bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression and Survival in a 17-Year Longitudinal Study of People With HIV: Moderating Effects of Race and Education
Authors: Ironson Gail , Fitch Calvin , Stuetzle Rick 
Published: May 2017

ABSTRACT

Objective
The prevalence of clinically significant depressive symptoms is three times higher in people living with HIV than in the general population. Although studies have shown that depression predicts worse course with HIV, few have investigated its relationship with mortality, and none have had a 17-year follow-up period and been conducted entirely during the time since the advent of protease inhibitors.

Methods
We followed a diverse sample of HIV-positive people (N = 177) in the mid-range of illness for a study on stress and coping. Participants were assessed every 6 months (for 12 years) via blood draw, questionnaires, and interview. Depression was measured using the Beck Depression Inventory. The study began in March 1997 and mortality was assessed in April 2014.

Results
In the primary analysis depression, analyzed as a continuous variable, significantly predicted all-cause mortality (hazard ratio = 1.038, 95% confidence interval = 1.008–1.068). With Beck Depression Inventory scores dichotomized, the hazard ratio was 2.044 (95% confidence interval = 1.176–3.550). Furthermore, this result was moderated by race and educational attainment such that depression only predicted worse survival for non-African Americans and those with a college education or higher.

Conclusion
Depression is associated with worse long-term survival in people with HIV during 17 years of follow-up. Interventions targeting depression may improve well-being and potentially survival in individuals with HIV. However, since depression did not predict survival in African Americans or those with low education, more research is needed to identify risk factors for long term outcomes in these groups.
Influence of Acute Multispecies and Multistrain Probiotic Supplementation on Cardiovascular Function and Reactivity to Psychological Stress in Young Adults: A Double-Blind, Randomized, Placebo-Controlled Trial
Authors: Möller Clara M. , Olsa Eamon J.A. , Ginty Annie T. , Rapelje Alyssa L. , Tindall Christina L. , Holesh Laura A. , Petersen Karen L. , Conklin Sarah M. 
Published: May 2017

ABSTRACT

Objective
The potential influence of probiotic supplementation on cardiovascular health and stress responsivity remains largely unexplored. Some evidence suggests the possibility that probiotics may influence blood pressure. A separate body of research suggests that exaggerated cardiovascular reactions to acute psychological stress in the laboratory predict cardiovascular morbidity and mortality. The current investigation explored the effect of acute probiotic use on (1) resting cardiovascular measures in healthy young adults and (2) cardiovascular and psychological reactions to an acute psychological stressor in the laboratory.

Method
Participants (N = 105, M [SD] age = 20.17 [1.26], 84.8% white) completed a 2-week, double-blind, and placebo-controlled trial of a multispecies and multistrain probiotic. Exclusion criteria included previous probiotic use, diagnosed gastrointestinal disorder, and/or current antibiotic use. At visits 1 and 2, participants completed the Paced Auditory Serial Addition Test, a widely used psychological stress task. Participants were randomly assigned to a probiotic blend or matched placebo.

Results
Compared with placebo, 2-week probiotic supplementation did not affect resting measures of cardiovascular function, cardiovascular responses during or recovery from stress, or psychological reactions to acute psychological stress.

Conclusions
Contrary to expectations, short-term use of a probiotic supplement in healthy participants did not influence measures of cardiovascular function or responsivity to psychological stress. Future research is needed to determine species- and strain-specific effects of probiotics in healthy participants with various degrees of stress responsiveness, as well as in diseased populations.
Patterns of Attendance at Mother Support Groups in Zimbabwe. The EPAZ Trial (2014–2016)
Authors: Orne-Gliemann Joanna , Font Hélène , Maphosa Talent , Kangwende Abigail , Rusakaniko Simba , Magezi Vhumani , Sengai Tonderai , Shumba Bridget , Zambezi Pemberai , Foster Geoff ,   for the EPAZ trial study group
Published: May 2017

Background:In Southern Africa, groups of mothers living with HIV successfully provide peer psychosocial support during pregnancy and early childhood. We report patterns of attendance at Mother Support Groups (MSGs) sessions among women and mothers living with HIV in rural Zimbabwe.Methods:In the Elimination of Pediatric AIDS cluster-randomized trial, MSGs were established in 14 health facilities in Mutare and Makoni districts. Patterns of attendance at MSG sessions were categorized by calendar attendance from delivery to 6-month postpartum using a Dynamic Time Warping clustering method. Baseline characteristics of women and postpartum MSG attendance patterns were described. Linkages between these patterns and 12-month postpartum retention in care were explored using mixed-effects models.Results:Most women (88%) attended at least 1 MSG session between enrollment and 6-month postpartum. Two patterns of postpartum MSG attendance, “Regular Attendance” and “Non-Regular Attendance,” were readily identified. Being older than 32 (P= 0.01), booking for antenatal care before 22 weeks gestational age (P= 0.02), and being on antiretroviral therapy at first antenatal care booking (P= 0.01) were significantly associated with “Regular Attendance.” “Regular Attendance” at MSG sessions during the 6-month postpartum period was significantly associated with better retention in care at 12 months, compared with “Non-Regular Attendance” (P< 0.01).Discussion:Women living with HIV attended MSG sessions. However, few attended regularly. Younger and newly diagnosed women were less likely to attend postpartum MSG sessions or remain in care at 12 months postpartum. Peer support models should consider specific needs of these women, especially in rural areas, in order for MSGs to contribute to improve maternal and child health outcomes.
The Effect of a Continuous Quality Improvement Intervention on Retention-In-Care at 6 Months Postpartum in a PMTCT Program in Northern Nigeria: Results of a Cluster Randomized Controlled Study
Authors: Oyeledun Bolanle , Phillips Abimbola , Oronsaye Frank , Alo Oluwafemi David , Shaffer Nathan , Osibo Bamidele , Imarhiagbe Collins , Ogirima Francis , Ajibola Abiola , Ezebuka Obioma , Ojong-Etta Bebia , Obi Adaobi , Falade John , Uthman Adunbi Kareem , Famuyide Busuyi , Odoh Deborah , Becquet Renaud 
Published: May 2017

Background:
Retention in care is critical for improving HIV-infected maternal outcomes and reducing vertical transmission. Health systems' interventions such as continuous quality improvement (CQI) may support health services to address factors that affect the delivery of HIV-related care and thereby influence rates of retention-in-care.

Methodology:
We evaluated the effect of a CQI intervention on retention-in-care at 6 months postpartum of pregnant women and mothers living with HIV who had been started on lifelong antiretroviral treatment. Thirty-two health care facilities were randomized to either implement the intervention or not. We considered women fully retained in care when they attended the 6-month postpartum visit and did not miss any previous scheduled visit by more than 30 days.

Results:
Five hundred eleven women living with HIV attending antenatal clinics at 26 facilities were included in the analysis. Median age at enrolment was 27 years and gestational age was 20 weeks. Seventy-one percent of women were seen at 6-month postpartum irrespective of missing any scheduled visit. However, 43% of women were fully retained at 6-month postpartum and did not miss any scheduled visit based on our stringent study definition of retention. There was no significant difference in retention at 6 months between the intervention and control arms [44% vs. 41%, relative risk: 1.08; 95% confidence interval (CI): 0.78 to 1.49]. Initiation of ARV prophylaxis among infants within 72 hours was not different by study arm (66.0% vs. 74.7%, relative risk = 0.95; 95% CI: 0.84 to 1.07) but rates of early infant testing at 4–6 weeks were higher in intervention sites (48.8% vs. 25.3%, adjusted relative risk: 1.76; 95% CI: 1.27 to 2.42).

Conclusions:
CQI as implemented in this study did not differ across study arms in the rates of retention. Several intervention design or implementation issues or other contextual constraints may explain the absence of effect.
Viral Suppression and HIV Drug Resistance at 6 Months Among Women in Malawi's Option B+ Program: Results From the PURE Malawi Study
Authors: Hosseinipour Mina , Nelson Julie A. E. , Trapence Clement , Rutstein Sarah E. , Kasende Florence , Kayoyo Virginia , Kaunda-Khangamwa Blessings , Compliment Kara , Stanley Christopher , Cataldo Fabian , van Lettow Monique , Rosenberg Nora E. , Tweya Hannock , Gugsa Salem , Sampathkumar Veena , Schouten Erik , Eliya Michael , Chimbwandira Frank , Chiwaula Levison , Kapito-Tembo Atupele , Phiri Sam ,   the PURE Malawi Consortium
Published: May 2017

Background:
In 2011, Malawi launched Option B+, a program of universal antiretroviral therapy (ART) treatment for pregnant and lactating women to optimize maternal health and prevent pediatric HIV infection. For optimal outcomes, women need to achieve HIVRNA suppression. We report 6-month HIVRNA suppression and HIV drug resistance in the PURE study.

Methods:
PURE study was a cluster-randomized controlled trial evaluating 3 strategies for promoting uptake and retention; arm 1: Standard of Care, arm 2: Facility Peer Support, and arm 3: Community Peer support. Pregnant and breastfeeding mothers were enrolled and followed according to Malawi ART guidelines. Dried blood spots for HIVRNA testing were collected at 6 months. Samples with ART failure (HIVRNA ≥1000 copies/ml) had resistance testing. We calculated odds ratios for ART failure using generalized estimating equations with a logit link and binomial distribution.

Results:
We enrolled 1269 women across 21 sites in Southern and Central Malawi. Most enrolled while pregnant (86%) and were WHO stage 1 (95%). At 6 months, 950/1269 (75%) were retained; 833/950 (88%) had HIVRNA testing conducted, and 699/833 (84%) were suppressed. Among those with HIVRNA ≥1000 copies/ml with successful amplification (N = 55, 41% of all viral loads > 1000 copies/ml), confirmed HIV resistance was found in 35% (19/55), primarily to the nonnucleoside reverse transcriptase inhibitor class of drugs. ART failure was associated with treatment default but not study arm, age, WHO stage, or breastfeeding status.

Conclusions:
Virologic suppression at 6 months was <90% target, but the observed confirmed resistance rates suggest that adherence support should be the primary approach for early failure in option B+.
Using Small Tests of Change to Improve PMTCT Services in Northern Nigeria: Experiences From Implementation of a Continuous Quality Improvement and Breakthrough Series Program
Authors: Osibo Bamidele , Oronsaye Frank , Alo Oluwafemi D. , Phillips Abimbola , Becquet Renaud , Shaffer Nathan , Ogirima Francis , Imarhiagbe Collins , Ameh Bernice , Ezebuka Obioma , Sodzi-Tettey Sodzi , Obi Adaobi , Afolabi Olusegun T. , Inedu Abutu , Anyaike Chukwuma , Oyeledun Bolanle 
Published: May 2017

Background:
Continuous Quality Improvement (CQI) is a process where health teams systematically collect and regularly reflect on local data to inform decisions and modify local practices and so improve delivery of services. We implemented a cluster randomized trial to examine the effects of CQI interventions on Prevention of Mother-to-Child Transmission (PMTCT) services. Here, we report our experiences and challenges establishing CQI in 2 high HIV prevalence states in northern Nigeria.

Methods:
Facility-based teams were trained to implement CQI activities, including structured assessments, developing change packages, and participation in periodic collaborative learning sessions. Locally evolved solutions (change ideas) were tested and measured using process data and intermediate process indicators were agreed including overall time spent accessing services, client satisfaction, and quality of data.

Results:
Health workers actively participated in clinic activities and in the collaborative learning sessions. During the study, the mean difference in time spent accessing services during clinic visits increased by 40 minutes (SD = 93.4) in the control arm and decreased by 44 minutes (SD = 73.7) in the intervention arm. No significant difference was recorded in the mean client satisfaction assessment score by study arm. The quality of data was assessed using a standardized tool scored out of 100; compared with baseline data, quality at the end of study had improved at intervention sites by 6 points (95% CI: 2.0 to 10.1).

Conclusions:
Health workers were receptive to CQI process. A compendium of “change ideas” compiled into a single change package can be used to improve health care delivery.
The Roles of Expert Mothers Engaged in Prevention of Mother-to-Child Transmission (PMTCT) Programs: A Commentary on the INSPIRE Studies in Malawi, Nigeria, and Zimbabwe
Authors: Cataldo Fabian , Sam-Agudu Nadia A. , Phiri Sam , Shumba Bridget , Cornelius Llewellyn J. , Foster Geoff 
Published: May 2017

Introduction:
Several initiatives aiming to improve retention and adherence in Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs include “expert mothers” (EMs) as a central tenet of their interventions. This article compares the role of EMs in 3 implementation research studies examining approaches for improving retention in care among mothers living with HIV.

Methods:
We compared and synthesized qualitative data and lessons learned from 3 studies (MoMent in Nigeria, PURE in Malawi, and EPAZ in Zimbabwe) with respect to the involvement of EMs in supporting PMTCT clients. The frame of reference for the comparison is the role that EMs play in PMTCT service delivery for individuals, at the health facility, within the health system, and in the community.

Results:
EMs' role was positively perceived by PMTCT clients and health care workers, as EMs provided an expanded range of services directly benefiting clients and enabling health care workers to share their workload. Common challenges included difficulties in reaching male partners and fear of stigma. The lack of structure and standardization in EM interventions in relation to eligibility criteria, training, certification, and remuneration were identified as important barriers to EMs' role development within existing health systems.

Conclusions:
The role of EMs within PMTCT programs continues to expand rapidly. There is a need for coordinated action to develop shared standards and principles commensurate with the new roles and additional demands placed on EMs to support PMTCT services, including EM certification, mentoring and supervision standards, standardized PMTCT-specific training curricula, and, where appropriate, agreed remuneration rates.
Hydrogen Sulfide: A Potential Novel Therapy for the Treatment of Ischemia
Authors: Jensen Amanda R. , Drucker Natalie A. , Khaneki Sina , Ferkowicz Michael J. , Yoder Mervin C. , DeLeon Eric R. , Olson Kenneth R. , Markel Troy A. 
Published: May 2017

ABSTRACT
Hydrogen sulfide (H2S) is a novel signaling molecule most recently found to be of fundamental importance in cellular function as a regulator of apoptosis, inflammation, and perfusion. Mechanisms of endogenous H2S signaling are poorly understood; however, signal transmission is thought to occur via persulfidation at reactive cysteine residues on proteins. Although much has been discovered about how H2S is synthesized in the body, less is known about how it is metabolized. Recent studies have discovered a multitude of different targets for H2S therapy, including those related to protein modification, intracellular signaling, and ion channel depolarization. The most difficult part of studying hydrogen sulfide has been finding a way to accurately and reproducibly measure it. The purpose of this review is to: elaborate on the biosynthesis and catabolism of H2S in the human body, review current knowledge of the mechanisms of action of this gas in relation to ischemic injury, define strategies for physiological measurement of H2S in biological systems, and review potential novel therapies that use H2S for treatment.
Target Serum Sodium Levels During Intensive Care Unit Management of Aneurysmal Subarachnoid Hemorrhage
Authors: Okazaki Tomoya , Hifumi Toru , Kawakita Kenya , Shishido Hajime , Ogawa Daisuke , Okauchi Masanobu , Shindo Atsushi , Kawanishi Masahiko , Tamiya Takashi , Kuroda Yasuhiro 
Published: May 2017

ABSTRACT

Introduction:
Dysnatremia commonly occur in the intensive care unit (ICU) management of patients with aneurysmal subarachnoid hemorrhage (SAH). However, detailed management strategies have not been provided even by current guidelines. The purposes of this study were to examine the association of abnormal serum sodium levels with unfavorable neurologic outcomes and to identify the target range of serum sodium in patients with SAH.

Methods:
We retrospectively reviewed all patients who were consecutively hospitalized with a confirmed diagnosis of SAH between January 2009 and December 2015. Univariate/multivariate analyses were performed to identify the independent predictors of an unfavorable neurologic outcome (modified Rankin scale of 3–6 upon hospital discharge).

Results:
There were 131 patients included in this study. Unfavorable neurologic outcomes occurred in 45% of patients. On multiple regression analysis, age, Hunt and Kosnik grade, and serum sodium levels in the ICU at the maximum [odds ratio (OR), 1.18; 95% CI, 1.05–1.35; P < 0.01] and minimum (OR, 0.88; 95% CI, 0.77–0.99; P = 0.048) values were significantly associated with unfavorable neurologic outcomes. The receiver operating characteristic curve analysis showed that the cut-off serum sodium levels were 145 mmol/L for maximum value and 132 mmol/L for minimum value. Patients with hyponatremia and hypernatremia during the first 2 weeks in the ICU accounted for 88.2% of patients with an unfavorable neurologic outcome; whereas, those with normal sodium levels accounted for only 15.6%.

Conclusions:
In patients with SAH, both hyponatremia and hypernatremia during ICU management were significantly associated with unfavorable neurologic outcomes.
Interleukin-22 Prevents Microbial Dysbiosis and Promotes Intestinal Barrier Regeneration Following Acute Injury
Authors: Hammer Adam M. , Morris Niya L. , Cannon Abigail R. , Khan Omair M. , Gagnon Robin C. , Movtchan Nellie V. , van Langeveld Ilse , Li Xiaoling , Gao Bin , Choudhry Mashkoor A. 
Published: May 2017

ABSTRACT
Intestine barrier disruption and bacterial translocation can contribute to sepsis and multiple organ failure, leading causes of mortality in burn-injured patients. In addition, findings suggest that ethanol (alcohol) intoxication at the time of injury worsens symptoms associated with burn injury. We have previously shown that interleukin-22 (IL-22) protects from intestinal leakiness and prevents overgrowth of gram-negative bacteria following ethanol and burn injury, but how IL-22 mediates these effects has not been established. Here, utilizing a mouse model of ethanol and burn injury, we show that the combined insult results in a significant loss of proliferating cells within small intestine crypts and increases Enterobacteriaceae copies, despite elevated levels of the antimicrobial peptide lipocalin-2. IL-22 administration restored numbers of proliferating cells within crypts, significantly increased Reg3β, Reg3γ, lipocalin-2 AMP transcript levels in intestine epithelial cells, and resulted in complete reduction of Enterobacteriaceae in the small intestine. Knockout of signal transducer and activator of transcription factor-3 (STAT3) in intestine epithelial cells resulted in complete loss of IL-22 protection, demonstrating that STAT3 is required for intestine barrier protection following ethanol combined with injury. Together, these findings suggest that IL-22/STAT3 signaling is critical to gut barrier integrity and targeting this pathway may be of beneficial clinical relevance following burn injury.
Does individual heterogeneity shape retail investor behaviour?
Authors: Chandra Abhijeet , Sanningammanavara Kantesha , Nandini A. Satya 
Published: May 2017

PurposeThe purpose of this paper is to survey retail investors to study the determinants of their investment behaviour and show that individual heterogeneity and financial factors such as gender, age, educational status, income, and investment levels determine their trading behaviour across three domains; however, features such as marital status and occupation do not play any significant role in shaping their trading behaviour.Design/methodology/approachStructured surveys are conducted on retail and small investors using the brokerage services of a firm. Data collected from primary methods are used for statistical analysis in ANOVA and multiple regression frameworks.FindingsThe authors also report that retail investors’ self-perceived confidence as a function of both expected and unexpected changes in the market and personal factors largely determines trading behaviour of retail investors and that self-perceived confidence level and self-reported portfolio size are positively associated implying that (over-)confident retail investors tend to believe that their investment skills being superior are bound to perform better and thus they typically hold larger than average investment portfolios.Practical implicationsThese findings are significant because research on cross-sectional variance of individual investment behaviour explains how investor heterogeneity plays a critical role in investment and asset allocation decisions. Investors, researchers, and practitioners would use the results for financial decision making specifically related to personal finance, behavioural portfolio management, and investment advisory.Originality/valueThis paper is an empirical approach to explore the retail investor behaviour using psychometric approach with respect to self-perceived confidence and other perceived measures of investor behaviour. The authors contribute to the emerging set of literature on investor behaviour and behavioural finance.
Factors determining child mortality in Uganda
Authors: Kaberuka Will , Mugarura Alex , Tindyebwa Javan , Bishop Debra S. 
Published: May 2017

PurposeThe purpose of this paper is to establish socio-economic factors and maternal practices that determine child mortality in Uganda.Design/methodology/approachThe paper examines the role of sex, birth weight, birth order and duration of breastfeeding of a child; age, marital status and education of the mother; and household wealth in determining child mortality. The study employs a logistic regression model to establish which of the factors significantly impacts child mortality in Uganda.FindingsThe study established that education level, age and marital status of the mother as well as household wealth significantly impact child mortality. Also important are the sex, birth weight, birth order and breastfeeding duration.Research limitations/implicationsPolicies aimed at promoting breastfeeding and education of female children can make a significant contribution to the reduction of child mortality in Uganda.Practical implicationsHealth care intervention programs should focus on single, poor and uneducated mothers as their children are at great risk due to poor and inadequate health care utilization.Originality/valueThis paper could be the first effort in examining child mortality status in Uganda using a logistic regression model.