bluuebunny/crossref_metadata_2025_split huggingface dataset:
Respiratory Drive in Patients with Sepsis and Septic Shock: Modulation by High-flow Nasal Cannula
Authors: Mauri Tommaso , Spinelli Elena , Pavlovsky Bertrand , Grieco Domenico Luca , Ottaviani Irene , Basile Maria Cristina , Dalla Corte Francesca , Pintaudi Gabriele , Garofalo Eugenio , Rundo Annalisa , Volta Carlo Alberto , Pesenti Antonio , Spadaro Savino 
Published: October 2021

Background
Experimental and pilot clinical data suggest that spontaneously breathing patients with sepsis and septic shock may present increased respiratory drive and effort, even in the absence of pulmonary infection. The study hypothesis was that respiratory drive and effort may be increased in septic patients and correlated with extrapulmonary determinant and that high-flow nasal cannula may modulate drive and effort.

Methods
Twenty-five nonintubated patients with extrapulmonary sepsis or septic shock were enrolled. Each patient underwent three consecutive steps: low-flow oxygen at baseline, high-flow nasal cannula, and then low-flow oxygen again. Arterial blood gases, esophageal pressure, and electrical impedance tomography data were recorded toward the end of each step. Respiratory effort was measured as the negative swing of esophageal pressure (ΔPes); drive was quantified as the change in esophageal pressure during the first 500 ms from start of inspiration (P0.5). Dynamic lung compliance was calculated as the tidal volume measured by electrical impedance tomography, divided by ΔPes. The results are presented as medians [25th to 75th percentile].

Results
Thirteen patients (52%) were in septic shock. The Sequential Organ Failure Assessment score was 5 [4 to 9]. During low-flow oxygen at baseline, respiratory drive and effort were elevated and significantly correlated with arterial lactate (r = 0.46, P = 0.034) and inversely with dynamic lung compliance (r = –0.735, P < 0.001). Noninvasive support by high-flow nasal cannula induced a significant decrease of respiratory drive (P0.5: 6.0 [4.4 to 9.0] vs. 4.3 [3.5 to 6.6] vs. 6.6 [4.9 to 10.7] cm H2O, P < 0.001) and effort (ΔPes: 8.0 [6.0 to 11.5] vs. 5.5 [4.5 to 8.0] vs. 7.5 [6.0 to 12.6] cm H2O, P < 0.001). Oxygenation and arterial carbon dioxide levels remained stable during all study phases.

Conclusions
Patients with sepsis and septic shock of extrapulmonary origin present elevated respiratory drive and effort, which can be effectively reduced by high-flow nasal cannula.

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Esophagitis Mimicking Esophageal Cancer on 68Ga-FAPI PET/CT
Authors: Yang Xiao , You Zhouxiang , Mou Chunru , Hu Zhi , Liu Huipan 
Published: October 2021

Abstract
A 69-year-old man presented with dysphagia for 6 months. Endoscopic biopsy showed no sign of malignancy, but enhanced chest CT revealed thickening of the esophageal wall, which was considered likely a potential malignancy. The patient subsequently was enrolled in our clinical trial of 68Ga-FAPI study in tumors. Intense 68Ga-FAPI activity was noted in the thickened esophagus. However, repeated endoscopic biopsies and relief of symptoms after drug treatment rendered a diagnosis of Candida albicans esophagitis.
JAK Inhibitor Effectiveness in Giant-Cell Arteritis With Large-Vessel Involvement Assessed by 18F-FDG PET-CT
Authors: Prigent Kevin , Aouba Achille , Aide Nicolas , de Boysson Hubert 
Published: October 2021

Abstract
We report the case of a 76-year-old woman with relapsing giant-cell arteritis and large-vessel vasculitis demonstrated on 18F-FDG-PET/CT. Methotrexate and tocilizumab failed to achieve remission, and the patient ultimately exhibited a favorable clinical and radiological response to baricitinib, a JAK inhibitor. This case suggests that baricitinib may be a promising treatment for giant-cell arteritis–related large-vessel vasculitis and that 18F-FDG-PET/CT may be used to monitor therapeutic response.
FDG PET/CT in Dendritic Fibromyxolipoma of the Thigh
Authors: Ji Xia , Nian Shensheng , Bai Yushu , Dong Aisheng 
Published: October 2021

Abstract
Dendritic fibromyxolipoma is a rare recently described benign soft tissue tumor, which may be misinterpreted histologically as myxoid liposarcoma or myxoid malignant fibrous histiocytoma. We describe FDG PET/CT and MRI findings of a dendritic fibromyxolipoma incidentally detected in a case with rectal adenocarcinoma. The dendritic fibromyxolipoma showed inhomogeneous FDG uptake with SUVmax of 4.0 mimicking malignancy.
FDG PET/CT in Cryptogenic Multifocal Ulcerating Stenosing Enteropathy
Authors: Zhang Jian , Li Zhi , Zhang Ling , Dong Aisheng , Zhu Yuzhao 
Published: October 2021

Abstract
Cryptogenic multifocal ulcerating stenosing enteropathy (CMUSE) is a rare and exclusive small intestine disease, characterized by repeated anemia or obstruction resulting from multiple shallow ulcers with strictures in the small intestine. We present a case of CMUSE showing multiple foci of activity in the small bowel on FDG PET/CT. This case indicates that CMUSE should be included in the differential diagnosis of multifocal FDG activity in the small bowel along with lymphoma, carcinoma, tuberculosis, Crohn disease, Behçet disease, and drug-induced enteropathy.
A Randomized Clinical Trial of Bioimpedance Spectroscopy or Tape Measure Triggered Compression Intervention in Chronic Breast Cancer Lymphedema Prevention
Authors: Ridner Sheila H. , Dietrich Mary S. , Boyages John , Koelmeyer Louise , Elder Elisabeth , Hughes T. Michael , French James , Ngui Nicholas , Hsu Jeremy , Abramson Vandana G. , Moore Andrew , Shah Chirag 
Published: October 2021

AbstractBackgroundThis study compared rates of progression to chronic breast cancer-related lymphedema (defined as a ≥ 10% arm volume change from baseline requiring complex decongestive physiotherapy (CDP)) following an intervention for subclinical lymphedema (S-BCRL) triggered by bioimpedance spectroscopy (BIS) or by tape measurement (TM).Methods and ResultsThis stratified, randomized, international trial enrolled new breast cancer patients undergoing: mastectomy/partial mastectomy, axillary treatment (dissection, sentinel lymph node biopsy >6 nodes or radiation), radiation therapy (chest wall/ breast, supraclavicular fossa), or taxane-based chemotherapy. Following post-surgery eligibility reassessment, centralized, 1:1 randomization to prospective surveillance by BIS or TM occurred. S-BCRL detection triggered a 4-week, 12-hour per day, compression sleeve and gauntlet intervention. The primary outcome (n=209), rates of post-intervention progression to CDP, were assessed over three years. Between June 24, 2014 and September 11, 2018, 1,200 patients were enrolled, 963 randomized (BIS n=482;TM n=481) and 879 analyzed (BIS n=442;TM n=437). Median follow-up was 32.9 months (IQR=22,35). BIS patients triggered an intervention at a lower rate than TM patients (20.1%, n=89 vs 27.5%, n=120, p = 0.011). Median months to trigger was longer with BIS than TM (9.7; 95%CI,8.2-12.6 vs 3.9; 95%CI,2.8-4.5, p = 0.001). Overall, 14.4%(n=30) progressed post-intervention, with reduced likelihood for BIS patients than TM patients (7.9%, n=7 vs 19.2%, n=23; RR=0.41; 95%CI,0.13-0.81; absolute reduction 11.3%; 95%CI,2.3%-20.3%; p = 0.016).ConclusionsAs compared to TM, BIS provides a more precise identification of patients likely to benefit from an early compression intervention.Condensed AbstractThis stratified, multi-site, international trial enrolled newly diagnosed breast cancer patients, randomized them to prospective surveillance by bioimpedance spectroscopy (BIS) or tape measurement (TM), and screened them for lymphedema development at frequent intervals for three years after surgery. When subclinical lymphedema was detected a 4-week, 12-hour per day, compression sleeve and gauntlet intervention was implemented. Overall, 14.4% (n=30) progressed post-intervention to chronic lymphedema, with reduced likelihood for BIS patients than TM patients (7.9%, n=7 vs 19.2%, n=23; RR=0.41; 95%-CI,0.13-0.81; absolute reduction 11.3%; 95%-CI,2.3%-20.3%; p = 0.016). BIS best supported intervention success for prevention of chronic lymphedema compared to TM.
A second view on the evolution of flight in stick and leaf insects (Phasmatodea)
Authors: Bank Sarah , Bradler Sven 
Published: October 2021

AbstractThe re-evolution of complex characters is generally considered impossible, yet, studies of recent years have provided several examples of phenotypic reversals shown to violate Dollo’s law. Along these lines, the regain of wings in stick and leaf insects (Phasmatodea) was hypothesised to have occurred several times independently after an ancestral loss, a scenario controversially discussed among evolutionary biologists. Here, we revisit the recovery of wings by reconstructing a phylogeny based on a comprehensive taxon sample of over 500 representative phasmatodean species to infer the evolutionary history of wings. We additionally explored the presence of ocelli, the photoreceptive organs used for flight stabilisation in winged insects, which might provide further information for interpreting flight evolution. Our findings support an ancestral loss of wings and that the ancestors of most major lineages were wingless. While the evolution of ocelli was estimated to be dependent on the presence of (fully-developed) wings, ocelli are nevertheless absent in the majority of all examined winged species and only appear in the members of few subordinate clades, albeit winged and volant taxa are found in every lineage. The disjunct distribution of ocelli substantiates the hypothesis on trait reacquisition and that wings were regained in Phasmatodea.
Causality of Abdominal Obesity on Cognition: a Trans-ethnic Mendelian Randomization study
Authors: Wang Shi-Heng , Su Mei-Hsin , Chen Chia-Yen , Lin Yen-Feng , Feng Yen-Chen A. , Hsiao Po-Chang , Pan Yi-Jiun , Wu Chi-Shin 
Published: October 2021

AbstractObesity has been associated with cognition in observational studies; however, whether its effect is confounding, reverse causality, or causal remains inconclusive. Using two-sample Mendelian randomization (MR) analyses, we investigated the causality of overall obesity, measured by BMI, and abdominal adiposity, measured by waist–hip ratio adjusted for BMI (WHRadjBMI), on cognition. Using summary data from the GIANT consortium, COGENT consortium, and UK Biobank of European ancestry, there was no causal effect of BMI on cognition performance (beta[95% CI]=-0.04[-0.12,0.04], p-value=0.35); however, a 1-SD increase in WHRadjBMI was associated with 0.07 standardized decrease in cognition performance (beta[95% CI]=-0.07[-0.12,-0.02], p=0.006). Using raw data from the Taiwan Biobank of Asian ancestry, there was no causal effect of BMI on cognitive aging (beta[95% CI]=0.00[-0.09,0.09], p-value=0.95); however, a 1-SD increase in WHRadjBMI was associated with a 0.17 standardized decrease in cognitive aging (beta[95% CI]=-0.17[-0.30,-0.03], p=0.02). This trans-ethnic MR study reveals that abdominal adiposity impairs cognition.
Predicting COVID-19 Vaccine Efficacy from Neutralizing Antibody Levels
Authors: Abedi Majid R. , Dixon Samuel , Guyon Timothy , Hsu Serene , Jacobs Aviva R. , Nair Lakshmi , Terbrueggen Robert 
Published: October 2021

AbstractRecent studies using data accrued from global SARS-CoV-2 vaccination efforts have demonstrated that breakthrough infections are correlated with levels of neutralizing antibodies. The decrease in neutralizing antibody titers of vaccinated individuals over time, combined with the emergence of more infectious variants of concern has resulted in waning vaccine efficacy against infection and a rise in breakthrough infections. Here we use a combination of neutralizing antibody measurements determined by a high throughput surrogate viral neutralization test (sVNT) together with published data from vaccine clinical trials and comparative plaque reduction neutralization test (PRNT) between SARS-CoV-2 variants to develop a model for vaccine efficacy (VE) against symptomatic infection. Vaccine efficacy estimates using this model show good concordance with real world data from the US and Israel. Our work demonstrates that appropriately calibrated neutralizing antibody measurements determined by high throughput sVNT can be used to provide a semi-quantitative estimate of protection against infection. Given the highly variable antibody levels among the vaccinated population, this model may be of use in identification of individuals with an elevated risk of breakthrough infections.
How frequent are acute reactions to COVID-19 vaccination and who is at risk?
Authors: Dreyer Nancy A. , Reynolds Matthew W , Albert Lisa , Brinkley Emma , Kwon Tom , Mack Christina , Toovey Stephen 
Published: October 2021

AbstractIntroductionOur objective was to describe and compare self-reported side effects of COVID-19 vaccines in the USA.MethodsA web-based registry enrolled volunteers who received a COVID-19 vaccine between March 19 –July 15, 2021. We collected self-reported short-term side effects, medical consultation, hospitalization, and quality of life impact following completed vaccination regimens (Pfizer, Moderna, J&J).ResultsWe recruited 6,966 volunteers who completed their full course of vaccination (median age 48 years, IQR 35.0-62.0; 83.6% female): Pfizer 3,486; Moderna 2,857; J&J 623. Few (3.1%) sought medical care for post-vaccination side effects. Hospitalization (n=17; 0.3%) and severe allergic reactions (n=39; 0.6%) also were rare. Those with autoimmune disease or lung disease were approximately twice as likely to seek medical care (adjusted odds ratio (aOR) 2.01 [95% CI: 1.39;2.92] and 1.70 [95% CI: 1.12;2.58] respectively). 92.4% of participants reported ≥1 side effect (median 3), with injection site reactions (78.9%), fatigue (70.3%), headache (49.0%) reported most frequently. More side effects were reported after the second dose of two-dose vaccines (medians: 1 vs. 2 for Pfizer and 1 vs. 3 for Moderna for first and second doses respectively) versus 3 for J&J’s single-dose vaccine. For the employed, the median number of workdays missed was one. Diabetics and those vaccinated against influenza were substantially less likely to report ≥3 symptoms (aOR 0.68, 95% CI 0.56,0.82 and aOR 0.82, 95% CI 0.73,0.93, respectively.)DiscussionThe total side effect burden was, not unexpectedly, greater with two-dose regimens but all three vaccines appear relatively safe. Very few subjects reported side effects serious enough to warrant medical care or reported post-vaccination hospitalization. While these findings do not address possible long-term effects, they do inform on their short-term safety and tolerability and will hopefully provide some reassurance and positively inform the benefit-risk and pharmacoeconomic assessment for all three vaccines.Clinicaltrials.govNCT04368065
Evaluation of viral loads in patients with SARS-CoV-2 Delta variant infection: Higher loads do not translate into different testing scenarios
Authors: Gomez Marti Juan Luis , Mays Ashley , McCullough Melissa , Wells Alan , Phan Tung 
Published: October 2021

AbstractThe Delta SARS-CoV-2 variant is very infectious, and it is spreading quickly during this pandemic. In the study, we compared viral loads in surging cases infected with the SARS-CoV-2 Delta variant in the fourth wave of COVID-19 with the three prior waves. The data comprised viral loads from positive cases detected within the UPMC health care system in Allegheny County, Pennsylvania. A total of 2,059 upper airway samples were collected and tested for SARS-CoV-2 positive by RT-PCR during March 2020-September 2021. We did not observe significant difference in viral load difference between the third (December 2020 – January 2021) and fourth (June 2021 – September 2021) waves; however, they had the higher viral load than the first (March 2020 – June 2020) and second waves (June 2020 – August 2020). We did find an age-related effect with the elderly presenting with lower viral loads, which was also seen in the earlier waves. However, the level of viral load in the fourth wave was not sufficient higher to qualitatively change our expected detected rates using various testing modalities.
Second-generation optoacoustic imaging of breast cancer patients
Authors: Kukačka Jan , Metz Stephan , Dehner Christoph , Muckenhuber Alexander , Paul-Yuan Korbinian , Karlas Angelos , Rummeny Ernst , Jüstel Dominik , Ntziachristos Vasilis 
Published: October 2021

AbstractSince the initial breast transillumination almost a century ago, breast cancer imaging using light has been considered in different implementations aiming to improve diagnostics, minimize the number of available biopsies, or monitor treatment. However, due to strong photon scattering, conventional optical imaging yields low resolution images, challenging quantification and interpretation. Optoacoustic imaging addresses the scattering limitation and yields high-resolution visualization of optical contrast, offering great potential value for breast cancer imaging. Nevertheless, the image quality of experimental systems remains limited due to a number of factors, including signal attenuation with depth and partial view angle and motion effects, particularly in multi-wavelength measurements. We developed data analytics methods to improve the accuracy of handheld optoacoustic breast cancer imaging, yielding second-generation optoacoustic imaging performance operating in tandem with ultrasonography. We produced the best images yet with handheld optoacoustic examinations of the human breast and breast cancer, in terms of resolution and contrast. Using these advances, we examined optoacoustic markers of malignancy, including vasculature abnormalities, hypoxia, and inflammation, on images obtained from breast cancer patients. We achieved the best optoacoustic images of the human breast ever obtained using handheld examination, advancing the diagnostic and theranostic potential of the hybrid optoacoustic-ultrasound (OPUS) examination over routine ultrasonography.
Prediction of severe COVID-19 infection at the time of testing: A machine learning approach
Authors: Khoshbakhtian Faraz , Lagman Ardian , Aleman Dionne M. , Giffen Randy , Rahman Proton 
Published: October 2021

AbstractEarly and effective detection of severe infection cases during a pandemic can significantly help patient prognosis and resource allocation. We develop a machine learning framework for detecting severe COVID-19 cases at the time of RT-PCR testing. We retrospectively studied 988 patients from a small Canadian province that tested positive for SARS-CoV-2 where 42 (4%) cases wereat-risk(i.e., resulted in hospitalization, admission to ICU, or death), and 8 (< 1%) cases resulted in death. The limited information available at the time of RT-PCR testing included age, comorbidities, and patients’ reported symptoms, totaling 27 features. Vaccination status was unavailable. Due to the severe class imbalance and small dataset size, we formulated the problem of detecting severe COVID as anomaly detection and applied three models: one-class support vector machine (OCSVM), weight-adjusted XGBoost, and weight-adjusted Ad-aBoost. The OCSVM was the best performing model for detecting the deceased cases with an average 95% true positive rate (TPR) and 27.2% false positive rate (FPR). Meanwhile, the XGBoost provided the best performance for detecting the at-risk cases with an average 96.2% TPR and 19% FPR. In addition, we developed a novel extension to SHAP interpretability to explain the outputs from the models. In agreement with conventional knowledge, we found that comorbidities were influential in predicting severity, however, we also found that symptoms were generally more influential, noting that machine learning combines all available data and is not a single-variate statistical analysis.
Hierarchical Representation of Complex Intervention Sequences for Automated Subgroup Analysis in Critical Care Settings
Authors: Trivedi Amee , Ogallo William , Tadesse Girmaw Abebe 
Published: October 2021

AbstractOur understanding of the impact of interventions in critical care is limited by the lack of techniques that represent and analyze complex intervention spaces applied across heterogeneous patient populations. Existing work has mainly focused on selecting a few interventions and representing them as binary variables, resulting in oversimplification of intervention representation. The goal of this study is to find effective representations of sequential interventions to support intervention effect analysis. To this end, we have developed Hi-RISE (Hierarchical Representation of Intervention Sequences), an approach that transforms and clusters sequential interventions into a latent space, with the resulting clusters used for heterogenous treatment effect analysis. We apply this approach to the MIMIC III dataset and identified intervention clusters and corresponding subpopulations with peculiar odds of 28-day mortality. Our approach may lead to a better understanding of the subgrouplevel effects of sequential interventions and improve targeted intervention planning in critical care settings.
Ab initio phasing macromolecular structures using electron-counted MicroED data
Authors: Martynowycz Michael W. , Clabbers Max T.B. , Hattne Johan , Gonen Tamir 
Published: October 2021

AbstractStructures of two globular proteins were determined ab initio using microcrystal electron diffraction (MicroED) data that was collected on a direct electron detector in counting mode. Microcrystals were identified using a scanning electron microscope (SEM) and thinned with a focused ion-beam (FIB) to produce crystalline lamellae of ideal thickness. Continuous rotation data were collected using an ultra-low exposure rate on a Falcon 4 direct electron detector in electron-counting mode. For the first sample, triclinic lysozyme extending to 0.87 Å resolution, an ideal helical fragment of only three alanine residues provided initial phases. These phases were improved using density modification, allowing the entire atomic structure to be built automatically. A similar approach was successful on a second macromolecular sample, proteinase K, which is much larger and diffracted to a modest 1.5 Å resolution. These results demonstrate that macromolecules can be determined to sub-Ångström resolution by MicroED and that ab initio phasing can be successfully applied to counting data collected on a direct electron detector.
The ESX-1 secretion system senses bacterial contact and prepares mycobacteria for environmental adaptation
Authors: Herrera Nadia , Odermatt Pascal D. , Voorhies Mark , Nakagawa Rachel , Sil Anita , Chang Fred , Rosenberg Oren S. 
Published: October 2021

AbstractThe ESX-1 system (6-kDa early secretory antigenic target (ESAT-6) secretion system-1) is essential for Mycobacterium tuberculosis pathogenesis and conjugal transfer in Mycobacterium smegmatis, yet little is known about how its function is regulated. Live-cell fluorescence microscopy showed natively expressed ESX-1 was organized into distinct foci predominantly observed at cell-cell contacts. These foci formed when two cells touched and required a fully assembled ESX-1 system in both bacteria, suggesting the generation of an ESX-1 megacomplex across multiple membranes. The emergence of ESX-1 foci and ESX-1 secretion was environmentally dependent: foci formed in low nitrogen environments in which secretion was suppressed, yet with increasing concentrations of nitrogen, ESX-1 systems diffused along the plasma membrane and secretion was activated. Genome-wide transcriptional profiling revealed ESX-1 dependent induction of genes required for the SOS response and error prone DNA replication in high nitrogen. Based on these findings, we propose a new model of ESX-1 function where ESX-1 localization and secretion are responsive to nitrogen levels and form an integral node in the mycobacterial response to neighboring cells and environmental adaptation.