bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme
Authors: Carvalhaes Cecilia G , Rhomberg Paul R , Pfaller Michael , Castanheira Mariana 
Published: June 2021

Abstract

Objectives
The activity of mould-active azoles was evaluated against 397 filamentous fungi causing invasive mould infections (IMI) worldwide. In addition, a tentative posaconazole epidemiological cut-off value (ECV) against Aspergillus fumigatus was investigated.

Methods
Isolates were susceptibility tested by the CLSI reference broth microdilution methods. Species identification was confirmed by MALDI-TOF and/or sequencing analysis.

Results
Aspergillus spp. (81.9%) remained the most common organism causing IMI worldwide; approximately two-thirds of Aspergillus spp. recovered were A. fumigatus. In general, more than 90% of 220 A. fumigatus isolates were wild type (WT) to all mould-active azoles, except itraconazole (84.5% WT). The voriconazole non-susceptible (NS) A. fumigatus rate was 7.7% overall and was higher in Europe (12.9%) than in the other regions (0%–5.8%). Posaconazole (MIC50/MIC90, 0.25/0.5 mg/L) showed similar or slightly higher activity than voriconazole (MIC50/MIC90, 0.5/0.5 mg/L) and isavuconazole (MIC50/MIC90, 0.5/1 mg/L) against A. fumigatus. The mould-active azoles displayed similar activity against non-fumigatus Aspergillus (WT rates &gt;93%), but differences were observed among the main species/sections. Posaconazole, voriconazole, and isavuconazole inhibited at their respective ECVs 100%, 97.0%, and 100% of A. section Nigri; 100%, 100%, and 93.8% of A. section Terrei; and 97.3%, 100%, and 100% of A. section Flavi isolates. Posaconazole displayed potency greater than or equal to the other azoles against the Mucorales group and Scedosporium spp.

Conclusions
Posaconazole and other mould-active azoles showed good activity against Aspergillus spp. causing IMI, but clinicians should be aware of regional rates of voriconazole-NS A. fumigatus.
Which other disorders cause dementia?
Authors: Budson Andrew E. , O’Connor Maureen K. 
Published: June 2021

Abstract
In addition to Alzheimer’s disease, other brain disorders of aging that affect thinking and memory include vascular dementia, dementia with Lewy bodies, Parkinson’s disease dementia, behavioral variant frontotemporal dementia, primary progressive aphasia that has logpenic, semantic, and non-fluent agrammatic variants, and normal pressure hydrocephalus. Each produces characteristic changes in thinking, memory, language, behavior, and/or movement that allow you and the doctor to know when to consider them as possible causes of your loved one’s dementia. Note that the dementia of every individual is unique, so the symptoms and signs that they will manifest are all different. However, when dementias reach the moderate to severe stage, most dementias looks similar, despite having different causes.
How to manage sleep problems
Authors: Budson Andrew E. , O’Connor Maureen K. 
Published: June 2021

Abstract
When you get a good night’s rest, you’re better able to tackle the most challenging dementia issues. On the other hand, when your sleep is poor, even small difficulties can cause you to feel frustrated and irritable. And if that’s true for you with a healthy brain, think about how important sleep is for your loved one with dementia. Poor sleep can cause many problems in those with dementia—not to mention often disrupting your own sleep! Although sleep problems are common in dementia, most of them can be managed without medications. Start by using a sleep log. Work to improve your loved one’s sleep habits and modify their daily routines to improve sleep. Be alert for disorders such as sleep apnea and abnormal sleep movements; let your loved one’s doctor know if you suspect them.
What are some ways to sustain your relationship?
Authors: Budson Andrew E. , O’Connor Maureen K. 
Published: June 2021

Abstract
There are many activities that you can enjoy with your loved one. Visiting museums, attending the theater, watching movies, and listening to music are just a few. You may both enjoy having a massage, strolling on a nature walk, or filling in an adult coloring book—even if you never pursued such pastimes before. Exercise is good for everyone and is a wonderful way to spend time with your loved one. Most people enjoy the touch and warmth of human contact and, for couples, sexual intimacy can be an important aspect of your relationship. Lastly, participating in meaningful activities—including research, advocacy, and providing support to others—can provide an important sense of purpose in life for you and your loved one.
Rationale, Foundations, and Goals of CALM
Authors: Rodin Gary , Hales Sarah 
Published: June 2021

Abstract
This chapter introduces the Managing Cancer and Living Meaningfully (CALM) treatment manual. It summarizes the intent and purpose of the manual, which outlines the essential features of the CALM intervention and provides clinical examples to elucidate its implementation. Although it has been challenging to manualize the key therapeutic elements of a semi-structured intervention such as CALM, treatment manuals are essential to ensure the reliability and integrity of treatment delivery.
Military Medical Ethics in Contemporary Armed Conflict
Authors: Gross Michael L. 
Published: June 2021

Abstract
Beleaguered countries struggling against aggression or powerful nations defending others from brutal regimes mobilize medicine to wage just war. As states funnel medical resources to maintain unit readiness and conserve military capabilities, numerous ethical challenges foreign to peacetime medicine ensue. Force conservation drives combat hospitals to prioritize warfighter care over all others. Civilians find themselves bereft of medical attention; prison officials force feed hunger-striking detainees; policymakers manage health care to win the hearts and minds of local nationals; and scientists develop neuro-technologies or nanosurgery to create super soldiers. When the fighting ends, intractable moral dilemmas rebound. Postwar justice demands enormous investments of time, resources, and personnel. But losing interest and no longer zealous, war-weary nations forget their duties to rebuild ravaged countries abroad and rehabilitate their war-torn veterans at home. Addressing these incendiary issues, Military Medical Ethics in Contemporary Armed Conflict integrates the ethics of medicine and the ethics of war. Medical ethics in times of war is not identical to medical ethics in times of peace but a unique discipline. Without war, there is no military medicine, and without just war, there is no military medical ethics. Military Medical Ethics in Contemporary Armed Conflict revises, defends, and rebuts wartime medical practices, just as it lays the moral foundation for casualty care in future conflicts.
Care and Compensation for Civilian Victims of War
Authors: Gross Michael L. 
Published: June 2021

Abstract
Lacking bed space, Coalition military hospitals in Iraq and Afghanistan declined to admit any civilian except those injured by multinational forces. There are, however, no firm moral grounds for granting collateral casualties a special right to medical attention. Military necessity justifies preferential care for civilians who can contribute to a counterinsurgency, not those suffering collateral damage. Money, not medicine, is a better vehicle to assuage resentment among wounded civilians. Considering the rights of compatriots, allies, civilians, and detainees, five ethical principles govern the distribution of medical care during war: military-medical necessity, associative duties, liability for collateral or accidental harm, beneficence, and urgent medical need. Judging by the number of patients each principle reaches, the cost of care, and the feasibility of implementation, necessity and associative duties best serve military medicine. Once patients assemble by identity and military status, urgent medical need governs care within each group.
Carotid Stenting
Authors: Khanna Omaditya , Mouchtouris Nikolaos , Peterson Eric C. , Jabbour Pascal M. 
Published: June 2021

Abstract
Several large-scale studies have corroborated the indications for carotid artery revascularization in patients who present with carotid artery stenosis. The two treatment options are carotid endarterectomy and carotid artery stent, both of which show equipoise in outcomes, and although the latter is associated with increased risk of periprocedural stroke, it confers the benefit of shorter procedural and recovery times. Currently, radial artery access is rarely used for placement of carotid artery stents, both among neurosurgeons and vascular surgeons. However, radial artery access for carotid stent placement has been shown to be safe and efficacious, and it confers the benefit of reduced access-site complications and improved patient satisfaction measures. In this chapter, aimed at practitioners who would like to incorporate radial artery access into their clinical practice, we review the evaluation and management of carotid artery stenosis and present an operative technique for carotid artery stent placement via radial artery access.
Access-Site Complications of the Transfemoral Approach
Authors: Chen Stephanie H. , Jabbour Pascal M. , Peterson Eric C. 
Published: June 2021

Abstract
The radial access route has significantly lower complications compared to the femoral access route. Often users have become used to the femoral approach and its attendant complications but it is worth reviewing that despite its minimally invasive nature as opposed to open craniotomy, endovascular transfemoral access is certainly not without risk. These risks include life threatening retroperiotenal hematoma formation and local hematoma formation as well as limb threatening occlusion of the femoral artery, which is an end artery thus must be urgently revascularlized in the event of compromise. The complications of femoral access are reviewed as well as strategies for management.
Future Directions
Authors: Sweid Ahmad , Peterson Eric C. , Jabbour Pascal M. 
Published: June 2021

Abstract
The transradial approach (TRA) reduces mortality, morbidity, access-site complications, hospital cost, and length of stay while maximizing patient satisfaction. The overall lag between the introduction of the transradial approach and its widespread use within the neurointerventional niche is due to a variety of factors, including perceived difficulties in navigation, lack of exposure during training, and complexity of the neurointerventional procedures. With more training programs converting to TRA, a new generation of fellows will be trained in the technique; in addition to that, a lot of work is on the way to develop new catheters dedicated for TRA.
New technical developments in cardiac CT: Anatomy, fractional flow reserve (FFR), and machine learning
Authors: Achenbach Stephan , Leipsic Jonathan , Min James 
Published: June 2021

Abstract
Computed tomography (CT), in the context of cardiac imaging, faces numerous challenges. The heart is a complex, three-dimensional organ, which moves very rapidly and has small dimensions. The coronary arteries, the main target of cardiac CT imaging, are especially difficult to visualize by any non-invasive technique. All the same, technology progress has made the use of CT for cardiac and coronary diagnosis possible. For selected applications, including ruling out coronary artery stenoses in low-risk individuals, CT has become a clinical tool. This chapter describes the progress of CT technology, from the first commercially available CT scanner that permitted visualization of the heart with high temporal and spatial resolution in the late 1980s, to today’s incarnations that utilize radiomics and artificial intelligence.
Intraoperative transoesophageal echocardiography for valvular surgery
Authors: Maalouf Joseph F. , Michelena Hector I. 
Published: June 2021

Abstract
Intraoperative transoesophageal echocardiography (IOTEE) is widely used to guide valvular heart disease (VHD) surgery. The critical role of IOTEE is to aid the surgeon in tailoring the surgical approach to the specific mechanism(s) of valve dysfunction in patients with mitral or aortic regurgitation undergoing valve repair surgery, identify all valvular abnormalities that may warrant intervention, and to assess in a timely manner the results of the operative intervention upon coming off cardiopulmonary bypass (pump) thus allowing immediate correction of less-than-satisfactory results before the patient leaves the operating room (OR). IOTEE is also useful to monitor results of concurrent interventions such as coronary artery bypass graft surgery and aorta aneurysm repair, and to evaluate post-bypass biventricular function.
Valvular prostheses
Authors: Badano Luigi P. , Muraru Denisa 
Published: June 2021

Abstract
Prosthetic heart valves may be mechanical or bioprosthetic. Mechanical valves, which are composed primarily of metal or carbon alloys, are classified according to their design as ball-caged, single-tilting-disc, or bileaflet-tilting-disc valves. In ball-cage valves, the occluder is a sphere which is contained by a metal ‘cage’ when the valve is in its open position, and fills the orifice when the valve is in its closed position. In single-tilting-valves, the occluder is a single circular disc which is constrained in its motion by a cage, a central strut, or a slanted slot in the valve ring, therefore it opens at an angle less than 90° to the sewing ring plane. In bileaflet-tilting-disc valves there two occluders, two semicircular discs that open forming three orifices, a central one and two lateral ones. Biological tissue valves prostheses may be heterografts, which are composed of porcine, bovine, or equine tissue (valvular or pericardial), or homografts, which are preserved human aortic valves. Heterografts include stented and stentless bioprostheses. In stented valves, the biological tissue of the valve is mounted on a rigid stent (plastic or metallic) covered with fabric. Conversely stentless bioprostheses use the patient’s native aortic root as the valve stent. The absence of a stent and sewing ring cuff make it possible to implant a larger valve for a given native annulus size, resulting in a larger effective orifice area (EOA).
Transcatheter pulmonic valve replacement
Authors: Pushparajah Kuberan , Frigiola Alessandra 
Published: June 2021

Abstract
Right ventricular outflow tract dysfunction is the most frequent residual lesion following repair of various congenital heart diseases and can be characterized by predominant pulmonary valve stenosis, regurgitation, or a combination of both lesions. The need to replace the malfunctioning pulmonary valve in order to avoid detrimental effects on right ventricular function is widely recognized. While a surgical approach was the only possible option until less than two decades ago, advances in the medical field have made it possible to replace such valves percutaneously in selected patients, with favourable anatomy, and with comparably good results. In more recent years, further developments of the percutaneous pulmonary valve design and technology have allowed an increasing number of patients to be suitable for this preferred approach due to the less invasive nature and quicker recovery time.
Assessment of viability
Authors: Pierard Luc A. , Gargiulo Paola , Perrone-Filardi Pasquale , Gerber Bernhard , Selvanayagam Joseph B. 
Published: June 2021

Abstract
Ischaemic left ventricular (LV) dysfunction due to coronary artery disease (CAD) is steadily increasing as a consequence of the ageing of the population and of improved survival of patients with acute coronary syndromes and currently represents the first cause of heart failure (HF). Myocardial function is dependent on blood supply, as anaerobic reserve is minimum due to a nearly maximal arteriovenous oxygen extraction. At rest, myocardial blood flow remains normal even in the presence of severe coronary artery stenosis (up to 85% diameter stenosis) by coronary autoregulation. In the presence of transstenotic pressure gradient due to epicardial coronary stenosis, arteriolar dilatation maintains normal myocardial flow at rest but with a progressive reduction in flow reserve. When arteriolar dilatation is maximal, autoregulation is exhausted and myocardial ischaemia develops. The limit of autoregulation depends on myocardial oxygen demand and is influenced by heart rate. Tachycardia increases oxygen demand and supply is reduced because of a decreased diastolic perfusion time. In the presence of acute ischaemia, there is a close relation between subendocardial perfusion and transmural function. Indeed, the contribution of subendocardium to myocardial thickening largely exceeds the contribution of the subepicardium. Akinesia can therefore result from subendocardial ischaemia and transmural ischaemia is not necessary. This chapter looks at how viability of the different techniques for treating myocardial dysfunction is assessed.
Infiltrative cardiomyopathy
Authors: Lombardi Massimo , Pica Silvia , Camporeale Antonella , Gimelli Alessia , Pennell Dudley J. 
Published: June 2021

Abstract
Infiltrative cardiomyopathies are comprised of a variety of inherited or acquired conditions. Myocardial involvement is often part of a complex systemic disorder, but sometimes the disease can manifest predominantly in the heart. Clinical manifestations are heterogeneous, from mild symptoms to early cardiac death. A multimodality imaging approach by means of echocardiography, cardiovascular magnetic resonance (CMR), and molecular imaging is necessary; a comprehensive assessment of morphologic, functional, tissue, and metabolic changes is the key to improve the pathophysiologic understanding of these diseases, favouring early differential diagnosis and risk stratification of patients. Furthermore, quantitative, non-invasive assessment of tissue pathology is now available and plays a crucial role in the follow-up of patients affected by infiltrative cardiomyopathies, improving their management and potentially guiding the development of existing and new therapies.
Pericardial effusion and cardiac tamponade
Authors: Klein Allan , Cosyns Bernard , Schenone Aldo L. 
Published: June 2021

Abstract
Pericardial effusion (Peff) is a commonly encountered findings in clinical practice. It is usually asymptomatic, but can present as a life-threatening condition when cardiac tamponade ensues. The use of multimodality cardiac imaging has emerged as a crucial tool in the early detection and characterization of Peff and cardiac tamponade allowing prompt and effective treatment. Transthoracic echocardiography (TTE) is first-line imaging technique in the evaluation for Peff and cardiac tamponade. They key echocardiographic findings supporting cardiac tamponade include the presence of (1) cardiac chambers collapse; (2) an exaggerated ventricular interdependence; and (3) plethoric inferior vena cava (IVC). Advance cardiac imaging including transoesophageal echocardiography, cardiac CT, and cardiac MRI are reserved for complex cases with high suspicion for focal effusion or tamponade when TTE is unrevealing. Medical treatment of underlying cause is recommended for effusion without haemodynamic compromise, while emergent drainage is warranted when in cardiac tamponade.
Cardiac masses and tumours
Authors: López-Fernández Teresa , Buser Peter 
Published: June 2021

Abstract
The care for cancer patients has dramatically improved over the past century. Cardio-oncology, the multidisciplinary cardiovascular care of cancer patients, has been proposed as a new approach to improve prevention, early identification, and management of cardiotoxicity. However this field is not simply limited to complications of cancer therapies, it also encompasses cardiac neoplasias. Cardiac masses include tumours, thrombi, cysts, calcific lesions, vegetations, and other rare conditions. The present chapter will cover all these entities from the imaging diagnostic perspective. Although echocardiography is generally the first imaging tool used, tissue characterization by cardiac magnetic resonance (CMR) can be particularly helpful for differential diagnosis.
The role of echocardiography in adult congenital heart disease
Authors: Smith Lindsay A. , Friedberg Mark K. , Mertens Luc 
Published: June 2021

Abstract
Echocardiography plays a key role in the diagnosis and management of adult patients with congenital heart disease and is considered the first-line diagnostic technique. Apart from traditional cross-sectional imaging, three-dimensional echocardiography and strain and strain rate imaging were introduced for specific indications and for better describing anatomical details and functional consequences of the different congenital lesions. For specific indications, additional imaging may be required including cardiac magnetic resonance imaging and computational tomography. Especially in adult congenital heart disease, echocardiographic imaging may be limited by poor acoustic windows and additional evaluation using other imaging modalities may be required. Additionally, MRI and CT imaging have proven to be extremely valuable for evaluation of right ventricular size and function and for describing extracardiac anatomy (pulmonary arteries, pulmonary veins, and aorta).
pyrpipe: a Python package for RNA-Seq workflows
Authors: Singh Urminder , Li Jing , Seetharam Arun , Wurtele Eve Syrkin 
Published: June 2021

Abstract
The availability of terabytes of RNA-Seq data and continuous emergence of new analysis tools, enable unprecedented biological insight. There is a pressing requirement for a framework that allows for fast, efficient, manageable, and reproducible RNA-Seq analysis. We have developed a Python package, (pyrpipe), that enables straightforward development of flexible, reproducible and easy-to-debug computational pipelines purely in Python, in an object-oriented manner. pyrpipe provides access to popular RNA-Seq tools, within Python, via high-level APIs. Pipelines can be customized by integrating new Python code, third-party programs, or Python libraries. Users can create checkpoints in the pipeline or integrate pyrpipe into a workflow management system, thus allowing execution on multiple computing environments, and enabling efficient resource management. pyrpipe produces detailed analysis, and benchmark reports which can be shared or included in publications. pyrpipe is implemented in Python and is compatible with Python versions 3.6 and higher. To illustrate the rich functionality of pyrpipe, we provide case studies using RNA-Seq data from GTEx, SARS-CoV-2-infected human cells, and Zea mays. All source code is freely available at https://github.com/urmi-21/pyrpipe; the package can be installed from the source, from PyPI (https://pypi.org/project/pyrpipe), or from bioconda (https://anaconda.org/bioconda/pyrpipe). Documentation is available at (http://pyrpipe.rtfd.io).