bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advanced Care Planning in Parkinson's Disease: In-depth Interviews With Patients on Experiences and Needs
Authors: Kurpershoek Elisabeth , Hillen Marij A. , Medendorp Niki M. , de Bie Rob M. A. , de Visser Marianne , Dijk Joke M. 
Published: July 2021

Introduction:Advance care planning (ACP) is an iterative process of discussing the needs, wishes, and preferences of patients regarding disease-specific and end-of-life issues. There is ample evidence that ACP improves the quality of life and promotes the autonomy of patients with cancer and motor neuron disease who have a high disease burden and shortened life expectancy. In Parkinson's disease (PD) though, knowledge about the experiences and preferences of patients regarding ACP is scarce, despite the major disease burden associated with PD.Aim:This study aims to explore the experiences, needs, and preferences of PD patients regarding the content and timing of ACP.Methods:In-depth interviews were conducted with a purposively selected sample of patients diagnosed with PD. Using a semi-structured topic list, the participants were asked about their prospects for a future living with PD and with whom they wanted to discuss this. Qualitative analysis was performed in parallel with data collection using a data-driven constant comparative approach. The transcribed interviews were coded and analyzed by two researchers using MAXQDA software.Results:Of all 20 patients (13 males; age 47–82; disease duration 1–27 years), most expressed a wish to talk about ACP with a healthcare provider, enabling them to anticipate the uncertain future. The majority of patients preferred their healthcare provider to initiate the discussion on ACP, preferably at an early stage of the disease. Nearly all patients expressed the wish to receive more information regarding the long-term impact of PD, although, the preferred timing varied between patients. They also perceived that their neurologist was primarily focused on medication and had little time to address their need for a more holistic approach toward living with PD.Conclusion:Our results suggest that PD patients are in need of discussing ACP with their healthcare provider (HCP), even in the early stages of the disease. In addition, PD patients perceive a lack of information on their disease course and miss guidance on available supportive care. We recommend HCPs to inquire the information requirements and preferences of patients regarding ACP regularly, starting soon after diagnosis.
Clinical Outcome of Pulsed-Radiofrequency Combined With Transforaminal Epidural Steroid Injection for Lumbosacral Radicular Pain Caused by Distinct Etiology
Authors: Yang Liuqing , Huang Yuzhao , Ma Jiahui , Li Zhenxing , Han Rui , Guo Gangwen , Ni Yuncheng , Hu Rong , Yan Xuebin , Zhou Haocheng , Huang Dong 
Published: July 2021

BackgroundLumbosacral radicular pain (LSRP) can be caused by disc herniation, spinal stenosis, and failed back surgery syndrome. The clinical effect of pulsed-radiofrequency (PRF) combined with transforaminal epidural steroid injection (TESI) for radiating pain in different population remains unclear.MethodsWe retrospectively reviewed the medical recordings of patients with LSRP caused by different etiologies, who underwent PRF and TESI treatment. The primary clinical outcome was assessed by a 10-point Visual Analog Scale (VAS) pre- and post-treatment.ResultsA total of 34 LSRP patients were identified and classified into 3 subgroups (disc herniation, spinal stenosis, and failed back surgery syndrome). The overall immediate pain reduction was 4.4 ± 1.1 after procedure. After a median follow-up of 9.5 months, the VAS decreased from 6.5 ± 1.0 to 2.4 ± 1.9 at the last follow-up.ConclusionPRF combined with TESI is an effective approach to treat persistent LSRP in distinct population.
Prognostic Factors of Survival of Advanced Liver Cancer Patients Treated With Palliative Radiotherapy: A Retrospective Study
Authors: Hua Qingling , Zhang Dejun , Li Yunqiao , Hu Yue , Liu Pian , Xiao Guangqin , Zhang Tao , Xue Jun 
Published: July 2021

AimsSurvival benefit of liver cancer patients who undergo palliative radiotherapy varies from person to person. The present study aims to identify indicators of survival of advanced liver cancer patients receiving palliative radiotherapy.Patients and MethodsOne hundred and fifty-nine patients treated with palliative radiotherapy for advanced liver cancer were retrospectively assessed. Of the 159 patients, 103 patients were included for prediction model construction in training phase, while other 56 patients were analyzed for external validation in validation phase. In model training phase, clinical characteristics of included patients were evaluated by Kaplan-Meier curves and log-rank test. Thereafter, multivariable Cox analysis was taken to further identify characteristics with potential for prediction. In validation phase, a separate dataset including 56 patients was used for external validation. Harrell’s C-index and calibration curve were used for model evaluation. Nomograms were plotted based on the model of multivariable Cox analysis.ResultsThirty-one characteristics of patients were investigated in model training phase. Based on the results of Kaplan-Meier plots and log-rank tests, 6 factors were considered statistically significant. On multivariable Cox regression analysis, bone metastasis (HR = 1.781, P = 0.026), portal vein tumor thrombus (HR = 2.078, P = 0.015), alpha-fetoprotein (HR = 2.098, P = 0.007), and radiation dose (HR = 0.535, P = 0.023) show significant potential to predict the survival of advanced liver cancer patients treated with palliative radiotherapy. Moreover, nomograms predicting median overall survival, 1- and 2-year survival probability were plotted. The Harrell’s C-index of the predictive model is 0.709(95%CI, 0.649-0.769) and 0.735 (95%CI, 0.666-0.804) for training model and validation model respectively. Calibration curves of the 1- and 2-year overall survival of the predictive model indicate that the predicted probabilities of OS are very close to the actual observed outcomes both in training and validation phase.ConclusionBone metastasis, portal vein tumor thrombus, alpha-fetoprotein and radiation dose are independent prognostic factors for the survival of advanced liver cancer patients treated with palliative radiotherapy.
Clinicopathological Analysis of the ISUP Grade Group And Other Parameters in Prostate Cancer: Elucidation of Mutual Impact of the Various Parameters
Authors: Okubo Yoichiro , Sato Shinya , Osaka Kimito , Yamamoto Yayoi , Suzuki Takahisa , Ida Arika , Yoshioka Emi , Suzuki Masaki , Washimi Kota , Yokose Tomoyuki , Kishida Takeshi , Miyagi Yohei 
Published: July 2021

BackgroundProstate cancer has become increasingly common worldwide. Although Grade group (GG) is widely accepted as an indicator of prostate cancer grade, there are malignancies that cannot be defined by GG alone. Moreover, the relationship between GG and other parameters remains unclear. Herein, we aimed to explore the biological characteristics of prostate cancer.MethodsThis study included 299 radical prostatectomy cases. The Chi-square test and analysis of variance were used to analyze the association of GG with binary and continuous variables. We then conducted morphological analyses. Multivariate analyses were performed to extract the data on risk factors for biochemical recurrence (BCR) and lymph node metastasis.ResultsThe lymphatic, venous, perineural, and seminal vesicle invasion rates were 37/299 (12.4%), 25/299 (8.4%), 280/299 (93.6%), and 23/299 (7.7%), respectively. The extraprostatic extension (EPE), positive surgical margin, tertiary Gleason pattern 5, intraductal carcinoma of the prostate gland, and lymph node metastasis rates were 89/299 (29.8%), 106/299 (35.5%), 33/260 (12.7%), 56/299 (18.7%), and 23/299 (7.7%), respectively. As GG increased, various parameters became easier to visualize; however, there were differences between the parameters. Postoperative BCR was observed in 31/242 (12.8%) cases without preoperative hormone therapy; GG2, GG3, GG4, and GG5 accounted for 4, 7, 7, and 13 cases, respectively. Multivariate analyses revealed that GG and tumor diameter were significant risk factors for early BCR, whereas lymphatic invasion, EPE, and seminal vesicle invasion were significant risk factors for lymph node metastasis. For BCR, the odds ratios (ORs) for GG and tumor diameter were 2.253 (95% confidence interval (CI]): 1.297–3.912; P=0.004) and 1.074 (95% CI: 1.011–1.142; P=0.022), respectively. For lymph node metastasis, ORs for the presence of lymphatic invasion, EPE, and seminal vesicle invasion were 7.425 (95% CI: 1.688–22.583; P=0.004), 4.391 (95% CI: 1.037–18.589; P=0.044), and 5.755 (95% CI: 1.308–25.316; P=0.021), respectively.ConclusionsWe summarized various parameters correlating with each GG. Through multivariate analyses, we established the independent risk factors for early BCR and lymph node metastasis. In addition to GG, other important indices of malignancy were determined and weighted to provide a basis for future investigations.
Complications of Radiofrequency Ablation for Hepatic Hemangioma: A Multicenter Retrospective Analysis on 291 Cases
Authors: Wu Shilun , Gao Ruize , Yin Tao , Zhu Ruhang , Guo Shigang , Xin Zonghai , Li Aolei , Kong Xinliang , Gao Jun , Sun Wenbing 
Published: July 2021

PurposeTo report the complications of radiofrequency ablation (RFA) for hepatic hemangioma.Patients and MethodsInvestigators from six centers performed RFA for hepatic hemangioma and used a standardized follow-up protocol. Data were collected from 291 patients, including 253 patients with hepatic hemangioma 5 to 9.9 cm in diameter (group A) and 38 with hepatic hemangioma ≥ 10 cm (group B). Technical success, complete ablation, and complications attributed to the RFA procedure were reported. Analysis of variance was used to determine whether the major complication rate was related to tumor size or clinical experience.ResultsA total of 304 lesions were treated in 291 patients. Technical success was achieved without adverse events in all cases. A total of 301 lesions were completely ablated, including 265 of 265 (100%) lesions in group A, and 36 of 39 (92.31%) in group B. The rate of technology-related complications was similar in groups A and B (5.14% (13/253) and 13.16% (5/38), respectively; P = 0.121). Moreover, all technology-related complications occurred during the early learning curve period. The rate of hemolysis-related complications in two groups were 83.40% (211/253) and 100% (38/38) (P =0.007) and the systemic inflammatory response syndrome-related complications in two groups were 33.99% (86/253) and 86.84% (33/38) (P&lt;0.001). There were no delayed complications in either group.ConclusionRFA is minimally invasive, safe, and effective for hepatic hemangiomas 5 to 9.9 cm in diameter. More clinical data are needed to confirm the safety of RFA for hepatic hemangiomas ≥ 10 cm.
Investigation of the Therapeutic Effect of Doxorubicin Combined With Focused Shockwave on Glioblastoma
Authors: Liao Wei-Hao , Hsiao Ming-Yen , Kung Yi , Huang Abel Po-Hao , Chen Wen-Shiang 
Published: July 2021

BackgroundGlioblastoma multiforme (GBM) is currently the most devastating brain tumor globally and produces a high mortality rate. GBM is also challenging to eradicate using surgery due to its invasive characteristics. Moreover, the blood-brain barrier (BBB) increases the difficulty of transporting most therapeutic drugs to tumor sites. The use of transcranial focused ultrasound (FUS) has recently been investigated for opening the BBB to facilitate drug delivery. A special form of FUS, the shockwave (SW), has also been shown to open BBB efficiently. SW has several advantages including no heating effect, less reactive oxygen species production, good transcranial ability, and no need to supply microbubbles.MethodsWe employed a commercial SW device, which is a common tool used for musculoskeletal disorders, to improve doxorubicin delivery across the BBB and evaluated its therapeutic efficacy on GBM rat models. SW emits relatively short but stronger mechanical pulses comparing with FUS.ResultsThe results demonstrated that doxorubicin combined with SW treatment substantially inhibited tumor growth and prolonged overall survival.ConclusionsThe present study shows the non-invasive transcranial SW may have potential for the treatment of GBM in future clinical setting.
8-Gingerol Ameliorates Myocardial Fibrosis by Attenuating Reactive Oxygen Species, Apoptosis, and Autophagy via the PI3K/Akt/mTOR Signaling Pathway
Authors: Xue Yucong , Zhang Muqing , Liu Miaomiao , Liu Yu , Li Li , Han Xue , Sun Zhenqing , Chu Li 
Published: July 2021

8-gingerol (8-Gin) is the series of phenolic substance that is extracted from ginger. Although many studies have revealed that 8-Gin has multiple pharmacological properties, the possible underlying mechanisms of 8-Gin against myocardial fibrosis (MF) remains unclear. The study examined the exact role and potential mechanisms of 8-Gin against isoproterenol (ISO)-induced MF. Male mice were intraperitoneally injected with 8-Gin (10 and 20 mg/kg/d) and concurrently subcutaneously injected with ISO (10 mg/kg/d) for 2 weeks. Electrocardiography, pathological heart morphology, myocardial enzymes, reactive oxygen species (ROS) generation, degree of apoptosis, and autophagy pathway-related proteins were measured. Our study observed 8-Gin significantly reduced J-point elevation and heart rate. Besides, 8-Gin caused a marked decrease in cardiac weight index and left ventricle weight index, serum levels of creatine kinase and lactate dehydrogenase (CK and LDH, respectively), ROS generation, and attenuated ISO-induced pathological heart damage. Moreover, treatment with 8-Gin resulted in a marked decrease in the levels of collagen types I and III and TGF-β in the heart tissue. Our results showed 8-Gin exposure significantly suppressed ISO-induced autophagosome formation. 8-Gin also could lead to down-regulation of the activities of matrix metalloproteinases-9 (MMP-9), Caspase-9, and Bax protein, up-regulation of the activity of Bcl-2 protein, and alleviation of cardiomyocyte apoptosis. Furthermore, 8-Gin produced an obvious increase in the expressions of the PI3K/Akt/mTOR signaling pathway-related proteins. Our data showed that 8-Gin exerted cardioprotective effects on ISO-induced MF, which possibly occurred in connection with inhibition of ROS generation, apoptosis, and autophagy via modulation of the PI3K/Akt/mTOR signaling pathway.
B0-Shimming Methodology for Affordable and Compact Low-Field Magnetic Resonance Imaging Magnets
Authors: Wenzel Konstantin , Alhamwey Hazem , O’Reilly Tom , Riemann Layla Tabea , Silemek Berk , Winter Lukas 
Published: July 2021

Low-field (B0&lt; 0.2 T) magnetic resonance imaging (MRI) is emerging as a low cost, point-of-care alternative to provide access to diagnostic imaging technology even in resource scarce environments. MRI magnets can be constructed based on permanent neodymium-iron-boron (NdFeB) magnets in discretized arrangements, leading to substantially lower mass and costs. A challenge with these designs is, however, a goodB0field homogeneity, which is needed to produce high quality images free of distortions. In this work, we describe an iterative approach to build a low-field MR magnet based on aB0-shimming methodology using genetic algorithms. The methodology is tested by constructing a small bore (inner bore diameter = 130 mm) desktop MR magnet (&lt;15 kg) at a field strength ofB0= 0.1 T and a target volume of 4 cm in diameter. The configuration consists of a base magnet and shim inserts, which can be placed iteratively without modifying the base magnet assembly and without changing the inner dimensions of the bore or the outer dimensions of the MR magnet. Applying the shims,B0field inhomogeneity could be reduced by a factor 8 from 5,448 to 682 ppm in the target central slice of the magnet. Further improvements of these results can be achieved in a second or third iteration, using more sensitive magnetic field probes (e.g., nuclear magnetic resonance based magnetic field measurements). The presented methodology is scalable to bigger magnet designs. The MR magnet can be reproduced with off-the-shelf components and a 3D printer and no special tools are needed for construction. All design files and code to reproduce the results will be made available as open source hardware.
Immune-Related Endocrine Dysfunctions in Combined Modalities of Treatment: Real-World Data
Authors: Chan Wing-Lok , Choi Horace Cheuk-Wai , Ho Patty Pui-Ying , Lau Johnny Kin-San , Tse Rosa Pui-Ying , Au Joyce , Lam Vivian , Liu Ronald , Ho Isaac , Wong Charlotte , Cheung Ben , Lam Eric , Chow Daryn , Lam Ka-On , Yuen Kwok-Keung , Kwong Dora Lai-Wan 
Published: July 2021

The number of immune-related endocrine dysfunctions (irEDs) has concurrently increased with the widespread use of immunotherapy in clinical practice and further expansion of the approved indications for immune checkpoint inhibitor (ICI) in cancer management. A retrospective analysis was conducted on consecutive patients ≥18 years of age with advanced solid malignancies who had received at least one dose of anti-programmed cell death protein 1 (anti-PD-1) and/or anti-CTLA4 antibodies between January 2014 and December 2019 at a university hospital in Hong Kong. Patients were reviewed up to two months after the last administration of an ICI. The types, onset times and grades of irEDs, including hypothyroidism, hyperthyroidism, adrenal insufficiency and immune-related diabetes mellitus, were recorded. Factors associated with irEDs were identified using multivariate analysis. A total of 953 patients (male: 603, 64.0%; median age: 62.0 years) were included. Of these, 580 patients (60.9%) used ICI-alone, 132 (13.9%) used dual-ICI, 187 (19.6%) used an ICI combined with chemotherapy (chemo + ICI), and 54 (5.70%) used immunotherapy with a targeted agent (targeted + ICI). A significantly higher proportion of patients using targeted + ICI had irEDs and hypothyroidism; in contrast, a higher proportion of patients using dual-ICI had adrenal insufficiency. There was no significant difference in the incidence of irED between the younger (<65 years) and older (≥65 years) patients. Using logistic regression, only treatment type was significantly associated with irEDs. Notably, older patients had a higher risk of having immune-related diabetes mellitus. This large, real-world cohort demonstrates that targeted + ICI has a higher risk of overall irED and hypothyroidism. Immunotherapy is safe and well-tolerated regardless of age, but close monitoring of fasting glucose is essential in older populations.
Cultivation of Autochthonous Microalgae for Biomass Feedstock: Growth Curves and Biomass Characterization for Their Use in Biorefinery Products
Authors: González Juan Félix , Cuello Teresa Belén , Calderón Antonio José , Calderón Manuel , González Jerónimo , Carmona Diego 
Published: July 2021

In this work, the biomass productivity for biorefinery products and growth curves of three autochthonous microalgae collected in different reservoirs (“Scenedesmus sp.” (SSP), mixture of Scenedesmus sp., Chlorella minutissima, Chlorellas sp. and Nannochloropsis sp. named “La Orden” (LO) consortium and Chlorella minutissima named “Charca Brovales” (CB) consortium) were studied in a 5.5 L column laboratory photobioreactor. Two different culture media, Arnon culture (AM) and an agriculture fertilizer-based liquid medium (FM), have been used to evaluate the growth effect of the microalgae; it was found that the medium has a clear effect on the biomass productivity and growth rate, which ranged between 0.26–0.498 g L−1 d−1 and 0.288–0.864 d−1, respectively. In general, the elemental analysis and higher heating value of microalgae biomass for the three species were independent of the culture medium used for its growth, while their lipids and sugars content depended upon the species type and culture medium used in the cultivation. “La Orden” microalga was selected (given its best adaption to the climatic conditions) to study the biomass productivity and growth rate in two exterior photobioreactors (100 L column and 400 L flat panel), using FM as a medium, obtaining values of 0.116–0.266 g L−1 d−1 and 0.360–0.312 d−1, respectively. An automation and control system was designed to operate the exterior photobioreactors pilot plant. The lipid content of this microalga in these photobioreactors was lower than in the laboratory one, with a fatty acids profile with predominantly palmitic, oleic, linoleic and linolenic acids. Also, the fresh biomass collected from these photobioreactors was studied in a batch type digestion process for biogas production, obtaining a CH4 yield of 296 ± 23 L CH4 kgVSS−1 added with a reduction in percentage of COD and vs. of 50 ± 1% and 50 ± 1.7%, respectively.
Categories and Frequency: Cognition Verbs in Spanish Subject Expression
Authors: Travis Catherine E. , Torres Cacoullos Rena 
Published: July 2021

Are semantic classes of verbs genuine or do they merely mask idiosyncrasies of frequent verbs? Here, we examine the interplay between semantic classes and frequent verb-form combinations, providing new evidence from variation patterns in spontaneous speech that linguistic categories are centered on high frequency members to which other members are similar. We offer an account of the well-known favoring effect of cognition verbs on Spanish subject pronoun expression by considering the role of high-frequency verbs (e.g., creer ‘think’ and saber ‘know’) and particular expressions ((yo) creo ‘I think’, (yo) no sé ‘I don’t know’). Analysis of variation in nearly 3000 tokens of unexpressed and pronominal subjects in conversational data replicates well-established predictors, but highlights that the cognition verb effect is really one of 1sg cognition verbs. In addition, particular expressions stand out for their high frequency relative to their component parts (for (yo) creo, proportion of lexical type, and proportion of pronoun). Further analysis of 1sg verbs with frequent expressions as fixed effects reveals shared patterns with other cognition verbs, including an association with non-coreferential contexts. Thus, classes can be identified by variation constraints and contextual distributions that are shared among class members and are measurably different from those of the more general variable structure. Cognition verbs in variable Spanish subject expression form a class anchored in lexically particular constructions.