bluuebunny/crossref_metadata_2025_split huggingface dataset:
Same‐day antiretroviral therapy is associated with increased loss to follow‐up in South African public health facilities: a prospective cohort study of patients diagnosed with HIV
Authors: Joseph Davey Dvora , Kehoe Kathleen , Serrao Claire , Prins Marlien , Mkhize Ntokozo , Hlophe Khanyo , Sejake Senate , Malone Todd 
Published: June 2020

AbstractIntroductionSouth Africa introduced Universal Test and Treat in 2016 including antiretroviral therapy (ART) initiation on the same‐day as HIV diagnosis. Our study sought to evaluate the impact of same‐day ART initiation on loss to follow‐up (LTFU) and mortality comparing with patients who initiated ART after their HIV diagnosis.MethodsWe conducted a file review of patients with a HIV diagnosis and ART start date on file between September 2016 and May 2018 in six high HIV burden districts. Our primary outcome was LTFU (>90 days from the last clinical visit or drug pick‐up until database closure 31 July 2018). The secondary outcome was mortality after ART initiation. Time to outcome was assessed comparing same‐day vs. one to seven, eight to twenty‐one and ≥ twenty‐two days to ART initiation using Kaplan‐Meier estimators stratified by sex. We investigated predictors using univariate and multivariable Cox proportional hazards models, adjusting for a priori characteristics.ResultsOverall, 92,609 ART patients contributed 43,922 person‐years from ART initiation, with a median follow‐up time of 246 days (IQR = 112 to 455). Of these patients, 33,399 (36%) initiated ART on the same‐day as their HIV diagnosis date and had a median follow‐up time of 174 days (IQR = 85 to 349). Same‐day patients were predominantly non‐pregnant females (56%) and aged 25 to 34 years (40%). Same‐day ART initiation increased from 2.8% in September 2016 to 7.1% in April 2018. In same‐day patients, 33% (n = 11,114) were classified as LTFU with a median time of 55 days (IQR = 1 to 185), compared to 371 mean days (IQR = 161 to 560) in patients who initiated ≥22 days after diagnosis. A similar proportion of LTFU was observed for patients who initiated later: 31% 1 to 21 day and 33% ≥22 day. Same‐day ART patients had an increased risk of LTFU vs. ≥1 day (adjusted hazard ratio (aHR) = 1.28, 95% CI = 1.24 to 1.33) adjusting for covariates. Although all‐cause mortality was slightly lower in same‐day patients (0.9%) vs. >1 day (1.4%; aHR = 0.87, 95% CI = 0.72 to 1.05) adjusting for covariates. Men had highest risk of mortality and LTFU.ConclusionsSame‐day ART increased the risk of LTFU, but same‐day patients experienced slightly lower mortality. Same‐day patients may require additional counselling and interventions to improve retention. Additional research is needed on targeted interventions, including differentiated care, to reduce LTFU in patients initiating ART same‐day.
A primer to gene therapy: Progress, prospects, and problems
Authors: Zittersteijn Hidde A. , Gonçalves Manuel A.F.V. , Hoeben Rob C. 
Published: June 2020

AbstractGenetic therapies based on gene addition have witnessed a variety of clinical successes and the first therapeutic products have been approved for clinical use. Moreover, innovative gene editing techniques are starting to offer new opportunities in which the mutations that underlie genetic diseases can be directly corrected in afflicted somatic cells. The toolboxes underpinning these DNA modifying technologies are expanding with great pace. Concerning the ongoing efforts for their implementation, viral vector‐based gene delivery systems have acquired center‐stage, providing new hopes for patients with inherited and acquired disorders. Specifically, the application of genetic therapies using viral vectors for the treatment of inborn metabolic disorders is growing and clinical applications are starting to appear. While the field has matured from the technology perspective and has yielded efficacious products, it is the perception of many stakeholders that from the regulatory side further developments are urgently needed. In this review, we summarize the features of state‐of‐the‐art viral vector systems and the corresponding gene‐centered therapies they seek to deliver. Moreover, a brief summary is also given on emerging gene editing approaches built on CRISPR‐Cas9 nucleases and, more recently, nickases, including base editors and prime editors. Finally, we will point at some regulatory aspects that may deserve further attention for translating these technological developments into actual advanced therapy medicinal products (ATMPs).
Comparative Complication Rates of 854 Central Venous Access Devices for Home Parenteral Nutrition in Cancer Patients: A Prospective Study of Over 169,000 Catheter‐Days
Authors: Cotogni Paolo , Mussa Baudolino , Degiorgis Claudia , De Francesco Antonella , Pittiruti Mauro 
Published: June 2020

AbstractBackgroundWhether peripherally inserted central catheters (PICCs) are appropriate as safe and durable venous access devices (VADs) is still controversial. The aim of this 7‐year, prospective cohort study was to compare the incidence rate differences of catheter‐related complications (CRCs) among 4 types of central VADs in cancer patients receiving home parenteral nutrition (HPN).MethodsWe enrolled all adult cancer outpatients who were candidates for HPN and who had a central VAD inserted during the study period, focusing on the incidence rate of CRCs.ResultsWe evaluated 854 central VADs (401 PICCs, 137 nontunneled centrally inserted central catheters [CICCs], 118 tunneled‐cuffed CICCs, and 198 ports) in 761 patients, for a total of 169,116 catheter‐days. Overall, the rate of total CRCs was 1.08/1000 catheter‐days. The incidence of catheter‐related bloodstream infections was low (0.29/1000), particularly for PICCs (0.08/1000; P < .001 vs tunneled‐cuffed CICCs) and for ports (0.21/1000; P < .019 vs tunneled‐cuffed CICCs). The rates of mechanical complications (0.58/1000) and of catheter‐related symptomatic thrombosis (0.09/1000) were low and similar for PICCs, tunneled‐cuffed CICCs, and ports. In terms of duration and removal rate due to complications, PICCs were like tunneled‐cuffed CICCs and ports. Altogether, PICCs had fewer total complications than tunneled‐cuffed CICCs (P < .001), there was no difference in total complications between PICCs and ports.ConclusionPICCs had significantly better outcomes than tunneled‐cuffed CICCs and were safe and durable as ports. Our extensive, long‐term study suggests that PICCs can be successfully used as safe and long‐lasting VADs for HPN in cancer patients.
Microsimulation Model to Compare Enteral and Parenteral Iron Supplementation in Children With Intestinal Failure
Authors: Raghu Vikram Kalathur , Rudolph Jeffrey A. , Jalal Hawre J. , Smith Kenneth J. 
Published: June 2020

AbstractBackgroundChildren with chronic intestinal failure have a high prevalence of anemia, commonly from iron deficiency, leading to frequent blood transfusions. No current guideline exists for iron supplementation in these children. In this analysis, we evaluate the effectiveness and the cost‐effectiveness of using parenteral, enteral, and no iron supplementation to reduce blood transfusions.MethodsWe created a microsimulation model of pediatric intestinal failure over a 1‐year time horizon. Model outcomes included cost (US dollars), blood transfusions received, and hemoglobin trend. Strategies tested included no supplementation, daily enteral supplementation, and monthly parenteral supplementation. We estimated parameters for the model using an institutional cohort of 55 patients. Model parameters updated each 1‐month cycle using 2 regressions. A multivariate mixed‐effects linear regression estimated hemoglobin values at the next month based on data from the prior month. A mixed‐effects logistic regression on hemoglobin predicted the probability of receiving a blood transfusion in a given month.ResultsCompared with no supplementation, both enteral and parenteral iron supplementation reduced blood transfusions required per patient by 0.3 and 0.5 transfusions per year, respectively. Enteral iron cost $34 per avoided blood transfusion. Parenteral iron cost an additional $6600 per avoided blood transfusion compared with enteral iron.ConclusionsWe found both parenteral and enteral iron to be effective at reducing blood transfusions. The cost of enteral iron makes it the desired choice in patients who can tolerate it. Future work should aim to identify which subpopulations of patients may benefit most from one strategy over the other.
Validation of an Objective Assessment Tool for Tonsillectomy in Otolaryngology Resident Training
Authors: Jakubowski Luke , Leader Brittany A. , Ishman Stacey L. , Chun Robert , Tarima Sergey S. , Parikh Sanjay , Skinner Margaret , Thorne Marc , Weatherly Robert , Wiet Gregory , Brown David J. 
Published: June 2020

ObjectiveCreate and validate an objective structured assessment of technical skills (OSATS) for otolaryngology residents learning how to perform a tonsillectomy.Study DesignMulticenter prospective longitudinal validation study.MethodsA multi‐institutional study at six tertiary academic otolaryngology residency programs from July 2009 to May 2012. Using the modified Delphi technique, a panel of pediatric otolaryngologists created a tonsillectomy task‐based checklist (TBC) for a tonsil OSATS using a 5‐point Likert‐type scale. Residents were assessed by pediatric otolaryngology staff at the time of surgery with the TBC and a global rating scale. Procedure time, patient age, number of previously performed tonsillectomies, and surgical technique were also collected.ResultsOne hundred sixty‐seven tonsil OSATS were completed for 38 residents, and competency was recorded for 99 (59.2%). Residents scored as competent had performed significantly more previous tonsillectomies than those deemed noncompetent, 44.4 ± 35.6 and 13.5 ± 11.6, respectively (P < .001). The mean overall score on the tonsil TBC was 4.0 ± 0.8 and 2.6 ± 1.0 for competent and noncompetent, respectively (P < .001). Higher number of tonsillectomies performed and mean tonsil TBC score significantly increased the likelihood of competency (P < .001). Each additional tonsillectomy performed increased the likelihood of achieving competency by 6.3% (P = .006, 95% confidence interval (CI): 1.330–1.110), and each 1.0 point increase in mean tonsil TBC score increased the likelihood of competency by a factor of 2.71 (P = .006, 95% CI:1.330–5.513). There is a 95% likelihood of competency at 48 tonsillectomies or a tonsil TBC score of 4.91.ConclusionThe tonsil OSATS is a valid and feasible instrument to assess resident competency with tonsillectomy and provides timely objective feedback.Level of Evidence4. Laryngoscope, 131:E359–E366, 2021
Current vegetation structure and composition of woody species in community‐derived categories of land degradation in a semiarid rangeland in Kunene region, Namibia
Authors: Inman Emilia N. , Hobbs Richard J. , Tsvuura Zivanai , Valentine Leonie 
Published: June 2020

AbstractLand degradation has put the world's rangelands under intense pressure and reduced their capacity to provide vital services to those who solely depend on them for survival. With the current pressures on rangelands, worldwide, there is an urgent need to survey the present condition of rangelands. Such detailed surveys can identify where improvement programmes can be emphasised; whether it be reseeding, stock control, sociological restraints or other actions. To combat rangeland degradation, management systems are more effective when they account for community perceptions and practices. This study aims to assess the current status of woody plants in different categories of degradation as perceived by herders in Kunene, Namibia. Furthermore, we wished to compare the perception of degradation by herders with the measured ecological condition. With the help of herders, sites representing different categories of degradation (low, moderate, high and protected) were identified and 10 plots of 400m2 each were established in each category. Species diversity, density, basal area and regeneration of woody plants increased sequentially along the degradation gradient (high to low). Vegetation attributes such as species diversity, seedling density and standing basal area increased with increasing distances from the villages. Although the herders' perception of degradation, for high and moderate degradation, matches the ecological results, the low degradation sites show signs of bush encroachment, a type of degradation that the herders did not perceive as degradation. Colophospermum mopane, a known encroacher species across Namibia, was the dominant species in the moderate and low degradation sites. Pechuel‐loeschea leubnitziae, which is also known to be an indicator of degradation, was the dominant species in the high degradation sites. The findings highlight the present and future threats the study area is facing and form the basis for current restoration research.
Spatiotemporal analysis of deforestation in the Chapare region of Bolivia using LANDSAT images
Authors: Bagan Hasi , Millington Andrew , Takeuchi Wataru , Yamagata Yoshiki 
Published: June 2020

AbstractThe purpose of this study is to quantify (a) spatiotemporal deforestation patterns, and (b) the relationships between changes in the main land‐cover types in the Chapare region of Bolivia. We applied subspace classification methods to LANDSAT data from 1986, 1999, and 2018 and used grid cells at scales of 150, 300, 600, and 900 m to measure deforestation trajectories. The 150 m grids provided better detail to determine deforestation trajectories than coarser‐scale grid cells. Differences in grid‐cell scale did not influence the statistical trends in land‐cover changes significantly. Changes in forest area were negatively correlated with changes in cropland (r = −.44), grassland (r = −.34), swamp grassland (r = −.38), and regrowth (r = −.32) areas. Correlations between forest losses in cropland, grassland, and regrowth change analyses were weaker between 1999 and 2018 compared to 1986 to 1999. Forest cover declined from 6,635 km2 (1986) to 3,800 km2 (2018), and the deforestation rate increased from an annual average of 1.36% between 1986 and 1999 to 2.0% between 1999 and 2018. The key proximate drivers of forest clearance rates and patterns were increasing population, agricultural expansion, and road building. While coca is an economically important crop in Chapare, its direct and indirect effects on deforestation could not be determined unambiguously. It is probable that the expansion of agriculture will lead to further deforestation and forest fragmentation and, along with decreases in forest cover, further changes will take place between non‐forest categories.
1.3 µm Quantum Dot‐Distributed Feedback Lasers Directly Grown on (001) Si
Authors: Wan Yating , Norman Justin C. , Tong Yeyu , Kennedy M. J. , He William , Selvidge Jenny , Shang Chen , Dumont Mario , Malik Aditya , Tsang Hon Ki , Gossard Arthur C. , Bowers John E. 
Published: June 2020

AbstractDistributed feedback (DFB) lasers represent a central focus for wavelength‐division‐multiplexing‐based transceivers in metropolitan networks. Here, the first 1.3 µm quantum dot (QD) DFB lasers grown on a complementary metal‐oxide‐semiconductor (CMOS)‐compatible (001) Si substrate are reported. Temperature‐stable, single‐longitudinal‐mode operation is achieved with a side‐mode suppression ratio of more than 50 dB and a threshold current density of 440 A cm−2. A single‐lane rate of 128 Gbit s−1 with a net spectral efficiency of 1.67 bits−1 Hz−1 is demonstrated, with an aggregate total transmission capacity of 640 Gbit s−1 using five channels in the O‐band. Apart from the QD active region growth, the overall fabrication is essentially identical to the commercial process for quantum well (QW) DFB lasers. This provides a process‐compatible path for QD technology into commercial applications previously filled by QW devices. In addition, the capability to grow laser epi across entire CMOS‐compatible (001) Si wafers adds extra benefits of reduced cost, improved heat dissipation, and manufacturing scalability. Through direct epitaxial integration of III–Vs and Si, one can envision a revolution of the photonics industry in the same way that CMOS design and processing revolutionize the microelectronics industry. This is discussed from a system perspective for on‐chip optical interconnects.
Line Singularities and Hopf Indices of Electromagnetic Multipoles
Authors: Chen Weijin , Chen Yuntian , Liu Wei 
Published: June 2020

AbstractElectromagnetic multipoles serve as one of the most ubiquitous languages in photonics, forming a complete expansion basis for radiations of arbitrary types. Electromagnetic multipoles from the perspective of line fields and singularities are explored. It is then discovered that, for arbitrary finite sources in a homogeneous background, there have to be isolated directions along which the radiation is either zero or circularly polarized. For such singular directions, half‐integer Hopf indices can be assigned and the index sum has to be a global invariant of 2. With this topological insight, the hidden dimensions of radiative circularly polarized Bloch modes of photonic crystal slabs are unveiled, revealing their topological origins of line singularities and indices. This work has established subtle connections between three seemingly unrelated but sweeping physical entities (line singularities of Hopf indices, electromagnetic multipoles, and Bloch modes), which can nourish new frames of visions and applications fertilizing many related fields.
Glutathione S‐Transferase T1 Mismatch Is a Risk Factor for Chronic Ductopenic Rejection of Liver Allografts
Authors: Sousa Jose Manuel , Barrera Lydia , Gomez‐Bravo Miguel Angel , Nuñez‐Roldan Antonio , Aguilera Isabel 
Published: June 2020

The underlying causes of chronic rejection (CR) after liver transplantation (LT) are not completely known. The main aim of this study was to explore the involvement of the minor histocompatibility antigen glutathione S‐transferase T1 (GSTT1) in CR. We retrospectively studied 611 patients who underwent LTs at University Hospital Virgen del Rocío between 2003 and 2016 with a median follow‐up of 7.4 ± 4.2 years. The GSTT1 genotype was determined by polymerase chain reaction. We defined GSTT1 mismatch as a specific donor/recipient combination in which a recipient who was homozygous for the deletion allele received a transplant from a positive donor. The prevalence of CR in our whole cohort was 11.6% (71/611), and the prevalence in the GSTT1‐mismatched group was 18.8% (16/85) versus 10.5% (55/526) in the GSTT1‐matched group. In the cyclosporine A (CsA) group, the prevalence was 26.3% (26/99), much higher than the 8.8% (45/512) observed in the tacrolimus (Tac) group. For statistical analysis, the patients were distributed into 2 groups: group 1, regarded as GSTT1 mismatched, which included the donor (D)+/recipient (R)− allelic combination; and group 2, regarded as GSTT1 matched, which included the other allelic combinations of D+/R+, D−/R−, and D−/R+. All relevant clinical information was collected, and a diagnosis of CR was always confirmed by liver biopsy. GSTT1 mismatch (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.08‐3.66; P = 0.03) and use of CsA/Tac (P < 0.001) were independent risk factors for CR. CR increased the risk of mortality (HR, 2; 95% CI, 1.2‐3.6; P = 0.01). Out of the 71 CR patients, 12 (16.9%) needed retransplantation. In conclusion, the GSTT1 D+/R− allelic mismatch is an independent risk factor for CR. A long follow‐up of LT patients is recommended because the incidence of CR in adults seems to be underestimated.
Complementary EIS/FTIR study of the degradation of adhesives in electronic packaging
Authors: Schneider Michael , Gierth Uta , Simunkova Lenka , Gierth Paul , Rebenklau Lars 
Published: June 2020

AbstractAdhesives are widely used in electronic packaging and are of vital importance in the reliability of electronic systems. A deep understanding of the degradation mechanism of adhesives under corrosion load plays a key role in lifetime prediction. Unfortunately, most of the common reliability tests are destructive. The present approach combines the nondestructive methods, electrochemical impedance spectroscopy and the Fourier‐transform infrared spectroscopy, as powerful tools in a complementary manner to describe the degradation mechanism and kinetics of two epoxy‐based adhesives, which are commonly used in electronic packaging. It is demonstrated that the application quality is the dominating impact on the optimization of the lifetime.
Clinical study and some molecular features of Mexican patients with syndromic craniosynostosis
Authors: Ibarra‐Arce Aurora , Almaraz‐Salinas Manuel , Martínez‐Rosas Víctor , Ortiz de Zárate‐Alarcón Gabriela , Flores‐Peña Laura , Romero‐Valdovinos Mirza , Olivo‐Díaz Angélica 
Published: June 2020

AbstractBackgroundCraniosynostosis is one of the major genetic disorders affecting 1 in 2,100–2,500 live newborn children. Environmental and genetic factors are involved in the manifestation of this disease. The suggested genetic causes of craniosynostosis are pathogenic variants in FGFR1, FGFR2, FGFR3, and TWIST1 genes.MethodsIn order to describe their major clinical characteristics and the presence of pathogenic variants, a sample of 36 Mexican patients with craniosynostosis diagnosed as: Crouzon (OMIM 123,500), Pfeiffer (OMIM 101,600), Apert (OMIM 101,200), Saethre‐Chotzen (OMIM 101,400), and Muenke (OMIM 602,849) was analyzed.ResultsIn addition to craniosynostosis, most of the patients presented hypertelorism, midface hypoplasia, and abnormalities in hands and feet. To detect the pathogenic variants p.Pro252Arg FGFR1 (OMIM 136,350), p.Ser252Trp, p.Pro253Arg FGFR2 (OMIM 176,943), p.Pro250Arg, FGFR3 (OMIM 134,934), and p.Gln119Pro TWIST1 (OMIM 601,622), PCR amplification and restriction enzyme digestion were performed. Four and two patients with Apert presented the pathogenic variants p.Ser252Trp and p.Pro253Arg in FGFR2, respectively (with a frequency of 11.1% and 5.5%). The p.Pro250Arg pathogenic variant of FGFR3 was found in a patient with Muenke (with a frequency of 2.8%). The above percentages were calculated with the total number of patients.ConclusionThe contribution of this work is discreet, since only 4 genes were analyzed and sample size is small. However, this strategy could be improved by sequencing the FGFR1, FGFR2, FGFR3, and TWIST1 genes, to determine different pathogenic variants. On the other hand, it would be important to include other genes, such as TCF12 (OMIM 600,480), MSX2 (OMIM 123,101), RAB23 (OMIM 606,144), and EFNB1 (OMIM 300,035), to determine their participation in craniosynostosis in the Mexican population.