bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for the process evaluation of the Promoting Activity, Independence and Stability in Early Dementia (PrAISED), following changes required by the COVID-19 pandemic
Authors: Di Lorito Claudio , Bosco Alessandro , Goldberg Sarah E , Nair Roshan , O'Brien Rebecca , Howe Louise , van der Wardt Veronika , Pollock Kristian , Booth Vicky , Logan Pip , Godfrey Maureen , Dunlop Marianne , Horne Jane , Harwood Rowan H 
Published: August 2020

IntroductionThe Promoting Activity, Independence and Stability in Early Dementia (PrAISED) randomised controlled trial (RCT) is evaluating a home-based, face-to-face, individually tailored, activity and exercise programme for people living with dementia. Social distancing requirements following the COVID-19 pandemic necessitated rapid changes to intervention delivery.Methods and analysisA mixed-methods process evaluation will investigate how the changes were implemented and the impact that these have on participants’ experience. An implementation study will investigate how the intervention was delivered during the pandemic. A study on the mechanisms of impact and context will investigate how these changes were experienced by the PrAISED participants, their carers and the therapists delivering the intervention. The study will commence in May 2020.Ethics and disseminationThe PrAISED RCT and process evaluation have received ethical approval number 18/YH/0059. The PrAISED process evaluation will enable us to understand how distancing and isolation affected participants, their activity and exercise routines and whether the therapy programme could be continued with remote support. This will be valuable both in explaining trial results and also contribute to understanding and designing new ways of delivering home-based services and rehabilitation interventions for people with dementia and their carers.Trial registration numberISRCTN15320670; Pre-results.
Spinal epidural arteriovenous fistula embolization with ethylene vinyl alcohol (EVOH) copolymer using the Scepter Mini dual-lumen balloon
Authors: Clarençon Frédéric , Shotar Eimad , Pouvelle Arnaud , Premat Kevin , Lenck Stéphanie , Drir Mehdi , Guillaumet Gonzague , Maillart Elisabeth , Sourour Nader-Antoine 
Published: August 2020

Left unattended, spinal epidural arteriovenous fistulas (EAVFs) have a potentially severe clinical course. Embolization using ethylene vinyl alcohol (EVOH) copolymers through regular dual-lumen balloons has emerged as a potential option for the treatment of spinal arteriovenous (AV) fistulas;1–3 the main issue with this technique is the navigability of these balloons. The Scepter Mini is a low-profile, dual-lumen balloon, which may be helpful for EVOH embolization of spinal AV fistulas, as it may help to overcome the navigation drawbacks. In this technical video, we present a case of EVOH embolization of a right T6 spinal EAVF through a Scepter Mini balloon. Of note, particular attention should be paid to radiculomedullary arteries arising at the same level or at adjacent levels to avoid severe neurologic complications related to uncontrolled migration of the liquid embolic agent. Moreover, excessive use of embolic material should be avoided to prevent spinal cord compression (video 1).Video 1
Machine Learning Approaches for Efficient Design Space Exploration of Application-Specific NoCs
Authors: Hu Yong , Mettler Marcel , Mueller-Gritschneder Daniel , Wild Thomas , Herkersdorf Andreas , Schlichtmann Ulf 
Published: August 2020

In many Multi-Processor Systems-on-Chip (MPSoCs), traffic between cores is unbalanced. This motivates the use of an application-specific Network-on-Chip (NoC) that is customized and can provide a high performance at low cost in terms of power and area. However, finding an optimized application-specific NoC architecture is a challenging task due to the huge design space.
This article proposes to apply machine learning approaches for this task. Using graph rewriting, the NoC Design Space Exploration (DSE) is modelled as a Markov Decision Process (MDP). Monte Carlo Tree Search (MCTS), a technique from reinforcement learning, is used as search heuristic. Our experimental results show that—with the same cost function and exploration budget—MCTS finds superior NoC architectures compared to Simulated Annealing (SA) and a Genetic Algorithm (GA). However, the NoC DSE process suffers from the high computation time due to expensive cycle-accurate SystemC simulations for latency estimation. This article therefore additionally proposes to replace latency simulation by fast latency estimation using a Recurrent Neural Network (RNN). The designed RNN is sufficiently general for latency estimation on arbitrary NoC architectures. Our experiments show that compared to SystemC simulation, the RNN-based latency estimation offers a similar speed-up as the widely used Queuing Theory (QT). Yet, in terms of estimation accuracy and fidelity, the RNN is superior to QT, especially for high-traffic scenarios. When replacing SystemC simulations with the RNN estimation, the obtained solution quality decreases only slightly, whereas it suffers significantly when QT is used.
Risk of Persistent Opioid Use following Major Surgery in Matched Samples of Patients with and without Cancer
Authors: Falcone Mary , Luo Chongliang , Chen Yong , Birtwell David , Cheatle Martin , Duan Rui , Gabriel Peter E. , He Lifang , Ko Emily M. , Lenz Heinz-Josef , Mirkovic Nebojsa , Mowery Danielle L. , Ochroch E. Andrew , Paulson E. Carter , Schriver Emily , Schnoll Robert A. , Bekelman Justin E. , Lerman Caryn 
Published: August 2020

Abstract

Background:
The opioid crisis has reached epidemic proportions, yet risk of persistent opioid use following curative intent surgery for cancer and factors influencing this risk are not well understood.

Methods:
We used electronic health record data from 3,901 adult patients who received a prescription for an opioid analgesic related to hysterectomy or large bowel surgery from January 1, 2013, through June 30, 2018. Patients with and without a cancer diagnosis were matched on the basis of demographic, clinical, and procedural variables and compared for persistent opioid use.

Results:
Cancer diagnosis was associated with greater risk for persistent opioid use after hysterectomy [18.9% vs. 9.6%; adjusted OR (aOR), 2.26; 95% confidence interval (CI), 1.38–3.69; P = 0.001], but not after large bowel surgery (28.3% vs. 24.1%; aOR 1.25; 95% CI, 0.97–1.59; P = 0.09). In the cancer hysterectomy cohort, persistent opioid use was associated with cancer stage (increased rates among those with stage III cancer compared with stage I) and use of neoadjuvant or adjuvant chemotherapy; however, these factors were not associated with persistent opioid use in the large bowel cohort.

Conclusions:
Patients with cancer may have an increased risk of persistent opioid use following hysterectomy.

Impact:
Risks and benefits of opioid analgesia for surgical pain among patients with cancer undergoing hysterectomy should be carefully considered.
Changes in Dietary Inflammatory Index Patterns with Weight Loss in Women: A Randomized Controlled Trial
Authors: Duggan Catherine , Tapsoba Jean de Dieu , Shivappa Nitin , Harris Holly R. , Hébert James R. , Wang Ching-Yun , McTiernan Anne 
Published: August 2020

Abstract

Dietary composition can influence systemic inflammation; higher levels of circulating inflammatory biomarkers are associated with increased risk of breast and other cancers. A total of 438 overweight/obese, healthy, postmenopausal women were randomized to a caloric-restriction diet (goal: 10% weight-loss), aerobic-exercise (225 min/week moderate-to-vigorous activity), combined diet+exercise, or control. Dietary inflammatory index (DII) and energy-adjusted (E-DII) scores were derived from food frequency questionnaires (FFQ) and could be calculated for 365 participants with complete FFQs at baseline and 12 months. Changes from baseline to 12 months in E-DII scores in the intervention arms versus controls were analyzed using generalized estimating equations, adjusted for confounders. We examined associations between changes in previously measured biomarkers and E-DII at 12 months. Participants randomized to diet and diet+exercise arms had greater reductions in E-DII (−104.4% and −84.4%), versus controls (−34.8%, both P &lt; 0.001). Weight change had a more marked effect than E-DII change on biomarkers at 12-months; associations between E-DII and biomarker changes were reduced after adjustment by weight change. Changes in E-DII at 12 months, adjusted for weight change, were negatively associated with changes in ghrelin [r = −0.19; P = 0.05 (diet), r = −0.29; P = 0.02 (diet+exercise)], and positively with VEGF [r = 0.22; P = 0.03 (diet+exercise)], and red blood cell counts [r = 0.30; P = 0.004 (exercise)]. C-reactive protein (CRP) and IL6 levels were not associated with E-DII changes at 12 months. In conclusion, a behavior change of low-calorie, low-fat diet significantly reduces dietary inflammatory potential, modulating biomarkers that are associated with tumorigenesis, such as VEGF, but not CRP or IL6.

Prevention Relevance:
Diets high in saturated fats and low in fruit and vegetable intake are associated with increased inflammation, which increases cancer risk. This study showed that changes in diet quality had effects on factors associated with cancer; however, the majority of beneficial effects were associated with weight loss rather than diet quality.
Upper Endoscopic Surveillance in Lynch Syndrome Detects Gastric and Duodenal Adenocarcinomas
Authors: Kumar Shria , Dudzik Christina M. , Reed Mallory , Long Jessica M. , Wangensteen Kirk J. , Katona Bryson W. 
Published: August 2020

Abstract
Lynch syndrome is a prevalent hereditary cancer predisposition syndrome. While colorectal cancer is the most common gastrointestinal (GI) cancer in Lynch syndrome, there is also increased risk of gastric and small intestinal cancers. Recommendations for upper GI cancer surveillance in Lynch syndrome vary widely with limited data supporting effectiveness. Herein, we collected data on individuals with a diagnosis of Lynch syndrome seen at our tertiary care referral center. We identified individuals who underwent upper endoscopy and those with upper GI cancers, and associated demographics, genetic testing results, and endoscopic information. Standard statistical analyses were performed. Among 295 individuals with Lynch syndrome seen at our center, 217 (73.6%) underwent 660 total upper endoscopies. Of these 217, precancerous upper endoscopy findings included Barrett's esophagus (7, 3.2%), gastric intestinal metaplasia (18, 8.3%), and duodenal adenomas (4, 1.8%), and Helicobacter pylori was identified in 6 (2.8%). Upper GI cancers were diagnosed in 11 individuals (3.7%), including esophageal in 1, gastric in 6, and duodenal in 4. Five (1.7%) of these upper GI cancers were identified on surveillance. Individuals with upper GI cancers identified on surveillance were older at first surveillance endoscopy, with median age 63.3 versus 44.9 years (P &lt; 0.001). Of the upper GI cancers detected on surveillance, 80% (4/5) occurred within 2 years of last upper endoscopy and 80% were stage I. In conclusion, upper endoscopy surveillance in Lynch syndrome identifies upper GI cancers. For individuals with Lynch syndrome who undergo upper GI surveillance, a short surveillance interval may be warranted.
Pre‐percutaneous Coronary Intervention Pericoronary Adipose Tissue Attenuation Evaluated by Computed Tomography Predicts Global Coronary Flow Reserve After Urgent Revascularization in Patients With Non–ST‐Segment–Elevation Acute Coronary Syndrome
Authors: Kanaji Yoshihisa , Hirano Hidenori , Sugiyama Tomoyo , Hoshino Masahiro , Horie Tomoki , Misawa Toru , Nogami Kai , Ueno Hiroki , Hada Masahiro , Yamaguchi Masao , Sumino Yohei , Hamaya Rikuta , Usui Eisuke , Yonetsu Taishi , Sasano Tetsuo , Kakuta Tsunekazu 
Published: August 2020

Background
Impaired global coronary flow reserve (g‐CFR) is related to worse outcomes. Inflammation has been postulated to play a role in atherosclerosis. This study aimed to evaluate the relationship between pre‐procedural pericoronary adipose tissue inflammation and g‐CFR after the urgent percutaneous coronary intervention in patients with first non–ST‐segment–elevation acute coronary syndrome.

Methods and Results

Phase‐contrast cine‐magnetic resonance imaging was performed to obtain g‐CFR by quantifying coronary sinus flow at 1 month after percutaneous coronary intervention in a total of 116 first non–ST‐segment–elevation acute coronary syndrome patients who underwent pre‐percutaneous coronary intervention computed tomography angiography. On proximal 40‐mm segments of 3 major coronary vessels on computed tomography angiography, pericoronary adipose tissue attenuation was assessed by the crude analysis of mean computed tomography attenuation value. The patients were divided into 2 groups with and without impaired g‐CFR divided by the g‐CFR value of 1.8. There were significant differences in age, culprit lesion location, N‐terminal pro‐B‐type natriuretic peptide levels, high‐sensitivity C‐reactive protein (hs‐CRP) levels, mean pericoronary adipose tissue attenuation between patients with impaired g‐CFR and those without (g‐CFR, 1.47 [1.16, 1.68] versus 2.66 [2.22, 3.28];
P
<0.001). Multivariable logistic regression analysis revealed that age (odds ratio [OR], 1.060; 95% CI, 1.012–1.111,
P
=0.015) and mean pericoronary adipose tissue attenuation (OR, 1.108; 95% CI, 1.026–1.197,
P
=0.009) were independent predictors of impaired g‐CFR (g‐CFR <1.8).

Conclusions
Mean pericoronary adipose tissue attenuation, a marker of perivascular inflammation, obtained by computed tomography angiography performed before urgent percutaneous coronary intervention, but not hs‐CRP, a marker of systemic inflammation was significantly associated with g‐CFR at 1‐month after revascularization. Our results may suggest the pathophysiological mechanisms linking perivascular inflammation and g‐CFR in patients with non–ST‐segment–elevation acute coronary syndrome.
The effects of roflumilast, a phosphodiesterase type-4 inhibitor, on EEG biomarkers in schizophrenia: A randomised controlled trial
Authors: Gilleen James , Nottage Judith , Yakub Farah , Kerins Sarah , Valdearenas Lorena , Uz Tolga , Lahu Gez , Tsai Max , Ogrinc Frank , Williams Steve C , Ffytche Dominic , Mehta Mitul A , Shergill Sukhi S 
Published: August 2020

Background: Patients with schizophrenia have significant cognitive deficits, which may profoundly impair quality of life. These deficits are also evident at the neurophysiological level with patients demonstrating altered event-related potential in several stages of cognitive processing compared to healthy controls; within the auditory domain, for example, there are replicated alterations in Mismatch Negativity, P300 and Auditory Steady State Response. However, there are no approved pharmacological treatments for cognitive deficits in schizophrenia. Aims: Here we examine whether the phosphodiesterase-4 inhibitor, roflumilast, can improve neurophysiological deficits in schizophrenia. Methods: Using a randomised, double-blind, placebo-controlled, crossover design study in 18 patients with schizophrenia, the effect of the phosphodiesterase-4 inhibitor, roflumilast (100 µg and 250 µg) on auditory steady state response (early stage), mismatch negativity and theta (intermediate stage) and P300 (late stage) was examined using electroencephalogram. A total of 18 subjects were randomised and included in the analysis. Results: Roflumilast 250 µg significantly enhanced the amplitude of both the mismatch negativity ( p=0.04) and working memory-related theta oscillations ( p=0.02) compared to placebo but not in the other (early- or late-stage) cognitive markers. Conclusions: The results suggest that phosphodiesterase-4 inhibition, with roflumilast, can improve electroencephalogram cognitive markers, which are impaired in schizophrenia, and that phosphodiesterase-4 inhibition acts at an intermediate rather than early or late cognitive processing stage. This study also underlines the use of neurophysiological measures as cognitive biomarkers in experimental medicine.
Determination of optimum pixel size and slice thickness for tractography and ulnar nerve diffusion tensor imaging at the cubital tunnel using 3T MRI
Authors: Park Sun-Young , Koh Sung Hye , Lee In Jae , Lee Kwanseop , Lee Yul 
Published: August 2020

Background Small peripheral nerve tractography is challenging because of the trade-off among resolution, image acquisition time, and signal-to-noise ratio. Purpose To optimize pixel size and slice thickness parameters for fiber tractography and diffusion tensor imaging (DTI) of the ulnar nerve at the cubital tunnel using 3T magnetic resonance imaging (MRI). Material and Methods Fifteen healthy volunteers (mean age 30 ± 6.8 years) were recruited prospectively. Axial T2-weighted and DTI scans were acquired, covering the cubital tunnel, using different pixel sizes and slice thicknesses. Three-dimensional (3D) nerve tractography was evaluated for the median number and length of the reconstructed fiber tracts and visual score from 0 to 5. Two-dimensional (2D) cross-sectional DTI was evaluated for fractional anisotropy (FA) values throughout the length of the ulnar nerve. Results A pixel size of 1.3 mm2 revealed the highest number of reconstructed nerve fibers compared to that of 1.1 mm2 ( P = 0.048), with a good visual score. A slice thickness of 4 mm had the highest number of reconstructed nerve fibers and visual score compared with other thicknesses (all P < 0.05). In 2D cross-sectional images, the median FA values were in the range of 0.40–0.63 at the proximal, central, and distal portions of the cubital tunnel. Inter-observer agreement for all parameters was good to excellent. Conclusion For fiber tractography and DTI of the ulnar nerve at the cubital tunnel, optimal image quality was obtained using a 1.3-mm2 pixel size and 4-mm slice thickness under MR parameters of this study at 3T.
The clinical and imaging features of infratentorial germinomas compared with supratentorial ectopic germinomas
Authors: Li Wei , Ran Chao , Ma Jun 
Published: August 2020

Background Intracranial germinoma is very sensitive to chemoradiotherapy, while the risk of infratentorial operation is high. The accurate diagnosis can provide the more reasonable treatment, avoiding the unnecessary therapeutic risks. Purpose To evaluate the clinical and imaging features of infratentorial germinomas. Material and Methods The clinical and imaging data of 13 infratentorial germinomas were collected and compared with 17 supratentorial germinomas in the same period. The clinical and imaging findings were retrospectively analyzed. Results Infratentorial germinomas were more common in female patients than supratentorial ones (53.85% vs. 11.76%, P = 0.020). The mean age of the infratentorial group (23.0 ± 10.2 years) was significantly older than that of supratentorial group (12.4 ± 3.3 years, P = 0.003). Most infratentorial germinomas (12/13, 92.31%) underwent surgical resection, while stereotactic biopsy was more common in the supratentorial group (11/17, 64.71%, P = 0.002). Infratentorial germinomas were significantly smaller than supratentorial ones (25.85 ± 8.13 mm vs. 37.18 ± 18.11 mm, P = 0.031). Cystic lesions were more common in supratentorial germinomas (12/17, 70.59%), while most infratentorial germinomas were solid lesions (10/13, 76.92%, P = 0.025). On post-contrast T1-weighted imaging, obvious enhancement was more common in infratentorial germinomas than in supratentorial ones (100% vs. 64.71%, P = 0.024). Conclusion In addition to the common findings with supratentorial germinomas, infratentorial lesions have some specific clinical and imaging features.
Volunteering among Older Lesbian and Gay Adults: Associations with Mental, Physical and Social Well-Being
Authors: Lyons Anthony , Alba Beatrice , Waling Andrea , Minichiello Victor , Hughes Mark , Fredriksen-Goldsen Karen I. , Edmonds Samantha , Blanchard Michelle , Irlam Corey 
Published: August 2020

Objectives: Volunteering is associated with positive well-being among older people, providing opportunities to stay active and socially connected. This may be especially relevant for older lesbian and gay people, who are less likely than heterosexual people to have a partner, children or support from their family of origin. Methods: Patterns of volunteering and mental, physical and social well-being were examined in a sample of 754 lesbian and gay adults in Australia aged 60 years and older who completed a nationwide survey. Results: Volunteers reported greater positive mental health than non-volunteers. Among the gay men, volunteers additionally reported higher self-rated health and social support and lower psychological distress. Both the lesbian women and gay men who volunteered for lesbian, gay, bisexual, transgender or intersex (LGBTI) organisations also reported greater LGBTI community connectedness than volunteers for non-LGBTI organisations. Discussion: These findings provide further insight into potential factors associated with the well-being of older lesbian and gay adults.
MDM2 inhibition improves cisplatin-induced renal injury in mice via inactivation of Notch/hes1 signaling pathway
Authors: Luo X , Zhang L , Han G-D , Lu P , Zhang Y 
Published: August 2020

Objective: To explore the potential function of MDM2-mediated Notch/hes1 signaling pathway in cisplatin-induced renal injury. Methods: The acute renal injury models of mice after intraperitoneal injection of cisplatin in vivo, and the apoptotic models of human renal tubular epithelial (HK-2) cells induced by cisplatin in vitro, were conducted respectively. The renal function-related parameters were measured. The renal tissue pathological changes and apoptosis were observed by PAS staining and TUNEL staining, respectively. Cell viability and apoptosis were detected by MTT and flow cytometry. Notch/hes1 pathway-related proteins were tested by Western blotting. Results: After mice injected by cisplatin, the levels of Cr, BUN, urine cystatin C, urine NGAL and urine ACR were increased and GFR was decreased with the elevation of renal tubular injury scores, the upregulation of the expressions of MDM2, N1ICD, Hes1 and Cleaved caspase-3, as well as the enhancement of cell apoptosis accompanying decreased ratio of Bcl-2/Bax. However, these cisplatin-induced renal injuries of mice have been improved by MDM2 inhibition. Besides, the declined viability, increased cytotoxicity, and enhanced apoptosis were observed in cisplatin-induced HK-2 cells, with the activated Notch/hes1 pathway. Notably, the phenomenon was alleviated in cisplatin-induced HK-2 cells transfected with MDM2 shRNA, but was severer in those co-treated with AdMDM2. Moreover, Notch1 siRNA can reverse the injury of AdMDM2 on HK-2 cells. Conclusion: Inhibiting MDM2 could reduce cell apoptosis through blocking Notch/hes1 signaling pathway, thus alleviating the acute renal injury caused by cisplatin.