bluuebunny/crossref_metadata_2025 huggingface dataset:
Temperature dependence of the hyperfine parameters on Fe3O4(111) surfaces
Authors: Asakawa Kanta , Kawauchi Taizo , Fukutani Katsuyuki
Published: October 2022

The Verwey transition on Fe3O4(111) surface was investigated using nuclear resonant x-ray scattering (NRS). Measurements were conducted below (85 K) and above (297 and 500 K) the Verwey transition temperature. The internal magnetic field estimated from the NRS frequency spectra agreed with that of bulk Fe3O4 at all measured temperatures. A clear change in the intensity ratio of the two peaks in the frequency spectra was observed across the Verwey transition. The results indicate that despite the presence of the peculiar surface electronic states which makes the changes in the electronic properties across the Verwey transition temperature blurred, the hyperfine parameters of the (111) surface show a clear change across the Verwey transition temperature.
Asciminib (Scemblix): A third-line treatment option for chronic myeloid leukemia in chronic phase with or without T315I mutation
Authors: Monestime Shanada , Al Sagheer Tiba , Tadros Monica
Published: October 2022

Purpose

To review the pharmacology, efficacy, safety, dosing and administration, and place in therapy of asciminib, an oral tyrosine kinase inhibitor (TKI) used as a third-line treatment option for Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic phase.

CML is a rare cancer caused by a chromosomal translocation that forms a fusion of the BCR and ABL1 genes on chromosomes 22 and 9. Until recently, patients for whom first-line treatment options failed were treated with TKIs that bind to the adenosine triphosphate–binding site on BCR-ABL1. However, because of similar mechanisms of action, there continues to be an unmet need in patients for whom at least 2 TKIs have failed or those with a T315I mutation unable to tolerate ponatinib. In October 2021, the Food and Drug Administration approved asciminib (Scemblix), the first TKI specifically targeting the ABL1 myristoyl pocket (STAMP) via allosteric binding, as a third-line option for patients with chronic-phase (CP)-CML. Asciminib received accelerated approval due to meeting its primary endpoint at week 24, demonstrating a major molecular response rate of 25.5% for patients on asciminib compared to 13.2% for those receiving bosutinib. In addition, patients on asciminib achieved a higher rate of complete cytogenetic response at 40.8% compared to a rate of 24.2% for bosutinib. Clinicians prescribing asciminib should monitor for increased levels of pancreatic enzymes, hypertension, cardiovascular toxicity including ischemic and thromboembolic conditions, and decreased numbers of neutrophils and platelets, as these may require treatment interruption, dose reduction, or treatment discontinuation.

Conclusion

Asciminib is a unique targeted TKI that provides clinicians with an additional third-line and beyond treatment option for adults with CP-CML regardless of mutation status as well as a second TKI treatment option for patients harboring a T315I mutation.
A Systematic Review and a Latin American Clinical Model for Teleneuropsychological Assessment
Authors: Serrano-Juárez Carlos Alberto , Reyes-Méndez Carolina , Prieto-Corona Belén , Seubert-Ravelo Ana Natalia , Moreno-Villagómez Julieta , Cabañas-Tinajero José-Ángel , Yáñez-Téllez Ma Guillermina , Quezada-Torres Rocío Alejandra , Téllez-Rodríguez Marybeth , Barrera-Rodríguez Bárbara , Soto-Jiménez Martha Paola , González-Gutiérrez Fátima Aideé , Castillo-Tejeda Elena
Published: October 2022

Objective

The objective of this study is to propose a TeleNP model for remote assessment and offer practical recommendations for clinical practice with patients in Mexico and Latin America, based on a systematic literature review and clinical experience.

Method

A systematic review of studies from 2011 to 2021 in English and Spanish used TeleNP, teleneuropsychology, telepsychology, online, assessment, teleneuropsicología, and evaluación for the search; the databases examined included PubMed, BiDi UNAM, ScienceDirect, Google Scholar, and Wiley One Library; the Oxford Centre for Evidence-Based Medicine system was used to grade the levels of evidence. The experience of the last two years of students and faculty in the Master’s and Doctoral Programs in Psychology, Clinical Neuropsychology Residency Program, was also used as a basis for this guide.

Results

We propose a clinical model for TeleNP assessment in Mexico and Latin America based on the review of 31 articles and the practice of professors and students of clinical neuropsychology.

Conclusion

The proposed model describes a procedure and adaptations for home-to-home clinical practice in the neuropsychological assessment of Mexican patients that could also be used in other Latin American countries. Its reliability remains to be assessed, but this model and the suggestions proposed could be used in future studies and clinical trials for Mexican and Latin American populations.
Immediate breast reconstruction uptake in older women with primary breast cancer: systematic review
Authors: Lee Rachel Xue Ning , Cardoso Maria Joao , Cheung Kwok Leung , Parks Ruth M
Published: October 2022

Background

Postmastectomy immediate breast reconstruction (PMIBR) may improve the quality of life of patients with breast cancer, of whom older women (aged 65 years or more) are a growing proportion. This study aimed to assess PMIBR in older women with regard to underlying impediments (if any).

Methods

MEDLINE, Embase, and PubMed were searched by two independent researchers up to June 2022. Eligible studies compared PMIBR rates between younger and older women with invasive primary breast cancer.

Results

A total of 10 studies (2012–2020) including 466 134 women were appraised, of whom two-thirds (313 298) were younger and one-third (152 836) older. Only 10.0 per cent of older women underwent PMIBR in contrast to 45.0 per cent of younger women. Two studies explored factors affecting uptake of PMIBR in older women; surgeon-associated (usual practice), patient-associated (socioeconomic status, ethnicity, and co-morbidities), and system-associated (insurance status and hospital location) factors were identified.

Conclusion

Uptake of PMIBR in older women is low with definable (and some correctable) barriers.
Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial
Authors: Tandon Sarthak , Ensor Nicholas D , Pacilli Maurizio , Laird Ashleigh J , Bortagaray Juan I , Stunden Robert J , Nataraja Ramesh M
Published: October 2022

Background

Tissue adhesive, adhesive tape, and sutures are used to close surgical incisions. However, it is unclear which produces the best results in children, and whether combination wound closure is better than sutures alone.

Methods

In this parallel randomised controlled trial (ANZCTR: ACTRN12617000158369), children (aged 18 years or less) undergoing elective general surgical or urological procedures were randomized to skin closure with sutures alone, sutures and adhesive tape, or sutures and tissue adhesive. Participants were assessed 2 weeks, 6 weeks, and more than 6 months after operation. Outcomes included wound cosmesis (clinician- and parent-rated) assessed using four validated scales, parental satisfaction, and wound complication rates.

Results

295 patients (333 wounds) were recruited and 277 patients (314 wounds) were included in the analysis. Tissue adhesive wounds had poorer cosmesis at 6 weeks: median 10-point VAS score 7.7 with sutures alone, 7.5 with adhesive tape, and 7.0 with tissue adhesive (P = 0.014). Respective median scores on a 100-point VAS were 80.0, 77.2, and 73.8 (P = 0.010). This difference was not sustained at over 6 months. There was no difference in parent-rated wound cosmesis at 6 weeks (P = 0.690) and more than 6 months (P = 0.167): median score 9.0 with sutures alone, 10.0 with adhesive tape, and 10.0 with tissue adhesive at both stages. Parental satisfaction was similar at all points, with a median score of 5 (very satisfied) for all groups. There was one instance of wound dehiscence in the tissue adhesive group and no wound infections.

Conclusion

Short-term wound cosmesis was poorer with tissue adhesive although it is unclear whether this difference is sustained in the long-term. There were no differences between techniques for the study outcomes.

Registration number

ACTRN12617000158369 (ANZCTR) (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372177&isReview=true).
Antibiotic prophylaxis in breast cancer surgery (PAUS trial): randomised clinical double-blind parallel-group multicentre superiority trial
Authors: Stallard Sheila , Savioli Francesca , McConnachie Alex , Norrie John , Dudman Katie , Morrow Elizabeth S , Romics Laszlo
Published: October 2022

Background

Participants were patients with invasive breast cancer undergoing primary surgery. The aim was to test whether a single dose of amoxicillin–clavulanic acid would reduce wound infection at 30 days postoperatively, and to identify risk factors for infection.

Methods

Participants were randomised to either a single bolus of 1.2 g intravenous amoxicillin–clavulanic acid after the induction of anaesthesia (intervention) or no antibiotic (control). The primary outcome was the incidence of wound infection at 30 days postoperatively.

Results

There were 871 evaluable patients. Of these, 438 received prophylactic antibiotic and 433 served as controls. Seventy-one (16.2 per cent) patients in the intervention group developed a wound infection by 30 days, while there were 83 (19.2 per cent) infections in the control group. This was not statistically significant (odds ratio (OR) 0.82, 95 per cent c.i. 0.58 to 1.15; P = 0.250). The risk of infection increased for every 5 kg/m2 of BMI (OR 1.29, 95 per cent c.i. 1.10 to 1.52; P = 0.003). Patients who were preoperative carriers of Staphylococcus aureus had an increased risk of postoperative wound infection; however, there was no benefit of preoperative antibiotics for patients with either a high BMI or who were carriers of S. aureus.

Conclusion

There was no statistically significant or clinically meaningful reduction in wound infection at 30 days following breast cancer surgery in patients who received a single dose of amoxicillin–clavulanic acid preoperatively.

Registration number

N0399145605 (National Research Register).
Long-term outcomes of implant-based immediate breast reconstruction with and without radiotherapy: a population-based study
Authors: de Boniface Jana , Coudé Adam Hannah , Frisell Axel , Oikonomou Ira , Ansarei Dhirar , Ljung Konstantinidou Anna , Liu Yihang , Abo Alniaj Basel , Wallmon Paula , Halle Martin , Johansson Anna L V , Sackey Helena
Published: October 2022

Background

Radiotherapy (RT) is a risk factor for impaired outcomes after implant-based immediate breast reconstruction (IBR). Large studies including long-term follow-up are relatively scarce. The purpose of this analysis was to assess long-term effects of RT in implant-based IBR, distinguishing between implant removal because of postoperative complications versus patient preference.

Methods

This population-based cohort study included all patients with breast cancer who underwent implant-based IBR in Stockholm between 2005 and 2015. Data were collected through national registers and medical charts. The main endpoint was implant removal owing to postoperative complications (wound breakdown, infection, bleeding) or patient preference (dissatisfaction, pain, capsular contracture), with or without conversion to autologous reconstruction.

Results

Some 1749 implant-based IBRs in 1687 women were included. Median follow-up was 72 (range 1–198) months. Reconstructions were divided according to receipt of RT: No RT (n = 856, 48.9 per cent), adjuvant RT (n = 749, 42.8 per cent), and previous RT (n = 144, 8.2 per cent). Implant removal occurred after 266 reconstructions (15.2 per cent); 68 (7.9 per cent) in the no RT, 158 (21.1 per cent) in the adjuvant RT, and 40 (27.8 per cent) in the previous RT group. Implant removal was because of postoperative complications in 152 instances (57.1 per cent) and was most common in the first 3 years. This was especially observed in the previous RT group, where 15 of 23 implant removals occurred during the first 6 months. Implant removal owing to patient preference (114 of 266, 42.9 per cent) became more common with increasing follow-up.

Conclusion

Implant removal after implant-based IBR is significantly associated with RT. The reason for implant removal shifts over time from postoperative complications to patient preference.
Individual differences in brain aging: heterogeneity in cortico-hippocampal but not caudate atrophy rates
Authors: Nyberg Lars , Andersson Micael , Lundquist Anders , Baaré William F C , Bartrés-Faz David , Bertram Lars , Boraxbekk Carl-Johan , Brandmaier Andreas M , Demnitz Naiara , Drevon Christian A , Duezel Sandra , Ebmeier Klaus P , Ghisletta Paolo , Henson Richard , Jensen Daria E A , Kievit Rogier A , Knights Ethan , Kühn Simone , Lindenberger Ulman , Plachti Anna , Pudas Sara , Roe James M , Madsen Kathrine Skak , Solé-Padullés Cristina , Sommerer Yasmine , Suri Sana , Zsoldos Enikő , Fjell Anders M , Walhovd Kristine B
Published: October 2022

It is well documented that some brain regions, such as association cortices, caudate, and hippocampus, are particularly prone to age-related atrophy, but it has been hypothesized that there are individual differences in atrophy profiles. Here, we document heterogeneity in regional-atrophy patterns using latent-profile analysis of 1,482 longitudinal magnetic resonance imaging observations. The results supported a 2-group solution reflecting differences in atrophy rates in cortical regions and hippocampus along with comparable caudate atrophy. The higher-atrophy group had the most marked atrophy in hippocampus and also lower episodic memory, and their normal caudate atrophy rate was accompanied by larger baseline volumes. Our findings support and refine models of heterogeneity in brain aging and suggest distinct mechanisms of atrophy in striatal versus hippocampal-cortical systems.
Regional static diversification and relatedness between industries
Authors: Østergaard Christian Richter , Holm Jacob Rubæk
Published: October 2022

Relatedness has often been shown to have a central role in regional diversification. Knowledge flows between related industries are an important source of innovation, leading to industry growth and the establishment of new industries. Earlier studies have focused on dynamic diversification into new industries, but in this study, we emphasize static diversification, that is, changes in the balance between existing industries in a region. We use linked employer–employee data from Denmark and construct a range of measures at the level of regional industries. The role of relatedness in static diversification 2008–2013 is then analyzed based on industry characteristics in 2008. We find that relatedness plays a more important role in regions that are either spatially peripheral or economically non-peripheral, while relatedness has no relationship to static diversification on average. In addition to the empirical result, we contribute by comparing indices of relatedness, suggesting an alternative employment-weighted index, and conceptualizing relatedness as itself a disparity dimension of diversity. We finally ask how static and dynamic diversification affect disparity. We find that human capital intensity plays an important role in the link between diversification and the evolution of disparity.
Descriptive Analysis of Current Burn Care for Plain Communities in Ohio and Pennsylvania: A Qualitative Study of Strengths and Needs in a Hospital–Community Partnership
Authors: Snider Mira D H , Kelleher Jennifer , Brumbaugh Jamey T , Aballay Ariel , Duncan Christina L
Published: October 2022

Plain communities present with a higher risk of sustaining burn injuries. Yet, little is known about the hospital–community partnerships with Plain caretakers to facilitate culturally competent burn care. The current study provides a qualitative analysis of Plain caretakers’ perspectives on an existing hospital–community partnership for facilitating culturally sensitive burn care and their perspectives on the ongoing physical, structural, and behavioral health needs of this population. Twelve Plain community caregivers who serve on a burn wound treatment team or an oil therapy team within their community took part in a focus group interview. Caretakers identified as White, were majority male (83%), and resided in Plain communities. Retrospective thematic analysis was used to analyze the data. Five major themes (ie, informational needs, strengths of Plain community burn care, behavioral health concerns, behavioral health resources, and preferred teaching methods) evolved. Results revealed that Plain caregivers displayed an openness to learning about recommended burn care from the medical providers. Caretakers also cited their traditional (homeopathic) burn care procedures as perceived strengths, while simultaneously maintaining that their relationship with the hospital is a valuable part of life-saving burn care. Regarding their behavioral health needs, caretakers highlighted difficulties in helping their children cope with burn injuries and pain during rehabilitation and treatment. Other topics discussed included social support and cultural factors that impact the delivery of burn care to Plain communities from non-Plain providers. These results provide important considerations that other burn centers may consider when establishing similar partnerships to deliver of culturally competent medicine for Plain burn survivors.
Activation of cytokine responses by Candida africana
Authors: Rosati Diletta , Bruno Mariolina , van de Veerdonk Frank , ten Oever Jaap , Meis Jacques F , Netea Mihai G
Published: October 2022

Candida africana is a fungal pathogen that rarely causes invasive infections, but is mainly isolated from patients with vaginal infections. Vulvovaginal candidiasis is associated with dysregulated inflammatory responses of the host, however, the innate immune responses against C. africana are currently unknown. In this study, we explored the cytokine production of human peripheral blood mononuclear cells (PBMCs) in response to different C. africana isolates (intra-species diversity), and compared it with that induced by other yeasts belonging to the C. albicans species complex such as C. dubliniensis and C. albicans. Candida africana isolates induced both pro- and anti-inflammatory cytokines broadly similar to other Candida species. Candida africana-stimulated PBMCs tended to produce lower Interleukin (IL)-17 and IL-22 levels in comparison with C. albicans, whereas the induction of trained immunity was similar between C. africana and other Candida species. Overall, our results demonstrate that C. africana induces similar innate immune responses as the other Candida species. Therefore, its propensity to cause vulvovaginal infections is not due to an increased capacity to induce cytokine-related immune pathology. Nor is the infrequent occurrence of invasive infection by C. africana explained by a quantitatively different cytokine induction.
The stability of Prendergast magnetic fields
Authors: Kaufman Emma , Lecoanet Daniel , Anders Evan H , Brown Benjamin P , Vasil Geoffrey M , Oishi Jeffrey S , Burns Keaton J
Published: October 2022

Convection in massive main-sequence stars generates large-scale magnetic fields in their cores that persists as they evolve up the red giant branch. The remnants of these fields may take the form of the Prendergast magnetic field, a combination of poloidal and toroidal field components that are expected to stabilize each other. Previous analytic and numerical calculations did not find any evidence for instability of the Prendergast field over short time-scales. In this paper, we present numerical simulations which show a long time-scale, linear instability of this magnetic field. We find the instability to be robust to changes in boundary conditions and it is not stabilized by strong stable stratification. The instability is a resistive instability, and the growth rate has a power-law dependence on the resistivity, in which the growth rate decreases as the resistivity decreases. We estimate the growth rate of the instability in stars by extrapolating this power law to stellar values of the resistivity. The instability is sufficiently rapid to destabilize the magnetic field on time-scales shorter than the stellar evolution time-scale, indicating that the Prendergast field is not a good model to use in studies of magnetic fields in stars.
Multi-heterointerfaces for selective and efficient urea production
Authors: Zhang Danyan , Xue Yurui , Zheng Xuchen , Zhang Chao , Li Yuliang
Published: October 2022

A major impediment to industrial urea synthesis is the lack of catalysts with high selectivity and activity, which inhibits the efficient industrial production of urea. Here, we report a new catalyst system suitable for the highly selective synthesis of industrial urea by in situ growth of graphdiyne on the surface of cobalt–nickel mixed oxides. Such a catalyst is a multi-heterojunction interfacial structure resulting in the obvious incomplete charge-transfer phenomenon between a graphdiyne and metal oxide interface and multiple intermolecular interactions. These intrinsic characteristics are the origin of the high performance of the catalyst. Studies on the mechanism reveal that the catalyst could effectively optimize the adsorption/desorption capacities of the intermediate and promote direct C–N coupling by significantly suppressing by-product reactions toward the formation of H2, CO, N2 and NH3. The catalyst can selectively synthesize urea directly from nitrite and carbon dioxide in water at room temperature and pressure, and exhibits a record-high Faradaic efficiency of 64.3%, nitrogen selectivity (Nurea-selectivity) of 86.0%, carbon selectivity (Curea-selectivity) of ∼100%, as well as urea yield rates of 913.2 μg h−1 mgcat−1 and remarkable long-term stability.
Manipulating Hubbard-type Coulomb blockade effect of metallic wires embedded in an insulator
Authors: Yang Xing , Gu Zhao-Long , Wang Huimin , Xian Jing-Jing , Meng Sheng , Nagaosa Naoto , Zhang Wen-Hao , Liu Hai-Wen , Ling Zi-Heng , Fan Kai , Zhang Zhi-Mo , Qin Le , Zhang Zhi-Hao , Liang Yan , Li Jian-Xin , Fu Ying-Shuang
Published: October 2022

Correlated states have emerged in low-dimensional systems owing to enhanced Coulomb interactions. Elucidating these states requires atomic-scale characterization and delicate control capabilities. Herein, spectroscopic imaging-scanning tunneling microscopy was employed to investigate the correlated states residing in 1D electrons of the monolayer and bilayer MoSe2 mirror twin boundary (MTB). The Coulomb energies, determined by the wire length, drive the MTB into two types of ground states with distinct respective out-of-phase and in-phase charge orders. The two ground states can be reversibly converted through a metastable zero-energy state with in situ voltage pulses, which tune the electron filling of the MTB via a polaronic process, substantiated by first-principles calculations. Our Hubbard model calculation with an exact diagonalization method reveals the ground states as correlated insulators from an on-site U-originated Coulomb interaction, dubbed the Hubbard-type Coulomb blockade effect. Our study lays a foundation for understanding and tailoring correlated physics in complex systems.
Relative Risks of COVID-19–Associated Hospitalizations and Clinical Outcomes by Age and Race/Ethnicity—March 2020–March 2021
Authors: Bozio Catherine H , Butterfield Kristen , Irving Stephanie A , Vazquez-Benitez Gabriela , Ong Toan C , Zheng Kai , Ball Sarah W , Naleway Allison L , Barron Michelle , Reed Carrie
Published: October 2022

Background

Limited data exist on population-based risks and risk ratios (RRs) of coronavirus disease 2019 (COVID-19)–associated hospitalizations and clinical outcomes stratified by age and race/ethnicity.

Methods

Using data from electronic health records and claims from 4 US health systems for the period March 2020–March 2021, we calculated risk and RR by age and race/ethnicity for COVID-19–associated hospitalizations and clinical outcomes among adults (≥18 years). COVID-19–associated hospitalizations were defined based on COVID-19 discharge codes or a positive severe acute respiratory syndrome coronavirus 2 result. Proportions of acute exacerbations of underlying conditions were estimated among hospitalized patients with select underlying conditions, stratified by age and race/ethnicity.

Results

Among 2.6 million adults included in the patient cohort, 6879 had COVID-19–associated hospitalizations during March 2020–March 2021 (risk: 264 per 100 000 population). Compared with younger, non-Hispanic White adults, non-Hispanic Black and Hispanic adults aged ≥65 years had the highest hospitalization risk ratios (RR, 8.6; 95% CI, 7.6–9.9; and RR, 9.3; 95% CI, 8.5–10.3, respectively). Among hospitalized adults with COVID-19 and renal disease or cardiovascular disease, the highest proportion of acute renal failure (55.5%) or congestive heart failure (43.9%) occurred in older, non-Hispanic Black patients. Among hospitalized adults with chronic lung disease or asthma, the highest proportion of respiratory failure (62.9%) or asthma exacerbation (66.7%) occurred in older, Hispanic patients.

Conclusions

During the first year of the US COVID-19 pandemic in this cohort, older non-Hispanic Black and Hispanic adults had the highest relative risks of COVID-19–associated hospitalization and adverse outcomes and, among those with select underlying conditions, the highest occurrences of acute exacerbations of underlying conditions.
Low-Dose Linezolid for Treatment of Patients With Multidrug-Resistant Tuberculosis
Authors: Mase Anjeli , Lowenthal Phil , True Lisa , Henry Leslie , Barry Pennan , Flood Jennifer
Published: October 2022

Background

Linezolid has been prioritized for treating multidrug-resistant tuberculosis (MDR TB), but toxicity limits its use. We report treatment outcomes for MDR TB patients in California who received standard-dose linezolid vs those who switched to low-dose.

Methods

We include culture-positive MDR TB cases treated with linezolid and receiving California MDR TB Service consultation during 2009–2016. Demographic, clinical, and laboratory data are analyzed using univariate analysis to compare patients who received linezolid of different dosing strategies. Analysis end points are linezolid treatment duration (measure of tolerability), treatment success (completion or cure), and adverse events (AEs).

Results

Sixty-nine of 194 (36%) MDR TB patients met inclusion criteria. While all patients began linezolid treatment at 600 mg daily, 39 (57%) continued at this dosage (standard-dose), and 30 (43%) switched to 300 mg daily (29%) or intermittent dosing (14%) (low dose). Patients on standard-dose linezolid were treated for 240 days, compared with 535 for those on low-dose (P < .0001). Sixty-three patients (91%) achieved treatment success, 2 (2.9%) died, 1 (1.5%) failed treatment, 1 (1.5%) stopped treatment due to side effects, and 2 (2.9%) were lost or moved. Treatment success was higher (P = .03) in the low-dose group. Sixty-two patients experienced ≥1 hematologic (71%) or neurologic (65%) AE. Those on low-dose linezolid experienced significantly (P = .03) fewer AEs per linezolid-month after switching (0.32 vs 0.10).

Conclusions

Patients who switched to low dose tolerated linezolid longer with better treatment outcomes and fewer recurring AEs.
At-home Testing and Risk Factors for Acquisition of SARS-CoV-2 Infection in a Major US Metropolitan Area
Authors: Woolley Ann E , Dryden-Peterson Scott , Kim Andy , Naz-McLean Sarah , Kelly Christina , Laibinis Hannah H , Bagnall Josephine , Livny Jonathan , Ma Peijun , Orzechowski Marek , Gomez James , Shoresh Noam , Gabriel Stacey , Hung Deborah T , Cosimi Lisa A
Published: October 2022

Background

Unbiased assessment of the risks associated with acquisition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to informing mitigation efforts during pandemics. The objective of our study was to understand the risk factors for acquiring coronavirus disease 2019 (COVID-19) in a large prospective cohort of adult residents in a large US metropolitan area.

Methods

We designed a fully remote longitudinal cohort study involving monthly at-home SARS-CoV-2 polymerase chain reaction (PCR) and serology self-testing and monthly surveys.

Results

Between October 2020 and January 2021, we enrolled 10 289 adults reflective of the Boston metropolitan area census data. At study entry, 567 (5.5%) participants had evidence of current or prior SARS-CoV-2 infection. This increased to 13.4% by June 15, 2021. Compared with Whites, Black non-Hispanic participants had a 2.2-fold greater risk of acquiring COVID-19 (hazard ratio [HR], 2.19; 95% CI, 1.91–2.50; P < .001), and Hispanics had a 1.5-fold greater risk (HR, 1.52; 95% CI, 1.32–1.71; P < .016). Individuals aged 18–29, those who worked outside the home, and those living with other adults and children were at an increased risk. Individuals in the second and third lowest disadvantaged neighborhood communities were associated with an increased risk of acquiring COVID-19. Individuals with medical risk factors for severe disease were at a decreased risk of SARS-CoV-2 acquisition.

Conclusions

These results demonstrate that race/ethnicity and socioeconomic status are the biggest determinants of acquisition of infection. This disparity is significantly underestimated if based on PCR data alone, as noted by the discrepancy in serology vs PCR detection for non-White participants, and points to persistent disparity in access to testing. Medical conditions and advanced age, which increase the risk for severity of SARS-CoV-2 disease, were associated with a lower risk of COVID-19 acquisition, suggesting the importance of behavior modifications. These findings highlight the need for mitigation programs that overcome challenges of structural racism in current and future pandemics.
Morbidity and Functional Outcomes Following Rocky Mountain Spotted Fever Hospitalization—Arizona, 2002–2017
Authors: Drexler Naomi A , Close Ryan , Yaglom Hayley D , Traeger Marc , Parker Kristen , Venkat Heather , Villarroel Lisa , Brislan Jeanette , Pastula Daniel M , Armstrong Paige A
Published: October 2022

Background

Rocky Mountain spotted fever (RMSF) is a deadly tickborne disease disproportionately affecting Arizona tribal communities. While the acute clinical effects of RMSF are well-documented, more complete understanding of the long-term health consequences is needed to provide guidance for providers and patients in highly impacted areas.

Methods

We performed a retrospective review of hospitalized RMSF cases from 2 tribal communities in Arizona during 2002–2017. Medical records from acute illness were abstracted for information on clinical presentation, treatment, and status at discharge. Surviving patients were interviewed about disease recovery, and patients reporting incomplete recovery were eligible for a neurologic examination.

Results

Eighty hospitalized cases of RMSF met our inclusion criteria and were reviewed. Of these, 17 (21%) resulted in a fatal outcome. Among surviving cases who were interviewed, most (62%) reported full recovery, 15 (38%) reported ongoing symptoms or reduced function following RMSF illness, and 9 (23%) had evidence of neurologic sequelae at the time of examination. Sequelae included impaired cognition, weakness, decreased deep tendon reflexes, seizures, and cranial nerve dysfunction. Longer hospitalization (25.5 days vs 6.2 days, P < .001), a higher degree of disability at discharge (median modified Rankin score 1 vs 0, P = .03), and delayed doxycycline administration (6.2 days vs 4.1 days, P = .12) were associated with long-term sequelae by logistic regression.

Conclusions

Although the etiology of sequelae is not able to be determined using this study design, life-altering sequelae were common among patients surviving severe RMSF illness. Delayed administration of the antibiotic doxycycline after day 5 was the strongest predictor of morbidity.
Misdiagnoses in the Context of Suspected Pandemic Influenza or Coronavirus Disease 2019: A Systematic Review
Authors: Bray Lucy , Meznikova Katerina , James Daniel , Rislan Razan , Shah Rahul , Mason Pavan , Staniland Tim , Lillie Patrick , Barlow Gavin , Easom Nicholas
Published: October 2022

There have been numerous reports of patients initially misdiagnosed in the 2009 H1N1 influenza and coronavirus disease 2019 (COVID-19) pandemics within the literature. A systematic review was undertaken to collate misdiagnoses during the H1N1 and COVID-19 pandemics and identify which cognitive biases may contribute to this. MEDLINE, Embase, Cochrane and MedRxiv databases were searched for misdiagnoses or cognitive biases resulting in misdiagnosis, occurring during the H1N1 or COVID-19 virus pandemics. Eligible studies were assessed for quality using JBI criteria; primary outcome was the final diagnosis. Sixty-nine studies involving 2551 participants were included. We identified 686 cases of misdiagnosis, categorized as viral respiratory infection, other respiratory infection, non-respiratory infection, and non-infective. Misdiagnoses are listed and relevant investigations are offered. No article described prospective assessment of decision making in the pandemic setting or debiasing diagnostic thinking. Further research is required to understand why misdiagnoses occur and harm arises and how clinicians can be assisted in their decision making in a pandemic context.
Bull selection and management in extensive rangeland production systems of California: a producer survey
Authors: Banwarth Megan R , DeAtley Kasey L , Gifford Craig A , Schohr Tracy K , McFarlane Zachary D
Published: October 2022

California’s approximately 660,000 head of beef cattle are highly dependent on range bulls used to produce offspring that can perform across the state’s diverse ecological regions. Bulls need to be functional on rugged coastal landscapes, rolling foothills, deserts, and in high-elevation terrain. Few data exist that indicate factors related to selection, maintenance, and longevity of bulls used in rangeland landscapes. Objectives herein, were to assess factors influencing bull purchasing, management, and culling decisions of California beef producers. Surveys were mailed to the California Cattlemen’s Association membership (N = 1,410) with ~ 16% response rate (N = 227). Mean age and years of bull selection experience of respondents was 61 ± 1 yr and 27 ± 1 yr, respectively. Respondents managed cattle on a total of 694,949 hectare of owned, private leased, and leased public rangelands in California and surrounding states. Cow–calf herd size was 333 ± 92 head and bull battery averaged 18 ± 2 head with average bull longevity of 5 ± 1.3 yr. The average price paid for bulls in the last 2 yr was $5007 ± 163.33, while the highest price paid in the last 5 yr was $7291 ± 335.40. Survey responses were used to define current factors driving management after purchase and for subsequent breeding seasons. After bull purchase, 48% of producers turned bulls out directly with females, while 52% held bulls until the following breeding season. Additionally, most producers (70%) did not manage bulls to reduce condition after purchase. Semen quality analysis, a major component of a breeding soundness exam, was evaluated annually by 45% of respondents, while 20% of respondents never evaluated semen quality. Respondents indicated bull age (35%) and structural soundness (29%) as the most common factors for culling bulls. This research shows that despite the variability in operation demographics, there were similarities in beef bull selection and management across the state. Additionally, these data suggest the need for additional research focused on bull selection and management to maximize producer investment in reproduction.
Gene dosage changes in KCTD13 result in penile and testicular anomalies via diminished androgen receptor function
Authors: Seth Abhishek , Rivera Armando , Chahdi Ahmed , Choi In‐Seon , Medina‐Martinez Olga , Lewis Shaye , O'Neill Marisol , Ridgeway Alex , Moore Joshua , Jorgez Carolina , Lamb Dolores J.
Published: October 2022

Despite the high prevalence of hypospadias and cryptorchidism, the genetic basis for these conditions is only beginning to be understood. Using array‐comparative‐genomic‐hybridization (aCGH), potassium‐channel‐tetramerization‐domain‐containing‐13 (KCTD13) encoded at 16p11.2 was identified as a candidate gene involved in hypospadias, cryptorchidism and other genitourinary (GU) tract anomalies. Copy number variants (CNVs) at 16p11.2 are among the most common syndromic genomic variants identified to date. Many patients with CNVs at this locus exhibit GU and/or neurodevelopmental phenotypes. KCTD13 encodes a substrate‐specific adapter of a BCR (BTB–CUL3–RBX1) E3–ubiquitin–protein–ligase complex (BCR (BTB–CUL3–RBX1) E3–ubiquitin–protein–ligase complex (B‐cell receptor (BCR) [BTB (the BTB domain is a conserved motif involved in protein‐protein interactions) Cullin3 complex RING protein Rbx1] E3‐ubiqutin‐protein‐ligase complex), which has essential roles in the regulation of cellular cytoskeleton, migration, proliferation, and neurodevelopment; yet its role in GU development is unknown. The prevalence of KCTD13 CNVs in patients with GU anomalies (2.58%) is significantly elevated when compared with patients without GU anomalies or in the general population (0.10%). KCTD13 is robustly expressed in the developing GU tract. Loss of KCTD13 in cell lines results in significantly decreased levels of nuclear androgen receptor (AR), suggesting that loss of KCTD13 affects AR sub‐cellular localization. Kctd13 haploinsufficiency and homozygous deletion in mice cause a significant increase in the incidence of cryptorchidism and micropenis. KCTD13‐deficient mice exhibit testicular and penile abnormalities together with significantly reduced levels of nuclear AR and SOX9. In conclusion, gene‐dosage changes of murine Kctd13 diminish nuclear AR sub‐cellular localization, as well as decrease SOX9 expression levels which likely contribute in part to the abnormal GU tract development in Kctd13 mouse models and in patients with CNVs in KCTD13.
Genetic deletion of the nuclear factor of activated T cells 5 in collecting duct principal cells causes nephrogenic diabetes insipidus
Authors: Petrillo Federica , Chernyakov Dmitry , Esteva‐Font Cristina , Poulsen Søren B. , Edemir Bayram , Fenton Robert A.
Published: October 2022

Water homeostasis is tightly regulated by the kidneys via the process of urine concentration. During reduced water intake, the antidiuretic hormone arginine vasopressin (AVP) binds to the vasopressin receptor type II (V2R) in the kidney to enhance countercurrent multiplication and medullary osmolality, and increase water reabsorption via aquaporin‐2 (AQP2) water channels. The importance of this AVP, V2R, and AQP2 axis is highlighted by low urine osmolality and polyuria in people with various water balance disorders, including nephrogenic diabetes insipidus (NDI). ELF5 and nuclear factor of activated T cells 5 (NFAT5) are two transcription factors proposed to regulate Aqp2 expression, but their role is poorly defined. Here we generated two novel mouse lines with principal cell (PC)‐specific deletion of ELF5 or NFAT5 and phenotyped them in respect to renal water handling. ELF5‐deficient mice (ELF5PC‐KO) had a very mild phenotype, with no clear differences in AQP2 abundance, and mild differences in renal water handling and maximal urinary concentrating capacity. In contrast, NFAT5 (NFAT5PC‐KO) mice had significantly higher water intake and their 24 h urine volume was almost 10‐fold greater than controls. After challenging with dDAVP or 8 h water restriction, NFAT5PC‐KO mice were unable to concentrate their urine, demonstrating that they suffer from NDI. The abundance of AQP2, other AQPs, and the urea transporter UT‐A1 were greatly decreased in NFAT5PC‐KO mice. In conclusion, NFAT5 is a major regulator of not only Aqp2 gene transcription, but also other genes important for water homeostasis and its absence leads to the development of NDI.
Relationships Between Abdominal Pain, Mental Health, and Functional Disability in Youth With Inflammatory Bowel Diseases
Authors: Feldman Estée C. H. , Lampert-Okin Sara L. , Greenley Rachel N.
Published: October 2022

Objectives:

Abdominal pain can be a debilitating symptom for youth with inflammatory bowel diseases (IBDs). Across various pediatric conditions, pain predicts adverse physical and mental health outcomes. Understanding mechanisms by which pain impacts outcomes is of critical importance to enhance the well-being of those with IBDs. Pain catastrophizing mediates the aforementioned relationships in other pediatric populations, but little research has examined its role in pediatric IBDs. Attention to the role of pain catastrophizing as a potential mediator in pediatric IBD is the important given unique elements of the pain experience for this population. This study aimed to examine pain catastrophizing as a potential mediator of the relationship between abdominal pain and adverse outcomes in youth with IBDs.

Methods:

Seventy six youth (ages 11 to 18; M [SD] age=14.71 [1.80]) with IBD completed the Abdominal Pain Index (T1), Pain Catastrophizing Scale (T2, week 12), Revised Children’s Anxiety and Depression Scale (T3, week 20), and Functional Disability Inventory (T3, week 20).

Results:

Catastrophizing mediated the relationship between abdominal pain and both anxiety symptoms (b=1.61, Bias-Corrected Accelerated [BCa] CI, 0.25, 4.62) and functional disability (b=0.77, BCa CI, 0.15, 2.38). A direct effect of abdominal pain on low mood was also noted (b=1.17, BCa CI, 0.03, 2.50). Post hoc analyses examining mediation via catastrophizing subscales indicated that while magnification and rumination functioned as mediators, helplessness did not.

Discussion:

Findings are consistent with fear avoidance models and suggest that interventions directed at pain catastrophizing may be worthwhile in pediatric IBD populations, given catastrophizing-mediated relationships between pain and mental and physical health outcomes.
Direct Costs Attributable to Hearing Loss in China: Based on an Econometric Model
Authors: Ye Xin , He Ping
Published: October 2022

Objectives:

To our knowledge, hearing loss has been proved by a few studies from developed countries to bring a high economic burden of disease, but there is no relevant cost estimate in China. The purpose of our study was to measure the direct costs attributable to hearing loss among middle-aged and older people aged 45 and above in China in 2011, 2013, and 2015.

Design:

On the basis of data from the China Health and Retirement Longitudinal Study and the China Statistical Yearbook, an econometric model was used to obtain the hearing-attributable fraction, and then the direct costs attributable to hearing loss of middle-aged and older people aged 45 and above in China in 2011, 2013, and 2015 were calculated.

Results:

In 2011, 2013, and 2015, the direct costs attributable to hearing loss of middle-aged and older people aged 45 and above in China were $50.699 billion, $81.783 billion, and $106.777 billion, accounting for 3.43, 4.54, and 5.54% of the overall healthcare costs in the same year, respectively. Among the direct costs attributable to hearing loss, direct outpatient costs accounted for 75.75 to 81.13%, and direct inpatient costs accounted for 18.87 to 24.25%.

Conclusions:

The direct costs attributable to hearing loss for Chinese adults aged 45 and above have placed a heavy burden on Chinese society. The government should give priority and take effective measures to the prevention and treatment of hearing loss.
Sildenafil Improves Pulmonary Vascular Remodeling in a Rat Model of Persistent Pulmonary Hypertension of the Newborn
Authors: Kang Lili , Liu Xianghong , Li Zilong , Li XiaoMei , Han Yujie , Liu Chen , Zhao Cuifen , Li Xiaoying
Published: October 2022

Persistent pulmonary hypertension of the newborn (PPHN) is characterized by pulmonary arterial remodeling mainly because of apoptosis resistance and excessive proliferation of pulmonary artery smooth muscle cells (PASMCs). Sildenafil is a phosphodiesterase-5 inhibitor. Some reports have shown that sildenafil exerts protective effects against PPHN. However, the function of sildenafil in PPHN and the underlying molecular mechanisms is not clear. Here, we revealed that sildenafil effectively suppressed hypoxia-induced PASMC proliferation and apoptosis inhibition (P < 0.05). Also, sildenafil obviously reduced ventricular hypertrophy, and inhibited pulmonary vascular remodeling in the PPHN model (P < 0.05). Moreover, sildenafil treatment significantly attenuated the induction of Notch3 and Hes1 induced by hypoxia treatment (P < 0.05). Furthermore, overexpression of Notch3 abolished the reduction of PASMC proliferation and promotion of PASMC apoptosis induced by sildenafil under hypoxia (P < 0.05), whereas knockdown of Notch3 had an opposite effect (P < 0.05). Together, our study demonstrates that sildenafil shows a potential benefit against the development of PPHN by inhibiting Notch3 signaling, providing a strategy for treating PPHN in the future.
Correction of Darwin’s Tubercle with Plasma Exeresis
Authors: Valeriani Roberto , Firmani Guido , Valeriani Maurizio
Published: October 2022

Darwin’s tubercle (DT) is a congenital outer ear deformity characterized by a posterior thickening of the auricular helix. It is particularly common in certain ethnic groups, with reports ranging between 10% and 58% of the specific populations. Despite being common, this vestigial trait is poorly known. It carries no clinical significance, except in the cases where it might be hypertrophic, potentially causing psychological distress and significant social impairment. DT has been traditionally treated with surgical resections where part of the helical cartilage is removed. More recently, cartilage reshaping has been envisioned without cutting, suturing, or scars, using laser irradiation. Surgical resection, laser ablation and plasma exeresis are different tools in the surgeon’s armamentarium which may all be used successfully. Nevertheless, the first may cause noticeable scarring while the second may cause relevant laser-related complications. We present a noninvasive aesthetic medicine procedure based on plasma exeresis, which combines the benefits of a noninvasive procedure with the advantage of not requiring lasers for the correction of this cartilage defect. We present the case of a 28-year-old woman with right-sided hypertrophic DT, who requested a correction of the outer ear deformity. Two sessions were required, pain intensity during treatment was low, no complications were reported, and the patient was satisfied with the result at 6 months from the last session. Although plasma exeresis has been described in the past for several other non-invasive procedures of the skin, this is the first report of its kind for the correction of minor cartilage reshaping.
Combating Stigma in the Era of Monkeypox—Is History Repeating Itself?
Authors: Bergman Alanna , McGee Kara , Farley Jason , Kwong Jeffrey , McNabb Katherine , Voss Joachim
Published: October 2022

Men who have sex with men (MSM) and people with HIV (PWH) perceive, internalize, and experience significant stigma from family members, health care providers, and community members because of their sexual behaviors. The current monkeypox (MPX) outbreak is affecting both communities. The pandemic has spread to 89 countries with more than 31,000 confirmed cases, and global agencies are concerned about how the disease is portrayed in the media. This article will introduce MPX and its associated stigmas, providing a brief theoretical perspective on adaptive behaviors and nursing interventions to mitigate stigma. This is followed by a case-based description of the current experiences of an MSM with MPX. We will discuss stigma prevention strategies from an adaptation and mitigation perspective. We conclude with how nurses can contribute to stigma prevention for individuals with MPX.