bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retention in care and reasons for discontinuation of lifelong antiretroviral therapy in a cohort of Cameroonian pregnant and breastfeeding HIV‐positive women initiating ‘Option B+’ in the South West Region
Authors: Atanga Pascal N. , Ndetan Harrison T. , Achidi Eric A. , Meriki Henry D. , Hoelscher Michael , Kroidl Arne 
Published: November 2016

AbstractObjectiveTo assess linkage and retention in care along the PMTCT cascade in HIV‐positive pregnant and breastfeeding women initiating Option B+ in Cameroon.MethodsWe prospectively determined uptake of HIV testing and counselling (HTC), uptake of ART and retention in care after Option B+ initiation between October 2013 and December 2014 in pregnant and breastfeeding women from five sites within the Kumba Health District. Retention in care was assessed over at least 12 months follow‐up and estimated by Kaplan–Meier analysis. During follow‐up, tracing outcomes and reasons for discontinuing treatment were documented.ResultsThe uptake of HTC of 5813 women with unknown HIV status was 98.5%, 251 (4.4%) were newly diagnosed HIV positive, and ART uptake in women eligible to start Option B+ was 96.8%. We enrolled 268 women initiating lifelong ART in the follow‐up. Overall, 65 (24.3%) discontinued treatment, either defined by loss to follow‐up (44.6%) or actively stopped treatment (55.8%). Retention in care was 88.0% and 81.1% at 6 and 12 months, respectively. Discontinuation was significantly associated in multivariate analysis with small sites and high staff turnover [aOR 2.5 (95% CI 1.6, 3.9), P < 0.001]. Main reasons for stopping treatment were HIV status denial and stigma (52.8%), religious reasons (25.0%) and lack of transport fare (11.1%).ConclusionWe observed good uptake of HTC, ART and retention in care, which declined over time. Discontinuation of Option B+ was highest at small sites with a high staff turnover. Improved staffing, adequate task shifting and community interventions to track defaulters including reducing stigma and religious beliefs may improve Option B+ retention.
Dynamic and rapid changes in the transcriptome and epigenome during germination and in developing rice (Oryza sativa) coleoptiles under anoxia and re‐oxygenation
Authors: Narsai Reena , Secco David , Schultz Matthew D. , Ecker Joseph R. , Lister Ryan , Whelan James 
Published: November 2016

SummaryDetailed molecular profiling of Oryza sativa (rice) was carried out to uncover the features that are essential for germination and early seedling growth under anoxic conditions. Temporal analysis of the transcriptome and methylome from germination to young seedlings under aerobic and anaerobic conditions revealed 82% similarity in the transcriptome and no differences in the epigenome up to 24 h. Following germination, significant changes in the transcriptome and DNA methylation were observed between 4‐day aerobically and anaerobically grown coleoptiles. A link between the epigenomic state and cell division versus cell elongation is suggested, as no differences in DNA methylation were observed between 24‐h aerobically and anaerobically germinating embryos, when there is little cell division. After that, epigenetic changes appear to correlate with differences between cell elongation (anaerobic conditions) versus cell division (aerobic conditions) in the coleoptiles. Re‐oxygenation of 3‐day anaerobically grown seedlings resulted in rapid transcriptomic changes in DNA methylation in these coleoptiles. Unlike the transcriptome, changes in DNA methylation upon re‐oxygenation did not reflect those seen in aerobic coleoptiles, but instead, reverted to a pattern similar to dry seeds. Reversion to the ‘dry seed’ state of DNA methylation upon re‐oxygenation may act to ‘reset the clock’ for the rapid molecular changes and cell division that result upon re‐oxygenation.
Reduced MHC alloimmunization and partial tolerance protection with pathogen reduction of whole blood
Authors: Jackman Rachael P. , Muench Marcus O. , Inglis Heather , Heitman John W. , Marschner Susanne , Goodrich Raymond P. , Norris Philip J. 
Published: November 2016

BACKGROUNDAllogeneic blood transfusion can result in an immune response against major histocompatibility complex (MHC) antigens, potentially complicating future transfusions or transplants. We previously demonstrated that pathogen reduction of platelet‐rich plasma (PRP) with riboflavin and ultraviolet light (UV+R) can prevent alloimmunization in mice. A similar pathogen‐reduction treatment is currently under development for the treatment of whole blood using riboflavin and a higher dose of UV light. We sought to determine the effectiveness of this treatment in the prevention of alloimmunization.STUDY DESIGN AND METHODSBALB/cJ mice were transfused with untreated or UV+R‐treated, allogeneic C57Bl/6J whole blood with or without leukoreduction. Mice were evaluated for donor‐specific antibodies, ex vivo splenocyte cytokine responses, and changes in the frequency of regulatory T (Treg) cells.RESULTSUV+R treatment blocked cytokine priming and reduced anti‐MHC alloantibody responses to transfused whole blood. Leukoreduction reduced alloantibody levels in both the untreated and UV+R‐treated groups. Mice transfused with UV+R‐treated whole blood had reduced alloantibody and cytokine responses when subsequently transfused with untreated blood from the same donor type. This reduction in responses was not associated with increased Treg cells.CONCLUSIONSPathogen reduction of whole blood with UV+R significantly reduces, but does not eliminate, the alloimmune response. Exposure to UV+R‐treated whole blood transfusion does appear to induce tolerance to alloantigens, resulting in reduced anti‐MHC alloantibody and cytokine responses to subsequent exposures to the same alloantigens. This tolerance does not appear to be driven by an increase in Treg cells.
Blood transfusion in hematologic intensive care unit
Authors: Chantepie Sylvain P. , Mear Jean‐Baptiste , Parienti Jean‐Jacques , Bazin Agnès , Benabed Khaled , Cheze Stéphane , Gac Anne‐Claire , Johnson‐Ansah Hyacinthe , Macro Margaret , Cabrera Quentin , Reboursiere Emilie , Lancesseur Charles , Damaj Gandhi , Reman Oumedaly 
Published: November 2016

BACKGROUNDThere is increasing evidence that excessive blood transfusion may be associated with impaired survival or cardiovascular events. One way to reduce the number of red blood cells (RBCs) is to transfuse 1 unit (1RBC) instead of 2 units of RBCs (2RBC).STUDY DESIGN AND METHODSPatients requiring blood transfusions in hematologic intensive care unit were included in a prospective study using a single RBC unit per transfusion and were compared with an historical cohort who received 2 RBC units per transfusion.RESULTSA total of 1323 units were transfused to 126 patients between 2013 and 2014. The 186 patients in the comparative cohort received a total of 1824 RBC units in a 2‐RBC‐unit policy between 2010 and 2012. The mean number of units was 7.35 (SD, 5.9 units; 95% confidence interval [CI], 6.5‐8.2 units) in the 1RBC group and 8.14 units (SD, 6.2 units; 95% CI, 7.3‐8.9 units) in the 2RBC group. The absolute mean difference was −0.79 (95% CI, −1.98 to 0.40; p = 0.09). In the 1RBC allogeneic hematopoietic stem cell transplantation (allo‐HSCT) subgroup, a significant reduction in the number of RBC units transfused was observed in comparison with the historical 2RBC allo‐HSCT group (5 units vs. 7.7 units; p = 0.01). No anemia‐related side effects were reported. Overall survival did not differ between the two groups.CONCLUSIONThe 1RBC transfusion policy made is feasible in patients with transient hematologic toxicity after chemotherapy. The number of units transfused between the two groups was not different. However, in the allo‐HSCT group, the use of a single RBC unit reduced significantly RBC consumption. A randomized trial comparing the two strategies is planned with a medicoeconomic evaluation.
Use of a 350‐mm2Baerveldt glaucoma drainage device to maintain vision and control intraocular pressure in dogs with glaucoma: a retrospective study (2013–2016)
Authors: Graham Kathleen L. , Donaldson David , Billson Francis A. , Billson F. Mark 
Published: November 2016

AbstractObjectiveTo evaluate the 350‐mm2Baerveldt glaucoma drainage device (GDD) in dogs with refractory glaucoma when modifications to address postoperative hypotony (extraluminal ligature; intraluminal stent) and the fibroproliferative response (intraoperative Mitomycin‐C; postoperative oral colchicine and prednisolone) are implemented as reported in human ophthalmology.DesignRetrospective case series.AnimalsTwenty‐eight client‐owned dogs (32 eyes) including seven dogs (nine eyes) with primary glaucoma and 21 dogs (23 eyes) with secondary glaucoma.MethodsThe medical records of all dogs undergoing placement of a 350‐mm2BaerveldtGDDat a veterinary ophthalmology referral service between 2013 and 2016 were reviewed. Signalment, diagnosis, duration and previous treatment of glaucoma, previous intraocular surgery,IOP, visual, and surgical outcomes were recorded.ResultsIOPwas maintained <20mmHg in 24 of 32 (75.0%) eyes. Fourteen eyes (43.8%) required no adjunctive treatments to maintain thisIOPcontrol. Fewer doses of glaucoma medication were required following surgery. Vision was retained in 18 of 27 (66.7%) eyes with vision at the time of surgery. No eyes that were blind at the time of surgery (n= 5) had restoration of functional vision. Complications following surgery included hypotony (26/32; 81.3%), intraocular hypertension (24/32; 75.0%), and fibrin formation within the anterior chamber (20/32; 62.5%). The average follow‐up after placement of theGDDwas 361.1 days (median 395.6 days).ConclusionEfforts to minimize postoperative hypotony and address the fibroproliferative response following placement of a 350‐mm2BaerveldtGDDshowed an increased success rate to other reports of this device in dogs and offers an alternative surgical treatment for controlling intraocular pressure in dogs with glaucoma.
Relationship between opioid treatment and rate of healing in chronic wounds
Authors: Shanmugam Victoria K. , Couch Kara S. , McNish Sean , Amdur Richard L. 
Published: November 2016

AbstractOpioids are routinely used analgesics in patients with chronic wounds; however the impact of opioid exposure on wound healing is poorly understood. The purpose of this study was to investigate the association between opioid exposure and wound outcome in the Wound Etiology and Healing study. This longitudinal observational study was conducted on 450 subjects enrolled in the Wound Etiology and Healing biorepository. Data were collected prospectively including baseline characteristics, pain score, longitudinal opioid exposure, and total wound surface area (tWSA). Data were analyzed using static multivariate models, fixed‐effects mixed models, and time to event analysis. Using fixed‐effects models, opioid dose was significantly associated with tWSA after accounting for the effects of pain score and baseline co‐variates (p < 0.0001). For each 1‐unit increase in ln(opioid dose + 1) the ln(tWSA + 1) increased by 0.16 units (95% confidence interval 0.13–0.19, p < 0.0001). Visits where opioids were present had ln(tWSA + 1) 0.48 units larger (95% confidence interval 0.38–0.58, p < 0.0001) than visits with no opioid exposure. Using time‐to‐event analysis, patients who never received opioids healed faster than those who received opioids (log‐rank chi‐square 11.00, p = 0.0009). Using Cox regression analysis, patients with mean opioid dose ≥10 mg were significantly less likely to heal than those with no opioid (HR 0.67 [0.49–0.91], p = 0.011) after adjusting for wound size. Patients with opioid dose >0 to <10 mg had a similar hazard of not healing as those with no opioid exposure (HR 0.88 [0.65–1.19], p = 0.40). In conclusion, opioid analgesics are commonly prescribed to patients with chronic wounds; however, the data presented suggest that opioid exposure is associated with reduced likelihood of healing in patients with chronic wounds. Whether this is a causal relationship will require further study.
Clinical outcome of design modifications to the CLS Spotorno Stem in total hip replacement
Authors: Graceffa Angelo , Indelli Pier , Latella Leonardo , Poli Paolo , Fulco Alexander , Marcucci Massimiliano 
Published: November 2016

Purpose: historically, the original CLS Spotorno Stem has demonstrated excellent survival. The design of this stem was recently modified, resulting in the introduction of a shorter, modular version (CLS Brevius). The purpose of the current study was to evaluate the functional, radiological and survivorship outcomes of the cementless CLS Brevius Stem in a multi-surgeon, single center, consecutive series study at two years post-surgery.
Methods: the Authors performed 170 total hip arthroplasties in 155 patients using the shorter, tripletaper stem design (CLS Brevius). The patients’ diagnoses were primary hip osteoarthritis (OA) in 74.4%, secondary hip OA in 22.6%, and post-traumatic hip OA in 3%. All operations were performed through a mini-posterior approach, with the patient in the lateral decubitus position. The mean follow-up was 32 months (24-44 months). Outcome was assessed using the Harris Hip Score (HHS).
Results: the mean HHS improved from 32 preoperatively to 92 points at final follow-up, while the stem survival rate was 99.4%.Overall, the results were excellent in148 hips (87%), good in 14 hips (8.2%), fair in six hips (3.6%), and poor in two hips (1.2%). Intraoperative complications included a calcar fissure in three hips (1.7%). Correct femoral offset was reproduced in 97% while the planned center of hip rotation was achieved in 98%. Only one hip underwent early stem revision; this was due to major subsidence.
Conclusions: the modified CLS stem design showed excellent short-term results with a low rate of early postoperative complications. One of the main findings of this study was the high correlation between the planned femoral offset and center of hip rotation and the final radiographic measurements. This high reproducibility, which indicates the ability of the system to restore normal hip anatomy, is indeed due to the extensive modularity that characterizes this stem system. Long-term follow-up studies are necessary to fully compare the outcomes of the new design with its highly successful predecessor.
Level of Evidence: Level IV, therapeutic cases series.
Results From Belgium’s 2016 Report Card on Physical Activity for Children and Youth
Authors: Wijtzes Anne I. , Verloigne Maïté , Mouton Alexandre , Cloes Marc , De Ridder Karin A.A. , Cardon Greet , Seghers Jan 
Published: November 2016

Background:This 2016 Belgium Report Card on Physical Activity for Children and Youth is the first systematic evaluation of physical activity (PA) behaviors, related health behaviors, health outcomes, and influences thereon, using the Active Healthy Kids Canada grading framework.Methods:A research working group consisting of PA experts from both Flanders and Wallonia collaborated to determine the indicators to be graded, data sources to be used, and factors to be taken into account during the grading process. Grades were finalized after consensus was reached among the research working group and 2 stakeholder groups consisting of academic and policy experts in the fields of PA, sedentary behavior, and dietary behavior.Results:Eleven indicators were selected and assigned the following grades: Overall PA (F+), Organized Sport Participation (C-), Active Play (C+), Active Transportation (C-), Sedentary Behaviors (D-), School (B-), Government Strategies and Investment (C+), and Weight Status (D). Incomplete grades were assigned to Family and Peers, Community and the Built Environment, and Dietary Behaviors due to a lack of nationally representative data.Conclusions:Despite moderately positive social and environmental influences, PA levels of Belgian children and youth are low while levels of sedentary behaviors are high.
Results From Ireland North and South’s 2016 Report Card on Physical Activity for Children and Youth
Authors: Harrington Deirdre M. , Murphy Marie , Carlin Angela , Coppinger Tara , Donnelly Alan , Dowd Kieran P. , Keating Teresa , Murphy Niamh , Murtagh Elaine , O’Brien Wesley , Woods Catherine , Belton Sarahjane 
Published: November 2016

Background:Physical activity (PA) is a key performance indicator for policy documents in both the Republic of Ireland and Northern Ireland. Building on baseline grades set in 2014, Ireland’s second Report Card on Physical Activity for Children and Youth allows for continued surveillance of indicators related to PA in children and youth.Methods:Data and information were extracted and collated for 10 indicators and graded using an international standardized grading system.Results:Overall, 7 grades stayed the same, 2 increased, and 1 decreased. Grades were assigned as follows: Overall PA, D (an increase); Sedentary Behavior (TV), C-; Physical Education, D-; Active Play, Incomplete/Inconclusive (INC); Active Transportation, D; School, D (a decrease); Home (Family), INC; Community and the Built Environment, B+ (an increase); and Government, INC. Unlike 2014’s report card, different grades for the Republic (C-) and Northern Ireland (C+) were assigned for Organized Sport Participation.Conclusions:Although the grade for Overall PA levels increased to a D, this may reflect the increased quality and quantity of data available. The double burden of low PA and high sedentary levels are concerning and underscore the need for advocacy toward, and surveillance of, progress in achieving targets set by the new National Physical Activity Plan in the Republic and obesity and sport plans in the North.
Fault activation by hydraulic fracturing in western Canada
Authors: Bao Xuewei , Eaton David W. 
Published: November 2016

Triggered quakes get unconventional
The big earthquakes induced by human activity are mostly linked with disposal of wastewater. However, Bao and Eaton implicate hydraulic fracturing (or fracking) as the culprit in western Canada (see the Perspective by Elsworth). Fracking near Fox Creek, Alberta, reactivated faults, clustering earthquakes along the old fault traces. Fracking does not appear to cause large earthquakes in many other areas that are prone to induced seismicity. Understanding the underlying causes of seismicity in different localities is vital for developing sound regulation to limit damaging earthquakes.

Science
, this issue p.
1406
; see also p.
1380
Complete Genome Sequence of Lytic Bacteriophage LZ35 Infecting Acinetobacter baumannii Isolates
Authors: Guo Zhonghe , Huang Honglan , Wu Xiaolin , Hao Yuchong , Sun Yanbo 
Published: November 2016

ABSTRACT

Acinetobacter baumannii
is a Gram-negative opportunistic pathogen that is frequently associated with nosocomial infections. Bacteriophages infecting
A. baumannii
can be used as effective agents to control these infections. Here, we announce the complete genome sequence of the lytic bacteriophage LZ35 infecting
A. baumannii
isolates.
Genome Sequence of a Ranavirus Isolated from Pike-Perch
Sander lucioperca
Authors: Holopainen Riikka , Subramaniam Kuttichantran , Steckler Natalie K. , Claytor Sieara C. , Ariel Ellen , Waltzek Thomas B. 
Published: November 2016

ABSTRACT
The pike-perch iridovirus (PPIV) was isolated in Finland from apparently healthy pike-perch fingerlings during routine disease surveillance. Our phylogenomic analysis revealed that PPIV is the first fish member of a clade of ranaviruses previously described from European and Chinese amphibians.
Lost information during the handover of critically injured trauma patients: a mixed-methods study
Authors: Zakrison Tanya Liv , Rosenbloom Brittany , McFarlan Amanda , Jovicic Aleksandra , Soklaridis Sophie , Allen Casey , Schulman Carl , Namias Nicholas , Rizoli Sandro 
Published: November 2016

BackgroundClinical information may be lost during the transfer of critically injured trauma patients from the emergency department (ED) to the intensive care unit (ICU). The aim of this study was to investigate the causes and frequency of information discrepancies with handover and to explore solutions to improving information transfer.MethodsA mixed-methods research approach was used at our level I trauma centre. Information discrepancies between the ED and the ICU were measured using chart audits. Descriptive, parametric and non-parametric statistics were applied, as appropriate. Six focus groups of 46 ED and ICU nurses and nine individual interviews of trauma team leaders were conducted to explore solutions to improve information transfer using thematic analysis.ResultsChart audits demonstrated that injuries were missed in 24% of patients. Clinical information discrepancies occurred in 48% of patients. Patients with these discrepancies were more likely to have unknown medical histories (p<0.001) requiring information rescue (p<0.005). Close to one in three patients with information rescue had a change in clinical management (p<0.01). Participants identified challenges according to their disciplines, with some overlap. Physicians, in contrast to nurses, were perceived as less aware of interdisciplinary stress and their role regarding variability in handover. Standardising handover, increasing non-technical physician training and understanding unit cultures were proposed as solutions, with nurses as drivers of a culture of safety.ConclusionTrauma patient information was lost during handover from the ED to the ICU for multiple reasons. An interprofessional approach was proposed to improve handover through cross-unit familiarisation and use of communication tools is proposed. Going beyond traditional geographical and temporal boundaries was deemed important for improving patient safety during the ED to ICU handover.