bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stable Transmission of Borrelia burgdorferi Sensu Stricto on the Outer Banks of North Carolina
Authors: Levine J. F. , Apperson C. S. , Levin M. , Kelly T. R. , Kakumanu M. L. , Ponnusamy L. , Sutton H. , Salger S. A. , Caldwell J. M. , Szempruch A. J. 
Published: December 2016

SummaryThe spirochaete (Borrelia burgdorferi) associated with Lyme disease was detected in questing ticks and rodents during a period of 18 years, 1991–2009, at five locations on the Outer Banks of North Carolina. The black‐legged tick (Ixodes scapularis) was collected at varied intervals between 1991 and 2009 and examined for B. burgdorferi. The white‐footed mouse (Peromyscus leucopus), house mouse (Mus musculus) marsh rice rat (Oryzomys palustris), marsh rabbit (Sylvilagus palustris), eastern cottontail (Sylvilagus floridanus) and six‐lined racerunner (Cnemidophorus sexlineatus) were live‐trapped, and their tissues cultured to isolate spirochaetes. Borrelia burgdorferi isolates were obtained from questing adult I. scapularis and engorged I. scapularis removed from P. leucopus, O. palustris and S. floridanus. The prevalence of B. burgdorferi infection was variable at different times and sites ranging from 7 to 14% of examined questing I. scapularis. Mitochondrial (16S) rRNA gene phylogenetic analysis from 65 adult I. scapularis identified 12 haplotypes in two major clades. Nine haplotypes were associated with northern/Midwestern I. scapularis populations and three with southern I. scapularis populations. Sixteen isolates obtained from tick hosts in 2005 were confirmed to be B. burgdorferi by amplifying and sequencing of 16S rRNA and 5S‐23S intergenic spacer fragments. The sequences had 98–99% identity to B. burgdorferi sensu stricto strains B31, JD1 and M11p. Taken together, these studies indicate that B. burgdorferi sensu stricto is endemic in questing I. scapularis and mammalian tick hosts on the Outer Banks of North Carolina.
Reinventing the community hospital: a retrospective population-based cohort study of a natural experiment using register data
Authors: Swanson Jayson O , Hagen Terje P 
Published: December 2016

ObjectivesTo investigate whether implementation of municipal acute bed units (MAUs) resulting from the Norwegian Coordination Reform (2012) was associated with reductions in hospital admissions, particularly for the elderly.DesignA municipality-based retrospective comparative cohort study using monthly population-based registry data analysed with fixed-effects log–log regressions.SettingNorwegian municipalities and hospitals.PopulationAll patients admitted to secondary hospital care in Norway between 2010 and 2014, excluding psychiatric admissions, with additional focus on admission type and elderly age subgroups.Main outcome measuresMonthly admission rates in total and by age group for all patients, patients admitted with acute conditions and with acute conditions at internal medicine departments.ResultsThe introduction of MAUs was associated with a small yet significant overall negative effect on hospital admissions. The reduction in all admissions was significant for the entire population (−1.2%, 95% CI −2.0% to −0.0%) and slightly stronger for those aged 80 years and above (−1.9%, 95% CI −3.0% to −1.0%). The more detailed analysis of the elderly population aged 80 years and above revealed that effects were affected by the institutional characteristics of the MAUs. The significant effects ranged between −1.6% and −8.6%, depending on the availability of physicians on duty at the MAUs, the MAUs location or combinations thereof.ConclusionsIntroduction of MAUs following implementation of the Norwegian Coordination Reform in 2012 was associated with a significant reduction in hospital admissions primarily for the elderly. Our findings suggest that this type of intermediate care is a viable option in an effort to alleviate the burden on hospitals by reducing the acute secondary care admission volume. Further examinations focused on cost-effectiveness, health status of patients, number of patients treated at the MAUs and comparing other intermediate care alternatives would all add important perspectives to the issue.
Setting priorities for research in medical nutrition education: an international approach
Authors: Ball Lauren , Barnes Katelyn , Laur Celia , Crowley Jennifer , Ray Sumantra 
Published: December 2016

ObjectivesTo identify the research priorities for medical nutrition education worldwide.DesignA 5-step stakeholder engagement process based on methodological guidelines for identifying research priorities in health.Participants277 individuals were identified as representatives for 30 different stakeholder organisations across 86 countries. The stakeholder organisations represented the views of medical educators, medical students, doctors, patients and researchers in medical education.InterventionsEach stakeholder representative was asked to provide up to three research questions that should be deemed as a priority for medical nutrition education.Main outcome measuresResearch questions were critically appraised for answerability, sustainability, effectiveness, potential for translation and potential to impact on disease burden. A blinded scoring system was used to rank the appraised questions, with higher scores indicating higher priority (range of scores possible 36–108).Results37 submissions were received, of which 25 were unique research questions. Submitted questions received a range of scores from 62 to 106 points. The highest scoring questions focused on (1) increasing the confidence of medical students and doctors in providing nutrition care to patients, (2) clarifying the essential nutrition skills doctors should acquire, (3) understanding the effectiveness of doctors at influencing dietary behaviours and (4) improving medical students' attitudes towards the importance of nutrition.ConclusionsThese research questions can be used to ensure future projects in medical nutrition education directly align with the needs and preferences of research stakeholders. Funders should consider these priorities in their commissioning of research.
Sex differences in the relationship between socioeconomic status and cardiovascular disease: a systematic review and meta-analysis
Authors: Backholer Kathryn , Peters Sanne A E , Bots Sophie H , Peeters Anna , Huxley Rachel R , Woodward Mark 
Published: December 2016

BackgroundLow socioeconomic status (SES) is a known risk factor for cardiovascular disease (CVD) but whether its effects are comparable in women and men is unknown.MethodsPubMed MEDLINE was systematically searched. Studies that reported sex-specific estimates, and associated variability, of the relative risk (RR) for coronary heart disease (CHD), stroke or CVD according to a marker of SES (education, occupation, income or area of residence), for women and men were included. RRs were combined with those derived from cohort studies using individual participant data. Data were pooled using random effects meta-analyses with inverse variance weighting. Estimates of the ratio of the RRs (RRR), comparing women with men, were computed.ResultsData from 116 cohorts, over 22 million individuals, and over 1 million CVD events, suggest that lower SES is associated with increased risk of CHD, stroke and CVD in women and men. For CHD, there was a significantly greater excess risk associated with lower educational attainment in women compared with men; comparing lowest with highest levels, the age-adjusted RRR was 1.24 (95% CI 1.09 to 1.41) and the multiple-adjusted RRR was 1.34 (1.09 to 1.63). For stroke, the age-adjusted RRR was 0.93 (0.72 to 1.18), and the multiple-adjusted was RRR 0.79 (0.53 to 1.19). Corresponding results for CVD were 1.18 (1.03 to 1.36), 1.23 (1.03 to 1.48), respectively. Similar results were observed for other markers of SES for all three outcomes.ConclusionsReduction of socioeconomic inequalities in CHD and CVD outcomes might require different approaches for men and women.
Pre-emptive administration of fibrinogen concentrate contributes to improved prognosis in patients with severe trauma
Authors: Yamamoto Koji , Yamaguchi Atsushi , Sawano Makoto , Matsuda Masaki , Anan Masahiro , Inokuchi Koichi , Sugiyama Satoru 
Published: December 2016

BackgroundPatients with severe trauma often present with critical coagulopathy, resulting in impaired hemostasis, massive hemorrhage, and a poor survival prognosis. The efficacy of hemostatic resuscitation in correcting coagulopathy and restoring tissue perfusion has not been studied. We assessed a novel approach of pre-emptive administration of fibrinogen concentrate to improve critical coagulopathy in patients with severe trauma.MethodsWe retrospectively compared blood transfusion volumes and survival prognosis between three groups of patients with trauma, with an Injury Severity Score (ISS) ≥26 over three consecutive periods: group A, no administration of fibrinogen concentrate; group B, administration of 3 g of fibrinogen concentrate after evaluation of trauma severity and a plasma fibrinogen level <1.5 g/L; group C, pre-emptive administration of 3 g of fibrinogen concentrate immediately on patient arrival based on prehospital information, including high-severity injury or assessed need for massive transfusion before measurement of fibrinogen.Results∼56% of patients with an ISS ≥26 and transfused with red blood cell concentrates ≥10 units, had hypofibrinogenemia (fibrinogen <1.5 g/L) on arrival. Patients who received fibrinogen concentrate in group C showed significantly higher fibrinogen levels after treatment with this agent than those in group B (2.41 g/L vs 1.88 g/L; p=0.01). Although no significant difference was observed in blood transfusion volumes between the groups, the 30-day survival of patients in group C (all, and those with an ISS ≥26) was significantly better than in group A (p<0.05). The 48-hour mortality rate in patients with an ISS ≥26 was significantly lower in group C than in group A (8.6% vs 22.9%; p=0.005). Further, among patients with an ISS ≥41, the overall mortality was significantly lower in group C than in group A (20% vs 50%; p=0.02).ConclusionPre-emptive administration of fibrinogen concentrate for patients with trauma with critical coagulopathy may contribute to improved survival.Level of evidenceLevel IV.
Accelerated deflation promotes homogeneous airspace liquid distribution in the edematous lung
Authors: Wu You , Nguyen Tam L. , Perlman Carrie E. 
Published: December 2016

Edematous lungs contain regions with heterogeneous alveolar flooding. Liquid is trapped in flooded alveoli by a pressure barrier—higher liquid pressure at the border than in the center of flooded alveoli—that is proportional to surface tension, T. Stress is concentrated between aerated and flooded alveoli, to a degree proportional to T. Mechanical ventilation, by cyclically increasing T, injuriously exacerbates stress concentrations. Overcoming the pressure barrier to redistribute liquid more homogeneously between alveoli should reduce stress concentration prevalence and ventilation injury. In isolated rat lungs, we test whether accelerated deflation can overcome the pressure barrier and catapult liquid out of flooded alveoli. We generate a local edema model with normal T by microinfusing liquid into surface alveoli. We generate a global edema model with high T by establishing hydrostatic edema, which does not alter T, and then gently ventilating the edematous lungs, which increases T at 15 cmH2O transpulmonary pressure by 52%. Thus ventilation of globally edematous lungs increases T, which should increase stress concentrations and, with positive feedback, cause escalating ventilation injury. In the local model, when the pressure barrier is moderate, accelerated deflation causes liquid to escape from flooded alveoli and redistribute more equitably. Flooding heterogeneity tends to decrease. In the global model, accelerated deflation causes liquid escape, but—because of elevated T—the liquid jumps to nearby, aerated alveoli. Flooding heterogeneity is unaltered. In pulmonary edema with normal T, early ventilation with accelerated deflation might reduce the positive feedback mechanism through which ventilation injury increases over time. NEW & NOTEWORTHY We introduce, in the isolated rat lung, a new model of pulmonary edema with elevated surface tension. We first generate hydrostatic edema and then ventilate gently to increase surface tension. We investigate the mechanical mechanisms through which 1) ventilation injures edematous lungs and 2) ventilation with accelerated deflation might lessen ventilation injury.
Exposure-response modeling of flow-mediated dilation provides an unbiased and informative measure of endothelial function
Authors: Van Brackle Charles H. , Harris Ryan A. , Hallow K. Melissa 
Published: December 2016

The brachial artery flow-mediated dilation (FMD) test is the most widely utilized method to evaluate endothelial function noninvasively in humans by calculating the percent change in diameter (FMD%). However, the underutilized velocity and diameter time course data, coupled with confounding influences in shear exposure, noise, and upward bias, make the FMD test less desirable. In this study, we developed an exposure-response, model-based approach that not only quantifies FMD based on the rich velocity and diameter data, it overcomes previously acknowledged challenges. FMD data were obtained from 15 apparently healthy participants, each exposed to four different cuff occlusion durations. The velocity response following cuff release was described by an exponential model with two parameters defining peak velocity and rate of decay. Shear exposure derived from velocity was used to drive the diameter response model, which consists of additive constriction and dilation terms. Three parameters describing distinct aspects of the vascular response to shear (magnitude of the initial constriction response, and magnitude and time constant of the dilation response) were estimated for both the individuals and population. These parameters are independent of shear exposure. Thus this approach produces identifiable and physiologically meaningful parameters that may provide additional information for comparing differences between experimental groups or over time, and provides a means to completely account for shear exposure. NEW & NOTEWORTHY While flow-mediated dilation (FMD) is a valuable tool for evaluating endothelial function, analytical challenges include confounding influences of shear exposure, upward bias, and underutilization of rich time course data collected during FMD testing. We have developed an exposure-response, model-based approach that quantifies endothelial function based on the velocity and diameter data and fully accounts for shear exposure. It produces physiologically meaningful parameters that may provide useful information for comparing differences between experimental groups or over time.
Abstract A05: Proteomic analysis of exosome content changes induced by gemcitabine in pancreatic cancer stromal cells
Authors: Huang Wei , Feist Peter , Hummon Amanda , Hill Reginald 
Published: December 2016

Abstract
Despite recent advances in multimodality therapy, pancreatic ductal adenocarcinoma (PDAC) remains the 3rd leading cause of cancer-related deaths in the United States with a 5-year survival rate of 8%. One hallmark of this disease is desmoplasia that consist largely of stromal cells and extracellular matrix (ECM) proteins. The abundant stromal cells provide a unique tumor microenvironment that aid tumorigenesis. Unfortunately, there is little data on the mechanism underlying the stromal cells’ ability to impact chemoresistance in neighboring cancer cells in response to drug treatment. Exosomes are small vesicles secreted into the extracellular environment from cells and evidence is accumulating that exosomes play a key role in intercellular signaling. Researchers have focused on exosomes secreted from cancer cells, but the function of stromal exosomes has not been investigated, especially in pancreatic cancer. As stromal cells comprise the majority of the pancreatic tumor bulk, we hypothesize that stromal cell-derived exosomes help pancreatic cancer cells resist chemotherapy. Thus, it is critical to characterize the complex composition of stromal exosomes. In this study, we analyzed the proteomic content of exosomes collected from stromal cell lines created from PDAC patients. Furthermore, we also determined the change in exosomal proteomic composition after the patient-derived stromal cells were treated with gemcitabine, the current standard of care chemotherapy for patients with PDAC. Our studies have identified possible diagnostic and prognostic biomarkers and suggest novel molecular mechanism responsible for the tumor microenvironment’s ability to regulate chemoresistance in neighboring pancreatic cancer cells.
Citation Format: Wei Huang, Peter Feist, Amanda Hummon, Reginald Hill.{Authors}. Proteomic analysis of exosome content changes induced by gemcitabine in pancreatic cancer stromal cells. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr A05.
Abstract A14: Engineering pancreatic cancer through molecular and cellular reconstruction
Authors: Akanuma Naoki , Liu Jun , Wang Pei 
Published: December 2016

Abstract
Pancreatic ductal adenocarcinoma (PDAC) is one of the most deadly human malignancies characterized by the accumulation of a series of genetic mutations during disease progression. Despite significant amount of studies using genetically engineered mouse PDAC models, human PDAC still has a dismal prognosis, and there are few models for human PDAC tumorigenesis. To establish a genetic modification system for human pancreatic tissue, we made lentiviral CRISPR to target CDKN2A/p16, p53 and SMAD4. We have confirmed the efficiency of the p16 CRISPR, p53 CRISPR and SMAD4 CRISPR constructs in editing the genome to delete the respective gene loci. We then generated a lentiviral vector to express KRASG12D-mCherry and transduced normal human primary pancreatic exocrine cells with single or multiple viral vector combinations. After one week of culture, two million of the cells were transplanted into the renal sub-capsular space of NOD-SCID mice. The engraftments were harvested 4 months after transplantation. We observed two PanIN lesions in kidneys where KRASG12D mutant cells were transplanted. Human cells were detected using anti-human nuclear antigen antibody (anti-HuNu). Anti-Pan cytokeratin staining proved that the lesions were made up of epithelial cells. The histologic appearance of the lesion from the cells with all four mutations, KRASG12D p16-/- p53-/- SMAD4-/-, differed from that of the two PanIN lesions in that has a single, much larger cyst with mucin rich cytoplasm reminiscent of mucinous cystic neoplasm (MCN). To further define the cellular origin of PDAC initiation, we also developed a flow cytometry-based method to sort viable ductal cells and acinar cells from primary normal human pancreatic cells for genetic modifications. In summary, we have successfully generated PDAC-associated-precancerous lesions from primary normal human pancreatic tissues. The system established in this study could be a valuable platform to address the fundamental mechanisms for the human PDAC tumorigenesis process.
Citation Format: Naoki Akanuma, Jun Liu, Pei Wang.{Authors}. Engineering pancreatic cancer through molecular and cellular reconstruction. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr A14.
Abstract A89: Is it justified to have pancreaticoduodenectomy in elderly patients with pancreatic malignancy? A population-based study
Authors: Yang Ching-Yao , Wu Jin-Ming , Kuo Ting-Chun , Lai Hong-Shiee , Tien Yu-Wen 
Published: December 2016

Abstract
Introduction: Although the perioperative outcome of pancreaticoduodenectomy (PD) has improved in these 10 years, and several studies found the short-term, perioperative outcome is similar between the groups in the elderly or younger patients, the issue of PD on eldely patients is still controversial. Most of the studies were performed in single institute or only reported the short-term outcome. The purpose of this study is to use population-based data to analyze the age effect on perioperative and long-term outcome after PD, esp. in the elderly patients more than 75 years old, and with pancreatic malignancy.
Methods: By using the National Health Insurance Research Database (NHIRD) of Taiwan, we performed this nationwide retrospective cohort study.
Results: Between 2001-2010, totally, 4475 adult patients (&gt;= 20 years) who received elective PD with ICD procedure code: 52.7 were included. Overall, the 30-day including in-hospital mortality, and 1-year mortality was 5.2%, and 22.9% in younger patients (&lt;= 75 years), and 14.4% and 40% in the elderly (&gt; 75 years). 3639 cases were malignancy, while only 836 cases were benign disease. We further analyzed the data from patients with pancreatic malignancy, elderly patients have significantly longer hospital stay (41.5 days vs 35.9 days), ICU stay and hospital cost after PD. After multivariate analysis, the elderly has significantly higher 30-day mortality (adjusted OR: 2.425 comparing with the younger), and higher 1-year mortality (adjusted OR: 1.867), the age effect on mortality can also be observed as a significant trend (for patients &gt;80, 70-80, 60-70 comparing with &lt;= 60 years: adjusted OR 3.85, 3.50, 2.12). Other factors to predict higher mortality included patients need PRBC transfusion, CCI&gt;2, patients with preoperative comorbidity: myocardia infarction and renal failure. Patients received PD at high volume center (PD &gt;=20 cases / year) have significant less 30-day, and 1-year mortality (adjusted OR: 0.447, and 0.748). Female patients, and operation during the late era, 2006-2010 are the good predictors for less mortality. Furtherly, decision-tree analysis found the old age and operation at high volume center are the most important effects on mortality.
Conclusion: Elderly patients (&gt; 75 years) with pancreatic malignancy after pancreaticoduodenectomy have significantly higher 30-day and 1-year mortality. We recommended all elderly patients should be treated at high-volume centers.
Citation Format: Ching-Yao Yang, Jin-Ming Wu, Ting-Chun Kuo, Hong-Shiee Lai, Yu-Wen Tien.{Authors}. Is it justified to have pancreaticoduodenectomy in elderly patients with pancreatic malignancy? A population-based study. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr A89.