bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revised Protocol for Secondary Prevention of Congenital Cytomegalovirus Infection With Valaciclovir Following Infection in Early Pregnancy
Authors: Amir Jacob , Chodick G , Pardo Joseph 
Published: May 2023

Abstract

Background
A previous randomized placebo-controlled study found valaciclovir to be effective in reducing the rate of vertical cytomegalovirus transmission from mother to fetus. The better results in women infected in the first trimester compared to the periconception period were attributed to the timing of treatment. The aim of the present study was to evaluate valaciclovir efficacy in this setting using a revised protocol.

Methods
All pregnant women treated with valaciclovir in 2020–2022 who met the same criteria as in the original study were identified retrospectively from the database of the same medical center. Treatment, however, was initiated earlier: up to 9 weeks or 8 weeks from the presumed time of infection in women infected in the periconception period or the first trimester, respectively. The primary endpoint was rate of vertical cytomegalovirus transmission. Results were compared with the placebo arm in the previous study.

Results
Among 178 women who completed valaciclovir treatment, amniocentesis was positive for cytomegalovirus in 14 women (7.9%), significantly (P &lt; .001) lower compared with 14 of 47 (30%) in the placebo arm in the previous study. The proportion of positive amniocentesis in the valaciclovir was significantly lower than the placebo arm both among women infected in the first trimester (14/119 vs 11/23; odds ratio [OR] = 0.15; 95% confidence interval [CI]: .05–.45, P &lt; .001), as well as among those infected in the periconception period (0/59 vs 3/24, OR = 0; 95% CI 0–.97, P = .02).

Conclusions
This study provides further evidence of the efficacy of valaciclovir in preventing vertical transmission of cytomegalovirus after primary maternal infection. Efficacy is improved with earlier treatment.
Combination of Amoxicillin 3000 mg and Probenecid Versus 1500 mg Amoxicillin Monotherapy for Treating Syphilis in Patients With Human Immunodeficiency Virus: An Open-Label, Randomized, Controlled, Non-Inferiority Trial
Authors: Ando Naokatsu , Mizushima Daisuke , Omata Kazumi , Nemoto Takashi , Inamura Natsumi , Hiramoto Saori , Takano Misao , Aoki Takahiro , Watanabe Koji , Uemura Haruka , Shiojiri Daisuke , Yanagawa Yasuaki , Tanuma Junko , Teruya Katsuji , Kikuchi Yoshimi , Gatanaga Hiroyuki , Oka Shinichi 
Published: May 2023

Abstract

Background
Amoxicillin plus probenecid is an alternative to intramuscular benzathine penicillin G for treating syphilis in the United Kingdom. Low-dose amoxicillin is an alternative treatment option used in Japan.

Methods
We conducted an open-label, randomized, controlled, non-inferiority trial between 31 August 2018, and 3 February 2022, to compare 1500 mg low-dose amoxicillin monotherapy with the combination of 3000 mg amoxicillin and probenecid (non-inferiority margin 10%). Patients with human immunodeficiency virus (HIV) infection and syphilis were eligible. The primary outcome was the cumulative serological cure rate within 12 months post-treatment, measured using the manual rapid plasma reagin card test. Secondary outcomes included safety assessment.

Results
A total of 112 participants were randomized into 2 groups. Serological cure rates within 12 months were 90.6% and 94.4% with the low-dose amoxicillin and combination regimens, respectively. Serological cure rates for early syphilis within 12 months were 93.5% and 97.9% with the low-dose amoxicillin and combination regimens, respectively. Non-inferiority of low-dose amoxicillin compared with amoxicillin plus probenecid overall and for early syphilis was not confirmed. No significant side effects were detected.

Conclusions
This is the first randomized controlled trial to demonstrate a high efficacy of amoxicillin-based regimens for treating syphilis in patients with HIV infection, and the non-inferiority of low-dose amoxicillin compared with amoxicillin plus probenecid was not seen. Therefore, amoxicillin monotherapy could be a good alternative to intramuscular benzathine penicillin G with fewer side effects. However, further studies comparing with benzathine penicillin G in different populations and with larger sample sizes are needed.

Trials Registration
(UMIN000033986).
Timesweeper: accurately identifying selective sweeps using population genomic time series
Authors: Whitehouse Logan S , Schrider Daniel R 
Published: May 2023

Abstract
Despite decades of research, identifying selective sweeps, the genomic footprints of positive selection, remains a core problem in population genetics. Of the myriad methods that have been developed to tackle this task, few are designed to leverage the potential of genomic time-series data. This is because in most population genetic studies of natural populations, only a single period of time can be sampled. Recent advancements in sequencing technology, including improvements in extracting and sequencing ancient DNA, have made repeated samplings of a population possible, allowing for more direct analysis of recent evolutionary dynamics. Serial sampling of organisms with shorter generation times has also become more feasible due to improvements in the cost and throughput of sequencing. With these advances in mind, here we present Timesweeper, a fast and accurate convolutional neural network-based tool for identifying selective sweeps in data consisting of multiple genomic samplings of a population over time. Timesweeper analyzes population genomic time-series data by first simulating training data under a demographic model appropriate for the data of interest, training a one-dimensional convolutional neural network on said simulations, and inferring which polymorphisms in this serialized data set were the direct target of a completed or ongoing selective sweep. We show that Timesweeper is accurate under multiple simulated demographic and sampling scenarios, identifies selected variants with high resolution, and estimates selection coefficients more accurately than existing methods. In sum, we show that more accurate inferences about natural selection are possible when genomic time-series data are available; such data will continue to proliferate in coming years due to both the sequencing of ancient samples and repeated samplings of extant populations with faster generation times, as well as experimentally evolved populations where time-series data are often generated. Methodological advances such as Timesweeper thus have the potential to help resolve the controversy over the role of positive selection in the genome. We provide Timesweeper as a Python package for use by the community.
Prospective Association Between Plasma Concentrations of Fatty Acids and Other Lipids, and Multimorbidity in Older Adults
Authors: Caballero Francisco Félix , Lana Alberto , Struijk Ellen A , Arias-Fernández Lucía , Yévenes-Briones Humberto , Cárdenas-Valladolid Juan , Salinero-Fort Miguel Ángel , Banegas José R , Rodríguez-Artalejo Fernando , Lopez-Garcia Esther 
Published: May 2023

Abstract
Biological mechanisms that lead to multimorbidity are mostly unknown, and metabolomic profiles are promising to explain different pathways in the aging process. The aim of this study was to assess the prospective association between plasma fatty acids and other lipids, and multimorbidity in older adults. Data were obtained from the Spanish Seniors-ENRICA 2 cohort, comprising noninstitutionalized adults ≥65 years old. Blood samples were obtained at baseline and after a 2-year follow-up period for a total of 1 488 subjects. Morbidity was also collected at baseline and end of the follow-up from electronic health records. Multimorbidity was defined as a quantitative score, after weighting morbidities (from a list of 60 mutually exclusive chronic conditions) by their regression coefficients on physical functioning. Generalized estimating equation models were employed to assess the longitudinal association between fatty acids and other lipids, and multimorbidity, and stratified analyses by diet quality, measured with the Alternative Healthy Eating Index-2010, were also conducted. Among study participants, higher concentrations of omega-6 fatty acids [coef. per 1-SD increase (95% CI) = −0.76 (−1.23, −0.30)], phosphoglycerides [−1.26 (−1.77, −0.74)], total cholines [−1.48 (−1.99, −0.96)], phosphatidylcholines [−1.23 (−1.74, −0.71)], and sphingomyelins [−1.65 (−2.12, −1.18)], were associated with lower multimorbidity scores. The strongest associations were observed for those with a higher diet quality. Higher plasma concentrations of omega-6 fatty acids, phosphoglycerides, total cholines, phosphatidylcholines, and sphingomyelins were prospectively associated with lower multimorbidity in older adults, although diet quality could modulate the associations found. These lipids may serve as risk markers for multimorbidity.
Pressure robust SUPG-stabilized finite elements for the unsteady Navier–Stokes equation
Authors: Beirão da Veiga L , Dassi F , Vacca G 
Published: May 2023

Abstract
In the present contribution, we propose a novel conforming finite element scheme for the time-dependent Navier–Stokes equation, which is proven to be both convection quasi-robust and pressure robust. The method is built combining a ‘divergence-free’ velocity/pressure couple (such as the Scott–Vogelius element), a discontinuous Galerkin in time approximation and a suitable streamline upwind Petrov–Galerkin-curl stabilization. A set of numerical tests, in accordance with the theoretical results, is included.
Sparse Kronecker product decomposition: a general framework of signal region detection in image regression
Authors: Wu Sanyou , Feng Long 
Published: May 2023

Abstract
This paper aims to present the first Frequentist framework on signal region detection in high-resolution and high-order image regression problems. Image data and scalar-on-image regression are intensively studied in recent years. However, most existing studies on such topics focussed on outcome prediction, while the research on region detection is rather limited, even though the latter is often more important. In this paper, we develop a general framework named Sparse Kronecker Product Decomposition (SKPD) to tackle this issue. The SKPD framework is general in the sense that it works for both matrices and tensors represented image data. Our framework includes one-term, multi-term, and nonlinear SKPDs. We propose nonconvex optimization problems for one-term and multi-term SKPDs and develop path-following algorithms for the nonconvex optimization. Under a Restricted Isometric Property, the computed solutions of the path-following algorithm are guaranteed to converge to the truth with a particularly chosen initialization even though the optimization is nonconvex. Moreover, the region detection consistency could also be guaranteed. The nonlinear SKPD is highly connected to shallow convolutional neural networks (CNN), particularly to CNN with one convolutional layer and one fully-connected layer. Effectiveness of SKPD is validated by real brain imaging data in the UK Biobank database.
Complete Genome Sequence Resource for Cercospora apii Causing Leaf Spot of Celery
Authors: Yang Lijuan , Gao Guoxun , Gao Wei , Zhang Chunxiang , Wu Feng , Huo Jianfei , Wang Yong 
Published: May 2023

Cercospora apii is an important seedborne pathogenic fungus causing severe Cercospora leaf spot of celery worldwide. Here, we first present a complete genome assembly of C. apii QCYBC from celery, based on Illumina paired-end and PacBio long-read sequencing data. The high-quality genome assembly contains 34 scaffolds with a 34.81 Mb genome size, 330 interspersed repeat genes, 114 noncoding RNAs, and 12,631 protein-coding genes. The benchmarking universal single-copy ortholog (BUSCO) analysis indicated that 98.2% of the BUSCOs were complete, whereas 0.3, 0.7, and 1.1% were duplicated, fragmented, and missing, respectively. Based on annotation, 508 carbohydrate-active enzymes, 243 cytochromes P450 enzymes, 1,639 translocators, 1,358 transmembrane proteins, and 1,146 virulence genes were identified. This genome sequence provides a valuable reference for future studies to improve understanding of the C. apii–celery pathosystem. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Facilitators of palliative care quality improvement team cohesion
Authors: Connell Natalie B. , Zupanc Sophia N. , Lorenz Karl A. , Bhatnagar Sushma , Fereydooni Soraya , Gamboa Raziel C. , Ganesh Archana , Satija Aanchal , Singh Nainwant , Spruijt Odette , Giannitrapani Karleen F. 
Published: May 2023

Background
The Palliative Care: Promoting Access and Improvement of the Cancer Experience (PC-PAICE) initiative is a team-based, palliative care (PC) quality improvement (QI) project working to promote high-quality PC in India. As a PC QI initiative, PC-PAICE implementation relied upon building interdisciplinary teams, providing the ideal context for understanding facilitators of team cohesion that compelled clinical, organizational, and administrative team members to work together. There is an opportunity to leverage the intersection between QI implementation and organizational theory to inform and improve implementation science.

Purpose
As a subaim of a larger implementation evaluation, we aimed to identify facilitators of team cohesion within QI implementation context.

Methodology
A quota sampling approach captured the perspectives of 44 stakeholders across three strata (organizational leaders, clinical leaders, and clinical team members) from all seven sites through a semistructured interview guide informed by the Consolidated Framework for Implementation Research (CFIR). We used a combination of inductive and deductive approaches informed by organizational theory to identify facilitators.

Result
We identified three facilitators of PC team cohesion: (a) balancing formalization and flexibility around team roles, (b) establishing widespread awareness of the QI project, and (c) prioritizing a nonhierarchical organizational culture.

Practice Implications
Leveraging CFIR to analyze PC-PAICE stakeholder interviews created a data set conducive to understanding complex multisite implementation. Layering role and team theory to our implementation analysis helped us identify facilitators of team cohesion across levels within the team (bounded team), beyond the team (teaming), and surrounding the team (culture). These insights demonstrate the value of team and role theories in implementation evaluation efforts.
Surgeons’ mental distress and risks after severe complications following radical gastrectomy in China: a nationwide cross-sectional questionnaire
Authors: He Hongyong , Lin Chao , Li Ruochen , Zang Lu , Huang Xiao , Liu Fenglin 
Published: May 2023

Background:This study was designed to investigate incidences of surgeons’ mental distress following severe complications after radical gastrectomy.Methods:A cross-sectional survey was conducted between 1 June 2021 and 30 September 2021 among Chinese general and/or gastrointestinal surgeons who experienced severe complications after radical gastrectomy. The clinical features collected in the questionnaire included: (i) feeling burnout, anxiety, or depression; (ii) avoiding radical gastrectomy or feeling stress, slowing down the process during radical gastrectomy operations; (iii) having physical reactions, including heart pounding, trouble breathing, or sweating while recalling; (iv) having urges to quit being a surgeon; (v) taking psychiatric medications; and (vi) seeking psychological counselling. Analyses were performed to identify risk factors of severe mental distress, which was defined as meeting three or more of the above-mentioned clinical features.Results:A total of 1062 valid questionnaires were received. The survey showed that most of the participating surgeons (69.02%) had at least one clinical feature of mental distress following severe complications after radical gastrectomy, and more than 25% of the surgeons suffered from severe mental distress. Surgeons from non-university affiliated hospitals, the junior surgeons, and existing violent doctor–patient conflicts were recognized as independent risk factors for surgeons’ severe mental distress related to the severe complications after radical gastrectomy.Conclusions:About 70% of surgeons had mental health problems following severe complications after radical gastrectomy, and more than 25% of the surgeons suffered from severe mental distress. More strategies and policies are needed to improve the mental well-being of these surgeons after such incidences.
Bilateral Robotic Nephrectomy in a Pediatric Female Patient: A Case Report
Authors: Durham Scott , Cheng Nathan , Jain Namrata G. , Stifelman Michael , Schlussel Richard 
Published: May 2023

Background:
We present a report of a robotic bilateral native nephrectomy (BNN) performed on a pediatric patient awaiting kidney transplantation. We describe this rarely performed minimally invasive procedure, especially in the pediatric population.

Case Summary:
The procedure was performed on a six-year-old girl suffering from worsening kidney function secondary to focal segmental glomerulosclerosis (FSGS). The patient's disease was refractory to all medical management and incurred many complications throughout her course. Because of the complicated course and worsening proteinuria, it was decided to perform a robotic BNN while the patient awaited kidney transplantation.

Conclusion:
Heavy proteinuria carries a greater risk of severe complications in children with FSGS. Synchronized BNN has significantly reduced these risks, specifically thromboembolisms. In addition, these children could benefit from implementing robotic-assisted BNN with the techniques described. Minimally invasive robotic surgery provides a feasible approach to managing this problematic clinical condition.
Patterns of Relapse and Complications of Immunoglobulin G4–Related Disease
Authors: Kowa Jie-Ying , Kim Tae Kyoung , Khalili Korosh , Elbanna Khaled Y. 
Published: May 2023

Abstract

Background
Immunoglobulin G4–related disease (IgG4-RD) is a multisystemic fibroinflammatory condition potentially resulting in organ dysfunction. We aimed to evaluate imaging characteristics of disease relapse and complications in this cohort of patients.

Methods
This was a cohort study of IgG4-RD patients imaged between 2010 and 2020. Radiological manifestations of disease activity (remission/stability vs. relapse and complications) were correlated with clinical symptoms. Univariate analyses were performed with χ
2, Fisher exact, and Mann-Whitney U tests. Times to relapse and organ atrophy were studied with Kaplan-Meier analyses.

Results
A total of 69 patients had imaging surveillance over a median duration of 47 months. Radiological relapse occurred in 50.7% (35/69) with median time to relapse at 74 months (95% confidence interval, 45–122 months); 42.8% (15/35) of this cohort had different-site relapse with the following recognized primary-secondary patterns: pancreas-hepatobiliary (p = 0.005), hepatobiliary-pancreas (p = 0.013), and periaortitis-mesenteric (p = 0.006). Clinical symptoms were significantly associated with imaging characteristics (p < 0.001). Abdominal complications were detected in 52.2% (36/69) of patients, mostly solid organ atrophy (97.2% [35/36]). New-onset diabetes was more likely in pancreatic IgG4-RD (n = 51) when accompanied by gland atrophy (4/21 vs. 0/30 nonatrophy, p = 0.024).

Conclusion
Radiological relapse of IgG4-RD is common over prolonged imaging surveillance and is significantly associated with symptomatic relapse. A multisystem review to detect new/different sites of disease and abdominal complications may help predict future organ dysfunction.
Circumferential Radical Debridement and Omental Free Flap in the Treatment of Severe Chronic Venous Ulcers
Authors: Cavadas Pedro C. , Padial Beatriz 
Published: May 2023

Background
Chronic venous leg ulcers are a significant health care burden with a difficult and unreliable treatment. Free flaps may be needed for wound coverage in severe cases. Incomplete removal of dermatoliposclerosis (DLS) area and/or not addressing the underlying venous dysfunction may contribute to the reported modest long-term results.

Methods
A series of 5 patients with severe chronic venous ulcers of the leg, resistant to conservative treatment and superficial venous surgery, were treated with radical, circumferential, subfascial resection of the DLS skin and coverage with omental free flaps. Delayed arteriovenous (AV) loops were used as recipients. All patients had previous superficial venous surgery and multiple skin grafts. Mean follow-up was 8 years (4–15 years).

Results
One hundred percent of flaps survived completely. No major complications occurred. One patient developed ulceration of the flap at 2 years and healed with basic wound care. At a mean follow-up of 8 years, all patients were ulcer-free. One patient died 15 years after the surgery for unrelated causes.

Conclusions
Radical circumferential resection of DLS area in severe chronic venous leg ulcers and coverage with a free omental flap using staged AV loop provided durable coverage in a series of 5 patients. Complete resection of DLS area, addressing the underlying venous pathology, and draining the flap to a healthy competent vein graft (AV loop) may contribute to these favorable results.
Clinical Evaluation of 310 Abdominoplasties and Measurement of Scar Level
Authors: Swanson Eric 
Published: May 2023

Background
Most published studies on abdominoplasty focus on methods to reduce the risk of seromas. These methods include limited dissection (lipoabdominoplasty), quilting sutures, and preservation of the Scarpa fascia. Quantitative evaluation of the aesthetic result has been lacking.

Methods
A retrospective study was undertaken of all patients undergoing abdominoplasty in the author's practice from 2016 to 2022. A full abdominoplasty was performed, usually with liposuction (87%). All patients were treated under total intravenous anesthesia without paralysis or prone positioning. A single closed suction drain was removed 3 or 4 days after surgery. All procedures were performed as outpatients. Ultrasound surveillance was used to detect any deep venous thromboses. No patient received chemoprophylaxis. The operating table was flexed, often to 90°. Deep fascial anchoring sutures were used to attach the Scarpa fascia of the flap to the deep muscle fascia. Measurements of the scar level were made at intervals after surgery up to 1 year.

Results
Three hundred ten patients were evaluated, including 300 women. The mean follow-up time was 1 year. The overall complication rate, which included minor scar deformities, was 35.8%. Five deep venous thromboses were detected. There were no hematomas. Fifteen patients (4.8%) developed seromas that were successfully treated by aspiration. The mean vertical scar level 1 month after surgery was 9.9 cm (range, 6.1–12.9 cm). There was no significant change in scar level at subsequent follow-up times up to 1 year. By comparison, the scar level in published studies ranged from 8.6 to 14.1 cm.

Discussion
Avoidance of electrodissection reduces tissue trauma that causes seromas. Flexed patient positioning during surgery and deep fascial anchoring sutures are effective in keeping the scar low. By avoiding chemoprophylaxis, hematomas can be avoided. Limiting the dissection (lipoabdominoplasty), preserving the Scarpa fascia, and adding quilting (progressive tension) sutures are unnecessary.

Conclusions
Total intravenous anesthesia offers important safety advantages. Avoiding electrodissection is effective in keeping seroma rates at a tolerable level (5%), and the scar low and more easily concealed. Alternative methods present disadvantages that may contribute to a suboptimal aesthetic result and require additional operating time.