bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Associated With Sarcopenia Risk in Hospitalized Renal Cell Carcinoma Patients
Authors: Hu Qiang , Mao Weipu , Wu Tiange , Xu Zhipeng , Yu Junjie , Wang Can , Chen Saisai , Chen Shuqiu , Xu Bin , Xu Yueshuang , Chen Ming 
Published: October 2021

PurposeThis study aimed i) to identify the best cutoff points of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) that predict sarcopenia and ii) to illustrate the association between sarcopenia risk and NLR or PLR in renal cell carcinoma (RCC) patients undergoing laparoscopic partial or radical nephrectomy.MethodsA total of 343 RCC patients who underwent laparoscopic partial or radical nephrectomy between 2014 and 2019 were enrolled in our study. Sarcopenia was assessed by lumbar skeletal muscle index (SMI). Receiver operating characteristic (ROC) curve was used to identify the best cutoff point of NLR or PLR to predict sarcopenia risk. Univariate and multivariate logistic regression and dose–response analysis curves of restricted cubic spline function were conducted to assess the relationship between sarcopenia and NLR or PLR.ResultsThe best cutoff points of NLR &gt;2.88 or PLR &gt;135.63 were confirmed by the ROC curve to predict sarcopenia risk. Dose–response curves showed that the risk of sarcopenia increased with raising NLR and PLR. Patients with NLR &gt;2.88 or PLR &gt;135.63 had a higher sarcopenia risk than those in the NLR ≤2.8 or PLR ≤135.63 group, respectively. By adjusting for all variables, we found that patients with NLR &gt;2.88 and PLR &gt;135.63 had 149% and 85% higher risk to develop sarcopenia, respectively, than those with NLR ≤2.8 (aOR = 2.49; 95% CI = 1.56–3.98; p &lt; 0.001) or PLR ≤135.63 (aOR = 1.85; 95% CI = 1.16–2.95; p = 0.010).ConclusionIn RCC patients receiving laparoscopic partial or radical nephrectomy, NLR and PLR, which were biomarkers of systemic inflammation, were associated with sarcopenia risk.
Real-World Lenvatinib Versus Sorafenib in Patients With Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis
Authors: Kuo Yuan-Hung , Lu Sheng-Nan , Chen Yen-Yang , Kee Kwong-Ming , Yen Yi-Hao , Hung Chao-Hung , Hu Tsung-Hui , Chen Chien-Hung , Wang Jing-Houng 
Published: October 2021

BackgroundLenvatinib is approved for patients with advanced hepatocellular carcinoma (HCC) due to its non-inferiority to sorafenib of overall survival (OR) in clinical trials. This study was to compare the effectiveness and safety of lenvatinib and sorafenib in the real world.MethodsWe retrospectively evaluated 338 patients with unresectable HCC who had undergone lenvatinib or sorafenib treatment between January 2018 and August 2020. Propensity-score matching analysis was performed with a 1:2 ratio to reduce the real-life baseline difference between the two groups.ResultsA total of 210 patients (Male/Female: 150/60, mean age: 65.8 years) were recruited including 70 patients in the Lenvatinib group and 140 patients in the Sorafenib group. Compared with sorafenib, lenvatinib had significantly longer progression-free survival (PFS) (5.2 vs 3.3 months, p=0.019) but similar OR (13.3 vs 11.8 months, p=0.714). Additionally, lenvatinib had better disease control rates (62.3 vs 48.6%, p=0.029) and equivalent incidences of treatment-related adverse events over sorafenib. In multivariate analysis, lenvatinib was associated with better PFS over sorafenib (hazard ratio: 0.49, 95% confidence interval: 0.3–0.79, p=0.004) after adjustments of albumin-bilirubin grade and alpha-fetoprotein level; however, different agents using lenvatinib or sorafenib did not contribute to OS, whether in univariate or multivariate analysis. Patients who failed lenvatinib had a lower proportion of having sequential systemic therapies compared with the Sorafenib group (36.2 vs 47.8%, p=0.02). The most frequently used sequential therapy following lenvatinib and sorafenib was chemotherapy (n=9, 42.8%) and regorafenib (n=33, 50.8%), respectively.ConclusionsIn clinical real-life practice, lenvatinib illustrated promising survival benefits and acceptable safety for patients with unresectable HCC, while reducing the risk of progression disease compared with sorafenib. Additionally, lack of approved post-lenvatinib systemic therapies is a serious issue in the real world.
Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors for Advanced Non-small Cell Lung Cancer: A Network Meta-Analysis of Randomized Clinical Trials
Authors: Zhang Weidong , Gu Jingjing , Bian Chunming , Huang Guanhong 
Published: October 2021

Objective: This network meta-analysis will provide a complete toxicity profile, toxicity profile, and safety ranking of immune checkpoint inhibitors (ICIs) for treatment of advanced non-small cell lung cancer (NSCLC).Methods: We found 12 phase II or III randomized clinical trials (RCTs) including 8,453 patients with NSCLC by searching Pubmed, Embase, and ClinicalTrials.gov. Risk ratios (RRs) and 95% confidence interval (CI) were used to compare the rate of immune-related adverse events (irAEs) for different ICIs-based treatments using pairwise and network meta-analysis with random effects.Results: For dermatologic irAEs, the corresponding ranking of incidences of the seven groups from high to low was: nivolumab + ipilimumab (97.4%), pembrolizumab (80.1%), nivolumab (67.1%), pembrolizumab + platinum (43.3%), atezolizumab + platinum (39.9%), durvalumab (17.5%), platinum-based chemotherapy (4.7%). For colitis, the corresponding ranking of incidences of the six groups from high to low was: atezolizumab + platinum (77.1%), nivolumab (67.3%), pembrolizumab (60.5%), durvalumab (45.2%), pembrolizumab + platinum (41.4%), platinum-based chemotherapy (8.5%). For endocrine irAEs, the corresponding ranking of incidences of the seven groups from high to low was: nivolumab + ipilimumab (79.1%), durvalumab (69.1%), pembrolizumab (61.9%), atezolizumab + platinum (60.4%),nivolumab (45.7%), pembrolizumab + platinum (33.5%), platinum-based chemotherapy (0.3%). For pneumonitis, the corresponding ranking of incidences of the seven groups from high to low was: pembrolizumab (99.3%), pembrolizumab + platinum (65.1%), durvalumab (62.2%), atezolizumab + platinum (56%), nivolumab (35.9%), platinum-based chemotherapy (18.1%),atezolizumab (13.3%). For hepatitis, the corresponding ranking of incidences of the six groups from high to low was: pembrolizumab (71.2%), pembrolizumab + platinum (64.3%), durvalumab (56.4%), atezolizumab + platinum (53.8%), nivolumab (44.5%), platinum-based chemotherapy (9.8%).Conlusion: In addition to platinum-based chemotherapy, durvalumab for dermatologic and liver irAEs, pembrolizumab for gastrointestinal irAEs, pembrolizumab + platinum for endocrine irAEs, and atezolizumab for pneumonitis may be associated with lower rates of irAEs than other immune-based regimens. Nivolumab + ipilimumab for dermatologic and endocrine irAEs, atezolizumab + platinum for colitis, and pembrolizumab for pneumonitis and hepatitis may be associated with higher rates of irAEs.
Institutional Satisfaction and Anxiety Mediate the Relationship Between Social Support and Depression in Hypertension Patients in Elderly Caring Social Organizations: A Cross-Sectional Study
Authors: Ji Kai , Bai Zhongliang , Tang Ling , Yan Huosheng , Zhu Ying , Chen Guimei , Chen Ren 
Published: October 2021

Background:Depression is a prevalent health condition among hypertension patients in elderly caring social organizations (SOs). Patients with hypertension and depression symptoms have worse health outcomes than those without depression. As the population ages, chronic and mental health issues such as depression of hypertension patients in elderly caring SOs have become prominent. However, the combined effects of social support, institutional satisfaction, and anxiety on depression among hypertension individuals in elderly caring SOs remain unclear. This study aimed to explore the mediating effects of institutional satisfaction and anxiety on the relationship between social support and depression among hypertension patients in elderly caring SOs in Anhui Province, China.Methods:A cross-sectional study was conducted using a multi-stage stratified random sampling method. A questionnaire was used to collect data on demographic characteristics, the satisfaction of elderly caring SOs, social support, anxiety, and depression. A multiple linear regression model was utilized to investigate depression-related factors, and structural equation modeling (SEM) was employed to examine the relationships between social support, institutional satisfaction, anxiety, and depression among patients with hypertension in elderly caring SOs.Results:Our results indicated that the mean scores of social support were 20.19 ± 6.98 and 1.92 ± 3.18 for anxiety, and 6.24 ± 5.03 for depression; besides, 33.3% of participants were very satisfied with elderly caring SOs, 48.5% were satisfied, and only 6.0% were dissatisfied or very dissatisfied. Comorbid chronic diseases were significantly associated with depression. Institutional satisfaction was directly negatively related to depression, whereas anxiety was directly positively correlated with depression. Social support had an indirect negative association with depression by the mediating effects of institutional satisfaction and anxiety.Conclusions:The study highlights the importance of social support in maintaining mental health among hypertension patients residing in elderly caring SOs. To alleviate depression among hypertension patients in elderly caring SOs, strategies that target enhancing social support, institutional satisfaction, and anxiety reduction should be prioritized. More importantly, more attention should be paid to patients with comorbid chronic diseases.
Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review
Authors: Paulus Frank W. , Ohmann Susanne , Möhler Eva , Plener Paul , Popow Christian 
Published: October 2021

Background:Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature.Methods:This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2–17 years) using the following search terms: “emotional dysregulation” OR “affect dysregulation,” retrieving 943 articles.Results:The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED.Conclusion:Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
A Local Health Situation Room for COVID-19: Recommendations for Decision-Making From a Higher Education Institution in Mexico
Authors: Ramos Herrera Igor Martín , Romero Lozano Diana Core , López Corona Adolfo , Muñoz Valle José Francisco , González Castañeda Miguel Ernesto , Pérez Gómez Héctor Raúl , Kasten Monges Marina de Jesús , Ramos Solano Moisés , Ruvalcaba Romero Norma Alicia , Pérez Ávila Fabian Alejandro , Yokogawa Teraoka Patricia , Macedo Ojeda Gabriela 
Published: October 2021

Introduction: The Situation Room is a physical or virtual space where experts systematically analyze information to characterize a health situation, especially during emergencies. Decision-making processes are made toward solving health needs and promoting collaboration among institutions and social sectors. This paper presents the context and circumstances that led the University of Guadalajara (UdeG) to install a local health situation room (HSR) to address the COVID-19 pandemic at this institution based in the state of Jalisco, Mexico, a narrative is also made of its working processes and some of its results.Methods: The design of this situation room for COVID-19 was based on the methodology established by the Pan American Health Organization (PAHO)/WHO. This local-type situation room was installed on February 12, 2020. The health problem was characterized, and strategic lines, objectives, and goals were established; the first analysis was derived from an action plan deployed at the UdeG. The strategic lines were situational diagnosis, preventive actions, and containment strategies.Results: The situation room influenced the activities of the UdeG before the epidemic cases started in the state. One of the actions with the greatest impact was developing a mathematical model for predicting COVID-19 cases. Subsequently, new models have been developed according to the epidemiological evolution of the disease, helping manage the epidemic in the state. Another important result was the early closing of face-to-face university activities, reducing contagion risks and the mobility of more than 310,000 students, faculty, and administrative personnel throughout Jalisco.Conclusions: A consequence of the closure was that the confinement generated by the pandemic was the change to virtual meetings from April 2020 to date; but at the same time, this working format was a strength, since it influenced the decision of the university board to change all the academic activities to virtual format before other educational, economic, and social activities in the state did. By April 2020, the situation room transcended its institutional boundaries and was invited to participate at the Jalisco State's Health Committee. Its recommendations have helped to maintain the state with one of Mexico's lowest COVID-19 incidence and mortality rates.
Risk Factors for Anorectal Dysfunction After Interspincteric Resection in Patients With Low Rectal Cancer
Authors: Min Li , Fan Zhang , Zhi Wang , Pingang Li , Lijuan Xie , Min Deng , Yan Wen , Xiaosong Wang , Bo Tang 
Published: October 2021

Purpose: The objective of this study was to explore the risk factors for anorectal dysfunction after intersphincteric resection in patients with low rectal cancer.Methods: A total of 251 patients who underwent intersphincteric resection from July 2014 to June 2020 were included in this study, for which the Kirwan's grade, Wexner score, and anorectal manometric index were used to evaluate the anorectal function and other parameters including demographics, surgical features, and clinical and pathological characteristics. These parameters were analysed to explore the potential risk factors for anorectal function after intersphincteric resection.Results: In the 251 included patients, 98 patients underwent partial intersphincteric resection, 87 patients underwent subtotal intersphincteric resection, and 66 patients underwent total intersphincteric resection. There were 53 (21.1%) patients who had postoperative complications, while no significant difference was observed between the three groups. Furthermore, 30 patients (45.5%) in the total intersphincteric resection group were classified as having anorectal dysfunction (Kirwan's grade 3–5), which was significantly higher than that in the partial intersphincteric resection group (27.6%) and subtotal intersphincteric resection group (29.9%). The mean Wexner score of patients that underwent total intersphincteric resection was 7.9, which was higher than that of patients that had partial intersphincteric resection (5.9, p = 0.002) and subtotal intersphincteric resection (6.4, p = 0.027). The initial perceived volume was lower in the total intersphincteric resection group than in the partial and subtotal intersphincteric resection groups at 1, 3, and 6 months after intersphincteric resection. In addition, the resting pressure, maximum squeeze pressure, and maximum tolerated volume in the total intersphincteric resection group were worse than those in the partial and subtotal groups at 3 and 6 months after intersphincteric resection. Univariate and multivariate analyses suggested that an age ≥65, total intersphincteric resection, and preoperative chemoradiotherapy were independent risk factors for anorectal dysfunction (P = 0.023, P = 0.003, and P = 0.008, respectively). Among the 66 patients who underwent total intersphincteric resection, 17 patients received preoperative chemoradiotherapy, of which 12 patients (70.6%) were classified as having anorectal dysfunction.Conclusion: The current study concluded that age ≥65, total intersphincteric resection, and preoperative chemoradiotherapy were risk factors for anorectal dysfunction after intersphincteric resection. The morbidity of anorectal dysfunction after total intersphincteric resection for patients who received preoperative chemoradiotherapy was relatively high, and the indication should be carefully evaluated.
H-alpha and Ca ii Infrared Triplet Variations During a Transit of the 23 Myr Planet V1298 Tau c
Authors: Feinstein Adina D. , Montet Benjamin T. , Johnson Marshall C. , Bean Jacob L. , David Trevor J. , Gully-Santiago Michael A. , Livingston John H. , Luger Rodrigo 
Published: October 2021

Abstract
Young transiting exoplanets (<100 Myr) provide crucial insight into atmospheric evolution via photoevaporation. However, transmission spectroscopy measurements to determine atmospheric composition and mass loss are challenging due to the activity and prominent stellar disk inhomogeneities present on young stars. We observed a full transit of V1298 Tau c, a 23 Myr, 5.59 R
⊕ planet orbiting a young K0-K1.5 solar analog with GRACES on Gemini North. We were able to measure the Doppler tomographic signal of V1298 Tau c using the Ca ii infrared triplet (IRT) and find a projected obliquity of λ = 5° ± 15°. The tomographic signal is only seen in the chromospherically driven core of the Ca ii IRT, which may be the result of star-planet interactions. Additionally, we find that excess absorption of the Hα line decreases smoothly during the transit. While this could be a tentative detection of hot gas escaping the planet, we find this variation is consistent with similar timescale observations of other young stars that lack transiting planets over similar timescales. We show this variation can also be explained by the presence of starspots with surrounding facular regions. More observations both in and out of the transits of V1298 Tau c are required to determine the nature of the Ca ii IRT and Hα line variations.
MHD-PIC Simulations of Cosmic-Ray Scattering and Transport in Inhomogeneously Ionized Plasma
Authors: Bambic Christopher J. , Bai Xue-Ning , Ostriker Eve C. 
Published: October 2021

Abstract
Cosmic rays (CRs) have critical impacts in the multiphase interstellar medium (ISM), driving dynamical motions in low-density plasma and modifying the ionization state, temperature, and chemical composition of higher-density atomic and molecular gas. We present a study of CR propagation in inhomogeneously ionized plasma, addressing CR transport issues that arise in the cloudy ISM. Using one-dimensional magnetohydrodynamic (MHD) particle-in-cell simulations that include ion–neutral drag to damp Alfvén waves in a portion of the simulation domain, we self-consistently evolve the kinetic physics of CRs and background gas MHD. By introducing a damping region in our periodic domain, our simulations break translational symmetry and allow the emergence of spatial gradients in the CR distribution function. A spatial gradient opposite to the CR flux forms across the fully ionized region as a result of pitch angle scattering. We connect our results with CR hydrodynamics formulations by computing the wave–particle scattering rates as predicted by quasilinear, fluid, and Fokker–Planck theory. For momenta where the mean free path is short relative to the box size, we find excellent agreement among all scattering rates. However, we also find evidence of a reduced scattering rate for less energetic particles that are subject to the μ = 0 barrier in our simulations. Our work provides a first-principles verification of CR hydrodynamics when particles stream down their pressure gradient and opens a pathway toward comprehensive calibrations of transport coefficients from self-generated Alfvén wave scattering with CRs.
Infrared Excesses Around Bright White Dwarfs from Gaia and unWISE. II
Authors: Lai 赖 Samuel 民希 , Dennihy Erik , Xu 许 Siyi 偲艺 , Nitta Atsuko , Kleinman Scot , Leggett S. K. , Bonsor Amy , Hodgkin Simon , Rebassa-Mansergas Alberto , Rogers Laura K. 
Published: October 2021

Abstract
Infrared excesses around white dwarf stars indicate the presence of various astrophysical objects of interest, including companions and debris disks. In this second paper of a series, we present follow-up observations of infrared excess candidates from Gaia and unWISE discussed in the first paper, Paper I. We report space-based infrared photometry at 3.6 and 4.5 micron for 174 white dwarfs from the Spitzer Space Telescope and ground-based near-infrared J, H, and K photometry of 235 white dwarfs from Gemini Observatory with significant overlap between Spitzer and Gemini observations. These data are used to confirm or rule out the observed unWISE infrared excess. From the unWISE-selected candidate sample, the most promising infrared excess sample comes from both color and flux excess, which has a Spitzer confirmation rate of 95%. We also discuss a method to distinguish infrared excess caused by stellar or sub-stellar companions from potential dust disks. In total, we confirm the infrared excess around 62 white dwarfs, 10 of which are likely to be stellar companions. The remaining 52 bright white dwarfs with infrared excess beyond two microns has the potential to double the known sample of white dwarfs with dusty exoplanetary debris disks. Follow-up high-resolution spectroscopic studies of a fraction of confirmed excess white dwarfs in this sample have discovered emission from gaseous dust disks. Additional investigations will be able to expand the parameter space from which dust disks around white dwarfs are found.