bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment and treatment of tracheostomy tube manipulation: Effects of competing stimuli and protective equipment
Authors: Falligant John M. , Hardesty Samantha L. , Pierce David , Kurtz Patricia F. 
Published: May 2021

Functional analyses (FA) are widely used in the assessment and treatment of problem behavior. However, with limited exceptions, the procedures are rarely applied to potentially dangerous behaviors involving medical equipment. The current study replicated and extended procedures previously used by Kurtz and Chin (2004) to assess and treat tracheostomy tube manipulation in a 5‐year‐old boy diagnosed with extensive medical and developmental conditions. FA results indicated that tracheostomy tube manipulation (i.e., touching, pulling, occluding) was automatically maintained. An augmented competing stimulus assessment was conducted to identify stimuli associated with low levels of tracheostomy tube manipulation and elevated levels of item engagement. A treatment package consisting of noncontingent access to competing stimuli with prompting and continuous application of protective equipment produced significant reductions in tracheostomy tube manipulation, as well as significant increases in toy engagement.
Prosthetic meshes for hernia repair: State of art, classification, biomaterials, antimicrobial approaches, and fabrication methods
Authors: Serrano‐Aroca Ángel , Pous‐Serrano Salvador 
Published: May 2021

AbstractWorldwide, hernia repair represents one of the most frequent surgical procedures encompassing a global market valued at several billion dollars. This type of surgery usually requires the implantation of a mesh that needs the appropriate chemical, physical and biological properties for the type of repair. This review thus presents a description of the types of hernias, current hernia repair methods, and the state of the art of prosthetic meshes for hernia repair providing the most important meshes used in clinical practice by surgeons working in this area classified according to their biological or chemical nature, morphology and whether bioabsorbable or not. We emphasise the importance of surgical site infection in herniatology, how to deal with this microbial problem, and we go further into the future research lines on the production of advanced antimicrobial meshes to improve hernia repair and prevent microbial infections, including multidrug‐resistant strains. A great deal of progress has been made in this biomedical field in the last decade. However, we are still far from an ideal antimicrobial mesh that can also provide excellent integration to the abdominal wall, mechanical performance, low visceral adhesion and minimal inflammatory or foreign body reactions, among many other problems.
Suicidal ideation among active and nonactive/former Latter‐day Saint sexual minorities
Authors: Lefevor G. Tyler , McGraw James S. , Skidmore Samuel J. 
Published: May 2021

AbstractSexual minorities (SMs) in the Church of Jesus Christ of Latter‐day Saints (LDS) experience a number of unique risks related to their religious/spiritual and SM experience that may increase their likelihood of experiencing suicidal ideation (SI) and ultimately dying by suicide. However, it is unclear which aspects of these experiences are responsible for elevated SI. It is further unclear whether religiousness/spirituality and minority stress relate to SI similarly for active and nonactive/former LDS SMs. To address this gap, we examined data from 602 active and nonactive/former LDS SMs. Active and nonactive LDS SMs reported similar degrees of SI and minority stress but differing degrees of religiousness/spirituality with active LDS SMs reporting more religiousness/spirituality than nonactive/former LDS SMs. Several variables were associated with increased SI in both groups including positive religious coping, interpersonal religious struggles, internalized homonegativity, and concealment. Other variables were associated with decreased SI in both groups including resolving conflict between sexual and religious identities, family support, and friend support. Our results suggest that whether LDS SMs are active in their faith is an important factor to consider when understanding how religiousness/spirituality and minority stress relate to SI.
Utility of lignin‐modifying enzymes: a green technology for organic compound mycodegradation
Authors: Dhagat Swasti , Jujjavarapu Satya Eswari 
Published: May 2021

AbstractOrganic compounds such as heavy metals, polychlorinated biphenyls, petroleum hydrocarbons, pesticides and phenolic derivatives have become major environmental pollutants. These compounds are also known as xenobiotics as they are not produced or essentially utilized by any organism for its biological function. Xenobiotics are degraded by many microorganisms owing to the presence of enzymes that break down these complex compounds and utilize them as substrates. One group of enzymes commonly produced by microorganisms that have a major role in the degradation of xenobiotic organic compounds are lignin‐modifying enzymes, as the chemical structure of xenobiotic compounds resembles lignin. Lignin‐modifying enzymes are oxidative enzymes that have an important role in degrading abundant lignocellulosic wastes present in the environment. These enzymes include laccase, lignin peroxidase, manganese‐dependent peroxidase and versatile peroxidase, and are produced by bacteria and fungi, with white rot fungi being the major producer. They have a wide range of applications in detoxification of industrial and agricultural wastes and xenobiotic organic compounds. Mycodegradation or fungal degradation forms an important part of the ecosystem, as fungi can degrade many toxic substances because the fungal mycelia penetrate deep into substrates and help colonize the substrates rapidly. In this review, the problems associated with xenobiotic compounds are explained. Fungal lignin‐modifying enzymes, as a probable solution to xenobiotic degradation, have also been discussed in detail, along with their mechanism of action. © 2021 Society of Chemical Industry (SCI).
High gestational folic acid supplementation prevents hypoxia‐ischemia‐induced caspase‐3 augmenting without changing synapsin and H3 methylation levels in the rat hippocampus
Authors: Deniz Bruna Ferrary , Confortim Heloísa Deola , Miguel Patrícia Maidana , Bronauth Loise , Fernandes Isabela R. , Muotri Alysson R. , Pereira Lenir Orlandi 
Published: May 2021

AbstractPerinatal asphyxia is a peripartum event that can cause permanent sequelae to the newborns, affecting the brain development. Recently, it has been demonstrated that epigenetics mechanisms play an important role in this injury and that folic acid (FA) supplementation during pregnancy can affect these epigenetics modifications as well as gene expression. We have identified both positive and negative effects of FA treatment in rats submitted to a model of neonatal hypoxia‐ischemia (HI). Considering that FA supplementation is already used in pregnant women and that HI occurs in the peripartum period, this study was designated to evaluate how gestational FA supplementation and neonatal HI affect: apoptosis (caspase‐3) and expression of synaptic proteins (synapsin and PSD‐95) and the methylation of histone H3 lysine (K) 4 and 27 in the rat hippocampus. Pregnant Wistar rats were divided according to the diets: standard (SD), supplemented with 2 mg/kg of FA or with 20 mg/kg of FA. HI procedure was performed at the 7th PND. Protein expression and H3 methylation were evaluated at the 60th PND in the rats’ hippocampus. Neonatal HI increased caspase‐3 expression decreased synapsin expression and reduced H3K4me2, ‐me3 and H3K27me2, ‐me3 in the ipsilateral hippocampus. FA only prevented the augment in caspase‐3 expression. In conclusion, neonatal HI caused lasting effects on caspase‐3‐mediated cell death (prevented by the FA) and synaptic proteins in the rats’ hippocampus. This is the first study to show that histone modifications may contribute to these pathological findings in the hippocampus of HI animals.
Micro‐ and nano‐tomography analysis of mouse soleus muscle using radiation
Authors: Jang Sang‐Hun , Lee Jiwon , Lee Onseok 
Published: May 2021

AbstractIn this study, we analyze radiation images of muscle structure of mice soleus muscles using radiation source‐based microtomography and nanotomography. Soleus muscle samples were collected for analysis from 8‐week‐old male Institute of Cancer Research mice. First, phase‐contrast X‐ray microtomography was employed in these experiments. Then to obtain images with excellent contrast, imaging was performed using monochromatic light with excellent transmission power. To analyze additional muscle structures in higher magnification images than these images, nanotomography was performed, which facilitated obtaining high‐magnification and high‐resolution images. Muscle tissue microstructures were confirmed through three‐dimensional images obtained from phase‐contrast X‐ray microtomography. Thus, the muscle tissue's overall shape at microscopic level can be captured. Additionally, a single muscle fiber was examined using hard X‐ray nano‐imaging, through which we could observe the alignment of countless myofibrils, that is, actin and myosin filaments in the muscle fibers. Thus, the methodology adopted here proved to be advantageous in analyzing the muscle tissue's overall structure with microtomography and in observing the myofibrils in detail using nanotomography.
Circulating tumor DNA as a predictive marker for occult metastases in pancreatic cancer patients with radiographically non‐metastatic disease
Authors: Hata Tatsuo , Mizuma Masamichi , Iseki Masahiro , Takadate Tatsuyuki , Ishida Masaharu , Nakagawa Kei , Hayashi Hiroki , Morikawa Takanori , Motoi Fuyuhiko , Unno Michiaki 
Published: May 2021

AbstractPurposeTo elucidate the effectiveness of circulating tumor DNA (ctDNA) for predicting occult metastases in patients with pancreatic cancer without apparent metastases.MethodsCirculating tumor DNA was obtained from plasma samples of 165 patients with pancreatic cancer and analyzed using droplet digital PCR. The prevalence and allele frequencies of ctDNA were compared across different patterns and degrees of metastatic spread.ResultsOf the 142 patients without apparent metastases who underwent abdominal exploration, 39 (27.5%) harbored occult metastases including positive peritoneal lavage cytology. The prevalence of ctDNA was significantly higher in patients with occult metastases than in those without (41.0% vs 14.6%, P = .001). A markedly high prevalence of ctDNA was observed in patients with radiographically visible metastases (78.3%). ctDNA was found to be an independent predictor of the presence of occult metastases (odds ratio: 3.113, P = .039), and its diagnostic performance in combination with tumor markers had a sensitivity of 66.7% and a specificity of 81.6%. In 62 treatment‐naïve patients without metastases, multivariate analysis identified the presence of ctDNA as an independent prognostic factor (hazard ratio: 6.311, P = .001).ConclusionCirculating tumor DNA can help predict the presence of occult metastases in pancreatic cancer patients with radiographically non‐metastatic disease.
Clinical impact of recombinant thrombomodulin administration on disseminated intravascular coagulation due to severe acute cholangitis (Recover‐AC study)
Authors: Ogura Takeshi , Eguchi Takaaki , Nakahara Kazunari , Kanno Yoshihide , Omoto Shunsuke , Itonaga Masahiro , Kuroda Taira , Hakoda Akitoshi , Ikeoka Seitaro , Takagi Megumi , Okada Akihiko , Sato Junya , Morita Ryo , Michikawa Yousuke , Ito Kei , Koshita Shinsuke , Takenaka Mamoru , Kitano Masayuki , Koizumi Mitsuhito , Higuchi Kazuhide 
Published: May 2021

AbstractBackground and AimRecombinant thrombomodulin (rhTM) is potentially effective in the treatment of disseminated intravascular coagulation (DIC). Several studies related to drugs for the treatment of acute cholangitis have shown negative results in improvement of overall survival (OS) with rhTM. The aim of this multicenter study was to evaluate the clinical effectiveness of rhTM in patients with acute cholangitis and sepsis‐induced DIC who underwent biliary drainage.MethodsA total of 284 consecutive patients, who were complicated with sepsis‐induced DIC due to severe acute cholangitis, were included (rhTM group, n = 173; non‐rhTM, n = 111) in this study. The primary outcome was the DIC resolution rate at 7 days after starting treatment. The 28‐day survival rate was secondarily evaluated.ResultsDIC scores in the rhTM group improved significantly compared with the non‐rhTM group on day 7 (P = .020). According to multivariate analysis, etiology of cholangitis (malignant, HR 2.28), rhTM (non‐administration, HR 4.13), and DIC score (≥5, HR 2.46) were significant factors associated with failed DIC resolution on day 7. Propensity score matching created 103 matched pairs. Survival rate at day 28 was significantly higher in rhTM group (94.3%) compared with non‐rhTM group (82.6%; P = .048) after propensity score matching. rhTM (non‐administration, HR 2.870), DIC score (≥5, HR 2.751), and APACHE II score (≥20, HR 9.310) were significant factors associated with decreasing survival rate at day 28.ConclusionIn conclusion, rhTM seemed to improve patient survival, but future studies should only include patients with benign or malignant disease and should be performed according to APACHE II scores.
Ten‐year attrition and antiretroviral therapy response among HIV‐positive adults: a sex‐based cohort analysis from eight West African countries
Authors: Tiendrebeogo Thierry , Messou Eugène , Arikawa Shino , Ekouevi Didier K , Tanon Aristophane , Kwaghe Vivian , Balestre Eric , Zannou Marcel Djimon , Poda Armel , Dabis François , Jaquet Antoine , Minga Albert , Becquet Renaud ,   IeDEA West Africa Collaboration
Published: May 2021

AbstractIntroductionSex differences have already been reported in sub‐Saharan Africa for attrition and immunological response after antiretroviral therapy (ART) initiation, but follow‐up was usually limited to the first two to three years after ART initiation. We evaluated sex differences on the same outcomes in the 10 years following ART initiation in West African adults.MethodsWe used cohort data of patients included in the IeDEA West Africa collaboration, who initiated ART between 2002 and 2014. We modelled no‐follow‐up and 10‐year attrition risks, and immunological response by sex using logistic regression analysis, survival analysis with random effect and linear mixed models respectively.ResultsA total of 71,283 patients (65.8% women) contributed to 310,007 person‐years of follow‐up in 16 clinics in eight West African countries. The cumulative attrition incidence at 10‐year after ART initiation reached 75% and 68% for men and women respectively. Being male was associated with an increased risk of no follow‐up after starting ART (5.1% vs. 4.0%, adjusted Odds Ratio: 1.25 [95% CI: 1.15 to 1.35]) and of 10‐year attrition throughout the 10‐year period following ART initiation: adjusted Hazard Ratios were 1.22 [95% CI: 1.17 to 1.27], 1.08 [95% CI: 1.04 to 1.12] and 1.04 [95% CI: 1.01 to 1.08] during year 1, years 2 to 4 and 5 to 10 respectively. A better immunological response was achieved by women than men: monthly CD4 gain was 30.2 and 28.3 cells/mL in the first four months and 2.6 and 1.9 cells/μL thereafter. Ultimately, women reached the average threshold of 500 CD4 cells/μL in their sixth year of follow‐up, whereas men failed to reach it even at the end of the 10‐year follow‐up period. The proportion of patients reaching the threshold was much higher in women than in men after 10 years since ART initiation (65% vs. 44%).ConclusionsIn West Africa, attrition is unacceptably high in both sexes. Men are more vulnerable than women on both attrition and immunological response to ART in the 10 years following ART initiation. Innovative tracing strategies that are sex‐adapted are needed for patients in care to monitor attrition, detect early high‐risk groups so that they can stay in care with a durably controlled infection.
HIV treatment outcomes among people who acquired HIV via injecting drug use in the Asia‐Pacific region: a longitudinal cohort study
Authors: Han Win Min , Jiamsakul Awachana , Salleh Nur Afiqah Mohd , Choi Jun Yong , Huy Bui Vu , Yunihastuti Evy , Do Cuong Duy , Merati Tuti P , Gani Yasmin M , Kiertiburanakul Sasisopin , Zhang Fujie , Chan Yu‐Jiun , Lee Man‐Po , Chaiwarith Romanee , Ng Oon Tek , Khusuwan Suwimon , Ditangco Rossana , Kumarasamy Nagalingeswaran , Sangle Shashikala , Ross Jeremy , Avihingsanon Anchalee ,   TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiology Databases to Evaluate AIDS (IeDEA) Asia‐Pacific Group
Published: May 2021

AbstractINTRODUCTIONData on HIV treatment outcomes in people who inject drugs (PWID) in the Asia‐Pacific are sparse despite the high burden of drug use. We assessed immunological and virological responses, AIDS‐defining events and mortality among PWID receiving antiretroviral therapy (ART).METHODSWe investigated HIV treatment outcomes among people who acquired HIV via injecting drug use in the TREAT Asia HIV Observational Database (TAHOD) between January 2003 and March 2019. Trends in CD4 count and viral suppression (VS, HIV viral load <1000 copies/mL) were assessed. Factors associated with mean CD4 changes were analysed using repeated measures linear regression, and combined AIDS event and mortality were analysed using survival analysis.RESULTSOf 622 PWID from 12 countries in the Asia‐Pacific, 93% were male and the median age at ART initiation was 31 years (IQR, 28 to 34). The median pre‐ART CD4 count was 71 cells/µL. CD4 counts increased over time, with a mean difference of 401 (95% CI, 372 to 457) cells/µL at year‐10 (n = 78). Higher follow‐up HIV viral load and pre‐ART CD4 counts were associated with smaller increases in CD4 counts. Among 361 PWID with ≥1 viral load after six months on ART, proportions with VS were 82%, 88% and 93% at 2‐, 5‐ and 10‐years following ART initiation. There were 52 new AIDS‐defining events and 50 deaths during 3347 person‐years of follow‐up (PYS) (incidence 3.05/100 PYS, 95% CI, 2.51 to 3.70). Previous AIDS or TB diagnosis, lower current CD4 count and adherence <95% were associated with combined new AIDS‐defining event and death.CONCLUSIONSDespite improved outcomes over time, our findings highlight the need for rapid ART initiation and adherence support among PWID within Asian settings.
Timing of HIV diagnosis relative to pregnancy and postpartum HIV care continuum outcomes among Latin American women, 2000 to 2017
Authors: Yohannes Nathaniel T , Jenkins Cathy A , Clouse Kate , Cortés Claudia P , Mejía Cordero Fernando , Padgett Denis , Rouzier Vanessa , Friedman Ruth K , McGowan Catherine C , Shepherd Bryan E , Rebeiro Peter F 
Published: May 2021

AbstractBackgroundHIV incidence among women of reproductive age and vertical HIV transmission rates remain high in Latin America. We, therefore, quantified HIV care continuum barriers and outcomes among pregnant women living with HIV (WLWH) in Latin America.MethodsWLWH (aged ≥16 years) enrolling at Caribbean, Central and South America network for HIV epidemiology (CCASAnet) sites from 2000 to 2017 who had HIV diagnosis, pregnancy and delivery dates contributed. Logistic regression produced adjusted odds ratios (aOR) and 95% confidence intervals (CI) for retention in care (≥2 visits ≥3 months apart) and virological suppression (viral load <200 copies/mL) 12 months after pregnancy outcome. Cumulative incidences of loss to follow‐up (LTFU) postpartum were estimated using Cox regression. Evidence of HIV status at pregnancy confirmation was the exposure. Covariates included pregnancy outcome (born alive vs. others); AIDS diagnosis prior to delivery; CD4, age, HIV‐1 RNA and cART regimen at first delivery and CCASAnet country.ResultsAmong 579 WLWH, median postpartum follow‐up was 4.34 years (IQR 1.91, 7.35); 459 (79%) were HIV‐diagnosed before pregnancy confirmation, 445 (77%) retained in care and 259 (45%) virologically suppressed at 12 months of postpartum. Cumulative incidence of LTFU was 21% by 12 months and 40% by five years postpartum. Those HIV‐diagnosed during pregnancy had lower odds of retention (aOR = 0.58, 95% CI: 0.35 to 0.97) and virological suppression (aOR = 0.50, 95% CI: 0.31 to 0.82) versus those HIV‐diagnosed before.ConclusionHIV diagnosis during pregnancy was associated with poorer 12‐month retention and virological suppression. Young women should be tested and linked to HIV care earlier to narrow these disparities.
Using the adherence‐efficacy relationship of emtricitabine and tenofovir disoproxil fumarate to calculate background HIV incidence: a secondary analysis of a randomized, controlled trial
Authors: Glidden David V , Das Moupali , Dunn David T , Ebrahimi Ramin , Zhao Yongwu , Stirrup Oliver T , Baeten Jared M , Anderson Peter L 
Published: May 2021

AbstractIntroductionRandomized trials of new agents for HIV pre‐exposure prophylaxis (PrEP) compare against emtricitabine and tenofovir disoproxil fumarate (F/TDF), without a placebo group. We used the well‐characterized adherence‐efficacy relationship for F/TDF to back‐calculate the (non‐PrEP) counterfactual background HIV incidence (bHIV) in a randomized trial of a novel PrEP agent and estimate comparative efficacy (to counterfactual bHIV).MethodsThe DISCOVER trial (ClinicalTrials.gov: NCT02842086) randomized 5387 men who have sex with men (MSM) and transgender women who have sex with men and demonstrated non‐inferiority of emtricitabine and tenofovir alafenamide (F/TAF) to F/TDF (HIV incidence rate ratio [IRR] 0·47, 95% CI: 0·19 to 1.15). Tenofovir diphosphate (TFV‐DP) levels in dried blood spots (DBS) were assessed for all diagnosed with HIV and in a random 10% of the cohort. We used a Bayesian model with a diffuse prior distribution, derived from established data relating tenofovir diphosphate levels to HIV prevention efficacy. This prior, combined with the F/TDF seroconversion rate and tenofovir diphosphate levels in DISCOVER, yielded Bayesian inferences on the counterfactual bHIV.ResultsThere were six versus 11 postbaseline HIV infections (0.14 vs. 0.25/100 person‐years [PY]) on F/TAF and F/TDF respectively. Of the 11 on F/TDF, 10 had low, none had medium and one had high tenofovir diphosphate levels; among HIV‐negative controls, 5% of the person‐time years had low, 9% had medium and 86% had high TFV‐DP levels. A non‐informative prior distribution for counterfactual bHIV, combined with the prior for TFV‐DP level‐efficacy relationship, yielded a posterior counterfactual bHIV of 3·4 infections/100 PY (0.80 Bayesian credible interval [CrI] 1·9 to 5·9), which suggests a median HIV efficacy of 96% (0.95 CrI [88% to 99%]) for F/TAF and 93% (0.95 CrI [87% to 96%]) for F/TDF compared to bHIV.ConclusionsBased on the established connection of drug concentrations to PrEP prevention efficacy, a Bayesian framework can be used to estimate a synthetic non‐PrEP control group in randomized, active‐controlled PrEP trials that include a F/TDF‐comparator group.