bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breastfeeding Among Women Living With HIV in the Era of Lifelong ART: An Observational Multicountry Study in Eastern and Southern Africa
Authors: Taha Taha E. , Bandala-Jacques Antonio , Yende-Zuma Nonhlanhla , Violari Avy , Stranix-Chibanda Lynda , Atuhaire Patience , Hanley Sherika , Gadama Luis , Chinula Lameck , Dadabhai Sufia , Aizire Jim , Brummel Sean S. , Fowler Mary Glenn 
Published: September 2023

Background:
Lifelong antiretroviral treatment (ART) use is recommended for pregnant and breastfeeding (BF) women living with HIV (WLWH) to prevent perinatal HIV transmission and improve maternal health. We address 2 objectives in this analysis: (1) determine timing and factors associated with BF cessation and (2) assess the impact of BF on health of WLWH on ART.

Setting:
This multicountry study included 8 sites in Uganda, Malawi, Zimbabwe, and South Africa.

Methods:
This was a prospective study of WLWH on lifelong ART. These women initially participated from 2011 to 2016 in a randomized clinical trial (PROMISE) to prevent perinatal HIV transmission and subsequently reenrolled in an observational study (PROMOTE, 2016–2021) to assess ART adherence, safety, and impact.

Results:
The PROMOTE cohort included 1987 women on ART. Of them, 752 breastfed and were included in analyses of objective 1; all women were included in analyses of objective 2. The median time to BF cessation varied by country (11.2–19.7 months). Country of residence, age, and health status of women were significantly associated with time to BF cessation (compared with Zimbabwe: Malawi, adjusted hazard ratio [aHR] 0.50, 95% confidence interval [95% CI]: 0.40 to 0.62, P < 0.001; South Africa, aHR 1.49, 95% CI: 1.11 to 2.00, P = 0.008; and Uganda, aHR 1.77, 95% CI: 1.37 to 2.29, P < 0.001). Women who breastfed had lower risk of being “unwell” compared with women who never breastfed (adjusted rate ratio 0.87, 95% CI: 0.81 to 0.95 P = 0.030).

Conclusion:
Women on lifelong ART should be encouraged to continue BF with no concern for their health. Time to BF cessation should be monitored for proper counseling in each country.
Brief Report: HIV Drug Resistance Assessment Among Women Who Seroconverted During the MTN-025/HOPE Open-Label Extension Dapivirine Vaginal Ring Trial
Authors: Parikh Urvi M. , Penrose Kerri J. , Heaps Amy L. , Sethi Rahil , Goetz B. Jay , Szydlo Daniel , Chandran Uma , Palanee-Phillips Thesla , Mgodi Nyaradzo M. , Baeten Jared M. , Mellors John W. ,   the MTN-025/HOPE Study Team
Published: September 2023

Background:
Clinical trials of dapivirine (DPV) vaginal ring have shown it is safe, effective, and desired by women as an HIV prevention option. The risk of drug resistance is a potential concern for DPV ring users who acquire HIV. We conducted a comprehensive resistance evaluation of plasma samples from the women who seroconverted during the Microbicide Trials Network-025/HIV Open-label Prevention Extension (HOPE) study of DPV ring.

Methods:
Plasma collected on the visit at which seroconversion was detected was tested by next-generation sequencing with unique molecular identifiers for non-nucleoside reverse transcriptase inhibitor (NNRTI) drug resistance mutations (DRM) present at ≥1% frequency. Bulk-cloned plasma-derived recombinant HIV was phenotyped in a TZM-bl–based assay for susceptibility to DPV and other NNRTI. HIV-1 RNA was retrospectively quantified in plasma samples collected before HIV seroconversion.

Results:
Among 38 participants who seroconverted in HOPE, 7 (18%) had NNRTI DRM detected by next-generation sequencing with unique molecular identifiers including A98G, K103N, V106M, E138A, and V179D. Six of 7 samples with NNRTI DRM had <3-fold reduction in susceptibility to DPV. Only 1 sample with K103N and V179I polymorphism had 9-fold reduction in susceptibility to DPV, but this genotype occurred in an individual who did not use DPV ring, likely indicating transmitted resistance. Detection of NNRTI resistance was not higher in individuals who remained on DPV ring >3 months after acquiring HIV infection.

Conclusions:
NNRTI resistance among women who seroconverted during HOPE was infrequent and selection of DPV-specific mutations was not detected. DPV ring is considered a safe and effective option for HIV prevention in women.
Mucormycosis: update on clinical presentation, diagnosis, and treatment
Authors: Dailey Garnes Natalie J.M. , Kontoyiannis Dimitrios P. 
Published: September 2023

Purpose of review
Mucormycosis (MCR) is a common opportunistic mold infection, and Mucorales were recently designated by WHO as priority pathogens. The interest in this infection has risen significantly since the major outbreak of MCR in the context of the COVID-19 pandemic, particularly in India. Herein, we summarize recently (last 24 months) published information regarding clinical aspects of MCR.

Recent findings
The disease remains protean in its clinical presentation, difficult to diagnose, and challenging to treat. In 2021, cases of COVID-19-associated mucormycosis (CAM) exploded in India during COVID-19 and manifested primarily as sino-orbital or sino-cerebral disease. Its classic risk factors included the triad of COVID-19, uncontrolled diabetes mellitus and use of corticosteroids. Despite difficulties in the timely diagnosis of MCR, significant progress has been made with the use of molecular techniques in blood to assist with earlier diagnosis, which can facilitate earlier appropriate therapy and improve outcomes. In addition, advances have been made in the use of imaging to stage the disease, determining what types of multimodal therapy are required depending on staging, and tissue-based identification of Mucorales.

Summary
Although the outlook for MCR has improved, effective new antifungals, risk stratification, and the optimal multimodality approaches remain an unmet need.
Elastic Registration Algorithm Based on Three-dimensional Pulmonary MRI in Quantitative Assessment of Severity of Idiopathic Pulmonary Fibrosis
Authors: Yang Xiaoyan , Yu Pengxin , Xu Wenqing , Sun Haishuang , Duan Jianghui , Han Yueyin , Zhu Lili , Xie Bingbing , Geng Jing , Luo Sa , Wang Shiyao , Ren Yanhong , Zhang Rongguo , Liu Min , Dai Huaping , Wang Chen 
Published: September 2023

Purpose:
To quantitatively analyze lung elasticity in idiopathic pulmonary fibrosis (IPF) using elastic registration based on 3-dimensional pulmonary magnetic resonance imaging (3D-PMRI) and to assess its’ correlations with the severity of IPF patients.

Material and Methods:
Thirty male patients with IPF (mean age: 62±6 y) and 30 age-matched male healthy controls (mean age: 62±6 y) were prospectively enrolled. 3D-PMRI was acquired with a 3-dimensional ultrashort echo time sequence in end-inspiration and end-expiration. MR images were registered from end-inspiration to end-expiration with the elastic registration algorithm. Jacobian determinants were calculated from deformation fields on color maps. The log means of the Jacobian determinants (Jac-mean) and Dice similarity coefficient were used to describe lung elasticity between 2 groups. Then, the correlation of lung elasticity with dyspnea Medical Research Council (MRC) score, exercise tolerance, health-related quality of life, lung function, and the extent of pulmonary fibrosis on chest computed tomography were analyzed.

Results:
The Jac-mean of IPF patients (−0.19, [IQR: −0.22, −0.15]) decreased (absolute value), compared with healthy controls (−0.28, [IQR: −0.31, −0.24], P<0.001). The lung elasticity in IPF patients with dyspnea MRC≥3 (Jac-mean: −0.15; Dice: 0.06) was significantly lower than MRC 1 (Jac-mean: −0.22, P=0.001; Dice: 0.10, P=0.001) and MRC 2 (Jac-mean: −0.21, P=0.007; Dice: 0.09, P<0.001). In addition, the Jac-mean negatively correlated with forced vital capacity % (r=−0.487, P<0.001), forced expiratory volume 1% (r=−0.413, P=0.004), TLC% (r=−0.488, P<0.001), diffusing capacity of the lungs for carbon monoxide % predicted (r=−0.555, P<0.001), 6-minute walk distance (r=−0.441, P=0.030) and positively correlated with respiratory symptoms (r=0.430, P=0.042). Meanwhile, the Dice similarity coefficient positively correlated with forced vital capacity % (r=0.577, P=0.004), forced expiratory volume 1% (r=0.526, P=0.012), diffusing capacity of the lungs for carbon monoxide % predicted (r=0.435, P=0.048), 6-minute walk distance (r=0.473, P=0.016), final peripheral oxygen saturation (r=0.534, P=0.004), the extent of fibrosis on chest computed tomography (r=−0.421, P=0.021) and negatively correlated with activity (r=−0.431, P=0.048).

Conclusion:
Lung elasticity decreased in IPF patients and correlated with dyspnea, exercise tolerance, health-related quality of life, lung function, and the extent of pulmonary fibrosis. The lung elasticity based on elastic registration of 3D-PMRI may be a new nonradiation imaging biomarker for quantitative evaluation of the severity of IPF.
Findings on High Resolution Computed Tomography in Symptomatic Veterans with Deployment-Related Lung Disease
Authors: Rose Cecile S. , Zell-Baran Lauren M. , Cool Carlyne , Moore Camille M. , Wolff Jenna , Oh Andrea S. , Koelsch Tilman , Richards John C. , Krefft Silpa D. , Wilson Carla G. , Lynch David A. 
Published: September 2023

Purpose:
Military deployment to dusty, austere environments in Southwest Asia and Afghanistan is associated with symptomatic airways diseases including asthma and bronchiolitis. The utility of chest high-resolution computed tomographic (HRCT) imaging in lung disease diagnosis in this population is poorly understood. We investigated visual assessment of HRCT for identifying deployment-related lung disease compared with healthy controls.

Materials and Methods:
Chest HRCT images from 46 healthy controls and 45 symptomatic deployed military personnel with clinically confirmed asthma and/or biopsy-confirmed distal lung disease were scored by 3 independent thoracic radiologists. We compared demographic and clinical characteristics and frequency of imaging findings between deployers and controls, and between deployers with asthma and those with biopsy-confirmed distal lung disease, using χ2, Fisher exact or t tests, and logistic regression where appropriate. We also analyzed inter-rater agreement for imaging findings.

Results:
Expiratory air trapping was the only chest CT imaging finding that was significantly more frequent in deployers compared with controls. None of the 24 deployers with biopsy-confirmed bronchiolitis and/or granulomatous pneumonitis had HRCT findings of inspiratory mosaic attenuation or centrilobular nodularity. Only 2 of 21 with biopsy-proven emphysema had emphysema on HRCT.

Conclusions:
Compared with surgical lung biopsy, visual assessment of HRCT showed few abnormalities in this small cohort of previously deployed symptomatic veterans with normal or near-normal spirometry.
Lung Magnetic Resonance Imaging for Prediction of Progression in Patients With Nonidiopathic Pulmonary Fibrosis Interstitial Lung Disease
Authors: Ruano Carina A. , Moraes-Fontes Maria Francisca , Borba Alexandra , Grafino Mónica , Veiga José , Fernandes Otília , Bilhim Tiago , Irion Klaus L. 
Published: September 2023

Purpose:
Correlate magnetic resonance imaging (MRI) parameters at baseline with disease progression in nonidiopathic pulmonary fibrosis interstitial lung disease (ILD).

Materials and Methods:
Prospective observational cohort study, in which patients with non-idiopathic pulmonary fibrosis ILD underwent MRI at baseline (1.5 T). T2-weighted images (T2-WI) were acquired by axial free-breathing respiratory-gated fat-suppressed “periodically rotated overlapping parallel lines with enhanced reconstruction” and T1-weighted images (T1-WI) by coronal end-expiratory breath-hold fat-suppressed “volumetric interpolated breath-hold examination” sequences, before and at time points T1, T3, T5, and T10 minutes after gadolinium administration. After MRI segmentation, signal intensity values were extracted by dedicated software. Percentage of the ILD volume and a ratio between signal intensity of ILD (SIILD) and normal lung (SInormal lung) were calculated for T2-WI; percentage of signal intensity (%SI) at each time point, time to peak enhancement, and percent relative enhancement of ILD in comparison with normal lung (%SIILD/normal lung) were calculated for T1-WI. MRI parameters at baseline were correlated with diagnosis of disease progression and variation in percent predicted forced vital capacity (%FVC) and diffusing capacity of the lung for carbon monoxide after 12 months.

Results:
Comprehensive MRI evaluation (T2-WI and T1-WI) was performed in 21 of the 25 patients enrolled (68% females; mean age: 62.6 y). Three of the 24 patients who completed follow-up fulfilled criteria for disease progression. Baseline T2-WI SIILD/SInormal lung was higher for the progression group (P = 0.052). T2-WI SIILD/SInormal lung and T1-WI %SIILD/normal lung at T1 were positively correlated with the 12-month variation in %FVC (r = 0.495, P = 0.014 and r = 0.489, P= 0.034, respectively).

Conclusions:
Baseline MRI parameters correlate with %FVC decline after 12 months.
Detection of Bacterial Colonization in Lung Transplant Recipients Using an Electronic Nose
Authors: Wijbenga Nynke , de Jong Nadine L.A. , Hoek Rogier A.S. , Mathot Bas J. , Seghers Leonard , Aerts Joachim G.J.V. , Bos Daniel , Manintveld Olivier C. , Hellemons Merel E. 
Published: September 2023

Background.Bacterial colonization (BC) of the lower airways is common in lung transplant recipients (LTRs) and increases the risk of chronic lung allograft dysfunction. Diagnosis often requires bronchoscopy. Exhaled breath analysis using electronic nose (eNose) technology may noninvasively detect BC in LTRs. Therefore, we aimed to assess the diagnostic accuracy of an eNose to detect BC in LTRs.Methods.We performed a cross-sectional analysis within a prospective, single-center cohort study assessing the diagnostic accuracy of detecting BC using eNose technology in LTRs. In the outpatient clinic, consecutive LTR eNose measurements were collected. We assessed and classified the eNose measurements for the presence of BC. Using supervised machine learning, the diagnostic accuracy of eNose for BC was assessed in a random training and validation set. Model performance was evaluated using receiver operating characteristic analysis.Results.In total, 161 LTRs were included with 80 exclusions because of various reasons. Of the remaining 81 patients, 16 (20%) were classified as BC and 65 (80%) as non-BC. eNose-based classification of patients with and without BC provided an area under the curve of 0.82 in the training set and 0.97 in the validation set.Conclusions.Exhaled breath analysis using eNose technology has the potential to noninvasively detect BC.
Cell-mediated and Neutralizing Antibody Responses to the SARS-CoV-2 Omicron BA.4/BA.5–adapted Bivalent Vaccine Booster in Kidney and Liver Transplant Recipients
Authors: Fernández-Ruiz Mario , Almendro-Vázquez Patricia , Redondo Natalia , Ruiz-Merlo Tamara , Abella Sandra , Somoza Adán , López-Medrano Francisco , San Juan Rafael , Loinaz Carmelo , Andrés Amado , Paz-Artal Estela , Aguado José María 
Published: September 2023

Background.
The immunogenicity elicited by the Omicron BA.4/BA.5–adapted bivalent booster vaccine after solid organ transplantation (SOT) has not been characterized.

Methods.
We assessed cell-mediated and neutralizing IgG antibody responses against the BA.4/BA.5 spike receptor-binding domain at baseline and 2 wk after the administration of an mRNA-based bivalent (ancestral strain and BA.4/BA.5 subvariants) vaccine among 30 SOT recipients who had received ≥3 monovalent vaccine doses. Previous coronavirus disease 2019 history was present in 46.7% of them. We also recruited a control group of 19 nontransplant healthy individuals. Cell-mediated immunity was measured by fluorescent ELISpot assay for interferon (IFN)-γ secretion, whereas the neutralizing IgG antibody response against the BA.4/BA.5 spike receptor-binding domain was quantified with a competitive ELISA.

Results.
The median number of BA.4/BA.5 spike–specific IFN-γ–producing spot-forming units (SFUs) increased from baseline to 2 wk postbooster (83.8 versus 133.0 SFUs/106 peripheral blood mononuclear cells; P = 0.0017). Seropositivity rate also increased (46.7%–83.3%; P = 0.001), as well as serum neutralizing activity (4.2%–78.3%; P < 0.0001). Patients with no prior coronavirus disease 2019 history experienced higher improvements in cell-mediated and neutralizing responses after booster vaccination. There was no correlation between BA.4/BA.5 spike–specific IFN-γ–producing SFUs and neutralizing activity. Nontransplant controls showed more robust postbooster cell-mediated immunity than SOT recipients (591.1 versus 133.0 IFN-γ–producing SFUs/106 peripheral blood mononuclear cells; P < 0.0001), although no differences were observed for antibody responses in terms of postbooster seropositivity rates or neutralizing activity.

Conclusions.
Booster with the BA.4/BA.5–adapted bivalent vaccine generated strong subvariant-specific responses among SOT recipients. Booster-induced cell-mediated immunity, however, remained lower than in immunocompetent individuals.
Clinical Course, Immunogenicity, and Efficacy of BNT162b2 mRNA Vaccination Against SARS-CoV-2 Infection in Liver Transplant Recipients
Authors: Tan Eunice X. , Lim Wen Hui , Thong Elizabeth , Chavatte Jean-Marc , Zhang Jinyan , Lim Jonathan , Jin Jocelyn Y. , Lim Daniel R.X. , Kang Jaclyn Y.T. , Tang Ansel Shao Pin , Chan Kai En , Tan Caitlyn , Tan Shi Ni , Nah Benjamin , Huang Daniel Q. , Wang Lin-Fa , Tambyah Paul A. , Somani Jyoti , Young Barnaby , Muthiah Mark D. 
Published: September 2023

Background.
Immunocompromised individuals have been excluded from landmark studies of messenger RNA vaccinations for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). In such patients, the response to vaccination may be blunted and may wane more quickly compared with immunocompetent patients. We studied the factors associated with decreased antibody response to SARS-CoV-2 vaccination and risk factors for subsequent breakthrough infections in liver transplant (LT) patients undergoing coronavirus disease 2019 vaccination with at least 2 doses of messenger RNA vaccine from April 28, 2021, to April 28, 2022.

Methods.
All LT recipients received at least 2 doses of the BNT162b2 (Pfizer BioNTech) vaccine 21 d apart. We measured the antibody response against the SARS-CoV-2 spike protein using the Roche Elecsys immunoassay to the receptor-binding domain of the SARS-CoV-2 spike protein, and the presence of neutralizing antibodies was measured by the surrogate virus neutralization test (cPass) before first and second doses of vaccination and also between 2 and 3 mo after the second dose of vaccination.

Results.
Ninety-three LT recipients who received 2 doses of BNT162b2 were included in the analysis. The mean time from LT was 110 ± 154 mo. After 2-dose vaccination, 38.7% of LT recipients (36/93) were vaccine nonresponders on the cPass assay compared with 20.4% (19/93) on the Roche S assay. On multivariable analysis, increased age and increased tacrolimus trough were found to be associated with poor neutralizing antibody response (P = 0.038 and 0.022, respectively). The use of antimetabolite therapy in conjunction with tacrolimus approached statistical significance (odds ratio 0.21; 95% confidence interval, 0.180-3.72; P = 0.062). Breakthrough infection occurred in 18 of 88 LT recipients (20.4%). Female gender was independently associated with breakthrough infections (P < 0.001).

Conclusions.
Among LT recipients, older age and higher tacrolimus trough levels were associated with poorer immune response to 2-dose SARS-CoV-2 vaccination. Further studies are needed to assess variables associated with breakthrough infections and, hence, who should be prioritized for booster vaccination.
Effective amelioration of lucio phenomenon with adjuvant tofacitinib therapy in a patient with dual infection of M. leprae and M. lepromatosis: A case report from India.
Authors: Patel Nayankumar Harshadkumar , Padhiyar Jignaben Krunal , Patel Kathak Ashok , Patel Jahnvi Rakeshkumar , Lakum Megha Pratapabhai , Singh Itu 
Published: September 2023

Introduction: Lucio phenomenon (LP) is characteristic reaction pattern seen in patient of diffuse lepromatous leprosy(DLL). Dual infection of M. leprae and M. lepromatosis in case of DLL is confirmed from other endemic country but same is yet to be documented from India. Conventionally LP is treated with high dose of systemic glucocorticoid (GC) and anti-leprosy treatment (ALT). Here we are reporting an interesting case of leprosy lymphadenitis as initial presentation in case of LP and DLL due to dual infection with M. leprae and M. lepromatosis who responded favorably to tofacitinib as adjuvant to ALT and systemic GC therapy. Case report: A 24-year-old man presented with complaint of swelling over bilateral inguinal region, pus filled skin lesions with multiple ulcers, fever and joint pain. Post hospitalization investigations showed presence of anemia, leukocytosis and elevated acute and chronic inflammatory markers. Skin and lymph node biopsies were suggestive of LP and Leprosy lymphadenitis. Presence of M.leprae and M. lepromatosis was confirmed by PCR study of tissue. Despite of anti-leprosy treatment, oral GC and thalidomide therapy patient continue developing new lesions. Post one-month commencement of adjuvant tofacitinib, patient experienced excellent clinical improvement as healing of all existing lesions and cessation of new lesion of LP. Conclusion: Our case confirms the presence of dual infection with M. leprae and lepromatosis in India. Lymph node involvement as initial presentation of DLL should be considered in endemic area. Tofacitinib can emerge as promising new adjuvant therapy for recalcitrant lepra reaction.
A conserved cell-pole determinant organizes proper polar flagellum formation
Authors: Arroyo-Pérez Erick Eligio , Hook John C. , Alvarado Alejandra , Wimmi Stephan , Glatter Timo , Thormann Kai M. , Ringgaard Simon 
Published: September 2023

AbstractThe coordination of cell cycle progression and flagellar synthesis is a complex process in motile bacteria. In γ-proteobacteria, the localization of the flagellum to the cell pole is mediated by the SRP-type GTPase FlhF. However, the mechanism of action of FlhF, and its relationship with the cell pole landmark protein HubP remain unclear. In this study, we discovered a novel protein called FipA that is required for normal FlhF activity and function in polar flagellar synthesis. We demonstrated that membrane-localized FipA interacts with FlhF and is required for normal flagellar synthesis inVibrio parahaemolyticus,Pseudomonas putida, andShewanella putrefaciens, and it does so independently of the polar localization mediated by HubP. FipA exhibits a dynamic localization pattern and is present at the designated pole before flagellar synthesis begins, suggesting its role in licensing flagellar formation. This discovery provides insight into a new pathway for regulating flagellum synthesis and coordinating cellular organization in bacteria that rely on polar flagellation and FlhF-dependent localization.