bluuebunny/crossref_metadata_2025_split huggingface dataset:
Routine Postoperative Antibiotics After Tissue Expander Placement Postmastectomy Does Not Improve Outcome
Authors: Yamin Feras , Nouri Andrew , McAuliffe Phoebe , Vasilakis Vasileios , Ganz Jason , Khan Sami , Huston Tara , Dagum Alexander , Bui Duc 
Published: April 2021

Purpose
In an attempt to reduce the incidence of infectious complications after tissue expander–based breast reconstruction, the routine administration of postoperative antibiotics regimen is common in many practices. In recent years, there has been a plethora of reports scrutinizing the prophylactic use of postoperative antibiotics in this setting. The aim of this study was to determine the efficacy of prolonged administration of postoperative antibiotics compared with perioperative-only antibiotic administration for prophylaxis after tissue expander placement for immediate mastectomy reconstruction.

Methods and Materials
A retrospective chart review of all patients who underwent immediate tissue expander placement after mastectomy at our institution from June 2005 to September 2018 was performed. All patients in the study received perioperative intravenous antibiotics 30 to 60 min preoperatively and for 24 hours postoperatively. Patients were divided into 2 groups. Patients in group A did not receive antibiotics beyond the perioperative period. Patients in group B received oral antibiotics for at least 7 days postoperatively in addition to the perioperative intravenous antibiotics. The 2 groups were compared for demographics and prevalence of risk factors such as radiation, chemotherapy, smoking, and diabetes. The incidence of complications such as infection, wound complications, hematoma, seroma, capsular contracture, loss of tissue expander, and reoperations was assessed.

Summary of Results
A total of 529 patients were included in the study, of which 241 were in group A and 288 were in group B. The total number of breasts reconstructed in group A was 398, whereas in group B, it was 466 breasts. Patients were followed up to 5 months postoperatively in each group. There were no statistically significant differences in the demographic and patient characteristics among the 2 groups. The incidence of infection in group A was 23.24% and in group B was 21.53% (P = 0.412). The incidence of other complications follows the same trend when comparing group A versus B.

Conclusions
This retrospective study shows that the routine use of postoperative antibiotics after tissue expander placement for immediate mastectomy reconstruction does not result in reduction in the incidence of common complications or improvement of clinical outcomes.
Effects of repeated injection of 1% lidocaine vs. radial extra-corporeal shock wave therapy for treating myofascial trigger points: a randomized controlled trial
Authors: Suputtitada Areerat , Chen Carl P.C. , Ngamrungsiri Narin , Schmitz Christoph 
Published: April 2021

AbstractBackground and ObjectivesThis study tested the hypothesis that treatment of myofascial trigger points (MTrPs) in the upper trapezius muscle (UTM) with repeated injection of 1% lidocaine results in better alleviation of muscular stiffness and soreness as well as improved metabolism in the hypercontracted MTrP area than treatment with radial extracorporeal shock wave therapy (rESWT).Materials and MethodsA single-blinded, prospective, randomized controlled trial was conducted on patients suffering from MTrPs in the UTM. Thirty patients were treated with repeated injection of 2 ml of 1% lidocaine (three injections; one injection per week). Another 30 patients were treated with rESWT (three treatment sessions; one treatment session per week; 2000 radial extracorporeal shock waves per treatment session; positive energy flux density = 0.10 mJ/mm2). The primary outcome measure was pain severity using the VAS score. The secondary outcome measures included muscle elasticity index, pressure pain threshold and neck disability index. Evaluation was performed at baseline (T1), 15-30 minutes after the first treatment in order to register immediate treatment effects (T2), before the second treatment (i.e., one week after baseline) (T3) and one week after the third treatment (i.e., four weeks after baseline) (T4).ResultsThere were no statistically significant differences in the primary and secondary outcome measures between the patients in the lidocaine arm and the patients in the rESWT arm at T1 and T4. Within the arms, the mean differences of all outcomes were statistically significant (P < 0.001) when comparing the data obtained at T1 with the data obtained at T3 and the data obtained at T4.ConclusionsThe results of this pilot study suggest that the use of rESWT in patients with MTrPs in the UTM is safe and leads to reduced pain and improved muscle elasticty, pressure pain threshold and neck disability index, without adverse effects. Larger trials are necessary to verify this. Clinicians should consider rESWT instead of injections of lidocaine in the treatment of MTrPs in the UTM.
A human-interpretable machine learning approach to predict mortality in severe mental illness
Authors: Banerjee Soumya , Liò Pietro , Jones Peter B. , Cardinal Rudolf N. 
Published: April 2021

AbstractMachine learning (ML), one aspect of artificial intelligence (AI), involves computer algorithms that train themselves. They have been widely applied in the healthcare domain. However, many trained ML algorithms operate as “black boxes”, producing a prediction from input data without a clear explanation of their workings. Non-transparent predictions are of limited utility in many clinical domains, where decisions must be justifiable.Here, we apply class-contrastive counterfactual reasoning to ML to demonstrate how specific changes in inputs lead to different predictions of mortality in people with severe mental illness (SMI), a major public health challenge. We produce predictions accompanied by visual and textual explanations as to how the prediction would have differed given specific changes to the input. We apply it to routinely collected data from a mental health secondary care provider in patients with schizophrenia. Using a data structuring framework informed by clinical knowledge, we captured information on physical health, mental health, and social predisposing factors. We then trained an ML algorithm and other statistical learning techniques to predict the risk of death.The ML algorithm predicted mortality with an area under receiver operating characteristic curve (AUROC) of 0.80 (95% confidence intervals [0.78, 0.82]). We used class-contrastive analysis to produce explanations for the model predictions. We outline the scenarios in which class-contrastive analysis is likely to be successful in producing explanations for model predictions. Our aim is not to advocate for a particular model but show an application of the class-contrastive analysis technique to electronic healthcare record data for a disease of public health significance.In patients with schizophrenia, our work suggests that use or prescription of medications like antide-pressants was associated with lower risk of death. Abuse of alcohol/drugs and a diagnosis of delirium were associated with higher risk of death. Our ML models highlight the role of co-morbidities in determining mortality in patients with SMI and the need to manage them. We hope that some of these bio-social factors can be targeted therapeutically by either patient-level or service-level interventions. Our approach combines clinical knowledge, health data, and statistical learning, to make predictions interpretable to clinicians using class-contrastive reasoning. This is a step towards interpretable AI in the management of patients with SMI and potentially other diseases.
Prime hAd5 Spike + Nucleocapsid Vaccination Induces Ten-Fold Increases in Mean T-Cell Responses in Phase 1 Subjects that are Sustained Against Spike Variants
Authors: Sieling Peter , King Thomas , Wong Raymond , Nguyen Andy , Wnuk Kamil , Gabitzsch Elizabeth , Rice Adrian , Adisetiyo Helty , Hermreck Melanie , Verma Mohit , Zakin Lise , Shin Annie , Morimoto Brett , Higashide Wendy , Dinkins Kyle , Balint Joseph , Peykov Victor , Taft Justin , Patel Roosheel , Buta Sofija , Martin-Fernandez Marta , Bogunovic Dusan , Spilman Patricia , Sender Lennie , Reddy Sandeep , Robinson Philip , Rabizadeh Shahrooz , Niazi Kayvan , Soon-Shiong Patrick 
Published: April 2021

ABSTRACTIn response to the need for a safe, efficacious vaccine that elicits vigorous T cell as well as humoral protection against SARS-CoV-2 infection, we have developed a dual-antigen COVID-19 vaccine comprising both the viral spike (S) protein modified to increase cell-surface expression (S-Fusion) and nucleocapsid (N) protein with an Enhanced T-cell Stimulation Domain (N-ETSD) to enhance MHC class I and II presentation and T-cell responses. The antigens are delivered using a human adenovirus serotype 5 (hAd5) platform with E1, E2b, and E3 regions deleted that has been shown previously in cancer vaccine studies to be safe and effective in the presence of pre-existing hAd5 immunity. The findings reported here are focused on human T-cell responses due to the likelihood that such responses will sustain efficacy against emerging variants, a hypothesis supported by ourin silicoprediction of T-cell epitope HLA binding for both the first-wave SARS-CoV-2 ‘A’ strain and the B.1.351 strain K417N, E484K, and N501Y spike and T201I N variants. We demonstrate the hAd5 S-Fusion + N-ETSD vaccine antigens expressed by previously SARS-CoV-2-infected patient dendritic cells elicit Th1 dominant activation of autologous patient T cells, indicating the vaccine antigens have the potential to elicit immune responses in previously infected patients. For participants in our open-label Phase 1b study of the vaccine (NCT04591717;https://clinicaltrials.gov/ct2/show/NCT04591717), the magnitude of Th-1 dominant S- and N-specific T-cell responses after a single prime subcutaneous injection were comparable to T-cell responses from previously infected patients. Furthermore, vaccinated participant T-cell responses to S were similar for A strain S and a series of spike variant peptides, including S variants in the B.1.1.7 and B.1.351 strains. The findings that this dual-antigen vaccine elicits SARS-CoV-2-relevant T-cell responses and that such cell-mediated protection is likely to be sustained against emerging variants supports the testing of this vaccine as a universal booster that would enhance and broaden existing immune protection conferred by currently approved S-based vaccines.
Impaired Humoral and Cellular Immunity after SARS-CoV2 BNT162b2 (Tozinameran) Prime-Boost Vaccination in Kidney Transplant Recipients
Authors: Sattler Arne , Schrezenmeier Eva , Weber Ulrike , Potekhin Alexander , Bachmann Friederike , Budde Klemens , Storz Elena , Proß Vanessa , Bergmann Yasmin , Thole Linda , Tizian Caroline , Hölsken Oliver , Diefenbach Andreas , Schrezenmeier Hubert , Jahrsdörfer Bernd , Zemojtel Tomasz , Jechow Katharina , Conrad Christian , Lukassen Sören , Stauch Diana , Lachmann Nils , Choi Mira , Halleck Fabian , Kotsch Katja 
Published: April 2021

AbstractNovel mRNA-based vaccines have been proven powerful tools to combat the global pandemic caused by SARS-CoV2 with BNT162b2 efficiently protecting individuals from COVID-19 across a broad age range. Still, it remains largely unknown how renal insufficiency and immunosuppressive medication affect development of vaccine induced immunity. We therefore comprehensively analyzed humoral and cellular responses in kidney transplant recipients after prime-boost vaccination with BNT162b2. As opposed to all healthy vaccinees and the majority of hemodialysis patients, only 4/39 and 1/39 transplanted individuals showed IgA and IgG seroconversion at day 8±1 after booster immunization with minor changes until day 23±5, respectively. Although most transplanted patients mounted spike-specific T helper cell responses, frequencies were significantly reduced compared to controls and dialysis patients, accompanied by a broad impairment in effector cytokine production, memory differentiation and activation-related signatures. Spike-specific CD8+ T cell responses were less abundant than their CD4+ counterparts in healthy controls and hemodialysis patients and almost undetectable in transplant patients. Signs of alloreactivity promoted by BNT162b2 were not documented within the observation period. In summary, our data strongly suggest revised vaccination approaches in immunosuppressed patients, including individual immune monitoring for protection of this vulnerable group at risk to develop severe COVID-19.
Reduction in the 2020 Life Expectancy in Brazil after COVID-19
Authors: Castro Marcia C , Gurzenda Susie , Turra Cassio M , Kim Sun , Andrasfay Theresa , Goldman Noreen 
Published: April 2021

AbstractBrazil has the second-largest number of COVID-19 deaths worldwide. We use data on reported deaths to measure and compare the death toll across states from a demographic perspective. We estimate a decline in 2020 life expectancy at birth of 1.94 years, resulting in a mortality level not seen since 2013. The reduction in life expectancy at age 65 was 1.58 years, setting Brazil back to 2009 levels. The decline was larger for males, widening by 2.3% and 5.4% the female-male gap in life expectancy at birth and at age 65, respectively. Among states, Amazonas lost 59.6% of the improvements in life expectancy at birth since 2000. With 2021 COVID-19 deaths at about 43% of the total 2020 figures (as of mid-March) the demographic effect is likely to be even higher this year.
The Role of Community Health Workers in Oral Health Promotion and the Impact of their services in Sub-Saharan Africa: A Systematic Review
Authors: Khan Mohammed Azhar , Okeah Bernard Ojiambo , Mbivnjo Etheldreda Leinyuy , Kisangala Ephraim , Pritchard Aaron Wyn 
Published: April 2021

AbstractOral ailments are largely preventable but remain a significant public health concern afflicting nearly half the global population. These conditions account for 220 years of life lost per 100,000 people and about US$500 billion in health-related expenditures. Sub-Saharan Africa bears a significant burden of oral health problems thus exerting additional pressure on the scarce human resources for health. Community healthcare workers (CHWs) could be potentially utilised to bridge the shortage of oral health professionals in sub-Saharan Africa, hence, this systematic review that seeks to explore their current roles in oral health and potential impact on general physical health. This review follows the PRISMA guidelines and databases searched include PubMed, Web of Science, Medline, and CINAHL published between January 2010 and December 2019. Nine studies met the study eligibility criteria. This review established that CHWs perform variable roles cutting across primary, secondary, and tertiary prevention including providing oral hygiene education, recognising common pathologies, and treating oral lesions, administration of tooth extractions, dental pain management, and referral for advanced care. Although this could potentially improve oral health, our review did not establish the extent of the specific impact on general physical health of patients and the burden of oral condition.
An extended SEIARD model for COVID-19 vaccination in Mexico: analysis and forecast
Authors: Pérez Ángel G. C. , Oluyori David A. 
Published: April 2021

AbstractIn this study, we propose and analyse an extended SEIARD model with vaccination. We compute the control reproduction number ℛcof our model and study the stability of equilibria. We show that the set of disease-free equilibria is locally asymptotically stable when ℛc< 1 and unstable when ℛc> 1, and we provide a sufficient condition for its global stability. Furthermore, we perform numerical simulations using the reported data of COVID-19 infections and vaccination in Mexico to study the impact of different vaccination, transmission and efficacy rates on the dynamics of the disease.
Propelling and perturbing appendages together facilitate strenuous ground self-righting
Authors: Othayoth Ratan , Li Chen 
Published: April 2021

AbstractTerrestrial animals must self-right when overturned on the ground, but this locomotor task is strenuous. To do so, the discoid cockroach often pushes its wings against the ground to begin a somersault which rarely succeeds. As it repeatedly attempts this, the animal probabilistically rolls to the side to self- right. During winged self-righting, the animal flails its legs vigorously. Here, we studied whether wing opening and leg flailing together facilitate strenuous ground self-righting. Adding mass to increase hind leg flailing kinetic energy increased the animal’s self-righting probability. We then developed a robot with similar strenuous self-righting behavior and used it as a physical model for systematic experiments. The robot’s self-righting probability increased with wing opening and leg flailing amplitudes. A potential energy landscape model revealed that, although wing opening did not generate sufficient kinetic energy to overcome the high pitch potential energy barrier to somersault, it reduced the barrier for rolling, facilitating the small kinetic energy from leg flailing to probabilistically overcome it to self-right. The model also revealed that the stereotyped body motion during self-righting emerged from physical interaction of the body and appendages with the ground. Our work demonstrated the usefulness of potential energy landscape for modeling self-righting transitions.Impact statementAnimals can, and robots should, use different types of appendages together to propel and perturb themselves to self-right when overturned, a strenuous yet crucial locomotor task.
Sensory readout accounts for adaptation
Authors: Sheehan Timothy C. , Serences John T. 
Published: April 2021

AbstractSensory responses and behavior are strongly shaped by stimulus history. For instance, perceptual reports are sometimes biased towards previously viewed stimuli (serial dependence). While behavioral studies have pointed to both perceptual and post-perceptual origins of this phenomenon, neural data that could elucidate where these biases emerge is limited. We recorded fMRI responses while human participants (male and female) performed a delayed orientation discrimination task. While behavioral reports wereattractedto the previous stimulus, response patterns in visual cortex wererepelled. We reconciled these opposing neural and behavioral biases using a model where both sensory encoding and readout are shaped by stimulus history. First, neural adaptation reduces redundancy at encoding and leads to the repulsive biases that we observed in visual cortex. Second, our modeling work suggest that serial dependence is induced by readout mechanisms that account for adaptation in visual cortex. According to this account, the visual system can simultaneously improve efficiency via adaptation while still optimizing behavior based on the temporal structure of natural stimuli.
Transcriptome profiling and comparison ofRhinanthus majorandRhinanthus minorreciprocal F1hybrids during seed stratification and germination
Authors: Mirzaei Khaled , Wesselingh Renate A. 
Published: April 2021

AbstractBackground and AimsGermination is a vital stage in a plant’s life cycle, and a different germination behavior of offspring in comparison to their parents can have fitness consequences. In studies on hybridization betweenRhinanthus minorandR. major, low germination rates of F1hybrids withR. majoras the maternal parent have often been reported. In contrast, the F1mhybrid, withR. minoras the maternal parent, germinates readily and rapidly.MethodsIn order to find the cause of this difference, we used RNA-Seq to obtain transcriptome profiles of F1aand F1mseeds during stratification at 4°C and just after germination, after 40 days of stratification for the F1mseeds and 60 days for the F1aseeds.Key ResultsA comparison of the transcriptome of F1aseeds that had just germinated (60 days) with non-germinated F1aseeds after 40 and 60 days revealed 2918 and 1349 differentially expressed (DE) genes, respectively. For F1mseeds, 958 genes showed differential expression in germinated and non-germinated seeds after 40 days. The DE genes of F1aand F1mhybrids clustered into two separate groups, even though they had the same parents, and no differentially expression was found for plastid genes. Non-germinated F1aseeds had an abundance of enzymes and proteins associated with peroxidase activity, peroxiredoxin activity and nutrient reservoir activity. Expression of genes related to seed germination and seed development increased in non-germinated F1ahybrid seeds between 40 and 60 days of cold stratification. F1aseeds that had germinated showed an upregulation of genes related to the gibberellic acid-mediated signaling pathway and response to gibberellin, along with a low expression of DELLA superfamily.ConclusionsAlthough the results demonstrated strong differences in gene expression during stratification between the reciprocal hybrids, we could not identify its cause, since no plastid genes were differentially expressed. It is possible that differences in embryo development after seed formation and before stratification play a role, including epigenetic imprinting.
Ligand Strain Energy in Large Library Docking
Authors: Gu Shuo , Smith Matthew S. , Yang Ying , Irwin John J. , Shoichet Brian K. 
Published: April 2021

ABSTRACTWhile small molecule internal strain is crucial to molecular docking, using it in evaluating ligand scores has remained elusive. Here, we investigate a technique that calculates strain using relative torsional populations in the Cambridge Structural Database, enabling fast pre-calculation of these energies. In retrospective studies of large docking screens of the dopamine D4 receptor and of AmpC β-lactamase, where close to 600 docking hits were tested experimentally, including such strain energies improved hit rates by preferentially reducing high-scoring decoy molecules that were strained. In a 40 target subset of the DUD-E benchmark, we found two thresholds that usefully distinguished between ligands and decoys: one based on the total strain energy of the small molecules, and one based on the maximum strain allowed for any given torsion within them. Using these criteria, about 75% of the benchmark targets had improved enrichment after strain filtering. Relying on pre-calculated population distributions, this approach is rapid, taking less than 0.04 second to evaluate a conformation on a standard core, making it pragmatic for pre-calculating strain in even ultra-large libraries. Since it is scoring function agnostic, it may be useful to multiple docking approaches; it is openly available athttp://tldr.docking.org