bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monocyte activation and gut barrier dysfunction in South African youth on antiretroviral therapy and their associations with endothelial dysfunction
Authors: Dirajlal-Fargo Sahera , Yu Jiao , Albar Zainab , Sattar Abdus , Mahtab Sana , Jao Jennifer , Myer Landon , Zar Heather J. , McComsey Grace A. 
Published: July 2020

Background:
There is evidence for endothelial dysfunction in youth living with perinatally acquired HIV (YLPHIV). However, little data exist on its mechanisms.

Methods:
YLPHIV and age-matched HIV-uninfected (HIV−) youth enrolled in the Cape Town Adolescent Antiretroviral Cohort in South Africa between 9 and 14 years of age were included. YLPHIV were on antiretroviral therapy more than 6 months with viral load less than 400 copies/ml at baseline and 24 months. Serum biomarkers of systemic inflammation, monocyte activation, intestinal integrity, and oxidized LDL-cholesterol were measured at baseline and after 24 months. Endothelial function was measured at 24 months using reactive hyperemic index (RHI); endothelial dysfunction was defined as RHI less than 1.35. Spearman correlation coefficient and quantile regression were used to examine associations between RHI and different biomarkers.

Results:
We included 266 YLPHIV and 69 HIV− participants. At baseline, median (Q1, Q3) age was 12 (11, 13) years and 53% were females. YLPHIV had poorer endothelial function compared with HIV− youth (RHI = 1.36 vs. 1.52, P < 0.01). At baseline and 24 months, YLPHIV had higher markers of monocyte activation (soluble CD14), gut barrier dysfunction (intestinal fatty acid binding protein) and oxidized LDL-cholesterol (P ≤ 0.04) compared with HIV− youth. Among YLPHIV, soluble CD14 remained associated with endothelial dysfunction after adjusting for age, sex, Tanner stage, and antiretroviral therapy duration (β: −0.05, P = 0.01).

Conclusion:
Despite viral suppression, South African YLPHIV have poor endothelial function and persistent evidence of monocyte activation and gut barrier dysfunction compared with HIV− youth. The long-term clinical significance of gut integrity and monocyte activation needs to be further assessed in YLPHIV.
Tenofovir resistance in early and long-term treated patients on first-line antiretroviral therapy in eight low-income and middle-income countries
Authors: Inzaule Seth C. , Jordan Michael R. , Cournil Amandine , Girón-Callejas Amalia , Avila-Rios Santiango , Mulenga Lloyd , Ssemwanga Deogratius , Asio Juliet , Diop-Ndiaye Halimatou , Niasse-Traore Fatou , Nhan Do T. , Dat Vu Q. , Aghokeng Avelin F. , Billong Serge , Cham Fatim , Doherty Meg , Bertagnolio Silvia 
Published: July 2020

Objective:
We aimed to assess the frequency of tenofovir (TDF) resistance in people failing tenofovir/lamivudine or emtricitabine (XTC)/nonnucleotide reverse-transcriptase inhibitor-based first-line antiretroviral treatment (ART) using data from 15 nationally representative surveys of HIV drug resistance conducted between 2014 and 2018 in Cameroon, Guatemala, Honduras, Nicaragua, Senegal, Uganda, Vietnam and Zambia.

Methods:
Prevalence of nucleoside reverse-transcriptase inhibitor resistance among participants with virological nonsuppression (viral load ≥1000 copies/ml) who had received TDF-based ART for 12–24 months (early ART group) and at least 40 months (long-term ART group) was assessed using Sanger sequencing and resistance was interpreted using the Stanford HIVdb algorithm. For each group, we estimated a pooled prevalence using random effect meta-analysis.

Results:
Of 4677 participants enrolled in the surveys, 640 (13.7%) had virological nonsuppression, 431 (67.3%) were successfully genotyped and were included in the analysis; of those, 60.3% (260) were participants in the early ART group. Overall, 39.1, 57.9, 38.5 and 3.6% patients in the early ART group and 42.9, 69.3, 42.9 and 10.0% patients on long-term ART had resistance to TDF, XTC, TDF + XTC and TDF + XTC + zidovudine, respectively. Overall, tenofovir resistance was mainly due to K65R or K70E/G/N/A/S/T/Y115F mutations (79%) but also due to thymidine analogue mutations (21%) which arise from exposure to thymidine analogues but causing cross-resistance to TDF.

Conclusion:
Dual resistance to TDF + XTC occurred in more than 40% of the people with viral nonsuppression receiving tenofovir-based first-line ART, supporting WHO recommendation to optimize the nucleoside backbone in second-line treatment and cautioning against single drug substitutions in people with unsuppressed viral load.
Antiretroviral drug concentrations in brain tissue of adult decedents
Authors: Ferrara Micol , Bumpus Namandjé N. , Ma Qing , Ellis Ronald J. , Soontornniyomkij Virawudh , Fields Jerel A. , Bharti Ajay , Achim Cristian L. , Moore David J. , Letendre Scott L. 
Published: July 2020

Objective:
Determine concentrations of antiretroviral therapy (ART) drugs in the human brain.

Design:
Cohort study of persons with HIV who consented to antemortem assessment and postmortem autopsy.

Methods:
Eleven persons with HIV who were taking ART at the time of death and had detectable concentrations of at least one ART drug in intracardiac aspirate at autopsy were evaluated. Autopsies were performed within 24 h of death and brain tissue was stored at −80 °C. Concentrations of 11 ART drugs were measured in three brain regions (globus pallidus, cortical gray matter, white matter) by HPLC tandem mass spectrometry with a lower limit of quantification of 25 ng/ml.

Results:
Participants were mostly men (82%) with a mean age of 40.4 years. Drug concentrations in brain tissue were highly variable and exceeded published concentrations in cerebrospinal fluid for several drugs, including for tenofovir, efavirenz, and lopinavir. Drug concentrations correlated most strongly between cortical gray matter and globus pallidus (rho = 0.70) but less well between globus pallidus and white matter (rho = 0.43). Combining all drugs and brain regions (n = 89), higher drug concentrations in brain were associated with longer estimated duration of HIV infection (P = 0.015), lower HIV RNA in plasma (P = 0.0001), lower nadir CD4+ T-cell count (P = 0.053), and worse neurocognitive performance (P = 0.017).

Conclusion:
This is the first analysis of ART drug concentrations in human brain tissue. Concentrations of several drugs in this analysis were similar to published concentrations in cerebrospinal fluid but others exceeded published concentrations. The association between higher drug concentrations in the brain and worse neurocognitive performance may indicate ART neurotoxicity.
No HIV-1 molecular evolution on long-term antiretroviral therapy initiated during primary HIV-1 infection
Authors: Abdi Basma , Nguyen Thuy , Brouillet Sophie , Desire Nathalie , Sayon Sophie , Wirden Marc , Jary Aude , Achaz Guillaume , Assoumou Lambert , Palich Romain , Simon Anne , Tubiana Roland , Valantin Marc-Antoine , Katlama Christine , Calvez Vincent , Marcelin Anne-Geneviève , Soulie Cathia 
Published: July 2020

Objective:
Most studies about HIV-1 molecular evolution have shown the lack of viral evolution on effective antiretroviral therapy (ART), although controversial results have been documented. We therefore aimed to look for evidence of HIV-1 evolution in patients who initiated ART at the time of primary HIV-1 infection (PHI).

Design:
We included retrospectively 20 patients diagnosed at PHI, treated at the time of acute infection and with subsequent effective long-term suppressive ART (HIV viral load <20 copies/ml during at least 5 years without any blips).

Methods:
Longitudinal blood samples were deep sequenced using Illumina Miseq. Drug-resistance-associated mutations were retained at 2% cutoff and interpreted using the latest Agence Nationale de Recherches sur le Sida et les Hépatites Virales resistance algorithm. Viral evolution was established when temporal structure on maximum-likelihood phylogenetic tree and significant change over time of HIV-1 genetic diversity measured as the average pairwise distance was observed.

Results:
Emergences or disappearances of drug-resistance-associated mutations were detected in the blood cells during follow-up despite sustained virological control. In all patients, tree topologies showed an absence of segregation between sequences and blood viral populations from all time-points were intermingled. Comparison of the average pairwise distance showed the absence of significant viral diversity at the time of primary infection and afterwards during 5 years of full virological control under ART.

Conclusion:
Despite a slight variation of minority resistance-associated mutation variants, there was no clear evidence of viral evolution during a prolonged period of time in this population of highly controlled adult patients treated at time of PHI.
A High-Fidelity Hybrid Virtual Reality Simulator of Aneurysm Clipping Repair With Brain Sylvian Fissure Exploration for Vascular Neurosurgery Training
Authors: Teodoro-Vite Sergio , Pérez-Lomelí Juan S. , Domínguez-Velasco César F. , Hernández-Valencia Aldo F. , Capurso-García Marino A. , Padilla-Castañeda Miguel A. 
Published: July 2020

Introduction
Microsurgery clipping is one of the most challenging surgical interventions in neurosurgery. The opportunities to train residents are scarce, but the need for accumulating practice is mandatory. New simulating tools are needed for skill learning.

Methods
The design, implementation, and assessment of a new hybrid aneurysm clipping simulator are presented. It consists of an ergonomic workstation with a patient head mannequin and a physics-based virtual reality simulation with bimanual haptic feedback. The simulator recreates scenarios of microsurgery from the patient fixation and the exploration of the brain lobes through Sylvian fissure and vascular structures to the aneurysm clipping. Skill metrics were introduced, including monitoring of gestures movements, exerted forces, tissue displacements, and precision in clipping.

Results
Two experimental conditions were tested: (1) simple clipping without brain tissue exploration and (2) clipping the aneurysm with brain Sylvian fissure exploration. Differences in the bimanual gestures were observed between both conditions. The quantitative measurements of tissue displacement of the brain lobes exhibited more tissue retrieval for the surgical gestures of neurosurgeons. Appraisal with questionnaires showed positive scores by neurosurgeons in all items evaluating the usability and realism of the simulator.

Conclusions
The simulator was well accepted and feasible for training purposes. The analysis of the interactions with virtual tissues offers information to establish differential and common patterns between tested groups and thus useful metrics for skill evaluation of practitioners. Future work can lead to other tasks during the intervention and the inclusion of more clinical cases.
A Simulation-Based Prospective Cohort Study on Teaching Best Practices in Firearms Safety
Authors: Ketterer Andrew R. , Lewis Jason J. , Ellis Joshua C. , Hall Matthew M. , Abuhasira Ran , Ullman Edward A. , Dubosh Nicole M. 
Published: July 2020

Background
Gun violence in the United States is a significant public health concern. The high rate of weapons carriage by Americans places medical providers at risk for exposure to firearms in the workplace and provides an opportunity for patient safety counseling. Few curricular interventions have been published on teaching firearms safety principles to medical providers. Given the risk of encountering firearms in the workplace and the opportunity to engage patients in firearms safety counseling, providers may benefit from dedicated training on safely handling firearms.

Methods
This was a prospective cohort pilot study of a simulation-based educational intervention for third- and fourth-year medical students enrolled in an emergency medicine subinternship and emergency medicine bootcamp elective. Before undergoing the educational intervention, students completed a preintervention simulation case during which they discovered a model firearm in the patient's belongings and were asked to remove it. Students then received the intervention that included a discussion and demonstration on how to safely remove a firearm in the clinical setting. Two weeks later, the students were presented with a model firearm in a different simulation case, which they needed to remove. During the preintervention and postintervention simulations, students were evaluated on their performance of the critical actions in firearm removal using an 8-item checklist. Students' scores on this checklist were compared.

Results
Fifty-three students participated in the study, 25 of whom completed the postintervention assessment. The median number of correctly performed critical actions preintervention was 5 (interquartile range = 4–6) and postintervention was 7 (interquartile range = 6–8, P < 0.001). Students showed particular improvement in 4 steps: holding the firearm by the grip only, pointing the firearm in a safe direction at all times, removing the firearm from the immediate patient care area and placing it in a safe area, and ensuring that the firearm is monitored and untouched until police or security personnel arrive to secure it.

Conclusions
This educational intervention is the first to formally teach students about the safe handling of firearms found in the clinical care space. This low-cost pilot project is easily transferrable to other training centers for teaching principles of safe firearms handling.
Simulation-Based Mastery Learning of Bronchoscopy-Guided Percutaneous Dilatational Tracheostomy
Authors: Kattan Eduardo , De la Fuente Rene , Putz Francisca , Vera Magdalena , Corvetto Marcia , Inzunza Oscar , Achurra Pablo , Inzunza Martin , Munoz-Gama Jorge , Sepulveda Marcos , Galvez Victor , Pavez Nicolas , Retamal Jaime , Bravo Sebastian 
Published: July 2020

Introduction
Although simulation-based training has demonstrated improvement of procedural skills and clinical outcomes in different procedures, there are no published training protocols for bronchoscopy-guided percutaneous dilatational tracheostomy (BG-PDT). The objective of this study was to assess the acquisition of BG-PDT procedural competency with a simulation-based mastery learning training program, and skills transfer into cadaveric models.

Methods
Using a prospective interventional design, 8 trainees naive to the procedure were trained in a simulation-based mastery learning BG-PDT program. Students were assessed using a multimodal approach, including blind global rating scale (GRS) scores of video-recorded executions, total procedural time, and hand-motion tracking–derived parameters. The BG-PDT mastery was defined as proficient tracheostomy (successful procedural performance, with less than 3 puncture attempts, and no complications) with GRS scores higher than 21 points (of 25). After mastery was achieved in the simulator, residents performed 1 BG-PDT execution in a cadaveric model.

Results
Compared with baseline, in the final training session, residents presented a higher procedural proficiency (0% vs. 100%, P < 0.001), with higher GRS scores [8 (6–8) vs. 25 (24–25), P = 0.01] performed in less time [563 (408–600) vs. 246 (214–267), P = 0.01] and with higher movement economy. Procedural skills were further transferred to the cadaveric model.

Conclusions
Residents successfully acquired BG-PDT procedural skills with a simulation-based mastery learning training program, and skills were effectively transferred to a cadaveric model. This easily replicable program is the first simulation-based BG-PDT training experience reported in the literature, enhancing safe competency acquisition, to further improve patient care.
Use of the Fundamentals of Arthroscopic Surgical Training Workstation for Immediate Objective Feedback During Training Improves Hand-Tied Surgical Knot Proficiency
Authors: Schneider Andrew M. , Davis William , Walsh Daniel , Pedowitz Robert A. , Evans Douglas A. 
Published: July 2020

Introduction
In a prior study, we validated the FAST workstation as an objective evaluator of hand-tied surgical knots. The goal of this study was to determine whether guided practice with the FAST workstation could lead to objective improvement in hand-tied surgical knot performance.

Methods
Sixty participants were randomized into 1 of 2 groups: a control group, with access to only the knot-tying station, and a test group, with access to the knot-tying station plus the knot testing station. The study was divided into 3 phases: prepractice, practice, and postpractice. Using the FAST workstation, participants hand-tied 5 knots, 15 knots, and 5 knots using 0 Vicryl suture in the prepractice, practice, and postpractice phases, respectively. Knots for each participant from the prepractice and postpractice phases were collected, tested, and compared.

Results
Within the control group, the average number of prepractice knot successes was 2.63, and the average number of postpractice knot successes was 3.40, which resulted in an improvement of average knot successes of 0.77 (P < 0.01). Within the test group, the average number of prepractice knot successes was 2.40, and the average number of postpractice knot successes was 4.10, which resulted in an improvement of average knot successes of 1.70 (P < 0.01). The difference in average improvement of knot-tying successes (0.93 knots) between the 2 groups was statistically significant (P < 0.01).

Discussion
A knot-tying trainer that provides objective feedback on knot performance may better improve hand-tied surgical knot proficiency compared with one without objective feedback.
Effects of Balance Training on Nonmotor Symptoms in Individuals With Parkinson Disease
Authors: Singh Gurpreet , Jain Tarang K. , Liu Wen , Colgrove Yvonne , Pahwa Rajesh , Lyon Kelly , Sharma Neena 
Published: July 2020

Objective:
Evaluate the effects of balance training on nonmotor symptoms associated with Parkinson disease (PD) using Biodex stability system (BSS).

Methods:
Twenty individuals with PD were assigned to either a BSS group (n = 10) or a non-BSS group (n = 10) who performed exercises for 4 weeks. Assessments of depression, fatigue, pain, fear of falling, and quality of life (QOL) were done using standardized measures.

Results:
Fatigue was found to be significantly different within (mean difference: 8 ± 11.5 points; 95% CI, −0.27, 16) as well as between groups (mean difference: 12.6 ± 12.3 points; 95% CI, 23.4, 1.7) for only the BSS group.

Conclusion:
Balance exercise training can decrease fatigue, which may have valuable implications on fear of falling and QOL in individuals with PD.
Epidemiologic, Clinical, and Biological Characteristics of Adult T-cell Leukemia / Lymphoma in Martinique (1983-2013)
Authors: Yves Plumelle , Stephane Michel , Christine Delaunay , Moumouni Kone , Jean-Côme Meniane , Derancourt Christian , Harold Merle , Vincent Molinié , Gérard Panelatti 
Published: July 2020

SummaryWe report one of the largest non-Japanese cohorts of adult T-cell leukemia/lymphoma (ATL). A total of 175 cases were identified in Martinique between 1983 and 2013. The sex ratio was 1.01. The median age was 56 years. The overall incidence rate was 1.16/105inhabitants/year, with a risk 1.29 times higher for men. The distribution of clinical types (acute, lymphoma, and chronic) was 62.9%, 29.1%, and 8%, respectively. Median survival time was 3.06, 8.13, and 45.16 months, respectively, for the acute, lymphoma, and chronic types (p <0.001). Survival was significantly higher for lymphoma type with skin lesions (median 13.96 months versus 6.06, p <0.002) and for the acute type without hypercalcemia (5.1 versus 2.4 months, p <0.01). Symptoms associated with hypercalcemia present in 46.9% of patients and skin lesions in 43.4% were the best-performing clinical signs for the diagnosis of ATL. However, only 16.9% had these manifestations.Strongyloïdes stercoralisinfection was documented in 42.5% of patients. Twenty-three patients had an atypical phenotype, including 14 cases with CD4-CD8- and 4 with CD4+CD8+. Twenty-four patients did not express CD25 with no significant impact on overall survival. The hyperploidy, trisomy of chromosome 3 and rearrangements of chromosome 14 were the most frequent karyotype abnormalities.
Cytochrome OmcS is not essential for long-range electron transport inGeobacter sulfurreducensstrain KN400
Authors: Walker David J. F. , Li Yang , Meier David , Pinches Samantha , Holmes Dawn E. , Smith Jessica A. 
Published: July 2020

AbstractThe multi-hemec-type cytochrome OmcS, is one of the central components for extracellular electron transport inGeobacter sulfurreducensstrain DL-1, but its role in other microbes, including other strains ofG. sulfurreducensis currently a matter of debate. Therefore, we investigated the function of OmcS inG. sulfurreducensstrain KN400, which is even more effective in extracellular electron transfer than strain DL-1. We found that deletingomcSfrom strain KN400 did not negatively impact the rate of Fe(III) oxide reduction and did not affect the strain’s ability to accept electrons via direct interspecies electron transfer. The OmcS-deficient strain also continued to produce conductive filaments, consistent with the concept that electrically conductive pili are the primary conduit for long-range electron transfer inG. sulfurreducensand closely related species. These findings, coupled with the lack of OmcS homologs in most other microbes capable of extracellular electron transfer, suggest that OmcS is not a common critical component for extracellular electron transfer.
The hidden role of owners' spouses in family firm innovativeness: a dynamic managerial capabilities perspective
Authors: Gerulaitiene Neringa , Pundziene Asta , Vaiciukynaite Egle 
Published: July 2020

PurposeThe purpose of this paper is to investigate the effect of the dynamic managerial capabilities (DMC) of the spouse (either working or non-working) of a family firm owner on firm innovativeness. This paper assesses the role of three elements of the DMC of owners' spouses (emotion regulation, conflict resolution and networking capabilities) that are bridged by familiness on family firm innovativeness.Design/methodology/approachThis paper presents the results of a multiple case study. Twelve cases were selected: six innovative and six non-innovative family firms in Lithuania. The study design enabled a comparison not only of innovative and non-innovative family firms but also of non-working and working spouses of family firm owners.FindingsThe findings show that family firm owners' spouses contribute to firm innovativeness through their DMC in terms of emotion regulation, conflict resolution and networking capabilities.Research limitations/implicationsThis research focused on a sample of firms in Lithuania. Future studies should broaden the research to other countries.Originality/valueThis research provides empirical evidence of the hidden role of the DMC of family firm owners' spouses and their contribution to firm innovativeness. This paper extends the application of DMC to family business research.