bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bioprosthetic vs. Mechanical Mitral Valve Replacement for Rheumatic Heart Disease in Patients Aged 50–70 Years
Authors: Yu Jun , Wang Wei 
Published: May 2022

BackgroundRheumatic heart disease (RHD) is a critical problem in developing countries and is the cause of most of the cardiovascular adverse events in young people. In patients aged 50–70 years with RHD requiring mitral valve replacement (MVR), deciding between bioprosthetic and mechanical prosthetic valves remains controversial because few studies have defined the long-term outcomes.Methods1,691 Patients aged 50–70 years with RHD who received mechanical mitral valve replacement (MVRm) or bioprosthetic mitral valve replacement (MVRb) were retrospectively reviewed in Fuwai hospital from 2010 to 2014. Follow-up ended 31/12/2021; median duration was 8.0 years [interquartile range (IQR), 7.7–8.3 years]. Propensity score matching at a 1:1 ratio for 24 baseline features between MVRm and MVRb yielded 300 patient pairs. The primary late outcome was postoperative mid- to long-term all-cause mortality.ResultsTen-year survival after MVR was 63.4% in the MVRm group and 63.7% in the MVRb group (HR, 0.91; 95% CI, 0.69–1.21; P = 0.528). The cumulative incidence of mitral valve reoperation was 0.0% in the MVRm group and 1.2% in the MVRb group (HR, 0.92; 95% CI, 0.69–1.21; P = 0.530). The cumulative incidence of stroke was 5.5% in the MVRm group and 6.1% in the MVRb group (HR, 0.89; 95% CI, 0.67–1.18; P = 0.430). The cumulative incidence of major bleeding events was 3.3% in the MVRm group and 3.4% in the MVRb group (HR, 0.92; 95% CI, 0.70–1.22; P = 0.560).ConclusionsIn patients aged 50–70 years with RHD who underwent mitral valve replacement, there was no significant difference on survival, stroke, mitral valve reoperation and major bleeding events at 10 years. These findings suggest mechanical mitral valve replacement may be a more reasonable alternative in patients aged 50–70 years with rheumatic heart disease.
Geochemistry and Isotopic Characteristics of Apatite and Zircon From Late Jurassic Granites in the Jiaobei Terrane, East China: Implications for Petrogenesis and Geodynamic Setting
Authors: Mao Xiancheng , Qu Xin , Liu Zhankun , Huang Jixian , Hollings Pete , Du Peijie , Yang Haibin 
Published: May 2022

The North China Craton (NCC) was stable for more than 2.0 Gyr before a Jurassic–Cretaceous large-scale lithospheric thinning event, but the geodynamic setting during the early phases (Late Jurassic) of NCC reworking remains controversial. We present new petrological and whole-rock geochemical data, zircon and apatite geochemistry, U–Pb ages, O isotopic data, and Sr–Nd isotopic data for two phases of Late Jurassic granite (Linglong and Luanjiahe) from the Jiaobei terrane, southeastern NCC. LA-ICP-MS zircon U-Pb dating suggests that the Linglong granite formed about 6 Myr earlier than Luanjiahe granite (158 Ma vs 152 Ma), after the inception of the paleo-Pacific plate subduction. High zircon U/Yb ratios, high δ18O values [7.89 ± 0.10‰ to 7.67 ± 0.14‰ (2σ)], and inherited zircon age spectra, as well as high apatite F/Cl ratios and Sr–Nd isotopic compositions, suggest that the Linglong and Luanjiahe granites formed by partial melting of ancient thickened lower continental crust of the NCC and Yangtze Craton. Magma evolution modelling based on Rb and Rb/Nb data suggests a similar decoupled assimilation-fractional crystallization process for the generation of Linglong and Luanjiahe granite but with different assimilation degrees. The water contents of parental magma evaluated by using whole-rock Ba, Sr and apatite F, Cl data indicate that the Linglong granite was formed in a relatively water-rich environment than Luanjiahe. This is consistent with the presence of amphibole and minor negative Eu anomalies in the Linglong granite, as water input can promote amphibole fractionation and suppresses plagioclase crystallization. Considering the similar magma sources but distinct water contents of the granites, and the oblique Paleo-Pacific plate subduction setting in the Late Jurassic, the fluids were likely released from the ocean plate beneath a stacked thickened crust. Since the earliest mafic dikes (OIB-type) in the NCC are coeval with the Luanjiahe granite, we suggest that the lower water contents of the Luanjiahe granite were associated with roll-back that resulted in an increasing distance from slab to continental crust. Such a tectonic transition from subduction compression (158 Ma) to initial extension (152 Ma) in the Late Jurassic perhaps possibly marks the beginning of the reworking of the NCC.
Hydrologic Controls on Peat Permafrost and Carbon Processes: New Insights From Past and Future Modeling
Authors: Treat Claire C. , Jones Miriam C. , Alder Jay , Frolking Steve 
Published: May 2022

Soil carbon (C) in permafrost peatlands is vulnerable to decomposition with thaw under a warming climate. The amount and form of C loss likely depends on the site hydrology following permafrost thaw, but antecedent conditions during peat accumulation are also likely important. We test the role of differing hydrologic conditions on rates of peat accumulation, permafrost formation, and response to warming at an Arctic tundra fen using a process-based model of peatland dynamics in wet and dry landscape settings that persist from peat initiation in the mid-Holocene through future simulations to 2100 CE and 2300 CE. Climate conditions for both the wet and dry landscape settings are driven by the same downscaled TraCE-21ka transient paleoclimate simulations and CCSM4 RCP8.5 climate drivers. The landscape setting controlled the rates of peat accumulation, permafrost formation and the response to climatic warming and permafrost thaw. The dry landscape scenario had high rates of initial peat accumulation (11.7 ± 3.4 mm decade−1) and rapid permafrost aggradation but similar total C stocks as the wet landscape scenario. The wet landscape scenario was more resilient to 21st century warming temperatures than the dry landscape scenario and showed 60% smaller C losses and 70% more new net peat C additions by 2100 CE. Differences in the modeled responses indicate the largest effect is related to the landscape setting and basin hydrology due to permafrost controls on decomposition, suggesting an important sensitivity to changing runoff patterns. These subtle hydrological effects will be difficult to capture at circumpolar scales but are important for the carbon balance of permafrost peatlands under future climate warming.
Developmental Validation of the Novel Five-Dye-Labeled Multiplex Autosomal STR Panel and Its Forensic Efficiency Evaluation
Authors: Huang Shimei , Jin Xiaoye , Zhang Hongling , Jin Haiying , Ren Zheng , Wang Qiyan , Liu Yubo , Ji Jingyan , Yang Meiqing , Zhang Han , Zheng Xingkai , Song Danlu , Zheng Bingjie , Huang Jiang 
Published: May 2022

Short tandem repeats (STRs) are the most frequently used genetic markers in forensic genetics due to their high genetic diversities and abundant distributions in the human genome. Currently, the combined DNA index system is commonly incorporated into various commercial kits for forensic research. Some novel STRs that are different from the combined DNA index system were not only used to assess complex paternity cases but also could provide more genetic information and higher forensic efficiency in combination with those commonly used STRs. In this study, we validated forensic performance of a novel multiplex amplification STR panel to evaluate its sensitivity, species specificity, forensic application values, and so on. Obtained results revealed that the kit showed high sensitivity, and the complete allelic profile could be observed at 0.125 ng DNA sample. In addition, the kit possessed high species specificity, good tolerance to common inhibitors, and accurate genotyping ability. More importantly, STRs out of the kit displayed high discrimination power and probability of exclusion. To sum up, the novel kit presented in this study can be viewed as a promising tool for forensic human identification and complex paternity analysis.
Mortality and Cardiovascular Events in Patients With Chronic Kidney Disease and Sleep Apnea Syndrome
Authors: Watanabe Yu , Tanaka Akihito , Furuhashi Kazuhiro , Saito Shoji , Maruyama Shoichi 
Published: May 2022

BackgroundThe incidence of sleep apnea syndrome (SAS) is reported to be markedly high in patients with chronic kidney disease (CKD). Therefore, it is extremely important to know whether SAS affects prognosis in patients with CKD. Further, it is imperative to understand the prognostic impact of home continuous positive airway pressure (CPAP) therapy, which is one of the most common treatments for SAS.Materials and MethodsWe used a clinical database to identify patients with CKD using diagnosis codes. We included patients with CKD aged 20 years or more, not on renal replacement therapy, with a known change in renal function for at least 1 year. The propensity score was used to compare event rates for patients with SAS and those without SAS. In addition, the prognostic impact of CPAP therapy was investigated. The primary outcome is a composite of death, initiation of renal replacement therapy, hospitalization for heart failure, ischemic heart disease, and cerebrovascular disease.ResultsFrom the database, 31,294 patients with CKD without SAS and 1,026 with SAS were found to be eligible. Of these, 419 (41%) patients with SAS and 10,713 (34%) patients without SAS (P &lt; 0.01) reached the primary outcome. After adjustment with the propensity score, the SAS group was found to have a similarly poor prognosis (P &lt; 0.01): the hazard ratio for the primary outcome was 1.26 (95% CI, 1.08–1.45, P &lt; 0.01) in the group with SAS compared with the group without SAS. Conversely, in patients with SAS and using CPAP, the hazard ratio was lower and did not differ significantly (HR 0.96, 95% CI: 0.76–1.22, P = 0.76).ConclusionIn patients with CKD and SAS, the risk of death and cardiovascular disease is high. In addition, patients treated with CPAP may have improved life expectancy.
Associations of the Dietary Magnesium Intake and Magnesium Depletion Score With Osteoporosis Among American Adults: Data From the National Health and Nutrition Examination Survey
Authors: Wang Jie , Xing Fei , Sheng Ning , Xiang Zhou 
Published: May 2022

ObjectivesThe study aimed to explore the associations between dietary magnesium (Mg) intake and magnesium depletion score (MDS) among American adults with osteoporosis.MethodsThe continuous data from the National Health and Nutrition Examination Survey 2005–2006, 2007–2008, 2009–2010, 2013–2014, and 2017–2018 were merged to ensure a large and representative sample and a total of 14,566 participants were enrolled for the analysis. The weighted multivariate linear regression model was performed to assess the linear relationship between dietary Mg intake and osteoporosis. Further, the non-linear relationship was also characterized by smooth curve fitting (SCF) and weighted generalized additive model (GAM). In addition, the odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between the MDS and osteoporosis were assessed by weighted logistic regression models.ResultsAfter adjusting all covariates, the weighted multivariable linear regression models demonstrated that the dietary Mg intake negatively correlated with osteoporosis, especially in participants aged 55 years or older. In addition, the non-linear relationship characterized by SCF and weighted GAM showed that the dietary Mg intake presented an L-shaped association with osteoporosis among females aged 55 years or older. Moreover, the weighted logistic regression model demonstrated that compared with MDS 0, the OR between MDS ≥3 and osteoporosis was 2.987 (95% CI 1.904, 4.686) in the male-middle intake group. Moreover, compared with MDS 0, the ORs between MDS ≥3 and osteoporosis was 5.666 (95% CI 3.188, 10.069) in the female-low intake group and 1.691 (95% CI 1.394, 2.051) in the female-middle intake group.ConclusionThe present study indicated that in people with a daily intake of Mg level below the recommended daily intake (RDI), the dietary Mg intake and Mg bioavailability represented by MDS have a negative correlation with osteoporosis. According to the results, the combination of MDS and dietary Mg intake may be more comprehensive and rigorous in screening the population with osteoporosis. Therefore, early monitoring and interventions for osteoporosis may be necessary for those with insufficient dietary Mg intake or high MDS scores.
A Germline Mutation in ATR Is Associated With Lung Adenocarcinoma in Asian Patients
Authors: Bao Guangyao , Guan Xiaojiao , Liang Jie , Yao Yao , Xiang Yifan , Li Tian , Zhong Xinwen 
Published: May 2022

BackgroundFamilial lung cancer (FLC) accounts for 8% of lung adenocarcinoma. It is known that a few germline mutations are associated with risk increasing and may provide new screening and treatment option. The goal of this study is to identify an FLC gene among three members of an FLC family.MethodsTo uncover somatic and embryonic mutations linked with familial lung cancer, whole exome sequencing was done on surgical tissues and peripheral blood from three sisters in a family diagnosed with pulmonary lung adenocarcinoma (LUAD). At the same time, single-cell RNA sequencing (scRNA-seq) and bulk RNA sequencing data in public databases were enrolled to identify specific gene expression level.ResultsAtaxia Telangiectasia and Rad3-Related Protein (ATR) gene C.7667C &gt;G (p.T2556S) mutation were found in 3 patients with familial lung cancer. Whole-genome sequencing revealed that the three sisters exhibited similar somatic mutation patterns. Besides ATR mutations, common mutated genes (BRCA1, EGFR, and ROS1) that characterize LUAD were also found in 5 tumor samples. Analysis for the ATR expression in LUAD patients by single-cell sequencing data, we found ATR expression of tumor patients at high level in immune cells when compared with normal patients, but the expression of ATR in stromal cells has the opposite result.ConclusionWe found a germline mutation in the ATR gene in three sisters of a Chinese family affected by familial lung cancer, which may be a genetic factor for lung cancer susceptibility.
Perioperative Outcomes of Video-Assisted Thoracoscopic Surgery Versus Open Thoracotomy After Neoadjuvant Chemoimmunotherapy in Resectable NSCLC
Authors: Zhang Baihua , Xiao Qin , Xiao Haifan , Wu Jie , Yang Desong , Tang Jinming , Li Xu , Wu Zhining , Zhou Yong , Wang Wenxiang 
Published: May 2022

BackgroundNeoadjuvant chemoimmunotherapy becomes more widespread in the treatment of NSCLC, but few studies have reported the details of surgical techniques and perioperative challenges following neoadjuvant chemoimmunotherapy until now. The primary aim of our study was to address the feasibility and safety of pulmonary resection after neoadjuvant chemoimmunotherapy via different surgical approaches, video-assisted thoracoscopic surgery (VATS) and open thoracotomy.MethodsPatients with an initial diagnosis of clinical stage IB-IIIB(T3-4N2) NSCLC, who received neoadjuvant chemoimmunotherapy and surgery between January 2019 and August 2021 were included. Patients were retrospectively divided into two groups (VATS, and thoracotomy), and differences in perioperative, oncological, and survival outcomes were compared.ResultsIn total, there were 131 NSCLC patients included. Surgery was delayed beyond 42 days in 21 patients (16.0%), and radical resection (R0) was achieved in 125 cases (95.4%). Lobectomy was the principal method of pulmonary resection (102 cases, 77.9%) and pneumonectomy was performed in 11 cases (8.4%). Postoperative complications within 30 days occurred in 28 patients (21.4%), and no 90-day mortality was recorded. There were 53 patients (38.5%) treated with VATS, and 78 (59.5%) with open thoracotomy. VATS could achieve similar definitive resection rates, postoperative recovery courses, comparable morbidities, and equivalent RFS rates(p&gt;0.05), with the advantages of reduced operative time (160.1 ± 40.4 vs 177.7 ± 57.7 min, p=0.042), less intraoperative blood loss (149.8 ± 57.9 vs 321.2 ± 72.3 ml, p=0.021), and fewer intensive care unit(ICU) stays after surgery (3.8% vs 20.5%, p=0.006) compared with open thoracotomy. However, the mean number of total lymph nodes resected was lower in the VATS group (19.5 ± 7.9 vs 23.0 ± 8.1, p=0.013). More patients in the thoracotomy group received bronchial sleeve resection/bronchoplasty (53.8% vs 32.1%, p=0.014) and vascular sleeve resection/angioplasty (23.1% vs 3.8%, p=0.003). After propensity score matching (PSM) analysis, VATS still had the advantage of fewer ICU stays after surgery (2.3% vs. 20.5%, p=0.007).ConclusionsOur results have confirmed that pulmonary resection following neoadjuvant PD-1 inhibitors plus chemotherapy is safe and feasible. VATS could achieve similar safety, definitive surgical resection, postoperative recovery, and equivalent oncological efficacy as open thoracotomy, with the advantage of fewer ICU stays after surgery.
Safety and Efficacy of Sintilimab and Anlotinib as First Line Treatment for Advanced Hepatocellular Carcinoma (KEEP-G04): A Single-Arm Phase 2 Study
Authors: Chen Xiaofeng , Li Wei , Wu Xiaofeng , Zhao Fengjiao , Wang Deqiang , Wu Hao , Gu Yanhong , Li Xiao , Qian Xiaofeng , Hu Jun , Li Changxian , Xia Yongxiang , Rao Jianhua , Dai Xinzheng , Shao Qianwen , Tang Jie , Li Xiangcheng , Shu Yongqian 
Published: May 2022

PurposeImmune checkpoint inhibitors plus antiangiogenic tyrosine kinase inhibitors may offer a first-line treatment for advanced hepatocellular carcinoma (HCC). In this phase 2 trial [registered with clinicaltrials.gov (NCT04052152)], we investigated the safety and efficacy of first-line anti-PD-1 antibody sintilimab plus antiangiogenic TKI anlotinib for advanced HCC.Methods and MaterialsPathologically-proven advanced HCC patients received sintilimab (200 mg) on day 1 and anlotinib (12 mg) once daily on days 1 to 14 every 3 weeks, with a safety run-in for the first six participants to assess dose-limiting toxicities (DLTs). The primary endpoints were safety and objective response rate (ORR) per RECIST v1.1.ResultsTwenty advanced HCC patients were enrolled. No DLTs occurred in the safety run-in. All patients had treatment-related adverse events (TRAEs). Grade 3 TRAEs occurred in 8 (40.0%) patients, the most common being decreased platelet count (10.0%) and increased γ-glutamyl transferase (10.0%). No grade 4/5 TRAEs occurred. Five (25%) patients developed immune-related AEs. The ORR was 35.0% (95%CI 15.4%-59.2%) per RECIST v1.1 and 55.0% (95%CI 31.5%-76.9%) per modified RECIST. At data cutoff (March 31, 2021), the median progression-free survival was 12.2 months (95%CI, 3.8 to not reached). The median PFS was significantly longer in patients with lower LDH levels (not reached [NR], 95% CI, 8.7 to NR vs. higher LDH levels 5.2 months, 95% CI 3.4 to NR; P=0.020) and a CONUT score ≤2 (NR, 95% CI 5.1 to NR vs. CONUT score &gt;2 6.2 months, 95% CI 1.8 to NR; P=0.020). Furthermore, patients showing tumor response had a significantly higher median proportion of CD16+CD56+ NK cells than patients who had stable or progressive disease (21.6% vs. 14.6%; P=0.026).ConclusionSintilimab plus anlotinib showed promising clinical activities with manageable toxicity as first-line treatment of advanced HCC.
The Effect of Risk Accumulation on Childhood Stunting: A Matched Case-Control Study in China
Authors: Tang Xiao , Zhao Yanxiang , Liu Qigui , Hu Dongmei , Li Guorong , Sun Jin , Song Guirong 
Published: May 2022

BackgroundChildhood stunting is still a public health issue in developing countries. However, the traditional risk factors in underdeveloped areas are not suitable for developed areas. Moreover, childhood stunting is influenced by several aspects, including genetic factors, perinatal conditions, maternal conditions, and feeding practices, but researchers have not yet clearly determined which aspect of risk accumulation exerts the strongest effect on stunting. A matched case-control study was performed to assess the effect of different aspects of risk accumulation on childhood stunting.MethodsIn total, 173 non-stunted children aged under 7 years were matched in our study from June 2015 to August 2015. The children's heights and weights were measured, and a self-administered questionnaire was used to collect information from the children and their parents. The risk factors were assigned to the following five aspects: genetic factors, family socioeconomic status, perinatal conditions, maternal conditions, and feeding practices. The risk accumulation (cumulative risk score) in each aspect was defined as the total number of risk factors that occurred in a certain aspect. A conditional logistic regression model was used to assess the effect of risk accumulation in different aspects on stunting, and a decision-tree model was used to predict the children's stunting based on the cumulative risk scores.ResultsRisk accumulation in perinatal conditions, genetic factors, maternal conditions, and feeding practices was significant in the conditional logistic regression model (P &lt; 0.05). Perinatal conditions showed the strongest association with stunting in both the regression analysis and the decision-tree model. The risk of stunting increased by 1.199 times if the cumulative risk score for perinatal conditions increased by one, and the probability of stunting was 75.8% if the cumulative risk score for perinatal conditions was ≥1.ConclusionRisk accumulation in perinatal conditions, genetic factors, maternal conditions, and feeding practices substantially increased the probability of stunting in childhood. Perinatal conditions were the main aspect associated with stunting. Prevention and intervention measures should be adopted to avoid risk accumulation in stunting.