bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma levels of β2-microglobulin are associated with atherosclerosis in patients with systemic lupus erythematosus: a cross-sectional cohort study
Authors: Leffers H C B , Hermansen M L , Sandholt B , Fuchs A , Sillesen H , Køber L , Kofoed K F , Faurschou M , Jacobsen S 
Published: June 2018

Objective The objective of this paper is to examine the association between plasma levels of β2-microglobulin (β2MG), a protein previously associated with atherosclerosis, and the presence of carotid plaque (CP) or coronary artery calcium (CAC) in a cross-sectional cohort study of patients with systemic lupus erythematosus (SLE). Methods Patients with SLE were enrolled between June 2013 and May 2014. The presence of CP and CAC was assessed with ultrasonography and computed tomography scan, respectively. The presence of CP or CAC in the SLE patients was analyzed with respect to plasma levels of β2MG and renal function expressed as the estimated glomerular filtration rate (eGFR). Results The study cohort consisted of 147 patients, 89% women and 95% Caucasians. The median age was 46 (range: 21–75) years with a median disease duration of 14 years. CP and CAC was observed in 29 (20%) and 57 (39%) of patients, respectively. CP or CAC was seen in 62 (42%) patients and was associated with the highest quartile of plasma β2MG in patients with eGFR ≥ 90 ml/min/1.73 m2; OR = 18 (95% CI: 1.7–181). β2MG adjusted for eGFR was also associated with presence of CP or CAC in the total cohort. The exclusion of 25 patients with a prior history of cardiovascular disease did not change the observed associations. Conclusion In this study, we found significant associations between imaging markers of atherosclerosis and high plasma levels of plasma β2MG. These data suggest that β2MG is a candidate for further study as a biomarker for atherosclerosis in SLE.
Social security coordination in Association Agreements
Authors: Eisele Katharina 
Published: June 2018

In March 2012, the European Commission adopted a Communication on the external dimension of EU social security coordination. On the one hand, the Commission explained that social security coordination between the EU and rest of the world is dealt with at a national level. On the other hand, the Commission argued that a common EU approach to social security coordination with third countries was under development. This common EU approach to social security coordination consists of a number of elements. One element relates to Association Agreements and Stabilisation and Association Agreements. These Agreements and specific Decisions taken by Association Councils (established by such Agreements) stipulate rules, which govern social security coordination for workers and their families, who move between the EU and the associated country. According to the Commission, once the Association Council Decisions are adopted, the common EU approach to social security coordination will be implemented. Six years after the publication of the 2012 European Commission Communication, questions arise as to whether or not the Association Agreements have been implemented, and the reasons for this. This article seeks to examine and contrast selected Association Agreements and Stabilisation and Association Agreements (SAAs), which provide social security rules for the nationals of the contracting parties. These will include the Ankara Agreement concluded with Turkey, the Euro-Mediterranean Agreements with Algeria, Morocco and Tunisia, and the SAAs with the Balkan countries. The aim of this article is to provide an overarching overview of the different legal positions that third-country nationals may rely on, based on their nationality, and to explore whether or not Association Agreements have been implemented in terms of social security coordination rules.
Chronic inflammatory pain induced GABAergic synaptic plasticity in the adult mouse anterior cingulate cortex
Authors: Koga Kohei , Shimoyama Shuji , Yamada Akihiro , Furukawa Tomonori , Nikaido Yoshikazu , Furue Hidemasa , Nakamura Kazuhiko , Ueno Shinya 
Published: June 2018

Background Chronic pain is a persistent unpleasant sensation that produces pathological synaptic plasticity in the central nervous system. Both human imaging study and animal studies consistently demonstrate that the anterior cingulate cortex is a critical cortical area for nociceptive and chronic pain processing. Thus far, the mechanisms of excitatory synaptic transmission and plasticity have been well characterized in the anterior cingulate cortex for various models of chronic pain. By contrast, the potential contribution of inhibitory synaptic transmission in the anterior cingulate cortex, in models of chronic pain, is not fully understood. Methods Chronic inflammation was induced by complete Freund adjuvant into the adult mice left hindpaw. We performed in vitro whole-cell patch-clamp recordings from layer II/III pyramidal neurons in two to three days after the complete Freund adjuvant injection and examined if the model could cause plastic changes, including transient and tonic type A γ-aminobutyric acid (GABAA) receptor-mediated inhibitory synaptic transmission, in the anterior cingulate cortex. We analyzed miniature/spontaneous inhibitory postsynaptic currents, GABAA receptor-mediated tonic currents, and evoked inhibitory postsynaptic currents. Finally, we studied if GABAergic transmission-related proteins in the presynapse and postsynapse of the anterior cingulate cortex were altered. Results The complete Freund adjuvant model reduced the frequency of both miniature and spontaneous inhibitory postsynaptic currents compared with control group. By contrast, the average amplitude of these currents was not changed between two groups. Additionally, the complete Freund adjuvant model did not change GABAA receptor-mediated tonic currents nor the set of evoked inhibitory postsynaptic currents when compared with control group. Importantly, protein expression of vesicular GABA transporter was reduced within the presynpase of the anterior cingulate cortex in complete Freund adjuvant model. In contrast, the complete Freund adjuvant model did not change the protein levels of GABAA receptors subunits such as α1, α5, β2, γ2, and δ. Conclusion Our results suggest that the induction phase of inflammatory pain involves spontaneous GABAergic plasticity at presynaptic terminals of the anterior cingulate cortex.
Children with post-stroke epilepsy have poorer outcomes one year after stroke
Authors: Fox Christine K , Jordan Lori C , Beslow Lauren A , Armstrong Jennifer , Mackay Mark T , deVeber Gabrielle 
Published: June 2018

Background Epilepsy is a common complication of pediatric stroke. Aim In this study, we aim to measure the association between epilepsy and neurologic outcome after childhood arterial ischemic stroke. Methods Prospective cohort study of children (29 days–19 years) enrolled after an acute arterial ischemic stroke at 21 international pediatric stroke centers and followed to identify epilepsy. One year post-stroke, outcomes were scored using the examination-based Pediatric Stroke Outcome Measure (range = 0–10); higher values reflect greater disability. Ordinal logistic regression was used to measure the association of Pediatric Stroke Outcome Measure scores (categorized as 0–1, 1.5–3, 3.5–6, 6.5–10) with epilepsy. Results Investigators enrolled 86 children (median age = 6.1 years, interquartile range (IQR) = 1.4–12.2 years) with acute stroke. At 1 year, 18/80 (23%) remained on an anticonvulsant including 8/80 (10%) with epilepsy. Among the 70 with Pediatric Stroke Outcome Measure scored, the median was 0.5 (IQR = 0–1.5) for children without epilepsy ( n = 63), and 6 (IQR = 0.5–10) for children with epilepsy ( n = 7). In univariable analyses, poorer 1-year outcome was associated with middle cerebral artery stroke, cortical infarcts, hemorrhagic transformation, hospital disposition not to home, and epilepsy. In multivariable analysis, middle cerebral artery stroke (odds ratio (OR) = 4.9, 95% confidence intervals (CI) = 1.1–21.3) and epilepsy (OR = 24.1, CI = 1.5–380) remained associated with poorer outcome. Conclusions Children who developed epilepsy during the first year post-stroke had poorer neurologic outcomes than those without epilepsy.
Autonomic nervous system dysfunction and sinonasal symptoms
Authors: Yao Alexander , Wilson Janet A. , Ball Stephen L. 
Published: June 2018

Background The autonomic nervous system (ANS) richly innervates the nose and paranasal sinuses, and has a significant role in lower airway diseases, e.g., asthma. Nonetheless, its contribution to sinonasal symptoms is poorly understood. This review aimed to explore the complex relationship between the ANS and sinonasal symptoms, with reference to systemic diseases and triggers of ANS dysfunction. Methods A review of articles published in English was conducted by searching medical literature databases with the key words “autonomic nervous system” and (“sinusitis” or “nose” or “otolaryngology”). All identified abstracts were reviewed, and, from these, relevant published whole articles were selected. Results The ANS has a significant role in the pathophysiologic mechanisms that produce sinonasal symptoms. There was limited evidence that describes the relationship of the ANS in sinonasal disease with systemic conditions, e.g. hypertension. There was some evidence to support mechanisms related to physical and psychological stressors in this relationship. Conclusion The role of ANS dysfunction in sinonasal disease is highly complex. The ANS sits within a web of multiple factors, including personality and psychological distress, that contribute to sinonasal symptoms. Further research will help to clarify the etiology of ANS dysfunction and its contribution to common systemic conditions.
A 3-State Analysis of Black–White Disparities in Diabetes Hospitalizations Among Medicaid Beneficiaries
Authors: Mkanta William N. , Reece Michelle C. , Alamri Abeer D. , Ezekekwu Emmanuel U. , Potluri Aishwarya , Chumbler Neale R. 
Published: June 2018

Introduction: Although diabetes is one of the leading chronic disease in the country, efforts in primary care and patient self-care management could prevent most of the diabetes-related hospitalizations and produce cost savings and improvements in quality of life. We used information from Medicaid beneficiaries in 3 states to predict racial differences in diabetes hospitalizations and demonstrate how they vary across states. Methods: We conducted a cross-sectional study to examine differences between black and white patients with diabetes hospitalizations. Information was obtained from the Medicaid Analytic eXtract files. We used multiple logistic regression models to assess the significance of the differences. Results: Analysis included 10 073 adult Medicaid recipients from the states of Mississippi (51%), Georgia (35%), and Michigan (14%). Blacks were more likely to experience longer hospital stays in Georgia (odds ratio [OR] = 1.040; 95% confidence interval [CI]: 1.03-1.06) and Mississippi (OR = 1.048; 95% CI: 1.03-1.07). A majority of patients in both groups were likely to be discharged to their homes for self-care. Black patients had lower odds of repeated stays in Georgia (OR = 0.670; 95% CI: 0.54-0.84), but higher odds in Michigan (OR = 1.580; 95% CI: 1.12-2.24). Similar differences occurred when patients were matched by age and sex. Blacks had lower odds of qualifying for dual Medicare–Medicaid enrollment benefit in Georgia and Mississippi. Conclusion: Racial differences in diabetes-related hospitalizations reflect possible inefficiencies in the process of care. Identification of race-specific factors for hospitalizations and implementation of primary care strategies that support effective self-management skills would aid in reducing diabetes hospitalizations and related disparities.
Low-dose cytarabine to prevent myeloid leukemia in children with Down syndrome: TMD Prevention 2007 study
Authors: Flasinski Marius , Scheibke Kira , Zimmermann Martin , Creutzig Ursula , Reinhardt Katarina , Verwer Femke , de Haas Valerie , van der Velden Vincent H. J. , von Neuhoff Christine , Zwaan C. Michel , Reinhardt Dirk , Klusmann Jan-Henning 
Published: June 2018

Key Points
Low-dose cytarabine treatment reduced mortality in symptomatic TMD patients compared with the historical control. An MRD monitoring–based low-dose cytarabine treatment does not prevent progression from preleukemic TMD to ML-DS.
Evaluating the effect of Brainfood groups for people with mild cognitive impairment and mild dementia: preliminary mixed-methodology study
Authors: Hassan Saba , Aguirre Elisa , Betz Anna , Robertson Sarah , Sankhla Deepak , Cooper Claudia 
Published: June 2018

BackgroundBrainfood is a 5-week group intervention for people with mild cognitive impairment and mild dementia, promoting cognitive health through a Mediterranean-style diet, exercise, mindfulness and health self-management.AimsTo evaluate Brainfood acceptability and the feasibility of conducting a randomised controlled trial; in a single group study in two National Health Service (NHS) memory services.MethodParticipants self-completed quantitative and semi-structured questionnaires. Recruitment, attendance and outcome completion were the primary outcomes.ResultsIn total, 30 of 59 people invited to Brainfood attended; of the 26 (87%) who completed baseline measures: 25 (96%) completed post-intervention quantitative measures, 16 (67%) qualitative questions and 21 (81%) attended ≥3/5 sessions. Compared with baseline, participants reported significantly higher quality of life, Mediterranean diet adherence and exercising more, up to 2 months after the groups. Participants valued the groups and felt enabled to improve their well-being.ConclusionsBrainfood was acceptable and feasible to implement in an NHS setting.Declaration of interestA.B. and C.C. developed Brainfood – they hold a creative commons license for the manual and make it available to use for free to all. The manual evolves iteratively, but the manual used in this research study is provided in an online supplement.
Managing Cancer and Living Meaningfully (CALM): A Randomized Controlled Trial of a Psychological Intervention for Patients With Advanced Cancer
Authors: Rodin Gary , Lo Christopher , Rydall Anne , Shnall Joanna , Malfitano Carmine , Chiu Aubrey , Panday Tania , Watt Sarah , An Ekaterina , Nissim Rinat , Li Madeline , Zimmermann Camilla , Hales Sarah 
Published: June 2018

PurposeIndividuals with advanced cancer experience substantial distress in response to disease burden and impending mortality. Managing Cancer And Living Meaningfully (CALM) is a novel, brief, manualized psychotherapeutic intervention intended to treat and prevent depression and end-of-life distress in patients with advanced cancer. We conducted a randomized controlled trial to compare CALM with usual care (UC) in this population.MethodsPatients with advanced cancer were recruited from outpatient oncology clinics at a comprehensive cancer center into an unblinded randomized controlled trial. Permuted block randomization stratified by Patient Health Questionnaire-9 depression score allocated participants to CALM plus UC or to UC alone. Assessments of depressive symptoms (primary outcome), death-related distress, and other secondary outcomes were conducted at baseline, 3 months (primary end point), and 6 months (trial end point). Analyses were by intention to treat. Analysis of covariance was used to test for outcome differences between groups at follow-up, controlling for baseline. Mixed-model results are reported.ResultsParticipants (n = 305) were recruited between February 3, 2012, and March 4, 2016, and randomly assigned to CALM (n = 151) or UC (n = 154). CALM participants reported less-severe depressive symptoms than UC participants at 3 months (Δ = 1.09; P = .04; Cohen’s d = 0.23; 95% CI, 0.04 to 2.13) and at 6 months (Δ = 1.29; P = .02; d = 0.29; 95% CI, 0.24 to 2.35). Significant findings for greater end-of-life preparation at 6 months also favored CALM versus UC. No adverse effects were identified.ConclusionFindings suggest that CALM is an effective intervention that provides a systematic approach to alleviating depressive symptoms in patients with advanced cancer and addresses the predictable challenges these patients face.
Hypothalamic–Pituitary and Growth Disorders in Survivors of Childhood Cancer: An Endocrine Society* Clinical Practice Guideline
Authors: Sklar Charles A , Antal Zoltan , Chemaitilly Wassim , Cohen Laurie E , Follin Cecilia , Meacham Lillian R , Murad M Hassan 
Published: June 2018

Abstract

Objective
To formulate clinical practice guidelines for the endocrine treatment of hypothalamic–pituitary and growth disorders in survivors of childhood cancer.

Participants
An Endocrine Society–appointed guideline writing committee of six medical experts and a methodologist.

Conclusions
Due to remarkable improvements in childhood cancer treatment and supportive care during the past several decades, 5-year survival rates for childhood cancer currently are &gt;80%. However, by virtue of their disease and its treatments, childhood cancer survivors are at increased risk for a wide range of serious health conditions, including disorders of the endocrine system. Recent data indicate that 40% to 50% of survivors will develop an endocrine disorder during their lifetime. Risk factors for endocrine complications include both host (e.g., age, sex) and treatment factors (e.g., radiation). Radiation exposure to key endocrine organs (e.g., hypothalamus, pituitary, thyroid, and gonads) places cancer survivors at the highest risk of developing an endocrine abnormality over time; these endocrinopathies can develop decades following cancer treatment, underscoring the importance of lifelong surveillance. The following guideline addresses the diagnosis and treatment of hypothalamic–pituitary and growth disorders commonly encountered in childhood cancer survivors.
Prospective Observational Investigation of Capnography and Pulse Oximetry Monitoring After Cesarean Delivery With Intrathecal Morphine
Authors: Weiniger Carolyn F. , Akdagli Seden , Turvall Elliot , Deutsch Lisa , Carvalho Brendan 
Published: June 2018

BACKGROUND:
Intrathecal morphine provides excellent analgesia after cesarean delivery; however, respiratory events such as apnea, bradypnea, and hypoxemia have been reported. The primary study aim was to estimate the number of apneas per subject, termed “apnea alert events” (AAEs) defined by no breath for 30–120 seconds, using continuous capnography in women who underwent cesarean delivery.

METHODS:
We performed a prospective, observational study with institutional review board approval of women who underwent cesarean delivery with spinal anesthesia containing 150-µg intrathecal morphine. A STOP-Bang obstructive sleep apnea assessment was administered to all women. Women were requested to use continuous capnography and pulse oximetry for 24 hours after cesarean delivery. Nasal sampling cannula measured end-tidal carbon dioxide (Etco
2) and respiratory rate (RR), and oxygen saturation (Spo
2) as measured by pulse oximetry. Capnography data were defined as “valid” when Etco
2 >10 mm Hg, RR >5 breaths per minute (bpm), Spo
2 >70%, or during apnea (AAE) defined as “no breath” (Etco
2, <5 mm Hg) for 30–120 seconds. Individual respiratory variable alerts were 10-second means of Etco
2 <10 mm Hg, RR <8 bpm, and Spo
2 <94%. Nurse observations of RR (hourly and blinded to capnography) are reported.

RESULTS:
We recruited 80 women, mean (standard deviation [SD]) 35 (5) years, 47% body mass index >30 kg/m2/weight >90 kg, and 11% with suspected obstructive sleep apnea (known or STOP-Bang score >3). The duration of normal capnography and pulse oximetry data was mean (SD) (range) 8:28 (7:51) (0:00–22:32) and 15:08 (6:42) (1:31–23:07) hours:minutes, respectively; 6 women did not use the capnography. There were 198 AAEs, mean (SD) duration 57 (27) seconds experienced by 39/74 (53%) women, median (95% confidence interval for median) (range) 1 (0–1) (0–29) per subject. Observation of RR by nurses was ≥14 bpm at all time-points for all women, r = 0.05 between capnography and nurse RR (95% confidence interval, −0.04 to 0.14). There were no clinically relevant adverse events for any woman. Sixty-five women (82%) had complaints with the capnography device, including itchy nose, nausea, interference with nursing baby, and overall inconvenience.

CONCLUSIONS:
We report 198 AAEs detected by capnography among women who underwent cesarean delivery after receiving intrathecal morphine. These apneas were not confirmed by the intermittent hourly nursing observations. Absence of observer verification precludes distinction between real, albeit nonclinically significant alerts with capnography versus false apneas. Discomfort with the nasal sampling cannula and frequent alerts may impact capnography application after cesarean delivery. No clinically relevant adverse events occurred.
Monitoring Depth of Hypnosis: Mid-Latency Auditory Evoked Potentials Derived aepEX in Children Receiving Desflurane-Remifentanil Anesthesia
Authors: Cheung Yuen M. , Scoones Gail P. , Stolker Robert Jan , Weber Frank 
Published: June 2018

BACKGROUND:The aepEXplus monitoring system, which uses mid-latency auditory evoked potentials to measure depth of hypnosis, was evaluated in pediatric patients receiving desflurane-remifentanil anesthesia.METHODS:Seventy-five patients, 1–18 years of age (stratified for age; 1–3, 3–6, 6–18 years, for subgroup analyses), were included in this prospective observational study. The aepEX and the bispectral index (BIS) were recorded simultaneously, the latter serving as a reference. The ability of the aepEX to detect different levels of consciousness, defined according to the University of Michigan Sedation Scale, investigated using prediction probability (Pk), and receiver operating characteristic (ROC) analysis, served as the primary outcome parameter. As a secondary outcome parameter, the relationship between end-tidal desflurane and the aepEX and BIS values were calculated by fitting in a nonlinear regression model.RESULTS:ThePkvalues for the aepEX and the BIS were, respectively, .68 (95% CI, 0.53–0.82) and .85 (95% CI, 0.73–0.96;P= .02). The aepEX and the BIS had an area under the ROC curve of, respectively, 0.89 (95% CI, 0.80–0.95) and 0.76 (95% CI, 0.68–0.84;P= .04). The maximized sensitivity and specificity were, respectively, 81% (95% CI, 61%–93%) and 86% (95% CI, 74%–94%) for the aepEX at a cutoff value of >52, and 69% (95% CI, 56%–81%) and 70% (95% CI, 57%–81%) for the BIS at a cutoff value of >65. The age-corrected end-tidal desflurane concentration associated with an index value of 50 (EC50) was 0.59 minimum alveolar concentration (interquartile range: 0.38–0.85) and 0.58 minimum alveolar concentration (interquartile range: 0.41–0.70) for, respectively, the aepEX and BIS (P= .69). Age-group analysis showed no evidence of a difference regarding the area under the ROC curve or EC50.CONCLUSIONS:The aepEX can reliably differentiate between a conscious and an unconscious state in pediatric patients receiving desflurane-remifentanil anesthesia.