bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Pregnancy on Response to Antiretroviral Therapy in HIV-Infected African Women
Authors: Kourtis Athena P. , Wiener Jeffrey , King Caroline C. , Heffron Renee , Mugo Nelly R. , Nanda Kavita , Pyra Maria , Donnell Deborah , Celum Connie , Lingappa Jairam R. , Baeten Jared M. ,   for the Partners in Prevention HSV/HIV Transmission Study and Partners PrEP Study Teams
Published: October 2016

Background:While most recent evidence does not support a role for pregnancy in accelerating HIV disease progression, very little information is available on the effects of incident pregnancy in response to antiretroviral therapy (ART). Hormonal, immune, and behavioral changes during pregnancy may influence response to ART. We sought to explore the effects of incident pregnancy (after ART initiation) on virologic, immunologic, and clinical response to ART.Methods:Data were collected from HIV-infected women participating in 3 prospective studies (Partners in Prevention Herpes simplex virus/HIV Transmission Study, Couples Observational Study, and Partners Preexposure Prophylaxis Study) from 7 countries in Africa from 2004 to 2012. Women were included in this analysis if they were ≤45 years of age, were started on ART during the study and were not pregnant at ART initiation. Pregnancy was treated as a time-dependent exposure variable covering the duration of pregnancy, including all pregnancies occurring after ART initiation. Virologic failure was defined as a viral load (VL) greater than 400 copies per milliliter ≥6 months after ART initiation and viral suppression was defined as VL ≤400 copies per milliliter. Multivariable Cox proportional hazards models were used to assess the association between pregnancy and time to viral suppression, virologic failure, World Health Organization clinical stage III/IV, and death. Linear mixed-effects models were used to assess the association between pregnancy and CD4+count and VL. All analyses were adjusted for confounders, including pre-ART CD4+count and plasma VL.Results:A total of 1041 women were followed, contributing 1196.1 person-years of follow-up. Median CD4+count before ART initiation was 276 cells per cubic millimeter (interquartile range, 209–375); median pre-ART VL was 17,511 copies per milliliter (interquartile range, 2480–69,286). One hundred ten women became pregnant after ART initiation. Pregnancy was not associated with time to viral suppression (adjusted hazard ratio [aHR], 1.20, 95% confidence interval [CI]: 0.82 to 1.77), time to virologic failure (aHR, 0.67, 95% CI: 0.37 to 1.22), time to World Health Organization clinical stage III or IV (aHR, 0.79, 95% CI: 0.19 to 3.30), or time to death (aHR, 2.04, 95% CI: 0.25 to 16.8). Incident pregnancy was associated with an adjusted mean decrease in CD4+T-cell count of 47.3 cells per cubic millimeter (P< 0.001), but not with difference in VL (P= 0.06).Conclusions:For HIV-infected women on ART, incident pregnancy does not affect virologic control or clinical HIV disease progression. A modest decrease in CD4+T-cell count could be due to physiologic effects of pregnancy.
Brief Report: Impaired CD4 T-Cell Response to Autophagy in Treated HIV-1–Infected Individuals
Authors: Gómez-Mora Elisabet , Robert-Hebmann Véronique , García Elisabet , Massanella Marta , Clotet Bonaventura , Cabrera Cecilia , Blanco Julià , Biard-Piechaczyk Martine 
Published: October 2016

Abstract:
Autophagy restricts infection of CD4 T lymphocytes by HIV-1, but little is known about autophagy in treated HIV-1–infected individuals. We have analyzed the capability of CD4 T cells from aviremic-treated individuals to trigger autophagy and correlated this response with parameters known to be important for immunological recovery. Autophagy was significantly decreased in CD4 T cells from HIV-1–treated individuals compared with uninfected controls, and this defective autophagic response was more pronounced in individuals with poor CD4 T-cell recovery, suggesting a link between impaired autophagy in CD4 T cells and chronic immunological defects that remain in treated HIV infection.
Housing Stability and Medication Adherence among HIV-Positive Individuals in Antiretroviral Therapy: A Meta-Analysis of Observational Studies in the United States
Authors: Harris Rebecca Arden , Xue Xiaonan , Selwyn Peter A. 
Published: October 2016

Background:
Previous research has produced inconsistent evidence of an association between housing stability and medication adherence among HIV-positive individuals in antiretroviral therapy.

Objective:
We conducted a meta-analysis of the housing–adherence relationship based on a comprehensive search of observational studies in the PubMed, Embase, and Cochrane databases (January 2000–January 2016). Ten qualifying studies were identified representing 10,556 individuals.

Methods:
A random-effects model was used to estimate the overall effect size and 95% confidence interval (CI). Robustness of the estimate was determined by sensitivity analysis. Heterogeneity was assessed by meta-regression analysis, subgroup analysis, and quality effects estimation. Publication bias was evaluated with a funnel plot and the Egger and Begg tests.

Results:
The summary effect for the association between housing stability and medication adherence was positive and significant (standardized mean difference = 0.15, 95% CI: 0.02 to 0.29). The association was slightly larger in the quality effects analysis (standardized mean difference = 0.20, 95% CI: 0.01 to 0.39). Sensitivity analysis disclosed that the association was robust at the P = 0.09 level. Results of the subgroup and meta-regression analyses were nonsignificant. Publication bias was not detected.

Conclusion:
Antiretroviral medication adherence is an increasing function of housing stability, but the magnitude of the effect is small. The finding challenges the view that unstable housing is incompatible with adherence and questions the potential benefit of deferring antiretroviral therapy initiation until the patient's housing circumstances are improved.
Combined Stent Insertion and High-intensity Focused Ultrasound Ablation for Patients With Malignant Obstructive Jaundice
Authors: Niu Su , Cheng Long , Qiao Yan , Fu Yu-Fei , Cao Chi 
Published: October 2016

Purpose:
We aimed to determine the clinical effectiveness of combined stent insertion and high-intensity focused ultrasound (HIFU) ablation for patients with malignant obstructive jaundice (MOJ).

Materials and Methods:
From June 2013 to May 2015, consecutive patients with inoperable MOJ underwent biliary stent with or without HIFU ablation in our center. Treatment-related complications, stent patency time, and survival time were compared between 2 groups.

Results:
During the enrolled time, a total of 51 patients with MOJ underwent biliary stent with HIFU ablation (n=24) or biliary stent only (n=27) in our center. There was no significant difference in baseline data between 2 groups. Relief of jaundice was achieved in all patients in both groups. Cholangitis was observed in 2 patients in stent with HIFU ablation group and 1 patient in stent only group (P=0.483). Reobstruction of stent was observed in 4 patients in stent with HIFU ablation group and 8 patients in stent only group (P=0.276). The mean stent patency time was 367±41 days in stent with HIFU ablation group and 257±35 days in stent only group (P=0.037). The mean overall survival was 238±31 days in stent with HIFU ablation group and 152±20 days in stent only group (P=0.014).

Conclusions:
Combined biliary stent insertion and HIFU ablation is a safe and easy method for patients with MOJ, and seems to extend stent patency time and survival when compared with biliary stent only.
Obliterative Versus Reconstructive Prolapse Repair for Women Older than 70: Is There an Optimal Approach?
Authors: Dessie Sybil G. , Shapiro Alex , Haviland Miriam J. , Hacker Michele R. , Elkadry Eman A. 
Published: October 2016

Objectives
This study aimed to evaluate outcomes among women 70 years and older who underwent obliterative compared with reconstructive procedures for pelvic organ prolapse.

Methods
This was a retrospective cohort study of patients 70 years and older who underwent surgical prolapse repair at our institution from January 2004 through June 2010. Only patients with at least 4 weeks of follow-up were included. Patient characteristics and relevant pre, intra, and postoperative information were abstracted from medical records. Severity of postoperative complications was classified using the Dindo surgical classification system.

Results
We analyzed 143 (97.3%) patients. Fifty-four (37.8%) women underwent an obliterative procedure, whereas 89 (62.2%) underwent a reconstructive procedure. Twenty-eight (31.5%) women who had a reconstructive surgery met our criteria for recurrent prolapse compared with only 5 (9.3%) women in the obliterative group (P = 0.002).
The incidence of intraoperative complication was 4.9%, and the incidence of any postoperative complication was 62.9%. Similar proportions of women who underwent each type of procedure experienced a postoperative complication. However, the severity of the complications differed between the groups (P = 0.02). In particular, 16.9% of women who had a reconstructive procedure experienced a grade III complication according to the Dindo scale compared with 13.0% of women who had an obliterative procedure.

Conclusions
The majority of women 70 years and older do not have high-grade complications after pelvic organ prolapse repair, but women who undergo reconstructive procedures are more likely to experience high-grade complications and recurrent prolapse compared with women who undergo obliterative procedures.
Analysis of Physical Therapy Intervention Outcomes for Urinary Incontinence in Women Older Than 65 Years in Outpatient Clinical Settings
Authors: Neville Cynthia E. , Beneciuk Jason , Bishop Mark , Alappattu Meryl 
Published: October 2016

Background:
Conservative interventions provided by physical therapists for the treatment of bladder control problems in adult females are strongly supported in the literature and in clinical practice guidelines. However, physical therapy (PT) intervention outcomes specifically for women older than 65 years with urinary incontinence (UI) in outpatient settings in the United States have not been extensively reported.

Objectives:
To provide preliminary PT intervention outcome data specific to female patients older than 65 years receiving outpatient PT for UI.

Design:
Preliminary retrospective analysis of a convenience sample of women 65 to 93 years of age.

Methods:
Women older than 65 years with UI who were referred to outpatient PT and answered “yes” to a UI screening question at intake completed 3 UI surveys (3 Incontinence Questions [3IQ], Incontinence Impact Questionnaire Short-Form [IIQ-7] and the International Consultation on Incontinence Modular Questionnaire—Urinary Incontinence [ICIQ-UI]). Patients received individualized treatment provided by a physical therapist. Physical therapists were asked to administer the surveys again during and/or after treatment. Demographic, clinical, and health-related quality of life data were collected. Frequency of UI types, UI symptoms, and impact of quality of life were analyzed. Paired samples t test was used to evaluate the change in measures between the initial survey and a follow-up survey.

Results:
Surveys were collected from 62 women. Significant changes in scores on 2 outcome measures (ICIQ-UI and IIQ-7) indicated significant reductions in UI symptom severity and improvements in UI-related health-related quality of life after undergoing individualized PT treatment of UI.

Limitations:
The study population was a convenience sample. Data on treatment interventions were not collected.

Conclusions:
Individualized interventions provided by physical therapists have the potential to significantly improve symptom severity and health-related quality of life in women older than 65 years with different types of UI.
Clinical Commentary: Pelvic Organ Prolapse and Incontinence
Authors: Hulme Janet A. 
Published: October 2016

Background and Purpose:
Pelvic organ prolapse (POP) and urinary incontinence (UI) are more prevalent with increasing life expectancy. Up to 75% of women age 45 to 85 years have some degree of prolapse. Typical symptoms related to POP include pelvic pressure, pelvic and low back pain, urinary and bowel symptoms, and sexual dysfunction. The purpose of this report is to describe the theoretical basis of a novel conservative intervention for the treatment of symptoms related to POP and incontinence in older women through the use of a case description.

Methods:
The conservative management program combines deep pelvic and hip muscle exercises with pelvic postural inversion. The case description exemplifies the treatment protocol that has the potential to reduce the severity or degree of prolapse and improve symptoms and quality of life in women with POP and associated UI.

Conclusion:
The basis for the novel conservative approach to treatment of POP and UI revolves around the perspective that POP is the functional failure of the pelvic organ support system and associated lumbopelvic hip musculoskeletal system. The combined organ and musculoskeletal system, the “pelvic core” system, includes all structures within the lower pelvis. As one organ's descent occurs, it leads to alterations in the position of adjacent organs, fascia, and muscles. Postural or positional inversion of the pelvis simultaneous with deep pelvic muscle and pelvic core exercises theoretically realigns the pelvic organs within the pelvic cavity and reduces strain on fascia and ligaments. Without the strain of the organs descending in the pelvis, the pelvic core muscles can theoretically work more efficiently for muscle strengthening and motor control retraining. Organ realignment and deep pelvic core muscle activation theoretically recreates the support system for optimal organ function and symptom-free daily activities.
Resolution of Calciphylaxis After Urgent Kidney Transplantation in 3 Patients With End-Stage Kidney Failure
Authors: Nordheim Espen , Dahle Dag Olav , Syse Ingrid Marie , Åsberg Anders , Reisæter Anna V. , Hartmann Anders 
Published: October 2016

Background
Calcific uremic arteriolopathy (CUA), also referred to as calciphylaxis, is a rare and serious complication of kidney failure with limited treatment options. Kidney transplantation (KTX) restores kidney function and is hence a potential treatment option for CUA. We present 3 patients who had their CUA lesions successfully healed after urgent KTX.

Methods
Data were retrospectively retrieved from hospital records at our national transplant center.

Results
All 3 patients had previously been kidney transplanted and had experienced graft loss and were in stage 5 kidney failure when CUA developed. One patient was on warfarin treatment for pulmonary embolism. Skin lesions developed in the lower limbs in all 3 patients. Multidisciplinary care including intensified hemodialysis did not induce any clinically relevant improvement of the lesions. The recipients were enlisted on a clinically urgent waitlist for KTX and received a deceased donor kidney after 2 to 4 weeks. All recipients experienced good graft function. The lesions healed completely within 6 weeks in 2 patients. In the third patient, partial healing occurred after 2 months and complete healing was achieved 4 months after transplantation.

Conclusions
These cases indicate that urgent KTX may contribute to an efficient treatment for end-stage renal disease patients with CUA.
Forest defoliator pests alter carbon and nitrogen cycles
Authors: l-M-Arnold Anne , Grüning Maren , Simon Judy , Reinhardt Annett-Barbara , Lamersdorf Norbert , Thies Carsten 
Published: October 2016

Climate change may foster pest epidemics in forests, and thereby the fluxes of elements that are indicators of ecosystem functioning. We examined compounds of carbon (C) and nitrogen (N) in insect faeces, leaf litter, throughfall and analysed the soils of deciduous oak forests (
Quercus petraea
L.) that were heavily infested by the leaf herbivores winter moth (
Operophtera brumata
L.) and mottled umber (
Erannis defoliaria
L.). In infested forests, total net canopy-to-soil fluxes of C and N deriving from insect faeces, leaf litter and throughfall were 30- and 18-fold higher compared with uninfested oak forests, with 4333 kg C ha
−1
and 319 kg N ha
−1
, respectively, during a pest outbreak over 3 years. In infested forests, C and N levels in soil solutions were enhanced and C/N ratios in humus layers were reduced indicating an extended canopy-to-soil element pathway compared with the non-infested forests. In a microcosm incubation experiment, soil treatments with insect faeces showed 16-fold higher fluxes of carbon dioxide and 10-fold higher fluxes of dissolved organic carbon compared with soil treatments without added insect faeces (control). Thus, the deposition of high rates of nitrogen and rapidly decomposable carbon compounds in the course of forest pest epidemics appears to stimulate soil microbial activity (i.e. heterotrophic respiration), and therefore, may represent an important mechanism by which climate change can initiate a carbon cycle feedback.
TheDrosophila melanogasterpheromone Z4-11Al is encoded together with habitat olfactory cues and mediates species-specific communication
Authors: Lebreton Sebastien , Borrero-Echeverry Felipe , Gonzalez Francisco , Solum Marit , Wallin Erika , Hedenström Erik , Hansson Bill S. , Gustavsson Anna-Lena , Bengtsson Marie , Birgersson Göran , Walker William B. , Dweck Hany , Becher Paul G. , Witzgall Peter 
Published: October 2016

AbstractMate recognition in animals evolves during niche adaptation and involves habitat and social olfactory signals.Drosophila melanogasteris attracted to fermenting fruit for feeding and egg-laying. We show that, in addition, female flies release a pheromone (Z)-4-undecenal (Z4-11Al), that elicits flight attraction in both sexes. The biosynthetic precursor ofZ4-11Al is the cuticular hydrocarbon (Z,Z)-7,11-heptacosadiene (7,11-HD), which is known to afford reproductive isolation between the sibling speciesD. melanogasterandD. simulans. A pair of alternatively spliced receptors, Or69aB and Or69aA, is tuned toZ4-11Al and to food olfactory cues, respectively. These receptors are co-expressed in the same olfactory sensory neurons, and feed into a neural circuit mediating species-specific, long-range communication: the close relativeD. simulans, which shares food resources and co-occurs withD. melanogaster, does not respond. That Or69aA and Or69aB have adopted dual olfactory traits highlights the interplay of habitat and social signals in mate finding. These olfactory receptor genes afford a collaboration between natural and sexual selection, which has the potential to drive phylogenetic divergence.Significance StatementVolatile insect sex pheromones carry a message over a distance, they are perceived by dedicated olfactory receptors, and elicit a sequence of innate behaviours. Pheromones mediate specific mate recognition, but are embedded in and perceived together with environmental olfactory cues. We have identified the first long-range, species-specific pheromone inDrosophila melanogaster.A pair of spliced olfactory receptors, feeding into the same neural circuit, has developed a dual affinity to this pheromone and kairomones, encoding adult and larval food. Blends of this pheromone and kairomone specifically attractD. melanogaster, but not the close relativeD. simulans.This becomes an excellent paradigm to study the interaction of social signals and habitat olfactory cues in premating reproductive isolation and phylogenetic divergence.
Cytoplasmic-nuclear incompatibility between wild-isolates ofCaenorhabditis nouraguensis
Authors: Lamelza Piero , Ailion Michael 
Published: October 2016

ABSTRACTHow species arise is a fundamental question in biology. Species can be defined as populations of interbreeding individuals that are reproductively isolated from other such populations. Therefore, understanding how reproductive barriers evolve between populations is essential for understanding the process of speciation. Hybrid incompatibility (e.g. hybrid sterility and lethality) is a common and strong reproductive barrier in nature, but few studies have molecularly identified its genetic basis. Here we report a lethal incompatibility between two wild-isolates of the nematodeCaenorhabditis nouraguensis.Hybrid inviability results from the incompatibility between a maternally inherited cytoplasmic factor from each strain and a recessive nuclear locus from the other. We have excluded the possibility that maternally inherited endosymbiotic bacteria cause the incompatibility by treating both strains with tetracycline and show that hybrid death is unaffected. Furthermore, cytoplasmic-nuclear incompatibility commonly occurs between other wild-isolates, indicating that this is a significant reproductive barrier withinC. nouraguensis. We hypothesize that the maternally inherited cytoplasmic factor is the mitochondrial genome and that mitochondrial dysfunction underlies hybrid death. This system has the potential to shed light on the dynamics of divergent mitochondrial-nuclear coevolution and its role in promoting speciation.
The interrelations between competences for sustainable development and research competences
Authors: Lambrechts Wim , Van Petegem Peter 
Published: October 2016

Purpose
The purpose of this paper is to explore how competences for sustainable development and research interrelate within a context of competence-based higher education. Specific focus is oriented towards strengthening research competences for sustainability.

Design/methodology/approach
Following a hermeneutic–interpretive methodology, this paper builds upon a critical literature review to demarcate the theoretical framework and an in-depth analysis of a case study exploring the interrelations between both types of competences.

Findings
The paper discusses current issues in the integration of competences and explores the contribution of research-based methods to acquire competences for sustainable development. The analysis shows that research skills are often mentioned to contribute to this acquisition, though from a general perspective, or from the sidelines of the learning process. A holistic view on how both concepts are linked is missing.

Research limitations/implications
First, the complex nature of competences and their integration in higher education could lead to difficulties in interpreting and analysing them. Second, the analysis is based on a single-case study, limiting possibilities to generalise the results. Third, this study is not looking at curriculum practices in these fields.

Practical implications
There is a need to holistically (re-)frame research competences within the concepts of education for sustainable development and, to a wider extent, sustainable development.

Social implications
Framing research competences within the concept of sustainable development enables a thorough and “conscious”, rather than coincidental, acquisition of competences for sustainable development.

Originality/value
The originality of this paper lies in the fact that there is little literature about the interrelations between competences for sustainable development and research competences.