ABSTRACT
ConspectusRecent years have witnessed significant interest in two-dimensional metal-organic frameworks (MOFs) due to their unique properties and promising applications across various fields. These materials offer distinct advantages, including high porosity and excellent charge transport properties. Their tunability allows precise control over various factors, including the electronic structure adjustments and local reactivity modulation, facilitating a wide range of properties and applications, such as material sensing and spin dynamics control. Moreover, the precise crystal structure of 2D MOFs supports rational design and mechanism studies, providing insights into their potential applications and enhancing their utility in various scientific and technological endeavors.To fully unveil the latent capabilities of 2D MOFs and advance their applications across diverse fields, thin film synthesis is crucial. Thin films provide a platform for investigating the intrinsic electrical properties of 2D MOFs with anisotropic structures, enabling the exploration of their unique characteristics comprehensively. Additionally, thin films offer the advantage of minimizing interference at contacts and junctions, thereby enhancing the performance of 2D MOFs for various applications. Furthermore, the properties of thin films can vary with thickness, presenting an opportunity to tailor their characteristics based on specific requirements.In this Account, we present an overview of our research focusing on the synthesis of 2D conductive MOF thin films encompassing two primary methods: chemical vapor deposition and solution processing. The chemical vapor deposition method allows for one-step, all-vapor-phase processes resulting in MOFs with edge-on orientation, controllable film thicknesses ranging from 55 to 662.7 nm, and smooth, homogeneous surfaces. On the other hand, solution-processing introduces a novel MOF, Cu3(HHTATP)2, by reducing interlayer interactions through the addition of pendent Brønsted bases on a ligand, enabling spin coating for thin film synthesis. This method yields a concentrated 2D MOF solution, enabling spin coating for thin film synthesis, where reversible electrical conductivity changes occur through doping with an acid and dedoping with a base. Additionally, we discuss various other synthesis methods, such as interfacial synthesis, layer-by-layer assembly, and microfluidic-assisted synthesis, offering versatile approaches for fabricating large-area thin films with tailored properties. Finally, we address ongoing challenges and potential strategies for further advancement in 2D conductive MOF thin film synthesis. We hope that this Account provides insights for selecting synthesis methods tailored to specific purposes, contributes to the development of varied synthesis techniques, and facilitates the exploration of diverse applications, unlocking the full potential of 2D conductive MOFs for next-generation technologies.
ABSTRACT
BACKGROUND: The 2022 global outbreak of Monkeypox virus (MPXV) highlighted challenges with polymerase chain reaction detection as divergent strains emerged and atypical presentations limited the applicability of swab sampling. Recommended testing in the United States requires a swab of lesions, which arise late in infection and may be unrecognized. We present MPXV detections using plasma microbial cell-free DNA (mcfDNA) sequencing. METHODS: Fifteen plasma samples from 12 case-patients were characterized through mcfDNA sequencing. Assay performance was confirmed through in silico inclusivity and exclusivity assessments. MPXV isolates were genotyped using mcfDNA, and phylodynamic information was imputed using publicly available sequences. RESULTS: MPXV mcfDNA was detected in 12 case-patients. Mpox was not suspected in 5, with 1 having documented resolution of mpox >6 months previously. Six had moderate to severe mpox, supported by high MPXV mcfDNA concentrations; 4 died. In 7 case-patients, mcfDNA sequencing detected coinfections. Genotyping by mcfDNA sequencing identified 22 MPXV mutations at 10 genomic loci in 9 case-patients. Consistent with variation observed in the 2022 outbreak, 21 of 22 variants were G > A/C > T. Phylogenetic analyses imputed isolates to sublineages arising at different time points and from different geographic locations. CONCLUSIONS: We demonstrate the potential of plasma mcfDNA sequencing to detect, quantify, and, for acute infections with high sequencing coverage, subtype MPXV using a single noninvasive test. Sequencing plasma mcfDNA may augment existing mpox testing in vulnerable patient populations or in patients with atypical symptoms or unrecognized mpox. Strain type information may supplement disease surveillance and facilitate tracking emerging pathogens.
Subject(s)
Cell-Free Nucleic Acids , Mpox (monkeypox) , Humans , Monkeypox virus , Phylogeny , Biological AssayABSTRACT
Two-dimensional (2D) electrically conductive metal-organic frameworks (MOFs) have emerged as viable candidates for active electrode materials in supercapacitors due to their high electrical conductivity, high specific surface area, and intrinsic redox-active sites. Despite their promising electrochemical performance, their pseudocapacitive behavior via fast and reversible charge transfer reactions remains yet to be fully exploited. Here, we investigate the electrochemical energy storage mechanism of Cu3(HHTATP)2 (HHTATP = 2,3,6,7,10,11-hexahydroxy-1,5,9-triaminotriphenylene), a 2D conductive MOF featuring characteristic redox-active pendant aromatic amines. Cu3(HHTATP)2 exhibited pseudocapacitive charge storage with an average gravimetric capacitance of 340 ± 15 F g-1 at a discharge rate of 0.2 A g-1 and maintained a capacitance retention over 90% after 7000 galvanostatic cycles at 5 A g-1. The polar pendant amines not only enhanced capacitance via additional amine/imine redox activity but also reduced interfacial charge transfer resistance through modified electrode-electrolyte interactions. These results highlight the potential of molecular-level pore environment tuning as a strategic approach in materials design for energy storage applications.
ABSTRACT
The development of conductive metal-organic frameworks (MOFs) presents a unique challenge in materials chemistry because it is unclear how to dope them. Here, we demonstrate that the inclusion of pendant amines on hexahydroxytriphenylene linkages results in two-dimensional (2D) polycrystalline frameworks Cu3(HHTATP)2, isostructural to its Cu3(HHTP)2 parent, and exhibits the highest electrical conductivity of 1.21 S/cm among 2D MOFs featuring CuO4 metal nodes. Moreover, the bulk material can be treated with acid, resulting in a protonation-dependent increase in the conductivity. By spin-coating the acidic solution, we fabricated large-area thin films and collectively demonstrated an intuitive route to solution-processable, dopable, conductive MOFs.
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The incidence of spotted fever group (SFG) rickettsioses in the United States has tripled since 2010. Rocky Mountain spotted fever, the most severe SFG rickettsiosis, is caused by Rickettsia rickettsii. The lack of species-specific confirmatory testing obfuscates the relative contribution of R. rickettsii and other SFG Rickettsia to this increase. We report a newly recognized rickettsial pathogen, Rickettsia sp. CA6269, as the cause of severe Rocky Mountain spotted fever-like illness in 2 case-patients residing in northern California. Multilocus sequence typing supported the recognition of this pathogen as a novel Rickettsia genotype most closely related to R. rickettsii. Cross-reactivity observed for an established molecular diagnostic test indicated that Rickettsia sp. CA6269 might be misidentified as R. rickettsii. We developed a Rickettsia sp. CA6269-specific real-time PCR to help resolve this diagnostic challenge and better characterize the spectrum of clinical disease and ecologic epidemiology of this pathogen.
Subject(s)
Multilocus Sequence Typing , Phylogeny , Rickettsia , Rocky Mountain Spotted Fever , Humans , California/epidemiology , Rocky Mountain Spotted Fever/diagnosis , Rocky Mountain Spotted Fever/microbiology , Rocky Mountain Spotted Fever/epidemiology , Rickettsia/genetics , Rickettsia/isolation & purification , Rickettsia/classification , Male , Female , Middle Aged , Spotted Fever Group Rickettsiosis/diagnosis , Spotted Fever Group Rickettsiosis/microbiology , Spotted Fever Group Rickettsiosis/epidemiology , Adult , Rickettsia rickettsii/geneticsABSTRACT
Donation after circulatory death (DCD) could account for the largest expansion of the donor allograft pool in the contemporary era. However, the organ yield and associated costs of normothermic regional perfusion (NRP) compared to super-rapid recovery (SRR) with ex-situ normothermic machine perfusion, remain unreported. The Organ Procurement and Transplantation Network (December 2019 to June 2023) was analyzed to determine the number of organs recovered per donor. A cost analysis was performed based on our institution's experience since 2022. Of 43 502 donors, 30 646 (70%) were donors after brain death (DBD), 12 536 (29%) DCD-SRR and 320 (0.7%) DCD-NRP. The mean number of organs recovered was 3.70 for DBD, 3.71 for DCD-NRP (P < .001), and 2.45 for DCD-SRR (P < .001). Following risk adjustment, DCD-NRP (adjusted odds ratio 1.34, confidence interval 1.04-1.75) and DCD-SRR (adjusted odds ratio 2.11, confidence interval 2.01-2.21; reference: DBD) remained associated with greater odds of allograft nonuse. Including incomplete and completed procurement runs, the total average cost of DCD-NRP was $9463.22 per donor. By conservative estimates, we found that approximately 31 donor allografts could be procured using DCD-NRP for the cost equivalent of 1 allograft procured via DCD-SRR with ex-situ normothermic machine perfusion. In conclusion, DCD-SRR procurements were associated with the lowest organ yield compared to other procurement methods. To facilitate broader adoption of DCD procurement, a comprehensive understanding of the trade-offs inherent in each technique is imperative.
Subject(s)
Organ Preservation , Organ Transplantation , Tissue Donors , Tissue and Organ Procurement , Humans , Tissue and Organ Procurement/economics , Female , Male , Tissue Donors/supply & distribution , Middle Aged , Organ Transplantation/economics , Adult , Organ Preservation/methods , Organ Preservation/economics , Perfusion , Tissue and Organ Harvesting/economics , Tissue and Organ Harvesting/methods , Brain Death , Retrospective Studies , Follow-Up Studies , PrognosisABSTRACT
BACKGROUND: Blueberries and anthocyanins, their key bioactive component, may improve eye health. However, few long-term studies have examined blueberries and anthocyanins with cataract and age-related macular degeneration (AMD). OBJECTIVES: To investigate the prospective association between blueberry and anthocyanin intake with incident cataract, total AMD, and visually significant AMD among middle-aged and older women. METHODS: A total of 36,653 and 35,402 women initially free of AMD and cataract, respectively, aged ≥45 y from the Women's Health Study provided semiquantitative food frequency questionnaire data on blueberry intake categorized as none, 1-3 servings/mo, 1 serving/wk, or ≥2 servings/wk, plus a combined category of ≥1 serving/wk. Total anthocyanin intake and major subclasses were energy-adjusted and categorized into quintiles. Self-reported risk factors of eye disease were adjusted in multivariable hazard ratios (HRs) (95% confidence intervals [CIs]) of confirmed cataract, AMD, and visually significant AMD with mean follow-up of 11 y. RESULTS: Among the participants, 10.5% consumed ≥1 serving/wk of blueberries, with mean total anthocyanin intake of 11.2 mg/d. Compared to no blueberry intake, women consuming 1-3 servings/mo, 1 serving/wk, and ≥2 servings/wk had corresponding multivariable HRs of total AMD of 0.90 (95% CI: 0.73, 1.11), 0.71 (95% CI: 0.50, 1.00), and 0.36 (95% CI: 0.14, 0.93) (Ptrend = 0.011); those consuming ≥1 servings/wk had an HR of 0.68 (95% CI: 0.47, 0.98). A similar magnitude of HRs were found for visually significant AMD (Ptrend = 0.012) but not for cataract. There were no significant associations between increasing total anthocyanin quintiles and total and visually significant AMD, but there was a modest inverse association with cataract (Ptrend = 0.022), driven by a 10% reduction in cataract in the upper 2 quintiles. CONCLUSIONS: Greater blueberry intake significantly reduced total AMD, but not visually significant AMD or cataract. However, the magnitude of effect for visually significant AMD was similar to total AMD. There was a modest but significant inverse association between dietary anthocyanin intake with cataract but not AMD.
Subject(s)
Blueberry Plants , Cataract , Middle Aged , Humans , Female , Aged , Anthocyanins , Follow-Up Studies , Risk Factors , Cataract/epidemiology , Cataract/prevention & controlABSTRACT
During its temporary tenure, the placenta has extensive and specialized functions that are critical for pre- and post-natal development. The consequences of chemical exposure in utero can have profound effects on the structure and function of pregnancy-associated tissues and the life-long health of the birthing person and their offspring. However, the toxicological importance and critical functions of the placenta to embryonic and fetal development and maturation have been understudied. This narrative will review early placental development in humans and highlight some in vitro models currently in use that are or can be applied to better understand placental processes underlying developmental toxicity due to in utero environmental exposures.
Subject(s)
Placenta , Humans , Pregnancy , Female , Placenta/drug effects , Placentation/drug effects , Models, Biological , Fetal Development/drug effectsABSTRACT
Trichinellosis is a parasitic zoonotic disease transmitted through the consumption of meat from animals infected with Trichinella spp. nematodes. In North America, human trichinellosis is rare and is most commonly acquired through consumption of wild game meat. In July 2022, a hospitalized patient with suspected trichinellosis was reported to the Minnesota Department of Health. One week before symptom onset, the patient and eight other persons shared a meal that included bear meat that had been frozen for 45 days before being grilled and served rare with vegetables that had been cooked with the meat. Investigation identified six trichinellosis cases, including two in persons who consumed only the vegetables. Motile Trichinella larvae were found in remaining bear meat that had been frozen for >15 weeks. Molecular testing identified larvae from the bear meat as Trichinella nativa, a freeze-resistant species. Persons who consume meat from wild game animals should be aware that that adequate cooking is the only reliable way to kill Trichinella parasites and that infected meat can cross-contaminate other foods.
Subject(s)
Disease Outbreaks , Meat , Trichinellosis , Trichinellosis/epidemiology , Trichinellosis/diagnosis , Humans , Animals , Male , Minnesota/epidemiology , Female , Adult , South Dakota/epidemiology , Arizona/epidemiology , Meat/parasitology , Middle Aged , Trichinella/isolation & purification , Ursidae/parasitology , Adolescent , Aged , Young AdultABSTRACT
While the survival of children with cancer has improved over time, infection remains a major morbidity and mortality risk. We conducted a systematic literature review to determine the unmet needs in diagnosing infection in immunocompromised children with cancer. The comprehensive search strategy followed the guidelines established by the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement, and spanned multiple bibliographic databases and other public sources from January 1, 2012 to June 23, 2022. From 5188 records, 34 unique pediatric-focused studies met inclusion criteria. This review highlights the lack of published data on infectious disease testing in pediatric oncology patients, and the need for well-designed clinical impact and cost-effectiveness studies of both existing and novel diagnostic platforms. Such studies are necessary to optimize diagnostic and antimicrobial stewardship, leading to improvement in patient outcomes.
Subject(s)
Medical Oncology , Neoplasms , Humans , Child , Neoplasms/complicationsABSTRACT
Short-read sequencers provide highly accurate reads at very low cost. Unfortunately, short reads are often inadequate for important applications such as assembly in complex regions or phasing across distant heterozygous sites. In this study, we describe novel bench protocols and algorithms to obtain haplotype-phased sequence assemblies with ultra-low error for regions 10 kb and longer using short reads only. We accomplish this by imprinting each template strand from a target region with a dense and unique mutation pattern. The mutation process randomly and independently converts â¼50% of cytosines to uracils. Sequencing libraries are made from both mutated and unmutated templates. Using de Bruijn graphs and paired-end read information, we assemble each mutated template and use the unmutated library to correct the mutated bases. Templates are partitioned into two or more haplotypes, and the final haplotypes are assembled and corrected for residual template mutations and PCR errors. With sufficient template coverage, the final assemblies have per-base error rates below 10-9. We demonstrate this method on a four-member nuclear family, correctly assembling and phasing three genomic intervals, including the highly polymorphic HLA-B gene.
Subject(s)
Genome , Genomics , Algorithms , HLA-B Antigens , Haplotypes , High-Throughput Nucleotide Sequencing/methods , Mutagenesis , Sequence Analysis, DNA/methodsABSTRACT
There is a paucity of bibliometric data on pediatric-focused hidradenitis suppurativa (HS) publications. To better characterize research trends in pediatric HS and gaps in literature, we systematically searched PubMed between 2012 and 2022 for publications on pediatric HS and collected data on study design, topic, country, and level of evidence. Of 109 articles that met inclusion criteria, less than half (44/109, 40.4%) were high level of evidence studies; the most common study types were case reports/series (41/109, 37.6%) and cross-sectional studies (25/109, 22.9%), and the most common study topics were HS treatments (44/109, 40.4%), comorbidities (20/109, 18.3%), and clinical presentation (14/109, 12.8%). Although there has been expansion of the pediatric HS literature in recent years, our study highlights the need for larger prospective studies and trials to improve our ability to optimally manage pediatric HS patients and identify predictors of disease progression and treatment response.
Subject(s)
Bibliometrics , Hidradenitis Suppurativa , Hidradenitis Suppurativa/therapy , Hidradenitis Suppurativa/epidemiology , Humans , Child , Pediatrics/trendsABSTRACT
Infection with Borrelia miyamotoi in California, USA, has been suggested by serologic studies. We diagnosed B. miyamotoi infection in an immunocompromised man in California. Diagnosis was aided by plasma microbial cell-free DNA sequencing. We conclude that the infection was acquired in California.
Subject(s)
Borrelia Infections , Borrelia , Ixodes , Animals , Humans , Male , Borrelia/genetics , Borrelia/isolation & purification , Borrelia Infections/diagnosis , California/epidemiology , Immunocompromised HostABSTRACT
BACKGROUND & AIMS: Safety of biologic agents is a key consideration in patients with inflammatory bowel disease (IBD) and active or recent cancer. We compared the safety of tumor necrosis factor (TNF)-α antagonists vs non-TNF biologics in patients with IBD with active or recent cancer. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD and either active cancer (cohort A) or recent prior cancer (within ≤5 years; cohort B) who were treated with TNFα antagonists or non-TNF biologics after their cancer diagnosis. Primary outcomes were progression-free survival (cohort A) or recurrence-free survival (cohort B). Safety was compared using inverse probability of treatment weighting with propensity scores. RESULTS: In cohort A, of 125 patients (483.8 person-years of follow-up evaluation) with active cancer (age, 54 ± 15 y, 75% solid-organ malignancy), 10 of 55 (incidence rate [IR] per 100 py, 4.4) and 9 of 40 (IR, 10.4) patients treated with TNFα antagonists and non-TNF biologics had cancer progression, respectively. There was no difference in the risk of progression-free survival between TNFα antagonists vs non-TNF biologics (hazard ratio, 0.76; 95% CI, 0.25-2.30). In cohort B, of 170 patients (513 person-years of follow-up evaluation) with recent prior cancer (age, 53 ± 15 y, 84% solid-organ malignancy; duration of remission, 19 ± 19 mo), 8 of 78 (IR, 3.4) and 5 of 66 (IR 3.7) patients treated with TNFα antagonists and non-TNF biologics had cancer recurrence, respectively. The risk of recurrence-free survival was similar between both groups (hazard ratio, 0.94; 95% CI, 0.24-3.77). CONCLUSIONS: In patients with IBD with active or recent cancer, TNFα antagonists and non-TNF biologics have comparable safety. The choice of biologic should be dictated by IBD disease severity in collaboration with an oncologist.
Subject(s)
Biological Products , Inflammatory Bowel Diseases , Neoplasms , Humans , Adult , Middle Aged , Aged , Tumor Necrosis Factor-alpha , Biological Factors , Retrospective Studies , Inflammatory Bowel Diseases/drug therapy , Inflammatory Bowel Diseases/chemically induced , Neoplasms/epidemiology , Neoplasms/chemically induced , Tumor Necrosis Factor Inhibitors , Biological Products/adverse effectsABSTRACT
We show the use of 5'-Acrydite oligonucleotides to copolymerize single-cell DNA or RNA into balls of acrylamide gel (BAGs). Combining this step with split-and-pool techniques for creating barcodes yields a method with advantages in cost and scalability, depth of coverage, ease of operation, minimal cross-contamination, and efficient use of samples. We perform DNA copy number profiling on mixtures of cell lines, nuclei from frozen prostate tumors, and biopsy washes. As applied to RNA, the method has high capture efficiency of transcripts and sufficient consistency to clearly distinguish the expression patterns of cell lines and individual nuclei from neurons dissected from the mouse brain. By using varietal tags (UMIs) to achieve sequence error correction, we show extremely low levels of cross-contamination by tracking source-specific SNVs. The method is readily modifiable, and we will discuss its adaptability and diverse applications.
Subject(s)
Acrylamide , Nucleic Acids , Single-Cell Analysis/methods , Acrylamide/chemistry , DNA , DNA Contamination , DNA Copy Number Variations , Gene Dosage , Gene Expression Profiling/methods , Gene Expression Profiling/standards , Gene Library , Humans , Neoplasms/genetics , Neoplasms/metabolism , Neoplasms/pathology , Nucleic Acids/chemistry , Oligonucleotide Array Sequence Analysis/methods , Oligonucleotide Array Sequence Analysis/standards , Polymerization , RNA , Single-Cell Analysis/standardsABSTRACT
Microbial cell-free DNA (mcfDNA) sequencing is an emerging infectious disease diagnostic tool which enables unbiased pathogen detection and quantification from plasma. The Karius Test, a commercial mcfDNA sequencing assay developed by and available since 2017 from Karius, Inc. (Redwood City, CA), detects and quantifies mcfDNA as molecules/µL in plasma. The commercial sample data and results for all tests conducted from April 2018 through mid-September 2021 were evaluated for laboratory quality metrics, reported pathogens, and data from test requisition forms. A total of 18,690 reports were generated from 15,165 patients in a hospital setting among 39 states and the District of Columbia. The median time from sample receipt to reported result was 26 h (interquartile range [IQR] 25 to 28), and 96% of samples had valid test results. Almost two-thirds (65%) of patients were adults, and 29% at the time of diagnostic testing had ICD-10 codes representing a diverse array of clinical scenarios. There were 10,752 (58%) reports that yielded at least one taxon for a total of 22,792 detections spanning 701 unique microbial taxa. The 50 most common taxa detected included 36 bacteria, 9 viruses, and 5 fungi. Opportunistic fungi (374 Aspergillus spp., 258 Pneumocystis jirovecii, 196 Mucorales, and 33 dematiaceous fungi) comprised 861 (4%) of all detections. Additional diagnostically challenging pathogens (247 zoonotic and vector-borne pathogens, 144 Mycobacterium spp., 80 Legionella spp., 78 systemic dimorphic fungi, 69 Nocardia spp., and 57 protozoan parasites) comprised 675 (3%) of all detections. This is the largest reported cohort of patients tested using plasma mcfDNA sequencing and represents the first report of a clinical grade metagenomic test performed at scale. Data reveal new insights into the breadth and complexity of potential pathogens identified.
Subject(s)
Fungi , Viruses , Adult , Humans , Fungi/genetics , Bacteria/genetics , Viruses/genetics , High-Throughput Nucleotide Sequencing/methods , Metagenomics , Sequence Analysis, DNAABSTRACT
BACKGROUND: Hidradenitis suppurativa (HS) is an inflammatory skin condition which predominantly affects women of childbearing age in the USA. There is a lack of research on the association between HS and fertility. OBJECTIVES: The aim of this study was to understand the perspectives of females with HS regarding the impact of their disease on reproductive health, the impact of fertility treatments on HS, and the impact of HS treatments on fertility. METHODS: An anonymous, online survey was disseminated through HS support groups from June to July 2022. Respondents aged 18-50 who were assigned female sex at birth were eligible for participation. Comparative statistics were performed using t tests/χ2 tests to assess associations between respondents' demographics and survey responses. RESULTS: Among the 312 respondents (80.8% White, mean age 35.7 ± 7.4 [range 18-50]), two-thirds of respondents (66.6%, 207/311) had been pregnant before and 79.5% (248/312) had ever tried to conceive. 41.5% (103/248) had unsuccessfully tried to conceive for 12 months or more. Of the 59 respondents who had never attempted to conceive, 39% reported that HS had impacted this decision. Amongst respondents who experienced fertility challenges but did not pursue fertility treatments, top barriers to fertility treatments include concerns about financial support/insurance coverage (47.5%, 29/61) and fertility treatments worsening HS (21.3%, 13/61). Most respondents who used fertility treatments reported either no change (73.7%, 28/38 or 77.8%, 14/18) or improvement (15.8%, 6/38 or 11.1%, 2/18) in their HS symptoms with oral or injectable medications. Respondents were most concerned about the effects of oral antibiotics (44.9%, 140/312), followed by hormonal medications (38.8%, 121/312) and biologics (35.9%, 112/312) on fertility. CONCLUSION: Females with HS reported high rates of infertility compared to the general population. The majority reported no change in HS symptoms with fertility treatments, and clinicians can use this finding to help counsel patients during family planning discussions. Further research in the field of HS and fertility is needed.
Subject(s)
Hidradenitis Suppurativa , Infertility , Pregnancy , Infant, Newborn , Humans , Female , Adult , Hidradenitis Suppurativa/complications , Hidradenitis Suppurativa/therapy , Hidradenitis Suppurativa/diagnosis , Fertility , Surveys and Questionnaires , SkinABSTRACT
BACKGROUND/AIMS: Medication non-adherence is a leading cause of transplant rejection, organ loss, and death; yet no rigorous controlled study to date has shown compelling clinical benefits from an adherence-improving intervention. Non-adherent patients are less likely to participate in trials, and therefore, most studies enroll a majority of adherent patients who do not stand to benefit from the intervention, as they do not have the condition (non-adherence) under investigation. The improving Medication Adherence in adolescent Liver Transplant recipients trial specifically targets non-adherent patients to investigate whether a remote intervention to improve adherence results in reduced incidence of biopsy-confirmed rejection. METHODS: Improving Medication Adherence in adolescent Liver Transplant is a randomized single-blind controlled multisite, multinational National Institutes of Health-funded trial involving 13 pediatric transplant centers in the United States and Canada. An innovative, objective adherence biomarker-the Medication Level Variability Index, which is the standard deviation of a series of medication blood levels for each patient, is used to identify non-adherent patients at risk for rejection. The index is computed using electronic health record information for all potentially eligible patients based on repeated reviews of the entire clinic's roster. Identified patients, after consent, are randomized to intervention versus control (treatment as usual) arms. The remote intervention is delivered for 2 years by trained interventionists who reside in various locations in the United States. The primary outcome is the incidence of biopsy-confirmed acute cellular rejection, as confirmed by a majority vote of three pathologists who are masked to the study allocation and clinical information. DISCUSSION: Improving Medication Adherence in adolescent Liver Transplant includes several innovative design elements. The use of a validated, objective adherence index to survey a large cohort of transplant recipients allows the teams to avoid bias inherent in both convenience sampling and referral-based recruitment and enroll only patients whose computed index indicates substantially increased risk of rejection. The remote intervention paradigm helps to engage patients who are by definition hard to engage. The use of an objective, masked medical (rather than behavioral) outcome measure reduces the likelihood of biases related to clinical information and ensures broad acceptance by the field. Finally, monitoring for potential adverse events related to increased medication exposure due to the adherence intervention acknowledges that a successful intervention (increasing adherence) could have detrimental side effects via increased exposure to and potential toxicity of the medication. Such monitoring is almost never attempted in clinical trials evaluating adherence interventions.
Subject(s)
Liver Transplantation , Adolescent , Humans , Young Adult , Medication Adherence , Outcome Assessment, Health Care , Single-Blind Method , Surveys and Questionnaires , United StatesABSTRACT
Although examples of colloidal crystal analogues to metal alloys have been reported, general routes for preparing 3D analogues to random substitutional alloys do not exist. Here, we use the programmability of DNA (length and sequence) to match nanoparticle component sizes, define parent lattice symmetry and substitutional order, and achieve faceted crystal habits. We synthesized substitutional alloy colloidal crystals with either ordered or random arrangements of two components (Au and Fe3O4 nanoparticles) within an otherwise identical parent lattice and crystal habit, confirmed via scanning electron microscopy and small-angle X-ray scattering. Energy dispersive X-ray spectroscopy reveals information regarding composition and local order, while the magnetic properties of Fe3O4 nanoparticles can direct different structural outcomes for different alloys in an applied magnetic field. This work constitutes a platform for independently defining substitution within multicomponent colloidal crystals, a capability that will expand the scope of functional materials that can be realized through programmable assembly.
Subject(s)
Colloids , Nanoparticles , Alloys , Colloids/chemistry , Crystallization , DNA/chemistry , Nanoparticles/chemistryABSTRACT
We demonstrated the synthesis of a conductive two-dimensional metal-organic framework (MOF) thin film by single-step all-vapor-phase chemical vapor deposition (CVD). The synthesized large-area thin film of Cu3(C6O6)2 has an edge-on-orientation with high crystallinity. Cu3(C6O6)2 thin film-based microdevices were fabricated by e-beam lithography and had an electrical conductivity of 92.95 S/cm. Synthesis of conductive MOF thin films by the all-vapor-phase CVD will enable fundamental studies of physical properties and may help to accomplish practical applications of conductive MOFs.