bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Musculoskeletal Injuries Sustained During Marine Corps Recruit Training
Authors: Jensen Andrew E , Laird Melissa , Jameson Jason T , Kelly Karen R 
Published: March 2019

Abstract
Musculoskeletal injuries cost the U.S. Marine Corps approximately $111 million and 356,000 lost duty days annually. Information identifying the most common types of injuries and events leading to their cause would help target mitigation efforts. The purpose of this effort was to conduct an archival data review of injuries and events leading to injury during recruit training. An archival dataset of Marine recruits from 2011 to 2016 was reviewed and included 43,004 observations from 28,829 unique individuals. Injuries were classified as mild, moderate, and severe and categorized into new overuse, preexisting overuse, and traumatic. Injury classification and categorization were stratified by event in which the injury occurred. The majority of injuries were due to overuse, and the most common types were sprains, strains, iliotibial band syndrome, and stress fractures, which constituted over 40% of all injuries. Conditioning hikes were the primary event leading to injury, with 31% of all injuries occurring during this training; running claimed 12%. Most injuries sustained during basic training comprised sprains and strains. Marines who remained uninjured during basic training outperformed those who reported at least one injury on fitness tests. These results point to enhanced conditioning as a potential entry point to target future intervention efforts.
A Novel Gradient Echo Plural Contrast Imaging Method Detects Brain Tissue Abnormalities in Patients With TBI Without Evident Anatomical Changes on Clinical MRI: A Pilot Study
Authors: Astafiev Serguei V , Wen Jie , Brody David L , Cross Anne H , Anokhin Andrey P , Zinn Kristina L , Corbetta Maurizio , Yablonskiy Dmitriy A 
Published: March 2019

AbstractResearch objectivesIt is widely accepted that mild traumatic brain injury (mTBI) causes injury to the white matter, but the extent of gray matter (GM) damage in mTBI is less clear.MethodsWe tested 26 civilian healthy controls and 14 civilian adult subacute-chronic mTBI patients using quantitative features of MRI-based Gradient Echo Plural Contrast Imaging (GEPCI) technique. GEPCI data were reconstructed using previously developed algorithms allowing the separation of R2t*, a cellular-specific part of gradient echo MRI relaxation rate constant, from global R2* affected by BOLD effect and background gradients.ResultsSingle-subject voxel-wise analysis (comparing each mTBI patient to the sample of 26 control subjects) revealed GM abnormalities that were not visible on standard MRI images (T1w and T2w). Analysis of spatial overlap for voxels with low R2t* revealed tissue abnormalities in multiple GM regions, especially in the frontal and temporal regions, that are frequently damaged after mTBI. The left posterior insula was the region with abnormalities found in the highest proportion (50%) of mTBI patients.ConclusionsOur data suggest that GEPCI quantitative R2t* metric has potential to detect abnormalities in GM cellular integrity in individual TBI patients, including abnormalities that are not detectable by a standard clinical MRI.
A Military Case Review Method to Determine and Record the Mechanism of Injury (BioTab) from In-Theater Attacks
Authors: Danelson Kerry A , Frounfelker Patricia , Pizzolato-Heine Karen , Valentine Raymond , Watkins Laura C , Tegtmeyer Michael , Bolte John H , Hardy Warren N , Loftis Kathryn L 
Published: March 2019

Abstract
A recent study of all mounted vehicle underbody blast attacks found that 21% of Abbreviated Injury Scale Severity 2+ injuries in the Joint Trauma Analysis and Prevention of Injury in Combat network were injuries to the leg and ankle. To develop effective countermeasure systems for these attacks, the epidemiology and mechanisms of injury from this loading environment need to be quantified. The goal of this study was to develop a military correlate of an existing civilian case review framework, the Crash Injury Research and Engineering Network (CIREN), to consider the differences in military event types and the amount of available vehicle/attack information. Additional data fields were added to the CIREN process to cover military-specific data and “certainty” definitions in the proposed injury hypothesis were modified. To date, six group reviews have been conducted analyzing 253 injuries to the foot/ankle, tibia, femur, pelvis, and lumbar spine from 52 occupants. The familiar format and unclassified nature of the presentations allowed for the involvement of biomechanics experts from multiple disciplines.
Sources of Stress and Psychological Health Outcomes Among U.S. Air Force Total Force Distributed Common Ground System Operators
Authors: Chappelle Wayne L , Prince Lillian R , Goodman Tanya M 
Published: March 2019

Abstract
U.S. Air Force Distributed Common Ground Station (DCGS) intelligence (Intel) operators sustain 24/7 battlefield situational awareness and facilitate precision-strike operations. DCGS operations are global, synergistic, Total Force (TF) endeavors by active duty, Air National Guard (ANG) and Reserve units, providing combatant commanders with critical real-time intelligence and shaping operational and tactical decisions. Continual surveillance of this community’s psychological health is important to its military leaders. This study re-examines the most frequently reported occupational stressors, as well as the prevalence of occupational burnout (i.e., high-emotional exhaustion and cynicism, and low professional efficacy), and psychological distress within this population. Active duty (n = 1717), ANG (n = 139), and Reserve (n = 173) Intel operators participated in a comprehensive, online, occupational health assessment. Results reveal that occupational stressors contributing to elevated rates of distress, regardless of TF status (i.e., low manning, long work hours, excessive workload, and organizational communication concerns) are consistent with previous research. The prevalence of high-emotional exhaustion (AD: 29%/ANG: 25%/RES: 14%) and psychological distress (AD: 19%/ANG: 17%/RES: 5%) are above estimates for other military communities. These findings combined with demographic and occupational risk factors lay the foundation for improving psychological health within this Total Force community.
Serum Biomarkers for Racial Disparities in Breast Cancer Progression
Authors: Srivastava Meera , Eidelman Ofer , Craig James , Starr Joshua , Kvecher Leonid , Liu Jianfang , Hueman Matthew , Pollard Harvey B , Hu Hai , Shriver Craig D 
Published: March 2019

Abstract
African American (AA) women are often diagnosed with more aggressive breast cancers and have worse survival outcomes than their Caucasian American (CA) counterparts. However, a comprehensive understanding of this disparity remains unclear. In this study, we attempted to identify the race-specific non-invasive protein biomarkers that may particularly benefit interventions aimed at reducing the risk of recurrence and metastasis in breast cancers (BrCa). Our technical strategy has been to discover candidate protein biomarkers in patient sera using a high throughput antibody microarray platform. A total of 240 subjects were selected, composed of controls and all immunohistochemistry-based subtypes of breast cancer cases, subdivided by pre- and post-menopausal status and by race. A global Wilcoxon analysis comparing no-cancer controls and cancer patients identified Pyk2, SAPK/JNK, and phosphatase and tensin homolog as present in higher concentrations in cancer patient serum. A paired t-test revealed that c-kit and Rb are significantly over-represented in AA cancer serum when compared to CA cancer serum. Interestingly, VEGFR2, a protein linked to BrCa metastasis and poor prognosis, was significantly over-represented in AA cancer serum compared to AA controls; however, this was not found in CA cancer serum compared to CA controls, suggesting a possible explanation for the higher incidence of aggressive BrCa in AA versus CA patients. Through examining race-specific differences in the protein landscape of BrCa patient serum, the identified proteins could lay the groundwork for the development of an all-inclusive “liquid mammogram test.”
Tumorigenesis as the Paradigm of Quasi-neutral Molecular Evolution
Authors: Chen Bingjie , Shi Zongkun , Chen Qingjian , Shen Xu , Shibata Darryl , Wen Haijun , Wu Chung-I 
Published: March 2019

AbstractIn the absence of both positive and negative selections, coding sequences evolve at a neutral rate (R = 1). Such a high genomic rate is generally not achievable due to the prevalence of negative selection against codon substitutions. Remarkably, somatic evolution exhibits the seemingly neutral rate R ∼ 1 across normal and cancerous tissues. Nevertheless, R ∼ 1 may also mean that positive and negative selections are both strong, but equal in intensity. We refer to this regime as quasi-neutral. Indeed, individual genes in cancer cells often evolve at a much higher, or lower, rate than R ∼ 1. Here, we show that 1) quasi-neutrality is much more likely when populations are small (N &lt; 50); 2) stem-cell populations in single normal tissue niches, from which tumors likely emerge, have a small N (usually &lt;50) but selection at this stage is measurable and strong; 3) when N dips below 50, selection efficacy decreases precipitously; and 4) notably, N is smaller in the stem-cell niche of the small intestine than in the colon. Hence, the ∼70-fold higher rate of phenotypic evolution (observed as cancer risk) in the latter can be explained by the greater efficacy of selection, which then leads to the fixation of more advantageous and fewer deleterious mutations in colon cancers. In conclusion, quasi-neutral evolution sheds a new light on a general evolutionary principle that helps to explain aspects of cancer evolution.
An integrative method to predict signalling perturbations for cellular transitions
Authors: Zaffaroni Gaia , Okawa Satoshi , Morales-Ruiz Manuel , del Sol Antonio 
Published: March 2019

AbstractInduction of specific cellular transitions is of clinical importance, as it allows to revert disease cellular phenotype, or induce cellular reprogramming and differentiation for regenerative medicine. Signalling is a convenient way to accomplish such transitions without transfer of genetic material. Here we present the first general computational method that systematically predicts signalling molecules, whose perturbations induce desired cellular transitions. This probabilistic method integrates gene regulatory networks (GRNs) with manually-curated signalling pathways obtained from MetaCore from Clarivate Analytics, to model how signalling cues are received and processed in the GRN. The method was applied to 219 cellular transition examples, including cell type transitions, and overall correctly predicted experimentally validated signalling molecules, consistently outperforming other well-established approaches, such as differential gene expression and pathway enrichment analyses. Further, we validated our method predictions in the case of rat cirrhotic liver, and identified the activation of angiopoietins receptor Tie2 as a potential target for reverting the disease phenotype. Experimental results indicated that this perturbation induced desired changes in the gene expression of key TFs involved in fibrosis and angiogenesis. Importantly, this method only requires gene expression data of the initial and desired cell states, and therefore is suited for the discovery of signalling interventions for disease treatments and cellular therapies.
Association between timing of dialysis initiation and clinical outcomes in the paediatric population: an ESPN/ERA-EDTA registry study
Authors: Preka Evgenia , Bonthuis Marjolein , Harambat Jerome , Jager Kitty J , Groothoff Jaap W , Baiko Sergey , Bayazit Aysun K , Boehm Michael , Cvetkovic Mirjana , Edvardsson Vidar O , Fomina Svitlana , Heaf James G , Holtta Tuula , Kis Eva , Kolvek Gabriel , Koster-Kamphuis Linda , Molchanova Elena A , Muňoz Marina , Neto Gisela , Novljan Gregor , Printza Nikoleta , Sahpazova Emilija , Sartz Lisa , Sinha Manish D , Vidal Enrico , Vondrak Karel , Vrillon Isabelle , Weber Lutz T , Weitz Marcus , Zagozdzon Ilona , Stefanidis Constantinos J , Bakkaloglu Sevcan A 
Published: March 2019

AbstractBackgroundThere is no consensus regarding the timing of dialysis therapy initiation for end-stage kidney disease (ESKD) in children. As studies investigating the association between timing of dialysis initiation and clinical outcomes are lacking, we aimed to study this relationship in a cohort of European children who started maintenance dialysis treatment.MethodsWe used data on 2963 children from 21 different countries included in the European Society of Pediatric Nephrology/European Renal Association–European Dialysis and Transplant Association Registry who started renal replacement therapy before 18 years of age between 2000 and 2014. We compared two groups according to the estimated glomerular filtration rate (eGFR) at start: eGFR ≥8 mL/min/1.73 m2 (early starters) and eGFR <8 mL/min/1.73 m2 (late starters). The primary outcomes were patient survival and access to transplantation. Secondary outcomes were growth and cardiovascular risk factors. Sensitivity analyses were performed to account for selection- and lead time-bias.ResultsThe median eGFR at the start of dialysis was 6.1 for late versus 10.5 mL/min/1.73 m2 for early starters. Early starters were older [median: 11.0, interquartile range (IQR): 5.7–14.5 versus 9.4, IQR: 2.6–14.1 years]. There were no differences observed between the two groups in mortality and access to transplantation at 1, 2 and 5 years of follow-up. One-year evolution of height standard deviation scores was similar among the groups, whereas hypertension was more prevalent among late initiators. Sensitivity analyses resulted in similar findings.ConclusionsWe found no evidence for a clinically relevant benefit of early start of dialysis in children with ESKD. Presence of cardiovascular risk factors, such as high blood pressure, should be taken into account when deciding to initiate or postpone dialysis in children with ESKD, as this affects the survival.
A Multicenter, Prospective, Randomized, Placebo-Controlled, Double-Blind Study of a Novel Pain Management Device, AT-02, in Patients with Fibromyalgia
Authors: Oka Hiroshi , Miki Kenji , Kishita Iwao , Kong David F , Uchida Takahiro 
Published: March 2019

Abstract

Objectives
Existing treatments for fibromyalgia have limited efficacy, and only a minority of individuals clinically respond to any single intervention. This study was a prospective, multicenter, randomized, double-blind, controlled clinical trial to evaluate the feasibility of alternating magnetic field therapy in fibromyalgia patients by comparing the Angel Touch device (AT-02) with a sham control (S-01).

Methods
Two sites enrolled 44 subjects with diagnosed fibromyalgia. After informed consent, subjects taking prohibited concomitant drugs underwent a washout period of two or more weeks. All subjects then began a one-week run-in period. Numerical rating scale (NRS) pain scores were collected without device intervention for one day, followed by S-01 application to four or more painful sites for 10 minutes at each site, twice daily for six days. Subjects were then randomized to AT-02 or S-01, applied to four or more painful sites for 10 minutes at each site, twice daily for eight weeks. NRS scores were obtained twice daily during the entire treatment period.

Results
The primary end point (change in NRS ± SD at week 8 vs baseline) was –0.94 ± 1.33 in the AT-02 group and –0.22 ± 1.38 in the S-01 group. A trend toward a between-group difference in eight-week NRS scores favored the AT-02 group (–0.73, 95% confidence interval = –1.56 to 0.11, P = 0.086). An adjusted repeated measure analysis detected a significant difference in NRS scores (P = 0.039).

Conclusions
The reduction in NRS scores for AT-02 relative to sham was comparable to reductions observed in meta-analyses of fibromyalgia drug therapy. The unadjusted results and the persistence of the pain score reductions remain encouraging.
What if Acupuncture Were Covered by Insurance for Pain Management? A Cross-Sectional Study of Cancer Patients at One Academic Center and 11 Community Hospitals
Authors: Liou Kevin T , Hung Tony K W , Meghani Salimah H , Epstein Andrew S , Li Q Susan , Romero Sally A D , Cohen Roger B , Mao Jun J 
Published: March 2019

Abstract

Objective
In response to the national opioid crisis, governmental and medical organizations have called for broader insurance coverage of acupuncture to improve access to nonpharmacologic pain therapies, especially in cancer populations, where undertreatment of pain is prevalent. We evaluated whether cancer patients would be willing to use insurance-covered acupuncture for pain.

Design and Setting
We conducted a cross-sectional survey of cancer patients with pain at one academic center and 11 community hospitals.

Methods
We used logistic regression models to examine factors associated with willingness to use insurance-covered acupuncture for pain.

Results
Among 634 cancer patients, 304 (47.9%) reported willingness to use insurance-covered acupuncture for pain. In univariate analyses, patients were more likely to report willingness if they had severe pain (odds ratio [OR] = 1.59, 95% confidence interval [CI] = 1.03–2.45) but were less likely if they were nonwhite (OR = 0.59, 95% CI = 0.39–0.90) or had only received high school education or less (OR = 0.46, 95% CI = 0.32–0.65). After adjusting for attitudes and beliefs in multivariable analyses, willingness was no longer significantly associated with education (adjusted OR [aOR] = 0.78, 95% CI = 0.50–1.21) and was more negatively associated with nonwhite race (aOR = 0.49, 95% CI = 0.29–0.84).

Conclusions
Approximately one in two cancer patients was willing to use insurance-covered acupuncture for pain. Willingness was influenced by patients’ attitudes and beliefs, which are potentially modifiable through counseling and education. Further research on racial disparities is needed to close the gap in utilization as acupuncture is integrated into insurance plans in response to the opioid crisis.
Pregnancy outcomes in mixed connective tissue disease: a multicentre study
Authors: Radin Massimo , Schreiber Karen , Cuadrado Maria José , Cecchi Irene , Andreoli Laura , Franceschini Franco , Caleiro Teresa , Andrade Danieli , Gibbone Elena , Khamashta Munther , Buyon Jill , Izmirly Peter , Aguirre Maria Angeles , Benedetto Chiara , Roccatello Dario , Marozio Luca , Sciascia Savino 
Published: March 2019

Abstract

Objectives
In this study we aimed to investigate foetal and maternal pregnancy outcomes from a large multicentre cohort of women diagnosed with MCTD and anti-U1RNP antibodies.

Methods
This multicentre retrospective cohort study describes the outcomes of 203 pregnancies in 94 consecutive women ever pregnant who fulfilled the established criteria for MCTD with confirmed U1RNP positivity.

Results
The foetal outcomes in 203 pregnancies were as follows: 146 (71.9%) live births, 38 (18.7%) miscarriages (first trimester pregnancy loss of <12 weeks gestation), 18 (8.9%) stillbirths (pregnancy loss after 20 weeks gestation) and 11 (5.4%) cases with intrauterine growth restriction. Maternal pregnancy outcomes were as follows: 8 (3.9%) developed pre-eclampsia, 2 (0.9%) developed eclampsia, 31 (15.3%) developed gestational hypertension and 3 (1.5%) developed gestational diabetes. Women with MCTD and aPL and pulmonary or muscular involvement had worse foetal outcomes compared with those without. Moreover, we report a case of complete congenital heart block (0.45%) and a case of cutaneous neonatal lupus, both born to a mother with positive isolated anti-U1RNP and negative anti-Ro/SSA antibodies.

Conclusion
In our multicentre cohort, women with MCTD had a live birth rate of 72%. While the true frequency of heart block associated with anti-U1RNP remains to be determined, this study might raise the consideration of echocardiographic surveillance in this setting. Pregnancy counselling should be considered in women with MCTD.
Medical Burden of Disease Among Individuals in Recovery From Alcohol and Other Drug Problems in the United States: Findings From the National Recovery Survey
Authors: Eddie David , Greene M. Claire , White William L. , Kelly John F. 
Published: March 2019

Objectives:
The medical sequalae of alcohol and other drug (AOD) problems exact a prodigious personal and societal cost, but little is known about the specific prevalence of such medical problems, and their relationship to quality of life and indices of well-being among those recovering from problematic AOD use. To better characterize the lifetime physical disease burden, this study investigated the prevalence of medical conditions commonly caused or exacerbated by excessive and chronic AOD exposure in a nationally representative sample of US adults in AOD problem recovery. Comparisons were made to the general US population. Demographic and clinical correlates of disease prevalence were also investigated along with the relationship between distinct medical conditions and indices of quality of life/well-being.

Methods:
Cross-sectional nationally representative survey of the US adult population who report resolving an AOD problem (n = 2002). Weighted lifetime prevalence of common medical conditions were estimated and compared to the US population. Demographic and clinical correlates of medical conditions, and also overall disease burden, were estimated using logistic regression.

Results:
Relative to the general population, prevalence of hepatitis C, chronic obstructive pulmonary disease, heart disease, and diabetes were elevated. Likelihood of having a lifetime diagnosis of a specific disease was related to primary substance used and sex. Quality of life was lower among those with physical disease histories relative to those without.

Conclusions:
Findings highlight the increased medical burden associated with AOD problems, and speak to the need for earlier and more sustained intervention for AOD problems, greater integration of addiction treatment and primary health care, and longitudinal research to explore the complex, dynamic relationships between AOD use and physical disease.