bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regular Yogurt Intake and Risk of Cardiovascular Disease Among Hypertensive Adults
Authors: Buendia Justin R , Li Yanping , Hu Frank B , Cabral Howard J , Bradlee M Loring , Quatromoni Paula A , Singer Martha R , Curhan Gary C , Moore Lynn L 
Published: January 2018

Abstract

BACKGROUND
High blood pressure (HBP) is a major cardiovascular disease (CVD) risk factor. Clinical trials including Dietary Approaches to Stop Hypertension (DASH) have demonstrated beneficial effects of dairy consumption on risks of HBP and CVD. Yogurt, a fermented dairy product, may independently be related to CVD risk.

OBJECTIVE
To evaluate the association between yogurt consumption and CVD risk among hypertensive individuals in 2 large cohorts and to determine whether the association differs among those whose eating pattern more closely resembles the DASH diet.

METHODS
Overall, 55,898 female Nurses’ Health Study (NHS) and 18,232 male Health Professionals Follow-Up Study (HPFS) participants with prevalent HBP were included. Cumulative average estimates of yogurt intake from validated food frequency questionnaires were related to verified self-reported CVD outcomes using Cox proportional hazards models. Hazard ratios and 95% confidence intervals (CI) were adjusted for CVD risk factors, medications, and diet covariates.

RESULTS
Yogurt intake was inversely associated with CVD risk (myocardial infarction and stroke) among hypertensive participants (P &lt;0.01 in both cohorts). Among participants consuming ≥2 servings/week of yogurt, NHS women had a 17% (95% CI: 0.74–0.92) lower risk while HPFS men experienced a 21% (95% CI: 0.66–0.96) lower CVD risk compared to those who consumed &lt;1 serving/month. Regular yogurt consumers with higher DASH diet scores had 16% (95% CI: 0.73–0.96) and 30% (95% CI: 0.57–0.85) CVD risk reductions in the 2 cohorts, respectively.

CONCLUSION
Hypertensive men and women who consumed ≥2 servings/week of yogurt, especially in the context of a healthy diet, were at lower risk for developing CVD.
Rapid immunosurveillance by recirculating lymphocytes in the rat intestine: critical role of unsulfated sialyl-Lewis X on high endothelial venules of the Peyer’s patches
Authors: Uchida Tomomi , Ueta Hisashi , Xu Xue-Dong , Hirakawa Jotaro , Tahara Kazunori , Zhou Shu , Sawanobori Yasushi , Simmons Szandor , Kitazawa Yusuke , Kawashima Hiroto , Matsuno Kenjiro 
Published: January 2018

Abstract
Naive lymphocytes systemically recirculate for immunosurveillance inspecting foreign antigens and pathogens in the body. Trafficking behavior such as the migration pathway and transit time within the gastrointestinal tract, however, remains to be elucidated. Rat thoracic duct lymphocytes (TDLs) were transferred to a congeneic host that had undergone mesenteric lymphadenectomy. The migration pathway was investigated using newly developed four-color immunohistochemistry and immunofluorescence. Donor TDLs showed rapid transition in gut tissues from which they emerged in mesenteric lymph around 4 h after intravenous injection. Immunohistochemistry showed that donor TDLs predominantly transmigrated across high endothelial venules (HEVs) at the interfollicular area of the Peyer’s patches (PPs), then exited into the LYVE-1+ efferent lymphatics, that were close to the venules. The rapid recirculation depended largely on the local expression of unsulfated sialyl-Lewis X on these venules where putative dendritic cells (DCs) were associated underneath. Recruited naive T cells briefly made contact with resident DCs before exiting to the lymphatics in the steady state. In some transplant settings, however, the T cells retained contact with DCs and were sensitized and differentiated into activated T cells. In conclusion, we directly demonstrated that lymphocyte recirculation within the gut is a very rapid process. The interfollicular area of PPs functions as a strategically central site for rapid immunosurveillance where HEVs, efferent lymphatics and resident DCs converge. PPs can, however, generate alloreactive T cells, leading to exacerbation of graft-versus-host disease or gut allograft rejection.
Factors Associated With Small Aggressive Non–Small Cell Lung Cancers in the National Lung Screening Trial: A Validation Study
Authors: Warkentin Matthew T , Tammemägi Martin C , Freedman Matthew T , Ragard Lawrence R , Hocking William G , Kvale Paul A , Brenner Darren R , Hu Ping , Riley Thomas L , Commins John , Church Timothy R , Berg Christine D 
Published: January 2018

Abstract

Background
A small proportion of non–small cell lung cancers (NSCLCs) have been observed to spread to distant lymph nodes (N3) or metastasize (M1) or both, while the primary tumor is small (≤3 cm, T1). These small aggressive NSCLCs (SA-NSLSC) are important as they are clinically significant, may identify unique biologic pathways, and warrant aggressive follow-up and treatment. This study identifies factors associated with SA-NSCLC and attempts to validate a previous finding that women with a family history of lung cancer are at particularly elevated risk of SA-NSCLC.

Methods
This study used a case–case design within the National Cancer Institute’s National Lung Screening Trial (NLST) cohort. Case patients and “control” patients were selected based on TNM staging parameters. Case patients (n = 64) had T1 NSCLCs that were N3 or M1 or both, while “control” patients (n = 206) had T2 or T3, N0 to N2, and M0 NSCLCs. Univariate and multivariable logistic regression were used to identify factors associated with SA-NSCLC.

Results
In bootstrap bias–corrected multivariable logistic regression models, small aggressive adenocarcinomas were associated with a positive history of emphysema (odds ratio [OR] = 5.15, 95% confidence interval [CI] = 1.63 to 23.00) and the interaction of female sex and a positive family history of lung cancer (OR = 6.55, 95% CI = 1.06 to 50.80).

Conclusions
Emphysema may play a role in early lung cancer progression. Females with a family history of lung cancer are at increased risk of having small aggressive lung adenocarcinomas. These results validate previous findings and encourage research on the role of female hormones interacting with family history and genetic factors in lung carcinogenesis and progression.
The Advocacy Portfolio: A Standardized Tool for Documenting Physician Advocacy
Authors: Nerlinger Abby L. , Shah Anita N. , Beck Andrew F. , Beers Lee S. , Wong Shale L. , Chamberlain Lisa J. , Keller David 
Published: January 2018

Recent changes in health care delivery systems and in medical training have primed academia for a paradigm shift, with strengthened support for an expanded definition of scholarship. Physicians who consider advocacy to be relevant to their scholarly endeavors need a standardized format to display activities and measure the value of health outcomes to which their work can be attributed. Similar to the Educator Portfolio, the authors here propose the Advocacy Portfolio (AP) to document a scholarly approach to advocacy.
Despite common challenges faced in the arguments for both education and advocacy to be viewed as scholarship, the authors highlight inherent differences between the two fields. On the basis of prior literature, the authors propose a broad yet comprehensive set of domains to categorize advocacy activities, including advocacy engagement, knowledge dissemination, community outreach, advocacy teaching/mentoring, and advocacy leadership/administration. Documenting quality, quantity, and a scholarly approach to advocacy within each domain is the first of many steps to establish congruence between advocacy and scholarship for physicians using the AP format.
This standardized format can be applied in a variety of settings, from medical training to academic promotion. Such documentation will encourage institutional buy-in by aligning measured outcomes with institutional missions. The AP will also provide physician–advocates with a method to display the impact of advocacy projects on health outcomes for patients and populations. Future challenges to broad application include establishing institutional support and developing consensus regarding criteria by which to evaluate the contributions of advocacy activities to scholarship.
Cortical Pain Response of Newborn Infants to Venepuncture
Authors: Rioualen Stéphane , Durier Virginie , Hervé David , Misery Laurent , Sizun Jacques , Roué Jean-Michel 
Published: January 2018

Objective:
Sucrose administration and breastfeeding decrease behavioral expressions of pain in neonates. However, recent studies indicated that there is a persistent cortical response with sucrose. This study compared the efficacy of sucrose administration versus breastfeeding to decrease cortical responses to pain during venepuncture.

Patients and Methods:
A randomized, prospective, controlled trial was conducted in a tertiary level maternity ward. Healthy, 3-day-old term neonates, undergoing venepuncture for neonatal screening, were randomly assigned to receive sucrose solution or be breastfed before venepuncture. Variations in the total hemoglobin concentration [HbT] in the contralateral somatosensory cortex were assessed with near infrared spectroscopy. The Neonatal Facial Coding System (NFCS) was used to assess reactions.

Results:
There were 114 term neonates included, with 102 included for the primary outcome (breastfed group: 48; sucrose group: 54). Similar maximum increases in [HbT] were observed in both groups (mean±SD: sucrose group: 31.2±58.1 μmol/L; breastfed group: 38.9±61.4 μmol/L; P=0.70). Breastfed neonates presented more behavioral expressions that indicated pain compared with sucrose-administered neonates (46.8% vs. 26.8% of NFCS ≥1, P=0.04). The maximum increase in [HbT] was persistent, although newborn infants who did not express behavioral signs of pain had lower concentrations than neonates who did (mean±SD: 21.2±29.1 vs. 60.0±89.8 μmol/L, P<0.01).

Discussion:
There was no difference in the cortical responses to pain during venepuncture in newborn infants who were administered sucrose versus those who were breastfed.
FLUORESCEIN ANGIOGRAPHIC EVALUATION OF PERIPHERAL RETINAL VASCULATURE AFTER PRIMARY INTRAVITREAL RANIBIZUMAB FOR RETINOPATHY OF PREMATURITY
Authors: Harper C. Armitage , Wright Lauren M. , Young Ryan C. , Read Sarah P. , Chang Emmanuel Y. 
Published: January 2018

Purpose:
To evaluate angiographic findings in neonates up to 150 weeks postmenstrual age who received intravitreal ranibizumab for primary treatment of Type 1 retinopathy of prematurity.

Methods:
Retrospective evaluation of fluorescein angiogram findings was completed for 30 eyes of 16 neonates who received intravitreal ranibizumab as primary treatment for Type 1 retinopathy of prematurity between April 2013 and January 2015. Outcome measures included maturity to Zone III, vascular blunting, vascular loops, vascular dilatation, capillary dropout, and vascular fluorescein leakage.

Results:
Mean gestational age was 241/7 weeks and mean postmenstrual age at time of intravitreal ranibizumab treatment was 35 weeks. Fluorescein angiograms performed at 44 weeks to 150 weeks postmenstrual age showed only 50% of eyes reached vascularization to Zone III; 40% had persistent vascular leakage; and ≥90% exhibited vascular blunting, vascular dilatation, and/or capillary dropout.

Conclusion:
Although intravitreal ranibizumab is effective in initial cessation of Type 1 retinopathy of prematurity, vascularization to Zone III was only achieved in 50% of eyes in our series and most eyes had fluorescein angiography evidence of vascular anomalies. If future studies are performed comparing treatment with laser photocoagulation to anti–vascular endothelial growth factor, fluorescein angiographic studies should be considered to assess the status of the peripheral retinal vasculature to determine treatment effect.
Incidence of Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty
Authors: Kocaba Viridiana , Mouchel Romain , Fleury Jacques , Marty Anne-Sophie , Janin-Manificat Hélène , Maucort-Boulch Delphine , Burillon Carole 
Published: January 2018

Purpose:
The incidence of and risk factors for cystoid macular edema (CME) after Descemet membrane endothelial keratoplasty (DMEK) remain uncertain. This study examines the incidence of and risk factors for CME after DMEK.

Methods:
This retrospective, single-center study included patients with no history of CME who had undergone DMEK. Patients were examined weekly for 1 month after surgery and at 3 and 6 months after surgery. Follow-up examinations included visual acuity (VA) assessment, pachymetry, anterior segment optical coherence tomography, biomicroscopy, intraocular pressure measurement, and fundoscopy. Eyes suspected of having CME (reduced VA and/or abnormal fundoscopic findings) underwent macular optical coherence tomography. Potential risk factors for CME examined included age, axial length, anterior chamber rebubbling, not using a topical nonsteroidal antiinflammatory after surgery, and concurrent DMEK and cataract surgery (triple-DMEK).

Results:
Eighty eyes (74 subjects) were included. Eleven eyes (13.8%) developed CME within 6 months after undergoing DMEK. Univariate analyses did not identify any significant CME risk factors. Interestingly, the triple-DMEK procedure did not put subjects at risk for developing CME (P = 0.184). Visual prognosis after medical treatment for CME was excellent, and subjects with and without CME had comparable VA at 6 months [CME: logarithm of the minimum angle of resolution (logMAR) VA = 0.3 (first–third quartile: 0.1–1.0), 20/40; no CME: logMAR VA = 0.3 (0.1–0.5), 20/40; P = 0.391].

Conclusions:
Although CME frequently occurred after DMEK, no CME risk factors were identified. In addition, CME did not significantly affect long-term visual outcomes when it was appropriately treated.
Human pain genetics database: a resource dedicated to human pain genetics research
Authors: Meloto Carolina B. , Benavides Rodrigo , Lichtenwalter Ryan N. , Wen Xia , Tugarinov Nicol , Zorina-Lichtenwalter Katerina , Chabot-Doré Anne-Julie , Piltonen Marjo H. , Cattaneo Stefano , Verma Vivek , Klares Richard , Khoury Samar , Parisien Marc , Diatchenko Luda 
Published: January 2018

AbstractThe Human Pain Genetics Database (HPGDB) is a comprehensive variant-focused inventory of genetic contributors to human pain. After curation, the HPGDB currently includes 294 studies reporting associations between 434 distinct genetic variants and various pain phenotypes. Variants were then submitted to a comprehensive analysis. First, they were validated in an independent high-powered replication cohort by testing the association of each variant with 10 different pain phenotypes (n = 1320-26,973). One hundred fifty-five variants replicated successfully (false discovery rate 20%) in at least one pain phenotype, and the associationPvalues of the HPGDB variants were significantly lower compared with those of random controls. Among the 155 replicated variants, 21 had been included in the HPGDB because of their association with analgesia-related and 13 with nociception-related phenotypes, confirming analgesia and nociception as pathways of vulnerability for pain phenotypes. Furthermore, many genetic variants were associated with multiple pain phenotypes, and the strength of their association correlated between many pairs of phenotypes. These genetic variants explained a considerable amount of the variance between different pairs of pain phenotypes, indicating a shared genetic basis among pain phenotypes. In addition, we found that HPGDB variants show many pleiotropic associations, indicating that genetic pathophysiological mechanisms are also shared among painful and nonpainful conditions. Finally, we demonstrated that the HPGDB data set is significantly enriched for functional variants that modify gene expression, are deleterious, and colocalize with open chromatin regions. As such, the HPGDB provides a validated data set that represents a valuable resource for researchers in the human pain field.
Therapeutic Approaches to Secondary Fracture Prevention in High Risk Populations: Current Recommendations and Advances
Authors: Lim Huei-Wen , Chamblain Melissa , Wong Benny , Raghavan Siddharth 
Published: January 2018

Background:Osteoporotic fragility fracture is a burgeoning health epidemic that is associated with high rates of disability, morbidity, and mortality. Based on NHANES data, approximately 10 million Americans are affected by this disease.Areas of Uncertainty:Successful secondary fracture prevention measures are often limited by the under-diagnosis of osteoporosis after fragility fractures because of lack of patient and physician awareness of the disease, lack of follow-up, and medical nonadherence.Therapeutic Advances:Current guidelines recommend the use of Bisphosphonate as the first-line therapy for secondary fracture prevention. Compared with placebo, randomized controlled trials have demonstrated a significant reduction in vertebral and nonvertebral fractures using Alendronate, Risedronate, Ibandronate, and Zoledronic acid. All but Ibandronate showed a significant reduction in hip fractures as well (all trials withP< 0.05). Denosumab is an option in patients with impaired renal function or who are unresponsive to other therapies. It significantly decreases the risk of new vertebral fracture [hazard ratio (HR) = 0.32, 95% confidence interval (CI), 0.26–0.41], hip fracture (HR = 0.60, 95% CI, 0.37–0.97) and nonvertebral fracture (HR = 0.80; 95% CI, 0.67–0.95) without an increased in adverse events. Hormonal therapy has been shown to be effective but should be used in the lowest effective dose to minimize the risk of coronary heart disease, stroke, and venous thromboembolism. Selective estrogen replacement modulators, calcitonin, and parathyroid hormone analog are other alternatives described in this article. In addition to current therapies, emerging therapies under investigation such as Abaloparatide, a parathyroid receptor ligand, and Romosozumab, a monoclonal anti-sclerotin antibody both showed a reduction in new morphometric vertebral fractures compared with placebo (0.58% vs. 4.22%, relative risk = 0.14, 95% CI, 0.05–0.39 and 0.5 vs. 1.8%, relative risk = 0.27, 95% CI, 0.16–0.47, respectively). In this article, we summarize advances in current therapeutic agents used for secondary fracture prevention and provide insight into potential therapies that hold promise in the future of osteoporosis.Conclusion:Secondary prevention of fragility fractures through care coordination and initiation of various pharmacologic agents is crucial in the elderly population. Careful risk assessment and stratification should be performed before the initiation of pharmacologic treatment to optimize disease management.
Therapeutic Advances in the Management of Orthostatic Hypotension
Authors: Patel Karishma , Kiszko Kinga , Torbati Ali 
Published: January 2018

Background:
Orthostatic hypotension (OH) is a common condition in hospitalized geriatric patients. These patients are more susceptible to OH during dehydration and volume depletion.

Areas of Uncertainty:
OH is often times asymptomatic. There is clear evidence that OH is a risk factor for cardiovascular disease, ischemic stroke, and mortality. Although certain treatments have demonstrated some success in improving OH, it is unclear whether these interventions have any effect on clinical outcomes such as falls, syncope, and mortality.

Therapeutic Advances:
Initial approaches to treatment should focus on nonpharmaceutical interventions, such as education about symptom recognition, lifestyle modifications, promotion of early mobilization, and avoidance of unnecessary bed rest orders. Pharmaceutical treatments are only indicated if the patient continues to be symptomatic in spite on nonpharmacologic interventions. The 2 main approaches to treating hypotension with pharmaceuticals include increasing blood volume and peripheral vascular resistance. Fludrocortisone should not be used as an isolated therapy, but a next step after dietary salt and water expansion. The recommended starting dose of fludrocortisone is 0.1 mg daily early in the morning with potential weekly increase up to 0.3 mg per day. If fludrocortisone is unsuccessful, midodrine may be used to increase peripheral vascular resistance. The starting dose of midodrine is 2.5 mg 3 times per day, with a slow titration to a maximum of 10 mg 3 times per day. Given the increased potential for underlying cardiovascular diseases in geriatric patients, midodrine should be used cautiously in acute illness. The use of prostaglandin inhibitors that is nonsteroidal anti-inflammatory drugs to raise blood pressure should be limited because of the increased risk of gastrointestinal bleeding, renal failure, and electrolytes abnormalities in elderly adults. Other agents which may be of benefit include clonidine, yohimbine, pyridostigmine, methylxanthine, dihydroergotamine, Cafergot, octreotide, and droxidopa; however, their use is conditional to certain etiologies behind OH, and the supporting evidence is low.

Conclusions:
Although there is no accepted protocol regarding how to manage hypertension in patients with OH, some studies favor the use of beta blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, over alpha-receptor antagonists and diuretics.
Trends in Preventable Inpatient and Emergency Department Utilization in California Between 2012 and 2015
Authors: Cunningham Peter , Sheng Yaou 
Published: January 2018

Background:
Expansions of health insurance coverage tend to increase hospital emergency department (ED) utilization and inpatient admissions. However, provisions in the Affordable Care Act that expanded primary care supply were intended in part to offset the potential for increased hospital utilization.

Objectives:
To examine the association between health insurance coverage, primary care supply, and ED and inpatient utilization, and to assess how both factors contributed to trends in utilization in California between 2012 and 2015.

Methods:
Population-based measures of ED and inpatient utilization, insurance coverage, and primary care supply were constructed for California counties for the years 2012 through 2015. Fixed effects regression analysis is used to examine the association between health insurance coverage, primary care supply, and rates of preventable ED and inpatient utilization.

Results:
Higher levels of Medicaid coverage in a county are associated with higher levels of preventable ED and inpatient utilization, although greater numbers of primary care practitioners and Federally Qualified Health Centers reduce this type of utilization.

Conclusions:
Increases in coverage accelerated a long-term increase in ED visits and prevented an even larger decrease in inpatient admissions, but changes in coverage do not fully explain these underlying trends. Increases in primary care supply offset the effects of coverage changes only modestly. Policymakers should not overstate the impact of the Affordable Care Act on increasing ED visits, and should focus on better understanding the underlying factors that are driving the trends.