bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Quasi-Biweekly Oscillation of Summer Rainfall in Southern China and Its Relationship With the Geopotential Height Anomaly Over the North Atlantic Ocean
Authors: Huang Qian , Yin Xinyu , Yao Suxiang 
Published: November 2021

Summer precipitation in East Asia has significant quasi-biweekly (10–30-day) oscillation characteristics. By using gauge-based precipitation and ERA-Interim reanalysis data, the basic mode of the quasi-biweekly oscillation of summer precipitation in East Asia and the related circulation from 1979 to 2012 were analyzed. It was found that the middle and lower reaches of the Yangtze River and its south in China were among the key areas for the 10- to 30-day oscillation of summer precipitation. After selecting typical summer precipitation events with 10- to 30-day oscillation characteristics in key areas and conducting composite analysis, it is found that in the dry (wet) phase of quasi-biweekly precipitation in southern China, it is controlled by quasi-biweekly anticyclone (cyclone) at 500 hPa above the key area. During the evolution of quasi-biweekly precipitation, the ridge of the Northwest Pacific Subtropical High is located between 20 and 22°N latitude, and there is no significant variability in the large-scale background circulation. Furthermore, composite analysis of the precursory signal at 500 hPa during quasi-biweekly precipitation in southern China found that there was an obvious quasi-biweekly geopotential height anomaly over the North Atlantic Ocean almost 30 days before the peak day of quasi-biweekly precipitation. While the quasi-biweekly geopotential height anomaly at 500 hPa in the North Atlantic propagates eastward, it also leads the cold air to transport southward. Cold air from high latitudes and warm air from low latitudes converge in southern China, which affects the quasi-biweekly oscillation of precipitation. Hysteresis synthesis of precipitation based on 500 hPa geopotential height’s quasi-biweekly oscillation events over the North Atlantic Ocean comes to almost the same conclusion. Therefore, the 500 hPa geopotential height quasi-biweekly anomaly in the North Atlantic may have important prediction significance for an extended-range forecast of summer rainfall in China.
The Emerging Interplay Between Recirculating and Tissue-Resident Memory T Cells in Cancer Immunity: Lessons Learned From PD-1/PD-L1 Blockade Therapy and Remaining Gaps
Authors: Gitto Silvia , Natalini Ambra , Antonangeli Fabrizio , Di Rosa Francesca 
Published: November 2021

Remarkable progress has been made in the field of anti-tumor immunity, nevertheless many questions are still open. Thus, even though memory T cells have been implicated in long-term anti-tumor protection, particularly in prevention of cancer recurrence, the bases of their variable effectiveness in tumor patients are poorly understood. Two types of memory T cells have been described according to their traffic pathways: recirculating and tissue-resident memory T cells. Recirculating tumor-specific memory T cells are found in the cell infiltrate of solid tumors, in the lymph and in the peripheral blood, and they constantly migrate in and out of lymph nodes, spleen, and bone marrow. Tissue-resident tumor-specific memory T cells (TRM) permanently reside in the tumor, providing local protection.Anti-PD-1/PD-L1, a type of immune checkpoint blockade (ICB) therapy, can considerably re-invigorate T cell response and lead to successful tumor control, even in patients at advanced stages. Indeed, ICB has led to unprecedented successes against many types of cancers, starting a ground-breaking revolution in tumor therapy. Unfortunately, not all patients are responsive to such treatment, thus further improvements are urgently needed. The mechanisms underlying resistance to ICB are still largely unknown. A better knowledge of the dynamics of the immune response driven by the two types of memory T cells before and after anti-PD-1/PD-L1 would provide important insights on the variability of the outcomes. This would be instrumental to design new treatments to overcome resistance.Here we provide an overview of T cell contribution to immunity against solid tumors, focusing on memory T cells. We summarize recent evidence on the involvement of recirculating memory T cells and TRM in anti-PD-1/PD-L1-elicited antitumor immunity, outline the open questions in the field, and propose that a synergic action of the two types of memory T cells is required to achieve a full response. We argue that a T-centric vision focused on the specific roles and the possible interplay between TRM and recirculating memory T cells will lead to a better understanding of anti-PD-1/PD-L1 mechanism of action, and provide new tools for improving ICB therapeutic strategy.
The Pilling-Bedworth Ratio of Oxides Formed From the Precipitated Phases in Magnesium Alloys
Authors: Jiang Quantong , Lu Dongzhu , Liu Chang , Liu Nazhen , Hou Baorong 
Published: November 2021

The Pilling-Bedworth ratio of oxides preferentially formed from the precipitated phases in magnesium alloys were calculated. The results showed that the PBR value of Nd2O3 preferentially formed from Mg12Nd was 1.0584, and the PBR value of Y2O3 preferentially formed from Mg24Y5 was 1.1923. Both the Nd2O3 and Y2O3 would provide a good protection to the Mg matrix. The Gd2O3 preferentially formed from Mg3Gd, whereas the MgO preferentially formed from MgNi2. The PBR value of these two oxides were both larger than 2. The corresponding oxides formed from the common precipitated phases Mg17Al12, MgZn2, MgCu2, Mg2Ca, Mg12Ce, and MgAg were all less than 1. The oxide films formed on surfaces of pure Mg and Mg-xY (x = 3, 5, 7 wt.%) alloys at high temperatures were analyzed. The results showed that the oxide films were composed of a Y2O3/MgO outer layer and an inner layer rich with Y2O3. The formation of Y2O3 was mainly caused by the oxidation of Mg24Y5. The more Y2O3 existed in the composite oxidation film, the better corrosion resistance of the Mg-Y samples.
Machine Learning Approach to Predict Positive Screening of Methicillin-Resistant Staphylococcus aureus During Mechanical Ventilation Using Synthetic Dataset From MIMIC-IV Database
Authors: Hirano Yohei , Shinmoto Keito , Okada Yohei , Suga Kazuhiro , Bombard Jeffrey , Murahata Shogo , Shrestha Manoj , Ocheja Patrick , Tanaka Aiko 
Published: November 2021

Background: Mechanically ventilated patients are susceptible to nosocomial infections such as ventilator-associated pneumonia. To treat ventilated patients with suspected infection, clinicians select appropriate antibiotics. However, decision-making regarding the use of antibiotics for methicillin-resistant Staphylococcus aureus (MRSA) is challenging, because of the lack of evidence-supported criteria. This study aims to derive a machine learning model to predict MRSA as a possible pathogen responsible for infection in mechanically ventilated patients.Methods: Data were collected from the Medical Information Mart for Intensive Care (MIMIC)-IV database (an openly available database of patients treated at the Beth Israel Deaconess Medical Center in the period 2008–2019). Of 26,409 mechanically ventilated patients, 809 were screened for MRSA during the mechanical ventilation period and included in the study. The outcome was positivity to MRSA on screening, which was highly imbalanced in the dataset, with 93.9% positive outcomes. Therefore, after dividing the dataset into a training set (n = 566) and a test set (n = 243) for validation by stratified random sampling with a 7:3 allocation ratio, synthetic datasets with 50% positive outcomes were created by synthetic minority over-sampling for both sets individually (synthetic training set: n = 1,064; synthetic test set: n = 456). Using these synthetic datasets, we trained and validated an XGBoost machine learning model using 28 predictor variables for outcome prediction. Model performance was evaluated by area under the receiver operating characteristic (AUROC), sensitivity, specificity, and other statistical measurements. Feature importance was computed by the Gini method.Results: In validation, the XGBoost model demonstrated reliable outcome prediction with an AUROC value of 0.89 [95% confidence interval (CI): 0.83–0.95]. The model showed a high sensitivity of 0.98 [CI: 0.95–0.99], but a low specificity of 0.47 [CI: 0.41–0.54] and a positive predictive value of 0.65 [CI: 0.62–0.68]. Important predictor variables included admission from the emergency department, insertion of arterial lines, prior quinolone use, hemodialysis, and admission to a surgical intensive care unit.Conclusions: We were able to develop an effective machine learning model to predict positive MRSA screening during mechanical ventilation using synthetic datasets, thus encouraging further research to develop a clinically relevant machine learning model for antibiotics stewardship.
Simple Self-Assessment Tool to Predict Osteoporosis in Taiwanese Men
Authors: Liu Dung-Huan , Hsu Chung-Yuan , Wu Pei-Ching , Chen Ying-Chou , Chen You-Yin , Chen Jia-Feng , Yu Shan-Fu , Cheng Tien-Tsai 
Published: November 2021

Background: Although the self-assessment tools for predicting osteoporosis are convenient for clinicians, they are not commonly used among men. We developed the Male Osteoporosis Self-Assessment Tool for Taiwan (MOSTAi) to identify the patients at risk of osteoporosis.Methods: All the participants completed a questionnaire on the clinical risk factors for the fracture risk assessment tool. The risk index was calculated by the multivariate regression model through the item reduction method. The receiver operating characteristic (ROC) curve was used to analyze its sensitivity and specificity, and MOSTAi was developed and validated.Results: A total of 2,290 men participated in the bone mineral density (BMD) survey. We chose a model that considered two variables (age and weight). The area under the curve (AUC) of the model was 0.700. The formula for the MOSTAi index is as follows: 0.3 × (weight in kilograms) – 0.1 × (years). We chose 11 as the appropriate cut-off value for the MOSTAi index to identify the subjects at the risk of osteoporosis.Conclusions: The MOSTAi is a simple, intuitive, and country-specific tool that can predict the risk of osteoporosis in Taiwanese men. Due to different demographic characteristics, each region of the world can develop its own model to identify patients with osteoporosis more effectively.
Risk Factors for Invasive Aspergillosis in Patients Admitted to the Intensive Care Unit With Coronavirus Disease 2019: A Multicenter Retrospective Study
Authors: Xu Jiqian , Yang Xiaobo , Lv Zheng , Zhou Ting , Liu Hong , Zou Xiaojing , Cao Fengsheng , Zhang Lu , Liu Boyi , Chen Wei , Yu Yuan , Shu Huaqing , Yuan Shiying , Hu Ming , Huang Chaolin , Shang You 
Published: November 2021

Background: Invasive pulmonary aspergillosis (IPA) is a life-threatening complication in coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs), but risk factors for COVID-19-associated IPA (CAPA) have not been fully characterized. The aim of the current study was to identify factors associated with CAPA, and assess long-term mortality.Methods: A retrospective cohort study of adult COVID-19 patients admitted to ICUs from six hospitals was conducted in Hubei, China. CAPA was diagnosed via composite clinical criteria. Demographic information, clinical variables, and 180-day outcomes after the diagnosis of CAPA were analyzed.Results: Of 335 critically ill patients with COVID-19, 78 (23.3%) developed CAPA within a median of 20.5 days (range 13.0–42.0 days) after symptom onset. Compared to those without CAPA, CAPA patients were more likely to have thrombocytopenia (50 vs. 19.5%, p &lt; 0.001) and secondary bacterial infection prior to being diagnosed with CAPA (15.4 vs. 6.2%, p = 0.013), and to receive vasopressors (37.2 vs. 8.6%, p &lt; 0.001), higher steroid dosages (53.9 vs. 34.2%, p = 0.002), renal replacement therapy (37.2 vs. 13.6%, p &lt; 0.001), and invasive mechanical ventilation (57.7 vs. 35.8%, p &lt; 0.001). In multivariate analysis incorporating hazard ratios (HRs) and confidence intervals (CIs), thrombocytopenia (HR 1.98, 95% CI 1.16–3.37, p = 0.012), vasopressor use (HR 3.57, 95% CI 1.80–7.06, p &lt; 0.001), and methylprednisolone use at a daily dose ≥ 40 mg (HR 1.69, 95% CI 1.02–2.79, p = 1.02–2.79) before CAPA diagnosis were independently associated with CAPA. Patients with CAPA had longer median ICU stays (17 days vs. 12 days, p = 0.007), and higher 180-day mortality (65.4 vs. 33.5%, p &lt; 0.001) than those without CAPA.Conclusions: Thrombocytopenia, vasopressor use, and corticosteroid treatment were significantly associated with increased risk of incident IPA in COVID-19 patients admitted to ICUs. The occurrence of CAPA may increase the likelihood of long-term COVID-19 mortality.
Comparison of the New Viscoelastic Coagulation Analyzer ClotPro® With ROTEM® Delta and Conventional Coagulation Tests in Critically Ill Patients With COVID-19
Authors: Infanger Lukas , Dibiasi Christoph , Schaden Eva , Ulbing Stefan , Wiegele Marion , Lacom Conrad , Gratz Johannes 
Published: November 2021

Background: Viscoelastic coagulation testing has been suggested to help manage coagulopathy in critically ill patients with COVID-19. However, results from different viscoelastic devices are not readily comparable. ClotPro® is a novel thromboelastometry analyzer offering a wider range of commercially available assays.Methods: We compared the results from ClotPro with results from the well-established ROTEM® Delta device and conventional coagulation tests in critically ill patients with COVID-19.Results: Viscoelastic parameters indicated the presence of a potentially hypercoagulable state in the majority of patients. In up to 95 paired measurements, we found strong correlations between several parameters routinely used in clinical practice: (i) EX test vs. EXTEM CT, A5, A10, MCF, (ii) IN test vs. INTEM A5, A10, MCF, and (iii) FIB test vs. FIBTEM A5, A10, MCF (all R &gt; 0.7 and p &lt; 0.001). In contrast, IN test CT vs. INTEM CT showed only a moderate correlation (R = 0.53 and p &lt; 0.001). Clot strength parameters of both devices exhibited strong correlations with platelet counts and fibrinogen levels (all R &gt; 0.7 and p &lt; 0.001). Divergent correlations of intrinsically activated assays with aPTT and anti-factor Xa activity were visible. Regarding absolute differences of test results, considerable delta occurred in CT, CFT, and clot strength parameters (all p &lt; 0.001) between both devices.Conclusions: Several parameters obtained by ClotPro show strong correlations with ROTEM Delta. Due to weak correlations of intrinsically activated clotting times and considerable absolute differences in a number of parameters, our findings underline the need for device-specific algorithms in this patient cohort.
Activity of PD-1 Inhibitor Combined With Anti-Angiogenic Therapy in Advanced Sarcoma: A Single-Center Retrospective Analysis
Authors: You Yang , Guo Xi , Zhuang Rongyuan , Zhang Chenlu , Wang Zhiming , Shen Feng , Wang Yan , Liu Wenshuai , Zhang Yong , Lu Weiqi , Hou Yingyong , Wang Jing , Zhang Xuan , Lu Minzhi , Zhou Yuhong 
Published: November 2021

Background: Immune checkpoint inhibitors (ICIs) are employed to treat various cancers, including soft tissue sarcomas (STSs), and less than 20% of patients benefit from this treatment. Vascular endothelial growth factor (VEGF) promotes the immunosuppressive tumor microenvironment and contributes to ICI-resistant therapy. Anti-VEGF receptor tyrosine-kinase inhibitors (TKIs) combined with ICIs have shown antitumor activity in patients with alveolar soft-part sarcoma (ASPS). However, they have not been extensively studied to treat other STS subtypes, such as leiomyosarcoma (LMS), dedifferentiated liposarcoma (DDLPS), undifferentiated pleomorphic sarcoma (UPS), myxofibrosarcoma (MFS), and angiosarcoma (AS).Methods: In this retrospective study, we collected data from 61 patients who were diagnosed with advanced STS based on imaging and histology, including LMS, DDLPS, and UPS. Among them, 41 patients were treated with ICIs combined with TKIs and 20 patients received ICI therapy. The endpoints of progression-free survival (PFS) and overall response rate (ORR) were analyzed in the two groups, and the overall response [partial response (PR), stable disease (SD), and progressive disease (PD)] of each patient was determined using RECIST 1.1 evaluation criteria.Results: In total, 61 STS patients had the following subtypes: LMS (n = 20), DDLPS (n = 17), UPS (n = 8), ASPS (n = 7), MFS (n = 7), and AS (n = 2). The median PFS (mPFS) was significantly prolonged after ICI treatment in combination with TKIs (11.74 months, 95% CI 4.41–14.00) compared to ICI treatment alone (6.81 months, 95% CI 5.43–NA) (HR 0.5464, p = 0.043). The 12-month PFS rates of patients who received ICI–TKI treatment were increased from 20.26% (95% CI 0.08–0.53) to 42.90% (95% CI 0.27–0.68). In the combination therapy group, 12 patients (30%) achieved PR, 25 patients (62.5%) achieved SD, and 3 patients (7.5%) achieved PD for 3 months or longer. In the non-TKI-combination group, 2 patients (9.5%) achieved PR, 14 patients (66.7%) achieved SD, and 5 patients (23.8%) achieved PD within 3 months. The ORRs in the two groups were 30.0% (ICI–TKI combination) and 9.5% (ICI only), respectively. A notable ORR was observed in the ICI–TKI combination group, especially for subtypes ASPS (66.7%), MFS (42.9%), and UPS (33.3%). The PD-L1 expression (n = 33) and tumor mutation burden (TMB, n = 27) were determined for each patient. However, our results showed no significant difference in PFS or response rates between the two groups.Conclusion: This study suggests that ICI–TKI treatment has antitumor activity in patients with STS, particularly the ASPS and MFS subtypes. Moreover, effective biomarkers to predict clinical outcomes are urgently needed after combination therapy in the STS subtypes.
Prognosis for Cutaneous Melanoma by Clinical and Pathological Profile: A Population-Based Study
Authors: Buja Alessandra , Bardin Andrea , Damiani Giovanni , Zorzi Manuel , De Toni Chiara , Fusinato Riccardo , Spina Romina , Vecchiato Antonella , Del Fiore Paolo , Mocellin Simone , Baldo Vincenzo , Rugge Massimo , Rossi Carlo Riccardo 
Published: November 2021

IntroductionAmong white people, the incidence of cutaneous malignant melanoma (CMM) has been increasing steadily for several decades. Meanwhile, there has also been a significant improvement in 5-year survival among patients with melanoma. This population-based cohort study investigates the five-year melanoma-specific survival (MSS) for all melanoma cases recorded in 2015 in the Veneto Tumor Registry (North-Est Italian Region), taking both demographic and clinical-pathological variables into consideration.MethodsThe cumulative melanoma-specific survival probabilities were calculated with the Kaplan-Meier method, applying different sociodemographic and clinical-pathological variables. Cox’s proportional hazards model was fitted to the data to assess the association between independent variables and MSS, and also overall survival (OS), calculating the hazard ratios (HR) relative to a reference condition, and adjusting for sex, age, site of tumor, histotype, melanoma ulceration, mitotic count, tumor-infiltrating lymphocytes (TIL), and stage at diagnosis.ResultsCompared with stage I melanoma, the risk of death was increased for stage II (HR 3.31, 95% CI: 0.94-11.76, p=0.064), almost ten times higher for stage III (HR 10.51, 95% CI: 3.16-35.02, p&lt;0.001), and more than a hundred times higher for stage IV (HR 117.17, 95% CI: 25.30-542.62, p&lt;0.001). Among the other variables included in the model, the presence of mitoses and histological subtype emerged as independent risk factors for death.ConclusionsThe multivariable analysis disclosed that older age, tumor site, histotype, mitotic count, and tumor stage were independently associated with a higher risk of death. Data on survival by clinical and morphological characteristics could be useful in modelling, planning, and managing the most appropriate treatment and follow-up for patients with CMM.
Mean Corpuscular Volume as a Prognostic Factor for Patients With Habitual Alcohol or Tobacco Use After Esophagectomy
Authors: Huang Shu-jie , Zhan Peng-fei , Chen Shao-bin 
Published: November 2021

BackgroundThe goal of this study was to investigate the impact of mean corpuscular volume (MCV) in patients with esophageal squamous cell carcinoma (ESCC) who underwent surgical resection.MethodsA total of 615 patients with ESCC who underwent esophagectomy were analyzed. Patients were divided into two groups according to the standard MCV: the high MCV group (&gt;100 fl) and the low MCV group (≤100 fl). Survival analyses were performed to calculate overall survival (OS) and cancer-specific survival (CSS) and investigate the independent prognostic factors.ResultsFifty-one patients (8.3%) were in the high MCV group, and the other 564 patients (91.7%) were defined as the low MCV group. MCV was significantly correlated with sex, habitual alcohol or tobacco use, tumor length, body mass index, and multiple primary malignancies (P &lt; 0.05). Elevated MCV was significantly correlated with poor survival in univariate and multivariate analyses. However, in subgroup analyses, MCV was found to be correlated with survival only in patients with alcohol or tobacco consumption and not in patients without alcohol or tobacco consumption.ConclusionsPretreatment MCV was correlated with survival in ESCC patients after esophagectomy. However, its prognostic value might only exist in patients with alcohol or tobacco consumption.
A System Pharmacology Model for Decoding the Synergistic Mechanisms of Compound Kushen Injection in Treating Breast Cancer
Authors: Li Yi , Wang Kexin , Chen Yupeng , Cai Jieqi , Qin Xuemei , Lu Aiping , Guan Daogang , Qin Genggeng , Chen Weiguo 
Published: November 2021

Breast cancer (BC) is one of the most common malignant tumors among women worldwide and can be treated using various methods; however, side effects of these treatments cannot be ignored. Increasing evidence indicates that compound kushen injection (CKI) can be used to treat BC. However, traditional Chinese medicine (TCM) is characterized by “multi-components” and “multi-targets”, which make it challenging to clarify the potential therapeutic mechanisms of CKI on BC. Herein, we designed a novel system pharmacology strategy using differentially expressed gene analysis, pharmacokinetics synthesis screening, target identification, network analysis, and docking validation to construct the synergy contribution degree (SCD) and therapeutic response index (TRI) model to capture the critical components responding to synergistic mechanisms of CKI in BC. Through our designed mathematical models, we defined 24 components as a high contribution group of synergistic components (HCGSC) from 113 potentially active components of CKI based on ADME parameters. Pathway enrichment analysis of HCGSC targets indicated that Rhizoma Heterosmilacis and Radix Sophorae Flavescentis could synergistically target the PI3K-Akt signaling pathway and the cAMP signaling pathway to treat BC. Additionally, TRI analysis showed that the average affinity of HCGSC and targets involved in the key pathways reached -6.47 kcal/mmol, while in vitro experiments proved that two of the three high TRI-scored components in the HCGSC showed significant inhibitory effects on breast cancer cell proliferation and migration. These results demonstrate the accuracy and reliability of the proposed strategy.