bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of force magnitude on effectiveness in cervical headgear therapy: a cephalometric analysis
Authors: Talvitie Tuula H , Helminen Mika , Karsila Susanna , Varho Reeta , Signorelli Luca , Pirttiniemi Pertti , Peltomäki Timo 
Published: April 2019

Summary

Aim
The main aim of this study was to study the impact of different force magnitudes on effectiveness in cervical headgear (CHG) therapy.

Materials and methods
Forty patients were treated with CHG with light (L; 300 g) or heavy (H; 500 g) force in this controlled clinical trial. Patients were asked to wear CHG for 10 hours/day for 10 months. The inner bow of the CHG was expanded (3–4 mm) and the long outer bow bent (10–20 degree) upward in relation to the inner bow. Adherence to instructions and force magnitude in CHG use was monitored by electronic module (Smartgear, Swissorthodontics, Switzerland). Lateral cephalograms were taken before (T1) and after (T2) the treatment and studied with modified Pancherz analysis using a Planmeca Romexis Ceph module (Planmeca, Finland).

Results
In both groups, skeletal and dental effects were seen. The only statistically significant difference in cephalometric analysis was the inclination of upper incisors at T1 (P = 0.010) and at T2 (P = 0.011). In both groups, a reduction in Sella-Nasion- point A (SNA) angle was found: L group T1 82.7degree (SD ± 3.6degree), T2 82.0degree (SD ± 3.5 degree) and H group T1 82.6 degree (SD ± 4.7 degree), T2 81.5 degree (SD ± 4.5 degree), but no statistically significant difference between the groups. Children in the L group used CHG statistically significantly more than those in the H group (10.0 ± 1.5 hour, and 8.3 ± 2.1 hour, respectively, P = 0.002).

Conclusion
Children with lower force CHG seem to adhere better to instructions for CHG use. After 10 months of use, no statistically significant differences were found in dental or skeletal outcome. However, in the H group, the outcome was achieved with less daily hours of use.
New-onset left bundle branch block after transcatheter aortic valve replacement is associated with adverse long-term clinical outcomes in intermediate-risk patients: an analysis from the PARTNER II trial
Authors: Nazif Tamim M , Chen Shmuel , George Isaac , Dizon Jose M , Hahn Rebecca T , Crowley Aaron , Alu Maria C , Babaliaros Vasilis , Thourani Vinod H , Herrmann Howard C , Smalling Richard W , Brown David L , Mack Michael J , Kapadia Samir , Makkar Raj , Webb John G , Leon Martin B , Kodali Susheel K 
Published: April 2019

Abstract

Aims
Transcatheter aortic valve replacement (TAVR) is now an established therapy for intermediate-risk surgical candidates with symptomatic, severe aortic stenosis. The clinical impact of new-onset left bundle branch block (LBBB) after TAVR remains controversial and has not been studied in intermediate-risk patients. We therefore sought to analyse outcomes associated with new LBBB in a large cohort of intermediate-risk patients treated with TAVR.

Methods and results
A total of 2043 patients underwent TAVR in the PARTNER II trial and S3 intermediate-risk registry and survived to hospital discharge. Patients were excluded from the current analysis due to baseline conduction disturbances, pre-existing permanent pacemaker (PPM), and new PPM during the index hospitalization. Clinical outcomes at 2 years were compared between patients with and without persistent, new-onset LBBB at hospital discharge, and multivariable analysis was performed to identify predictors of mortality. Among 1179 intermediate-risk patients, new-onset LBBB at discharge occurred in 179 patients (15.2%). Patients with new LBBB were similar to those without except for more frequent diabetes and more frequent treatment with SAPIEN 3 vs. SAPIEN XT. At 2 years, new LBBB was associated with increased rates of all-cause mortality (19.3% vs. 10.8%, P = 0.002), cardiovascular mortality (16.2% vs. 6.5%, P &lt; 0.001), rehospitalization, and new PPM implantation. By multivariable analysis, new LBBB remained an independent predictor of 2-year all-cause [hazard ratio (HR) 1.98, 95% confidence interval (95% CI) 1.33, 2.96; P &lt; 0.001] and cardiovascular (HR 2.66 95% CI 1.67, 4.24; P &lt; 0.001) mortality. New LBBB was also associated with worse left ventricular systolic function at 1 and 2-year follow-up.

Conclusions
In a large cohort of intermediate-risk patients from the PARTNER II trial and registry, persistent, new-onset LBBB occurred in 15.2% of patients without baseline conduction disturbances or pacemaker. New LBBB was associated with adverse clinical outcomes at 2 years, including all-cause and cardiovascular mortality, rehospitalization, new pacemaker implantation, and worsened left ventricular systolic function.

Clinical Trial Registration
ClinicalTrials.gov #NCT01314313 and NCT03222128.
Diastolic pressure ratio: new approach and validation vs. the instantaneous wave-free ratio
Authors: Johnson Nils P , Li Wenguang , Chen Xi , Hennigan Barry , Watkins Stuart , Berry Colin , Fearon William F , Oldroyd Keith G 
Published: April 2019

Abstract

Aims
The instantaneous wave-free ratio (iFR) and whole-cycle Pd/Pa investigate coronary physiology during non-hyperaemic conditions. To test for unique physiologic properties of the wave-free period when making resting coronary pressure measurements, we compared post hoc a diastolic pressure ratio (dPR) and Pd/Pa against iFR for numerical similarity and test/retest repeatability.

Methods and results
Eight hundred and ninety-three lesions from 833 subjects were included from the VERIFY 2 and CONTRAST studies. Diastolic pressure ratio and a linear transform of Pd/Pa were compared against iFR for diagnostic performance. Mean difference between dPR and iFR [Δ = −0.006 ± 0.011, r 2 = 0.993, area under receiver operating characteristic (ROC) curve (AUC) = 0.997] mirrored the difference of two iFR measurements repeated immediately (Δ = &lt;0.001 ± 0.004, r 2 = 0.998, AUC = 1.00). Minor variations in the definition of dPR changed its value by &lt;1–2% over a broad range of the cardiac cycle. A linear transform of Pd/Pa showed very good diagnostic performance (Δ = −0.012 ± 0.031, r 2 = 0.927, AUC = 0.979). Post hoc iFR values were validated against real-time iFR values and matched almost exactly (average Δ = &lt;0.001 ± 0.004, 99.6% within ±0.01).

Conclusions
Our dPR offers numerical equivalency to iFR. Despite different technical approaches for identifying the relevant period of diastole, the agreement between dPR and iFR and the insensitivity of dPR to minor variations in its definition further confirm numerical equivalency among resting metrics.
Company-level determinants of disability retirement: a multilevel study of Finnish private sector workplaces
Authors: Laaksonen Mikko , Rantala Juha , Liukko Jyri , Polvinen Anu , Varis Jarno , Kesälä Meeri , Kuivalainen Susan 
Published: April 2019

Abstract

Background
We examined whether the risk for disability retirement varies between companies over and above the individual-level characteristics of their employees and which company-level characteristics are associated with the risk for any, full or partial disability retirement.

Methods
A 30% random sample of Finnish private sector companies with at least 10 employees was used (5567 companies and 301 313 employees). The risk for disability retirement over 6 years was analyzed using multilevel logistic regression. Company size and industry, as well as gender, age, education and social class measured both at the individual- and the company-level were used as explanatory variables.

Results
3.8% of the variance in the risk for disability retirement was attributed to the company level after controlling for individual-level characteristics of the employees. Company-level variance was much larger in partial (11.7%) than in full (4.2%) disability retirement. After controlling for all individual- and company-level characteristics, those working in health and social work activities had increased risk for both full and partial disability retirement. The risk for full disability retirement increased by decreasing educational level of the company. The risk for partial disability retirement increased by increasing company size and was elevated in companies with the highest proportion of women.

Conclusions
After controlling for the individual-level characteristics, variation in the risk for disability retirement between companies was modest. The more substantial variation in partial disability pension suggests that companies have a marked role in advancing working with partial disabilities.
Trajectories of mobility limitations over 24 years and their characterization by shift work and leisure-time physical activity in midlife
Authors: Prakash K C , Neupane Subas , Leino-Arjas Päivi , Härmä Mikko , von Bonsdorff Mikaela B , Rantanen Taina , von Bonsdorff Monika E , Hinrichs Timo , Seitsamo Jorma , Ilmarinen Juhani , Nygård Clas-Håkan 
Published: April 2019

Abstract

Background
We aimed to investigate trajectories of mobility limitations (MLs) over a period of 24 years. In addition, we aimed to study how shift work and leisure-time physical activity (LTPA) in midlife predict assignment to MLs trajectories separately for those retired on statutory pensions (SPs) and on disability pensions (DPs).

Methods
Subjects who responded MLs questionnaires (1985–2009, N = 3048) in Finnish Longitudinal Study on Aging Municipal Employees were included in this prospective cohort study. LTPA and shift work were measured during baseline. International Classification of Functioning was used to code MLs. Growth mixture modeling was used to identify the trajectories of MLs. Odds ratio (OR) and their 95% Confidence interval (CI) were assessed by using multinomial logistic regression.

Results
We identified four trajectories of MLs, namely low persistent, low increasing, high decreasing and high persistent. Among the SP recipients, shift work with night shifts was associated with an increased risk (adjusted OR 1.49; 95% CI 1.03–2.14) of belonging to the high persistent MLs trajectory. The inactive LTPA (SP: OR 5.99, 95% CI 3.39–10.58, DP: OR 6.81, 95% CI 2.52–18.43) was similarly associated with high persistent MLs trajectory.

Conclusion
Nearly two-thirds of the people retired due to disability belonged to high MLs trajectory. High persistent MLs trajectory was associated with physical inactivity in midlife among those retired on SP and on DP. Shift work with night shift predicted high persistent MLs in SP strata. Active involvement in LTPA during midlife could be beneficial to spend MLs free later life.
Comparative Efficacy of Vedolizumab and Adalimumab in Ulcerative Colitis Patients Previously Treated With Infliximab
Authors: Favale Agnese , Onali Sara , Caprioli Flavio , Pugliese Daniela , Armuzzi Alessandro , Macaluso Fabio Salvatore , Orlando Ambrogio , Viola Anna , Fries Walter , Rispo Antonio , Castiglione Fabiana , Mocci Giammarco , Chicco Fabio , Usai Paolo , Calabrese Emma , Biancone Livia , Monteleone Giovanni , Fantini Massimo Claudio ,   Italian Group for the study of Inflammatory Bowel Disease (IG-IBD)
Published: April 2019

Abstract

Background
Adalimumab (ADA) and vedolizumab (VDZ) have shown efficacy in moderate to severe ulcerative colitis (UC) patients who failed infliximab (IFX). Although, a comparative efficacy evaluation of ADA and VDZ in this clinical setting is currently missing.

Aim
The aim of this study is to compare the efficacy of ADA and VDZ in patients affected by UC who failed IFX.

Methods
Clinical records of UC patients from 8 Italian IBD referral centers who failed IFX and were candidates to receive either ADA or VDZ were retrospectively reviewed. The primary end point was therapeutic failure at week 52. Secondary end points included therapy discontinuation at weeks 8, 24 and 52, the discontinuation-free survival, and safety.

Results
One hundred sixty-one UC patients, 15 (9.2%) primary, 83 (51.6%) secondary IFX failures, and 63 (39.2%) IFX intolerants were included. Sixty-four (40%) patients received ADA and 97 (60%) VDZ as second line therapy. At week 52, 37.5% and 28.9% of patients on ADA and VDZ, respectively, had therapeutic failure (P = 0.302). However, the failure rate was significantly higher in the ADA group as compared with VDZ group among IFX secondary failures (48.0% ADA vs 22.4%VDZ, P = 0.035). The therapy discontinuation-free survival was significantly higher in the group of IFX secondary failures who received VDZ as compared with ADA at both the univariate (P = 0.007) and multivariate survival analysis (OR 2.79; 95% CI, 1.23–6.34; P = 0.014). No difference in the failure and biologic discontinuation-free survival was observed in the IFX primary failure and intolerant subgroups.

Conclusion
Vedolizumab might be the therapy of choice in those UC patients who showed secondary failure to IFX.
Association of Infliximab Levels With Mucosal Healing Is Time-Dependent in Crohn’s Disease: Higher Drug Exposure Is Required Postinduction Than During Maintenance Treatment
Authors: Feng Ting , Chen Baili , Ungar Bella , Qiu Yun , Zhang Shenghong , He Jinshen , Lin Sinan , He Yao , Zeng Zhirong , Ben-Horin Shomron , Chen Minhu , Mao Ren 
Published: April 2019

AbstractBackgroundInfliximab levels have been reported to be associated with mucosal healing (MH) in Crohn’s disease (CD). However, whether the association differs between postinduction (week 14) and maintenance (week 30) has seldom been investigated. We aimed to analyze the association between serum infliximab trough levels and MH at the 2 different time points.MethodsA retrospective study of CD patients treated with infliximab in a tertiary referral center between January 2012 and May 2018 was conducted. MH was defined as absence of ulceration by endoscopy. Correlations between infliximab level and MH were investigated at 2 specific time points, weeks 14 and 30.ResultsMedian infliximab levels were higher in patients with MH than those without at weeks 14 (7.5 vs 1.5 μg/mL; P < 0.001) and 30 (5.9 vs 0.5 μg/mL; P < 0.001). The median levels in patients with MH at week 14 were higher than at week 30 (7.5 vs 5.9 μg/mL; P < 0.05). Multivariate analysis showed that infliximab level was independently associated with MH (both P < 0.001 at weeks 14 and 30). Infliximab level above 4.85 μg/mL and 2.85 μg/mL identified patients with MH at week 14 (area under the curve [AUC], 0.796; P < 0.001) and week 30 (AUC, 0.780; P < 0.001) with 80% specificity. The rates of MH reached a plateau (>85%) when infliximab levels were above 10 and 6 μg/mL at weeks 14 and 30, respectively.ConclusionsInfliximab levels correlated with MH at weeks 14 and 30 in CD patients. Higher levels might be required to achieve MH at postinduction than during maintenance treatment.
Thirty years from Tiananmen: China, Hong Kong, and the ongoing experiment to preserve liberal values in an authoritarian state
Authors: Chan Cora 
Published: April 2019

Abstract
The 1989 Tiananmen Square Massacre marked China out as an exception in the chapter of world history that saw the fall of international communism. The massacre crystalized the mistrust between China and Hong Kong into an open ideological conflict—Leninist authoritarianism versus liberal democracy—that has colored relations between the two since then. This article tracks the hold that authoritarianism has gained over liberal values in Hong Kong in the past thirty years and reflects on what needs to be done in the next thirty years for the balance to be re-tilted and sustained beyond 2047, when China’s fifty-year commitment to preserving Hong Kong’s autonomy expires. Still surviving (just) as a largely liberal (though by no means fully democratic) jurisdiction after two decades of Chinese rule, Hong Kong is a testing ground for whether China can respect liberal values, how resilient such values are to the alternative authoritarian vision offered by an economic superpower, and the potential for establishing a liberal-democratic pocket within an authoritarian state. The territory’s everyday wrestle with Chinese pressures speaks to the liberal struggles against authoritarian challenges (in their various guises) that continue to plague the world thirty years after the end of the Cold War.​
‘Somehow This Whole Process Became so Artificial’: Exploring the Transitional Justice Implementation Gap in Uganda
Authors: Macdonald Anna 
Published: April 2019

Abstract∞
This article explores a key challenge in contemporary international efforts to promote transitional justice (TJ) in nontransitioning, conflict-affected states: the ‘implementation gap,’ in which policies are designed and funded but neither enacted nor implemented. Findings based on long-term qualitative fieldwork in Uganda indicate the implementation gap is co-constituted by technocratic donor approaches and domestic elite political maneuvering in a semi-authoritarian regime. The interaction between the two produces two forms of political artifice: ‘isomorphic mimicry’ and ‘calculated stasis,’ which stall the emergence of substantive TJ reform. Findings are relevant to the wide range of nontransitioning contexts where TJ is promoted by international donors and have important implications for its claimed potential to catalyze or restore civic trust in political systems in the aftermath of massive human rights violations.
An Open-Label, Randomized, Active-Controlled Trial of 8 Versus 12 Weeks of Elbasvir/Grazoprevir for Treatment-Naive Patients With Chronic Hepatitis C Genotype 1b Infection and Mild Fibrosis (EGALITE Study): Impact of Baseline Viral Loads and NS5A Resistance-Associated Substitutions
Authors: Huang Chung-Feng , Hung Chao-Hung , Cheng Pin-Nan , Bair Ming-Jong , Huang Yi-Hsiang , Kao Jia-Horng , Hsu Shih-Jer , Lee Pei-Lun , Chen Jyh-Jou , Chien Rong-Nan , Peng Cheng-Yuan , Lin Chun-Yen , Hsieh Tsai-Yuan , Cheng Chun-Han , Dai Chia-Yen , Huang Jee-Fu , Chuang Wan-Long , Yu Ming-Lung 
Published: April 2019

AbstractBackgroundA 12-week grazoprevir/elbasvir regimen is highly effective against hepatitis C virus genotype 1 (HCV-1) infection. The efficacy of an 8-week regimen for treatment-naive HCV-1–infected patients with mild fibrosis has not been determined.MethodsTreatment-naive HCV-1b–infected patients with mild fibrosis were randomly assigned to receive 8 (n = 41) or 12 (n = 41) weeks of grazoprevir/elbasvir therapy. The primary end point was a sustained virologic response, defined as an HCV RNA level of < 12 IU/mL, at posttreatment week 12 (SVR12).ResultsSVR12 was achieved by 87.8% of patients (36 of 41) in the 8-week arm and 100% (41 of 41) in the 8-week arm of the full-analysis population and by 90.0% (36 of 40) and 100% (41 of 41), respectively, in the per-protocol population (all P = .055). In the 8-week arm, a significantly lower SVR12 rate was observed among patients with a high HCV-1b load, defined as ≥1 500 000 IU/mL (79% vs 100%; P = .042), and among those with a baseline Y93H resistance-associated substitution (RAS) frequency of >15% in HCV nonstructural protein 5A (NS5A; 40.0% vs 97.1%; P = .004). Between-group analysis demonstrated that, among patient with a high HCV-1b load and a baseline Y93H RAS frequency of >15%, those in the 8-week arm had a substantially lower SVR12 rate than those in the 12-week arm (40.0% vs 100.0%). All 4 HCV-1b relapses had a Y93H RAS frequency of >99% at posttreatment week 12.ConclusionsTwelve weeks of grazoprevir/elbasvir therapy is highly effective for treatment-naive patients with mild fibrosis. A truncated, 8-week grazoprevir/elbasvir regimen might be applied for those with low viral loads or without a significant NS5A RAS frequency.Clinical trials registrationNCT03186365.
Patient education in relation to informational needs and postoperative complications in surgical patients
Authors: Koivisto Jaana-Maija , Saarinen Ira , Kaipia Antti , Puukka Pauli , Kivinen Katri , Laine Kirsi-Marja , Haavisto Elina 
Published: April 2019

Abstract

Objective
To study surgical patients’ informational expectations and the level of received knowledge at the time of hospital discharge. To examine if there is an association with postoperative complications and the patient´s level of received knowledge.

Design
Comparative descriptive design.

Setting
The data on patients admitted for non-cardiac surgery were collected in three phases during an eight-month period.

Participants
258 in-ward non-cardiac general surgery and orthopedic surgery adult patients.

Interventions
Questionnaires before admission (knowledge expectations) and at discharge (received knowledge). A telephone interview 30 days after discharge.

Main Outcome Measures
Received knowledge (as much or more / less) compared to expectations, and its association with post-discharge complications.

Results
There were differences between patient groups in their perception of receiving enough knowledge and they were connected to gender (male vs. female OR 2.67, 95% CI 1.55–4.60, P = 0.0004) and procedure (elective orthopedic implant surgery vs. elective minor orthopedic and hand surgery: OR 3.25, 95% CI 1.72–6.17, P = 0.0003). Patients who received less knowledge than expected had more postoperative complications than those who received sufficient (as much or more than expected) information.

Conclusions
Patients differ in terms of informational needs, and preoperative education prepares the patient for the information provided postoperatively. Patient education may have an influence on recovery from surgery.
Twenty-four hour pharmacokinetic relationships for intravenous vancomycin and novel urinary biomarkers of acute kidney injury in a rat model
Authors: Avedissian Sean N , Pais Gwendolyn M , O’Donnell J Nicholas , Lodise Thomas P , Liu Jiajun , Prozialeck Walter C , Joshi Medha D , Lamar Peter C , Becher Leighton , Gulati Anil , Hope William , Scheetz Marc H 
Published: April 2019

Abstract

Objectives
To identify the pharmacokinetic (PK) and toxicodynamic (TD) relationship for vancomycin-induced kidney injury.

Methods
Male Sprague–Dawley rats received intravenous (iv) vancomycin. Doses ranging from 150 mg/kg/day to 400 mg/kg/day were administered as a single or twice-daily injection over 24 h (total protocol duration). Controls received iv saline. Plasma was sampled with up to eight samples in 24 h per rat. Twenty-four hour urine was collected and assayed for kidney injury molecule 1 (KIM-1), osteopontin and clusterin. Vancomycin in plasma was quantified via LC-MS/MS. PK analyses were conducted using Pmetrics for R. PK exposures during the first 24 h (i.e. AUC0–24h, Cmax 0–24h and Cmin 0–24h) were calculated. PK/TD relationships were assessed with Spearman’s rank coefficient (rs) and the best-fit mathematical model.

Results
PK/TD data were generated from 45 vancomycin-treated and 5 control rats. A two-compartment model fit the data well (Bayesian: observed versus predicted R2 = 0.97). Exposure–response relationships were found between AUC0–24h versus KIM-1 and osteopontin (R2 = 0.61 and 0.66) and Cmax 0–24h versus KIM-1 and osteopontin (R2 = 0.50 and 0.56) using a four-parameter Hill fit. Conversely, Cmin 0–24h was less predictive of KIM-1 and osteopontin (R2 = 0.46 and 0.53). A vancomycin AUC0–24h of 482.2 corresponded to a 90% of maximal rise in KIM-1.

Conclusions
Vancomycin-induced kidney injury as defined by urinary biomarkers is driven by vancomycin AUC or Cmax rather than Cmin. Further, an identified PK/TD target AUC0–24h of 482.2 mg·h/L may have direct relevance to human outcomes.