bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and associated factors of insufficient physical activity among elderly people in Bangladesh: a nationally representative cross-sectional study
Authors: Hanif Abu Abdullah Mohammad , Hasan Mehedi , Khan Md Showkat Ali , Hossain Md Mokbul , Shamim Abu Ahmed , Mitra Dipak Kumar , Hossaine Moyazzam , Ullah Mohammad Aman , Sarker Samir Kanti , Rahman S M Mustafizur , Bulbul Md Mofijul Islam , Mridha Malay Kanti 
Published: September 2021

ObjectivesInsufficient physical activity (IPA) is a crucial risk factor for non-communicable diseases (NCDs). The elderly population has a higher likelihood of suffering from NCDs. We aimed to estimate the prevalence of and factors associated with IPA among the elderly people in Bangladesh.MethodsWe analysed data from the Bangladesh Food Security and Nutrition Surveillance round 2018–2019, collected from 82 rural, non-slum urban and slum clusters selected using multistage cluster sampling. IPA was defined as <150 min of moderate intensity or <75 min of vigorous intensity or equivalent in a typical week. The weighted prevalence of IPA was estimated by gender and across different variables. Crude and adjusted prevalence ratios were calculated using Poisson regression with robust variance.ResultsThe weighted prevalence of IPA among elderly people was 38.4%, with a slightly higher prevalence in women (39.7% vs 37.3%). Factors associated with higher prevalence of IPA in both sexes were—higher age, living in non-slum urban areas, unemployed or homemaker, not currently married, sedentary behaviour and self-reported hypertension. Further, >10 years of education, inadequate fruits and vegetable consumption, self-reported asthma and higher waist circumference among men; and higher household income and self-reported diabetes among women were associated with a higher prevalence of IPA.ConclusionsIPA is highly prevalent among Bangladeshi elderly men and women. Sedentary behaviour, inadequate fruits and vegetable consumption and higher waist circumference were the modifiable factors of IPA. Evidence from this study can guide the development of appropriate interventions to promote healthy ageing in Bangladesh.
Medical student anxiety in caring for dying patients and their family: a cross-sectional study
Authors: Wells Geoffrey , Llewellyn Carrie , Hiersche Andreas , Minton Ollie , Wright Juliet 
Published: September 2021

ObjectivesTo investigate the level of medical student anxiety in caring for a dying patient and their family and identify influencing factors.MethodsWe conducted a cross-sectional survey in a UK medical school to measure medical student anxiety using a validated Thanatophobia Scale questionnaire.ResultsIn total, 332 questionnaires were completed. Mean thanatophobia score was 19.5 (SD 7.78, range 7–49). Most respondents were female (67.4%) and did not have a previous undergraduate degree (56%). Median student age was 22 years (IQR 20–24). Year of study influenced anxiety level, with second year students displaying an increase in mean thanatophobia score of 6.088 (95% CI 3.778 to 8.398, p<0.001). No significant differences were observed between final year and first year thanatophobia scores. For each 1-year increase in student age, mean thanatophobia score reduced by −0.282 (95% CI −0.473 to −0.091, p=0.004). Degree status and gender identity did not significantly affect thanatophobia score.ConclusionA degree of thanatophobia exists among medical students, with no significant improvement observed by completion of training. Recognising this anxiety to care for the dying earlier in undergraduate curricula will give educators the opportunity to address students’ fears and concerns and better prepare our future doctors for their role in caring for our dying patients and their families.
Laboratory interpretative comments and guidance: clinical and operative outcomes on moderate to severe hyponatraemia patient management
Authors: Montero-San-Martín Blanca , Oliver Paloma , Fernandez-Calle Pilar , Sánchez-Pascuala Callau Juan J , Díaz Almirón Mariana , Alcaide Martín María J , Fernández-Puntero Belen , Duque Alcorta Marta , Valero Recio José M , Martín Quirós Alejandro , de Ceano-Vivas la Calle María , Martín Sánchez Julia , Rivas Becerra Begoña , Vega Cabrera Cristina , Melgosa Hijosa Marta , Buno Soto Antonio 
Published: September 2021

AimsHyponatraemia is the most common body fluid disorders but often goes unnoticed. Our laboratory incorporated a standardised procedure to help clinicians detect moderate/severe hyponatraemia. The study aims were to evaluate the outcomes on patient care and clinicians’ satisfaction.MethodsThe study, observational and retrospective, included 1839 cases, adult and paediatric patients, with sodium concentration <130 mmol/L. The procedure consisted of interpretative comments in the emergency and core laboratories report and the point-of-care testing blood gas network report. We evaluated hyponatraemia length in two equal periods: before and after the implementation. We conducted a survey addressed to the staff of the clinical settings involved to know their satisfaction.ResultsThe median hyponatraemia length decreased significantly from 4.95 hours (2.08–16.57) in the first period to 2.17 hours (1.06–5.39) in the second period. The lack of hyponatraemia patients follow-up was significantly less after the procedure implementation. The survey was answered by 92 (60 senior specialists and 32 residents) out of 110 clinicians surveyed. Ninety of them (98%) answered positively.ConclusionsWe have demonstrated the reduction in the time for diagnosing and management by physicians, the higher uniformity in the time required to solve hyponatraemia episodes following our laboratory procedure and the clinicians’ satisfaction.
Functional analysis of peripheral and intratumoral neoantigen-specific TCRs identified in a patient with melanoma
Authors: Bräunlein Eva , Lupoli Gaia , Füchsl Franziska , Abualrous Esam T , de Andrade Krätzig Niklas , Gosmann Dario , Wietbrock Lukas , Lange Sebastian , Engleitner Thomas , Lan Huan , Audehm Stefan , Effenberger Manuel , Boxberg Melanie , Steiger Katja , Chang Yinshui , Yu Kai , Atay Cigdem , Bassermann Florian , Weichert Wilko , Busch Dirk H , Rad Roland , Freund Christian , Antes Iris , Krackhardt Angela M 
Published: September 2021

BackgroundNeoantigens derived from somatic mutations correlate with therapeutic responses mediated by treatment with immune checkpoint inhibitors. Neoantigens are therefore highly attractive targets for the development of therapeutic approaches in personalized medicine, although many aspects of their quality and associated immune responses are not yet well understood. In a case study of metastatic malignant melanoma, we aimed to perform an in-depth characterization of neoantigens and respective T-cell responses in the context of immune checkpoint modulation.MethodsThree neoantigens, which we identified either by immunopeptidomics or in silico prediction, were investigated using binding affinity analyses and structural simulations. We isolated seven T-cell receptors (TCRs) from the patient’s immune repertoire recognizing these antigens. TCRs were compared in vitro by multiparametric analyses including functional avidity, multicytokine secretion, and cross-reactivity screenings. A xenograft mouse model served to study in vivo functionality of selected TCRs. We investigated the patient’s TCR repertoire in blood and different tumor-related tissues over 3 years using TCR beta deep sequencing.ResultsSelected mutated peptide ligands with proven immunogenicity showed similar binding affinities to the human leukocyte antigen complex and comparable disparity to their wild-type counterparts in molecular dynamic simulations. Nevertheless, isolated TCRs recognizing these antigens demonstrated distinct patterns in functionality and frequency. TCRs with lower functional avidity showed at least equal antitumor immune responses in vivo. Moreover, they occurred at high frequencies and particularly demonstrated long-term persistence within tumor tissues, lymph nodes and various blood samples associated with a reduced activation pattern on primary in vitro stimulation.ConclusionsWe performed a so far unique fine characterization of neoantigen-specific T-cell responses revealing defined reactivity patterns of neoantigen-specific TCRs. Our data highlight qualitative differences of these TCRs associated with function and longevity of respective T cells. Such features need to be considered for further optimization of neoantigen targeting including adoptive T-cell therapies using TCR-transgenic T cells.
Paediatric/young versus adult patients with long QT syndrome
Authors: Lee Sharen , Zhou Jiandong , Jeevaratnam Kamalan , Wong Wing Tak , Wong Ian Chi Kei , Mak Chloe , Mok Ngai Shing , Liu Tong , Zhang Qingpeng , Tse Gary 
Published: September 2021

IntroductionLong QT syndrome (LQTS) is a less prevalent cardiac ion channelopathy than Brugada syndrome in Asia. The present study compared the outcomes between paediatric/young and adult LQTS patients.MethodsThis was a population-based retrospective cohort study of consecutive patients diagnosed with LQTS attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).ResultsA total of 142 LQTS (mean onset age=27±23 years old) were included. Arrhythmias other than VT/VF (HR 4.67, 95% CI (1.53 to 14.3), p=0.007), initial VT/VF (HR=3.25 (95% CI 1.29 to 8.16), p=0.012) and Schwartz score (HR=1.90 (95% CI 1.11 to 3.26), p=0.020) were predictive of the primary outcome for the overall cohort, while arrhythmias other than VT/VF (HR=5.41 (95% CI 1.36 to 21.4), p=0.016) and Schwartz score (HR=4.67 (95% CI 1.48 to 14.7), p=0.009) were predictive for the adult subgroup (>25 years old; n=58). A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic and arrhythmias other than VT/VF as the most important variables for risk prediction.ConclusionClinical and ECG presentation varies between the paediatric/young and adult LQTS population. Machine learning models achieved more accurate VT/VF prediction.
Impact of risk factors for major cardiovascular diseases: a comparison of life-time observational and Mendelian randomisation findings
Authors: Lind Lars , Ingelsson Martin , Sundstrom Johan , Ärnlöv Johan 
Published: September 2021

BackgroundThis study compared the strength and causality of associations between major risk factors for cardiovascular disease (CVD) and the four major CVDs: myocardial infarction, ischaemic stroke, heart failure and atrial fibrillation. Both a long-term follow-up in an observational cohort and Mendelian randomisation (MR) were used for this aim.MethodsIn the Uppsala Longitudinal Study of Adult Men study, 2322 men, all aged 50 years, were assessed for CVD risk factors and then followed for four decades regarding incident CVDs. The two-sample MR part used public available Genome-Wide Association Study (GWAS) data.ResultsIn multivariate analyses, systolic blood pressure was overall by far the most important risk factor, since it was related to all four CVDs, both in observational and MR analyses. Body mass index was the second most overall important risk factor, being linked to all four CVDs, except ischaemic stroke, both in observational and MR analyses. Smoking was an important risk factor for ischaemic stroke and heart failure, both in observational and MR analyses, while low-density lipoprotein-cholesterol mainly was related to myocardial infarction. Diabetes was mainly a causal risk factor for incident myocardial infarction and heart failure. Neither HDL-cholesterol nor triglycerides were of major importance as risk factors in these multivariable models.ConclusionBy combining long-term observational data with genetic data, we show that the impact and causal role of specific established cardiovascular risk factors varies between different major CVDs. Systolic blood pressure was causally related to all four cardiovascular outcomes and was therefore, overall, the most important risk factor.
Small-strain shear modulus of calcareous sand under anisotropic consolidation
Authors: Shi Jinquan , Xiao Yang , Hu Jian , Wu Huanran , Liu Hanlong , Haegeman Wim 
Published: September 2021

In this study, the small-strain shear modulus of a calcareous sand was investigated by conducting bender element tests on both horizontal and vertical planes. The effects of sample preparation method, stress path and stress history on the developing of void ratio, the parameters in the modified Hardin Equation, and the stiffness anisotropy were examined. The test results show that the moist tamping samples have the least void ratio variation among the five samples. The void ratio recovery in effective horizontal stress [Formula: see text] = 100 kPa tests is higher than that in the effective vertical stress [Formula: see text] = 100 kPa tests. The samples prepared in the dry state have lower stiffness than those prepared in the moisture state, which is not influenced by the anisotropic stress state. The stiffness anisotropy induced by the sample preparation method is significant under anisotropic consolidation. In [Formula: see text] = 100 kPa tests, the stiffness ratios at the end of the unloading stage are lower than the initial values at the loading stage, which is not found in the [Formula: see text] = 100 kPa tests, meaning that the stress history and stress path could affect the stiffness anisotropy and eliminate the impact of fabric anisotropy.
Effect of biochar applications on soil phosphorus availability under different soil moisture levels
Authors: Li Yuxin , Li Haixiao , Lu Xueqiang 
Published: September 2021

Soil moisture level is crucial to soil phosphorus (P) availability; however, there is no quantitative research on the relation between soil P availability and moisture level. In addition, biochar application could also alter soil P availability at different moisture levels. In this study, a 16 d soil incubation experiment was conducted at a laboratory scale to analyze the effects of soil moisture and P fertilization regimes (P-laden biochar fertilizer and conventional mineral P fertilizer) on soil P availability and fractionation. The results showed that soil P availability was positively correlated with soil moisture level (Pearson coefficients ranged from 0.46 to 0.91). High moisture level would lead to less amount of P in readily available fractions under P-laden biochar application. However, even with less P in readily available fractions, P-laden biochar could maintain soil P availability (117.7 mg P·m−2) at a similar level as the conventional P fertilizer (116.1 mg P·m−2).
Generic flexibility of affine cones over del Pezzo surfaces of degree 2
Authors: Kim Jaehyun , Park Jihun 
Published: September 2021

Various ample divisors on smooth del Pezzo surfaces of degree [Formula: see text] have been verified to allow polar cylinders in [I. Cheltsov, J. Park and J. Won, Cylinders in del Pezzo surfaces, Int. Math. Res. Not. 2017(4) (2015) 1179–1230]. We show that affine cones over smooth del Pezzo surfaces of degree [Formula: see text] polarized by such ample divisors are flexible in codimension one. All varieties in this paper are assumed to be defined over an algebraically closed field of characteristic zero.
Self-gasified biosystems for enhanced oil recovery
Authors: Suleimanov B. A. , Rzayeva S. J. , Akhmedova U. T. 
Published: September 2021

Microbial enhanced oil recovery is considered to be one of the most promising methods of stimulating formation, contributing to a higher level of oil production from long-term fields. The injection of bioreagents into a reservoir results in the creation of oil-displacing agents along with a significant amount of gases, mainly carbon dioxide. Earlier, the authors failed to study the preparation of self-gasified biosystems and the implementation of the subcritical region (SR) under reservoir conditions. Gasified systems in the subcritical phase have better oil-displacing properties than nongasified systems. In a heterogeneous porous medium, the filtration profile of gasified liquids in the SR should be more uniform than for a degassed liquid. Based on experimental studies, the superior efficiency of oil displacement by gasified biosystems compared with degassed ones has been demonstrated. The possibility of efficient use of gasified hybrid biopolymer systems has been shown.
Arginase 1–Based Immune Modulatory Vaccines Induce Anticancer Immunity and Synergize with Anti–PD-1 Checkpoint Blockade
Authors: Aaboe Jørgensen Mia , Ugel Stefano , Linder Hübbe Mie , Carretta Marco , Perez-Penco Maria , Weis-Banke Stine Emilie , Martinenaite Evelina , Kopp Katharina , Chapellier Marion , Adamo Annalisa , De Sanctis Francesco , Frusteri Cristina , Iezzi Manuela , Zocca Mai-Britt , Hargbøll Madsen Daniel , Wakatsuki Pedersen Ayako , Bronte Vincenzo , Andersen Mads Hald 
Published: September 2021

Abstract

Expression of the L-arginine catabolizing enzyme arginase 1 (ARG1) is a central immunosuppressive mechanism mediated by tumor-educated myeloid cells. Increased activity of ARG1 promotes the formation of an immunosuppressive microenvironment and leads to a more aggressive phenotype in many cancers. Intrinsic T-cell immunity against ARG1-derived epitopes in the peripheral blood of cancer patients and healthy subjects has previously been demonstrated. To evaluate the antitumor efficacy of ARG1-derived peptide vaccines as a monotherapy and as a combinational therapy with checkpoint blockade, different in vivo syngeneic mouse tumor models were utilized. To evaluate the antitumor effects, flow cytometry analysis and IHC were performed on tumors, and ELISPOT assays were performed to characterize immune responses. We show that ARG1-targeting therapeutic vaccines were able to activate endogenous antitumor immunity in several in vivo syngeneic mouse tumor models and to modulate the cell composition of the tumor microenvironment without causing any associated side effects or systemic toxicity. ARG1-targeting vaccines in combination with anti–PD-1 also resulted in increased T-cell infiltration, decreased ARG1 expression, reduced suppressive function of tumor-educated myeloid cells, and a shift in the M1/M2 ratio of tumor-infiltrating macrophages. These results indicated that the induced shift toward a more proinflammatory microenvironment by ARG1-targeting immunotherapy favors effective tumor control when combined with anti–PD-1 checkpoint blockade. Our data illustrate the ability of ARG1-based immune modulatory vaccination to elicit antigen-specific immunosurveillance and imply the feasibility of this novel immunotherapeutic approach for clinical translation.
Baseline and Postprocedural Health Status Outcomes in Contemporary Patients With Atrial Fibrillation Who Underwent Catheter Ablation: A Report from the Japanese Outpatient Registry
Authors: Ikemura Nobuhiro , Spertus John A. , Kimura Takehiro , Katsumata Yoshinori , Fujisawa Taishi , Ueda Ikuko , Fukuda Keiichi , Takatsuki Seiji , Kohsaka Shun 
Published: September 2021

Background
Randomized clinical trials have demonstrated that catheter ablation (CA) for atrial fibrillation improves health‐related quality of life (HRQoL). In daily practice, however, CA is performed on a wide range of patients, and outcomes may vary. We aimed to examine baseline and 1‐year HRQoL outcomes of patients with atrial fibrillation after CA in daily practice.

Methods and Results
Using a registry‐based cohort study designed to recruit patients with atrial fibrillation newly referred to 11 hospitals, we extracted data from 1097 consecutive patients with atrial fibrillation who underwent CA between 2012 and 2019. The Atrial Fibrillation Effects on Quality of Life Overall Summary (AFEQT‐OS) was assessed at registration and 1 year after, and a 5‐point increase in AFEQT‐OS score was considered a meaningful improvement. Overall, the median age was 64 (interquartile range, 56–70) years, 836 (76.2%) were men, and 93.0% (n=1021) of the patients answered the AFEQT questionnaire. The mean AFEQT‐OS score was 74.9 (SD, 18.0) at registration and 88.8 (SD, 12.6) at 1 year after. Notably, the incidence of meaningful improvement in HRQoL after CA was 88.6% for the patients with impaired HRQoL (AFEQT‐OS score <80), which was only 40.1% in those with preserved HRQoL (AFEQT‐OS score ≥80). Female sex, left atrium diameter, and high baseline HRQoL were independently associated with nonimprovement after CA.

Conclusions
The improvement in HRQoL after CA was similar to that seen in clinical trials; however, one‐third of patients did not show improvement. These results underscore the importance of quantitative evaluation of patients’ HRQoL to maximize the effect of CA before its performance.
Associations Between Cardiorespiratory Fitness, Cardiovascular Risk, and Cognition Are Mediated by Structural Brain Health in Midlife
Authors: España‐Irla Goretti , Gomes‐Osman Joyce , Cattaneo Gabriele , Albu Sergiu , Cabello‐Toscano María , Solana‐Sanchéz Javier , Redondo‐Camós María , Delgado‐Gallén Selma , Alviarez‐Schulze Vanessa , Pachón‐García Catherine , Tormos Josep M. , Bartrés‐Faz David , Morris Timothy P. , Pascual‐Leone Álvaro 
Published: September 2021

Background
Evidence in older adults suggests that higher cardiorespiratory fitness and lower cardiovascular risk are associated with greater cognition. However, given that changes in the brain that lead to cognitive decline begin decades before the onset of symptoms, understanding the mechanisms by which modifiable cardiovascular factors are associated with brain health in midlife is critical and can lead to the development of strategies to promote and maintain brain health as we age.

Methods and Results

In 501 middle‐aged (aged 40–65 years) adult participants of the BBHI (Barcelona Brain Health Initiative), we found differential associations among cardiorespiratory fitness, cardiovascular risk, and cognition and cortical thickness. Higher cardiorespiratory fitness was significantly associated with better visuospatial abilities and frontal loading abstract problem solving (β=3.16,
P
=0.049) in the older middle‐aged group (aged 55–65 years). In contrast, cardiovascular risk was negatively associated with better visuospatial reasoning and problem‐solving abilities (β=−0.046,
P
=0.002), flexibility (β=−0.054,
P
<0.001), processing speed (β=−0.115,
P
<0.001), and memory (β=−0.120,
P
<0.001). Cortical thickness in frontal regions mediated the relationship between cardiorespiratory fitness and cognition, whereas cortical thickness in a disperse network spanning multiple cortical regions across both hemispheres mediated the relationship between cardiovascular risk and cognition.

Conclusions
The relationships between modifiable cardiovascular factors, cardiorespiratory fitness, and cardiovascular risk, and cognition are present in healthy middle‐aged adults. These relationships are also mediated by brain structure highlighting a potential mechanistic pathway through which higher cardiorespiratory fitness and lower cardiovascular risk can positively impact cognitive function in midlife.