bluuebunny/crossref_metadata_2025_split huggingface dataset:
An incidental finding of a bicuspid aortic valve and pseudocoarctation of the descending aorta in a patient presenting with an acute coronary syndrome: a case report
Authors: Vivekanantham Hari , Cook Stéphane , Stauffer Jean-Christophe 
Published: June 2020

Abstract

Background
Aortic pseudocoarctation (PsCoA) is an elongation of the supra-isthmic aorta with kinking and low-grade narrowing. Consequently, no collateral circulation is found. It is frequently associated with other congenital heart anomalies, such as bicuspid aortic valve (BAV).

Case summary
We report the case of 60-year-old patient who presented to the ED with acute chest pain. Physical examination was remarkable for an elevated blood pressure (BP) and the presence of a systolic murmur on the left lower sternal border. An acute coronary syndrome was suspected and the patient underwent urgent coronary angiogram which showed an occluded obtuse marginal artery. Additionally, the presence of an aortic anomaly was noted during the aortography, and additional work-up, including a thoracic computed tomography angiography and transoesophageal echocardiography, revealed a BAV and a PsCoA of the descending aorta. The patient was discharged after optimizing BP control with oral medication and periodical follow-up was arranged.

Discussion
Aortic PsCoA may mimic true coarctation (CoA), but the absence of a haemodynamically significant descending aortic narrowing and of the typical clinical findings associated with aortic CoA, distinguishes both entities. Treatment is therefore conservative and based on the control of cardiovascular risk factors and in particular of arterial hypertension. Work-up should include imaging of the entire aorta and the search for associated congenital cardiac anomalies, which, if present, should be managed in consequence.
Differential effects of dual antiplatelet therapy in patients presented with acute coronary syndrome vs. stable ischaemic heart disease after coronary artery bypass grafting
Authors: Choi Ki Hong , Song Young Bin , Jeong Dong Seop , Jang Yong Ho , Hong David , Lee Sang Yoon , Youn Taeho , Bak Minjung , Min Kyung Min , Lee Joo Myung , Park Taek Kyu , Yang Jeong Hoon , Hahn Joo-Yong , Choi Jin-Ho , Choi Seung-Hyuk , Chung Su Ryeun , Cho Yang Hyun , Sung Kiick , Kim Wook Sung , Gwon Hyeon-Cheol , Lee Young Tak 
Published: June 2020

Abstract

Aims
The current study sought to evaluate whether long-term clinical outcomes according to the use of dual antiplatelet therapy (DAPT) or single antiplatelet therapy (SAPT) differed between acute coronary syndrome (ACS) and stable ischaemic heart disease (SIHD) patients who underwent coronary artery bypass grafting surgery (CABG).

Methods and results
Between January 2001 and December 2017, 3199 patients with ACS (55.3%) and 2583 with SIHD (44.7%) who underwent isolated CABG were enrolled. The study population was stratified using DAPT or SAPT in ACS patients and SIHD patients. The primary outcome was a cardiovascular death or myocardial infarction (MI) at 5 years. After CABG, DAPT was more frequently used in patients with ACS than in those with SIHD [n = 1960 (61.3%) vs. n = 1313 (50.8%), P &lt; 0.001]. Among patients with ACS, the DAPT group showed a significantly lower risk of cardiovascular death or MI at 5 years than the SAPT group [DAPT vs. SAPT, 4.0% vs. 7.8%, hazard ratio (HR) 0.521, 95% confidence interval (CI) 0.339–0.799; P = 0.003]. In contrast, among patients with SIHD, there was no significant difference in the rate of cardiovascular death or MI at 5 years between the use of DAPT and SAPT (4.0% vs. 4.0%, HR 0.991, 95% CI 0.604–1.626; P = 0.971). These findings were robust to multiple sensitivity analyses and competing risk analysis. In the subgroup analysis, the use of DAPT was associated with a significantly lower risk of cardiovascular death or MI among SIHD patients with a previous percutaneous coronary intervention (PCI), with a significant interaction between the use of DAPT and PCI history (interaction P = 0.011).

Conclusion
Among ACS patients who underwent CABG, the use of DAPT was associated with lower cardiovascular death or MI than the use of SAPT, but this was not the case in SIHD patients.

Trial registration
ClinicalTrials.gov, NCT03870815.
The Last Will be First, and the First Last: Segregation in Societies with Relative Pay-off Concerns*
Authors: Herings P Jean-Jacques , Saulle Riccardo D , Seel Christian 
Published: June 2020

Abstract
This article studies coalition formation among individuals who differ in productivity. We consider egalitarian societies in which coalitions split their surplus equally and individualistic societies in which coalitions split their surplus according to productivity. Preferences of coalition members depend on their material pay-offs, but are also influenced by relative pay-off concerns. The stable partitions in both egalitarian and individualistic societies are segregated, i.e., individuals with adjacent productivities form coalitions. If some individuals are not part of a productive coalition, then these are the least productive ones for egalitarian societies and the most productive ones for individualistic societies.
Teaching about antibiotic resistance to a broad audience: a multidisciplinary approach
Authors: Kvint Kristian , Palm Martin , Farewell Anne 
Published: June 2020

ABSTRACT
Education for the general public about antibiotic resistance is advocated as a key component of our response to this crisis. Since this is a multidisciplinary problem encompassing natural, medical and social sciences, it is an educational challenge as both students and lecturers will have vastly different backgrounds in the topics. Here we describe an online multidisciplinary course on antibiotic resistance spanning topics as diverse as chemistry and practical philosophy. The target group was any post-secondary school student and the participating students had different occupations and educational experience. Although as many as 38% of the students were currently studying natural sciences at university, the course included a diverse group with medical professionals (16%) and teachers (6%) making up a significant fraction of the class. The outcomes based on examination and the course evaluations were very positive and we have indications that the information students gained from this course has been spread to others. Unlike other online courses addressing antibiotic resistance, this course is both accessible to a wide range of students and covers a broad range of topics. We advocate courses like ours as an effective tool in educating the public about this crisis.
The Mental Landscape of Imagining Life Beyond the Current Life Span: Implications for Construal and Self-Continuity
Authors: Tausen Brittany M , Csordas Attila , Macrae C Neil 
Published: June 2020

AbstractBackground and ObjectivesWith rapid advancements in medicine, technology, and nutrition, the future holds the possibility of longer and healthier lives. Despite garnering attention from myriad disciplines, psychological perspectives on life extension are scarce. In three studies, we addressed this gap by exploring key mental characteristics and psychological variables associated with simulating an expanded life span and thus an extremely distant future self.Research Design and MethodsThree studies investigated the construal (i.e., valence, vividness, and visual perspective) of extremely distant future simulations and the extent to which participants felt connected to their future selves (i.e., self-continuity). Studies 1 and 2 investigated the characteristics of imagery associated with different ages ranging from near the current species maximum (e.g., 120, 150) to more highly hypothetical ages (e.g., 201, 501). Study 3 probed the mental construal of extreme aging among different populations (i.e., life-extension supporters, students, and Mechanical Turk workers). Studies also assessed participants’ general feelings about the ethicality and likelihood of techniques that halt or reverse biological aging to help individuals live beyond the current life expectancy.ResultsParticipants in all studies reported being able to vividly imagine expanded aging scenarios (increased chronological, without biological, and aging), but these simulations were characterized by a decreased sense of connection to one’s future self (i.e., self-continuity) compared to a control condition. Temporal distance did not, however, impact ratings of self-continuity when comparing experimental conditions (i.e., imagining one’s self 120 vs 150 or 201 vs 501). Curiously, a sense of self-continuity (when simulating oneself well beyond the current life expectancy) remained intact for individuals who belonged to a community of life-extension supporters. The perceived likelihood and ethicality of extended life-span scenarios also varied significantly across different populations.Discussion and ImplicationsThe current work is the first to quantify the disconnect between one’s current and extremely distant (i.e., beyond the current life expectancy) future self. Given the behavioral implications of feeling disconnected from one’s future self (e.g., failing to save for retirement or care for one’s own physical health), these findings inform a critical barrier of extended life spans and provide insight into potential remedies (e.g., enhancing the perceived likelihood of living longer). Theoretical implications of hypotheticality and temporal distance, two key dimensions of Construal Level Theory, and their impact on the construal and self-continuity associated with future simulations are also discussed.
Detecting 1-D and 2-D ground resonances with a single-station approach
Authors: Sgattoni Giulia , Castellaro Silvia 
Published: June 2020

SUMMARYThe vibration modes of the ground have been described both in the 1-D and 2-D case. The 1-D resonance is found on geological structures whose aspect ratio is low, that is on layers with a lateral width much larger than their thickness. A typical example is that of a horizontal soft sediment layer overlying hard bedrock. In this case, the 1-D resonance frequency, traditionally detected by means of the microtremor H/V (horizontal to vertical spectral ratio) technique, depends on the bedrock depth and on the shear wave velocity of the resonating cover layer. The H/V technique is thus used both to map the resonance frequencies in seismic microzonation studies and for stratigraphic imaging. When 2-D resonance occurs, generally on deep and narrow valleys, the whole sedimentary infill vibrates at the same frequency and stratigraphic imaging can no longer be performed by means of the 1-D resonance equation. Understanding the 1-D or 2-D resonance nature of a site is therefore mandatory to avoid wrong stratigraphic and dynamic interpretations, which is in turn extremely relevant for seismic site response assessment. In this paper, we suggest a procedure to address this issue using single-station approaches, which are much more common compared to the multistation synchronized approach presented by research teams in earlier descriptions of the 2-D resonances. We apply the procedure to the Bolzano sedimentary basin in Northern Italy, which lies at the junction of three valleys, for which we observed respectively 1-D-only, 1-D and 2-D, and 2-D-only resonances. We conclude by proposing a workflow scheme to conduct experimental measurements and data analysis in order to assess the 1-D or 2-D resonance nature of a site using a single-station approach.
Tracing theories in realist evaluations of large-scale health programmes in low- and middle-income countries: experience from Nigeria
Authors: Mirzoev Tolib , Etiaba Enyi , Ebenso Bassey , Uzochukwu Benjamin , Ensor Tim , Onwujekwe Obinna , Huss Reinhard , Ezumah Nkoli , Manzano Ana 
Published: June 2020

Abstract
Realist evaluations (RE) are increasingly popular in assessing health programmes in low- and middle-income countries (LMICs). This article reflects on processes of gleaning, developing, testing, consolidating and refining two programme theories (PTs) from a longitudinal mixed-methods RE of a national maternal and child health programme in Nigeria. The two PTs, facility security and patient–provider trust, represent complex and diverse issues: trust is all encompassing although less tangible, while security is more visible. Neither PT was explicit in the original programme design but emerged from the data and was supported by substantive theories. For security, we used theories of fear of crime, which perceive security as progressing from structural, political and socio-economic factors. Some facilities with the support of communities erected fences, improved lighting and employed guards, which altogether contributed to reduced fear of crime from staff and patients and improved provision and uptake of health care. The social theories for the trust PT were progressively selected to disentangle trust-related micro, meso and macro factors from the deployment and training of staff and conditional cash transfers to women for service uptake. We used taxonomies of trust factors such as safety, benevolent concerns and capability. We used social capital theory to interpret the sustainability of ‘residual’ trust after the funding for the programme ceased. Our overarching lesson is that REs are important though time-consuming ways of generating context-specific implications for policy and practice within ever-changing contexts of health systems in LMICs. It is important to ensure that PTs are ‘pitched at the right level’ of abstraction. The resource-constrained context of LMICs with insufficient documentation poses challenges for the timely convergence of nuggets of evidence to inform PTs. A retroductive approach to REs requires iterative data collection and analysis against the literature, which require continuity, coherence and shared understanding of the analytical processes within collaborative REs.
Fecal Calprotectin Thresholds to Predict Endoscopic Remission Using Advanced Optical Enhancement Techniques and Histological Remission in IBD Patients
Authors: Cannatelli Rosanna , Bazarova Alina , Zardo Davide , Nardone Olga Maria , Shivaji Uday , Smith Samuel Charles Lloyd , Gkoutos Georgios , Ricci Chiara , Gui Xianyong Sean , Ghosh Subrata , Iacucci Marietta 
Published: June 2020

Abstract

Background
Fecal calprotectin (FC) is a common surrogate marker of mucosal healing (MH) in patients with ulcerative colitis (UC) and Crohn’s disease (CD). We investigated the optimum FC thresholds for defining endoscopic remission (ER) and histological remission (HR) using advanced endoscopic techniques.

Patients and Methods
In this cross-sectional study, we collected clinical, endoscopic, histological data, and FC from 76 UC and 41 CD patients. Receiver operating characteristic curves were created to evaluate the optimum cut-off of FC to predict ER evaluated by Mayo Endoscopic Score (MES), Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and modified PICaSSO (Paddington International Virtual Chromoendoscopy Score) for UC patients and Simple Endoscopic Score (SES-CD) in CD patients; and HR was scored by the Robarts Histology Index (RHI) and Nancy Index for UC and modified Riley for CD.

Results
In UC patients, the best thresholds of FC to identify ER calculated with MES, UCEIS, and modified PICaSSO were 112, 148, and 161 mcg/g with accuracy of 86.9% 86.8%, and 81.6%, respectively. The best value of FC to predict HR was 112 mcg/g and 172 mcg/g with accuracy of 84.2% and 81.6% for RHI and Nancy Index, respectively.
In CD patients, the best cut-off of FC to predict ER was 96 mcg/g with accuracy of 82.9%. The HR was best predicted by an FC value of 225 mcg/g with accuracy of 75.6%.

Conclusions
The FC value threshold between 112 and 172 mcg/g could identify ER and HR in UC patients, whereas a value under 225 mcg/g should be considered for CD patients.
Early Combined Immunosuppression May Be More Effective for Reducing Complications in Isolated Colonic- vs Ileal-Dominant Crohn Disease
Authors: Dulai Parambir S , Jairath Vipul , Zou Guangyong , Stitt Larry W , Khanna Reena , Sandborn William J , Feagan Brian G , Singh Siddharth 
Published: June 2020

Abstract

Background
We assessed whether differential efficacy of early combined immunosuppression (ECI) in comparison with conventional management (CM) is present in patients with Crohn disease (CD) according to disease location.

Methods
In this posthoc analysis of the Randomized Evaluation of an Algorithm for Crohn’s Treatment trial, the effect of ECI vs CM modified by disease location (isolated-colonic vs ileal-dominant) in terms of time to first complication (hospitalization, surgery, or disease-related complications—presence of a new abscess, fistula, or stricture; serious worsening of disease activity; extraintestinal manifestations) was analyzed using a marginal Cox proportional hazard model to account for cluster randomization. Factors adjusted included practice size, country, and other covariates selected in a backward logistic regression analysis with the first composition as outcome and P &lt; 0.10.

Results
Of the 1969 patients with CD, 435 had isolated colonic CD (ECI n = 257, CM n = 178) and 1534 had ileal CD (ECI n = 817, CM n = 717). Over 24 months there was a significant differential impact for ECI vs CM for reducing the risk of a CD-related complication between patients with colonic CD and ileal CD (colonic CD hazard ratio [HR] = 0.51; 95% CI, 0.30-0.85 vs ileal CD HR = 0.79; 95% CI, 0.57-1.10; P = 0.033). No difference was identified between ECI vs CM for reducing the risk of surgery (colonic HR = 0.52 vs ileal HR = 0.74; P = 0.468) or hospitalization (colonic HR = 0.77 vs ileal HR = 0.83; P = 0.806).

Conclusions
In this posthoc analysis of the Randomized Evaluation of an Algorithm for Crohn’s Treatment trial, symptom-based ECI was associated with greater efficacy for reducing the risk of CD-related complications in patients with colonic disease location relative to ileal disease location.
Association Between Common Vaginal Infections and Cervical Non–Human Papillomavirus (HPV) 16/18 Infection in HPV-Vaccinated Women
Authors: Hu Shang-Ying , Tsang Sabrina H , Chen Feng , Pan Qin-Jing , Zhang Wen-Hua , Hong Ying , Sampson Joshua N , Hildesheim Allan , Zhao Fang-Hui , Kreimer Aimée R 
Published: June 2020

Abstract

Background
How vaginal infections such as bacterial vaginosis, Candida spp, and Trichomonas vaginalis affect persistence of human papillomavirus (HPV) infection is not well established. Our study aimed to evaluate the association between common vaginal infections and cervical non-HPV16/18 infection, as risk factors associated with persistence of nonvaccine HPV types will become increasingly relevant in the setting of HPV vaccination.

Methods
We performed an analysis in 2039 AS04-HPV16/18–vaccinated women enrolled in a phase II/III trial in China, who were HPV DNA negative at month 0 and 6 and had at least 1 subsequent follow-up visit. Vaginal infections were detected in liquid-based cytology according to the diagnostic criteria of the Bethesda System. Associations between vaginal infections and incident and 6-month persistent non-HPV16/18 infections in the cervix were evaluated using generalized estimating equations, adjusting for the age at initial vaccination, as well as HPV types in the persistence analysis.

Results
Study visits with any vaginal infection had a statistically significant increased risk of incident non-HPV16/18 infection compared to those without vaginal infections (odds ratio [OR], 1.44 [95% confidence interval {CI}, 1.09–1.92]). However, vaginal infections were not associated with 6-month persistent non-HPV16/18 infection (OR, 1.02 [95% CI, .62–1.69]).

Conclusions
Our study suggests that common vaginal infections are not associated with persistence of non-HPV16/18 infection among HPV16/18-vaccinated women.
Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research Consortium
Authors: Johnson Melissa D , Lewis Russell E , Dodds Ashley Elizabeth S , Ostrosky-Zeichner Luis , Zaoutis Theoklis , Thompson George R , Andes David R , Walsh Thomas J , Pappas Peter G , Cornely Oliver A , Perfect John R , Kontoyiannis Dimitrios P 
Published: June 2020

AbstractIn recent years, the global public health community has increasingly recognized the importance of antimicrobial stewardship (AMS) in the fight to improve outcomes, decrease costs, and curb increases in antimicrobial resistance around the world. However, the subject of antifungal stewardship (AFS) has received less attention. While the principles of AMS guidelines likely apply to stewarding of antifungal agents, there are additional considerations unique to AFS and the complex field of fungal infections that require specific recommendations. In this article, we review the literature on AMS best practices and discuss AFS through the lens of the global core elements of AMS. We offer recommendations for best practices in AFS based on a synthesis of this evidence by an interdisciplinary expert panel of members of the Mycoses Study Group Education and Research Consortium. We also discuss research directions in this rapidly evolving field. AFS is an emerging and important component of AMS, yet requires special considerations in certain areas such as expertise, education, interventions to optimize utilization, therapeutic drug monitoring, and data analysis and reporting.
Efficient T-Cell Compartment in HIV-Positive Patients Receiving Orthotopic Liver Transplant and Immunosuppressive Therapy
Authors: Franceschini Erica , De Biasi Sara , Digaetano Margherita , Bianchini Elena , Lo Tartaro Domenico , Gibellini Lara , Menozzi Marianna , Zona Stefano , Tarantino Giuseppe , Nasi Milena , Codeluppi Mauro , Guaraldi Giovanni , Magistri Paolo , Di Benedetto Fabrizio , Pinti Marcello , Mussini Cristina , Cossarizza Andrea 
Published: June 2020

Abstract

Background
In patients undergoing orthotopic liver transplant (OLT), immunosuppressive treatment is mandatory and infections are leading causes of morbidity/mortality. Thus, it is essential to understand the functionality of cell-mediated immunity after OLT. The aim of the study was to identify changes in T-cell phenotype and polyfunctionality in human immunodeficiency virus–positive (HIV+) and –negative (HIV–) patients undergoing immunosuppressive treatment after OLT.

Methods
We studied peripheral blood mononuclear cells from 108 subjects divided into 4 groups of 27: HIV+ transplanted patients, HIV– transplanted patients, HIV+ nontransplanted patients, and healthy subjects. T-cell activation, differentiation, and cytokine production were analyzed by flow cytometry.

Results
Median age was 55 years (interquartile range, 52–59 years); the median CD4 count in HIV+ patients was 567 cells/mL, and all had undetectable viral load. CD4+ and CD8+ T-cell subpopulations showed different distributions between HIV+ and HIV– OLT patients. A cluster representing effector cells expressing PD1 was abundant in HIV– transplanted patients and they were characterized by higher levels of CD4+ T cells able to produce interferon-γ and tumor necrosis factor–α.

Conclusions
HIV– transplanted patients have more exhausted or inflammatory T cells compared to HIV+ transplanted patients, suggesting that patients who have already experienced a form of immunosuppression due to HIV infection respond differently to anti-rejection therapy.