bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plant Stanol Esters Reduce LDL (Low-Density Lipoprotein) Aggregation by Altering LDL Surface Lipids
Authors: Ruuth Maija , Äikäs Lauri , Tigistu-Sahle Feven , Käkelä Reijo , Lindholm Harri , Simonen Piia , Kovanen Petri T. , Gylling Helena , Öörni Katariina 
Published: July 2020

Objective:
Plant stanol ester supplementation (2–3 g plant stanols/d) reduces plasma LDL (low-density lipoprotein) cholesterol concentration by 9% to 12% and is, therefore, recommended as part of prevention and treatment of atherosclerotic cardiovascular disease. In addition to plasma LDL-cholesterol concentration, also qualitative properties of LDL particles can influence atherogenesis. However, the effect of plant stanol ester consumption on the proatherogenic properties of LDL has not been studied.

Approach and Results:

Study subjects (n=90) were randomized to consume either a plant stanol ester-enriched spread (3.0 g plant stanols/d) or the same spread without added plant stanol esters for 6 months. Blood samples were taken at baseline and after the intervention. The aggregation susceptibility of LDL particles was analyzed by inducing aggregation of isolated LDL and following aggregate formation. LDL lipidome was determined by mass spectrometry. Binding of serum lipoproteins to proteoglycans was measured using a microtiter well-based assay. LDL aggregation susceptibility was decreased in the plant stanol ester group, and the median aggregate size after incubation for 2 hours decreased from 1490 to 620 nm,
P
=0.001. Plant stanol ester-induced decrease in LDL aggregation was more extensive in participants having body mass index<25 kg/m
2
. Decreased LDL aggregation susceptibility was associated with decreased proportion of LDL-sphingomyelins and increased proportion of LDL-triacylglycerols. LDL binding to proteoglycans was decreased in the plant stanol ester group, the decrease depending on decreased serum LDL-cholesterol concentration.

Conclusions:
Consumption of plant stanol esters decreases the aggregation susceptibility of LDL particles by modifying LDL lipidome. The resulting improvement of LDL quality may be beneficial for cardiovascular health.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01315964.
Pedal Misapplication: Interruption Effects and Age-Related Differences
Authors: Hasegawa Kunihiro , Kimura Motohiro , Takeda Yuji 
Published: July 2020

Objective This study aimed to investigate whether pedal misapplication occurs more frequently when a pedal task is interrupted for a longer period of time. Background Misapplication of a vehicle’s brake and accelerator pedals can cause severe traffic accidents, especially for older drivers. The present study provides empirical support for the hypothesis that pedal misapplication occurs more frequently when drivers are interrupted for longer periods of time and is demonstrated more prominently in older drivers. Methods Forty younger participants and 40 older participants were asked to perform a pedal choice response task (stepping on either a brake or accelerator pedal) that had been preceded by an interruption task (i.e., touch number task). Results Pedal misapplications occurred more frequently when the pedal choice response task was preceded by the touch number task for a longer interval (about 120 s) than for a shorter interval (about 30 s). Furthermore, the time-related increase in pedal misapplications was greater for older participants. Conclusion Pedal misapplication increases when the pedal task is interrupted for a longer time period, especially for older adults. Application The findings contribute to our understanding of when and where pedal misapplications tend to occur.
Personal recovery and depression, taking existential and social aspects into account: A struggle with institutional structures, loneliness and identity
Authors: Damsgaard Janne Brammer , Overgaard Camilla Lyhne , Birkelund Regner 
Published: July 2020

Background: Although depression is one of the most studied mental illness phenomena, the studies attempt to understand depression as different phases, turning points and transitions, but depression has an existential and social resonance. There is progress to be made in seeking to understand how people experience, cope and process, living with depression. There is a need of supplementary and alternative approaches that goes beyond medicine and traditional treatment of psychiatric disabilities. Aim: The aim of this study was to explore perceptions and challenging issues related to living with depression, allowing the researchers to get a deeper understanding of existential and social aspects. Method: A phenomenological–hermeneutic study design was applied, based on the French philosopher Paul Ricoeur’s theory of interpretation. Data were collected through observations and semi-structured interviews. Findings: Several of the interviewees were lonely at home as well as at the hospital. This caused experiences of sheer isolation with feelings of sadness enhancing desperation concerning what to do with themselves. This could even cause physical feelings of pain. In different ways, the interviewees expressed how being with other people filled their lives with relationships and closeness. Health care professionals were focused on applying structure into the users’ everyday life, shadowing the person’s individuality, strengths and resources. The prioritizations between users and healthcare professionals were not always in concordance. The interviewees experienced recurrent situations where their authority and individuality were ignored or felt non-existent. Conclusion: Existential and social aspects are vital in regard to understanding people living with depression. However, personal recovery can be diminished by controlling structures and lack of a caring guidance, creating feelings of stigmatization missing out on autonomy, causing inner doubts. A recommendation is that we challenge institutional structures and accelerate education developing the healthcare professionals’ empathic competences and ability to make wise judgments, empowering the users’ autonomy.
Usability of the lateral decubitus position on four-dimensional ultra-low-dose computed tomography for the detection of localized pleural adhesion in the pulmonary apical region
Authors: Sato Shigetaka , Nagatani Yukihiro , Hashimoto Masayuki , Nitta Norihisa , Hanaoka Jun , Ushio Noritoshi , Tsukagoshi Shinsuke , Uranishi Ayumi , Kimoto Tatsuya , Oshio Yasuhiko , Mayumi Masayuki , Sonoda Akinaga , Otani Hideji , Yamashiro Tsuneo , Moriya Hiroshi , Murata Kiyoshi , Watanabe Yoshiyuki ,   for the investigators of ACTIve study group
Published: July 2020

Background Localized pleural adhesion (LPA) evaluation in the apical region is difficult even with four-dimensional ultra-low-dose computed tomography (4D-ULDCT) in the supine position due to smaller pleural movements. Purpose To assess usability of 4D-ULDCT in the lateral decubitus (LD) position for LPA detection in the apical region. Material and Methods Forty-seven patients underwent 4D-ULDCT of a single respiration cycle with 16-cm coverage of body axis in supine and LD positions with the affected lung uppermost. Intraoperative thoracoscopic findings confirmed LPA presence. A pleural point and a corresponding point on costal outer edge were placed in identical axial planes at end-inspiration. Pleuro-chest wall distance between two points (PCD) was calculated at each respiratory phase. In the affected lung, average change in amount of PCD (PCDACA) was compared between patients with and without LPA in total and two sub-groups (non-COPD and COPD, non-emphysematous and emphysematous patients) in supine and non-dependent (ND) LD positions. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal thresholds in PCDACA for differentiating patients with LPA from those without. Results In COPD/emphysematous patients and total population, PCDACA with LPA was smaller than in those without in the supine and NDLD positions for overall, lateral, and dorsal regions. For the lateral region in COPD patients, area under ROC curve (AUC) increased from supine (0.64) to NDLD position (0.81). For the dorsal region in emphysematous patients, AUC increased from supine (0.76) to NDLD position (0.96). Conclusion 4D-ULDCT in LD position may be useful for LPA detection in apical regions for COPD and/or emphysematous patients.
Comparison Between Treacher Collins Syndrome and Pierre Robin Sequence: A Cephalometric Study
Authors: Kato Renata Mayumi , Moura Priscila Padilha , Zechi-Ceide Roseli Maria , Tonello Cristiano , Peixoto Adriano Porto , Garib Daniela 
Published: July 2020

Objective: The aim of this study was to compare the dentoskeletal pattern of Treacher Collins syndrome (TCS) and nonsyndromic Pierre Robin sequence (PRS). Design: Retrospective. Setting: Single center. Patients: Eighteen patients diagnosed with TCS (Group TCS) or PRS (Group PRS) in rehabilitation treatment at a single center. Group TCS was composed of 9 patients (4 male, 5 female) with a mean age of 12.9 years (standard deviation = 4.8). Group PRS was composed of 9 patients paired by age and sex with group TCS. Main Outcome Measure(s): Cone beam computed tomography–derived cephalometric images taken before the orthodontic or the orthodontic-surgical treatment were analyzed using Dolphin Imaging (Dolphin Imaging 11.0 & Management Solutions). Variables evaluating the cranial base, the maxillary and mandibular skeletal components, maxillomandibular relationship, the vertical components and the dentoalveolar region were measured. Intergroup comparisons were performed using t tests. The significance level considered was 5%. Results: Intergroup differences in the mandible size and growth pattern were observed. Group TCS showed a smaller mandibular length (Co-Go, Co-Gn) and a higher palatal plane (SN-Palatal Plane) and mandibular plane angles (SN-Go.Gn) compared to group PRS. No differences between TCS and PRS were observed for the sagittal position of the maxilla, maxillomandibular relationship, and dental components. Conclusions: Treacher Collins syndrome presented a decreased mandible and a more severe vertical growth pattern compared to PRS.
Macular ganglion cell–inner plexiform layer thinning as a biomarker of disability progression in relapsing multiple sclerosis
Authors: Bsteh Gabriel , Berek Klaus , Hegen Harald , Altmann Patrick , Wurth Sebastian , Auer Michael , Zinganell Anne , Di Pauli Franziska , Rommer Paulus , Leutmezer Fritz , Deisenhammer Florian , Berger Thomas 
Published: July 2020

Background: Macular ganglion cell–inner plexiform layer (mGCIPL) is an emerging biomarker of neuroaxonal degeneration in multiple sclerosis (MS). Objective: We aimed to determine cut-off values of mGCIPL thinning for discriminating between progressing and stable patients in relapsing multiple sclerosis (RMS). Methods: This is a 3-year prospective longitudinal study on 183 RMS patients with annual optical coherence tomography. Best possible cut-off values of baseline mGCIPL and annual loss of macular ganglion cell–inner plexiform layer (aLmGCIPL) for discriminating clinically progressing (physical progression or cognitive decline) from stable patients were defined by receiver operating characteristics analysis and tested using multivariate regression models. Results: Baseline mGCIPL thickness <77 µm was associated with an increased risk (hazard ratio: 2.7, 95% confidence interval (CI): 1.5–4.7, p < 0.001) of disability progression. An aLmGCIPL cut-off ⩾1 µm accurately identified clinically progressing patients (87% sensitivity at 90% specificity) and was a strong predictor of clinical progression (odds ratio: 18.3, 95% CI: 8.8–50.3). Conclusion: We present evidence that cross-sectionally measured mGCIPL thickness and annualized thinning rates of mGCIPL are able to identify clinically progressing RMS with high accuracy.
Helical IMRT-Based Stereotactic Body Radiation Therapy Using an Abdominal Compression Technique and Modified Fractionation Regimen for Small Hepatocellular Carcinoma
Authors: Chen Yi-Xing , Zhuang Yuan , Yang Ping , Fan Jia , Zhou Jian , Hu Yong , Zhu Wen-Chao , Sun Jing , Zeng Zhao-Chong 
Published: July 2020

Purpose: To assess the efficacy and safety of stereotactic body radiation therapy using an abdominal compression technique and modified fractionation regimen (5-10 fractions) in patients with small-sized hepatocellular carcinoma. Methods: A total of 101 patients with small-sized hepatocellular carcinoma treated with stereotactic body radiation therapy using an abdominal compression technique and modified fractionation regimen were registered between June 2011 and June 2019 in our hospital. A total dose of 48 to 60 Gy was applied over 5 to 14 consecutive days. Liver motion was controlled by abdominal compression, and a helical intensity-modified radiation therapy-based stereotactic body radiation therapy administrated in tomotherapy platform. Results: The median follow-up period was 23.2 months (range: 4.1-99.2 months). Complete response and partial response were observed in 63 (62.4%) patients and in 24 (23.8%) patients, respectively. At the time of our analysis, the 1-, 3-, and 5-year local control rates after stereotactic body radiation therapy were 96.1%, 89.0%, and 89.0%, respectively. However, logistic regression analysis revealed no correlation between the biologically effective dose and 3-year local control rates. The 1-, 3-, and 5-year overall survival rates were 96.9%, 69.0%, and 64.3%, respectively. For patients who were treatment-naive, the 1-, 3-, and 5-year overall survival were 96.3%, 82.0%, and 82.0%, respectively. No patients experienced classic radiation-induced liver disease or nonclassic radiation-induced liver disease after stereotactic body radiation therapy completion. Conclusions: When using an abdominal compression technique and modified fractionation regimen (5-10 fractions) based on helical intensity-modified radiation therapy, stereotactic body radiation therapy led to a lower toxicity and comparative rate of local control and overall survival for patients who with small-sized hepatocellular carcinoma.
Predictive value of ankle–brachial index for long-term events of ischemic stroke in hemodialysis patients
Authors: Lee Kai-Ni , Chou Li-Ping , Liu Chi-Chu , Chen Tsang-Shan , Lui Eric Kim-Tai , Chou Chih-Ho , Chen Chien-An 
Published: July 2020

Objectives The ankle–brachial index is a noninvasive modality to evaluate atherosclerosis and is a predictive role for future cardiovascular events and mortality. However, few studies have evaluated its relation to long-term future ischemic stroke in hemodialysis patients. Therefore, we examined the relationship between ankle–brachial index and ischemic stroke events among hemodialysis patients in a seven-year follow-up. Methods A total of 84 patients were enrolled. Ankle–brachial index was assessed in January 2009. Primary outcomes included ischemic stroke. An ankle–brachial index < 0.9 was considered abnormal and 1.4 ≥ ankle–brachial index ≥ 0.9 to be normal ankle–brachial index. Results Mean values for ankle–brachial index were 0.98 ± 0.21at study entrance. In addition, 28 patients encountered ischemic stroke in the seven-year follow-up. In univariate Cox regression analysis, old age (hazard ratio (HR): 1.065, 95% confidence interval (CI): 1.030–1.102, p < 0.001), low seven-year averaged serum phosphate levels (HR: 0.473, 95% CI: 0.306–0.730, p = 0.001), and abnormal ankle–brachial index (HR: 0.035, 95% CI: 0.009–0.145, p < 0.001) were risk factors for ischemic stroke. In multivariate Cox regression analysis for significant variables in univariate analysis, abnormal ankle–brachial index (HR: 0.058, 95% CI: 0.012–0.279, p < 0.001) and low seven-year averaged serum phosphate levels (HR: 0.625, 95% CI: 0.404–0.968, p = 0.035) remained the risk factors for ischemic stroke. The risk of ischemic stroke was 3.783-fold in patients with abnormal ankle–brachial index compared with patients with normal ankle–brachial index (HR: 3.783, 95% CI: 1.731–8.269, p = 0.001). Conclusions These findings suggest that ankle–brachial index is an impressive predictor of future ischemic stroke among hemodialysis patients.
Management of abdominal aortic aneurysm in nonagenarians: A single-centre experience
Authors: Pasqui Edoardo , de Donato Gianmarco , Giannace Giovanni , Panzano Claudia , Setacci Carlo , Palasciano Giancarlo 
Published: July 2020

Objective In the last decades, life expectancy has increased worldwide considerably. Traditionally, very elderly patients have been considered too frail to undergo major vascular interventions. Considering that abdominal aortic aneurysm is an age-related disease, there is an increasing need of a correct management of the disease even in nonagenarians, but data are still scarce. The purpose of this single-centre study is to report early and mid-term outcomes of all-comer abdominal aortic aneurysm patients in their 10th decades of age. Methods A retrospective review of our prospectively maintained database identified a total of 33 patients aged ≥ 90 presenting with abdominal aortic aneurysm between 2014 and 2019. Elective and emergency repairs were both considered. Early technical success and mortality rate at 30 days were considered as primary outcomes. Mid-term clinical success was reported, and overall survival, freedom from aneurysm-related death, re-interventions and endoleaks were estimated with the Kaplan–Meier method, stratified for elective of emergency repair and type of treatment. Results The mean age was 91.7 (range 90–96), and 63.6% were male. Mean abdominal aortic aneurysm diameter was 67.4 ± 16.8 mm. Sixteen patients were admitted for rupture abdominal aortic aneurysm: three untreated, five underwent open and seven underwent endovascular aneurysm repair (EVAR), with an early mortality rate of 100, 100 and 42.8%, respectively. Eighteen (60%) patients were asymptomatic, and all underwent elective EVAR, with an early mortality rate of 0%. At one-month follow-up, clinical success was 84% in EVAR group. At a median follow-up of 22.4 ± 14.5 months, no abdominal aortic aneurysm-related death was registered. Freedom from all cause of mortality was 77.3, 59.4 and 40.7% at one, two and three years. Freedom from endoleaks was 95.4% at one month and 61.7% at one and three years. Freedom from reintervention was 85.8% at three years. Conclusion Elective EVAR in nonagenarians is associated with acceptable early and mid-term outcomes. Age by itself should not be considered an exclusion criterion for treatment.
Accident reconstructions of falls, collisions, and punches in sports
Authors: Kendall Marshall , Anna Oeur  , Brien Susan E , Cusimano Michael , Marshall Shawn , Gilchrist Michael D , Hoshizaki Thomas B 
Published: July 2020

Objective Impacts to the head are the primary cause of concussive injuries in sport and can occur in a multitude of different environments. Each event is composed of combinations of impact characteristics (striking velocity, impact mass, and surface compliance) that present unique loading conditions on the head and brain. The purpose of this study was to compare falls, collisions, and punches from accident reconstructions of sports-related head impacts using linear, rotational accelerations and maximal principal strain of brain tissue from finite element simulation. Methods This study compared four types of head impact events through reconstruction. Seventy-two head impacts were taken from medical reports of accidental falls and game video of ice hockey, American football, and mixed-martial arts. These were reconstructed using physical impact systems to represent helmeted and unhelmeted falls, player-to-player collisions, and punches to the head. Head accelerations were collected using a Hybrid III headform and were input into a finite element brain model used to approximate strain in the cerebrum associated with the external loading conditions. Results Significant differences ( p < 0.01) were found for peak linear and rotational accelerations magnitudes (30–300 g and 3.2–7.8 krad/s2) and pulse durations between all impact event types characterized by unique impact parameters. The only exception was found where punch impacts and helmeted falls had similar rotational durations. Regression analysis demonstrated that increases to strain from unhelmeted falls were significantly influenced by both linear and rotational accelerations, meanwhile helmeted falls, punches, and collisions were influenced by rotational accelerations alone. Conclusion This report illustrates that the four distinct impact events created unique peak head kinematics and brain tissue strain values. These distinct patterns of head acceleration characteristics suggest that it is important to keep in mind that head injury can occur from a range of low to high acceleration magnitudes and that impact parameters (surface compliance, striking velocity, and impact mass) play an important role on the duration-dependent tolerance to impact loading.
Inflammation-driven activation of JAK/STAT signaling reversibly accelerates acute myeloid leukemia in vitro
Authors: Habbel Jan , Arnold Lucas , Chen Yiyang , Möllmann Michael , Bruderek Kirsten , Brandau Sven , Dührsen Ulrich , Hanoun Maher 
Published: July 2020

Abstract
Acute myeloid leukemia (AML) is characterized by a high relapse rate and dismal long-term overall survival which is related to persistence of leukemia-initiating cells in their niche. Different animal models of myeloid malignancies reveal how neoplastic cells alter the structural and functional characteristics of the hematopoietic stem cell niche to reinforce malignancy. Understanding and disruption of the microenvironmental interactions with AML cells are a vital need. Malignant niches frequently go along with inflammatory responses, but their impact on cancerogenesis often remains unexplored. Here, we uncovered an aberrant production of inflammatory cytokines in untreated AML bone marrow that was proved to promote the proliferation of leukemia cells. This inflammatory response induced an activation of the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway in AML blasts as well as bone marrow stromal cells that also fostered leukemia proliferation. Inhibition of JAK/STAT signaling using the selective JAK1/2 inhibitor ruxolitinib resulted in significant antileukemic activity in AML in vitro which is mediated through both cell-autonomous and microenvironment-mediated mechanisms. However, in a xenograft transplantation model, monotherapy with ruxolitinib did not achieve substantial antileukemic activity, possibly suggesting a complementary function of JAK1/2 inhibition in AML.