bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Circulating Proprotein Convertase Subtilisin/Kexin Type 9 Concentrations and Cardiovascular Events in Cardiovascular Disease: A Systemic Review and Meta-Analysis
Authors: Liu Jiahui , Fan Fangfang , Luo Xingyu , Ji Wenjun , Liu Yaokun , Zhang Yan , Zheng Bo 
Published: November 2021

Background: A large amount of evidence suggests that proprotein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors have clinical benefits in patients with cardiovascular disease (CVD). However, whether PCSK9 concentrations predict future cardiovascular (CV) events remains unclear.Methods: We conducted a meta-analysis to investigate the ability of PCSK9 concentrations to predict future CV events in patients with established CVD. A comprehensive search of electronic databases was conducted in June 2021. We included relative risk (RR) estimates with 95% CI or events of interest.Results: Eleven cohort studies including 8,471 patients with CVD were enrolled. The pooled RR of CV events for the increase in the circulating baseline PCSK9 concentrations by 1 SD showed a positive association in a random-effect model (RR 1.226, 95% CI: 1.055–1.423, P = 0.008). Similarly, the risk of the total CV events increased by 52% in the patients in the highest tertile compared with those in the lowest tertile of circulating PCSK9 concentrations (RR 1.523, 95% CI: 1.098–2.112, P = 0.012). The association between PCSK9 and CV events was stronger in stable patients with CVD, patients treated with statins, and Asian patients.Conclusions: High PCSK9 concentrations are significantly related to the increased risk of future CV events. These results enrich the knowledge of PCSK9 function and suggest the further possible clinical role of PCSK9 inhibitors.
Six Months of Inspiratory Muscle Training to Lower Blood Pressure and Improve Endothelial Function in Middle-Aged and Older Adults With Above-Normal Blood Pressure and Obstructive Sleep Apnea: Protocol for the CHART Clinical Trial
Authors: Tavoian Dallin , Ramos-Barrera Lupita E. , Craighead Daniel H. , Seals Douglas R. , Bedrick Edward J. , Alpert Joseph S. , Mashaqi Saif , Bailey E. Fiona 
Published: November 2021

Background: Cardiovascular disease is a major global health concern and prevalence is high in adults with obstructive sleep apnea (OSA). Lowering blood pressure (BP) can greatly reduce cardiovascular disease risk and physical activity is routinely prescribed to achieve this goal. Unfortunately, many adults with OSA suffer from fatigue, daytime sleepiness, and exercise intolerance—due to poor sleep quality and nocturnal hypoxemia—and have difficulty initiating and maintaining an exercise program. High-resistance inspiratory muscle strength training (IMST) is a simple, time-efficient breathing exercise consistently reported to reduce BP in small, selective groups of both healthy and at-risk adults. Herein we present the study protocol for a randomized clinical trial to determine the long-term efficacy of IMST performed regularly for 24 weeks in middle-aged and older adults with OSA. The primary outcome is casual systolic BP. Secondary outcomes are 24-h systolic BP and circulating plasma norepinephrine concentration. Other outcomes include vascular endothelial function (endothelial-dependent and -independent dilation), aortic stiffness, casual and 24-h diastolic BP, and the influence of circulating factors on endothelial cell nitric oxide and reactive oxygen species production. Overall, this trial will establish efficacy of high-resistance IMST for lowering BP and improving cardiovascular health in middle-aged and older adults with OSA.Methods: This is a single-site, double-blind, randomized clinical trial. A minimum of 92 and maximum of 122 male and female adults aged 50–80 years with OSA and above-normal BP will be enrolled. After completion of baseline assessments, subjects will be randomized in a 1:1 ratio to participate in either high-resistance or sham (low-resistance) control IMST, performed at home, 5 min/day, 5 days/week, for 24 weeks. Repeat assessments will be taken after the 24-week intervention, and after 4 and 12 weeks of free living.Discussion: This study is designed to assess the effects of 24 weeks of IMST on BP and vascular function. The results will characterize the extent to which IMST can reduce BP when performed over longer periods (i.e., 6 months) than have been assessed previously. Additionally, this study will help to determine underlying mechanisms driving IMST-induced BP reductions that have been reported previously.Clinical Trial Registration: This trial is registered with ClinicalTrials.gov (Registration Number: NCT04932447; Date of registration June 21, 2021).
Association Between Long-Term Visit-to-Visit Hemoglobin A1c and Cardiovascular Risk in Type 2 Diabetes: The ACCORD Trial
Authors: Huang Dan , Huang Yong-Quan , Zhang Qun-Ying , Cui Yan , Mu Tian-Yi , Huang Yin 
Published: November 2021

Background: To explore the association between visit-to-visit variability of glycated hemoglobin (HbA1c) and cardiovascular outcomes in the patients with type 2 diabetes mellitus (T2DM) of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.Methods: We conducted a post-hoc analysis on the ACCORD population including 9,544 participants with T2DM. Visit-to-visit variability of HbA1c was defined as the individual SD, coefficient of variation (CV), and variability independent of the mean (VIM) across HbA1c measurements. The clinical measurements included primary outcome [the first occurrence of non-fatal myocardial infarction (MI), non-fatal stroke or cardiovascular death], total mortality, cardiovascular death, non-fatal MI event, non-fatal stroke, total stroke, heart failure, macrovascular events, and major coronary events (CHD).Results: Over a median follow-up of 4.85 years, 594 and 268 participants experienced all-cause mortality and cardiovascular mortality, respectively. After adjusting for baseline HbA1c levels and confounding factors, the adjusted hazard ratio (HR) comparing patients in the highest vs. the lowest quartile CV of HbA1c variability was 1.61 (95% CI 1.29–2.00) for the primary outcome. Similar trends for secondary outcome were also observed. There was no association between HbA1c fluctuation and non-fatal stroke. Noticeably, there was 66% greater risk for the all-cause mortality among patients in the highest vs. the lowest quartile (HR 1.66, 95% CI 1.27–2.17).Conclusions: Greater variability of HbA1c is associated with higher risk for cardiovascular complications and all-cause death in T2DM. Our study stresses the significance of well-controlled glycemic levels for improving cardiovascular outcomes. Further randomized clinical trials are required to confirm these findings.
Clinical Impact of Single and Dual Antiplatelet Therapy Beyond 12 Months on Ischemic Risk in Patients With Acute Myocardial Infarction
Authors: Roh Ji Woong , Bae SungA , Kim Yongcheol , Son Nak-Hoon , Cho Deok-Kyu , Kim Jung-Sun , Kim Byeong-Keuk , Choi Donghoon , Hong Myeong-Ki , Jeong Myung Ho , Jang Yangsoo ,   the KAMIR-NIH Investigators
Published: November 2021

Background: There is ongoing debate regarding the optimal antiplatelet strategy beyond 12 months in patients with acute myocardial infarction (AMI) who undergo successful percutaneous coronary intervention (PCI). This study therefore aimed to investigate the clinical outcomes of single (SAPT) vs. dual antiplatelet therapy (DAPT) beyond 12 months in patients with stable AMI and second-generation drug-eluting stent (DES) implantation.Methods: Of 13,104 patients from the Korea Acute Myocardial Infarction Registry-National Institutes of Health database, we selected 4,604 patients who underwent PCI with second-generation DES and exhibited no adverse clinical events within 12 months; they were classified into SAPT (aspirin or clopidogrel) or DAPT (aspirin and clopidogrel) groups. The primary endpoints were major adverse cardiac and cerebrovascular events (MACCE), including the composite of all-cause death, myocardial infarction (MI), and stroke between 12 and 36 months.Results: The SAPT group (n = 1,862) was associated with a significantly lower risk of MACCE between 12 and 36 months [4.2 vs. 8.5%, hazard ratio (HR): 0.47, 95% confidence interval (CI): 0.37–0.61; p &lt; 0.001] than the DAPT group (n = 2,742). The results were consistent after adjusting for confounders through multivariable and propensity score matching analysis. Moreover, in patients with complex features (defined as an unprotected left main PCI, implanted stent length of ≥38 mm, multivessel PCI, or ≥3 stents per patients), the SAPT group (n = 678) also demonstrated a significantly lower risk of MACCE between 12 and 36 months (4.9 vs. 9.9%, HR: 0.46, CI: 0.31–0.68, p &lt; 0.001) than the DAPT group (n = 1,167).Conclusions: In patients with AMI who underwent successful PCI with second-generation DES and exhibited no adverse clinical events within 12 months, the use of SAPT was associated with a significantly lower MACCE between 12 and 36 months compared with the use of DAPT.
Alternative Pathways for Hearing Care May Address Disparities in Access
Authors: Willink Amber , Assi Lama , Nieman Carrie , McMahon Catherine , Lin Frank R. , Reed Nicholas S. 
Published: November 2021

Background/Objectives: Low-uptake of hearing aids among older adults has long dogged the hearing care system in the U.S. and other countries. The introduction of over-the-counter hearing aids is set to disrupt the predominantly high-cost, specialty clinic-based delivery model of hearing care with the hope of increasing accessibility and affordability of hearing care. However, the current model of hearing care delivery may not be reaching everyone with hearing loss who have yet to use hearing aids. In this study, we examine the group of people who do not use hearing aids and describe their characteristics and health care utilization patterns. We also consider what other healthcare pathways may be utilized to increase access to hearing treatment.Design: Cross-sectional, the 2017 Medicare Current Beneficiary Survey.Setting: Non-institutionalized adults enrolled in Medicare, the U.S. public health insurance program for older adults (65 years and older) and those with qualifying medical conditions and disabilities.Participants: A nationally representative sample of 7,361 Medicare beneficiaries with self-reported trouble hearing and/or hearing aid use.Measurements: Survey-weighted proportions described the population characteristics and health care utilization of those with hearing loss by hearing aid use, and the characteristics of those with untreated hearing loss by health care service type utilized.Results: Women, racial/ethnic minorities, and low-income Medicare beneficiaries with self-reported hearing trouble were less likely to report using hearing aids than their peers. Among those who do not use hearing aids, the most commonly used health care services were obtaining prescription drugs (64%) and seeing a medical provider (50%). Only 20% did not access either service in the past year. These individuals were more likely to be young and to have higher educational attainment and income.Conclusion: Alternative models of care delivered through pharmacies and general medical practices may facilitate access to currently underserved populations as they are particularly high touch-points for Medicare beneficiaries with untreated hearing trouble. As care needs will vary across a spectrum of hearing loss, alternative models of hearing care should look to complement not substitute for existing access pathways to hearing care.
Experimental Study on Gangue Backfilling Materials Improved by Soda Residue and Field Measurement of Surface Subsidence
Authors: Yin Wei , Zhang Kun , Ouyang Shenyang , Bai Xiaomin , Sun Wenjie , Zhao Jingru 
Published: November 2021

In coal mining, the problems of massive discharge of solid waste, environmental pollution, and surface subsidence disaster are urgent to be solved. Based on this engineering background, the feasibility of using solid waste soda residue to improve gangue cemented backfilling material was discussed, and the surface subsidence of the test working face was measured in this study. Besides, the influence of soda residue on the performance of gangue cemented backfilling materials was analyzed through laboratory tests. The experimental results show that 1) as the content of soda residue increases within the range of 0–12%, the slump of the soda residue gangue backfilling material (SRGBM) slurry gradually increases, and the bleeding rate increases. The early strength and later strength of SRGBM increase first and then decrease with the increase in soda residue content. 2) The optimal ratio of the soda residue cemented backfilling material is soda residue: fly ash: lime: cement: gangue = 6%: 34%: 10%: 2.5%: 47.5%. Compared with the reference group, the slump of the material is increased by 12.7%, the bleeding rate is only 3.8%, and the early strength and later strength are increased by 449 and 187%, respectively. 3) The addition of soda residue promotes the hydration reaction of the slurry system of soda residue cemented materials. The coexistence of C-S-H gel and N-A-S-H gel reduces the connectivity of pores and improves the strength of the material. 4) The maximum surface subsidence of the test working face is only 245 mm, and the surface subsidence control effect is good. Therefore, the preparation of SRGBM with soda residue can achieve energy saving and emission reduction, with significant technical, economic, and social benefits, and has good promotion and application value.
Aerodynamic Characteristics Over Fine-Grained Gravel Surfaces in a Wind Tunnel
Authors: Liu Jiaqi , Kimura Reiji , Wu Jing 
Published: November 2021

Gravels can protect soil from wind erosion, however, there is little known about the effects of fine-grained gravel on aerodynamic characteristics of the near-surface airflow. Drag coefficient, wind-speed gradient, and turbulent transfer coefficient over different coverages of gravel surfaces were investigated in a compact boundary-layer wind tunnel. The drag coefficient of the fine-grained gravel surface reached the maximum value at 15% coverage and then tended to stabilize at gravel coverage 20% and greater. At a height of 4 cm, near-surface airflow on gravel surfaces can be divided clearly into upper and lower sublayers, defined as the inertial and roughness sublayers, respectively. The coefficient of variation of wind speed over gravel surfaces in the roughness sublayer was 8.6 times that in the inertial sublayer, indicating a greater effect of gravel coverage on wind-speed fluctuations in the lower layer. At a height of 4 cm, wind-speed fluctuations under the observed wind speeds were independent of changes in gravel coverage. In addition, an energy-exchange region, where sand particles can absorb more energy from the surrounding airflow, was found between the roughness and inertial sublayers, enhancing the erosional state of wind-blown sand. This finding can be applied to evaluate the aerodynamic stability of the gravel surface in the Gobi Desert and provide a theoretical basis for elucidation of the vertical distributions of wind-blown sand flux.
Techno-Economic Analysis of a Flexible Process Concept for the Production of Transport Fuels and Heat from Biomass and Renewable Electricity
Authors: Habermeyer Felix , Kurkela Esa , Maier Simon , Dietrich Ralph-Uwe 
Published: November 2021

Different processes have been proposed to meet the global need for renewable fuel. The Biomass to Liquid process (BtL) converts biomass via the Fischer-Tropsch route to hydrocarbon chains that can be refined to transport fuel. With the addition of electrolytic hydrogen to the Power and Biomass to Liquid process (PBtL), the carbon efficiency can be increased relative to the BtL process. It was shown in previous studies that the PBtL concept has an economic edge over BtL when cheap electricity is available to maximize the fuel yield. In this study, a techno-economic analysis is conducted for a hybrid process concept which can switch operation modes from electrolysis enhanced to only biomass conversion. In case studies the effect of the Fischer-Tropsch conversion, H2/CO ratio of the Fischer-Tropsch feed and the biomass feed rate in the electrolysis enhanced mode are analyzed. Every process configuration is modeled based on experimentally validated unit models from literature in the commercial software Aspen Plus and analyzed using DLR’s software tool TEPET. For a 200 MWth biomass input plant, production costs of 1.08 €2019/L for the hybrid concept with a carbon efficiency of 53.3% compared to 0.66 €2019/L for BtL with 35.4% and 1 €2019/L for PBtL with 61.1% were found based on the Finnish day-ahead market for the base case. The net production cost for the hybrid concept can be decreased by 0.07 €2019/L when a Fischer-Tropsch H2/CO ratio of 1.6 instead of 2.05 is used.
Analysis of Drought and Flood Disasters During 0–1950 AD in the Hexi Corridor, China, Based on Historical Documents
Authors: Tang Xia , Feng Qi 
Published: November 2021

It is important to analyze the characteristics of drought and flood change in an arid area over a long timescale for the evolution of the environment. Historical documents were used to reconstruct a drought and flood grade series for the Hexi Corridor from 0 to 1950 AD. The moving average and wavelet transform processing methods were used to determine the temporal evolution characteristics of droughts and floods, as well as the corresponding relationships with climate change and human activities in the Hexi Corridor after 1000 AD. The results showed the occurrence of eight drought phases (370–410 AD, 790–870 AD, 1050–1150 AD, 1260–1340 AD, 1430–1570 AD, 1710–1770 AD, 1800–1890 AD, and 1910–1950 AD), five flood phases (320–360 AD, 1670–710 AD, 1730–1790 AD, 1810–1860 AD, and 1880–1950 AD), and 3 oscillation periods of drought and flood events. Climate change may have been the main factor inducing droughts and floods before 1580 AD, whereas human activities may have increased the frequency of droughts and floods after the 16th century. Therefore, quantifying the impacts of natural factors and human activities on droughts and floods can provide important theoretical guidance for the prevention and reduction of future disasters.
Association Between a History of Nontyphoidal Salmonella and the Risk of Systemic Lupus Erythematosus: A Population-Based, Case-Control Study
Authors: Tu Ting-Yu , Yeh Chiu-Yu , Hung Yao-Min , Chang Renin , Chen Hsin-Hua , Wei James Cheng-Chung 
Published: November 2021

ObjectiveWe investigated the correlation between nontyphoidal Salmonella (NTS) infection and systemic lupus erythematosus (SLE) risk.MethodsThis case-control study comprised 6,517 patients with newly diagnosed SLE between 2006 and 2013. Patients without SLE were randomly selected as the control group and were matched at a case-control ratio of 1:20 by age, sex, and index year. All study individuals were traced from the index date back to their NTS exposure, other relevant covariates, or to the beginning of year 2000. Conditional logistic regression analysis was used to analyze the risk of SLE with adjusted odds ratios (aORs) and 95% confidence intervals (CIs) between the NTS and control groups.ResultsThe mean age was 37.8 years in the case and control groups. Females accounted for 85.5%. The aOR of having NTS infection were significantly increased in SLE relative to controls (aOR, 9.20; 95% CI, 4.51-18.78) in 1:20 sex-age matching analysis and (aOR, 7.47; 95% CI=2.08-26.82) in propensity score matching analysis. Subgroup analysis indicated that the SLE risk was high among those who dwelled in rural areas; had rheumatoid arthritis, multiple sclerosis, or Sjogren’s syndrome; and developed intensive and severe NTS infection during admission.ConclusionsExposure to NTS infection is associated with the development of subsequent SLE in Taiwanese individuals. Severe NTS infection and other autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, or Sjogren’s syndrome also contributed to the risk of developing SLE.
Newly Found Peacekeeper: Potential of CD8+ Tregs for Graft-Versus-Host Disease
Authors: Wang Weihao , Hong Tao , Wang Xiaoqi , Wang Rui , Du Yuxuan , Gao Qiangguo , Yang Shijie , Zhang Xi 
Published: November 2021

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the most effective and potentially curative treatment for a variety of hematologic malignancies. However, graft-versus-host disease (GVHD) is a major obstacle that limits wide application of allo-HSCT, despite the development of prophylactic strategies. Owing to experimental and clinical advances in the field, GVHD is characterized by disruption of the balance between effector and regulatory immune cells, resulting in higher inflammatory cytokine levels. A reduction in regulatory T cells (Tregs) has been associated with limiting recalibration of inflammatory overaction and maintaining immune tolerance. Moreover, accumulating evidence suggests that immunoregulation may be useful for preventing GVHD. As opposed to CD4+ Tregs, the CD8+ Tregs population, which constitutes an important proportion of all Tregs, efficiently attenuates GVHD while sparing graft-versus-leukemic (GVL) effects. CD8+ Tregs may provide another form of cellular therapy for preventing GVHD and preserving GVL effects, and understanding the underlying mechanisms that different from those of CD4+ Tregs is significant. In this review, we summarize preclinical experiments that have demonstrated the role of CD8+ Tregs during GVHD and attempted to obtain optimized CD8+ Tregs. Notably, although optimized CD8+ Tregs have obvious advantages, more exploration is needed to determine how to apply them in the clinic.
Drastic Ce3+ Insertion Enhancement in YAG Garnet Nanocrystals Through a Solvothermal Route
Authors: Cantarano Alexandra , Testemale Denis , Homeyer Estelle , Okuno Hanako , Potdevin Audrey , Dujardin Christophe , Ibanez Alain , Dantelle Geraldine 
Published: November 2021

Y3Al5O12 (YAG) nanocrystals have been synthesized by a modified solvothermal method (300°C) allowing the incorporation of cerium ions in much larger proportion (up to 30 mol.% with respect to yttrium ions) than ever published. The reasons are the nanometric size of the produced nanocrystals, allowing to accommodate Ce3+ ions in the rigid YAG structure thanks to the presence of local distortions, and also the soft synthesis route, at low temperatures and far from the thermodynamic equilibrium, which favors the cerium insertion. As a consequence, Ce3+ photoluminescence spectrum can be tuned with the doping concentration, from 541 nm for low Ce3+ concentration to 580 nm for a cerium concentration of 30 mol.%. The internal quantum yield reaches 40 ± 5% before decreasing due to concentration quenching. The nanocrystal brightness, which combines the internal quantum yield and the cerium concentration, has been found optimal for a doping of 2 mol.% Ce3+.
A Solar-Blind Ultraviolet Photodetector With Graphene/MgZnO/GaN Vertical Structure
Authors: Wang Zhao , Lin Jun , Wei Xuan , Zheng Wei , Hu Qichang 
Published: November 2021

Graphene (Gr) has high transmittance to ultraviolet (UV) light and high mobility, which can effectively collect and transfer carriers. In this work, MgZnO (MZO) films were grown on the surface of the p-GaN by magnetron sputtering. A heterojunction solar-blind UV detector with Gr/MZO/GaN structure was constructed by introducing Gr as the window layer film. The test results show that the device has excellent detection ability for solar-blind UV light. The light response cut-off edge of the device is 263 nm, under the illumination of 255 nm and the bias voltage of −5 V, the responsivity is 14.6 mA/W, the rise time is 0.79 s, the decay time is 0.2 s, and the external quantum efficiency is 71.1%. The importance of this work lies in providing a reference for the application of Gr-based photodetectors.