bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparative Separation and Purification of Liquiritin and Glycyrrhizic Acid from Glycyrrhiza uralensis Fisch by High-Speed Countercurrent Chromatography
Authors: Wang Hao , Shan Hu , Lü Haitao 
Published: July 2020

Abstract
The technique of high-speed countercurrent chromatography (HSCCC) was applied to the preparative isolation and purification of liquiritin and glycyrrhizic acid from a crude extract of Glycyrrhiza uralensis Fisch for the first time. Using single factor and orthogonal design experiments, the best extraction conditions were 70% ethanol, 1:25 ratio of solid-to-liquid (w/v) and extracted 1.5 h at 80°C. The contents of liquiritin and glycyrrhizic acid in the crude extract were 1.3 and 5.3%, respectively. Using the two-phase solvent system of ethyl acetate–methanol–water (5:2:5, v/v), 6.0 mg liquiritin (the purity was 96.7%, and the recovery was 89.3%), and 20.5 mg glycyrrhizic acid (the purity was 98.9%, and the recovery was 77.1%) were obtained from 500 mg crude extraction by HSCCC, respectively. The retention rate of stationary phase was 51.0%. Their structures were identified by high-performance liquid chromatography, melting points, ultraviolet radiation, Fourier transform infrared (FTIR), Electrospray ionization mass spectrometry (ESI-MS), 1H Nuclear Magnetic Resonance (NMR) and 13C NMR spectra. The scavenging abilities of glycyrrhizic acid to 1,1-diphenyl-2-picrylhydrazyl and hydroxyl free radicals were stronger than those of liquiritin.
Infectious Diseases Society of America Guidelines on Infection Prevention for Healthcare Personnel Caring for Patients With Suspected or Known COVID-19 (July 2020)
Authors: Lynch John B , Davitkov Perica , Anderson Deverick J , Bhimraj Adarsh , Cheng Vincent Chi-Chung , Guzman-Cottrill Judith , Dhindsa Jasmine , Duggal Abhijit , Jain Mamta K , Lee Grace M , Liang Stephen Y , McGeer Allison , Lavergne Valery , Murad M Hassan , Mustafa Reem A , Morgan Rebecca L , Falck-Ytter Yngve , Sultan Shahnaz 
Published: July 2020

Abstract

Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that can infect healthcare personnel (HCP) and patients in healthcare settings. Specific care activities, in particular, aerosol-generating procedures, may have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 has created significant challenges in healthcare facilities, particularly with severe shortages of personal protective equipment (PPE) used to protect HCP. Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care are needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators.

Objective
Our objective was to develop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known coronavirus disease 2019 (COVID-19).

Methods
The Infectious Diseases Society of America (IDSA) formed a multidisciplinary guideline panel that included front-line clinicians, infectious diseases specialists, experts in infection control, and guideline methodologists with representation from the disciplines of preventive care, public health, medical microbiology, pediatrics, critical care medicine, and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then, a systematic review of the peer-reviewed and gray literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence and make recommendations.

Results
The IDSA guideline panel agreed on 8 recommendations and provided narrative summaries of other interventions undergoing evaluations.

Conclusions
Using a combination of direct and indirect evidence, the panel was able to provide recommendations for 8 specific questions on the use of PPE for HCP who provide care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. Significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 remain, and PPE recommendations may need to be modified in response to new evidence.
Drug Resistance Mutations Among South African Children Living With HIV on WHO-recommended ART Regimens
Authors: Hackett Stephanie , Teasdale Chloe A , Pals Sherri , Muttiti Anthony , Mogashoa Mary , Chang Joy , Zeh Clement , Ramos Artur , Rivadeneira Emilia D , DeVos Joshua , Sleeman Katrina , Abrams Elaine J 
Published: July 2020

Abstract

Background
Children living with human immunodeficiency virus (HIV) (CLHIV) receiving antiretroviral therapy (ART) in resource-limited settings are susceptible to high rates of acquired HIV drug resistance (HIVDR), but few studies include children initiating age-appropriate World Health Organization (WHO)-recommended first-line regimens. We report data from a cohort of ART-naive South African children who initiated first-line ART.

Methods
ART-eligible CLHIV aged 0–12 years were enrolled from 2012 to 2014 at 5 public South African facilities and were followed for up to 24 months. Enrolled CLHIV received standard-of-care WHO-recommended first-line ART. At the final study visit, a dried blood spot sample was obtained for viral load and genotypic resistance testing.

Results
Among 72 successfully genotyped CLHIV, 49 (68.1%) received ABC/3TC/LPV/r, and 23 (31.9%) received ABC/3TC/EFV. All but 2 children on ABC/3TC/LPV/r were &lt;3 years, and all CLHIV on ABC/3TC/EFV were ≥3 years. Overall, 80.6% (58/72) had at least one drug resistance mutation (DRM). DRMs to nonnucleoside reverse transcriptase inhibitors (NNRTIs) and nucleoside reverse transcriptase inhibitors (NRTIs) were found among 65% and 51% of all CLHIV, respectively, with no statistical difference by ART regimen. More CLHIV on ABC/3TC/EFV, 47.8% (11/23), were found to have 0 or only 1 effective antiretroviral drug remaining in their current regimen compared to 8.2% (4/49) on ABC/3TC/LPV/r.

Conclusions
High levels of NNRTI and NRTI DRMs among CLHIV receiving ABC/3TC/LPV/r suggests a lasting impact of failed mother-to-child transmission interventions on DRMs. However, drug susceptibility analysis reveals that CLHIV with detectable viremia on ABC/3TC/LPV/r are more likely to have maintained at least 2 effective agents on their current HIV regimen than those on ABC/3TC/EFV.
Why is the euro punching below its weight?
Authors: Ilzetzki Ethan , Reinhart Carmen M , Rogoff Kenneth S 
Published: July 2020

SUMMARY
On the twentieth anniversary of its inception, the euro has yet to expand its role as an international currency. We document this fact with a wide range of indicators including its role as an anchor or reference in exchange rate arrangements – which we argue is a portmanteau measure – and as a currency for the denomination of trade and assets. On all these dimensions, the euro comprises a far smaller share than that of the US dollar. Furthermore, that share has been roughly constant since 1999. By some measures, the euro plays no larger role than the Deutschemark and French franc that it replaced. We explore the reasons for this underperformance. While the leading anchor currency may have a natural monopoly, a number of additional factors have limited the euro’s reach, including lack of financial centre, limited geopolitical reach and US and Chinese dominance in technology research. Most important, in our view, is the comparatively scarce supply of (safe) euro-denominated assets, which we document. The European Central Bank’s (ECB's) lack of policy clarity may have also played a role. We show that the euro era can be divided into a ‘Bundesbank-plus’ period and a ‘Whatever it Takes’ period. The first shows a smooth transition from the European Exchange Rate Mechanism and continued to stabilize German inflation. The second period is characterized by an expanding ECB arsenal of credit facilities to European banks and sovereigns.
Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial
Authors: Szarek Michael , Bittner Vera A , Aylward Philip , Baccara-Dinet Marie , Bhatt Deepak L , Diaz Rafael , Fras Zlatko , Goodman Shaun G , Halvorsen Sigrun , Harrington Robert A , Jukema J Wouter , Moriarty Patrick M , Pordy Robert , Ray Kausik K , Sinnaeve Peter , Tsimikas Sotirios , Vogel Robert , White Harvey D , Zahger Doron , Zeiher Andreas M , Steg Ph Gabriel , Schwartz Gregory G ,   for the ODYSSEY OUTCOMES Investigators
Published: July 2020

Abstract

Aims
Lipoprotein(a) concentration is associated with first cardiovascular events in clinical trials. It is unknown if this relationship holds for total (first and subsequent) events. In the ODYSSEY OUTCOMES trial in patients with recent acute coronary syndrome (ACS), the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab reduced lipoprotein(a), low-density lipoprotein cholesterol (LDL-C), and cardiovascular events compared with placebo. This post hoc analysis determined whether baseline levels and alirocumab-induced changes in lipoprotein(a) and LDL-C [corrected for lipoprotein(a) cholesterol] independently predicted total cardiovascular events.

Methods and results
Cardiovascular events included cardiovascular death, non-fatal myocardial infarction, stroke, hospitalization for unstable angina or heart failure, ischaemia-driven coronary revascularization, peripheral artery disease events, and venous thromboembolism. Proportional hazards models estimated relationships between baseline lipoprotein(a) and total cardiovascular events in the placebo group, effects of alirocumab treatment on total cardiovascular events by baseline lipoprotein(a), and relationships between lipoprotein(a) reduction with alirocumab and subsequent risk of total cardiovascular events. Baseline lipoprotein(a) predicted total cardiovascular events with placebo, while higher baseline lipoprotein(a) levels were associated with greater reduction in total cardiovascular events with alirocumab (hazard ratio P trend = 0.045). Alirocumab-induced reductions in lipoprotein(a) (median −5.0 [−13.6, 0] mg/dL) and corrected LDL-C (median −51.3 [−67.1, −34.0] mg/dL) independently predicted lower risk of total cardiovascular events. Each 5-mg/dL reduction in lipoprotein(a) predicted a 2.5% relative reduction in cardiovascular events.

Conclusion
Baseline lipoprotein(a) predicted the risk of total cardiovascular events and risk reduction by alirocumab. Lipoprotein(a) lowering contributed independently to cardiovascular event reduction, supporting the concept of lipoprotein(a) as a treatment target after ACS.
Live births following fertility preservation using in-vitro maturation of ovarian tissue oocytes
Authors: Segers Ingrid , Bardhi Erlisa , Mateizel Ileana , Van Moer Ellen , Schots Rik , Verheyen Greta , Tournaye Herman , De Vos Michel 
Published: July 2020

Abstract

STUDY QUESTION
Can oocytes extracted from excised ovarian tissue and matured in vitro be a useful adjunct for urgent fertility preservation (FP)?

SUMMARY ANSWER
Ovarian tissue oocyte in-vitro maturation (OTO-IVM) in combination with ovarian tissue cryopreservation (OTC) is a valuable adjunct technique for FP.

WHAT IS KNOWN ALREADY
Despite the impressive progress in the field, options for FP for cancer patients are still limited and, depending on the technique, clinical outcome data are still scarce.

STUDY DESIGN, SIZE, DURATION
This was a retrospective cohort study conducted at a university hospital-affiliated fertility clinic between January 2012 and May 2019.

PARTICIPANTS/MATERIALS, SETTING, METHODS
The study included 77 patients who underwent unilateral oophorectomy for OTC. Cumulus-oocyte complexes (COCs) obtained during ovarian tissue processing were matured in vitro for 28–42 h. Oocytes reaching metaphase II stage were vitrified or inseminated for embryo vitrification.

MAIN RESULTS AND THE ROLE OF CHANCE
Overall, 1220 COCs were collected. The mean oocyte maturation rate was 39% ± 23% (SD). There were 64 patients who had vitrification of oocytes (6.7 ± 6.3 oocytes per patient). There were 13 patients who had ICSI of mature oocytes after IVM, with 2.0 ± 2.0 embryos vitrified per patient. Twelve patients have returned to the clinic with a desire for pregnancy. For seven of these, OTO-IVM material was thawed. Two patients had OTO-IVM oocytes warmed, with survival rates of 86% and 60%. After ICSI, six oocytes were fertilised in total, generating three good quality embryos for transfer, leading to a healthy live birth for one patient. In five patients, for whom a mean of 2.0 ± 0.8 (SD) embryos had been vitrified, seven embryos were warmed in total: one embryo did not survive the warming process; two tested genetically unsuitable for transfer; and four were transferred in separate cycles to three different patients, resulting in two healthy babies. In this small series, the live birth rate per patient after OTO-IVM, ICSI and embryo transfer was 43%.

LIMITATIONS, REASONS FOR CAUTION
The retrospective study design and the limited sample size should be considered when interpreting results.

WIDER IMPLICATIONS OF THE FINDINGS
The results of the study illustrate the added value of OTO-IVM in combination with OTC. We report the first live birth following the use of this appended technique combined with oocyte vitrification.

STUDY FUNDING/COMPETING INTEREST(S)
No external funding was used for this study. M.D.V. reports honoraria for lectures in the last 2 years from MSD and Ferring, outside the submitted work, as well as grant support from MSD. The other authors have nothing to declare.

TRIAL REGISTRATION NUMBER
N/A
Comparison of nZEB indicators for hotel renovations under different European climatic conditions
Authors: Cunha Filipe O , Oliveira Armando C 
Published: July 2020

Abstract
Hotels hold an important role in the energy efficiency policies of the European Union (EU), as they are typically ranked among the top energy consumers in the non-residential sector. However, a significant amount of the energy used in hotels is wasted, leaving ample room for enhancing energy-efficiency and resource conservation. Indeed, energy refurbishment of the hotel building stock is crucial in order to reach the nearly zero energy building (nZEB) status imposed by EU Directives for energy efficiency, and also an important pillar to achieve the energy targets for 2030 and the transition towards climate-neutral levels by 2050.
A typical 4-star hotel in operation in Faro (Portugal) was used as a case study in order to establish energy performance indicators for nZEB hotels in three European cities, taking into account the influence of the climatic context, the technical feasibility and cost effectiveness of the best energy retrofit packages. The study started after the calibration of the building energy model by means of an energy audit and measured data, in order to have a baseline model that represents well the actual energy use of the hotel in the reference location. The building energy model was developed by using DesignBuilder/EnergyPlus software. The validated model was then used to assess the effect of the best retrofit interventions (energy efficiency measures and active solar systems) in order to set minimum energy performance requirements and to reach cost-optimal levels and nZEB levels for refurbished hotels. A significant energy-saving potential was found for the cost-optimal benchmarks, and the obtained nZEB levels can be achieved under technically and economically conditions for the selected cities: Faro, London and Athens.
Wavelet invariants for statistically robust multi-reference alignment
Authors: Hirn Matthew , Little Anna 
Published: July 2020

AbstractWe propose a nonlinear, wavelet-based signal representation that is translation invariant and robust to both additive noise and random dilations. Motivated by the multi-reference alignment problem and generalizations thereof, we analyze the statistical properties of this representation given a large number of independent corruptions of a target signal. We prove the nonlinear wavelet-based representation uniquely defines the power spectrum but allows for an unbiasing procedure that cannot be directly applied to the power spectrum. After unbiasing the representation to remove the effects of the additive noise and random dilations, we recover an approximation of the power spectrum by solving a convex optimization problem, and thus reduce to a phase retrieval problem. Extensive numerical experiments demonstrate the statistical robustness of this approximation procedure.
Oscillatory Asymptotics for the Airy Kernel Determinant on Two Intervals
Authors: Blackstone Elliot , Charlier Christophe , Lenells Jonatan 
Published: July 2020

AbstractWe obtain asymptotics for the Airy kernel Fredholm determinant on two intervals. We give explicit formulas for all the terms up to and including the oscillations of order $1$, which are expressed in terms of Jacobi $\theta $-functions.
Risk Factors for Cytomegalovirus Viremia following Liver Transplantation With a Seropositive Donor and Seronegative Recipient Receiving Antiviral Therapy
Authors: Singh Nina , Winston Drew J , Razonable Raymund R , Lyon G Marshall , Silveira Fernanda P , Wagener Marilyn M , Limaye Ajit P 
Published: July 2020

Abstract

Background
The risk factors for development of viremia in high-risk donor cytomegalovirus (CMV)-seropositive and recipient CMV-seronegative (D+R−) transplant recipients are incompletely defined.

Methods
The study population comprised patients in the preemptive therapy (PET) arm of a randomized, controlled trial of PET versus prophylaxis using valganciclovir in D+R− liver transplant recipients. Weekly surveillance monitoring for viremia for 100 days was performed using a sensitive CMV-DNA polymerase chain reaction assays. Risk factors for viremia and time to onset (≤4 vs &gt;4 weeks) of viremia were examined using logistic regression models.

Results
Viremia developed in 84% (79/94) of recipients and older donor age was the only independent factor associated with viremia (odds ratio, 2.20 for each quartile increase in donor age; 95% confidence interval [CI], 1.07–4.52; P = .031). Recipients who developed early-onset viremia (within 4 weeks) also had significantly older donors than those with later-onset viremia (difference in age 10.1 years; 95% CI, 2–19; P = .03).

Conclusions
Older donor age was an independent predictor of viremia and earlier-onset of viremia in D+R− liver transplant recipients. Future studies should assess the mechanistic links underlying this novel association.

Clinical Trial Registration
NCT01552369.
Radiologic Technologist and Radiologist Knowledge Gaps about Breast Density Revealed by an Online Continuing Education Course
Authors: Seitzman Robin L , Pushkin JoAnn , Berg Wendie A 
Published: July 2020

Abstract

Objective
We sought to identify provider knowledge gaps and their predictors, as revealed by a breast density continuing education course marketed to the radiology community.

Methods
The course, continually available online during the study period of November 2, 2016 and December 31, 2018, includes demographics collection; a monograph on breast density, breast cancer risk, and screening; and a post-test. Four post-test questions were modified during the study period, resulting in different sample sizes pre- and postmodification. Multiple logistic regression was used to identify predictors of knowledge gaps (defined as &gt; 25% of responses incorrect).

Results
Of 1649 analyzable registrants, 1363 (82.7%) were radiologic technologists, 226 (13.7%) were physicians, and 60 (3.6%) were other nonphysicians; over 90% of physicians and over 90% of technologists/nonphysicians specialized in radiology. Sixteen of 49 physicians (32.7%) and 80/233 (34.3%) technologists/nonphysicians mistakenly thought the Gail model should be used to determine “high-risk” status for recommending MRI or genetic testing. Ninety-nine of 226 (43.8%) physicians and 682/1423 (47.9%) technologists/nonphysicians misunderstood the inverse relationship between increasing age and lifetime breast cancer risk. Fifty-two of 166 (31.3%) physicians and 549/1151 (47.7%) technologists/nonphysicians were unaware that MRI should be recommended for women with a family history of BRCA1/BRCA2 mutations. Tomosynthesis effectiveness was overestimated, with 18/60 (30.0%) physicians and 95/272 (34.9%) technologists/nonphysicians believing sensitivity nearly equaled MRI. Knowledge gaps were more common in technologists/nonphysicians.

Conclusions
Important knowledge gaps about breast density, breast cancer risk assessment, and screening exist among radiologic technologists and radiologists. Continued education efforts may improve appropriate breast cancer screening recommendations.
Pathogenic ATM Mutations in Cancer and a Genetic Basis for Radiotherapeutic Efficacy
Authors: Pitter Kenneth L , Casey Dana L , Lu Yue C , Hannum Margaret , Zhang Zhigang , Song Xinmao , Pecorari Isabella , McMillan Biko , Ma Jennifer , Samstein Robert M , Pei Isaac X , Khan Atif J , Braunstein Lior Z , Morris Luc G T , Barker Christopher A , Rimner Andreas , Alektiar Kaled M , Romesser Paul B , Crane Christopher H , Yahalom Joachim , Zelefsky Michael J , Scher Howard I , Bernstein Jonine L , Mandelker Diana L , Weigelt Britta , Reis-Filho Jorge S , Lee Nancy Y , Powell Simon N , Chan Timothy A , Riaz Nadeem , Setton Jeremy 
Published: July 2020

Abstract

Background
Radiation therapy is one of the most commonly used cancer therapeutics but genetic determinants of clinical benefit are poorly characterized. Pathogenic germline variants in ATM are known to cause ataxia-telangiectasia, a rare hereditary syndrome notable for marked radiosensitivity. In contrast, somatic inactivation of ATM is a common event in a wide variety of cancers, but its clinical actionability remains obscure.

Methods
We analyzed 20 107 consecutively treated advanced cancer patients who underwent targeted genomic sequencing as part of an institutional genomic profiling initiative and identified 1085 harboring a somatic or germline ATM mutation, including 357 who received radiotherapy (RT). Outcomes of irradiated tumors harboring ATM loss-of-function (LoF) mutations were compared with those harboring variants of unknown significance. All statistical tests were 2-sided.

Results
Among 357 pan-cancer patients who received 727 courses of RT, genetic inactivation of ATM was associated with improved radiotherapeutic efficacy. The 2-year cumulative incidence of irradiated tumor progression was 13.2% vs 27.5% for tumors harboring an ATM LoF vs variant of unknown significance allele, respectively (hazard ratio [HR] = 0.51, 95% confidence interval [CI] = 0.34 to 0.77, P = .001). The greatest clinical benefit was seen in tumors harboring biallelic ATM inactivation (HR = 0.19, 95% CI = 0.06 to 0.60, P = .005), with statistically significant benefit also observed in tumors with monoallelic ATM inactivation (HR = 0.57, 95% CI = 0.35 to 0.92, P = .02). Notably, ATM LoF was highly predictive of outcome in TP53 wild-type tumors but not among TP53-mutant tumors.

Conclusions
We demonstrate that somatic ATM inactivation is associated with markedly improved tumor control following RT. The identification of a radio-sensitive tumor phenotype across multiple cancer types offers potential clinical opportunities for genomically guided RT.