bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alkaline Dehydration of Human Urine Collected in Source-Separated Sanitation Systems Using Magnesium Oxide
Authors: Simha Prithvi , Friedrich Christopher , Randall Dyllon Garth , Vinnerås Björn 
Published: January 2021

Fresh human urine, after it is alkalized to prevent the enzymatic hydrolysis of urea, can be dehydrated to reduce its volume and to produce a solid fertilizer. In this study, we investigated the suitability of MgO to alkalize and dehydrate urine. We selected MgO due to its low solubility (&lt;2 g·L−1) and relatively high saturation pH (9.9 ± 0.2) in urine. Using a laboratory-scale setup, we dehydrated urine added to pure MgO and MgO mixed with co-substrates (biochar, wheat bran, or calcium hydroxide) at a temperature of 50°C. We found that, dehydrating urine added to a mixture of MgO (25% w/w), biochar, and wheat bran resulted in a mass reduction of &gt;90% and N recovery of 80%, and yielded products with high concentrations of macronutrients (7.8% N, 0.7% P and 3.9% K). By modeling the chemical speciation in urine, we also showed that ammonia stripping rather than urea hydrolysis limited the N recovery, since the urine used in our study was partially hydrolyzed. To maximize the recovery of N during alkaline urine dehydration using MgO, we recommend treating fresh/un-hydrolysed urine a temperature &lt;40°C, tailoring the drying substrate to capture NH4+ as struvite, and using co-substrates to limit the molecular diffusion of ammonia. Treating fresh urine by alkaline dehydration requires only 3.6 kg MgO cap−1y−1 and a cost of US$ 1.1 cap−1y−1. Therefore, the use of sparingly soluble alkaline compounds like MgO in urine-diverting sanitation systems holds much promise.
Efficacy and Safety of Eculizumab in the Treatment of Transplant-Associated Thrombotic Microangiopathy: A Systematic Review and Meta-Analysis
Authors: Zhang Rui , Zhou Meng , Qi Jiaqian , Miao Wenjing , Zhang Ziyan , Wu Depei , Han Yue 
Published: January 2021

BackgroundTransplant-associated thrombotic microangiopathy (TA-TMA) is a dangerous and life-threatening complication in patients undergoing hematopoietic stem cell transplantation (HSCT). Eculizumab has been used in the treatment of TA-TMA, and several studies have confirmed the benefit of Eculizumab in patients with TA-TMA. However, the results remain controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of Eculizumab for TA-TMA.Materials and MethodsWe searched PubMed and Embase for studies on the efficacy and safety of Eculizumab in TA-TMA patients. Efficacy outcomes consisted of overall response rate (ORR), complete response rate (CRR), and survival rate at the last follow-up (SR). Safety outcomes were adverse events (AEs), including infection, sepsis, impaired liver function, infusion reactions, and death.ResultsA total of 116 patients from six studies were subjected to meta-analysis. The pooled estimates of ORR, CRR, and SR for TA-TMA patients were 71% (95% CI: 58–82%), 32% (95% CI: 11–56%), and 52% (95% CI: 40–65%), respectively. Only one patient presented with a severe rash, and infection was the most common AEs. The main causes of death were infection and GvHD.ConclusionCurrent evidence suggests that Eculizumab improves SR and ORR in patients with TA-TMA and that Eculizumab is well tolerated. However, the number of studies is limited, and the findings are based mainly on data from observational studies. Higher quality randomized controlled trials and more extensive prospective cohort studies are needed.
Integrated Analysis of circRNA-miRNA-mRNA Regulatory Networks in the Intestine of Sebastes schlegelii Following Edwardsiella tarda Challenge
Authors: Cao Min , Yan Xu , Su Baofeng , Yang Ning , Fu Qiang , Xue Ting , Song Lin , Li Qi , Li Chao 
Published: January 2021

Sebastes schlegelii, an important aquaculture species, has been widely cultured in East Asian countries. With the increase in the cultivation scale, various diseases have become major threats to the industry. Evidence has shown that non-coding RNAs (ncRNAs) have remarkable functions in the interactions between pathogens and their hosts. However, little is known about the mechanisms of circular RNAs (circRNAs) and coding RNAs in the process of preventing pathogen infection in the intestine in teleosts. In this study, we aimed to uncover the global landscape of mRNAs, circRNAs, and microRNAs (miRNAs) in response to Edwardsiella tarda infection at different time points (0, 2, 6, 12, and 24 h) and to construct regulatory networks for exploring the immune regulatory mechanism in the intestine of S. schlegelii. In total, 1,794 mRNAs, 87 circRNAs, and 79 miRNAs were differentially expressed. The differentially expressed RNAs were quantitatively validated using qRT-PCR. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that most of the differentially expressed mRNA genes and the target genes of ncRNAs were related to immune signaling pathways, such as the NF-κB signal pathway, pathogen recognition receptors related to signaling pathways (Toll-like receptors and Nod-like receptors), and the chemokine signaling pathway. Based on these differentially expressed genes, 624 circRNA-miRNA pairs and 2,694 miRNA-mRNA pairs were predicted using the miRanda software. Integrated analyses generated 25 circRNA-miRNA-mRNA interaction networks. In a novel_circ_0004195/novel-530/IκB interaction network, novel_530 was upregulated, while its two targets, novel_circ_0004195 and IκB, were downregulated after E. tarda infection. In addition, two circRNA-miRNA-mRNA networks related to apoptosis (novel_circ_0003210/novel_152/apoptosis-stimulating of p53 protein 1) and interleukin (novel_circ_0001907/novel_127/interleukin-1 receptor type 2) were also identified in our study. We thus speculated that the downstream NF-κB signaling pathway, p53 signaling pathway, and apoptosis pathway might play vital roles in the immune response in the intestine of S. schlegelii. This study revealed a landscape of RNAs in the intestine of S. schlegelii during E. tarda infection and provided clues for further study on the immune mechanisms and signaling networks based on the circRNA-miRNA-mRNA axis in S. schlegelii.
Mechanism Analysis of the Influence of Delay Period on Mechanical Properties of Reactive Powder Concrete
Authors: Wang Xiaohui , Zhao Qingxin , He Xiaojun , Zhang Shuang 
Published: January 2021

In order to analyze the influence mechanism of delay period on the mechanical properties of reactive powder concrete (RPC), the compressive strength of RPC with delay periods of 18, 24, and 30 h was tested at the age of 7, 28, and 90 days, respectively. The results show that compared with the RPC with delay period of 18 h, the compressive strength of the RPC with delay periods of 24 and 30 h increases by 3.2 and 4.2%, respectively, and the long-term strength reduction ratio decreases by 22.8 and 71.9%, respectively. The constitutive model curves of RPC under different delay period show that the initial elastic modulus E increases with the delay period and the strength and rigidity of RPC increase with the extension of delay period. According to the non-evaporation water quantity test, it could be speculated that the quantities of hydration products of the RPC with delay periods of 24 and 30 h slightly increase compared with the RPC with delay period of 18 h. X-ray diffraction (XRD) analysis show that the delay periods of 24 and 30 h consume more 3CaO·SiO2 (C3S) and 2CaO·SiO2 (C2S) compared with delay period of 18 h. Seen from the scanning electron microscope (SEM) image, the structures of the three groups of samples are relatively dense and have no significant difference. Through energy dispersive X-ray spectroscopy (EDS) analysis, the calcium-silicon ratios of hydration products of the RPC with delay periods of 18, 24, and 30 h are 1.81, 1.56, and 1.54, respectively. The existence of C-S-H gel and Ca(OH)2 in hydration products is confirmed by thermogravimetric-differential scanning calorimetry (DSC-TG) analysis. An appropriate delay period (30 h in this paper) generates more hydration products, then improves the compactness of the internal structure and reduces the calcium-silicon ratio of hydration products, and it is conducive to the growth of RPC compressive strength and the stability of long-term compressive strength.
Idiopathic Pulmonary Fibrosis in Elderly Patients: Analysis of the INSIGHTS-IPF Observational Study
Authors: Leuschner Gabriela , Klotsche Jens , Kreuter Michael , Prasse Antje , Wirtz Hubert , Pittrow David , Frankenberger Marion , Behr Jürgen , Kneidinger Nikolaus ,   The INSIGHTS-IPF Registry Group
Published: January 2021

Background: An association between idiopathic pulmonary fibrosis (IPF) and advancing age is suspected since IPF occurs primarily in patients over 60 years of age. Though, little is known about the disease in the elderly. The aim of this study was to characterize elderly IPF patients using data from the longitudinal, German-wide INSIGHTS-IPF registry.Methods: Patients were grouped into elderly (≥75 years) and nonelderly IPF (&lt;75 years) at the time of enrollment into the study. Baseline clinical characteristics, comorbidities, health related quality of life (HRQoL), medical therapy and survival were compared between age groups. Effects of antifibrotic therapy on forced vital capacity (FVC) were analyzed over 24 months.Results: Of 1,009 patients, 350 (34.7%) were ≥75 years old. Elderly IPF patients compared to younger patients had a higher number of comorbidities (3.6 ± 2.5 vs. 2.8 ± 2.3; p &lt; 0.001). The mean ± SD EQ-5D score (0.64 ± 0.21 vs. 0.69 ± 0.21; p = 0.005), and the overall WHO-5 score (13.1 ± 5.9 vs. 14.3 ± 6.0; p = 0.015) were significantly lower while the UCSD-SOBQ (52.6 ± 31.2 vs. 45.5 ± 31.2; p = 0.030) was significantly higher in elderly patients, indicating a more impaired HRQoL and more breathlessness. At baseline, 55.4% of elderly and 56.8% of nonelderly patients with IPF were treated with antifibrotic therapy (p = 0.687). For FVC decline after initiation of antifibrotic therapy, there was neither a significant difference between age groups at the different time points over 24 months (beta: 0.41; 95%-CI: −0.98 to 1.81; p = 0.563) nor over the whole course of time (beta: −0.05; 95%-CI: −0.20 to 0.09; p = 0.478). All-cause mortality was higher in elderly patients (49.1 vs. 37.9%; HR 1.65; 95%-CI 1.36–2.00; p &lt; 0.001). Antifibrotic therapy was associated with improved survival in IPF patients, independent from age (&lt;75 years: beta 0.76; 95%-CI: 0.59–0.99; p = 0.049; ≥75 years: beta 0.71; 95%-CI: 0.51–0.98; p = 0.043).Conclusion: In real life, a significant proportion of IPF patients are ≥75 years old, characterized by higher number of comorbidities and global reduced HRQoL. However, the effect of an antifibrotic therapy was similar between age groups and associated with a survival benefit emphasizing the importance for an early antifibrotic therapy in IPF, independent from age.
Cerebral Blood Flow Deviations in Critically Ill Patients: Potential Insult Contributing to Ischemic and Hyperemic Injury
Authors: Slessarev Marat , Mahmoud Ossama , McIntyre Christopher W. , Ellis Christopher G. 
Published: January 2021

Background: Ischemic and hyperemic injury have emerged as biologic mechanisms that contribute to cognitive impairment in critically ill patients. Spontaneous deviations in cerebral blood flow (CBF) beyond ischemic and hyperemic thresholds may represent an insult that contributes to this brain injury, especially if they accumulate over time and coincide with impaired autoregulation.Methods: We used transcranial Doppler to measure the proportion of time that CBF velocity (CBFv) deviated beyond previously reported ischemic and hyperemic thresholds in a cohort of critically ill patients with respiratory failure and/or shock within 48 h of ICU admission. We also assessed whether these CBFv deviations were more common during periods of impaired dynamic autoregulation, and whether they are explained by concurrent variations in mean arterial pressure (MAP) and end-tidal PCO2 (PetCO2).Results: We enrolled 12 consecutive patients (three females) who were monitored for a mean duration of 462.6 ± 39.8 min. Across patients, CBFv deviated by more than 20–30% from its baseline for 17–24% of the analysis time. These CBFv deviations occurred equally during periods of preserved and impaired autoregulation, while concurrent variations in MAP and PetCO2 explained only 13–21% of these CBFv deviations.Conclusion: CBFv deviations beyond ischemic and hyperemic thresholds are common in critically ill patients with respiratory failure or shock. These deviations occur irrespective of the state of dynamic autoregulation and are not explained by changes in MAP and CO2. Future studies should explore mechanisms responsible for these CBFv deviations and establish whether their cumulative burden predicts poor neurocognitive outcomes.
Clinical Characteristics of Itch in Renal Transplant Recipients
Authors: Krajewski Piotr K. , Olczyk Piotr , Krajewska Magdalena , Krajewski Wojciech , Szepietowski Jacek C. 
Published: January 2021

Background:Chronic itch is the most common symptom in dermatology. End-stage renal disease-associated chronic itch (ESRDCI) is a common burden affecting up to 35% of patients treated with hemodialysis. Kidney transplant (KTx) is believed to be the best renal replacement therapy leading to the elimination of ESRDCI. The study was undertaken to characterize and assess the prevalence of itch among patients after renal transplantation.Methods:Between October 2019 and January 2020, we analyzed the data of 197 patients comprising 121 males (61.4%) and 76 females (38.6%) and aged 54.5 ± 13.6 years. The data collection was performed with a specially designed questionnaire. Level of itch after renal transplantation was assessed with the use of a Numeral Rating Scale, a Visual Rating Scale, and 4-Item Itch Questionnaire. Moreover, the previous 3 days of itching were evaluated.Results:The patients suffered from chronic renal disease for 20.2 ± 12.3 years, with a mean time of pre-transplant dialysis of 2.6 ± 2.4 years and a mean time after the KTx of 8.0 ± 6.5 years. The itch was present in 38.6% of the patients during the hemodialysis, and in 73.7% of cases, the itch ceased completely after the successful transplantation. Moreover, only 2.63% of the cases had no improvement. Nevertheless, the itch was reported in 42 (21.3%) renal transplant recipients (RTR), and in 22 (52.4%) cases, the itch appeared after transplantation. The majority of patients suffering from itch were women (54.8%). Itch in the last 3 days was reported in 21 patients. The itch's severity was assessed with a numerical rating scale (NRS), with the worst severity measured at 6 ± 2.2 points indicating moderate itch. In most cases (57.1%), itch affected multiple body areas. Extremities (50%) and the back (50%) were among the most frequently affected areas. The sensation had a mostly short duration and was most frequently reported in the evening. Only eight patients suffered for the whole day. Hot water was the most frequently reported (16.7%) alleviating factor, whilst sweat was responsible for itch aggravation in 35.9% of cases.Conclusion:Our analysis on representative patients' population indicates that itch after KTx is an important problem. Moreover, it is worth noting that more than half of the RTR did not suffer from itch during dialysis.
Clinical Phenotyping and Biomarkers in Spinal and Bulbar Muscular Atrophy
Authors: Millere Elina , Rots Dmitrijs , Glazere Ieva , Taurina Gita , Kurjane Natalja , Priedite Viktorija , Gailite Linda , Blennow Kaj , Zetterberg Henrik , Kenina Viktorija 
Published: January 2021

Background: Spinal and bulbar muscular atrophy (SBMA) or Kennedy disease [OMIM: 313200] is a rare X-linked neuromuscular disease. Patients commonly present with muscle cramps, tremors, leg weakness, dysarthria and dysphagia.Methods: We deeply phenotyped and evaluated the possible extent of affected systems in all patients with SBMA in Latvia (n = 5). In addition, neurophysiological studies and blood analyses were used to perform a molecular diagnosis and evaluate biochemical values. We analyzed neurofilament light (NfL) as a possible biomarker.Results: Neurological examination revealed typical SBMA clinical manifestations; all patients had small or large nerve fiber neuropathy. Three of five patients had increased neurofilament light levels.Conclusion: The study confirms the systemic involvement in patients suffering from SBMA. Increased NfL concentration was associated with either peripheral neuropathy or decreased body mass index. The complex phenotype of the disease should be kept in mind, as it could help to diagnose patients with SBMA.
Prevalence and Risk Factors for Spasticity After Stroke: A Systematic Review and Meta-Analysis
Authors: Zeng Huangling , Chen Jian , Guo Yang , Tan Sheng 
Published: January 2021

Background: Spasticity is a common sequela of stroke. The incidence of poststroke spasticity (PSS) has not been systematically reviewed in recent years, and some risk factors remain debated. This systematic review and meta-analysis was conducted to determine the prevalence and risk factors for PSS.Methods: We searched electronic databases (PubMed, Embase, Cochrane Library, CNKI, WANFANG and CBM) inception to May 12, 2020. Observational studies summarizing the incidence or risk factors for PSS were included. Only cohort studies were enrolled in meta-analysis. For risk factors examined in at least three different studies, we combined effects into odds ratios (OR) and 95% confidence intervals (CI).Results: One thousand four hundred sixty-seven studies were retrieved and 23 were involved in meta-analysis. The pooled prevalence of spasticity after stroke was 25.3% and that after the first-ever stroke was 26.7%. The incidence of spasticity after the first-ever stroke with paresis was 39.5%. The prevalence of disabling or severe spasticity (MAS ≥ 3) in stroke patients with paresis was 9.4% (95% CI 0.056–0.133), and severe spasticity was 10.3% (95% CI 0.058–0.149). Moderate to severe paresis (OR = 6.573, 95% CI 2.579–16.755, I2 = 0.0%), hemorrhagic stroke (OR = 1.879, 95% CI 1.418–2.490, I2 = 27.3%) and sensory disorder were risk factors for PSS.Conclusions: The incidence of PSS was significantly higher in stroke patients with paresis. Patients with moderate to severe paresis and sensory disorder should be closely followed up. The role of hemorrhagic stroke in predicting PSS remains to be further explored.
Influence of Magnetic Field Strength on Magnetic Resonance Imaging Radiomics Features in Brain Imaging, an In Vitro and In Vivo Study
Authors: Ammari Samy , Pitre-Champagnat Stephanie , Dercle Laurent , Chouzenoux Emilie , Moalla Salma , Reuze Sylvain , Talbot Hugues , Mokoyoko Tite , Hadchiti Joya , Diffetocq Sebastien , Volk Andreas , El Haik Mickeal , Lakiss Sara , Balleyguier Corinne , Lassau Nathalie , Bidault Francois 
Published: January 2021

BackgroundThe development and clinical adoption of quantitative imaging biomarkers (radiomics) has established the need for the identification of parameters altering radiomics reproducibility. The aim of this study was to assess the impact of magnetic field strength on magnetic resonance imaging (MRI) radiomics features in neuroradiology clinical practice.MethodsT1 3D SPGR sequence was acquired on two phantoms and 10 healthy volunteers with two clinical MR devices from the same manufacturer using two different magnetic fields (1.5 and 3T). Phantoms varied in terms of gadolinium concentrations and textural heterogeneity. 27 regions of interest were segmented (phantom: 21, volunteers: 6) using the LIFEX software. 34 features were analyzed.ResultsIn the phantom dataset, 10 (67%) out of 15 radiomics features were significantly different when measured at 1.5T or 3T (student’s t-test, p &lt; 0.05). Gray levels resampling, and pixel size also influence part of texture features. These findings were validated in healthy volunteers.ConclusionsAccording to daily used protocols for clinical examinations, radiomic features extracted on 1.5T should not be used interchangeably with 3T when evaluating texture features. Such confounding factor should be adjusted when adapting the results of a study to a different platform, or when designing a multicentric trial.
A Novel Prognostic Scoring System of Intrahepatic Cholangiocarcinoma With Machine Learning Basing on Real-World Data
Authors: Li Zhizhen , Yuan Lei , Zhang Chen , Sun Jiaxing , Wang Zeyuan , Wang Yu , Hao Xin , Gao Fei , Jiang Xiaoqing 
Published: January 2021

Background and ObjectivesCurrently, the prognostic performance of the staging systems proposed by the 8th edition of the American Joint Committee on Cancer (AJCC 8th) and the Liver Cancer Study Group of Japan (LCSGJ) in resectable intrahepatic cholangiocarcinoma (ICC) remains controversial. The aim of this study was to use machine learning techniques to modify existing ICC staging strategies based on clinical data and to demonstrate the accuracy and discrimination capacity in prognostic prediction.Patients and MethodsThis is a retrospective study based on 1,390 patients who underwent surgical resection for ICC at Eastern Hepatobiliary Surgery Hospital from 2007 to 2015. External validation was performed for patients from 2015 to 2017. The ensemble of three machine learning algorithms was used to select the most important prognostic factors and stepwise Cox regression was employed to derive a modified scoring system. The discriminative ability and predictive accuracy were assessed using the Concordance Index (C-index) and Brier Score (BS). The results were externally validated through a cohort of 42 patients operated on from the same institution.ResultsSix independent prognosis factors were selected and incorporated in the modified scoring system, including carcinoembryonic antigen, carbohydrate antigen 19-9, alpha-fetoprotein, prealbumin, T and N of ICC staging category in 8th edition of AJCC. The proposed scoring system showed a more favorable discriminatory ability and model performance than the AJCC 8th and LCSGJ staging systems, with a higher C-index of 0.693 (95% CI, 0.663–0.723) in the internal validation cohort and 0.671 (95% CI, 0.602–0.740) in the external validation cohort, which was then confirmed with lower BS (0.103 in internal validation cohort and 0.169 in external validation cohort). Meanwhile, machine learning techniques for variable selection together with stepwise Cox regression for survival analysis shows a better prognostic accuracy than using stepwise Cox regression method only.ConclusionsThis study put forward a modified ICC scoring system based on prognosis factors selection incorporated with machine learning, for individualized prognosis evaluation in patients with ICC.