bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Pulmonary Valve Morphology Differences With Outcomes in Tetralogy of Fallot Repair With Right Ventricular Outflow Tract Incision
Authors: Liu Jinyang , Jiang Xianchao , Peng Bo , Li Shoujun , Yan Jun , Wang Qiang , Liu Zhimin 
Published: August 2021

Background: Current observational studies may not have large samples to investigate the relationship between pulmonary valve (PV) morphology differences and outcomes after complete repair for tetralogy of Fallot (TOF) by right ventricular outflow tract (RVOT) incision. This study aimed to assess the impact of PV morphology differences on outcomes after complete repair for TOF.Methods: This is a retrospective cohort study. Consecutive patients who underwent TOF repair with RVOT incision at Fuwai Hospital from January 2012 to December 2017 were included and compared according to PV morphology differences (unicuspid or bicuspid was abnormal morphology, while the tricuspid valve was normal morphology). The primary outcome was defined as a composite of death, or reintervention, or significant annular peak gradient (APG), or significant pulmonary regurgitation (PR), whichever occurred first. Multivariable Cox model analysis was used to assess the relationships between PV morphology differences and outcomes. Subgroup analysis and Propensity-score analysis were performed as sensitivity analyses to assess the robustness of our results.Results: The cohort included a total of 1,861 patients with primary diagnosis of TOF, with 1,688 undergoing CR-TOF with RVOT incision. The median age was 318 days [interquartile range (IQR): 223–534 days], a median weight of 8.9 kg (IQR: 7.6–10.5 kg) and 60.0% (1,011) were male. Complete follow-up data were available for 1,673 CR-TOF patients with a median follow-up duration of 49 months. Adjusted risks for the primary outcome and significant APG were lower for patients with normal PV morphology at follow up [adjusted hazard ratio (HR): 0.68; 95% CI: 0.46–0.98; adjusted HR: 0.22; 95% CI: 0.07–0.71, respectively]. The trend for the primary outcome during follow-up remained unchanged, even in subgroups and propensity score matching analyses.Conclusions: In this analysis of data from a large TOF cohort, patients with normal tricuspid PVs were associated with a decreased risk of the primary outcome and a lower risk of significant APG, as compared with patients with abnormal unicuspid or bicuspid PVs.
Dynamic Changes of Metabolic Syndrome Alter the Risks of Cardiovascular Diseases and All-Cause Mortality: Evidence From a Prospective Cohort Study
Authors: He Di , Zhang Xuhui , Chen Shuohua , Dai Chen , Wu Qiong , Zhou Yaohan , Jin Ziqi , Wu Shouling , Zhu Yimin 
Published: August 2021

Background: Metabolic syndrome (MetS) at baseline increases the risks of cardiovascular diseases (CVD) and all-cause mortality. However, MetS status is changeable during follow-up. The associations of dynamic changes of MetS with CVD and all-cause mortality remain unclear.Methods: Thirty-one thousand four hundred eighty-one eligible subjects were included from the Kailuan cohort. Dynamic changes of MetS were divided into four patterns as MetS-free, MetS-developed, MetS-recovery and MetS-stable. The outcomes were CVD, all-cause mortality, and the subtypes of CVD as myocardial infarction (MI), stroke and heart failure. Multiple Cox regression models were used to calculate the adjusted hazard ratios (HRs) and confidence intervals (95% CIs).Results: Altered risks of CVD, the subtypes of CVD, and all-cause mortality were observed among different dynamic patterns of MetS. Compared with the MetS-free group, MetS-developed group increased the risks of CVD (HR = 1.78, 95% CI = 1.51–2.11), MI (HR = 1.54, 95% CI = 1.01–2.34), stroke (HR = 1.78, 95% CI = 1.45–2.18), and heart failure (HR = 1.63, 95% CI = 1.11–2.39). MetS-recovery group decreased these risks with the HRs of 0.59 (95% CI = 0.48–0.72) for CVD, 0.62 (95% CI = 0.41–0.96) for MI, 0.59 (95% CI = 0.46–0.75) for stroke, and 0.56 (95% CI = 0.34–0.91) for heart failure compared with the MetS-stable group. However, the increased risk in the MetS-developed group and the decreased risk in the MetS-recovery group were not significant for all-cause mortality. When stratified by the onset age of MetS status change, early development of MetS (&lt;50 years) had higher risks of CVD (HR = 2.20, 95% CI = 1.58–3.05), MI (HR = 2.35, 95% CI = 1.00–5.50), stroke (HR = 2.05, 95% CI = 1.38–3.05), heart failure (HR = 2.63, 95% CI = 1.15–6.04), and all-cause mortality (HR = 1.61, 95% CI = 1.13–2.30) than late development (≥50 years). Early recovery of MetS had lower risks with the HRs of 0.38 (95% CI = 0.24–0.59) for CVD, 0.43 (95% CI = 0.18–1.06) for MI, 0.37 (95% CI = 0.21–0.64) for stroke, 0.30 (95% CI = 0.09–1.04) for heart failure, and 0.68 (95% CI = 0.43–1.06) for all-cause mortality than late recovery.Conclusion: Dynamic changes of MetS altered the risks of CVD and all-cause mortality, especially in individuals with an early onset age. These findings highlight the importance of dynamic changes of MetS and onset age on the prevention and control for CVD.
FinDerS(+): Real-Time Earthquake Slip Profiles and Magnitudes Estimated from Backprojected Displacement with Consideration of Fault Source Maturity Gradient
Authors: Böse Maren , Hutchison Allie A. , Manighetti Isabelle , Li Jiawei , Massin Frédérick , Clinton John Francis 
Published: August 2021

The Finite-Fault Rupture Detector (FinDer) algorithm computes rapid line-source rupture models from high-frequency seismic acceleration amplitudes (PGA). In this paper, we propose two extensions to FinDer, called FinDerS and FinDerS+, which have the advantage of taking into account a geological property of the source fault, its structural maturity, as well as its relation to the earthquake slip distribution. These two new algorithms calculate real-time earthquake slip profiles by backprojecting seismic and/or geodetic displacement amplitudes onto the FinDer line-source. This backprojection is based on a general empirical equation established in previous work that relates dynamic peak ground displacement (PGD) at the stations to on-fault coseismic slip. While FinDerS projects PGD onto the current FinDer line-source, FinDerS+ allows the rupture to grow beyond the current model extent to predict future rupture evolution. For an informed interpolation and smoothing of the estimated slip values, FinDerS and FinDerS+ both employ a generic empirical function that has been shown to relate the along-strike gradient of structural maturity of the ruptured fault, the earthquake slip distribution, and the rupture length. Therefore, while FinDer derives magnitudes from a relatively uncertain and general empirical rupture length-magnitude relations, FinDerS and FinDerS+ provide alternate and better informed magnitude estimates using the mean slip of the profiles derived from the integration of fault source maturity. The two new algorithms can incorporate both seismic strong-motion and geodetic displacement data. In order to recover PGD from strong-motion instruments, we double-integrate and high-pass filter (>0.075 Hz) the seismic acceleration records. Together, the three algorithms exploit the full spectrum of ground-motions, including high frequencies to derive a source fault model (FinDer) and low frequencies to determine the static offsets along this model (FinDerS and FinDerS+). We test the three algorithms for the 2019 MW7.1 Ridgecrest (California), 2016 MW7.0 Kumamoto (Japan), and 2008 MW7.9 Wenchuan (China) earthquakes. Conclusively, low-frequency PGD data and integration of the fault maturity gradient do not speed-up calculations for these events, but provide additional information on slip distribution and final rupture length, as well as alternative estimates of magnitudes that can be useful to check for consistency across the algorithm suite. The FinDer algorithms systematically outperform previously established real-time PGD-based magnitude estimates in terms of speed and accuracy. The resulting slip distributions can be useful for improved ground-motion prediction given the observed relationship between seismic radiation and fault maturity.
Paleodietary and Paleoclimatic Reconstruction of Hipparion Fauna at ∼9 Ma From the Xunhua Basin on the Northeastern Tibetan Plateau
Authors: Hu Fei , Song Bowen , Sun Yuanyuan , Huang Wei , Luo Mansheng , Ji Junliang , Lin Qixiang , Algeo Thomas J. , Zhang Kexin 
Published: August 2021

Stable isotope analysis is pivotal for investigating the paleodiet and paleoecology of ancient mammals. Recently, a ∼9-Myr-old Hipparion fauna was discovered at an elevation of ∼2,200 m above sea level (a.s.l.) in the Xunhua Basin on the northeastern Tibetan Plateau. These fossils can provide key evidence for the ecosystem structure and regional paleoenvironmental reconstruction. Here we present carbon and oxygen isotopic compositions of 56 bulk and 85 serial tooth enamel samples from this fauna, which includes Hipparion platyodus Selve, Chilotherium sp. and Gazella gaudryi Schlosser. The enamel−δ13°C values display a wide range of variation (−11.4 to −5.0‰), with a mean value of −8.9 ± 1.0‰, indicating that the fauna consumed mainly C3 plants. However, the heaviest δ13C value of Hipparion (−5.0‰) suggests at least some consumption of C4 plants. Combined with pollen records, we infer that the Hipparion fauna in the Xunhua Basin was living in forest-grassland setting at ∼9 Ma. The reconstructed paleo-meteoric δ18O values of the Xunhua Basin at ∼9 Ma are lower than the mean annual δ18O of present-day precipitation in this region, suggesting a wetter climate or stronger monsoonal influence than today. Hipparion fauna in the Xunhua Basin yield significantly higher mean values of δ13C and δ18O than contemporary fossils in the Linxia Basin to the east, which is attributed to rapid uplift of the Jishi Shan, blocking water vapor transport by the East Asian Summer Monsoon and making the climate of the Xunhua Basin relatively drier.
Anthropometric Measures and Incident Diabetic Nephropathy in Participants With Type 2 Diabetes Mellitus
Authors: Hukportie Daniel Nyarko , Li Fu-Rong , Zhou Rui , Zheng Jia-Zhen , Wu Xiao-Xiang , Wu Xian-Bo 
Published: August 2021

BackgroundThe prevalence of diabetes is on the rise globally coupled with its associated complications, such as diabetic nephropathy (DN). Obesity has been identified as a risk factor for the development of DN but it is still unclear which obesity index is the best predictor of incident DN.MethodsData from the participants with type 2 diabetes mellitus (T2DM) in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study were used to examine the sex-specific association between waist circumference (WC), waist-to-height ratio (WHtR), and body mass index (BMI) with incident DN risk.ResultsAmong the 8,887 participants with T2DM (5,489 men and 3,398 women), 5,296 participants (3,345 men and 1,951 women) developed the DN composite outcome during a follow-up period of 24302 person-years. Among men, null associations were observed between all anthropometric measures with incident DN in the multivariate analysis although the 3rd quartile of WHtR showed marginally significant results (P = 0.052). However, among women, both central and general obesity measures were associated with increased risks of incident DN. Compared with participants in the WC &lt;88 cm category, the fully adjusted HR and 95% CI for those in the ≥88 cm of WC was 1.35 (95% CI 1.15-1.57). Compared with the lowest quartile, the fully adjusted HRs and 95% CIs for the 2nd to the 4th quartile of WHtR were 1.09 (95% CI 0.96-1.25), 1.12 (95% CI 0.98-1.28), and 1.14 (95% CI 1.00-1.30) respectively; also, compared with the normal BMI category, the fully adjusted HRs and 95% CIs for class I – class III obese were 1.36 (95% CI 1.10 – 1.67), 1.43 (95% CI 1.16 – 1.78) and 1.32 (95% CI 1.05 – 1.66) respectively.ConclusionsAmong participants with T2DM, higher levels of both central and general obesity indexes were associated with DN risk among women but not in men. Women with T2DM should maintain a healthy weight targeted at reducing both central and general obesity to enhance nephroprotection. Trial registration: ClinicalTrials.gov., no. NCT00000620.
Causal Effect of Blood Pressure on Bone Mineral Density and Fracture: A Mendelian Randomization Study
Authors: He Bin , Yin Lifeng , Zhang Muzi , Lyu Qiong , Quan Zhengxue , Ou Yunsheng 
Published: August 2021

BackgroundHypertension may have some association with osteoporosis. This Mendelian randomization (MR) study aimed to explore the causal effect of blood pressure (BP) on bone mineral density (BMD), fall, and fracture.MethodsWe used the genome-wide association study (GWAS) summary data among 330,956 European-descent individuals to identify 107 single-nucleotide polymorphisms (SNPs) as the instrumental variables of BP. MR analyses of these instruments were performed on 53,236 European individuals for the association with forearm BMD (FA-BMD), femoral neck BMD (FN-BMD), and lumbar spine BMD (LS-BMD); 451,179 European individuals for fall susceptibility; and up to 1.2 million individuals from European descent for fracture. Conventional inverse variance weighted (IVW) method was adopted to obtain the causal estimates of BP on different outcomes, while weighted median, MR-egger, and MR pleiotropy residual sum and outlier (MR-PRESSO) test were used for sensitivity analyses.ResultsGenetically high pulse pressure (PP) could significantly improve FA-BMD (beta-estimate: 0.038, 95% confidence interval [CI]: 0.013 to 0.063, SE:0.013, P-value=0.003&lt;Bonferroni correction P) in the IVW analysis, indicating that 1-SD increase in PP was associated with the improvement in FA-BMD levels by 0.038 g/cm2 (95% CI: 0.013 to 0.063). This positive finding was also confirmed by weighted-median analysis (beta-estimate: 0.034, 95% CI: 0.000 to 0.067, SE:0.017, P-value=0.046) and MR-Egger analysis (beta-estimate: 0.117, 95% CI: 0.026 to 0.208, SE:0.046, P-value=0.011). However, there was no remarkable MR association between BP and other outcomes (i.e., FN-BMD, LS-BMD, fall, and fracture).ConclusionsOur findings reveal a potentially causal relationship between high PP and improved FA-BMD, which may provide new sights for the treatment of osteoporosis.
Systematic Analysis Identifies a Specific RNA-Binding Protein-Related Gene Model for Prognostication and Risk-Adjustment in HBV-Related Hepatocellular Carcinoma
Authors: Li Maoshi , Liu Zhongwei , Wang Jing , Liu Huimin , Gong Hongmei , Li Shilian , Jia Ming , Mao Qing 
Published: August 2021

ObjectiveIncreasing evidence shows that dysregulated RNA binding proteins (RBPs) modulate the progression of several malignancies. Nevertheless, their clinical implications of RBPs in HBV-related hepatocellular carcinoma (HCC) remain largely undefined. Here, this study systematically analyzed the associations of RBPs with HBV-related HCC prognosis.MethodsBased on differentially expressed RBPs between HBV-related HCC and control specimens, prognosis-related RBPs were screened by univariate analyses. A LASSO model was then created. Kaplan-Meier curves, ROCs, multivariate analyses, subgroup analyses and external verification were separately applied to assess the efficacy of this model in predicting prognosis and recurrence of patients. A nomogram was created by incorporating the model and clinical indicators, which was verified by ROCs, calibration curves and decision curve analyses. By CIBERSORT algorithm, the association between the risk score and immune cell infiltrations was evaluated.ResultsTotally, 54 RBPs were distinctly correlated to prognosis of HBV-related HCC. An 11-RBP model was created, containing POLR2L, MRPS12, DYNLL1, ZFP36, PPIH, RARS, SRP14, DDX41, EIF2B4, and NOL12. This risk score sensitively and accurately predicted one-, three- and five-year overall survival, disease-free survival, and progression-free interval. Compared to other clinical parameters, this risk score had the best predictive efficacy. Also, the clinical generalizability of the model was externally verified in the GSE14520 dataset. The nomogram may predict patients’ survival probabilities. Also, the risk score was related to the components in the immune microenvironment.ConclusionCollectively, RBPs may act as critical elements in the malignant progression of HBV-related HCC and possess potential implications on prognostication and therapy decision.
Predictive Value of the TP53/PIK3CA/ATM Mutation Classifier for Patients With Bladder Cancer Responding to Immune Checkpoint Inhibitor Therapy
Authors: Pan Yi-Hui , Zhang Jia-Xing , Chen Xu , Liu Fei , Cao Jia-Zheng , Chen Yu , Chen Wei , Luo Jun-Hang 
Published: August 2021

BackgroundOnly a proportion of patients with bladder cancer may benefit from durable response to immune checkpoint inhibitor (ICI) therapy. More precise indicators of response to immunotherapy are warranted. Our study aimed to construct a more precise classifier for predicting the benefit of immune checkpoint inhibitor therapy.MethodsThis multi-cohort study examined the top 20 frequently mutated genes in five cohorts of patients with bladder cancer and developed the TP53/PIK3CA/ATM mutation classifier based on the MSKCC ICI cohort. The classifier was then validated in a validation set consisting of IMvigor210 cohort and Broad/Dana-Farber cohort. The molecular profile and immune infiltration characteristics in each subgroup as defined by this classifier were explored.ResultsAmong all 881 patients with bladder cancer, the mutation frequency of TP53, PIK3CA, and ATM ranked in the top 20 mutated genes. The TP53/PIK3CA/ATM mutation classifier was constructed based on the Memorial Sloan Kettering Cancer Center (MSKCC) ICI cohort and only showed predictive value for patients with bladder cancer who received ICI therapy (median overall survival: low-risk group, not reached; moderate-risk group, 13.0 months; high-risk group, 8.0 months; P&lt;0.0001). Similar results were found in subgroups of MSKCC ICI cohort defined by tumor mutation burden. Multivariate Cox analysis revealed that the risk group defined by the classifier served as an independent prognostic factor for overall survival in patients with bladder cancer. Efficacy of the classifier was verified in a validation set consisting of IMvigor210 cohort and Broad/Dana-Farber cohort. Lower expression of PD-1/PD-L1 and less tumor immune infiltration were observed in the high-risk group than the other two groups of the TCGA cohort and the IMvigor210 cohort.ConclusionOur study constructed a TP53/PIK3CA/ATM mutation classifier to predict the benefit of immune checkpoint inhibitor therapy for patients with bladder cancer. This classifier can potentially complement the tumor mutation burden and guide clinical ICI treatment decisions according to distinct risk levels.
Communication About End of Life for Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review of the Empirical Evidence
Authors: Genuis Shelagh K. , Luth Westerly , Campbell Sandra , Bubela Tania , Johnston Wendy S. 
Published: August 2021

Background: Communication about end of life, including advance care planning, life-sustaining therapies, palliative care, and end-of-life options, is critical for the clinical management of amyotrophic lateral sclerosis patients. The empirical evidence base for this communication has not been systematically examined.Objective: To support evidence-based communication guidance by (1) analyzing the scope and nature of research on health communication about end of life for amyotrophic lateral sclerosis; and (2) summarizing resultant recommendations.Methods: A scoping review of empirical literature was conducted following recommended practices. Fifteen health-related and three legal databases were searched; 296 articles were screened for inclusion/exclusion criteria; and quantitative data extraction and analysis was conducted on 211 articles with qualitative analysis on a subset of 110 articles that focused primarily on health communication. Analyses summarized article characteristics, themes, and recommendations.Results: Analysis indicated a multidisciplinary but limited evidence base. Most reviewed articles addressed end-of-life communication as a peripheral focus of investigation. Generic communication skills are important; however, substantive and sufficient disease-related information, including symptom management and assistive devices, is critical to discussions about end of life. Few articles discussed communication about specific end-of-life options. Communication recommendations in analyzed articles draw attention to communication processes, style and content but lack the systematized guidance needed for clinical practice.Conclusions: This review of primary research articles highlights the limited evidence-base and consequent need for systematic, empirical investigation to inform effective communication about end of life for those with amyotrophic lateral sclerosis. This will provide a foundation for actionable, evidence-based communication guidelines about end of life. Implications for research, policy, and practice are discussed.
Rapid Intravenous Glyceryl Trinitrate in Ischemic Damage (RIGID) After Stroke: Rationale, Design and Protocol for a Prospective Randomized Controlled Trial
Authors: Cai Lipeng , Rajah Gary , Duan Honglian , Gao Jie , Cheng Zhe , Xin Ruiqiang , Jiang Shangqian , Palmer Peter , Geng Xiaokun , Ding Yuchuan 
Published: August 2021

Background: Despite intravenous thrombolysis and endovascular therapy for acute ischemic stroke (AIS), many survivors still have varying degrees of disability. Glyceryl trinitrate (GTN), a nitric oxide (NO) donor, has been previously reported to induce neuroprotection after AIS. The use of GTN to reduce brain damage after stroke remains yet to be elucidated. This study was designed to explore the safety, feasibility, and preliminary efficacy of intravenous administration of GTN after AIS.Methods: A prospective randomized controlled trial is proposed with AIS patients. Participants will be randomly allocated to GTN group and control group with a 1:1 ratio (n = 40). Both groups will be treated with standard therapies according to the current stroke guidelines. Participants allocated to the GTN group will receive intravenous administration of GTN (5 mg GTN in 50 ml saline at a rate of 0.4 mg/h that is continued for 12.5 h/day for 2 days) within 24 h of symptom onset. Participants allocated to the control group will receive intravenous administration at equal capacity of 0.9% normal saline (NS) (total 50 ml/day at 4 ml/h that is continued for 12.5 h/day for 2 days). The primary outcome is safety [systolic blood pressure (SBP) &lt;110 mmHg, headache], while the secondary outcomes include changes in functional outcome and infarction volume.Discussion: Rapid Intravenous Glyceryl Trinitrate in Ischemic Damage (RIGID) is a prospective randomized controlled trial that aims to ascertain the safety, feasibility, and preliminary efficacy of intravenous GTN as a neuroprotection strategy after AIS. These results will provide parameters for future studies as well as provide insights into treatment effects. Any possible neuroprotective qualities of GTN in AIS will also be elucidated.Trial Registration:www.chictr.org.cn, identifier: ChiCTR2100046271.