bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hydrogen/oxygen therapy for the treatment of an acute exacerbation of chronic obstructive pulmonary disease: results of a multicenter, randomized, double-blind, parallel-group controlled trial
Authors: Zheng Ze-Guang , Sun Wu-Zhuang , Hu Jie-Ying , Jie Zhi-Jun , Xu Jin-Fu , Cao Jie , Song Yuan-Lin , Wang Chang-Hui , Wang Jing , Zhao Hui , Guo Zhong-Liang , Zhong Nan-Shan 
Published: May 2021

Abstract
Background
To investigate whether the administration of hydrogen/oxygen mixture was superior to oxygen in improving symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods
This prospective, randomized, double-blind, controlled clinical trial in 10 centres enrolled patient with AECOPD and a Breathlessness, Cough, and Sputum Scale (BCSS) score of at least 6 points. Eligible patients were randomly assigned (in a 1:1 ratio) to receive either hydrogen/oxygen mixture or oxygen therapy. Primary endpoint was the change from baseline in BCSS score at day 7. Adverse events (AEs) were recorded to evaluate safety.

Results
Change of BCSS score in Hydrogen/oxygen group was larger than that in Oxygen group (− 5.3 vs. − 2.4 point; difference: − 2.75 [95% CI − 3.27 to − 2.22], meeting criteria for superiority). Similar results were observed in other time points from day 2 through day 6. There was a significant reduction of Cough Assessment Test score in Hydrogen/oxygen group compared to control (− 11.00 vs. − 6.00, p < 0.001). Changes in pulmonary function, arterial blood gas and noninvasive oxygen saturation did not differ significantly between groups as well as other endpoints. AEs were reported in 34 (63.0%) patients in Hydrogen/oxygen group and 42 (77.8%) in Oxygen group. No death and equipment defects were reported during study period.

Conclusions
The trial demonstrated that hydrogen/oxygen therapy is superior to oxygen therapy in patient with AECOPD with acceptable safety and tolerability profile. Trial registration: Name of the registry: U.S National Library of Medicine Clinical Trials; Trial registration number: NCT04000451; Date of registration: June 27, 2019-Retrospectively registered; URL of trial registry record: https://www.clinicaltrials.gov/ct2/show/study/NCT04000451?term=04000451&draw=2&rank=1.
The association of insulinemic potential of diet and lifestyle with the risk of insulin-related disorders: a prospective cohort study among participants of Tehran Lipid and Glucose Study
Authors: Mokhtari Ebrahim , Farhadnejad Hossein , Teymoori Farshad , Mirmiran Parvin , Azizi Fereidoun 
Published: May 2021

Abstract
Background
We aim to assess the association of empirical dietary (EDIH) and lifestyle (ELIH) index for hyperinsulinemia with the risk of insulin resistance, hyperinsulinemia, insulin sensitivity, and β-cell dysfunction in Iranian adults.

Methods
In this prospective study, a total of 1244 men and women aged ≥ 20 years were selected among participants of the Tehran lipid and glucose study and followed for 3.2 years. Dietary intakes were assessed using a valid semi-quantitative food frequency questionnaire. Dietary and lifestyle insulinemic potential indices were calculated using dietary intake, body mass index, and physical activity information. Multivariable logistic regression was used to estimate the associated risk of a 3-year incidence of insulin-related disorders.

Results
The mean ± SD age and BMI of all eligible participants (42.7% males) were 43.0 ± 13.0 and 27.4 ± 4.9 in the study's baseline. After adjusting for all potential confounders, participants in the highest tertile of ELIH score had a greater risk of developing hyperinsulinemia (OR:2.42, 95%CI:1.52–3.86, P for trend =  < 0.001), insulin resistance (OR:2.71, 95%CI:1.75–4.18, P for trend =  < 0.001) and insulin insensitivity (OR:2.65, 95%CI: 1.72–4.10, P for trend =  < 0.001) compared with those in the lowest tertile. However, the risk of incident β-cell dysfunction was lower in individuals with a higher score of ELIH in comparison to those with the lowest score (OR:0.30, 95%CI:0.19–0.45, P for trend =  < 0.001).

Conclusions
Empirical lifestyle index for hyperinsulinemia was directly associated with insulin resistance, insulin insensitivity, and hyperinsulinemia and was inversely associated with β-cells dysfunction.
Low-grade serous epithelial ovarian cancer: a comprehensive review and update for radiologists
Authors: Amante Sofia , Santos Filipa , Cunha Teresa Margarida 
Published: May 2021

AbstractLow-grade serous carcinoma (LGSC) is an infrequent subtype of ovarian cancer, corresponding to 5% of epithelial neoplasms. This subtype of ovarian carcinoma characteristically has molecular features, pathogenesis, clinical behaviour, sensitivity to chemotherapy, and prognosis distinct to high-grade serous carcinoma (HGSC). Knowing the difference between LGSC and other ovarian serous tumours is vital to guide clinical management, which currently is only possible histologically. However, imaging can provide several clues that allow differentiating LGSC from other tumours and enable precise staging and follow-up of ovarian cancer treatment. Characteristically, LGSC appears as mixed lesions with variable papillary projections and solid components, usually in different proportions from those detected in serous borderline tumour and HGSC. Calcified extracellular bodies, known as psammoma bodies, are also a common feature of LGSC, frequently detectable within lymphadenopathies and metastases associated with this type of tumour. In addition, the characterisation of magnetic resonance imaging enhancement also plays an essential role in calculating the probability of malignancy of these lesions. As such, in this review, we discuss and update the distinct radiological modalities features and the clinicopathologic characteristics of LGSC to allow radiologists to be familiarised with them and to narrow the differential diagnosis when facing this type of tumour.
Post-reconstruction enhancement of [18F]FDG PET images with a convolutional neural network
Authors: Ly John , Minarik David , Jögi Jonas , Wollmer Per , Trägårdh Elin 
Published: May 2021

Abstract
Background
The aim of the study was to develop and test an artificial intelligence (AI)-based method to improve the quality of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) images.

Methods
A convolutional neural network (CNN) was trained by using pairs of excellent (acquisition time of 6 min/bed position) and standard (acquisition time of 1.5 min/bed position) or sub-standard (acquisition time of 1 min/bed position) images from 72 patients. A test group of 25 patients was used to validate the CNN qualitatively and quantitatively with 5 different image sets per patient: 4 min/bed position, 1.5 min/bed position with and without CNN, and 1 min/bed position with and without CNN.

Results
Difference in hotspot maximum or peak standardized uptake value between the standard 1.5 min and 1.5 min CNN images fell short of significance. Coefficient of variation, the noise level, was lower in the CNN-enhanced images compared with standard 1 min and 1.5 min images. Physicians ranked the 1.5 min CNN and the 4 min images highest regarding image quality (noise and contrast) and the standard 1 min images lowest.

Conclusions
AI can enhance [18F]FDG-PET images to reduce noise and increase contrast compared with standard images whilst keeping SUVmax/peak stability. There were significant differences in scoring between the 1.5 min and 1.5 min CNN image sets in all comparisons, the latter had higher scores in noise and contrast. Furthermore, difference in SUVmax and SUVpeak fell short of significance for that pair. The improved image quality can potentially be used either to provide better images to the nuclear medicine physicians or to reduce acquisition time/administered activity.
Energy Absorption Characteristics of PVC Coarse Aggregate Concrete under Impact Load
Authors: Hu Shi , Tang Huaming , Han Shenyao 
Published: May 2021

AbstractIn this paper, polyvinyl chloride (PVC) coarse aggregate with different mixing contents is used to solve the problems of plastic pollution, low energy absorption capacity and poor damage integrity, which provides an important reference for PVC plastic concrete used in the initial support structures of highway tunnels and coal mine roadway. At the same time, the energy absorption characteristics and their relationship under different impact loads are studied, which provides an important reference for predicting the energy absorption characteristics of concrete under other PVC aggregate content or higher impact speed. This study replaced natural coarse aggregate in concrete with different contents and equal volume of well-graded flaky PVC particles obtained by crushing PVC soft board. Also, slump, compression, and splitting strength tests, a free falling low-speed impact test of steel balls and a high-speed impact compression test of split Hopkinson pressure bar (SHPB) were carried out. Results demonstrate that the static and dynamic compressive strength decreases substantially, and the elastic modulus and slump decrease slowly with the increase of the mixing amount of PVC aggregate (0–30%). However, the energy absorption rate under low-speed impact and the specific energy absorption per MPa under high-speed impact increase obviously, indicating that the energy absorption capacity is significantly enhanced. Regardless of the mixing amount of PVC aggregate, greater strain rate can significantly enhance the dynamic compressive strength and the specific energy absorption per MPa. After the uniaxial compression test or the SHPB impact test, the relative integrity of the specimen is positively correlated with the mixing amount of PVC aggregate. In addition, the specimens are seriously damaged with the increase of the impact strain rate. When the PVC aggregate content is 20%, the compressive strength and splitting strength of concrete are 33.8 MPa and 3.26 MPa, respectively, the slump is 165 mm, the energy absorption rate under low-speed impact is 89.5%, the dynamic compressive strength under 0.65 Mpa impact air pressure is 58.77 mpa, and the specific energy absorption value per MPa is 13.33, which meets the requirements of shotcrete used in tunnel, roadway support and other impact loads. There is a linear relationship between the energy absorption characteristics under low-speed impact and high-speed impact. The greater the impact pressure, the larger the slope of the fitting straight line. The slope and intercept of the fitting line also show a good linear relationship with the increase of impact pressure. The conclusions can be used to predict the energy absorption characteristics under different PVC aggregate content or higher-speed impact pressure, which can provide important reference for safer, more economical, and environmental protection engineering structure design.
Healthcare in a pure gatekeeping system: utilization of primary, mental and emergency care in the prison population over time
Authors: Spycher Jacques , Dusheiko Mark , Beaupère Pascale , Gravier Bruno , Moschetti Karine 
Published: May 2021

Abstract
Background
This study investigates the prisoner and prison-level factors associated with healthcare utilization (HCU) and the dynamic effects of previous HCU and health events. We analyze administrative data collected on annual adult prisoner-stay HCU (n = 10,136) including physical and mental chronic disease diagnoses, acute health events, penal circumstances and prison-level factors between 2013 and 2017 in 4 prisons of Canton of Vaud, Switzerland. Utilization of four types of health services: primary, nursing, mental and emergency care; are assessed using multivariate and multi-level negative binomial regressions with fixed/random effects and dynamic models conditional on prior HCU and lagged health events.

Results
In a prison setting with health screening on detention, removal of financial barriers to care and a nurse-led gatekeeping system, we find that health status, socio-demographic characteristics, penal history, and the prison environment are associated with HCU overtime. After controlling for chronic and past acute illnesses, female prisoners have higher HCU, younger adults more emergencies, and prisoners from Africa, Eastern Europe, and the Americas lower HCU. New prisoners, pretrial detainees or repeat offenders utilize more all types of care. Overcrowding increases primary care but reduces utilization of mental and emergency services. Higher expenditure on medical staff resources is associated with more primary care visits and less emergency visits. The dynamics of HCU across types of care shows persistence over time related to emergency use, previous somatic acute illnesses, and acting out events. There is also evidence of substitution between psychiatric and primary care.

Conclusions
The prison healthcare system provides an opportunity to diagnose and treat unmet health needs for a marginalized population. Access to psychiatric and chronic disease management during incarceration and prevention of emergency or acute events can reduce future demand for care. Prioritization of high-risk patients and continuity of care inside and outside of prisons may reduce public health pressures in the criminal system. The prison environment and prisoners’ penal circumstances impacts healthcare utilization, suggesting better coordination between the criminal justice and prison health systems is required.
Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review
Authors: Kawahara Mampei , Kuroshima Shinichiro , Sawase Takashi 
Published: May 2021

Abstract
Background
Medication-related osteonecrosis of the jaw (MRONJ), which was first reported as bisphosphonate-related osteonecrosis of the jaw (BRONJ) in bisphosphonate users, is a rare but severe soft and hard tissue disease induced by several types of medications. There has been a deluge of information about MRONJ, such as epidemiology, risk factors, clinical recommendations for dental treatment to prevent it, and treatment strategies in medication-prescribed users. The aim of this study was to comprehensively review recent articles and provide the current scientific information about MRONJ, especially clinical considerations or recommendations for dental treatment to prevent its occurrence.

Materials and methods
The current literature review was mainly based on 14 systematic reviews with or without meta-analysis, 4 position papers, 1 consensus statement, 1 clinical guideline, and 2 clinical reviews regarding MRONJ after a PubMed database and manual searches according to inclusion and exclusion criteria. Moreover, 53 articles were selected by manual search in regard to all references from selected articles and other articles identified on the PubMed search, irrespective of publication date, and inclusion and exclusion criteria.

Results
The incidence and prevalence of MRONJ are relatively low, although they are clearly higher in cancer patients receiving high-dose antiresorptive agents or angiogenesis inhibitors rather than osteoporosis patients receiving oral bisphosphonates or denosumab. There are many types of local, systemic, and other risk factors for the development of MRONJ. Clinical recommendations are provided for each clinical situation of patients to prevent MRONJ. There are also treatment strategies for MRONJ in each stage.

Conclusions
General dentists should perform appropriate dental treatment to prevent MRONJ in the patients prior to or when receiving medications that could induce MRONJ. Moreover, there are treatment strategies for MRONJ in each stage that oral surgeons could follow. Adequate and updated clinical information regarding MRONJ based on scientific data is required whenever possible.
Laparoscopic surgical treatment for hydrocele of canal of Nuck: A case report and literature review
Authors: Wang Liming , Maejima Taku , Fukahori Susumu , Shun Katayose , Yoshikawa Daitaro , Kono Toru 
Published: May 2021

Abstract
Background
Hydrocele of canal of Nuck (HCN) is a rare disease in adult female. The diagnosis and treatment of HCN is still a challenge for surgeons.

Case presentation
A 56-year-old female presented with recent onset of occasional pain during exercise and an asymptomatic left groin swelling. Ultrasonography results were suspicious for left inguinal hernia incarceration and computed tomography (CT) scan showed no intestinal obstruction, which was considered as HCN. Laparoscopic hydrocelectomy of the HCN and a routine laparoscopic hernia repair via the transabdominal preperitoneal (TAPP) approach were performed. Postoperative pathology showed no malignant lesions or endometriosis.

Conclusions
The preoperative diagnosis of HCN is extremely important. Surgeons should choose appropriate surgical methods for different anatomical HCNs based on the preoperative diagnosis.
“A coalition of the willing”: experiences of co-designing an online pain management programme (iSelf-help) for people with persistent pain
Authors: Devan Hemakumar , Perry Meredith A. , Yaghoubi Mostafa , Hale Leigh 
Published: May 2021

Abstract
Background
Participatory approaches to developing health interventions with end-users are recommended to improve uptake and use. We aimed to explore the experiences of co-designing an online-delivered pain management programme (iSelf-help) for people with persistent pain.

Methods
A modified participatory action research (PAR) framework was used to co-design contents and delivery of iSelf-help. The PAR team included: (1) a patient advisory group consisting of people living with persistent pain (n = 8), (2) pain management service clinicians (n = 2), (3) health researchers (n = 3), (4) digital health experts (n = 2), (5) a health literacy expert, and (6) two Māori health researchers and our community partner who led the cultural appropriateness of iSelf-help for Māori (the Indigenous population of New Zealand). The iSelf-help co-design processes and activities of the ‘PAR’ team is reported in another paper. In this paper, all PAR team members were invited to share their experiences of the co-design process. Individual interviews were held with 12 PAR team members. Interview transcripts were analysed using the General Inductive Approach.

Results
Five common themes were identified from the interviews: (1) Shared understanding and values of the co-design process, (2) Mismatched expectations with content creation, (3) Flexibility to share power and decision making, (4) Common thread of knowledge, and (5) Shared determination. Sustaining these themes was an overarching theme of “A coalition of the willing”.

Conclusions
PAR team members valued the shared determination and responsibility to co-design iSelf-help. They also acknowledged the complexities and challenges during the process related to mismatched expectations, power sharing and establishing a common thread of knowledge. Successful co-design requires a shared commitment and responsibility as a coalition to meet the aspirations of end-users, within the boundaries of time and budget.
Lower endothelium-dependent microvascular function in adult breast cancer patients receiving radiation therapy
Authors: Banister Heather R. , Hammond Stephen T. , Parr Shannon K. , Sutterfield Shelbi L. , Turpin Vanessa-Rose G. , Treinen Scott , Bell Martin J. , Ade Carl J. 
Published: May 2021

Abstract
Purpose
Cancer patients with a history of radiotherapy are at an increased risk of ischemic heart disease. Preclinical animal studies demonstrate markedly impaired acetylcholine (ACh)-mediated endothelium-dependent vasorelaxation within days to weeks post-irradiation, however, whether microvascular function is affected in the intact human circulation during cancer radiation therapy has yet to be determined.

Materials and methods
Using laser-Doppler flowmetry, microvascular endothelium-dependent and independent responses were evaluated through iontophoresis of acetylcholine (ACh) (part 1, n = 7) and sodium nitroprusside (SNP) (part 2, n = 8), respectively, in women currently receiving unilateral chest adjuvant radiation therapy for breast cancer. Measurements were performed at the site of radiation treatment and at a contralateral control, non-radiated site. Cutaneous vascular conductance (CVC) was calculated by normalizing for mean arterial pressure.

Results and Conculsions
In part 1, patients received an average radiation dose of 2104 ± 236 cGy. A significantly lower peak ACh-mediated endothelium-dependent vasodilation was observed within the radiated microvasculature when compared to non-radiated (radiated: 532 ± 167%, non-radiated 1029 ± 263%; P = 0.02). In part 2, the average radiation dose received was 2251 ± 196 cGy. Iontophoresis of SNP elicited a similar peak endothelium-independent vasodilator response in radiated and non-radiated tissue (radiated: 179 ± 58%, non-radiated: 310 ± 158; P = 0.2). The time to 50% of the peak response for ACh and SNP was similar between radiated and non-radiated microvasculature (P < 0.05). These data provide evidence of early endothelium-dependent microvascular dysfunction in cancer patients currently receiving chest radiation and provide the scientific premise for future work evaluating coronary endothelial function and vasomotor reactivity using more detailed and invasive procedures.
Diagnostic role of computed tomography enterography (CTE) in assessment of intra-mural and extra-intestinal CT findings in active Crohn’s disease (CD)
Authors: Ali Rasha Mostafa Mohamed , Ghonimy Mai Bahgat Ibrahim 
Published: May 2021

Abstract
Background
Crohn’s disease (CD) is a ruinous bowel disease, which, if left uncured, leads to penetrating bowel complications. Computed tomography enterography (CTE) is nowadays accepted as a principal modality for the assessment of small bowel diseases. The aim of this study is to assess the role of CT enterography in the identification of intramural as well as extra-intestinal CT changes yielding more thorough data about the level and severity of the disease process thus planning appropriate treatment strategy.

Results
From March 2017 to January 2019, 50 patients in Cairo, Egypt, who had clinical manifestations of inflammatory bowel disease, were evaluated by MDCTE. CT image analysis was processed, including anatomical localization of bowel segments affection, assessment of mucosal thickening and hyper-enhancement, and extra-enteric affection. Diagnosis of Crohn’s disease (CD) was confirmed by endoscopy and histopathology; mucosal thickening was seen in 42 patients (84%), mucosal hyper-enhancement was seen in 44 patients (88%) while engorgement of vasa recta (comb’s sign) was seen in 38 patients (76%).

Conclusion
Although ileocolonoscopy is a proven sensitive method to detect mucosal injury and diagnose disease activity, it is limited by its maximal extent and inability to detect transmural complications as well as limited ability to assess deep bowel wall involvement. CT enterography (CTE) is a valuable technique in diagnostic evaluation of intramural and extra-intestinal involvement in Crohn’s disease (CD) during disease activity.