bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient actor training improves preexposure prophylaxis delivery for adolescent girls and young women in Kenya: a cluster randomized trial
Authors: Kohler Pamela , Larsen Anna , Abuna Felix , Owiti George , Sila Joseph , Owens Tamara , Kemunto Valarie , Lagat Harrison , Vera Melissa , Richardson Barbra A. , Wilson Kate , Pintye Jillian , John-Stewart Grace , Kinuthia John 
Published: June 2024

Objective:
To evaluate effectiveness of a standardized patient actor (SP) training intervention to improve quality of preexposure prophylaxis (PrEP) services for adolescent girls and young women (AGYW) in Kenya.

Design:
Cluster randomized trial and mystery shopper evaluation.

Methods:
Twelve of 24 maternal child health and family planning facilities were randomized to SP training. Providers at intervention facilities participated in 2-day training in adolescent health, PrEP guidelines, values clarification, and communication skills, followed by role-playing and de-briefing with trained actors. Control facilities received standard national training. The primary outcome was quality of care, assessed by unannounced SPs (USPs) or “mystery shoppers” blinded to intervention arm. Quality was measured in two domains: guideline adherence and communication skills. Intent to treat analysis compared postintervention quality scores by randomization arm, clustering on facility, and adjusting for baseline scores and USP.

Results:
Overall, 232 providers consented to USP visits, and 94 providers completed the training. Following training, USPs posed as AGYW seeking PrEP in 142 encounters (5–6 encounters per site). The mean quality score was 73.6% at intervention sites and 58.4% at control sites [adjusted mean difference = 15.3, 95% confidence interval (CI): 9.4–21.1, P < 0.001]. Mean guideline adherence scores were 57.2% at intervention sites and 36.2% at control sites (adjusted mean difference = 21.0, 95% CI: 12.5–29.4, P < 0.001). Mean communication scores were 90.0% at intervention sites and 80.5% at control sites (adjusted mean difference = 9.5, 95% CI: 5.5–13.6, P < 0.001).

Conclusions:
SP training significantly improved quality of PrEP care for AGYW in Kenya. Incorporating SP training and unannounced SP evaluation could improve PrEP uptake among AGYW.
Weight excess and obesity are associated with binge-eating behaviours in people with HIV
Authors: Mazzitelli Maria , Cozzolino Claudia , Gasparini Gianluca , Chiaro Eleonora , Brazzale Camilla , Mancino Flavia , Mingardo Sara , Sasset Lolita , Leoni Davide , Baldo Vincenzo , Favaro Angela , Cattelan Annamaria 
Published: June 2024

Objective:
Binge eating is a mental health disorder related to weight gain, whose prevalence/correlation with weight excess in people with HIV (PWH) have been scarcely investigated.
Design: A cross-sectional study of PWH who underwent the validated Binge Eating Scale (BES) questionnaire.

Methods:
We included adult PWH during routine visits from October 2022 to February 2023. The BES questionnaire was administered with the support of a psychiatrist (score <17 binge eating very unlikely, binge eating ≥17 possible/very likely). We performed a logistic regression for the binary outcome BES at least 17 and being overweighted/obese as effect measure of risk association, and then adjusted for possible confounders (as integrase inhibitor exposure) and performed a sensitivity analysis fitting the regression model including and excluding depression (which may drive binge eating).

Results:
We included 1204 PWH, 75.2% men, median age 53 years [interquartile range (IQR): 44–60], 95.6% with undetectable HIV-RNA. As for BMI, we had overweight and obesity in 35.1 and 19.4% cases. Considering BES, 1089 (90.4%) PWH had a score less than 17, 115 (9.6%) at least 17. Multivariable analysis showed that obesity [odds ratio (OR) = 6.21, P < 0.0001), overweight (OR = 2.21, P = 0.006) and depression (OR = 1.98, P = 0.028) were significantly associated with high BES score. By excluding depression, our results were confirmed, and obesity/overweight remained significantly associated with binge eating (obesity OR = 6.58, P < 0.0001, overweight OR = 2.17, P = 0.023).

Conclusion:
Binge eating should be considered among possible causes of weight gain in PWH. Our results push towards an in-depth study of this topic for a better understanding of the phenomenon in PWH, possibly identifying subgroups of this population who could benefit from a psychoeducational/psychological intervention to preventing WG.
Free-Breathing High-Resolution, Swap-Free, and Motion-Corrected Water/Fat Separation in Pediatric Abdominal MRI
Authors: Nosrati Reyhaneh , Calakli Fatih , Afacan Onur , Pelkola Kristina , Nichols Reid , Connaughton Pauline , Bedoya M. Alejandra , Tsai Andy , Bixby Sarah , Warfield Simon K. 
Published: June 2024

Objectives
The T1-weighted GRE (gradient recalled echo) sequence with the Dixon technique for water/fat separation is an essential component of abdominal MRI (magnetic resonance imaging), useful in detecting tumors and characterizing hemorrhage/fat content. Unfortunately, the current implementation of this sequence suffers from several problems: (1) low resolution to maintain high pixel bandwidth and minimize chemical shift; (2) image blurring due to respiratory motion; (3) water/fat swapping due to the natural ambiguity between fat and water peaks; and (4) off-resonance fat blurring due to the multipeak nature of the fat spectrum. The goal of this study was to evaluate the image quality of water/fat separation using a high-resolution 3-point Dixon golden angle radial acquisition with retrospective motion compensation and multipeak fat modeling in children undergoing abdominal MRI.

Materials and Methods
Twenty-two pediatric patients (4.2 ± 2.3 years) underwent abdominal MRI on a 3 T scanner with routine abdominal protocol and with a 3-point Dixon radial-VIBE (volumetric interpolated breath-hold examination) sequence. Field maps were calculated using 3D graph-cut optimization followed by fat and water calculation from k-space data by iteratively solving an optimization problem. A 6-peak fat model was used to model chemical shifts in k-space. Residual respiratory motion was corrected through soft-gating by weighting each projection based on the estimated respiratory motion from the center of the k-space. Reconstructed images were reviewed by 3 pediatric radiologists on a PACS (picture archiving and communication systems) workstation. Subjective image quality and water/fat swapping artifact were scored by each pediatric radiologist using a 5-point Likert scale. The VoL (variance of Laplacian) of the reconstructed images was used to objectively quantify image sharpness.

Results
Based on the overall Likert scores, the images generated using the described method were significantly superior to those reconstructed by the conventional 2-point Dixon technique (P < 0.05). Water/fat swapping artifact was observed in 14 of 22 patients using 2-point Dixon, and this artifact was not present when using the proposed method. Image sharpness was significantly improved using the proposed framework.

Conclusions
In smaller patients, a high-quality water/fat separation with sharp visualization of fine details is critical for diagnostic accuracy. High-resolution golden angle radial-VIBE 3-point Dixon acquisition with 6-peak fat model and soft-gated motion correction offers improved image quality at the expense of an additional ~1-minute acquisition time. Thus, this technique offers the potential to replace the conventional 2-point Dixon technique.
Implementation of an Enhanced Recovery After Surgery Protocol for Cleft Palate Repair
Authors: Hopper Samuel J. , Fernstrum Colton J. , Phillips John B. , Sink Matthew C. , Goza Shelby D. , Brown Madyson I. , Brown Kathryn W. , Humphries Laura S. , Hoppe Ian C. 
Published: June 2024

Objective
This study examines an Enhanced Recovery After Surgery (ERAS) protocol for patients with cleft palate and hypothesizes that patients who followed the protocol would have decreased hospital length of stay and decreased narcotic usage than those who did not.

Design
Retrospective cohort study.

Setting
The study takes place at a single tertiary children's hospital.

Patients
All patients who underwent cleft palate repair during a 10-year period (n = 242).

Interventions
All patients underwent cleft palate repair with the most recent cohort following a new ERAS protocol.

Main Outcome Measures
Primary outcomes included hospital length of stay and narcotic usage in the first 24 hours after surgery.

Results
Use of local bupivacaine during surgery was associated with decreased initial 24-hour morphine equivalent usage: 2.25 vs 3.38 mg morphine equivalent (MME) (P < 0.01), and a decreased hospital length of stay: 1.71 days vs 2.27 days (P < 0.01). The highest 24-hour morphine equivalent a patient consumed prior to the ERAS protocol implementation was 24.53 MME, compared with 6.3 MME after implementation. Utilization of the ERAS protocol was found to be associated with a decreased hospital length of stay: 1.67 vs 2.18 days (P < 0.01).

Conclusions
Use of the proposed ERAS protocol may lead to lower narcotic usage and decreased length of stay.
Increased Time Interval of Postoperative Flap Monitoring After Autologous Breast Reconstruction
Authors: Schwartzberg Harel G. , Doran Hannah E. , Bartow Matthew J. , Patterson Charles , Stalder Mark W. , Allen Robert J. , St. Hilaire Hugo 
Published: June 2024

Background
Hourly flap checks are the most common means of flap monitoring during the first 24 hours following autologous breast reconstruction (ABR). This practice often requires intensive care unit (ICU) admission, which is a key driver of health care costs and decreased patient satisfaction. This study addresses these issues by demonstrating decreased cost and length of admission associated with a 4-hour interval between flap checks during the first 24 hours following ABR.

Methods
This is a retrospective review of ABR surgeries performed by multiple surgeons from 2017 to 2020. Two cohorts were identified, one that underwent flap checks every hour in the ICU (Q1 cohort) and the other that underwent flap checks every 4 hours on the hospital floor (Q4 cohort). Our primary outcome measures were length of stay (LOS), flap takebacks, flap loss, and encounter cost.

Results
Rates of flap takeback and loss did not differ between cohorts (P = 0.18, P = 0.21). The Q4 cohort's average LOS was shorter than the Q1 cohort (P = 0.002). The Q4 cohort's average cost was also $25,554.80 less than the Q1 cohort (P < 0.001). This association persisted after controlling for LOS, operating room takeback, timing and laterality of reconstruction, and flap configuration (hazard ratio = 0.65, P = 0.0007).

Conclusion
This study demonstrates the benefits of lengthened flap check intervals during the first 24 hours following ABR. These intervals decrease the cost of ABR while also maintaining safety, making ABR a more accessible option for breast reconstruction patients.
Optimizing Safety and Aesthetics in Facial Feminization: Laryngoscopic-Assisted Chondrolaryngoplasty (2019–2023)
Authors: James Andrew J. , Assi Patrick E. , Torres-Guzman Ricardo A. , Nemani Sriya V. , Saad Mariam , Kalmar Christopher L. , Perdikis Galen , Al Kassis Salam 
Published: June 2024

Introduction:
The thyroid cartilage, an androgen-sensitive structure, enlarges during puberty in individuals assigned male at birth, often resulting in a pronounced neck protuberance. This feature can exacerbate gender dysphoria in transfeminine patients. Chondrolaryngoplasty, commonly known as tracheal shave, is a procedure incorporated into facial feminization surgery (FFS) to address this issue. This study reports on the implementation of an endoscopic-assisted chondrolaryngoplasty technique, its safety, and the outcomes observed.

Methods:
The authors conducted a retrospective review of chondrolaryngoplasty cases at our center, examining patient outcomes and procedural safety. The analysis included a breakdown of concurrent gender-affirming surgeries performed. An endoscopic-guided technique was utilized, and its procedural steps were documented in a video.

Results:
In the past five years, 32 patients received chondrolaryngoplasty at our facility. Postoperative complications were minimal, with no infections, wound separations, or surgical site complications reported. Only one patient experienced temporary hoarseness, which resolved within 6 weeks without intervention. The procedure was frequently combined with other surgical interventions, with the average patient undergoing 3 additional procedures, the most common being augmentation mammaplasty, brow lifting, and frontal bone reduction.

Conclusions:
Tracheal shave is an effective surgical technique for alleviating gender dysphoria in transfeminine patients. Keys to its success include the accurate identification of thyroid cartilage, especially in patients with enlarged cricoid cartilages, intraoperative coordination with anesthesia for laryngoscopic vocal cord visualization, sub-perichondrial cartilage excision to minimize the risk of bleeding and damage near the vocal cords, and carefully layered closure to optimize scar healing.
A Comparison of Automatically Extracted Quantitative EEG Features for Seizure Risk Stratification in Neonatal Encephalopathy
Authors: Keene Jennifer C. , Loe Maren E. , Fulton Talie , Keene Maire , Morrissey Michael J. , Tomko Stuart R. , Vesoulis Zachary A. , Zempel John M. , Ching ShiNung , Guerriero Réjean M. 
Published: June 2024

Purpose:
Seizures occur in up to 40% of neonates with neonatal encephalopathy. Earlier identification of seizures leads to more successful seizure treatment, but is often delayed because of limited availability of continuous EEG monitoring. Clinical variables poorly stratify seizure risk, and EEG use to stratify seizure risk has previously been limited by need for manual review and artifact exclusion. The goal of this study is to compare the utility of automatically extracted quantitative EEG (qEEG) features for seizure risk stratification.

Methods:
We conducted a retrospective analysis of neonates with moderate-to-severe neonatal encephalopathy who underwent therapeutic hypothermia at a single center. The first 24 hours of EEG underwent automated artifact removal and qEEG analysis, comparing qEEG features for seizure risk stratification.

Results:
The study included 150 neonates and compared the 36 (23%) with seizures with those without. Absolute spectral power best stratified seizure risk with area under the curve ranging from 63% to 71%, followed by range EEG lower and upper margin, median and SD of the range EEG lower margin. No features were significantly more predictive in the hour before seizure onset. Clinical examination was not associated with seizure risk.

Conclusions:
Automatically extracted qEEG features were more predictive than clinical examination in stratifying neonatal seizure risk during therapeutic hypothermia. qEEG represents a potential practical bedside tool to individualize intensity and duration of EEG monitoring and decrease time to seizure recognition. Future work is needed to refine and combine qEEG features to improve risk stratification.
Comparing behaviours induced by natural memory retrieval and optogenetic reactivation of an engram ensemble in mice
Authors: Park Sungmo , Ko Sang Yoon , Frankland Paul W. , Josselyn Sheena A. 
Published: June 2024

Memories are thought to be stored within sparse collections of neurons known as engram ensembles. Neurons active during a training episode are allocated to an engram ensemble (‘engram neurons’). Memory retrieval is initiated by external sensory or internal cues present at the time of training reactivating engram neurons. Interestingly, optogenetic reactivation of engram ensemble neurons alone in the absence of external sensory cues is sufficient to induce behaviour consistent with memory retrieval in mice. However, there may exist differences between the behaviours induced by natural retrieval cues or artificial engram reactivation. Here, we compared two defensive behaviours (freezing and the syllable structure of ultrasonic vocalizations, USVs) induced by sensory cues present at training (natural memory retrieval) and optogenetic engram ensemble reactivation (artificial memory retrieval) in a threat conditioning paradigm in the same mice. During natural memory recall, we observed a strong positive correlation between freezing levels and distinct USV syllable features (characterized by an unsupervised algorithm, MUPET (Mouse Ultrasonic Profile ExTraction)). Moreover, we observed strikingly similar behavioural profiles in terms of freezing and USV characteristics between natural memory recall and artificial memory recall in the absence of sensory retrieval cues. Although our analysis focused on two behavioural measures of threat memory (freezing and USV characteristics), these results underscore the similarities between threat memory recall triggered naturally and through optogenetic reactivation of engram ensembles.
This article is part of a discussion meeting issue ‘Long-term potentiation: 50 years on’.
Cortical nitric oxide required for presynaptic long-term potentiation in the insular cortex
Authors: Yamamoto Kiyofumi , Chen Qi-Yu , Zhou Zhaoxiang , Kobayashi Masayuki , Zhuo Min 
Published: June 2024

Nitric oxide (NO) is a key diffusible messenger in the mammalian brain. It has been proposed that NO may diffuse retrogradely into presynaptic terminals, contributing to the induction of hippocampal long-term potentiation (LTP). Here, we present novel evidence that NO is required for kainate receptor (KAR)-dependent presynaptic form of LTP (pre-LTP) in the adult insular cortex (IC). In the IC, we found that inhibition of NO synthase erased the maintenance of pre-LTP, while the induction of pre-LTP required the activation of KAR. Furthermore, NO is essential for pre-LTP induced between two pyramidal cells in the IC using the double patch-clamp recording. These results suggest that NO is required for homosynaptic pre-LTP in the IC. Our results present strong evidence for the critical roles of NO in pre-LTP in the IC.
This article is part of a discussion meeting issue ‘Long-term potentiation: 50 years on’.
A study on viruses and bacteria with particular interest on Mycoplasma pneumoniae in children with exacerbation of asthma from a tertiary care hospital in Sri Lanka
Authors: Wijesooriya Lakmini Inoka , Chalker Victoria , Perera Priyantha , Sunil-Chandra N.P. 
Published: June 2024

Asthma is a significant public health concern, particularly in children with severe symptoms. Exacerbation of asthma (EOA) is life-threatening and respiratory infections (RIs) play a crucial role. Though viruses play a significant role in EOA, patients are empirically treated with antibiotics which contribute to the development of antibiotic resistance. Although there are widely reported association of EOA with viral or M. pneumoniae infections, there are no published data in Sri Lanka. The present study aimed to identify the association of common respiratory viruses, typical respiratory bacterial pathogens, and M. pneumoniae in children with EOA and relate them with the compatibility of antimicrobial use.
A case-control study was conducted in the pediatric unit of North Colombo Teaching Hospital, Sri Lanka, involving two groups of children between 5-15 years of age. Group-1: children with EOA, Group-2: children with stable asthma (SA). Each group consisted of 100 children. Sputum/throat swabs were tested for common respiratory viruses using virus specific FITC-labelled monoclonal antibodies (MAbs), bacteria by routine culture and M. pneumoniae by RT-PCR. Macrolide-resistance in M. pneumoniae was detected using conventional PCR and sequencing specific genetic mutations in the 23S rRNA gene. M. pneumoniae was genotyped using nested multilocus sequence typing (MLST), which targeted eight housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC, adk).
There was no significant difference in age, gender, demographic or geographical locations between the two groups. In children with EOA, antibiotics were used in 66% (66/100) and macrolides in 42% (42/100) in children with EOA. Samples consisted of 78% (78/100) sputum and 22% (22/100) throat swabs. Adenovirus was the most common virus identified, and it was significantly higher in children with EOA compared to those with SA, but no significant difference in typical bacteria findings between the two groups. M. pneumoniae was detected in one patient with EOA, with none detected in the SA group. The M. pneumoniae was macrolide sensitive, and it was ST14 by Multi Locus Sequence Typing. This study showed that the empiric use of antibiotics in children with asthma may be better targeted with prior pathogen screening to inform appropriate treatment to minimize antibiotic resistance.
TORC1 reactivation by pheromone signaling revealed by phosphoproteomics of fission yeast sexual reproduction
Authors: Bérard Melvin , Merlini Laura , Martin Sophie G 
Published: June 2024

AbstractStarvation, which is associated with inactivation of the growth-promoting TOR complex 1 (TORC1), is a strong environmental signal for cell differentiation. In the fission yeastSchizosaccharomyces pombe, nitrogen starvation has distinct physiological consequences depending on the presence of mating partners. In their absence, cells enter quiescence, and TORC1 inactivation prolongs their life. In presence of compatible mates, TORC1 inactivation is essential for sexual differentiation. Gametes engage in paracrine pheromone signaling, grow towards each other, fuse to form the diploid zygote, and form resistant, haploid spore progenies. To understand the signaling changes in the proteome and phospho-proteome during sexual reproduction, we developed cell synchronization strategies and present (phospho-)proteomic datasets that dissect pheromone from starvation signals over the sexual differentiation and cell-cell fusion processes. Unexpectedly, these datasets reveal phosphorylation of ribosomal protein S6 during sexual development, which we establish requires TORC1 activity. We demonstrate that TORC1 is re-activated by pheromone signaling, in a manner that does not require autophagy. Mutants with low TORC1 re-activation exhibit compromised mating and poorly viable spores. Thus, while inactivated to initiate the mating process, TORC1 is reactivated by pheromone signaling in starved cells to support sexual reproduction.