bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for severe acute pain and persistent pain after surgery for breast cancer: a prospective observational study
Authors: Habib Ashraf S , Kertai Miklos D , Cooter Mary , Greenup Rachel A , Hwang Shelley 
Published: January 2019

Background and objectivesThere are few prospective studies providing comprehensive assessment of risk factors for acute and persistent pain after breast surgery. This prospective observational study assessed patient-related, perioperative, and genetic risk factors for severe acute pain and persistent pain following breast cancer surgery.MethodsWomen presenting for elective breast cancer surgery completed State Trait Anxiety Inventory, Beck Depression Inventory, and Pain Catastrophizing Scale questionnaires preoperatively. Diffuse noxious inhibitory control and mechanical temporal summation were assessed. A blood sample was obtained for genetic analysis. Analgesic consumption and pain scores were collected in the post-anesthesia care unit, and at 24 and 72 hours. Patients were contacted at 1, 3, 6, and 12 months to assess persistent pain. Primary outcome was maximum acute pain score in first 72 hours and secondary outcome was persistent pain.ResultsOne hundred twenty-four patients were included in analysis. Increased duration of surgery, surgeon, and higher pain catastrophizing scores were associated with increased severity of acute pain, while preoperative radiotherapy was associated with reduced severity. Persistent pain was reported by 57.3% of patients. Postdischarge chemotherapy (OR 2.52, 95% CI 1.13 to 5.82), postdischarge radiation (OR 3.39, 95% CI 1.24 to 10.41), severe acute pain (OR 5.39, 95% CI 2.03 to 15.54), and moderate acute pain (OR 5.31, 95% CI 1.99 to 15.30) were associated with increased likelihood of persistent pain.ConclusionsIncreased duration of surgery, higher pain catastrophizing score, and surgeon were associated with increased severity of acute pain. Preoperative radiation was associated with lower acute pain scores. Postsurgery radiation, chemotherapy, and severity of acute pain were associated with increased likelihood of persistent pain.Trial registrationNCT03307525.
Understanding Event Organization at Scale in Event-Based Social Networks
Authors: Zhang Jason Shuo , Lv Qin 
Published: January 2019

Understanding real-world event participation behavior has been a subject of active research and can offer valuable insights for event-related recommendation and advertisement. The emergence of event-based social networks (EBSNs), which attracts online users to host/attend offline events, has enabled exciting new research in this domain. However, most existing works focus on understanding or predicting individual users’ event participation behavior or recommending events to individual users. Few studies have addressed the problem of event popularity from the event organizer’s point of view.
In this work, we study the latent factors for determining event popularity using large-scale datasets collected from the popular Meetup.com EBSN in five major cities around the world. We analyze and model four contextual factors: spatial factor using location convenience, quality, popularity density, and competitiveness; group factor using group member entropy and loyalty; temporal factor using temporal preference and weekly event patterns; and semantic factor using readability, sentiment, part of speech, and text novelty. In addition, we have developed a group-based social influence propagation network to model group-specific influences on events. By combining the COntextual features and Social Influence NEtwork, our integrated prediction framework COSINE can capture the diverse influential factors of event participation and can be used by event organizers to predict/improve the popularity of their events. Detailed evaluations demonstrate that our COSINE framework achieves high accuracy for event popularity prediction in all five cities with diverse cultures and user event behaviors.
The Role of Access to a Regular Primary Care Physician in Mediating Immigration-Based Disparities in Colorectal Screening: Application of Multiple Mediation Methods
Authors: Blair Alexandra , Gauvin Lise , Schnitzer Mireille E. , Datta Geetanjali D. 
Published: January 2019

Abstract

Background:
Colorectal cancer screening participation is lower among recent immigrants than among Canadian-born individuals. We assessed whether this screening disparity is mediated by access to regular primary care physicians (PCP).

Methods:
Pooling years 2003 to 2014 of the Canadian Community Health Survey, lifetime screening in respondents aged 50 to 75 years of age who immigrated in the previous 10 years (n = 1,067) was compared with Canadian-born respondents (N = 102,366). Regression- and inverse probability weighting-based methods were used to estimate the total effect (TE) and controlled direct effect (CDE) of recent immigration on never having received either a stool- or endoscopic-based screening test. The proportion of the TE that would be eliminated if all had a PCP was computed using these estimates [proportion eliminated (PE) = (TE − CDE)/(TE − 1)]. Analyses were stratified by visible minority status and adjusted for income, rurality, age, sex, marital status, education, and exposure to a provincially organized colorectal screening program.

Results:
The prevalence of never having been screened was 71% and 57% in visible minority and white recent immigrants, respectively, and 46% in white Canadian-born respondents. If all had regular PCPs, there would be no reduction in the screening inequality between white recent immigrants and Canadian-born (null PE), and the inequality between visible minority immigrants and white Canadian-born may increase by 6% to 13%.

Conclusions:
Ensuring all have regular PCPs may lead to greater screening gains among Canadian-born than recent immigrants.

Impact:
Improving access to PCPs may increase colorectal screening overall, but not reduce immigration-based disparities screening. Alternative interventions to reduce this disparity should be explored.
Aspirin Does Not Prevent Pancreatic Cancer in a Large Asian Cohort
Authors: Kim Min-Hyung , Park Sang Min , Yun Young Ho , Hwang In Cheol 
Published: January 2019

Abstract

Background:
Evidence has suggested that aspirin reduces the incidence of several cancers, but these benefits may not occur with pancreatic cancer.

Methods:
A 12-year nationwide longitudinal cohort merged with the health checkup data was divided into “exposure ascertainment period” and “outcome ascertainment period” to avoid immortal time bias. The daily defined dose system was used to indicate the drug exposure.

Results:
We found no significant association between aspirin use and incident pancreatic cancer based on HR.

Conclusions:
Aspirin does not prevent pancreatic cancer.

Impact:
A large Asian cohort study with reliable medication information affirms no impact of aspirin on pancreatic cancer development.
No Cell Left Unturned: Intraductal Papillary Mucinous Neoplasm Heterogeneity
Authors: Hernandez-Barco Yasmin G. , Bardeesy Nabeel , Ting David T. 
Published: January 2019

Abstract
Intraductal papillary mucinous neoplasm (IPMN) is a pancreatic cancer precursor lesion with established genetic features, but the cellular ecosystem of these tumors remains to be fully characterized. This study utilizes single-cell RNA sequencing to describe the dynamic landscape of epithelial, immune, and stromal cells during IPMN progression to invasive cancer.
See related article by Bernard et al., p. 2194
Immunotherapy for the First-Line Treatment of Patients with Metastatic Non–Small Cell Lung Cancer
Authors: Martinez Pablo , Peters Solange , Stammers Timothy , Soria Jean-Charles 
Published: January 2019

Abstract
Immunotherapy has fundamentally changed the treatment landscape for many patients with cancer. mAbs targeting programmed cell death-1 (PD-1), programmed cell death ligand-1 (PD-L1), and cytotoxic T-lymphocyte–associated antigen-4 immune checkpoints have received regulatory approval across a wide range of tumor types, including non–small cell lung cancer (NSCLC). Indeed, treatment approaches for a majority of patients with newly diagnosed metastatic NSCLC are evolving rapidly. Only for the small proportion of patients with metastatic NSCLC and genomic-driven tumors with EGFR or anaplastic lymphoma kinase (ALK)–sensitizing mutations (5%–15%), and possibly BRAF mutations and ROS rearrangements, have initial treatment recommendations remained unchanged, with specific tyrosine kinase inhibitors as the preferred therapy. For the remaining patients, an immunotherapy-based regimen alone or in combination with chemotherapy is now the preferred option based on high-level evidence obtained from randomized controlled trials and in accordance with all available guidelines. Deciding between therapeutic options can be difficult due to the lack of direct cross-comparison studies, differences in chemotherapies and stratification factors, and differences in study populations resulting from inclusion criteria such as histology, PD-L1 expression, or tumor mutational burden (TMB). In an attempt to aid the decision-making process, we discuss and summarize the most recent data from studies using immunotherapies for the treatment of patients with previously untreated metastatic NSCLC.
NPR-C (Natriuretic Peptide Receptor-C) Modulates the Progression of Angiotensin II–Mediated Atrial Fibrillation and Atrial Remodeling in Mice
Authors: Jansen Hailey J. , Mackasey Martin , Moghtadaei Motahareh , Liu Yingjie , Kaur Jaspreet , Egom Emmanuel E. , Tuomi Jari M. , Rafferty Sara A. , Kirkby Adam W. , Rose Robert A. 
Published: January 2019

Background:
Atrial fibrillation (AF) commonly occurs in hypertension and in association with elevated Ang II (angiotensin II) levels. The specific mechanisms underlying Ang II–mediated AF are unclear, and interventions to prevent the effects of Ang II are lacking. NPs (natriuretic peptides), which elicit their effects through specific NP receptors, including NPR-C (natriuretic peptide receptor-C), are cardioprotective hormones that affect cardiac structure and function.

Methods:

This study used wild-type and NPR-C knockout (NPR-C
−/
−
) mice to investigate the effects of Ang II (3 mg/kg per day for 3 weeks) on AF susceptibility and atrial function using in vivo electrophysiology, high-resolution optical mapping, patch clamping, and molecular biology. In some experiments, wild-type mice were cotreated with Ang II and the NPR-C agonist cANF (0.07–0.14 mg/kg per day) for 3 weeks.

Results:

In wild-type mice, Ang II increased susceptibility to AF in association with a prolongation of P-wave duration, increased atrial refractory period, and slowed atrial conduction. These effects were exacerbated in Ang II–treated NPR-C
−/−
mice. Ang II prolonged action potential duration and reduced action potential upstroke velocity (V
max
). These effects were greater in left atrial myocytes from Ang II–treated NPR-C
−/−
mice. Ang II also increased fibrosis in both atria in wild-type mice, whereas Ang II–treated NPR-C
−/−
mice exhibited substantially higher fibrosis throughout the atria. Fibrotic responses were associated with changes in expression of profibrotic genes, including
TGFβ
and
TIMP1
. Cotreating wild-type mice with Ang II and the NPR-C agonist cANF dose dependently reduced AF inducibility by preventing some of the Ang II–induced changes in atrial myocyte electrophysiology and preventing fibrosis throughout the atria.

Conclusions:
NPR-C may represent a new target for the prevention of Ang II–induced AF via protective effects on atrial electrical and structural remodeling.
Genetic Association Study in Multigenerational Kindreds With Vasovagal Syncope
Authors: Sheldon Robert , Rose M. Sarah , Ritchie Debbie , Martens Kristina , Maxey Connor , Jagers Jennie , Parboosingh Jillian , Gerull Brenda 
Published: January 2019

Background:
Several studies suggest that vasovagal syncope has a genetic origin, but this is unclear. We assessed whether plausible gene variants associate with vasovagal syncope.

Methods:

We studied 160 subjects in 9 kindreds comprising 82 fainters and 78 controls. The diagnosis was ascertained with the Calgary Syncope Score. Common genetic variants were genotyped for 12 genes for vascular signaling, potassium channels, the
HTR1A
(serotonin 5-HT1A receptor),
SLC6A4
(serotonin reuptake transporter), and
COMT
(catecholamine O-methyltransferase). Sex-specific associations between genotypes and phenotypes were tested.

Results:

In 9 out of 12 variants, there was no significant association between genotype and phenotype. However, the
HTR1A
(−1019) G alleles associated with syncope in males, but not in females (
P
=0.005). CC and GG males had 9% versus 77% likelihoods of syncope. The
SLC6A4
promoter L alleles associated with decreased syncope in males but increased in females (
P
=0.059). The LL and SS males had 25% and 47% syncope likelihoods, whereas females had 75% and 50% syncope likelihoods. The
COMT
c.472 A alleles associated with decreased syncope in males but increased in females (
P
=0.017). The GG and AA males had 50% and 15% syncope likelihoods, whereas females had 52% and 73% syncope likelihoods.

Conclusions:
There is a sex-dependent effect of alleles of serotonin signaling and vasovagal syncope, supporting the serotonin hypothesis of the physiology of vasovagal syncope.
Preparedness and Mutuality Affect Quality of Life for Patients With Mechanical Circulatory Support and Their Caregivers
Authors: Magasi Susan , Buono Sarah , Yancy Clyde W. , Ramirez Ricardo D. , Grady Kathleen L. 
Published: January 2019

Background:
Clinical and US regulatory guidelines for patients with mechanical circulatory support (MCS) require the identification of a caregiver to assist with MCS care. There is limited understanding of the impact of MCS caregiving on patients and caregivers. The purpose of this study was to examine how living with MCS affects the quality of life (QoL) of patients and their caregivers through the lens of preparedness and mutuality.

Methods and Results:
The sample included 30 MCS patients and their caregivers. Semistructured qualitative interviews about factors contributing to QoL were conducted with patients and caregivers and analyzed using a 2-phase thematic process. Caregiving impacts QoL of MCS patients and their caregivers long term. When there was limited time to engage in decision-making about MCS implantation, people entered MCS caregiving relationships naive to its full demands. Although most people adjusted to the task demands, MCS caregiving had a significant impact, both positive and negative, on interpersonal relationships. We applied the concepts of preparedness and mutuality to help frame the understanding of the emergent themes of forced choice, adjustment, gratitude, relationship change, strain, and burden (both caregiver and patient perceived). Availability of networks of support was identified as a crucial resource.

Conclusions:
MCS caregiving affects QoL for both patients and caregivers. Specifically, preparedness, mutuality, and availability of supportive networks influence QoL of MCS patients and their caregivers. Caregiving relationships change over time. Long-term support by the MCS clinical team can help ensure that physical and emotional needs of MCS patients and caregivers are identified and addressed.
Association of Body Mass Index With Risk Factor Optimization and Guideline-Directed Medical Therapy in US Veterans With Cardiovascular Disease
Authors: Hira Ravi S. , Kataruka Akash , Akeroyd Julia M. , Ramsey David J. , Pokharel Yashashwi , Gurm Hitinder S. , Nasir Khurram , Deswal Anita , Jneid Hani , Alam Mahboob , Ballantyne Christie M. , Petersen Laura A. , Virani Salim S. 
Published: January 2019

Background:
Obesity is a growing epidemic that has been linked to the development of cardiovascular disease (CVD). Guideline-directed medications for secondary prevention and risk factor control are recommended for patients with all forms of CVD. The association of body mass index (BMI) with use of medications for secondary prevention and risk factor control in patients with CVD are poorly understood.

Methods and Results:

We identified 1 122 567 patients with CVD receiving care in 130 Veterans Affairs facilities from October 1, 2013, to September 30, 2014. Five groups were stratified by BMI—underweight (BMI, <18.5 kg/m
2
), normal (BMI, 18.5–24.9 kg/m
2
), overweight (BMI, 25–29.9 kg/m
2
), obese (BMI, 30–39.9 kg/m
2
), and extremely obese (BMI, ≥40 kg/m
2
). A composite of 4 measures—blood pressure <140/90 mm Hg, hemoglobin A1c ≤9% in diabetic patients, statin use, and antiplatelet use—termed optimal medial therapy (OMT) was compared among groups. Multivariable logistic regression was performed with normal BMI as the referent category. Underweight patients comprised 12 623 (1.1%), normal BMI 230 471 (20.5%), overweight 413 590 (36.8%), obese 404 105 (36%), and extremely obese 61 778 (5.5%) of the cohort. Only 43.7% of the entire cohort received OMT, and this was the highest in the overweight group. Adjusted odds ratios for receiving OMT were 0.81 (95% CI, 0.77–0.85), 1.11 (95% CI, 1.10–1.13), 1.08 (95% CI, 1.06–1.09), and 0.87 (95% CI, 0.85–0.89), for patients who were underweight, overweight, obese, and extremely obese, respectively, compared with normal BMI.

Conclusions:
OMT was low in the entire cohort. There is an inverse U-shaped relationship between OMT and BMI with patients who are underweight and extremely obese less likely to receive OMT compared with patients with normal BMI.
Encephalopathy in a Large Cohort of British Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy Patients
Authors: Drazyk Anna M. , Tan Rhea Y.Y. , Tay Jonathan , Traylor Matthew , Das Tilak , Markus Hugh S. 
Published: January 2019

Background and Purpose—
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common monogenic form of stroke usually presenting with migraine with aura, lacunar infarcts, and cognitive impairment. Acute encephalopathy is a less recognized presentation of the disease.

Methods—
Data collected prospectively from 340 consecutively recruited symptomatic patients with diagnosis of CADASIL seen in a British National CADASIL clinic was retrospectively reviewed and original clinical records and imaging obtained. An encephalopathic event was defined as an acute event of an altered state of consciousness in a patient with CADASIL, manifesting with signs of brain dysfunction, which warranted hospital admission in the absence of any other cause. Clinical characteristics, risk factors, and outcome of encephalopathic presentations were studied.

Results—

A total of 35 of 340 (10.3%) participants had a history of 50 encephalopathic events which was the first hospital presentation of CADASIL in 33 (94.3%) patients. Most commonly reported features during episodes were visual hallucinations (44%), seizures (22%), and focal neurological deficits (60%).Complete recovery within 3 months was reported in 48(96%) episodes. In 62% of episodes, there was a history of migraine or migraine aura directly preceding the encephalopathy. In 2 out of 15 cases where magnetic resonance imaging during episodes was available, unilateral focal cortical swelling was seen. A past history of migraine was independently associated with encephalopathy (odds ratio=12.3 [95% CI, 1.6–93.7];
P
=0.015).

Conclusions—
In up to 10% of CADASIL patients, a reversible encephalopathy is the first presentation leading to diagnosis. The strong association with migraine suggests a shared pathogenesis. Focal cortical swelling may be seen on magnetic resonance imaging during the acute episode.
Southern Ocean Seasonal Restratification Delayed by Submesoscale Wind–Front Interactions
Authors: du Plessis Marcel , Swart Sebastiaan , Ansorge Isabelle J. , Mahadevan Amala , Thompson Andrew F. 
Published: January 2019

AbstractOcean stratification and the vertical extent of the mixed layer influence the rate at which the ocean and atmosphere exchange properties. This process has direct impacts for anthropogenic heat and carbon uptake in the Southern Ocean. Submesoscale instabilities that evolve over space (1–10 km) and time (from hours to days) scales directly influence mixed layer variability and are ubiquitous in the Southern Ocean. Mixed layer eddies contribute to mixed layer restratification, while down-front winds, enhanced by strong synoptic storms, can erode stratification by a cross-frontal Ekman buoyancy flux. This study investigates the role of these submesoscale processes on the subseasonal and interannual variability of the mixed layer stratification using four years of high-resolution glider data in the Southern Ocean. An increase of stratification from winter to summer occurs due to a seasonal warming of the mixed layer. However, we observe transient decreases in stratification lasting from days to weeks, which can arrest the seasonal restratification by up to two months after surface heat flux becomes positive. This leads to interannual differences in the timing of seasonal restratification by up to 36 days. Parameterizing the Ekman buoyancy flux in a one-dimensional mixed layer model reduces the magnitude of stratification compared to when the model is run using heat and freshwater fluxes alone. Importantly, the reduced stratification occurs during the spring restratification period, thereby holding important implications for mixed layer dynamics in climate models as well as physical–biological coupling in the Southern Ocean.
Nebulizer Use in Adults With Subglottic Stenosis: A Survey Study
Authors: Tanner Kristine , Anderson Catherine , Smith Marshall E. 
Published: January 2019

Objective: People with subglottic stenosis (SGS) may experience laryngeal symptoms that pose significant challenges to management. This study surveyed the use and effects of nebulized treatments on laryngeal symptoms in a large cohort of adults with SGS. Methods: A survey of nebulized treatment practices was distributed to an online international community of over 2000 members; 316 individuals (298 female, 1 male, 17 declined to specify; age 25+ years) completed the survey. Results: Nearly half (144) of participants had tried a nebulizer in the past. Among those, half currently used nebulized treatments; the majority used these treatments regularly and for greater than 1 year. The most frequently reported treatments included isotonic saline (0.9% Na+Cl–) or hypertonic saline (3% Na+Cl–). Symptoms improved by these treatments included thick mucus (69%), cough (57%), throat dryness (31%), stridor (28%), and voice (15%). The most frequently reported limitations to nebulizer use included time, noise, and portability. Conclusion: Among those individuals with SGS who have tried nebulized treatments, nearly half experienced relief from secondary laryngeal symptoms. Additional efficacy research is needed, particularly with respect to treatment type and dosage. The results are encouraging given the adverse impact these laryngeal symptoms can have on activities of daily living and quality of life.