bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blast-Related Traumatic Brain Injury: Current Concepts and Research Considerations
Authors: Bryden Daniel W , Tilghman Jessica I , Hinds Sidney R 
Published: September 2019

Traumatic brain injury (TBI) is a well-known consequence of participation in activities such as military combat or collision sports. But the wide variability in eliciting circumstances and injury severities makes the study of TBI as a uniform disease state impossible. Military Service members are under additional, unique threats such as exposure to explosive blast and its unique effects on the body. This review is aimed toward TBI researchers, as it covers important concepts and considerations for studying blast-induced head trauma. These include the comparability of blast-induced head trauma to other mechanisms of TBI, whether blast overpressure induces measureable biomarkers, and whether a biodosimeter can link blast exposure to health outcomes, using acute radiation exposure as a corollary. This examination is contextualized by the understanding of concussive events and their psychological effects throughout the past century’s wars, as well as the variables that predict sustaining a TBI and those that precipitate or exacerbate psychological conditions. Disclaimer: The views expressed in this article are solely the views of the authors and not those of the Department of Defense Blast Injury Research Coordinating Office, US Army Medical Research and Development Command, US Army Futures Command, US Army, or the Department of Defense.
Non-rigid fixation of the glenoid bone block for patients with recurrent anterior instability and major glenoid bone loss: A systematic review
Authors: Malahias Michael-Alexander , Mitrogiannis Leonidas , Gerogiannis Dimitrios , Chronopoulos Efstathios , Kaseta Maria-Kyriaki , Antonogiannakis Emmanouil 
Published: September 2019

Background New types of glenoid bone block fixation, involving suture buttons, suture anchors or even implant-free impaction of the graft, have been recently introduced. In contrast to screws which allow for a rigid fixation of the bone block, these alternative procedures provide a non-rigid type of fixation. Methods Two reviewers independently conducted the search in a systematic way (according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “Latarjet” OR “Eden-Hybbinette” OR “bone block” AND “anterior” AND “shoulder” AND “instability.” Results Eight out of the 325 initial studies were finally chosen according to our inclusion–exclusion criteria. In total, 750 patients were included in this review. The overall anterior instability recurrence rate for patients treated with non-rigid fixation was 2.6%, while the overall rate of non-union or graft osteolysis was 5.4%. Conclusions Regardless of the graft type, bone block non-rigid fixation showed satisfactory clinical and functional outcomes for the treatment of anterior shoulder instability with substantial glenoid bone deficiency. Furthermore, non-rigid fixation resulted in adequate bone graft healing and osseous incorporation. Lastly, given the relative lack of data, further prospective controlled studies are required to assess bone block non-rigid fixation procedures in comparison with the traditional rigid (with screws) fixation techniques. Level Systematic review, IV.
Impaired right ventricular lusitropy is associated with ventilatory inefficiency in pulmonary arterial hypertension
Authors: Tello Khodr , Dalmer Antonia , Vanderpool Rebecca , Ghofrani Hossein A. , Naeije Robert , Roller Fritz , Seeger Werner , Dumitrescu Daniel , Sommer Natascha , Brunst Anne , Gall Henning , Richter Manuel J. 
Published: September 2019

Cardiopulmonary exercise testing (CPET) is an important tool for assessing functional capacity and prognosis in pulmonary arterial hypertension (PAH). However, the associations of CPET parameters with the adaptation of right ventricular (RV) function to afterload remain incompletely understood.In this study, 37 patients with PAH (idiopathic in 31 cases) underwent single-beat pressure–volume loop measurements of RV end-systolic elastance (Ees), arterial elastance (Ea) and diastolic elastance (Eed). Pulmonary arterial stiffness was assessed by magnetic resonance imaging. The results were correlated to CPET variables. The predictive relevance of RV function parameters for clinically relevant ventilatory inefficiency, defined as minute ventilation/carbon dioxide production (V′E/V′CO2) slope >48, was evaluated using logistic regression analysis.The median (interquartile range) of theV′E/V′CO2slope was 42 (32–52) and theV′E/V′CO2nadir was 40 (31–44). The mean±sdof peak end-tidal carbon dioxide tension (PETCO2) was 23±8 mmHg. Ea, Eed and parameters reflecting pulmonary arterial stiffness (capacitance and distensibility) correlated with theV′E/V′CO2slope,V′E/V′CO2nadir,PETCO2and peak oxygen pulse. RV Ees and RV–arterial coupling as assessed by the Ees/Ea ratio showed no correlations with CPET parameters. Ea (univariate OR 7.28, 95% CI 1.20–44.04) and Eed (univariate OR 2.21, 95% CI 0.93–5.26) were significantly associated with ventilatory inefficiency (p<0.10).Our data suggest that impaired RV lusitropy and increased afterload are associated with ventilatory inefficiency in PAH.
Increased mortality in patients with corticosteroid-dependent asthma: a nationwide population-based study
Authors: Lee Hyun , Ryu Jiin , Nam Eunwoo , Chung Sung Jun , Yeo Yoomi , Park Dong Won , Park Tai Sun , Moon Ji-Yong , Kim Tae-Hyung , Sohn Jang Won , Yoon Ho Joo , Kim Sang-Heon 
Published: September 2019

IntroductionChronic systemic corticosteroid (CS) therapy is associated with an increased risk of mortality in patients with many chronic diseases. However, it has not been elucidated whether chronic systemic CS therapy is associated with increased mortality in patients with asthma. The aim of this study was to determine the effects of chronic systemic CS therapy on long-term mortality in adult patients with asthma.MethodsA population-based matched cohort study of males and females aged ≥18 years with asthma was performed using the Korean National Health Insurance Service database from 2005 to 2015. Hazard ratio (HR) with 95% confidence interval for all-cause mortality among patients in the CS-dependent cohort (CS use ≥6 months during baseline period) relative to those in the CS-independent cohort (CS use <6 months during baseline period) was evaluated.ResultsThe baseline cohort included 466 941 patients with asthma, of whom 8334 were CS-dependent and 458 607 were CS-independent. After 1:1 matching, 8334 subjects with CS-independent asthma were identified. The HR of mortality associated with CS-dependent asthma relative to CS-independent asthma was 2.17 (95% CI 2.04–2.31). In patients receiving low-dose CS, the HR was 1.84 (95% CI 1.69–2.00); in patients receiving high-dose CS, the HR was 2.56 (95% CI 2.35–2.80).ConclusionsIn this real-world, clinical practice, observational study, chronic use of systemic CS was associated with increased risk of mortality in patients with asthma, with a significant dose–response relationship between systemic CS use and long-term mortality.
Does maintenance azithromycin reduce asthma exacerbations? An individual participant data meta-analysis
Authors: Hiles Sarah A. , McDonald Vanessa M. , Guilhermino Michelle , Brusselle Guy G. , Gibson Peter G. 
Published: September 2019

BackgroundPreventing exacerbations is an important goal of asthma treatment. Long-term treatment with azithromycin may help achieve this. Our aim was to conduct a systematic review and individual participant data (IPD) meta-analysis to examine the efficacy of azithromycin in reducing exacerbations in asthma, and in the subphenotypes of noneosinophilic asthma, eosinophilic asthma and severe asthma.MethodWe completed a systematic search of Embase, MEDLINE, PubMed, Cochrane Library,ClinicalTrials.govand reference lists of previous systematic reviews in February 2019. We included parallel-group, double-blind, randomised controlled trials in adults comparing at least 8 weeks of azithromycin treatment with placebo, where the outcome of exacerbations was assessed over at least 6 months. Data were extracted from published sources, Cochrane Risk of Bias Tool was applied and IPD were sought from authors. Reviews were undertaken in duplicate. We conducted an IPD meta-analysis on the primary outcome of exacerbations and a random effects meta-analysis for secondary outcomes.ResultsThree studies were identified (n=604). In the IPD meta-analysis, treatment with azithromycin was associated with a reduced rate of exacerbations (oral corticosteroid course due to worsening asthma, antibiotic use for lower respiratory tract infection, hospitalisation and/or emergency department visits) in asthma as well as in the noneosinophilic, eosinophilic and severe asthma subgroups. Examining each exacerbation type separately, patients with eosinophilic asthma reported fewer oral corticosteroid courses, and patients with noneosinophilic and severe asthma reported fewer antibiotic courses. Azithromycin was well tolerated.DiscussionMaintenance use of azithromycin reduces exacerbations in patients with eosinophilic, noneosinophilic and severe asthma.
Effect of Facile p-Doping on Electrical and Optoelectronic Characteristics of Ambipolar WSe2 Field-Effect Transistors
Authors: Seo Junseok , Cho Kyungjune , Lee Woocheol , Shin Jiwon , Kim Jae-Keun , Kim Jaeyoung , Pak Jinsu , Lee Takhee 
Published: September 2019

Abstract
We investigated the electrical and optoelectronic characteristics of ambipolar WSe2 field-effect transistors (FETs) via facile p-doping process during the thermal annealing in ambient. Through this annealing, the oxygen molecules were successfully doped into the WSe2 surface, which ensured higher p-type conductivity and the shift of the transfer curve to the positive gate voltage direction. Besides, considerably improved photoswitching response characteristics of ambipolar WSe2 FETs were achieved by the annealing in ambient. To explore the origin of the changes in electrical and optoelectronic properties, the analyses via X-ray photoelectron, Raman, and photoluminescence spectroscopies were performed. From these analyses, it turned out that WO3 layers formed by the annealing in ambient introduced p-doping to ambipolar WSe2 FETs, and disorders originated from the WO3/WSe2 interfaces acted as non-radiative recombination sites, leading to significantly improved photoswitching response time characteristics.
Comparison of intracorporeal and extracorporeal urinary diversions after laparoscopic radical cystectomy in females with bladder cancer
Authors: Wu Liyuan , Yang Feiya , Song Liming , Xiao Zejun , Han Sujun , Wu Song , Liu Sai , He Qingbao , Xing Nianzeng 
Published: September 2019

AbstractPurposeTo compare the peri-operative outcomes of females undergoing laparoscopic intracorporeal urinary diversions (ICUD) and extracorporeal urinary diversions (ECUD) after laparoscopic radical cystectomies (LRC).Patients and methodsThirty-eight females who underwent LRCs and urinary diversions from February 2008 to October 2018 were divided into two groups: the ECUD group (19 patients) and the ICUD group (19 patients). We retrospectively analysed the patients in terms of patients’ demographics, peri-operative outcomes, and oncological follow-ups.ResultsThere were significant differences in the mean operative times between ECUDs and ICUDs (364.6 vs. 297.1 min,p = 0.007), transfusion rates (37% vs. 5%,p = 0.042), time to flatus (5 vs. 3 days,p = 0.020), time to ambulation (2 vs. 1 days,p = 0.022), and duration of postoperative hospital stays (22 vs. 13 days,p = 0.002). The mean lymph node yield was 12.9 in the ECUD group and 18.6 in the ICUD group (p = 0.140). Seven out of 19 patients (37%) in the ECUD group and 6 out of 19 patients (32%) in the ICUD group had positive lymph nodes (p > 0.9). Two out of 19 ECUD patients (11%) and 4 of 19 ICUD patients (21%) had positive surgical margins (p = 0.660). Although there were no differences in major complications at 30 days and in all complications at 90 days, the Clavien grade II complications were significantly different at 30 days (ECUD 8, ICUD 2;p = 0.026). The mean follow-up times were 48.7 months (ECUD group) and 26.4 months (ICUD group). There were no statistically significant differences in estimated glomerular filtration rates postoperatively (p = 0.516). Seven patients had disease metastases (ECUD 2 out of 19, ICUD 5 out of 19;p = 0.405) and 5 died (ECUD 3 out of 19, ICUD 2 out of 19;p > 0.9).ConclusionsICUDs benefit females by having smaller incisions, faster recoveries, and decreased complication rates.
E6 and E7 gene polymorphisms in human papillomavirus Type-6 identified in Southwest China
Authors: Chen Zuyi , Li Qiongyao , Huang Jian , Li Jin , Yang Feng , Min Xun , Chen Zehui 
Published: September 2019

Abstract

Background
Human papillomavirus type-6 (HPV6) is the major etiological agent of anogenital warts both men and women. The present study aimed to characterize the genetic diversity among HPV6 in Southwest China, and to investigate the origin of, selective pressure experienced by, and impact of the resultantly identified genetic variants on the HPV6 secondary structure.

Methods
Phylogenetic trees were constructed by Maximum-likelihood and the Kimura 2-parameters methods by Molecular Evolutionary Genetics Analysis version 6.0. The diversity of secondary structure was analyzed by PSIPred software. The selection pressures acting on the E6/E7 genes were estimated by Phylogenetic Analyses by Maximum Likelihood version 4.8 software.

Results
HPV6 was the most prevalent low risk HPV type in southwest China. In total, 143 E6 and E7 gene sequences of HPV6 isolated from patients were sequenced and compared to GenBank HPV6 reference sequence X00203. The results of these analyses revealed that both the HPV6 E6 and E7 were highly conserved within the analyzed patient samples, and comprised only 3 types of variant sequence, respectively. Furthermore, the analysis of HPV6 E6 and E7 sequences revealed seven/five single-nucleotide mutations, two/four and five/one of which were non-synonymous and synonymous, respectively. The phylogenetic analyses of the E6 and E7 sequences indicated that they belonged to sub-lineage A1 and sub-lineage B1, whereas the selective pressure analyses showed that only the E7 mutation sites 4R, 34E, and 52F were positive selection.

Conclusions
HPV6 (detection rate = 13.10%) was very prevalent in southwest China, both the HPV6 E6 and E7 sequences were highly conserved within the analyzed patient samples in southwest China, indicating that the low risk HPV6 can adapt to the environment well without much evolution.
Incidence and death in 29 cancer groups in 2017 and trend analysis from 1990 to 2017 from the Global Burden of Disease Study
Authors: Lin Longfei , Yan Lei , Liu Yuling , Yuan Fang , Li Hui , Ni Jian 
Published: September 2019

Abstract

Background and aims
Cancer has become the second most serious disease threatening human health, followed by cardiovascular diseases. This study aimed to quantitatively estimate the mortality, morbidity, and analyze the trends of 29 cancer groups in 195 countries/regions between 1990 and 2017.

Methods
Detailed information of 29 cancer groups were collected from the Global Burden of Disease (GBD) study in 2017 and age-standardized incidence rates (ASIR) and age-standardized death rates (ASDR) of 29 cancer groups were calculated based on gender, age, region, and country. Trend analyses were conducted for major cancer types.

Results
In 2017, the global death population caused by cancer reached 9 million, which was nearly twice the number in 1990. The ASDR and ASIR of cancer in males were about 1.5 times those of females. Breast cancer showed the highest mortality rate in females in 2017. Individuals aged over 50 are at high risk of developing cancer and the number of cases and deaths in this age group accounted for more than 80% of all cancers in all age groups. Asia has the heaviest cancer burden due to its large population density. Different cancers in varied countries globally have their own characteristics. The ASDR and ASIR of some major cancers demonstrated changes from 1990 to 2017.

Conclusions
Analyses of these data provided basis for future investigations to the common etiological factors, leading to the occurrence of different cancers, the development of prevention strategies based on local characteristics, socioeconomic and other conditions, and the formulation of more targeted interventions.
Leveraging the lessons learned from financing HIV programs to advance the universal health coverage (UHC) agenda in the East African Community
Authors: Zakumumpa Henry , Bennett Sara , Ssengooba Freddie 
Published: September 2019

Abstract

Background
Although there is broad consensus around the need to accelerate progress towards universal health coverage (UHC) in Sub-Saharan Africa, the financing strategies for achieving it are still unclear. We sought to leverage the lessons learned in financing HIV programs over the past two decades to inform efforts to advance the universal health coverage agenda in the East African Community.

Methods
We conducted a literature review of studies reporting financing mechanisms for HIV programs between 2004 and 2014. This review is further underpinned by evidence from a mixed-methods study entailing a survey of 195 health facilities across Uganda supplemented with 18 semi-structured interviews with HIV service managers.

Results
Our data shows that there are six broad HIV financing strategies with potential for application to the universal health coverage agenda in the East African Community (EAC); i) Bi-lateral and multi-lateral funding vehicles: The establishment of HIV-specific global financing vehicles such as PEPFAR and The Global Fund heralded an era of unprecedented levels of international funding of up to $ 500 billion over the past two decades ii) Eliciting private sector contribution to HIV funding: The private sector’s financial contribution to HIV services was leveraged through innovative engagement and collaborative interventions iii) Private sector-led alternative HIV financing mechanisms: The introduction of ‘VIP’ HIV clinics, special ‘HIV insurance’ schemes and the rise of private philanthropic aid were important alternatives to the traditional sources of funding iv) Commodity social marketing: Commodity social marketing campaigns led to an increase in condom use among low-income earners v) The use of vouchers: Issuing of HIV-test vouchers to the poor was an important demand-side financing approach vi) Earmark HIV taxes: Several countries in Africa have introduced ‘special HIV’ taxes to boost domestic HIV funding.

Conclusions
The lessons learned from financing HIV programs suggest that a hybrid of funding strategies are advisable in the quest to achieve UHC in EAC partner states. The contribution of the private sector is indispensable and can be enhanced through targeted interventions towards UHC goals.
Individual Patient Data Meta-Analysis of the Value of Microsatellite Instability As a Biomarker in Gastric Cancer
Authors: Pietrantonio Filippo , Miceli Rosalba , Raimondi Alessandra , Kim Young Woo , Kang Won Ki , Langley Ruth E. , Choi Yoon Young , Kim Kyoung-Mee , Nankivell Matthew Guy , Morano Federica , Wotherspoon Andrew , Valeri Nicola , Kook Myeong-Cherl , An Ji Yeong , Grabsch Heike I. , Fucà Giovanni , Noh Sung Hoon , Sohn Tae Sung , Kim Sung , Di Bartolomeo Maria , Cunningham David , Lee Jeeyun , Cheong Jae-Ho , Smyth Elizabeth Catherine 
Published: September 2019

PURPOSE In the CLASSIC and MAGIC trials, microsatellite instability (MSI)–high status was a favorable prognostic and potential negative predictive factor for neoadjuvant/adjuvant chemotherapy in resectable gastric cancer (GC). Given the low prevalence of MSI-high status in GC and its association with other positive prognostic variables, large data sets are needed to draw robust evidence of its prognostic/predictive value. PATIENTS AND METHODS We performed a multinational, individual-patient-data meta-analysis of the prognostic/predictive role of MSI in patients with resectable GC enrolled in the MAGIC, CLASSIC, ARTIST, and ITACA-S trials. Prognostic analyses used multivariable Cox models (MVM). The predictive role of MSI was assessed both in an all-comer population and in MAGIC and CLASSIC trials by MVM testing of the interaction of treatment (chemotherapy plus surgery v surgery) with MSI. RESULTS MSI status was available for 1,556 patients: 121 (7.8%) had MSI-high status; 576 were European, and 980 were Asian. In MSI-high versus MSI-low/microsatellite stable (MSS) comparisons, the 5-year disease-free survival (DFS) was 71.8% (95% CI, 63.8% to 80.7%) versus 52.3% (95% CI, 49.7% to 55.1%); the 5-year overall survival (OS) was 77.5% (95% CI, 70.0% to 85.8%) versus 59.3% (95% CI, 56.6% to 62.1%). In MVM, MSI was associated with longer DFS (hazard ratio [HR], 1.88; 95% CI, 1.28 to 2.76; P < .001) and OS (HR, 1.78; 95% CI, 1.17 to 2.73; P = .008), as were pT, pN, ethnicity, and treatment. Patients with MSI-low/MSS GC benefitted from chemotherapy plus surgery: the 5-year DFS compared with surgery only was 57% versus 41% (HR, 0.65; 95% CI, 0.53 to 0.79), and the 5-year OS was 62% versus 53% (HR, 0.75; 95% CI, 0.60 to 0.94). Conversely, those with MSI-high GC did not: the 5-year DFS was 70% versus 77% (HR, 1.27; 95% CI, 0.53 to 3.04), and the 5-year OS was 75% versus 83% (HR, 1.50; 95% CI, 0.55 to 4.12). CONCLUSION In patients with resectable primary GC, MSI is a robust prognostic marker that should be adopted as a stratification factor by clinical trials. Chemotherapy omission and/or immune checkpoint blockade should be investigated prospectively in MSI-high GCs according to clinically and pathologically defined risk of relapse.
Differential Resting State Connectivity Responses to Glycemic State in Type 1 Diabetes
Authors: Parikh Lisa , Seo Dongju , Lacadie Cheryl , Belfort-Deaguiar Renata , Groskreutz Derek , Hamza Muhammad , Dai Feng , Scheinost Dustin , Sinha Rajita , Todd Constable R , Sherwin Robert , Hwang Janice Jin 
Published: September 2019

Abstract

Context
Individuals with type 1 diabetes mellitus (T1DM) have alterations in brain activity that have been postulated to contribute to the adverse neurocognitive consequences of T1DM; however, the impact of T1DM and hypoglycemic unawareness on the brain’s resting state activity remains unclear.

Objective
To determine whether individuals with T1DM and hypoglycemia unawareness (T1DM-Unaware) had changes in the brain resting state functional connectivity compared to healthy controls (HC) and those with T1DM and hypoglycemia awareness (T1DM-Aware).

Design
Observational study.

Setting
Academic medical center.

Participants
27 individuals with T1DM and 12 HC volunteers participated in the study.

Intervention
All participants underwent blood oxygenation level dependent (BOLD) resting state functional magnetic brain imaging during a 2-step hyperinsulinemic euglycemic (90 mg/dL)–hypoglycemic (60 mg/dL) clamp.

Outcome
Changes in resting state functional connectivity.

Results
Using 2 separate methods of functional connectivity analysis, we identified distinct differences in the resting state brain responses to mild hypoglycemia between HC, T1DM-Aware, and T1DM-Unaware participants, particularly in the angular gyrus, an integral component of the default mode network (DMN). Furthermore, changes in angular gyrus connectivity also correlated with greater symptoms of hypoglycemia (r = 0.461, P = 0.003) as well as higher scores of perceived stress (r = 0.531, P = 0.016).

Conclusion
These findings provide evidence that individuals with T1DM have changes in the brain’s resting state connectivity patterns, which may be further associated with differences in awareness to hypoglycemia. These changes in connectivity may be associated with alterations in functional outcomes among individuals with T1DM.