bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Analytical Method for Quantifying Flavoring Chemicals of Potential Respiratory Health Risk Concerns in e-Cigarette Liquids
Authors: Page Michelle K. , Goniewicz Maciej L. 
Published: October 2021

Numerous flavoring chemicals are added to e-cigarette liquids to create various flavors. Flavorings provide sensory experience to users and increase product appeal; however, concerns have been raised about their potential inhalation toxicity. Estimating potential health risk of inhaling these chemicals has been challenging since little is known about their actual concentrations in e-cigarette products. To date, a limited number of analytical methods exist to measure the concentrations of flavoring chemicals in e-cigarette products. We have developed an analytical method that accurately and precisely measures the concentrations of 20 flavoring chemicals of potential inhalation risk concerns: 2,3,5-trimethylpyrazine, acetoin, benzaldehyde, benzyl alcohol, butanoic acid, dl-limonene, ethyl maltol, ethyl salicylate, ethyl vanillin, eucalyptol, eugenol, furaneol, isovanillin, l-menthol, maltol, methyl salicylate, pulegone, trans-cinnamaldehyde, triacetin, and vanillin. Calibration and QC solutions were prepared in 50:50 propylene glycol (PG):vegetable glycerin (VG) and 5% H2O and flavoring concentrations ranging from 0.02 to 10.00 mg/ml. Samples of commercial e-cigarette liquids, calibration and QC solutions were combined with 30 µL of an internal standard mix (benzene-d6, pyridine-d5, chlorobenzene-d5, naphthalene-d8 and acenaphthene-d10; 1 mg/ml each) and were diluted 100-fold into methanol. Analysis was performed on an Agilent 7890B/7250 GC/Q-TOF using a DB-624UI column (30 m x 0.25 mmID x 1.4 μm film thickness), with a total runtime of 13.5 min. Calibration curves were fit using a weighted quadratic model and correlations of determination (r2) values exceeded 0.990 for all chemicals. Bias and precision tests yielded values less than 20% and lower limits of quantitation (LLOQ) ranged from 0.02 to 0.63 mg/ml. Over 200 commercially available products, purchased or collected from adult e-cigarette users and spanning a range of flavor categories, were evaluated with this method. Concentrations of pulegone, a suspected carcinogen, varied from below limit of quantitation (BLOQ) to 0.32 mg/ml, while acetoin and vanillin, known precursors to more cytotoxic byproducts, ranged from BLOQ to 1.52 mg/ml and from BLOQ to 16.22 mg/ml, respectively. This method features a wide dynamic working range and allows for a rapid routine analysis of flavoring additives in commercial e-cigarette liquids.
Influence of Rainfall Conditions on Stability of Slope Reinforced by Polymer Anti-slide Pile
Authors: Wang Yuke , Han Musen , Lin Xiaoying , Li Dongbiao , Yu Hongliang , Zhu Lei 
Published: October 2021

Traditional reinforced concrete piles have high strength and low cost in slope engineering, but the slow forming and long maintenance period make it difficult to meet the needs of emergency and disaster relief tasks, such as landslides caused by rainfall. In this paper, the influence of a new type of polymer anti-slide pile on slope stability under rainfall conditions is studied. With the advantages of fast forming, high strength, simple construction technology, and small disturbance to slope, the new type of anti-slide pile can meet the requirements of emergency and disaster relief tasks. The influence of different rainfall duration, rainfall form, location, and spacing of pile laying on the stability of rainfall slope is explored with fluid-solid coupling analysis. The results show that the slope stability gradually deteriorates with the increase of the peak duration of rainfall intensity. Without rainfall conditions, the reinforcement effect is optimal when the position of pile cloth is 1/2–3/4 L away from the foot of the slope (L is the horizontal length of the slope); with rainfall conditions, when the position of pile cloth is 1/4–1/2 L away from the foot of the slope, the reinforcement effect is optimal. Without rainfall conditions, the reduction of pile spacing can improve the reinforcement effect; with rainfall conditions, the reduction of pile spacing will affect the flow and discharge of seepage rainwater and reduce the reinforcement effect.
Proprioceptive Training for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Wang Yi , Wu Zugui , Chen Zehua , Ye Xiangling , Chen Guoqian , Yang Jiaman , Zhang Peiming , Xie Fang , Guan Yingxin , Wu Jiatao , Chen Weijian , Ye Zixuan , Xu Xuemeng 
Published: October 2021

Background:There is increased interest in proprioceptive training for knee osteoarthritis (KOA). However, little consensus supports the effectiveness of this intervention.Objective:This meta-analysis aimed to assess the effects of proprioceptive training on symptoms, function, and proprioception in people with KOA.Methods:The PubMed, Cochrane Library, Web of Science, and EMBASE databases were systematically searched from the inception dates to April 16, 2021 for relevant randomized controlled trials (RCTs). Data were pooled by calculating the standardized mean differences (SMDs) and 95% confidence intervals (CIs). A random-effects model was used for the analyses.Results:A total of 24 RCTs involving 1,275 participants were included in our analysis. This study indicated that compared to no intervention, proprioceptive training significantly improved pain, stiffness, physical function, joint position sense (JPS), muscle strength, mobility, and knee ROM (P&lt; 0.05) in people with KOA. When compared to other non-proprioceptive training, proprioceptive training provided better results in terms of JPS (SMD = −1.28, 95%CI: [−1.64, −0.92],I2= 0%,P&lt; 0.00001) and mobility (timed walk over spongy surface) (SMD = −0.76, 95%CI: [−1.33, −0.18],I2= 64%,P= 0.01), and other results are similar. When proprioceptive training plus other non-proprioceptive training compared to other non-proprioceptive training, the two groups showed similar outcomes, but there was a greater improvement for JPS (SMD = −1.54, 95%CI: [−2.74, −0.34],I2= 79%,P= 0.01), physical function (SMD = −0.34, 95%CI: [−0.56, −0.12],I2= 0%,P= 0.003), and knee ROM (P&lt; 0.05) in the proprioceptive training plus other non-proprioceptive training group. When proprioceptive training plus conventional physiotherapy compared against conventional physiotherapy, the two groups demonstrated similar outcomes, but there was a significant improvement for JPS (SMD = −0.95, 95%CI: [−1.73, −0.18],I2= 78%,P= 0.02) in the proprioceptive training plus conventional physiotherapy group.Conclusions:Proprioceptive training is safe and effective in treating KOA. There is some evidence that proprioceptive training combined with general non-proprioceptive training or conventional physiotherapy appears to be more effective and should be considered as part of the rehabilitation program. However, given that the majority of current studies investigated the short-term effect of these proprioceptive training programs, more large-scale and well-designed studies with long-term follow up are needed to determine the long-term effects of these proprioceptive training regimes in KOA.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/#recordDetails, PROSPERO, identifier: CRD42021240587.
Sex Differences in Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis
Authors: Jiménez-Sánchez Lorena , Hamilton Olivia K. L. , Clancy Una , Backhouse Ellen V. , Stewart Catriona R. , Stringer Michael S. , Doubal Fergus N. , Wardlaw Joanna M. 
Published: October 2021

Background:Cerebral small vessel disease (SVD) is a common cause of stroke, mild cognitive impairment, dementia and physical impairments. Differences in SVD incidence or severity between males and females are unknown. We assessed sex differences in SVD by assessing the male-to-female ratio (M:F) of recruited participants and incidence of SVD, risk factor presence, distribution, and severity of SVD features.Methods:We assessed four recent systematic reviews on SVD and performed a supplementary search of MEDLINE to identify studies reporting M:F ratio in covert, stroke, or cognitive SVD presentations (registered protocol: CRD42020193995). We meta-analyzed differences in sex ratios across time, countries, SVD severity and presentations, age and risk factors for SVD.Results:Amongst 123 relevant studies (n= 36,910 participants) including 53 community-based, 67 hospital-based and three mixed studies published between 1989 and 2020, more males were recruited in hospital-based than in community-based studies [M:F = 1.16 (0.70) vs. M:F = 0.79 (0.35), respectively;p&lt; 0.001]. More males had moderate to severe SVD [M:F = 1.08 (0.81) vs. M:F = 0.82 (0.47) in healthy to mild SVD;p&lt; 0.001], and stroke presentations where M:F was 1.67 (0.53). M:F did not differ for recent (2015–2020) vs. pre-2015 publications, by geographical region, or age. There were insufficient sex-stratified data to explore M:F and risk factors for SVD.Conclusions:Our results highlight differences in male-to-female ratios in SVD severity and amongst those presenting with stroke that have important clinical and translational implications. Future SVD research should report participant demographics, risk factors and outcomes separately for males and females.Systematic Review Registration:[PROSPERO], identifier [CRD42020193995].
Spatial Distribution of Immune Cells in Head and Neck Squamous Cell Carcinomas
Authors: Idel Christian , Ribbat-Idel Julika , Klapper Luise , Krupar Rosemarie , Bruchhage Karl-Ludwig , Dreyer Eva , Rades Dirk , Polasky Christina , Offermann Anne , Kirfel Jutta , Perner Sven , Wollenberg Barbara 
Published: October 2021

BackgroundHead and neck squamous cell carcinomas (HNSCCs) have a very moderate response rate to immune checkpoint inhibitor (ICI) treatment compared to other cancer types. Lacking predictive markers for treatment response, we analyzed the immune status of HNSCC and assessed the spatial distribution of immune cells.Materials and MethodsVia assessing hematoxylin–eosin (H&amp;E) stains, we divided HNSCCs by the immune cell distribution in hot, cold, and excluded tumors. For each group, each with 10 tumors, we performed serial immunohistochemical (IHC) staining of the immune cell markers, checkpoint molecules, and immune regulators.ResultsThe spatial distributions were different for each immune cell type, allocating regulatory T cells (Tregs) and CD11b cells predominantly in the stroma. CD4 and CD8 cells were present either in the tumor stroma or between cancer cells. Interestingly, the expressions of PD-1 (programmed cell death 1 receptor) and PD-L1 (programmed death-ligand 1) were higher in hot tumors in comparison to cold and excluded tumors. The expression of pSMAD [indicating active transforming growth factor beta (TGF-β)] was higher in excluded tumors.ConclusionDifferent immune cell distribution patterns within tumors might be crucial for ICI treatment response since hot tumors have the highest expressions of PD-1 and PD-L1. TGF-β might be a key regulator for immune cell distribution and a promising therapeutic target that determines the formation of hot or excluded immune patterns.
Results of WICOVIR Gargle Pool PCR Testing in German Schools Based on the First 100,000 Tests
Authors: Kheiroddin Parastoo , Schöberl Patricia , Althammer Michael , Cibali Ezgi , Würfel Thea , Wein Hannah , Kulawik Birgit , Buntrock-Döpke Heike , Weigl Eva , Gran Silvia , Gründl Magdalena , Langguth Jana , Lampl Benedikt , Judex Guido , Niggel Jakob , Pagel Philipp , Schratzenstaller Thomas , Schneider-Brachert Wulf , Gastiger Susanne , Bodenschatz Mona , Konrad Maike , Levchuk Artem , Roth Cornelius , Schöner David , Schneebauer Florian , Rohrmanstorfer René , Dekens Marcus P. , Brandstetter Susanne , Zuber Johannes , Wallerstorfer Daniel , Burkovski Andreas , Ambrosch Andreas , Wagner Thomas , Kabesch Michael 
Published: October 2021

Background: Opening schools and keeping children safe from SARS-CoV-2 infections at the same time is urgently needed to protect children from direct and indirect consequences of the COVID-19 pandemic. To achieve this goal, a safe, efficient, and cost-effective SARS-CoV-2 testing system for schools in addition to standard hygiene measures is necessary.Methods: We implemented the screening WICOVIR concept for schools in the southeast of Germany, which is based on gargling at home, pooling of samples in schools, and assessment of SARS-CoV-2 by pool rRT-PCR, performed decentralized in numerous participating laboratories. Depooling was performed if pools were positive, and results were transmitted with software specifically developed for the project within a day. Here, we report the results after the first 13 weeks in the project.Findings: We developed and implemented the proof-of-concept test system within a pilot phase of 7 weeks based on almost 17,000 participants. After 6 weeks in the main phase of the project, we performed &gt;100,000 tests in total, analyzed in 7,896 pools, identifying 19 cases in &gt;100 participating schools. On average, positive children showed an individual CT value of 31 when identified in the pools. Up to 30 samples were pooled (mean 13) in general, based on school classes and attached school staff. All three participating laboratories detected positive samples reliably with their previously established rRT-PCR standard protocols. When self-administered antigen tests were performed concomitantly in positive cases, only one of these eight tests was positive, and when antigen tests performed after positive pool rRT-PCR results were already known were included, 3 out of 11 truly positive tests were also identified by antigen testing. After 3 weeks of repetitive WICOVIR testing twice weekly, the detection rate of positive children in that cohort decreased significantly from 0.042 to 0.012 (p = 0.008).Interpretation: Repeated gargle pool rRT-PCR testing can be implemented quickly in schools. It is an effective, valid, and well-received test system for schools, superior to antigen tests in sensitivity, acceptance, and costs.
Routine Administration of a Multispecies Probiotic Containing Bifidobacterium and Lactobacillus to Very Low Birth Weight Infants Had No Significant Impact on the Incidence of Necrotizing Enterocolitis
Authors: Juber Brian A. , Boly Timothy J. , Pitcher Graeme J. , McElroy Steven J. 
Published: October 2021

Background: Necrotizing enterocolitis (NEC) is the leading cause of gastrointestinal morbidity in preterm infants, and prevention and treatment strategies have remained largely unchanged over the past several decades. As understanding of the microbiome has increased, probiotics have been hypothesized as a possible strategy for decreasing rates of NEC, and several studies have noted significant decreases in rates of NEC after initiation of probiotics in preterm infants. However, a recent AAP report cited caution on the use of probiotic use in part because studies of probiotic use in ELBW infants are lacking. As our unit began routine use of probiotics for all infants &lt;33 weeks in 2015 and we are a leading institution for intact survival of ELBW infants, we attempted to answer if probiotic use can impact the rate of NEC in VLBW and ELBW infants.Methods: We conducted a single-center retrospective chart review of infants with modified Bell's stage ≥2a NEC for the 4 years prior to and 5 years after initiation of a protocol involving routine supplementation of a multispecies probiotic to premature infants at the University of Iowa, Stead Family Children's Hospital. The primary outcome measures were rates of modified Bell's stage ≥2a NEC and all-cause pre-discharge mortality at our institution before and after initiation of routine probiotic supplementation in 2015.Results: In our institution, neither the rates of modified Bell's stage ≥2a NEC, nor the rates of all-cause mortality were significantly altered in very low birth weight (VLBW) infants by the initiation of routine probiotic use (NEC rates pre-probiotic 2.1% vs. post-probiotic 1.5%; all-cause mortality rates pre-probiotic 8.4% vs. post-probiotic 7.4%). Characteristics of our two cohorts were overall similar except for a significantly lower 5-minute APGAR score in infants in the post-probiotic epoch (pre-probiotic 8 vs. post-probiotic 6 p = 0.0316), and significantly more infants in the post-probiotic epoch received probiotics (pre-probiotics 0% vs. post-probiotics 65%; p &lt; 0.0001). Similarly, probiotic use had no impact on the incidence of NEC when we restricted our data to only extremely low birth weight (ELBW) infants (pre-probiotics 1.6% vs post-probiotics 4.1%). When we restricted our analysis to only inborn infants, probiotics still had no impact on NEC rates in VLBW infants (1.5% pre- and 1.1% post-probiotic, p = 0.61) or ELBW infants (2% pre- and 2.1% post-probiotic, p = 0.99)Conclusions: Contrary to other studies, we found no significant difference in rates of modified Bell's stage ≥2a NEC or all-cause pre-discharge mortality in VLBW infants following routine administration of a multispecies probiotic supplement.
The Trend of Targeted Therapies in Chinese Patients With Ankylosing Spondylitis: Results From a Real-Life Survey
Authors: Wen Yiquan , Hu Zhuoran , Xie Baozhao , Yuan Fei , Xie Zhengquan , Jiang Yutong , Lin He , Qi Jun , Chen Qiyun 
Published: October 2021

Introduction: Targeted medication, including mostly biologics and small-molecule chemical drugs, is an important therapy for ankylosing spondylitis (AS). There are still limited data on the preference of different targeted drugs in Chinese AS patients.Methods: A questionnaire-based cross-sectional study was performed on AS patients from six hospitals in three provinces in South China. Anti-rheumatic diseases’ medication history includes the recent and previous usage of biologics or Janus kinase inhibitors (JAKi) in the last complete course of treatment, disease severity, and reasons for targeted-treatment change or preference.Results: 354 of 366 participants responded to the online survey. The participants’ median age was 32 years, with a median of 7.3 years of disease duration; 79.7% were male. 63.6% of them were in the course of biologics or JAKi. Generic ETN is the most widely used and willing-to-use biologic though the proportion of its usage shrunk in the present compared with the past. The choice of original-branded ADA demonstrated an increase in usage. The preference of secukinumab and tofacitinib depicted a quick ascending trend.Conclusion: TNF-α inhibitors (TNFi) are still the most popular targeted medication for AS in China. Their price influences patients’ preferences mostly. The doctor’s recommendation is also part of the equation. Rheumatologists should pay more attention to patients’ education to formulate targeted therapeutic plans.
Doctor-Patient Relationship in the Eyes of Medical Professionals in China During the COVID-19 Pandemic: A Cross-Sectional Study
Authors: Zhou Yanan , Yang Winson Fu Zun , Ma Yuejiao , Wu Qiuxia , Yang Dong , Liu Tieqiao , Wu Xiaoming 
Published: October 2021

Background: Doctor-patient relationship (DPR) is very important for patient outcomes, especially during a public health emergency like the COVID-19 pandemic. However, few studies have evaluated DPR and related sentiments from medical professionals' perspectives. Thus, the aim of the study is to provide a better understanding of DPR from medical professionals' perspectives during the COVID-19 pandemic in China.Methods: A total of 979 medical professionals, including doctors, nurses, technicians, and other workers have completed a series of questionnaires to evaluate their attitudes toward DPR, trust, violence against doctors, factors that affected and improved DPR, and the importance of these factors on DPR. Analyses of variances (ANOVA) and linear regressions were used to analyze the effects of the pandemic, demographic variables, and various elements on DPR.Results: One-way ANOVA revealed a significant effect of education on recent DPR [F(2, 976) = 6.17, p &lt; 0.001 and trust at F(2, 976) = 9.54, p &lt; 0.001], indicating that individuals with higher level of education (bachelor's degree, Master's degree and above) showed poorer recent DPR and lower level of trust. The level of hospital also showed a significant effect on trust [F(5, 973) = 3.79, p = 0.0021]. Cochran's Q test revealed a significant difference in factors that affected [Q(11) = 3,997.83, p &lt; 0.001] and improved [Q(8) = 3,304.53, p &lt; 0.001] DPR. Backward stepwise linear regressions revealed predictors for changes during [F(9, 969) = 21.17, p &lt; 0.001, R2 = 0.16], shortly after [F(7, 971) = 54.98, p &lt; 0.001, R2 = 0.28], and long after [F(10, 968) = 37.83, p &lt; 0.001, R2 = 0.29] the pandemic.Conclusions: Medical professionals' perceptions of DPR is important as they provide basis for the improvement in working environment of medical professionals and hospital visiting experience of patients, as well as healthcare policy making and preparation for future public health emergencies.
Factors Affecting Perceived Health Benefits and Use Behaviors in Urban Green Spaces During the COVID-19 Pandemic in Southern China Megacities
Authors: Li Haiwei , Luo Weijing , Hou Yongqi , Xia Yu , Yao Jing , Kang Ning , Deng Congshuang , Sun Hu , Chen Chongxian 
Published: October 2021

Background: The COVID-19 pandemic has alienated people from urban green spaces (UGSs) that have various health outcomes for humans. However, little is known about the influential factors of perceived health benefits and use behaviors in UGSs during the COVID-19 pandemic. This study aims to explore the key factors that influence perceived health benefits and use behaviors in UGSs and to assess the mediating role of place attachment in relationships during the COVID-19 pandemic in Chinese megacities.Methods: We conducted an online questionnaire survey from December 2020 to March 2021 in Guangzhou and Shenzhen, China. Six multiple regression models were constructed to investigate the main factors by which UGSs influence citizens' perceived health benefits and use behaviors. Four mediation models were established using the structural equation modeling (SEM) method to explore the mediating effect of place attachment.Results: A total of 628 questionnaires were included in the analysis. The results revealed that some UGS components (green space access, maintenance, and soundscape) significantly affected perceived health benefits for citizens (physical, mental, and social health) during the COVID-19 pandemic. Conversely, use behaviors (frequency of visits, duration of visits, and activity intensity) were mainly affected by the sociodemographic context but less affected by UGS components. In addition, UGS components were found to significantly predict place attachment, which in turn influenced the perceived health benefits, frequency, and duration of visits.Conclusions: This study distinguished the key factors that affect perceived health benefits and use behaviors during the COVID-19 pandemic: green space access, maintenance, soundscape, and sociodemographic characteristics. Place attachment still needs to be considered when discussing how to encourage citizens to visit UGSs during the pandemic. These findings provide implications for policymakers and landscape planners regarding design and management measures for UGSs that are conducive to coping with pandemics.