bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiretroviral Adherence Level Necessary for HIV Viral Suppression Using Real-World Data
Authors: Byrd Kathy K. , Hou John G. , Hazen Ron , Kirkham Heather , Suzuki Sumihiro , Clay Patrick G. , Bush Tim , Camp Nasima M. , Weidle Paul J. , Delpino Ambrose ,   for the Patient-Centered HIV Care Model Team
Published: July 2019

Background:
A benchmark of near-perfect adherence (≥95%) to antiretroviral therapy (ART) is often cited as necessary for HIV viral suppression. However, given newer, more effective ART medications, the threshold for viral suppression may be lower. We estimated the minimum ART adherence level necessary to achieve viral suppression.

Settings:
The Patient-centered HIV Care Model demonstration project.

Methods:
Adherence to ART was calculated using the proportion of days covered measure for the 365-day period before each viral load test result, and grouped into 5 categories (<50%, 50% to <80%, 80% to <85%, 85% to <90%, and ≥90%). Binomial regression analyses were conducted to determine factors associated with viral suppression (HIV RNA <200 copies/mL); demographics, proportion of days covered category, and ART regimen type were explanatory variables. Generalized estimating equations with an exchangeable working correlation matrix accounted for correlation within subjects. In addition, probit regression models were used to estimate adherence levels required to achieve viral suppression in 90% of HIV viral load tests.

Results:
The adjusted odds of viral suppression did not differ between persons with an adherence level of 80% to <85% or 85% to <90% and those with an adherence level of ≥90%. In addition, the overall estimated adherence level necessary to achieve viral suppression in 90% of viral load tests was 82% and varied by regimen type; integrase inhibitor- and nonnucleoside reverse transcriptase inhibitor-based regimens achieved 90% viral suppression with adherence levels of 75% and 78%, respectively.

Conclusions:
The ART adherence level necessary to reach HIV viral suppression may be lower than previously thought and may be regimen-dependent.
Endonasal Endoscopic Management of Pterigopalatine Fossa Hydatid Cyst
Authors: Gökmen Muhammet Fatih , Beton Süha , Meço Cem 
Published: July 2019

Abstract
Hydatid cyst (echinococcosis) is an infectious disease caused mainly by Echinococcus granulosus, a parasite transmitted by dogs and encountered first in the liver and then in the lungs. Involvement in the head and neck region is uncommon, and pterygopalatine fossa disease resulting from hydatid cyst is extremely rare, with only 4 reported patients. In this report, the authors present a patient with exophthalmus caused by a primary hydatid cyst and involving the pterygopalatine fossa which treated only with endoscopic endonasal approach.
The Effect of Neuroscientists on the Studies of Autonomic Nervous System Dysfunction Following Experimental Subarachnoid Hemorrhage
Authors: Ozdemir Bulent , Kanat Ayhan , Ozdemir Vacide , Batcik Osman Ersegun , Yazar Ugur , Guvercin Ali Riza 
Published: July 2019

Objective:
The autonomic nervous system dysfunctions following subarachnoid hemorrhage (SAH) are common in neurosurgical clinical practice. The aim of the study is to investigate the effect of Asian neuroscientists on the studies of autonomic nervous system dysfunction following experimental subarachnoid hemorrhage.

Methods:
A systematic search was conducted using the MEDLINE and Web of Science databases for studies pertaining to SAH and autonomic nervous system dysfunction. The searched terms contained “experimental subarachnoid hemorrhage,” “autonomic nervous system,” and “Ganglion.”

Results:
There are many animal studies because the live human brain vessels cannot be used in investigations. The considerable efforts have been made to investigate the effect of SAH on the autonomic nervous system in laboratory animals. Seventy-four studies were published by various authors. Most of the articles came from Asian Countries 49 studies (66.2% of the total studies). The most preferred animals were rabbits (in 43 studies, 58.1% of the total studies).

Conclusion:
Asian neuroscientists published enormous contributions in SAH-related autonomic nervous system dysfunction. It was shown that there is a great interest of Asian neuroscientists for autonomic nervous system changes secondary to SAH.
An Unexpected Conjunctival Prolapse Following Frontalis Muscle Flap Transfer for Severe Ptosis
Authors: Wang Jia-Qi , Tang Zhong-Yuan , Yin Xia , Liu Hai-Peng , Zhang Duo 
Published: July 2019

Abstract
Conjunctival prolapse may occur following ocular, eyelid, and orbital surgeries. Conjunctival prolapse usually results as a complication of maximal levator resection or cosmetic lower eyelid blepharoplasty. Here, we describe conjunctival prolapse as an unexpected complication of frontalis muscle flap transfer for severe ptosis. On postoperative day 5, the patient experienced upper eyelid swelling after closing his eyes suddenly and standing up abruptly. The conjunctiva was reddish and ballooned up, and they protruded over the eyelids. Conjunctival prolapse persisted until postoperative day 8. The patient and surgeon were concerned that this complication would affect ptosis correction and surgical outcome. U-shaped fixations were placed to suture and force the prolapsed conjunctiva back to their normal anatomical positions. At postoperative 6 months, the patient had not experienced additional issues, and he was satisfied with the appearance of his eyes. This report describes a rare clinical case of conjunctival prolapse and provides a reference for surgeons treating similar complications.
Rectus Fascia Versus Fascia Lata for Autologous Fascial Pubovaginal Sling: A Single-Center Comparison of Perioperative and Functional Outcomes
Authors: Peng Michelle , Sussman Rachael D. , Escobar Christina , Palmerola Ricardo , Pape Dominique M. , Smilen Scott S. , Rosenblum Nirit , Brucker Benjamin M. , Peyronnet Benoit , Nitti Victor W. 
Published: July 2019

Objective
To compare perioperative and functional outcomes of autologous fascia lata versus rectus fascia pubovaginal sling in female patients with stress urinary incontinence (SUI).

Methods
The charts of all patients undergoing pubovaginal sling for SUI from 2012 to 2017 at a single center were retrospectively reviewed. Patients were divided into 2 groups: those with the sling harvested from the fascia lata (FL group) and those with the sling harvested from the rectus fascia (RF group).

Results
Between 2012 and 2017, 105 women underwent pubovaginal slings: 21 using FL and 84 using RF. Operative time did not differ significantly between the FL and RF groups (84 vs 81.9 minutes; P=0.68). Estimated blood loss was lower in the FL group (91.7 vs 141.6 mL; P=0.04). There were more wound complications in the RF group, although this was not statistically significant (0% vs 14.3%; P=0.12). Overall complications were comparable between FL and RF groups (52.4% vs 48.9%; P=0.81), but the proportion of Clavien grade 2 or greater were higher in the RF group (4.8% vs 20.2%; P=0.11). Overall, wound complications accounted for 29.3% of postoperative complications in the RF group (12/41). Functional outcomes were comparable between FL and RF groups, with similar rates of patients without SUI symptoms after 1 month (82.4% vs 76.4%; P=0.74), 1 year (55.6% vs 63.8%; P=0.76), and at the latest follow-up (66.7% vs 65.8%; P=0.87).

Conclusions
When compared with rectus fascia for pubovaginal sling, fascia lata may decrease perioperative morbidity, especially wound complications, without compromising functional outcomes.
Concomitant bladder and rectal injuries: Results from the American Association for the Surgery of Trauma Multicenter Rectal Injury Study Group
Authors: Osterberg E. Charles , Veith Jacob , Brown Carlos V. R. , Sharpe John P. , Musonza Tashinga , Holcomb John B. , Bui Eric , Bruns Brandon , Hopper H. Andrew , Truitt Michael , Burlew Clay Cothren , Schellenberg Morgan , Sava Jack , Van Horn Jon 
Published: July 2019

BACKGROUND
Combined traumatic injuries to the rectum and bladder are rare. We hypothesized that the combination of bladder and rectal injures would have worse outcomes than rectal injury alone.

METHODS
This is an American Association for the Surgery of Trauma multi-institutional retrospective study from 2004 to 2015 traumatic rectal injury patients who were admitted to one of 22 participating centers. Demographics, mechanism, and management of rectal injury were collected. Patients who sustained a rectal injury alone were compared with patients who sustained a combined injury to the bladder and rectum. Multivariable logistic regression was used to determine if abdominal complications, mortality, and length of stay were impacted by a concomitant bladder injury after adjusting for cofounders.

RESULTS
There were 424 patients who sustained a traumatic rectal injury, of which 117 (28%) had a combined injury to the bladder. When comparing the patients with a combined bladder/rectal injury to the rectal alone group, there was no difference in admission demographics admission physiology, or Injury Severity Score. There were also no differences in management of the rectal injury and no difference in abdominal complications (13% vs. 16%, p = 0.38), mortality (3% vs. 2%, p = 0.68), or length of stay (17 days vs. 21 days, p = 0.10). When looking at only the 117 patients with a combined injury, the addition of a colostomy did not significantly decrease the rate of abdominal complications (14% vs. 8%, p = 0.42), mortality (3% vs. 0%, p = 0.99), or length of stay (17 days vs. 17 days, p = 0.94). After adjusting for cofounders (AAST rectal injury grade, sex, damage-control surgery, diverting colostomy, and length of stay) the presence of a bladder injury did not impact outcomes.

CONCLUSION
For patients with traumatic rectal injury, a concomitant bladder injury does not increase the rates of abdominal complications, mortality, or length of stay. Furthermore, the addition of a diverting colostomy for management of traumatic bladder and rectal injury does not change outcomes.

LEVEL OF EVIDENCE
Level IV; prognostic/therapeutic.
Efficacy and Safety of a Weight-based Dosing Regimen of Valganciclovir for Cytomegalovirus Prophylaxis in Pediatric Solid-organ Transplant Recipients
Authors: Pappo Adi , Peled Orit , Berkovitch Matitiahu , Bilavsky Efraim , Rom Eran , Amir Jacob , Krause Irit , Yarden-Bilavsky Havatzelet , Scheuerman Oded , Ashkenazi-Hoffnung Liat 
Published: July 2019

Background.
Valganciclovir has been widely used for cytomegalovirus (CMV) prophylaxis in solid-organ transplant recipients. However, the optimal dosing protocol and target exposure in children are still unclear. Specific data as to the efficacy and safety of low-dose/low-exposure regimens are lacking and urgently needed.

Methods.
During 2010 to 2015, the clinical efficacy and safety of a weight-based regimen of valganciclovir of 17 mg/kg/day, with a stratified dose reduction for impaired creatinine clearance, given as a CMV prophylaxis for 3 to 6 months, was retrospectively evaluated among pediatric kidney and liver transplant recipients, 12 months posttransplantation. Incidence of CMV infection was assessed by periodic measurements of viral load; adverse events were evaluated.

Results.
Eighty-three children who had undergone 86 transplantations and were treated with 17 mg/kg of valganciclovir were included. Median age was 9.77 years (range, 0.6 to 18.9). Twelve (14%) developed CMV infection: 1 during prophylaxis and 11 during follow-up. These events comprised 6 cases of asymptomatic viremia and 6 cases of a clinically significant disease without occurrences of tissue-invasive disease. Treatment-related adverse effects occurred in 7 patients (8%), mostly hematological, resulting in premature drug cessation.

Conclusions.
Our results support the use of 17 mg/kg of valganciclovir for CMV prophylaxis in liver and kidney transplanted children as it showed satisfactory long-term efficacy and a good safety profile.
Lung Density Analysis Using Quantitative Chest CT for Early Prediction of Chronic Lung Allograft Dysfunction
Authors: Horie Miho , Levy Liran , Houbois Christian , Salazar Pascal , Saito Tomohito , Pakkal Mini , O'Brien Ciara , Sajja Shailaja , Brock Kristy , Yasufuku Kazuhiro , Keshavjee Shaf , Paul Narinder , Martinu Tereza 
Published: July 2019

Background.
Chronic lung allograft dysfunction (CLAD) limits long-term survival after lung transplantation (LTx). Early detection or prediction of CLAD can lead to changes in patient management that, in turn, may improve prognosis. The purpose of this study was to investigate the utility of quantitative computed tomography (CT) lung density analysis in early prediction of CLAD.

Methods.
This retrospective cohort was drawn from all consecutive adult, first LTxs performed between 2006 and 2011. Post-transplant monitoring included scheduled surveillance bronchoscopies with concurrent pulmonary-functions tests and low-dose chest CT. Quantitative density metrics (QDM) derived from CT scans obtained at the time of 10%–19% decline in forced expiratory volume in 1 second (FEV1) were evaluated: 114 bilateral LTx recipients (66 with CLAD and 48 stable) and 23 single LTx recipients (11 with CLAD, 12 stable) were included in the analysis.

Results.
In both single and double LTx, at the time of 10%–19% drop in FEV1 from baseline, the QDM was higher in patients who developed CLAD within 3 years compared with those patients who remained stable for at least 3.5 years. The area under the receiver operating characteristic curve (AUC) was 0.89 for predicting CLAD in single LTx and 0.63 in bilateral LTx. A multipredictor AUC accounting for FEV1, QDM, presence of consolidation, and ground glass opacities increased the AUC to 0.74 in double LTx.

Conclusions.
QDM derived from a CT histogram at the time of early drop in FEV1 may allow prediction of CLAD in patients after single or double LTx.
Differential Regulation of T-cell Immunity and Tolerance by Stromal Laminin Expressed in the Lymph Node
Authors: Simon Thomas , Li Lushen , Wagner Chelsea , Zhang Tianshu , Saxena Vikas , Brinkman C. Colin , Tostanoski Lisa H. , Ostrand-Rosenberg Suzanne , Jewell Chris , Shea-Donohue Terez , Hippen Keli , Blazar Bruce , Abdi Reza , Bromberg Jonathan S. 
Published: July 2019

Background.
Stromal laminins α4 and α5 are differentially regulated in transplant tolerance and immunity, respectively, resulting in altered T-cell trafficking. We hypothesized that laminins directly regulated T-cell activation and polarization.

Methods.
Human and mouse CD4 T cells were activated in Th1, Th2, Th17, or regulatory T cell (Treg) environments with/without laminin α4 and/or α5. Laminin α5 receptors were blocked with anti-α6 integrin or anti-α-dystroglycan (αDG) monoclonal antibodies, and T-cell polarization was determined. T-cell receptor transgenic TEa CD4 cells that recognized donor alloantigen were transferred into C57BL/6 mice that received alloantigen or cardiac allografts. Laminin receptors were blocked, and TEa T-cell migration and differentiation were assessed. Laminin expression was measured in several models of immunity and tolerance.

Results.
In diverse models, laminins α4 and α5 were differentially regulated. Immunity was associated with decreased laminin α4:α5 ratio, while tolerance was associated with an increased ratio. Laminin α4 inhibited CD4+ T-cell proliferation and Th1, Th2, and Th17 polarization but favored Treg induction. Laminin α5 favored T-cell activation and Th1, Th2, and Th17 polarization and inhibited Treg. Laminin α5 was recognized by T cell integrin α6 and is important for activation and inhibition of Treg. Laminin α5 was also recognized by T cell α-DG and required for Th17 differentiation. Anti-α6 integrin or anti-DG prolonged allograft survival.

Conclusions.
Laminins α4 and α5 are coinhibitory and costimulatory ligands for human and mouse CD4 T cells, respectively. Laminins and their receptors modulate immune responses by acting as one of the molecular switches for immunity or suppression.
Perceptions and Practices Regarding Frailty in Kidney Transplantation: Results of a National Survey
Authors: McAdams-DeMarco Mara A. , Van Pilsum Rasmussen Sarah E. , Chu Nadia M. , Agoons Dayawa , Parsons Ronald F. , Alhamad Tarek , Johansen Kirsten L. , Tullius Stefan G. , Lynch Raymond , Harhay Meera N. , Rao Maya K. , Berger Joseph , Cooper Matthew , Tan Jane C. , Cheng XingXing S. , Woodside Kenneth J. , Parajuli Sandesh , Lentine Krista L. , Kaplan Bruce , Segev Dorry L. , Kobashigawa Jon A. , Dadhania Darshana 
Published: July 2019

Background.
Given the potential utility of frailty, a clinical phenotype of decreased physiologic reserve and resistance to stressors, to predict postkidney transplant (KT) outcomes, we sought to understand the perceptions and practices regarding frailty measurement in US KT programs.

Methods.
Surveys were emailed to American Society of Transplantation Kidney/Pancreas Community of Practice members and 202 US transplant programs (November 2017 to April 2018). Program characteristics were gleaned from Scientific Registry of Transplant Recipients.

Results.
The 133 responding programs (response rate = 66%) represented 77% of adult KTs and 79% of adult KT candidates in the United States. Respondents considered frailty to be a useful concept in evaluating candidacy (99%) and endorsed a need to develop a frailty measurement specific to KT (92%). Frailty measurement was more common during candidacy evaluation (69%) than during KT admission (28%). Of the 202 programs, 38% performed frailty assessments in all candidates while 23% performed assessments only for older candidates. There was heterogeneity in the frailty assessment method; 18 different tools were utilized to measure frailty. The most common tool was a timed walk test (19%); 67% reported performing >1 tool. Among programs that measure frailty, 53% reported being less likely to list frail patients for KT.

Conclusions.
Among US KT programs, frailty is recognized as a clinically relevant construct and is commonly measured at evaluation. However, there is considerable heterogeneity in the tools used to measure frailty. Efforts to identify optimal measurement of frailty using either an existing or a novel tool and subsequent standardization of its measurement and application across KT programs should be considered.
Metagenomic identification of severe pneumonia pathogens with rapid Nanopore sequencing in mechanically-ventilated patients
Authors: Yang Libing , Haidar Ghady , Zia Haris , Nettles Rachel , Qin Shulin , Wang Xiaohong , Shah Faraaz , Rapport Sarah F. , Charalampous Themoula , Methé Barbara , Fitch Adam , Alison Morris MS , McVerry Bryan J. , O’Grady Justin , D. Kitsios Georgios 
Published: July 2019

AbstractBackgroundMetagenomic sequencing of respiratory microbial communities for etiologic pathogen identification in pneumonia may help overcome the limitations of current culture-based methods. We examined the feasibility and clinical validity of rapid-turnaround metagenomics with Nanopore™ sequencing of respiratory samples for severe pneumonia diagnosis.Methods and FindingsWe conducted a case-control study of mechanically-ventilated patients with pneumonia (nine culture-positive and five culture-negative) and without pneumonia (eight controls). We collected endotracheal aspirate samples (ETAs) and applied a microbial DNA enrichment method prior to performing metagenomic sequencing with the Oxford Nanopore MinION device. We compared Nanopore results against clinical microbiologic cultures and bacterial 16S rRNA gene sequencing. In nine culture-positive cases, Nanopore revealed communities with low alpha diversity and high abundance of the bacterial (n=8) or fungal (n=1) species isolated by clinical cultures. In four culture-positive cases with resistant organisms, Nanopore detected antibiotic resistance genes corresponding to the phenotypic resistance identified by clinical antibiograms. In culture-negative pneumonia, Nanopore revealed probable bacterial pathogens in 1/5 cases and airway colonization by Candida species in 3/5 cases. In controls, Nanopore showed high abundance of oral bacteria in 5/8 subjects, and identified colonizing respiratory pathogens in the three other subjects. Nanopore and 16S sequencing showed excellent concordance for the most abundant bacterial taxa.ConclusionWe demonstrated technical feasibility and proof-of-concept clinical validity of Nanopore metagenomics for severe pneumonia diagnosis, with striking concordance with positive microbiologic cultures and clinically actionable information offered from the sequencing profiles of culture-negative samples. Prospective studies with real-time metagenomics are warranted to examine the impact on antimicrobial decision-making and clinical outcomes.
Genomic Retargeting of Tumor Suppressors p53 and CTCF Promotes Oncogenesis
Authors: Schwartz Michal , Portugez Avital Sarusi , Attia Bracha Zukerman , Tannenbaum Miriam , Loza Olga , Chase Aliza , Turman Yousef , Kaplan Tommy , Salah Zaidoun , Hakim Ofir 
Published: July 2019

AbstractGene transcription is substantially regulated by distant regulatory elements via combinatorial binding of transcription factors. It is more and more recognized that alterations in chromatin state and transcription factor binding in these distant regulatory elements may have key roles in cancer development. Here we focused on the first stages of oncogene induced carcinogenic transformation, and characterized the regulatory network underlying transcriptional reprogramming associated with this process. Using Hi-C data, we couple between differentially expressed genes and their differentially active regulatory elements and reveal two candidate transcription factors, p53 and CTCF, as major determinants of transcriptional reprogramming at early stages of HRas-induced transformation. Strikingly, the malignant transcriptional reprograming is promoted by redistribution of chromatin binding of these factors without major variation in their expression level. Our results demonstrate that alterations in the regulatory landscape have a major role in driving oncogene-induced transcriptional reprogramming.
Reaching around obstacles accounts for uncertainty in coordinate transformations
Authors: Abedi Khoozani Parisa , Voudouris Dimitris , Blohm Gunnar , Fiehler Katja 
Published: July 2019

AbstractWhen reaching to a visual target, humans need to transform the spatial target representation into the coordinate system of their moving arm. It has been shown that increased uncertainty in such coordinate transformations, for instance when the head is rolled toward one shoulder, leads to higher movement variability and influence movement decisions. However, it is unknown whether the brain incorporates such added variability in planning and executing movements. We designed an obstacle avoidance task in which participants had to reach with or without visual feedback of the hand to a visual target while avoiding collisions with an obstacle. We varied coordinate transformation uncertainty by varying head roll (straight, 30° clockwise and 30° counterclockwise). In agreement with previous studies, we observed that the reaching variability increased when the head was tilted. Indeed, head roll did not influence the number of collisions during reaching compared to the head straight condition, but it did systematically change the obstacle avoidance behavior. Participants changed the preferred direction of passing the obstacle and increased the safety margins indicated by stronger movement curvature. These results suggest that the brain takes the added movement variability during head roll into account and compensates for it by adjusting the reaching trajectories.