bluuebunny/crossref_metadata_2025_split huggingface dataset:
The science of xenotransplantation for nephrologists
Authors: Hansen-Estruch Christophe , Porrett Paige M. , Kumar Vineeta , Locke Jayme E. 
Published: June 2022

Purpose of review
The field of xenotransplantation has seen remarkable progress since its inception with recent preclinical trials in human recipients pushing kidney xenotransplantation one-step closer to clinical reality. In this review, we update practicing clinicians on recent advances in kidney xenotransplantation given the proximity of clinical trials in humans.

Recent findings
Early studies in the field established the physiologic basis of xenotransplantation and suggested that the pig kidney will support human physiology. Genetic engineering of source pigs has greatly reduced the immunogenicity of kidney grafts, and studies in nonhuman primates have demonstrated the viability of kidney xenotransplants for months after transplantation. Finally, a recent study in a novel preclinical human model demonstrated that key findings in NHP experiments are generalizable to humans, namely, the absence of hyperacute rejection.

Summary
Overall, it appears that critical physiologic, immunologic and technical barriers to implementation of clinical trials in humans have been overcome.
Differences in tumor-to-normal organ SUV ratios measured with 68Ga-DOTATATE PET compared with 177Lu-DOTATATE SPECT in patients with neuroendocrine tumors
Authors: Wong Ka Kit , Frey Kirk A. , Niedbala Jeremy , Kaza Ravi K. , Worden Francis P. , Fitzpatrick Kellen J. , Dewaraja Yuni K. 
Published: June 2022

Background
Our goal is to quantitatively compare radiotracer biodistributions within tumors and major normal organs on pretherapy 68Ga-DOTATATE PET to post-therapy 177Lu-DOTATATE single-photon emission computed tomography (SPECT) in patients receiving peptide receptor radionuclide therapy (PRRT).

Methods
PET/CT at ~ 60 min postinjection of Ga-68 DOTATATE and research 177Lu-SPECT/CT imaging ~ at 4 h (SPECT1) and ~ 24 h (SPECT2) post-cycle#1 were available. Manual contours of lesions on baseline CT or MRI were applied to co-registered SPECT/CT and PET/CT followed by deep learning-based CT auto-segmentation of organs. Tumor-to-normal organ ratios (TNR) were calculated from standardized uptake values (SUV)mean and SUVpeak for tumor, and SUVmean for non-tumoral liver (nliver), spleen and kidney.

Results
There were 90 lesons in 24 patients with progressive metastatic neuroendocrine tumor. The correlation between PET and SPECT SUV TNRs were poor/moderate: PET versus SPECT1 R2 = 0.19, 0.21, 0.29; PET versus SPECT2 R2 = 0.06, 0.16, 0.33 for TNRnliver,TNRspleen,TNRkidney, respectively. Across all patients, the average value of the TNR measured on PET was significantly lower than on SPECT at both time points (P < 0.001). Using SUVmean for tumor, average TNR values and 95% confidence intervals (CI) were PET: TNRnliver = 3.5 [CI: 3.0-3.9], TNRspleen = 1.3 [CI, 1.2-1.5], TNRkidney = 1.7 [CI: 1.6-1.9]; SPECT1: TNRnliver = 10 [CI: 8.2-11.7], TNRspleen = 2.9 [CI: 2.5-3.4], TNRkidney = 2.8 [CI: 2.3-3.3]; SPECT2: TNRnliver = 16.9 [CI: 14-19.9], TNRspleen = 3.6 [CI: 3-4.2], TNRkidney = 3.6 [CI: 3.0-4.2]. Comparison of PET and SPECT results in a sphere phantom study demonstrated that these differences are not attributed to imaging modality.

Conclusions
Differences in TNR exist for the theranostic pair, with significantly higher SUV TNR on 177Lu SPECT compared with 68Ga PET. We postulate this phenomenon is due to temporal differences in DOTATATE uptake and internalization in tumor as compared to normal organs.
Supporting the Growth of Domestic HIV Implementation Research in the United States Through Coordination, Consultation, and Collaboration: How We Got Here and Where We Are Headed
Authors: Mustanski Brian , Smith Justin D. , Keiser Brennan , Li Dennis H. , Benbow Nanette 
Published: June 2022

Background:
The Ending the HIV Epidemic (EHE) initiative sets a goal to virtually eliminate new HIV infections in the United States by 2030. The plan is predicated on the fact that tools exist for diagnosis, prevention, and treatment, and the current scientific challenge is how to implement them effectively and with equity. Implementation research (IR) can help identify strategies that support effective implementation of HIV services.

Setting:
NIH funded the Implementation Science Coordination Initiative (ISCI) to support rigorous and actionable IR by providing technical assistance to NIH-funded projects and supporting local implementation knowledge becoming generalizable knowledge.

Methods:
We describe the formation of ISCI, the services it provided to the HIV field, and data it collected from 147 NIH-funded studies. We also provide an overview of this supplement issue as a dissemination strategy for HIV IR.

Conclusion:
Our ability to reach EHE 2030 goals is strengthened by the knowledge compiled in this supplement, the services of ISCI and connected hubs, and a myriad of investigators and implementation partners collaborating to better understand what is needed to effectively implement the many evidence-based HIV interventions at our disposal.
Five Common Myths Limiting Engagement in HIV-Related Implementation Research
Authors: Beres Laura K. , Schwartz Sheree , Mody Aaloke , Geng Elvin H. , Baral Stefan 
Published: June 2022

Abstract:
HIV-related implementation research holds great promise in achieving the potential of efficacious prevention and treatment tools in reducing the incidence of HIV and improving HIV treatment outcomes among people living with HIV. From the perspectives of HIV-related implementation research training and academia and through consultations with funders and investigators new to implementation research, we identified 5 myths that act as barriers to engagement in implementation research among new investigators. Prevailing myths broadly include (1) one must rigidly apply all aspects of an implementation framework for it to be valid, (2) implementation research limits the type of designs available to researchers, (3) implementation strategies cannot be patient-level or client-level approaches, (4) only studies prioritizing implementation outcomes are “true” implementation research, and (5) if not explicitly labeled implementation research, it may have limited impact on implementation. We offer pragmatic approaches to negotiate these myths with the goal of encouraging dialog, ensuring high-quality research, and fostering a more inclusive and dynamic field of implementation research. Ultimately, the goal of dispelling these myths was to lower the perceived bar to engagement in HIV-related implementation research while still ensuring quality in the methods and measures used.
Implementation of an HIV Pre-exposure Prophylaxis Strategy Into Abortion and Early Pregnancy Loss Care
Authors: Sonalkar Sarita , McAllister Arden , Kete Corinne , Fishman Jessica , Frarey Alhambra , Short William R. , Schreiber Courtney A. , Teitelman Anne 
Published: June 2022

Background:
Family planning and abortion clinics routinely address sexual health. We sought to evaluate implementation outcomes of an HIV pre-exposure prophylaxis (PrEP) care strategy for patients seeking management of induced abortion and pregnancy loss.

Setting:
Single-center, urban, academic, hospital-based family planning service.

Methods:
We used a multifaceted implementation strategy directed toward family planning providers comprised of educational sessions, an electronic medical record-prompted verbal assessment of HIV risk, electronic medical record shortcuts for PrEP prescription, and support of a PrEP navigator. We assessed penetration of the intervention by calculating the penetration of a PrEP offer, measured as the proportion of encounters in which PrEP was offered to PrEP-eligible individuals. We evaluated feasibility, acceptability, and appropriateness of the intervention using belief elicitation interviews with providers.

Results:
From November 2018 to April 2019, the proportion of PrEP eligible patients who were offered PrEP, was 87.9% (29/33). Providers found the intervention acceptable and appropriate, but reported barriers including time constraints, and disappointment if patients did not adhere to PrEP. Providers liked that PrEP provision in abortion care settings felt innovative, and that they could contribute to HIV prevention.

Conclusion:
Family planning providers in an academic center found HIV risk assessment and PrEP provision to be feasible, acceptable, and appropriate. Further research should evaluate implementation outcomes of PrEP care strategies in additional abortion care contexts, including clinics offering reproductive health care outside of academia.
Identification of Determinants and Implementation Strategies to Increase PrEP Uptake Among Black Same Gender–Loving Men in Mecklenburg County, North Carolina: The PrEP-MECK Study
Authors: Corneli Amy , Perry Brian , Wilson Johnny , Reif Susan , Gulden Chelsea , Hanlen-Rosado Emily , Cooper Haley , Taylor Jamilah , Starling Summer , Thompson J. Wesley 
Published: June 2022

Background:
Pre-exposure prophylaxis (PrEP) use is low among Black same gender–loving men (BSGLM) in Mecklenburg County, NC, an Ending the HIV Epidemic priority jurisdiction. We created PrEP-MECK—an investigator partnership among a community-based organization representative, a PrEP provider, and researchers—and conducted iterative preparation research to identify determinants of PrEP uptake and implementation strategies to address them.

Methods:
We first established the PrEP-MECK Coalition of community stakeholders. Next, informed by PrEP-MECK Coalition input and PRECEDE-PROCEED's educational/ecological assessment phase, we conducted focus group discussions with BSGLM not using PrEP and in-depth interviews with BSGLM who were currently or had previously taken PrEP to describe determinants and suggest implementation strategies. Based on interim findings, we partnered with clinics participating in the Mecklenburg County PrEP Initiative, which offers free PrEP services to uninsured individuals. We also conducted Consolidated Framework for Implementation Research–informed organizational assessments with community-based organizations and clinics to assess readiness to pilot the implementation strategies.

Results:
We conducted 4 focus group discussions, 17 in-depth interviews, and 6 assessments. BSGLM were aware of PrEP yet perceived that costs made it unattainable. Awareness of how to access PrEP and the Mecklenburg County PrEP Initiative was lacking, and clinic scheduling barriers and provider mistrust limited access. We identified client-level implementation strategies, primarily focusing on engaging the consumer, to increase comfort with and awareness of how to access PrEP, and clinic-level implementation strategies focusing on changing clinic infrastructure, to make PrEP access easier.

Conclusion:
We plan to evaluate implementation of these strategies once fully developed to determine their acceptability and other outcomes in future research.
Comparison of Wireless Localization Alternatives with Wire Localization for Nonpalpable Breast Lesions
Authors: Webster Alexandra J , Kelly Bridget N , McGugin Caroline , Coopey Suzanne B , Smith Barbara L , Gadd Michele A , Specht Michelle C 
Published: June 2022

BACKGROUND:
Radiofrequency identification tag localization (TL) and magnetic seed localization (MSL) are alternatives to wire localization (WL) for excision of nonpalpable breast lesions. We sought to compare localization methods with respect to operative time, specimen volume, and re-excision rate.

STUDY DESIGN:
A retrospective cohort analysis was performed on TL, MSL, and WL lumpectomies and excisional biopsies at a single institution. Association between localization method and operative time, specimen volume, and re-excision rate was assessed by multiple logistic regression using odds ratios (ORs) and 95% CIs.

RESULTS:
A total of 506 procedures were included: 147 TL (29.0%), 140 MSL (27.7%), and 219 WL (43.3%). On logistic regression analysis, MSL was associated with longer operative times than WL for excisional biopsies only (OR 4.24, 95% CI 1.92 to 9.34, p < 0.001). Mean excisional biopsy time was 39.1 minutes for MSL and 33.0 minutes for WL. Specimen volume did not vary significantly across surgery types between localization methods. In an analysis of all lumpectomies with an indication of carcinoma, marker choice was not associated with rate of re-excision (TL vs WL OR 0.64, 95% CI 0.26 to 1.60, p = 0.342; MSL vs WL OR 1.22, 95% CI 0.60 to 2.49, p = 0.587; TL vs MSL OR 0.65, 95% CI 0.26 to 1.64, p = 0.359).

CONCLUSION:
TL, MSL, and WL are comparable in performance for excision of nonpalpable breast lesions. Although increased operative time associated with MSL vs WL excisional biopsies is statistically significant, clinical significance warrants additional study. With similar outcomes, physicians may choose the marker most appropriate for the patient and setting.
Robotic vs Laparoscopic Ventral Hernia Repair with Intraperitoneal Mesh: 1-Year Exploratory Outcomes of the PROVE-IT Randomized Clinical Trial
Authors: Petro Clayton C , Thomas Jonah D , Tu Chao , Krpata David M , Beffa Lucas R , Rosen Michael J , Prabhu Ajita S 
Published: June 2022

BACKGROUND:
Laparoscopic and robotic ventral hernia repair with intraperitoneal mesh have been demonstrated previously to have comparable 30-day outcomes in the PROVE-IT randomized clinical trial. Here we report our 1-year follow-up of enrolled patients to examine exploratory outcomes.

STUDY DESIGN:
All patients enrolled in a previously published, registry-based, randomized trial investigating laparoscopic vs robotic ventral hernia repair with intraperitoneal mesh were reviewed. Several exploratory secondary outcomes were assessed: pain intensity (Patient-Reported Outcomes Measurement Information System [PROMIS 3a]), hernia-specific quality of life (Hernia-Specific Quality of Life Survey [HerQLes]), composite hernia recurrence, and reoperations.

RESULTS:
A total of 95% (71 of 75) follow-up was achieved: 33 laparoscopic repairs and 38 robotic repairs. Median follow-up time was 12 months [interquartile range 10 to 12 months]. Following regression analysis adjusting for baseline scores, there was no difference in postoperative pain intensity at 1 year (p = 0.94). However, HerQLes scores increased by 12.0 more points following robotic repairs compared to laparoscopic counterparts (95% CI 1.3 to 22.7, p = 0.03). Composite hernia recurrence was 6% (2 of 33) for the laparoscopic cohort and 24% (9 of 38) for the robotic group (p = 0.04). There was no difference in rates of reoperation (p = 0.61).

CONCLUSIONS:
Our exploratory analyses have identified potential differences in quality of life and recurrence, favoring the robotic and laparoscopic approaches, respectively. These findings warrant further study with larger patient cohorts to verify their potential significance.
Evolving Metrics of Quality for Kidney Transplant Candidates: Transplant Center Variability in Delisting and 1-Year Mortality
Authors: Sokas Claire M , Husain S Ali , Xiang Lingwei , King Kristen , Mohan Sumit , Salim Ali , Rodrigue James R , Adler Joel T 
Published: June 2022

BACKGROUND:
Management of patients on the kidney transplant waitlist lacks oversight, and transplant centers can delist candidates without consequence. To better understand between-center differences in waitlist management, we examined delisting rates and mortality after delisting within 3 years of removal from the kidney transplant waitlist.

STUDY DESIGN:
This is a retrospective cohort study using data from the Scientific Registry of Transplant Recipients of adults listed for deceased donor kidney transplant in 2015 and followed until the end of 2018. Patients of interest were those delisted for reasons other than transplant, death, or transfer. Centers were excluded if they had fewer than 20 waitlisted patients per year. We calculated probability of delisting and death after delisting using multivariable competing risk models.

RESULTS:
During follow-up, 14.2% of patients were delisted. The median probability of delisting within 3 years, adjusted for center-level variability, was 7.0% (interquartile range [IQR]: 3.9% to 10.6%). Median probability of death was 58.2% (IQR: 40% to 73.4%). There was no meaningful correlation between probability of delisting and death (τ = –0.05, p = 0.34).

CONCLUSIONS:
There is significant variability in the rate of death after delisting across kidney transplant centers. Likelihood of transplant is extremely important to candidates, and improved data collection efforts are needed to inform whether current delisting practices are successfully removing patients who could not meaningfully benefit from transplant, or whether certain populations may benefit from remaining on the list and maintaining eligibility.
Reviewing Patient-Reported Outcomes 1 Year after Orthotopic Liver Transplantation
Authors: Ahmed Ola , Lee Angela , Vachharajani Neeta , Chang Su-Hsin , Park Yikyung , Khan Adeel S , Chapman William C , Doyle MB Majella 
Published: June 2022

BACKGROUND:
With improved survivorship in liver transplantation (LT), there is an emerging focus on functional recovery and health-related quality of life (HRQoL) after surgery. The present study aimed to assess HRQoL after LT using the Patient-Reported Outcomes Measurement Information System (PROMIS).

STUDY DESIGN:
This was a prospective analysis of LT recipients between 2020 and 2021. A total of 238 patients were contacted by phone at 3, 6, and 12 months postoperatively using the PROMIS 29-Profile. Scores were recorded and computed using the HealthMeasures Scoring Service.

RESULTS:
PROMIS was available for 174 patients at 3 (n = 58), 6 (n = 57), and 12 months (n = 59). Overall, mean PROMIS scores were 47.6 ± 3, 47.6 ± 3, and 47.6 ± 3 at 3, 6, and 12 months, respectively. Most domains improved postoperatively by 12 months except for anxiety and sleep disturbance measures. The lowest domain in the immediate postoperative period was physical functioning, but this had the closest return to normative population values. Pain interference was above the population reference during the initial postoperative period, improving by 12 months where they were below mean population values. Depression and fatigue scores improved by 6 months and appeared to stabilize by 12 months post-LT. Patients demonstrated increased social participation, and scores were remarkably higher than general population means at each timepoint.

CONCLUSION:
LT can impact physical, mental, and social health which, in this setting, remains largely unexplored using PROMIS instruments. We report that although overall patient well being can improve, some mental health domains require further consideration during the postoperative period.
Online dashboards for SARS-CoV-2 wastewater data need standard best practices: an environmental health communication agenda
Authors: Naughton Colleen C. , Holm Rochelle H. , James Brooklyn P. , Smith Ted 
Published: June 2022

AbstractThe rapid development of scientific communication approaches for environmental surveillance data with online information dashboards has been done in the absence of a global organizing body during the coronavirus disease 2019 pandemic. We aim to make a case for standardization of dashboards presenting SARS-CoV-2 wastewater data. The list of dashboards was compiled as of March 31, 2022. The 127 dashboards reviewed represented 27 countries using a range of line/bar graphs, maps, and tables with symbol presentation. We identified 96 separate units of measure for the wastewater SARS-CoV-2 data. There was also inconsistency in using linear or log scale. Twenty-five percent of dashboards presented SARS-CoV-2 variant monitoring. Only 30% (38/125) of dashboards provided downloadable source data. There is great opportunity to improve scientific communication though the adoption of uniform data presentation conventions or standards for this field.
Using routinely collected hospital data to investigate healthcare worker mobility and patient contacts within a UK hospital during the COVID-19 pandemic
Authors: Wilson-Aggarwal Jared K , Gotts Nick , Wong Wai Keong , Liddington Chris , Knight Simon , Spyer Moira J , Houlihan Catherine , Nastouli Eleni , Manley Ed 
Published: June 2022

AbstractMovement and contacts are central to the transmission of infectious diseases and, within the hospital setting, healthcare worker (HCW) mobility and their contact with patients play an important role in the spread of nosocomial disease. Yet data relating to HCW behaviours associated with mobility and contacts in the healthcare environment are often limited. This paper proposes a framework for integrating several electronic data sources routinely-collected by modern hospitals, to enable the measurement of HCW behaviours relevant to the transmission of infections. Using data from a London teaching hospital during the COVID-19 pandemic, we demonstrate how, at an aggregate level, electronic medical records (EMRs) and door access logs can be used to establish changes in HCW mobility and patient contacts. In addition, to show the utility of these data sources in supporting infection prevention and control (IPC), we investigate changes in the indirect connectivity of patients (resulting from shared contacts with HCWs) and spatial connectivity of floors (owing to the movements of HCWs). Average daily rates of patient contacts are computed and found to be higher throughout the pandemic compared to that pre-pandemic, while the average daily rates of HCW mobility remained stable until the second wave, where they surpassed pre-pandemic levels. The response of HCW behaviour to the pandemic was not equal between floors, whereby the highest increases in patient contacts and mobility were on floors handling the majority of COVID-19 patients. The first wave of COVID-19 patients resulted in changes to the flow of HCWs between floors, but the interconnectivity between COVID-19 and non COVID-19 wards was evident throughout the pandemic. Daily rates of indirect contact between patients provided evidence for reactive staff cohorting, whereby indirect contact rates between COVID-19 positive and negative patients were lowest during peaks in COVID-19 hospital admissions. We propose that IPC practitioners use these routinely collected data on HCW behaviour to support infection control activities and to help better protect hospital staff and patients from nosocomial outbreaks of communicable diseases.