bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of stress CTP versus CTA in detecting obstructive CAD or in-stent restenosis in stented patients
Authors: Kim S. H. , Rübenthaler J. , Nörenberg D. , Huber T. , Kunz W. G. , Sommer W. H. , Schoenberg S. O. , Janssen S. , Overhoff D. , Froelich M. F. 
Published: September 2020

Abstract
Objectives
The aim of this retrospective study was to determine cost-effectiveness of stress myocardial CT perfusion (CTP), coronary CT angiography (CTA), and the combination of both in suspected obstructive coronary artery disease (CAD) or in-stent restenosis (ISR) in patients with previous coronary stent implantation.

Methods
A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with CTA, CTP, and CTA + CTP. Model input parameters were obtained from published literature. Probabilistic sensitivity analysis was performed to evaluate overall model uncertainty. A single-variable deterministic sensitivity analysis evaluated the sensitivity of the results to plausible variations in model inputs. Cost-effectiveness was assessed based on a cost-effectiveness threshold of $100,000 per QALY.

Results
In the base-case scenario with willingness to pay of $100,000 per QALY, CTA resulted in total costs of $47,013.87 and an expected effectiveness of 6.84 QALYs, whereas CTP resulted in total costs of $46,758.83 with 6.93 QALYs. CTA + CTP reached costs of $47,455.63 with 6.85 QALYs. Therefore, strategies CTA and CTA + CTP were dominated by CTP in the base-case scenario. Deterministic sensitivity analysis demonstrated robustness of the model to variations of diagnostic efficacy parameters and costs in a broad range. CTP was cost-effective in the majority of iterations in the probabilistic sensitivity analysis as compared with CTA.

Conclusions
CTP is cost-effective for the detection of obstructive CAD or ISR in patients with previous stenting and therefore should be considered a feasible approach in daily clinical practice.

Key Points
• CTP provides added diagnostic value in patients with previous coronary stents.
• CTP is a cost-effective method for the detection of obstructive CAD or ISR in patients with previous stenting.
Ultra-low-dose chest CT imaging of COVID-19 patients using a deep residual neural network
Authors: Shiri Isaac , Akhavanallaf Azadeh , Sanaat Amirhossein , Salimi Yazdan , Askari Dariush , Mansouri Zahra , Shayesteh Sajad P. , Hasanian Mohammad , Rezaei-Kalantari Kiara , Salahshour Ali , Sandoughdaran Saleh , Abdollahi Hamid , Arabi Hossein , Zaidi Habib 
Published: September 2020

Abstract
Objectives
The current study aimed to design an ultra-low-dose CT examination protocol using a deep learning approach suitable for clinical diagnosis of COVID-19 patients.

Methods
In this study, 800, 170, and 171 pairs of ultra-low-dose and full-dose CT images were used as input/output as training, test, and external validation set, respectively, to implement the full-dose prediction technique. A residual convolutional neural network was applied to generate full-dose from ultra-low-dose CT images. The quality of predicted CT images was assessed using root mean square error (RMSE), structural similarity index (SSIM), and peak signal-to-noise ratio (PSNR). Scores ranging from 1 to 5 were assigned reflecting subjective assessment of image quality and related COVID-19 features, including ground glass opacities (GGO), crazy paving (CP), consolidation (CS), nodular infiltrates (NI), bronchovascular thickening (BVT), and pleural effusion (PE).

Results
The radiation dose in terms of CT dose index (CTDIvol) was reduced by up to 89%. The RMSE decreased from 0.16 ± 0.05 to 0.09 ± 0.02 and from 0.16 ± 0.06 to 0.08 ± 0.02 for the predicted compared with ultra-low-dose CT images in the test and external validation set, respectively. The overall scoring assigned by radiologists showed an acceptance rate of 4.72 ± 0.57 out of 5 for reference full-dose CT images, while ultra-low-dose CT images rated 2.78 ± 0.9. The predicted CT images using the deep learning algorithm achieved a score of 4.42 ± 0.8.

Conclusions
The results demonstrated that the deep learning algorithm is capable of predicting standard full-dose CT images with acceptable quality for the clinical diagnosis of COVID-19 positive patients with substantial radiation dose reduction.

Key Points
• Ultra-low-dose CT imaging of COVID-19 patients would result in the loss of critical information about lesion types, which could potentially affect clinical diagnosis.
• Deep learning–based prediction of full-dose from ultra-low-dose CT images for the diagnosis of COVID-19 could reduce the radiation dose by up to 89%.
• Deep learning algorithms failed to recover the correct lesion structure/density for a number of patients considered outliers, and as such, further research and development is warranted to address these limitations.
In situ magnetorheological SANS setup at Institut Laue-Langevin
Authors: Zákutná Dominika , Graef Kevin , Dresen Dominique , Porcar Lionel , Honecker Dirk , Disch Sabrina 
Published: September 2020

AbstractA magnetorheological sample environment is presented that allows for in situ magnetic field and shear flow during small-angle neutron scattering (SANS) measurements and is now available at the Institut Laue-Langevin (ILL). The setup allows performing simultaneous magnetorheological measurements together with the investigation of structural and magnetic changes on the nanometer length scale underlying the rheological response of ferrofluids. We describe the setup consisting of a commercial rheometer and a custom-made set of Helmholtz coils and show exemplarily data on the field and shear flow alignment of a dispersion of hematite nanospindles in water.
Intraoperative quantification of floating mass transducer coupling quality in active middle ear implants: a multicenter study
Authors: Fröhlich Laura , Rahne Torsten , Plontke Stefan K. , Oberhoffner Tobias , Dahl Rüdiger , Mlynski Robert , Dziemba Oliver , Aristeidou Aristotelis , Gadyuchko Maria , Koscielny Sven , Hoth Sebastian , Kropp Miriam H. , Mir-Salim Parwis , Müller Alexander 
Published: September 2020

Abstract
Purpose
Evaluating the effectiveness of intraoperative auditory brainstem responses (ABRs) to stimulation by the Vibrant Soundbridge (VSB) active middle ear implant for quantifying the implant’s floating mass transducer (FMT) coupling quality.

Methods
In a diagnostic multicentric study, patients (> 18 years) who received a VSB with different coupling modalities were included. Pre- and postoperative bone conduction thresholds, intraoperative VSB-evoked ABR thresholds (VSB-ABR) using a modified audio processor programmed to preoperative bone conduction thresholds, postoperative vibrogram thresholds, and postoperative VSB-ABR thresholds were measured. Coupling quality was calculated from the difference between the pure tone average at 1000, 2000, and 4000 Hz (3PTA) vibrogram and postoperative 3PTA bone conduction thresholds.

Results
Twenty-three patients (13 males, 10 females, mean age 56.6 (± 12.5) years) were included in the study. Intraoperative VSB-ABR response thresholds could be obtained in all except one patient where the threshold was > 30 dB nHL. Postoperatively, an insufficient coupling of 36.7 dB was confirmed in this patient. In a Bland–Altman analysis of the intraoperative VSB-ABRs and coupling quality, the limits of agreement exceeded ± 10 dB, i.e., the maximum allowed difference considered as not clinically important but the variation was within the general precision of auditory brainstem responses to predict behavioral thresholds. Five outliers were identified. In two patients, the postoperative VSB-ABR thresholds were in agreement with the coupling quality, indicating a change of coupling before the postoperative testing.

Conclusion
The response thresholds recorded in this set-up have the potential to predict the VSB coupling quality and optimize postoperative audiological results.
Association of imaging biomarkers and local activation of complement in aqueous humor of patients with early forms of age-related macular degeneration
Authors: Sitnilska Vasilena , Enders Philip , Cursiefen Claus , Fauser Sascha , Altay Lebriz 
Published: September 2020

Abstract
Purpose
To investigate a possible correlation between established imaging biomarkers for age-related macular degeneration and local complement system activation, measured in aqueous humor (AH) of patients with early stages of age-related macular degeneration (AMD) and controls.

Methods
This analysis included prospectively acquired AH samples of 106 eyes (35 with early/intermediate AMD, 71 controls). The levels of complement protein 3 (C3), 4 (C4), 5 (C5); activation products of complement factor 3a (C3a) and Ba, C3b/iC3b; complement factors B, D, H, I (CFB, CFD, CFH, CFI); and total protein concentration were analyzed. Quantitative levels of complement factors were correlated to the presence of reticular pseudodrusen (RPD), the presence of hyperreflective foci (HRF), and total drusen volume (DV) graded on imaging by spectral-domain optical coherence tomography and using Spearman’s rank correlation test.

Results
DV correlated with C3b/iC3b (r = 0.285; P = 0.034), C3a (r = 0.200; P = 0.047), Ba (r = 0.262; P = 0.009), and C5 (r = 430; P = 0.005), and showed a tendency towards correlation with C3a (r = 0.198; P = 0.057). HRF correlated significantly with C5 (r = 0.388; P = 0.011) and RPD showed a tendency towards correlation with CFB (r = 0.196; P = 0.050).

Conclusion
In patients with early AMD, HRF and drusen parameters but not RPD show low to fair levels of correlation with local complement activation in patients’ AH. Better understanding of complement activation could provide some insights into the pathogenesis of AMD. Imaging biomarkers could be useful to identify suitable patients for future clinical trials with complement-modulating therapies.
Molecular mechanisms involved in the positive effects of physical activity on coping with COVID-19
Authors: Nigro Ersilia , Polito Rita , Alfieri Andreina , Mancini Annamaria , Imperlini Esther , Elce Ausilia , Krustrup Peter , Orrù Stefania , Buono Pasqualina , Daniele Aurora 
Published: September 2020

Abstract
Purpose
Physical activity (PA) represents the first line of defence against diseases characterised by increased inflammation status, such as metabolic and infectious diseases. Conversely, a sedentary lifestyle—associated with obesity, type 2 diabetes and cardiovascular disorders—negatively impacts on general health status, including susceptibility to infections. At a time of a pandemic SARS-CoV2 infection, and in the context of the multiorgan crosstalk (widely accepted as a mechanism participating in the pathophysiology of all organs and systems), we examine the complex interplay mediated by skeletal muscle contraction involving the immune system and how this contributes to control health status and to counteract viral infections. In so doing, we review the molecular mechanisms and expression of molecules modulated by PA, able to provide the proper molecular equipment against viral infections such as the current SARS-CoV2.

Methods
A critical review of the literature was performed to elucidate the molecular mechanisms and mediators induced by PA that potentially impact on viral infections such as SARS-CoV2.

Results
We showed the effects mediated by regular moderate PA on viral adverse effects through the regulation of biological processes involving the crosstalk between skeletal muscle, the immune system and adipose tissue. Evidence was provided of the effects mediated by modulation of the expression of inflammation markers.

Conclusion
A tigth association between PA and reduction in inflammation status allows effective counteracting of SARS-CoV2 infection. It is therefore essential to persuade people to keep active.
Role of minimally invasive surgery versus open approach in patients with early-stage uterine carcinosarcomas: a retrospective multicentric study
Authors: Corrado Giacomo , Ciccarone Francesca , Cosentino Francesco , Legge Francesco , Rosati Andrea , Arcieri Martina , Turco Luigi Carlo , Certelli Camilla , Federico Alex , Vizza Enrico , Fanfani Francesco , Scambia Giovanni , Ferrandina Gabriella 
Published: September 2020

Abstract
Objective
The aim of this retrospective study was to compare surgical and survival outcome in only patients with early-stage UCSs managed by laparotomic surgery (LPT) versus minimally invasive surgery (MIS).

Methods
Data were retrospectively collected in four Italian different institutions. Inclusion criteria were UCS diagnosis confirmed by the definitive histological examination, and stage I or II according to the FIGO staging system.

Results
Between August 2000 and March 2019, the data relative to 170 patients bearing UCSs were collected: of these, 95 were defined as early-stage disease (stage I–II) based on the histological report at the primary surgery, and thus were included in this study. Forty-four patients were managed by LPT, and 51 patients were managed by MIS. The operative time was lower in the MIS group versus the LPT group (p value 0.021); the median estimated blood loss was less in the MIS group compared to the median of LPT group (p value < 0.0001). The length of hospital stay days was shorter in the MIS patients (p value < 0.0001). Overall, there were eight (8.4%) post-operative complications; of these, seven were recorded in the LPT group versus one in the MIS group (p value 0.023). There was no difference in the disease-free survival (DFS) and overall survival (OS) between the two groups.

Conclusion
There was no difference of oncologic outcome between the two approaches, in face of a more favourable peri-operative and post-operative profile in the MIS group.
Influence of geographical factors on thermal stress in northern Carpathians
Authors: Krzysztof Błażejczyk , Pavol Nejedlik , Oleh Skrynyk , Agnieszka Halaś , Olesya Skrynyk , Anna Błażejczyk , Katarina Mikulova 
Published: September 2020

AbstractWhile general features of mountain climate are well recognised, there is not many research regarded their bioclimatic differentiation. The aim of the present study is to answer the question how different geographical factors: elevation above sea level, physiographical type of area, climate continentality and location of area in relation to the main mountain ridge influence thermal stress in northern Carpathians. To analyse thermal stress in the region, daily meteorological data from 21 stations of national weather networks of Poland, Ukraine and Slovakia for the period 1986–2015 were used. Daily data of air temperature, relative humidity, total cloud cover and wind speed at 10 m above ground for 12 UTC were used because they represent midday hours which are mostly used for any human activity. The Universal Thermal Climate Index (UTCI) was applied as a measure of thermal stress. The results show that (1) cold stress significantly increases and heat stress decreases due to rise of altitude, (2) due to climate continentality and physiographical differences between western and eastern parts of northern Carpathians in their eastern edge, the cold stress is more evident than in western one, (3) at southward slopes of Carpathian, heat stress is significantly more frequent then at northward areas.
Bloodstream infection due to Enterobacter ludwigii, correlating with massive aggregation on the surface of a central venous catheter
Authors: Wagner Lysett , Bloos Frank , Vylkova Slavena 
Published: September 2020

AbstractWe report a case of catheter associated bloodstream infection due to Enterobacter ludwigii with a massive aggregation on the outside surface of a central venous catheter (CVC). The 57 years old patient with a history of spondylodiscitis and Staphylococcus aureus-associated endocarditis was admitted to the intensive care unit for acute cerebral infarction. The patient developed signs of infections and the CVC was removed 11 days after placement. The infectious agent was identified by standard diagnostics to the genus level as belonging to the Enterobacter cloacae complex, and additional molecular testing determined the species as E. ludwigii. The catheter was selected for a study aiming to identify the influence of blood components on the formation of central venous catheter-associated biofilms. In this course a massive biofilm was recognized and is presented here.
Digestive enzymes of fungal origin as a relevant cause of false positive Aspergillus antigen testing in intensive care unit patients
Authors: Schroeder Ines , Dichtl Karl , Liebchen Uwe , Wagener Johannes , Irlbeck Michael , Zoller Michael , Scharf Christina 
Published: September 2020

Abstract
Background
Galactomannan antigen (GM) testing is widely used in the diagnosis of invasive aspergillosis (IA). Digestive enzymes play an important role in enzyme substitution therapy in exocrine pancreatic insufficiency. As digestive enzymes of fungal origin like Nortase contain enzymes from Aspergillus, a false-positive result of the test might be possible because of cross-reacting antigens of the cell wall of the producing fungi. We, therefore, asked whether the administration of fungal enzymes is a relevant cause of false-positive GM antigen test results.

Methods
Patients with a positive GM antigen test between January 2016 and April 2020 were included in the evaluation and divided into two groups: group 1—Nortase-therapy, group 2—no Nortase-therapy. In addition, dissolved Nortase samples were analyzed in vitro for GM and β-1,3-D-glucan. For statistical analysis, the chi-squared and Mann‒Whitney U tests were used.

Results
Sixty-five patients were included in this evaluation (30 patients receiving Nortase and 35 patients not receiving Nortase). The overall false positivity rate of GM testing was 43.1%. Notably, false-positive results were detected significantly more often in the Nortase group (73.3%) than in the control group (17.1%, p < 0.001). While the positive predictive value of GM testing was 0.83 in the control group, there was a dramatic decline to 0.27 in the Nortase group. In vitro analysis proved that the Nortase enzyme preparation was highly positive for the fungal antigens GM and β-1,3-D-glucan.

Conclusions
Our data demonstrate that the administration of digestive enzymes of fungal origin like Nortase leads to a significantly higher rate of false-positive GM test results compared to that in patients without digestive enzyme treatment.
Modeling the Number of Confirmed Cases and Deaths from the COVID-19 Pandemic in the UK and Forecasting from April 15 to May 30, 2020
Authors: Jamshidi Babak , Rezaei Mansour , Kakavandi Mohsen , Jamshidi Zargaran Shahriar 
Published: September 2020

ABSTRACTObjective:The UK is one of the epicenters of coronavirus disease (COVID-19) in the world. As of April 14, there have been 93 873 confirmed patients of COVID-19 in the UK and 12 107 deaths with confirmed infection. On April 14, it was reported that COVID-19 was the cause of more than half of the deaths in London.Methods:The present paper addresses the modeling and forecasting of the outbreak of COVID-19 in the UK. This modeling must be accomplished through a 2-part time series model to study the number of confirmed cases and deaths. The period we aimed at a forecast was 46 days from April 15 to May 30, 2020. All the computations and simulations were conducted on Matlab R2015b, and the average curves and confidence intervals were calculated based on 100 simulations of the fitted models.Results:According to the obtained model, we expect that the cumulative number of confirmed cases will reach 282 000 with an 80% confidence interval (242 000 to 316 500) on May 30, from 93 873 on April 14. In addition, it is expected that, over this period, the number of daily new confirmed cases will fall to the interval 1330 to 6450 with the probability of 0.80 by the point estimation around 3100. Regarding death, our model establishes that the real case fatality rate of the pandemic in the UK approaches 11% (80% confidence interval: 8%–15%). Accordingly, we forecast that the total death in the UK will rise to 35 000 (28 000–50 000 with the probability of 80%).Conclusions:The drawback of this study is the shortage of observations. Also, to conduct a more exact study, it is possible to take the number of the tests into account as an explanatory variable besides time.
Costs of ambulatory pediatric healthcare-associated infections: Central-line–associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs)
Authors: Rinke Michael L. , Oyeku Suzette O. , Ford William J. H. , Heo Moonseong , Saiman Lisa , DeLaMora Patricia , Rabin Barbara , Zachariah Philip , Rosenberg Rebecca E. , Mirhaji Parsa , Obaro-Best Oghale , Drasher Michael , Klein Elizabeth , Peshansky Alexandre , Bundy David G. 
Published: September 2020

AbstractObjective:Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This study estimated additional costs associated with pediatric ambulatory central-line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery.Design:Retrospective case-control study.Setting:Four academic medical centers.Patients:Children aged 0–22 years seen between 2010 and 2015 and at risk for HAI as identified by electronic queries.Methods:Chart review adjudicated HAIs. Charges were obtained for patients with HAIs and matched controls 30 days before HAI, on the day of, and 30 days after HAI. Charges were converted to costs and 2015 USD. Mixed-effects linear regression was used to estimate the difference-in-differences of HAI case versus control costs in 2 models: unrecorded charge values considered missing and a sensitivity analysis with unrecorded charge considered $0.Results:Our search identified 177 patients with ambulatory CLABSIs, 53 with ambulatory CAUTIs, and 26 with SSIs following ambulatory surgery who were matched with 382, 110, and 75 controls, respectively. Additional cost associated with an ambulatory CLABSI was $5,684 (95% confidence interval [CI], $1,005–$10,362) and $6,502 (95% CI, $2,261–$10,744) in the 2 models; cost associated with a CAUTI was $6,660 (95% CI, $1,055, $12,145) and $2,661 (95% CI, −$431 to $5,753); cost associated with an SSI following ambulatory surgery at 1 institution only was $6,370 (95% CI, $4,022–$8,719).Conclusions:Ambulatory HAI in pediatric patients are associated with significant additional costs. Further work is needed to reduce ambulatory HAIs.