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An extensive body of demographic literature has described Jews as ‘long-lifers’. From the mid-nineteenth century onwards, this pattern affected all age groups and was particularly well expressed among Jewish males but was also present among Jewish females. It held good independently of the Jews’ socio-economic position. This became known as ‘Jewish pattern of mortality’. This paper has two aims. The first aim is to show the impact of COVID-19 on Jewish mortality. This is a study of a global pandemic in the Jewish population which is, to the best of our knowledge, unique in its scope and quality. The second aim is to settle the finding of relatively high mortality from COVID-19 in certain Jewish communities (‘Jewish penalty’ in relation to COVID-19) with the notion of ‘Jewish pattern of mortality’. The author proceeds to show that the status of Jews as a low mortality group under a Western epidemiological regime, when mortality and morbidity are dominated by non-communicable diseases, does not stand in contradiction to a higher vulnerability among Jews to coronavirus. Thus, the paper further develops understanding of mortality of Jews and serves as a contribution to ethnic and religious demography and epidemiology.

PURPOSE To improve skin cancer screening among survivors of childhood cancer treated with radiotherapy where skin cancers make up 58% of all subsequent neoplasms. Less than 30% of survivors currently complete recommended skin cancer screening. PATIENTS AND METHODS This randomized controlled comparative effectiveness trial evaluated patient and provider activation (PAE + MD) and patient and provider activation with teledermoscopy (PAE + MD + TD) compared with patient activation alone (PAE), which included print materials, text messaging, and a website on skin cancer risk factors and screening behaviors. Seven hundred twenty-eight participants from the Childhood Cancer Survivor Study (median age at baseline 44 years), age > 18 years, treated with radiotherapy as children, and without previous history of skin cancer were randomly assigned (1:1:1). Primary outcomes included receiving a physician skin examination at 12 months and conducting a skin self-examination at 18 months after intervention. RESULTS Rates of physician skin examinations increased significantly from baseline to 12 months in all three intervention groups: PAE, 24%-39%, relative risk [RR], 1.65, 95% CI, 1.32 to 2.08; PAE + MD, 24% to 39%, RR, 1.56, 95% CI, 1.25 to 1.97; PAE + MD + TD, 24% to 46%, RR, 1.89, 95% CI, 1.51 to 2.37. The increase in rates did not differ between groups ( P = .49). Similarly, rates of skin self-examinations increased significantly from baseline to 18 months in all three groups: PAE, 29% to 50%, RR, 1.75, 95% CI, 1.42 to 2.16; PAE + MD, 31% to 58%, RR, 1.85, 95% CI, 1.52 to 2.26; PAE + MD + TD, 29% to 58%, RR, 1.95, 95% CI, 1.59 to 2.40, but the increase in rates did not differ between groups ( P = .43). CONCLUSION Although skin cancer screening rates increased more than 1.5-fold in each of the intervention groups, there were no differences between groups. Any of these interventions, if implemented, could improve skin cancer prevention behaviors among childhood cancer survivors.

PURPOSE: Despite evidence of clinical benefits, widespread implementation of remote symptom monitoring has been limited. We describe a process of adapting a remote symptom monitoring intervention developed in a research setting to a real-world clinical setting at two cancer centers. METHODS: This formative evaluation assessed core components and adaptations to improve acceptability and fit of remote symptom monitoring using Stirman's Framework for Modifications and Adaptations. Implementation outcomes were evaluated in pilot studies at the two cancer centers testing technology (phase I) and workflow (phase II and III) using electronic health data; qualitative evaluation with semistructured interviews of clinical team members; and capture of field notes from clinical teams and administrators regarding barriers and recommended adaptations for future implementation. RESULTS: Core components of remote symptom monitoring included electronic delivery of surveys with actionable symptoms, patient education on the intervention, a system to monitor survey compliance in real time, the capacity to generate alerts, training nurses to manage alerts, and identification of personnel responsible for managing symptoms. In the pilot studies, while most patients completed > 50% of expected surveys, adaptations were identified to address barriers related to workflow challenges, patient and clinician access to technology, digital health literacy, survey fatigue, alert fatigue, and data visibility. CONCLUSION: Using an implementation science approach, we facilitated adaptation of remote symptom monitoring interventions from the research setting to clinical practice and identified key areas to promote effective uptake and sustainability.

One opportunity for organizations to participate in open source software (OSS) development is through organizations OSS (orgsOSS), a term we use to describe a group of organizations that commit resources to collectively develop OSS. This archetype of OSS development is distinct from other types that include organizations, yet is understudied. As organizations increasingly contribute to and rely on OSS as part of their strategy, understanding how they can collaborate to build software holds importance for the future of software development. This study collects a unique dataset of development tasks from a large orgsOSS project spanning over two years and seven releases. Building on existing OSS research, we explore norms with respect to collaboration, i.e., how developers assign, discuss, and complete tasks, in an orgsOSS project. Interestingly, our analysis reveals that developers in orgsOSS do not always adhere to ideals of widespread sharing and participation espoused by traditional OSS, however some developer and task characteristics helped foster these ideals. Based on these and other findings, we develop a set of propositions and associated collaboration mechanisms that are important to future orgsOSS and other similarly structured software development projects.

With the increase in international travel and development of insecticide resistance, a re-emergence of the bed bug has been observed since the 2000s and it is becoming a worldwide public health problem. Hospitals and other medical settings have not been spared, while the cases reported remain limited. However, there are no specific recommendations for the healthcare settings in the literature.To report our experience of a bed bug infestation in a medical unit, in the French University Hospital Centre of Brest, caused by the admission of a patient carrier in October 2020. We described the practical methods used to control bed bugs infestation, evaluated the cost of this episode and created a specific procedure to take care of at-risk patients or known carriers of bed bugs.The decision to close the unit for global treatment was taken after the investigations using a sniffer dog revealed that four rooms were infested. The closure lasted 24 days. We estimated the total cost of the infestation to be approximately US$400,000. No other wave of infestation occurred. We created a specific protocol of care for patients who were known carriers or at risk of carriage of bed bugs to graduate a strategy of control.Bed bug infestations in health facilities have a major impact on the care of patients and relevant economic consequences. Prevention and education policies are an essential starting point to respond to the scale of the phenomenon.

Lipid nanoparticles (LNPs) have evolved rapidly as promising delivery systems for oligonucleotides, including siRNAs. However, current clinical LNP formulations show high liver accumulation after systemic administration, which is unfavorable for the treatment of extrahepatic diseases, such as hematological disorders. Here we describe the specific targeting of LNPs to hematopoietic progenitor cells in the bone marrow. Functionalization of the LNPs with a modified Leu-Asp-Val tripeptide, a specific ligand for the very-late antigen 4 resulted in an improved uptake and functional siRNA delivery in patient-derived leukemia cells when compared to their non-targeted counterparts. Moreover, surface-modified LNPs displayed significantly improved bone-marrow accumulation and retention. These were associated with increased LNP uptake by immature hematopoietic progenitor cells, also suggesting similarly improved uptake by leukemic stem cells. In summary, we describe an LNP formulation that successfully targets the bone marrow including leukemic stem cells. Our results thereby support the further development of LNPs for targeted therapeutic interventions for leukemia and other hematological disorders.

Semi-flexible polymers in crowded environments exhibit complex dynamics that play a crucial role in various biological and material design processes. Based on the classic reptation theory, it is generally believed that semiflexible polymers are trapped within static confinements. Here we demonstrate that semi-flexible polymers are indeed trapped in short-lived kinetic cages. We have developed a novel scaling law for rotational diffusion through the examination of the polymer network at the level of an individual nanofiber and quantify the onset of entanglement and entanglement itself by introducing an effective tube diameter. We also show that understanding these dynamics is critical for interpreting the macroscopic behavior of such systems, as evidenced by our micro-rheology analysis. The insight from our study provides a rectified microscopic understanding of the dynamics of semi-flexible polymers in complex environments, yielding new principles to better understand the macroscopic behavior of crowded systems, from biophysics to materials science.

The efficient removal of the antibiotic ciprofloxacin (CIP) from aqueous samples using magnetic nanosorbents prepared using three sulfated polysaccharides, κ-, ι- and λ-carrageenan and an alkoxysilane agent containing a reactive epoxide ring is described. The prepared nanosorbents were characterized in detail using FTIR spectroscopy, solid-state 29Si and 13C NMR spectroscopy and elemental microanalysis. The synthesis method was more effective for incorporating higher amounts of κ-carrageenan in the siliceous shells. Although being less sulfated, κ-carrageenan is cheaper than the other carrageenan tested. The CIP adsorption was a cooperative process, well described by the Dubinin–Radushkevich isotherm, with maximum adsorption capacities of 878, 969 and 865 mg/g for κ-, ι- and λ-carrageenan sorbents, respectively. Overall, the produced magnetic nanosorbents are among the best magnetic systems with high adsorptive efficiency for CIP. It is suggested that protonated CIP molecules are exchanged with ester sulfate counterions of carrageenan at the particles’ surface as the main pathway for CIP adsorption. The adsorption process was exothermic and entropically favorable for the three sorbents. However, at 298 K, the adsorption was spontaneous for κ-carrageenan-based sorbents and non-spontaneous for ι- and λ-carrageenan particles. The magnetic sorbents could be reused and maintained their ability towards CIP removal up to four cycles. The removal efficiency in wastewater was enhanced with the sorbent dose. Graphical abstract: [Figure not available: see fulltext.] Magnetic carrageenan nanosorbents were prepared using three carrageenan polysaccharides (κ-, ι-, and λ-carrageenan). The resulting magnetic particles removed the antibiotic ciprofloxacin efficiently from ultra-pure water and wastewater samples. Magnetic features enabled the fast magnetic separation of the nanosorbents from water. published

Transition metal (TM)-modification of silica matrices are found in numerous materials for diverse applications. In other related hybrid materials, one tries to explore properties that result from combining the silica network with organic moieties, such as in the covalent grafting of polysaccharides onto amorphous nanosilicas. However, sol–gel routes for modification with TM have been less explored for hybrid siliceous materials. The present study demonstrates the effective modification of hybrid siliceous materials with TM (TM = Co2+, Ni2+, Cu2+, Zn2+) that result from a sol–gel method that uses as a precursor the polysaccharide κ-carrageenan that was modified with a covalently alkoxysilane linked. Structural analysis and characterization studies of the derived carrageenan-silica hybrids were undertaken, and, in particular, the effects of the TM ions on the hybrids’ properties have been assessed. This work clearly indicates that the modification with TM imposes changes on the morphological, optical, and thermal properties of the hybrids compared to the unmodified analogs. Hence, the practical applicability of the modification with TM using the sol–gel described here is not limited to the presence of the guest ion but also provides a tool for changing the properties of the host particles. Graphical Abstract

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Higher prevalence of cancer-related risk factors, for example, tobacco use, obesity, poor diet, and physical inactivity, is observed in the U.S. Deep South and likely contributes to its increased cancer burden. While this region is largely rural, it is unknown whether cancer-related beliefs and lifestyle practices differ by rural–urban status or are more influenced by other factors. We contacted 5,633 Alabamians to complete a cross-sectional survey to discern cancer-related beliefs and lifestyle practices, and compared data from respondents residing in rural- versus urban-designated counties. Findings were summarized using descriptive statistics; rural–urban subgroups were compared using two-tailed, χ2 and t tests. Multivariable logistic regression models were used to explore associations by rural–urban status and other sociodemographic factors. Surveys were completed by 671 rural- and 183 urban-county respondents (15.2% response rate). Overall, the prevalence for overweight and obesity (77.8%) and sugar-sweetened beverage intake (273–364 calories/day) was higher than national levels. Most respondents (58%) endorsed raising the state tobacco tax. Respondents from rural- versus urban-designated counties were significantly more likely to be racial/ethnic minority, have lower education, employment, income, food security, and internet access, and endorse fatalistic cancer-related beliefs (Prevention Relevance: Cancer incidence and mortality are higher in the U.S. Deep South, likely due to increased tobacco-use, obesity, poor diet, and physical inactivity. This study explores whether cancer-related beliefs and lifestyle practices differ by rural-urban status or other sociodemographic factors in a random sample of 855 residents across Alabama.

How does neural activity drive muscles to produce behavior? The recent development of genetic lines in Hydra that allow complete calcium imaging of both neuronal and muscle activity, as well as systematic machine learning quantification of behaviors, makes this small cnidarian an ideal model system to understand and model the complete transformation from neural firing to body movements. To achieve this, we have built a neuromechanical model of Hydra ’s fluid-filled hydrostatic skeleton, showing how drive by neuronal activity activates distinct patterns of muscle activity and body column biomechanics. Our model is based on experimental measurements of neuronal and muscle activity and assumes gap junctional coupling among muscle cells and calcium-dependent force generation by muscles. With these assumptions, we can robustly reproduce a basic set of Hydra ’s behaviors. We can further explain puzzling experimental observations, including the dual timescale kinetics observed in muscle activation and the engagement of ectodermal and endodermal muscles in different behaviors. This work delineates the spatiotemporal control space of Hydra movement and can serve as a template for future efforts to systematically decipher the transformations in the neural basis of behavior.

Sensory feedback is essential to both animals and robotic systems for achieving coordinated, precise movements. Mechanosensory feedback, which provides information about body deformation and position in space, depends not only on the properties of sensors but also on the structure in which they are embedded. In insects, wing structure plays a particularly important role in flapping flight: in addition to generating aerodynamic forces, wings provide mechanosensory feedback necessary for guiding flight while undergoing dramatic deformations over the course of each wingbeat. However, the role that wing structure plays in determining mechanosensory information is relatively unexplored. Insect wings exhibit characteristic stiffness gradients, with greatest stiffness at the base and leading edge and lowest stiffness at the tip of the trailing edge. Additionally, wings are subject to both aerodynamic and structural damping. The sensory consequences of stiffness gradients and damping are unknown. Here we examine how both the nonuniform stiffness profile of a wing and its damping impacts sensory performance, using finite elements analysis combined with sensor placement optimization approaches. We show that wings with nonuniform stiffness exhibit several advantages over uniform stiffness wings, resulting in higher accuracy of rotation detection and lower sensitivity to the placement of sensors on the wing. Moreover, we show that higher damping generally improves the accuracy with which body rotations can be detected. These results contribute to our understanding of the evolution of the nonuniform stiffness patterns in insect wings, as well as suggest design principles for robotic systems.

BACKGROUND: Thiopurines are an important class of immunosuppressants despite their risk for hematopoietic toxicity and narrow therapeutic indices. Benign neutropenia related to an ACKR1 variant (rs2814778-CC) is common among individuals of African ancestries. OBJECTIVE: We tested whether rs2814778-CC was associated with azathioprine discontinuation attributed to hematopoietic toxicity and lower thiopurine dosing. DESIGN: Retrospective cohort study. SETTING: Two tertiary care centers. PATIENTS: Thiopurines users with White or Black race. MEASUREMENTS: Azathioprine discontinuation attributed to hematopoietic toxicity. Secondary outcomes included weight-adjusted last dose, white blood cell (WBC) and delta WBC counts. RESULTS: The discontinuation rate of azathioprine attributed to hematopoietic toxicity was 3.92/100 person-years among patients with the CC genotype (n=101) and 1.34/100 person-years among patients without the CC genotype (n=1,365) [hazard ratio (HR)=2.92, 95%CI: 1.57–5.41, competing hazards model]. The risk remained significant when adjusted by race (HR=2.61, 1.01–6.71). The risk associated with race alone (HR=2.13, 1.21–3.75) was abrogated by adjustment for genotype (HR=1.13, 0.48–2.69). Lower dosing and other secondary outcomes, except delta WBC count, were significant among patients who did not discontinue for hematopoietic toxicity. Lower dosing was validated in an external cohort of 94 children of African ancestries prescribed the thiopurine 6-mercaptopurine (6-MP) for acute lymphoblastic leukemia (ALL). The CC genotype was independently associated with lower 6-MP intensity dosages relative to the target daily dose—75 mg/m(2) (CC: median 0.83 interquartile range [0.70–0.94] vs TT or TC: 0.94 [0.73–1.13], P=0.013). LIMITATIONS: Unmeasured confounding. Data limited to tertiary centers. CONCLUSION: Patients with the CC genotype faced higher risk for discontinuation for attributed hematopoietic toxicity and lower doses. Genotype, even adjusted for race, is associated with those risks. PRIMARY FUNDING SOURCE: National Institutes of Health

Research on paper substrates prepared by inkjet deposition of metal nanoparticles for sensing applications has become a hot topic in recent years; however, the design of such substrates based on the deposition of alloy nanoparticles remains less explored. Herein, we report for the first time the inkjet printing of dendrimer-stabilized colloidal metal nanoalloys for the preparation of paper substrates for surface-enhanced Raman scattering (SERS) spectroscopy. To this end, nanoassemblies containing variable molar ratios of Au:Ag were prepared in the presence of poly(amidoamine) dendrimer (PAMAM), resulting in plasmonic properties that depend on the chemical composition of the final materials. The dendrimer-stabilized Au:Ag:PAMAM colloids exhibit high colloidal stability, making them suitable for the preparation of inks for long-term use in inkjet printing of paper substrates. Moreover, the pre-treatment of paper with a polystyrene (PS) aqueous emulsion resulted in hydrophobic substrates with improved SERS sensitivity, as illustrated in the analytical detection of tetramethylthiuram disulfide (thiram pesticide) dissolved in aqueous solutions. We suggest that the interactions established between the two polymers (PAMAM and PS) in an interface region over the cellulosic fibres, resulted in more exposed metallic surfaces for the adsorption of the analyte molecules. The resulting hydrophobic substrates show long-term plasmonic stability with high SERS signal retention for at least ninety days. published

The recent approval of several COVID-19 vaccines signals progress toward controlling the pandemic. Although social distancing and masking have been effective, vaccines are an important additional measure of protection to reduce COVID-19 spread. Adequate uptake is essential to reach herd immunity, estimated to be approximately 67%. However, vaccine hesitancy, the fast-tracked nature of the COVID-19 vaccines, and misinformation circulating through various forms of media have contributed to lower vaccination intention than desired. The current research study developed an online survey conducted via Facebook to explore the attitudes and perceptions of adult Alabama residents about COVID-19 and the COVID-19 vaccines. Of the 3,781 respondents, only 44.3% reported intent to receive a vaccine, with a large proportion reporting they were unsure (28.1%). Lack of intention to vaccinate was associated with low educational attainment, low COVID-19 knowledge levels, low income, and African American race. The current survey also explored participants’ influenza vaccine behavior as this information can also be used to inform successful COVID-19 vaccine distribution. Of the respondents, 56% report receiving the yearly influenza vaccine and the majority receive it at a pharmacy or healthcare provider office. This informs likely successful locations for COVID-19 vaccine distribution. Appropriate education targeted to populations most likely to refuse COVID-19 vaccination is essential to promote uptake. The information collected from the current study should be utilized to inform effective and efficient vaccine distribution strategies.

ACS nano 16(2), 2120 - 2132 (2022). doi:10.1021/acsnano.1c07769, The nanostructure, primarily particle orientation, controls mechanical and functional (e.g., mouthfeel, cell compatibility, optical, morphing) properties when macroscopic materials are assembled from nanofibrils. Understanding and controlling the nanostructure is therefore an important key for the continued development of nanotechnology. We merge recent developments in the assembly of biological nanofibrils, X-ray diffraction orientation measurements, and computational fluid dynamics of complex flows. The result is a digital twin, which reveals the complete particle orientation in complex and transient flow situations, in particular the local alignment and spatial variation of the orientation distributions of different length fractions, both along the process and over a specific cross section. The methodology forms a necessary foundation for analysis and optimization of assembly involving anisotropic particles. Furthermore, it provides a bridge between advanced in operandi measurements of nanostructures and phenomena such as transitions between liquid crystal states and in silico studies of particle interactions and agglomeration., Published by Soc., Washington, DC

Background: Multiple reports associate the cardiac sodium channel gene ( SCN5A ) variants S1103Y and R1193Q with type 3 congenital long QT syndrome and drug-induced long QT syndrome. These variants are too common in ancestral populations to be highly arrhythmogenic at baseline, however: S1103Y allele frequency is 8.1% in African Americans and R1193Q 6.1% in East Asians. R1193Q is known to increase late sodium current ( I Na-L ) in cardiomyocytes derived from induced pluripotent stem cells but the role of these variants in modulating repolarization remains poorly understood. Methods: We determined the effect of S1103Y on QT intervals among African-American participants in a large electronic health record. Using cardiomyocytes derived from induced pluripotent stem cells carrying naturally occurring or genome-edited variants, we studied action potential durations (APDs) at baseline and after challenge with the repolarizing potassium current ( I Kr ) blocker dofetilide and I Na-L and I Kr at baseline. Results: In 1479 African-American participants with no confounding medications or diagnoses of heart disease, QT intervals in S1103Y carriers was no different from that in noncarriers. Baseline APD was no different in cells expressing the Y allele (SY, YY cells) compared with isogenic cells with the reference allele (SS cells). However, I Na-L was increased in SY and YY cells and the I Na-L blocker GS967 shortened APD in SY/YY but not SS cells ( P I Kr was increased almost 2-fold in SY/YY cells compared with SS cells (tail current: 0.66±0.1 versus 1.2±0.1 pA/pF; P P P Kr and increased dofetilide sensitivity. Conclusions: These common ancestry-specific variants do not affect baseline repolarization, despite generating increased I Na-L . We propose that increased I Kr serves to maintain normal repolarization but increases the risk of manifest QT prolongation with I Kr block in variant carriers. Our findings emphasize the need for inclusion of diverse populations in the study of adverse drug reactions.

ImportanceTwo risk variants in the apolipoprotein L1 gene (APOL1) have been associated with increased susceptibility to sepsis in Black patients. However, it remains unclear whetherAPOL1high-risk genotypes are associated with either progression from infection to sepsis or sepsis-related phenotypes, independent of their association with severe renal disease.ObjectiveTo examine the association betweenAPOL1high-risk genotypes and the risk of progression from infection to sepsis and sepsis-related phenotypes.Design, setting, and participantsA retrospective cohort study of 2,242 Black patients hospitalized with an infection.ExposuresCarriage ofAPOL1high-risk genotypes.Main outcomes and measuresThe primary outcome was sepsis; secondary outcomes were death and organ failure related to sepsis.ResultsOf 2,242 Black patients hospitalized with infections, 565 developed sepsis. Patients with high-riskAPOL1genotypes had a significantly increased risk of sepsis (odds ratio [OR]=1.29 [95% CI, 1.00–1.67; p=0.047]); however, this association was not significant after adjustment for pre-existing severe renal disease (OR=1.14 [95% CI, 0.88-1.48; p=0.33]), nor after exclusion of those patients with pre-existing severe renal disease (OR=0.99 [95% CI, 0.70-1.39; p=0.95].APOL1high-risk genotypes were significantly associated with the renal dysfunction component of the Sepsis-3 criteria (OR=1.64 [95% CI, 1.21–2.22; p=0.001], but not with other sepsis-related organ dysfunction or death. The association between high-riskAPOL1genotypes and sepsis-related renal dysfunction was markedly attenuated by adjusting for pre-existing severe renal disease (OR=1.36 [95% CI, 1.00–1.86; p=0.05]) and was nullified after exclusion of patients with pre-existing severe renal disease (OR=1.16 [95% CI, 0.74–1.81; p=0.52]).Conclusion and relevanceAPOL1high-risk genotypes were associated with an increased risk of sepsis; however, this increased risk was attributable predominantly to pre-existing renal disease.

Polymorphisms thiopurine-S-methyltransferase (TPMT) and nudix hydrolase 15 (NUDT15) can increase the risk of azathioprine myelotoxicity, but little is known about other genetic factors that increase risk for azathioprine-associated side effects. PrediXcan is a gene-based association method that estimates the expression of individuals’ genes and examines their correlation to specified phenotypes. As proof of concept for using PrediXcan as a tool to define the association between genetic factors and azathioprine side effects, we aimed to determine whether the genetically predicted expression of TPMT or NUDT15 was associated with leukopenia or other known side effects. In a retrospective cohort of 1364 new users of azathioprine with EHR-reported White race, we used PrediXcan to impute expression in liver tissue, tested its association with pre-specified phecodes representing known side effects (e.g., skin cancer), and completed chart review to confirm cases. Among confirmed cases, patients in the lowest tertile (i.e., lowest predicted) of TPMT expression had significantly higher odds of developing leukopenia (OR=3.30, 95%CI: 1.07-10.20, p=0.04) versus those in the highest tertile; no other side effects were significant. The results suggest that this methodology could be deployed on a larger scale to uncover associations between genetic factors and drug side effects for more personalized care.

First colorimetric and low-cost approach for detecting and quantifying galectin-3 using gold nanoparticles (AuNPs) bioconjugated with Gal-3 antibody.

BACKGROUND: Many cancers metastasize to bone and may lead to pathologic fracture or impending pathologic fracture. Prophylactically stabilizing bones before fracture has been shown to be more cost-effective with improved outcomes. Many studies have examined risk factors for pathological fracture, with radiographic and functional pain data serving as predominant indicators for surgery. Conditions associated with poor bone health and increased risk of fracture in the non-oncologic population, including diabetes mellitus, chronic obstructive pulmonary disease (COPD), cardiovascular disease, renal disease, smoking, corticosteroid use, and osteoporosis, have not been studied in the context of metastatic disease. Characterization of these factors could help providers identify candidates for prophylactic stabilization thereby reducing the number of completed pathological fractures. METHODS: 298 patients over the age of 40 with metastatic bone disease of the femur treated between 2010-2021 were retrospectively identified. Patients without complete medical documentation or with non-metastatic diagnoses were excluded. 186 patients met inclusion and exclusion criteria, including 74 patients who presented with pathological femur fracture and 112 patients who presented for prophylactic stabilization. Patient demographics and comorbidities including diabetes mellitus, COPD, cardiovascular disease, renal disease, osteoporosis, active tobacco or corticosteroid use, and use of anti-resorptive therapy were collected. Descriptive statistics were compiled, with univariable analysis by Mann-Whitney or chisquared testing. Multiple logistic regression was then performed to identify the most significant patient variables for presenting with completed fracture. RESULTS: On univariable analysis, patients with COPD were more likely to present with pathologic fracture (19/32 [59%] compared to 55/154 [36%], p = 0.02). A trend emerged for patients with an increasing number of comorbidities (28/55 [51%] for 2+ comorbidities compared to 18/61 [29%] with zero comorbidities, p = 0.06). On multivariable analysis, patients with two or more comorbidities (OR: 2.49; p=0.02) were more likely to present with a femur fracture. CONCLUSION: This analysis suggests that those with an increasing number of comorbidities may be at increased risk for pathologic fracture. This study raises the possibility that patient factors and/ or comorbidities alter bone strength and/or pain experiences and may guide orthopaedic oncologists weighing prophylactic stabilization of femur lesions. Level of Evidence: III

ACS applied materials & interfaces 14(50), 55850 - 55863 (2022). doi:10.1021/acsami.2c15514, Printed paper-based electronics offers solutions to rising energy concerns by supplying flexible, environmentally friendly, low-cost infrastructure for portable and wearable electronics. Herein, we demonstrate a scalable spray-coating approach to fabricate tailored paper poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS)/cellulose nanofibril (CNF) electrodes for all-printed supercapacitors. Layer-by-layer spray deposition was used to achieve high-quality electrodes with optimized electrode thickness. The morphology of these electrodes was analyzed using advanced X-ray scattering methods, revealing that spray-coated electrodes have smaller agglomerations, resulting in a homogeneous film, ultimately suggesting a better electrode manufacturing method than drop-casting. The printed paper-based supercapacitors exhibit an areal capacitance of 9.1 mF/cm$²$, which provides enough energy to power electrochromic indicators. The measured equivalent series resistance (ESR) is as low as 0.3 Ω, due to improved contact and homogeneous electrodes. In addition, a demonstrator in the form of a self-powered wearable wristband is shown, where a large-area (90 cm$²$) supercapacitor is integrated with a flexible solar cell and charged by ambient indoor light. This demonstration shows the tremendous potential for sequential coating/printing methods in the scaling up of printed wearables and self-sustaining systems., Published by Soc., Washington, DC

Background Symptomatic progressive collapsing foot deformity (PCFD) is frequently treated with reconstructive surgery. Multiple studies have documented successful treatment based on improvements in symptoms and physical examination findings. However, it is not well-established whether there are corresponding improvements in gait function following surgical treatment for PCFD. Methods A systematic review of biomechanical outcomes of treatments for flexible PCFD was conducted on PubMed. The 4 articles chosen involved patients with symptomatic flexible PCFD who underwent a reconstructive surgery. Surgical interventions included osteotomy, tendon transfer, and/or ligament repair or reconstruction. Primary outcomes involved objective quantifiable measurements of kinematic, kinetic, or temporospatial parameters. Results The initial search yielded 605 articles, from which 26 were retained after screening the title and abstract. Twenty-two were eliminated yielding 4 articles. Temporospatial, kinematic, and kinetic parameters were all altered after the patients underwent surgical intervention. Specifically, stride length, cadence, and walking speed all improved postoperatively. Walking kinetics also improved with restoration of normal motion in the frontal and sagittal planes and improvements in the dorsiflexion angle. There were also improvements in sagittal power. Discussion Surgical intervention to treat flexible PCFD improves objective biomechanical outcomes; however, more follow-up studies are needed to establish the reliability and durability of these improvements. Level of Evidence: Level III: Systematic review

The use of gold nanoparticles for drug delivery, photothermal or photodynamic therapy, and biosensing enhances the demand for knowledge about the protein corona formed on the surface of nanoparticles. In this study, gold nanospheres (AuNSs), gold nanorods (AuNRs), and gold nanoflowers (AuNFs) were incubated with saliva or urine. After the interaction, the surface of gold nanoparticles was investigated using UV-VIS spectroscopy, zeta potential, and dynamic light scattering. The shifting of the localized surface plasmon resonance (LSPR) band, the increase in hydrodynamic diameter, and the changes in the surface charge of nanoparticles indicated the presence of biomolecules on the surface of AuNSs, AuNRs, and AuNFs. The incubation of AuNFs with saliva led to nanoparticle aggregation and minimal protein adsorption. AuNSs and AuNRs incubated in saliva were analyzed through liquid chromatography with tandem mass spectrometry (LC-MS/MS) to identify the 96 proteins adsorbed on the surface of the gold nanoparticles. Among the 20 most abundant proteins identified, 14 proteins were common in both AuNSs and AuNRs. We hypothesize that the adsorption of these proteins was due to their high sulfur content, allowing for their interaction with gold nanoparticles via the Au-S bond. The presence of distinct proteins on the surface of AuNSs or AuNRs was also investigated and possibly related to the competition between proteins present on the external layers of corona and gold nanoparticle morphology.

Diffusion-weighted imaging (DWI) may allow for breast cancer screening MRI without a contrast injection. Multishot methods improve prone DWI of the breasts but face different challenges in the supine position.To establish a multishot DWI (msDWI) protocol for supine breast MRI and to evaluate the performance of supine vs. prone msDWI.Prospective.Protocol optimization: 10 healthy women (ages 22-56), supine vs. prone: 24 healthy women (ages 22-62) and five women (ages 29-61) with breast tumors.3-T, protocol optimization msDWI: free-breathing (FB) 2-shots, FB 4-shots, respiratory-triggered (RT) 2-shots, RT 4-shots, supine vs. prone: RT 4-shot msDWI, T2-weighted fast-spin echo.Protocol optimization and supine vs. prone: three observers performed an image quality assessment of sharpness, aliasing, distortion (vs. T2), perceived SNR, and overall image quality (scale of 1-5). Apparent diffusion coefficients (ADCs) in fibroglandular tissue (FGT) and breast tumors were measured.Effect of study variables on dichotomized ratings (4/5 vs. 1/2/3) and FGT ADCs were assessed with mixed-effects logistic regression. Interobserver agreement utilized Gwet's agreement coefficient (AC). Lesion ADCs were assessed by Bland-Altman analysis and concordance correlation (ρProtocol optimization: 4-shots significantly improved sharpness and distortion; RT significantly improved sharpness, aliasing, perceived SNR, and overall image quality. FGT ADCs were not significantly different between shots (P = 0.812), FB vs. RT (P = 0.591), or side (P = 0.574). Supine vs. prone: supine images were rated significantly higher for sharpness, aliasing, and overall image quality. FGT ADCs were significantly higher supine; lesion ADCs were highly correlated (ρBased on image quality, supine msDWI outperformed prone msDWI. Lesion ADCs were highly correlated between the two positions, while FGT ADCs were higher in the supine position.2.Stage 1.

Policy development and subsequent action occur at all levels of government with various opportunities for input from nongovernmental organizations and individual citizens. U.S. Environmental Protec...