bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-Preferences Favoring Treatment Discontinuation Are Reduced With Vedolizumab and Ustekinumab Compared With TNF Antagonists in Inflammatory Bowel Disease
Authors: Kumar Anand , Kim Emilie S , Kozan Philip , Jacob Vinita , Longman Randy S , Scherl Ellen J , Battat Robert J , Lukin Dana J 
Published: September 2020

Abstract

Background
Nonadherence to biologic therapy in inflammatory bowel disease (IBD) is associated with risk of relapse, immunogenicity, and disease complications. Significant nonadherence prevalence is reported with tumor necrosis factor (TNF) antagonists but the risk of nonadherence with newer biologics with better safety profiles is unknown. This study aimed to investigate if IBD patient-preferences favoring biologic discontinuation vary by biologic class and analyze factors associated with such preferences.

Methods
A convenience sample of 200 adults with IBD on biologic therapy treated at an academic outpatient center was surveyed using a 22-point questionnaire. Patient-preference favoring treatment discontinuation between TNF-antagonist and non-TNF-antagonist biologics [vedolizumab (VDZ)/ustekinumab (UST)] was compared using χ 2 test. Risk factors associated with a preference to discontinue biologic therapy were evaluated using univariable and multivariable logistic regression, and Spearman rank correlation analyses.

Results
A total of 190 questionnaires were analyzed that contained data on preferences regarding biologic discontinuation (median age 36 years, 62% were females; 63% had Crohn disease; 56% were receiving a TNF antagonist, 31% VDZ, and 14% UST). Overall, 32% patients reported a preference to discontinue biologic treatment with a higher proportion among those receiving a TNF antagonist compared with VDZ/UST (39.6% vs 21.4%; P &lt; 0.01). Current VDZ/UST use was independently associated with a reduced odds of patient-preference favoring biologic discontinuation [adjusted odds ratio: 2.67 (1.42–5.01); P &lt; 0.01]. The most concerning factor to patients was the perceived risk of side effects. Patients on VDZ/UST perceived their therapy to be safer than those receiving a TNF antagonist (r = 0.2, P = 0.04).

Conclusions
Patient-preference favoring treatment discontinuation is improved with VDZ/UST compared with TNF-antagonist biologic therapy.
Apical hypertrophic cardiomyopathy, are low-risk patients really at low risk? A case report
Authors: Files Flores Rui , Mané Fernando , Antunes Nuno , Pereira Vítor Hugo 
Published: September 2020

Abstract

Background
Hypertrophic cardiomyopathy (HCM) is a genetically determined myocardial disease that constitutes the main cause of sudden cardiac death (SCD) in young athletes. Apical HCM (ApHCM) represents a complex subset of patients, whose risk of SCD seems not negligible. Most applied scores likely underestimate the risk of heart events in this subset of patients.

Case summary
We report the case of a 55-year-old man who was admitted in the emergency department after an episode of aborted sudden death due to ventricular fibrillation. The electrocardiogram made at admission was noted for atrial fibrillation and a new-onset left bundle branch block. Emergency coronary angiography was normal. The electrocardiogram was repeated and showed symmetrical and profound inversion of T waves in the lateral leads. Transthoracic echocardiogram and cardiac magnetic resonance revealed left ventricular apical hypertrophy suggestive of apical variant of HCM. A cardiac defibrillator was implanted for secondary prevention of SCD. After 6 months of follow-up no further rhythmic events were noted.

Discussion
Although low, the risk of SCD of ApHCM patients is not negligible. This case illustrates the need for searching of new predictors of rhythmic risk in patients with ApHCM.
Prospective follow-up in various subtypes of cardiomyopathies: insights from the ESC EORP Cardiomyopathy Registry
Authors: Gimeno Juan R , Elliott Perry M , Tavazzi Luigi , Tendera Michal , Kaski Juan P , Laroche Cecile , Barriales-Villa Roberto , Seferovic Petar , Biagini Elena , Arbustini Eloisa , Lopes Luis R , Linhart Ales , Mogensen Jens , Hagege Albert , Espinosa Maria A , Saad Aly , Maggioni Aldo P , Caforio Alida L P , Charron Philippe H ,   the EORP Cardiomyopathy Registry Investigators group
Published: September 2020

Abstract

Aims
The European Society of Cardiology (ESC) European Observational Research Programme (EORP) Cardiomyopathy Registry is a prospective multinational registry of consecutive patients with cardiomyopathies. The objective of this report is to describe the short-term outcomes of adult patients (≥18 years old).

Methods and results
Out of 3208 patients recruited, follow-up data at 1 year were obtained in 2713 patients (84.6%) [1420 with hypertrophic (HCM); 1105 dilated (DCM); 128 arrhythmogenic right ventricular (ARVC); and 60 restrictive (RCM) cardiomyopathies]. Improvement of symptoms (dyspnoea, chest pain, and palpitations) was globally observed over time (P &lt; 0.05 for each). Additional invasive procedures were performed: prophylactic implantation of implantable cardioverter-defibrillator (ICD) (5.2%), pacemaker (1.2%), heart transplant (1.1%), ablation for atrial or ventricular arrhythmia (0.5% and 0.1%). Patients with atrial fibrillation increased from 28.7% to 32.2% of the cohort. Ventricular arrhythmias (VF/ventricular tachycardias) in ICD carriers (primary prevention) at 1 year were more frequent in ARVC, then in DCM, HCM, and RCM (10.3%, 8.2%, 7.5%, and 0%, respectively). Major cardiovascular events (MACE) occurred in 29.3% of RCM, 10.5% of DCM, 5.3% of HCM, and 3.9% of ARVC (P &lt; 0.001). MACE were more frequent in index patients compared to relatives (10.8% vs. 4.4%, P &lt; 0.001), more frequent in East Europe centres (13.1%) and least common in South Europe (5.3%) (P &lt; 0.001). Subtype of cardiomyopathy, geographical region, and proband were predictors of MACE on multivariable analysis.

Conclusions
Despite symptomatic improvement, patients with cardiomyopathies remain prone to major clinical events in the short term. Outcomes were different not only according to cardiomyopathy subtypes but also in relatives vs. index patients, and according to European regions.
Concordance of Immunohistochemistry-Based and Gene Expression-Based Subtyping in Breast Cancer
Authors: Holm Johanna , Yu Nancy Yiu-Lin , Johansson Annelie , Ploner Alexander , Hall Per , Lindström Linda Sofie , Czene Kamila 
Published: September 2020

Abstract

Background
Use of immunohistochemistry-based surrogates of molecular breast cancer subtypes is common in research and clinical practice, but information on their comparative validity and prognostic capacity is scarce.

Methods
Data from 2 PAM50-subtyped Swedish breast cancer cohorts were used: Stockholm tamoxifen trial–3 with 561 patients diagnosed 1976-1990 and Clinseq with 237 patients diagnosed 2005-2012. We evaluated 3 surrogate classifications; the immunohistochemistry-3 surrogate classifier based on estrogen receptor, progesterone receptor, and HER2 and the St. Gallen and Prolif surrogate classifiers also including Ki-67. Accuracy, kappa, sensitivity, and specificity were computed as compared with PAM50. Alluvial diagrams of misclassification patterns were plotted. Distant recurrence-free survival was assessed using Kaplan-Meier plots, and tamoxifen treatment benefit for luminal subtypes was modeled using flexible parametric survival models.

Results
The concordance with PAM50 ranged from poor to moderate (kappa = 0.36-0.57, accuracy = 0.54-0.75), with best performance for the Prolif surrogate classification in both cohorts. Good concordance was only achieved when luminal subgroups were collapsed (kappa = 0.71-0.69, accuracy = 0.90-0.91). The St. Gallen surrogate classification misclassified luminal A into luminal B; the reverse pattern was seen with the others. In distant recurrence-free survival, surrogates were more similar to each other than PAM50. The difference in tamoxifen treatment benefit between luminal A and B for PAM50 was not replicated with any surrogate classifier.

Conclusions
All surrogate classifiers had limited ability to distinguish between PAM50 luminal A and B, but patterns of misclassifications differed. PAM50 subtyping appeared to yield larger separation of survival between luminal subtypes than any of the surrogate classifications.
Comparisons of Equality With Germanso…wie, and the Relationship Between Degrees and Properties
Authors: Hohaus Vera , Zimmermann Malte 
Published: September 2020

AbstractWe present a compositionally transparent, unified semantic analysis of two kinds of so…wie-equative constructions in German, namely degree equatives and property equatives in the domain of individuals or events. Unlike in English and many other European languages (Haspelmath & Buchholz 1998, Rett 2013), both equative types in German feature the parameter marker so, suggesting a unified analysis. We show that the parallel formal expression of German degree and property equatives is accompanied by a parallel syntactic distribution (in predicative, attributive, and adverbial position), and by identical semantic properties: Both equative types allow for scope ambiguities, show negative island effects out of context, and license the negative polarity item überhaupt ‘at all’ in the complement clause. As the same properties are also shared by German comparatives, we adopt the influential quantificational analysis of comparatives in von Stechow (1984ab), Heim (1985, 2001, 2007), and Beck (2011), and treat both German equative types in a uniform manner as expressing universal quantification over sets of degrees or over sets of properties (of individuals or events). Conceptually, the uniform marking of degree-related and property-related meanings is expected given that the abstract semantic category degree (type $d$) can be reconstructed in terms of equivalence classes, i.e., ontologically simpler sets of individuals (type $\langle e,t\rangle $) or events (type $\langle v,t\rangle $). These are found in any language, showing that whether or not a language makes explicit reference to degrees (by means of gradable adjectives, degree question words, degree-only equatives) does not follow on general conceptual or semantic grounds, but is determined by the grammar of that language.
A Randomized Trial of Caspofungin vs Triazoles Prophylaxis for Invasive Fungal Disease in Pediatric Allogeneic Hematopoietic Cell Transplant
Authors: Dvorak Christopher C , Fisher Brian T , Esbenshade Adam J , Nieder Michael L , Alexander Sarah , Steinbach William J , Dang Ha , Villaluna Doojduen , Chen Lu , Skeens Micah , Zaoutis Theoklis E , Sung Lillian 
Published: September 2020

Abstract

Background
Children and adolescents undergoing allogeneic hematopoietic cell transplantation (HCT) are at high risk for invasive fungal disease (IFD).

Methods
This multicenter, randomized, open-label trial planned to enroll 560 children and adolescents (3 months to &lt;21 years) undergoing allogeneic HCT between April 2013 and September 2016. Eligible patients were randomly assigned to antifungal prophylaxis with caspofungin or a center-specific comparator triazole (fluconazole or voriconazole). Prophylaxis was administered from day 0 of HCT to day 42 or discharge. The primary outcome was proven or probable IFD at day 42 as adjudicated by blinded central review. Exploratory analysis stratified this evaluation by comparator triazole.

Results
A planned futility analysis demonstrated a low rate of IFD in the comparator triazole arm, so the trial was closed early. A total of 290 eligible patients, with a median age of 9.5 years (range 0.3–20.7), were randomized to caspofungin (n = 144) or a triazole (n = 146; fluconazole, n = 100; voriconazole, n = 46). The day 42 cumulative incidence of proven or probable IFD was 1.4% (95% confidence interval [CI], 0.3%–5.4%) in the caspofungin group vs 1.4% (95% CI, 0.4%–5.5%) in the triazole group (P = .99, log-rank test). When stratified by specific triazole, there was no significant difference in proven or probable IFD at day 42 between caspofungin vs fluconazole (1.0%, 95% CI, 0.1%–6.9%, P = .78) or caspofungin vs voriconazole (2.3%, 95% CI, 0.3%–15.1%, P = .69).

Conclusions
In pediatric HCT patients, prophylaxis with caspofungin did not significantly reduce the cumulative incidence of early proven or probable IFD compared with triazoles. Future efforts to decrease IFD-related morbidity and mortality should focus on later periods of risk.

Trial Registration
NCT01503515.
New explanation of opposite position angles in red and blue wings of spectral lines
Authors: Silant’ev N A , Alekseeva G A , Ananjevskaja Yu K 
Published: September 2020

ABSTRACTWe consider the emission of resonance line radiation from rotating circular accretion disc with the progressive increasing height (the inclined ring). Our theory can also be applied to the rotating spot-like sources of resonance radiation. We assume that the atmosphere of inclined ring is homogeneous. In this case, the every part of ring emits the radiation with the wave electric field oscillations perpendicular to plane $(\boldsymbol{nN^{\prime }})$, where ${\boldsymbol{n}}$ is the direction to a telescope and $\boldsymbol{N^{\prime }}$ is the normal to considered local surface of a ring. Geometrical consideration shows that the radiation polarization angle χ (frequently denoted as position angle or PA) depends on the inclination angle α of the ring relative to the central plane of accretion disc, the inclination angle θ of the central plane of accretion disc with the normal $\boldsymbol{N}$, and on azimuthal angle φ of radiating part on the ring. The right and left parts of a ring according to the symmetry plane $(\boldsymbol{nN})$ give rise to opposite polarization angles. For rotating accretion disc, due to Doppler’s effect, this means that polarization angles have opposite signs in the red and blue wings of emerging spectral line radiation. Such behaviour is observed in many objects.
Georges de La Tour
Authors: Judovitz Dalia 
Published: September 2020

Georges de La Tour’s (b. 1593–d. 1652) artistic contributions were largely ignored by posterity until his “rediscovery” in 1915 by the art historian Hermann Voss. The patronage of such luminaries as the Duke of Lorraine, King Louis xiii, and Cardinal Richelieu, and the plethora of early copies, attest to his success during his lifetime. His eventual lapse into obscurity lasting almost three centuries led to the reattribution of his works to Italian, Netherlandish, Spanish, or French Baroque painters. While more than seventy oil paintings have been attributed to La Tour, fewer than forty are accepted as originals. The existence of his paintings in two or more versions, some as autograph replicas or as copies, along with questions about his son Étienne de La Tour’s possible pictorial contributions, left the attribution and chronology of his works mired in conjecture and controversy. Born the second son of a baker of some means at Vic-sur-Seille, he married a widow of minor nobility in 1617. Resettling to Luneville in the Duchy of Lorraine, he gained recognition as a painter in a region devastated by the ravages of the Thirty Years’ War (1618–1648). A casualty of an epidemic, La Tour died a few days after his wife at the height of his artistic career. The scarcity of documentary sources about his life is compounded by the total absence of evidence concerning his artistic training, professional travels, and artistic influences. La Tour’s pursuit of likeness between image and the natural world is believed to bear the influence of Caravaggio or his followers, reflecting post-Tridentine calls for the revitalization of religious imagery. La Tour’s paintings have been traditionally divided into daylight and night-time works, despite notable exceptions. Depictions of daylight serve to bring into moralizing relief foibles of secular life shown in realist genre scenes of brawling, cheating, and fortune-telling. Biblically inspired, his mysterious nocturnal or tenebrist works glow with a poetic luminosity imbued with spiritual connotations. Suspended in the stillness of religious contemplation, his candlelight paintings bear witness to the presence of inner life, depicting modes of consciousness that painting may only suggest but cannot ultimately show. Celebrated for their aura of mystery, his paintings continue to invite scholarly interest and public fascination.
John Adams
Authors: Cotter Alice 
Published: September 2020

American composer John Coolidge Adams (b. 1947, Worcester, MA) has created some of the most provocative artistic statements of our age. Adams’s controversial operas about real-life recent events contributed to a reinvigoration of contemporary opera in America. While the composer’s stage works have generated much scholarly and critical interest, the breadth of scholarship on Adams’s music expands beyond the operas. Early instrumental works have been the subject of scholarly discussion about the evolution of musical minimalism to postminimalism. Interviews and Adams’s autobiography offer insight into the many musical tributaries that have informed the composer’s life: big band jazz heard at the family’s dance hall in New Hampshire; musical theater sung by Adams’s mother in community productions; classical music as a clarinetist in youth symphonies; rock and roll; and the New England landscapes that would long inspire Adams. At Harvard University, Adams studied composition with Leon Kirchner, a former student of Arnold Schoenberg. Kirchner introduced Adams to the rigors of academic serialism and also to the problem, which would later plague Adams, of how to balance instinct with method. In 1971, after completing degrees (BA and MA) in music composition, Adams relocated to northern California. Adams joined the San Francisco experimental music scene and eventually established a voice as a distinctly American composer. Much scholarship has been devoted to the plurality of Adams’s stylistic impulses. Phrygian Gates (1977) and China Gates (1977) were the composer’s first works in the strict minimalist style. Soon thereafter, Adams began to integrate compositional techniques drawn from pre-Baroque to late-19th-century Romantic styles. Shaker Loops (1978), Harmonium (1981), and Harmonielehre (1984–1985) resulted. In 1985, Adams began composing the opera Nixon in China (1987) in collaboration with director Peter Sellars and librettist Alice Goodman, discovering a penchant for text setting. Their next opera, The Death of Klinghoffer (1991), proved to be a critical minefield, giving rise to a series of polemical debates about music, politics, and representation. After Klinghoffer, Adams composed primarily instrumental works using increasingly chromatic and modal idioms. In the early 2000s, Adams returned to grand opera with Doctor Atomic (2005) and continued to compose stage works, including A Flowering Tree (2006), The Gospel According to the Other Mary (2012), and Girls of the Golden West (2017), all in collaboration with Sellars. Adams’s focus on subjects of living memory in both the operas and instrumental works, such as On the Transmigration of Souls (2002), transformed the contemporary classical repertoire, making Adams a principal figure in late-20th and early-twenty-first-century American music.
Fully Endoscopic Resection of an Epidermoid Cyst of the Cerebellopontine Angle: Bilateral Resection via a Unilateral Approach
Authors: Gopakumar Sricharan , Srinivasan Visish M , Sharma Himanshu , Cherian Jacob , Patel Akash J 
Published: September 2020

ABSTRACT

BACKGROUND AND IMPORTANCE
Epidermoid cysts are rare, benign intracranial neoplasms that typically arise at the cerebellopontine angle (CPA) and can be extensive lesions that intricately involve many critical neurovascular structures. We describe the case of a patient who presents with the classic picture of CPA epidermoid cyst and describe the value of the 4K endoscope for resection, which is illustrated in our accompanying surgical video.

CLINICAL PRESENTATION
The patient presents with headache, nausea, and vomiting accompanied by dizziness and balance issues. Radiographic imaging demonstrated a large lesion highly consistent with epidermoid cyst which involved the left CPA, encircled the basilar artery, and extended to the opposite side. Surgery was planned with a small left-sided retrosigmoid craniotomy with use of a 2-dimensional 4K endoscope to aid in resection, particularly of the contralateral side. This approach was successful with gross total resection apparent at 14-mo follow-up.

CONCLUSION
We describe the use of a fully endoscopic technique from a unilateral approach for resection of a lesion that extended in the CPA bilaterally. Additionally, we highlight the relevant neuroanatomical and neurovascular structures in this highly critical intracranial region which is well-visualized through endoscopy in the associated surgical video.
Engineering therapeutic antibodies for patient safety: tackling the immunogenicity problem
Authors: Ulitzka Michael , Carrara Stefania , Grzeschik Julius , Kornmann Henri , Hock Björn , Kolmar Harald 
Published: September 2020

Abstract
Established monoclonal antibodies (mAbs) allow treatment of cancers, autoimmune diseases and other severe illnesses. Side effects either arise due to interaction with the target protein and its biology or result from of the patient’s immune system reacting to the foreign protein. This immunogenic reaction against therapeutic antibodies is dependent on various factors. The presence of non-human sequences can trigger immune responses as well as chemical and post-translational modifications of the antibody. However, even fully human antibodies can induce immune response through T cell epitopes or aggregates. In this review, we briefly describe, how therapeutic antibodies can interact with the patient’s immune system and summarize recent advancements in protein engineering and in silico methods to reduce immunogenicity of therapeutic monoclonal antibodies.
The Effect of Bank Supervision and Examination on Risk Taking: Evidence from a Natural Experiment
Authors: Kandrac John , Schlusche Bernd 
Published: September 2020

Abstract
We exploit an exogenous reduction in bank supervision and examination to demonstrate a causal effect of supervisory oversight on financial institutions’ risk taking. The additional risk took the form of risky lending, faster asset growth, and a greater reliance on low-quality capital. This response to less oversight boosted banks’ odds of failure. Lastly, we show that the reduction in oversight capacity led to more costly failures because there were longer delays in closing insolvent institutions, and because more bad assets were passed to the government insurance fund.