bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Antiretroviral Therapies in Pregnant Women Living With Human Immunodeficiency Virus and Hepatitis B Virus
Authors: Bhattacharya Debika , Tierney Camlin , Butler Kevin , Kiweewa Flavia Matovu , Moodley Dhayendre , Govender Vani , Vhembo Tichaona , Mohtashemi Neaka , Ship Hannah , Dula Dingase , George Kathy , Chaktoura Nahida , Fowler Mary Glenn , Peters Marion G. , Currier Judith S. 
Published: August 2023

OBJECTIVE:
To describe the anti–hepatitis B virus (HBV) efficacy, HBeAg serologic changes, HBV perinatal transmission, and safety in pregnant women who are living with human immunodeficiency virus (HIV) and HBV co-infection who were randomized to various antiretroviral therapy (ART) regimens.

METHODS:
The PROMISE (Promoting Maternal and Infant Survival Everywhere) trial was a multicenter randomized trial for ART-naive pregnant women with HIV infection. Women with HIV and HBV co-infection at 14 or more weeks of gestation were randomized to one of three ART arms: one without HBV treatment (group 1) and two HBV treatment arms with single (group 2) or dual anti-HBV activity (group 3). The primary HBV outcome was HBV viral load antepartum change from baseline (enrollment) to 8 weeks; safety assessments included alanine aminotransferase (ALT) level, aspartate aminotransferase (AST) level, and anemia (hemoglobin less than 10 g/dL). Primary comparison was for the HBV-active treatment arms. Pairwise comparisons applied t test and the Fisher exact tests.

RESULTS:
Of 3,543 women, 3.9% were HBsAg-positive; 42 were randomized to group 1, 48 to group 2, and 48 to group 3. Median gestational age at enrollment was 27 weeks. Among HBV-viremic women, mean antepartum HBV viral load change at week 8 was −0.26 log10 international units/mL in group 1, −1.86 in group 2, and −1.89 in group 3. In those who were HBeAg-positive, HBeAg loss occurred in 44.4% at delivery. Two perinatal HBV transmissions occurred in group 2. During the antepartum period, one woman (2.4%) in group 1 had grade 3 or 4 ALT or AST elevations, two women (4.2%) in group 2, and three women (6.3%) in group 3.

CONCLUSION:
Over a short period of time, HBV DNA suppression was not different with one or two HBV-active agents. HbeAg loss occurred in a substantial proportion of participants. Perinatal transmission of HBV infection was low. Hepatitis B virus–active ART was well-tolerated in pregnancy, with few grade 3 or 4 ALT or AST elevations.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT01061151.
Abnormal Postoperative PROMIS Scores are Associated with Patient Satisfaction in Adult Spinal Deformity and Degenerative Spine Patients
Authors: Covarrubias Oscar , Andrade Nicholas S , Mo Kevin C , Dhanjani Suraj , Olson Jarod , Musharbash Farah N , Sachdev Rahul , Kebaish Khaled M , Skolasky Richard L , Neuman Brian J 
Published: August 2023

Study Design.
Retrospective review

Objectives.
To evaluate 1) patient satisfaction after adult spine surgery; 2) associations between number of abnormal PROMIS domain scores and postoperative satisfaction; and 3) associations between normalization of a patient’s worst preoperative PROMIS domain score and postoperative satisfaction.

Summary of Background Data.
Although “legacy” patient-reported outcome measures correlate with patient satisfaction after adult spine surgery, it is unclear whether PROMIS scores do.

Methods.
We included 1119 patients treated operatively for degenerative spine disease (DSD) or adult spinal deformity (ASD) from 2014–2019 at our tertiary hospital who completed questionnaires preoperatively and at ≥1 postoperative timepoints up to 2 years. Postoperative satisfaction was measured in ASD patients using items 21 and 22 from the SRS 22-revised questionnaire and in DSD patients using the NASS Patient Satisfaction Index. “Worst” preoperative PROMIS domain was that with the greatest clinically negative deviation from the mean. “Normalization” was a postoperative score within 1 standard deviation of the general population mean. Multivariate logistic regression identified factors associated with satisfaction.

Results.
Satisfaction was reported by 88% of DSD and 86% of ASD patients at initial postoperative follow-up; this proportion did not change during the first year after surgery. We observed an inverse relationship between postoperative satisfaction and number of abnormal PROMIS domains at all postoperative timepoints beyond 6 weeks. Only among ASD patients was normalization of the worst preoperative PROMIS domain associated with greater odds of satisfaction at all timepoints up to 1 year.

Conclusion.
The proportion of DSD and ASD patients satisfied postoperatively did not change from 6 weeks to 1 year. Normalizing the worst preoperative PROMIS domain and minimizing the number of abnormal postoperative PROMIS scores may reduce the number of dissatisfied patients. PROMIS data can guide perioperative patient management to improve satisfaction.

Level of Evidence.
3
Single-cell multiomic understanding of HIV-1 reservoir at epigenetic, transcriptional, and protein levels
Authors: Wong Michelle , Wei Yulong , Ho Ya-Chi 
Published: August 2023

Purpose of review
The success of HIV-1 eradication strategies relies on in-depth understanding of HIV-1-infected cells. However, HIV-1-infected cells are extremely heterogeneous and rare. Single-cell multiomic approaches resolve the heterogeneity and rarity of HIV-1-infected cells.

Recent findings
Advancement in single-cell multiomic approaches enabled HIV-1 reservoir profiling across the epigenetic (ATAC-seq), transcriptional (RNA-seq), and protein levels (CITE-seq). Using HIV-1 RNA as a surrogate, ECCITE-seq identified enrichment of HIV-1-infected cells in clonally expanded cytotoxic CD4+ T cells. Using HIV-1 DNA PCR-activated microfluidic sorting, FIND-seq captured the bulk transcriptome of HIV-1 DNA+ cells. Using targeted HIV-1 DNA amplification, PheP-seq identified surface protein expression of intact versus defective HIV-1-infected cells. Using ATAC-seq to identify HIV-1 DNA, ASAP-seq captured transcription factor activity and surface protein expression of HIV-1 DNA+ cells. Combining HIV-1 mapping by ATAC-seq and HIV-1 RNA mapping by RNA-seq, DOGMA-seq captured the epigenetic, transcriptional, and surface protein expression of latent and transcriptionally active HIV-1-infected cells. To identify reproducible biological insights and authentic HIV-1-infected cells and avoid false-positive discovery of artifacts, we reviewed current practices of single-cell multiomic experimental design and bioinformatic analysis.

Summary
Single-cell multiomic approaches may identify innovative mechanisms of HIV-1 persistence, nominate therapeutic strategies, and accelerate discoveries.
Serratus Anterior-rib Composite Flap Partial Thumb Reconstruction
Authors: Xu Kyle Y. , Qureshi Hassan A. , Tadisina Kashyap Komarraju , Frojo Gianfranco , Kraemer Bruce A. 
Published: August 2023

Summary:
The serratus anterior-rib composite flap is a well described and versatile flap used for reconstruction in a variety of anatomical regions. However, reconstruction of a thumb defect using this flap has not been well described since first mentioned in the literature by the Buncke et al group 20 years ago. The authors describe the use of this technique for thumb reconstruction in a complex defect from a gunshot wound.
Usefulness of Harmonic ACE+7 Scalpel in Breast Reconstruction with Extended Latissimus Dorsi Flap: An Open-label Single Institution Pilot Study
Authors: Takaya Kento , Baba Miho , Kuranami Masaru , Shido Hirokazu , Asou Toru , Kishi Kazuo 
Published: August 2023

Background:
The extended latissimus dorsi (ELD) flap is a safe and aesthetically acceptable method to reconstruct small to medium-sized breasts. However, the long time required for flap elevation and intraoperative bleeding contributes to various postoperative complications. We investigated the use of alternative devices, such as the Harmonic ACE+7, which has a long arm that can help simultaneously detach and seal tissues to prevent such complications.

Methods:
We compared 27 patients who underwent breast reconstruction with the ELD flap using the Harmonic ACE +7 scalpel, and 28 patients who underwent breast reconstruction using an electrocautery scalpel, between May 2019 and March 2022. Data on patient demographics, surgery, and postoperative complications were collected. Surgical outcomes were compared between electrocautery (EC) and Harmonic ACE+7 (HA) groups.

Results:
The median age of the patients was 50.2 years. The patient demographics between the groups did not show significant differences. Flap necrosis and hematomas did not occur, and seroma was the major postoperative complication (65.7% in the EC group and 70% in the HA group). The time required for flap elevation was significantly shorter in the HA group than in the EC group (286.0 minutes and 179.0 minutes, respectively). Blood loss reduced significantly in the HA and EC groups (138.5 mL and 78.2 mL, respectively). Moreover, decreased drainage was observed for the breast area. There were no significant differences in other end points.

Conclusion:
In breast reconstruction with ELD flaps, using the Harmonic ACE+7 can help reduce the rate of seroma, operative time, and intraoperative bleeding without further disadvantages.
Living donor liver transplantation can address disparities in transplant access for patients with primary sclerosing cholangitis
Authors: Onofrio Fernanda , Zheng Katina , Xu Cherry , Chen Shiyi , Xu Wei , Vyas Mary , Bingham Katie , Patel Keyur , Lilly Leslie , Cattral Mark , Selzner Nazia , Jaeckel Elmar , Tsien Cynthia , Gulamhusein Aliya , Hirschfield Gideon M. , Bhat Mamatha 
Published: August 2023

Background:
Liver transplantation (LT) is frequently lifesaving for people living with primary sclerosing cholangitis (PSC). However, patients are waitlisted for LT according to the model for end-stage liver disease-sodium (MELD-Na) score, which may not accurately reflect the burden of living with PSC. We sought to describe and analyze the clinical trajectory for patients with PSC referred for LT, in a mixed deceased donor/living donor transplant program.

Methods:
This was a retrospective cohort study from November 2012 to December 2019, including all patients with PSC referred for assessment at the University Health Network Liver Transplant Clinic. Patients who required multiorgan transplant or retransplantation were excluded. Liver symptoms, hepatobiliary malignancy, MELD-Na progression, and death were abstracted from chart review. Competing risk analysis was used for timing of LT, transplant type, and death.

Results:
Of 172 PSC patients assessed, 84% (n = 144) were listed of whom 74% were transplanted. Mean age was 47.6 years, and 66% were male. Overall mortality was 18.2% at 2 years. During the follow-up, 16% (n = 23) were removed from the waitlist for infection, clinical deterioration, liver-related mortality or new cancer; 3 had clinical improvement. At listing, 82% (n = 118) had a potential living donor (pLD). Patients with pLD had significantly lower waitlist and liver-related waitlist mortality (HR 0.20, p<0.001 and HR 0.17, p<0.001, respectively), and higher rates of transplantation (HR 1.83, p = 0.05). Exception points were granted to 13/172 (7.5%) patients.

Conclusions:
In a high-volume North American LT center, most patients with PSC assessed for transplant were listed and subsequently transplanted. However, this was a consequence of patients engaging in living donor transplantation. Our findings support the concern from patients with PSC that MELD-Na allocation does not adequately address their needs.
OCTA Biomarkers and Microperimetry Features in Behçet's Uveitis
Authors: Ferreira Bruno F. A. , Higashi Alex H. , Prado Leandro L. , Gonçalves Célio R. , Haddad Maria A. O. , Zacharias Leandro C. , Hirata Carlos E. , Yamamoto Joyce H. 
Published: August 2023

Abstract

Purpose:
To evaluate the parafoveal macular microvasculature and the macular function in patients with retinal vasculitis associated with Behçet's uveitis (BU).

Methods:
In 14 patients with inactive BU and 26 control individuals (13 with nonocular Behçet's syndrome and 13 healthy subjects), we analyzed the retinal nerve fiber layer, ganglion cell layer (GCL), full retinal thickness (FRT), foveal avascular zone area and sectorial parafoveal vessel density in the superficial vascular plexus, intermediate capillary plexus, and deep capillary plexus (DCP) using Spectralis optical coherence tomography (OCT) 2 and OCT angiography (OCTA). Macular sensitivity was analyzed using an MP-3 microperimeter.

Results:
Eighteen eyes (78%) had a best-corrected visual acuity (BCVA) > 20/25. Significant differences were found in BU in comparison to the controls on the OCT and OCTA: 14.8%, 22.4%, and 14.9% GCL thinning in the global, nasal, and inferior sectors, respectively; 6%, 13.2%, and 7.5% FRT thinning in the superior, nasal, and inferior sectors; and 16.8%, 14.9%, 23.6%, 15.8%, and 12.6% mean DCP density reduction in the global, superior, nasal, inferior, and temporal sectors. Microperimetry data demonstrated significant mean reductions of 21% and 23.6% in central and average macular sensitivities, and 28.8%, 40.4%, 27.7%, and 24.2% in the superior, nasal, inferior, and temporal sectors, respectively. Outer plexiform layer elevations were observed in BU (69.6%).

Conclusions:
BU presented structural and functional macular damage despite good BCVA, mainly affecting the nasal sector and the DCP. On OCT and OCTA, quantitative and qualitative changes can be valuable biomarkers of ocular involvement in BS.
Characteristics of surgically induced astigmatism after standardized microincisional cataract surgery with a superior limbal incision
Authors: Wendelstein Jascha , Casazza Marina , Riaz Kamran M. , Fischinger Isaak , Fuchs Barbara , Bolz Matthias , Seiler Theo G. , Kohnen Thomas , Langenbucher Achim 
Published: August 2023

Purpose:
To determine (1) if measurements of surgically induced astigmatism (SIA) as measured by keratometry (K) and total keratometry (TK) differ (2) if SIA affects the magnitude and/or meridian of keratometric astigmatism (3) if SIA evolves over time.

Setting:
Tertiary care center.

Design:
Retrospective data analysis.

Methods:
A swept-source optical coherence tomography biometry dataset (IOLMaster700) consisting of 498 eyes (327 patients) from a tertiary care center was analyzed. For all eyes preoperative and postoperative biometric measurements at 1-month, 3-month, and 6-months postoperative visits were considered for vector analysis of SIAK and SIATK.

Results:
Centroids in right and left eyes were 0.26 diopters (D) @5 degrees/0.31 D @1 degree for SIAK and 0.27 D @4 degrees/0.34 D @1 degree for SIATK. Centroids for difference vectors K-TK in right and left eyes were 0.02 D @ 176 degrees/0.03 D @6 degrees. The mean SIA magnitudes in right and left eyes were 0.48 ± 0.41 D and 0.50 ± 0.37 D for SIAK and 0.53 ± 0.42 D and 0.54 ± 0.40 D for SIATK. In eyes with ATR astigmatism, an increase in postoperative astigmatism magnitude was more common than a decrease. More than 30% of eyes showed changes in the meridian of more than 15 degrees.

Conclusions:
Overall, we observed differences in K- and TK-derived SIA, and changes in SIA magnitude over time. For postsurgical interventions, postoperative astigmatism meridian values should be measured to base treatments. Astigmatism magnitude showed a tendency to decrease for steep-meridian incisions and to increase in flat-meridian incisions.
Quantitative somatosensory testing of the abdomen: establishing initial reference values across developmental age and biological sex
Authors: Sieberg Christine B. , Lunde Claire E. , Shafrir Amy L. , Meints Samantha M. , Madraswalla Mehnaz , Huntley Devon , Olsen Hannah , Wong Cindy , DiVasta Amy D. , Missmer Stacey A. , Sethna Navil 
Published: August 2023

Abstract
Abdominal pain is a common symptom of several debilitating conditions (eg, inflammatory bowel disease, irritable bowel syndrome, and endometriosis) and affects individuals throughout their lifespan. Quantitative sensory testing (QST) reference values exist for many body sites but not the abdomen. Using a QST battery adapted from the German Research Network on Neuropathic Pain, we collected QST data on the upper and lower abdomen in 181 pain-free participants, ages 12 to 50 years, to establish reference values by age and biological sex. The normative values are presented as medians for each QST measure by sex (male, n = 63; female, n = 118) and across 3 age categories (adolescents: 12-19 years, n = 48; young adults: 20-30 years, n = 87; and adults: 31-50 years, n = 46). Evaluating the sensory functioning of the abdomen and characterizing ranges of QST measures is an essential first step in understanding and monitoring the clinical course of sensory abnormalities in patients with underlying diseases affecting the abdomen and pelvis. The impact of age and development on sensory functioning is necessary, given age-related changes in pain perception and modulation.
Residual risk of hepatocellular carcinoma development for chronic hepatitis C patients treated by all oral direct-acting antivirals with sustained virological response
Authors: Luan Chih-Hsuan , Su Pin-Shuo , Chu Chi-Jen , Lin Chung-Chi , Su Chien-Wei , Lee Shou-Dong , Wang Yuan-Jen , Lee Fa-Yauh , Huang Yi-Hsiang , Hou Ming-Chih 
Published: August 2023

Background:
The treatment of chronic hepatitis C (CHC) infection underwent a significant transformation with the introduction of all-oral direct-acting anti-virals (DAAs). These medications offered a high success rate in treatment, shorter duration, good tolerability, and expanded treatment options. However, a residual risk of hepatocellular carcinoma (HCC) development remained for a few patients even after achieving sustained virological response (SVR). To date, there is a lack of real-world data on evaluating risk factors associated with de novo HCC in CHC patients post-SVR, particularly in Taiwan.

Methods:
Between January 2017 and December 2019, a total of 671 consecutive CHC patients who achieved SVR after receiving DAAs were included for analysis. Patients with a history of HCC or liver transplantation prior to DAAs, a short follow-up period (<1 year), or treatment failure with DAAs were excluded. The primary outcome was the development of HCC following the initiation of DAAs. Variables associated with the primary outcome were assessed using multivariate Cox proportional hazards models.

Results:
The mean age of the enrolled patients was 65.1 ± 12.8 years, with 39.6% of them being male. Among the patients, 30.6% had advanced (F3-4) fibrosis, and the median follow-up period was 2.90 years. The cumulative incidence of HCC in CHC patients post-SVR12 was 1.6% at 1 year, 4.4% at 2 years, 4.8% at 3 years, 5.3% at 4 years, and 6.1% at 4.8 years, respectively. Variables independently associated with de novo HCC were advanced liver fibrosis (hazard ratio [HR] = 6.745; 95% CI = 1.960-23.218; p = 0.002), end-of-treatment 12 weeks (EOT12) alpha-fetoprotein (AFP) >7 ng/mL (HR = 3.059; 95% CI = 1.215-7.669; p = 0.018), EOT12 albumin-bilirubin (ALBI) grade ≥ 2 (HR = 2.664; 95% CI = 1.158-6.128; p = 0.021), and body mass index (BMI) ≥ 25 kg/m2 (HR = 2.214; 95% CI = 1.011-4.852; p = 0.047).

Conclusion:
Despite achieving viral clearance with DAAs, CHC patients still face a residual risk of de novo HCC. Establishing a risk stratification model based on independent variables could facilitate the prediction of future HCC development and enhance screening strategies.
Neither Words nor Images: Health Departments' and Hospitals' Use of Twitter During COVID-19 Had Limited Racial Representation and Content on Disparities Decreased Over Time
Authors: Sheth Poorva , Thompson Chloe , Bhavsar Avi , Smith Allie , Rozier Michael 
Published: August 2023

Objective:
To determine the degree to which hospitals and state health departments used written content or visual representation on social media to draw attention to racial disparities during the COVID-19 pandemic.

Study Design:
A retrospective analysis, using Twitter content (words and images) between May-June 2020 and May-June 2021 from organizations in the 5 states with the largest documented racial disparities in COVID-19–related mortality.

Main Outcomes:
All tweets and retweets (n = 6790) were coded along several lines. For May-June 2020 and May-June 2021, posts were coded as pandemic related (yes/no) and disparities related (yes/no). Open-coding methods categorized pandemic-related content into content areas, including COVID-19 education, hospital or public policy, and addressing misinformation. After self-identifying their own race/ethnicity, survey respondents (n = 100) coded pandemic-related Twitter images (n = 198) as including individuals of a similar race/ethnicity (yes/no).

Results:
In May-June 2020, health departments posted more pandemic-related content than hospitals (μ = 204 and 71 tweets, respectively; P = .03), including more about health disparities (μ = 14.3% and 2.11% of tweets, respectively; P = .03). Between May-June 2020 and May-June 2021, content addressing health disparities decreased for both groups (47% decrease for health departments and 69% decrease for hospitals). Black respondents were more likely to feel represented in images from health departments than in those from hospitals (44.3% and 23.7% of images, respectively; P = .05). Both hospitals and health departments were more likely to use images where White respondents felt represented (hospitals = 76.1% of images; health departments = 59.7%) than images where respondents from racial/ethnic minorities felt represented (hospitals = 19.3% of images; health departments = 21.4%) (P ≤ .001 for hospitals; P = .004 for health departments).

Conclusions:
Health education ideally comes in a variety of ways. Hospitals used social media for this purpose less than health departments, and neither group increased such content during the COVID-19 pandemic even as evidence of racial disparities grew.
HIV and urethritis: Time required for antiretroviral therapy to suppress HIV in semen
Authors: Matoga Mitch , Chen Jane S. , Massa Cecilia , Thengolose Isaac , Tegha Gerald , Ndalama Beatrice , Bonongwe Naomi , Mathiya Esther , Jere Edward , Banda Gabriel , Khan Shiraz , Loftis Amy J. , Kashuba Angela , Cottrell Mackenzie L. , Schauer Amanda P. , Van Horne Brian , Tompkins Lauren A. , Lancaster Kathryn E. , Miller William C. , Eron Joseph E. , Hoffman Irving F. , Cohen Myron S. 
Published: August 2023

Objectives:
To examine the time required to suppress HIV in the genital tract with antiretroviral therapy (ART) in men with urethritis.

Design:
An observational cohort study.

Methods:
Men with HIV and urethritis not on ART were enrolled at an STI clinic in Malawi and offered to initiate ART. Blood and semen samples were collected pre-treatment and at 1, 2, 4, 8, 12 and 24 weeks post-urethritis treatment. Median viral loads (VL) were calculated by ART initiation groups: ‘within 1 week’, ‘between 1–4 weeks’ and ‘no ART before 4 weeks’, based on the men's choice about whether or not to initiate ART. The presence of ART at each visit was confirmed by bioanalytical methods.

Findings:
Between January 2017- November 2018, 74 men with urethritis and HIV and were confirmed ART naive. The median age was 32 years. Forty-one (55% of men) initiated ART within 1 week; 12 (16%) between 1–4 weeks; and 21 (28%) did not initiate ART by week 4. Within the 1 week group, median VL was suppressed within 4 weeks in both semen and blood. Among the 1–4 weeks group, VL was suppressed within 4 weeks in semen and 5 weeks in blood. Among the no ART before 4 weeks group, VL in semen declined within the first 4 weeks but remained unsuppressed through week 24, and there was no significant decline in blood HIV.

Conclusion:
Treatment of urethritis and prompt initiation of ART with counseling for safer sex for at least one month is a critical measure to reduce transmission of HIV.