bluuebunny/crossref_metadata_2025 huggingface dataset:
Illusion-enhanced Virtual Reality Exercise for Neck Pain
Authors: Harvie Daniel S. , Smith Ross T. , Moseley G. Lorimer , Meulders Ann , Michiels Bart , Sterling Michele
Published: November 2019

Objectives:

Body illusions have shown promise in treating some chronic pain conditions. We hypothesized that neck exercises performed in virtual reality (VR) with visual feedback of rotation amplified would reduce persistent neck pain.

Methods:

In a multiple-baseline replicated single case series, 8 blinded individuals with persistent neck pain completed a 4-phase intervention (initial n=12, 4 dropouts): (1) “baseline”; (2) “VR” during which participants performed rotation exercises in VR with no manipulation of visual feedback; (3) “VR enhanced” during which identical exercises were performed but visual feedback overstated the range of motion being performed; (4) “follow-up.” Primary outcomes were twice-daily measures of pain-free range of motion and pain intensity. During the baseline and follow-up phases, measures were taken but no intervention took place.

Results:

No differences in primary outcomes were found between VR and baseline, VR enhanced and VR, or VR enhanced and follow-up.

Discussion:

Our hypothesis, that neck exercises performed in VR with visual feedback of rotation amplified, would reduce persistent neck pain was not supported. Possible explanations and future directions are discussed.
Do socioeconomic factors play a role in nonadherence to follow-up colonoscopy after a positive faecal immunochemical test in the Flemish colorectal cancer screening programme?
Authors: Hoeck S. , van de Veerdonk W. , De Brabander I.
Published: November 2019

Objective

In Flanders (Belgium), a population-based colorectal cancer (CRC) screening programme was started in 2013, coordinated by the Centre for Cancer Detection (CCD) in cooperation with the Belgian Cancer Registry (BCR). The CCD offers a biennial faecal immunochemical test (FIT) to Flemish citizens aged 56–74 years and recommends a colonoscopy when screened positive by FIT. The study objective is to investigate sociodemographic differences in follow-up colonoscopy adherence after a positive FIT.

Methods

Characteristics of the study population were derived by linkage of data from the CCD and BCR, linked with data of the Intermutualistic Agency and the Crossroads Bank for Social Security, resulting in aggregated tables to ensure anonymity. A total of 37 834 men and women aged 56–74 years with a positive FIT in 2013–2014 were included. Adherence to follow-up colonoscopy was calculated for age, sex, work intensity at household level, preferential reimbursement status, and first and current nationality. Descriptive analyses and logistic regressions were performed.

Results

Nonadherence to follow-up colonoscopy was associated with increasing age, and was significantly higher in men [odds ratio (OR), 1.08], participants with a preferential reimbursement status (OR, 1.34), very low work intensity (OR, 1.41), no payed work (OR, 1.38) and other than Belgian nationality by birth (OR, 1.6–4.66).

Conclusion

Adherence to follow-up colonoscopy after a positive FIT differs according to sociodemographic variables. Additional research is needed to explore reasons for nonadherence to colonoscopy and tackle barriers by exploring interventions to increase colonoscopy follow-up adherence after a positive FIT in the Flemish colorectal cancer screening programme.
Inattention and Hyperactivity in Children with Symptomatic and Asymptomatic Congenital Cytomegalovirus
Authors: Topham Jonathan D. , Miller Jerry A. , Wright Garry W. , Turcich Marie , Vinson Sherry S. , Iovino Isabella , Voigt Robert G. , Demmler-Harrison Gail ,   On behalf of the Houston Congenital Cytomegalovirus Longitudinal Study Group
Published: November 2019

Objectives:

To explore the relationship between congenital cytomegalovirus (CMV) and inattention and hyperactivity among school-aged children.

Methods:

The Behavior Assessment System for Children, Second Edition, parent- and self-report, was completed among children with symptomatic congenital CMV (ScCMV) (n = 36), asymptomatic congenital CMV (AcCMV) (n = 76), and controls (n = 29) enrolled in a longitudinal cohort. The proportions of children with ScCMV, AcCMV, and controls with Attention Problems or Hyperactivity T-scores ever ≥ 65 were compared. Mean T-scores in these domains were also compared and adjusted for IQ.

Results:

Children with AcCMV did not differ from controls in the proportion of children with elevated Attention Problems or Hyperactivity T-scores or in mean Attention Problems or Hyperactivity T-scores. Children with ScCMV had a higher proportion of elevated Attention Problems T-scores compared with the AcCMV group but not controls. There were no differences in the proportions of children with elevated Hyperactivity T-scores between ScCMV and AcCMV or control groups. Children with ScCMV had higher mean Attention Problems T-scores versus those with AcCMV and controls and higher mean Hyperactivity T-scores versus those with AcCMV but not controls. After adjustment for IQ, differences in mean Attention Problems or Hyperactivity T-scores were no longer significant.

Conclusion:

Children with AcCMV are not at increased risk of inattention or hyperactivity compared with controls. However, our study suggests an increased prevalence of inattention and hyperactivity among children with ScCMV. Differences in IQ were confirmed to have a confounding effect. Evaluation for attention-deficit/hyperactivity disorder may be warranted in this population.
Within-city Spatial Variations in Ambient Ultrafine Particle Concentrations and Incident Brain Tumors in Adults
Authors: Weichenthal Scott , Olaniyan Toyib , Christidis Tanya , Lavigne Eric , Hatzopoulou Marianne , Van Ryswyk Keith , Tjepkema Michael , Burnett Rick
Published: November 2019

Background:

Ambient ultrafine particles (UFPs, <0.1 µm) can reach the human brain, but to our knowledge, epidemiologic studies have yet to evaluate the relation between UFPs and incident brain tumors.

Methods:

We conducted a cohort study of within-city spatial variations in ambient UFPs across Montreal and Toronto, Canada, among 1.9 million adults included in multiple cycles of the Canadian Census Health and Environment Cohorts (1991, 1996, 2001, and 2006). UFP exposures (3-year moving averages) were assigned to residential locations using land-use regression models with exposures updated to account for residential mobility within and between cities. We followed cohort members for malignant brain tumors (ICD-10 codes C71.0–C71.9) between 2001 and 2016; Cox proportional hazards models (stratified by age, sex, immigration status, and census cycle) were used to estimate hazard ratios (HRs) adjusting for fine particle mass concentrations (PM2.5), nitrogen dioxide (NO2), and various sociodemographic factors.

Results:

In total, we identified 1,400 incident brain tumors during the follow-up period. Each 10,000/cm3increase in UFPs was positively associated with brain tumor incidence (HR = 1.112, 95% CI = 1.042, 1.188) after adjusting for PM2.5, NO2, and sociodemographic factors. Applying an indirect adjustment for cigarette smoking and body mass index strengthened this relation (HR = 1.133, 95% CI = 1.032, 1.245). PM2.5and NO2were not associated with an increased incidence of brain tumors.

Conclusions:

Ambient UFPs may represent a previously unrecognized risk factor for incident brain tumors in adults. Future studies should aim to replicate these results given the high prevalence of UFP exposures in urban areas.
Type 2 Diabetes Mellitus, Glycated Hemoglobin Levels, and Cardiopulmonary Exercise Capacity in Patients With Ischemic Heart Disease
Authors: Uribe-Heredia Giovanna , Arroyo-Espliguero Ramón , Viana-Llamas María Carmen , Piccone-Saponara Luis Guillermo , Álvaro-Fernández Henar , García-Magallón Belén , Torán-Martínez Claudio , Silva-Obregón Alberto , Izquierdo-Alonso José Luis
Published: November 2019

Purpose:

Diabetes mellitus (DM) is associated with long-term cardiovascular complications, including ischemic heart disease (IHD). Nonetheless, DM may directly impair myocardial and lung structure and function. The aim of this study was to assess the impact of type 2 DM (T2DM) and glycemic control on cardiopulmonary exercise capacity in patients with IHD.

Methods:

The study involved a cross-sectional analysis of 91 consecutive patients (57 ± 10 yr, 90% men) who underwent a cardiopulmonary exercise test at the beginning of an exercise-based standard phase-II cardiac rehabilitation program, 2 to 3 mo after an acute coronary syndrome. Association of T2DM with cardiopulmonary exercise test parameters was assessed using multiple linear regression analysis controlling for prespecified potential confounders.

Results:

There were 26 (29%) diabetic subjects among IHD patients included in the study. After adjustment, T2DM was an independent predictor of a reduced peak oxygen uptake (

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2peak) (P = .005), a reduced pulse O2 trajectory (P = .001), a steeper minute ventilation to carbon dioxide output (VE/

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2) slope (P = .046), and an increased dead space-to-tidal volume ratio (VD/VT) at peak exercise (P = .049). Glycated hemoglobin (HbA1c) levels were significantly associated with a reduced forced expiratory volume in the first second of expiration (FEV1) (P = .013), VE (P = .001), and VT (P = .007).

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2peak (P trend < .001),

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o
2 at anaerobic threshold (P trend < .001), and pulse O2 trajectory (P trend < .001) decreased among HbA1c tertiles.

Conclusions:

Patients with IHD and a previous diagnosis of T2DM had a reduced aerobic capacity and a ventilation- perfusion mismatch compared with nondiabetic patients. Poor glycemic control in men further deteriorates aerobic capacity probably due to ventilatory inefficiency.
Electroconvulsive Therapy in Children and Adolescents: Clinical Indications and Special Considerations
Authors: Benson Nicole M. , Seiner Stephen J.
Published: November 2019

Electroconvulsive therapy (ECT) is a well-tolerated, well-established, and efficacious treatment in adults, particularly in the setting of severe mood and psychotic disorders. In children and adolescents, however, ECT is infrequently administered and likely underutilized. Results from older studies evaluating the utility of ECT in children and adolescents were mixed, but recent studies have supported ECT treatment success in these patients, with particularly high response rates for treating depression. In this Perspectives, we discuss the current clinical indications for ECT in managing mood and psychotic disorders in children and adolescents. We then review the pretreatment evaluation and management of patients receiving ECT and examine the efficacy of ECT for those indications. We also address issues unique to children and adolescents, versus adults, that need to be considered when determining whether treatment with ECT is appropriate for a patient in this age group. Included in this context are the distinct side-effect profile in children and adolescents, ethical issues regarding informed consent, incorporating the child into the decision-making process when developmentally appropriate, and the need to take into account differing state jurisdictional processes.
Pterygium Is Related to Short Axial Length
Authors: Zhang Li Mei , Lu Yang , Gong Lan
Published: November 2019

Purpose:

To test the hypothesis that pterygium presents with both refractive and anatomical changes, especially short axial length.

Methods:

A retrospective, hospital-based cross-sectional study included 521 eyes from 521 patients who were enrolled through a community survey by Shanghai Heping Eye Hospital was conducted. Patients with primary pterygium in at least 1 eye were considered the pterygium group, and those with normal eyes were considered the nonpterygium group. The prevalence and length of pterygium, refractive characteristics including spherical power, astigmatism, corneal curvature, and anatomical parameters including axial length, anterior chamber depth, endothelial cell density, and corneal thickness were compared between groups.

Results:

Five hundred twenty-one eyes of 521 patients (214 men and 307 women) with a mean age of 70.5 ± 7.6 years were included in the study. The prevalence of hyperopia (81.6%, 65.1%, P = 0.001), axial length (23.1 ± 1.2 mm, 24.2 ± 2.4 mm, P < 0.001), anterior chamber depth (2.9 ± 0.3 cm, 3.1 ± 0.4 cm, P = 0.001), flat K value (42.94 ± 2.16 diopters, 43.73 ± 1.48 diopters, P = 0.002), Kmax (51.13 ± 7.74 diopters, 47.49 ± 5.62 diopters, P < 0.001), and spherical power (0.97 ± 2.40 diopters, −0.82 ± 4.40 diopters, P < 0.001) were statistically different between the pterygium and nonpterygium groups. Age (r = −0.21, P = 0.025), corneal astigmatism (r = −0.41, P < 0.001), flat K value (r = −0.39, P < 0.001), and endothelial cell density (r = −0.33, P = 0.001) were all negatively correlated with the length of pterygium. The prevalence of pterygium and severe pterygium over 3 mm were statistically different according to the severity of hyperopia (P < 0.001) and axial length (P < 0.001). Stratified χ2 analysis showed that axial length, rather than hyperopia, was a related factor to pterygium (odds ratio = 5.23, 95% confidence interval: 2.50–10.93).

Conclusions:

We conclude from our study that the prevalence of pterygium is related to small eye size. SDF-1/CXCR4 signaling may play a vital role in pterygium and shorter axial length. Further study focused on SDF-1/CXCR4 signaling will be needed.
Histone Deacetylase Inhibitors Enhance the Amoebicidal Effect of Low Concentration of Polyhexamethylene Biguanide by Inducing Apoptosis
Authors: Quan Fu-Shi , Lee Hae-Ahm , Kong Hyun-Hee , Moon Eun-Kyung
Published: November 2019

Purpose:

The aim of this study was to reduce the cytotoxicity and improve the amoebicidal effect of polyhexamethylene biguanide (PHMB) at low concentrations by combining it with histone deacetylase (HDAC) inhibitors.

Methods:

To reduce the cytotoxic effect on human corneal epithelial (HCE) cells, the concentration of PHMB was reduced to 0.0002%. To enhance the amoebicidal effect of PHMB, HDAC inhibitors such as suberoylanilide hydroxamic acid, MS275, or MC1568 were combined with it. Acanthamoeba and HCE cells were treated with 3 combinations to evaluate the amoebicidal and cytotoxic effects. Microscopy and fluorescence-activated cell sorting analysis were performed to investigate the apoptotic cell death of Acanthamoeba by these combinatorial treatments.

Results:

The low concentration of PHMB (0.0002%) alone demonstrated no cytopathic effects (CPEs) on HCE cells. Three combinatorial treatments using 0.0002% PHMB with 10 μM suberoylanilide hydroxamic acid, 10 μM MS275, or 10 μM MC1568 showed higher amoebicidal effects on A. castellanii trophozoites than PHMB alone. Fluorescence-activated cell sorting analysis confirmed that HDAC inhibitors increased the apoptotic cell death of Acanthamoeba. Mild CPEs were observed from HCE cells cotreated with PHMB and the HDAC inhibitors after 24 hours of exposure.

Conclusions:

Combinatorial treatments showed high amoebicidal effects on Acanthamoeba and low CPEs on HCE cells, which suggests their potential application for Acanthamoeba keratitis treatment.
Highly effective treatment response and well tolerability by all oral direct acting antivirals for chronic hepatitis C patients post organ transplantation
Authors: Wu Sih-Hsien , Loong Che-Chuan , Chu Chi-Jen , Su Chien-Wei , Lin Chung-Chi , Hsia Cheng-Yuan , Liu Chinsu , Lee Shou-Dong , Wang Yuan-Jen , Lee Fa-Yauh , Linb Niang-Cheng , Chen Cheng-Yen , Huang Yi-Hsiang , Hou Ming-Chih
Published: November 2019

Background:

Immunosuppressant-related acceleration of fibrosis has been documented in chronic hepatitis C (CHC) patients who receive organ transplantation (Tx), and sustained virological response (SVR) rates for these patients by pegylated interferon (IFN)-based therapy are generally poor and associated with unfavorable safety profiles. In addition, IFN treatment varies by patient and poses a high risk of post-renal Tx graft rejection. This study was aimed to investigate the efficacy and safety of all oral direct acting antivirals (DAAs) for CHC patients following organ Tx.

Methods:

A total of 32 organ Tx (liver: 17, kidney: 13, kidney then liver: 1, and heart: 1) patients with CHC on an oral DAA (paritaprevir/ritonavir, ombitasvir, and dasabuvir: 11, daclatasvir and asunaprevir: 4, sofosbuvir-based: 17) were enrolled in the study. DAAs regimen was based by genotype/subtype, patient characteristics, drug interaction profiles, and health insurance coverage.

Results:

Mean patient age was 61.4 ± 9.5 years, 50.0% male, and 15.6% with cirrhosis. Fourteen (43.7%) patients experienced unsuccessful IFN treatment. Genotype distribution was as follows: 1a: 6, 1b: 17, 2: 7, 3: 1, and 6: 1. Mean time between Tx and DAAs therapy was 77.3 ± 11.0 months. Baseline HCV RNA before DAAs was 6.20 ± 0.19 log10 IU/mL. After DAAs, the distribution of week 2 HCV RNA was as follows: <15 IU/mL (53.1%), 15 to 50 IU/mL (15.6%), 50 to 100 IU/mL (6.3%), and >100 IU/mL (25.0%), respectively. The rates of undetectable HCV RNA (<15 IU/mL) at week 4 and end-of-treatment were 93.8% and 100%, respectively. Subjective adverse events during therapy were generally mild, with no treatment terminations. After posttreatment follow-up, all 32 patients (100%) achieved SVR12.

Conclusion:

Highly responsive treatment and favorable tolerability were achieved by all oral DAAs in this difficult-to-treat patient population.
Cognitive Effects of a Ketogenic Diet on Neurocognitive Impairment in Adults Aging With HIV: A Pilot Study
Authors: Morrison Shannon A. , Fazeli Pariya L. , Gower Barbara , Willig Amanda L. , Younger Jarred , Sneed N. Markie , Vance David E.
Published: November 2019

We assessed a ketogenic diet (KD) intervention protocol and the cognitive effects of KD in older adults with HIV-associated neurocognitive impairment. Adults older than 50 years and living with HIV and mild-to-moderate neurocognitive impairment were randomized to either a KD or a patient-choice diet for 12 weeks followed by a 6-week washout period. A neurocognitive battery was administered at baseline, Week 12, and Week 18. Paired t tests compared groups at baseline, and multivariate analyses of covariance were used to assess between-group differences on primary outcome variables at Weeks 12 and 18. We enrolled 17 participants, and 14 completed the study. No between-group baseline differences were noted. The KD group demonstrated improved executive function and speed of processing at Week 12, which were negated after participants resumed their usual diets. Our study supports the potential efficacy of a KD for the treatment of HIV-associated neurocognitive impairment.
Cognitive Impairment Among Aging People Living With HIV on Antiretroviral Therapy: A Cross-Sectional Study in Hunan, China
Authors: Xiao Xueling , Zeng Hui , Feng Caiyun , Tan Hang , Wu Lanlan , Zhang Hui , Brecht Mary-Lynn , Wang Honghong , Koniak-Griffin Deborah
Published: November 2019

Our cross-sectional study examined the prevalence of cognitive impairment among people living with HIV (PLWH) aged 60 years or older. The sample, composed of 250 PLWH, was recruited from 2 clinics in Hunan, China. Structured questionnaires guided face-to-face interviews, including items addressing demographic characteristics, regimens of antiretroviral therapy, and cognitive status as measured by the Montreal Cognitive Assessment. Findings revealed cognitive function of this population was significantly lower than that of uninfected individuals based on historical comparisons; 87.2% (n= 218) of PLWH in our study had cognitive impairment. Global cognitive function as well as the domains of language and orientation decreased with age. Global cognitive function was associated with sex and education, but not with antiretroviral therapy regimens. These findings support an urgent need to include routine screening for cognitive function in older PLWH and the need to consider the complexity of the evaluation process.
Black Women's Approaches to Encourage Male Partners to Get Tested for HIV: Predictors of Approaches and Partner Tests
Authors: Nolte Kerry , Guthrie Barbara , Griffith John , Kim Tiffany
Published: November 2019

New HIV infection rates in Black women are 15 times higher than that of White women, and new infections in women have been primarily associated with heterosexual sex. Encouraging sex partner testing may increase HIV status awareness. Prevention campaigns have not recommended specific approaches with established efficacy for women to encourage partner testing. We examined approaches to encourage HIV testing, interpersonal contexts of relationships, and HIV testing behaviors in 18- to 29-year-old Black women (n = 158). Findings from our quantitative analysis included the following: (a) Partner type (main or nonmain), intimate risk taking, sexual coercion, condom use, and age were related to varied approaches (Active Persuasion, Decisive Collaboration, Ultimatum, and Sweet Talking); (b) the greatest predictor of male partner HIV testing was whether the female partner had been tested for HIV; and (c) Active Persuasion and Decisive Collaboration approaches were associated with partner HIV testing. These findings can inform HIV prevention campaigns.
Behavioral Changes and Associated Factors After Diffuse Axonal Injury
Authors: Sardinha Debora Souza , Vieira Rita de Cássia Almeida , Paiva Wellingson Silva , de Oliveira Daniel Vieira , de Sousa Regina Márcia Cardoso
Published: November 2019

Diffuse axonal injury (DAI) is a frequent injury after traumatic brain injury (TBI), which causes cognitive and behavioral symptoms. Behavioral changes after DAI affect the patients' quality of life, in addition to causing great damage to their family and society. This study aimed to analyze the behavioral changes of patients with DAI according to family members and to identify the associated factors. This study included patients with DAI, aged between 18 and 60 years, who presented to a referral hospital for traumatic injuries. A prospective cohort study was conducted with 2 evaluations of family members at 3, 6, and 12 months posttrauma. Behavioral changes were evaluated using a questionnaire designed to identify changes according to the perception of family members. The mixed-effects model was applied to identify significant behavioral changes, the effect of time on these changes, and the association between sociodemographic variables, DAI severity, and behavioral changes. Anxiety, dependency, depression, irritability, memory, and mood swings were significantly different (p ≤ .05) before and after trauma. An analysis of the evolution of these behaviors showed that the changes persisted with the same intensity up to 12 months posttrauma. There was an association between depression and income, age and irritability, and DAI severity and dependency. Unfavorable behavioral changes were frequent consequences of DAI, and no improvement in these changes was noted up to 12 months after the injury. Income, age, and DAI severity were related to behavioral changes.
Clinical Utility of Human Papillomavirus Genotyping in Cervical Cancer Screening: A Systematic Review
Authors: Bonde Jesper H. , Sandri Maria-Teresa , Gary Devin S. , Andrews Jeffrey C.
Published: November 2019

Objective

Thirteen human papillomavirus (HPV) genotypes are associated with the highest risk of cervical disease/cancer; however, the risk of disease progression and cancer is genotype dependent. The objective of this systematic review was to examine evidence for high-grade cervical intraepithelial neoplasia (≥CIN 3) risk discrimination using HPV genotyping.

Materials and Methods

A systematic review of English and non-English articles through MEDLINE, Cochrane, clinicaltrials.gov, and abstracts presented at relevant professional society conferences were searched from 2000 to 2019. Search terms included: cervical cancer screening, HPV genotyping, CIN, HPV persistence, humans, and colposcopy; prospective, controlled trials, observational studies, and retrospective studies of residual specimens; evidence included HPV genotyping (beyond genotypes 16/18/45) results. Data were obtained independently by authors using predefined fields. Risk of bias was evaluated with a modified Newcastle-Ottawa Scale. The Grading of Recommendations, Assessment, Development and Evaluation methodology facilitated overall quality of evidence evaluation for risk estimation. The study protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42018091093). The primary outcome was CIN 3 or worse risk both at baseline and at different follow-up periods.

Results

Of 236 identified sources, 60 full texts were retrieved and 16 articles/sources were included. Risk of bias was deemed low; the overall quality of evidence for CIN 3 or worse risk with negative for intraepithelial lesions or malignancies or low-grade squamous intraepithelial cytology was assessed as moderate; that with atypical squamous cells-undetermined significance and “all cytology” was assessed as high. Clinical and methodological heterogeneity precluded meta-analysis. Human papillomavirus genotyping discriminated risk of CIN 3 or worse to a clinically significant degree, regardless of cytology result.

Conclusions

The evidence supports a clinical utility for HPV genotyping in risk discrimination during cervical cancer screening.
The usefulness of 24-hour blood pressure monitoring for the patients with atrial fibrillation: based on the variability of blood pressure parameters
Authors: Tong Hui-Yu , Fan Wei-Guo , Su Hai
Published: November 2019

Objective

The aim of this study was to test whether ambulatory blood pressure monitoring (ABPM) in patients with atrial fibrillation is reliable as in patients with sinus rhythm.

Method

This study included 92 persistent atrial fibrillation patients (50% females; mean age 70.49 ± 11.56 years) and 92 matched sinus rhythm patients (46% females; mean age 69.23 ± 12.63 years). The participants were examined simultaneously with 24-hour ABPM and 24-hour Holter electrocardiography. The mean 24-hour (24-hour-), daytime (day-) and nighttime (night-) BP, types of BP curve, morning systolic BP (SBP) surge (MBPS), the SD of BP readings and the coefficient of variability (the SD/mean BP × 100%) were compared between atrial fibrillation and sinus rhythm patients.

Results

No differences of 24-hour-, day- and night-SBP levels were observed between two groups. Meanwhile, the 24-hour-SD, day-SD and night-SD, as well as the coefficient of variability for SBP were also similar between two groups. There was no significant difference in the number of MBPS between the two groups. On diastolic BP (DBP), the similar 24 hour and day levels, the 24-hour-SD, day-SD and night-SD as well as the coefficient of variability were also similar between two groups. But the nighttime DBP levels and the night-SD were higher in atrial fibrillation than in sinus rhythm.

Conclusion

ABPM provides data with similar SBP variability in patients with atrial fibrillation as in subject with normal cardiac rhythm. The ABPM on oscillometric method may be suitable for the atrial fibrillation patients, especially for the SBP evaluation.
Helicobacter pylori infection may increase the severity of nonalcoholic fatty liver disease via promoting liver function damage, glycometabolism, lipid metabolism, inflammatory reaction and metabolic syndrome
Authors: Chen Chen , Zhang Caiyun , Wang Xuelin , Zhang Feijuan , Zhang Ze , Ma Pengchai , Feng Shuzhi
Published: November 2019

Background and aim

Recent clinical trials have confirmed that Helicobacter pylori infection is positively associated with nonalcoholic fatty liver disease (NAFLD), although some research has shown a negative association. Therefore, to confirm whether H. pylori eradication treatment is feasible for NAFLD patients in our hospital, we aimed to establish the association between H. pylori infection and NAFLD.

Methods

We enrolled 91 patients with NAFLD diagnosed by abdominal B-mode ultrasonography between January and December 2018. H. pylori infection was confirmed by C13 urea breath test, and liver function, glycometabolism, insulin sensitivity, lipid metabolism, as well as inflammatory reaction were assessed through blood biochemical analyses.

Results

A minority of NAFLD patients had liver dysfunction, increased fasting glucose and insulin levels, a score of insulin-resistance (HOMA-Ir), lipid metabolism, slight inflammatory response, fasting hyperglycemia and hypertension. Most patients were complicated with overweight/visceral obesity and dyslipidemia. Moreover, these abnormal indicators were closely associated with the severity of NAFLD and H. pylori infection. Notably, the prevalence of H. pylori infection showed a significant difference between mild, moderate and severe NAFLD, and hepatic steatosis with coexistent NAFLD also revealed a striking difference between H. pylori-positive and H. pylori-negative patients (P < 0.01).

Conclusion

Our results suggest that H. pylori infection may be an independent risk factor in NAFLD progress.
Upper Limb Three-Dimensional Reachable Workspace Analysis Using the Kinect Sensor in Hemiplegic Stroke Patients
Authors: Lee Yong Min , Lee Seunghwan , Uhm Kyeong Eun , Kurillo Gregorij , Han Jay J. , Lee Jongmin
Published: November 2019

Objective

A reachable workspace evaluation using the Kinect sensor was previously introduced as a novel upper limb outcome measure in neuromuscular and musculoskeletal conditions. This study investigated its usefulness in hemiplegic stroke patients.

Design

Forty-one patients with hemiplegic stroke were included. Kinect-based reachable workspace analysis was performed on both paretic and nonparetic sides. Upper limb impairment was measured using the Fugl-Meyer Assessment and the Motricity Index on the paretic side. Disability was assessed using the shortened Disabilities of the Arm, Shoulder, and Hand questionnaire. Correlations between the relative surface areas, impairment scores, and disability were analyzed.

Results

Quadrants 1, 3, and 4 as well as the total relative surface area of the paretic side were significantly reduced compared with the nonparetic side. The total relative surface area of the paretic side correlated with the Fugl-Meyer Assessment scores, the Motricity Index for Upper Extremity, and the Disabilities of the Arm, Shoulder, and Hand questionnaire score. Furthermore, quadrant 3 was the most important determinant of upper limb impairment and disability.

Conclusions

A reachable workspace (a sensor-based measure that can be obtained relatively quickly and unobtrusively) could be a useful and alternative outcome measure for upper limb in hemiplegic stroke patients.
Lifetime alcohol use among persons living with HIV is associated with frailty
Authors: Maffei Vincent J. , Ferguson Tekeda F. , Brashear Meghan M. , Mercante Donald E. , Theall Katherine P. , Siggins Robert W. , Taylor Christopher M. , Molina Patricia , Welsh David A.
Published: November 2019

Background:

The average lifespan of persons living with HIV (PLWH) on antiretroviral therapy approximates the general population. However, PLWH are susceptible to early aging and frailty. Behaviors such as alcohol consumption may contribute to frailty among PLWH.

Objective:

To determine the relationships between recent and lifetime alcohol use and frailty among PLWH.

Design:

Cross-sectional, prospective cohort study of in-care PLWH (n = 365) participating in the New Orleans Alcohol Use in HIV Study.

Methods:

Recent alcohol exposure was measured by the 30-day alcohol timeline follow-back (TLFB) assessment and by whole-blood-spot phosphatidylethanol (PEth) quantitation. Lifetime alcohol exposure (LAE) was estimated by a modified lifetime drinking history instrument. Frailty was assessed by a 58-item deficit index (DI58) and the phenotypic frailty index (PFI). The Veterans Aging Cohort Study Risk Index 2.0 was calculated.

Results:

Using generalized linear regression, LAE was positively associated with the DI58 (95% CI 0.001--0.006) and PFI severity (95% CI 0.004--0.023) after adjustment for age and other factors. Conversely, recent alcohol exposure was negatively associated with the DI58 [TLFB 95% CI: (−0.126 to −0.034), PEth: (−0.163 to −0.058)] and PFI severity [TLFB 95% CI (−0.404 to −0.015), PEth (−0.406 to 0.034)]. The VACS was not associated with alcohol use. Median per-decade alcohol exposure peaked in the second decade and tapered with aging thereafter. Increasing LAE and decreasing TLFB were co-associated with a specific subset of health deficits.

Conclusion:

Lifetime alcohol use is positively associated with frailty among PLWH. Specific health deficits may discourage alcohol consumption in some PLWH.
Left Ventricular Function, Epicardial Adipose Tissue, and Carotid Intima-Media Thickness in Children and Adolescents With Vertical HIV Infection
Authors: Marsico Fabio , Lo Vecchio Andrea , Paolillo Stefania , D'Andrea Claudia , De Lucia Vittoria , Bruzzese Eugenia , Vallone Gianfranco , Dellegrottaglie Santo , Marciano Caterina , Trimarco Bruno , Guarino Alfredo , Perrone Filardi Pasquale
Published: November 2019

Background:

Life expectancy of HIV patients has increased considerably as a result of antiretroviral therapy (ART), and cardiovascular (CV) disease has emerged as an important late concern. People with HIV infection could have an impaired systolic function; however data on diastolic function and markers of CV risk, such as epicardial adipose tissue (EAT) and intima-media thickness (IMT), are lacking. Aim of this study is to evaluate left ventricular function, EAT, and IMT in children and adolescents with vertically acquired HIV infection.

Methods:

We enrolled 29 subjects on ART (13, 45% men; median age of 13.0, and interquartile range 9–18), and 29 age-matched controls. All patients and controls underwent echocardiographic evaluation, with study of the systolic and diastolic function and measurement of the EAT, and a carotid ultrasound study for IMT measurement.

Results:

Comparing HIV-infected patients to healthy controls, we found a statistically significant increase of EAT and IMT (mean ± SD) (EAT: 3.16 ± 1.05 vs 1.24 ± 0.61 mm; P < 0.0001. IMT: 0.77 ± 0.15 vs 0.51 ± 0.11 mm; P < 0.0001), and a significant reduction of ejection fraction, evaluated with the biplane Simpson method (mean ± SD) (58.5% ± 6.66% vs 66% ± 4.24%; P = 0.029). These results are not related with age, gender, degree of lipodystrophy, dyslipidemia, hyperinsulinism, and ART duration or the use of single antiretroviral classes.

Conclusions:

Vertically infected HIV children and adolescents show an increased thickness of EAT and IMT, expression of potentially increased CV risk. They also show an impaired systolic function.
The Mediating Role of Partner Selection in the Association Between Transactional Sex and HIV Incidence Among Young Women
Authors: Ranganathan Meghna , Kilburn Kelly , Stoner Marie C.D. , Hughes James P. , MacPhail Catherine , Gomez-Olive Francesc Xavier , Wagner Ryan G. , Kahn Kathleen , Agyei Yaw , Pettifor Audrey
Published: November 2019

Objective:

In sub-Saharan Africa, transactional sex is associated with an increased risk of HIV infection in adolescent girls and young women, but the mechanisms for this relationship remain unclear. We hypothesize that young women who report transactional sex may have multiple partners and older partners, thereby increasing their HIV risk.

Setting:

We used longitudinal data from the HPTN 068 trial in rural South Africa where young women aged 13–20 who were HIV-negative at enrolment (n = 2362) were followed approximately annually for up to 6 years.

Methods:

We used the parametric g-formula to estimate the total effect of time-varying, frequent transactional sex (receipt of gifts/money at least weekly versus monthly or less) on HIV incidence and the controlled direct effect for mediation in a simulated cohort using 20,000 bootstrapped observations. We calculated rates and hazard ratios (HRs) over the entire study period.

Results:

The HR for the total effect of frequent transactional sex on HIV incidence was 1.56 (95% confidence interval: 1.28 to 1.85). However, this effect was mediated by partner age (>5+) and number of partners (>1) and the HR was attenuated to 1.09 (95% confidence interval: 0.90 to 1.28) when setting both partner age and partner number constant.

Conclusion:

Both partner age difference and partner number mediate the relationship between transactional sex and incident HIV infection. Through this mediation analysis, we provide important longitudinal evidence to suggest that young women who engage in frequent transactional sex select multiple partners, often older male partners that may be part of higher risk sexual networks.
Postmastectomy Radiation Therapy on Permanent Implants or Tissue Expanders
Authors: Lin Alex M. , Christensen Joani M. , Liao Eric C. , Cetrulo Curtis L. , Smith Barbara L. , Austen William G. , Winograd Jonathan , Colwell Amy S.
Published: November 2019

Objectives:

This study evaluates complications and reconstructive failure rates in implant-based reconstruction with radiotherapy.

Background:

Postmastectomy radiotherapy may adversely affect breast reconstructive outcomes. However, the comparative effect of radiotherapy on direct-to-implant versus tissue expander-implant reconstruction has not been examined.

Methods:

Single institution retrospective review was performed and patients were followed 2 to 10 years.

Results:

Of 1566 patients, 265 patients received radiation (149 immediate implants and 116 tissue expanders). Demographics were similar except more smokers in the expander group (7.7% vs 1.3%; P = 0.012). Patients who received radiation with an expander in place had overall more complications (32.8% vs 11.4%; P < 0.001), skin necrosis (10.3% vs 4.0%; P = 0.043), wound breakdown (9.5% vs 2.7%; P = 0.029), and infections (16.4% vs 4.03%; P = 0.001) leading to a higher rate of explantation (16.4% vs 4.0%; P < 0.001). A radiation boost likewise predicted complications [odds ratio (OR) 2.199, 95% confidence interval (CI) 1.154–4.188, P = 0.017]. When comparing reconstructive outcomes, radiated expanders had a higher failure rate (21.6% vs 11.4%; P = 0.025). Revision for capsular contracture was similar between the 2 cohorts (11.4% vs 11.2%; P = 0.959) as were revision rates for contour asymmetry and breast asymmetry. In our multivariable logistic regression analysis, radiation to the expander had a higher risk of reconstruction failure than radiation to the permanent implant (OR 2.020, 95% CI 1.010–4.037, P = 0.047).

Conclusion:

Most patients had successful implant-based reconstructions after mastectomy and radiotherapy. Our study showed radiotherapy after direct-to-implant breast reconstruction had a lower rate of complications and reconstructive failure compared to tissue expander-implant reconstruction.
Endoscopic Management of a Complex Gastrojejunal and Pancreatic Leak Following Pancreaticoduodenectomy
Authors: Sweigert Patrick J. , Neelon Jamie , Abood Gerard , Marcotte Eric , Chand Bipan
Published: November 2019

Background:

Pancreaticoduodenectomy remains the mainstay of surgical treatment of malignant periampullary disorders. Postoperative morbidity rates are driven by postoperative pancreatic fistula. Although most can be managed conservatively or with percutaneous techniques, complex fistulas including gastroenteric leakage frequently require operative reexploration. Endoscopic therapies in this setting offer an opportunity to avoid invasive reoperation.

Case Report:

We present the case of a 67-year-old male individual who developed a complex intra-abdominal abscess after pancreaticoduodenectomy with confirmed pancreaticojejunal disruption, gastric staple line dehiscence, and enterocutaneous fistula. Five endoscopic sessions utilizing advanced techniques over a period of 60 days led to complete healing of the patient’s external fistula, resolution of complex abdominal abscess, creation of functional communication between the gastric staple line disruption and the afferent jejunum, and return of normal gastrointestinal function. Baseline functional and dietary status was restored without gastrointestinal symptoms or necessity for supplemental tube feedings.
Visual snow syndrome: a review on diagnosis, pathophysiology, and treatment
Authors: Traber Ghislaine L. , Piccirelli Marco , Michels Lars
Published: November 2019

Purpose of review

Visual snow is considered a disorder of central visual processing resulting in a perturbed perception of constant bilateral whole-visual field flickering or pixelation. When associated with additional visual symptoms, it is referred to as visual snow syndrome. Its pathophysiology remains elusive. This review highlights the visual snow literature focusing on recent clinical studies that add to our understanding of its clinical picture, pathophysiology, and treatment.

Recent findings

Clinical characterization of visual snow syndrome is evolving, including a suggested modification of diagnostic criteria. Regarding pathophysiology, two recent studies tested the hypothesis of dysfunctional visual processing and occipital cortex hyperexcitability using electrophysiology. Likewise, advanced functional imaging shows promise to allow further insights into disease mechanisms. A retrospective study now provides Class IV evidence for a possible benefit of lamotrigine in a minority of patients.

Scientific understanding of visual snow syndrome is growing. Major challenges remain the subjective nature of the disease, its overlap with migraine, and the lack of quantifiable outcome measures, which are necessary for clinical trials. In that context, refined perceptual assessment, objective electrophysiological parameters, as well as advanced functional brain imaging studies, are promising tools in the pipeline.
Flavicella sediminum sp. nov., isolated from marine sediment
Authors: Hu Zhenzhen , Wang Zengmeng , Zhang Zenghu , Li Hongmei , Zhang Yongyu , Liu Jihua , Jiao Nianzhi
Published: November 2019

A novel, Gram-stain-negative, motile, flagellated, aerobic, rod-shaped (0.5–0.7 µm wide and 1.0–1.2 µm long) and faint-yellow strain, designated ALS 84T, was isolated from marine sediment sampled at Ailian bay, Rongcheng, PR China. Growth occurred in the presence of 1–3 % (w/v) NaCl (optimum, 2 % NaCl), at pH 4.0–8.0 (pH 6.0–7.0) and at 8–30 °C (28 °C). The genome size was 4.37 Mbp. The G+C content of the genomic DNA was 33.6 mol%. The results of phylogenetic analysis based on 16S rRNA gene sequences suggested that strain ALS 84T belongs to the genus

Flavicella

within the family

Flavobacteriaceae

, and is most closely related to

Flavicella marina

(95.6 % similarity). The major fatty acids (>10 %) were iso-C15 : 0 3-OH (22.9 %), iso-C15 : 0 (14.0 %) and C16 : 0 (10.9 %). The major polar lipids were phosphatidylethanolamine and three unidentified lipids. Menaquinone-6 (MK-6) was identified as the respiratory quinone. On the basis of the phenotypic, phylogenetic and chemotaxonomic data obtained in the study, strain ALS 84T is considered to represent a novel species of the genus

Flavicella

, for which the name Flavicella sediminum sp. nov. is proposed. The type strain of the novel species is strain ALS 84T (=KCTC 62398T=MCCC 1K03480T).
Seonamhaeicola maritimus sp. nov., isolated from coastal sediment
Authors: Cao Wen-Rui , Lu De-Chen , Sun Xun-Ke , Sun Yuan-Yuan , Saren Gaowa , Yu Xin-Ke , Du Zong-Jun
Published: November 2019

A Gram-stain-negative, facultatively anaerobic, non-motile, rod-shaped and orange-pigmented bacterium, designated 1505T, was isolated from marine sediment that was obtained off the coast of Weihai, PR China. Strain 1505T was found to grow at 10–35 °C (optimum, 28 °C), at pH 6.0–9.0 (optimum, 7.5) and in the presence of 1–4 % (w/v) NaCl (optimum, 2 %). Cells were positive for oxidase and catalase activity. The 16S rRNA gene based phylogenetic analysis revealed that the nearest phylogenetic neighbours of strain 1505T were

Seonamhaeicola algicola

Gy8T (97.1 %),

Seonamhaeicola marinus

B011T (96.3 %) and

Seonamhaeicola aphaedonensis

KCTC 32578T (95.6 %). Based on phylogenomic analysis, the average nucleotide identity values between strain 1505T and

S. algicola

Gy8T,

S. marinus

B011T and

S. aphaedonensis

KCTC 32578T were 75.9, 76.0 and 77.7 %, respectively; the digital DNA–DNA hybridization values based on the draft genomes between strain 1505T and

S. algicola

Gy8T,

S. marinus

B011T and

S. aphaedonensis

KCTC 32578T were 20.0, 20.7 and 21.4 %, respectively. Menaquinone-6 (MK-6) was detected as the major respiratory quinone. The dominant cellular fatty acids were iso-C15 : 1 G and C18 : 1ω9c. The DNA G+C content of strain 1505T was 33.3 mol%. The polar lipids included phosphatidylethanolamine, six aminolipids and four unidentified lipids. Based on its phylogenetic and phenotypic characteristics, strain 1505T is considered to represent a novel species of the genus

Seonamhaeicola

, for which the name Seonamhaeicola maritimus sp. nov. is proposed. The type strain is 1505T (=KCTC 72528T=MCCC 1H00389T).
Gramella sabulilitoris sp. nov., isolated from a marine sand
Authors: Park Sooyeon , Kim In Kyu , Kim Wonyong , Yoon Jung-Hoon
Published: November 2019

A Gram-stain-negative, aerobic, non-spore-forming, motile by gliding and rod-shaped bacterial strain, designated HSMS-1T, was isolated from a marine sand collected from the Yellow Sea, Republic of Korea, and identified by a polyphasic taxonomic approach. The neighbour-joining phylogenetic tree of 16S rRNA gene sequences showed that HSMS-1T fell within the clade comprising the type strains of species of the genus

Gramella

. HSMS-1T exhibited 16S rRNA gene sequence similarity values of 99.0 and 98.7 % to the type strains of

Gramella echinicola

and

Gramella sediminilitoris

and of 93.3–98.5 % to the type strains of the other species of the genus

Gramella

. The ANI and dDDH values between HSMS-1T and the type strains of

G. echinicola

,

Gramella gaetbulicola

,

Gramella forsetii

,

Gramella salexigens

,

Gramella portivictoriae

and

Gramella flava

were 72.6–79.3 % and 17.4–22.2 %, respectively. Mean DNA–DNA relatedness value between HSMS-1T and the type strain of

G. sediminilitoris

was 18 %. HSMS-1T contained MK-6 as the predominant menaquinone and iso-C15 : 0, anteiso-C15 : 0, iso-C17 : 0 3-OH and iso-C16 : 0 as the major fatty acids. The major polar lipid of HSMS-1T was phosphatidylethanolamine. The DNA G+C content of HSMS-1T from genomic sequence data was 39.2 %. Distinguishing phenotypic properties, along with the phylogenetic and genetic distinctiveness, revealed that HSMS-1T is separated from recognized species of the genus

Gramella

. On the basis of the data presented, strain HSMS-1T is considered to represent a novel species of the genus

Gramella

, for which the name Gramella sabulilitoris sp. nov. is proposed. The type strain is HSMS-1T(=KACC 19899T=NBRC 113648T).