bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffusion-weighted imaging or MR spectroscopy: Which to use for the assessment of the response to chemotherapy in breast cancer patients?
Authors: Mansour Sahar , Selim Ashraf , Kassam Loay , Adel Mirna , Hashem Aya Bassam 
Published: August 2021

Abstract
Background
Diffusion-weighted MRI (DWI) and MR spectroscopy (MRS) both are noninvasive MR sequences that could be used as a reliable tool to assess the functional behavior of the breast cancer. The aim of the study was to assess the value of DWI and MRS in predicting the early response to neo-adjuvant chemotherapy (NAC) and absence of residual disease after treatment.

Results
One hundred thirty-three patients diagnosed with breast cancer and scheduled for NAC were enrolled in this study. All lesions were subjected to qualitative and quantitative analysis of DCE-MRI, DWI and MRS, where the lesions size, kinetic parameters, ADC values and MRS choline peak were recorded before the start of NAC and after completion of chemotherapy. The results of each MRI modality were correlated with the findings that were found at the pathology report of the complete surgical specimen. The sensitivity and specificity of the MR modalities to predict pathological complete remission post-NAC were 73.68% and 83.33%, respectively, using the kinetic curve pattern, 78.95% and 83.33%, respectively, using the ADC value and finally 78.95% and 91.67%, respectively, using the MRS choline peak. Similar sensitivity (89.47%) to predict pathological complete remission was presented by the ADC value and the MRS choline peak together when compared to the ADC value and dynamic curve patterns.

Conclusion
DWI and MRS are valuable MRI techniques and their accuracy in detecting residual disease is almost similar to that of DCE MRI. The inclusion of these sequences in the imaging protocol of NAC candidates improve monitoring of the response to treatment and allow early distinction between complete, partial and non-responders' cases in breast cancer patients.
Champions for improved adherence to guidelines in long-term care homes: a systematic review
Authors: Hall Amanda M. , Flodgren Gerd M. , Richmond Helen L. , Welsh Sheila , Thompson Jacqueline Y. , Furlong Bradley M. , Sherriff Andrea 
Published: August 2021

Abstract
Background
The champion model is increasingly being adopted to improve uptake of guideline-based care in long-term care (LTC). Studies suggest that an on-site champion may improve the quality of care residents’ health outcomes. This review assessed the effectiveness of the champion on staff adherence to guidelines and subsequent resident outcomes in LTC homes.

Method
This was a systematic review and meta-analyses of randomised controlled trials. Eligible studies included residents aged 65 or over and nursing staff in LTC homes where there was a stand-alone or multi-component intervention that used a champion to improve staff adherence to guidelines and resident outcomes. The measured outcomes included staff adherence to guidelines, resident health outcomes, quality of life, adverse events, satisfaction with care, or resource use. Study quality was assessed with the Cochrane Risk of Bias tool; evidence certainty was assessed using the GRADE approach.

Results
After screening 4367 citations, we identified 12 articles that included the results of 1 RCT and 11 cluster-RCTs. All included papers evaluated the effects of a champion as part of a multicomponent intervention. We found low certainty evidence that champions as part of multicomponent interventions may improve staff adherence to guidelines. Effect sizes varied in magnitude across studies including unadjusted risk differences (RD) of 4.1% [95% CI: − 3%, 9%] to 44.8% [95% CI: 32%, 61%] for improving pressure ulcer prevention in a bed and a chair, respectively, RD of 44% [95% CI: 17%, 71%] for improving depression identification and RD of 21% [95% CI: 12%, 30%] for improving function-focused care to residents.

Conclusion
Champions may improve staff adherence to evidence-based guidelines in LTC homes. However, methodological issues and poor reporting creates uncertainty around these findings. It is premature to recommend the widespread use of champions to improve uptake of guideline-based care in LTC without further study of the champion role and its impact on cost.

Trial registration
PROSPERO CRD42019145579. Registered on 20 August 2019.
Evaluation of hydromorphological conditions of Grand Popo Beach using two unique video cameras
Authors: Arnaud KoueKam K. , Bonou Frédéric , Sohou Zacharie , Angnuureng Donatus B. , Almar Rafael 
Published: August 2021

Beaches are characterized by complex spatial and temporal patterns of erosion and accretion subjected to significant wave and tide influence. The objective of this study is to estimate the evolution of hydromorphodynamic conditions on the shoreline of Grand Popo Beach observed from two adjacent video camera setups. We have analyzed the impact of the variability of hydrodynamic parameters on the beach evolution and evaluated the variabilities of the hydrodynamic and morphologic parameters from the two cameras. Despite the nonhomogeneity within the cameras’ intrinsic properties, the various results obtained from the two systems indicate that wave conditions (peak period and significant height) from the cameras have the same variations, whereas the shoreline variations of camera A are not the same as those of camera B. It is generally during the summer that the Grand Popo Beach is exposed to an agitated environment with strong observed values of significant wave heights and wave energy flux, undoubtedly resulting in significant sediment transport along the beach leading a shoreline retreat. The results indicate that in 3.5 years the shoreline of Grand Popo Beach has retreated by 10 m.
Use of olanzapine compared with clozapine for treatment-resistant schizophrenia in a real-world setting: nationwide register-based study
Authors: Jo Young Tak , Joo Sung Woo , Ahn Soojin , Choi Youngjae , Lee Jungsun 
Published: August 2021

BackgroundClozapine is generally considered as the treatment of choice for patients with treatment-resistant schizophrenia (TRS). However, its superiority has recently been questioned because olanzapine has been suggested as non-inferior to clozapine in its effectiveness.AimsWe aimed to investigate the current status of clozapine prescriptions to identify any disparity between clinical guidelines and real-world practices.MethodIn this study, we utilised the Health Insurance Review Agency database in the Republic of Korea to investigate the real-world effectiveness of clozapine for patients with TRS. We compared differences in patient variables before and after clozapine administration, and we also performed survival analyses for both psychiatric admissions and emergency room visits among patients who used clozapine or olanzapine.ResultsThis study investigated an incident cohort of 64 442 patients, and 2338 patients have been prescribed clozapine. Of these, 998 patients had TRS. In survival analysis, clozapine showed a worse survival rate for psychiatric admissions than olanzapine (hazard ratio 0.615). We also identified that clinicians tended to try a number of antipsychotics, as recommended, before starting patients on clozapine.ConclusionsIn conclusion, we found that olanzapine led to higher survival rates for psychiatric admissions than clozapine. Thus, considering the risk of serious adverse effects, clozapine may be used conservatively. Considering several studies advocating superior efficacy of clozapine, further studies with extensive data are recommended.
Patterns of Palliative Radiotherapy Utilization for Patients With Metastatic Breast Cancer in Harare, Zimbabwe
Authors: Mushonga Melinda , Nyakabau Anna Mary , Ndlovu Ntokozo , Iyer Hari Subramaniam , Bellon Jennifer Ruth , Kanda Caroline , Ndarukwa-Jambwa Sandra , Chipidza Fallon , Makunike-Mutasa Rudo , Muchuweti David , Muguti Edwin G. , Cluff Elmore Shekinah Nefreteri 
Published: August 2021

PURPOSEIn sub-Saharan Africa, radiotherapy (RT) utilization and delivery patterns have not been extensively studied in patients with metastatic breast cancer.METHODSA retrospective cohort study of female patients with metastatic breast cancer seen at Parirenyatwa Radiotherapy Centre in Zimbabwe from 2014 to 2018 was conducted. Demographics, pathology, staging, and treatment data were abstracted through chart review. Fisher's exact test and chi-squared test of independence were used to compare proportions, and independent two-sample t-tests were used to compare means.RESULTSOf 351 patients with breast cancer, 152 (43%) had metastatic disease, median age 51 years (interquartile range: 43-61 years). Of those with metastatic disease, 30 patients (20%) received radiation to various metastatic sites: 16 spine; three nonspine bone metastases; six whole brain; and five chest wall or supraclavicular. Patients who received radiation were younger (46 v 52 years; P = .019), but did not differ significantly by performance status than those who did not. The most common dose prescription was 30 Gy in 10 fractions (33%). Five (17%) patients had treatment interruption and two (7%) had treatment noncompletion. Province of origin and clinical tumor stage were significant predictors of RT receipt ( P = .002; and P = .018, respectively).CONCLUSIONA minority of patients with metastatic breast cancer received RT (20%), and these were likely to be younger, with advanced tumor stage, and resided in provinces where RT is available. Conventional courses were generally prescribed. There is a need to strongly consider palliative RT as an option for patients with metastatic breast cancer and use of hypofractionated courses (e.g. 8 Gy in one fraction) may support this goal.
Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis
Authors: Walker Zoe J. , Xue Siqi , Jones Michael P. , Ravindran Arun V. 
Published: August 2021

PURPOSECancer is a growing public health issue in low- and lower-middle–income countries (LLMICs), but the mental health consequences in this setting have not been well-characterized. We aimed to systematically evaluate the available literature on the prevalence, associates, and treatment of mental disorders in patients with cancer in LLMICs.METHODSWe systematically searched Medline, PsycINFO, EMBASE, and CINAHL. We performed a random effects meta-analysis to determine the pooled prevalence of major depression or anxiety disorders in this population, defined by Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria. We qualitatively reviewed studies that examined the prevalence of depressive or anxiety disorders defined by self-report tools, the prevalence of other mental disorders, associated factors of depressive and anxiety symptoms, and the treatment of mental disorders in this population.RESULTSForty studies spanning a 15-year period were included in the review. The pooled prevalence defined by Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria was 21% for major depression (95% CI, 15 to 28) and 18% for anxiety disorders (95% CI, 8 to 30). Depressive and anxiety symptoms were most frequently associated with advanced disease and low levels of education. Among the four studies evaluating treatment, three evaluated the effectiveness of psychotherapy and one evaluated a yoga program.CONCLUSIONThe prevalence of depression and anxiety in patients with cancer generally appears higher in LLMICs than in upper-income countries. Our findings demonstrate the existence of a significant and underappreciated disease burden. We suggest that clinicians remain vigilant to psychiatric symptoms. Improved screening and treatment are likely to improve quality of life and reduce both morbidity and mortality.
Clinical Characteristics and Incidences of Benign and Malignant Insulinoma Using a National Inpatient Database in Japan
Authors: Kurakawa Kayo Ikeda , Okada Akira , Manaka Katsunori , Konishi Takaaki , Jo Taisuke , Ono Sachiko , Uda Kazuaki , Michihata Nobuaki , Matsui Hiroki , Fushimi Kiyohide , Yamaguchi Satoko , Yamauchi Toshimasa , Nangaku Masaomi , Yasunaga Hideo , Kadowaki Takashi 
Published: August 2021

Abstract

Context
Insulinoma is the most common pancreatic functional neuroendocrine neoplasm, yet little information on recent clinical practice in patients with insulinoma, especially malignant insulinoma, is available.

Objective
This work aims to clarify the characteristics and practice patterns in patients with insulinoma using a national inpatient database.

Methods
Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified patients with insulinoma admitted between 2010 and 2018. We compared background characteristics and therapeutic interventions between patients with benign and malignant insulinoma. We also estimated the incidence of insulinoma using the number of patients with newly diagnosed insulinoma in 2012.

Results
We identified 844 patients with benign insulinoma and 102 patients with malignant insulinoma. Patients with malignant insulinoma were younger (median, 55.5 vs 66.0 years, P &lt; .001) and less likely to be female (55.9% vs 65.3%, P = .061) than patients with benign insulinoma. Analysis of therapeutic interventions revealed that patients with malignant insulinoma more frequently received medications (71.6% vs 49.6%, P &lt; .001) but less frequently underwent pancreatic surgery (57.8% vs 72.0%, P = .003). Older patients were a smaller proportion of those undergoing surgery and a larger proportion of those managed with medications without surgery (P &lt; .001). The incidence of insulinoma was estimated to be 3.27 (95% CI, 2.93-3.61) individuals per million Japanese adult population per year.

Conclusion
The present study using a nationwide database had a larger sample size than previous studies and revealed definitive differences in patient characteristics and therapeutic patterns between benign and malignant insulinoma.
Identification of qPCR reference genes suitable for normalising gene expression in the developing mouse embryo
Authors: Hildyard John C.W. , Wells Dominic J. , Piercy Richard J. 
Published: August 2021

Background: Progression through mammalian embryogenesis involves many interacting cell types and multiple differentiating cell lineages. Quantitative polymerase chain reaction (qPCR) analysis of gene expression in the developing embryo is a valuable tool for deciphering these processes, but normalisation to stably-expressed reference genes is essential for such analyses. Gene expression patterns change globally and dramatically as embryonic development proceeds, rendering identification of consistently appropriate reference genes challenging. Methods: We have investigated expression stability in mouse embryos from mid to late gestation (E11.5–E18.5), both at the whole-embryo level, and within the head and forelimb specifically, using 15 candidate reference genes (ACTB, 18S, SDHA, GAPDH, HTATSF1, CDC40, RPL13A, CSNK2A2, AP3D1, HPRT1, CYC1, EIF4A, UBC, B2M and PAK1IP1), and four complementary algorithms (geNorm, Normfinder, Bestkeeper and deltaCt). Results: Unexpectedly, all methods suggest that many genes within our candidate panel are acceptable references, though AP3D1, RPL13A and PAK1IP1 are the strongest performing genes overall. HPRT1 and B2M are conversely poor choices, and show strong developmental regulation. We further show that normalisation using our three highest-scoring references can reveal subtle patterns of developmental expression even in genes ostensibly ranked as acceptably stable (CDC40, HTATSF1). Conclusion: AP3D1, RPL13A and PAK1IP1 represent universally suitable reference genes for expression studies in the E11.5-E18.5 mouse embryo.
Can multiple sclerosis nurses help reduce non-elective admissions? An analysis of a service delivery audit
Authors: Metcalfe Gale , Owen Audrey 
Published: August 2021

Background: It has been identified that nearly one-in-five people with multiple sclerosis (MS) have been admitted to hospital as a non-elective admission in 2018–2019. The average national stay is 7.7 days, at an average cost of £2844. Emergency hospital admissions for people with multiple sclerosis are rising nationally. Method: The authors conducted a 12-month audit of non-elective admissions across two clinical sites, comparing and contrasting the data gathered with national Hospital Episode Statistics. The outcome of the data collection influenced changes in local service delivery. Findings: The most common reasons identified for non-elective admissions related to MS were associated with respiratory issues (4255 admissions), with the most common single cause being urinary tract infections (2960 admissions). Bladder and bowel issues combined also accounted for 3550 admissions in 2018/19. Conclusion: The data identified urinary tract infections and sepsis as the largest presentation of non-elective MS admissions to both trusts. Certain recommendations have been made that will contribute to the improvement of service delivery and better quality care.
De-noising imaging through diffusers with autocorrelation
Authors: Cheng Qianqian , Guo Enlai , Gu Jie , Bai Lianfa , Han Jing , Zheng Dongliang 
Published: August 2021

Recovering targets through diffusers is an important topic as well as a general problem in optical imaging. The difficulty of recovering is increased due to the noise interference caused by an imperfect imaging environment. Existing approaches generally require a high-signal-to-noise-ratio (SNR) speckle pattern to recover the target, but still have limitations in de-noising or generalizability. Here, featuring information of high-SNR autocorrelation as a physical constraint, we propose a two-stage (de-noising and reconstructing) method to improve robustness based on data driving. Specifically, a two-stage convolutional neural network (CNN) called autocorrelation reconstruction (ACR) CNN is designed to de-noise and reconstruct targets from low-SNR speckle patterns. We experimentally demonstrate the robustness through various diffusers with different levels of noise, from simulative Gaussian noise to the detector and photon noise captured by the actual optical system. The de-noising stage improves the peak SNR from 20 to 38 dB in the system data, and the reconstructing stage, compared with the unconstrained method, successfully recovers targets hidden in unknown diffusers with the detector and photon noise. With the help of the physical constraint to optimize the learning process, our two-stage method is realized to improve generalizability and has potential in various fields such as imaging in low illumination.
Suicide after reception into prison: A case-control study examining differences in early and late events
Authors: Radeloff Daniel , ten Hövel Marian , Brennecke Gerald , Stoeber Franziska S. , Lempp Thomas , Kettner Mattias , Zacher Hannes , von Klitzing Kai , Bennefeld-Kersten Katharina 
Published: August 2021

Objective
Prisoners constitute a high-risk group for suicide, with suicide rates about 5 to 8 times higher than in the general population. The first weeks of imprisonment are a particularly vulnerable time, but there is limited knowledge about the risk factors for either early or late suicide events.

Methods
Based on a national total sample of prison suicides in Germany between 2005 and 2017, suicides within the first 2 (4 and 8) weeks after reception into prison were matched by age and penalty length with cases that occurred later. Factors that potentially influence the timing of suicide were investigated.

Results
The study has shown that 16.7% (31.5%) of all 390 suicides in German prisons occurred within the first two weeks (two months) of imprisonment. Factors that facilitate adaptation to the prison environment (e.g. prior prison experience) were negatively associated with early suicide events. Factors that hindered the adaptation process (e.g. withdrawal from illicit drugs) were observed more frequently in early suicide events than in late ones. These factors are active at different times of imprisonment.

Conclusion
At reception, particular attention should be paid to the following factors associated with early suicide events: widowed marital status, lack of prison experience, and drug dependency.
An automatic screening method for strabismus detection based on image processing
Authors: Huang Xilang , Lee Sang Joon , Kim Chang Zoo , Choi Seon Han 
Published: August 2021

Purpose
This study aims to provide an automatic strabismus screening method for people who live in remote areas with poor medical accessibility.

Materials and methods
The proposed method first utilizes a pretrained convolutional neural network-based face-detection model and a detector for 68 facial landmarks to extract the eye region for a frontal facial image. Second, Otsu’s binarization and the HSV color model are applied to the image to eliminate the influence of eyelashes and canthi. Then, the method samples all of the pixel points on the limbus and applies the least square method to obtain the coordinate of the pupil center. Lastly, we calculated the distances from the pupil center to the medial and lateral canthus to measure the deviation of the positional similarity of two eyes for strabismus screening.

Result
We used a total of 60 frontal facial images (30 strabismus images, 30 normal images) to validate the proposed method. The average value of the iris positional similarity of normal images was smaller than one of the strabismus images via the method (p-value<0.001). The sample mean and sample standard deviation of the positional similarity of the normal and strabismus images were 1.073 ± 0.014 and 0.039, as well as 1.924 ± 0.169 and 0.472, respectively.

Conclusion
The experimental results of 60 images show that the proposed method is a promising automatic strabismus screening method for people living in remote areas with poor medical accessibility.
Romaison 2020 Rome, an Extraordinary Maison: The Archives and Creations of Its Costume Studios, curated by Clara Tosi Pamphili
Authors: Colombini Grazia 
Published: August 2021

Romaison 2020 Rome, an Extraordinary Maison: The Archives and Creations of Its Costume Studios, curated by Clara Tosi Pamphili
Museo dell’Ara Pacis, Roma, 23 October–29 November 2020
RANCANG BANGUN GENERATOR AXIAL FLUX PERMANENT MAGNET (AFPM) MULTICAKRAM 1 FASA DENGAN KUTUB BERLAWANAN (N-S) MENGGUNAKAN MAGNET PERMANEN NEODYMIUM IRON BORON (NdFeB)
Authors: Pratama Pandu Putra , Hadi Widyono , Cahyadi Widya 
Published: August 2021

Generator yang ada dipasaran merupakan generator dengan tipe High Speed. Sehingga dibutuhkan generator yang mampu menghasilkan tegaangan yang relatif tinggi dengan putaran rendah seperti tipe Axial Flux Permanen Magnet (AFPM). Sehingga dilakukan pengembangan generator seperti multicakram. Generator multicakram merupakan generator yang dapat menghasilkan tegangan yang relatif tinggi dari generator lainnya, karena memilki jumlah stator dan rotor yang cukup banyak. Pada generator ini menggunakan magnet jenis Neodyimium Iron Boron (NdFeB) yang disusun secara berlawanan (N-S) untuk membangkitkan luaran AC 1 fasa. Penelitian ini dilakukan pada putaran 3000 RPM dengan jumlah beban paralel 8 yang disetiap paralel terdapat 7 LED seri. Pada luaran AC diperoleh frekuensi 400.6 Hz, tegangan beban 14.65 V, arus beban 13.704 mA, daya 0.2008 W, dan torsi Nm. Pada luaran rectifier diperoleh frekuensi rectifier 800 Hz, tegangan beban 12.380 V, arus beban 13.340 mA, daya 0.161 W, dan torsi Nm. Pada luaran DC diperoleh frekuensi DC 800 Hz, tegangan beban 14.700 V, arus beban 15.147 mA, daya 0.223 W, dan torsi 7.115 Nm. Ketika jumlah beban ditambah maka tegangan semakin mengecil, dan arus, daya, dan torsi semakin besar.