bluuebunny/crossref_metadata_2025_split huggingface dataset:
Response to baricitinib therapy in patients with rheumatoid arthritis with inadequate response to csDMARDs as a function of baseline characteristics
Authors: Kremer Joel M , Schiff Michael , Muram David , Zhong Jinglin , Alam Jahangir , Genovese Mark C 
Published: January 2018

ObjectiveWe analysed the effects of baseline characteristics on the safety and efficacy of baricitinib in patients with rheumatoid arthritis (RA) with inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) from two phase III trials.MethodsIn RA-BEAM (NCT01710358), patients with inadequate response to methotrexate were randomised to placebo, baricitinib 4 mg or adalimumab 40 mg. RA-BUILD (NCT01721057) patients had inadequate response to ≥1 csDMARDs and were randomised to either placebo or once-daily baricitinib (2 or 4 mg). Both study populations were naïve to biologic DMARDs (bDMARDs). Primary end point for both studies was American College of Rheumatology 20% improvement (ACR20) response at week 12. Pooled data from the two trials were analysed post hoc based on select subgroups defined by age, previous csDMARD use, baseline RA disease activity, etc, with assessment of clinical and safety outcomes at week 12 and radiographic outcomes at week 24 for the baricitinib 4 mg and placebo-treated patients.ResultsEfficacy was observed with baricitinib 4 mg treatment irrespective of patient demographics and baseline disease characteristics. ORs primarily favoured baricitinib over placebo in the ACR20 response. In other outcomes such as Disease Activity Score for 28 joints based on high-sensitivity C reactive protein levels, Simplified Disease Activity Index score ≤11 and radiographic progression, baricitinib 4 mg showed better responses than placebo regardless of baseline characteristics. Safety events were more common in patients over 65 years, but similar between baricitinib 4 mg and placebo patients.ConclusionBaseline characteristics did not substantially affect clinical response to baricitinib 4 mg in patients with RA with inadequate response to csDMARDs.
Prestroke selective serotonin reuptake inhibitor use and functional outcomes after ischaemic stroke
Authors: Etherton Mark R , Siddiqui Khawja A , Schwamm Lee H 
Published: January 2018

BackgroundSelective serotonin reuptake inhibitors (SSRIs) have been implicated in contributing to recovery after acute ischaemic stroke. In particular, poststroke initiation of an SSRI has been demonstrated to improve motor recovery. The role of prestroke SSRI use on functional outcomes and stroke recovery is less clear. We aimed to examine the effect of prestroke SSRI use on metrics of hospitalisation and functional recovery.MethodsWe included 4968 consecutive patients from January 2006 to June 2015 in our local Get With The Guidelines-Stroke registry in whom a preadmission drug list could be extracted from an administrative research data registry. Univariate and multivariate analyses were performed to identify predictors of functional outcomes.ResultsOn univariate analysis, among 4698 ischaemic strokes (740 SSRI users and 3948 non-users), SSRI use before acute ischaemic stroke did not impact the National Institutes of Health Stroke Scale (NIHSS) admission score, length of stay or rate of symptomatic haemorrhage. Patients using SSRIs prior to their stroke were more likely to present with weakness (57% vs 47.3%; P<0.001) and have hospitalisations complicated by pneumonia (7.6% vs 5.7%; P<0.001). Moreover, prestroke SSRI use was associated with a negative impact on ambulatory status at discharge and discharge to home. On multivariate regression analysis, SSRI use was associated with lower likelihood of discharge to home (adjusted OR 0.79, 95% CI 0.62 to 0.997, P<0.05).ConclusionsSSRI use preceding an acute ischaemic stroke is associated with lower rates of discharge to home despite no significant increase in length of stay or NIHSS score.
Can necrotizing soft tissue infection be reliably diagnosed in the emergency department?
Authors: Henry Sharon M , Davis Kimberly A , Morrison Jonathan J , Scalea Thomas M 
Published: January 2018

Necrotizing soft tissue infections (NSTIs) are associated with a high mortality and require prompt recognition and treatment, consisting of aggressive surgical debridement and critical care support. Diagnosis is a key step, which is generally made in the operating room (OR), but the decision to debride requires guidance. This is frequently made on clinical grounds, but NSTI can be occult in presentation and several other infective processes can mimic NSTI. It is unknown whether the various scoring systems described in the literature can enable clinicians to reliably diagnose NSTI in the emergency department, rather than the OR. The topic was debated at the 36thAnnual Point/Counterpoint Acute Care Surgery Conference and the following article summarizes the discussants points of view along with a summary of the evidence.Level of evidenceLevel III.
Adenosine Production by Biomaterial‐Supported Mesenchymal Stromal Cells Reduces the Innate Inflammatory Response in Myocardial Ischemia/Reperfusion Injury
Authors: Shin Eric Y. , Wang Lanfang , Zemskova Marina , Deppen Juline , Xu Kai , Strobel Frederick , García Andrés J. , Tirouvanziam Rabindra , Levit Rebecca D. 
Published: January 2018

Background

During myocardial ischemia/reperfusion (
MI
/R) injury, there is extensive release of immunogenic metabolites that activate cells of the innate immune system. These include
ATP
and
AMP
, which upregulate chemotaxis, migration, and effector function of early infiltrating inflammatory cells. These cells subsequently drive further tissue devitalization. Mesenchymal stromal cells (
MSC
s) are a potential treatment modality for
MI
/R because of their powerful anti‐inflammatory capabilities; however, the manner in which they regulate the acute inflammatory milieu requires further elucidation.
CD
73, an ecto‐5′‐nucleotidase, may be critical in regulating inflammation by converting pro‐inflammatory
AMP
to anti‐inflammatory adenosine. We hypothesized that
MSC
‐mediated conversion of
AMP
into adenosine reduces inflammation in early
MI
/R, favoring a micro‐environment that attenuates excessive innate immune cell activation and facilitates earlier cardiac recovery.

Methods and Results

Adult rats were subjected to 30 minutes of
MI
/R injury.
MSC
s were encapsulated within a hydrogel vehicle and implanted onto the myocardium. A subset of
MSC
s were pretreated with the
CD
73 inhibitor, α,β‐methylene adenosine diphosphate, before implantation. Using liquid chromatography/mass spectrometry, we found that
MSC
s increase myocardial adenosine availability following injury via
CD
73 activity.
MSC
s also reduce innate immune cell infiltration as measured by flow cytometry, and hydrogen peroxide formation as measured by Amplex Red assay. These effects were dependent on
MSC
‐mediated
CD
73 activity. Finally, through echocardiography we found that
CD
73 activity on
MSC
s was critical to optimal protection of cardiac function following
MI
/R injury.

Conclusions

MSC
‐mediated conversion of
AMP
to adenosine by
CD
73 exerts a powerful anti‐inflammatory effect critical for cardiac recovery following
MI
/R injury.
Probenecid Improves Cardiac Function in Patients With Heart Failure With Reduced Ejection Fraction In Vivo and Cardiomyocyte Calcium Sensitivity In Vitro
Authors: Robbins Nathan , Gilbert Mark , Kumar Mohit , McNamara James W. , Daly Patrick , Koch Sheryl E. , Conway Ginger , Effat Mohamed , Woo Jessica G. , Sadayappan Sakthivel , Rubinstein Jack 
Published: January 2018

Background
Transient receptor potential vanilloid 2 is a calcium channel activated by probenecid. Probenecid is a Food and Drug Administration–approved uricosuric drug that has recently been shown to induce positive lusitropic and inotropic effects in animal models through cardiomyocyte transient receptor potential vanilloid 2 activation. The aim of this study was to test the hypothesis that oral probenecid can improve cardiac function and symptomatology in patients with heart failure with reduced ejection fraction and to further elucidate its calcium‐dependent effects on myocyte contractility.

Methods and Results

The clinical trial recruited stable outpatients with heart failure with reduced ejection fraction randomized in a single‐center, double‐blind, crossover design. Clinical data were collected including a dyspnea assessment, physical examination, ECG, echocardiogram to assess systolic and diastolic function, a 6‐minute walk test, and laboratory studies. In vitro force generation studies were performed on cardiomyocytes isolated from murine tissue exposed to probenecid or control treatments. The clinical trial recruited 20 subjects (mean age 57 years, mean baseline fractional shortening of 13.6±1.0%). Probenecid therapy increased fractional shortening by 2.1±1.0% compared with placebo −1.7±1.0% (
P
=0.007). Additionally, probenecid improved diastolic function compared with placebo by decreasing the E/E′ by −2.95±1.21 versus 1.32±1.21 in comparison to placebo (
P
=0.03). In vitro probenecid increased myofilament force generation (92.36 versus 80.82 mN/mm
2
,
P
<0.05) and calcium sensitivity (pCa 5.67 versus 5.60,
P
<0.01) compared with control.

Conclusions
Probenecid improves cardiac function with minimal effects on symptomatology and no significant adverse effects after 1 week in patients with heart failure with reduced ejection fraction and increases force development and calcium sensitivity at the cardiomyocyte level.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
01814319.
Mitral Valve Anatomic Predictors of Hemodynamic Success With Transcatheter Mitral Valve Repair
Authors: Thaden Jeremy J. , Malouf Joseph F. , Nkomo Vuyisile T. , Pislaru Sorin V. , Holmes David R. , Reeder Guy S. , Rihal Charanjit S. , Eleid Mackram F. 
Published: January 2018

Background
Mitral regurgitation is a heterogeneous disease. Determining which patients derive optimal outcomes from transcatheter edge‐to‐edge mitral valve repair (TMVR) remains challenging. We sought to determine whether baseline mitral valve anatomic characteristics are predictive of left atrial pressure (LAP) changes during TMVR with MitraClip.

Methods and Results

Consecutive patients with severe mitral regurgitation undergoing TMVR (n=112) underwent continuous intraprocedural LAP monitoring and retrospective echocardiographic analysis for specific mitral anatomic characteristics. Procedural success (optimal LAP reduction) was defined as ≥40% reduction in left atrial V‐wave pressure compared with baseline. Echocardiographic predictors of optimal LAP reduction and increased postprocedure mean diastolic gradient were evaluated. Mean age was 79±14 years, and 36 patients (32%) were women. Primary, mixed, and secondary mitral regurgitation were present in 78 patients (70%), 22 patients (20%), and 12 patients (10%), respectively. Baseline mean LAP and V‐wave were 22±6 and 38±13 mm Hg; after TMVR, these decreased to 19±5 and 27±10 mm Hg, respectively (
P
<0.0001 for both). Independent predictors of optimal LAP reduction were the presence of a flail scallop, mitral regurgitation localized to a single scallop, and high‐quality 3‐dimensional echocardiographic imaging. Independent predictors of elevated postprocedure mean diastolic gradient were elevated preprocedure mean diastolic gradient, mitral annular calcification, and implantation of multiple clips.

Conclusions
Mitral valve pathoanatomic features, including a flail leaflet and single jet, are predictive of optimal LAP reduction with TMVR. High‐quality 3‐dimensional imaging may help select patients with the highest likelihood of optimal hemodynamic results with TMVR. These data expand current knowledge about patient selection for TMVR and deserve further study in larger cohorts.
Pregnancy Loss and Carotid Intima–Media Thickness in Mexican Women
Authors: Hartasanchez Sandra A. , Flores‐Torres Mario , Monge Adriana , Yunes Elsa , Rodriguez Beatriz , Cantu‐Brito Carlos , Colaci Daniela , Lamadrid‐Figueroa Hector , Lopez‐Ridaura Ruy , Lajous Martin 
Published: January 2018

Background
Cardiovascular disease in women often develops without conventional risk factors. Prenatal loss is a common pregnancy outcome that may result in physiological changes can increase the potential future risk of cardiovascular disease. Insufficient information exists regarding the impact of pregnancy loss on early markers of cardiovascular disease risk.

Methods and Results
Cross‐sectional analysis of 1767 disease‐free women from the MTC (Mexican Teachers' Cohort) who had been pregnant was used to evaluate the relationship between pregnancy loss and carotid intima–media thickness (IMT). Participants responded to a questionnaire regarding their reproductive history, risk factors, and medical conditions. We defined pregnancy loss as history of miscarriage and/or stillbirth. Trained neurologists measured IMT using ultrasound. We log‐transformed IMT and defined subclinical carotid atherosclerosis (SCA) as IMT ≥0.8 mm and/or plaque. We used multivariable linear and logistic regression models to assess the relation of pregnancy loss, IMT, and SCA. The mean age of participants was 49.8±5.1 years. The prevalence of pregnancy loss was 22%, and we observed SCA in 23% of participants. Comparing participants who reported a pregnancy loss and those who did not, the multivariable‐adjusted odds ratio for SCA was 1.52 (95% confidence interval, 1.12–2.06). Women who experienced a stillbirth had 2.32 higher odds (95% confidence interval, 1.03–5.21) of SCA than those who did not. Mean IMT appeared to be higher in women who reported a pregnancy loss relative to those who did not; nevertheless, this was not statistically significant.

Conclusions
Pregnancy loss could be linked to cardiovascular disease later in life. The key findings of our study await confirmation and further investigation of the potential underlying mechanisms for this association is required.
Mental health history—a contributing factor for poorer outcomes in burn survivors
Authors: Li Frank , Coombs Danielle 
Published: January 2018

Abstract

Background
A pre-morbid mental health history is common in patients with severe burn injuries. This creates challenges in providing rehabilitation. The aim of this study is to cross examine the possible impact of psychological co-morbidities on outcomes.

Methods
A notes audit was carried out examining patients that were admitted to Concord Hospital Burns Unit in a 3-year period (2010–2012). Patients with total body surface area (TBSA) of 20% or greater and aged between 16 and 50 years were included. Subjects were divided into a mental health group and a control group. SPSS version 21 statistic program was used for analysis the data.

Results
Data collected included length of stay, time to achieve independence, %TBSA, types of burns and surgery required. Results of 69 files showed that the average length of stay per %TBSA was nearly double in the patients with a mental health problem (1.47 vs 0.88). They also had a higher rate of re-graft (52% vs 22%) due to infection and poor nutrition. The average time for patients to achieve independence in daily living activity was significantly higher (p = 0.046) in the mental health group (36.2 days) versus the control group (24.1 days).

Conclusion
Patients with a mental health history may have poorer general health. This may result in a higher failure rate of grafting, leading to a requirement of re-graft. Hence, it took a longer time to achieve independence, as well as a longer hospital stay. A mental health history in burn survivors can be a contributing factor for poorer outcomes in the adult population.
Average Intermolecular Distances and Dynamics of Ruthenium-Containing Organometallic Ionic Liquids Studied by Nuclear Overhauser Effects between 19F and 1H Nuclei and NMR Relaxation Rate Measurements
Authors: Tei Chikai , Kuwahara Daisuke , Higashi Tomomi , Mochida Tomoyuki 
Published: January 2018

Abstract
The physical properties of organometallic ionic liquids containing cationic ruthenium sandwich complexes {[Ru(C5H5)(C6H5R)]X; R = OCH(C4H9)2, OCH(C2H5)(C6H13); X = N(SO2CF3)2, N(SO2F)2} are dependent on the substituents. To obtain detailed information about the motional states and configurations of the constituent ions of these ionic liquids, we performed one-dimensional (1D) heteronuclear Overhauser enhancement spectroscopy (HOESY) NMR experiments and the standard relaxation rate (1/T1 and 1/T2) measurements. We determined the intermolecular cross-relaxation rates between some cation blocks and the anion in each ionic liquid by analyzing the experimental data based on the extended Solomon differential equations. As a result, we were able to estimate several intermolecular distances between the cations and anions in the ionic liquids. This is the first time that NMR has been applied to the determination of the intermolecular cross-relaxation rates and the estimation of intermolecular distances of highly viscous ionic liquids consisting of heteronuclear multiple-spin systems without the support of any X-ray data. The viscosities of these ionic liquids depended largely on the motional correlation times of the cations rather than on the intermolecular distances between the cations and anions.
Moderately Flexible Trans-Chelating Diphosphine Ligands Consisting of a Triazine Unit Showing High Ligand Acceleration Effect for Heck Reaction
Authors: Korenaga Toshinobu , Kowata Ryo , Kotaki Tomohiro , Shibasaki Yuji , Oishi Yoshiyuki , Shimada Kazuaki 
Published: January 2018

Abstract
Originally designed trans-chelating diphosphine ligands with moderate flexibility that allows trans- to cis-isomerization and bidentate to monodentate complex form were developed. The novel ligand shows high ligand acceleration effect (LAE) for Heck reaction. The catalyst loading was decreased to 0.0001 mol%, and the turnover number (TON) reached 970,000. The catalytic cycle was evaluated by DFT calculations. The calculations revealed the following: 1) the insertion step in monodentate pathway was the rate-determining step, 2) the high LAE effect of the novel ligand was due to a facile change of conformation from trans to cis form and flexibility to avoid steric repulsion between substrate and catalyst in the insertion step as well.
The Synthesis of a Novel Bulky Primary Alkyl Group and Its Application toward the Kinetic Stabilization of a Tetraalkyldisilene
Authors: Yukimoto Mariko , Minoura Mao 
Published: January 2018

Abstract
A novel, peripherally extended sterically demanding primary alkyl group based on the triptycene (Trp) framework, Trp*CH2, was designed and synthesized via a convenient one-pot reaction using the Friedel-Crafts alkylation of the corresponding TrpCH2 precursor. The introduction of the Trp*CH2 groups onto a Si=Si double bond allowed isolating the first stable tetraalkyldisilene that contains primary alkyl groups.
Mortalitas dan Morbiditas pada Bayi Prematur dengan Resusitasi Menggunakan Oksigen Konsentrasi Rendah
Authors: Munadzilah Syarimonitha , Dewi Rosalina 
Published: January 2018

Latar belakang. Bayi prematur merupakan kelompok yang berisiko membutuhkan bantuan resusitasi aktif. Selama bertahun-tahun, resusitasi neonatus menggunakan oksigen hingga konsentrasi 100% namun penggunaan oksigen 100% akan menyebabkan stress oksidatif dan kerusakan jaringan yang akan meningkatkan morbiditas dan mortalitas. Akhir-akhir ini penggunaan oksigen konsentrasi rendah (21% - 30% ) mulai dianjurkan.Tujuan. Mengetahui mortalitas dan morbiditas bayi prematur yang mendapatkan resusitasi neonatus dengan oksigen konsentrasi rendah dibandingkan konsentrasi tinggi.Metode. Penelusuran pustaka database elektronik: PubMed, Cochrane, Google scholar dan melalui penulis.Hasil. Didapatkan dua studi meta analisis yang relevan dan 1 studi acak terkontrol. Studi pertama menunjukkan tidak ada perbedaan mortalitas dan morbiditas pada kedua kelompok. Studi kedua menunjukkan tidak ada perbedaan mortalitas antara kedua kelompk, namun kejadian displasia bronkopulmonar lebih rendah pada kelompok konsentrasi oksigen rendah (RR 0,62). Studi terakhir menunjukkan bahwa resusitasi neonatus dengan oksigen hingga konsentrasi 50% masih aman digunakan.Kesimpulan. Resusitasi neonatus menggunakan oksigen konsentrasi rendah tidak lebih inferior dibandingkan konsnetrasi tinggi, bahkan menurunkan angka kejadian displasia bronkopulmonar.
Consumer Heterogeneity and Surplus under Two-Part Pricing
Authors: Kolay Sreya , Tyagi Rajeev K. 
Published: January 2018

Abstract
For many products, consumers need to sign a pricing contract with the seller under uncertainty about their future consumption needs. Recent empirical literature has consistently pointed out that consumers may not be good forecasters of their future consumption needs, and may suffer from overestimation or underestimation biases. This paper considers consumers who are heterogeneous in their expected demands arising from heterogeneity in their biases about their forecasted consumption needs. We show that the optimal menu of two-part pricing in this case leads to the lower-expected demand segment getting exactly the same surplus on the average as the higher-expected demand segment, or the higher-expected demand segment getting even lower surplus on the average than the lower-expected demand segment. We show directions of externalities these unbiased, positively-biased, and negatively-biased segments impose on one another, and how they can be different under no price discrimination, and second- and third-degree price discrimination.
The Choice of Prices versus Quantities under Outsourcing
Authors: Chang Ray-Yun , Hu Jin-Li , Lin Yan-Shu 
Published: January 2018

Abstract
This paper establishes a duopoly model with product differentiation and outsourcing in order to analyze the equilibrium competition strategies (choice of prices versus quantities) when the outsourcer outsources its intermediate good to a final product competitor. We show that: (1) both firms choose the quantity strategy when the cost efficiency of the subcontractor is low; (2) the choice of competition strategy is the price strategy for the subcontractor and the quantity strategy for the outsourcer when the cost efficiency of the subcontractor is moderate; (3) both firms choose the price strategy when the cost efficiency of the subcontractor is sufficiently high.
The prognostic value of serum PCT, hs-CRP, and IL-6 in patients with sepsis
Authors: Suhua Zou , Lefeng Zhang , Qingli Chen , Yueying Wu 
Published: January 2018

AbstractObjectiveTo evaluate the prognostic value of serum procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) in patients with sepsis.MethodsSixty-six patients with sepsis were recruited in the 6th affiliated hospital of Wenzhou Medical University from February 2012 to April 2016. According to status of death or survival within 4 weeks, the patients were divided into death group (n=14) and survival group (n=52). The serum PCT concentration on the day of hospitalization was measured by double antibody immunosorbent assay, hs-CRP serum level was measured by immunoturbidimetric assay, and IL-6 serum concentration was tested by enzyme-linked immunosorbent assay (ELISA) of the included 66 patients. Serum PCT, hs-CRP, and IL-6 were compared between the two groups. The prognostic performance of serum PCT, hs-CRP, and IL-6 in patients with sepsis was evaluated through sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (AUC).ResultsThe serum concentrations of PCT, hs-CRP, and IL-6 in the death group were significantly higher than those of the survival group on the day of hospitalization (P<0.05). The sensitivities of serum PCT, hs-CRP, and IL-6 to predict the mortality of septic patients within 4 weeks were 94.64%, 83.93%, and 82.14%, and the specificities were 73.33%, 64.29%, and 71.43%, respectively. The areas under the ROC curves were 0.88, 0.76, and 0.77.ConclusionThe serum levels of PCT, hs-CRP and IL-6 were significantly elevated in the death group, which could be used as serological markers to predict the risk of death for sepsis patients within 4 weeks.