bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser Photocoagulation Treatment for Candida Chorioretinitis
Authors: Su Robin C. , Mehra Ankur , Chiang Tsun-Kang , Seraly Mark , Kurup Shree 
Published: September 2024

Purpose:
The purpose of this article is to describe the novel surgical technique utilizing laser photocoagulation for the management of Candida chorioretinal lesions that are refractory to medical therapy.

Methods:
This report presents the use of laser photocoagulation applied to a Candida chorioretinal lesion that was refractory to extensive systemic and intravitreal antifungal medications. The presenting lesion was in an immunosuppressed patient. Argon laser photocoagulation was applied onto and surrounding the Candida chorioretinal lesion.

Results:
Following laser photocoagulation, the Candida chorioretinal lesion has remained resolved for over one year with no further reactivation, extensions, or satellites.

Conclusion:

Candida chorioretinitis can be extremely therapeutically resistant. Current treatment involves systemic and intravitreal antifungals. There are currently limited options for chorioretinal lesions refractory to standard medical therapy. The authors report the novel application of laser photocoagulation as a potential treatment option in refractory cases of Candida chorioretinitis.
COVID-Related Visitor Restrictions and Childbirth Experiences in One US Hospital
Authors: Sciarratta Payton , Rondini Kelsey , Barry Ghislaine , Dube Nandi , Seddon Isabella , Katial John , Mirabal-Beltran Roxanne 
Published: September 2024

Objective:
The objective of this study was to explore childbirth experiences during COVID-19 visitor restrictions.

Methods:
We used a descriptive phenomenological approach in our study, which took place in a postpartum unit at a level IV birthing hospital in the Mideastern United States, where 3617 births occurred in 2019.

Results:
A total of 22 participants who were older than 18 years, who gave birth at 37 weeks gestation or more, and who had at least 1 birth experience in the United States prior to the COVID-19 pandemic participated in this study. We assessed participants’ birth experiences before and during COVID-19 visitor restrictions through in-depth interviews. Participant perspectives revealed the following 6 themes after an iterative analysis: A Shared Personal Connection is a Valued Trait, A Female Support Person is Important, Nurses Went the Extra Mile, Support People Help with Decision-Making, Two is an Ideal Number of Support People, and Increased Psychological Burden.

Discussion:
These findings are vital to inform hospital visitor policies moving forward in the endemic reality of COVID-19 pandemic.
A Staff Educational Intervention to Increase the Time of Skin-to-Skin Care in a Swedish NICU
Authors: Nyholm Annika , Thernström Blomqvist Ylva , Risberg Rebecca , Örnberg Hanna , van den Berg Johannes 
Published: September 2024

Background:
Skin-to-skin contact (SSC) is crucial in neonatal intensive care unit (NICU) care; yet, challenges exist in its implementation. This study addresses a knowledge gap by examining the most effective ways to introduce SSC in the NICU, emphasizing the need to seamlessly integrate this practice for optimal infant and parent care. One way, among many, to implement SSC is to increase staff's knowledge and awareness about SSC.

Objective:
To describe the effect of an educational intervention on SSC time, the number of SSC sessions per day, and the number of infants cared for with SSC within their first day of life.

Methods:
A pre- and postinterventional study design was used to determine the effect of an educational intervention on SSC time, the number of SSC sessions per day, and the number of infants cared for with SSC within their first day of life.

Results:
The prevalence of infants receiving SSC during their first 24 hours of life, the number of SSC sessions per day, and the duration of each SSC session increased after the intervention, and these effects persisted over 2 years.

Implications for Practice:
Our study highlights the impact of staff education and reflective discussions on SSC in the NICU. Integrating these with practical training, parental education, and NICU environment modifications is pivotal for enhancing and sustaining optimal SSC practices, benefiting both infants and parents.
Temporal trends in the treatment and outcome of nonagenarians with acute coronary syndrome
Authors: Losin Ilya , Giladi Ela , Arow Ziad , Hilu Ranin , Ovdat Tal , Assali Abid , Pereg David 
Published: September 2024

Background
Nonagenarians are a fast-growing age group among acute coronary syndrome (ACS) patients. While new therapeutic options have improved outcomes of ACS patients, data regarding very elderly ACS patients are limited. We aimed to evaluate temporal trends in the treatment and outcomes of nonagenarian ACS patients.

Methods
Included were ACS patients aged below 90 years enrolled in ACS Israeli Survey. Patients were divided into two groups according to enrolment period: early (2000–2010) and recent (2012–2021). The primary endpoints were 30-day major adverse cardiovascular events and all-cause mortality. Secondary outcomes included in-hospital and 1-year all-cause mortality.

Results
Included were 316 elderly ACS patients. Of them, 184 were enrolled in the early and 132 in recent surveys. Patients enrolled in the recent period were more commonly referred for an invasive strategy and more commonly received guideline-based medical therapy. All-cause mortality at 30 days was significantly lower in the recent group compared with the early group (12.5 and 26.1%, respectively, P = 0.005). Rates of 30-day major adverse cardiovascular events were also significantly lower in the recent group (21.9 and 35.9%, respectively, P = 0.012). Patients in the recent group received more aggressive medical therapy in discharge but at 30-day follow-up, no difference in medical treatment was observed in the two groups. There were no significant differences in 1-year mortality rates.

Conclusions
Treatment of nonagenarians with ACS has improved over the past decade. Treatment improvement was associated with a significant improvement in 30-day outcomes without any effect in 1 year. Nevertheless, even with contemporary treatment, nonagenarians with ACS remain a high-risk group with high mortality rates.
Diagnostic performance of simultaneous PET-MR versus PET-CT in oncology with an overview on clinical utility and referral pattern of PET-MR: a single institutional study
Authors: Palaniswamy Shanmuga Sundaram , Subramanyam Padma 
Published: September 2024

Background
PET-Magnetic Resonance (PET-MR) imaging is an upcoming investigative modality with a few installations in Asia and only three in India. PET-Computed Tomography (PET-CT) is an established diagnostic cornerstone for oncological indications but with limited resolution for small lesions due to low soft-tissue contrast and additional radiation exposure.

Objective
Our primary objective was to evaluate the diagnostic performance of simultaneous PET-MR and PET-CT in lesion detection in oncological practice. Secondly to assess the referral pattern and study the clinical utility of PET-MR in a university hospital practice.

Materials and methods
A total of 100 consecutive biopsy-proven cancer patients (breast or lung malignancy with suspected metastases) underwent 18F Fluorodeoxyglucose (FDG) PET-MR and PET-CT for staging as a single injection, double examination protocol. Morphological lesion detection on correlative imaging/histopathology was used as the gold standard. Analysing the referral pattern, a total of 9366 patients underwent simultaneous PET-MR imaging for various indications in the past 5 years since installation.

Results

18F FDG PET-MR detected 100% of primary tumours in breast/lung carcinoma patients while PET-CT was positive in 96%. Overall accuracy of nodal metastases detection for PET-MR and PET-CT was 96 and 88%, while for distant metastases the accuracy was 100 and 93%, respectively. FDG PET-MR proved more sensitive and specific than PET-CT for regional nodal (P = 0.011 and P < 0.001) and distant metastases detection (P = 0.017 and P < 0.001, respectively). Analysing the general referral pattern for PET-MR, the majority were oncology referrals when compared to nononcological indications (66.5, 33.5%). About 66.24% were FDG based, followed by 68Ga Prostate-Specific Membrane Antigen (PSMA) and dodecane tetraacetic acid (DOTA). The general utility of PET-MR was found incremental in better delineation of small lesions especially in head, neck, liver, brain and gynaecological malignancies.

Conclusion
In our past 5 years of PET-MR practice, we found that simultaneous PET-MR is a highly recommended ideal imaging technique for oncological and nononcological indications. It has excellent diagnostic performance with high sensitivity, specificity and accuracy when compared to PET-CT in primary tumour, nodal and distant metastases (TNM) staging in specific subgroup of breast and lung malignancy patients.
Detection of Antiretroviral Drug-Resistant Mutations and HIV-1 Subtypes in Circulation Among Men Who Have Sex With Men, SEM Females, and Female Sex Workers: Results of Vietnam's HIV Sentinel Surveillance Plus System, 2018–2020
Authors: Ngo Hanh Hong Thi , Pham Tram Phuong Thi , Hoang Ha Thanh Thi , Bui Duc Hoang , Phan Huong Thu Thi , Nguyen Quoc Cuong , Duong Thanh Cong , Bui Hien Thu , Nguyen Ha Thanh Thi , Le Mai Quynh Thi , Dang Anh Duc , McFarland Willi , Truong Hong-Ha M. , Pham Thang Hong 
Published: September 2024

Background:
HIV drug resistance can reduce the effectiveness of antiretroviral drugs in preventing morbidity and mortality, limit options for treatment, and prevention. Our study aimed to assess HIV-1 subtypes and HIV drug resistance among key populations in HIV Sentinel Surveillance Plus Behavior in 2018 and 2020.

Methods:
One-stage venue-based cluster sampling was used to recruit participants at hotspots identified for men who have sex with men (MSM) in 7 provinces and sexual minority females and female sex workers (FSW) in 13 provinces. Participants completed a standard questionnaire about risk and preventive behaviors, and antiretroviral therapy history, and provided intravenous blood for HIV testing. HIV drug resistance testing was conducted on HIV-positive samples with viral load >1000 copies/mL.

Results:
A total of 185 of 435 (42.5%) HIV-positive samples had viral load ≥1000 copies/mL, of which 130 of 136 from MSM and 26 of 49 from FSW were successfully sequenced. Six HIV-1 subtypes were detected (CRF01_AE, A, CRF07/08_BC, B, C, CRF25_cpx), with CRF01_AE (82.7%, 129/156) the most common. Drug resistance mutations were detected in 16.7% of participants overall (26/156), in 15.4% (20/130) of MSM, and in 23.1% (6/26) of FSW. Mutations associated with resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI) were the most frequently detected (73.1%, 19/26). The high level of resistance was presented in NNRTI and nucleoside reverse transcriptase inhibitors classes. There are 10 major resistance mutations detected with nucleoside reverse transcriptase inhibitors (M184VI-25.0%, K65KR-50.0%, Y115F-25%), NNRTI (K103N-21.1%, E138A-10.5%, V106M-5.3%, K101E-5.3%, G190A-5.3%), protease inhibitors (L33F-40.0%, M46L-20.0%).

Conclusions:
Vietnam's HIV Sentinel Surveillance Plus system identified an emerging strain of HIV-1 and mutations associated with resistance to multiple drug classes among MSM and FSW.
Potential Utility of SPECT/CT for Early Detection of Scapular Stress Reaction Following Reverse Total Shoulder Arthroplasty
Authors: Cho Chul-Hyun , Kim Du-Han , Won Kyoung Sook 
Published: September 2024

Abstract
Scapular stress fracture (SSF) after reverse total shoulder arthroplasty is a unique and common complication that may have negative impact for long-term outcomes. Scapular stress reaction (SSR), characterized by pain and tenderness without radiographic evidence of fracture, can be precursor of SSF. We believe that early detection using SPECT/CT with proper management for SSRs including acromion, scapular spine, and coracoid process is crucial for better prognosis without additional complications by preventing SSFs. Therefore, we present 3 typical cases with SSR following reverse total shoulder arthroplasty with the findings of SPECT/CT.
Impact of Social Vulnerability, Race, and Urbanicity on Early Nutritional Outcomes in Patients With Cleft Palate
Authors: Edwards Shelley R. , Elver Ashlie A. , Frederick Keeley B. , Humphries Laura S. , Hoppe Ian C. 
Published: September 2024

Patients with cleft palate experience early feeding difficulties, resulting in increased hospital utilization due to poor nutritional status. Sociodemographic factors may impact access and outcomes for cleft patients. This study investigates the association of social vulnerability, race, and urbanicity on birth encounter metrics and failure to thrive (FTT) rates for patients with cleft palate. Retrospective data from 2013 to 2023 was queried from Cosmos, a national deidentified database from Epic electronic health record. Birth metrics, the prevalence of FTT, and MyChart activation rates were compared across sociodemographic cohorts based on (1) social vulnerability index (SVI) quartiles, (2) patient race, and (3) USDA Rural-Urban Commuting Area (RUCA) codes using χ2 or Fisher exact tests. There were 92,437 patients diagnosed with cleft palate. Birth weight was lower in socially vulnerable and Black patients (SVI 75%: 101.50±1.57 oz; SVI 25%: 106.40±1.85 oz; Black: 95.3±2.63 oz; White: 104.90±1.02 oz; Other: 104.80±2.09 oz), and length of stay was longer (SVI 75%: 21±2.39 d; SVI 25%: 15±2.18 d; Black: 22±4 d). FTT related admissions increased with SVI quartile (Q25: 0.19%; Q25–50; 0.29%, Q50–75: 0.34%; Q75: 0.47%; P<0.001). An opposite trend was observed for MyChart activation rates (P<0.001). High SVI and Black patients are susceptible to unfavorable nutritional outcomes. Access disparities, such as direct-to-provider communication systems (ie, MyChart), may contribute. Awareness of social identities, geography, and community may assist in providing individualized care in early life.
Early Electrophysiology in Suspected Acute Guillain–Barré Syndrome: A Prospective Study of Comprehensive Testing
Authors: Winkel Antony , Sanders Lauren , Seiderer Linda , Cook Mark , Roberts Leslie 
Published: September 2024

Purpose:
Electrophysiologic changes in early Guillain–Barré Syndrome (GBS) can be nondiagnostic. Improved testing paradigms may improve hyperacute treatment.

Methods:
This work prospectively evaluated consecutive patients admitted to a metropolitan teaching hospital in Melbourne, Australia, with suspected acute GBS. We performed extensive neurophysiology at three different time points. Novel tests, including cutaneous silent periods, long latency reflexes, and contraction-induced H reflexes, were assessed.

Results:
Twenty-three participants were studied, including 13 cases of acute GBS. In total, 69% of acute cases of GBS were accurately diagnosed on the first nerve conduction study using published neurophysiologic criteria, with serial studies rarely altering the GBS subtype classification. Antidromic and orthodromic upper limb sensory studies were diagnostically equivalent. A sural sparing pattern was seen in 77% of cases of GBS at the first test. Long latency reflexes and contraction-induced H reflexes testing were abnormal in most participants but were limited by muscle weakness in some. Cutaneous silent periods testing was unobtainable in approximately 50% of cases because of weakness and did not discriminate from mimic disorders.

Conclusions:
Abnormalities of long latency reflexes and contraction-induced H reflexes may be helpful where initial electrophysiology is nondiagnostic but are nonspecific. Cutaneous silent periods testing seems of limited value. Comprehensive testing provides diagnostic certainty in most cases of GBS from the very first study.
Universal Receptive System as a novel regulator of transcriptomic activity ofStaphylococcus aureus
Authors: Tetz George , Kardava Kristina , Vecherkovskaya Maria , Khodadadi-Jamayran Alireza , Tsirigos Aristotelis , Tetz Victor 
Published: September 2024

AbstractOur previous studies revealed the existence of a Universal Receptive System that regulates interactions between cells and their environment. This system is composed of DNA- and RNA-based Teazeled receptors (TezRs) found on the surface of prokaryotic and eukaryotic cells, as well as integrases and recombinases.. In the current study, we aimed to provide further insight into the regulatory role of TezR and its loss inStaphylococcus aureusgene transcription. To this end, transcriptomic analysis ofS. aureusMSSA VT209 was performed following the destruction of TezRs. Bacterial RNA samples were extracted from nuclease-treated and untreatedS. aureusMSSA VT209. After destruction of the DNA-based-, RNA-, or combined DNA- and RNA-based TezRs ofS. aureus, 103, 150, and 93 genes were significantly differently expressed, respectively. The analysis revealed differential clustering of gene expression following the loss of different TezRs, highlighting individual cellular responses following the loss of DNA- and RNA-based TezRs. KEGG pathway gene enrichment analysis revealed that the most upregulated pathways following TezR inactivation included those related to energy metabolism, cell wall metabolism, and secretion systems. Some of the genetic pathways were related to the inhibition of biofilm formation and increased antibiotic resistance, and we confirmed this at the phenotypic level usingin vitrostudies. The results of this study add another line of evidence that the Universal Receptive System plays an important role in cell regulation, including cell responses to the environmental factors of clinically important pathogens, and that nucleic acid-based TezRs are functionally active parts of the extrabiome.
RNA-DCGen: Dual Constrained RNA Sequence Generation with LLM-Attack
Authors: Shahgir Haz Sameen , Ratul Md. Rownok Zahan , Tahmid Md Toki , Sayeed Khondker Salman , Rahman Atif 
Published: September 2024

AbstractDesigning RNA sequences with specific properties is critical for developing personalized medications and therapeutics. While recent diffusion and flow-matching-based generative models have made strides in conditional sequence design, they face two key limitations: specialization for fixed constraint types, such as tertiary structures, and lack of flexibility in imposing additional conditions beyond the primary property of interest. To address these challenges, we introduce RNA-DCGen, a generalized framework for RNA sequence generation that is adaptable to any structural or functional properties through straightforward finetuning with an RNA language model (RNA-LM). Additionally, RNA-DCGen can enforce conditions on the generated sequences by fixing specific conserved regions. On RNA generation conditioned on RNA distance maps, RNA-DCGen generates sequences with an averageR2score of 0.625 compared to random sequences that score only 0.118 over 250 generations as judged by a separate more capable RNA-LM. When conditioned on RNA secondary structures, RNA-DCGen achieves an average F1 score of 0.4 against a random baseline of 0.006.
Genetic analysis of the X-linked AdrenoleukodystrophyABCD1 geneinDrosophilauncovers a role in Peroxisomal dynamics
Authors: Manor Joshua , Jangam Sharayu V , Chung Hyung-lok , Bhagwat Pranjali , Andrews Jonathan , Chester Hillary , Kondo Shu , Srivastav Saurabh , Botas Juan , Moser Ann B. , Huguenin Suzette M. , Wangler Michael F 
Published: September 2024

ABSTRACTX-linked adrenoleukodystrophy (X-ALD) is a progressive neurodegenerative disorder caused by a loss-of-function (LOF) mutation in theATP-binding cassette subfamily D member 1(ABCD1)gene, leading to the accumulation of very long-chain fatty acids (VLCFAs). This disorder exhibits striking heterogeneity; some male patients develop an early childhood neuroinflammatory demyelination disorder, while other patients, including adult males and most affected female carriers, experience a chronic progressive myelopathy. Adrenocortical failure is observed in almost all male patients, with age of onset varying sometimes being the first diagnostic finding. The gene underlying this spectrum of disease encodes an ATP-binding cassette (ABC) transporter that localizes to peroxisomes and facilitates VLCFA transport. X-ALD is considered a single peroxisomal component defect and does not play a direct role in peroxisome assembly.Drosophilamodels of other peroxisomal genes have provided mechanistic insight into some of the neurodegenerative mechanisms with reduced lifespan, retinal degeneration, and VLCFA accumulation. Here, we perform a genetic analysis of the fly ABCD1 orthologAbcd1(CG2316). Knockdown or deficiency ofAbcd1leads to VLCFA accumulation, salivary gland defects, locomotor impairment and retinal lipid abnormalities. Interestingly, there is also evidence of reduced peroxisomal numbers. Flies overexpressing the human cDNA forABCD1display a wing crumpling phenotype characteristic of thepex2loss-of-function. Surprisingly, overexpression of humanABCD1appears to inhibit or overwhelm peroxisomal biogenesis to levels similar to null mutations in flypex2,pex16andpex3.Drosophila Abcd1is therefore implicated in peroxisomal number, and overexpression of the humanABCD1gene acts a potent inhibitor of peroxisomal biogenesis in flies.
Normative trajectories of extra-axial cerebrospinal fluid during childhood and adolescence defined in a clinically-acquired MRI dataset
Authors: Mandal Ayan S. , Dorfschmidt Lena , Schabdach Jenna M. , Gardner Margaret , Yerys Benjamin E. , Bethlehem Richard A. I. , Sotardi Susan , Katherine Henry M. , Wood Joanne N. , Chaiyachati Barbara H. , Alexander-Bloch Aaron , Seidlitz Jakob 
Published: September 2024

BackgroundExtra-axial cerebrospinal fluid (eaCSF) refers to the CSF in the subarachnoid spaces that surrounds the brain parenchyma. Benign enlargement of the subarachnoid space (BESS), a condition marked by increased eaCSF thickness, has been associated with macrocephaly and may be associated with subdural collections. However, diagnosis of BESS is complicated by the lack of age-specific normative data which hinders rigorous investigation of its clinical associations. Growth charts of eaCSF could shed light on normal CSF dynamics while also providing a normative benchmark to assist the diagnosis of BESS and other associated conditions.MethodsWe accessed clinically-acquired T1w MRI scans from 1226 pediatric patients to form a clinical control cohort. Nine scans from subjects with a diagnosis of BESS from a board-certified pediatric neuroradiologist were also reviewed. SynthSeg was used to segment each T1w scan into various tissue types, including eaCSF. Growth charts of eaCSF were modeled using the clinical control cohort. The confirmed BESS cases were then benchmarked against these charts to test the performance of eaCSF growth charts.ResultseaCSF thickness varied nonlinearly with age, steadily decreasing from birth to two years, then trending upwards in early adolescence. Seven of the nine patients with a clinical diagnosis of BESS were above the 97.5thpercentile for their age for at least one eaCSF measure. Centile scores were able to distinguish BESS cases from controls with an area under curve (AUC) greater than 0.95.DiscussioneaCSF thickness evolves in a dynamic pattern throughout childhood and adolescence. Patients with BESS can be differentiated from clinical controls using computational measurements of eaCSF thickness paired with normative modeling. Our findings demonstrate the feasibility of computational extraction of eaCSF with a potential point of clinical relevance, delineation of BESS diagnosis. Enhanced understanding of normative eaCSF is critical in further investigations its clinical associations.