bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor‐associated lymphocytes and macrophages are related to stromal elastosis and vascular invasion in breast cancer
Authors: Chen Ying , Klingen Tor Audun , Aas Hans , Wik Elisabeth , Akslen Lars A 
Published: June 2021

AbstractThe tumor microenvironment plays a critical role in breast cancer progression. Here, we investigated tumor‐infiltrating lymphocytes (TILs) and associations with macrophage numbers, tumor stromal elastosis, vascular invasion, and tumor detection mode. We performed a population‐based retrospective study using data from The Norwegian Breast Cancer Screening Program in Vestfold County (2004–2009), including 200 screen‐detected and 82 interval cancers. The number of TILs (CD45+, CD3+, CD4+, CD8+, and FOXP3+) and tumor‐associated macrophages (CD163+) was counted using immunohistochemistry on tissue microarray slides. Lymphatic and blood vessel invasion (LVI and BVI) were recorded using D2‐40 and CD31 staining, and the amount of elastosis (high/low) was determined on regular HE‐stained slides. High numbers of all TIL subsets were associated with LVI (p ≤ 0.04 for all), and high counts of several TIL subgroups (CD8+, CD45+, and FOXP3+) were associated with BVI (p ≤ 0.04 for all). Increased levels of all TIL subsets, except CD4+, were associated with estrogen receptor‐negative tumors (p < 0.001) and high tumor cell proliferation by Ki67 (p < 0.001). Furthermore, high levels of all TIL subsets were associated with high macrophage counts (p < 0.001) and low‐grade stromal elastosis (p ≤ 0.02). High counts of CD3+, CD8+, and FOXP3+ TILs were associated with interval detected tumors (p ≤ 0.04 for all). Finally, in the luminal A subgroup, high levels of CD3+ and FOXP3+ TILs were associated with shorter recurrence‐free survival, and high counts of FOXP3+ were linked to reduced breast cancer‐specific survival. In conclusion, higher levels of different TIL subsets were associated with stromal features such as high macrophage counts (CD163+), presence of vascular invasion, absence of stromal elastosis, as well as increased tumor cell proliferation and interval detection mode. Our findings support a link between immune cells and vascular invasion in more aggressive breast cancer. Notably, presence of TIL subsets showed prognostic value within the luminal A category.
Predictive value of the age, creatinine, and ejection fraction score in patients with myocardial infarction with nonobstructive coronary arteries
Authors: Gao Side , Ma Wenjian , Huang Sizhuang , Lin Xuze , Yu Mengyue 
Published: June 2021

AbstractBackgroundLittle is known about risk stratification in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA). We investigated whether the age, creatinine, and ejection fraction (ACEF) score (age [years]/ejection fraction [%] + 1 [if creatinine >176 μmol/L]) might predict long‐term outcomes after MINOCA.HypothesisThe ACEF score enables accurate risk prediction in patients with MINOCA.MethodsA total of 1179 patients with MINOCA were enrolled and divided based on their ACEF score tertile levels. The primary endpoint was a composite of major adverse cardiovascular events (MACE), including all‐cause death, nonfatal MI, nonfatal stroke, revascularization, and hospitalization for unstable angina or heart failure. Kaplan–Meier and Cox regression analyses were performed. Discrimination was defined as the area under the curve (AUC) using receiver operating characteristic analysis.ResultsDuring the median follow‐up of 41.7 months, patients with MINOCA with higher ACEF score tertiles had a significantly higher incidence of MACE (6.3%, 12.5%, and 23.8%, respectively; p < .001). The adjusted risk of MACE increased with the rising ACEF score tertiles (1st tertile as reference; 2nd tertile: HR 2.70, 95% CI: 1.38–5.29, p = .004; and 3rd tertile: HR 5.35, 95% CI: 2.72–10.51, p < .001). Moreover, an elevated ACEF score was closely associated with an increased risk of MACE overall (HR 4.23, 95% CI: 3.37–5.30, p < .001) and in subgroups (all p < .05). The ACEF score also yielded a good predictive value (AUC 0.79) for MACE.ConclusionElevated ACEF scores were strongly associated with a poor prognosis after MINOCA. This simple and valid risk score may facilitate risk stratification and decision making in the population with MINOCA.
Gender differences in acute myocardial infarction—A nationwide German real‐life analysis from 2014 to 2017
Authors: Kuehnemund Leonie , Koeppe Jeanette , Feld Jannik , Wiederhold Achim , Illner Julia , Makowski Lena , Gerß Joachim , Reinecke Holger , Freisinger Eva 
Published: June 2021

AbstractBackgroundFemale sex was reported to be associated with an unfavorable outcome in acute myocardial infarction (AMI). In this nationwide analysis we assessed sex differences in acute outcomes of AMI and recent trends in patient healthcare.MethodsWe analyzed 875 735 German cases hospitalized with a main diagnosis of ST‐ (STEMI) and non ST‐elevation myocardial infarction (NSTEMI) between January 01 2014 and December 31 2017 regarding morbidity, in‐hospital mortality and treatments. A multivariable logistic regression model was designed to evaluate the use of interventions and their impact on in‐hospital mortality.ResultsSTEMI cases decreased from 72 894 in 2014 to 68 213 in 2017, with 70% assignable to men. Female sex was associated with older age (74 vs. 62 years), and higher prevalence of cardiovascular risk factors such as chronic kidney disease (19.2% vs. 12.5%), hypertension (69.0% vs. 65.0%) and left ventricular heart failure (36.0% vs. 32.1%). In NSTEMI, female sex was also associated with older age (78 vs. 71 years), and higher prevalence of cardiovascular risk factors such as chronic kidney disease (29.7% vs. 23.9%), hypertension (77.4% vs. 74.5%) and left ventricular heart failure (40.5% vs. 36.4%). Overall, 74.3% of female and 81.3% of male STEMI cases received percutaneous coronary intervention (PCI, p < 0.001). In NSTEMI, PCI was performed in 40.8% of female and 52.0% of male cases (p < 0.001). In‐hospital mortality was notably increased in female patients with STEMI (15.0% vs. 9.6%; p < 0.001; OR 1.07; 95% CI 1.03–1.10) and NSTEMI (8.3% vs. 6.3%; p < 0.001; OR 0.91; 95% CI 0.89–0.93) compared to males.ConclusionsOur nationwide real‐world data document that in‐patient STEMI cases continue to decrease in women and men. The observed higher in‐hospital mortality in women was largely attributed to a more unfavorable risk and age distribution rather than to female‐intrinsic factors. Women with AMI continue to be less likely to receive revascularization therapies.
Material, behavioral, and psychological financial hardship among survivors of childhood cancer in the Childhood Cancer Survivor Study
Authors: Fair Douglas , Park Elyse R. , Nipp Ryan D. , Rabin Julia , Hyland Kelly , Kuhlthau Karen , Perez Giselle K. , Nathan Paul C. , Armstrong Gregory T. , Oeffinger Kevin C. , Robison Leslie L. , Leisenring Wendy , Kirchhoff Anne C. 
Published: June 2021

BackgroundMedical financial burden includes material, behavioral, and psychological hardship and has been underinvestigated among adult survivors of childhood cancer.MethodsA survey from 698 survivors and 210 siblings from the Childhood Cancer Survivor Study was analyzed. The intensity of financial hardship was estimated across 3 domains: 1) material, including conditions that arise from medical expenses; 2) behavioral, including coping behaviors to manage medical expenses; and 3) psychological hardship resulting from worries about medical expenses and insurance, as measured by the number of instances of each type of financial hardship (0, 1‐2, and ≥3 instances). Multivariable logistic regressions were conducted to examine the clinical and sociodemographic predictors of experiencing financial hardship (0‐2 vs ≥3 instances).ResultsThe intensity of financial hardship did not significantly differ between survivors and siblings. Survivors reported more instances of material hardship than siblings (1‐2 instances: 27.2% of survivors vs 22.6% of siblings; ≥3 instances: 15.9% of survivors vs 11.4% siblings; overall P = .03). In multivariable regressions, insurance was protective against all domains of financial hardship (behavioral odds ratio [OR], 0.12; 95% confidence interval [CI], 0.06‐0.22; material OR, 0.37; 95% CI, 0.19‐0.71; psychological OR, 0.10; 95% CI, 0.05‐0.21). Survivors who were older at diagnosis, female, and with chronic health conditions generally had higher levels of hardship. Brain radiation and alkylating agents were associated with higher levels of hardship.ConclusionsMaterial, behavioral, and psychological financial burden among survivors of childhood cancer is common.
Receipt of guideline‐concordant care among young adult women with breast cancer
Authors: White Dolly P. , Kurian Allison W. , Stevens Jennifer L. , Liu Benmei , Brest Ariel E. , Petkov Valentina I. 
Published: June 2021

BackgroundLittle is known about the real‐world care of young adult (YA) females (aged 20‐39 years) with breast cancer. This study describes factors associated with the receipt of guideline‐concordant care (GCC) among YAs.MethodsThe authors identified 1259 YA women with invasive breast cancer diagnosed in 2013 in the National Cancer Institute's Patterns of Care study. Hospital records were re‐abstracted, and treatment was verified. Using the National Comprehensive Cancer Network's 2013 breast cancer guidelines, the authors assessed the receipt of GCC by cancer subtype among a subset of YAs (n = 952). Associations between sociodemographic and clinical factors and GCC receipt were examined.ResultsMost YAs were 35 to 39 years old (51.2%) and partnered (56.4%); half had hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2−) tumors. GCC was found for 81.7% of YAs. Relationships between sociodemographic and clinical factors and GCC receipt differed by subtype. Stage was the only significant predictor of GCC receipt for all subtypes (stage II vs III: odds ratio [OR] for HR+/HER2+, 0.20; 95% confidence interval [CI], 0.08‐0.50; OR for HR−/HER2+, 0.13; 95% CI, 0.07‐0.25; OR for HR−/HER2−, 3.86; 95% CI, 1.55‐9.62; OR for HR+/HER2−, 2.81; 95% CI, 1.63‐5.80).ConclusionsGCC is high among YAs with breast cancer. The effects of sociodemographic factors and treatment facility size on GCC differ by subtype. Consistent with recommendations, tumor biology, not age, is associated with GCC for all subtypes. Future studies should assess the effect of GCC on survival among YAs.
The PREPARE for Your Care program increases advance care planning engagement among diverse older adults with cancer
Authors: Nouri Sarah S. , Barnes Deborah E. , Shi Ying , Volow Aiesha M. , Shirsat Nikita , Kinderman Anne L. , Harris Heather A. , Sudore Rebecca L. 
Published: June 2021

BackgroundAdvance care planning (ACP) is low among older adults with cancer. In a secondary analysis of randomized trial data, the authors compared the efficacy of the PREPARE for Your Care (PREPARE) website plus an easy‐to‐read advance directive (AD) with an AD only among older adults with and without cancer.MethodsSafety net, primary care patients in San Francisco were included if they were 55 years old or older, were English‐ or Spanish‐speaking, and had 2 or more chronic conditions. The authors determined cancer diagnoses by using International Classification of Diseases, Ninth Revision/Tenth Revision codes. The primary outcome was new ACP documentation in the medical record at 15 months; the secondary outcomes were self‐reported ACP engagement, ease of use, satisfaction, and depression/anxiety. The authors used mixed effects logistic and linear regression adjusted for prior ACP, health literacy, and clinician, including a cancer interaction term.ResultsOf 986 participants, 220 (22%) had cancer. The mean age was 63 years (SD, 6 years), 61% were women, 81% were of a minority race/ethnicity, 45% were Spanish‐speaking, 39% had limited health literacy, and 27% had prior ACP. New ACP documentation was higher in the PREPARE arm versus the AD‐only arm among participants with cancer (62% vs 43%; P = .01) and without cancer (38% vs 28%; P = .01), as was ACP engagement in both arms (P < .001), with no interactions by cancer. Ease of use and satisfaction were high, and depression/anxiety was low, with no differences by study arm or by cancer/no cancer.ConclusionsPREPARE plus an easy‐to‐read AD increased ACP documentation and engagement among diverse older adults with cancer more than an AD alone, with no increase in depression or anxiety between study arms or by cancer. PREPARE may help to decrease ACP disparities among patients with cancer.Lay Summary

Advance care planning (ACP) is the process of sharing values, goals, and preferences for medical care, but engagement in ACP is low among older adults with cancer.

Among 986 English‐ and Spanish‐speaking older adults from a safety net hospital, an interactive, multimedia, web‐based ACP program (PREPARE for Your Care at https://prepareforyourcare.org/) plus an easy‐to‐read advance directive increased ACP documentation and engagement more than an advance directive alone.

There were no differences in this increase in ACP between older adults with cancer and older adults without cancer. Also, engaging in ACP did not result in increased depression or anxiety.
Multiscale generative adversarial network for real‐world super‐resolution
Authors: Sun Ying , Yang Zhiwen , Tao Bo , Jiang Guozhang , Hao Zhiqiang , Chen Baojia 
Published: June 2021

SummaryRecently, most deep convolutional neural networks used for image super‐resolution have achieved impressive performance on ideal datasets. However, these methods always fail in real‐world super‐resolution, and the results are blurred and structurally deformed. In this paper, a multiscale generative adversarial network (MGAN) is proposed to alleviate these issues. The model's multiscale loss function can effectively reduce the solution space and obtain the best features to reconstruct the image. The degraded framework based on kernel estimation and noise injection is mainly applied to obtain LR images that share the same domain with real‐world pictures. Moreover, the gradient branch is presented to provide other structural priors for SR processing. Simultaneously, to obtain better visual effects, LPIPS is used for perceptual losses instead of Visual Geometry Group (VGG). The competitive results show that our MGAN model outperforms the state‐of‐the‐art methods, resulting in lower noise and better visual quality, and reflects the superiority in image structure restoration.
A quinazoline‐based bromodomain inhibitor, CN210, ameliorates indomethacin‐induced ileitis in mice by inhibiting inflammatory cytokine expression
Authors: Noguchi Takehisa , Hidaka Kyosuke , Kobayashi Satsuki , Matsumoto Kenjiro , Yoshioka Makoto , Hu Xin , Maloney David J. , Yang Shyh‐Ming , Kato Shinichi 
Published: June 2021

AbstractInhibitors of bromodomain and extra‐terminal motif (BET) proteins are emerging epigenetic therapeutics that suppress gene expressions that drive cancer and inflammation. The present study examined anti‐inflammatory effects of a quinazoline‐based BET inhibitor, CN210, in a murine ileitis model. CN210 was given orally 30 min before and 24 h after a subcutaneous administration of indomethacin. Macroscopic and histological evidences of ileitis, mucosal myeloperoxidase (MPO) activity and cytokine expressions were evaluated 48 h after the indomethacin administration. To further characterize the anti‐inflammatory pathways modulated by CN210, its effects on RAW264 cells treated with lipopolysaccharide (LPS) were investigated. Competitive ligand binding and docking studies of CN210 to CREB‐binding protein (CBP) and p300 were also performed. Oral administration of CN210 significantly reduced the severity of ileitis, normalized both proinflammatory MPO activity and concomitant cytokine expressions induced by indomethacin administration. Furthermore, CN210 attenuated the expression of cytokines and reversed the activation of nuclear factor κB (NF‐κB) and mitogen‐activated protein kinases (MAPK) induced by LPS. Competitive ligand binding assays showed that CN210 bound to the bromodomains of two paralogous histone acetyltransferases, CBP and p300, in addition to the bromodomains of BET proteins. Docking studies of CN210 to the bromodomains of CBP and p300 showed a similarity to the binding mode of SGC‐CBP30, a specific CBP/p300 inhibitor. CN210 ameliorates indomethacin‐induced ileitis by inhibiting the expression of inflammatory cytokines through the attenuation of NF‐κB and MAPK pathways. CN210 thus represents a new mode of therapy for non‐steroidal anti‐inflammatory drug‐induced ileitis and inflammatory bowel disease.
Mindfulness‐based interventions for eating disorders: The potential to mobilize multiple associative‐learning change mechanisms
Authors: Roos Corey R. , Sala Margaret , Kober Hedy , Vanzhula Irina A. , Levinson Cheri A. 
Published: June 2021

AbstractMindfulness is a two‐component skill that includes mindful awareness (attentional monitoring of present moment experience) and mindful acceptance (adopting an attitude of acceptance toward this experience). Although mindfulness‐based interventions (MBIs) are efficacious for many conditions, there is a lack of research on MBIs for eating disorders (EDs). We propose that MBIs may be promising for EDs given their potential to mobilize not one, but multiple associative‐learning change mechanisms in EDs–defined as adaptive processes of change involving one of two forms of associative‐learning: Pavlovian and operant learning. We hypothesize how MBIs–via increasing either mindful awareness or mindful acceptance–may mobilize up to eight associative‐learning change mechanisms, two involving Pavlovian learning, and six involving operant learning. We also elaborate on similarities and differences between MBIs and CBT approaches for EDs, as well as opportunities for synergy. Finally, we present recommendations for future research related to the development and evaluation of novel MBI interventions for EDs and the testing of mechanisms and patient‐treatment matching hypotheses.
Changes in treatment needs for chronic postoperative hypoparathyroidism during initiation of conventional treatment compared to stable phase of treatment
Authors: Storm Pernille , Underbjerg Line , Rejnmark Lars 
Published: June 2021

AbstractIntroductionIn our clinical experience, need for doses of active vitamin D and calcium supplements changes during the period following a diagnosis of postsurgical hypoparathyroidism (HypoPT), but only sparse data are available. In the present study, we aimed to investigate the magnitude of changes in need for activated vitamin D (alfacalcidol) and calcium supplements during initiation of therapy as well as time to be expected until a stable phase was achieved. Furthermore, we determined the frequency of (unexpected) episodes of hypo‐ and hypercalcaemia after reaching a steady state for alfacalcidol and calcium.MethodsRetrospective study of twenty‐four patients with chronic postsurgical HypoPT (>6 months) diagnosed from 2016 to 2018. Data were extracted from medical records on doses of alfacalcidol and calcium as well as ionized plasma calcium levels (P‐Ca2+) from time of diagnosis and until 86 weeks after surgery.ResultsPatients were treated with alfacalcidol and calcium in order to maintain a stable concentration of P‐Ca2+. Our data demonstrated a great variation in treatment needs until 11 weeks after surgery, where the mean doses of alfacalcidol stabilize, while calcium doses stabilized a bit earlier. After the stable phase had emerged, 21 out of 24 patients continued to have one or more episodes of spontaneous hypo‐ or hypercalcaemia.ConclusionsPatients with chronic HypoPT attain a steady state for alfacalcidol 11 weeks after the diagnosis. Continuous monitoring of P‐Ca2+ is of continued importance after reaching steady state due to a high frequency of spontaneous hypo‐ or hypercalcaemia.
Temperature, soil moisture, and microbial controls on CO2 and CH4 emissions from a permafrost peatland
Authors: Song Yanyu , Song Changchun , Hou Aixin , Sun Li , Wang Xianwei , Ma Xiuyan , Jiang Lei , Liu Chao , Gao Jinli 
Published: June 2021

AbstractPeatlands are significant carbon dioxide (CO2) sinks and methane (CH4) sources. In this study, we investigated changes in CO2 and CH4 emissions from topsoil (0–20 cm) to subsoil (20–40 cm) in a permafrost peatland, and the related soil microbial abundance in response to increasing temperature and soil water content by using an incubation experiment. Our results indicated that CO2 and CH4 emissions from the permafrost peatland are highly sensitive to temperature and soil water content. CO2 emissions from topsoil and subsoil at 15°C were 3.36 and 2.74 times larger, respectively, compared to those at 5°C under the field moisture condition, and were 1.70 times larger under the waterlogged treatment in both topsoil and subsoil. CH4 emissions from 0–20 to 20–40 cm soils at 15°C were 34 and 83 times larger, respectively, than those at 5°C under the original state and 17 and 32 times larger under the waterlogged treatment. These results indicated that CH4 emissions are more sensitive than CO2 emissions, and waterlogged conditions could decrease temperature sensitivity of CO2 and CH4 emissions. Microbial analyses showed that the cumulative emissions amount of CO2 positively correlated with bacterial, fungal, and methanotroph abundances. Positive relationships were observed between CH4 emissions and abundances of bacteria, fungi, and archaea. These findings suggested that changes in temperature and water content alter CO2 and CH4 emissions from permafrost peatlands through controlling abundances of soil bacteria, fungi, archaea, and methanotrophs. These variables bear importance in accurately estimating C emissions from permafrost peatlands.
Experimental testing of hybrid sliding‐rocking bridge columns under torsional and biaxial lateral loading
Authors: Salehi Mohammad , Sideris Petros , Liel Abbie B. 
Published: June 2021

AbstractHybrid sliding‐rocking (HSR) bridge columns are precast concrete segmental columns with unbonded posttensioning, end rocking joints, and intermediate sliding joints. Having been developed for construction in seismic regions, HSR columns offer self‐centering, energy dissipation, and low damageability. Recent advances in the computational modeling of HSR columns have resulted in the proposal of a number of refinements to their original design, leading to the introduction of Second‐Generation HSR columns. Compared to First‐Generation HSR columns, Second‐Generation HSR columns use a reduced number of sliding joints made of high‐performance polytetrafluoroethylene (PTFE) materials to provide desirable levels of sliding and frictional energy dissipation. The seismic performance of Second‐Generation HSR columns was recently investigated through an extensive experimental study. The present paper discusses the major results of the tests performed on two half‐scale HSR column specimens under combined lateral‐torsional loading and biaxial lateral loading to demonstrate their performance under such loading scenarios. A variety of loading protocols were used to test each column specimen, including both cyclic and arbitrary paths. Both columns sustained minimal damage under displacement demands representing 975‐ and 2475‐year seismic hazards, meeting their design objectives. Because of the torsional sliding at sliding joints, the column subjected to lateral‐torsional loading did not exhibit any distinct torsional damage. The biaxial lateral loading was, however, found more damaging to HSR columns than torsional and uniaxial lateral loading.