bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Treatment Regimens Containing Bedaquiline and Delamanid in the endTB Cohort
Authors: Hewison Catherine , Khan Uzma , Bastard Mathieu , Lachenal Nathalie , Coutisson Sylvine , Osso Elna , Ahmed Saman , Khan Palwasha , Franke Molly F , Rich Michael L , Varaine Francis , Melikyan Nara , Seung Kwonjune J , Adenov Malik , Adnan Sana , Danielyan Narine , Islam Shirajul , Janmohamed Aleeza , Karakozian Hayk , Kamene Kimenye Maureen , Kirakosyan Ohanna , Kholikulov Begimkul , Krisnanda Aga , Kumsa Andargachew , Leblanc Garmaly , Lecca Leonid , Nkuebe Mpiti , Mamsa Shahid , Padayachee Shrivani , Thit Phone , Mitnick Carole D , Huerga Helena 
Published: January 2022

Abstract

Background
Safety of treatment for multidrug-resistant tuberculosis (MDR/RR-TB) can be an obstacle to treatment completion. Evaluate safety of longer MDR/RR-TB regimens containing bedaquiline and/or delamanid.

Methods
Multicentre (16 countries), prospective, observational study reporting incidence and frequency of clinically relevant adverse events of special interest (AESIs) among patients who received MDR/RR-TB treatment containing bedaquiline and/or delamanid. The AESIs were defined a priori as important events caused by bedaquiline, delamanid, linezolid, injectables, and other commonly used drugs. Occurrence of these events was also reported by exposure to the likely causative agent.

Results
Among 2296 patients, the most common clinically relevant AESIs were peripheral neuropathy (26.4%), electrolyte depletion (26.0%), and hearing loss (13.2%) with an incidence per 1000 person months of treatment, 1000 person-months of treatment 21.5 (95% confidence interval [CI]: 19.8–23.2), 20.7 (95% CI: 19.1–22.4), and 9.7 (95% CI: 8.6–10.8), respectively. QT interval was prolonged in 2.7% or 1.8 (95% CI: 1.4–2.3)/1000 person-months of treatment. Patients receiving injectables (N = 925) and linezolid (N = 1826) were most likely to experience events during exposure. Hearing loss, acute renal failure, or electrolyte depletion occurred in 36.8% or 72.8 (95% CI: 66.0–80.0) times/1000 person-months of injectable drug exposure. Peripheral neuropathy, optic neuritis, and/or myelosuppression occurred in 27.8% or 22.8 (95% CI: 20.9–24.8) times/1000 patient-months of linezolid exposure.

Conclusions
AEs often related to linezolid and injectable drugs were more common than those frequently attributed to bedaquiline and delamanid. MDR-TB treatment monitoring and drug durations should reflect expected safety profiles of drug combinations.

Clinical Trials Registration
NCT03259269.
Necessity of Coronavirus Disease 2019 (COVID-19) Vaccination in Persons Who Have Already Had COVID-19
Authors: Shrestha Nabin K , Burke Patrick C , Nowacki Amy S , Terpeluk Paul , Gordon Steven M 
Published: January 2022

Abstract

Background
The aim was to evaluate the necessity of coronavirus disease 2019 (COVID-19) vaccination in persons with prior COVID-19.

Methods
Employees of the Cleveland Clinic working in Ohio on 16 December 2020, the day COVID-19 vaccination was started, were included. Anyone who tested positive for COVID-19 at least once before the study start date was considered previously infected. One was considered vaccinated 14 days after receiving the second dose of COVID-19 mRNA vaccine. Cumulative incidences of COVID-19, symptomatic COVID-19, and hospitalizations for COVID-19 were examined over the next year.

Results
Among 52 238 employees, 4718 (9%) were previously infected and 36 922 (71%) were vaccinated by the study’s end. Cumulative incidence of COVID-19 was substantially higher throughout for those previously uninfected who remained unvaccinated than for all other groups, lower for the vaccinated than unvaccinated, and lower for those previously infected than those not. Incidence of COVID-19 increased dramatically in all groups after the Omicron variant emerged. In multivariable Cox proportional hazards regression, both prior COVID-19 and vaccination were independently associated with significantly lower risk of COVID-19. Among previously infected subjects, a lower risk of COVID-19 overall was not demonstrated, but vaccination was associated with a significantly lower risk of symptomatic COVID-19 in both pre-Omicron (HR, .60; 95% CI, .40–.90) and Omicron (HR, .36; 95% CI, .23–.57) phases.

Conclusions
Both previous infection and vaccination provide substantial protection against COVID-19. Vaccination of previously infected individuals does not provide additional protection against COVID-19 for several months, but after that provides significant protection at least against symptomatic COVID-19.
The kidney in hantavirus infection—epidemiology, virology, pathophysiology, clinical presentation, diagnosis and management
Authors: Koehler Felix C , Di Cristanziano Veronica , Späth Martin R , Hoyer-Allo K Johanna R , Wanken Manuel , Müller Roman-Ulrich , Burst Volker 
Published: January 2022

ABSTRACTHantavirus-induced diseases are emerging zoonoses with endemic appearances and frequent outbreaks in different parts of the world. In humans, hantaviral pathology is characterized by the disruption of the endothelial cell barrier followed by increased capillary permeability, thrombocytopenia due to platelet activation/depletion and an overactive immune response. Genetic vulnerability due to certain human leukocyte antigen haplotypes is associated with disease severity. Typically, two different hantavirus-caused clinical syndromes have been reported: hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). The primarily affected vascular beds differ in these two entities: renal medullary capillaries in HFRS caused by Old World hantaviruses and pulmonary capillaries in HCPS caused by New World hantaviruses. Disease severity in HFRS ranges from mild, e.g. Puumala virus-associated nephropathia epidemica, to moderate, e.g. Hantaan or Dobrava virus infections. HCPS leads to a severe acute respiratory distress syndrome with high mortality rates. Due to novel insights into organ tropism, hantavirus-associated pathophysiology and overlapping clinical features, HFRS and HCPS are believed to be interconnected syndromes frequently involving the kidneys. As there are no specific antiviral treatments or vaccines approved in Europe or the USA, only preventive measures and public awareness may minimize the risk of hantavirus infection. Treatment remains primarily supportive and, depending on disease severity, more invasive measures (e.g., renal replacement therapy, mechanical ventilation and extracorporeal membrane oxygenation) are needed.
Histologic characterization and risk factors for persistent albuminuria in adolescents in a region of highly prevalent end-stage renal failure of unknown origin
Authors: Macias Diaz Dulce M , Corrales Aguirre Myriam del Carmen , Reza Escalera Ana Lilian , Tiscareño Gutiérrez Maria Teresa , Ovalle Robles Itzel , Macías Guzmán Mariana Jocelyn , García Díaz Andrea L , Gutiérrez Peña Mauricio C , Alvarado-Nájera Andrea Natalia , González Domínguez Israel , Villavicencio-Bautista Juan Carlos , Herrera Rodríguez Angela Azucena , Marín-García Ricardo , Avelar González Francisco Javier , Wong Alfredo Chew , Galván Guerra Elba , Delgadillo Castañeda Rodolfo , Prado Aguilar Carlos Alberto , Zúñiga-Macías Leslie P , Arreola Guerra José Manuel 
Published: January 2022

ABSTRACT

Background
End-stage renal failure of unknown origin (ESRD-UO) is a public health problem in Mexico and many regions of the world. The prevalence of ESRD-UO in Aguascalientes, Mexico, is one of the highest worldwide, particularly in adults between 20 and 40 years of age. Our aim was to screen adolescents for chronic kidney disease (CKD) to identify risk factors and histologically characterize adolescents with persistent albuminuria.

Methods
This was a cross-sectional, observational and comparative study of adolescents in whom serum creatinine and the albumin:creatinine ratio (ACR) were determined when screening for CKD. A clinical evaluation and risk factor survey were conducted. Patients with an abnormal ACR (≥30 mg/g) or a low glomerular filtration rate (GFR) (≤75 mL/min/1.73 m2) were re-evaluated and a renal ultrasound (US) was obtained. A kidney biopsy was performed in patients with persistent albuminuria.

Results
A total of 513 students were included; 19 had persistent albuminuria and 494 were controls. The prevalence of persistent albuminuria was 3.7% [95% confidence interval (CI) 2.1–5.3]. Only one patient had a decreased GFR. None of the patients with persistent albuminuria had anatomical abnormalities of the urinary tract by renal US. Patients with persistent albuminuria had a decreased total renal volume compared with the control group (150 versus 195 mL/m2; P &lt; 0.01). Eighteen kidney biopsies were performed; 72% had glomerulomegaly and only one patient had mild fibrosis. Podocyte abnormalities were evident on electron microscopy, including partial fusion (100%), microvillous degeneration (80%) and increased organelles (60%). Risk factors for persistent albuminuria were: homestead proximity to maize crops, the use of pesticides at the father’s workplace, a family history of CKD and blood pressure abnormalities. The body mass index and breastfeeding were protective factors.

Conclusions
The prevalence of persistent albuminuria in adolescents in Aguascalientes is high and histologic compromise is characterized by podocyte injury in the absence of fibrosis. The renal volume of persistent albuminuria patients was decreased, suggesting oligonephronia. Exposure to environmental toxins such as pesticides, even prenatally, may be responsible for this pathological entity. Screening programs in adolescents by determining ACR are necessary in this setting.
Delayed juvenile behavioral development and prolonged dependence are adaptations to desert life in the grey falcon
Authors: Schoenjahn Jonny , Pavey Chris R , Walter Gimme H 
Published: January 2022

Abstract
Rapid learning in the young of most endothermic animals can be expected to be favored by natural selection because early independence reduces the period of vulnerability. Cases of comparatively slow juvenile development continue, therefore, to attract scientific attention. In most species of birds, including raptors, the young depend on their parents for some time after fledging for the provisioning of food and for protection while they learn to become nutritionally and otherwise independent. Among raptors, post-fledging dependence periods that exceed 6 months are exclusive to the largest species and these have reproductive cycles that exceed 12 months. By contrast, young of the medium-sized grey falcon Falco hypoleucos have been reported in close company with their parents up to 12 months after fledging, that is, at a time when the adults are expected to breed again. We investigated the occurrence and characteristics of prolonged adult–juvenile association relative to other falcons and similar-sized raptors. We found that the behavioral development of grey falcon young is extremely delayed, and that they even depend nutritionally on their parents for up to 12 months after fledging. We suggest that these 2 distinctive features are, ultimately, adaptations of the grey falcon to its extreme environment, Australia’s arid and semi-arid zone, one of the hottest environments in the world.
Imaging assessment of the right atrium: anatomy and function
Authors: Lang Roberto M , Cameli Matteo , Sade Leila E , Faletra Francesco F , Fortuni Federico , Rossi Alexia , Soulat-Dufour Laurie 
Published: January 2022

Abstract
The right atrium (RA) is the cardiac chamber that has been least well studied. Due to recent advances in interventional cardiology, the need for greater understanding of the RA anatomy and physiology has garnered significant attention. In this article, we review how a comprehensive assessment of RA dimensions and function using either echocardiography, cardiac computed tomography, and magnetic resonance imaging may be used as a first step towards a better understanding of RA pathophysiology. The recently published normative data on RA size and function will likely shed light on RA atrial remodelling in atrial fibrillation (AF), which is a complex phenomenon that occurs in both atria but has only been studied in depth in the left atrium. Changes in RA structure and function have prognostic implications in pulmonary hypertension (PH), where the increased right ventricular (RV) afterload first induces RV remodelling, predominantly characterized by hypertrophy. As PH progresses, RV dysfunction and dilatation may begin and eventually lead to RV failure. Thereafter, RV overload and increased RV stiffness may lead to a proportional increase in RA pressure. This manuscript provides an in-depth review of RA anatomy, function, and haemodynamics with particular emphasis on the changes in structure and function that occur in AF, tricuspid regurgitation, and PH.
Percutaneous thrombectomy and right ventricular mechanical circulatory support for pulmonary embolism in a coronavirus disease 2019 patient: case report, 1-year update, and echocardiographic findings
Authors: Cohen Gerald I , Schreiber Theodore , Singh Hemindermeet , Kaki Amir 
Published: January 2022

Abstract

Background
We previously described percutaneous thrombectomy and right ventricular (RV) mechanical support of a coronavirus disease 2019 (COVID-19) patient with a massive pulmonary embolism. Here, we present a detailed echocardiographic and clinical timeline with 1-year follow-up.

Case summary
A 57-year-old female with COVID-19 went into shock from a massive pulmonary embolism. After percutaneous removal of a large thrombus burden (AngioVac system; AngioDynamics Inc., Latham, NY, USA), she became severely hypotensive, requiring cardiopulmonary resuscitation, and hemodynamic support with an Impella RP device (Abiomed, Danvers, MA, USA). A paediatric transoesophageal echocardiography (TOE) probe monitored the procedure because an adult probe would not pass (S7-3t—Philips Medical Systems, Andover, MA, USA). Post-thrombectomy, surface imaging documented gradual resolution of RV dysfunction, tricuspid regurgitation, and elevated pulmonary artery pressure. Her course was complicated by renal failure requiring temporary dialysis. She was discharged home on apixaban. Hypercoagulability work-up was negative. Two months later, vocal cord surgery was performed for persistent stridor. Esophagoscopy at that time was prevented by osteophyte obstruction. At 10 months, she received the Pfizer-BioNTech vaccine. At 1 year, the patient remains healthy on apixaban, and her echocardiogram is normal.

Discussion
This case illustrates the pivotal role of echocardiography in the diagnosis, percutaneous treatment, and near- and long-term follow-up and management of a patient with massive pulmonary embolism due to COVID-19 with documentation of complete recovery from severe RV dysfunction and haemodynamic collapse. A paediatric TOE probe was a crucial alternative to the adult probe because of possible osteophyte obstruction.
A Subsidy That is Inversely Related to the Product Price
Authors: Kiso Takahiko 
Published: January 2022

Abstract
This study considers a new subsidy design to support the purchase or production of target products. Under the proposed design, subsidy payments are inversely related to product prices. Compared to ‘flat’ subsidies, this design reduces producers’ market power and the subsidy benefits passed on to them, improving the cost-effectiveness of government spending (by up to 50% according to simulations based on an actual subsidy programme). Additionally, this subsidy’s cost-effectiveness and incidence can be adjusted flexibly by changing the policy parameters. Finally, the subsidy design can be modified to provide larger payments to higher-quality products, thereby offsetting disincentives for quality improvement.
Sex-related differences in treatment and outcome of chronic limb-threatening ischaemia: a real-world cohort
Authors: Makowski Lena , Köppe Jeanette , Engelbertz Christiane , Kühnemund Leonie , Fischer Alicia J , Lange Stefan A , Dröge Patrik , Ruhnke Thomas , Günster Christian , Malyar Nasser , Gerß Joachim , Freisinger Eva , Reinecke Holger , Feld Jannik 
Published: January 2022

AbstractAimsThe prevalence of chronic limb-threatening ischaemia (CLTI) is increasing and available data often derive from cohorts with various selection criteria. In the present study, we included CLTI patients and studied sex-related differences in their risk profile, vascular procedures, and long-term outcome.Methods and resultsWe analysed 199 953 unselected patients of the largest public health insurance in Germany (AOK: Local healthcare funds), hospitalized between 2010 and 2017 for a main diagnosis of CLTI. A baseline period of 2 years before index hospitalization to assess comorbidities and previous procedures, and a follow-up period until 2018 were included. Female CLTI patients were older (median 81.4 vs. 73.8 years in males; P &lt; 0.001) and more often diagnosed with hypertension, atrial fibrillation, chronic heart failure, and chronic kidney disease. Male patients suffered more frequently from diabetes mellitus, dyslipidaemia, smoking, cerebrovascular disease, and chronic coronary syndrome (all P &lt; 0.001). Within hospitalized CLTI patients, females represent the minority (43% vs. 57%; P &lt; 0.001) and during index hospitalization, women underwent less frequently diagnostic angiographies (67 vs. 70%) and revascularization procedures (61 vs. 65%; both P &lt; 0.001). Moreover, women received less frequently guideline-recommended drugs like statins (35 vs. 43%) and antithrombotic therapy (48 vs. 53%; both P &lt; 0.001) at baseline. Interestingly, after including age and comorbidities in a Cox regression analysis, female sex was associated with increased overall-survival (OS) [hazard ratio (HR) 0.95; 95% confidence interval (CI) 0.94–0.96] and amputation-free survival (AFS) (HR 0.84; 95% CI 0.83–0.85; both P &lt; 0.001).ConclusionFemale patients with CLTI were older, underwent less often vascular procedures, and received less frequently guideline-recommended medication. Nevertheless, female sex was independently associated with better OS and AFS during follow-up.
Early and late-onset syncope: insight into mechanisms
Authors: Torabi Parisa , Rivasi Giulia , Hamrefors Viktor , Ungar Andrea , Sutton Richard , Brignole Michele , Fedorowski Artur 
Published: January 2022

Abstract

Aims
Unexplained syncope is an important clinical challenge. The influence of age at first syncope on the final syncope diagnosis is not well studied.

Methods and results
Consecutive head-up tilt patients (n = 1928) evaluated for unexplained syncope were stratified into age groups &lt;30, 30–59, and ≥60 years based on age at first syncope. Clinical characteristics and final syncope diagnosis were analysed in relation to age at first syncope and age at investigation. The age at first syncope had a bimodal distribution with peaks at 15 and 70 years. Prodromes (64 vs. 26%, P &lt; 0.001) and vasovagal syncope (VVS, 59 vs. 19%, P &lt; 0.001) were more common in early-onset (&lt;30 years) compared with late-onset (≥60 years) syncope. Orthostatic hypotension (OH, 3 vs. 23%, P &lt; 0.001), carotid sinus syndrome (CSS, 0.6 vs. 9%, P &lt; 0.001), and complex syncope (&gt;1 concurrent diagnosis; 14 vs. 26%, P &lt; 0.001) were more common in late-onset syncope. In patients aged ≥60 years, 12% had early-onset and 70% had late-onset syncope; older age at first syncope was associated with higher odds of OH (+31% per 10-year increase, P &lt; 0.001) and CSS (+26%, P = 0.004). Younger age at first syncope was associated with the presence of prodromes (+23%, P &lt; 0.001) and the diagnoses of VVS (+22%, P &lt; 0.001) and complex syncope (+9%, P = 0.018).

Conclusion
In patients with unexplained syncope, first-ever syncope incidence has a bimodal lifetime pattern with peaks at 15 and 70 years. The majority of older patients present only recent syncope; OH and CSS are more common in this group. In patients with early-onset syncope, prodromes, VVS, and complex syncope are more common.
Myths of Multipolarity: The Sources of Brazil's Foreign Policy Overstretch
Authors: Schenoni Luis L , Ribeiro Pedro Feliú , Lopes Dawisson Belém , Casarões Guilherme 
Published: January 2022

AbstractIn this article, we provide a framework to analyze the foreign policy overstretch of middle powers, that is, their recent tendency to expand foreign policy goals and ambitions beyond their capabilities. We propose that overstretch results from the interaction of permissive international environments and the collusion of domestic actors to produce foreign policy myths. These myths, in turn, justify unsustainable swelling of foreign policy expenditures until they are shattered. After laying out our theory, we test it against the case of twenty-first-century Brazil. First, we document how interest groups logrolled to foster and capitalize on a “myth of multipolarity,” which, once entrenched in elite discourse and public opinion, resulted in a tangible overgrowth of foreign policy. Second, we show the extent of overstretch across four indicators—number of embassies, participation in peacekeeping operations, membership in international organizations, and aid projects overseas—using the synthetic control method to compare Brazil with a plausible counterfactual.
Melatonin maintains the storage quality of fresh-cut Chinese water chestnuts by regulating phenolic and reactive oxygen species metabolism
Authors: Xu Yuhan , Yu Jian , Chen Jinhui , Gong Jiabao , Peng Li , Yi Yang , Ai Youwei , Hou Wenfu , Wang Hongxun , Min Ting 
Published: January 2022

Abstract
Fresh-cut Chinese water chestnuts (CWCs) are prone to quality deterioration during storage, which does not meet consumer demand. In this study, the effect of exogenous melatonin (5 mmol·L−1) on the quality and potential mechanisms in fresh-cut CWC was investigated. The results showed that melatonin treatment alleviated the cut-surface discoloration of CWCs. Not only did this treatment significantly slow down the increase in browning degree and yellowness (b∗) as well as the decrease in lightness (L∗), but it also significantly delayed the loss of weight and total soluble solids. Further investigations indicated that melatonin-treated fresh-cut CWCs exhibited significantly lower total phenolics and soluble quinones and suppressed the activities of phenylalanine ammonia-lyase, polyphenol oxidase, and peroxidase. Meanwhile, when fresh-cut CWCs were treated with melatonin, the total flavonoid concentration was significantly decreased compared to the control. Additionally, melatonin significantly inhibited the accumulation of H2O2 and malondialdehyde as well as enhanced the activities of superoxide dismutase and catalase by promoting the production of O2–•. In summary, melatonin treatment may delay the surface discoloration of fresh-cut CWCs by inhibiting phenolic compound metabolism and improving antioxidant capacity, thereby effectively maintaining the quality and prolonging the shelf life of fresh-cut CWCs.