bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative patient optimization for endourological procedures: the current best clinical practice
Authors: Halawani Abdulghafour , Koo Kyo Chul , Wong Victor K.F. , Chew Ben H. 
Published: November 2022

Purpose of review
Despite technological advancements in endourological surgery, there is room for improvement in preoperative patient optimization strategies. This review updates recent best clinical practices that can be implemented for optimal surgical outcomes.

Recent findings
Outcome and complication predictions using novel scoring systems and techniques have shown to assist clinical decision-making and patient counseling. Innovative preoperative simulation and localization methods for percutaneous nephrolithotomy have been evaluated to minimize puncture-associated adverse events. Novel antibiotic prophylaxis strategies and further recognition of risk factors that attribute to postoperative infections have shown the potential to minimize perioperative morbidity. Accumulating data on the roles of preoperative stenting and selective oral alpha-blockers adds evidence to the current paradigm of preventive measures for ureteral injury.

Summary
Ample tools and technologies exist that can be utilized preoperatively to improve surgical outcomes. The combination of these innovations, along with validation in larger-scale studies, presents the cornerstone of future urolithiasis management.
Selective Skeletal Surveys for Infants With Skull Fractures
Authors: Dominguez Michelle M. , Moore Jessica L. , Cook Megan , Rogers Michelle L. , McCarten Kathleen , Slingsby Brett 
Published: November 2022

Objectives
This study aimed to describe which infants with a skull fracture (1) receive a child abuse pediatrician (CAP) consultation, (2) receive a skeletal survey, and (3) re-present to medical care before age 3 years with concerns for physical abuse.

Methods
We conducted a retrospective chart review of infants younger than 12 months who presented to the emergency department between January 1, 2005, and December 30, 2015, with a skull fracture. Medical records were reviewed for the skull fracture presentation and for all future medical evaluations at the same institution with concerns for physical abuse until 3 years of age.

Results
Of 366 infants with a skull fracture, a CAP was contacted for 272 (74%) and 76 (20.8%) infants who received a skeletal survey. Factors associated with skeletal survey acquisition included younger age (<6 months), no history to explain the skull fracture, other injuries on examination, and social risk factors. Six children (1.6%) re-presented to medical care with concerns of physical abuse before age 3 years. Five of these infants did not have a skeletal survey at the time of their skull fracture, and 1 was likely a case of missed physical abuse at the time of the skull fracture.

Discussion
Most skull fractures in infancy occur accidentally, and a skeletal survey may not be necessary for every infant. Obtaining a thorough history including social risk factors, performing a complete physical examination, and consulting with a CAP is an effective first step in the evaluation of physical abuse in infants with skull fractures.
HIV infection drives pro-inflammatory immunothrombotic pathway activation and organ dysfunction among adults with sepsis in Uganda
Authors: Cummings Matthew J. , Bakamutumaho Barnabas , Price Adam , Owor Nicholas , Kayiwa John , Namulondo Joyce , Byaruhanga Timothy , Jain Komal , Postler Thomas S. , Muwanga Moses , Nsereko Christopher , Nayiga Irene , Kyebambe Stephen , Che Xiaoyu , Sameroff Stephen , Tokarz Rafal , Shah Shivang S. , Larsen Michelle H. , Lipkin W. Ian , Lutwama Julius J. , O’Donnell Max R. 
Published: November 2022

Background:
The global burden of sepsis is concentrated in high HIV-burden settings in sub-Saharan Africa (SSA). Despite this, little is known about the immunopathology of sepsis in persons with HIV (PWH) in the region. We sought to determine the influence of HIV on host immune responses and organ dysfunction among adults hospitalized with suspected sepsis in Uganda.

Design:
Prospective cohort study.

Methods:
We compared organ dysfunction and 30-day outcome profiles of PWH and those without HIV. We quantified 14 soluble immune mediators, reflective of key domains of sepsis immunopathology, and performed whole-blood RNA-sequencing on samples from a subset of patients. We used propensity score methods to match PWH and those without HIV by demographics, illness duration, and clinical severity, and compared immune mediator concentrations and gene expression profiles across propensity score-matched groups.

Results:
Among 299 patients, 157 (52.5%) were PWH (clinical stage 3 or 4 in 80.3%, 67.7% with known HIV on antiretroviral therapy). PWH presented with more severe physiologic derangement and shock, and had higher 30-day mortality (34.5% vs. 10.2%; P < 0.001). Across propensity score-matched groups, PWH exhibited greater pro-inflammatory immune activation, including upregulation of interleukin (IL)-6, IL-8, IL-15, IL-17 and HMGB1 signaling, with concomitant T-cell exhaustion, prothrombotic pathway activation, and angiopoeitin-2-related endothelial dysfunction.

Conclusions:
Sepsis-related organ dysfunction and mortality in Uganda disproportionately affect PWH, who demonstrate exaggerated activation of multiple immunothrombotic and metabolic pathways implicated in sepsis pathogenesis. Further investigations are needed to refine understanding of sepsis immunopathology in PWH, particularly mechanisms amenable to therapeutic manipulation.
Measurement of 24-hour Continuous Human CH4Release in a Whole Room Indirect Calorimeter
Authors: Carnero E.A. , Bock C.P. , Liu Y. , Corbin K.D. , Wohlers-Kariesch E. , Ruud K. , Moon J. , Andrew M. , Krajmalnik-Brown R. , Muraviev A. , Vodopyanov K.L. , Smith S.R. 
Published: November 2022

AbstractWe describe the technology and validation of a new whole room indirect calorimeter (WRIC) methodology to quantify methane (CH4) released from the human body over 24h concurrently with the assessment of energy expenditure and substrate utilization. The new system extends the assessment of energy metabolism by adding CH4, a downstream product of microbiome fermentation that could contribute to energy balance.MethodsOur new system consists of an established whole room indirect calorimeter WRIC combined with the addition of off-axis integrated-cavity output spectroscopy (OA-ICOS) to measure CH4concentrations ([CH4]). The volume of CH4released (VCH4) was calculated after measuring air flow rates. Development and validation included environmental experiments to measure the stability of the atmospheric [CH4], infusing CH4into the WRIC and cross-validation studies comparing [CH4] quantified by OA-ICOS and mid-infrared dual-comb spectroscopy (MIR DCS). Reliability of the whole system is reported between years, weeks, days, and validated CH4infusions. The cross-validation and reliability of VCH4released from the human body was determined in 19 participants on consecutive days. In addition, we describe a postprocessing analytical method to differentiate CH4released from breath versus intestine by matching times of stool production and contemporaneous VCH4release.ResultsOur infusion data indicated that the system measured 24h [CH4] and VCH4with high sensitivity, reliability and validity. Cross-validation studies showed good agreement between OA-ICOS and MIR DCS technologies (r= 0.979, P<0.0001). Initial human data revealed 24h VCH4was highly variable between subjects and within / between days; this highlights the importance of a 24-h continuous assessment to have a complete picture of VCH4 release. Finally, our method to quantify VCH4released by breath or colon suggested that over 50% of the CH4was eliminated through the breath.ConclusionsThe method allows, for the first time, measurement of 24h VCH4(in kcal) and therefore the measurement of the proportion of human energy intake fermented to CH4by the gut microbiome and released via breath or directly from the intestine. Our method is accurate, valid, and will provide meaningful data to understand not only interindividual variation, but also allows us to track the effects of dietary, probiotic, bacterial and fecal microbiota transplantation on VCH4.
Evaluating the use of dose-sparing vaccination strategies for Monkeypox
Authors: Dimitrov Dobromir , Adamson Blythe , Matrajt Laura 
Published: November 2022

AbstractThe spring-summer 2022 monkeypox outbreak had over 50,000 cases globally, most of them in gay, bisexual, and other men who have sex with men (MSM). In response to vaccine shortages, several countries implemented dose-sparing vaccination strategies, stretching a full-dose vaccine vial in up to 5 fractional-dose vaccines. Recent studies have found mixed results regarding the effectiveness of the monkeypox vaccine, raising the question of the utility of dose-sparing strategies. We used an age- and risk-stratified mathematical model of an urban MSM population in the United States with approximately 12% high-risk MSM to evaluate potential benefits from implementing dose-sparing vaccination strategies in which a full dose is divided in 3.5 fractional-doses. We found that results strongly depend on the fractional-dose vaccine effectiveness (VE) and vaccine supply. With very limited vaccine available, enough to protect with a full-dose approximately one-third of the high-risk population, dose-sparing strategies are more beneficial provided that fractional-dose preserved at least 40% of full dose effectiveness (34% absolute VE), projecting 13% (34% VE) to 70% (68% absolute VE) fewer infections than full-dose strategies. In contrast, if vaccine supply is enough to cover the majority of the high-risk population, dose-sparing strategies can be outperformed by full-dose strategies. Scenarios in which fractional-dosing was 34% efficacious result in almost three times more infections than full-dosing. Our analysis suggests that when monkeypox vaccine supply is limited and fractional-dose vaccination retains moderate effectiveness, there are meaningful health benefits from providing a smaller dose to a larger number of people in the high-risk population.
High-dimensional immune profiling of dimethyl fumarate and ocrelizumab in multiple sclerosis
Authors: Zhang Yinan , Lee Brian , Xie Hui , Rockoff Jonathan , Satyanarayan Sammita , Brandstadter Rachel , Kim-Schulze Seunghee , Ntranos Achillefs , Lublin Fred 
Published: November 2022

AbstractBackgroundDimethyl fumarate (DMF) and ocrelizumab are two effective immunomodulators for multiple sclerosis (MS) with distinct mechanisms of action. Identifying overlapping therapeutic effects between both agents may elucidate common pathways in preventing disease activity.ObjectivesIn this study we analyzed cytokine and immune-profiling data to evaluate the similarities and differences between the two disease-modifying therapies for MS.Methods: Plasma and PBMCs from MS patients were collected at baseline, 3 months and 6 months after treatment with DMF (n=16) and ocrelizumab (n=13). Immunophenotyping was performed with mass cytometry (CyTOF) and analyzed with gating based on cell surface markers. Cytokine analysis from plasma was performed with Olink assays and analyzed with linear mixed effects models.ResultsDMF reduced both effector T and memory B cell populations while increasing CD56brightnatural killer (NK) cells. Ocrelizumab exerted its main immunomodulatory effect by reducing the frequency of all B cells and increasing frequency of NK cells. At 6 months, naive B-cells began to reconstitute; however, memory B cells remain depleted. DMF treatment was associated with a significant reduction of plasma cytokines involved in inflammatory pathways, such as IL-6, IL-12, and Dectin-1 signaling. In addition, DMF lowered plasma cytokines that are dysregulated in psoriasis and involved in allograft rejection pathways. Ocrelizumab treatment led to the upregulation of neurotropic proteins in the plasma of MS patients, including proteins involved in NAD+ biosynthesis and tryptophan catabolism.ConclusionOur high-dimensional immunophenotyping results suggest that to exert their effects on MS patients, DMF and ocrelizumab both increase NK cells in addition to affecting different immune cell populations and cytokine pathways. Detecting similarities between the mechanisms of the two drugs may contribute to identifying more specific therapeutic targets.
Clinical accuracy of SARS-CoV-2 rapid antigen testing in screening children and adolescents in comparison to RT-qPCR, November 2020 to September 2022
Authors: Krone Manuel , Wagenhäuser Isabell , Knies Kerstin , Hofmann Daniela , Engels Geraldine , Taurines Regina , McDonogh Miriam , Flemming Sven , Meyer Thomas , Böhm Hartmut , Scherzad Agmal , Eisenmann Michael , Rauschenberger Vera , Gabel Alexander , Petri Nils , Reusch Julia , Forster Johannes , Weißbrich Benedikt , Dölken Lars , Kurzai Oliver , Vogel Ulrich , Härtel Christoph , Liese Johannes , Andres Oliver 
Published: November 2022

AbstractBackgroundRapid antigen detection tests (RDT) are an easily accessible, feasible, inexpensive, and point-of-care method in SARS-CoV-2 diagnostics – established in adults as well as in children and adolescents. Despite this, large-scale data of clinical performance in the paediatric population especially regarding the influence of SARS-CoV-2 virus variants of concern (VOC) and COVID-19 vaccination on test accuracy is rare.MethodsThis single-centre prospective diagnostic study evaluates three RDT (NADAL®, Panbio™, MEDsan®) in comparison to quantitative reverse transcription polymerase chain reaction (RT-qPCR). 9,760 oropharyngeal screening samples regarding SARS-CoV-2 VOC and COVID-19 vaccination in paediatric hospitalised patients aged younger than 18 years were enrolled.FindingsRDT sensitivity was 44·7% (157/351, 95% CI 39·6%–50·0%) compared to the reference standard RT-qPCR, specificity 99·8% (9,392/9,409, 95% CI 99·7%–99·9%). Most SARS-CoV-2 infections considered were caused by Omicron VOC. Diagnostic accuracy of RDT depended on specimen containing viral load with a decreasing RDT sensitivity by descending viral load, corresponding with a significantly impaired sensitivity in asymptomatic children. A sensitivity of 71·0% was obtained for a viral load higher than 106SARS-CoV-2 RNA copies per ml suggested as infectivity threshold. No significant differences in RDT sensitivity could be observed regarding gender, symptoms, COVID-19 vaccination status, and VOC.InterpretationIn a paediatric population, RDT have proven to reliably detect potentially highly infectious patients with a viral load of at least 106SARS-CoV-2 RNA copies per ml. Due to the low sensitivity in asymptomatic individuals, the usefulness of RDT seems limited in large-scale SARS-CoV-2 screening programs.FundingFederal Ministry for Education and Science (BMBF), Free State of Bavaria
Music sound quality assessment in bimodal cochlear implant users – toward improved hearing aid fitting
Authors: Abdellatif Khaled H. A. , Müller Verena , Walger Martin , Meister Hartmut 
Published: November 2022

AbstractThe use of cochlear implants (CI) is the common treatment to counteract severe-profound hearing loss. CI often allow reasonable speech understanding but are generally limited in terms of spectro-temporal resolution. Many CI recipients use a hearing aid (HA) on the non-implanted ear (so called bimodal patients) that complements the electrical stimulation of the CI by providing acoustical fine structure information. Amongst others, this might be especially beneficial for music appraisal. However, it is not clear how the HA should be fitted in conjunction with the CI in order to provide the best sound quality.The purpose of this study was to vary different fitting parameters of the HA systematically and to determine the resulting music sound quality. To this end, a master hearing aid was used in order to have controlled access to the different parameters. Three different music excerpts (pop with and without vocals, classic) were presented to 13 bimodally fitted CI users and the sound quality was assessed using the “multiple-stimulus with hidden reference and anchor” (MUSHRA) test. Since the goal was to gain information on possible improvement of fitting, a complete retest was performed and individual reliability of the assessments was determined by the eGauge method.It could be shown that most of the listeners were able to provide reliable sound quality judgements. In terms of HA fitting it turned out that changing compression and varying low frequency gain had a significant effect compared to a standard prescriptive fitting based on DSL v5.0. However, especially the effect of changing low frequency gain depended on the music excerpts presented, since pop music with vocals revealed the largest effect.The study gives evidence that hearing aid fitting can be optimized relative to a standard prescriptive rule in order to improve music sound quality in bimodal CI users. Moreover, the method might be helpful in a clinical setting to determine the best fitting based on individual results.
Estimating the seroincidence of scrub typhus using antibody dynamics following infection
Authors: Aiemjoy Kristen , Katuwal Nishan , Vaidya Krista , Shrestha Sony , Thapa Melina , Teunis Peter , Bogoch Isaac I. , Trowbridge Paul , Kantipong Pacharee , Blacksell Stuart D. , Wangrangsimakul Tri , Varghese George M , Maude Richard , Tamrakar Dipesh , Andrews Jason R. 
Published: November 2022

AbstractIntroductionScrub typhus is an acute febrile illness caused by the bacteriumOrientia tsutsugamushi. Characterizing the population-level burden of scrub typhus is challenging due to the lack of accessible and accurate diagnostics. In this study, we present a novel approach that utilizes information on antibody dynamics after infection to generate population-level scrub typhus seroincidence estimates from cross-sectional serosurveys.MethodsWe use data from three cohorts of scrub typhus patients enrolled in Chiang Rai, Thailand, and Vellore, India, and representative population data from two serosurveys in and around the Kathmandu valley, Nepal, and Vellore, India. The samples were tested for IgM and IgG responses toOrientia tsutsugamushi-derived recombinant 56-kDa antigen using commercial ELISA kits. We used Bayesian hierarchical models to fit two-phase models to the antibody responses from scrub typhus cases and used the joint distributions of the peak antibody titers and decay rates to estimate population-level incidence rates in the cross-sectional serosurveys. We compared this new method to a traditional cut-off-based approach for estimating seroincidence.ResultsMedian IgG antibodies persisted above OD 1.7 for 22 months, while IgM displayed longer persistence than expected, with 50% of participants having an OD >1 for 5 months. We estimated an overall seroincidence of 18 per 1000 person-years (95% CI: 16-21) in India and 4 per 1000 person-years (95% CI: 3-6) in Nepal. Among 18 to 29-year-olds, the seroincidence was 8 per 1000 person-years (95% CI 4 -16) in India and 9 per 1000 person-years (95% CI: 6-14) in Nepal. In both India and Nepal, seroincidence was higher in urban and periurban settings compared to rural areas. Compared to our method, seroincidence estimates derived from age-dependent IgG-seroprevalence without accounting for antibody decay underestimated the disease burden by 50%. By incorporating antibody dynamics, the approach described here provides more accurate age-specific infection risk estimates, emphasizing the importance of considering both IgG and IgM decay patterns in scrub typhus seroepidemiology.ConclusionThe sero-surveillance approach developed in this study efficiently generates population-level scrub typhus seroincidence estimates from cross-sectional serosurveys. This methodology offers a valuable new tool for informing targeted prevention and control strategies, ultimately contributing to a more effective response to scrub typhus in endemic regions worldwide.
Contact bioassay in tandem with HPLC analysis of the active ingredients in LLINs revealed hidden possible causes of the unabated rise in malaria cases
Authors: Kusimo Michael O. , Ibrahim Sulaiman S. , Kusimo Nelly O. , Nwokeoji Alison O. , Yemitan Omoniyi K. 
Published: November 2022

AbstractBackgroundThe World Malaria Report 2021 revealed that Nigeria accounted for 27% of 241 million malaria cases worldwide and 31% of 602,000 malaria deaths. This WHO report is in sharp contrast to the ambitious goal of the National Malaria Strategic Plan (NMSP) 2014-2020, which aimed to transition Nigeria from malaria control to malaria elimination status by 2020. In this study, we combined contact bioassay with HPLC analysis to investigate how the end users’ treatment of Long-Lasting Insecticide Treated Nets (LLINs) inadvertently contributes to the unabated rise in malaria cases.MethodsWe randomly selected a few LLINs used under normal household conditions in Port-Harcourt and one on sale in Lagos, Nigeria. The continued potency of these LLINs to protect the users against malaria vectors, assuming the local vectors are insecticide-susceptible, was evaluated by exposing laboratory-susceptibleAnopheles gambiaKisumu strain to the nets according to the WHO cone bioassay protocol. After the exposure, the active ingredients (AI) in the LLINs were extracted and analysed using reverse phase HPLC to establish the quantity of the AIs and correlate it to bio-efficacy. The AI loss per wash was also computed based on the information provided by the users.ResultsThe labels on the LLINs revealed them to be Royal Sentry, PermaNet 2.0 and DuraNet. The bio-efficacy of these LLINs under household usage is less than two years. AI lost per wash was higher by 2.5-fold in LLIN made of polyethylene nets than polyester nets: 0.35g/Kg/wash and 0.14g/Kg/wash, respectively. The AI lost per wash increased by 31% for net exposed longer to the harsh environmental conditions of this region. The LLIN (ParmaNet) purchased in the open market has the highest AI concentration but only achieved 70.62% mortality, far below the acceptable standard.ConclusionThe AI in the LLIN bought from the open market was the highest, but of poor quality. This bed net was a counterfeit product, not approved by WHOPES. More importantly, this study revealed that field examination of LLINs under normal household use should be examined per region for policy makers to have informed knowledge of the duration of the bio-efficacy of the LLINs being distributed.