bluuebunny/crossref_metadata_2025_split huggingface dataset:
Partner-based HIV treatment for seroconcordant couples attending antenatal and postnatal care in rural Mozambique: A cluster randomized controlled trial
Authors: Audet Carolyn M. , Graves Erin , Shepherd Bryan E. , Prigmore Heather L. , Brooks Hannah L. , Emílio Almiro , Matino Ariano , Paulo Paula , Diemer Matthew A. , Frisby Michael , Sack Daniel E. , Aboobacar Arifo , Barreto Ezequiel , Van Rompaey Sara , De Schacht Caroline 
Published: April 2024

Introduction:
There is evidence that a supportive male partner facilitates maternal HIV testing during pregnancy, increases maternal ART initiation and adherence, and increases HIV-free infant survival. Most male partner engagement clinical strategies have focused on increasing uptake of couple-based HIV testing and counseling. We delivered a couple-based care and treatment intervention to improve of ART adherence in expectant couples living with HIV.

Methods:
We implemented a cluster randomized controlled trial for seroconcordant couples living with HIV, comparing retention (patient’s medication possession ratio) in HIV care for a couple-based care and treatment intervention versus standard of care services in rural Mozambique. The intervention included couple-based treatment, couple-based education and skills building, and couple-peer educator support.

Results:
We recruited 1080 couples to participate in the study. Using a linear mixed effect model with a random effect for clinic, the intervention had no impact on the medication possession ratio among women at 12 months. However, the intervention increased men’s medication ratio by 8.77%. Our unadjusted logistic regression model found the odds of an infant seroconverting in the intervention group was 30% less than in the control group, but the results were not statistically significant.

Discussion:
Our intervention resulted in no difference in maternal outcomes, but improved medication possession ratio among male partners. We provide a community/clinic-based treatment framework that can improve outcomes among male partners. Further work needs to be done to improve social support for pregnant women and to facilitate prevention of vertical transmission to infants among couples living with HIV.
Development of a Better Nomogram for Prediction of Preoperative Microvascular Invasion and Postoperative Prognosis in Hepatocellular Carcinoma Patients: A Comparison Study
Authors: Pei Jinxia , Wang Longsheng , Li Huan 
Published: April 2024

Objective
Personalized precision medicine can be facilitated by clinically available preoperative microvascular invasion (MVI) prediction models that are reliable and postoperative MVI pathological grade-related recurrence prediction models that are accurate. In this study, we aimed to compare different mathematical models to derive the best preoperative prediction and postoperative recurrence prediction models for MVI.

Methods
A total of 143 patients with hepatocellular carcinoma (HCC) whose clinical, laboratory, imaging, and pathological data were available were included in the analysis. Logistic regression, Cox proportional hazards regression, LASSO regression with 10-fold cross-validation, stepwise regression, and random forest methods were used for variable screening and predictive modeling. The accuracy and validity of seven preoperative MVI prediction models and five postoperative recurrence prediction models were compared in terms of C-index, net reclassification improvement, and integrated discrimination improvement.

Results
Multivariate logistic regression analysis revealed that a preoperative nomogram model with the variables cirrhosis diagnosis, alpha-fetoprotein > 400, and diameter, shape, and number of lesions can predict MVI in patients with HCC reliably. Postoperatively, a nomogram model with MVI grade, number of lesions, capsule involvement status, macrovascular invasion, and shape as the variables was selected after LASSO regression and 10-fold cross-validation analysis to accurately predict the prognosis for different MVI grades. The number and shape of the lesions were the most common predictors of MVI preoperatively and recurrence postoperatively.

Conclusions
Our study identified the best statistical approach for the prediction of preoperative MVI as well as postoperative recurrence in patients with HCC based on clinical, imaging, and laboratory tests results. This could expedite preoperative treatment decisions and facilitate postoperative management.
Keeping Up With ChatGPT
Authors: Rogasch Julian M.M. , Jochens Hans V. , Metzger Giulia , Wetz Christoph , Kaufmann Jonas , Furth Christian , Amthauer Holger , Schatka Imke 
Published: April 2024

Purpose
The latest iteration of GPT4 (generative pretrained transformer) is a large multimodal model that can integrate both text and image input, but its performance with medical images has not been systematically evaluated. We studied whether ChatGPT with GPT-4V(ision) can recognize images from common nuclear medicine examinations and interpret them.

Patients and Methods
Fifteen representative images (scintigraphy, 11; PET, 4) were submitted to ChatGPT with GPT-4V(ision), both in its Default and “Advanced Data Analysis (beta)” version. ChatGPT was asked to name the type of examination and tracer, explain the findings and whether there are abnormalities. ChatGPT should also mark anatomical structures or pathological findings. The appropriateness of the responses was rated by 3 nuclear medicine physicians.

Results
The Default version identified the examination and the tracer correctly in the majority of the 15 cases (60% or 53%) and gave an “appropriate” description of the findings or abnormalities in 47% or 33% of cases, respectively. The Default version cannot manipulate images. “Advanced Data Analysis (beta)” failed in all tasks in >90% of cases. A “major” or “incompatible” inconsistency between 3 trials of the same prompt was observed in 73% (Default version) or 87% of cases (“Advanced Data Analysis (beta)” version).

Conclusions
Although GPT-4V(ision) demonstrates preliminary capabilities in analyzing nuclear medicine images, it exhibits significant limitations, particularly in its reliability (ie, correctness, predictability, and consistency).
PROACTIVE SCREENING ALGORITHM FOR EARLY-ONSET PNEUMONIA IN PATIENTS WITH OUT-OF-HOSPITAL CARDIAC ARREST: A BEFORE-AFTER IMPLEMENTATION STUDY
Authors: Lemée Pauline , Chapalain Xavier , Bailly Pierre , Sparrow Rosemary L. , Jean-Michel Vanessa , Prat Gwenael , Renault Anne , Tonnelier Jean-Marie , Aubron Cécile 
Published: April 2024

ABSTRACT

Introduction: Early-onset pneumonia (EOP) occurs in around 50% of critically ill patients with out-of-hospital cardiac arrest (OHCA) and is associated with increased morbidity. Prompt diagnosis of EOP in these patients is difficult because of targeted temperature management and the postcardiac arrest syndrome. We hypothesized that an algorithm for proactive screening of EOP would improve patient outcomes. Methods: We conducted a single-center observational study comparing the outcomes of mechanically ventilated adult patients with OHCA, before (study period 1) and after (study period 2) implementation of an algorithm for proactive diagnosis of EOP, including an early distal pulmonary specimen. An inverse probability treatment weighted multivariable regression was performed to identify independent parameters associated with duration of mechanical ventilation. A subgroup analysis was conducted in patients alive on day 5 after intensive care unit admission. Results: Over the 4-year study period, 190 patients (99 and 91 for study periods 1 and 2, respectively) were enrolled. The overall incidence of EOP was 57.4% and was similar between both study periods. Although there was no difference in the time interval to antibiotic initiation, study period 2 was independently associated with higher SpO2/FiO2 ratios on days 3 and 4. We also observed a decrease in mechanical ventilation time in study period 2 (4.5 [1–11.3] vs. 3 [2–5.8] days; P = 0.07), and this reached statistical significance in the subgroup analysis of patients alive at day 5 (10 [5–17] vs. 5 [3–9] days, P = 0.01). Conclusion: In critically ill patients with OHCA, proactive diagnosis of EOP was not associated with a significant change in the time to antibiotic initiation. Further research is warranted to better define optimal diagnosis and management of EOP in this setting.
BONE MARROW MESENCHYMAL STROMAL CELL-DERIVED EXOSOMAL NRF2 AMELIORATES CEREBRAL ISCHEMIA-REPERFUSION INJURY BY TRANSCRIPTIONALLY ACTIVATING LIN28A
Authors: Liu Dongwen , Song Chunyan , Lv Cuiling , Zhang Aihua 
Published: April 2024

ABSTRACT

Background: Cerebral ischemia-reperfusion (I/R) injury (CIRI) have severe consequences on brain function, and the exciting evidence has revealed protective role of acyl-CoA synthetase long chain family member 4 (Lin28a) against cerebral ischemia-reperfusion injury. The present work aims to reveal its molecular mechanism in regulating CIRI, with the hope of providing a therapeutic method for cerebral I/R injury. We hypothesized that the exosomal nuclear factor erythroid 2-related factor 2 (NRF2) derived from bone marrow mesenchymal stromal cells could transcriptionally activate Lin28a and thereby alleviate cerebral ischemia-reperfusion injury. This hypothesis was validated in the present work. Methods: Middle cerebral artery occlusion (MCAO) model was established using C57BL/6J mice, and the neurological deficit, infarct volume, and brain water content were assessed to evaluate neuron injury. Human glioblastoma cells (A172) were subjected to oxygen-glucose deprivation and reoxygenation (OGD/R) treatment to mimic a cerebral I/R injury cell model. Exosome isolation reagent was used to isolate exosomes from cell supernatant of bone marrow mesenchymal stromal cells through sequential centrifugation and filtration steps. mRNA expression level of Lin28a was detected by quantitative real-time polymerase chain reaction. Protein expression was analyzed by western blotting assay. TUNEL cell apoptosis detection kit was used to analyze cell apoptosis in brain tissues. Enzyme-linked immunosorbent assays and commercial kits were used to detect levels of inflammatory markers and oxidative stress markers. Ferrous Iron Colorimetric Assay Kit and Fe2+ colorimetric assay kit were used to analyze Fe2+ level. The association of Lin28a and NRF2 was identified by chromatin immunoprecipitation assay and dual-luciferase reporter assay. Results: The treatment of MCAO substantially augmented infarct volume in mice, impaired neurological function, and elevated brain water content. Lin28a was lowly expressed in brain tissues of mice with CIRI, and its overexpression protected against cerebral I/R injury of MCAO mice. Moreover, Lin28a overexpression protected A172 cells against OGD/R treatment-induced injury. Additionally, NRF2 transcriptionally activated Lin28a in A172 cells. Bone marrow mesenchymal stromal cell-derived exosomes increased Lin28a expression in a NRF2-dependent manner. Bone marrow mesenchymal stromal cell-derived exosomal NRF2 improved OGD/R-induced A172 cell injury by inducing Lin28a production. Conclusion: Bone marrow mesenchymal stromal cell-derived exosomal NRF2 improved CIRI by transcriptionally activating Lin28a.
NOVEL ECHOCARDIOGRAM ANALYSIS OF CARDIAC DYSFUNCTION IS ASSOCIATED WITH MORTALITY IN PEDIATRIC SEPSIS
Authors: Cater Daniel T. , Meyers Brett A. , Mitra Shailee , Bhattacharya Sayantan , Machado Roberto F. , Serrano Ryan , Rowan Courtney M. , Gaston Benjamin , Vlachos Pavlos 
Published: April 2024

ABSTRACT

Objectives: The objective of our study was to semiautomatically generate echocardiogram indices in pediatric sepsis using novel algorithms and determine which indices were associated with mortality. We hypothesized that strain and diastolic indices would be most associated with mortality. Design: Retrospective cohort study of children with sepsis from 2017 to 2022. Survivors and nonsurvivors were compared for echocardiogram indices. Multivariate Cox proportional hazard models were constructed for our primary outcome of in-hospital mortality. Linear regression was performed for secondary outcomes, which included multiple composite 28-day outcomes. Results: Of the 54 patients in the study, 9 (17%) died. Multiple echocardiogram indices of both right (RV) and left ventricles (LV) were associated with in-hospital mortality [RV GLS adjusted hazard ratio (aHR): 1.16 (1.03–1.29), P = 0.011; RV global longitudinal early diastolic strain rate (GLSre) aHR: 0.24 (0.07 to 0.75), P = 0.014; LV GLSre aHR: 0.33 (0.11–0.97), P = 0.044]. Impairment in GLS was associated with fewer ventilator-free days [RV GLS β-coefficient: −0.47 (−0.84 to −0.10), P = 0.013; LV GLS β-coefficient −0.62 (−1.07 to −0.17), P = 0.008], organ-support free days [RV GLS β-coefficient: −0.49 (−0.87 to −0.11), P = 0.013; LV GLS β-coefficient: −0.64 (−1.10 to −0.17), P = 0.008], and days free from ICU [RV GLS β-coefficient: −0.42 (−0.79 to −0.05), P = 0.026; LV GLS β-coefficient: −0.58 (−1.03 to −0.13), P = 0.012]. Systolic indices were not associated with mortality in this cohort. Conclusion: Our study demonstrates the feasibility of obtaining echocardiogram indices in a semiautomatic method using our algorithms. We showed that abnormal strain is associated with worse outcomes in a cohort of children with sepsis.
VASOPRESSOR REDUCTION EFFECT OF POLYMYXIN B HEMOPERFUSION IN PATIENTS WITH PERITONITIS-INDUCED SEPTIC SHOCK: A PROPENSITY SCORE-MATCHED ANALYSIS
Authors: Cho Ara , Oh Seung-Young , Lee Hannah , Ryu Ho Geol 
Published: April 2024

ABSTRACT

Background: This study aimed to evaluate the effect of polymyxin B hemoperfusion (PMX-HP) in patients with peritonitis-induced septic shock who still required high-dose vasopressors after surgical source control. Methods: This retrospective study included adult patients admitted to the surgical intensive care unit (ICU) at Seoul National University Hospital between July 2014 and February 2021 who underwent major abdominal surgery to control the source of sepsis. Patients were divided into two groups based on whether PMX-HP was applied after surgery or not. The primary and secondary endpoints were the vasopressor reduction effect, and in-ICU mortality, respectively. Propensity score matching was performed to compare the vasopressor reduction effect. Results: A total of 338 patients met the inclusion criteria, of which 23 patients underwent PMX-HP postoperatively, whereas 315 patients did not during the study period. Serum norepinephrine concentration decreased over time regardless of whether PMX-HP was applied. However, it decreased more rapidly in the PMX-HP(+) group than in the PMX-HP(−) group. There were no significant differences in demographics including age, sex, body mass index, and most underlying comorbidities between the two groups. Risk factors for in-ICU mortality were identified by comparing patient characteristics and perioperative factors between the two groups using multivariate analysis. Conclusion: For patients with peritonitis-induced septic shock, PMX-HP rapidly reduces the requirement of vasopressors immediately after surgery but does not reduce in-ICU mortality. This effect could potentially accelerate recovery from shock, reduce sequelae from vasopressors, and ultimately improve quality of life after discharge.
Safety of Non-invasive Brain Stimulation in Patients with Implants: A Computational Study
Authors: Karimi Fariba , Cassarà Antonino M. , Capstick Myles , Kuster Niels , Neufeld Esra 
Published: April 2024

AbstractObjectiveNon-invasive brain stimulation (NIBS) methodologies, such as transcranial electric (tES) and magnetic stimulation are increasingly employed for therapeutic, diagnostic, or research purposes. The concurrent presence of active or passive implants can pose safety risks, affect the NIBS delivery, or generate confounding signals. A systematic investigation is required to understand the interaction mechanisms, quantify exposure, assess safety, and establish guidance for NIBS applications.ApproachWe used measurements, simplified generic, and detailed anatomical modeling to: (i) systematically analyze exposure conditions with passive and active implants, considering local field enhancement, exposure dosimetry, tissue heating and neuromodulation, capacitive lead current injection, low-impedance pathways between electrode contacts, and insulation damage; (ii) identify safety metrics and efficient prediction strategies; (iii) quantify these metrics in relevant exposure cases and (iv) identify worst case conditions. Various aspects including implant design, positioning, scar tissue formation, anisotropy, and frequency were investigated.ResultsAt typical tES frequencies, local enhancement of dosimetric exposure quantities can reach up to one order of magnitude for DBS and SEEG implants (more for elongated passive implants), potentially resulting in unwanted neuromodulation that can confound results but is still 2-3 orders of magnitude lower than active DBS. Under worst-case conditions, capacitive current injection in the lead of active implants can produce local exposures of similar magnitude as the passive field enhancement, while capacitive pathways between contacts are negligible. Above 10 kHz, applied current magnitudes increase, necessitating consideration of tissue heating. Furthermore, capacitive effects become more prominent, leading to current injection that can reach DBS-like levels. Adverse effects from abandoned/damaged leads in direct electrode vicinity cannot be excluded.SignificanceSafety related concerns of tES application in the presence of implants are systematically identified and explored, resulting in specific and quantitative guidance and establishing a basis for safety standards. Furthermore, several methods for reducing risks are suggested.
Defect-Engineered Metal-Organic Frameworks as Nanocarriers for Pharmacotherapy: Insights into Intracellular Dynamics at The Single Particle Level
Authors: Huang Ge , Dreisler Marcus Winther , Kæstel-Hansen Jacob , Nielsen Annette Juma , Zhang Min , Hatzakis Nikos S. 
Published: April 2024

AbstractNanoMOFs are widely implemented in a host of assays involving drug delivery, biosensing catalysis, and bioimaging. Despite their wide use, the cell entry pathways and cell fate remain poorly understood. Here we have synthesized a new fluorescent nanoMOF integrating ATTO 655 into surface defects of colloidal nano UiO-66 that allowed us to track the spatiotemporal localization of Single nanoMOF in live cells. Density Functional Theory(DFT) reveals the stronger binding of ATTO 655 to the uncoordinated saturated Zr6cluster nodes compared with phosphate and Alendronate Sodium (AL). Parallelized tracking of the spatiotemporal localization of tens of thousands of nanoMOFs and analysis using machine learning platforms revealed whether nanoMOFs remain outside as well as their cellular internalization pathways. To quantitatively assess their colocalization with endo/lysosomal compartments, we developed a colocalization proxy approach relying on the nanoMOF detection of particles in one channel to the signal in the corresponding endo/lysosomal compartments channel, considering signal vs local background intensity ratio (S/B) and signal-to-noise ratio (SNR). This strategy effectively mitigates the potential inflation of colocalization values arising from the heightened expression of signals originating from endo/lysosomal compartments, it also overcomes limitations of low SNRs in the endo/lysosomal compartments marker channel, which incapacitates any trajectory-trajectory colocalization assessment. The results accurately measure the amount of nanoMOFs’ colocalization in real-time from early (EE) to late endosomes(LE) and lysosomes(LY) and emphasize the importance of understanding their intracellular dynamics based on single-particle tracking (SPT) for optimal and safe drug delivery.
A morphing map model for place field organization in large environments
Authors: Naim Michelangelo , Khona Mikail , Cueva Christopher J. 
Published: April 2024

AbstractNavigation and spatial memory, essential for animal survival, are founded on the hippocampal formation’s ability to host spatial neurons marking an animal’s position. Within controlled settings, the place cells of the hippocampus are activated in specific regions, the ‘place fields’. In this paper, we introduce a “morphing map algorithm” based on bat data from a 200-meter tunnel, highlighting a multifield, multiscale spatial representation of place fields. This algorithm posits that in vast environments, bats opt to select landmarks or ‘anchors’ for spatial representation. The method introduces a hyperbolic geometry in spatial representation, aligning with bat data from vast areas. We apply Procrustes distance to evaluate similarities between neural maps of bats and model-generated maps, revealing shared structure across bat maps, which might be dictated by common anchor points. Further explorations into anchor point ablation provide insights into their crucial role in map stability. The results present an evolved neural navigation strategy in expansive habitats and guide future spatial representation research across species.
An aortic hemodynamic fingerprint reduced order modeling analysis reveals traits associated with vascular disease in a medical biobank
Authors: Sokolow Ryan , Kissas Georgios , Beeche Cameron , Swago Sophia , Thompson Elizabeth W. , Viswanadha Mukund , Chirinos Julio , Damrauer Scott , Perdakaris Paris , Rader Daniel J. , Witschey Walter R. 
Published: April 2024

AbstractPurposeTo determine the clinical relevance of reduced order model (ROM) aortic hemodynamic imaging-derived phenotypes (IDPs) for a range of flow conditions applied to computed tomography (CT) scan data in the Penn Medicine Biobank (PMBB).MethodsThe human thoracic aorta was automatically segmented in 3,204 chest CT scans from patients in the Penn Medicine Biobank (PMBB) patients using deep learning. Thoracic aorta anatomic IDPs such as aortic diameter and length were computed. Resistance, and flow boundary conditions, were varied, resulting in 125,000 ROM simulations, producing a fingerprint of aortic hemodynamics IDPs for a range of flow conditions. To determine the clinical relevance of the aortic hemodynamic fingerprint, untargeted phenome wide association studies (PheWAS) for disease conditions were performed using aortic geometries and pulse pressure as IDPs.ResultsBy utilizing patient metadata from the PMBB, the human aortic radius for different age groups over a normalized radius was visualized, showing how the vessel deforms with age, as well as other characteristic geometric information. The average radius of the ascending thoracic aortic data set was 26.6 ± 3.1 mm, with an average length of 310 ± 37 mm. A combination of pathology codes (phecodes) and hemodynamic simulations were utilized to develop a relationship between them, showing a strong relationship between the resulting pulse pressure and diseases relating to aortic aneurysms and heart valve disorders. The average pulse pressure calculated by the model was 22.5 ± 8.5 mmHg, with the maximum pressure modeled by the system being 201 mmHg, with the minimum being 63.6 mmHg. The pulse pressures of the most significant phecodes were examined for patients with and without the condition, showing a slight separation between the two cases. The pulse pressure was also slightly negatively correlated with the calculated tapering angle of the ascending thoracic aorta.ConclusionsROM hemodynamic simulations can be applied to aortic imaging traits from thoracic imaging data in a medical biobank. The derived hemodynamic fingerprint, describing the response of the aorta to a range of flow conditions, shows clinically relevant associations with disease.