bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of chronic liver diseases in the USA in the past three decades
Authors: Younossi Zobair M , Stepanova Maria , Younossi Youssef , Golabi Pegah , Mishra Alita , Rafiq Nila , Henry Linda 
Published: July 2019

ObjectiveGiven significant advances in treatment of viral hepatitis and the growing epidemic of obesity, the burden of the different types of liver diseases in the USA may be changing. Our aim was to assess the shift in the prevalence of different liver disease aetiologies in the USA over the past three decades.DesignNational Health and Nutrition Examination Surveys (NHANES; cross-sectional 1988–1994 and 1999–2016) were used.ResultsA total of 58 731 adults from NHANES (1988–2016) were included. Over the study period, the prevalence of chronic hepatitis B and alcoholic liver disease remained stable: 0.3%–0.4% and 0.8%–1.0%, respectively (p>0.05). The prevalence of chronic hepatitis C decreased nearly twofold: 1.6% in 1988–1994 to 0.9% in 2013–2016 (p=0.03). In contrast, the prevalence of non-alcoholic fatty liver disease (NAFLD; by US-Fatty Liver Index) increased from 20.0% (1988–1994) to 28.3% (1999–2004) to 33.2% (2009–2012) and 31.9% (2013–2016) (p<0.0001). Furthermore, steady increases were observed in the rates of obesity (22.2% in 1988–1994 to 31.0% in 1999–2004 to 38.9% in 2013–2016), type 2 diabetes mellitus (T2DM) (from 7.2% to 8.2% to 13.5% same years), insulin resistance and hypertension (all p<0.0001). Yearly trend analyses showed that the only LD with consistently increasing prevalence was NAFLD (trend p=0.01). Multivariable regression analysis showed that obesity (OR 10.4; 95% CI 9.5 to 11.3) and T2DM (OR 3.7; 95% CI 3.2 to 4.2) were the major independent predictors of NAFLD.ConclusionsOver the past 30 years in the USA, NAFLD is the only liver disease with growing prevalence, synchronous with the increasing rates of obesity and T2DM.
Distinct features of bivalent direct thrombin inhibitors, hirudin and bivalirudin, revealed by clot waveform analysis and enzyme kinetics in coagulation assays
Authors: Wakui Masatoshi , Fujimori Yuta , Nakamura Shoko , Kondo Yoshino , Kuroda Yuko , Oka Shusaku , Nakagawa Terumichi , Katagiri Hisako , Murata Mitsuru 
Published: July 2019

AimsBivalent direct thrombin inhibitors (DTIs), hirudin and bivalirudin, bind to the active site and exosite 1 of thrombin irreversibly and reversibly, respectively. The present study aims to assess in vitro effects of hirudin and bivalirudin through clot waveform analysis (CWA) and enzyme kinetics in coagulation assays.MethodsThe pooled normal plasma and its dilutions were spiked with hirudin or bivalirudin. The activated partial thromboplastin time (APTT) assay and the Clauss fibrinogen assay were performed using the CS-5100 (Sysmex). The APTT-CWA data were automatically gained by the CS-5100 programme.ResultsIn APTT-CWA, the maximum coagulation velocity, acceleration and deceleration were decreased dependently on the drug concentrations, demonstrating evidence for the blockade of thrombin-positive feedback by hirudin or bivalirudin. The Hill plot analysis was applied to the dose-dependent curves in bivalirudin. The Hill coefficients were greater than 1, showing positive anticoagulant cooperativity. Regarding the dose-dependent curves in hirudin, all the parameters dropped to almost zero without making an asymptotic line. In the Clauss fibrinogen assay, the Lineweaver-Burk plots demonstrated that both drugs exhibit mixed inhibition mimicking uncompetitive binding. The Dixon plots in bivalirudin were linear and supported the inhibition type described above. The Dixon plots in hirudin were non-linear and inappropriate to use for determination of the inhibition type. In addition, the inverse function of the clotting time appeared to drop to zero without making an asymptotic line, suggesting complete loss of thrombin activity by irreversible binding.ConclusionsThe results provide insights into anticoagulation with bivalent DTIs.
Eating “junk food” has opposite effects on intrinsic excitability of nucleus accumbens core neurons in obesity-susceptible versus -resistant rats
Authors: Oginsky Max F. , Ferrario Carrie R. 
Published: July 2019

The nucleus accumbens (NAc) plays critical roles in motivated behaviors, including food seeking and feeding. Differences in NAc function contribute to overeating that drives obesity, but the underlying mechanisms are poorly understood. In addition, there is a fair degree of variation in individual susceptibility versus resistance to obesity that is due in part to differences in NAc function. For example, using selectively bred obesity-prone and obesity-resistant rats, we have found that excitability of medium spiny neurons (MSNs) within the NAc core is enhanced in obesity-prone versus -resistant populations, before any diet manipulation. However, it is unknown whether consumption of sugary, fatty “junk food” alters MSN excitability. Here whole cell patch-clamp recordings were conducted to examine MSN intrinsic excitability in adult male obesity-prone and obesity-resistant rats with and without exposure to a sugary, fatty junk food diet. We replicated our initial finding that basal excitability is enhanced in obesity-prone versus obesity-resistant rats and determined that this is due to a lower fast transient potassium current ( IA) in prone versus resistant groups. In addition, the junk food diet had opposite effects on excitability in obesity-prone versus obesity-resistant rats. Specifically, junk food enhanced excitability in MSNs of obesity-resistant rats; this was mediated by a reduction in IA. In contrast, junk food reduced excitability in MSNs from obesity-prone rats; this was mediated by an increase in inward-rectifying potassium current. Thus individual differences in obesity susceptibility influence both basal excitability and how MSN excitability adapts to junk food consumption. NEW & NOTEWORTHY Medium spiny neurons (MSNs) in the nucleus accumbens of obesity-prone rats are hyperexcitable compared with MSNs from obesity-resistant rats. We found that 10 days of “junk food” exposure reduces MSN excitability in obesity-prone rats by increasing inward-rectifying potassium current and increases MSN excitability in obesity-resistant rats by decreasing fast transient potassium current. These data show that there are basal and junk food diet-induced differences in MSN excitability in obesity-prone and obesity-resistant individuals; this may contribute to previously observed differences in incentive motivation.
Sustained envelope periodicity representations are associated with speech-in-noise performance in difficult listening conditions for younger and older adults
Authors: McClaskey Carolyn M. , Dias James W. , Harris Kelly C. 
Published: July 2019

Temporal modulations are an important part of speech signals. An accurate perception of these time-varying qualities of sound is necessary for successful communication. The current study investigates the relationship between sustained envelope encoding and speech-in-noise perception in a cohort of normal-hearing younger (ages 18–30 yr, n = 22) and older adults (ages 55–90+ yr, n = 35) using the subcortical auditory steady-state response (ASSR). ASSRs were measured in response to the envelope of 400-ms amplitude-modulated (AM) tones with 3,000-Hz carrier frequencies and 80-Hz modulation frequencies. AM tones had modulation depths of 0, −4, and −8 dB relative to m = 1 ( m = 1, 0.631, and 0.398, respectively). The robustness, strength at modulation frequency, and synchrony of subcortical envelope encoding were quantified via time-domain correlations, spectral amplitude, and phase-locking value, respectively. Speech-in-noise ability was quantified via the QuickSIN test in the 0- and 5-dB signal-to-noise (SNR) conditions. All ASSR metrics increased with increasing modulation depth and there were no effects of age group. ASSR metrics in response to shallow modulation depths predicted 0-dB speech scores. Results demonstrate that sustained amplitude envelope processing in the brainstem relates to speech-in-noise abilities, but primarily in difficult listening conditions at low SNRs. These findings furthermore highlight the utility of shallow modulation depths for studying temporal processing. The absence of age effects in these data demonstrate that individual differences in the robustness, strength, and specificity of subcortical envelope processing, and not age, predict speech-in-noise performance in the most difficult listening conditions. NEW & NOTEWORTHY Failure to correctly understand speech in the presence of background noise is a significant problem for many normal-hearing adults and may impede healthy communication. The relationship between sustained envelope encoding in the brainstem and speech-in-noise perception remains to be clarified. The present study demonstrates that the strength, specificity, and robustness of the brainstem’s representations of sustained stimulus periodicity relates to speech-in-noise perception in older and younger normal-hearing adults, but only in highly challenging listening environments.
Transcatheter Aortic Valve Replacement With the HLT Meridian Valve
Authors: Rodés-Cabau Josep , Williams Mathew R. , Wijeysundera Harindra C. , Kereiakes Dean J. , Paradis Jean-Michel , Staniloae Cezar , Saric Muhamed , Radhakrishnan Sam , Wilson Robert F. , Kubo Spencer H. 
Published: July 2019

Background:
While most self-expanding transcatheter valves are repositionable, only one fully retrievable valve is currently available. The Meridian valve is a new self-expanding valve with full retrievability properties. The objective of our study was to evaluate the early feasibility, preliminary safety, and efficacy of transcatheter aortic valve replacement with the HLT Meridian valve (HLT, Inc).

Methods:
This was a multicenter early feasibility study including patients with severe aortic stenosis at high surgical risk undergoing transfemoral transcatheter aortic valve replacement with the 25-mm Meridian valve. All serious adverse events were adjudicated by an independent clinical events committee according to Valve Academic Research Consortium-2 criteria. Echocardiography data were assessed by an independent echocardiography core laboratory.

Results:
A total of 25 patients (mean age, 85±6 years; 80% of men) were included. The valve was successfully implanted in 22 (88%) patients (annulus too large and extreme horizontal aorta in 2 and 1 unsuccessful cases, respectively). Valve retrieval because of an initial nonadequate positioning was attempted and successfully performed in 10 (40%) patients. Echocardiography post-transcatheter aortic valve replacement showed a low mean residual gradient (10±4 mm Hg) and the absence of moderate-severe aortic regurgitation (none-trace and mild aortic regurgitation in 76% and 24% of patients, respectively). Mortality at 30 days was 8%, with no cases of disabling stroke, valve embolization, or major/life-threatening bleeding complications. At 6-month follow-up, the cumulative mortality rate was 12%, with no changes in echocardiographic parameters and no cases of valve dysfunction. The majority of patients (89%) were in New York Heart Association class I-II at 6 months.

Conclusions:
Transcatheter aortic valve replacement with the Meridian valve was feasible and associated with acceptable early and 6-month clinical results. Valve retrieval after full valve deployment was successfully performed in all attempted cases, and valve performance was excellent, with low residual gradients, no cases of moderate-severe aortic regurgitation, and none-trace residual aortic regurgitation in the majority of patients.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02838680 (RADIANT-Canada); NCT02799823 (RADIANT-US).
Angina Severity, Mortality, and Healthcare Utilization Among Veterans With Stable Angina
Authors: Owlia Mina , Dodson John A. , King Jordan B. , Derington Catherine G. , Herrick Jennifer S. , Sedlis Steven P. , Crook Jacob , DuVall Scott L. , LaFleur Joanne , Nelson Richard , Patterson Olga V. , Shah Rashmee U. , Bress Adam P. 
Published: July 2019

Background

Canadian Cardiovascular Society (
CCS
) angina severity classification is associated with mortality, myocardial infarction, and coronary revascularization in clinical trial and registry data. The objective of this study was to determine associations between
CCS
class and all‐cause mortality and healthcare utilization, using natural language processing to extract
CCS
classifications from clinical notes.

Methods and Results

In this retrospective cohort study of veterans in the United States with stable angina from January 1, 2006, to December 31, 2013, natural language processing extracted
CCS
classifications. Veterans with a prior diagnosis of coronary artery disease were excluded. Outcomes included all‐cause mortality (primary), all‐cause and cardiovascular‐specific hospitalizations, coronary revascularization, and 1‐year healthcare costs. Of 299 577 veterans identified, 14 216 (4.7%) had ≥1
CCS
classification extracted by natural language processing. The mean age was 66.6±9.8 years, 99% of participants were male, and 81% were white. During a median follow‐up of 3.4 years, all‐cause mortality rates were 4.58, 4.60, 6.22, and 6.83 per 100 person‐years for
CCS
classes I,
II
,
III
, and
IV
, respectively. Multivariable adjusted hazard ratios for all‐cause mortality comparing
CCS II
,
III
, and
IV
with those in class I were 1.05 (95% CI, 0.95–1.15), 1.33 (95% CI, 1.20–1.47), and 1.48 (95% CI, 1.25–1.76), respectively. The multivariable hazard ratio comparing
CCS IV
with
CCS
I was 1.20 (95% CI, 1.09–1.33) for all‐cause hospitalization, 1.25 (95% CI, 0.96–1.64) for acute coronary syndrome hospitalizations, 1.00 (95% CI, 0.80–1.26) for heart failure hospitalizations, 1.05 (95% CI, 0.88–1.25) for atrial fibrillation hospitalizations, 1.92 (95% CI, 1.40–2.64) for percutaneous coronary intervention, and 2.51 (95% CI, 1.99–3.16) for coronary artery bypass grafting surgery.

Conclusions

Natural language processing–extracted
CCS
classification was positively associated with all‐cause mortality and healthcare utilization, demonstrating the prognostic importance of anginal symptom assessment and documentation.
Localization of actin filaments and cortical microtubules in wood-forming tissues of conifers
Authors: Begum Shahanara , Furusawa Osamu , Shibagaki Masaki , Nakaba Satoshi , Yamagishi Yusuke , Yoshimoto Joto , Hasnat Rahman Md , Sano Yuzou , Funada Ryo 
Published: July 2019

ABSTRACT
The aim of the present study was to investigate the orientation and localization of actin filaments and cortical microtubules in wood-forming tissues in conifers to understand wood formation. Small blocks were collected from the main stems of Abies firma, Pinus densiflora, and Taxus cuspidata during active seasons of the cambium. Bundles of actin filaments were oriented axially or longitudinally relative to the cell axis in fusiform and ray cambial cells. In differentiating tracheids, actin filaments were oriented longitudinally relative to the cell axis during primary and secondary wall formation. In contrast, the orientation of well-ordered cortical microtubules in tracheids changed from transverse to longitudinal during secondary wall formation. There was no clear relationship between the orientation of actin filaments and cortical microtubules in cambial cells and cambial derivatives. Aggregates of actin filaments and a circular band of cortical microtubules were localized around bordered pits and cross-field pits in differentiating tracheids. In addition, rope-like bands of actin filaments were observed during the formation of helical thickenings at the final stage of formation of secondary walls in tracheids. Actin filaments might not play a major role in changes in the orientation of cortical microtubules in wood-forming tissues. However, since actin filaments were co-localized with cortical microtubules during the formation of bordered pits, cross-field pits and helical thickenings at the final stage of formation of the secondary wall in tracheids, it seems plausible that actin filaments might be closely related to the localization of cortical microtubules during the development of these modifications of wood structure.
The Thermohaline Modes of the Global Ocean
Authors: Pauthenet Etienne , Roquet Fabien , Madec Gurvan , Sallée Jean-Baptiste , Nerini David 
Published: July 2019

AbstractThe first 2000 m of the global thermohaline structure of the ocean are statistically decomposed into vertical thermohaline modes, using a multivariate functional principal component analysis (FPCA). This method is applied on the Monthly Isopycnal and Mixed-Layer Ocean Climatology (MIMOC). The first three modes account for 92% of the joint temperature and salinity (T–S) variance, which yields a surprisingly good reduction of dimensionality. The first mode (69% of the variance) is related to the thermocline depth and delineates the subtropical gyres. The second mode (18%) is mostly driven by salinity and mainly displays the asymmetry between the North Pacific and Atlantic basins and the salty circumpolar deep waters in the Southern Ocean. The third mode (5%) identifies the low- and high-salinity intermediate waters, covarying with the freshwater inputs of the upper ocean. The representation of the ocean in the space defined by the first three modes offers a simple visualization of the global thermohaline structure that strikingly emphasizes the role of the Southern Ocean in linking and distributing water masses to the other basins. The vertical thermohaline modes offer a convenient framework for model and observation data comparison. This is illustrated by projecting the repeated Pacific section P16 together with profiles from the Array for Real-Time Geostrophic Oceanography (ARGO) global array of profiling floats on the modes defined with the climatology MIMOC. These thermohaline modes have a potential for water mass identification and robust analysis of heat and salt content.
Open Airway Surgery in a Paraplegic: The Importance of an Adequate Cough
Authors: Amin Shaunak N. , Rodney Jennifer P. , Gelbard Alexander 
Published: July 2019

Objectives: To describe a case of open airway surgery with postoperative respiratory complications in a paraplegic woman and to review the unique respiratory physiology seen in patients with a history of cervical or thoracic spinal cord injury (SCI). Methods Case report and literature review. Results: We describe the case of a 25-year-old paraplegic who developed tracheal stenosis after tracheotomy, eventually requiring tracheal resection and re-anastomosis. Her postoperative course was complicated by mucus plugging and severe atelectasis, necessitating reintubation. After extubation, the patient reported difficulty expectorating secretions ever since her SCI, requiring manual abdominal pressure from her family members to assist her when she needed to cough. Conclusion: This first report of cricotracheal resection in a patient with paraplegia following SCI highlights the importance of an adequate cough and demonstrates the unique respiratory management necessary for patients with SCI.
Maturation of arteriovenous fistulas in patients with ventricular assist devices
Authors: Salem Karim M , Abou Ali Adham N , Sue Erika , Mohapatra Abhisekh , Eid Raymond E , Kormos Robert L , Chaer Rabih A , Avgerinos Efthymios D 
Published: July 2019

Objective: Postoperative renal dysfunction necessitating hemodialysis after implantation of ventricular assist devices presents a challenge with respect to establishment of hemodialysis access. Lack of pulsatile flow has led to concerns that arteriovenous fistulas will not mature. This study aims to evaluate arteriovenous fistula as a method of hemodialysis. Methods: Consecutive patients who underwent implantation of a ventricular assist device between 1988 and 2016 with a subsequent need for hemodialysis were identified. Retrospective data were collected for patients requiring hemodialysis through an arteriovenous fistula or arteriovenous graft. Access flow rates and duration of patency are reported. Results: Sixty-four patients were identified (10 required long-term hemodialysis, 5 via arteriovenous fistula, 1 via arteriovenous graft). All six patients receiving long-term hemodialysis access were on continuous-flow ventricular assist devices. Brachiocephalic arteriovenous fistulas were performed in all arteriovenous fistula patients, and the average preoperative vein diameter was 4.1 ± 0.9 mm. On 30-day follow-up, the average flow rate was 1262 ± 643 mL/min (880–2220). In arteriovenous fistula patients, one died at 30 days, one arteriovenous fistula required ligation for steal syndrome at 5 months, and one was abandoned after 10.7 months for low flow. Of remaining fistulas, one was converted to an arteriovenous graft at 1.7 years for malfunction (with 5.3 month patency), and one remains open at 4.0 years. Conclusion: Arteriovenous fistulas should be considered in selected patients with ventricular assist devices as a means of long-term hemodialysis access to avoid use of catheters. Maturation and usage of primary arteriovenous fistulas is possible despite lack of pulsatile flow.
Arp2/3 and Unc45 maintain heterochromatin stability in Drosophila polytene chromosomes
Authors: Dialynas George , Delabaere Laetitia , Chiolo Irene 
Published: July 2019

Repairing DNA double-strand breaks is particularly challenging in pericentromeric heterochromatin, where the abundance of repeated sequences exacerbates the risk of ectopic recombination. In Drosophila Kc cells, accurate homologous recombination repair of heterochromatic double-strand breaks relies on the relocalization of repair sites to the nuclear periphery before Rad51 recruitment and strand invasion. This movement is driven by Arp2/3-dependent nuclear actin filaments and myosins’ ability to walk along them. Conserved mechanisms enable the relocalization of heterochromatic repair sites in mouse cells, and defects in these pathways lead to massive ectopic recombination in heterochromatin and chromosome rearrangements. In Drosophila polytene chromosomes, extensive DNA movement is blocked by a stiff structure of chromosome bundles. Repair pathways in this context are poorly characterized, and whether heterochromatic double-strand breaks relocalize in these cells is unknown. Here, we show that damage in heterochromatin results in relaxation of the heterochromatic chromocenter, consistent with a dynamic response. Arp2/3, the Arp2/3 activator Scar, and the myosin activator Unc45, are required for heterochromatin stability in polytene cells, suggesting that relocalization enables heterochromatin repair also in this tissue. Together, these studies reveal critical roles for actin polymerization and myosin motors in heterochromatin repair and genome stability across different organisms and tissue types. Impact statement Heterochromatin relies on dedicated pathways for ‘safe’ recombinational repair. In mouse and fly cultured cells, DNA double-strand break repair requires the movement of damaged sites away from the heterochromatin ‘domain’ via nuclear actin filaments and myosins. Here, we explore the importance of these pathways in Drosophila salivary gland cells, which feature a stiff bundle of endoreduplicated polytene chromosomes. Repair pathways in polytene chromosomes are largely obscure and how nuclear dynamics operate in this context is unknown. We show that heterochromatin relaxes in response to damage, and relocalization pathways are necessary to prevent abnormal repair and promote the stability of heterochromatic sequences. These results deepen our understanding of DNA damage response mechanisms in polytene chromosomes, revealing unexpected dynamics. It also provides a first understanding of nuclear dynamics responding to replication damage and rDNA breaks, providing a new understanding of the importance of nuclear architecture in genome stability. We expect these discoveries will shed light on tumorigenic processes, including therapy-induced cancer relapses.