bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards improvement in malaria policy implementation in Nigeria: a qualitative study on factors influencing the translation of malaria policies to practice
Authors: Omo-Imafidon Evbogaghe S , Adeogun Adedapo O , Babalola Ayodele S , Okefu Philip O , Akinyemi Oluwaseun O 
Published: January 2022

AbstractBackgroundMalaria is a severe health issue in Nigeria, particularly for pregnant women and children &lt;5 y of age, despite all malaria control programs. From the standpoint of major stakeholders in Nigeria, this study explored both promoting and limiting factors affecting the implementation of malaria policy.MethodsFrom March to June 2019, in-depth interviews were conducted with 16 key respondents. Key informants such as malaria researchers, policy advisers and program managers were identified using purposive and snowballing sampling strategies. Interviews were performed in English, recorded, transcribed and analysed using QSR NVivo 11.ResultsSome of the variables increasing the implementation of malaria policies in Nigeria, according to respondents, were political will, access to funds from donors, and staff commitment. Insufficient planning, lack of commitment, poor finance, manpower shortages, and a lack of synergy between academics and policymakers, on the other hand, were recognized as important barriers to the malaria policy implementation process by respondents.ConclusionsImplementation gaps may result from a lack of capability for the policy implementation process and a lack of support for policy objectives. The difficulties in implementing malaria policy in Nigeria were highlighted in this study, and relevant recommendations were made.
Clinicopathologic characteristics and risk factors for endometrial malignancy in postmenopausal women with endometrial thickening
Authors: Ai Fangfang , Wang Yiling , Zhou Liane , Wang Shijun 
Published: January 2022

Abstract

Objective:
To evaluate the clinicopathological characteristics and risk factors for endometrial malignancy in postmenopausal women with endometrial thickening.

Methods:
This was a retrospective study. Postmenopausal women with endometrial thickening (defined as the thickest endometrial portion in the sagittal uterine plane was greater than or equal to 5 mm) through transvaginal ultrasound in our outpatient department, and further referred to the gynecology department at Xuanwu Hospital for hysteroscopic diagnostic curettage assessment between January 2018 and March 2021 were included. According to the histopathological results, participants were divided into the benign group and malignant group. Univariate analysis was used to compare the differences in various factors, including demographics, clinical characteristics, medical complications, and ultrasound characteristics, between the two groups. Multiple logistic regression analysis was used to identify the factors that were independent contributors to the development of endometrial malignancy. Receiver operating characteristic analysis of endometrial thickness (ET) to predict endometrial malignancy was performed.

Results:
In total, 385 eligible cases were included in the analysis. The results suggested that older age (odds ratio [OR] 1.061, 95% confidence interval [CI] 1.008-1.116, P = 0.023), thicker ET (OR 5.032, 95% CI 2.453-10.322, P < 0.001), irregular menstruation in the past (OR 19.203, 95% CI 1.936-190.431, P = 0.012), postmenopausal bleeding (OR 12.341, 95% CI 4.440-34.302, P < 0.001), and polypoid mass-like lesions (OR 30.330, 95% CI 8.974-102.509, P < 0.001) were risk factors that were independently associated with the development of endometrial malignancy in postmenopausal women with increased ET. The optimal critical value of ET in predicting malignancy was 9.5 mm, and the sensitivity and specificity were 71.70% and 71.69%, respectively.

Conclusions:
For postmenopausal women with endometrial thickening, our results suggested that women who are older, have a thicker ET, had irregular menstruation in the past, have postmenopausal bleeding, and have polypoid mass-like lesions should seek medical attention as soon as possible and undergo further invasive examination. The use of 9.5 mm as the ET value to prompt investigations may be acceptable since it is unlikely to miss any atypical endometrial hyperplasia or endometrial cancer.
Clinical Reasoning Behind Antibiotic Use in PICUs: A Qualitative Study*
Authors: Fontela Patricia S. , Gaudreault Josée , Dagenais Maryse , Noël Kim C. , Déragon Alexandre , Lacroix Jacques , Razack Saleem , Rennick Janet , Quach Caroline , McNally James D. , Carnevale Franco A. ,   on behalf of the Canadian Critical Care Trials Group
Published: January 2022

OBJECTIVES:
To describe the reasoning processes used by pediatric intensivists to make antibiotic-related decisions.

DESIGN:
Grounded theory qualitative study.

SETTING:
Three Canadian university-affiliated tertiary medical, surgical, and cardiac PICUs.

PATIENTS:
Twenty-one PICU physicians.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We conducted field observation during morning rounds followed by semistructured interviews with participants to examine the clinical reasoning behind antibiotic-related decisions (starting/stopping antibiotics, or treatment duration) made for patients with a suspected/proven bacterial infection. We used a grounded theory approach for data collection and analysis. Thematic saturation was reached after 21 interviews. Of the 21 participants, 10 (48%) were female, 15 (71%) were PICU attending staff, and 10 (48%) had greater than 10 years in clinical practice. Initial clinical reasoning involves using an analytical approach to determine the likelihood of bacterial infection. In case of uncertainty, an assessment of patient safety is performed, which partly overlaps with the use of intuitive clinical reasoning. Finally, if uncertainty remains, physicians tend to consult infectious diseases experts. Factors that override this clinical reasoning process include disease severity, pressure from consultants, and the tendency to continue antibiotic treatment initiated by colleagues.

CONCLUSIONS:
Antibiotic-related decisions for critically ill children are complex, and pediatric intensivists use several clinical reasoning strategies to decrease the uncertainty around the bacterial etiology of infections. However, disease severity and patient safety concerns may overrule decisions based on clinical evidence and lead to antibiotic use. Several cognitive biases were identified in the clinical reasoning processes.
Brain aging and cardiovascular factors in HIV: a longitudinal volume and shape MRI study
Authors: Jakabek David , Rae Caroline D. , Brew Bruce J. , Cysique Lucette A. 
Published: January 2022

Objective:
We aimed to examine the relative contributions of HIV infection, age, and cardiovascular risk factors to subcortical brain atrophy in people with HIV (PWH).

Design:
Longitudinal observational study.

Methods:
Virally suppressed PWH with low neuropsychological confounds (n
= 75) and demographically matched HIV-negative controls (n = 31) completed baseline and 18-month follow-up MRI scans, neuropsychological evaluation, cardiovascular assessments, and HIV laboratory tests. PWH were evaluated for HIV-associated neurocognitive disorder (HAND). Subcortical volumes were extracted with Freesurfer after removal of white matter hyperintensities. Volumetric and shape analyses were conducted using linear mixed-effect models incorporating interactions between age, time, and each of HIV status, HAND status, HIV disease factors, and cardiovascular markers.

Results:
Across baseline and follow-up PWH had smaller volumes of most subcortical structures compared with HIV-negative participants. In addition, over time older PWH had a more rapid decline in caudate volumes (P
= 0.041), predominantly in the more severe HAND subgroups (P = 0.042). Higher CD4+ cell counts had a protective effect over time on subcortical structures for older participants with HIV. Increased cardiovascular risk factors were associated with smaller volumes across baseline and follow-up for most structures, although a more rapid decline over time was observed for striatal volumes. There were no significant shape analyses findings.

Conclusion:
The study demonstrates a three-hit model of general (as opposed to localized) subcortical injury in PWH: HIV infection associated with smaller volumes of most subcortical structures, HIV infection and aging synergy in the striatum, and cardiovascular-related injury linked to early and more rapid striatal atrophy.
Cerebral Vasospasm-Left Heart Failure-Cerebral Infarction May Be a Potential Pathophysiological Mechanism of Malignant Cerebral Vasospasm
Authors: Sun Bing , Chang Hao , Ding Yasuo 
Published: January 2022

Abstract
Cerebral vasospasm (CV) and delayed cerebral ischemia are serious complications after ruptured aneurysm with high mortality and disability rate. However, there are few reports of cardiogenic CV, the mechanism is unclear, and the treatment recommended by the guidelines is not detailed. This article describes in detail a 47-year-old woman with intracranial aneurysm rupture and hemorrhage. After interventional operation, left heart failure worsened CV and cerebral infarction. This article summarizes the diagnosis and treatment process of patients in detail, summarizes the treatment strategies of cardiogenic CV, and elaborates the pathological mechanism of CV-left heart failure-CV and cerebral infarction. increase new understanding of the clinical diagnosis and treatment strategies of cardiogenic CV.
Twelve-Year Experience With Nasofrontal Angle (Radix) Augmentation in Rhinoplasty
Authors: Alawadh Ibrahim , Bogari Ahmad , Bedaiwi Reenad , Alanazi Hani , Bafaqeeh Sameer 
Published: January 2022

Abstract
The nasofrontal angle (radix) has a great impact on the rhinoplasty outcome. Minimal alterations in this area can give an unusual nasal appearance and midfacial length. Different management approaches have been described with regard to radix augmentation. This study aimed to describe the techniques of rhinoplasty, different materials used in the procedure, and results of at least 1 year of follow-up in our 12-year experience in this field. The authors retrospectively reviewed the data of patients who underwent rhino-plasty/septorhinoplasty with radix augmentation performed by 1 of the authors (a senior surgeon at our institution) using different graft materials, between January 2007 and December 2019. Patients younger than 18 years or who were followed up for less than 1 year were excluded from the study. In total, 387 patients (235 [60.7%] female; age range, 19–39 years) were included. Primary procedures were performed in 311 patients (80.5%), and revision procedures were performed in 76 patients (19.6%). Most patients (97%) were satisfied with the aesthetic result. There was no incidence of infection, displacement, or extrusion of the graft. The only complications observed were irregularities; 3% required revision surgery. It is important to consider the nasal radix when pursuing a balanced profile in rhinoplasty. Many graft materials can be used safely and can achieve good aesthetic outcomes. Proper anatomical analysis and patient selection are essential for successful graft placement.
Craniofacial Dysmorphology in Infants With Non-Syndromic Unilateral Coronal Craniosynostosis
Authors: Bellaire Christopher P. , Devarajan Alex , Napoli James G. , Rutland John W. , Liu Helen , Jacob Laya , Mandelbaum Max , Sayegh Farah , Margulies Ilana G. , Goel Pedram , Delman Bradley N. , Urata Mark M. , Taub Peter J. 
Published: January 2022

Background:
Unilateral coronal craniosynostosis (UCS) is a congenital disorder resulting from the premature suture fusion, leading to complex primary and compensatory morphologic changes in the shape of not only the calvarium and but also into the skull base. This deformity typically requires surgery to correct the shape of the skull and prevent neurologic sequelae, including increased intracranial pressure, sensory deficits, and cognitive impairment.

Methods:
The present multicenter study sought to reverse-engineer the bone dysmorphogenesis seen in non-syndromic UCS using a geometric morphometric approach. Computed tomography scans for 26 non-syndromic UCS patients were converted to three-dimensional mesh models. Two hundred thirty-six unique anatomical landmarks and semi-landmarked curves were then plotted on each model, creating wireframe representations of the Patients’ skulls.

Results:
Generalized Procrustes superimposition, Principal Component Analysis, and heatmaps identified significant superior displacement of the ipsilateral orbit (“harlequin” eye deformity), anterior displacement of the ear ipsilateral to the fused coronal suture, acute deviation of midline skull base structures ipsilateral to the fused coronal suture and flattening of the parietal bone and associated failure to expand superiorly.

Conclusions:
The described technique illustrates the impact of premature coronal suture fusion on the development of the entire skull and proposes how bone dysmorphology contributes to the Patients’ neurologic sequelae. By bridging novel basic science methodologies with clinical research, the present study quantitatively describes craniofacial development and bone dysmorphogenesis.
Thalamo-Prefrontal Connectivity Correlates with Early Command Following After Severe Traumatic Brain Injury
Authors: Cosgrove Megan E. , Saadon Jordan R. , Mikell Charles B. , Stefancin Patricia L. , Alkadaa Leor , Wang Zhe , Saluja Sabir , Servider John , Razzaq Bayan , Huang Chuan , Mofakham Sima 
Published: January 2022

AbstractRecovery of consciousness after traumatic brain injury (TBI) is heterogeneous and difficult to predict. Structures such as the thalamus and prefrontal cortex are thought to be important in facilitating consciousness. We sought to investigate whether the integrity of thalamo-prefrontal circuits, assessed via diffusion tensor imaging (DTI), was associated with the return of goal-directed behavior after severe TBI. We classified a cohort of severe TBI patients (N = 25, 20 males) into Early and Late/Never outcome groups based on their ability to follow commands within 30 days post-injury. We assessed connectivity between whole thalamus, and mediodorsal thalamus (MD), to prefrontal cortex (PFC) subregions including dorsolateral PFC (dlPFC), medial PFC (mPFC), anterior cingulate (ACC), and orbitofrontal (OFC) cortices. We found that the integrity of thalamic projections to PFC subregions (L OFC, L and R ACC, and R mPFC) was significantly associated with Early command-following. This association persisted when the analysis was restricted to prefrontal-mediodorsal (MD) thalamus connectivity. In contrast, dlPFC connectivity to thalamus was not significantly associated with command-following. Using the integrity of thalamo-prefrontal connections, we created a linear regression model that demonstrated 72% accuracy in predicting command-following after a leave-one-out analysis. Together, these data support a role for thalamo-prefrontal connectivity in the return of goal-directed behavior following TBI.
Can single-neuron frequency tuning in human auditory cortex be quantified through fMRI adaptation?
Authors: Besle Julien , Sánchez-Panchuelo Rosa-María , Francis Susan , Krumbholz Katrin 
Published: January 2022

AbstractMeasuring neuronal frequency selectivity in human auditory cortex may be crucial for understanding common auditory deficits such as speech-in-noise difficulty. Non-invasive methods measure aggregate responses of large populations of neurons and therefore overestimate single-neuron tuning selectivity. Here we explore whether cortical frequency selectivity can be estimated through fMRI adaptation. Using ultra-high-field (7T) BOLD-fMRI and individualized functional parcellation of auditory cortex, we measured the suppression (or adaptation) of primary and non-primary cortical responses to a high-frequency (3.8 kHz) probe sound as a function of the frequency of a preceding adaptor sound (ranging from 0.5 to 3.8 kHz). The degree of frequency tuning of the adaptation effect strongly depended on the temporal structure of the adaptor. Suppression by a single 200-ms adaptor showed little or no tuning, despite clear frequency tuning of the responses to the different adaptors. In contrast, suppression by multiple (four) 50-ms adaptor bursts was clearly tuned, with greater frequency selectivity than the adaptor response tuning, suggesting that fMRI adaption to multiple adaptors may reflect the frequency tuning of the underlying neuronal response. Importantly, adaptation tuning differed between primary and non-primary regions, suggesting a local suppression effect, rather than inheritance from upstream subcortical structures. Using a computational model of fMRI adaptation in a tonotopically-organized neuronal array, we identify key factors determining the relationship between observed fMRI adaptation tuning and the frequency selectivity of the underlying neuronal response. Using this model, we derive a plausible range for the frequency selectivity of individual neurons in each region of auditory cortex.
Diversity of cave Phlebotomines (Diptera: Psychodidae) from a Colombian cave
Authors: Velazquez Manuela , Stuckert Adam M. M. , Vivero Rafael J. , Matute Daniel R. 
Published: January 2022

ABSTRACTSandflies are vector species ofLeishmania, among many other pathogens, with a global distribution and a variety of ecological niches. Previous samplings have found that karstic formations (i.e., caves and folds formed by the erosion of limestone) serve as a natural habitat to sandfly species. The majority of samplings of cave sandfly diversity have occurred in Brazil and to date none have studied the species composition in a cave in the Northern Andes. We collected sandflies in the Cave “Los Guácharos”, in the state of Antioquia, Colombia. The sampling was carried out during two consecutive nights in September 2019. CDC-type light traps were installed inside the cavern and in other surrounding karst systems (caves and folds). In total, we identified 18 species of sandfly from the cave and surrounding karst systems, including three new records for Colombia (Bichromomyia olmeca nociva, Brumptomyia brumpti, andWarileya leponti), and provide the first karstic reports for four other species (Lutzomyia gomezi, Lutzomyia hartmanni, Pintomyia ovallesi, andPsychodopygus panamensis). We then used the results of our survey and published literature to test two hypotheses. First, that sandfly diversity in Neotropical caves is richest nearer to the equator and second that there is a phylogenetic signal of karstic habitat use in sandflies. Counter to our predictions, we found no evidence that diversity follows a latitudinal gradient. Further, we find no evidence of a phylogenetic signal of karstic habitat use, instead finding that the use of caves likely evolved multiple times across several genera. Our results highlight the importance of a wide sampling to understand the natural habitat of sandflies and other disease vectors.
Fusogenicity and neutralization sensitivity of the SARS-CoV-2 Delta sublineage AY.4.2
Authors: Saunders Nell , Planas Delphine , Bolland William , Rodriguez Christophe , Fourati Slim , Buchrieser Julian , Planchais Cyril , Prot Matthieu , Staropoli Isabelle , Guivel-Benhassine Florence , Porrot Françoise , Veyer David , Péré Hélène , Robillard Nicolas , Saliba Madelina , Baidaliuk Artem , Seve Aymeric , Hocqueloux Laurent , Prazuck Thierry , Mouquet Hugo , Simon-Lorière Etienne , Bruel Timothée , Pawlotsky Jean-Michel , Schwartz Olivier 
Published: January 2022

AbstractSARS-CoV-2 lineages are continuously evolving. As of December 2021, the AY.4.2 Delta sub-lineage represented 20 % of sequenced strains in UK and has been detected in dozens of countries. It has since then been supplanted by the Omicron variant. AY.4.2 displays three additional mutations (T95I, Y145H and A222V) in the N-terminal domain (NTD) of the spike when compared to the original Delta variant (B.1.617.2) and remains poorly characterized. Here, we analyzed the fusogenicity of the AY.4.2 spike and the sensitivity of an authentic AY.4.2 isolate to neutralizing antibodies. The AY.4.2 spike exhibited similar fusogenicity and binding to ACE2 than Delta. The sensitivity of infectious AY.4.2 to a panel of monoclonal neutralizing antibodies was similar to Delta, except for the anti-RBD Imdevimab, which showed incomplete neutralization. Sensitivity of AY.4.2 to sera from individuals having received two or three doses of Pfizer or two doses of AstraZeneca vaccines was reduced by 1.7 to 2.1 fold, when compared to Delta. Our results suggest that mutations in the NTD remotely impair the efficacy of anti-RBD antibodies. The temporary spread of AY.4.2 was not associated with major changes in spike function but rather to a partially reduced neutralization sensitivity.
Functionally distinct BMP1 isoforms show an opposite pattern of abundance in plasma from non-small cell lung cancer subjects and controls
Authors: Donovan Margaret K. R. , Huang Yingxiang , Blume John E. , Wang Jian , Hornburg Daniel , Ferdosi Shadi , Mohtashemi Iman , Kim Sangtae , Ko Marwin , Benz Ryan W. , Platt Theodore L. , Batzoglou Serafim , Diaz Luis A. , Farokhzad Omid C. , Siddiqui Asim 
Published: January 2022

AbstractAdvancements in deep plasma proteomics are enabling high-resolution measurement of plasma proteoforms, which may reveal a rich source of novel biomarkers previously concealed by aggregated protein methods. Here, we analyze 188 plasma proteomes from non-small cell lung cancer subjects (NSCLC) and controls to identify NSCLC-associated protein isoforms by examining differentially abundant peptides as a proxy for isoform-specific exon usage. We find four proteins comprised of peptides with opposite patterns of abundance between cancer and control subjects. One of these proteins, BMP1, has known isoforms that can explain this differential pattern, for which the abundance of the NSCLC-associated isoform increases with stage of NSCLC progression. The presence of cancer and control-associated isoforms suggests differential regulation of BMP1 isoforms. The identified BMP1 isoforms have known functional differences, which may reveal insights into mechanisms impacting NSCLC disease progression.
Dominance of coniferous and broadleaved trees drives bacterial associations with boreal feather mosses
Authors: Rodríguez-Rodríguez Juanita C. , Bergeron Yves , Kembel Steven W. , Fenton Nicole J. 
Published: January 2022

SummaryThe composition of ecologically important moss-associated bacterial communities seems to be mainly driven by host species, but may also be shaped by environmental conditions related with tree-canopy dominance. The moss phyllosphere has been studied in coniferous forests while broadleaf forests remain understudied. To determine if host species or environmental conditions defined by tree-canopy dominance drives the bacterial diversity in the moss phyllosphere, we used 16S rRNA gene amplicon sequencing to quantify changes in bacterial communities as a function of host species (Pleurozium schreberiandPtilium crista-castrensis) and forest type (coniferous black spruce versus deciduous broadleaf trembling aspen) in eastern Canada. Forest type, not host species, was the main factor affecting moss phyllosphere bacterial community composition, though the interaction of both variables was significant. Bacterial α-diversity was highest in spruce forests, while there was greater turnover (β- diversity) and higher γ-diversity in aspen forests. Unexpectedly, Cyanobacteria were much more relatively abundant in aspen than in spruce forests, with the bacterial family Nostocaceae (Cyanobacteria) differing the most between both forest types. Our results suggest that the increasing change in dominance from coniferous to broadleaf trees due to natural and anthropic disturbances is likely to affect the composition of moss-associated bacteria in boreal forests.