bluuebunny/crossref_metadata_2025_split huggingface dataset:
Large Volume Fat Grafting: Identifying Risk Factors for Fat Necrosis
Authors: Chang Catherine S. , Lanni Michael A. , Mirzabeigi Michael N. , Bucky Louis P. 
Published: August 2022

Purpose:
Fat necrosis is a well-recognized complication following autologous fat grafting. The purpose of this study is to evaluate the incidence of fat necrosis after large volume fat grafting (LVFG) and identify risk factors for fat necrosis.

Methods:
A retrospective review was performed on 83 consecutive patients who underwent LVFG (>100ccs) to the breast performed by the senior author between September 2011-May 2016. Fat necrosis was defined as palpable nodules or nodules seen on imaging.

Results:
A total of 148 breasts underwent 170 autologous fat transplantations. Indications included: 72 reconstructions after surgical therapy and 98 cosmetic augmentations. Mean age was 48 years, median graft volume of 300ccs and median length of follow-up 423 days. Overall incidence of necrosis was 32.9%, with 47.8% in previously irradiated patients. Increased incidence of necrosis was associated with increasing fat graft volumes(p=0.032, OR=1.002), increasing BMI(p=0.04, OR=1.13), and simultaneous implant exchange with fat(p=0.003). Fat grafting volumes greater than 450ccs in a single breast was also associated with an increase in fat necrosis(p=0.04). Within a group of six patients that had bilateral fat grafting with unilateral radiation, there was a significant increase in necrosis on the radiated side(p=0.015). In a cohort of non-BRAVA patients, reconstruction (compared to augmentation) was associated with fat necrosis(p=0.039).

Conclusion:
Increased rates of fat necrosis were associated with volumes greater than 450ccs, patients undergoing concurrent implant exchange with fat grafting, and fat grafting after a history of lumpectomy or mastectomy without preexpansion. Additionally, radiation may be associated with a higher rate of complications.
The Role of Social Biases, Race, and Condom Use in Willingness to Prescribe HIV Pre-exposure Prophylaxis to MSM: An Experimental, Vignette-Based Study
Authors: Bunting Samuel R. , Feinstein Brian A. , Calabrese Sarah K. , Hazra Aniruddha , Sheth Neeral K. , Wang Gary , Garber Sarah S. 
Published: August 2022

Introduction:
Daily antiretroviral pre-exposure prophylaxis (PrEP) is a safe and effective method of preventing HIV. Clinicians' assumptions, biases, and judgments may impede access to PrEP. Specifically, concern that patients will engage in more condomless sex (“risk compensation”) has been cited by clinicians as a reason for not prescribing PrEP.

Methods:
In this experimental study among medical students, we systematically varied race (White or Black) and condom-use behaviors (continued-use, planned-discontinuation, or continued-nonuse) of a fictional patient (all men with multiple male sex partners). Participants indicated the patients' assumed adherence to PrEP, patients' overall HIV risk, and willingness to prescribe PrEP. Participants completed an implicit association test to detect implicit racism and measures of heterosexism and attitudes toward nonmonogamy, which were examined as moderators of patient race and condom-use effects on participants' assumptions and ultimate willingness to prescribe PrEP.

Results:
Participants (N = 600) were most willing to prescribe PrEP to the continued-nonuse patient and least willing to prescribe to the planned-discontinuation patient. No differences were identified based on patient race. The continued-nonuse (vs. continued-use) patient was perceived as less likely to adhere to PrEP, which was associated with lower willingness to prescribe. Negative attitudes toward nonmonogamy exacerbated this effect. No effects of implicit racism or explicit heterosexism were identified.

Conclusions:
Participants were least willing to prescribe PrEP to patients who planned to discontinue condom use. Patients seeking PrEP are exhibiting agency over their sexual health, and clinicians should fulfill their role in ensuring access to this primary preventative therapy. Training and curricular reform regarding PrEP are needed.
Congenital cytomegalovirus infection diagnostics and management
Authors: Pinninti Swetha , Boppana Suresh 
Published: August 2022

Purpose of the review
Congenital cytomegalovirus infection (cCMV) is the most frequent congenital infection and a leading nongenetic cause of sensorineural hearing loss (SNHL) and brain disease. The purpose of this review is to highlight recent developments in the diagnosis and management of children with cCMV.

Recent Findings
Progress is being made in the efforts to identify more infants with cCMV, especially those with asymptomatic infection. Largely due to efforts by various advocacy/parent groups, a number of states in the United States and many hospital systems have implemented hearing targeted CMV screening and mandated education of pregnant women about CMV.

Summary
cCMV is an important cause of SNHL and neurologic morbidity worldwide. Early identification of infected children is critical to improve outcomes by providing timely interventions and guidance for long-term follow up. The fact that most infants with cCMV have no abnormal clinical findings, and the need to obtain samples for diagnosis within the first 2–3 weeks of life, makes it challenging to identify a majority of infants with cCMV without universal newborn CMV screening.
Critical Importance of the First Postoperative Days After Head and Neck Free Flap Reconstruction
Authors: Elmer Nicholas A. , Baltodano Pablo A. , Webster Theresa , Deng Mengying , Egleston Brian , Massada Karen , Kaplunov Briana , Brebion Rohan , Araya Sthefano , Patel Sameer A. 
Published: August 2022

Background
Head and neck free flaps remain associated with considerable rates of take-back and prolonged hospital length of stay. However, there have been no studies on a national level benchmarking the timeline and predictors of head and neck free flap take-back.

Methods
Patients undergoing head and neck free flap reconstruction from the American College of Surgeons National Surgical Quality Improvement Program 2012–2019 database were analyzed to determine the rates of take-back. Timing and rates of unplanned head and neck free flap take-backs were stratified by tissue type and postoperative day (POD) over the first month. Weibull survival models were used to compare rates of take-backs among time intervals. Multivariable logistic regression was used to identify the independent predictors of take-back.

Results
Three thousand nine hundred six head and neck free flaps were analyzed. The mean daily proportion of patients experiencing take-back during PODs 0 to 1 was 0.95%; this dropped significantly to a mean daily proportion of 0.54% during POD 2 (P < 0.01). In addition, there were significant drops in take-back when comparing POD 2 (0.54%) to POD 3 (0.26%) and also when comparing POD 4 (0.20%) with PODs 5 to 30 (0.032% per day) (P < 0.05). The soft tissue and osseous flap populations demonstrated a similar trend in unplanned take-back.

Conclusion
This is the first national study to specifically analyze the timing of take-back in the head and neck reconstruction population. These data highlight the importance of flap monitoring during the first 5 PODs, with ERAS pathway optimization aiming for discharge by the end of the first postoperative week.
Development of the Sm14/GLA-SE - schistosomiasis vaccine candidate: An open, not placebo-controlled, standardized dose immunization phase Ib clinical trial targeting healthy young women
Authors: Santini-Oliveira Marilia , Pinto Patrícia Machado , dos Santos Tatiane , Vilar Monica Magno , Grinsztejn Beatriz , Veloso Valdilea , Paes-de-Almeida Elan C. , Amaral Maria A. Z. , Ramos Celso R. , Marroquin-Quelopana Miryam , Coler Rhea , Reed Steven , Ciol Marcia , Savino Wilson , de Carvalho Parra Juçara , dos Santos Almeida Marília Sirianni , Tendler Miriam 
Published: August 2022

AbstractWe report the successful closure of Phase I clinical trials of the Schistosoma mansoni 14 kDa fatty acid-binding protein (Sm14) + glucopyranosyl lipid A in squalene emulsion (GLA-SE) vaccine candidate against human Schistosomiasis, comprising Phases Ia and Ib. Shown here are the results of Phase Ib, an open, not placebo-controlled, standardized-dose immunization trial, involving 10 healthy 18-49 years old women submitted to the same clinical protocol and the same batch of cGMP Sm14+GLA-SE used in Phase Ia, which was one on men. Fifty µg Sm14 protein plus 10 µg GLA-SE per dose were given intramuscularly thrice at 30-day intervals. Participants were assessed clinically, biochemically, and immunologically for up to 120 days. In preambular experiments involving vaccinated pregnant female rabbits, we did not find any toxicological feature either in offspring or mothers, as ascertained by histopathology and biochemical parameters. The vaccine induced adaptive immunity in the animals, as defined by the detection of anti-Sm14 antibodies in the sera. In women, neither serious nor light adverse events were observed. Sm14+GLA-SE vaccination induced high titers of anti-Sm14 serum IgG antibody production. Total anti-IgG serum levels remained high 120 days after the first vaccination dose. Significant increases in Sm14-specific total IgG, IgG1, and IgG3 were observed 30 days after the first vaccination, with specific IgG2 and IgG4 after 60 days. Sm14+GLA-SE vaccination also elicited robust cytokine responses with increased TNFα, IFNγ, and IL-2 profiles in all female vaccinees on days 90 and 120.As in Phase Ia, the Sm14+GLA-SE vaccine was shown to be strongly immunogenic and well tolerated. The completion of Phase I clinical trials performed to the highest standards set by the Good Clinical Research Practice (GCP) standards and pre-clinical data in pregnant rabbits enabled the vaccine candidate to proceed to Phase II clinical trials in endemic areas.Study registration IDNCT01154049 at http://www.clinicaltrials.gov. Brazilian Registry of Clinical Trials UTN: U1111-1135-6815
Uptake of health insurance in Malawi in 2019-2020: Evidence from the Multiple Indicator Cluster Survey
Authors: Ng’ambi Wingston Felix , Chigaru Farai , Mwase Takondwa , Banda Agnes Jack , Mfutso-Bengo Joseph 
Published: August 2022

ABSTRACTIntroductionAlthough countries in sub-Sahara Africa (SSA) show progress in implementing various forms of health insurance, there is a dearth of information regarding health insurance in settings like Malawi. Therefore, we conducted this study to determine the uptake of health insurance and describe some of the factors associated with the prevailing uptake of health insurance in Malawi using the 2019-20 Multiple Indicator Cluster Survey (MICS).MethodsThis was a secondary analysis of the 2019-20 MICS data. Data were analysed using frequencies and weighted percentages in Stata v.17. Furthermore, since the number of persons with health insurance is very small, we were unable to perform multivariate analysis.ResultsA total of 205 (1%) of the 31259 had health insurance in Malawi in 2019-20. Of the 205 individuals that owned health insurance, 118 (47%) had health insurance through their employers while 39 (16%) had health insurance through mutual health organization or ccommunity-based. Men had higher uptake of health insurance than the women. The residents from urban areas were more likely to have a health insurance than those in the rural areas. Persons with media exposure were more likely to own health insurance as compared to their counterparts. There was increasing trend in the uptake of health insurance by wealth of the individual with the poorest being less likely to have health insurance compared to the richest. The persons with no education being least likely to have a health insurance while those with tertiary education were most likely to have health insurance.ConclusionThe uptake of health insurance in Malawi was extremely low. In order to increase the uptake of health insurance, there is need to increase insurance coverage amongst those in formal employment, consider minimizing the geographic, economic and demographic barriers in accessing the health insurance.
Relative contributions of vaccination and previous infection to population-level SARS-CoV-2 immunity over time: a simulation modelling study
Authors: Szanyi Joshua , Wilson Tim , Andrabi Hassan , Blakely Tony 
Published: August 2022

AbstractPopulation-level immunity to SARS-CoV-2 directly impacts the incidence of COVID-19 morbidity and mortality. Understanding how this immunity is likely to change over time in the context of future vaccination schedules and emerging SARS-CoV-2 variants is critical to inform pandemic policy. This study simulates population-level COVID-19 immunity (including relative contributions of vaccination and previous infection) in Victoria, Australia over 18 months using an agent-based model and logistic regression equations that predict immunity and waning following vaccination and/or infection. Previous infection was found to drive most immunity against infection even with ongoing regular vaccination, however a greater proportion of overall immunity against mortality was accounted for by vaccination. Although previous infection appears to be driving a substantial component of population-level COVID-19 immunity currently, improved vaccines providing longer lasting (and better sterilizing) immunity are likely to be a critical component of the future pandemic response given the risks associated with SARS-CoV-2 infection.
The Vitality Project: A Randomized Control Trial Comparing Effects of Qigong and Exercise/Nutrition Training on Fatigue, Emotional Health, and Stress in Fatigued Female Cancer Survivors
Authors: Zimmerman Chloe S. , Temereanca Simona , Daniels Dylan , Penner Cooper , Cannonier Tariq , Jones Stephanie R. , Kerr Catherine 
Published: August 2022

AbstractCancer-related fatigue (CRF) is a common and burdensome, often long term side effect of cancer and its treatment. Many non-pharmacological treatments have been investigated as possible CRF therapies, including exercise, nutrition, health/psycho-education, and mind-body therapies. However, studies directly comparing the efficacy of these treatments are lacking. To fill this gap, we conducted a parallel single blind randomized control trial with women with CRF to directly compare the effects of Qigong (a form of mind-body intervention) (n=11) to an intervention that combined strength and aerobic exercise, plant-based nutrition and health/psycho-education (n=13). This design was chosen to determine the comparative efficacy of two non-pharmacologic interventions, with different physical demand intensity, in reducing the primary outcome measure of self-reported fatigue (FACIT ‘Additional Concerns’ subscale). Both interventions showed a mean fatigue improvement of more than double the pre-established minimal clinically important difference of three (Qigong: 7.068 +/- 10.30, Exercise/Nutrition: 8.846 +/- 12.001). Mixed effects ANOVA analysis of group x time interactions revealed a significant main effect of time, such that both groups significantly improved fatigue from pre- to post treatment (F(1,22)=11.898, p=.002, generalized eta squared effect size=.116) There was no significant difference between fatigue improvement between groups (independent samples t-test: p=.70), suggesting a potential equivalence or non-inferiority of interventions, which we could not definitively establish due to our small sample size. This study provides evidence from a small sample that Qigong improves fatigue similarly to standard exercise-nutrition. Qigong additionally significantly improved secondary measures of mood, emotion regulation, and stress, while exercise/nutrition significantly improved secondary measures of sleep/fatigue. These findings provide preliminary evidence for divergent mechanisms of fatigue improvement across interventions, with Qigong providing a gentler and lower-intensity alternative to exercise/nutrition. This clinical trial was registered with clinicaltrials.gov.
Genetic analysis of protein efficiency and its association with performance and meat quality traits under a protein-restricted diet
Authors: Ewaoluwagbemiga Esther Oluwada , Bee Giuseppe , Kasper Claudia 
Published: August 2022

AbstractBackgroundAn essential component in the development of a sustainable pig production is the reduction of nitrogen excretion in fattening pigs. Pig feeds typically contain high levels of dietary crude protein, and due to incomplete conversion to muscle tissue, excess nitrogen is excreted, resulting in environmental problems such as nitrate pollution and greenhouse gas emissions. Therefore, improving protein efficiency (PE), i.e., the proportion of dietary protein that remains in the carcass, is desirable. This study aimed to estimate the heritability (h2) of PE and its genetic correlations with phosphorus efficiency, three performance, seven meat quality and two carcass quality traits when pigs were fed a 20% protein-restricted diet, using a total of 1,071 Swiss Large White pigs. To determine PE, the intake of feed with known nutrient content was accurately recorded for each pig and the nitrogen and phosphorus content of the carcass was determined using dual-energy X-ray absorptiometry.ResultsWe found an average PE of 0.39 ± 0.04 and a heritability of 0.60 ± 0.08. PE showed a high genetic correlation with phosphorus efficiency (0.68 ± 0.08), moderate genetic correlations with feed conversion ratio (−0.53 ± 0.13) and average daily feed intake (−0.42 ± 0.13), and very little to no genetic correlation with average daily gain (−0.06 ± 0.16). While PE has favourable genetic correlations with the performance traits and some meat quality traits, there is a potentially unfavourable relationship of PE with meat colour (redness [rg= −0.26 ± 0.17]; yellowness [rg= −0.30 ± 0.18]) and intra-muscular fat (IMF; rg= −0.39 ± 0.15). Feed conversion ratio (FCR) also showed unfavourable genetic correlations with meat lightness, redness yellowness, IMF and cooking loss.ConclusionsPE is heritable and can be considered in breeding to reduce the environmental impact of pig production. We found no strong negative influence on meat quality traits (except for meat color and IMF), and there is the potential for indirectly selecting for improved phosphorus efficiency. Selecting nutrient efficiencies might be a more suitable strategy to reduce nitrogen pollution from manure than focusing on FCR because the latter also shows genetic antagonism with some meat quality traits in our population.
Characterization of three-dimensional bone-like tissue growth and organization under influence of curvature and directional fluid flow
Authors: de Wildt Bregje W.M. , Zhao Feihu , Lauwers Iris , van Rietbergen Bert , Ito Keita , Hofmann Sandra 
Published: August 2022

AbstractThe transition in the field of bone tissue engineering from bone regeneration to three-dimensional in vitro models has come with the challenge of recreating a dense and anisotropic bone-like extracellular matrix with cell culture. The creation of such an organized bone-like extracellular matrix has received little attention thus far. Although the mechanism by which bone extracellular matrix gains its structure is not fully understood, curvature (especially concavities), mechanical loading due to deformations or directional fluid flow, and osteocyte signaling have been identified as potential contributors. Here, guided by computational simulations, we evaluated three-dimensional cell and bone-like tissue growth and organization in a concave channel with and without directional fluid flow stimulation. Human bone-marrow derived mesenchymal stromal cells were seeded on donut-shaped silk fibroin scaffolds and stimulated to undergo osteogenic differentiation for 42 days statically or in a flow perfusion bioreactor. Constructs were investigated for cell distribution, and tissue growth and organization on day 14, 28, and 42. As a result, directional fluid flow was able to improve bone-like tissue growth but not organization. After 28 days of culture, when osteogenic differentiation was likely accomplished, cells tended to have a small preference for orientation in the tangential (i.e., circumferential) direction of the channel. Based on our results, we suggest that three-dimensional bone-like tissue anisotropy might be guided by curvature, while extracellular matrix production can be increased through the application of fluid shear stress. With this study, an initial attempt in three-dimensions was made to improve the resemblance of in vitro produced bone-like extracellular matrix to the physiological bone extracellular matrix.
Rational optimization of a transcription factor activation domain inhibitor
Authors: Basu Shaon , Martínez-Cristóbal Paula , Pesarrodona Mireia , Frigolé-Vivas Marta , Lewis Michael , Szulc Elzbieta , Bañuelos C. Adriana , Sánchez-Zarzalejo Carolina , Bielskutė Stasė , Zhu Jiaqi , Pombo-García Karina , Garcia-Cabau Carla , Batlle Cristina , Mateos Borja , Biesaga Mateusz , Escobedo Albert , Bardia Lídia , Verdaguer Xavier , Ruffoni Alessandro , Mawji Nasrin R. , Wang Jun , Tam Teresa , Brun-Heath Isabelle , Ventura Salvador , Meierhofer David , García Jesús , Robustelli Paul , Stracker Travis H. , Sadar Marianne D. , Riera Antoni , Hnisz Denes , Salvatella Xavier 
Published: August 2022

SummaryTranscription factors are among the most attractive therapeutic targets but are considered largely undruggable due to the intrinsically disordered nature of their activation domains. Here we show that the aromatic character of the activation domain of the androgen receptor, a therapeutic target for castration resistant prostate cancer, is key for its activity as a transcription factor by allowing it to partition into transcriptional condensates. Based on this knowledge we optimized the structure of a small molecule inhibitor, previously identified by phenotypic screening, that targets a specific transactivation unit within the domain that is partially folded and rich in aromatic residues. The optimized compounds had more affinity for their target, inhibited androgen receptor-dependent transcriptional programs, and had antitumorigenic effect in models of castration-resistant prostate cancer in cells andin vivo. These results establish a generalizable framework to target small molecules to the activation domains of oncogenic transcription factors and other disease-associated proteins with therapeutic intent.