bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global, Regional, and National Burden of Myocarditis From 1990 to 2017: A Systematic Analysis Based on the Global Burden of Disease Study 2017
Authors: Wang Xiqiang , Bu Xiang , Wei Linyan , Liu Jing , Yang Dandan , Mann Douglas L. , Ma Aiqun , Hayashi Tomohiro 
Published: July 2021

Objective: The global trends in myocarditis burden over the past two decades remain poorly understood and might be increasing during the coronavirus disease 2019 (COVID-19) worldwide pandemic. This study aimed to provide comprehensive estimates of the incidence, mortality, and disability-adjusted life years (DALYs) for myocarditis globally from 1990 to 2017.Methods: Data regarding the incidence, mortality, DALY, and estimated annual percentage change (EAPC) between 1990 and 2017 for myocarditis worldwide were collected and calculated from the 2017 Global Burden of Disease study. We additionally calculated the myocarditis burden distribution based on the Socio-Demographic Index (SDI) quintile and Human Development Index (HDI).Results: The incidence cases of myocarditis in 2017 was 3,071,000, with a 59.6% increase from 1990, while the age-standardized incidence rate (ASIR) was slightly decreased. The number of deaths due to myocarditis increased gradually from 27,120 in 1990 to 46,490 in 2017. The middle SDI quintile showed the highest number of myocarditis-related deaths. On the contrary, the global age-standardized death rate (ASDR) decreased with an overall EAPC of −1.4 [95% uncertainty interval (UI) = −1.8 to −1.0]. Similar to ASDR, the global age-standardized DALY rate also declined, with an EAPC of −1.50 (95% UI = −2.30 to −0.8) from 1990 to 2017. However, there was a 12.1% increase in the number of DALYs in the past 28 years; the middle SDI and low-middle SDI quintiles contributed the most to the DALY number in 2017. We also observed significant positive correlations between the EPAC of age-standardized rate and HDI for both death and DALY in 2017.Conclusions: Globally, the ASIR, ASDR, and age-standardized DALY rate of myocarditis decreased slightly from 1990 to 2017. The middle SDI quintile had the highest level of ASIR, ASDR, and age-standardized DALY rate, indicating that targeted control should be developed to reduce the myocarditis burden especially based on the regional socioeconomic status. Our findings also provide a platform for further investigation into the myocarditis burden in the era of COVID-19.
Evaluating the Effectiveness of Medical–Dental Integration to Close Preventive and Disease Management Care Gaps
Authors: Mosen David M. , Banegas Matthew P. , Dickerson John F. , Fellows Jeffrey L. , Pihlstrom Daniel J. , Kershah Hala M. , Scott Jason L. , Keast Erin M. 
Published: July 2021

Background: The integration of medical care into the dental setting has been shown to facilitate the closure of care gaps among patients with unmet needs. However, little is known about whether program effectiveness varies depending on whether the care gap is related to preventive care or disease management.Materials and Methods: We used a matched cohort study design to compare closure of care gaps between patients aged 65+ who received care at a Kaiser Permanente Northwest (KPNW) Medical–Dental Integration (MDI) clinic or a non-MDI dental clinic between June 1, 2018, and December 31, 2019. The KPNW MDI program focuses on closing 12 preventive (e.g., flu vaccines) and 11 disease management care gaps (e.g., HbA1c testing) within the dental setting. Using the multivariable logistic regression, we separately analyzed care gap closure rates (yes vs. no) for patients who were overdue for: (1) preventive services only (n = 1,611), (2) disease management services only (n = 538), or (3) both types of services (n = 429), analyzing closure of each care gap type separately. All data were obtained through the electronic health record of KPNW.Results: The MDI patients had significantly higher odds of closing preventive care gaps (OR = 1.51, 95% CI = 1.30–1.75) and disease management care gaps (OR = 1.65, 95% CI = 1.27–2.15) than the non-MDI patients when they only had care gaps of one type or the other. However, no significant association was found between MDI and care gap closure when patients were overdue for both care gap types.Conclusions: Patients with care gaps related to either preventive care or disease management who received dental care in an MDI clinic had higher odds of closing these care gaps, but we found no evidence that MDI was helpful for those with both types of care gaps.Practical Implications: MDI may be an effective model for facilitating the delivery of preventive and disease management services, mainly when patients are overdue for one type of these services. Future research should examine the impact of MDI on long-term health outcomes.
The Driving Forces Underlying Spatiotemporal Lake Extent Changes in the Inner Tibetan Plateau During the Holocene
Authors: Liu Xiangjun , Madsen David , Zhang Xiaojian 
Published: July 2021

The Inner Tibetan Plateau (ITP), the central and western part of the Tibetan Plateau (TP), covers about one-fourth of the entire TP and contains more than 800 endorheic lakes larger than 1 km2. These lakes are important water reservoirs and sensitive to TP climate changes. They regulate regional water circulations, and further influence local ecosystems. Many lakes in ITP are surrounded by conspicuous paleoshorelines indicating much higher past lake levels. Previous studies found that lakes in the western ITP (west of ∼86°E) apparently expanded to higher levels than those to the east during the Holocene high lake level stage, however, there is no in-depth study on the reasons for the spatial differences of high lake levels within the ITP. In this study, we first identify Holocene lake level (or lake extent) changes over the ITP by combining published lake level variation data with our reconstruction of Dagze Co lake level variations. We then investigate spatial differences in the magnitude of lake expansions and explore the underlying forces driving these differences using the transient climate evolution of the last 21 ka (TraCE-21ka) and Kiel Climate Model (KCM) simulation results. We find that lakes in the ITP expanded to their highest levels during the early Holocene when the Indian summer monsoon (ISM) greatly intensified. After the mid-Holocene, lake levels fell as a result of the weakening of the ISM. The early Holocene northward shift of the westerly jet and a positive phase of the Atlantic multidecadal oscillation (AMO) resulted in the intensification of southwesterly winds on the southwest TP flank. Concurrently, westerly winds over the TP weakened, causing a differential increase in water vapor transport to the ITP with higher precipitation levels in the southwestern ITP and lower levels to the northeast. These wind-driven differential precipitation levels caused lakes in the southwestern ITP to expand to higher levels than those in the central, northern and northeastern ITP. During the early Holocene, expansion of lakes in the northwestern ITP was enhanced by an increase in glacier melt water besides the increased summer rainfall associated with the intensified ISM.
Spectrum of Endocrine Dysfunction and Association With Disease Severity in Patients With COVID-19: Insights From a Cross-Sectional, Observational Study
Authors: Das Liza , Dutta Pinaki , Walia Rama , Mukherjee Soham , Suri Vikas , Puri Goverdhan Dutt , Mahajan Varun , Malhotra Pankaj , Chaudhary Shakun , Gupta Rahul , Jayant Satyam Singh , Agrawal Kanhaiya , Kumar Vijay , Sachdeva Naresh , Rastogi Ashu , Bhadada Sanjay Kumar , Ram Sant , Bhansali Anil 
Published: July 2021

IntroductionEvidence on new-onset endocrine dysfunction and identifying whether the degree of this dysfunction is associated with the severity of disease in patients with COVID-19 is scarce.Patients and MethodsConsecutive patients enrolled at PGIMER Chandigarh were stratified on the basis of disease severity as group I (moderate-to-severe disease including oxygen saturation &lt;94% on room air or those with comorbidities) (n= 35) and group II (mild disease, with oxygen saturation &gt;94% and without comorbidities) (n=49). Hypothalamo-pituitary-adrenal, thyroid, gonadal axes, and lactotroph function were evaluated. Inflammatory and cell-injury markers were also analysed.ResultsPatients in group I had higher prevalence of hypocortisolism (38.5 vs 6.8%, p=0.012), lower ACTH (16.3 vs 32.1pg/ml, p=0.234) and DHEAS (86.29 vs 117.8µg/dl, p= 0.086) as compared to group II. Low T3 syndrome was a universal finding, irrespective of disease severity. Sick euthyroid syndrome (apart from low T3 syndrome) (80.9 vs 73.1%, p= 0.046) and atypical thyroiditis (low T3, high T4, low or normal TSH) (14.3 vs 2.4%, p= 0.046) were more frequent in group I than group II. Male hypogonadism was also more prevalent in group I (75.6% vs 20.6%, p=0.006) than group II, with higher prevalence of both secondary (56.8 vs 15.3%, p=0.006) and primary (18.8 vs 5.3%, p=0.006) hypogonadism. Hyperprolactinemia was observed in 42.4% of patients without significant difference between both groups.ConclusionCOVID-19 can involve multiple endocrine organs and axes, with a greater prevalence and degree of endocrine dysfunction in those with more severe disease.
Mouse Spexin: (I) NMR Solution Structure, Docking Models for Receptor Binding, and Histological Expression at Tissue Level
Authors: Wong Matthew K. H. , He Mulan , Sze Kong Hung , Huang Tao , Ko Wendy K. W. , Bian Zhao-Xiang , Wong Anderson O. L. 
Published: July 2021

Spexin (SPX), a highly conserved neuropeptide, is known to have diverse functions and has been implicated/associated with pathological conditions, including obesity, diabetes, anorexia nervosa, and anxiety/mood disorders. Although most of the studies on SPX involved the mouse model, the solution structure of mouse SPX, structural aspects for SPX binding with its receptors GalR2/3, and its cellular expression/distribution in mouse tissues are largely unknown. Using CD and NMR spectroscopies, the solution structure of mouse SPX was shown to be in the form of a helical peptide with a random coil from Asn1 to Pro4 in the N-terminal followed by an α-helix from Gln5 to Gln14 in the C-terminus. The molecular surface of mouse SPX is largely hydrophobic with Lys11 as the only charged residue in the α-helix. Based on the NMR structure obtained, docking models of SPX binding with mouse GalR2 and GalR3 were constructed by homology modeling and MD simulation. The models deduced reveal that the amino acids in SPX, especially Asn1, Leu8, and Leu10, could interact with specific residues in ECL1&amp;2 and TMD2&amp;7 of GalR2 and GalR3 by H-bonding/hydrophobic interactions, which provides the structural evidence to support the idea that the two receptors can act as the cognate receptors for SPX. For tissue distribution of SPX, RT-PCR based on 28 tissues/organs harvested from the mouse demonstrated that SPX was ubiquitously expressed at the tissue level with notable signals detected in the brain, GI tract, liver, gonad, and adrenal gland. Using immunohistochemical staining, protein signals of SPX could be located in the liver, pancreas, white adipose tissue, muscle, stomach, kidney, spleen, gonad, adrenal, and hypothalamo-pituitary axis in a cell type-specific manner. Our results, as a whole, not only can provide the structural information for ligand/receptor interaction for SPX but also establish the anatomical basis for our on-going studies to examine the physiological functions of SPX in the mouse model.
Metabolic and Hormonal Profile of Adolescent Girls With Polycystic Ovary Syndrome With Concomitant Autoimmune Thyroiditis
Authors: Skrzyńska Karolina Joanna , Zachurzok Agnieszka , Gawlik Aneta Monika 
Published: July 2021

IntroductionBoth polycystic ovary syndrome (PCOS) and autoimmune thyroiditis (AT) are considered to be among the most common endocrinopathies in young women, and they are classified as diseases that affect many processes in the human body. Their role in the development of metabolic disorders and diseases of the cardiovascular system in adult women is also emphasized. However, there are no data available to assess such risk in the teenage girl population. The aim of the study was to assess the hormonal and metabolic profile of adolescent girls with PCOS, additionally diagnosed with AT, as well as to identify possible risk factors for the coexistence of AT and PCOS.Material and Methods80 euthyroidic PCOS patients were qualified for the study (chronological age 16.54 ± 1.00 years, BMI 24.60 ± 4.16 kg/m2). Eighteen girls diagnosed with AT were included in the study group and 62 girls without AT—in the control group. Each patient had biochemical and hormonal tests performed. Additionally, to diagnose AT, the level of antibodies against thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG), as well as the image of the thyroid gland on ultrasound examination, were taken into account.ResultsEstradiol concentration was significantly higher in the study than in the control group (203.00 ± 217.00 vs. 152.00 ± 78.50 pmol/L, p=0.02). Higher DHEAS concentrations were also observed in the AT group compared with the group without AT (391.28 ± 176.40 vs. 317.93 ± 114.27 µg/dl, p=0.04). Moreover, there was a positive correlation between AT and estradiol concentration (ry=0.27; p=0.04). It was also shown that there is a tendency toward statistical significance for the positive correlation between the positive anti-TPO titer and the glucose concentration at 120 min OGTT (rƴ=0.26; p=0.07) and girls with PCOS and AT had higher glucose levels in 120 min OGTT (115.29±41.70 vs. 98.56±28.02 mg/dl, p=0.08).ConclusionThe study results showed no difference in the metabolic profile between the groups. The high concentration of estradiol found in girls with PCOS and AT may indicate the role of this hormone in the development of the autoimmune process. However, the numbers are small, and more research is needed to confirm our findings.
Design Optimization and Dynamic Simulation of Steam Cycle Power Plants: A Review
Authors: Martelli Emanuele , Alobaid Falah , Elsido Cristina 
Published: July 2021

After more than one century from its first use for electric power production, steam cycles are still the object of continuous research and development efforts worldwide. Indeed, owing to its favorable thermodynamic properties, steam cycles are not only used in coal-fired power plants but in a large variety of applications such as combined cycles, concentrated solar power plants and polygeneration plants. On the other hand, to cope with the efficiency and flexibility requirements set by today’s energy markets, the design and the operation of steam cycles must be carefully optimized. A key rule is played by the simulation and optimization codes developed in the last 30 years. This paper provides an introduction to the main types of simulation and optimization problems (design, off-design operation and dynamic), an overview of the mathematical background (possible solution approaches, numerical methods and available software), and a review of the main scientific contributions.
Hydrogeological Criteria to Improve the Sponge City Strategy of China
Authors: Jin Mengxiao , Lancia Michele , Tian Yong , Viaroli Stefano , Andrews Charles , Liu Junguo , Zheng Chunmiao 
Published: July 2021

China is facing frequent waterlogging and an increasing water scarcity that mirrors the fast urban and economic expansion of the last 4 decades. To mitigate these issues, the government promulgated the “Sponge City” strategy; a concept rooted in practices in western countries aimed at collecting and reusing 65–90% of urban rainfall. The application consists of absorbent infrastructures such as green roofs and rain gardens combined with the pre-existing urban environment. However, due to climate heterogeneities and the different urbanization contexts in China, these goals may seem overly ambitious in many areas of the country. Compact urbanization, together with heavy rainfall concentrated in short events, puts dramatic stresses on these infrastructures. At the same time, overdesigned infrastructures are expensive and may not be practical to retrofit in existing urban areas. In this paper, the role of urban aquifers as natural Sponge City elements are investigated throughout China. The method of implementation is inexpensive and easy to apply, favoring the direct infiltration to the subsoil after the conversion of the urban surfaces from impervious to permeable. Infiltration to urban aquifers alleviates the pressure on sewers, urban streams, as well as waste-water treatment plants. Considering urban aquifers with different hydraulic characteristics, water table dynamics after large infiltration events from rainfall are simulated via numerical analysis. Hydrogeological and geomorphological analyses are carried out to individuate criteria for the mapping of high absorbance areas at the regional and local scales. A Sponge City approach involving the urban aquifers can represent a winning formula for the success of this ambitious but compelling plan.
Bronchopulmonary Dysplasia Predicted by Developing a Machine Learning Model of Genetic and Clinical Information
Authors: Dai Dan , Chen Huiyao , Dong Xinran , Chen Jinglong , Mei Mei , Lu Yulan , Yang Lin , Wu Bingbing , Cao Yun , Wang Jin , Zhou Wenhao , Qian Liling 
Published: July 2021

BackgroundAn early and accurate evaluation of the risk of bronchopulmonary dysplasia (BPD) in premature infants is pivotal in implementing preventive strategies. The risk prediction models nowadays for BPD risk that included only clinical factors but without genetic factors are either too complex without practicability or provide poor-to-moderate discrimination. We aim to identify the role of genetic factors in BPD risk prediction early and accurately.MethodsExome sequencing was performed in a cohort of 245 premature infants (gestational age &lt;32 weeks), with 131 BPD infants and 114 infants without BPD as controls. A gene burden test was performed to find risk genes with loss-of-function mutations or missense mutations over-represented in BPD and severe BPD (sBPD) patients, with risk gene sets (RGS) defined as BPD–RGS and sBPD–RGS, respectively. We then developed two predictive models for the risk of BPD and sBPD by integrating patient clinical and genetic features. The performance of the models was evaluated using the area under the receiver operating characteristic curve (AUROC).ResultsThirty and 21 genes were included in BPD–RGS and sBPD–RGS, respectively. The predictive model for BPD, which combined the BPD–RGS and basic clinical risk factors, showed better discrimination than the model that was only based on basic clinical features (AUROC, 0.915 vs. AUROC, 0.814, P = 0.013, respectively) in the independent testing dataset. The same was observed in the predictive model for sBPD (AUROC, 0.907 vs. AUROC, 0.826; P = 0.016).ConclusionThis study suggests that genetic information contributes to susceptibility to BPD. The predictive model in this study, which combined BPD–RGS with basic clinical risk factors, can thus accurately stratify BPD risk in premature infants.
Pre-Treatment Neutrophil Count as a Predictor of Antituberculosis Therapy Outcomes: A Multicenter Prospective Cohort Study
Authors: Carvalho Anna Cristina C. , Amorim Gustavo , Melo Mayla G. M. , Silveira Ana Karla A. , Vargas Pedro H. L. , Moreira Adriana S. R. , Rocha Michael S. , Souza Alexandra B. , Arriaga María B. , Araújo-Pereira Mariana , Figueiredo Marina C. , Durovni Betina , Lapa-e-Silva José R. , Cavalcante Solange , Rolla Valeria C. , Sterling Timothy R. , Cordeiro-Santos Marcelo , Andrade Bruno B. , Silva Elisangela C. , Kritski Afrânio L. ,   the RePORT Brazil consortium
Published: July 2021

BackgroundNeutrophils have been associated with lung tissue damage in many diseases, including tuberculosis (TB). Whether neutrophil count can serve as a predictor of adverse treatment outcomes is unknown.MethodsWe prospectively assessed 936 patients (172 HIV-seropositive) with culture-confirmed pulmonary TB, enrolled in a multicenter prospective cohort study from different regions in Brazil, from June 2015 to June 2019, and were followed up to two years. TB patients had a baseline visit before treatment (month 0) and visits at month 2 and 6 (or at the end of TB treatment). Smear microscopy, and culture for Mycobacterium tuberculosis (MTB) were performed at TB diagnosis and during follow-up. Complete blood counts were measured at baseline. Treatment outcome was defined as either unfavorable (death, treatment failure or TB recurrence) or favorable (cure or treatment completion). We performed multivariable logistic regression, with propensity score regression adjustment, to estimate the association between neutrophil count with MTB culture result at month 2 and unfavorable treatment outcome. We used a propensity score adjustment instead of a fully adjusted regression model due to the relatively low number of outcomes.ResultsAmong 682 patients who had MTB culture results at month 2, 40 (5.9%) had a positive result. After regression with propensity score adjustment, no significant association between baseline neutrophil count (103/mm3) and positive MTB culture at month 2 was found among either HIV-seronegative (OR = 1.06, 95% CI = [0.95;1.19] or HIV-seropositive patients (OR = 0.77, 95% CI = [0.51; 1.20]). Of 691 TB patients followed up for at least 18 months and up to 24 months, 635 (91.9%) were either cured or completed treatment, and 56 (8.1%) had an unfavorable treatment outcome. A multivariable regression with propensity score adjustment found an association between higher neutrophil count (103/mm3) at baseline and unfavorable outcome among HIV-seronegative patients [OR= 1.17 (95% CI= [1.06;1.30]). In addition, adjusted Cox regression found that higher baseline neutrophil count (103/mm3) was associated with unfavorable treatment outcomes overall and among HIV-seronegative patients (HR= 1.16 (95% CI = [1.05;1.27]).ConclusionIncreased neutrophil count prior to anti-TB treatment initiation was associated with unfavorable treatment outcomes, particularly among HIV-seronegative patients. Further prospective studies evaluating neutrophil count in response to drug treatment and association with TB treatment outcomes are warranted.
Comparison of the Filtration Efficiency of Different Face Masks Against Aerosols
Authors: Stahl Connor , Frederick Kevin , Chaudhary Sachin , Morton Christopher J. , Loy Douglas , Muralidharan Krishna , Sorooshian Armin , Parthasarathy Sairam 
Published: July 2021

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic can spread through virus-containing aerosols ( ≤ 5 μm) and larger airborne droplets. Quantifying filtration efficiency of different kinds of masks and linings for aerosols that fall within the most penetrating particle size (80-400 nm) is critical to limiting viral transmission. The objective of our experiment was to compare the “real-world” filtering efficiency of different face masks for fine aerosols (350 nm) in laboratory simulations.Methods: We performed a simulated bench test that measured the filtering efficiency of N95 vs. N99 masks with elastomeric lining in relation to baseline (“background”) aerosol generation. A mannequin head was placed within a chamber and was attached to an artificial lung simulator. Particles of known size (350 ± 6 nm aerodynamic diameter) were aerosolized into the chamber while simulating breathing at physiological settings of tidal volume, respiratory rate, and airflow. Particle counts were measured between the mannequin head and the lung simulator at the tracheal airway location.Results: Baseline particle counts without a filter (background) were 2,935 ± 555 (SD) cm−3, while the N95 (1348 ± 92 cm−3) and N99 mask with elastomeric lining (279 ± 164 cm−3; p &lt;0.0001) exhibit lower counts due to filtration.Conclusion: The filtration efficiency of the N95 (54.1%) and N99 (90.5%) masks were lower than the filtration efficiency rating. N99 masks with elastomeric lining exhibit greater filtration efficiency than N95 masks without elastomeric lining and may be preferred to contain the spread of SARS-CoV-2 infection.