EuSi7P10: An Inorganic Supramolecular Nonlinear Optical Crystal Exhibiting Strong Second-Harmonic Generation Response.

Inorganic supramolecular compounds are the emergent class of infrared (IR) nonlinear optical (NLO) materials. However, the reported inorganic supramolecular IR NLO pnictides are still scarce. In this work, a new inorganic supramolecular IR NLO phosphide, EuSi7P10, has been synthesized using the metal salt flux method. The structure of EuSi7P10 features an anionic host framework containing the oriented [Si7P16] dual-T2 supertetrahedra with the guest Eu2+ cations filling in the intervals. Additionally, EuSi7P10 exhibits strong phase-matched (PM) second-harmonic generation (SHG) (4.0 × AgGaS2), large birefringence (0.087 @2050 nm), and wide infrared transparency. This study highlights the potential of inorganic supramolecular pnictides for exploring high-performance IR NLO crystals.

Successful management of subglottic stenosis in pregnancy.

Evaluation and management of subglottic stenosis in pregnancy is challenging. It often is not only a multidisciplinary approach between obstetricians, otolaryngologists (ENT surgeons) and anesthesiologists, but also requires a thorough understanding of possible foreseen complications by the patient as well. Hence, whenever we are presented with a challenging case requiring multidisciplinary approach involving team of physicians from different specialties, it is routine practice to huddle regarding the preoperative, intraoperative and postoperative management and care. We present a case of a 37-year-old woman with a known history of idiopathic subglottic stenosis, 16 weeks' pregnant, G4P1, with a surgical history significant for two previous subglottic dilations in the past and who now presented with an audible stridor and shortness of breath on activity. We highlighted the unique challenges encountered and the corresponding management adopted. This is a case of successful management of symptomatic worsening of subglottic stenosis managed during pregnancy.

Molecular Epidemiology of HIV-1 in Jiangsu Province, Southeast China: Genotypes and HIV-1 Transmission Networks Among Newly Diagnosed Men Having Sex with Men in 2017.

Investigation of disease and intervention in populations of men having sex with men (MSM) has garnered attention globally, a primary reason being the rapid increase in the prevalence of human immunodeficiency virus (HIV)-1 among MSM. The purpose of this study was to understand the current HIV-1 molecular characteristics and characterize HIV-1 transmission networks in the MSM population. Nine hundred and fourteen newly diagnosed HIV-positive MSM were included in this study. The HIV-1 pol gene region was amplified and sequenced. A maximum likelihood phylogenetic tree was constructed, and transmission clusters were identified using 1.5% distance and 0.9 bootstrap values. In total, 767 sequences were successfully obtained, with CRF01_AE being the major genotype (43.3%, 332/767), followed by CRF07_BC (31.3%, 240/767), CRF67_01B (7.2%, 55/767), and URF (6.4%, 49/767). The transmitted HIV drug resistance rate was 4.0% (31/767), and the most common mutations were E138G (n = 4) and G190A (n = 4). A total of 182 (23.7%) sequences were included in the HIV-1 transmission networks, forming 79 clusters. Four clusters were identified as fast-growing, and the proportion of young MSM was higher than that of non-MSM (51.6% vs. 31.8%). The genetic diversity of HIV-1 in Jiangsu was complex, and cross-region transmission might exist for CRF67_01B. Transmission among young MSM within networks was greater than the other age groups; thus, they could be essential in the control of the HIV epidemic in Jiangsu. This study was approved by the ethical review board of the National Center for AIDS/STD Control and Prevention (Project No. X140617334).

The association between vaginal microbiota and female infertility: a systematic review and meta-analysis.

PURPOSE: This study aimed to explore the association between vaginal microbiota and infertility. METHODS: We searched a range of electronic databases for appropriate articles, including PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure (CNKI), and Wanfang, from inception to 8th September 2019. Identified articles were then screened using strict inclusion and exclusion criteria. By referring to Tamarelle's method, we divided vaginal microbiota into two categories: low-Lactobacillus vaginal microbiota (LL-VMB) and high-Lactobacillus vaginal microbiota (HL-VMB). Patients were defined as HL-VMB if they had a Nugent score of 0-3, a negative Amesel/Spiegel's test, or if the vaginal community status was dominated by either L. crispatus, L. iners, L. gasseri and L. jensenii via 16S rRNA sequencing. Otherwise, cases were regarded as LL-VMB. Statistical analyses were performed with STATA 13.0 statistical software. Effect estimates are presented as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Fifteen articles were included in our final analysis. The HL-VMB was negatively related to infertility; a fixed model showed that the pooled OR was 0.83 (95% CI 0.77-0.90). There was no significant publication bias, as determined by Begg's test (P = 0.488) and Egger's test (P = 0.652). Using a random effect model, the pooled OR for intermediate bacterial vaginitis (BV) and infertility was 1.39 (95% CI 1.10-1.76) and the pooled OR for positive BV was 1.72 (95% CI 1.10-2.69). Subgroup and sensitivity analyses further demonstrated that the associations identified were stable. However, the acquired evidence was not sufficient to make inferences with regards to the mechanisms underlying these relationships. CONCLUSION: This systematic review and meta-analysis identified a negative correlation between HL-VMB and female infertility. However, due to a variety of limitations, the evidence acquired does not allow us to identify the specific mechanisms underlying this association. Further high-quality studies are needed to verify the causal relationship and explore the molecular mechanisms involved.

Characteristics of the vaginal microbiome in cross-border female sex workers in China: a case-control study.

BACKGROUND: Female sex workers (FSWs) are key groups in the transmission of sexual transmitted infections (STI), and vaginal microbiome variations play an important role in transmission. We aimed to explore the characteristics of vaginal microbiome among FSWs. MATERIALS AND METHODS: A total of 24 cross-border FSWs were randomly selected from a cross-sectional survey for female sex workers in southwest China. Thirty-seven female non-sex workers (FNSWs) were randomly selected from the gynecology clinic and health examination center. Vaginal swabs were collected, bacterial DNA extracted and 16S rRNA genes were sequenced. Differences in the vaginal microbiome between both groups were compared using bioinformatics analysis. RESULTS: One DNA sample was excluded due to unqualified concentration, therefore 60 samples were sequenced. FSWs had significantly different vaginal microbiota ß diversity, but undifferentiated α diversity when compared with non-sex workers. The average relative abundance of Sneathia, Shigella, Neisseria, Chlamydia, Prevotella, Enterococcus and Ureaplasma among FSWs was higher than FNSWs, and relative abundance of Atopobium in FSWs was lower than FNSWs. The Lactobacillus genus was the major genus in both groups. At the species level, Lactobacllus crispatus, Lactobacllus gasseri and Lactobacllus jensenii, in female sex workers, were lower when compared to FNSWs. CONCLUSION: There were distinct differences in vaginal bacteria variety between FSWs and FNSWs. Some disease-related genus were also more abundant in FSWs. Based on these observations, further research is required to identify microbiome communities related to high STI risks and other diseases in these cohorts.

Persistent post-discharge opioid prescribing after traumatic brain injury requiring intensive care unit admission: A cross-sectional study with longitudinal outcome.

Traumatic brain injury (TBI) is associated with increased risk for psychological and substance use disorders. The study aim is to determine incidence and risk factors for persistent opioid prescription after hospitalization for TBI. Electronic medical records of patients age ≥ 18 admitted to a neuroscience intensive care unit between January 2013 and February 2017 for an intracranial injury were retrospectively reviewed. Primary outcome was opioid use through 12 months post-hospital discharge. A total of 298 patients with complete data were included in the analysis. The prevalence of opioid use among preadmission opioid users was 48 (87%), 36 (69%) and 22 (56%) at 1, 6 and 12-months post-discharge, respectively. In the opioid naïve group, 69 (41%), 24 (23%) and 17 (19%) were prescribed opioids at 1, 6 and 12 months, respectively. Preadmission opioid use (OR 324.8, 95% CI 23.1-16907.5, p = 0.0004) and higher opioid requirements during hospitalization (OR 4.5, 95% CI 1.8-16.3, p = 0.006) were independently associated with an increased risk of being prescribed opioids 12 months post-discharge. These factors may be used to identify and target at-risk patients for intervention.

Use of capillary glucose combined with other non-laboratory examinations to screen for diabetes and prediabetes.

AIM: To evaluate the value and feasibility of capillary glucose assessment, combined with other non-laboratory measures, in screening for diabetes and prediabetes in the community. METHODS: In this cross-sectional study, we assessed fasting capillary glucose, fasting plasma glucose, and both capillary glucose and plasma glucose values after 2-h oral glucose tolerance tests in a total of 3736 samples. We determined the optimal threshold of capillary glucose using receiver-operating characteristic curve analysis. The effect of screening methods using capillary glucose combined with other variables, such as age, BMI and waist circumference, was assessed according to area under the receiver-operating characteristic curve. RESULTS: There was a strong positive correlation between capillary glucose and venous plasma glucose. The area under the curve for the model using fasting capillary glucose to screen for impaired fasting glucose was 0.722, while that for the model using capillary glucose after a 2-h oral glucose tolerance test to screen for impaired glucose tolerance was 0.916. The area under the curve for the model using fasting capillary glucose to screen for diabetes was 0.835, while that for the model using 2-h oral glucose tolerance test capillary glucose was 0.912. The area under the curve for the model using fasting capillary glucose + 2-h oral glucose tolerance test capillary glucose to screen for diabetes was 0.945. The discriminatory capability of models using capillary glucose was somewhat improved by adding non-laboratory variables. CONCLUSIONS: Capillary glucose could be an alternative for screening for diabetes and prediabetes, especially in low-resource areas.

Preconception blood pressure and time to pregnancy among couples attempting to conceive their first pregnancy.

BACKGROUND: The association of abnormal blood pressure levels (including hypertension and prehypertension) with reduced fecundability among young childbearing-age couples is not yet elucidated completely. OBJECTIVE: The purpose of this study was to investigate the association between abnormal preconception blood pressure level and time to pregnancy among couples who are attempting to conceive their first pregnancy. STUDY DESIGN: A total of 2,234,350 eligible couples (with no previous gravidity and whose female partners were 20-49 years old) participated in the National Free Preconception Check-up Projects from January 1, 2015, to December 31, 2016. Each couples' preconception blood pressure levels were measured, and time to pregnancy was recorded. Cox models for discrete survival time were used to estimate fecundability odds ratios and their corresponding 95% confidence intervals after adjustment for age, ethnicity, educational level, occupation, household registration, region, tobacco exposure, alcohol intake, body mass index, duration of marriage of the couples, and fasting plasma glucose levels of the female partner. RESULTS: Compared with normotensive women, those women with hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) had a 21% lower pregnancy rate (fecundability odds ratio, 0.79; 95% confidence interval, 0.78-0.81). A similar finding was found among men (fecundability odds ratio, 0.89; 95% confidence interval, 0.88-0.90). Prehypertension (systolic blood pressure between 120 and 139 mm Hg, and/or a diastolic blood pressure between 80 and 89 mm Hg) in both male and female partners was associated slightly with reduced fecundability odds ratios. Compared with couples in which both partners were normotensive, the pregnancy rate was reduced by 27% (fecundability odds ratio, 0.73; 95% confidence interval, 0.69-0.77) among couples in which both partners had hypertension. CONCLUSION: Abnormal preconception blood pressure levels were associated with prolonged time to pregnancy among couples who were attempting to conceive their first pregnancy; the mechanism is worth further investigation.

Quasiparticle effects on the linear and nonlinear susceptibility of ZnGeP2.

The semiconductor zinc germanium diphosphide (ZnGeP2) has wide applications in the infrared nonlinear optics (NLO) due to its high nonlinear optical coefficient, wide infrared transparency range and high thermal conductivity. Absorptions near the pump or generation wavelength limit the effectiveness of this materials, with their complicated microscopic origins remaining largely elusive. Most research on the absorption mechanism of ZnGeP2 focused on the defect effect, while the quasi-particle effect and exciton effect are significant as well. We herein carried out the ab initio studies of the electronic band structure and optical properties of ZnGeP2 crystal. The quasiparticle and excitonic effects were examined by comparing the results of PBE, GW approximation and Bethe-Salpeter equation. Quasiparticle effect was found to widen the quasi-direct band gap and increases the valence and conduction band dispersions, which mainly blue-shifts the imaginary part of the dielectric function. The increased band gap also leads to a broadened lineshape in the second order susceptibility. The excitonic effects significantly enhance the peak intensity in the long wave regime of the dielectric function and red-shift the peaks in the high energy regime, leading to the greatly improved agreement with experiment. Our results provided a microscopic guidance for improving ZnGeP2's optical performance.

Safety profile of intraoperative methadone for analgesia after major spine surgery: An observational study of 1,478 patients.

OBJECTIVE: To investigate the incidence of perioperative adverse events in patients receiving intravenous methadone for major spine surgery. DESIGN: Retrospective review of perioperative records from March 2011 and February 2016. SETTING: University of Virginia Healthsystem. PATIENTS: Adult patients undergoing elective spinal fusion of two or more levels. MAIN OUTCOME MEASURES: Incidence of respiratory depression, time to extubation, hypotension, hypoxemia, reintubation, cardiac complications, and death. RESULTS: Reviewed 1,478 patient records. Mean intraoperative methadone dose was 0.14 ± 0.07 mg/kg. A total of 1,142 patients (77.4 percent) were extubated in the operating room, 543 (36.8 percent) experienced respiratory depression, 1,180 (79.8 percent) hypoxemia, and 22 (1.5 percent) required reintubation. Cardiac complications included arrhythmias (289 patients, 29.9 percent), QTc prolongation (568 patients, 58.8 percent), and myocardial infarction (16 patients, 1.1 percent). Two in hospital deaths occurred (0.14 percent). CONCLUSIONS: Mild-moderate respiratory depression is observed following a one-time dose of intraoperative methadone, and monitoring in an appropriate postoperative setting is recommended.

Incidence and Risk Factors for Chronic Postoperative Opioid Use After Major Spine Surgery: A Cross-Sectional Study With Longitudinal Outcome.

BACKGROUND: Chronic opioid use is a significant public health concern. Surgery is a risk factor for developing chronic opioid use. Patients undergoing major spine surgery frequently are prescribed opioids preoperatively and may be at risk for chronic opioid use postoperatively. The aim of this study was to investigate the incidence of and perioperative risk factors associated with chronic opioid use after major spine surgery. METHODS: The records of patients who underwent elective major spine surgery at the University of Virginia between March 2011 and February 2016 were retrospectively reviewed. The primary outcome was chronic opioid use through 12 months postoperatively. Demographic data, medical comorbidities, preoperative pain scores, and medication use including daily morphine-equivalent (ME) dose, intraoperative use of lidocaine and ketamine, estimated blood loss, postoperative pain scores and medication use, and postoperative opioid use were collected. Logistic regression models were used to examine factors associated with chronic opioid use. RESULTS: Of 1477 patient records reviewed, 412 patients (27.9%) were opioid naive and 1065 patients (72.3%) used opioids before surgery. Opioid data were available for 1325 patients, while 152 patients were lost to 12-month follow-up and were excluded. Of 958 preoperative opioid users, 498 (52.0%) remained chronic users through 12 months. There was a decrease in opioid dosage (mg ME) from preoperative to 12 months postoperatively with a mean difference of -14.7 mg ME (standard deviation, 1.57; 95% confidence interval [CI], -17.8 to -11.7). Among 367 previously opioid-naive patients, 67 (18.3%) became chronic opioid users. Factors associated with chronic opioid use were examined using logistic regression models. Preoperative opioid users were nearly 4 times more likely to be chronic opioid users through 12 months than were opioid-naive patients (odds ratio, 3.95; 95% CI, 2.51-6.33; P < .001). Mean postoperative pain score (0-10) was associated with increased odds of chronic opioid use (odds ratio for a 1 unit increase in pain score 1.25, 95% CI, 1.13-1.38; P < .001). Use of intravenous ketamine or lidocaine was not associated with chronic opioid use through 12 months. CONCLUSIONS: Greater than 70% of patients presenting for major spine surgery used opioids preoperatively. Preoperative opioid use and higher postoperative pain scores were associated with chronic opioid use through 12 months. Use of ketamine and lidocaine did not decrease the risk for chronic opioid use. Surveillance of patients for these factors may identify those at highest risk for chronic opioid use and target them for intervention and reduction strategies.

Growth and optical properties of nonlinear LuAl3(BO3)4 crystals.

The optical properties of pure LuAl(3)(BO(3))(4) (abbreviated as LuAB) crystals were investigated for the first time. Large UV-transparent LuAl(3)(BO(3))(4) crystals were grown by a high-temperature top-seeding method with Li(2)WO(4)O(7)-B(2)O(3) as the flux. The refractive indices of LuAl(3)(BO(3))(4) at several wavelengths covering ultraviolet-visible and near-infrared regions were measured by the auto-collimation method. The parameters of Sellmeier's dispersion equation were determined from the experimental data. The phase-matching curve of second harmonic generation was measured. The nonlinear optical coefficient d(11) of LuAB crystal was determined to be 1.10 pm/V by a phase-matching method. The UV cut-off wavelength of the LuAl(3)(BO(3))(4) crystal was shorter than 190 nm.