bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of PD-1/PD-L1 Inhibitors Combined With Palliative Radiotherapy and Anti-Angiogenic Therapy in Advanced Hepatocellular Carcinoma
Authors: Zhong Liting , Wu Dehua , Peng Weiwei , Sheng Hailong , Xiao Yazhi , Zhang Xuebing , Wang Yuli 
Published: May 2021

BackgroundPrevious studies have explored cancer immunotherapy with radiotherapy or anti-angiogenic therapy, but no trials have reported a triple therapy approach. This study aimed to investigate safety and clinical outcome of PD-1/PD-L1 inhibitors combined with palliative radiotherapy and targeted angiogenesis therapy in hepatocellular carcinoma (HCC) of Barcelona Clinic Liver Cancer (BCLC) stage C.MethodsConsecutive patients (n=16) treated with PD-1/PD-L1 inhibitors combined with radiotherapy and anti-angiogenic therapy in a bi-institutional cohort between July 2017 and December 2020 were retrospectively included. Radiotherapy was conducted within 14 days of the first administration of immunotherapy. The primary endpoint was treatment-related adverse event (TRAE).ResultsThe median follow-up was 383 days. Fifteen patients (93.8%) experienced at least 1 TRAE. The most common TRAEs of any grade were rash (25%), diarrhea (25%), aspartate aminotransferase increase (18.8%), alanine transaminase increase (18.8%), decreased appetite (18.8%), and fatigue (18.8%). Grade 3/4 TRAEs occurred in 4 patients (25%) and finally led to treatment interruption. No patient death was attributed to treatment. No specific events were responsible for the addition of radiotherapy. Six patients showed partial response, 7 showed stable disease, and 2 showed progressive disease. The objective response rate and disease control rate were 40.0% (95% CI 16.3%–67.7%) and 86.7% (95% CI 59.5%–98.3%), respectively. Moreover, the median progression-free survival was 140 days. Patients had a median overall survival of 637 days, and the estimated rates of survival at 6 and 12 months were 92.3% and 75.5%, respectively.ConclusionPD-1/PD-L1 inhibitors combined with palliative radiotherapy and anti-angiogenic therapy appear to be safe, with no unexpected adverse events. Additional studies exploring the clinical benefit are warranted.
Neutrophil to Lymphocyte Ratio Is Increased and Associated With Left Ventricular Diastolic Function in Newly Diagnosed Essential Hypertension Children
Authors: Hou Miao , Cao Lei , Ding Yueyue , Chen Ye , Wang Bo , Shen Jie , Zhou Wanping , Huang Jie , Xu Qiuqin , Lv Haitao , Sun Ling 
Published: May 2021

Aim: Hypertension is associated with cardiac structural and functional changes, including left ventricular hypertrophy (LVH) and LV systolic dysfunction diastolic dysfunction. Neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory biomarker associated with cardiovascular diseases. The current study aimed to evaluate NLR in children with newly diagnosed essential hypertension and its relationship between blood pressure and cardiac changes.Methods and Subjects: Sixty-five children with newly diagnosed essential hypertension and 54 healthy children were included. Clinical characteristics, blood cell counts, and biochemical parameters were collected. LVH was assessed by calculation of LV mass index (LVMI), and LV systolic function was evaluated by measuring LV ejection fraction and fractional shortening. LV diastolic function was primarily assessed with E/E′ ratio by Doppler and echocardiography.Results: The hypertension children had significantly higher LVMI and E/E′ ratio than the controls, whereas there was no difference in LV systolic function between the two groups. The NLR was significantly higher in the hypertension group than the control group. Moreover, NLR was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels in the hypertension group. Additionally, a significantly positive correlation between NLR and E/E′ ratio was found in the hypertension group. However, NLR was not related to LVH and LV systolic function indicators in hypertension children.Conclusion: NLR is elevated in hypertension children, and it is associated positively with office blood pressure levels. Moreover, NLR may help assess LV diastolic function in hypertension children.
Prevalence of Polypharmacy, Hyperpolypharmacy and Potentially Inappropriate Medication Use in Older Adults in India: A Systematic Review and Meta-Analysis
Authors: Bhagavathula Akshaya S. , Vidyasagar Kota , Chhabra Manik , Rashid Muhammed , Sharma Rishabh , Bandari Deepak K. , Fialova Daniela 
Published: May 2021

Background:Older people often receive multiple medications for chronic conditions, which often result in polypharmacy (concomitant use of 5‒9 medicines) and hyperpolypharmacy (concomitant use of ≥10 medicines). A limited number of studies have been performed to evaluate the prevalence of polypharmacy, hyperpolypharmacy, and potentially inappropriate medication (PIM) use in older people of developing countries. The present study aimed to investigate regional variations in the prevalence of polypharmacy, hyperpolypharmacy, and PIM use in older people (60 + years) in India.Methods:Studies were identified using Medline/PubMed, Scopus, and Google Scholar databases published from inception (2002) to September 31, 2020. Out of the total 1890 articles, 27 were included in the study.Results:Overall, the pooled prevalence of polypharmacy was 49% (95% confidence interval: 42–56;p&lt; 0.01), hyperpolypharmacy was 31% (21–40;p&lt; 0.01), and PIM use was 28% (24–32;p&lt; 0.01) among older Indian adults. Polypharmacy was more prevalent in North-east India (65%, 50–79), whereas hyperpolypharmacy was prevalent in south India (33%, 17–48). Region-wize estimates for the pooled prevalence of PIM use in India were as follows: 23% (21–25) in East, 33% in West (24–42), 17.8% in North (11–23), and 32% (26–38) in South India. The prevalence of PIM use in adults aged ≥70°years was 35% (28–42), in those taking more medications (≥5.5/day) was 27% (22–31), and in adults using a high number of PIMs (≥3) was 29% (22–36). Subgroup analysis showed that cross-sectional studies had a higher pooled prevalence of polypharmacy 55% (44–65) than cohorts 45% (37–54). Hyperpolypharmacy in inpatient care settings was 37% (26–47), whereas PIM use was higher in private hospitals 31% (24–38) than government hospitals 25% (19–31).Conclusion:Polypharmacy and hyperpolypharmacy are widely prevalent in India. About 28% of older Indian adults are affected by PIM use. Thus, appropriate steps are needed to promote rational geriatric prescribing in India.Systematic Review Registration:https://clinicaltrials.gov, identifier [CRD42019141037].
Non-Persistence With Antiplatelet Medications Among Older Patients With Peripheral Arterial Disease
Authors: Wawruch Martin , Murin Jan , Tesar Tomas , Paduchova Martina , Petrova Miriam , Celovska Denisa , Havelkova Beata , Trnka Michal , Aarnio Emma 
Published: May 2021

Introduction: Antiplatelet therapy needs to be administered life-long in patients with peripheral arterial disease (PAD). Our study was aimed at 1) the analysis of non-persistence with antiplatelet medication in older PAD patients and 2) identification of patient- and medication-related characteristics associated with non-persistence.Methods: The study data was retrieved from the database of the General Health Insurance Company. The study cohort of 9,178 patients aged ≥ 65 years and treated with antiplatelet medications was selected from 21,433 patients in whom PAD was newly diagnosed between 01/2012 and 12/2012. Patients with a 6 months treatment gap without antiplatelet medication prescription were classified as non-persistent. Characteristics associated with non-persistence were identified using the Cox regression.Results: At the end of the 5 years follow-up, 3,032 (33.0%) patients were non-persistent. Age, history of ischemic stroke or myocardial infarction, clopidogrel or combination of aspirin with clopidogrel used at the index date, higher co-payment, general practitioner as index prescriber and higher overall number of medications were associated with persistence, whereas female sex, atrial fibrillation, anxiety disorders, bronchial asthma/chronic obstructive pulmonary disease, being a new antiplatelet medication user (therapy initiated in association with PAD diagnosis), and use of anticoagulants or antiarrhythmic agents were associated with non-persistence.Conclusion: In patients with an increased probability of non-persistence, an increased attention should be paid to improvement of persistence.
The Effects of Menstrual Cycle Phase on Elite Athlete Performance: A Critical and Systematic Review
Authors: Meignié Alice , Duclos Martine , Carling Christopher , Orhant Emmanuel , Provost Peggy , Toussaint Jean-François , Antero Juliana 
Published: May 2021

Background: In elite athletes, training individualization is widely recommended to optimize competitive performance. Previous studies have evidenced the impact of hormonal fluctuations on different performance parameters among female athletes. While consideration of menstrual cycle (MC) phases as a parameter in training individualization strategies is necessary, systematic evidence identifying such impacts in elite athletes should be evaluated.Objective: Systematically review publications that have investigated the link between MC phases and performance in elite female athletes. The overarching aim is to identify whether a consensus across studies exists enabling evidence-based recommendations for training individualization depending on menstrual cycle phases.Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three major scientific publication databases were searched from inception until November 3, 2020. Studies included focused on the influence of physiological or psychological parameters throughout at least one phase of the menstrual cycle of elite athletes.Results: A total of 780 search results were yielded and 26 references from a past bibliography were added manually. About 662 papers were reviewed of which 218 studies were assessed for eligibility. Of these, only seven (1%) precisely investigated the influence of a performance or physical parameter during at least one menstrual cycle phase. These seven studies included a total of 314 elite female participants (20.58 ± 1.91 years). Three used interviews, questionnaires or prospective analyses of reports. Four conducted several performance tests or included physical measures although only two performed tests during training or before/during competition. Among the seven studies, five performed hormonal testing through sampling of blood, saliva, or urine. The remaining relied on athletes’ menstruation diaries. The current evidence suggests a variable association between menstrual cycle and a few performance-related outcomes, such as endurance or power resistance, ligament stiffness, decision making skills, psychology, or competitiveness.Conclusion: Different sports performance-related parameters are affected during the menstrual cycle among elite athletes, but the parameters themselves and the magnitude and the direction of the effects are inconclusive. Additional longitudinal and prospective studies to systematically monitor on-field performance parameters are urgently required in order to enable recommendations and training individualization in female elite athletes.
Isha Yoga Practices and Participation in Samyama Program are Associated with Reduced HbA1C and Systemic Inflammation, Improved Lipid Profile, and Short-Term and Sustained Improvement in Mental Health: A Prospective Observational Study of Meditators
Authors: Sadhasivam Senthilkumar , Alankar Suresh , Maturi Raj , Williams Amy , Vishnubhotla Ramana V. , Hariri Sepideh , Mudigonda Mayur , Pawale Dhanashri , Dubbireddi Sangeeth , Packiasabapathy Senthil , Castelluccio Peter , Ram Chithra , Renschler Janelle , Chang Tracy , Subramaniam Balachundhar 
Published: May 2021

Background: Meditation is gaining recognition as a tool to impact health and well-being. Samyama is an 8-day intensive residential meditation experience conducted by Isha Foundation requiring several months of extensive preparation and vegan diet. The health effects of Samyama have not been previously studied. The objective was to assess physical and emotional well-being before and after Samyama participation by evaluating psychological surveys and objective health biomarkers.Methods: This was an observational study of 632 adults before and after the Isha Samyama retreat. All participants were invited to complete surveys. Controls included household significant others. Surveys were completed at baseline (T1), just before Samyama (T2), immediately after Samyama (T3), and 3 months later (T4) to assess anxiety, depression, mindfulness, joy, vitality, and resilience through validated psychometric scales. Voluntary blood sampling for biomarker analysis was done to assess hemoglobin (Hb), HbA1c, lipid profile, and C-reactive protein (CRP). Primary outcomes were changes in psychometric scores, body weight, and blood biomarkers.Results: Depression and anxiety scores decreased from T1 to T3, with the effect most pronounced in participants with baseline depression or anxiety. Scores at T4 remained below baseline for those with pre-existing depression or anxiety. Vitality, resilience, joy, and mindfulness increased from T1 to T3 (sustained at T4). Body weight decreased by 3% from T1 to T3. Triglycerides (TG) were lower from T2 to T3. Participants had lower HbA1c and HDL at T2, and lower CRP at all timepoints compared with controls.Conclusions: Participation in the Isha Samyama program led to multiple benefits. The 2-month preparation reduced anxiety, and participants maintained lower anxiety levels at 3 months post-retreat. Physical health improved over the course of the program as evidenced by weight loss and improved HbA1C and lipid profile. Practices associated with the Samyama preparation phase and the retreat may serve as an effective way to improve physical and mental health. Future studies may examine their use as an alternative therapy in patients with depression and/or anxiety.Clinical Trial Registration:www.ClinicalTrials.gov, Identifier: 1801728792. Registered retrospectively on 4/17/2020.
Persistence of Multimorbidity Among Women Aged 15–49 Years in India: An Analysis of Prevalence, Patterns and Correlation
Authors: Hossain Babul , Govil Dipti , Sk Md Illias K. 
Published: May 2021

Objectives: The present study has examined the patterns and possible correlates of coexisting morbidities among women aged 15–49 years based on biomarker measurement data at the national level in India.Methods: National Family Health Survey conducted during 2015–16 used in the present study. Simple disease count approach was used to calculate the multimorbidity among women. Multinomial logistic regression was applied to analyze the predictors of multimorbidity among women.Results: Almost 30% of the women had any of the selected morbidity and 9% of them had two or more morbidities. Hypertension and overweight combination (3%) was the most prevalent among women. The risk of having two or more morbidities was predominantly high among women aged above 30 years, low educated women, women from the wealthier group, ever-married women and women who were consuming tobacco as compared to their counterparts.Conclusions: From the policy perspective, the identification of groups of women vulnerable to multimorbidity will help in the selection of programmatic focus and preventive public health intervention in adult phase to reduce the multimorbidity burden among women in old ages.
Adolescentes cumprindo medidas socioeducativas
Authors: VIEIRA Danielli 
Published: May 2021

Este artigo traz reflexões tangenciadas pelas categorias adolescência, medidas socioeducativas, governamentalidade, moralidades e subjetivação a partir de uma etnografia
acerca da “experiência” na vida do crimee centrada em narrativas de meninos e meninas em cumprimento de medidas socioeducativas na região sul do Brasil. Discute a dimensão moral que atravessa os discursos e práticas de/sobre tais sujeitos e especialmente a
gerência do Estado sobre eles via processos de judicialização, tutela, institucionalização,
ortopedias morais. Reflete, também, sobre os efeitos desses processos na produção de
subjetividades bem como as resistências dos sujeitos.
A Stellar Activity F-statistic for Exoplanet Surveys (SAFE)
Authors: Holzer Parker H. , Cisewski-Kehe Jessi , Zhao Lily , Ford Eric B. , Gilbertson Christian , Fischer Debra A. 
Published: May 2021

Abstract
In the search for planets orbiting distant stars, the presence of stellar activity in the atmospheres of observed stars can obscure the radial velocity signal used to detect such planets. Furthermore, this stellar activity contamination is set by the star itself and cannot simply be avoided with better instrumentation. Various stellar activity indicators have been developed that may correlate with this contamination. We introduce a new stellar activity indicator called the Stellar Activity F-statistic for Exoplanet surveys (SAFE) that has higher statistical power (i.e., probability of detecting a true stellar activity signal) than many traditional stellar activity indicators in a simulation study of an active region on a Sun-like star with a moderate-to-high signal-to-noise ratio. Also through simulation, the SAFE is demonstrated to be associated with the projected area on the visible side of the star covered by active regions. We also demonstrate that the SAFE detects statistically significant stellar activity in most of the spectra for HD 22049, a star known to have high stellar variability. Additionally, the SAFE is calculated for recent observations of the three low-variability stars HD 34411, HD 10700, and HD 3651, the latter of which is known to have a planetary companion. As expected, the SAFE for these three only occasionally detects activity. Furthermore, initial exploration appears to indicate that the SAFE may be useful for disentangling stellar activity signals from planet-induced Doppler shifts.
Laboratory Data on the EUV/Soft-X-Ray Flux Problem of Fe xviii and Fe xix
Authors: Träbert Elmar , Beiersdorfer Peter 
Published: May 2021

Abstract
Observations by the spacecraft Extreme Ultraviolet Explorer (EUVE), Far Ultraviolet Spectroscopic Explorer (FUSE), Chandra, and XMM-Newton of Capella (α Aurigae) have encountered problems with the relative intensities of the Fe xviii and Fe xix line emission in the soft-X-ray (XUV) and extreme-ultraviolet spectral ranges versus various model predictions based on theoretical atomic data. The reason may either lie in astrophysical phenomena, e.g., at emission or because of absorption by the interstellar medium, in the theoretical atomic data, in one or more spectrometer calibrations, or in the spectral modeling. By measurements using an electron beam ion trap we provide laboratory data obtained under conditions that are reasonably close to stellar emission regions. The laboratory data on Fe xviii and Fe xix show line ratios that are rather similar to the observations of Capella. The measurements, therefore, rule out astrophysical phenomena and calibration errors and point to issues with the modeling of the observed Capella emission.
Magnetohydrodynamic Simulations of Spicular Jet Propagation Applied to Lower Solar Atmosphere Model
Authors: Mackenzie Dover Fionnlagh , Sharma Rahul , Erdélyi Robertus 
Published: May 2021

Abstract
We report a series of numerical experiments for the propagation of a momentum pulse representing a chromospheric jet, simulated using an idealized magnetohydrodynamic model. The jet in a stratified lower solar atmosphere is subjected to a varied initial driver (amplitude, period) and magnetic field conditions to examine the parameter influence over jet morphology and kinematics. The simulated jet captured key observed spicule characteristics including maximum heights, field-aligned mass motions/trajectories, and cross-sectional width deformations. Next, the jet features also show a prominent bright, bulb-like apex, similar to reported observed chromospheric jets, formed due to the higher density of plasma and/or waves. Furthermore, the simulations highlight the presence of not yet observed internal crisscross/knots substructures generated by shock waves reflected within the jet structure. Therefore we suggest verifying these predicted fine-scale structures in highly localized lower solar atmospheric jets, e.g., in spicules or fibrils by high-resolution observations, offered by the Daniel K. Inoyue Solar Telescope or otherwise.
X-Ray Constraint on the Location of the AGN Torus in the Circinus Galaxy
Authors: Uematsu Ryosuke , Ueda Yoshihiro , Tanimoto Atsushi , Kawamuro Taiki , Setoguchi Kenta , Ogawa Shoji , Yamada Satoshi , Odaka Hirokazu 
Published: May 2021

Abstract
The location of the obscuring “torus” in an active galactic nucleus (AGN) is still an unresolved issue. The line widths of X-ray fluorescence lines originating from the torus, particularly Fe Kα, carry key information on the radii of line-emitting regions. Utilizing XCLUMPY, an X-ray clumpy torus model, we develop a realistic model of emission line profiles from an AGN torus where we take into account line broadening due to the Keplerian motion around the black hole. Then, we apply the updated model to the best available broadband spectra (3–100 keV) of the Circinus galaxy observed with Suzaku, XMM-Newton, Nuclear Spectroscopic Telescope Array, and Chandra, including 0.62 Ms Chandra/HETG data. We confirm that the torus is Compton-thick (hydrogen column density along the equatorial plane is

), geometrically thin (torus angular width

), viewed edge-on (inclination

), and has supersolar abundance (

times solar). Simultaneously analyzing the Chandra/HETG first-, second-, and third-order spectra with consideration of the spatial extent of the Fe Kα line-emitting region, we constrain the inner radius of the torus to be

times the gravitational radius, or

for a black hole mass of (1.7 ± 0.3) × 106
M
⊙. This is about three times smaller than that estimated from the dust sublimation radius, suggesting that the inner side of the dusty region of the torus is composed of dust-free gas.
Circumbinary Disk Accretion into Spinning Black Hole Binaries
Authors: Lopez Armengol Federico G. , Combi Luciano , Campanelli Manuela , Noble Scott C. , Krolik Julian H. , Bowen Dennis B. , Avara Mark J. , Mewes Vassilios , Nakano Hiroyuki 
Published: May 2021

Abstract
Supermassive black hole binaries are likely to accrete interstellar gas through a circumbinary disk. Shortly before merger, the inner portions of this circumbinary disk are subject to general relativistic effects. To study this regime, we approximate the spacetime metric of close orbiting black holes by superimposing two boosted Kerr–Schild terms. After demonstrating the quality of this approximation, we carry out very long-term general relativistic magnetohydrodynamic simulations of the circumbinary disk. We consider black holes with spin dimensionless parameters of magnitude 0.9, in one simulation parallel to the orbital angular momentum of the binary, but in another anti-parallel. These are contrasted with spinless simulations. We find that, for a fixed surface mass density in the inner circumbinary disk, aligned spins of this magnitude approximately reduce the mass accretion rate by 14% and counter-aligned spins increase it by 45%, leaving many other disk properties unchanged.