bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Prior Major Bleeding on the Safety and Effectiveness of Left Atrial Appendage Closure in Non-Valvular Atrial Fibrillation Patients: A Single-Center Study
Authors: Zhao Mingzhong , Hou Cody R. , Xiong Xiaolin , Post Felix , Herold Nora , Walsleben Jens , Meng Zhaohui , Yu Jiangtao 
Published: April 2021

Abstract
Purpose: Left atrial appendage closure (LAAC) may present an alternative to anticoagulation in patients with non-valvular atrial fibrillation (NVAF). However, evidence regarding benefit of LAAC in patients with prior major bleeding is limited. We evaluate whether a previous bleeding factor influences the safety and effectiveness of LAAC. Methods: A total of 377 consecutive patients scheduled for LAAC were categorized into a bleeding group (n=137) and non-bleeding group (n=240). The implantation success and prevalence of severe peri-procedural complications, and efficacy/ safety endpoints during follow-up were investigated. Results: The bleeding group had more patients ≥75 years old (P=0.044), higher CHA2DS2-VASc (P=0.029) and HAS-BLED scores (P=0.001) than the non-bleeding group. Implantation success and severe peri-procedural complications were similar. During an average 2 years’ follow-up, major bleeding events (P=0.917), all-cause death (P=0.313), co-primary efficacy events (P=0.063), and the cumulative survival ratio (P=0.828) were comparable. However, the incidence of thromboembolism was lower in the bleeding group (P=0.031). The observed thromboembolism rate was reduced by 86.1% (P<0.005) and 43.9% (P<0.05) and the observed bleeding rate was decreased by 39.0% (P<0.05) and 34.8% (P<0.05) in the bleeding and non-bleeding groups, respectively. The extent of relative risk reduction in thromboembolism was significantly higher in the bleeding group (86.1% vs. 43.9%, P<0.01). Conclusion: LAAC may provide a safe and effective alternative to long-term antithrombotic therapy in NVAF patients with or without prior bleeding. The efficacy of LAAC in reducing thromboembolism instead of major bleeding seems to be higher in patients with versus without prior bleeding.
Effects of parity, frustration, and stochastic fluctuations on integrated information of consciousness for networks with two small-sized loops
Authors: Hosaka Tadaaki 
Published: April 2021

Abstract
Background: Integrated Information Theory (IIT) has been attracting attention as a theory of consciousness. The latest version, IIT3.0, is still at the stage of accumulating knowledge concerning fundamental networks. This paper presents an evaluation of the system-level integrated conceptual information of a major complex, ΦMax, associated with the center of consciousness for a small-scale network containing two small loops in accordance with the IIT3.0 framework. We focus on the following parameters characterizing the system model: 1) number of nodes in the loop, 2) frustration of the loop, and 3) temperature controlling the stochastic ﬂuctuation of the state transition. Speciﬁcally, assuming that the two loops are coupled systems, such as cerebral hemispheres, the eﬀect of these parameters on the values of ΦMax and conditions for major complexes formed by a single loop, rather than the entire network, is investigated.Results: Our ﬁrst ﬁnding is that parity of the number of nodes forming a loop has a strong eﬀect on the integrated conceptual information ΦMax. For loops with an even number of nodes, the number of concepts tends to decrease, and ΦMax becomes smaller. When the loop is formed with an odd number of nodes, the system without frustration and the system with two frustrated loops can have exactly the same ΦMax. It is also shown that, although counterintuitive, the value of ΦMax can be maximized in the presence of stochastic ﬂuctuations. Our second ﬁnding is that a major complex is more likely to be formed by a small number of nodes under small stochastic ﬂuctuations. In particular, this tendency is enhanced for larger numbers of nodes constituting a loop. On the other hand, the entire network can easily become a major complex under larger stochastic ﬂuctuations, and this tendency can be reinforced by frustration.Conclusions: Our results indicating that the entire network dominates and maintains a high level of consciousness in the presence of a certain degree of ﬂuctuation and frustration may qualitatively correspond to actual neural behaviors. The results of this study are expected to contribute to the veriﬁcation of the consistency of IIT with the actual nervous system in the future.
Rheumatic? - A Digital Diagnostic Decision Support Tool for Individuals Suspecting Rheumatic Diseases: A Multicenter Validation Study
Authors: Knevel Rachel , Knitza Johannes , Hensvold Aase , Circiumaru Alexandra , Bruce Tor , Evans Sebastian , Maarseveen Tjardo , Maurits Marc , Voorde Liesbeth Beaart - van de , Simon David , Kleyer Arnd , Johannesson Martina , Schett Georg , Huizinga Tom , Svanteson Sofia , Lindfors Alexandra , Klareskog Lars , Catrina Anca 
Published: April 2021

Abstract
BackgroundDigital diagnostic decision support tools promise to accelerate diagnosis and increase health care efficiency in rheumatology. Rheumatic? is an online tool developed by specialists in rheumatology and general medicine together with patients and patient organizations. It calculates a risk score for several rheumatic diseases. In the current pilot study, we retrospectively test Rheumatic? for its ability to differentiate symptoms from immune-mediated diseases from other rheumatic and musculoskeletal complaints and disorders in patients visiting rheumatology clinics. MethodsThe performance of Rheumatic? was tested using data from 175 patients from three university rheumatology centers covering two different settings:A. Risk-RA phase setting. Here, we tested whether Rheumatic? could predict the development of arthritis in 50 individuals with musculoskeletal complaints and anti-citrullinated protein antibody positivity from the KI (Karolinska Institutet)B. Early arthritis setting. Here, we tested whether Rheumatic? could predict the development of an immune-mediated rheumatic disease in i) EUMC (Erlangen) n=52 patients and ii) LUMC (Leiden) n=73 patients.In each setting, we examined the discriminative power of the total score with the Wilcoxon rank test and the area-under-the-receiver-operating-characteristic curve (AUC-ROC). Next, we calculated the test characteristics for these patients at a rheumatology setting passing the first or second threshold for at least one of the rheumatic diseases.ResultsThe total test score clearly differentiated between: A) individuals developing arthritis or not, median 245 versus 163, P < 0.0001, AUC-ROC = 75.3B) patients with an immune-mediated arthritic disease or not, in EUMC median 191 versus 107, P < 0.0001, AUC-ROC = 79.0, and LUMC median 262 versus 212, P < 0.0001, AUC-ROC = 53.6.Threshold-1 (advising on seeking primary care doctor) was highly specific in two centers (0.72, 0.87 and 0.23, respectively) and far more sensitive (0.67, 0.61 and 0.67) in KI, EUMC respectively LUMC.Threshold-2 was very specific in all three centers but not very sensitive: specificity of 1.0, 0.96 and 0.91, sensitivity 0.05, 0.07, 0.14 in KI, EUMC respectively LUMC. ConclusionsRheumatic? is a web-based patient-centered multilingual diagnostic tool capable of differentiating immune-mediated rheumatic conditions from other musculoskeletal problems. The scoring system might be further optimized, for which we will perform a prospective study.
Dyslipidemia in Chinese Pancreatic Cancer Patients: A Two-Center Retrospective Study
Authors: Wang Feiyang , Wu Heshui , Xu Junming 
Published: April 2021

Abstract
Background: Pancreatic cancer (PC) is one of the most aggressive and lethal malignancies in the world. High cholesterol intake may have a certain association with an elevated risk of PC, though dyslipidemia in PC patients has rarely been reported. In this study, we compared serum lipids levels between PC and non-PC tumor patients and assessed their prognostic value in PC. Methods: 271 patients treated at Wuhan Union Hospital from January 2012 to December 2016 and 204 individuals at Shanghai General Hospital from January 2018 to December 2019 were recruited. Their demographic parameters, laboratory data, pathological information, and clinical outcomes were extracted and analyzed. The mRNA expressions of related lipoprotein, low density lipoprotein receptor (LDLR) and high density lipoprotein binding protein (HDLBP), in PC tissues and paired noncancerous tissues and follow-up information were assessed based on the GEO database (GSE15471 and GSE62165) and TCGA database. Results: A total of 172 non-PC tumor patients and 260 PC patients were finally eligible for our analysis. PC patients exhibited higher levels of serum triglyceride, cholesterol, and low-density lipoprotein (LDL) and a lower serum high-density lipoprotein (HDL) level on admission versus the non-PC tumor group. In PC patients, LDLR mRNA expression was upregulated, and HDLBP mRNA expression was downregulated in cancerous tissues compared to these levels in paired noncancerous tissues. The survival analysis revealed that dyslipidemia had a non-significant association with a poor prognosis, but PC patients with a high LDLR level were at risk of poor survival. Conclusion: Dyslipidemia is detected in PC patients but has a non-significant relation to PC prognosis. However, LDLR may be a potential predictive marker for PC prognosis.
Genomic epidemiology of SARS-CoV-2 in Russia reveals recurring cross-border transmission throughout 2020
Authors: Matsvay Alina , Klink Galya , Safina Ksenia , Nabieva Elena , Garushyants Sofya , Biba Dmitry , Bazykin Georgii , Mikhaylov Ivan , Say Anna , Zakamornaya Anastasiya , Khakhina Anastasiya , Lisitsa Tatiana , Ayginin Andrey , Abramov Ivan , Bogdan Sergey , Kolbutova Kseniya , Oleynikova Daria , Avdeenko Tatiana , Shipulin German , Yudin Sergey , Skvortsova Veronika 
Published: April 2021

Abstract
SARS-CoV-2 has spread rapidly across the globe, with most nations failing to prevent or substantially delay its introduction. While many countries have imposed some limitations on trans-border passenger traffic, the effect of these measures on the spread of COVID-19 strains remains unclear. Here, we report an analysis of whole-genome sequencing of 3206 SARS-CoV-2 samples from 78 regions of Russia covering the period between March and November 2020. We describe recurring imports of multiple COVID-19 strains throughout this period, giving rise to 457 uniquely Russian transmission lineages, as well as repeated cross-border transmissions of local circulating variants out of Russia.
Self-Reported Eating Speed Is Associated With Overweight Among Chinese School-Children: A Cross-Sectional Survey
Authors: gong qing , Li X , Wang J , Zhang Y 
Published: April 2021

Abstract
PurposeThis study aimed to examine the association between eating speed and overweight in Chinese school-children. MethodsIn all, 664 schoolchildren (10-12 y) from 3 primary schools participated in this study in China. Their height and body weight were measured. Information about eating speed and other lifestyle behaviors was collected using a self-administered questionnaire. Multivariable logistic regression model was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for overweight. ResultsData from 629 students were analyzed. 26.2% of participants reported they were eating fast. The prevalence of overweight (including obesity) was 22.9%, and the mean of sleep duration was 9.69 (SD= 0.63) hours (Table 1). In the multiple linear regression analysis, eating speed was negatively associated with BMI (B=-0.70; P﹤0.05) and TG (B=-0.16; P﹤0.05). In addition, participants who ate fast were more likely to be overweight (OR=1.81, 95% CI= 1.19 to 2.75) after adjusting for potential confounding factors. ConclusionsThis study indicates that eating fast is associated with overweight among Chinese school-children.Level of evidence﻿Level V; cross-section descriptive study
Combined Effects of Lung Disease History, Environmental Exposures, and Family History of Lung Cancer to Susceptibility of Lung Cancer in Chinese Non-smokers
Authors: Yu Fanglin , Xiao Rendong , Li Xu , Hu Zhijian , Cai Lin , He Fei 
Published: April 2021

Abstract
Background: Although cigarette smoking is a major risk factor for lung cancer, the incidence rate of lung cancer among non-smokers is notable. The etiology and potential mechanism of non-smoker lung cancer are worthy of further research. This study was designed to explore the collective effects of environmental factors and the relationship between environmental exposure index (EEI) and lung cancer among non-smokers by evaluating the joint effects among lung disease history, environmental factors, and family history of lung cancer without smoking confounders.Methods: A total of 767 never-smoked lung cancer cases and 767 sex- and age-matched controls were selected from the department of Thoracic Surgery and Respiratory Medicine of three hospitals in Fujian, China. We used two methods to develop the EEI according to 12 statistically significant environmental risk factors. Restricted cubic spline (RCS) was applied to analyze the non-linear relationship between EEI and lung cancer in non-smokers. Combined effects, additive interaction, and multiplicative interaction were assessed among lung disease history, EEI, and family history of lung cancer to estimate susceptibility to develop lung cancer.Results: Lung disease history, especially asthma, was significantly associated with an increased risk of lung cancer with an odds ratio (OR) for asthma history of 14.720 (95% CI: 1.877–115.449). Family history of lung cancer was related to susceptibility of lung cancer (OR = 3.347, 95% CI: 1.930–5.806). According to type of relatives and cancer, a parental or children’s history and a sibling’s history of lung cancer were significantly associated with an increased risk of lung cancer. The positive association between EEI and lung cancer was apparently stronger in those with lung disease history or family lung cancer history. Furthermore, there was a addictive interaction between EEI and lung disease history, and a possibly addictive interaction between EEI and family lung cancer history on development of lung cancer.Conclusions: There were combined effects among lung disease history, environmental exposures, and family history of lung cancer toward susceptibility to lung cancer in Chinese non-smokers. Non-smokers who had a family history of lung cancer were at higher risk of lung cancer than non-smokers who had lung disease history. Non-smokers with family cancer history may obtain benefits from removal of environmental exposures and active treatment of lung disease.
Impact of HIV-1 CRF55_01B infection on the evolution of CD4 count and plasma HIV RNA load in men who have sex with men prior to antiretroviral therapy
Authors: Wei Lan , Li Hao , Lv Xing , Zheng Chenli , Li Guilian , Yang Zhengrong , Chen Lin , Han Xiaoxu , Zou Huachun , Gao Yanxiao , Cheng Jinquan , Wang Hui , Zhao Jin 
Published: April 2021

Abstract
Background CRF55_01B is a newly identified HIV-1 circulating recombinant form originated from MSM in China. However, its impact on the disease progression and transmission risk has not been investigated. This study aimed to determine the impact of CRF55_01B infection on viral dynamics and immunological status, so as to provide implications for future prevention, treatment, or target interventions. Linear mixed effect models were applied to evaluate CD4 cell count decline and viral load increase by subtype.Results Of the 3418 blood samples, 1446 (42.3%) were CRF07_BC, 1169 (34.2%) CRF01_AE, 467 (13.7%) CRF55_01B, 249 (7.3%) type B, and 87 (2.5%) other subtypes (CRF_08BC, CRF_01B, C). CRF55_01B had replaced subtype B as the third predominant strain since 2012 in Shenzhen, China. CRF55_01B-infected MSM showed lower median of CD4 count than CRF07_BC-infected MSM (349.5 [IQR, 250.2~474.8] vs 370.0 [IQR, 278.0~501.0], P<0.05). CRF55_01B infection was associated with slower loss of CD4 count than CRF01_AE (13.6 vs 23.3 [cells/μL]¹/²/year, P<0.05)among MSM with initial CD4 count of 200~350 cells/μL. On the other hand, those infected with CRF55_01B showed higher median plasma HIV RNA load (5.4 [IQR, 5.0~5.9]) than both CRF01_AE (5.3 [IQR, 4.8~5.7], P<0.05) and CRF07_BC (5.0 log10 [IQR, 4.5~5.5], P<0.001) at the initiation of antiretroviral therapy. Furthermore, the annual increasing rate of viral load for CRF55_01B infection was significantly higher than that of CRF07_BC (2.0 vs 0.7 log10 copies/ml/year, P<0.01).Conclusions The relatively lower CD4 count and faster increase of plasma HIV RNA load of CRF55_01B-infected MSM without antiretroviral therapy suggest that CRF55_01B may lead to longer asymptomatic phase and higher risk of HIV transmission. Strengthened surveillance, tailored prevention strategies and interventions, and in-depth research focusing on CRF55_01B are urgently needed to forestall potential epidemic.
Geotechnical Evaluation of Gully Erosion and Landslides Materials and their Impact in Iguosa and its Environs, Western Anambra Basin, Nigeria.
Authors: Aigbadon Godwin Okumagbe , Ocheli Azuka , Akudo Ernest Oji 
Published: April 2021

Abstract
Background: Field survey and geotechnical evaluation was done to determine the soil characteristics of the gullies and landslides materials and their impact in Iguosa and its environs, Western Anambra Basin. This was done to explain and evaluate the root problems, causes, mechanism of the continuous gullies and landslides in the study area.Results: The field study reveals that the geomorphological characteristics, weakly developed structures, slope steepness, wrong use of the land and poor vegetation cover coupled with intense and prolonged rainfall contributed to the origin, causes of gullies and landslides in the study area. Geotechnical parameters for soil samples in the study area shows that the mean liquid limit (LL) of 40, mean plastic limit (PL) of 8.30, mean plasticity index (PI) of 21.20, mean coefficient of permeability (K) of 3.65 × 10cm/sec, mean cohesion and mean angles of internal angles between grains of 2.56 kƿa and 23.70 respectively. The low PL, low LL and low PI values of the Ajali sand, low cohesion (poor compaction) and low angle of internal resistance between grains of the soil, high K of Ajali sand coupled with the swelling and shrinking nature of the clay beds beneath the Ajali sand, resulted to easily weathering of the Ajali sands, erosional and continuous landslide activities in these affected areas.Conclusions: The origin, mechanism and impacts of landslide hazards have been investigated in Iguosa and its environs, Western Anambra Basin, Nigeria. Field observation reveals that the geomorphological characteristics, weakly developed structure, high slope instability, wrong use of land, as well as the steepness of the slope and intense and prolonged rainfall contributed to the origin of landslide as well as the gully erosion in the study area. The unconsolidated nature of the soil, less cohesion, high permeability, and weak plasticity of the soil that occurs under and above the clay lithologic units (gliding planes) contributed to landslide and gully erosion. Possible prospective implications of the gully erosion and landslides in the study areas are land degradation, destruction of houses and other properties, farm lands and roads. The following suggestions have been made to solve these problems by covering the landslide areas with impermeable layers/materials, diverting surface water away from the landslide areas, enacting laws to prevent erection of structures on landslide prone areas, the use of biotechnical slope techniques and bioengineering methods. The application of these recommended methods will go a long way in solving the problem of landslide hazards in the study area.
Electro-Hydraulic Proportional System Real Time Tracking Control Development Based on Pulse Width Modulation Method
Authors: Mohamed Ezz Eldin Ibrahim , Elnady Tarek , Hassan Mohamed Saffaa , Saleh  
Published: April 2021

Abstract
The present work is directed to develop the dynamic performance of an electro-hydraulic proportional system (EHPS). a mathematical model of (EHPS) is presented using electrohydraulic proportional valve (EHPV) by the aim of Matlab-simulink which facilitate the simulation of the hydraulic behavior inside the main control unit. Experimental work is done and closed loop system is designed using linear variable displacement transducer sensor (LVDT). The controller of the system is an Arduino uno which is considered as the processor of the system. The model is validated by the experimental system. The study also presents a real time tracking control method based on pulse width modulation by controlling the speed of the actuator to achieve position tracking with minimum error.
Integrative Pan-cancer Analysis of MEK1 Aberrations and the Potential Clinical Implications
Authors: Zhou Zhiyang , Peng Bi , Li Juanni , Huang Jinzhou , Cai Yuan , Xu Zhijie , Yan Yuanliang 
Published: April 2021

Abstract
Background: Alterations of mitogen-activated protein kinase kinase 1 (MEK1) are commonly associated with tumorigenesis, and MEK1 is thought to be a suitable targeted therapy for various cancers. However, abnormal MEK1 alterations and their relevant clinical implications are unknown. Our research comprehensively analyzed the MEK1 alteration spectrum and provided novel insight for targeted therapies. Methods: There were 7694 samples covering 32 types of cancer from The Cancer Genome Atlas (TCGA) database. They were used to conduct an integrative analysis of MEK1 expression, alterations, functional impacts and clinical significance. Results: There was a dramatic difference in the alteration frequency and distribution and clinical implications in 32 types of cancer from the TCGA. Skin cutaneous melanoma (SKCM) has the most alterations and has therapeutic targets located in the protein kinase domain, and the growing expression of SKCM is positively related to patient prognosis. MEK1 expression in lung adenocarcinoma (LUAD), kidney renal papillary cell carcinoma (KIRP), esophageal carcinoma (ESCA) and liver hepatocellular carcinoma (LIHC) is decreased, which is associated with better prognosis, while MEK1 expression in thymoma (THYM), stomach adenocarcinoma (STAD), kidney renal clear cell carcinoma (KIRC), testicular germ cell tumors (TGCTs) and head and neck squamous cell carcinoma (HNSC) is increased, which is associated with better prognosis. Mesothelioma (MESO) has the second highest alterations but has no therapy targets. Conclusion: This study provided a great and detailed interpretation of MEK1 expression, alterations and clinical implications in 32 types of cancer and reminded us to fill the gap in MEK1 research from a new perspective. Keywords: MEK1, gene mutation, gene alteration, outcome, pan-cancer