bluuebunny/crossref_metadata_2025_split huggingface dataset:
RIG-I and TLR-7/8 agonists as combination adjuvant shapes unique antibody and cellular vaccine responses to seasonal influenza vaccine
Authors: Jangra Sonia , Laghlali Gabriel , Choi Angela , Rathnasinghe Raveen , Chen Yong , Yildiz Soner , Coughlan Lynda , García-Sastre Adolfo , De Geest Bruno G. , Schotsaert Michael 
Published: November 2022

Influenza vaccine effectiveness could be improved by combination with an adjuvant with the potential to enhance the host-vaccine response both quantitatively and qualitatively. The goal of this study was to explore a RIG-I agonist (SDI-nanogel) and a TLR7/8 agonist (Imidazoquinoline (IMDQ)‐PEG‐Chol) as adjuvants, when co-administered with a licensed quadrivalent inactivated influenza vaccine (QIV), and to determine the role of these adjuvants in directing helper T (Th) cell responses for their role in the immunoglobulin (Ig) class switching. Administration of QIV with the two adjuvants, individually or combined, resulted in enhanced HA-specific serum ELISA IgG titers, serum hemagglutination inhibition (HAI) titers and splenic T cell responses as examined by IFN-γ and IL-4 enzyme-linked immunosorbent spot (ELISPOT) assays, 4-weeks post-prime and post-boost vaccination in BALB/c mice. While QIV+SDI-nanogel largely induced antigen-specific IgG1 responses, QIV+IMDQ-PEG-Chol predominantly induced IgG2a antibody isotypes post-prime vaccination, suggesting efficient induction of Th2 (IL-4) and Th1 (IFN-γ) responses, respectively. Combination of the two adjuvants not only skewed the response completely towards IgG2a, but also resulted in induction of HAI titers that outperformed groups that received single adjuvant. Moreover, enhanced IgG2a titers correlate with antibody-mediated cellular cytotoxicity (ADCC) that targets both the highly conserved H1 hemagglutination (HA) stalk domain and N1 neuraminidase (NA). A booster vaccination with QIV+IMDQ-PEG-Chol resulted in a more balanced IgG1/IgG2a response in animals primed with QIV+IMDQ-PEG-Chol but increased only IgG2a titers in animals that received the combination adjuvant during prime vaccination, suggesting that class switching events in germinal centers during the prime vaccination contribute to the outcome of booster vaccination. Importantly, IMDQ-PEG-Chol, alone or in combination, always outperformed the oil-in-water control adjuvant Addavax. Vaccine-induced antibody and T cell responses correlated with protection against lethal influenza virus infection. This study details the benefit of adjuvants that target multiple innate immune receptors to shape the host vaccine response.
Spatiotemporal coastline variations in the Pearl River Estuary and the relationship with multiple human disturbances
Authors: Li Xin , Yan Haiming , Yang Ying , Xu Zhihao , Yang Huicai 
Published: November 2022

Coastlines and estuaries as one of the most dynamic systems in the marine environment are influenced by not only natural factors but also various anthropogenic activities, but there have been limited comprehensive studies on the relationship between coastline variation and anthropogenic activities at the watershed and local scales. The Pearl River Estuary (PRE) in China has experienced remarkable coastline variation along with rapid economic development and urbanization. In this study, the coastline of the PRE was extracted using Landsat images during 1987-2017, and the impacts of multiple factors on coastline variation were explored with correlation analysis and regression analysis. Results suggested coastlines of the PRE demonstrated a clear expanding trend over recent decades, and the coastline length had increased by 74.81 km and the land area had increased by 679.25 km2 by 2017, and results also showed rapid coastline variation during 1987-2004 and relatively slow variation during 2004-2017. Artificial coastlines accounted for 80.90% of the total coastline length in 2017, while natural coastlines accounted for only 19.10%. In addition, reduction in the sand content caused by construction of reservoirs and river dredging in upstream areas played a dominant role in affecting natural coastline variation in the PRE, especially on the west coast. Moreover, the artificial coastline in the study area expanded quickly due to the influence of various human activities, among which the urbanization and land reclamation for aquaculture played a dominant role in affecting the artificial coastline variation on the east and west coasts, respectively. Results of this study have important value for understanding the individual and joint effects of various human activities on coastline variation and can provide important reference information for the sustainable management of the PRE as well as other estuaries.
Disparities in the unmet mental health needs between LGBTQ+ and non-LGBTQ+ populations during COVID-19 in the United States from 21 July 2021 to 9 May 2022
Authors: Chen Shanquan , Wang Yuqi , She Rui , Qin Pei , Ming Wai-Kit 
Published: November 2022

BackgroundEvidence highlighted the likelihood of unmet mental health needs (UMHNs) among LGBTQ+ than non-LGBTQ+ populations during COVID-19. However, there lacks evidence to accurately answer to what extent the gap was in UMHN between LGBTQ+ and non-LGBTQ+ populations. We aim to evaluate the difference in UMHN between LGBTQ+ and non-LGBTQ+ during COVID-19.MethodsCross-sectional data from Household Pulse Survey between 21 July 2021 and 9 May 2022 were analyzed. LGBTQ+ was defined based on self-reported sex at birth, gender, and sexual orientation identity. UMHN was assessed by a self-reported question. Multivariable logistic regressions generated adjusted odds ratios (AODs) of UMHN, both on overall and subgroups, controlling for a variety of socio-demographic and economic-affordability confounders.Findings81267 LGBTQ+ and 722638 non-LGBTQ+ were studied. The difference in UMHN between LGBTQ+ and non-LGBTQ+ (as reference) varied from 4.9% (95% CI 1.2–8.7%) in Hawaii to 16.0% (95% CI 12.2–19.7%) in Utah. In multivariable models, compared with non-LGBTQ+ populations, LGBTQ+ had a higher likelihood to report UMHN (AOR = 2.27, 95% CI 2.18–2.39), with the highest likelihood identified in transgender (AOR = 3.63, 95% CI 2.97–4.39); compared with LGBTQ+ aged 65+, LGBTQ+ aged 18–25 had a higher likelihood to report UMHN (AOR = 1.34, 95% CI 1.03–1.75); compared with White LGBTQ+ populations, Black and Hispanic LGBTQ+ had a lower likelihood to report UMHN (AOR = 0.72, 95% CI 0.63–0.82; AOR = 0.85, 95% CI 0.75–0.97, respectively).InterpretationDuring the COVID-19, LGBTQ+ had a substantial additional risk of UMHN than non-LGBTQ+. Disparities among age groups, subtypes of LGBTQ+, and geographic variance were also identified.
The therapeutic effect of capsaicin on oropharyngeal dysphagia: A systematic review and meta-analysis
Authors: Yang Cong-wen , Chen Ru-dong , Feng Meng-ting , Zhang Meng-zhen , Liu Wei , Liu Xu-chang , Wang Da-chuan 
Published: November 2022

ObjectivesCapsaicin is a specific agonist of TRPV1 (multimodal sensory receptor), which improves oropharyngeal dysphagia by increasing sensory input from the oropharynx and hypopharynx and by increasing repetitive stimulation of the cerebral cortex. The aim of this systematic review was to evaluate the therapeutic effect of capsaicin on swallowing disorders in stroke patients and the elderly.MethodWe searched Medline, Embase, PubMed, and Cochrane Library databases. We used the Mesh terms search database to screen all clinical trials that complied with the inclusion criteria. Studies were subjected to literature screening, quality assessment, and data extraction to remove studies that did not meet the inclusion criteria. After literature screening, quality assessment, and data extraction, a systematic review and meta-analysis of the included study were performed.ResultsThis systematic review and meta-analysis were prospectively registered on PROSPERO under registration number CRD42022313958. Five high-quality randomized controlled trials were ultimately included. The results of our meta-analysis showed a more significant reduction in swallowing function score change in the capsaicin group compared to the control group [SMD = −1.30, 95% CI: (−2.35, −0.25), P = 0.01] and on the Water swallowing test the improvement was significantly higher in the capsaicin group [RR = 2.46, 95% CI: (1.73, 3.50), P &lt; 0.0001].ConclusionsAlthough the results of our meta-analysis showed that capsaicin improved swallowing function, most studies had an unclear bias and included few studies. More studies are needed to support this in the future.Systematic review registrationwww.crd.york.ac.uk/prospero/display_record.php?RecordID=304061, identifier: 304061.
KIDMED 2.0, An update of the KIDMED questionnaire: Evaluation of the psychometric properties in youth
Authors: López-Gajardo Miguel A. , Leo Francisco M. , Sánchez-Miguel Pedro Antonio , López-Gajardo Dori , Soulas Candelaria , Tapia-Serrano Miguel A. 
Published: November 2022

Background and aimsAs children and adolescents' eating patterns have changed over the last few years, researchers have found inconsistencies in the current questionnaires. Therefore, this research aims to (i) update the 2019 KIDMED questionnaire; and (ii) test the psychometric properties of this new questionnaire.MethodA study with 419 children and adolescents in southwestern Spain was conducted in 2021. The new version of the KIDMED 2.0 was tested, which measures adherence to the Mediterranean diet through 16 items, of which 12 are positive, and 4 are negative. Content validation involved consultation with nutritionists, experts, and adolescents to assess whether the questionnaire was reliable and valid regarding dietary patterns associated with the Mediterranean diet. The expert assessment provided content validity indices for the clarity and representativeness of the questionnaire. Construct validity and test-retest reliability involved 419 students (Mage = 14.40 ± 2.00) from southwestern Spain. Students responded twice (one week apart) to the KIDMED developed in the previous stage and completed a 7-day dietary record.ResultsRegarding validity, results show a moderate agreement for 10 items (ranging between 0.21 and 0.47) of the KIDMED and the 7-day dietary record. Concerning Items 3, 4, 5, and 6, the agreement was slight (ranging between 0.08 and 0.17), whereas the agreement for Item 8 was low. Cohen's kappa showed that most items had moderate to substantial test-retest reliability. Also, kappa showed significant test-retest values for all items (p &lt; 0.001).ConclusionThe new version of the KIDMED 2.0 was shown to be a reliable and valid instrument to measure adherence to the Mediterranean diet in children and adolescents.
Case report: Capillary hemangioma in the renal hilum mimicking paraganglioma
Authors: Jiang Weixing , Liu Xiaoqi , Wen Li 
Published: November 2022

BackgroundCapillary hemangioma is a common benign tumor in children. Its presence in the kidney is rare, and there have been only case reports in the English literature. Herein, we report a special case of capillary hemangioma located in the renal hilum, which was suspected to be a paraganglioma.Case presentationA 44-year-old woman had an irregular mass in the right hilar region. She had a history of hypertension for 3 years, and her 24-hour urinary norepinephrine was slightly high (41.53 µg, normal range: 16.69-40.65 µg). Abdominal MRI revealed a mass in the renal hilum measuring approximately 4.8×4.0×3.2 cm, slightly low signal intensity on T1WI, and very high signal intensity on both T2WI and DWI. The multiphase enhanced scan showed that the tumor had obvious enhancement with a central hypointense area. Therefore, paraganglioma was initially diagnosed. Phenoxybenzamine was administered over the next 2 weeks. She performed laparoscopic right hilar area tumor resection, and the kidney was preserved. Unexpectedly, the final pathology report was capillary hemangioma.ConclusionsCapillary hemangioma in the renal hilum is extremely rare. Surgery is the first choice to reduce the risk of compression symptoms and to rule out malignancy with respect to an undefined growing retroperitoneal mass. In addition, renal-sparing surgery should be preferred.
The effect of chemotherapy in patients with stage I mucinous ovarian cancer undergoing fertility-sparing surgery
Authors: Long Xingtao , Li Rengui , Tang Ying , Yang Lingling , Zou Dongling 
Published: November 2022

ObjectiveTo determine the effect of adjuvant chemotherapy in patients with stage I mucinous ovarian cancer (MOC) undergoing fertility-preserving surgery.Patients and methodsThe clinicopathological characteristics and survival information of young women with stage I MOC from SEER databases between 2004 and 2019 were collected. The relationship between chemotherapy and the characteristics was examined by univariate and multivariate logistic regression analyses. Univariable and multivariate Cox proportional hazards survival analysis were employed for cancer-specific survival. Cox analysis was performed to build a nomogram model.ResultsAll 901 eligible patients with stage I MOC were screened from the SEER database. There were 321(35.6%) patients aged 9-30 years, 580(64.4%) aged 31-45 years, 645 (71.6%) patients with stage IA/IB, 256 (28.4%) with stage IC disease, 411(45.6%) who underwent fertility-sparing surgery, and276(30.6%) who received postoperative adjuvant chemotherapy. Multivariate logistic regression analyses showed that postoperative chemotherapy was often used in patients aged 31-45 relative to aged 9-30 (HR: 2.215, 95%CI 1.443-3.401, P &lt; 0.001) or with grade 3 compared to grade 1 tumors (HR: 7.382, 95%CI 4.054-13.443, P &lt; 0.001) or with stage IC compared to stage IA/IB (HR: 6.436, 95%CI 4.515-9.175, P &lt; 0.001) or with non-fertility sparing surgery relative to fertility-sparing (HR:2.226, 95%CI 1.490-3.327, P &lt; 0.001). Multivariate analysis for the special population with fertility preservation indicated that patients with chemotherapy (HR: 2.905, 95% CI: 0.938-6.030, P=0.068) or with grade 3 (HR: 4.750, 95% CI: 1.419-15.896, P=0.011) had a greater risk of mortality. Significant CSS differences were observed between the non-chemotherapy and chemotherapy groups in MOC when patients were stage IA/IB-grade 2 (P=0.004) (10-year CSS rates of chemotherapy=84%, non-chemotherapy = 100%), but not when they were stage IA/IB-grade 1, stage IA/IB-grade 3 or stage IC (both P&gt;0.05). A prognostic prediction nomogram model was built for stage I MOC patient who underwent fertility-sparing and the C-index was 0.709.DiscussionThe patients aged 31-45 years, with grade 3, stage IC, and non-fertility-sparing surgery were more likely to receive adjuvant chemotherapy in the real world. For stage I MOC patient who underwent fertility-sparing surgery, the choice of chemotherapy may increase the risk of death, and it should be carefully selected in clinical practice.
Trends in rates and causes of hospitalization among people living with HIV in the antiretroviral therapy era: A retrospective cohort study in China, 2008–2020
Authors: Liu Ying , Hao Yiwei , Xiao Jiang , Wu Liang , Liang Hongyuan , Han Junyan , Zhao Hongxin 
Published: November 2022

BackgroundThe introduction of antiretroviral therapy (ART) has resulted in marked reductions in morbidity among people living with HIV (PLWH). Monitoring the hospitalizations of PLWH is important in evaluating the quality of healthcare and forecasting the co-morbidity pattern. We aimed to describe the trends in the rates and causes of hospitalization among PLWH who initiated ART in an HIV-designated hospital in China.MethodsPLWH who initiated ART and were hospitalized in Beijing Ditan Hospital from 2008 to 2020 were selected for the study. Hospitalizations were classified based on AIDS-defining events (ADEs), non-AIDS-defining events (nADEs), and other causes. Hospitalization rates were calculated in terms of person-years, with risk factors determined by Poisson regression. The proportion of hospitalization causes at different ART treatment statuses was also evaluated.ResultsA total of 9,404 patients (94.7% were male patients) were included, contributing to 49,419 person-years. Overall, 1,551 PLWH were hospitalized for 2,667 hospitalization events, among which 60.4% of hospitalizations were due to ADEs, 11.4% were due to nADEs, and 28.2% were due to other causes. Unadjusted hospitalization rates decreased for all causes and all three diagnostic categories with year. After adjusting for the variables that changed substantially over time, ADE-related [IRR, 1.01 (0.96–1.05)] and nADE-related hospitalization rates [IRR, 0.92 (0.84–1.01)] appeared stable. Hospitalization for ADEs constituted an increasing proportion over time (36.3% in 2008–57.4% in 2020), especially in ART-naive inpatients (43.8% in 2008–83.3% in 2020). The proportion of nADE-related hospitalizations remained low (9.0% in 2008–15.4% in 2020). Hospitalization rate was highest for patients treated with ART during the first 6 months after ART initiation (46.2%) when ADEs were still the leading cause of hospitalizations (30.6%). Older age, non-men who have sex with men transmission, late presenters, HIV viral load (VL) &gt; 50 copies/mL, and CD4 counts ≤ 200 cells/μL were associated with a higher hospitalization risk (all P &lt; 0.05).ConclusionDespite some progress, ADEs remain the most common and serious problem among PLWH in China. In order to avoid deteriorating to the stage of needing hospitalization, more work is needed to diagnose and treat HIV infection earlier.
Regional maldistribution of human resources of rehabilitation institutions in China Mainland based on spatial analysis
Authors: Chen Cheng , Chen Ting , Zhao Ning , Dong Siping 
Published: November 2022

ObjectiveWith the demand for rehabilitation has been increasing faster for the aging of China's population, the equity of rehabilitation resource has aroused great concern. This study aimed to analyze the spatial distribution and evolution of the human resources of rehabilitation institutions and propose targeted countermeasures and suggestions to promote optimal allocation.MethodsA total of 31 provinces in China Mainland were identified and geocoded. The spatial weight matrix was introduced to analyze the spatial correlation. Spatial autocorrelation analysis and tests were used to analyze the spatial distribution and evolution characteristics of rehabilitation institutions' human resources in China from 2016 to 2019.ResultsThe average density of rehabilitation staff from 2016 to 2019 has been rising yearly (From 1.60 to 1.88). From 2018 to 2019, the proportion of rehabilitation professionals was higher than 75% in only 5 provinces, and no provinces met 75% from 2016 to 2017. Global Moran's I index from 2016 to 2019 showed no apparent aggregation phenomenon in the allocation of management personnel resources (P &gt; 0.05). Three provinces in western China belonged to the Low-Low area and a province in northeastern China fitted to the Low–High area, with statistically significant differences. In addition, the changes in the spatial distribution and evolution trend of the human resources of rehabilitation institutions in different periods were affected by health policies.ConclusionsAlthough the overall spatial distribution gap of human resource allocation of rehabilitation institutions is shrinking, there are still internal structural defects and a maldistribution at the provincial level. It is necessary to improve the overall number of staff in rehabilitation institutions and to ameliorate the proportion of different types of staffing.
Development and validation of tools for predicting the risk of death and ICU admission of non-HIV-infected patients with Pneumocystis jirovecii pneumonia
Authors: Jin Fan , Liang Hao , Chen Wen-can , Xie Jing , Wang Huan-ling 
Published: November 2022

IntroductionThe mortality rate of non-HIV-infected Pneumocystis jirovecii pneumonia (PCP) is high. This research aimed to develop and validate two clinical tools for predicting the risk of death and intensive care unit (ICU) admission in non-HIV-infected patients with PCP to reduce mortality.MethodsA retrospective study was conducted at Peking Union Medical College Hospital between 2012 and 2021. All proven and probable non-HIV-infected patients with PCP were included. The least absolute shrinkage and selection operator method and multivariable logistic regression analysis were used to select the high-risk prognostic parameters. In the validation, the receiver operating characteristic curve and concordance index were used to quantify the discrimination performance. Calibration curves were constructed to assess the predictive consistency compared with the actual observations. A likelihood ratio test was used to compare the tool and CURB-65 score.ResultsIn total, 508 patients were enrolled in the study. The tool for predicting death included eight factors: age, chronic lung disease, respiratory rate, blood urea nitrogen (BUN), lactate dehydrogenase (LDH), cytomegalovirus infection, shock, and invasive mechanical ventilation. The tool for predicting ICU admission composed of the following factors: respiratory rate, dyspnea, lung moist rales, LDH, BUN, C-reactive protein/albumin ratio, and pleural effusion. In external validation, the two clinical models performed well, showing good AUCs (0.915 and 0.880) and fit calibration plots. Compared with the CURB-65 score, our tool was more informative and had a higher predictive ability (AUC: 0.880 vs. 0.557) for predicting the risk of ICU admission.ConclusionIn conclusion, we developed and validated tools to predict death and ICU admission risks of non-HIV patients with PCP. Based on the information from the tools, clinicians can tailor appropriate therapy plans and use appropriate monitoring levels for high-risk patients, eventually reducing the mortality of those with PCP.