bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of Racial-Ethnic Inequities in COVID-19 Healthcare and Willingness to Receive the COVID-19 Vaccine
Authors: Sherchan Juliana S. , Fernandez Jessica R. , Njoku Anuli , Brown Tyson H. , Forde Allana T. 
Published: April 2024

Background:
Perceptions of the US healthcare system can impact individuals’ healthcare utilization, including vaccination intentions. This study examined the association between perceived racial–ethnic inequities in COVID-19 healthcare and willingness to receive the COVID-19 vaccine.

Methods:
This study used data from REACH-US, a nationally representative online survey of a large, diverse sample of U.S. adults (N=5145 January 26, 2021-March 3, 2021). Confirmatory factor and regression analyses examined a latent factor of perceived racial–ethnic inequities in COVID-19 healthcare, whether the factor was associated with willingness to receive the COVID-19 vaccine, and whether associations varied across racial–ethnic groups reported as probit estimates (B) and 95% confidence intervals (CIs).

Results:
Perceived racial–ethnic inequities in COVID-19 healthcare were highest among Black/African American adults (mean latent factor score: 0.65 ± 0.43) and lowest among White adults (mean latent factor score: 0.04 ± 0.67). Black/African American (B = −0.08; 95% CI = −0.19, 0.03) and Native Hawaiian/Pacific Islander (B = −0.08; 95% CI = −0.23, 0.07) adults who perceived greater racial–ethnic inequities in COVID-19 healthcare were less willing than participants who perceived lower inequities. In contrast, American Indian/Alaska Native (B = 0.15; 95% CI = −0.01, 0.30), Asian (B = 0.20; 95% CI = 0.08, 0.31), Hispanic/Latino (English language preference) (B = 0.22; 95% CI = 0.01, 0.43), Multiracial (B = 0.23; 95% CI = 0.09, 0.36), and White (B = 0.31; 95% CI = 0.19, 0.43) adults who perceived greater racial–ethnic inequities in COVID-19 healthcare were more willing to receive the COVID-19 vaccine than participants perceiving higher inequities.

Conclusions:
Greater perceived racial–ethnic inequities in COVID-19 healthcare were associated with less willingness to receive the COVID-19 vaccine among Black/African American and Native Hawaiian/Pacific Islander adults.
Society and Nuclear Energy: What Is the Role for Radiological Protection?
Authors: Allison Wade 
Published: April 2024

Abstract
The harm that society expects from ionizing radiation does not match experience. Evidently there is some basic error in this assumption. A reconsideration based on scientific principles shows how simple misunderstandings have exaggerated dangers. The consequences for society are far-reaching. The immediate impact of ionizing radiation on living tissue is destructive. However, this oxidative damage is similar to that produced during normal metabolic activity where the subsequent biological reaction is not only protective but also stimulates enhanced protection. This adaptation means that the response to oxidative damage depends on past experience. Similarly, social reaction to a radiological accident depends on the regulations and attitudes generated by the perception of previous instances. These shape whether nuclear technology and ionizing radiation are viewed as beneficial or as matters to avoid. Evidence of the spurious damage to society caused by such persistent fear in the second half of the 20th century suggests that these laws and attitudes should be rebased on evidence. The three stages of radiological impact—the initial physical damage, the subsequent biological response, and the personal and social reaction—call on quite different logic and understanding. When these are confused, they lead to regulations and public policy decisions that are often inept, dangerous, and expensive. One example is when the mathematical rigor of physics, appropriate to the immediate impact, is misapplied to the adaptive behavior of biology. Another, the tortured historical reputation of nuclear technology, is misinterpreted as justifying a radiological protection policy of extreme caution.
Specialized education and closed groups of experts tend to lock in interdisciplinary misperceptions. In the case of nuclear technology, the resulting lack of independent political confidence endangers the adoption of nuclear power as the replacement for fossil fuels. In the long term, nuclear energy is the only viable source of large-scale primary energy, but this requires a re-working of public understanding.
En Face Depth Resolved OCTA Monitoring of Macular Outer Retinal Deposits in a Case of Multifocal Choroiditis Mimicking Syphilitic Uveitis
Authors: Akotoye Christian , Hoyek Sandra , Garg Itika , Singh Nakul , Miller John B. , Sobrin Lucia , Patel Nimesh A 
Published: April 2024

Purpose:
Multifocal choroiditis (MFC) is a rare inflammatory condition characterized by retinal and choroidal lesions that may present similarly to ocular pathology of various etiologies. Here we present a case of MFC mimicking syphilitic uveitis with unique en face optical coherence tomography angiography (OCTA) imaging characteristics

Methods:
Case report.

Results:
A 61-year-old woman presented with blurry vision, floaters and multiple whitish subretinal deposits on en face swept-source OCTA in the left eye. Fluorescent treponemal antibody test absorption was positive which led to the initial diagnosis of syphilitic uveitis and subsequent treatment with intravenous penicillin. During follow-up, OCTA of the left eye revealed the development of new choroidal neovascular membrane and new punched-out lesions in the posterior pole. The patient was eventually diagnosed with MFC and treated with aflibercept injections.

Conclusions:
Immune-mediated uveitis can simulate infectious and neoplastic uveitis. En face OCTA is unique imaging modality that allowed for the complete characterization and monitoring of the sub-macular deposits. This expands the clinical spectrum of multifocal choroiditis.
A CASE OF ALSTRÖM SYNDROME WITH A NOVEL VARIANT IN ALMS1 GENE PRESENTING WITH CONE ROD DYSTROPHY AS FIRST FINDING
Authors: Yen Busra , Ciftci Mukaddes Damla , Afrashi Filiz , Onay Huseyin , Goksen Damla 
Published: April 2024

Purpose:
Alström Syndrome (AS) is a rare autosomal recessive monogenic ciliopathy which is caused by a mutation of the Alström syndrome 1 (ALMS1) gene. It is a multisystemic disorder characterized by insulin resistance, childhood obesity, cardiomyopathy, progressive hepatic and renal failure, sensorineural hearing loss and retinal degeneration. Herein, we aimed to report a novel variant in ALMS1 gene causing AS in a patient presenting with visual impairment.

Methods:
Case report.

Results:
A 10-year-old male patient presented with photophobia and visual impairment in both eyes. Anterior and posterior segment examinations were unremarkable bilaterally. Optical coherence tomography (OCT) showed attenuated ellipsoid zone. Electroretinography revealed diminished cone and rod responses consistent with cone rod dystrophy (CRD). Genetic testing demonstrated a novel homozygous variant in ALMS1 (NM_015120.4) gene. The patient also was found to have early-stage dilated cardiomyopathy through systemic evaluation after the diagnosis of AS.

Conclusion:
Cone-rod dystrophy in pediatric population is relatively rare condition that can be associated with syndromic ciliopathies. The authors presented a case of AS with a novel variant in ALMS1 gene based on ophthalmic findings. Ophthalmologists play an important role in the diagnosis of this syndrome and early detection of systemic manifestations.
Identifying Autism Spectrum Disorder in a High-risk Follow-up Program through Quality Improvement Methodology
Authors: Raches Christine M. , Hines Elesia N. , Hines Abbey C. , Scott Emily K. 
Published: April 2024

Introduction:
Children born prematurely are at increased risk for autism spectrum disorder (ASD). ASD can be diagnosed between 18 and 24 months of age, but access barriers and medical complexity can delay diagnosis. ASD screening was implemented in a high-risk infant follow-up program using QI methodology. The project aimed to screen 60% of children and refer 90% of those with positive screens.

Methods:
The team developed a standardized workflow to administer the M-CHAT-R/F to HRIF patients between the ages of 16–22 months. Telehealth ASD assessment, using the TELE-ASD-PEDS, was conducted for those who screened positive. Monthly team meetings were held to implement change cycles and review the impact of the previous month’s change.

Results:
Within 7 months of program implementation, ASD screening exceeded the 60% aim. The program referred 72% of patients who screened as medium/high risk on the M-CHAT-R/F. The remaining patients were not referred per provider discretion. Twenty-seven percent of patients who received an autism evaluation received an ASD diagnosis. The average age at diagnosis was 22.5 months.

Conclusions:
An ASD screening protocol was implemented for patients enrolled in a high-risk infant follow-up program. Patients identified as at risk for ASD received an expedited telehealth ASD evaluation. The screening protocol was maintained for 13 months and is now part of the standard workflow. Screening has been expanded to other HRIF clinics, and evaluation appointments have been added to meet access needs. QI methodology is an effective tool for implementing ASD screening and referral in multidisciplinary HRIF programs.
A Quality Improvement Initiative to Minimize Unnecessary Chest X-Ray Utilization in Pediatric Asthma Exacerbations
Authors: Sakr Mohamed , Al Kanjo Mohamed , Balasundaram Palanikumar , Kupferman Fernanda , Al-Mulaabed Sharef , Scott Sandra , Viswanathan Kusum , Basak Ratna B. 
Published: April 2024

Background:
Current national guidelines recommend against chest X-rays (CXRs) for patients with acute asthma exacerbation (AAE). The overuse of CXRs in AAE has become a concern, prompting the need for a quality improvement (QI) project to decrease CXR usage through guideline-based interventions. We aimed to reduce the percentage of CXRs not adhering to national guidelines obtained for pediatric patients presenting to the Emergency Department (ED) with AAE by 50% within 12 months of project initiation.

Methods:
We conducted this study at a New York City urban level-2 trauma center. The team was composed of members from the ED and pediatric departments. Electronic medical records of children aged 2 to 18 years presenting with AAE were evaluated. Monthly data on CXR utilization encompassing instances where the ordered CXR did not adhere to guidelines was collected before and after implementing interventions. The interventions included provider education, visual reminders, printed cards, grand-round presentations, and electronic medical records modifications.

Results:
The study encompassed 887 eligible patients with isolated AAE. Baseline data revealed a mean preintervention CXR noncompliance rate of 37.5% among children presenting to the ED with AAE. The interventions resulted in a notable decrease in unnecessary CXR utilization, reaching 16.7%, a reduction sustained throughout subsequent months.

Conclusions:
This QI project successfully reduced unnecessary CXR utilization in pediatric AAE. A multi-faceted approach involving education, visual aids, and electronic reminders aligned clinical practice with evidence-based guidelines. This QI initiative is a potential template for other healthcare institutions seeking to curtail unnecessary CXR usage in pediatric AAE.
Impact of COVID-19 on People Living With HIV: Data From Five Medical Monitoring Project Sites, 2020–2022
Authors: Erly Steven , Menza Tim W. , Granillo Lauren , Navejas Michael , Udeagu Chi-Chi N. , Brady Kathleen A. , Hixson Lindsay K. , Raj-Sing Shavvy , Nassau Tanner , Kaasa Chelsey , Buskin Susan 
Published: April 2024

Background:
The COVID-19 pandemic disrupted global economic and healthcare systems. People living with HIV (PLWH) represent a marginalized and stigmatized population who may have been particularly impacted. The purpose of this analysis was to describe the impact of the COVID-19 pandemic on PLWH in the United States.

Setting:
United States.

Methods:
We analyzed surveys of behavioral and clinical characteristics of PLWH residing in 5 states that participated in the Medical Monitoring Project between 2020 and 2022. We described the impact of COVID-19 illness, testing, and diagnoses; receipt of medical care; social service access; employment; and preventive measures by project site and demographic characteristics.

Results:
Unweighted data from 1715 PLWH were analyzed. A high proportion of PLWH had medical care disrupted by the pandemic; 31% of PLWH missed medical appointments, 26% missed routine laboratory test results, and 7% missed antiretroviral therapy doses. In total, 30% of PLWH reported losing wages and 19% reported difficulty in accessing social services. Overall, 88% reported receiving at least 1 dose of COVID-19 vaccine, but vaccine uptake was low among younger, Black, and Hispanic or Latina/o/x PLWH.

Conclusions:
This descriptive analysis reinforces previous findings that show that COVID-19 negatively impacted PLWH and their ability to obtain medical care. Additional efforts will be critical to ameliorating the longer-term impacts of COVID-19 on the health of PLWH and supporting PLWH through future pandemics and healthcare system disruptions.
Intense 18F-FAPI Uptake in Small Recurrent Lesions of Combined Hepatocellular-Cholangiocarcinoma Negative on 18F-FDG PET/CT
Authors: Liang Jiucen , Zhang Jing , Song Jingjing , Zhang Rusen , Zhang Linqi 
Published: April 2024

Abstract
A 70-year-old man presented with combined hepatocellular-cholangiocarcinoma underwent partial hepatectomy and chemoradiotherapy approximately 3 months ago. Follow-up abdominal ultrasound detected a new small lesion with decreased echogenicity in the hepatic segment I, potentially indicating recurrence. The patient was enrolled in a clinical trial of comparison of 18F-FDG and 18F-FAPI PET/CT in hepatic lesions. Compared with non–18F-FDG avidity, 18F-FAPI PET/CT showed intense tracer uptake of the hepatic lesion. Resection of the lesion was subsequently performed, and pathologic analysis confirmed the diagnosis of recurrent combined hepatocellular-cholangiocarcinoma.
Climate extremes increase dengue risk along elevation and socio-economic gradients in Colombia
Authors: Kache Pallavi , Ruiz-Carrascal Daniel , Lowe Rachel , Stewart-Ibarra Anna M. , Seto Karen C. , Diuk-Wasser Maria , Santos-Vega Mauricio 
Published: April 2024

AbstractGlobally, urban settlements face increases in the frequency, magnitude, and duration of extreme climate events and shifts in their timing and spatial extent. Variation in temperature and rainfall conditions affect the temporal onset of dengue transmission. However, there is a need to understand how climate-related patterns and disease transmission mechanisms vary by location, particularly for topographically complex landscapes. In this investigation, we used dengue cases from 1,120 municipalities and five regions across Colombia during 2008–2019, and analyzed associations with extreme climate covariates generated from fine-scale, daily-level meteorological data, accounting for varying landscape and socio-economic properties. Using Bayesian spatio-temporal hierarchical models, we determined that high-intensity warm spells (with positive temperature anomalies of 8–12°C above mean monthly conditions) resulted in an earlier onset of dengue transmission risk in high-elevation settlements compared to low- elevation settlements. Furthermore, the risk of dengue transmission after extremely dry conditions was greater and extended for a longer duration in highly urbanized municipalities compared to those with a low urban population. Our findings highlight that meteorological hazards affect disease transmission in urban settlements differently based on elevation and socio-economic conditions. Additionally, our analysis adds to increasing evidence of the vulnerability of mountainous urban communities to extreme weather and vector-borne diseases. Overall, we emphasize the need for monitoring and forecasting the occurrence and intensity of meteorological hazards and associations with emerging climate-sensitive disease threats.
Spatially and Temporally Precise Microbiome Profiling in the Small Intestine using the SIMBA Capsule with X-ray tracking
Authors: Wang Gang , Menon Sharanya , Wilsack Lynn , Rehak Renata , Lou Lawrence , Turbide Christian , Auger Jeremie , Tremblay Annie , Mathieu Olivier , Binda Sylvie , Tompkins Thomas A , Bruehlmann Sabina , Andrews Christopher N 
Published: April 2024

AbstractFew minimally invasive options for sampling the small intestinal (SI) luminal fluid exist to study the SI microbiota in health and disease. To address the lack of tools and methods to study GI regions that are difficult to access, Nimble Science developed a fully autonomous and passive sampling method, the Small Intestine MicroBiome Aspiration (SIMBATM) capsule, for convenient, high-quality, and reliable sampling to study the diet-microbiota interactions in the SI. The sealing efficacy and microbial DNA preservation capacity of the SIMBA capsules was first validated throughin vitrosimulation assays. Then, a clinical study was conducted with 20 healthy participants to validate thein vivouse of SIMBA capsules to reliably capture samples for SI microbiome analysis before and after an intervention (NCT04489329). Briefly, participants ingested the capsules at baseline and 7 days later, with a probiotic capsule containing a blend ofL. rhamnosusR0011 andB. longumR0175. Following baseline SIMBA capsule ingestion, multiple low-dosage x-ray scans were performed to track the sampling location. Fecal samples corresponding with the baseline and intervention capsule were analyzed for comparison. The SIMBA capsules’ performancein vitrodemonstrated the potential for contamination-free sampling with preservation of the microbial communities. Within the clinical study, the capsules performed safely and reliably for collection of SI content. X-ray tracking confirmed that 97.2% of the capsules completed sample collection in the SI regions before reaching the colon. Importantly, our data showed that the capsules sampled in the right area of the intestines and that baseline SIMBA microbiome profile is significantly different from fecal microbiome profile. SIMBA successfully detected a concurrent probiotic intervention in the small intestine, which was not detectable using stool samples. The high accuracy of sampling location and sealing efficacy of the SIMBA capsules makes them potentially useful research tools in clinical trials for studying diet-microbiota interactions in health and disease, and perhaps eventually for the clinical diagnosis of GI tract conditions affecting the SI such as SIBO.
Evidence from Madagascar shows that vaccination could mitigate climate-driven disruptions to malaria control
Authors: Rice Benjamin L. , Raobson Estelle , Miharisoa Sylviane , Rebaliha Mahery , Lewinski Joseph , Raharinirina Hanitriniaina , Golden Christopher D. , Vecchi Gabriel A. , Wesolowski Amy , Grenfell Bryan , Metcalf C. Jessica E. 
Published: April 2024

AbstractExtreme weather events are common in high malaria burden areas and likely to increase in severity due to climate change. Yet, data on infection rates following these events and the consequences for disease control programs remain rare. Using data from Madagascar, we estimate high rates of infection in the wake of two major tropical cyclones and show infection rebounds rapidly during gaps in standard interventions. Relative to other control options, recently available malaria vaccines have a longer duration of protection, with the potential to address interruptions in prevention deployment. Evaluating this use, we quantify the reduction in symptomatic infections expected for a range of vaccination scenarios. We find long-lasting interventions such as vaccination are a key mitigation measure against climatic disruptions to disease control.
APOE regulates the transport of GM1
Authors: Zhang Dong Yan , Wang Jian , Huang Gangtong , Langberg Sara , Ding Feng , Dokholyan Nikolay V. 
Published: April 2024

ABSTRACTApolipoprotein E (APOE) is responsible for lipid transport, including cholesterol transport and clearance. While the ε4 allele of APOE (APOE4) is associated with a significant genetic risk factor for late-onset Alzheimer’s disease (AD), no mechanistic understanding of its contribution to AD etiology has been established yet. In addition to cholesterol, monosialotetrahexosylganglioside (GM1) is a crucial lipid component in cell membranes and has been implicated in promoting the aggregation of amyloid beta protein (Aβ), a key protein associated with AD. Here, we ask whether there are direct interactions between APOE and GM1 that further impact AD pathology. We find that both APOE3 and APOE4 exhibit superior binding affinity to GM1 compared to cholesterol and have an enhanced cellular uptake to GM1 lipid structures than cholesterol lipid structures. APOE regulates the transport process of GM1 depending on the cell type, which is influenced by the expression of APOE receptors in different cell lines and alters GM1 contents in cell membranes. We also find that the presence of GM1 alters the secondary structure of APOE3 and APOE4 and enhances the binding affinity between APOE and its receptor low-density lipoprotein receptor (LDLR), consequently promoting the cellular uptake of lipid structures in the presence of APOE. To understand the enhanced cellular uptake observed in lipid structures containing 20% GM1, we determined the distribution of GM1 on the membrane and found that GM1 clustering in lipid rafts, thereby supporting the physiological interaction between APOE and GM1. Overall, we find that APOE plays a regulatory role in GM1 transport, and the presence of GM1 on the lipid structures influences this transport process. Our studies introduce a plausible direct link between APOE and AD etiology, wherein APOE regulates GM1, which, in turn, promotes Aβ oligomerization and aggregation.
Evaluation of Deep Neural Network Models for Instance Segmentation of Lumbar Spine MRI
Authors: Chen Jiasong , Qian Linchen , Ma Linhai , Urakov Timur , Gu Weiyong , Liang Liang 
Published: April 2024

AbstractIntervertebral disc disease, a prevalent ailment, frequently leads to intermittent or persistent low back pain, and diagnosing and assessing of this disease rely on accurate measurement of vertebral bone and intervertebral disc geometries from lumbar MR images. Deep neural network (DNN) models may assist clinicians with more efficient image segmentation of individual instances (discs and vertebrae) of the lumbar spine in an automated way, which is termed as instance image segmentation. In this work, we evaluated 15 existing DNN models for lumbar spine MR image segmentation. We introduced a new data augmentation technique to create synthetic yet realistic MR image dataset, named SSMSpine, which is made publicly available. The 15 image segmentation models are evaluated on our private in-house dataset and the public SSMSpine dataset, using two metrics, Dice Similarity Coefficient and 95% Hausdorff Distance. The SSMSpine dataset are available athttps://github.com/jiasongchen/SSMSpine.