bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications Related to Pectus Carinatum Correction: Lessons Learned from 15 Years’ Experience. Management and Literature Review
Authors: Del Frari Barbara , Sigl Stephan , Schwabegger Anton H. 
Published: August 2016

Background:
Various methods of corrective thoracoplasty for pectus carinatum deformity have been described, but to date no studies describe a review of complications and how to manage them. Complications are dependent not only on the technique used and the patient’s age, but also on the experience of the treating surgeon. The authors present their 15 years’ experience with surgical correction of pectus carinatum and the complications that have occurred. A literature review regarding complications with pectus carinatum surgery is performed.

Methods:
A retrospective review of 95 patients (mean age, 19 years) was performed. One hundred four surgical procedures for repair of pectus carinatum were performed from July of 2000 to July of 2015 using a modified Ravitch technique, bioabsorbable material, postoperative bracing, and in some cases a diced rib cartilage graft technique. Intraoperative and postoperative complications were evaluated.

Results:
The mean patient follow-up was 13.6 months (range, 4 months to 9.75 years). Intraoperative complications were pleura lesion and laceration of the internal mammary vein. Postoperative complications were recurrent mild protrusion, persistent protrusion of one or two costal cartilages, minor wound healing delay, skin ulcer, hypertrophic scar, transient intercostal dysesthesia, marginal pneumothorax, seroma, meningitis, and epidural hematoma.

Conclusions:
In our reported series of pectus carinatum repair, increasing experience and progressively less extensive techniques have resulted in fewer complications, low morbidity, and early return to activity. Complications were observed in the early period of application, predominantly because of a lack of experience, and usually subsided with increasing numbers of patients and frequency of surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Suggestions to Reduce Clinical Fibromyalgia Pain and Experimentally Induced Pain Produce Parallel Effects on Perceived Pain but Divergent Functional MRI–Based Brain Activity
Authors: Derbyshire Stuart W.G. , Whalley Matthew G. , Seah Stanley T.H. , Oakley David A. 
Published: August 2016

ABSTRACT

Objective
Hypnotic suggestion is an empirically validated form of pain control; however, the underlying mechanism remains unclear.

Methods
Thirteen fibromyalgia patients received suggestions to alter their clinical pain, and 15 healthy controls received suggestions to alter experimental heat pain. Suggestions were delivered before and after hypnotic induction with blood oxygen level–dependent (BOLD) activity measured concurrently.

Results
Across groups, suggestion produced substantial changes in pain report (main effect of suggestion, F
2, 312 = 585.8; p < .0001), with marginally larger changes after induction (main effect of induction, F
1, 312 = 3.6; p = .060). In patients, BOLD response increased with pain report in regions previously associated with pain, including thalamus and anterior cingulate cortex. In controls, BOLD response decreased with pain report. All changes were greater after induction. Region-of-interest analysis revealed largely linear patient responses with increasing pain report. Control responses, however, were higher after suggestion to increase or decrease pain from baseline.

Conclusions
Based on behavioral report alone, the mechanism of suggestion could be interpreted as largely similar regardless of the induction or type of pain experience. The functional magnetic resonance imaging data, however, demonstrated larger changes in brain activity after induction and a radically different pattern of brain activity for clinical pain compared with experimental pain. These findings imply that induction has an important effect on underlying neural activity mediating the effects of suggestion, and the mechanism of suggestion in patients altering clinical pain differs from that in controls altering experimental pain. Patient responses imply that suggestions altered pain experience via corresponding changes in pain-related brain regions, whereas control responses imply suggestion engaged cognitive control.
Trends in the Marginal Cost of Male Circumcision in Rural Rakai Uganda
Authors: Alfonso Yira N. , Bishai David , Nantongo Agnes , Kakembo Rebecca , Kobusinge Sarah , Kacker Seema , Kigozi Godfrey , Gray Ronald 
Published: August 2016

Introduction:
Male circumcision (MC) is an effective intervention to reduce HIV acquisition in men in Africa. We conducted a cost analysis using longitudinal data on expenditures on services and community mobilization to estimate the marginal cost of MC over time and understand cost drivers during scale-up.

Methods:
We used a time series with monthly records from 2008 to 2013, for a total of 72 monthly observations, from the Rakai MC Program in Uganda. Generalized linear models were used to estimate the marginal cost of an MC procedure.

Results:
The marginal cost per MC in a mobile camp was $23 (P < 0.01) and in static facilities was $35 (P < 0.1). Major cost drivers included supplies in mobile camps with increasing numbers of surgeries, savings due to task shifting from physicians to clinical officers, and increased efficiency as personnel became more experienced.

Conclusions:
As scale-up continues, marginal costs may increase because of mobilization needed for less motivated late adopters, but improved efficiency could contain costs.
Maternal and Breastmilk Viral Load: Impacts of Adherence on Peripartum HIV Infections Averted—The Breastfeeding, Antiretrovirals, and Nutrition Study
Authors: Davis Nicole L. , Miller William C. , Hudgens Michael G. , Chasela Charles S. , Sichali Dorothy , Kayira Dumbani , Nelson Julie A. E. , Fiscus Susan A. , Tegha Gerald , Kamwendo Deborah D. , Rigdon Joseph , Stringer Jeffrey S. A. , Juliano Jonathan J. , Ellington Sascha R. , Kourtis Athena P. , Jamieson Denise J. , van der Horst Charles ,   for the BAN study team
Published: August 2016

Background:
Antiretroviral (ARV) interventions are used to reduce HIV viral replication and prevent mother-to-child transmission. Viral suppression relies on adherence to ARVs.

Methods:
A 2-phase study was conducted using data from the Breastfeeding, Antiretrovirals, and Nutrition study. We included mothers randomized to 28 weeks of postpartum ARVs with ≥1 plasma or breastmilk specimen. All mothers who transmitted HIV to their infants from 2–28 weeks (n = 31) and 15% of mothers who did not (n = 232) were included. Adherence was measured by pill count [categorized as poor (0%–80%), partial (81%–98%), and near perfect (>98%)]. Associations between adherence and breastmilk RNA were assessed using mixed-effects models. Cox models were used to estimate associations between breastmilk RNA and HIV transmission. Using Monte Carlo simulation, we estimated the number of transmissions that would occur had everyone randomized to maternal ARVs been 90% and 100% adherent.

Results:
Partial or near perfect ARV adherence significantly reduced the odds of having detectable (≥40 copies/mL) breastmilk RNA, compared with poor adherence (Odds Ratio (OR) 0.23, 95% CI: 0.08 to 0.67; OR 0.36, 95% CI: 0.16 to 0.81, respectively). Detectable breastmilk RNA was associated with increased breastmilk transmission compared with undetectable breastmilk RNA (hazard ratio 3.8, 95% CI: 1.2 to 12.1). All transmitting mothers had ≥1 plasma viral load specimen >100 copies per milliliter. An estimated similar number of transmissions would occur with 90% adherence compared with 100%.

Conclusions:
Helping patients adhere to ARVs throughout breastfeeding is important for realizing the full potential of recommended ARV interventions to prevent mother-to-child HIV transmission. Maintaining plasma viral load <100 copies per milliliter may prevent breastmilk transmission.
Performance of the Bio-Rad Geenius HIV1/2 Supplemental Assay in Detecting “Recent” HIV Infection and Calculating Population Incidence
Authors: Keating Sheila M. , Kassanjee Reshma , Lebedeva Mila , Facente Shelley N. , MacArthur Jeffrey C. , Grebe Eduard , Murphy Gary , Welte Alex , Martin Jeffrey N. , Little Susan , Price Matthew A. , Kallas Esper G. , Busch Michael P. , Pilcher Christopher D. ,   on behalf of the Consortium for the Evaluation and Performance of HIV Incidence Assays (CEPHIA)
Published: August 2016

Objective:
HIV seroconversion biomarkers are being used in cross-sectional studies for HIV incidence estimation. Bio-Rad Geenius HIV-1/2 Supplemental Assay is an immunochromatographic single-use assay that measures antibodies (Ab) against multiple HIV-1/2 antigens. The objective of this study was to determine whether the Geenius assay could additionally be used for recency estimation.

Design:
This assay was developed for HIV-1/2 confirmation; however, quantitative data acquired give information on increasing concentration and diversity of antibody responses over time during seroconversion. A quantitative threshold of recent HIV infection was proposed to determine “recent” or “nonrecent” HIV infection; performance using this cutoff was evaluated.

Methods:
We tested 2500 highly characterized specimens from research subjects in the United States, Brazil, and Africa with well-defined durations of HIV infection. Regression and frequency estimation were used to estimate assay properties relevant to HIV incidence measurement: mean duration of recent infection (MDRI), false-recent rate, and assay reproducibility and robustness.

Results:
Using the manufacturer's proposed cutoff index of 1.5 to identify “recent” infection, the assay has an estimated false-recent rate of 4.1% (95% CI: 2.2 to 7.0) and MDRI of 179 days (155 to 201) in specimens from treatment-naive subjects, presenting performance challenges similar to other incidence assays. Lower index cutoffs associated with lower MDRI gave a lower rate of false-recent results.

Conclusions:
These data suggest that with additional interpretive analysis of the band intensities using an algorithm and cutoff, the Geenius HIV-1/2 Supplemental Assay can be used to identify recent HIV infection in addition to confirming the presence of HIV-1 and HIV-2 antibodies.
Hospitalization for Anxiety and Mood Disorders in HIV-Infected and -Uninfected Gay and Bisexual Men
Authors: Moore Cecilia L. , Grulich Andrew E. , Prestage Garrett , Gidding Heather F. , Jin Fengyi , Petoumenos Kathy , Zablotska Iryna B. , Poynten I. Mary , Mao Limin , Law Matthew G. , Amin Janaki 
Published: August 2016

Background:
Prevalence of anxiety and mood disorders (AMDs) in HIV-infected individuals has varied widely because of the variety of measurements used and differences in risk factor profiles between different populations. We aimed to examine the relationship between HIV status and hospitalization for AMDs in gay and bisexual men (GBM).

Design and Methods:
HIV-infected (n = 557) and HIV-uninfected (n = 1325) GBM recruited in Sydney, Australia were probabilistically linked to their hospital admissions and death notifications (2000–2012). Random-effects Poisson models were used to assess HIV risk factors for hospitalization. Cox regression methods were used to assess risk factors for mortality.

Results:
We observed 300 hospitalizations for AMDs in 15.3% of HIV-infected and 181 in 5.4% of HIV-uninfected participants. Being infected with HIV was associated with a 2.5-fold increase in risk of hospitalization for AMDs in GBM. Other risk factors in the HIV-infected cohort included previous hospitalization for HIV-related dementia, a more recent HIV diagnosis, and a CD4 T-cell count above 350 cells per cubic millimeter. Being hospitalized for an AMD was associated with a 5.5-fold increased risk of mortality; this association did not differ by HIV status. An association between substance use and mortality was observed in individuals hospitalized for AMDs.

Conclusions:
There is a need to provide more effective strategies to identify and treat AMDs in HIV-infected GBM. This research highlights the importance of further examination of the effects of substance use, neurocognitive decline, and AMDs on the health of HIV-infected individuals.
The human gut microbiome of Latin America populations: a landscape to be discovered
Authors: Magne Fabien , O’Ryan Miguel L. , Vidal Roberto , Farfan Mauricio 
Published: August 2016

Purpose of review
The gut microbiome is critical for human health, and its alteration is associated with intestinal, autoimmune and metabolic diseases. Numerous studies have focused on prevention or treatment of dysbiotic microbiome to reduce the risk or effect of these diseases. A key issue is to define the microbiome associated with the state of good health. The purpose of this review is to describe factors influencing the gut microbiome with special emphasis on contributions from Latin America. In addition, we will highlight opportunities for future studies on gut microbiome in Latin America.

Recent findings
A relevant factor influencing gut microbiome composition is geographical location associated with specific genetic, dietary and lifestyle factors. Geographical specificities suggest that a universal ‘healthy microbiome’ is unlikely.

Summary
Several research programs, mostly from Europe and North America, are extensively sequencing gut microbiome of healthy people, whereas data from Latin America remain scarce yet slowly increasing. Few studies have shown difference in the composition of gut microbiome between their local populations with that of other industrialized countries (North American populations). Latin America is composed of countries with a myriad of lifestyles, traditions, genetic backgrounds and socioeconomic conditions, which may determine differences in gut microbiome of individuals from different countries. This represents an opportunity to better understand the relationship between these factors and gut microbiome.
Situation of Sri Lanka, where autochthonous malaria is no longer a problem, and other infections dominate, such as dengue, leptospirosis and rickettsioses
Authors: Agampodi Suneth , Wijerathne Buddhika , Weerakoon Kosala 
Published: August 2016

Purpose of review
Sri Lanka achieved a major milestone in communicable disease control in 2012 by reporting zero incidence of autochthonous malaria. However, reduction of malaria was associated with concurrent increase of several tropical diseases. This review looks into the time trends and epidemiology of these communicable diseases in Sri Lanka.

Recent findings
Reduction of malaria cases coincides with an increase of dengue, leptospirosis and rickettsioses in Sri Lanka. Although the case fatality rate of dengue has reduced and maintained below 1%, leptospirosis in clinical management is questionable. Despite having national focal points for control and prevention, these emerging diseases are completely out of control. Whether the holding back of vector control activities of malaria after a successful control programme is having an effect on emergence of other vector-borne diseases should be studied.

Summary
The communicable disease control programme in Sri Lanka should be further strengthened with availability of proper and rapid diagnostic facilities. Malaria control could not be considered as a great achievement due to the fact that other emerging infectious diseases are replacing malaria.
Chikugunya and zika virus dissemination in the Americas: different arboviruses reflecting the same spreading routes and poor vector-control policies
Authors: Fernández-Salas Ildefonso , Díaz-González Esteban E. , López-Gatell Hugo , Alpuche-Aranda Celia 
Published: August 2016

Purpose of review
This review gathers the most recent investigations about chikungunya and zika viruses in America and would help in creating new research approaches.

Recent findings
Clinical descriptions of chikungunya fever have been performed in the American outbreak observing that fever, polyarthalgia, myalgia and rash are the most common symptoms in the acute phase, while chronic arthralgia has persisted in 37–90% of small cohorts. The Asian origin of American strains of chikungunya virus (CHIKV) and zika virus (ZIKV) evidences a dissemination route in common and both are being transmitted by Aedes aegypti. Regarding zika fever, the association of congenital malformations with previous ZIKV exposure of pregnant women and potential sexual transmission of ZIKV are the most important discoveries in the New World.

Summary
Massive outbreaks of chikungunya fever in 2014 and then followed by zika fever epidemics of lower magnitude in the next year throughout the American continent have their origins in Asia but may have used Pacific Islands as a path of dissemination. Reports of chronic arthralgia have been little described in the continent and more research is needed to measure the economic and health impact in patients who contracted CHIKV before. On the contrary, zika is menacing newborns’ health because of its link with congenital microcephaly and sexual health by prolonged presence of viral particles in semen and urine.
Large Amplitude Cortical Evoked Potentials in Nonepileptic Patients. Reviving an Old Neurophysiologic Tool to Help Detect CNS Pathology
Authors: Martín-Palomeque Guillermo , Castro-Ortiz Antonio , Pamplona-Valenzuela Pilar , Saiz-Sepúlveda Miguel Á. , Cabañes-Martínez Lidia , López Jaime R. 
Published: August 2016

Purpose:
Although large amplitude evoked potentials (EPs) are typically associated with progressive myoclonic epilepsy patients, giant EPs imply central nervous system (CNS) hyperexcitability and can be seen in various nonepileptic disorders.

Methods:
We performed a retrospective chart review including history, physical examination, imaging and diagnostic studies of nonepileptic patients with large amplitude somatosensory evoked potentials (SSEPs) and visual evoked potentials (VEPs) during 2007 to 2013. Large amplitude EPs were defined as follows: VEPs (N75-P100) >18 μV; and SSEPs (N20-P25) >6.4 μV. Recording montage for VEPs was Oz-Cz and SSEPs C3′/C4′-Fz.

Results:
Fifty-two patients (33 females, 19 males; age range, 9–90 years) were identified. No CNS pathology was detected in 7 patients. All remaining patients were diagnosed with new CNS disorders including: vascular (37%); myelopathies (13%); demyelinating (11%); space occupying lesions (8.7%); syringomyelia (8.7%); hydrocephalus (6.5%); Vitamin B-12 deficiency (4.3%); multiple system atrophy (4.3%); and toxins (2.2%).

Conclusions:
This study supports the notion that large amplitude EP implies CNS hyperexcitability and CNS disease. These results confirm the utility of EP studies in patients with suspected CNS pathology.
The spatial distribution of African savannah herbivores: species associations and habitat occupancy in a landscape context
Authors: Anderson T. Michael , White Staci , Davis Bryant , Erhardt Rob , Palmer Meredith , Swanson Alexandra , Kosmala Margaret , Packer Craig 
Published: August 2016

Herbivores play an important role in determining the structure and function of tropical savannahs. Here, we (i) outline a framework for how interactions among large mammalian herbivores, carnivores and environmental variation influence herbivore habitat occupancy in tropical savannahs. We then (ii) use a Bayesian hierarchical model to analyse camera trap data to quantify spatial patterns of habitat occupancy for lions and eight common ungulates of varying body size across an approximately 1100 km2landscape in the Serengeti ecosystem. Our results reveal strong positive associations among herbivores at the scale of the entire landscape. Lions were positively associated with migratory ungulates but negatively associated with residents. Herbivore habitat occupancy differed with body size and migratory strategy: large-bodied migrants, at less risk of predation and able to tolerate lower quality food, were associated with high NDVI, while smaller residents, constrained to higher quality forage, avoided these areas. Small herbivores were strongly associated with fires, likely due to the subsequent high-quality regrowth, while larger herbivores avoided burned areas. Body mass was strongly related to herbivore habitat use, with larger species more strongly associated with riverine and woodlands than smaller species. Large-bodied migrants displayed diffuse habitat occupancy, whereas smaller species demonstrated fine-scale occupancy reflecting use of smaller patches of high-quality habitat. Our results demonstrate the emergence of strong positive spatial associations among a diverse group of savannah herbivores, while highlighting species-specific habitat selection strongly determined by herbivore body size.This article is part of the themed issue ‘Tropical grassy biomes: linking ecology, human use and conservation’.
Logic workflow structure modeling of product variant design and activity path generating
Authors: Xu Xinsheng , Huang Tiequn , Wang Cheng , Yuan Jun , Zhu Fanfan 
Published: August 2016

Purpose
Product variant design process consists of a series of asynchronous activities. These activities and the logic relations among them are important in constructing general logic workflow structure, which is the foundation of deriving an activity path for variant design business. Traditional process modeling approaches have not defined activities for product variant design and cannot describe the complex relations among these activities because of the lack of logic express elements. Thus, logic workflow structure modeling method is anticipated to meet the requirements of logic description and path generation in product variant design application. This paper aims to address these issues.

Design/methodology/approach
The paper identifies the variant design modes of different types of parts and defines their variant design activities. The procedure of constructing general logic workflow structure of product variant design is proposed. Simultaneously, the principles of inferring logic relations among activities are put forward based on their adjacency information and connectivity probability. A general logic workflow structure of product variant design is constructed. Based on this, activity path corresponding to a variant design business can be generated. The algorithm of generating activity path is designed as well. In addition, Boolean vectors of activity path, based on the functional contour matrix of polychromatic set theory, can be inferred, which denotes the functional character of activity path.

Findings
A general logic workflow structure for product variant design has been established, which comprises variant design activities and basic process logic nodes. The logic relations among activities can be inferred based on their in-degree/out-degree and connectivity probability. The function character of activity path can also be expressed based on the polychromatic set theory.

Originality/value
The combination of variant design activity and basic process logic node makes diverse variant design business descriptions possible in a general workflow structure. The proposed approach provides evidences for designer to plan and develop product variant design system effectively.