bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and angiographic outcomes of mycophenolate versus methotrexate in South Asian patients of Takayasu arteritis: Results from an open-label, outcome-assessor blinded randomized controlled trial
Authors: Padiyar Shivraj , Danda Debashish , Goel Ruchika , Joseph Elizabeth , Nair Aswin M , Joseph George , Antonisamy Belavendra 
Published: December 2022

ABSTRACT

Objective
To compare the clinical and angiographic responses of mycophenolate mofetil (MMF) versus methotrexate (MTX) in Takayasu arteritis (TAK).

Methods
This was an open-label, outcome assessor–blinded trial. Adult patients with active TAK were randomized 1:1 to MMF 1 g twice daily or MTX 20 mg once weekly by a computer-generated program. All patients were started on 0.5 mg/kg of steroids with a predetermined tapering protocol. The primary outcome was the treatment response as defined by Indian Takayasu arteritis score at 9 months. The secondary end points included the time to first failure and angiographic progression.

Results
A total of 52 patients (26 in each arm) were recruited. The rate of responders was 71.43% (15/21) in the MMF arm and 63.64% (14/22) in the MTX arm (P = .58). The median time to the first failure was 9 months (range: 3–9) and 4.5 months (range: 3–9) in the MMF and MTX arms, respectively (P = .052). In both groups, 15% of patients (n = 3) had a progressive disease in angiography.

Conclusions
The results showed numerically better outcomes favouring MMF, with a longer time to the first failure than MTX (9 months versus 4.5 months, P = .052). No significant difference was seen in the angiographic outcomes.
Deep learning based on preoperative magnetic resonance (MR) images improves the predictive power of survival models in primary spinal cord astrocytomas
Authors: Sun Ting , Wang Yongzhi , Liu Xing , Li Zhaohui , Zhang Jie , Lu Jing , Qu Liying , Haller Sven , Duan Yunyun , Zhuo Zhizheng , Cheng Dan , Xu Xiaolu , Jia Wenqing , Liu Yaou 
Published: December 2022

Abstract

Background
Prognostic models for spinal cord astrocytoma patients are lacking due to the low incidence of the disease. Here, we aim to develop a fully automated deep learning (DL) pipeline for stratified overall survival (OS) prediction based on preoperative MR images.

Methods
A total of 587 patients diagnosed with intramedullary tumors were retrospectively enrolled in our hospital to develop an automated pipeline for tumor segmentation and OS prediction. The automated pipeline included a T2WI-based tumor segmentation model and 3 cascaded binary OS prediction models (1-year, 3-year, and 5-year models). For the tumor segmentation model, 439 cases of intramedullary tumors were used to model training and testing using a transfer learning strategy. A total of 138 patients diagnosed with astrocytomas were included to train and test the OS prediction models via 10 × 10-fold cross-validation using CNNs.

Results
The dice of the tumor segmentation model with the test set was 0.852. The results indicated that the best input of OS prediction models was a combination of T2W and T1C images and the tumor mask. The 1-year, 3-year, and 5-year automated OS prediction models achieved accuracies of 86.0%, 84.0%, and 88.0% and AUCs of 0.881 (95% CI 0.839–0.918), 0.862 (95% CI 0.827–0.901), and 0.905 (95% CI 0.867–0.942), respectively. The automated DL pipeline achieved 4-class OS prediction (&lt;1 year, 1–3 years, 3–5 years, and &gt;5 years) with 75.3% accuracy.

Conclusions
We proposed an automated DL pipeline for segmenting spinal cord astrocytomas and stratifying OS based on preoperative MR images.
The Telemedicine Program Design Canvas: a visual tool for planning telemedicine interventions
Authors: Verma Neha , Samuel Izabella , Weinreb Samuel , Hall Mackenzie , Zhang Kai , Bendavit Mariana , Bhirud Vibha , Shuff Jordan , Yazdi Youseph , Acharya Soumyadipta 
Published: December 2022

Abstract
Telemedicine has seen widespread adoption during the COVID-19 pandemic. The implementation of telemedicine projects can be complex, with over 75% of telemedicine initiatives failing in the implementation phase. Health organizations that want to adopt telemedicine as part of their healthcare delivery programs struggle to plan and implement sustainable and scalable initiatives effectively. This paper presents the Telemedicine Program Design Canvas—a tool to guide health organizations in planning telemedicine interventions and drive intervention success. It was developed and validated through six workshops with users and stakeholders of telemedicine. Based on the workshops and the lessons learned from the subsequent interventions of these projects, we identified the 14 key elements that must be addressed while planning and implementing a telemedicine project. We organized these into a simple visual tool that health organizations could use. The 14 elements include the problem, ecosystem, patients, patient journey, patient engagement and trust, providers, provider training, provider engagement, channels, technology, medicines and diagnostics, desired outcomes, costs and revenues. The tool was then tested and validated by applying it with a new group of six telemedicine projects. Overall, the perspectives of 108 users and stakeholders of telemedicine projects, including organizational leadership, doctors, nurses, midwives, community health workers, patients, policymakers, technologists, legal and finance experts, were included in the development of the tool. The Telemedicine Program Design Canvas provides a structured and straightforward method for the rapid prototyping and holistic planning of telemedicine interventions.
Botrytis cinerea identifies host plants via the recognition of antifungal capsidiol to induce expression of a specific detoxification gene
Authors: Kuroyanagi Teruhiko , Bulasag Abriel Salaria , Fukushima Keita , Ashida Akira , Suzuki Takamasa , Tanaka Aiko , Camagna Maurizio , Sato Ikuo , Chiba Sotaro , Ojika Makoto , Takemoto Daigo 
Published: December 2022

Abstract
The gray mold pathogen Botrytis cinerea has a broad host range, causing disease in &gt;400 plant species, but it is not known how this pathogen evolved this polyxenous nature. Botrytis cinerea can metabolize a wide range of phytoalexins, including the stilbenoid resveratrol in grape, and the sesquiterpenoids capsidiol in tobacco and rishitin in potato and tomato. In this study, we analyzed the metabolism of sesquiterpenoid phytoalexins by B. cinerea. Capsidiol was dehydrogenated to capsenone, which was then further oxidized, while rishitin was directly oxidized to epoxy- or hydroxyrishitins, indicating that B. cinerea has separate mechanisms to detoxify structurally similar sesquiterpenoid phytoalexins. RNA-seq analysis revealed that a distinct set of genes were induced in B. cinerea when treated with capsidiol or rishitin, suggesting that B. cinerea can distinguish structurally similar phytoalexins to activate appropriate detoxification mechanisms. The gene most highly upregulated by capsidiol treatment encoded a dehydrogenase, designated Bccpdh. Heterologous expression of Bccpdh in a capsidiol-sensitive plant symbiotic fungus, Epichloë festucae, resulted in an acquired tolerance of capsidiol and the ability to metabolize capsidiol to capsenone, while B. cinerea Δbccpdh mutants became relatively sensitive to capsidiol. The Δbccpdh mutant showed reduced virulence on the capsidiol producing Nicotiana and Capsicum species but remained fully pathogenic on potato and tomato. Homologs of Bccpdh are found in taxonomically distant Ascomycota fungi but not in related Leotiomycetes species, suggesting that B. cinerea acquired the ancestral Bccpdh by horizontal gene transfer, thereby extending the pathogenic host range of this polyxenous pathogen to capsidiol-producing plant species.
“Scum (of the Earth)”: Incarcerated Mothers’ Experiences of Slow Violence
Authors: Fedock Gina , Doria Celina , Malcome Marion 
Published: December 2022

ABSTRACT
Incarcerated mothers experience multiple forms of harm embedded within the criminal legal system, yet relatively little attention has been paid to incarcerated mothers’ experiences of slow violence, violence whose harm occurs gradually over time, often in mundane and disregarded ways. We conducted semi-structured interviews with incarcerated mothers to explore their parenting experiences while in prison and analyzed their experiences through the frame of slow violence. The findings include salient themes of environmentally hazardous prison conditions that negatively impacted their health; broken phones that disrupted communication with and parenting of their children; and unending waitlists that jeopardized their parenting rights and delayed reunification with their children. We situate these findings within the framework of slow violence to highlight the insidious and overlooked forms of harm in the prison environment which impacted aspects of incarcerated mothers’ wellbeing. We argue that understanding incarcerated mothers’ experiences within this framework draws attention to ways that state actors, as well as common theoretical framings of incarceration dynamics, perpetuate and normalize the suffering of incarcerated mothers. By reframing the harms of incarceration as acts of slow violence, new insights are gleaned for theorizing and addressing violence against incarcerated women.
Neutrophilic inflammation in chronic rhinosinusitis
Authors: Delemarre Tim , Bachert Claus 
Published: December 2022

Purpose of review
Over the last years, extensive research has been done on neutrophils and their contribution in chronic rhinosinusitis (CRS), and made it clear that they are more than just a bystander in this disease. In this article, we will review all recent publications on this topic and look to what the future hold regarding therapeutics targeting the neutrophilic inflammation in CRS.

Recent findings
Evidence is growing that the presence of neutrophils are associated with a worse disease outcome in certain CRS patient groups. They are highly activated in type 2 inflammations and exhibit damaging properties through their proteases, contributing to the chronicity of the disease. Several recent studies identified useful biomarkers and targets for future therapeutics.

Summary
The findings we review in this manuscript are of utmost importance in unraveling the complexity of CRS and provide us with the necessary knowledge for future clinical practices.
CHOROIDAL VASCULAR ALTERATIONS IN AGE-RELATED MACULAR DEGENERATION AND POLYPOIDAL CHOROIDAL VASCULOPATHY
Authors: Cheung Chui Ming Gemmy , Wong Mark Yu Zheng , Teo Kelvin Yi Chong 
Published: December 2022

Purpose:
To evaluate morphologic alterations in choroidal veins in eyes with typical neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV).

Methods:
A retrospective review of baseline indocyanine green angiography in eyes with typical nAMD and PCV. We evaluated Haller layer veins in the early-phase indocyanine green angiography (before 2 minutes) for 1) macular anastomosis, 2) dilated Haller veins, and 3) focal variation in vessel caliber by at least 50% from the narrowest to largest diameters.

Results:
We included 70 patients with gradable indocyanine green angiography for the prespecified features in the study eye (36 typical nAMD and 34 PCV) and 59 fellow eyes. The median subfoveal choroidal thickness was 167 µm versus 219 µm, P = 0.08, in the presenting eyes in typical nAMD and PCV, respectively. Macular anastomosis was common in both typical nAMD and PCV (presenting eyes 58.3% vs. 58.8%. P = 0.97; fellow eyes 65.5% vs. 63.3%, P = 0.86). Dilated Haller veins were numerically less common in typical nAMD than PCV (presenting eyes 52.8% vs. 67.6%, P = 0.21; fellow eyes 65.5% vs. 70.0%, P = 0.71), while vascular caliber variation was numerically more common in typical nAMD than PCV (presenting eyes 72.2% vs. 63.8%, P = 0.45; fellow eyes 69.0% vs. 56.7%, P = 0.33). The presence of all three features was more common in the presenting eyes with PCV compared with typical nAMD (35.3% vs. 13.9%, P = 0.03). In a multivariable analysis, every increase of 100 µm of CT conferred a 2.75 risk of having all three features present.

Conclusion:
Choroidal vascular remodeling is common in both tAMD and PCV but may be driven by different stimuli.
Heart Failure Knowledge, Symptom Perception, and Symptom Management in Patients With Heart Failure
Authors: Wu Jia-Rong , Lin Chin-Yen , Hammash Muna , Moser Debra K. 
Published: December 2022

Background
Prevention of heart failure (HF) exacerbations requires that patients carefully self-manage their condition. Symptom perception is a key component in self-care for patients with HF that involves monitoring for HF symptoms and recognizing symptom changes. Heart failure knowledge is a prerequisite for better symptom perception and symptom management. However, the relationships among HF knowledge, symptom perception, and symptom management remain unclear.

Objective
The aim of this study was to explore the inter-relationships among HF knowledge, symptom monitoring, symptom recognition, and symptom response in patients with HF.

Method
We included 185 patients with HF in this study. Heart failure knowledge was measured using the Dutch HF Knowledge Scale. Symptom monitoring, symptom recognition, and symptom response were measured using the Self-care of HF Index. Structural equation modeling was used for data analyses.

Results
Heart failure knowledge was associated with symptom monitoring (β = .357, P < .001). Symptom monitoring was directly associated with both symptom recognition (β = .371, P < .001) and symptom response (β = .499, P < .001). Symptom recognition was directly associated with symptom response (β = .274, P < .001). Heart failure knowledge was not directly associated with symptom recognition, nor with symptom response. Heart failure knowledge was indirectly associated with symptom recognition and symptom response through symptom monitoring.

Conclusion
Symptom monitoring is associated with both symptom recognition and symptom response and is a mediator between HF knowledge and symptom recognition and between HF knowledge and symptom response. This finding suggests that it is important for clinicians not just to increase patients' HF knowledge but also to enhance their skills of symptom monitoring and symptom recognition and promote symptom monitoring among patients to improve symptom response in self-care.
Update on management of paediatric dyslipidaemia
Authors: Bansal Nidhi , Kumar Seema , Brar Preneet Cheema 
Published: December 2022

Purpose of review
Atherosclerosis and associated cardiovascular risk factors originate in childhood; hence, early management of dyslipidaemia is vital. However, hypercholesterolemia remains untreated or undertreated in many youths. We review current therapies, drugs under investigation and consider potential future directions for the management of paediatric dyslipidaemia to highlight the recent evidence and new therapeutic options for future use.

Recent findings
Cardiovascular disease (CVD) risk factors in childhood, including dyslipidaemia, are associated with CVD risk and clinical CVD events in adulthood. Recent data show that initiation of statin therapy in childhood in children with familial hypercholesterolemia reduces the risk of CVD in adulthood. Several well tolerated and efficacious treatment options have become available in recent times for the management of dyslipidaemia in youth. Many new lipid-lowering drugs are under investigation to widen the available choices. Some of these drugs are now available for use in paediatrics, while some remain targets for future use.

Summary
We review available treatment options for paediatric dyslipidaemia management, discuss potential limitations and propose future directions. We also acknowledge the need for continued research in paediatrics for optimal paediatric dyslipidaemia management.
Coaching to Bedside Shift Report and Its Correlation to Hospital Consumer Assessment of Healthcare Providers and Systems and Value-Based Purchasing Dimension Scores
Authors: O'Donnell Lauren , George Elisabeth , Donnelly James , Bilderback Andrew , Buchanan Dan 
Published: December 2022

OBJECTIVE
The objective of this multihospital study was to investigate how the intervention of coaching to bedside shift report (BSR) correlates with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) outcomes and relates to Centers for Medicare and Medicaid Services (CMS) Hospital Value-Based Purchasing (VBP) Program points over a 4-year period (2017-2020) for an acute care hospital health system.

BACKGROUND
Hospital leaders' responsibilities include intertwined areas of patient experience and fiscal accountability. Coaching to BSR is reported to have numerous benefits to the patient's experience. Published studies completed with hospital systems evaluating the intervention of coaching to BSR and how it correlated to patient experience and VBP are limited.

METHODS
Coaching to BSR was implemented at 16 adult acute care hospitals. Patient-reported BSR rates were collected in tandem with HCAHPS for 4 years. Statistical correlations were assessed between patient-reported BSR and HCAHPS and consequential effect on VBP dimension scores.

RESULTS
Coaching to BSR had a significant impact on top- and bottom-box “rate the hospital” HCAHPS scores at a system and hospital level. Value-based purchasing points and percentages increased over 2017-2020, potentially leading to lower CMS penalty claims over the period the BSR was implemented.

CONCLUSIONS
Coaching is a key factor when creating a favorable patient experience. The implementation and sustainability of coaching to BSR may result in improved patient experience ratings and increase VBP point accumulation to hospital systems.
Assessing the Effectiveness Between Nurse Educator and Clinical Coach Critical Care Training Programs for New Graduate Nurses in the ICU
Authors: Blass Tammy , McFee Ruth , Hunt Debra , Francone Maybeth , Nguyen Samantha , Vermillion Greg , Canamar Catherine , Sarff Laura 
Published: December 2022

OBJECTIVE
The aim of this study was to assess the differences in effectiveness between nurse educator–led and clinical coach–led intensive care unit (ICU) training programs for new graduate nurses.

BACKGROUND
New graduate ICU nurses require substantial clinical training, which is often provided by peers serving as clinical coaches who have not been formally trained for an educator role. Our medical center successfully transitioned from a nurse educator–led to clinical coach–led model for initial ICU education after formally training the clinical coaches.

METHODS
Nurses enrolled in nurse educator–led (n = 114) or clinical coach–led (n = 166) ICU clinical training programs were compared on program pass rate, satisfaction, preparedness, turnover, and competence.

RESULTS
There were no statistically significant differences between the groups on any of the identified measures of program effectiveness.

CONCLUSIONS
Both educator-led and clinical coach–led models, with appropriate training, effectively prepared ICU nurses in this setting. Implementing a clinical coaching model for ICU training of new graduate nurses could assuage common resource issues, such as a shortage of nurse educators, as well as address the increasing demand for well-trained ICU nurses.
HTPN 078: an enhanced case management study to achieve viral suppression among viremic HIV-positive men who have sex with men in the United States
Authors: Remien Robert H. , Dacus Jagadīśa-devaśrī , Farley Jason E. , Hughes James P. , Gamble Theresa , Wang Zhe (Zoe) , Batey D. Scott , Mayer Kenneth H. , del Rio Carlos , Balán Iván C. , Irvin Risha , Mitchell Kate M. , Cummings Vanessa , Eshleman Susan H. , Conserve Donaldson F. , Knox Justin , Yu Kaiyue , Beyrer Chris 
Published: December 2022

Objective(s):
After identifying and recruiting men who have sex with men living with HIV and virally unsuppressed, this study attempted to enhance treatment and care via case management to increase the proportion who achieved viral suppression.

Design:
Participants were randomized into one of two study arms: standard of care (SOC) or enhanced case management (CM) intervention. Participants were followed for 12 months with quarterly study assessments, with blood collected for CD4+ cell count testing, HIV viral load testing (primary prespecified outcome), and plasma storage.

Methods:
Participants identified via respondent-driven sampling and direct recruitment and were invited to participate in the randomized controlled trial. The CM intervention provided a wide range of support services including, health education, clinical care coordination, medication adherence support, and social service assistance. The month-12 assessment included questions about healthcare utilization, stigma, substance use, and mental health.

Results:
Among the 144 participants virally unsuppressed at baseline, most had had a previous positive HIV test result; were Black, non-Hispanic, gay and bisexual men, aged 22–50. Among the 128 participants at the last study visit, 68 were virally suppressed, with no statistically significant difference between the CM and SOC arms (viral suppression 42% and 53%, respectively; adjusted odds ratio = 0.62 [P = 0.15; 95% confidence interval: 0.32, 1.2]).

Conclusions:
Reaching targets of at least 90% sustained viral suppression among all people with HIV will likely require more than an individual-level CM approach that addresses barriers to optimal care and treatment at multiple levels.
Prevalence of HIV drug resistance in Nigeria: results from a cross-sectional, population-based survey of Nigerian adults with unsuppressed viral load
Authors: Aliyu Gambo G. , Lawton Jonathan G. , Mitchell Andrew B. , Abimiku Alash’le G. , Jelpe Tapdiyel , Bassey Orji , Riedel David J. , Swaminathan Mahesh , Chang Joy Chih-Wei , DeVos Joshua R. , Patel Hetal , Charurat Man E. , Stafford Kristen A. 
Published: December 2022

Background:
HIV drug resistance (HIVDR) surveillance is an important tool to monitor threats to progress towards epidemic control. The characterization of HIVDR in Nigeria at the national level is needed to inform both clinical decisions and population-level HIV policy strategies. This study uses data obtained from the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) to describe the prevalence and distribution of HIVDR in Nigeria.

Methods:
NAIIS was a cross-sectional, population-based survey of households throughout Nigeria in 2018. NAIIS was designed to provide estimates of HIV prevalence and related health indicators from a nationally representative sample. The study population included participants aged 15–64 years who tested positive for HIV, had a viral load at least 1000 copies/ml, and had available HIV drug resistance genotypes. HIV isolates were genotyped to detect drug resistance mutations. Individual characteristics of study participants associated with HIVDR were identified using a weighted multivariable logistic regression model.

Results:
Of 1355 respondents with available HIV genotypes, 293 (19%) had evidence of drug-resistant mutations (DRMs) that conferred resistance to at least one antiretroviral drug. The majority of DRMs observed conferred resistance to NNRTIs (17.6%) and NRTIs (11.2%). HIVDR was associated with being ART-experienced, longer duration on ART, and lower CD4+ count but not sociodemographic characteristics.

Conclusion:
The population level DRM prevalence in Nigeria was consistent with what would be expected in a mature HIV treatment landscape. The continued roll out of dolutegravir-anchored regimens should mitigate the impact of NNRTI resistance on population viral load suppression and progress towards epidemic control.