bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative Perceptions of Dapivirine VR Adherence and Drug Level Feedback Following an Open-Label Extension Trial
Authors: Naidoo Kalendri , Mansoor Leila E. , Katz Ariana W. K. , Garcia Morgan , Kemigisha Doreen , Morar Neetha S. , Zimba Chifundo C. , Chitukuta Miria , Reddy Krishnaveni , Soto-Torres Lydia , Naidoo Sarita , Montgomery Elizabeth T. 
Published: December 2020

Background:
There continues to be a need for HIV prevention options that women can initiate and use autonomously. The dapivirine vaginal ring (VR) has been shown to have a favorable safety profile and reduce the risk of HIV-1 acquisition. We report on women's experiences with VR adherence during the MTN-025/HIV Open-label Prevention Extension (HOPE) study and responses to Residual Drug Level (RDL) results.

Setting:
Ten women at each of the 6 HOPE research sites in Lilongwe, Malawi; Durban (2 sites) and Johannesburg, South Africa; Kampala, Uganda; and Chitungwiza, Zimbabwe, were randomly selected (n = 60).

Methods:
After confirmation of eligibility criteria, in-depth interviews were conducted where available RDL results were presented.

Results:
Many women with low RDL release measurements deflected blame onto other factors (the ring, the drug, and faulty testing machines) and distrust of the testing method. The disclosure of RDL results enabled some users to discuss their challenges experienced (fear of partner objections, perceived side effects, and removals during menses). Consistent users reported important motivators (support from others, protection from HIV, and enhanced sexual experiences from the VR).

Conclusion:
The VR provided a sense of security for some women; however, adherence was still challenging for others regardless of it being a female controlled, long-acting HIV prevention technology. Adherence measurements may not be sustainable in the real-world implementation of the VR, although they can be seen as a benefit as they provide a better understanding of actual product use and provide women with a platform to discuss their experiences.
Steadily Increasing Inversion Time Improves Blood Suppression for Free-Breathing 3D Late Gadolinium Enhancement MRI With Optimized Dark-Blood Contrast
Authors: Holtackers Robert J. , Gommers Suzanne , Van De Heyning Caroline M. , Mihl Casper , Smink Jouke , Higgins David M. , Wildberger Joachim E. , ter Bekke Rachel M.A. 
Published: December 2020

Objectives
Free-breathing 3-dimensional (3D) late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) techniques with high isotropic resolution and dark-blood contrast may optimize the delineation of myocardial scar patterns. The extended acquisition times required for such scans, however, are paralleled by a declining contrast agent concentration. Consequently, the optimal inversion time (TI) is continuously increasing. We hypothesize that a steadily increasing (dynamic) TI can compensate for this effect and can lead to improved blood nulling to optimize the dark-blood contrast.

Materials and Methods
Fifty consecutive patients with previous cardiac arrhythmias, scheduled for high-resolution 3D LGE MRI, were prospectively enrolled between October 2017 and February 2020. Free-breathing 3D dark-blood LGE MRI with high isotropic resolution (1.6 × 1.6 × 1.6 mm) was performed using a conventional fixed TI (n = 25) or a dynamic TI (n = 25). The average increase in blood nulling TI per minute was obtained from Look-Locker scans before and after the 3D acquisition in the first fixed TI group. This average increment in TI was used as input to calculate the dynamic increment of the initial blood nulling TI value as set in the second dynamic TI group. Regions of interest were drawn in the left ventricular blood pool to assess mean signal intensity as a measure for blood pool suppression. Overall image quality, observer confidence, and scar demarcation were scored on a 3-point scale.

Results
Three-dimensional dark-blood LGE data sets were successfully acquired in 46/50 patients (92%). The calculated average TI increase of 2.3 ± 0.5 ms/min obtained in the first fixed TI group was incorporated in the second dynamic TI group and led to a significant decrease of 72% in the mean blood pool signal intensity compared with the fixed TI group (P < 0.001). Overall image quality (P = 0.02), observer confidence (P = 0.02), and scar demarcation (P = 0.01) significantly improved using a dynamic TI.

Conclusions
A steadily increasing dynamic TI improves blood pool suppression for optimized dark-blood contrast and increases observer confidence in free-breathing 3D dark-blood LGE MRI with high isotropic resolution.
A Deep-Learning Diagnostic Support System for the Detection of COVID-19 Using Chest Radiographs
Authors: Fontanellaz Matthias , Ebner Lukas , Huber Adrian , Peters Alan , Löbelenz Laura , Hourscht Cynthia , Klaus Jeremias , Munz Jaro , Ruder Thomas , Drakopoulos Dionysios , Sieron Dominik , Primetis Elias , Heverhagen Johannes T. , Mougiakakou Stavroula , Christe Andreas 
Published: December 2020

Objectives
The aim of this study was to compare a diagnosis support system to detect COVID-19 pneumonia on chest radiographs (CXRs) against radiologists of various levels of expertise in chest imaging.

Materials and Methods
Five publicly available databases comprising normal CXR, confirmed COVID-19 pneumonia cases, and other pneumonias were used. After the harmonization of the data, the training set included 7966 normal cases, 5451 with other pneumonia, and 258 CXRs with COVID-19 pneumonia, whereas in the testing data set, each category was represented by 100 cases. Eleven blinded radiologists with various levels of expertise independently read the testing data set. The data were analyzed separately with the newly proposed artificial intelligence–based system and by consultant radiologists and residents, with respect to positive predictive value (PPV), sensitivity, and F-score (harmonic mean for PPV and sensitivity). The χ2 test was used to compare the sensitivity, specificity, accuracy, PPV, and F-scores of the readers and the system.

Results
The proposed system achieved higher overall diagnostic accuracy (94.3%) than the radiologists (61.4% ± 5.3%). The radiologists reached average sensitivities for normal CXR, other type of pneumonia, and COVID-19 pneumonia of 85.0% ± 12.8%, 60.1% ± 12.2%, and 53.2% ± 11.2%, respectively, which were significantly lower than the results achieved by the algorithm (98.0%, 88.0%, and 97.0%; P < 0.00032). The mean PPVs for all 11 radiologists for the 3 categories were 82.4%, 59.0%, and 59.0% for the healthy, other pneumonia, and COVID-19 pneumonia, respectively, resulting in an F-score of 65.5% ± 12.4%, which was significantly lower than the F-score of the algorithm (94.3% ± 2.0%, P < 0.00001). When other pneumonia and COVID-19 pneumonia cases were pooled, the proposed system reached an accuracy of 95.7% for any pathology and the radiologists, 88.8%. The overall accuracy of consultants did not vary significantly compared with residents (65.0% ± 5.8% vs 67.4% ± 4.2%); however, consultants detected significantly more COVID-19 pneumonia cases (P = 0.008) and less healthy cases (P < 0.00001).

Conclusions
The system showed robust accuracy for COVID-19 pneumonia detection on CXR and surpassed radiologists at various training levels.
Management of Pediatric Orbital Fractures
Authors: Wolff Amir , Ohayon Chaim , Emodi Omri , Sviri Gill E. , Shapira Vladimir , Rachmiel Adi 
Published: December 2020

Introduction:
Although uncommon in children, orbital fractures can be devastating to both vision and appearance. Due to the scarce information in the literature, the authors here present our experience and management with all pediatric orbital fracture patients.

Material and methods:
A 6-years retrospective study was conducted on pediatric patients presented with orbital wall fracture (OFx). All patients (n = 43) were grouped for comparison based on the treatment method. The cohorts were analyzed for demographics data, location of fracture, type of material used for reconstruction, complication rate and follow up length. Data was analyzed utilizing SPSS for χ
2 test.

Results:
The majority of patients were male (86%) and the mean age of patients was 12.09 ± 4 years. Mean follow-up time was 237 ± 72 days. Most of Patients 31 (72%) underwent surgical intervention. A higher rate of complications was observed in the surgically treated group (32%) compared to the conservative group (8%) regardless to the defect size. Subgroup analysis of the surgery treated group revealed that large size defect had inferior outcome compared to small size defect.

Conclusion:
The consequences of treatment on long-term growth and development must be a cornerstone when choosing the optimal therapeutic method. Conservative management should be considered first in the absence of significant clinical pathologies. In addition, when surgery is indicated the least invasive procedure should be applied. The use of autogenous bone graft is preferable over alloplastic materials, however, when there is insufficient bone quantity the use of alloplastic materials is not contraindicated for reconstruction.
Prominent Ear Repair Surgery: Long-Term Results
Authors: Toplu Gaye , Altinel Dincer 
Published: December 2020

Purpose:Prominent ear is common in the white population at a rate of 5%. Many surgical incision and suture techniques have been described for its correction. The purpose of this article was to report the results of the prominent ear surgeries applied in our clinic for the last 5 years and to show the details of the surgical technique, to evaluate long-term results, complications, revisions and to compare them with previously published studies.Materials and Methods:A total of 27 patients were included in the study. The patient age ranged from 7 to 60 at the time of surgery (mean age: 18.7). Of the 27 patients, 13 were female (48.2%) and 14 were male (51.8%). The procedure was bilateral in 19 cases (70.4%) and unilateral in 8 cases (29.6%). The patients were treated with the same technique by three surgeons. Aesthetic results were evaluated by patient and surgeon surveys.Results:The follow-up was between 1 and 5 years (mean: 3 years). The patients very satisfied with the overall appearance of the ears, and the symmetry of the ears was rated as excellent by all patients, parents, and surgeons.Conclusion:Regardless of the technique used, patient satisfaction appears to be high. To reduce negative results and prevent recurrence, the authors recommend that the ear is preoperatively evaluated and the treatment algorithm is used accordingly.
The Effect of Medial Sural Artery Perforator Flap on Reconstruction of Soft Tissue Defects: A Meta-Analysis With Multiple Free Soft Flaps
Authors: Xu Qiang , Yin Shou-Cheng , Su Xing-Zhou , Wang Si-Min , Liu Yi-Hao , Xu Zhong-Fei 
Published: December 2020

Background:With the gradual popularity of relatively novel medial sural artery perforator flap (MSAPF), robust studies are needed to compare the surgical outcomes of MSAPF versus multiple free soft flaps (MFSFs) to verify the advantages and disadvantages of MSAPF.Methods:The authors searched PubMed, Web of Science, EMBASE, Cochrane Library, Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) until September, 2020, to identify studies that compared surgical outcomes of MSAPF and MFSFs. Two authors followed the PRISMA guidelines, individually extracted the data and performed the quality assessments. Survival rate of flaps, satisfaction degree of patients in recipient and donor site, skin grafting, and morbidity of recipient and donor site were evaluated.Results:A total of 441 cases from 7 studies were included in our analysis. No significant differences were found regarding survival rate of flaps, recipient morbidity, and recipient satisfaction degree between the 2 groups. However, MSAPF group was significantly superior to MFSFs group in terms of skin grafting, morbidity, and satisfaction degree of donor site.Conclusion:Our meta-analysis showed that the MSPAF and MFSFs groups were similar in terms of survival rate of flaps, recipient morbidity, and recipient satisfaction degree. Medial sural artery perforator flap group was superior to MFSFs group in terms of morbidity and satisfaction degree of donor site. The results may prove that MSAPF is gaining popularity for a reason and is a good choice for repairing soft tissue defects.
Occlusal Plane and Skeletal Changes After Cervical Headgear Treatment With and Without Lower Utility Arch in Class II Growing Patients
Authors: Sambataro Sergio , Bocchieri Salvatore , Fastuca Rosamaria , Giuntini Veronica , Fiorillo Luca , Cicciù Marco , Caprioglio Alberto 
Published: December 2020

Abstract
The purpose of this study was to investigate skeletal and dental changes affecting occlusal plane inclination after cervical headgear treatment with and without lower utility arch. In order to distinguish the orthodontic changes from natural growth a control group was employed.
The sample of this study consisted by 20 Class II subjects (10 males, 10 females; mean age 8.54) treated by using cervical headgear, 19 class II children (19 males, 9 females; mean age 8.64) treated with cervical headgear and utility arch, and 21 Class II patients (11 males, 10 females; mean age 8.41) who had no therapy.
Lateral head films were studied for all the patients before treatment (T1) and after therapy (T2) for all the treated groups and at the beginning and at the end of observational period for the control group; cephalometric analysis was carried out in order to seek for the modifications between time points and between groups.
Means and standard deviation have been analyzed for all the groups. In order to compare the modification between the time points within the same group the ANOVA test was applied. The ANOVA test was used to compare the mean differences (T2-T1) of 3 groups.
The study revealed that there were significant changes in occlusal plane inclination after the different treatment modalities employed instead control group. The treatment with cervical headgear and utility arch is more effective than cervical headgear alone in lowering occlusal plane posteriorly when it is compared with controls.
Improved Mortality, Morbidity, and Long-Term Outcome After Anatomical Hepatectomy With the Glissonean Pedicle Approach in Patients With Hepatocellular Carcinoma
Authors: Ariizumi Shun-ichi , Katagiri Satoshi , Kotera Yoshihito , Yamashita Shingo , Omori Akiko , Kato Takaaki , Shibuya Go , Egawa Hiroto , Takasaki Ken , Yamamoto Masakazu 
Published: December 2020

Objective:
We evaluated the morbidity and mortality after anatomical hepatectomy with the Glissonean pedicle approach, and long-term outcomes in relation to the morbidity in patients with hepatocellular carcinoma (HCC).

Summary Background Data:
The mortality, morbidity, and long-term outcomes were evaluated retrospectively.

Methods:
A total of 1953 patients with HCC underwent various anatomical hepatectomies with the Glissonean pedicle approach between 1985 and 2014. The mortality (30-day and 90-day) and morbidity (Clavien-Dindo class Ilia or higher) were evaluated among six 5-year eras (1985–1989, 1990–1994, 1995–1999, 2000–2004, 2005–2009, 2010–2014).

Results:
A total of 460 patients (24%) showed morbidity, and the overall 30-day and 90-day mortality rates were 1.8% and 3.3%, respectively. The 30-day (3.9%, 3.0%, 1.8%, 1.3%, 0.3%, 0.5%: P = 0.0074) and 90-day mortality (6.0%, 4.3%, 3.8%, 2.8%, 2.2%, 1.4%: P = 0.0445) significantly improved over the eras. Blood loss >2 L (odds ratio: 11.808, P = 0.0244) was an independent risk factor for 30-day mortality, and blood loss >2 L (odds ratio: 4.046, P = 0.0271) and bile leakage (odds ratio: 2.122, P = 0.0078) were independent risk factors for 90-day mortality on multivariate analysis. Morbidity was significant independent prognostic factors for overall survival (relative risk: 2.129, P < 0.0001) and recurrence-free survival (relative risk: 1.299, P < 0.0001) in patients with HCC.

Conclusions:
Anatomical hepatectomy with the Glissonean pedicle approach was achieved safely in patients with HCC. For more safety and longer survival, blood loss, bile leakage, and morbidity should be reduced. Longterm outcomes after anatomical hepatectomy with the Glissonean pedicle approach in patients with HCC have been improved over 30 years with gradually less mortality and morbidity due to decreases in blood loss >2 L and bile leakage.
Development and Validation of a Multiplex, Bead-based Assay to Detect Antibodies Directed Against SARS-CoV-2 Proteins
Authors: Bray Robert A. , Lee Jar-How , Brescia Peter , Kumar Deepali , Nong Thoa , Shih Remi , Woodle E. Steve , Maltzman Jonathan S. , Gebel Howard M. 
Published: December 2020

Background.
Transplant recipients who develop COVID-19 may be at increased risk for morbidity and mortality. Determining the status of antibodies against SARS-CoV-2 in both candidates and recipients will be important to understand the epidemiology and clinical course of COVID-19 in this population. While there are multiple tests to detect antibodies to SARS-CoV-2, their performance is variable. Tests vary according to their platforms and the antigenic targets which make interpretation of the results challenging. Furthermore, for some assays, sensitivity and specificity are less than optimal. Additionally, currently available serological tests do not exclude the possibility that positive responses are due to cross reactive antibodies to community coronaviruses rather than SARS-CoV-2.

Methods.
This study describes the development and validation of a high-throughput multiplex antibody detection assay.

Results.
The multiplex assay has the capacity to identify, simultaneously, patient responses to 5 SARS-CoV-2 proteins, namely, the full spike protein, 3 individual domains of the spike protein (S1, S2, and receptor binding domain), and the nucleocapsid protein. The antibody response to the above proteins are SARS-CoV-2-specific, as antibodies against 4 common coronaviruses do not cross-react.

Conclusions.
This new assay provides a novel tool to interrogate the spectrum of immune responses to SAR-CoV-2 and is uniquely suitable for use in the transplant setting. Test configuration is essentially identical to the single antigen bead assays used in the majority of histocompatibility laboratories around the world and could easily be implemented into routine screening of transplant candidates and recipients.
Dietary protein increases T cell independent sIgA production through changes in gut microbiota-derived extracellular vesicles
Authors: Tan Jian , Ni Duan , Taitz Jemma , Pinget Gabriela Veronica , Read Mark , Senior Alistair , Wali Jibran Abdul , Nanan Ralph , King Nicholas Jonathan Cole , Grau Georges Emile , Simpson Stephen J. , Macia Laurence 
Published: December 2020

AbstractSecretory IgA (sIgA) is a key mucosal component ensuring host-microbiota mutualism. Using nutritional geometry modelling in mice fed 10 different macronutrient-defined, isocaloric diets, we identified dietary protein as the major driver of sIgA production. Protein-driven sIgA induction was not mediated by T cell-dependent pathways or changes in gut microbiota composition. Instead, the microbiota of high-protein fed mice produced significantly higher quantities of extracellular vesicles (EV), compared to those of mice fed high-carbohydrate or high-fat diets. These EV activated TLR4 to increase the epithelial expression of IgA-inducing cytokine, APRIL, B cell chemokine, CCL28, and the IgA transporter, PIGR. We showed that succinate, produced in high concentrations by microbiota of high-protein fed animals, increased the generation of reactive oxygen species by bacteria, which in turn promoted EV production. This is the first report establishing a causal link between dietary macronutrient composition, gut microbial EV release and host sIgA response.
Single-Shot Lightweight Model For The Detection of Lesions And The Prediction of COVID-19 From Chest CT Scans
Authors: Ter-Sarkisov Aram 
Published: December 2020

AbstractWe introduce a lightweight model based on Mask R-CNN with ResNet18 and ResNet34 backbone models that segments lesions and predicts COVID-19 from chest CT scans in a single shot. The model requires a small dataset to train: 650 images for the segmentation branch and 3000 for the classification branch, and it is evaluated on 21292 images to achieve a 42.45% average precision (main MS COCO criterion) on the segmentation test split (100 images), 93.00% COVID-19 sensitivity and F1-score of 96.76% on the classification test split (21192 images) across 3 classes: COVID-19, Common Pneumonia and Control/Negative. The full source code, models and pretrained weights are available on https://github.com/AlexTS1980/COVID-Single-Shot-Model.
Prediction of Covid-19 spreading and optimal coordination of counter-measures: From microscopic to macroscopic models to Pareto fronts
Authors: Wulkow Hanna , Conrad Tim , Conrad Nataša Djurdjevac , Mueller Sebastian A. , Nagel Kai , Schuette Christof 
Published: December 2020

AbstractThe Covid-19 disease has caused a world-wide pandemic with more than 60 million positive cases and more than 1.4 million deaths by the end of November 2020. As long as effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, self-isolation and quarantine as well as far-reaching shutdowns of economic activity and public life are the only available strategies to prevent the virus from spreading. These interventions must meet conflicting requirements where some objectives, like the minimization of disease-related deaths or the impact on health systems, demand for stronger counter-measures, while others, such as social and economic costs, call for weaker counter-measures. Therefore, finding the optimal compromise of counter-measures requires the solution of a multi-objective optimization problem that is based on accurate prediction of future infection spreading for all combinations of counter-measures under consideration. We present a strategy for construction and solution of such a multi-objective optimization problem with real-world applicability. The strategy is based on a micro-model allowing for accurate prediction via a realistic combination of person-centric data-driven human mobility and behavior, stochastic infection models and disease progression models including micro-level inclusion of governmental intervention strategies. For this micro-model, a surrogate macro-model is constructed and validated that is much less computationally expensive and can therefore be used in the core of a numerical solver for the multi-objective optimization problem. The resulting set of optimal compromises between counter-measures (Pareto front) is discussed and its meaning for policy decisions is outlined.