bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of the EndoBarrier Gastrointestinal Liner on obesity and type 2 diabetes: protocol for systematic review and meta-analysis of clinical studies
Authors: Rohde Ulrich , Hedbäck Nora , Gluud Lise L , Vilsbøll Tina , Knop Filip K 
Published: September 2013

IntroductionObese patients with type 2 diabetes undergoing bariatric surgery experience significant and lasting weight loss and improved glycaemic control. However, bariatric surgical procedures such as Roux-en-Y gastric bypass are irreversible and associated with considerable short-term and long-term risks. The EndoBarrier Gastrointestinal Liner or duodenal-jejunal bypass sleeve (DJBS) is a fully reversible procedure that has been developed to treat obesity and type 2 diabetes. We aim to perform a systematic review and meta-analysis of safety and efficacy of DJBS.Methods and analysesA systematic review with meta-analysis (as per the preferred reporting items for systematic reviews and meta-analyses) of randomised controlled trials of the device (vs no intervention, sham and/or low-calorie diet) will be performed. Primary endpoints include change in body weight and glycated haemoglobin and safety. Secondary endpoints constitute changes in other glycaemic parameters and blood lipids and the proportion of patients discontinuing antidiabetic medication. MEDLINE, EMBASE, The Cochrane Library and Science Citation Index will be sought electronically along with manual searches. The primary meta-analysis will use random effects models due to an expected intertrial heterogeneity. Fixed effect meta-analysis will be executed to assess the impact of small trials. Dichotomous data will be analysed using risk difference and continuous data using weighted mean differences, both with 95% CIs.Ethics and disseminationThe study will describe the impact of DJBS on obesity and type 2 diabetes and possibly contribute to clinical decision-making. The results of this study will be disseminated by peer-reviewed publication and scientific presentations.RegistrationPROSPERO CRD42013004819
Geochemistry of soil contamination from lead smelters near Eureka Nevada
Authors: Chaffee Maurice A. , King Harley D. 
Published: September 2013

Eureka, Nevada, was once a boom-mining town with peak production of Pb, Ag, and Au between the 1870s and 1890s. Most of the ores from the area were processed in two smelters located at the north and south edges of the town. Smelter effluent was exhausted in the vicinity of the smelter furnaces with little regard to potential health concerns.
For this study, 186 soil samples from sites in the area surrounding Eureka were analysed for 43 elements. Factor analysis and element plots identified 16 smelter-related elements: Ag, As, Bi, Cd, Cu, Hg, In, Mo, Pb, S, Sb, Sn, Te, Tl, W, and Zn. Eight other elements (Ba, Be, Co, Cr, Mn, Ni, U, and V), whose distributions are controlled by the chemical composition of the underlying substrate material, were also evaluated.
Of these 24 elements, only six (As, Cd, Pb, Tl, Sb, and Mn) had concentrations that exceeded U.S. Environmental Protection Agency (EPA) estimated residential soil screening levels considered to represent possible health risks. For some analysed elements (In, S, Te, and W) no screening levels have been established. Whether these elements, or any of the others determined, constitute a health risk in the local population is not known.

Supplementary Material:

Analyses for 43 elements in 186 soil samples are available at
www.geolsoc.org.uk/SUP18673
PowerNap
Authors: Meisner David , Gold Brian T. , Wenisch Thomas F. 
Published: September 2013

Data center power consumption is growing to unprecedented levels: the EPA estimates U.S. data centers will consume 100 billion kilowatt hours annually by 2011. Much of this energy is wasted in idle systems: in typical deployments, server utilization is below 30%, but idle servers still consume 60% of their peak power draw. Typical idle periods though frequent--last seconds or less, confounding simple energy-conservation approaches.
In this paper, we propose PowerNap, an energy-conservation approach where the entire system transitions rapidly between a high-performance active state and a near-zero-power idle state in response to instantaneous load. Rather than requiring fine-grained power-performance states and complex load-proportional operation from each system component, PowerNap instead calls for minimizing idle power and transition time, which are simpler optimization goals. Based on the PowerNap concept, we develop requirements and outline mechanisms to eliminate idle power waste in enterprise blade servers. Because PowerNap operates in low-efficiency regions of current blade center power supplies, we introduce the Redundant Array for Inexpensive Load Sharing (RAILS), a power provisioning approach that provides high conversion efficiency across the entire range of PowerNap's power demands. Using utilization traces collected from enterprise-scale commercial deployments, we demonstrate that, together, PowerNap and RAILS reduce average server power consumption by 74%.
Lower Skin Cancer Risk in Women with Higher Body Mass Index: The Women's Health Initiative Observational Study
Authors: Tang Jean Y. , Henderson Michael T. , Hernandez-Boussard Tina , Kubo Jessica , Desai Manisha , Sims Stacy T. , Aroda Vanita , Thomas Fridtjof , McTiernan Anne , Stefanick Marcia L. 
Published: September 2013

Abstract
The unclear relationship of obesity to incident melanoma and nonmelanoma skin cancer (NMSC) risks was evaluated in the large, geographically diverse longitudinal, prospective Women's Health Initiative (WHI) observational study. Risks of melanoma and NMSC in normal weight women were compared with risks in overweight [body mass index (BMI) = 25–29.0 kg/m2] and obese (BMI ≥ 30 kg/m2) women, using Cox proportional hazards models for melanoma and logistic regression for NMSC. Over a mean 9.4 years of follow-up, there were 386 melanoma and 9,870 NSMC cases. Risk of melanoma did not differ across weight categories (P = 0.86), whereas in fully adjusted models, NMSC risk was lower in overweight [OR, 0.93; 95% confidence interval (CI), 0.89–0.99] and obese (OR, 0.85; 95% CI, 0.80–0.91) women (P &lt; 0.001). Excess body weight was not associated with melanoma risk in postmenopausal women but was inversely associated with NMSC risk, possibly due to lower sun exposure in overweight and obese women. This supports previous work demonstrating the relationship between excess body weight and skin cancer risk. Cancer Epidemiol Biomarkers Prev; 22(12); 2412–5. ©2013 AACR.
Clinical Monoclonal B Lymphocytosis versus Rai 0 Chronic Lymphocytic Leukemia: A Comparison of Cellular, Cytogenetic, Molecular, and Clinical Features
Authors: Morabito Fortunato , Mosca Laura , Cutrona Giovanna , Agnelli Luca , Tuana Giacomo , Ferracin Manuela , Zagatti Barbara , Lionetti Marta , Fabris Sonia , Maura Francesco , Matis Serena , Gentile Massimo , Vigna Ernesto , Colombo Monica , Massucco Carlotta , Recchia Anna Grazia , Bossio Sabrina , De Stefano Laura , Ilariucci Fiorella , Musolino Caterina , Molica Stefano , Di Raimondo Francesco , Cortelezzi Agostino , Tassone Pierfrancesco , Negrini Massimo , Monti Sara , Rossi Davide , Gaidano Gianluca , Ferrarini Manlio , Neri Antonino 
Published: September 2013

Abstract
Purpose: To investigate the incidence and clinical relevance of classic and new prognostic markers, IGHV gene mutational status, and chromosomal abnormalities in clinical monoclonal B lymphocytosis (cMBL) compared with Rai stage 0 chronic lymphocytic leukemia (Rai0-CLL).
Experimental Design: A group of 136 patients with cMBL and a group of 216 Rai0-CLL cases were investigated prospectively.
Results: IGHV-mutated cases were significantly more frequent among cMBLs (P = 0.005), whereas the distribution of CD38 and ZAP-70 positive cases, of patients with NOTCH1 and SF3B1 mutations or exhibiting the major CLL cytogenetic abnormalities, was similar in the two groups. Moreover, no significant differences were found either in IGHV/IGHD/IGHJ gene usage or in the overall prevalence of stereotyped IGHV gene sequences. Cells from cMBL and Rai0-CLL exhibited similar gene and microRNA (miRNA) signatures; in addition, when grouped according to the IGHV mutational status, IGHV-unmutated cases showed different transcriptional signatures compared with IGHV-mutated patients, irrespective of the cMBL or Rai0-CLL classification. cMBL diagnosis per se was predictive of longer progression-free survival.
Conclusions: Our study based on a prospective series of patients indicates that no major differences exist between the circulating cells from cMBL and Rai0-CLL, at least based on a comparison of the markers used in the study. This possibly suggests that the two conditions mainly differ in the initial size of the monoclonal cell population, which may influence the subsequent timing of clonal expansion and clinical manifestations. Clin Cancer Res; 19(21); 5890–900. ©2013 AACR.
Targeted Nanomedicine for Suppression of CD44 and Simultaneous Cell Death Induction in Ovarian Cancer: An Optimal Delivery of siRNA and Anticancer Drug
Authors: Shah Vatsal , Taratula Oleh , Garbuzenko Olga B. , Taratula Olena R. , Rodriguez-Rodriguez Lorna , Minko Tamara 
Published: September 2013

Abstract
Purpose: The proposed project is aimed at enhancing the efficiency of epithelial ovarian cancer treatment and reducing adverse side effects of chemotherapy using nanotechnology. Overexpression of the CD44 membrane receptor results in tumor initiation, growth, cancer stem cells' specific behavior, development of drug resistance, and metastases. We hypothesize that a developed cancer-targeted delivery system that combines CD44 siRNA with paclitaxel would successfully deliver its payload inside cancer cells, effectively induce cell death, and prevent metastases.
Experimental Design: We synthesized, characterized, and tested a nanoscale-based drug delivery system (DDS) containing a modified polypropylenimine (PPI) dendrimer as a carrier; anticancer drug paclitaxel as a cell death inducer; a synthetic analog of luteinizing hormone–releasing hormone (LHRH) peptide as a tumor-targeting moiety; and siRNA targeted to CD44 mRNA. The proposed DDS was tested in vitro and in vivo using metastatic ovarian cancer cells isolated from patients with malignant ascites.
Results: We found that in contrast with cells isolated from primary tumors, CD44 was highly overexpressed in metastatic cancer cells. Treatment with the proposed tumor-targeted nanoscale-based nucleic acid and DDS led to the suppression of CD44 mRNA and protein, efficient induction of cell death, effective tumor shrinkage, and prevention of adverse side effects on healthy organs.
Conclusion: We show a high therapeutic potential for combinatorial treatment of ovarian carcinoma with a novel DDS that effectively transports siRNA targeting to CD44 mRNA simultaneously with cytotoxic agents. Clin Cancer Res; 19(22); 6193–204. ©2013 AACR.
GITR Pathway Activation Abrogates Tumor Immune Suppression through Loss of Regulatory T-cell Lineage Stability
Authors: Schaer David A. , Budhu Sadna , Liu Cailian , Bryson Campbell , Malandro Nicole , Cohen Adam , Zhong Hong , Yang Xia , Houghton Alan N. , Merghoub Taha , Wolchok Jedd D. 
Published: September 2013

AbstractLigation of GITR (glucocorticoid-induced TNF receptor-related gene, or TNFRSF18) by agonist antibody has recently entered into early-phase clinical trials for the treatment of advanced malignancies. Although the ability of GITR modulation to induce tumor regression is well documented in preclinical studies, the underlying mechanisms of action, particularly its effects on CD4+Foxp3+ regulatory T cells (Treg), have not been fully elucidated. We have previously shown that GITR ligation in vivo by agonist antibody DTA-1 causes more than 50% reduction of intratumor Tregs with down modulation of Foxp3 expression. Here, we show that the loss of Foxp3 is tumor dependent. Adoptively transferred Foxp3+ Tregs from tumor-bearing animals lose Foxp3 expression in the host when treated with DTA-1, whereas Tregs from naïve mice maintain Foxp3 expression. GITR ligation also alters the expression of various transcription factors and cytokines important for Treg function. Complete Foxp3 loss in intratumor Tregs correlates with a dramatic decrease in Helios expression and is associated with the upregulation of transcription factors, T-Bet and Eomes. Changes in Helios correspond with a reduction in interleukin (IL)-10 and an increase in IFN-γ expression in DTA-1–treated Tregs. Together, these data show that GITR agonist antibody alters Treg lineage stability inducing an inflammatory effector T-cell phenotype. The resultant loss of lineage stability causes Tregs to lose their intratumor immune-suppressive function, making the tumor susceptible to killing by tumor-specific effector CD8+ T cells. Cancer Immunol Res; 1(5); 320–31. ©2013 AACR.
Effects of Age and Aerobic Fitness on Myocardial Lipid Content
Authors: Sarma Satyam , Carrick-Ranson Graeme , Fujimoto Naoki , Adams-Huet Beverley , Bhella Paul S. , Hastings Jeffrey L. , Shafer Keri M. , Shibata Shigeki , Boyd Kara , Palmer Dean , Szczepaniak Edward W. , Szczepaniak Lidia S. , Levine Benjamin D. 
Published: September 2013

Background—
Aging and sedentary lifestyles lead to cardiac atrophy, ventricular stiffening, and impaired diastolic function. Both conditions are marked by increased adiposity, which can lead to ectopic fat deposition in nonadipocyte tissues including the myocardium. The effect of excess intramyocardial fat on cardiac function in nonobese individuals is unknown.

Methods and Results—

Cardiac lipid content was measured by magnetic resonance spectroscopy in 153 healthy nonobese subjects with varying fitness levels quantified by peak oxygen uptake during treadmill exercise. Cardiac function (echo) and left ventricular (LV) filling pressures (right heart catheterization) were measured under varying preloads. LV stiffness was calculated from a curve fit of the diastolic portion of the pressure–volume curve. The strongest clinical predictors of lipid content were body mass index (β=+0.03; 95% confidence interval, 0.001–0.06) and peak oxygen uptake (β=−0.02; 95% confidence interval, −0.03 to −0.009;
R
2
=0.14;
P
<0.001). Subjects in the highest quintile had smaller LV end-diastolic volumes (68±13 versus 58±12 mL/m
2
;
P
<0.01) and decreased peak early mitral annular and increased peak late mitral inflow velocities. There were no differences in LV stiffness, but a leftward shift in the pressure–volume curve suggested a less distensible ventricle with increasing myocardial lipid levels. After adjusting for age, fitness, and body mass index, echocardiographic and morphometric differences among groups were attenuated and no longer significant.

Conclusions—
Body mass index and fitness levels are the strongest predictors of myocardial lipid content in nonobese humans. Cardiac lipid content is associated with decreased ventricular distensibility, and it may provide a causal mechanism linking changes in LV function related to age and fitness.
Intramyocardial Adiposity After Myocardial Infarction
Authors: Pouliopoulos Jim , Chik William W.B. , Kanthan Ajita , Sivagangabalan Gopal , Barry Michael A. , Fahmy Peter N.A. , Midekin Christine , Lu Juntang , Kizana Eddy , Thomas Stuart P. , Thiagalingam Aravinda , Kovoor Pramesh 
Published: September 2013

Background—
Collagen has been attributed as the principal structural substrate of ventricular tachycardia (VT) after myocardial infarction (MI), even though adiposity of myocardium after MI is well recognized histologically. We investigated the effects of intramyocardial adiposity compared with collagen on electrophysiological properties, connexin43 expression, and VT induction after MI.

Methods and Results—

Simultaneous left ventricular plunge-needle, noncontact mapping was performed in sheep without MI (MI−; n=5), with MI and inducible VT (MI+VT+; n=7), and with MI and no inducible VT (MI+VT−; n=8). Histological intramyocardial quantity of adipose and collagen and degree of discontinuity were coregistered with electrophysiological parameters (MI+; 290 specimens). Additional assessment of connexin43 expression was performed. Left ventricular scar contained a body mass–independent abundance of adipocytes (adipose:collagen=0.8). Increased adipose density and discontinuity contributed to a greater inverse correlation (
r
) with conduction velocity (
r
for adipose=0.39,
r
for discontinuity=0.45,
r
for collagen=0.26) and electrogram amplitude (
r
for adipose=0.73,
r
for contiguity=0.77,
r
for collagen=0.68) compared with collagen. Collagen density was similar between the MI+ groups (
P
>0.29). However, the MI+VT+ group demonstrated a significant (all
P
≤0.01) increase in adipose (8%) and discontinuity (qualitative) and decrease in conduction velocity (13%) and electrogram amplitude (21%) at MI borders compared with the MI+VT− group. In scar, myocytes adjacent to fibrofatty interfaces demonstrated increased connexin43 lateralization. A gradient increase in adipose was observed at sites that supported preferential presystolic VT activation and exhibited attenuation of excitation wavelength (
P
<0.001).

Conclusions—
Intramyocardial adiposity, in association with myocardial discontinuity within left ventricular scar borders, is a significant factor associated with altered electrophysiological properties, aberrant connexin43 expression, and increased propensity for VT after MI.
Use of Remote Monitoring of Newly Implanted Cardioverter-Defibrillators
Authors: Akar Joseph G. , Bao Haikun , Jones Paul , Wang Yongfei , Chaudhry Sarwat I. , Varosy Paul , Masoudi Frederick A. , Stein Kenneth , Saxon Leslie A. , Curtis Jeptha P. 
Published: September 2013

Background—
Current guidelines recommend using remote patient monitoring (RPM) for implantable cardioverter-defibrillators, but the patterns of adoption of this technology have not been described. Successful use of RPM depends on (1) the enrollment of the patient into an RPM system and (2) subsequent activation of RPM by the enrolled patient. We examined RPM enrollment and activation rates and the patient, physician, and institutional determinants of RPM use.

Methods and Results—
Information about the use of RPM-capable devices was obtained from the Boston Scientific Corporation ALTITUDE program and linked to the National Cardiovascular Data Registry ICD Registry. Patients were first categorized as RPM-enrolled and RPM-not enrolled, and the RPM-enrolled patients were further categorized into RPM-active and RPM-inactive groups based on whether they transmitted RPM data. Variables associated with RPM enrollment and activation were identified with the use of multivariable logistic regression. Among 39 158 patients with newly implanted RPM-capable devices, 62% (n=24 113) were RPM-enrolled. Of those enrolled, 76% (n=18 289, or 47% of the entire cohort) activated their device. RPM enrollment was highly variable among institutions. The hospital-specific median odds ratio for RPM enrollment was 3.43, signifying that physician or institutional factors are associated with RPM enrollment. In contrast, the hospital-specific median odds ratio for RPM activation was 1.69. Age, race, health insurance, geographic location, and health-related factors were similarly associated with both RPM enrollment and activation.

Conclusions—
RPM technology is used in less than half of eligible patients. Lack of enrollment into RPM systems is the major cause of underutilization, and this primarily relates to the local practice environment.
Long-Term Outcomes of Dilated Cardiomyopathy Diagnosed During Childhood
Authors: Alexander Peta M.A. , Daubeney Piers E.F. , Nugent Alan W. , Lee Katherine J. , Turner Christian , Colan Steven D. , Robertson Terry , Davis Andrew M. , Ramsay James , Justo Robert , Sholler Gary F. , King Ingrid , Weintraub Robert G. 
Published: September 2013

Background—
Existing studies of childhood dilated cardiomyopathy deal mainly with early survival. This population-based study examines long-term outcomes for children with dilated cardiomyopathy.

Methods and Results—

The diagnosis of dilated cardiomyopathy was based on clinical, echocardiographic, and pathological findings. The primary study end point included time to the combined outcome of death or cardiac transplantation. There were 175 patients 0 to <10 years of age at the time of diagnosis. Survival free from death or transplantation was 74% (95% confidence interval, 67–80) 1 year after diagnosis, 62% (95% confidence interval, 55–69) at 10 years, and 56% (95% confidence interval, 46–65) at 20 years. In multivariable analysis, age at diagnosis <4 weeks or >5 years, familial cardiomyopathy, and lower baseline left ventricular fractional shortening
Z
score were associated with increased risk of death or transplantation, as was lower left ventricular fractional shortening
Z
score during follow-up. At 15 years after diagnosis, echocardiographic normalization had occurred in 69% of surviving study subjects. Normalization was related to higher baseline left ventricular fractional shortening
Z
score, higher left ventricular fractional shortening
Z
score during follow-up, and greater improvement in left ventricular fractional shortening
Z
score. Children with lymphocytic myocarditis had better survival and a higher rate of echocardiographic normalization. At the latest follow-up, 100 of 104 of survivors (96%) were free of cardiac symptoms, and 83 (80%) were no longer receiving pharmacotherapy.

Conclusions—
Death or transplantation occurred in 26% of patients with childhood dilated cardiomyopathy within 1 year of diagnosis and ~1% per year thereafter. Risk factors for death or transplantation include age at diagnosis, familial cardiomyopathy, and severity of left ventricular dysfunction. The majority of surviving subjects are well and free of cardiac medication.
Automated External Defibrillators Inaccessible to More Than Half of Nearby Cardiac Arrests in Public Locations During Evening, Nighttime, and Weekends
Authors: Hansen Carolina Malta , Wissenberg Mads , Weeke Peter , Ruwald Martin Huth , Lamberts Morten , Lippert Freddy Knudsen , Gislason Gunnar Hilmar , Nielsen Søren Loumann , Køber Lars , Torp-Pedersen Christian , Folke Fredrik 
Published: September 2013

Background—
Despite wide dissemination, use of automated external defibrillators (AEDs) in community settings is limited. We assessed how AED accessibility affected coverage of cardiac arrests in public locations.

Methods and Results—

We identified cardiac arrests in public locations (1994–2011) in terms of location and time and viewed them in relation to the location and accessibility of all AEDs linked to the emergency dispatch center as of December 31, 2011, in Copenhagen, Denmark. AED coverage of cardiac arrests was defined as cardiac arrests within 100 m (109.4 yd) of an AED and further categorized according to AED accessibility at the time of cardiac arrest. Daytime, evening, and nighttime were defined as 8
am
to 3:59
pm
, 4 to 11:59
pm
, and midnight to 7:59
am
, respectively. Of 1864 cardiac arrests in public locations, 61.8% (n=1152) occurred during the evening, nighttime, or weekends. Of 552 registered AEDs, 9.1% (n=50) were accessible at all hours, and 96.4% (n=532) were accessible during the daytime on all weekdays. Regardless of AED accessibility, 28.8% (537 of 1864) of all cardiac arrests were covered by an AED. Limited AED accessibility decreased coverage of cardiac arrests by 4.1% (9 of 217) during the daytime on weekdays and by 53.4% (171 of 320) during the evening, nighttime, and weekends.

Conclusions—
Limited AED accessibility at the time of cardiac arrest decreased AED coverage by 53.4% during the evening, nighttime, and weekends, which is when 61.8% of all cardiac arrests in public locations occurred. Thus, not only strategic placement but also uninterrupted AED accessibility warrant attention if public-access defibrillation is to improve survival after out-of-hospital cardiac arrest.