bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Update on Osteoporosis
Authors: Anthamatten Angelina , Parish Abby 
Published: March 2019

AbstractOsteoporosis is described as a silent disease prior to fracture, and the sequelae of an osteoporotic fracture can be devastating. Primary care providers should routinely assess and remediate bone health during wellness visits for women aged at least 50 years. Assessment includes review of a variety of risk factors, bone density testing, and an online fracture risk assessment tool calculation. Diagnosis is based on bone density score and clinical risk factors. Evidence‐based nonpharmacologic therapies are important adjuncts of care, and pharmacologic intervention may also be recommended. A variety of pharmacologic options are available for women with postmenopausal osteoporosis, and it is important to weigh benefits and risks. Pharmacologic indications, therapeutic variations among products, adverse effect profiles, administration considerations, and cost are addressed. Once pharmacotherapy is initiated, duration and drug holidays should also be considered. In general, medication benefits fade when treatment stops, so health care providers should be prepared to routinely revisit therapy indicators that will help define risk and guide treatment decisions. A comprehensive approach to bone health can make a valuable difference in the health of women.
Metabolic syndrome in advanced amyotrophic lateral sclerosis patients with tracheostomy‐invasive ventilation
Authors: Nishiyama Yutaka , Abe Kazuhiro , Tokunaga Jun , Numayama Takaya 
Published: March 2019

AbstractBackgroundAmyotrophic lateral sclerosis (ALS) patients have an energy imbalance. Little is known regarding the association between ALS and metabolic syndrome.AimWe aimed to investigate the clinical characteristics of patients with ALS and the association with metabolic syndrome.MethodsWe examined the prevalence of metabolic syndrome using the International Diabetes Federation (IDF) diagnostic criteria and analyzed its association with clinical characteristics, including subcutaneous and preperitoneal fat thickness, in 66 patients with ALS who underwent tracheostomy‐invasive ventilation.ResultsMetabolic syndrome was diagnosed in 29 patients (43.9% of all participants). Metabolic syndrome was more common in women and in those with a longer ALS disease duration, higher body mass index, and higher total serum cholesterol levels. Subcutaneous and preperitoneal fat thickness were significantly higher in patients diagnosed with metabolic syndrome.ConclusionMetabolic syndrome is prevalent among patients with advanced ALS. The hypometabolism in patients receiving mechanical ventilation may be the underlying cause.
Gut microbe–generated metabolite trimethylamine N‐oxide and the risk of diabetes: A systematic review and dose‐response meta‐analysis
Authors: Zhuang Rulin , Ge Xinyu , Han Lu , Yu Ping , Gong Xin , Meng Qingshu , Zhang Yuzhen , Fan Huimin , Zheng Liang , Liu Zhongmin , Zhou Xiaohui 
Published: March 2019

SummaryElevated circulating concentrations of the gut bacteria choline metabolite trimethylamine N‐oxide (TMAO) were found in patients with type 2 diabetes mellitus (T2DM). However, whether a high level of TMAO is related to the risk of diabetes has not been studied. We aimed to synthesize the evidence on the relation between TMAO levels and the risk of diabetes mellitus (DM) and to investigate the association further in a dose‐response meta‐analysis. PubMed, Web of Science, and Scopus databases were searched for studies from inception to June 2018. A total of 12 clinical studies were included in this study, and 15 314 enrolled subjects were included. A meta‐analysis of two‐class variables and continuous variables were used to obtain pooled effects. Dose‐response meta‐analysis was used to investigate the dose‐response relationship between TMAO concentrations and the risk of DM. Meta‐regression and subgroup analyses were applied to identify the source of heterogeneity in this study. High levels of circulating TMAO were associated with an increased risk of DM (odds ratio [OR] = 1.89) using the two‐class meta‐analysis. Plasma levels of TMAO in patients with diabetes were higher than in subjects without diabetes (standardized mean difference [SMD]: 0.36) using a meta‐analysis of continuous variables. The OR for DM prevalence increased by 54% per 5 μmol L−1 increment of plasma TMAO (OR = 1.54) according to the dose‐response meta‐analysis. This is the first systematic review and meta‐analysis to demonstrate a positive dose‐dependent association between circulating TMAO levels and increased diabetes risk.
Alterations in monocyte subsets and cytokine production after TLR activation in American Cutaneous Leishmaniasis
Authors: Quixabeira Valéria Bernadete Leite , Pereira Ledice Inacia de Araújo , Veras Poliana Ribeiro Valadares , da Costa Ana Carolina Vieira , Fonseca Larissa Gomides , Galdino Jr. Hélio , da Silva Jr. Ildefonso Alves , Morato Camila Imai , Pinto Sebastião Alves , Pereira Ana Joaquina Cohen Serique , Dorta Miriam Leandro , Oliveira Milton Adriano Pelli de , Gomes Rodrigo Saar , Ribeiro‐Dias Fátima 
Published: March 2019

AbstractPhenotypic and functional aspects of monocytes from Localized Cutaneous Leishmaniasis (LCL) patients were evaluated. The frequencies of monocyte subsets and TLR2/TLR4 expression were evaluated in fresh peripheral blood whereas cytokine production was evaluated in whole blood cell cultures stimulated with TLR agonists or Leishmania braziliensis antigen (Ag). CD16+ monocytes frequency was increased in patients compared with controls. A TLR4 agonist (LPS) induced expression of TNF and IL‐10 in monocyte subsets of patients and controls. The CD14+CD16+ monocytes expressed higher levels of these cytokines than CD14+CD16− cells. The levels of secreted TNF were higher in whole blood cell cultures from patients than controls after LPS/TLR4 or Ag stimulation. Whereas in controls there was a positive correlation between TNF and IL‐10 levels, this was not observed in stimulated cell cultures from patients. The high levels of LPS‐induced TNF were associated with the number of lesions and the percentages of CD14hiCD16+ monocytes. The levels of TLR2‐induced TNF were also associated with number of lesions. All monocyte subsets from patients expressed higher levels of TLR2 and TLR4 than controls. Data suggest that systemically activated monocytes contribute for an imbalance in pro‐ and anti‐inflammatory cytokine production during LCL, participating in the immunopathogenesis of the disease.
Motivating Political Participation Among Youth: An Analysis of Factors Related to Adolescents’ Political Engagement
Authors: Levy Brett L. M. , Akiva Thomas 
Published: March 2019

Prior research has identified political efficacy and political interest as strong predictors of political participation, but few studies have examined these two attitudes in tandem or compared their relative importance vis‐à‐vis political participation. Drawing on the expectancy‐value model of motivation, we begin to address this research gap while also considering several related issues. Our sample includes a diverse group of high school students in grades 10, 11, and 12 (N = 422) from the midwestern United States. Through quantitative analyses of participants’ survey data, we found that political interest (a central aspect of value) and political efficacy (closely related to expectancy) predicted participants’ expected future political participation, controlling for background characteristics—and that political interest was a particularly strong predictor. In addition, we identified political‐engagement differences on various demographic measures, such as grade level. We also found a significant interaction between political interest and internal political efficacy, suggesting that high levels of both attitudes can have an especially positive effect on adolescents’ political participation. We discuss the implications of these findings for researchers and educators interested in fostering political engagement among youth.
Mineralogy, Fluid Inclusions, and Sulfur Isotopes of the Huanzala Deposits, Peru: Early Skarn and Late Polymetallic Replacement Style Mineralizations
Authors: Suzuki Yuki , Hayashi Ken‐ichiro 
Published: March 2019

AbstractCarbonate‐replacement polymetallic mineralization at the Huanzala deposits (9°51′S, 77°00′W) was conducted in two contrasting stages that occurred in almost the same location. Early‐stage mineralization has a relation with a granodiorite porphyry stock, whereas the late‐stage mineralization is genetically associated with quartz porphyry sills. The early stage involved low to intermediate sulfidation Cu–Zn–(Pb) mineralization associated with metasomatic skarn, and the late stage involved high to intermediate sulfidation Cu–Zn–Pb–(Mn) mineralization associated with hydrothermal alteration characterized by paragonitic sericitization. The orebodies are hosted by steeply dipping (approximately 60°NE) Lower Cretaceous carbonate rocks in a relatively narrow range of approximately 4 km in horizontal extent and less than 1 km in depth. The pathway of the early‐stage brine‐derived fluids (300–>400°C, >33 wt% NaCl equivalent) along a plot of log against 1000/T is best explained by the progressive dual decline of the value and the temperature under rock‐buffering conditions; this decline saw the pathway progress through the stability field of pyrrhotite to reach that of pyrite and promoted a decrease in FeS from 14.5 to 1.6 mol% in the sphalerite. In contrast, an explanation for the pathway of the late‐stage fluids (140–290°C, 3–13 wt% NaCl equivalent) is given by an almost isothermal decline at approximately 270°C, with passing through the stability field of pyrite–bornite to reach that of chalcopyrite, promoting an increase in FeS from 0.1 to 1.6 mol% in the sphalerite, suggesting gas‐buffering conditions. The ore formation pressure records in the fluid inclusions illustrate an approximately 2‐km erosion during the roughly 2‐Myr total lifetime of the hydrothermal system.
A general quantile residual life model for length‐biased right‐censored data
Authors: Bai Fangfang , Chen Xuerong , Chen Yan , Huang Tao 
Published: March 2019

AbstractThe quantile residual lifetime function provides comprehensive quantitative measures for residual life, especially when the distribution of the latter is skewed or heavy‐tailed and/or when the data contain outliers. In this paper, we propose a general class of semiparametric quantile residual life models for length‐biased right‐censored data. We use the inverse probability weighted method to correct the bias due to length‐biased sampling and informative censoring. Two estimating equations corresponding to the quantile regressions are constructed in two separate steps to obtain an efficient estimator. Consistency and asymptotic normality of the estimator are established. The main difficulty in implementing our proposed method is that the estimating equations associated with the quantiles are nondifferentiable, and we apply the majorize–minimize algorithm and estimate the asymptotic covariance using an efficient resampling method. We use simulation studies to evaluate the proposed method and illustrate its application by a real‐data example.
Interpretation and management of positive anti‐hepatitis B core antibody tests in immunocompromised pediatric patients
Authors: Kitt Eimear , Hayes Molly , Cárdenas Ana María , Green Abby M. 
Published: March 2019

AbstractIntravenous immunoglobulin (IVIg) therapy is increasingly used in the pediatric population, in particular among children with immune‐compromising conditions. Pooled immunoglobulin products are routinely tested for hepatitis B surface antigen (HBsAg) and nucleic acid; however, screening for hepatitis B core antibody (anti‐HBc) is not commonly performed. Thus, the administration of IVIg containing anti‐HBc to children with immune‐compromising conditions may complicate the interpretation of hepatitis B serologic testing in that a positive anti‐HBc test may represent passive transfer of antibody from IVIg or may indicate resolved or chronic hepatitis B infection. Due to the risk of hepatitis B reactivation in immunocompromised patients, a positive anti‐HBc test must be carefully considered. As part of a quality improvement initiative, we identified and reviewed the records of all pediatric patients at our institution who tested positive for anti‐HBc over an 18‐month period. Of 44 total patients with positive anti‐HBc tests, we found that 22 (50%) had previously received IVIg in the preceding 4 months. All but one of these, 21/22 (95%), went on to receive immunosuppressive therapy (IS). Among the patients who received IS, 19 (86%) had not undergone hepatitis B serologic testing prior to IVIg administration and 16 (73%) did not have subsequent testing to distinguish between passive acquisition of anti‐HBc from IVIg and chronic hepatitis B infection. Our single‐center experience reveals that a high proportion of positive anti‐HBc tests in children are presumed to be because of the passive antibody transfer from IVIg. However, a low proportion of patients undergo confirmatory testing, despite the risk of hepatitis B reactivation during IS. We thus propose a risk‐based algorithm for interpretation and monitoring of hepatitis B testing in immunocompromised children.
Cardiomyopathy in obesity, insulin resistance and diabetes
Authors: Nakamura Michinari , Sadoshima Junichi 
Published: March 2019

AbstractThe prevalence of obesity, insulin resistance and diabetes is increasing rapidly. Most patients with these disorders have hypertriglyceridaemia and increased plasma levels of fatty acids, which are taken up and stored in lipid droplets in the heart. Intramyocardial lipids that exceed the capacity for storage and oxidation can be lipotoxic and induce non‐ischaemic and non‐hypertensive cardiomyopathy, termed diabetic or lipotoxic cardiomyopathy. The clinical features of diabetic cardiomyopathy are cardiac hypertrophy and diastolic dysfunction, which lead to heart failure, especially heart failure with preserved ejection fraction. Although the pathogenesis of the cardiomyopathy is multifactorial, diabetic dyslipidaemia and intramyocardial lipid accumulation are the key pathological features, triggering cellular signalling and modifications of proteins and lipids via generation of toxic metabolic intermediates. Most clinical studies have shown no beneficial effect of anti‐diabetic agents and statins on outcomes in heart failure patients without atherosclerotic diseases, indicating the importance of identifying underlying mechanisms and early interventions for diabetic cardiomyopathy. Here, we summarize the molecular mechanisms of diabetic cardiomyopathy, with a special emphasis on cardiac lipotoxicity, and discuss the role of peroxisome proliferator‐activated receptor α and dysregulated fatty acid metabolism as potential therapeutic targets.
Cardiac perfusion and function after high-intensity exercise training in late premenopausal and recent postmenopausal women: an MRI study
Authors: Egelund Jon , Nyberg Michael , Mandrup Camilla M. , Abdulla Jawdat , Stallknecht Bente , Bangsbo Jens , Hellsten Ylva , Larsson Henrik Bo Wiberg 
Published: March 2019

We examined the influence of recent menopause and aerobic exercise training in women on myocardial perfusion, left ventricular (LV) dimension, and function. Two groups ( n = 14 each) of healthy late premenopausal (50.2 ± 2.1 yr) and recent postmenopausal (54.2 ± 2.8 yr) women underwent cardiac magnetic resonance imaging (cMRI) at baseline and after 12 wk of high-intensity aerobic training. Measurements included LV morphology, systolic function, and myocardial perfusion at rest and during an adenosine stress test. At baseline, resting myocardial perfusion was lower in the postmenopausal than the premenopausal group (77 ± 3 vs. 89 ± 3 ml·100 g−1·min−1; P = 0.01), while adenosine-induced myocardial perfusion was not different ( P = 0.81). After exercise training, resting myocardial perfusion was lower in both groups (66 ± 2; P = 0.002 vs. 81 ± 3 ml·100 g−1·min−1; P = 0.03). The adenosine-induced change in myocardial perfusion was lower in the groups combined (by 402 ± 17 ml·100 g−1·min−1; P = 0.02), and the adenosine-induced increase in heart rate was 10 ± 2 beats/min lower ( P < 0.0001) in both groups after training. Normalization of myocardial perfusion using an estimate of cardiac work eliminated the differences in perfusion between the premenopausal and postmenopausal groups and the effect of training. Left ventricle mass was higher in both groups ( P = 0.03; P = 0.006), whereas LV end-diastolic ( P = 0.02) and stroke ( P = 0.045) volumes were higher in the postmenopausal group after training. Twelve weeks of exercise training increased left ventricle mass and lowered resting and adenosine-induced myocardial perfusion, an effect that was likely related to cardiac work. The current data also suggest that the early menopausal transition has limited impact on cardiac function and structure. NEW & NOTEWORTHY This study provides for the first time estimates of myocardial perfusion in late premenopausal and recent postmenopausal women before and after a period of intense aerobic training. Resting myocardial perfusion was lower in postmenopausal than premenopausal women. Training lowered myocardial resting and stress perfusion in both groups, an effect that was likely influenced by the lower heart rate.
Prognostic Impact of Pre‐Transcatheter and Post‐Transcatheter Aortic Valve Intervention Troponin: A Large Cohort Study
Authors: Akodad Mariama , Spaziano Marco , Chevalier Bernard , Garot Philippe , Benamer Hakim , Dinan‐Zannier Annabelle , Troussier Xavier , Unterseeh Thierry , Champagne Stéphane , Hovasse Thomas , Lefèvre Thierry 
Published: March 2019

Background
Biomarkers were advocated as prognostic factors in patients undergoing transcatheter aortic valve intervention, with contradictory results concerning prognostic impact of troponin. Our aim was to assess the prognostic impact of preprocedural and postprocedural troponin in transcatheter aortic valve intervention.

Methods and Results

Preprocedural and postprocedural high‐sensitivity troponin levels were measured in all patients undergoing transcatheter aortic valve intervention. Primary end point was 1‐year mortality. This study included 1390 patients, with a mean age of 83.4±6.8 years. Patients were divided into 3 tertiles according to preprocedural troponin values: tertile 1: 0.001 to 0.023 μg/L; tertile 2: 0.024 to 1.80 μg/L; and T3: 1.81 to 12.1 μg/L. One‐year mortality was higher in patients in tertile 2 (hazard ratio, 2.1;
P
=0.001) and T3 (hazard ratio, 1.8;
P
=0.009) compared with those in tertile 1. Myocardial injury was predictive of 1‐year mortality (hazard ratio, 1.7;
P
=0.01). This effect may be stronger in the tertile 1 subgroup (hazard ratio, 5.1;
P
=0.03 [
P
value for interaction: 0.18]).

Conclusions
Elevated preprocedural troponin and myocardial injury are associated with 1‐year mortality after transcatheter aortic valve intervention.
Non–Vitamin K Antagonist Oral Anticoagulants Versus Warfarin in Atrial Fibrillation Patients With Intracerebral Hemorrhage
Authors: Nielsen Peter Brønnum , Skjøth Flemming , Søgaard Mette , Kjældgaard Jette Nordstrøm , Lip Gregory Y.H. , Larsen Torben Bjerregaard 
Published: March 2019

Background and Purpose—
Recurrent bleeding associated with oral anticoagulants (OACs) causes a dilemma in patients with atrial fibrillation (AF) sustaining an intracerebral hemorrhage. Treatment recommendations guiding clinical practice on optimal OAC agent selection in this population are lacking. This study aimed to investigate the comparative effectiveness and safety of non–vitamin K antagonist OAC (NOAC) versus warfarin in patients with AF sustaining an intracerebral hemorrhage.

Methods—
We conducted a nationwide observational cohort study including patients with AF sustaining an intracerebral hemorrhage and who subsequently claimed an OAC prescription. Contrasts of 1-year risks for ischemic stroke and intracerebral hemorrhage risks were obtained and evaluated by inverse probability treatment weighted absolute risk reduction and risk ratios.

Results—
Among 622 AF patients with intracerebral hemorrhage, 274 claimed a warfarin prescription and 348 a NOAC prescription. Mean age was 76 years (39% females); 72% had an index nonsevere event and 28% moderate to severe index event according to the Scandinavian Stroke Severity scale. The 1-year ischemic stroke risk was 7.85% for warfarin and 4.01% for NOACs, with a weighted absolute risk reduction of 3.78% (95% CI, −0.15% to 7.71%); the weighted risk ratio was 0.52 (0.27–1.00). For recurrent intracerebral hemorrhage, the risk was 7.00% for warfarin and 5.07% for NOACs. The absolute risk reduction was 1.93% (−2.02% to 5.87%), with an a weighted risk ratio of 0.72 (0.38–1.38).

Conclusions—
NOACs were associated with a nonsignificant lower risk of ischemic stroke and recurrent intracerebral hemorrhage compared with warfarin. The results add to current recommendations of selecting a NOAC agent for stroke prophylaxis treatment in patients with AF, including those with sustaining an intracerebral hemorrhage.
100 Years of Earth System Model Development
Authors: Randall David A. , Bitz Cecilia M. , Danabasoglu Gokhan , Denning A. Scott , Gent Peter R. , Gettelman Andrew , Griffies Stephen M. , Lynch Peter , Morrison Hugh , Pincus Robert , Thuburn John 
Published: March 2019

AbstractToday’s global Earth system models began as simple regional models of tropospheric weather systems. Over the past century, the physical realism of the models has steadily increased, while the scope of the models has broadened to include the global troposphere and stratosphere, the ocean, the vegetated land surface, and terrestrial ice sheets. This chapter gives an approximately chronological account of the many and profound conceptual and technological advances that made today’s models possible. For brevity, we omit any discussion of the roles of chemistry and biogeochemistry, and terrestrial ice sheets.
Kharitonov’s theorem: A good starting point for robust control
Authors: Asadi Farzin , Abut Nurettin 
Published: March 2019

Advanced robust controller design methods such as: [Formula: see text], [Formula: see text] synthesis, or linear matrix inequality require advanced mathematics which makes these techniques difficult topics for final year projects. A robust controller (for plants with parametric uncertainty) can be designed with the aid of Kharitonov’s theorem, which has simpler mathematical machinery. This paper studies the robust control of DC–DC converters with the aid of Kharitonov’s theorem. It presents a tutorial exposition of robust controller design based on Kharitonov’s theorem. Kharitonov’s theorem provides a good starting point for BSc students who wish to continue their future studies in robust control.