bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coping and Its Relation to PTSD in Greek Firefighters
Authors: Theleritis Christos , Psarros Constantin , Mantonakis Leonidas , Roukas Dimitris , Papaioannou Angeliki , Paparrigopoulos Thomas , Bergiannaki Joanna Despoina 
Published: January 2020

Abstract
Firefighters are exposed continuously to intense stress situations and traumatic incidents, and are at high risk of developing posttraumatic stress disorder (PTSD). Coping mechanisms and behaviors have been examined as factors contributing to PTSD. The strategies that may be used to cope with stress and/or trauma differ between individuals and also between different professions and traumatic events (Nydegger et al., 2011). Although there is a vast literature on stress and coping processes that exists, very few studies investigated the way individual firefighters cope with trauma. Among several questionnaires that have been used to examine the effects of different types of coping mechanisms after traumatic incidents is the Albert Einstein College of Medicine–Coping Style Questionnaire (AECOM-CSQ; Plutchik and Conte, 1989). In August 2007, large areas in the Peloponnese, Greece, were devastated by wildfires. One month after the event, experienced researchers visited the affected area to provide psychological support and to investigate the psychosocial consequences among the local professional firefighters. One hundred two firefighters that were on duty for the entire period of firefighting (several days) were interviewed using several questionnaires, among them the AECOM-CSQ. Our hypothesis was that firefighters who presented with PTSD would be more inclined toward engaging in avoidance coping mechanisms. A total of 18.6% of the firefighters were found to have PTSD according to ICD-10 criteria. Logistic regression showed that firefighters using the coping mechanisms of minimization and blame were associated with the greater likelihood of PTSD. It seems that specific coping mechanisms used by firefighters immediately after the traumatic event might contribute to the development of PTSD.
Implementation of Targeted Point of Care HIV Testing in a Pediatric Emergency Department
Authors: Bhatt Seema R. , Eckerle Michelle D. , Reed Jennifer L. , Robinson Venita , Brown Angela , Lippe Joyce , Holland Carolyn , Iyer Srikant 
Published: January 2020

Introduction:
HIV infection rates are increasing among adolescents. Despite guidelines recommending annual HIV screening among sexually active adolescents, 3.6% of adolescents tested for other sexually transmitted infections (STI) in a pediatric emergency department (PED) were screened for HIV. The aim was to increase HIV screening to 90%.

Methods:
Interventions were designed to address 4 key drivers thought to be critical in reliably offering HIV testing. The primary outcome measure was the proportion of adolescents offered HIV testing among those being tested for common STIs. Statistical process control charts were used to measure performance over time and differentiate common versus special cause variation.

Results:
We instituted point of care (POC) HIV testing in the PED in January 2012. The proportion of STI tested patients offered HIV testing was increased to >87% and sustained this performance. Implementation of a clinical decision support tool had the highest impact. The majority offered testing agreed, and the most common reason for refusal was a recent negative test. We identified eleven HIV positive patients over 5 years. Eight were newly diagnosed, and 3 had prior positive tests but were not connected to care. All 11 were successfully connected to providers with HIV care expertise.

Conclusions:
POC HIV testing is feasible, acceptable, and sustainable in a PED setting. The implementation of targeted HIV POC testing in the PED increased the number of HIV tests being offered, the number of high-risk patients being screened, and the number diagnosed and connected to care.
Effects of Eradication of HCV on Cardiovascular Risk and Preclinical Atherosclerosis in HIV/HCV-Coinfected Patients
Authors: Carrero Ana , Berenguer Juan , Hontañón Víctor , Navarro Jordi , Hernández-Quero José , Galindo María J. , Quereda Carmen , Santos Ignacio , Téllez María J. , Ortega Enrique , Sanz José , Medrano Luz M. , Pérez-Latorre Leire , Bellón José M. , Resino Salvador , Bermejo Javier , González-García Juan ,   GeSIDA 3603b Study Group
Published: January 2020

Background:To assess the effects of eradication of hepatitis C virus (HCV) on cardiovascular risk (CVR) and preclinical atherosclerosis in HIV/HCV-coinfected patients.Setting:Prospective cohort study.Methods:We assessed serum lipids, 10-year Framingham CVR scores, pulse wave velocity, carotid intima–media thickness, and biomarkers of inflammation and endothelial dysfunction (BMKs) at baseline and 96 weeks (wk) after initiation of anti-HCV therapy (Rx) in HIV/HCV-coinfected patients.Results:A total of 237 patients were included. Anti-HCV therapy comprised pegylated interferon and ribavirin plus 1 direct-acting antiviral in 55.2%, pegylated interferon and ribavirin in 33.8%, and all-oral direct-acting antiviral in 11.0%. A total of 147 (62.0%) patients achieved sustained viral response (SVR). Median increases in low-density lipoprotein cholesterol in patients with and without SVR were 14 mg/dL and 0 mg/dL (P= 0.024), respectively. Increases in CVR categories were found in 26.9% of patients with SVR (P= 0.005 vs. baseline) and 8.1% of patients without SVR (P= 0.433). This resulted in a significant interaction between SVR and CVR over time (P< 0.001). No significant effect of SVR was observed for pulse wave velocity (P= 0.446), carotid intima–media thickness (P= 0.320), and BMKs of inflammation and endothelial dysfunction.Conclusions:In coinfected patients, eradication of HCV had no effect on markers of preclinical atherosclerosis and BMKs of inflammation and endothelial dysfunction but was associated with a clinically relevant rise in serum low-density lipoprotein cholesterol. Evaluation of CVR should be an integral part of care after the cure of chronic hepatitis C in patients with HIV.
Impaired Cognition Predicts Falls Among Women With and Without HIV Infection
Authors: Sharma Anjali , Vance David E. , Hoover Donald R. , Shi Qiuhu , Yin Michael T. , Holman Susan , Plankey Michael W. , Tien Phyllis C. , Weber Kathleen M. , Floris-Moore Michelle , Bolivar Hector H. , Golub Elizabeth T. , McDonnell Holstad Marcia , Rubin Leah H. 
Published: January 2020

Objective:
To determine whether domain-specific neurocognitive (NC) impairments predict falls in HIV+ compared with HIV− women.

Design:
Cross-sectional data analysis from 825 HIV+ and 392 HIV− women in the Women's Interagency HIV Study with NC testing within 2 years before falls surveys.

Methods:
NC impairment (T score <40) was assessed in 7 domains: executive function, psychomotor speed, attention, learning, memory, fluency, and fine motor function. For domains associated with any fall within 6 months in simple logistic regression (P < 0.05), hierarchical regression models evaluated associations between NC impairment and odds of falling, adjusting for: (1) study site and HIV, (2) demographics, (3) comorbid conditions, (4) substance use/central nervous system active medications, and HIV-specific factors.

Results:
Median age was higher in HIV+ than HIV− women (51 vs. 48 yrs); prevalence of falls was similar (19% HIV+, 16% HIV−). Overall, executive function [OR (odds ratio) = 1.82, 95% CI (confidence interval): 1.21 to 2.74; P = 0.004], psychomotor speed (OR = 1.59, 95% CI: 1.05 to 2.42, P = 0.03), and fine motor (OR 1.70, 95% CI: 1.11 to 2.61, P = 0.02) impairments were associated with greater odds of falls in fully adjusted models. In fully adjusted models, associations of executive function, psychomotor speed, and fine motor were nonsignificant among HIV+ women; conversely, among HIV− women, associations with impaired executive and fine motor functions were strengthened and remained significant.

Conclusions:
Cognitive impairment was associated with falls among middle-aged HIV− but not HIV+ women. Additional studies should elucidate mechanisms by which domain-specific NC impairment impacts fall risk among older HIV+ and HIV− women and how different factors modify relationships between cognition and falls.
Time to Viral Suppression in Perinatally HIV-Infected Infants Depends on the Viral Load and CD4 T-Cell Percentage at the Start of Treatment
Authors: Schröter Juliane , Anelone Anet J.N. , Yates Andrew J. , de Boer Rob J. ,   on behalf of the EPIICAL Consortium
Published: January 2020

Background:
Interventions aiming for an HIV cure would benefit from rapid elimination of virus after the onset of antiretroviral therapy (ART), by keeping the latent HIV reservoir small.

Setting:
We investigated HIV suppression in 312 perinatally infected infants starting ART within 6 months after birth from the EPPICC (European Pregnancy and Paediatric HIV Cohort Collaboration).

Methods:
To better understand kinetic differences in HIV suppression among infants, we investigated their individual viral load (VL) decay dynamics. We identified VL decay patterns and determined times to viral suppression (TTS). For infants with strictly declining VLs (n = 188), we used parameter fitting methods to estimate baseline VLs, decay rates, and TTS. We subsequently identified the parameters determining TTS by linear modeling.

Results:
The majority of infants suppress HIV VL after the onset of ART. Some children experienced a long TTS due to an “erratic” VL decay pattern. We cannot exclude that this is partly due to treatment complications and subsequent treatment changes, but these children were characterized by significantly lower CD4 percentages (CD4%) at start of treatment compared with those with a “clean” VL decline. Focusing on this “clean” subset, the TTS could be predicted by mathematical modeling, and we identified baseline VL and CD4% as the major factors determining the TTS.

Conclusions:
As VL steeply increases and CD4% constantly decreases in untreated HIV-infected infants, the progression of an HIV infection is largely determined by these 2 factors. To prevent a further disease progression, treatment should be initiated early after contracting HIV, which consequently shortens TTS.
Brief Report: Interferon-γ–Inducible Protein 10—A Potential Marker for Targeted Viral Load Monitoring of Antiretroviral Treatment?
Authors: Reepalu Anton , Arimide Dawit A. , Balcha Taye Tolera , Björkman Per , Medstrand Patrik 
Published: January 2020

Background:
The use of surrogate markers for targeting viral load (VL) testing could be an alternative to universal VL testing during antiretroviral treatment (ART) and would allow for more effective resource allocation. We investigated the correlation between levels of HIV RNA and interferon-γ–inducible protein 10 (IP-10) in Ethiopian adults at 12 months after ART initiation. In addition, we specifically investigated differences in IP-10 levels between patients with and without virological suppression.

Setting:
Cohort of HIV-positive adults receiving ART at Ethiopian health centers.

Methods:
Using a nested case–control design, individuals without virological suppression (HIV RNA ≥ 150 copies/mL) at 12 months after ART initiation were gender-matched with virologically suppressed controls (1:2 ratio). IP-10 levels were correlated with HIV RNA, and the distribution of IP-10 was compared for 3 VL strata: <150 copies/mL (VL < 150), 150–999 copies/mL (VL150-999), and ≥1000 copies/mL (VL ≥ 1000).

Results:
At 12 months after ART initiation, the following VL distribution was found among 192 individuals (50% women): VL < 150, 122/192 (63.5%); VL150-999, 23/192 (12.0%); and VL ≥ 1000 47/192 (24.5%). IP-10 and HIV RNA levels were positively correlated (r = 0.481; P < 0.0001). Median IP-10 levels for the VL strata were VL < 150: 159 pg/mL [interquartile range (IQR) 121–246], VL150-999: 174 pg/mL (IQR 131–276), and VL ≥ 1000: 343 pg/mL (IQR 190–529), respectively. These differences were statistically significant for VL ≥ 1000 versus VL < 150 (adjusted P < 0.001) and VL150-999 (adjusted P = 0.004), respectively.

Conclusions:
IP-10 and HIV RNA levels during ART showed significant correlations, with significantly higher IP-10 concentration in ART recipients with VL ≥ 1000 copies/mL compared to those with suppressed or undetectable VL.
Assessment of Lung Cancer Development in Idiopathic Pulmonary Fibrosis Patients Using Quantitative High-Resolution Computed Tomography
Authors: Palmucci Stefano , Torrisi Sebastiano E. , Falsaperla Daniele , Stefano Alessandro , Torcitto Alfredo G. , Russo Giorgio , Pavone Mauro , Vancheri Ada , Mauro Letizia A. , Grassedonio Emanuele , Sambataro Gianluca , Puglisi Silvia , Piciucchi Sara , Tomassetti Sara , Poletti Venerino , Basile Antonio , Vancheri Carlo 
Published: January 2020

Purpose:
The purpose of this study was to investigate histogram-based quantitative high-resolution computed tomography (HRCT) indexes in the assessment of lung cancer (LC) development in idiopathic pulmonary fibrosis (IPF) patients.

Materials and Methods:
From IPF databases of 2 national respiratory centers, we retrospectively studied patients with and without LC development—respectively, divided into Group A (n=16) and Group B (n=33). The extent of fibrotic disease was quantified on baseline and follow-up HRCT examinations using kurtosis, skewness, percentage of high attenuation area (HAA%), and percentage of fibrotic area (FA%). These indexes were compared between the 2 groups using the Mann-Whitney U test. In the prediction of LC development, receiver operating characteristic analysis was performed to assess threshold values of HRCT indexes.

Results:
At baseline, no difference was reported among groups for kurtosis, skewness, HAA%, and FA%, with P-values of 0.0881, 0.0606, 0.0578, and 0.0606, respectively. On follow-up, significant differences were reported, with P-values of 0.0174 for kurtosis, 0.0313 for skewness, 0.0297 for HAA%, and 0.0407 for FA%.
On baseline HRCT, in the prediction of LC development, receiver operating characteristic analysis reported sensibility and specificity of 87.5% and 45.45% for kurtosis, 68.75% and 63.64% for skewness, 81.25% and 54.55% for FA%, and 75% and 60.61% for HAA%.

Conclusions:
LC development is associated with progression of fibrosis; at baseline, FA% and HAA% reported more convenient sensitivity/specificity ratios in the prediction of LC development.
Pericardial Fat Enhancement
Authors: Kallianos Kimberly G. , Lorca Maria C. , Moraes Gustavo L. , Devcic Zlatko , Lobach Iryna , Ordovas Karen G. 
Published: January 2020

Purpose:
Studies have shown a modest association between pericardial fat volume (PFV) and coronary artery disease (CAD), potentially mediated by local inflammation. We aimed to investigate the association between a new biomarker of pericardial fat inflammation, named pericardial fat enhancement (PFE), and the severity of CAD on coronary computed tomography angiography (CCTA).

Materials and Methods:
We evaluated 114 patients referred for CCTA from 2007 to 2011. PFV, presence of obstructive CAD, and the burden of CAD were determined. PFE was measured in 10 mm2 regions of interest, adjusted to aortic enhancement (aPFE). The population was divided into those with greater than median (G-PFE) versus less than median pericardial fat enhancement (L-PFE). Stratified adjusted logistic regressions were performed. A P-value <0.05 was considered significant. The study was approved by our institutional review board.

Results:
Patients were 54.3±14.8 years of age, and 57/114 (50%) were male individuals, with body mass index of 27.3±6.3. There was an independent association between CAD severity and PFV. There was a significant independent association between PFV and obstructive CAD (odds ratio=1.26, P=0.005), and PFV and burden of CAD (odds ratio=1.25, P=0.05) in those with greater PFE. However, there was no significant association between obstructive CAD and CAD burden in either adjusted model for patients with less PFE.

Conclusions:
Our results suggest that PFE influences significantly the relationship between PFV and CAD, supporting the hypothesis of local pericardial fat inflammation as a mechanism for CAD development.
Program Director Survey of Aesthetic Plastic Surgery Fellowships in the United States
Authors: Brown Ciara A. , Nahai Foad , Miotto Gabriele C. 
Published: January 2020

Background
Aesthetic surgery is a core component of plastic and reconstructive surgery. In 2014, the Accreditation Council for Graduate Medical Education established aesthetic surgery minimums for plastic surgery residents in training. Although many plastic surgery graduates successfully enter practice as an attending plastic surgeon after completion of plastic surgery training, others choose subspecialization. Aesthetic surgery fellowships offer further instruction in surgical and nonsurgical aesthetic procedures in addition to a unique opportunity for mentorship. The American Society for Aesthetic Plastic Surgery currently endorses 25 aesthetic fellowships. However, the literature regarding fellowship specifics is lacking.

Objectives
This study aimed to better define the current aesthetic surgery fellowships programs regarding operative experience, fellowship autonomy, program strengths, didactic learning, research experience/opportunities, compensation, and geographic region.

Methods
This study was performed by Emory University, Division of Plastic and Reconstructive Surgery, Atlanta, Georgia. In February 2019, an anonymous survey was sent via e-mail to all American Society for Aesthetic Plastic Surgery–endorsed aesthetic fellowship program directors. Three weeks later, a reminder e-mail was sent. No incentives were provided for survey completion.

Results
A 40% survey response rate was achieved (10/25). Aesthetic surgery fellowships are diverse in exposure, number of procedures, and training environment. In all programs, the fellow functioned as the first assistant in most cases. The percentages of face, breast, and total body procedures varied greatly among fellowships, as well as fellow involvement in critical portions of a case. Nearly all fellowships (9/10) offered a fellow's clinic. Didactic learning and research are components of all programs.

Conclusion
This study provides an overview of the current state of plastic surgery aesthetic fellowships in the United States, serving as the first of its kind.
A Systematic Review of Learning Curves in Plastic and Reconstructive Surgery Procedures
Authors: Tapking Christian , Kowalewski Karl-Friedrich , Hundeshagen Gabriel , Kneser Ulrich , Hirche Christoph 
Published: January 2020

Background
Surgical learning curves reflect the trainee's rate of progress in gaining skills and competence for new procedures. Complex interventions such as free tissue transfers, with various linked skills and competences, transferred to one procedure are likely to have steep learning curves. This work aimed to report influence of learning curves on outcomes such as success rate, operative time, and complication rates in plastic surgery procedures.

Methods
The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic database literature search (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trails) was performed. Articles were included when reporting effects of learning curves on outcomes in plastic surgery procedures.

Results
Twenty-nine articles focusing on learning curves in plastic surgery procedures were included. Studies reported on non–free flap breast reconstruction, mastectomy, and free flap reconstruction in general and for breast reconstruction and did not allow for pooling of the data because of heterogeneity. Most common outcomes for measuring improvements were success rate, operation time, and complication rate, which demonstrated improvements in almost all studies. Plateaus were reached in 45 to 100 cases for breast reconstructions and were not reported for other procedures. Only 2 studies did not find associations between surgical experience and clinical outcomes.

Conclusions
There are sparse data on learning curves in plastic surgery. Existing studies draw a heterogeneous picture, but especially free flap breast reconstructions seem to undergo learning curves with improvements in operative time, complication rates, and success rates. However, well-designed studies with clearly defined outcomes and comparison between surgeons of different levels over time should be performed.

Systematic review registration: PROSPERO: CRD42018108634
Complement Activation in Human Sepsis is Related to Sepsis-Induced Disseminated Intravascular Coagulation
Authors: Abe Tomohiro , Kubo Keisuke , Izumoto Shintaro , Shimazu Shihoko , Goan Atsushi , Tanaka Tatsuya , Koroki Takatoshi , Saito Katsutoshi , Kawana Ryo , Ochiai Hidenobu 
Published: January 2020

ABSTRACT

Introduction:
In human sepsis, little is known about the relationships between complement activation and the clinical characteristics of sepsis, including disseminated intravascular coagulation (DIC), interventions, and prognosis.

Patients and Methods:
Adult patients with sepsis admitted from November 2016 to December 2018 were included. We used the plasma levels of soluble C5b-9 (SC5b-9) as a marker of complement activation. We compared the clinical characteristics and complement components between patients with and without DIC. We also compared the clinical characteristics and each DIC parameter across quartile groups for the SC5b-9 value.

Results:
Forty-nine sepsis patients were eligible. Thirty-four patients developed DIC, and eight patients died. The median (interquartile range) SC5b-9 value was 342 (261–501) ng/mL. Compared with patients without DIC, patients with DIC showed lower C3 levels (mean, 95.7 vs. 70.4 mg/dL, P < 0.01) and higher SC5b-9 levels (median, 287 vs. 400 ng/mL, P = 0.01). Patients were stratified by SC5b-9 quartile (ng/mL: low: < 260, moderate: 260–342, high: 343–501, highest: > 501). The mean Sequential Organ Failure Assessment score varied across these groups (P = 0.02). In the high and highest groups, many more patients received vasopressors and developed DIC. In the highest group, the coagulation parameters were severe, and thrombocytopenia was prolonged. In-hospital mortality tended to be high (33%) in the highest group.

Conclusions:
The degree of complement activation is related to DIC, severity, intensive interventions, and mortality. Further studies are needed to confirm the usefulness of SC5b-9 for stratifying sepsis patients.