bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different mechanisms underlying divergent responses of autotrophic and heterotrophic respiration to long-term throughfall reduction in a warm-temperate oak forest
Authors: Zhang Jinglei , Liu Shirong , Liu Cuiju , Wang Hui , Luan Junwei , Liu Xiaojing , Guo Xinwei , Niu Baoliang 
Published: July 2021

Abstract
Background
There are many studies on disentangling the responses of autotrophic (AR) and heterotrophic (HR) respiration components of soil respiration (SR) to long-term drought, but few studies have focused on the mechanisms underlying its responses.

Methods
To explore the impact of prolonged drought on AR and HR, we conducted the 2-year measurements on soil CO2 effluxes in the 7th and 8th year of manipulated throughfall reduction (TFR) in a warm-temperate oak forest.

Results
Our results showed long-term TFR decreased HR, which was positively related to bacterial richness. More importantly, some bacterial taxa such as Novosphingobium and norank Acidimicrobiia, and fungal Leptobacillium were identified as major drivers of HR. In contrast, long-term TFR increased AR due to the increased fine root biomass and production. The increased AR accompanied by decreased HR appeared to counteract each other, and subsequently resulted in the unchanged SR under the TFR.

Conclusions
Our study shows that HR and AR respond in the opposite directions to long-term TFR. Soil microorganisms and fine roots account for the respective mechanisms underlying the divergent responses of HR and AR to long-term TFR. This highlights the contrasting responses of AR and HR to prolonged drought should be taken into account when predicting soil CO2 effluxes under future droughts.
Association of fluid balance trajectories with clinical outcomes in patients with septic shock: a prospective multicenter cohort study
Authors: Wang Mei-Ping , Jiang Li , Zhu Bo , Du Bin , Li Wen , He Yan , Xi Xiu-Ming ,   China Critical Care Sepsis Trial (CCCST) workgroup, Du Bin , Weng Li , Li Tong , Duan Mei-Li , Li Wen-Xiong , Sun Bing , Zhou Jian-Xin , Jia Jian-Guo , Zhu Xi , Zhan Qing-Yuan , Ma Xiao-Chun , Qin Tie-He , Wang Shou-Hong , Ai Yu-Hang , Kang Yan , Liao Xue-Lian , Cao Xiang-Yuan , Wang Yu-Shan , Zhu Du-Ming 
Published: July 2021

Abstract
Background
Septic shock has a high incidence and mortality rate in Intensive Care Units (ICUs). Earlier intravenous fluid resuscitation can significantly improve outcomes in septic patients but easily leads to fluid overload (FO), which is associated with poor clinical outcomes. A single point value of fluid cannot provide enough fluid information. The aim of this study was to investigate the impact of fluid balance (FB) latent trajectories on clinical outcomes in septic patients.

Methods
Patients were diagnosed with septic shock during the first 48 h, and sequential fluid data for the first 3 days of ICU admission were included. A group-based trajectory model (GBTM) which is designed to identify groups of individuals following similar developmental trajectories was used to identify latent subgroups of individuals following a similar progression of FB. The primary outcomes were hospital mortality, organ dysfunction, major adverse kidney events (MAKE) and severe respiratory adverse events (SRAE). We used multivariable Cox or logistic regression analysis to assess the association between FB trajectories and clinical outcomes.

Results
Nine hundred eighty-six patients met the inclusion criteria and were assigned to GBTM analysis, and three latent FB trajectories were detected. 64 (6.5%), 841 (85.3%), and 81 (8.2%) patients were identified to have decreased, low, and high FB, respectively. Compared with low FB, high FB was associated with increased hospital mortality [hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.22–2.17], organ dysfunction [odds ratio (OR) 2.18, 95% CI 1.22–3.42], MAKE (OR 1.80, 95% CI 1.04–2.63) and SRAE (OR 2.33, 95% CI 1.46–3.71), and decreasing FB was significantly associated with decreased MAKE (OR 0.46, 95% CI 0.29–0.79) after adjustment for potential covariates.

Conclusion
Latent subgroups of septic patients followed a similar FB progression. These latent fluid trajectories were associated with clinical outcomes. The decreasing FB trajectory was associated with a decreased risk of hospital mortality and MAKE.
Prognostic impact of immune-related adverse events on patients with and without cardiovascular disease: a retrospective review
Authors: Kazama Shingo , Morimoto Ryota , Kimura Yuki , Shibata Naoki , Ozaki Reina , Araki Takashi , Mizutani Takashi , Oishi Hideo , Arao Yoshihito , Kuwayama Tasuku , Hiraiwa Hiroaki , Kondo Toru , Furusawa Kenji , Shimokata Tomoya , Okumura Takahiro , Bando Yasuko K. , Ando Yuichi , Murohara Toyoaki 
Published: July 2021

Abstract
Background
The emergence of immune checkpoint inhibitors (ICIs) has brought about a paradigm shift in cancer treatment as the use of these drugs has become more frequent and for a longer duration. As a result of T-cell-mediated inflammation at the programmed cell death-1, programmed death-ligand-1, and cytotoxic T-lymphocyte antigen-4 pathways, immune-related adverse events (irAEs) occur in various organs and can cause a rare but potentially induced cardiotoxicity. Although irAEs are associated with the efficacy of ICI therapy and better prognosis, there is limited information about the correlation between irAEs and cardiotoxicity and whether the benefits of irAEs apply to patients with underlying cardiovascular disease. This study aimed to investigate the association of irAEs and treatment efficacy in patients undergoing ICI therapy with and without a cardiovascular history.

Methods
We performed a retrospective review of the medical records of 409 consecutive patients who received ICI therapy from September 2014 to October 2019.

Results
Median patient age was 69 years (29.6% were female). The median follow-up period was 278 days. In total, 69 (16.9%) patients had a history of any cardiovascular disease and 14 (3.4%) patients experienced cardiovascular irAEs after ICI administration. The rate of cardiovascular irAEs was higher in patients with prior non-cardiovascular irAEs than without. The prognosis of patients with irAEs ( +) was significantly better than that of the patients without irAEs (P < 0.001); additionally, this tendency did not depend on the presence or absence of a cardiovascular history. Furthermore, the Cox proportional hazards analysis revealed that irAEs were an independent predictor of mortality.

Conclusions
Although cardiovascular irAEs may be related to prior non-cardiovascular irAEs under ICI therapy, the occurrence of irAEs had a better prognostic impact and this tendency was not affected by cardiovascular history.
Barriers and facilitators for early and exclusive breastfeeding in health facilities in Sub-Saharan Africa: a systematic review
Authors: Kinshella Mai-Lei Woo , Prasad Sarina , Hiwa Tamanda , Vidler Marianne , Nyondo-Mipando Alinane Linda , Dube Queen , Goldfarb David , Kawaza Kondwani 
Published: July 2021

AbstractBackgroundSub-Saharan Africa carries a disproportionate burden of under-five child deaths in the world and appropriate breastfeeding practices can support efforts to reduce child mortality rates. Health facilities are important in the promotion of early and exclusive breastfeeding. The purpose of this review was to examine facility-based barriers and facilitators to early and exclusive breastfeeding in Sub-Saharan Africa.MethodsA systematic search was conducted on Medline, Web of Science, CINAHL, African Journals Online and African Index Medicus from database inception to April 29, 2021 and primary research studies on breastfeeding practices in health facilities in Sub-Saharan Africa were included in the review. We assessed qualitative studies with the Critical Appraisal Skills Programme Qualitative Checklist and quantitative studies using the National Heart, Lung, and Blood Institute tool. The review protocol was registered to Prospero prior to conducting the review (CRD42020167414).ResultsOf the 56 included studies, relatively few described health facility infrastructure and supplies-related issues (5, 11%) while caregiver factors were frequently described (35, 74%). Facility-based breastfeeding policies and guidelines were frequently available but challenged by implementation gaps, especially at lower health service levels. Facilitators included positive caregiver and health worker attitudes, knowledge and support during the postpartum period. Current studies have focused on caregiver factors, particularly around their knowledge and attitudes, while health facility infrastructure and supplies factors appear to be growing concerns, such as overcrowding and lack of privacy during breastfeeding counselling that lowers the openness and comfort of mothers especially those HIV-positive.ConclusionThere has been a dramatic rise in rates of facility births in Sub-Saharan Africa, which must be taken into account when considering the capacities of health facilities to support breastfeeding practices. As the number of facility births rise in Sub-Saharan Africa, so does the responsibility of skilled healthcare workers to provide the necessary breastfeeding support and advice to caregivers. Our review highlighted that health facility infrastructure, supplies and staffing appears to be a neglected area in breastfeeding promotion and a need to strengthen respectful maternity care in the delivery of breastfeeding counselling, particularly in supporting HIV-positive mothers within the context of Sub-Saharan Africa.
Epidemiological, life style, and occupational factors associated with lower limb varicose veins: a case control study
Authors: Elamrawy Shahira , Darwish Iman , Moustafa Sameh , Elshaer Noha , Ahmed Nesma 
Published: July 2021

Abstract
Background
Few data were documented about risk factors for lower limb varicose veins (LLVV) among Egyptian population. Identifying modifiable risk factors is crucial to plan for prevention. The current research aims to study the epidemiological, life style, and occupational factors associated with LLVV in a sample of Egyptian population.

Methods
A case control study was adopted. Cases with LLVV (n = 150) were compared with controls (n = 150). Data was collected using an interview questionnaire and clinical assessment. Data was analyzed using the univariate and multivariate logistic regression analyses.

Results
According to multivariate analysis among all participants (n = 300), the odds of LLVV was 59.8 times greater for those who frequently lift heavy objects (95% CI = 6.01, 584.36) and 6.95 times higher for those who drink < 5 cups of water/day (95% CI = 2.78, 17.33). Moreover, it was 4.27 times greater for those who infrequently/never consume fiber-rich foods (95% CI = 1.95, 9.37) and 3.65 times greater for those who stand > 4 h/day (95% CI = 1.63, 8.17). Additionally, odds of LLVV was 3.34 times greater for those who report irregular defecation habit (95% CI = 1.68, 6.60), and 2.86 times higher for those who sleep < 8 h/day (95% CI = 1.14, 7.16), and 2.53 times higher for smokers compared with ex-smokers/non-smokers (95% CI = 1.15, 5.58). In addition, a standing posture at work was an independent predictor of LLVV among ever employed participants (n = 234) in the current study (OR = 3.10; 95% CI = 1.02, 9.38).

Conclusions
This study highlighted seven modifiable independent predictors of LLVV mostly related to the life style, namely, frequent lifting of heavy objects, drinking < 5 cups of water/day, infrequent/no consumption of fiber-rich food, standing more than 4 h/day, irregular defecation habit, sleeping less than 8 h/day, and smoking. These findings provide a basis to design an evidence-based low-cost strategy for prevention of LLVV among Egyptian population.
Intrusion of maxillary molar roots into the maxillary sinus in a sample of the Egyptian population using cone beam computed tomography
Authors: Eid Esraa Ahmed , El-Badawy Fatma Mostafa , Hamed Walaa Mohamed 
Published: July 2021

AbstractBackgroundThe proximity of the maxillary sinus floor to the maxillary molar roots increases the probability of oroantral communication on conducting any surgical or endodontic procedure in the involved area. The aim of this study is to evaluate the relationship between each maxillary molar root and maxillary sinus floor using cone beam computed tomography. Predicting the probability of protrusion of each root into the sinus will consequently predict the probability of occurrence of the oroantral fistula in a sample of the Egyptian population.ResultsThe total number of roots located outside the sinus was 121 (35.3%), while those contacting the sinus floor were 80 (23.3%) and those intruded the sinus were 141 (41.2%). The percentage of root intrusion into the sinus in males (56.9%) was significantly (p= 0.01) higher than females (42.9%). The probability of root intrusion in the left molars (54.2%) was non-significantly (p= 0.067) higher than that of the right side (44.3%). As for the type of tooth, the second molar showed the highest probability of root intrusion into the sinus (55.3%) followed by the third molars (52.6%) then the first molars (40.9). According to the type of root, the mesiobuccal root showed the highest probability of intrusion into the sinus (50.9%) followed by the palatal root (49.1%) then the distobuccal root (47.4%). However, the difference in both type of tooth and type of root was statistically non-significant (p= 0.051 and 0.869 respectively). As for the individual root with the highest probability of intrusion, the mesio-buccal root of the right third molar is the most frequent root to intrude the sinus (71.4%) and the mesio-buccal root of the right first molar is the least frequent (22.7%).ConclusionsIn a sample of the Egyptian population, males exhibit higher probability of root protrusion into the sinus than females. The side and type of tooth are of higher impact on the probability of its intrusion into the sinus compared to the type of root. Left second molars are at a higher risk of oroantral communications on surgical or endodontic procedures compared to other molars due to its highest probability of intrusion into the sinus.
Modified perichondrial-periosteal flaps to camouflage nasal dorsum in rhinoplasty
Authors: Khafagy Ahmed Gamal , El-Sersy Hesham Abdelaty , Maarouf Ahmed Mahmoud 
Published: July 2021

Abstract
Background
The smooth and straight nasal dorsum is a goal after nasal hump reduction as dorsal irregularities are unexpectable and inevitable complications. The aim of this study is to evaluate modified perichondrial-periosteal flaps functionally and aesthetically to camouflage nasal dorsal irregularities. A total of 115 patients with nasal humps were enrolled in the study. The perichondrium over the upper lateral cartilages is divided in the midline and dissected forming two laterally based flaps while the periosteum over the nasal bones is dissected superiorly. After completion of all rhinoplasty steps, the flaps were repositioned and sutured as a separate layer. Follow-up for 2 years with an assessment of irregularities of the nasal dorsum, collapse of the upper lateral cartilage, and nasal breathing.

Results
Aesthetically, no nasal dorsal irregularities were noticed. Also, no patients complained of nasal obstruction.

Conclusion
The modified perichondrial-periosteal flap is a successful technique, functionally and aesthetically. It avoids the appearance of dorsal irregularities.
Outcomes and Prognostic Factors in a Large Cohort of Hospitalized Cancer Patients With COVID-19
Authors: Nader Marta Guilherme , Colombo Bonadio Renata , Nicole Encinas Sejas Odeli , Watarai Gabriel , Mathias Machado Maria Cecilia , Teixeira Frasson Lorena , Motta Venchiarutti Moniz Camila , de Luca Ito Raquel Keiko , Peixoto Driele , Oliveira Hoff Camilla , Menegatti Anastacio Veruska , Ribeiro Ulysses , Pereira Juliana , Rocha Vanderson , Abdala Edson , Del Pilar Estevez-Diz Maria , Hoff Paulo M. 
Published: July 2021

PURPOSE Patients with cancer are at increased risk for unfavorable outcomes from COVID-19. Knowledge about the outcome determinants of severe acute respiratory syndrome coronavirus 2 infection in this population is essential for risk stratification and definition of appropriate management. Our objective was to evaluate prognostic factors for all-cause mortality in patients diagnosed with both cancer and COVID-19. METHODS All consecutive patients with cancer hospitalized at our institution with COVID-19 were included. Electronic medical records were reviewed for clinical and laboratory characteristics potentially associated with outcomes. RESULTS Five hundred seventy-six consecutive patients with cancer and COVID-19 were included in the present study. An overall in-hospital mortality rate of 49.3% was demonstrated. Clinical factors associated with increased risk of death because of COVID-19 were age over 65 years, Eastern Cooperative Oncology Group performance status > 0 zero, best supportive care, primary lung cancer, and the presence of lung metastases. Laboratory findings associated with a higher risk of unfavorable outcomes were neutrophilia, lymphopenia, and elevated levels of D-dimer, creatinine, C-reactive protein, or AST. CONCLUSION A high mortality rate in patients with cancer who were diagnosed with COVID-19 was demonstrated in the present study, emphasizing the need for close surveillance in this group of patients, especially in those with unfavorable prognostic characteristics.
Using Geriatric Assessment to Guide Conversations Regarding Comorbidities Among Older Patients With Advanced Cancer
Authors: Kleckner Amber S. , Wells Megan , Kehoe Lee A. , Gilmore Nikesha J. , Xu Huiwen , Magnuson Allison , Dunne Richard F. , Jensen-Battaglia Marielle , Mohamed Mostafa R. , O'Rourke Mark A. , Vogelzang Nicholas J. , Dib Elie G. , Peppone Luke J. , Mohile Supriya G. 
Published: July 2021

PURPOSE: Older patients with advanced cancer often have comorbidities that can worsen their cancer and treatment outcomes. We assessed how a geriatric assessment (GA)–guided intervention can guide conversations about comorbidities among patients, oncologists, and caregivers. METHODS: This secondary analysis arose from a nationwide, multisite cluster-randomized trial (ClinicalTrials.gov identifier: NCT02107443 ). Eligible patients were ≥ 70 years, had advanced cancer (solid tumors or lymphoma), and had impairment in at least one GA domain (not including polypharmacy). Oncology practices (n = 30) were randomly assigned to usual care or intervention. All patients completed a GA; in the intervention arm, a GA summary with recommendations was provided to their oncologist. Patients completed an Older Americans Resources and Services Comorbidity questionnaire at screening. The clinical encounter following GA was audio-recorded, transcribed, and coded for topics related to comorbidities. Linear mixed models examined the effect of the intervention on the outcomes adjusting for practice site as a random effect. RESULTS: Patients (N = 541) were 76.6 ± 5.2 years old; 94.6% of patients had at least one comorbidity with an average of 3.2 ± 1.9. The intervention increased the average number of conversations regarding comorbidities per patient from 0.52 to 0.99 ( P < .01). Moreover, there were a greater number of concerns acknowledged (0.52 v 0.32; P = .03) and there was a 2.4-times higher odds of having comorbidity concerns addressed via referral, handout, or other modes (95% CI, 1.3 to 4.3; P = .004). Most oncologists in the intervention arm (76%) discussed comorbidities in light of the treatment plan, and 41% tailored treatment plans. CONCLUSION: Providing oncologists with a GA-guided intervention enhanced communication regarding comorbidities.
Proinsulin to C-Peptide Ratio in the First Year After Diagnosis of Type 1 Diabetes
Authors: Freese Jurhee , Al-Rawi Rawan , Choat Heather , Martin Alexandra , Lunsford Alison , Tse Hubert , Mick Gail , McCormick Kenneth 
Published: July 2021

Abstract

Objective
The proinsulin to C-peptide (PI:C) ratio is reputedly a biomarker of β-cell endoplasmic reticulum (ER) stress.

Objective
This study examined the natural history of the PI:C ratio and its correlation with residual β-cell function in childhood new-onset type 1 diabetes (T1D). Over the first year of T1D, the temporal trend in fasting and nutrient-stimulated PI data is limited.

Methods
PI was a secondary pre-planned analysis of our 1-year, randomized, double-blind, placebo-controlled gamma aminobutyric acid (GABA) trial in new-onset T1D. Of the 99 participants in the primary study, aged 4 to 18 years, 30 were placebo. This study only involved the 30 placebo patients; all were enrolled within 5 weeks of T1D diagnosis. A liquid mixed meal tolerance test was administered at baseline and 5 and 12 months for determination of C-peptide, PI, glucose, and hemoglobin A1C.

Results
Both the fasting (P = 0.0003) and stimulated (P = 0.00008) PI:C ratios increased from baseline to 12 months, indicating escalating β-cell ER stress. The baseline fasting PI correlated with the fasting change in C-peptide at 12 months (P = 0.004) with a higher PI correlating with greater decline in C-peptide. Patients with an insulin-adjusted A1C &gt;9% (hence, not in remission) had higher fasting PI:C ratios. Younger age at diagnosis correlated with a higher PI:C ratio (P = 0.04).

Conclusion
Children with new-onset T1D undergo progressive β-cell ER stress and aberrant proinsulin processing, as evidenced by increasing PI:C ratios. Moreover, the PI:C ratio reflects more aggressive β-cell onslaught with younger age, as well as diminished glycemic control.
Novel Laboratory Index, Based on Fasting Blood Parameters, Accurately Reflects Insulin Sensitivity
Authors: Karczewska-Kupczewska Monika , Nikołajuk Agnieszka , Stefanowicz Magdalena , Matulewicz Natalia , Arnoriaga-Rodriguez Maria , Fernandez-Real Jose Manuel , Strączkowski Marek 
Published: July 2021

AbstractContextSimple and reliable measurement of insulin sensitivity may be important for the prevention of insulin-resistance-related diseases. Surrogate indices of insulin sensitivity are of limited utility in population without signs of metabolic syndrome.ObjectiveThe aim of our study was to provide simple and accurate index of insulin sensitivity.DesignThe study group comprised 150 young healthy participants. Hyperinsulinemic-euglycemic clamp was performed. Regression models with different laboratory parameters were constructed. Validation cohort 1 comprised independent group of 110 subjects, including individuals with prediabetes and newly diagnosed type 2 diabetes. Validation cohort 2 comprised 38 obese subjects before and after diet-induced weight loss. Validation cohort 3 comprised 60 nondiabetic subjects from an independent center.ResultsThe supervised principal component model established optimal set of variables correlated with insulin sensitivity. This model (Fasting Laboratory Assessment of Insulin Sensitivity [FLAIS]) used red blood cell count, alanine aminotransferase activity, serum C-peptide, SHBG, IGF-binding protein 1, and adiponectin concentrations. FLAIS exhibited strong correlation with clamp-derived insulin sensitivity. The sensitivity of the model was 90% and the specificity was 68%. In validation cohort 1, differences in FLAIS among the groups paralleled those observed with the clamp, with the lowest values in prediabetes and diabetes. In validation cohort 2, FLAIS reflected the change in insulin sensitivity after weight loss. The main findings were confirmed in validation cohort 3.ConclusionWe provide simple and accurate method of assessing insulin sensitivity, which allows to identify insulin resistance even in the population without overt metabolic disturbances.