bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation and Diagnostic Performance of a CFD-Based Non-invasive Method for the Diagnosis of Aortic Coarctation
Authors: Lu Qiyang , Lin Weiyuan , Zhang Ruichen , Chen Rui , Wei Xiaoyu , Li Tingyu , Du Zhicheng , Xie Zhaofeng , Yu Zhuliang , Xie Xinzhou , Liu Hui 
Published: December 2020

Purpose: The clinical diagnosis of aorta coarctation (CoA) constitutes a challenge, which is usually tackled by applying the peak systolic pressure gradient (PSPG) method. Recent advances in computational fluid dynamics (CFD) have suggested that multi-detector computed tomography angiography (MDCTA)-based CFD can serve as a non-invasive PSPG measurement. The aim of this study was to validate a new CFD method that does not require any medical examination data other than MDCTA images for the diagnosis of CoA.Materials and methods: Our study included 65 pediatric patients (38 with CoA, and 27 without CoA). All patients underwent cardiac catheterization to confirm if they were suffering from CoA or any other congenital heart disease (CHD). A series of boundary conditions were specified and the simulated results were combined to obtain a stenosis pressure-flow curve. Subsequently, we built a prediction model and evaluated its predictive performance by considering the AUC of the ROC by 5-fold cross-validation.Results: The proposed MDCTA-based CFD method exhibited a good predictive performance in both the training and test sets (average AUC: 0.948 vs. 0.958; average accuracies: 0.881 vs. 0.877). It also had a higher predictive accuracy compared with the non-invasive criteria presented in the European Society of Cardiology (ESC) guidelines (average accuracies: 0.877 vs. 0.539).Conclusion: The new non-invasive CFD-based method presented in this work is a promising approach for the accurate diagnosis of CoA, and will likely benefit clinical decision-making.
Morphometric Changes to Corneal Dendritic Cells in Individuals With Mild Cognitive Impairment
Authors: Dehghani Cirous , Frost Shaun , Jayasena Rajiv , Fowler Christopher , Masters Colin L. , Kanagasingam Yogesan , Jiao Haihan , Lim Jeremiah K. H. , Chinnery Holly R. , Downie Laura E. 
Published: December 2020

PurposeThere has been increasing interest in identifying non-invasive, imaging biomarkers for neurodegenerative disorders of the central nervous system (CNS). The aim of this proof-of-concept study was to investigate whether corneal sensory nerve and dendritic cell (DC) parameters, captured using in vivo confocal microscopy (IVCM), are altered in individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD).MethodsFifteen participants were recruited from the Australian Imaging Biomarkers and Lifestyle (AIBL) study in Melbourne, VIC, Australia. The cohort consisted of cognitively normal (CN) individuals (n = 5), and those with MCI (n = 5) and AD (n = 5). Participants underwent a slit lamp examination of the anterior segment, followed by corneal imaging using laser-scanning in vivo confocal microscopy (IVCM) of the central and inferior whorl regions. Corneal DC density, field area, perimeter, circularity index, aspect ratio, and roundness were quantified using Image J. Quantitative data were derived for corneal nerve parameters, including nerve fiber length (CNFL), fiber density (CNFD), branch density (CNBD), and diameter.ResultsCorneal DC field area and perimeter were greater in individuals with MCI, relative to CN controls, in both the central and inferior whorl regions (p &lt; 0.05 for all comparisons). In addition, corneal DCs in the whorl region of MCI eyes had lower circularity and roundness indices and a higher aspect ratio relative to CNs (p &lt; 0.05 for all comparisons). DC density was similar across participant groups in both corneal regions. There was a trend toward lower quantitative parameters for corneal nerve architecture in the AD and MCI groups compared with CN participants, however, the inter-group differences did not reach statistical significance. Central corneal nerve diameters were similar between groups.ConclusionThis study is the first to report morphological differences in corneal DCs in humans with MCI. These differences were evident in both the central and mid-peripheral cornea, and in the absence of significant nerve abnormalities or a difference in DC density. These findings justify future large-scale studies to assess the utility of corneal IVCM and DC analysis for identifying early stage pathology in neurodegenerative disorders of the CNS.
Abnormal Regional Spontaneous Brain Activity and Its Indirect Effect on Spasm Ratings in Patients With Hemifacial Spasm
Authors: Luo Fei-Fei , Xu Hui , Zhang Ming , Wang Yuan 
Published: December 2020

PurposeThree classical methods of resting-state functional magnetic resonance imaging (rs-fMRI) were employed to explore the local functional abnormalities and their effect on spasm ratings in hemifacial spasm (HFS) patients.MethodsThirty HFS patients and 30 matched healthy controls (HCs) were recruited. Rs-fMRI data, neurovascular compression (NVC) degree and spasm severity were collected in each subject. Fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and degree centrality (DC) were calculated in the whole brain voxels. Two samplet-tests were performed to investigate group differences of fALFF, ReHo, and DC. Correlation analysis was performed to assess the relationships between the regional brain abnormalities and clinical variables in HFS.ResultsCompared with HCs, HFS patients exhibited increased fALFF in the left precuneus and right posterior cingulate cortex (PCC), together with increased ReHo in the bilateral PCC and bilateral precuneus. Decreased ReHo was observed in the right middle occipital gyrus (MOG), right superior occipital gyrus (SOG), right cuneus, and right angular gyrus (AG) in HFS patients. Moreover, ReHo in the right PCC were positively correlated with NVC degree and spasm severity in HFS patients, respectively. Mediation analysis revealed that increased ReHo in the right PCC regulated the neurovascular compression degree, and further resulted in increased spasm ratings.ConclusionOur study revealed regional brain dysfunctions from different perspectives and an indirect effect of ReHo in right PCC on spasm ratings predominantly through the alteration of NVC.
Cone-Beam-CT Guided Adaptive Radiotherapy for Locally Advanced Non-small Cell Lung Cancer Enables Quality Assurance and Superior Sparing of Healthy Lung
Authors: Hoegen Philipp , Lang Clemens , Akbaba Sati , Häring Peter , Splinter Mona , Miltner Annette , Bachmann Marion , Stahl-Arnsberger Christiane , Brechter Thomas , El Shafie Rami A. , Weykamp Fabian , König Laila , Debus Jürgen , Hörner-Rieber Juliane 
Published: December 2020

PurposeTo evaluate the potential of cone-beam-CT (CB-CT) guided adaptive radiotherapy (ART) for locally advanced non-small cell lung cancer (NSCLC) for sparing of surrounding organs-at-risk (OAR).Materials and MethodsIn 10 patients with locally advanced NSCLC, daily CB-CT imaging was acquired during radio- (n = 4) or radiochemotherapy (n = 6) for simulation of ART. Patients were treated with conventionally fractionated intensity-modulated radiotherapy (IMRT) with total doses of 60–66 Gy (pPlan) (311 fraction CB-CTs). OAR were segmented on every daily CB-CT and the tumor volumes were modified weekly depending on tumor changes. Doses actually delivered were recalculated on daily images (dPlan), and voxel-wise dose accumulation was performed using a deformable registration algorithm. For simulation of ART, treatment plans were adapted using the new contours and re-optimized weekly (aPlan).ResultsCB-CT showed continuous tumor regression of 1.1 ± 0.4% per day, leading to a residual gross tumor volume (GTV) of 65.3 ± 13.4% after 6 weeks of radiotherapy (p = 0.005). Corresponding PTVs decreased to 83.7 ± 7.8% (p = 0.005). In the actually delivered plans (dPlan), both conformity (p = 0.005) and homogeneity (p = 0.059) indices were impaired compared to the initial plans (pPlan). This resulted in higher actual lung doses than planned: V20Gy was 34.6 ± 6.8% instead of 32.8 ± 4.9% (p = 0.066), mean lung dose was 19.0 ± 3.1 Gy instead of 17.9 ± 2.5 Gy (p = 0.013). The generalized equivalent uniform dose (gEUD) of the lung was 18.9 ± 3.1 Gy instead of 17.8 ± 2.5 Gy (p = 0.013), leading to an increased lung normal tissue complication probability (NTCP) of 15.2 ± 13.9% instead of 9.6 ± 7.3% (p = 0.017). Weekly plan adaptation enabled decreased lung V20Gy of 31.6 ± 6.2% (−3.0%, p = 0.007), decreased mean lung dose of 17.7 ± 2.9 Gy (−1.3 Gy, p = 0.005), and decreased lung gEUD of 17.6 ± 2.9 Gy (−1.3 Gy, p = 0.005). Thus, resulting lung NTCP was reduced to 10.0 ± 9.5% (−5.2%, p = 0.005). Target volume coverage represented by conformity and homogeneity indices could be improved by weekly plan adaptation (CI: p = 0.007, HI: p = 0.114) and reached levels of the initial plan (CI: p = 0.721, HI: p = 0.333).ConclusionIGRT with CB-CT detects continuous GTV and PTV changes. CB-CT-guided ART for locally advanced NSCLC is feasible and enables superior sparing of healthy lung at high levels of plan conformity.
Analysis of N6-Methyladenosine Methyltransferase Reveals METTL14 and ZC3H13 as Tumor Suppressor Genes in Breast Cancer
Authors: Gong Peng-Ju , Shao You-Cheng , Yang Yan , Song Wen-Jing , He Xin , Zeng Yi-Fan , Huang Si-Rui , Wei Lei , Zhang Jing-Wei 
Published: December 2020

ObjectivesRecently, an increasing number of studies have revealed that N6-methyladenosine (m6A) functions as a significant post-transcriptional modification which plays a critical role in the occurrence and progression of enriched tumors by regulating coding and non-coding RNA biogenesis. However, the biological function of m6A in breast cancer remains largely unclear.Materials and MethodsIn this study, we used a series of bioinformatic databases and tools to jointly analyze the expression of m6A methylation transferases (METTL3, METTL14, WTAP, RBM15, RBM15B and ZC3H13) and investigate the prognostic value of METTL14 and ZC3H13 in breast cancer. Besides, we analyzed the downstream carcinogenic molecular mechanisms related to METTL14 and ZC3H13 and their relationship with immune infiltration in breast tumor tissues.ResultsThe results showed that METTL14 and ZC3H13 were the down-regulated m6A methylation transferases in breast cancer. Survival outcome analysis suggested that abnormally low expression of METTL14 and ZC3H13 could predict unfavorable prognosis in four breast cancer subtypes. Moreover, their down-regulation was associated with ER-, PR- and triple-negative breast cancer patients, as well as tumor progression (increased Scarff, Bloom and Richardson grade status and Nottingham Prognostic Index classification). Co-expression analysis revealed that METTL14 and ZC3H13 had a strong positive correlation with APC, an antagonist of the Wnt signaling pathway, indicating they might cooperate in regulating proliferation, invasion, and metastasis of tumor cells. METTL14, ZC3H13, and APC expression levels had significant positive correlation with infiltrating levels of CD4+ T cells, CD8+ T cells, neutrophils, macrophages, and dendritic cells, and negative correlation with Treg cells in breast cancer.ConclusionsThis study demonstrated that down-regulation of METTL14 and ZC3H13 which act as two tumor suppressor genes was found in breast cancer and predicted poor prognosis. Their abnormal expression promoted breast cancer invasion by affecting pathways related to tumor progression and mediating immunosuppression.
Targets and Mechanism Used by Cinnamaldehyde, the Main Active Ingredient in Cinnamon, in the Treatment of Breast Cancer
Authors: Liu Yufei , An Tian , Wan Donggui , Yu Bowen , Fan Yingyi , Pei Xiaohua 
Published: December 2020

Background: Breast cancer has become one of the most common malignant tumors in women owing to its increasing incidence each year. Clinical studies have shown that Cinnamomum cassia (L.) J. Presl (cinnamon) has a positive influence on the prevention and treatment of breast cancer.Aim: We aimed to screen the potential targets of cinnamon in the treatment of breast cancer through network pharmacology and explore its potential therapeutic mechanism through cell experiments.Methods: We used the TCMSP, TCM Database @ Taiwan, and TCMID websites and established the active ingredient and target database of cinnamon. Thereafter, we used the GeneCards and OMIM databases to establish a breast cancer-related target database, which matched the cinnamon target database. Based on the matching results, the STRING database was used to analyze the interaction between the targets, and the biological information annotation database was used to analyze the biological process of the target (gene ontology) and the pathway enrichment of Kyoto Encyclopedia of Genes and Genomes (KEGG). After establishing the layout of the analysis, we used Cytoscape 3.6.0 software for network analysis. Finally, the cell experiment was used to verify the anti-breast cancer effect of cinnamaldehyde.Results: Our research showed that the main components of cinnamon, including cinnamaldehyde, can play a role in the treatment of breast cancer through 59 possible important targets. Subsequently, enrichment analysis by gene ontology and Kyoto Encyclopedia of Genes and Genomes showed that 83 cell biological processes and 37 pathways were associated with breast cancer (p &lt; 0.05), including the peroxisome proliferator-activated receptor and PI3K-Akt pathway, which are closely related to tumor cell apoptosis. In vitro cell verification experiments showed that cinnamaldehyde can significantly inhibit cell proliferation, change cell morphology, inhibit cell migration and invasion ability, and promote cell apoptosis.Conclusion: Our results showed that cinnamaldehyde is a potential novel drug for the treatment and prevention of breast cancer.
Causality Orientations and Supportive/Controlled Environment: Understanding Their Influence on Basic Needs, Motivation for Health and Emotions in French Hospitalized Older Adults
Authors: Souesme Guillaume , Martinent Guillaume , Akour Donia , Giraudeau Caroline , Ferrand Claude 
Published: December 2020

ObjectivesFrom a self-determination theory perspective, the purpose of this cross sectional study was to better understand how to motivate hospitalized older adults’ behaviors and test an integrative model of the role of causality orientations and a supportive/controlled environment on basic need satisfaction, motivation for health oriented physical activity, positive and negative affective states, depressive symptoms, apathy, and boredom.MethodsOlder adults (N = 146; Mage = 81.27 years, SD = 7.75, 74.7% female) in French hospital units completed self-report questionnaires and socio-demographic data were also collected.ResultsPartial least squares path modeling results showed that participants’ autonomy orientation positively associated with the perception of a supportive environment was related to need satisfaction, autonomous motivation for health-oriented physical activity, and high scores on positive affective states. Conversely, participants’ impersonal orientation positively associated with the perception of a controlled environment was related to undermining need satisfaction, controlled motivation for health-oriented physical activity, and amotivation, and high scores on both negative affective states, and boredom.ConclusionThe present results indicate that taking into account personality factors in hospital units can be useful and health professionals should take an interest both in the patients’ causality orientations and the supportive nature of the environment in order to understand better how to motivate patients’ behaviors. The present study points to the need to focus on all motivational dynamics which allow patients’ need satisfaction.
Cross-sectoral video consultation in cancer care: GPs’ evaluation of a randomised controlled trial
Authors: Trabjerg Theis Bitz , Jensen Lars Henrik , Sondergaard Jens , Wehberg Sonja , Sisler Jeffrey James , Hansen Dorte Gilså 
Published: December 2020

BackgroundShared care models present an opportunity for patients to receive the benefits of specialist care combined with the continuity of care provided by a GP.AimTo test the effects on GP-perceived involvement in cancer care and their satisfaction with this cross-sectoral information after bringing the patient, GP, and oncologist together in a shared video consultation.Design & settingGPs from the Region of Southern Denmark evaluated a randomised controlled trial testing shared video consultations.MethodThis study describes secondary outcomes based on a 4 months' follow-up survey from GPs participating in The Partnership Project (PSP). Patient perception of coordination of care at 7 months' follow-up was the primary outcome of the PSP. A tripartite video consultation was conducted during cancer treatment to share tasks and roles between health professionals with the patient.ResultsThe study included 281 patients, and 105 unique GPs returned 124 questionnaires. Video consultations were accomplished in 68% of scheduled cases. The study found an increased odds ratio (OR) of 3.03 for GP satisfaction with the distribution of tasks and roles, and they experienced more involvement in the cancer patients' trajectory. The study found an increased OR of 6.95 for the GP perception of more direct contact and dialogue with the Department of Oncology. There was a decreased OR of 0.88 for the GP to be engaged in handling anxiety and psychological concerns.ConclusionThe study showed that involving the GP in one shared consultation increased the odds of the GP being satisfied with the distribution of tasks and roles, and feeling more involved in the cancer patient’s trajectory. However, recruitment and response rates from GPs were limiting factors.
Evaluating the delay prior to primary care presentation in patients with lung cancer: a cohort study
Authors: Kotecha Jalpa , Clark Allan , Burton Matthew , Chan Wei Yee , Menzies Di , Dernedde Ulrike , Banham Rachel , Wilson Andrew , Martin William Craig 
Published: December 2020

BackgroundLittle is known about 'within-patient delay', which is the time from first symptom of lung cancer to contacting primary care.AimPrimary outcomes were length of within-patient delay and the proportion of total delay it represents. Secondary outcomes were factors causing delay and survival.Design & settingA cohort study of newly diagnosed patients with lung cancer at two hospitals in Norfolk.MethodPatients completed questionnaires regarding onset of symptoms, whether they had delayed, and their reasons. GPs completed correlating questionnaires. Pathway times and other data were extracted from cancer registry and hospital records, and outcomes obtained prospectively. Factors causing delay were compared using ratios of geometric means.ResultsIn 379 patients, mean within-patient delay and pre-secondary care delay were 188.6 days and 241 days (61.4% and 78.5% of total delay, respectively). It was found that 38.8% of patients felt they had delayed. Patient-related causes of delay were denial (ratio of means [ROM] = 4.36; P = 0.002, 95% confidence interval [CI] = 1.71 to 11.1); anxiety (ROM = 3.36; P = 0.026; 95% CI = 1.16 to 9.76); non-recognition of symptoms (ROM = 2.80; P = 0.004; 95% CI = 1.41 to 5.59); and smoking (ROM = 1.76; P = 0.021; 95% CI = 1.09 to 2.86), respectively. These symptoms were associated with delay: finger swelling or discomfort (ROM = 2.72; P = 0.009, 95% CI = 1.29 to 5.74); cough (ROM = 2.53; P<0.001; 95% CI = 1.52 to 4.19); weight loss (ROM = 2.41; P<0.001; 95% CI = 1.49 to 3.88); weakness (ROM = 2.35; P = 0.001; 95% CI = 1.45 to 3.83); dyspnoea (ROM = 2.30; P = 0.001; 95% CI = 1.40 to 3.80); voice change (ROM = 1.90; P = 0.010; 95% CI = 1.17 to 3.10); and sputum (ROM = 1.66; P = 0.039; 95% CI = 1.03 to 2.67), respectively, also having more than five symptoms (compared with 1–3) (ROM = 3.69; P<0.001; 95% CI = 2.05 to 6.64). No overall relation between within-patient delay and survival was seen.ConclusionUsing smoking registers, awareness literature, and self-care manuals, primary care staff could liaise with people who have ever smoked regarding their symptoms to ensure early referral to secondary care.
Promoting parkrun to patients using the general practice website: a qualitative exploration of ‘parkrun practice’ websites
Authors: Fleming Joanna , Mensah Rebecca 
Published: December 2020

BackgroundThe parkrun practice initiative is a widely accessible and low-cost approach in primary care, which promotes patient and staff health and wellbeing through increased physical activity and volunteering opportunities. The parkrun practice Toolkit offers guidance to practices on how to promote parkrun. One recommendation is to include a parkrun page on the practice website, or a link to the parkrun website. How practices are presenting this information is unknown.AimTo explore how parkrun practices are using their websites to promote parkrun, including the content and format of information presented and variety of promotion methods used, in order to provide recommendations for inclusion in the Toolkit.Design & settingQualitative content analysis of a sample of parkrun practice websites.MethodThe websites of 114 practices that reported using their websites for parkrun promotion were systematically searched and the content analysed.ResultsFive main types of content were identified, namely: what parkrun or parkrun practice is; activities and events; addressing patients’ concerns; benefits of parkrun; and practical information. While there were similarities in the information provided, there were variations in presentation. Websites ranged from being extensive and highly informative, to minimal amounts of text or solely images.ConclusionFindings highlight the variability that currently exists across parkrun practice websites. Including a link on the homepage would assist patients to find information on parkrun and clarify the information that can be found. Suggestions are made on the type of information and how it could be presented to be further developed for inclusion in the Toolkit.