bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating a multicomponent survivorship programme for men with prostate cancer in Australia: a single cohort study
Authors: Yates Patsy , Carter Rob , Cockerell Robyn , Cowan Donna , Dixon Cyril , Lal Anita , Newton Robert U , Hart Nicolas , Galvão Daniel A , Baguley Brenton , Denniston Nicholas , Skinner Tina , Couper Jeremy , Emery Jon , Frydenberg Mark , Liu Wei-Hong 
Published: February 2022

ObjectiveTo evaluate the implementation of a multicomponent survivorship programme for men with prostate cancer and their carers.DesignA single cohort study, guided by the RE-AIM framework.SettingMultiple health services in Australia.ParticipantsMen with prostate cancer and their carers, and health professionals.InterventionA 12-month telehealth programme that provided centralised and coordinated decision and information support, exercise and nutrition management, specialised clinical support and practical support to men and their carers.Data collectionMultiple sources of data including participant-reported health outcomes and experience of care, qualitative interviews, records of the programme were collected at different time points.ResultsReach: Of 394 eligible men at various stages of survivorship, 142 consented (36% consent rate) and 136 (96%) completed the programme. Adoption: All men participated in general care coordination and more than half participated in exercise and/or nutrition management interventions. Participation in the specialised support component (ie, psychosocial and sexual health support, continence management) was low despite the high level of need reported by men. Effectiveness: Overall, the men reported improvements in their experience of care. Implementation: Factors such as addressing service gaps, provision of specialised services, care coordination, adoption of needs-based and telehealth-based approaches were identified as enablers to the successful implementation of the programme. Issues such as insufficient integration with existing services, lack of resources and high caseload of the intervention team, men’s reluctance to discuss needs and lack of confidence with technology were barriers in implementing the programme.ConclusionSurvivorship interventions are relevant to men regardless of the stage of their disease and treatments undertaken. It is possible to provide access to a comprehensive model of survivorship care to promote the health and quality of life for men with prostate cancer.Trial registration numberThis study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12617000174381).
Randomised controlled trial of Advanced Hybrid Closed Loop in an Adult Population with Type 1 Diabetes (ADAPT): study protocol and rationale
Authors: de Portu Simona , Vorrink Linda , Re Roseline , Shin John , Castaneda Javier , Habteab Aklilu , Cohen Ohad 
Published: February 2022

IntroductionFor many people with type 1 diabetes who struggle to achieve glycaemic control with multiple daily injections of insulin (MDI) plus self-monitoring of blood glucose, MDI plus intermittently scanned continuous glucose monitoring (IS-CGM) or real-time continuous glucose monitoring (RT-CGM), or insulin administration using insulin pump therapy represent optimised care in many regions. Through technological advances an advanced hybrid closed loop (AHCL) system has been developed; studies of incremental effects relative to MDI plus IS-CGM are lacking.Methods and analysisThe Advanced Hybrid Closed Loop study in Adult Population with Type 1 Diabetes (ADAPT) study is a multinational, prospective, open-label, confirmatory and exploratory randomised controlled trial to examine outcomes with the MiniMed 670G version 4.0 AHCL system (with an equivalent algorithm and commercialised as the MiniMed 780G system, referred to as AHCL) relative to MDI plus IS-CGM in adults with baseline HbA1c≥8.0%. An exploratory cohort will compare AHCL with MDI plus RT-CGM. The study will be conducted in approximately 124 adults on MDI plus either IS-CGM or RT-CGM for at least 3 months prior to screening. The primary endpoint will be the difference in mean HbA1c change from baseline to 6 months between the AHCL and the MDI plus IS-CGM arms. Secondary endpoints will include proportion of time spent in hypoglycaemic, euglycaemic and hyperglycaemic ranges.Ethics and disseminationThe ADAPT study will be conducted in accordance with the requirements of the Declaration of Helsinki and local laws and regulations, and has been approved by ethics committees. The trial will provide valuable information on the incremental benefits that may be provided by AHCL for patients failing to achieve glycaemic targets on MDI plus IS-CGM or RT-CGM and form a basis for health economic evaluations to support market access.Trial registration numberNCT04235504; Pre-results.
Role of cardiac CT in the diagnostic evaluation and risk stratification of patients with myocardial infarction and non-obstructive coronary arteries (MINOCA): rationale and design of the MINOCA-GR study
Authors: Rampidis Georgios P , Kampaktsis Polydoros Ν , Kouskouras Konstantinos , Samaras Athanasios , Benetos Georgios , Giannopoulos Andreas Α , Karamitsos Theodoros , Kallifatidis Alexandros , Samaras Antonios , Vogiatzis Ioannis , Hadjimiltiades Stavros , Ziakas Antonios , Buechel Ronny R , Gebhard Catherine , Smilowitz Nathaniel R , Toutouzas Konstantinos , Tsioufis Konstantinos , Prassopoulos Panagiotis , Karvounis Haralambos , Reynolds Harmony , Giannakoulas George 
Published: February 2022

IntroductionMyocardial infarction with non-obstructive coronary arteries (MINOCA) occurs in 5%–15% of all patients with acute myocardial infarction. Cardiac MR (CMR) and optical coherence tomography have been used to identify the underlying pathophysiological mechanism in MINOCA. The role of cardiac CT angiography (CCTA) in patients with MINOCA, however, has not been well studied so far. CCTA can be used to assess atherosclerotic plaque volume, vulnerable plaque characteristics as well as pericoronary fat tissue attenuation, which has not been yet studied in MINOCA.Methods and analysisMINOCA-GR is a prospective, multicentre, observational cohort study based on a national registry that will use CCTA in combination with CMR and invasive coronary angiography (ICA) to evaluate the extent and characteristics of coronary atherosclerosis and its correlation with pericoronary fat attenuation in patients with MINOCA. A total of 60 consecutive adult patients across 4 participating study sites are expected to be enrolled. Following ICA and CMR, patients will undergo CCTA during index hospitalisation. The primary endpoints are quantification of extent and severity of coronary atherosclerosis, description of high-risk plaque features and attenuation profiling of pericoronary fat tissue around all three major epicardial coronary arteries in relation to CMR. Follow-up CCTA for the evaluation of changes in pericoronary fat attenuation will also be performed. MINOCA-GR aims to be the first study to explore the role of CCTA in combination with CMR and ICA in the underlying pathophysiological mechanisms and assisting in diagnostic evaluation and prognosis of patients with MINOCA.Ethics and disseminationThe study protocol has been approved by the institutional review board/independent ethics committee at each site prior to study commencement. All patients will provide written informed consent. Results will be disseminated at national meetings and published in peer-reviewed journals.Trial registration numberNCT4186676.
Sex differences in risks of in-hospital and late outcomes after cardiac surgery: a nationwide population-based cohort study
Authors: Chang Feng-Cheng , Chen Shao-Wei , Chan Yi‐Hsin , Lin Chia-Pin , Wu Victor Chien-Chia , Cheng Yu-Ting , Chen Dong-Yi , Hung Kuo-Chun , Chu Pao-Hsien , Chou An-Hsun 
Published: February 2022

ObjectivesOutcomes of sex differences in major cardiac surgery remain controversial. A comprehensive understanding of sex differences in major adult cardiac surgery could provide better knowledge of risk factors, management strategy and short-term or long-term outcomes. The present study aimed to investigate sex differences in the risks of outcomes of major cardiac surgeries and subgroup analyses of different valve types.DesignPopulation-based nationwide cohort study.SettingData were obtained from National Health Insurance Research Database (NHIRD) in Taiwan.ParticipantsA total of 66 326 adult patients (age ≥20 years; 30.3% women) who underwent a first major cardiac surgery (isolated coronary artery bypass graft (CABG), isolated valve or concomitant bypass/valve) from 2000 to 2013 were identified via Taiwan NHIRD.Main outcome measuresOutcomes of primary interest were in-hospital death and all-cause mortality during follow-up period. Propensity score matching was conducted as a secondary analysis for the sensitivity test.ResultsWomen who underwent isolated CABG tended to have greater risks of both in-hospital (OR 1.37; 95% CI 1.26 to 1.49) and late outcomes (HR 1.26; 95% CI 1.22 to 1.31). Women after concomitant CABG/valve also had a greater in-hospital (OR 1.19; 95% CI 1.01 to 1.40) and long-term mortality (HR 1.14; 95% CI 1.05 to 1.24). Women after isolated mitral valve repair have a non-favourable outcome of in-hospital mortality (OR 1.70; 95% CI 1.01 to 2.87). Women who did not receive an isolated aortic valve replacement had more favourable all-cause mortality outcome (HR 0.90; 95% CI 0.84 to 0.96). Secondary analysis in the propensity score-matching cohort demonstrated results similar to the primary analysis.ConclusionsFemale patients who underwent procedures involving CABG (with or without concurrent valvular intervention) had generally worse outcomes. However, the results of isolated valve surgery were variable on the basis of the type of intervened valve.
Trauma radiology teaching for foundation doctors working within the Scottish Trauma Network improves radiology requests and patient safety: a multidepartmental quality improvement project
Authors: O'Rourke Sara Caterina Maria , Christmas Daniel , Blankenstein Tom 
Published: February 2022

Abstract
The importance of radiology in trauma management is particularly relevant today as Scotland develops its Scottish Trauma Network. Trauma and radiology are scarcely covered in the 2016 and 2021 Foundation Programme Curriculum. Trauma is a significant and endemic public health challenge, while radiology is ever growing in use as a diagnostic and interventional tool. Currently, the majority of radiological investigation requests in trauma are made by foundation doctors. Accordingly, there is an urgent need to ensure foundation doctors are adequately trained in trauma radiology. This prospective, multidepartmental quality improvement project at a single major trauma centre primarily analysed the impact of trauma radiology teaching on the quality of foundation doctors’ radiology requests according to Ionising Radiation Medical Exposure Regulations (IRMER) criteria. As a secondary outcome, the impact of teaching on patient safety was also evaluated. 50 foundation doctors across three departments dealing with trauma patients had their trauma radiology requests analysed before and after the intervention of trauma-focused radiology teaching. Results showed cancelled and altered radiology requests decreased from 20% to 5% and from 25% to 10%, respectively, with a p value of 0.01. This translated to fewer delays in trauma patients receiving radiological investigations. The foundation curriculum would benefit from the introduction of trauma radiology teaching for its foundation doctors, in parallel to the demands of a growing national trauma network. Education globally improves radiology request quality by raising awareness and respect of IRMER criteria and ultimately leads to positive changes for patient safety.
Modelling and Analysing Replica- and Fault-aware Management of Horizontally Scalable Applications
Authors: Soldani Jacopo , Cameriero Marco , Paparelli Giulio , Brogi Antonio 
Published: February 2022

Modern enterprise applications integrate multiple interdependent software components, whose management must be suitably coordinated. This must be done by taking into account all inter-component dependencies, the faults potentially affecting them, and the fact that each component can be horizontally scaled, i.e., that multiple instances of each component can be spawned or destroyed, depending on application needs. In this article, we introduce a novel solution for suitably modelling and analysing the replica- and fault-aware management of multi-component applications, based on topology graphs and management protocols. More precisely, we first introduce a compositional model of the management behaviour of the (possibly multiple) instances of the components forming an application, faults included. We then show how this model enables automating various useful analyses, from checking the validity of management plans to automatically determining management plans allowing the instance of an application to reach and maintain a desired target configuration.
EZH2 Inhibitors: The Unpacking Revolution
Authors: Adema Vera , Colla Simona 
Published: February 2022

Abstract
The methylation of lysine 27 on histone H3 (H3K27me3) is a chromatin mark associated with nucleosome condensation and gene expression silencing. EZH2 is a lysine methyltransferase that catalyzes H3K27me3. In this issue of Cancer Research, Porazzi and colleagues report that pretreatment with EZH2 inhibitors opened up the H3K27me3-marked chromatin of acute myeloid leukemia (AML) cells, which enhanced DNA damage and apoptosis induced by chemotherapeutic agents, in particular the topoisomerase II inhibitors, doxorubicin and etoposide. The EZH2 inhibitor/doxorubicin combination also enabled the expression of proapoptotic genes, potentially contributing to the death of AML cells. This study has significant implications for improving the efficacy of DNA-damaging cytotoxic agents in AML, thereby enabling lower chemotherapy doses and reducing treatment-related side effects.
See related article by Porazzi et al., p. 458
Combined Treatment with a WNT Inhibitor and the NSAID Sulindac Reduces Colon Adenoma Burden in Mice with Truncated APC
Authors: Faux Maree C. , Weinstock Janet , Gogos Sophia , Prato Emma , Azimpour Alexander I. , O'Keefe Ryan , Cathcart-King Yasmin , Garnham Alexandra L. , Ernst Matthias , Preaudet Adele , Christie Michael , Putoczki Tracy L. , Buchert Michael , Burgess Antony W. 
Published: February 2022

Adenomatous polyposis coli (APC) truncations occur in many colorectal cancers and are often associated with immune infiltration. The aim of this study was to determine whether a combination of Wnt inhibition with anti-inflammatory (sulindac) and/or proapototic (ABT263) drugs can reduce colon adenomas. Apcmin/+ and doublecortin-like kinase 1 (Dclk1)Cre/+;Apcfl/fl mice were exposed to dextran sulphate sodium (DSS) in their drinking water to promote the formation of colon adenomas. Mice were then treated with either a Wnt-signaling antagonist pyrvinium pamoate (PP), an anti-inflammatory agent sulindac or proapoptotic compound ABT263 or a combination of PP+ABT263, or PP+sulindac. Colon adenoma frequency, size, and T-cell abundance were measured. DSS treatment resulted in significant increases in colon adenoma number (P &lt; 0.001, n &gt; 5) and burden in Apcmin/+ (P &lt; 0.01, n &gt; 5) and Dclk1Cre/+;Apcfl/fl (P &lt; 0.02, n &gt; 5) mice. There was no effect on adenomas following treatment with PP in combination with ABT263. Adenoma number and burden were reduced with PP+sulindac treatment in Dclk1Cre/+;Apcfl/fl mice (P &lt; 0.01, n &gt; 17) and in Apcmin/+ mice (P &lt; 0.001, n &gt; 7) treated with sulindac or PP+sulindac with no detectable toxicity. PP treatment of Apcmin/+ mice increased the frequency of CD3+ cells in the adenomas. The combination of Wnt pathway inhibition with sulindac was more effective in Dclk1Cre/+;Apcfl/fl mice and provides an opportunity for killing Apc-mutant colon adenoma cells, indicating a strategy for both colorectal cancer prevention and potential new treatments for patients with advanced colorectal cancer. Outcomes from the results of this study may be translatable to the clinic for management of FAP and other patients with a high risk of developing colorectal cancer.

Significance:
Colorectal cancer is one of the most common cancers worldwide with limited therapeutic options. APC and other Wnt signaling mutations occur in the majority of colorectal cancers but there are currently no Wnt inhibitors in the clinic. The combination of Wnt pathway inhibition with sulindac provides an opportunity for killing Apc-mutant colon adenoma cells and suggests a strategy for colorectal cancer prevention and new treatments for patients with advanced colorectal cancer.
Magnitude of Blood Pressure Change After Endovascular Therapy and Outcomes: Insight From the BP-TARGET Trial
Authors: Anadani Mohammad , Maïer Benjamin , Escalard Simon , Labreuche Julien , de Havenon Adam , Sabben Candice , Lapergue Bertrand , Gory Benjamin , Richard Sebastien , Sibon Igor , Desilles Jean-Philippe , Blanc Raphael , Piotin Michel , Mazighi Mikael , Redjem Hocine , Smajda Stanislas , Delvoye François , Hebert Solène , Obadia Michael , Obadia Alexandre , Raynouard Igor , Morvan Erwan , Boursin Perrine , Maacha Malek Ben , Consoli Arturo , Wang Adrien , Mione Gioia , Humbertjean Lisa , Bonnerot Matthieu , Lacour Jean-Christophe , Anxionnat René , Tonnelet Romain , Bracard Serge , Barreau Xavier , Marnat Gaultier , Berge Jérôme , Lucas Ludovic , Renou Pauline , Debruxelles Sabrina , Poli Mathilde , Sagnier Sharmila 
Published: February 2022

Background and Purpose:
To assess the association between systolic blood pressure change (ΔSBP) at different time intervals after successful reperfusion with radiographic and clinical outcomes.

Methods:
This is a post hoc analysis of the BP-TARGET multicenter trial (Blood Pressure Target in Acute Stroke to Reduce Hemorrhage After Endovascular Therapy). ΔSBP was defined as end of procedure SBP minus mean SBP at different time intervals (15–60 minutes, 1–6 hours, and 6–24 hours postprocedure). The primary outcome was the poor functional outcome (90-day modified Rankin Scale score 3–6).

Results:

We included a total of 267 patients (130 in the intensive treatment group). Compared with patients with favorable outcome, patients with poor outcome had lower ΔSBP (less SBP reduction) at all times intervals. After adjusting for potential confounders including baseline SBP, both ΔSBP
15
–60M
and ΔSBP
6
–24H
were associated with lower odds of poor outcome (adjusted odds ratio per 5 mm Hg SBP reduction, 0.89 [95% CI, 0.81–0.99], and adjusted odds ratio 0.82 [95% CI, 0.73–0.92], respectively). Concerning safety outcomes, patients with intraparenchymal hemorrhage had lower ΔSBP at all time intervals. ΔSBP
15
–60M
was associated with lower odds of any intraparenchymal hemorrhage (adjusted odds ratio per 5 mm Hg SBP reduction 0.91 [95% CI, 0.83–0.99]). Conversely, ΔSBP was not associated with mortality or neurological deterioration at any time interval.

Conclusions:
After successful reperfusion, ΔSBP had a linear relationship with poor outcome and the risk of poor outcome was higher with less reduction from the baseline SBP.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03160677.
Intracranial Large Artery Stenosis and Past Infectious Exposures: Results From the NOMAS Cohort
Authors: Mehta Amol , Khasiyev Farid , Wright Clinton B. , Rundek Tatjana , Sacco Ralph L. , Elkind Mitchell S.V. , Gutierrez Jose 
Published: February 2022

Background:
Intracranial large artery stenosis (ILAS) is an important contributor to ischemic stroke in the United States and worldwide. There is evidence to suggest that chronic exposure to certain infectious agents may also be associated with ILAS. We aimed to study this association further in an ethnically diverse, prospective, population-based sample of Northern Manhattan.

Methods:

We enrolled a random sample of stroke-free participants from an urban, racially, and ethnically diverse community in 1993. Participants have been followed prospectively and a subset underwent brain magnetic resonance angiograms from 2003 to 2008. Intracranial stenoses of the circle of Willis and vertebrobasilar arteries were scored as 0=no stenosis, 1≤50% (or luminal irregularities), 2=50% to 69%, 3≥70% stenosis, and 4=flow gap. We summed the individual score of each artery to produce a global ILAS score (possible range, 0–44). Past infectious exposure to
Chlamydia pneumoniae
,
Helicobacter pylori
, cytomegalovirus, and herpes simplex virus 1 and 2 was determined using serum antibody titers.

Results:

Among 572 NOMAS (Northern Manhattan Study) participants (mean age 71.0±8.0 years, 60% women, 68% Hispanic) with available magnetic resonance angiogram and serological data, herpes simplex virus 2 (beta=0.051,
P
<0.001) and cytomegalovirus (beta=0.071,
P
<0.05) were associated with ILAS score after adjusting for demographics and vascular risk factors. Stratifying by anterior and posterior circulations, herpes simplex virus 2 remained associated with the anterior circulation (beta=0.055
P
<0.01) but not with posterior circulation ILAS score.

Conclusions:
Chronic infectious exposures, specifically herpes simplex virus 2 and cytomegalovirus were associated with asymptomatic ILAS as seen on magnetic resonance angiogram imaging. This may represent an additional target of intervention in the ongoing effort to stem the substantial global burden of strokes related to ILAS.
Emergency Medical Service Time Intervals for Patients With Suspected Stroke in the United States
Authors: Cash Rebecca E. , Boggs Krislyn M. , Richards Christopher T. , Camargo Carlos A. , Zachrison Kori S. 
Published: February 2022

Background:
Optimal care for patients with stroke relies on timely recognition and rapid transport to appropriate treatment, often by emergency medical services (EMS). Our primary objective was to describe EMS time intervals for patients with suspected stroke in the United States. We also sought to quantify the variation in EMS time intervals by geographic location and urbanicity.

Methods:
We conducted a cross-sectional evaluation of EMS 9-1-1 activations (ie, calls for service) included in the 2018 and 2019 National EMS Information System datasets. We included ground or air EMS activations for a 9-1-1 scene response where a patient aged ≥18 years with suspected stroke was treated and transported by EMS. Time intervals for dispatch, response, scene, transport, and total prehospital time (ie, from dispatch to hospital arrival) were calculated, stratified by ground and air transport type.

Results:
A total of 410 187 activations for suspected stroke were included, of which 98% were a ground transport. The median total prehospital time for ground transports was 35 minutes (interquartile range, 27–45, 90th percentile 58). Median total prehospital time for air transports was substantially longer at 56 minutes (interquartile range, 43–70, 90th percentile 86). Times varied by Census division and urbanicity with the shortest ground total prehospital times in the East North Central division and urban areas and longest times in the East South Central and rural and frontier areas.

Conclusions:
Timely EMS response and transport is critical for optimizing care of patients with suspected stroke. Using a large, national dataset of EMS activations, we found variations by geographic location and urbanicity in total prehospital time for ground and air EMS activations for patients with stroke.