bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nomogram based on multimodal echocardiography for assessing the evolution of diabetic cardiomyopathy in diabetic patients with normal cardiac function
Authors: Liu Yi , Lu Hao , Zhang Yan , Cai Mengjie , Guo Jia , Ruan Xiaofen 
Published: September 2022

BackgroundDiabetic cardiomyopathy (DCM) remains asymptomatic for many years until progression to asymptomatic left ventricular diastolic dysfunction (ALVDD), a subclinical cardiac abnormality present in early-stage DCM. Because LV function in patients with type 2 diabetes mellitus (T2DM) may be subtly altered long before the onset of ALVDD, quantitative assessment of the risk of progression to early-stage DCM in T2DM patients with normal hearts is critical for delaying or even reversing DCM.ObjectiveThis study aimed to establish a nomogram with the aid of DCM characteristics revealed by multimodal echocardiography to assess the likelihood of the progression to early-stage DCM in T2DM patients with normal cardiac function.MethodsOf the 423 T2DM patients enrolled, 302 were included in the training cohort and 121 in the validation cohort. The clinical characteristics, biochemical data, and multimodal echocardiographic parameters were collected. In the training cohort, the screened correlates of ALVDD were utilized to develop a nomogram for estimating the risk coefficient for early-stage DCM. This model was validated both in the training and validation cohorts.ResultsALVDD was independently correlated with the number of comorbidities [with one comorbidity: odds ratio (OR) = 3.009; with two comorbidities: OR = 4.026], HbA1c (OR = 1.773), myocardial blood flow (OR = 0.841), and global longitudinal strain (OR = 0.856) (all P &lt; 0.05). They constituted a nomogram to visualize the likelihood of DCM development in T2DM patients with normal cardiac function. The model was validated to present strong discrimination and calibration, and obtained clinical net benefits both in the training and validation cohorts.ConclusionWe constructed and validated a nomogram to estimate the likelihood of developing early-stage DCM in T2DM patients with normal cardiac function. The alteration of the nomogram-predicted risk coefficient is expected to be proposed as a therapeutic target to slow or stop DCM progression.
Long-Term prognosis of radiofrequency catheter ablation for atrial fibrillation with different subtypes of heart failure in the era of ablation index guidance
Authors: Qiao Yu , Zhao Zhen , Cai Xiang , Guo Yulong , Fu Mingpeng , Liu Ke , Guo Jinrui , Guo Tao , Niu Guodong 
Published: September 2022

BackgroundThe long-term outcomes of ablation index (AI)-guided radiofrequency catheter ablation (RFCA) on atrial fibrillation (AF) and different subtypes of heart failure (HF) remain unknown. The aim of the study was to evaluate the long-term prognosis of AI-guided RFCA procedures in patients with AF and concomitant HF.MethodsWe retrospectively included consecutive patients with AF and HF who underwent the initial RFCA procedure with AI guidance from March 2018 to June 2021 in our institution. The patients were categorized into two groups: HF with preserved ejection fraction (HFpEF) group and HF with mid-range ejection fraction (HFmrEF) +HF with reduced ejection fraction (HFrEF) group.ResultsA total of 101 patients were included. HFpEF and HFmrEF + HFrEF groups consisted of 71 (70.3%) and 30 patients (29.7%), respectively. During a median follow-up of 32.0 (18.2, 37.6) months, no significant difference was detected in AF recurrence between groups (21.1 vs. 33.3%) after multiple procedures, whereas the incidence of the composite endpoint of all-cause death, thromboembolic events, and HF hospitalization was significantly lower in HFpEF group (9.9 vs. 25.0%, Log-rank p = 0.018). In multivariable analysis, a history of hypertension [hazard ratio (HR) 4.667, 95% confidence interval (CI) 1.433–15.203, p = 0.011], left ventricular ejection fraction (LVEF) &lt; 50% (HR 5.390, 95% CI 1.911–15.203, p = 0.001) and recurrent AF after multiple procedures (HR 7.542, 95% CI 2.355–24.148, p = 0.001) were independently associated with the incidence of the composite endpoint.ConclusionLong-term success could be achieved in 75% of patients with AF and concomitant HF after AI-guided RFCA procedures, irrespective of different HF subtypes. Preserved LVEF was associated with a reduction in the composite endpoint compared with impaired LVEF. Patients with recurrent AF tend to have a poorer prognosis.
Selexipag-based triple combination therapy improves prognosis in Chinese pulmonary arterial hypertension patients
Authors: Cui Xiaopei , Lu Weida , Zhang Deyuan , Qie Liangyi , Li Haijun , Li Xiao , Liu Hui , Ji Qiushang 
Published: September 2022

AimSelexipag is an oral selective prostacyclin receptor agonist approved for treatment of patients with pulmonary arterial hypertension (PAH). In the present study, we aim to assess the safety and efficacy of selexipag in triple combination therapy with endothelial receptor antagonists (ERAs) and PDE5is for Chinese PAH patients.Methods and resultsA single center retrospective study was performed on group 1 PAH patients (n = 68) initiating triple combination therapy with selexipag from 1 February 2020 to 31 August 2021 in Qilu Hospital of Shandong University (Shandong, China). Adolescents, children, and PAH patients with unrepaired congenital heart disease were excluded. The French pulmonary hypertension network (FPHN) non-invasive risk assessment, echocardiogram parameters, and clinical data, including tolerability, safety, and death/hospitalization events associated with PAH, were collected. Of the 68 patients, 31 (45.6%) patients had tolerable side effects while only a single patient discontinued selexipag due to severe diarrhea. In the analysis of the efficacy set of 62 patients, the median selexipag treatment time from selexipag initiation to last risk assessment was 27 (21, 33) weeks. Compared to baseline parameters, the percentage of WHO FC III/IV decreased from 77.4% (48) to 24.2% (15) (p = 0.000), median 6-min walk distance (6MWD) increased 82 m [from 398 (318, 450) to 480 (420, 506) m; p = 0.000], and NT-proBNP levels decreased from 1,216 (329, 2,159) to 455 (134, 1,678) pg/mL (p = 0.007). Patients who improved to three low-risk criteria increased from 9.7 to 38.7%. Right ventricular diameter (RV) diameter also decreased and was accompanied by an improved tricuspid annular plane systolic excursion (TAPSE). Patients transitioning from subcutaneous treprostinil to selexipag continued to show improvements in WHO FC, 6MWD (404 ± 94 vs. 383 ± 127 m) and NT-proBNP levels (2,319 ± 2,448 vs. 2,987 ± 3,770 pg/mL). Finally, the 1-year event free survival rate was 96.7% for patients initiating the triple combination therapy within 3 years of PAH diagnosis.ConclusionTriple combination therapy with selexipag was safe and effective in Chinese PAH patients, which was confirmed by acceptable tolerability, and improved exercise capacity, right heart function, risk assessment, and prognosis.
Preclinical findings: The pharmacological targets and molecular mechanisms of ferulic acid treatment for COVID-19 and osteosarcoma via targeting autophagy
Authors: Pang Guangfu , Yi Tingzhuang , Luo Hongcheng , Jiang Lihe 
Published: September 2022

The variant virus-based 2019 coronavirus disease (COVID-19) pandemic has reportedly impacted almost all populations globally, characterized by a huge number of infected individuals. Clinical evidence proves that patients with cancer are more easily infected with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) because of immunologic deficiency. Thus, there is an urgent need to develop candidate medications to treat patients with cancer plus COVID-19, including those with osteosarcoma (OS). Ferulic acid, a latent theriacal compound that has anti-tumor and antivirus activities, is discovered to have potential pharmacological use. Thus, in this study, we aimed to screen and determine the potential therapeutic targets of ferulic acid in treating patients with OS plus COVID-19 as well as the pharmacological mechanisms. We applied a well-established integrated methodology, including network pharmacology and molecular docking technique, to detail target prediction, network construction, gene ontology, and pathway enrichment in core targets. The network pharmacology results show that all candidate genes, by targeting autophagy, were the core targets of ferulic acid in treating OS and COVID-19. Through molecular docking analysis, the signal transducer and activator of transcription 3 (STAT3), mitogen-activated protein kinase 1 (MAPK1), and phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1) were identified as the pharmacological targets of ferulic acid in treating OS. These preclinical findings from bioinformatics analysis altogether effectively determined the pharmacological molecules and mechanisms via targeting autophagy, demonstrating the therapeutic effectiveness of ferulic acid against COVID-19 and OS.
Chinese famine exposure in early life and metabolic obesity phenotype in middle age: Results from the China health and retirement longitudinal study
Authors: Xu Yunhan , Yi Qian , Shan Shiyi , Zhou Jiali , Li Shuting , Hou Leying , Ye Xinxin , Ying Jiayao , Song Peige , An Lin 
Published: September 2022

ObjectiveTo assess the association between early life exposure to famine and the risk of metabolic obesity phenotypes among adults in middle age.MethodsThe study selected two comparison groups. Comparison A consisted of a non-exposed group born between 1963-1965 from the China Health and Retirement Longitudinal Study (CHARLS) 2015 wave (N=862) and a fetal-exposed group born between 1959-1961 from the 2011 wave (N=507). Comparison B consisted of an early childhood-exposed group born between 1955-1957 from the 2011 wave (N=830) and a fetal-exposed group born between 1959-1961 from the 2015 wave (N=552). Multivariable logistic regressions were conducted to explore the associations between different periods of famine exposure and obesity, metabolic health status, and metabolic obesity phenotypes, with stratification by sex.ResultsCompared with the non-exposed group, participants exposed to famine in the fetal period had a significantly lower risk of overweight/obesity (OR: 0.78, 95%CI: 0.63-0.97) and a higher risk of metabolically unhealthy status (OR: 1.73, 95%CI: 1.34-2.23) and metabolically unhealthy non-obesity (MUNO) (OR: 2.12, 95%CI: 1.46-3.08) at the age of 50-52 years. In the sex-stratified analysis, males exposed to famine in the fetal period had a significantly lower risk of overweight/obesity (OR: 0.59, 95%CI: 0.43-0.80) and metabolically healthy obesity (MHO) (OR: 0.56, 95%CI: 0.37-0.85), while such associations were not found in females. Compared with the early childhood exposure group, participants in the fetal exposure group had a significantly lower risk of metabolic unhealthy status (OR: 0.65, 95%CI: 0.51-0.85) and MUNO (OR: 0.50, 95%CI: 0.35-0.72). Those associations were observed in both males and females.ConclusionExposure to famine in early life increased the risk of metabolically unhealthy status in adulthood. Different metabolic subtypes should be identified at an early stage and followed by classification, intervention, and treatment.
Implementation of sustainable public procurement in China: An assessment using quantitative text analysis in large-scale tender documents
Authors: Cao Fuguo , Li Runyu , Cao Xiaoyan 
Published: September 2022

In recent years, increasing attention has been paid worldwide to the sustainable development of the economy and society. Because of its size and prevalence, public procurement has always been a powerful policy tool used to tackle issues related to the sustainability of society, economy, and environment. China has attached high priority to sustainable development, and many aspects of sustainable public procurement (SPP) have been implemented though no official documents have referred to the concept of SPP. Therefore, little is known about the actual implementation and patterns of SPP in practice. The purpose of the study is to assess the actual implementation and patterns of SPP in China. We obtained 42,369 public procurement documents for 2015–2020 using the web crawler technique and the actual implementation of SPP was assessed through the text-mining technique. The research shows that SPP is implemented in more than 82% of the documents and appears in an upward trend in the past 6 years. Several patterns of SPP implementation are also identified. First, most documents implement more than one category of SPP. Second, small and medium-sized enterprise-oriented procurement is the most implemented SPP main category, overtaking environmentally friendly procurement only by a small margin, and the procurement for the circular economy is the least implemented. Third, there seem to be some relationships between the level of SPP implementation and the award method, tender price, and contract type. Finally, there is a substantial transformation of China’s SPP toward social aspects of SPP in recent years. Policy implications, limitations, and issues for future studies are also discussed.
Break point identification and spatiotemporal dynamic evolution of air pollutants: An empirical study from Anhui province, east China
Authors: Wang Huajie , Gui Herong , Wang Houfeng , Liu Guijian 
Published: September 2022

The new modality of inter-regional joint prevention and control is increasingly important to the integrated process of collaborative governance of air pollutants. Therefore, it has become necessary to analyze the degree of interaction among air pollutants within and between cities, master the dynamics of their spatiotemporal distribution and its influencing factors, and diagnose the primary obstacle factors. Long-term data on the concentrations of six air pollutants among 16 cities of Anhui province from 2015 to 2020 were analyzed using harmonic regression, the coupling coordination degree model, the obstacle degree model, the logarithmic mean Divisia index (LMDI), and exploratory spatial data analysis (ESDA). Over all, the annual mean concentrations of five of these pollutants (NO2, SO2, CO, PM10, and PM2.5) decreased to a certain extent over time, whereas O3 concentrations increased. The biggest decrease was observed in BZ city, where SO2 decreased by 80.60% (halving time: −2.03 ± 0.02 years), and the biggest increase was observed in CZ city, where O3 increased by 113.85% (doubling time: 1.74 ± 0.01 years). The O3 concentrations in most cities reached their break points starting in 2018, but the break points of other air pollutants appeared earlier than that of O3, mostly before 2018. With the exception of NO2 and O3, the halving times of other air pollutants were basically shorter than the doubling times. The high degree of interaction among air pollutants within and between cities contrasted sharply with the low degree of coordination. An analysis of hotspot evolution revealed that particulate matter (PM10 and PM2.5) migrated to northern Anhui, NO2 and O3 agglomerated to central Anhui, and CO eventually gathered in the Wanjiang City Belt. The primary obstacle factors of air pollutants in Anhui were particulate matter, SO2 and NO2. The seasonal differences in primary obstacle factors were most evident in 2020: NO2 dominated in winter (in 10 cities), SO2 dominated in southern Anhui, and particulate matter dominated in northern and central Anhui in spring. Other seasons were almost entirely dominated by particulate matter. Industrial structure was found to be more effective in reducing industrial carbon emissions, and technological improvement was found to be more advantageous in reducing industrial particulate matter, NOx and SO2. Finally, the policy implications of these results and suggestions for strengthening the inter-city joint prevention and control of air pollutants are discussed.
Neither COVID-19, nor cryopreservation, prevented allogeneic product infusion: A report from the National Marrow Donor Program
Authors: Farhadfar Nosha , Newman Jeni , Novakovich Jennifer , Barten Jacklyn , Ndifon Eric T. , Oakes Jason , Cody Meghann , Pham Huy P. , Auletta Jeffery J. , Miller John P. , Devine Steven M. , Stefanski Heather E. 
Published: September 2022

BackgroundThe Coronavirus Disease 2019 (COVID-19) pandemic in early 2020 has resulted in an unprecedented level of uncertainty and challenge for the stem cell donor registries. To address these challenges, rapid strategies were implemented by the National Marrow Donor Registry (NMDP) and its network partners. Herein, we aim to report the impact of the COVID-19 pandemic on the collection, utilization of grafts, and short-term outcomes of patients who received stem cell products from COVID-19-positive donors.MethodsNMDP data during the early phase (1 March 2020 through 1 May 2020) of the pandemic were compared to the later phase (1 March 2021 through 1 May 2021). Odds ratios were calculated to determine the impact of the pandemic on graft sources requested by transplant centers (TCs). The Kruskal–Wallis test was used to test the effect of the pandemic on the disease indication, volume of searches, and number of products not infused.ResultsAlthough there was an initial decline in overall donor searches during the early phase of the pandemic, these numbers increased reaching pre-pandemic levels during the later phase. Urgent malignant diseases remained the most common indication for transplant in 2021. The pandemic necessitated cryopreservation of stem cell products due to transportation restrictions as well as clinical uncertainties in managing the virus. Cryopreserved grafts remained the most common requested grafts throughout the pandemic. In the later phase of the pandemic, the total numbers of requests for fresh grafts increased, mostly due to the increase in requests for fresh bone marrow (BM) grafts. As the pandemic continued, TCs became more accepting of cryopreservation, resulting in a reduction in the number of products not infused. Lastly, no short-term deleterious outcomes were noted among the patients who had stem cell products infused from a SARS-CoV-2-positive donor.ConclusionThroughout the pandemic, the NMDP and TCs worked tirelessly to ensure that patients would receive lifesaving grafts when needed. The data reported here, although limited by small numbers, illustrate that transplantation from donors with COVID-19 is feasible and safe.
Case report: Two PD-L1 positive unresectable advanced pancreatic carcinoma patients with microsatellite stability achieved R0 resection after PD-1 antibody plus chemotherapy as a successful downstaging therapy: A report of two cases
Authors: Shang Lin , Li Peng , Fan Jie , Zhao Chunning , Niu Xiangying , Bian Qitian , Yuan Zhilin , Kong Yanlong , Zhu Tingshun , Xu Bin , Dong Jianxin , Xiang Hongjun 
Published: September 2022

BackgroundNonobvious early symptoms are a prominent characteristic of pancreatic cancer, resulting in only 20% of patients having resectable tumors at the time of diagnosis. The optimal management of unresectable advanced pancreatic cancer (UAPC) remains an open research question. In this study, the tumors shrank significantly after PD-1 antibody combined with chemotherapy in two UAPC patients, and both have achieved R0 (pathologically negative margin) resection and survival to date.Case presentationCase 1: A 53-year-old man was diagnosed with pancreatic adenocarcinoma (Stage III). He received six cycles of PD-1 antibody plus chemotherapy as the first-line treatment. The tumor was reduced from 11.8×8.8 cm to “0” (the pancreatic head was normal as shown by enhanced computed tomography, ECT) after preoperative neoadjuvant therapy (PNT) and the adverse effects were tolerable. The patient underwent radical surgery and achieved R0 resection. Case 2: A 43-year-old man diagnosed with pancreatic adenocarcinoma with liver metastasis (Stage IV) received three cycles of PD-1 antibody combined with chemotherapy. The tumor was reduced from 5.2×3.9 cm to 2.4×2.3 cm with no side effects. The patient also underwent radical surgery and achieved R0 resection.ConclusionPD-1 antibody plus a chemotherapy regimen resulted in a surprising curative effect and safety in two patients with UAPC, which may portend an improvement in pancreatic carcinoma treatment. We may have a way for UAPC patients to obtain radical treatment and gain long-term survival. Two PD-L1 positive UAPC patients with microsatellite stability (MSS) enlighten us to have a more comprehensive understanding of the prediction of immunotherapy.
Blood gene expression predicts intensive care unit admission in hospitalised patients with COVID-19
Authors: Penrice-Randal Rebekah , Dong Xiaofeng , Shapanis Andrew George , Gardner Aaron , Harding Nicholas , Legebeke Jelmer , Lord Jenny , Vallejo Andres F. , Poole Stephen , Brendish Nathan J. , Hartley Catherine , Williams Anthony P. , Wheway Gabrielle , Polak Marta E. , Strazzeri Fabio , Schofield James P. R. , Skipp Paul J. , Hiscox Julian A. , Clark Tristan W. , Baralle Diana 
Published: September 2022

BackgroundThe COVID-19 pandemic has created pressure on healthcare systems worldwide. Tools that can stratify individuals according to prognosis could allow for more efficient allocation of healthcare resources and thus improved patient outcomes. It is currently unclear if blood gene expression signatures derived from patients at the point of admission to hospital could provide useful prognostic information.MethodsGene expression of whole blood obtained at the point of admission from a cohort of 78 patients hospitalised with COVID-19 during the first wave was measured by high resolution RNA sequencing. Gene signatures predictive of admission to Intensive Care Unit were identified and tested using machine learning and topological data analysis, TopMD.ResultsThe best gene expression signature predictive of ICU admission was defined using topological data analysis with an accuracy: 0.72 and ROC AUC: 0.76. The gene signature was primarily based on differentially activated pathways controlling epidermal growth factor receptor (EGFR) presentation, Peroxisome proliferator-activated receptor alpha (PPAR-α) signalling and Transforming growth factor beta (TGF-β) signalling.ConclusionsGene expression signatures from blood taken at the point of admission to hospital predicted ICU admission of treatment naïve patients with COVID-19.
Slow-sinking particulate organic carbon and its attenuation in the mesopelagic water of the South China Sea
Authors: Yang Weifeng , Zhao Xiufeng , Zheng Minfang 
Published: September 2022

Coastal acidification has been widely investigated in terms of its rationale and ecological effects in the last decade. However, the driving mechanism for acidification in open seawater, especially in mesopelagic water, is still poorly understood. Here, the sinking velocity and flux attenuation of particulate organic carbon (POC) were examined based upon the radioactive 210Po-210Pb tracer to reveal the remineralization of POC in the mesopelagic zone in the northeastern South China Sea (SCS). Overall, the profiles of 210Po followed those of 210Pb, lending support to the particle sinking controlled top-down deficits of 210Po. Using an inverse model, the sinking velocity of particles, for the first time in the SCS, was estimated to vary from 3 to 34 m d-1 with the mean value of 15 ± 9 m d-1, indicating that the slow sinking particles largely contribute to the POC flux in the SCS. Beneath the euphotic zone, a consistent descending of the sinking speed implied continuous remineralization of sinking POC in the twilight zone. A preliminary estimate revealed that 1.9-5.4 mmol-C m-2 d-1 remineralized back to carbon dioxide within 100-500 m, representing about 70% of the exported autochthonous POC from the euphotic zone. In 100-1000 m, 2.4-6.6 mmol-C m-2 d-1 (i.e., 84%) remineralized. Thus, the upper twilight zone (i.e., 100-500 m) is the dominant layer of POC remineralization, and POC-induced acidification could be unneglectable there. These results provided insights into the POC-induced acidification mechanism in the mesopelagic water, especially in the upper mesopelagic layer.