bluuebunny/crossref_metadata_2025_split huggingface dataset:
Agreement between self-reported and objective measures of sleep in people with HIV and lifestyle-similar HIV-negative individuals
Authors: De Francesco Davide , Sabin Caroline A. , Winston Alan , Mallon Patrick W.G. , Anderson Jane , Boffito Marta , Doyle Nicki D. , Haddow Lewis , Post Frank A. , Vera Jaime H. , Sachikonye Memory , Redline Susan , Kunisaki Ken M. 
Published: February 2021

Objectives:
The aim of this study was to evaluate the agreement between self-reported sleep measures and insomnia with objectively measured sleep parameters in people with HIV (PWH) and HIV-negative individuals.

Design:
A cross-sectional analysis of PWH and lifestyle-similar HIV-negative individuals.

Methods:
Self-reported measures included time spent in bed, sleep onset latency and a validated insomnia questionnaire. Objective measures were assessed via 7-days/nights of actigraphy data to determine average and intra-individual variability of several sleep measures (including time spent in bed and onset latency). Spearman's correlation coefficient and Cohen's κ were used to assess the agreement between self-reported and actigraphy-assessed measures. Associations between insomnia and actigraphy-assessed sleep parameters were evaluated using partial least-square discriminant analysis (PLS-DA).

Results:
We found fair correlation between self-reported and actigraphy-assessed time spent in bed in 342 PWH (r
s = 0.46) and 119 HIV-negative individuals (r
s = 0.48). Among PWH, the correlation did not differ by age, education, depressive symptoms and self-reported insomnia (all P > 0.05), but was stronger in men (P = 0.05) and in those with a BMI of at least 25 kg/m2 (P < 0.001). Agreement between self-reported and actigraphy-assessed sleep onset latency was poor in both PWH (κ = 0.002, P = 0.49) and HIV-negative individuals (κ = 0.009, P = 0.65). According to PLS-DA, self-reported insomnia most strongly correlated with intra-individual variability of sleep duration, movement index and efficiency.

Conclusion:
We report poor-to-fair agreement between self-reported and actigraphy-assessed sleep measures in PWH. Insomnia symptoms correlated with regularity of sleep duration, quality and efficiency. These findings highlight the importance of both patient-reported and objective measures of daily sleep variation, for better understanding sleep disorders in PWH.
Pre-treatment integrase inhibitor resistance is uncommon in antiretroviral therapy-naive individuals with HIV-1 subtype A1 and D infections in Uganda
Authors: McCluskey Suzanne M. , Kamelian Kimia , Musinguzi Nicholas , Kigozi Simone , Boum Yap , Bwana Mwebesa B. , Muzoora Conrad , Brumme Zabrina L. , Carrington Mary , Carlson Jonathan , Foley Brian , Hunt Peter W. , Martin Jeffrey N. , Bangsberg David R. , Harrigan P. Richard , Siedner Mark J. , Haberer Jessica E. , Lee Guinevere Q. 
Published: February 2021

Objective:
Dolutegravir (DTG) is now a preferred component of first-line antiretroviral therapy (ART). However, prevalence data on natural resistance to integrase inhibitors [integrase strand transfer inhibitors (INSTIs)] in circulating non-subtype B HIV-1 in sub-Saharan Africa is scarce. Our objective is to report prevalence of pre-treatment integrase polymorphisms associated with resistance to INSTIs in an ART-naive cohort with diverse HIV-1 subtypes.

Design:
We retrospectively examined HIV-1 integrase sequences from Uganda.

Methods:
Plasma samples were derived from the Uganda AIDS Rural Treatment Outcomes (UARTO) cohort, reflecting enrollment from 2002 to 2010, prior to initiation of ART. HIV-1 integrase was amplified using nested-PCR and Sanger-sequenced (HXB2 4230-5093). Stanford HIVdb v8.8 was used to infer clinically significant INSTI-associated mutations. Human leukocyte antigen (HLA) typing was performed for all study participants.

Results:
Plasma samples from 511 ART-naive individuals (subtype: 48% A1, 39% D) yielded HIV-1 integrase genotyping results. Six out of 511 participants (1.2%) had any major INSTI-associated mutations. Of these, two had E138T (subtype A1), three had E138E/K (subtype D), and one had T66T/I (subtype D). No participants had mutations traditionally associated with high levels of INSTI resistance. HLA genotypes A∗02:01/05/14, B∗44:15, and C∗04:07 predicted the presence of L74I, a mutation recently observed in association with long-acting INSTI cabotegravir virologic failure.

Conclusion:
We detected no HIV-1 polymorphisms associated with high levels of DTG resistance in Uganda in the pre-DTG era. Our results support widespread implementation of DTG but careful monitoring of patients on INSTI with virologic failure is warranted to determine if unique mutations predict failure for non-B subtypes of HIV-1.
Brief Report: Switching to DOR/3TC/TDF Maintains HIV-1 Virologic Suppression Through Week 144 in the DRIVE-SHIFT Trial
Authors: Kumar Princy , Johnson Margaret , Molina Jean-Michel , Rizzardini Giuliano , Cahn Pedro , Bickel Markus , Wan Hong , Xu Zhi Jin , Morais Cristiana , Sklar Peter , Greaves Wayne ,   for the DRIVE-SHIFT Study Group
Published: February 2021

Background:
In the primary analysis of the DRIVE-SHIFT trial, switching to doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF) maintained suppression of HIV-1 through week 48. Here, we present long-term efficacy and safety outcomes through week 144 of the DRIVE-SHIFT trial.

Methods:
This phase 3, randomized, open-label trial evaluated switching from a stable antiretroviral regimen to once-daily DOR/3TC/TDF in adults with HIV-1 suppressed for ≥6 months and no previous virologic failure. Participants switched at day 1 [immediate switch group (ISG); n = 447] or week 24 [delayed switch group (DSG); n = 209]. Nine ISG participants who completed week 48 but did not enter extension-1 were excluded from week 144 efficacy analyses.

Results:
At week 144, HIV-1 RNA <50 copies/mL was maintained in 80.1% of the ISG (351/438) and 83.7% of the DSG (175/209), while 2.7% (12/438) and 4.8% (10/209), respectively, had HIV-1 RNA ≥50 copies/mL (Food and Drug Administration Snapshot approach). Protocol-defined virologic failure after switch occurred in 2.1% of ISG (9/438) and 3.3% of DSG (7/209); no viral resistance to doravirine was detected in 4 participants with samples available. Reductions in fasting lipids were observed at 24 weeks after switch and maintained through week 144. The mean weight change from switch to week 144 was +1.4 kg for ISG and +1.2 kg for DSG. The most common adverse events were nasopharyngitis (16.2%), headache (12.3%), and diarrhea (9.1%). Overall, 4.1% discontinued because of adverse events, and no deaths occurred.

Conclusions:
These results confirm that switching to once-daily DOR/3TC/TDF is a generally well-tolerated option for maintaining viral suppression in adults considering a change in therapy.

Registration:

ClinicalTrials.gov NCT02397096.
HIV Testing by Public Health Centers and Municipalities and New HIV Cases During the COVID-19 Pandemic in Japan
Authors: Ejima Keisuke , Koizumi Yoshiki , Yamamoto Nao , Rosenberg Molly , Ludema Christina , Bento Ana I. , Yoneoka Daisuke , Ichikawa Seiichi , Mizushima Daisuke , Iwami Shingo 
Published: February 2021

Background:
During the COVID-19 outbreak, facility capacity for HIV testing has been limited. Furthermore, people may have opted against HIV testing during this period to avoid COVID-19 exposure. We investigated the influence of the COVID-19 pandemic on HIV testing and the number of reported HIV cases in Japan.

Methods:
We analyzed quarterly HIV/AIDS-related data from 2015 to the second quarter of 2020 using an anomaly detection approach. The data included the number of consultations, the number of HIV tests performed by public health centers or municipalities, and the number of newly reported HIV cases with and without an AIDS diagnosis. We further performed the same analysis for 2 subgroups: men who have sex with men (MSM) and non-Japanese persons.

Results:
The number of HIV tests (9,584 vs. 35,908 in the year-before period) and consultations (11,689 vs. 32,565) performed by public health centers significantly declined in the second quarter of 2020, whereas the proportion of new HIV cases with an AIDS diagnosis (36.2% vs. 26.4%) significantly increased after removing the trend and seasonality effects. HIV cases without an AIDS diagnosis decreased (166 vs. 217), but the reduction was not significant. We confirmed similar trends for the men who have sex with men and non-Japanese subgroups.

Conclusions:
During the COVID-19 pandemic, the current HIV testing system in Japan seems to have missed more cases of HIV before developing AIDS. Continuously monitoring the situation and securing sufficient test resources by use of self-testing is essential to understand the clear epidemiological picture of HIV incidence during the COVID-19 pandemic.
Genetic Associations with Weight Gain among South Africans who Initiated Dolutegravir-Containing and Tenofovir-Containing Regimens
Authors: Cindi Zinhle , Maartens Gary , Bradford Yuki , Venter Willem D.F. , Sokhela Simiso , Chandiwana Nomathemba C. , Haas David W. , Sinxadi Phumla 
Published: February 2021

Background:Excessive weight gain affects some HIV-positive individuals prescribed dolutegravir-containing regimens. Mechanisms underlying such weight gain are unknown.Setting:Data and DNA from antiretroviral therapy–naïve participants who were randomized to initiate dolutegravir with emtricitabine plus either tenofovir alafenamide (TAF) or tenofovir disoproxil fumarate (TDF) in the ADVANCE study (NCT03122262) were used to characterize associations between human genetic polymorphisms and magnitude of weight gain.Methods:Associations with percent weight gain from baseline to week 48 were assessed using multivariable linear regression models. Primary analyses a priori considered 59 polymorphisms and 10 genes of potential relevance to dolutegravir, TAF, or TDF pharmacokinetics. We also explored genome-wide associations.Results:Among the 314 (92%) of 340 dolutegravir recipients who were successfully genotyped, 160 (47%) and 154 (45%) were randomized to TAF/emtricitabine and TDF/emtricitabine, respectively. In target gene analyses, the lowestP-values for the dolutegravir and tenofovir groups wereABCG2rs4148149 (P= 7.0 × 10−4) andABCC10rs67861980 (P= 1.0 × 10−2), respectively, which were not significant after correction for multiple testing. In genome-wide analyses, the lowestP-values were rs7590091 inTMEM163(P= 3.7 × 10−8) for dolutegravir, rs17137701 inLOC105379130(P= 6.4 × 10−8) for TAF, and rs76771105 inLOC105371716(P= 9.7 × 10−8) for TDF.Conclusions:Among South African participants in a randomized clinical trial of dolutegravir plus either TAF/emtricitabine or TDF/emtricitabine, we identified several potential genetic associations with weight gain. OnlyTMEM163rs7590091 withstood correction for multiple testing. These associations warrant replication in other cohorts.
Interaction of Religion/Spirituality With Internalized HIV Stigma, Depression, Alcohol Use, and Sexual Risk Among Black Men Who Have Sex With Men: The 6 City HPTN 061 Study
Authors: Taggart Tamara , Mayer Kenneth H. , Vermund Sten H. , Huang Shu , Hayashi Kamden , Ransome Yusuf 
Published: February 2021

Background:
Black men who have sex with men (BMSM) remain at highest risk for HIV in the United States. Internalized HIV stigma and depression contribute to substance use and condomless anal intercourse (CAI). Religion and spirituality (R/S) are associated with decreased HIV-related risk behaviors for some groups, but their impact among BMSM is uncertain. We investigated the main and moderating roles of R/S on pathways from internalized HIV stigma to CAI while under the influence of drugs.

Methods:
We used baseline data from 1511 BMSM from the HIV Prevention Trials Network (HPTN) 061 study to examine the associations between internalized HIV stigma, depressive symptoms, alcohol use, and CAI while under the influence of drugs, adjusting for covariates in generalized structural equation models. We then tested whether R/S moderated the association between (1) internalized HIV stigma and depressive symptoms, (2) depressive symptoms and alcohol use, and (3) alcohol use and CAI while under the influence of drugs.

Results:
Spiritual beliefs [F(1,2) = 9.99, P < 0.001], spiritual activities [F(1,2) = 9.99, P < 0.001], and religious attendance [F(1,2) = 9.99, P < 0.001] moderated the pathway between internalized HIV stigma and depressive symptoms. As internalized HIV stigma increased, those with lower spiritual activity scores experienced significantly higher increases in depressive symptoms compared with those with higher spiritual activity scores whose depressive symptom scores remained unchanged [stigma × spiritual activities B = −0.18 (SE = 0.07), P < 0.001].

Conclusions:
Religion and spirituality were protective against CAI among BMSM. Future intervention research should explore ways to incorporate religious and/or spiritual activities to reduce internalized HIV stigma as one way to reduce depressive symptoms among BMSM.
Long-Acting Injection and Implant Preferences and Trade-Offs for HIV Prevention Among South African Male Youth
Authors: Montgomery Elizabeth T. , Browne Erica N. , Atujuna Millicent , Boeri Marco , Mansfield Carol , Sindelo Siyaxolisa , Hartmann Miriam , Ndwayana Sheily , Bekker Linda-Gail , Minnis Alexandra M. 
Published: February 2021

Background:
Long-acting pre-exposure prophylaxis (LA-PrEP) formulated as implants and injections are promising prevention method strategies offering simplicity, discretion, and long dose duration. Men are important end users of LA-PrEP, and early assessment of their preferences could enhance downstream male engagement in HIV prevention.

Methods:
A discrete-choice experiment survey was conducted with 406 men, aged 18–24, in Cape Town, South Africa, to assess preferences for 5 LA-PrEP attributes with 2–4 pictorially-depicted levels: delivery form, duration, insertion location, soreness, and delivery facility. Latent class analysis was used to explore heterogeneity of preferences and estimate preference shares.

Results:
The median age was 21 (interquartile range 19–22), and 47% were men who have sex with men. Duration was the most important product attribute. Latent class analysis identified 3 classes: “duration-dominant decision makers” (46%) were the largest class, defined by significant preference for a longer duration product. “Comprehensive decision makers” (36%) had preferences shaped equally by multiple attributes and preferred implants. “Injection-dominant decision makers” (18%) had strong preference for injections (vs. implant) and were significantly more likely to be men who have sex with men. When estimating shares for a 2-month injection in the buttocks with mild soreness (HPTN regimen) vs. a 6-month implant (to arm) with moderate soreness (current target), 95% of “injection-dominant decision makers” would choose injections, whereas 79% and 63% of “duration-dominant decision makers” and “comprehensive decision makers” would choose implant.

Conclusions:
Young South African men indicated acceptability for LA-PrEP. Preferences were shaped mainly by duration, suggesting a sizeable market for implants, and underscoring the importance of product choice. Further research into men's acceptability of LA PrEP strategies to achieve engagement in these HIV prevention tools constitutes a priority.
Cost Savings in Urology Operating Rooms by Editing Surgeon Preference Cards
Authors: Pesigan Precy , Chen Henry , Bajaj Arjun A. , Gill Harcharan S. 
Published: February 2021

Background and Objectives:
Operating room costs contribute significantly to the overall expenditure for inpatient care. We evaluated a simple way to reduce urology operating room costs by limiting the loss from unused disposable items.

Methods:
Baseline data were collected on opened and unused disposable items. Surgeons were asked to edit their preference cards and mark optional surgical items that would only be opened if requested.

Results:
The cost of unused disposable items during the first 4 weeks in 3 operating rooms averaged $410/week. Costs after implementing the intervention declined to an average of $30/week. This yielded $380/week in savings, equating to a 92% reduction in waste, and a potential savings of $19 760 annually in the 2 urology operating rooms alone.

Conclusion:
Since the urology department represents only 10% of the main operating rooms at our institution, if other operating rooms implemented similar cost saving methods the hospital could potentially accrue significant savings.
Multiple Myeloma Presenting as Disseminated Osteoblastic Lesions With Intense 18F-FDG Uptake on PET/CT
Authors: Wang Yueqi , Fan Qiuping , Su Minggang 
Published: February 2021

Abstract
A 42-year-old woman presented with numbness and weakness in the lower limbs. The radiograph, MRI, and 99mTc-MDP bone scintigraphy revealed multiple bone lesions. The lesions were sclerotic on radiograph. Subsequent 18F-FDG PET/CT showed the lesions were disseminated and had intense 18F-FDG uptake. Monoclonal lambda plasmacytoma was confirmed after CT-guided biopsy of the third lumbar vertebral lesion. The laboratory data also showed a monoclonal immunoglobulin G lambda protein in serum and urine immunofixation. The patient was diagnosed as multiple myeloma finally. Multiple myeloma should be in the differential diagnosis scope of multiple osteoblastic lesions with intense 18F-FDG uptake on PET/CT.
Immunoglobulin G4–Related Sclerosing Cholangitis Revealed by 68Ga-FAPI PET/MR
Authors: Qin Chunxia , Yang Ling , Ruan Weiwei , Shao Fuqiang , Lan Xiaoli 
Published: February 2021

Abstract
A 60-year-old woman with surgically confirmed immunoglobulin G4–related sclerosing cholangitis underwent 18F-FDG PET/CT due to significantly elevated serum CA-19-9 level, which revealed a hypermetabolic lesion in the residual liver. 68Ga-FAPI PET/MR was performed to further evaluate whether the FDG-avid lesion is a malignant tumor. Astonishingly, diffuse intense radioactivity was revealed throughout the liver, suggesting involvement of active immunoglobulin G4–related sclerosing cholangitis, but nonfocal elevated 68Ga-FAPI accumulation in the FDG-avid lesion indicated postoperative change. From this case, we speculated that FAPI imaging could be used for evaluation of chronic liver disease because fibroblast activation protein has a profibrogenic role in chronic liver injury.
Cardiac Transthyretin Amyloidosis
Authors: Roteta Unceta Barrenechea Ana , Aibar Arregui Miguel Angel , Nogueira Souto Daniel , Melero Polo Jorge , Moreno Gázquez Inmaculada , Tardin Cardoso Leticia , Saker Diffalah Yasmina , Andrés Gracia Alejandro 
Published: February 2021

Purpose
Amyloidosis is a heterogeneous group of diseases caused by abnormal extracellular deposition of insoluble proteins and can involve myocardium. One of the causes of myocardial involvement is TTR amyloidosis. Our objective has been to evaluate the situation of cardiac amyloidosis (CA) in our center and the role of nuclear medicine, and to review the state of the art of nuclear medicine in this entity.

Patients and Methods
We have evaluated retrospectively 186 patients with clinical suspicion of CA and analyzed the clinical characteristics, free light chains and immunofixation in serum and/or urine, and the most relevant biomarkers associated with transthyretin CA (C-ATTR) of these patients and compared them with the results of the 99mTc-DPD scintigraphy.

Results
We have verified the growing bibliographic evidence concerning C-ATTR. A total of 51 scintigraphies (27.4%) were positive, 2 (1.1%) indeterminate and 133 (71.5%) negative according to the Perugini score. ATTR was diagnosed in 22 (11.8%; 77.3% males; mean age, 79.4 years). Of these, 12 (75% men; 82.3 years) were ATTRwt (wild-type or age-associated) patients, 2 (50% men; 52 years) experienced ATTRv (variant or hereditary), and 8 (87.5% men; 82.3 years) were not classified because of the absence genetic test. The origin of amyloidosis could not be determined in 31 (16.7%; 80.7% males; 84.5 years). In 29 of them (93.6%), it was because there was no study of free light chains or immunofixation.

Conclusions
Nuclear medicine is playing an increasing role in the diagnosis and classification of CA. However, the monitoring of these is still patchy.
Squamous Cell Carcinoma Mimicking Neck Paraganglioma on 68Ga-DOTATATE PET/CT
Authors: Civan Caner , Isik Emine Goknur , Has Simsek Duygu , Sen Comert , Unal Seher Nilgun 
Published: February 2021

Abstract
Somatostatin receptor (SSTR) imaging with 68Ga-labeled somatostatin analogs has been used for many tumors with high SSTR expression. Increased uptake mostly depends on the SSTR status of tumors; however, false-positive uptake can be demonstrated in benign diseases or other malignancies because of the increased SSTR expression. We present a case of a 50-year-old man with increased SSTR activity on cervical lesion located in internal jugular chain in 68Ga-DOTATATE PET/CT, which was performed for suspicion of paraganglioma. Biopsy revealed lymph node metastasis of squamous cell carcinoma other than paraganglioma. 18F-FDG PET/CT showed primary malignancy on larynx and lymph node metastasis, which were correlated surgically.
18F-FDG PET/CT Detection of a Popliteal Mycotic Aneurysm Complicating Staphylococcus aureus Bacteremia
Authors: El Yaagoubi Yacine , Prunier-Aesch Caroline , Chetanneau Alain , Philippe Laurent , Bleuet François , Menard Eric , Doll Gérard 
Published: February 2021

Abstract
A 75-year-old man presented with Staphylococcus aureus bacteremia, fever, and right posterior knee pain. Venous Doppler ultrasound of the lower extremity showed an isolated right calf muscle vein thrombosis, without any sign of deep vein thrombosis. 18F-FDG PET/CT revealed an intense focal uptake on the right popliteal artery, suggesting a mycotic aneurysm (MA). Lower limb CT angiography confirmed an MA of the right popliteal artery. The patient underwent surgical procedure with excision of the MA, whose cultures grew methicillin-sensitive S. aureus. Our case highlights the importance of including lower limbs in 18F-FDG PET/CT acquisition in case of suspicion of septic emboli.