bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of thiopurines on the natural history and surgical outcome of ulcerative colitis: a cohort study
Authors: Eriksson Carl , Rundquist Sara , Cao Yang , Montgomery Scott , Halfvarson Jonas 
Published: April 2018

ObjectiveThiopurines are used as maintenance therapy in ulcerative colitis (UC), but whether these drugs influence the natural history of the disease is unknown. We aimed to assess the effect of thiopurines in terms of colectomy, hospital admission, progression in disease extent and anti-tumour necrosis factor (TNF) therapy within 10 years from initiation.DesignPatients diagnosed with UC within the Örebro University Hospital catchment area, during 1963–2010, who initiated thiopurines (n=253) were included. To overcome the risk of confounding by indication, we compared patients who stopped treatment within 12 months because of an adverse reaction (n=76) with patients who continued therapy or discontinued due to other reasons (n=177) and assessed long-term outcomes using Cox regression with adjustment for potential confounding factors.ResultsThe cumulative probability of colectomy within 10 years was 19.5% in tolerant patients compared with 29.0% in intolerant (adjusted HR 0.49; 95% CI 0.21 to 0.73). The probability of hospital admission was 34.0% in tolerant versus 56.2% in intolerant patients (adjusted HR 0.36; 95% CI 0.23 to 0.56). The risk for progression in disease extent was 20.4% in tolerant patients compared with 48.8% in intolerant (adjusted HR 0.47; 95% CI 0.21 to 1.06). Within 10 years, 16.1% of tolerant and 27.5% of intolerant patients received anti-TNF therapy (adjusted HR 0.49; 95% CI 0.26 to 0.92).ConclusionBased on the novel approach of comparing patients tolerant and intolerant to thiopurines, we reveal that thiopurines have a profound beneficial impact of the natural history and long-term colectomy rates of UC.
Biochemical and molecular characterisation of neurological Wilson disease
Authors: Seo Go Hun , Kim Yoon-Myung , Oh Seak Hee , Chung Sun Ju , Choi In Hee , Kim Gu-Hwan , Yum Mi-Sun , Choi Jin-Ho , Kim Kyung Mo , Ko Tae-Sung , Lee Beom Hee , Yoo Han-Wook 
Published: April 2018

BackgroundTo identify biochemical and genetic features that characterise neurological Wilson disease as a distinct disease subgroup.MethodsDetailed biochemical profiles and genotypic characteristics of neurological (86 patients) and hepatic subgroups (233 patients) from 368 unrelated Korean families were analysed.ResultsCompared with patients in the hepatic subgroup, patients in the neurological subgroup had a later age at onset, a higher proportion with Kayser-Fleischer rings and higher serum creatinine levels, and a lower proportion with favourable outcome (62% vs 80%, P<0.016). At diagnosis, the neurological subgroup had lower serum ceruloplasmin (3.1±2.1 mg/dL vs 4.2±3.2 mg/dL, P<0.001), total copper (26.4±13.8 µg/dL vs 35.8±42.4 µg/dL, P=0.005), free copper (17.2±12.5 µg/dL vs 23.5±38.2 µg/dL, P=0.038) and urinary copper (280.9±162.9 µg/day vs 611.1±1124.2 µg/day, P<0.001) levels. Serum aspartate aminotransferase, alanine aminotransferase, gamma glutamyltransferase and total bilirubin levels, as well as prothrombin time, were also lower in the neurological subgroup. Liver cirrhosis was more common but mostly compensated in the neurological subgroup. Frameshift, nonsense or splice-siteATP7Bmutations and mutations in transduction or ATP hinge domains (2.4% vs 23.1%, P=0.006) were less common in the neurological subgroup.ConclusionThe neurological subgroup had distinct clinical, biochemical and genetic profiles. Further studies are required to identify the factors, with or without association with copper metabolism, underlying the neurological presentation for which treatment needs to be targeted to improve the clinical outcome of this subgroup.
Does free or lower cost smoking cessation medication stimulate quitting? Findings from the International Tobacco Control (ITC) Netherlands and UK Surveys
Authors: van den Brand Floor A , Nagelhout Gera E , Hummel Karin , Willemsen Marc C , McNeill Ann , van Schayck Onno C P 
Published: April 2018

ObjectiveTo investigate whether mentioning free or lower cost smoking cessation medication as a trigger for thinking about quitting is related to higher medication use, more quit attempts and quit success, and whether these associations are modified by education and income.MethodsData were derived from the 2013 and 2014 surveys of the International Tobacco Control Netherlands (n=1164) and UK (n=768) cohort. Logistic regression analyses were used to assess associations between mentioning in 2013 that free/lower cost smoking cessation medication was a trigger for thinking about quitting smoking and the use of medication, quit attempts and smoking cessation in 2014.Results37.0% of smokers in the UK and 24.9% of smokers in the Netherlands mentioned free/lower cost medication as a trigger for thinking about quitting. Smokers who mentioned this trigger were more likely to have used cessation medication during a quit attempt both in the UK (OR=4.19, p<0.001) and in the Netherlands (OR=2.14, p=0.033). The association between mentioning free/lower cost medication as a trigger for thinking about quitting and actual quit attempts was significant in the UK (OR=1.45, p=0.030), but not in the Netherlands (OR=1.10, p=0.587). There was no significant association with quit success. Associations did not differ across income and education groups.ConclusionFree/lower cost smoking cessation medication may increase the use of cessation medication and stimulate quit attempts among smokers with low, moderate and high education and income.
On Resource Pooling and Separation for LRU Caching
Authors: Tan Jian , Quan Guocong , Ji Kaiyi , Shroff Ness 
Published: April 2018

Caching systems using the Least Recently Used (LRU) principle have now become ubiquitous. A fundamental question for these systems is whether the cache space should be pooled together or divided to serve multiple flows of data item requests in order to minimize the miss probabilities. In this paper, we show that there is no straight yes or no answer to this question, depending on complex combinations of critical factors, including, e.g., request rates, overlapped data items across different request flows, data item popularities and their sizes. To this end, we characterize the performance of multiple flows of data item requests under resource pooling and separation for LRU caching when the cache size is large.
Analytically, we show that it is asymptotically optimal to jointly serve multiple flows if their data item sizes and popularity distributions are similar and their arrival rates do not differ significantly; the self-organizing property of LRU caching automatically optimizes the resource allocation among them asymptotically. Otherwise, separating these flows could be better, e.g., when data sizes vary significantly. We also quantify critical points beyond which resource pooling is better than separation for each of the flows when the overlapped data items exceed certain levels. Technically, for a broad class of heavy-tailed distributions we derive the asymptotic miss probabilities of multiple flows of requests with varying data item sizes in a shared LRU cache space. It also validates the characteristic time approximation under certain conditions. These results provide new insights on improving the performance of caching systems.
Diagnosing Cervical Neoplasia in Rural Brazil Using a Mobile Van Equipped withIn VivoMicroscopy: A Cluster-Randomized Community Trial
Authors: Hunt Brady , Fregnani José Humberto Tavares Guerreiro , Schwarz Richard A. , Pantano Naitielle , Tesoni Suelen , Possati-Resende Júlio César , Antoniazzi Marcio , de Oliveira Fonseca Bruno , de Macêdo Matsushita Graziela , Scapulatempo-Neto Cristovam , Kerr Ligia , Castle Philip E. , Schmeler Kathleen , Richards-Kortum Rebecca 
Published: April 2018

AbstractCervical cancer is a leading cause of death in underserved areas of Brazil. This prospective randomized trial involved 200 women in southern/central Brazil with abnormal Papanicolaou tests. Participants were randomized by geographic cluster and referred for diagnostic evaluation either at a mobile van upon its scheduled visit to their local community, or at a central hospital. Participants in both arms underwent colposcopy, in vivo microscopy, and cervical biopsies. We compared rates of diagnostic follow-up completion between study arms, and also evaluated the diagnostic performance of in vivo microscopy compared with colposcopy. There was a 23% absolute and 37% relative increase in diagnostic follow-up completion rates for patients referred to the mobile van (102/117, 87%) compared with the central hospital (53/83, 64%; P = 0.0001; risk ratio = 1.37, 95% CI, 1.14–1.63). In 229 cervical sites in 144 patients, colposcopic examination identified sites diagnosed as cervical intraepithelial neoplasia grade 2 or more severe (CIN2+; 85 sites) with a sensitivity of 94% (95% CI, 87%–98%) and specificity of 50% (95% CI, 42%–58%). In vivo microscopy with real-time automated image analysis identified CIN2+ with a sensitivity of 92% (95% CI, 84%–97%) and specificity of 48% (95% CI, 40%–56%). Women referred to the mobile van were more likely to complete their diagnostic follow-up compared with those referred to a central hospital, without compromise in clinical care. In vivo microscopy in a mobile van provides automated diagnostic imaging with sensitivity and specificity similar to colposcopy. Cancer Prev Res; 11(6); 359–70. ©2018 AACR.
Novel Measure of Local Impedance Predicts Catheter–Tissue Contact and Lesion Formation
Authors: Sulkin Matthew S. , Laughner Jacob I. , Hilbert Sebastian , Kapa Suraj , Kosiuk Jedrzej , Younan Paul , Romero Iñaki , Shuros Allan , Hamann Jason J. , Hindricks Gerhard , Bollmann Andreas 
Published: April 2018

Background:
Coupling between the ablation catheter and myocardium is critical to resistively heat tissue with radiofrequency ablation. The objective of this study was to evaluate whether a novel local impedance (LI) measurement on an ablation catheter identifies catheter–tissue coupling and is predictive of lesion formation.

Methods and Results:

LI was studied in explanted hearts (n=10 swine) and in vivo (n=10; 50–70 kg swine) using an investigational electroanatomic mapping system that measures impedance from an ablation catheter with mini-electrodes incorporated in the distal electrode (Rhythmia and IntellaNav MiFi OI, Boston Scientific). Explanted tissue was placed in a warmed (37 °C) saline bath mounted on a scale, and LI was measured 15 mm away from tissue to 5 mm of catheter–tissue compression at multiple catheter angles. Lesions were created with 31 and 50 W for 5 to 45 seconds (n=90). During in vivo evaluation of LI, measurements of myocardium (n=90) and blood pool (n=30) were guided by intracardiac ultrasound while operators were blinded to LI data. Lesions were created with 31 and 50 W for 45 seconds in the ventricles (n=72). LI of myocardium (119.7 Ω) was significantly greater than that of blood pool (67.6 Ω;
P
<0.01). Models that incorporate LI drop (ΔLI) to predict lesion size had better performance than models that incorporate force-time integral (
R
2
=0.75 versus
R
2
=0.54) and generator impedance drop (
R
2
=0.82 versus
R
2
=0.58). Steam pops displayed a significantly higher starting LI and larger ΔLI compared with successful radiofrequency applications (
P
<0.01).

Conclusions:
LI recorded from miniature electrodes provides a valuable measure of catheter–tissue coupling, and ΔLI is predictive of lesion formation during radiofrequency ablation.
Timing of Postdischarge Follow‐Up and Medication Adherence Among Patients With Heart Failure
Authors: Chang Leslie L. , Xu Haolin , DeVore Adam D. , Matsouaka Roland A. , Yancy Clyde W. , Fonarow Gregg C. , Allen Larry A. , Hernandez Adrian F. 
Published: April 2018

Background
Medication adherence improves outcomes for patients with heart failure, but adherence rates remain low. We examined the association between earlier postdischarge follow‐up and medication adherence.

Methods and Results
We performed a retrospective cohort study of patients ≥65 years who were hospitalized for heart failure, covered by Medicare Part D, and discharged alive from April 2006 to October 2012 using the Get With The Guidelines‐Heart Failure Registry linked to Medicare claims. Patients were categorized into 4 groups by timing of first postdischarge follow‐up visit: ≤1, 1 to 2, 2 to 6, and >6 weeks. Medication adherence was defined by proportion of days covered of >80% at 90 days and 1‐year posthospital discharge to 5 guideline‐directed medical therapies (angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker, evidence‐based β‐blocker, aldosterone antagonist, hydralazine/isosorbide dinitrate, and anticoagulation for atrial fibrillation). Among 9878 patients with heart failure, 73% had left ventricular ejection fraction ≤40%, median age was 78 years (25th–75th percentile, 71–84), and 48% were male. Overall, 30% had a follow‐up appointment within 1‐week postdischarge and 25% >6 weeks. At 1 year, medication adherence was 53% for evidence‐based β‐blockers, 48% for angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, and 8% for hydralazine/isosorbide dinitrate. We found no significant association between timing of first follow‐up visit and medication adherence at 1 year (1.04, 0.92–1.17) when comparing follow‐up visits >6 weeks to the earliest ones.

Conclusions
Posthospital heart failure discharge, overall adherence to medical therapies in Medicare beneficiaries was low. Early follow‐up was not associated with increased medication adherence to guideline‐directed medical therapy in the short or long term.
Is Transcatheter Aortic Valve Replacement Better Than Surgical Aortic Valve Replacement in Patients With Chronic Obstructive Pulmonary Disease? A Nationwide Inpatient Sample Analysis
Authors: Ando Tomo , Adegbala Oluwole , Akintoye Emmanuel , Ashraf Said , Pahuja Mohit , Briasoulis Alexandros , Takagi Hisato , Grines Cindy L. , Afonso Luis , Schreiber Theodore 
Published: April 2018

Background

Chronic obstructive pulmonary disease (
COPD
) patients are at increased risk of respiratory related complications after cardiac surgery. It is unclear whether transcatheter aortic valve replacement (
TAVR
) or surgical aortic valve replacement (
SAVR
) results in favorable outcomes among
COPD
patients.

Methods and Results

Patients were identified from the Nationwide Inpatient Sample database from 2011 to 2014. Patients with age ≥60,
COPD
, and either went transarterial
TAVR
or
SAVR
were included in the analysis. A 1:1 propensity‐matched cohort was created to examine the outcomes. A matched pair of 1210
TAVR
and 1208
SAVR
patients was identified. Respiratory‐related complications such as tracheostomy (0.8% versus 5.8%; odds ratio [
OR
], 0.14;
P
<0.001), acute respiratory failure (16.4% versus 23.7%;
OR
, 0.63;
P
=0.002), reintubation (6.5% versus 10.0%;
OR
, 0.49;
P
<0.001), and pneumonia (4.5% versus 10.1%;
OR
, 0.41;
P
<0.001) were significantly less frequent with
TAVR
versus
SAVR
. Use of noninvasive mechanical ventilation was similar between
TAVR
and
SAVR
(4.1% versus 4.8%;
OR
, 0.84;
P
=0.41). Non‐respiratory‐related complications, such as in‐hospital mortality (3.3% versus 4.2%;
OR
, 0.64;
P
=0.035), bleeding requiring transfusion (9.9% versus 21.7%;
OR
, 0.38;
P
<0.001), acute kidney injury (17.7% versus 25.3%;
OR
, 0.63;
P
<0.001), and acute myocardial infarction (2.4% versus 8.4%;
OR
, 0.19;
P
<0.001), were significantly less frequent with
TAVR
than
SAVR
. Cost ($56 099 versus $63 146;
P
<0.001) and hospital stay (mean, 7.7 versus 13.0 days;
P
<0.001) were also more favorable with
TAVR
than
SAVR
.

Conclusions

TAVR
portended significantly fewer respiratory‐related complications compared with
SAVR
in
COPD
patients.
TAVR
may be a preferable mode of aortic valve replacement in
COPD
patients.
Relationship Between Changes in Fat and Lean Depots Following Weight Loss and Changes in Cardiovascular Disease Risk Markers
Authors: Clifton Peter M. 
Published: April 2018

Background
Gluteofemoral fat mass has been associated with improved cardiovascular disease risk factors. It is not clear if loss of this protective fat during weight loss partially negates the effect of loss of visceral fat. The aim of this study was to examine regional fat loss in a large weight‐loss cohort from one center and to determine if fat loss in the leg and total lean tissue loss is harmful.

Methods and Results

We combined the data from 7 of our previously published 3‐month weight‐loss studies and examined the relationship between regional fat and lean tissue loss and changes in cardiovascular disease risk factors in 399 participants. At baseline, leg fat was positively associated with high‐density lipoprotein cholesterol in women and inversely with fasting triglyceride level in both sexes. Abdominal lean tissue was also related to systolic blood pressure in men. Changes in regional fat and lean tissue were positively associated with changes in glucose, insulin, total cholesterol, triglycerides, low‐density lipoprotein cholesterol and systolic and diastolic blood pressure (
r
=0.11–0.22,
P
<0.05) with leg fat and arm lean tissue dominating in multivariate regression. After adjustment for total weight or total fat change, these relationships disappeared except for a positive relationship between arm and lean leg mass loss and changes in triglycerides and systolic blood pressure.

Conclusions
Loss of leg fat and leg lean tissue was directly associated with beneficial changes in cardiovascular disease risk markers. Loss of lean tissue may not have an adverse effect on cardiovascular disease risk, and measures to retain lean tissue during weight loss may not be necessary.
Thrombectomy for M1-Middle Cerebral Artery Occlusion
Authors: Consoli Arturo , Rosi Andrea , Coskun Oguzhan , Nappini Sergio , Di Maria Federico , Renieri Leonardo , Limbucci Nicola , Rodesch Georges , Mangiafico Salvatore , Decroix Jean-Pierre , Kyheng Maeva , Labreuche Julien , Lapergue Bertrand 
Published: April 2018

Background and Purpose—
Despite the recent technical evolution of the endovascular treatment of acute ischemic stroke, late and incomplete recanalization can be achieved after several maneuvers but with a potentially higher risk of futile reperfusion and complications, such as clot fragmentation. The aim of this article is to investigate the impact of the angiographic phenotype of M1-middle cerebral artery occlusions, classified as regular and irregular in aspect, on the results of treatment by stent retrievers (SRs) or contact aspiration (CA).

Methods—
From January to April 2016, 84 consecutive patients, admitted for acute ischemic stroke with a middle cerebral artery occlusion, were treated by endovascular therapy. Among them, 60 patients (26M, 34F, median age, 70.5; interquartile range, 58.5–80.0) were treated by SR (25/60, 41.7%) or CA (35/60, 58.3%) as a first-line approach in 2 experienced centers. Patients’ characteristics, timing, and procedural data were prospectively recorded and compared between the 2 study subgroups (regular and irregular phenotype).

Results—

A regular phenotype at the occlusion site was observed in 24 patients (40%). Among these, successful recanalization after the first-line strategy (Thrombolysis in Cerebral Infarction 2b-3) was achieved in 100% of patients treated by CA and in only 33.3% of patients treated by SR (
P
=0.001). For irregular phenotypes, SR achieved Thrombolysis in Cerebral Infarction 2b-3 in 73.9% and CA, in 38.5% (
P
=0.036) of cases. Among regular phenotype patients, the average number of maneuvers was 1.3 (median, 1; range 1–3) with first-line CA and 2.7 (median, 3; range 1–5) with first-line SR (
P
=0.008).

Conclusions—
The angiographic phenotype of the occlusion site may be associated with a different response to SR and CA in this preliminary experience.
Effects of Non-Driving Related Task Modalities on Takeover Performance in Highly Automated Driving
Authors: Wandtner Bernhard , Schömig Nadja , Schmidt Gerald 
Published: April 2018

Objective: Aim of the study was to evaluate the impact of different non-driving related tasks (NDR tasks) on takeover performance in highly automated driving. Background: During highly automated driving, it is allowed to engage in NDR tasks temporarily. However, drivers must be able to take over control when reaching a system limit. There is evidence that the type of NDR task has an impact on takeover performance, but little is known about the specific task characteristics that account for performance decrements. Method: Thirty participants drove in a simulator using a highly automated driving system. Each participant faced five critical takeover situations. Based on assumptions of Wickens’s multiple resource theory, stimulus and response modalities of a prototypical NDR task were systematically manipulated. Additionally, in one experimental group, the task was locked out simultaneously with the takeover request. Results: Task modalities had significant effects on several measures of takeover performance. A visual-manual texting task degraded performance the most, particularly when performed handheld. In contrast, takeover performance with an auditory-vocal task was comparable to a baseline without any task. Task lockout was associated with faster hands-on-wheel times but not altered brake response times. Conclusion: Results showed that NDR task modalities are relevant factors for takeover performance. An NDR task lockout was highly accepted by the drivers and showed moderate benefits for the first takeover reaction. Application: Knowledge about the impact of NDR task characteristics is an enabler for adaptive takeover concepts. In addition, it might help regulators to make decisions on allowed NDR tasks during automated driving.
Heart rate-reducing therapy with add-on ivabradine and bisoprolol before coronary computed tomographic angiography in a fast-track ambulatory setting
Authors: Muster Viktoria , Wallner Markus , Schmidt Albrecht , Kapl Martin , von Lewinski Friederike , Rainer Peter , Reittner Pia , Tillich Manfred , Brader Peter , Szolar Dieter HM , von Lewinski Dirk 
Published: April 2018

Objective This study was performed to determine whether add-on oral ivabradine in patients treated with beta blockers 1 hour before coronary computed tomographic angiography (CCTA) is effective in lowering the heart rate and thus improving CCTA quality. Methods In this single-center cohort study, the data of 294 patients referred for ambulant CCTA were retrospectively screened. Patients with an initial heart rate of ≥75 bpm (n = 112) were pretreated with either a combination of bisoprolol and ivabradine or with bisoprolol alone. Results During the scan, there was no difference in heart rate between the two groups Likewise, there was no significant difference in additionally administered intravenous bradycardic agents, the number of motion artifacts, or the radiation dose. Both drug regimens were tolerated well. Conclusion Additive oral ivabradine 1 hour before CCTA does not result in a further reduction of the heart rate. Consequently, neither movement artifacts nor radiation dose can be reduced. Therefore, pretreatment with ivabradine does not seem reasonably appropriate in an outpatient clinical setting with short patient contact.