bluuebunny/crossref_metadata_2025_split huggingface dataset:
The feasibility of a self-regulation and mental imagery programme to enhance everyday functioning for people with Parkinson’s disease: study protocol
Authors: Hill Christine , Pillay Renai , Liu Karen P. Y. 
Published: December 2024

Abstract
Background
Less dopaminergic neurons in people with Parkinson’s disease result in a reliance on a slow and energy-intensive control, restricting their ability to complete routine everyday activities. Self-regulation takes an active learning approach to rehabilitation by enhancing the person’s self-awareness and encourages self-reflection to overcome problems. Mental imagery assists the person to focus attention on the requirements for the task, making it a goal-directed action and allowing for faster movements. There is a growing body of evidence to support the use of self-regulation and mental imagery in rehabilitation to maintain or improve the performance of everyday activities for people with a neurological condition.

Methods
A prospective pilot study using a single-group, pre-test and posttest design will test the feasibility and acceptability of a self-regulation and mental imagery programme to enhance performance of everyday activities and motor and cognitive function in people with Parkinson’s disease. People who have a diagnosis of Parkinson’s disease with mild-to-moderate severity and intact attention, comprehension and short-term memory will be recruited. The participants will receive a 6-week programme with one therapist-led session, a home programme and a telephone call each week. The programme uses self-regulation through a step-based problem-solving process and mental imagery to assist in movement planning. Appropriate rehabilitation strategies are used as solutions to tackle problems experienced, impacting performance in everyday activities. The attendance rate will be recorded to indicate the feasibility. A questionnaire will be administered post-intervention to collect feedback on programme acceptability. Patient outcomes will include Barthel index, Lawton Instrumental Activities of Daily Living Scale, Canadian Occupational Performance Measure and Timed Up and Go test. Trail Making Test and Montreal Cognitive Assessment will be collected pre- and post-intervention.

Discussion
The programme aims to combine the metacognitive strategies of self-regulation and mental imagery to enable individuals with Parkinson’s disease to improve the performance of everyday activities. If feasible, the programme has the potential to be further tested in a randomised controlled trial and benefit people with Parkinson’s disease by enhancing their performance required in independent community living.

Trial registration
Australian New Zealand Clinical Trials Registry ACTRN12621000903886, Registered on 12 July 2021 — retrospectively registered.
Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer
Authors: Beitzen-Heineke Antonia , Wise David R. , Berger Jeffrey S. 
Published: December 2024

AbstractAndrogen deprivation therapy (ADT), a key element of prostate cancer treatment, is associated with increased risk for cardiovascular morbidity and mortality. The underlying mechanisms include adverse metabolic alterations, but further mechanisms are likely. Animal studies suggest increased progression of atherosclerosis in androgen deprived conditions. Based on in vitro studies, lack of androgens may modulate immune cells including monocytes, macrophages, and T-cells towards a pro-inflammatory phenotype and pro-atherogenic function. As a novel aspect, this review summarizes existing data on the effect of androgens and androgen deprivation on platelet activity, which play a major role in inflammation and in the initiation and progression of atherosclerotic lesions. Testosterone modulates platelet aggregation responses which are affected by dose level, source of androgen, and age. Data on the effects of ADT on platelet activity and aggregation are limited and conflicting, as both increased and decreased aggregation responses during ADT have been reported. Gaps in knowledge about the mechanisms leading to increased cardiovascular risk during ADT remain and further research is warranted. Improved understanding of pathogenic pathways linking ADT to cardiovascular risk may help identify clinically useful diagnostic and prognostic biomarkers, and accelerate finding novel therapeutic targets, and thus optimize prostate cancer treatment outcomes.
Identifying innovation factors and actors in autonomous inland shipping: a literature review
Authors: Al Amien Dhaneswara 
Published: December 2024

AbstractAutonomous shipping is introduced to increase the competitiveness of inland shipping and promote a modal shift toward sustainable transport. This innovation has the potential to disrupt the existing inland shipping industry paradigm. This paper identifies the characteristics of autonomous inland shipping through the lens of the diffusion of innovation theory. A systematic literature review, based on the PRISMA 2020 guidelines methodology, was conducted. The existing literature aligns well with the theory and reveals most of the innovation variables and relevant actors. The result indicates that the literature on this topic is limited but still developing, and the paper presents opportunities for agendas in business, innovation, and transportation research. Further discussion shows industry implications, using a generalized transport cost model and stakeholder analysis to emphasize the motivations for sustainable transport through the adoption of autonomous shipping.
Assessment of the physiological effects and safety of transpulmonary chemoembolization with doxorubicin on pulmonary tissue using a human-isolated lung perfusion model
Authors: Slama Alexis , Steinberg Hannah , Collaud Stéphane , Okumus Özlem , Hilger Ralph-Axel , Bauer Sebastian , Schildhaus Hans-Ulrich , Aigner Clemens , Schaarschmidt Benedikt M. 
Published: December 2024

Abstract
Background
Whole lung transpulmonary chemoembolization using a combination of doxorubicin (DXO) and degradable starch microspheres (DSM-TPCE) might be a promising treatment option in soft tissue sarcoma. To pave the way for clinical studies, this study aimed to evaluate the short-term effects of DSM-TPCE with DXO using an ex vivo isolated lung perfusion (ILP) model.

Methods
Nine lung specimens retrieved from patients undergoing lobectomy underwent ex vivo ILP. In groups of three, lung specimens were either treated with sole DXO, sole DSM, or combined substances (DSM + DXO). During ex vivo ILP, histological samples were obtained from each lung every 15 min. Quantitative DXO analysis and histopathological grading of possible tissue damage using a five-point Likert scale was performed. Two-way repeated measures ANOVA tested for differences between treatment groups and changes over time.

Results
We created a preclinical ex vivo ILP model to simulate the effects of DSM-TPCE. In histopathological analysis, only two specimens, treated with only DXO, showed an increase in parenchymal damage over time. No significant effect of time (3.3%, p = 0.305) or group (23.3; p = 0.331) was identified. Within the lung tissue, the DXO concentration ranged from 205 to 1,244 ng/g. No significant effects could be detected regarding different treatment groups (4.9% of total variation, p = 0.103).

Conclusion
In an ex vivo ILP model using human lung lobes, the physiological effects of DSM-TPCE with DXO could be tested. Neither increased DXO concentrations in lung tissue nor histopathological changes indicating early lung toxicity were observed.

Relevance statement
An ex vivo ILP model using human lung specimens did not show any signs of early lung toxicity after transpulmonary chemoembolization with DXO. These results support further evaluation of DSM-TPCE in phase I/II trials.

Key Points

Transpulmonary chemoembolization can be investigated in an ex vivo ILP model.

DSM did not increase DXO in normal lung tissue.

DSM did not increase parenchymal toxicity compared to the control groups.

Graphical Abstract
Focal liver lesions: multiparametric microvasculature characterization via super-resolution ultrasound imaging
Authors: Zeng Qian-Qian , An Shi-Zhe , Chen Chao-Nan , Wang Zhen , Liu Jia-Cheng , Wan Ming-Xi , Zong Yu-Jin , Jian Xiao-Hua , Yu Jie , Liang Ping 
Published: December 2024

Abstract
Background
Noninvasive and functional imaging of the focal liver lesion (FLL) vasculature at microscopic scales is clinically challenging. We investigated the feasibility of using super-resolution ultrasound (SR-US) imaging for visualizing and quantifying the microvasculature of intraparenchymal FLLs.

Methods
Patients with FLLs between June 2022 and February 2023 were prospectively screened. Following bolus injection of microbubbles at clinical concentration, SR-US was performed using a high frame rate (350–500 Hz) modified ultrasound scanner and a convex array transducer with a central frequency of 3.1 MHz.

Results
In total, 47 pathologically proven FLLs at a depth of 5.7 ± 1.7 cm (mean ± standard deviation) were included: 30 hepatocellular carcinomas (HCC), 11 liver metastases (LM), and 6 focal nodular hyperplasias (FNH). The smallest detectable vessel size of the hepatic microvasculature was 128.4 ± 18.6 μm (mean ± standard deviation) at a depth of 8 cm. Significant differences were observed among the three types of lesions in terms of pattern categories, vessel density, minimum flow velocity, and perfusion index. We observed higher vessel density for FNH versus liver parenchyma (p < 0.001) as well as fractal dimension and local flow direction entropy value for FNH versus HCC (p = 0.002 and p < 0.001, respectively) and for FNH versus LM (p = 0.006 and p = 0.002, respectively).

Conclusion
Multiparametric SR-US showed that these three pathological types of FLLs have specific microvascular phenotypes. Vessel density, fractal dimension and local flow direction entropy served as valuable parameters in distinguishing between benign and malignant FLLs.

Trial registration
ClinicalTrials.gov (NCT06018142).

Relevance statement
Multiparametric SR-US imaging offers precise morphological and functional assessment of the microvasculature of intraparenchymal focal liver lesions, providing insights into tumor heterogeneity and angiogenesis.

Key Points

Super-resolution (SR)-US imaging allowed morphological and functional evaluation of intraparenchymal hepatic lesion microvasculature.

Hepatocellular carcinoma, liver metastasis, and focal nodular hyperplasia exhibit distinct microvascular architectures and hemodynamic profiles.

Multiparametric microvasculature characterization via SR-US imaging facilitates the differentiation between benign and malignant microvascular phenotypes.

Graphical Abstract
Diagnostic value of digital breast tomosynthesis in suspicious lesions detected in screening mammogram
Authors: Mousa Waleed Abd El-Fattah , Tolba Dalia Ayman Abd El-Raof , Moawad Mahmoud Mohamed 
Published: December 2024

Abstract
Background
Digital mammography (DM) serves as the primary breast imaging technique for early cancer detection and diagnosis. However, it faces certain limitations, particularly in imaging dense breasts. DM exhibits reduced sensitivity and specificity in women with radiographically dense breast tissue due to diminished contrast between potential tumors and surrounding tissue, as well as tissue summation potentially obscuring lesions. The aim of this study was to assess the diagnostic efficacy of digital breast tomosynthesis compared to digital mammography in evaluating suspicious breast lesions. The study included 60 female patients eligible for mammography. All participants underwent full-field digital mammography and 3d tomosynthesis. Written informed consent was obtained from all subjects after explaining the research’s purpose and benefits. The Ethics Committee of the Faculty of Medicine, Menoufia University approved the study under code no. 10/2022RADI24.

Results
Regarding BIRADS classification: All 60 patients were categorized using the BIRADS lexicon for both mammography and digital breast tomosynthesis. Mammography results showed BIRADS 3 in 10% (6/60), BIRADS 4a in 33.3% (20/60), 4b in 10% (6/60), BIRADS 4c in 26.7% (16/60), and BIRADS 5 in 20% (12/60) of cases. In comparison, tomosynthesis classified cases as BIRADS 3 in 13.3% (8/60), 4b in 16.7% (10/60), BIRADS 4c in 23.3% (14/60), and BIRADS 5 in 46.7% (28/60) of cases.

Conclusions
Digital breast tomosynthesis (DBT) has established itself as a significant advancement in three-dimensional breast imaging for both screening and diagnostic purposes. It exhibits enhanced performance in identifying breast abnormalities and generates images of superior diagnostic quality with improved precision compared to conventional digital mammography. This improvement is particularly notable when examining dense breast tissue, which has traditionally been one of the most challenging aspects of breast imaging.
Mental health and its wider determinants in young people in the UK during 12 months of the COVID-19 pandemic: repeated cross-sectional representative survey
Authors: Rouquette Olivier Y. , Dekel Dana , Siddiqi Abdul-Moiz , Seymour Catherine , Weeks Lauren , John Ann 
Published: December 2024

Background
The COVID-19 pandemic posed an unprecedented global challenge, with past evidence suggesting negative psychological effects with the additional concern that social and physical restrictions might disproportionately affect adolescents.

Aims
To explore mental health and its wider determinants in young people in the UK during 1 year of the COVID-19 pandemic (August 2020–August 2021).

Method
A representative sample of 11 898 participants (48.7% female) aged between 13 and 19 years (mean = 16.1) participated in five waves of data collection. Using validated self-reported questionnaires for loneliness, anxiety and depression, this survey measured the extent and nature of the mental health impacts of the coronavirus pandemic and help-seeking behaviours, and changes over time.

Results
Young people experienced higher levels of anxiety during the summer and fall 2020, followed by higher levels of depression during the winter 2020–2021, with loneliness gradually increasing then peaking during the spring and summer of 2021. Young people who were older, female, with pre-existing mental-health issues and experiencing financial difficulties were at higher risk of anxiety, depression and loneliness. Help-seeking behaviours reduced the risk of depression and loneliness.

Conclusions
The COVID-19 pandemic had substantial impact on young people, whether on their mental health, their social contacts and interactions or their perspective on what the future holds for them. Young people strongly advocated for better teacher training, and a better integration of mental health services, particularly within their schools.
Development and Validation of Dynamic 5-Year Breast Cancer Risk Model Using Repeated Mammograms
Authors: Jiang Shu , Bennett Debbie L. , Rosner Bernard A. , Tamimi Rulla M. , Colditz Graham A. 
Published: December 2024

PURPOSE
Current image-based long-term risk prediction models do not fully use previous screening mammogram images. Dynamic prediction models have not been investigated for use in routine care.

METHODS
We analyzed a prospective WashU clinic-based cohort of 10,099 cancer-free women at entry (between November 3, 2008 and February 2012). Follow-up through 2020 identified 478 pathology-confirmed breast cancers (BCs). The cohort included 27% Black women. An external validation cohort (Emory) included 18,360 women screened from 2013, followed through 2020. This included 42% Black women and 332 pathology-confirmed BC excluding those diagnosed within 6 months of screening. We trained a dynamic model using repeated screening mammograms at WashU to predict 5-year risk. This opportunistic screening service presented a range of mammogram images for each woman. We applied the model to the external validation data to evaluate discrimination performance (AUC) and calibrated to US SEER.

RESULTS

Using 3 years of previous mammogram images available at the current screening visit, we obtained a 5-year AUC of 0.80 (95% CI, 0.78 to 0.83) in the external validation. This represents a significant improvement over the current visit mammogram AUC 0.74 (95% CI, 0.71 to 0.77;
P
< .01) in the same women. When calibrated, a risk ratio of 21.1 was observed comparing high (>4%) to very low (<0.3%) 5-year risk. The dynamic model classified 16% of the cohort as high risk among whom 61% of all BCs were diagnosed. The dynamic model performed comparably in Black and White women.

CONCLUSION
Adding previous screening mammogram images improves 5-year BC risk prediction beyond static models. It can identify women at high risk who might benefit from supplemental screening or risk-reduction strategies.
Pancreatic Adenocarcinoma: Long-Term Outcomes of Adjuvant Therapy in the ESPAC4 Phase III Trial
Authors: Palmer Daniel H. , Jackson Richard , Springfeld Christoph , Ghaneh Paula , Rawcliffe Charlotte , Halloran Christopher M. , Faluyi Olusola , Cunningham David , Wadsley Jonathan , Darby Suzanne , Meyer Tim , Gillmore Roopinder , Lind Pehr , Glimelius Bengt , Falk Stephen , Ma Yuk Ting , Middleton Gary William , Cummins Sebastian , Ross Paul J. , Wasan Harpreet , McDonald Alec , Crosby Tom , Hammel Pascal , Borg David , Sothi Sharmila , Valle Juan W. , Mehrabi Arianeb , Bailey Peter , Tjaden Christine , Michalski Christoph , Hackert Thilo , Büchler Markus W. , Neoptolemos John P. 
Published: December 2024

PURPOSE
The ESPAC4 trial showed that adjuvant chemotherapy with gemcitabine plus capecitabine (GemCap) produced longer overall survival (OS) than gemcitabine monotherapy. Subsequently, the PRODIGE24-CCTG PA.6 trial showed even longer survival for modified fluorouracil, folinic acid, irinotecan, and oxaliplatin (mFOLFIRINOX) than gemcitabine but had more restrictive eligibility criteria. Our aim was to analyze the ESPAC4 survival on long-term follow-up.

METHODS
The OS of 732 ESPAC4 patients comparing 367 randomly assigned to gemcitabine and 365 to GemCap was previously reported after a median follow-up time of 43.2 months (95% CI, 39.7 to 45.5) and 458 deaths. Analysis was now carried out after a median follow-up of 104 months (101-108) and 566 deaths.

RESULTS

The median OS was 29.5 months (27.5-32.1) for all patients, 28.4 months (25.2-32.0) in the gemcitabine group and 31.6 months (26.5-38.0) in the GemCap group (hazard ratio [HR], 0.83 [0.71 to 0.98];
P
= .031). R0 patients given gemcitabine had a median survival of 32.2 months (27.9-41.6) compared with 49.9 months (39.0-82.3) for those given GemCap (HR, 0.63 [0.47 to 0.84];
P
= .002). Lymph node-negative patients had significantly higher 5 year OS rates on GemCap (59% [49%-71%]) than gemcitabine (53% [42%-66%]; HR, 0.63 [0.41 to 0.98];
P
= .04) but not those with positive lymph nodes (
P
= .225). The OS advantage for GemCap was retained in the PRODIGE24 subgroup of 193 (26.4%) ESPAC4 patients not eligible for PRODIGE24 with a median survival of 20.7 (16.2-27.3) months in patients allocated to gemcitabine compared with 25.9 (22.3-30.2) months for ineligible patients allocated to GemCap (HR, 0.71 [95% CI, 0.52 to 0.98]; χ
2
log-rank-1df
= 4.31;
P
= .038).

CONCLUSION
GemCap is a standard option for patients not eligible for mFOLFIRINOX. Exploratory evidence suggests that GemCap may be particularly efficacious in R0 patients and also in lymph node-negative patients.
Genomic Landscape of Malignant Phyllodes Tumors Identifies Subsets for Targeted Therapy
Authors: Bansal Rani , Adeyelu Tolulope , Elliott Andrew , Tan Antoinette R. , Ribeiro Jennifer R. , Meisel Jane , Oberley Matthew J. , Graff Stephanie L. , Sledge George W. , Grilley-Olson Juneko E. , Sammons Sarah L. , Rosenberger Laura H. 
Published: December 2024

PURPOSE
Malignant phyllodes tumors (MPTs) are rare fibroepithelial tumors of the breast with aggressive biologic behavior and high recurrence rates. Surgery remains the primary treatment modality for these tumors; however, initial investigations suggest a potential for targeted therapies in managing this disease. Therefore, we aimed to assess the molecular landscape of MPTs to reveal possible treatment opportunities.

METHODS

MPTs (n = 57) from primary and metastatic sites underwent genomic sequencing (592-gene panel or whole exome), whole-transcriptome sequencing, and immunohistochemistry (PD-L1, human epidermal growth factor receptor 2 [HER2]) at Caris Life Sciences (Phoenix, AZ). Immune cell fractions in the tumor microenvironment were estimated using quanTIseq. Mann-Whitney
U
, chi-square, and Fisher’s exact tests were used to determine significance (
P
< .05).

RESULTS

MPTs had low
ERBB2
expression, comparable with the HER2-negative subset of a large cohort of breast adenocarcinoma samples (N = 9,926). Frequent alterations included
TERT
promoter;
MED12
,
TP53
, and
NF1
mutations; and less frequently
EGFR
,
PIK3CA
, and
BRAF
. Differences in mutation prevalences were observed between primary sites, lung metastases, and nonlung metastases. One MPT specimen harbored a pathogenic
TPM4:NTRK1
fusion, and treatment with larotrectinib for over 16 months suggested a clinical response to therapy. PD-L1+ status was observed in 15.2% of MPTs overall, with similar prevalence in primary sites and lung metastases. B cells, M2 macrophages, neutrophils, and natural killer cells had the highest median cell fractions in MPTs.

CONCLUSION

Considering the occurrence of several actionable alterations including a
TPM4:NTRK1
fusion reported herein, these results support the use of next-generation sequencing (NGS) including RNA analysis for fusion detection to identify such alterations in patients with MPTs. These findings highlight the importance of comprehensive NGS in MPT research to uncover potential targeted treatment options for these patients.
Macroscopic arrow of time from multiscale perspectives
Authors: Verma Mahendra K. 
Published: December 2024

Abstract
Fundamental laws of physics are symmetric under time reversal (T) symmetry, but the T symmetry is strongly broken in the macroscopic world. In this Perspective, I review T symmetry breaking frameworks: second law of thermodynamics, multiscale energy transfer, and open systems. In driven dissipative nonequilibrium systems, including turbulence, the multiscale energy flux from large scales to small scales helps determine the arrow of time. In addition, open systems are often irreversible due to particle and energy exchanges between the system and the environment. Causality is another important factor that breaks the T symmetry.