bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, clearance, persistence and factors related with high-risk anal HPV persistence in South-East Asian MSM and transgender women
Authors: Yunihastuti Evy , Teeratakulpisarn Nipat , Jeo Wifanto Saditya , Nilasari Hanny , Rachmadi Lisnawati , Somia I Ketut Agus , Sukmawati Made Dewi Dian , Amijaya Komang Agus Trisna , Yee Ilias A. , Hairunisa Nany , Hongchookiat Piranun , Trachunthong Deondara , Pankam Tippawan , Nonenoy Siriporn , Ramautarsing Reshmie , Azwa Iskandar , Merati Tuti P. , Phanuphak Praphan , Phanuphak Nittaya , Palefsky Joel M. 
Published: August 2020

Objectives:
Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence.

Design:
Prospective cohort study.

Methods:
MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence.

Results:
Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1–0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47–5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22–11.19) and Bali (aOR 3.39; 95% CI 1.07–10.75), being employed/freelance (aOR 3.99; 95% CI 1.48–10.77), and not being circumcised (aOR 2.29; 95% CI 1.07–4.88) were independently associated with anal HR-HPV persistence.

Conclusion:
HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.
Tailoring Contrast Media Protocols to Varying Tube Voltages in Vascular and Parenchymal CT Imaging
Authors: Martens Bibi , Hendriks Babs M.F. , Mihl Casper , Wildberger Joachim E. 
Published: August 2020

Abstract
The latest technical developments in CT have created the possibility for individualized scan protocols at variable kV settings. Lowering tube voltages closer to the K-edge of iodine increases attenuation. However, the latter is also influenced by patient characteristics such as total body weight. To maintain a robust contrast enhancement throughout the patient population in both vascular and parenchymal CT scans, one must adapt the contrast media administration protocols to both the selected kV setting and patient body habitus. This article proposes a simple rule of thumb for how to adapt the contrast media protocol to any kV setting: the 10-to-10 rule.
Remote Ischemic Conditioning Reduced Acute Lung Injury After Traumatic Brain Injury in the Mouse
Authors: Saber Maha , Rice Amanda D. , Christie Immaculate , Roberts Rebecca G. , Knox Kenneth S. , Nakaji Peter , Rowe Rachel K. , Wang Ting , Lifshitz Jonathan 
Published: August 2020

ABSTRACT
Traumatic brain injury (TBI) can induce acute lung injury (ALI). The exact pathomechanism of TBI-induced ALI is poorly understood, limiting treatment options. Remote ischemic conditioning (RIC) can mitigate detrimental outcomes following transplants, cardiac arrests, and neurological injuries. In this study, we hypothesized that RIC would reduce TBI-induced ALI by regulating the sphingosine-1-phosphate (S1P)-dependent pathway, a central regulator of endothelial barrier integrity, lymphocyte, and myokine trafficking. Male mice were subjected to either diffuse TBI by midline fluid percussion or control sham injury and randomly assigned among four groups: sham, TBI, sham RIC, or TBI RIC; RIC was performed 1 h prior to TBI. Mice were euthanized at 1-h postinjury or 7 days post-injury (DPI) and lung tissue, bronchoalveolar lavage (BAL) fluid, and blood were collected. Lung tissue was analyzed for histopathology, irisin myokine levels, and S1P receptor levels. BAL fluid and blood were analyzed for cellularity and myokine/S1P levels, respectively. One-hour postinjury, TBI damaged lung alveoli and increased neutrophil infiltration; RIC preserved alveoli. BAL from TBI mice had more neutrophils and higher neutrophil/monocyte ratios compared with sham, where TBI RIC mice showed no injury-induced change. Further, S1P receptor 3 and irisin-associated protein levels were significantly increased in the lungs of TBI mice compared with sham, which was prevented by RIC. However, there was no RIC-associated change in plasma irisin or S1P. At 7 DPI, ALI in TBI mice was largely resolved, with evidence for residual lung pathology. Thus, RIC may be a viable intervention for TBI-induced ALI to preserve lung function and facilitate clinical management.
Aluminum Adjuvant Improves Survival Via NLRP3 Inflammasome and Myeloid Non-Granulocytic Cells in a Murine Model of Neonatal Sepsis
Authors: Rincon Jaimar C. , Hawkins Russell B. , Hollen Mckenzie , Nacionales Dina C. , Ungaro Ricardo , Efron Philip A. , Moldawer Lyle L. , Larson Shawn D. 
Published: August 2020

ABSTRACT
Neonatal sepsis leads to significant morbidity and mortality with the highest risk of death occurring in preterm (<37 weeks) and low birth weight (<2,500 g) infants. The neonatal immune system is developmentally immature with well-described defects in innate and adaptive immune responses. Immune adjuvants used to enhance the vaccine response have emerged as potential therapeutic options, stimulating non-specific immunity and preventing sepsis mortality. Aluminum salts (“alum”) have been used as immune adjuvants for over a century, but their mechanism of action remains poorly understood. This study aims to identify potential mechanisms by which pretreatment with alum induces host protective immunity to polymicrobial sepsis in neonatal mice. Utilizing genetic and cell-depletion studies, we demonstrate here that the prophylactic administration of aluminum adjuvants in neonatal mice improves sepsis survival via activation of the nucleotide oligomerization domain-like receptor family, pyrin-domain-containing 3 inflammasome and dendritic cell activation. Furthermore, this beneficial effect is dependent on myeloid, non-granulocytic Gr1-positive cells, and MyD88-signaling pathway activation. These findings suggest a promising therapeutic role for aluminum-based vaccine adjuvants to prevent development of neonatal sepsis and improve mortality in this highly vulnerable population.
The Risk of Incarceration During Nonoperative Management of Incisional Hernias
Authors: Dadashzadeh Esmaeel R. , Huckaby Lauren V. , Handzel Robert , Hossain M. Shanaz , Sanin Gloria D. , Anto Vincent P. , Bou-Samra Patrick , Moses J. B. , Cai Stephen , Phelos Heather M. , Simmons Richard L. , Rosengart Matthew R. , van der Windt Dirk J. 
Published: August 2020

Objective:
The aim of the study was to quantify the risk of incarceration of incisional hernias.

Background:
Operative repair is the definitive treatment for incisional ventral hernias but is often deferred if the perceived risk of elective operation is elevated secondary to comorbid conditions. The risk of incarceration during nonoperative management (NOM) factors into shared decision making by patient and surgeon; however, the incidence of acute incarceration remains largely unknown.

Methods:
A retrospective analysis of adult patients with an International Classification of Diseases, Ninth Revision or Tenth Revision diagnosis of incisional hernia was conducted from 2010 to 2017 in 15 hospitals of a single healthcare system. The primary outcome was incarceration necessitating emergent operation. The secondary outcome was 30-, 90-, and 365-day mortality. Univariate and multivariate analyses were used to determine independent predictors of incarceration.

Results:
Among 30,998 patients with an incisional hernia (mean age 58.1 ± 15.9 years; 52.7% female), 23,022 (78.1%) underwent NOM of whom 540 (2.3%) experienced incarceration, yielding a 1- and 5-year cumulative incidence of 1.24% and 2.59%, respectively. Independent variables associated with incarceration included: age older than 40 years, female sex, current smoker, body mass index 30 or greater, and a hernia-related inpatient admission. All-cause mortality rates at 30, 90, and 365 days were significantly higher in the incarceration group at 7.2%, 10%, and 14% versus 1.1%, 2.3%, and 5.3% in patients undergoing successful NOM, respectively.

Conclusions:
Incarceration is an uncommon complication of NOM but is associated with a significant risk of death. Tailored decision making for elective repair and considering the aforementioned risk factors for incarceration provides an initial step toward mitigating the excess morbidity and mortality of an incarceration event.
Detection, Treatment, and Survival of Pancreatic Cancer Recurrence in the Netherlands
Authors: Daamen Lois A. , Groot Vincent P. , Besselink Marc G. , Bosscha Koop , Busch Olivier R. , Cirkel Geert A. , van Dam Ronald M. , Festen Sebastiaan , Groot Koerkamp Bas , Haj Mohammad Nadia , van der Harst Erwin , de Hingh Ignace H. J. T. , Intven Martijn P. W. , Kazemier Geert , Los Maartje , Meijer Gert J. , de Meijer Vincent E. , Nieuwenhuijs Vincent B. , Pranger Bobby K. , Raicu Mihaela G. , Schreinemakers Jennifer M. J. , Stommel Martijn W. J. , Verdonk Robert C. , Verkooijen Helena M. , Molenaar Izaak Quintus , van Santvoort Hjalmar C. ,   for the Dutch Pancreatic Cancer Group
Published: August 2020

Objective:
To evaluate whether detection of recurrent pancreatic ductal adenocarcinoma (PDAC) in an early, asymptomatic stage increases the number of patients receiving additional treatment, subsequently improving survival.

Summary of Background data:
International guidelines disagree on the value of standardized postoperative surveillance for early detection and treatment of PDAC recurrence.

Methods:
A nationwide, observational cohort study was performed including all patients who underwent PDAC resection (2014–2016). Prospective baseline and perioperative data were retrieved from the Dutch Pancreatic Cancer Audit. Data on follow-up, treatment, and survival were collected retrospectively. Overall survival (OS) was evaluated using multivariable Cox regression analysis, before and after propensity-score matching, stratified for patients with symptomatic and asymptomatic recurrence.

Results:
Eight hundred thirty-six patients with a median follow-up of 37 months (interquartile range 30-48) were analyzed. Of those, 670 patients (80%) developed PDAC recurrence after a median follow-up of 10 months (interquartile range 5–17). Additional treatment was performed in 159/511 patients (31%) with symptomatic recurrence versus 77/159 (48%) asymptomatic patients (P < 0.001). After propensity-score matching on lymph node ratio, adjuvant therapy, disease-free survival, and recurrence site, additional treatment was independently associated with improved OS for both symptomatic patients [hazard ratio 0.53 (95% confidence interval 0.42–0.67); P < 0.001] and asymptomatic patients [hazard ratio 0.45 (95% confidence interval 0.29–0.70); P < 0.001].

Conclusions:
Additional treatment of PDAC recurrence was independently associated with improved OS, with asymptomatic patients having a higher probability to receive recurrence treatment. Therefore, standardized postoperative surveillance aiming to detect PDAC recurrence before the onset of symptoms has the potential to improve survival. This provides a rationale for prospective studies on standardized surveillance after PDAC resection.
Enhanced Stress Resilience Training in Surgeons
Authors: Lebares Carter C. , Coaston Troy N. , Delucchi Kevin L. , Guvva Ekaterina V. , Shen Wen T. , Staffaroni Adam M. , Kramer Joel H. , Epel Elissa S. , Hecht Frederick M. , Ascher Nancy L. , Harris Hobart W. , Cole Steven W. 
Published: August 2020

Objective:
To determine the effects of ESRT (an iteratively adapted and tailored MBI) on perceived stress, executive cognitive function, psychosocial well-being (ie, burnout, mindfulness), and pro-inflammatory gene expression in surgical (ESRT-1) and mixed specialty (ESRT-2) PGY-1 volunteers.

Summary of Background and Data:
Tailored MBIs have proven beneficial in multiple high-stress and high-performance populations. In surgeons, tailored MBIs have been shown to be feasible and potentially beneficial, but whether mindfulness-based cognitive training can improve perceived stress, executive function, well-being or physiological distress in surgical and nonsurgical trainees is unknown.

Methods:
In 2 small single-institution randomized clinical trials, ESRT, a tailored mindfulness-based cognitive training program, was administered and iteratively adapted for first-year surgical (ESRT-1, 8 weekly, 2-hour classes, n = 44) and mixed specialty (ESRT-2, 6 weekly, 90-minute classes, n = 45) resident trainees. Primary and secondary outcomes were, respectively, perceived stress and executive function. Other prespecified outcomes were burnout (assessed via Maslach Burnout Inventory), mindfulness (assessed via Cognitive Affective Mindfulness Scale - Revised), and pro-inflammatory gene expression (assessed through the leukocyte transcriptome profile “conserved transcriptional response to adversity”).

Results:
Neither version of ESRT appeared to affect perceived stress. Higher executive function and mindfulness scores were seen in ESRT-1, and lower emotional exhaustion and depersonalization scores in ESRT-2, at pre-/postintervention and/or 50-week follow-up (ESRT-1) or at 32-week follow-up (ESRT-2), compared to controls. Pooled analysis of both trials found ESRT-treated participants had reduced pro-inflammatory RNA expression compared to controls.

Conclusions:
This pilot work suggests ESRT can variably benefit executive function, burnout, and physiologic distress in PGY-1 trainees, with potential for tailoring to optimize effects.
Changes in error patterns in unanticipated trauma deaths during 20 years: In pursuit of zero preventable deaths
Authors: LaGrone Lacey N. , McIntyre Lisa , Riggle Andrew , Robinson Bryce R.H. , Maier Ronald V. , Bulger Eileen , Cuschieri Joseph 
Published: August 2020

BACKGROUND
A fundamental goal of continuous process improvement programs is to evaluate and improve the ratio of actual to expected mortality. To study this, we examined contributors to error-associated deaths during two consecutive periods from 1996 to 2004 (period 1) and 2005 to 2014 (period 2).

METHODS
All deaths at a level I trauma center with an anticipated probability of death less than 50% and/or identified through process improvement committees were examined. Demographics were assessed for trend only because period 1 data were only available in median and interquartile range. Each death was critically appraised to identify potential error, with subsequent classification of error type, phase, cause, and contributing cognitive processes, with comparison of outcomes made using χ2 test of independence.

RESULTS
During period 1, there were a total of 44,401 admissions with 2,594 deaths and 64 deaths (2.5%) associated with an error, compared with 60,881 admissions during period 2 with 2,659 deaths and 77 (2.9%) associated with an error. Deaths associated with an error occurred in younger and less severely injured patients in period 1 and were likely to occur during the early phase of care, primarily from failed resuscitation and hemorrhage control. In period 2, deaths occurred in older more severely injured patients and were likely to occur in the later phase of care primarily because of respiratory failure from aspiration.

CONCLUSION
Despite injured patients being older and more severely injured, error-associated deaths during the early phase of care that was associated with hemorrhage improved over time. Successful implementation of system improvements resolved issues in the early phase of care but shifted deaths to later events during the recovery phase including respiratory failure from aspiration. This study demonstrates that ongoing evaluation is essential for continuous process improvement and realignment of efforts, even in a mature trauma system.

LEVEL OF EVIDENCE
Therapeutic/Care Management, level IV.
In situarchitecture of neuronal α-Synuclein inclusions
Authors: Trinkaus Victoria A. , Riera-Tur Irene , Martínez-Sánchez Antonio , Bäuerlein Felix J.B. , Guo Qiang , Arzberger Thomas , Baumeister Wolfgang , Dudanova Irina , Hipp Mark S. , Hartl F. Ulrich , Fernández-Busnadiego Rubén 
Published: August 2020

Summaryα-Synuclein (α-Syn) aggregation is a hallmark of devastating neurodegenerative disorders including Parkinson’s disease (PD) and multiple systems atrophy (MSA)1,2. α-Syn aggregates spread throughout the brain during disease progression2, suggesting mechanisms of intercellular seeding. Formation of α-Syn amyloid fibrils is observedin vitro3,4and fibrillar α-Syn has been purified from patient brains5,6, but recent reports questioned whether disease-relevant α-Syn aggregates are fibrillar in structure7-9. Here we use cryo-electron tomography (cryo-ET) to image neuronal Lewy body-like α-Syn inclusionsin situat molecular resolution. We show that the inclusions consist of α-Syn fibrils crisscrossing a variety of cellular organelles such as the endoplasmic reticulum (ER), mitochondria and autophagic structures, without interacting with membranes directly. Neuronal inclusions seeded by recombinant or MSA patient-derived α-Syn aggregates have overall similar architecture, although MSA-seeded fibrils show higher structural flexibility. Using gold-labeled seeds we find that aggregate nucleation is predominantly mediated by α-Syn oligomers, with fibrils growing unidirectionally from the seed. Our results conclusively demonstrate that neuronal α-Syn inclusions contain α-Syn fibrils intermixed with cellular membranes, and illuminate the mechanism of aggregate nucleation.
An Epitope-based Malaria Vaccine Targeting the Junctional Domain of Circumsporozoite Protein
Authors: Jelínková Lucie , Jhun Hugo , Eaton Allison , Petrovsky Nikolai , Zavala Fidel , Chackerian Bryce 
Published: August 2020

AbstractA malaria vaccine that elicits long-lasting protection and is suitable for use in endemic areas remains urgently needed. Here, we assessed the immunogenicity and prophylactic efficacy of a vaccine targeting a recently described epitope on the major surface antigen onPlasmodium falciparumsporozoites, circumsporozoite protein (CSP). Using a virus-like particle (VLP)-based vaccine platform technology, we developed a vaccine that targets the junctional region between the N-terminal and central repeat domains of CSP. This region is recognized by monoclonal antibodies, including mAb CIS43, that have been shown to potently prevent liver invasion in animal models. We show that CIS43 VLPs elicit high titer and long-lived anti-CSP antibody responses in mice and non-human primates. Immunization with CIS43 VLPs confers partial protection from malaria infection in a mouse model, and both immunogenicity and protection were enhanced when mice were immunized with CIS43 VLPs in combination with adjuvants including delta inulin polysaccharide particles and TLR9 agonists. Passive transfer of serum from immunized macaques also inhibited parasite liver invasion in the mouse infection model. Our findings demonstrate that a Qß VLP-based vaccine targeting the CIS43 epitope combined with various adjuvants is highly immunogenic in mice and macaques, elicits long-lasting anti-CSP antibodies, and inhibits parasite infection in a mouse model. Thus, the CIS43 VLP vaccine is a promising pre-erythrocytic malaria vaccine candidate.
Rhizobium leguminosarumsymbiovarviciaestrains are natural wheat endophytes and can stimulate root development and colonization by arbuscular mycorrhizal fungi
Authors: Bartoli Claudia , Boivin Stéphane , Marchetti Marta , Gris Carine , Gasciolli Virginie , Gaston Mégane , Auriac Marie-Christine , Cottret Ludovic , Carlier Aurélien , Masson-Boivin Catherine , Lepetit Marc , Lefebvre Benoit 
Published: August 2020

SummaryAlthough rhizobia establishing a nitrogen-fixing symbiosis with legumes are also known to promote growth in non-legumes, studies on rhizobia association with wheat roots are scarce.We searched forRhizobium leguminosarumsymbiovarviciae(Rlv) strains naturally competent for wheat roots colonization. We isolated 20 strains and tested the ability of a subset for wheat roots colonization when co-inoculated with otherRlv. We also measured the effect of these strains on wheat root architecture and Arbuscular Mycorrhizal Fungal (AMF) colonization.We found a low diversity ofRlvin wheat roots compared to that observed in theRlvspecies complex. Only a few strains, including those isolated from wheat roots, and one strain isolated from pea nodules, were efficient to colonize wheat roots in co-inoculation conditions. These strains had a high ability for endophytic colonization of wheat root and were able to stimulate root development and AMF colonization in single strain inoculation conditions.These results suggest that wheat is an alternative host for someRlv; nevertheless, there is a strong competition betweenRlvstrains for wheat root colonization. Furthermore, our study suggests that the level of endophytic colonization is critical forRlvability to promote wheat growth.
Robust Estimation of Noise for Electromagnetic Brain Imaging with the Champagne Algorithm
Authors: Cai Chang , Diwakar Mithun , Hashemi Ali , Haufe Stefan , Sekihara Kensuke , Nagarajan Srikantan S 
Published: August 2020

AbstractRobust estimation of the number, location, and activity of multiple correlated brain sources has long been a challenging task in electromagnetic brain imaging from M/EEG data, one that is significantly impacted by interference from spontaneous brain activity, sensor noise, and other sources of artifacts. Recently, we introduced the Champagne algorithm, a novel Bayesian inference algorithm that has shown tremendous success in M/EEG source reconstruction. Inherent to Champagne and most other related Bayesian reconstruction algorithms is the assumption that the noise covariance in sensor data can be estimated from “baseline” or “control” measurements. However, in many scenarios, such baseline data is not available, or is unreliable, and it is unclear how best to estimate the noise covariance. In this technical note, we propose several robust methods to estimate the contributions to sensors from noise arising from outside the brain without the need for additional baseline measurements. The incorporation of these methods for noise covariance estimation improves the robust reconstruction of complex brain source activity under high levels of noise and interference, while maintaining the performance features of Champagne. Specifically, we show that the resulting algorithm, Champagne with noise learning, is quite robust to initialization and is computationally efficient. In simulations, performance of the proposed noise learning algorithm is consistently superior to Champagne without noise learning. We also demonstrate that, even without the use of any baseline data, Champagne with noise learning is able to reconstruct complex brain activity with just a few trials or even a single trial, demonstrating significant improvements in source reconstruction for electromagnetic brain imaging.