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Abstract HIV-1 Vpr promotes efficient spread of HIV-1 from macrophages to T cells by transcriptionally downmodulating restriction factors that target HIV-1 Envelope protein (Env). Here we find that Vpr induces broad transcriptomic changes by targeting PU.1, a transcription factor necessary for expression of host innate immune response genes, including those that target Env. Consistent with this, we find silencing PU.1 in infected macrophages lacking Vpr rescues Env. Vpr downmodulates PU.1 through a proteasomal degradation pathway that depends on physical interactions with PU.1 and DCAF1, a component of the Cul4A E3 ubiquitin ligase. The capacity for Vpr to target PU.1 is highly conserved across primate lentiviruses. In addition to impacting infected cells, we find that Vpr suppresses expression of innate immune response genes in uninfected bystander cells, and that virion-associated Vpr can degrade PU.1. Together, we demonstrate Vpr counteracts PU.1 in macrophages to blunt antiviral immune responses and promote viral spread.

IntroductionAsian and Pacific Islander (API), African, and Caribbean immigrant groups in the U.S. are disproportionately impacted by chronic hepatitis B and hepatocellular carcinoma (primary liver cancer). Creating educational communication campaigns about hepatitis B and liver cancer for these communities is necessary to increase disease-related awareness and prompt health-promoting behaviors. Identifying interpersonal communication (IPC) preferences within diverse communities for integration into an educational campaign that emphasizes the link between hepatitis B and liver cancer can ultimately promote uptake of screening, vaccination and linkage to appropriate care.MethodsFifteen focus groups and two key informant interviews were conducted with participants from Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Data were analyzed using thematic coding and analysis.ResultsFindings demonstrate that all communities preferred that materials be offered in both English and native languages and emphasized that campaigns highlight the connection between hepatitis B and liver cancer. Educational sessions should take place in settings where communities feel safe, including community-based organizations, religious establishments, and healthcare offices, and should be facilitated by trusted messengers, including patient navigators, doctors and faith leaders. Presenting accurate information and dispelling myths and misconceptions around hepatitis B, liver cancer, and their connection were the biggest needs identified across all focus groups.DiscussionThis study provides insight into community-specific preferences for learning about hepatitis B and liver cancer through IPC methods. The findings from this study can be used to design multi-platform, culturally and linguistically appropriate health education campaigns to facilitate improved diagnosis, prevention, and management of hepatitis B and liver cancer among heavily impacted communities in the U.S.

Background: Immigrant groups from Southeast Asia, the Pacific Islands, sub-Saharan Africa, and the Caribbean bear the heaviest burden of chronic hepatitis B and primary liver cancer in the United States. Educational campaigns to increase knowledge about these diseases and their connection are necessary to promote protective health behaviors within these communities, to ultimately reduce the burden of disease, lessen stigma, and eliminate health disparities. Objectives: This project sought to engage groups within highly impacted communities to identify existing gaps in hepatitis B- and liver cancer-related knowledge, in order to inform future health education programming that will aim to reduce stigma and promote liver cancer prevention and early detection behaviors within and across groups. Methods: Fifteen focus groups and two key informant interviews were conducted virtually with participants from Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Qualitative data were analyzed using thematic coding. Results: There are large gaps in knowledge and awareness of hepatitis B and liver cancer, and the link between these two diseases among Asian, Pacific Islander, African and Haitian immigrant communities. This limited knowledge and misinformation, exacerbated by stigma, hinder these groups’ utilization of hepatitis B and liver cancer diagnostic and preventative healthcare services. Conclusion: To reduce hepatitis B and liver cancer health disparities within heavily burdened groups, health education needs to be community-informed, culturally sensitive, and actionable. Study results can guide the development of culturally and linguistically appropriate education programs that focus on the link between hepatitis B and liver cancer and the need for vaccination and routine screening, and that are responsive to the knowledge gaps and misperceptions of diverse communities. The results also provide valuable insights for healthcare providers to improve the knowledge gaps of the diverse patient populations that they serve.

Ertapenem, a carbapenem-type beta-lactam antibiotic, demonstrates broad-spectrum efficacy against a wide range of Gram-positive and Gram-negative bacteria, including aerobes and anaerobes. Importantly, it demonstrates resistance to virtually all beta-lactamases, including the extended spectrum beta-lactamases (ESBLs). Haematologic complications such as thrombocytosis, haemolysis, anaemia, and neutropenia are infrequent side effects associated with this drug. In this report, we present a rare case of ertapenem-induced thrombocytosis in a 62-year-old female patient who was admitted for a complicated urinary tract infection caused by Escherichia coli.

Introduction1.5 Tesla (1.5T) remain a significant field strength for brain imaging worldwide. Recent computer simulations and clinical studies at 3T MRI have suggested that dynamic susceptibility contrast (DSC) MRI using a 30° flip angle (“low-FA”) with model-based leakage correction and no gadolinium-based contrast agent (GBCA) preload provides equivalent relative cerebral blood volume (rCBV) measurements to the reference-standard acquisition using a single-dose GBCA preload with a 60° flip angle (“intermediate-FA”) and model-based leakage correction. However, it remains unclear whether this holds true at 1.5T. The purpose of this study was to test this at 1.5T in human high-grade glioma (HGG) patients.MethodsThis was a single-institution cross-sectional study of patients who had undergone 1.5T MRI for HGG. DSC-MRI consisted of gradient-echo echo-planar imaging (GRE-EPI) with a low-FA without preload (30°/P-); this then subsequently served as a preload for the standard intermediate-FA acquisition (60°/P+). Both normalized (nrCBV) and standardized relative cerebral blood volumes (srCBV) were calculated using model-based leakage correction (C+) with IBNeuro™ software. Whole-enhancing lesion mean and median nrCBV and srCBV from the low- and intermediate-FA methods were compared using the Pearson’s, Spearman’s and intraclass correlation coefficients (ICC).ResultsTwenty-three HGG patients composing a total of 31 scans were analyzed. The Pearson and Spearman correlations and ICCs between the 30°/P-/C+ and 60°/P+/C+ acquisitions demonstrated high correlations for both mean and median nrCBV and srCBV.ConclusionOur study provides preliminary evidence that for HGG patients at 1.5T MRI, a low FA, no preload DSC-MRI acquisition can be an appealing alternative to the reference standard higher FA acquisition that utilizes a preload.

**Objective**: Review preoperative risk stratification encounters performed by a hospital medicine consult service at a tertiary academic medical center to better characterize practice patterns and evaluate the need to standardize our approach to risk assessment. **Methods**: Retrospective chart review of 200 randomly selected patients representing approximately 40% of all patients seen by the hospital medicine consult service from 2019-2020. **Results**: Of the 200 charts reviewed, there were 71 preoperative risk assessments performed and 8 distinct approaches utilized. The most common risk stratification tool used was the Revised Cardiac Risk Index (RCRI), followed by the American College of Surgeons-Surgical Risk Calculator (ACS-SRC) and then the Gupta Myocardial Infarction and Cardiac Arrest calculator. 19 encounters (27%) used multiple risk stratification tools, while 11 encounters (15%) were not consistent with American College of Cardiology/American Heart Association guidelines. **Conclusion**: Significant heterogeneity exists within preoperative risk stratification practices in this single-center study. Follow-up work remains to promote standardization in approach and documentation.

This paper quantifies the coverage area of Low-Power Wide-Area Networks (LPWAN) for Packet Success Rates (PSR) above 85%, where acceptable Quality of Service (QoS) can be achieved. The network consists of battery-operated end-nodes (ENs) and multiple stationary gateways (GWs). We consider asynchronous communication that uses ALOHA-based random channel access. Each transmission from the ENs can be received by multiple GWs. Such spatial diversity results in favorable Signal-to-Noise ratios (SNR). The LoRa modulation is assumed and its specific features, such as IQ inversion, further contribute to decreasing the impact of interference. An increase in the GW density improves network performance, which allows support for a larger density of end-nodes as well as increasing the coverage area. Our simulation results show that a suburban area of up to 1.44 km2 can be covered with five GWs with up to fifty end-nodes with a PSR greater than 86%.

Physiological events related to oxygen concentration gradients provide valuable information to determine the state of metabolizing biological cells. The existing oxygen sensing methods (i.e., optical photoluminescence, magnetic resonance, and scanning electrochemical) are well-established and optimized for existing in vitro analyses. However, such methods also present various limitations in resolution, real-time sensing performance, complexity, and costs. An electrochemical imaging system with an integrated microelectrode array (MEA) would offer attractive means of measuring oxygen consumption rate (OCR) based on the cell’s two-dimensional (2D) oxygen concentration gradient. This paper presents an application of an electrochemical sensor platform with a custom-designed complementary-metal-oxide-semiconductor (CMOS)-based microchip and its Pt-coated surface MEA. The high-density MEA provides 16,064 individual electrochemical pixels that cover a 3.6 mm × 3.6 mm area. Utilizing the three-electrode configuration, the system is capable of imaging low oxygen concentration (18.3 µM, 0.58 mg/L, or 13.8 mmHg) at 27.5 µm spatial resolution and up to 4 Hz temporal resolution. In vitro oxygen imaging experiments were performed to analyze bovine cumulus-oocytes-complexes cells OCR and oxygen flux density. The integration of a microfluidic system allows proper bio-sample handling and delivery to the MEA surface for imaging. Finally, the imaging results are processed and presented as 2D heatmaps, representing the dissolved oxygen concentration in the immediate proximity of the MEA. This paper provides the results of real-time 2D imaging of OCR of live cells/tissues to gain spatial and temporal dynamics of target cell metabolism.

Trimethoprim-sulfamethoxazole (TMP-SMX, co-trimoxazole, or bactrim) has been the standard first-line treatment against Pneumocystis jirovecii pneumonia (PCP) for decades. However, adverse effects and cases of treatment failure have led to a search for alternative agents. We present a case of a 50 year old immune compromised female whose course of PCP did not improve until Caspofungin was added to TMP-SMX.