bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Hepatitis B Virus Infection Among US Adults Aged 20–59 Years With a History of Injection Drug Use: National Health and Nutrition Examination Survey, 2001–2016
Authors: Shing Jaimie Z , Ly Kathleen N , Xing Jian , Teshale Eyasu H , Jiles Ruth B 
Published: July 2019

Abstract

Background
Hepatitis B virus (HBV) can transmit through needle sharing. The national HBV infection prevalence in persons who inject drugs remains ill-defined. We estimated the prevalence of total HBV core antibody (anti-HBc) positivity, indicating a previous or ongoing HBV infection, among adults aged 20–59 years with an injection drug use (IDU) history. We compared select characteristics by anti-HBc status.

Methods
Using 2001–2016 National Health and Nutrition Examination Survey data, we calculated the anti-HBc positivity prevalence among adults with IDU histories and among the general US population. For adults with IDU histories, we compared sex, age group, birth cohort, race/ethnicity, health insurance coverage, and hepatitis A immunity by anti-HBc status. Using marginal structural models, we calculated model-adjusted prevalence rates and ratios to determine the characteristics associated with anti-HBc positivity among adults with IDU histories.

Results
From 2001–2016, the anti-HBc positivity prevalence was 19.7% (95% confidence interval [CI] 16.0–24.0%) among those with IDU histories, compared with 4.6% (95% CI 4.3–5.0%) in the general population. The HBV surface antigen positivity prevalence was 0.4% (95% CI 0.3–0.5%) in the general population. Among adults with IDU histories, 19.8% reported prior-year IDU and 28.5% had a hepatitis A immunity.

Conclusions
One-fifth of adults with IDU histories had a previous or ongoing HBV infection: a rate over 4 times higher than the prevalence in the general population. One-fifth of adults with IDU histories reported prior-year use. Programs promoting safe IDU practices, drug treatment, and hepatitis A and B vaccinations should be key components of viral hepatitis prevention.
Efficacy of Direct-acting Antivirals for Chronic Hepatitis C Virus Infection in People Who Inject Drugs or Receive Opioid Substitution Therapy: A Systematic Review and Meta-analysis
Authors: Graf Christiana , Mücke Marcus M , Dultz Georg , Peiffer Kai-Henrik , Kubesch Alica , Ingiliz Patrick , Zeuzem Stefan , Herrmann Eva , Vermehren Johannes 
Published: July 2019

Abstract

Background
Treatment uptake for hepatitis C virus (HCV) infection in people who inject drugs (PWID) and patients on opioid substitution therapy (OST) is still low despite treatment guidelines that advocate the use of direct-acting antivirals (DAAs) in all patients. Our aim in this review was to investigate treatment outcomes among PWID and patients on OST in comparison to control cohorts.

Methods
A search of Embase, Medline, PubMed, and Web of Science (from October 2010 to March 2018) was conducted to assess sustained virologic response (SVR), discontinuation rates, adherence, and HCV reinfection in PWID and patients on OST.

Results
We identified 11 primary articles and 12 conference abstracts comprising 1702 patients on OST, 538 PWID, and 19 723 patients who served as controls. Among patients on OST, the pooled SVR was 90% (95% confidence interval [CI], 87% to 93%) and pooled treatment discontinuation rate was 7% (95% CI, 4% to 11%). Similarly, the pooled SVR was 88% (95% CI, 80% to 93%) in PWID and the pooled treatment discontinuation rate was 9% (95% CI, 5% to 15%). There was no significant difference regarding pooled rates of SVR, adherence, and discontinuation between patients on OST and controls as well as between PWID and controls. HCV reinfection rates among patients on OST ranged from 0.0 to 12.5 per 100 person-years.

Conclusions
HCV treatment outcomes in PWID and patients on OST are similar to those in patients without a history of injecting drugs, supporting current guideline recommendations to treat HCV in these patient populations.
Hybrid Network Intrusion Detection System for Smart Environments Based on Internet of Things
Authors: Subbarayalu Venkatraman , Surendiran B , Arun Raj Kumar P 
Published: July 2019

Abstract
The proliferation of Internet of Things (IoT) devices has led to many applications, including smart homes, smart cities and smart industrial control systems. Attacks like Distributed Denial of Service, event control hijacking, spoofing, event replay and zero day attacks are prevalent in smart environments. Conventional Network Intrusion Detection Systems (NIDSs) are tedious to deploy in the smart environment because of numerous communication architectures, manufacturer policies, technologies, standards and application-specific services. To overcome these challenges, we modeled the operational behavior of IoT network events using timed ACs and proposed a novel hybrid NIDS in this paper. A web server is integrated with IoT devices for remote access, and Constrained Application Protocol is employed in inter- and intra-smart device communication. Experiments are conducted in real time to validate our proposal and achieve 99.17% detection accuracy and 0.01% false positives.
Heterogeneity and plasticity in healthy and atherosclerotic vasculature explored by single-cell sequencing
Authors: van Kuijk Kim , Kuppe Christoph , Betsholtz Christer , Vanlandewijck Michael , Kramann Rafael , Sluimer Judith C 
Published: July 2019

Abstract
Cellular characteristics and their adjustment to a state of disease have become more evident due to recent advances in imaging, fluorescent reporter mice, and whole genome RNA sequencing. The uncovered cellular heterogeneity and/or plasticity potentially complicates experimental studies and clinical applications, as markers derived from whole tissue ‘bulk’ sequencing is unable to yield a subtype transcriptome and specific markers. Here, we propose definitions on heterogeneity and plasticity, discuss current knowledge thereof in the vasculature and how this may be improved by single-cell sequencing (SCS). SCS is emerging as an emerging technique, enabling researchers to investigate different cell populations in more depth than ever before. Cell selection methods, e.g. flow assisted cell sorting, and the quantity of cells can influence the choice of SCS method. Smart-Seq2 offers sequencing of the complete mRNA molecule on a low quantity of cells, while Drop-seq is possible on large numbers of cells on a more superficial level. SCS has given more insight in heterogeneity in healthy vasculature, where it revealed that zonation is crucial in gene expression profiles among the anatomical axis. In diseased vasculature, this heterogeneity seems even more prominent with discovery of new immune subsets in atherosclerosis as proof. Vascular smooth muscle cells and mesenchymal cells also share these plastic characteristics with the ability to up-regulate markers linked to stem cells, such as Sca-1 or CD34. Current SCS studies show some limitations to the number of replicates, quantity of cells used, or the loss of spatial information. Bioinformatical tools could give some more insight in current datasets, making use of pseudo-time analysis or RNA velocity to investigate cell differentiation or polarization. In this review, we discuss the use of SCS in unravelling heterogeneity in the vasculature, its current limitations and promising future applications.
Liposomal doxorubicin attenuates cardiotoxicity via induction of interferon-related DNA damage resistance
Authors: Gyöngyösi Mariann , Lukovic Dominika , Zlabinger Katrin , Spannbauer Andreas , Gugerell Alfred , Pavo Noemi , Traxler Denise , Pils Dietmar , Maurer Gerald , Jakab Andras , Riesenhuber Martin , Pircher Andreas , Winkler Johannes , Bergler-Klein Jutta 
Published: July 2019

Abstract

Aims
The clinical application of doxorubicin (DOX) is severely compromised by its cardiotoxic effects, which limit the therapeutic index and the cumulative dose. Liposomal encapsulation of DOX (Myocet®) provides a certain protective effect against cardiotoxicity by reducing myocardial drug accumulation. We aimed to evaluate transcriptomic responses to anthracyclines with different cardiotoxicity profiles in a translational large animal model for identifying potential alleviation strategies.

Methods and results
We treated domestic pigs with either DOX, epirubicin (EPI), or liposomal DOX and compared the cardiac, laboratory, and haemodynamic effects with saline-treated animals. Cardiotoxicity was encountered in all groups, reflected by an increase of plasma markers N-terminal pro-brain-natriuretic peptide and Troponin I and an impact on body weight. High morbidity of EPI-treated animals impeded further evaluation. Cardiac magnetic resonance imaging with gadolinium late enhancement and transthoracic echocardiography showed stronger reduction of the left and right ventricular systolic function and stronger myocardial fibrosis in DOX-treated animals than in those treated with the liposomal formulation. Gene expression profiles of the left and right ventricles were analysed by RNA-sequencing and validated by qPCR. Interferon-stimulated genes (ISGs), linked to DNA damage repair and cell survival, were downregulated by DOX, but upregulated by liposomal DOX in both the left and right ventricle. The expression of cardioprotective translocator protein (TSPO) was inhibited by DOX, but not its liposomal formulation. Cardiac fibrosis with activation of collagen was found in all treatment groups.

Conclusions
All anthracycline-derivatives resulted in transcriptional activation of collagen synthesis and processing. Liposomal packaging of DOX-induced ISGs in association with lower cardiotoxicity, which is of high clinical importance in anticancer treatment. Our study identified potential mechanisms for rational development of strategies to mitigate anthracycline-induced cardiomyopathy.
High-sensitivity C-reactive protein in chronic heart failure: patient characteristics, phenotypes, and mode of death
Authors: Pellicori Pierpaolo , Zhang Jufen , Cuthbert Joe , Urbinati Alessia , Shah Parin , Kazmi Syed , Clark Andrew L , Cleland John G F 
Published: July 2019

Abstract

Aims
Plasma concentrations of high-sensitivity C-reactive protein (hsCRP) are often raised in chronic heart failure (CHF) and might indicate inflammatory processes that could be a therapeutic target. We aimed to study the associations between hsCRP, mode and cause of death in patients with CHF.

Methods and results
We enrolled 4423 patients referred to a heart failure clinic serving a local population. CHF was defined as relevant symptoms or signs with either a reduced left ventricular ejection fraction &lt;40% or raised plasma concentrations of amino-terminal pro-B type natriuretic peptide (NT-proBNP &gt;125 pg/mL). The median [interquartile range (IQR)] plasma hsCRP for patients diagnosed with CHF (n = 3756) was 3.9 (1.6–8.5) mg/L and 2.7 (1.3–5.1) mg/L for those who were not (n = 667; P &lt; 0.001). Patients with hsCRP ≥10 mg/L (N = 809; 22%) were older and more congested than those with hsCRP &lt;2 mg/L (N = 1117, 30%). During a median follow-up of 53 (IQR 28–93) months, 1784 (48%) patients with CHF died. Higher plasma hsCRP was associated with greater mortality, independent of age, symptom severity, creatinine, and NT-proBNP. Comparing a hsCRP ≥10 mg/L to &lt;2 mg/L, the hazard ratio for all-cause mortality was 2.49 (95% confidence interval 2.19–2.84; P &lt; 0.001), for cardiovascular (CV) mortality was 2.26 (1.91–2.68; P &lt; 0.001), and for non-CV mortality was 2.96 (2.40–3.65; P &lt; 0.001).

Conclusion
In patients with CHF, a raised plasma hsCRP is associated with more congestion and a worse prognosis. The proportion of deaths that are non-CV also increases with higher hsCRP.
Income contingent university loans: Policy design and an application to Spain
Authors: Cabrales Antonio , Güell Maia , Madera Rocio , Viola Analía 
Published: July 2019

SUMMARY
In Europe, the need for additional funding coming from either budget cuts and/or increased costs due to increased competition in university quality has reopened the debate on the financing of university systems. An attractive alternative to the current general-tax-financed subsidies is Income Contingent Loans (ICL), a flexible scheme that puts more weight on private resources while enhancing progressivity. One challenge of the viability of ICL systems is the functioning of the labor market for university graduates. This paper offers a general analysis of the economics of ICL, followed by an application to Spain. We set up a loan laboratory in which we can explore the distributional effects of different loan systems to finance tertiary education at current costs as well as to increase university funding to improve its quality. We use simulated lifetime earnings of graduates matching the dynamics of employment and earnings in the Spanish administrative social security data to calculate the burden of introducing ICL for individuals at different points of the earnings distribution and for the government. We find that (1) our proposed structure is highly progressive under all specifications, with the top quarter of the distribution paying close to the full amount of the tuition and the bottom 10% paying almost no tuition and (2) the share of total university education subsidized by the government is between 16 and 56 percentage points less than under the current system.
Routinely reported ejection fraction and mortality in clinical practice: where does the nadir of risk lie?
Authors: Wehner Gregory J , Jing Linyuan , Haggerty Christopher M , Suever Jonathan D , Leader Joseph B , Hartzel Dustin N , Kirchner H Lester , Manus Joseph N A , James Nick , Ayar Zina , Gladding Patrick , Good Christopher W , Cleland John G F , Fornwalt Brandon K 
Published: July 2019

Abstract

Aims
We investigated the relationship between clinically assessed left ventricular ejection fraction (LVEF) and survival in a large, heterogeneous clinical cohort.

Methods and results
Physician-reported LVEF on 403 977 echocardiograms from 203 135 patients were linked to all-cause mortality using electronic health records (1998–2018) from US regional healthcare system. Cox proportional hazards regression was used for analyses while adjusting for many patient characteristics including age, sex, and relevant comorbidities. A dataset including 45 531 echocardiograms and 35 976 patients from New Zealand was used to provide independent validation of analyses. During follow-up of the US cohort, 46 258 (23%) patients who had undergone 108 578 (27%) echocardiograms died. Overall, adjusted hazard ratios (HR) for mortality showed a u-shaped relationship for LVEF with a nadir of risk at an LVEF of 60–65%, a HR of 1.71 [95% confidence interval (CI) 1.64–1.77] when ≥70% and a HR of 1.73 (95% CI 1.66–1.80) at LVEF of 35–40%. Similar relationships with a nadir at 60–65% were observed in the validation dataset as well as for each age group and both sexes. The results were similar after further adjustments for conditions associated with an elevated LVEF, including mitral regurgitation, increased wall thickness, and anaemia and when restricted to patients reported to have heart failure at the time of the echocardiogram.

Conclusion
Deviation of LVEF from 60% to 65% is associated with poorer survival regardless of age, sex, or other relevant comorbidities such as heart failure. These results may herald the recognition of a new phenotype characterized by supra-normal LVEF.
2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
Authors: Cronin Edmond M , Bogun Frank M , Maury Philippe , Peichl Petr , Chen Minglong , Namboodiri Narayanan , Aguinaga Luis , Leite Luiz Roberto , Al-Khatib Sana M , Anter Elad , Berruezo Antonio , Callans David J , Chung Mina K , Cuculich Phillip , d’Avila Andre , Deal Barbara J , Della Bella Paolo , Deneke Thomas , Dickfeld Timm-Michael , Hadid Claudio , Haqqani Haris M , Kay G Neal , Latchamsetty Rakesh , Marchlinski Francis , Miller John M , Nogami Akihiko , Patel Akash R , Pathak Rajeev Kumar , Sáenz Morales Luis C , Santangeli Pasquale , Sapp John L , Sarkozy Andrea , Soejima Kyoko , Stevenson William G , Tedrow Usha B , Tzou Wendy S , Varma Niraj , Zeppenfeld Katja ,   ESC Scientific Document Group, Asirvatham Samuel J , Sternick Eduardo Back , Chyou Janice , Ernst Sabine , Fenelon Guilherme , Gerstenfeld Edward P , Hindricks Gerhard , Inoue Koichi , Kim Jeffrey J , Krishnan Kousik , Kuck Karl-Heinz , Avalos Martin Ortiz , Paul Thomas , Scanavacca Mauricio I , Tung Roderick , Voss Jamie , Yamada Takumi , Yamane Teiichi 
Published: July 2019

AbstractVentricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta-analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow-up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.
Pulmonary vein encirclement using an Ablation Index-guided point-by-point workflow: cardiovascular magnetic resonance assessment of left atrial scar formation
Authors: O’Neill Louisa , Karim Rashed , Mukherjee Rahul K , Whitaker John , Sim Iain , Harrison James , Razeghi Orod , Niederer Steven , Ismail Tevfik , Wright Matthew , O’Neill Mark D , Williams Steven E 
Published: July 2019

Abstract

Aims
A point-by-point workflow for pulmonary vein isolation (PVI) targeting pre-defined Ablation Index values (a composite of contact force, time, and power) and minimizing interlesion distance may optimize the creation of contiguous ablation lesions whilst minimizing scar formation. We aimed to compare ablation scar formation in patients undergoing PVI using this workflow to patients undergoing a continuous catheter drag workflow.

Methods and results
Post-ablation cardiovascular magnetic resonance imaging was performed in patients undergoing 1st-time PVI using a parameter-guided point-by-point workflow (n = 26). Total left atrial scar burden and the width and continuity of the pulmonary vein encirclement were determined on analysis of atrial late gadolinium enhancement sequences. Comparison was made with a cohort of patients (n = 20) undergoing PVI using continuous drag lesions. Mean post-ablation scar burden and scar width were significantly lower in the point-by-point group than in the control group (6.6 ± 6.8% vs. 9.6 ± 5.0%, P = 0.03 and 7.9 ± 3.6 mm vs. 10.7 ± 2.3 mm, P = 0.003). More complete bilateral pulmonary vein encirclements were seen in the point-by-point group (P = 0.038). All patients achieved acute PVI.

Conclusion
Pulmonary vein isolation using a point-by-point workflow is feasible and results in a lower scar burden and scar width with more complete pulmonary vein encirclements than a conventional drag lesion approach.
A comparison of European countries FBDG in the light of their contribution to tackle diet-related health inequalities
Authors: Carrillo-Álvarez Elena , Boeckx Hilde , Penne Tess , Palma Linares Imma , Storms Berénice , Goedemé Tim 
Published: July 2019

Abstract

Background
The purpose of this article is to report on a comparative analysis of the official food-based dietary guidelines (FBDG) that were applicable in 2015 in 25 EU Member States. We assess FBDG in relation to the main guidelines established by the FAO/WHO, the EURODIET project and the EFSA, with a particular focus on identifying strengths and limitations of current FBDG in Europe towards addressing diet-related health inequalities.

Methods
This is a review research, in which a mixed-methods sequenced procedure was utilized. In each EU country key informants, including sociologists, economists, dietitians and nutritionists were asked to provide data regarding: (i) current dietary guidelines and national health priorities, (ii) model of health promotion currently available, (iii) results of the latest food consumption survey. All documents were reviewed by the coordinating team. Full data were analysed by two nutritionists, using a tabulated sheet to organize and compare the results.

Results
While all countries have national FBDG, the level of detail and quality varies substantially with regard to: time of last update; availability of recommendations for specific target groups; specification of frequency and portion size; the graphical representation; recommended amounts and limits of foods consumed; and recommendations regarding physical activity.

Conclusions
European countries have great opportunities to improve FBDG to better serve Public Health policy through a more consistent foundation of how these guidelines are developed, the inclusion of different population subgroups as a target for recommendations and the implementation of monitoring systems.