bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Converse 4-1BB and CD40 Ligand Expression Pattern Delineates Activated Regulatory T Cells (Treg) and Conventional T Cells Enabling Direct Isolation of Alloantigen-Reactive Natural Foxp3+ Treg
Authors: Schoenbrunn Anne , Frentsch Marco , Kohler Siegfried , Keye Jacqueline , Dooms Hans , Moewes Beate , Dong Jun , Loddenkemper Christoph , Sieper Joachim , Wu Peihua , Romagnani Chiara , Matzmohr Nadine , Thiel Andreas 
Published: November 2012

Abstract
Natural regulatory T cells (nTreg) play a central role in the induction and maintenance of immunological tolerance. Experimental transplant models and recent clinical trials demonstrate that nTreg can control alloreactivity. To upgrade Treg-based cell therapies to a selective suppression of undesired immune reactions, only the transfer of Ag-specific nTreg represents the appropriate therapeutic option. However, Ag-specific nTreg are present at extremely low frequencies in the periphery, and so far appropriate surface markers for their precise identification are missing. In this study, we demonstrate that activated nTreg and activated conventional T cells differ in their 4-1BB and CD40 ligand (CD40L) expression signatures, allowing a clear dissection from each other. Based on the expression of 4-1BB and absence of CD40L expression, human alloantigen-reactive Foxp3+ nTreg can be directly isolated from MLR cultures with high purity. Alloantigen-reactive 4-1BB+CD40L− nTreg were characterized by a completely demethylated Treg-specific demethylated region and showed alloantigen-specific suppressive properties superior to polyclonal Treg. Importantly, isolated 4-1BB+CD40L− nTreg maintain the nTreg phenotype and alloantigen-reactivity after in vitro expansion. Our results offer the possibility to simultaneously analyze Ag-specific nTreg and conventional T cells, and to establish cellular therapies with Ag-specific nTreg aiming at a specific inhibition of unwanted immunity.
Role of Recycling, Mindbomb1 Association, and Exclusion from Lipid Rafts of Delta-like 4 for Effective Notch Signaling To Drive T Cell Development
Authors: Shah Divya K. , Mohtashami Mahmood , Zúñiga-Pflücker Juan Carlos 
Published: November 2012

Abstract
Intrathymic T cell development is predicated on the Notch1 ligand Delta-like (Dll) 4. However, both Dll4 and Dll1 can support T cell development in vitro. Endocytosis of Dll1 is important for Notch activation, whereas currently there is no evidence for the role of Dll4 endocytosis in T cell development. To elucidate this, we generated Dll4 constructs that modify or inhibit endocytosis. Our results show that targeting the intracellular domain affects Dll4’s ability to induce Notch target gene expression, support efficient T cell development, and inhibit B cell development. Dll4 function relies on a combination of factors, which include strong Mindbomb1 (Mib1) association, ubiquitination, and internalization and recycling back to the cell surface, to engage Notch1 effectively. Distinct membrane localization and the Delta/Serrate/Lag2 (DSL) domain were important for Dll4 function. These features are consistent with a “recycling” model, but not in opposition to a “mechano-transduction” model, whereby Dll4 is able to engage Notch and create a pulling force required to activate signaling, leading to the induction of T-lineage development. Taken together, in contrast to Dll1, Dll4 does not localize to lipid rafts and shows stronger association with Mib1 and increased Notch1 uptake, which likely account for its superior ability to induce T cell development.
Subclavian Central Venous Catheters and Ultrasound Guidance: Policy vs Practice
Authors: Griswold-Theodorson Sharon , Farabaugh Eric , Handly Neal , McGrath Todd , Wagner David 
Published: November 2012

Purpose Policy statements recommend the use of ultrasound guidance (USG) to improve patient safety during placement of central venous catheters (CVCs). Studies have conclusively demonstrated greater success rates and fewer complications with the use of USG in catheter placement using the internal jugular vein approach. Data supporting the use of USG for the subclavian vein (SCV) approach, however, have been less conclusive, and USG for SCV cannulation is rarely used in clinical practice. We compared USG placement versus anatomic placement during subclavian insertion of a CVC. Methods A prospective randomized study was performed in March 2010 using a simulation model. Results Ultrasound guidance did not provide a statistically significant benefit for successful cannulation of the SCV (93.3% with USG and 100% without; P=0.15 or 2) or for rate of inadvertent arterial puncture (3.3% with USG and 0% without; P=0.31). Conclusions The use of USG to access the SCV utilizing a task trainer did not improve time to cannulation or success rates. Further study is required to delineate why USG for SCV cannulation has not been widely adopted in clinical practice.
An Exploration of Sense of Community and Student Success Using the National Survey of Student Engagement
Authors: Brown Susannah K. , Burdsal Charles A. 
Published: November 2012

Abstract
This study created a sense-of-community survey from the National Survey of Student Engagement to study the relationship between sense of community and student success. Factor analysis suggested four factors: Campus Social Milieu, Divergent Thinking, Institutional Involvement, and Relationships. Reliable relationships were apparent between sense of community and student success.
Evaluation of a Newly Implemented Undergraduate Global Health Course in the Public University Setting
Authors: Moore Brianna , Sorensen William , Cooper Cheryl , Daussat Lura 
Published: November 2012

Abstract
This study evaluates the effectiveness of a new undergraduate global health course by assessing students' pre/post global knowledge and beliefs. Using factor analysis, student beliefs coalesced into two belief foci: safety/comfort and responsibility/connectedness. Knowledge significantly increased across the board, whereas belief change was more localized.
Utilisation des services en déficience intellectuelle et satisfaction des parents à leur égard
Authors: Tremblay Karine N. , Côté Alain , Lachance Lise , Richer Louis 
Published: November 2012

Cette étude dresse un portrait des services utilisés par des parents et leur enfant ayant une déficience intellectuelle, évalue la satisfaction à l’égard de ceux-ci et répertorie ceux que les parents souhaiteraient recevoir. Un questionnaire a été complété par 199 parents lors d’une rencontre à domicile. Les résultats révèlent qu’ils sont généralement satisfaits des services reçus. Cependant, ceux dont ils ne bénéficient pas sont réclamés dans des proportions variant de 32 à 58 %. Le répit-gardiennage s’avère le plus utilisé et le plus réclamé. Quant aux services non reçus, plusieurs parents jugent que l’intervention de spécialistes, particulièrement des orthophonistes, serait significative pour leur enfant. Comme les résultats convergent avec ceux d’études antérieures, il importe d’ajuster l’offre de services aux besoins réels des parents.
Intervention précoce et instruments d'évaluation des jeunes enfants ayant un trouble du spectre autistique
Authors: Rousseau Myriam , Dionne Carmen , Paquet Annie 
Published: November 2012

Cet article propose une réflexion sur les différents types d’outils d’évaluation utilisés en intervention précoce, en tentant de préciser les motifs de leur utilisation. Ainsi, les évaluations utiles à des fins de dépistage, de diagnostic et d’intervention seront situées les unes par rapport aux autres. Ce dernier type d’évaluation sera particulièrement détaillé, considérant son importance au niveau des services et pratiques d’intervention précoce. Finalement, afin d’illustrer ces distinctions, des exemples d’outils d’évaluations utilisés auprès des enfants présentant un trouble du spectre de l’autisme seront présentés. Il s’agit des instruments suivants: le CHecklist for Autism in Toddlers, l’Autism Diagnostic Observation Schedule-Generic (ADOS-G) et le Profil Psychoéducatif – Troisième Édition (PEP-3).
Characterization of newly diagnosed HIV‐infected patients who are lost to follow up
Authors: Fridman V , Bello N , Lasala M 
Published: November 2012

Purpose of the studyWe previously identified that a great amount of newly diagnosed HIV‐infected patients were lost to follow up after the diagnosis. The aim of the present study is to describe the characteristics of the newly diagnosed HIV‐infected patients who are lost to follow up.MethodsWe reviewed the clinical charts of the adult (>18 y/o) patients who attended for the first time our HIV clinic between 1/Jan/2005 and 31/Dec/2010. Among the patients who were newly diagnosed with HIV infection, we identified those who consulted the clinic only once. We considered patients were lost to follow up if they never came back within 12 months. We compared age, gender, nationality, education level and socioeconomic characteristics between those patients who were lost to follow and those who continue HIV care. We considered the first visit the one in which the patient was informed about his/her HIV seropositive condition.Summary of resultsWe included 504 patients, 179 (35.5%) never came back after the first visit. Patients who were lost to follow up (A) were younger (mean age 33.8 vs. 39.07 y/o) than those who continue follow up (B). We identified 11/179 patients older than 50 years in A and 52/325 in B; P = 0.001 (OR 0.34, 95% CI 0.16–0.70). In A 136/179 were male and 232/325 in B. 142/179 were Argentinian in A and 289/325 in B; P = 0.003 (OR 0.48, 95% CI 0.28–0.81). In A 61/179 lived alone and 39/325 in B; P = 0.000 (OR 3.79, 95% CI 0.64–1.37). 41/179 had health insurance in A and 162/325 in B; P = 0.003 (OR 0.30, 95% CI 0.28‐0.81). A university or tertiary degree was reached in 33/179 in A and 110/325 in B; P = 0.000 (OR 0.44, 95% CI 0.28–0.70).

Patients lost to follow up, n=179
Patients who continue follow up, n=325

Male/female
136/43
232/93
P=1.24 OR 1.27 (95% CI 0.82–1.97)

Mean age (years)
33.8
39.07

Older than 50 years old
11
62
P=0.001 OR 0.34 (95% CI 0.16–0.70)

Argentinian
142
289
P=0.003 OR 0.48 (95% CI 0.28–0.81)

Health insurance
41
162
P=0.003 OR 0.30 (95% CI 0.28–0.81)

Tertiary/university degree
33
110
P=0.000 OR 0.44 (95% CI 0.28–0.70)

Living alone
61
39
P=0.000 OR 3.79 (95% CI 0.64–1.37)

Employed
83
156
P=0.72 OR 0.94 (95% CI 0.64–1.37)

ConclusionsWe must continue reinforcing need for consistent clinical care in the newly diagnosed HIV patients, especially those who are younger, foreigners and socially excluded.
Effect of the treatment of hepatitis C with interferon (IFN) and ribavirin (RBV) in body composition measurement by DEXA in HIV‐HCV infected patients
Authors: De Los Santos I , Sanz J , Manzano Luque M 
Published: November 2012

Purpose of the studyHIV infection and antiretroviral therapy (ART) have been associated with lipodystrophy (LD), but we unknown the effect of IFN/RBV on the body composition, mainly body fat, in HIV patients, already with a degree of LD. Our objective: to assess the body composition in HIV‐HCV patients that start treatment with IFN/RBV and the changes at its ending.Material and MethodsPilot and prospective study of HIV‐HCV patients. We performed (baseline and at the end of treatment) clinical and laboratory parameters, HIV and HCV‐related. Total and regional body fat contents were measured in the same periods with DEXA (dual‐energy X‐ray absorptiometry) scanners. For LD diagnostic we used the definition of fat/mass ratio (FMR): absence, <1, obvious >1.5, and between 1–1.5 it could have LD but is better to see the evolution. Data are expressed in median.ResultsWe included 10 male patients; age 45 yo; time on ART 115 months. HIV VL < 20 in 9; CD4 count 577/mm3. Genotype 1 in 8, and 3 in 2. Time on IFN/RBV: 10 months. At the end of the treatment we observed a decrease in the level of total, HDL and LDL‐cholesterol (expressed in percentage: 4, 16 and 1.5 respectively) and a slightly increase in the level of TGR (9%). The total body mass decreased 7% (from 76.2 kg to 70.6), the total body fat decreased 18.4% (from 21.060 g to 17.172) and the total lean mass decreased only 3%. Results expressed in percentage and by regional parts, we observed also a decrease in all the parameters: 11% in total body fat (from 26.3 to 23.4), 6% in the fat in arms (21.9 to 20.5), 10% in total fat in legs (22.5 to 20.3) and 12.5% in total trunk fat (30.3 to 26.5). The FMR also decreased from 1.5 to 1.4.ConclusionsTrend to LD at baseline, as the FMR was 1.5. After 10 months on treatment with IFN/RBV there was a decrease in the total body mass (7%), mainly due to the loss of total body fat and less in the lean mass. Regarding the percentage of fat loss, we observed the biggest decrease in the trunk fat and the lesser in the limb fat. So, the FMR also decreased. This effect does not get worse the baseline LD; on the contrary it improves it, although very slightly (decrease of 0.1 in FMR), and could serve to advise the patients and not to be afraid of a possible worsening of LD. The study is ongoing and the next objective will be to perform DXA one year after the end of treatment and to expand the cohort to study clinical or laboratory factors related with these results.
Iron overload, an immunosuppression marker in HIV‐infected patients
Authors: López‐Calderón C , Palacios R , Cobo A , Moreno T , Ruiz J , Nuño E , Márquez M , Santos J 
Published: November 2012

PurposeIron overload (IO) has been associated with increased cardiovascular risk (CVR) and metabolic syndrome (MS) in the general population; both elevated CVR and MS are frequent in HIV‐patients. Our aim was to analyze the prevalence of IO in a cohort of asymptomatic patients with HIV infection, and related factors.MethodsCross‐sectional study of a cohort of HIV outpatients in regular follow‐up. Demographic, epidemiological, clinical, analytical and therapeutic data were collected. Patients completed a questionnaire about CVR factors and 10‐year CV disease risk estimation (Framingham score), underwent a physical exam, and a fasting blood analysis. IO was defined as a plasma ferritin level higher than 200 μ/L in women and 300 μ/L in men.Results571 patients (446 men, 125 women), with a mean age of 43.2 years, sexual transmission of HIV in 68.5%, median CD4 count 474 cell/μL (IQR: 308–666), and 36.3% Aids cases. 86.2% were on antiretroviral therapy (ART), and 74.8% of them had undetectable HIV viral load. 14.6% met MS criteria, and mean CVR at 10 years was 6.67%. IO was detected in 11% of cases. Patients with IO were more immunosuppressed (CD4 count 369 vs 483/μL, p<0.0001), presented a higher prevalence of detectable HIV viral load (17.6% vs 8.9%; p<0.005), and of Aids cases (14.9% vs 8.7%; p<0.023), and lower plasma levels of cholesterol, HDLc and LDLc (154 vs 183, 34 vs 43, 93 vs 110 mg/dL, respectively; p<0.0001. In the multivariate analysis, the only related factor was CD4 count <350 cell/μL (OR 2.86, 95% CI 1.6–4.9; p<0.0001). IO was not associated with CVR nor with MS.ConclusionsIO is not uncommon in HIV patients, and it is only related with immunosuppression defined as CD4 count <350 cell/μL, and in contrast to general population, it is not related with increased CVR nor with MS.
Experience with polymethylmethacrylate 30% (PMMA) facial filling in patients with facial HIV lipoatrophy using of local anesthesia dentistry
Authors: Matsuda E , Soares F , Brigido L 
Published: November 2012

BackgroundHIV‐associated lipoatrophy in a common and stigmatizing side effect of HIV infection, is aggravated by antiretroviral therapy; its presence causes distress and compromises adherence to therapy. PMMA filling is often associated with pain and discomfort.ObjectiveTo evaluate outpatient intervention using local dentistry anesthesia.MethodsPatients complaining of facial lipoatrophy, from 10/2007 to 11/2011, were offered the filling with PMMA. Cases with bleeding potential, acute or decompensated chronic diseases or use of immunosuppressors or chemotherapy were excluded. Inclusion criteria: perception of distressing malar lipoatrophy and both the assisting physician and the applicant agreeing with potential benefit. After informed consent, patients were infused with 30 mg prilocaine/0.03 IU felypressin in 1.8 ml, using a carpule type syringe aiming to block the posterior superior alveolar nerve. This was followed by PMMA infiltration in different points at the malar region. At first return a simple questionnaire evaluating pain, satisfaction, grading 0 to 10 and if would repeat the procedure.ResultsAll 64 eligible patients were included. Mean age 46 (13 to 73) years, mostly white (71.87%), males (68.75%), 37.5% of them MSM. Arterial hypertension was the most prevalent comorbidity (17%), 78% with viral load <50 c/mL, with a median 585 CD4 cells/mL (95–2063). On a median of 8 years on treatment, 1/3 had been exposed to three classes (NRTI/ NNRTI/PI), one antiretroviral‐naïve. Of the 12 patients who had detectable viral load in the first procedure, seven were suppressed to below 50 copies/mL during follow up. Two of the five patients remaining with detectable viremia died from other causes, 2 transferred and 1 remained naïve. 127 procedures were made in 64 patients, a median of 2 (1–6) per patient. After a mean follow‐up of 33 weeks, no infection or late complications were observed. Mean dispensed volume was 9 mL (1.5 to 22). Pain grade was documented in 105 procedures; grade <4 reported by 46%, 4–6 by 34%; 7–8 by 16%, 9 by 2%. All reported that the pain would not hamper future procedures; 94% refer an overall satisfaction from 8 to 10.ConclusionThe use of local anesthesia in dental facial filling with PMMA in patients with HIV lipoatrophy of the face is safe, decreases pain to tolerable levels and allows high levels of satisfaction with the procedure. The procedure may improve patient adherence to ARV.
Tenofovir‐induced acute kidney injury in HIV‐infected patients in western India: a resource limited setting perspective
Authors: Sadre A , Munshi N , Dhande S , Dravid A 
Published: November 2012

Background and objectiveTenofovir use in HIV positive patients is associated with 0.5–2.5% risk of acute kidney injury (AKI). Data on AKI due to tenofovir use in resource limited settings like India is sparse. Objective of this study is to determine incidence, risk factors and outcome of tenofovir‐induced acute kidney injury (serum creatinine>2 mg/dl or creatinine clearance decrease by 50% compared to baseline) in HIV infected patients attending tertiary level HIV clinic in Western India.MethodsAll patients enrolled at the clinic from 2009 to 2012 who were initiated on tenofovir‐based ART and had regular follow up creatinine clearance values available were included in this retrospective observational cohort analysis. Patients already on tenofovir‐based ART during enrollment were also included.Summary of results512 patients were enrolled in the study with 70% being males. Average age of the cohort was 41 years, average body weight 56 kilograms and median baseline CD4 count 164 cells/mm3. Mean baseline creatinine clearance was 90 ml/min. Median duration of follow up was 26 months. Tenofovir‐induced AKI developed in 25 patients (incidence 4.88 %). Median time to developing AKI was 6 months. On stopping tenofovir, 15 patients had complete recovery of renal function, 5 had partial recovery while 5 patients died. Hemodialysis as a treatment option was used in 3 patients. Age>50 yrs (p=0.001), baseline creatinine clearance<50 ml/min (p=0.0001), diabetes mellitus (p=0.0001), use of tenofovir with protease inhibitors (p=0.001), presence of renal calculus disease (p =0.0001) and use of concomitant nephrotoxic medications (p=0.001) were significantly associated with risk of tenofovir AKI on applying Pearson's Chi square test.ConclusionsIncidence of tenofovir‐induced AKI in our cohort is higher than previously reported and could be attributed to lower body weight, lower baseline creatinine clearance, higher incidence of advanced HIV disease and higher incidence of co‐morbidities in our patients.
Association of fibroblast growth factor 23 and hypophosphatemia in well‐suppressed HIV‐infected patients receiving antiretroviral therapy
Authors: Avihingsanon A , Praditpornsilpa K , Avihingsanon Y , Wongsabut J , Klongpetch C , Ubolyam S , Ruxrungtham K 
Published: November 2012

IntroductionProlong hypophosphatemia may result in future bone loss which will have effect on patient's quality of life. Hypophosphatemia is observed in 4–31% of HIV‐infected patients receiving highly active antiretroviral therapy (HAART). Fibroblast growth factor 23 (FGF‐23), a potent phosphaturic hormone, has not been well studied in HIV‐infected Thai patients. We aimed to investigate whether FGF‐23 is involved in the etiology of hypophosphatemia in our HIV‐positive patients on HAART.MethodThis study was a case‐controlled study at HIV‐NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand during June 2011‐May 2012. Serum and urine phosphate was studied in 696 well‐suppressed HIV‐infected patients. Hypophosphatemia was defined as a serum phosphate level <2.5 mg/dl. All fasting blood and urine samples were taken between 7.00 and 10.00 hr to measure serum phosphate, calcium, 1,25 OHD, parathyroid hormone (PTH), FGF‐23 and urinary phosphate excretion. The renal phosphate threshold tubular maximum phosphate reabsorption per glomerular filtration rate (TmP/GFR) was calculated. eGFR was calculated using the MDRD.ResultsTotally 65 (9.3%) subjects were identified for hypophosphatemia. The prevalence of hypophosphatemia was not difference between TDF exposure [(46/544: 8.5%) and TDF unexposure (19/154: 12.5%), p=0.13]. However, only 56 subjects for a case group (hypophosphatemia group) and 65 subjects with normal phosphate (normophosphatemia group were included in this analysis. In the hypophosphatemia group, they were more likely younger, less female, and lower CD4 cell counts than the control group. About 80% and 74% of the case and control group had TDF exposure, respectively. The renal phosphate reabsorption threshold was significantly lower in hypophosphatemia group than in the control [43 (2.19–2.6) vs 3.16 (2.92–3.61) mg/dl, p<0.001]. FGF‐23 was significantly higher in hypophosphatemia group [31.9 (24.7–40.0) vs 26.2 (19.3–34.1) pg/dl, p<0.017]. TmP/GFR was strongly related to FGF‐23 levels (p<0.04), but not for PTH (p<0.06), and urine calcium (p<0.07).ConclusionFGF‐23 is involved in pathogenesis of hypophosphatemia in our HIV‐positive patients on HAART.
Hierachically Structured Hollow Silica Spheres for High Efficiency Immobilization of Enzymes
Authors: Cao Shunsheng , Fang Long , Zhao Zhiyuan , Ge Yi , Piletsky Sergey , Turner Anthony P. F. 
Published: November 2012

AbstractIn this work, the first example of a hierarchically structured hollow silica system is reported without any chemical modification to the enzyme involved in the process. The leaching of the physically adsorbed enzyme is substantially restrained in comparison to pure hollow silica supports. The hierarchical architecture is composed of the ordered hollow silica spheres with a shell‐in‐shell structure. This rationally integrated architecture, which serves as the host for glucose oxidase immobilization, displays many significant advantages, including increases in mechanical stability, enzyme loading, and bioactivity, and a decrease in enzyme leaching compared to existing pure hollow silica matrices. This facilitates further multifarious applications for enhanced enzyme immobilization, biosensors, and biocatalysis.