bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Ongoing Anticholinergic Burden Associated With Greater Cognitive Decline and Dementia Severity in Mild to Moderate Alzheimer’s Disease?
Authors: Dyer Adam H , Murphy Claire , Segurado Ricardo , Lawlor Brian , Kennelly Sean P ,   for the NILVAD Study Group
Published: October 2019

Abstract

Background
Use of anticholinergic medication is associated with an increased risk of cognitive impairment and/or dementia. Despite this, the impact of continuing medication with anticholinergic properties in those diagnosed with Alzheimer’s Disease (AD) is not clear.

Methods
Analysis of data from NILVAD, an 18-month randomized controlled trial of Nilvadipine in AD. Effects of ongoing Anticholinergic Cognitive Burden (ACB) on cognition (ADAS-Cog: Alzheimer’s Disease Cog Subsection) and dementia severity (CDR-sb: Clinical Dementia Rating – Sum of Boxes/DAD: Disability Assessment for Dementia) over 18 months was evaluated adjusting for important clinical covariates.

Results
Just over one-quarter (27.90%, n = 142/510) of patients with mild to moderate AD were prescribed a potential/definite anticholinergic. While ACB score was not associated with greater progression on the ADAS-Cog/CDR-sb over time, a higher total ACB predicted greater dementia severity on the DAD, which persisted after robust covariate adjustment (β Coef: −1.53, 95% CI: −2.83 to −0.23, p = .021). There was a significant interaction between APOE ε4 status and ACB score, with carriers experiencing greater progression on both the CDR-Sb (β Coef: 0.36, 95% CI: 0.05–0.67, p = .021) and DAD (β Coef: −3.84, 95% CI: −7.65 to 0.03, p = .049).

Conclusions
Ongoing use of anticholinergic medication was associated with greater dementia progression on the DAD, but not the CDR-sb. APOE ε 4 carriers may be particularly vulnerable to the effect of ongoing anticholinergic medication on dementia severity, with significant APOE ε 4 x ACB score interactions demonstrated on both the DAD and CDR-sb.
The Institutional “Hinge”: How the End of the Cold War Conditioned Canadian, Russian, and Swiss IR Scholarship
Authors: Grenier Félix , Hagmann Jonas , Biersteker Thomas , Lebedeva Marina , Nikitina Yulia , Koldunova Ekaterina 
Published: October 2019

AbstractMajor international events contribute to guiding IR scholarship's interests, yet it remains surprisingly unexplored how transformative political events affect international relations as an academic field. This article focuses on the linkage between key global moments and the institutional factors that condition IR scholarship, focusing on the important yet under-explored intervening elements in the interrelation between political events and academic practice. The article defines the utility of such focus and illustrates it with case studies of three central parties to the Cold War conflict: Russia as representative of the Eastern bloc, Canada of the Western alliance, and Switzerland as a neutral polity. This article shows how institutional factors such as funding schemes, the marketization of education, and the creation of new IR departments operate as effective “hinges” exerting significant influence over the ways scholars develop ideas about international relations.
Increased Prediction Ability in Norway Spruce Trials Using a Marker X Environment Interaction and Non-Additive Genomic Selection Model
Authors: Chen Zhi-Qiang , Baison John , Pan Jin , Westin Johan , Gil Maria Rosario García , Wu Harry X 
Published: October 2019

AbstractA genomic selection study of growth and wood quality traits is reported based on control-pollinated Norway spruce families established in 2 Northern Swedish trials at 2 locations using exome capture as a genotyping platform. Nonadditive effects including dominance and first-order epistatic interactions (including additive-by-additive, dominance-by-dominance, and additive-by-dominance) and marker-by-environment interaction (M×E) effects were dissected in genomic and phenotypic selection models. Genomic selection models partitioned additive and nonadditive genetic variances more precisely than pedigree-based models. In addition, predictive ability in GS was substantially increased by including dominance and slightly increased by including M×E effects when these effects are significant. For velocity, response to genomic selection per year increased up to 78.9/80.8%, 86.9/82.9%, and 91.3/88.2% compared with response to phenotypic selection per year when genomic selection was based on 1) main marker effects (M), 2) M + M×E effects (A), and 3) A + dominance effects (AD) for sites 1 and 2, respectively. This indicates that including M×E and dominance effects not only improves genetic parameter estimates but also when they are significant may improve the genetic gain. For tree height, Pilodyn, and modulus of elasticity (MOE), response to genomic selection per year improved up to 68.9%, 91.3%, and 92.6% compared with response to phenotypic selection per year, respectively.Subject Area: Quantitative genetics and Mendelian inheritance
Diabetes and Clinical Outcome in Patients With Metastatic Colorectal Cancer: CALGB 80405 (Alliance)
Authors: Brown Justin C , Zhang Sui , Ou Fang-Shu , Venook Alan P , Niedzwiecki Donna , Lenz Heinz-Josef , Innocenti Federico , O’Neil Bert H , Shaw James E , Polite Blase N , Denlinger Crystal S , Atkins James N , Goldberg Richard M , Ng Kimmie , Mayer Robert J , Blanke Charles D , O’Reilly Eileen M , Fuchs Charles S , Meyerhardt Jeffrey A 
Published: October 2019

Abstract

Background
Diabetes is a prognostic factor for some malignancies, but its association with outcome in patients with advanced or metastatic colorectal cancer (CRC) is less clear.

Methods
This cohort study was nested within a randomized trial of first-line chemotherapy and bevacizumab and/or cetuximab for advanced or metastatic CRC. Patients were enrolled at 508 community and academic centers throughout the National Clinical Trials Network. The primary exposure was physician-documented diabetes at the time of enrollment. The primary endpoint was overall survival (OS); secondary endpoints were progression-free survival (PFS) and adverse events. Tests of statistical significance were two-sided.

Results
Among 2326 patients, 378 (16.3%) had diabetes. The median follow-up time was 6.0 years. We observed 1973 OS events and 2173 PFS events. The median time to an OS event was 22.7 months among those with diabetes and 27.1 months among those without diabetes (HR = 1.27, 95% CI = 1.13 to 1.44; P &lt; .001). The median time to a PFS event was 9.7 months among those with diabetes and 10.8 months among those without diabetes (HR = 1.16, 95% CI = 1.03 to 1.30; P = .02). Patients with diabetes were more likely to experience no less than grade 3 hypertension (8.1% vs 4.4%; P = .054) but were not more likely to experience other adverse events, including neuropathy.

Conclusions
Diabetes is associated with an increased risk of mortality and tumor progression in patients with advanced or metastatic CRC. Patients with diabetes tolerate first-line treatment with chemotherapy and monoclonal antibodies similarly to patients without diabetes.
Tailoring treatment of hyperkalemia
Authors: Coutrot Maxime , Dépret Francois , Legrand Matthieu 
Published: October 2019

Abstract
Hyperkalemia is a common electrolyte disorder that may be rapidly life-threatening because of its cardiac toxicity. Hyperkalemia risk factors are numerous and often combined in the same patient. Most of the strategies to control serum potassium level in the short term have been used for decades. However, evidence for their efficacy and safety remains low. Treatment of hyperkalemia remains challenging, poorly codified, with a risk of overtreatment, including short-term side effects, and with the priority of avoiding unnecessary hospital stays or chronic medication changes. Recently, new oral treatments have been proposed for non-life-threatening hyperkalemia, with encouraging results. Their role in the therapeutic arsenal remains uncertain. Finally, a growing body of evidence suggests that hyperkalemia might negatively impact outcomes in the long term in patients with chronic heart failure or kidney failure through underdosing or withholding of cardiovascular medication (e.g. renin–angiotensin–aldosterone system inhibitors). Recognition of efficacy and potential side effects of treatment may help in tailoring treatments to the patient’s status and conditions. In this review we discuss how treatment of hyperkalemia could be tailored to the patient’s conditions and status, both on the short and mid term.
A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2018
Authors: Chahine Elias B , Durham Spencer H , Mediwala Krutika N , Chastain Daniel B , Gauthier Timothy P , Hill Brandon K , Jones Bruce M , Kisgen Jamie J , Marx Ashley H , Stover Kayla R , Worley Marylee V , Bland Christopher M , Bookstaver P Brandon 
Published: October 2019

AbstractWith an increasing number of antimicrobial stewardship–related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship–related peer-reviewed literature that detailed an actionable intervention for 2018. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training as well as to identify potential intervention opportunities within one’s institution.
A case of fatal disseminated strongyloidiasis accompanied with intestinal obstruction
Authors: Heydarian Peyman , Mobedi Iraj , Mohaghegh Mohamad Ali , Hosseini Abozar , Chegini Fatemeh Goudarzvand , Esboei Bahman Rahimi 
Published: October 2019

AbstractStrongyloides stercoralis is an endemic parasite in some regions including the tropical and subtropical areas with high humidity. Most infections are asymptomatic with nonspecific signs and symptoms, making the final diagnosis complicated. Here, we report a patient referred to our hospital with signs consistent with sepsis, intestine obstruction, which finally died with the diagnosis of strongyloidiasis. The patient was from northern parts of Iran which are considered as endemic areas for S. stercoralis. In conclusion, there is an important message in this history, i.e. physicians should be aware of specific and non-specific signs of strongyloidiasis especially in people living in endemic areas to make an accurate final diagnosis by proper clinical and paraclinical examinations.
Borromean Feshbach resonance in $^{11}$Li studied via $^{11}$Li($p$,$p'$)
Authors: Matsumoto Takuma , Tanaka Junki , Ogata Kazuyuki 
Published: October 2019

Abstract
A dipole resonance of $^{11}$Li is found by a $^9$Li + $n$ + $n$ three-body model analysis with the complex-scaling method. The resonance can be interpreted as a bound state in the $^{10}$Li + $n$ system, i.e., a Feshbach resonance in the $^9$Li + $n$ + $n$ system. As a characteristic feature of the Feshbach resonance of $^{11}$Li, the $^{10}$Li + $n$ threshold is open above the $^{9}$Li + $n$ + $n$ one, which reflects a distinctive property of the Borromean system. A microscopic four-body reaction calculation for the $^{11}$Li($p$,$p'$) reaction at 6 MeV/nucleon is performed by taking into account the resonant and nonresonant continuum states of the three-body system. The calculation of angular distributions of the elastic and inelastic scattering as well as the energy spectrum reproduced a recent experimental result. Furthermore, the $E1$ strength distribution from a Coulomb dissociation experiment was also reproduced in this framework. This means that the existence of the Borromean Feshbach resonance may consistently answer a long-standing open question of an excited state of $^{11}$Li.
Auditory Training Supports Auditory Rehabilitation: A State-of-the-Art Review
Authors: Stropahl Maren , Besser Jana , Launer Stefan 
Published: October 2019

Objectives:
Auditory training (AT), which is active listening to various auditory stimuli, aims to improve auditory skills. There is evidence that AT can be used as a tool in auditory rehabilitation to improve speech perception and other auditory cognitive skills in individuals with hearing impairment. The present state-of-the-art review examines the effect of AT on communication abilities in individuals with hearing impairment. In particular, transfer of AT effects on performance in untrained speech perception tasks was evaluated.

Design:
PubMed, Medline, and Web of Science databases were searched using combinations of key words with restriction to the publication date from December 2012 until December 2018. The participant, intervention, control, outcome, and study design criteria were used for the inclusion of articles. Only studies comparing effects in an intervention group to a control group were considered. The target group included individuals with a mild to moderately severe hearing impairment, with and without hearing-aid experience. Out of 265 article abstracts reviewed, 16 met the predefined criteria and were taken for review.

Results:
The majority of studies that were included in this state of- the-art review report at least one outcome measure that shows an improvement in non-trained tasks after a period of intense AT. However, observed shortcomings are that a comparison between studies remains difficult as training benefits were assessed with various outcome measures. Also, the sustainability of training benefits was not investigated sufficiently.

Conclusions:
Recent evidence suggests that intensive auditory (-cognitive) training protocols are a valid tool to improve auditory communication skills. Individuals with hearing impairment seem to benefit the most using a combination of sensory rehabilitation with hearing aids and AT to enhance auditory rehabilitation. Long term benefits of AT are still not consistently observed and should be in the focus of future research.
Maximum Output and Low-Frequency Limitations of B71 and B81 Clinical Bone Vibrators: Implications for Vestibular Evoked Potentials
Authors: Clinard Christopher G. , Piker Erin G. , Thorne Andrew P. , Surface Elizabeth N. , Anderson Allison E. , Beacham Valerie A. , Crouse Megan C. , Whitney Victoria H. , Depaolis Rory A. 
Published: October 2019

Objectives:
Bone-conducted vestibular evoked myogenic potentials (VEMPs) are tuned to have their maximum amplitude in response to tone bursts at or below 250 Hz. The low-frequency limitations of clinical bone vibrators have not been established for transient, tone burst stimuli at frequencies that are optimal for eliciting VEMPs.

Design:
Tone bursts with frequencies of 250 to 2000 Hz were delivered to B71 and B81 bone vibrators and their output was examined using an artificial mastoid. The lower-frequency limit of the transducers was evaluated by examining the spectral output of the bone vibrators. Maximum output levels were evaluated by measuring input–output functions across a range of stimulus levels.

Results:
Both the B71 and B81 could produce transient tone bursts with frequency as low as 400 Hz. However, tone bursts with frequencies of 250 and 315 Hz resulted in output with peak spectral energy at approximately 400 Hz. From 500 to 2000 Hz, maximum output levels within the linear range were between 120 and 128 dB peak force level. The newer B81 bone vibrator had a maximum output approximately 5 dB higher than the B71 at several frequencies.

Conclusions:
These findings demonstrate that both transducers can reach levels appropriate to elicit bone-conducted VEMPs, but the low-frequency limitations of these clinical bone vibrators limit tone burst frequency to approximately 400 Hz when attempting to stimulate the otolith organs via tone bursts.
Breastfeeding Behaviors and Maternal Interaction Quality in a Low-Income, Ethnic Minority Population
Authors: Whipps Mackenzie D. M. , Miller Elizabeth B. , Bogen Debra L. , Mendelsohn Alan L. , Morris Pamela A. , Shaw Daniel , Gross Rachel S. 
Published: October 2019

ABSTRACT:

Objective:
To examine the associations between breastfeeding intensity and underexplored features of maternal-child interaction quality over and above the influence of breastfeeding initiation.

Methods:
The current study leveraged an on-going, multisite randomized controlled trial of a tiered parenting program for 462 Medicaid-eligible mothers and their infants in the United States. We examined whether breastfeeding intensity and exclusivity was associated with observed maternal sensitivity, intrusiveness, and detachment, as well as self-reported maternal verbal responsiveness, 6 months infant age. Analyses controlled for breastfeeding initiation, demographics, and early parenting experiences.

Results:
Higher intensity breastfeeding at 6 months was significantly related to higher maternal sensitivity (β = 0.12, p = 0.004) and lower maternal intrusiveness (β = −0.10, p = 0.045). There was no significant association between breastfeeding intensity at 6 months and detachment (β = −0.02, no significant [ns]) or self-reported verbal responsiveness (β = 0.11, ns). Results were the same when intensity was measured as a dichotomous indicator for exclusive breastfeeding. Effect sizes were small-to-moderate, ranging from Cohen's d = 0.26 to 0.31. Associations did not vary by site, race/ethnicity, infant difficultness, or household poverty.

Conclusion:
The finding that breastfeeding intensity was significantly and independently associated with maternal sensitivity and intrusiveness is novel in the literature on low-income families from the United States. These findings have implications for breastfeeding promotion strategies and indicate that future research should explore synergistic or spillover effects of interventions aimed at maternal-child interaction quality into the infant feeding domain, particularly in the primary care setting.
Potential of the Cardiovascular Drug Levosimendan in the Management of Amyotrophic Lateral Sclerosis: An Overview of a Working Hypothesis
Authors: Al-Chalabi Ammar , Heunks Leo M. A. , Papp Zoltán , Pollesello Piero 
Published: October 2019

Abstract:
Levosimendan is a calcium sensitizer that promotes myocyte contractility through its calcium-dependent interaction with cardiac troponin C. Administered intravenously, it has been used for nearly 2 decades to treat acute and advanced heart failure and to support the heart function in various therapy settings characterized by low cardiac output. Effects of levosimendan on noncardiac muscle suggest a possible new application in the treatment of people with amyotrophic lateral sclerosis (ALS), a neuromuscular disorder characterized by progressive weakness, and eventual paralysis. Previous attempts to improve the muscle response in ALS patients and thereby maintain respiratory function and delay progression of disability have produced some mixed results. Continuing this line of investigation, levosimendan has been shown to enhance in vitro the contractility of the diaphragm muscle fibers of non-ALS patients and to improve in vivo diaphragm neuromuscular efficiency in healthy subjects. Possible positive effects on respiratory function in people with ALS were seen in an exploratory phase 2 study, and a phase 3 clinical trial is now underway to evaluate the potential benefit of an oral form of levosimendan on both respiratory and overall functions in patients with ALS. Here, we will review the various known pharmacologic effects of levosimendan, considering their relevance to people living with ALS.
Biocompatibility and zinc release testing of a zinc-containing vaginal gel
Authors: Fenyvesi Ferenc , Váradi Judit , Fehér Pálma , Bácskay Ildikó , Vecsernyés Miklós , Sipos Attila , Takacs Peter 
Published: October 2019

Abstract

Objective:
To test the biocompatibility of a zinc-containing vaginal gel, evaluate its ability to release zinc, and to assess the transepithelial permeability of zinc on human vaginal epithelium.

Methods:
The release and membrane diffusion of zinc from the vaginal gel was tested by a vertical Franz-diffusion cell system. The biocompatibility of the gel was tested on HaCaT cells and reconstructed human vaginal epithelium. MTT assay was used to detect cell viability. Lactate dehydrogenase (LDH) assay was used to access cytotoxicity. The permeability of zinc was tested on the reconstructed human vaginal epithelium. The integrity of the reconstructed human vaginal epithelium after the permeability experiments was measured by transepithelial electric resistance. Zinc levels were determined by inductively coupled plasma optical emission spectrometry.

Results:
20 μM zinc sulfate did not decrease cell viability during the 24 and 72-hour treatment. Similarly, cell viability did not decrease significantly after 60 minutes of incubation with the gel and no toxic compound released from the vaginal gel during the 120 minutes diffusion experiment. A total of 72-hour exposure to the zinc-containing vaginal gel showed no cytotoxicity using LDH assay. Using cellulose-acetate membranes, 24.6% of the zinc content of the gel was released and appeared in the acceptor phase after 15 minutes. Zinc had high permeability (2.2 ± 0.8 × 10−5 cm/s) from the vaginal gel on reconstructed human vaginal epithelium.

Conclusions:
The zinc-containing (20 μM) vaginal gel was not toxic. The release of zinc is rapid from the vaginal gel. Zinc permeated rapidly through the vaginal epithelial cell layers.
SEROUS MACULAR DETACHMENT IN BEST DISEASE
Authors: Zatreanu Luca , Freund K. Bailey , Leong Belinda C. S. , Yu Hyeong G. , Teke Mehmet Y. , Yzer Suzanne , Sadda SriniVas R. , Sarraf David 
Published: October 2019

Purpose:
To describe the clinical and multimodal imaging findings of a series of cases of serous macular detachment (SMD) caused by Best disease (BD) masquerading as neovascular age-related macular degeneration or central serous chorioretinopathy that were inappropriately treated with intravitreal anti–vascular endothelial growth factor or laser therapy. This study will also present data to support age-related progressive choroidal thickening in BD patients, which may play a role in the development of SMD in this population.

Methods:
Clinical examination and multimodal imaging findings, including color fundus photography, spectral-domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and optical coherence tomography-angiography, were reviewed and analyzed. Subfoveal choroidal thickness was also formally measured, and an age-related choroidal thickness analysis was performed and compared with a normal population.

Results:
Twenty-six eyes of 13 patients (5 women) were included. Median age was 44 years. Nine patients presented with a history of SMD and subretinal fluid recalcitrant to various therapies, including intravitreal anti–vascular endothelial growth factor injections and photodynamic therapy. Best disease was subsequently diagnosed genetically in six patients and by detailed family history in seven. Mean logarithm of the minimum angle of resolution best-corrected visual acuity for all 26 eyes at last follow-up was +0.36 (Snellen equivalent of 20/46). Subfoveal choroidal thickness positively correlated with age for our cohort, increasing linearly at a rate of 25.6 µm per decade (R2 = 0.64; P < 0.001). Choroidal neovascularization was identified in four eyes on optical coherence tomography angiography, but these eyes did not respond to anti–vascular endothelial growth factor treatment.

Conclusion:
The diagnosis of BD should be considered in patients presenting with SMD and recalcitrant subretinal fluid masquerading as neovascular age-related macular degeneration or chronic central serous chorioretinopathy to avoid unnecessary treatment procedures. The positive correlation of subfoveal choroidal thickness with age in BD patients may be a factor in the pathogenesis and development of SMD in this population. Recognizing the multimodal imaging features of SMD associated with BD, described in detail in this study, will guide practitioners to the accurate diagnosis of BD and reduce the risk of unnecessary intraocular procedures with potential complications.