bluuebunny/crossref_metadata_2025_split huggingface dataset:
319 Effects of omega-3 fatty acid supplementation on atopic dermatitis
Authors: Abdelnour Alyssa M , Shareef Sarah J , Kreuser Kaitlin , Ashack Kurt 
Published: January 2023

Abstract
Oral supplements are commonly used by patients to enhance skin health for aesthetic purposes and in response to cutaneous disorders. Currently, the Food and Drug Administration (FDA) is not authorized to approve the efficacy or safety of dietary supplements prior to public marketing. Therefore, evidence-based medicine is needed for dermatologists to better counsel patients regarding oral supplementation. Physicians must take this into consideration while treating patients with chronic conditions, such as atopic dermatitis (AD). AD is the most common cutaneous inflammatory disease affecting individuals from infancy through adulthood. Prevention and management are focused on avoiding environmental triggers, daily skin care with emollients and/or topical steroids, and decreasing systemic inflammation. Patients with AD use various treatment options and over-the-counter supplements throughout their lifetime. Interestingly, omega-3 fatty acids (O3FA) are marketed for their anti-inflammatory effects and have been widely studied to understand health benefits. To our knowledge, the effects of oral supplementation of O3FA (docosahexaenoic acid [DHA] and eicosapentaenoic acid [EPA]) for AD are not summarized in the literature. Thus, this study was conducted to examine O3FA’s impact on AD and ultimately, to determine if supplementation is an effective therapy for the prevention and/or treatment of AD. A comprehensive electronic search with EPA and DHA for atopic dermatitis in PubMed/MEDLINE, Cochrane Central, Embase, and Google Scholar yielded 45 articles. Duplicate, non-English articles and irrelevant articles were excluded. These parameters resulted in 38 articles being excluded as they did not meet study qualifications. Therefore, seven articles are included in this review. Of the included articles, 2/7 studies discussed an improvement in skin inflammation with O3FA supplementation, while 5/7 did not find a significant difference in the prevention of allergic disease. On the other hand, one trial resulted in a significant decline in the prevalence of eczema and another indicated significant clinical improvement compared to baseline, but not in comparison to the placebo. O3FA supplementation is not effective in preventing allergic symptoms, but may decrease the prevalence of AD and provide clinical improvement. Further evaluation is needed to characterize the efficacy of O3FA supplementation in the prevention and treatment of AD.
353 Amlitelimab reduces serum IL-13 in a phase 2a clinical trial in atopic dermatitis without impacting T-cell expansion in a T-cell recall assay
Authors: Weidinger Stephan , Cork Michael , Reich Adam  , Bieber Thomas , Lucchesi Davide  , Rynkiewicz Natalie  , Sainson Richard C A   , Chen Ron  , Prandi Francesca , van Krinks Cassandra  , Stebegg Marisa , Porter-Brown Ben  
Published: January 2023

Abstract
Amlitelimab (SAR445229), a fully human non-depleting, non-cytotoxic, monoclonal antibody, binds to OX40Ligand (OX40L) on antigen-presenting cells (APC) to block OX40-OX40L interactions. In a 16-week, double-blind, Phase 2a trial (NCT03754309), amlitelimab induced clinically meaningful disease activity improvement in patients with moderate-to-severe atopic dermatitis (AD). To assess the effects of amlitelimab on interleukin (IL)-13 and T-cell recall responses. In the trial, 89 patients were randomized to amlitelimab low dose (LD; 200 mg loading/100 mg maintenance every 4 weeks [Q4W]), high dose (HD; 500 mg loading/250 mg maintenance Q4W), or placebo. Serum IL-13 levels were assessed by single molecule immunoassay (259 samples). Using human peripheral blood mononuclear cells from five healthy donors, a T-cell recall assay was performed. At baseline in the trial, IL-13 levels significantly correlated with disease severity (Eczema Area and Severity Index; r = 0.4784, P &lt; 0.0001). Week 16 IL-13 levels were significantly reduced with amlitelimab vs. baseline but not placebo (median fold change [95% confidence interval, CI] from baseline to week 16 with P-values based on two-way Analysis of Variance [ANOVA] of log10-transformed fold change for patients with a complete dataset at week 16: LD 0.345 [0.23–0.44], P &lt; 0.0001; HD 0.390 [0.30–0.63], P = 0.0002; placebo 0.835 [0.34–1.12], P = 0.1544). In a T-cell recall assay, amlitelimab significantly reduced IL-13 protein levels at days 3 and 6 without negatively impacting T-cell expansion, based on the percentage of proliferating CD4+ T-cells vs. isotype control. Amlitelimab decreased IL-13 levels in patients with AD and in a T-cell recall assay without negative effects on T-cell expansion, thus reducing inflammation without blocking T-cell proliferation during recall responses.
Perspectives on Adherence From the ACTG 5360 MINMON Trial: A Minimum Monitoring Approach With 12 Weeks of Sofosbuvir/Velpatasvir in Chronic Hepatitis C Treatment
Authors: Sowah Leonard A , Smeaton Laura , Brates Irena , Bhattacharya Debika , Linas Benjamin , Kreter Bruce , Wagner-Cardoso Sandra , Solomon Sunil , Sulkowski Mark , Robbins Gregory K 
Published: January 2023

Abstract

Background
With the advent of efficacious oral direct-acting antivirals (DAAs) for hepatitis C virus (HCV), identification of characteristics associated with adherence is critical to treatment success. We examined correlates of sub-optimal adherence to HCV therapy in a single-arm, multinational, clinical trial.

Methods
ACTG A5360 enrolled HCV treatment-naive persons without decompensated cirrhosis from 5 countries. All participants received a 12-weeks course of sofosbuvir/velpatasvir at entry. In-person visits occurred at initiation and week 24, sustained virologic response (SVR) assessment. Adherence at week 4 was collected remotely and was dichotomized optimal (100%, no missed doses) versus sub-optimal (&lt;100%). Correlates of sub-optimal adherence were explored using logistic regression.

Results
In total, 400 participants enrolled; 399 initiated treatment; 395/397 (99%) reported completing at week 24. Median age was 47 years with 35% female. Among the 368 reporting optimal adherence at week 4 SVR was 96.5% (95% confidence interval [CI] [94.1%, 97.9%]) vs 77.8% (95% CI [59.2%, 89.4%]) P value &lt; .001. In the multivariate model age &lt;30 years and being a US participant were independently associated with early sub-optimal adherence. Participants &lt;30 years were 7.1 times more likely to have early sub-optimal adherence compared to their older counterparts.

Conclusions
Self-reported optimal adherence at week 4 was associated with SVR. Early self-reported adherence could be used to identify those at higher risk of treatment failure and may benefit from additional support. Younger individuals &lt;30 years may also be prioritized for additional adherence support.
Clinical Trials Registration. NCT03512210.
Structure Fault Tolerance of Exchanged Hypercube
Authors: Liu Heqin , Cheng Dongqin 
Published: January 2023

Abstract
The undirected graph, exchanged hypercube $EH(s,t)$, is a variant of hypercube proposed by Loh et al. It is obtained by removing some links from $(s+t+1)$-dimensional hypercube. It retains many excellent properties, so many people have studied its reliability and fault tolerance. In this paper, combining the structure connectivity and substructure connectivity of graphs proposed not long ago, we obtain its $P_k$-path, $C_{2l}$-cycle and $K_{1,r}$-star structure connectivity and substructure connectivity where $2\le k,r\le s-1\le t-1$ and $6\le 2l\le s-1\le t-1$; we also establish $\kappa ^s(EH(s,t);C_4)$ for $5\le s\le t$ and the upper bound of $\kappa (EH(s,t);C_4)$ for $4\le s\le t$.
The nature of losses from cyber-related events: risk categories and business sectors
Authors: Shevchenko Pavel V , Jang Jiwook , Malavasi Matteo , Peters Gareth W , Sofronov Georgy , Trück Stefan 
Published: January 2023

Abstract
In this study, we examine the nature of losses from cyber-related events across different risk categories and business sectors. Using a leading industry dataset of cyber events, we evaluate the relationship between the frequency and severity of individual cyber-related events and the number of affected records. We find that the frequency of reported cyber-related events has substantially increased between 2008 and 2016. Furthermore, the frequency and severity of losses depend on the business sector and type of cyber threat: the most significant cyber loss event categories, by number of events, were related to data breaches and the unauthorized disclosure of data, while cyber extortion, phishing, spoofing, and other social engineering practices showed substantial growth rates. Interestingly, we do not find a distinct pattern between the frequency of events, the loss severity, and the number of affected records as often alluded to in the literature. We also analyse the severity distribution of cyber-related events across all risk categories and business sectors. This analysis reveals that cyber risks are heavy-tailed, i.e. cyber risk events have a higher probability to produce extreme losses than events whose severity follows an exponential distribution. Furthermore, we find that the frequency and severity of cyber-related losses exhibit a very dynamic and time-varying nature.
Contribution Threat Perception, School Climate and Prejudice as Mediator to Student’s Cyber Aggression
Authors: Mardianto Mardianto , Hartati Niken , Aulia Farah , Fikry Zulian , Utami Rahayu Hardianti , Magistarina Elrisfa 
Published: January 2023

AbstractThis study aims to test students’ cyber aggression models based on previous studies, especially those related to high school students’ Cyber Aggression behavior. Following the stages of adolescent development, this research uses the socio-ecological theoretical perspective of the cyber context. This study determines several predictive variables as risk factors and protective factors that have the most potential to influence student cyber aggression, such as perceived threats, school climate, and prejudice. The model tested in this study is the role of the perceived threat and school climate on students’ Cyber Aggression behavior mediated by prejudice. This study uses a quantitative approach with structural equation modeling analysis, namely the structural equation model (SEM). The sampling technique used in this study is purposive sampling. The subjects of this study are high school students who actively use social media every day, with 1118 students as respondents from several cities in Indonesia. The result shows that the theoretical model of students’ Cyber Aggression behavior as per the empirical conditions in the field has met the goodness of fit model standard, meaning that the perception of threats and the school climate-mediated by prejudice were simultaneously proven to play a role as predictors of student Cyber Aggression
Electrocardiographic predictors of disease severity, mortality, and advanced ventilatory support among hospitalized covid-19 patients: a two year single center retrospective, cohort study
Authors: Vista G , Vestal M 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
For detecting myocardial injury in severe and critical COVID-19, the electrocardiogram (ECG) is neither sensitive nor specific; but in a resource-poor environment, it remains relevant. Changes in the ECG can be a potential marker of severe and critical COVID-19 to be used for predicting not only disease severity but also the prognosis for recovery.

Methods
The admitting and interval ECGs of 1,333 COVID-19 patients were reviewed in a two-year, single-center, retrospective cohort study. Each was evaluated for 29 pre-defined ECG patterns under the categories of rhythm, rate, McGinn-White and RV overload patterns, axis and QRS abnormalities, ischemia/infarct patterns, and AV blocks before univariate and multivariate regression analyses for correlation with disease severity; need for advanced ventilatory support; and in-hospital mortality.

Results
Of the 29 ECG patterns, 18 showed a significant association with the dependent variables on univariate analysis. Multivariate analysis revealed that atrial fibrillation, HR &gt;100 bpm, low QRS voltage, QTc &gt;500msec, diffuse nonspecific T-wave changes, and "any AMI" ECG patterns correlate with disease severity; need for advanced ventilatory support and in-hospital mortality. S1Q3 and S1Q3T3 increased the odds of critical disease and need for high oxygen requirement by 2.5-3 fold. Fractionated QRS increased odds of advanced ventilatory support.

Conclusion
The ECG can be useful for predicting the severity and outcome of more than moderate COVID-19. Their use can facilitate rapid triage, predict disease trajectory, and prompt a decision to intensify therapy early in the disease to make a positive impact on clinical outcomes.
Demographic, clinical, and echocardiographic factors predicting maintenance of sinus rhythm following first elective cardioversion
Authors: Plant A , Hooks D , Larsen P 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Atrial fibrillation is common. Cardioversion to restore sinus rhythm is successful in over 90% of cases, but reversion to atrial fibrillation within a year occurs in the majority. Although predictors of maintenance of sinus rhythm following cardioversion have been described, to our knowledge no study has looked specifically at the population of patients undergoing first elective cardioversion for atrial fibrillation.

Purpose
We aimed to examine the demographic, clinical, and echocardiographic parameters that predict the maintenance of sinus rhythm to one year following first elective cardioversion, with the goal of generating a prediction tool to aid patient selection for the procedure.

Methods
Coding data was used to identify all patients who had undergone elective cardioversion at two centres in central New Zealand over a five-year period. Those with previous cardioversion were excluded. A range of demographic, clinical, and echocardiographic variables were collated, and univariate followed by multivariate analysis conducted to identify predictors of maintained sinus rhythm at one year, evidenced by documented recurrence of arrhythmia in the clinical record.

Results
287 patients underwent first elective cardioversion across both sites, restoring sinus rhythm in 86% with 39% in sinus rhythm at one year. Atrial flutter (66 patients) had higher rates of successful cardioversion (96%), and maintained sinus rhythm (64%) than atrial fibrillation (83% and 32%), whilst cardioversion in one centre (52% vs. 31%) and the absence of paroxysmal symptoms (41% vs. 26%) were both associated with higher likelihood of maintained sinus rhythm at one year. Only the presence of atrial flutter (OR 1.34, P&lt;0.001), and cardioversion in one of the centres (OR 1.19, P=0.002) increased the odds of maintained sinus rhythm at one year in multivariate analysis.
A range of other demographic (age, gender, BMI), clinical (duration of symptoms, antiarrhythmics, renal function), and echocardiographic (left atrial volume, left ventricular ejection fraction, mitral valve dysfunction) variables failed to predict restoration and maintenance of sinus rhythm.

Conclusion
In patients undergoing first elective cardioversion, the presence of atrial flutter and site of cardioversion both predict maintained sinus rhythm at one year. A range of other demographic, clinical, and echocardiographic variables shown elsewhere to predict sinus rhythm after cardioversion fail to do so in this study. This negative outcome likely reflects low numbers of patients in sinus rhythm at one year following first cardioversion, significant population heterogeneity, and small effect size of contributor variables. Overcoming this would require a substantially larger dataset, something that could be overcome through the use of a national dataset for patients undergoing cardioversion.
Frequent need for apixaban dose adjustment for atrial fibrillation in an unselected acute medical admission population during the COVID 19 pandemic
Authors: Kyaw K K K , Menown I B 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
During the COVID-19 pandemic, systematic switching patients of eligible patients with atrial fibrillation from warfarin to direct oral anticoagulants (DOACs) was encouraged to simplify drug dosing and obviate the need for regular monitoring. Regional exclusions to switching included mechanical heart valves, moderate to severe mitral stenosis and stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR]&lt; 15ml/min/1.73m2). However, each DOAC requires dose adjustment depending on renal function and other patient factors.

Purpose
Failure to dose reduce when indicated leads to excessive serum drug concentration and increased risk of major haemorrhage, particularly in patients who are acutely unwell. We thus quantified the likelihood of need for dose adjustment in an unselected acute medical admission population.

Methods
While on call, a single investigator prospectively identified all patients admitted on the acute medical or cardiology take-in between 1/12/21 and 1/2/22 who were taking apixaban for atrial fibrillation. Apixaban was selected as the study DOAC as it was the most commonly used DOAC but had the most complex dose adjustment algorithm and hence risk of dose error. In order to determine the appropriate drug dosage, patient age, weight, serum creatinine and eGFR were recorded. Dose reduction to 2.5mg was required if the patient meet 2 of the following 3 criteria of [age&gt;80 years, weight &lt;60kg, serum creatinine &gt;133umol/l], or a single criterion, had an eGFR &lt;30ml/min/1.73m2. Drug discontinuation was required if eGFR was &lt;15ml/min/1.73m2.

Results
All patients identified (n=50) had a CHA2DS2-VASc score of ≥2. Patients with active COVID-19 infection were excluded. Mean age was 77.2 years (range 46-102). Mean weight was 78kg (range 52-101). Mean serum creatinine was 212umol/l (range 62-595). Mean eGFR was 33ml/min/1.73m2 (range 8 to &gt;60). Of the 50 patients, 24 (48%) were taking the appropriate apixaban dose on admission which did not require dose adjustment (18 of whom were appropriately taking 5mg bd and 6 were taking 2.5mg bd). Dose reduction from 5mg bd to 2.5mg bd was required in 17 (34%) patients. Stopping treatment, at least temporarily due to eGFR&lt;15ml/min/1.73m2, was indicated in 9 (18%) of patients. No patient required an increase in drug dose. (Graph 1)

Conclusion
Over half of acute medical or cardiology patients admitted within a COVID-19 setting and taking apixaban for atrial fibrillation required at least temporary drug dose adjustment or discontinuation. Clinicians should expect that adjustment of apixaban dose may be required during acute admission.
Influence of non-apical permanent pacing on left ventricular systolic impairment
Authors: Baimbetov A , Jukenova A , Yakupova I , Bizhanov K , Tursunkhanov Z H , Bigeldiyev N , Azatkhanova N 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Right ventricular apical (RVA) pacing deleterious effects on left ventricular ejection fraction (LVEF) had been demonstrated. Non-apical pacing, such as right ventricular mid-septal (RVMS) and His Bundle pacing, appear as practical alternatives. Our purpose is to evaluate the effect of alternate sites of right ventricular (RV) pacing on left ventricular (LV) function and hemodynamics in patients with bradyarrhythmias.

Methods
We observed 118 patients (age 58±27 years, 64% men) with AV block III, who underwent permanent dual chamber pacemaker implantation. To 72 patients RV lead has implanted the middle area of RV septum (RVMS) and 46 patients’ RV lead has been implanted traditionally to the right ventricular apex (RVA). Color tissue velocity imaging was performed to analyze time to peak systolic velocity (Ts) in a 12 segment model of the LV for each pacing site. Measurements included standard deviation of time to peak systolic velocity (SD-Ts) for all segments, the maximal difference in Ts between any 2/6 basal (Ts-B), any 2/6 mid segments (Ts-M) and maximal Ts difference between any 2/12 segments (Ts-12). Stroke volume was estimated using Doppler velocity time integral (TVI) in the left ventricular outflow tract (LVOT). QRS width for each site was recorded. Measurements were observed by transthoracic echocardiography and electrocardiography before and 12 months after implantation.

Results
Ts-12 was significantly higher with RVA - pacing (107 ms, p=0.003) compared to RVMS - pacing (81 ms) sites. SD-Ts were significantly higher with RVA - pacing (38.5 ms, p=0.01) than RVMS - pacing (28.7 ms). QRS duration was the longest for RVA - pacing (157 ms) while significantly shorter RVMS - pacing (115 ms, p&lt;0.001). LVOT VTI was significantly higher for RVMS - pacing than for RVA (p=0.0014) pacing.

Conclusions
Right ventricular mid-septal pacing may reduce electro-mechanical dyssynchrony compared to RVA pacing and RVMS – pacing to effect better LV function and hemodynamics than RVA pacing in patients with permanent pacemaker implantation.
Advantages of leadless pacemakers compared to conventional pacemakers
Authors: Baimbetov A , Bizhanov K , Yakupova I , Bozshagulov T , Tursunkhanov Z H , Bigeldiyev N , Jukenova A 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Leadless pacemakers (L-PM) are a new safe alternative technology for pacing the right ventricle. However, not enough information is available on their potential benefits for quality of life (QoL) in patients with L-PM. The purpose of the study was the quality of life comparison of patients with L-PM and conventional pacemakers (C-PM).

Methods
The study included patients who underwent implantation of a single-chamber pacemaker from December 2018 to March 2022. We used the SF-36 Questionnaire to assess quality of life at baseline and after 6 and 12 months of follow-up. We also used a questionnaire consisting of 10 specific questions related to the implantation procedure.

Results
Total of 32 patients were included (16 L-PM; 16 C-PM). There were no differences in baseline characteristics between groups (L-PM vs. C-PM), except for age (47.5 vs. 57.3 years; P = 0.012) and diabetes 28% vs. 21%; P = 0.021). Baseline SF-36 did not differ between groups. After 6 months of follow-up, patients in the L-PM group showed significantly higher scores on physical function (47 vs 32; P&lt;0.001), physical role (53 vs 37; P=0.004) and mental health (67 vs 52; P=0.017), even after adjusting for covariates. Pacemaker-related discomfort and physical limitations were significantly lower in the L-PM group.

Conclusion
L-PM is associated with a better quality of life than C-PM, both in terms of physical and mental health. Patients who underwent L-PM implantation reported less procedure-related discomfort, physical limitations, and anxiety.