bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of a Short Psychoeducational Group Intervention for the Prevention of Cardiovascular Risk in Patients With Severe Mental Disorder
Authors: Torralbas-Ortega Jordi , Paños-Martínez Montserrat , Patró-Moncunill Ester , Santiago-Barragán Angel Maria , Cobo Jesus , Escayola-Maranges Ana María , Granero-Lázaro Albert , Marti-Mestre Marc 
Published: January 2020

Abstract
Psychoeducational interventions to improve healthy habits regarding cardiovascular risk (CVR) in people with a severe mental disorder showed scarce results in the literature. In this article, we showed the results of a randomized clinical trial including 80 adult outpatients (mainly psychosis spectrum) with moderate to very high CVR. A short-term psychoeducational group intervention to improve healthy habits regarding CVR was added to their as-usual individual psychoeducational schedule. With an intention-to-treat analysis, we expected improvements in the different parameters. Baseline and 1-year follow-up included CVR factors and indexes (REGICOR, SCORE, and DORICA). Basal characteristics did not show statistically significant differences between the groups. No significant improvements in any of the variables studied were observed in the intervention enriched group compared with the control individual group. Compliance with the sessions was scarce. The satisfaction with the intervention and the acquisition of knowledge were adequate. Moreover, the benefits of both interventions were weak.
Use of Chest Computed Tomography for Blunt Pediatric Chest Trauma
Authors: Holl Elizabeth M. , Marek Ashley P. , Nygaard Rachel M. , Richardson Chad J. , Hess Donavon J. 
Published: January 2020

Introduction
Given the concern for radiation-induced malignancy in children and the fact that risk of severe chest injury in children is low, the risk/benefit ratio must be considered in each child when ordering a computed tomography (CT) scan after blunt chest trauma.

Methods
The study included pediatric blunt trauma patients (age, <15 years) with chest radiograph (CR) before chest CT on admission to our adult and pediatric level I trauma center. Surgeons were asked to view the blinded images and reads and indicate if they felt CT was warranted based on CR findings, if their clinical management change based on additional findings on chest CT, and how they might change management.

Results
Of the 127 patients identified, 64.6% had no discrepancy between their initial CR and chest CT and 35.4% of the children's imaging contained a discrepancy. The majority of the pediatric and general trauma surgeons felt CT was indicated in 6 of 45 patients based on CR. In 87% of patients with a discrepancy in findings on CR and CT, the majority of surgeons agreed that their management would not change based on the additional information. In the 6 patients in which the CT was considered indicated, 4 of the 6 would have triggered a management change.

Conclusions
Our study suggests that chest CT scans frequently serve as confirmatory diagnostic tools and in the pediatric blunt chest trauma patient and can be withheld in many cases without hindering the management of an injured child.
Frequency and Predictors of HIV-Related Cognitive Impairment in East Africa: The Africa Cohort Study (AFRICOS)
Authors: Milanini Benedetta , Allen Isabel , Paul Robert , Bahemana Emmanuel , Kiweewa Francis , Nambuya Alice , Maswai Jonah , Langat Rither , Owuoth John , Martin Shayanne , Possin Katherine , Esber Allahna , Polyak Christina , Ake Julie A. , Valcour Victor ,   on behalf of the AFRICOS study Team
Published: January 2020

Background:
Medication adherence is a critical issue in achieving viral suppression targets, particularly in resource-limited countries. As HIV-related cognitive impairment (CI) impacts adherence, we examined frequency and predictors of CI in the African Cohort Study.

Setting:
Cross-sectional examination of enrollment data from President's Emergency Plan for AIDS Relief supported clinic sites.

Methods:
In a 30-minute cognitive assessment, CI was defined as -1SD on 2 tests or -2SD on one, as compared with 429 controls. We performed univariable and multivariable logistic and linear models examining clinical and demographic factors associated with CI and global neuropsychological performance (NP-6).

Results:
Two thousand four hundred seventy-two HIV+ participants from Kenya (n = 1503), Tanzania (n = 469), and Uganda (n = 500). The mean (SD) age was 39.7 (10.7) years, and 1452 (59%) were women. The majority reported completing or partially completing primary school (n = 1584, 64%). Mean (SD) current and nadir CD4 count were 463 (249) and 204 (221) cells/mm3, respectively; 1689 (68%) were on combination antiretroviral therapy. Nine hundred thirty-nine (38%) HIV+ versus 113 (26%) HIV− individuals showed CI: (P < 0.001). We found significant effects of literacy [odds ratio (OR): 0.3; 95% CI: 0.2 to 0.4; P < 0.001] and World Health Organization stage 4 (OR: 1.5; 95% CI: 1.0 to 2.q; P = 0.046) on CI. Tanzanians (OR: 3.2; 95% CI: 2.4 to 4.3; P < 0.001) and Kenyans (OR: 2.0; 95% CI: 1.6 to 2.6; P < 0.001) had higher risk of CI compared with Ugandans. Results were relatively unchanged in predictive models of NP-6, with the only difference being an additional significant effect of current CD4 cell count (coeff: 0.0; 95% CI: 0.0 to 0.0; P = 0.005).

Conclusions:
Literacy, country, World Health Organization stage, and current CD4 cell count were associated with increased risk of cognitive dysfunction. Our findings help optimize care practices in Africa, illustrating the importance of strategies for early and effective viral-immunological control.
Variations in HIV Risk by Young Women's Age and Partner Age Disparity in Rural South Africa (HPTN 068)
Authors: Topazian Hillary M. , Stoner Marie C. D. , Edwards Jessie K. , Kahn Kathleen , Gómez-Olivé Francesc Xavier , Twine Rhian , Hughes James P. , Cohen Myron S. , Pettifor Audrey 
Published: January 2020

Background:
Nearly all population-level research showing positive associations between age-disparate partnerships and HIV acquisition among adolescent girls and young women (AGYW) has classified age disparity as ≥5 or ≥10 years. We describe variations in 1-year risk of HIV infection after exposure to sexual partner(s) of continuous age disparities.

Methods:
Longitudinal data from the HPTN 068 randomized trial in South Africa were used to estimate 1-year risk of HIV infection at various age pairings. The parametric g-formula was used to estimate risk at up to 5 annual time points, stratified by maximum partner age difference, maximum partner age, and AGYW age.

Results:
AGYW reported an older partner in 86% of 5351 age pairings. The 1-year risk of HIV infection rapidly increased with maximum partner age difference among girls ages 13–14 years, from 0·01 with a same-age partner, to 0·21 with a partner 10 years older, and 0·24 with a partner 15 years older. A gradual increase occurred among AGYW ages 15–16 years, up to 0·13 with a partner 15 years older, and 0·09 among AGYW 17–18 years with partners 8–11 years older. Risk of HIV infection among AGYW ages 19–21 years remained relatively constant across maximum partner age differences.

Conclusions:
Age differences between AGYW and their sexual partners have a greater effect on HIV-risk infection in younger compared with older AGYW. Considering both the age of an AGYW and her sexual partners provides granular insight into identifying key groups for HIV transmission prevention efforts.
Brief Report: HIV-Associated Hodgkin Lymphoma Involving the Bone Marrow Identifies a Very High-Risk Subpopulation in the Era of Widescale Antiretroviral Therapy Use in Johannesburg, South Africa
Authors: Vaughan Jenifer , Perner Yvonne , McAlpine Ewen , Wiggill Tracey 
Published: January 2020

Background:
The incidence of HIV-associated Hodgkin lymphoma (HIV-HL) has not dropped in the era of widespread antiretroviral therapy (ART), and there have reportedly been shifts in the most prevalent variants encountered. In this study, factors of interest in cases of HIV-HL diagnosed before and after the widespread availability of ART in Johannesburg, South Africa, were compared.

Methods:
All cases of HIV-HL diagnosed in 2007 and 2017 were extracted from the laboratory information system, and pertinent factors compared.

Results:
The number of cases of HL increased significantly over the period assessed, but without a clear increase in the incidence of HIV-HL. As has been reported previously, the proportion of HIV-HL subclassified as the Nodular Sclerosis and Mixed Cellularity subtypes increased and decreased respectively over the period. The number of unclassifiable cases also increased significantly largely because of more frequent diagnosis in bone marrow (BM). BM involvement was highly prevalent at both timepoints (51.7% in 2007 vs 66.2% in 2017; P = 0.18), but was more frequently associated with multiple cytopenias in 2017. Despite significant ART upscaling, the median CD4 count was significantly lower in 2017 (242.5 cells/μL in 2007 vs 85.5 in 2017; P = 0.002). This particularly affected patients with BM involvement, and the median survival time was significantly shorter among BM+ patients diagnosed in 2017 as compared to those diagnosed in 2007. Notably, 40.8% of the patients with BM involvement diagnosed in 2017 died before the diagnosis was established.

Conclusion:
HIV-HL with BM involvement identifies a very high-risk subpopulation in the post-ART era.
Brief Report: Racial and Ethnic Disparities in Sustained Viral Suppression and Transmission Risk Potential Among Persons Aged 13–29 Years Living With Diagnosed HIV Infection, United States, 2016
Authors: Crepaz Nicole , Dong Xueyuan , Hess Kristen L. , Bosh Karin 
Published: January 2020

Background:
In 2016, persons aged 13–29 years represented 23.1% of the US population, yet accounted for 41.7% of HIV diagnoses. Racial/ethnic minorities are disproportionally affected by HIV. Sustaining viral suppression helps persons living with diagnosed HIV infection (PLWDH) stay healthy and reduces the risk of transmitting HIV. We examined racial/ethnic disparities in sustained viral suppression and transmission risk potential among PLWDH aged 13–29 years.

Methods:
We analyzed data from the National HIV Surveillance System reported through December 2018 from 42 jurisdictions with complete laboratory reporting. We included persons aged 13–29 years who received an HIV diagnosis by December 31, 2015, most recently resided in one of the 42 jurisdictions, and were alive at the end of 2016. Sustained viral suppression was defined as viral load <200 copies/mL for all tests in 2016. Transmission risk potential was estimated using the number of days with viral loads >1500 copies/mL.

Results:
Of the 90,812 PLWDH aged 13–29 years included in the analysis, 41.5% had sustained viral suppression in 2016. Across age, sex, and most transmission categories, blacks had the lowest prevalence of sustained viral suppression. Among the 28,154 who were in care but without sustained viral suppression, the average number of days with viral load >1500 copies/mL was 206 days (56.4% of the 12-month period).

Conclusions:
Sustained viral suppression was suboptimal and transmission risk potential was high for PLWDH aged 13–29 years. Racial/ethnic disparities were apparent, calling for strengthening tailored interventions to improve care outcomes.
Reverse-Flow Versus Perforator Propeller Lateral Arm Flap for Elbow Reconstruction
Authors: di Summa Pietro Giovanni , Sapino Gianluca , Guillier David , Dash Jeremy , Hart Andrew , Raffoul Wassim 
Published: January 2020

Background
The lateral arm flap (LAF) represents an attractive option for elbow reconstruction, due to low donor site morbidity and a consistent surgical anatomy. It has been described as reverse-flow and as perforator propeller flap (radial collateral artery perforator [RCAP]). We compared the 2 techniques in terms of immediate- and long-term outcomes, together with functional and aesthetic evaluation.

Methods
We retrospectively reviewed 15 patients, 9 males and 6 females, according to the department prospectively maintained database. Ethiology of the defects and patient comorbidities were listed together with flap and clinical data (operative time, time to healing, hospital stay, etc). Functional outcomes were measured according to Quick Disability of Arm Shoulder and Hand score at the time of the last follow-up.

Results
Seven LAF flaps were raised in a reverse-flow fashion, whereas 8 were RCAP flaps. No patients described any major elbow functional limitations, and they were generally satisfied with the aesthetic appearance. When comparing the 2 groups of reconstruction, harvest of RCAP flap resulted significantly faster and patients needed less hospitalization days (*P < 0.05). Aesthetic scores were lower where a cutaneous bridge was left intact during rotation (leading to a dogear), which was always the case in reverse-flow flap. Among complications, a partial RCAP flap necrosis occurred in a highly comorbid patient and required a skin graft coverage, whereas 4 reverse-flow flaps presented distal venous congestion which, in 1 patient, led to a secondary flap procedure.

Conclusions
In our practice, elbow reconstruction using the RCAP flap required less hospital stay and operative time. Being less prone to venous congestion, in presence of sizeable perforators, it should be preferred to the reverse-flow LAF flap.
Neurolysis of the Dorsal Nerve to the Penis to Restore Function After Trauma
Authors: Klifto Kevin M. , Dellon A. Lee 
Published: January 2020

Background
Loss of penile sensation or development of a painful penis and erectile dysfunction can occur after injury to the dorsal branch of the pudendal nerve. Although recovery of genital sensibility has been discussed frequently in transmen, this subject has been reported rarely in cismen. The purpose of this report is to review our experience with recovery of sensation in men after decompression of the dorsal branch of the pudendal nerve after trauma.

Methods
A retrospective chart review of men who have had decompression of the dorsal branch of the pudendal nerve was carried out from 2014 to 2018. Patients were included in the cohort if they had a loss of penile sensation or the development of a painful penis after trauma. Primary outcomes measured were the change in penile symptoms, including erection, ejaculation, ejaculatory pain, erogenous sensation, numbness, and penile pain.

Results
For the 7 men included in this study, the mean follow-up time was 57 weeks (range, 28–85 weeks). Bilateral surgery was done in 71% (5/7). Of the 6 patients with loss of penile sensation, complete recovery of erogenous sensibility occurred in 5 (83%) patients, with partial relief in 1 (17%) patient. Of the 3 men who had erectile dysfunction, normal erections were restored in 2 (67%) patients. Of the 2 patients unable to ejaculate, 1 (50%) patient regained ejaculatory function. Of the 4 patients with ejaculatory pain, complete relief of pain occurred in 2 (50%) patients, with partial relief in 2 (50%) patients. Of the 6 patients with penile pain in the absence of ejaculation, complete relief of pain occurred in 3 (50%) patients, with partial relief in 3 (50%) patients.

Conclusion
Neurolysis of the dorsal nerve to the penis at the inferior pubic ramus canal can be successful in relieving pain, and restoring sensation and erectile function in men who sustained an injury along the inferior pubic ramus.
Evaluation of the Impact of the Wound Treatment Associate (WTA) Education Program on Practice and Quality Patient Outcomes
Authors: Ramundo Janet , Coverstone Sara , Crumbley David R. , Geiger Donna , Jankowski Irene , Ritter Deborah , Smith Shannon , Sutton Angel 
Published: January 2020

PURPOSE:
The Wound Treatment Associate (WTA) program is an education offering of the WOCN Society. This evidence-based continuing education program prepares nurses to serve as a unit-based resource for nursing staff. The WTA program is approved by the American Nurses Credentialing Association (ANCC) for 32.25 contact hours and aimed at licensed health care personnel. This article focuses on the impact of this education program, in particular a reduction in hospital-acquired pressure injury (HAPI) in acute care and decrease in visits per episode (VPE) and supply costs in home health.

METHODS:
Surveys were sent to all course participants to date to fulfill the summative evaluation requirement for ANCC approval to determine the perception of improvement in knowledge, skills, and practice. An additional survey was developed and reviewed by members to send to WTA program course coordinators.

RESULTS:
Participants (n = 153) reported an increase in confidence in knowledge and skills about wound care and use in nursing practice. The number of respondents to the course coordinator survey was lower (n = 48). Coordinators did report a reduction in pressure injuries in acute care. Home health respondents noted a decrease in VPE and reduction in the cost of supplies. Data reported on abstracts and posters suggested positive impacts of pressure injury prevention programs in acute and home health care.

CONCLUSIONS:
Although there are limitations to the aforementioned reporting, incorporating the WTA program into pressure injury prevention programs and wound treatment programs showed a reduction in HAPIs in acute care and decreased VPE and supply costs in home health.
Pathway-specific deregulation of striatal excitatory synapses in LRRK2 mutations
Authors: Chen Chuyu , Soto Giulia , Bannon Nicholas , Kang Shuo , Kozorovitskiy Yevgenia , Parisiadou Loukia 
Published: January 2020

ABSTRACTLRRK2 is a kinase expressed in striatal spiny projection neurons (SPNs), cells which lose dopaminergic input in Parkinson’s disease (PD). R1441C and G2019S are the most common pathogenic mutations of LRRK2. How these mutations alter the structure and function of individual synapses on direct and indirect pathway SPNs is unknown and may reveal pre-clinical changes in dopamine-recipient neurons that predispose towards disease. Here, R1441C and G2019S knock-in mice enabled thorough evaluation of dendritic spines and synapses on pathway-identified SPNs. Biochemical synaptic preparations and super-resolution imaging revealed increased levels and altered organization of glutamatergic AMPA receptors in LRRK2 mutants. Relatedly, decreased frequency of excitatory post-synaptic currents accompanied changes in dendritic spine nano-architecture, and single-synapse currents, evaluated using 2-photon glutamate uncaging. Overall, LRRK2 mutations reshaped synaptic structure and function, an effect exaggerated in R1441C dSPNs. These data open the possibility of new neuroprotective therapies aimed at SPN synapse function, prior to disease onset.
Insulin signaling mediates neurodegeneration in glioma
Authors: Jarabo Patricia , de Pablo Carmen , Herranz Héctor , Martín Francisco Antonio , Casas-Tintó Sergio 
Published: January 2020

AbstractCell to cell communication facilitates tissue development and physiology. Under pathological conditions, brain tumors disrupt glia-neuron communication signals that in consequence, promote tumor expansion at the expense of surrounding healthy tissue. The glioblastoma is the most aggressive and frequent brain tumor. This type of glioma expands and infiltrates into the brain, causing neuronal degeneration and neurological decay, among other symptoms. Here we describe how the glioblastoma produce ImpL2, an antagonist of the insulin pathway, which is regulated by the microRNAmiR-8. ImpL2 targets neighboring neurons and causes mitochondrial disruption as well as synapse loss, both early symptoms of neurodegeneration. Furthermore, glioblastoma progression requires insulin pathway attenuation in neurons. Restoration of neuronal insulin activity is sufficient to rescue the synapse loss and to delay the premature death caused by glioma. Therefore, signals from GB to neuron emerge as a potential field of study to prevent neurodegeneration and to develop anti-tumoral strategies.Significance StatementGlioblastoma (GB) is the most aggressive type of brain tumour and currently there is no cure or effective treatment. Patients course with neurological decay and previous data in animal models indicate that GB cause a neurodegenerative process. We describe here a molecule named ImpL2 that is produced by GB cells and impact on neighbouring neurons. ImpL2 is an antagonist of the insulin pathway and signaling reduction in neurons causes mitochondrial defects and synapse loss. These mechanisms underlying GB-induced neurodegeneration plays a central role in the premature death caused by this tumour. Restoration of insulin signaling in neurons prevents tumour progression and rescues the lethality caused by GB inDrosophilamodels.
Iatrogenic endometriosis following apical pelvic organ prolapse surgery: a case report
Authors: Cubuk Alkan , Ozkaptan Orkunt , Neymeyer Jörg 
Published: January 2020

Abstract
Background
Iatrogenic endometriosis is the presence of endometrial glands and stroma out of the uterus following certain surgical interventions. The rate of iatrogenic endometriosis after gynecologic surgeries due to benign uterine disease is 1–2%. Laparoscopic supracervical hysterectomy is also a part of frequently used surgical treatment of apical pelvic organ prolapse, which is followed by sacrocervicopexy. However, there are no data about iatrogenic endometriosis after apical prolapse surgery in the current literature. Herein, we present a case report of a patient diagnosed with de novo endometriosis 1 year after laparoscopic supracervical hysterectomy and sacrocervicopexy.

Case presentation
A 46-year-old parous Slavic woman who underwent laparoscopic supracervical hysterectomy and sacrocervicopexy secondary to grade 3 symptomatic apical prolapse 1 year earlier was admitted to the same clinic with pelvic pain that had started 6 months following surgery. Deep vaginal palpation was painful. Transvaginal ultrasonography revealed an area with hypervascularization on the sacral promontory. She was scheduled for diagnostic laparoscopy. A 2 × 2-cm solid, wine-colored, hypervascular hemorrhagic lesion was seen on the sacral promontory. The lesion and the peritoneal layer behind it were totally excised. The patient was discharged on the first postoperative day, without any complications. Pathologic examination revealed foci of endometriosis comprising endometrial glands and stroma within the connective tissue, along with hemosiderin-laden macrophages. The symptoms of the patient resolved after the surgery, and no further adjuvant treatment was needed.

Conclusion
Although the rate of iatrogenic endometriosis is low after laparoscopic supracervical hysterectomy and sacrocervicopexy, the possibility of the occurrence of iatrogenic endometriosis should be discussed with patients who are diagnosed with apical prolapse to determine the type of surgical intervention. Iatrogenic endometriosis should be kept in mind for differential diagnosis in case of pain after laparoscopic supracervical hysterectomy and sacrocervicopexy.