bluuebunny/crossref_metadata_2025_split huggingface dataset:
Engaging Transgender People in NIH-Funded HIV/AIDS Clinical Trials Research
Authors: Siskind Rona L. , Andrasik Michele , Karuna Shelly T. , Broder Gail B. , Collins Clare , Liu Albert , Lucas Jonathan Paul , Harper Gary W. , Renzullo Philip O. 
Published: July 2016

Abstract:
In 2009, the National Institutes of Health recognized the need to expand knowledge of lesbian, gay, bisexual, and transgender (LGBT) health and commissioned the Institute of Medicine to report on the health of these populations in the United States. The resulting Institute of Medicine publication called for more knowledge of the health of LGBT populations, as well as improved methodologies to reach them, more LGBT-focused research, and enhanced training programs and cultural competency of physicians and researchers. Several of the National Institutes of Health–funded HIV/AIDS clinical trials networks, including the Adolescent Medicine Trials Network for HIV/AIDS Interventions, HIV Prevention Trials Network, HIV Vaccine Trials Network, and Microbicide Trials Network, have focused attention on engaging transgender (TG) individuals in research. They have identified issues that transcend the nature of research (ie, treatment or prevention, adult or adolescent) and have adopted various approaches to effectively engage the TG community. Each network has recognized the importance of developing partnerships to build trust with and seek input from TG individuals on research plans and policies. They have established standing advisory groups and convened consultations for this purpose. To ensure that trial data are reflective of the participants they are seeking to enroll, they have reviewed and revised data collection forms to incorporate the 2-step method of collecting sex at birth and gender identity as 2 independent variables, and some have also revised research protocol templates and policies for concept development to ensure that they are appropriate for the inclusion of TG participants. The networks have also initiated trainings to enhance cultural sensitivity and developed a range of materials and resources for network and clinical research site staff. They continue to identify TG-specific research needs in an effort to be more responsive to and improve the health of TG individuals, particularly related to HIV/AIDS.
Transgender Women in Clinical Trials of Pre-Exposure Prophylaxis
Authors: Grant Robert M. , Sevelius Jae M. , Guanira Juan V. , Aguilar Jana Villayzan , Chariyalertsak Suwat , Deutsch Madeline B. 
Published: July 2016

Abstract:
Lessons were learned with trans women who participated (as volunteers and investigators) in trials of HIV pre-exposure prophylaxis (PrEP). Trans women are not men. Compared with men who have sex with men, trans women trial participants were more likely to be involved with transactional sex, had more sexual partners, and were less likely to have PrEP medications detected in blood. Trans women define themselves differently in different cultures. One best practice is to ask at least 2 gender questions: sex assigned at birth and current gender. More information is needed to fully situate PrEP efficacy for trans women, including analysis of drug–drug interactions between PrEP medications and feminizing hormones and PrEP drug penetration into neovaginal tissues. Including trans women in studies is helpful only if their participation is specifically reported, as could occur in a table of baseline characteristics of the enrolled cohort. Gender-affirming care is important to foster appropriate uptake and use of PrEP. Such care includes use of preferred pronouns and names, safety to use the bathroom of choice, and access to gender-affirming hormone therapy and surgery. The consistent finding that PrEP works when taken across diverse populations having diverse practices related to gender, sexual intercourse, and hormone use provides a basis for offering PrEP to people at substantial risk of acquiring HIV although some subgroups may not have been fully represented in trials. Nonetheless, specific PrEP implementation science for trans women (and men) is essential to develop best practices for PrEP delivery and use.
Expanded Cheek-Shaped Flap for Aesthetic Cheek Reconstruction in the Cervicoperiauricular Area
Authors: Tian Jia , Fan Jincai , Liu Liqiang , Gan Cheng , Yang Zengjie , Chen Wenlin , Yin Zhuming 
Published: July 2016

Background
The cervical area is well acknowledged as an ideal donor site for aesthetic reconstruction of the cheek, and tissue expansion may play an important role for maximally achieving such a purpose. However, the conventional design of the expanded cervical flap generally results in unsightly morbidity of the donor site. The aim of this study is to evaluate the results of using an improvised cervical expanded flap in aesthetic reconstruction of the cheek.

Methods
From July 2004 to October 2012, a total of 23 burn sequelae patients (30 cheeks) underwent cheek reconstruction with an expanded flap that originated from the cervicoperiauricular area. The procedures were initially carried out with the insertion of a round tissue expander in the cervicoperiauricular area, followed by serial inflation of the expander, and finally, transplantation of the expanded flap to the cheek in a rotation advancement fashion. The donor site closure was along the auricular sulcus.

Results
The average area of the harvested flaps was 9.7 × 8.1 cm. All the flaps completely survived, only one major complication occur-a dome exposure of the tissue expander after the expansion was completed. The flap was salvaged, and the transfer stage was done without intact. Minor complications after flap transfer include: widened scar at the donor site, a “dog-ear” needing additional minor surgery, distal part of the flap transient congestion. The patients achieved very satisfactory results functionally and aesthetically.

Conclusions
Using the expanded cheek-shaped flap technique can provide a safe, thin, and color-matched flap in aesthetic reconstruction of the cheek with minimal donor site morbidity.
Using a Low Fluence Q-Switched 532/1064-nm Nd
Authors: Shen Jen-Hsiang , Chang Chang-Cheng , Chen Yu-Tsung , Hsih Chao-Jen , Huang Hsin , Lin Bor-Shyh 
Published: July 2016

Background and Objectives
Low fluence Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers are widely applied for facial depigmentation. Nonetheless, few reports analyze the general outcome, complications, of single and combined therapy of 532/1064-nm Nd:YAG lasers in Asian patients with Fitzpatrick type IV skin.

Study Design/Materials and Methods
We retrospectively reviewed all consecutive patients who completed 5 consecutive sessions at 1-month intervals of treatment with 1064-nm (spot size: 5–7 mm, 1.5–2.0 J/cm2) or combined with 532-nm (spot size, 2–3 mm; 0.5–1.5 J/cm2) Nd:YAG laser (Laseroptek, Korea) from October 2011 to March 2013. The patients, laser surgeon, and 3 blinded reviewers assessed the outcomes and complications. Improvement was graded as follows: 1, 0%–25%; 2, 26%–50%; 3, 51%–75%; 4, 76–90%; and 5, greater than 90%. Postinflammatory hyperpigmentation (PIH) was documented according to the severity (1, slight; 2, moderate; 3, severe; and 4, extreme). Other post-laser side effects were also documented (eg, scaling, dryness, erythema, and pruritus).

Results
Four male patients and 37 female patients were included with a mean age of 38.5 years (SD, 10.1 years). There were no significant differences on patients', surgeon's, or blinded reviewers' improvement gradings. (4.11 ± 0.62 vs 4.30 ± 0.46, P = 0.54; 3.88 ± 0.66 vs 3.89 ± 0.31, P = 0.50; 3.30 ± 0.69 vs 3.74 ± 0.38, P = 0.34). Transient minor side effect occurred as follows: erythema in 9 (22%), pruritus in 7 (17%), dryness in 6 (15%), and scaling in 6 (15%). There was no risk difference in these side effects between groups. The PIH scores were slight in 10 patients (4 in single and 6 in combined), severe in 4 (3 in single and 1 in combined), and extreme in 1 (single therapy). The PIH incidence also did not differ (33.3%, 35.3%; P = 0.58).

Conclusions
We reported satisfactory outcomes after low-fluence Q-switched sole 1064-nm or combined 532/1064-nm therapy. The outcome and complication profiles did not differ between the groups. The PIH incidence was not low, but usually transient. The incidence of severe or extreme PIH was rare.
Comparison of Short-term Outcomes After Laparoscopic Versus Open Hartmann Reversal: A Case-matched Study
Authors: Onder Akin , Gorgun Emre , Costedio Meagan , Kessler Hermann , Stocchi Luca , Benlice Cigdem , Remzi Feza 
Published: July 2016

Purpose:The aim of this study is to compare short-term outcomes of laparoscopic versus open Hartmann reversal.Materials and Methods:Patients who underwent Hartmann reversal between January 2005 and September 2014 were identified and matched for age, sex, body mass index, American Society of Anesthesiologists score, and creation of diverting ileostomy to open counterparts. Patient characteristics and postoperative outcomes (30 d) were evaluated.Results:Eighteen patients with laparoscopic Hartmann reversal were matched to 18 open patients. There were no differences between laparoscopic versus open groups in terms of operative time (157.7±52.2 vs. 151.5±49.3 min,P>0.05) or overall complication rates [6 (33.3%) vs. 6 (33.3%) (P>0.05)]. No anastomotic leaks or mortality occurred in either group. However, the laparoscopic group was associated with significantly decreased estimated blood loss (114±103 vs. 217±125 mL,P<0.05), faster return of bowel function (3.2±0.6 vs. 4±0.6 d,P<0.05), and reduced hospital stay (5.4±3.1 vs. 8.3±4.8 d,P<0.05).Conclusions:Laparoscopic Hartmann reversal can be safely performed with better short-term outcomes in carefully selected patients.
Triathlete Risk of Pelvic Floor Disorders, Pelvic Girdle Pain, and Female Athlete Triad
Authors: Yi Johnny , Tenfelde Sandi , Tell Dina , Brincat Cynthia , Fitzgerald Colleen 
Published: July 2016

Objectives
Our primary objective was to describe the prevalence of pelvic floor disorders (PFDs), pelvic girdle pain (PGP), and the female athlete triad (disordered eating, menstrual irregularities, and osteoporosis) in a female triathlete population. We also evaluated for an association between these conditions.

Methods
We administered an online survey to women who self-identified as female triathletes. Using validated questionnaires, Epidemiology of Prolapse and Incontinence Questionnaire and Pelvic Girdle Questionnaire, along with the female athlete triad questionnaire, we identified the prevalence of PFDs, PGP, and female athlete triad in this specific population. Demographic and exercise intensity were also queried to characterize these female triathletes.

Results
Three hundred eleven female triathletes responded to the Internet survey. There was a significant prevalence of PFDs with stress urinary incontinence and anal incontinence symptoms being most common (37.4% and 28%, respectively). Urgency urinary incontinence and pelvic organ prolapse were less common (16% and 5%, respectively). Stress urinary incontinence and pelvic organ prolapse were more common in parous triathletes (P = 0.001, P = 0.05). Pelvic girdle pain was noted in 18% of these triathletes but was not disabling. Twenty-four percent of participants screened positive for at least 1 arm of the female athlete triad. No association was found between the female athlete triad and PFDs.

Conclusions
Pelvic floor disorders are common and bothersome in female triathletes. Pelvic girdle pain, while present, does not limit these athletes from their training. These female triathletes may be at risk for the female athlete triad. Female triathletes may be at risk for both metabolic and PFDs and should be screened when identified.
Persistent Postoperative Pain: Pathophysiology, Risk Factors, and Prevention
Authors: Butrick Charles W. 
Published: July 2016

Objective
Persistent postoperative pain (PPOP) is the second most common reason for a patient to seek care at a chronic pain center. Many of the patients seen with prolapse or incontinence are at risk for developing PPOP as a result of the surgeries done for these problems. The pathophysiology of this disabling pain disorder is well understood, and the risk factors are easy to identify. Once identified, perioperative interventions can be offered to attempt to prevent PPOP.

Methods and Results
Evaluation of articles obtained using a MEDLINE search involving chronic pain and PPOP, including prevalence, pathophysiology, and prevention was reviewed. The concept of central censitization and the key role it plays in chronic pain disorders were also reviewed. A history of chronic pain (anywhere) as well as findings of levator myalgia, allodynia, and hypertonic pelvic floor disorders is critical in identifying patients at risk for PPOP.

Conclusions
Identification of patients at risk allows the clinician to educate the patient about the risk of PPOP and the various perioperative interventions that can be used to prevent its development. Further studies will be required to determine how effective these interventions are in patients undergoing surgery for incontinence and/or pelvic organ prolapse.
Outpatient Narcotic Use After Minimally Invasive Urogynecologic Surgery
Authors: Swenson Carolyn W. , Kelley Angela S. , Fenner Dee E. , Berger Mitchell B. 
Published: July 2016

Objectives
To quantify outpatient narcotic use in the first 2 weeks after urogynecologic surgery.

Methods
Using a convenience sample, women who underwent minimally invasive urogynecologic surgery between May and October 2014 were contacted by telephone 2 weeks postoperatively and given a questionnaire regarding their postoperative pain experience. To quantify narcotic use, patients were asked to count the tablets remaining from their discharge narcotic prescription. Postoperative pain scores and pain expectations were also assessed. Women using more than 30 narcotics were in the top quartile for use; therefore, those using 30 or fewer versus more than 30 were compared. Logistic regression was used to identify independent factors associated with women in the top quartile for postoperative narcotic use.

Results
Fifty women were included in the study. Median number of narcotics used was 13 (interquartile range (IQR), 1-30) versus 40 (IQR, 35-60) prescribed. Compared to women who used 30 or fewer narcotics (n=38), those using more than 30 (n=12) more frequently were taking narcotics before surgery (13.2% vs 41.7%; P=0.03) and had a chronic pain diagnosis (15.8% vs 58.3%; P=0.003). Although pain scores were similar, women who took more than 30 narcotics more frequently reported their postoperative pain to be much worse or worse than expected (7.9% vs 33.3%; P=0.048). In logistic regression, chronic pain remained the only factor associated with using more than 30 narcotics (odds ratio, 7.36; 95% confidence interval, 1.00-54.03; P=0.0496).

Conclusions
Women used one third of the narcotics they were prescribed after minimally invasive urogynecologic surgery. These data may be useful for establishing narcotic prescription guidelines.
Modelling tree growth taking into account carbon source and sink limitations
Authors: Hayat Amaury , Hacket-Pain Andrew J. , Pretzsch Hans , Rademacher Tim Tito , Friend Andrew D. 
Published: July 2016

AbstractIncreasing CO2concentrations are strongly controlled by the behaviour of undisturbed forests, which are believed to be a major current sink of atmospheric CO2. There are many models which predict forest responses to environmental changes but they are almost exclusively carbon source (i.e. photosynthesis) driven. Here we present a model for an individual tree that takes into account also the intrinsic limits of meristems and cellular growth rates, as well as control mechanisms within the tree that influence its diameter and height growth over time. This new framework is built on process-based understanding combined with differential equations solved by the Runge-Kutta-Fehlberg (RKF45) numerical method. It was successfully tested for stands of beech trees in two different sites representing part of a long-term forest yield experiment in Germany. This model provides new insights into tree growth and limits to tree height, and addresses limitations of previous models with respect to sink-limited growth.Author SummaryGreenhouse gas emissions, in particular of CO2, have emerged as one of the most important global concerns, and it is therefore important to understand the behaviour of forests as they absorb and store a very large quantity of carbon. Most models treat forests as boxes with growth only driven by photosynthesis, while their actual growth depends also on many other important processes such as the maximal rate at which individual cells can grow, the influences of temperature and soil moisture on these cells, and the control that the tree has on itself through endogenous signalling pathways. Therefore, and with inspiration from process-based understanding of the biological functioning of trees, we have developed a model which takes into account these different factors. We first use this knowledge and additional basic assumptions to derive a system of several equations which, when solved, enable us to predict the height and the radius of an individual tree at a given time, provided that we have enough information about its initial state and its surroundings. We use the Runge-Kutta-Fehlberg mathematical method to obtain a numerical solution and thus predict the development of the height and radius of an individual tree over time under specified conditions.
Inference of epistatic effects leading to entrenchment and drug resistance in HIV-1 protease
Authors: Flynn William F. , Haldane Allan , Torbett Bruce E. , Levy Ronald M. 
Published: July 2016

AbstractUnderstanding the complex mutation patterns that give rise to drug resistant viral strains provides a foundation for developing more effective treatment strategies for HIV/AIDS. Multiple sequence alignments of drug-experienced HIV-1 protease sequences contain networks of many pair correlations which can be used to build a (Potts) Hamiltonian model of these mutation patterns. Using this Hamiltonian model we translate HIV protease sequence covariation data into quantitative predictions for the probability of observing specific mutation patterns which are in agreement with the observed sequence statistics. We find that the statistical energies of the Potts model are correlated with the fitness of individual proteins containing therapy-associated mutations as estimated by in vitro measurements of protein stability and viral infectivity. We show that the penalty for acquiring primary resistance mutations depends on the epistatic interactions with the sequence background. Primary mutations which lead to drug resistance can become highly advantageous (or entrenched) by the complex mutation patterns which arise in response to drug therapy despite being destabilizing in the wildtype background. Anticipating epistatic effects is important for the design of future protease inhibitor therapies.
Conceptualizations of professional competencies in school health promotion
Authors: Carlsson Monica 
Published: July 2016

Purpose– The purpose of the paper is to contribute to the conceptualization and discussion of professional competencies needed for supporting the development of the whole-school approach in school health promotion (SHP).Design/methodology/approach– The paper is based on a conceptual synthesis of literature, guided by a theoretical perspective on health promotion agency and professional competencies to identify core competency domains and elements. This is followed by a discussion of focus, gaps and links in conceptualizations of competency domains and elements.Findings– The synthesis identifies five core competency domains: policy-development; organizational development; professional development; development of students’ learning; and development of health promotion activities. Three critical gaps in the conceptualizations of competency domains and elements are identified and discussed: the downplay of the development of learning domain and the narrow focus on cognitive elements within it; the narrow focus on cognitive elements and technical-organizational elements in the development of HP activities domain; and the downplay of affective competency elements across domains.Practical implications– The five competency domains may provide an overall guiding tool for professionals tasked with practice and competency development in SHP, and a point of departure for the development of conceptualizations of professional competencies in concrete practice contexts.Originality/value– The paper delineates an overall professional competency model for SHP, discusses the specific demands on professional competencies within this field in relation to this model, and addresses three critical gaps in the conceptualizations of competency.
Collective action competence: an asset to campus sustainability
Authors: Clark Charlotte R. 
Published: July 2016

Purpose
The purpose of this paper is to operationalize theories of social learning and collective action for campus sustainability practitioners at higher education instititions (IHEs) to enhance their work, and to introduce the concept of collective action competence as a practical tool.

Design/methodology/approach
This paper presents a theoretical argument based on the concepts of learning and collective action for stronger consideration of social learning, action competence and voluntary collective action in campus sustainability initiatives.

Findings
Many important sustainability outcomes depend heavily on voluntary behaviors by groups of campus stakeholders, making voluntary collective action an important, although underused, tool for campus sustainability practitioners. The term “collective action competence” is introduced and defined as the capability of a group of people to direct their behavior toward a common goal based on a collective literacy, a collective competence, and a collective need or goal.

Originality/value
The term “collective action competence” is introduced as a novel unifying concept that articulates a critical capability needed for collective behavior change in social settings such as HEIs. Collective action competence is based on the theories of collective action and of social and free-choice learning and on the concepts of action competence and strategic competence.