bluuebunny/crossref_metadata_2025_split huggingface dataset:
Speckle Tracking Echocardiography in Hypertensive Pregnancy Disorders: A Systematic Review
Authors: Moors Suzanne , van Oostrum Noortje H. M. , Rabotti Chiara , Long Xi , Westerhuis Michelle E. M. H. , Kemps Hareld M. C. , Oei S. Guid , van Laar Judith O. E. H. 
Published: August 2020

Importance
Hypertensive pregnancy disorders (HPDs) are associated with an increased risk of long-term cardiovascular disease. Speckle tracking echocardiography (STE) might be useful in the early detection of preclinical cardiac changes in women with HPDs.

Objective
The aim of this study was to study whether STE is a suitable method to detect differences in cardiac function in pregnant women with HPD compared with normotensive pregnant women or between women with a history of a pregnancy complicated by HPD compared with women with a history of an uncomplicated pregnancy.

Evidence Acquisition
The databases Medline, EMBASE, and Central were systematically searched for studies comparing cardiac function measured with STE in pregnant women with HPD or women with a history of HPD and women with a history of normotensive pregnancies.

Results
The search identified 16 studies, including 870 women with a history of HPD and 693 normotensive controls. Most studies during pregnancy (n = 12/13) found a decreased LV-GLS (left ventricular global longitudinal strain) in HPD compared with normotensive pregnant controls. LV-GRS (left ventricular global radial strain) and LV-GLCS (left ventricular global circumferential strain) are decreased in women with early-onset and severe preeclampsia. Women with a history of early-onset preeclampsia show lasting myocardial changes, with significantly decreased LV-GLS, LV-GLCS, and LV-GRS.

Conclusions and Relevance
LV-GLS is significantly decreased in pregnant women with HPD compared with normotensive pregnant women. Other deformation values show a significant decrease in women with severe or early-onset preeclampsia, with lasting myocardial changes after early-onset preeclampsia.

Target Audience
Obstetricians and gynecologists, family physicians, cardiologists.

Learning Objectives
After participating in this activity, the learner should be better able to identify the test characteristics of STE; describe the differences in STE between HPDs and normotensive pregnant controls; and explain which HPD causes lasting myocardial changes after pregnancy.
Umbilical Cord Prolapse: A Review of the Literature
Authors: Pagan Megan , Eads Lauren , Sward Lindsey , Manning Nirvana , Hunzicker Alixandra , Magann Everett F. 
Published: August 2020

Importance
Umbilical cord prolapse is a rare occurrence and is a life-threatening emergency for the fetus. These events are unpredictable and unpreventable. Umbilical cord prolapse requires swift diagnosis and management for optimal outcome.

Objective
The aim of this review is to describe the incidence, risk factor, pathophysiology, diagnosis, and management of this rare but potentially life-threatening event.

Evidence Acquisition
A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched.

Results
There were 200 articles identified, with 53 being the basis of review. Multiple risk factors for a umbilical cord prolapse have been suggested including fetal malpresentation or abnormal lie, prematurity, multifetal gestation, and polyhydramnios. The diagnosis is largely made by examination and found after rupture of membranes, and most often, examination is prompted by fetal heart rate decelerations. The management of umbilical cord prolapse is expedited delivery; however, there are rare specific scenarios in which immediate delivery is not possible and efforts should be made to relieve cord compression.

Conclusions
Rapid identification of an umbilical cord prolapse facilitates management and increases likelihood of an optimal outcome. The management is an expedited delivery with efforts to relieve cord compression until delivery can be achieved.

Relevance
Umbilical cord prolapse is a rare but a life-threatening obstetrical emergency.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completing this activity, the learner should be better able to evaluate published literature regarding umbilical cord prolapse; assess patients for potential risk factors; identify this obstetrical emergency promptly; and devise treatment and follow-up recommendations for optimal patient outcomes.
A Guide for Urogynecologic Patient Care Utilizing Telemedicine During the COVID-19 Pandemic: Review of Existing Evidence
Authors: Grimes Cara L. , Balk Ethan M. , Crisp Catrina C. , Antosh Danielle D. , Murphy Miles , Halder Gabriela E. , Jeppson Peter C. , Weber LeBrun Emily E. , Raman Sonali , Kim-Fine Shunaha , Iglesia Cheryl , Dieter Alexis A. , Yurteri-Kaplan Ladin , Adam Gaelen , Meriwether Kate V. 
Published: August 2020

(Abstracted from Int Urogynecol J 2020;31:1063–1089)
The novel coronavirus (COVID-19) pandemic has had a major impact on how patients are evaluated and treated for diseases and conditions in normal patient care. Due to lack of effective treatments for this virus or vaccines to prevent infection, focus is placed on infection prevention through use of social distancing, quarantine, and face masks.
Critical Elements of Community Engagement to Address Disparities and Related Social Determinants of Health: The Centers of Disease Control and Prevention Community Approaches to Reducing Sexually Transmitted Disease Initiative
Authors: Rhodes Scott D. , Daniel-Ulloa Jason , Wright Shauntá S. , Mann-Jackson Lilli , Johnson David B. , Hayes Norman A. , Valentine Jo A. 
Published: August 2020

Background
Community Approaches to Reducing Sexually Transmitted Disease (CARS), a unique initiative of the US Centers for Disease Control and Prevention, promotes the use of community engagement to increase sexually transmitted disease (STD) prevention, screening, and treatment and to address locally prioritized STD-related social determinants of health within communities experiencing STD disparities, including youth, persons of color, and sexual and gender minorities. We sought to identify elements of community engagement as applied within CARS.

Methods and Materials
Between 2011 and 2018, we collected and analyzed archival and in-depth interview data to identify and explore community engagement across 8 CARS sites. Five to 13 interview participants (mean, 7) at each site were interviewed annually. Participants included project staff and leadership, community members, and representatives from local community organizations (e.g., health departments; lesbian, gay, bisexual, transgender, and queer–serving organizations; faith organizations; businesses; and HIV-service organizations) and universities. Data were analyzed using constant comparison, an approach to grounded theory development.

Results
Twelve critical elements of community engagement emerged, including commitment to engagement, partner flexibility, talented and trusted leadership, participation of diverse sectors, establishment of vision and mission, open communication, reducing power differentials, working through conflict, identifying and leveraging resources, and building a shared history.

Conclusions
This study expands the community engagement literature within STD prevention, screening, and treatment by elucidating some of the critical elements of the approach and provides guidance for practitioners, researchers, and their partners as they develop, implement, and evaluate strategies to reduce STD disparities.
A Novel Pediatric Multisystem Inflammatory Syndrome During the COVID-19 Pandemic
Authors: Del Greco Giuseppina , Brady KeriAnne , Clark Barbara , Park Hannah 
Published: August 2020

Abstract
In late March and early April, New York City was an epicenter of the COVID-19 pandemic. Citizens were ordered to stay at home to flatten the curve. The adult population was affected with a severe respiratory illness as well as acute kidney injury, cardiomyopathy, arrhythmia, and thromboembolism. Although children were not affected in the same manner, weeks after the peak, reports from other countries emerged about cases of pediatric patients presenting with a novel inflammatory syndrome. We present 4 patients along with their emergency department course, so providers will have a better understanding of the identification and workup of these patients. Currently, it is unclear when this inflammatory syndrome develops in respect to a COVID-19 infection. The clinical features of this syndrome seem to overlap between Kawasaki disease, toxic shock syndrome, and myocarditis. All patients presenting to our emergency department had fever, variable rash, abdominal pain, vomiting, and/or diarrhea. Patients remained persistently tachycardic and febrile despite being given proper doses of antipyretics. Severity of presentations varied among the 4 cases. All 4 patients were found to have antibodies to COVID-19. All patients required admission, but 2 required the pediatric intensive care unit for cardiac and/or respiratory support or closer monitoring. Upon follow-up on our patients, it seems that most patients are recovering with treatment, and overall, there is a low reported mortality rate.
Noninvasive detection of impaired pulmonary artery endothelial function in people living with HIV
Authors: Goerlich Erin , Mukherjee Monica , Schar Michael , Brown Todd T. , Bonanno Gabriele , Weiss Robert G. , Hays Allison G. 
Published: August 2020

Objective:
People living with HIV (PLWH) have an increased risk of pulmonary vascular disease and pulmonary hypertension. Endothelial cell dysfunction is thought to contribute, but human studies have been limited by the invasive nature of conventional measures of pulmonary artery endothelial function (PAEF). We report here a noninvasive MRI approach to measure nitric oxide mediated PAEF by quantifying changes in pulmonary artery area and blood flow during isometric handgrip exercise (IHE), an endothelial nitric oxide dependent stressor. We used this to test the hypothesis that PLWH have impaired PAEF, even before development of pulmonary hypertension.

Design:
A prospective cohort study.

Methods:
We enrolled 25 HIV-positive viral-suppressed individuals on stable antiretroviral therapy without known or suspected pulmonary hypertension and 19 matched seronegative control individuals (HIV-negative). Pulmonary artery area and blood flow changes in response to IHE were measured with noncontrast MRI. Data previously collected during nitric oxide-synthase inhibition were analysed to determine the role of nitric oxide in the pulmonary artery response to IHE.

Results:
Seronegative individuals exhibited the anticipated PA vasodilatory response to IHE, but this was completely absent in HIV-positive individuals who exhibited an impaired area change (−1.1 ± 1.2 vs. +7.7 ± 2.2%, HIV-positive vs. HIV-negative, mean ± SEM, respectively, P = 0.002) and blood flow response (0.2 ± 2.3 vs. 13.5 ± 4.8%, P = 0.005). The pulmonary artery vasodilatory effect of IHE in healthy individuals was fully blocked by nitric oxide-synthase, demonstrating this pulmonary artery response is predominantly nitric oxide mediated.

Conclusion:
Using noninvasive MRI methods to quantify PAEF, we observed significantly impaired PAEF in PLWH compared with matched HIV-negative controls. Noninvasive PAEF testing may be useful in evaluating early HIV-related pulmonary vascular disease.
Impact of the COVID-19 Pandemic on the Medical Follow-up and Psychosocial Well-Being of People Living With HIV: A Cross-Sectional Survey
Authors: Siewe Fodjo Joseph Nelson , Villela Edlaine Faria de Moura , Van Hees Stijn , dos Santos Thalia Tibério , Vanholder Pieter , Reyntiens Patrick , Van den Bergh Rafael , Colebunders Robert 
Published: August 2020

Background:
Empirical data on the consequences of the novel coronavirus disease (COVID-19) pandemic on HIV care are lacking. We surveyed people living with HIV (PLWH) in different countries to investigate whether their medical follow-up and psychosocial well-being had been compromised due to COVID-19 and associated restrictions.

Methods:
In April 2020, a cross-sectional survey among PLWH was conducted using a web-based multilingual questionnaire. The research tool assessed HIV follow-up, psychosocial well-being, COVID-19 (flu-like) symptoms and prevention measures. Consenting respondents provided answers anonymously.

Results:
Three hundred seventeen PLWH were included (mean age 43.4 ± 11.7; 71.6% men); 60.3% of participants resided in Belgium and Brazil. One hundred forty (44.2%) reported experiencing a cold with at least one flu-like symptom since January 2020. Of the 18 who reported COVID-19 test results, 4 (22.2%) were positive. Seventy-four (23.3%) respondents screened positive for major depressive disorders, whereas 72 (22.7%) had generalized anxiety disorders. Fifty-six (17.7%) respondents reported difficulties in obtaining antiretroviral medications because of COVID-19–related measures. Adaptations of HIV care during the COVID-19 outbreak included greater quantities of antiretroviral refill in 67 (21.1%), phone consultations in 25 (7.9%), and new refill sites in 12 (3.9%). Factors associated with a reduced risk of experiencing flu-like symptoms included flu vaccination during the past 12 months (P = 0.005) and adaptations of HIV care during the COVID-19 pandemic (P = 0.010).

Conclusion:
COVID-19 and associated restrictive measures seem detrimental to the well-being and follow-up of PLWH. We recommend that health systems devise innovative approaches for antiretroviral provision and psychosocial support to PLWH during such outbreaks.
Predictors of First-Time and Repeat HIV Testing Among HIV-Positive Individuals in Kenya
Authors: De Anda Sofia , Njoroge Anne , Njuguna Irene , Dunbar Matthew D. , Abuna Felix , Macharia Paul , Betz Bourke , Cherutich Peter , Bukusi David , Farquhar Carey , Katz David A. 
Published: August 2020

Background:
Despite a doubling of HIV testing coverage in Kenya over the past decade, approximately 2 in 10 people with HIV remained unaware of their infection in 2018. HIV testing is most effective in identifying people with undiagnosed HIV through frequent and strategic testing in populations at high risk. An assessment of testing frequency and predictors of first-time and repeat testing is critical for monitoring effectiveness of testing strategies.

Methods:
We conducted a cross-sectional analysis of adults aged ≥18 years who tested HIV-positive at 4 HIV testing and counseling clinics in Kenya from February 2015 to February 2016. We categorized individuals based on testing history, used Wilcoxon rank-sum tests to assess differences in intervals between the most recent and current HIV test, and used log-binomial regression to determine characteristics associated with first-time and repeat testing.

Results:
Among 1136 people testing HIV-positive, 336 (30%) had never tested before and 800 (70%) had, of whom 208 (26%) had previously tested positive. Among previously negative repeat testers, the median intertest interval was 414 days in key/priority populations (interquartile range = 179–1072) vs. 538 in the general population (interquartile range = 228–1299) (P = 0.09). Compared with previously negative repeat testers, being a first-time tester was associated with being age ≥40 years [vs. 18–24; adjusted risk ratio = 1.67, 95% confidence interval (CI): 1.23 to 2.26], men (vs. women; adjusted risk ratio = 1.45, 95% CI: 1.21 to 1.71), and testing through provider-initiated testing and counseling (vs. client initiated; 1.19, 95% CI: 1.00 to 1.40).

Conclusions:
There is a need to increase HIV testing among older individuals and men, increase testing frequency in key/priority populations, and maintain provider-initiated and facility-based testing to reach first-time testers.
Brief Report: Subclinical Kidney Dysfunction in HIV-Infected Children: A Cross-Sectional Study
Authors: Bk Kruthika , Tiwari Soumya , Chhapola Viswas , Debnath Ekta , Seth Anju , Jain Anju 
Published: August 2020

Objective:
Most of the kidney dysfunction in HIV-positive children receiving antiretroviral therapy (ART) is attributed to tenofovir. There is a paucity of data on kidney dysfunction in tenofovir-naive children. The primary objective was to know the point prevalence of albuminuria and β2-microglobulinuria in HIV-infected children aged 3–18 years receiving ART. Albuminuria and β2-microglobulinuria were used as surrogates for glomerular and tubular dysfunction, respectively. The secondary objective was to determine their predictors.

Design:
Cross-sectional study-design.

Methods:
One hundred consecutive HIV-positive children (3–18 years) on ART were included. Spot urine sample was analyzed for urinary creatinine, total protein, microalbumin, and β2-microglobulin. Albuminuria was defined as albumin to creatinine ratio of >30 mg/g; proteinuria as urine dipstick ≥trace or spot urine protein to creatinine ratio (uPCR) of ≥0.2. β2-microglobulinuria was defined as β2-microglobulin levels of >350 µg/L.

Results:
There were 71 boys and 29 girls. Most of the children had WHO clinical stage I and were getting zidovudine-based regimen. Only 7 children were getting tenofovir. estimated Glomerular Filtration Rate and serum creatinine were normal in all children. Approximately half (48%) had renal dysfunction in the form of glomerular dysfunction (26%), tubular dysfunction (27%), or both (5%). Age at diagnosis was significantly associated with β2-microglobulinuria (P = 0.044). None of the selected variables were associated with albuminuria.

Conclusions:
HIV-associated glomerular and tubular dysfunction is common in children receiving ART other than tenofovir. The standard guidelines should consider including routine urinary biomarker monitoring in children on ART.
Cross-Sectional and Longitudinal Performance of Creatinine- and Cystatin C-Based Estimating Equations Relative to Exogenously Measured Glomerular Filtration Rate in HIV-Positive and HIV-Negative Persons
Authors: Lucas Gregory M. , Atta Mohamed G. , Zook Katie , Vaidya Dhananjay , Tao Xueting , Maier Paula , Schwartz George J. 
Published: August 2020

Background:
Reliable estimates of glomerular filtration rate (GFR) are important in the clinical management of HIV-positive patients. Data on the performance of widely used estimating equations (eGFR) relative to exogenously measured GFR are sparse in this population.

Methods:
We evaluated cross-sectional and longitudinal accuracy and bias of eGFR, based on creatinine and cystatin C, relative to disappearance of infused iohexol from plasma (iGFR) in a cohort of participants followed annually for up to 7 years.

Results:
A total of 222 HIV-positive and 139 HIV-negative participants contributed 1240 visits with valid iGFR and eGFR measures. Estimated GFR based on both creatinine and cystatin C performed the best. Estimated GFR based on creatinine alone overestimated iGFR by 9 mL·min·1.73 m−2 on average and was significantly less accurate in HIV-positive than HIV-negative individuals. The performance of equations based on either creatinine alone or cystatin C alone were significantly affected by participant factors (eg, non-suppressed HIV RNA, nadir CD4 count, hepatitis C virus coinfection). The average iGFR slope was −4% per year in HIV-positive participants. In both HIV-positive and HIV-negative participants, eGFR slope measures were generally unbiased but inaccurate, with only 60%–74% of observations falling within ±5% points of iGFR slope.

Conclusions:
Both creatinine and cystatin C have limitations as GFR indices in HIV-positive individuals. Estimated GFR based on both creatinine and cystatin C performed best in our study and may be preferred in HIV-positive persons with kidney disease or comorbidities that place them at high risk for kidney disease.
Pre-exposure Prophylaxis Uptake Among Men Who Have Sex With Men Who Used nPEP: A Longitudinal Analysis of Attendees at a Large Sexual Health Clinic in Montréal (Canada)
Authors: Xia Yiqing , Greenwald Zoë R. , Milwid Rachael M. , Trottier Claire , Boissonnault Michel , Gaul Neil , Charest Louise , Landry Gabrielle , N. Zahedi Navid , Szabo Jason , Thomas Réjean , Maheu-Giroux Mathieu 
Published: August 2020

Background:
Reducing HIV transmission using pre-exposure prophylaxis (PrEP) requires focussing on individuals at high acquisition risk, such as men who have sex with men with a history of nonoccupational post-exposure prophylaxis (nPEP). This study aims to characterize longitudinal trends in PrEP uptake and its determinants among nPEP users in Montréal.

Methods:
Eligible attendees at Clinique médicale l'Actuel were recruited prospectively starting in October 2000 (nPEP) and January 2013 (PrEP). Linking these cohorts, we characterized the nPEP-to-PrEP cascade, examined the determinants of PrEP uptake after nPEP consultation using a Cox proportional-hazard model, and assessed whether PrEP persistence differed by nPEP history using Kaplan–Meier curves.

Results:
As of August 2019, 31% of 2682 nPEP cohort participants had 2 or more nPEP consultations. Subsequent PrEP consultations occurred among 36% of nPEP users, of which 17% sought nPEP again afterward. Among 2718 PrEP cohort participants, 46% reported previous nPEP use. Among nPEP users, those aged 25–49 years [hazard ratio (HR) = 1.3, 95% confidence interval (CI): 1.1 to 1.7], with more nPEP episodes (HR = 1.4, 95% CI: 1.3 to 1.5), who reported chemsex (HR = 1.3, 95% CI: 1.1 to 1.7), with a sexually transmitted infection history (HR = 1.5; 95% CI: 1.3 to 1.7), and who returned for their first nPEP follow-up visit (HR = 3.4, 95% CI: 2.7 to 4.2) had higher rates of PrEP linkage. There was no difference in PrEP persistence between nPEP-to-PrEP and PrEP only participants.

Conclusion:
Over one-third of nPEP users were subsequently prescribed PrEP. However, the large proportion of men who repeatedly use nPEP calls for more efficient PrEP-linkage services and, among those who use PrEP, improved persistence should be encouraged.
Validation of the Bayley Infant Neurodevelopmental Screener Among HIV-Exposed Infants in Rural South Africa
Authors: Rodriguez Violeta J. , Zegarac Miriam , La Barrie Dominique L. , Parrish Manasi Soni , Matseke Gladys , Peltzer Karl , Jones Deborah L. 
Published: August 2020

Introduction:
Screening for developmental delays during critical periods of infant development is essential for early detection and intervention. Among high-risk infants in resource-limited settings, including those who are HIV exposed, there is a greater need for screening. This study expanded on previous analyses of the Bayley Infant Neurodevelopmental Screener (BINS) by providing psychometric properties to evaluate the appropriateness of using the BINS in a sample of HIV-exposed infants in rural South Africa.

Method:
A total of 160 mothers with HIV, their infants, and their male partners were recruited. The BINS was administered to the infants, and their weights were recorded. Mothers completed measures of depression, intimate partner violence, male involvement, and adherence. Male partners reported their own involvement in perinatal care.

Results:
Results demonstrated support for a 5-factor structure consistent with previous transcultural adaptations of the BINS, demonstrating construct validity, and adequate reliability. Convergent validity was partially supported, as shown by associations with intimate partner violence and male involvement as reported by men and women and maternal adherence, although not with birth weight or maternal depression. The BINS showed adequate discriminating power, with only a few low-performing items.

Conclusion:
In rural South Africa, a resource-limited setting, the BINS seems to be an adequate screening tool for developmental delays in children that may be used to identify those in need of intervention. Considering the high prevalence of delays identified in this study, antiretroviral therapy–exposed and HIV-exposed infants may benefit from further assessment to determine a need for intervention in community-based clinics.