bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Associations Between Cervical Microbiota and HPV Infection, Clearance, and Persistence in Cytologically Normal Women
Authors: Ritu Wu , Enqi Wu , Zheng Siriguleng , Wang Jiandong , Ling Yaqin , Wang Yan 
Published: November 2018

Abstract
The aim of this study was to investigate the associations between cervical microbiota and different human papillomavirus (HPV) infection statuses in cytologically normal women. The cervical microbiota of HPV-positive or -negative women with a normal cytologic diagnosis was characterized and compared using 16S rDNA-based high-throughput sequencing, and the differences in cervical microbiota associated with new acquisition, persistence, and clearances of HPV genotypes were analyzed via one-year follow-up. The results showed that the cervical microbial richness of HPV-positive women was lower than for HPV-negative women, and the difference was more significant in the postmenopausal group relative to the premenopausal group. Ureaplasma parvum and related taxa were associated with baseline HPV positivity, while Brochothrix, Diplorickettsia, Ezakiella, Faecalibacterium, and Fusobacterium genera and their related taxa and Pseudomonas aeruginosa were associated with baseline HPV negativity. For HPV-positive women, the baseline abundance of Actinomyces was negatively associated with new HPV infection, Alloprevotella tannerae, Prevotella nigrescens, and Prevotella oulorum; and Dialister invisus were positively associated with new HPV-type infection within the year of follow-up. Lactobacillus delbrueckii was found to be negatively associated with persistent HPV infection and 9 taxa belonging to Prevotella, Dialister, and Lachnospiraceae were found to be positively associated with persistence, and/or negatively associated with clearance of HPV types. We also observed 10 novel taxa associated with the clearance/persistence of HPV that had not been reported elsewhere. Those taxa associated with different infection statuses of HPV could be used as a biomarker to help predict the risk of developing persistent HPV infection.
EGFR and MET Amplifications Determine Response to HER2 Inhibition in ERBB2-Amplified Esophagogastric Cancer
Authors: Sanchez-Vega Francisco , Hechtman Jaclyn F. , Castel Pau , Ku Geoffrey Y. , Tuvy Yaelle , Won Helen , Fong Christopher J. , Bouvier Nancy , Nanjangud Gouri J. , Soong Joanne , Vakiani Efsevia , Schattner Mark , Kelsen David P. , Lefkowitz Robert A. , Brown Karen , Lacouture Mario E. , Capanu Marinela , Mattar Marissa , Qeriqi Besnik , Cecchi Fabiola , Tian Yuan , Hembrough Todd , Nagy Rebecca J. , Lanman Richard B. , Larson Steven M. , Pandit-Taskar Neeta , Schöder Heiko , Iacobuzio-Donahue Christine A. , Ilson David H. , Weber Wolfgang A. , Berger Michael F. , de Stanchina Elisa , Taylor Barry S. , Lewis Jason S. , Solit David B. , Carrasquillo Jorge A. , Scaltriti Maurizio , Schultz Nikolaus , Janjigian Yelena Y. 
Published: November 2018

Abstract

The anti-HER2 antibody trastuzumab is standard care for advanced esophagogastric (EG) cancer with ERBB2 (HER2) amplification or overexpression, but intrinsic and acquired resistance are common. We conducted a phase II study of afatinib, an irreversible pan-HER kinase inhibitor, in trastuzumab-resistant EG cancer. We analyzed pretreatment tumor biopsies and, in select cases, performed comprehensive characterization of postmortem metastatic specimens following acquisition of drug resistance. Afatinib response was associated with coamplification of EGFR and ERBB2. Heterogeneous 89Zr-trastuzumab PET uptake was associated with genomic heterogeneity and mixed clinical response to afatinib. Resistance to afatinib was associated with selection for tumor cells lacking EGFR amplification or with acquisition of MET amplification, which could be detected in plasma cell-free DNA. The combination of afatinib and a MET inhibitor induced complete tumor regression in ERBB2 and MET coamplified patient-derived xenograft models established from a metastatic lesion progressing on afatinib. Collectively, differential intrapatient and interpatient expression of HER2, EGFR, and MET may determine clinical response to HER kinase inhibitors in ERBB2-amplified EG cancer.

Significance:
Analysis of patients with ERBB2-amplified, trastuzumab-resistant EG cancer who were treated with the HER kinase inhibitor afatinib revealed that sensitivity and resistance to therapy were associated with EGFR/ERBB2 coamplification and MET amplification, respectively. HER2-directed PET imaging and cell-free DNA sequencing could help guide strategies to overcome the emergence of resistant clones.
See related commentary by Klempner and Catenacci, p. 166.
This article is highlighted in the In This Issue feature, p. 151
Decremental Responses to Repetitive Nerve Stimulation in Amyotrophic Lateral Sclerosis
Authors: Hu Fangfang , Jin Jiaoting , Kang Li , Jia Rui , Qin Xing , Liu Xuan , Liu Xiao , Liu Chenyu , Wang Liang , Zhang Ronghua , Dang Jingxia 
Published: November 2018

<b><i>Introduction:</i></b> To illuminate the mechanism of neuromuscular junction involvement by analyzing the features of a slow-rate repetitive nerve simulation (RNS) and EMG in amyotrophic lateral sclerosis (ALS) patients. <b><i>Methods:</i></b> We retrospectively analyzed relationship between clinical features and the decremental response in RNS in 184 sporadic ALS patients. <b><i>Results:</i></b> (1) 44.3 and 43.5% of compound muscle action potentials (CMAP) decrement were more than –10% in deltoid muscle (Del) and Trap; (2) ALS patients were divided into RNS positive (RNS+) and RNS negative (RNS–) group according to decremental percentage of RNS greater or less than –10%. The diagnostic delay time was shorter and ALSFRS-r score was lower in RNS+ than RNS– group (<i>p</i> &#x3c; 0.05), progression rate had no difference. The incidence of RNS+ decrement was higher in cervical enlargement onset and definite diagnostic degrees (<i>p</i> &#x3c; 0.05); (3) In EMG+ group, the CMAP amplitude was lower (Axillary: 3.1 ± 1.91 vs. 5.92 ± 2.896, <i>p</i> = 0.000; Accessory: 2.68 ± 1.349 vs. 3.65 ± 1.53, <i>p</i> = 0.002), decremental percentage of RNS was higher (Axillary: –10.85 ± 7.508 vs. –5.43 ± 8.425, <i>p</i> = 0.000; Accessory: –13.11 ± 7.539 vs. –8.03 ± 5.999, <i>p</i> = 0.000) compared with needle EMG– group whether in Del or Trap; (4) Decremental response of RNS was positively correlated with the CMAP amplitude in Axillary and Accessory nerves (<i>R</i> = 0.201, <i>p</i> &#x3c; 0.0001; <i>R</i> = 0.103, <i>p</i> &#x3c; 0.0001). <b><i>Conclusions:</i></b> Our clinical results support the mechanism of decremental phenomenon of RNS is immature sprouts and unstable conduction by the degenerating axons in ALS patients. The more serious the axon damage, the more significant the RNS decremental response. But decremental response dose not effect disease progression.
Impact of price elasticity on the healthfulness of food choices by gender
Authors: Privitera Gregory J , Gillespie James J , Zuraikat Faris M 
Published: November 2018

Objective: To extend findings from experimental price elasticity studies by examining these effects in a field setting and identifying gender differences in purchasing behaviour in response to variations in the cost of lower energy-dense (ED) and higher ED foods. Setting: Data were collected from low- and median-income male and female grocery shoppers at a supermarket in the Western New York region. Design: Using a procedure adapted from experimental economics, participants were given a debit card in a grocery store setting and allowed to purchase any foods from two pricing conditions. Conditions were identical, except one had lower ED foods low priced, and the other had lower ED foods higher priced. The design was fully counterbalanced. Results: Overall, when lower ED foods were more expensive, fewer lower ED foods were purchased (95% confidence interval [CI]: −1.0, −.40). Gender differences revealed that men spent more money (in dollars) when higher ED foods were higher priced (95% CI: US$0.51, US$1.73) and women spent more money when lower ED foods were higher priced (95% CI: − US$2.21, − US$0.11). Furthermore, women, but not men, increased spending when lower ED foods were higher priced (95% CI: − US$2.85, − US$0.73). Conclusion: Higher costs for fruits and vegetables among consumers can adversely affect the purchase volume of these foods, with men being most susceptible to pricing manipulations. Results contribute to an understanding of how perceptions of price impact consumer choice and suggest that efforts aimed to increase the perceived value of health over cost should be tailored towards men.
Proposal for a Migraine Aura Complexity Score
Authors: Petrusic Igor , Viana Michele , Dakovic Marko , J Goadsby Peter , Zidverc-Trajkovic Jasna 
Published: November 2018

Objectives Currently, there is no scoring system for assessing the complexity of migraine aura. Our goal was to develop a Migraine Aura Complexity Score that synthesizes the quantity and quality of aura symptoms and to test its applicability in neuroimaging studies. Methods Patients with migraine aura were interviewed in order to obtain characteristics of migraine aura. Explorative and confirmatory analyses were used to develop the Migraine Aura Complexity Score. Median values were derived from 10 consecutive migraine auras in each patient. The Migraine Aura Complexity Score was correlated with an average cortical thickness of different brain areas in studied patients. The Surface-based Morphometric Analysis approach was used to estimate cortical thickness. Results This study included 23 (16 females and seven males) migraineurs with aura. Confirmatory factor analysis suggested the second-order model with three-factor measurement for grading migraine aura. The first factor is linked to higher cortical dysfunction during migraine aura, while the second is associated with the degree of involvement of primary visual and somatosensory cortices; the third linked symptoms of somatosensory aura and hand and head involvement. Positive correlation of Migraine Aura Complexity Score and averaged cortical thickness were found in the left and right hemispheres overall (r = 0.568, p = 0.007; r = 0.617, p = 0.003) and in some of their regions. Conclusions This study demonstrates that the Migraine Aura Complexity Score could be a valuable tool for assessing migraine aura. The score could be used in neuroradiological studies in order to achieve a stratification of patients with migraine aura.
Is complete anatomical endoscopic laser enucleation of the prostate always necessary? Yes, it is!
Authors: Castellani Daniele , Claudini Redi , Gasparri Luca , Branchi Alessandro , Pavia Maria Pia , Dellabella Marco 
Published: November 2018

Introduction: Thulium laser enucleation of the prostate is gaining popularity due to its short learning curve and low postoperative morbidity. The aim of Thulium laser enucleation of the prostate is the complete endoscopic enucleation of the adenoma. We report an unusual case of bladder outlet obstruction developed 6 weeks after Thulium laser enucleation of the prostate. Case description: A 74-year-old man complained of severe voiding phase symptoms lasting 2 weeks, starting 6 weeks after Thulium laser enucleation of the prostate. He underwent a transrectal ultrasound, which showed a wide prostatic fossa. A cystoscopy revealed that the prostatic fossa was filled with whitish tissue arising from two tiny residual adenomas. The obstructing tissue was resected with the aid of Thulium laser and the histopathology report showed necrotic prostatic glands. Conclusion: Partially enucleated and left inside adenoma may become necrotic and cause bladder outlet obstruction several weeks after Thulium laser enucleation of the prostate. Transrectal ultrasound control at the end of enucleation may help reduce this complication.
Looking Forwards through the Past: Bukovina’s “Return to Europe” after 1989–1991
Authors: Fisher Gaëlle 
Published: November 2018

This article is part of the special cluster titled Bukovina and Bukovinians after the Second World War: (Re)shaping and (re)thinking a region after genocide and ‘ethnic unmixing’, guest edited by Gaëlle Fisher and Maren Röger. Over the course of the 1990s, the region of Bukovina, once the easternmost province of the Austrian half of the Habsburg Empire, gained unprecedented visibility abroad. This was the case in German-language space in particular. There, Bukovina became the subject of newspaper articles, books, films, and exhibitions; travel and tourism to the area developed; political agreements and partnerships were even established between German or Austrian and “Bukovinian” regions. These initiatives, across “East and West,” across the former Iron Curtain, were meant to bridge the former divide. But many were based on proclaimed historical and cultural connections: as the widespread slogan read, Bukovina “returned to Europe.” In the process, historical Bukovina, by then split between Romania and a newly independent Ukraine, was not so much rediscovered as resurrected, reconstructed, and reinvented on the basis of existing ideas and assumptions. This raises a range of questions: why Bukovina, why in these countries, and why then? In this article, I identify different groups of actors, trends, and phases in the popular resurgence of Bukovina after 1989–1991 and highlight their origins, differences, and interactions. By tracing the activities and narratives of some of the key actors of the reinvention of the region after 1989–1991, this article explores the tensions between visions of the past and visions of the future in Germany, Austria, and Europe after 1989. It thereby also contributes to a critical reflection on the meaning of the wider “return to Europe” of Central and Eastern Europe after the end of the Cold War.
Discrimination of epileptogenic lesions and perilesional white matter using diffusion tensor magnetic resonance imaging
Authors: Rau Alexander , Kellner Elias , Foit Niels A , Lützen Niklas , Heiland Dieter H , Schulze-Bonhage Andreas , Reisert Marco , Kiselev Valerij G , Prinz Marco , Urbach Horst , Mader Irina 
Published: November 2018

The aim of this study was to evaluate whether ganglioglioma (GGL), dysembryoplastic neuroepithelial tumour (DNET) and FCD (focal cortical dysplasia) are distinguishable through diffusion tensor imaging. Additionally, it was investigated whether the diffusion measures differed in the perilesional (pNAWM) and in the contralateral normal appearing white matter (cNAWM). Six GGLs, eight DNETs and seven FCDs were included in this study. Quantitative diffusion measures, that is, axial, radial and mean diffusivity and fractional anisotropy, were determined in the lesion identified on isotropic T2 or FLAIR-weighted images and in pNAWM and cNAWM, respectively. DNET differed from FCD in mean diffusivity, and GGL from FCD in radial diffusivity. Both types of glioneuronal tumours were different from pNAWM in fractional anisotropy and radial diffusivity. For identifying the tumour edges, threshold values for tumour-free tissue were investigated with receiver operating characteristic analyses: tumour could be separated from pNAWM at a threshold ≤ 0.32 (fractional anisotropy) or ≥ 0.56 (radial diffusivity) *10–3 mm2/s (area under the curve 0.995 and 0.990 respectively). While diffusion parameters of FCDs differed from cNAWM (radial diffusivity (*10–3 mm/s2): 0.74 ± 0.19 vs. 0.43 ± 0.05; corrected p-value < 0.001), the pNAWM could not be differentiated from the FCD.
Charlson Comorbidity Index Predicts 5-Year Survivorship of Surgically Treated Hip Fracture Patients
Authors: Jiang Lei , Chou Andrew Chia Chen , Nadkarni Nivedita , Ng Caris En Qi , Chong Yun San , Howe Tet Sen , Koh Joyce Suang Bee 
Published: November 2018

Introduction: This study aims to assess the correlation of the age-adjusted Charlson comorbidity index (ACCI) with 5-year mortality in a surgically treated hip fracture population. Materials and Methods: A retrospective analysis was performed on 1057 patients aged 60 years and above who underwent surgery for hip fracture with a minimum of 5-year follow-up (92.2% 5-year follow-up rate) in a tertiary hospital. Manual review of patients’ electronic hospital records was performed to record demographic data, comorbidities, and length of stay. Mortality data were extracted from the hospital’s electronic medical records and corroborated with the National Electronic Health Record. Results: Of the 1057 patients, 283 (26.8%) were male. The majority of patients were 80 years of age and above (42.5%), with the oldest patient operated on age 102 with a mean age of 77.8 (8.6) years. Four hundred eighteen (39.5%) patients sustained extracapsular intertrochanteric fractures. The mean follow-up duration was 8 years and 3 days with an overall survivorship of 37.2%. A multiple regression model constructed with ACCI, age, gender, and fracture pattern demonstrated satisfactory predictive ability with a concordance statistic of 0.68. Patients with a higher ACCI category (≥6) had an increased 5-year mortality rate (41.8%) with an odds ratio of 13.6 (6.7-31.8, P < .001) compared to those with an ACCI category of 3 and below (89.3%). Discussion: The study demonstrates that ACCI correlated with 5-year mortality after surgical treatment of hip fracture. This information is pertinent in the counseling of patients with regard to their midterm survival following hip fracture surgery and may inform policy makers of the varied midterm survival rates in patients with differing ACCI scores and educate the allocation of health-care resources. Conclusion: The ACCI correlates with 5-year mortality after surgical treatment of hip fracture.
Differences in the Mechanism of Head Impacts Measured Between Men’s and Women’s Intercollegiate Lacrosse Athletes
Authors: Le Rachel K. , Saunders Tabitha D. , Breedlove Katherine M. , Bradney Debbie A. , Lucas Jill M. , Bowman Thomas G. 
Published: November 2018

Background: Lacrosse is a rapidly growing sport in the United States. Comparing the magnitude and frequency of head impact mechanisms between sexes will provide data for injury prevention techniques and risk reduction of head injuries. Purpose: To compare sex-specific differences in the magnitude and frequency of head impact mechanisms in National Collegiate Athletic Association (NCAA) Division III intercollegiate lacrosse athletes. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 31 NCAA Division III intercollegiate lacrosse athletes (16 men [mean age, 21 ± 1 years; mean height, 179.70 ± 5.82 cm; mean weight, 80.71 ± 6.33 kg] and 15 women [mean age, 20 ± 1 years; mean height, 165.43 ± 5.25 cm; mean weight, 64.08 ± 7.59 kg]) voluntarily participated in this study. Participants wore xPatch sensors at every event during the 2015 spring season. Sensors recorded the magnitude, frequency, and location of head impacts over 10 g. Linear ( g) and rotational (deg/s2) acceleration determined impact magnitudes. We calculated incidence rates (IRs; per 1000 athlete-exposures [AEs]) and incidence rate ratios (IRRs) with 95% CIs to determine frequency differences. Film footage from each event was synchronized with the time of each head impact for verification and mechanism coding. Sex and impact mechanism served as the independent variables. Results: A significant interaction was found between impact mechanism and sex ( P < .001) and main effects for impact mechanism ( P < .001) and sex ( P < .001). The most common mechanism in men’s lacrosse was head to body (IR, 970.55/1000 AEs [95% CI, 266.14-331.98]), and in women’s lacrosse, stick to head (IR, 289.87/1000 AEs [95% CI, 124.32-184.55]) was most common. Only 9 of 419 impermissible head impacts in men’s lacrosse games were classed as penalties (2%); 7 of 25 impermissible head impacts in women’s lacrosse games were called as penalties (28%). Conclusion: The impact mechanisms of head to body in men’s lacrosse and stick to head in women’s lacrosse are penalties but occur frequently, suggesting that a focus on stressing rule enforcement is warranted. Because mechanism and sex affect the magnitude of head impacts, proper offensive and defensive techniques against opponents should be encouraged to reduce head impacts.
Anticoagulating patients with high-risk acquired thrombophilias
Authors: Skeith Leslie 
Published: November 2018

Abstract
Antiphospholipid syndrome (APS), heparin-induced thrombocytopenia, and paroxysmal nocturnal hemoglobinuria are 3 acquired thrombophilias that carry a high risk of venous and arterial thromboembolism. Management of these conditions has largely included anticoagulation with a vitamin K antagonist after an initial period of a parenteral anticoagulant, for as long as the thrombotic risk is still present. The available evidence for the use of direct oral anticoagulants (DOACs) is limited and primarily consists of case series and cohort studies, which are summarized in this chapter. Randomized trials evaluating DOACs in patients with APS are reviewed. Further research is needed prior to widely adopting DOACs for use in these high-risk acquired thrombophilias; however, there may be selected low-risk subgroups where DOAC use is possible after careful consideration and patient discussion.
Prospective comparison of the HEP score and 4Ts score for the diagnosis of heparin-induced thrombocytopenia
Authors: Pishko Allyson M. , Fardin Sara , Lefler Daniel S. , Paydary Koosha , Vega Rolando , Arepally Gowthami M. , Crowther Mark , Rice Lawrence , Cines Douglas B. , Cuker Adam 
Published: November 2018

Abstract
The HIT Expert Probability (HEP) score compared favorably with the 4Ts score in a retrospective study. We assessed the diagnostic accuracy of the HEP score compared with the 4Ts score in a prospective cohort of 310 patients with suspected heparin-induced thrombocytopenia (HIT). A member of the clinical team calculated the HEP score and 4Ts score. An independent panel adjudicated HIT status based on a clinical summary as well as the results of HIT laboratory testing. The prevalence of HIT in the study population was 14.7%. At a cutoff of ≥3, the HEP score was 95.3% sensitive (95% confidence interval [CI], 84.2-99.4) and 35.7% specific (95% CI, 29.8-42.0) for HIT. A 4Ts score of ≥4 had a sensitivity of 97.7% (95% CI, 86.2-99.8) and specificity of 32.9% (95% CI, 27.2-39.1). The areas under the receiver operating characteristic (ROC) curves (AUCs) for the HEP score and 4Ts score were similar (0.81 [95% CI, 0.74-0.87] vs 0.76 [95% CI, 0.69-0.83]; P = .12). The HEP score exhibited a significantly higher AUC than the 4Ts score in patients in the intensive care unit (ICU) (0.86 vs 0.79; P = .03). Among trainee scorers, the HEP score performed significantly better than the 4Ts score (AUC, 0.80 vs 0.73; P = .03). Our data suggest that either the 4Ts score or the HEP score may be used in clinical practice. The HEP score may be preferable in ICU patients and among less experienced clinicians.