bluuebunny/crossref_metadata_2025 huggingface dataset:
Probing into crystallography and morphology properties of MoS2 nanoflowers synthesized via temperature dependent hydrothermal method
Authors: Kumar Naveen , Siroha Piyush , Shankar Hari , Singh Davender , Sharma Yashpal , Kumar Rajesh , Ramovatar  , Yadav Navneet , Dey Kajal Kumar , Borkar Hitesh , Gangwar Jitendra
Published: June 2022

This paper reports the formation of flower-like hierarchical molybdenum disulfide (MoS2) nanoparticles following a simple one-step hydrothermal process with varying temperatures (200 °C and 220 °C). The as-synthesized particles were examined crystallographically by X-ray diffraction (XRD) method which revealed the formation of hexagonal MoS2 (2H-MoS2) and that the crystallite size of the particles increased with increasing hydrothermal temperature. Surface morphological characteristics of the particles were investigated by a field emission scanning electron microscope (FESEM) and interesting details were revealed such as the rounded 3D flower-like microstructure of the MoS2 particles and the petals of the flowers were composed of platelets built up by stacked-up MoS2 nanosheets. With the increase in hydrothermal temperature, the interlayer spacing of stacked layers of intense (002) plane is slightly decreased although the crystallinity of the material is improved. Both diameter and thickness of the nanoflowers and the nanoplatelets increased twice with increasing the temperatures. A visual crystallographic perspective was presented through simulation of 3D wireframe unit cell associated with the individual lattice planes as observed in the XRD pattern of the samples. In addition, a plausible growth mechanism is proposed for the formation of the obtained MoS2 nanoflowers on the basis of experimental observations and analysis.
Associative memories using complex-valued Hopfield networks based on spin-torque oscillator arrays
Authors: Prasad Nitin , Mukim Prashansa , Madhavan Advait , Stiles Mark D
Published: June 2022

Simulations of complex-valued Hopfield networks based on spin-torque oscillators can recover phase-encoded images. Sequences of memristor-augmented inverters provide tunable delay elements that implement complex weights by phase shifting the oscillatory output of the oscillators. Pseudo-inverse training suffices to store at least 12 images in a set of 192 oscillators, representing 16 × 12 pixel images. The energy required to recover an image depends on the desired error level. For the oscillators and circuitry considered here, 5% root mean square deviations from the ideal image require approximately 5 μs and consume roughly 130 nJ. Simulations show that the network functions well when the resonant frequency of the oscillators can be tuned to have a fractional spread less than 10−3, depending on the strength of the feedback.
Random 2-cell embeddings of multistars
Authors: Campion Loth Jesse , Halasz Kevin , Masařík Tomáš , Mohar Bojan , Šámal Robert
Published: June 2022

Random 2-cell embeddings of a given graphGGare obtained by choosing a random local rotation around every vertex. We analyze the expected number of faces,E[FG]\mathbb {E}[F_G], of such an embedding which is equivalent to studying its average genus. So far, tight results are known for two families called monopoles and dipoles. We extend the dipole result to a more general family called multistars, i.e., loopless multigraphs in which there is a vertex incident with all the edges. In particular, we show that the expected number of faces of every multistar withnnnonleaf edges lies in an interval of length2/(n+1)2/(n+1)centered at the expected number of faces of annn-edge dipole. This allows us to derive bounds onE[FG]\mathbb {E}[F_G]for any given graphGGin terms of vertex degrees. We conjecture thatE[FG]≤O(n)\mathbb {E}[F_G]\le O(n)for any simplenn-vertex graphGG.
Low expression of exosomal miR-150 predicts poor prognosis in colorectal cancer patients after surgical resections
Authors: Zhang Yong , Liu Wen-Shuai , Zhang Xiang-Yu , Tong Han-Xing , Yang Hua , Liu Wei-Feng , Fan Jia , Zhou Jian , Hu Jie
Published: June 2022

Liver metastasis is a leading indicator of poor prognosis in patients with colorectal cancer (CRC). Exosomal intercellular communication has been reported to play an important role in cancer invasion and metastasis. Here, we characterized exosomal miRNAs underlying liver metastasis in CRC patients (Cohort 1, n = 30) using miRNA arrays. Exosomal miR-150 was found to be downregulated in CRC patients with liver metastases compared to those without (P = 0.025, fold change [FC] = 2.01). These results were then validated using another independent cohort of CRC patients (Cohort 2, n = 64). Patients with low expression of exosomal miR-150 had significantly shorter overall survival (OS) time (33.3 months versus 43.3 months, P = 0.002). In addition, the low expression of exosomal miR-150 was significantly correlated with advanced tumor node metastasis staging (P = 0.013), higher CA199 level (P = 0.018), and the presence of liver metastasis (P = 0.048). Multivariate analysis showed that low expression of exosomal miR-150 (P = 0.035) and liver metastasis (P < 0.001) were independent prognostic factors for overall survival. In vivo and in vitro studies showed that the viability and invasion of CRC cells were both significantly suppressed by ExomiR-150. Target-prediction assessment and dual-luciferase reporter assay indicated that FTO (the fat mass and obesity-associated gene) was a direct target for miR-150. This study first demonstrated that exosomal miR-150 may be a potential prognostic factor and treatment target for CRC.
Malaria Transmission Dynamics in a High-Transmission Setting of Western Kenya and the Inadequate Treatment Response to Artemether-Lumefantrine in an Asymptomatic Population
Authors: Andagalu Ben , Watson Oliver J , Onyango Irene , Opot Benjamin , Okoth Raphael , Chemwor Gladys , Sifuna Peter , Juma Dennis , Cheruiyot Agnes , Yeda Redemptah , Okudo Charles , Wafubwa Jackline , Yalwala Santos , Abuom David , Ogutu Bernhards , Cowden Jessica , Akala Hoseah M , Kamau Edwin
Published: June 2022

Background

Assessing the infectious reservoir is critical in malaria control and elimination strategies. We conducted a longitudinal epidemiological study in a high-malaria-burden region in Kenya to characterize transmission in an asymptomatic population.

Methods

488 study participants encompassing all ages in 120 households within 30 clusters were followed for 1 year with monthly sampling. Malaria was diagnosed by microscopy and molecular methods. Transmission potential in gametocytemic participants was assessed using direct skin and/or membrane mosquito feeding assays, then treated with artemether-lumefantrine. Study variables were assessed using mixed-effects generalized linear models.

Results

Asexual and sexual parasite data were collected from 3792 participant visits, with 903 linked with feeding assays. Univariate analysis revealed that the 6–11-year-old age group was at higher risk of harboring asexual and sexual infections than those <6 years old (odds ratio [OR] 1.68, P < .001; and OR 1.81, P < .001), respectively. Participants with submicroscopic parasitemia were at a lower risk of gametocytemia compared with microscopic parasitemia (OR 0.04, P < .001), but they transmitted at a significantly higher rate (OR 2.00, P = .002). A large proportion of the study population who were infected at least once remained infected (despite treatment) with asexual (71.7%, 291/406) or sexual (37.4%, 152/406) parasites. 88.6% (365/412) of feeding assays conducted in individuals who failed treatment the previous month resulted in transmissions.

Conclusions

Individuals with asymptomatic infection sustain the transmission cycle, with the 6–11-year age group serving as an important reservoir. The high rates of artemether-lumefantrine treatment failures suggest surveillance programs using molecular methods need to be expanded for accurate monitoring and evaluation of treatment outcomes.
Motif importance measurement based on multi-attribute decision
Authors: Feng Biao , Yang Yunyun , Zhang Liao , Xue Shuhong , Xie Xinlin , Wang Jiianrong , Xie Gang
Published: June 2022

Complex network is an important tool for studying complex systems. From the mesoscopic perspective, the complex network is composed of a large number of different types of motifs, research on the importance of motifs is helpful to analyse the function and dynamics of a complex network. However, the importance of different motifs or the same kind of motifs in the network is different, and the importance of motifs is not only affected by a single factor. Therefore, we propose a comprehensive measurement method of motif importance based on multi-attribute decision-making (MAM). We use the idea of MAM and take into account the influence of the local attribute, global attribute and location attribute of the motif on the network structure and function, and the information entropy method is used to give different weight to different attributes, finally, a comprehensive importance measure of the motif is obtained. Experimental results on the artificial network and real networks show that our method is more direct and effective for a small network.
Case report: multi-modality imaging of a right ventricular fibroma in a teenager
Authors: Liu Yuexia , Shi Jiayao , Cen Huan , Sun Pengtao
Published: June 2022

Background

Cardiac fibroma is a rare primary benign tumour of the heart. It often causes arrhythmia, endangers the lives of patients, and has a worse prognosis than other benign tumours. We report a 14-year-old female patient with a right ventricular fibroma. Various preoperative imaging examinations showed that the lesion was benign, and postoperative pathology confirmed that the lesions were fibroma.

Case summary

A 14-year-old female patient visited her doctor for more than 5 months because of a heart murmur. Echocardiography revealed a slightly hyperechoic mass in the right ventricle, and on myocardial perfusion contrast imaging, the lesion showed equal enhancement. And the lesion also showed enhancement on contrast-enhanced gated cardiac computed tomography (CT). Contrast-enhanced magnetic resonance imaging (MRI) of the heart revealed that the lesion was isointense on T1-weighted image (T1WI), and isointense to slightly hyperintense on T2-weighted image (T2WI). The lesion was significantly homogeneously enhanced on a delayed enhancement scan. A positron emission tomography-CT (PET-CT) with 18F-fluorodeoxyglucose (18F-FDG) demonstrated that the mass showed lower levels of 18F-FDG uptake. These features suggested this lesion was a benign lesion. The postoperative pathology suggested the lesion was a right ventricular fibroma. The patient was discharged 14 days after surgery and remains disease-free and asymptomatic 14 months after surgery.

Discussion

Cardiac fibromas are histologically benign, but they can cause obstruction and malignant arrhythmia. The gold standard for diagnosing fibroma is pathology. However, in the absence of pathology, it is necessary to use various imaging methods to evaluate the lesions to distinguish between benign and malignant tumours.
Early and long-term results of ventricular septal defect repair in children with severe pulmonary hypertension and elevated pulmonary vascular resistance by the double or traditional patch technique
Authors: Golovenko Oleksandr , Lazorhyshynets Vasyl , Prokopovych Liliya , Truba Yaroslav , DiSessa Thomas , Novick William
Published: June 2022

OBJECTIVES

In upper-income countries, infants undergo low-risk ventricular septal defect (VSD) repair. Children in low- and middle-income countries frequently present at older ages with elevated pulmonary vascular resistance (PVR) and pulmonary arterial hypertension (PAH). Expensive interventions for pulmonary hypertensive crisis are not available, and children are often denied an operation due to the mortality risk. We report our early and late experiences with these patients who underwent VSD closure by traditional patch (TP) or double patch (DP) techniques.

METHODS

We extracted data from patients with VSD and PAH who underwent VSD closure operations from 1996 to 2016. Information regarding cardiac catheterizations, operations, time in the intensive care unit and follow-up information was found. We identified 129 children and analysed the differences between the TP (89/129) and the DP (40/129) in unidirectional groups. After 2005, the patients were pretreated with sildenafil 3 months before catheterization.

RESULTS

The TP group was younger (P  < 0.001). Hospital mortality (2.5%, DP; 10.1%,TP) was not significantly different (P  = 0.17) between the 2 groups despite significant differences in baseline PVR, PVR/systemic vascular resistance and the number of children with a saturation less than 90%. The long-term survival and regression of PAH were better in the DP group (survival over 97% vs 93% in the TP group). Moreover, 61% of children with DP and 75% of those with TP had normal to mild elevations in pulmonary artery pressures at the last follow-up examination (P  = 0.046).

CONCLUSIONS

The DP operation is a low-risk procedure. Moreover, the long-term outcome with the use of this technique in high-risk patients with VSD and high PVR and PAH is favourable with respect to survival and showed a decrease in PAH at the last follow-up.
Assessing the contribution of rare genetic variants to phenotypes of chronic obstructive pulmonary disease using whole-genome sequence data
Authors: Kim Wonji , Hecker Julian , Barr R Graham , Boerwinkle Eric , Cade Brian , Correa Adolfo , Dupuis Josée , Gharib Sina A , Lange Leslie , London Stephanie J , Morrison Alanna C , O'Connor George T , Oelsner Elizabeth C , Psaty Bruce M , Vasan Ramachandran S , Redline Susan , Rich Stephen S , Rotter Jerome I , Yu Bing , Lange Christoph , Manichaikul Ani , Zhou Jin J , Sofer Tamar , Silverman Edwin K , Qiao Dandi , Cho Michael H ,   NHLBI Trans-Omics in Precision Medicine (TOPMed) Consortium and TOPMed Lung Working Group
Published: June 2022

Rationale: Genetic variation has a substantial contribution to chronic obstructive pulmonary disease (COPD) and lung function measurements. Heritability estimates using genome-wide genotyping data can be biased if analyses do not appropriately account for the nonuniform distribution of genetic effects across the allele frequency and linkage disequilibrium (LD) spectrum. In addition, the contribution of rare variants has been unclear. Objectives: We sought to assess the heritability of COPD and lung function using whole-genome sequence data from the Trans-Omics for Precision Medicine program. Methods: Using the genome-based restricted maximum likelihood method, we partitioned the genome into bins based on minor allele frequency and LD scores and estimated heritability of COPD, FEV1% predicted and FEV1/FVC ratio in 11 051 European ancestry and 5853 African-American participants. Measurements and Main Results: In European ancestry participants, the estimated heritability of COPD, FEV1% predicted and FEV1/FVC ratio were 35.5%, 55.6% and 32.5%, of which 18.8%, 19.7%, 17.8% were from common variants, and 16.6%, 35.8%, and 14.6% were from rare variants. These estimates had wide confidence intervals, with common variants and some sets of rare variants showing a statistically significant contribution (P-value < 0.05). In African-Americans, common variant heritability was similar to European ancestry participants, but lower sample size precluded calculation of rare variant heritability. Conclusions: Our study provides updated and unbiased estimates of heritability for COPD and lung function, and suggests an important contribution of rare variants. Larger studies of more diverse ancestry will improve accuracy of these estimates.
Nationwide implementation of online communication skills training to reduce overprescribing of antibiotics: a stepped-wedge cluster randomized trial in general practice
Authors: D’Hulster Leon , Abrams Steven , Bruyndonckx Robin , Anthierens Sibyl , Adriaenssens Niels , Butler Chris C , Verheij Theo , Goossens Herman , Little Paul , Coenen Samuel
Published: June 2022

Objectives

Primary care is responsible for a large proportion of unnecessary antibiotic use, which is one of the main drivers of antibiotic resistance. Randomized trials have found that online communication skills training for GPs reduces antibiotic prescribing for respiratory infections. This study assesses the real-world effect of implementing online communication skills training in general practice.

Methods

In a closed cohort stepped-wedge cluster randomized trial all Belgian GPs were invited to participate in online communication skills training courses (TRACE and INTRO) and provided with linked patient information booklets. The primary outcome was the antibiotic prescribing rate per 1000 patient contacts. Intention-to-treat and per protocol analyses were performed. Trial registration at ClinicalTrials.gov: NCT03265028.

Results

In total, 118 487 observations from 10 375 GPs were included in the analysis. Overall, 299 (2.88%) GPs completed TRACE and 93 (0.90%) completed INTRO, 30 of which completed both. There was no effect of the national implementation of TRACE and INTRO on the population-level antibiotic prescribing rate (prescribing rate ratio [PRR] = 0.99 [95% CI: 0.97–1.02]). GPs who actually completed TRACE prescribed fewer antibiotic prescriptions (PRR = 0.93 [95% CI: 0.90–0.95]).

Conclusions

Inviting GPs to complete an online communication skills training course and providing them with the linked patient information booklets did not reduce antibiotic prescribing. However, GPs who completed TRACE prescribed 7% fewer antibiotics, especially during winter. This suggests a significant decrease in population-wide antibiotic consumption could be achieved by focusing on increasing the uptake of this intervention by identifying and overcoming barriers to participation.
Determination of Total Amino Acids in Infant Formulas, Adult Nutritionals, Dairy, and Cereal Matrixes by UHPLC–UV: Interlaboratory Validation Study, Final Action 2018.06
Authors: Jaudzems Greg , Fuerer Christophe
Published: June 2022

Background

A method for the quantification of total amino acids (including taurine and excluding tryptophan) using ultra- HPLC separation coupled to UV detection (UHPLC–UV) was granted First Action status (AOAC 2018.06) by the AOAC INTERNATIONAL Stakeholder Program for Infant Formula and Adult Nutritionals (SPIFAN) in 2018.

Objective

An interlaboratory study was conducted to further assess method performance against the AOAC Standard Method Performance Requirements (AOAC SMPR® 2014.013). Dairy and cereal matrixes were added to expand the scope of the method in collaboration with IDF (International Dairy Federation), ISO (International Organization for Standardization), and AACCI (American Association of Cereal Chemists International, now Cereals & Grains Association).

Methods

Sixteen different matrixes were chosen to cover the requirements of AOAC, IDF/ISO, and AACCI. Blind duplicate samples were organized into specific series to ensure that each pair was analyzed on the same day. Fifteen laboratories returned results. Data from four laboratories were considered invalid and removed from the dataset. Remaining data were assessed according to the Appendix D of the AOAC Official Methods of AnalysisSM (guidelines for collaborative study procedures).

Results

This method generally met the requirements listed in the SMPR for infant formulas and adult nutritionals, except for taurine. Method performance was comparable in dairy and cereal matrixes. Five different UHPLC instruments were used with either commercial or in-house reagents, demonstrating that the method is not limited to a single supplier.

Conclusion

This method was recommended for Final Action in infant and adult/pediatric nutritional formulas by the AOAC SPIFAN Nutrients Expert Review Panel in April 2021, with the exception of taurine. The corresponding IDF/ISO Draft International Standard (DIS) was approved by national bodies in May 2022, and comments collected during the ballot were incorporated into this manuscript.

Highlights

AOAC Official Method 2018.06 for the determination of total amino acids in infant formulas, adult nutritionals, dairy, and cereal matrixes was successfully validated in an interlaboratory study.
Fatal Rectal Injection of 3-MMC in a Sexual Context: Toxicological Investigations Including Metabolites Identification Using LC–HRMS
Authors: Aknouche Frédéric , Ameline Alice , Gheddar Laurie , Maruejouls Christophe , Kintz Pascal
Published: June 2022

The dead body of a 59-year-old man was found at his home by his father. The subject was naked in the corridor, wearing a black hood and a collar around the neck where a dog leash was attached. An empty syringe was discovered in the decedent’s rectal vein. The autopsy revealed marked asphyxia signs with no indication of violence or trauma. Femoral blood, urine and hair (4 cm, brown) were collected and submitted for comprehensive toxicological investigation. Initial screening did not indicate the presence of ethanol or any other over-the-counter or prescription pharmaceuticals. Routine toxicology screening by liquid chromatography–tandem mass spectrometry (LC–MS-MS) tentatively identified only the cathinone stereoisomer(s), 3-methylmethcathinone (3-MMC) or mephedrone. Analysis by gas chromatography–MS to distinguish between the isomers revealed the presence of 3-MMC, which was subsequently quantified by LC–MS-MS. Femoral blood and urine concentrations were 1,437 and 16,733 ng/mL, respectively. In 4 × 1-cm hair segments, 3-MMC was detected at <10 pg/mg (limit of quantification). Further analysis by liquid chromatography–high-resolution mass spectrometry (LC–HRMS) allowed the identification of two metabolites in both blood and urine: desmethyl-3-MMC and hydroxyl-3-MMC. The pathologist established the cause of death in this case as acute 3-MMC poisoning in the context of ChemSex.
Burn Registries State of Affairs: A Scoping review
Authors: Gus Eduardo , Brooks Stephanie , Multani Iqbal , Zhu Jane , Zuccaro Jennifer , Singer Yvonne
Published: June 2022

Registry science allows for the interpretation of disease-specific patient data from secondary databases. It can be utilized to understand disease and injury, answer research questions, and engender benchmarking of quality-of-care indicators. Numerous burn registries exist globally, however, their contributions to burn care have not been summarized. The objective of this study is to characterize the available literature on burn registries. The authors conducted a scoping review, having registered the protocol a priori. A thorough search of the English literature, including grey literature, was carried out. Publications of all study designs were eligible for inclusion provided they utilized, analyzed, and/or critiqued data from a burn registry. Three hundred twenty studies were included, encompassing 16 existing burn registries. The most frequently used registries for peer-reviewed publications were the American Burn Association Burn Registry, Burn Model System National Database, and the Burns Registry of Australia and New Zealand. The main limitations of existing registries are the inclusion of patients admitted to burn centers only, deficient capture of outpatient and long-term outcome data, lack of data standardization across registries, and the paucity of studies on burn prevention and quality improvement methodology. Registries are an invaluable source of information for research, delivery of care planning, and benchmarking of processes and outcomes. Efforts should be made to stimulate other jurisdictions to build burn registries and for existing registries to be improved through data linkage with administrative databases, and by standardizing one international minimum dataset, in order to maximize the potential of registry science in burn care.
Aging-associated accumulation of mitochondrial DNA mutations in tumor origin
Authors: Kong Minghua , Guo Lishu , Xu Weilin , He Chengpeng , Jia Xiaoyan , Zhao Zhiyao , Gu Zhenglong
Published: June 2022

The majority of cancer patients are among aged population, suggesting an urgent need to advance our knowledge on complicated relationship between aging and cancer. It has been hypothesized that metabolic changes during aging could act as a driver for tumorigenesis. Given the fact that mitochondrial DNA (mtDNA) mutations are common in both tumors and aged tissues, it is interesting to contemplate possible role of age-related mtDNA mutations in tumorigenesis. MtDNA encodes genes essential for mitochondrial metabolism, and mtDNA mutates at a much higher rate than nuclear genome. Random drifting of somatic mtDNA mutations, as a result of cell division or mitochondrial turnover during aging, may lead to more and more cells harboring high-frequency pathogenic mtDNA mutations, albeit at different loci, in single-cells. Such mutations can induce metabolic reprogramming, nuclear genome instability and immune response, which might increase the likelihood of tumorigenesis. In this review, we summarize current understanding of how mtDNA mutations accumulate with aging and how these mutations could mechanistically contribute to tumor origin. We also discuss potential prevention strategies for mtDNA mutation-induced tumorigenesis, and future works needed in this direction.
Simulating cold shear flows on a moving mesh
Authors: Zier Oliver , Springel Volker
Published: June 2022

Rotationally supported, cold, gaseous discs are ubiquitous in astrophysics and appear in a diverse set of systems, such as protoplanetary discs, accretion discs around black holes, or large spiral galaxies. Capturing the gas dynamics accurately in these systems is challenging in numerical simulations due to the low sound speed compared to the bulk velocity of the gas, the resolution limitations of full disc models, and the fact that numerical noise can easily source spurious growth of fluid instabilities if not suppressed sufficiently well, negatively interfering with real physical instabilities present in such discs (like the magnetorotational instability). Here, we implement the so-called shearing-box approximation in the moving-mesh code arepo in order to facilitate achieving high resolution in local regions of differentially rotating discs and to address these problems. While our new approach offers manifest translational invariance across the shearing-box boundaries and offers continuous local adaptivity, we demonstrate that the unstructured mesh of arepo introduces unwanted levels of ‘grid-noise’ in the default version of the code. We show that this can be rectified by high-order integrations of the flux over mesh boundaries. With our new techniques we obtain highly accurate results for shearing-box calculations of the magnetorotational instability that are superior to other Lagrangian techniques. These improvements are also of value for other applications of the code that feature strong shear flows.
POLQ suppresses genome instability and alterations in DNA repeat tract lengths
Authors: Liddiard Kate , Aston-Evans Alys N , Cleal Kez , Hendrickson Eric A , Baird Duncan M
Published: June 2022

DNA polymerase theta (POLQ) is a principal component of the alternative non-homologous end-joining (ANHEJ) DNA repair pathway that ligates DNA double-strand breaks. Utilizing independent models of POLQ insufficiency during telomere-driven crisis, we found that POLQ–/– cells are resistant to crisis-induced growth deceleration despite sustaining inter-chromosomal telomere fusion frequencies equivalent to wild-type (WT) cells. We recorded longer telomeres in POLQ–/– than WT cells pre- and post-crisis, notwithstanding elevated total telomere erosion and fusion rates. POLQ–/– cells emerging from crisis exhibited reduced incidence of clonal gross chromosomal abnormalities in accordance with increased genetic heterogeneity. High-throughput sequencing of telomere fusion amplicons from POLQ-deficient cells revealed significantly raised frequencies of inter-chromosomal fusions with correspondingly depreciated intra-chromosomal recombinations. Long-range interactions culminating in telomere fusions with centromere alpha-satellite repeats, as well as expansions in HSAT2 and HSAT3 satellite and contractions in ribosomal DNA repeats, were detected in POLQ–/– cells. In conjunction with the expanded telomere lengths of POLQ–/– cells, these results indicate a hitherto unrealized capacity of POLQ for regulation of repeat arrays within the genome. Our findings uncover novel considerations for the efficacy of POLQ inhibitors in clinical cancer interventions, where potential genome destabilizing consequences could drive clonal evolution and resistant disease.
Transmission of Antibiotic-Susceptible Escherichia coli Causing Urinary Tract Infections in a Fecal Microbiota Transplantation Recipient: Consequences for Donor Screening?
Authors: Vendrik Karuna E W , de Meij Tim G J , Bökenkamp Arend , Ooijevaar Rogier E , Groenewegen Bas , Hendrickx Antoni P A , Terveer Elisabeth M , Kuijper Ed J , van Prehn Joffrey
Published: June 2022

Fecal microbiota transplantation (FMT) has been reported to decrease the incidence of recurrent urinary tract infections (UTIs), presumably by restoring microbiome diversity and/or uropathogen competition. We report a 16-year-old female with recurrent UTIs caused by multidrug-resistant Klebsiella pneumoniae, for which frequent intravenous broad-spectrum antibiotic treatment was necessary. The patient was treated with FMT from a well-screened healthy donor without multidrug-resistant bacteria in the feces. After FMT, she developed several UTIs with an antibiotic-susceptible Escherichia coli that could be treated orally. The uropathogenic E. coli could be cultured from donor feces, and whole genome sequencing confirmed donor-to-recipient transmission. Our observation should stimulate discussion on long-term follow-up of all infections after FMT and donor fecal screening for antibiotic-susceptible Enterobacterales.
Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial
Authors: Li Fiona G. , Maheux-Lacroix Sarah , Deans Rebecca , Nesbitt-Hawes Erin , Budden Aaron , Nguyen Kimberly , Lim Claire Y. , Song Sophia , McCormack Lalla , Lyons Stephen D. , Segelov Eva , Abbott Jason A.
Published: June 2022

(Abstracted from JAMA 2021;326:1381–1389)

An estimated 40% to 60% of women experience vaginal symptoms associated with menopause, which can lead to physical discomfort, as well as negatively affecting sexual function, relationships, and quality of life. Preliminary data have shown that fractional laser treatments used as nonhormonal alternatives for postmenopausal vaginal symptoms result in improvement in vaginal atrophy after treatment.
Digital Therapeutic Device for Urinary Incontinence: A Randomized Controlled Trial
Authors: Weinstein Milena M. , Dunivan Gena , Guaderrama Noelani M. , Richter Holly E.
Published: June 2022

(Abstracted from Obstet Gynecol 2022;139:606–615)

As many as 50% of women are affected by urinary incontinence (UI) throughout their lifetimes. Over time, related quality of life and symptom severity tend to worsen and can be improved with therapy.
Pilot Randomized Controlled Trial of Diabetes Group Prenatal Care
Authors: Carter Ebony B. , Barbier Kate , Hill Pamela K. , Cahill Alison G. , Colditz Graham A. , Macones George A. , Tuuli Methodius G. , Mazzoni Sara E.
Published: June 2022

(Abstracted from Am J Perinatol 2022;39:45–53)

Type 2 diabetes or gestational diabetes mellitus (GDM) occurs in approximately 10% of pregnant women. Having these conditions increases the risk of several adverse outcomes, including macrosomia, shoulder dystocia, cesarean delivery, metabolic syndrome, and future cardiovascular diseases.
Mortality, In-Hospital Morbidity, Care Practices, and 2-Year Outcomes for Extremely Preterm Infants in the US, 2013–2018
Authors: Bell Edward F. , Hintz Susan R. , Hansen Nellie I. , Bann Carla M. , Wyckoff Myra H. , DeMauro Sara B. , Walsh Michele C. , Vohr Betty R. , Stoll Barbara J. , Carlo Waldemar A. , Van Meurs Krisa P. , Rysavy Matthew A. , Patel Ravi M. , Merhar Stephanie L. , Sánchez Pablo J. , Laptook Abbot R. , Hibbs Anna Maria , Cotten C. Michael , D'Angio Carl T. , Winter Sarah , Fuller Janell , Das Abhik ,   for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Published: June 2022

(Abstracted from JAMA 2022;327:248–263)

Although mortality and short-term morbidities have declined in extremely preterm infants, there is still a need for the ongoing review of longer-term health and neurodevelopmental outcomes. Since 1991, the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network tracks such outcomes in infants born <29 weeks' gestation.
The role of temporary mechanical circulatory support as a bridge to advanced heart failure therapies or recovery
Authors: Oren Daniel , Zilinyi Robert , Lotan Dor , Uriel Matan , Uriel Nir , Sayer Gabriel
Published: June 2022

Purpose of review

Temporary mechanical circulatory support (tMCS) has become central in the treatment of refractory cardiogenic shock and can be used to bridge patients to durable MCS, heart transplant or recovery. This review will discuss contemporary data regarding bridging strategies utilizing tMCS.

Recent findings

There has been significant growth in tMCS use recently, driven by increased familiarity with tMCS devices, and increased experience with both implantation and management. Identifying goals of therapy at the time of therapy initiation can facilitate better outcomes. The three primary goals are bridge to recovery, bridge to heart transplantation or bridge to durable left ventricular assist device. Bridging to recovery requires adequate treatment of underlying conditions and optimization of haemodynamics. Bridging to heart transplantation has become more frequent following changes to the heart allocation policy. Despite early concerns, patients bridge with tMCS, including ventricular-arterial extracorporeal membrane oxygenation, do not appear to have worse posttransplant outcomes. When bridging to durable mechanical circulatory support, tMCS can be used to enhance end-organ dysfunction and improve perioperative outcomes. In situations in which none of these goals are attainable, palliative care plays a critical role to identify patient wishes and assist with withdrawal of care when necessary.

The use of tMCS, as a bridge to recovery or heart replacement therapy in patients with refractory cardiogenic shock has grown significantly over the past decade. Multiple device choices are available and must be chosen appropriately to address the specific situation and the goals of therapy.
Impact of COVID-19 on Pediatric Mental and Behavioral Health Visits to the Emergency Department
Authors: Bolt Jacqueline , Patel Faisalmohemed , Stone Laura , Pandian Divya , Manuel Matthias M. , Gaines Nakia
Published: June 2022

Objectives

This study aimed to describe changes in pediatric emergency department (ED) mental and behavioral health (MBH) visits before and during the early COVID-19 pandemic.

Methods

We retrospectively reviewed medical records of patients aged from 5 to 17 years presenting to the pediatric ED of a major tertiary care hospital with MBH-related concerns from March 2017 to September 2020. We evaluated trends in MBH ED visits over the study period, specifically comparing patient demographics, diagnosis categories, and ED disposition between the pre-COVID (2019) and COVID (2020) periods using pairwise Pearson χ2 analyses with reported odds ratios (ORs) in SAS statistical software version 9.4 (SAS Institute Inc, Cary, NC).

Results

Of 8093 MBH-related visits, 58.5% were females, 85.4% were adolescents, and 62.7% self-identified as non-Hispanic. The proportion of MBH-related ED visits increased from 3.8% to 7.5% over the study period (P < 0.0001). Although total MBH visits decreased by 17.3% from 2019 to 2020, there was a proportionate increase in MBH-to-total-ED visits, representing a 42.8% increase through 2019. Compared with 2019, there was a proportionate increase in MBH-related ED visits by females (10.6%, P < 0.0001), older adolescents (18.2%, P < 0.0001), and non-Hispanic patients (6.1%, P = 0.017) in 2020. The MBH visits in 2020 were more likely related to suicidality/self-harm (OR, 1.2; confidence interval [CI], 1.1–1.4) or substance use (OR, 1.4; CI, 1.1–1.9). Compared with 2019, there were significantly higher odds of admission (OR, 1.6; CI, 1.3–2.1) or transfer for inpatient psychiatric care (OR, 1.8; CI, 1.6–2.1) in 2020.

Conclusions

Our data suggest that the early COVID-19 pandemic had a significant impact on MBH-related ED visits. Compared with 2019, we observed a significant increase in the proportion of MBH-to-total-ED visits primarily affecting older adolescent, non-Hispanic girls with suicidality/self-harm and substance-related disorders in 2020, despite an overall decrease in the number of MBH visits during this period. There was also an increase in the proportion of visits resulting in admission or transfer for inpatient psychiatric care in 2020.
Bilateral Cleft Lip Repair: Lessons from History
Authors: Xue Amy S. , Buchanan Edward P. , Hollier Larry H.
Published: June 2022

Learning Objectives:

After studying this article, the participant should be able to: 1. Describe the bilateral cleft lip and nasal deformity and associated anatomical variations. 2. Understand the history and evolution of the bilateral cleft lip repair. 3. Understand the key principles of the surgical repair.

This article describes characteristics of the bilateral cleft lip and nasal deformity and its management, including presurgical orthopedics, operative techniques, and postsurgical care.
From policy to practice: uptake of pre-exposure prophylaxis among adolescent girls and young women in United States President's Emergency Plan for AIDS Relief-supported countries, 2017–2020
Authors: Patel Pragna , Sato Kimi , Bhandari Neeta , Kanagasabai Udhayashankar , Schelar Erin , Cooney Caroline , Eakle Robyn , Klucking Sara , Toiv Nora , Saul Janet
Published: June 2022

Background:

The US President's Emergency Plan for AIDS Relief's (PEPFAR) first implemented pre-exposure prophylaxis (PrEP) for HIV prevention through the Determined, Resilient, Empowered, AIDS-Free, Mentored and Safe (DREAMS) partnership in 2016. PrEP is a critical intervention to achieve the main objective of DREAMS, reducing new HIV infections among 15-14 year old adolescent girls and young women (AGYW) in 15 high HIV burdened countries.

Methods:

We describe uptake of PrEP among AGYW in PEPFAR. Most PrEP programs screened persons who tested HIV-negative for eligibility and offered PrEP as part of combination prevention with follow-up, including repeat HIV testing and counseling, at 3-month intervals. Platforms providing comprehensive services for AGYW were also leveraged. We examined two PEPFAR monitoring indicators, using the FY20Q4 Monitoring, Evaluation, Reporting (MER) indicator dataset to assess progress in PrEP uptake, and descriptive narratives to understand successes and challenges from fiscal year 2017 to 2020. To assess coverage, we calculated the PrEP to Need ratio (PnR) using a published methodology.

Results:

From FY2017 to FY2020, 576570 total clients initiated PrEP and the number of PEPFAR countries offering PrEP doubled from 12 to 24. Of 360073 (62% of total) initiations among women, 52% were among AGYW with steady increases from year to year. Among all AGYW, 20–24–year-old women represented a significantly higher proportion of PrEP initiators than adolescents (15–19years) (64 versus 36%, P 
< 0.05). Of all 186985 PrEP initiations among AGYW, 99% were in DREAMS countries. Barriers, such as low demand and adherence, were addressed through outreach efforts, including mobile sites, use of technology to educate and support AGYW, media campaigns, and engaging peers in program implementation. We saw a 2.5-fold increase in PrEP uptake among AGYW from 2018 to 2019; by 2020, all DREAMS countries were implementing PrEP. However, PrEP coverage among AGYW in DREAMS countries remains low (PnR range: 0–4.1); only two have a PnR greater than 1 where there were more PrEP users than new HIV diagnoses.

Conclusion:

PrEP uptake among AGYW has grown since 2016; however, challenges remain. Tools to improve adherence are needed to improve PrEP persistence among AGYW. National policies to facilitate greater PrEP uptake among adolescents would be beneficial. A greater need for PrEP in DREAMS countries is evident and if realized, will contribute to epidemic control.
The association of exposure to DREAMS on sexually acquiring or transmitting HIV amongst adolescent girls and young women living in rural South Africa
Authors: Mthiyane Nondumiso , Baisley Kathy , Chimbindi Natsayi , Zuma Thembelihle , Okesola Nonhlanhla , Dreyer Jaco , Herbst Carina , Smit Theresa , Danaviah Siva , McGrath Nuala , Harling Guy , Sherr Lorraine , Seeley Janet , Floyd Sian , Birdthistle Isolde , Shahmanesh Maryam
Published: June 2022

Objective:

We investigate how risk of sexually acquiring or transmitting HIV in adolescent girls and young women (AGYW) changed following the real-world implementation of DREAMS (Determined, Resilient, Empowered, AIDS free, Mentored and Safe) HIV prevention programme.

Design:

A representative population-based prospective cohort study of AGYW living in rural KwaZulu-Natal.

Methods:

Between 2017 and 2019, we interviewed a random sample of AGYW aged 13–22 years annually. We measured exposure to DREAMS as self-reported receipt of an invitation to participate and/or participation in DREAMS activities that were provided by DREAMS implementing organizations. HIV and herpes simplex virus type 2 (HSV-2) statuses were ascertained through blood tests on Dried Blood Spot (DBS). We used multivariable regression analysis to assess the association between exposure to DREAMS and risk of acquiring HIV: measured as incident HSV-2 (a proxy of sexual risk) and incident HIV;and the risk of sexually transmitting HIV: measured as being HIV positive with a detectable HIV viral load (≥50 copie/ml) on the last available DBS. We adjusted for sociodemographic, sexual relationship, and migration.

Results:

Two thousand one hundred and eighty-four (86.4%) of those eligible agreed to participate and 2016 (92.3%) provided data for at least one follow-up time-point. One thousand and thirty (54%) were exposed to DREAMS;HIV and HSV-2 incidence were 2.2/100 person-years [95% confidence interval (CI) 1.66–2.86] and 17.3/100 person-years (95% CI 15.5–19.4), respectively. There was no evidence that HSV-2 and HIV incidence were lower in those exposed to DREAMS: adjusted rate ratio (aRR) 0.96 (95% CI 0.76–1.23 and 0.83 (95% CI 0.46–1.52), respectively. HIV viral load was detectable for 169 (8.9%) respondents;there was no evidence this was lower in those exposed to DREAMS with an adjusted risk difference, compared with those not exposed to DREAMS, of 0.99% (95% CI–1.52 to 3.82]. Participants who lived in peri-urban/ urban setting were more likely to have incident HIV and transmissible HIV. Both HSV-2 incidence and the transmissible HIV were associated with older age and ever having sex. Findings did not differ substantively by respondent age group.

Conclusion:

DREAMS exposure was not associated with measurable reductions in risk of sexually acquiring or transmitting HIV amongst a representative cohort of AGYW in rural South Africa
Modeling DREAMS impact: trends in new HIV diagnoses among women attending antenatal care clinics in DREAMS countries
Authors: Saul Janet , Cooney Caroline , Hosseini Parviez R. , Beamon Ta’Adhmeeka , Toiv Nora , Bhatt Samir , Zaidi Irum , Birx Deborah
Published: June 2022

Objectives:

To understand the impact of United States President's Emergency Plan for AIDS Relief (PEPFAR's) DREAMS (Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe) Partnership on new HIV diagnoses among women in antenatal care (ANC) settings in 10 African countries from 2015 to 2020.

Design:

We modeled spatiotemporal changes in new HIV diagnoses among women in ANC settings using PEPFAR data. Statistical tests were performed in R to compare differences in new diagnoses rates between DREAMS and non-DREAMS subnational units (SNUs) and to explore predictors of new diagnoses declines within DREAMS SNUs.

Methods:

We used a predictive geospatial model to forecast the rate of new diagnoses for each time period in a 5 km grid cell (n = 861 SNUs). Linear model analyses were conducted using predictor variables: urbanicity, DREAMS geographic footprint, ‘layering’ proxy, and community-level male viral load suppression.

Results:

New HIV diagnoses in ANC from 2015 to 2020 declined in nearly all SNUs. ‘Always’ DREAMS SNUs reported declines of 45% while ‘Never’ DREAMS SNUs reported a decline of only 37% (F = 8.1, 1 and 829 DF, P < 0.01). Within Always DREAMS SNUs, greater declines were seen in areas with a higher number of minimum services in their DREAMS primary package (t = 2.77, P < 0.01).

Conclusion:

New HIV diagnoses among women are declining in both DREAMS and non-DREAMS SNUs; mirroring HIV incidence decreases and reflecting increasing community viral load suppression and voluntary male medical circumcision rates. DREAMS programming may have contributed to accelerated declines of new HIV diagnoses in DREAMS SNUs compared with non-DREAMS SNUs. Increased progress is needed to further reduce the disparities between adolescent girls and young women (AGYW) and young men to achieve epidemic control.
Facial and Neck Reconstruction With Pre-expanded Medial Upper Arm Flap: An Alternative method and 20-Year Experience
Authors: Chen Sen , Li Yangqun , Ma Ning , Wang Weixin , Wu Qi , Luo Sisi , Qu Siwei , Yang Zhe
Published: June 2022

Purpose:

To present our experience with pre-expanded medial upper arm flap in facial and neck reconstruction.

Patients and Methods:

This was a retrospective study operated between January 1st, 2001 and January 1st, 2021, at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College. Staged face and/or neck reconstruction was performed.

Results:

Forty-one patients were treated in our institution and thirty-eight patients (forty-three flaps) were included in this cohort as. They ranged from 6 to 44 years old. There was no total flap loss in the cohort. Partial flap necrosis was observed in the earlier patients (4 cases).

Conclusion:

Pre-expanded medial upper arm flap is well matched to the facial and neck skin in color, texture, and thickness. Considering the excellent aesthetic outcomes, this flap is a good alternative for selected patients with soft tissue defects of the head and neck.