Analysis of Geographic Accessibility of Breast, Lung, and Colorectal Cancer Screening Centers Among American Indian and Alaskan Native Tribes.

PURPOSE: To evaluate geographic accessibility of ACR mammographic screening (MS), lung cancer screening (LCS), and CT colorectal cancer screening (CTCS) centers among US federally recognized American Indian and Alaskan Native (AI/AN) tribes. METHODS: Distances from AI/AN tribes' ZIP codes to their closest ACR-accredited LCS and CTCS centers were recorded using tools from the ACR website. The FDA's database was used for MS. Persistent adult poverty (PPC-A), persistent child poverty (PPC-C), and rurality indexes (rural-urban continuum codes) were from the US Department of Agriculture. Logistic and linear regression analyses were used to assess distances to screening centers and relationships among rurality, PPC-A, and PPC-C. RESULTS: Five hundred ninety-four federally recognized AI/AN tribes met the inclusion criteria. Among all closest MS, LCS, or CTCS center to AI/AN tribes, 77.8% (1,387 of 1,782) were located within 200 miles, with a mean distance of 53.6 ± 53.0 miles. Most tribes (93.6% [557 of 594]) had MS centers within 200 miles, 76.4% (454 of 594) had LCS centers within 200 miles, and 63.5% (376 of 594) had CTCS centers within 200 miles. Counties with PPC-A (odds ratio [OR], 0.47; P < .001) and PPC-C (OR, 0.19; P < .001) were significantly associated with decreased odds of having a cancer screening center within 200 miles. PPC-C was associated with decreased likelihood of having an LCS center (OR, 0.24; P < .001) and an CTCS center (OR, 0.52; P < .001) within the same state as the tribe's location. No significant association was found between PPC-A and PPC-C and MS centers. CONCLUSIONS: AI/AN tribes experience distance barriers to ACR-accredited screening centers, resulting in cancer screening deserts. Programs are needed to increase equity in screening access among AI/AN tribes.

Active and durable R2MnRuO7 pyrochlores with low Ru content for acidic oxygen evolution.

The production of green hydrogen in water electrolyzers is limited by the oxygen evolution reaction (OER). State-of-the-art electrocatalysts are based on Ir. Ru electrocatalysts are a suitable alternative provided their performance is improved. Here we show that low-Ru-content pyrochlores (R2MnRuO7, R = Y, Tb and Dy) display high activity and durability for the OER in acidic media. Y2MnRuO7 is the most stable catalyst, displaying 1.5 V at 10 mA cm-2 for 40 h, or 5000 cycles up to 1.7 V. Computational and experimental results show that the high performance is owed to Ru sites embedded in RuMnOx surface layers. A water electrolyser with Y2MnRuO7 (with only 0.2 mgRu cm-2) reaches 1 A cm-2 at 1.75 V, remaining stable at 200 mA cm-2 for more than 24 h. These results encourage further investigation on Ru catalysts in which a partial replacement of Ru by inexpensive cations can enhance the OER performance.

Natural Killer T (NKT) Cells and Periodontitis: Potential Regulatory Role of NKT10 Cells.

Natural killer T (NKT) cells constitute a unique subset of T lymphocytes characterized by specifically interacting with antigenic glycolipids conjugated to the CD1d receptor on antigen-presenting cells. Functionally, NKT cells are capable of performing either effector or suppressor immune responses, depending on their production of proinflammatory or anti-inflammatory cytokines, respectively. Effector NKT cells are subdivided into three subsets, termed NKT1, NKT2, and NKT17, based on the cytokines they produce and their similarity to the cytokine profile produced by Th1, Th2, and Th17 lymphocytes, respectively. Recently, a new subgroup of NKT cells termed NKT10 has been described, which cooperates and interacts with other immune cells to promote immunoregulatory responses. Although the tissue-specific functions of NKT cells have not been fully elucidated, their activity has been associated with the pathogenesis of different inflammatory diseases with immunopathogenic similarities to periodontitis, including osteolytic pathologies such as rheumatoid arthritis and osteoporosis. In the present review, we revise and discuss the pathogenic characteristics of NKT cells in these diseases and their role in the pathogenesis of periodontitis; particularly, we analyze the potential regulatory role of the IL-10-producing NKT10 cells.

Analysis of socioeconomic and demographic factors and imaging exam characteristics associated with missed appointments in pediatric radiology.

BACKGROUND: Missed appointments can have an adverse impact on health outcomes by delaying appropriate imaging, which can be critical in influencing treatment decisions. OBJECTIVE: To assess for socioeconomic and imaging exam factors associated with missed appointments among children scheduled for diagnostic imaging. MATERIALS AND METHODS: We retrospectively analyzed children (<18 years) scheduled for outpatient diagnostic imaging during a 12-month period. In doing so, we obtained socioeconomic and radiology exam characteristics (modality, intravenous contrast administration, radiation and use of sedation) data from the electronic medical record. We employed multivariate logistic regression to assess the association of socioeconomic, demographic and imaging exam characteristics with imaging missed appointments. RESULTS: In total, 7,275 children met inclusion criteria. The mean age was 8.8 years (standard deviation [SD] = 6.2 years) and the study population consisted of 52% female gender, 69% White race, 38% adolescent age group and 32% with a median household income by ZIP-code category of <$50,000. Logistic regression showed increased likelihood of missed appointments among children of Black/African-American race (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.4-2.5); with insurance categories including Medicaid (OR=2.0; 95% CI=1.6-2.4), self-pay (OR=2.1; 95% CI=1.3-3.6) and other (OR=2.7; 95% CI=1.3-5.4); with <$50,000 median household income by ZIP-code category (OR=1.7; 95% CI=1.4-2.0); and with examination wait time of 7-21 days (OR=2.7; 95% CI=2.1-3.5) and >21 days (OR=3.7; 95% CI=2.9-4.8). The use of radiation, intravenous contrast agent or sedation was not associated with increased likelihood of missed appointments. CONCLUSION: Expanding our knowledge of how different socioeconomic and imaging-related factors influence missed appointments among children can serve as a foundational step to better understand existing and emerging disparities and inform strategies to advance health equity efforts in radiology.

Mature Andean forests as globally important carbon sinks and future carbon refuges.

It is largely unknown how South America's Andean forests affect the global carbon cycle, and thus regulate climate change. Here, we measure aboveground carbon dynamics over the past two decades in 119 monitoring plots spanning a range of >3000 m elevation across the subtropical and tropical Andes. Our results show that Andean forests act as strong sinks for aboveground carbon (0.67 ± 0.08 Mg C ha-1 y-1) and have a high potential to serve as future carbon refuges. Aboveground carbon dynamics of Andean forests are driven by abiotic and biotic factors, such as climate and size-dependent mortality of trees. The increasing aboveground carbon stocks offset the estimated C emissions due to deforestation between 2003 and 2014, resulting in a net total uptake of 0.027 Pg C y-1. Reducing deforestation will increase Andean aboveground carbon stocks, facilitate upward species migrations, and allow for recovery of biomass losses due to climate change.

Addressing Linguistic Barriers to Care: Evaluation of Breast Cancer Online Patient Educational Materials for Spanish-Speaking Patients.

PURPOSE: The purpose of this study was to evaluate the readability of breast cancer online patient educational materials (OPEM) written in Spanish and to compare to equivalent English-language OPEM. METHODS: The breast cancer-related terms cáncer de seno (breast cancer), detección de cáncer de seno (breast cancer screening), and biopsia de seno (breast biopsy) were queried using an online search engine. After each query, educational information related to the queried term was downloaded from each website appearing on the first five search engine result pages. Readability of Spanish-language OPEM was evaluated using the Crawford reading grade score. When available, equivalent English-language OPEM from the same website was then evaluated using the mean of five validated readability indices. Differences in readability, word count, and reading time between Spanish- and English-language OPEM were compared using an unpaired t test. The Fisher exact test was used to compare the proportion of websites meeting AMA recommendations for patient educational resources. RESULTS: Queries for cáncer de seno, detección de cáncer de seno, and biopsia de seno yielded 27, 31, and 30 results of term-specific OPEM. Equivalent English-language versions were available for 19 (70.4%), 18 (58.1%), and 20 (66.7%) websites, respectively. Spanish-language OPEM were written at a lower grade reading level than equivalent English-language versions overall (5.49 ± 0.50 versus 7.77 ± 1.95, P < .01). Spanish-language OPEM were also more likely than English-language OPEM to meet AMA recommendations (82.9% versus 40.4%, P < .01). CONCLUSIONS: Breast cancer-related Spanish-language OPEM were written at a significantly lower grade reading level compared with equivalent information written in English.

Effect of the Thermal Treatment of Fe/N/C Catalysts for the Oxygen Reduction Reaction Synthesized by Pyrolysis of Covalent Organic Frameworks.

A nitrogen-containing covalent organic framework obtained from the polymerization of 1,3-dicyanobenzene has been used as a starting material for the synthesis of Fe/N/C catalysts for the oxygen reduction reaction (ORR). In this work we report the effect of the thermal treatments on the nature and catalytic properties of the catalysts obtained after the thermal treatments. After the first thermal treatment, the catalysts obtained contain metallic iron and iron carbide particles, along with a minority fraction of inorganic FeN x sites. After acid leaching and a second thermal treatment, FeN x sites remain in the catalysts, along with a minor fraction of graphite-wrapped Fe3C particles. Both catalysts display high activity for the ORR, with the catalyst subjected to acid leaching and a second thermal treatment, 2HT-1,3DCB, displaying higher ORR activity and a lower production of H2O2. This observation suggests that iron particles, such as Fe3C, display ORR activity but mainly toward the two-electron pathway. On the contrary, FeN x ensembles promote the ORR via the four-electron pathway, that is, via H2O formation.

Abbreviated MRI for Hepatocellular Carcinoma Screening and Surveillance.

To detect potentially curable hepatocellular carcinoma (HCC), clinical practice guidelines recommend semiannual surveillance US of the liver in adult patients at risk for developing this malignancy, such as those with cirrhosis and some patients with chronic hepatitis B infection. However, cirrhosis and a large body habitus, both of which are increasingly prevalent in the United States and the rest of the world, may impair US visualization of liver lesions and reduce the sensitivity of surveillance with this modality. The low sensitivity of US for detection of early-stage HCC contributes to delayed diagnosis and increased mortality. Abbreviated MRI, a shortened MRI protocol tailored for early-stage detection of HCC, has been proposed as an alternative surveillance option that provides high sensitivity and specificity. Abbreviated MRI protocols include fewer sequences than a complete multiphase MRI examination and are specifically designed to identify small potentially curable HCCs that may be missed at US. Three abbreviated MRI strategies have been studied: (a) nonenhanced, (b) dynamic contrast material-enhanced, and (c) hepatobiliary phase contrast-enhanced abbreviated MRI. Retrospective studies have shown that simulated abbreviated MRI provides high sensitivity and specificity for early-stage HCC, mostly in nonsurveillance cohorts. If it is supported by scientific evidence in surveillance populations, adoption of abbreviated MRI could advance clinical practice by increasing early detection of HCC, allowing effective treatment and potentially prolonging life in the growing number of individuals with this cancer. Online supplemental material is available for this article. ©RSNA, 2020.

Effects of support and reaction pressure for the synthesis of dimethyl ether over heteropolyacid catalysts.

Dimethyl ether (DME) is an advanced second-generation biofuel produced via methanol dehydration over acid catalysts such as γ-Al2O3, at temperatures above 240 °C and pressures above 10 bar. Heteropolyacids such as tungstosilicic acid (HSiW) are Brønsted acid catalysts with higher DME production rates than γ-Al2O3, especially at low temperatures (140-180 °C). In this work, we show that the performance of supported HSiW for the production of DME is strongly affected by the nature of the support. TiO2 and SiO2 supported HSiW display the highest DME production rates of ca. 50 mmolDME/h/gHSiW. Characterization of acid sites via 1H-NMR, NH3-isotherms and NH3-adsrobed DRIFT reveal that HSiW/X have Brønsted acid sites, HSiW/TiO2 showing more and stronger sites, being the most active catalyst. Methanol production increases with T until 200 °C where a rapid decay in methanol conversion is observed. This effect is not irreversible, and methanol conversion increases to ca. 90% by increasing reaction pressure to 10 bar, with DME being the only product detected at all reaction conditions studied in this work. The loss of catalytic activity with the increasing temperature and its increasing with reaction pressure accounts to the degree of contribution of the pseudo-liquid catalysis under the reaction conditions studied.

La1.5Sr0.5NiMn0.5Ru0.5O6 Double Perovskite with Enhanced ORR/OER Bifunctional Catalytic Activity.

Perovskites (ABO3) with transition metals in active B sites are considered alternative catalysts for the water oxidation to oxygen through the oxygen evolution reaction (OER) and for the oxygen reduction through the oxygen reduction reaction (ORR) back to water. We have synthesized a double perovskite (A2BB'O6) with different cations in A, B, and B' sites, namely, (La1.5Sr0.5)A(Ni0.5Mn0.5)B(Ni0.5Ru0.5)B'O6 (LSNMR), which displays an outstanding OER/ORR bifunctional performance. The composition and structure of the oxide has been determined by powder X-ray diffraction, powder neutron diffraction, and transmission electron microscopy to be monoclinic with the space group P21/ n and with cationic ordering between the ions in the B and B' sites. X-ray absorption near-edge spectroscopy suggests that LSNMR presents a configuration of ∼Ni2+, ∼Mn4+, and ∼Ru5+. This bifunctional catalyst is endowed with high ORR and OER activities in alkaline media, with a remarkable bifunctional index value of ∼0.83 V (the difference between the potentials measured at -1 mA cm-2 for the ORR and +10 mA cm-2 for the OER). The ORR onset potential ( Eonset) of 0.94 V is among the best reported to date in alkaline media for ORR-active perovskites. The ORR mass activity of LSNMR is 1.1 A g-1 at 0.9 V and 7.3 A g-1 at 0.8 V. Furthermore, LSNMR is stable in a wide potential window down to 0.05 V. The OER potential to achieve a current density of 10 mA cm-2 is 1.66 V. Density functional theory calculations demonstrate that the high ORR/OER activity of LSNMR is related to the presence of active Mn sites for the ORR- and Ru-active sites for the OER by virtue of the high symmetry of the respective reaction steps on those sites. In addition, the material is stable to ORR cycling and also considerably stable to OER cycling.

Na-doped ruthenium perovskite electrocatalysts with improved oxygen evolution activity and durability in acidic media.

The design of active and durable catalysts for the H2O/O2 interconversion is one of the major challenges of electrocatalysis for renewable energy. The oxygen evolution reaction (OER) is catalyzed by SrRuO3 with low potentials (ca. 1.35 VRHE), but the catalyst's durability is insufficient. Here we show that Na doping enhances both activity and durability in acid media. DFT reveals that whereas SrRuO3 binds reaction intermediates too strongly, Na doping of ~0.125 leads to nearly optimal OER activity. Na doping increases the oxidation state of Ru, thereby displacing positively O p-band and Ru d-band centers, weakening Ru-adsorbate bonds. The enhanced durability of Na-doped perovskites is concomitant with the stabilization of Ru centers with slightly higher oxidation states, higher dissolution potentials, lower surface energy and less distorted RuO6 octahedra. These results illustrate how high OER activity and durability can be simultaneously engineered by chemical doping of perovskites.

Increase in post-thaw viability by adding seminal plasma proteins to Sanmartinero and Zebu sperm / Incremento en la viabilidad espermática post-descongelación por la adición de proteínas del plasma seminal a semen de toros Sanmartinero y Cebú / Aumento da viabilidade espermática pós-descongelamento, com a adição de proteínas do plasma seminal de sêmen de touros das raças Sanmartinero e Zebu

Background: cryopreservation decreases sperm viability by approximately 50%. Objective: the objective of this study was to determine the effect of the addition of seminal plasma proteins on post-thawing sperm viability in Sanmartinero and Zebu semen. Methods: semen samples from 10 bulls of each breed were used, and seminal plasma was subjected to two-dimensional electrophoresis to establish the relationship between the relative amount of each protein spot and sperm viability. Then, seminal plasma was subjected to exclusion chromatography to separate the fraction containing these proteins. This fraction was added in doses of 0.5, 1.0, 1.5 and 2.0 mg, to 1 x 10(6). Sperm was thawed and incubated at 37 °C for 1 h to determine its effect on postthaw viability. Sperm were frozen using two media (citrate-fructose-yolk and Bioxcell®). Results: we found one protein spot (16.20 kDa, PI 5.5) in Sanmartinero seminal plasma that correlated (r = 0.64 p<0.001) with viability. This spot was found in 21-25 chromatography fractions. The percentage of post-thaw viable sperm increased 20% (p<0.05) at 1.0 and 1.5 mg of the fraction when sperm was frozen using citrate-fructose-yolk; it increased 25% (p<0.01) with 0.5 mg when it was frozen with Bioxcell® media. Addition of 0.5 mg of the fraction to semen cryopreserved with Bioxcell® resulted in a greater (p<0.05) percentage increase of viable sperm in Sanmartinero semen (23 ± 8.3%) compared with Zebu semen (6.0 ± 2.0%). Conclusions: these results show that seminal plasma proteins decrease cryopreservation damage in sperm. The effect depends on the cryoprotectant dose as well as the breed of bull.

Antecedentes: la criopreservación disminuye la viabilidad espermática por debajo del 50%. Objetivo: el objetivo de esta investigación fue determinar el efecto de la adición de proteínas del plasma seminal sobre la viabilidad espermática post-descongelación de semen de toros Sanmartinero y Cebú. Métodos: se colectó semen de 10 toros de cada raza, y el plasma seminal se sometió a electroforesis bidimensional, para establecer la relación entre la cantidad relativa de cada punto de proteína y la viabilidad espermática. Identificados dichos puntos, el plasma seminal se sometió a cromatografía de exclusión para separar la fracción que contenía estas proteínas. Esta se adicionó en dosis de 0,5, 1,0, 1,5 y 2,0 mg, a muestras de 1 x 10(6) espermatozoides, descongelados e incubados a 37 °C durante 1 hora, para determinar su efecto en la viabilidad post-descongelación. Los espermatozoides se congelaron usando dos medios (citrato-fructosa-yema y Bioxcell®). Resultados: se encontró un punto de proteína (16,20 kDa, punto Isoeléctrico 5,5) en plasma de toros Sanmartinero, que correlacionó (r = 0,64 p<0,001) con la viabilidad. Este punto de proteína se encontró en la fracción 21-25 de la cromatografía. El porcentaje de espermatozoides viables post-descongelación aumentó 20% (p<0,05) con dosis de 1 y 1,5 mg de la fracción, cuando los espermatozoides se congelaron en medio citrato-fructosa-yema; y 25% (p<0,01) con dosis de 0,5 mg cuando se congelaron en medio Bioxcell®. La adición de 0,5 mg de la fracción a semen descongelado previamente criopreservado en medio Bioxcell®, evidenció un incremento mayor (p<0,05) en el porcentaje de espermatozoides viables de semen de toros Sanmartinero (23 ± 8,3 %), que en semen de toros Cebú (6,0 ± 2,0%). Conclusiones: los resultados anteriores demuestran que las proteínas del plasma seminal disminuyen el daño en los espermatozoides por la criopreservación, y que el efecto de estas proteínas depende del medio de congelación, la dosis adicionada y la raza de los toros.

Antecedentes: a criopreservação diminui a viabilidade espermática abaixo de um 50%. Objetivo: o objetivo desta pesquisa foi determinar o efeito da adição de proteínas do plasma seminal na viabilidade espermática pós-descongelamento de sêmen de touros das raças Sanmartinero y Zebú. Métodos: coletou-se sêmen de 10 touros de cada raça, as amostras do plasma seminal foram submetidas à eletroforese bidimensional, para estabelecer a relação entre a quantidade relativa de cada ponto de proteína e a viabilidade espermática. Ao serem identificados os pontos, o plasma seminal também foi submetido ao processo de cromatografia por exclusão para separar a fração que continha as proteínas. A fração foi adicionada nas doses de 0,5, 1,0, 1,5 y 2,0 mg, amostras de 1 x 106 espermatozoides, em descongelamento e incubados à temperatura de 37 ° C durante 1 hora, para determinar o efeito na viabilidade pós-descongelamento. Os espermatozoides foram congelados utilizando dois meios (Citrato- frutose-gema e Bioxcell®). Resultados: encontrou-se um ponto de proteína (16,20 kDa, ponto Isoelétrico 5,5) no plasma de touro Sanmartinero, que correlacionou (r=0,64 p<0,001) com a viabilidade. Esse ponto de proteína foi encontrado na fração 21-25 da cromatografia. O percentagem de espermatozoides viáveis pós-descongelamento aumentou em 20% (p<0,05) nas doses de 1 y 1,5 mg da fração, quando os espermatozoides foram congelados em meio de citrato-frutose-gema; e 25% (p<0,01) com doses de 0,5 mg congelados em meio Bioxcell®. A adição de 0,5 mg da fração ao sêmen descongelado e previamente criopreservado em meio Bioxcell®, evidenciou um incremento maior (p<0,05) no percentagem de espermatozoides viáveis do sêmen de touros Sanmartinero (23 ± 8,3 %), do que em sêmen de touros zebu (6,0 ± 2,0%). Conclusões: os anteriores resultados demonstram que as proteínas do plasma seminal diminuem o dano nos espermatozoides pela criopreservação e que o efeito destas proteínas depende do meio de congelação, a dose adicionada e a raça dos touros.

Complications with the use of botulinum toxin type A for cosmetic applications and hyperhidrosis.

In dermatology, botulinum toxin is now most often used to reduce dynamic facial creases and treat primary focal hyperhidrosis. The exemplary safety record of this medication is such that after nearly 2 decades, it is not known to have any long-term adverse events. Transient adverse events, such as mild injection pain, are typically minor and spontaneously remitting. Headache, nausea and flu-like symptoms, lid and brow ptosis after upper face injection, lower face asymmetry after perioral injection, and fine motor impairment after palmar injection are uncommon to rare. Understanding of anatomic landmarks and site-specific precautions can further mitigate the incidence of unwanted effects. Patients who do experience uncommon, transient effects can be reassured that these are not dangerous and will resolve completely without intervention.

Palladium-catalyzed aryl-aryl cross-coupling reaction using ortho-substituted arylindium reagents.

A range of biaryl compounds (aryl-aryl, aryl-heteroaryl, and heteroaryl-heteroaryl) can be efficiently prepared by a palladium-catalyzed cross-coupling reaction between ortho-substituted triarylindium reagents and aryl halides. The triarylindium reagents are prepared by directed ortho-lithiation and transmetallation to indium from the corresponding benzene derivatives using various directed metallation groups (DMGs). The reaction proceeds smoothly in high yields and short reaction times with high atom economy (the three aryl groups attached to indium are efficiently transferred).

Multifold and sequential cross-coupling reactions with indium organometallics.

Multifold and sequential palladium-catalyzed cross-coupling reactions can be performed between triorganoindium compounds and oligohaloarenes using only a small excess of the organometallic reagent, low catalyst charge loading and short reaction times.