bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in Nicotine Strength in Electronic Cigarettes Sold in the United States by Flavor, Product Type, and Manufacturer, 2017–2022
Authors: Wang Xu , Ghimire Ramesh , Shrestha Sundar S , Borowiecki Mateusz , Emery Sherry , Trivers Katrina F
Published: March 2023

Introduction

Most e-cigarettes contain highly addictive nicotine. This study assessed trends in nicotine strength in e-cigarettes sold in the United States during January 2017–March 2022.

Aims and Methods

We obtained January 2017–March 2022 national retail e-cigarette sales data from NielsenIQ. We assessed monthly average nicotine strength overall, by e-cigarette product and flavor type, and manufacturer. A Joinpoint regression model assessed the magnitude and significance of changes in nicotine strength.

Results

During January 2017–March 2022, monthly average nicotine strength of e-cigarette products increased from 2.5% to 4.4%, an average of 0.8% per month (p < .001). Monthly average nicotine strength of disposable e-cigarettes increased the most (average monthly percentage change [AMPC] = 1.26%, p < .001) as compared to prefilled pods (AMPC = 0.6%, p < .001) and e-liquids (AMPC = 0.5%, p = .218). Monthly average nicotine strength for all flavors of e-cigarette products increased except for mint-flavored products. Increases were greatest for beverage-flavored products (AMPC = 2.1%, p < .001), followed by menthol-flavored products (AMPC = 1.2%, p < .001). Among the top 10 e-cigarette manufacturers assessed, monthly average nicotine strength decreased for Juul Labs products from 5% to 4.7% (AMPC = −0.1%, p < .001) but increased significantly for five manufacturers’ products and remained unchanged at 5%–6% for four manufacturers’ products.

Conclusions

Monthly average nicotine strength of e-cigarette products increased overall, for most product and flavor types, and for some manufacturers in the United States during the study period. Imposing maximum limits on nicotine strength of e-cigarettes together with other evidence-based tobacco control strategies can help reduce the use of e-cigarettes among youth and increase tobacco product cessation among adults.

Implications

From January 2017 to March 2022, the monthly average nicotine strength of disposable e-cigarettes increased substantially and exceeded prefilled pods since May 2020. E-cigarettes with menthol flavor and youth-appealing flavors, like fruit, also had sharp increases in monthly average nicotine strength. Among the top 10 e-cigarette manufacturers, monthly average nicotine strength increased or remained unchanged at a high nicotine level for all manufacturers’ products, except Juul Lab’s products. Comprehensive strategies including restricting sales of all flavored e-cigarettes, restricting youth tobacco product access, and imposing maximum limits on nicotine strength may help reduce youth e-cigarette use and increase tobacco cessation.
Increased HIV Transmissions With Reduced Insurance Coverage for HIV Preexposure Prophylaxis: Potential Consequences ofBraidwood Management v. Becerra
Authors: Paltiel A David , Ahmed Ali R , Jin Elena Y , McNamara Meredithe , Freedberg Kenneth A , Neilan Anne M , Gonsalves Gregg S
Published: March 2023

A US federal court recently ruled against requiring health insurers to cover human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) under the Affordable Care Act. For every 10% decrease in PrEP coverage resulting from this ruling among US men who have sex with men, we estimate an additional 1140 HIV infections in the following year in that population.
Clinical Use of the Thematic Apperception Test and Other Non-Normed Idiographic Assessment Methods
Authors: Lewis Katie C. , Clemence A. Jill
Published: March 2023

Performance-based assessment methods provide important insight into psychological functioning in ways that differ from those afforded by more structured tasks. Data obtained through performance-based methods can reveal the underlying issues, concerns, and preoccupations that are salient in understanding a respondent’s personality functioning and provide important insight into how they integrate information, approach novel situations and dilemmas, and utilize internal resources to achieve desired outcomes or avoid undesirable ones. This chapter reviews several commonly used performance-based measures, including the Thematic Apperception Test (TAT), Early Memories Task, and human figure drawing tasks. The chapter explores how data yielded by these measures can assist clinicians in evaluating patterns of personality that unfold over time and across relational contexts and identifies how contextual factors might influence trait expression in ways that are otherwise difficult to determine in assessment contexts. The chapter reviews the history, administration process, and general scoring and interpretation procedures of these measures, focusing primarily on the TAT, and provides a discussion of the limitations of these measures and areas in need of further study and development.
Changes in sexual function over 12 months after native-tissue vaginal pelvic organ prolapse surgery with and without hysterectomy
Authors: Chang Olivia H , Yao Meng , Ferrando Cecile A , Paraiso Marie Fidela R , Propst Katie
Published: March 2023

Background

There is a need to determine how preoperative sexual activity, uterine preservation, and hysterectomy affect sexual function after pelvic organ prolapse surgery.

Aim

(1) To determine changes in sexual function in women, stratified by preoperative sexual activity status, after native-tissue pelvic organ prolapse surgery. (2) To examine the impact of hysterectomy and uterine preservation on sexual function. (3) To determine predictors for postoperative dyspareunia.

Methods

This was a planned secondary analysis of a prospective cohort study. Sexual function was evaluated preoperatively and 6 and 12 months postoperatively. Sexual function was compared between those who had a hysterectomy and those who had uterine-preserving prolapse surgery. A logistic regression analysis was performed to assess predictors for dyspareunia.

Outcomes

Pelvic Organ Prolapse–Urinary Incontinence Sexual Function Questionnaire.

Results

At 12 months, 59 patients underwent surgery and were followed up (hysterectomy [n = 28, 47.5%] vs no hysterectomy [n = 31, 52.5%]; sexually active [n = 26, 44.1%] vs non–sexually active [n = 33, 55.9%]). Of those who did not undergo a hysterectomy, 17 (54.8%) had a uterine-preserving procedure. At 12 months, sexually active patients had significant improvement in sexual function (mean ± SD, 0.37 ± 0.43; P = .005), while non–sexually active patients reported significant improvement in satisfaction of sex life (P = .04) and not feeling sexually inferior (P = .003) or angry (P = .03) because of prolapse. No variables were associated with dyspareunia on bivariate analysis.

Clinical Implications

It did not appear that either uterine preservation or hysterectomy had any impact on sexual function. There was a 10% increase in people who were sexually active after surgery.

Strengths and Limitations

The major strength of our study is the use of a condition-specific validated questionnaire intended for sexually active and non–sexually active women. We interpreted our results utilizing a validated minimal clinically important difference score to provide interpretation of our results with statistical and clinical significance. The limitation of our study is that it was a secondary analysis that was not powered for these specific outcomes.

Conclusion

At 12 months, for patients who were sexually active preoperatively, there was a clinically meaningful improvement in sexual function after native-tissue pelvic organ prolapse surgery. Non–sexually active women reported improvement in satisfaction of sex life. There was no difference in the sexual function of patients undergoing uterine preservation or posthysterectomy colpopexy when compared with those with concurrent hysterectomy, though this sample size was small.
Grading the severity of anaphylaxis
Authors: Stafford Aisling , Turner Paul J.
Published: March 2023

Purpose of review

Despite no global consensus on a definition of anaphylaxis, there is increasing recognition that just as allergic reactions lie on a spectrum of severity, the same is for anaphylaxis. A variety of severity scores exist in the literature. We review the approaches taken to develop these scores, and their relative advantages and disadvantages.

Recent findings

There have been four recent comparisons of published severity scores. All have highlighted the heterogeneity between scoring systems, and the lack of transferability from one approach to another. Notably, only one score has been developed using a data-driven approach, and none has undergone formal and comprehensive validation.

It is unclear whether a single severity score is achievable, or indeed desirable. If the aim is to guide management of acute reactions, then assignment of severity is not only unnecessary but might delay treatment and cause harm. Severity scores are needed in the research setting, but require an approach which can discriminate between reactions of similar but nonidentical severity (particularly, nonanaphylaxis reactions). Any approach should be fit for purpose, informed by patient and clinician experience, and ideally be data-driven to minimize subjective bias and facilitate objective validation.
Compassionate Care for Parents Experiencing Miscarriage in the Emergency Department
Authors: Emond Tina , de Montigny Francine , Webster Jessica , Zeghiche Sabrina , Bossé Mylène
Published: March 2023

In many countries, parents experiencing miscarriage seek treatment in the emergency department (ED). Parents frequently report dissatisfaction with ED care, while nurses report not knowing how to provide optimal care. This article describes the development of a situation-specific theory, Compassionate care for parents experiencing miscarriage in the ED, based on 4 concepts (change trigger, transition properties, conditions of change, and interventions). This theory evolved from a comprehensive review of the literature, 2 empirical studies, Transitions Theory, and collaborative efforts of an experienced team. The detailed theory development process facilitates its integration in practice and supports new theory development.
Self-Reported Cycling Performance and Impact on Falls in Persons With Bilateral Vestibulopathy
Authors: Danneels Maya , van de Berg Raymond , Leyssens Laura , Van Hecke Ruth , Dhooge Ingeborg , Cambier Dirk , Van Rompaey Vincent , Maes Leen
Published: March 2023

Objectives:

The aim of this study was to investigate cycling skills, cycling difficulties, fall concern, and fall history while cycling in persons with bilateral vestibulopathy.

Design:

Fifty-one persons with bilateral vestibulopathy and 51 healthy control subjects filled out a questionnaire about cycling abilities. This questionnaire consisted of four parts: (1) general information about audiovestibular function, vision, and physical activity; (2) general cycling abilities, history, and difficulties; (3) fall concern while cycling in various situations; and (4) fall history.

Results:

Out of the 51 patients, 61% found riding a bicycle difficult, 29% were not able to cycle anymore, and 10% reported not having any problems riding a bicycle. Their mean cycling time decreased from 3.15 hrs weekly before to 1.27 hrs weekly after disease onset (p = 0.002). The latter also differed significantly from the mean cycling time of 3.51 hrs weekly in control subjects (p < 0.001). The main complaints while cycling were not being able to look behind (88%), having difficulties with visually stabilizing the environment (65%), and not being able to ride in a straight line (61%). The fall concern was significantly higher in the patient group, with cycling in the dark and at dusk, and turning the head as their main concerns (p < 0.001). Falls and near-falls were respectively reported in 50% and 65% of the patient group. Only the latter differed significantly from the control group. However, the number of reported falls differed significantly between both groups.

Conclusions:

This study demonstrates cycling difficulties in persons with bilateral vestibulopathy, related to problems with postural control and gaze stabilization. Knowledge about specific complaints and triggers is important to prevent future falls. A combination of coping strategies and aids, with vestibular rehabilitation focused on gaze stabilization might be considered, as well as avoidance of cycling in specific cases.
External Validation and Comparison of a General Ward Deterioration Index Between Diversely Different Health Systems
Authors: Cummings Brandon C. , Blackmer Joseph M. , Motyka Jonathan R. , Farzaneh Negar , Cao Loc , Bisco Erin L. , Glassbrook James D. , Roebuck Michael D. , Gillies Christopher E. , Admon Andrew J. , Medlin Richard P. , Singh Karandeep , Sjoding Michael W. , Ward Kevin R. , Ansari Sardar
Published: March 2023

OBJECTIVES:

Implementing a predictive analytic model in a new clinical environment is fraught with challenges. Dataset shifts such as differences in clinical practice, new data acquisition devices, or changes in the electronic health record (EHR) implementation mean that the input data seen by a model can differ significantly from the data it was trained on. Validating models at multiple institutions is therefore critical. Here, using retrospective data, we demonstrate how Predicting Intensive Care Transfers and other UnfoReseen Events (PICTURE), a deterioration index developed at a single academic medical center, generalizes to a second institution with significantly different patient population.

DESIGN:

PICTURE is a deterioration index designed for the general ward, which uses structured EHR data such as laboratory values and vital signs.

SETTING:

The general wards of two large hospitals, one an academic medical center and the other a community hospital.

SUBJECTS:

The model has previously been trained and validated on a cohort of 165,018 general ward encounters from a large academic medical center. Here, we apply this model to 11,083 encounters from a separate community hospital.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The hospitals were found to have significant differences in missingness rates (> 5% difference in 9/52 features), deterioration rate (4.5% vs 2.5%), and racial makeup (20% non-White vs 49% non-White). Despite these differences, PICTURE’s performance was consistent (area under the receiver operating characteristic curve [AUROC], 0.870; 95% CI, 0.861–0.878), area under the precision-recall curve (AUPRC, 0.298; 95% CI, 0.275–0.320) at the first hospital; AUROC 0.875 (0.851–0.902), AUPRC 0.339 (0.281–0.398) at the second. AUPRC was standardized to a 2.5% event rate. PICTURE also outperformed both the Epic Deterioration Index and the National Early Warning Score at both institutions.

CONCLUSIONS:

Important differences were observed between the two institutions, including data availability and demographic makeup. PICTURE was able to identify general ward patients at risk of deterioration at both hospitals with consistent performance (AUROC and AUPRC) and compared favorably to existing metrics.
Ureteroscopy during pregnancy under local anesthesia and light sedation: Technique and video
Authors: Juliebø-Jones Patrick , Beisland Christian , Gjengstø Peder , Maheswaran Rachel , Ulvik Øyvind
Published: March 2023

Ureteroscopy during pregnancy has become increasingly recognized as a safe intervention. Performing it under local anesthesia and light sedation reduces the risks associated with general or regional anesthesia, such as difficult airway scenarios, hypothermia, and hypotension. In addition, this approach reduces the total amount of fetal exposure to medications and anesthetic agents. Performing ureteroscopy in this manner requires a number of adjustments and modifications to the standard technique. This article provides a summary in a step-by-step format, as well as an accompanying video demonstration.
New insights into decidualization: immunological and genetic factors
Authors: Cuadrado-Torroglosa Isabel , García-Velasco Juan Antonio , Alecsandru Diana
Published: March 2023

Purpose of review

Nowadays, there are many efforts focused on improving embryo quality for assisted reproduction treatments. Nevertheless, there are important maternal aspects, such as decidualization, also essential for pregnancy, often forgotten. With this review, we intend to highlight the main events involved in this endometrial phenomenon, as well as the cells and molecules that have recently been related to it.

Recent findings

Decidualization entails a complete transformation of the endometrium, with recent research reaffirming progesterone as its main molecular trigger. Certain immune components and membrane molecules have also been found to play a role in it, notably the killer immunoglobulin-like receptors (KIR) of uterine natural killer (uNK) cells, as well as the human leukocyte antigen (HLA)-F.

Progesterone directs the cellular changes that take place during decidualization, as well as the recruitment and maturation of uNKs, along with the coordinated action of interleukin-15. Likewise, the role of KIR and HLA-F in this process and in the subsequent development of pregnancy is being highlighted in many studies, with effects on reproductive outcomes related to the different genotypes of these molecules.
Pap smear recommendations in older women, does the data support stopping?
Authors: Grabinski Emma , Dunsmoor-Su Rebecca
Published: March 2023

Purpose of review

To review the recommendations for cervical cancer screening in older women and to determine the evidence upon which the current and emerging recommendations are based on. To evaluate the possible consequences of stopping cervical cancer screening in older women.

Recent findings

Recommendations are to space cervical cancer screening intervals for women aged 21–65 and stop in women older than 65. Cervical cancer incidence and mortality burden are significant in women over the age of 65. Human papillomavirus (HPV) vaccination rates are poor in older women. Advanced cervical cancer rates are increasing, including adenocarcinoma rates. Vulvar carcinoma rates are also increasing, and gynecological care and exams are less frequent when women are not getting routine pap testing.

The current review shows that there is limited evidence on which to base the recommendation to stop screening. There is confusion among patients and physicians, and other healthcare providers over who to screen and when, and this is exacerbating the already known difficulty accessing healthcare among racial and ethnic minorities, underinsured, and rural populations, but rates of cancer are also rising most rapidly in white women. Recommendations to space or stop screening are often based on the perceived psychological distress of women undergoing testing and the cost of population screening.
Peripartum cardiomyopathy: risk factors and predictors of outcome
Authors: Viljoen Charle , Hoevelmann Julian , Sliwa Karen
Published: March 2023

Purpose of review

Peripartum cardiomyopathy (PPCM) contributes significantly to maternal morbidity and mortality worldwide. In this review, we describe the present-day epidemiology and current understanding of the pathogenesis of PPCM. We provide an updated approach to diagnosis and management of PPCM, and discuss risk factors and predictors of outcome.

Recent findings

The highest incidences of PPCM have been reported in African, Asian, and Caribbean populations. Contemporary literature supports a ‘two-hit’ hypothesis, whereby the ‘first hit’ implies a predisposition, and the ‘second hit’ refers to an imbalanced peripartal hormonal milieu that results in cardiomyopathy. Whereas a half of patients will have left ventricular (LV) recovery, a tenth do not survive. Clinical findings and special investigations (ECG, echocardiography, cardiac MRI, biomarkers) can be used for risk stratification. Frequent prescription of guideline-directed medical therapy is associated with improved outcomes.

Despite advances in elucidating the pathogenesis of PPCM, it remains unclear why only certain women develop the disease. Moreover, even with better diagnostic work-up and management, it remains unknown why some patients with PPCM have persistent LV dysfunction or die. Future research should be aimed at better understanding of the mechanisms of disease and finding new therapies that could improve survival and LV recovery.
Expectations of Patients and Their Families After the Treatment of Substance Use Disorder
Authors: Alenezi Atallah
Published: March 2023

Background

Substance use disorders are economically and socially devastating to families and societies. Expectations of the patients and their families during the posttreatment phase of substance use disorder need to be emphasized to maintain a patient's sobriety and prevent relapse.

Aim

The aim of this study was to examine the prediction power of personal and sociodemographic factors of patients and their families to treatment outcomes.

Methods

A descriptive, correlational, cross-sectional design was used. Data were collected from 80 patients treated for substance use disorders from a major psychiatric hospital and their family members regarding social, health, and psychological expectations. A three-step multiple hierarchical regression analysis was used to predict the power of personal and sociodemographic characteristics of patients' and their families' expectations to treatment outcomes.

Results

Heroin use, codeine use, family education, and family support were significant predictors of rehabilitation expectation (p < .05). Level of education and heroin use were predictors for lower levels of rehabilitation expectation, whereas family support and codeine use were indicators for higher scores of rehabilitation expectation.

Conclusion

Emphasis should be given to expectations of the patient and their family through appropriate psychoeducation and enhanced understanding and partnership.
Familial hypercholesterolemia: The nexus of endothelial dysfunction and lipoprotein metabolism in COVID-19
Authors: Vuorio Alpo , Raal Frederick , Kovanen Petri T.
Published: March 2023

Purpose of review

Patients with heterozygous familial hypercholesterolemia (HeFH) are at increased risk for COVID-19 cardiovascular complications in the acute phase of the infection. Elevated levels of LDL-C and often lipoprotein(a) are present from birth and lead to endothelial dysfunction, which is aggravated by a direct viral attack of the endothelial cells and their exposure to the toxic levels of circulating proinflammatory and prothrombotic mediators during the hyperinflammatory reaction typical of COVID-19.

Recent findings

Evidence to date shows the benefit of lipid-lowering therapy in patients with COVID-19. In HeFH patients who are at much higher cardiovascular risk, the focus should, therefore, be on the effective lowering of LDL-C levels, the root cause of the greater cardiovascular vulnerability to COVID-19 infection in these patients. The ongoing use of statins and other lipid-lowering therapies should be encouraged during the ongoing COVID pandemic to mitigate the risk of cardiovascular complications from COVID-19, particularly in HeFH patients.

Epidemiologic registry data show that the incidence of myocardial infarction is increased in SARS-CoV-2-infected HeFH patients. There is a need to study whether the risk for acute cardiovascular events is increased in the long-term and if there are changes in lipid metabolism after SARS-CoV infection(s) in patients with HeFH.
“Fighting for the Last Gasp”—Severe Borderline Personality Disorder and Posttraumatic Stress Disorder, Chronic Deliberate Ingestion of Foreign Bodies, and Palliative Struggles in Intensive Care
Authors: Vourliotis Christopher , Ng Faith , Bruxner George
Published: March 2023

Repeated deliberate ingestion of foreign bodies can have tragic long-term consequences. We report the case of a young woman with borderline personality disorder and chronic posttraumatic stress disorder, whose chronic repeated ingestion of razor blades and batteries eventually resulted in severe medical complications. We focus on the involvement of the consultation-liaison psychiatry team as part of her multidisciplinary care, predominantly in the intensive care environment. Her care posed extensive challenges due to the retraumatizing effects of the intensive care environment and the measures required to provide life-sustaining care when the young woman was emotionally dysregulated. Strategies used to address team dynamics and “compassion fatigue” are discussed, including some pertinent relevant literature that was used as educational material for staff to develop a better understanding of the confronting and apparently self-defeating antitherapeutic behavior she frequently displayed. The consultation-liaison psychiatry team has a significant role to play in such situations, carefully balancing patient advocacy roles while simultaneously supporting staff who may be vicariously traumatized by the substantial emotional challenges of providing care in these circumstances.
Motor Proficiency, Manual Dexterity, and Visual Perception in School-age Children With ADHD: Contribution of Different Comorbidities
Authors: Şahan Nilay , Atasavun Uysal Songül , Çak Halime T.
Published: March 2023

Attention-deficit/hyperactivity disorder (ADHD) is often comorbid with a number of other psychiatric conditions. The goal of this study was to investigate whether motor skills, manual dexterity, and visual perception differ in the presence of ADHD and comorbid psychiatric conditions in school-age boys by comparing them to a group of children with typical development (TD). We evaluated 81 boys 6 to 10 years of age in 5 groups: ADHD only (n=18); ADHD+specific learning disorders (ADHD+SLDs) (n=17); ADHD+oppositional defiant disorder (n=16); ADHD+anxiety disorders (n=15); and TD (n=15). The participants with ADHD only and those with ADHD+comorbidity had significantly lower scores than the participants in the TD group in every area we evaluated. The lowest scores were observed in the ADHD+SLD group in all motor skills domains except for the fine motor precision field. Furthermore, the group with ADHD+SLD had statistically significantly lower scores than the 3 other groups with ADHD+comorbidity in 3 areas: balance, upper extremity coordination, and speed and agility. Motor problems in patients with ADHD and comorbid conditions may not be a focus of attention in clinics. However, especially in the case of comorbid conditions accompanying ADHD, it is important to consider problems in motor skills, manual dexterity, and visual perception in evaluation and treatment to increase these children’s quality of life.
A Proposal to Optimize Satisfaction and Adherence in Group Fitness Programs For Patients With Major Depressive Disorder
Authors: Bandara Nilanga Aki , Huen Nicholas , Vallani Tanisha , Herath Jay , Jhauj Ricky
Published: March 2023

It is clear that exercise can be a source of great support for patients with major depressive disorder. However, it is important to recognize that several multifactorial and intersecting challenges are associated with exercise for this patient population. Group fitness programs for this patient population have the potential to be cost-effective while serving as an avenue of social interaction for participants. From an administrative perspective, it is challenging to balance satisfaction and adherence in group fitness programs targeting patients with major depressive disorder. This article presents a proposal that highlights what the challenges may look like in practice and discusses 3 strategies for improving satisfaction and adherence with a group fitness program: diagnosis and needs assessment, exercise diversity, and ongoing evaluation.
Cerebrospinal Fluid HIV-1 Escape in Patients With Neurocognitive Symptoms: Pooled Data From a Neuro-HIV Platform and the NAMACO Study
Authors: Filippidis Paraskevas , Damas Jose , Viala Benjamin , Assal Frederic , Nawej Tshikung Olivier , Tarr Philip , Derfuss Tobias , Oberholzer Michael , Jelcic Ilijas , Hundsberger Thomas , Sacco Leonardo , Cavassini Matthias , Du Pasquier Renaud , Darling Katharine E.A. ,   the NAMACO study group, Swiss HIV Cohort Study
Published: March 2023

Background:

Despite modern antiretroviral therapy, human immunodeficiency virus-1 (HIV-1) ribonucleic acid (RNA) escape into the cerebrospinal fluid (CSF) may occur. We examined the prevalence of and factors associated with CSF HIV-1 escape among people living with HIV (PLWH) in Switzerland.

Setting:

The Neurocognitive Assessment in the Metabolic and Aging Cohort study is an ongoing, prospective, longitudinal, multicenter study within the Swiss HIV Cohort Study. The neuro-HIV platform is a multidisciplinary, single-day outpatient consultation at Lausanne University Hospital.

Methods:

We pooled data from the Neurocognitive Assessment in the Metabolic and Aging Cohort study and the neuro-HIV platform participants who underwent lumbar puncture between 2011 and 2019. Both patient groups had neurocognitive symptoms. Cerebrospinal fluid HIV-1 escape was defined as the presence of quantifiable CSF HIV-1 RNA when plasma HIV-1 RNA was suppressed or CSF HIV-1 RNA greater than plasma HIV-1 RNA when the latter was detectable.

Results:

Of 1166 PLWH assessed, 288 underwent lumbar puncture. Cerebrospinal fluid HIV-1 escape was observed in 25 PLWH (8.7%) of whom 19 (76%) had suppressed plasma HIV-1 RNA. Characteristics of PLWH were comparable whether they had CSF HIV-1 escape or not, including comorbidities, time since HIV diagnosis (15 vs 16 years, P = 0.9), median CD4 nadir (158.5/mm3 vs 171/mm3, P = 0.6), antiretroviral CSF penetration-effectiveness score (7 vs 7 points, P = 0.8), and neurocognitive diagnosis based on Frascati criteria and radiological findings.

Conclusions:

In this large pooled sample of PLWH with neurocognitive symptoms, CSF HIV-1 escape occurred in 8.7% of PLWH. People living with HIV with CSF HIV-1 escape presented no distinctive clinical or paraclinical characteristics. We conclude that lumbar puncture is unavoidable in confirming CSF HIV-1 escape.
Partial Response Upon Peptide Receptor Radionuclide Therapy in a Highly Proliferative Pancreatic Neuroendocrine Tumor
Authors: Weich Alexander , Serfling Sebastian E. , Rowe Steven P. , Solnes Lilja B. , Buck Andreas K. , Higuchi Takahiro , Werner Rudolf A.
Published: March 2023

We report on a patient diagnosed with an aggressive pancreatic neuroendocrine tumor (NET G3; Ki67 = 60%), who underwent pancreatic resection with partial removal of liver lesions. The patient refused chemotherapy. Dual-tracer imaging with 18F-FDG and somatostatin receptor (SSTR)-targeted PET/CT was conducted. Radiotracer accumulation on both imaging modalities in bilobar hepatic lesions was observed. “Cold” somatostatin analogues with four cycles of peptide receptor radionuclide therapy (PRRT) were initiated, leading to partial response. Even in highly proliferative but differentiated G3 NET (Ki67>55%), SSTR expression in sites of disease should be evaluated, which may then allow PRRT, even as first-line systemic treatment.
Chest Wall Keloids Depicted by 18F-Piflufolastat PET/CT Imaging
Authors: Nguyen Amanda , Martinez Felipe , Nguyen Ba D.
Published: March 2023

Keloids are pathological scars from exuberant fibroproliferative collagen response and excessive extracellular matrix production usually extending beyond the original wound margins. Although keloids are mostly of dermatological concern, they could be incidentally depicted on scintigraphic planar and PET/CT imaging and could mimic other types of skin diseases. The authors present a case of chest wall keloids documented on18F-piflufolastat PET/CT during the evaluation of prostate cancer recurrence.
An Initial Analysis of the Baseline Levels of Dd-cfDNA After Pancreas Transplantation: A Prospective Study From High-volume Centers in the United States
Authors: Yoo Ashley , Riedel Alexandria , Qian Ian , Bartosic Amanda , Soltani Rudi , Kibria Gulam , Haririan Abdolreza , Drachenberg Cinthia B. , Abrams Peter L. , Odorico Jon S. , Cooper Matthew , Bromberg Jonathan S. , Scalea Joseph R.
Published: March 2023

Background.

Pancreas transplantation offers patients with diabetes an opportunity for glucose homeostasis. Current blood tests to surveil for rejection have poor sensitivity and specificity for identifying rejection, and pancreas biopsies are challenging and associated with morbidity and graft loss. Donor-derived cell-free DNA (dd-cfDNA) is shed from transplanted organs and detectable in peripheral blood. Thus, a potential dd-cfDNA blood test assessing rejection would be clinically advantageous.

Methods.

One hundred eighty-one dd-cfDNA samples (n) were collected from 77 patients (N) up to 132 mo posttransplant.

Results.

The median dd-cfDNA level among all subjects was 0.28% (0.13%, 0.71%). In simultaneous pancreas-kidney (SPK) transplant recipients, the median dd-cfDNA level was 0.29% (0.13%, 0.71%), and it was 0.23% (0.08%, 0.71%) in pancreas transplant alone (PTA) recipients. When isolating for when without infection or rejection, the median dd-cfDNA level was 0.28% (0.13%, 0.64%) for SPK and 0.20% (0.00%, 0.32%) for PTA. Both transplant types approached 1.0% ≤1 mo posttransplant followed by a decrease in median dd-cfDNA. During episodes of rejection or infection, median dd-cfDNA levels were greater among all transplant types.

Conclusions.

The mean dd-cfDNA level for all pancreas transplant recipients is <1.0%, consistent with the published kidney transplant rejection threshold (>1.0%), regardless of SPK or PTA. Early posttransplant dd-cfDNA levels are transiently higher than later measurements. Dd-cfDNA elevation also correlates with rejection and infection and thus is a promising biomarker for surveilling pancreas transplant dysfunction.
Croceibacterium selenioxidans sp. nov., isolated from seleniferous soil
Authors: Hong Mengjuan , Luo Xiong , Fan Rongrong , An Lijin , Li Qiushi , Zhang Xiaoyan , Xu Mingzhu , Lan Yan , Shi Heli , Li Mingshun
Published: March 2023

A Gram-negative, aerobic bacterial strain, designated LX-88T, was isolated from seleniferous soil in Enshi, Hubei Province, PR China. Strain LX-88Toxidized elemental selenium to selenite, and produced carotenoids but not bacteriochlorophyll. The isolate grew optimally at 28 °C, pH 8.0 and with 0.5 % (w/v) NaCl. Phylogenetic analysies of the organism’s 16S rRNA and bacterial core gene set sequences indicated that LX-88T belongs to the genus

Croceibacterium

, and has the highest degree of 16S rRNA gene sequence similarity to

Croceibacterium soli

MN-1T (97.4 %). The LX-88T genome was 3.4 Mbp and had a G+C content of 63.6 mol%. The average nucleotide identity and digital DNA–DNA hybridization values showed low relatedness (below 95 and 70 %, respectively) between strain LX-88T and other strains in the genus

Croceibacterium

. Ubiquinone-10 was the predominant quinone. The polar lipid profile was dominated by diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, sphingoglycolipid, an unidentified aminolipid, an unidentified phospholipid and an unidentified lipid. The major fatty acid was summed feature 8 (C18 : 1
 ω7c and/or C18 : 1
 ω6c). These physiological and biochemical tests facilitated the differentiation of strain LX-88T from other members of the genus

Croceibacterium

. The results of this multifaceted taxonomic study indicate that strain LX-88T represents a novel species in the genus

Croceibacterium

, for which the name Croceibacterium selenioxidans sp. nov. is proposed. The type strain is LX-88T (=MCCC 1K08007T=LMG 32570T).
Dyadobacter chenhuakuii sp. nov., Dyadobacter chenwenxiniae sp. nov., and Dyadobacter fanqingshengii sp. nov., isolated from soil of the Qinghai-Tibetan Plateau
Authors: Ma Caiyun , Zhang Gui , Cheng Yanpeng , Lei Wenjing , Yang Caixin , Liu Yue , Yang Jing , Lu Shan , Jin Dong , Liu Liyun , Xu Jianguo
Published: March 2023

Six novel bacterial strains, designated CY22T, CY357, LJ419T, LJ53, CY399T and CY107 were isolated from soil samples collected from the Qinghai–Tibetan Plateau, PR China. Cells were aerobic, rod-shaped, yellow-pigmented, catalase- and oxidase-positive, Gram-stain-negative, non-motile and non-spore-forming. All strains were psychrotolerant and could grow at 0 °C. The results of phylogenetic and phylogenomic analyses, based on 16S rRNA gene sequences and core genomic genes, indicated that the three strain pairs (CY22T/CY357, LJ419T/LJ53 and CY399T/CY107) were closely related to members of the genus

Dyadobacter

and clustered tightly with two species with validly published names,

Dyadobacter alkalitolerans

12116T and

Dyadobacter psychrophilus

BZ26T. Values of digital DNA–DNA hybridization between genome sequences of the isolates and other strains from the GenBank database in the genus

Dyadobacter

were far below the 70.0 % threshold. The genomic DNA G+C content of these six strains ranged from 45.2 to 45.8 %. The major cellular fatty acids of all six strains were iso-C15 : 0 and summed feature 3 (comprising C16 : 1
ω7c and/or C16 : 1
ω6c). MK-7 was the only respiratory quinone, and phosphatidylethanolamine was the predominant polar lipid for strains CY22T, LJ419T and CY399T. On the basis of the phenotypic, phylogenetic and genomic evidence presented, these six strains represent three novel members of the genus

Dyadobacter

, for which the names Dyadobacter chenhuakuii sp. nov., Dyadobacter chenwenxiniae sp. nov. and Dyadobacter fanqingshengii sp. nov. are proposed. The type strains are CY22T (= GDMCC 1.3045T = KCTC 92299T), LJ419T (= GDMCC 1.2872T = JCM 33794T) and CY399T (= GDMCC 1.3052T = KCTC 92306T), respectively.
Legionellapneumophila induces methylomic changes in ten-eleven translocation to ensure bacterial reproduction in human lung epithelial cells
Authors: Guirgis Sherry A. , El-Halfawy Khalil A. , Alalem Mai , Khalil Hany
Published: March 2023

Introduction.

Legionella pneumophila

is a Gram-negative flagellated bacteria that can infect human lungs and cause a severe form of pneumonia named Legionnaires' disease.

Hypothesis. We hypothesize that

L. pneumophila

infection induces methylomic changes in methylcytosine dioxygenases, ten-eleven translocation (TET) genes, and controls DNA methylation following infection.

Aim. In the current research, we sought to further investigate DNA methylation changes in human lung epithelial cells upon

L. pneumophila

infection and determine how methylation inhibitor agents disturb

L. pneumophila

reproduction.

Methodology. A549 cell line was used in

L. pneumophila

infection and inhibitors' treatment, including 5-azacytidine (5-AZA) and (-)-epigallocatechin-3-O-gallate (EGCG).

Results. Interestingly, DNA methylation analysis of infected A549 using sodium bisulfite PCR and the methylation-sensitive HpaII enzyme showed potential methylation activity within the promoter regions of ten-eleven translocation (TET) genes located on CpG/397–8 and CpG/385–6 of TET1 and TET3, respectively. Such methylation changes in TET effectors decreased their expression profile following infection, indicated by quantitative real-time PCR (RT-qPCR), immunoblotting and flow cytometry. Furthermore, pre-treatment of A549 cells with 5-AZA or EGCG significantly decreased the bacterial reproduction characterized by the expression of

L. pneumophila

16S ribosomal RNA and the c.f.u. ml−1 of bacterial particles. Moreover, both methylation inhibitors showed potent inhibition of methionine synthase (MS) expression, which was further confirmed by the docking analysis of inhibitor ligands and crystal structure of MS protein.

Conclusion. These data provide evidence for the methylomic changes in the promoter region of TET1 and TET3 by

L. pneumophila

infection in the A549 cell line and suggest the anti-bacterial properties of 5-AZA and EGCG, as methylation inhibitors, are due to targeting the epigenetic effector methionine synthase.
Insights into the genomic evolution and the alkali tolerance mechanisms of Agaricus sinodeliciosus by comparative genomic and transcriptomic analyses
Authors: Ling Zhi-Lin , Cao Bin , Hu Song-Nian , Geng Jia-Ning , Liu Fei , Liu Dong-Mei , Zhao Rui-Lin
Published: March 2023

Agaricus sinodeliciosus is a rare wild edible mushroom from northwest China, and grows naturally in mild saline-alkali soil, which is also unusual in mushrooms. A. sinodeliciosus represents a potential model organism for explaining saline-alkali tolerance mechanisms and revealing related physiological processes in mushrooms. Here, we provide a high-quality genome of A. sinodeliciosus. Comparative genomic analyses reveal A. sinodeliciosus has numerous changes to its genome organization after a solitary evolutionary history under saline-alkali environments, such as gene family contraction, retrotransposon expansion and rapid evolution of adaptative genes. Our saline and alkali tolerance tests show that mycelium growth and fruit body formation of this species are effected by mild alkalinity. Transcriptomic analyses reveal that genes involved in carbon and nitrogen utilization, cell stability and fruit body formation of A. sinodeliciosus could be activated under mildly alkaline conditions. In particular, the ‘starch and sucrose metabolism’, ‘biosynthesis of amino acids’ and ‘phenylpropanoid biosynthesis’ pathways are important for mildly alkaline tolerance of A. sinodeliciosus. Like plants and arbuscular mycorrhizal fungi, in the rot fungus A. sinodeliciosus, the biosynthesis of intracellular small molecules could be enhanced to counter osmotic and oxidative stresses caused by mild alkalinity, and the biosynthesis of monolignol could be suppressed to increase cell wall infiltrates under mildly alkaline conditions. This research provides an understanding of the genomic evolution and mechanisms of A. sinodeliciosus in tolerance to saline-alkali environments. The A. sinodeliciosus genome constitutes a valuable resource for evolutionary and ecological studies of Agaricus.
Reproductive Experiences and Cardiovascular Disease Care in Pregnancy Capable and Post-Menopausal Individuals: Insights from the American Heart Association Research Goes Red Registry
Authors: Rao Shiavax J. , Kwapong Yaa A. , Boakye Ellen , Mallya Pratheek , Zhao Juan , Akel William , Hong Haoyun , Li Shen , Oyeka Chigolum P. , Metlock Faith Elise , Ouyang Pamela , Blumenthal Roger S. , Nasir Khurram , Khandelwal Abha , Kinzy Claire , Mehta Laxmi S. , Roger Veronique L. , Hall Jennifer L. , Sharma Garima
Published: March 2023

Background

Information on reproductive experiences and awareness of adverse pregnancy outcomes (APOs) and cardiovascular disease (CVD) risk among pregnancy-capable and post-menopausal individuals has not been well described. We sought to evaluate preconception health and APO awareness in a large population-based registry.

Methods

Data from the Fertility and Pregnancy Survey of the American Heart Association Research Goes Red Registry (AHA-RGR) were used. Responses to questions pertaining to prenatal health care experiences, postpartum health, and awareness of the association of APOs with CVD risk were used. We summarized responses using proportions for the overall sample and by stratifications, and we tested differences using the Chi-squared test.

Results

Of 4,651individuals in the AHA-RGR registry, 3,176 were of reproductive age, and 1,475 were postmenopausal. Among postmenopausal individuals, 37% were unaware that APOs were associated with long-term CVD risk. This varied by different racial/ethnic groups (non-Hispanic White: 38%, non-Hispanic Black: 29%, Asian: 18%, Hispanic: 41%, Other: 46%;P= 0.03). Fifty-nine percent of the participants were not educated regarding the association of APOs with long-term CVD risk by their providers. Thirty percent of the participants reported that their providers did not assess pregnancy history during current visits; this varied by race-ethnicity (P= 0.02), income (P= 0.01), and access to care (P= 0.02). Only 37.1% of the respondents were aware that CVD was the leading cause of maternal mortality.

Conclusions

Considerable knowledge gaps exist in the association of APOs with CVD risk, with disparities by race/ethnicity, and most patients are not educated on this association by their health care professionals. There is an urgent and ongoing need for more education on APOs and CVD risk, to improve the health-care experiences and postpartum health outcomes of pregnant individuals.
Neural processing of bottom up perception of biological motion under attentional load
Authors: Nizamoglu Hilal , Urgen Burcu A.
Published: March 2023

Considering its importance for one’s survival and social significance, biological motion (BM) perception is assumed to occur automatically. Indeed, Thornton and Vuong (2004) showed that task-irrelevant BM in the periphery interfered with task performance at the fovea. However, the neural underpinnings of this bottom-up processing of BM lacks thorough examination in the field. Under selective attention, BM perception is supported by a network of regions including the occipito-temporal, parietal, and premotor cortices. A retinotopy mapping study on BM showed distinct maps for its processing under and away from selective attention (Saygin & Sereno, 2008). Based on these findings, we investigated how bottom-up perception of BM would be processed in the human brain under attentional load when it was shown away from the focus of attention as a task-irrelevant stimulus. Participants (N=31) underwent an fMRI study in which they performed an attentionally demanding visual detection task at the fovea while intact or scrambled PLDs of BM were shown at the periphery. Our results showed the main effect of attentional load in fronto-parietal regions and the main effect of peripheral stimuli in occipito-temporal cortex. Both univariate activity maps and multivariate pattern analysis results support the attentional load modulation on BM in the occipito-temporal cortex. In conclusion, BM is processed within the motion sensitive regions in the occipito-temporal cortex even when it is away from selective attention, and is modulated by the top-down factor of attentional load.
Adolescence is characterized by more sedentary behavior and less physical activity even among highly active forager-farmers
Authors: Caldwell Ann E. , Cummings Daniel K. , Hooper Paul L. , Trumble Benjamin C. , Gurven Michael , Stiegltz Jonathan , Davis Helen E. , Kaplan Hillard
Published: March 2023

Over 80% of adolescents worldwide are insufficiently active, posing massive public health and economic challenges. Declining physical activity (PA) and sex differences in PA consistently accompany transitions from childhood to adulthood in post-industrialized populations and are attributed to psychosocial and environmental factors. An overarching evolutionary theoretical framework and data from pre-industrialized populations are lacking. In this cross-sectional study we test a hypothesis from life history theory, that adolescent PA reductions reflect an evolved strategy to conserve energy, given the increasing sex-specific energetic demands for growth and reproductive maturation. Detailed measures of PA and pubertal maturation are assessed among Tsimane forager-farmers (age: 7-22 yrs.; 50% female, n=110). We find that 71% of Tsimane sampled meet World Health Organization PA guidelines (≥60 minutes/day of moderate-to-vigorous PA). Consistent with post-industrialized populations, we observe sex differences and inverse age-activity associations mediated by Tanner stage. Physical inactivity in adolescence is distinct from other health risk behaviors and also not merely resulting from obesogenic environments.