bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adenoma Detection is Increased in the Setting of Melanosis Coli
Authors: Blackett John W. , Rosenberg Richard , Mahadev Srihari , Green Peter H.R. , Lebwohl Benjamin 
Published: November 2016

Goals:
To compare the adenoma detection rate (ADR) during colonoscopy in patients with melanosis coli against matched controls without melanosis.

Background:
Melanosis coli is a colonoscopic finding in which the colon wall appears darkly pigmented, most often due to extended laxative use, and is considered benign. The pigmentation spares adenomas, which should therefore be more readily detectable in melanosis coli.

Study:
We identified all patients with melanosis on colonoscopy at our institution over a 5-year period. We matched each patient with 2 controls by age, gender, and endoscopist. We compared the prevalence of adenomas between groups, and used multivariable analysis, adjusting for procedure indication and bowel preparation quality, to determine the independent association of melanosis with adenoma detection.

Results:
At least 1 adenoma was detected in 34.7% of melanosis patients and 26.5% of controls [odds ratio (OR)=1.52; 95% confidence interval (CI), 1.04-2.24; P=0.03]. On multivariable analysis, the presence of melanosis remained associated with increased adenoma detection (OR=1.56; 95% CI, 1.05-2.33; P=0.03). Melanosis patients were more likely to have an adenoma ≤5 mm (OR=1.62; 95% CI, 1.04-2.51; P=0.03), but not adenomas 6 to 9 mm or ≥10 mm.

Conclusions:
Melanosis coli is associated with a significant increase in ADR during colonoscopy compared with controls. The increased visibility of adenomas given their contrast with the pigmented background is a likely explanation. Future efforts to identify bowel preparation agents that can induce a similar effect could improve ADRs during colonoscopy.
Gastrointestinal hormones and the gut connectome
Authors: Ye Lihua , Liddle Rodger A. 
Published: November 2016

Purpose of review
Provision of adequate nutrients by the gut is essential for survival and essential behaviors are linked to the proper ingestion and digestion of food. Recently, a new neural connection has been reported between sensory cells of the gut epithelium and the nervous system that mediates signals from the gut to the brain.

Recent findings
This review describes how the gut senses its environment, relays those signals to the brain, and how the brain influences the gut.

Summary
This gut–brain connection provides a pathway for how the body handles food.
Understanding Treatment Disconnect and Mortality Trends in Renal Cell Carcinoma Using Tumor Registry Data
Authors: Smaldone Marc C. , Egleston Brian , Hollingsworth John M. , Hollenbeck Brent K. , Miller David C. , Morgan Todd M. , Kim Simon P. , Malhotra Aseem , Handorf Elizabeth , Wong Yu-Ning , Uzzo Robert G. , Kutikov Alexander 
Published: November 2016

Background and Objectives:
The paradoxical rise in overall and cancer-specific mortality despite increased detection and treatment of renal cell carcinoma (RCC) is termed “treatment disconnect.” We reassess this phenomenon by evaluating impact of missing data and rising incidence on mortality trends.

Research Design, Subjects, and Measures:
Using Surveillance, Epidemiology, and End Results data, we identified patients with RCC diagnosis from 1973 to 2011. We estimated mortality rates by tumor size after accounting for lags from diagnosis to death using multiple imputations for missing data from 1983. Mortality rates were estimated irrespective of tumor size after adjustment for prior cumulative incidence using ridge regression.

Results:
A total of 78,891 patients met inclusion criteria. Of 70,212 patients diagnosed since 1983, 10.4% had missing data. Significant attenuation in cancer-specific mortality was noted from 1983 to 2011 when comparing observed with imputed rates: Δobs0.05 versus Δimp0.10 (P=0.001, <2 cm tumors); Δobs0.29 versus Δimp0.18 (P=0.005, 2–4 cm tumors); Δobs0.46 versus Δimp–0.20 (P<0.001, 4–7 cm tumors); Δobs0.93 versus Δimp–0.15 (P<0.001, >7 cm tumors). Holding incidence of RCC constant to 2011 rates, temporal increase in overall mortality for all patients was attenuated (P<0.001) when comparing observed estimates (3.9–6.8) with 2011 adjusted estimates (5.9–7.1), suggesting that rapidly rising incidence may influence reported overall mortality trends. These findings were supported by assessment of mortality to incidence ratio trends.

Conclusions:
Missing data and rising incidence may contribute substantially to the “treatment disconnect” phenomenon when examining mortality rates in RCC using tumor registry data. Caution is advised when basing clinical and policy decisions on these data.
Knowledge as a Predictor of Insurance Coverage Under the Affordable Care Act
Authors: Hoerl Maximiliane , Wuppermann Amelie , Barcellos Silvia H. , Bauhoff Sebastian , Winter Joachim K. , Carman Katherine G. 
Published: November 2016

Background:
The Affordable Care Act established policy mechanisms to increase health insurance coverage in the United States. While insurance coverage has increased, 10%–15% of the US population remains uninsured.

Objectives:
To assess whether health insurance literacy and financial literacy predict being uninsured, covered by Medicaid, or covered by Marketplace insurance, holding demographic characteristics, attitudes toward risk, and political affiliation constant.

Research Design:
Analysis of longitudinal data from fall 2013 and spring 2015 including financial and health insurance literacy and key covariates collected in 2013.

Subjects:
A total of 2742 US residents ages 18–64, 525 uninsured in fall 2013, participating in the RAND American Life Panel, a nationally representative internet panel.

Measures:
Self-reported health insurance status and type as of spring 2015.

Results:
Among the uninsured in 2013, higher financial and health insurance literacy were associated with greater probability of being insured in 2015. For a typical uninsured individual in 2013, the probability of being insured in 2015 was 8.3 percentage points higher with high compared with low financial literacy, and 9.2 percentage points higher with high compared with low health insurance literacy. For the general population, those with high financial and health insurance literacy were more likely to obtain insurance through Medicaid or the Marketplaces compared with being uninsured. The magnitude of coefficients for these predictors was similar to that of commonly used demographic covariates.

Conclusions:
A lack of understanding about health insurance concepts and financial illiteracy predict who remains uninsured. Outreach and consumer-education programs should consider these characteristics.
The role of sinus surgery in sleep outcomes
Authors: Alt Jeremiah A. , Orb Quinn , Orlandi Richard R. 
Published: November 2016

Purpose of review
Poor sleep is associated with reduced health, increased morbidity, and increased mortality.

Recent findings
Chronic rhinosinusitis (CRS) is one of the most prevalent chronic diseases in the United States, affecting up to 16% of the U.S. population. It has been linked to poor sleep with up to 75% of patients with CRS reporting reduced sleep. Yet there has been little examining the improvement in sleep following surgical treatment of patients with CRS.

Summary
In this review, we examine the current knowledge on the association between sleep and CRS as well as review the current data examining the role of sinus surgery. After a structured literature search, we conclude that an evolving body of research demonstrates that sleep is compromised in the majority of patients with CRS. Following surgical treatment of CRS, there is a significant improvement in reported sleep quality that is correlated with subsequent improvement in disease-specific quality of life. Furthermore, we acknowledge that additional research characterizing both objective and subjective measures of sleep following surgical treatment is still needed. Additional investigation is required to better elucidate the underlying pathophysiology of the relationship between sleep dysfunction and CRS.
Impact of Breast Milk, Respiratory Insufficiency, and Gastroesophageal Reflux Disease on Enteral Feeding in Infants With Omphalocele
Authors: Haug Shelly , St. Peter Shawn , Ramlogan Sandhya , Goff Donna , Thorpe Donna , Hopper Andrew , Baerg Joanne 
Published: November 2016

ABSTRACTObjectives:The aim of this study was to document the process of achieving full enteral feeding in infants with omphalocele and to identify factors that affect feeding success.Methods:After institutional review board approval (study no. 5100169), 123 infants with omphalocele, born between 1993 and 2011 were reviewed. Mortalities were excluded. All survivors had complete follow‐up. Variables suspected to impact enteral feeding in infants with non‐giant versus giant omphalocele were compared. Independent t test, Mann‐Whitney, and χ2 test were used. Regression evaluated for variable independence.Results:Of 123 infants with omphalocele, 97 (79%) survived, 62/97 (64%) had non‐giant, and 35/97 (36%) giant omphalocele. For survivors, the mean gestational age was 37 ± 4 weeks with median follow‐up of 4.4 years (range: 1.4–7.4 years). The median time to full feeds was 4 days (range: 0–85 days) for non‐giant versus 8 days (range: 1–96 days) for giant, a significant difference (P < 0.01). Breast milk significantly decreased time to full feeds independent of omphalocele size. Giant omphalocele infants had a significantly higher incidence of respiratory insufficiency at birth (P < 0.01) and sac rupture (P = 0.02), but fewer chromosomal anomalies (P = 0.04). Respiratory insufficiency at birth (P < 0.01) and gastroesophageal reflux disease (P < 0.01) independently delayed feeding in omphalocele infants.Conclusions:Infants with non‐giant omphalocele can achieve full enteral feeds within the first week of life, but giant omphalocele infants require significantly more time. Breast milk independently promotes feeding success whereas gastroesophageal reflux disease and respiratory insufficiency at birth independently delay feeding in infants with omphalocele.
Breast Metastases in Children and Adolescents With Rhabdomyosarcoma: A Large Single-Institution Experience and Literature Review
Authors: Kebudi Rejin , Koc Begum S. , Gorgun Omer , Celik Alaaddin , Kebudi Abut , Darendeliler Emin 
Published: November 2016

Introduction:
Breast metastasis is rare in childhood malignancies. Soft tissue sarcomas, especially rhabdomyosarcomas (RMS), and hematologic neoplasms, such as lymphomas, are the most common tumors that metastasize to the breast, albeit rare.

Materials and Methods:
All cases with breast metastasis within a cohort of 200 RMS patients followed in our institution during 1990 to 2014 were assessed retrospectively and the literature was reviewed.

Results:
There were 3 adolescent female patients with breast metastasis. All had alveolar histology. The primary tumors were in the parameningeal sites, extremities, and the perineum, respectively. Two patients had breast metastasis at diagnosis, and 1 during follow-up. In 1 breast lesion, there was a complete response to chemotherapy, and in another there was no response to chemotherapy, and the patient underwent radical mastectomy. In the third patient, there was partial response, and lesions progressed. All patients died with recurrent/progressive disease, 2 with no recurrence in the breast. In the English literature, there are 70 cases including our cases. All but 1 involve female patients, all adolescents, most have alveolar histology and poor prognosis. All had chemotherapy, whereas some had surgery and/or radiotherapy for local treatment.

Conclusion:
Breast metastasis should be considered in adolescent female patients with RMS. Optimal management is not clear. Besides chemotherapy, mastectomy and radiotherapy should be considered on a case basis.
Comparison of Clinical Features and Outcomes in Patients With Bilateral Versus Unilateral Adrenal Neuroblastoma
Authors: Dinh Tu , Truong Bao , Matthay Katherine K. , DuBois Steven G. 
Published: November 2016

Background:
While nearly half of cases of neuroblastoma arise in one of the adrenal glands, bilateral origin is rare. We aimed to compare clinical characteristics and outcomes between patients with bilateral versus unilateral adrenal neuroblastoma.

Procedure:
We utilized the Surveillance, Epidemiology, and End Results database to identify patients with bilateral and unilateral adrenal neuroblastoma from 1973 to 2012. We used Fisher exact tests to compare demographics and clinical features between groups. We used Kaplan-Meier methods to describe the 5-year overall survival rate for these 2 groups. We conducted a literature review to complement the Surveillance, Epidemiology, and End Results data.

Results:
Of 1617 patients in the cohort, 1585 (98%) had unilateral disease and 32 (2%) had bilateral disease. Compared with patients with unilateral disease, a significantly greater proportion of patients with bilateral disease was below 1 year of age (53.1% vs. 31.8%; P=0.01) and had distant metastasis at diagnosis (90.6% vs. 69.0%; P=0.006). The 5-year overall survival rate for patients diagnosed with bilateral disease was 70.5% (95% confidence interval, 45.1%-85.8%), compared with 62.4% (95% confidence interval, 59.7%-65%) for patients with unilateral disease (P=0.26).

Conclusions:
Compared with patients with unilateral disease, patients with bilateral adrenal neuroblastoma are younger, more likely to have distant metastasis, and have a favorable outcome.
The Effects of Mind Subtraction Meditation on Breast Cancer Survivors’ Psychological and Spiritual Well-being and Sleep Quality
Authors: Yun Mi Ra , Song Misoon , Jung Kyung-Hae , Yu Boas J. , Lee Kyung Jae 
Published: November 2016

Background:
Most breast cancer survivors experience psychological and spiritual distress, including depression, anxiety, perceived stress, and loss of meaningfulness in life. This distress can negatively impact physical health, quality of life, and quality of sleep.

Objective:
The aim of this study was to compare and examine the effectiveness of mind subtraction meditation (MSM) and a self-management education (SME) group on breast cancer survivors.

Methods:
A randomized controlled trial was conducted with South Korean female breast cancer survivors (stages I-III). Self-reported questionnaires were administered to both MSM group (n = 22) and SME group (n = 24) to measure psychological and spiritual well-being, as well as quality of sleep.

Results:
Compared with the SME group, the MSM group reported a significant decrease in depression (P = .034), anxiety (P = .036), and perceived stress (P = .009) and an increase in quality of life (P < .001), satisfaction with life (P < .001), posttraumatic growth (P = .007), and quality of sleep (P = .010).

Conclusions:
Mind subtraction meditation may have positive therapeutic effects among breast cancer survivors. This meditation program may be useful to manage psychological and spiritual distress, as well as improve quality of life and sleep, in clinical settings among breast cancer survivors.

Implications for Practice:
This study demonstrated the clinical effectiveness and the feasibility of applying the MSM method to breast cancer survivors. The participants had a high attendance rate in the program, which speaks to the likelihood of the applicability of the meditation program on an outpatient basis.
Sudden Cardiac Death
Authors: Ifteni Petru , Barabas Barna , Gavris Claudia , Moga Marius , Burtea Victoria , Dracea Laura 
Published: November 2016

Background
Sudden cardiac death (SCD) is a sudden unexpected event, from a cardiac cause, that occurs in less than 1 hour after the symptom onset in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before being found dead.

Objective
The aims of the study were to describe the features of SCD in Brasov County, Romania (400,000 inhabitants) according to local forensic department autopsy files.

Methods
We retrospectively chart reviewed a number of 7200 autopsy reports between 2001 and 2015 to identify cases of SCD. Data included cause of death, demographics, location of the event, prior known illnesses, as well as psychiatric comorbidities.

Results
Of 7200 autopsies effectuated during the 15-year period, we excluded 276 cases with incomplete data. The rest of the 6924 cases included 3000 autopsies (43.3%) of individuals with a violent death: accidents, suicides, and homicides. In 3924 cases (56.7%), the death was nonviolent. Of 3924 nonviolent deaths, based on the registry of Forensic department, we identified 1085 cases of SCD (749 males [69%]; mean age, 56 ± 17.4 years).

Conclusion
Sudden death with a cardiac etiology remained a major cause of unexpected end of life in the vast majority of cases autopsied during the study period.
Lyme neuroborreliosis
Authors: Koedel Uwe , Pfister Hans-Walter 
Published: November 2016

Purpose of review
Lyme disease is a multistage and multisystem disease. Neurological manifestations [termed Lyme neuroborreliosis (LNB)] occur in about 10% of patients with Lyme disease. Diagnostics and treatment of early and late LNB are widely established. However, the management of persistent symptoms is still fraught with controversies, and therefore is the focus of this review.

Recent findings
The incidence of Lyme disease seems to be much higher than previously assumed. Laboratory methods (namely serological tests) are essential for diagnosing LNB, but only when performed according to the guidelines of scientific medical societies. Most patients treated for LNB have good outcomes. However, some patients remain with nonspecific symptoms despite conventional therapy, a syndrome called posttreatment Lyme disease syndrome (PTLDS). IDSA has provided a formal definition of PTLDS, but its pathogenesis and even its existence remains to be clarified. Of note, there is evidence that these patients do not suffer from persistent Borrelia burgdorferi infection and do not benefit from additional antibiotic therapy.

Summary
Acute and late LNB are well established disorders. The existence of PTLDS as a disease entity is still unclear and needs further investigation. Unorthodox alternative therapies advertised to patients with Lyme disease on the Internet are not proven to be effective and well tolerated.
Drosophila BEACH domain autophagic adaptorblue cheeseshuttles between vesicle populations and is required for an early step in autophagy
Authors: Sim Joan , Osborne Kathleen A. , Garcia Irene Argudo , Matysik Artur S. , Kraut Rachel 
Published: November 2016

AbstractDrosophila melanogaster blue cheese(bchs) encodes a large BEACH (Beige and Chediak-Higashi) family protein that is postulated to function as an adaptor protein with roles in vesicle trafficking. Mutation inbchsleads to the accumulation of ubiquitinated aggregates in aged brains, presumably because of a conserved function with its human homologue Autophagy-Linked FYVE (ALFY), which interacts with Atg5 and p62 to promote the clearance of aggregate-prone proteins. In this study, we present pharmacological and genetic evidence using a well-defined larval motorneuron paradigm that inDrosophila bchsmutants, autophagic deficit contributes to neurodegeneration. Specifically, we show that motorneuron death in larvae is accompanied by the accumulation of prominent ubiquitinated aggregates in synaptic termini, and that these are sensitive to autophagy modulating drugs. In primarybchsneurons, early autophagic compartments increase in number and intensity based on Atg5 expression, but fail to progress to Atg8-labelled compartments, indicating non-clearance. A rescuing transgene encoding the longest Bchs BEACH domain isoform not only reverses this defect, but also greatly increases Atg8 compartment number and rescues neuronal death. Although only a small fraction of Bchs colocalizes with these markers under wild-type conditions, the population of Bchs that does associate with autophagosomes shuttles between different locations depending on how autophagy is induced. These observations, together with epistatic relationships betweenbchsmutant alleles and autophagy-modulating drugs and genetic backgrounds, points to a model whereby BEACH domain isoforms of Bchs participate in the early steps of autophagy by recruiting Atg5 to target substrates for clearance, and that Bchs’ association with different parts of the autophagy machinery depends upon the type of autophagic stress imposed upon the neuron.
A modification-specific peptide-based immunization approach using CRM197 carrier protein:Development of a selective vaccine against pyroglutamate Aβ peptides
Authors: Vingtdeux Valérie , Zhao Haitian , Chandakkar Pallavi , Acker Christopher M. , Davies Peter , Marambaud Philippe 
Published: November 2016

ABSTRACTStrategies aimed at reducing cerebral accumulation of the amyloid-β (Aβ) peptides have therapeutic potential in Alzheimer’s disease (AD). Aβ immunization has proven to be effective at promoting Aβ clearance in animal models but adverse effects have hampered its clinical evaluation. The first anti-Aβ immunization clinical trial, which assessed a full-length Aβ1-42 vaccine, increased the risk of encephalitis most likely because of autoimmune pro-inflammatory T helper 1 (Th1) response against all forms of Aβ. Immunization against less abundant but potentially more pathologically relevant Aβ products, such as N-terminally-truncated pyroglutamate-3 Aβ (AβpE3), could provide efficacy and improve tolerability in Aβ immunotherapy. Here, we describe a selective vaccine against AβpE3 using the diphtheria toxin mutant CRM197 as carrier protein for epitope presentation. CRM197 is currently used in licensed vaccines and has demonstrated excellent immunogenicity and safety in humans. In mice, our AβpE3:CRM197 vaccine triggered the production of specific anti-AβpE3 antibodies that did not cross-react with Aβ1-42, non-cyclized AβE3, or N-terminally-truncated pyroglutamate-11 Aβ (AβpE11). AβpE3:CRM197 antiserum strongly labeled AβpE3 in insoluble protein extracts and decorated cortical amyloid plaques in human AD brains. Anti-AβpE3 antibodies were almost exclusively of the IgG1 isotype, suggesting an anti-inflammatory Th2 response bias to the AβpE3:CRM197 vaccine. To the best of our knowledge, this study shows for the first time that CRM197 has potential as a safe and suitable vaccine carrier for active and selective immunization against specific protein sequence modifications or conformations, such as AβpE3.