bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 Patients
Authors: Pappalardo Marco , Starnoni Marta , De Maria Federico , Lolli Francesca , Pedone Antonio , Baccarani Alessio , De Santis Giorgio 
Published: November 2022

Summary:
Due to the spread of the coronavirus disease 2019 pandemic, an increasing number of ill patients have been admitted to intensive care unit requiring mechanical ventilation. Although prone positioning is considered beneficial, long periods in this position may induce important complications, including pressure ulcers in high-risk and uncommon body areas. We report five cases of pressure ulcer necrosis of the chin in coronavirus disease 2019 patients as a consequence of mechanical ventilation in prone positioning using autologous fat grafting (AFG) as a secondary technique. A series of five patients with secondarily-healed chin necrosis treated by AFG between February and June 2020 were reviewed. All patients had been treated initially with surgical debridement followed by conservative treatment. Secondary AFG was performed to reduce patient’s pain, improve chin contour-projection, and minimize cosmetic sequelae and scarring. Patient satisfaction was assessed using a five-point Likert scale (0–4). Vancouver scale was used to evaluate the chin scars clinically. The average amount of fat injected into the chin area was 8.1 ± 2.0 ml. At 6-month follow-up, all patients were mostly satisfied (average Likert-scale 3.2 ± 0.4). Based on the Vancouver scale, improvement of the chin scar from 9.5 ± 0.8 to 4.7 ± 0.8 was found. We report a positive experience with secondary AFG for correction of painful and unaesthetic scarring and contour abnormality following surgical debridement and secondary-intention healing of chin pressure ulcers.
Predictors of Perianal Fistula Healing in Children With Newly Diagnosed Crohn Disease
Authors: Singer Andrew A. M. , Rompca Annemarie , Gadepalli Samir K. , Adler Jeremy 
Published: November 2022

Objectives:
Perianal fistulas are among the most severe complications of Crohn disease, but limited data regarding their outcomes are available in children. Our objective was to determine predictors of perianal fistula healing among pediatric patients newly diagnosed with Crohn disease.

Methods:
This single-center retrospective study followed patients with perianal fistulas at Crohn disease diagnosis until fistula healing. Time to healing was analyzed using Cox proportional hazard regression models considering relevant covariates including patient demographics, disease characteristics, medical therapies [no anti-tumor necrosis factor (TNF)α therapy, anti-TNFα therapy ±therapeutic drug monitoring], and perianal surgical procedures including fistulotomy, fistulectomy, removal of perianal lesions, seton placement, and incision and drainage.

Results:
Of 485 patients identified, 107 (22%) had a perianal fistula at Crohn disease diagnosis. Multivariate analysis identified that perianal fistulotomy, fistulectomy, and lesion removal [hazard ratio (HR) 0.46; P = 0.028], non-White race (HR 0.30, P < 0.01), and male sex (HR 0.42; P = 0.02) were associated with delayed fistula healing. Faster fistula healing was associated with treatment with anti-TNFα with therapeutic drug monitoring (HR 1.78, P = 0.009). There were no other differences in healing by treatment.

Conclusions:
Fistulotomy, fistulectomy, and perianal lesion removal as well as non-White race were associated with delayed fistula healing. Anti-TNFα therapy was associated with faster fistula healing when combined with therapeutic drug monitoring, compared to all other medical treatment groups, including anti-TNFα therapy without therapeutic drug monitoring.
High-risk human papillomavirus genotype distribution among women living with and at risk for HIV in Africa
Authors: Chachage Mkunde , Parikh Ajay P. , Mahenge Anifrid , Bahemana Emmanuel , Mnkai Jonathan , Mbuya Wilbert , Mcharo Ruby , Maganga Lucas , Mwamwaja Jaqueline , Gervas Reginald , Kibuuka Hannah , Maswai Jonah , Singoei Valentine , Iroezindu Michael , Fasina Abiola , Esber Allahna , Dear Nicole , Imbach Michelle , Crowell Trevor A. , Hern Jaclyn , Song Xiaofang , Hoelscher Michael , Polyak Christina S. , Ake Julie A. , Geldmacher Christof 
Published: November 2022

Objective:
Cervical cancer is a common preventable cancer among African women living with HIV (WLWH). Molecular diagnostics for high-risk human papillomavirus (HR-HPV) genotypes are standard components of cervical cancer screening in resource-rich countries but not in resource-limited settings. We evaluated HR-HPV genotypes among women with and without HIV in four African countries to inform cervical cancer preventive strategies.

Methods:
The African Cohort Study (AFRICOS) enrolled participants with and without HIV at 12 clinics in Tanzania, Kenya, Uganda, and Nigeria. Cervical cytobrush specimens from women were genotyped for 14 HR-HPV types using the multiplex Seegene Anyplex real-time PCR assay. Robust Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with HR-HPV in WLWH.

Results:
From January 2015 to March 2020, 868 WLWH and 134 women living without HIV (WLWoH) were tested for HR-HPV with prevalence of 50.9 and 38.1%, respectively (P = 0.007). Among WLWH, 844 (97.4%) were antiretroviral therapy (ART)-experienced and 772 (89.7%) virally suppressed 1000 copies/ml or less. The most frequent HR-HPV types among WLWH were HPV-16 (13.5%), HPV-52 (9.5%), and HPV-35 (9.3%). HR-HPV infection was more common among Tanzanian WLWH (adjusted RR: 1.23, 95% CI 1.05–1.44, P = 0.012). Also, WLWH with CD4+ T cells of less than 200 cell/μl had 1.51-fold increased risk of having HR-HPV (95% CI 1.23–1.86, P < 0.001).

Conclusion:
HR-HPV was common in WLWH in four African countries, particularly among women with low CD4+ cell count. Scale up of HPV vaccines and development of vaccines with broader activity against less common HR-HPV types may improve cervical cancer prevention in Africa.
Humoral and Cellular Response of Transplant Recipients to a Third Dose of mRNA SARS-CoV-2 Vaccine: A Systematic Review and Meta-analysis
Authors: Bailey Adrian J.M. , Maganti Harinad B. , Cheng Wei , Shorr Risa , Arianne Buchan C. , Allan David S. 
Published: November 2022

Background.
High rates of nonresponse to 2 doses of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine have been reported in transplant recipients. Several studies have investigated the efficacy of a third dose in this population. However, efficacy remains unclear, as response rates vary across studies. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy of a third dose of any mRNA SARS-CoV-2 vaccine in transplant recipients.

Methods.
Preferred Reporting Items for Systematic Review and Meta-Analysis reporting guidelines (PROSPERO:CRD42021281498) were followed. Medline, Embase, and CENTRAL were searched from inception to December 2, 2021, without restrictions. All full-text studies reporting on the efficacy of a third dose of any mRNA SARS-CoV-2 vaccine in pediatric and adult transplant recipients were included. The National Institutes of Health quality assessment tool for case series and the Cochrane risk of bias tool determined study quality. Meta-analysis was performed via the DerSimonian-Laird random-effect model.

Results.
Of 84 records, 12 studies totaling 1257 patients met inclusion criteria. One study was a randomized controlled trial, whereas all other studies were observational. Across 7 studies (801 patients), humoral response after 3 doses was observed in 66.1% (95% confidence interval, 62.8%-69.4%; I
2 = 0%) of transplant recipients. Triple immunosuppression, mycophenolate, antiproliferatives, and belatacept use were associated with reduced odds of humoral response in studies reporting multivariate analyses. Transplant recipients receiving a third dose displayed higher levels of neutralizing antibodies to SARS-CoV-2 variants (Alpha, Beta, and Delta) compared with placebo.

Conclusions.
A third dose SARS-CoV-2 mRNA vaccine should be strongly considered in transplant recipients. Limitations included lack of controlled studies and clinically relevant thresholds to determine response to vaccination.
Image-localized biopsy mapping of brain tumor heterogeneity: A single-center study protocol
Authors: Urcuyo Javier C. , Curtin Lee , Langworthy Jazlynn M. , De Leon Gustavo , Anderies Barrett , Singleton Kyle W. , Hawkins-Daarud Andrea , Jackson Pamela R. , Bond Kamila M. , Ranjbar Sara , Lassiter-Morris Yvette , Clark-Swanson Kamala R. , Paulson Lisa E. , Sereduk Chris , Mrugala Maciej M. , Porter Alyx B. , Baxter Leslie , Salomao Marcela , Donev Kliment , Hudson Miles , Meyer Jenna , Zeeshan Qazi , Sattur Mithun , Patra Devi P. , Jones Breck A. , Rahme Rudy J. , Neal Matthew T. , Patel Naresh , Kouloumberis Pelagia , Turkmani Ali H. , Lyons Mark , Krishna Chandan , Zimmerman Richard S. , Bendok Bernard R. , Tran Nhan L. , Hu Leland S. , Swanson Kristin R. 
Published: November 2022

AbstractBrain cancers pose a novel set of difficulties due to the limited accessibility of human brain tumor tissue. For this reason, clinical decision-making relies heavily on MR imaging interpretation, yet the mapping between MRI features and underlying biology remains ambiguous. Standard (clinical) tissue sampling fails to capture the full heterogeneity of the disease. Biopsies are required to obtain a pathological diagnosis and are predominantly taken from the tumor core, which often has different traits to the surrounding invasive tumor that typically leads to recurrent disease. One approach to solving this issue is to characterize the spatial heterogeneity of molecular, genetic, and cellular features of glioma through the intraoperative collection of multiple image-localized biopsy samples paired with multi-parametric MRIs. We have adopted this approach and are currently actively enrolling patients for our ‘Image-Based Mapping of Brain Tumors’ study. Patients are eligible for this research study (IRB #16-002424) if they are 18 years or older and undergoing surgical intervention for a brain lesion. Once identified, candidate patients receive dynamic susceptibility contrast (DSC) perfusion MRI and diffusion tensor imaging (DTI), in addition to standard sequences (T1, T1Gd, T2, T2-FLAIR) at their presurgical scan. During surgery, sample anatomical locations are tracked using neuronavigation. The collected specimens from this research study are used to capture the intra-tumoral heterogeneity across brain tumors including quantification of genetic aberrations through whole-exome and RNA sequencing as well as other tissue analysis techniques. To date, these data (made available through a public portal) have been used to generate, test and validate predictive regional maps of the spatial distribution of tumor cell density and/or treatment-related key genetic marker status to identify biopsy and/or treatment targets based on insight from the entire tumor makeup. This type of methodology, when delivered within clinically feasible time frames, has the potential to further inform medical decision-making by improving surgical intervention, radiation, and targeted drug therapy for patients with glioma.
How effective are commercialized products used in the treatment of superficial partial-thickness burn injuries? – Systematic Review with Meta-analysis
Authors: da Silva Oliveira Merola Luana Nice , Sampaio Guilherme Albuquerque , Vinaud Marina Clare , Coutinho Erika Lima , de Souza Lino Junior Ruy 
Published: November 2022

AbstractBurns are an important public health issue, related to 11 million cases annually around the world and up to 180 thousand direct or indirect deaths. Thus, it is vitally important to understand the effectiveness of the different products commercialized for the treatment of burn injuries.ObjectivesTo analyze the effectiveness of products used in the treatment of superficial-type partial-thickness burn injuries.MethodsThis is a systematic review, using the PICO strategy, with a search period between 2004 and 2020, consulting the COCHRANE Library, Lilacs, Medline, PubMed and Scielo databases. The inclusion criteria were studies that used commercialized products for the treatment of superficial-type partial-thickness burn injuries in humans. To assess the quality and risk of bias of the studies, the Oxford scale and criteria from the Cochrane Guidelines were used.Results19 eligible studies were selected, most of the products were presented as an alternative to the traditional treatment that involves the use of the silver sulfadiazine product. The methodological quality of the studies allowed performing a meta-analysis of only 2 studies, evaluating the healing outcome, the low number of studies included for statistical analysis suggests that it is not possible to conclude which product is more effective.ConclusionsThere is a limitation in the available studies that address the costs and outcomes of existing interventions for the treatment of burns. Future research should develop systematic, valid measures in order to obtain an analytically and statistically adequate result.
KIT-LSTM: Knowledge-guided Time-aware LSTM for Continuous Clinical Risk Prediction
Authors: Liu Lucas Jing , Ortiz-Soriano Victor , Neyra Javier A. , Chen Jin 
Published: November 2022

AbstractRapid accumulation of temporal Electronic Health Record (EHR) data and recent advances in deep learning have shown high potential in precisely and timely predicting patients’ risks using AI. However, most existing risk prediction approaches ignore the complex asynchronous and irregular problems in real-world EHR data. This paper proposes a novel approach called Knowledge-guIded Time-aware LSTM (KIT-LSTM) for continuous mortality predictions using EHR. KIT-LSTM extends LSTM with two time-aware gates and a knowledge-aware gate to better model EHR and interprets results. Experiments on real-world data for patients with acute kidney injury with dialysis (AKI-D) demonstrate that KIT-LSTM performs better than the state-of-the-art methods for predicting patients’ risk trajectories and model interpretation. KIT-LSTM can better support timely decision-making for clinicians.
Did financial interventions offset the impact of financial adversity on mental health during the COVID-19 pandemic? A longitudinal analysis of the UCL COVID-19 Social Study
Authors: Paul Elise , Fancourt Daisy 
Published: November 2022

AbstractBackgroundIt remains unclear whether financial support interventions (e.g., furlough, mortgage freezes, foodbanks, Universal Credit) provide protection against the negative impact of financial adversity on mental health.MethodsData were from adults who took part in the UCL COVID -19 Social Study between 1 April 2020 and 4 April 2022 who had variability over time in depression (N = 27,297) and anxiety symptoms (N = 26,452). Fixed-effects Poisson regressions examined the associations between an index of financial adversity (e.g., job or income loss) with depression and anxiety symptoms and controlled for other adversities and loneliness. Interaction terms between financial adversity and having used i) any, ii) charity based, iii) government based, iv) work based, and v) other forms of financial supports were examined.ResultsExperiencing financial adversity had a negative impact on mental health. Only charity based support (e.g., foodbanks) consistently attenuated the impact of financial adversity on mental health, whilst work based support exacerbated the impact. Government based support only attenuated the impact of facing limited financial adversity on depression symptoms.ConclusionFindings suggest that most financial interventions are insufficient for alleviating mental health difficulties resulting from financial adversity.
Social Media Sensors to Detect Early Warnings of Influenza at Scale
Authors: Martín-Corral David , García-Herranz Manuel , Cebrian Manuel , Moro Esteban 
Published: November 2022

ABSTRACTDetecting early signs of an outbreak in a viral process is challenging due to its exponential nature, yet crucial given the benefits to public health it can provide. If available, the network structure where infection happens can provide rich information about the very early stages of viral outbreaks. For example, more central nodes have been used as social network sensors in biological or informational diffusion processes to detect early contagious outbreaks. We aim to combine both approaches to detect early warnings of a biological viral process (influenza-like illness, ILI), using its informational epidemic coverage in public social media. We use a large social media dataset covering three years in a country. We demonstrate that it is possible to use highly central users on social media, more precisely high out-degree users from Twitter, as sensors to detect the early warning outbreaks of ILI in the physical world without monitoring the whole population. We also investigate other behavioral and content features that distinguish those early sensors in social media beyond centrality. While high centrality on Twitter is the most distinctive feature of sensors, they are more likely to talk about local news, language, politics, or government than the rest of the users. Our new approach could detect a better and smaller set of social sensors for epidemic outbreaks and is more operationally efficient and privacy respectful than previous ones, not requiring the collection of vast amounts of data.
Bronchoalveolar lavage metabolome dynamics reflect underlying disease and chronic lung allograft dysfunction
Authors: Martin Christian , Mahan Kathleen S. , Wiggen Talia D. , Gilbertsen Adam J. , Hertz Marshall I. , Hunter Ryan C. , Quinn Robert A. 
Published: November 2022

AbstractBackgroundProgression of chronic lung disease often leads to the requirement for a lung transplant (LTX). Despite improvements in short-term survival after LTX, chronic lung allograft dysfunction (CLAD) remains a critical challenge for long-term survival. This study investigates the relationship between the metabolome of bronchoalveolar lavage fluid (BALF) from subjects post-LTX with underlying lung disease and CLAD severity.MethodsUntargeted LC-MS/MS metabolomics was performed on 960 BALF samples collected over 10 years from LTX recipients with alpha-1-antitrypsin disease (AATD, n=22), cystic fibrosis (CF, n=46), chronic obstructive pulmonary disease (COPD, n = 79) or pulmonary fibrosis (PF, n=47). Datasets were analyzed using machine learning and multivariate statistics for associations with underlying disease and final CLAD severity.ResultsBALF metabolomes varied by underlying disease state, with AATD LT recipients being particularly distinctive (PERMANOVA,p=0.001). We also found a significant association with the final CLAD severity score (PERMANOVA,p=0.001), especially those with underlying CF. Association with CLAD severity was driven by changes in phosphoethanolamine (PE) and phosphocholine lipids that increased and decreased, respectively, and metabolites from the bacterial pathogenPseudomonas aeruginosa. P. aeruginosasiderophores, quorum-sensing quinolones, and phenazines were detected in BALF, and 4-hydroxy-2-heptylquinoline (HHQ) was predictive of the final CLAD stage in samples from CF patients (R=0.34;p≤0.01). Relationships between CLAD stage andP. aeruginosametabolites were especially strong in those with CF, where 61% of subjects had at least one of these metabolites in their first BALF sample after transplant.ConclusionsBALF metabolomes after LTX are distinctive based on the underlying disease and reflect final CLAD stage. In those with more severe outcomes, there is a lipid transition from PC to predominantly PE phospholipids. The association ofP. aeruginosametabolites with CLAD stages in LTX recipients with CF indicates this bacterium and its metabolites may be drivers of allograft dysfunction.Key messagesDespite the high prevalence of CLAD among LTX recipients, its pathology is not well understood, and no single molecular indicator is known to predict disease onset. Our machine learning metabolomic-based approach allowed us to identify patterns associated with a shift in the lipid metabolism and bacterial metabolites predicting CLAD onset in CF. This study provides a better understanding about the progression of allograft dysfunction through the molecular transitions within the transplanted lung from the host and bacterial pathogens.
Projected Cancer Burden, Challenges, and Barriers to Cancer Prevention and Control Activities in the State of Telangana
Authors: Mahajan Hemant , Neha Reddy M , Devi NG Marina , Poli Usha Rani , Jayaram M , Tetali Shailaja , Murthy GVS 
Published: November 2022

AbstractBackground and AimThe Telangana cancer care program is a proactive, comprehensive initiative encompassing infrastructure development, human resource skilling and ensuring financial protection to those below poverty line. The broad aim of this exercise was to identify modalities to augment the Telangana State Cancer control Plan to implement a sustainable comprehensive cancer care model for Telangana.MethodsWe conducted in-depth interviews of stakeholders (17 patients and 25 providers) to identify barriers and challenges to access existing cancer care system; calculated the estimated magnitude of cancer and commensurate workload (in terms of visits to tertiary cancer care system for chemotherapy, radiotherapy, and surgery and human and equipment requirement) for the next 15 years (from 2021 to 2036). Using the anecdotal evidence and information from stakeholders’ interviews, we developed patient-journey funnels for cancer patients, which helped us to appreciate at what levels of care leakages occur.ResultsWe estimated a 28% increase in the number of new cancer cases per year and the resultant workload: number of visits, chemotherapy, radiotherapy, surgeries, specialized human resources and equipment, from 2021 to 2036. Stakeholders mentioned delayed access to healthcare system as the main reason for the poor prognosis of patients. The common reasons cited for delayed access were: poor cancer-literacy including prevailing myths and misconception, financial barriers, and rural residence. Patient journey funnel for cancer care revealed major leakage from screened positive to diagnosis confirmation step. Patient leakage varies from ∼70% to 90% from screened positive till treatment completion.ConclusionGovt. of Telangana has initiated several measures to strengthen the healthcare system and to promote the uptake of cancer care services to manage the rising burden of cancer and resultant increasing workload. However, there is ample scope for further improvement (such as improved healthcare access, reduced patient leakage, commensurate human skills and infrastructure development etc.) to deliver comprehensive cancer care services in the state.Highlights-Cancer cases are rising in Telangana, which is experiencing high epidemiological transition-The healthcare infrastructure for cancer care is predominantly urban-centric-Overall, 28% increase in new cancer cases and resultant workload per year from 2021 to 2036 was estimated-Delayed access to healthcare system due to barriers at community and health system level-Major patient leakage across cancer care continuum, which ranges from 70 to 90%