51.1; P = 0.066). The clinical variables did not show a significant association with RSBI.

Conclusions

None of the clinical or analytical variables assessed were associated with the RSBI. However, according to a post hoc analysis, in patients with greater than 5000 leukocytes/μL, a neutrophil percentage less than 20% could be an independent risk factor for SBI. A thorough physical examination and basic diagnostic tests (urinalysis and chest x-ray) may help to establish a diagnosis of SBI in the vast majority of cases.
The Batwing Mastopexy in Immediate Implant-Based Breast Reconstruction: An Aesthetic Enhancement for Patients with Cancer
Authors: Kadakia Nikita , Kubiak Jeremy W. , Landau Mark J. , Mohiuddin Waseem , Lewis Priya G. , Kim Hahns Y.
Published: June 2022

Background:

Historically, many patients with breast ptosis have been excluded from nipple-sparing mastectomies. By performing mastopexy at the time of immediate reconstruction, more patients with breast ptosis can be considered for nipple-sparing mastectomies. The authors review their experience of simultaneous batwing mastopexy performed at the time of immediate implant-based reconstruction.

Methods:

Using retrospective chart review, the authors identified patients who underwent immediate implant-based breast reconstruction from 2015 through 2020 at a single institution. The patients were divided into two cohorts—batwing mastopexy and standard reconstruction (no mastopexy)—and compared.

Results:

A total of 324 breast operations in 188 patients were included (80 concurrent batwing and 244 standard implant-based reconstructions). Patient characteristics were similar between the groups, except that patients in the batwing group had greater ptosis and more patients in the standard group underwent adjuvant chemotherapy. Mean follow-up was 15.9 months (range, 3.19 to 55.20 months). Complication rates were comparable in the batwing and standard groups, with no statistically significant differences in rates of hematoma (1.3 versus 3.3 percent; = 0.34), seroma (5.0 versus 8.2 percent; p = 0.34), major infection (8.8 versus 9.0 percent; p = 0.94), skin or nipple necrosis (6.3 versus 11.5 percent; p = 0.18), or explantation (11.3 versus 14.8 percent; p = 0.43). The rate of minor infections was higher in the group with concurrent batwing mastopexy (10.0 versus 3.7 percent; p = 0.03).

Conclusions:

The authors demonstrate that simultaneous batwing mastopexy can be performed safely at the time of immediate breast reconstruction. This technique provides comparable complication rates, improves aesthetic outcomes in patients with significant ptosis or macromastia, and allows nipple-sparing mastectomy to be an option for those who would otherwise be excluded.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Assessing layered HIV prevention programming: optimizing outcomes for adolescent girls and young women
Authors: Mathur Sanyukta , Mishra Raman , Mahapatra Bidhubhusan , Heck Craig J. , Okal Jerry
Published: June 2022

Objective:

To assess how exposure to multiple, layered interventions predicts HIV-related outcomes among adolescent girls (15–19 years) and young women (20–24 years) in Kenya.

Design:

Survey data from adolescent girls and young women (n = 736) with 14–16 months of engagement with DREAMS, a comprehensive HIV prevention program that provides a range of health education, life skills, social protection, and social and behaviour change interventions.

Methods:

Nonparametric recursive partitioning technique – classification and regression tree (CART) – to identify the best predictors (DREAMS interventions) for achieving the desired HIV-related outcomes (consistent condom use and no transactional sex or sexual violence).

Results:

Among adolescent girls, schooling support reduced the likelihood of engaging in transactional sex, whereas schooling support and exposure to parenting program reduced the likelihood experiencing sexual violence. Likelihood of consistent condom use increased among adolescent girls with exposure to preexposure prophylaxis (PrEP), schooling support, and the violence prevention programming. Among young women, multiple pathways reduced the likelihood of engaging in transactional sex: exposure to the male sexual partner program; exposure to the youth fund program; exposure to the violence prevention program; or exposure/engagement with schooling support, parenting programming, and the youth fund program. For young women, consistent condom use increased with schooling support and male partner engagement. Additionally, engagement in violence prevention program and male partner engagement increased the likelihood of not experiencing sexual violence among young women.

Conclusion:

Exposure to a combination of DREAMS interventions predicted outcomes that can reduce HIV risk among AGYW, though the pathways differed by outcome and age group.