bluuebunny/crossref_metadata_2025_split huggingface dataset:
Costs of Expanded Rapid HIV Testing in Four Emergency Departments
Authors: Schackman Bruce R. , Eggman Ashley A. , Leff Jared A. , Braunlin Megan , Felsen Uriel R. , Fitzpatrick Lisa , Telzak Edward E. , El-Sadr Wafaa , Branson Bernard M. 
Published: June 2016

Objective. The HIV Prevention Trials Network (HPTN) 065 trial sought to expand HIV screening of emergency department (ED) patients in Bronx, New York, and Washington, D.C. This study assessed the testing costs associated with different expansion processes and compared them with costs of a hypothetical optimized process. Methods. Micro-costing studies were conducted in two participating EDs in each city that switched from point-of-care (POC) to rapid-result laboratory testing. In three EDs, laboratory HIV testing was only conducted for patients having blood drawn for clinical reasons; in the other ED, all HIV testing was conducted with laboratory testing. Costs were estimated through direct observation and interviews to document process flows, time estimates, and labor and materials costs. A hypothetical optimized process flow used minimum time estimates for each process step. National wage and fringe rates and local reagent costs were used to determine the average cost (excluding overhead) per completed nonreactive and reactive test in 2013 U.S. dollars. Results. Laboratory HIV testing costs in the EDs ranged from $17.00 to $23.83 per completed nonreactive test, and POC testing costs ranged from $17.64 to $37.60; cost per completed reactive test ranged from $89.29 to $123.17. Costs of hypothetical optimized HIV testing with automated process steps were approximately 45% lower for nonreactive tests and 20% lower for reactive tests. The cost per ED visit to conduct expanded HIV testing in each hospital ranged from $1.21 to $3.96. Conclusion. An optimized process could achieve additional cost savings but would require an investment in electronic system interfaces to further automate testing processes.
Expanded HIV Testing and Linkage to Care: Conventional vs. Point-of-Care Testing and Assignment of Patient Notification and Linkage to Care to an HIV Care Program
Authors: Bares Sara , Eavou Rebecca , Bertozzi-Villa Clara , Taylor Michelle , Hyland Heather , McFadden Rachel , Shah Sachin , Pho Mai T. , Walter James , Badlani Sameer , Schneider John , Prachand Nik , Benbow Nanette , Pitrak David 
Published: June 2016

Objective. The University of Chicago Medicine (UCM) led the Expanded Testing and Linkage to Care (X-TLC) program for disproportionately affected populations on the South Side of Chicago. The X-TLC program aimed to expand routine HIV testing to high-prevalence communities with disproportionately affected populations (i.e., minority men and women, men who have sex with men, and intravenous drug users) according to CDC guidelines at multiple clinical sites. Methods. The X-TLC program used standard blood-based laboratory testing vs. point-of-care rapid testing or rapid laboratory testing with point-of-care results notification. Site coordinators and the linkage-to-care coordinator at UCM oversaw testing, test notification, and linkage to care. Results. From February 1, 2011, through December 31, 2013, the X-TLC program completed 75,345 HIV tests on 67,153 unique patients. Of the total tests, 48,044 (63.8%) were performed on patients who self-identified as African American and 6,606 (8.8%) were performed on patients who self-identified as Hispanic. Of the 67,153 patients tested, 395 (0.6%) tested positive and 176 (0.3%) were previously unaware of their HIV-positive status. Seroprevalence was even higher for EDs, where 127 of 12,957 patients tested positive for HIV (1.0% seroprevalence), than for other patient care sites, including for new diagnoses, where 50 of 12,957 patients tested positive for HIV (0.4% seroprevalence). Of the 176 newly diagnosed patients, 166 of 173 (96.0%) patients who were still alive when testing was complete received their test results, and 148 of the 166 patients who were eligible for care (89.0%) were linked to care. Patients linked to X-TLC physicians did well with respect to the continuum of care: 77 of 123 (62.6%) patients achieved HIV viral load of <200 copies/milliliter. Conclusion. Lead organizations such as UCM were able to assist and oversee HIV screening and linkage to care for HIV patients diagnosed at community sites. HIV screening and linkage to care can be accomplished by incorporating standard testing for HIV into routine medical care.
Implementing Routine HIV Screening in Three Chicago Hospitals: Lessons Learned
Authors: Rucker Monique Glover , Eavou Rebecca , Allgood Kristi L. , Sinclair Donna , Lawal Rukiyat , Tobin Audra , Pitrak David , Glick Nancy R. 
Published: June 2016

Objective. This study describes routine HIV screening implementation and outcomes in three hospitals in Chicago, Illinois. Methods. Retrospective data from three hospitals were examined, and routine testing procedures, testing volume, reactive test results, and linkage-to-care outcomes were documented. Results. From January 2012 through March 2014, 40,788 HIV tests were administered at the three hospitals: 18,603 (46%) in the emergency department (ED), 7,546 (19%) in the inpatient departments, and 14,639 (36%) in outpatient clinics. The screened patients varied from 1% to 22% of the total eligible patient population across hospitals. A total of 297 patients tested positive for HIV for a seropositivity rate of 0.7%; 129 (43%) were newly diagnosed and 168 (57%) were previously diagnosed, with 64% of those previously diagnosed out of care at the time of screening. The inpatient areas had the highest seropositivity rate (0.6%). The percentage of newly diagnosed patients overall who were linked to care was 77%. Of newly diagnosed patients, 51% had ≥1 missed opportunity for testing (with a mean of 3.8 visits since 2006), and 30% of patients with missed opportunities were late testers (baseline CD4+ counts <200 cells per cubic millimeter). Conclusion. Routine screening is an essential tool for identifying new infections and patients with known infection who are out of care. Hospitals need to provide HIV screening in inpatient and outpatient settings—not just EDs—to decrease missed opportunities. Routine screening success will be driven by how notification and testing are incorporated into the normal medical flow, the level of leadership buy-in, the ability to conduct quality assurance, and local testing laws.
Pharmacy Intervention to Improve HIV Testing Uptake Using a Comprehensive Health Screening Approach
Authors: Crawford Natalie D. , Dean Trevano , Rivera Alexis V. , Guffey Taylor , Amesty Silvia , Rudolph Abby , DeCuir Jennifer , Fuller Crystal M. 
Published: June 2016

Objective. HIV testing is increasingly available, yet barriers to HIV testing persist for low-income black and Latino people, especially those who use illicit drugs. HIV exceptionalism, or the idea that a positive HIV diagnosis is drastically different from a diagnosis for any other disease, may influence HIV testing-related stigma, resulting in reduced willingness to undergo HIV testing. This pharmacy-based intervention combined HIV testing with less stigmatized chronic disease screening tests (e.g., blood pressure, glucose, and cholesterol) to equate the concept of an HIV diagnosis with other diagnoses. Methods. Three pharmacies located in low-income, minority neighborhoods in New York City were enrolled in an intervention to provide ( 1) HIV testing, chronic disease screening, and a healthy lifestyles video that normalized all screening tests and destigmatized HIV as a fatal disease (comprehensive arm); ( 2) HIV testing and the video (video arm); and ( 3) HIV testing only (control arm). Injection drug users (IDUs) and pharmacy staff recruited un- and under-insured pharmacy customers, IDUs, and IDU peers from 2010 to 2012. Participants in the control group were compared with those in the comprehensive and video intervention groups. Results. Participants in the comprehensive arm (prevalence ratio [PR] = 1.61, 95% confidence interval [CI] 1.03, 2.49, p=0.08) and the video arm (PR=1.59, 95% CI 1.00, 2.53, p=0.09) were marginally significantly more likely to receive an HIV test in the pharmacy compared with those in the control arm after adjustment. Conclusions. These findings suggest that adoption of strategies that destigmatize and normalize HIV testing can improve uptake. Implementation of this strategy in low-access, minority communities with high HIV prevalence and among high-risk populations may help reduce racial/ethnic disparities in HIV.
Results of Hepatitis C Birth-Cohort Testing and Linkage to Care in Selected U.S. Sites, 2012–2014
Authors: Patel Rajiv C. , Vellozzi Claudia , Smith Bryce D. 
Published: June 2016

Objective. Following its recommendation for one-time hepatitis C virus (HCV) testing of people born between 1945 and 1965, CDC implemented the Hepatitis Testing and Linkage to Care (HepTLC) initiative to conduct birth-cohort hepatitis testing in U.S. health-care settings. We describe demographic characteristics, HCV infection prevalence, and HCV-related risk factors among people born between 1945 and 1965 who were tested as part of the program, which ran from 2012 to 2014. Methods. As part of the HepTLC initiative, 14 grantees supporting 104 health-care sites in 21 U.S. municipalities tested participants born between 1945 and 1965 for HCV antibody (anti-HCV). Demographic characteristics and HCV risk factors were reported for people tested for anti-HCV and who were anti-HCV or HCV RNA positive. We evaluated outcomes along the HCV testing-to-care continuum using the following indicators: anti-HCV positive, HCV RNA test offered, HCV RNA positive, referred to care, and attended first medical appointment. Results. Among 24,966 people tested for HCV infection, 2,900 (11.6%) were anti-HCV positive. Anti-HCV positivity was highest among those who self-identified as non-Hispanic black ( n=1,701 of 12,202, 13.9%), men ( n=2,073 of 12,130, 17.1%), and people born between 1951 and 1955 ( n=795 of 5,768, 13.8%). Of the 2,900 people testing anti-HCV positive, 2,108 (72.7%) received an HCV RNA test, 1,497 (51.6%) were HCV RNA positive, 1,201 (41.4%) were referred to care, and 938 (32.3%) attended their first appointment. Conclusion. Testing for HCV infection among those born between 1945 and 1965 without soliciting HCV risk factors was successful. Providers implementing birth-cohort testing should develop and evaluate strategies to improve outcomes along the testing-to-care continuum.
Testing and Linking Foreign-Born People with Chronic Hepatitis B Virus Infection to Care at Nine U.S. Programs, 2012–2014
Authors: Harris Aaron M. , Schoenbachler Ben T. , Ramirez Gilberto , Vellozzi Claudia , Beckett Geoff A. 
Published: June 2016

Objective. Hepatitis B virus (HBV) infection continues to be a public health threat in the United States. As many as 2.2 million people are infected, approximately 70% of whom are foreign-born, and fewer than one-third are aware of their infection. We launched an HBV testing and linkage-to-care initiative among foreign-born people. Methods. As part of the Hepatitis Testing and Linkage to Care (HepTLC) initiative, which promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites, nine U.S. programs in seven states conducted HBV screening from October 2012 to September 2014. The nine programs partnered with health-care centers and community-based organizations to recruit foreign-born people recommended for HBV testing. We assessed patient characteristics, region of origin, risk factors, hepatitis B surface antigen (HBsAg) status, and referral to medical care. Results. Of 23,144 participants tested for HBV, 1,317 (5.7%) were HBsAg positive. Of these, the median age was 47 years, 1,205 (91%) had at least one risk factor for HBV infection, 1,117 (85%) received posttest counseling, 1,098 (83%) were referred to care, and 606 (46%) attended a first medical appointment. The proportion of HBsAg-positive participants by region of origin included Africa (10%, 206/2,129), Western Pacific (6%, 616/9,673), Eastern Mediterranean (5%, 174/3,337), Southeast Asia (5%, 191/3,891), South America (2%, 6/252), Eastern Europe (2%, 6/262), and North America (1%, 17/1,936). Conclusion. Community-based HBV testing initiatives can identify substantial numbers of people with chronic HBV infection, inform them of their infection status, and provide posttest counseling and linkage to care. However, strategies are needed to improve linkage to HBV-directed medical care for foreign-born individuals living with chronic HBV infection.
The Hepatitis Testing and Linkage-to-Care Data Review Process: An Approach to Ensuring the Quality of Program Data
Authors: Mezzo Jennifer L. , Lamia Tamara L. , Danelski Lisa L. , Schipani Anne Marie , Stokes Scott A. , Jacobs-Ware Elizabeth D. 
Published: June 2016

Objective. CDC's 2012 Hepatitis Testing and Linkage to Care (HepTLC) initiative was a nationally coordinated effort to conduct hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites. This project provided support for data management and monthly data reviews between awardees and a data manager, which facilitated monitoring of awardee progress and regular program improvement opportunities. Methods. CDC provided technical assistance to awardees for testing processes and program improvement, including Internet-based data submission, reporting software and data management to awardees, offering assistance with submitting, and reviewing data in real time. We describe how one awardee, AIDS Resource Center of Wisconsin (ARCW), used the data management process to improve data quality, inform testing processes and implementation, and measure and report missing variables from an online database. Results. From October 2012 through July 2014, ARCW performed 2,255 HCV antibody (anti-HCV) tests and 244 HCV ribonucleic acid (RNA) tests as part of the HepTLC initiative. Participants who tested HCV RNA positive ( n=189) were referred to medical care. At the end of the study, no records were missing for the anti-HCV test result or HCV RNA test result variables, and only one record was missing for those who were referred to medical care. Conclusion. Regular data review and monitoring by awardees and CDC-supported data managers provided opportunities for data quality and program improvement. Through regular data review, ARCW reduced the amount of missing data and promoted timely follow-up with participants testing positive for HCV to ensure receipt of results and linkage to care. Other programs can adopt a similar data management model.
Increasing Hepatitis B Testing and Linkage to Care of Foreign-Born Asians, Sacramento, California, 2012–2013
Authors: Dang Julie H.T. , Chen Jr. Moon S. 
Published: June 2016

Objective. Without medical intervention, about one-quarter of the 1.4–2.2 million Americans chronically infected with the hepatitis B virus (HBV) will die of HBV-associated conditions, including liver failure and hepatocellular carcinoma. We report on a program in Sacramento County, California, that offered HBV screening to at-risk adults, referred infected individuals to care, and vaccinated uninfected adults who were susceptible to HBV infection (i.e., individuals who tested negative for hepatitis B surface antigen and who were never vaccinated against HBV). Methods. We engaged organizations linked to Chinese, Hmong, Korean, and Vietnamese communities to cosponsor HBV screenings of Asian Americans as part of the Hepatitis Testing and Linkage to Care initiative, which promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites. We held 28 hepatitis B community screening events throughout Sacramento County, California, in collaboration with these groups from September 2012 to September 2013. Results. We screened 1,004 Asian American adults (i.e., 283 Koreans, 242 Chinese, 233 Vietnamese, 223 Hmong, and 23 people from other Asian communities) for HBV, of whom 98% were foreign born and 87% had a language preference other than English. Of the 76 participants who tested positive for HBV (31 Hmong, 23 Vietnamese, 17 Chinese, two Koreans, and three from other Asian communities), we provided posttest counseling to 51 participants. Conclusion. By collaborating with community groups and addressing barriers to screening, we highlighted the importance of disaggregating chronic HBV infection rates by Asian ethnicity and sex vs. aggregated Asian American rates. Future HBV screening initiatives should target Hmong and Vietnamese men.
Book Review: Vinay Lal, Making and Unmaking the City: Politics, Culture and Life Forms and Vinay Lal, The City in its Plenitude
Authors: Nair Janaki 
Published: June 2016

Vinay Lal, Making and Unmaking the City: Politics, Culture and Life Forms. The Oxford Anthology of the Modern Indian City, Oxford University Press, New Delhi, 2013, i–xlviii + 469 pp. ₹ 808. Vinay Lal, The City in its Plenitude. The Oxford Anthology of the Modern Indian City, Oxford University Press, New Delhi, 2013, i–xlvi + 382 pp.
The efficacy and safety of extended-release methylphenidate following traumatic brain injury: a randomised controlled pilot study
Authors: Dymowski Alicia R , Ponsford Jennie L , Owens Jacqueline A , Olver John H , Ponsford Michael , Willmott Catherine 
Published: June 2016

Objective: To investigate the feasibility, safety and efficacy of extended-release methylphenidate in enhancing processing speed, complex attentional functioning and everyday attentional behaviour after traumatic brain injury. Design: Seven week randomised, placebo-controlled, double-blind, parallel pilot study. Setting: Inpatient and outpatient Acquired Brain Injury Rehabilitation Program. Participants: Eleven individuals with reduced processing speed and/or attention deficits following complicated mild to severe traumatic brain injury. Interventions: Participants were allocated using a blocked randomisation schedule to receive daily extended-release methylphenidate (Ritalin® LA at a dose of 0.6 mg/kg) or placebo (lactose) in identical capsules. Main outcomes: Tests of processing speed and complex attention, and ratings of everyday attentional behaviour were completed at baseline, week 7 (on-drug), week 8 (off-drug) and 9 months follow-up. Vital signs and side effects were monitored from baseline to week 8. Results: Three percent ( n = 11) of individuals screened participated (mean post-traumatic amnesia duration = 63.80 days, SD = 45.15). Results were analysed for six and four individuals on methylphenidate and placebo, respectively. Groups did not differ on attentional test performance or relative/therapist ratings of everyday attentional behaviour. One methylphenidate participant withdrew due to difficulty sleeping. Methylphenidate was associated with trends towards increased blood pressure and reported anxiety. Conclusion: Methylphenidate was not associated with enhanced processing speed, attentional functioning or everyday attentional behaviour after traumatic brain injury. Alternative treatments for attention deficits after traumatic brain injury should be explored given the limited feasibility of methylphenidate in this population.
The effectiveness of supplementary arm and upper body exercises following total hip arthroplasty for osteoarthritis in the elderly: a randomized controlled trial
Authors: Mitrovic Dragica , Davidovic Mladen , Erceg Predrag , Marinkovic Jelena 
Published: June 2016

Objective: To determine whether arm and upper body exercises in addition to the standard rehabilitation programme improve outcomes after hip arthroplasty. Design: Prospective, parallel, randomized, controlled trial. Setting: Orthopaedic and rehabilitation departments. Subjects: A total of 70 patients >60 years of age, who underwent hip replacement, out of 98 eligible candidates after exclusion criteria were implemented. Interventions: The study group took part in the supplementary arm and upper body exercise programme to be compared with the standard rehabilitation programme group. Main outcome: The primary outcome was a Harris Hip Score. Secondary outcomes were: Hand grip strength and Medical Outcomes Study 36-Item Short-Form Health Survey. Outcomes were assessed preoperatively, two weeks after surgery and at 12 weeks follow-up. Results: In the intervention group, significant improvements were found: in functional ability – Harris Hip Score after two (mean difference = 4.7 points) and 12 (mean difference = 5.85 points) weeks; in muscle strength – handgrip for both hands (mean difference for dominant hand = 4.16 and for the other hand = 2.8) after 12 weeks; and in role–physical dimension SF-36 Health Survey (mean difference = 6.42 points) after 12 weeks. Conclusion: Results of this study indicate that arm and upper body exercises in addition to the standard rehabilitation programme improve outcomes 12 weeks after hip arthroplasty.
NOS knockout or inhibition but not disrupting PSD-95-NOS interaction protect against ischemic brain damage
Authors: Kleinschnitz Christoph , Mencl Stine , Kleikers Pamela WM , Schuhmann Michael K , G López Manuela , Casas Ana I , Sürün Bilge , Reif Andreas , Schmidt Harald HHW 
Published: June 2016

Promising results have been reported in preclinical stroke target validation for pharmacological principles that disrupt the N-methyl-D-aspartate receptor–post-synaptic density protein-95–neuronal nitric oxide synthase complex. However, post-synaptic density protein-95 is also coupled to potentially neuroprotective mechanisms. As post-synaptic density protein-95 inhibitors may interfere with potentially neuroprotective mechanisms and sufficient validation has often been an issue in translating basic stroke research, we wanted to close that gap by comparing post-synaptic density protein-95 inhibitors with NOS1−/− mice and a NOS inhibitor. We confirm the deleterious role of NOS1 in stroke both in vivo and in vitro, but find three pharmacological post-synaptic density protein-95 inhibitors to be therapeutically ineffective.
The immediate effect of vaginal and caesarean delivery on anal sphincter measurements
Authors: Karcaaltincaba Deniz , Erkaya Salim , Isik Hatice , Haberal Ali 
Published: June 2016

Objective This study evaluated the effects of vaginal and caesarean delivery on internal and external anal sphincter muscle thickness using translabial ultrasonography (TL-US). Methods This prospective cohort study enrolled nulliparous women who either had vaginal or caesarean deliveries. The thickness of the hypoechoic internal anal sphincter (IAS) and hyperechoic external anal sphincter (EAS) at the 12, 3, 6, and 9 o’clock positions at the distal level were measured before delivery and within 24–48 h after delivery. Results A total 105 consecutive women were enrolled in the study: 60 in the vaginal delivery group and 45 in the caesarean delivery group. The IAS muscle thickness at the 12 o’clock position in the vaginal delivery group was significantly thicker before compared with after delivery (mean ± SD: 2.31 ± 0.74 mm versus 1.81 ± 0.64 mm, respectively). The EAS muscle thickness at the 12 o’clock position in the vaginal delivery group was significantly thicker before compared with after delivery (mean ± SD: 2.42 ± 0.64 mm versus 1.97 ± 0.85, respectively). Conclusions There was significant muscle thinning of both the IAS and EAS at the 12 o’clock position after vaginal delivery, but not after caesarean delivery.