bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapidly progressive aortic stenosis treated with transcatheter aortic valve implantation in a patient with Fabry disease: a case report
Authors: Saccheri María C , Cianciulli Tomás F , Blanco Federico L , Blanco Rodrigo I 
Published: June 2021

Abstract

Background
Fabry disease (FD) is a rare lysosomal storage disease, caused by mutations in the gene encoding the enzyme α-galactosidase A (α-Gal A). Cardiac involvement is one of the main causes of death and it is characterized by progressive concentric left ventricular hypertrophy (LVH), which in most cases is symmetric. Mild thickening of the left-sided valves is seen in as many as a quarter of patients. Severe aortic stenosis is an extremely rare disorder in FD.

Case summary
In this report, we describe the case of a 57-year-old male, who was diagnosed with a cardiac variant of FD 10 years ago. Since the patient had severe LVH, he was started on enzyme replacement therapy when he was 47 years old with an intravenous infusion of 0.2 mg/kg of agalsidase alpha every 14 days. The patient remained stable and asymptomatic for 9 years, until he presented with dyspnoea in New York Heart Association functional class II–III and severe aortic stenosis (aortic valve area: 0.97 cm2) together with severe systolic dysfunction [ejection fraction (EF): 29%]. Because of the patient’s comorbidities and high surgical risk, he underwent successful transfemoral transcatheter aortic valve implantation (TAVI). At 2 months following TAVI, the patient was asymptomatic and, in spite of his Fabry cardiomyopathy, the EF had increased to 45%.

Discussion
To our knowledge, this is the first case in the literature to demonstrate a rapid progression of aortic stenosis with severe impairment of left ventricular function and worsening in functional class in a patient with FD, who following TAVI improved his EF, with disappearance of symptoms and ventricular arrhythmias.
Iatrogenic perforation of a pulmonary artery side branch—a case report
Authors: Leick Juergen , Leinen Stefan , Friedrich Ivar , Werner Nikos 
Published: June 2021

Abstract

Background
The use of a pulmonary artery catheter (PAC) continues to be important for the diagnosis and therapeutic control of severe heart failure and in the diagnosis of pulmonary arterial hypertension. One of the most feared complications of this examination is perforation of a pulmonary artery with an estimated incidence of 0.031–0.05% and mortality rates of up to 70%.

Case summary
We report on an 80-year-old female patient who experienced a perforation of a pulmonary artery branch during the work-up of pulmonary arterial hypertension by PAC. Immediately after the perforation, haemodynamic shock developed rapidly, necessitating cardiopulmonary resuscitation. Occlusion of the pulmonary artery branch with a semicompliant balloon was applied immediately. After 40 min of occlusion, the bleeding persisted, and endovascular coil implantation was performed. Subsequently, the bleeding stopped, and the haemodynamics stabilized. After treatment, the patient was discharged home without any significant sequelae.

Discussion
Treatment options in pulmonary artery perforation are limited, especially if the patient is inoperable and if balloon occlusion fails. Based on our results, endovascular coil embolization can be considered a therapeutic option.
Highly differentiated soil bacterial communities in Victoria Land macro-areas (Antarctica)
Authors: Severgnini Marco , Canini Fabiana , Consolandi Clarissa , Camboni Tania , Paolo D'Acqui Luigi , Mascalchi Cristina , Ventura Stefano , Zucconi Laura 
Published: June 2021

ABSTRACT
Ice-free areas of Victoria Land, in Antarctica, are characterized by different terrestrial ecosystems, that are dominated by microorganisms supporting highly adapted communities. Despite the unique conditions of these ecosystems, reports on their bacterial diversity are still fragmentary. From this perspective, 60 samples from 14 localities were analyzed. These localities were distributed in coastal sites with differently developed biological soil crusts, inner sites in the McMurdo Dry Valleys with soils lacking of plant coverage, and a site called Icarus Camp, with a crust developed on a thin locally weathered substrate of the underlying parent granitic-rock. Bacterial diversity was studied through 16S rRNA metabarcoding sequencing. Communities diversity, composition and the abundance and composition of different taxonomic groups were correlated to soil physicochemical characteristics. Firmicutes, Bacteroidetes, Cyanobacteria and Proteobacteria dominated these communities. Most phyla were mainly driven by soil granulometry, an often disregarded parameter and other abiotic parameters. Bacterial composition differed greatly among the three macrohabitats, each having a distinct bacterial profile. Communities within the two main habitats (coastal and inner ones) were well differentiated from each other as well, therefore depending on site-specific physicochemical characteristics. A core community of the whole samples was observed, mainly represented by Firmicutes and Bacteroidetes.
Racial Segregation and Cognitive Function Among Older Adults in the United States: Findings From the Reasons for Geographic and Racial Differences in Stroke Study
Authors: Jang Joy Bohyun , Hicken Margaret T , Mullins Megan , Esposito Michael , Sol Ketlyne , Manly Jennifer J , Judd Suzanne , Wadley Virginia , Clarke Philippa J 
Published: June 2021

Abstract

Objectives
Residential segregation is one of the fundamental features of health disparities in the United States. Yet little research has examined how living in segregated metropolitan areas is related to cognitive function and cognitive decline with age. We examined the association between segregation at the metropolitan statistical area (MSA) level and trajectories of age-related cognitive function.

Method
Using data from Black and White older adults in the REasons for Geographic and Racial Differences in Stroke study (n = 18,913), we employed linear growth curve models to examine how living in racially segregated MSAs at baseline, measured by the degree of non-Hispanic Black (NHB) isolation and NHB dissimilarity, was associated with trajectories of age-related cognitive function and how the associations varied by race and education.

Results
Living in MSAs with greater levels of isolation was associated with lower cognitive function (b = −0.093, p &lt; .05) but was not associated with rates of change in cognitive decline with age. No effects of living in isolated MSAs were found for those with at least a high school education, but older adults with less than a high school education had lower cognitive function in MSAs with greater isolation (b = −0.274, p &lt; .05). The degree of dissimilarity was not associated with cognitive function. The association between segregation and cognitive function did not vary by race.

Discussion
Metropolitan segregation was associated with lower cognitive function among older adults, especially for those with lower education living in racially isolated MSAs. This suggests complex associations between individual socioeconomic status, place, and cognitive health.
Memorandum concerning Joseph Priestley
Authors: Jones Daniel A 
Published: June 2021

Abstract
A previously unpublished memorandum on the life of Dr. Joseph Priestley written by Priestley’s former student, Benjamin Vaughan. Vaughan, who participated in the negotiations of the Treaty of Paris and served as a member of parliament, recounts the academic accomplishments, research interests and character of one of England’s most famous eighteenth-century polymaths. Vaughan’s reflections provide a first-hand account of the personal nature of Priestley, who helped fuel the scientific discoveries of the Enlightenment, including experiments that led to the discovery of oxygen. The original manuscript is available in the Benjamin Vaughan papers at the American Philosophical Society in Philadelphia.
Oceanographic structure and seasonal variation contribute to high heterogeneity in mesozooplankton over small spatial scales
Authors: Brandão Manoela C , Comtet Thierry , Pouline Patrick , Cailliau Caroline , Blanchet-Aurigny Aline , Sourisseau Marc , Siano Raffaele , Memery Laurent , Viard Frédérique , Nunes Flávia 
Published: June 2021

Abstract
The coastal oceans can be highly variable, especially near ocean fronts. The Ushant Front is the dominant oceanographic feature in the Iroise Sea (NE Atlantic) during summer, separating warm stratified offshore waters from cool vertically-mixed nearshore waters. Mesozooplankton community structure was investigated over an annual cycle to examine relationships with oceanographic conditions. DNA metabarcoding of COI and 18S genes was used in communities from six sites along two cross-shelf transects. Taxonomic assignments of 380 and 296 OTUs (COI and 18S, respectively) identified 21 classes across 13 phyla. Meroplankton relative abundances peaked in spring and summer, particularly for polychaete and decapod larvae, respectively, corresponding to the reproductive periods of these taxa. Meroplankton was most affected by season, while holoplankton varied most by shelf position. Copepods with a mixed feeding strategy were associated with the most offshore sites, especially in the presence of the front, while filter-feeding or carnivorous copepods were associated with nearshore sites. In sum, mesozooplankton communities in well-mixed coastal waters were distinct from those found in the Ushant Front (high thermal stratification and chlorophyll-a). Furthermore, the benthic compartment, through its partial life cycle in the water column, contributed to high heterogeneity in planktonic communities over short temporal and spatial scales.
The limited usefulness of the proportionality principle
Authors: Chang Yun-chien , Dai Xin 
Published: June 2021

Abstract
The proportionality principle is used in constitutional law and administrative law worldwide. We argue that this doctrinal method is theoretically flawed and often practically not useful. Our major arguments are that, first, the proportionality principle is an ill-suited tool for legislative and administrative decision-making, because it is, in essence, an incomplete form of cost-benefit analysis, as it systematically ignores certain costs and benefits. Welfare-maximizing measures, as a result, may fail to pass the test of proportionality analysis. Second, representative of legal scholars’ efforts to theorize proportionality, the German theorist Robert Alexy’s influential Paretian formulation of the proportionality principle makes it either toothless or fatal. Alexy’s weight formula is not useful in comparing multiple means. Third, the use of the proportionality principle for constitutional review by courts may create an undesirable ex ante effect and may fall prey to its inherent loss aversion which cannot be easily avoided through re-framing.
Time is of the essence: where can we improve care in acute aortic dissection?
Authors: Saha Shekhar , Fabry Thomas G , Buech Joscha , Ali Ahmad , Joskowiak Dominik , Tsilimparis Nikolaos , Hagl Christian , Pichlmaier Maximilian , Peterss Sven 
Published: June 2021

Abstract

OBJECTIVES
In acute aortic dissection type A various components of the diagnostic and logistic pathways may affect the time to definitive treatment. This study aimed to characterize these components and to identify factors delaying the optimal management within our institutional referral network.

METHODS
Between January 2017 and January 2020, 96 consecutive patients with classical aortic dissection type A were admitted (28%) or referred (72%) to our tertiary care centre and analysed retrospectively. Data are presented as medians (25th–75th quartile).

RESULTS
Median age was 66 years (56–74), 63% were male. Most of the patients were primarily admitted to a cardiology department (40%), whereas about a fourth were admitted to departments for internal medicine (26%) and general surgery (27%). The median interval from the onset of symptoms to hospital admission was 2.1 (1–4.4) h. From admission to confirmed diagnosis it took 2.1 (0.6–9.5) h and the median interval from confirmed diagnosis to admission at our specialized tertiary care aortic centre was 1.5 (0.9–2.4) h. Following admission to our centre, 1.1 (0.5–1.9) h passed until the induction of anaesthesia and 0.8 (0.0–1.1) h until the start of surgery. The total interval from the onset of symptoms to the start of surgery was 7.6 h (5.1–12.3).

CONCLUSIONS
The marked variability of the time from symptoms to diagnosis at any medical facility demonstrates the importance of awareness in the optimization of the treatment of acute aortic dissection type A.
The Misogyny of Authoritarians in Contemporary Democracies
Authors: Kaul Nitasha 
Published: June 2021

AbstractContemporary democracy in multiple countries has been under assault from what has been variously called right-wing populism, authoritarian populism, cultural majoritarianism, new nativism, new nationalism, quasi-fascism, and neo-fascism. While the authoritarian behaviors of several electorally legitimated leaders in these countries have been in focus, their misogyny is seen as merely an incidental part of their personality. This article highlights the centrality of misogyny in legitimating the political goals and regimes of a set of leaders in contemporary democracies—Trump, Modi, Bolsonaro, Duterte, and Erdogan (all but Trump are still in power)—in countries from across Global North/South, non-West/West, with mixed populations and different majority religions. The argument proceeds as follows. First, I clarify the conceptualization of misogyny and explain why it matters. Second, I demonstrate the substantive misogyny of political leaders who are/have been heads of hegemonic right-wing political projects in five contemporary democracies (Trumpism, Modification, Bolsonarismo, Dutertismo, and Erdoganism). Third, I put forward three systematic ways in which misogyny works as an effective political strategy for these projects, by enabling a certain politics of identity to demonize opponents as feminine/inferior/anti-national, scavenging upon progressive ideas (rather than rejecting them) and distorting them, and sustaining and defending a militarized masculinist approach to policy and delegitimizing challenges to it. This article, thus, contributes to the literature on how masculinity, misogyny, and gender norms more broadly intersect with political legitimacy, by arguing for understanding the analytic centrality of misogyny to the exercise of political power in multiple global projects.
Antimicrobial guidelines in clinical practice: incorporating the ethical perspective
Authors: Lambregts Merel , Rump Babette , Ropers Fabienne , Sijbom Martijn , Petrignani Mariska , Visser Leo , de Vries Martine , de Boer Mark 
Published: June 2021

Abstract

Introduction
Guidelines on antimicrobial therapy are subject to periodic revision to anticipate changes in the epidemiology of antimicrobial resistance and new scientific knowledge. Changing a policy to a broader spectrum has important consequences on both the individual patient level (e.g. effectiveness, toxicity) and population level (e.g. emerging resistance, costs). By combining both clinical data evaluation and an ethical analysis, we aim to propose a comprehensive framework to guide antibiotic policy dilemmas.

Methods
A preliminary framework for decision-making on antimicrobial policy was constructed based on existing literature and panel discussions. Antibiotic policy themes were translated into specific elements that were fitted into this framework. The adapted framework was evaluated in two moral deliberation groups. The moral deliberation sessions were analysed using ATLAS.ti statistical software to categorize arguments and evaluate completeness of the final framework.

Results
The final framework outlines the process of data evaluation, ethical deliberation and decision-making. The first phase is a factual data exploration. In the second phase, perspectives are weighed and the policy of moral preference is formulated. Judgments are made on three levels: the individual patient, the patient population and society. In the final phase, feasibility, implementation and re-evaluation are addressed.

Conclusions
The proposed framework facilitates decision-making on antibiotic policy by structuring existing data, identifying knowledge gaps, explicating ethical considerations and balancing interests of the individual and current and future generations.
Optimal Public Investment in Resource-Rich Low-Income Countries
Authors: Algozhina Aliya 
Published: June 2021

Abstract
Recent studies have found that resource-rich low-income countries are better off investing their resource revenues domestically rather than saving them abroad in a sovereign wealth fund (SWF). This paper finds an optimal rule-based policy of accumulating public capital and its associated public investment path in a perfect foresight general equilibrium model. The model has several specific features different from the existing frameworks: the policy rule for public capital is introduced. Public investment is inefficient and has its absorptive capacity constraint costs. External savings clear the government budget. There is a variable share of resource revenues to accumulate the SWF, and the natural resource sector is assumed to be capital-intensive with its foreign direct investment shock. Based on calibration for African countries, the study finds that the front-loaded public investment path is optimal given an initial one-period resource windfall, public investment inefficiency and absorptive capacity constraints in the economies. This result also holds under less productive public capital and more patient households, while a scenario of no resource windfall produces the welfare loss due to a steady increase in consumption tax to finance public investment.
Comparison of Three Sample-to-Answer RT–PCR Testing Platforms for the Detection of SARS-CoV-2 RNA in Positive Nasopharyngeal and Nasal Swabs
Authors: Luethy Paul M , Johnson J Kristie 
Published: June 2021

Abstract

Background
The COVID-19 pandemic has strained clinical microbiology laboratories due to testing supply allocations. As a result, laboratories have had to invest in multiple COVID-19 assays performed on different testing instruments. Comparing the results achieved by testing positive samples between in-use assays can provide insights into which platforms may be interchangeable for testing in times of supply chain emergencies.

Methods
Nasopharyngeal and nasal swab specimens collected in viral transport media that tested positive on the Xpert® Xpress SARS-CoV-2 assay were tested on the ePlex® SARS-CoV-2 and BD SARS-CoV-2 Reagents for BD Max™ assays. Positive percent agreement was calculated using the Xpert Xpress SARS-CoV-2 assay as the reference method.

Results
We tested 78 positive swabs, resulting in a positive percentage agreement (PPA) of 92% (CI 84–97%) for the BD SARS-CoV-2 assay and 58% (CI 47–70%) for the ePlex assay. Following development of a new workflow for the ePlex, we detected SARS-CoV-2 in 7 additional samples, resulting in a new PPA of 68% (CI 56–78).

Conclusions
During times of supply allocation and shortage of the Xpert Xpress SARS-CoV-2 assay, the BD SARS-CoV-2 assay is well suited to test substitutions due to its high PPA.
Differential privacy in health research: A scoping review
Authors: Ficek Joseph , Wang Wei , Chen Henian , Dagne Getachew , Daley Ellen 
Published: June 2021

AbstractObjectiveDifferential privacy is a relatively new method for data privacy that has seen growing use due its strong protections that rely on added noise. This study assesses the extent of its awareness, development, and usage in health research.Materials and MethodsA scoping review was conducted by searching for [“differential privacy” AND “health”] in major health science databases, with additional articles obtained via expert consultation. Relevant articles were classified according to subject area and focus.ResultsA total of 54 articles met the inclusion criteria. Nine articles provided descriptive overviews, 31 focused on algorithm development, 9 presented novel data sharing systems, and 8 discussed appraisals of the privacy-utility tradeoff. The most common areas of health research where differential privacy has been discussed are genomics, neuroimaging studies, and health surveillance with personal devices. Algorithms were most commonly developed for the purposes of data release and predictive modeling. Studies on privacy-utility appraisals have considered economic cost-benefit analysis, low-utility situations, personal attitudes toward sharing health data, and mathematical interpretations of privacy risk.DiscussionDifferential privacy remains at an early stage of development for applications in health research, and accounts of real-world implementations are scant. There are few algorithms for explanatory modeling and statistical inference, particularly with correlated data. Furthermore, diminished accuracy in small datasets is problematic. Some encouraging work has been done on decision making with regard to epsilon. The dissemination of future case studies can inform successful appraisals of privacy and utility.ConclusionsMore development, case studies, and evaluations are needed before differential privacy can see widespread use in health research.
A slight bending of an α-helix in FliM creates a counterclockwise-locked structure of the flagellar motor in Vibrio
Authors: Takekawa Norihiro , Nishikino Tatsuro , Yamashita Toshiki , Hori Kiyoshiro , Onoue Yasuhiro , Ihara Kunio , Kojima Seiji , Homma Michio , Imada Katsumi 
Published: June 2021

Abstract
Many bacteria swim by rotating flagella. The chemotaxis system controls the direction of flagellar rotation. Vibrio alginolyticus, which has a single polar flagellum, swims smoothly by rotating the flagellar motor counterclockwise (CCW) in response to attractants. In response to repellents, the motor frequently switches its rotational direction between CCW and clockwise (CW). We isolated a mutant strain that swims with a CW-locked rotation of the flagellum, which pulls rather than pushes the cell. This CW phenotype arises from a R49P substitution in FliM, which is the component in the C-ring of the motor that binds the chemotaxis signalling protein, phosphorylated CheY. However, this phenotype is independent of CheY, indicating that the mutation produces a CW conformation of the C-ring in the absence of CheY. The crystal structure of FliM with the R49P substitution showed a conformational change in the N-terminal α-helix of the middle domain of FliM (FliMM). This helix should mediates FliM–FliM interaction. The structural models of wild type and mutant C-ring showed that the relatively small conformational change in FliMM induces a drastic rearrangement of the conformation of the FliMM domain that generates a CW conformation of the C-ring.