bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Survival and Freedom From Reintervention After Off-Pump Coronary Artery Bypass Grafting
Authors: Kirmani Bilal H. , Holmes Michael V. , Muir Andrew D. 
Published: October 2016

Background:
The long-term outcomes of off-pump coronary artery bypass grafting (CABG) are the subject of speculation. Our institution has >15 years of experience performing CABG both off-pump (OPCAB) and on cardiopulmonary bypass (CPB). Our null hypothesis was that there would be no difference in a long-term composite of death and revascularisation between the 2 methods.

Methods:
We performed a retrospective cohort study of all isolated CABG at our institution from 2001 to 2015. We used an intention-to-treat analysis, performing risk adjustment with adjustment for and matching to propensity score. In total, 13 226 patients had CABG: 5882 had OPCAB and 7344 had CPB, with a median follow-up of 6.2 years.

Results:

Of the 5882 OPCAB, 76 (1.3%) converted to CPB. One-, 5-, and 10-year survivals in each group were similar (OPCAB vs CPB: 96.7%, 87.9%, 72.1% vs 96.2%, 87.4%, 72.8%). No difference was found in long-term survival (adjusted hazards ratio [HR] 1.03; 95% confidence interval [CI]: 0.94–1.11 for OPCAB vs CPB;
P
=0.56) or freedom from death and reintervention (HR 0.98; 95% CI: 0.92–1.06 for OPCAB vs CPB;
P
=0.23). Patients receiving OPCAB had higher EuroSCOREs (median [quartiles]: 2.81 [1.53–5.57] vs 2.73 [1.51–5.22];
P
=0.01), fewer grafts (mean±SD: 3.0±0.9 vs 3.3±0.9;
P
<0.001), but more total arterial grafting (45.9% vs 8.4%;
P
<0.001). OPCAB also had more trainee first operators (15.3% vs 12.5%), lower cardiac enzyme rise, shorter length of stay, and fewer complications (such as myocardial infarction).

Conclusions:
OPCAB is associated with similar long-term outcomes to CABG performed on CPB in our institution. Our low conversion rate to CPB, while training junior surgeons, demonstrates that OPCAB can be taught safely. The number of grafts performed between the 2 approaches is clinically comparable, if statistically different, and appears to provide equal benefits to survival and freedom from reintervention as on-pump CABG.
Aortic Cross-Sectional Area/Height Ratio and Outcomes in Patients With a Trileaflet Aortic Valve and a Dilated Aorta
Authors: Masri Ahmad , Kalahasti Vidyasagar , Svensson Lars G. , Roselli Eric E. , Johnston Douglas , Hammer Donald , Schoenhagen Paul , Griffin Brian P. , Desai Milind Y. 
Published: October 2016

Background:
In patients with a dilated proximal ascending aorta and trileaflet aortic valve, we aimed to assess (1) factors independently associated with increased long-term mortality and (2) the incremental prognostic utility of indexing aortic root to patient height.

Methods:

We studied consecutive patients with a dilated aortic root (≥4 cm) that underwent echocardiography and gated contrast-enhanced thoracic aortic computed tomography or magnetic resonance angiography between 2003 and 2007. A ratio of aortic root area over height was calculated (cm
2
/m) on tomography, and a cutoff of 10 cm
2
/m was chosen as abnormal, on the basis of previous reports. All-cause death was recorded.

Results:

The cohort comprised 771 patients (63 years [interquartile range, 53–71], 87% men, 85% hypertension, 51% hyperlipidemia, 56% smokers). Inherited aortopathies, moderate to severe aortic regurgitation, and severe aortic stenosis were seen in 7%, 18%, and 2%, whereas 91% and 54% were on β-blockers and angiotensin-converting enzyme inhibitors, respectively. Aortic root area/height ratio was ≥10 cm
2
/m in 24%. The Society of Thoracic Surgeons score and right ventricular systolic pressure were 3.3±3 and 31±7 mm Hg, respectively. At 7.8 years (interquartile range, 6.6–8.9), 280 (36%) patients underwent aortic surgery (76% within 1 year) and 130 (17%) died (1% in-hospital postoperative mortality). A lower proportion of patients in the surgical (versus nonsurgical) group died (13% versus 19%,
P
<0.01). On multivariable Cox proportional hazard analysis, aortic root area/height ratio (hazard ratio, 4.04; 95% confidence interval [CI], 2.69–6.231) was associated with death, whereas aortic surgery (hazard ratio, 0.47; 95% CI, 0.27–0.81) was associated with improved survival (both
P
<0.01). For longer-term mortality, the addition of aortic root area/height ratio ≥10 cm
2
/m to a clinical model (Society of Thoracic Surgeons score, inherited aortopathies, hypertension, hyperlipidemia, medications, aortic regurgitation, and right ventricular systolic pressure), increased the c-statistic from 0.57 (95% CI, 0.35–0.77) to 0.65 (95% CI, 0.52–0.73) and net reclassification index from 0.17 (95% CI, 0.02–0.31) to 0.23 (95% CI, 0.04–0.34), both
P
<0.01. Of the 327 patients with aortic root diameter between 4.5 and 5.5 cm, 44% had an abnormal aortic root area/height ratio, of which 78% died.

Conclusions:
In patients with dilated aortic root and trileaflet aortic valve, a ratio of aortic root area to height provides independent and improved stratification for prediction of death.
Serum Total 25‐OH Vitamin D Adds Little Prognostic Value in Patients Undergoing Coronary Catheterization
Authors: Gerling Michael E. , James Matthew T. , Wilton Stephen B. , Naugler Christopher , Southern Danielle A. , Galbraith P. Diane , Knudtson Merril , de Koning Lawrence 
Published: October 2016

Background
Vitamin D deficiency is associated with an increased risk of cardiovascular disease; however, it is unclear whether vitamin D status should be considered in clinical risk assessments of patients with cardiovascular disease.

Methods and Results

This study included 2975 patients who had their first serum total 25‐hydroxy vitamin D (25‐OH vitamin D) measurement before their first coronary catheterization in Alberta, Canada. Cox regression was used to examine associations between 25‐
OH
vitamin D and mortality risk after adjusting for demographic and clinical risk factors. Interactions were tested using multiplicative terms, and prognostic value was assessed using measures of model discrimination, fit, calibration and net reclassification improvement. There were 401 deaths over a median of 5.8 years of follow‐up. Serum total 25‐
OH
vitamin D was inversely associated with mortality after adjusting for demographic and clinical risk factors, which was largely driven by excess risk in the bottom quintile (hazard ratio 1.84 for bottom versus top quintile, 95% CI 1.36–2.50,
P
for trend <0.001). Associations were weaker in the presence of several competing risk factors (e.g., advanced age;
P
for interactions <0.05). Adding 25‐
OH
vitamin D to a model containing demographic and clinical risk factors yielded similar discrimination, model fit, and calibration and only modest improvements in risk reclassification (net reclassification improvement 1.9% for deaths, 2.3% for survivors).

Conclusions

Pre‐catheterization, serum total 25‐
OH
vitamin D was inversely associated with mortality risk after adjusting for established demographic and clinical risk factors. This association was attenuated by several competing risk factors. Overall, 25‐
OH
vitamin D added little prognostic value over established risk factors; therefore, its measurement is not warranted in patients undergoing coronary catheterization.
Two‐Year Neurodevelopment and Growth Outcomes for Preterm Neonates Who Received Low‐Dose Intravenous Soybean Oil
Authors: Ong Margaret L. , Purdy Isabell B. , Levit Orly L. , Robinson Daniel T. , Grogan Tristan , Flores Martiniano , Calkins Kara L. 
Published: October 2016

AbstractBackground: In some studies, the dose of intravenous soybean oil (SO) has been associated with a decreased incidence of intestinal failure–associated liver disease. The effect of lipid sparing on neurodevelopment (ND) and growth remains unknown. This study investigated the impact of SO dose on ND and growth over the first 2 years of age in preterm neonates. Materials and Methods: This is a single‐site prospective follow‐up study. Neonates with a gestational age ≤29 weeks were randomized to low‐dose (LOW) or standard‐dose (CON) SO. Bayley Scales of Infant Development III and anthropometric measurements were collected at approximately 6, 12, and 24 months corrected gestational age. Results: Subjects were premature, with a mean (±SD) gestational age of 28 ± 1 and 27 ± 1 weeks (P = .3) for LOW and CON, respectively. Thirty subjects completed follow‐up (LOW = 15, CON = 15). There were no differences for ND and growth outcomes when LOW was compared with CON, with the exception of a higher 12‐month follow‐up cognitive scaled score in the LOW group (P = .02). Conclusion: A reduced SO dose did not adversely affect ND or growth in this cohort of preterm neonates. However, larger studies are needed to determine the long‐term safety of SO dose reduction before this strategy can be adopted.
The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial
Authors: John Leslie K. , Troxel Andrea B. , Yancy William S. , Friedman Joelle , Zhu Jingsan , Yang Lin , Galvin Robert , Miller-Kovach Karen , Halpern Scott D. , Loewenstein George , Volpp Kevin 
Published: October 2016

Purpose: To test the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally available weight management program. Design: A randomized trial tested the impact of employer subsidy: 100%; 80%, 50%, and a hybrid 50% subsidy that could become a 100% subsidy by attaining attendance targets. Trial registration: NCT01756066. Setting and Participants: Twenty three thousand twenty-three employees of 2 US companies. Measures: The primary outcome was the percentage of employees who enrolled in the weight management program. We also tested whether the subsidies were associated with differential attendance and weight loss over 12 months, as might be predicted by the expectation that they attract employees with differing degrees of motivation. Analysis and Results: Enrollment differed significantly by subsidy level ( P < .0001). The 100% subsidy produced the highest enrollment (7.7%), significantly higher than each of the lower subsidies (vs 80% subsidy: 6.2%, P = .002; vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Enrollment in the 80% subsidy group was significantly higher than both lower subsidy groups (vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Among enrollees, there were no differences among the 4 groups in attendance or weight loss. Conclusion: This pragmatic trial, conducted in a real-world workplace setting, suggests that higher rates of employer subsidization help individuals to enroll in weight loss programs, without a decrement in program effectiveness. Future research could explore the cost-effectiveness of such subsidies or alternative designs.
The effect of omitting an early population-based vision screen in the Netherlands: A micro-simulation model approach
Authors: Sloot F , Heijnsdijk EAM , Groenewoud JH , Goudsmit F , Steyerberg EW , de Koning HJ , Simonsz HJ 
Published: October 2016

Objective To estimate the effect of omitting an individual screen from a child vision screening programme on the detection of amblyopia in the Netherlands. A previous study (Rotterdam Amblyopia Screening Effectiveness Study) suggested that the three screens carried out between 6 and 24 months contributed little. Methods We developed a micro-simulation model that approximated the birth-cohort data from the previous study, in which 2964 children had completed follow-up at age 7, and 100 amblyopia cases were detected. Detailed data on screens, referrals, and orthoptic follow-up, including the cause of amblyopia, were available. The model predicted the number of amblyopia cases detected for each screen and for the entire screening programme, and the effect of omitting screens. Incidence curves for all types of amblyopia caused by strabismus, refractive anomalies or by both were estimated by approximation of the observational data, in conjunction with experts’ estimations and the literature. Results We calculated mean actual sensitivity per screen per type of amblyopia, and the effect per screen. Screening at 24 months was found to be least effective. The impact on the screening programme, estimated by summing the effectiveness per screen, omitting the 24-month screen, was a reduction of 3.4% (57 vs. 59 cases) in the number of detected cases of amblyopia at age 5. Conclusion The effectiveness of the Dutch vision screening programme would hardly be affected by omission of the 24-month screening examination. A disinvestment study is warranted.
Space Exploration by India and Socio-economic Cooperation with SAARC Countries
Authors: Gupta Biswanath , Raju KD  
Published: October 2016

For the last 50 years, Indian Space Research Organisation (ISRO) has seen a tremendous development in the field of space science and technology. Outer space exploration in social programme (education, telemedicine, communication and information) and economic activities (agricultural forecasting, meteorological data, telecommunication and broadcasting) helped India grow faster. Over the past few years, India is also engaging with other countries, offering them the space science and technology for their overall development. Very recently, Prime Minister of India offered the South Asian Association for Regional Cooperation (SAARC) nations SAARC satellite for the socio-economic development of the region. Engaging with the SAARC countries will not only help India economically, but also geopolitically, and this is very important for India’s future security reasons. This article examines the tremendous success of India’s space programme in the socio-economic field and finds out the scope of extending India’s support to the SAARC nations for outer space development in the region. South Asia is considered as one of the most under-developed regions in the world, and this article tries to find out possible cooperation between India and SAARC nations in utilising the space science for socio-economic development of the inhabitants of the region.
Gait Analysis of Foot Compensation After Arthrodesis of the First Metatarsophalangeal Joint
Authors: Stevens Jasper , Meijer Kenneth , Bijnens Wouter , Fuchs Mathijs C.H.W. , van Rhijn Lodewijk W. , Hermus Joris P.S. , van Hoeve Sander , Poeze Martijn , Witlox Adhiambo M. 
Published: October 2016

Background: Arthrodesis of the first metatarsophalangeal (MTP1) joint is an intervention often used in patients with severe MTP1 joint osteoarthritis and relieves pain in approximately 80% of these patients. The kinematic effects and compensatory mechanism of the foot for restoring a more normal gait pattern after this intervention are unknown. The aim of this study was to clarify this compensatory mechanism, in which it was hypothesized that the hindfoot and forefoot would be responsible for compensation after an arthrodesis of the MTP1 joint. Methods: Gait properties were evaluated in 10 feet of 8 patients with MTP1 arthrodesis and were compared with 21 feet of 12 healthy subjects. Plantar pressures and intersegmental range of motion were measured during gait by using the multisegment Oxford Foot Model. Pre- and postoperative X-rays of the foot and ankle were also evaluated. Results: The MTP1 arthrodesis caused decreased eversion of the hindfoot during midstance, followed by an increased internal rotation of the hindfoot during terminal stance, and ultimately more supination and less adduction of the forefoot during preswing. In addition, MTP1 arthrodesis resulted in a lower pressure time integral beneath the hallux and higher peak pressures beneath the lesser metatarsals. A mean dorsiflexion fusion angle of 30 ± 5.4 degrees was observed in postoperative radiographs. Conclusion: This study demonstrated that the hindfoot and forefoot compensated for the loss of motion of the MTP1 joint after arthrodesis in order to restore a more normal gait pattern. This resulted in a gait in which the rigid hallux was less loaded while the lesser metatarsals endured higher peak pressures. Further studies are needed to investigate whether this observed transfer of load or a preexistent decreased compensatory mechanism of the foot can possibly explain the disappointing results in the minority of the patients who experience persistent complaints after a MTP1 arthrodesis. Level of Evidence: Level III, comparative series.
Real-World Experience With Apremilast in Treating Psoriasis
Authors: Mayba Julia N. , Gooderham Melinda J. 
Published: October 2016

Background: Clinical trial data have shown apremilast, an oral phosphodiesterase-4 inhibitor, to be efficacious and safe for the treatment of psoriasis. However, little real-world experience using apremilast in the community setting has been documented. Objectives: Many patients with psoriasis are often unresponsive to various treatment modalities, including topical, systemic, and biologic medications. The aim of this chart review was to assess the overall patient experience while using apremilast to treat psoriasis. Methods: A retrospective chart review of electronic medical records was conducted of all patients prescribed apremilast in a community dermatology practice. Results: Of 99 patients who were prescribed apremilast, 81 patients took at least 1 dose. In 63 patients, apremilast improved clinical disease severity, with 37% of patients achieving a body surface area <1%. As a treatment, it was generally well tolerated and caused no serious adverse events. The most commonly reported side effect resulting in discontinuation of treatment of apremilast was nausea and vomiting. Conclusions: Overall, apremilast was a safe and well-tolerated treatment with significant clinical improvement in our patient population.
Cognition and fatigue in patients with relapsing multiple sclerosis treated by subcutaneous interferon β-1a: an observational study SKORE
Authors: Benešová Yvonne , Tvaroh Aleš 
Published: October 2016

Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, which often causes progressive neurological disability. In addition to motor and sensory dysfunction, cognitive decline and fatigue are frequent manifestations of the disease. Fatigue is probably the most common symptom, with up to 90% of MS individuals reporting fatigue at some point. Cognitive impairment affects about 50% of patients and may be present at all MS stages. The aim of this observational study was to evaluate changes in cognition, fatigue, and disability status in 300 relapsing–remitting MS (RRMS) patients, treated with subcutaneous (sc) interferon (IFN) β-1a over 2 years. Methods: The study was designed as an observational, multicentre, prospective, single-arm, phase IV study carried out in 13 MS centres in the Czech Republic. Cognition status was assessed using the Paced Auditory Serial Addition Task (PASAT), fatigue using the Fatigue Descriptive Scale (FDS), and disability using the Expanded Disability Status Scale (EDSS), at baseline, and after 6, 12 and 24 months. The percentage of patients with changed versus stable cognition, fatigue status and disability was calculated at each time point and the changes in these scores were evaluated. Results: The proportion of patients with cognitive improvement was higher compared with those with a stable or decreased PASAT scores at all time points, and the average cognitive performance improved during the follow-up period. Also the proportion of patients with stable or improved fatigue and EDSS scores was higher compared with those in which FDS or EDSS scores declined, this was found at all time points of the analysed sample. However, the direct effect of IFN β-1a on cognition and fatigue cannot be concluded from this study. Conclusions: The results of this observational study have demonstrated a stable or improved cognitive performance, fatigue status, and disability level in the majority of RRMS patients treated with sc IFN β-1a over a two-year follow-up period, in a real life setting, in the Czech Republic.
International Human Rights Law and the Menace of Atrocities on Dalit Communities in India
Authors: Babar Aniruddha Vithal 
Published: October 2016

Caste discrimination and atrocities on Dalit communities is a stigma on Indian society. By virtue of Article 17 of the Constitution of India, the evil practice of untouchability is abolished. However, menace of caste still exists largely in rural areas as well as in cities in various forms. The Supreme Court of India in Arumugam Sarvai vs State of Tamilnadu, (2011) 6 SCC 405 stated that, ‘A large section of Indian society still regards a section of their own countrymen as inferior.’ It is pertinent to note that as per the statistics published by the National Crime Record Bureau around 27,000 crimes against former untouchables are recorded yearly. The atrocities committed against Dalit communities are result of structural failure of government machinery. In addition to domestic protection available to Dalits, there are provisions in the International Human Rights Law too that address their issues. In this article an attempt is made to analyze the elements of International Human Rights Law and Municipal Laws of India that concerns with the welfare and legal protection of Dalit communities. The purpose of this research is to show how India failed to meet her obligations under various international human rights conventions to secure Dalit rights. This research work will debunk the state’s claims of compliance with international standards while protecting social–legal interest of Dalits. There are reports of atrocities and violence against Dalits that indicate that they are still society’s most vulnerable people in a ‘fragile’ state. This article will systematically reveal how international human rights norms were violated and how the situation of Dalits could be improved by improving the standards of the implementation of protective measures in conformity with international human rights law.
A statistical approach to detection of copy number variations in PCR-enriched targeted sequencing data
Authors: Demidov German , Simakova Tamara , Vnuchkova Julia , Bragin Anton 
Published: October 2016

Abstract
Background
Multiplex polymerase chain reaction (PCR) is a common enrichment technique for targeted massive parallel sequencing (MPS) protocols. MPS is widely used in biomedical research and clinical diagnostics as the fast and accurate tool for the detection of short genetic variations. However, identification of larger variations such as structure variants and copy number variations (CNV) is still being a challenge for targeted MPS. Some approaches and tools for structural variants detection were proposed, but they have limitations and often require datasets of certain type, size and expected number of amplicons affected by CNVs. In the paper, we describe novel algorithm for high-resolution germinal CNV detection in the PCR-enriched targeted sequencing data and present accompanying tool.

Results
We have developed a machine learning algorithm for the detection of large duplications and deletions in the targeted sequencing data generated with PCR-based enrichment step. We have performed verification studies and established the algorithm’s sensitivity and specificity. We have compared developed tool with other available methods applicable for the described data and revealed its higher performance.

Conclusion
We showed that our method has high specificity and sensitivity for high-resolution copy number detection in targeted sequencing data using large cohort of samples.