bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma osteopontin relates to myocardial fibrosis and steatosis and to immune activation among women with HIV
Authors: Robinson Jake A. , Toribio Mabel , Quinaglia Thiago , Awadalla Magid , Talathi Ria , Durbin Claudia G. , Alhallak Iad , Alagpulinsa David A. , Fourman Lindsay T. , Suero-Abreu Giselle Alexandra , Nelson Michael D. , Stanley Takara L. , Longenecker Christopher T. , Szczepaniak Lidia S. , Jerosch-Herold Michael , Neilan Tomas G. , Zanni Markella V. , Burdo Tricia H. 
Published: December 2022

Objective:
Women with HIV (WWH) have heightened heart failure risk. Plasma OPN (osteopontin) is a powerful predictor of heart failure outcomes in the general population. Limited data exist on relationships between plasma OPN and surrogates of HIV-associated heart failure risk.

Design:
Prospective, cross-sectional.

Methods:
We analyzed relationships between plasma OPN and cardiac structure/function (assessed using cardiovascular magnetic resonance imaging) and immune activation (biomarkers and flow cytometry) among 20 WWH and 14 women without HIV (WWOH).

Results:
Plasma OPN did not differ between groups. Among WWH, plasma OPN related directly to the markers of cardiac fibrosis, growth differentiation factor-15 (ρ = 0.51, P = 0.02) and soluble interleukin 1 receptor-like 1 (ρ = 0.45, P = 0.0459). Among WWH (but not among WWOH or the whole group), plasma OPN related directly to both myocardial fibrosis (ρ = 0.49, P = 0.03) and myocardial steatosis (ρ = 0.46, P = 0.0487). Among the whole group and WWH (and not among WWOH), plasma OPN related directly to the surface expression of C-X3-C motif chemokine receptor 1 (CX3CR1) on nonclassical (CD14−CD16+) monocytes (whole group: ρ = 0.36, P = 0.04; WWH: ρ = 0.46, P = 0.04). Further, among WWH and WWOH (and not among the whole group), plasma OPN related directly to the surface expression of CC motif chemokine receptor 2 (CCR2) on inflammatory (CD14+CD16+) monocytes (WWH: ρ = 0.54, P = 0.01; WWOH: ρ = 0.60, P = 0.03), and in WWH, this held even after controlling for HIV-specific parameters.

Conclusion:
Among WWH, plasma OPN, a powerful predictor of heart failure outcomes, related to myocardial fibrosis and steatosis and the expression of CCR2 and CX3CR1 on select monocyte subpopulations. OPN may play a role in heart failure pathogenesis among WWH.

Clinicaltrials.gov Registration:
NCT02874703.
HIV and race are independently associated with endothelial dysfunction
Authors: Mouchati Christian , Durieux Jared C. , Zisis Sokratis N. , McComsey Grace A. 
Published: December 2022

Objective:
Evaluating the vascular function in HIV-infected compared with HIV uninfected with assessment of body composition, inflammation, and gut integrity markers.

Design:
A noninvasive test that measures the endothelial function.

Methods:
We included participants at least 18 years old, with peripheral arterial tonometry testing (EndoPAT2000) between 2014 and 2022. Persons with HIV (PWH) had documented infection, a stable ART regimen, and a viral load less than 400 copies/ml. We measured the vessel's function with the reactive hyperemia index (RHI) (normal >1.67) and Augmentation Index. Lower Augmentation Index reflect better arterial elasticity. We assessed markers of systemic inflammation, immune activation, and gut integrity. We used linear mixed models to estimate endothelial dysfunction with a significant P value less than 0.05.

Results:
Overall, 511 participants (296 HIV-infected; 215 HIV-uninfected controls) were included. Estimated RHI among PWH was 13% lower (P = 0.01) compared with persons without HIV. In nonwhite race, the estimated RHI was 9% lower (P = 0.001) than white race. For every 1% increase in BMI, we would expect RHI to increase 0.17% (P = 0.01). At the time of EndoPAT, the estimated RHI was 8% lower (P = 0.04) among protease inhibitor users compared with PWH who were not taking protease inhibitors. The estimated odds of abnormal RHI ≤1.67) is 1.56 times greater [95% confidence interval (CI) 1.05–2.31] in nonwhite race compared with white race, independent of HIV status [OR = 1.4 (95% CI 0.94–2.13)]. There was not enough evidence to suggest that inflammation, gut, or monocyte markers, current or nadir CD4+ cell count, or duration of HIV were associated with endothelial dysfunction.

Conclusion:
HIV, nonwhite race, and protease inhibitor use are independently associated with endothelial dysfunction.
The changing prevalence of anemia and risk factors in people with HIV in North America who have initiated ART, 2007–2017
Authors: Lang Raynell , Gill M. John , Coburn Sally B. , Grossman Jennifer , Gebo Kelly A. , Horberg Michael A. , Mayor Angel M. , Silverberg Michael J. , Willig Amanda L. , Justice Amy C. , Klein Marina B. , Bosch Ronald J. , Rabkin Charles S. , Hogan Brenna , Thorne Jennifer E. , Moore Richard D. , Althoff Keri N. 
Published: December 2022

Objective:
To characterize the prevalence of anemia and risk factors between 2007 and 2017 for moderate/severe anemia among people with HIV (PWH) in North America who have initiated antiretroviral therapy (ART).

Design:
Observational study of participants in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

Methods:
We estimated the annual prevalence between 1 January 2007 and 31 December 2017 of mild (11.0–12.9 g/dl men, 11.0–11.9 g/dl women), moderate (8.0–10.9 g/dl regardless of sex) and severe (<8.0 g/dl regardless of sex) anemia. Poisson regression models with robust variance and general estimating equations estimated crude and adjusted prevalence ratios (aPR) with 95% confidence intervals ([–]) comparing risk factors for moderate/severe vs. no/mild anemia between 2007 and 2017.

Results:
Among 73 898 PWH we observed 366 755 hemoglobin measurements following ART initiation, 37 301 (50%) had one or more measures of anemia during follow-up (mild = 17 743 [24%]; moderate = 13 383[18%]; severe = 6175 [8%]). Moderate/severe anemia was more prevalent among women, non-Hispanic Black and Hispanic PWH (vs. non-Hispanic white), those with underweight body mass index (<18.5 kg/m2) and with comorbidities and coinfections. Older age had increased prevalence of moderate/severe anemia among males and decreased prevalence among females. Prevalence of moderate/severe anemia was greater among those with lower CD4+ cell count (≤200 cells/μl) [aPR = 2.11 (2.06–2.17)] unsuppressed HIV viral load (>200 copies/ml) [aPR = 1.26 (1.23–1.29)] and within the first 6 months of ART initiation (vs. >1 year of ART) [aPR = 1.66 (1.61–1.72)].

Conclusion:
The prevalence of anemia among PWH is reduced after ART initiation but remains high. Risk factors differ by sex and include comorbidities and HIV disease severity. The persistent, substantial prevalence of anemia among PWH merits further investigation, targeted screening, and clinical interventions.
Seroconversion and persistence of neutralizing antibody response after yellow fever vaccination in patients with perinatally acquired HIV infection
Authors: Martin Charlotte , Domingo Cristina , Hainaut Marc , Delforge Marc , De Wit Stéphane , Dauby Nicolas 
Published: December 2022

Objective(s):
To describe the dynamics of neutralizing antibody (NAbs) response after yellow fever (YF) vaccine in young adults and adolescents with perinatally acquired HIV (pHIV).

Design:
A retrospective cross-sectional study at three time points around YF vaccination and a matched case–control comparison of NAbs titers several years after YF vaccination.

Methods:
We selected patients who had both documented YF vaccination and perinatally acquired HIV (n = 46). The NAbs titers were measured in plasma samples from the following three time points: during the two years before (TP0), within the year after (TP1) and >1 year after (TP2) administration of the YF vaccine. The impact of perinatal infection was assessed by comparing pHIV YF vaccinees with 44 controls infected with HIV during adulthood.

Results:
The median time between the YF vaccine and TP1 and TP2 was 123 days and 7.3 years, respectively. After YF vaccination, 85% of vaccinees experienced seroconversion. The proportion of pHIV patients with NAbs above the protective threshold was stable between TP1 and TP2 (91% and 86%, respectively) but levels of NAbs decreased significantly between TP1 and TP2 (P = 0.0122). The case-control analysis found slightly higher geometrical mean titers (GMT) in pHIV than patients infected during adulthood.

Conclusions:
Patients with pHIV showed high seroconversion rate and NAbs persistence at levels above the protective threshold after first YF vaccination. However, a decline in antibody levels over time suggests that at least one revaccination may be necessary to maintain circulating antibodies, contrary to recommendations for the general population.
CORRELATION BETWEEN RED BLOOD CELL DISTRIBUTION WIDTH–TO–PLATELET RATIO AND MORTALITY IN PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME: A RETROSPECTIVE COHORT STUDY
Authors: Qin Tao , Liao Lin , Pinhu Liao 
Published: December 2022

ABSTRACT

Background: This study aims to assess the prognostic value of red blood cell distribution width–to–platelet ratio (RPR) in acute respiratory distress syndrome (ARDS) patients. Methods: The data collected from 540 ARDS patients from 2001 to 2012 were obtained from the Medical Information Mart for Intensive Care III Database. The 28-day all-cause mortality risk was considered as the primary outcome parameter, and the secondary outcomes were 60- and 90-day all-cause mortality. The association between RPR (≥0.19 vs. <0.19) and mortality was assessed by Cox proportional hazards models, and potential nonlinear associations were assessed by restricted cubic spline regression analysis. Results: The 28-day all-cause mortality was 22.4%. Among the 121 deaths, 92 (20.0%) presented with an RPR <0.19, and 29 patients had RPR ≥0.19 (P < 0.001). The 60- and 90-day all-cause mortality was 27% and 28.7%, respectively. After adjusting for the relevant factors in the multivariate model, RPR ≥0.19 was independently correlated with the 28-day all-cause mortality (hazard ratio, 2.74; 95% confidence interval, 1.46–5.15; P = 0.002). There was no nonlinear relationship between RPR and the risk of 28-day all-cause mortality (P for overall association <0.001, P for nonlinear = 0.635). Similar results were observed for both the pneumonia and nonpneumonia subgroups and sensitivity analyses. Conclusions: The data promote the use of RPR as a valuable prognostic indicator for ARDS patients.
PREHOSPITAL SHOCK INDEX MULTIPLIED BY AVPU SCALE AS A PREDICTOR OF CLINICAL OUTCOMES IN TRAUMATIC INJURY
Authors: Yang Ya-Chih , Lin Po-Chen , Liu Chi-Yuan , Tzeng I-Shiang , Lee Shu-Jui , Hou Yueh-Tseng , Chen Yu-Long , Chien Da-Sen , Yiang Giou-Teng , Wu Meng-Yu 
Published: December 2022

ABSTRACT

Objectives: Many prehospital trauma triage scores have been proposed, but none has emerged as a criterion standard. Therefore, a rapid and accurate tool is necessary for field triage. The shock index (SI) multiplied by the AVPU (Alert, responds to Voice, responds to Pain, Unresponsive) score (SIAVPU) reflected the hemodynamic and neurological conditions through a combination of the SI and AVPU. This study aimed to investigate the prediction performance of SI multiplied by the AVPU and to compare the prediction performance of other prehospital trauma triage scores in a population with traumatic injury. Patients and Methods: This study included 6,156 patients with trauma injury from the Taipei Tzu Chi trauma database. We investigated the accuracy of four scoring systems in predicting mortality, intensive care unit (ICU) admission, and prolonged hospital stay (defined as a duration of hospitalization >14 days). In the subgroup analysis, we also analyzed the effects of age, injury mechanism and severity, underlying diseases, and traumatic brain injury. Results: The predictive accuracy of SIAVPU for mortality, ICU admission, and prolonged hospital stay was significantly higher than that of SI, modified SI, and SI multiplied by age in the traumatic injury population, with an area under the receiver operating characteristic curve of 0.738 for mortality, 0.641 for ICU admission, and 0.606 for prolonged hospital stay. In the subgroup analysis, the prediction accuracy of mortality, ICU admission, and prolonged hospital stay of SIAVPU was also better in patients with younger age, older age, major trauma (Injury Severity Score ≥16), motor vehicle collisions, fall injury, healthy, cardiovascular disease, mixed traumatic brain injury, and isolated traumatic brain injury. The best cutoff levels of SIAVPU score to predict mortality, ICU admission, and total length of stay ≥14 days in trauma injury patients were 0.90, 0.82, and 0.80, with accuracies of 88.56%, 79.84%, and 78.62%, respectively. Conclusions: In conclusion, SIAVPU is a rapid and accurate field triage score with better prediction accuracy for mortality, ICU admission, and prolonged hospital stay than SI, modified SI, and SI multiplied by age in patients with trauma. Patients with SIAVPU ≥0.9 should be considered for the highest-level trauma center available within the geographic constraints of regional trauma systems.
Overactive Bladder Patients With and Without Urgency Incontinence: A Spectrum of One Condition or Different Phenotypes?
Authors: Torosis Michele , Jackson Nicholas , Nitti Victor , Ackerman A. Lenore 
Published: December 2022

Importance
The importance of this study is to explore potential differences in pathophysiologies of OAB-wet and OAB-dry.

Objectives
The aim of this study was to define fundamental and unique presenting features of patients exhibiting storage lower urinary tract symptoms (LUTS) with urgency incontinence (OAB-wet) and patients without urgency incontinence (OAB-dry).

Study Design
This was a secondary analysis of cross-sectional data from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases–sponsored Symptoms of Lower Urinary Tract Dysfunction Research Network. Demographic, physical examination, and questionnaire responses were analyzed for women seeking care for LUTS at 6 U.S. centers. Differences between OAB-wet and OAB-dry patients were compared using the Fisher exact test and Mann-Whitney U test. Differences in questionnaire data were assessed using a Benjamini-Hochberg false discovery rate correction.

Results
Fifty-six, 84, and 67 women were included in the OAB-dry, wet, and control cohorts, respectively. There was no difference in demographic and physical examination characteristics of the 2 groups. OAB-wet patients reported more urgency incontinence symptoms (LUTS 16a, P < 0.001). OAB-dry reported more bladder pain, feeling of incomplete bladder emptying (LUTS 4, P < 0.001), and a need to strain to urinate (AUA-SI 7, P = 0.003). Sensation of incomplete emptying and straining with urination did not correlate with elevated postvoid residual volumes. Although degrees of symptomatic bother were similar, bother in OAB-dry patients was most closely related to pelvic floor tenderness severity, whereas bother in OAB-wet patients was most related to urgency severity.

Conclusions
Women with OAB-dry have distinct presenting features of straining with urination, bladder pain, and a feeling of incomplete emptying. These suggest a unique pathophysiology driving OAB-dry symptoms, which we hypothesize is pelvic floor myofascial dysfunction.
Impact of Obstetric Anal Sphincter Injuries on Postpartum Sexual Function: A Prospective Cohort Study
Authors: Propst Katie , Yao Meng , Ferrando Cecile A. , Hickman Lisa C. 
Published: December 2022

Importance
Sexual dysfunction, which is common in the postpartum period, often does not resolve by 6 months and is likely more severe in women with severe obstetric lacerations.

Objectives
The aims are to describe sexual function at 6 months postpartum in women who experienced obstetric anal sphincter injury (OASI) and to compare sexual function between women with mild and severe OASI.

Study Design
This is a prospective cohort study of women with OASI. At 6 months postpartum, women were surveyed regarding sexual function using the Postpartum Pelvic Floor Birth Questionnaire, which compares current sexual function to sexual function before vaginal birth.

Results
One hundred fifty-one women were included. Eighty-one (53.6%) women had spontaneous vaginal delivery, and 70 (46.4%) had operative vaginal delivery. One hundred seventeen (77.5%) experienced a mild OASI, and 34 (22.5%) experienced a severe OASI. On the Postpartum Pelvic Floor Birth Questionnaire sexual activity domain, median score for all women was 2.6 (interquartile range, 2.1–3.0) with scores <3.0, indicating worse functioning. The sexual activity domain median scores were 2.4 (1.9–3.0) for mild OASI and 2.8 (2.6–3.0) for severe OASI (P = 0.011), indicating worse scores for women with mild OASI. Within the sexual activity domain, women with mild OASI had worse median scores than women with severe OASI when reporting on enjoyment of sexual activity, frequency of intercourse, and enjoyment during sexual intercourse.

Conclusions
Women who experience OASI have worse sexual function compared with predelivery. Discussion of sexual function is critical for postpartum women, especially for those who are at increased risk after experiencing OASI.
Enhanced Recovery Protocols in Urogynecologic and Pelvic Floor Reconstructive Surgery: A Systematic Review and Meta-Analysis
Authors: Zacharakis Dimitrios , Diakosavvas Michail , Prodromidou Anastasia , Kathopoulis Nikolaos , Angelou Kyveli , Kalantzis Christos , Ntounis Thomas , Athanasiou Stavros , Grigoriadis Themos 
Published: December 2022

Importance
The implementation of Enhanced Recovery After Surgery (ERAS) protocols may optimize the clinical outcome of surgical patients, by reducing the length of hospital stay (LOS) and improving the quality of recovery.

Objective
This study aims to evaluate the impact of ERAS protocols in the intraoperative and postoperative course of patients undergoing pelvic floor reconstructive surgery.

Methods
A systematic search of PubMed/MEDLINE, Embase, and the Cochrane Library was conducted up to January 2022, using the Systematic Reviews and Meta-analyses guidelines. Search terms, such as ERAS, urogynecology, sacrocolpopexy were tailored to each database as necessary. Statistical analysis was performed using the RevMan 5.4 software. Confidence intervals (CI) were set at 95%. Mean difference and risk ratio were used in the analysis, and the results were calculated using the random effect model.

Results
Six studies that reported outcomes of 1,153 women were included. The ERAS protocols were implemented in 553 women, whereas the remaining 600 received standard perioperative care. A significantly shorter LOS (mean difference, −16.17 hours; 95% CI, −24.07 to −8.26 hours; P < 0.0001) and a higher proportion of patients discharged within 24 hours postoperatively was observed in ERAS patients compared with non-ERAS controls (risk ratio, 3.08; 95% CI, 2.00–4.75; P < 0.00001). Operative time, estimated blood loss, complications, and readmission rates did not differ between the 2 groups.

Conclusions
Our analysis showed that ERAS protocols have a favorable impact on the perioperative course of urogynecologic populations. More research is required to determine those key components of ERAS protocols, specifically applicable and more beneficial to women with pelvic floor disorders.
Overactive Bladder and Cognitive Impairment: The American Urogynecologic Society and Pelvic Floor Disorders Research Foundation State-of-the-Science Conference Summary Report
Authors: Dengler Katherine L. , High Rachel A. , Moga Daniela C. , Zillioux Jacqueline , Wagg Adrian , DuBeau Catherine E. , Ackenbom Mary F. , Alperin Marianna , Dumoulin Chantale , Birder Lori A. , Mazloomdoost Donna , Lai H. Henry , Sung Vivian W. , Gray Shelly L. , Sanses Tatiana V.D. 
Published: December 2022

Importance
Overactive bladder (OAB) is prevalent in older adults in whom management is complicated by comorbidities and greater vulnerability to the cognitive effects of antimuscarinic medications.

Objectives
The aim of this study is to provide a comprehensive evidence-based summary of the 2021 State-of-the-Science (SOS) conference and a multidisciplinary expert literature review on OAB and cognitive impairment.

Study Design
The American Urogynecologic Society and the Pelvic Floor Disorders Research Foundation convened a 3-day collaborative conference. Experts from multidisciplinary fields examined cognitive function, higher neural control of the OAB patient, risk factors for cognitive impairment in older patients, cognitive effects of antimuscarinic medications for OAB treatment, OAB phenotyping, conservative and advanced OAB therapies, and the need for a multidisciplinary approach to person-centered treatment. Translational topics included the blood-brain barrier, purine metabolome, mechanotransduction, and gene therapy for OAB targets.

Results
Research surrounding OAB treatment efficacy in cognitively impaired individuals is limited. Short- and long-term outcomes regarding antimuscarinic effects on cognition are mixed; however, greater anticholinergic burden and duration of use influence risk. Oxybutynin is most consistently associated with negative cognitive effects in short-term, prospective studies. Although data are limited, beta-adrenergic agonists do not appear to confer the same cognitive risk.

Conclusions
The 2021 SOS summary report provides a comprehensive review of the fundamental, translational, and clinical research on OAB with emphasis on cognitive impairment risks to antimuscarinic medications. Duration of use and antimuscarinic type, specifically oxybutynin when examining OAB treatments, appears to have the most cognitive impact; however, conclusions are limited by the primarily cognitively intact population studied. Given current evidence, it appears prudent to minimize anticholinergic burden by emphasizing nonantimuscarinic therapeutic regimens in the older population and/or those with cognitive impairment.
Best practice implementation on reporting of coronavirus disease 2019 vaccine adverse events following immunization in Uasin Gishu County, Kenya
Authors: Amdany Henry , Koech Barbara 
Published: December 2022

ABSTRACTObjectives:This project's aim was to implement vaccine safety surveillance best practices to improve reporting of adverse events following immunization (AEFI) during coronavirus disease 2019 (COVID-19) vaccination roll out in Uasin Gishu County.Introduction:Weak vaccine safety surveillance systems in developing countries has contributed to underreporting of AEFIs undermining public confidence in immunization efforts, contributing to low uptake of vaccines critical in the fight against communicable diseases.Methods:The JBI Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit tool for promoting change in healthcare practice was utilized. Preimplementation and postimplementation audit cycles carried out utilized six best practice recommendations. Context-specific strategies and resources were used to address the gaps identified.Results:Less than half of the AEFIs reported were in accordance with the local policy recommendation, and most of the AEFIs reported were submitted in a timely manner in the baseline and follow-up cycle. Slight improvement was recorded in the number of health facilities with AEFIs reporting forms. An improvement of 33.7% was recorded in the number of health workers providing COVID-19 vaccination services who had received education and practical training on vaccine pharmacovigilance.Conclusion:Underreporting and delayed submission of COVID-19 vaccine AEFI was evident among the healthcare providers offering COVID-19 vaccination services, the majority of healthcare providers had received training on vaccine pharmacovigilance, and AEFI hard copy reporting forms were not adequate in the health facilities. Public education on vaccine safety before administration of vaccine needs emphasis in order to improve reporting of AEFI.