bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of asymptomatic arrhythmias: a European Heart Rhythm Association (EHRA) consensus document, endorsed by the Heart Failure Association (HFA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Cardiac Arrhythmia Society of Southern Africa (CASSA), and Latin America Heart Rhythm Society (LAHRS)
Authors: Arnar David O , Mairesse Georges H , Boriani Giuseppe , Calkins Hugh , Chin Ashley , Coats Andrew , Deharo Jean-Claude , Svendsen Jesper Hastrup , Heidbüchel Hein , Isa Rodrigo , Kalman Jonathan M , Lane Deirdre A , Louw Ruan , Lip Gregory Y H , Maury Philippe , Potpara Tatjana , Sacher Frederic , Sanders Prashanthan , Varma Niraj , Fauchier Laurent ,   ESC Scientific Document Group, Haugaa Kristina , Schwartz Peter , Sarkozy Andrea , Sharma Sanjay , Kongsgård Erik , Svensson Anneli , Lenarczyk Radoslaw , Volterrani Maurizio , Turakhia Mintu , Obel Isreal W P , Abello Mauricio , Swampillai Janice , Kalarus Zbigniew , Kudaiberdieva Gulmira , Traykov Vassil B ,   EHRA Scientific Documents Committee, Dagres Nikolaos , Boveda Serge , Vernooy Kevin , Kalarus Zbigniew , Kudaiberdieva Gulmira , Mairesse Georges H , Kutyifa Valentina , Deneke Thomas , Hastrup Svendsen Jesper , Traykov Vassil B , Wilde Arthur , Heinzel Frank R 
Published: February 2019

Abstract
Asymptomatic arrhythmias are frequently encountered in clinical practice. Although studies specifically dedicated to these asymptomatic arrhythmias are lacking, many arrhythmias still require proper diagnostic and prognostic evaluation and treatment to avoid severe consequences, such as stroke or systemic emboli, heart failure, or sudden cardiac death. The present document reviews the evidence, where available, and attempts to reach a consensus, where evidence is insufficient or conflicting.
The Calabi Flow with Rough Initial Data
Authors: He Weiyong , Zeng Yu 
Published: February 2019

Abstract
In this paper, we prove that there exists a dimensional constant $\delta&gt; 0$ such that given any background Kähler metric $\omega $, the Calabi flow with initial data $u_0$ satisfying $$\begin{equation*} \partial \bar \partial u_0 \in L^\infty (M)\ \textrm{and}\ (1- \delta )\omega &lt; \omega_{u_0} &lt; (1+\delta )\omega, \end{equation*}$$admits a unique short-time solution, and it becomes smooth immediately, where $\omega _{u_0}: = \omega +\sqrt{-1}\partial \bar \partial u_0$. The existence time depends on initial data $u_0$ and the metric $\omega $. As a corollary, we get that the Calabi flow has short-time existence for any initial data satisfying $$\begin{equation*} \partial \bar \partial u_0 \in C^0(M)\ \textrm{and}\ \omega_{u_0}&gt; 0, \end{equation*}$$which should be interpreted as a “continuous Kähler metric”. A main technical ingredient is a new Schauder-type estimates for biharmonic heat equation on Riemannian manifolds with time-weighted Hölder norms.
The effect of medication cost transparency alerts on prescriber behavior
Authors: Monsen Craig B , Liao Joshua M , Gaster Barak , Flynn Kevin J , Payne Thomas H 
Published: February 2019

Abstract

Objective
The purpose of this study was to determine if medication cost transparency alerts provided at time of prescribing led ambulatory prescribers to reduce their use of low-value medications.

Materials and Methods
Provider-level alerts were deployed to ambulatory practices of a single health system from February 2018 through April 2018. Practice sites included 58 primary care and 152 specialty care clinics totaling 1896 attending physicians, residents, and advanced practice nurses throughout western Washington. Prescribers in the randomly assigned intervention arm received a computerized alert whenever they ordered a medication among 4 high-cost medication classes. For each class, a lower cost, equally effective, and safe alternative was available. The primary outcome was the change in prescribing volume for each of the 4 selected medication classes during the 12-week intervention period relative to a prior 24-week baseline.

Results
A total of 15 456 prescriptions for high-cost medications were written during the baseline period including 7223 in the intervention arm and 8233 in the control arm. During the intervention period, a decrease in daily prescribing volume was noted for all high-cost medications including 33% for clobetasol propionate (p &lt; .0001), 59% for doxycycline hyclate (p &lt; .0001), 43% for fluoxetine tablets (p &lt; .0001), and a non-significant 3% decrease for high-cost triptans (p = .65). Prescribing volume for the high-cost medications overall decreased by 32% (p &lt; .0001).

Conclusion
Medication cost transparency alerts in an ambulatory setting lead to more cost-conscious prescribing. Future work is needed to predict which alerts will be most effective.
Absence of Day 3 Steroid Response Predicts Colitis-Related Complications and Colectomy in Hospitalized Ulcerative Colitis Patients
Authors: Leung Kristel , Rhee Glara , Parlow Simon , Bollu Apoorva , Sabri Elham , McCurdy Jeffrey D , Murthy Sanjay K 
Published: February 2019

Abstract

Background and Aims
Rates and predictors of complications among hospitalized ulcerative colitis (UC) patients requiring high-dose corticosteroids have not been well-characterized, especially in the era of biologics.

Methods
We retrospectively studied consecutive UC admitted for a colitis flare requiring high-dose corticosteroids between April 2006 and December 2016. We evaluated rates and determinants of serious in-hospital complications (colitis-related complications, systemic complications, peri-operative complications and death) and colectomy. We performed multivariable logistic regression analysis to assess the independent association between day 3 steroid response and the risk of incurring in-hospital complications and colectomy.

Results
Of 427 consecutive admissions, serious in-hospital complications occurred in 87 cases (20%), while colitis-related complications occurred in 47 cases (11%). There were significantly fewer colitis-related complications during the 2012 to 2016 period as compared to the 2006 to 2011 period (7% versus 16%, P &lt; 0.01), but significantly more systemic complications (16% versus 5%, P = 0.001). In-hospital colectomy occurred in 50 hospitalizations (12%). Day 3 steroid response was achieved in 167 hospitalizations (39%). Day 3 steroid nonresponse was significantly associated with colitis-related complications among males (adjusted odds ratio [aOR] 8.22, 95% confidence interval [CI] 1.77 to 38.17), but not among females (aOR 1.39, 95% CI 0.54 to 3.60). Older age, C. difficile infection and admission to a non-gastroenterology service were also associated with a higher risk of in-hospital complications. Day 3 steroid nonresponse was significantly associated with in-hospital colectomy (aOR 10.10, 95% CI 3.56 to 28.57).

Conclusion
In our series of UC hospitalizations for a colitis flare, absence of day 3 steroid response was associated with an increased risk of colitis-related complications among males and of in-hospital colectomy. Clinicians should recognize the importance of early steroid response as a marker to guide the need for treatment optimization.
Cumulative Toxicity in Targeted Therapies: What to Expect at the Recommended Phase II Dose
Authors: Altzerinakou Maria-Athina , Collette Laurence , Paoletti Xavier 
Published: February 2019

AbstractBackgroundIn the era of molecularly targeted agents (MTAs), it is recommended to account for toxicity over several cycles to identify the recommended phase II dose (RP2D). We investigated the relationship between the risk of toxicity at cycle 1 and the cumulative incidence of toxicity over subsequent cycles in trials of single MTAs.MethodsOn individual patient data from 26 phase I clinical trials of single MTAs provided by the National Cancer Institute, we estimated the probability of first-severe toxicity per treatment cycle as well as the cumulative incidence at, below, and above the maximum tolerated dose (MTD). Toxicity was further subclassified into nonhematologic and hematologic. A prediction table was developed to estimate the cumulative incidence up to six cycles based on the toxicity rate observed in the first cycle.ResultsOverall, 942 patients were included. For patients treated at the MTD, the probability of first-severe toxicity decreased from 24.8% (95% prediction interval [PI] = 20.3% to 32.9%) to 2.2% (95% PI = 0.1% to 7.7%) from cycle 1 to 6, whereas the cumulative incidence of toxicity reached 51.7% (95% PI = 40.5% to 66.3%) after six cycles. Toxicity rates ranging from 20.0% to 30.0% in the first cycle were associated with 46.8% (95% PI = 39.5% to 54.2%) and 65.8% (95% PI = 57.7% to 73.1%) cumulative incidence after six cycles.ConclusionThis study examined the risk of severe toxicity over time of single MTAs. The cumulative incidence of toxicity at the MTD was higher than the usually accepted toxicity targets, challenging the definition of the RP2D of MTAs. The prediction table may help calibrate the target rate at the RP2D.
Intravenous Tissue Plasminogen Activator for Large Vessel Ischemic Stroke – Is There Still a Role?
Authors: Sawyer Robert N 
Published: February 2019

Abstract
While the efficacy of Intravenous tissue plasminogen activator (tPA) is well established, its impact on large vessel occlusion (LVO) is controversial. Whether IV tPA should be bypassed in favor of endovascular thrombectomy (MT) will be addressed. Compelling evidence exists to suggest tPA administration might be bypassed in tPA eligible patients in favor of MT for LVO. A trial of MT with patients randomized for IV tPA within the 4.5-h time window should conducted at comprehensive stroke centers demonstrating equipoise between time to tPA or MT with time to treatment from ED arrival of 45 min. We may do well to consider the systems pathway taken by interventional cardiologists 15 years ago.
A New Piece of the Puzzle to Understand Cervical Sagittal Alignment: Utilizing a Novel Angle δ to Describe the Relationship among T1 Vertebral Body Slope, Cervical Lordosis, and Cervical Sagittal Alignment
Authors: Goldschmidt Ezequiel , Angriman Federico , Agarwal Nitin , Trevisan Marcos , Zhou James , Chen Katherine , Gerszten Peter C , Kanter Adam S , Okonkwo David O , Passias Peter , Scheer Justin , Protopsaltis Themistocles , Lafage Virginie , Lafage Renaud , Schwab Frank , Bess Shay , Ames Christopher , Smith Justin S , Shaffrey Christopher I , Miller Emily , Jain Amit , Neuman Brian , Sciubba Daniel M , Burton Douglas , Hamilton D Kojo ,   International Spine Study Group (ISSG)
Published: February 2019

Abstract
Cervical alignment has become increasingly important in the planning of spine surgery. A relationship between the slope of T1 (T1S), the cervical lordosis (CL), and the overall cervical sagittal vertical axis (cSVA) has previously been demonstrated, but the exact nature of this relationship is poorly understood. In this study, we derive theoretical and empirical equations to better understand how T1S and CL affect cSVA. The first equation was developed on a theoretical basis using inherent trigonometric relationships of the cervical spine. By treating the cervical spine as the arc of a circumference, and by taking into account the cervical height (CH), the geometric relationship between theT1S, CL, and cSVA was described via a trigonometric identity utilizing a novel angle δ subtended by the CH and cSVA (δ = T1S-CL/2). The second equation was developed on an empiric basis by performing a multiple linear regression on data obtained from a retrospective review of a large multicenter deformity database. The theoretical equation determined that the value of cSVA could be expressed as:

. The empirical equation determined that value of cSVA could be expressed as:

. In both, the sagittal alignment of the head over the shoulders is directly proportional to the T1S and inversely proportional to CL/2. These 2 equations may allow surgeons to better understand how the CL compensates for the T1S, to accurately predict the postoperative cSVA, and to customize cervical interbody grafts by taking into consideration each individual patient's specific cervical spine parameters.
Histotripsy Clot Liquefaction in a Porcine Intracerebral Hemorrhage Model
Authors: Gerhardson Tyler , Sukovich Jonathan R , Chaudhary Neeraj , Chenevert Thomas L , Ives Kim , Hall Timothy L , Camelo-Piragua Sandra , Xu Zhen , Pandey Aditya S 
Published: February 2019

Abstract

BACKGROUND
Intracerebral hemorrhage (ICH) is characterized by a 30-d mortality rate of 40% and significant disability for those who survive.

OBJECTIVE
To investigate the initial safety concerns of histotripsy mediated clot liquefaction and aspiration in a porcine ICH model. Histotripsy is a noninvasive, focused ultrasound technique that generates cavitation to mechanically fractionate tissue. Histotripsy has the potential to liquefy clot in the brain and facilitate minimally invasive aspiration.

METHODS
About 1.75-mL clots were formed in the frontal lobe of the brain (n = 18; n = 6/group). The centers of the clots were liquefied with histotripsy 48 h after formation, and the content was either evacuated or left within the brain. A control group was left untreated. Pigs underwent magnetic resonance imaging (MRI) 7 to 8 d after clot formation and were subsequently euthanized. Neurological behavior was assessed throughout. Histological analysis was performed on harvested brains. A subset of pigs underwent acute analysis (≤6 h).

RESULTS
Histotripsy was able to liquefy the center of clots without direct damage to the perihematomal brain tissue. An average volume of 0.9 ± 0.5 mL was drained after histotripsy treatment. All groups showed mild ischemia and gliosis in the perihematomal region; however, there were no deaths or signs of neurological dysfunction in any groups.

CONCLUSION
This study presents the first analysis of histotripsy-based liquefaction of ICH in vivo. Histotripsy safely liquefies clots without significant additional damage to the perihematomal region. The liquefied content of the clot can be easily evacuated, and the undrained clot has no effect on pig survival or neurological behavior.
X-ray spectra of Sagittarius A East and diffuse X-ray background near the Galactic center
Authors: Ono Akiko , Uchiyama Hideki , Yamauchi Shigeo , Nobukawa Masayoshi , Nobukawa Kumiko K , Koyama Katsuji 
Published: February 2019

AbstractThis paper reports the analysis procedure and results of simultaneous spectral fits of the Suzaku archive data for Sagittarius (Sgr) A East and the nearby Galactic center X-ray emission (GCXE). The results are that the mixed-morphology supernova remnant Sgr A East has a recombining plasma (RP) with Cr and Mn Heα lines, and a power-law component (PL) with an Fe i Kα line. The nearby GCXE has a ∼1.5-times larger surface brightness than the mean GCXE far from Sgr A East, although the spectral shape is almost identical. Based on these results, we interpret that the origins of the RP and the PL with the Fe i Kα line are past big flares of Sgr A⋆.
Where is the Hoechst Insulin?: The Role of Diabetics and Their Doctors as Consumers During the German Democratic Republic’s Autarkic Policy of ‘Making Free From Disturbance’, 1961–1966
Authors: Hiepko Kathrin A 
Published: February 2019

Summary
This article examines the treatment of the chronic disease, diabetes mellitus, during and immediately after the German Democratic Republic (GDR)’s autarkic policy of Störfreimachung, literally translated as ‘making free from disturbance’. I look specifically at an insulin favoured by East German diabetes specialists and their patients delivered from the West German pharmaceutical company, Hoechst AG, and the consequences of preventing this insulin from being imported. By using insulin as a case study, a medication necessary for the survival of insulin-dependent diabetics, the article offers a close analysis of the complex relationship between ordinary citizens, medical professionals and the ruling Socialist Unity Party (SED) following the building of the Berlin Wall. I argue that the intense focus on the issue of consumption in the competition between the GDR and West Germany shaped both the attitude of the SED and those responding to the policy of Störfreimachung. The SED regime and leading health officials espoused a highly ‘productionist’ medical ethos that was somewhat at odds with their growing desire to meet increasing consumer demands. This collision opened up ideological contradictions, which provided an opportunity for those on the receiving end of the policy to discredit it, and, by extension, justify the continued use of their preferred choice of insulin from Hoechst. I draw, in particular, on patient Eingaben (petitions) and reports by district diabetologists in order to uncover this trend.
Abu Dhabi Foundations Regime: strategic location in the Middle East for legacy planning towards emerging high growth markets
Authors: Mrazek Yann 
Published: February 2019

Abstract
Most Middle East entrepreneurial families are familiar with foreign offshore trusts and foundations, and have been using these tools to ensure wealth preservation and inter-generational continuity for several generations. In that context, the new foundation regime was introduced in 2017 in the Abu Dhabi Global Market, a Middle East common law familiar jurisdiction, meeting all the requirements for a simple-to-understand, cost-effective, and sustainable vehicle dedicated to wealth management and preservation, family succession planning, tax planning, asset protection, corporate structuring, and for public interest foundations (excluding charities). The purpose of this article is to present to the reader the context, mechanisms, and interests to use Abu Dhabi Global Market private foundations.
Nonpharmacologic options for treating irritable bowel syndrome
Authors: Kay Emelia , Hawramee Sham , Pollani Stephen , Mandel Ellen D. 
Published: February 2019

ABSTRACT
Irritable bowel syndrome (IBS) is a chronic functional disorder with no organic cause. Risk factors are multifactorial and treatment typically consists of antimotility or stimulant laxatives and antidepressants. This article reviews several newer areas of interest: probiotics, fecal microbiota transplant, a low FODMAP diet, and cognitive behavioral therapy.
ICU Survivors Have a Substantial Higher Risk of Developing New Chronic Conditions Compared to a Population-Based Control Group
Authors: van Beusekom Ilse , Bakhshi-Raiez Ferishta , van der Schaaf Marike , Busschers Wim B. , de Keizer Nicolette F. , Dongelmans Dave A. 
Published: February 2019

Objectives:
To describe the types and prevalence of chronic conditions in an ICU population and a population-based control group during the year before ICU admission and to quantify the risk of developing new chronic conditions in ICU patients compared with the control group.

Design:
We conducted a retrospective cohort study, combining a national health insurance claims database and a national quality registry for ICUs. Claims data in the timeframe 2012–2014 were combined with clinical data of patients who had been admitted to an ICU during 2013. To assess the differences in risk of developing new chronic conditions, ICU patients were compared with a population-based control group using logistic regression modeling.

Setting:
Eighty-one Dutch ICUs.

Patients:
All patients admitted to an ICU during 2013. A population-based control group was created, and weighted on the age, gender, and socio-economic status of the ICU population.

Interventions:
None.

Measurements and Main Results:
ICU patients (n = 56,760) have more chronic conditions compared with the control group (n = 75,232) during the year before ICU admission (p < 0.0001). After case-mix adjustment ICU patients had a higher risk of developing chronic conditions, with odds ratios ranging from 1.67 (CI, 1.29–2.17) for asthma to 24.35 (CI, 14.00–42.34) for epilepsy, compared with the control group.

Conclusions:
Due to the high prevalence of chronic conditions and the increased risk of developing new chronic conditions, ICU follow-up care is advised and may focus on the identification and treatment of the new developed chronic conditions.
Pregnancy outcomes of elective induction in low-risk term pregnancies
Authors: Na Eun Duc , Chang Sung Woon , Ahn Eun Hee , Jung Sang Hee , Kim Young Ran , Jung Inkyung , Cho Hee Young 
Published: February 2019

Abstract
We investigated the mode of delivery and perinatal outcomes in low-risk pregnant women whose labor was electively induced or expectantly managed at term.
Healthy women with viable, vertex singleton pregnancies at 37+0 to 40+6 weeks of gestation were included. Women electively induced (n = 416) in each week (37+0–37+6, 38+0–38+6, 39+0–39+6, 40+0–40+6 weeks) were compared with pregnant women with spontaneous labor (n = 487). The primary outcome was mode of delivery. A propensity score (PS) was derived using logistic regression to model the probability of elective induction group as a function of potential confounders. Altogether, 284 women with elective induction were matched with 284 women who underwent expectant management to create a PS-matched population. All analysis was performed using SAS software, version 9.4 (SAS Institute Inc., Cary, NC). All P values reported of the significance level was set at <.05.
There are no significant differences of delivery mode, neonatal intensive care unit (NICU) admission, and neonatal complication between PS-matched groups. Incidence of antepartum complications showed higher in the elective induction group compared to the spontaneous labor group (P = .04). When comparing each gestational week, incidence of NICU admission at 38 weeks in the elective induction group [10/74 (13.5%)] was significantly higher than in and the spontaneous labor group [2/74 (2.7%)] (P = .04).
Elective induction of labor at term is not associated with increased risk of cesarean delivery. However, overall incidence of NICU admission at 38 gestational weeks seems to be increased in elective induction.