bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetically Determined Risk of Depression and Functional Outcome After Ischemic Stroke
Authors: Gill Dipender , James Nicole E. , Monori Grace , Lorentzen Erik , Fernandez-Cadenas Israel , Lemmens Robin , Thijs Vincent , Rost Natalia S. , Scott Rodney , Hankey Graeme J. , Lindgren Arne , Jern Christina , Maguire Jane M. ,   on behalf of the International Stroke Genetics Consortium and the GISCOME Network
Published: June 2019

Background and Purpose—
Psychosocial factors can have implications for ischemic stroke risk and recovery. This study investigated the effect of genetically determined risk of depression on these outcomes using the Mendelian randomization (MR) framework.

Methods—

Genetic instruments for risk of depression were identified in a discovery genome-wide association study of 246 363 cases and 561 190 controls and further replicated in a separate population of 474 574 cases and 1 032 579 controls. Corresponding genetic association estimates for risk of ischemic stroke were taken from 60 341 cases and 454 450 controls, with those for functional outcome 3 months after ischemic stroke taken from an analysis of 6021 patients. Following statistical power calculation, inverse-variance weighted MR was performed to pool estimates across different instruments. The Cochran
Q
heterogeneity test, weighted median MR, and MR pleiotropy residual sum and outlier were used to explore possible bias relating to inclusion of pleiotropic variants.

Results—

There was no MR evidence for an effect of genetically determined risk of depression on ischemic stroke risk. Although suffering low statistical power, the main inverse-variance weighted MR analysis was suggestive of a detrimental effect of genetically determined risk of depression on functional outcome after ischemic stroke (odds ratio of poor outcome [modified Rankin Scale, ≥3] per 1-SD increase in genetically determined risk of depression, 1.81; 95% CI, 0.98–3.35;
P
=0.06). There was no evidence of heterogeneity between MR estimates produced by different instruments (Q
P
=0.26). Comparable MR estimates were obtained with weighted median MR (odds ratio, 2.57; 95% CI, 1.05–6.25;
P
=0.04) and MR pleiotropy residual sum and outlier (odds ratio, 1.81; 95% CI, 0.95–3.46;
P
=0.08).

Conclusions—
We found no MR evidence of genetically determined risk of depression affecting ischemic stroke risk but did find consistent MR evidence suggestive of a possible effect on functional outcome after ischemic stroke. Given the widespread prevalence of depression-related morbidity, these findings could have implications for prognostication and personalized rehabilitation after stroke.
Motivating Innovation: The Effect of Loss Aversion on the Willingness to Persist
Authors: Rosokha Yaroslav , Younge Kenneth 
Published: June 2019

AbstractWe investigate the willingness of individuals to persist at exploration when confronted by prolonged periods of negative feedback. We design a two-dimensional maze game and run a series of randomized experiments with human subjects in the game. Our results suggest individuals explore more when they are reminded of the incremental cost of their actions, a result that extends prior research on loss aversion and prospect theory to environments characterized by model uncertainty. In addition, we run simulations based on a model of reinforcement learning that extend beyond two-period models of decision making to account for repeated behavior in longer-running, dynamic contexts.
L’italiano in rete tra parola e immagine
Authors: Malagnini Francesca 
Published: June 2019

Nell’articolo si analizzano i rapporti tra parola e immagini nella comunicazione di alcuni media mostrando come i codici verbale e iconico, se accoppiati, sono spesso incoerenti fra loro, tanto da impedire la comprensione del messaggio. Inoltre, si esamina il processo di scrittura del messaggio verbale in rete, mettendolo in relazione con i testi semicolti: in entrambi i casi mancano la progettazione e la revisione. Un punto di partenza per insegnare una scrittura di massa strutturata e sequenziale, talvolta accompagnata da immagini, può essere quello di una riflessione linguistica e testuale sui testi verbali frammentati che circolano nella rete.
Effects of immediate versus delayed ex-vivo lung perfusion in a porcine cardiac arrest donation model
Authors: Olbertz Carolin , Pizanis Nikolaus , Bäumker Hagen , Becker Simon , Aigner Clemens , Rauen Ursula , Nolte Ingo , Kamler Markus , Koch Achim 
Published: June 2019

Objective: Ex-vivo lung perfusion is a promising tool to evaluate and recondition marginal donor lungs usually after a cold static preservation. The concept of continuous organ perfusion is supposed to reduce ischemic damage; however, the optimal perfusion protocol has not been established yet. The aim of this study was to compare immediate ex-vivo lung perfusion (I-EVLP) to delayed ex-vivo lung perfusion (D-EVLP) after a certain cold static preservation period on lung function in a large animal model. Methods: In a porcine model, lungs were procured after circulatory death and 60 min of no-touch warm ischemia. Lungs were preserved with single-flush cold low potassium dextran solution and prepared either for I-EVLP (n = 8) or stored cold for 9 h with subsequent D-EVLP (n = 8). Functional outcomes and morphology were compared during 4 h of ex-vivo lung perfusion, using STEEN SolutionTM as perfusion solution. Results: Pulmonary functional data, perfusate activities of lactate dehydrogenase, alkaline phosphatase, and products of lipid peroxidation did not differ significantly. There was a trend toward lower wet–dry ratio (I-EVLP: 13.4 ± 2.9; D-EVLP: 9.1 ± 2.5) and higher ΔpO2 in D-EVLP group (I-EVLP: 209 ± 51.6 mmHg; D-EVLP: 236.3 ± 47.3 mmHg). Conclusion: In this donation-after-circulatory-death model, 9 h of cold static preservation followed by ex-vivo lung perfusion results in comparable pulmonary function to I-EVLP as indicated by oxygenation capacities and wet–dry ratio. Our findings indicate that prolonged cold static preservation prior to ex-vivo lung perfusion is as safe and effective as I-EVLP in the procurement of donor lungs.
Psychiatrist and Psychiatric Pharmacists Beliefs and Preferences for Atypical Antipsychotic Treatments in Patients With Schizophrenia and Bipolar Disorders
Authors: Touchette Daniel R. , Gor Deval , Sharma Dolly , Chennault Rachel R. , Ng-Mak Daisy S. , Rajagopalan Krithika , Ellingrod Vicki 
Published: June 2019

Background: Selection of schizophrenia or bipolar disorder treatments is complicated by treatment-effect heterogeneity. Objectives: This study assessed how clinicians’ beliefs and health system/ insurace policies impact choice of atypical antipsychotic agent in schizophrenia and bipolar disorder. Methods: A cross-sectional survey was conducted of members of the American College of Clinical Pharmacy and College of Psychiatric & Neurologic Pharmacists. Beliefs regarding atypical antipsychotic effectiveness and safety, impact of comorbidity on drug selection, and factors influencing atypical antipsychotic therapy selection were assessed. Results: Twenty-four psychiatric pharmacists and 18 psychiatrists participated. Mean age was 39.6 years, 57.1% were female. Most clinicians (64.3%) believed medication effectiveness and safety equally important, while 26.2% believed safety and 9.4% believed effectiveness more important. The most important medication properties for schizophrenia were reducing positive symptoms (92.7%) and hospitalizations (87.8%) and for bipolar disorder were reducing manic episodes (87.8%), episode relapse (53.7%), and hospitalizations (53.7%). Agranulocytosis (78.1%), arrhythmias (70.7%), and extrapyramidal side effects (68.3%) were most concerning. Restrictions affected antipsychotic choice at 80.5% of sites and were believed to affect medication adherence (55.0%) and outcomes (53.4%). Conclusion: Efficacy and safety were considered equally important when choosing atypical antipsychotics. Formulary restrictions were perceived as impacting treatment choice and outcomes.
Real-world comparison of immune checkpoint inhibitors in non-small cell lung cancer following platinum-based chemotherapy
Authors: Weis Taylor M , Hough Shannon , Reddy Haritha G , Daignault-Newton Stephanie , Kalemkerian Gregory P 
Published: June 2019

Purpose Immunotherapy is a relatively new treatment modality for advanced non-small cell lung cancer following platinum-based chemotherapy. Nivolumab, pembrolizumab, and atezolizumab demonstrated superior outcomes and improved tolerability compared to standard treatment in randomized controlled trials; however, these studies vary significantly in inclusion criteria and study design. To our knowledge, the efficacy and safety of nivolumab and atezolizumab following platinum-based chemotherapy have not been directly compared to one another in a real-world clinic setting. Methods We retrospectively compared immunotherapy response rates and toxicity in patients with stage IV or recurrent non-small cell lung cancer following progression during or after platinum-based chemotherapy. Results Among 124 eligible patients, the objective response rate was 14.8% in the nivolumab group (n = 81) vs. 13.9% in the atezolizumab group (n = 43) (p = 0.897). Median overall survival was 8.4 months with nivolumab (95% confidence interval (CI), 6.3 to 11.2) vs. 6.5 months with atezolizumab (95% CI, 4.7 to not reached). Median progression free survival was 2.2 months (95% CI, 1.7 to 2.8) and 2.0 months (95% CI, 1.8 to 2.7) in the nivolumab and atezolizumab groups, respectively. Treatment-related adverse events occurred in 70.4% of patients in the nivolumab group and 65.1% in the atezolizumab group. Conclusions There was no statistically significant difference in efficacy outcomes in patients with non-small cell lung cancer who received atezolizumab or nivolumab after progression during or after platinum-based chemotherapy. Response rates in this study were numerically lower than response rates observed in the landmark randomized controlled trials leading to approval of immunotherapy in this setting. Rates of treatment-related adverse events were similar between groups.
Mammaglobin-A, VEGFR3, and Ki67 in Human Breast Cancer Pathology and Five Year Survival
Authors: Baker Elizabeth , Whiteoak Naomi , Hall Louise , France James , Wilson Deborah , Bhaskar Pudupalayam 
Published: June 2019

Background/Methods: This study determines the co-expression of mammaglobin-A, vascular endothelial growth factor receptor-3 (VEGFR3) and Ki67 by immunohistochemistry (IHC) in tissue samples from 80 patients undergoing breast surgery (cancer or benign disease). The tissue expression was compared with the tumour histopathology and Kaplan Meier 5-year survival analysis was performed. Results: Positive breast tissue expression was observed in 53% samples for mammaglobin, 41% Ki67 and 65% VEGFR3 with a significant positive correlation between Ki67 and VEGFR3 co-expression. Ki67 and VEGFR3 expression correlated with the breast tumour grade and Ki67 expression also correlated with oestrogen receptor (ER) status. At 5 years post-operatively, 6/80 patients had died and 3 patients were alive but had cancer recurrence. High Ki67 expression significantly correlated with poor survival (disease-free and overall). Conclusions: In this study, VEGFR3 and Ki67 expression but not mammaglobin-A correlated with breast tumour pathology. Positive Ki67 expression was also associated with a poor 5-year survival outcome.
The efficacy of prophylactic pancreatic stents against complications of post-endoscopic papillectomy or endoscopic ampullectomy: a systematic review and meta-analysis
Authors: Wang Yining , Qi Miao , Hao Yuanzhen , Hong Junbo 
Published: June 2019

Background: Endoscopic resection has been increasingly adopted for neoplasms in the major duodenal papilla. Previous studies have reached varying conclusions on whether prophylactic pancreatic stent (PS) placement is an effective measure against post-procedure complications. We aimed to investigate whether PS could reduce the incidence of post-procedure complications. Methods: The PubMed, Cochrane Library, and EMBASE databases were systematically searched from the inception dates to 25 December 2018 to identify all randomized controlled trials (RCTs) and retrospective cohort studies (RCSs) comparing prophylactic PS and no PS against post-procedure complications. The main outcomes measurements were post-procedure pancreatitis, bleeding, perforation and late papillary stenosis. Results: 23 RCSs (1001 subjects) and 2 RCTs met the inclusion criteria. Meta-analysis of the RCSs showed that prophylactic PS decreased the odds of post-procedure pancreatitis (OR, 0.71; 95% CI, 0.36–1.40; p = 0.325) as well as late papillary stenosis (OR, 0.35; 95% CI, 0.07–1.75; p = 0.200; I2 =0%) and increased the odds of bleeding (OR, 1.32; 95% CI, 0.50–3.46; p = 0.572; I2 = 0%) and perforation (OR, 2.25; 95% CI, 0.33–15.50; p = 0.412; I2 = 0%) but not significantly. Sensitivity analysis illustrated prophylactic PS significantly decreased the risk of post-procedure pancreatitis (OR, 0.44; 95% CI, 0.24–0.80; p = 0.007). Conclusions: PS placement was prophylactic against post-procedure complications although not significantly. Sensitivity analysis suggests the significant effect of prophylactic PS against post-procedure pancreatitis. More RCTs are required to validate the statistical significance of our results and potentially relevant characteristics improving the prophylactic efficacy of stents.
Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis
Authors: Nikolova Viktoriya , Zaidi Syed Yawar , Young Allan H. , Cleare Anthony J. , Stone James M. 
Published: June 2019

Background: Recently the gut microbiota has attracted significant interest in psychiatric research due to the observed bidirectional gut–brain communication. A growing body of evidence from preclinical work has suggested that probiotics may be effective in reducing stress and anxiety and alleviating low mood. It is unclear to what extent these effects are seen in clinical populations. We aimed to identify all published evidence on the efficacy of probiotics as treatment for depression in clinically depressed populations. Methods: Randomized controlled trials of patients with depression where probiotics were used as supplementary or standalone treatment were considered eligible. A literature search with the terms ( probiotic* OR bacteria OR Lactobacillus OR Bifidobacterium) AND depress* was performed in PubMed and Web of Science. Data on study population characteristics, treatment effectiveness, tolerability and risk of bias were extracted from eligible studies. A random effects model was used for meta-analyses. Results: Only three studies met inclusion criteria (229 individuals randomized), two of which administered probiotics as a supplementary treatment to antidepressants and one as a standalone treatment. Upon removal of the latter study from the meta-analysis due to clinical heterogeneity, there was an overall positive effect of probiotics on depressive symptoms (standardized mean difference = 1.371, 95% confidence interval 0.130–2.613). Conclusions: There is limited evidence for the efficacy of probiotics in depression at present, although there may be a beneficial effect of probiotics on depressive symptoms when administered in addition to antidepressants. Further studies are required to investigate this and explore potential mechanisms.
Distinct mutation in the feline coronavirus spike protein cleavage activation site in a cat with feline infectious peritonitis-associated meningoencephalomyelitis
Authors: André Nicole M , Cossic Brieuc , Davies Emma , Miller Andrew D , Whittaker Gary R 
Published: June 2019

Case summary This report describes a cat with chronic, progressive, non-painful, non-lateralizing multifocal neurologic clinical signs associated with feline infectious peritonitis (FIP). The cat initially presented as underweight, despite a good appetite, and a complete blood count showed non-regenerative anemia. Three months later the cat was returned having developed ataxia and paraparesis, which then progressed over 2 months to tetraparesis, tail plegia, urinary and fecal incontinence, and titubation. Histologic examination of the tissues with subsequent immunohistochemistry confirmed FIP-associated meningoencephalomyelitis following necropsy. Molecular analysis of the coronavirus spike protein within the tissues identified a specific, functionally relevant amino acid change (R793M), which was only identified in tissues associated with the central nervous system (ie, brain and spinal cord). Relevance and novel information This case report describes an early presentation of a cat with primarily neurologic FIP, with molecular characterization of the virus within various tissues.
Understanding Preoperative Demographics and Risk Factors for Early Revision Surgery in Patients Undergoing Hip Arthroscopic Surgery: A Large Database Study
Authors: Rogers Miranda J. , Adeyemi Temitope F. , Kim Jaewhan , Maak Travis G. 
Published: June 2019

Background: Hip arthroscopic surgery has become an increasingly common surgical technique to diagnose and treat various hip abnormalities. While increased efficacy has been reported, debate remains regarding appropriate surgical indications. Multiple factors including patient demographics, surgical procedure, and underlying disease have been associated with poor surgical outcomes. Preoperative diagnostic and treatment interventions including physical therapy and injections may affect surgical indications and outcomes. Purpose: To identify patient characteristics and preoperative factors associated with an increased risk of early revision surgery and/or extended postoperative medical care after index hip arthroscopic surgery. Study Design: Case-control study; Level of evidence, 3. Methods: Utah’s All Payer Claims Database, a state-mandated registry containing data from all payers, including private insurance, Medicare Advantage, and Medicaid, was queried to identify patients who underwent hip arthroscopic surgery during a 3-year period (January 1, 2013, to December 31, 2015). Demographics, comorbidities, nonoperative care modalities, pain medications, and revision procedures were collected using claims data at 6 months preoperatively and 12 months postoperatively. Results: A total of 1283 patients who underwent primary hip arthroscopic surgery were analyzed, of whom 57.6% (n = 739) were female. Within 1 year of index surgery, 7.8% and 2.1% of patients underwent revision hip arthroscopic surgery and conversion to total hip arthroplasty (THA), respectively. Patients older than 60 years and male patients were more likely to undergo revision arthroscopic surgery (odds ratio [OR], 0.89; P < .001 and OR, 1.59; P = .04, respectively) and convert to THA (OR, 1.03; P = .01 and OR, 2.25; P = .05, respectively). Preoperative opioid use was significantly associated with increased odds of revision surgery (OR, 1.64; P = .05) and THA (OR, 2.70; P = .03). No significant relationship existed between preoperative physical therapy or intra-articular hip injections and revision hip arthroscopic surgery (OR, 1.20; P = .45 and OR, 1.18; P = .52, respectively) or conversion to THA (OR, 0.89; P = .79 and OR, 0.71; P = .46, respectively). Conclusion: This study showed that predictable patient factors can effectively guide preoperative decision making and may improve prognosis. Certain patient pools require optimization preoperatively, and a subset of patients appears to require additional surgical indications.
Neighborhood Socioeconomic Status Affects Patient-Reported Outcome 2 Years After ACL Reconstruction
Authors: Jones Morgan H. , Reinke Emily K. , Zajichek Alexander , Kelley-Moore Jessica A. , Khair M. Michael , Malcolm Tennison L. ,   MOON Knee Group, Spindler Kurt P. , Amendola Annunziato , Andrish Jack T. , Brophy Robert H. , Flanigan David C. , Huston Laura J. , Kaeding Christopher C. , Marx Robert G. , Matava Matthew J. , Parker Richard D. , Wolf Brian R. , Wright Rick W. 
Published: June 2019

Background: Lower socioeconomic status (SES) is associated with worse patient-reported outcome (PRO) after orthopaedic procedures. In patients with anterior cruciate ligament (ACL) reconstruction, evaluating SES by use of traditional measures such as years of education or occupation is problematic because this group has a large proportion of younger patients. We hypothesized that lower education level and lower values for SES would predict worse PRO at 2 years after ACL reconstruction and that the effect of education level would vary with patient age. Purpose: To compare the performance of multivariable models that use traditional measures of SES with models that use an index of neighborhood SES derived from United States (US) Census data. Study Design: Cohort study; Level of evidence, 3. Methods: A cohort of 675 patients (45% female; median age, 20 years), were prospectively enrolled and evaluated 2 years after ACL reconstruction with questionnaires including the International Knee Documentation Committee (IKDC) questionnaire, the Knee injury and Osteoarthritis Outcome Score (KOOS), and the Marx activity rating scale (Marx). In addition, a new variable was generated for this study, the SES index, which used geocoding performed retrospectively to identify the census tract of residence for each participant at the time of enrollment and extract neighborhood SES measures from the 2000 US Census Descriptive Statistics. Multivariable models were constructed that included traditional measures of SES as well as the SES index, and the quality of models was compared through use of the likelihood ratio test. Results: Lower SES index was associated with worse PRO for all measures. Models that included the SES index explained more variability than models with traditional SES. In addition, a statistically significant variation was found regarding the impact of education on PRO based on patient age for the IKDC score, the Marx scale, and 4 of the 5 KOOS subscales. Conclusion: This study demonstrates that lower neighborhood SES is associated with worse PRO after ACL reconstruction and that age and education have a significant interaction in this patient population. Future studies in patients who have undergone ACL reconstruction should attempt to account for neighborhood SES when adjusting for confounding factors; further, targeting patients from areas with lower neighborhood SES with special interventions may offer an opportunity to improve their outcomes.