bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIV Incidence Among Pregnant and Nonpregnant Women in the FACTS-001 Trial: Implications for HIV Prevention, Especially PrEP Use
Authors: Rees Helen , Chersich Matthew Francis , Munthali Richard J. , Brumskine William , Palanee-Phillips Thesla , Nkala Busi , Ahmed Khatija , Sebe Modulakgotla , Mabude Zonke , Nchabeleng Maphoshane , Bekker Linda-Gail , Kotze Philip , Mogodiri Thembisile , Naidoo Ishana , Panchia Ravindre , Myer Landon , Lombard Carl , Doncel Gustavo F. , Gray Glenda , Delany-Moretlwe Sinead 
Published: October 2021

Background:
During pregnancy and postpartum period, the sexual behaviors of women and their partners change in ways that may either increase or reduce HIV risks. Pregnant women are a priority population for reducing both horizontal and vertical HIV transmission.

Setting:
Nine sites in 4 South African provinces.

Methods:
Women aged 18–30 years were randomized to receive pericoital tenofovir 1% gel or placebo gel and required to use reliable modern contraception. We compared HIV incidence in women before, during, and after pregnancy and used multivariate Cox Proportional hazards models to compare HIV incidence by pregnancy status.

Results:
Rates of pregnancy were 7.1 per 100 woman-years (95% confidence interval [CI]: 6.3 to 8.1) and highest in those who reported oral contraceptive use (25.1 per 100 woman-years; adjusted hazard ratio 22.97 higher than other women; 95% CI: 5.0 to 105.4) or had 2 children. Birth outcomes were similar between trial arms, with 59.8% having full-term live births. No difference was detected in incident HIV during pregnancy compared with nonpregnant women (2.1 versus 4.3%; hazard ratio = 0.56, 95% CI: 0.14 to 2.26). Sexual activity was low in pregnancy and the early postpartum period, as was consistent condom use.

Conclusions:
Pregnancy incidence was high despite trial participation being contingent on contraceptive use. We found no evidence that rates of HIV acquisition were elevated in pregnancy when compared with those in nonpregnant women. Risks from reductions in condom use may be offset by reduced sexual activity. Nevertheless, high HIV incidence in both pregnant and nonpregnant women supports consideration of introducing antiretroviral-containing pre-exposure prophylaxis for pregnant and nonpregnant women in high HIV prevalence settings.
Radiologist-supervised Transfer Learning
Authors: Hurt Brian , Rubel Meagan A. , Masutani Evan M. , Jacobs Kathleen , Hahn Lewis , Horowitz Michael , Kligerman Seth , Hsiao Albert 
Published: October 2021

Purpose:
To assess the potential of a transfer learning strategy leveraging radiologist supervision to enhance convolutional neural network-based (CNN) localization of pneumonia on radiographs and to further assess the prognostic value of CNN severity quantification on patients evaluated for COVID-19 pneumonia, for whom severity on the presenting radiograph is a known predictor of mortality and intubation.

Materials and Methods:
We obtained an initial CNN previously trained to localize pneumonia along with 25,684 radiographs used for its training. We additionally curated 1466 radiographs from patients who had a computed tomography (CT) performed on the same day. Regional likelihoods of pneumonia were then annotated by cardiothoracic radiologists, referencing these CTs. Combining data, a preexisting CNN was fine-tuned using transfer learning. Whole-image and regional performance of the updated CNN was assessed using receiver-operating characteristic area under the curve and Dice. Finally, the value of CNN measurements was assessed with survival analysis on 203 patients with COVID-19 and compared against modified radiographic assessment of lung edema (mRALE) score.

Results:
Pneumonia detection area under the curve improved on both internal (0.756 to 0.841) and external (0.864 to 0.876) validation data. Dice overlap also improved, particularly in the lung bases (R: 0.121 to 0.433, L: 0.111 to 0.486). There was strong correlation between radiologist mRALE score and CNN fractional area of involvement (ρ=0.85). Survival analysis showed similar, strong prognostic ability of the CNN and mRALE for mortality, likelihood of intubation, and duration of hospitalization among patients with COVID-19.

Conclusions:
Radiologist-supervised transfer learning can enhance the ability of CNNs to localize and quantify the severity of disease. Closed-loop systems incorporating radiologists may be beneficial for continued improvement of artificial intelligence algorithms.
Accuracy of Intentional Change of Frontal Ramal Inclination From Virtual to Actual Orthognathic Surgery Using Computer-Aided Design and Computer-Aided Manufacturing-Made Customized Metal Plates
Authors: Woo Min-Ho , Youn Sungbin , Woo Jae Man , Baek Seung-Hak , Choi Jin-Young 
Published: October 2021

Objective:
To evaluate the accuracy of intentional change of the frontal ramal inclination (FRI) from virtual to actual orthognathic surgery.

Materials and Methods:
A total of 16 patients who underwent orthognathic surgery for correction of facial asymmetry and took cone-beam computed tomography 2 to 3 weeks before surgery (T0) and 3 days after surgery (T1A) were selected. After reorientation of cone-beam computed tomography, the digital imaging and communications in medicine data was converted to StereoLithography format for the merging with dental cast scan using R2GATE software (MegaGen Implant, Daegu, Republic of Korea). During virtual surgery using Geomagic Freeform Plus software (3D Systems, Rock Hill, SC), bilateral FRI discrepancy was corrected (T1V) and 3D-printed surgical wafers and customized metal plates were manufactured using 3D printer (Meg-printer II, MegaGen Implant, Daegu, Republic of Korea) and computer numerical control milling machine (ARDEN, TPS Korea Ltd., Gwangju, Republic of Korea) accordingly. During surgery, FRI correction was done using surgical guide and customized plates. The difference between preoperative and virtually corrected FRI (Δ T1V — T0) and the difference between preoperative and actually surgically corrected FRI (Δ T1A — T0) were measured, and the achieved FRI correction in percentage ([Δ T1A — T0]/[Δ T1V — T0] × 100) was calculated.

Results:
The mean absolute value of virtual FRI correction (Δ T1V — T0) and actual FRI correction (Δ T1A - T0) were 3.0° and 2.9°, respectively (n = 32). In the increased (medial rotation) FRI group, mean virtual and actual correction amount were 3.2° and 2.8° (n = 17), whereas in the decreased (lateral rotation) group, mean virtual and actual correction amount were –2.7° and –3.1°, respectively (n = 15). No statistically significant difference between virtual and actual measurements were present in either group. The mean achievement rate was 102.8%. Tendency of undercorrection (91.2%) in the increased FRI group and overcorrection (116.0%) in the decreased FRI group were noted.

Discussion:
With virtual planning and computer-aided design and computer-aided manufacturing-made customized plates, it is possible to correct FRI during orthognathic surgery of patients with facial asymmetry.
How to Distinguish Solitary Neurofibroma From Neurofibromatosis Type 1
Authors: Guo Chengrui , Zhou Lucia , Sun Yi , Hu Xiaojie 
Published: October 2021

Abstract
Neurofibroma is a benign tumor originating from Schwann cells. It is diagnosed as a symptom of neurofibromatosis type 1 (NF1) or solitary neurofibroma. Neurofibromatosis type 1 belongs to a class of hereditary diseases, whereas solitary neurofibroma is not. Presence of germline NF1 gene mutations can be used to distinguish the 2 conditions. However, due to false negative results in gene tests, NF1 may be misdiagnosed as solitary neurofibroma. This calls for development of more accurate diagnostic methods. The authors report 2 patients with neurofibroma who required surgery and fertility consulting. using primary cell culture and next-generation sequencing experiments, the authors found NF1 mutation in neurofibroma Schwann cells. But this mutation was not exit in peripheral blood, hence demonstrate this NF1 mutation was somatic rather than germline. These results confirmed the diagnosis of solitary neurofibroma rather than NF1. The presented method is, therefore, suitable for fertility consultation and diagnosis of solitary neurofibroma patient.
Unusual Mandibular Distraction Complication in Two Neonatal Pierre Robin Sequence Patients
Authors: Morovic Carmen Gloria , Torres Javier , Jorquera Claudia 
Published: October 2021

Abstract
The Pierre Robin sequence (PRS) is characterized by the triad of micrognathia, glossoptosis, and airway obstruction. Conservative management in Pierre Robin sequence consists of nasogastric tube feeding and positioning of the neonate (prone or lateral position) that facilitates the anterior position of the tongue or the application of continuous positive nasal pressure. In case of failure of this treatment, emergency tracheostomy and/or mandibular distraction must be performed.
Mandibular distraction is a standard technique used by craniofacial surgeons to achieve an anteroposterior horizontal lengthening of the mandibular body, correcting the posterior position of the base of the tongue and thus retropharyngeal enlargement of the airway.
The authors present 2 clinical cases of hypertrophy of the sublingual salivary glands with the use of mandibular distractors in SPR patients with severe airway obstruction.
Endoscopic Resection of a Rare Chondromyxoid Fibroma From the Nasal Septum
Authors: Wang Yunxiu , Cao Zhiwei , Gu Zhaowei 
Published: October 2021

Abstract:
Chondromyxoid fibroma is a rare benign tumor mostly found in the metaphysis of long bones. In rare cases, it develops in unusual locations. We report a case of chondromyxoid fibroma from the nasal septum. Endoscopic surgery was performed with the patient under general anesthesia. A plasma knife was used to ablate the tumor. No recurrence was noted at the 4-year follow-up. The advantages of endoscopic surgery include direct observation, improved visibility and magnification, reduced intraoperative trauma, and fewer postoperative complications. The advantages of the plasma knife include its ability to separate and ablate the tumor simultaneously while effectively reducing bleeding and maintaining the visibility of the surgical field.
Promoting parental education of infants hospitalized in a children's hospital in Tabriz, Iran: a best practice implementation project
Authors: Kabiri Neda , Hajebrahimi Sakineh , Alizadeh Gisoo , Azimzadeh Solmaz , Dehkhoda Nahid , Talebpour Amin 
Published: October 2021

ABSTRACT

Introduction:
Parents of infants admitted to hospital have high information needs. A good educational program will improve the outcomes and communication needs of these parents. Results from some studies have shown that patient education in Iran is inappropriate and should be improved.

Objectives:
The aim of this evidence implementation project was to evaluate the current practice and implement the best practice related to promoting patient education in a children's hospital in Tabriz, Iran.

Methods:
A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Eight audit criteria that represent the best practice recommendations for patient education were used. A baseline audit was conducted followed by implementing multiple strategies, and the project was finalized with a follow-up audit to determine a change in practice.

Results:
Significant improvements in the follow-up audit in comparison with the baseline audit were as follows: evaluation of patient learning has been undertaken to determine met and unmet needs (from 65 to 77%); patients’ learning needs, readiness to learn, and their learning style have been assessed before the implementation of an educational initiative (from 55 to 66%); and educational resources in different formats (e.g., written handouts, brochures, and links to online materials) are available in the ward (from 33 to 77%). Strategies that were implemented to achieve change in practice included conducting workshops and conferences, determining a trained nurse as responsible for educating parents, training in discharge time, the presentation of educational films daily, conducting group training, and installing related posters in the department and patient's room. The other five criteria were less compliant with best practice in the follow-up audit rather than the baseline audit; however, all of them except one (Criterion 3) were still up to 75% compliant, which is considered excellent by the audit team.

Conclusion:
The follow-up audit results indicated an improvement in providing parental education. It can be concluded that these interventions can facilitate the implementation of evidence into clinical practice.
Inference of Electrical Stimulation Sensitivity from Recorded Activity of Primate Retinal Ganglion Cells
Authors: Madugula Sasidhar S. , Vilkhu Ramandeep , Shah Nishal P. , Grosberg Lauren E. , Kling Alexandra , Gogliettino Alex R. , Nguyen Huy , Hottowy Paweł , Sher Alexander , Litke Alan M. , Chichilnisky E.J. 
Published: October 2021

SummaryHigh-fidelity electronic implants can in principle restore the function of neural circuits by precisely activating neurons via extracellular stimulation. However, direct characterization of the individual electrical responses of a large population of target neurons, in order to precisely control their activity, is often difficult or impossible. A potential solution is to leverage biophysical principles to infer sensitivity to electrical stimulation from features of spontaneous electrical activity, which can be recorded relatively easily. Here, this approach is developed and its potential value for vision restoration is tested quantitatively using large-scale high-density stimulation and recording from primate retinal ganglion cells (RGCs)ex vivo. Electrodes recording larger spikes from a given cell exhibited lower stimulation thresholds, with distinct trends for somas and axons, across cell types, retinas, and eccentricities. Thresholds for somatic stimulation increased with distance from the axon initial segment. The dependence of spike probability on injected current was inversely related to threshold, and was substantially steeper for axonal than somatic compartments, which could be identified by recorded electrical signatures. Dendritic stimulation was largely ineffective for eliciting spikes. These findings were quantitatively reproduced with biophysical simulations, and confirmed in tests on human RGCs. The inference of stimulation sensitivity from recorded electrical features was tested in simulated visual reconstruction, and revealed that the approach could significantly improve the function of future high-fidelity retinal implants.
(–)-Epicatechin alters reactive oxygen and nitrogen species production independent of mitochondrial respiration in human vascular endothelial cells
Authors: Sadler Daniel G. , Barlow Jonathan , Draijer Richard , Jones Helen , Thijssen Dick H. J. , Stewart Claire E. 
Published: October 2021

AbstractIntroductionVascular endothelial dysfunction is characterised by lowered nitric oxide (NO) bioavailability, which may be explained by increased production of reactive oxygen species (ROS), mitochondrial dysfunction and altered cell signalling. (-)-Epicatechin (EPI) has proven effective in the context of vascular endothelial dysfunction, but the underlying mechanisms associated with EPI’s effects remain unclear.Objective(s)Our aim was to investigate whether EPI impacts reactive oxygen and nitrogen species (RONS) production and mitochondrial function of human vascular endothelial cells (HUVECs). We hypothesised that EPI would attenuate ROS production, increase NO bioavailability, and enhance indices of mitochondrial function.MethodsHUVECs were treated with EPI (0-20 µM) for up to 48 h. Mitochondrial and cellular ROS were measured in the absence and presence of antimycin A (AA), an inhibitor of the mitochondrial electron transport protein complex III, favouring ROS production. Genes associated with mitochondrial remodelling and the antioxidant response were quantified by RT-qPCR. Mitochondrial bioenergetics were assessed by respirometry and signalling responses determined by western blotting.ResultsMitochondrial superoxide production without AA was increased 32% and decreased 53% after 5 and 10 µM EPI treatment vs. CTRL (P<0.001). With AA, only 10 µM EPI increased mitochondrial superoxide production vs. CTRL (25%, P<0.001). NO bioavailability was increased by 45% with 10 µM EPI vs. CTRL (P=0.010). However, EPI did not impact mitochondrial respiration. NRF2 mRNA expression was increased 1.5- and 1.6-fold with 5 and 10 µM EPI over 48 h vs. CTRL (P=0.015 and P=0.001, respectively). Finally, EPI transiently enhanced ERK1/2 phosphorylation (2.9 and 3.2-fold over 15 min and 1 h vs. 0 h, respectively; P=0.035 and P=0.011).Conclusion(s)EPI dose dependently alters RONS production of HUVECs but does not impact mitochondrial respiration. The induction of NRF2 mRNA expression with EPI might relate to enhanced ERK1/2 signalling, rather than RONS production. In humans, EPI may improve vascular endothelial dysfunction via alteration of RONS and activation of cell signalling.
Safety Monitoring of mRNA Vaccines Administered During the Initial 6 Months of the U.S. COVID-19 Vaccination Program: Reports to Vaccine Adverse Events Reporting System (VAERS) and v-safe
Authors: Rosenblum Hannah G. , Gee Julianne M. , Liu Ruiling , Marquez Paige L. , Zhang Bicheng , Strid Penelope , Abara Winston E. , McNeil Michael M. , Myers Tanya R. , Hause Anne M. , Su John R. , Baer Bethany , Menschik David , Markowitz Lauri E. , Shimabukuro Tom T. , Shay David K. 
Published: October 2021

AbstractBackgroundIn December 2020, two mRNA-based COVID-19 vaccines were authorized for use in the United States. Vaccine safety was monitored using the Vaccine Adverse Event Reporting System (VAERS), a passive surveillance system, and v-safe, an active surveillance system.MethodsVAERS and v-safe data during December 14, 2020—June 14, 2021 were analyzed. VAERS reports were categorized as non-serious, serious, or death; reporting rates were calculated. Rates of reported deaths were compared to expected mortality rates by age. Proportions of v-safe participants reporting local and systemic reactions or health impacts the week following doses 1 and 2 were determined.FindingsDuring the analytic period, 298,792,852 doses of mRNA vaccines were administered in the United States. VAERS processed 340,522 reports; 92·1% were non-serious; 6·6%, serious, non-death; and 1·3%, death. Over half of 7,914,583 v-safe participants self-reported local and systemic reactogenicity, more frequently after dose 2. Injection-site pain, fatigue, and headache were commonly reported during days 0–7 following vaccination. Reactogenicity was reported most frequently one day after vaccination; most reactions were mild. More reports of being unable to work or do normal activities occurred after dose 2 (32·1%) than dose 1 (11·9%); <1% of participants reported seeking medical care after vaccination. Rates of deaths reported to VAERS were lower than expected background rates by age group.InterpretationSafety data from >298 million doses of mRNA COVID-19 vaccine administered in the first 6 months of the U.S. vaccination program show the majority of reported adverse events were mild and short in duration.
Hotmelt tissue adhesive with supramolecularly-controlled sol-gel transition for preventing postoperative abdominal adhesion
Authors: Nishiguchi Akihiro , Ichimaru Hiroaki , Ito Shima , Nagasaka Kazuhiro , Taguchi Tetsushi 
Published: October 2021

AbstractPostoperative adhesion is a serious and frequent complication, but there is currently no reliable anti-adhesive barrier available due to low tissue adhesiveness, undesirable chemical reactions, and poor operability. Here, we report a single-syringe hotmelt tissue adhesive to prevent postoperative abdominal adhesions. Through the augmentation of intermolecular hydrogen bonding by conjugation of the ureidopyrimidinone unit to tendon-derived gelatin, the sol-gel transition behavior of gelatin was supramolecularly-controlled, which provided a hotmelt tissue adhesive that dissolves upon warming over 40 °C and glues at 37 °C. This functionalization improved the key features necessary for an anti-adhesive barrier, including bulk mechanical strength, tissue adhesive properties, underwater stability, and anti-adhesive property. This hotmelt tissue adhesive with excellent tissue adhesiveness, biocompatibility, and operability has enormous potential to prevent postoperative complications.
Plant secondary metabolite diversity reflects both phylogeny and ecological adaptation
Authors: Pierce Simon , Guo Wen-Yong , Cerabolini Bruno. E.L. , Negreiros Daniel , Faoro Franco , Magoga Giulia , Montagna Matteo , Fernandes G. Wilson , Spada Alberto 
Published: October 2021

AbstractA phylogenetic framework explaining plant secondary metabolite diversity is lacking, but metabolite classes could represent adaptations to habitat resource availability. We test the hypothesis that primary adaptive strategies (competitors, C; stress-tolerators, S; ruderals, R) are associated, respectively, with nitrogenous metabolites synthesized in persistent organs (alkaloids), nitrogen-lacking aromatic terpenes and phenolics, and nitrogenous compounds prevalent in reproductive tissues (cyanogenic glucosides and glucosinolates). A matrix was compiled of 1019 species for which secondary metabolite pathways and CSR strategies are known. Accounting for phylogenetic relatedness and native biomes, we found that most phytochemical pathways did not correlate with strategy axes, but certain key associations were evident. C-selection was positively associated with amino acid-derived phenylpropanoids (low phylogenetic relatedness; λ <0.5) and pyrrolizidine alkaloids and galloyl derivatives (high λ), and negatively with N-lacking linear monoterpenes (low λ). Nitrogenous cyanogenic glucosides positively correlated with R-selection (low λ). Terpenoids were widely distributed, but correlated positively with S- and negatively with R-selection (low λ). Twenty-six correlations between phytochemicals and biomes (low λ) were evident. Most secondary metabolite synthesis pathways are widespread, reflecting common roles and obligate defence, and strong phylogenetic effects are often evident. However, the character of phytochemical/adaptive strategy associations agrees with ecological theory and thus reflects adaptation.
Transcriptome Dynamics of Floral Organs Approaching Blooming in the Flowering Cherry (Cerasus × yedoensis) Cultivar ‘Somei-Yoshino’
Authors: Shirasawa Kenta , Esumi Tomoya , Itai Akihiro , Isobe Sachiko 
Published: October 2021

AbstractTo gain insights into the genetic mechanisms underlying blooming and petal movement in flowering cherry (Cerasus × yedoensis), we performed time-course RNA-seq analysis of the floral buds and open-flowers of the most popular flowering cherry cultivar, ‘Somei-Yoshino’. Independent biological duplicate samples of floral buds and open-flowers were collected from ‘Somei-Yoshino’ trees grown at three different locations in Japan. RNA-seq reads obtained from floral bud and open-flower samples collected in the current study (in 2019) and in a previous study (in 2017) were aligned against the genome sequence of ‘Somei-Yoshino’ to quantify gene transcript levels. Clustering analysis of RNA-seq reads revealed dynamic changes in the transcriptome, with genes in seven modules predominantly expressed at specific time points, ranging from 5 weeks before flowering to 2 weeks after flowering. Based on the identified gene modules and Gene Ontology (GO) terms enriched at different floral stages, we speculate that the genetic mechanisms underlying petal movement and flower opening in cherry involve the processes of development, cell wall organization, reproduction, and metabolism, which are executed by genes encoding transcription factors, phytohormones, transporters, and polysaccharide metabolic enzymes. Furthermore, we propose a method for cherry bloom forecasting, based on gene expression levels at different time points before flowering as RNA markers.