bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous coronary artery dissection in a patient with hereditary polycystic kidney disease and a recent liver transplant: a case report
Authors: Verlaeckt Ezther , Van de Bruaene Laurens , Coeman Mathieu , Gevaert Sofie 
Published: December 2019

Abstract

Background
Spontaneous coronary artery dissection (SCAD) is an underestimated cause of acute coronary syndromes. A predisposing arteriopathy is often present and a stressor can sometimes be identified. Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disorder; its associated arteriopathy has been described as a predisposing condition for SCAD.

Case summary
A 44-year-old woman with ADPKD presented in the emergency room with recent onset thoracic pain radiating to the left arm at rest. She had undergone a recent liver transplant, for which she had received high-dose corticosteroids during 1 month. She was still taking tacrolimus and mycophenolate mofetil. She had no traditional risk factors but had experienced stress postoperatively. She was known with moderate chronic kidney disease. The initial electrocardiogram (ECG) was normal but high-sensitive troponin T was significantly elevated. Coronary angiography demonstrated diffuse narrowing of the distal left anterior descending artery with preserved flow, compatible with a SCAD Type 2 that was treated conservatively. However, under dual antiplatelet therapy (DAPT) with clopidogrel, the coronary dissection was progressive with new ischaemic ECG changes, further rise of troponins and development of apicoseptal hypokinesia. Because of the small vessel diameter and the preserved distal flow, conservative treatment was maintained. Clopidogrel was interrupted and the patient remained stable.

Discussion
As SCAD remains an underestimated cause of myocardial infarction, clinicians should be aware of the possibility of SCAD in ADPKD patients with chest pain. This case report illustrates that the decision DAPT vs. aspirin should be individualized in these patients.
Management of atrial fibrillation in patients with chronic kidney disease in clinical practice: a joint European Heart Rhythm Association (EHRA) and European Renal Association/European Dialysis and Transplantation Association (ERA/EDTA) physician-based survey
Authors: Potpara Tatjana S , Ferro Charles , Lip Gregory Y H , Dan George A , Lenarczyk Radoslaw , Mallamaci Francesca , Ortiz Alberto , Sarafidis Pantelis , Ekart Robert , Dagres Nikolaos 
Published: December 2019

Abstract

The European Heart Rhythm Association (EHRA) and European Renal Association/European Dialysis and Transplantation Association (ERA/EDTA) jointly conducted a physician-based survey to gain insight into the management of atrial fibrillation (AF) in patients with chronic kidney disease (CKD) and adherence to current European Society of Cardiology AF Guidelines in contemporary clinical practice. Physician-based survey conducted during an 8-week period using an internet-based questionnaire sent to all EHRA and ERA/EDTA members, with voluntary and anonymous responses. Among 306 physicians (160 EHRA and 146 ERA/EDTA members; 56 countries), a multidisciplinary team for management of AF-CKD patients was available to only 20/300 respondents (6.7%) and 132/295 (44.7%) routinely screened CKD patients for AF. Oral anticoagulation (OAC) use was based on individual stroke risk in mild/moderate CKD but on shared decision-making in advanced CKD. The CHA2DS2-VASc score-based decisions were more common among cardiologists, with substantial intra- and inter-specialty heterogeneity in the use and dosing of specific OAC drugs across CKD stages, heterogeneous strategies for OAC monitoring (especially among nephrologists) and a modest impact of CKD on rate and rhythm control treatment decisions. The HAS-BLED score was generally not a determinant of OAC prescribing. Our survey provided important insights into contemporary management of AF patients with CKD in clinical practice, revealing certain differences between nephrologists and cardiologists and highlighting shared and specific knowledge gaps and unmet needs. These findings emphasize the need for streamlining the care for AF patients across different specialties and may inform development of tailored education interventions.
Impact of catheter ablation therapy for atrial fibrillation on healthcare expenditures in a middle European cohort
Authors: Martinek Martin , Pürerfellner Helmut , Blessberger Hermann , Pruckner Gerald 
Published: December 2019

Abstract

Aims
Atrial fibrillation (AF) is the most prevalent arrhythmia in western countries. It is associated with increased mortality and morbidity and responsible for hospitalization rates of 10–40% per patient per year. Studies from the UK and the USA have shown that AF is responsible for ∼1% of the total healthcare expenditures in these countries. The only potentially curative treatment is pulmonary vein isolation (PVI). Published health economic data on the impact of PVI mainly consist of simulations of expenditures with assumed efficacy taken from ablation studies. Real expenditure data are missing as well as pre-ablation period data and long-term data.

Methods and results
We analyse true healthcare expenditures based on inpatient and outpatient data from the Upper Austrian Health Insurance Fund social security system of patients undergoing PVI during 2005 to 2015. We identified 1135 patients undergoing PVI with 268 having multiple procedures. Days of hospitalization and days of sick leave started to rise in the year before ablation. PVI was able to lower both parameters to the level of 1 year before ablation. Comparing four quarters before and after a single-index ablation, a highly significant reduction in inpatient healthcare expenditures was documented. There was a significant, but numerically small increase in outpatient expenditures, resulting in a significant reduction in overall healthcare expenditures.

Conclusion
Analysing a cohort of the Upper Austrian Health Insurance Fund undergoing PVI, we found significant cost-saving effects on post-interventional healthcare expenditures and a reduction in days of sick leave.
Whole Genome Sequencing and Assembly of the Asian Honey Bee Apis dorsata
Authors: Oppenheim Sara , Cao Xiaolong , Rueppel Olav , Krongdang Sasiprapa , Phokasem Patcharin , DeSalle Rob , Goodwin Sara , Xing Jinchuan , Chantawannakul Panuwan , Rosenfeld Jeffrey A 
Published: December 2019

AbstractThe Asian honey bee (Apis dorsata) is distinct from its more widely distributed cousin Apis mellifera by a few key characteristics. Most prominently, A. dorsata, nest in the open by forming a colony clustered around the honeycomb, whereas A. mellifera nest in concealed cavities. Additionally, the worker and reproductive castes are all of the same size in A. dorsata. In order to investigate these differences, we performed whole genome sequencing of A. dorsata using a hybrid Oxford Nanopore and Illumina approach. The 223 Mb genome has an N50 of 35 kb with the largest scaffold of 302 kb. We have found that there are many genes in the dorsata genome that are distinct from other hymenoptera and also large amounts of transposable elements, and we suggest some candidate genes for A. dorsata’s exceptional level of defensive aggression.
Differential gene expression and limited epigenetic dysregulation at the materno-fetal interface in preeclampsia
Authors: Leseva Milena N , Binder Alexandra M , Ponsonby Anne-Louise , Vuillermin Peter , Saffery Richard , Michels Karin B ,   Barwon Infant Study Investigator Group
Published: December 2019

Abstract
Despite the many advances made in the diagnosis and management of preeclampsia, this syndrome remains a leading cause of maternal mortality and life-long morbidity, as well as adverse fetal outcomes. Successful prediction and therapeutic intervention require an improved understanding of the molecular mechanisms, which underlie preeclampsia pathophysiology. We have used an integrated approach to discover placental genetic and epigenetic markers of preeclampsia and validated our findings in an independent cohort of women. We observed the microRNA, MIR138, to be upregulated in singleton preeclamptic placentas; however, this appears to be a female infant sex-specific effect. We did not identify any significant differentially methylated positions (DMPs) in singleton pregnancies, indicating that DNA methylation changes in mild forms of the disease are likely limited. However, we identified infant sex-specific preeclampsia-associated differentially methylated regions among singletons. Disease-associated DMPs were more obvious in a limited sampling of twin pregnancies. Interestingly, 2 out of the 10 most significant changes in methylation over larger regions overlap between singletons and twins and correspond to NAPRT1 and ZNF417.
The effects of steroidal and non-steroidal anti-inflammatory drugs on tracheal wound healing in an experimental rat model
Authors: Duman Elif , Ceylan Kenan Can , Akpınar Deniz , Yücel Nur , Ünsal Şaban , Duman Soner , Kaya Şeyda Örs 
Published: December 2019

Abstract

OBJECTIVES
The effect of non-steroidal anti-inflammatory drugs (NSAID), mostly used for postoperative analgesic purposes for wound healing, is still a matter of debate. Our goal was to evaluate the effects of the most widely used NSAID and corticosteroids after surgical operations on tracheal wound healing in an experimental rat model.

METHODS
Thirty-nine male Wistar albino rats were included in this study. Tracheotomy was performed in 32 rats; then they were divided into 3 groups. After the first day, the animals in group 1 were treated with an NSAID (diclofenac 10 mg/kg/day) (NSAID, n = 12) for 7 days; the animals in group 2 were treated with a corticosteroid (dexamethasone, 2 × 0.1 mg/kg/day) (steroid, n = 10) for 7 days; the animals in group 3 (control, n = 10) were not given any medications. For a fourth group (histological control, n = 7), in order to evaluate normal morphological and histological characteristics, neither surgery nor medication was used. Five rats were eliminated from the study (2 rats in the NSAID group died and 3 rats in the steroid group developed local wound infections). The drop-out rate was 12.8%. Histological characteristics, inflammation, fibrosis, necrosis, neochondrogenesis, neovascularization and epithelization were evaluated in 34 rats. Non-parametric tests were used for statistical analysis.

RESULTS
Inflammation, vascularization and number of fibroblasts and chondrocytes were significantly higher in the control group than in the histological control group. There was some reduction in all parameters except vascularization in the NSAID group (P &gt; 0.05). When the steroid group was compared to the NSAID group, inflammation (P &lt; 0.05), vascularization and number of chondrocytes (P &gt; 0.05) were more suppressed in the steroid group. The number of fibroblasts increased in the steroid group (P &gt; 0.05).

CONCLUSIONS
Steroids and NSAID may have negative effects on tracheal wound healing, probably by suppressing inflammation and fibroblast proliferation. NSAID was mostly used postoperatively for analgesic purposes and should be avoided.
A mixed-primal finite element method for the coupling of Brinkman–Darcy flow and nonlinear transport
Authors: Alvarez Mario , Gatica Gabriel N , Ruiz-Baier Ricardo 
Published: December 2019

AbstractThis paper is devoted to the mathematical and numerical analysis of a model describing the interfacial flow-transport interaction in a porous-fluidic domain. The medium consists of a highly permeable material, where the flow of an incompressible viscous fluid is governed by Brinkman equations (written in terms of vorticity, velocity and pressure), and a porous medium where Darcy’s law describes fluid motion using filtration velocity and pressure. Gravity and the local fluctuations of a scalar field (representing for instance, the solids volume fraction or the concentration of a contaminant) are the main drivers of the fluid patterns on the whole domain, and the Brinkman-Darcy equations are coupled to a nonlinear transport equation accounting for mass balance of the scalar concentration. We introduce a mixed-primal variational formulation of the problem and establish existence and uniqueness of solution using fixed-point arguments and small-data assumptions. A family of Galerkin discretizations that produce divergence-free discrete velocities is also presented and analysed using similar tools to those employed in the continuous problem. Convergence of the resulting mixed-primal finite element method is proven, and some numerical examples confirming the theoretical error bounds and illustrating the performance of the proposed discrete scheme are reported.
The Cone Structure Theorem
Authors: Batista Erica Boizan , Costa João Carlos Ferreira , Nuño-Ballesteros Juan José 
Published: December 2019

Abstract
We consider the topological classification of finitely determined map germs $f:(\mathbb {R}^n,0)\to (\mathbb {R}^p,0)$ with $f^{-1}(0)\neq \{0\}$. Associated with $f$ we have a link diagram, which is well defined up to topological equivalence. We prove that $f$ is topologically $\mathcal {A}$-equivalent to the generalized cone of its link diagram.
Discrete Invariant Curve Flows, Orthogonal Polynomials, and Moving Frame
Authors: Wang Bao , Chang Xiang-Ke , Hu Xing-Biao , Li Shi-Hao 
Published: December 2019

Abstract
In this paper, an orthogonal polynomials-based (OPs-based) approach to generate discrete moving frames and invariants is developed. It is shown that OPs can provide explicit expressions for the discrete moving frame as well as the associated difference invariants, and this approach enables one to obtain the corresponding discrete invariant curve flows simultaneously. Several examples in the cases of centro-affine plane, pseudo-Euclidean plane, and high-dimensional centro-affine space are presented.
Open Saito Theory for A and D Singularities
Authors: Basalaev Alexey , Buryak Alexandr 
Published: December 2019

Abstract
A well-known construction of B. Dubrovin and K. Saito endows the parameter space of a universal unfolding of a simple singularity with a Frobenius manifold structure. In our paper, we present a generalization of this construction for the singularities of types $A$ and $D$ that gives a solution of the open WDVV equations. For the $A$-singularity, the resulting solution describes the intersection numbers on the moduli space of $r$-spin disks, introduced recently in a work of the 2nd author, E. Clader and R. Tessler. In the 2nd part of the paper, we describe the space of homogeneous polynomial solutions of the open WDVV equations associated to the Frobenius manifolds of finite irreducible Coxeter groups.
Factors Associated With Antiretroviral Therapy Reinitiation in Medicaid Recipients With Human Immunodeficiency Virus
Authors: Zhang T , Wilson I B , Youn B , Lee Y , Shireman T I 
Published: December 2019

Abstract

Background
This study was conducted to examine patient characteristics associated with antiretroviral therapy (ART) reinitiation in Medicaid enrollees.

Methods
This is a retrospective cohort study that uses Cox proportional hazard regression to examine the association between person-level characteristics and time from ART discontinuation to the subsequent reinitiation within 18 months.

Results
There were 45 409 patients who discontinued ART, and 44% failed to reinitiate. More outpatient visits (3+ vs 0 outpatient visits: adjusted hazard ratio (adjHR), 1.56; 99% confidence interval [CI], 1.45–1.67) and hospitalization (adjHR, 1.18; 99% CI,1.16–1.20) during follow-up were associated with reinitiation.

Conclusions
Failure to reinitiate ART within 18 months was common in this sample. Care engagement was associated with greater ART reinitiation.
Men and Women Have an Equal Oropharyngeal and Anorectal Chlamydia trachomatis Bacterial Load: A Comparison of 3 Anatomic Sites
Authors: Wijers Juliën N A P , Dukers-Muijrers Nicole H T M , van Liere Geneviève A F S , Dirks Jeanne A M C , Wolffs Petra F G , Hoebe Christian J P A 
Published: December 2019

Abstract

Background
The Chlamydia trachomatis bacterial load could have impact on transmission and sequelae. This is the first study providing comparison of C. trachomatis load at 3 anatomic sites estimated by cycle quantification (Cq) values.

Methods
Data from 7900 C. trachomatis-positive samples were included (2012–2018). Cq value was used as an inversely proportional measure for C. trachomatis load. Multivariable linear regression analyses assessed differences in mean Cq values.

Results
Vaginal swabs had the lowest Cq values (31.0) followed by urine (32.5), anorectal swabs (34.0), and oropharyngeal swabs (36.8) (P &lt; .001). Men and women had similar oropharyngeal (36.4 vs 37.3; P = .13) and anorectal (34.2 vs 33.9; P = .19) Cq values. Men (32.2) and women (30.7) aged &lt;25 years had lower urogenital Cq values than men (32.8) and women (31.9) aged ≥25 years (P &lt; .001). HIV-positive patients had higher urogenital Cq values than HIV-negative patients (33.8 vs 32.6; P &lt; .03).

Conclusions
Men and women have a similar C. trachomatis load at extragenital locations arguing for similar transmission potential and clinical relevance. Older patients and HIV-coinfected patients had lower C. trachomatis load, suggesting exposure to previous C. trachomatis infections potentially leading to partial immunity reducing load.
Common ownership: an EU perspective
Authors: Burnside Alec J , Kidane Adam 
Published: December 2019

Abstract
Recent antitrust scholarship has claimed that parallel investments by institutional investors in competing firms may harm competition. Proponents of this theory, dubbed ‘common ownership’, posit that harm may arise even with small shareholdings, particularly in oligopolistic markets. Although the debate has been focused on the U.S., the European Commission recently invoked common ownership as an ‘element of context’ in two merger decisions. This article examines common ownership through a European lens. A threshold issue will be whether levels of common ownership in Europe are comparable to those in the U.S.; the available evidence suggests they are not. We note a number of misconceptions about the asset management industry, putting in doubt core elements of the common ownership hypothesis. We review the academic debate in which the theory has been vigorously contested on both methodological and theoretical grounds. We review the battle between empirical studies claiming to demonstrate and to disprove common ownership effects. The article considers whether the theory is sufficiently robust to provide a basis for enforcement, and (if so) whether current European Union competition law tools could be used to that end. The European Commission’s invocation of common ownership is subjected to critical evaluation. We conclude that it is premature to draw any conclusions as to the reality of alleged common ownership concerns or to base enforcement efforts on them. Until a better understanding of the underlying facts and a broad academic consensus emerge, reform prescriptions that have been advanced are a solution in search of a problem—to say nothing of the conflicts that would arise with other rules governing asset management.
Assessment of Hair Density and Sub-epidermal Tissue Thickness in Burn Scars Using High-Definition Ultrasound Imaging
Authors: Blome-Eberwein Sigrid A , Roarabaugh Chad , Gogal Christina 
Published: December 2019

Abstract
Burn scars show significant differences in structure, pigment, and hair density/sparsity from unburned skin, yet no formal documentation of these changes can be found in the literature. Evaluation of these differences is essential to assessing future intervention outcomes. The study was a prospective controlled clinical trial. Included were 19 adult burn survivors (18–63 years old, average age 47; 15 male, 4 female, 14 Caucasian, 2 African American, 1 Hispanic; 11 flame burns, 5 scald burns, 2 grease burns and 1 electrical burn, 2%–60% TBSA) with conspicuous, mature scars. All study subjects had either skin-grafted or nongrafted scars, as well as healthy skin in the same body area, to control for intraindividual variability. All scars were at least 9 months old and at a minimum 2 × 2 cm2 in size. On each individual, at least one nongrafted scar or one grafted scar and healthy skin was imaged with a high-definition ultrasound device (Longport, Inc., Glen Mills, PA, 35MHz probe, 1500 m/s). Vancouver scar scale was assessed. Although scarred skin had significantly fewer follicles than healthy skin in both grafted (P &lt; .0001) and un-grafted sites (P = .0090), there were even significantly fewer follicles in grafted scars than un-grafted scars (P = .0095). In thickness of the sub-epidermal layer, there was no difference between grafted and un-grafted scars (P = .1900). Both kinds of scars had a significantly thicker sub-epidermal layer than healthy skin (P = .0010). Vancouver scar scale was 7.4 for grafted and 4.6 for nongrafted scars with grafted flame burn scars ranging higher than all others (5–11). There was no discomfort during the imaging, and no adverse events occurred during the study period. Our study demonstrates two clear morphologic differences between scars and healthy skin: thickness of the sub-epidermal layer and hair follicle density. Grafted burn scars were shown to contain fewer hair follicles than un-grafted scars.
Economic Injury Levels for Flea Beetles (Phyllotreta spp.; Coleoptera: Chrysomelidae) in Spring Oilseed Rape (Brassica napus; Brassicales: Brassicaceae)
Authors: Lundin Ola 
Published: December 2019

Abstract
Flea beetles (Phyllotreta spp.) are major insect pests in spring oilseed rape (SOSR; Brassica napus L.). Prohibited use of three neonicotinoid insecticides in the European Union means that there are currently no insecticide seed treatment options available. Insecticide spraying remains as a control option, but there is a need to estimate the economic threshold for crop injury. As a first step to this end, economic injury levels were determined for flea beetles in SOSR. Data from 16 field experiments were used to quantify the relationship between flea beetle crop injury and SOSR yield, and additional data from paired sprayed and unsprayed plots in 12 commercial SOSR fields were used to determine the reduction in crop injury from a pyrethroid spray. There was a strong linear negative effect of flea beetle injury with 19 kg/ha yield loss per percent crop injury to seedlings and a pyrethroid spray reduced crop injury by 39%. These results gave an economic injury level of 11% defoliation of SOSR seedlings under average oilseed rape prices and insecticide use costs in 2017. This is considerably lower than previously used nominal thresholds of 25–30% injury to cotyledons. Increased yields and increasingly cheaper pyrethroids might be the reason for the lower levels of crop injury that warrant chemical control. The economic injury levels presented here can be used to construct economic thresholds that preferably should also take into account crop growth stage, crop growth rate, and anticipated flea beetle activity.