bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anaemia and the development of depressive symptoms following acute coronary syndrome: longitudinal clinical observational study
Authors: Steptoe Andrew , Wikman Anna , Molloy Gerard J , Kaski Juan-Carlos 
Published: February 2012

ObjectiveDepressive symptoms are common following acute coronary syndrome (ACS) and predict subsequent cardiovascular morbidity. Depression in acute cardiac patients appears to be independent of clinical disease severity and other cardiovascular measures. One factor that has not been considered previously is anaemia, which is associated with fatigue and adverse cardiac outcomes. This study assessed the relationship between anaemia on admission and depressive symptoms following ACS.DesignLongitudinal clinical observational study.SettingCoronary care unit.Patients223 patients with documented ACS.Main outcome measuresDepressive symptoms measured with the Beck Depression Inventory 3 weeks after admission.ResultsAnaemia was defined with WHO criteria and was present in 30 (13.5%) patients. Anaemia predicted raised depression scores 3 weeks later independently of age, gender, marital status, educational attainment, smoking, Global Registry of Acute Cardiac Events (GRACE) risk scores, negative mood in hospital and history of depression (p=0.003). The odds of a Beck Depression Inventory score ≥10 among anaemic patients were 4.03 (95% CIs 1.48 to 11.00), adjusted for covariates. Sensitivity analyses indicated that effects were also present when haemoglobin was analysed as a continuous measure. Anaemia also predicted major adverse cardiac events over the subsequent 12 months.ConclusionsAnaemia appears to contribute to depression following ACS and is associated with future cardiac morbidity. Studies evaluating the effects of anaemia management will help delineate the role of this pathway more precisely.
Empirical evidence that disease prevalence may affect the performance of diagnostic tests with an implicit threshold: a cross-sectional study
Authors: Willis Brian H 
Published: February 2012

ObjectiveTo investigate the effects that prevalence has on the diagnostic performance of junior doctors in interpreting x-rays.DesignTwo-armed cross-sectional design using systematic sampling.SettingEmergency department in the UK.ParticipantsFrom a sample of 2593 patients (1434 men and 1159 women) taken from an unselected attending cohort between January and April 2002, 967 x-rays were analysed. The sex distribution was 558 men and 409 women, and the mean age of those receiving an x-ray was 34.6.InterventionsThe interpretation of x-rays by junior doctors after their triage into high- and low-prevalence populations by radiographers.Main outcome measuresSensitivity, specificity, likelihood ratios, diagnostic odds ratios and receiver operator characteristic curve.ResultsThere were statistically significant differences in the performance characteristics of junior doctors when interpreting high-probability and low-probability x-rays. For the high- and low-probability populations, respectively, the sensitivities were 95.8% (95% CI 91.1% to 98.1%) and 78.3% (95% CI 65.7% to 87.2%) and the specificities were 56.0% (95% CI 41.9% to 69.2%) and 92.3% (95% CI 90.0% to 94.2%). Hierarchical logistic regression showed that the sensitivity did depend on the type of x-ray being interpreted but the diagnostic odds ratios did not vary significantly with prevalence, suggesting that doctors were changing their implicit threshold between the two populations along a common receiver operator characteristic curve.ConclusionsThis study provides evidence on how the prevalence may affect the performance of diagnostic tests with an implicit threshold and potentially includes the clinical history and examination. This has implications both for clinicians applying research findings to their practice and the design of future studies.
Utility of routine follow-up head CT scanning after mild traumatic brain injury: a systematic review of the literature
Authors: Stippler Martina , Smith Carl , McLean A Robb , Carlson Andrew , Morley Sarah , Murray-Krezan Cristina , Kraynik Jessica , Kennedy George 
Published: February 2012

ObjectiveTo evaluate the efficacy of routine follow-up CT scans of the head after complicated mild traumatic brain injury (TBI).Methods74 English language studies published from 1999 to February 2011 were reviewed. The papers were found by searching the PubMed database using a combination of keywords according to Cochrane guidelines. Excluding studies with missing or inappropriate data, 1630 patients in 19 studies met the inclusion criteria: complicated mild TBI, defined as a GCS score 13–15 with abnormal initial CT findings and the presence of follow-up CT scans. For these studies, the progression and type of intracranial haemorrhage, time from trauma to first scan, time between first and second scans, whether second scans were obtained routinely or for neurological decline and the number of patients who had a neurosurgical intervention were recorded.ResultsRoutine follow-up CT scans showed hemorrhagic progression in 324 patients (19.9%). Routine follow-up head CT scans did not predict the need for neurosurgical intervention (p=0.10) but a CT scan of the head performed for decline in status did (p=0.00046). For the 56 patients (3.4%) who declined neurologically, findings on the second CT scan were worse in 38 subjects (67%) and unchanged in the rest. Overall, 39 patients (2.4%) underwent neurosurgical intervention.ConclusionRoutine follow-up CT scans rarely alter treatment for patients with complicated mild TBI. Follow-up CT scans based on neurological decline alter treatment five times more often than routine follow-up CT scans.
School dropout: a major public health challenge: a 10-year prospective study on medical and non-medical social insurance benefits in young adulthood, the Young-HUNT 1 Study (Norway)
Authors: De Ridder Karin A A , Pape Kristine , Johnsen Roar , Westin Steinar , Holmen Turid Lingaas , Bjørngaard Johan Håkon 
Published: February 2012

BackgroundSchool and work participation in adolescence and young adulthood are important for future health and socioeconomic status. The authors studied the association between self-rated health in adolescents, high school dropout and long-term receipt of medical and non-medical social insurance benefits in young adulthood.MethodsSelf-rated health in adolescence was assessed in 8795 adolescents participating in the Norwegian Young-HUNT Study (1995–1997). Linkages to the National Education Database and the National Insurance Administration allowed identification of school dropout and receipt of long-term medical and non-medical benefits during a 10-year follow-up (1998–2007). The data were explored by descriptive statistics and by multinomial logistic regression.ResultsA total of 17% was registered as being high school dropouts at age 24. The predicted 5-year risk of receiving benefits between ages 24–28 was 21% (95% CI 20% to 23%). High school dropouts had a 5-year risk of receiving benefits of 44% (95% CI 41 to 48) compared with 16% (95% CI 15 to 17) in those who completed high school (adjusted for self-rated health, parental education and sex). There was a 27% school dropout rate in adolescents who reported poor health compared with 16% in those who reported good health. The predicted 5-year risk of receiving any long-term social insurance benefits in adolescents who reported poor health was 33% (95% CI 30 to 37) compared with 20% (95% CI 19 to 21) in those who reported good health.ConclusionThe strong association between poor self-rated health in adolescence, high school dropout and reduced work integration needs attention and suggests preventive measures on an individual as well as on a societal level.
Mechanical embolectomy for treatment of large vessel acute ischemic stroke in children
Authors: Tatum James , Farid Hamed , Cooke Daniel , Fullerton Heather , Smith Wade , Higashida Randall , Halbach Van V , Dowd Christopher 
Published: February 2012

Background and purposeThe three largest adult stroke trials investigating mechanical embolectomy retrieval devices in acute stroke (the Merci, Multi Merci and Penumbra Pivotal Stroke Trials) excluded children. There is a need to expand the literature on mechanical embolectomy in large vessel pediatric arterial ischemic stroke. This paper reports the use of two mechanical embolectomy devices cleared by the Federal Drug Administration (FDA) in four consecutive cases.MethodsOur pediatric stroke database from 2002 to the present was reviewed retrospectively. Patients were included if they were diagnosed with an acute large vessel occlusion, were <18 years of age and underwent recanalization with a device cleared by the FDA. Clinical and radiographic results were abstracted from medical record review. The Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score at presentation and at discharge and a pediatric-modified Rankin Scale (Ped-mRS) at approximately 90 days were scored retrospectively based on documented examinations.ResultsFour patients aged 4–17 years with a PedNIHSS score at presentation ranging from 2 to 17 points underwent mechanical embolectomy for reperfusion of the basilar artery (n=3), M1 segment of the right middle cerebral artery (n=1) and right internal carotid artery terminus (n=1). Thrombolysis in cerebral infarction (TICI) grade 3 was achieved in four vessels and TICI grade 2A was achieved in one vessel; there was one asymptomatic intraparenchymal hemorrhage. Intra-arterial tissue plasminogen activator was administered in two vessels. The PedNIHSS score at discharge ranged from 0 to 16 points and the Ped-mRS score at approximately 90 days ranged from 0 to 3 with 75% achieving a Ped-mRS score of ≤2.ConclusionMechanical embolectomy using the Merci and Penumbra systems may be a feasible therapeutic option in the treatment of large vessel pediatric arterial ischemic stroke.
Reprogramming Tumor-Associated Dendritic Cells In Vivo Using miRNA Mimetics Triggers Protective Immunity against Ovarian Cancer
Authors: Cubillos-Ruiz Juan R. , Baird Jason R. , Tesone Amelia J. , Rutkowski Melanie R. , Scarlett Uciane K. , Camposeco-Jacobs Ana L. , Anadon-Arnillas Jorge , Harwood Noah M. , Korc Murray , Fiering Steven N. , Sempere Lorenzo F. , Conejo-Garcia Jose R. 
Published: February 2012

Abstract
Modulating the activity of miRNAs provides opportunities for novel cancer interventions. However, low bioavailability and poor cellular uptake are major challenges for delivering miRNA mimetics specifically to tumor cells. Here, we took advantage of the spontaneous enhanced endocytic activity of ovarian cancer-associated dendritic cells (DC) to selectively supplement the immunostimulatory miRNA miR-155. In vivo processing of nanoparticles carrying oligonucleotide duplexes mimicking the bulged structure of endogenous pre-miRNA (but not siRNA-like oligonucleotides) dramatically augmented miR-155 activity without saturating the RNA-induced silencing complex. Endogenous processing of synthetic miR-155 favored Ago2 and, to a lesser extent, Ago4 loading, resulting in genome-wide transcriptional changes that included silencing of multiple immunosuppressive mediators. Correspondingly, tumor-infiltrating DCs were transformed from immunosuppressive to highly immunostimulatory cells capable of triggering potent antitumor responses that abrogated the progression of established ovarian cancers. Our results show both the feasibility and therapeutic potential of supplementing/replenishing miRNAs in vivo using nonviral approaches to boost protective immunity against lethal tumors. Thus, we provide a platform, an optimized design, and a mechanistic rationale for the clinical testing of nonviral miRNA mimetics. Cancer Res; 72(7); 1683–93. ©2012 AACR.
Mammary Tumor Regression Elicited by Wnt Signaling Inhibitor Requires IGFBP5
Authors: Liu Bob Y. , Soloviev Irina , Huang XiaoDong , Chang Peter , Ernst James A. , Polakis Paul , Sakanaka Chie 
Published: February 2012

Abstract
Wnt ligand–driven tumor growth is inhibited by the soluble Wnt inhibitor Fzd8CRD, but the mechanism through which this effect is mediated is unknown. In the MMTV-Wnt1 mouse model, regression of mammary tumors by Fzd8CRD treatment coincides with an acute and strong induction of insulin-like growth factor (IGF)–binding protein IGFBP5, an antagonist of IGF signaling that mediates involution of mammary gland in females after offspring are weaned. In this study, we show that repression of this IGF inhibitory pathway is crucial for Wnt-driven growth of mammary tumors. We found that IGFBP5 regulation was mediated by the β-catenin–dependent Wnt pathway. Wnt, in addition to IGF ligands, facilitated tumor growth by paracrine communication among tumor cells. In addition, Fzd8CRD caused precocious induction of IGFBP5 in normal mammary glands undergoing involution, implying an acceleration of the involution process by inhibition of Wnt signaling. The molecular and phenotypic parallel between tumor regression and mammary gland involution suggests that Wnt-driven mammary tumors use the same growth mechanism as proliferating normal mammary glands. Cancer Res; 72(6); 1568–78. ©2012 AACR.
A Population-Based Study of Prevalence and Adherence Trends in Average Risk Colorectal Cancer Screening, 1997 to 2008
Authors: Sinicrope Pamela S. , Goode Ellen L. , Limburg Paul J. , Vernon Sally W. , Wick Joseph B. , Patten Christi A. , Decker Paul A. , Hanson Andrew C. , Smith Christina M. , Beebe Timothy J. , Sinicrope Frank A. , Lindor Noralane M. , Brockman Tabetha A. , Melton L. Joseph , Petersen Gloria M. 
Published: February 2012

Abstract
Background: Increasing colorectal cancer screening (CRCS) is important for attaining the Healthy People 2020 goal of reducing CRC-related morbidity and mortality. Evaluating CRCS trends can help identify shifts in CRCS, and specific groups that might be targeted for CRCS.
Methods: We utilized medical records to describe population-based adherence to average-risk CRCS guidelines from 1997 to 2008 in Olmsted County, MN. CRCS trends were analyzed overall and by gender, age, and adherence to screening mammography (women only). We also carried out an analysis to examine whether CRCS is being initiated at the recommended age of 50.
Results: From 1997 to 2008, the size of the total eligible sample ranged from 20,585 to 21,468 people. CRCS increased from 22% to 65% for women and from 17% to 59% for men (P &lt; 0.001 for both) between 1997 and 2008. CRCS among women current with mammography screening increased from 26% to 74%, and this group was more likely to be adherent to CRCS than all other subgroups analyzed (P &lt; 0.001).The mean ages of screening initiation were stable throughout the study period, with a mean age of 55 years among both men and women in 2008.
Conclusion: Although overall CRCS tripled during the study period, there is still room for improvement.
Impact: Working to decrease the age at first screening, exploration of gender differences in screening behavior, and targeting women adherent to mammography but not to CRCS seem warranted. Cancer Epidemiol Biomarkers Prev; 21(2); 347–50. ©2011 AACR.
ω-3 and ω-6 Polyunsaturated Fatty Acid Intakes and the Risk of Breast Cancer in Mexican Women: Impact of Obesity Status
Authors: Chajès Véronique , Torres-Mejía Gabriela , Biessy Carine , Ortega-Olvera Carolina , Angeles-Llerenas Angélica , Ferrari Pietro , Lazcano-Ponce Eduardo , Romieu Isabelle 
Published: February 2012

Abstract
Background: ω-3 polyunsaturated fatty acids (PUFA) could play a protective role on the risk of breast cancer; however, little is known about this relation among Mexican women. We evaluated the association between ω-3 and ω-6 PUFA intake and breast cancer risk by obesity status in Mexican women.
Methods: A population-based case–control study was conducted in Mexico, including 1,000 incident breast cancer cases and 1,074 controls matched to cases by age, health care system, and region. Women provided information on health and diet by in-person interview. Body mass index (BMI) measures were used to define overall obesity. Obesity status was categorized as normal weight (18.5 &lt; BMI &lt; 25), overweight (25 ≤ BMI &lt; 30), and obese (BMI ≥ 30). A conditional logistic regression model was used to assess the association between PUFA and breast cancer risk.
Results: Overall, there was no significant association between ω-3 PUFA intake and breast cancer risk (P = 0.31). An increased risk of breast cancer was associated with increasing ω-6 PUFA intake in premenopausal women [OR = 1.92, 95% confidence interval (CI) = 1.13–3.26; P = 0.04]. A decreased risk of breast cancer was significantly associated with increasing ω-3 PUFA intake in obese women (OR = 0.58, 95% CI = 0.39–0.87; P = 0.008) but not in normal weight nor in overweight women (Pheterogeneity = 0.017).
Conclusions: Obesity status may affect the association between ω-3 PUFA intake and breast cancer risk. The underlying mechanisms may be related to decreased inflammation and improved adipokin and estrogen levels induced by ω-3 PUFA in adipose tissue in obese women.
Impact: Increased intake of ω-3 PUFA should be recommended among Mexican women in particular in obese women. Cancer Epidemiol Biomarkers Prev; 21(2); 319–26. ©2011 AACR.
Coffee, Tea, and Sugar-Sweetened Carbonated Soft Drink Intake and Pancreatic Cancer Risk: A Pooled Analysis of 14 Cohort Studies
Authors: Genkinger Jeanine M. , Li Ruifeng , Spiegelman Donna , Anderson Kristin E. , Albanes Demetrius , Bergkvist Leif , Bernstein Leslie , Black Amanda , van den Brandt Piet A. , English Dallas R. , Freudenheim Jo L. , Fuchs Charles S. , Giles Graham G. , Giovannucci Edward , Goldbohm R. Alexandra , Horn-Ross Pamela L. , Jacobs Eric J. , Koushik Anita , Männistö Satu , Marshall James R. , Miller Anthony B. , Patel Alpa V. , Robien Kim , Rohan Thomas E. , Schairer Catherine , Stolzenberg-Solomon Rachael , Wolk Alicja , Ziegler Regina G. , Smith-Warner Stephanie A. 
Published: February 2012

AbstractBackground: Coffee has been hypothesized to have pro- and anticarcinogenic properties, whereas tea may contain anticarcinogenic compounds. Studies assessing coffee intake and pancreatic cancer risk have yielded mixed results, whereas findings for tea intake have mostly been null. Sugar-sweetened carbonated soft drink (SSB) intake has been associated with higher circulating levels of insulin, which may promote carcinogenesis. Few prospective studies have examined SSB intake and pancreatic cancer risk; results have been heterogeneous.Methods: In this pooled analysis from 14 prospective cohort studies, 2,185 incident pancreatic cancer cases were identified among 853,894 individuals during follow-up. Multivariate (MV) study-specific relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models and then pooled using a random-effects model.Results: No statistically significant associations were observed between pancreatic cancer risk and intake of coffee (MVRR = 1.10; 95% CI, 0.81–1.48 comparing ≥900 to &lt;0 g/d; 237g ≈ 8oz), tea (MVRR = 0.96; 95% CI, 0.78–1.16 comparing ≥400 to 0 g/d; 237g ≈ 8oz), or SSB (MVRR = 1.19; 95% CI, 0.98–1.46 comparing ≥250 to 0 g/d; 355g ≈ 12oz; P value, test for between-studies heterogeneity &gt; 0.05). These associations were consistent across levels of sex, smoking status, and body mass index. When modeled as a continuous variable, a positive association was evident for SSB (MVRR = 1.06; 95% CI, 1.02–1.12).Conclusion and Impact: Overall, no associations were observed for intakes of coffee or tea during adulthood and pancreatic cancer risk. Although we were only able to examine modest intake of SSB, there was a suggestive, modest positive association for risk of pancreatic cancer for intakes of SSB. Cancer Epidemiol Biomarkers Prev; 21(2); 305–18. ©2011 AACR.
Detection and Characterization of a Novel Subset of CD8+CD57+ T Cells in Metastatic Melanoma with an Incompletely Differentiated Phenotype
Authors: Wu Richard C. , Liu Shujuan , Chacon Jessica A. , Wu Sheng , Li Yufeng , Sukhumalchandra Pariya , Murray James L. , Molldrem Jeffrey J. , Hwu Patrick , Pircher Hanspeter , Lizée Gregory , Radvanyi Laszlo G. 
Published: February 2012

AbstractPurpose: Tumor-specific T cells are frequently induced naturally in melanoma patients and infiltrate tumors. It is enigmatic why these patients fail to experience tumor regression. Given that CD8+ T cells mediate antigen-specific killing of tumor cells, the focus of this study was to identify alterations in the differentiation of CD8+ residing at the tumor site, with emphasis on a population expressing CD57, a marker for terminal differentiation.Experimental Design: We conducted flow cytometric analysis of CD8+ tumor-infiltrating lymphocytes (TIL) isolated from 44 resected melanoma metastases with known T-cell differentiation markers. For comparison, peripheral blood mononuclear cells were isolated from matched melanoma patients. We sorted different CD8+ subsets found in TIL and determined their effector functions. In addition, we carried out Vβ clonotype expression analysis of T-cell receptors to determine lineage relationship between the CD8+ TIL subsets.Results: The majority of CD8+ TIL was in the early-effector memory stage of differentiation. A significant population consisted of an oligoclonal subset of cells coexpressing CD27, CD28, CD57, and Granzyme B, with little or no perforin. These cells could be induced to proliferate, produce a high level of IFN-γ, and differentiate into CD27−CD57+, perforinhigh mature CTL in vitro. Addition of TGF-β1 prevented further differentiation.Conclusions: Our studies identified a novel subset of incompletely differentiated CD8+ CTL coexpressing early effector memory and late CTL markers. This population resembles that found in patients with uncontrolled chronic viral infections. TGF-β1, frequently produced by melanoma tumors, may be a key cytokine inhibiting further maturation of this subset. Clin Cancer Res; 18(9); 2465–77. ©2012 AACR.