bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weighing the potential late benefits versus early hazard associated with bioresorbable vascular scaffolds in percutaneous coronary interventions: a Markov decision analytic model
Authors: Fazel Reza , Vilain Katherine A. , Cohen David J. , Yeh Robert W. 
Published: October 2019

Objective
Use of poly-L-lactic acid-based bioresorbable scaffolds (BRS) has been associated with increased risk of device thrombosis during the first 3 years after implantation as compared to metallic everolimus-eluting stents (EES). The long-term performance of BRS relative to EES remains unknown.

Methods
We used a Markov decision analysis model to evaluate the effectiveness of BRS vs. EES over a lifetime horizon. In addition to one-way sensitivity analyses of key variables, we evaluated the impact of optimal implantation technique and limiting procedures to larger vessels (>2.6 mm in diameter) on model results.

Results
Assuming no risk of target lesion revascularization for BRS after 3 years, we found a small increment in quality-adjusted life expectancy (QALE) of 0.02 with the use of BRS relative to EES, with benefit being observed after 21.8 years. Optimal implantation technique and limiting to larger vessels resulted in larger gains in QALE (0.08 and 0.06, respectively) with BRS and shorter times to equipoise (6.7 and 8.3 years, respectively). Model results were highly sensitive to variations in the relative risk of stent thrombosis (BRS vs. EES).

Conclusions
Based on currently available data, it would take approximately 21.8 years for the presumed late benefits of current BRS relative to EES to overcome the early hazard associated with their use under favorable assumptions. Optimal implantation technique and limiting procedures to larger vessels improved BRS performance and reduced time to equipoise. Eliminating the higher BRS thrombosis risk is necessary in developing future generations of BRS as an acceptable alternative to EES.
SWEDEHEART-1-year data show no benefit of newer generation drug-eluting stents over bare-metal stents in patients with severe kidney dysfunction following percutaneous coronary intervention
Authors: Edfors Robert , James Stefan , Szummer Karolina , Evans Marie , Carrero Juan-Jesus , Faxén Jonas , Persson Jonas , Spaak Jonas , Varenhorst Christoph , Jernberg Tomas , Lagerqvist Bo 
Published: October 2019

Background
We hypothesized that the transition from bare-metal stents (BMS) to newer generation drug-eluting stents (n-DES) in clinical practice may have reduced the risk also in patients with kidney dysfunction.

Methods:
Observational study in the national SWEDEHEART registry, that compared the 1-year risk of in-stent restenosis (RS) and stent thrombosis (ST) in all percutaneous coronary intervention treated patients(n = 92 994) during 2007–2013.

Results:
N-DES patients were younger than BMS, but had more often diabetes, previous myocardial infarction, previous revascularization and were more often treated with potent platelet inhibition. N-DES versus BMS, was associated with lower 1-year risk of RS in patients with estimated glomerular filtration rate (eGFR) >60 with a cumulative probability of 2.1% versus 5.3%, adjusted hazard ratio 0.30, 95% CI (0.27–0.34) and with eGFR 30–60: 3.0% versus 4.9%; hazard ratio 0.46 (0.36–0.60) but not in patients with eGFR <30: 8.1% versus 6.0%; hazard ratio 1.32 (0.71–2.45) (pinteraction = 0.009) as well as lower risk of ST for eGFR >60 and eGFR 30–60: 0.5% versus 0.9%; hazard ratio 0.52 (0.40–0.68) and 0.6% versus 1.3%; hazard ratio 0.54 (0.54–0.72) but not for eGFR <30; 2.1% versus 1.1%; hazard ratio 1.49 (0.56–3.98) (pinteraction = 0.027).

Conclusion:
N-DES is associated with lower 1-year risk of in-stent restenosis and stent thrombosis in patients with normal or moderately reduced kidney function but not in patients with severe kidney dysfunction, where stenting is associated with worse outcomes regardless of stent type.
Effect of intracoronary tirofiban following aspiration thrombectomy on infarct size, in patients with large anterior ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
Authors: Basuoni Ahmed , El-Naggar Wael , Mahdy Mohamed , Al-Kaffas Sameh 
Published: October 2019

Background
Myocardial recovery following primary percutaneous coronary intervention is often suboptimal despite of restoration of thrombolysis in myocardial infarction (TIMI) 3 flow, in part due to thrombus embolization which results in impairing microvascular reperfusion besides increasing infarct size. The purpose of the present study was to estimate the effect of aspiration thrombectomy followed by intracoronary delivery of tirofiban on decreasing the infarct size utilizing cardiac MRI (cMR) in large anterior ST-segment elevation myocardial infarction (STEMI) patients.

Patients
A prospective randomized controlled study of 100 patients with large anterior STEMI were randomized to (Study group) using intracoronary tirofiban (intracoronary) and (control group) without intocoronary tirofiban. A 6 F thrombus aspiration catheter was used in all patients. Tirofiban was injected locally at the place of the highly thrombus burden through the aspiration device after flushing the aspiration device well.

Results
Patients of intracoronary tirofiban group compared with control group had a significant difference in decreasing the infarct size at 30 days [median, 15.451 g – interquartile range (IQR), 17.404 gm – n = 50] vs (median, 43.828 g – IQR, 49.599 g – n = 50) P value = 0.002.

Conclusion
In patients early presented with large anterior STEMI, infarct size at 30 days was significantly decreased by intracoronary tirofiban delivered to the infarct lesion site followed aspiration thrombectomy.
Vascular reactivity to mental stress is associated with poor cardiovascular disease outcomes in females following acute coronary syndrome
Authors: Widmer Robert J. , Prasad Megha , Gomaa Mohammed , Sara Jaskanwal Deep S. , Reriani Martin K. , Lerman Lilach O. , Suwaidi Jassim Al , Lerman Amir 
Published: October 2019

Background:
We aimed to test the hypothesis that peripheral endothelial dysfunction induced by mental stress may predict cardiovascular events after acute coronary syndrome beyond traditional cardiovascular disease risk factors.

Methods:
This was a prospective study in which 417 patients who had acute coronary syndrome were enrolled in two sites at the US and Qatar. Cardiovascular disease risk factors such as past medical history, blood pressure, heart rate, peripheral endothelial dysfunction, and response to three different mental stress examinations (Stroop Color Word, Arithmetic, and Spiral Omnibus) as assessed by ratio of reactive hyperemia tonometry (EndoPAT) with stress over EndoPAT at rest were obtained at baseline. Major adverse cardiac events were then recorded at 1 year after the index event.

Results:
There were no differences in baseline peripheral endothelial dysfunction or vascular response to mental stress between the US vs. Qatar patients. Women were more likely to experience major adverse cardiac events in the year following acute coronary syndrome (relative risk 2.42, 95% confidence interval 1.53–3.84, P = 0.044), and had a significantly lower mental stress ratio compared to women who did not (1.0 ± 0.17 vs. 1.20 ± 0.17, P = 0.04). In multivariate analyses stratified by sex, baseline peripheral endothelial dysfunction (EndoPAT < 1.7) (χ2 = 8.0, P = 0.005) and mental stress ratio (χ2 = 7.7, P = 0.006), were independently predictive of major adverse cardiac events in women, but not men.

Conclusion:
The current study demonstrates that in women both baseline endothelial function and vascular function in response to mental stress ratio are predictive of worse cardiovascular disease outcomes 1 year after acute coronary syndrome. The study may suggest an important mechanism for adverse clinical outcomes in women following acute coronary syndrome.
Profiling the patient with autoimmune hepatitis on calcineurin inhibitors: a real-world-experience
Authors: Pape Simon , Nevens Frederik , Verslype Chris , Mertens Caroline , Drenth Joost P.H. , Tjwa Eric T.T.L. 
Published: October 2019

Objective
Therapy for autoimmune hepatitis (AIH) consists of steroid induction therapy, followed by maintenance therapy with azathioprine. However, up to 20% of patients experience either insufficient response or intolerance on first-line therapy. Calcineurin inhibitors (CNIs) are frequently used when first-line therapy fails. Although a number of studies report on efficacy, less is known on the patient trajectory before switch to CNIs. Our aim was to describe the road toward CNI therapy in AIH patients.

Methods
Patients with an AIH diagnosis who used CNIs as either second- or third-line treatment were included in the study. Reason for switch to CNI was assessed as either an insufficient response or intolerance to prior therapy. Efficacy was assessed by normalization of transaminases at last moment of follow-up.

Results
Final analysis included 20 patients who were treated with CNIs. Ten patients were treated with tacrolimus and ten patients received cyclosporine. In patients who used CNI treatment as third-line therapy (n = 13), duration of first-line therapy was almost twice as long as duration of second-line therapy (2.58 years vs. 1.33 years; P = 0.67). Patients treated with tacrolimus had relatively high trough levels (7.6 ng/mL) and more (minor) adverse events. Fifty-five percent of patients had normalization of transaminases at last moment of follow-up.

Conclusion
CNI treatment in AIH as second- or third-line therapy is effective in ~50% of patients. The trajectory before switch varies considerably between patients.
Cascade of Provider-Initiated Human Immunodeficiency Virus Testing and Counselling at Specific Life Events (Pregnancy, Sexually Transmitted Infections, Marriage) in Côte d'Ivoire
Authors: Inghels Maxime , Kouassi Arsène Kra , Niangoran Serge , Bekelynck Anne , Carillon Séverine , Sika Lazare , Danel Christine , Kone Mariatou , du Loû Annabel Desgrées , Larmarange Joseph 
Published: October 2019

Background
Despite the implementation of Provider Initiated Testing and Counselling (PITC) in 2009, PITC coverage remains low in Cote d'Ivoire. The purpose of this study is to determine whether an human immunodeficiency virus (HIV) test was offered and performed at specific life events where PITC is recommended by national guidelines.

Methods
In 2017, a cross-sectional telephone survey was conducted among a representative sample of 3,867 adults from the general population in Côte d'Ivoire. The occurrences of the following events over the past 5 years were documented: pregnancy (event A) or partner's pregnancy (event B) of the last child, sexually transmitted infection (event C) and marriage (event D). For each of these events, participants were asked (i) if they consulted a health care professional, (ii) if they were offered an HIV test during that consultation and (iii) if they accepted it.

Results
Consulting a health care provider was reported by 94.9%, 58.3%, 70.3% and 19.1% of those who reported events A, B, C and D respectively. In case of medical consultations following events A, B, C and D, respectively 70.1%, 33.1%, 28.1%, and 78.8% of individuals were offered an HIV test. The testing acceptance was high regardless of the event. Overall, testing coverage was 63.7%, 16.9%, 13.4% and 14.5% for events A, B, C and D respectively.

Conclusions
Increasing HIV testing coverage in Côte d'Ivoire requires (i) facilitating attendance to health services in case of sexually transmitted infections, marriage and pregnancy—for men—and (ii) strengthening routine testing offer on these occasions.
Brief Report: Yield and Efficiency of Intensified Tuberculosis Case-Finding Algorithms in 2 High-Risk HIV Subgroups in Uganda
Authors: Semitala Fred C. , Cattamanchi Adithya , Andama Alfred , Atuhumuza Elly , Katende Jane , Mwebe Sandra , Asege Lucy , Nakaye Martha , Kamya Moses Robert , Yoon Christina 
Published: October 2019

Background:
Tuberculosis (TB) risk varies among different HIV subgroups, potentially impacting intensified case finding (ICF) performance. We evaluated the performance of the current ICF algorithm [symptom screening, followed by Xpert MTB/RIF (Xpert) testing] in 2 HIV subgroups and evaluated whether ICF performance could be improved if TB screening was based on C-reactive protein (CRP) concentrations.

Methods:
We enrolled consecutive adults with CD4 counts ≤350 cells/µL initiating antiretroviral therapy and performed symptom screening, CRP testing using a low-cost point-of-care (POC) assay, and collected sputum for Xpert testing. We compared the yield and efficiency of the current ICF algorithm to POC CRP-based ICF among patients new to HIV care and patients engaged in care.

Results:
Of 1794 patients, 126/1315 (10%) new patients and 21/479 (4%) engaged patients had Xpert-positive TB. The current ICF algorithm detected ≥98% of all TB cases in both subgroups but required ≥85% of all patients to undergo Xpert testing. POC CRP-based ICF halved the proportion of patients in both subgroups requiring Xpert testing relative to the current ICF algorithm and had lower yield among patients engaged in care [81% vs. 100%, difference −19% (95% confidence interval: −41 to 3)]. Among patients new to care, POC CRP-based ICF had similar yield as the current ICF algorithm [93% vs. 98%, difference −6% (95% confidence interval: −11 to 0)].

Conclusions:
Among patients new to care, POC CRP-based screening can improve ICF efficiency without compromising ICF yield, whereas symptom-based screening may be necessary to maximize ICF yield among patients engaged in care.
The Fight Against HIV Is a Fight for Human Rights: A Personal Reflection
Authors: Coates Thomas J. 
Published: October 2019

Abstract:
The fight against HIV started and continues to be a fight for human rights. AIDS was observed first in the United States in marginalized and stigmatized populations such as men who have sex with men, injection drug users, and commercial sex workers. Next were the observations of generalized epidemics in sub-Saharan Africa, a continent crippled by the legacy of colonialism. AIDS appeared in post-World War II, which witnessed independence of the former European colonies and the creation of the United Nations. There was remarkable advocacy that led to important advances in the rights of ethnic and racial minorities, sexual minorities, and women. This foundation of activism laid the groundwork to ensure that AIDS, and those infected with HIV, were addressed using the best of human rights frameworks. Social and behavioral sciences contributed important data to the human rights advances in the second half of the 20th century, and to the tools and resources needed for a human rights-based response to HIV. Remarkable investment in science have brought us new tools to treat and prevent HIV. Vigorous social and behavioral science research continues to be needed to ensure that the continued response to the HIV epidemic remains evidence-based, recognizing human rights, and ensuring that the scientific advances are available to everyone who needs them. Generations of scientists and activists need to continue as we are far from finished in the fight against HIV and for human rights.
Getting to Zero Begins With Getting to Ten
Authors: Auerbach Judith D. 
Published: October 2019

Background Statement:
The global “90-90-90” targets introduced by UNAIDS in 2014—90% of people living with HIV will know their HIV status; 90% of those will be on antiretroviral treatment; and 90% of those will achieve viral suppression by 2020—have become more than a useful heuristic device, and now are the predominant framework for monitoring progress in the HIV response. Although this allows for important reflection on where HIV treatment gaps and opportunities exist in any particular context and globally, it deflects attention away from other very important aspects of HIV epidemics and their often-disproportionate impact on specific populations. Most significantly, it begs the question, what about the other 10-10-10?

Approach:
This article takes a critical look at the 90-90-90 targets and what is known about the 10-10-10 left behind to highlight some core issues and attendant questions that should be prioritized if we really intend to “get to zero.”

Findings and Conclusions:
These issues include how the targets are measured in the first place, the limitations of focusing the global response only on antiretroviral treatment and only on people already living with HIV, and the need for more, basic social research to address the range of factors underlying disparities in who are and are not reached in the 90-90-90 framework.
Identifying Opportunities for Collaboration Across the Social Sciences to Reach the 10-10-10: A Multilevel Approach
Authors: Vincent Wilson , Sevelius Jae , Lippman Sheri A. , Linnemayr Sebastian , Arnold Emily A. 
Published: October 2019

Background:
The national and global strategy to combat HIV, often referred to as the “90-90-90,” aims to diagnose 90% of people living with HIV, get 90% of those diagnosed onto antiretroviral treatment (ART), and achieve viral suppression in 90% of those on ART. The remaining 10-10-10 who will be undiagnosed, not on ART, or not virally suppressed, include vulnerable persons and populations most affected by social determinants of health. Given their foci on the social determinants of health at the individual, social, and structural levels, social scientists are in a prime position to help reach the 10-10-10. A potentially effective way for social scientists to achieve this goal is to examine the issues that affect the 10-10-10 using a multilevel framework, to understand at what levels their own approaches fit within such a multilevel framework, and to seek intentional collaborations with other social scientists who may work at different levels but whose approaches may complement their own within multilevel collaborations.

Approach:
The present article describes how a multilevel framework can guide collaboration across disciplines within the social sciences toward the common goal of reaching the 10-10-10.

Conclusions:
Within a multilevel framework, social scientists can work collaboratively to address the needs of individuals among the 10-10-10 within the social and structural contexts (eg, social norms, stigma, poverty, and barriers to care) that affect their health. Such an approach draws on the unique strengths and approaches of different social-science disciplines while also building capacity for individuals most affected by social determinants of health.
Association Between Diagnoses of Chronic Noncancer Pain, Substance Use Disorder, and HIV-Related Outcomes in People Living With HIV
Authors: Denis Cecile M. , Morales Knashawn H. , Wu Qufei , Metzger David S. , Cheatle Martin D. 
Published: October 2019

Background:
Chronic pain is common in people living with HIV (PLWH). Few studies have evaluated the association between the diagnoses of chronic pain, substance use disorder (SUD), and HIV-related outcomes in clinical settings over a 10-year period.

Methods:
Using electronic medical records, the study described psychiatric diagnoses, pain medication, and HIV-related variables in PLWH and examined the factors associated with pain diagnosis and HIV-related outcomes.

Results:
Among 3528 PLWH, more than one-third exhibited a chronic pain diagnosis and more than one-third a psychiatric disorder. Chronic pain diagnosis has been associated with SUD and mood and anxiety disorders and occurred before SUD or psychiatric disorders about half of the time. Opioids have been commonly prescribed for pain management, more often than nonopioid analgesic, without any change in prescription pattern over the 10-year period. A dual diagnosis of pain and SUD has been associated with more psychiatric disorders and had a negative impact on the pain management by requesting more health care utilization and higher frequency of both opioid and nonopioid medication prescriptions. Chronic pain and SUD had a negative impact on ART adherence. SUD but not chronic pain has been associated with an unsuppressed HIV viral load.

Conclusions:
In the current intertwining opioid prescription and opioid epidemic, opioids are still commonly prescribed in PLWH in HIV care. A diagnosis of chronic pain and/or SUD worsened the HIV-related outcomes, emphasizing the potential risk of the HIV epidemic. These findings called for a better coordinated care program in HIV clinics.
Coupling functions: dynamical interaction mechanisms in the physical, biological and social sciences
Authors: Stankovski Tomislav , Pereira Tiago , McClintock Peter V. E. , Stefanovska Aneta 
Published: October 2019

Dynamical systems are widespread, with examples in physics, chemistry, biology, population dynamics, communications, climatology and social science. They are rarely isolated but generally interact with each other. These interactions can be characterized by coupling functions—which contain detailed information about the functional mechanisms underlying the interactions and prescribe the physical rule specifying how each interaction occurs. Coupling functions can be used, not only to understand, but also to control and predict the outcome of the interactions. This theme issue assembles ground-breaking work on coupling functions by leading scientists. After overviewing the field and describing recent advances in the theory, it discusses novel methods for the detection and reconstruction of coupling functions from measured data. It then presents applications in chemistry, neuroscience, cardio-respiratory physiology, climate, electrical engineering and social science. Taken together, the collection summarizes earlier work on coupling functions, reviews recent developments, presents the state of the art, and looks forward to guide the future evolution of the field.
This article is part of the theme issue ‘Coupling functions: dynamical interaction mechanisms in the physical, biological and social sciences’.
Dynamical disentanglement in an analysis of oscillatory systems: an application to respiratory sinus arrhythmia
Authors: Rosenblum M. , Frühwirth M. , Moser M. , Pikovsky A. 
Published: October 2019

We develop a technique for the multivariate data analysis of perturbed self-sustained oscillators. The approach is based on the reconstruction of the phase dynamics model from observations and on a subsequent exploration of this model. For the system, driven by several inputs, we suggest a dynamical disentanglement procedure, allowing us to reconstruct the variability of the system's output that is due to a particular observed input, or, alternatively, to reconstruct the variability which is caused by all the inputs except for the observed one. We focus on the application of the method to the vagal component of the heart rate variability caused by a respiratory influence. We develop an algorithm that extracts purely respiratory-related variability, using a respiratory trace and times of R-peaks in the electrocardiogram. The algorithm can be applied to other systems where the observed bivariate data can be represented as a point process and a slow continuous signal, e.g. for the analysis of neuronal spiking.This article is part of the theme issue ‘Coupling functions: dynamical interaction mechanisms in the physical, biological and social sciences’.