bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of maternal periconceptional alcohol consumption with offspring prehypertension/hypertension at age 6 years: the Growing Up in Singapore Towards healthy Outcomes prospective mother-offspring cohort study
Authors: Sadananthan Suresh Anand , Michael Navin , Tint Mya Thway , Thirumurugan Kashthuri , Yuan Wen Lun , Ong Yi Ying , Law Evelyn , Choo Jonathan , Ling Lieng Hsi , Shek Lynette , Fabian Yap , Tan Kok Hian , Vickers Mark , Godfrey Keith M. , Gluckman Peter D. , Chong Yap Seng , Fortier Marielle , Lee Yung Seng , Eriksson Johan G. , Chan Shiao-Yng , Moritz Karen , Velan S. Sendhil , Wlodek Mary E. 
Published: June 2022

Objective:
To evaluate the relationship of the levels of maternal alcohol consumption during the 1 year before pregnancy recognition with childhood cardiorenal, metabolic, and neurocognitive health.

Methods:
In 1106 women and their children from the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort, quantity of maternal alcohol consumption in the 12 months prior to pregnancy recognition was categorized as high (≥75th percentile: 1.9 g/day), low (<1.9 g/day), and none, and frequency of alcohol consumption was categorized as high (≥2–3 times/week), low (<2–3 times/week), and none. Offspring MRI-based abdominal fat depot, kidney, and brain volumes, blood pressure, metabolic syndrome score, and cognitive intelligence scores were assessed. Child prehypertension/hypertension at age 6 years was defined using a simplified pediatric threshold of 110/70 mmHg.

Results:
The average maternal alcohol consumption in the year prior to pregnancy recognition was 2.5 g/day, which is lower than the daily maximal limit of one standard drink (10 g) recommended for women by Singapore's Ministry of Health. After adjusting for participant characteristics, alcohol consumption at least 1.9 g/day was associated with over two-fold higher risk (risk ratio = 2.18, P = 0.013) of child prehypertension and 15% greater kidney growth between early infancy and age 6 years (P = 0.040) compared with abstinence. Alcohol consumption was not associated with metabolic and neurocognitive health at age 6–7 years. The associations with high frequency of alcohol consumption were concordant with those obtained for quantity of alcohol consumption.

Conclusion:
Maternal self-reported alcohol consumption at least 1.9 g/day prior to pregnancy recognition was associated with increased risk of child prehypertension and rapid kidney growth. Our findings highlight the potential detrimental effects of low periconceptional alcohol consumption, below national guidelines on offspring cardiorenal health.
New theory about the pathophysiology of preeclampsia derived from the paradox of positive effects of maternal smoking
Authors: Ekblad Mikael O. , Gissler Mika , Korhonen Päivi E. 
Published: June 2022

Objective:
The aim of this study was to evaluate if maternal height affects the link between the inverse association on smoking during pregnancy and preeclampsia.

Study design:
The study population consisted of all women with singleton pregnancies (n = 803 698) in Finland during the years 2004–2018, excluding women with unknown smoking and diagnosis of prepregnancy chronic hypertension. Information on smoking and background factors were derived from the Finnish Medical Birth Register. Smoking was categorized in three classes: no, quitted in the first trimester and continued throughout the pregnancy. Information on preeclampsia was derived from the Finnish Hospital Discharge Register and the Finnish Medical Birth Register. Multiple logistic regression models were used to estimate first the association between smoking and preeclampsia, and finally whether maternal height modified the association.

Results:
In the standard comparison, we found evidence of an association between preeclampsia and continued smoking [adjusted odds ratio = 0.74, 95% confidence interval (95% CI) = 0.67–0.81], but no association was found between quitted smoking and preeclampsia. Thus, the interaction of continued smoking and maternal height by z-scores was estimated. Among taller mothers, continued smoking was associated with a higher risk for preeclampsia than in smoking mothers with average height (β = 0.33, SE = 0.14, P
= 0.02).

Conclusion:
Our results partly challenge the smoking-preeclampsia paradox: smoking seems not to protect tall mothers against preeclampsia. We speculate the findings through a new theory about the pathophysiology of preeclampsia. It seems that tall pregnant smokers must raise their blood pressure aggressively to ensure perfusion in the dysfunctional placenta.
MACULAR HOLE HYDRODISSECTION TECHNIQUE WITH HUMAN AMNIOTIC MEMBRANE FOR REPAIR OF LARGE MACULAR HOLES
Authors: Felfeli Tina , Corrin Michael , Papanikolaou John , Mandelcorn Efrem D. 
Published: June 2022

Purpose:
To describe a combined surgical technique using the macular hole hydrodissection (MHH) with human amniotic membrane for repair of large macular holes.

Methods:
A step-by-step procedure and a surgical video using the combined MHH and human amniotic membrane technique are presented.

Description and technique:
As the first step, the MHH separates the adhesions of the macular hole to the underlying retinal pigment epithelium with a soft-tipped cannula through proportional reflux followed by gentle passive aspiration. The human amniotic membrane graft is marked to identify the nonsticky epithelial side and ensure that the stromal layer (sticky and nonshinny) is facing downward toward the retinal pigment epithelium. The graft is then tucked into the space created with MHH between the macular hole edges and the retinal pigment epithelium with closed forceps to decrease the likelihood of the graft from dislocating postoperatively.

Conclusion:
The MHH in combination with the human amniotic membrane is a practical and effective technique for addressing challenging large macular holes.
Association Between CYP2D6 Metabolizer Status and Vortioxetine Exposure and Treatment Switching
Authors: Frederiksen Trine , Smith Robert L. , Jukic Marin M. , Molden Espen 
Published: June 2022

Abstract

Purpose
The antidepressant vortioxetine is mainly metabolized by the polymorphic enzyme CYP2D6. The aim of this study was to investigate the absolute serum concentrations of vortioxetine and frequency of switching to an alternative antidepressant in relation to CYP2D6 genotype in a naturalistic patient population.

Methods
The analyses included data from 640 CYP2D6-genotyped patients treated with vortioxetine from a Norwegian therapeutic drug monitoring database. Serum concentration of vortioxetine was determined using ultrahigh-performance liquid chromatography—high-resolution mass spectrometry, whereas longitudinal reviews of therapeutic drug monitoring profiles were performed to identify cases of patients switching from vortioxetine to an alternative antidepressant.

Results
Compared with CYP2D6 normal metabolizers (n = 342), the median vortioxetine serum concentration (ng/mL) was 2.1-fold (P < 0.001) increased in poor metabolizers (PMs) (n = 48), 1.5-fold (P < 0.001) increased in intermediate metabolizers (n = 238), and not significantly changed in ultrarapid metabolizers (n = 12). Compared with CYP2D6 normal metabolizers, treatment switch from vortioxetine to alternative antidepressants was 5.1-fold (95% confidence interval, 1.6–15.4, P = 0.003) more frequent among PMs. The prescribed doses did not differ significantly between the subgroups (P = 0.26). A possible explanation for the increased frequency of treatment switch among PMs is that concentration-dependent adverse events were more frequent in this group because of increased drug exposure.

Conclusions
This naturalistic study provides novel data on the association between CYP2D6 genotype and treatment switch of vortioxetine, which likely reflects the significant effect of CYP2D6 genotype on vortioxetine exposure.
Therapeutic Drug Monitoring of Paliperidone in Patients With Schizophrenia in Taiwan
Authors: Chiu Chih-Chiang , Lin Chun , Chen Wen-Yin , Chen Chia-Ru , Lin Shih-Ku 
Published: June 2022

Abstract

Background
The blood level of antipsychotics affects clinical responses to the drug; it can be influenced by race and several individual factors. This study analyzed the therapeutic plasma concentrations (Cps) of paliperidone for both oral and long-acting injectable (LAI) formulations in clinical samples from Taiwanese patients.

Methods
Patients diagnosed with schizophrenia and treated with either oral paliperidone for at least 4 weeks or LAI paliperidone for at least 6 months were enrolled. Blood samples were taken before the morning dose of oral paliperidone or the injection of LAI paliperidone to obtain the trough Cps.

Results
Among the patients in this study, 51 were taking oral paliperidone, and 26 were receiving LAI paliperidone. In the oral group, the mean Cps were 40.2 ± 19.8 ng/mL in patients taking 9 mg/d and 44.2 ± 15.9 ng/mL in those taking 12 mg/d. In the LAI group, the mean Cps were 32.9 ± 12.7 ng/mL in patients receiving 100 mg per 28 days and 49.9 ± 25.9 ng/mL in those receiving 150 mg per 28 days. The mean Cps per daily dose (Cps/DD) were 4.11 ± 1.99 ng/mL/mg in the oral group and 9.24 ± 3.78 ng/mL/mg in the LAI group.

Conclusions
Under the suggested DD for oral and LAI paliperidone treatment, most Taiwanese patients with schizophrenia can reach the suggested therapeutic Cps range. Wide interindividual differences were observed in the Cps/DD for both the oral (7-fold) and LAI paliperidone (4-fold) groups. Compared with Western reports, no difference was observed in the body weight–adjusted Cps/DD.
Contrasting Comprehension of HIV Research by Adolescents, Young Adults, and Caregivers in Western Kenya: A Cross-sectional Analysis
Authors: Dyer Jessica , Shah Seema K. , Agot Kawango , Wilson Kate , Bosire Risper , Badia Jacinta , Inwani Irene , Beima-Sofie Kristin , Richardson Barbra A. , John-Stewart Grace , Kohler Pamela 
Published: June 2022

Abstract
Adolescent participation in research is critical to inform interventions that improve outcomes for this group. Adolescents and young adults living with HIV often present to care without caregivers, yet caregiver permission is typically required for those younger than 18 years. We evaluated whether understanding of key consent information differed between adolescents (n = 1,393) and caregiver adults (n = 169). Compared with caregivers, adolescents aged 10–14 years showed significantly lower understanding, whereas understanding for older adults living with HIV did not differ significantly from caregivers. Risks were the least understood consent information for all age groups. Our findings suggest that for low-risk research, waiving caregiver permission requirements will not compromise the ethical need to ensure understanding of research before enrollment and may allow adolescents greater access to potential research benefits.
Lessons from effect of etelcalcetide on left ventricular hypertrophy in patients with end-stage kidney disease
Authors: Dörr Katharina , Kainz Alexander , Oberbauer Rainer 
Published: June 2022

Purpose of review
Patients with end-stage kidney disease (ESKD) frequently develop left ventricular hypertrophy (LVH), which is associated with an exceptionally high risk of cardiovascular events and mortality. This review focuses on interventional studies that modify levels of fibroblast growth factor 23 (FGF23) and examine effects on myocardial hypertrophy, cardiovascular events and mortality.

Recent findings
Quantitative evaluations of trials of calcimimetics found no effects on cardiovascular events and cardiovascular and all-cause mortality when compared with placebo. However, a recent randomized, controlled trial of etelcalcetide versus alfacalcidol showed that etelcalcetide effectively inhibited the progression of LVH in comparison to vitamin D in patients on haemodialysis after 1 year of treatment. Prior to that, oral calcimimetic treatment has already been shown to reduce left ventricular mass in patients on haemodialysis, whereas treatment with active vitamin D or mineralocorticoids was ineffective in patients with ESKD.

Summary
Data from a recent trial of etelcalcetide on LVH suggest that FGF23 may be a possible therapeutic target for cardiac risk reduction in patients on haemodialysis. If these findings are confirmed by further research, it might be speculated that a treatment shift from active vitamin D towards FGF23-lowering therapy may occur in patients on haemodialysis.
Money Matters in Psychiatric Assessment, Case Formulation, Treatment Planning, and Ongoing Psychotherapy
Authors: Yager Joel , Kay Jerald 
Published: June 2022

Abstract
Trainees often receive little guidance concerning money matters in patients' lives and treatment, that is, clinical psycho-economics. Accordingly, this article considers: a) practical approaches to inquiring about intrapsychic and interpersonal influences of money matters pertinent to psychiatric assessment; b) how money matters should impact case formulation; c) how money matters realistically impact treatment planning; and d) money matters in ongoing psychotherapy affecting transference, countertransference, and clinical supervision. To supplement their clinical experiences, the authors conducted a limited narrative review via PubMed, followed by snowballing for articles of interest. Evidence suggests that money matters influencing intrapsychic and interpersonal lives commonly cause emotional distress, generating a range of dysfunctional behaviors. These reactions manifest as explicit conflicts, implicit issues, and unequivocal money-related pathologies. Clinical vignettes illustrate specific issues. By explicitly addressing money matters in patient's intrapsychic and interpersonal lives, trainees can enrich their assessments, case formulations, treatment planning, and ongoing psychotherapy.
A Novel Intervention: Stand Up Paddle Boarding Aquatic Therapy (SUPAT) for Pediatric Patients With Cerebral Palsy: 2 Case Studies
Authors: Walz Alyssa D. , Doran Stephen , Potter Priscilla , Chen Yuping 
Published: June 2022

Background and Purpose:
Cerebral palsy (CP) is a nonprogressive neurological condition that typically causes motor dysfunction. Children with CP often have decreased endurance, balance, and strength. This leads to decreased physical activity and difficulty performing sports with their age-related peers. The purpose of these case studies was to determine whether stand up paddle boarding aquatic therapy (SUPAT) improves gross motor function and decreases the number of falls experienced by 2 children with spastic CP.

Case Description:
Participants included 2 adolescent girls diagnosed with spastic CP categorized as Gross Motor Function Classification System (GMFCS) level II.

Intervention:
Over 10 weeks, the patients attended seven 1-hour SUPAT sessions. The sessions included a 10-minute warm-up and a variety of paddle boarding skills. Both participants completed Gross Motor Function Measure-88 (GMFM-88) and reported the average number of falls before and after the SUPAT intervention. During each session, a trial run (the total duration a child could maintain balance on the paddle board) was also measured.

Outcomes:
Participant 1 increased GMFM-88 scores from 92.5% to 95.5% and trial run duration from 1 minute 24 seconds to 6 minutes 14 seconds. Participant 2 increased GMFM-88 scores from 91.6% to 92.9% and trial run duration from 1 minute 12 seconds to 3 minutes 7 seconds. Both participants reported a reduction in the number of falls.

Discussion:
These case studies indicated the SUPAT program was beneficial for pediatric patients with CP. Following the SUPAT intervention, both participants improved scores on the GMFM-88 and increased their ability to maintain balance on the board (trial run). These findings support the notion that the SUPAT program is beneficial for increasing gross motor function, improving balance, and decreasing the number of falls. SUPAT could be a viable alternative therapeutic intervention to traditional aquatic therapy and an opportunity to participate in an outdoor sport.
Addressing Racism's Role in the US HIV Epidemic: Qualitative Findings From Three Ending the HIV Epidemic Prevention Projects
Authors: Harrison Sayward E. , Muessig Kathryn , Poteat Tonia , Koester Kimberly , Vecchio Alyssa , Paton Mariajosé , Miller Sarah J. , Pereira Nastacia , Harris Orlando , Myers Janet , Campbell Chadwick , Hightow-Weidman Lisa 
Published: June 2022

Background:
Racist socio-political and economic systems in the United States are root causes of HIV disparities among minoritized individuals. However, within HIV implementation science literature, there is scarce empirical research on how to effectively counter racism. This article names racism and White supremacy as key challenges to the success of the Ending the HIV Epidemic (EHE) initiative and delineates opportunities to integrate anti-racism into HIV interventions.

Methods:
Formative data were synthesized from 3 EHE studies in California, North Carolina, and South Carolina. Each study engaged with community stakeholders to inform pre-exposure prophylaxis interventions. Key informant interviews and focus groups were used to query individuals—including Black individuals—about implementation challenges. Although racism was not an a priori focus of included studies, discourse on race and racism emerged as key study findings from all projects.

Results:
Across diverse stakeholder groups and EHE locales, participants described racism as a threat to the success of the EHE initiative. Institutional and structural racism, intersectional stigma, and maltreatment of minoritized individuals within healthcare systems were cited as challenges to pre-exposure prophylaxis scale-up. Some recommendations for addressing racism were given—yet these primarily focused on the individual level (eg, enhanced training, outreach).

Conclusions:
EHE implementation scientists should commit to measurable anti-racist actions. To this end, we present a series of recommendations to help investigators evaluate the extent to which they are taking actionable steps to counter racism to improve the adoption, implementation, and real-world impact of EHE interventions for people of color.
Strengthening HIV Prevention Services Through an Implementation Science Approach: Perspectives From the HIV Testers in Philadelphia
Authors: Wood Sarah M. , Meanley Steven , Bonett Stephen , Torres Mary E. , Watson Dovie L. , Williams Javontae L. , Brady Kathleen A. , Bauermeister José A. 
Published: June 2022

Background:
Strengthening HIV prevention services is a key priority of the Ending the HIV Epidemic plan. Informed by the Consolidated Framework for Implementation Research, we examined HIV testers' perceived barriers and facilitators to implementing HIV prevention services, including testers' strengths and weaknesses; enabling factors within the inner and outer settings; and willingness to adopt potential implementation strategies.

Methods:
In 2019, the Penn Center for AIDS Research (CFAR) partnered with the Philadelphia Department of Public Health (PDPH) to examine system-level challenges and opportunities experienced by PDPH-funded HIV testers (individuals conducting HIV testing) in Philadelphia. We recruited HIV testers to complete 2 web surveys (n ≈ 40 each) and in-depth interviews (n = 11).

Results:
Testers self-reported high HIV testing self-efficacy and competence, despite identifying gaps in their knowledge of STI testing, reporting moderate willingness to recommend pre-exposure prophylaxis, and having insufficient cultural competency when working with priority populations. Testers indicated that educational materials and policies within their agencies might require realignment to affirm sexual and gender minority clients. In qualitative interviews, testers noted challenges to implementing PDPH priorities because limited funding fueled competition between local agencies, deterred interagency partnerships, and limited their ability to serve key populations locally.

Discussion:
HIV testers are critical partners in addressing agency-level barriers to HIV prevention service provision through multilevel implementation strategies. In partnership with PDPH, we will create and implement a train-the-trainers program consisting of skill-building activities, technical assistance, and capacity-building for all agency personnel to address missed opportunities in HIV prevention. These activities will reinforce scalability and sustainability of PDPH-supported HIV prevention programs.
Using Implementation Mapping to Ensure the Success of PrEP Optimization Through Enhanced Continuum Tracking (PrOTECT) AL-A Structural Intervention to Track the Statewide PrEP Care Continuum in Alabama
Authors: Creger Thomas , Burgan Kaylee , Turner Wesli H. , Tarrant Ashley , Parmar Jitesh , Rana Aadia , Mugavero Michael , Elopre Latesha 
Published: June 2022

Introduction:
Ending the HIV Epidemic initiatives provide a unique opportunity to use implementation scientific methods to guide implementation of evidence-based practices and evaluate their effectiveness in real-word settings to improve HIV inequities. This report demonstrates our use of Implementation Mapping (IM) to engage participating county health departments, AIDS services organizations, and community-based organizations in the development of a data dashboard to track the PrEP care continuum for the state of Alabama, an Ending the HIV Epidemic hotspot.

Methods:
Our project is guided by an overarching Implementation Research Logic Model and by the tenets of IM, a 5-step approach to support researchers and community partners in the systematic selection, development, and/or tailoring of implementation strategies to increase program adoption, implementation, and sustainability.

Results:
Step 1, the needs assessment, established baseline data elements for a PrEP care continuum for participating community-based organizations, AIDS services organizations, and the state health department as well as investigated their desire for data visualization and willingness to share data to inform initiatives to improve PrEP access. Step 2 identified adaptability, relative advantage, and complexity as determinants of intervention adoption. Based on findings from steps 1 and 2, the investigators and community partners determined to move forward with development of a data dashboard. Step 3 identified the following implementation strategies to support a dashboard, including development of educational materials, synchronous and asynchronous training, technical assistance, and improved record systems.

Discussion:
Using IM supports community-engaged researchers in designing strategies to end the epidemic that are context-specific and more impactful in real-word settings.