bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent nocardiosis in solid organ transplant recipients: An evaluation of secondary prophylaxis
Authors: Yetmar Zachary A. , Wilson John W. , Beam Elena 
Published: November 2021

AbstractBackgroundImmunocompromised individuals are at risk for Nocardia infection, with a recurrence rate of approximately 5%. Solid organ transplant (SOT) recipients often receive secondary prophylaxis due to their requirement of lifelong immunosuppression. However, data supporting this practice is sparse. We sought to evaluate Nocardia recurrence in SOT recipients, specifically evaluating secondary prophylaxis.MethodsWe conducted a retrospective cohort study of SOT recipients diagnosed with nocardiosis from 2000 through 2020. We included adult SOT recipients who completed their course of Nocardia therapy and had at least 6 months of posttherapy follow‐up. The primary outcome was Nocardia recurrence, which included relapse and reinfection.ResultsOne hundred two patients met inclusion criteria. Sixty‐six (64.7%) were male and mean age was 58.6 ± 11.7 years. Most common SOT types were kidney (46.1%), heart (18.6%), kidney‐pancreas (11.8%), and lung (10.8%). Most common sites of infection were lung (85.3%), skin (17.6%), and brain (14.7%). Secondary prophylaxis was utilized in 53 (52.0%) patients. Trimethoprim‐sulfamethoxazole (TMP‐SMX) single‐strength daily was the most common prophylaxis agent and dose. Five patients (4.9%) experienced Nocardia recurrence, three of which were receiving secondary prophylaxis at time of recurrence. Two recurrences were with the same Nocardia species. Factors associated with recurrence were lung transplantation (p = .011), chronic lung disease (p = .032), and treatment ≤120 days (p = .006). Time from treatment completion to recurrence ranged from 107 to 875 days.ConclusionsNocardia recurrence in SOT recipients is an uncommon event. TMP‐SMX secondary prophylaxis is incompletely protective and recurrence may be dependent upon other factors. Further study of secondary prophylaxis is warranted.
Use of anti‐CMV immunoglobulins in lung transplant recipients: The French experience
Authors: Roy Charlotte , Parquin François , Messika Jonathan , Véronique Boussaud , Brugière Olivier , Degot Tristan , Feuillet Séverine , Lepavec Jérôme , Tissot Adrien , Dromer Claire , Burnet Espérie , Camps Eve , Roux Antoine 
Published: November 2021

AbstractRationalPending the authorization of new anti‐CMV drugs with fewer adverse effects, exploring the possibilities offered by CMV immunoglobulins (CMVIG) seems necessary. In France, access to CMVIG requires official authorization by the national Health authority and is restricted to second line rescue therapy for CMV infection/disease. The aim of this multicenter retrospective study is to describe the indications and clinical situations that justified its use in France.MethodsA multicenter retrospective study included 22 lung transplant patients over a 3‐year period. Data on clinical indication, tolerance and efficacy were collected.ResultsThe main indication for CMVIG initiation, which was documented in 17 of them (82%) was complex clinical situations resulting from side effects to antiviral drug. CMVIG indication was documented as treatment for 15 patients (68%) and as a secondary prophylaxis for 7 patients (32%). Only one side effect (pruritus during infusion with no anaphylactic symptoms) attributable to CMVIG was reported. After CMVIG initiation, no recurrence of infection or disease was observed during a median follow‐up of 174 (12–682) days after treatment initiation for respectively 68% and 66% of the patients.ConclusionThis study describes an unusual indication of CMVIG use as a last resort treatment in complex situations, based on clinical needs. CMVIG could be useful to change the course of CMV infection with minimal adverse effects or comorbidity.
Alternative splicing triggered by the insertion of a CACTA transposon attenuates LsGLK and leads to the development of pale‐green leaves in lettuce
Authors: Zhang Lei , Qian Jinlong , Han Yuting , Jia Yue , Kuang Hanhui , Chen Jiongjiong 
Published: November 2021

SUMMARYLettuce (Lactuca sativa) is one of the most important vegetable crops in the world. As a leafy vegetable, the polymorphism of lettuce leaves from dark to pale green is an important trait. However, the genetic and molecular mechanisms underlying such variations remain poorly understood. In this study, one major locus controlling the polymorphism of dark‐ and pale‐green leaves in lettuce was identified using genome‐wide association studies (GWAS). This locus was then fine mapped to an interval of 5375 bp on chromosome 4 using a segregating population containing 2480 progeny. Only one gene, homologous to the GLK genes in Arabidopsis and other plants, is present in the candidate region. A complementation test confirmed that the candidate gene, LsGLK, contributes to the variation of dark‐ and pale‐green leaves. Sequence analysis showed that a CACTA transposon of 7434 bp was inserted 10 bp downstream of the stop codon of LsGLK, followed by a duplication of a 1826‐bp fragment covering exons 3–6 of the LsGLK gene. The transposon insertion did not change the expression level of the LsGLK gene. However, because of alternative splicing, only 6% of the transcripts produced from the transposon insertion were wild‐type transcripts, which led to the production of pale‐green leaves. An evolutionary analysis revealed that the insertion of the CACTA transposon occurred in cultivated lettuce and might have been selected in particular cultivars to satisfy the diverse demands of consumers. In this study, we demonstrated that a transposon insertion near a gene may affect its splicing and consequently generate phenotypic variations.
Therapeutic potential of the cytosine deaminase::uracil phosphoribosyl transferase/5‐fluorocytosine suicide system for canine melanoma
Authors: Allende Jesica B. , Finocchiaro Liliana M. E. , Glikin Gerardo C. 
Published: November 2021

AbstractWe tested the efficacy of a yeast cytosine deaminase::uracil phosphoribosyl transferase/5‐fluorocytosine (CDU/5‐FC) non‐viral suicide system on eight established canine melanoma cell lines. Albeit with different degree of sensitivity 5 days after lipofection, this system was significantly efficient killing melanoma cells, being four cell lines highly, two fairly and two not very sensitive to CDU/5‐FC (their respective IC50 ranging from 0.20 to 800 μM 5‐FC). Considering the relatively low lipofection efficiencies, a very strong bystander effect was verified in the eight cell lines: depending on the cell line, this effect accounted for most of the induced cell death (from 70% to 95%). In our assay conditions, we did not find useful interactions either with the herpes simplex thymidine kinase/ganciclovir suicide system (in sequential or simultaneous modality) or with cisplatin and bleomycin chemotherapeutic drugs. Furthermore, only two cell lines displayed limited useful interactions of the CDU/5‐FC either with interferon‐β gene transfer or the proteasome inhibitor bortezomib respectively. These results would preclude a wide use of these combinations. However, the fact that all the tested cells were significantly sensitive to the CDU/5‐FC system encourages further research as a gene therapy tool for local control of canine melanoma.
The effect of along-strike variation in dip on rupture propagation on strike-slip faults
Authors: Lozos Julian C. 
Published: November 2021

AbstractStrike-slip faults can be nonplanar in both their strike and dip dimensions. While a large body of work has investigated the effects of changes in strike on earthquake rupture and arrest, no previous studies have investigated the role of along-strike variations in dip on strike-slip ruptures. Here, I use the three-dimensional finite-element method to conduct dynamic simulations of ruptures on strike-slip faults with linear surface traces and changes in dip along strike. I experiment with the amount of dip change as well as the abruptness of that change under a variety of initial stress conditions. In all of my initial stress cases, I find that a change in dip along strike can cause rupture to stop, and that larger dip changes over shorter distances are more likely to do so. This is largely due to the change in strike at depth that inherently comes from changing the dip; the majority of these behaviors are a result of the rupture front being forced to change direction mid-rupture. While some dip-slip movement does occur on the nonvertical parts of the model fault, it does not have a significant effect on rupture extent. However, linear-surface-trace, nonvertical-dip faults do produce different surface slip, stress, and ground motion patterns compared to corresponding nonlinear-strike, vertical-dip faults. Together, my results show that changes in dip along strike-slip faults do considerably impact the rupture process, suggesting that this type of geometrical complexity should be considered in rupture forecasts and hazard assessments.
Neurodevelopmental outcomes of preterm infants after randomisation to initial resuscitation with lower (FiO2 <0.3) or higher (FiO2 >0.6) initial oxygen levels. An individual patient meta-analysis
Authors: Oei Ju Lee , Kapadia Vishal , Rabi Yacov , Saugstad Ola Didrik , Rook Denise , Vermeulen Marijn J , Boronat Nuria , Thamrin Valerie , Tarnow-Mordi William , Smyth John , Wright Ian M , Lui Kei , van Goudoever Johannes B , Gebski Val , Vento Maximo 
Published: November 2021

ObjectiveTo determine the effects of lower (≤0.3) versus higher (≥0.6) initial fractional inspired oxygen (FiO2) for resuscitation on death and/or neurodevelopmental impairment (NDI) in infants <32 weeks’ gestation.DesignMeta-analysis of individual patient data from three randomised controlled trials.SettingNeonatal intensive care units.Patients543 children <32 weeks’ gestation.InterventionRandomisation at birth to resuscitation with lower (≤0.3) or higher (≥0.6) initial FiO2.Outcome measuresPrimary: death and/or NDI at 2 years of age.Secondary: post-hoc non-randomised observational analysis of death/NDI according to 5-minute oxygen saturation (SpO2) below or at/above 80%.ResultsBy 2 years of age, 46 of 543 (10%) children had died. Of the 497 survivors, 84 (17%) were lost to follow-up. Bayley Scale of Infant Development (third edition) assessments were conducted on 377 children. Initial FiO2 was not associated with difference in death and/or disability (difference (95% CI) −0.2%, −7% to 7%, p=0.96) or with cognitive scores <85 (2%, −5% to 9%, p=0.5). Five-minute SpO2 >80% was associated with decreased disability/death (14%, 7% to 21%) and cognitive scores >85 (10%, 3% to 18%, p=0.01). Multinomial regression analysis noted decreased death with 5-minute SpO2 ≥80% (odds (95% CI) 09.62, 0.98 to 0.96) and gestation (0.52, 0.41 to 0.65), relative to children without death or NDI.ConclusionInitial FiO2 was not associated with difference in risk of disability/death at 2 years in infants <32 weeks’ gestation but CIs were wide. Substantial benefit or harm cannot be excluded. Larger randomised studies accounting for patient differences, for example, gestation and gender are urgently needed.
Cerebral perfusion and neurological examination characterise neonatal opioid withdrawal syndrome: a prospective cohort study
Authors: Benninger Kristen L , Peng Jin , Ho Mai-Lan , Newton Julia , Wang Danny J J , Hu Houchun H , Stark Ann R , Rusin Jerome A , Maitre Nathalie L 
Published: November 2021

ObjectiveTo test the hypothesis that cerebral blood flow (CBF) assessed with arterial spin labelling (ASL) MRI is increased and standardised neurological examination is altered in infants with neonatal opioid withdrawal syndrome (NOWS) compared with those without.DesignProspective cohort study.SettingLevel IV neonatal intensive care unit and outpatient primary care centre.ParticipantsInfants with NOWS receiving pharmacological treatment and unexposed controls matched for gestational age at birth and post-menstrual age at MRI.Main outcomesCBF assessed by ASL on non-sedated 3-Tesla MRI and standardised Hammersmith Neonatal Neurological Examination (HNNE) within 14 days of birth.ResultsThirty infants with NOWS and 31 control infants were enrolled and included in the final analysis. Global CBF across the brain was higher in the NOWS group compared with controls (14.2 mL/100 g/min±5.5 vs 10.7 mL/100 g/min±4.3, mean±SD, Cohen’s d=0.72). HNNE total optimality score was lower in the NOWS group compared with controls (25.9±3.6 vs 28.4±2.4, mean±SD, Cohen’s d=0.81). A penalised logistic regression model including both CBF and HNNE items discriminated best between the two groups.ConclusionsIncreased cerebral perfusion and neurological examination abnormalities characterise infants with NOWS compared with those without intrauterine drug exposure and suggest prenatal substance exposure affects fetal brain development. Identifying neurological and neuroimaging characteristics of infants with NOWS can contribute to understanding mechanisms underlying later outcomes and to designing potential new treatments.
Outcome of infants with 10 min Apgar scores of 0–1 in a low-resource setting
Authors: Tylleskär Thorkild , Cavallin Francesco , Höök Susanna Myrnerts , Pejovic Nicolas J , Lubulwa Clare , Byamugisha Josaphat , Nankunda Jolly , Trevisanuto Daniele 
Published: November 2021

BackgroundIn high-resource settings, postponing the interruption of cardiopulmonary resuscitation from 10 to 20 min after birth has been recently suggested, but data from low-resource settings are lacking. We investigated the outcome of newborns with Apgar scores of 0–1 at 10 min of resuscitative efforts in a low-resource setting.MethodsThis observational substudy from the NeoSupra trial included all 49 late preterm/full-term newborns with Apgar scores of 0–1 at 10 min of resuscitation. The study was carried out at Mulago National Referral Hospital (Kampala, Uganda) between May 2018 and August 2019. Outcome measures were mortality and hypoxic-ischaemic encephalopathy in the first week of life. All resuscitations were video recorded and daily reviewed by trial researchers.ResultsMedian duration of resuscitation was 32 min (IQR 17–37). Advanced resuscitation was provided to 21/49 neonates (43%). Overall, 48 neonates (98%) died within 2 days of life (44 in the delivery room, three on the first day and one on the second day) and one survived at 1 week with severe hypoxic-ischaemic encephalopathy.ConclusionOur study adds information from a low-resource setting to the recent evidence from high-resource settings about prolonging the resuscitation in infants with Apgar scores of 0–1 at 10 min. The vast majority died in the delivery room despite prolonged resuscitative efforts. We confirm that duration of resuscitation should be tailored to the setting, while the focus in low-resource settings should be improving the quality of antenatal and immediately after birth care.
Projections of human papillomavirus (HPV) vaccination impact in Ethiopia, India, Nigeria and Pakistan: a comparative modelling study
Authors: Portnoy Allison , Abbas Kaja , Sweet Steven , Kim Jane J , Jit Mark 
Published: November 2021

IntroductionCervical cancer is the second most common cancer among women in Ethiopia, India, Nigeria and Pakistan. Our study objective was to assess similarities and differences in vaccine-impact projections through comparative modelling analysis by independently estimating the potential health impact of human papillomavirus (HPV) vaccination.MethodsUsing two widely published models (Harvard and Papillomavirus Rapid Interface for Modelling and Economics (PRIME)) to estimate HPV vaccination impact, we simulated a vaccination scenario of 90% annual coverage among 10 cohorts of 9-year-old girls from 2021 to 2030 in Ethiopia, India, Nigeria and Pakistan. We estimated potential health impact in terms of cervical cancer cases, deaths and disability-adjusted life years averted among vaccinated cohorts from the time of vaccination until 2100. We harmonised the two models by standardising input data to comparatively estimate HPV vaccination impact.ResultsPrior to harmonising model assumptions, the range between PRIME and Harvard models for number of cervical cancer cases averted by HPV vaccination was: 262 000 to 2 70 000 in Ethiopia; 1 640 000 to 1 970 000 in India; 330 000 to 3 36 000 in Nigeria and 111 000 to 1 33 000 in Pakistan. When harmonising model assumptions, alignment on HPV type distribution significantly narrowed differences in vaccine-impact estimates.ConclusionDespite model differences, the Harvard and PRIME models yielded similar vaccine-impact estimates. The main differences in estimates are due to variation in interpretation around data on cervical cancer attribution to HPV-16/18. As countries make progress towards WHO targets for cervical cancer elimination, continued explorations of underlying differences in model inputs, assumptions and results when examining cervical cancer prevention policy will be critical.
Impact of zero-mark-up medicines policy on hospital revenue structure: a panel data analysis of 136 public tertiary hospitals in China, 2012–2020
Authors: Cheng Hanchao , Zhang Yuou , Sun Jing , Liu Yuanli 
Published: November 2021

ObjectiveTo quantify the overall and dynamic effects of the implementation of the zero-mark-up medicines policy on the proportionate revenue generated from medicines, medical services and government subsidies at Chinese tertiary public hospitals.MethodsThe revenue data of 136 tertiary public hospitals from 2012 to 2020 and the implementation-time framework of zero-mark-up medicines policy of these hospitals were obtained from the institutional survey of the third-party evaluation of the China Healthcare Improvement Initiative. The study adopted the time-varying difference-in-differences method and combined it with the event study approach to estimate the effects of the zero-mark-up medicines policy.ResultsFollowing the implementation of the policy, the proportionate medicines revenue decreased by 3.23% (p<0.001); the proportionate medical services revenue increased by 3.48% (p=0.001); and the difference in the proportionate government subsidies revenue was not significant. In the year of implementation, the proportion of revenue generated from medicines decreased by 7.76% (p=0.0148); and that from medical services increased by 8.62% (p=0.0167). The effect of the policy gradually strengthened thereafter. In 2020, the sixth year after some hospitals started the implementation of the policy, the share of revenue generated from medicines decreased the most by 18.43% (p=0.0151), and that generated from medical services increased the most by 15.29% (p=0.0219). The share of revenue generated from government subsidies increased by 2%–5% in the second, third, fifth and sixth years following implementation (p<0.05).ConclusionsAlthough the policy goal of adjusting hospital revenue structure has been achieved, the findings were insufficient to conclude whether the policy goal of establishing a scientific compensation mechanism was met by increasing the price of medical services and government input. Additionally, whether there was an unexpected policy effect requires further analysis.
How communication can help women who experience a maternal near-miss: a qualitative study from Tanzania
Authors: Kwezi Hilda Alinda , Mselle Lilian T , Leshabari Sebalda , Hanson Claudia , Pembe Andrea Barnabas 
Published: November 2021

ObjectivesThis study aimed to explore experiences of communication as an element of quality of care, among women surviving a maternal near-miss event, thus women who nearly died but survived haemorrhage, or pre-eclampsia complication during pregnancy, childbirth or within 42 days of termination of pregnancy.DesignA descriptive, phenomenological, qualitative study using semistructured interviews with women who survived a maternal near-miss in Southern Tanzania.SettingThe participants were recruited from two selected hospitals in Mtwara Region, where women sought child birth care and developed near-miss condition.ParticipantsParticipants for this study were women who experienced and survived a maternal near-miss event and who had lived in the study area for at least 1 year. Women were recruited using an adapted version of the WHO criteria for maternal near-miss.Data collectionWe identified 16 women and were able to conduct 10 in-depth interviews with women at their homes, 4 weeks after they were discharged. The interviews were audiorecorded and transcribed and translated word for word from Kiswahili. Thematic analysis was used to identify emerging themes.ResultsThree major themes evolved: (1) Being informed about the care and interaction, (2) Being engaged and encouraged and (3) Being afraid to ask questions. The study highlighted that good communication with women during the provision of care helped women feel grateful, supported and cared for. Women who were unconscious during care were often not informed later of what happened. This created some negative feelings and anxiety.ConclusionThis study highlights the importance of communication, and of being informed of what happened and why. Empathetic communication with sufficient explanation on what happened and why created trust among women—a positive finding which should encourage the development of consistent approaches to strengthen healthcare provider communication skills.
Acceptability of different mechanisms of action of contraception in women: a questionnaire survey
Authors: Tong Yu Wing , Lo Sue Seen Tsing , Fung Barbara Wai Kwan , Cameron Sharon T , Ng Ernest Hung Yu , Li Raymond Hang Wun 
Published: November 2021

BackgroundThe mechanism of action of a contraceptive method is an importantg consideration in a woman’s choice of contraception. For the development of new methods of contraception it is important to understand the acceptability of different contraceptive mechanisms within a population.MethodsWe recruited women attending contraceptive, termination of pregnancy or postnatal care services in Hong Kong for a questionnaire survey on their acceptability of the different ways in which contraceptive methods prevent pregnancy. Univariable and multivariable analyses were used to establish factors which may predict acceptability of the mechanism of action.ResultsA total of 1448 women completed the survey. The acceptability of contraceptive methods that act by preventing fertilisation ranked highest (78%), followed by those that inhibit ovulation (52%), disrupt implantation (43%) and dislodge an implanted embryo (30%). A history of termination of pregnancy was associated with greater acceptance of all posited contraceptive mechanisms. There was a very low degree of agreement between the declared acceptance of the various contraceptive mechanisms and the ever use of a method with the respective mechanism of action (Cohen’s kappa coefficient range 0.017–0.162).ConclusionsIn this population the acceptability of contraceptive methods that act by preventing fertilisation ranked highest, followed by those that inhibit ovulation, disrupt implantation and dislodge an implanted embryo. Women who had ever had a termination of pregnancy were more likely to accept all the posited contraceptive mechanisms.