bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emerging molecular mechanisms of vascular dementia
Authors: Romay Milagros C. , Toro Camilo , Iruela-Arispe M. Luisa 
Published: March 2019

Purpose of review
Microvascular ischemic disease of the brain is a common cause of cognitive impairment and dementia, particularly in the context of preexisting cardiovascular risk factors and aging. This review summarizes our current understanding of the emerging molecular themes that underlie progressive and irreparable vascular disease leading to neuronal tissue injury and dementia.

Recent findings
Cardiometabolic risk factors including diabetes and hypertension are known to contribute to vascular disease. Currently, the impact of these risk factors on the integrity and function of the brain vasculature has been target of intense investigation. Molecularly, the consequences associated with these risk factors indicate that reactive oxygen species are strong contributors to cerebrovascular dysfunction and injury. In addition, genetic linkage analyses have identified penetrant monogenic causes of vascular dementia. Finally, recent reports begun to uncover a large number of polymorphisms associated with a higher risk for cerebrovascular disease.

Summary
A comprehensive picture of key risk factors and genetic predispositions that contribute to brain microvascular disease and result in vascular dementia is starting to emerge. Understanding their relationships and cross-interactions will significantly aid in the development of preventive and intervention strategies for this devastating condition.
Effect of Cognitive Behavioral Therapy on Improving the Cognitive Function in Major and Minor Depression
Authors: He Hui-Li , Zhang Ming , Gu Chuan-Zheng , Xue Ran-Ran , Liu Hong-Xia , Gao Cai-Feng , Duan Hui-Feng 
Published: March 2019

Abstract
The aim of this study was to investigate the effectiveness of cognitive behavioral therapy (CBT) on improving the cognitive function in minor depression (MiD) and major depression (MaD). The study will constitute a placebo-controlled single-blind parallel-group randomized controlled trial. The selected participants will be randomly allocated into one of two parallel groups with a 1:1 ratio: the CBT-based group and the general health education group. CBT significantly alleviated depressive symptoms of MiD and MaD at 12 weeks (p < 0.001), and the treatment effect was maintained for at least 12 months (p < 0.001). Interestingly, CBT significantly promotes more cognitive function of MiD and partial cognitive function of MaD at 12 weeks in the intervention group than in the control group (p < 0.01). CBT can alleviate depressive symptoms of both minor and MaDs. The effectiveness of CBT is different on improving the cognitive function in MiD and MaD.
Military Veteran Status and Posttraumatic Stress Disorder Symptomatology Among Urban Firefighters
Authors: Bartlett Brooke A. , Gallagher Matthew W. , Tran Jana K. , Vujanovic Anka A. 
Published: March 2019

Abstract
A significant portion of firefighters are military veterans, and both populations experience high rates of trauma and posttraumatic stress disorder (PTSD) symptomatology. We investigated main and interactive effects of military veteran status (MVS) and emotion regulation difficulties (ERD) with regard to PTSD symptom severity in firefighters. Covariates included trauma load, number of years in the fire department, and depressive symptom severity. The sample was composed of 839 (93.9% men; mean age = 38.4, SD = 8.5) trauma-exposed firefighters who completed a web-based questionnaire battery. Structural equation modeling was used. ERD were significantly, positively associated with PTSD symptom severity (β = 0.30, confidence interval [CI] = 0.20–0.41, p < 0.001). A significant interactive effect was noted (β = 0.07, CI = 0.01–0.14, p = 0.020); firefighters who endorsed MVS and greater ERD had the highest levels of PTSD symptom severity. It is vital that future work examine associations between MVS and relevant cognitive mechanisms for the purposes of informing effective screening, intervention, and prevention programs.
Variables Impacting Program Completion of Readmitted Associate Degree Nursing Students
Authors: Dries Kelly J. 
Published: March 2019

Background
The projected shortfall in the number of RNs supports the need to identify variables impacting nursing student program completion. Studies are lacking as to variables that affect attrition and program completion of readmitted nursing students.

Purpose
This study examined academic and nonacademic variables that impact attrition and program completion of readmitted associate degree nursing students.

Methods
Survey and record review yielded student characteristics, support for learners, student effort, and student outcome measures that predicted attrition and program completion.

Results
Findings suggest that students earning a final grade of B+ or higher in the nursing fundamentals course complete the program. In addition, readmitted nursing students who were 33 years or older had decreased odds of completing the program by 1.44% for each year of age. The study also pointed to nonacademic variables that impacted attrition.

Conclusions
Measures to improve program completion of readmitted nursing students are included.
Performance of behavioral assays: the Rat Grimace Scale, burrowing activity and a composite behavior score to identify visceral pain in an acute and chronic colitis model
Authors: Leung Vivian S.Y. , Benoit-Biancamano Marie-Odile , Pang Daniel S.J. 
Published: March 2019

Abstract

Introduction:
The Rat Grimace Scale (RGS), a facial expression scale, quantifies the affective component of pain in rats. The RGS was developed to identify acute and inflammatory pain, and applicability in acute and chronic visceral pain is unknown. The dextran sulfate sodium (DSS) colitis model is commonly used in rats, but pain is rarely assessed, instead, disease progression is monitored with the Disease Activity Index (DAI; assessing fecal blood, stool consistency, and weight loss).

Objectives:
The aim of this study was to assess whether the RGS and 2 additional behavioral tools (composite behavior score [CBS] and burrowing) could identify pain in an acute and chronic DSS colitis model.

Methods:
Male and female Sprague-Dawley rats were block randomized to (1) acute colitis (4 days DSS in drinking water); (2) chronic colitis (4 days DSS, 7 days water, and 3 days DSS); or (3) control (14 days water). Disease Activity Index, RGS, CBS, and burrowing assessments were performed daily.

Results:
Rat Grimace Scale scores increased as DAI scores increased during both acute and chronic phases. Burrowing only decreased during the acute phase. By contrast, CBS scores did not increase significantly during either colitis phase.

Conclusions:
These data show that the RGS and burrowing did not decrease in a sustained manner during chronic phase visceral pain, and that variables assessed in the DAI are indicative of pain. This suggests that the RGS can be applied to a wider range of pain types and chronicity than originally suggested. These findings increase the application of the RGS as a pain scale and welfare improvement tool.
Brief Report: Response to Hepatitis A Virus Vaccine in HIV-Infected Patients Within a Retrospective, Multicentric Cohort: Facing Hepatitis A Outbreaks in the Clinical Practice
Authors: Neukam Karin , Delgado Fernández Marcial , Hernández Quero José , Rivero-Juárez Antonio , Llaves-Flores Silvia , Jiménez Oñate Francisco , Gutiérrez-Valencia Alicia , Espinosa Nuria , Viciana Pompeyo , López-Cortés Luis F. 
Published: March 2019

Background:
Various recent outbreaks of hepatitis A virus (HAV) have been described in men who have sex with men despite the availability of an effective vaccine. This study aimed to determine the current rates of seroconversion after receiving HAV vaccine (HAV-V) in HIV-infected patients under real-life conditions.

Setting:
Patients were selected from a Southern Spanish multicentric cohort of HIV-infected subjects.

Methods:
Retrospective analysis of all patients who received 2 doses (standard scheme) from April 2008 to May 2016 or from June 2016 to February 2018 facing an HAV outbreak with shortage of HAV-V, 1 single dose of HAV-V. Response to HAV-V was defined as positive anti-HAV IgG between 1 and 12 months after the last vaccination dose.

Results:
A total of 522 patients were included, mainly men who have sex with men (86.2%). In the standard-dose group, 303/343 [88.3%; 95% confidence interval (CI): 84.5 to 91.5] patients showed seroconversion as compared with 149/179 (83.2%; 95% CI: 76.9 to 88.4) of the single-dose group (P = 0.107). Undetectable baseline HIV-RNA (adjusted odds ratio: 4.86; 95% CI: 1.86 to 12.75; P = 0.001) and a CD4+ T-cell count ≥350/μL (adjusted odds ratio, 3.96; 95% CI: 1.26 to 12.49; P = 0.019) were independently associated with response to both regimens. A higher CD4/CD8+ ratio was also associated with response after a single dose.

Conclusions:
HIV-infected patients should be encouraged to undergo HAV-V with 2 standard doses 6 months apart; a single dose achieves a high rate of seroconversion in those patients with favorable response factors and may be enough to limit future outbreaks in case of HAV-V shortage until supply is reestablished.
Detecting Disengagement From HIV Care Before It Is Too Late: Development and Preliminary Validation of a Novel Index of Engagement in HIV Care
Authors: Johnson Mallory O. , Neilands Torsten B. , Koester Kimberly A. , Wood Troy , Sauceda John A. , Dilworth Samantha E. , Mugavero Michael J. , Crane Heidi M. , Fredericksen Rob J. , Mayer Kenneth H. , Mathews William C. , Moore Richard D. , Napravnik Sonia , Christopoulos Katerina A. 
Published: March 2019

Background:
Engagement in care is critical to achieving and sustaining optimal benefits of efficacious antiretroviral therapies for HIV infection. Current metrics of engagement in care, including problematic patterns of retention in care, adherence to treatment, and viral suppression, are often detected late in the disengagement process. We sought to develop and validate a patient-centered screener of engagement in care that can be used to identify deficits in patient perceptions of engagement before the development of poor outcomes, including loss to follow-up, treatment nonadherence, virologic failure, and the resulting increased likelihood of HIV-associated morbidity and mortality and onward transmission of HIV.

Setting and Methods:
Using input from patients, providers, and researchers through in-person focus groups and an online Delphi process, we developed a self-report measure of engagement in care that was validated with 3296 patients from 7 clinics across the United States.

Results:
Results supported a single dimension of engagement in care measured by 10 items. Lower scores on the HIV Index were related to higher depression and anxiety symptoms, greater use of alcohol and stimulants, and increased likelihood of reporting internalized HIV stigma. Higher Index scores were positively associated with self-report measures of antiretroviral therapy adherence, corroborative clinic records documenting appointment attendance, and increased likelihood of recent viral load suppression.

Conclusions:
The HIV Index offers promise as a patient-centered diagnostic and prognostic screener for engagement in care that can be used to trigger interventions to promote better clinical outcomes for persons living with HIV.
Predictors of Long-Term HIV Pre-exposure Prophylaxis Adherence After Study Participation in Men Who Have Sex With Men
Authors: Hoenigl Martin , Hassan Adiba , Moore David J. , Anderson Peter L. , Corado Katya , Dubé Michael P. , Ellorin Eric E. , Blumenthal Jill , Morris Sheldon R. ,   for the California Collaborative Treatment Group (CCTG) 601 Team
Published: March 2019

Background:
Efficacy of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men is well documented in randomized trials. After trial completion, participants are challenged with acquiring PrEP on their own and remaining adherent.

Methods:
This was a follow-up study of the TAPIR randomized controlled multicenter PrEP trial. Participants were contacted after their last TAPIR visit (ie, after study-provided PrEP was discontinued) to attend observational posttrial visits 24 and 48 weeks later. Adherence during TAPIR and posttrial visits was estimated by dried blood spot intracellular tenofovir diphosphate levels (adequate adherence defined as tenofovir diphosphate levels >719 fmol/punch). Binary logistic regression analysis assessed predictors of completing posttrial visits and PrEP adherence among participants completing ≥1 visit.

Results:
Of 395 TAPIR participants who were on PrEP as part of the TAPIR trial for a median of 597 days (range 3–757 days), 122 (31%) completed ≥1 posttrial visit (57% of University of California San Diego participants completed posttrial visits, whereas this was 13% or lower for other study sites). Among participants who completed ≥1 posttrial visit, 57% had adequate adherence posttrial. Significant predictors of adequate adherence posttrial were less problematic substance use, higher risk behavior, and adequate adherence in year 1 of TAPIR.

Conclusion:
More than half of PrEP users followed after trial completion had successfully acquired PrEP and showed adequate adherence. Additional adherence monitoring and intervention measures may be needed for those with low PrEP adherence and problematic substance use during the first year of trial.
Increasing Levels of Serum Heat Shock Protein 70 Precede the Development of AIDS-Defining Non-Hodgkin Lymphoma Among Carriers of HLA-B8-DR3
Authors: Aissani Brahim , Martinez-Maza Otoniel , Kaslow Richard A. , Wiener Howard W. , Bream Jay H. , Stosor Valentina , Martinson Jeremy J. , Jacobson Lisa P. , Shrestha Sadeep 
Published: March 2019

Background:We hypothesized that carriage of presumably high Hsp70-producing gene variants on a specific human major histocompatibility complex haplotype, the 8.1 ancestral haplotype (8.1AH), may predispose HIV-infected individuals to AIDS–non-Hodgkin lymphoma (NHL).Setting:We compared serum Hsp70 levels in the years preceding the diagnosis of AIDS-NHL in a matched case–control study (n = 151 pairs) nested in the Multicenter AIDS Cohort Study.Methods:We tested the impact of 8.1AH-specific single-nucleotide polymorphism (SNP) and joint SNP–human leukocyte antigen extended haplotypes previously associated with AIDS-NHL in the Multicenter AIDS Cohort Study on the circulating Hsp70 levels in mixed linear models.Results:We report elevated serum levels of Hsp70 in the 4 years preceding the diagnosis of AIDS-NHL in cases that carry 8.1AH, but not in noncarrier cases and not in carrier- or non–carrier-matched controls. The strongest predictor of higher serum Hsp70 was the haplotype A-G-A-C formed by SNPs rs537160(A) and rs1270942(G) in the complement factorCFBgene cluster, and rs2072633(A) and rs6467(C) in nearbyRDBPandCYP21A2located 70 Kb apart from the Hsp70 gene cluster. The association with A-G-A-C haplotype (beta = 0.718; standard error = 0.182;P= 0.0002) and with other 8.1AH-specific haplotypes including the high-producing tumor necrosis factor–alpha haplotype rs909253(G)–rs1800629(A) (beta = 0.308; standard error = 0.140;P= 0.032) were observed only with NHL identified as an AIDS-defining condition, but not as a post-AIDS condition, nor in combined AIDS and post-AIDS cases.Conclusion:Our combined genetic and functional approach suggests that the altered level of Hsp70 is a correlate of 8.1AH-mediated AIDS-NHL. Further investigation of the Hsp70 gene cluster and nearby loci that are tagged by A-G-A-C could better elucidate the genetic determinants of the malignancy.
Added Value of Ultra–low-dose Computed Tomography, Dose Equivalent to Chest X-Ray Radiography, for Diagnosing Chest Pathology
Authors: Kroft Lucia J.M. , van der Velden Levinia , Girón Irene Hernández , Roelofs Joost J.H. , de Roos Albert , Geleijns Jacob 
Published: March 2019

Purpose:
The purpose of this study was to assess the clinical value of ultra–low-dose computed tomography (ULDCT) compared with chest x-ray radiography (CXR) for diagnosing chest pathology.

Materials and Methods:
A total of 200 patients referred for CXR by outpatient clinics or general practitioners were enrolled prospectively. They underwent CXR (posteroanterior and lateral) and ULDCT (120 kV, 3 mAs) on the same day. In-room time and effective dose were recorded for each examination. Studies were categorized whether they were diagnostic or not, relevant radiologic diagnostic findings were reported, and confidence for diagnosis was recorded by a Likert scale. Differences in diagnostic confidence and effect on management decision were compared.

Results:
In-room time was <2 minutes for CXR and <3 minutes for ULDCT. Effective dose was 0.040 mSv for CXR and 0.071 mSv for ULDCT. CXR was considered diagnostic in 98% and ULDCT in 100%. The mean perceived confidence for diagnosis was 88±12% with CXR and 98±2% with ULDCT (P<0.0001), whereas discrepant findings between CXR and ULDCT were found in 101 of 200 patients. As compared with CXR, ULDCT had added value for management decisions in 40 of 200 patients.

Conclusions:
ULDCT provided added value to the radiologist by improved perceived confidence with a reduction in false-positive and false-negative CXR investigations that had management implications in 20% of patients. The effective dose of ULDCT will not be a limiting factor for introducing ULDCT of the chest on a broad scale in clinical practice.
What Do Plastic Surgery Patients Think of Financial Conflicts of Interest and the Sunshine Act?
Authors: Lopez Joseph , Naved Bilal A. , Pradeep Tejus , Pineault Kevin , Purvis Taylor , Macmillan Alexandra , Slezak Sheri , May James W. , Dorafshar Amir H. 
Published: March 2019

Background
The purpose of this study was to evaluate patients' views of conflicts of interest (COI) and their comprehension of recent legislation known as the Physician Payments Sunshine Act. This report constitutes the first evaluation of plastic surgery patients' views on COI and the government-mandated Sunshine Act.

Methods
This cross-sectional study invited patients at an academic, general plastic surgery outpatient clinic to complete an anonymous survey. The survey contained 25 questions that assessed respondents' perceptions of physician COI and awareness of the Sunshine Act. Analyses were performed to examine whether perspectives on COI and the Sunshine Act varied by level of education or age.

Results
A total of 361 individuals completed the survey (90% response rate). More than half of respondents with an opinion believed that COI would affect their physician's clinical decision-making (n = 152, 52.9%). Although almost three fourths (n = 196, 71.2%) believed that COI should be regulated and COI information reported to a government agency, the majority were not aware of the Sunshine Act before this survey (n = 277, 81.2%) and had never accessed the database (n = 327, 95.9%). More than half of patients (n = 161, 59.2%) stated that they would access a publicly available database with physicians' COI information. A larger proportion of older and educated patients believed that regulation of physicians' COI was important (P < 0.001).

Conclusions
Awareness of and access to plastic surgeon COI information is low among plastic surgery patients. Older and more educated patients believed that transparency regarding COI is important with regard to their clinical care.
Digital Pulley Reconstruction Using Pulley Allografts
Authors: Martinez Roberto A. , Liston Jared , Archual Anthony J. , Gui Jane , Drake David B. , DeGeorge Brent R. 
Published: March 2019

Background
The safety and feasibility of sterile, acellular pulley allografts in reconstruction has been previously demonstrated. Comparisons with tendon-based techniques for pulley reconstruction have not been reported. We hypothesized that the use of allograft pulleys would result in reduced procedural time and equivalent clinical outcomes as compared with traditional tendon-based reconstructive techniques.

Methods
All cases of pulley reconstruction using either allograft pulleys or tendon-based pulley reconstruction between November 2013 and November 2015 were reviewed. Patients who underwent concomitant procedures were excluded. Patient demographics, comorbidities, operative details (tourniquet and total operative times, number of pulleys repaired), postoperative complications (surgical site infection, reoperation, stiffness, and persistent pain), disability of the arm, shoulder and hand scores, and follow-up data were recorded. A P value of <0.05 was considered significant.

Results
Fifteen pulleys in 10 patients were reconstructed: 5 tendon-based and 5 with allograft. Average length of follow-up was 12.5 ± 2.9 months. There was no difference in patient demographic factors or comorbidities between groups. The most common indication for surgery was trauma. Four of 5 patients in the allograft group had multiple pulleys reconstructed versus 1 in the tendon-based group. One patient in the tendon-based group required reoperation versus 0 in the allograft group. Total operative and tourniquet times were significantly reduced in the allograft group (46 ± 5.5 vs 89 ± 12.9 minutes and 34 ± 6.8 vs 63 ± 5.3 minutes; P = 0.015 and 0.014). Postoperative disability of the arm, shoulder and hand scores were lower in the allograft group (56.8 vs 3.6, P = 0.11). There was no significant difference in postoperative range of motion between groups.

Conclusion
Pulley reconstruction with allograft is an efficient, technically feasible, reconstructive technique that adheres to the principle of replacing like with like, while eliminating donor site morbidity. Overall operative and tourniquet times were significantly shorter using allograft pulleys for pulley reconstruction.