bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of ketamine in electroconvulsive therapy for major depressive disorder: meta-analysis of randomised controlled trials
Authors: Li Xiao-Mei , Shi Zhan-Ming , Wang Pei-Jia , Hu Hua 
Published: June 2020

BackgroundThe use of ketamine in electroconvulsive therapy (ECT) has been examined in the treatment of major depressive disorder (MDD); however, there has been no systematic review and meta-analysis of related randomised controlled trials (RCTs).AimTo examine the efficacy and safety of ketamine augmentation of ECT in MDD treatment.MethodsTwo reviewers searched Chinese (China National Knowledge Infrastructure and Wanfang) and English (PubMed, PsycINFO, Embase and Cochrane Library) databases from their inception to 23 July 2019. The included studies" bias risk was evaluated using the Cochrane risk of bias assessment tool. The primary outcome of this meta-analysis was improved depressive symptoms at day 1 after a single ECT treatment session. Data were pooled to calculate the standardised mean difference and risk ratio with their 95% CIs using RevMan V.5.3. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the whole quality of evidence.ResultsFour RCTs (n = 239) compared ketamine alone or ketamine plus propofol (n = 149) versus propofol alone (n = 90) in patients with MDD who underwent a single ECT session. Three RCTs were considered as unclear risk with respect to random sequence generation using the Cochrane risk of bias. Compared with propofol alone, ketamine alone and the combination of ketamine and propofol had greater efficacy in the treatment of depressive symptoms at days 1, 3 and 7 after a single ECT session. Moreover, compared with propofol alone, ketamine alone and the combination of ketamine and propofol were significantly associated with increased seizure duration and seizure energy index. Compared with propofol, ketamine alone was significantly associated with increased opening-eye time. Based on the GRADE approach, the evidence level of primary and secondary outcomes ranged from very low (26.7%, 4/15) to ‘low’ (73.3%, 11/15).ConclusionCompared with propofol, there were very low or low evidence levels showing that ketamine alone and the combination of ketamine and propofol appeared to rapidly improve depressive symptoms of patients with MDD undergoing a single ECT session. There is a need for high-quality RCTs.
Development of a psychological first-aid model in inpatients with COVID-19 in Wuhan, China
Authors: Cheng Wenhong , Zhang Fang , Hua Yingqi , Yang Zhi , Liu Jun 
Published: June 2020

BackgroundFacing the social panic and substantial shortage of medical resources during the coronavirus disease 2019 (COVID-19) outbreak, providing psychological first-aid to inpatients is essential for their rehabilitation and the orderly operating of medical systems. However, the closed-ward environment and extreme shortage of onsite mental health workers have limited the use of traditional face-to-face diagnosis and psychological interventions.AimTo develop a mental health intervention model for inpatients that can be applied during a widespread epidemic, such as COVID-19.MethodsIn a medical team stationed in Leishenshan Hospital, Wuhan, China, we integrated onsite and online psychological support resources to implement a graded psychological intervention system. The onsite psychiatrist established trust with the patients and classified them into categories according to their symptom severity. While face-to-face evaluation and intervention are critical for effective online support, the online team effectively extended the scope of the ‘first-aid’ to all patients.ConclusionThis integrated onsite and online approach was effective and efficient in providing psychological interventions for inpatients during the crisis. Our model provides a realistic scheme for healthcare systems in or after the COVID-19 epidemic and also could be adopted in areas of the world with insufficient mental healthcare resources.
Improvisation during a crisis: hidden innovation in healthcare systems
Authors: Wiedner Rene , Croft Charlotte , McGivern Gerry 
Published: June 2020

BackgroundCrises, such as the COVID-19 pandemic, risk overwhelming health and social care systems. As part of their responses to a critical situation, healthcare professionals necessarily improvise. Some of these local improvisations have the potential to contribute to important innovations for health and social care systems with relevance beyond the particular service area and crisis in which they were developed.FindingsThis paper explores some key drivers of improvised innovation that may arise in response to a crisis. We highlight how services that are not considered immediate priorities may also emerge as especially fertile areas in this respect.ConclusionHealth managers and policymakers should monitor crisis-induced improvisations to counteract the potential deterioration of non-prioritised services and to identify and share useful innovations. This will be crucial as health and social care systems around the world recover from the COVID-19 pandemic and head into another potential crisis: a global economic recession.
Associations between cigarette prices and consumption in Europe 2004–2014
Authors: Laverty Anthony A , Millett Christopher , Filippidis Filippos T 
Published: June 2020

IntroductionIncreases in tobacco price are known to reduce smoking prevalence, but these correlations may be blunted by the availability of budget cigarettes, promoted by the tobacco industry to maintain profits.ObjectiveTo investigate the effect of budget cigarettes on cigarette consumption using data from Europe 2004–2014.MethodsData on the annual population-weighted cigarette consumption per adult come from the International Cigarette Consumption Database. Data on the annual tobacco price come from Euromonitor International for 23 European countries. Median prices and price differentials (operationalised as percentages obtained by dividing the difference between median and minimum prices by the median price) were examined. A linear random-effects model was used to assess associations between median prices and price differentials with cigarette consumption within 1 year and with a 1-year time lag.ResultsCigarette consumption per capita declined over the study period (−29.5 cigarettes per capita per year, 95% confidence interval −46.8 to −12.1). The analysis suggests that increases in cigarette price differentials, a marker of opportunities for smokers to switch to less expensive cigarettes, may be associated with greater consumption in the same year (6.4 for a 10% increase in differential, −40.0 to 52.6) and are associated with greater consumption in the following year (67.6, 25.8 to 109.5).ConclusionThese analyses suggest that even in Europe, where tobacco taxes are relatively high compared with other regions, differential cigarette pricing strategies may undermine tobacco control. Further research is needed on links between tobacco price structures and consumption, and policy design to maximise the effectiveness of tobacco taxation.
A semi-infinite matrix analysis of the BFKL equation
Authors: de León N. Bethencourt , Chachamis G. , Romagnoni A. , Sabio Vera A. 
Published: June 2020

AbstractThe forward BFKL equation is discretised in virtuality space and it is shown that the diffusion into infrared and ultraviolet momenta can be understood in terms of a semi-infinite matrix. The square truncation of this matrix can be exponentiated leading to asymptotic eigenstates sharing many features with the BFKL gluon Green’s function in the limit of large matrix size. This truncation is closely related to a representation of the XXX Heisenberg spin $$= - \frac{1}{2}$$=-12 chain with SL(2) invariance where the Hamiltonian acts on a symmetric double copy of the harmonic oscillator. A simple modification of the BFKL matrix suppressing the infrared modes generates evolution more compatible with the Froissart bound.
Prospect of undoped inorganic crystals at 77 Kelvin for low-mass dark matter search at Spallation Neutron Source
Authors: Chernyak Dmitry , Pershey Daniel , Liu Jing , Ding Keyu , Saunders Nathan , Oli Tupendra 
Published: June 2020

AbstractInvestigated in this work were sensitivities of a prototype detector for the detection of low-mass dark matter particles produced at the Spallation Neutron Source at the Oak Ridge National Laboratory in 2 years of data taking. The presumed prototype consisted of 10 kg undoped CsI or NaI scintillation crystals directly coupled with SiPM arrays operated at 77 K. Compared to the COHERENT CsI(Na) detector, a much higher light yield was assumed for the prototype. An experiment with a cylindrical 1 kg undoped CsI crystal coupled directly to two photomultiplier tubes at about 77 K was conducted as the first step to verify the idea. A light yield of $$26.0 \pm 0.4$$26.0±0.4 photoelectrons per keV electron-equivalent was achieved. This eliminated the concern of self light absorption in large crystals raised in some of the early studies.
Contrapposto: a antítese como construção de significado
Authors: Mirocznik Betty 
Published: June 2020

Problematiza-se aqui, a profusão das imagens que circulam pelas mídias na sociedade do hiperreal. Essas imagens planas captadas nas telas de TV, computador e celulares, simulam a realidade, sendo denominadas por Baudrillard, como simulacro. Nesse contexto, é imperativo produzir-se uma imagem de resistência, que desperte o mistério e a experiência em cada um - imagem-enigma. Para essa discussão, elegeu-se a obra Contrapposto de Bruce Nauman.
A narrativa dos viajantes pelo Piauí
Authors: Teixeira Marina Lages Gonçalves 
Published: June 2020

O presente artigo se utiliza da Teoria da Estética da Recepção, iniciada por Hans Robert Jauss, para discutir a narrativa dos viajantes que passaram pelo território do Piauí, utilizando como estudo de caso duas viagens chefiadas por Artur Neiva e Belisário Pena, por iniciativa das instituições IOCS e Fundação Oswaldo Cruz, em 1912; e a de Paulo Thedim Barreto, pelo SPHAN, em 1938. O estudo aqui proposto trata os viajantes como leitores de um espaço definido, Piauí, por nós considerado a literatura, assim apresentamos três eixos de análise: o primeiro, o horizonte de expectativas – ou mundivivencial – dos viajantes; o segundo, acerca das implicações estéticas, onde se pretende iniciar a discussão do Brasil dos Sertões e a narrativa sem fronteiras; e, o último, aborda as implicações históricas e a cadeia de recepções envolvida, a partir do qual se trabalha a questão da narrativa histórica e literária sobre os sertões, abordando a construção dos elementos simbólicos e culturais sobre a temática.
Histone Deacetylase 9 Activates IKK to Regulate Atherosclerotic Plaque Vulnerability
Authors: Asare Yaw , Campbell-James Thomas A. , Bokov Yury , Yu Lydia Luya , Prestel Matthias , El Bounkari Omar , Roth Stefan , Megens Remco T.A. , Straub Tobias , Thomas Kyra , Yan Guangyao , Schneider Melanie , Ziesch Natalie , Tiedt Steffen , Silvestre-Roig Carlos , Braster Quinte , Huang Yishu , Schneider Manuela , Malik Rainer , Haffner Christof , Liesz Arthur , Soehnlein Oliver , Bernhagen Jürgen , Dichgans Martin 
Published: June 2020

Rationale:
Arterial inflammation manifested as atherosclerosis is the leading cause of mortality worldwide. Genome-wide association studies have identified a prominent role of HDAC (histone deacetylase)-9 in atherosclerosis and its clinical complications including stroke and myocardial infarction.

Objective:
To determine the mechanisms linking HDAC9 to these vascular pathologies and explore its therapeutic potential for atheroprotection.

Methods and Results:

We studied the effects of
Hdac9
on features of plaque vulnerability using bone marrow reconstitution experiments and pharmacological targeting with a small molecule inhibitor in hyperlipidemic mice. We further used 2-photon and intravital microscopy to study endothelial activation and leukocyte-endothelial interactions. We show that hematopoietic
Hdac9
deficiency reduces lesional macrophage content while increasing fibrous cap thickness thus conferring plaque stability. We demonstrate that HDAC9 binds to IKK (inhibitory kappa B kinase)-α and β, resulting in their deacetylation and subsequent activation, which drives inflammatory responses in both macrophages and endothelial cells. Pharmacological inhibition of HDAC9 with the class IIa HDAC inhibitor TMP195 attenuates lesion formation by reducing endothelial activation and leukocyte recruitment along with limiting proinflammatory responses in macrophages. Transcriptional profiling using RNA sequencing revealed that TMP195 downregulates key inflammatory pathways consistent with inhibitory effects on IKKβ. TMP195 mitigates the progression of established lesions and inhibits the infiltration of inflammatory cells. Moreover, TMP195 diminishes features of plaque vulnerability and thereby enhances plaque stability in advanced lesions. Ex vivo treatment of monocytes from patients with established atherosclerosis reduced the production of inflammatory cytokines including IL (interleukin)-1β and IL-6.

Conclusions:
Our findings identify HDAC9 as a regulator of atherosclerotic plaque stability and IKK activation thus providing a mechanistic explanation for the prominence of HDAC9 as a vascular risk locus in genome-wide association studies. Its therapeutic inhibition may provide a potent lever to alleviate vascular inflammation.

Graphical Abstract:
A graphical abstract is available for this article.
Thrombolysis Outcomes in Acute Ischemic Stroke by Fluid-Attenuated Inversion Recovery Hyperintense Arteries
Authors: Zhou Zien , Yoshimura Sohei , Delcourt Candice , Lindley Richard I. , You Shoujiang , Malavera Alejandra , Torii-Yoshimura Takako , Carcel Cheryl , Wang Xia , Chen Xiaoying , Parsons Mark W. , Demchuk Andrew M. , Wardlaw Joanna M. , Mair Grant , Robinson Thompson G. , Chalmers John , Xu Jianrong , Anderson Craig S. 
Published: June 2020

Background and Purpose:
To determine factors associated with fluid-attenuated inversion recovery (FLAIR) hyperintense arteries (FLAIR-HAs) on magnetic resonance imaging and their prognostic significance in thrombolysis-treated patients with acute ischemic stroke from the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) trial alteplase-dose arm.

Methods:
Patients with acute ischemic stroke (N=293) with brain magnetic resonance imaging (FLAIR and diffusion-weighted imaging sequences) scanned <4.5 hours of symptom onset were assessed for location and extent (score) of FLAIR-HAs, infarct volume, large vessel occlusion (LVO), and other ischemic signs. Logistic regression models were used to determine predictors of FLAIR-HAs and the association of FLAIR-HAs with 90-day outcomes: favorable functional outcome (primary; modified Rankin Scale scores, 0–1), other modified Rankin Scale scores, and intracerebral hemorrhage.

Results:
Prior atrial fibrillation, LVO, large infarct volume, and anterior circulation infarction were independently associated with FLAIR-HAs. The rate of modified Rankin Scale scores 0 to 1 was numerically lower in patients with FLAIR-HAs versus without (69/152 [45.4%] versus 75/131 [57.3%]), as was the subset of LVO (37/93 [39.8%] versus 9/16 [56.3%]), but not in those without LVO (25/36 [69.4%] versus 60/106 [56.6%]). After adjustment for covariables, FLAIR-HAs were independently associated with increased primary outcome (adjusted odds ratio [95% CI]: overall 4.14 [1.63–10.50]; with LVO 4.92 [0.87–27.86]; no LVO 6.16 [1.57–24.14]) despite an increased risk of hemorrhagic infarct (4.77 [1.12–20.26]).

Conclusions:
FLAIR-HAs are more frequent in acute ischemic stroke with cardioembolic features and indicate potential for a favorable prognosis in thrombolysis-treated patients possibly mediated by LVO.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01422616.
Age-Based Trends of Gastric Adenocarcinoma in the United States
Authors: Trumbull Denslow , Lemini Riccardo , F. Elli Enrique , P. Bagaria Sanjay , Attwood Kristopher , Gabriel Emmanuel 
Published: June 2020

Background Recent studies have shown an increase in the incidence of gastric cancer (GC) among young adults in Asia and Latin America. However, it is unknown if a similar trend is happening in the United States. Methods A retrospective review of the National Cancer Database was conducted to identify patients diagnosed with gastric adenocarcinoma between the years of 2004 and 2013. Results A total of 93 734 patients were included. The two age groups below 40 did not see a change in GC incidence; however, age groups above 40 had increasing incidence. Patients aged 18 to 25 had the largest proportion of stage 4 disease and a poor survival (median 11.5 months), compared to older patients. Conclusion Despite the increasing trend of GC among individuals, the incidence of GC among young adults is not increasing. However, this subpopulation presents at more advanced stages (clinical stage 4) and thus has worse survival.
Likelihood of Aortic Valve Preservation During Repair of Acute Type A Aortic Dissection
Authors: Thornhill Rosanne , Shih Wendy , Amen Marvin I. , John Mohan M. , Floridia Rosario , Razzouk Anees J. , Rabkin David G. 
Published: June 2020

Background We sought risk factors for replacement of the aortic valve with or without the root (AVR/root) in the setting of acute type A aortic dissection (ATAD) repair. Methods All ATAD repairs at our institution from January 2005 to June 2018 were reviewed. Baseline characteristics were recorded. For patients with aortic valve preservation we documented the degree of aortic insufficiency (AI) postoperatively and on subsequent echocardiograms when available. Logistic regression was used to determine the association between preoperative characteristics and the odds ratio of AVR/root. Results A total of 206 patients underwent repair of ATAD. Thirty-four were excluded for no documented AI grading. Forty-six underwent AVR/root during repair of the ATAD (including 40 root replacements). Of 126 that did not undergo AVR/root, 42 (33.33%) had follow-up echocardiograms at a median of 68 months postoperatively and 2 required reintervention for valve insufficiency. Increase in degree of AI, bicuspid valve morphology, size of the aortic root, and connective tissue disorder were significantly associated with increased risk of AVR/root. Of 130 patients without connective tissue disorder, bicuspid aortic valve, aortic root aneurysm, or intimal root tear, the rate of valve preservation was 65/65 (100%), 25/29 (86.2%), and 22/40 (55%) for those presenting with mild, moderate, and severe AI, respectively. Discussion Degree of preoperative AI, bicuspid valve morphology, size of the aortic root, and connective tissue disorder significantly correlate with failure of aortic valve preservation in patients with ATAD. The vast majority of tricuspid valves in patients without connective tissue disorder or aortic root pathology can be salvaged.
Drawbacks of the Current Algorithm for Patients With Symptoms of Gastroesophageal Reflux Disease and the Impact of Adding Wireless pH Study to the Initial Diagnostic Endoscopy: Data From High-Volume Rural Antireflux Center
Authors: Fanous Medhat Y. , Hughes Tyler 
Published: June 2020

Background Patients with symptoms of gastroesophageal reflux disease (GERD) are often given a trial of proton pump inhibitors (PPIs). When they respond, patients usually continue PPI therapy. If this empiric treatment fails, esophagogastroduodenoscopy (EGD) is recommended. When EGD findings are equivocal, pH study is warranted. We hypothesize that this algorithm results in prolonged PPI therapy, repetition of EGDs and patient dissatisfaction. This study evaluates the impact of placing a pH probe at the time of the initial EGD. Methods IRB approval was obtained for retrospective chart review of patients who presented with GERD symptoms between August 2015 and March 2019. Patients were included if they underwent EGD with placement of wireless pH probe. Results A total of 379 patients (260 females, 119 males) with average age was 56.7±14.2 years. There were 253/379 (66.7%) patients who had previous EGDs (1-10). Health Satisfaction Survey was completed by 357/379 (94.2%) patients and 250/357 (70%) reported dissatisfaction with GERD control. PPI use was noted in 299/379 (78.8%) patients with average duration of 10.9±9.1 years. Testing off antisecretory medication was performed in 360/379 (94.9%). The average time interval between the clinic visit and performing EGD and pH study was 22±25 days. Conclusion The current GERD algorithm results in prolonged PPI therapy, repeated endoscopies and patient dissatisfaction. Placing a pH probe at the time of initial endoscopy is safe and expedient in a rural setting. Positive pH studies avoid repeating EGDs and negative pH studies warrant a search for potential alternative diagnosis.
Increased tortuosity of bilateral distal internal carotid artery is associated with white matter hyperintensities
Authors: Liu Jiyang , Ke Xiaoting , Lai Qingquan 
Published: June 2020

Background Although the pathophysiology of white matter hyperintensities remains unclear, we can recently explore the possible relationship with white matter hyperintensities by using quantitative parameter. Purpose To demonstrate the relationship between bilateral distal internal carotid arterial tortuosity and total brain white matter hyperintensities volume in elderly individuals. Material and Methods A total of 345 patients (age > 65 years) with brain magnetic resonance (MR) examinations were retrospectively included (44.1% men; mean age = 72.1 ± 6.25 years; 55.9% ≥ 70 years). We measured the Tortuosity Index (TI) of the bilateral distal internal carotid artery and basilar artery on MR angiography imaging, and white matter hyperintensities volume on fluid-attenuated inversion recovery MR sequence. Multiple linear regression was used to assess the association of the TI with quantitatively derived brain white matter hyperintensity volume, after adjusting for demographics (age, sex), vascular risk factors (hypertension, diabetes, heart disease), and vessel diameters, total intracranial volume (TIV). Results Increased tortuosity of bilateral distal internal carotid artery was associated with greater burden of white matter hyperintensity volume (right: β = 11.223, P = 0.016; left: β = 20.701, P < 0.001). This relationship was independent of age and hypertension, both of which have been considered the strongest risk factors for white matter hyperintensities. Conclusion Our results suggest that tortuosity of the bilateral distal internal carotid artery is associated with white matter hyperintensities, independent of age and hypertension.