bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlates of Rectal Douching Practices Among Men Who Have Sex With Men in Kenya
Authors: Saleska Jessica Londeree , Turner Abigail Norris , Syvertsen Jennifer , Nakhumwa Jesse , Soo Leonard , Ohaga Spala , Agot Kawango 
Published: June 2018

Background
Among men who have sex with men (MSM), rectal douching (RD) has been associated with increased prevalence of human immunodeficiency virus and other sexually transmitted infections. Substances commonly used for RD, especially water-based solutions, could disrupt the rectal epithelium and increase susceptibility to infection. The few existing reports on RD among MSM are primarily in middle- and high-income settings, and to date, no study has focused on RD among MSM in Africa.

Methods
We conducted a secondary data analysis of programmatic data from key population service centers in western Kenya. Data were extracted from records of clients who identified as MSM and accessed services between January 1, 2014, and September 1, 2016. We compared demographic and behavioral characteristics of men who did and did not practice RD. Logistic regression assessed associations with RD.

Results
Of the 202 MSM in this analysis, 63% engaged in RD. All who engaged in RD used water-based substances. Those who engaged in receptive anal intercourse in the last 3 months were more likely to report RD (odds ratio, 3.19; 95% confidence interval, 1.67–6.07). Among MSM who engaged in sex work, those who practiced RD reported more regular clients per week (2.8 clients vs. 1.3 clients, P = 0.01). Rectal douching practices did not vary by other sexual risk practices.

Conclusions
Rectal douching is common in this population of Kenyan MSM, especially among those who have recently engaged in receptive anal intercourse, suggesting that a rectal douche that delivers microbicides could be a potential intervention to reduce human immunodeficiency virus/sexually transmitted infection within this population.
Factors Associated With Mortality in Children Who Successfully Wean From Extracorporeal Membrane Oxygenation*
Authors: Howard Taylor S. , Kalish Brian T. , Rajagopal Satish K. , Williams Kathryn , Zalieckas Jill , Thiagarajan Ravi R. , Alexander Peta M. A. 
Published: June 2018

Objectives:
Extracorporeal membrane oxygenation is an established therapy for cardiac and respiratory failure unresponsive to usual care. Extracorporeal membrane oxygenation mortality remains high, with ongoing risk of death even after successful decannulation. We describe occurrence and factors associated with mortality in children weaned from extracorporeal membrane oxygenation.

Design:
Retrospective cohort study.

Setting:
Two hundred five extracorporeal membrane oxygenation centers reporting to the Extracorporeal Life Support Organization.

Subjects:
Eleven thousand ninety-six patients, less than 18 years, supported with extracorporeal membrane oxygenation during 2007–2013, who achieved organ recovery before decannulation.

Interventions:
None.

Measurements and Main Results:
Primary outcome was hospital mortality less than or equal to 30 days post extracorporeal membrane oxygenation decannulation. Among 11,096 patients, indication for extracorporeal membrane oxygenation cannulation was respiratory (6,206; 56%), cardiac (3,663; 33%), or cardiac arrest (extracorporeal cardiopulmonary resuscitation, 1,227; 11%); the majority were supported with venoarterial extracorporeal membrane oxygenation at some stage in their course (8,576 patients; 77%). Mortality was 13%. Factors associated with mortality included younger age (all < 1 yr categories compared with older, p < 0.05), lower weight among neonates (≤ 3 vs > 3 kg; p < 0.001), mode of extracorporeal membrane oxygenation support (venoarterial extracorporeal membrane oxygenation compared with venovenous extracorporeal membrane oxygenation, p < 0.001), longer admission to extracorporeal membrane oxygenation cannulation time (≥ 28 vs < 28 hr; p < 0.001), cardiac and extracorporeal cardiopulmonary resuscitation compared with respiratory extracorporeal membrane oxygenation (both p < 0.001), extracorporeal membrane oxygenation duration greater than or equal to 135 hours (p < 0.001), preextracorporeal membrane oxygenation hypoxemia (Po
2 ≤ 43 vs > 43 mm Hg; p < 0.001), preextracorporeal membrane oxygenation acidemia (p < 0.001), and extracorporeal membrane oxygenation complications, particularly cerebral or renal (both p < 0.001).

Conclusions:
Despite extracorporeal membrane oxygenation decannulation for organ recovery, 13% of patients die in hospital. Mortality is associated with patient factors, preextracorporeal membrane oxygenation illness severity, and extracorporeal membrane oxygenation management. Evidence-based strategies to optimize readiness for extracorporeal membrane oxygenation decannulation and postextracorporeal membrane oxygenation decannulation care are needed.
Chikungunya in Children
Authors: Ward Caleb E. , Chapman Jennifer I. 
Published: June 2018

Abstract
Chikungunya (CHIKV) is an emerging arboviral infection with recent spikes in transmission in the Americas. Chikungunya is most commonly transmitted by mosquitos, specifically Aedes aegypti and Aedes albopictus. These mosquitoes are found throughout many parts of the United States. The classic tetrad of symptoms for CHIKV is fever, symmetric polyarthralgia, maculopapular rash, and nonpurulent conjunctivitis. Although the majority (3 of 4) of infected people will be symptomatic, the viral illness generally runs a benign course. Nevertheless, when compared with infected adults, children more commonly have neurological and dermatological symptoms and are less likely to have arthralgia. The key differential diagnosis to consider is dengue, which has greater immediate morbidity and which can cause coinfection. Local health departments facilitate diagnostic testing, using either RNA polymerase chain reaction or antibody screening based on the timing of presentation. Management is supportive. The purpose of this review article is to provide readers basic knowledge regarding the microbiology, epidemiology, risk factors for transmission, and typical clinical presentation of CHIKV. A practical approach to diagnosis and management of infected children is provided.
Bridging the Gap: A 20-Year Experience with Vein Grafts for Free Flap Reconstruction. The Odds for Success
Authors: Inbal Amir , Silva Amanda K. , Humphries Laura S. , Teven Chad M. , Gottlieb Lawrence J. 
Published: June 2018

Background:
Successful free tissue transfer requires tension-free microvascular anastomosis. Vein grafts are used when this cannot be obtained, which increases microsurgical complexity and the chance of vessel thrombosis. Previous studies on vein grafts are limited to low numbers and selected techniques, making it difficult to draw conclusions.

Methods:
A retrospective chart review was performed for all patients who underwent vein grafts in free flap reconstruction from 1995 to 2015. Information on patient and flap characteristics, returns to the operating room, and flap loss was analyzed.

Results:
Seventy-two free flap reconstructions requiring 122 vein grafts were performed in the genitourinary/perineal (49 percent) and head and neck (38 percent) regions. The majority were performed in the initial operation (82 percent) and, of those, the majority were planned (71 percent). The most common vein graft types used were transposition arteriovenous loops (57 percent) and interpositions (26 percent). Of the initial cases, 22 percent returned to the operating room, resulting in a 7 percent total flap loss rate and a 7 percent partial flap loss rate. On univariate analysis, graft timing/planning, gap type, vein graft type, and reconstruction location were significantly associated with take-backs and flap loss. However, gap type and location seem to be strongly associated with graft timing/planning and vein graft type. Graft type and planning/timing do not have as strong a relationship and seem to independently relate to flap loss.

Conclusions:
Vein grafts are more successful when planned and when performing transpositions and arteriovenous loops over interpositions. These graft types should be considered over interpositions when possible.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Validity of 7-Joint Versus Simplified 12-Joint Ultrasonography Scoring Systems in Assessment of Rheumatoid Arthritis Activity
Authors: El-Gohary Rasmia M. , Ahmed Mahmoud Ayman Abdel-Monem , Khalil Adham , El-Gendy Hala , Gado Kamel Heshmat 
Published: June 2018

Introduction
Musculoskeletal ultrasonography (US) is an objective tool for the evaluation of disease activity in rheumatoid arthritis (RA) patients. There is no consensus on the exact number of joints that should be examined. Examination of reduced joint count is more practical than the comprehensive one.

Objectives
This is a cross-sectional study investigated the validity of a 7-joint US score (US7) in assessment of joint inflammation in RA patients compared with a simplified 12-joint US score (US12) and correlated both to composite disease activity indices.

Methods
The activity status of 50 RA patients was assessed clinically and ultrasonographically. The disease activity was calculated using 3 composite indices. Ultrasonography was performed by 1 blinded rheumatologist, using power Doppler (PD) and gray-scale (GS) US examination. The US7 and simplified US12 were performed as originally described. However, the GS synovitis and PD synovitis of US12 were computed in 2 separate scores instead of 1. Two sum US7 scores were added, sum (GS) US7 and sum (PD) US7 after summating synovitis and tenosynovitis scores. Ultrasonography interobserver/intraobserver reliability was evaluated on 40 stored images.

Results
Correlation coefficient between the different ultrasonographic scores showed no difference. The GS scores showed no correlation with disease activity parameters; however, the PD scores did. The sum (PD) US7 was the only score that showed significant correlation with the 3 different composite disease indices.

Conclusions
All studied US scores proved valid in assessment of disease activity status in RA. This is in favor of using the less-time-consuming US7 scores. The strongest correlation found with sum (PD) US7 confirmed the importance of incorporating the tendon in the disease activity assessment.
Effect of Uric Acid Control on Serum Creatinine
Authors: Yamamoto Ted , Xie John , Li Zhongze , Field Carey , Block Clay , Taylor Thomas 
Published: June 2018

Objective
Hyperuricemia has been epidemiologically associated with multiple comorbidities including chronic renal failure and cardiovascular disease. Cause and effect are difficult to address, given comorbidities associated with and prevalence of metabolic syndrome. One impediment to achieving serum uric acid (sUa) levels less than or equal to 6.0 mg/DL is the concept that allopurinol might be nephrotoxic. We examined the relation of sUa less than or equal to 6.0 mg/dL to renal function over time.

Methods
This is a medical records review study of 348 hyperuricemia patients identified in 2015, as having been followed with serial uric acid measurements. After 1 year of serial urate levels, to allow for treatment, patient cohorts were defined: sUa less than or equal to 6.0 mg/dL and sUa greater than 6.0 mg/dL. A repeated measure model was used to test for an association between uric acid level and serum creatinine, while adjusting for covariates.

Results
There was a significant difference in the least square means of serum creatinine comparing those who achieved an sUa less than or equal to 6.0 mg/dL versus sUa greater than 6.0 mg/dL (1.39 mg/dL [95% confidence interval, 1.30–1.48] vs 1.57 mg/dL [95% confidence interval, 1.46–1.69]; p = 0.0015). This is a between-group difference in creatinine of 0.18 mg/dL. If a change in serum creatinine of 0.2 is considered significant, this short-term between-group progression of renal failure approaches clinical significance.

Conclusions
Given that most serial measures were within the first few years of follow-up, and change in renal function occurs slowly over time, the between group difference of sUa of 0.18 mg/dL is close to a clinically significant creatinine difference of 0.2 mg/dL.
Quantifying the Effect of Transplanting Older Donor Livers Into Younger Recipients: The Need for Donor-recipient Age Matching
Authors: Bittermann Therese , Goldberg David S. 
Published: June 2018

Background
Increasing recipient and donor age are independently associated with survival after liver transplantation (LT). Whether donor age differentially impacts post-LT outcomes based on recipient age is unknown.

Methods
This was a retrospective cohort study using Organ Procurement and Transplantation Network data. All adult deceased-donor, single organ, primary LTs from 2002 to 2015 were included. Donor and recipient age were categorized as younger than 40 years, 40 to 59 years, and 60 years or older. Mixed-effects survival analysis evaluated the risk of graft failure and death according to the interaction of donor and recipient age categories.

Results
Of 63 628 LTs, 6.6% were in recipients younger than 40 years, of which 51.4% used an age-matched donor younger than 40 years. There was a significant among-center variability unrelated to United Network for Organ Sharing region in the use of older organs in young recipients, ranging from 0% to 25% or greater (overall center median, 9.7%; interquartile range, 5.4-16.5%). There was a significant interaction between donor and recipient age (P < 0.05) such that the impact of older donor age was more pronounced in younger recipients. Transplanting livers from donors aged 40 to 59 years and 60 years or older was associated with worse graft survival in recipients younger than 40 years, but there was no difference based on donor age in recipients 60 years or older.

Conclusions
There is a differential impact of using older donors in younger recipients than that in older recipients. Given their longer expected post-LT survival and the ethical imperative to maximize utilization of the scarce resource of transplantable livers, efforts should be made to allocate the highest-quality organs to those most likely to derive lasting benefit.
Measurement Characteristics of the Knowledge Assessment of Renal Transplantation
Authors: Peipert John D. , Hays Ron D. , Kawakita Satoru , Beaumont Jennifer L. , Waterman Amy D. 
Published: June 2018

Background.
Kidney transplant is the best treatment for most end-stage renal disease (ESRD) patients, but proportionally few ESRD patients receive kidney transplant. To make an informed choice about whether to pursue kidney transplant, patients must be knowledgeable of its risks and benefits. To reliably and validly measure ESRD patients’ kidney transplant knowledge, rigorously tested measures are required. This article describes the development and psychometric testing of the Knowledge Assessment of Renal Transplantation (KART).

Methods.
We administered 17 transplant knowledge items to a sample of 1294 ESRD patients. Item characteristics and scale scores were estimated using an Item Response Theory graded response model. Construct validity was tested by examining differences in scale scores between patients who had spent less than 1 and 1 hour or longer receiving various types of transplant education.

Results.
Item Response Theory modeling suggested that 15 items should be retained for the KART. This scale had a marginal reliability of 0.75 and evidenced acceptable reliability (>0.70) across most of its range. Construct validity was supported by the KART’s ability to distinguish patients who had spent less than 1 and 1 hour or longer receiving different types of kidney transplant education, including talking to doctors/medical staff (effect size [ES], 0.61; P < 0.001), reading brochures (ES, 0.45; P < 0.001), browsing the internet (ES, 0.56; P < 0.001), and watching videos (ES, 0.56; P < 0.001).

Conclusions.
The final 15-item KART can be used to determine the kidney transplant knowledge levels of ESRD patients and plan appropriate interventions to ensure informed transplant decision making occurs.
Comparison of Two Luminex Single-antigen Bead Flow Cytometry Assays for Detection of Donor-specific Antibodies After Renal Transplantation
Authors: Bertrand Dominique , Farce Fabienne , Laurent Charlotte , Hamelin Frédérique , François Arnaud , Guerrot Dominique , Etienne Isabelle , Hau Françoise 
Published: June 2018

Background.
Defining the clinical relevance of donor-specific HLA antibodies (DSA) detection by Luminex single-antigen (LSA) flow beads assay is critical in monitoring posttransplant outcome.

Methods.
Sera of kidney transplanted patients were tested by LSA1 and LSA2 with One Lambda Labscreen (test 1) and Immucor Lifecodes (test 2), at the time of a graft biopsy. The first group (G1, n = 50) had a biopsy highly suggestive of humoral rejection, and the second (G2, n = 50) had no criteria of rejection. Positivity criteria for DSA was mean fluorescence intensity greater than 500 for test 1, whereas specificity assignation respected the provider’s recommendations for test 2.

Results.
In G1, we identified at least 1 DSA in 44 patients with test 1, and in 39 patients with test 2. In G2, test 1 identified at least 1 DSA in 16 (32%) patients and test 2 in 7 (14%) patients. Sensitivity and specificity for antibody-mediated rejection diagnosis was 88% and 68%, respectively, with One Lambda, and 78% and 86%, respectively, with Immucor. Correlation and agreement were found in class I and II between intensity parameters of the 2 manufacturers. The use of the sum of the intensity of DSA improved the sensitivity and specificity of the 2 tests.

Conclusions.
We report the first comparative study of the 2 Luminex assays available for detecting DSA in the postkidney transplant setting. Although there is a good correlation and reliability between the 2 assays, significant differences exist. Positivity criteria for DSA determination differ and interpretation should take these specificities into account.
Neurofeedback helps to reveal a relationship between context reinstatement and memory retrieval
Authors: deBettencourt Megan T. , Turk-Browne Nicholas B. , Norman Kenneth A. 
Published: June 2018

AbstractTheories of mental context and memory posit that successful mental context reinstatement enables better retrieval of memories from the same context, at the expense of memories from other contexts. To test this hypothesis, we had participants study lists of words, interleaved with task-irrelevant images from one category (e.g., scenes). Following encoding, participants were cued to mentally reinstate the context associated with a particular list, by thinking about the images that had appeared between the words. We measured context reinstatement with fMRI, and related this to performance on a free recall test that followed immediately afterwards. To increase sensitivity, we used a closed-loop neurofeedback procedure, whereby higher levels of context reinstatement (measured neurally) elicited increased visibility of the images from the studied context onscreen. Our goal was to create a positive feedback loop that amplified small fluctuations in mental context reinstatement, making it easier to experimentally detect a relationship between context reinstatement and recall. As predicted, we found that higher levels of neural context reinstatement were associated with better recall of words from the reinstated context, and worse recall of words from a different context. In a second experiment, we assessed the role of neurofeedback in identifying this brain-behavior relationship by presenting context images again but manipulating whether their visibility depended on neural context reinstatement. When neurofeedback was removed, the relationship between context reinstatement and memory retrieval disappeared. Together, these findings demonstrate a clear effect of context reinstatement on memory recall and suggest that neurofeedback can be a useful tool for characterizing brain-behavior relationships.Abbreviated titleNeurofeedback context
Cheminformatics tools for analyzing and designing optimized small molecule libraries
Authors: Moret Nienke , Clark Nicholas A. , Hafner Marc , Wang Yuan , Lounkine Eugen , Medvedovic Mario , Wang Jinhua , Gray Nathanael , Jenkins Jeremy , Sorger Peter K. 
Published: June 2018

AbstractLibraries of highly annotated small molecules have many uses in chemical genetics, drug discovery and drug repurposing. Many such libraries have become available, but few data-driven approaches exist to compare these libraries and design new ones. In this paper, we describe such an approach that makes use of data on binding selectivity, target coverage and induced cellular phenotypes as well as chemical structure and stage of clinical development. We implement the approach asRsoftware and a Web-accessible tool (http://www.smallmoleculesuite.org) that uses incomplete and often confounded public data in combination with user preferences to score and create libraries. Analysis of six kinase inhibitor libraries using our approach reveals dramatic differences among them, leading us to design a newLSP-OptimalKinaselibrary that outperforms all previous collections in terms of target coverage and compact size. We also assemble a mechanism of action library that optimally covers 1852 targets of the liganded genome. Using our tools, individual research groups and companies can quickly analyze private compound collections and public libraries can be progressively improved using the latest data.
Chicken uric acid elimination via the uric acid transporters BCRP and MRP4 in the liver, kidneys, and intestines
Authors: Ding Xuedong , Li Manman , Qian Shoufa , Ma Yuying , Fang Tianyi , Li Xinlu , Liu Huan , Feng Shibin , Li Yu , Wang Xichun , Li Jinchun , Wu Jinjie 
Published: June 2018

AbstractBreast cancer resistance protein (BCRP) and multidrug resistance protein 4 (MRP4) are involved in uric acid excretion in humans and mice. Despite evidence suggesting that chicken renal proximal tubular epithelial cells participate in uric acid secretion, the roles of BCRP and MRP4 in chickens remain unclear. This study evaluated the relationship between chicken BCRP and MRP4 expression and renal function in the liver, kidneys, and intestines. Sixty 20-day-old Isa brown laying hens were randomly divided into four groups: a control group (NC) and groups provided with sulfonamide-treated drinking water (SD), a diet supplemented with fishmeal (FM), and an intraperitoneal injection of uric acid (IU). Serum uric acid, creatinine, and blood urea nitrogen (BUN) levels were significantly higher in the SD and IU groups than in the NC group. BCRP and MRP4 levels in the SD and IU groups were significantly increased in the kidneys and ileum and decreased in the liver. In the FM group, BCRP and MRP4 were significantly increased in the kidneys and slightly increased in the ileum. These results demonstrate that chicken BCRP and MRP4 are involved in renal and intestinal uric acid excretion. When renal function is impaired, serum uric acid increased and BCRP and MRP4 in the liver, kidneys, and ileum exhibit compensatory increases; when renal function is normal, serum uric acid changes have no effect on ileum BCRP and MRP4 expression. Therefore, this study may provide the references to the uric acid regulation in human.