bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel insights into the role of cell-free seminal mRNAs on semen quality and cryotolerance of spermatozoa in bulls (Bos taurus)
Authors: Shilpa Munivenkatappa , Selvaraju Sellappan , GirishKumar Venkataswamy , Parthipan Sivashanmugam , Binsila Krishnan B. , Arangasamy Arunachalam , Ravindra Janivara Parameshwaraiah
Published: June 2017

The aim of the present study was to ascertain the effectiveness of seminal plasma mRNAs as markers to assess the reproductive performance of bulls. Semen samples (33 ejaculates) from 11 bulls were evaluated for sperm kinematic and functional parameters. Total RNA was isolated from cell-free seminal (cfs) using TRIzol LS reagent and the concentration of cfs-RNA was 24.4 ± 2.3 µg mL−1 seminal plasma. The cfs-RNA was fragmented to a size of 25–500 bp. Of the cfs-mRNAs screened using real time PCR, expression of protamine 1 (PRM1) was positively (P < 0.05) associated with the mitochondrial membrane potential of raw semen, whereas expression of Fas Ligand (FASLG) was negatively (P < 0.05) associated with sperm velocity, membrane integrity and chromatin distribution in post-thaw semen samples. The percentage of Type A spermatozoa (amplitude of lateral movement of head >2.5 μm and straightness >85%) in raw semen was positively (P < 0.05) associated with bone morphogenetic protein 2 (BMP2), ubiquitin conjugating enzyme E2D3 (UBE2D3), tumour-associated necrotic factor-associated death domain (TRADD) and caspase-3 (CASP3) expression. Nerve growth factor (NGF) expression was positively (P < 0.05) associated with the maintenance of post-thaw functional membrane integrity in spermatozoa and could be used to assess the cryotolerance of bull semen. In conclusion, the expression of cfs mRNAs can be used to assess the reproductive performance of males and to predict the sensitivity of spermatozoa to cryoinjury.
Genome-wide CRISPR screen identifies HNRNPL as a prostate cancer dependency regulating RNA splicing
Authors: Fei Teng , Chen Yiwen , Xiao Tengfei , Li Wei , Cato Laura , Zhang Peng , Cotter Maura B. , Bowden Michaela , Lis Rosina T. , Zhao Shuang G. , Wu Qiu , Feng Felix Y. , Loda Massimo , He Housheng Hansen , Liu X. Shirley , Brown Myles
Published: June 2017

Significance

Alternative RNA splicing and the spliceosome machinery have been implicated in cancer progression. A genome-wide CRISPR screen identified the RNA processing factor heterogeneous nuclear ribonucleoprotein L (HNRNPL) as required for prostate cancer growth by regulating alternative RNA splicing and circular RNA formation. HNRNPL and its RNA clients are overexpressed during prostate cancer progression, supporting their potential role as therapeutic targets.
RNA target profiles direct the discovery of virulence functions for the cold-shock proteins CspC and CspE
Authors: Michaux Charlotte , Holmqvist Erik , Vasicek Erin , Sharan Malvika , Barquist Lars , Westermann Alexander J. , Gunn John S. , Vogel Jörg
Published: June 2017

Significance

Interactions between RNA and protein molecules are critical for many cellular processes. Bacterial cells rely on RNA–protein interactions to regulate gene expression in response to an ever-changing environment. To understand such regulation, it is key to identify the processes controlled by RNA-binding proteins. In this study, we have taken a RNA ligand-centered approach to chart the physiological processes controlled by a class of RNA-binding proteins harboring the highly conserved cold-shock domain. This approach revealed cold-shock proteins CspC and CspE to be critical for the stress response and virulence in the enterobacterial pathogen
Salmonella enterica
serovar Typhimurium, emphasizing RNA-binding proteins as major players in bacterial infection.
Inhibitory engrams in perception and memory
Authors: Barron Helen C. , Vogels Tim P. , Behrens Timothy E. , Ramaswami Mani
Published: June 2017

Nervous systems use excitatory cell assemblies to encode and represent sensory percepts. Similarly, synaptically connected cell assemblies or “engrams” are thought to represent memories of past experience. Multiple lines of recent evidence indicate that brain systems create and use inhibitory replicas of excitatory representations for important cognitive functions. Such matched “inhibitory engrams” can form through homeostatic potentiation of inhibition onto postsynaptic cells that show increased levels of excitation. Inhibitory engrams can reduce behavioral responses to familiar stimuli, thereby resulting in behavioral habituation. In addition, by preventing inappropriate activation of excitatory memory engrams, inhibitory engrams can make memories quiescent, stored in a latent form that is available for context-relevant activation. In neural networks with balanced excitatory and inhibitory engrams, the release of innate responses and recall of associative memories can occur through focused disinhibition. Understanding mechanisms that regulate the formation and expression of inhibitory engrams in vivo may help not only to explain key features of cognition but also to provide insight into transdiagnostic traits associated with psychiatric conditions such as autism, schizophrenia, and posttraumatic stress disorder.
All-angle negative refraction of highly squeezed plasmon and phonon polaritons in graphene–boron nitride heterostructures
Authors: Lin Xiao , Yang Yi , Rivera Nicholas , López Josué J. , Shen Yichen , Kaminer Ido , Chen Hongsheng , Zhang Baile , Joannopoulos John D. , Soljačić Marin
Published: June 2017

Significance

Realizing negative refraction of highly squeezed polaritons is an important step toward the active manipulation of light at the extreme nanoscale. To realize negative refraction, an effective means to tailor the coupling of different polaritons is absolutely necessary yet undeveloped. Here, we predict a viable way to flip the sign of group velocities of hybrid plasmon–phonon–polaritons in graphene–boron nitride (BN) heterostructures. The polaritonic strong coupling enables the all-angle negative refraction phenomena between highly squeezed graphene’s plasmons, BN’s phonon polaritons, and their hybrid polaritons. Due to the combined advantages of tunability, low loss, and ultrahigh confinement provided by these polaritons, graphene–BN heterostructures thus provide fundamental tools to explore the manipulation of light at the extreme nanoscale.
Enhanced interplanetary panspermia in the TRAPPIST-1 system
Authors: Lingam Manasvi , Loeb Abraham
Published: June 2017

Significance

The search for extraterrestrial life is one of the most exciting frontiers in present-day astronomy. Recently, the TRAPPIST-1 star was discovered to host seven rocky planets with masses and radii similar to those of the Earth, of which at least three of them may be capable of supporting life. Our paper addresses the possibility that life on one of these planets can spread to others through the transfer of rocky material. We conclude that this process has a high probability of being operational, implying that this planetary system may possess multiple life-bearing planets. Thus, our work has profound theoretical and observational consequences for future studies of the TRAPPIST-1 system and the likelihood of life in our galaxy.
Ubiquitin S65 phosphorylation engenders a pH-sensitive conformational switch
Authors: Dong Xu , Gong Zhou , Lu Yun-Bi , Liu Kan , Qin Ling-Yun , Ran Meng-Lin , Zhang Chang-Li , Liu Zhu , Zhang Wei-Ping , Tang Chun
Published: June 2017

Significance

Ubiquitination and phosphorylation are the two most important protein posttranslational modifications and cell signals. Ubiquitin can be specifically phosphorylated at S65, and the finding here suggests a general functional role for Ub phosphorylation. We show that subtle fluctuation near physiological pH can affect the protonation status of the S65 phosphoryl group and modulate the structure of the ubiquitin monomer and polyubiquitin. It is known that cellular pH varies among organelles and changes under physiological and pathological conditions. Because ubiquitin is involved in myriad aspects of cell biology, a pH-sensitive conformational switch acquired upon S65 phosphorylation would allow phosphorylated ubiquitin to interact with different target proteins upon environmental cues. It would also enable cross-talk between ubiquitination and phosphorylation signals.
The feral boy: archetypal image of pathos in a dream series
Authors: Kline Jim
Published: June 2017

The figure of a half-human, half-feline boy appearing in a dream series of a middle-aged businessman suffering from job burnout is investigated from a Jungian perspective, noting its relevance to Jung’s concept of eros as a relatedness principle as well as an example of the puer aeternus or eternal child archetype. Further investigation into the feral boy figure reveals its compensatory function: a reaction to the dreamer’s regression to a more primitive state of self-identity and forced alienation from his business profession and his private life. Additional references to the feral boy from the Mesoamerican Olmec civilization provide evidence of the figure’s identity as an archetypal image of pathos, arousing sympathetic pity that leads to reconnecting the dreamer with his societal and familial responsibilities.
Climate Change Assessments: Confidence, Probability, and Decision
Authors: Bradley Richard , Helgeson Casey , Hill Brian
Published: June 2017

The Intergovernmental Panel on Climate Change has developed a novel framework for assessing and communicating uncertainty in the findings published in its periodic assessment reports. But how should these uncertainty assessments inform decisions? We take a formal decision-making perspective to investigate how scientific input formulated in the IPCC’s novel framework might inform decisions in a principled way through a normative decision model.
In vivo manipulation of the extracellular matrix induces vascular regression in a basal chordate
Authors: Rodriguez Delany , Braden Brian P. , Boyer Scott W. , Taketa Daryl A. , Setar Leah , Calhoun Chris , Maio Alessandro Di , Langenbacher Adam , Valentine Megan T. , De Tomaso Anthony W.
Published: June 2017

We investigated the physical role of the extracellular matrix (ECM) in vascular homeostasis in the basal chordate Botryllus schlosseri, which has a large, transparent, extracorporeal vascular network encompassing an area >100 cm2. We found that the collagen cross-linking enzyme lysyl oxidase is expressed in all vascular cells and that in vivo inhibition using β-aminopropionitrile (BAPN) caused a rapid, global regression of the entire network, with some vessels regressing >10 mm within 16 h. BAPN treatment changed the ultrastructure of collagen fibers in the vessel basement membrane, and the kinetics of regression were dose dependent. Pharmacological inhibition of both focal adhesion kinase (FAK) and Raf also induced regression, and levels of phosphorylated FAK in vascular cells decreased during BAPN treatment and FAK inhibition but not Raf inhibition, suggesting that physical changes in the vessel ECM are detected via canonical integrin signaling pathways. Regression is driven by apoptosis and extrusion of cells through the basal lamina, which are then engulfed by blood-borne phagocytes. Extrusion and regression occurred in a coordinated manner that maintained vessel integrity, with no loss of barrier function. This suggests the presence of regulatory mechanisms linking physical changes to a homeostatic, tissue-level response.
matter: an R package for rapid prototyping with larger-than-memory datasets on disk
Authors: Bemis Kylie A , Vitek Olga
Published: June 2017

We introduce matter, an R package for direct interactions with larger-than-memory datasets, stored in an arbitrary number of files of any size. matter is primarily designed for datasets in new and rapidly evolving file formats, which may lack extensive software support. matter enables a wide variety of data exploration and manipulation steps and is extensible to many bioinformatics applications. It supports reproducible research by minimizing the need of converting and storing data in multiple formats. We illustrate the performance of matter in conjunction with the Bioconductor package Cardinal for analysis of high-resolution, high-throughput mass spectrometry imaging experiments.

Availability and implementation

The package, vignettes and examples of applications in several areas of bioinformatics are available open-source at www.bioconductor.org under the Artistic-2.0 license.
Routine Vaccines for Vaccine-Preventable Diseases
Authors: Tan Tina Q. , Flaherty John P. , Gerbie Melvin V.
Published: June 2017

The natural history, signs and symptoms, prevention, and treatment of common vaccine preventable infectious diseases are introduced. Dosing, immunization schedules, contraindications, precautions, and administration of vaccines are discussed for patients of all ages. Frequently asked question sections at the end of each chapter summarize issues that clinicians commonly encounter in their practices. This chapter details each of the diseases and specific vaccines that are recommended throughout life. The clinical presentations, clinical courses, complications, and post-exposure and pre-exposure managements are detailed. Differences in the disease in childhood and adult ages are noted. International variations of the diseases and vaccine requirements of individual countries are noted. The transmissions, incubation periods of the diseases, natural, and vaccine-induced durations of immunity are discussed. FAQs offer helpful answers to many of the questions that this wide variety of conditions present.
Introduction to nuclear cardiology
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

The cardiologist of the early twenty-first century takes for granted the wide range of imaging modalities at his/her disposal, but it was not always so. At the beginning of the 1970s, invasive cardiac catheterization was the only reliable cardiac imaging technique. Subsequently, nuclear cardiology investigations led the way in the non-invasive assessment of cardiac disease. This chapter covers the history of nuclear cardiology, including important milestones in the development of nuclear medicine. It details the relation of nuclear cardiology to other imaging modalities, covering the common imaging modalities used to evaluate left ventricular function and coronary artery disease, and the challenges of multislice X-ray computed tomography.
The gamma camera
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

Nuclear cardiology imaging is traditionally performed on an Anger gamma camera. Its key component is a large, flat, circular or rectangular sodium iodide crystal, activated by non-radioactive thallium (NaI(Tl)). The side of the crystal facing the patient is covered with a lead collimator, while the side away from the patient is viewed by an array of photomultiplier tubes (PMTs). This chapter provides detail on the gamma camera, including information on crystals and collimators, PMTs, and electronics. Important measures of gamma camera performance parameters and quality control are covered in detail, and a section on dedicated solid-state cardiac gamma cameras is included.
Single photon emission computed tomography (SPECT)
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

Single photon emission computed tomography (SPECT) allows an organ to be imaged in three dimensions with enhanced contrast. Of particular relevance in nuclear cardiology, it also allows the heart to be reorientated relative to its own axes, and slices presented in standard orthogonal planes. Scintigraphic imaging is thereby rendered more accessible to cardiologists already familiar with echocardiography and other imaging modalities. This chapter explores specific issues of instrumentation, acquisition, and processing, discussing camera options and specific quality control issues. SPECT reconstruction is covered with reference to both filtered back-projection and iterative reconstruction. Other key aspects of SPECT covered include image reorientation, colour display, gated SPECT, and attenuation correction.
Radionuclide ventriculography
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

Radionuclide ventriculography (RNV) was the first reliable non-invasive method of assessing left ventricular (LV) function, and established nuclear cardiology as a clinical discipline. The subsequent development of other imaging modalities, particularly echocardiography, has led to a sharp decline in the number of studies performed, but RNV still has a role in situations where reproducible serial assessments of LV ejection fraction are required. Equilibrium RNV (ERNV) is the most straightforward and commonly performed style of RNV, and this chapter therefore focuses on ERNV, covering blood-pool labelling, principles of electrocardiogram (ECG) gating, acquisition, processing and interpretation, and clinical value in relation to ERNV. A section on first-pass radionuclide ventriculography is also included.
Introduction to myocardial perfusion scintigraphy
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

Myocardial perfusion scintigraphy (MPS) is used to image relative myocardial blood flow at rest and during stress, thereby defining flow-limiting epicardial coronary stenoses and sometimes microvascular disease. It is commonly used diagnostically in patients with suspected coronary disease, and provides valuable prognostic information even in patients with proven disease. This chapter provides an introduction to MPS, including a brief overview of technique, equipment, and indications.
Stress testing for myocardial perfusion scintigraphy
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

This chapter focuses on stress testing for myocardial perfusion scintigraphy. Beginning with detail on coronary physiology and exercise testing, it explains the coronary arterial system and the effect of stress methods on flow. By providing practical details on stress testing and exercise stress including equipment, personnel, and patient preparation, this chapter provides a good basis for clinical practice. Information on vasodilator drugs is also provided, with detail on pharmacology, practical considerations when performing the stress test, and adverse effects. Similar detail is provided on dobutamine. A further section details the advantages and disadvantages of methods of stress, including cost considerations, side effects, and variable suitability for a range of patients. A handy and practical algorithm is also provided to aid decision-making for appropriate methods of stress.
Radiopharmaceuticals used in myocardial perfusion scintigraphy
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

Three radiopharmaceuticals are in routine clinical use in myocardial perfusion scintigraphy: thallium-201 (201Tl) as thallous chloride, technetium-99m (99mTc) sestamibi, and 99mTc tetrofosmin. This chapter covers physiological, imaging, and practical considerations of these radiopharmaceuticals, with detail on the properties and protocols of each explored in detail. Other perfusion tracers not in current clinical use are also listed.
Myocardial perfusion scintigraphy: image interpretation
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

This chapter focuses on image interpretation in myocardial perfusion scintigraphy. It covers planar acquisitions, the general approach to reporting single photon emission computed tomography (SPECT) images, and both qualitative and quantitative evaluation of tomographic slices. Detail is also provided on gated SPECT and attenuation correction, as well as a range of artefacts including image, instrumentation-related, and patient-related artefacts. Information is provided on abnormal appearances in coronary artery disease, perfusion defects, and indirect markers of severe coronary artery disease. The chapter also covers interpretation in left ventricular dysfunction and appearances in non-coronary cardiac disease, and includes a section on writing a useful report.
Myocardial perfusion scintigraphy: clinical value
Authors: Sabharwal Nikant , Arumugam Parthiban , Kelion Andrew
Published: June 2017

Myocardial perfusion scintigraphy (MPS) is most commonly used to diagnose or exclude obstructive coronary disease in patients presenting with chest pain. This chapter covers the value of MPS in this context, as well as providing detail on the guidelines which help the clinician choose what investigations are appropriate for the patient presenting with chest pain. It also details a number of considerations related to the use of MPS, such as its cost-effectiveness and the prognosis value in the diagnosis of coronary artery disease compared to exercise ECG, X-ray computed tomographic coronary angiography, and other imaging investigations. Risk assessment prior to elective non-cardiac surgery is covered, with detailed attention paid to the challenges of assessing coronary artery disease special groups including women and patients with diabetes or renal disease. This chapter also covers assessment in known stable coronary artery disease, predicting the value of coronary revascularization and hibernating myocardium.
HIV Psychiatry—A Paradigm for Integrated Care
Authors: Cohen Mary Ann , Mugavero Michael J. , Hall Elise
Published: June 2017

Psychiatric factors play a significant role in the transmission and perpetuation of the human immunodeficiency virus (HIV) pandemic. In less than four decades, competent HIV medical care and research transformed acquired immune deficiency syndrome (AIDS) from a rapidly fatal illness of unknown cause into a chronic manageable illness. These vast strides made in the care of persons with HIV have not been matched in the prevention of HIV transmission or in the psychiatric care of persons with HIV/AIDS. Although AIDS is an entirely preventable infectious illness, HIV transmission continues throughout the world. HIV transmission of HIV is fueled by the stigma of mental illness and of HIV, as well as discrimination, criminalization, and risky behaviors. A comprehensive biopsychosocial approach to sexual health and mental health and diminution of stigma is essential to both HIV prevention and HIV care. This chapter introduces the concept of HIV/AIDS as “the great magnifier of maladies” as it traces the history of HIV psychiatry, explores the paradoxes and disparities of HIV care, explains how HIV psychiatry is a paradigm for the psychiatric care of the medically ill (psychosomatic medicine), and sets the stage for an understanding of how integrated care can prevent transmission of HIV and decrease morbidity and mortality in persons with HIV.
HIV/AIDS in the Fourth Decade
Authors: Mugavero Michael J. , Kilby J. Michael
Published: June 2017

This chapter discusses the maturing HIV/AIDS epidemic, now in its fourth decade, with global scale-up of antiretroviral therapy (ART) and reductions in the number of new HIV cases in many regions in the world. Advances in biomedical prevention with promising clinical trial findings for pre-exposure prophylaxis (PrEP) and microbicides provide a scientific foundation for the prevention of new infections in persons who are HIV uninfected and at risk. Landmark trials identifying the benefits of ART treatment as prevention (TasP) of new HIV infections and demonstrating the benefits of early ART initiation at higher CD4 counts have informed global guidelines. The pendulum has swung back to recommending early ART initiation for all persons living with HIV upon learning of a new diagnosis. However, late diagnosis persists as a formidable challenge, and gaps in engagement in medical care among diagnosed persons, as depicted by the treatment cascade, as well as suboptimal adherence to biomedical prevention and ART threaten the effectiveness of these scientific discoveries. The tools and resources are available to hasten the end of HIV/AIDS around the globe with integration of service delivery to address the medical, psychiatric, psychological, and societal impact the virus poses to individuals and communities living with and at risk for HIV/AIDS.
HIV Discrimination, Stigma, and Gender-Based Violence
Authors: Douaihy Antoine , Shenai Neeta , Clinebell Kimberly , Cohen Mary Ann
Published: June 2017

Stigma, discrimination, and gender-based violence complicate and perpetuate the human immunodeficiency virus (HIV) pandemic. Although remarkable strides have transformed AIDS from a rapidly fatal infectious illness to a chronic manageable illness, HIV-based stigma, discrimination, and gender-based violence, together known as AIDSism, still exist and have not been transformed in the same way as the illness itself. These barriers continue to have a negative impact on prevention and testing as well as in engagement, retention, and adherence to care. This chapter explores the role that clinicians can play in recognizing and ameliorating HIV stigma, discrimination, and gender-based violence in order to diminish both suffering and HIV transmission and lead to compassionate and competent approaches to care.
How to Establish An Integrated Ambulatory Care Program Co-Located in An HIV Clinic
Authors: Cohen Mary Ann , Bourgeois James , Fisher Weston , Tran David
Published: June 2017

The pragmatic aspects of all steps involved in establishing an integrated psychiatry (and other mental health) care model in a HIV outpatient clinic are discussed in detail in this chapter. These include initial outreach inquiry, interdepartmental discussion, business case analysis, logistics in establishing clinical routines and operating relationships, utilization management, information technology, and research and educational opportunities specific to this model of collaborative care. The beneficial aspects of integrated care include increased engagement and retention in HIV care and decreased HIV morbidity and mortality. A biopsychosocial approach provides a model for compassionate and multidimensional care. Readers are encouraged to apply this framework within the parameters of their local institutions when establishing integrated psychiatric care models in HIV clinics.
Sociocultural Factors Influencing The Transmission of HIV/AIDS in The United States
Authors: Fullilove Robert E
Published: June 2017

This chapter discusses the unique impact that social disadvantage in general and the criminal justice systems in the United States in particular have on the conditions that drive the HIV/AIDS epidemic in this country. HIV/AIDS is classified as an important racial/ethnic health disparity because residents of marginalized black and Hispanic communities are overrepresented among persons living with HIV/AIDS in the United States. Members of black and Hispanic communities are also overrepresented in the criminal justice; in terms of the epidemic, approximately one out of seven persons living with HIV/AIDS will pass through a U.S. correctional facility in any given year. A history of incarceration is associated with poor treatment outcomes for HIV illness. Improving the quality of HIV care in correctional facilities and in the communities to which incarcerated persons will return is imperative, as is effective interventions in incarcerated populations and communities. Having AIDS activists, scientists, and healthcare workers join in efforts to reform incarceration policies and practices will improve efforts to prevent and treat HIV/AIDS, particularly in communities that confront high rates of HIV/AIDS and incarceration.
Training in HIV Psychiatry
Authors: Stoff David M. , Cohen Mary Ann , Forstein Marshall , Dickerman Anna L. , Petersen Daena L.
Published: June 2017

HIV education and training can improve HIV treatment and prevention services, improve HIV-related education, and increase the number of clinicians and investigators working with persons at risk for and living with HIV/AIDS. This chapter presents a biopsychosocial, integrated model of HIV/AIDS education for psychiatry trainees, relevant curriculum and content areas of HIV/AIDS education, and related areas, such as teaching treatment approaches and implementation of training curricula. HIV education is enriched through a balanced approach that emphasizes the importance of diversity training as well as research training. National Institutes of Health (NIH) research training and career development opportunities are highlighted, as are diversity issues in HIV psychiatry for the training of a diverse research workforce.
Neurological Complications of HIV in The Peripheral Nervous System
Authors: Keltner John R , Akkari Cherine , Ellis Ronald J
Published: June 2017

HIV sensory neuropathy affects approximately 50% of persons diagnosed with HIV and, in 40%, results in disabling symptoms including paresthesia and/or pain. This chapter focuses on providing guidance to psychiatrists in the clinical management of pain in persons with HIV and sensory neuropathy. The differential diagnostic evaluation of HIV sensory neuropathy, other peripheral neuropathies, and spinal cord mimics and management of HIV sensory neuropathy are reviewed, as well as management of HIV distal neuropathic pain. The differential diagnostic evaluation of peripheral neuropathies is simplified using a graphical decision tree. The chapter also reviews the pathophysiology of HIV sensory neuropathy and warning signs of advanced disease. Procedures to diagnose HIV sensory neuropathy, including nerve conduction studies and electromyography, quantitative sensory testing, skin biopsy, and the autonomic sweat test are discussed, as are clinical aspects of HIV distal neuropathic pain. The chapter addresses the impact of HIV distal neuropathic pain on quality of life and depression and concludes with a discussion of treatments for HIV distal neuropathic pain.
Homelessness and HIV Transmission
Authors: Livingstone Kimberly , Herman Daniel B. , Adler Naomi , Susser Ezra S.
Published: June 2017

Homelessness is associated with both poorer health and higher risk of morbidity and mortality. Recent research suggests that with growing availability of antiretroviral therapy and the expansion of housing alternatives for chronically homeless persons, HIV is no longer a leading cause of death among the homeless. Nonetheless, HIV prevalence is significantly higher among homeless persons than among their housed counterparts. This chapter examines the association between HIV/AIDS and homelessness in the United States. After providing a brief overview of homelessness and the characteristics of specific homeless subpopulations, we discuss HIV prevalence, transmission, treatment and prevention among people who are homeless in the United States.
Routine Testing for HIV Infection and Pre-Exposure and Post-Exposure Prophylaxis
Authors: Abraham Bisrat K. , Flores Inti , Gulick Roy M.
Published: June 2017

Substantial progress has been made in the fight against HIV/AIDS, and newer therapies are enabling individuals to live longer and healthier lives. Furthermore, the concept of treatment as prevention is now well solidified and has increased the urgency to identify and treat all HIV-infected individuals. As such, revised guidelines for HIV testing have shifted from a model of “targeted testing” to a more universal approach whereby all individuals have routine testing for HIV as part of medical care. Despite this approach, the number of incident HIV cases has remained stable in the United States. In addition to behavioral interventions and counseling, preventative strategies such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are being used to help protect at-risk individuals.
Vaccines for The Prevention and Treatment of HIV Infection
Authors: Cox Josephine H. , Shapiro Stuart Z. , Dawson Liza , Geppert Cynthia , Siegel Andrew M. , D’Souza M. Patricia
Published: June 2017

While the HIV/AIDS pandemic continues, the overall incidence of HIV infections has fallen through use of antiretroviral therapy (ART) and multiple prevention modalities. To achieve a durable end to the pandemic and avoid the requirement for daily antiretroviral medication over a lifetime, a safe and effective prophylactic vaccine remains essential. This chapter reviews current advances in prophylactic and therapeutic HIV-1 vaccine strategies and the challenges that lie ahead. Recent success in isolation of potent broadly neutralizing antibodies (bnAbs) from infected individuals, the discovery of mechanisms of bnAb induction, and progress in understanding mechanisms of CD8 T-cell killing of HIV-infected cells and the structure of the HIV envelope trimer have opened new strategies for HIV vaccine design. On the therapeutic front, the persistence of HIV reservoirs remains a formidable obstacle to achieving sustained virological remission in HIV-infected individuals after ART is discontinued. Development of a new generation of immune-based therapeutic agents might contribute to a curative intervention. The chapter closes with an overview of ethical challenges in vaccine development and clinical testing.
Childhood and Adolescence
Authors: Kapetanovic Suad , Wiener Lori , Tuchman Lisa , Pao Maryland
Published: June 2017

Mental health professionals need to understand how the psychosocial and mental health needs of HIV-infected youth evolve over time and to be able to identify salient clinical challenges that present with each developmental stage. It is also important to understand that HIV/AIDS affects children’s lives indirectly, by the presence of HIV/AIDS in a family member, even if the child is not HIV infected. This chapter uses a developmental perspective to introduce key mental health objectives in the lives of developing HIV-infected children and adolescents and provides an overview of epidemiological, psychosocial, and clinical parameters to be considered in their clinical care and management. The chapter also addresses issues facing perinatally and behaviorally HIV-infected children and adolescents. Separate sections of the chapter discuss biopsychosocial factors salient to children and adolescents who are affected by HIV infection in the family.
Women’s Issues
Authors: Gorman Sara , Currier Judith , Hall Elise , del Amo Julia
Published: June 2017

This chapter explores some of the unique challenges that often put women at higher risk of HIV infection and that create a course of illness that may differ from that found in men living with HIV. The first portion of the chapter discusses manifestations of HIV infection and the course of infection in women. It also addresses the particular issues associated with antiretroviral treatment (ART) and women, and the interactions between ART and depression in women. The chapter then goes on to broach an important topic that puts many women at high risk for HIV infection: gender-based violence, as well as some of the key, albeit limited, research on effective interventions for gender-based violence and HIV prevention. The third part of the chapter addresses issues related specifically to HIV and pregnancy, including vertical transmission. Finally, the chapter concludes with a discussion of a relatively neglected topic, HIV and menopause.
Older Age and HIV
Authors: Goodkin Karl , Stoff David M. , Jeste Dilip V. , Marquine Maria J.
Published: June 2017

This chapter addresses the growing problem of aging and HIV infection throughout the world. Emphasis is placed on conceptualization such as the development of phenotypes within the population of older persons with HIV. The phenotypes include (1) disability, (2) frailty/vulnerability, (3) comorbid conditions, (4) cognitive aging, (5) premature or accelerated aging, and (6) successful aging. Older age and illness progression is addressed with respect to frailty or vulnerability to progression and the development of a dysfunctional, disabled status in activities of daily living. The issue of older age and HIV-associated neurocognitive disorder is discussed, and the research related to pattern of cognitive impairment, including dementia, is reviewed. The chapter also differentiates characteristics of accelerated aging from characteristics of successful aging. Integration of gerontology with HIV medicine and HIV psychiatry can be accomplished through focusing future study on optimization of functional status and quality of life in aging with HIV.
Cardiovascular Disease, Metabolic Complications and Lipodystrophy in Persons with HIV
Authors: Pereira Luis F. , Goforth Harold W. , Martínez Esteban , Lux Joseph Z. , Ferrara Maria , Mullen Michael P.
Published: June 2017

The introduction of effective antiretroviral therapy has contributed to a dramatic reduction in HIV-related mortality. As patients live longer, evidence suggests an increased incidence of cardiovascular disease in persons with HIV over that among individuals who do not have HIV, thus early detection and treatment of multimorbidities and modifiable cardiovascular disease risk factors particularly in persons with HIV are needed. Several mechanisms have been proposed to explain the increased risk of cardiovascular disease, including the virus itself, antiretroviral therapy, and traditional risks factors. This chapter discusses detection and treatment of cardiovascular disease in persons with HIV, as well as metabolic complications involved, including dyslipidemia, insulin resistance, and lactic acidosis. The pathogenesis and management of HIV-associated lipodystrophy as well as its psychosocial impact are also addressed.
Infidelity
Authors: Troisi Alfonso
Published: June 2017

This chapter reviews recent data on the evolution of sexual strategies in humans and shows how, in the natural environment, the adaptive functions of sexual infidelity were substantially different in males and females. The meaning of technical terms used by evolutionary biologists to describe different behavioral strategies related to maximization of reproductive success are explained, including the Coolidge effect, good-gene sexual strategy, and serial monogamy. Biological analysis of motivations for sexual infidelity integrate evolutionary hypotheses with recent data from molecular genetic studies of personality showing that carriers of some genetic polymorphisms related to novelty seeking are more prone to sexual promiscuity. Finally, the chapter reports a clinical case showing how cultural prejudice can distort individual expectations about what is normal sexual desire.
Madness
Authors: Troisi Alfonso
Published: June 2017

Medicalization of human behavioral diversity is a recurring theme in the history of psychiatry, and the problem of defining what is a genuine mental disorder remains an unresolved question since the origins of clinical psychopathology. This chapter presents an evolutionary view of mental health, placing functional capacities and biological adaptation at the core of attempts to define mental disorder instead of other criteria of morbidity that are commonly used . This theoretical shift depends on the fact that the evolutionary concept of mental disorder is consequence oriented: what makes a condition pathological are its consequences, not its causes or correlates. The chapter then provides, an evolutionary analysis, which reveals that the degree of efficiency of functional capacities is dependent on features of the environment. Optimal functional capacities are sets of coevolved traits that are best suited to increasing adaptation in specific environments. The same trait can be highly adaptive in one environment and minimally adaptive in another.
Management of Acute Unilateral Nondisplaced Subaxial Cervical Facet Fractures
Authors: Vedantam Aditya , Fridley Jared Steven , Navarro Jovany Cruz , Gopinath Shankar P
Published: June 2017

BACKGROUND

Few studies have focused on the management of patients with nondisplaced cervical facet fractures.

OBJECTIVE

To determine the rate of successful nonoperative management and risk factors for instability in patients with acute traumatic, unilateral, nondisplaced cervical facet fractures.

METHODS

We reviewed patients with single or multilevel unilateral nondisplaced or minimally displaced subaxial cervical facet fractures between 2008 and 2014. Facet fractures were classified as type A1 fractures: superior facet fracture of caudal vertebra; type A2: inferior facet fracture of rostral vertebral; and type A3: floating lateral mass (fracture of pedicle and vertical laminar fracture). All patients were given a trial of nonoperative management with external immobilization using a hard cervical collar. Follow-up clinical data and cervical spine radiographs were analyzed to determine factors associated with instability.

RESULTS

Thirty-five patients (34 males, mean age 40.2 ± 2.4 yr) were reviewed. The mean follow-up duration was 2.7 ± 0.4 mo. The distribution of fracture types was type A1 (n = 15), type A2 (n = 4), type A3 (n = 5), type A1 and A2 fractures (n = 10), and type A1 and A3 fractures (n = 1). Nonoperative management was successful in 29 patients (82.9%), and 6 patients developed instability requiring surgery. All patients who failed nonoperative management had associated injuries suggesting a more severe mechanism of injury. No significant association was found between the type of facet fracture and outcome (Fisher's exact test, P = .18).

CONCLUSION

In our series, more than 80% of the patients with unilateral, nondisplaced cervical facet fractures underwent successful nonoperative management in the short term.
Anterior Cervical Pseudarthrosis Treated with Bilateral Posterior Cervical Cages
Authors: Smith William , Gillespy Mark , Huffman Jason , Vong Veasna , McCormack Bruce M
Published: June 2017

BACKGROUND

Pseudarthrosis after anterior cervical discectomy and fusion (ACDF) causes persistent pain and related disability. Posterior revision surgery results in higher healing rates, but is more extensive compared to anterior surgery.

OBJECTIVE

To evaluate minimally disruptive, tissue sparing posterior fusion via bilateral placement of posterior cages between the facet joints as an alternative treatment option.

METHODS

A retrospective, multicenter, medical chart review was performed and included 25 patients with symptomatic pseudarthrosis after ACDF treated with posterior cervical cages, and in select cases, anterior revision. Visual analog scale (VAS) for neck and arm pain, Neck Disability Index (NDI), and perioperative metrics were collected. Fusion at 1 yr was determined via assessment of computed tomography (CT) scan and x-rays.

RESULTS

Mean follow-up was 18 mo. VAS neck and arm scores at last follow-up improved significantly from 7.9 ± 1.5 to 3.8 ± 2.3 and 7.24 ± 2.2 to 3.12 ± 2.5, respectively. NDI scores decreased from 65.1 ± 20.3 to 29.1 ± 17.9 at 18 mo. Fusion at 1 yr was confirmed by CT in all 17 patients with available scans and by x-ray in all 25 patients.

CONCLUSION

Revision of cervical pseudarthrosis after ACDF using a tissue sparing posterior approach to place cages bilaterally between the facet joints is an effective surgical strategy in select cases. Along with positive clinical and radiological outcomes, the procedure is associated with less blood loss, shorter operating times, and briefer hospital stays compared to revision with lateral mass fixation or interspinous wiring.
Cervical Spine Deformities in Children With Rhizomelic Chondrodysplasia Punctata
Authors: Abousamra Oussama , Kandula Vinay , Duker Angela L. , Rogers Kenneth J. , Bober Michael B. , Mackenzie William G.
Published: June 2017

Background:

Cervical spine deformity in rhizomelic chondrodysplasia punctata (RCDP) has been described with different findings reported in the literature. However, available literature provides limited data from a few cases with magnetic resonance imaging (MRI) of the cervical spine. Our report describes the MRI findings in a group of children with RCDP, aiming to reach a better understanding of this pathology.

Methods:

An Institutional Review Board-approved RCDP Registry was created at our institution with the goal of identifying pertinent medical issues over the lifespan of individuals with RCDP. Records of children within the registry were evaluated, and magnetic resonance images obtained between 2004 and 2015, were available for review. The levels of spinal canal stenosis were recorded and the severity of the stenosis was decided based on adults’ parameters. Cord compression and myelomalacia were confirmed on the axial images. Sagittal lumbar spine magnetic resonance images were also evaluated when available, and the presence of tethered cord and fatty filum was recorded.

Results:

Twenty-six children (15 boys and 11 girls) were identified in the RCDP Registry. Eleven children (6 boys and 5 girls) had sagittal MRI of the cervical spine available for review. Age at the time of MRI study was variable (1 wk to 32 mo). All patients except 1 had stenosis of the cervical spinal canal. Myelomalacia of the cord was noted only in this patient.

Conclusions:

This study suggests that, in children with RCDP, cervical spinal stenosis and cord compression are a real risk, and children with this diagnosis should have monitoring for these issues. Tethered cord is also a possible finding that needs to be evaluated. Full sagittal spine MRI is necessary to detect the possible deformities at the cervical and lumbar levels.
Nasal Swab Screening for Staphylococcus aureus in Spinal Deformity Patients Treated With Growing Rods
Authors: Luhmann Scott J. , Smith June C.
Published: June 2017

Background:

Surgical-site infections are one of the most concerning complications in patients treated with growing rods (GR). The purpose of this study was to evaluate the use of preoperative screening for Staphylococcus aureus (SA) for all growing spine procedures, and if this would permit alteration of prophylactic antibiotics to cover the identified resistances.

Methods:

All patients were identified who had SA screening during the course of GR treatment. In otal, 34 patients [23 neuromuscular (NMS), 4 congenital, 4 idiopathic scoliosis (IS), and 3 syndromic] were identified who had 111 preoperative screenings [79 lengthenings, 23 insertions, 6 revisions, and 3 conversions to posterior spinal fusions (PSF)]. Mean age at GR insertion was 5.5 years (2 to 11 y).

Results:

There were 11 methicillin-resistant Staphylococcus aureus (MRSA) “+” screenings in 6 patients (5 NMS, 1 IS): 3 in 3 patients before GR insertion and 8 in 3 patients (all 3 were negative at GR insertion screening) at subsequent surgeries. There were 23 methicillin-sensitive Staphylococcus aureus (MSSA) “+” screenings in 12 patients (7 NMS, 2 congenital, 2 IS, 1 syndromic): 2 in 2 patients before GR insertion and 21 in 10 patients at subsequent surgeries (18 lengthenings, 3 revisions). Overall, 13 patients (3 MRSA+10 MSSA) were initially negative but screened positive for the first time at a subsequent surgery (12 lengthenings, 1 GR to PSF). All patients (n=5) with positive screenings before GR insertion were in patients with NMS (3 MRSA, 2 MSSA). On the basis of sensitivities, 9 patients demonstrated SA resistance to cefazolin (8 MRSA and 1 MSSA) and 6 to clindamycin (5 MRSA and 1 MSSA). Hence, if cefazolin was routinely used for all patients 26.5% of patients (9/34) would have been inadequately covered at some point during their GR treatment; clindamycin, 17.7% (6/34).

Conclusion:

The use of SA nasal swab screening in GR patients identified 9 patients (26.5%) whose prophylactic antibiotics (cefazolin) could be altered to permit appropriate SA coverage.

Level of Evidence:

Level IV—retrospective case series.