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  • 1
    Language: English
    In: Physical review. E, Statistical, nonlinear, and soft matter physics, May 2006, Vol.73(5 Pt 2), pp.056108
    Description: In this paper we formalize the small-world effect which describes the surprising fact that a hybrid graph composed of a local graph component and a very sparse random graph has a diameter of O(ln n) whereby the diameter of both components alone is much higher. We show that a large family of these hybrid graphs shows this effect and that this generalized family also includes classic small-world models proposed by various authors although not all of them are captured by the small-world definition given by Watts and Strogatz. Furthermore, we give a detailed upper bound of the hybrid's graph diameter for different choices of the expected number of random edges by applying a new kind of proof pattern that is applicable to a large number of hybrid graphs. The focus in this paper is on presenting a flexible family of hybrid graphs showing the small-world effect that can be tuned closely to real-world systems.
    Keywords: Physics;
    ISSN: 1539-3755
    E-ISSN: 15502376
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  • 2
    Language: English
    In: Journal of the American College of Cardiology, 05 January 2016, Vol.67(1), pp.16-26
    Description: It is uncertain whether a diagnostic strategy supplemented by early coronary computed tomography angiography (CCTA) is superior to contemporary standard optimal care (SOC) encompassing high-sensitivity troponin assays (hs-troponins) for patients suspected of acute coronary syndrome (ACS) in the emergency department (ED). This study assessed whether a diagnostic strategy supplemented by early CCTA improves clinical effectiveness compared with contemporary SOC. In a prospective, open-label, multicenter, randomized trial, we enrolled patients presenting with symptoms suggestive of an ACS at the ED of 5 community and 2 university hospitals in the Netherlands. Exclusion criteria included the need for urgent cardiac catheterization and history of ACS or coronary revascularization. The primary endpoint was the number of patients identified with significant coronary artery disease requiring revascularization within 30 days. The study population consisted of 500 patients, of whom 236 (47%) were women (mean age 54 ± 10 years). There was no difference in the primary endpoint (22 [9%] patients underwent coronary revascularization within 30 days in the CCTA group and 17 [7%] in the SOC group [p = 0.40]). Discharge from the ED was not more frequent after CCTA (65% vs. 59%, p = 0.16), and length of stay was similar (6.3 h in both groups; p = 0.80). The CCTA group had lower direct medical costs (€337 vs. €511, p 〈 0.01) and less outpatient testing after the index ED visit (10 [4%] vs. 26 [10%], p 〈 0.01). There was no difference in incidence of undetected ACS. CCTA, applied early in the work-up of suspected ACS, is safe and associated with less outpatient testing and lower costs. However, in the era of hs-troponins, CCTA does not identify more patients with significant CAD requiring coronary revascularization, shorten hospital stay, or allow for more direct discharge from the ED. (Better Evaluation of Acute Chest Pain with Computed Tomography Angiography [BEACON]; )
    Keywords: Chest Pain ; Coronary Artery Disease ; Diagnosis ; Emergency Department ; Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
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  • 3
    Language: English
    In: 2017
    Description: textabstractBackground: Early detection and treatment of neuropathy in leprosy is important to prevent disabilities. A recent study showed that the Nerve Conduction Studies (NCS) and Warm Detection Thresholds (WDT) tests can detect leprosy neuropathy the earliest. These two tests are not practical under field conditions, however, because they require climate-controlled rooms and highly trained staff and are expensive. We assessed the usefulness of alternative test methods and their sensitivity and specificity to detect neuropathy at an early stage. Methods: Through a literature search we identified five alternative devices that appeared user-friendly, more affordable, portable and/or battery-operated: the Neuropad®, Vibratip™, NC-Stat®DPNCheck™, NeuroQuick and the Thermal Sensibility Tester (TST), assessing respectively sweat function, vibration sensation, nerve conduction, cold sensation and warm sensation. In leprosy patients in Bangladesh, the posterior tibial and sural nerves that tested normal for the monofilament test and voluntary muscle test were assessed with the NCS and WDT as reference standard tests. The alternative devices were then tested on 94 nerves with abnormal WDT and/or NCS results and on 94 unaffected nerves. Sensitivity and specificity were the main outcomes. Results: The NeuroQuick and the TST showed very good sensitivity and specificity. On the sural nerve, the NeuroQuick had both a sensitivity and a specificity of 86%. The TST had a sensitivity of 83% and a specificity of 82%. Both the NC-Stat®DPNCheck™ and Vibratip™ had a high specificity (88% and 100%), but a low sensitivity (16% and 0%). On the posterior tibial nerve, the NeuroQuick and the TST also showed good sensitivity, but the sensitivity was lower than for the sural nerve. The Neuropad® had a sensitivity of 56% and a specificity of 61%. Conclusions: The NeuroQuick and TST are good candidates for further field-testing for reliability and reproducibility. The feasibility of production on a larger scale should be examined.
    Keywords: Detection ; Field Use ; Leprosy ; Neuropathy ; Subclinical
    Source: NARCIS (National Academic Research and Collaborations Information System)
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  • 4
    Language: English
    In: Catheterization and Cardiovascular Interventions, 01 November 2012, Vol.80(5), pp.756-765
    Description: : The aim of this pilot study was to determine whether early atorvastatin treatment will reduce left ventricle (LV) remodeling, infarct size, and improve microvascular perfusion. : In animal studies, early statin therapy reduces reperfusion injury after a percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Forty‐two consecutive patients (82% male, mean age 61.2 ± 9.8) who underwent a primary PCI for a first ST‐elevated AMI were randomized for pretreatment with atorvastatin 80 mg ( = 20) or placebo ( = 22) and continued with the same dosage daily for 1 week. All patients received atorvastatin 80 mg once daily 7 days after primary PCI. The LV function and infarct size were measured by magnetic resonance imaging within 1 day, at 1 week, and 3 months follow up. The primary endpoint was the end‐systolic volume index (ESVI) at 3 months. Secondary endpoints were global LV function measurements, myocardial infarct size, biochemical cardiac markers, TIMI flow, and ST‐T elevation resolution. : ESVI 3 months after AMI was 25.1 mL/m in the atorvastatin arm and 25.0 mL/m in the placebo arm ( = 0.74). The differences in change from baseline to 3 months follow up in global LV function and myocardial infarct size did not differ between both treatment arms. Furthermore, biochemical markers, TIMI flow, and ST‐T elevation resolution did not differ between atorvastatin and placebo arm. : In this pilot study, pretreatment with atorvastatin in an acute myocardial infarction does not result in an improved cardiac function, microvascular perfusion, or decreased myocardial infarct size. © 2012 Wiley Periodicals Inc.
    Keywords: Microvascular Perfusion ; Hmg‐Coa Reductase Inhibitors ; Remodeling ; Magnetic Resonance Imaging ; Percutaneous Coronary Intervention
    ISSN: 1522-1946
    E-ISSN: 1522-726X
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  • 5
    Language: English
    In: PL o S Neglected Tropical Diseases (Online), 2017, Vol.11(10)
    Description: textabstractCONCLUSION: In our study, a 20-week course of prednisolone was as effective as a 32-week course in improving and restoring recent clinical NFI in leprosy patients. Twenty weeks is therefore the preferred initial treatment duration for leprosy neuropathy, after which likely only a minority of patients require further individualized treatment.BACKGROUND: While prednisolone is commonly used to treat recent nerve function impairment (NFI) in leprosy patients, the optimal treatment duration has not yet been established. In this "Treatment of Early Neuropathy in Leprosy" (TENLEP) trial, we evaluated whether a 32-week prednisolone course is more effective than a 20-week course in restoring and improving nerve function.METHODS: In this multi-centre, triple-blind, randomized controlled trial, leprosy patients who had recently developed clinical NFI (〈6 months) were allocated to a prednisolone treatment regimen of either 20 weeks or 32 weeks. Prednisolone was started at either 45 or 60 mg/day, depending on the patient's body weight, and was then tapered. Throughout follow up, NFI was assessed by voluntary muscle testing and monofilament testing. The primary outcome was the proportion of patients with improved or restored nerve function at week 78. As secondary outcomes, we analysed improvements between baseline and week 78 on the Reaction Severity Scale, the SALSA Scale and the Participation Scale. Serious Adverse Events and the need for additional prednisolone treatment were monitored and reported.RESULTS: We included 868 patients in the study, 429 in the 20-week arm and 439 in the 32-week arm. At 78 weeks, the proportion of patients with improved or restored nerve function did not differ significantly between the groups: 78.1% in the 20-week arm and 77.5% in the 32-week arm (p = 0.821). Nor were there any differences in secondary outcomes, except for a significant higher proportion of Serious Adverse Events in the longer treatment arm.
    Keywords: Research Article ; Medicine And Health Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Research And Analysis Methods ; Research And Analysis Methods ; Biology And Life Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences;
    ISSN: 19352735
    ISSN: 19352727
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  • 6
    In: Circulation: Cardiovascular Genetics, 2015, Vol.8(5), pp.707-716
    Description: BACKGROUND—: Tobacco smoke contains numerous agonists of the aryl hydrocarbon receptor (AhR) pathway, and activation of the AhR pathway was shown to promote atherosclerosis in mice. Intriguingly, cigarette smoking is most strongly and robustly associated with DNA modifications to an AhR pathway gene, the AhR repressor (AHRR). We hypothesized that altered AHRR methylation in monocytes, a cell type sensitive to cigarette smoking and involved in atherogenesis, may be a part of the biological link between cigarette smoking and atherosclerosis. METHODS AND RESULTS—: DNA methylation profiles of AHRR in monocytes (542 CpG sites±150 kb of AHRR, using Illumina 450K array) were integrated with smoking habits and ultrasound-measured carotid plaque scores from 1256 participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Methylation of cg05575921 significantly associated (P=6.1×10) with smoking status (current versus never). Novel associations between cg05575921 methylation and carotid plaque scores (P=3.1×10) were identified, which remained significant in current and former smokers even after adjusting for self-reported smoking habits, urinary cotinine, and well-known cardiovascular disease risk factors. This association replicated in an independent cohort using hepatic DNA (n=141). Functionally, cg05575921 was located in a predicted gene expression regulatory element (enhancer) and had methylation correlated with AHRR mRNA profiles (P=1.4×10) obtained from RNA sequencing conducted on a subset (n=373) of the samples. CONCLUSIONS—: These findings suggest that AHRR methylation may be functionally related to AHRR expression in monocytes and represents a potential biomarker of subclinical atherosclerosis in smokers.
    Keywords: Medicine;
    ISSN: 1942-325X
    E-ISSN: 19423268
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  • 7
    Language: English
    In: Nature Communications, 01 August 2017, Vol.8(1), pp.1-12
    Description: The molecular mechanisms mediating the impact of environmental factors in atherosclerosis are unclear. Here, the authors examine CD14+ blood monocyte’s transcriptome and epigenome signatures to find differential methylation and expression of ARID5B to be associated with human atherosclerosis.
    Keywords: Biology
    E-ISSN: 2041-1723
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  • 8
    Language: English
    In: Pharmacy World & Science, 12/1994, Vol.16(S10), pp.J3-J19
    ISSN: 0928-1231
    E-ISSN: 1573-739X
    Source: Springer (via CrossRef)
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  • 9
    Language: English
    In: Pharmacy World and Science, 1994, Vol.16, pp.J3-J19
    ISSN: 0928-1231
    E-ISSN: 1573-739X
    Source: Springer Science & Business Media B.V.
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