bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apolipoprotein E4 genotype in combination with poor metabolic profile is associated with reduced cognitive performance in healthy postmenopausal women: implications for late onset Alzheimer's disease
Authors: Karim Roksana , Koc Melissa , Rettberg Jamaica R. , Hodis Howard N. , Henderson Victor W. , St. John Jan A. , Allayee Hooman , Brinton Roberta D. , Mack Wendy J. 
Published: July 2018

Abstract

Objective:
We hypothesized the association of metabolic profile on cognition in postmenopausal women will be greater among ApoE4 carriers compared with noncarriers.

Methods:
Metabolic biomarkers and measures of global cognition, executive functions, and verbal memory, collected among postmenopausal females, were used in this analysis. Clustering analyses of metabolic biomarkers revealed three phenotypes: healthy, predominantly hypertensive, and poor metabolic with (borderline normal laboratory values). General linear models tested whether an association of metabolic cluster with cognition differed by ApoE4 genotype.

Results:
In the total sample of 497 women, verbal memory was lower in the poor metabolic cluster (P = 0.04). Among ApoE4+ women, performance in all cognitive domains was lowest in the poor metabolic cluster. Differences in executive functions among metabolic clusters were detected only in ApoE4+ women (P value for interaction = 0.003).

Conclusions:
In a general population of postmenopausal women, association between poor metabolic profile with reduction in cognitive performance is more apparent in women who carry an ApoE4 allele. These data indicate a window of opportunity for interventions to reverse the trajectory of the preclinical phase of Alzheimer's disease.
Conceptualization, Assessment, and Treatment of Traumatic Stress in First Responders: A Review of Critical Issues
Authors: Lewis-Schroeder Nina F. , Kieran Kathryn , Murphy Beth L. , Wolff Jonathan D. , Robinson Matthew A. , Kaufman Milissa L. 
Published: July 2018

AbstractFirst responders are regularly confronted with exposure to traumatic events, including potentially life-threatening situations as well as the grave injuries and deaths of colleagues and civilians. Evidence indicates that the prevalence of posttraumatic stress disorder (PTSD) is substantially higher among first responders than the general population. This article provides information about the outpatient trauma services at McLean Hospital’s LEADER (Law Enforcement, Active Duty, Emergency Responder) program to assist clinicians who encounter these first responders in their practices or who are specifically interested in working with this patient population. We begin by synthesizing the literature on the prevalence of PTSD in first responders following work-related exposure to traumatic stress, and by addressing the occupation-specific risk factors and the third-variable risk factors that may contribute to potentiated risk. We then discuss assessment strategies and treatment options used in our program, which is tailored for individuals who are dealing with mental health issues stemming from occupation-specific traumatic-stress exposure. We also address the unique challenges of treating traumatized first responders with more complex issues such as traumatic stress exposure across the lifespan and safety issues, including acute suicidality. We conclude by discussing notable gaps in the literature, including the need to investigate why and how women present with different PTSD symptoms than men and how these differences need to be taken into account in determining appropriate treatment for women.
Obesity and Overweight Problems Among Individuals 1 to 25 Years Following Acute Rehabilitation for Traumatic Brain Injury: A NIDILRR Traumatic Brain Injury Model Systems Study
Authors: Dreer Laura E. , Ketchum Jessica M. , Novack Thomas A. , Bogner Jennifer , Felix Elizabeth R. , Corrigan John D. , Johnson-Greene Doug , Hammond Flora M. 
Published: July 2018

Objective:
Examine the prevalence of weight classifications and factors related to obesity/overweight among persons 1 to 25 years following traumatic brain injury (TBI) using the Traumatic Brain Injury Model Systems national database.

Design:
Multicenter, cross-sectional, observational design.

Setting:
Traumatic Brain Injury Model Systems inpatient rehabilitation facilities.

Participants:
Persons (N = 7287) 1, 2, 5, 10, 15, 20, or 25 years after TBI who required inpatient acute rehabilitation.

Main Outcome Measures:
Body mass index, demographic characteristics, functional, health, satisfaction with life, and global outcomes.

Results:
Overall postinjury weight prevalence rates were 23% obese, 36% overweight, 39% normal, and 3% underweight. Higher rates for obesity and overweight problems were associated with increasing time since injury. Younger (18-19 years) and older (80+ years) age, those in a vegetative state, and those reporting excellent health were less likely to be obese. Individuals with a history of hypertension, heart failure, or diabetes were more likely to be obese.

Conclusions:
Being obese or overweight presents a health risk in the years following rehabilitation for TBI. The findings support the need for longitudinal studies and highlight the advisability of monitoring weight and promoting healthy lifestyle behaviors over time in survivors of TBI.
Human Papillomavirus Correlates With Histologic Anal High-Grade Squamous Intraepithelial Lesions in Hispanics With HIV
Authors: Medina-Laabes Diana T. , Suarez-Perez Erick L. , Guiot Humberto M. , Muñoz Cristina , Colón-López Vivian , Tirado-Gómez Maribel , Ortiz Ana Patricia 
Published: July 2018

Objective
To estimate the magnitude of association between anal infection with high-risk human papilloma virus (HR-HPV) types and severity of biopsy-confirmed histopathological anal squamous intraepithelial lesions (SILs) among a clinic-based sample of HIV-infected adults in Puerto Rico.

Methods
This cross-sectional study analyzed data from medical records of adult patients who visited a specialized anal neoplasia clinic from June 2015 to December 2017 (n = 239); sociodemographics, behavioral risk factors, medical history, clinical data, and pathology reports were collected. The magnitude of association between anal HR-HPV and severity of anal SIL, adjusted for potential confounders, was assessed using a multinomial logistic model.

Results
A 78.7% of patients had anal HR-HPV infection, 43.9% had histopathological low-grade SIL (LSIL), and 37.7% had histopathological high-grade SIL (HSIL). The prevalence of anal HR-HPV infection was 63.6% among patients with no anal SIL, 70.5% for those with LSIL and 95.6% for those with HSIL. After adjusting for different predictors, patients with anal HR-HPV infection were more likely to have HSIL (odds ratio, 11.0; 95% confidence interval, 3.2-37.2) than those without anal HR-HPV infection, whereas no significant excess was observed for LSIL (odds ratio, 1.4; 95% confidence interval, 0.6-3.1).

Conclusions
This study showed a strong association between anal HR-HPV infection and HSIL. Likewise, a high prevalence of anal HR-HPV infection and presence of anal SIL was observed among HIV-infected individuals. Our result highlights the importance of screening for anal HR-HPV infection and anal SIL and optimizing strategies for HPV vaccination in HIV-infected individuals.
Treatment of hepatitis C with direct-acting antivirals significantly reduces liver-related hospitalizations in patients with cirrhosis
Authors: Hill Lucas A. , Delmonte Ronnie J. , Andrews Barbara , Richards Lisa , Soto Robin , Collier Summer , Kuo Alexander , Cachay Edward 
Published: July 2018

Background
The availability of direct-acting antivirals (DAA) for the treatment of hepatitis C (HCV) has resulted in the ability to safely and effectively treat patients with cirrhosis and end-stage liver disease. However, information is limited with regard to the impact of DAA treatment on inpatient health-related resource utilization in patients with advanced HCV-related cirrhosis. We aimed to ascertain the impact of DAA treatment on the frequency of liver-related hospitalizations and associated costs in patients with cirrhosis.

Patients and methods
Retrospective cohort analysis carried out at a single US reference center that compared patients with HCV cirrhosis according to treatment status: the untreated group (January 2011 to December 2013) and the DAA-treated group (January 2014 to March 2017). The primary outcome was the difference in the incidence rate of liver-related hospitalizations. Secondary outcomes included differences in the incidence of hepatocellular carcinoma, liver transplant, and all-cause mortality. We calculated the projected savings per-patient treated per-year on the basis of calculated hospitalization rate stratified by Child–Turquotte–Pugh (CTP) score.

Results
Baseline characteristics were similar between the untreated (n=182) and DAA-treated (n=196) cohorts. Mean follow-up time in the untreated and treated cohort was 20.4 and 17.7 months, respectively. The incidence rates of liver-related hospitalizations were 29.1/100 and 10.4/100 person-years of follow-up (P≤0.0001) in the untreated and treated cohorts, respectively. This was accounted for by a decreased incidence of hospitalizations in patients with CTP-A (75.8%) and CTP-B (64.5%), but not CTP-C.

Conclusion
Successful DAA treatment reduces hospitalization rate and resource utilization costs in patients with CTP-A and CTP-B, but not in those with CTP-C.
The Potential of Glycemic Control and Body Weight Change as Early Markers for Pancreatic Cancer in Patients With Long-standing Diabetes Mellitus
Authors: Mueller Alexandra M. , Meier Christoph R. , Jick Susan S. , Schneider Cornelia 
Published: July 2018

Objectives
The aim of this study was to characterize the role of glycemic control and weight change as markers for pancreatic cancer (PaC) in patients with long-standing diabetes.

Methods
We conducted case-control analyses in patients with long-standing diabetes (>2 years) in the United Kingdom–based Clinical Practice Research Datalink. Cases were patients with PaC matched to control subjects on variables including age, sex, and diabetes duration. We compared glycated hemoglobin (HbA1c) levels, blood glucose levels, and weight change before cancer detection (matched date) between cases and control subjects to assess associations between the potential markers and PaC.

Results
Cases were more likely than control subjects to have high HbA1c levels. The adjusted odds ratio (aOR) was 4.94 (95% confidence interval [CI], 3.52–6.94) for HbA1c of 64.0 mmol/mol or greater compared with HbA1c of 47.5 mmol/mol or less within 6 months before cancer detection and within >1 to 2 years, 2.66 (95% CI, 2.00–3.54). Weight loss was also more common in cases, with an aOR of 15.40 (95% CI, 10.65–22.26) for loss of 15.0% body weight or greater compared with stable weight. The aOR for patients with both weight loss of 15.0% or greater and high HbA1c at 2 years or less before diagnosis was 60.97 (95% CI, 35.87–103.65), compared with patients with neither.

Conclusions
Poor glycemic control and weight loss, particularly in combination, may be useful early markers for PaC in patients with long-standing diabetes.
Systemic Depletion of Nerve Growth Factor Inhibits Disease Progression in a Genetically Engineered Model of Pancreatic Ductal Adenocarcinoma
Authors: Saloman Jami L. , Singhi Aatur D. , Hartman Douglas J. , Normolle Daniel P. , Albers Kathryn M. , Davis Brian M. 
Published: July 2018

Objectives
In patients with pancreatic ductal adenocarcinoma (PDAC), increased expression of proinflammatory neurotrophic growth factors (eg, nerve growth factor [NGF]) correlates with a poorer prognosis, perineural invasion, and, with regard to NGF, pain severity. We hypothesized that NGF sequestration would reduce inflammation and disease in the KPC mouse model of PDAC.

Methods
Following biweekly injections of NGF antibody or control immunoglobulin G, beginning at 4 or 8 weeks of age, inflammation and disease stage were assessed using histological, protein expression, and quantitative polymerase chain reaction analyses.

Results
In the 8-week anti-NGF group, indicators of neurogenic inflammation in the dorsal root ganglia (substance P and calcitonin gene–related peptide) and spinal cord (glial fibrillary acidic protein) were significantly reduced. In the 4-week anti-NGF group, TRPA1 mRNA in dorsal root ganglia and spinal phosphorylated ERK protein were elevated, but glial fibrillary acidic protein expression was unaffected. In the 8-week anti-NGF group, there was a 40% reduction in the proportion of mice with microscopic perineural invasion, and no macrometastases were observed.

Conclusions
Anti-NGF treatment beginning at 4 weeks may increase inflammation and negatively impact disease. Treatment starting at 8 weeks (after disease onset), however, reduces neural inflammation, neural invasion, and metastasis. These data indicate that NGF impacts PDAC progression and metastasis in a temporally dependent manner.
Impact of the Controlling Nutritional Status Score on the Prognosis After Curative Resection of Pancreatic Ductal Adenocarcinoma
Authors: Kato Yoshiyasu , Yamada Suguru , Suenaga Masaya , Takami Hideki , Niwa Yukiko , Hayashi Masamichi , Iwata Naoki , Kanda Mitsuro , Tanaka Chie , Nakayama Goro , Koike Masahiko , Fujiwara Michitaka , Kodera Yasuhiro 
Published: July 2018

Objectives
The controlling nutritional status (CONUT) score is a useful tool to evaluate immune-nutritional status. This study aimed to investigate the impact of the CONUT score on short- and long-term outcomes after curative resection of pancreatic ductal adenocarcinoma (PDAC).

Methods
Consecutive 344 PDAC patients receiving pancreatectomy without neoadjuvant therapy were examined retrospectively. After the best predictive value of the CONUT score for survival was identified, association between the CONUT score and long-term outcomes was evaluated using log-rank tests and a Cox regression model. Then correlations between the CONUT score and postoperative complications were analyzed.

Results
The optimal cutoff value of the CONUT score was 4. The high CONUT score group showed significantly lower overall survival than the low CONUT score group (P = 0.002). In contrast, no significant difference in recurrence-free survival was found (P = 0.43). A multivariate analysis demonstrated that high CONUT score had an independent association with overall survival (hazard ratio, 1.64; P = 0.003). The CONUT score showed no association with postoperative pancreatic fistula, Clavien-Dindo grade, or postoperative hospital stay.

Conclusion
The CONUT score had an independent association with survival in patients with PDAC after pancreatectomy and was not associated with recurrence or postoperative complications.
Multimodal Treatment Strategies for Esophageal Perforation
Authors: Horvath Philipp , Lange Jessica , Stüker Dietmar , Wichmann Dörte , Hilbert Julia , Götz Martin , Königsrainer Alfred , von Feilitzsch Maximilian , Zdichavsky Marty 
Published: July 2018

Purpose:
Esophageal perforation constitutes a potentially life-threatening condition, and this study aimed to evaluate the indications and outcome for the different treatment modalities.

Patients and Methods:
In total, 43 patients with esophageal perforation were considered for this retrospective analysis. Age, sex, length of hospital stay and intensive care treatment, in-hospital mortality, localization of perforation and etiology, treatment modality, and 90-day morbidity were analyzed.

Results:
Most patients suffered from Boerhaave syndrome and from iatrogenic esophageal perforation. In total, 63% of patients (26/41) received successful nonoperative treatment, whereas 36% required additional surgery. Two patients (5%) underwent primary surgery. In all cases no esophagectomy was necessary. In-hospital mortality was 7%. During the 90-day follow-up 1 patient with stenosis required repetitive dilatations.

Conclusions:
Initial endoscopic treatment, either by stent or by endosponge, alone or combined with an additional operative treatment, seems feasible in patients suffering from esophageal perforation. In all patients, there was no need for esophagectomy.
Congenital Oculonasal Synkinesis
Authors: Torrado Laura A. , Hamilton Grant S. , Brodsky Michael C. 
Published: July 2018

Abstract:
A 4-year-old girl with maxillary hypoplasia, intermittent exotropia, and high myopia displayed congenital oculonasal synkinesis. We examine the implications for pathogenesis of these disparate craniofacial findings.
Segmentation of Myelin-like Signals on Clinical MR Images for Age Estimation in Preterm Infants
Authors: Deprez Maria , Wang Siying , Ledig Christian , Hajnal Joseph V. , Counsell Serena J. , Schnabel Julia A. 
Published: July 2018

AbstractMyelination is considered to be an important developmental process during human brain maturation and closely correlated with gestational age. Assessment of the myelination status requires dedicated imaging, but the conventional T2-weighted scans routinely acquired during clinical imaging of neonates carry signatures that are thought to be associated with myelination. In this work, we propose a new segmentation method for myelin-like signals on T2-weighted magnetic resonance images that could be used to assess neonatal brain maturation in clinical practice. Firstly we define a segmentation protocol for myelin-like signals, and delineate manual annotations according to this protocol. We then develop an expectation-maximization framework through which we obtain the automatic segmentations of myelin-like signals. We incorporate an explicit class for partial volume voxels whose locations are configured in relation to the composing pure tissues via second-order Markov random fields. We conduct experiments in the thalami and brainstem where the majority of myelination occurs during the perinatal period for 16 test subjects aged between 29 and 44 gestational weeks. The proposed method performs accurately and robustly in both regions with respect to the manual annotations over a range of intensity percentile thresholds that are used to generate the initial segmentation estimates. Finally, we construct spatio-temporal growth models for myelin-like signals in the thalami and brain-stem to demonstrate the applicability of the proposed method for age estimation in preterm infants.
Preparing for the worst: Evidence that older adults proactively downregulate negative affect
Authors: Corbett Brittany , Rajah M. Natasha , Duarte Audrey 
Published: July 2018

AbstractAge-related differences in processing emotional stimuli are well established. However, previous studies have only assessed the impact of age on emotional processing and encoding in response to, not in anticipation of, emotional stimuli. In the current study, we investigated age-related differences in the impact of emotional anticipation on affective responses and episodic memory for emotional images. Young and older were scanned while encoding negative and neutral images preceded by cues that were either valid or invalid predictors of image valence. Participants were asked to rate the emotional intensity of the images and to complete an episodic recognition task immediately after scanning. Using multivariate behavioral partial least squares (PLS) analysis, we found that young and older adults recruit the same set of brain regions to differentially support emotional processing during the anticipation of emotional images. Specifically, anticipatory recruitment of the amygdala, ventromedial PFC, and hippocampus in older adults predicts reduced memory for negative than neutral images for older adults and the opposite for young adults. Seed PLS analyses further show inverse coupling between the amygdala and ventromedial PFC activation following negative cues, consistent with the top-down spontaneous suppression of negative affect. To the best of our knowledge, this is the first study to provide evidence that the “positivity effect” seen in older adults’ memory performance is related to the spontaneous suppression of negative affect in anticipation of, not just in response to, negative stimuli.
Context Dependence of Biological Circuits
Authors: Catanach Thomas A. , McCardell Reed , Baetica Ania-Ariadna , Murray Richard M. 
Published: July 2018

AbstractIt has been an ongoing scientific debate whether biological parameters are conserved across experimental setups with different media, pH values, and other experimental conditions. Our work explores this question using Bayesian probability as a rigorous framework to assess the biological context of parameters in a model of the cell growth controller in Youet al. When this growth controller is uninduced, theE. colicell population grows to carrying capacity; however, when the circuit is induced, the cell population growth is regulated to remain well below carrying capacity. This growth control controller regulates theE. colicell population by cell–cell communication using the signaling molecule AHL and by cell death using the bacterial toxin CcdB.To evaluate the context dependence of parameters such as the cell growth rate, the carrying capacity, the AHL degradation rate, the leakiness of AHL, the leakiness of toxin CcdB, and the IPTG induction factor, we collect experimental data from the growth control circuit in two different media, at two different pH values, and with several induction levels. We define a set of possible context-dependencies that describe how these parameters may differ with the experimental conditions and we develop mathematical models of the growth controller across the different experimental contexts. We then determine whether these parameters are shared across experimental contexts or whether they are context-dependent. For each of these possible context-dependencies, we use Bayesian inference to assess its plausibility and to estimate the growth controller’s parameters assuming this context-dependency. Ultimately, we find that there is significant experimental context-dependence in this circuit. Moreover, we also find that the estimated parameter values are sensitive to our assumption of a context relationship.