bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the anaerobic microbial potential for the bioremediation of gas condensate-contaminated groundwater
Authors: Maksimovich N G , Khmurchik V T , Demenev A D , Yu Meshcheryakova O
Published: September 2021

The gas condensate leakage incident took place in Bashkortostan (Russian Federation), which caused soil and groundwater pollution with hydrocarbons. After the incident, the emergency plan was started and kinds of measures were carried out immediately. But the residual subsurface source of pollution within ground is still present and contaminates groundwater. We investigated the capability of ground’s indigenous microbial community to degrade gas condensate hydrocarbons under anaerobic conditions. The enrichment microbial cultures of nitrate reducers, ferric reducers, sulphate reducers and methanogens, capable to degrade gas condensate hydrocarbons, were isolated at incident site from polluted ground. All cultures demonstrated the ability to degrade hydrocarbons under laboratory conditions. The enrichment culture of nitrate reducers was chosen as the most appropriated one to biotechnological applicationin situ(i.e. at incident site) — it held the capability to degrade gas condensate hydrocarbons after three consecutive aerobic incubations in the rich medium (meat-peptone broth) amended with glucose. To our mind, biomass of this culture being readily and quickly grown in aerobic conditions on cheap organic media could be directly used to remediate gas condensate-polluted groundwater and groundin situ.
Anthropogenic eutrophication of lakes Turgoyak and Bolshoi Kisegach
Authors: Zakharov S G
Published: September 2021

The article examines the long-term dynamics of three main indicators of the trophic state of water bodies (transparency, phosphorus concentration and oxygen regime) for the natural oligotrophic lakes of the Southern Urals: Turgoyak and Bolshoi Kisegach. These lakes have a similar history of anthropogenic development (water intake and recreation). At the same time, the lakes have a different degree of anthropogenic transformation in connection with different volumes of incoming nutrients, which affect the quality of lake waters and natural recreational potential.
Assessing the sustainable development of an enterprise from the water use standpoint
Authors: Dvinskikh S A , Larchenko O V , Oskina M A
Published: September 2021

The role of industrial enterprises in ensuring a sustainable development project are analysed. It shows that when planning their work, the companies should take into account not only their economic performance, but also the state of the environment. It is the negative consequences of production that have a destructive effect on the environment, including water resources. To assess the state of water resources, which is shaped by the work of enterprises, it is proposed to use indicators and indices. The study gives an overview of the existing assessment methods, as well as proposes custom ones.
Phytoplankton of unique karst lakes (by the example of the Lake Klyuchik, the basin of the Cheboksary Reservoir)
Authors: Startseva N A , Vodeneeva E L , Kulizin P V , Sharagina E M , Zolotova M V , Okhapkin A G
Published: September 2021

The features of the composition, development and spatial distribution of phytoplankton of a small highly mineralized karst low-temperature lake (Lake Klyuchik or Svyatoe Doskinskoe, Nizhny Novgorod Region) with atypically high for the forest zone (subzone of mixed coniferous and broad-leaved forests) values of water salinity are considered. The lake is characterized by an expressed ecotone in terms of hydrological and hydrochemical indicators.
Mycrocystin-LR degradation by indigenous bacterial community of Rybinsk Reservoir
Authors: Medvedeva N G , Kuzikova I L
Published: September 2021

The fate of microcystin-LR (MC-LR) in water samples of Rybinsk Reservoir taken before and during water bloom was assessed. The decrease in the MC-LR concentration in the both samples was due to its biodegradation by indigenous bacterial community. The highest biodegradation rate and shortest half-life of MC-LR in the water sample taken during water bloom were observed. A microcystin degrading bacterium was isolated and shown be 98.92% similar to Sphingopyxis sp. based on a fragment of 16S rRNA gene sequence. The rate of MC-LR biodegradation by Sphingopyxis sp. S7 was strongly dependent on initial concentration of toxin and temperature.
On some degeneracy loci in the moduli space of pointed odd spin curves
Authors: Basok M.
Published: September 2021

Let

C
C

be a smooth projective curve of genus

g
≥
3

g\geq 3

and let

η
\eta

be an odd theta characteristic on it such that

h
0

(
C
,
η
)
=
1

h^0(C,\eta ) = 1

. Pick a point

p
p

from the support of

η
\eta

and consider the one-dimensional linear system

|

η
+
p

|

|\eta + p|

. In general this linear system is base-point free and all its ramification points are simple. The locus in the moduli space of odd spin curves is studied where the linear system

|

η
+
p

|

|\eta + p|

fails to have this general behavior. This locus is stratified with respect to multiplicities of degeneracies; these strata are called degeneracy schemes and their geometry is explored. Conormal spaces to these schemes are described in intrinsic terms and some consequences of this are presented.
PLX3397, a CSF1 receptor inhibitor, limits allotransplantation-induced vascular remodelling
Authors: Almonte Vanessa M , Uriyanghai Unimunkh , Egaña-Gorroño Lander , Parikh Dippal , Oliveira-Paula Gustavo H , Zhang Jinghang , Jayakumar Smitha , Riascos-Bernal Dario F , Sibinga Nicholas E S
Published: September 2021

Aims

Graft vascular disease (GVD), a clinically important and highly complex vascular occlusive disease, arises from the interplay of multiple cellular and molecular pathways. While occlusive intimal lesions are composed predominantly of smooth-muscle-like cells (SMLCs), the origin of these cells and the stimuli leading to their accumulation in GVD are uncertain. Macrophages have recently been identified as both potential drivers of intimal hyperplasia and precursors that undergo transdifferentiation to become SMLCs in non-transplant settings. Colony-stimulating factor-1 (CSF1) is a well-known regulator of macrophage development and differentiation, and prior preclinical studies have shown that lack of CSF1 limits GVD. We sought to identify the origins of SMLCs and of cells expressing the CSF1 receptor (CSF1R) in GVD, and to test the hypothesis that pharmacologic inhibition of CSF1 signalling would curtail both macrophage and SMLC activities and decrease vascular occlusion.

Methods and results

We used genetically modified mice and a vascular transplant model with minor antigen mismatch to assess cell origins. We found that neointimal SMLCs derive from both donor and recipient, and that transdifferentiation of macrophages to SMLC phenotype is minimal in this model. Cells expressing CSF1R in grafts were identified as recipient-derived myeloid cells of Cx3cr1 lineage, and these cells rarely expressed smooth muscle marker proteins. Blockade of CSF1R activity using the tyrosine kinase inhibitor PLX3397 limited the expression of genes associated with innate immunity and decreased levels of circulating monocytes and intimal macrophages. Importantly, PLX3397 attenuated the development of GVD in arterial allografts.

Conclusion

These studies provide proof of concept for pharmacologic inhibition of the CSF1/CSF1R signalling pathway as a therapeutic strategy in GVD. Further preclinical testing of this pathway in GVD is warranted.
Structural recognition of the mRNA 3′ UTR by PUF-8 restricts the lifespan of C. elegans
Authors: Xu Zheng , Zhao Jie , Hong Minjie , Zeng Chenming , Guang Shouhong , Shi Yunyu
Published: September 2021

The molecular mechanisms of aging are unsolved fundamental biological questions. Caenorhabditis elegans is an ideal model organism for investigating aging. PUF-8, a PUF (Pumilio and FBF) protein in C. elegans, is crucial for germline development through binding with the 3′ untranslated regions (3′ UTR) in the target mRNAs. Recently, PUF-8 was reported to alter mitochondrial dynamics and mitophagy by regulating MFF-1, a mitochondrial fission factor, and subsequently regulated longevity. Here, we determined the crystal structure of the PUF domain of PUF-8 with an RNA substrate. Mutagenesis experiments were performed to alter PUF-8 recognition of its target mRNAs. Those mutations reduced the fertility and extended the lifespan of C. elegans. Deep sequencing of total mRNAs from wild-type and puf-8 mutant worms as well as in vivo RNA Crosslinking and Immunoprecipitation (CLIP) experiments identified six PUF-8 regulated genes, which contain at least one PUF-binding element (PBE) at the 3′ UTR. One of the six genes, pqm-1, is crucial for lipid storage and aging process. Knockdown of pqm-1 could revert the lifespan extension of puf-8 mutant animals. We conclude that PUF-8 regulate the lifespan of C. elegans may not only via MFF but also via modulating pqm-1-related pathways.
Designed architectural proteins that tune DNA looping in bacteria
Authors: Tse David H , Becker Nicole A , Young Robert T , Olson Wilma K , Peters Justin P , Schwab Tanya L , Clark Karl J , Maher L James
Published: September 2021

Architectural proteins alter the shape of DNA. Some distort the double helix by introducing sharp kinks. This can serve to relieve strain in tightly-bent DNA structures. Here, we design and test artificial architectural proteins based on a sequence-specific Transcription Activator-like Effector (TALE) protein, either alone or fused to a eukaryotic high mobility group B (HMGB) DNA-bending domain. We hypothesized that TALE protein binding would stiffen DNA to bending and twisting, acting as an architectural protein that antagonizes the formation of small DNA loops. In contrast, fusion to an HMGB domain was hypothesized to generate a targeted DNA-bending architectural protein that facilitates DNA looping. We provide evidence from Escherichia coli Lac repressor gene regulatory loops supporting these hypotheses in living bacteria. Both data fitting to a thermodynamic DNA looping model and sophisticated molecular modeling support the interpretation of these results. We find that TALE protein binding inhibits looping by stiffening DNA to bending and twisting, while the Nhp6A domain enhances looping by bending DNA without introducing twisting flexibility. Our work illustrates artificial approaches to sculpt DNA geometry with functional consequences. Similar approaches may be applicable to tune the stability of small DNA loops in eukaryotes.
COVID-19 and Co-infection in Children: The Indian Perspectives
Authors: Raychaudhuri Dibyendu , Sarkar Mihir , Roy Aniket , Roy Debapriya , Datta Kalpana , Sengupta Tapti , Hazra Avijit , Mondal Rakesh
Published: September 2021

Background and objectives

Assessing the co-infections with COVID-19 is crucial to delineate its true clinical impact. Pediatric information in this aspect is limited. Our study aims to analyze the spectrum of co-infections in pediatric COVID-19 patients and determine the clinical as well as laboratory parameters predicting co-infection.

Methodology

In this prospective observational study conducted from June to December 2020 in a single tertiary care institution, data pertaining to demographic, illness and treatment-related variables were analyzed among two subsets of pediatric patients of age 1 month–12 years with RT–PCR-confirmed COVID-19 infection-Group A: those with confirmed co-infection and Group B: moderate to severe disease without co-infection. Among Group A, etiology of co-infection was characterized through relevant microbiological examination within 48 h admission.

Result

Among our study population, 15.03% and 20.6% had co-infections and moderate to severe disease respectively. Among those with confirmed co-infection, 32.5%, 11.6% and 6.97% recorded blood culture, respiratory secretion and CSF growth, respectively, the picture being dominated by Methicillin resistant and sensitive Staphylococcus aureus. Serum serology demonstrated Scrub typhus infection to be most prevalent. Concurrent respiratory viral infections were seen in 11.6%. Children with co-infection had significantly higher morbidity and need for supportive therapy. Predictors of co-infection were localization of infection, Neutrophil count ≥10×109, age-specific lymphopenia, CRP > 100 mg/dl and hyperferritinemia.

Conclusion

Co-infections are an important factor prognosticating pediatric COVID infection. Their early detection, prompt and appropriate treatment is of paramount importance.
Detection of the G143A Mutation in the Cytochrome b Gene of Corynespora cassiicola Isolates from Soybean in Tennessee
Authors: Smith Tyler M. , Kelly Heather Y. , Lamour Kurt H.
Published: September 2021

Corynespora cassiicola is the causal pathogen of target spot in soybean and cotton grown in the United States. With target spot increasing in importance, fungicides are becoming an important tool for control of this disease. Unfortunately, there are reports of C. cassiicola isolates in other crops being resistant to some fungicide classes. The objective of this study was to identify if resistance to quinone outside inhibitor (QoI) fungicides is present in Tennessee soybean and cotton isolates of C. cassiicola. Four isolates of C. cassiicola were evaluated at a range of doses for the fungicide pyraclostrobin. Isolates were also sequenced to determine if the G143A mutation was present in the cyt b gene. Two isolates previously reported to be resistant to QoIs were also used as positive checks. Two isolates of C. cassiicola from Tennessee soybean were found to have the G143A mutation. EC50 values for the two isolates ranged from 15.7 to 121 μg/ml. As a result of this study, C. cassiicola isolates have exhibited resistance to QoI fungicides in Tennessee soybean.
Teaching Baccalaureate Students Research Concepts Using Colored Candies
Authors: Gaffney Mary K.
Published: September 2021

A collaborative, experiential learning activity was designed to develop nursing students’ understanding of research concepts. Working in pairs, students determine if a candy company is filling bags with equal numbers of each candy color. Pairs receive 100 colored candies and instructions to obtain simple random, systematic, stratified, and cluster samples. Color counts from each sampling method are entered on a Google spreadsheet. During debriefing, students explore results, unexpected problems (e.g., inconsistent technique, missing candies), representativeness of samples (size, inclusion/exclusion criteria), and ethical conduct. Students develop knowledge to be better consumers of research and more capable advocates for high-quality nursing care.
Psychological Interventions for Parents of Youth With Chronic Pain
Authors: Lee Soeun , Dick Bruce D. , Jordan Abbie , McMurtry C. Meghan
Published: September 2021

Objective:

Parents are integral to their youth’s chronic pain experiences, and intervening with parents may improve parent and youth functioning. Existing systematic reviews are not specific to pain or do not systematically report critical aspects to facilitate implementation of parent interventions in diverse settings. Thus, this scoping review aimed to map published parent interventions for pediatric chronic pain to summarize the participant and intervention characteristics, treatment components, methods, outcomes, feasibility, and acceptability, as well as identify gaps for future research.

Methods:

Four databases were searched (PubMed, PsycINFO, CINAHL, and Google Scholar). Studies of any design reporting psychological interventions including parents of youth (0 to 18 y) with chronic pain were included. Data on study characteristics, treatment components, effectiveness, and feasibility/acceptability were extracted.

Results:

Fifty-four studies met inclusion criteria from 9312 unique titles. The majority were nonrandomized cognitive-behavioral therapy interventions delivered individually. The degree of parent participation ranged from 17% to 100%; the average enrollment rate was 68%. Reported parent and youth outcomes were variable; 26% of studies did not include any parent-related outcomes.

Discussion:

Parent interventions may be a helpful and feasible way to support parents and youth with chronic pain. There is variability across study characteristics, treatment content/aims, parent participation, and parent/youth outcomes.
Relationship Between Vertebral Bone Marrow Edema and Early Progression of Intervertebral Disc Wedge or Narrowing After Lumbar Decompression Surgery
Authors: Nakajima Hideaki , Honjoh Kazuya , Watanabe Shuji , Kubota Arisa , Matsumine Akihiko
Published: September 2021

Study Design.

A retrospective study.

Objectives.

The aim of this study was to review clinical and imaging features in patients with lumbar spinal canal stenosis (LSS) with and without postoperative early progression of intervertebral disc degeneration (IDD) and to identify predictive factors.

Summary of Background Data.

Progression of IDD after lumbar decompression surgery can induce low back pain and leg pain, and may require revision surgery. However, risk factors for postoperative radiological changes indicating IDD linked to development of symptoms have not been described.

Methods.

We included 564 patients with LSS without degenerative lumbar scoliosis who underwent lumbar decompression surgery without fusion. Clinical features and imaging findings were compared in cases with (group P) and without (group N) progression of IDD (intervertebral disc wedge or narrowing) at 1 year after surgery.

Results.

Of the 564 patients, 49 (8.7%) were in group P. On preoperative MRI, all patients in group P had findings of vertebral bone marrow edema (diffuse high intensity on T2-weighted images and low-intensity on T1-weighted images), compared to only 5.4% in group N. The rate of revision surgery was significantly higher in group P in 5 years’ follow-up (12.2% vs. 1.4%, P < 0.01). In group P, 44.9% of patients developed postoperative symptoms associated with postoperative radiological changes, and the frequency was higher in narrowing-type than in wedge-type cases. Vertebral bone marrow edema area and IDD grade were not predictors for postoperative early IDD progression.

Conclusion.

Careful consideration is required to determine whether lumbar decompression surgery should be performed if vertebral bone marrow edema is detected on MRI, since this is a predictor for a negative clinical outcome. If surgery is symptomati-cally urgent, careful clinical and radiological follow-up is required.

Level of Evidence: 4
Bronchoscopy During Coronavirus Disease 2019 Pandemic: A Bronchoscopist’s Perspective
Authors: Saha Biplab K. , Chaudhary Raghav , Saha Santu , Bonnier Alyssa , Chong Woon H. , Chenna Praveen
Published: September 2021

Bronchoscopy is a safe and commonly performed procedure for diagnostic as well as therapeutic indications. Bronchoscopy is also an aerosol-generating procedure, and due to the risk of severe acute respiratory syndrome coronavirus 2 transmission during the procedure, routine bronchoscopy has been discouraged by multiple professional societies, despite any solid evidence. There are only a few reports of bronchoscopy in patients with coronavirus disease 2019 in the literature. Bronchoscopy in this patient population plays a crucial role not only in the diagnosis of coronavirus disease 2019 but also in the identification of secondary bacterial or fungal infections and in directing appropriate antimicrobial therapy. Bronchoscopy with therapeutic interventions may be lifesaving. Based on the literature, the risk of coronavirus disease 2019 transmission appears to be low among bronchoscopists and other healthcare workers when appropriate personal protective equipment is used. Bronchoscopy in patients with coronavirus disease 2019 should be strongly considered when clinically indicated.
Mutational burden and immune recognition of gliomas
Authors: Prost Diego , Bielle Franck , Ligon Keith L. , Touat Mehdi
Published: September 2021

Purpose of review

Recent evidence suggests high tumor mutational burden (TMB-H) as a predictor of response to immune checkpoint blockade (ICB) in cancer. However, results in TMB-H gliomas have been inconsistent. In this article, we discuss the main pathways leading to TMB-H in glioma and how these might affect immunotherapy response.

Recent findings

Recent characterization of TMB-H gliomas showed that ‘post-treatment’ related to mismatch repair (MMR) deficiency is the most common mechanism leading to TMB-H in gliomas. Unexpectedly, preliminary evidence suggested that benefit with ICB is rare in this population. Contrary to expectations, ICB response was reported in a subset of TMB-H gliomas associated with constitutional MMR or polymerase epsilon (POLE) defects (e.g., constitutional biallelic MMRd deficiency). In other cancers, several trials suggest increased ICB efficacy is critically associated with increased lymphocyte infiltration at baseline which is missing in most gliomas. Further characterization of the immune microenvironment of gliomas is needed to identify biomarkers to select the patients who will benefit from ICB.

Intrinsic molecular and immunological differences between gliomas and other cancers might explain the lack of efficacy of ICB in a subset of TMB-H gliomas. Novel combinations and biomarkers are awaited to improve immunotherapy response in these cancers.
A nomogram integrating non-ECG factors with ECG to screen left ventricular hypertrophy among hypertensive patients from northern China
Authors: Li Guangxiao , Shi Chuning , Li Tan , Ouyang Nanxiang , Guo XiaoFan , Chen Yanli , Li Zhao , Zhou Ying , Yang Hongmei , Yu Shasha , Sun Guozhe , Sun Yingxian
Published: September 2021

Objective:

We aimed to establish and validate a user-friendly and clinically practical nomogram for estimating the probability of echocardiographic left ventricular hypertrophy (echo-LVH) indexed to BSA among hypertensive patients from northern China.

Methods:

A total of 4954 hypertensive patients were recruited from a population-based cohort study from January 2012 to August 2013. The dataset was randomly split into two sets: training (n = 3303) and validation (n = 1651). Three nomograms were initially constructed. That is the Cornell product nomogram, the non-ECG nomogram, and the integrated nomogram which integrated non-ECG risk factors and Cornell-voltage duration product. The least absolute shrinkage and selection operator strategies were employed to screen for non-ECG features. The performance of the nomograms was evaluated using discrimination, calibration, and decision curve analysis (DCA). The net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were also calculated.

Results:

The AUCs, NRIs, IDIs, and DCA curves of the nomograms demonstrated that the integrated nomogram performed best among all three nomograms. The integrated nomogram incorporated age, sex, educational level, hypertension duration, SBP, DBP, eGFR, sleep duration, tea consumption, and the Cornell-voltage duration product. The AUC was 0.758 and had a good calibration (Hosmer–Lemeshow test, P = 0.73). Internal validation showed an acceptable AUC of 0.735 and good calibration was preserved (Hosmer–Lemeshow test, P = 0.19). The integrated nomogram was clinically beneficial across a range of thresholds of 10–50%.

Conclusion:

The integrated nomogram is a convenient and reliable tool that enables early identification of hypertensive patients at high odds of LVH and can assist clinicians in their decision-making.
Evaluation of the Correction Methods Using Age and BMI for Estimating CT Organ Dose Using a Radiophotoluminescence Glass Dosimeter and a Monte Carlo-based Dose Calculator
Authors: Chang Weishan , Koba Yusuke
Published: September 2021

The size-specific dose estimates (SSDE) have been recommended to replace the volume computed tomography dose index (CTDIvol) because it takes patient size into account. On the other hand, organ dose is thought to be a more appropriate quantity in the radiation protection field due to its correlation with radiation risk. The web-based computed tomography (CT) dose calculator WAZA-ARIv2 only offers organ doses for adults with four different body shapes and for children with five different ages. Since the American Association of Physicists in Medicine (AAPM) offers the conversion factors for SSDE and the correlation of SSDE with organ dose has been demonstrated, implementation of the conversion table might improve the accuracy of WAZA-ARIv2. This study aimed to evaluate a body mass index (BMI)-based and age-based correction method for estimation of the organ dose by using a radiophotoluminescence dosimeter (RGD), an anthropomorphic phantom, and the dose calculator WAZA-ARIv2. RGDs were individually calibrated by using an ISOVOLT TITAN-320 x-ray generator. The ratio of the SSDE conversion factors (CFSSDE) was used as the comparison index. For the BMI-based correction method, the ratio of CFSSDE values for the adult phantoms was expected to be 1.065, and the average ratio of the organ doses for the adult phantoms was 1.163 ± 0.169. For the age-based correction method, the ratio of CFSSDE value for 5- and 10-y-old pediatric phantoms was expected to be 0.889, and the ratios of the organ doses were 0.866 ± 0.024 and 0.909 ± 0.047 for the WAZA-ARIv2 dosimetry system and RGD dosimetry system, respectively. In conclusion, both evaluations of the experimental results showed the consistency between WAZA-ARIv2 and the SSDE conversion factor table. Moreover, the importance of taking the measurement position into account when applying the mass attenuation coefficient was demonstrated according to this study.
Mucosal defense: gastroduodenal injury and repair mechanisms
Authors: Hagen Susan J.
Published: September 2021

Purpose of review

The mucosal barrier serves as a primary interface between the environment and host. In daily life, superficial injury to the gastric or duodenal mucosa occurs regularly but heals rapidly by a process called ‘restitution’. Persistent injury to the gastroduodenal mucosa also occurs but initiates a regenerative lesion with specific wound healing mechanisms that attempt to repair barrier function. If not healed, these lesions can be the site of neoplasia development in a chronic inflammatory setting. This review summarizes the past year of advances in understanding mucosal repair in the gastroduodenal mucosa, which occurs as a defense mechanism against injury.

Recent findings

Organoids are an emerging new tool that allows for the correlation of in vivo and in vitro models; organoids represent an important reductionist model to probe specific aspects of injury and repair mechanisms that are limited to epithelial cells. Additionally, proof-of-concept studies show that machine learning algorithms may ultimately assist with identifying novel, targetable pathways to pursue in therapeutic interventions. Gut-on-chip technology and single cell RNA-sequencing contributed to new understanding of gastroduodenal regenerative lesions after injury by identifying networks and interactions that are involved in the repair process.

Recent updates provide new possibilities for identifying novel molecular targets for the treatment of acute and superficial mucosal injury, mucosal regeneration, and regenerative lesions in the gastrointestinal tract.
Beyond Disease Intervention: Exploring an Expanded Role for Partner Services in the MATRix-NC Demonstration Project
Authors: Hurt Christopher B. , Morrison Arianne S. , Guy Jalila , Mobley Victoria L. , Dennis Ann M. , Barrington Clare , Samoff Erika , Hightow-Weidman Lisa B. , McNeil Candice J. , Carry Monique G. , Hogben Matthew , Seña Arlene C.
Published: September 2021

Background

Disease intervention specialists (DIS) provide partner services for sexually transmitted infections (STIs). We assessed an expansion of DIS services for clients with HIV and/or syphilis, and contacts within their social and sexual networks.

Methods

Black and Latinx cisgender men and transgender women who have sex with men diagnosed with HIV and/or syphilis in 4 urban North Carolina counties were referred to designated DIS, who were trained to recruit clients as “seeds” for chain-referral sampling of sociosexual network “peers.” All received HIV/STI testing and care; referrals for preexposure prophylaxis (PrEP) and social, behavioral, and non-STI medical services were offered. Participants completed baseline, 1-month, and 3-month computerized surveys.

Results

Of 213 cases referred to DIS from May 2018 to February 2020, 42 seeds (25 with syphilis, 17 with HIV) and 50 peers participated. Median age was 27 years; 93% were Black and 86% were cisgender men. Most peers came from seeds’ social networks: 66% were friends, 20% were relatives, and 38% were cisgender women. Incomes were low, 41% were uninsured, and 10% experienced recent homelessness. More seeds than peers had baseline PrEP awareness; attitudes were favorable, but utilization was poor. Thirty-seven participants were referred for PrEP 50 times; 17 (46%) accessed PrEP by month 3. Thirty-nine participants received 129 non-PrEP referrals, most commonly for housing assistance, primary care, Medicaid navigation, and food insecurity.

Conclusions

Chain-referral sampling from partner services clients allowed DIS to access persons with significant medical and social service needs, demonstrating that DIS can support marginalized communities beyond STI intervention.
Sexual Risk Behaviors Among Persons Diagnosed With Primary and Secondary Syphilis Who Reported High-Risk Substance Use: Data From the National Notifiable Diseases Surveillance System, 2018
Authors: Copen Casey E. , Brookmeyer Kathryn A. , Haderxhanaj Laura T. , Hogben Matthew , Torrone Elizabeth A.
Published: September 2021

Background

Recent increases in high-risk substance use (HRSU; i.e., injection drug use, heroin, methamphetamine, crack/cocaine) have coincided with rising primary and secondary (P&S) syphilis rates. To further understand these trends, we examined sexual risk behaviors among women, men who have sex with women only (MSW), and men who have sex with men (MSM) who were diagnosed with P&S syphilis in 2018 and reported HRSU.

Methods

Data on HRSU and sexual risk behaviors among persons with P&S syphilis were drawn from syphilis case reports in 2018 from the National Notifiable Diseases Surveillance System. Persons with P&S syphilis were asked about sexual risk behaviors in the past 12 months including exchange sex for drugs/money, sex while intoxicated and/or high on drugs, sex with a person who injects drugs (PWID), sex with an anonymous partner, and number of sex partners. We describe percentages and adjusted prevalence ratios (aPRs) for women, MSW, and MSM reporting these behaviors by age, race/Hispanic ethnicity, type of drug used, and incarceration history (both in the past 12 months).

Results

Among 19,634 persons diagnosed with P&S syphilis in 2018 with information on HRSU, 29.3% of women, 22.7% of MSW, and 12.4% of MSM reported HRSU. Among those reporting HRSU, percentages reporting exchange sex ranged from 17% to 35% (highest for women), whereas reports of anonymous sex ranged from 44% to 71% (highest for MSM). In this population, sexual risk behaviors were more commonly reported among those with a recent incarceration history than those without such history. Among those reporting injection drug use or heroin use, percentages reporting sex with a PWID ranged from 51% to 77%. In adjusted models, HRSU was significantly associated with one or more sexual risk behaviors for women (aPR, 2.63 [95% confidence interval {CI}, 2.39–2.90]; MSW: aPR, 1.38 [95% CI, 1.31–1.46]; and MSM: aPR, 1.30 [95% CI, 1.26–1.34]).

Conclusions

Collaborative partnerships across the US public health system could help address barriers to timely clinical care among persons diagnosed with P&S syphilis who report HRSU.
Lessons Learned From a Centers for Disease Control and Prevention Virtual Partner Services Technical Assistance Pilot Project to Respond to a Local Syphilis Outbreak
Authors: Davis Cassandra , Wright Shauntā S. , Babcock Marcie , Kingdon Elisabeth , Broussard Dawn , Oyervides Otilio , Carr Deborah
Published: September 2021

A virtual partner services technical assistance (TA) project was piloted with the Minnesota Department of Health to address an ongoing syphilis outbreak. The TA reduced the health department's disease intervention specialist workload, achieved partner services outcomes comparable with in-person methods, and identified lessons learned to replicate with other jurisdictions.
Antimicrobial Susceptibility of Urogenital and Extragenital Neisseria gonorrhoeae Isolates Among Men Who Have Sex With Men: Strengthening the US Response to Resistant Gonorrhea and Enhanced Gonococcal Isolate Surveillance Project, 2018 to 2019
Authors: Quilter Laura A.S. , St. Cyr Sancta B. , Hong Jaeyoung , Asbel Lenore , Bautista Ilene , Carter Bonnie , Casimir Yanick , Denny Michael , Ervin Melissa , Gomez Raquel , Harvey Alesia , Holderman Justin L. , Johnson Kimberly , Kohn Robert P. , Learner Emily R. , Mauk Kerry , Menza Timothy , Mettenbrink Christie , Nettleton William D. , Nicosia Karen R. , Pham Cau D. , Ried Christopher , Schlanger Karen , Schneider Annah , Soge Olusegun O. , Tabidze Irina , Taylor Stephanie N. , Tilghman Winston , Toler Cindy , Weinstock Hillard , Torrone Elizabeth A.
Published: September 2021

Background

We investigated differences in gonococcal antimicrobial susceptibility by anatomic site among cisgender men who have sex with men (MSM) using specimens collected through the Centers for Disease Control and Prevention's enhanced Gonococcal Isolate Surveillance Project and Strengthening the US Response to Resistant Gonorrhea.

Methods

During the period January 1, 2018–December 31, 2019, 12 enhanced Gonococcal Isolate Surveillance Project and 8 Strengthening the US Response to Resistant Gonorrhea sites collected urogenital, pharyngeal, and rectal isolates from cisgender MSM in sexually transmitted disease clinics. Gonococcal isolates were sent to regional laboratories for antimicrobial susceptibility testing by agar dilution. To account for correlated observations, linear mixed-effects models were used to calculate geometric mean minimum inhibitory concentrations (MICs), and mixed-effects logistic regression models were used to calculate the proportion of isolates with elevated or resistant MICs; comparisons were made across anatomic sites.

Results

Participating clinics collected 3974 urethral, 1553 rectal, and 1049 pharyngeal isolates from 5456 unique cisgender MSM. There were no significant differences in the geometric mean MICs for azithromycin, ciprofloxacin, penicillin, and tetracycline by anatomic site. For cefixime and ceftriaxone, geometric mean MICs for pharyngeal isolates were higher compared with anogenital isolates (P < 0.05). The proportion of isolates with elevated ceftriaxone MICs (≥0.125 μg/mL) at the pharynx (0.67%) was higher than at rectal (0.13%) and urethral (0.18%) sites (P < 0.05).

Conclusions

Based on data collected from multijurisdictional sentinel surveillance projects, antimicrobial susceptibility patterns of Neisseria gonorrhoeae isolates may differ among MSM at extragenital sites, particularly at the pharynx. Continued investigation into gonococcal susceptibility patterns by anatomic site may be an important strategy to monitor and detect the emergence of antimicrobial resistant gonorrhea over time.
Rectal Chlamydia trachomatis Infection: A Narrative Review of the State of the Science and Research Priorities
Authors: Khosropour Christine M. , Dombrowski Julia C. , Vojtech Lucia , Patton Dorothy L. , Campbell Lee Ann , Barbee Lindley A. , Franzi Michaela C. , Hybiske Kevin
Published: September 2021

Chlamydia trachomatis (CT) is the most commonly reported infection in the United States. Most chlamydial research to date has focused on urogenital infection, but a growing body of research has demonstrated that rectal chlamydia is a relatively common infection among clinic-attending men and women. We know that most rectal CT infections are asymptomatic, but the health implications of these infections, particularly for women, are unclear. In addition, there are key knowledge gaps related to the epidemiologic parameters of rectal chlamydia, the routes of acquisition, the duration of infection, and the clinical significance of a positive rectal CT test result. This lack of information has led to a blind spot in the potential role of rectal chlamydia in sustaining high levels of CT transmission in the United States. Furthermore, recent findings from animal models suggest that the immune response generated from gastrointestinal chlamydial infection can protect against urogenital infection; however, it remains to be determined whether rectal chlamydia similarly modulates anti-CT immunity in humans. This is a critical question in the context of ongoing efforts to develop a CT vaccine. In this narrative review, we summarize the state of the science for rectal chlamydia and discuss the key outstanding questions and research priorities in this neglected area of sexual health research.
Identifying Sexually Transmitted Infection Risk Groups Based on Behavioral and Psychological Characteristics Among Heterosexuals During the COVID-19 Pandemic
Authors: van Wees Daphne A. , Godijk Noortje G. , den Daas Chantal , Kretzschmar Mirjam E.E. , Heijne Janneke C.M.
Published: September 2021

Background

Measures to reduce coronavirus disease (COVID-19) transmission may impact sexual health. We aimed to examine the impact of COVID-19 on sexual behavior and sexually transmitted infection (STI) testing and to characterize individuals who were at high STI risk.

Methods

Dutch heterosexual males and females who participated in a cohort study in 2016 to 2018 were invited to fill out 2 questionnaires again in 2020 (age, 21–28 years). We used behavioral and psychological data from: prelockdown (September 2019 to February 2020), lockdown (March to May 2020), and postlockdown (June to August 2020). Behavior change was compared between subgroups identified with latent class analysis.

Results

Four latent classes were identified (n = 238). Individuals in class 1 (48% of study population) and class 2 (36%) were at low STI risk and reported mostly steady partnerships. Individuals in class 3 (9%) and class 4 (7%) reported multiple casual partners prelockdown. Class 4 was characterized by lower condom use and health goals, negative infection prevention attitudes, and higher impulsiveness compared with class 3. Furthermore, same/increased partner numbers during lockdown (class 3, 18%; class 4, 56%) and postlockdown (class 3, 36%; class 4, 42%) compared with prelockdown was often reported. Of individuals who wanted an STI test during the pandemic, 62% in class 3 and 56% in class 4 did not get tested, mainly because they were unable to get an appointment.

Conclusions

A subgroup of individuals, characterized by low health goals, negative infection prevention attitudes, and high impulsiveness, engaged in high-risk behavior during the pandemic. Identifying these individuals may help provide appropriate health care during strict lockdowns and after relaxation of measures.
Report From the National Academies of Sciences, Engineering and Medicine—STI: Adopting a Sexual Health Paradigm—A Synopsis for Sexually Transmitted Infection Practitioners, Clinicians, and Researchers
Authors: Rietmeijer Cornelis A. , Kissinger Patricia J. , Guilamo-Ramos Vincent , Gaydos Charlotte A. , Hook Edward W. , Mead Aimee , Yang Sophie , Geller Amy , Vermund Sten H.
Published: September 2021

Despite decades of medical, diagnostic, and public health advances related to diagnosis and management of sexually transmitted infections (STIs), rates of reportable STIs continue to grow. A 2021 National Academies of Sciences, Engineering, and Medicine report on the current state of STI management and prevention in the United States, entitled Sexually Transmitted Infections: Adopting a Sexual Health Paradigm, offers recommendations on future public health programs, policy, and research. This new report builds upon the 1997 Institute of Medicine report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases, and provides 11 recommendations organized under 4 action areas: (1) adopt a sexual health paradigm, (2) broaden ownership and accountability for responding to STIs, (3) bolster existing systems and programs for responding to STIs, and (4) embrace innovation and policy change to improve sexual health. We present our interpretive synopsis of this report, highlighting elements of particular interest to STI and sexual health practitioners, including clinicians, researchers, disease intervention specialists, community outreach workers, and public health staff. The report asserts that it is possible to create a healthier and more equitable future where fewer adolescents and adults are infected, fewer babies are born with STIs, and people entering their sexual debut and continuing throughout the life span are taught the language and skills to conceptualize and enact their own vision for what it means to be sexually healthy.
Enhancing Gonococcal Antimicrobial Resistance Surveillance in Cisgender Women, Strengthening the US Response to Resistant Gonorrhea, 2018 to 2019
Authors: Wendel Karen A. , Mauk Kerry , Amsterdam Lori , McNeil Candice J. , Pfister John R. , Mobley Victoria , Mettenbrink Christie , Nishiyama Masayo , Terrell Erica , Baldwin Tamara , Pham Cau D. , Nash Evelyn E. , Kirkcaldy Robert D. , Schlanger Karen
Published: September 2021

Background

Cisgender women have been underrepresented in antibiotic-resistant gonorrhea (ARGC) surveillance systems. Three of 8 project sites (City of Milwaukee [MIL], Guilford County [GRB], Denver County [DEN]), funded under the Centers for Disease Control and Prevention's Strengthening the US Response to Resistant Gonorrhea (SURRG), focused efforts to better include cisgender women in ARGC surveillance.

Methods

MIL, GRB, and DEN partnered with diverse health care settings and developed gonorrhea culture criteria to facilitate urogenital specimen collection in cisgender women and men. Regional laboratories within the Antibiotic Resistance Laboratory Network performed agar dilution antibiotic susceptibility testing (AST) of gonococcal isolates. Data from 2018 and 2019 were analyzed.

Results

In SURRG, 90.5% (11,464 of 12,667) of the cisgender women from whom urogenital culture specimens were collected were from MIL, GRB, and DEN. Of women in SURRG whose gonococcal isolates underwent AST, 70% were from these 3 sites. In these 3 sites, a substantial proportion of cisgender women with positive urogenital cultures and AST were from health care settings other than sexually transmitted disease (STD) clinics (non-STD clinics; MIL, 56.0%; GRB, 80.4%; and DEN, 23.5%). Isolates with AST were obtained from 5.1%, 10.2%, and 2.4% of all diagnosed gonorrhea cases among cisgender women in MIL, GRB, and DEN, respectively, and were more often susceptible to all antibiotics than those from cisgender men from each of these sites.

Conclusions

With focused efforts and partnerships with non-STD clinics, 3 SURRG sites were able to include robust ARGC surveillance from cisgender women. These findings may guide further efforts to improve gender equity in ARGC surveillance.
Training Death Investigators to Identify Decedents' Sexual Orientation and Gender Identity
Authors: Blosnich John R. , Butcher Barbara A. , Mortali Maggie G. , Lane Andrew D. , Haas Ann P.
Published: September 2021

There is growing impetus within mortality surveillance to identify decedents' sexual orientation and gender identity (SOGI), but key personnel to this effort (eg, death investigators) are not currently trained to collect SOGI information. To address this gap, we developed a training for death investigators on this topic and tested its feasibility with 114 investigators in 3 states. Participants completed pretraining and posttraining questionnaires that measured 4 perceived outcomes: training relevance, success of delivery, adequacy for future use, and likelihood of future use. Overall, strongly positive responses affirmed the training's relevance, success of delivery, and adequacy for future use. Responses about attempting to identify the decedent's SOGI in future cases were not quite as positive, with close to 80% of the participants saying that they were at least “somewhat likely” to collect this information. Despite design limitations, the study results support the feasibility of training death investigators to gather SOGI information. Although not systematically assessed in the study, investigators' positive endorsement of training outcomes seemed higher in training sites where leadership strongly supported SOGI identification, suggesting that the role of leadership may be key to encouraging SOGI identification among death investigators.
Common Differential Diagnostic Issues in Bone Tumor Pathology
Authors: Hakim Muhammad O. , Behtaj Mohadese , Torres Jaylou Velez , Montgomery Elizabeth A. , Rosenberg Andrew E.
Published: September 2021

Bone tumors are a diverse group of lesions that have a broad spectrum of biological behavior. They range from reactive conditions to benign and malignant neoplasms, and their accurate distinction from one another requires careful correlation with their clinical and imaging findings. Clues to the correct diagnosis can be derived from the patient's age, symptoms, and location of the tumor both within the skeleton and the individual bone. Tumor size, radiodensity, margination, cortical integrity, periosteal reaction, and extension into the soft tissues are useful imaging characteristics in determining phenotype and estimating biological potential. In combination, these attributes help build a differential diagnosis that should form the framework for the interpretation of the pathological findings. There are many diagnostic pitfalls, as common bone tumors may have uncommon clinical presentations, and conversely, rare bone tumors may masquerade as garden variety neoplasms. The most important task of the pathologist is to distinguish whether a tumor is reactive or neoplastic, and if neoplastic, benign or malignant—this interpretation can be extremely challenging. In this review, a select group of diagnostically challenging differential diagnoses is explored to provide a guide in generating the correct diagnosis.
Chondromyxoid Fibroma of the Temporal Bone: Case Report and Literature Review
Authors: Grover Abhinav , Mannem Rajeev R. , Hunt Bryan C. , Singh Reena
Published: September 2021

Chondromyxoid fibroma (CMF) is a rare, benign, cartilaginous bone tumor that commonly affects the metaphysis of the lower-extremity long bones in young adults. Involvement of the craniofacial bones, especially the temporal bone, is exceedingly rare. We report a case of a 64-year-old man who presented with a left ear mass, but on subsequent imaging was found to have a more extensive mass centered in the temporal bone. Initial biopsy raised the concern for a low-grade chondrosarcoma. However, following surgical resection, a diagnosis of CMF was rendered. The clinical findings, radiographic features, histology, and differential diagnoses are discussed.
Myxofibrosarcoma-Like Pleomorphic Liposarcoma
Authors: Hariri Dana J. , Benyounes Amin , Davis Derik L. , Mulligan Michael E. , Ng Vincent Y. , Kallen Michael Edward
Published: September 2021

Pleomorphic liposarcoma is the least common subtype of liposarcoma, accounting for less than 5% of cases, but is important to distinguish from other liposarcoma subtypes due to a significantly worse prognosis closer to that of a high-grade sarcoma. A substantial proportion of cases demonstrate histologic features overlapping with myxofibrosarcoma, except for the presence of diagnostic pleomorphic lipoblasts. These lipoblasts are essential to the diagnosis of pleomorphic liposarcoma, in contrast to the other subtypes of liposarcoma, but can be highly focal/variable in extent, mandating extensive gross sampling and thorough histologic examination and representing a pitfall in diagnosis particularly in small biopsies. Awareness of the less common histologic patterns of this uncommon entity will hopefully facilitate correct diagnosis.