bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Burden of Unintentional Injury Mortality Among American Indians/Alaska Natives in Michigan, Minnesota, and Wisconsin
Authors: Porter Meghan A. , Cirillo Lilli Alexandra N. , Schellinger Chalyse N. 
Published: July 2019

Objectives:
To characterize the burden of unintentional injury mortality among American Indians/Alaska Natives (AI/ANs) in Michigan, Minnesota, and Wisconsin and identify segments of the population that may especially benefit from policy and practice actions to reduce unintentional injury mortality risk factors.

Design:
Surveillance of mortality data from CDC WONDER and WISQARS online databases.

Setting:
The 3 states in the Indian Health Service (IHS) Bemidji Area: Michigan, Minnesota, and Wisconsin.

Participants:
AI/ANs and whites who died from unintentional injuries in 2011-2015 in Michigan, Minnesota, and Wisconsin.

Main Outcome Measure:
Unintentional injury mortality rates and AI/AN versus white unintentional injury mortality disparity ratios.

Results:
For all types of unintentional injury mortality, from 2011 to 2015, AI/ANs in the Bemidji Area died at an age-adjusted rate that was 77% higher than that for whites, a statistically significant difference. For AI/ANs in the 3-state area, the top cause of unintentional death was poisoning. The poisoning rate was a statistically significant 2.64 times as high for AI/ANs as that for whites, the highest disparity seen by type. When analyzed by age, gender, and rural/urban residence, unintentional injury mortality rates were almost always higher for AI/ANs. AI/ANs also had a much higher burden of years of potential life lost.

Conclusions:
Unintentional injury mortality significantly affects AI/ANs in the 3-state area and to a larger degree than for whites. However, some of the risk factors for unintentional injury are modifiable and, if addressed effectively, can reduce injury deaths. Governments, local leaders, organizations, and individuals can reduce AI/ANs' risk of unintentional injury by providing effective programming; encouraging or modeling behavior change; advocating for, creating, and enforcing laws and policies; and making infrastructure improvements. Increased attention to this topic and equitable efforts to reduce risk factors have great potential to reduce the burden of unintentional injury deaths for AI/ANs and all peoples.
Unilateral Absence of the Basal Ganglia on 123I-Ioflupane DaTScan
Authors: Baghdadi Yaser , Anh Se Jin , Brook Allan , Moadel Renee , Freeman Leonard M. 
Published: July 2019

Abstract
This 33-year-old man presented with hemorrhagic stroke manifesting with left hemiparesis and right ptosis. Angiography revealed no patent carotids. The anterior and middle cerebral arteries were filling collaterally through the posterior vertebrobasilar pathway. The presumptive diagnosis was moyamoya disease. The etiology of the bleeding was right basilar tip aneurysm that subsequently had partial coil placement. Months later, the neck of the aneurysm perforated and second coiling was performed. Later on follow-up, patient developed left hand tremor. A radionuclide DATscan revealed total absence of right-sided basal ganglia activity. A possible etiology was occlusion of the middle cerebral artery’s lenticulostriate branches.
Potential Causes of False-Negative Interpretations in 68Ga-PSMA PET/CT for the Detection of Local and Recurrent Prostate Cancer
Authors: Yakar Derya , Noordzij Walter , Kwee Thomas C. 
Published: July 2019

Abstract

68Ga-PSMA PET/CT has emerged as a highly promising diagnostic method for the evaluation of prostate cancer. Although it is increasingly recognized that its specificity is imperfect, data on false-negatives in the prostate have been underreported. We present 3 cases with false-negatives for local (recurrent) prostate cancer on 68Ga-PSMA PET/CT, using multiparametric MRI and histopathology as reference standard. Metal artifact of prostate gold markers placed for external beam radiation therapy, low level of PSMA uptake, and bladder spillover are potential causes of misinterpretation. Awareness of these diagnostic pitfalls may improve 68Ga-PSMA PET/CT interpretation.
Stem Cell Therapy and Hydrogen Sulfide: Conventional or Nonconventional Mechanisms of Action?
Authors: Jensen Amanda R. , Drucker Natalie A. , Olson Ken R. , Markel Troy A. 
Published: July 2019

ABSTRACT

Purpose:
Hydrogen sulfide (H2S) has many beneficial biological properties, including the ability to promote vasodilation. It has been shown to be released from stem cells and increased by hypoxia. Therefore, H2S may be an important paracrine factor in stem cell-mediated intestinal protection. We hypothesized that H2S created through conventional pathways would be a critical component of stem cell-mediated intestinal protection after ischemic injury.

Methods:
Human bone marrow-derived mesenchymal stem cells (BMSCs) were transfected with negative control siRNA (Scramble), or with siRNA to CBS, MPST, or CTH. Knockdown was confirmed with PCR and H2S gas assessed with AzMC fluorophore. Eight-week-old male mice then underwent intestinal ischemia for 60 min, after which time, perfusion was restored. BMSCs from each of the above groups were then placed into the mouse abdominal cavity before final closure. After 24 h, mice were reanesthetized and mesenteric perfusion was assessed by Laser Doppler Imaging (LDI). Animals were then sacrificed and intestines excised, placed in formalin, paraffin embedded, and stained with H & E. Intestines were then scored with a common mucosal injury grading scale.

Results:
PCR confirmed knockdown of conventional H2S-producing enzymes (CBS, MPST, CTH). H2S gas was decreased in MPST and CTH-transfected cells in normoxic conditions, but was not decreased compared with Scramble in any of the transfected groups in hypoxic conditions. BMSCs promoted increased mesenteric perfusion at 24 h postischemia compared with vehicle. Transfected stem cells provided equivalent protection. Histologic injury was improved with BMSCs compared with vehicle. CBS, MPST, and CTH knockdown cell lines did not have any worse histological injury compared with Scramble.

Conclusions:
Knocking down conventional H2S-producing enzymes only impacted gas production in normoxic conditions. When cells were transfected in hypoxic conditions, as would be expected in the ischemic intestines, H2S gas was not depressed. These data, along with unchanged perfusion and histological injury parameters with conventional enzyme knockdown, would indicate that alternative H2S production pathways may be initiated during hypoxic and/or ischemic events.
Hepatic Ablation Promotes Colon Cancer Metastases in an Immunocompetent Murine Model
Authors: Jones Edward L. , Halpern Alison L. , Carmichael Heather , Wikiel Krzysztof J. , Jones Teresa S. , Moore John T. , Robinson Thomas N. , Barnett Carlton C. 
Published: July 2019

Objective:
To determine the impact of radiofrequency (RF) and microwave (MW) energy compared to direct cautery on metatstatic colon cancer growth.

Background:
Hepatic ablation with MW and RF energy creates a temperature gradient around a target site with temperatures known to create tissue injury and cell death. In contrast, direct heat application (cautery) vaporizes tissue with a higher site temperature but reduced heat gradient on surrounding tissue. We hypothesize that different energy devices create variable zones of sublethal injury that may promote tumor recurrence. To test this hypothesis we applied MW, RF, and cautery to normal murine liver with a concomitant metastatic colon cancer challenge.

Methods:
C57/Bl6 mice received hepatic thermal injury with MW, RF, or cautery to create a superficial 3-mm lesion immediately after intrasplenic injection of 50K MC38 colon cancer cells. Thermal imaging recorded tissue temperature during ablation and for 10 seconds after energy cessation. Hepatic tumor location and volume was determined at day 7.

Results:
Cautery demonstrated the highest maximum tissue temperatures (129°C) with more rapid return to baseline compared to MW or RF energy. All mice had metastasis at the ablation site. Mean tumor volume was significantly greater in the MW (95.3 mm3; P = 0.007) and RF (55.7 mm3; P = 0.015) than cautery (7.13 mm3). There was no difference in volume between MW and RF energy (P = 0.2).

Conclusions:
Hepatic thermal ablation promotes colon cancer metastasis at the injury site. MV and RF energy result in greater metastatic volume than cautery. These data suggest that the method of energy delivery promotes local metastasis.
Real-World Effectiveness and Safety of Fingolimod in Patients With Relapsing Remitting Multiple Sclerosis: A Prospective Analysis in Buenos Aires, Argentina
Authors: Patrucco Liliana , Cristiano Edgardo , Sánchez Francisco , Miguez Jimena , Rojas Juan Ignacio 
Published: July 2019

Objectives
The aim of this prospective observational postmarketing study was to evaluate fingolimod effectiveness in a real-world setting in Buenos Aires, Argentina.

Methods
Relapsing remitting multiple sclerosis patients who had been prescribed fingolimod owing to treatment failure and had at least greater than or equal to 24 months of follow-up were included during August 2013 and June 2018. Three-monthly clinical evaluations and 12-monthly magnetic resonance were performed. Demographic and clinical variables were described as well as the safety and the effectiveness outcomes that included the proportion of patients free from clinical relapses, from disability progression, from new or enlarging T2 or T1 gadolinium-enhancing lesions on annual magnetic resonance imaging, and from any disease activity during the follow-up.

Results
A total of 97 patients were included (68% female [n = 66]; mean ± SD age, 30 ± 10.5 years; mean ± SD disease duration, 6.5 ± 3.1 years; mean ± SD Expanded Disability Status Scale, 3.5 ± 1; mean ± SD fingolimod use, 30 ± 13 months [range, 18–56 months]). One hundred percent (97) used previous disease-modifying therapy, mainly interferons (87%; n = 84). Fourteen patients (14.4%) discontinued/withdrew fingolimod (10 owing to disease activity and 4 owing to tolerance and personal decisions). Eighty-two percent were free from clinical relapses, and 85% were free from disability progression; 75% of patients remained free from new or newly enlarging T2 lesions, and 78% of patients were free from gadolinium enhancing lesions. The proportion of patients free from any disease activity was 54%.

Conclusions
The effectiveness of fingolimod in a newly real-world setting was consistent with information provided from phase III clinical trials.
Early assessment of molecular progression and response by whole-genome circulating tumor DNA in advanced solid tumors
Authors: Davis Andrew A. , Iams Wade T. , Chan David , Oh Michael S. , Lentz Robert W. , Peterman Neil , Robertson Alex , Shah Abhik , Srivas Rohith , Wilson Timothy , Lambert Nicole , George Peter , Wong Becky , Wood Haleigh , Close Jason , Tezcan Ayse , Nesmith Ken , Tezcan Haluk , Chae Young Kwang 
Published: July 2019

AbstractTreatment response assessment for patients with advanced solid tumors is complex and existing methods require greater precision. Current guidelines rely on imaging, which has known limitations, including the time required to show a deterministic change in target lesions. Serial changes in whole-genome (WG) circulating tumor DNA (ctDNA) were used to assess response or resistance to treatment early in the treatment course. 96 patients with advanced cancer were prospectively enrolled (91 analyzed and 5 excluded), and blood was collected before and after initiation of a new, systemic treatment. Plasma cell-free DNA libraries were prepared for either WG or WG bisulfite sequencing. Longitudinal changes in the fraction of ctDNA were quantified to retrospectively identify molecular progression (MP) or major molecular response (MMR). Study endpoints were concordance with first follow-up imaging (FFUI) and stratification of progression-free survival (PFS) and overall survival (OS). Patients with MP (n=13) had shorter PFS (median 62d vs. 310d) and OS (255d vs. not reached). Sensitivity for MP to identify clinical progression was 54% and specificity was 100%. MP calls were from samples taken a median of 28d into treatment and 39d before FFUI. Patients with MMR (n=27) had longer PFS and OS compared to those with neither call (n=51). Molecular response assessment can potentially enable early switching to potentially effective therapies, therefore minimizing side effects and costs associated with additional cycles of ineffective treatment. MMR may present a novel endpoint to target to improve long-term patient outcomes.
Use of viral load to improve survey estimates of known HIV-positive status and antiretroviral treatment coverage in Kenya
Authors: Young Peter W. , Zielinski-Gutierrez Emily , Wamicwe Joyce , Mukui Irene , Kim Andrea A. , Waruru Anthony , Zeh Clement , Kretzschmar Mirjam E. , De Cock Kevin M. 
Published: July 2019

AbstractObjectiveTo compare alternative methods of adjusting self-reported knowledge of HIV-positive status and antiretroviral (ARV) therapy use based on undetectable viral load (UVL) and ARV detection in blood.DesignPost hoc analysis of nationally-representative household survey to compare alternative biomarker-based adjustments to population HIV indicators.MethodsWe reclassified HIV-positive participants aged 15–64 years in the 2012 Kenya AIDS Indicator Survey (KAIS) that were unaware of their HIV-positive status by self-report as aware and on antiretroviral treatment if either ARVs were detected or viral load was undetectable (<550 copies/mL) on dried blood spots. We compared self-report to adjustments for ARVs measurement, UVL, or both.ResultsTreatment coverage among all HIV-positive respondents increased from 31.8% for self-report to 42.5% [95% confidence interval (CI) 37.4–47.8] based on ARV detection alone, to 42.8% (95% CI 37.9–47.8) when ARV-adjusted, 46.2% (95% CI 41.3–51.1) when UVL-adjusted and 48.8% (95% CI 43.9–53.8) when adjusted for either ARV or UVL. Awareness of positive status increased from 46.9% for self-report to 56.2% (95% CI 50.7– 61.6) when ARV-adjusted, 57.5% (95% CI 51.9–63.0) when UVL-adjusted, and 59.8% (95% CI 54.2–65.1) when adjusted for either ARV or UVL.ConclusionsUndetectable viral load, which is routinely measured in surveys, may be a useful adjunct or alternative to ARV detection for adjusting survey estimates of knowledge of HIV status and antiretroviral treatment coverage.
Hospital Resource Utilization in Epilepsy: Disparities in Rural vs Urban Care
Authors: Bensken Wyatt P. , Norato Gina , Khan Omar I. 
Published: July 2019

SummaryObjectiveThis study assessed differences in resource utilization during epilepsy and seizure related hospitalizations in urban versus rural environments, to identify potential disparities in care for people living with epilepsy in rural communities.MethodsA 10 year (2001 to 2011) state-wide hospital discharge database was used. Cost, length of stay, illness severity, and procedure use were compared between urban facilities, rural facilities, and epilepsy centers. Comparison across three separate years helped to identify differences between facility type as well as to assess practices changes within facilities over time.ResultsAverage total charges between the three types of facilities was significantly different, with epilepsy centers having the highest average charge per patient, followed by urban and rural facilities (corrected p-values < 0.001). Illness severity was similar between the three groups, with the exception that epilepsy centers had a higher proportion of major severity cases. Length of stay remained fairly consistent across all three years for epilepsy centers (mean: 4.75 days), while decreasing for urban facilities (means: 4.39 to 3.72) and ultimately decreasing for rural facilities (mean: 3.31 to 3.09). Rates of procedure utilization revealed CT scan use persisted longer at rural facilities compared to urban facilities, while EEG and vEEG was low at rural facilities. vEEG was relatively restricted to epilepsy centers and had an initial substantial rise in use over the years and was associated with corresponding greater surgical procedure rates.SignificanceThis study indicates a measurable difference between epilepsy centers, urban facilities, and rural facilities in cost and procedure utilization while caring for patients during epilepsy- and seizure-related hospitalizations. If these conclusions are valid, they support that persons living with epilepsy who live in rural communities and utilize these services receive care that is considered suboptimal when compared to urban centers or epilepsy centers.
Multidimensional factors predicting exclusive breastfeeding in Ethiopia: evidence from a meta-analysis of studies in the past 10 years
Authors: Habtewold Tesfa Dejenie , Endalamaw Aklilu , Mohammed Shimels Hussien , Mulugeta Henok , Dessie Getenet , Kassa Getachewu Mullu , Asmare Yared , Tadesse Mesfin , Alemu Yihun Mulugeta , Sharew Niguse Tadesse , Tura Abera Kenay , Tegegne Balewgizie Sileshi , Alemu Sisay Mulugeta 
Published: July 2019

AbstractBackgroundIn Ethiopia, the prevalence of exclusive breastfeeding (EBF) is 60.1%, which is lower than the national Health Sector Transformation Plan 2016-2020, National Nutrition Program 2016–2020 and WHO global target. This may be attributed to multidimensional factors.ObjectiveThe aim of this meta-analysis was to investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia.MethodsDatabases used were PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library, and key terms were searched using interactive searching syntax. It was also supplemented by manual searching. Observational studies published between September 2000 and March 2019 were included. The methodological quality of studies was examined using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Data were extracted using the Joanna Briggs Institute (JBI) data extraction tool. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran’s Q test, τ2, and I2 statistics. Additional analysis conducted includes Jackknife sensitivity analysis, cumulative meta-analysis, and meta-regression analysis.ResultsOut of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all studies were conducted on mothers with newborn less than 23 months. Maternal educational status (OR = 1.39; p = 0.03; 95% CI = 1.03 - 1.89; I2 = 86.11%), household income (OR = 1.27; p = 0.02; 95% CI = 1.05 - 1.55; I2 = 60.9%) and marital status (OR = 1.39; p = 0.02; 95% CI = 1.05 - 1.83; I2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose-response relationship of EBF with educational status and income. Significant association was not observed between EBF and parity, media exposure and paternal educational status.ConclusionsIn this meta-analysis, we depicted the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase national breastfeeding rates in Ethiopia.
Analyzing the Reversal Hypothesis of Obesity with Education: A Cross-Sectional Study of Adult Females in 34 Low- and Lower-Middle-Income Countries
Authors: Tang Cynthia Y. , Woldu Henok G. , Sheets Lincoln R. 
Published: July 2019

AbstractSettingObesity, once considered an epidemic of the developed world, is now becoming an even more prominent problem than underweight in low and lower middle income countries (LLMICs). Ample literature has shown that as a country’s income increases, the burden of obesity shifts from the rich to the poor. This is known as the “Reversal Hypothesis.” Many studies have explored the effects of various social determinants of health on obesity, but few have studied education as an independent variable on female obesity across LLMICs.ObjectiveGlobally, adult females have a higher prevalence of obesity and the obesity shift occurs more quickly for women than for men. We aim to address this disparity and contribute towards the reversal hypothesis by exploring the association of education and obesity in women in LLMICs.DesignIn this cross-sectional study, we used a multi-national and multi-year database from the publicly available Demographic and Health Surveys program with data from 34 LLMICs. Education levels are standardized across countries during survey collection.ResultsOur age-adjusted prevalence ratio (AA-PR) analysis shows that women in LLMICs with higher education have a significantly greater prevalence of obesity than women with no education. We analyzed this phenomenon by individual nations, continents, and income classifications. Educated women living in low income countries are 5.12 times more obese than uneducated women (AA-PR, 95% CI=4.75, 5.53) and 3.42 times more obese in lower middle income countries (AA-PR, 95% CI=3.31, 3.54).ConclusionThese findings highlight a need for more studies and policy attention focusing on female education levels, among other factors, to understand, predict, and prevent obesity in LLMICs.ARTICLE SUMMARYStrengths and limitations of this studyA rigorous sample size of 943,947 adult females in 34 LLMIC countries was utilized to study the association between adult female obesity and education level.Age-adjusted and age-and-wealth-adjusted prevalence ratios of obesity were analyzed based on 34 individual nations, three continents, and two major income categories.This study includes the most recent data available through the Demographic and Health Surveys program, which standardizes education levels during data collection, allowing for comparison between all surveyed countries.This study is limited by the relatively small number of countries for which data is available through the DHS dataset, and thus, further research will be needed to show whether these results are generalizable to other LLMICs.
CpG-creating Mutations are Costly in Many Human Viruses
Authors: Caudill Victoria R. , Qin Sarina , Winstead Ryan , Kaur Jasmeen , Tisthammer Kaho , Pineda E. Geo , Carja Oana , Eggo Rosalind M , Koelle Katia , Lythgoe Katrina , Roy Scott , Allen Nicole , Aviles Milo , Baker Brittany A. , Bauer William , Bermudez Shannel , Carlson Corey , Catalan Francisca L. , Chemel Angeline Katia , Evans Dwayne , Fiutek Natalie , Fryer Emily , Goodfellow Samuel Melvin , Hecht Mordecai , Hopp Kellen , Hopson E. Deshawn , Jaberi Amirhossein , Kinney Christen , Lao Derek , Le Adrienne , Lo Jacky , Lopez Alejandro G. , López Andrea , Lorenzo Fernando G , Luu Gordon T , Mahoney Andrew R , Melton Rebecca L. , Nascimento Gabriela Do , Pradhananga Anjani , Rodrigues Nicole S. , Shieh Annie , Sims Jasmine , Singh Rima , Sulaeman Hasan , Thu Ricky , Tran Krystal , Tran Livia , Winters Elizabeth J. , Wong Albert , Pennings Pleuni S. 
Published: July 2019

AbstractMutations can occur throughout the virus genome and may be beneficial or deleterious. We are interested in mutations that yield a C next to a G, producing CpG sites. CpG sites are rare in eukaryotic and viral genomes. For the eukaryotes, it is thought that CpG sites are rare because they are prone to mutation when methylated. In viruses, we know less about why CpG sites are rare. A previous study in HIV suggested that CpG-creating transition mutations are more costly that similar non-CpG-creating mutations. To determine if this is the case in other viruses, we analyzed the allele frequencies of CpG-creating and non-CpG-creating mutations across various strains, subtypes, and genes of viruses using existing data obtained from Genbank, HIV Databases, and Virus Pathogen Resource. Our results suggest that CpG sites are costly for most viruses. By understanding the cost of CpG sites, we can obtain further insights into the evolution and adaptation of viruses.