bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progress in Eliminating Perinatal HIV Transmission in the Metropolitan DC Area Between 2018-2022
Authors: Unternaher Justin , Koay Wei Li A. , Mareuil Joanna , Williams Tierra , Rakhmanina Natella 
Published: May 2024

Background:
The number of perinatal HIV cases have continued to decline since the United States achieved the goal of perinatal HIV elimination in 2019. We aimed to evaluate dynamics in perinatal HIV transmission in the metropolitan District of Columbia (DC) area during 2018–2022.

Setting:
Children's National Hospital's (CNH) is a major referral site for the metropolitan DC area, including suburban Maryland and Virginia, and evaluates >95% of HIV-exposed infants (HEI) in the region.

Methods:
A retrospective cohort study of mother–infant pairs with perinatal HIV exposure seen at CNH during 2018–2022. We describe the demographics, intrapartum/postpartum management, and outcomes among mothers and HEI.

Results:
We analyzed 503 HEI; most (78.9%) were at low risk for perinatal HIV. Most mothers were African or African American (87.1%) and had HIV RNA <50 copies/mL around delivery (78.1%). The proportion of HEI at high risk for perinatal HIV decreased from 28.2% to 15.5% in 2018 and 2020, respectively, but increased to 24.8% in 2022. Most HEI received postnatal antiretroviral drugs for at least 4 weeks (95.3%). Seventy-nine infants (15.7%) were born to mothers diagnosed with HIV during pregnancy. Two infants (0.4%) were diagnosed with perinatally acquired HIV.

Conclusions:
We report high rates of antiretroviral drugs use among mother–infant pairs and a low rate of perinatal HIV transmission in metropolitan DC. Despite a 1.8-fold decrease in the number of high-risk perinatal HIV exposures since 2018, this rate rebounded in 2022. There remain opportunities to optimize maternal care and reduce the number of high-risk HEI.
Brief Report: Interest in Long-acting Injectable PrEP Among Transgender Women in Eastern and Southern United States
Authors: Cooney Erin E. , Reisner Sari L. , Poteat Tonia C. , Althoff Keri N. , Radix Asa , Stevenson Meg , Wawrzyniak Andrew J. , Cannon Christopher , Schneider Jason S. , Mayer Kenneth H. , Beyrer Chris , Brown Carolyn A. , Vannappagari Vani , de Ruiter Annemiek , Ragone Leigh , Wirtz Andrea L. 
Published: May 2024

Background:
Among communities with elevated HIV burden, increased uptake of PrEP, including long-acting injectable (LAI) PrEP, could lower HIV incidence. Lack of data on LAI PrEP interest among transgender women in the United States has limited scientific understanding of the potential impact of LAI PrEP on new infections within transgender communities. Our objective was to determine the percent of transgender women interested in LAI PrEP and identify correlates of interest.

Methods:
Transgender women enrolled in the LITE Cohort who completed 12-month surveys between March 2019 and September 2021 were asked about interest in using LAI PrEP. Prevalence ratios (PR) estimated with modified Poisson regression models were assessed for predictors of interest in LAI PrEP.

Results:
Among 867 participants, 15% were current users of oral PrEP and 11% were former oral PrEP users. In total, 47% reported interest in LAI PrEP. Interest in LAI PrEP was more common among participants who were Black (PR: 1.28; 95% CI: 1.05 to 1.55), college-educated (PR: 1.28; 95% CI: 1.04 to 1.57), food insecure (PR: 1.19; 95% CI: 1.00 to 1.41), and had PrEP indications (PR: 1.44; 95% CI: 1.21 to 1.71). LAI PrEP interest was also more common among adherent users of oral PrEP and those who had discontinued oral PrEP, compared with PrEP-naïve participants.

Conclusions:
Interest in LAI PrEP among transgender women varied by demographic and clinical characteristics. Increased interest in LAI PrEP among Black transgender women, those with PrEP indications, and those who had previously discontinued oral PrEP underscores the need to increase LAI PrEP access for transgender women who are interested.
Detecting Amyloid Goiter With 99mTc-PYP SPECT/CT in the Setting of Ankylosing Spondylitis
Authors: Denizmen Dilara , Salmaslioglu Artur , Bakkaloglu Dogu Vuralli , Simsek Duygu Has , Sanli Yasemin 
Published: May 2024

Abstract
We present a case with systemic amyloidosis secondary to ankylosing spondylitis (AA amyloidosis), whose 99mTc PYP scintigraphy revealed amyloid deposition in the thyroid gland (amyloid goiter). Amyloidosis is characterized by extracellular accumulation of amyloid fibril proteins leading to organ malfunction. Even though AA amyloidosis can be observed in patients with systemic inflammatory diseases, it is a very rare complication in ankylosing spondylitis. SPECT/CT images showed diffuse tracer uptake in enlarged thyroid gland containing fat density areas.
New Approaches for Robot-Assisted Neck Surgery: Clavicular and Submental Approaches Using the da Vinci SP System
Authors: Virós Porcuna David , Suen Ka Hei , Stein Hubert , Pollán Guisasola Carlos 
Published: May 2024

Background:
Minimally invasive robot-assisted thyroid surgery or neck dissection can improve cosmetic results and reduce surgical trauma. Several approaches have been described but each has both advantages and limitations. We aimed to determine the feasibility of performing robot-assisted neck surgery using the da Vinci SP system.

Methods:
The clavicular approach using the da Vinci SP system was done in 1 cadaveric model. Lateral neck dissection was carried out with parapharyngeal space dissection, lateral thyroid gland exposure, and anatomical references. The submental approach was performed in the same cadaveric model. Total thyroidectomy plus lateral neck dissection was performed.

Results:
The required 2.5-cm skin incision, minimal flap development to insert the SP Access Port plus docking was done in 5 minutes for each procedure. The neck dissection by clavicular access took 77 minutes, the parapharyngeal dissection 60 minutes, and hemi-thyroidectomy 30 minutes. The neck dissection by submental access took 60 minutes and the total thyroidectomy took 45 minutes.

Conclusion:
We have demonstrated the feasibility of single-incision clavicular and submental approaches in neck surgery using the da Vinci SP system. The amount of skin flap dissection was minimal, the system docking was rapid, and no additional ports or retractors were required. Further studies on patients are warranted.
Quantifying Patient Risk Threshold in Managing Pancreatic Intraductal Papillary Mucinous Neoplasms
Authors: Kaslow Sarah R. , Sharma Acacia R. , Hewitt D. Brock , Bridges John F.P. , Javed Ammar A. , Wolfgang Christopher L. , Braithwaite Scott , Sacks Greg D. 
Published: May 2024

Objective:
We aimed to better understand patients’ treatment preferences and quantify the level of cancer risk at which treatment preferences change (risk threshold) to inform better counseling of patients with intraductal papillary mucinous neoplasms (IPMNs).

Summary Background Data:
The complexity of IPMN management provides an opportunity to align treatment with individual preference.

Methods:
We surveyed a sample of healthy volunteers simulating a common scenario: undergoing an imaging study that incidentally identifies an IPMN. In the scenario, the estimated risk of cancer in the IPMN was 5%. Patients were asked their treatment preference (surgery or surveillance), to quantify the level of cancer risk in the IPMN at which their treatment preference would change (i.e. risk threshold), and their level of cancer anxiety as measured on a 5-point Likert scale. We examined associations between participant characteristics, treatment preferences, and risk threshold using multivariable linear regression.

Results:
The median risk threshold among the 520 participants was 25% (IQR 2.3-50%). The risk threshold had a bimodal distribution: 40% of participants had a risk threshold between 0-10% and 47% had a risk threshold above 30%. When informed that the risk of cancer was 5%, 62% of participants (n=323) preferred surveillance, and the remaining 38% (n=197) preferred surgery. After adjusting for potential confounders, participants who expressed “worry” or “extreme worry” about the malignancy risk of IPMN had significantly lower risk thresholds than participants who were “not at all worried” (Coefficient -12, 95%CI -21 to -2, P=0.015 and Coefficient -18, 95%CI -29 to -8, P<0.001, respectively).

Conclusions:
Participants varied in treatment preference and risk threshold of incidentally identified IPMNs. Given the uncertainty in estimating the true malignant potential of IPMNs, a better understanding of a patient’s risk threshold, as influenced by patient concern about malignancy, will help inform the shared decision-making process.
What Is the Optimal Strategy for Pouch Salvage at Time of Redo Ileal-Pouch Anal Anastomosis? Pouch Repair with Reanastomosis vs Pouch Excision with Neopouch
Authors: Uchino Tairin , Maspero Marianna , Alipouriani Ali , Hernandez Dominguez Oscar , Holubar Stefan D , Gorgun Emre , Steele Scott R , Hull Tracy L 
Published: May 2024

BACKGROUND:
The long-term risk of pouch failure after restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) range from 5% to 15%. Salvage surgery for failing IPAA may be achieved by disconnecting the IPAA and either repairing and reusing the existing pouch (REP) or constructing a neopouch (NEO). We aimed to evaluate whether there are differences in long-term functional pouch survival and functional outcomes between the REP group and the NEO group. We hypothesized that patients undergoing REP have higher long-term pouch survival rates compared with patients who require NEO pouch construction.

STUDY DESIGN:
Our prospectively maintained Pouch Registry was queried for patients who underwent a pouch salvage surgery with either pouch REP or NEO from 1988 to 2020. Patients who underwent pouch repair without disconnection from the anus were excluded. The primary endpoint was long-term pouch survival after redo pouch surgery. Secondary outcomes were patient-reported quality of life and pouch function.

RESULTS:
Of 653 patients undergoing redo IPAA, 462 met inclusion criteria of transabdominal redo surgery with pouch reconnection: 243 (52.6%) had REP and 219 (47.4%) had NEO. Median age was 39 years and 59% were women. Median time between index and redo IPAA was 34 months for REP vs 54 months for NEO (p = 0.002). The 5-year pouch survival after redo IPAA was similar between REP (79.5%) and NEO (76.8%) groups (p = 0.4). Fewer patients in the REP group reported nighttime pad use (51.4% vs 68.2%, p = 0.04).

CONCLUSIONS:
Pouch survival and functional outcomes after salvage surgery for failing ileoanal pouch was similar regardless of pouch salvage procedure. When performing redo pouch surgery, surgeons should not hesitate to construct a new pouch if indicated.
Dual-mode action of scalable, high-quality engineered stem cell-derived SIRPα-extracellular vesicles for treating acute liver failure
Authors: Kim Seohyun , Kim Yoon Kyoung , Kim Seonghyun , Choi Yong-Soon , Lee Inkyu , Joo Hyemin , Kim Jaehyun , Kwon Minjeong , Park Seryoung , Jo Min Kyoung , Choi Yoonjeong , D’Souza Theresa , Jung Jae Woong , Zakhem Elie , Lenzini Stephen , Woo Jiwan , Choi Hongyoon , Park Jeongbin , Park Seung-Yoon , Kim Gi Beom , Nam Gi-Hoon , Kim In-San 
Published: May 2024

AbstractAcute liver failure (ALF) is a critical inflammatory condition characterized by rapid hepatocyte death, impaired liver regeneration due to the delayed removal of necroptotic cells, and high mortality rates. This study introduces a novel dual-mode action therapeutic approach using extracellular vesicles expressing Signal Regulatory Protein Alpha (SIRP-EVs) derived from genetically engineered mesenchymal stem cells (MSCs). These SIRP-EVs are designed to concurrently resolve necroptosis and promote liver regeneration. Our studies identified CD47 and SIRPα as promising therapeutic targets for ALF. We developed a scalable 3D bioreactor-based process that produces high-purity SIRP-EVs, which preserve MSC properties and achieve significant production levels. SIRP-EVs target both macrophages and necroptotic hepatocytes in ALF models, enhancing macrophage phagocytic activity against necroptotic cells via CD47 blockade and promoting liver regeneration by reprogramming macrophages with MSC-derived cargo. Comprehensivein vitroandin vivostudies demonstrate that SIRP-EVs decrease CD47+necroptotic cells and promote liver regeneration in ALF models, leading to reduced liver damage markers and enhanced survival rates. These findings highlight the potential of SIRP-EVs as a dual-mode action therapeutic for ALF, offering promising prospects for their application in other inflammatory diseases. Moreover, these results pave the way for advancing engineered EV-based therapies toward clinical implementation.
Perforin-mediated pore formation at the lytic synapse triggers the canonical pyroptotic cell death pathway
Authors: McKenzie Brienne , Puissegur Marie-Pierre , Demeersseman Lucie , Rodriguez Frecia , Cini Emma , Bernand Agathe , Müller Sabina , Valitutti Salvatore 
Published: May 2024

ABSTRACTProkaryotic pore-forming toxins drive inflammasome activation and pyroptosis through K+- dependent activation of the canonical NLRP3/caspase-1/gasdermin D signaling axis. In this study, we hypothesized that perforin, a eukaryotic pore-forming protein released into the lytic synapse by antigen-specific cytotoxic T lymphocytes (CTLs)upon cognate antigen recognition, mimics the pro-pyroptotic activity of ancestral pore-forming toxins, complementing its role as a conduit for granzymes. Utilizing imaging and molecular approaches, we demonstrate that perforation of target cells upon CTL attack elicits swift K+efflux followed by NLRP3-dependent activation of proinflammatory caspase-1 and its major substrate, the pyroptotic executioner gasdermin D (GSDMD). Acute target cell death upon CTL attack is gasdermin-dependent and demonstrates morphological and molecular features of pyroptosis, including pyroptotic body formation, cell bloating, plasma membrane rupture, and release of intracellular contents; by contrast, sustained interaction with CTLs unmasks a delayed apoptotic phenotype in the remaining target cells. Perforation of target cells by soluble perforin is sufficient to trigger rapid K+efflux, caspase-1 activation, and pyroptosis. Our results reveal a novel mechanism for engagement of pyroptotic machinery upon CTL attack, in which perforin itself can autonomously engage programmed cell death (PCD), highlighting the complexity and diversity of the CTL lytic arsenal.
Attachment-related anxiety and social anxiety: the mediating role of self-esteem
Authors: Lincoln Jacob , Tip Liesbeth Muriel , Garcia Sofia De La Fuente 
Published: May 2024

AbstractNumerous studies have found an association between attachment-related anxiety and social anxiety. However, none have investigated the potential role of the internal working model of the self in explaining this relationship. The purposes of this study were to replicate the finding that attachment-related anxiety and social anxiety are associated, and to test whether the internal working model of the self mediated this relationship. The internal working model of the self was operationalised by measuring self-esteem. It was hypothesised that attachment-related anxiety, self-esteem, and social anxiety would be intercorrelated, and that self-esteem would mediate the relationship between attachment-related anxiety and social anxiety. A sample of 63 adults (79.4% female) was recruited through social media, University course groups, and snowball sampling. Participants completed an online survey that consisted of a reduced version of the anxiety subscale of the Experiences in Close Relationships-Revised Scale, the Rosenberg Self-Esteem Scale, and the Social Interaction Anxiety Scale. Ethical approval was given by the University of Edinburgh School of Health in Social Science Research Ethics Committee. Pearson correlation tests showed that attachment-related anxiety, self-esteem, and social anxiety were intercorrelated. A mediation analysis conducted using thePROCESSv4.0 macro for SPSS, found that the indirect effect of attachment-related anxiety on social anxiety through self-esteem was significant. This finding is congruent with a theoretical account linking attachment-related anxiety to social anxiety through the mediating role of the internal working model of the self.
A multilevel modeling of factors on Sulfadoine-Pyrimethanie uptake in Cameroon: Evidence from national cross-sectional survey
Authors: Baatiema Linus , Naawa Ambrose , Tampah-Naah Anthony M. , Ninnoni Jerry P. K , Alatinga Kennedy A. , Zankawah Mukaila Mumuni , Sufuyan Gladys , Koray Munawar Harun 
Published: May 2024

AbstractIntroductionPregnant women worldwide face significant risks from malaria, which can adversely affect both mother and baby. To combat malaria in Cameroon, the WHO, in 2004, recommended a strategy including intermittent preventive treatment during pregnancy (IPTp) using sulfadoxine-pyrimethamine (SP), insecticide-treated nets (ITNs), and proper management for clinical malaria and anaemia. This study explores the prevalence and predictors of IPTp-SP uptake across individual, community, and regional levels in Cameroon.Material and MethodWe utilized data from the 2018 Cameroon Demographic and Health Survey (CDHS) to analyze IPTp-SP uptake employing three-level multi-level models to capture individual, community, and regional influences. Responses from 4,823 women were analyzed, with results presented in 95% credible intervals.ResultsWomen aged 35-39 were more likely to receive at least 3 doses of IPTp-SP during their last pregnancies compared to those aged 45-49 (aOR=1.92, 95% Crl=1.08-3.41). Women without formal education were less likely to have optimal IPTp-SP uptake (aOR=0.81, 95% Crl=0.70-0.92) compared to those with higher education. The wealthiest women and those attending at least eight ANC visits had higher odds of optimal IPTp-SP uptake (aOR=1.47, 95% Crl=1.20-2.09 and aOR=1.97, 95% Crl=1.25-3.12, respectively). Additionally, those with health insurance, urban residents, and moderately disadvantaged communities showed increased uptake (aOR=1.70, 95% Crl=1.46-1.94, aOR=2.15, 95% Crl=1.89-3.08, and aOR=1.84, 95% Crl=1.63-2.13, respectively).ConclusionsCommunity-level factors such as urban residence, female-headed households, and residence in the least disadvantaged communities were also linked to higher IPTp-SP uptake. Optimal uptake of IPTp-SP was more evident in the least disadvantaged regions. The findings of this study should guide the Cameroonian Ministry of Health and other stakeholders in developing targeted interventions to enhance the uptake of IPTp-SP in Cameroon.
Maternal and neonatal IgG againstKlebsiella pneumoniaeare associated with broad protection from neonatal sepsis: a case-control study of hospitalized neonates in Botswana
Authors: Zhang Siqi Linsey , McGann Carolyn M. , Duranova Tereza , Strysko Jonathan , Steenhoff Andrew P. , Gezmu Alemayehu , Nakstad Britt , Arscott-Mills Tonya , Bayani One , Moorad Banno , Tlhako Nametso , Richard-Greenblatt Melissa , Planet Paul J. , Coffin Susan E. , Silverman Michael A. 
Published: May 2024

ABSTRACTSepsis is the leading postnatal cause of neonatal mortality worldwide. GloballyKlebsiella pneumoniaeis the leading cause of sepsis in hospitalized neonates. This study reports development and evaluation of ELISA for anti-KlebsiellaIgG using dried blood spot samples and evaluates the association of anti-KlebsiellaIgG (anti-Kleb IgG) antibodies in maternal and neonatal samples and the risk of neonatal sepsis. Neonates and their mothers were enrolled at 0-96 hours of life in the neonatal unit of a tertiary referral hospital in Gaborone, Botswana and followed until death or discharge to assess for episodes of blood culture-confirmed neonatal sepsis. Neonates with sepsis had significantly lower levels ofKleb-IgG compared to neonates who did not develop sepsis (Mann-Whitney U, p=0.012). Similarly, samples from mothers of neonates who developed sepsis tended to have lessKleb-IgG compared to mothers of controls (p=0.06). The inverse correlation betweenKleb-IgGlevels and all-cause bacteremia suggests that maternalKleb-IgG is broadly protective through cross-reactivity with common bacterial epitopes. These data support the continued use of immunoglobulin assays using DBS samples to explore the role of passive immunity on neonatal sepsis risk and reaffirm the critical need for research supporting the development of maternal vaccines for neonatal sepsis.
Developmental maturation of millimeter-scale functional networks across brain areas
Authors: Powell Nathaniel J. , Hein Bettina , Kong Deyue , Elpelt Jonas , Mulholland Haleigh N. , Kaschube Matthias , Smith Gordon B. 
Published: May 2024

AbstractInteracting with the environment to process sensory information, generate perceptions, and shape behavior engages neural networks in brain areas with highly varied representations, ranging from unimodal sensory cortices to higher-order association areas. Recent work suggests a much greater degree of commonality across areas, with distributed and modular networks present in both sensory and non-sensory areas during early development. However, it is currently unknown whether this initially common modular structure undergoes an equally common developmental trajectory, or whether such a modular functional organization persists in some areas—such as primary visual cortex—but not others. Here we examine the development of network organization across diverse cortical regions in ferrets of both sexes usingin vivowidefield calcium imaging of spontaneous activity. We find that all regions examined, including both primary sensory cortices (visual, auditory, and somatosensory—V1, A1, and S1, respectively) and higher order association areas (prefrontal and posterior parietal cortices) exhibit a largely similar pattern of changes over an approximately 3 week developmental period spanning eye opening and the transition to predominantly externally-driven sensory activity. We find that both a modular functional organization and millimeter-scale correlated networks remain present across all cortical areas examined. These networks weakened over development in most cortical areas, but strengthened in V1. Overall, the conserved maintenance of modular organization across different cortical areas suggests a common pathway of network refinement, and suggests that a modular organization—known to encode functional representations in visual areas—may be similarly engaged in highly diverse brain areas.SignificanceDifferent areas of the mature brain encode vastly different representations of the world. This study shows that a modular functional organization where nearby neurons participate in similar functional networks is shared across different brain areas not only during early development, but also as the brain matures where it remains a shared feature that shapes neural activity. The largely conserved trajectory of developmental changes across brain areas suggests that similar circuit mechanisms may drive this maturation. This implies that the large literature on developing cortical circuits, which is largely focused on sensory areas, may also apply more broadly, and that perturbations during development that impinge on any such shared mechanisms may produce deficits that extend across multiple brain systems.