bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatitis C Virus Screening Trends: Serial Cross-Sectional Analysis of the National Health Interview Survey Population, 2013–2015
Authors: Kasting Monica L. , Giuliano Anna R. , Reich Richard R. , Roetzheim Richard G. , Nelson David R. , Shenkman Elizabeth , Vadaparampil Susan T. 
Published: March 2018

Abstract
Background: Rates of hepatitis C virus (HCV) infection are markedly higher for baby boomers compared with other birth cohorts, and they are now recommended for universal one-time screening. This study examines HCV screening rates and predictors for four birth cohorts [born &lt;1945, born 1945–1965 (baby boomers), born 1966–1985, and born &gt;1985] of a nationally representative sample over time.
Methods: We used data from the 2013–2015 National Health Interview Surveys, an annual weighted survey of the U.S. civilian noninstitutionalized population. We assessed HCV screening prevalence stratified birth cohort with bivariate and multivariable logistic regression analyses.
Results: There were 15,100 participants born &lt;1945, 28,725 baby boomers, 28,089 born 1966–1985, and 13,296 born &gt;1985 in the final analytic sample. Screening was 11.5%–12.8% for baby boomers. The second youngest birth cohort was similar to baby boomers (13.7%–14.9%), whereas the older birth cohort was screened less. After excluding participants who typically have higher rates of HCV screening than the general population, we developed a multivariable model of the general population. In the final model for baby boomers the odds of HCV screening increased significantly with each subsequent year (OR=1.20; 95% CI=1.05–1.38 and OR=1.31; 95% CI=1.13–1.52). HCV screening was also significantly associated with age, gender, and race/ethnicity in baby boomers.
Conclusions: While HCV screening is increasing over time, these increases are minimal and there is substantial room for improvement.
Impact: Future research should develop interventions to increase HCV screening with special focus on groups demonstrating significantly lower screening rates, such as Hispanics and females. Cancer Epidemiol Biomarkers Prev; 27(4); 503–13. ©2018 AACR.
Appendicitis before Age 20 Years Is Associated with an Increased Risk of Later Prostate Cancer
Authors: Ugge Henrik , Udumyan Ruzan , Carlsson Jessica , Davidsson Sabina , Andrén Ove , Montgomery Scott , Fall Katja 
Published: March 2018

Abstract
Background: Appendicitis before age 20 years has been observed to influence the risk of several inflammatory conditions, possibly through underlying immunological mechanisms. Inflammation has further been suggested to be involved in prostate cancer development. We therefore hypothesized that immunological characteristics signaled by appendicitis before late adolescence might influence the risk of later prostate cancer, and aimed to evaluate this association in a population-based study.
Methods: We identified a large cohort of Swedish men who underwent assessment for military conscription around the age of 18 years (n = 242,573). Medical diagnoses at time of conscription were available through the Swedish Military Conscription Register. The Swedish Cancer Register was used to identify diagnoses of prostate cancer. Multivariable adjusted Cox regression analyses were used to estimate HR and 95% confidence intervals (95% CIs) for the association between appendicitis and prostate cancer.
Results: During a median of 36.7 years of follow-up, 1,684 diagnoses of prostate cancer occurred. We found a statistically significant association between appendicitis and overall prostate cancer (adjusted HR 1.70; 95% CI, 1.08–2.67). The risk was notably increased for advanced (HR 4.42; 95% CI, 1.74–11.22) and lethal (HR 8.95; 95% CI, 2.98–26.91) prostate cancer.
Conclusions: These results suggest that a diagnosis of appendicitis before adulthood potentially signals underlying immune characteristics and a pattern of inflammatory response relevant to prostate cancer risk.
Impact: The study lends support to the proposed role of inflammation in prostate carcinogenesis, and adds another area of investigation potentially relevant to prostate cancer development. Cancer Epidemiol Biomarkers Prev; 27(6); 660–4. ©2018 AACR.
Urinary Bladder Cancer Tregs Suppress MMP2 and Potentially Regulate Invasiveness
Authors: Winerdal Malin E. , Krantz David , Hartana Ciputra A. , Zirakzadeh Ali A. , Linton Ludvig , Bergman Emma A. , Rosenblatt Robert , Vasko Janos , Alamdari Farhood , Hansson Johan , Holmström Benny , Johansson Markus , Winerdal Max , Marits Per , Sherif Amir , Winqvist Ola 
Published: March 2018

AbstractRegulatory T cells (Treg) have long been considered one-sided suppressors of antitumor immune responses and hence associated with poor patient outcome in cancer. However, evidence is mounting of a paradoxical positive prognostic effect of Tregs on certain malignancies, including urinary bladder cancer (UBC). This discrepancy has partly been attributed to the shear misidentification of Tregs, but also to the inflammatory profile of the tumor. Our aim was to determine whether tumor-infiltrating Forkhead box P3+ (FOXP3+) cells confer a stable Treg phenotype and to investigate putative beneficial Treg functions, focusing on tumor-promoting inflammatory pathways in UBC. Patients (n = 52) with suspected UBC were prospectively included. We show, by using a broad range of analytical approaches, that tumor-infiltrating CD4+FOXP3+ T cells in UBC phenotypically, functionally, and epigenetically represent a true Treg population. At the invasive front of UBC tumors, we found an inverse relationship between Treg frequency and expression of matrix metalloproteinase 2 (MMP2), a key proinvasive factor induced by tumor-promoting inflammation. Correspondingly, a significant, dose-dependent Treg-mediated downregulation of MMP2 protein and mRNA expression was observed in both macrophages and UBC cells. Also, we found that Treg frequency specifically at the invasive front positively correlated with survival. Thus, we identify Treg-mediated suppression of MMP2 in the tumor microenvironment as a mechanism explaining the paradoxical positive prognostic impact of tumor-infiltrating Tregs in UBC. Cancer Immunol Res; 6(5); 528–38. ©2018 AACR.
Cholesterol Efflux Pathways Suppress Inflammasome Activation, NETosis, and Atherogenesis
Authors: Westerterp Marit , Fotakis Panagiotis , Ouimet Mireille , Bochem Andrea E. , Zhang Hanrui , Molusky Matthew M. , Wang Wei , Abramowicz Sandra , la Bastide-van Gemert Sacha , Wang Nan , Welch Carrie L. , Reilly Muredach P. , Stroes Erik S. , Moore Kathryn J. , Tall Alan R. 
Published: March 2018

Background:

The CANTOS trial (Canakinumab Antiinflammatory Thrombosis Outcome Study) showed that antagonism of interleukin (IL)–1β reduces coronary heart disease in patients with a previous myocardial infarction and evidence of systemic inflammation, indicating that pathways required for IL-1β secretion increase cardiovascular risk. IL-1β and IL-18 are produced via the NLRP3 inflammasome in myeloid cells in response to cholesterol accumulation, but mechanisms linking NLRP3 inflammasome activation to atherogenesis are unclear. The cholesterol transporters ATP binding cassette A1 and G1 (ABCA1/G1) mediate cholesterol efflux to high-density lipoprotein, and
Abca1/g1
deficiency in myeloid cells leads to cholesterol accumulation.

Methods:

To interrogate mechanisms connecting inflammasome activation with atherogenesis, we used mice with myeloid
Abca1/g1
deficiency and concomitant deficiency of the inflammasome components
Nlrp3
or
Caspase-1/11
. Bone marrow from these mice was transplanted into
Ldlr
−/−
recipients, which were fed a Western-type diet.

Results:

Myeloid
Abca1/g1
deficiency increased plasma IL-18 levels in
Ldlr
−/−
mice and induced IL-1β and IL-18 secretion in splenocytes, which was reversed by
Nlrp3
or
Caspase-1/11
deficiency, indicating activation of the NLRP3 inflammasome.
Nlrp3
or
Caspase-1/11
deficiency decreased atherosclerotic lesion size in myeloid
Abca1/g1
-deficient
Ldlr
−/−
mice. Myeloid
Abca1/g1
deficiency enhanced caspase-1 cleavage not only in splenic monocytes and macrophages, but also in neutrophils, and dramatically enhanced neutrophil accumulation and neutrophil extracellular trap formation in atherosclerotic plaques, with reversal by
Nlrp3
or
Caspase-1/11
deficiency, suggesting that inflammasome activation promotes neutrophil recruitment and neutrophil extracellular trap formation in atherosclerotic plaques. These effects appeared to be indirectly mediated by systemic inflammation leading to activation and accumulation of neutrophils in plaques. Myeloid
Abca1/g1
deficiency also activated the noncanonical inflammasome, causing increased susceptibility to lipopolysaccharide-induced mortality. Patients with Tangier disease, who carry loss-of-function mutations in
ABCA1
and have increased myeloid cholesterol content, showed a marked increase in plasma IL-1β and IL-18 levels.

Conclusions:
Cholesterol accumulation in myeloid cells activates the NLRP3 inflammasome, which enhances neutrophil accumulation and neutrophil extracellular trap formation in atherosclerotic plaques. Patients with Tangier disease, who have increased myeloid cholesterol content, showed markers of inflammasome activation, suggesting human relevance.
Clustered Emergency Room Visits Following an Acute Heart Failure Admission: A Population‐Based Study
Authors: Duero Posada Juan G. , Moayedi Yasbanoo , Zhou Limei , McDonald Michael , Ross Heather J. , Lee Douglas S. , Bhatia R. Sacha 
Published: March 2018

Background

While it is well known that heart failure patients presenting to the emergency room (ER) have high short‐term mortality after discharge, the outcomes of patients with heart failure with repeated
ER
visits within a short time are not known. In this study, we aimed to determine whether clustering is associated with an increased risk of death.

Methods and Results

This is a retrospective, population‐based cohort study with an accrual window between 2003 and 2014 and maximal follow‐up up to and including March 31, 2015. Data were obtained from administrative databases from Ontario, Canada. Clustering was defined a priori as 3 or more
ER
visits within a 6‐month period. The main outcome of interest was time to death conditional on 6‐month survival. A total of 72 810 patients with an index hospitalization for acute heart failure were evaluated.
ER
clustering was observed in 15.1% of the population. Increased burden of comorbidities, primary rural residence, and lack of primary care provider were identified as factors associated with
ER
clustering. Age‐ and sex‐adjusted mortality for clustered patients was higher than for nonclustered (hazard ratio [HR] 1.51; 95% confidence interval, 1.47–1.55,
P
<0.0001). Adjusted mortality risk was also higher for patients with clustered
ER
visits (
HR
1.42; 95% confidence interval 1.38–1.46;
P
<0.0001).

Conclusions

Clustering, as defined by 3 or more
ER
visits for any reason within 6 months of index heart failure hospitalization reflects a novel risk factor associated with increased mortality. Future research into the strategies to better manage complex patients with heart failure with recurrent
ER
visits are warranted.
Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German Statutory Quality Assurance Database
Authors: Tsantilas Pavlos , Kuehnl Andreas , Kallmayer Michael , Knappich Christoph , Schmid Sofie , Breitkreuz Thorben , Zimmermann Alexander , Eckstein Hans‐Henning 
Published: March 2018

Background
Subgroup analyses from randomized trials indicate that the time interval between the neurologic index event and carotid artery stenting is associated with periprocedural stroke and death rates in patients with symptomatic carotid stenosis. The aim of this article is to analyze whether this observation holds true under routine conditions in Germany.

Methods and Results

Secondary data analysis was done on 4717 elective carotid artery stenting procedures that were performed for symptomatic carotid stenosis. The patient cohort was divided into 4 groups according to the time interval between the index event and intervention (group I 0‐2,
II
3‐7,
III
8‐14, and
IV
15‐180 days). Primary outcome was any in‐hospital stroke or death. For risk‐adjusted analyses, a multilevel multivariable regression model was used. The in‐hospital stroke or death rate was 3.7% in total and 6.0%, 4.4%, 2.4%, and 3.0% in groups I,
II
,
III
, and
IV
, respectively. Adjusted analysis showed a decreased risk for any stroke or death in group
III
, a decreased risk for any major stroke or death in groups
III
and
IV
, and a decreased risk for any death in groups
II
and
III
compared to the reference group I.

Conclusions
A short time interval between the neurologic index event and carotid artery stenting of up to 7 days is associated with an increased risk for stroke or death under routine conditions in Germany. Although results cannot prove causal relationships, carotid artery stenting may be accompanied by an increased risk of stroke or death during the early period after the index event.
Reliability and Physiological Interpretation of Pulmonary Gas Exchange by “Circulatory Equivalents” in Chronic Heart Failure
Authors: Tan Chunting , Rossiter Harry B. , Porszasz Janos , Bowen T. Scott , Witte Klaus K. , Stringer William W. , Casaburi Richard , Hansen James E. 
Published: March 2018

Background

Peak ratios of pulmonary gas‐exchange to ventilation during exercise (

V
˙

O
2

/

V
˙

E

and

V
˙

CO
2

/

V
˙

E

, termed “circulatory equivalents”) are sensitive to heart failure (
HF
) severity, likely reflecting low and/or poorly distributed pulmonary perfusion. We tested whether peak

V
˙

O
2

/

V
˙

E

and

V
˙

CO
2

/

V
˙

E

would: (1) distinguish
HF
patients from controls; (2) be independent of incremental exercise protocol; and (3) correlate with lactate threshold (
LT
) and ventilatory compensation point (
VCP
), respectively.

Methods and Results

Twenty‐four
HF
patients (61±11 years) with reduced ejection fraction (31±8%) and 11 controls (63±7 years) performed ramp‐incremental cycle ergometry. Eighteen
HF
patients also performed slow (5±1 W/min), medium (9±4 W/min), and fast (19±6 W/min) ramps. Peak

V
˙

O
2

/

V
˙

E

and

V
˙

CO
2

/

V
˙

E

from X‐Y plot, and
LT
and
VCP
from 9‐panel plot, were determined by 2 independent, blinded, assessors. Peak

V
˙

O
2

/

V
˙

E

(31.2±4.4 versus 41.8±4.8 mL/L;
P
<0.0001) and

V
˙

CO
2

/

V
˙

E

(29.3±3.0 versus 36.9±4.0 mL/L;
P
<0.0001) were lower in
HF
than controls. Within individuals, there was no difference across 3 ramp rates in peak

V
˙

O
2

/

V
˙

E

(
P
=0.62) or

V
˙

CO
2

/

V
˙

E

(
P
=0.97). Coefficient of variation (
CV
) in peak

V
˙

O
2

/

V
˙

E

was lower than for
LT
(5.1±2.1% versus 8.2±3.7%;
P
=0.014), and coefficient of variation in peak

V
˙

CO
2

/

V
˙

E

was lower than for
VCP
(3.3±1.8% versus 8.7±4.2%;
P
<0.001). In all participants, peak

V
˙

O
2

/

V
˙

E

was correlated with, but occurred earlier than,
LT
(
r
2
=0.94; mean bias, −0.11 L/min), and peak

V
˙

CO
2

/

V
˙

E

was correlated with, but occurred earlier than,
VCP
(
r
2
=0.98; mean bias −0.08 L/min).

Conclusions

Peak circulatory equivalents during exercise are strongly associated with (but not identical to)
LT
and
VCP
. Peak circulatory equivalents are reliable, objective, effort‐independent indices of gas‐exchange abnormality in
HF
.
Forty years of dietary studies on barn owl (Tyto alba) reveal long term trends in diversity metrics of small mammal prey
Authors: Milana Giuliano , Luiselli Luca , Amori Giovanni 
Published: March 2018

Abstract
The diet of predators is influenced by local conditions (e.g., characteristics of habitat and microhabitat, seasonality, prey availability) and therefore tends to change across time. In this paper, the diet composition of the barn owl (Tyto alba) in Italy was studied using a meta-analysis of 47 articles (covering 212 independent sites, with multiple surveys for some sites, thus giving a total of 290 datasets) between 1972 and 2012. General Linear Models were used to assess the effects of year and study site on four distinct diversity indices (species richness, dominance, Shannon-Weaver diversity and equitability). The year of data collection was a factor used in all analyses. Year had a greater effect than study site on all diversity indices, but the effect was not significant for the evenness and the species richness. However, dietary dominance increased significantly over the years, the Shannon-Weaver index of diversity decreased significantly over time, and equitability also decreased significantly over time. The relative abundance of various species of rodents did not increase/decrease progressively over the years, although there were inter-annual fluctuations. On the other hand, the relative abundance of insectivores tended to decrease with time, and there was a significantly negative correlation between year and the frequency of consumption of Sorex spp. and a marginally significant negative correlation for Crocidura leucodon.
Green Revolution Model and Agrarian Crisis: Towards a Perspectival Critique
Authors: Srinivasulu K. 
Published: March 2018

In the dominant interpretation, the agrarian crisis and farmers’ suicides have been viewed either as outcomes of individual decisions/actions of the farmers or as caused by vagaries of nature or certain policies. The present study views them as symptomatic of a deeper systemic crisis in agriculture in the post-Green Revolution and post-economic reform period. By examining the transformation of the agrarian question, especially consequent upon the generalisation of the Green Revolution model, this article highlights the importance of the changing dynamics between farm and non-farm sector in terms of accumulation and interaction and the changes in the class–caste relations internal to the rural society as the causes of the crisis.
Time, Resident Involvement, and Supply Drive Cost Variability in Septoplasty with Turbinate Reduction
Authors: Quinn Nicholas A. , Alt Jeremiah A. , Ashby Shaelene , Orlandi Richard R. 
Published: March 2018

ObjectiveTo determine factors that influence cost variability in septoplasty with inferior turbinate reduction.Study DesignCase series with chart review.SettingTertiary care hospital and affiliated ambulatory surgical center.Subjects and MethodsSurgical costs were reviewed for adult patients undergoing septoplasty with inferior turbinate reduction between December 2014 and September 2017. Cases where additional procedures were performed were excluded. Operative supply costs, operative time, room time, and resident involvement were determined. Contribution of these factors to total costs and variability were analyzed.ResultsThe study included 116 patients (mean age, 38 years) and 4 faculty surgeons. Total cost was primarily driven by operative time (74%), with a smaller portion of total cost arising from supplies (26%). Time cost (P <. 0001) and supply cost (P =. 006) varied significantly among surgeons. A resident was involved in 46.6% of cases. When subanalyzed by resident year, no‐resident and senior resident (postgraduate years 4 and 5) cases had nearly identical mean times, while junior resident (postgraduate years 1‐3) cases had mean times and operative time costs that were 39% greater (P <. 001).ConclusionFor septoplasty with inferior turbinate reduction, the greatest driver of cost variation was operative time. Resident involvement correlated with increased time and cost. Supply costs had a much smaller impact. When subanalyzed by resident year, junior resident–involved cases were significantly longer than no‐resident cases.
Longitudinal Tracking of Sound Exposure and Hearing Aid Usage through Objective Data Logs
Authors: Doyle John B. , Raghunathan Rohit R. , Cellum Ilana , Li Gen , Golub Justin S. 
Published: March 2018

ObjectiveTo use data‐logging technology to objectively track and identify predictors of hearing aid (HA) usage and aided sound exposure.Study DesignCase series with planned data collection.SettingTertiary academic medical center.Subjects and MethodsIndividuals with HAs between 2007 and 2016 were included (N = 431; mean, 74.6 years; 95% CI, 73.1‐76.0). Data‐logging technology intrinsic to new‐generation HAs was enabled to track usage and sound exposure. With multivariable linear regression, age, sex, number of audiology visits, duration of audiologic follow‐up, pure tone average, and HA side were assessed as predictors of usage (hours/day) and aided sound exposure (dB‐hours/day; ie, “dose” of sound per day).ResultsMean follow‐up was 319 days (95% CI, 277‐360). Mean HA usage was 8.4 hours/day (95% CI, 8.0‐8.8; N = 431). Mean aided sound exposure was 440 dB‐hours/day (95% CI, 385‐493; n = 110). HA use (β < 0.001, P =. 45) and aided sound exposure (β = −0.006, P =. 87) were both stable over time. HA usage was associated only with hearing loss level (pure tone average; β = 0.030, P =. 04). Aided sound exposure was associated only with duration of audiologic follow‐up (β = 0.100, P =. 02).ConclusionWhile measurement of HA use has traditionally relied on subjective reporting, data logging offers an objective tool to longitudinally track HA use and sound exposure. We demonstrate the feasibility of using this potentially powerful research tool. Usage and sound exposure were stable among patients throughout the study period. Use was greater among subjects with greater hearing loss. Maximizing aided sound exposure might be possible through continued audiology follow‐up visits.
Direct Analysis of Pathogenic Structures Affixed to the Tympanic Membrane during Chronic Otitis Media
Authors: Monroy Guillermo L. , Hong Wenzhou , Khampang Pawjai , Porter Ryan G. , Novak Michael A. , Spillman Darold R. , Barkalifa Ronit , Chaney Eric J. , Kerschner Joseph E. , Boppart Stephen A. 
Published: March 2018

ObjectiveTo characterize otitis media–associated structures affixed to the mucosal surface of the tympanic membrane (TM) in vivo and in surgically recovered in vitro samples.Study DesignProspective case series without comparison.SettingOutpatient surgical care center.Subjects and MethodsForty pediatric subjects scheduled for tympanostomy tube placement surgery were imaged intraoperatively under general anesthesia. Postmyringotomy, a portable optical coherence tomography (OCT) imaging system assessed for the presence of any biofilm affixed to the mucosal surface of the TM. Samples of suspected microbial infection–related structures were collected through the myringotomy incision. The sampled site was subsequently reimaged with OCT to confirm collection from the original image site on the TM. In vitro analysis based on confocal laser scanning microscope (CLSM) images of fluorescence in situ hybridization–tagged samples and polymerase chain reaction (PCR) provided microbiological characterization and verification of biofilm activity.ResultsOCT imaging was achieved for 38 of 40 subjects (95%). Images from 38 of 38 (100%) of subjects observed with OCT showed the presence of additional microbial infection–related structures. Thirty‐four samples were collected from these 38 subjects. CLSM images provided evidence of clustered bacteria in 32 of 33 (97%) of samples. PCR detected the presence of active bacterial DNA signatures in 20 of 31 (65%) of samples.ConclusionPCR and CLSM analysis of fluorescence in situ hybridization–stained samples validates the presence of active bacteria that have formed into a middle ear biofilm that extends across the mucosal layer of the TM. OCT can rapidly and noninvasively identify middle ear biofilms in subjects with severe and persistent cases of otitis media.