bluuebunny/crossref_metadata_2025_split huggingface dataset:
Zero Echo Time MRAC on FDG-PET/MR Maintains Diagnostic Accuracy for Alzheimer’s Disease; A Simulation Study Combining ADNI-Data
Authors: Ando Takahiro , Kemp Bradley , Warnock Geoffrey , Sekine Tetsuro , Kaushik Sandeep , Wiesinger Florian , Delso Gaspar 
Published: November 2020

AimAttenuation correction using zero-echo time (ZTE) – magnetic resonance imaging (MRI) (ZTE-MRAC) has become one of the standard methods for brain-positron emission tomography (PET) on commercial PET/MR scanners. Although the accuracy of the net tracer-uptake quantification based on ZTE-MRAC has been validated, that of the diagnosis for dementia has not yet been clarified, especially in terms of automated statistical analysis. The aim of this study was to clarify the impact of ZTE-MRAC on the diagnosis of Alzheimer’s disease (AD) by performing simulation study.MethodsWe recruited 27 subjects, who underwent both PET/computed tomography (CT) and PET/MR (GE SIGNA) examinations. Additionally, we extracted 107 subjects from the Alzheimer Disease Neuroimaging Initiative (ADNI) dataset. From the PET raw data acquired on PET/MR, three FDG-PET series were generated, using two vendor-provided MRAC methods (ZTE and Atlas) and CT-based AC. Following spatial normalization to Montreal Neurological Institute (MNI) space, we calculated each patient’s specific error maps, which correspond to the difference between the PET image corrected using the CTAC method and the PET images corrected using the MRAC methods. To simulate PET maps as if ADNI data had been corrected using MRAC methods, we multiplied each of these 27 error maps with each of the 107 ADNI cases in MNI space. To evaluate the probability of AD in each resulting image, we calculated a cumulative t-value using a fully automated method which had been validated not only in the original ADNI dataset but several multi-center studies. In the method, PET score = 1 is the 95% prediction limit of AD. PET score and diagnostic accuracy for the discrimination of AD were evaluated in simulated images using the original ADNI dataset as reference.ResultsPositron emission tomography score was slightly underestimated both in ZTE and Atlas group compared with reference CTAC (−0.0796 ± 0.0938 vs. −0.0784 ± 0.1724). The absolute error of PET score was lower in ZTE than Atlas group (0.098 ± 0.075 vs. 0.145 ± 0.122, p &lt; 0.001). A higher correlation to the original PET score was observed in ZTE vs. Atlas group (R2: 0.982 vs. 0.961). The accuracy for the discrimination of AD patients from normal control was maintained in ZTE and Atlas compared to CTAC (ZTE vs. Atlas. vs. original; 82.5% vs. 82.1% vs. 83.2% (CI 81.8–84.5%), respectively).ConclusionFor FDG-PET images on PET/MR, attenuation correction using ZTE-MRI had superior accuracy to an atlas-based method in classification for dementia. ZTE maintains the diagnostic accuracy for AD.
Early Loss of Fat Mass During Chemoradiotherapy Predicts Overall Survival in Locally Advanced Squamous Cell Carcinoma of the Lung, but Not in Locally Advanced Squamous Cell Carcinoma of the Head and Neck
Authors: Willemsen A. C. H. , Degens J. H. R. J. , Baijens L. W. J. , Dingemans A-M. C. , Hoeben A. , Hoebers F. J. P. , De Ruysscher D. K. M. , Schols A. M. W. J. 
Published: November 2020

Background: Cancer cachexia is highly prevalent in advanced non-small cell lung cancer (NSCLC) and locally advanced head and neck squamous cell carcinoma (LAHNSCC), and compromises treatment tolerance and overall survival (OS). NSCLC and LAHNSCC patients share similar risk factors, and receive comparable anti-cancer treatment regimens. The aim of this study was to determine the predictive value of body composition assessed by bioelectrical impedance analysis (BIA) and handgrip strength (HGS) (baseline and early changes during therapy) on OS in NSCLC and LAHNSCC patients treated with platinum-based chemoradiotherapy (CRT) or cetuximab-based bioradiotherapy (BRT). To elucidate potential underlying determinants of early changes in body composition and HGS, specific (fat and fat free) mass loss patterns of squamous NSCLC (sNSCLC) were compared to human papilloma virus negative (HPV–) LAHNSCC patients treated with CRT.Methods: Between 2013 and 2016, BIA and HGS were performed at baseline and after 3 weeks of CRT/BRT in LAHNSCC and NSCLC patients treated with curative intent.Results: Two hundred thirty-three patients were included for baseline measurements. Fat free mass index (FFMI) and HGS&lt;10th percentile of reference values at baseline were both prognostic for poor OS in NSCLC and LAHNSCC [HR 1.64 [95%CI 1.13–2.39], p = 0.01 and HR 2.30 [95%CI 1.33–3.97], p = 0.003, respectively], independent of Charlson Comorbidity Index, cancer site, and gross tumor volume. Early fat mass (FM) loss during CRT was predictive for poor OS in sNSCLC (n = 64) [HR 3.80 [95%CI 1.79–8.06] p ≤ 0.001] but not in HPV– LAHNSCC (n = 61). In patients with significant weight loss (&gt;2%) in the first 3 weeks of CRT (sNSCLC n = 24, HPV– LAHNSCC n = 23), the FM change was −1.4 ± 14.5% and −8.7 ± 9.0% in sNSCLC and HPV– LAHNSCC patients, respectively (p &lt; 0.05). Fat fee mass change was −5.6 ± 6.3% and −4.0 ± 4.3% for sNSCLC and HPV– LAHNSCC, respectively (p = 0.31).Conclusion: FFMI and HGS&lt;10th percentile at baseline are independent prognostic factors for poor OS in NSCLC and LAHNSCC patients treated with CRT/BRT. The specific composition of mass loss during first 3 weeks of CRT significantly differs between sNSCLC and HPV– LAHNSCC patients. Early FM loss was prognostic in sNSCLC only.
The Faster-Onset Antidepressant Effects of Hypidone Hydrochloride (YL-0919) in Monkeys Subjected to Chronic Unpredictable Stress
Authors: Yin Yong-Yu , Tian Chao-Yang , Fang Xin-Xin , Shang Chao , Zhang Li-Ming , Xu Qiang , Li Yun-Feng 
Published: November 2020

Given the limited monkey models of depression available to date, as well as the procedural complexity and time investments that they involve, the ability to test the efficacy and time course of antidepressants in monkey models is greatly restricted. The present study attempted to build a simple and feasible monkey model of depression with chronic unpredictable stress (CUS) and evaluate the antidepressant effect and onset time of fluoxetine hydrochloride (FLX) and the new drug hypidone hydrochloride (YL-0919), a potent and selective 5-HT reuptake inhibitor, 5-HT1A receptor partial agonist and 5-HT6 receptor full agonist. Female cynomolgus monkeys with low social status in their colonies were selected and subjected to CUS for 8 weeks by means of food and water deprivation, space restriction, loud noise, strobe light, and intimidation with fake snakes. Huddling, self-clasping, locomotion and environmental exploration were monitored to evaluate behavioral changes. In addition, the window-opening test was used to evaluate the exploratory interest of the monkeys. The present results revealed that CUS-exposed monkeys displayed significant depression-like behaviors, including significant decreases in exploratory interest, locomotion, and exploration as well as significant increases in huddling and self-clasping behavior and the level of fecal cortisol after 8 weeks of CUS. Treatment with FLX (2.4 mg/kg, i. g.) or YL-0919 (1.2 mg/kg, i. g.) markedly reversed the depression-like behaviors caused by CUS, producing significant antidepressant effects. YL-0919 (once daily for 9 days) had a faster-onset antidepressant effect, compared with FLX (once daily for 17 days). In summary, the present study first established a CUS model using female cynomolgus monkeys with low social status and then successfully evaluated the onset time of 5-HTergic antidepressants. The results suggested that monkeys exposed to CUS displayed significant depression-like behaviors, and both FLX and YL-0919 produced antidepressant effects in this model. Moreover, YL-0919 appeared to act faster than FLX. The present study provides a promising prospect for the evaluation of fast-onset antidepressant drugs based on a CUS monkey model.
‘Dual Sensory Loss Protocol’ for Communication and Wellbeing of Older Adults With Vision and Hearing Impairment – A Randomized Controlled Trial
Authors: Vreeken Hilde L. , van Nispen Ruth M. A. , Kramer Sophia E. , van Rens Ger H. M. B. 
Published: November 2020

ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss (DSL) protocol on communication and wellbeing of older persons with DSL and their communication partners (e.g., spouse or child) in the Netherlands and Belgium.MethodsParticipants (N= 131) and their communication partners (n= 113) were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired (CPHI). Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory (HHDI) - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models (LMM) were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies (effect size SMD = 0.60, 95% CI: 0.25 to 0.95) in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843.
The CANNA-TICS Study Protocol: A Randomized Multi-Center Double-Blind Placebo Controlled Trial to Demonstrate the Efficacy and Safety of Nabiximols in the Treatment of Adults With Chronic Tic Disorders
Authors: Jakubovski Ewgeni , Pisarenko Anna , Fremer Carolin , Haas Martina , May Marcus , Schumacher Carsten , Schindler Christoph , Häckl Sebastian , Aguirre Davila Lukas , Koch Armin , Brunnauer Alexander , Cimpianu Camelia Lucia , Lutz Beat , Bindila Laura , Müller-Vahl Kirsten 
Published: November 2020

Background: Gilles de la Tourette syndrome (TS) is a chronic neuropsychiatric disorder characterized by motor and vocal tics. First-line treatments for tics are antipsychotics and tic-specific behavioral therapies. However, due to a lack of trained therapists and adverse events of antipsychotic medication many patients seek alternative treatment options including cannabis. Based on the favorable results obtained from case studies on different cannabis-based medicines as well as two small randomized controlled trials using delta-9-tetrahydrocannabinol (THC), we hypothesize that the cannabis extract nabiximols can be regarded as a promising new and safe treatment strategy in TS.Objective: To test in a double blind randomized clinical trial, whether treatment with the cannabis extract nabiximols is superior to placebo in patients with chronic tic disorders.Patients and Methods: This is a multicenter, randomized, double-blind, placebo controlled, parallel-group, phase IIIb trial, which aims to enroll 96 adult patients with chronic tic disorders (TS or chronic motor tic disorder) across 6 centers throughout Germany. Patients will be randomized with a 2:1 ratio into a nabiximols and a placebo arm. The primary efficacy endpoint is defined as tic reduction of at least 30% (compared to baseline) according to the Total Tic Score of the Yale Global Tic Severity Scale (YGTSS-TTS) after 13 weeks of treatment. In addition, several secondary endpoints will be assessed including changes in different psychiatric comorbidities, quality of life, driving ability, and safety assessments.Discussion: This will be the first large, controlled study investigating efficacy and safety of a cannabis-based medicine in patients with TS. Based on available data using different cannabis-based medicines, we expect not only a reduction of tics, but also an improvement of psychiatric comorbidities. If the cannabis extract nabiximols is proven to be safe and effective, it will be a valuable alternative treatment option. The results of this study will be of high health-economic relevance, because a substantial number of patients uses cannabis (illegally) as self-medication.Conclusion: The CANNA-TICS trial will clarify whether nabiximols is efficacious and safe in the treatment of patients with chronic tic disorders.Clinical Trial Registration: This trial is registered at clinicaltrialsregister.eu (Eudra-CT 2016-000564-42) and clinicaltrials.gov (NCT03087201).
The Effect of Shelter-in-Place Orders on Social Distancing and the Spread of the COVID-19 Pandemic: A Study of Texas
Authors: Castaneda Marco A. , Saygili Meryem 
Published: November 2020

Objectives:We study how the state-wide shelter-in-place order affected social distancing and the number of cases and deaths in Texas.Methods:We use daily data at the county level. The COVID-19 cases and fatalities data are from the New York Times. Social distancing measures are from SafeGraph. Both data are retrieved from the Unfolded Studio website. The county-level COVID-related policy responses are from the National Association of Counties. We use an event-study design and regression analysis to estimate the effect of the state-wide shelter-in-place order on social distancing and the number of cases and deaths.Results:We find that the growth rate of cases and deaths is significantly lower during the policy period when the percentage of the population that stays at home is highest. The crucial question is whether the policy has a causal impact on the sheltering percentages. The fact that some counties in Texas adopted local restrictive policies well before the state-wide policy helps us address this question. We do not find evidence that this top-down restrictive policy increased the percentage of the population that exercised social distancing.Discussion:Shelter-in-place policies are more effective at the local level and should go along with efforts to inform and update the public about the potential consequences of the disease and its current state in their localities.
Superselective Renal Artery Embolization Management of Post-percutaneous Nephrolithotomy Hemorrhage and Its Methods
Authors: Dong Xiangjun , Ren Yanqiao , Han Ping , Chen Lei , Sun Tao , Su Yangbo , Feng Yiming , Ma Jinqiang , Liang Huimin , Zheng Chuansheng 
Published: November 2020

Objective: The purpose of this study was to evaluate the therapeutic efficacy and safety of superselective renal arterial embolization (SRAE) in the treatment of patients with renal hemorrhage after percutaneous nephroscopy (PCNL). In addition, embolization techniques and embolization materials during operation were also worthy of further discussion.Methods: From February 2015 to December 2019, clinical data of 49 consecutive patients with renal hemorrhage after PCNL were retrospectively analyzed. Demographic and clinical data of patients were recorded, changes in serum creatinine values were analyzed, and the safety and efficacy of TAE were evaluated. Clinical experience was also recorded.Results: A total of 49 patients underwent angiography, of which 46 patients received SRAE due to positive hemorrhagic foci detected by angiography, and the technical success rate of 46 patients was 100%. Among the three patients who did not receive embolization, one patient underwent nephrectomy, and two patients improved with conservative treatment, with a clinical success rate of 98%. There was no statistically significant difference between serum creatinine before PCNL and 7 days after SRAE (101.6 ± 36.5 to 100.5 ± 27.1 μmol/L; P = 0.634), and no significant change was observed in serum creatinine at the last follow-up (99.4 ± 34 μmol/L, P = 0.076). No major complications occurred after embolization.Conclusions: SRAE is safe and effective in patients with renal hemorrhage after PCNL. The experience of interventional therapy and the choice of embolization materials in this study may provide certain benefits for the treatment of patients with renal hemorrhage after PCNL.
COVID-19 in Patients with CKD in New York City
Authors: Akchurin Oleh , Meza Kelly , Biswas Sharmi , Greenbaum Michaela , Licona-Freudenstein Alexandra P. , Goyal Parag , Choi Justin J. , Choi Mary E. 
Published: November 2020

Background
COVID-19 has affected millions of people, and several chronic medical conditions appear to increase the risk of severe COVID-19. However, our understanding of COVID-19 outcomes in patients with CKD remains limited.

Methods
This was a retrospective cohort study of patients with and without CKD consecutively admitted with COVID-19 to three affiliated hospitals in New York City. Pre–COVID-19 CKD diagnoses were identified by billing codes and verified by manual chart review. In-hospital mortality was compared between patients with and without underlying CKD. Logistic regression was used to adjust this analysis for confounders and to identify patient characteristics associated with mortality.

Results
We identified 280 patients with CKD, and 4098 patients without CKD hospitalized with COVID-19. The median age of the CKD group was 75 (65–84) years, and age of the non-CKD group 62 (48–75) years. Baseline (pre–COVID-19) serum creatinine in patients with CKD was 1.5 (1.2–2.2) mg/dl. In-hospital mortality was 30% in patients with CKD versus 20% in patients without CKD (P<0.001). The risk of in-hospital death in patients with CKD remained higher than in patients without CKD after adjustment for comorbidities (hypertension, diabetes mellitus, asthma, and chronic obstructive pulmonary disease), adjusted OR 1.4 (95% CI,1.1 to 1.9), P=0.01. When stratified by age, elderly patients with CKD (age >70 years) had higher mortality than their age-matched control patients without CKD. In patients with CKD, factors associated with in-hospital mortality were age (adjusted OR, 1.09 [95% CI, 1.06 to 1.12]), P<0.001, baseline and admission serum phosphorus (adjusted OR, 1.5 [95% CI, 1.03 to 2.1], P=0.03 and 1.4 [95% CI, 1.1 to 1.7], P=0.001), serum creatinine on admission >0.3 mg/dl above the baseline (adjusted OR 2.6 [95% CI, 1.2 to 5.4]P=0.01), and diagnosis of acute on chronic kidney injury during hospitalization (adjusted OR 4.6 [95% CI, 2.3 to 8.9], P<0.001).

Conclusions
CKD is an independent risk factor for COVID-19–associated in-hospital mortality in elderly patients. Acute-on–chronic kidney injury increases the odds of in-hospital mortality in patients with CKD hospitalized with COVID-19.
Muestreo de senos petrosos
Authors: Meléndez Negrette Fernando José , Escudero-Pineda Pablo Andrés , Díaz-Pacheco Carlos Alberto , Builes-Barrera Carlos Alfonso 
Published: November 2020

Objetivos: analizar, evaluar y describir la utilidad del muestreo de senos petrosos para diagnóstico del síndrome de Cushing de origen central.
Material y métodos: se analizaron los aspectos técnicos y resultados del muestreo bilateral venoso de senos petrosos, desde el 1º de enero de 2012 a 31 de diciembre de 2018 en el Hospital Universitario San Vicente de Paúl en Medellín, Colombia.
Resultados: el promedio de edad fue 43.3 años con un rango de edad desde los 19 hasta los 69 años. La lateralidad pudo ser demostrada en 68.2% de los casos con una tendencia a la localización en el lado izquierdo en 53.3%. El origen central de producción de ACTH logró ser demostrado en 95.4% de los casos, con una relación central/periferia basal promedio de 21.7 y postestimulación de 70.8. Todas las muestras a los 3, 5 y 10 minutos fueron confirmatorias tras la estimulación.
Conclusión: en nuestro estudio retrospectivo el cateterismo de senos petrosos confirmó la fuente central de producción de ACTH por laboratorio en un alto porcentaje de pacientes sin ninguna complicación inmediata
Derechos Humanos, Educación y Aprendizaje Estratégico
Authors: Aldana Rabanales Karla Irene 
Published: November 2020

El presente ensayo aborda la educación como Derecho Humano fundamentado en la dignidad de la persona. Cada persona, está en constante proceso de aprendizaje, un aprendizaje que debe ser idealmente estratégico y autónomo, para lograr el desarrollo integral que un ser humano es capaz de alcanzar y dar así­ cumplimiento a los Derechos Humanos.
Para comprender el aprendizaje estratégico, es imperativo describir las estrategias de aprendizaje y centrarse en procesos cognitivos superiores. El aprendizaje es un acto cotidiano, evidente en procesos como leer y escribir, siendo éstos, entre otros, los que nos permitirán valorar la educación como un Derecho Humano inalienable.
Se propone como conclusión que el generar un ambiente de aprendizaje estratégico y autónomo, enmarcado en los Derechos Humanos es el escenario idóneo de la educación. Conclusión que pretende abrir un espacio a la reflexión, el análisis y la exploración de los constructos aquí­ abordados.
PENGARUH PENGGUNAAN MEDIA PEMBELAJARAN E-LEAFLET SEBAGAI MEDIA INTERAKTIF TERHADAP MATERI HARDWARE DI SMAN 7 KUPANG
Authors: Yunus Isnai 
Published: November 2020

Tujuan dalam penelitian ini untuk mengetahui pengaruh penggunaan media pembelajaran e-leaflet berbasis android sebagai media interaktif terhadap materi hardware.Berdasarkan Hasil daya beda soal kriteria jelek 3 soal, kriteria cukup 14 soal, kriteria baik 3 soal,sedangkan hasil tingkat kesukaran diperoleh 17 soal dengan kriteria mudah, dan 3 soal kriteria sedang, dan distraktor 125% atau 13 responden, baik 75% atau 14 responden, kurang baik 175% atau 6 responden.Persentase indikator kelas eksperimen post-test C1 (mengingat) sebesar 75% > kelas kontrol hanya memiliki nilai C1 (mengingat) sebesar 59% , dengan uji deskriptif kelas eksperimen post-test dengan nilai rata-rata sebesar 78 > kelas kontrol mempunyai nilai rata-rata sebesar 70, dengan uji prasyarat analisis untuk uji normalitas nilai sig. 2 tailed > 0,05 maka dapat diperoleh bahwa semua data berdistribusi normal, dengan uji linieritas nilai > sig.0,05 data keseluruhan berasal dari data yang linear,maka dengan uji homogenitas maka nilai sig. > 0,05 secara keseluruhan berasal dari data yang sama (homogen). Sedangkan Uji t independent dengan menggunakan menunjukan bahwa dilihat dari sig.(2-tailed) < α (0,05) maka H0 ditolak dan Ha diterima. Hasil angket diperoleh menunjukan nilai sebesar 120% (sangat setuju) jika media pembelajaran e-leaflet berbasis android sebagai media interaktif terhadap materi hardware dapat digunakan dalam proses pembelajaran. Disimpulkan bahwa dengan menggunakan media pembelajaran e-leaflet berbasis android dapat meningkatkan hasil belajar siswa