bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intentional Weight Loss and Obesity-Related Cancer Risk
Authors: Luo Juhua , Hendryx Michael , Manson JoAnn E , Figueiredo Jane C , LeBlanc Erin S , Barrington Wendy , Rohan Thomas E , Howard Barbara V , Reding Kerryn , Ho Gloria Yf , Garcia David O , Chlebowski Rowan T 
Published: August 2019

Abstract

Background
Epidemiologic studies regarding weight loss and subsequent cancer risk are sparse. The study aim was to evaluate the association between weight change by intentionality and obesity-related cancer incidence in the Women’s Health Initiative Observational Study. Eleven cancers were considered obesity related: breast, ovary, endometrium, colon and rectum, esophagus, kidney, liver, multiple myeloma, pancreas, stomach, and thyroid.

Methods
Postmenopausal women (n = 58 667) aged 50–79 years had body weight and waist circumference (WC) measured at baseline and year 3. Weight or WC change was categorized as stable (change &lt; ±5%), loss (≥5%), and gain (≥5%). Self-report at year 3 characterized weight loss as intentional or unintentional. During the subsequent 12 years (mean) of follow-up, 6033 incident obesity-related cancers were identified. Relationships were evaluated using multivariable Cox proportional hazards regression models.

Results
Compared to women with stable weight, women with intentional weight loss had lower obesity-related cancer risk (hazard ratio [HR] = 0.88, 95% confidence interval [CI] = 0.80 to 0.98). A similar result was observed for intentional WC reduction (HR = 0.88, 95% CI = 0.80 to 0.96). Among all cancers, intentional weight loss was most strongly associated with endometrial cancer (HR = 0.61, 95% CI = 0.42 to 0.88). Intentional WC loss was also associated with lower colorectal cancer risk (HR = 0.79, 95% CI = 0.63 to 0.99). Unintentional weight loss or weight gain was not associated with overall obesity-related cancer risk.

Conclusion
Intentional weight or WC loss in postmenopausal women was associated with lower risk of obesity-related cancer. These findings suggest that postmenopausal women who intentionally lose weight can reduce their obesity-related cancer risk.
Nulling at short wavelengths: theoretical performance constraints and a demonstration of faint companion detection inside the diffraction limit with a rotating-baseline interferometer
Authors: Serabyn E , Mennesson B , Martin S , Liewer K , Kühn J 
Published: August 2019

ABSTRACT
The Palomar Fiber Nuller (PFN) is a rotating-baseline nulling interferometer that enables high-accuracy near-infrared (NIR) nulling observations with full azimuth coverage. To achieve NIR null-depth accuracies of several x 10−4, the PFN uses a common-mode optical system to provide a high degree of symmetry, single-mode-fibre beam combination to reduce sensitivity to pointing and wavefront errors, extreme adaptive optics to stabilize the fibre coupling and the cross-aperture fringe phase, rapid signal calibration and camera readout to minimize temporal effects, and a statistical null-depth fluctuation analysis to relax the phase stabilization requirement. Here, we describe the PFN’s final design and performance and provide a demonstration of faint-companion detection by means of nulling-baseline rotation, as originally envisioned for space-based nulling interferometry. Specifically, the Ks-band null-depth rotation curve measured on the spectroscopic binary η Peg reflects both a secondary star 1.08 ± 0.06 × 10−2 as bright as the primary, and a null-depth contribution of 4.8 ± 1.6 × 10−4 due to the size of the primary star. With a 30 mas separation at the time, η Peg B was well inside both the telescope’s diffraction-limited beam diameter (88 mas) and typical coronagraphic inner working angles. Finally, we discuss potential improvements that can enable a number of small-angle nulling observations on larger telescopes.
Tidal disruption events on to stellar black holes in triples
Authors: Fragione Giacomo , Leigh Nathan W C , Perna Rosalba , Kocsis Bence 
Published: August 2019

ABSTRACT
Stars passing too close to a black hole can produce tidal disruption events (TDEs), when the tidal force across the star exceeds the gravitational force that binds it. TDEs have usually been discussed in relation to massive black holes that reside in the centres of galaxies or lurk in star clusters. We investigate the possibility that triple stars hosting a stellar black hole (SBH) may be sources of TDEs. We start from a triple system made up of three main-sequence stars and model the supernova (SN) kick event that led to the production of an inner binary comprised of an SBH. We evolve these triples with a high-precision N-body code and study their TDEs as a result of Kozai–Lidov oscillations. We explore a variety of distributions of natal kicks imparted during the SN event, various maximum initial separations for the triples, and different distributions of eccentricities. We show that the main parameter that governs the properties of the SBH–MS binaries that produce a TDE in triples is the mean velocity of the natal kick distribution. Smaller σ’s lead to larger inner and outer semimajor axes of the systems that undergo a TDE, smaller SBH masses, and longer time-scales. We find that the fraction of systems that produce a TDE is roughly independent of the initial conditions, while estimate a TDE rate of $2.1\times 10^{-4}{\!-\!}4.7 \, \mathrm{yr}^{-1}$, depending on the prescriptions for the SBH natal kicks. This rate is almost comparable to the expected TDE rate for massive black holes.
X-ray and optical observations of the black hole candidate MAXI J1828−249
Authors: Oda Sonoe , Shidatsu Megumi , Nakahira Satoshi , Tamagawa Toru , Moritani Yuki , Itoh Ryosuke , Ueda Yoshihiro , Negoro Hitoshi , Makishima Kazuo , Kawai Nobuyuki , Mihara Tatehiro 
Published: August 2019

AbstractWe report results from X-ray and optical observations of the Galactic black hole candidate MAXI J1828−249 performed with Suzaku and the Kanata telescope around the X-ray flux peak in the 2013 outburst. The time-averaged X-ray spectrum covering 0.6–168 keV was approximately characterized by a strong multi-color disk blackbody component with an inner disk temperature of ∼0.6 keV, and a power-law tail with a photon index of ∼2.0. We detected an additional structure at 5–10 keV, which can be modeled neither with X-ray reflection on the disk nor relativistic broadening of the disk emission. Instead, it was successfully reproduced with a Comptonization of disk photons by thermal electrons with a relatively low temperature (≲10 keV). We infer that the source was in the intermediate state, considering its long-term trend in the hardness intensity diagram, the strength of the spectral power-law tail, and its variability properties. The low-temperature Comptonization component could be produced in a boundary region between the truncated standard disk and the hot inner flow, or a Comptonizing region that somehow developed above the disk surface. The multi-wavelength spectral energy distribution suggests that the optical and ultraviolet fluxes were dominated by irradiated outer disk emission.
Is immunotherapy with fungal vaccines effective?
Authors: Di Bona Danilo , Albanesi Marcello , Macchia Luigi 
Published: August 2019

Purpose of review
Although allergen immunotherapy (AIT) for fungi has been performed for many years, evidence clearly demonstrating its clinical benefit are still lacking. Here, we reviewed the available studies assessing efficacy and safety of AIT for molds.

Recent findings
Studies on AIT for fungi were performed only for the two predominating mold species in the external environment, namely Cladosporium and Alternaria. There is no evidence for other mold species. Recent finding in the literature are lacking; the 2 most recent studies on AIT for molds were published in 2011. Overall, 13 studies were identified (the first was published in 1986), but only nine of these compared AIT to placebo. The studies are small (median study sample size, 27 patients) and of low quality, owing to several defects leading to moderate-to-high risk of bias. Symptoms improvement and medication use reduction, which are the main outcome measures of the studies, were inconsistently demonstrated. There are some concerns about safety with Cladosporium extracts, whereas vaccines with Alternaria extracts seem to be safe and well tolerated.

Summary
Low strength evidence suggests that mold AIT is efficacious for the treatment of respiratory allergies. High-quality studies with an adequate sample size are needed.
Upper Airway Collapsibility during Dexmedetomidine and Propofol Sedation in Healthy Volunteers
Authors: Lodenius Åse , Maddison Kathleen J. , Lawther Brad K. , Scheinin Mika , Eriksson Lars I. , Eastwood Peter R. , Hillman David R. , Fagerlund Malin Jonsson , Walsh Jennifer H. 
Published: August 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Dexmedetomidine is a sedative promoted as having minimal impact on ventilatory drive or upper airway muscle activity. However, a trial recently demonstrated impaired ventilatory drive and induction of apneas in sedated volunteers. The present study measured upper airway collapsibility during dexmedetomidine sedation and related it to propofol.

Methods
Twelve volunteers (seven female) entered this nonblinded, randomized crossover study. Upper airway collapsibility (pharyngeal critical pressure) was measured during low and moderate infusion rates of propofol or dexmedetomidine. A bolus dose was followed by low (0.5 μg · kg−1 · h−1 or 42 μg · kg−1 · min−1) and moderate (1.5 μg · kg−1 · h−1 or 83 μg · kg−1 · min−1) rates of infusion of dexmedetomidine and propofol, respectively.

Results
Complete data sets were obtained from nine volunteers (median age [range], 46 [23 to 66] yr; body mass index, 25.4 [20.3 to 32.4] kg/m2). The Bispectral Index score at time of pharyngeal critical pressure measurements was 74 ± 10 and 65 ± 13 (mean difference, 9; 95% CI, 3 to 16; P = 0.011) during low infusion rates versus 57 ± 16 and 39 ± 12 (mean difference, 18; 95% CI, 8 to 28; P = 0.003) during moderate infusion rates of dexmedetomidine and propofol, respectively. A difference in pharyngeal critical pressure during sedation with dexmedetomidine or propofol could not be shown at either the low or moderate infusion rate. Median (interquartile range) pharyngeal critical pressure was −2.0 (less than −15 to 2.3) and 0.9 (less than −15 to 1.5) cm H2O (mean difference, 0.9; 95% CI, −4.7 to 3.1) during low infusion rates (P = 0. 595) versus −0.3 (−9.2 to 1.4) and −0.6 (−7.7 to 1.3) cm H2O (mean difference, 0.0; 95% CI, −2.1 to 2.1; P = 0.980) during moderate infusion of dexmedetomidine and propofol, respectively. A strong linear relationship between pharyngeal critical pressure during dexmedetomidine and propofol sedation was evident at low (r = 0.82; P = 0.007) and moderate (r = 0.90; P < 0.001) infusion rates.

Conclusions
These observations suggest that dexmedetomidine sedation does not inherently protect against upper airway obstruction.
Intraoperative Mechanical Ventilation and Postoperative Pulmonary Complications after Cardiac Surgery
Authors: Mathis Michael R. , Duggal Neal M. , Likosky Donald S. , Haft Jonathan W. , Douville Nicholas J. , Vaughn Michelle T. , Maile Michael D. , Blank Randal S. , Colquhoun Douglas A. , Strobel Raymond J. , Janda Allison M. , Zhang Min , Kheterpal Sachin , Engoren Milo C. 
Published: August 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Compared with historic ventilation strategies, modern lung-protective ventilation includes lower tidal volumes (VT), lower driving pressures, and application of positive end-expiratory pressure (PEEP). The contributions of each component to an overall intraoperative protective ventilation strategy aimed at reducing postoperative pulmonary complications have neither been adequately resolved, nor comprehensively evaluated within an adult cardiac surgical population. The authors hypothesized that a bundled intraoperative protective ventilation strategy was independently associated with decreased odds of pulmonary complications after cardiac surgery.

Methods
In this observational cohort study, the authors reviewed nonemergent cardiac surgical procedures using cardiopulmonary bypass at a tertiary care academic medical center from 2006 to 2017. The authors tested associations between bundled or component intraoperative protective ventilation strategies (VT below 8 ml/kg ideal body weight, modified driving pressure [peak inspiratory pressure − PEEP] below 16 cm H2O, and PEEP greater than or equal to 5 cm H2O) and postoperative outcomes, adjusting for previously identified risk factors. The primary outcome was a composite pulmonary complication; secondary outcomes included individual pulmonary complications, postoperative mortality, as well as durations of mechanical ventilation, intensive care unit stay, and hospital stay.

Results
Among 4,694 cases reviewed, 513 (10.9%) experienced pulmonary complications. After adjustment, an intraoperative lung-protective ventilation bundle was associated with decreased pulmonary complications (adjusted odds ratio, 0.56; 95% CI, 0.42–0.75). Via a sensitivity analysis, modified driving pressure below 16 cm H2O was independently associated with decreased pulmonary complications (adjusted odds ratio, 0.51; 95% CI, 0.39–0.66), but VT below 8 ml/kg and PEEP greater than or equal to 5 cm H2O were not.

Conclusions
The authors identified an intraoperative lung-protective ventilation bundle as independently associated with reduced pulmonary complications after cardiac surgery. The findings offer insight into components of protective ventilation associated with adverse outcomes and may serve as targets for future prospective interventional studies investigating the impact of specific protective ventilation strategies on postoperative outcomes after cardiac surgery.
Disparities Among Cervical Cancer Patients Receiving Brachytherapy
Authors: Bruce Shaina F. , Joshi Tanvi V. , Chervoneva Inna , Yi Misung , Chatterjee-Paer Sudeshna , Burton Elizabeth R. , Edelson Mitchell I. , Sorosky Joel I. , Shahin Mark S. 
Published: August 2019

OBJECTIVE:
To evaluate the effects of race and insurance status on the use of brachytherapy for treatment of cervical cancer.

METHODS:
This is a retrospective cohort study of the National Cancer Database. We identified 25,223 patients diagnosed with stage IB2 through IVA cervical cancer who received radiation therapy during their primary treatment from 2004 to 2015. A univariate analysis was used to assess covariate association with brachytherapy. A multivariable regression model was used to evaluate the effect of race and insurance status on rates of brachytherapy treatment. The Cox proportional hazards model and the multiplicative hazard model were used to evaluate overall survival. P<.05 indicated a statistically significant difference for comparisons of primary and secondary outcomes.

RESULTS:
Non-Hispanic black patients received brachytherapy at a significantly lower rate than non-Hispanic white patients (odds ratio [OR] 0.93; 95% CI 0.86–0.99; P=.036); Hispanic (OR 0.93; 95% CI 0.85–1.02; P=.115) and Asian (OR 1.13; 95% CI 0.99–1.29; P=.074) patients received brachytherapy at similar rates. Compared with patients with private insurance, those who were uninsured (OR 0.72; 95% CI 0.65–0.79; P<.001), had Medicaid (OR 0.83; 95% CI 0.77–0.89; P<.001) or Medicare insurance (OR 0.85; 95% CI 0.78–0.92; P<.001) were less likely to receive brachytherapy. Brachytherapy was not found to be a mediator of race and insurance-related disparities in overall survival.

CONCLUSION:
Racial and insurance disparities exist for those who receive brachytherapy, with many patients not receiving the standard of care, but overall survival was not affected.
Endometriosis and Risk of Adverse Pregnancy Outcomes
Authors: Farland Leslie V. , Prescott Jennifer , Sasamoto Naoko , Tobias Deirdre K. , Gaskins Audrey J. , Stuart Jennifer J. , Carusi Daniela A. , Chavarro Jorge E. , Horne Andrew W. , Rich-Edwards Janet W. , Missmer Stacey A. 
Published: August 2019

OBJECTIVE:To investigate the relationship between endometriosis and adverse pregnancy outcomes.METHODS:Women between ages 25 and 42 years in 1989 (n=116,429) reported detailed information on pregnancies and reproductive health at baseline and every 2 years thereafter in the Nurses' Health Study II, a cohort study. In 2009, they completed a detailed, pregnancy-focused questionnaire. A total of 196,722 pregnancies were reported. Adverse pregnancy outcomes included spontaneous abortion, ectopic pregnancy, stillbirth, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (preeclampsia or gestational hypertension), preterm birth, and low birth weight. We estimated the relative risks (RRs) and 95% CIs of adverse pregnancy outcomes comparing pregnancies in women with and without a history of laparoscopically confirmed endometriosis using multivariable log-binomial regression, with generalized estimating equations to account for multiple pregnancies per woman.RESULTS:Endometriosis was associated with a greater risk of pregnancy loss (spontaneous abortion: RR 1.40, 95% CI 1.31–1.49; ectopic pregnancy: RR 1.46, 95% CI 1.19–1.80). Endometriosis was also associated with a greater risk of GDM (RR 1.35, 95% CI 1.11–1.63) and hypertensive disorders of pregnancy (RR 1.30, 95% CI 1.16–1.45).CONCLUSIONS:We observed an association between laparoscopically confirmed endometriosis and several adverse pregnancy outcomes. Future research should focus on the potential biological pathways underlying these relationships to inform screening or preventive interventions.
Blood Lead Levels in Females of Childbearing Age in Flint, Michigan, and the Water Crisis
Authors: Gómez Hernán F. , Borgialli Dominic A. , Sharman Mahesh , Weber Annika T. , Scolpino Anthony J. , Oleske James M. , Bogden John D. 
Published: August 2019

OBJECTIVE:
To compare blood lead levels in females of childbearing age, 12–50 years, living within and adjacent to Flint, Michigan, before, during, and after the Flint River water exposure and compare the levels to those that have been shown to cause fetal loss and preterm birth.

METHODS:
The switch in the community water source to the Flint River occurred on April 25, 2014, and was reverted to the original source on October 15, 2015. Using a retrospective cross-sectional study design using geocoded blood lead levels obtained from all females of childbearing age available from a single hospital database, we compared blood lead levels for the following 18-month time periods: April 25, 2012–October 15, 2013 (PRE), April 25, 2014–October 15, 2015 (DURING), and April 25, 2016–October 15, 2017 (POST).

RESULTS:
Results are reported as geometric mean (95% CI). Within Flint, PRE blood lead levels in females of childbearing age were 0.69 micrograms/dL (95% CI 0.63–0.75), DURING blood lead levels were 0.65 micrograms/dL (95% CI 0.60–0.71), and POST blood lead levels were 0.55 micrograms/dL (95% CI 0.54–0.56). DURING Flint River water exposure blood lead levels were not significantly different than the PRE Flint River water time period. POST Flint River water exposure blood lead levels were significantly lower than both PRE and DURING levels. Overall, lower blood lead levels were found outside the Flint boundary in all cohorts.

CONCLUSION:
Blood lead levels in Flint females of childbearing age did not increase during the Flint River water exposure and subsequent 18-month time period. Mean blood lead levels during the Flint River water exposure are not consistent with the markedly higher blood lead levels reported in the literature to be associated with fetal loss, low birth weight, or preterm birth.
PICU Follow-Up: The Impact of Missed School in a Cohort of Children Following PICU Admission
Authors: Kastner Kathleen , Pinto Neethi , Msall Michael E. , Sobotka Sarah 
Published: August 2019

Objectives:
For children and their families, PICU admission can be one of the most stressful and traumatic experiences in their lives. Children admitted to the PICU and their parents experience sequelae following admission including psychologic symptoms and lower health-related quality of life. The impact of a PICU admission on school attendance and performance may influence these sequelae. The purpose of our study was to examine how community supports from pediatricians and schools influence school success after critical illness.

Design:
Parents were recruited during their child’s admission to the PICU. Three months after discharge, parents completed follow-up questionnaires via telephone.

Setting:
PICU in an urban academic children's hospital.

Subjects:
Thirty-three parents were enrolled in the study, and 21 (64%) completed phone follow-up.

Measurements and Main Results:
Forty-three percent of children missed 7 or more days of school while admitted to the PICU. Sixty-seven percent of parents reported that their pediatrician did not ask about missed school, and 29% felt their child’s grades worsened since admission. Twenty percent of respondents felt that their child’s school did not provide adequate services to help their child catch up.

Conclusions:
There are missed opportunities for care coordination and educational support after critical illness. The transition back to school is challenging for some children, as reported by parents who described inadequate support from the school after PICU hospitalization and a subsequent decline in their child’s school performance. Additional studies are needed to develop proactive community supports to improve the transition back to school for a child after critical illness.
Mapping the Lipid Layer of the Human Tear Film
Authors: Cohen Yoel , Trokel Stephen , Arieli Yoel , Epshtien Shlomi , Gefen Raanan , Harris Alon 
Published: August 2019

Purpose:
To describe a new method to distinguish between normal versus lipid-deficient dry eye using a Tear Film Imager (TFI).

Methods:
Two groups of study subjects, controls versus lipid-deficient dry eye, were tested using the TFI. This instrument provides an accurate measurement of the thickness and spatial distribution of the muco-aqueous and lipid layers of the tear film. The nanometer thickness resolution of the TFI enables the creation of detailed maps of the lipid layer thickness (LLT) across the corneal surface. These maps are captured with a large field of view of 6.5 mm diameter.

Results:
A LLT map taken at 1 second from a blink end in the controls appears uniform, whereas a nonuniform layer was measured in the lipid-deficient dry eye. Lipid map uniformity can quantify the spatial variation of lipid across the cornea. A case study showed the ability to distinguish between controls [lipid map uniformity (LMU) = 14 nm2] and lipid-deficient dry eye (LMU = 125 nm2) through characterization of the LLT distribution.

Conclusions:
High-resolution lateral LLT maps demonstrate the significance of the lipid layer uniformity, which may play an important role in maintaining tear film health. LLT maps and the quantitative LMU could be used to diagnose and treat patients with dry eye.