bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaginal microbiota associated with oncogenic HPV in a cohort of HPV-vaccinated women living with HIV
Authors: McClymont Elisabeth , Albert Arianne Y , Wang Christine , Dos Santos Scott J , Coutlée François , Lee Marette , Walmsley Sharon , Lipsky Nancy , Loutfy Mona , Trottier Sylvie , Smaill Fiona , Klein Marina B , Yudin Mark H , Harris Marianne , Wobeser Wendy , Hill Janet E , Money Deborah M ,   the CTN 236 HPV in HIV Study Team
Published: July 2022

Background Women living with HIV (WLWH) experience higher rates of human papillomavirus (HPV) infection and cervical cancer than women without HIV. Changes in the vaginal microbiome have been implicated in HPV-related disease processes such as persistence of high-risk HPV infection but this has not been well defined in a population living with HIV. Methods Four hundred and 20 girls and WLWH, age ≥9, across 14 clinical sites in Canada were enrolled to receive three doses of quadrivalent HPV vaccine for assessment of vaccine immunogenicity. Blood, cervical cytology, and cervico-vaginal swabs were collected. Cervico-vaginal samples were tested for HPV DNA and underwent microbiota sequencing. Results Principal component analysis (PCA) and hierarchical clustering generated community state types (CSTs). Relationships between taxa and CSTs with HPV infection were examined using mixed-effects logistic regressions, Poisson regressions, or generalized linear mixed-effects models, as appropriate. Three hundred and fifty-six cervico-vaginal microbiota samples from 172 women were sequenced. Human papillomavirus DNA was detected in 211 (59%) samples; 110 (31%) contained oncogenic HPV. Sixty-five samples (18%) were taken concurrently with incident oncogenic HPV infection and 56 (16%) were collected from women with concurrent persistent oncogenic HPV infection. Conclusions No significant associations between taxa, CST, or microbial diversity and HPV-related outcomes were found. However, we observed weak associations between a dysbiotic microbiome and specific species, including Gardnerella, Porphyromonas, and Prevotella species, with incident HPV infection.
STI prevalence, incidence, and partner notification among women in a periconception HIV prevention program in Uganda
Authors: Chitneni Pooja , Muyindike Winnie , Bwana Mwebesa Bosco , Owembabazi Moran , O’Neil Kasey , Kalyebara Paul Kato , Hedt-Gauthier Bethany , Bangsberg David R , Marrazzo Jeanne M , Kaida Angela , Haberer Jessica E , Matthews Lynn T 
Published: July 2022

Background We provided sexually transmitted infection (STI) screening and facilitated partner notification and treatment among women participating in a periconception HIV prevention program in southwestern Uganda to understand follow-up STI incidence. Methods Women at-risk for HIV exposure while planning for pregnancy completed laboratory screening for chlamydia, gonorrhea, trichomoniasis, and syphilis at enrollment and 6 months of follow-up and/or incident pregnancy; facilitated partner notification and treatment were offered for those with positive tests. We performed a logistic regression to determine correlates of follow-up STI. Results Ninety-four participants completed enrollment STI screening with a median age of 29 (IQR 26–34); 23 (24%) had ≥1 STI. Of the 23 participants with enrollment STI(s), all completed treatment and 19 (83%) returned for follow-up; 18 (78%) reported delivering partner notification cards and discussing STIs with partner(s), and 14 (61%) reported all partners received STI treatment. Of the 81 (86%) who successfully completed follow-up STI screening, 17 (21%) had ≥1 STI. The STI incidence rate was 29.0 per 100 person-years. In univariable regression analysis, enrollment STI, younger age, less education, and alcohol consumption were all significantly associated with follow-up STI. Conclusions We demonstrated high enrollment and follow-up STI rates and moderate participant-reported partner treatment among women planning for pregnancy in Uganda despite partner notification and treatment. Novel STI partner notification and treatment interventions are needed to decrease the STI burden, especially among women planning for and with pregnancy.
Contraceptive use among cisgender women with bacterial sexually transmitted infections: A cross-sectional study
Authors: Blain Michela , Micks Elizabeth , Dombrowski Julia , Balkus Jennifer E , Barbee Lindley 
Published: July 2022

Background Data on contraceptive use among women with bacterial sexually transmitted infections (STIs) are sparse, despite this population’s high risk for unplanned pregnancy. Methods This cross-sectional study included 1623 cisgender women recently diagnosed with a bacterial STI who completed a public health Partner Services interview between January 2017 and December 2019 in King County, WA, USA. Contraceptive methods were categorized as: (1) highly or moderately effective and (2) least effective or no method. Poisson regression models were used to assess associations between individual characteristics and contraceptive method. Results Almost two thirds of the women (62.6%) reported using highly or moderately effective contraception, with 30.3% of women using long-acting contraception (LARC). More than one in three women (37.4%) reported using least effective methods or no method. Black women were less likely to report using a highly or moderately effective method compared to White women (aRR 0.58, 95% CI 0.43–0.80) and women with private insurance were more likely to report using a highly or moderately effective method compared to those with public insurance (aRR 1.67, 95% CI 1.28–2.19). Conclusions Given that many women with bacterial STIs are not desiring pregnancy, this study highlights the need for additional reproductive health services for women with recent STI diagnoses.
Benefits and Challenges of Assistance Dogs for Families of Children on the Autism Spectrum: Mothers’ Perspectives
Authors: Hellings Dana , Joosten Annette , Hatfield Megan , Netto Julie 
Published: July 2022

Assistance dogs are a potential intervention for families of children on the autism spectrum to support participation. However, the lived experience of families with new assistance dogs has not previously been explored. This study described the expectations, benefits, and challenges of assistance dog ownership for families of children on the autism spectrum. Data were collected from four mothers through semi-structured interviews and photovoice prior to assistance dog placement and following 6 months of ownership. Findings indicated assistance dog ownership enhanced the child’s self-regulation and socialization, and increased participation in daily routines. Having an assistance dog also enhanced participation in family outings and activities. Challenges included the adjustment period and the lack of public awareness of autism assistance dogs.
Inclisiran: A First-in-Class siRNA Therapy for Lowering Low-Density Lipoprotein Cholesterol
Authors: Samuel Essie , Watford Maya , Egolum Ugochukwu O. , Ombengi David N. , Ling Hua , Cates Drew W. 
Published: July 2022

Objective: To review the current pharmacology, pharmacokinetics/pharmacodynamics, safety, and efficacy of inclisiran in lowering lipid levels. Data Sources: A PubMed (from December 1, 2014 to April 15, 2022) and ClinicalTrials.gov search was conducted using ALN-PCSsc, ALN-60212, PCSK9si KJX-839, and inclisiran. Additional articles were identified by hand from references. Study Selection and Data Extraction: We included English-language articles evaluating inclisiran pharmacology, efficacy, or safety in humans for lowering low-density lipoprotein cholesterol (LDL-C). Data Synthesis: Inclisiran is a novel small interfering RNA-based therapy administered as a twice-yearly subcutaneous injection. By binding to the messenger RNA (mRNA) precursor of proprotein convertase subtilisin/kexin type 9 (PCSK9), inclisiran inhibits expression of the PCSK9 gene, resulting in increased recycling and expression of LDL receptors and decreased levels of LDL-C. Like PCSK9 inhibitors, inclisiran was associated with a comparable extent of LDL-C reduction in several phase II/III trials. Compared with placebo, inclisiran was found to have similar adverse events except for injection-site reaction. Relevance to Patient Care and Clinical Practice: Currently, inclisiran lacks data on clinical outcome improvement or long-term safety. However, it may play a role in patients with atherosclerotic cardiovascular disease (ASCVD) or ASCVD risk equivalent if optimal LDL-C cannot be achieved by statins and PCSK9 inhibitors cannot be tolerated. The drug may be used for heterozygous familial hypercholesterolemia. Conclusion: Inclisiran is an effective and safe medication for lowering LDL-C levels. Additional data regarding efficacy on cardiovascular outcomes and long-term safety profile with inclisiran are needed.
Feline Diaphyseal Fractures: Management and treatment options
Authors: Zurita Maria , Craig Andrew 
Published: July 2022

Practical relevance: Cats frequently present with diaphyseal fractures, which require treatment in order to achieve a good return to function. These fractures often occur due to significant trauma; for example, as a result of road traffic accidents, high-rise syndrome and dog bite wounds. The first priority is to ensure the patient is systemically well before embarking on any specific surgical treatment of a fracture. Clinical challenges: Surgical management of diaphyseal fractures can be challenging due to the surgical approach for some bones being technically demanding, for example because of the presence of important neurovascular structures, and the small size of feline bones, which limits the choice of implant size and strength. Further, it may be difficult to visualise fracture alignment when using minimally invasive techniques, although the use of intraoperative fluoroscopy can aid with this, and malalignment can be common for some fracture repairs, particularly in cases where anatomical reconstruction is not possible. Aims: This review focuses on diaphyseal long bone fractures and aims to assist decision-making, with an overview of the management and treatment options available. Evidence base: Many textbooks and original articles have been published on aspects of managing fractures in small animals. The authors also provide recommendations based upon their own clinical experience.
Chronic angle closure glaucoma with an atypical iris-pupillary membrane
Authors: Lam Sophia S. , Amarasekera Dilru C. , Razeghinejad Reza 
Published: July 2022

Purpose To report the presentation and management of a 65-year-old female who presented with chronic angle closure glaucoma and an atypical iris membrane. Case Report A 65-year-old healthy female with no significant past medical history presented to the emergency room with a 2-day history of headache, blurry vision, and right ocular pain. She denied any such prior episodes, any prior ocular history including ocular trauma, or a family history of glaucoma. She was diagnosed with bilateral, severe chronic angle closure glaucoma with an atypical, pigmented iris-pupillary membrane in the right eye. Given the appearance of the membrane, ocular oncology consultation and anterior segment imaging were unremarkable. Surgical management included complex cataract extraction, limited pars plana anterior vitrectomy, iris membrane removal, and placement of a sulcus tube shunt. Conclusions This complex case of chronic angle closure glaucoma with an atypical pupillary membrane highlights the importance of maintaining a broad differential and ruling out secondary pathologies such as iris melanoma. Additionally, it highlights the complexities of cataract extraction with a shallow anterior chamber.
Ambulation on hip fracture postoperative day 1: a marker for better outcomes following hip fracture surgery in patients 55 years or older
Authors: Fisher Nina D , Parola Rown , Bi Andrew S , Konda Sanjit R , Egol Kenneth A 
Published: July 2022

Purpose: The purpose of this study was to investigate if early postoperative ambulation metrics affect hospital quality measures and 1-year outcomes in operative hip fracture patients. Methods: A consecutive series of hip fracture patients [OTA/AO 31A, 31B, 32A-C] who underwent operative treatment were reviewed for demographic and clinical data. Chart review was performed to determine participation with physical therapy [PT] and ambulation distance on postoperative day (POD) 1, 3, and 5. POD1 ambulators and non-ambulators were statistically compared. Outcome correlates of postoperative ambulation distance were investigated by univariate and multivariate linear and logistic regression. Results: 1044 patients were identified with 546 (52.3%) able to ambulate on POD1. Those able to ambulate on POD1 were significantly younger (78.4 ± 10.9 vs. 82.1 ± 10.4, p  < 0.001), had fewer co-morbidities (CCI 1.22 ± 1.60 vs. 1.73 ± 1.82, p  < 0.001), and were more likely to be preoperative community ambulators (82.2% vs. 68.3%, p  < 0.001). Patients unable to ambulate on POD1 had significantly higher rate of inpatient mortality (2.8% vs. 0.5%, p = 0.004), 1-year mortality (14.6% vs. 6.9%, p  < 0.001), and a longer length of stay (7.94 ± 4.73 vs. 6.43 ± 4.02 days, p  < 0.001). Non-ambulators more often required the intensive care unit postoperatively (18.7% vs. 7.1%, p  < 0.001), and had increased rates of major complications (15.5% vs. 5.7%, p  < 0.001). Patients with OTA 31B or 32A fractures were 1.63 times more likely to ambulate on POD1 while patients with an assistive device at baseline were 0.51 times less likely to ambulate on POD1. Increasing postoperative ambulation distance correlated with shorter length of stay ( p  < 0.001 for POD1, 3, and 5) and every foot walked was associated with 0.57% decreased odds of a hospital complication ( p = 0.0353). Conclusions: Failure to ambulate on POD1 following hip fracture surgery in >55 years is associated with an increased risk of in-hospital complications and mortality. Every effort should be made address this modifiable risk factor and mobilise patients on POD1 to improve patient outcomes.
Functioning tailor-made 3D-printed vascular graft for hemodialysis
Authors: Li Ming-Chia , Chang Pu-Yuan , Luo Huai-Rou , Chang Ling-Yuan , Lin Chuan-Yi , Yang Chih-Yu , Lee Oscar Kuang-Sheng , Wu Lee Yan-Hwa , Tarng Der-Cherng 
Published: July 2022

Background: The two ends of arteriovenous graft (AVG) are anastomosed to the upper limb vessels by surgery for hemodialysis therapy. However, the size of upper limb vessels varies to a large extent among different individuals. Methods: According to the shape and size of neck vessels quantified from the preoperative computed tomography angiographic scan, the ethylene-vinyl acetate (EVA)-based AVG was produced in H-shape by the three-dimensional (3D) printer and then sterilized. This study investigated the function of this novel 3D-printed AVG in vitro and in vivo. Results: This 3D-printed AVG can be implanted in the rabbit’s common carotid artery and common jugular vein with ease and functions in vivo. The surgical procedure was quick, and no suture was required. The blood loss was minimal, and no hematoma was noted at least 1 week after the surgery. The blood flow velocity within the implanted AVG was 14.9 ± 3.7 cm/s. Additionally, the in vitro characterization experiments demonstrated that this EVA-based biomaterial is biocompatible and possesses a superior recovery property than ePTFE after hemodialysis needle cannulation. Conclusions: Through the 3D printing technology, the EVA-based AVG can be tailor-made to fit the specific vessel size. This kind of 3D-printed AVG is functioning in vivo, and our results realize personalized vascular implants. Further large-animal studies are warranted to examine the long-term patency.
Fear of Falling Avoidance Behavior in Parkinson’s Disease: Most Frequently Avoided Activities
Authors: Rider John V. , Longhurst Jason K. , Navalta James W. , Young Daniel L. , Landers Merrill R. 
Published: July 2022

Background: Fear of falling avoidance behavior (FFAB) is common in Parkinson’s disease (PD). Objectives: The objectives of the study are to determine what activities are most avoided due to FFAB among people with PD and whether any associations exist with demographic factors or fall history. Method: Cross-sectional analysis of 174 individuals with PD using the Modified FFAB Questionnaire. Results: Walking in dimly lit, unfamiliar places, and different surfaces, lifting and carrying objects, walking in crowded places, recreational/leisure activities, and going up/downstairs were most avoided. Fallers reported more FFAB ( ps < .029). FFAB for certain activities was associated with increased or decreased odds of falling. Conclusion: Individuals with PD avoid walking in compromised situations and engaging in recreational/leisure activities due to FFAB. While excessive FFAB may increase the odds of falling, protective forms may be associated with decreased odds. Targeting FFAB among individuals with PD may increase safe participation in meaningful occupations in the home and community.
When is it impractical to ask informed consent? A systematic review
Authors: Laurijssen Sara JM , van der Graaf Rieke , van Dijk Wouter B , Schuit Ewoud , Groenwold Rolf HH , Grobbee Diederick E , de Vries Martine C 
Published: July 2022

Background Informed consent is one of the cornerstones of biomedical research with human subjects. Research ethics committees may allow for a modification or a waiver of consent when the research has social value, involves minimal risk, and if consent is impractical to obtain. While the conditions of social value and minimal risk have received ample attention in research ethics literature, the impractical condition remains unclear. There seem to be different interpretations of the meaning of impractical within academic literature. To address this lack of clarity, we performed a systematic review on the interpretation of impractical. Methods First, we examined international research ethics guidelines on their usage and interpretation of impractical. Next, we used international ethical guidelines to identify synonyms of the term “impractical.” Accordingly, PubMed, Embase, and Web of Science were searched for articles that included “informed consent” and “impractical” or one of its synonyms. Results We found that there were only a few international ethics guidelines that described what could be considered impractical. Out of 2329 identified academic articles, 42 were included. Impractical was used to describe four different conditions: (1) obtaining informed consent becomes too demanding for researchers, (2) obtaining informed consent leads to invalid study outcomes, (3) obtaining informed consent harms the participant, and (4) obtaining informed consent is meaningless for the participant. Conclusion There are conditions that render conventional informed consent truly impractical, such as untraceable participants or harm for participants. At the same time, researchers have a moral responsibility to design an infrastructure in which consent can be obtained, even if they face hardship in obtaining consent. In addition, researchers should seek to minimize harm inflicted upon participants when harm may occur as a result of the consent procedure. Invalidity of research due to consent issues should not be regarded as impractical but as a condition that limits the social value of research. Further research is essential for when a waiver of informed consent based on impractical is also reasonable.
¿Cuáles son las brechas de conocimiento y qué priorizar en investigación en salud mental del adulto mayor? Estudio cuali-cuantitativo utilizando la matriz de estrategias combinadas para Argentina (MECA)
Authors: Prado Carolina , Santero Marilina , Caruso Diego , Ortiz Fabián , Zamorano María Silvia , Irazola Vilma 
Published: July 2022

Introducción: el envejecimiento poblacional es un fenómeno mundial. Los problemas de salud mental, altamente prevalentes en este grupo, impactan en la vida de los individuos, sus familias y la sociedad en su conjunto. Objetivo: identificar brechas de conocimiento y prioridades de investigación en salud mental del adulto mayor en Argentina. Material y métodos: diseño cuali-cuantitativo, en tres etapas: (1) diagnóstico de situación, (2) evaluación global de necesidades de investigación y (3) ejercicio de priorización basado en la Matriz de Estrategias Combinadas validada para Argentina (MECA). Resultados: con base en las primeras dos etapas del estudio se identificaron dos áreas temáticas investigar en el país y dimensiones priorizadas: (a) soledad-aislamiento y (b) deterioro cognitivo y demencia. Como resultado del ejercicio de priorización surgieron las siguientes dimensiones: en relación con soledad-aislamiento: 1. efecto de los programas, 2. falta de acceso a los recursos, 3. capacidad de adaptación a los contextos locales (integración social del adulto mayor) y 4. calidad de servicios. En relación con deterioro cognitivo y demencia: 1. impacto cuidadores y entorno, 2. barreras para la implementación de guías y capacitación, 3. estudios de costo-efectividad sobre intervenciones y calidad de vida, y 4. recolección y publicación de datos epidemiológicos. Conclusión: se debe enfatizar la importancia de fortalecer la investigación en Argentina sobre la implementación y difusión de intervenciones de promoción, prevención y prestación de servicios en la salud mental del adulto mayor.
Smart Pen Exposes Missed Basal Insulin Injections and Reveals the Impact on Glycemic Control in Adults With Type 1 Diabetes
Authors: Ekberg Neda Rajamand , Hartvig Niels Væver , Kaas Anne , Møller Jonas Bech , Adolfsson Peter 
Published: July 2022

Background: Adherence to basal insulin injections and the effects of missed basal insulin injections in adults with type 1 diabetes (T1D) were investigated using data from continuous glucose monitoring (CGM) and smart insulin pen devices in a real-world study. Methods: This was a post hoc analysis of a prospective, real-world study conducted in Sweden. Adults with T1D who were using CGM received a smart insulin pen device (NovoPen 6) for insulin injections. Missed basal insulin doses (≥40 hours between doses) were evaluated over 14-day periods, and the probability of missing basal insulin doses was estimated. Associations between missed basal insulin doses and glycemic outcomes were also explored. Results: Thirty-two patients with 4410 acceptable CGM days (315 14-day periods) were included. The number of missed basal insulin doses ranged from 0 to 4 over 315 14-day periods. The estimated probability of missing at least one basal insulin dose over any given 14-day period was 22% (95% confidence interval: 10%-40%). Missed basal insulin doses were significantly associated with higher mean glycemic levels, higher glucose management indicator, and lower time in range (70-180 mg/dL [3.9-10.0 mmol/L]). Similar results were observed when adjusted for missed bolus insulin doses; age and sex had no statistically significant effect on any glycemic parameter. Conclusions: This is the first study, based on accurate real-world injection data, to demonstrate the challenge of adherence to basal insulin injections in patients with T1D, and document that just one missed basal injection per week can result in clinically significant changes in glycemic control.