bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased risks of venous thromboembolism in patients with psoriasis
Authors: Chung Wei-Sheng , Lin Cheng-Li 
Published: May 2017

SummarySystemic inflammation and hypercoagulability in psoriasis are related to cardiovascular morbidity. The aim of the study was to investigate the incidence and risk of venous thromboembolism (VTE) in patients with psoriasis in Taiwan. We identified inpatients aged ≥ 18 years with a diagnosis of psoriasis and controls at a 1: 1 ratio of frequency matched by sex, age, frequency of medical visits, length of stay, and comorbidities between 2000 and 2010 in the Taiwan National Health Insurance Research Database. Each patient was traced to the date of VTE occurrence, loss to follow-up, death, or the December 31, 2011, whichever occurred first. We analysed 8945 patients with psoriasis and 8945 controls. The patients with psoriasis exhibited a greater incidence rate of VTE (19.2 vs 9.88 per 10 000 person-years) than did the controls. After adjustment for covariates, the patients with psoriasis presented a 2.02-fold risk of VTE (adjusted hazard ratio [aHR] = 2.02, 95% confidence interval [CI] = 1.42–2.88) compared with that in the control cohort. The aHR of VTE was significantly higher in the first year of follow-up (aHR = 3.30, 95% CI = 1.45–7.55) than after one year (aHR = 1.68, 95% CI = 1.13–2.49).
Gastric Bypass Surgery Produces a Durable Reduction in Cardiovascular Disease Risk Factors and Reduces the Long‐Term Risks of Congestive Heart Failure
Authors: Benotti Peter N. , Wood G. Craig , Carey David J. , Mehra Vishal C. , Mirshahi Tooraj , Lent Michelle R. , Petrick Anthony T. , Still Christopher , Gerhard Glenn S. , Hirsch Annemarie G. 
Published: May 2017

Background
Obesity and its association with reduced life expectancy are well established, with cardiovascular disease as one of the major causes of fatality. Metabolic surgery is a powerful intervention for severe obesity, resulting in improvement in comorbid diseases and in cardiovascular risk factors. This study investigates the relationship between metabolic surgery and long‐term cardiovascular events.

Methods and Results

A cohort of Roux‐en‐Y gastric bypass surgery (
RYGB
) patients was tightly matched by age, body mass index, sex, Framingham Risk Score, smoking history, use of antihypertension medication, diabetes mellitus status, and calendar year with a concurrent cohort of nonoperated control patients. The primary study end points of major cardiovascular events (myocardial infarction, stroke, and congestive heart failure) were evaluated using Cox regression. Secondary end points of longitudinal cardiovascular risk factors were evaluated using repeated‐measures regression. The
RYGB
and matched controls (N=1724 in each cohort) were followed for up to 12 years after surgery (overall median of 6.3 years). Kaplan–Meier analysis revealed a statistically significant reduction in incident major composite cardiovascular events (
P
=0.017) and congestive heart failure (0.0077) for the
RYGB
cohort. Adjusted Cox regression models confirmed the reductions in severe composite cardiovascular events in the
RYGB
cohort (hazard ratio=0.58, 95%
CI
=0.42–0.82). Improvements of cardiovascular risk factors (eg, 10‐year cardiovascular risk score, total cholesterol, high‐density lipoprotein, systolic blood pressure, and diabetes mellitus) were observed within the
RYGB
cohort after surgery.

Conclusions
Gastric bypass is associated with a reduced risk of major cardiovascular events and the development of congestive heart failure.
Cost of Alteplase Has More Than Doubled Over the Past Decade
Authors: Kleindorfer Dawn , Broderick Joseph , Demaerschalk Bart , Saver Jeffrey 
Published: May 2017

Background and Purpose—
Intravenous alteplase (tissue-type plasminogen activator) has been shown to be cost-effective because of savings in long-term disability. In October of 2005, an increased DRG payment to hospitals for alteplase-treated stroke patients was introduced. We sought to describe the trends in the cost of alteplase over time, in comparison to trends in hospital reimbursement in the United States.

Methods—

Using publicly available information on the Centers for Medicare and Medicaid Services (CMS) website (
www.cms.gov
), we obtained CMS quarterly payment amounts between January 1, 2005, and October 1, 2014, for alteplase, listed as alteplase recombinant, per mg. CMS payment amounts are the manufacturer’s average sales price+6% until April 2014, when it was lowered to +4.3%. Estimates for DRG base payments were calculated within the Medicare Provider and Analysis Review (MEDPAR) for fiscal years 2006 (DRG 559) and 2013 (MS DRGs 61, 62, and 63) as (DRG relative weights)×(standardized operating and capital amount). The consumer price index was also queried for all prescription drugs, urban areas, during the same study period as reference.

Results—
The CMS payment amount for alteplase per milligram was $30.50 in January 2005 and $64.30 in October 2014. Trends in the CMS payment amounts for alteplase increased by 111% between 2005 and 2014. The consumer price index for all prescription drugs increased by 30.2% in the same time frame. The base payment for alteplase-treated stroke admissions was $11 173 in 2006 and $12 064 in 2013, an 8% increase.

Conclusions—
We found a striking increase in the cost of alteplase over the last decade, with a 100 mg vial now with a CMS payment of ≈$6400, a >100% increase over 10 years. During the same time frame, the DRG base payment to hospitals increased by only 8%, and alteplase cost increased from 27% of the payment in 2006 to 53% in 2013. Researchers and stroke physicians should be aware of these changes in drug costs and their impact on cost-effectiveness analyses.
Psychiatric Hospitalization Increases Short-Term Risk of Stroke
Authors: Zuflacht Jonah P. , Shao Yuefan , Kronish Ian M. , Edmondson Donald , Elkind Mitchell S.V. , Kamel Hooman , Boehme Amelia K. , Willey Joshua Z. 
Published: May 2017

Background and Purpose—
Recent evidence suggests that psychological distress, including the symptoms of psychiatric illness, may acutely increase the risk of stroke. However, existing studies are limited by small sample sizes, inherent recall bias, and poorly defined criteria for what constitutes psychological distress.

Methods—

We analyzed administrative data from the Healthcare Cost and Utilization Project for the state of California from 2007 to 2009 using a case-crossover design. Conditional logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for combined hemorrhagic and ischemic stroke risk occurring within 15, 30, 90, 180, and 365 days of a hospitalization for a psychiatric diagnosis (as defined by
International Classification of Diseases, Ninth Revision
, code) among adults.

Results—
Psychiatric hospitalizations within 1 year before stroke were found in 2585 (5.3%) of 48 558 stroke patients. Hospitalization for a psychiatric condition was associated with increased risk of stroke within all 5 time periods, with the highest odds of stroke occurring within 15 days (0–15 days: OR, 3.5; 95% confidence interval [CI], 2.6–4.8; 0–30 days: OR, 3.0; 95% CI, 2.4–3.8; 0–90 days: OR, 2.3; 95% CI, 2.0–2.7; 0–180 days: OR, 2.2; 95% CI, 2.0–2.5; and 0–365 days: OR, 2.6; 95% CI, 2.4–2.8).

Conclusions—
Psychiatric hospitalization increases the short-term risk of stroke, particularly within the 15-day period after hospitalization.
Optimal Timing of Diffusion-Weighted Imaging to Avoid False-Negative Findings in Patients With Transient Ischemic Attack
Authors: Shono Kenji , Satomi Junichiro , Tada Yoshiteru , Kanematsu Yasuhisa , Yamamoto Nobuaki , Izumi Yuishin , Kaji Ryuji , Harada Masafumi , Nagahiro Shinji 
Published: May 2017

Background and Purpose—
We aimed to investigate the optimal timing of diffusion-weighted imaging (DWI) in patients with transient ischemic attack (TIA).

Methods—
Seventy-three consecutive patients with TIA underwent DWI on admission (initial DWI) and at 24 hours after admission (second DWI). Patients were divided into 2 groups based on initial DWI findings in relation to the second examination: false negative (group 1) and other (group 2). The probability of initial false-negative findings was determined for each hour from TIA onset to initial DWI. Multivariate analysis was used to evaluate the independent risk factors associated with false-negative findings on initial DWI.

Results—

Of the 73 patients examined (56 men; mean age, 68 years), 9 (12%) were categorized into group 1. The latency from TIA onset to initial DWI was 1.7±0.6 hours for group 1 (range, 1–2.8 hours) and 3.3±2.6 hours for group 2 (range, 35 minutes to 12 hours). The probability of false-negative findings on initial DWI decreased in a time-dependent manner (25%, 21%, and 7% for 1, 2, and 3 hours, respectively), and no false-negative findings were observed on initial DWI performed at >3 hours from symptom onset. Short latency (≤2 hours) from TIA onset to initial DWI was an independent risk factor related to false-negative findings (odds ratio, 13.11; 95% confidence interval, 1.07–161.38;
P
=0.045).

Conclusions—
If the duration between TIA symptom onset and initial DWI is <2 hours, a repeat examination should be performed to minimize the risk of false-negative findings.
Histological observations by light and scanning electron microscopy of the Japanese pine sawyer, Monochamus alternatus, infected with the entomopathogenic nematode, Steinernema carpocapsae
Authors: Mamiya Yasuharu , Shoji Tugio 
Published: May 2017

Light (LM) and scanning electron microscopy (SEM) were used to study infection of adults and larvae of the Japanese pine sawyer,Monochamus alternatus, by infective juveniles (IJ) ofSteinernema carpocapsae(Mexican strain). The IJ entered the alimentary canal of both larvae and adults ofM. alternatusviathe anus. Entry through spiracles was not observed. Both larvae and adult died within 48 h after infection. SEM revealed the changes in the distribution and reproduction of the symbiotic bacterium,Xenorhabdus nematophila, in the insect body over time. The observations were consistent with the hypothesis that septicaemia was the main cause of insect death. Bacteria grew vigorously and were distributed widely in the insect body as soon as the IJ invaded the insect. Reproduction of the nematode within the insect followed the reproduction of the bacterium throughout the insect body.
Assessment of Radio Occultation Observations from the COSMIC-2 Mission with a Simplified Observing System Simulation Experiment Configuration
Authors: Cucurull L. , Li R. , Peevey T. R. 
Published: May 2017

AbstractThe mainstay of the global radio occultation (RO) system, the COSMIC constellation of six satellites launched in April 2006, is already past the end of its nominal lifetime and the number of soundings is rapidly declining because the constellation is degrading. For about the last decade, COSMIC profiles have been collected and their retrievals assimilated in numerical weather prediction systems to improve operational weather forecasts. The success of RO in increasing forecast skill and COSMIC’s aging constellation have motivated planning for the COSMIC-2 mission, a 12-satellite constellation to be deployed in two launches. The first six satellites (COSMIC-2A) are expected to be deployed in December 2017 in a low-inclination orbit for dense equatorial coverage, while the second six (COSMIC-2B) are expected to be launched later in a high-inclination orbit for global coverage. To evaluate the potential benefits from COSMIC-2, an earlier version of the NCEP’s operational forecast model and data assimilation system is used to conduct a series of observing system simulation experiments with simulated soundings from the COSMIC-2 mission. In agreement with earlier studies using real RO observations, the benefits from assimilating COSMIC-2 observations are found to be most significant in the Southern Hemisphere. No or very little gain in forecast skill is found by adding COSMIC-2A to COSMIC-2B, making the launch of COSMIC-2B more important for terrestrial global weather forecasting than that of COSMIC-2A. Furthermore, results suggest that further improvement in forecast skill might better be obtained with the addition of more RO observations with global coverage and other types of observations.
Short- and Long-Term Management of an Acute Pustular Psoriasis Flare: A Case Report
Authors: Georgakopoulos Jorge R. , Ighani Arvin , Yeung Jensen 
Published: May 2017

Background: Generalised pustular psoriasis (GPP) and acrodermatitis continua of Hallopeau (ACH) are chronic, relapsing variants of pustular psoriasis proven to be remarkably challenging to treat. Due to their uncommon presentation, there are few described cases in literature and scarce evidence for management. Further information is needed to help dermatologists formulate treatment plans for patients presenting with such diseases. Case Summary: We report the case of a 68-year-old man with a 3-year history of psoriasis presenting to our clinic with a severe breakout of GPP and associated ACH. The patient underwent treatment with cyclosporine A (200 mg PO twice daily) for a period of 2 weeks. This provided dramatic improvement in disease symptoms, with clearance of pustules, remarkable reduction of ACH lesions, and absence of pain. The patient was transitioned to infliximab (5 mg/kg intravenous) and apremilast (30 mg PO twice daily), displaying minimal GPP relapse and well-controlled onychodystrophy for several months. Conclusion: This case supports the use of cyclosporine as a first-line agent in providing immediate symptomatic relief for pustular psoriasis flares. Transitioning to infliximab and apremilast combination therapy offers a unique treatment regime for long-term GPP and ACH management.
Three-year clinical outcomes of relapsing multiple sclerosis patients treated with dimethyl fumarate in a United States community health center
Authors: Smoot Kyle , Spinelli Kateri J , Stuchiner Tamela , Lucas Lindsay , Chen Chiayi , Grote Lois , Baraban Elizabeth , Kresa-Reahl Kiren , Cohan Stanley 
Published: May 2017

Background: Following approval of dimethyl fumarate (DMF), we established a registry of relapsing multiple sclerosis (RMS) patients taking DMF at our community MS center. Objective: To track DMF patients’ tolerability, disease progression, and lymphopenia. Methods: Patients prescribed DMF for RMS from March 2013 to March 2016 were prospectively enrolled ( N = 412). Baseline data, clinical relapses, magnetic resonance imaging (MRI) activity, discontinuation, and lymphocyte counts were captured through chart review. Results: The mean age of patients starting DMF was 49.4 ± 12.0 years and 70% transitioned from a previous disease-modifying therapy (DMT). Of the patients, 38% discontinued DMF, 76% of whom discontinued due to side effects. Clinical relapse and MRI activity were low. Comparing patients who transitioned from interferon-β (IFN), glatiramer acetate (GA), or natalizumab (NTZ), patients previously on NTZ had higher rates of relapse than those previously on GA (annualized relapse rate p = 0.039, percent relapse p = 0.021). Grade III lymphopenia developed in 11% of patients. Lymphopenia was associated with older age ( p < 0.001) and longer disease duration ( p < 0.001). Conclusion: Given the high rates of lymphopenia and discontinuation, it has become our clinical practice to more closely scrutinize older patients and those with a longer disease duration who are potential candidates for initiating DMF therapy.
Cerebrospinal fluid neurofilament light levels mark grey matter volume in clinically isolated syndrome suggestive of multiple sclerosis
Authors: Tortorella Carla , Direnzo Vita , Ruggieri Maddalena , Zoccolella Stefano , Mastrapasqua Mariangela , D’Onghia Mariangela , Paolicelli Damiano , Dicuonzo Franca , Gasperini Claudio , Trojano Maria 
Published: May 2017

Background: Brain atrophy is a known marker of irreversible tissue damage in multiple sclerosis (MS). Cerebrospinal fluid (CSF) osteopontin (OPN) and neurofilament light chain (NF-L) have been proposed as candidate surrogate markers of inflammatory and neurodegenerative processes in MS. Objective: To evaluate the relationship between CSF NF-L and OPN levels and brain grey and white matter volumes in patients with clinically isolated syndrome (CIS) suggestive of MS. Methods: A total of 41 CIS patients and 30 neurological controls (NCs) were included. CSF NF-L and OPN were measured by commercial ELISA. Measures of brain volume (normalized brain volume (NBV), normalized grey matter volume (NGV), peripheral grey matter volume (PGV), normalized white matter volume (WMV), and ventricular volume) were obtained by SIENAX. Corpus callosum index (CCI) was calculated. Brain volumes were categorized into ‘high’ and ‘low’ according to the median value. Results: CSF NF-L and OPN levels were higher in CIS patients in comparison with NCs. CIS patients with ‘low’ TGV, PGV, and TBV showed higher CSF NF-L levels than CIS patients with ‘high’ brain volumes. TGV and PGV correlated inversely with NF-L levels, whereas CCI was inversely related to OPN levels. CSF NF-L was the only independent predictor of TGV and PGV. Conclusion: CSF NF-L tracks mainly grey matter damage in patients with CIS suggestive of MS.
Remote autopsy services: A feasibility study on nine cases
Authors: Vodovnik Aleksandar , Aghdam Mohammad Reza F , Espedal Dan Gøran 
Published: May 2017

Introduction We have conducted a feasibility study on remote autopsy services in order to increase the flexibility of the service with benefits for teaching and interdepartmental collaboration. Methods Three senior staff pathologists, one senior autopsy technician and one junior resident participated in the study. Nine autopsies were performed by the autopsy technician or resident, supervised by the primary pathologist, through the secure, double encrypted video link using Jabber Video (Cisco) with a high-speed broadband connection. The primary pathologist and autopsy room each connected to the secure virtual meeting room using 14″ laptops with in-built cameras (Hewlett-Packard). A portable high-definition web camera (Cisco) was used in the autopsy room. Primary and secondary pathologists independently interpreted and later compared gross findings for the purpose of quality assurance. The video was streamed live only during consultations and interpretation. A satisfaction survey on technical and professional aspects of the study was conducted. Results Independent interpretations of gross findings between primary and secondary pathologists yielded full agreement. A definite cause of death in one complex autopsy was determined following discussions between pathologists and reviews of the clinical notes. Our satisfaction level with the technical and professional aspects of the study was 87% and 97%, respectively. Discussion Remote autopsy services are found to be feasible in the hands of experienced staff, with increased flexibility and interest of autopsy technicians in the service as a result.
Perceived determinants to alcohol consumption and misuse: a survey of university students
Authors: Muli Nicholas , Lagan Briege M 
Published: May 2017

Aim: Before an attempt is made to develop any population-specific behavioural change programme, it is important to know what the factors that influence behaviours are. The aim of this study was to identify what are the perceived determinants that attribute to young people’s choices to both consume and misuse alcohol. Method: Using a descriptive survey design, a web-based questionnaire based on the Theory of Triadic Influence was administered to students aged 18–29 years at one university in Northern Ireland. Results: Out of the total respondents ( n = 595), knowledge scores on alcohol consumption and the health risks associated with heavy episodic drinking were high (92.4%, n = 550). Over half (54.1%, n = 322) cited the Internet as their main source for alcohol-related information. The three most perceived influential factors of inclination to misuse alcohol were strains/conflict within the family home ( M = 2.98, standard deviation ( SD) = 0.18, 98.7%, n = 587), risk taking/curiosity behaviour ( M = 2.97, SD = 0.27, 97.3%, n = 579) and the desire not to be socially alienated ( M = 2.94, SD = 0.33, 96%, n = 571). Females were statistically significantly more likely to be influenced by desire not to be socially alienated than males (  p = .029). Religion and personal reasons were the most commonly cited reasons for not drinking. Conclusion: Future initiatives to reduce alcohol misuse and alcohol-related harms need to focus on changing social normative beliefs and attitudes around alcohol consumption and the family and environmental factors that influence the choice of young adult’s alcohol drinking behaviour. Investment in multi-component interventions may be a useful approach.
Improved outcomes in ex-smokers with COPD: a UK primary care observational cohort study
Authors: Josephs Lynn , Culliford David , Johnson Matthew , Thomas Mike 
Published: May 2017

Smoking cessation in chronic obstructive pulmonary disease (COPD) reduces accelerated forced expiratory volume in 1 s decline, but impact on key health outcomes is less clear. We studied the relationship of smoking status to mortality and hospitalisation in a UK primary care COPD population.Using patient-anonymised routine data in the Hampshire Health Record Analytical Database, we identified a prevalent COPD cohort, categorising patients by smoking status (current, ex- or never-smokers). Three outcomes were measured over 3 years (2011–2013): all-cause mortality, respiratory-cause unplanned hospital admission and respiratory-cause emergency department attendance. Survival analysis using multivariable Cox regression after multiple imputation was used to estimate hazard ratios for each outcome by smoking status, adjusting for measured confounders (including age, lung function, socioeconomic deprivation, inhaled medication and comorbidities).We identified 16 479 patients with COPD, mean±sdage 70.1±11.1 years. Smoking status was known in 91.3%: 35.1% active smokers, 54.3% ex-smokers, 1.9% never-smokers. Active smokers predominated among younger patients. Compared with active smokers (n=5787), ex-smokers (n=8941) had significantly reduced risk of death, hazard ratio (95% confidence interval) 0.78 (0.70–0.87), hospitalisation, 0.82 (0.74–0.89) and emergency department attendance, 0.78 (0.70–0.88).After adjusting for confounders, ex-smokers had significantly better outcomes, emphasising the importance of effective smoking cessation support, regardless of age or lung function.