bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delivering an mRNA vaccine using a lymphatic drug delivery device improves humoral and cellular immunity against SARS-CoV-2
Authors: Chen Runqiang , Xie Hui , Khorsandzadeh Sahba , Smith Madison , Shaabani Namir , Hu Qidong , Lyu Xiaoxuan , Wang Hua , Lim Wan-lin , Sun Haotian , Ji Henry , Cooley Brian , Ross Russell , Francis David M 
Published: July 2022

Abstract
The exploration and identification of safe and effective vaccines for the SARS-CoV-2 pandemic have captured the world's attention and remains an ongoing issue due to concerns of balancing protection against emerging variants of concern while also generating long-lasting immunity. Here, we report the synthesis of a novel messenger ribonucleic acid encoding the spike protein in a lipid nanoparticle formulation (STI-7264) that generates robust humoral and cellular immunity following immunization of C57Bl6 mice. In an effort to improve immunity, a clinically focused lymphatic drug delivery device (MuVaxx) was engineered to modulate immune cells at the injection site (epidermis and dermis) and draining lymph node (LN) and tested to measure adaptive immunity. Using MuVaxx, immune responses were elicited and maintained at a 10-fold dose reduction compared to traditional intramuscular (IM) administration as measured by anti-spike antibodies, cytokine-producing CD8 T cells, neutralizing antibodies against the Washington (wild type) strain and South African (Beta) variants, and LN-resident spike-specific memory B cells. Remarkably, a 4-fold-elevated T cell response was observed in MuVaxx-administered vaccination compared to that of IM-administered vaccination. Thus, these data support further investigation into STI-7264 and lymphatic-mediated delivery using MuVaxx for SARS-CoV-2 and VoC vaccines.
Obstructive jaundice, early satiety and xerostomia in an 82-year-old woman
Authors: Bhanot Kunal , Taheem Muhesh , Perry Robert , Wong Christopher , Muehlschlegel Charlotte , Cheent Kuldeep 
Published: July 2022

Abstract
Amyloid light-chain (AL) amyloidosis is a multisystem disease with obstructive jaundice and gastrointestinal (GI) involvement being uncommon initial presentations. Patients with AL amyloidosis seldom have jaundice and advanced GI tract involvement as their presenting symptoms. This case report describes an 82-year-old lady who presented with a 6-month history of early satiety, weight loss, xerostomia and progressive jaundice. Imaging did not suggest a biliary cause but demonstrated hepatomegaly and ascites. Oesophagogastroduodenoscopy revealed a duodenal stricture. Duodenal and liver biopsies were consistent with amyloid deposition. Multiple myeloma was confirmed to be the underlying cause. Significant cholestatic liver dysfunction and a duodenal stricture have not been previously described as simultaneous manifestations of amyloidosis. This case also highlights the difficulty in treating multiple myeloma as the cause of AL amyloidosis in the context of liver dysfunction, given that many chemotherapy agents undergo hepatic metabolism.
The Impact of Churn on HIV Outcomes in a Southern United States Clinical Cohort
Authors: Gopalsamy Srinivasa Nithin , Shah N Sarita , Marconi Vincent C , Armstrong Wendy S , del Rio Carlos , Pennisi Eugene , Wortley Pascale , Colasanti Jonathan A 
Published: July 2022

Abstract

Background
Persons with human immunodeficiency virus (PWH) may experience a cycle of engaging and disengaging in care referred to as “churn.” While human immunodeficiency virus (HIV) churn is predicted to be more prevalent in the southern United States (US), it has not been well characterized in this region.

Methods
We conducted a retrospective cohort study involving PWH newly establishing care at a large urban clinic in Atlanta, Georgia, from 2012 to 2017, with follow-up data collected through 2019. The primary exposure was churn, defined as a ≥12-month gap between routine clinic visits or viral load (VL) measurements. We compared HIV metrics before and after churn and assessed the risk of future churn or loss to follow-up.

Results
Of 1303 PWH newly establishing care, 81.7% were male and 84.9% were Black; 200 (15.3%) experienced churn in 3.3 years of median follow-up time. The transmissible viremia (TV) rate increased from 28.6% prechurn to 66.2% postchurn (P &lt; .0001). The 122 PWH having TV on reengagement had delayed time to subsequent viral suppression (adjusted hazard ratio, 0.59 [95% confidence interval {CI}, .48–.73]), and PWH returning to care contributed disproportionately to the community viral load (CVL) (proportion of CVL/proportion of patients, 1.96). Churn was not associated with an increased risk of subsequent churn (adjusted odds ratio [aOR], 1.53 [95% CI, .79–2.97]) or loss to follow-up (aOR, 1.04 [95% CI, .60–1.79]).

Conclusions
The rate of churn in a southern US clinic was high, and those who experienced churn had increased TV at reentry and disproportionately contributed to the CVL and likely contributing to ongoing HIV transmission.
Identification of curcumin as a novel potential drug for promoting the development of small ovarian follicles for infertility treatment
Authors: Zhao Yu , Zhang Yihui , Liu Dongteng , Feng Haiwei , Wang Xiaohui , Su Jiajun , Yao Yuanqing , Ng Ernest H Y , Yeung William S B , Li Raymond H W , Rodriguez-Wallberg Kenny A , Liu Kui 
Published: July 2022

AbstractIn-vitro fertilization is an effective treatment for various causes of infertility. However, management of women with poor ovarian response or premature ovarian insufficiency remains challenging because these women have underdeveloped small ovarian follicles that do not respond to hormone treatment. In-vitro activation of small follicles has been developed but its efficiency has much room for improvement. In the current study, we provide several lines of evidence showing that curcumin, an FDA-approved traditional medicine, can specifically promote the development of mouse ovarian follicles from the primary to secondary stage, which greatly potentiates these small follicles for subsequent in-vivo development into antral follicles that can be ovulated. Mechanistically, we show that curcumin promotes the proliferation and differentiation of granulosa cells and the growth of oocytes by activating the phosphatidylinositol 3 kinase (PI3K) signaling pathway. Most importantly, we show that in-vitro treatment of human ovarian tissues with curcumin can promote the in-vivo survival and development of small human ovarian follicles, showing that curcumin can be used as a potential drug to increase the success rate of in-vitro activation of small human follicles. We thus identify curcumin as a novel potential drug for promoting the development of small human ovarian follicles for infertility treatment.
Does Ethnic Federalism Lead to Greater Ethnic Identity? The Case of Ethiopia
Authors: Ishiyama John 
Published: July 2022

Abstract
In this article, I examine the connection between ethnic federalism and the development of ethnic rather than national identities. The literature suggests such ethnification can lead to conflict and collapse of federal states—does such ethnification occur and is it attributable to ethnofederalism? Using recent data from the Afrobarometer for Ethiopia, which adopted an ethnofederal arrangement in 1995, I examine whether individuals who were politically socialized under the conditions of ethnic federalism are more likely to favor ethnic identity over a national, Ethiopian, identity. I find that individuals politically socialized under the conditions of ethnic federalism are indeed significantly more likely to embrace an ethnic rather than a national identity. However, generational affects do not appear to be related to perceptions of continuing ethnic federalism as a political arrangement. Differences of opinion on ethnic federalism are more a function of one’s group identity, rather than the intensity of ethnic identification.
“Just Be There”: Desired Partner Behaviors Among Pregnant People Living With Opioid Use Disorder, a Qualitative Study
Authors: Sack Daniel E. , Sheridan Maria E. , Audet Carolyn M. 
Published: July 2022

Objectives
Elicit how partners impact pregnant peoples experience living with opioid use disorder (OUD) during pregnancy and summarize participant recommendations to improve partner support from people engaged in treatment for OUD during pregnancy.

Methods
In this qualitative study, we completed 20 in-depth interviews in pregnant people with OUD at an outpatient clinic in Tennessee. We employed inductive and deductive coding based on a relationship intimacy model and thematic analysis to elicit the perspectives, attitudes, and experiences that shaped desired partner behaviors during their pregnancy. We placed our findings in a modified relationship intimacy model of couple adaptation to OUD. Finally, we summarized interviewed participants’ recommendations on how to best educate and involve their partners.

Results
Our analysis generated 24 codes and 5 themes. Previous lived experience and interpersonal factors influenced participants’ experiences with relationship-compromising and relationship-enhancing behaviors. They also reported that positive, or relationship-enhancing behaviors, could mitigate some of their negative intrapersonal feelings such as self-stigma. Participants agreed that partners should display emotional intelligence and empathy, provide supportive logistic and physical behaviors, and be open to improve. Participants also suggested that partners be equipped with information about expected physiological changes during pregnancy, supportive behavior examples, and information about OUD treatment.

Conclusions
Additional input from pregnant people and partners in future projects can build on these findings and guide the creation and assessment of comprehensive interventions to improve care for pregnant people with OUD.
Neurocysticercosis Complicating Pregnancy
Authors: Cunningham F. Gary , Twickler Diane M. 
Published: July 2022

OBJECTIVE:
Infection with the pork tapeworm can result in neurocysticercosis caused by infestation of central nervous system tissues by the parasite cysts. Parenchymal brain infection can cause symptoms from mass effect that include headache, seizures, confusion, and even coma. Our objective was to describe the clinical course of neurocysticercosis infections in pregnant women.

METHODS:
This was a case series that described clinical findings and pregnancy outcomes of women diagnosed with neurocysticercosis from 1994 through 2016 at a single institution. Their medical records were reviewed, cranial computed tomography and magnetic resonance imaging scans were assessed, and the infections were classified according to the criteria of the 2018 Infectious Diseases Society of America and the American Society of Tropical Medicine and Hygiene.

RESULTS:
Overall, 37 pregnant women with neurocysticercosis were identified. Of the 37 women, 32 were symptomatic, and 16 each had severe headaches or new-onset seizures or other neurologic sequelae. Some of these women had multiple symptoms. Others were diagnosed when neuroimaging was done for a history of neurocysticercosis or evaluation of a preexisting seizure disorder. The most common treatment was with anthelmintics—albendazole, praziquantel, or both—usually given with anticonvulsants and corticosteroids to decrease inflammation. There were eight women in whom invasive neurosurgical procedures were performed, usually for hydrocephaly. Overall, 32 healthy neonates were born at term, and there was one preterm delivery at 34 weeks of gestation. The four pregnancy losses included two molar pregnancies, one anembryonic miscarriage, and a 23-week stillbirth of a pregnancy complicated by preeclampsia with severe features.

CONCLUSION:
Neurocysticercosis in pregnant women may be asymptomatic or result in headaches, seizures, confusion, nausea and vomiting, altered mental status, or obtundation. Anthelmintic treatment is usually successful, but in some women neurosurgical procedures are necessary to relieve obstructive hydrocephaly.
Prophylactic Methylergonovine and Oxytocin Compared With Oxytocin Alone in Patients Undergoing Intrapartum Cesarean Birth
Authors: Masse Nicole , Dexter Franklin , Wong Cynthia A. 
Published: July 2022

OBJECTIVE:
To evaluate whether the administration of prophylactic methylergonovine in addition to oxytocin in patients undergoing intrapartum cesarean birth reduces the need for additional uterotonic agents.

METHODS:
This was a single-center, placebo-controlled, randomized trial of patients undergoing intrapartum cesarean birth. Patients were randomly allocated to receive intravenous oxytocin 300 mL/minute plus intramuscular methylergonovine 0.2 mg (1 mL) or intravenous oxytocin 300 mL/minute plus intramuscular normal saline (1 mL). The primary outcome was the receipt of additional uterotonic agents. Secondary outcomes included surgeon assessment of uterine tone, incidence of postpartum hemorrhage, quantitative blood loss, and blood transfusion. To detect a twofold decrease in the need for additional uterotonic agents (assuming a 42% baseline) with a two-sided type 1 error of 5% and power of 80%, a sample size of 76 patients per group was required.

RESULTS:
From June 2019 through February 2021, 80 patients were randomized to receive methylergonovine plus oxytocin and 80 were randomized to receive to oxytocin alone. Significantly fewer patients who were allocated to the methylergonovine group received additional uterotonic agents (20% vs 55%, relative risk [RR] 0.4, 95% CI 0.2–0.6). Participants receiving methylergonovine were more likely to have satisfactory uterine tone (80% vs 41%, RR 1.9, 95% CI 1.5–2.6), lower incidence of postpartum hemorrhage (35% vs 59%, RR 0.6, 95% CI 0.4–0.9), lower mean quantitative blood loss (967 mL vs 1,315 mL; mean difference 348, 95% CI 124–572), and a lower frequency of blood transfusion (5% vs 23%, RR 0.2, 95% CI 0.1–0.6).

CONCLUSION:
The administration of prophylactic methylergonovine in addition to oxytocin in patients undergoing intrapartum cesarean birth reduces the need for additional uterotonic agents.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT03904446.
Associations Between Implementation of the Collaborative Care Model and Disparities in Perinatal Depression Care
Authors: Snowber Khadija , Ciolino Jody D. , Clark Crystal T. , Grobman William A. , Miller Emily S. 
Published: July 2022

OBJECTIVE:
To evaluate whether perinatal collaborative care model implementation was associated with a reduction in racial disparities in depression care.

METHODS:
This retrospective cohort study included pregnant and postpartum people who self-identified as either Black or White, and received prenatal care at academic faculty offices affiliated with an urban quaternary medical center. Individuals were divided into two cohorts to reflect the epochs of implementation. The primary outcome was the frequency of depression screening. The secondary outcome was the frequency of provision of a treatment recommendation for those with a positive depression screen. Antenatal and postpartum care were analyzed separately. A propensity score was used in multivariable models to control for confounders chosen a priori across implementation epoch. Interaction terms were created between race and implementation epoch to identify whether effect modification was present. Subgroup analyses were performed for outcomes with significant race-by-epoch interaction terms.

RESULTS:
Of the 4,710 individuals included in these analyses, 4,135 (87.8%) self-identified as White and 575 (12.2%) self-identified as Black. Before implementation, Black individuals were more likely to receive screening (adjusted odds ratio [aOR] 2.44) but less likely to have a treatment recommended when a positive screen was identified (aOR 0.05). In multivariable models, race-by-epoch interaction terms were significant for both antenatal screening (P<.001) and antenatal treatment recommendation (P=.045), demonstrating that implementation of the perinatal collaborative care model was associated with reductions in extant racial disparities. After implementation, there were no significant differences by race (referent=White) in screening for antenatal depression (aOR 1.22, 95% CI 0.89–1.68) or treatment recommendations for those who screened positive (aOR 0.64, 95% CI 0.27–1.53). Race-by-epoch interaction terms were not significant in multivariable models for either postpartum screening or treatment recommendation.

CONCLUSION:
Implementation of the perinatal collaborative care model is associated with a mitigation of racial disparities in antenatal depression care and may be an equity-promoting intervention for maternal health.
Three-Dimensional–Printed Vaginal Molds for Use After McIndoe Neovagina Creation
Authors: Kisby Cassandra K. , Agosta Patrina O. , Alexander Amy , Erie Eric , Morris Jonathan M. , Gebhart John B. 
Published: July 2022

BACKGROUND:
Surgical vaginoplasty is a highly successful treatment for congenital absence of the vagina. One key to long-term success is the use of an appropriate vaginal mold in the immediate postoperative period. We present the use of a three-dimensional (3D)–printed vaginal mold, customizable to the anatomy of individual patients.

TECHNIQUE:
Vaginal molds were designed using a 3D modeling software program. The design included narrowing around the urethra, holes for egress of secretions, and a knob for insertion and removal. Dental resin was 3D-printed into various-sized vaginal molds, and postprocessing was performed.

EXPERIENCE:
We present the use of the 3D-printed mold for a patient with a history of cloacal exstrophy and a unique pelvic shape. Two prior neovagina surgeries in this patient had been unsuccessful due to ineffective handheld dilator use; the patient experienced success with the 3D-printed intravaginal mold.

CONCLUSION:
The use of the 3D-printed vaginal mold is an alternative to the limited commercially available models today and allows for customization to user anatomy. With 3D printers becoming more widely accessible, we believe this method could become universally accepted, with hopes of contributing to increased patient satisfaction and decreased complications.
Indications and Technical Considerations for Transanal Total Mesorectal Excision
Authors: McFadgen Heather L. , Farooq Ameer O. 
Published: July 2022

CASE SUMMARY:A 53-year-old man presented after noting bright red blood from his rectum. On examination, he was found to have a mass 1 cm above the anal sphincter complex. He had a BMI of 40 kg/m2and was otherwise healthy. MRI revealed a T2/early T3 lesion with extramural venous invasion and suspicious perirectal lymph nodes. Low rectal cancer was diagnosed. He underwent long-course neoadjuvant chemoradiation with good but not complete clinical response. Given his obesity and the low nature of his rectal cancer, a transanal total mesorectal excision (taTME) was planned.
Plume Generated by Different Electrosurgical Techniques: An In Vitro Experiment on Human Skin
Authors: Riopelle Alexandria M. , Potter Christian T. , Jeong Daehee , Schanbacher Carl F. 
Published: July 2022

BACKGROUND
Plume generated by electrosurgical techniques is a health hazard to patients and dermatologists.

OBJECTIVE
To compare the particle concentration generated by various energy devices used in dermatologic surgery.

MATERIALS AND METHODS
Five surgical techniques were tested on human tissue samples in a closed chamber. A particle counter, positioned at a fixed point 20 cm away from the sample, recorded the concentrations of aerosolized particles generated over 7 particle sizes (0.3, 0.5, 0.7, 1, 2.5, 5, and 10 μm).

RESULTS
Monopolar electrocoagulation created the greatest concentration of particles followed by electrocautery, electrodesiccation, electrofulguration, and bipolar electrocoagulation. Bipolar electrocoagulation created 80 times fewer 0.3 μm particles and 98 times fewer 0.5 μm particles than monopolar electrocoagulation. Across all electrosurgical techniques, the greatest concentrations of particles generated were of the 0.3 and 0.5 μm particle size.

CONCLUSION
Bipolar electrocoagulation created the lowest concentration of particulate matter. Given the noxious and hazardous nature of surgical plume, the bipolar forceps offer surgeons a safer method of performing electrical surgery for both the surgical staff and the patient.
Evaluation of coagulation parameters and impact of transfusion on coagulation in patients with beta thalassemia major
Authors: Kurt Zehra Deniz Çelik , Sönmez Çiğdem , Kaçar Dilek , Eker İbrahim , Bayhan Turan , Yarali Neşe , Özbek Namik Yaşar 
Published: July 2022

There have been several studies that have shown that patients with beta thalassemia major are at a higher risk of thrombosis due to the procoagulant activity of thalassemic erythrocytes, decreased liver synthetic function, increased platelet activity and vascular endothelial activation attributed to chronic oxidative stress, although there are no established tests to predict thrombotic risk in TM patients.
In this study, we evaluated whether or not the platelet function analyser (PFA-200) and thrombin generation test (TGT) would be useful tools to identify hypercoagulability and risk of thrombosis in thalassemia major patients.
The study included 50 patients with thalassemia major and 104 healthy control group. Pretransfusion and posttransfusion PFA-200 and TGT results were compared with control group. We found that median C/ADP and C/EPI values in the thalassemia major group were greater in both the pre and posttransfusion samples than the C/ADP and C/EPI results from the control group. The TGT results showed there was no difference between control group and the results from the thalassemia major group.
The TGT and PFA-200 testing did not identify hypercoagulability nor identify clear testing parameters to predict a thalassemia major patient's risk of thrombosis. There may be other mechanisms/causes yet unidentified that could better explain thalassemia major patient's increased risk from thromboembolic events.
Establishment of the First Professional Organization of Traditional Chinese Medicine and Acupuncture in California
Authors: Huang Sam Xian Sheng , Hu Jun , Chen Da-Ren , Chau Jackson 
Published: July 2022

Abstract
The California Chinese Medicine and Acupuncture Research Association, founded on March 25, 1974, is the first Chinese medicine organization registered with the state government in California. It was established after more than a year of arduous preparation and had 15 founding members. Over time, it evolved into the biggest organization of Chinese medicine and acupuncture in California. And in 2015, it became the American Association of Chinese Medicine and Acupuncture with more than 500 members.