bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Experiences and Support Needs of Women With Gestational Breast Cancer in Singapore
Authors: Liow Kelly Hui Fang , Ng Teresa Ruey Pyng , Choo Chih Huei , Koh Serena Siew Lin , Shorey Shefaly 
Published: November 2020

Background
Gestational breast cancer is diagnosed during pregnancy or within the first postpartum year. There is a lack of studies on the experiences of ethnically diverse Asian women with gestational breast cancer.

Objective
The aim of this study was to explore the experiences of Asian women with gestational breast cancer so necessary support can be rendered.

Methods
This qualitative descriptive study used purposive sampling to recruit 7 women with gestational breast cancer who were following up at the breast center of a tertiary women's hospital in Singapore. Semistructured, individual, face-to-face, audio-recorded interviews were used to explore the in-depth experiences of these women. Data were transcribed verbatim and analyzed using thematic analysis.

Results
Three main themes emerged from the thematic analysis: (1) being a sick woman, (2) juggling between being a mother and a patient, and (3) seeking normalcy. Women had to contend with disruptive changes from gestational breast cancer, both emotionally and physically. They were constantly distressed by their altered body images, and family support was vital to help these women cope with their treatments. Alternative support sources included healthcare professionals and the Internet.

Conclusion
Gestational breast cancer experiences varied based on the women's encounter perceptions and existing support. Their experiences may be improved through further support to mediate their coping efforts. Future quantitative and qualitative research should explore and evaluate the various aspects of the long-term disease and psychosocial effects of gestational breast cancer.

Implications for Practice
Hospitals should include support strategies in antenatal classes and postnatal workshops to lessen disruptions of the motherhood experiences.
Accuracy of self-reported HIV-testing history and awareness of HIV-positive status in four sub-Saharan African countries
Authors: Xia Yiqing , Milwid Rachael M. , Godin Arnaud , Boily Marie-Claude , Johnson Leigh F. , Marsh Kimberly , Eaton Jeffrey W. , Maheu-Giroux Mathieu 
Published: November 2020

Background:
In many countries in sub-Saharan Africa, self-reported HIV testing history and awareness of HIV-positive status from household surveys are used to estimate the percentage of people living with HIV (PLHIV) who know their HIV status. Despite widespread use, there is limited empirical information on the sensitivity of those self-reports, which can be affected by nondisclosure.

Methods:
Bayesian latent class models were used to estimate the sensitivity of self-reported HIV-testing history and awareness of HIV-positive status in four Population-based HIV Impact Assessment surveys in Eswatini, Malawi, Tanzania, and Zambia. Antiretroviral (ARV) metabolite biomarkers were used to identify persons on treatment who did not accurately report their status. For those without ARV biomarkers, we used a pooled estimate of nondisclosure among untreated persons that was 1.48 higher than those on treatment.

Results:
Among PLHIV, the model-estimated sensitivity of self-reported HIV-testing history ranged from 96% to 99% across surveys. The model-estimated sensitivity of self-reported awareness of HIV status varied from 91% to 97%. Nondisclosure was generally higher among men and those aged 15–24 years. Adjustments for imperfect sensitivity did not substantially influence estimates of PLHIV ever tested (difference <4%) but the proportion of PLHIV aware of their HIV-positive status was higher than the unadjusted proportion (difference <8%).

Conclusion:
Self-reported HIV-testing histories in four Eastern and Southern African countries are generally robust although adjustment for nondisclosure increases estimated awareness of status. These findings can contribute to further refinements in methods for monitoring progress along the HIV testing and treatment cascade.
Age-specific mortality rate ratios in adolescents and youth aged 10–24 years living with perinatally versus nonperinatally acquired HIV
Authors: Desmonde Sophie , Ciaranello Andrea L. , Malateste Karen , Musick Beverly , Patten Gabriela , Vu An Thien , Edmonds Andrew , Neilan Anne M. , Duda Stephany N. , Wools-Kaloustian Kara , Davies Mary-Ann , Leroy Valériane 
Published: November 2020

Objective:
To measure mortality incidence rates and incidence rate ratios (IRR) in adolescents and youth living with perinatally acquired HIV (YPHIV) compared with those living with nonperinatally acquired HIV (YNPHIV), by region, by sex, and during the ages of 10–14, 15–19, and 20–24 years in IeDEA.

Design and methods:
All those with a confirmed HIV diagnosis, antiretroviral therapy (ART)-naive at enrollment, and who have post-ART follow-up while aged 10–24 years between 2004 and 2016 were included. We estimated post-ART mortality incidence rates and 95% confidence intervals (95% CI) per 100 person-years for YPHIV (enrolled into care <10 years of age) and YNPHIV (enrolled ≥10 years and <25 years). We estimate mortality IRRs in a negative binomial regression model, adjusted for sex, region time-varying age, CD4+ cell count at ART initiation (<350 cells/μl, ≥350 cells/μl, unknown), and time on ART (<12 and ≥12 months).

Results:
Overall, 104 846 adolescents and youth were included: 21 340 (20%) YPHIV (50% women) and 83 506 YNPHIV (80% women). Overall mortality incidence ratios were higher among YNPHIV (incidence ratio: 2.3/100 person-years; 95% CI: 2.2–2.4) compared with YPHIV (incidence ratio: 0.7/100 person-years; 95% CI: 0.7–0.8). Among adolescents aged 10–19 years, mortality was lower among YPHIV compared with YNPHIV (all IRRs <1, ranging from 0.26, 95% CI: 0.13–0.49 in 10–14-year-old boys in the Asia-Pacific to 0.51, 95% CI: 0.30–0.87 in 15–19-year-old boys in West Africa).

Conclusion:
We report substantial amount of deaths occurring during adolescence. Mortality was significantly higher among YNPHIV compared to YPHIV. Specific interventions including HIV testing and early engagement in care are urgently needed to improve survival among YNPHIV.
Monocyte activation in persons living with HIV and tuberculosis coinfection
Authors: Huaman Moises A. , Juchnowski Steven M. , Zidar David A. , Kityo Cissy M. , Nalukwago Sophie , Nazzinda Rashidah , Fichtenbaum Carl J. , Longenecker Chris T. 
Published: November 2020

Objectives:
To characterize monocyte subsets and activation in persons living with HIV (PLWH) with tuberculosis coinfection.

Design:
Cross-sectional study within a cohort of PLWH and HIV-uninfected participants at the Joint Clinical Research Centre in Kampala, Uganda.

Methods:
Participants were at least 45 years old with at least one cardiovascular risk factor. PLWH had an HIV viral load 1000 copies/ml or less on stable antiretroviral therapy prior to cohort entry. QuantiFERON-TB testing was performed to define latent tuberculosis infection (LTBI). Prior active TB was defined by self-report and verified by medical records. Blood was stained with monocyte subset markers (CD14+, CD16), CD62p, CD69, CX3CR1, HLA-DR, and tissue factor, and examined with flow cytometry.

Results:
One hundred and twenty-five participants (83 PLWH and 42 without HIV) were included. Median CD4+ count was 582 cells/μl in PLWH. PLWH had a higher frequency of total monocytes (4.3% vs. 3.2%; P < 0.001) and inflammatory monocyte subset (15.5% vs. 11.7%; P = 0.016) compared with HIV-uninfected individuals. No differences in the frequency of monocyte subsets were observed by TB status. Among PLWH, prior active TB was associated with increased frequency of total monocytes compared with LTBI (5.1% vs. 3.7%; P = 0.013). HLA-DR density on monocytes was three-fold higher in PLWH with LTBI or prior TB compared with PLWH without LTBI (P = 0.002). In multivariate analysis, a higher monocyte HLA-DR density remained associated with LTBI or prior TB in PLWH (log-MFI; b = 1.17; P < 0.001).

Conclusion:
Our findings indicate enhanced monocyte activation in PLWH with LTBI or prior active TB, which may contribute to the pathogenesis of noncommunicable diseases in HIV.
Effects of anticholinergic medication use on brain integrity in persons living with HIV and persons without HIV
Authors: Cooley Sarah A. , Paul Robert H. , Strain Jeremy F. , Boerwinkle Anna , Kilgore Collin , Ances Beau M. 
Published: November 2020

Objective:
This study examined relationships between anticholinergic medication burden and brain integrity in people living with HIV (PLWH) and people without HIV (HIV−).

Methods:
Neuropsychological performance z-scores (learning, retention, executive function, motor/psychomotor speed, language domains, and global cognition), and neuroimaging measures (brain volumetrics and white matter fractional anisotropy) were analyzed in PLWH (n = 209) and HIV− (n = 95) grouped according to the Anticholinergic Cognitive Burden (ACB) scale (0 = no burden, 1–3 = low burden, >3 = high burden). Neuropsychological performance and neuroimaging outcomes were compared between HIV− and PLWH with high anticholinergic burden. Within a cohort of PLWH (n = 90), longitudinal change in ACB score over ∼2 years was correlated to the rate of change per month of study interval in neuropsychological performance and neuroimaging measures.

Results:
A higher number of anticholinergic medications and ACB was observed in PLWH compared with HIV− (P < 0.05). A higher ACB was associated with worse motor/psychomotor performance, smaller occipital lobe, putamen, subcortical gray matter and total gray matter volumes in HIV−; and poorer executive function, retention and global cognition, smaller brain volumes (frontal, parietal and temporal lobes, hippocampus, amygdala, cortex, subcortical gray matter and total gray matter), and reduced fractional anisotropy (posterior corpus callosum, perforant pathway) in PLWH. PLWH with high anticholinergic burden performed worse on tests of learning and executive function compared with HIV− with high anticholinergic burden. Longitudinally, PLWH who reduced their ACB over time had better neuropsychological performance and neuroimaging measures.

Conclusion:
Anticholinergic medications were associated with worse neuropsychological performance and reduced structural brain integrity, and these effects were more widespread in PLWH. Use of anticholinergic medications should be carefully monitored in older adults with deprescription considered whenever possible.
Maintenance of statin therapy among people living with HIV
Authors: Boettiger David C. , Kerr Stephen , Chattranukulchai Pairoj , Siwamogsatham Sarawut , Avihingsanon Anchalee 
Published: November 2020

Objective:
Statins play a critical role in reducing the elevated risk of atherosclerotic cardiovascular disease (ASCVD) among people living with HIV (PLHIV). However, maintaining statin therapy is difficult and may be impeded further in PLHIV due to the risk of antiretroviral therapy (ART)/statin interactions. We estimated rates of statin discontinuation and reinitiation, and the percentage of days covered by statin use among PLHIV on ART, and investigated factors associated with these outcomes.

Design:
Observational cohort study.

Methods:
Clinical data from individuals attending the HIV-NAT Centre in Bangkok, Thailand between 2001 and 2020 were analyzed using Kaplan–Meier curves, competing-risk regression, and generalized estimating equations. Discontinuation was defined as statin cessation lasting 90 days.

Results:
Data on 318 PLHIV were included. After 1, 3, and 5 years, 22.3, 50.8, and 61.1% had discontinued statin use, respectively. Among those who discontinued (n = 178), 52.0% reinitiated statin use within 5 years. Factors associated with statin discontinuation were low education level, fewer concomitant medications, and lack of ASCVD. Factors associated with statin reinitiation were older age, diabetes, and high levels of LDL cholesterol. The adjusted mean percentage of days covered by a statin was 86.7, 61.1, and 58.1% in the 6 months prior to 1, 3, and 5 years of follow-up, respectively.

Conclusion:
Maintenance of statin therapy is poor among PLHIV on ART but is not associated with using contraindicated antiretroviral/statin combinations. A better understanding of statin use in PLHIV will aid clinicians treating individuals and policy makers designing interventions for population-level ASCVD risk reduction.
Maternal HIV and child anthropometric outcomes over time: an analysis of Zimbabwe demographic health surveys
Authors: Groene Emily A. , Valeris-Chacin Robert J. , Stadelman Anna M. , Safo Sandra E. , Cusick Sarah E. 
Published: November 2020

Objective(s):
To understand the association between children's anthropometric measures and maternal HIV status in Zimbabwe and to determine whether these relationships changed over time.

Design:
Data from Demographic Health Surveys in Zimbabwe rounds 2005, 2010, and 2015 were used to conduct cross-sectional analyses of child anthropometric measures (stunting, underweight, and wasting).

Methods:
Using separate logistic regression models for each of the anthropometric measures, we estimated the adjusted prevalence odds ratio (OR) of stunting, underweight, and wasting in children according to maternal HIV status. Moreover, we evaluated an interaction by survey year to evaluate change over time.

Results:
Children of mothers with HIV had 32% greater odds [OR = 1.32, 95% confidence interval (CI) 1.16–1.5] of stunting, 27% greater odds (OR = 1.27, 95% CI 1.1–1.48) of underweight status and 7% greater odds (OR = 1.07, 95% CI 0.81–1.42) of wasting status, than children of mothers without HIV. These associations between maternal HIV status and child undernutrition did not differ by year (P > 0.05 for all interaction terms).

Conclusion:
In Zimbabwe, having a mother who tested positive for HIV at the time of the survey has been associated with greater child undernutrition over the last two decades with no significant change by survey round. This emphasizes the need for continued programming to address nutritional deficiencies, sanitation, and infectious disease prevention in this high-risk population. The greatest impact of maternal HIV status has been on child stunting and underweight, associated with poor long-term child development.
Depressive symptoms and use of HIV care and medication-assisted treatment among people with HIV who inject drugs
Authors: Zeziulin Oleksandr , Mollan Katie R. , Shook-Sa Bonnie E. , Hanscom Brett , Lancaster Kathryn E. , Dumchev Kostyantyn , Go Vivian F. , Chu Viet A. , Kiriazova Tetiana , Syarif Zulvia , Dvoryak Sergii , Reifeis Sarah A. , Hamilton Erica , Sarasvita Riza , Rose Scott , Richardson Paul , Clarke William , Latkin Carl A. , Metzger David S. , Hoffman Irving F. , Miller William C. 
Published: November 2020

Objective:
Vietnam, Indonesia, and Ukraine have major burdens of IDU and HIV. We estimated the prevalence of depressive symptoms at baseline among people living with HIV who inject drugs, evaluated associations between depression at baseline and 12-month HIV care outcomes and medication-assisted treatment (MAT), and evaluated the study intervention effect by baseline depression subgroups.

Design:
HPTN 074 was a randomized study. The study intervention included psychosocial counseling, systems navigation, and antiretroviral treatment (ART) at any CD4+ cell count.

Methods:
Moderate-to-severe depression was defined as a Patient Health Questionnaire-9 score of 10 or above. ART and MAT were self-reported. Eligibility criteria were: 18–60 years of age, active IDU, and viral load of at least 1000 copies/ml. Adjusted probability differences (aPD) were estimated using inverse-probability weighting.

Results:
A total of 502 participants enrolled from April 2015 to June 2016. Median age was 35 years; 85% identified as men. Prevalence of baseline moderate-to-severe depression was 14% in Vietnam, 14% in Indonesia, and 56% in Ukraine. No evident associations were detected between baseline depression and ART, viral suppression, or MAT at 12-month follow-up. The study intervention improved the proportions of people who inject drugs achieving 12-month viral suppression in both the depressed [intervention 44%; standard of care 24%; estimated aPD = 25% (95% confidence interval: 4.0%, 45%)] and nondepressed subgroups [intervention 38%; standard of care 24%; aPD = 13% (95% confidence interval: 2.0%, 25%)].

Conclusion:
High levels of depressive symptoms were common among people living with HIV who inject drugs in Ukraine but were less common in Vietnam and Indonesia. The study intervention was effective among participants with or without baseline depression symptoms.
Reconstruction of Lagophthalmos of Upper Eyelid With a Subcutaneous Pedicled Propeller Flap
Authors: Ding Jin-Ping , Chen Bo , Yao Jian-Min 
Published: November 2020

Abstract
An 11-year-old boy presented with lagophthalmos of the left upper eyelid after traumatic scar contracture. Chronic eyelid hypophasis could produce dryness, foreign body sensation, cornea exposure. To reconstruct the upper eyelid defects after scar release represented a significant challenge in terms of recreating functional eyelids. The authors applied the orbital subcutaneous pedicled propeller flap for one-stage reconstruction of the lagophthalmos. Four weeks after surgery, the patient had functional eyelid with no ectropion, cornea exposure or conjunctivitis and the appearance of eyelid was improved. And the final result was found to be acceptable at 6 months follow-up. The authors consider that to repair the lagophthalmos of upper eyelid, the use of orbital subcutaneous propeller flap can achieve both functional and appearance improvement, it is an effective method with flexibility and personalization.
Quantitative Assessment of the Pupil: An Underrecognized Yet Important Factor Related to Orbital Blowout Fracture Repair
Authors: Li Chenglin , Li Zhengri , Jin Hua , Deng Wenqing , Cui Hong , Jin Haiyan , Ru Xinyu , Zhao Jinghua , Jia Yujie , Lin Shuhua , Li Yingjun 
Published: November 2020

Purpose:
To investigate dynamic pupil changes after orbital blowout fracture repair. To compare postoperative changes in under photopic and mesopic pupil size and center position after orbital blowout fracture repair surgery.

Methods:
The study evaluated 19 eyes. Pupils were imaged for pupil size and center position before and 3 months after orbital blowout fracture repair surgery. Pupil size changes were measured, and the correlation between preoperative and postoperative pupil centroid shift was evaluated.

Results:
After repair, operative eyes exhibited a growth of 9.3% ± 8.6% in pupil size, and contralateral eyes showed a growth of 8.6% ± 8.2% (P = 0.011, P = 0.007). Similar findings were noted in mesopic conditions. Under mesopic conditions, the pupil of operative eyes in medial orbital wall fracture deviated 0.030 ± 0.019 mm towards the nasal side along the X-axis (P = 0.031). The postoperative orbital floor fracture group demonstrated statistical significance at a spatial frequency of 5 (P = 0.041).

Conclusions:
Orbital blowout fracture repair surgery affects pupil size and center position.
Anatomic Approximation Approach to Bilateral Macrostomia Repair
Authors: Ueno Kazuki , Miyazaki Hidetaka , Oshima Toshiyuki , Wada Yoshitaka , Asamura Shinichi 
Published: November 2020

Abstract
In principle, reconstruction in macrostomia requires symmetry and accurate positioning of the newly reconstructed commissure. The proper position of the new commissure can be determined by several methods. In the determination of the new commissure of bilateral cases, generally the average length of the lips or the distance from anatomical landmarks other than the lips, such as the pupils or tragi, has been used. A new approach was reported by Tse et al in 2018: the anatomic approximation approach. Macrostomia repair refers to anatomical landmarks in the lips to determine the new commissure. The authors performed surgery using this anatomic approximation approach for bilateral macrostomia and achieved the good results.
Neurological Functional Connectivity in Unilateral Coronal Synostosis: A Side-Based Comparison
Authors: Park Kitae E. , Singh Anusha , Lacadie Cheryl , Allam Omar , Smetona John , Alperovich Michael , Persing John A. 
Published: November 2020

Purpose:
Unicoronal synostosis (UCS) has been associated with reading, language, and social dysfunction. Limited brain function connectivity studies exist for UCS with none devoted to comparing outcomes by side of synostosis (left versus right-sided UCS).

Methods:
Twelve patients with surgically treated UCS, 7 right-sided and 5 left-sided, were age matched to healthy controls. Resting state functional MRI was acquired in a 3T Siemens TIM Trio scanner (Erlangen, Germany). Data was collected with intrinsic connectivity distribution and seed-connectivity analysis using BioImage Suite (Yale School of Medicine). Region of interest analysis was performed based on Brodmann areas related to emotional, executive, language, motor, and visuo-spatial function. Significance was set at P < 0.05.

Results:
Compared to controls, all UCS patients demonstrated decreased connectivity in areas of the parietal and temporal cortices responsible for visuo-motor coordination and language function. Right UCS patients demonstrated decreased intrinsic connectivity in regions related to complex motor movement and proprioception relative to control subjects. Left UCS patients demonstrated decreased seed connectivity between regions of the parietal lobe and occipital lobe related to motor coordination, visual function, and language compared to right UCS patients.

Conclusion:
Unicoronal synostosis had decreased functional connectivity in regions associated with memory, visual information processing, and motor function. Moreover, left-sided UCS had decreased connectivity in circuits for motor coordination and language when compared to right-sided UCS. This study provides data suggestive of long-term sequelae of UCS that varies by sidedness, which may be responsible for neurocognitive impairments found in previous cognitive analyses.
A Pilot Study of Identification Genetic Background of Craniosynostosis Cases
Authors: Atli Emine Ikbal , Yalcintepe Sinem , Atli Engin , Demir Selma , Mail Cisem , Eker Damla , Kalkan Rasime , Gurkan Hakan 
Published: November 2020

Abstract
The early fusion of the cranial sutures was described as a craniosynostosis. The early diagnosis and management of craniosynostosis is very important. Environmental factors and genetic abnormalities plays a key role during the development of craniosynostosis. Syndromic craniosynostosis cases are related with autosomal dominant disorders but nearly half of the affected cases carry a new mutation. In this study, in order to identify the genetic etiology of craniosynostosis the authors analyzed 20 craniosynostosis patients by using conventional karyotype, aCGH, sanger sequencing, next generation sequencing (NGS) and Multiplex ligation-dependent probe amplification (MLPA) techniques. The authors identified mutations on FGFR2 and FGFR3 genes which were associated with Muenke syndrome, Crouzon syndrome and skeletal dysplasia syndromes. NGS applied all of the cases and 7 clinical variations in 5 different gene were detected in %20 of cases. In addition to these abnormalities; del(11)(q14.1q22.2), del(17)(q21.31), dup(22)(q13.31) and t(2;16)(q37;p13) have been identified in our cohort which are not previously detected in craniosynostosis cases. Our study demonstrates the importance of detailed genetic analysis for the diagnosis, progression and management of the craniosynostosis.