Showing papers by "University of Western Ontario published in 2012"
Johns Hopkins University1, University of Barcelona2, St George's, University of London3, Taipei Veterans General Hospital4, Maastricht University5, Washington University in St. Louis6, Imperial College London7, University of Virginia8, Virginia Commonwealth University9, Thomas Jefferson University10, Beaumont Hospital11, University of Bordeaux12, Leipzig University13, University of Oklahoma14, University of Michigan15, Royal Melbourne Hospital16, University College Dublin17, Korea University18, University of Birmingham19, University of Münster20, University of Western Ontario21, Cleveland Clinic22, Harvard University23, University of Pennsylvania24, Northwestern University25, Université de Montréal26, Mayo Clinic27, Icahn School of Medicine at Mount Sinai28, University of California, Los Angeles29, National Yang-Ming University30, Loyola University Chicago31
TL;DR: This 2012 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a Task Force, convened by the Heart Rhythm Society, the European Heart Rhythm Association, and the European Cardiac Arrhythmia Society and charged with defining the indications, techniques, and outcomes of this procedure.
Abstract: During the past decade, catheter ablation of atrial fibrillation (AF) has evolved rapidly from an investigational procedure to its current status as a commonly performed ablation procedure in many major hospitals throughout the world. Surgical ablation of AF, using either standard or minimally invasive techniques, is also performed in many major hospitals throughout the world.
In 2007, an initial Consensus Statement on Catheter and Surgical AF Ablation was developed as a joint effort of the Heart Rhythm Society, the European Heart Rhythm Association, and the European Cardiac Arrhythmia Society.1 The 2007 document was also developed in collaboration with the Society of Thoracic Surgeons and the American College of Cardiology. Since the publication of the 2007 document, there has been much learned about AF ablation, and the indications for these procedures have changed. Therefore the purpose of this 2012 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a Task Force, convened by the Heart Rhythm Society, the European Heart Rhythm Association, and the European Cardiac Arrhythmia Society and charged with defining the indications, techniques, and outcomes of this procedure. Included within this document are recommendations pertinent to the design of clinical trials in the field of AF ablation, including definitions relevant to this topic.
This statement summarizes the opinion of the Task Force members based on an extensive literature review as well as their own experience. It is directed to all health care professionals who are involved in the care of patients with AF, particularly those who are undergoing, or are being considered for, catheter or surgical ablation procedures for AF. This statement is not intended to recommend or promote catheter ablation of AF. Rather the ultimate judgment regarding care of a particular patient …
2,754 citations
University of Pennsylvania1, Johns Hopkins University2, Mayo Clinic3, University of Barcelona4, St George's, University of London5, Maastricht University6, Cleveland Clinic7, University of Virginia8, Baylor University9, Virginia Commonwealth University10, Thomas Jefferson University11, Beaumont Hospital12, University of Bordeaux13, Leipzig University14, University of Oklahoma15, University of Michigan16, Royal Melbourne Hospital17, University College Dublin18, Korea University19, University of Münster20, University of Birmingham21, University of Western Ontario22, Imperial College London23, Harvard University24, Northwestern University25, National Yang-Ming University26, Washington University in St. Louis27, Université de Montréal28, Icahn School of Medicine at Mount Sinai29, University of California, Los Angeles30, Loyola University Chicago31
TL;DR: A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology and the European Cardiac Arrhythmia Society (ECAS), was published in this paper.
1,271 citations
TL;DR: Blockade of IL-17A was ineffective and higher rates of adverse events were noted compared with placebo, and unfavourable responses on secukinumab were driven by patients with elevated inflammatory markers.
Abstract: Objective: The authors tested whether the anti-interleukin (IL)-17A monoclonal antibody secukinumab was safe and effective for the treatment of active Crohn's disease. Design: In a double-blind, randomised, placebocontrolled proof-of-concept study, 59 patients with moderate to severe Crohn's disease (Crohn's Disease Activity Index (CDAI) ≥220 to ≤450) were assigned in a 2:1 ratio to 2x10 mg/kg intravenous secukinumab or placebo. The primary end point, addressed by Bayesian statistics augmented with historical placebo information, was the probability that secukinumab reduces the CDAI by ≥50 points more than placebo at week 6. Ancillary analyses explored associations of 35 candidate genetic polymorphisms and faecal calprotectin response. Results 59 patients (39 secukinumab, 20 placebo, mean baseline CDAI 307 and 301, respectively) were recruited. 18/59 (31%) patients discontinued prematurely (12/39 (31%) secukinumab, 6/20 (30%) placebo), 10/59 (17%) due to insufficient therapeutic effect (8/39 (21%) secukinumab, 2/20 (10%) placebo). Fourteen serious adverse events occurred in 10 patients (seven secukinumab, three placebo); 20 infections, including four local fungal infections, were seen on secukinumab versus none on placebo. Primary end point analysis estimated <0.1% probability (ΔCDAI (SD) =33.9 (19.7), 95% credible interval -4.9 to 72.9) that secukinumab reduces CDAI by ≥50 points more than placebo. Secondary area under the curve analysis (weeks 4-10) showed a significant difference (mean ΔDCDAI=49; 95% CI (2 to 96), p=0.043) in favour of placebo. Post hoc subgroup analysis showed that unfavourable responses on secukinumab were driven by patients with elevated inflammatory markers (CRP≥10 mg/l and/or faecal calprotectin≥200 ng/ml; mean ΔDCDAI=62; 95% CI (-1 to 125), p=0.054 in favour of placebo). Absence of the minor allele of tumour necrosis factor-like ligand 1A was strongly associated with lack of response measured by baseline-adjusted changes in calprotectin at week 6 (p=0.00035 Bonferroni-corrected). Conclusions Blockade of IL-17A was ineffective and higher rates of adverse events were noted compared with placebo. Clinical trial registration This trial was registered at ClinicalTrial.gov with the number NCT01009281.
1,253 citations
TL;DR: A significant number of new palaeomagnetic poles have become available since the last time a compilation was made (assembled in 2005, published in 2008) to indicate to us that a new and significantly expanded set of tables with palaeOMagnetic results would be valuable, with results coming from the Gondwana cratonic elements, Laurentia, Baltica/Europe, and Siberia as mentioned in this paper.
1,094 citations
TL;DR: In this article, the authors focus on the common important management questions for which, at a minimum, low-quality published evidence is available to guide best practices and provide guidance for many common anticoagulation-related management problems.
1,061 citations
University of California, San Diego1, Janssen Pharmaceutica2, Icahn School of Medicine at Mount Sinai3, University of Chicago4, Cedars-Sinai Medical Center5, Katholieke Universiteit Leuven6, University of Calgary7, University of Kentucky8, University of Toronto9, University of Kiel10, University of Western Ontario11
TL;DR: Patients with moderate-to-severe Crohn's disease that was resistant to TNF antagonists had an increased rate of response to induction with ustekinumab, as compared with placebo.
Abstract: Background In patients with Crohn's disease, the efficacy of ustekinumab, a human monoclonal antibody against interleukin-12 and interleukin-23, is unknown. Methods We evaluated ustekinumab in adul...
934 citations
TL;DR: In this article, a review of the recent progress and advances in the development of C/LiFePO4 composite materials is presented, based on selected reports from peer-reviewed journal publications.
Abstract: Olivine-structured LiFePO4 has been the focus of research in developing low cost, high performance cathode materials for lithium ion batteries. Various processes have been developed to synthesize LiFePO4 or C/LiFePO4 (carbon coating on LiFePO4), and some of them are being used to mass produce C/LiFePO4 at the commercial or pilot scale. Due to the low intrinsic electronic and ionic conductivities of LiFePO4, the decrease of particle size and the nano-layer of carbon coating on LiFePO4 particle surfaces are necessary to achieve a high electrochemical performance. Significant progress has been made in understanding and controlling phase purity, particle size and carbon coating of the C/LiFePO4 composite material in the past. However, there are still many challenges in achieving a high quality product with high consistency. In this review, we summarize some of the recent progress and advances based on selected reports from peer-reviewed journal publications. Several typical synthesis methods and the effect of carbon coating quality on the properties of C/LiFePO4 composite are reviewed. An insight into the future research and further development of C/LiFePO4 composite is also discussed.
831 citations
TL;DR: A new database search tool, PEAKS DB, has been developed by incorporating the de novo sequencing results into the database search, and achieves significantly improved accuracy and sensitivity over two other commonly used software packages.
815 citations
TL;DR: Because of its ability to provide a long-term, month-by-month measure of systemic cortisol exposure, hair cortisol analysis is becoming a useful tool, capable of answering clinical questions that could previously not be answered by other tests.
795 citations
TL;DR: Evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunction and fall risk in older people in clinical practice is presented and a potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through nonpharmacological and pharmacological treatments is presented.
Abstract: Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults, but increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are interrelated in older adults. Quantifiable alterations in gait in older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single- and dual-task testing and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia. This article reviews the importance of the interrelationship between gait and cognition in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunction and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. A potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through nonpharmacological and pharmacological treatments is also presented. Untangling the relationship between early gait disturbances and early cognitive changes may be helpful in identifying older adults at risk of experiencing mobility decline, falls, and progression to dementia.
748 citations
TL;DR: A comprehensive review of the related literature to examine recent findings related to the issue of nursing turnover and its causes and consequences and to identify on methodological challenges and the implications of new evidence for future studies is conducted.
TL;DR: In this paper, the authors used the middle-range theory of partnership synergy to analyze and synthesize the data, using the PR partnership as the main unit of analysis, and identified mechanisms by which PR may add value to the research process.
Abstract: CONTEXT: Participatory research (PR) is the co-construction of research through partnerships between researchers and people affected by and/or responsible for action on the issues under study. Evaluating the benefits of PR is challenging for a number of reasons: the research topics, methods, and study designs are heterogeneous; the extent of collaborative involvement may vary over the duration of a project and from one project to the next; and partnership activities may generate a complex array of both short- and long-term outcomes. METHODS: Our review team consisted of a collaboration among researchers and decision makers in public health, research funding, ethics review, and community-engaged scholarship. We identified, selected, and appraised a large-variety sample of primary studies describing PR partnerships, and in each stage, two team members independently reviewed and coded the literature. We used key realist review concepts (middle-range theory, demi-regularity, and context-mechanism-outcome configurations [CMO]) to analyze and synthesize the data, using the PR partnership as the main unit of analysis. FINDINGS: From 7,167 abstracts and 591 full-text papers, we distilled for synthesis a final sample of twenty-three PR partnerships described in 276 publications. The link between process and outcome in these partnerships was best explained using the middle-range theory of partnership synergy, which demonstrates how PR can (1) ensure culturally and logistically appropriate research, (2) enhance recruitment capacity, (3) generate professional capacity and competence in stakeholder groups, (4) result in productive conflicts followed by useful negotiation, (5) increase the quality of outputs and outcomes over time, (6) increase the sustainability of project goals beyond funded time frames and during gaps in external funding, and (7) create system changes and new unanticipated projects and activities. Negative examples illustrated why these outcomes were not a guaranteed product of PR partnerships but were contingent on key aspects of context. CONCLUSIONS: We used a realist approach to embrace the heterogeneity and complexity of the PR literature. This theory-driven synthesis identified mechanisms by which PR may add value to the research process. Using the middle-range theory of partnership synergy, our review confirmed findings from previous PR reviews, documented and explained some negative outcomes, and generated new insights into the benefits of PR regarding conflicts and negotiation between stakeholders, program sustainability and advancement, unanticipated project activity, and the generation of systemic change.
TL;DR: Shift work is associated with vascular events, which may have implications for public policy and occupational medicine, and pooled risk ratios were significant for both unadjusted analyses and analyses adjusted for risk factors.
Abstract: Objective To synthesise the association of shift work with major vascular events as reported in the literature. Data sources Systematic searches of major bibliographic databases, contact with experts in the field, and review of reference lists of primary articles, review papers, and guidelines. Study selection Observational studies that reported risk ratios for vascular morbidity, vascular mortality, or all cause mortality in relation to shift work were included; control groups could be non-shift (“day”) workers or the general population. Data extraction Study quality was assessed with the Downs and Black scale for observational studies. The three primary outcomes were myocardial infarction, ischaemic stroke, and any coronary event. Heterogeneity was measured with the I 2 statistic and computed random effects models. Results 34 studies in 2 011 935 people were identified. Shift work was associated with myocardial infarction (risk ratio 1.23, 95% confidence interval 1.15 to 1.31; I 2 =0) and ischaemic stroke (1.05, 1.01 to 1.09; I 2 =0). Coronary events were also increased (risk ratio 1.24, 1.10 to 1.39), albeit with significant heterogeneity across studies (I 2 =85%). Pooled risk ratios were significant for both unadjusted analyses and analyses adjusted for risk factors. All shift work schedules with the exception of evening shifts were associated with a statistically higher risk of coronary events. Shift work was not associated with increased rates of mortality (whether vascular cause specific or overall). Presence or absence of adjustment for smoking and socioeconomic status was not a source of heterogeneity in the primary studies. 6598 myocardial infarctions, 17 359 coronary events, and 1854 ischaemic strokes occurred. On the basis of the Canadian prevalence of shift work of 32.8%, the population attributable risks related to shift work were 7.0% for myocardial infarction, 7.3% for all coronary events, and 1.6% for ischaemic stroke. Conclusions Shift work is associated with vascular events, which may have implications for public policy and occupational medicine.
TL;DR: This paper used an instrumental variables strategy to estimate the causal effect of income on children's math and reading achievement, and found that a $1,000 increase in income raises combined test scores by 6 percent of a standard deviation.
Abstract: Using an instrumental variables strategy, we estimate the causal effect of income on children’s math and reading achievement. Our identification derives from the large, nonlinear changes in the Earned Income Tax Credit. The largest of these changes increased family income by as much as 20 percent, or approximately $2,100, between 1993 and 1997. Our baseline estimates imply that a $1,000 increase in income raises combined math and reading test scores by 6 percent of a standard deviation in the short run. Test gains are larger for children from disadvantaged families and robust to a variety of alternative specifications. (JEL H24, H31, I21, I38, J13)
TL;DR: Best practice recommendations for state-transition modeling are provided, directed both to modelers and to users of modeling results such as clinicians, clinical guideline developers, manufacturers, or policymakers.
TL;DR: There is strong evidence global measures of cognition are associated with serious fall-related injury, though there is no consensus on threshold values and the method used to define cognitive impairment and the type of fall outcome are both important when quantifying risk.
Abstract: Background: cognitive impairment is an established fall risk factor; however, it is unclear whether a disease-specific diagnosis (i.e. dementia), measures of global cognition or impairments in specific cognitive domains (i.e. executive function) have the greatest association with fall risk. Our objective was to evaluate the epidemiological evidence linking cognitive impairment and fall risk. Methods: studies were identified through systematic searches of the electronic databases of MEDLINE, EMBASE, PyschINFO (1988–2009). Bibliographies of retrieved articles were also searched. A fixed-effects meta-analysis was performed using an inverse-variance method. Results: twenty-seven studies met the inclusion criteria. Impairment on global measures of cognition was associated with any fall, serious injuries (summary estimate of OR = 2.13 (1.56, 2.90)) and distal radius fractures in community-dwelling older adults. Executive function impairment, even subtle deficits in healthy community-dwelling older adults, was associated with an increased risk for any fall (summary estimate of OR = 1.44 (1.20, 1.73)) and falls with serious injury. A diagnosis of dementia, without specification of dementia subtype or disease severity, was associated with risk for any fall but not serious fall injury in institution-dwelling older adults. Conclusion: the method used to define cognitive impairment and the type of fall outcome are both important when quantifying risk. There is strong evidence global measures of cognition are associated with serious fall-related injury, though there is no consensus on threshold values. Executive function was also associated with increased risk, which supports its inclusion in fall risk assessment especially when global measures are within normal limits.
TL;DR: The epidemiology and clinical presentation ofSepsis-associated encephalopathy is discussed, recent evidence for SAE pathophysiology is outlined and a diagnostic approach to patients with this syndrome is presented.
Abstract: Sepsis-associated encephalopathy (SAE) is a diffuse brain dysfunction that occurs secondary to infection in the body without overt CNS infection. SAE is frequently encountered in critically ill patients in intensive care units, and in up to 70% of patients with severe systemic infection. The severity of SAE can range from mild delirium to deep coma. Seizures and myoclonus are infrequent and cranial nerves are almost always spared, but most severe cases have an associated critical illness neuromyopathy. Development of SAE probably involves a number of mechanisms that are not mutually exclusive and vary from patient to patient. Substantial neurological and psychological morbidities often occur in survivors. Mortality is almost always due to multiorgan failure rather than neurological complications, and is almost 70% in patients with severe SAE. Further research into the pathophysiology, management and prevention of SAE is needed. This Review discusses the epidemiology and clinical presentation of SAE. Recent evidence for SAE pathophysiology is outlined and a diagnostic approach to patients with this syndrome is presented. Lastly, prognosis and management of SAE is discussed.
TL;DR: An extensive review of the research on NSSI and suicidal behavior among adolescents and adults concludes that an integrated model is introduced and several recommendations for future research are provided to extend theory development.
TL;DR: A greater understanding of the pathogenesis of CD allows alternative future CD treatments to hydrolyse toxic gliadin peptide, prevent toxic gl iadin peptides absorption, blockage of selective deamidation of specific glutamine residues by tissue, restore immune tolerance towards gluten, modulation of immune response to dietarygliadin, and restoration of intestinal architecture.
Abstract: Celiac disease (CD) is one of the most common diseases, resulting from both environmental (gluten) and genetic factors [human leukocyte antigen (HLA) and non-HLA genes]. The prevalence of CD has been estimated to approximate 0.5%-1% in different parts of the world. However, the population with diabetes, autoimmune disorder or relatives of CD individuals have even higher risk for the development of CD, at least in part, because of shared HLA typing. Gliadin gains access to the basal surface of the epithelium, and interact directly with the immune system, via both trans- and para-cellular routes. From a diagnostic perspective, symptoms may be viewed as either "typical" or "atypical". In both positive serological screening results suggestive of CD, should lead to small bowel biopsy followed by a favourable clinical and serological response to the gluten-free diet (GFD) to confirm the diagnosis. Positive anti-tissue transglutaminase antibody or anti-endomysial antibody during the clinical course helps to confirm the diagnosis of CD because of their over 99% specificities when small bowel villous atrophy is present on biopsy. Currently, the only treatment available for CD individuals is a strict life-long GFD. A greater understanding of the pathogenesis of CD allows alternative future CD treatments to hydrolyse toxic gliadin peptide, prevent toxic gliadin peptide absorption, blockage of selective deamidation of specific glutamine residues by tissue, restore immune tolerance towards gluten, modulation of immune response to dietary gliadin, and restoration of intestinal architecture.
TL;DR: This report presents the details of the new recommendations, along with the background and rationale, for focused updating of the 2010 Guidelines with respect to stroke prevention and rate/rhythm control.
TL;DR: In this paper, three key social management capabilities: monitoring, collaboration, and innovation are defined and used to underpin case research in five multinational firms, and the field research revealed four key linkages that detail how managers actively can work toward mitigating social risks, creating new opportunities, and improving firm performance.
TL;DR: The new Knee Society Knee Scoring System has been developed and validated, in part, to better characterize the expectations, satisfaction, and physical activities of the younger and more diverse population of current patients undergoing TKA.
Abstract: In 1989, The Knee Society Clinical Rating System [3] was developed as a simple, but objective scoring system to rate the knee and patient’s functional abilities such as walking and stair climbing before and after TKA. Since the scoring system did not include assessment of radiographs, The Knee Society endorsed a method to evaluate radiographs [2]. The Knee Society Clinical Rating System has been the most popular method of tracking and reporting outcomes after total and partial knee arthroplasty worldwide. However, the reliability, responsiveness, and validity of the original score have been challenged. In addition, it became clear over time that there were ambiguities and deficiencies with the original Knee Society Clinical Rating System that challenged its utility and validity in our contemporary patients, who often have expectations, demands, and functional requirements that are different from those of prior generations of patients who underwent knee arthroplasty.
The Knee Society therefore embarked on a complete review of the previous system. The project started more than 3 years ago and involved Knee Society members from 18 institutions in the United States and Canada; these individuals contributed more than 500 cases of both preoperative and postoperative TKA. The magnitude of this exhaustive project involved a multidisciplinary team of arthroplasty surgeons, epidemiologists, and statisticians. The prior objective knee score was amplified from the prior Knee Society score to incorporate current knee arthroplasty clinical parameters. The functional component of the new score was developed on the basis of comprehensive inventories of the activities and observations of 101 patients at five major knee arthroplasty centers who completed a 120-item survey, which was ultimately condensed down to the current assessment tool. This assessment tool was then included in the validation process at the 18 participating centers. The final scoring system was then approved by the Knee Society Scoring Committee.
The new Knee Society Knee Scoring System is both physician and patient derived. It includes versions to be administered preoperatively (Appendix 1) and postoperatively (Appendix 2). It has an initial assessment of demographic details, including an expanded Charnley functional classification [1]. The objective knee score, completed by the surgeon, includes a VAS score of pain walking on level ground and on stairs or inclines, as well as an assessment of alignment, ligament stability, and ROM, along with deductions for flexion contracture or extensor lag. Patients then record their satisfaction, functional activities, and expectations. Given the diverse activity profiles of many contemporary patients, the functional component of the score was improved to include a patient-specific survey, which evaluates features such as standard activities of daily living, patient-specific sports and recreational activities, patient satisfaction, and patient expectations. Portions of the original Knee Society Clinical Rating System have been integrated into the new version to maintain the integrity of the prior version of the Knee Society score.
The new Knee Society Knee Scoring System has been developed and validated, in part, to better characterize the expectations, satisfaction, and physical activities of the younger and more diverse population of current patients undergoing TKA. The new score provides sufficient flexibility and depth to capture the diverse lifestyles and activities of our current patients. The score was validated in a thoughtful and methodical fashion confirming internal reliability and analyzed for differential item functioning [4]. The new Knee Society Scoring System is broadly applicable across sex, age, activity level, and implant type.
In conclusion, the new Knee Society Scoring System is a validated and responsive method for assessing objective and subjective outcomes after total and partial knee arthroplasty, without the ambiguities of the prior scoring system. As physicians, clinical practices, and health systems become increasingly more responsible for reporting patient outcomes, the clear value of this new scoring system will become apparent. The new scoring system is available through application on the Knee Society Web site (http://www.kneesociety.org).
TL;DR: This paper demystifies active and passive fault-tolerant control systems (FTCSs) by examining the similarities and differences between these two approaches from both philosophical and practical points of view.
TL;DR: Recent advances in using ALD for LIB studies are thoroughly reviewed, covering two technical routes: one for designing and synthesizing new LIB components, i.e., anodes, cathodes, and solid electrolytes, and; 2) ALD used in modifying electrode properties via surface coating.
Abstract: Lithium-ion batteries (LIBs) are used widely in today's consumer electronics and offer great potential for hybrid electric vehicles (HEVs), plug-in HEVs, pure EVs, and also in smart grids as future energy-storage devices. However, many challenges must be addressed before these future applications of LIBs are realized, such as the energy and power density of LIBs, their cycle and calendar life, safety characteristics, and costs. Recently, a technique called atomic layer deposition (ALD) attracted great interest as a novel tool and approach for resolving these issues. In this article, recent advances in using ALD for LIB studies are thoroughly reviewed, covering two technical routes: 1) ALD for designing and synthesizing new LIB components, i.e., anodes, cathodes, and solid electrolytes, and; 2) ALD used in modifying electrode properties via surface coating. This review will hopefully stimulate more extensive and insightful studies on using ALD for developing high-performance LIBs.
TL;DR: Baseline risk status of patients who presented for surgery as shown by the ASA score increased over the decades, and Meta-regression showed a significant relation between risk of perioperative and anaesthetic-related mortality and HDI.
TL;DR: A meta-analysis of genome-wide association studies in 39,883 individuals of European ancestry to identify genes associated with metabolic disease identifies novel genetic determinants of adiponectin levels, which, taken together, influence risk of T2D and markers of insulin resistance.
Abstract: Circulating levels of adiponectin, a hormone produced predominantly by adipocytes, are highly heritable and are inversely associated with type 2 diabetes mellitus (T2D) and other metabolic traits. We conducted a meta-analysis of genome-wide association studies in 39,883 individuals of European ancestry to identify genes associated with metabolic disease. We identified 8 novel loci associated with adiponectin levels and confirmed 2 previously reported loci (P = 4.5×10(-8)-1.2×10(-43)). Using a novel method to combine data across ethnicities (N = 4,232 African Americans, N = 1,776 Asians, and N = 29,347 Europeans), we identified two additional novel loci. Expression analyses of 436 human adipocyte samples revealed that mRNA levels of 18 genes at candidate regions were associated with adiponectin concentrations after accounting for multiple testing (p<3×10(-4)). We next developed a multi-SNP genotypic risk score to test the association of adiponectin decreasing risk alleles on metabolic traits and diseases using consortia-level meta-analytic data. This risk score was associated with increased risk of T2D (p = 4.3×10(-3), n = 22,044), increased triglycerides (p = 2.6×10(-14), n = 93,440), increased waist-to-hip ratio (p = 1.8×10(-5), n = 77,167), increased glucose two hours post oral glucose tolerance testing (p = 4.4×10(-3), n = 15,234), increased fasting insulin (p = 0.015, n = 48,238), but with lower in HDL-cholesterol concentrations (p = 4.5×10(-13), n = 96,748) and decreased BMI (p = 1.4×10(-4), n = 121,335). These findings identify novel genetic determinants of adiponectin levels, which, taken together, influence risk of T2D and markers of insulin resistance.
John Radcliffe Hospital1, Warner Chilcott2, University of Miami3, University of Oxford4, Lille University of Science and Technology5, University of Western Ontario6, University of Chicago7, University of Paris8, University of Pennsylvania9, Medical University of Vienna10, Icahn School of Medicine at Mount Sinai11, University of Cincinnati12, French Institute of Health and Medical Research13, University of California, San Diego14
TL;DR: The Ulcerative Colitis Endoscopic Index of Severity accurately predicts overall assessment of endoscopic severity of UC and needs further testing before it can be applied as an outcome measure in clinical trials or clinical practice.
Abstract: Background Variability in endoscopic assessment necessitates rigorous investigation of descriptors for scoring severity of ulcerative colitis (UC) Objective To evaluate variation in the overall endoscopic assessment of severity, the intra- and interindividual variation of descriptive terms and to create an Ulcerative Colitis Endoscopic Index of Severity which could be validated Design A two-phase study used a library of 670 video sigmoidoscopies from patients with Mayo Clinic scores 0–11, supplemented by 10 videos from five people without UC and five hospitalised patients with acute severe UC In phase 1, each of 10 investigators viewed 16/24 videos to assess agreement on the Baron score with a central reader and agreed definitions of 10 endoscopic descriptors In phase 2, each of 30 different investigators rated 25/60 different videos for the descriptors and assessed overall severity on a 0–100 visual analogue scale κ Statistics tested inter- and intraobserver variability for each descriptor A general linear mixed regression model based on logit link and β distribution of variance was used to predict overall endoscopic severity from descriptors Results There was 76% agreement for ‘severe’, but 27% agreement for ‘normal’ appearances between phase I investigators and the central reader In phase 2, weighted κ values ranged from 034 to 065 and 030 to 045 within and between observers for the 10 descriptors The final model incorporated vascular pattern, (normal/patchy/complete obliteration) bleeding (none/mucosal/luminal mild/luminal moderate or severe), erosions and ulcers (none/erosions/superficial/deep), each with precise definitions, which explained 90% of the variance (pR 2 , Akaike Information Criterion) in the overall assessment of endoscopic severity, predictions varying from 4 to 93 on a 100-point scale (from normal to worst endoscopic severity) Conclusion The Ulcerative Colitis Endoscopic Index of Severity accurately predicts overall assessment of endoscopic severity of UC Validity and responsiveness need further testing before it can be applied as an outcome measure in clinical trials or clinical practice
TL;DR: There is strong empirical support for the hypothesis that trauma causes dissociation, and that dissociation remains related to trauma history when fantasy proneness is controlled, and little support is found for the hypotheses that the dissociation-trauma relationship is due toantasy proneness or confabulated memories of trauma.
Abstract: The relationship between a reported history of trauma and dissociative symptoms has been explained in 2 conflicting ways. Pathological dissociation has been conceptualized as a response to antecedent traumatic stress and/or severe psychological adversity. Others have proposed that dissociation makes individuals prone to fantasy, thereby engendering confabulated memories of trauma. We examine data related to a series of 8 contrasting predictions based on the trauma model and the fantasy model of dissociation. In keeping with the trauma model, the relationship between trauma and dissociation was consistent and moderate in strength, and remained significant when objective measures of trauma were used. Dissociation was temporally related to trauma and trauma treatment, and was predictive of trauma history when fantasy proneness was controlled. Dissociation was not reliably associated with suggestibility, nor was there evidence for the fantasy model prediction of greater inaccuracy of recovered memory. Instead, dissociation was positively related to a history of trauma memory recovery and negatively related to the more general measures of narrative cohesion. Research also supports the trauma theory of dissociation as a regulatory response to fear or other extreme emotion with measurable biological correlates. We conclude, on the basis of evidence related to these 8 predictions, that there is strong empirical support for the hypothesis that trauma causes dissociation, and that dissociation remains related to trauma history when fantasy proneness is controlled. We find little support for the hypothesis that the dissociation–trauma relationship is due to fantasy proneness or confabulated memories of trauma.
TL;DR: Compared with the M probe, the FibroScan XL probe reduces TE failure and facilitates reliable LSM in obese patients, and lower liver stiffness cutoffs will be necessary when the XL probe is used to noninvasively assess liver fibrosis.
Johns Hopkins University1, University of Barcelona2, St George's, University of London3, Maastricht University4, Washington University in St. Louis5, Imperial College London6, University of Virginia7, Baylor University8, Virginia Commonwealth University9, Thomas Jefferson University10, Beaumont Hospital11, University of Bordeaux12, Leipzig University13, University of Oklahoma14, University of Michigan15, Royal Melbourne Hospital16, University College Dublin17, Korea University18, University of Birmingham19, University of Münster20, University of Western Ontario21, Cleveland Clinic22, Harvard University23, University of Pennsylvania24, Northwestern University25, Université de Montréal26, Mayo Clinic27, Icahn School of Medicine at Mount Sinai28, University of California, Los Angeles29, National Yang-Ming University30, Loyola University Chicago31
TL;DR: This is a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA).
Abstract: This is a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology and the European Cardiac Arrhythmia Society (ECAS), and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). This is endorsed by the governing bodies of the ACC Foundation, the AHA, the ECAS, the EHRA, the STS, the APHRS, and the HRS.