bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-Effectiveness of Thrombectomy in Patients With Acute Ischemic Stroke
Authors: Achit Hamza , Soudant Marc , Hosseini Kossar , Bannay Aurélie , Epstein Jonathan , Bracard Serge , Guillemin Francis 
Published: September 2017

Background and Purpose—
The benefit of mechanical thrombectomy added to intravenous thrombolysis (IVT) in patients with acute ischemic stroke has been largely demonstrated. However, evidence of the economic incentive of this strategy is still limited, especially in the context of a randomized controlled trial. We aimed to analyze whether mechanical thrombectomy combined with IVT (IVMT) is cost-effective when compared with IVT alone.

Methods—
Individual-level cost and outcome data were collected in the THRACE randomized controlled trial (Thrombectomie des Artères Cerébrales) including patients with acute ischemic stroke. Patients were assigned to receive IVT or IVMT. The primary outcomes were modified Rankin Scale score of functional independence at 90 days (score 0–2) and the EuroQol-5D quality-of-life score at 1 year.

Results—

Treating acute ischemic stroke with IVMT (n=200) versus IVT (n=202) increased the rate of functional independence by 10.9% (53.0% versus 42.1%;
P
=0.028), at an increased cost of $2116 (€1909), with no significant difference in mortality (12% versus 13%;
P
=0.70) or symptomatic intracranial hemorrhage (2% versus 2%;
P
=0.71). The cost per one averted case of disability was estimated at $19 379 (€17 480). The incremental cost per one quality-adjusted life year gained was $14 881 (€13 423). On sensitivity analysis, the probability of cost-effectiveness with IVMT was 84.1% in terms of cases of averted disability and 92.2% in terms of quality-adjusted life years.

Conclusions—
Based on randomized trial data, this study demonstrates that IVMT used to treat acute ischemic stroke is cost-effective when compared with IVT alone.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01062698.
Regional Evaluation of the Severity-Based Stroke Triage Algorithm for Emergency Medical Services Using Discrete Event Simulation
Authors: Bogle Brittany M. , Asimos Andrew W. , Rosamond Wayne D. 
Published: September 2017

Background and Purpose—
The Severity-Based Stroke Triage Algorithm for Emergency Medical Services endorses routing patients with suspected large vessel occlusion acute ischemic strokes directly to endovascular stroke centers (ESCs). We sought to evaluate different specifications of this algorithm within a region.

Methods—
We developed a discrete event simulation environment to model patients with suspected stroke transported according to algorithm specifications, which varied by stroke severity screen and permissible additional transport time for routing patients to ESCs. We simulated King County, Washington, and Mecklenburg County, North Carolina, distributing patients geographically into census tracts. Transport time to the nearest hospital and ESC was estimated using traffic-based travel times. We assessed undertriage, overtriage, transport time, and the number-needed-to-route, defined as the number of patients enduring additional transport to route one large vessel occlusion patient to an ESC.

Results—
Undertriage was higher and overtriage was lower in King County compared with Mecklenburg County for each specification. Overtriage variation was primarily driven by screen (eg, 13%–55% in Mecklenburg County and 10%–40% in King County). Transportation time specifications beyond 20 minutes increased overtriage and decreased undertriage in King County but not Mecklenburg County. A low- versus high-specificity screen routed 3.7× more patients to ESCs. Emergency medical services spent nearly twice the time routing patients to ESCs in King County compared with Mecklenburg County.

Conclusions—
Our results demonstrate how discrete event simulation can facilitate informed decision making to optimize emergency medical services stroke severity-based triage algorithms. This is the first step toward developing a mature simulation to predict patient outcomes.
Effects of Statin Intensity and Adherence on the Long-Term Prognosis After Acute Ischemic Stroke
Authors: Kim Jinkwon , Lee Hye Sun , Nam Chung Mo , Heo Ji Hoe 
Published: September 2017

Background and Purpose—
Statin is an established treatment for secondary prevention after ischemic stroke. However, the effects of statin intensity and adherence on the long-term prognosis after acute stroke are not well known.

Methods—
This retrospective cohort study using a nationwide health insurance claim data in South Korea included patients admitted with acute ischemic stroke between 2002 and 2012. Statin adherence and intensity were determined from the prescription data for a period of 1 year after the index stroke. The primary outcome was a composite of recurrent stroke, myocardial infarction, and all-cause mortality. We performed multivariate Cox proportional regression analyses.

Results—
We included 8001 patients with acute ischemic stroke. During the mean follow-up period of 4.69±2.72 years, 2284 patients developed a primary outcome. Compared with patients with no statin, adjusted hazard ratios (95% confidence interval) were 0.74 (0.64–0.84) for good adherence, 0.93 (0.79–1.09) for intermediate adherence, and 1.07 (0.95–1.20) for poor adherence to statin. Among the 1712 patients with good adherence, risk of adverse events was lower in patients with high-intensity statin (adjusted hazard ratio [95% confidence interval], 0.48 [0.24–0.96]) compared with those with low-intensity statin. Neither good adherence nor high intensity of statin was associated with an increased risk of hemorrhagic stroke.

Conclusions—
After acute ischemic stroke, high-intensity statin therapy with good adherence was significantly associated with a lower risk of adverse events.
Anti-IgE and Anti-IL5 Biologic Therapy in the Treatment of Nasal Polyposis: A Systematic Review and Meta-analysis
Authors: Rivero Alexander , Liang Jonathan 
Published: September 2017

Objective:To determine the role of biologic therapy on sinonasal symptoms and objective outcomes in chronic rhinosinusitis with nasal polyposis (CRSwNP).Methods:PubMed, OVID MEDLINE, and Cochrane Central were reviewed from 2000 to 2015. Inclusion criteria included English-language studies containing original data on biologic therapy in CRSwNP patients with reported outcome measures. Two investigators independently reviewed all manuscripts and performed quality assessment and quantitative meta-analysis using validated tools.Results:Of 495 abstracts identified, 7 studies fulfilled eligibility: 4 randomized control trials (RCT), 1 case-control, and 2 case series. Outcome measures included nasal polyp score (NPS,6), computer tomography score (5), and symptom scores (5). Meta-analysis was performed on 5 studies: Anti-IL5 therapy (mepolizumab/reslizumab) and anti-IgE therapy (omalizumab) demonstrated a standard mean difference of NPS improvement of −0.66 (95% CI, −1.24 to −0.08) and −0.75 (95% CI, −1.93 to 0.44), respectively, between biologic therapy and placebo. Quality assessment indicated a low to moderate risk of bias for the RCTs.Conclusion:Biologic therapies may prove beneficial in the treatment of recalcitrant nasal polyposis in select populations. In meta-analysis, anti-IL5 therapy demonstrates a reduction in nasal polyp score. Anti-IgE therapy reduces nasal polyp score in patients with severe comorbid asthma. Additional high-level evidence is needed to assess clinical efficacy.
Comparable Postoperative Pain Levels Using 2 Different Nerve Blocks in the Operative Treatment of Displaced Intra-articular Calcaneal Fractures
Authors: Dingemans Siem A. , de Ruiter Kristian J. , Birnie Merel F. N. , Goslings J. Carel , van Samkar Gan , Schepers Tim 
Published: September 2017

Background: The aim of this study was to compare the postoperative pain levels in patients undergoing osteosynthesis of the calcaneus with either a popliteal nerve block or an ankle block. Methods: A retrospective analysis of all consecutive patients undergoing operative fixation of a calcaneal fracture via a sinus tarsi approach between August 2012 and April 2017 in a single foot/ankle specialized center was performed. Single-shot popliteal blocks were placed using ultrasound guidance by an anesthesiologist while ankle blocks were placed by a foot/ankle specialized surgeon. Pain levels were measured through the numerical rating scale (NRS). In total, 83 patients were included in this study; 33 received a popliteal block, and 50 received an ankle block. No statistically significant differences were present in baseline characteristics between the 2 groups. Results: Comparable postoperative pain levels were observed in both groups. There was no statistically significant difference in amount of morphine used between the 2 groups. Conclusion: No differences were found in postoperative pain levels between patients receiving a single-shot popliteal block and patients who received a single-shot ankle block following calcaneal fracture surgery. Level of Evidence: III, comparative series.
Marriage markets as explanation for why heavier people work more hours
Authors: Grossbard Shoshana , Mukhopadhyay Sankar 
Published: September 2017

Abstract
Is BMI related to hours of work through marriage market mechanisms? We empirically explore this issue using data from the NLSY79 and NLSY97 and a number of estimation strategies (including OLS, IV, and sibling FE). Our IV estimates (with same-sex sibling’s BMI as an instrument and a large set of controls including wage) suggest that a one-unit increase in BMI leads to an almost 2% increase in White married women’s hours of work. However, BMI is not associated with hours of work of married men. We also find that a one-unit increase in BMI leads to a 1.4% increase in White single women’s hours of work, suggesting that single women may expect future in-marriage transfers that vary by body weight. We show that the positive association between BMI and hours of work of White single women increases with self-assessed probability of future marriage and varies with expected cumulative spousal income. Comparisons between the association between BMI and hours of work for White and Black married women suggest a possible racial gap in intra-marriage transfers from husbands to wives.
Insights from the draft genome into the pathogenicity of a clinical isolate of Elizabethkingia meningoseptica Em3
Authors: Chen Shicheng , Soehnlen Marty , Downes Frances P. , Walker Edward D. 
Published: September 2017

AbstractElizabethkingia meningoseptica is an emerging, healthcare-associated pathogen causing a high mortality rate in immunocompromised patients. We report the draft genome sequence of E. meningoseptica Em3, isolated from sputum from a patient with multiple underlying diseases. The genome has a length of 4,037,922 bp, a GC-content 36.4%, and 3673 predicted protein-coding sequences. Average nucleotide identity analysis (>95%) assigned the bacterium to the species E. meningoseptica. Genome analysis showed presence of the curli formation and assembly operon and a gene encoding hemagglutinins, indicating ability to form biofilm. In vitro biofilm assays demonstrated that E. meningoseptica Em3 formed more biofilm than E. anophelis Ag1 and E. miricola Emi3, both lacking the curli operon. A gene encoding thiol-activated cholesterol-dependent cytolysin in E. meningoseptica Em3 (potentially involved in lysing host immune cells) was also absent in E. anophelis Ag1 and E. miricola Emi3. Strain Em3 showed α-hemolysin activity on blood agar medium, congruent with presence of hemolysin and cytolysin genes. Furthermore, presence of heme uptake and utilization genes demonstrated adaptations for bloodstream infections. Strain Em3 contained 12 genes conferring resistance to β-lactams, including β-lactamases class A, class B, and metallo-β-lactamases. Results of comparative genomic analysis here provide insights into the evolution of E. meningoseptica Em3 as a pathogen.
Reversing thyroid-hormone-mediated repression of a HSV-1 promoter via computationally guided mutagenesis
Authors: Figliozzi Robert W. , Chen Feng , Hsia Shaochung V. 
Published: September 2017

ABSTRACT
Thyroid hormones (THs) and their DNA-binding nuclear receptors (TRs) direct transcriptional regulation in diverse ways depending on the host cell environment and specific promoter characteristics of TH-sensitive genes. This study sought to elucidate the impact on transcriptional repression of nucleotide sequence or orientation within TR binding sites – the TH response elements (TREs) of TH-sensitive promoters – to better understand ligand-dependent transcriptional repression of wild-type promoters. Computational analysis of the HSV-1 thymidine kinase (TK) gene TRE bound by TR and retinoid X receptor (RXR) revealed a single TRE point mutation sufficient to reverse the TRE orientation. In vitro experiments showed that the TRE point mutation had distinct impacts on promoter activity, sufficient to reverse the TH-dependent negative regulation in neuroendocrine differentiated cells. This point mutation altered the promoter's regulatory mechanism by discrete changes in transcription factor TR occupancy and altered enrichment of the repressive chromatin modification of histone-3-lysine-9-trimethyl (H3K9Me3). Insights relating to this negative TRE (nTRE) mechanism aids our understanding of other nTREs and TRE mutations associated with TH and herpes diseases.
The metabolic syndrome as a risk factor for colorectal cancer
Authors: Nikitenko Tatiana M. , Shcherbakova Lilia V. , Malyutina Sofia K. , Mustafina Svetlana V. , Verevkin Eugene G. , Ragino Yuliya I. , Voytsitsky Vladimir E. , Pyatibratova Anna V. , Rymar Oksana D. 
Published: September 2017

Objective. To evaluate the prognostic significance of metabolic syndrome (MS) in the development of colorectal cancer (CRC) using various MS criteria in Novosibirsk population.
Materials and Methods. The study was designed as nested case-control. Baseline population cohort (9360 men, women aged 4569) was examined in the HAPIEE project and followed-up during 11 years. The cases included all subjects, who had CRC during 11-year follow-up according to the Register of Cancer (n=99, M-52, M-47). The matched control group (2/1) was selected from HAPIEE cohort (n=198, m-104, w-94). The prospective study of CRC was supported by RSF. MS criteria were determined in accordance to VNOK (2009), IDF (2005), NCEP ATP III (2001). Statistical package SPSS v.11.0 was used. Logistic regression was used to estimate the association between MS and risk of CRC.
Results. Women with glucose levels 6.1 mmol/l had 3 times higher 11-year risk of CRC then those with glucose 6.1 mmol/l (OR=3.11;
95%CI:1.237.87, VNOK, 2009; OR=3.20; 95%CI:1.278.08, NCEP ATP III, 2001). Blood pressure (BP) 130/85 mmHg was associated with decreased risk of CRC in women and in both sexes, but the relationship became insignificant after controlling for antihypertensive treatment. Other components of the MS were not significantly associated with CRC risk.
Conclusions. In studied sample the 11-year risk of developing CRC was significantly increased in women with elevated glucose levels. The negative relationship between elevated BP and the risk of CRC in women and both sexes became insignificant when adjusted for antihypertensive treatment; this finding requires further exploration.
Association of obesity susceptibility gene variants with metabolic syndrome in women
Authors: Kochetova Olga V. , Akhmadishina Leysan Z. , Korytina Gulnaz F. , Karpov Artyom A. , Mustafina Olga E. 
Published: September 2017

Aim. The aim of the study was a replicative analysis of the association of polymorphic variants of genes associated with obesity revealed by results of wide-genomic studies (GWAS) with the development of a cluster of metabolic syndrome risk parameters in women of Bashkir and Tatar ethnicity. The polymorphic markers of the following genes were analyzed: SEC16B, FADS1, KCTD15, MAF, MAP2K5, NEGR1, BDNF, TMEM18.
Materials and methods. The study involved 243 women with metabolic syndrome and 298 women without the metabolic syndrome. Amplification of DNA fragments was performed using real-time PCR and TaqMan technique.
Results. We found the association the metabolic syndrome with genetic markers of genes MAF and TMEM18 from Tatar. Protective informative marker of the metabolic syndrome among Tatar and Bashkir was the TT haplotype TMEM18 gene (rs2860323 and rs6548238) (р=0.005 and р=0.001, respectively). We identified the association marker rs2241423 MAP2K5 gene with the level of waist circumference (p=0.003) and with the level of cholesterol (p=0.014), the marker rs11084753 KCTD15 gene with glucose levels after exercise (p=0.002), the level of triglycerides (p=0.003) and HDL (p=0.0008) among Tatar women. We identified the association rs2241423 MAP2K5 gene marker to glycated hemoglobin level (p=0.002) and a marker gene rs174550 FADS1 with triglyceride levels (p=0.02) among Bashkir women.
Conclusion. It can be assumed that the polymorphic variants FADS1, KCTD15, MAF, MAP2K5, TMEM18 genes are an important part of the genetic structure of predisposition to metabolic syndrome and/or to a cluster of clinical and biochemical indicators of the risk of metabolic syndrome.
Nutritional profile of the morbidly obese patients attending a bariatric clinic in a South Indian tertiary care centre
Authors: Joseph Mini , Kapoor Nitin , Ramasamy Shobana , Jiwanmall Stephen Amarjeet , Kattula Dheeraj , Abraham Vijay , Samarasam Inian , Paul Thomas , Thomas Nihal 
Published: September 2017

Background: Obesity is sweeping across continents and is a major public health concern of the modern society.
Aims: The main objective of this study was to study the demographic, anthropometric and dietary patterns of the morbidly obese and study region wise variation in their nutrient intake.
Materials and Methods: The study was conducted on 101 morbidly obese individuals from different regions of India who attended the Bariatric clinic of a tertiary care hospital in India. Their socio-demographic details, anthropometric measurements were collected. The dietary assessment was done using a 24 hour dietary recall and a food frequency questionnaire. The study was approved by the Institutional review board and informed consent was obtained from them.
Results: More than 3/4th of the patients were females and 61 per cent had Type 2 diabetes mellitus. The mean age of the male and female population was 41.3 + 15.5 years and 36.7 + 11.9 years respectively. Their mean BMI was 41kg/m2. The mean daily intake of calories was more than 2200kcal/day with a gross deficit in the intake of micronutrients. Bonferroni Test showed that there was region wise variation in dietary intake, South Indian female population had the lowest intake of the micronutrients and those from East India had the highest intake. In the male population, there was a significant regional difference in intake of Proteins (p=0.039) and Energy (p=0.024). Independent Sample T test showed that South Indian had the highest intake of Energy and proteins. Anthropometric measures showed positive relation with various macronutrient intakes.
Conclusion: The obese patients require intense counselling by a dedicated team of an endocrinologist, psychiatrist, dietician, bariatric surgeon and a social worker to make achievable changes in the quality of life of the morbidly obese patients. Regional influences must be considered when counselling the patient.
The Myth of Cronus in Plato’sStatesman: Cosmic Rotation and Earthly Correspondence
Authors: Gartner Corinne , Yau Claudia 
Published: September 2017

AbstractThe cosmological myth in Plato’sStatesmanhas generated several longstanding scholarly disputes, among them a controversy concerning the number and nature of the cosmic rotation cycles that it depicts. According to the standard interpretation, there are two cycles of rotation: west-to-east rotation occurs during the age of Cronus, and east-to-west rotation occurs during the age of Zeus, which is also our present era. Recent readings have challenged this two-cycle interpretation, arguing that the period of rotation opposed to our own is governed neither by Cronus nor by Zeus, but is instead a separate rotational cycle during which chaos reigns before a divine ruler reestablishes control. We introduce a new constraint on any plausible interpretation of the myth. According to theCorrespondence Principle, changes in fundamental cyclical processes that shape the way of life on earth (mode of generation, growth, aging, and mode of death) occur if and only if there is a change in the direction of cosmic rotation. We use theCorrespondence Principleto defend a version of the standard two-cycle interpretation.
Role of the gut-brain axis in the eating behavior of children with autism spectrum disorders
Authors: Siwek Justyna , Kawala-Janik Aleksandra , Walecki Piotr 
Published: September 2017

Abstract

Introduction:
The occurrence of autism spectrum disorders (ASD) has significantly increased in the last few years. One of the common problems in this group are eating disorders and ailments from the gastrointestinal systems. According to some studies, these problems have a significant impact on the occurrence and severity of symptoms in the neurological system, so it is crucial to increase the attention paid on the role of diet in the treatment of this disease. One of the theories connects ASD with disorders of the digestive system and the intestinal bacterial flora. This theory is based on the gut-brain axis, which means the interaction between the gastrointestinal and nervous systems.

Objectives:
To demonstrate the differences in behavior habits, interest in nutrition, and frequency of consumption of food products between children suffering from ASD and healthy children.

Materials and methods:
The study was conducted among 44 children suffering from ASD and 33 healthy children as a control group. Data were collected using a questionnaire that was specially designed for this study. The questionnaire contained questions about eating habits and the frequency of consumption of selected food products.

Results:
Parents of healthy children showed more interest in their children’s way of feeding and nutritional recommendations compared to parents of children with ASD (4% and 11.3%, respectively). In addition, 24.3% more children with ASD consulted with a nutritionist compared to the control group. Complaints of the digestive system were 21.1% more likely by children with ASD. Children suffering from ASD were characterized by a higher intake of red meat and giblets and less frequent consumption of milk and milk products compared to the control group. There were no statistically significant differences between the study group and the control group in terms of frequency of consumption of products, which are the source of gluten, artificial food additives-preservatives, and artificial colors.

Conclusions:
There are differences in the habits and eating behaviors and the frequency of consumption of selected food products between a group of children with ASD and a group of healthy children.