bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiologic and viral predictors of antiretroviral drug resistance among persons living with HIV in a large treatment program in Nigeria
Authors: Ekong Ernest , Ndembi Nicaise , Okonkwo Prosper , Dakum Patrick , Idoko John , Banigbe Bolanle , Okuma James , Agaba Patricia , Blattner William , Adebamowo Clement , Charurat Manhattan 
Published: February 2020

Abstract
Background
Expanded access to combination antiretroviral therapy (cART) throughout sub-Saharan Africa over the last decade has remarkably improved the prognosis of persons living with HIV (PLWH). However, some PLWH experience virologic rebound after a period of viral suppression, usually followed by selection of drug resistant virus. Determining factors associated with drug resistance can inform patient management and healthcare policies, particularly in resource-limited settings where drug resistance testing is not routine.

Methods
A case–control study was conducted using data captured from an electronic medical record in a large treatment program in Nigeria. Cases PLWH receiving cART who developed acquired drug resistance (ADR) and controls were those without ADR between 2004 and 2011. Each case was matched to up to 2 controls by sex, age, and education. Logistic regression was used estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with ADR.

Results
We evaluated 159 cases with ADR and 299 controls without ADR. In a multivariate model, factors associated with ADR included older age (OR = 2.35 [age 30–40 years 95% CI 1.29, 4.27], age 41 + years OR = 2.31 [95% CI 1.11, 4.84], compared to age 17–30), higher education level (secondary OR 2.14 [95% CI 1.1.11–4.13]), compared to primary and tertiary), non-adherence to care (OR = 2.48 [95% CI 1.50–4.00]), longer treatment duration (OR = 1.80 [95% CI 1.37–2.35]), lower CD4 count((OR = 0.95 [95% CI 0.95–0.97]) and higher viral load (OR = 1.97 [95% CI 1.44–2.54]).

Conclusions
Understanding these predictors may guide programs in developing interventions to identify patients at risk of developing ADR and implementing prevention strategies.
Development and evaluation of a high-fidelity lactation simulation model for health professional breastfeeding education
Authors: Sadovnikova Anna , Chuisano Samantha A. , Ma Kaoer , Grabowski Aria , Stanley Kate P. , Mitchell Katrina B. , Eglash Anne , Plott Jeffrey S. , Zielinski Ruth E. , Anderson Olivia S. 
Published: February 2020

Abstract
Background
A key reason for premature cessation of breastfeeding is inadequate support from healthcare providers. Most physicians and nurses do not feel confident in their ability to support families with breastfeeding initiation or maintenance. Increasing health professional confidence in clinical lactation skills is key to improving maternal and child health outcomes. High-fidelity (realistic) simulators encourage learner engagement, resulting in increased clinical skills competency, confidence, and transfer to patient care. Lactation educators teach with low-fidelity cloth and single breast models. There are no high-fidelity breast simulators for health professional education in clinical lactation.

Development and evaluation of a high-fidelity lactation simulation model
In this commentary we describe the development of a high-fidelity Lactation Simulation Model (LSM) and how physician residents, nurse-midwifery students, and clinical lactation experts provided feedback on LSM prototypes.

Limitations
The user-testing described in this commentary does not represent comprehensive validation of the LSM due to small sample sizes and the significant conflict of interest.

Conclusion
For breastfeeding rates to improve, mothers need support from their nurses, midwives, pediatricians, obstetricians and gynecologists, and all healthcare staff who interact with pregnant and lactating women. Clinical education with high-fidelity breastfeeding simulators could be the ideal learning modality for trainees and hospital staff to build confidence in clinical lactation skills. The ability of a high-fidelity breastfeeding simulator to increase a learner’s lactation knowledge and psychomotor skills acquisition, retention, and transfer to patient care still needs to be tested.
Is marijuana use associated with decreased use of prescription opioids? Toxicological findings from two US national samples of drivers
Authors: Li Guohua , Chihuri Stanford 
Published: February 2020

Abstract
Background
State governments in the United States are increasingly viewing marijuana legalization as a policy option for controlling the opioid epidemic under the premise that marijuana is a less harmful substitute for opioids. The purpose of this study is to assess whether marijuana use is associated with decreased odds of prescription opioid use.

Methods
A cross-sectional study design was applied to toxicological testing data from two national samples of drivers: 1) the 2011–2016 Fatality Analysis Reporting System (FARS) and 2) the 2013–2014 National Roadside Survey of Alcohol and Drug Use by Drivers (NRS). Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) estimated from multivariable logistic regression models were used to assess the associations of marijuana use with prescription opioid use and alcohol use.

Results
Among the 47,602 drivers from the FARS, 15.7% tested positive for marijuana and 6.9% positive for prescription opioids. Compared with drivers testing negative for marijuana, those testing positive for marijuana were 28% more likely to test positive for prescription opioids (adjusted OR = 1.28, 95% CI = 1.15–1.42). Among the 7881 drivers from the NRS, 7.9% tested positive for marijuana and 4.5% positive for prescription opioids. Relative to drivers testing negative for marijuana, those testing positive for marijuana were twice as likely to test positive for prescription opioids (adjusted OR = 2.03, 95% CI = 1.29–3.20). In both study samples, marijuana use was associated with significantly increased odds of alcohol positivity.

Conclusions
Drivers who test positive for marijuana are significantly more likely to test positive for prescription opioids. Longitudinal studies with rigorous designs and toxicological testing data are needed to further address the substitution hypothesis between marijuana and prescription opioids.
The opioid mortality epidemic in North America: do we understand the supply side dynamics of this unprecedented crisis?
Authors: Fischer Benedikt , Pang Michelle , Jones Wayne 
Published: February 2020

AbstractWhile there has been extensive attention to the ‘demand side’ – or use and adverse consequences, including mortality – of the ‘opioid crisis’ presently unfolding across North America, few considerations have focused on the supply side. This paper examines the supply side dynamics of this unprecedented public health phenomenon. We provide evidence for several interrelated supply-side elements that have contributed to the present public health crisis. We observe that initially, persistently high levels of prescription opioid availability and use exposed large proportions of the North American population to opioids, resulting in correspondingly high levels of medical and non-medical use (e.g., involving diversion). While various intervention measures to control prescription opioid availability and use have been implemented in recent years, leading to eventual reductions in opioid dispensing levels, these occurred late in the crisis’s evolution. Moreover, these supply reductions have not been met by corresponding reductions in opioid use or demand levels. These growing discrepancies between opioid demand and prescription-based sources have left major gaps in opioid supplies. In response to such supply gaps, highly potent and toxic illicit opioid products have rapidly proliferated across North America, and become a core driver of the dramatic spikes in opioid overdose fatality levels in recent years. These supply-related interrelations are corroborated by a corresponding increase in illicit opioid-related fatalities, which arose just as medical opioid supplies began to decrease in many jurisdictions. Improved analyses and understanding of the supply-side dynamics of the opioid crisis are urgently needed in order to inform future intervention and policy development. Meanwhile, the high mortality toll related to illicit, highly toxic opioid exposure requires sustained solutions, including supply-oriented measures (e.g., safer opioid distribution for at–risk users) towards improved public health protection.
Acoustic diagnosis of elastic properties of human tooth by 320 MHz scanning acoustic microscopy after radiotherapy treatment for head and neck cancer
Authors: Demirkan Irem , Yaprak Gokhan , Ceylan Cemile , Algul Emriye , Tomruk Ceyda Ozcakir , Bilen Bukem , Unlu Mehmet Burcin 
Published: February 2020

Abstract
Background
On the elastic profiles of human teeth after radiotherapy for head and neck cancers, generation of dental complications, which may bring several side effects preventing the quality of life, has not well clarified. Thus, we aimed to show the applicability of using 320 MHz Scanning Acoustic Microscopy (SAM) in the evaluation of the tooth damage acoustically at the micrometer level following radiation therapy, and also in the determination of the safe dose limits to impede severe dental damage.

Methods
This prospective study was performed by SAM employed at 320 MHz by an azimuthal resolution of 4.7 μm resolving enamel and dentin. A total of 45 sound human third molar teeth collected between September 2018 and May 2019 were used for the acoustic impedance measurements pre- and post irradiation. Nine samples for each group (control, 2 Gy, 8 Gy, 20 Gy, 30 Gy and 60 Gy) were evaluated to acquire the acoustic images and perform a qualitative analysis. Scanning Electron Microscopy (SEM) images were obtained to establish a relationship between micromechanical and morphological characteristics of the teeth. Statistical analysis was conducted using the Student t-test succeded by Mann-Whitney U investigation (p < .05), while SEM images were assessed qualitatively.

Results
The analysis included 45 sound teeth collected from men and women 18 to 50 years old. Post irradiation micromechanical variations of human teeth were significant only in the radiation groups of 30 Gy and 60 Gy compared to pre-irradiation group for enamel (7.24 ± 0.18 MRayl and 6.49 ± 028 MRayl; p < 0.05, respectively). Besides, the teeth subjected to radiation doses of 20, 30 and 60 Gy represented significantly lower acoustic impedance values relative to non-irradiated group for dentin (6.52 ± 0.43 MRayl, 5.71 ± 0.66 MRayl and 4.82 ± 0.53 MRayl p < 0.05), respectively.

Conclusions
These results are evidence for a safe acoustic examination device which may be a useful tool to visualize and follow the safe dose limits to impede severe dental damage through the radiation therapy treatment for head and neck cancers.
Changing soil carbon: influencing factors, sequestration strategy and research direction
Authors: Xu Shangqi , Sheng Chunlei , Tian Chunjie 
Published: February 2020

AbstractSoil carbon (C) plays a critical role in the global C cycle and has a profound effect on climate change. To obtain an in-depth and comprehensive understanding of global soil C changes and better manage soil C, all meta-analysis results published during 2001–2019 relative to soil C were collected and synthesized. The effects of 33 influencing factors on soil C were analyzed, compared and classified into 5 grades according to their effects on soil C. The effects of different categories of influencing factors, including land use change (LUC), management and climate change, on soil C and the underlying mechanism were compared and discussed. We propose that natural ecosystems have the capacity to buffer soil C changes and that increasing C inputs is one of the best measures to sequester C. Furthermore, a comparison between the meta-analyses and previous studies related to soil C based on bibliometric analysis suggested that studies on wetland soil C, soil C budgets and the effects of pollution and pesticides on soil C should be strengthened in future research.
The effect of TLR4 on the growth and local inflammatory microenvironment of HPV-related cervical cancer in vivo
Authors: Jiang Ninghong , Xie Feng , Chen Limei , Chen Fang , Sui Long 
Published: February 2020

Abstract
Background
Cervical cancer is the most common malignancy of the female lower genital tract. In our previous study, we found that TLR4 promotes cervical cancer cell growth in vitro. The aim of this study was to further explore the role of TLR4 in HPV-related cervical cancer in vivo by using a nude mouse xenograft model.

Methods
Cervical cancer-derived HeLa and CaSki cells (5 × 107/mL) were either stimulated with an optimal concentration of LPS for the appropriate time (HeLa cells were treated with 1 μg/mL LPS for 1 h, and CaSki cells were treated with 2 μg/mL LPS for 1.5 h) or transfected with TLR4 shRNA and then injected subcutaneously into the dorsal right posterior side of nude mice. The shortest width and longest diameter of the transplanted tumors in the nude mice were measured every 3 days.TLR4, IL-6,iNOS, IL-8,COX-2, MIP-3α, TGF-β1 and VEGF expression levels in the transplanted tumor tissue were detected by immunohistochemistry.

Results
The tumor formation rate was 100% in both HeLa and CaSki nude mouse groups. The tumors grew faster, and the cachexia symptoms were more serious in the LPS groups than in the control group. In contrast, the tumors grew slower, and the cachexia symptoms were milder in the TLR4-silenced groups. TLR4, iNOS, IL-6, MIP-3α and VEGF were highly expressed in the transplanted tumor tissues from the LPS groups, and their expression levels were decreased in the TLR4-silenced groups.

Conclusion
TLR4 expression is closely associated with the tumorigenesis and growth of HPV-positive cervical cancer; TLR4 promotes HPV-positive cervical tumor growth and facilitates the formation of a local immunosuppressive microenvironment. Eventually, these conditions may lead to cervical cancer development.
Retrospective analysis of the clinical features of 172 patients with BCR-ABL1-negative chronic myeloproliferative neoplasms
Authors: Lin Xiaolan , Huang Huifang , Chen Ping 
Published: February 2020

Abstract
Background
To explore the clinical features of the patients with BCR-ABL1-negative chronic myeloproliferative neoplasms (MPNs) in our hospital and to reveal the unique features of BCR-ABL1-negative MPNs patients in our center.

Methods
Retrospective analysis of routine karyotype analysis results, driver gene mutations and other related clinical parameters of 172 patients with newly diagnosed BCR-ABL1-negative MPNs who were admitted to our hospital between October 2013 and June 2018.

Results
(1) The rate of karyotypic abnormalities were 25, 6.3 and 2.9% in primary myelofibrosis (PMF), polycythemia vera (PV) and essential thrombocythemia (ET) patients, respectively. (2) The mutation rate of JAK2-V617F was 62.5%, and that of the CALR, MPL and EZH2 genes was 4.2% in PMF. The mutation rates of JAK2-V617F and JAK2-12exon were 91.3 and 1.3% in PV, respectively. The mutation rates of JAK2-V617F and CALR were 69.1 and 11.8% in ET, respectively. (3) Patients with JAK2-V617F mutation than with the wild-type gene were more often female in PMF (P = 0.027); had higher peripheral blood white blood cell (WBC) counts (P = 0.006), platelet (PLT) count (P = 0.001) and splenomegaly (P < 0.05) in PV; and had higher WBC (P = 0.001), hemoglobin concentrations (P = 0.001), lower PLT (P = 0.037), splenomegaly and endogenous coagulopathy (P < 0.05) in ET. (4) Among the PV and ET patients, those with thrombus were older than those in the nonthrombotic group.

Conclusion
PMF patients have more chromosomal abnormalities than PV and ET patients, and the effect of driver mutations on the clinical features of patients with MPNs differs among the three subtypes.
Outpatient balloon catheter vs inpatient prostaglandin for induction of labour (OBLIGE): a randomised controlled trial
Authors: Wise Michelle R. , Marriott Joy , Battin Malcolm , Thompson John M. D. , Stitely Michael , Sadler Lynn 
Published: February 2020

Abstract
Background
Approximately one in four pregnant women undergo an induction of labour. The purpose of this study is to investigate the clinical effectiveness, safety, and cost-effectiveness for mothers and babies of two methods of cervical ripening – inpatient care for women starting induction with vaginal prostaglandin E2 hormones, or allowing women to go home for 18 to 24 h after starting induction with a single-balloon catheter.

Methods/design
This is a multi-centre randomised controlled trial in New Zealand. Eligible pregnant women, with a live singleton baby in a cephalic presentation who undergo a planned induction of labour at term, will be randomised to outpatient balloon-catheter induction or in-hospital prostaglandin induction. The primary outcome is caesarean section rate. To detect a 24% relative risk reduction in caesarean rate from a baseline of 24.8%, with 80% power and 5% type 1 error, will require 1552 participants in a one to one ratio.

Discussion
If outpatient balloon-catheter induction reduces caesarean section rates, has additional clinical benefits, and is safe, cost-effective, and acceptable to women and clinicians, we anticipate change in induction of labour practice around the world. We think that home-based balloon-catheter induction will be welcomed as part of a patient-centred labour-induction care package for pregnant women.

Trial registration
Australia New Zealand Clinical Trials Registry (ANZCTR), ACTRN: 12616000739415. Registered on 6 June 2016.
Smartphone-based secondary prevention intervention for university students with unhealthy alcohol use identified by screening: study protocol of a parallel group randomized controlled trial
Authors: Bertholet Nicolas , Schmutz Elodie , Grazioli Véronique S. , Faouzi Mohamed , McNeely Jennifer , Gmel Gerhard , Daeppen Jean-Bernard , Cunningham John A. 
Published: February 2020

Abstract
Background
Unhealthy alcohol use is a leading cause of morbidity and mortality among young people, including university students. Delivering secondary prevention interventions against unhealthy alcohol use is challenging. Information technology has the potential to reach large parts of the general population. The present study is proposed to test a proactive secondary prevention smartphone-based intervention against unhealthy alcohol use.

Methods
This is a parallel-group, randomized controlled trial (1:1 allocation ratio) among 1696 university students with unhealthy alcohol use, identified by screening and followed up at 3, 6, and 12 months. Participants will be randomized to receive access to a smartphone-based intervention or to a no intervention control condition.
The primary outcome will be self-reported volume of alcohol drunk over the past 30 days, reported as the mean number of standard drinks per week over the past 30 days, measured at 6 months. Secondary outcomes will be number of heavy drinking days over the past 30 days, at 6 months. Additional outcomes will be maximum number of drinks on any day over the past 30 days, alcohol-related consequences (measured using the Short Inventory of Problems (SIP-2R), and academic performance.

Discussion
The aim of this trial is to close the evidence gap on the efficacy of smartphone-based secondary prevention interventions. If proven effective, smartphone-based interventions have the potential to reach a large portion of the population, completing what is available on the Internet.

Trial registration
ISRCTN, 10007691. Registered on 2 December 2019. Recruitment will start in April 2020.
Expression of gynoecium patterning transcription factors in Aristolochia fimbriata (Aristolochiaceae) and their contribution to gynostemium development
Authors: Peréz-Mesa Pablo , Ortíz-Ramírez Clara Inés , González Favio , Ferrándiz Cristina , Pabón-Mora Natalia 
Published: February 2020

AbstractBackgroundInAristolochia(Aristolochiaceae) flowers, the congenital fusion of the anthers and the commissural, stigmatic lobes forms a gynostemium. Although the molecular bases associated to the apical–basal gynoecium patterning have been described in eudicots, comparative expression studies of the style and stigma regulatory genes have never been performed in early divergent angiosperms possessing a gynostemium.ResultsIn this study, we assess the expression of five genes typically involved in gynoecium development inAristolochia fimbriata. We found that all five genes (AfimCRC,AfimSPT,AfimNGA,AfimHEC1andAfimHEC3) are expressed in the ovary, the placenta, the ovules and the transmitting tract. In addition, onlyAfimHEC3,AfimNGAandAfimSPTare temporarily expressed during the initiation of the stigma, while none of the genes studied is maintained during the elaboration of the stigmatic surfaces in the gynostemium.ConclusionsExpression patterns suggest thatCRC,HEC,NGAandSPThomologs establish ovary and style identity inAristolochia fimbriata.OnlyNGA,HEC3andSPTgenes may play a role in the early differentiation of the stigmatic lobes, but none of the genes studied seems to control late stigma differentiation in the gynostemium. The data gathered so far raises the possibility that such transient expression early on provides sufficient signal for late stigma differentiation or that unidentified late identity genes are controlling stigma development in the gynostemium. Our data does not rule out the possibility that stigmas could correspond to staminal filaments with convergent pollen-receptive surfaces.
Segmentation-based image defogging using modified dark channel prior
Authors: Sabir Aneela , Khurshid Khawar , Salman Ahmad 
Published: February 2020

AbstractImage acquisition under bad weather conditions is prone to yield image with low contrast, faded color, and overall poor visibility. Different computer vision applications including surveillance, object classification, tracking, and recognition get effected due to degraded hazy images. Dehazing can significantly improve contrast, balance luminance, correct distortion, remove unwanted visual effects/ and therefore enhance the image quality. As a result, image defogging is imperative pre-processing step in computer vision applications. Previously, dark channel prior-based algorithms have proven promising results over the available techniques. In this paper, we have proposed a modified dark channel prior that uses fog density and guided image-filtering technique to estimate and refine transmission map, respectively. Guided image filter speeds up the refinement of transmission map, hence reduces the overall computational complexity of algorithm. We have also incorporated segmentation of the foggy image into sky and non-sky regions, after which, the modified dark channel prior and atmospheric light is computed for each segment. Then, the average value of atmospheric light for each segment is used to estimate transmission map. We have performed quantitative and subjective comparison for effective evaluation of our proposed algorithm against the current state-of-the-art algorithms on natural and synthetic images. Different quality metrics, such as saturation, mean square error, fog density, peak signal to noise ratio, structural similarity index metric, dehazing algorithm index (DHQI), full-reference image quality assessmen (FR-IQA), and naturalness of dehazed images have shown the proposed algorithm to be better than existing techniques.