bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urgent Pelvic Exenteration: Should the Indication Be Extended?
Authors: Thiptanakit Charnjiroj , Chowchankit Irin , Panya Sirinya , Kanjanasilp Prapon , Malakorn Songphol , Pattana-arun Jirawat , Sahakitrungruang Chucheep 
Published: April 2018

BACKGROUND:
Pelvic exenteration carries significant risks of morbidity and mortality. Preoperative management is therefore crucial, and the exenteration procedure is usually performed in an elective setting. In cases of rectal cancer, however, tumor-related complications may cause a patient’s condition to deteriorate rapidly, despite optimal management. Urgent pelvic exenteration then may be an option for these patients.

OBJECTIVE:
This study aims to compare the outcomes of pelvic exenteration between the urgent and elective settings.

DESIGN:
This is a retrospective study.

SETTING:
This study was conducted at King Chulalongkorn Memorial Hospital between February 2006 and June 2012.

PATIENTS:
Fifty-three patients with locally advanced rectal cancer were included.

INTERVENTION:
All patients underwent pelvic exenteration for locally advanced rectal cancer. They were assigned to urgent and elective setting groups according to their preoperative conditions. The urgent setting group included patients who required urgent pelvic exenteration because of intestinal obstruction, bowel perforation, bleeding, or uncontrolled sepsis, despite optimal management preoperatively.

MAIN OUTCOME MEASURES:
Twenty-six patients were classified in the urgent setting group, and 27 were classified in the elective setting group. Three-year overall and disease-free survivals were compared between the 2 groups. Thirty-day postoperative morbidity and mortality were also studied.

RESULTS:
Three-year overall survival was 62.2% and 54.4% in the elective and urgent groups (p = 0.7), whereas three-year disease-free survival was 43% and 63.8% (p = 0.33). The median follow-up time was 33 months. Thirty-day morbidity did not differ between the 2 groups (p = 0.49). A low serum albumin level was a significant risk factor for complications. There was no postoperative mortality in this study.

LIMITATIONS:
This was a retrospective study performed at 1 institution, and it lacked quality-of-life scores.

CONCLUSION:
Pelvic exenteration in an urgent setting is feasible and could offer acceptable outcomes. See Video Abstract at http://links.lww.com/DCR/A591.
Can Survival Bias Explain the Age Attenuation of Racial Inequalities in Stroke Incidence?
Authors: Mayeda Elizabeth Rose , Banack Hailey R. , Bibbins-Domingo Kirsten , Zeki Al Hazzouri Adina , Marden Jessica R. , Whitmer Rachel A. , Glymour M. Maria 
Published: April 2018

Background:In middle age, stroke incidence is higher among black than white Americans. For unknown reasons, this inequality decreases and reverses with age. We conducted simulations to evaluate whether selective survival could account for observed age patterning of black–white stroke inequalities.Methods:We simulated birth cohorts of 20,000 blacks and 20,000 whites with survival distributions based on US life tables for the 1919–1921 birth cohort. We generated stroke incidence rates for ages 45–94 years using Reasons for Geographic and Racial Disparities in Stroke (REGARDS) study rates for whites and setting the effect of black race on stroke to incidence rate difference (IRD) = 20/10,000 person-years at all ages, the inequality observed at younger ages in REGARDS. We compared observed age-specific stroke incidence across scenarios, varying effects ofU, representing unobserved factors influencing mortality and stroke risk.Results:Despite a constant adverse effect of black race on stroke risk, the observed black–white inequality in stroke incidence attenuated at older age. When the hazard ratio forUon stroke was 1.5 for both blacks and whites, butUonly directly influenced mortality for blacks (hazard ratio forUon mortality =1.5 for blacks; 1.0 for whites), stroke incidence rates in late life were lower among blacks (average observed IRD = −43/10,000 person-years at ages 85–94 years versus causal IRD = 20/10,000 person-years) and mirrored patterns observed in REGARDS.Conclusions:A relatively moderate unmeasured common cause of stroke and survival could fully account for observed age attenuation of racial inequalities in stroke.
DIFFERENCES IN REFRACTIVE OUTCOMES BETWEEN PHACOEMULSIFICATION FOR CATARACT ALONE AND COMBINED PHACOEMULSIFICATION AND VITRECTOMY FOR EPIRETINAL MEMBRANE
Authors: Shi Lynn , Chang Jonathan S. , Suh Leejee H. , Chang Stanley 
Published: April 2018

Purpose:
To determine whether preoperative adjustments are required for intraocular lens calculations in combined phacovitrectomy surgery.

Methods:
A single-center, retrospective study of 50 eyes that underwent combined phacovitrectomy and a control group of 50 eyes after cataract surgery over a 3-year period by a single anterior segment surgeon and a single posterior segment surgeon. Main outcome measures were predicted refractive error (RE), as determined by SRK/T and Holladay 1 formulas, change compared with actual RE, surgically induced astigmatism, and the relationships between preoperative central foveal thickness or change in central foveal thickness and final RE.

Results:
The differences in predicted and final RE between groups were not statistically significant between groups when both SRK/T and Holladay 1 formulas were used (P > 0.05). Regardless of the formula used, final RE was neither significantly hyperopic nor myopic as compared to the target. There was no difference in surgically induced astigmatism between the two groups. Increased preoperative central foveal thickness was correlated with greater difference between predicted and actual RE. No relationship was noted between change in central foveal thickness and RE.

Conclusion:
Combined phacovitrectomy for concurrent cataract epiretinal membrane by experienced cataract and vitreoretinal surgeons seems to deliver as predictable refractive results as cataract surgery alone.
EXPERIENCE WITH OCRIPLASMIN IN PATIENTS WITH VITREOMACULAR TRACTION SYNDROME: A RETROSPECTIVE STUDY OF 10 PATIENTS
Authors: Bormann Caroline , Apitzsch Bianca C. , Habermann Anke , Hammer Ute , Hammer Thomas 
Published: April 2018

Purpose:
To assess the efficacy of ocriplasmin in patients with vitreomacular traction (VMT) syndrome <1,500 μm with or without a full-thickness macular holes of <400 μm.

Methods:
In this study, a retrospective analysis of 10 eyes of 10 patients with VMT who were treated with ocriplasmin between December 2014 and January 2016 was performed. Ocriplasmin 0.125 mg was injected only once in all cases. Outcome measures included the detachment of VMT, best-corrected visual acuity, the evaluation of optical coherence tomography, including the closure of full-thickness macular holes, and the reduction of macular edema (if present) and the decrease of metamorphopsia if present.

Results:
Ten patients (7 women and 3 men) with an average age of 75.1 years (range, 63–84 years) were treated with ocriplasmin with a follow-up period of 8 weeks. All patients were treated for VMT syndrome, and 5 patients (50.0%) showed an additional macular hole. An absolute detachment of VMT was seen in 3 patients (30.0%) and partially in 4 patients (40.0%). In three of the five patients, a complete closure of the full-thickness macular holes was seen. The two other patients needed an additional pars plana vitrectomy as a result of the persistent macular hole. An improvement of visual acuity was seen in 6 out of 10 patients (60.0%), a reduction of macular edema in 8 out of 9 patients (88.9%), and a decrease of metamorphopsia in 6 out of 7 patients (85.7%).

Conclusion:
In this retrospective analysis, the treatment with ocriplasmin showed a resolution of VMT in 7 of 10 patients (70.0%) after a follow-up period of 8 weeks.
Use of Cerebrospinal Fluid (1,3)-β-d-Glucan to Monitor Treatment Response in Candida albicans Meningitis in an HIV-infected Patient
Authors: Moran Caitlin A. , Terry Charles , Nguyen Minh Ly T. , Sheth Anandi N. 
Published: April 2018

Abstract

Candida meningitis is rare in the setting of human immunodeficiency virus (HIV) infection and often presents a diagnostic challenge. Its clinical features typically mimic those of cryptococcal or tuberculous meningitis and Candida can be difficult to culture from cerebrospinal fluid. Furthermore, optimal treatment and monitoring parameters are not well defined. Cerebrospinal fluid levels of (1,3)-β-d-glucan, which is a component of the fungal cell wall, have been used to diagnose and monitor response to therapy in other cases of fungal meningitis, but its utility in the setting of Candida meningitis and HIV infection is less clear. Here, we present a case of spontaneous Candida albicans meningitis in a woman with advanced HIV infection and report on the clinical utility of cerebrospinal fluid (1,3)-β-d-glucan for diagnosis and monitoring of chronic infection.
Hamstring Muscle Injury Prediction by Isokinetic Ratios Depends on the Method Used
Authors: Dauty Marc , Menu Pierre , Fouasson-Chailloux Alban 
Published: April 2018

Objectives:
Hamstring muscle injury prediction by isokinetic strength ratios is low but could result from the method—depending either on the use of the limbs or of the sportsmen as references. We aimed to establish a predictive model including unilateral and bilateral ratios calculated from the dominant, nondominant, right, and left limb in injured and uninjured professional soccer players.

Design:
Cohort study.

Setting:
Soccer team of the French Professional Premier League.

Patients:
Ninety-one professional soccer players.

Interventions:
Isokinetic muscle strength was prospectively measured at the beginning of 5 consecutive seasons (2009-2014).

Main Outcome Measures:
Several bilateral, conventional, and functional ratios were calculated from isokinetic measurements at different angular speeds (60 and 240 degrees/s in concentric mode and 30 degrees/s in eccentric mode). Thirty-one soccer players had a hamstring injury during the seasons and were compared with 60 uninjured players. Four models were tested to predict the occurrence of hamstring injury from isokinetic ratios calculated in accordance with the dominant, nondominant, right, and left limb.

Results:
No predictive model was found when ratios were calculated from the dominant or the right limb. Two models of prediction were found when ratios were calculated from the nondominant or the left limb. In these 2 models, only the bilateral concentric hamstring-to-hamstring ratio at 60 degrees/s was predictive. The best prediction was found with the left limb.

Conclusions:
We identified 2 low predictive models for hamstring muscle injuries depending on the limbs studied. Because of a low prediction, the consensual method used to predict hamstring muscle injury must be defined in future studies.
Steps to Enhance Early Recovery After Hematopoietic Stem Cell Transplantation
Authors: Hacker Eileen Danaher , Peters Tara , Patel Pritesh , Rondelli Damiano 
Published: April 2018

Aims:
This pilot study tested and refined a free-living physical activity intervention. The investigators evaluated the acceptability and feasibility of the intervention after hematopoietic stem cell transplantation and determined preliminary effects on physical activity, fatigue, muscle strength, functional ability, and quality of life.

Design:
This pilot study used a 1-group, pretest-posttest design.

Methods:
The free-living physical activity intervention consisted of an education component and 6 weeks of gradually increasing physical activity after discharge from the hospital. The intervention was designed to increase steps by 10% weekly. Subjects were assessed before transplantation and during the seventh week after discharge from the hospital after completing the intervention. Pretest-posttest scores were analyzed with paired t tests.

Results:
Subject wore the physical activity tracker for an average of 38 of 42 days and met their physical activity goals 57% of the time. Subjects reported significantly less physical fatigue after the free-living physical activity intervention compared with baseline (P = .05). Improvements in quality of life approached significance (P = .06).

Conclusion:
The findings demonstrate that the free-living physical activity intervention implemented during the very early recovery period after transplantation is feasible and acceptable. The intervention potentially reduces fatigue and improves quality of life. The positive results must be interpreted cautiously given the pilot nature of the study. The evidence supports continued investigation.
Sexual Behaviors of Human Immunodeficiency Virus–Infected Pregnant Women and Factors Associated With Sexually Transmitted Infection in South Africa
Authors: Joseph Davey Dvora , Peters Remco P.H. , Kojima Noah , Mudau Maanda , De Vos Lindsey , Olivier Dawie , McIntyre James A. , Klausner Jeffrey D. , Medina-Marino Andrew 
Published: April 2018

Background
Sexual behaviors in human immunodeficiency virus (HIV)-infected pregnant women in South Africa are not well understood.

Methods
Human immunodeficiency virus–infected pregnant women were recruited into a prospective cohort at first antenatal care visit. Sociodemographic information and self-collected vulvovaginal swab samples were collected from participants. Vulvovaginal swab samples were tested for Chlamydia trachomatis, Neisseria gonorrhoea, and Trichomonas vaginalis using GeneXpert. We investigated sexual behaviors, alcohol use, factors associated with condomless sex during pregnancy, and prevalent sexually transmitted infection (STI) among our cohort. We report descriptive, univariate and multivariable logistic regression results of sexual behaviors and alcohol use, factors associated with condomless sex at last sex, and having any STI during pregnancy adjusting for a priori confounders.

Results
We recruited and enrolled 430 HIV-infected pregnant women. Median age was 30 years; median gestational age was 20 weeks. Eighty-nine percent of women reported sex during pregnancy. At last sex, 68% reported condomless sex; 18% reported having more than 1 sex partner in the past 12 months. Adjusting for age, income and relationship status, condom use at last sex was associated with prior knowledge of HIV status (adjusted odds ratio [aOR], 2.46; 95% confidence interval [CI], 1.54–3.92) and being in a concordant HIV-positive (aOR, 3.17; 95% CI, 1.84–5.50), or serodiscordant relationship (aOR, 6.50; 95% CI, 3.59–11.80). The prevalence of any STI was 41% (95% CI, 36%–45%). Adjusting for mothers' age and employment, odds of having an STI increased if the woman reported alcohol use during pregnancy (aOR, 1.96; 95% CI, 1.06–3.64) or if the father of the child was a non-cohabiting or casual partner (aOR, 1.42; 95% CI, 0.97–2.03).

Conclusions
Almost all HIV-infected pregnant women were sexually active during pregnancy and most women reported condomless sex at last sex. Condom use was associated with knowledge of serostatus and/or partner's serostatus before first antenatal care visit. Factors associated with having STIs included: alcohol use during pregnancy and father of child being a non-cohabiting partner.
Optimizing a Positive Psychology Intervention to Promote Health Behaviors After an Acute Coronary Syndrome: The Positive Emotions After Acute Coronary Events III (PEACE-III) Randomized Factorial Trial
Authors: Celano Christopher M. , Albanese Ariana M. , Millstein Rachel A. , Mastromauro Carol A. , Chung Wei-Jean , Campbell Kirsti A. , Legler Sean R. , Park Elyse R. , Healy Brian C. , Collins Linda M. , Januzzi James L. , Huffman Jeff C. 
Published: April 2018

ABSTRACT

Objective
Despite the clear benefits of physical activity and related behaviors on prognosis, most patients experiencing an acute coronary syndrome (ACS) remain nonadherent to these behaviors. Deficits in positive psychological constructs (e.g., optimism) are linked to reduced participation in health behaviors, supporting the potential utility of a positive psychology (PP)-based intervention in post-ACS patients. Accordingly, we aimed to identify optimal components of a PP-based intervention to promote post-ACS physical activity.

Methods
As part of a multiphase optimization strategy, we completed a randomized factorial trial with eight conditions in 128 post-ACS patients to efficiently identify best-performing intervention components. All participants received a PP-based intervention, with conditions varying in duration (presence/absence of booster sessions), intensity (weekly/daily PP exercises), and content (PP alone or combined with motivational interviewing), allowing three concurrent comparisons within the trial. The study aims included assessments of the overall feasibility, acceptability, and impact of the intervention, along with the primary aim of determining which components were associated with objectively measured physical activity and self-reported health behavior adherence at 16 weeks, assessed using longitudinal models.

Results
The intervention was well accepted and associated with substantial improvements in behavioral and psychological outcomes. Booster sessions were associated with greater activity to a nearly significant degree (β = 8.58, 95% confidence interval = −0.49–17.65, effect size difference = .43, p = .064), motivational interviewing was associated with overall adherence (β = 0.95, 95% confidence interval = 0.02–1.87, effect size difference = .39, p = .044), and weekly exercise completion was generally superior to daily.

Conclusions
These findings will enable optimization of the PP-based intervention in preparation for a well-powered controlled trial.

Clinical Trial Registration

Clinicaltrials.gov, NCT02754895.
HIV Infection Is Associated With Abnormal Bone Microarchitecture: Measurement of Trabecular Bone Score in the Women's Interagency HIV Study
Authors: Sharma Anjali , Ma Yifei , Tien Phyllis C. , Scherzer Rebecca , Anastos Kathryn , Cohen Mardge H. , Hans Didier , Yin Michael T. 
Published: April 2018

Objectives:
We compared skeletal microarchitecture using trabecular bone score (TBS) and evaluated relationships between change in TBS and lumbar spine (LS) bone mineral density (BMD) in women with and without HIV.

Methods:
Dual-energy X-ray absorptiometry was performed on 319 women with HIV and 118 without HIV in the Women's Interagency HIV Study at baseline and 2 and 5 years, to measure regional BMD and lean and fat mass. TBS was extracted from LS dual-energy X-ray absorptiometry images and examined continuously and categorically [normal (≥1.35), intermediate (1.20–1.35), or degraded (≤1.20) microarchitecture]. Pearson correlation and linear regression examined associations of TBS with regional BMD at baseline and over time.

Results:
Women with HIV were older (43 vs. 37 years), more likely to be postmenopausal (27% vs. 4%), have lower baseline total fat mass, trunk fat, and leg fat than uninfected women, degraded microarchitecture (27% vs. 9%, P = 0.001), and lower baseline mean TBS (1.3 ± 0.1 vs. 1.4 ± 0.1, P < 0.001). After adjusting for age, race, menopause status, and body mass index, TBS remained lower in women with HIV (P < 0.0001). Annual change in TBS correlated with LS BMD change among women with HIV (r = 0.36, P < 0.0001) and without HIV (r = 0.26, P = 0.02); however, mean % annual TBS change did not differ by HIV status (−1.0%/yr ± 2.9% for HIV+ vs. −0.8%/yr ± 1.7% for HIV−, P = 0.42).

Conclusions:
Women with HIV have worse bone microarchitecture than uninfected women, but annual percent change in LS BMD or TBS was similar. Use of TBS as an adjunct to BMD to improve prediction of fragility fractures in women with HIV merits further study.
Effect of Lactobacillus rhamnosus GG Supplementation on Intestinal Inflammation Assessed by PET/MRI Scans and Gut Microbiota Composition in HIV-Infected Individuals
Authors: Arnbjerg Caroline J. , Vestad Beate , Hov Johannes R. , Pedersen Karin K. , Jespersen Sofie , Johannesen Helle H. , Holm Kristian , Halvorsen Bente , Fallentin Eva , Hansen Adam E. , Lange Theis , Kjær Andreas , Trøseid Marius , Fischer Barbara M. , Nielsen Susanne D. 
Published: April 2018

Background:Alterations in the gut microbiome have been associated with inflammation and increased cardiovascular risk in HIV-infected individuals. The aim of this study was to investigate the effects of the probiotic strainLactobacillus rhamnosus GG(LGG) on intestinal inflammation, gut microbiota composition, and systemic markers of microbial translocation and inflammation in HIV-infected individuals.Methods:This prospective, clinical interventional trial included 45 individuals [15 combination antiretroviral treatment (cART) naive and 30 cART treated] who ingestedLGGtwice daily at a dosage of 6 × 109 colony-forming units per capsule for a period of 8 weeks. Intestinal inflammation was assessed using18F-2-fluoro-2-deoxy-D-glucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) scans in 15 individuals. Gut microbiota composition (V3–V4 region of the 16s rRNA gene) and markers of microbial translocation and inflammation (lipopolysaccharide, sCD14, sCD163, sCD25, high-sensitive CRP, IL-6, and tumor necrosis factor-alpha) were analyzed at baseline and after intervention.Results:At baseline, evidence of intestinal inflammation was found in 75% of the participants, with no significant differences between cART-naive and cART-treated individuals. AfterLGGsupplementation, a decrease in intestinal inflammation was detected on PET/MRI (−0.3 mean difference in the combined activity grade score from 6 regions,P= 0.006), along with a reduction of Enterobacteriaceae (P= 0.018) and Erysipelotrichaceae (P= 0.037) in the gut microbiome, with reduced Enterobacteriaceae among individuals with decreased18F-FDG uptake on PET/MRI (P= 0.048). No changes were observed for soluble markers of microbial translocation and inflammation.Conclusions:A decrease in intestinal inflammation was found in HIV-infected individuals after ingestion ofLGGalong with a reduced abundance of Enterobacteriaceae, which may explain the local anti-inflammatory effect in the gut.
Factors Associated With Initiation of Biologics in Patients With Axial Spondyloarthritis in an Urban Asian City
Authors: Png Wan Yu , Kwan Yu Heng , Lee Yi Xuan , Lim Ka Keat , Chew Eng Hui , Lui Nai Lee , Tan Chuen Seng , Thumboo Julian , Østbye Truls , Fong Warren 
Published: April 2018

Objective
The aim of this study was to examine if patients' sociodemographic, clinical characteristics, and patient-reported outcomes were associated with biologics initiation in patients with axial spondyloarthritis in Singapore.

Methods
Data from a dedicated registry from a tertiary referral center in Singapore from January 2011 to July 2016 were used. Initiation of first biologics was the main outcome of interest. Logistic regression analyses were used to explore the association of various factors on biologics initiation.

Results
Of 189 eligible patients (aged 37.7 ± 13.3 years; 76.2% were males), 30 (15.9 %) were started on biologics during follow-up. In the multivariable analysis model, age (odds ratio [OR]; 0.93; 95% confidence interval [CI], 0.89–0.98; p < 0.01), mental component summary score of Short-Form 36 Health Survey (OR, 0.18; 95% CI, 0.03–0.89; p = 0.04), erythrocyte sedimentation rate (OR, 1.02; 95% CI, 1.00–1.04; p = 0.02), presence of peptic ulcer disease (OR, 10.4; 95% CI, 2.21–48.8; p < 0.01), and lack of good response to nonsteroidal anti-inflammatory drugs (OR, 4.44; 95% CI, 1.63–12.1; p < 0.01) were found to be associated with biologics initiation.

Conclusions
Age, erythrocyte sedimentation rate, mental component summary score, comorbidities of peptic ulcer disease, and responsiveness to nonsteroidal anti-inflammatory drugs were associated with biologics initiation. It is essential that clinicians recognize these factors in order to optimize therapy.