bluuebunny/crossref_metadata_2025_split huggingface dataset:
Literature meta-analysis about the efficacy of anti-programmed death protein 1 and anti-programmed death ligand 1 re-challenge in cancer patients
Authors: Gobbini Elisa , Charles Julie , Toffart Anne-Claire , Leccia Marie-Thérèse , Moro-Sibilot Denis , Levra Matteo Giaj 
Published: April 2020

Abstract
Background

Immune checkpoint inhibitor (ICPis) re-challenge could be an attractive therapeutic option considering its good safety profile. However, little data is available regarding anti-PD-1/anti-PD-L1 retreatment. We conducted a meta-analysis focusing on outcomes of solid cancer patients performing this strategy.

Methods

Fourteen full papers involving 74 patients were included. Individual data about best response or progression-free survival (PFS) upon the first and second course of anti-PD-1/ anti-PD-L1 were collected.

Results

Non-small-cell lung cancer (53%) and melanoma (34%) were the most represented cancers. Higher objective response (46% versus 24%, p = 4.10 -4 ) and disease control rates (73% versus 52%, p = 7.10 -3 ) were obtained upon the first ICPi course compared to re-challenge. No association between responses obtained with the two ICPis courses was found ( p = 3.10 -1 ). The PFS upon the first ICPi (PFS1) was longer than that after re-challenge (PFSR) (6.6 versus 2.8 months, hazard ratio (HR) 0.57, p = 2.10 -3 ). A longer PFSR was obtained in patients with a longer PFS1 ( p = 6.10 -3 ), in those who discontinued the first ICPi due to toxicity or per protocol (8.8 versus 2.1 months if disease progression occurs, p = 2.10 -3 ), and in those not receiving intercalated treatment between the two ICPis (6.6 versus 2.1 months for the treated ones, p = 1.10 -3 ).

Conclusion

Anti-PD-1/anti-PD-L1 re-challenge showed interesting clinical activity in selected patients, mainly in those achieving a long-term response upon the first ICPi course, that do not discontinue therapy because of disease progression, or that are able to keep a treatment-free period.
Opioid Prescribing Practices Among Surgical Providers: The Relationship with Patient-Level Factors: Rural Residency or Cancer Diagnosis
Authors: Thiesset Heather F. , Huang Lyen C , Schliep Karen C , Valentin Virginia L , Gren Lisa H. , Porucznik Christina A 
Published: April 2020

Abstract
Background Patients living in rural communities and patients with a cancer diagnosis are two areas potentially overlooked in opioid prescribing clinical decision making that may relate to the amount of overprescribed opioids in the postsurgical environment.Methods A 35-item questionnaire was administered to surgeons, residents/ fellows (trainees), and advanced practice clinicians (APCs). Descriptive statistics were generated.Results Surgeons, trainees, and APCs self-reported that they give the same amount of opioids to rural patients as other patients. APCs were more likely to agree that it is easy to e-prescribe (56%) than surgeons (41%) and trainees (35%), so rural patients do not need different consideration. Surgeons (50%) and trainees (50%) agreed compared to APCs (0%) that it is easier to give more opioids so a patient does not have get refills if needed for pain. Compared to APCs (5%), 21% of surgeons and 45% of trainees acknowledged giving more opioid narcotics to patients with cancer than patients without a cancer diagnosis.Conclusions While both groups of prescribing providers reported that they gave the same amount of opioids to rural patients, they differed in their knowledge about e-prescribing and what healthcare access disparities may exist for the rural patient. No differences were reported between provider groups for cancer patients. Responses indicate an opportunity to work with providers to identify potential solutions for improving opioid prescribing practices in rural and cancer patients.
Spatial characteristics of open park spaces and perceived warmness in a tropical city
Authors: Hanif Noor Rosly , Fong Chng Saun , Ramakreshnan Logaraj , Aziz Wan Nor Azriyati Wan Abd , Aini Ainoriza Mohd , Sulaiman Nik Meriam , Aghamohammadi Nasrin 
Published: April 2020

Abstract
Background: Rapid urbanization in Kuala Lumpur Metropolitan City (KLMC) has resulted in urban heat island (UHI) effect that deteriorated public health of the urban dwellers. In a motive of identifying the heat sources, this study reported the perceived warmness and the characteristics of Open Park Spaces (OPS) that induce the reported warmness of the surrounding environment in Kuala Lumpur Metropolitan City (KLMC), a tropical city of Malaysia.Methods: A cross sectional survey using structured questionnaires is conducted on randomly clustered respondents in selected localities of KLMC from January to May, 2018. Pearson correlation is performed to examine the relationship between perceived characteristics of OPS and perceived warmness of the surrounding environment according to three time slots of a day.Results: The outcomes demonstrated that respondents felt warm during nights (89%) compared to morning (75%) and afternoon (87%). Meanwhile, the existing OPS are reported to be equipped with a mix of biodiversity such as birds, rodents and insects (89%), a mix of natural plants and animal populations (88%), water bodies (88%), variety of plants (86%), well-maintained grass surfaces (80%), ornamental flowers (79%) as well as wooded pasture (78%) in their neighbourhood. As the maximum warming sensation is reported to be felt at nights, especially in the presence of water bodies (r= 0.318, p<0.01) and wooded pasture (r= 0.222, p<0.01) in the vicinity, the integration of heat ameliorators across the existing water bodies and wood pasture deemed essential to reduce the surrounding heat impacts.Conclusion: The findings of this preliminary investigation are useful for urban designers and policy makers to make tacit evidence-based decisions.
Enhanced production of Canine parvovirus VP2 protein using improved Baculovirus expression system and its immunogenicity
Authors: Chang Dao , Liu Yangkun , Chen Yangyang , Hu Xiaomin , Burov Andrey , Puzyr Alexey , Bondar Vladimir , Yao Lunguang 
Published: April 2020

Abstract
Background : Canine parvovirus (CPV) is now recognized as a serious threat to dog industry worldwide. Vaccination remains the principal tool to control CPV infection. However, due to low yield, production of VP2 protein of CPV in baculovirus expression system remains challenging. The aim of this study was to increase the VP2 protein production by using a improved baculovirus expression system (Multibac) and evaluate the immunogenicity of the purified VP2 protein in mice. Results: The results showed that CPV VP2 protein was successfully expressed in the improved baculovirus expression system efficiently. A high level of expression of the full length VP2 protein was achieved using our modified system. The recombinant virus carrying two copies of VP2 showed the highest expression level, with a productivity of 186 mg/L, which is about 1.4-1.6 fold that of the recombinant viruses carrying only one copy. The purified protein could react with Mouse anti-His tag monoclonal antibody and Rabbit anti-VP2 polyclonal antibody with good reactogenicity. The mice were then immunized with purified full length VP2 protein to evaluate its immunogenicity. After vaccination, VP2 protein could induce the mice produce high level of hemagglutination inhibition antibodies. Conclusions: Full length CPV VP2 protein was successfully expressed at high level and purified efficiently. And it stimulated mice to produce high level of antibody. The full length VP2 expressed in this study could be used as a putative economic and efficient subunit vaccine against CPV infection.
Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina
Authors: Santos Leonardo Pozza , Meller Fernanda de Oliveira , Amann Valeria Romina , Schäfer Antônio Augusto 
Published: April 2020

Abstract
Background: Despite available information on trends in behavioral factors for Brazil and Argentina, little is known about the association of these trends with mortality. Understanding this association is important to avoid early deaths.Objectives: To evaluate temporal trends in behavioral risk and protective factors in Brazil and Argentina, and to assess their association with overall and cause-specific mortality rates.Methods: Ecological study with data from two population surveys from Brazil and Argentina. Weighted prevalence of tobacco smoking, excessive alcohol consumption, fruit and vegetable consumption and physical activity for the 27 Brazilian state capitals and for the 23 Argentinean provinces were used as behavioral factors. Information on overall mortality as well as cardiovascular diseases and cancer mortality for the year 2015 was collected from national mortality banks of both countries. Estimated prevalence rates were used to describe trends in behavioral factors from 2006 to 2014 in Brazil, and from 2005 to 2013 in Argentina, while Pearson’s correlation and linear regression models were used to assess their association with overall and cause-specific mortality rates.Results: Brazil presented improvements in behavioral risk and protective factors: sharp decrease in tobacco smoking prevalence (from 15% to 9%), increase in regular fruit and vegetable consumption (from 28% to 36%), and increase in physical activity (45% to 51%). In Argentina, results were more disappointing: small reduction in tobacco smoking (from 55% to 50%) and decrease in physical activity (from 55% to 45%). In both countries, excessive alcohol consumption remained stable, with increase only among women. The association between behavioral factors and mortality showed that in those Brazilian capitals with higher prevalence of regular consumption of fruits and vegetables, there were lower overall mortality rates. Stratification by gender revealed that significant results were only found among women.Conclusion: Prevalence of regular consumption of fruits and vegetables increased in Brazilian capitals and was associated with lower overall mortality rate, suggesting a positive impact of Brazilian policies to improve dietary intake patterns on its population’s mortality. Approaches focusing on behavioral factors are especially needed in Argentina to reach similar results of those seen in Brazil.
How to choose kinematic or mechanical alignment individually according to preoperative characteristics of patients?
Authors: Luan Chong , Xu Dong-Tan , Chen Ning-Jie , Wang Fei-Fei , Tian Kang- Song , Wei Chao , Wang Xian-Bin 
Published: April 2020

Abstract
Background Making decision in alignment techniques in total knee arthroplasty (TKA) remains controversial. This study aims to identify the potential patients who were suitable for the kinematic (KA) or mechanical alignment (MA). Methods We reviewed 296 patients (296 TKAs, including 114 KA-TKAs and 182 MA-TKAs) who underwent unilateral TKA using a portable navigation system from 2016 to 2018 in our prospectively maintained database. The minimum followup was 1 year. Clinical outcomes including range of motion (ROM) and knee society score (KSS) were compared between KA-TKAs and MA-TKAs. Multiple regression models were used to evaluate the relationship between alignment techniques and KSS at the 1-year followup. Interaction and stratified analyses were conducted according to gender, age, body mass index (BMI), preoperative hip-knee-ankle (HKA) angle, ROM and KSS. Results ROM and KSS at the 1-year followup didn’t differ between MA-TKAs and KA-TKAs (all p>0.05). Alignment techniques did not associate with postoperative ROM (Adjusted β=0.4, 95% confidence interval [CI]: -0.3, 1.6; p=0.752) or 1-year KSS (Adjusted β=2.2, 95%CI: -0.7, 5.6; p=0.107). Patients with BMI more than 30 kg/m^2 achieved better 1-year KSS when using MA than KA (p for interaction<0.05), Additionally, patients with preoperative HKA angle more than 10 degrees varus benefited more from KA than MA (p for interaction<0.05). Conclusions Patients with severe varus deformity may be suitable for the KA technique, whereas MA should be used in obese patients.
Soil origin and plant genotype structure distinct microbiome compartments in the model legume Medicago truncatula
Authors: Brown Shawn P. , Grillo Michael A. , Podowski Justin C. , Heath Katy Denise 
Published: April 2020

Abstract
Background: Understanding the genetic and environmental factors that structure plant microbiomes is necessary for leveraging these interactions to address critical needs in agriculture, conservation, and sustainability. Legumes, which form root nodule symbioses with nitrogen-fixing rhizobia, have served as model plants for understanding the genetics and evolution of beneficial plant-microbe interactions for decades, and thus have added value as models of plant-microbiome interactions. Here we use a common garden experiment with 16S rRNA gene amplicon and shotgun metagenomic sequencing to study the drivers of microbiome diversity and composition in three genotypes of the model legume Medicago truncatula grown in two native soil communities.Results: Bacterial diversity decreased between external (rhizosphere) and internal plant compartments (root endosphere, nodule endosphere, and leaf endosphere). Community composition was shaped by strong compartment x soil origin and compartment x plant genotype interactions, driven by significant soil origin effects in the rhizosphere and significant plant genotype effects in the root endosphere. Nevertheless all compartments were dominated by Ensifer, the genus of rhizobia that forms root nodule symbiosis with M. truncatula , and additional shotgun metagenomic sequencing suggests that the nodulating Ensifer were not genetically distinguishable from those elsewhere in the plant. We also identify a handful of OTUs that are common in nodule tissues, which are likely colonized from the root endosphere.Conclusions: Our results demonstrate strong host filtering effects, with rhizospheres driven by soil origin and internal plant compartments driven by host genetics, and identify several key nodule-inhabiting taxa that coexist with rhizobia in the native range. Our results set the stage for future functional genetic experiments aimed at expanding our pairwise understanding of legume-rhizobium symbiosis towards a more mechanistic understanding of plant microbiomes.
Open submucosal tunneling endoscopic resection for special submucosal tumors originating from the muscularis propria
Authors: Huang Silin , Tu Sufang , Fu Jingwen , Tang Xiaowei , Yang Genhua , Gong Wei 
Published: April 2020

Abstract
Background and Purpose Esophageal submucosal tumors (SMTs) are primarily benign but can have the potential for malignancy. Surgery is the primary treatment; however, the development of endoscopic techniques has promoted the use of endoscopic resection for esophageal SMTs. Submucosal tunneling endoscopic resection (STER) is the current optimal treatment for esophageal SMTs; however, it is challenging to perform in cases of tumors located in the upper esophagus and cardia as well as those with a diameter > 3.5 cm. Based on STER, we proposed and used open STER (O-STER) for special esophageal SMTs. The study aimed to evaluate the safety and efficacy of O-STER for special esophageal SMTs, including those located in the upper esophagus and cardia and those with a diameter > 3.5 cm. Methods The study enrolled 21 patients whose baseline characteristics, clinical data, and follow-up results were retrospectively analyzed. Results A total of 21 lesions were resected. The mean patient age was 44.2 ± 14.4 years. The mean tumor size was 38.2 ± 12.2 mm; 16 (76.2%) tumors had a diameter ≥ 3.5 cm. Tumors were in the cardia in 14 (66.7%) cases and in the upper esophagus in 2 (9.5%) cases. The mean operation time was 56.7 ± 19.3 minutes. The en bloc and complete resection rates were both 100%. There was 1 (4.8%) case of subcutaneous emphysema; no other serious complications were noted. Pathological examinations suggested that most tumors were leiomyomas and had negative margins. During the mean follow-up period of 26.7 months, no cases of residue, recurrence, or metastasis were observed. Conclusions O-STER is a safe and effective treatment for special esophageal SMTs that can reduce operative difficulty and complication rate.
Identification of drug targets and potential molecular mechanisms for Wantong Jingu Tablet extract in treatment of rheumatoid arthritis: bioinformatics analysis of fibroblast-like synoviocytes
Authors: Li Zhaodong , Qi Fangyuan , Li Fan 
Published: April 2020

Abstract
Background: Rheumatoid arthritis- fibroblast-like synoviocytes (RA-FLSs) play important roles in pathogenesis of rheumatoid arthritis (RA). Wantong Jingu Tablet (WJT), a mixture of traditional Chinese medicine, is a potentially effective therapy for RA, but its underlying mechanism is unclear. In this study, we explore the effects of WJT on human RA-FLSs and the underlying molecular mechanism. Methods: The major components of WJT were determined using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-QTOF/MS). Cell proliferative ability was evaluated by CCK-8, colony formation assay, and EdU incorporation assay. Cell apoptotic capacity was examined by caspase-3 and caspase-9 activity test. Protein levels of Bax and Bcl-2 were investigated by western blotting. High-throughput sequencing and bioinformatics analysis were conducted to screen and identify targeted genes, followed by identification by qRT-PCR and western blotting. Results: In this study, we have identified 346 compounds in WJT. Our results showed that WJT inhibited the RA-FLSs proliferation, and promoted apoptosis in a dose- and time-dependent manner. More importantly, 184 differentially expressed genes (DEGs) has been screened after WJT treatment based on DEGSeq2 and 278 DEGs was identified by DEGSeq2 combined with WGCNA. Then, 10 hub genes were identified based on two different analyses, while the expression levels of only SMC3 , THOC1 , BUB1 , and STAG2 were decreased after WJT treatment, which was identical to the sequencing profiles.Conclusions: WJT exerted its anti-proliferation and pro-apoptosis effects possibly through suppressing the expression of SMC3, THOC1, BUB1, and STAG2 in RA-FLSs. Thus, therapeutics targeting these genes may be a promising strategy for rescuing RA. Keywords: Rheumatoid arthritis; bioinformatics; fibroblast-like synoviocytes; Wantong Jingu Tablet
Associations of cognitive condition with nutritional status in an elderly population: an analysis based on a 7-year database in Chongqing, the Southwest of China
Authors: Yu Wuhan , Yu Weihua , Liu Xintong , Wan Tianchi , Chen Chenxi , Xiong Lei , Hu Cheng , Yu Xingyan , Yuan Shiyun , Zhang Wenbo , Zhong Fuxin , Qin Zhangjin , Yang Wenkai , Chen Daimin , Lü Yang 
Published: April 2020

Abstract
Background: Malnutrition is one of the health problems in the elderly population, which increases the risk of poor clinical outcomes. The purpose of this investigation was to evaluate the nutritional status and cognitive function of an elderly Chinese population, to explore the association between malnutrition and cognitive condition as well as the cognitive domain.Methods: A cross-sectional study was conducted in 2365 participants aged 60 years or above from January 2013 to September 2019. We used the Mini Nutritional Assessment Short Form (MNA-SF), and the Mini Mental State Examination (MMSE) to assess the impact of malnutrition on cognitive function. Nutrition-associated factors were analyzed.Results: 33.45% of the participants were identified as malnutrition risk and 5.54% were malnourished, while 36.74% had cognitive impairments. 48.63% had nutritional deficits and 53.65% had cognitive impairment in those over 80 years old. Malnutrition is associated with global cognition (ρ= 0.349, P < 0.0001) and the cognitive domain particularly in orientation (ρ= 0.343, P < 0.0001). The impact was extended to attention and calculation (ρ=0.310, P < 0.0001) as well as language (ρ= 0.302, P < 0.0001) of those over 80 years of age. Malnutrition is an independent risk factor for cognitive impairment after adjusting for other variables (OR=2.004, 95% CI: 1.621-2.479).Conclusion: The prevalence of malnutrition and cognitive impairment was relatively high and increased with age. Malnutrition leads to cognitive decline and disorientation, and also contributes to attention problems, calculation problem and language impairment in the oldest old. Thus, clinicians should assess the nutritional and cognitive status of the elderly regularly to the early dictation and timely intervention.
Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients
Authors: Han Xiudi , Liu Xuedong , Chen Liang , Wang Yimin , Li Hui , Zhou Fei , Xing Xiqian , Zhang Chunxiao , Suo Lijun , Wang Jinxiang , Yu Guohua , Wang Guangqiang , Yao Xuexin , Yu Hongxia , Wang Lei , Liu Meng , Xue Chunxue , Liu Bo , Zhu Xiaoli , Li Yanli , Xiao Ying , Li Lijuan , Cui Xiaojing , Cao Bin 
Published: April 2020

Abstract
Background: The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP). Methods: 3,011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis. Results: The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH<7.3, PaO 2 /FiO 2 < 200 mmHg, sodium <130 mmol/L, healthcare-associated pneumonia, white blood cells >10000/mm 3 , pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors. Conclusions: Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP. Trial registration : A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb