bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of HIV Preexposure Prophylaxis Adherence Among Female Sex Workers in a Demonstration Study in Cotonou, Benin: A Study of Behavioral and Demographic Factors
Authors: Mboup Aminata , Diabaté Souleymane , Béhanzin Luc , Guédou Fernand Aimé , Zannou Djimon Marcel , Kêkê René K. , Bachabi Moussa , Gangbo Flore , Marzinke Mark A. , Hendrix Craig , Gagnon Marie-Pierre , Alary Michel 
Published: January 2021

Background
HIV preexposure prophylaxis (PrEP) efficacy is closely linked to adherence, and factors associated with PrEP adherence are not well understood and may differ across populations. As PrEP demonstration projects and implementation are ongoing, it is essential to understand factors associated with adherence to oral PrEP to design effective adherence interventions and maximize the public health impact of PrEP. We thus aimed to assess demographic and behavioral factors associated with optimal PrEP adherence (100%) among female sex workers (FSWs) participating in a demonstration project in Cotonou, Benin.

Methods
Female sex workers were provided with daily Truvada and followed quarterly for 1 to 2 years. Sociodemographics, partners, and behaviors were collected through face-to-face questionnaires. Another questionnaire based on sexual the theory of planned behavior and the theory of interpersonal behavior was also administered. Generalized estimating equations were used to identify factors associated with optimal daily adherence.

Results
At baseline, 255 FSWs were followed up. One-year increase in age of FSWs was associated with a 3% increase in optimal adherence (prevalence ratio, 1.03; 95% confidence interval, 1.01–1.05; P for trend = 0.0003), and optimal adherence decreased by 31% for every 6 months of follow-up (prevalence ratio, 0.69; 95% confidence interval, 0.59–0.79; P for trend < 0.0001). For the participants who have completed the behavioral questionnaires, high intention to adhere to the treatment was also a predictor of optimal adherence.

Conclusions
Efforts should be geared toward FSWs intending to use PrEP to help them reach adequate adherence levels for effective HIV protection.
Evaluation of an Integrated Psychology Service in a Pediatric Emergency Department and Urgent Care
Authors: Casher Gabriel A. , Sutton Brianne , Roosevelt Genie , Simpson Scott A. 
Published: January 2021

Objectives
Children visiting emergency departments (EDs) are disproportionately affected by mental health disorders. Integrated behavioral health models hold promise for improving care among ED patients. We implemented and evaluated a novel behavioral health service integrated psychology trainees in a safety net hospital's pediatric ED and urgent care.

Methods
Consultations and interventions provided were identified from the service's patient registry. Patients treated by the service were matched based on age, sex, day, and month of presentation to control patients who received a brief assessment by a specialized psychiatric nurse or patients receiving comprehensive management in a psychiatric emergency service. Rates of ED return visits were obtained from local hospital records, and insurance claims were used to identify rates of psychiatric hospitalization and outpatient follow-up care.

Results
The most commonly provided interventions among 71 intervention patients were assistance with connection to follow-up behavioral health treatment (65%), relaxation training (41%), and motivational interviewing (31%). These patients were matched with 142 comparison patients. There was no difference among groups in return rates within 90 days among intervention versus nurse assessment or psychiatric emergency service patients (25% vs 23% vs 13%, P = 0.14). Insurance claims data were available for 115 patients (54%): within 90 days, integrated care patients were less likely to have at least 1 outpatient claim (52% vs 78% vs 84%, P < 0.01), and there was no difference in rates of psychiatric hospital admission (18% vs 20% vs 24%, P = 0.83).

Conclusions
Although this psychology-led integrated behavioral health service delivered a range of brief psychotherapeutic interventions, its impact on outpatient, inpatient, and emergency care was mixed. This lower follow-up rate among intervention patients may reflect the success of active psychological treatment in the ED, lower acuity among intervention patients, or implications of the study's safety net setting. The authors discuss this model's potential for enhancing mental health care in pediatric EDs.
Aromatherapy for Procedural Anxiety in Pain Management and Interventional Spine Procedures
Authors: Singh Jaspal R. , Rand Ethan B. , Erosa Samantha C. , Cho Rosa S. , Sein Michael 
Published: January 2021

ObjectiveThe aim of this study was to evaluate a nonsedating agent, lavender aromatherapy, to reduce anxiety before interventional spinal procedures.DesignIn this prospective, single-blind study performed at a tertiary care center for an academic institution, 144 patients undergoing spinal procedures (epidural steroid injection, medial branch block, or radiofrequency ablation) were randomized into two groups of 72 patients. The experimental group was exposed to a tablet formulation of lavender aromatherapy, while the control group was exposed to tablets devoid of any scent. The exposure duration for each group was 5 mins. The primary outcome measurement was patients’ anxiety state before the spinal procedure using the six-item State-Trait Anxiety Inventory. Secondary outcomes quantified the rate of vasovagal events and aborted procedures because of patient intolerance.ResultsCompared with the control group, the posttreatment anxiety score of those exposed to lavender aromatherapy revealed a statistically significant difference as measured by the six-item State-Trait Anxiety Inventory (12.15 ± 2.67 and 10.67 ± 2.81,P< 0.05). Within group, the experimental group’s anxiety level decreased from 12.26 ± 2.75 to 10.67 ± 2.81 (P< 0.05). There were two vasovagal episodes and one aborted procedure in the control group, whereas there was one vasovagal episode and no aborted procedures in the aromatherapy group.ConclusionsLavender-based aromatherapy is effective in reducing preprocedural anxiety before interventional spine procedures for pain management.
The Prevalence and Impact of Back and Neck Pain in Veterans With Upper Limb Amputation
Authors: Resnik Linda , Borgia Matthew , Clark Melissa A. 
Published: January 2021

Objective
The aims of the study were (1) to describe frequency of back pain only, neck pain only, and co-occurring pain in veterans with upper limb amputation, (2) to examine changes in pain over 1 yr, and (3) to quantify the association of pain and health-related quality of life and disability.

Design
This is an observational cohort study with a survey of a sample of 792 veterans with upper limb amputation, with 1-yr reassessment of 585 (85.3%) of 777 eligible participants. Pain prevalence and intensity were examined. Logistic and linear regressions identified variables associated with pain and examined associations between intensity and veterans RAND-12 mental component score and physical component score and QuickDASH.

Results
At baseline, 52.3% had co-occurring pain, 20.0% had back pain, and 8.3% had neck pain. Persistent back and neck pain is present in 60.8% and 48.1% respondents, respectively. Pain intensity was unchanged for 59.1% with back pain and 61.3% with neck pain. Mental component score and QuickDASH were significantly worse with severe and moderate back and neck pain, compared with no pain. Severe/moderate back pain intensity was associated with lower physical component score.

Conclusions
Back and neck pain is highly prevalent and persistent in veterans with upper limb amputation. Pain intensity is negatively associated with health-related quality of life and disability. Pain prevention and intervention are needed in this population.
Using longitudinal genetic-network study to understand HIV treatment-as-prevention
Authors: Kang Ruihua , Li Jianjun , Chen Huanhuan , Tang Zhenzhu , Pan Stephen W. , Luo Liuhong , Zhu Qiuying , Lan Guanghua , Liang Shujia , Lu Huaxiang , Zhu Jinhui , Feng Yi , Liao Lingjie , Xing Hui , Shao Yiming , Ruan Yuhua , Shen Zhiyong 
Published: January 2021

Objective:
The WHO has recommended that antiretroviral therapy be provided to all HIV patients to reduce future HIV transmission rates. However, few studies have examined this public health strategy at the population level in a real-world setting.

Methods:
In this longitudinal genetic-network study in Guangxi, China, the baseline and follow-up data were collected from HIV patients in 2014 and newly diagnosed HIV patients from 2015 to 2018, respectively. The prevention efficacy was used to estimate the effect of treatment-as-prevention in reducing HIV secondary transmission.

Results:
Among 804 newly diagnosed HIV patients during 2015–2018, 399 (49.6%) of them genetically linked to HIV patients at baseline during 2014–2017. The overall proportion of genetic linkage between newly diagnosed HIV patients during 2015–2018 with untreated and treated HIV patients at baseline during 2014–2017 was 6.2 and 2.9%, respectively. The prevention efficacy in HIV transmission for treated HIV patients was 53.6% [95% confidence interval (95% CI): 42.1–65.1]. Subgroup analyses indicated an 80.3% (95% CI: 74.8–85.8) reduction in HIV transmission among HIV patients who were treated for 4 years or more and had viral loads less than 50 copies/ml. There was no significant reduction in HIV transmission among treated HIV patients who dropped out or who had missing viral load measures.

Conclusion:
Our study results support the feasibility of treating all HIV patients for future reductions in HIV transmission at the population level in real-world settings. Comprehensive intervention prevention programmes are urgently needed.
Clinical Outcomes and Inflammatory Markers by HIV Serostatus and Viral Suppression in a Large Cohort of Patients Hospitalized With COVID-19
Authors: Patel Viraj V. , Felsen Uriel R. , Fisher Molly , Fazzari Melissa J. , Ginsberg Mindy S. , Beil Robert , Akiyama Matthew J. , Anastos Kathryn , Hanna David B. 
Published: January 2021

Background:
Limited data exist about clinical outcomes and levels of inflammatory and immune markers among people hospitalized with COVID-19 by HIV serostatus and by HIV viral suppression.

Setting:
Large tertiary care health system in the Bronx, NY, USA.

Methods:
We conducted a retrospective cohort study of 4613 SARS-CoV-2 PCR-positive patients admitted between March 10, 2020, and May 11, 2020. We examined in-hospital intubation, acute kidney injury (AKI), hospitalization length, and in-hospital mortality by HIV serostatus, and by HIV-viral suppression and CD4 counts among people living with HIV (PLWH) using adjusted competing risks regression. We also compared immune and inflammatory marker levels by HIV serostatus and viral suppression.

Results:
Most patients were either non-Hispanic Black (36%) or Hispanic (37%); 100/4613 (2.2%) were PLWH, among whom 15 had detectable HIV viral load. PLWH compared to patients without HIV had increased intubation rates (adjusted hazard ratio 1.73 [95% CI: 1.12 to 2.67], P = 0.01). Both groups had similar rates of AKI, length of hospitalization, and death. No (0%) virally unsuppressed PLWH were intubated or died, versus 21/81 (26%, P = 0.04) and 22/81 (27%, P = 0.02) of virally suppressed PLWH, respectively. Among PLWH, higher CD4 T-cell counts were associated with increased intubation rates. C-reactive protein, IL-6, neutrophil counts, and ferritin levels were similar between virally suppressed PLWH and patients without HIV, but significantly lower for unsuppressed PLWH (all P < 0.05).

Conclusions:
PLWH had increased risk of intubation but similarly frequent rates of AKI and in-hospital death as those without HIV. Findings of no intubations or deaths among PLWH with unsuppressed HIV viral load warrant further investigation.
Brain 18F-FDG and 18F-Flumetamol PET Imaging of Fragile X-Associated Tremor Ataxia Syndrome
Authors: Bacchin Ruggero , Salgarello Matteo , Trentin Michela , Zanette Giampietro , Tamburin Stefano 
Published: January 2021

Abstract
Fragile X-associated tremor/ataxia syndrome (FXTAS) is a rare movement disorder caused by a 55-to-200 CGG-trinucleotide expansion premutation in the FMR1 gene. Core diagnostic criteria are tremor, ataxia, and T2-weighted hyperintensity of the middle cerebellar peduncles on MRI, but FXTAS encompass a broad spectrum of neurological symptoms. FXTAS pathophysiology is largely unknown, and some animal models and neuropathology findings suggest possible overlap with Alzheimer disease. We report the combined PET imaging of a genetically confirmed FXTAS patient, presenting reduced temporal-frontal 18F-FDG uptake, and pathological cortical deposition of amyloid to 18F-flumetamol PET scan. This report may offer clues to FXTAS pathophysiology.
Compromised Flap Salvage With Closed Incision Negative Pressure Therapy Under Real-Time Indocyanine Green Fluorescence Assessment
Authors: Chien Yi-Chun , Lin Yu-Hsien , Chen Cha-Chun , Lin Huwang-Chi 
Published: January 2021

Background
Skin flap transfer is a commonly used technique by surgeons; however, compromised blood flow may result in flap ischemia and necrosis. We describe the use of closed incision negative pressure therapy (ciNPT) to help manage skin flap reconstructions with indocyanine green fluorescence angiography (ICG-FA) to assess perfusion of the flaps before and after ciNPT.

Methods
Three female and 5 male patients underwent various skin flap reconstructions, including local flaps, pedicled flaps, and propeller flaps, for wound defects related to trauma, infection, or cancer. After flap setting and suturing, ciNPT (−125 mm Hg) was applied to the closed incision for 7 days. Perfusion was assessed using ICG-FA before applying ciNPT and again at 24 hours later. The Shapiro-Wilk test and Wilcoxon signed rank test were used in statistical analysis.

Results
Initial postoperative survival was observed for all skin flaps; however, 1 flap failed after 2 weeks due to uncontrolled infection. The remaining 7 flaps healed well without any surgical revision. All patients were initially determined to have impaired flap perfusion; however, skin flap perfusion was significantly higher after ciNPT than before ciNPT in each case (P = 0.012).

Conclusions
This study showed good healing outcomes for skin flap reconstructions without complications, despite the fact that each flap had compromised flap perfusion to some extent during the surgery. This case series is novel in that it used laser-assisted ICG-FA to provide a real-time assessment of skin flap perfusion before and after ciNPT.
Diced Cartilage Rhinoplasty for Cleft Nose Deformities
Authors: Lonic Daniel , Hsiao Yen-Chang , Huang Jung-Ju , Chang Chun-Shin , Chen Jyh-Ping , Denadai Rafael , Bosselmann Talia , Kehrer Andreas , Prantl Lukas , Lo Lun-Jou , Chen Yu-Ray 
Published: January 2021

Background
The objective of this trial is to evaluate the flexibility of the cartilaginous component of the cleft nose after diced cartilage rhinoplasty by determining the degree of possible bending in relation to the vertical nasal dorsum axis and to compare with to a control group of the unaffected population.

Patients and Methods
Fifteen cleft nose patients with diced cartilage rhinoplasty were included in this study, as well as a control group of 15 unaffected individuals. The angle of maximum nasal bending is measured between the basic and maximum bending axis and performed by the same rater twice at least 2 weeks apart to account for intrarater reliability. Study groups were compared with Fisher and independent t test.

Results
The maximum bending to the left side was 16.10 ± 5.03 degrees for the study group and 23.95 ± 6.54 degrees for the control group (P = 0.001). The maximum bending to the right side were 16.54 ± 6.73 degrees for the study group and 23.00 ± 8.88 degrees for the control group (P = 0.034).

Conclusion
Diced cartilage graft injection for dorsal augmentation yields reproducible and esthetically pleasing outcomes with good flexibility and natural feel of the nasal tip. Although there is a significant difference compared with a nonaffected control group in maximum bending capacity, all patients in this study were satisfied with the results.
Neutrophil Gelatinase-Associated Lipocalin (NGAL) Measured at Admission is Associated With Development of Late Cardiogenic Shock and Mortality in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Frydland Martin , Møgelvang Rasmus , Møller Jacob Eifer , Helgestad Ole K. L. , Holmvang Lene , Mark Peter D. , Jensen Lisette Okkels , Hassager Christian 
Published: January 2021

ABSTRACT
In patients with ST-elevation myocardial infarction (STEMI) the immune system is activated with an inflammatory response to follow. In STEMI patients with a severe inflammatory response, risk of development of cardiogenic shock (CS) seems increased. Neutrophil Gelatinase-Associated Lipocalin (NGAL) is a glycoprotein released from mature neutrophils and plasma concentration may increase immediately after STEMI. We therefore aimed to assess whether admission NGAL plasma concentration in patients with STEMI was associated with CS development after leaving the catheterization laboratory (late CS) and 30-day all-cause mortality.

Patients and Methods:
From 1,892 consecutive patients with STEMI 1,626 (86%) had plasma NGAL concentration measured upon hospital admission before angiography throughout a 1-year period at two tertiary heart centers in Denmark. Patients were stratified according to NGAL quartiles (Q1–4). To assess late CS development, we adjusted for the Observatoire Régional Breton sur l’Infarctus risk score for late CS. For mortality assessment, we adjusted for gender, age, post-PCI culprit Thrombolysis in myocardial infarction flow, left ventricular ejection fraction (LVEF), kidney dysfunction, and being comatose after cardiac arrest.

Results:
Increasing NGAL concentration was associated with higher age, more comorbidities, and more critical patient conditions including lower blood pressure and LVEF. When adjusted for factors associated with poor outcome, NGAL remained independently associated with both late CS development (Q4 vs. Q1–3) (OR (95% CI) 3.64 (1.79–7.41) and 30-day mortality (HR (95% CI) 3.18 (1.73–5.84)).

Conclusion:
Admission plasma concentration of NGAL in STEMI patients is independently associated with 30-day all-cause mortality and predictive of late CS development.
Effects of Community-based Exercise Prehabilitation for Patients Scheduled for Colorectal Surgery With High Risk for Postoperative Complications: Results of a Randomized Clinical Trial
Authors: Berkel Annefleur E. M. , Bongers Bart C. , Kotte Hayke , Weltevreden Paul , de Jongh Frans H. C. , Eijsvogel Michiel M. M. , Wymenga Machteld , Bigirwamungu-Bargeman Marloes , van der Palen Job , van Det Marc J. , van Meeteren Nico L. U. , Klaase Joost M. 
Published: January 2021

Objective:
To assess the effects of a 3-week community-based exercise program on 30-day postoperative complications in high-risk patients scheduled for elective colorectal resection for (pre)malignancy.

Summary Background Data:
Patients with a low preoperative aerobic fitness undergoing colorectal surgery have an increased risk of postoperative complications. It remains, however, to be demonstrated whether prehabilitation in these patients reduces postoperative complications.

Methods:
This 2-center, prospective, single-blinded randomized clinical trial was carried out in 2 large teaching hospitals in the Netherlands. Patients (≥60 years) with colorectal (pre)malignancy scheduled for elective colorectal resection and with a score ≤7 metabolic equivalents on the veterans-specific activity questionnaire were randomly assigned to the prehabilitation group or the usual care group by using block-stratified randomization. An oxygen uptake at the ventilatory anaerobic threshold <11 mL/kg/min at the baseline cardiopulmonary exercise test was the final inclusion criterion. Inclusion was based on a power analysis. Patients in the prehabilitation group participated in a personalized 3-week (3 sessions per week, nine sessions in total) supervised exercise program given in community physical therapy practices before colorectal resection. Patients in the reference group received usual care. The primary outcome was the number of patients with one or more complications within 30 days of surgery, graded according to the Clavien-Dindo classification. Data were analyzed on an intention-to-treat basis.

Results:
Between February 2014 and December 2018, 57 patients [30 males and 27 females; mean age 73.6 years (standard deviation 6.1), range 61–88 years] were randomized to either prehabilitation (n = 28) or usual care (n = 29). The rate of postoperative complications was lower in the prehabilitation group (n = 12, 42.9%) than in the usual care group (n = 21, 72.4%, relative risk 0.59, 95% confidence interval 0.37–0.96, P = 0.024).

Conclusions:
Exercise prehabilitation reduced postoperative complications in high-risk patients scheduled to undergo elective colon resection for (pre)malignancy. Prehabilitation should be considered as usual care in high-risk patients scheduled for elective colon, and probably also rectal, surgery.
A Structured, Hybrid Cystoscopy Simulation Curriculum for Obstetrics/Gynecology Residents
Authors: Do Linh , Pasha Kainat , Sanchez Sheralyn , Montoya T. Ignacio , Maldonado Pedro A. 
Published: January 2021

Objectives
This study aimed to assess the subjective and objective cystoscopy skills of gynecology residents before and after implementation of a comprehensive simulation curriculum.

Methods
Residents in an obstetrics/gynecology program at a single academic institution participated in a 6-week cystoscopy simulation course. Residents attended an initial orientation and didactic presentation, and then weekly 20- to 30-minute training sessions using a water balloon model and a virtual reality simulator. Pretesting and posttesting were performed, including (1) subjective self-assessments, (2) a written quiz, and (3) objective structured assessment of technical skills. Paired t test was used to assess the differences in residents’ objective assessment scores before and after simulation training.

Results
A total of 16 residents were recruited. Residents reported significant subjective improvements in comfort, confidence, and proficiency in performing cystoscopy after completing the curriculum. Their overall objective assessment improved, including written quiz scores (mean score, 49% vs 78%; P < 0.001), efficiency in cystoscope assembly (means score, 0 vs 4; P < 0.001), overall bladder survey score (56% vs 86%, P < 0.001), and global rating score (mean score, 15 vs 24; P < 0.001). Residents tended to prefer the water-balloon model compared with the virtual reality simulator (75% vs 25%).

Conclusions
Obstetrics/gynecology residents demonstrated significant improvements in subjective and objective measures of skill after completion of a 6-week cystoscopy simulation training course using a combination of low- and high-fidelity models. Although universal cystoscopy at the time of hysterectomy for benign indications remains controversial, cystoscopy simulation should remain an important part of resident training.