bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurse Faculty Shortage
Authors: Jarosinski Judith M. , Seldomridge Lisa , Reid Tina P. , Willey Jeffrey 
Published: December 2021

Background:
The nurse faculty shortage has impacted current and future nursing workforce needs and health outcomes. What has not been expansively reported is the perspective of nursing program administrators as they grapple with the nurse faculty shortage and its effect in their schools.

Purpose:
The purpose was to explore nursing program administrators' perspectives of the nurse faculty shortage.

Method:
Administrators from 8 community colleges and 8 universities representing undergraduate and graduate nursing programs in the mid-Atlantic region participated in semistructured interviews pre-coronavirus disease (SARS COVID-19). Researchers used a 7-stage Heideggerian hermeneutic analysis.

Findings:
Twenty-four interviews elicited 4 themes: onboarding and integration; “elephant in the room”; making do: getting by; and changing expectations.

Conclusions:
Administrators faced increasing faculty workloads, academic/practice pay disparities, and staffing challenges—a stark contrast to their goal of teaching excellence, quality student outcomes, and faculty satisfaction. An unexpected finding was a deterioration in workplace climate and its untoward effects on meeting workforce needs.
Validation of a New Software Application for Tear Breakup Measurement
Authors: Pena-Verdeal Hugo , Ramos Lucía , Garcia-Queiruga Jacobo , García-Resúa Carlos , Giráldez María J. , Yebra-Pimentel Eva 
Published: December 2021

SIGNIFICANCE
Tear film instability has been recognized as one key mechanism on dry eye disease. There is a need for new instruments, methods, or protocols to improve the repeatability and reproducibility of the tear film stability to facilitate its clinical evaluation use as a rapid and reliable primary diagnostic test.

PURPOSE
The present pilot study aimed to validate a method to automatically measure the tear film breakup time (BUT).

METHODS
A total of 264 videos of BUT were randomly selected among the clinical history of subjects attending the optometry clinic. Videos were stored in a backup server through a secure file transfer protocol and analyzed by three different examiners: two masked observers (subjective evaluation) and a third investigator using the automatic software application (objective evaluation). Subjective evaluation was conducted only once on an online software designed for this protocol where videos were presented in random masked order. Automatic evaluation based on color and texture analysis was performed by (1) automatic localization of sequences of interest in the video, (2) extraction of the region of interest within each frame, and (3) automatic BUT measurement from evolution curves in the region of interest as time elapsed from the beginning of the sequence of interest until the curve exceeds a threshold.

RESULTS
Substantial correlation was observed among the examiners (intraclass correlation coefficient, 0.752). There was a statistical difference between observer 1 and 2 evaluations (t test, P < .001), whereas data provided by the software showed no significant differences from those of the observers (t test, P ≥ .26). Similar results to the whole data set analysis were obtained when the sample was reassessed only considering mean BUT values ≤15 seconds.

CONCLUSIONS
The present pilot study showed acceptable clinical results for the software application designed to objectively measure the BUT.
Inflammation-mediated vitamin K and vitamin D effects on vascular calcifications in people with HIV on active antiretroviral therapy
Authors: Janus Scott E. , Durieux Jared C. , Hajjari Jamal , Carneiro Herman , McComsey Grace A. 
Published: December 2021

Background:
People with HIV (PWH) experience increased systemic inflammation and monocyte activation, leading to increased risk of cardiovascular events (death, stroke, and myocardial infarction) and higher coronary artery calcium scores (CACs). Vitamins D and K2 have significant anti-inflammatory effects; in addition, vitamin K2 is involved in preventing vascular calcifications in the general population. The roles of vitamins D and K in increased coronary calcifications in successfully treated PWH is less understood.

Methods:
We prospectively recruited 237 PWH on antiretroviral treatment (ART) and 67 healthy controls. CACs were derived from noncontrast chest computed tomography (CT) and levels of 25-hydroxyvitamin D (vitamin D) and inactive vitamin K-dependent dephosphorylated-uncarboxylated matrix Gla protein (dp-uc MGP, marker of vitamin K deficiency) were measured in plasma during a fasting state. The relationship between inflammation markers, dp-uc MGP, and vitamin D on CACs were estimated using zero-inflated negative binomial regression. Adjusted models included 25(OH)D, MGP, sex, race, age, and markers of inflammation or monocyte activation.

Results:
Overall, controls had lower median age (45.8 vs. 48.8; P = 0.03), a larger proportion of female individuals (55.2 vs. 23.6%; P < 0.0001), and nonwhite (33.8 vs. 70%; P < 0.0001). Among PWH, less than 1% had detectable viral load and the median CD4+ cell count was 682 (IQR: 473.00–899.00). 62.17% of the participants had zero CACs and 51.32% were vitamin D-deficient (<20 ng/ml). There was no difference in detectable CACs (P = 0.19) or dp-uc MGP (P = 0.42) between PWH and controls. In adjusted models, PWH with nonzero CACs have three times greater expected CAC burden compared with controls. Every 1% increase in MGP (worse K status) decreases the probability of having CACs equal to zero by 21.33% (P = 0.01). Evidence suggests that the effects of 25(OH)D and MGP are inflammation-mediated, specifically through sVCAM, TNF-αRI, and TNF-αRII.

Conclusion:
Vitamin K deficiency is a modifiable preventive factor against coronary calcification in PWH. Further research should determine whether vitamin K supplementation would reduce systemic inflammation, vascular calcification, and risk of cardiovascular events in PWH.
Effects of Sex, Existing Antibodies, and HIV-1–Related and Other Baseline Factors on Antibody Responses to Quadrivalent HPV Vaccine in Persons With HIV
Authors: Kang Minhee , Umbleja Triin , Ellsworth Grant , Aberg Judith , Wilkin Timothy 
Published: December 2021

Background:
We compared antibody (Ab) responses to a quadrivalent (types 6, 11, 16, and 18) human papillomavirus (HPV) vaccine between men and women with HIV-1.

Methods:
A retrospective analysis of participant-level data from published clinical trials of HPV vaccine administered at study entry and at weeks 8 and 24 was conducted separately for baseline Ab undetectable and baseline Ab detectable using Ab titers and titer changes from baseline, respectively, at week 28 and year 1.5. Generalized estimating equations accounted for multiple HPV types and were adjusted for multiple baseline factors, including existing HPV antibodies before vaccination from natural exposure.

Results:
We evaluated 575 participants with CD4+ count >200 cells/mm3, 323 men and 252 women: median ages 46 and 38 years, respectively. Week 28 and year 1.5 Ab titers were similar between men and women regardless of the baseline Ab detection in multivariate models. HIV-1 RNA ≥400 copies/mm3 was associated with a lower week 28 Ab response; in baseline Ab detectable, the baseline HPV Ab titer level, HPV DNA detection, and lower CD4+/CD8+ ratio were also associated with a lower response. CD4+/CD8+ ratio was a stronger predictor in the year 1.5 Ab analysis than in the week 28 analysis. Ab responses among baseline Ab detectable were only somewhat higher than those among baseline Ab undetectable (eg, type 16 week 28 median 3.46 vs 3.20 log10 mMU/mL) despite the existing baseline titer (median 1.74).

Conclusions:
We did not find any sex differences of serologic response to HPV vaccine. Ab titer gain was lower in those with preexisting antibodies due to previous natural infection.
Rehabilitation of Atrophic Maxilla With Immediate Loading of Extrasinus Zygomatic Implant
Authors: de Carvalho Laura Firmo , de Carvalho Liliane Pacheco , Sotto-Maior Bruno Salles , Dias André Luiz , Bezerra Fabio José Barbosa , Bergamo Edmara T.P. , de Carvalho Alexandre Marcelo 
Published: December 2021

Abstract:
The aim of this case series was to evaluate the long-term success rate of immediate occlusal loading of extrasinus zygomatic dental implants after a 3-year follow-up. The sample consisted of 31 patients (mean age of 64 years) with atrophic maxillae rehabilitated with 1 to 4 extrasinus zygomatic implants, placed unilaterally or bilaterally. All the patients received complete implant-supported dental prostheses with immediate loading by associating zygomatic implants with conventional implants. None of the procedures were associated with bone grafts. During the 3-year period of follow-up in the present study, all the patients attended clinical sessions and underwent radiographic exams every 6 months. In total 55 zygomatic and 69 conventional implants were placed, where 1 zygomatic and 2 conventional implants were lost, representing success rates of 98.18% and 97.20%, respectively. None of the studied patients had signs of sinusitis or changes in the maxillary sinuses. All the patients showed occlusal contact on natural antagonist teeth or implant-supported dental prostheses. Therefore, it was concluded that the use of exteriorized zygomatic implants with immediate loading represented a feasible option with high success rates for the treatment of atrophic maxilla.
Application of Computer-Aided Design and Individualized Templates for Bilateral Zygomaticomaxillary Complex Fractures
Authors: Zhou Tianren , Li Jianping , Chen Songling , Ren Jing , Geng Ningbo 
Published: December 2021

Purpose:
Reduction of the bilateral zygomaticomaxillary complex (ZMC) fracture with individualized templates based on computer- aided surgical simulation system. To evaluate the practicality and accuracy of this approach in the treatment of bilateral ZMC fracture.

Methods:
Sixteen patients with bilateral ZMC fractures were collected to create a study model. The authors reconstruct the ZMC on one side via the three-dimensional (3D) model, and then mirrored to the opposite side. Multiple individualized templates were made based on the 3D model, and used as intraoperative guidance to reduce fractures. After surgery, the facial symmetry and the position of zygoma were observed. The mouth opening, pupil level, and sensation of infraorbital nerve were evaluated. Some mark points on zygoma were measured and the postoperative horizontal asymmetry rate (H) was calculated. Besides, orbital height and width were measured.

Results:
For all patients, the position of bilateral ZMC was basically restored. The patients with restriction of mouth opening all recovered to normal. The H values were less than 3.0% at all mark points. There was almost no difference in bilateral orbital width and height. Meanwhile, there was no significant difference between the preoperative measurements of the ideal virtual 3D model and the postoperative measurements of patients.

Conclusions:
The study proves that application of computer-aided design and individualized templates can accurately guide the reduction operation of ZMC fracture, restore the ideal shape of ZMC, and obtain good facial symmetry.
Effects of Positioning Errors Onto the Ratio and Angle Measurements in Photographs of Patients With Unilateral Cleft Lip and Palate
Authors: Titiz Serap 
Published: December 2021

Background:
Nasolabial esthetics is 1 of the most important issues in the evaluation of treatment outcomes in patients with unilateral cleft lip and palate (CLP). Frontal and basal view photographs are commonly used to evaluate nasolabial esthetics in patients with unilateral CLP. High-quality photography plays an important role in evaluating the treatment outcomes and poor quality photographs can result in errors, whereas evaluating the treatment results. Facial proportions and angles are important in the esthetic perception of the face. Hence, this study aimed to determine the effects of positioning errors on the ratio and angle measurements in photographs of patients with unilateral CLP.

Methods:
In the clinical and computer environment, a mechanism was set up to take photos at standard and at different angles. A real-size unilateral CLP silicone doll was constructed for the photographs to be taken in the clinical setting. A test-retest was performed to determine the reliability of the measured values.

Results:
The correlation coefficients for the first measurement and remeasurement values were statistically significant; positive and strong correlations were obtained.

Conclusions:
Based on the data obtained from our study, the angle and ratio measurements obtained from the two-dimensional photographs provided reliable results.
Reduction Malarplasty Using Customized Surgical Stent Based on 3D Virtual Surgery, CAD/CAM, and 3D Printing Technology: Case Series
Authors: Ha Sung-Ho , Jung Sungyoung , Choi Jin-Young 
Published: December 2021

Abstract:
The zygomatic bone is a structure that protrudes symmetrically on both sides of the midface and plays an important role in the overall aesthetic appearance of the face. Unlike Caucasians, the mesocephalic facial shape is predominant in Asians, and therefore, many people have a relatively laterally developed zygomatic bone. In Asians, when the zygomatic bone is excessively developed, it gives a strong and stubborn image, and aesthetically, many people want to reduce the zygomatic bone because they prefer an oval and slim face.
To reduce the excessive zygomatic bone, a reduction malar- plasty through an intraoral and preauricular approach has been performed. Although reducing the zygomatic bone is not a big problem in most cases of symmetric reduction malarplasty, it is not easy to produce surgical results as intended by the surgeon in asymmetric malar patients or patients requiring a three-dimensional (3D) change of zygoma. In addition, because of the mobility of the zygoma segment, it may be difficult to drill holes and fix plate after osteotomy. Moreover, these factors can increase the possibility of malunion or nonunion.
In this study, cutting guides made with the aid of 3D virtual surgery, 3D printing, and customized titanium plates manufactured with the computer-aided design/computer-aided manufacturing technology are used for 8 patients to maximize the recovery of 3D symmetry and minimize complications through accurate fixation after surgery. During the surgical procedures, screw hole drilling and osteotomy were performed using a cutting guide, and then, the malar segment was fixed by matching the premade customized plates with the predrilled holes. As a result of checking the accuracy of the surgery by superimposing the postoperative 3D cone beam computed tomography image and virtual surgery data based on the skull base, the 2 images almost overlapped and no significant differences were observed, so it was confirmed that the operation was performed exactly as planned.
When using the 3D technology, it is possible to perform a more accurate surgery in patients with asymmetry due to congenital anomalies or trauma as well as simple asymmetry, so it can be concluded that using the 3D technology can overcome the limitations and disadvantages of the conventional method as in the cases in this study. The accurate prediction of soft tissue is still insufficient, and further research is needed to overcome this limitation
Detection of acne by deep learning object detection
Authors: Sangha Amandip , Rizvi Mohammad 
Published: December 2021

AbstractImportanceState-of-the art performance is achieved with a deep learning object detection model for acne detection. There is little current research on object detection in dermatology and acne in particular. As such, this work is early in this field and achieves state of the art performance.ObjectiveTrain an object detection model on a publicly available data set of acne photos.Design, Setting, and ParticipantsA deep learning model is trained with cross validation on a data set of facial acne photos.Main Outcomes and MeasuresObject detection models for detecting acne for single-class (acne) and multi-class (four severity levels). We train and evaluate the models using standard metrics such as mean average precision (mAP). Then we manually evaluate the model predictions on the test set, and calculate accuracy in terms of precision, recall, F1, true and false positive and negative detections.ResultsWe achieve state-of-the art mean average precision mAP@0.5 value of 37.97 for the single class acne detection task, and 26.50 for the 4-class acne detection task. Moreover, our manual evaluation shows that the single class detection model performs well on the validation set, achieving true positive 93.59 %, precision 96.45 % and recall 94.73 %.Conclusions and RelevanceWe are able to train a high-accuracy acne detection model using only a small publicly available data set of facial acne. Transfer learning on the pre-trained deep learning model yields good accuracy and high degree of transferability to patient submitted photographs. We also note that the training of standard architecture object detection models has given significantly better accuracy than more intricate and bespoke neural network architectures in the existing research literature.Key PointsQuestionCan deep learning-based acne detection models trained on a small data set of publicly available photos of patients with acne achieve high prediction accuracy?FindingsWe find that it is possible to train a reasonably good object detection model on a small, annotated data set of acne photos using standard deep learning architectures.MeaningDeep learning-based object detection models for acne detection can be a useful decision support tools for dermatologists treating acne patients in a digital clinical practice. It can prove a particularly useful tool for monitoring the time evolution of the acne disease state over prolonged time during follow-ups, as the model predictions give a quantifiable and comparable output for photographs over time. This is particularly helpful in teledermatological consultations, as a prediction model can be integrated in the patient-doctor remote communication.
Contribution of endogenous and exogenous antibodies to clearance of SARS-CoV-2 during convalescent plasma therapy
Authors: Marconato Maddalena , Abela Irene A. , Hauser Anthony , Schwarzmüller Magdalena , Katzensteiner Rheliana , Braun Dominique L. , Epp Selina , Audigé Annette , Weber Jacqueline , Rusert Peter , Schindler Emèry , Pasin Chloé , West Emily , Böni Jürg , Kufner Verena , Huber Michael , Zaheri Maryam , Schmutz Stefan , Frey Beat M. , Kouyos Roger D. , Günthard Huldrych F. , Manz Markus G. , Trkola Alexandra 
Published: December 2021

AbstractNeutralizing antibodies are considered a key correlate of protection by current SARS-CoV-2 vaccines. The ability of antibody-based therapies, including convalescent plasma, to affect established disease remains to be elucidated. Only few monoclonal therapies and only when used at a very early stage of infection have shown efficacy. Here, we conducted a proof-of-principle study of convalescent plasma therapy in a phase I trial in 30 COVID-19 patients including immunocompromised individuals hospitalized early after onset of symptoms. A comprehensive longitudinal monitoring of the virologic, serologic, and disease status of recipients in conjunction with detailed post-hoc seroprofiling of transfused convalescent plasma, allowed deciphering of parameters on which plasma therapy efficacy depends. Plasma therapy was safe and had a significant effect on viral clearance depending on neutralizing and spike SARS-CoV-2 antibody levels in the supplied convalescent plasma. Endogenous immunity had strong effects on virus control. Lack of endogenous neutralizing activity at baseline was associated with a higher risk of systemic viremia. The onset of endogenous neutralization had a noticeable effect on viral clearance but, importantly, even after adjusting for their endogenous neutralization status recipients benefitted from therapy with high neutralizing antibody containing plasma.In summary, our data demonstrate a clear impact of exogenous antibody therapy on the rapid clearance of viremia in the early stages of infection and provide directions for improved efficacy evaluation of current and future SARS-CoV-2 therapies beyond antibody-based interventions. Incorporating an assessment of the endogenous immune response and its dynamic interplay with viral production is critical for determining therapeutic effects.One Sentence SummaryThis study demonstrates the impact of exogenous antibody therapy by convalescent plasma containing high neutralizing titers on the rapid clearance of viremia in the early stages of SARS-CoV-2 infection.
COVID-19 booster vaccine attitudes and behaviors among university students and staff: the USC Trojan Pandemic Research Initiative
Authors: Lee Ryan C. , Hu Howard , Kawaguchi Eric S. , Kim Andre. E , Soto Daniel W. , Shanker Kush , Klausner Jeffrey D. , Van Orman Sarah , Unger Jennifer B. 
Published: December 2021

AbstractIntroductionAlthough COVID-19 vaccines significantly reduce morbidity and mortality, recent evidence suggests that immunity wanes after 6-9 months, and that a third vaccine dose could further reduce COVID-19 transmission and severe illness. However, previous studies have not assessed attitudes about getting booster doses. This study examined COVID-19 booster vaccine attitudes and behaviors among university students and staff in the fall of 2021.MethodsParticipants responded to an email invitation and completed electronic surveys. Results. In our sample, 96.2% of respondents indicated willingness to get a COVID-19 booster shot at least once per year. In both bivariate and multivariate analyses higher trust in science was associated with having higher odds of booster willingness. Those who identify as Black, on average, reported trusting science less than other racial/ethnic groups.ConclusionsOur findings demonstrate high willingness to receive a COVID-19 booster shot and highlight the importance of educational and motivational messages that focus on trust in science to increase willingness to get the COVID-19 booster. More research is needed to better understand the impact of cultural beliefs on booster willingness and vaccine hesitancy. This understanding will help determine what messages and populations to target to increase booster willingness in the future.