bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of short-term exercise training intensity on β-cell function in older obese adults with prediabetes
Authors: Malin Steven K. , Francois Monique E. , Eichner Natalie Z. M. , Gilbertson Nicole M. , Heiston Emily M. , Fabris Chiara , Breton Marc 
Published: October 2018

The effect of work-matched exercise intensity on β-cell function is unknown in people with prediabetes before clinical weight loss. We determined if short-term moderate continuous (CONT) vs. high-intensity interval (INT) exercise increased β-cell function. Thirty-one subjects (age: 61.4 ± 2.5 yr; body mass index: 32.1 ± 1.0 kg/m2) with prediabetes [American Diabetes Association criteria, 75-g oral glucose tolerance test (OGTT)] were randomized to work-matched CONT (70% HRpeak) or INT (3 min 90% HRpeak and 3 min 50% HRpeak) exercise for 60 min/day over 2 wk. A 75-g 2-h OGTT was conducted after an overnight fast, and plasma glucose, insulin, C-peptide, and free fatty acids were determined for calculations of skeletal muscle [oral minimal model (OMM)], hepatic (homeostatic model of insulin resistance), and adipose (Adipose-IR) insulin sensitivity. β-Cell function was defined from glucose-stimulated insulin secretion (GSIS, deconvolution modeling) and the disposition index (DI). Glucagon-like polypeptide-1 [GLP-1(active)] and glucose-dependent insulinotropic polypeptide (GIP) were also measured during the OGTT, along with peak oxygen consumption and body composition. CONT and INT increased skeletal muscle- but not hepatic- or adipose-derived DI ( P < 0.05). Although both treatments tended to reduce fasting GLP-1(active) ( P = 0.08), early phase GLP-1(active) increased post-CONT and INT training ( P < 0.001). Interestingly, CONT exercise increased fasting GIP compared with decreases in INT ( P = 0.02). Early and total-phase skeletal muscle DI correlated with decreased total glucose area under the curve ( r = −0.52, P = 0.002 and r = −0.50, P = 0.003, respectively). Independent of intensity, short-term training increased pancreatic function adjusted to skeletal muscle in relation to improved glucose tolerance in adults with prediabetes. Exercise also uniquely affected GIP and GLP-1(active). Further work is needed to elucidate the dose-dependent mechanism(s) by which exercise impacts glycemia. NEW & NOTEWORTHY Exercise is cornerstone for reducing blood glucose, but whether high-intensity interval training is better than moderate continuous exercise is unclear in people with prediabetes before weight loss. We show that 2 wk of exercise training, independent of intensity, increased pancreatic function in relation to elevated glucagon-like polypeptide-1 secretion. Furthermore, β-cell function, but not insulin sensitivity, was also correlated with improved glucose tolerance. These data suggest that β-cell function is a strong predictor of glycemia regardless of exercise intensity.
Deep Learning to Distinguish Recalled but Benign Mammography Images in Breast Cancer Screening
Authors: Aboutalib Sarah S. , Mohamed Aly A. , Berg Wendie A. , Zuley Margarita L. , Sumkin Jules H. , Wu Shandong 
Published: October 2018

Abstract

Purpose:
False positives in digital mammography screening lead to high recall rates, resulting in unnecessary medical procedures to patients and health care costs. This study aimed to investigate the revolutionary deep learning methods to distinguish recalled but benign mammography images from negative exams and those with malignancy.

Experimental Design:
Deep learning convolutional neural network (CNN) models were constructed to classify mammography images into malignant (breast cancer), negative (breast cancer free), and recalled-benign categories. A total of 14,860 images of 3,715 patients from two independent mammography datasets: Full-Field Digital Mammography Dataset (FFDM) and a digitized film dataset, Digital Dataset of Screening Mammography (DDSM), were used in various settings for training and testing the CNN models. The ROC curve was generated and the AUC was calculated as a metric of the classification accuracy.

Results:
Training and testing using only the FFDM dataset resulted in AUC ranging from 0.70 to 0.81. When the DDSM dataset was used, AUC ranged from 0.77 to 0.96. When datasets were combined for training and testing, AUC ranged from 0.76 to 0.91. When pretrained on a large nonmedical dataset and DDSM, the models showed consistent improvements in AUC ranging from 0.02 to 0.05 (all P &gt; 0.05), compared with pretraining only on the nonmedical dataset.

Conclusions:
This study demonstrates that automatic deep learning CNN methods can identify nuanced mammographic imaging features to distinguish recalled-benign images from malignant and negative cases, which may lead to a computerized clinical toolkit to help reduce false recalls.
IGFBP7 (Insulin-Like Growth Factor–Binding Protein-7) and Neprilysin Inhibition in Patients With Heart Failure
Authors: Januzzi James L. , Packer Milton , Claggett Brian , Liu Jiankang , Shah Amil M. , Zile Michael R. , Pieske Burkert , Voors Adriaan , Gandhi Parul U. , Prescott Margaret F. , Shi Victor , Lefkowitz Martin P. , McMurray John J.V. , Solomon Scott D. 
Published: October 2018

Background:
Increased activity of IGFBP7 (insulin-like growth factor–binding protein-7) is associated with cellular senescence, tissue aging, and obesity. IGFBP7 may be related to heart failure with preserved ejection fraction, a disease of elderly obese people.

Methods and Results:

In a subset of patients with heart failure with preserved ejection fraction (N=228) randomized to receive sacubitril/valsartan versus valsartan, IGFBP7 concentrations were measured at baseline, 12 weeks, and 36 weeks. Patient characteristics and echocardiographic measures including left atrial (LA) size and volume, ratio of early mitral inflow velocity/annular diastolic velocity, and ratio of early diastole/peak late diastolic velocity were assessed as a function of IGFBP7 concentration. Effect of sacubitril/valsartan on IGFBP7 concentrations was analyzed. With increasing baseline IGFBP7 quartiles, LA size and LA volume index (LAVi) were higher (both
P
<0.001); modest association between IGFBP7 and higher early mitral inflow velocity/annular diastolic velocity (
P
=0.03) and early diastole/peak late diastolic velocity ratio (
P
=0.04) was also seen. IGFBP7 concentrations were higher in those with LAVi ≥34 mL/m
2
compared with lower LAVi at all time points (all
P
<0.01). IGFBP7 independently predicted LAVi at baseline even in the presence of NT-proBNP (N-terminal pro-B-type natriuretic peptide) concentrations; highest LAVi was seen in those with elevation in both biomarkers. Treatment with sacubitril/valsartan resulted in lower IGFBP7 concentrations over 36 weeks compared with valsartan (adjusted treatment effect, −7%;
P
<0.001).

Conclusions:
Among patients with heart failure with preserved ejection fraction, concentrations of the cellular senescence biomarker IGFBP7 were associated with abnormalities in diastolic filling and LA dilation. Treatment with sacubitril/valsartan resulted in lower IGFBP7 concentrations compared with valsartan.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT00887588.
Lifetime Risks of Valvular Heart Disease and Pacemaker Use in Patients With Ankylosing Spondylitis
Authors: Ward Michael M. 
Published: October 2018

Background

The likelihoods of valvular heart disease (
VHD
) and conduction abnormalities in patients with ankylosing spondylitis (
AS
p) are poorly defined. Knowing their lifetime risks of
VHD
and pacemaker use would help inform whether cardiac screening should be done.

Methods and Results

Patients with
AS
p and a comparison group without
AS
p were identified among US Medicare beneficiaries in 1999 to 2013. Frequencies of
VHD
and pacemaker use were compared in 4 age groups: 65 to 69 years, 70 to 74 years, 75 to 79 years, and 80 years or older, as were rates of valve surgeries, a measure of
VHD
severity, and new pacemaker insertions. Outcomes were compared between 42 327 patients with
AS
p and 19 211 703 patients without
AS
p. The prevalence of aortic valve disease in patients with
AS
p increased with age (2.6%, 6.7%, 10.9%, and 17.1%), as did the prevalence of mitral valve disease. Risks of
VHD
were slightly but significantly higher in patients with
AS
p (adjusted odds ratios 1.06–1.51). Rates of aortic valve replacement/repair were also higher in patients with
AS
p than in the comparison group (125 versus 93; 183 versus 149; 261 versus 208; 279 versus 191 per 100 000 patient‐years in the 4 age groups). Rates of mitral valve surgery did not differ between groups. Among patients with
AS
p, pacemaker use ranged from 1.0% to 7.6% across age groups, and was slightly higher than in controls (odds ratio range 1.11–1.32).

Conclusions

Lifetime risks of
VHD
and pacemaker use in
AS
p increase markedly with age, but are only slightly higher than in elderly people without
AS
p.
Laos’s Peripheral Centrality in Southeast Asia
Authors: Brown James Alan 
Published: October 2018

Abstract
Laos’s position at the centre of the Southeast Asian mainland has entailed peripherality to regional loci of power. Its geography of peripheral centrality has however resulted in Laos becoming a realm of contestation between powerful neighbours. The analysis traces the construction of Laos within a regional space from pre-colonial times to contemporary special economic zones. Laos has been produced through mobility, foreign actors’ attempts to reorient space to their sphere of influence, and transnational class relations incorporating Lao workers and peasants, Lao elites and foreign powers. These elements manifest within current special economic zone projects.
The Relationship between Wave Trains in the Southern Hemisphere Storm Track and Rainfall Extremes over Tasmania
Authors: Tozer Carly R. , Risbey James S. , O’Kane Terence J. , Monselesan Didier P. , Pook Michael J. 
Published: October 2018

Abstract
We assess the large-scale atmospheric dynamics influencing rainfall extremes in Tasmania, located within the Southern Hemisphere storm track. We characterize wet and dry multiday rainfall extremes in western and eastern Tasmania, two distinct climate regimes, and construct atmospheric flow composites around these extreme events. We consider the onset and decay of the events and find a link between Rossby wave trains propagating in the polar jet waveguide and wet and dry extremes across Tasmania. Of note is that the wave trains exhibit varying behavior during the different extremes. In the onset phase of rainfall extremes in western Tasmania, there is a coherent wave train in the Indian Ocean, which becomes circumglobal in extent and quasi-stationary as the event establishes and persists. Wet and dry extremes in this region are influenced by opposite phases of this circumglobal wave train pattern. In eastern Tasmania, wet extremes relate to a propagating wave train, which is first established in the Indian Ocean sector and propagates eastward to the Pacific Ocean sector as the event progresses. During dry extremes in eastern Tasmania, the wave train is first established in the Pacific Ocean, as opposed to Indian Ocean, and persists in this sector for the entire event, with a structure indicative of the Pacific–South American pattern. The findings regarding different wave train forms and their relationship to rainfall extremes have implications for extreme event attribution in other regions around the globe.
Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial
Authors: Wolny Tomasz , Linek Pawel 
Published: October 2018

Objective: The aim of this study was to evaluate the efficacy of manual therapy based on neurodynamic techniques in conservative treatment of carpal tunnel syndrome. Design: Randomized controlled trial. Setting: Several medical outpatient clinics in the south of Poland. Participants: The study included 103 patients with mild and moderate carpal tunnel syndrome (mean age = 53.95, SD = 9.5) years, who were randomly assigned to a neurodynamic techniques group (experimental group, n = 58) or a group without treatment (control group, n = 45). Intervention: Neurodynamic techniques were used in the experimental group. Treatment was conducted twice weekly (20 sessions). Control group did not receive treatment. Main measures: Nerve conduction study, pain, symptom severity and functional status of Boston Carpal Tunnel Questionnaire, and strength of cylindrical and pincer grips were assessed at baseline and immediately after treatment (nerve conduction study one month after treatment). Results: Baseline assessment revealed no group differences in any assessed parameters ( P > 0.05). There were significant differences between groups after treatment, including nerve conduction (e.g. sensory conduction velocity: experimental group: 38.3 m/s, SD = 11.1 vs control group: 25.9 m/s, SD = 7.72, P  < 0.01). Significant changes also occurred in pain (experimental group: 1.38, SD = 1.01 vs control group: 5.46, SD = 1.05, P < 0.01), symptom severity (experimental group: 1.08, SD = 0.46 vs control group: 2.87, SD = 0.68, P < 0.01), and functional status (experimental group: 1.96, SD = 0.64 vs control group: 2.87, SD = 1.12, P < 0.01). There were no group differences in strength ( P > 0.05). Conclusion: The use of neurodynamic techniques in conservative treatment for mild to moderate forms of carpal tunnel syndrome has significant therapeutic benefits.
Role of Th17-cell related cytokines in geriatric asthma
Authors: Quan-san Zhang , Xiaohong Xu , ying Li , Zhaojia Sun 
Published: October 2018

Objective This study aimed to investigate the pathogenesis of geriatric asthma through immunoglobulin E (IgE), interleukin-17A (IL-17A), IL-17F, and glucocorticoid receptor-β (GR-β) expression. Methods We studied 51 geriatric male patients with asthma and 50 young male patients with asthma. We also included 21 normal geriatric males and 21 normal young males. All geriatric and young patients were divided into groups according to pulmonary function. Levels of cytokines, such as IgE, IL-17A, IL-17F, and GR-β, were measured. Pulmonary function was assessed. The results from patients were compared with those from the 42 healthy subjects. Results Serum IgE, IL-17A, IL-17F, and GR-β levels in geriatric patients with moderate or severe asthma were significantly higher than those in young patients with moderate asthma and in the normal population. Geriatric patients with asthma had higher asthma control test scores than did young patients with asthma. Conclusion Hormone resistance in geriatric male patients with asthma is more serious than that in young male patients with asthma. Airway inflammation and airway remodeling in geriatric male patients with asthma may be more serious than those in young male patients with asthma, even when there is similar pulmonary function.
The Post-issue Market Performance of Initial Public Offerings: Empirical Evidence from the Malaysian Stock Markets
Authors: Yaakub Nurwahida , Sherif Mohamed , Haniffa Roszaini 
Published: October 2018

This study examines the long-run performance of the initial public offerings (IPOs) listed in the Malaysian main and alternative ‘Access, Certainty and Efficiency’ (ACE) markets at the economic and sectorial levels. Using event- and calendar-time study methods and monthly data from January 2000 to December 2011, we provide novel evidence on the existence of under performance anomaly in the Malaysian markets and more intensely in the ACE markets. We demonstrate robust evidence on the distinction in sector-specific characteristics from the aggregate market characteristics. While the consumer products and industrial sectors dominate the overall underperformance, the construction, property and technology sectors significantly overperform. The findings are robust to a wide range of other sensitivity checks including parametric and non-parametric tests. JEL Classification: G14, G15, G30, G34, G32, G38
The Association Between HIV Infection and the Use of Palliative Care in Patients Hospitalized With Heart Failure
Authors: Feder Shelli L. , Tate Janet P. , Akgün Kathleen M. , Womack Julie A. , Jeon Sangchoon , Funk Marjorie , Bedimo Roger J. , Budoff Matthew J. , Butt Adeel A. , Crothers Kristina , Redeker Nancy S. 
Published: October 2018

Background: The number of adults with heart failure (HF) and HIV infection is increasing. These patients may benefit from palliative care (PC). Objectives: Determine the association between HIV infection, other HIV characteristics, and PC among hospitalized patients with HF in the Veterans Health Administration (VHA). Design: Nested case–control study of patients with HF hospitalized from 2003 to 2015 and enrolled in the Veterans Aging Cohort Study. Setting/Patients: Two hundred and ten hospitalized patients with HF who received PC matched to 1042 patients with HF who did not receive PC, by age, discharge date, and left ventricular ejection fraction. Measurements: Palliative care use was the primary outcome. Independent variables included HIV infection identified by International Classification of Diseases Ninth Revision code and further characterized as the primary diagnosis for hospitalization, unsuppressed HIV-1 RNA, CD4 counts <200 cells/mm3, and other covariates. We examined associations between independent variables and PC using conditional logistic regression. Results: The sample was 99% male, mean age was 64 years (standard deviation ±10), 54% of cases and 59% of controls were black, and 30% of cases and 31% of controls were HIV-infected. In adjusted models, HIV as the primary diagnosis for hospitalization (odds ratio [OR]: 3.69, 95% confidence interval [CI]: 1.30-10.52), unsuppressed HIV-1 RNA (OR: 2.62, 95% CI: 1.31-5.24), and CD4 counts <200 cells/mm3 (OR: 3.47; 1.78-6.77), but not HIV infection (OR: 0.79, 95% CI: 0.55-1.13), were associated with PC. Conclusions: HIV characteristics indicative of severe disease are associated with PC for hospitalized VHA patients with HF. Increasing access to PC for patients with HF and HIV is warranted.
Transverse Maxillary Development in Complete Cleft Patients: Comparison of 2 Treatment Strategies by Longitudinal and Cross-Sectional Model Analysis
Authors: Loomans Natalie , Decombel Oona , Goethals Klara , Mommaerts Maurice Y. 
Published: October 2018

Objective: This study aimed to compare differences in the maxillary transverse dimension following cleft repair using 2 protocols involving a 2-staged palatal closure with similar timing but different techniques. Design: Retrospective study. Two matched study samples, each containing 10 patients. Setting: Cleft center A is a university hospital. Cleft Center B is a general teaching hospital. Patients: Patients with cleft lip alveolus and palate (CLAP) were matched by cleft type, gender, age, and palatal morphology at the age of 1 month. Differences in the transverse dimension were measured at 4 ages in 2 matched groups (A and B from center A and B), each including 5 patients with unilateral CLAP (UCLAP) and 5 patients with bilateral CLAP (BCLAP). Interventions: Orthodontic/orthopedic expansion treatment began at 8 and 5 years of age at centers A and B, respectively. Results: The mean intercanine distance decreased by 8 mm (standard deviation [SD] = 1.6; P = .030) in group A patients with UCLAP between 1 and 5 years (SD = 1.6; P = .030) and by 6.3 mm (SD = 3.2; P = .016) in group B patients with BCLAP. The mean intermolar distance increased by 4 mm (SD = 3.4; P = .076) in patients with BCLAP. A trend toward improved canine positioning was observed in patients with BCLAP by 12 years of age, with improvement occurring between 4 and 12 years. Conclusion: The type of palatal closure (inducing scar tissue at the bony level) and the late installment of orthodontic/orthopedic expansion probably reduced the intercanine width in bilateral complete clefts.
Neurovascular and Clinical Outcomes of the Percutaneous Endoscopically Assisted Calcaneal Osteotomy (PECO) Technique to Correct Hindfoot Malalignment
Authors: Veljkovic Andrea , Symes Michael , Younger Alastair , Rungprai Chamnanni , Abbas Kaniza Zahra , Salat Peter , Tennant Joshua , Phisitkul Phinit 
Published: October 2018

Background: Standard open calcaneal osteotomies to correct hindfoot malalignment have been associated with high complication rates, including nerve damage and wound infection. This has resulted in the development of minimally invasive techniques such as the percutaneous endoscopically assisted calcaneal osteotomy (PECO), which in cadaver studies has been shown to be potentially safer than open surgeries. The aim of this study was to demonstrate the safety and effectiveness of PECO in a clinical setting, with regard to neurovascular injury rates, infection, and short-term radiographic and functional outcomes. Methods: Forty-one (41) patients with planovalgus or cavovarus foot deformities underwent treatment using PECO. Outcomes were analyzed at 6 months and primarily included neurovascular outcomes and wound infection rates. Secondarily, radiographic and functional (visual analog scale for pain [VAS], 36-Item Short Form Medical Outcomes Survey [SF-36], and Foot Function Index [FFI] scores) outcomes were also assessed. Results: There were no reported cases of superficial wound infections, lateral calcaneal or sural nerve dysesthesia. Minor complications occurred in 6/41 feet. The mean postoperative hindfoot correction was 8.3 ± 2.2 mm (range: 6-15mm) compared to preoperative status. Compared to preoperative status, significant improvements ( P = .001 for all) were seen in the VAS, SF-36, and FFI at 6 months postoperatively. Conclusions: PECO resulted in minimal complications with no lateral calcaneal or sural nerve dysesthesias and no wound complications. It also resulted in significant improvements in postoperative radiographic and functional outcomes from baseline to 6-months postoperatively, demonstrating its use as a safe and effective means of treating hindfoot malalignment. Level of Evidence: Level IV, retrospective case series.
Anatomical variants of upper arm veins on preoperative mapping venography for hemodialysis access in Korean adults
Authors: Lee Hyung Seok , Song Young Rim , Kim Jwa Kyung , Choi Sun Ryoung , Joo Narae , Kim Hyung Jik , Park Pyoungju , Kim Sung Gyun 
Published: October 2018

Introduction: The number of elderly patients requiring hemodialysis has increased, along with the need for multiple vascular access placements. Thus, the frequency of access creation using the upper arm veins, including transposed basilic arteriovenous fistula, has also increased. The purpose of this study was to identify the prevalence of anatomical variations in the upper arm veins on preoperative mapping venography and to investigate the implications of such variants on access creation. Methods: A total of 494 venograms were performed on 251 patients for primary access creation from June 2014 to June 2017 in this single-center, retrospective study. The venograms were classified into eight subtypes, based on the anatomical relationship between the basilic and brachial veins. The presence of bifid cephalic arches and brachial–basilic ladders was also examined. Results: The presence of bifid cephalic arches and brachial–basilic ladders was identified in 8.7% and 14.0% of cases, respectively. Paired brachial veins joined separately with the basilic vein in 67.4% of venograms, whereas these veins merged into a common brachial vein before connecting to the basilic vein in 13.1% of cases. A single brachial vein was present in 19.3% of cases. 15.7% of cases were considered unsuitable for basilic vein transposition due to the early confluence of the brachial–basilic vein, posing a risk of obliterating the deep venous drainage if transposed. Conclusion: There are significant anatomical variations of upper arm veins, and the recognition of certain variants can affect surgical planning and outcomes of access placement. It is important to identify anatomical variants of the upper arm veins during preoperative vein mapping.