bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left Atrial Function and Arrhythmias in Relation to Small Vessel Disease on Brain MRI: The Multi‐Ethnic Study of Atherosclerosis
Authors: Austin Thomas R. , Jensen Paul N. , Nasrallah Ilya M. , Habes Mohamad , Rashid Tanweer , Ware Jeffrey B. , Chen Lin Yee , Greenland Philip , Hughes Timothy M. , Post Wendy S. , Shea Steven J. , Watson Karol E. , Sitlani Colleen M. , Floyd James S. , Kronmal Richard A. , Longstreth W. T. , Bertoni Alain G. , Shah Sanjiv J. , Bryan R. Nick , Heckbert Susan R. 
Published: October 2022

Background
Atrial fibrillation (AF) is associated with increased stroke risk and accelerated cognitive decline, but the association of early manifestations of left atrial (LA) impairment with subclinical changes in brain structure is unclear. We investigated whether abnormal LA structure and function, greater supraventricular ectopy, and intermittent AF are associated with small vessel disease on magnetic resonance imaging of the brain.

Methods and Results
In the Multi‐Ethnic Study of Atherosclerosis, 967 participants completed 14‐day ambulatory electrocardiographic monitoring, speckle tracking echocardiography and, a median 17 months later, magnetic resonance imaging of the brain. We assessed associations of LA volume index and reservoir strain, supraventricular ectopy, and prevalent AF with brain magnetic resonance imaging measures of small vessel disease and atrophy. The mean age of participants was 72 years; 53% were women. In multivariable models, LA enlargement was associated with lower white matter fractional anisotropy and greater prevalence of microbleeds; reduced LA strain, indicating worse LA function, was associated with more microbleeds. More premature atrial contractions were associated with lower total gray matter volume. Compared with no AF, intermittent AF (prevalent AF with <100% AF during electrocardiographic monitoring) was associated with lower white matter fractional anisotropy (−0.25 SDs [95% CI, −0.44 to −0.07]) and greater prevalence of microbleeds (prevalence ratio: 1.42 [95% CI, 1.12–1.79]).

Conclusions
In individuals without a history of stroke or transient ischemic attack, alterations of LA structure and function, including enlargement, reduced strain, frequent premature atrial contractions, and intermittent AF, were associated with increased markers of small vessel disease. Detailed assessment of LA structure and function and extended ECG monitoring may enable early identification of individuals at greater risk of small vessel disease.
Effects of Endocrine Therapy on Cardiovascular Diseases and Type 2 Diabetes Among Breast Cancer Survivors: The National Health Insurance Service Database of Korea
Authors: Kim Ji‐Eun , Choi Jaesung , Park JooYong , Han Wonshik , Kang Daehee , Choi Ji‐Yeob 
Published: October 2022

Background
Although endocrine therapy is an effective treatment for breast cancer, its antiestrogen effects are associated with increased risks of cardiovascular diseases and type 2 diabetes. This study aimed to investigate the association between endocrine therapy and the risk of cardiovascular diseases and type 2 diabetes among breast cancer survivors in Korea, in consideration of various age groups.

Methods and Results
In the National Health Insurance Service database of Korea, a total of 133 171 patients with breast cancer aged ≥20 years were included in the current study. Endocrine therapy was treated as time‐varying exposure, and patients were categorized as nonusers, selective estrogen receptor modulator users, aromatase inhibitor users, and both users. Time‐dependent Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs. Age at diagnosis, socioeconomic status, histological type, other treatments, and comorbidities were adjusted in the model. Compared with nonusers, selective estrogen receptor modulator users were associated with higher risks of stroke (HR, 1.20 [95% CI, 1.04–1.40]) and venous thromboembolism (HR, 1.47 [95% CI, 1.13–1.90]), whereas aromatase inhibitor users were associated with a higher risk of coronary heart disease (HR, 1.22 [95% CI, 1.06–1.41]). The risk of type 2 diabetes was associated with selective estrogen receptor modulator users (HR, 1.13 [95% CI, 1.05–1.21]), aromatase inhibitor users (HR, 1.14 [95% CI, 1.05–1.23]), and both users (HR, 1.24 [95% CI, 1.10–1.39]). In particular, the risk of a composite of cardiovascular diseases was higher in younger or premenopausal patients.

Conclusions
In breast cancer survivors in Korea, endocrine therapy is associated with a higher risk of cardiovascular diseases and type 2 diabetes. Monitoring of cancer comorbidities after endocrine therapy is needed in younger and older patients.
Perceived partner support and post-traumatic symptoms after an acute cardiac event:A longitudinal study
Authors: George-Levi Sivan , Fait Keren , Hod Hanoch , Matezky Shlomi , Vilchinsky Noa 
Published: October 2022

Objective Cardiac disease induced post-traumatic stress symptoms (CDI-PTSS) have been associated with negative consequences for patients’ mental and physical health. Identifying risk factors as well as potential buffers is necessary for understanding the development and maintenance of CDI-PTSS. The current study focused on the mediating and moderating role played by patients’ perceptions of their partners’ ways of providing support (active engagement, overprotection, and protective buffering) in the development and stabilization of CDI-PTSS levels over time. Method Male patients ( N = 106) were recruited at hospitalization (T1) and completed the study’s questionnaires at two time points: approximately four months after hospital discharge (T2) and approximately eight months after discharge (T3). Results Structual equation modeling was used to test the study hypotheses. All three forms of T2 perceived partner support were positively associated with T2 CDI-PTSS levels which, in turn, were positively associated with T3 CDI-PTSS levels. The linear association between T2 and T3 CDI-PTSS was positive but decreased as perceived partner protective buffering levels increased. Conclusions In the context of CDI-PTSS, perceived partner support seems to have a different effect than it has in non-traumatic illness contexts. Interventions for couples coping with CDI-PTSS should be designed accordingly.
Establishing reporting standards for participant characteristics in post-stroke aphasia research: An international e-Delphi exercise and consensus meeting
Authors: Wallace Sarah J , Isaacs Megan , Ali Myzoon , Brady Marian C 
Published: October 2022

Objective To establish international, multidisciplinary expert consensus on minimum participant characteristic reporting standards in aphasia research (DESCRIBE project). Methods An international, three-round e-Delphi exercise and consensus meeting, involving multidisciplinary researchers, clinicians and journal editors working academically or clinically in the field of aphasia. Results Round 1 of the DESCRIBE e-Delphi exercise ( n = 156) generated 113 items, 20 of which reached consensus by round 3. The final consensus meeting ( n = 19 participants) established DESCRIBE's 14 participant characteristics that should be reported in aphasia studies: age; years of education; biological sex; language of treatment/testing; primary language; languages used; history of condition(s) known to impact communication/cognition; history of previous stroke; lesion hemisphere; time since onset of aphasia; conditions arising from the neurological event; and, for communication partner participants, age, biological sex and relationship to person with aphasia. Each characteristic has been defined and matched with standard response options to enable consistent reporting. Conclusion Aphasia research studies should report the 14 DESCRIBE participant characteristics as a minimum. Consistent adherence to the DESCRIBE minimum reporting standard will reduce research wastage and facilitate evidence-based aphasia management by enabling replication and collation of research findings, and translation of evidence into practice.
Childhood Stunting and Wasting Following Independence in South Sudan
Authors: Hoffman Daniel J. , Kassim Ismail , Ndiaye Biram , McGovern Mark E. , Le Huyen , Abebe Kiross Tefera , Ayoya Mohamed Ag 
Published: October 2022

Background: South Sudan has experienced ongoing civil and environmental problems since gaining independence in 2011 that may influence childhood nutritional status. Objective: To estimate the prevalence of undernutrition among children in South Sudan in 2018 and 2019 compared to the prevalence in 2010. Methods: Data on height and weight were collected using a 2-stage stratified sample framework in which households were randomly selected at the county level and nutritional status was calculated for all children under 5 years of age to determine height-for-age, weight-for-height, and weight-for-age Z-scores (HAZ, WHZ, and WAZ) and the prevalence of stunting, wasting, and underweight. Linear and logistic regression analyses were used to determine factors associated with nutritional status and the odds ratio for nutritional outcomes. Results: In 2010, the mean HAZ, WHZ, and WAZ was −0.78, −0.82, and −1.15, respectively, and the prevalence of stunting, wasting, and underweight was 30%, 23%, and 32%, respectively. In 2018 and 2019, the mean HAZ, WHZ, and WAZ was −0.50, −0.70, −0.77 and −0.53, −0.77, −0.76, respectively. The prevalence of stunting, wasting, and underweight in 2018 and 2019 was 17%, 14%, 15% and 16%, 16%, 17%, respectively. Age was negatively associated with all nutritional indices and girls had higher HAZ, WHZ, and WAZ and a lower mid upper arm circumference ( P < .01) compared to boys. The risk of poor nutritional outcomes was associated with vaccine status and varied by state of residence. Conclusions: Following independence in 2010, the prevalence of undernutrition in South Sudan decreased, but the risk for undernutrition varied by state and efforts to address food security and health need to ensure equitable access for all children in South Sudan.
Development and validation of a nomogram involving immunohistochemical markers for prediction of recurrence in early low-risk endometrial cancer
Authors: Kong Wei , Tu Yuan , Jiang Peng , Huang Yuzhen , Zhang Jingni , Jiang Shan , Li Ning , Yuan Rui 
Published: October 2022

Background The purpose of this study was to construct a nomogram based on classical parameters and immunohistochemical markers to predict the recurrence of early low-risk endometrial cancer patients. Methods A total of 998 patients with early low-risk endometrial cancer who underwent primary surgical treatment were enrolled (668 in the training cohort, 330 in the validation cohort). Prognostic factors identified by univariate and multivariate analysis in the training cohort were used to construct the nomogram. Prediction performance of the nomogram was evaluated using the calibration curve, concordance index (C-index), and the time-dependent receiver operating characteristic curve. The cumulative incidence curve was used to describe the prognosis of patients in high-risk and low-risk groups divided by the optimal risk threshold of the model. Results In the training cohort, grade ( P = 0.040), estrogen receptor ( P < 0.001), progesterone receptor ( P = 0.001), P53 ( P = 0.004), and Ki67 ( P = 0.002) were identified as independent risk factors of recurrence of early low-risk endometrial cancer, and were used to establish the nomogram. The calibration curve showed that the fitting degree of the model was good. The C-indexes of training and validation cohorts were 0.862 and 0. 827, respectively. Based on the optimal risk threshold of the nomogram, patients were split into a high-risk group and a low-risk group. The cumulative incidence curves showed that the prognosis of the high-risk group was far worse than that of the low-risk group ( P < 0.001). Conclusion This nomogram, with a combination of classical parameters and immunohistochemical markers, can effectively predict recurrence in early low-risk endometrial cancer patients.
Natalizumab extended-interval dosing in multiple sclerosis to mitigate progressive multifocal leukoencephalopathy risk: initial study evidence and real-world experience
Authors: Perneczky Julian , Sellner Johann 
Published: October 2022

The high efficacy of natalizumab in the treatment of relapsing-remitting multiple sclerosis (MS) is without controversy. Indeed, effective disease control was not only demonstrated in the pivotal trials but has been corroborated impressively in real-world observations. This monoclonal IgG4 antibody blocks the α4β1 integrin-mediated leukocyte-endothelial interaction and thereby inhibits the migration of immune cells to the brain parenchyma. However, treatment with natalizumab carries the risk of progressive multifocal leukoencephalopathy (PML). This potentially lethal side effect is a significant limitation for treatment initiation and long-term therapy. Natalizumab is given intravenously or subcutaneously in the standard dose of 300 mg every 4 weeks, allowing drug concentrations at levels that ensure continuous α4β1 integrin receptor saturation on the surface of immune cells. Extended-interval dosing (EID) is an emerging treatment approach that aims to mitigate the natalizumab-related PML risk by prolonging the standard infusion intervals to 6 weeks or even more. This treatment approach may abrogate the PML risk due to improved immune surveillance within the central nervous system while maintaining clinical efficacy. Moreover, even an individual interval dosing can be envisioned based on the availability of a biomarker that is capable of monitoring both safety and efficacy aspects. This review summarizes the early and encouraging evidence for EID from observational and randomized-controlled trials and discusses current limitations and upcoming challenges for introducing a tailored treatment approach.
Normative values of short-term heart rate variability in a cross-sectional study of a Danish population. The DanFunD study
Authors: Brinth Louise S. , Jørgensen Torben , Mehlsen Jesper , Petersen Marie W. , Gormsen Lise , Linneberg Allan , Fink Per , Benros Michael E. , Dantoft Thomas M. 
Published: October 2022

Aims: The autonomic nervous system includes parasympathetic and sympathetic components that monitor and regulate most of the bodily functions and play a central role in the physiology and homeostasis of the human body. Heart rate variability is a non-invasive tool for quantification of rhythmic fluctuations in heart rate that reflects the function of the autonomic nervous system. The study aims to describe the heart rate variability distribution in the general population, stratified in sex and age groups, which is currently insufficiently described. Methods: A cross-sectional population-based study recruited participants in 10 municipalities in the western part of the greater Copenhagen area in Denmark, including 6891 men and women aged 18–72 years (participation rate was 29.5%). Short-term heart rate variability measures were obtained and related to age and gender. Results: Both time and frequency domain measures showed a huge variation in the different sex and age groups. Women had a higher median heart rate than men, and the association with age was U-shaped. Measures indicating a predominance of the parasympathetic component in relation to the sympathetic component were more frequent in women and younger age groups. Conclusions: Both sex and age influence the heart rate variability in this adult Danish population. Therefore, our age- and sex-related reference values of heart rate variability in the time and frequency domain should be used in further epidemiological and clinical research.
Piezoelectric vibration energy harvesting with asymmetric hybrid bracing beam
Authors: Ma Tianbing , Yin Liming , Zhang Zhihao , Yin Menghan , Du Fei , Sun Kaiheng 
Published: October 2022

In order to reduce the natural frequency of the piezoelectric vibration energy harvester, improve the output power of the piezoelectric vibration energy harvester, and meet the demand of power supply for the low-power wireless switch in the low-frequency vibration environment, an asymmetric hybrid supported beam piezoelectric vibration energy harvester is proposed. The theoretical model of the hybrid support beam was established. The correlation factors affecting the open-circuit voltage and the total output power of the hybrid braced beam were analyzed. The dimensional parameters of the hybrid supported beam piezoelectric energy harvester were optimized by using the optimization method of orthogonal experiments. Different coincidence degrees experiments were used to further optimize the structural design of the hybrid support beam. The test results show that the maximum output power is 770 μW, when the external excitation frequency is 1.0 g and the external resistance is 50 kΩ. Finally, a wireless switch test system was established, and the piezoelectric vibration energy harvester was experimentally verified to be capable of powering the wireless switch.
First-line therapeutic strategy for patients with advanced non–small cell lung cancer with Leu858Arg epidermal growth factor receptor mutations: a Bayesian network meta-analysis
Authors: Chen Chongxiang , Zhang Chunning , Lin Huaming , Liu Qianyin , Wu Limian , Zhou Chengzhi , Zhang Jiexia 
Published: October 2022

Aim: The objective of this network meta-analysis was to determine the most useful first-line therapeutic strategy for patients with advanced (IIIB/IV or relapsed) non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) Leu858Arg or EGFR 19del mutations. Methods: PubMed, the Web of Science, Medline, and reports of the top three world cancer conferences (WCLC, ESMO, and ASCO) were searched for appropriated randomized controlled studies (RCTs) discussing the use of various generations of tyrosine kinase inhibitors (TKIs; gefitinib, erlotinib, icotinib, afatinib, dacomitinib, osimertinib, aumolertinib), chemotherapy [pemetrexed-based chemotherapy (PC), non-pemetrexed-based chemotherapy (NPC)], and different combined therapies (osimertinib plus bevacizumab, afatinib plus cetuximab, erlotinib plus bevacizumab, erlotinib plus ramucirumab, gefitinib plus apatinib, gefitinib plus PC, and gefitinib plus pemetrexed) to treat patients with advanced NSCLC with EGFR Leu858Arg or 19del mutations. OpenBugs and Stata software were used to analyze the data. Results: We included 21 studies with 16 arms (including 2479 cases with EGFR Leu858Arg mutations and 3325 cases with EGFR 19del mutations). Among patients with NSCLC with EGFR Leu858Arg mutations, compared with the first-generation TKIs (such as gefitinib), the second- or third-generation TKIs [dacomitinib: hazard ratio (HR) = 0.63; 95% confidence index (CI) = (0.45, 0.89); osimertinib: HR = 0.63; 95% CI = (0.42, 0.97)] showed significant benefits in improving progression-free survival (PFS), as did afatinib plus cetuximab [HR = 1.98; 95% CI = (1.01, 3.95)], erlotinib plus bevacizumab [HR = 1.79; 95% CI = (1.22, 2.62)], and erlotinib plus ramucirumab [HR = 1.62; 95% CI = (1.07, 2.48)]. In terms of overall survival (OS), these 16 arms showed no significant differences between each other ( p > 0.05). Among patients with NSCLC with EGFR 19del mutations, compared with the first- or second-generation TKIs (such as gefitinib and afatinib), aumolertinib [ versus gefitinib: HR = 0.39; 95% CI = (0.28, 0.55) versus afatinib: HR = 0.53; 95% CI = (0.35, 0.84)] and osimertinib [ versus gefitinib: HR = 0.40; 95% CI = (0.32, 0.51) versus afatinib: HR = 0.53, 95% CI = (0.38, 0.79)] showed significantly beneficial effects. Among these first-line therapeutic strategies for patients with EGFR Leu858Arg mutations, the combination of afatinib and cetuximab ranked as the best to prolong PFS (33.0%). For NSCLC patients with 19del mutations, however, osimertinib plus bevacizumab was the best at prolonging PFS (84.3%). Conclusion: For NSCLC patients with EGFR Leu858Arg mutations, the second-generation TKIs, the third-generation TKIs, and the combined treatments showed better efficacy than the first-generation TKIs for PFS. There were, however, no significant differences between each group for OS.
Compassion focused therapy for pain management: ‘3 systems approach’ to understanding why striving and self-criticism are key psychological barriers to regulating activity and improving self-care for people living with persistent pain
Authors: Malpus Zoey , Nazar Zaynab , Smith Chloe , Armitage Lesley 
Published: October 2022

Background This paper describes the development of an eight-week Compassion Focused Therapy for Pain Management (CFT-PM) group. This group was specifically designed for ‘strivers’ a sub-group of people with persistent pain who tend to engage in over-activity and resist making reasonable adjustments to their activity levels to accommodate their persistent pain. ‘Strivers’ tend to cope by ignoring their pain and pushing on through, in the shorter term leading to ‘boom and bust’ activity-related exacerbations of their pain. They also risk the development of additional persistent fatigue and burnout in the longer term. Method 117 people completed the CFT-PM group; The group was delivered in person ( n = 84) but in online format from July 2020 ( n = 33). 162 people started the CFT-PM group but 45 dropped-out (27.43%). Results There was a significant effect for time across all measures: significant improvement was found for depression, self-compassion, pain-related disability, pain-related anxiety and pain self-efficacy. Pain numeric rating scores were approaching significance. There was a significant main effect of diagnosis; post-hoc t-test analysis found significant improvement for all diagnoses on all measures with the exception of spinal. There was also a significant interaction between time and format: post-hoc t-test analysis found greater improvement for virtual format on self-compassion and pain-related anxiety. Discussion Findings suggests that CFT-PM may be a clinically effective group intervention with virtual format showing superior improvement. This approach might be less suitable for certain diagnoses; the spinal group may benefit more from traditional CBT-based PMPs. Limitations include the lack of random selection or allocation to treatment group. Future studies should adopt an experimental design to be able to draw firm conclusions regarding causation and efficacy. Despite these limitations, present findings suggest that CFT-PM may be an effective group intervention worthy of further investigation and clinical application.