bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soil Characteristics and Hydromorphological Patterns Control Denitrification at the Floodplain Scale
Authors: Kaden Ute Susanne , Fuchs Elmar , Geyer Sophie , Hein Thomas , Horchler Peter , Rupp Holger , Scholz Mathias , Schulz-Zunkel Christiane , Weigelhofer Gabriele 
Published: July 2021

Nitrate pollution in aquatic ecosystems is still a major problem in Germany. There is a great potential to permanently remove nitrate from aquatic systems through denitrification as a relevant ecosystem function. However, the controlling factors and the dimension of the denitrification potential are still not fully understood due to the high complexity of the process. This study presents the combined assessment of potential soil denitrification rates, physical and chemical soil parameters, and hydrological parameters from six floodplains of four large German rivers, namely the Rhine, the Elbe, the Weser, and the Main. Based on multivariate statistics, results show that the denitrification potential of soil was almost solely controlled by soil pH. The lab assays showed mean soil denitrification potentials of 6.4–11.4 mg N m−2h−1(pH &lt; 7) and 23.0–30.5 mg N m−2h−1(pH &gt; 7). We contend that when upscaling these estimates to annual rates of potential denitrification, the duration of average inundation should be incorporated, as this accounts for water saturation and nutrient supply − the major controlling variables for denitrification. Results provide evidence that the denitrification potential can only be fully exploited in frequently inundated floodplains. Thus, despite favorable soil conditions for denitrification, floodplains that have suffered from anthropogenic impacts, lose their importance in nitrate removal for the river system. We conclude that pH and lateral hydrological connectivity are likely to be key factors that should be considered when estimating denitrification as an ecosystem function.
The Association Between Particulate Air Pollution and Respiratory Mortality in Beijing Before, During, and After the 2008 Olympic and Paralympic Games
Authors: Breitner Susanne , Su Chang , Franck Ulrich , Wiedensohler Alfred , Cyrys Josef , Pan Xiaochuan , Wichmann H-Erich , Schneider Alexandra , Peters Annette 
Published: July 2021

To improve ambient air quality during the 2008 Summer Olympic and Paralympic Games, the Chinese Government and Beijing’s municipal government implemented comprehensive emission control policies in Beijing and its neighboring regions before and during this period. The goal of this study was to investigate the association between particulate air pollution and cause-specific respiratory mortality before, during and after the period of the Olympic Games. Further, we wanted to assess whether changes in pollutant concentrations were linked to changes in respiratory mortality. We obtained daily data on mortality due to respiratory diseases (coded as J00-J99 according to the International Classification of Diseases and Related Health Problems 10th revision [ICD10]) and pneumonia (ICD10: J12–18), meteorology, particulate matter less than 10 µm or 2.5 μm in diameter (PM10, PM2.5) and particle number size distribution from official monitoring networks and sites located on the Peking University campus between May 20 and December 1, 2008. We assessed the effects of particulate air pollution on daily respiratory mortality using confounder-adjusted Quasi-Poisson regression models. Furthermore, we estimated air pollution effects for three periods—before (May 20 to July 20, 2008), during (August 1 to September 20, 2008) and after (October 1 to December 1, 2008)—by including interaction terms in the models. We found associations between different particle metrics and respiratory and pneumonia mortality, with more pronounced effects in smaller particle size ranges. For example, an interquartile range increase of 7,958 particles/cm3 in ultrafine particles (particles &lt;100 nm in diameter) led to a 16.3% (95% confidence interval 4.3%; 26.5%) increase in respiratory mortality with a delay of seven days. When investigating the sub-periods, results indicate that a reduction in air pollution during the Olympics resulted in reduced (cause-specific) respiratory mortality. This reduction was especially pronounced for pneumonia mortality. The findings suggest that even a short-term reduction in pollution concentrations may lead to health benefits and that smaller particles in the ultrafine size range may be particularly important for respiratory health.
Interleukin-18 Is a Potential Biomarker to Discriminate Active Adult-Onset Still’s Disease From COVID-19
Authors: Chen Po-Ku , Lan Joung-Liang , Huang Po-Hao , Hsu Jye-Lin , Chang Ching-Kun , Tien Ni , Lin Hui-Ju , Chen Der-Yuan 
Published: July 2021

BackgroundHyperinflammation with dysregulated production of galectins and cytokines may develop in COVID-19 or adult-onset Still’s disease (AOSD). Given the similar clinical features in both diseases, it is necessary to identify biomarkers that can differentiate COVID-19 from AOSD. However, the related data remain scarce currently.MethodsIn this cross-sectional study, plasma levels of galectin-3, galectin-9, and soluble TIM-3 (sTIM-3) were determined by ELISA in 55 COVID-19 patients (31 non-severe and 24 severe), 23 active AOSD patients, and 31 healthy controls (HC). The seropositivity for SARS-CoV-2 was examined using an immunochromatographic assay, and cytokine profiles were determined with the MULTIPLEX platform.ResultsSignificantly higher levels of galectin-3, galectin-9, IL-1β, IL-1Ra, IL-10, IFN-α2, IL-6, IL-18, and TNF-α were observed in severe COVID-19 and active AOSD patients compared with HC (all p&lt;0.001). AOSD, but not COVID-19, showed significantly higher IFN-γ and IL-17A compared with HC (both p&lt;0.01). Moreover, active AOSD patients had 68-fold higher IL-18 levels and 5-fold higher ferritin levels than severe COVID-19 patients (both p&lt;0.001). IL-18 levels at the cut-off value 190.5pg/mL had the highest discriminative power for active AOSD and severe COVID-19, with AUC 0.948, sensitivity 91.3%, specificity 95.8%, and accuracy of 91.5% (p&lt;0.005). Multivariate regression analysis revealed IL-18 as a significant predictor of active AOSD (p&lt;0.05).ConclusionActive AOSD patients share features of hyperinflammation and cytokine storm with severe COVID-19 patients but possess a distinct cytokine profile, including elevated IL-18, IL-6, IFN-γ, and IL-17A. IL-18 is a potential discriminator between AOSD and COVID-19 and may significantly predict active AOSD.
A Switchable Ultra-Wideband Metamaterial Absorber with Polarization-Insensitivity and Wide-incident Angle at THz Band
Authors: Wang Liansheng , Xia Dongyan , Fu Quanhong , Ding Xueyong , Wang Yuan 
Published: July 2021

In this paper, we report a switchable ultra-wideband metamaterial absorber with polarization-insensitivity and wide-incident angle at THz band which is composed of VO2 disk, polyimide dielectric substrate, and gold ground plane. The results show that the absorption is greater than 90% from 3.5–8 THz for a temperature of 300 K and this absorption band disappears when the temperature rises to 350 K. The absorption property of our proposed metamaterial absorber is insensitive to polarization states and angles and it can withhold high absorption of more than 80% for wide-incident angles, up to 60° for TE mode and TM mode. The wideband absorption mechanism is elucidated using an effective medium and surface current analysis.
Efficacy and Safety of Remimazolam in Endoscopic Sedation—A Systematic Review and Meta-Analysis
Authors: Zhu Xianlin , Wang Hongbai , Yuan Su , Li Yinan , Jia Yuan , Zhang Zhe , Yan Fuxia , Wang Zaiping 
Published: July 2021

Background: The aim of this systematic review and meta-analysis was to investigate the efficacy and safety of remimazolam in clinical endoscopic procedure sedation.Methods: The authors searched the databases of PubMed, Embase, and Cochrane Library for studies published until January 2, 2021, that reported remimazolam sedation for endoscopic procedures. The sedative efficiency and the incidence of adverse events were assessed as outcomes. Cochrane Review Manager Software 5.3 was used to perform the statistical analyses.Results: Seven relevant studies involving a total of 1,996 patients were identified. We conducted a meta-analysis of the different controls used in the studies, that is, the placebo, midazolam, and propofol. The results demonstrated that remimazolam had a strong sedative effect, and its sedative efficiency was significantly higher than that of placebo [OR = 0.01, 95% CI: (0.00, 0.10), I2 = 30%, p &lt;0.00001]. The sedative efficiency of remimazolam was significantly higher than that of midazolam [OR = 0.12, 95% CI: (0.08, 0.21), I2 = 0%, p &lt; 0.00001] but lesser than that of propofol [OR = 12.22, 95% CI: (1.58, 94.47), I2 = 0%, p = 0.02]. Regarding the adverse events, remimazolam is associated with a lower incidence of hypotension than placebo and midazolam. Similarly, remimazolam was associated with a lower incidence of hypotension and hypoxemia than propofol.Conclusions: Remimazolam is a safe and effective sedative for patients undergoing endoscopic procedures. The sedative efficiency of remimazolam was significantly higher than that of midazolam but slightly lower than that of propofol. However, the respiration and circulation inhibitory effects of remimazolam were weaker than those of midazolam and propofol.
A High Epigenetic Risk Score Shapes the Non-Inflamed Tumor Microenvironment in Breast Cancer
Authors: Zhang Dong , Wang Yingnan , Yang Qifeng 
Published: July 2021

Background: Epigenetic dysregulation via aberrant DNA methylation has gradually become recognized as an efficacious signature for predicting tumor prognosis and response to therapeutic targets. However, reliable DNA methylation biomarkers describing tumorigenesis remain to be comprehensively explored regarding their prognostic and therapeutic potential in breast cancer (BC).Methods: Whole-genome methylation datasets integrated from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database were profiled (n = 1,268). A three-stage selection procedure (discovery, training, and external validation) was utilized to screen out the prominent biomarkers and establish a robust risk score from more than 300,000 CpG sites after quality control, rigorous filtering, and reducing dimension. Moreover, gene set enrichment analyses guided us to systematically correlate this epigenetic risk score with immunological characteristics, including immunomodulators, anti-cancer immunity cycle, immune checkpoints, tumor-infiltrating immune cells and a series of signatures upon modulating components within BC tumor microenvironment (TME). Multi-omics data analyses were performed to decipher specific genomic alterations in low- and high-risk patients. Additionally, we also analyzed the role of risk score in predicting response to several treatment options.Results: A 10-CpG-based prognostic signature which could significantly and independently categorize BC patients into distinct prognoses was established and sufficiently validated. And we hypothesize that this signature designs a non-inflamed TME in BC based on the evidence that the derived risk score is negatively correlated with tumor-associated infiltrating immune cells, anti-cancer immunity cycle, immune checkpoints, immune cytolytic activity, T cell inflamed score, immunophenoscore, and the vast majority of immunomodulators. The identified high-risk patients were characterized by upregulation of immune inhibited oncogenic pathways, higher TP53 mutation and copy number burden, but lower response to cancer immunotherapy and chemotherapy.Conclusion: Our work highlights the complementary roles of 10-CpG-based signature in estimating overall survival in BC patients, shedding new light on investigating failed events concerning immunotherapy at present.
From Three-Months to Five-Years: Sustaining Long-Term Benefits of Endovascular Therapy for Ischemic Stroke
Authors: Ganesh Aravind , Ospel Johanna Maria , Marko Martha , van Zwam Wim H. , Roos Yvo B. W. E. M. , Majoie Charles B. L. M. , Goyal Mayank 
Published: July 2021

Background and Purpose: During the months and years post-stroke, treatment benefits from endovascular therapy (EVT) may be magnified by disability-related differences in morbidity/mortality or may be eroded by recurrent strokes and non-stroke-related disability/mortality. Understanding the extent to which EVT benefits may be sustained at 5 years, and the factors influencing this outcome, may help us better promote the sustenance of EVT benefits until 5 years post-stroke and beyond.Methods: In this review, undertaken 5 years after EVT became the standard of care, we searched PubMed and EMBASE to examine the current state of the literature on 5-year post-stroke outcomes, with particular attention to modifiable factors that influence outcomes between 3 months and 5 years post-EVT.Results: Prospective cohorts and follow-up data from EVT trials indicate that 3-month EVT benefits will likely translate into lower 5-year disability, mortality, institutionalization, and care costs and higher quality of life. However, these group-level data by no means guarantee maintenance of 3-month benefits for individual patients. We identify factors and associated “action items” for stroke teams/systems at three specific levels (medical care, individual psychosocioeconomic, and larger societal/environmental levels) that influence the long-term EVT outcome of a patient. Medical action items include optimizing stroke rehabilitation, clinical follow-up, secondary stroke prevention, infection prevention/control, and post-stroke depression care. Psychosocioeconomic aspects include addressing access to primary care, specialist clinics, and rehabilitation; affordability of healthy lifestyle choices and preventative therapies; and optimization of family/social support and return-to-work options. High-level societal efforts include improving accessibility of public/private spaces and transportation, empowering/engaging persons with disability in society, and investing in treatments/technologies to mitigate consequences of post-stroke disability.Conclusions: In the longtime horizon from 3 months to 5 years, several factors in the medical and societal spheres could negate EVT benefits. However, many factors can be leveraged to preserve or magnify treatment benefits, with opportunities to share responsibility with widening circles of care around the patient.
Predictors for Fear of Cancer Recurrence in Breast Cancer Patients Referred to Radiation Therapy During the COVID-19 Pandemic: A Multi-Center Cross-Section Survey
Authors: Xie Jinrong , Qi Weixiang , Cao Lu , Tan Yuting , Huang Jin , Gu Xiaodong , Chen Bingguang , Shen Peipei , Zhao Yutian , Zhang Ying , Zhao Qingwen , Huang Hecheng , Wang Yubin , Fang Haicheng , Jin Zhenjun , Li Hui , Zhao Xuehong , Qian Xiaofang , Xu Feifei , Ou Dan , Wang Shubei , Xu Cheng , Li Min , Jiang Zefei , Wang Yu , Huang Xiaobo , Chen Jiayi 
Published: July 2021

ObjectiveThe outbreak of COVID-19 pandemic has greatly impacted on radiotherapy (RT) strategy for breast cancer patients, which might lead to increased distressing psychological symptoms. We performed a multi-center cross-section survey to investigate prevalence of fear of cancer recurrence (FCR) and predictors for FCR in patients referred to RT during pandemic.Methods542 patients were consecutively enrolled from three regions in China including Yangtze Delta River Region, Guangdong and Shanxi province. Patients’ characteristics were collected using an information sheet, Fear of progression questionnaire-short form, Hospital Anxiety/Depression Scale and EORTC QLQ-C30. The hierarchical multiple regression models were performed.Results488 patients with complete data were eligible. The RT strategy was affected in 265 (54.3%) patients, including 143 with delayed RT initiation, 66 believing to have delayed RT initiation but actually not, 24 with RT interruptions, 19 shifting to local hospitals for RT and the remaining 13 influenced on both RT schedule and hospital level. The model explained 59.7% of observed variances in FCR (p&lt;0.001) and showed that influence of RT strategy had significantly impacted on FCR (△R2 = 0.01, △F=2.966, p=0.019). Hospitals in Shanxi province (β=-0.117, p=0.001), emotional function (β=-0.19, p&lt;0.001), social function (β=-0.111, p=0.006), anxiety (β=0.434, p&lt;0.001) and RT interruption (β=0.071, p=0.035) were independent predictors.ConclusionsRT strategy for breast cancer patients was greatly influenced during pandemic. RT interruption is an independent predictor for high FCR. Our findings emphasize the necessity to ensure continuum of RT, and efforts should be taken to alleviate FCR through psychological interventions.
Comparing the Effectiveness of Endoscopic Surgeries With Intensity-Modulated Radiotherapy for Recurrent rT3 and rT4 Nasopharyngeal Carcinoma: A Meta-Analysis
Authors: Peng Zhouying , Wang Yumin , Wang Yaxuan , Fan Ruohao , Gao Kelei , Zhang Hua , Jiang Weihong 
Published: July 2021

BackgroundThis meta-analysis aimed to compare the efficacy of intensity-modulated radiotherapy (IMRT) and endoscopic surgery (ES) for high T-stage recurrent nasopharyngeal carcinoma (NPC).MethodsRelevant studies were retrieved in six databases from 02/28,2011 to 02/28,2021. The 2-year, 3-year, 5-year overall survival (OS) rates and 2-year disease-free survival (DFS) rates were calculated to compare the survival outcomes of the two treatments of IMRT and ES. Combined odds ratios (ORs) and 95% confidence interval (C Is) were measured as effect size on the association between high T-stage and 5-year OS rates.ResultsA total of 23 publications involving 2,578 patients with recurrent NPC were included in this study. Of these, 1611 patients with recurrent rT3-4 NPC were treated with ES and IMRT in 358 and 1,253 patients, respectively. The combined 2-year OS and 5-year OS rates for the two treatments were summarized separately, and the 2-year OS and 5-year OS rate for ES were 64% and 52%, respectively. The 2-year OS and 5-year OS rate for IMRT were 65% and 31%, respectively. The combined 2-year DFS rates of IMRT and ES were 60% and 50%, respectively. Combined ORs and 95% confidence intervals for 5-year survival suggest that ES may improve survival in recurrent NPC with rT3-4. In terms of complications, ES in the treatment of high T-stage recurrent NPC is potentially associated with fewer complications.ConclusionsThe results of our study suggest that ES for rT3-4 may be a better treatment than IMRT, but the conclusion still needs to be sought by designing more studies.
Essential Infantile Esotropia: A Course of Treatment From Our Experience
Authors: Pensiero Stefano , Diplotti Laura , Presotto Marianna , Ronfani Luca , Barbi Egidio 
Published: July 2021

Background: Essential infantile esotropia (EIE) is the most common type of childhood esotropia. Although its classical approach is surgical, less invasive techniques have been proposed as an adjunct or alternative to traditional surgery. Among them, chemodenervation with botulinum toxin (BT) has been investigated, showing variable and sometimes conflicting results.Objectives: To compare the outcomes of bilateral BT injection and traditional surgery in a pediatric population with EIE in order to optimize and standardize the therapeutic approach. Other purposes are to evaluate whether early intervention may prevent the onset of vertical ocular deviation (which is part of the clinical picture of EIE) and/or influence the development of fine stereopsis, and also to assess changes in refractive status over time among the enrolled population.Methods: A retrospective consecutive cohort study was conducted in 86 children aged 0–48 months who underwent correction of EIE. The primary intervention in naïve subjects was either bilateral BT injection (36 subjects, “BT group”) or strabismus surgery (50 subjects, “surgery group”).Results: Overall, BT chemodenervation (one or two injections) was effective in 13 (36.1%) subjects. With regard to residual deviation angle, the outcomes at least 5 years after the last intervention were overlapping in children receiving initial treatment with either injection or surgery; however, the success rate of primary intervention in the surgery group was higher, and the average number of interventions necessary to achieve orthotropia was smaller. Both early treatment with chemodenervation and surgery at a later age were not found to prevent the onset of vertical ocular deviation, whereas, surprisingly, the percentage of subjects developing fine stereopsis was higher in the surgery group. Finally, with regard to the change in refractive status over time, most of the subjects increased their initial hyperopia, whereas 10% became myopic.Conclusions: Our data suggest that a single bilateral BT injection by age 2 years should be considered as the first-line treatment of EIE without vertical component; whereas, traditional surgery should be considered as the first-line treatment for all other cases and in subjects unresponsive to primary single BT injection.
Cytokine Release Syndrome Is an Independent Risk Factor Associated With Platelet Transfusion Refractoriness After CAR-T Therapy for Relapsed/Refractory Acute Lymphoblastic Leukemia
Authors: Liu Yadan , Liang Bin , Liu Yan , Wei Guoqing , Wu Wenjun , Yang Luxin , Yang Li , Huang He , Xie Jue , Hu Yongxian 
Published: July 2021

Background: Chimeric antigen receptor T cell (CAR-T) therapy is successful in improving treatment outcomes for relapsed/refractory acute lymphoblastic leukemia (R/R ALL). However, toxicities associated with CAR-T therapy are being increasingly identified. Pancytopenia is one of the most common complications after CAR-T therapy, and platelet transfusions are an essential part of its supportive care.Study Design and Methods: This study aimed to assess the effectiveness of platelet transfusions for R/R ALL patients at our single center and identify associated risk factors. Overall, 44 R/R ALL patients were enrolled in this study, of whom 26 received CAR-T therapy and 18 received salvage chemotherapy.Result: Patients in the CAR-T group had a higher incidence of platelet transfusion refractoriness (PTR) (15/26, 57.7%) than those in the chemotherapy group (3/18, 16.7%) (p = 0.007). For patients receiving CAR-T therapy, multivariate analysis showed that the grade of cytokine release syndrome (CRS) was the only independent risk factor associated with PTR (p = 0.007). Moreover, higher peak serum IL-6 and IFN-γ levels suggested a higher risk of PTR (p = 0.024 and 0.009, respectively). Patients with PTR received more platelet infusion doses than those without PTR (p = 0.0426). Patients with PTR had more grade 3–4 bleeding events than those without PTR (21.4 vs. 0%, p = 0.230), and the cumulative incidence of grade 3–4 bleeding event was different (p = 0.023).Conclusion: We found for the first time that PTR is associated with the CRS grade. Improved knowledge on the mechanisms of PTR after CAR-T therapy is needed to design a rational therapeutic strategy that aims to improve the efficiency of transfusions.