bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of stable ischaemic heart disease: the old and the new
Authors: Santucci Andrea , Riccini Clara , Cavallini Claudio 
Published: June 2020

Abstract
Stable ischaemic heart disease is a frequent and very heterogeneous condition. Drug therapy is important, in these patients, for improving their prognosis and controlling their symptoms. The typical clinical manifestation of obstructive coronary disease is angina pectoris. This symptom can be improved by various classes of compounds, namely beta-blockers (BBs), calcium antagonist, and nitrates. More recently, ranolazine and ivabradine have been introduced. All these drugs have been proven to reduce significantly angina. On the other hand, there are no evidences supporting improvement in prognosis, besides for the use of BBs, in patients with previous myocardial infarction (MI) or systolic dysfunction. Besides drugs for symptoms control, these patients also receive antiplatelet drugs, specifically aspirin, and lipid lowering compounds such as statins. Furthermore, recent evidences supported the use of low doses direct anticoagulant, or a second antiplatelet agent in patients with previous MI. Similarly, a very low LDL cholesterol level, such as obtained with PCKS9 inhibitors, seems very beneficial in these patients. It is possible that in the near future a specific role for neo-angiogenesis factors and cellular therapies, could be proven, albeit, presently these treatments are not supported by solid evidences.
Transcatheter aortic valve implantation in Italy: an uneven growth
Authors: Masiero Giulia , Musumeci Giuseppe 
Published: June 2020

Abstract
Transcatheter aortic valve implantation (TAVI) is the treatment of choice in patients with severe symptomatic aortic stenosis who are not suitable for surgery. The procedure has become the preferred strategy in patients at intermediate/high surgical risk with favourable clinical and anatomical characteristics. The collected scientific evidences, as well as the technologic innovations shaping the newer devices, allowed for a progressive reduction of the procedure-related complications as a well as a simplification of the procedure itself, promoting the gradual expansion of the indication for TAVI with the consequent increase in the estimated number of procedures performed each year. There are significant geographic and socio-economic disparities in the use of TAVI around the world and in Italy as well, reflecting an application of the procedure directly related to the economic prosperity of the Health System of the Country examined. The Italian situation, similar to the worldwide reality, reveals an uneven application of the procedure, signalling a disparity in the socio-economic and organizational capabilities of each single region. Standardization of patient selection for treatment, and of the clinical pathway for TAVI are crucial for an homogeneous integration of this new technology in the current Health Care System.
Preventing myocardial infarction: use and limitation of non-invasive imaging modalities
Authors: Perna Gian Piero 
Published: June 2020

Abstract
Identifying patients at high risk of coronary events is the main focus of cardiovascular prevention. For primary prevention score and risk cards are very low cost solutions, but only of limited efficacy, thus justifying the use of non-invasive imaging testing for the purpose of increasing the ‘diagnostic gain’. Considering all the diagnostic tests employed, only few demonstrated significant additional contribution to the risk score stratification. Coronary imaging with high speed volumetric computed tomography can provide essential information in ruling out and/or definition of coronary artery disease but also has limitations as far as the biological risk, the costs, and the difficulties of putting into perspective the results obtained in asymptomatic patients.
Coronary inflammation: why searching, how to identify and treat it
Authors: Prati Francesco , Marco Valeria , Paoletti Giulia , Albertucci Mario 
Published: June 2020

Abstract
Inflammation plays an important role in the development of atherosclerotic lesions. A variety of stimuli promote atherosclerosis, including increased LDL cholesterol in blood, exposure to tobacco, diabetes mellitus, hypertension, or rheological stress. Inflammatory cells have an established role in the growth of atherosclerotic lesions. Macrophages recognize and internalise ox-LDL to eventually become lipid-laden foam cells, the hallmark cellular component of atheroma. Infiltrating CD4-T cells have a role too, by interacting with ox-LDL and other antigens. Cytokines secreted by inflammatory cells stimulate smooth muscle cells migration whilst macrophages produce metalloprotease that lead to fibrous cap rupture. The necrotic debris of died macrophages and smooth muscle cells help to continue the inflammatory process. The inflammatory response can also directly activate platelets and promote thrombus formation at the surface of complicated coronary plaques. The CANTOS trial can be waived as an innovative study promoting a novel approach of personalized medicine. In patients with previous myocardial infarction, high-sensitivity C-reactive protein level of 2 mg and normal LDL level (&lt;70 mg/dL), canakinumab a therapeutic monoclonal antibody targeting interleukin-1β, at a dose of 150 mg every 3 months, led to a significant reduction of the primary efficacy end point: nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death at 48 months. Based on the CANTOS results, patients on statins and residual inflammatory risk as assessed by means of a high-sensitivity CRP &gt;2 mg/l at baseline have a high risk of future cardiac events, comparable to that of statin-treated patients with suboptimal cholesterol LDL level. The inhibition of interleukin-1β by means of canakinumab, which is only one of many potential anti-inflammatory pathways, open new perspectives, showing that a selective inhibition of the inflammatory pathway may be beneficial in reducing cardiovascular risk. In a process of personalized medicine, there is need to accurately identify patients at high risk of events, to be treated with potent statins or anti-inflammatory drugs. Perhaps in the near future a more specific assessment of coronary inflammations, possibly obtained with imaging modalities (either invasive or non-invasive), will better select patients at risk of events. In this scenario, in the setting of secondary prevention, OCT may serve the scope of identifying vulnerable plaques with local aggregates of inflammatory cells. Future studies are needed to understand the clinical effectiveness of strategies based on invasive coronary assessment.
Prevention after acute coronary syndrome the ‘less is more’ philosophy
Authors: Temporelli Pier Luigi 
Published: June 2020

Abstract
In the cardiology field, in recent years, we have witnessed an exponential increase in the use of both invasive and non-invasive instrument diagnostics. Particularly after an acute coronary syndrome, instrumental examinations, especially non-invasive ones, are often prescribed inappropriately until they almost completely replace the clinical evaluation. Their correct use, on the contrary, would require the choice of a test to be prescribed according to the epidemiological and clinical context of the individual patient. The strategy of early diagnosis, obtainable through instrumental screening and borrowed from oncological pathologies, was transferred ‘tout court’ in the cardiovascular field without any scientific basis, replacing the pharmacological or non-pharmacological intervention, such as the appropriate lifestyle, aimed at reducing cardiovascular risk factors. The guidelines of the main scientific societies define the most appropriate paths in the management of the coronary heart disease patients, both in the immediate post-acute phase and in the chronic phase. Although the guidelines sometimes show an excessive simplification of clinical problems, in an age in which the control of health expenditure has become a priority the correctness of the indications is an indispensable objective, being incontrovertible that a test is indicated only when an instrumental examination is able to modify the diagnostic-therapeutic path and the outcome of the patient.
Antiplatelet therapy and coronary artery bypass grafting: a systematic review and network meta-analysis
Authors: Gupta Saurabh , Belley-Cote Emilie P , Panchal Puru , Pandey Arjun , Basha Ameen , Pallo Lindsay , Rochwerg Bram , Mehta Shamir , Schwalm J -D , Whitlock Richard P 
Published: June 2020

Abstract

OBJECTIVES
Acetylsalicylic acid (ASA) monotherapy is the standard of care after coronary artery bypass grafting (CABG), but the benefits of more intense antiplatelet therapy, specifically dual antiplatelet therapy (DAPT), require further exploration in CABG patients. We performed a network meta-analysis to compare the effects of various antiplatelet regimens on saphenous vein graft patency, mortality, major adverse cardiovascular events and bleeding among CABG patients.

METHODS
We searched Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval Systems Online, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, American College of Physicians Journal Club and conference proceedings for randomized controlled trials. Screening, data extraction, risk of bias assessment and Grading of Recommendations Assessment, Development and Evaluation were performed in duplicate. We conducted a random effect Bayesian network meta-analysis including both direct and indirect comparisons.

RESULTS
We included 43 randomized controlled trials studying 15 511 patients. DAPT with low-dose ASA and ticagrelor [odds ratio (OR) 2.53, 95% credible interval (CrI) 1.35–4.72; I2 = 55; low certainty] or clopidogrel (OR 1.56, 95% CrI 1.02–2.39; I2 = 55; very low certainty) improved saphenous vein graft patency when compared to low-dose ASA monotherapy. DAPT with low-dose ASA and ticagrelor was associated with lower mortality (OR 0.52, 95% CrI 0.30–0.87; I2 = 14; high certainty) and lower major adverse cardiovascular events (OR 0.63, 95% CrI 0.44–0.91; I2 = 0; high certainty) when compared to low-dose ASA monotherapy. Based on moderate certainty evidence, DAPT was associated with an increase in major bleeding.

CONCLUSIONS
Our results suggest that DAPT improves saphenous vein graft patency, mortality and major adverse cardiovascular event. As such, surgeons and physicians should consider re-initiating DAPT for acute coronary syndrome patients after their CABG, at the expense of an increased risk for major bleeding.

Clinical trial registration
International Prospective Register of Systematic Reviews ID Number CRD42019127695
Elevated CXCL10 Serum Levels in Measles Virus Primary Infection and Reinfection Correlate With the Serological Stage and Hospitalization Status
Authors: Semmler Georg , Griebler Hannah , Aberle Stephan W , Stiasny Karin , Richter Lukas , Holzmann Heidemarie , Weseslindtner Lukas 
Published: June 2020

Abstract
We quantified serum concentrations of chemokine CXCL10 in 288 patients with measles virus (MeV) primary infection and 16 patients with reinfection (vaccine failure). CXCL10 peaked with emergence of IgM antibodies and was elevated in hospitalized patients (3233 vs 1930 pg/mL, P &lt; .0001). CXCL10 differed between primary and reinfection (1958 vs 932 pg/mL, P = .0402). In comparison to other viral infections with rash-like symptoms, CXCL10 was highly elevated in MeV infection (area under the curve = 0.935; 95% confidence interval, .905–.965; P &lt; .0001). CXCL10 is a potential marker for diagnosis, stage, and severity of MeV infection.
Multi-residue Analysis of Pesticides in Turmeric (Powder and Rhizome) Using Gas Chromatography Tandem Mass Spectrometry
Authors: Ghosh Bappa , Kamble Narayan , Bhattacharyya Arijita , Kandaswamy Chandrasekar , Banerjee Kaushik 
Published: June 2020

Abstract

Background and objectives
Turmeric is widely used as an ingredient of food and medicinal products. There exists no validated method for multi-residue analysis of pesticides in turmeric.

Objective
This study was undertaken to develop a simple and robust method for the quantitative determination of multi-class pesticides in turmeric powder and rhizome by GC-MS/MS.

Method
Initially, the samples were soaked in water for 30 min and homogenized to a fine paste. A portion of this paste (2 g) was extracted with acetonitrile (2 mL) and partitioned with hexane (2 mL) after adding 5 mL of 20% NaCl. The cleanup step involved dispersive solid phase extraction with graphitized carbon black (GCB, 5 mg/mL). Its performance was evaluated against primary secondary amine (PSA) and C18 sorbents. The cleaned extract was evaporated to dryness and reconstituted in ethyl acetate before GC-MS/MS analysis. The method was validated for a mixture of 208 multi-class pesticides at 10 ng/g and higher levels (i.e., 20 and 50 ng/g).

Results
The findings, which demonstrated a satisfactory recovery and precision (RSDs &lt;20%) for all compounds at 10 ng/g and higher spiking levels, are aligned with the analytical quality control criteria of SANTE/12682/2019 guidelines. The cleanup effect of GCB was much superior to that of PSA, C18, and their combinations. The solvent exchange step with hexane was effective in removing co-extractives and minimizing matrix effects.

Conclusions
This method complies with the regulatory requirements and is fit-for-purpose for pesticide residue monitoring in turmeric.

Highlights
The study reports a validated GC-MS/MS method for multi-residue analysis of pesticides in turmeric for the first time. The method provided a high throughput analysis of multi-class pesticides in turmeric rhizome and powder matrices with satisfactory selectivity, sensitivity, accuracy, and precision.
A Novel Bioanalytical Method for the Determination of Opioids in Blood and Pericardial Fluid
Authors: Ferreira Elisa , Corte Real Francisco , Pinho e Melo Teresa , Margalho Cláudia 
Published: June 2020

Abstract
Opioids are the drugs most commonly detected in overdose deaths and the second most consumed worldwide. An analytical methodology has been optimized and fully validated for the determination of codeine, morphine, 6-acetylmorphine, 6-acetylcodeine, oxycodone, oxymorphone and fentanyl in whole blood and pericardial fluid. The internal standards used were codeine-d3, morphine-d3, 6-acetylmorphine-d3 and fentanyl-d5. Before solid-phase extraction, volumes of 250 μL of blood and pericardial fluid were subjected to a protein precipitation (with 750 μL of ice-cold acetonitrile) and a microwave-induced oximation was performed using a solution of 1% aqueous hydroxylamine hydrochloride in phosphate-buffered saline (1:2, v/v). Finally, the dried extracts were further derivatized with a solution of n-methyl-n-(trimethylsilyl) trifluoroacetamide + 5% trimethylchlorosilane under microwave irradiation. The chromatographic analysis was carried out using gas chromatography–mass spectrometry operating in electron impact and selected ion monitoring mode. For all analytes, the method was linear between 5 and 1,000 ng/mL with determination coefficients (r2) &gt;0.99. Depending on the analyte and matrix, the limit of detection varies between 3 and 4 ng/mL. Intra- and intermediate precision (&lt;20%) and bias (±20%) were acceptable for all analytes in both matrices. The stability of the substances in the studied matrices was guaranteed, at least, 24 h in the autosampler, 4 h at room temperature and 30 days after three freeze/thaw cycles. This methodology was applied to real samples from the Laboratory of Chemistry and Forensic Toxicology, Centre Branch, of the National Institute of Legal Medicine and Forensic Sciences, Portugal.
Incidence Rates of Gynecologic Cancers in the U.S. Active Duty Military Population
Authors: Owens Steffanie , Blando Tara , Tesema Yohannes B , Butts Elizabeth , Newton Jessica , Bristow Robert , Randall Leslie M 
Published: June 2020

Abstract

Introduction
Despite an increasing number of female service members, incidence rates of gynecologic cancers (other than cervical cancer) have not been previously documented in the U.S. active duty military population. This study sought to determine the incidence rates of all gynecologic, including peritoneal, malignancies in the U.S. Active Duty population compared to the general US population as reported in the Surveillance, Epidemiology, and End Results Program database.

Materials and Methods
Gynecologic cancers diagnosed in U.S. Active Duty women aged 20–59 between 2004 and 2013 were retrospectively ascertained. Cancer cases were identified in both the Automated Central Tumor Registry and the Military Health System Data Repository. All cases in Automated Central Tumor Registry plus cases recorded in Military Health System Data Repository, but not duplicative of Automated Central Tumor Registry cases, were included. Age-specific and age-adjusted incidence rates were calculated in military and Surveillance, Epidemiology, and End Results cases.

Results
In U.S. Active Duty women, 327 incident cases of gynecologic cancer were identified. There were 110 cases of cervical cancer, 40 cases of endometrial cancer, 152 cases of ovarian cancer, and 25 other gynecologic malignancies. Of the 327 cases, 154 were ascertained from the Automated Central Tumor Registry database and the remainder from Military Health System Data Repository claims data. The age-adjusted rate of all gynecologic cancers for U.S. Active Duty women was 49.17 per 105 (95%CI 37.58, 65.12), while the age-adjusted rate for Surveillance, Epidemiology, and End Results −18 was 42.09 per 105 (95%CI 41.83, 42.35). The kappa coefficient assessing the overlap between the data sources was −0.1937. Though insufficient in numbers for statistical analysis, the observed proportion of ovarian to cervical cancer cases in active duty women &lt; 45 years of age was substantially greater than in the general population.

Conclusions
U.S. Active Duty women exhibited a similar age-adjusted rate of gynecologic cancer as the general US population. There was suboptimal overlap between the Automated Central Tumor Registry and Military Health System Data Repository databases, indicating the necessity of using both databases in order to obtain reliable data in the active duty population. This study is the current best estimate of a baseline rate of gynecologic cancer in U.S. active duty military women. This rate might change over time as women’s roles and exposures in recent and future military conflicts evolve.
Factors Considered When Ranking Military Orthopedic Surgery Residency Candidates
Authors: Wells Matthew , Polmear Michael , Nesti Leon J , Dunn John C 
Published: June 2020

Abstract

Introduction
The intangible personal characteristic grit has become a popular topic of concentration within contemporary psychology studies. Grit is defined as persistent work on a focused topic for an extended period of time until a desired goal is achieved. Its application to physician selection and development is not well known. We sought to determine which factors were considered most important among leadership within the U.S. Army’s orthopedic surgical training programs when selecting applications and ascertain if grit was one of the primary factors.

Materials and Methods
A standardized, 18-question survey was sent to all program chairs, program directors, and assistant program directors at the six U.S. Army orthopedic surgery residency programs. Questions included demographic factors pertaining to both the individual and their respective training program. Participants were asked to rank, in order, the 10 most important variables when considering applicants. Each variable was ranked using a point system (1–10 with 10 as the best score), referred to as the factor score (FS). Further statistical analyses using descriptive statistics, paired t-test, and ANOVA were performed and reported.

Results
The response rate was 83% (15/18). The most important variable considered was the applicant’s performance on their audition rotation (FS = 9.8), which was significantly more important than any other variable (P = 0.001). The second most important variable was the applicant’s USMLE scores (FS = 7.13), followed by involvement in research (FS = 5.60) and conscientiousness (FS = 4.73), respectively. Grit was considered the fifth most important variable (FS = 4.27). There was no significant difference in the ranking of grit among the different programs (P = 0.282). In applicants with low United States Medical Licensing Examination scores according to leadership idiosyncrasy, their audition rotation was considered a redeeming portion of their application (P = 0.02) followed by their level of grit.

Conclusions
The most important factor when considering an orthopedic surgery applicant was how well the applicant performed on an audition rotation, followed by their United States Medical Licensing Examination scores. Grit has become an important consideration in resident selection.
Does resource availability influence the vital rates of the tropical copepod Apocyclops royi (Lindberg, 1940) under changing salinities?
Authors: Van Someren Gréve Hans , Jepsen Per Meyer , Hansen Benni Winding 
Published: June 2020

Abstract
The physiology of invertebrates inhabiting many coastal ecosystems is challenged by strong temporal fluctuations in salinity. We investigated how food availability influences vital rates in the tropical cyclopoid copepod Apocyclops royi subjected to different salinities (5–32 PSU). We hypothesized that (i) mortality decreases and egg production rate increases with food availability; (ii) under suboptimal salinity, mortality increases and the egg production rate is reduced and (iii) the threshold concentration for egg production (the lowest food concentration where egg production is initiated) shifts to higher food concentrations when challenged by salinity. Surprisingly, A. royi survived, ingested food and produced eggs at all tested salinities. Mortality rate was, however, dependent on salinity level, but not on food availability. Mortality increased (~12% h−1) during short-term (1 h) salinity acclimatization to 5 PSU and during the following 24-h incubations (~5% d−1) compared with higher salinities. Feeding and egg production rates increased with food availability up to an optimum at all salinity levels, with no effect of salinity on the lowest food concentration initiating egg production. This reveals a high-salinity tolerance by A. royi and may partly explain why this particular copepod is so successful compared with its congeners in occupying extreme habitats.
THE POLARISED PARTITION RELATION FOR ORDER TYPES
Authors: Klausner L D , Weinert T 
Published: June 2020

AbstractWe analyse partitions of products with two ordered factors in two classes where both factors are countable or well-ordered and at least one of them is countable. This relates the partition properties of these products to cardinal characteristics of the continuum. We build on work by Erd̋s, Garti, Jones, Orr, Rado, Shelah and Szemerédi. In particular, we show that a theorem of Jones extends from the natural numbers to the rational ones, but consistently extends only to three further equimorphism classes of countable orderings. This is made possible by applying a 13-year-old theorem of Orr about embedding a given order into a sum of finite orders indexed over the given order.