bluuebunny/crossref_metadata_2025 huggingface dataset:
Landscape Complexity has Mixed Effects on an Invasive Aphid and Its Natural Enemies in Sorghum Agroecosystems
Authors: Elkins Blake H , Eubanks Micky D , Faris Ashleigh M , Wang Hsiao-Hsuan , Brewer Michael J
Published: May 2022

Landscapes with more complex composition and configuration are generally expected to enhance natural enemy densities and pest suppression. To evaluate this hypothesis for an invasive aphid pest of sorghum, Melanaphis sorghi Theobald (Hemiptera: Aphididae), sampling in sorghum fields for aphids and natural enemies was conducted over two years in a southern U.S. coastal production region. Landscape composition and configuration of crop and noncrop elements were assessed using correlation and multivariate regression modeling to detect relationships with insects at different spatial scales. Significant models found more complex landscape configuration, particularly the amount of habitat edges, was associated with increased aphid and natural enemy abundance. Composition associated with noncrop habitats had the opposite effect. Numerical response of natural enemies was taxa dependent, with parasitism lower as landscape complexity increased, while predator numerical response was not affected by landscape complexity. These results indicate landscape complexity may increase both aphid and natural enemy abundance, but with decreasing parasitism and little association with predator numerical response. These relationships are likely contingent on overall environmental suitability to aphid population increase as results were less evident in the second year when average aphid abundance regularly exceeded the economic threshold. This study supports the importance of configuration, especially habitat borders, as a critical metric for determining pest-natural enemy dynamics within a large-scale cereal agroecosystem.
Radiographic and histological assessment of root resorption associated with conventional and mini-screw assisted rapid palatal expansion: a systematic review
Authors: Abu Arqub Sarah , Gandhi Vaibhav , Iverson Marissa G , Alam Mohammad Khursheed , Allareddy Veerasathpurush , Liu Dawei , Yadav Sumit , Mehta Shivam
Published: May 2022

Background and objectives

The aim of this systematic review and meta-analysis was to evaluate root resorption after maxillary expansion with conventional rapid palatal expansion (RPE) and mini-screw assisted rapid palatal expansion appliances (MARPE) using 2D and 3D radiographic methods and histologic methods of measuring root resorption.

Search methods and selection criteria

A search of PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Global Index Medicus, Dissertations & Theses Global, ClinicalTrials.gov registry, ISRCTN Registry, National Research Register, OpenGrey, and the Trip Database was performed. The studies that had analysed root resorption after RPE or MARPE were selected for the systematic review.

Data collection and analysis

The database research, elimination of duplicate studies, data extraction, and risk of bias were performed by the authors independently and in duplication. This systematic review included prospective studies to evaluate root resorption following RPE after tooth-borne (TB), tooth-tissue borne (TTB), bone-borne (BB), and tooth-bone borne (TBB) expansion appliances.

Results

A total of 13 prospective trials (six randomized clinical trials and seven non-randomized prospective clinical trials) were identified for inclusion in this systematic review. Histological studies revealed that most teeth experience root resorption on the buccal surfaces after maxillary expansion. MARPE designs with BB and TBB expansion appliances were found to lead to reduced volumetric root resorption than conventional RPE using micro-computed tomography. However, one study using cone beam computed tomography showed no difference in the root resorption with MARPE and RPE designs.

Conclusions and implications

Maxillary expansion with RPE can lead to root resorption of maxillary posterior teeth. Root resorption occurs more frequently on buccal surfaces on maxillary posterior teeth. Limited evidence suggests that MARPE may lead to reduced root resorption than RPE.

Registration

This systematic review was conducted following the Cochrane handbook for systematic reviews and interventions and reported according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The protocol was registered at PROSPERO database (https://www.crd.york.ac.uk/prospero/; registration number: PROSPERO CRD42021271181).
X-ray fluorescence microscopy methods for biological tissues
Authors: Pushie M Jake , Sylvain Nicole J , Hou Huishu , Hackett Mark J , Kelly Michael E , Webb Samuel M
Published: May 2022

Synchrotron-based X-ray fluorescence microscopy is a flexible tool for identifying the distribution of trace elements in biological specimens across a broad range of sample sizes. The technique is not particularly limited by sample type and can be performed on ancient fossils, fixed or fresh tissue specimens, and in some cases even live tissue and live cells can be studied. The technique can also be expanded to provide chemical specificity to elemental maps, either at individual points of interest in a map or across a large field of view. While virtually any sample type can be characterized with X-ray fluorescence microscopy, common biological sample preparation methods (often borrowed from other fields, such as histology) can lead to unforeseen pitfalls, resulting in altered element distributions and concentrations. A general overview of sample preparation and data-acquisition methods for X-ray fluorescence microscopy is presented, along with outlining the general approach for applying this technique to a new field of investigation for prospective new users. Considerations for improving data acquisition and quality are reviewed as well as the effects of sample preparation, with a particular focus on soft tissues. The effects of common sample pretreatment steps as well as the underlying factors that govern which, and to what extent, specific elements are likely to be altered are reviewed along with common artifacts observed in X-ray fluorescence microscopy data.
Wide angle acceptance and high-speed track recognition in nuclear emulsion
Authors: Suzuki Y , Fukuda T , Kawahara H , Komatani R , Naiki M , Nakano T , Odagawa T , Yoshimoto M
Published: May 2022

A nuclear emulsion film is a three-dimensional tracking device that is widely used in cosmic-ray and high-energy physics experiments. Scanning with a wide angle acceptance is crucial for obtaining track information in emulsion films. This study presents a new method developed for wide angle acceptance and high-speed track recognition of nuclear emulsion films for neutrino–nucleus interaction measurements. The nuclear emulsion technique can be used to measure tracks of charged particles from neutrino interactions with a low momentum threshold. The detection of the particles with a wide angle acceptance is essential for obtaining detailed information on the interactions in the sub- and multi-GeV neutrino energy region. In the new method developed for a neutrino interaction measurement in J-PARC called NINJA, the angle acceptance is covered up to |tan θx(y)| < 5.0 (80% of all solid angles) with $150\, \mathrm{m^2/year}$. This method can also be used to improve the angle accuracy and recognition efficiency of the tracks.
Evaluation and Application of Ultra-Low-Resolution Pressure Reactivity Index in Moderate or Severe Traumatic Brain Injury
Authors: Gritti Paolo , Bonfanti Marco , Zangari Rosalia , Farina Alessia , Longhi Luca , Rasulo Frank A. , Bertuetti Rita , Biroli Antonio , Biroli Francesco , Lorini Ferdinando Luca
Published: May 2022

Background:

The pressure reactivity index (PRx) has emerged as a surrogate method for the continuous bedside estimation of cerebral autoregulation and a predictor of unfavorable outcome after traumatic brain injury (TBI). However, calculation of PRx require continuous high-resolution monitoring currently limited to specialized intensive care units. The aim of this study was to evaluate a new index, the ultra-low-frequency PRx (UL-PRx) sampled at ∼0.0033 Hz at ∼5 minutes periods, and to investigate its association with outcome.

Methods:

Demographic data, admission Glasgow coma scale, in-hospital mortality and Glasgow outcome scale extended at 12 months were extracted from electronic records. The filtering and preparation of time series of intracranial pressure (ICP), mean arterial pressure and cerebral perfusion pressure (CPP), and calculation of the indices (UL-PRx, Δ-optimal CPP), were performed in MATLAB using an in-house algorithm.

Results:

A total of 164 TBI patients were included in the study; in-hospital and 12-month mortality was 29.3% and 38.4%, respectively, and 64% of patients had poor neurological outcome at 12 months. On univariate analysis, ICP, CPP, UL-PRx, and ΔCPPopt were associated with 12-month mortality. After adjusting for age, Glasgow coma scale, ICP and CPP, mean UL-PRx and UL-PRx thresholds of 0 and +0.25 remained associated with 12-month mortality. Similar findings were obtained for in-hospital mortality. For mean UL-PRx, the area under the receiver operating characteristic curves for in-hospital and 12-month mortality were 0.78 (95% confidence interval [CI]: 0.69-0.87; P<0.001) and 0.70 (95% CI: 0.61-0.79; P<0.001), respectively, and 0.65 (95% CI: 0.57-0.74; P=0.001) for 12-month neurological outcome.

Conclusions:

Our findings indicate that ultra-low-frequency sampling might provide sufficient resolution to derive information about the state of cerebrovascular autoregulation and prediction of 12-month outcome in TBI patients.
A Socioecological Model of Heart Failure Self-Care
Authors: Whyte Michelle , Sethares Kristen A.
Published: May 2022

Heart failure is a chronic, progressively worsening condition afflicting more than 64 million individuals worldwide. Heart failure outcomes are influenced by self-care, a naturalistic patient-centered decision-making process. The situation-specific theory of heart failure self-care addresses how this decision-making process determines actions and outcomes. However, little is known about the impact of socioecological determinants of health on heart failure self-care. A theoretical synthesis could advance the situation-specific theory of heart failure self-care through the inclusion of socioecological determinants of health. Thus, socioecological determinants of health related to heart failure self-care can be better explored, understood, and overcome through research and health promotion.
Strategies to Engage Systematically Marginalized Youth and Their Families in Research Using High-Tech Methods
Authors: Hardin Heather K. , Bender Anna E. , Killion Cheryl M. , Moore Shirley M.
Published: May 2022

The purpose of this study was to identify facilitators and barriers for engaging youth and families from a historically and systematically marginalized community in high-tech research. Adapting community-based participatory research principles, 4 focus groups were conducted with 13 youth and 12 parents. Using codebook thematic analysis, 5 facilitator themes (develop skills, ensure health, build understanding, promote safety, and help others, youth-initiated interest) and 4 barrier themes (anxiety and fear, skepticism, confusion, and unfamiliar/unknown experience) were identified. Youth and parent responses informed proposed guidelines for recruiting and engaging families in research using high-tech methods, particularly those from historically and systematically marginalized communities.
High Pretreatment Mean Corpuscular Volume Can Predict Worse Prognosis in Patients With Esophageal Squamous Cell Carcinoma who Have Undergone Curative Esophagectomy
Authors: Yoshida Naoya , Sasaki Ken , Kanetaka Kengo , Kimura Yasue , Shibata Tomotaka , Ikenoue Makoto , Nakashima Yuichiro , Sadanaga Noriaki , Eto Kojiro , Tsuruda Yusuke , Kobayashi Shinichiro , Nakanoko Tomonori , Suzuki Kosuke , Takeno Shinsuke , Yamamoto Manabu , Morita Masaru , Toh Yasushi , Baba Hideo
Published: May 2022

Objective:

To establish the prognostic value of mean corpuscular volume (MCV) in patients with esophageal squamous cell carcinoma (ESCC) who have undergone esophagectomy.

Background:

The MCV increases in patients with high alcohol and tobacco consumption. Such a lifestyle can be a risk factor for malnutrition, comorbidities related to those habits, and multiple primary malignancies, which may be associated with frequent postoperative morbidity and poor prognosis.

Methods:

This study included 1673 patients with ESCC who underwent curative esophagectomy at eight institutes between April 2005 and November 2020. Patients were divided into normal and high MCV groups according to the standard value of their pretreatment MCV. Clinical background, short-term outcomes, and prognosis were retrospectively compared between the groups.

Results:

Overall, 26.9% of patients had a high MCV, which was significantly associated with male sex, habitual smoking and drinking, multiple primary malignancies, and malnutrition, as estimated by the body mass index, hemoglobin and serum albumin values, and the Geriatric Nutritional Risk Index. Postoperative respiratory morbidity (P = 0.0075) frequently occurred in the high MCV group. A high MCV was an independent prognostic factor for worse overall survival (hazard ratio, 1.27; 95% confidence interval, 1.049–1.533; P = 0.014) and relapse-free survival (hazard ratio, 1.23; 95% confidence interval, 1.047–1.455; P = 0.012).

Conclusions:

A high MCV correlates with habitual drinking and smoking, malnutrition, and multiple primary malignancies and could be a surrogate marker of worse short-term and long-term outcomes in patients with ESCC who undergo esophagectomy.
Posterior-only Resection of Single Hemivertebrae With 2-Level Versus >2-Level Fusion: Can We Improve Outcomes?
Authors: Gomez Jaime A. , Ge David H. , Boden Emma , Hanstein Regina , Alvandi Leila Mehraban , Lo Yungtai , Hwang Steven , Samdani Amer F. , Sponseller Paul D. , Garg Sumeet , Skaggs David L. , Vitale Michael G. , Emans John ,   Pediatric Spine Study Group
Published: May 2022

Background:

The outcomes of congenital scoliosis (CS) patients undergoing hemivertebra (HV) resection surgery with a 2-level fusion versus a >2-level fusion are unclear. We hypothesized that CS patients undergoing HV resection and a >2-level fusion have decreased curve progression and reoperation rates compared with 2-level fusions.

Methods:

Retrospective review of prospectively collected data from a multicenter scoliosis database. Fifty-three CS patients (average age 4.5, range 1.2 to 10.9 y) at index surgery were included. Radiographic and surgical parameters, complications, as well as revision surgery rates were tracked at a minimum of 2-year follow-up.

Results:

Twenty-six patients had a 2-level fusion while 27 patients had a >2-level fusion with similar age and body mass index between groups. The HV was located in the lumbar spine for 69% (18/26) 2-level fusions and 30% (8/27) >2-level fusions (P=0.006). Segmental HV scoliosis curve was smaller in 2-level fusions compared to >2-level fusions preoperatively (38 vs. 50 degrees, P=0.016) and at follow-up (25 vs. 34 degrees, P=0.038). Preoperative T2-T12 (28 vs. 41 degrees, P=0.013) and segmental kyphosis (11 vs. 23 degrees, P=0.046) were smaller in 2-level fusions, but did not differ significantly at postoperative follow-up (32 vs. 39 degrees, P=0.22; 13 vs. 11 degrees, P=0.64, respectively). Furthermore, the 2 groups did not significantly differ in terms of surgical complications (27% vs. 22%, P=0.69; 2-level fusion vs. >2-level fusion, respectively), unplanned revision surgery rate (23% vs. 22%, 0.94), growing rod placement or extension of spinal fusion (15% vs. 15%, P=0.95), or health-related quality of life per the EOS-Questionnaire 24 (EOSQ-24). Comparison of patients with or without the need for growing rod placement or posterior spinal fusion revealed no significant differences in all parameters analyzed.

Conclusions:

Two-level and >2-level fusions can control congenital curves successfully. No differences existed in curve correction, proximal junctional kyphosis or complications between short and long-level fusion after HV resection. Both short and long level fusions are viable options and generate similar risk of revision. The decision should be individualized by patient and surgeon.
Exposure patterns among Coast Guard responders to the Deepwater Horizon Oil Spill
Authors: Gribble Matthew O. , Keshav Taj , Denic-Roberts Hristina , Engel Lawrence S. , Rusiecki Jennifer A.
Published: May 2022

Background:

The Deepwater Horizon Oil Spill was an environmental crisis for which multiple groups, including the United States Coast Guard (USCG), provided emergency response services. A cohort of 5,665 USCG oil spill responders completed postdeployment surveys eliciting information on a variety of topics, including oil spill–related exposures and experiences. Our objective was to determine the most common exposure patterns among USCG responders.

Methods:

We used latent class analysis based on six indicator variables reflecting different aspects of the responders’ experiences: exposure to oil, exposure to engine exhaust fumes or carbon monoxide, hand sanitizer use, sunblock use, mosquito bites, and level of anxiety. We validated our interpretation of these latent classes using ancillary variables.

Results:

The model distinguished four distinct exposure profiles, which we interpreted as “low overall exposure” (prevalence estimate = 0.18), “low crude oil/exhaust and moderate time outdoors/anxiety (prevalence estimate = 0.18), “high crude oil/exhaust and moderate time outdoors/anxiety” (prevalence estimate = 0.25), and “high overall exposure” (prevalence estimate = 0.38). The validation analysis was consistent with our interpretation of the latent classes.

Conclusions:

The exposure patterns identified in this analysis can help inform future studies of the health impacts of exposure mixtures among USCG oil spill responders.
Short-Term High-Fat Diet Alters Acetaminophen Metabolism in Healthy Individuals
Authors: Achterbergh Roos , Lammers Laureen A. , Klümpen Heinz-Josef , Mathôt Ron A. A. , Romijn Johannes A.
Published: May 2022

Background:

Acetaminophen is metabolized through a nontoxic sulfation and glucuronidation pathway and toxic oxidation pathway (via CYP2E1 and CYP1A2). A short-term high-fat diet induces alterations in the steatotic liver and may alter hepatic drug enzyme activity. In the case of acetaminophen, these alterations may result in an increased risk of hepatotoxicity. Therefore, this study was conducted to assess the effect of a 3-day hypercaloric high-fat diet on the plasma levels of acetaminophen metabolites.

Methods:

Nine healthy subjects participated in this randomized, crossover intervention study. The subjects consumed a regular diet or a regular diet supplemented with 500 mL of cream (1700 kcal) for 3 days and then fasted overnight. After ingesting 1000-mg acetaminophen, the plasma concentration of acetaminophen (APAP) and its metabolites [acetaminophen glucuronide, acetaminophen sulfate, 3-cysteinyl-acetaminophen, and 3-(N-acetyl-L-cystein-S-yl)-acetaminophen, and 3-methoxy-acetaminophen] were measured.

Results:

The 3-day high-fat diet increased the extrapolated area under the concentration–time curve from 0 to infinity (area under the curve0–inf) of APAP-Cys by approximately 20% (P = 0.02) and that from 0 to 8 hours (area under the curve0–8) of APAP-Cys-NAC by approximately 39% (P = 0.01). The 3-day high-fat diet did not alter the pharmacokinetic parameters of the parent compound acetaminophen and other metabolites.

Conclusions:

A short-term, hypercaloric, high-fat diet increases the plasma levels of the APAP metabolites formed by the oxidation pathway, which may increase the risk of hepatotoxicity.
Ketogenic diet prevents methylglyoxal-evoked nociception by scavenging methylglyoxal
Authors: Enders Jonathan D. , Thomas Sarah , Swanson Matthew Taylor , Ryals Janelle M. , Wright Douglas E.
Published: May 2022

Methylglyoxal (MGO) is a reactive dicarbonyl byproduct of glycolysis implicated in a growing number of neuropathic pain conditions, including chemotherapy-induced peripheral neuropathy, diabetic peripheral neuropathy, and radiculopathy with lumbar disk herniation. Recent studies show success in preclinical models treating these disorders with an interventional ketogenic diet. Here, we tested the hypothesis that a ketogenic diet modifies pathological MGO signaling as a mechanism underlying neuropathy improvement. We found that mice injected with MGO displayed nocifensive behaviors, whereas mice prefed a ketogenic diet were resistant to mechanical allodynia elicited by MGO. In addition, levels of circulating MGO were reduced in ketogenic diet-fed mice and negatively correlated with levels of the ketone body β-hydroxybutyrate (β-HB). Methylglyoxal is normally scavenged by the glyoxalase system, and ketogenic diet-fed mice displayed increased glyoxalase 1 activity compared with chow-fed control mice. Recent studies also suggest that ketone bodies contribute to MGO detoxification, consistent with a negative correlation between β-HB and MGO. To assess whether ketone bodies modified MGO-evoked nociception through direct MGO detoxification, we coincubated either acetoacetate or β-HB with MGO before injection. Mice receiving intraplantar MGO injection exhibit increased nociceptive behavior (lifting, licking, biting, and scratching), which was significantly reduced by coincubation with either acetoacetate or β-HB. Methylglyoxal increased phospho-extracellular signal-regulated kinase–positive cells in the spinal dorsal horn, and this evoked spinal activation was ameliorated by preincubation with acetoacetate or β-HB. These results suggest that a ketogenic diet and ketone bodies ameliorate MGO-evoked nociception, partially through detoxification of MGO, and provide rationale for therapeutic intervention with a ketogenic diet in MGO-driven pathologies.
Pilot Study to Investigate the Effect of a 10-Week Aquatic Exercise Program on Individuals With High Levels of Disability Due to Multiple Sclerosis
Authors: Sames Carol , DeBlois Amy
Published: May 2022

Background and Purpose:

Research has suggested that a properly designed and implemented aquatic exercise (AE) program can improve physiological function and quality-of-life (QOL) outcomes in individuals with minimal disability levels due to multiple sclerosis (MS). Minimal research has investigated AE in individuals with higher levels of disability. The purpose of this study was to investigate a 10-week AE program on walking speed and QOL outcomes, specifically the effect of fatigue, in individuals with higher levels of disability due to MS, at an Expanded Disability Status Scale (EDSS) score between 5.0 and 6.5.

Methods:

Fifteen females and 4 males with relapsing-remitting MS, mean age 46.4 years ± 10.0, EDSS score 5.9 ± 0.4, and disease duration 10.4 years ± 6.5. The AE group was individually modified and performed 3 times per week for 45 minutes at a rating of perceived exertion of 11 to 13 for 10 weeks. Prior to and upon completion of structured AE intervention, subjects performed the following tests: Multiple Sclerosis Functional Composite (MSFC), Multiple Sclerosis Quality of Life Inventory (MSQLI), and 25-ft Water Walk Test.

Results:

Improvement in the MSFC (P = .001) was noted in all 3 MSFC components: 25-ft Water Walk Test (P = .020), 9-Hole Peg Test (P = .006), and Paced Auditory Serial Addition Test (P = .005). Improvements in the following subtests of the MSQLI were noted: SF-36 (36-Item Short Form Health Survey) physical and mental component summary (PCS, P = .006) (MCS, P = .009); Modified Fatigue Impact Scale (P = .006); Pain Effects Scale (P = .006); Perceived Deficits Questionnaire (P = .003); and Mental Health Inventory (P = .040).

Discussion and Conclusions:

Results suggest that a 10-week AE program for individuals with MS improved walking speed, arm function, memory, mental health, and generic QOL and reduced fatigue, pain, and perceived cognitive impairment in individuals with moderate to severe disability without adverse symptoms.
Mucinous Proliferations of the Uterine Corpus: Comprehensive Appraisal of an Evolving Spectrum of Neoplasms
Authors: Fadare Oluwole
Published: May 2022

A variety of endometrial lesions may contain mucinous cells. Herein, the author reviews the literature on the classification and clinicopathologic significance of uterine corpus proliferations with a significant mucinous component, assesses the 2020 World Health Organization classification of such lesions, and presents a diagnostic framework. The key epithelial mucinous lesions include mucinous metaplasia, atypical mucinous glandular proliferation and mucinous carcinoma. Each of these categories are classifiable into “usual” and gastrointestinal subtypes, the latter being indicative of intestinal (presence of goblet cells) and/or gastric-type (abundant, pale eosinophilic or clear cytoplasm and well-defined cell borders) morphology. It has been proposed that at least focal expression of gastrointestinal immunohistochemical markers be required for all gastrointestinal type lesions, and for gastrointestinal type atypical mucinous glandular proliferation and carcinoma, minimality or absence of estrogen receptor expression, and the absence of an endometrioid component. Mucinous carcinomas of the usual type, in which >50% of the tumor is comprised of a mucinous component, are the most common. Morphologic subtypes include mucinous carcinoma with microglandular features and mucinous carcinoma with signet rings (signet ring carcinoma). Endometrioid carcinomas with a less than a 50% mucinous component are classified as endometrioid carcinoma with mucinous differentiation. Several studies have directly compared endometrioid and mucinous carcinomas, the latter presumably of the usual type, with respect to patient outcomes after treatment. All have found no difference in overall and disease free survival between these groups. However, three major studies have found mucinous carcinomas to be associated with a higher risk of lymph node metastases. Nineteen cases of mucinous carcinoma of the gastrointestinal type have been reported, and the limited data on their follow-up after primary treatment suggests that this subtype is more clinically aggressive and should accordingly be classified separately from mucinous carcinomas of the usual type. The morphologic spectrum of mucinous carcinoma of the gastrointestinal type is unclear and continues to evolve. Mucinous change, which may sometimes be extensive, may also be associated with papillary proliferation of the endometrium, adenomyoma of the endocervical type, atypical, and typical adenomyomas. In a curettage or biopsy, intestinal type mucinous epithelium may be indicative of any of the gastrointestinal lesions mentioned above, but may also represent samplings of uterine teratomas, yolk sac tumors, genital and extragenital adenocarcinomas with intestinal differentiation, or low-grade appendiceal mucinous neoplasms that secondarily involve the endometrium.
Association of Radiation Timing with Long-Term Satisfaction and Health-Related Quality of Life in Prosthetic Breast Reconstruction
Authors: Nelson Jonas A. , Cordeiro Peter G. , Polanco Thais , Shamsunder Meghana G. , Patel Aadit , Allen Robert J. , Matros Evan , Disa Joseph J. , Cuaron John J. , Morrow Monica , Mehrara Babak J. , Pusic Andrea L. , McCarthy Colleen M.
Published: May 2022

Background:

Radiation therapy is increasingly used after breast cancer surgery, which may impact patients’ postoperative quality of life. This study assessed differences in long-term patient satisfaction and health-related quality of life after radiation therapy administered at different stages of implant-based breast reconstruction or with no radiation after surgery.

Methods:

In this observational study, long-term outcomes were evaluated for four cohorts of women who completed breast reconstruction and received (1) no radiation, (2) radiation before tissue expander placement, (3) radiation after tissue expander placement, or (4) radiation after permanent implant between 2010 and 2017 at Memorial Sloan Kettering. Satisfaction and health-related quality of life were assessed using the prospectively collected Satisfaction with Breasts and Physical Well-Being of Chest BREAST-Q subscales. Score distributions were examined by radiation exposure status for 3 years after surgery using nonparametric analyses and regression models.

Results:

Of 2932 patients who met the inclusion criteria, 25.8 percent received radiation during breast cancer treatment, including before tissue expander placement (n = 239; 8.2 percent), after tissue expander placement (n = 290; 9.9 percent), and after implant placement (n = 228; 7.8 percent). Radiotherapy patients had average scores 7 to 9 points lower at all postoperative time points for Satisfaction with Breasts and Physical Well-Being of Chest subscales (p < 0.001). Although patient-reported outcomes did not differ by radiation timing, there were higher rates of severe capsular contracture with postimplant radiotherapy (p < 0.001).

Conclusions:

Radiation therapy significantly affected patient satisfaction and health-related quality of life following implant breast reconstruction through 3 years postoperatively. Patient perception of outcome was unaffected by radiotherapy timing; however, capsular contracture was higher after postimplant radiotherapy, suggesting there may be an advantage to performing radiotherapy before placement of the final reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Nerve Blocks in Breast Plastic Surgery: Outcomes, Complications, and Comparative Efficacy
Authors: Abi-Rafeh Jad , Safran Tyler , Abi-Jaoude Joanne , Kazan Roy , Alabdulkarim Abdulaziz , Davison Peter G.
Published: May 2022

Background:

As plastic surgeons continue to evaluate the utility of nonopioid analgesic alternatives, nerve block use in breast plastic surgery remains limited and unstandardized, with no syntheses of the available evidence to guide consensus on optimal approach.

Methods:

A systematic review was performed to evaluate the role of pectoralis nerve blocks, paravertebral nerve blocks, transversus abdominus plane blocks, and intercostal nerve blocks in flap-based breast reconstruction, prosthetic-based reconstruction, and aesthetic breast plastic surgery, independently.

Results:

Thirty-one articles reporting on a total of 2820 patients were included in the final analysis; 1500 patients (53 percent) received nerve blocks, and 1320 (47 percent) served as controls. Outcomes and complications were stratified according to procedures performed, blocks employed, techniques of administration, and anesthetic agents used. Overall, statistically significant reductions in opioid consumption were reported in 91 percent of studies evaluated, postoperative pain in 68 percent, postanesthesia care unit stay in 67 percent, postoperative nausea and vomiting in 53 percent, and duration of hospitalization in 50 percent. Nerve blocks did not significantly alter surgery and/or anesthesia time in 83 percent of studies assessed, whereas the overall, pooled complication rate was 1.6 percent.

Conclusions:

Transversus abdominus plane blocks provided excellent outcomes in autologous breast reconstruction, whereas both paravertebral nerve blocks and pectoralis nerve blocks demonstrated notable efficacy and versatility in an array of reconstructive and aesthetic procedures. Ultrasound guidance may minimize block-related complications, whereas the efficacy of adjunctive postoperative infusions was proven to be limited. As newer anesthetic agents and adjuvants continue to emerge, nerve blocks are set to represent essential components of the multimodal analgesic approach in breast plastic surgery.
Beauty Is in the Eye of the Beholder: Factors Influencing Disparity in Perceptions of Breast Reconstruction Aesthetic Outcomes
Authors: Wu Shannon S. , Duraes Eliana F. R. , Scomacao Isis , Morisada Megan , Djohan Risal S. , Bernard Steven L. , Moreira Andrea , Schwarz Graham S.
Published: May 2022

Background:

Patient-reported outcomes are the primary measurement of breast reconstruction success, but results may be affected by nontechnical factors such as socioemotional determinants. Third-party observers provide an independent assessment of aesthetic outcomes. Factors associated with disparity between patient and observer perceptions of outcomes are not well understood.

Methods:

One hundred forty-seven patients underwent breast reconstruction at the authors’ institution between 2009 and 2011, completed the BREAST-Q, and had photographs graded by a diverse panel using the Validated Breast Aesthetic Scale. Patient satisfaction with breasts scores that aligned with observer scores were categorized as group 2; patient satisfaction that exceeded observer scores were group 1; and those lower than observer scores were group 3. Statistical analysis was performed using SPSS, with values of p < 0.05 considered statistically significant.

Results:

Twenty-eight patients (19 percent) were categorized as group 1, 93 (63 percent) in group 2, and 26 (18 percent) in group 3. Median overall appearance was highest in group 3 (median, 4.0; interquartile range, 4 to 4) and lowest in group 1 (median, 3.0; interquartile range, 2 to 3) (p < 0.001). Psychosocial, sexual, and physical well-being were significantly associated with disparity (group 1 or 3 status) (p < 0.01). Satisfaction with outcomes, nipples, abdomen, and breasts were significantly associated with disparity. Factors not significantly associated with disparity include age, body mass index, autologous or implant-based, adjuvant therapies, and timing of reconstruction.

Conclusions:

Incongruously high patient satisfaction with breast reconstruction aesthetics relative to third-party perception of aesthetic outcomes is associated with high quality-of-life scores. Incongruously low patient satisfaction with breast cosmesis compared with higher third-party perceptions was associated with low quality-of-life scores.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, II.
Brief Report: Pediatric Saliva-Based HIV Testing: Health care Worker and Caregiver Acceptability
Authors: Neary Jillian , Bulterys Michelle A. , Ogutu Emily A. , O'Malley Gabrielle , Otieno Anita A. , Omondi Vincent O. , Wang Yu , Zhai Xinyi , Katz David A. , Oyiengo Laura , Wamalwa Dalton C. , Slyker Jennifer A. , John-Stewart Grace C. , Njuguna Irene N. , Wagner Anjuli D.
Published: May 2022

Background:

Pediatric HIV testing remains suboptimal. The OraQuick test [saliva-based test (SBT)] is validated in pediatric populations ≥18 months. Understanding caregiver and health care worker (HCW) acceptability of pediatric SBT is critical for implementation.

Methods:

A trained qualitative interviewer conducted 8 focus group discussions (FGDs): 4 with HCWs and 4 with caregivers of children seeking health services in western Kenya. FGDs explored acceptability of pediatric SBT and home- and facility-based SBT use. Two reviewers conducted consensus coding and thematic analyses of transcripts using Dedoose.

Results:

Most HCWs but few caregivers had heard of SBT. Before seeing SBT instructions, both had concerns about potential HIV transmission through saliva, which were mostly alleviated after kit demonstration. Noted benefits of SBT included usability and avoiding finger pricks. Benefits of facility-based pediatric SBT included shorter client waiting and service time, higher testing coverage, and access to HCWs, while noted challenges included ensuring confidentiality. Benefits of caregivers using home-based SBT included convenience, privacy, decreased travel costs, increased testing, easier administration, and child comfort. Perceived challenges included not receiving counseling, disagreements with partners, child neglect, and negative emotional response to a positive test result. Overall, HCWs felt that SBT could be used for pediatric HIV testing but saw limited utility for caregivers performing SBT without an HCW present. Caregivers saw utility in home-based SBT but wanted easy access to counseling in case of a positive test result.

Conclusions:

SBT was generally acceptable to HCWs and caregivers and is a promising strategy to expand testing coverage.
A Demedicalized Model to Provide PrEP in a Sexual Health Clinic
Authors: Ramchandani Meena S. , Berzkalns Anna , Cannon Chase A. , Dombrowski Julia C. , Ocbamichael Negusse , Khosropour Christine M. , Barbee Lindley A. , Golden Matthew R.
Published: May 2022

Background:

Sexual health clinics (SHCs) serve large numbers of patients who might benefit from preexposure prophylaxis (PrEP). Integrating longitudinal PrEP care into SHCs can overburden clinics. We implemented an SHC PrEP program that task shifted most PrEP operations to nonmedical staff, disease intervention specialists (DIS).

Methods:

We conducted a retrospective cohort analysis of PrEP patients in an SHC in Seattle, WA, from 2014 to 2020 to assess the number of patients served and factors associated with PrEP discontinuation. Clinicians provide same-day PrEP prescriptions, whereas DIS coordinate the program, act as navigators, and provide most follow-up care.

Results:

Between 2014 and 2019, 1387 patients attended an initial PrEP visit, 93% of whom were men who have sex with men. The number of patients initiating PrEP per quarter year increased from 20 to 81. The number of PrEP starts doubled when the clinic shifted from PrEP initiation at scheduled visits to initiation integrated into routine walk-in visits. The percentage of visits performed by DIS increased from 3% in 2014 to 45% in 2019. Median duration on PrEP use was 11 months. PrEP discontinuation was associated with non-Hispanic black race/ethnicity [hazard ratio (HR) 1.34, 95% confidence interval (CI) 1.02 to 1.76], age <20 years (HR 2.17, 95% CI: 1.26 to 3.75), age between 20 and 29 years (HR 1.55, 95% CI: 1.06 to 2.28), and methamphetamine use (HR 1.98, 95% CI: 1.57 to 2.49). The clinic had 750 patients on PrEP in the final quarter of 2019.

Conclusions:

A demedicalized SHC PrEP model that task shifts most operations to DIS can provide PrEP at scale to high priority populations.
Sexual Relationship Power Equity Is Associated With Consistent Condom Use and Fewer Experiences of Recent Violence Among Women Living With HIV in Canada
Authors: Closson Kalysha , Lee Melanie , Gibbs Andrew , Nicholson Valerie , Gormley Rebecca , Parry Rebeccah , Ding Erin , Li Jenny , Carter Allison , Pick Neora , Loutfy Mona , de Pokomandy Alexandra , Greene Saara , Logie Carmen H. , Kaida Angela
Published: May 2022

Background:

Sexual relationship power (SRP) inequities, including having a controlling partner, have not been widely examined among women living with HIV (WLWH). We measured the prevalence and key outcomes of relationship control among WLWH in Canada.

Methods:

Baseline data from WLWH (≥16 years), reporting consensual sex in the last month enrolled in a Canadian community-collaborative cohort study in British Columbia, Ontario, and Quebec, included the relationship control SRP subscale by Pulerwitz (2000). Scale scores were dichotomized into medium/low (score = 1–2.82) vs. high relationship control (score = 2.82–4), and high scores indicate greater SRP equity. Cronbach's alpha assessed scale reliability. Bivariate analyses compared women with high vs. medium/low relationship control. Crude and adjusted multinomial regression examined associations between relationship control and condom use [consistent (ref), inconsistent, or never]; any sexual, physical, and/or emotional violence; and physical and/or sexual violence [never (ref), recent (≤3 months ago), and previous (>3 months ago)].

Results:

Overall, 473 sexually active WLWH (33% of cohort), median age = 39 (IQR = 33–46) years, 81% on antiretroviral therapy, and 78% with viral loads <50 copies/mL were included. The subscale demonstrated good reliability (Cronbach's alpha = 0.92). WLWH with high relationship control (80%) were more likely (P < 0.05) to be in a relationship, have no children, have greater resilience, and report less sociostructural inequities. In adjusted models, high relationship control was associated with lower odds of inconsistent vs. consistent condom use [adjusted odds ratio (aOR): 0.39 (95% confidence interval: 0.18 to 0.85)], any recent violence [aOR: 0.14 (0.04–0.47)] as well as recent physical and/or sexual [aOR : 0.05 (0.02–0.17)] but not previous violence (vs. never).

Discussion:

Prioritizing relationship equity and support for WLWH is critical for addressing violence and promoting positive health outcomes.
Improved antiproliferative activity of doxorubicin-loaded calcium phosphate nanoparticles against melanoma cells
Authors: Lima Igor Barbosa , Alvarenga Betania Mara , Tótaro Priscila Izabel Santos de , Boratto Fernanda , Leite Elaine Amaral , Guimaraes Pedro Pires Goulart
Published: May 2022

The high incidence of melanoma has received significant attention. Despite advances in early detection and standard treatment options, new strategies that improve therapy with reduced side effects are highly desirable. Several studies have demonstrated the efficiency of doxorubicin (Dox) to treat melanoma, however, side effects limit its clinical use. Drug delivery systems, especially nanostructured ones, are a useful approach to enhance antitumor activity and reduce the toxicity of drugs. Here, we report the use of calcium phosphate nanoparticles functionalized with Dox and hyaluronic acid (N-Dox) to enhance Dox antiproliferative activity. The effects were accessed in A-375 melanoma cells, in which N-Dox significantly decreased IC50 over 48 hours (0.142 ± 0.07) compared to the free drug (0.44 ± 0.25). Treatment triggered DNA damage, increased nuclear area, and senescent phenotype. Furthermore, it did not form colonies after 14 days of incubation preceded by short exposure treatment. These preliminary results indicate that N-Dox hold promise for melanoma treatment, reducing the minimum effective dose and perhaps a reduction in the cost of treatment.
Direct Visualization of Translesion DNA Synthesis Polymerase IV at the Replisome
Authors: Tuan Pham Minh , Gilhooly Neville , Marians Kenneth J. , Kowalczykowski Stephen C.
Published: May 2022

In bacterial cells, DNA damage tolerance is manifested by the action of translesion DNA polymerases that can synthesize DNA across template lesions that typically block the replicative DNA polymerase III. It has been suggested that one of these TLS DNA polymerases, DNA polymerase IV, can either act in concert with the replisome, switching places on the β sliding clamp with DNA polymerase III to bypass the template damage, or act subsequent to the replisome skipping over the template lesion in the gap in nascent DNA left behind as the replisome continues downstream. Evidence exists in support of both mechanisms. Using single-molecule analyses we show that DNA polymerase IV associates with the replisome in a concentration-dependent manner and remains associated over long stretches of replication fork progression under unstressed conditions. This association slows the replisome, requires DNA polymerase IV binding to the β clamp but not its catalytic activity, and is reinforced by the presence of the γ subunit of the β clamp-loading DnaX complex in the DNA polymerase III holoenzyme. Thus, DNA damage is not required for association of DNA polymerase IV with the replisome. We suggest that under stress conditions such as induction of the SOS response, the association of DNA polymerase IV with the replisome provides both a surveillance/bypass mechanism and a means to slow replication fork progression, thereby reducing the frequency of collisions with template damage and the overall mutagenic potential.

Significance

Damage to the nucleotide bases that make up the DNA in chromosomes creates a problem for their subsequent accurate duplication each time a cell divides. Typically, the cellular enzymatic machinery that replicates the DNA cannot copy a damaged base and specialized trans-lesion DNA polymerases, which are prone to making errors that result in mutations, are required to copy the damaged base, allowing replication to proceed. We demonstrate that the bacterial replisome, which is comprised of the enzymes required to replicate the chromosome, can associate with one of these specialized trans-lesion polymerases over long distances of replicated DNA. This association slows the speed of replication, thereby reducing the chance of mutations arising in the cell under conditions of stress.
Opposite polarity programs regulate asymmetric subsidiary cell divisions in grasses
Authors: Zhang Dan , Abrash Emily B. , Nunes Tiago D. G. , Prados Ines Hidalgo , Gil M. Ximena Anleu , Jesenofsky Barbara , Lindner Heike , Bergmann Dominique C. , Raissig Michael T.
Published: May 2022

Stomata are cellular pores on the leaf epidermis that Grass stomata recruit lateral subsidiary cells (SCs), which are key to the unique stomatal morphology and the efficient plant-atmosphere gas exchange in grasses. Subsidiary mother cells (SMCs) strongly polarise before an asymmetric division forms a SC. Yet apart from a proximal polarity module that includes PANGLOSS1 (PAN1) and guides nuclear migration, little is known regarding the developmental processes that form SCs. Using the genetic model grass Brachypodium distachyon, we identified BdPOLAR, which forms a novel, distal polarity domain in SMCs that is reciprocal to the proximal PAN1 domain. Both polarity domains are required for the formative SC division yet exhibit distinct roles in regulating pre-mitotic nuclear migration and SMC division plane orientation, respectively. Nonetheless, the domains are linked as the proximal domain controls polarisation of the distal domain. In summary, we identified two opposing polarity domains that coordinate the SC division, a process crucial for grass stomatal physiology.
Detection of M. tuberculosis in the environment as a tool for identifying high-risk locations for tuberculosis transmission
Authors: Verma Renu , Moreira Flora Martinez Figueira , Morais Agne Oliveira do Prado , Walter Katharine S. , Santos Paulo César Pereira dos , Kim Eugene , Soares Thiego Ramon , Araujo Rafaele Carla Pivetta de , Silva Bruna Oliveira da , Santos Andrea da Silva , Croda Julio , Andrews Jason R.
Published: May 2022

Tuberculosis (TB) remains a leading cause of infectious mortality globally, yet most cases cannot be epidemiologically linked even with extensive contact investigations and whole genome sequencing. Consequently, there remain major gaps in our understanding of where and when M. tuberculosis (Mtb) exposures occur. We aimed to investigate whether Mtb can be detected in environments where TB patients were recently present, which could serve as a tool for characterizing exposure risk. We collected 389 environment surface (ES) swabs from two high TB burden prisons in Brazil, sampling 41 (n=340) cells occupied by individuals with active TB and 7 (n=49) cells from individuals without TB. In a subset of pooled swabs (n=6) and a swab from a cigarette lighter from the cell with active TB patients, we enriched Mtb DNA using RNA-bait hybrid capture assays and performed whole genome sequencing. In prison cells, Mtb DNA was detected in 55/340 (16%) of ES swabs from cells occupied by active TB patients and none (0/49) from cells in which no active TB patients were present. Mtb was detected in 13/16 (81%) prison cells occupied by the individuals with high/medium sputum Xpert Mtb load and 8/25 (32%) with low/very low sputum Mtb load (p=0.003). Seven hybrid capture samples had a median genomic coverage of 140X. rpoB mutations conferring high-level rifampin resistance were detected in 3/7 ES swabs. Mtb was frequently detectable in environments recently occupied by individuals with active TB. This approach could be applied in congregate environments to identify and characterize high-risk settings for Mtb exposure.