bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 severity is associated with population-level gut microbiome variations
Authors: Lymberopoulos Eva , Gentili Giorgia Isabella , Budhdeo Sanjay , Sharma Nikhil 
Published: August 2022

The human gut microbiome interacts with many diseases, with recent small studies suggesting a link with COVID-19 severity. Exploring this association at the population-level may provide novel insights and help to explain differences in COVID-19 severity between countries. We explore whether there is an association between the gut microbiome of people within different countries and the severity of COVID-19, measured as hospitalisation rate. We use data from the large (n = 3,055) open-access gut microbiome repository curatedMetagenomicData, as well as demographic and country-level metadata. Twelve countries were placed into two groups (high/low) according to COVID-19 hospitalisation rate before December 2020 (ourworldindata.com). We use an unsupervised machine learning method, Topological Data Analysis (TDA). This method analyses both the local geometry and global topology of a high-dimensional dataset, making it particularly suitable for population-level microbiome data. We report an association of distinct baseline population-level gut microbiome signatures with COVID-19 severity. This was found both with a PERMANOVA, as well as with TDA. Specifically, it suggests an association of anti-inflammatory bacteria, including Bifidobacteria species and Eubacterium rectale, with lower severity, and pro-inflammatory bacteria such as Prevotella copri with higher severity. This study also reports a significant impact of country-level confounders, specifically of the proportion of over 70-year-olds in the population, GDP, and human development index. Further interventional studies should examine whether these relationships are causal, as well as considering the contribution of other variables such as genetics, lifestyle, policy, and healthcare system. The results of this study support the value of a population-level association design in microbiome research in general and for the microbiome-COVID-19 relationship, in particular. Finally, this research underscores the potential of TDA for microbiome studies, and in identifying novel associations.
Provincial heterogeneity in the management of care cascade for hypertension, diabetes, and dyslipidaemia in China: Analysis of nationally representative population-based survey
Authors: Zhao Yang , Anindya Kanya , Atun Rifat , Marthias Tiara , Han Chunlei , McPake Barbara , Duolikun Nadila , Hulse Emily , Fang Xinyue , Ding Yimin , Oldenburg Brian , Lee John Tayu 
Published: August 2022

BackgroundThis study aims to examine (1) province-level variations in the levels of cardiovascular disease (CVD) risk and behavioral risk for CVDs, (2) province-level variations in the management of cascade of care for hypertension, diabetes, and dyslipidaemia, and (3) the association of province-level economic development and individual factors with the quality of care for hypertension, diabetes, and dyslipidaemia.MethodsWe used nationally representative data from the China Health and Retirement Longitudinal Study in 2015, which included 12,597 participants aged 45 years. Using a care cascade framework, we examined the quality of care provided to patients with three prevalent NCDs: hypertension, diabetes, and dyslipidaemia. The proportion of WHO CVD risk based on the World Health Organization CVD risk prediction charts, Cardiovascular Risk Score (CRS) and Behavior Risk Score (BRS) were calculated. We performed multivariable logistic regression models to determine the individual-level drivers of NCD risk variables and outcomes. To examine socio-demographic relationships with CVD risk, linear regression models were applied.ResultsIn total, the average CRS was 4.98 (95% CI: 4.92, 5.05), while the average BRS was 3.10 (95% confidence interval: 3.04, 3.15). The weighted mean CRS (BRS) in Fujian province ranged from 4.36 to 5.72 (P &lt; 0.05). Most of the provinces had a greater rate of hypertension than diabetes and dyslipidaemia awareness and treatment. Northern provinces had a higher rate of awareness and treatment of all three diseases. Similar patterns of regional disparity were seen in diabetes and dyslipidaemia care cascades. There was no evidence of a better care cascade for CVDs in patients who reside in more economically advanced provinces.ConclusionOur research found significant provincial heterogeneity in the CVD risk scores and the management of the cascade of care for hypertension, diabetes, and dyslipidaemia for persons aged 45 years or more. To improve the management of cascade of care and to eliminate regional and disparities in CVD care and risk factors in China, local and population-based focused interventions are necessary.
Development and validation of a predictive model for new-onset atrial fibrillation in sepsis based on clinical risk factors
Authors: Li Zhuanyun , Pang Ming , Li Yongkai , Yu Yaling , Peng Tianfeng , Hu Zhenghao , Niu Ruijie , Li Jiming , Wang Xiaorong 
Published: August 2022

ObjectiveNew-onset atrial fibrillation (NOAF) is a common complication and one of the primary causes of increased mortality in critically ill adults. Since early assessment of the risk of developing NOAF is difficult, it is critical to establish predictive tools to identify the risk of NOAF.MethodsWe retrospectively enrolled 1,568 septic patients treated at Wuhan Union Hospital (Wuhan, China) as a training cohort. For external validation of the model, 924 patients with sepsis were recruited as a validation cohort at the First Affiliated Hospital of Xinjiang Medical University (Urumqi, China). Least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression analyses were used to screen predictors. The area under the ROC curve (AUC), calibration curve, and decision curve were used to assess the value of the predictive model in NOAF.ResultsA total of 2,492 patients with sepsis (1,592 (63.88%) male; mean [SD] age, 59.47 [16.42] years) were enrolled in this study. Age (OR: 1.022, 1.009–1.035), international normalized ratio (OR: 1.837, 1.270–2.656), fibrinogen (OR: 1.535, 1.232–1.914), C-reaction protein (OR: 1.011, 1.008–1.014), sequential organ failure assessment score (OR: 1.306, 1.247–1.368), congestive heart failure (OR: 1.714, 1.126–2.608), and dopamine use (OR: 1.876, 1.227–2.874) were used as risk variables to develop the nomogram model. The AUCs of the nomogram model were 0.861 (95% CI, 0.830–0.892) and 0.845 (95% CI, 0.804–0.886) in the internal and external validation, respectively. The clinical prediction model showed excellent calibration and higher net clinical benefit. Moreover, the predictive performance of the model correlated with the severity of sepsis, with higher predictive performance for patients in septic shock than for other patients.ConclusionThe nomogram model can be used as a reliable and simple predictive tool for the early identification of NOAF in patients with sepsis, which will provide practical information for individualized treatment decisions.
Abdominal Visceral Adipose Tissue and All-Cause Mortality: A Systematic Review
Authors: Saad Randa K. , Ghezzawi Malak , Horanieh Renee , Khamis Assem M. , Saunders Katherine H. , Batsis John A. , Chakhtoura Marlene 
Published: August 2022

IntroductionIncreased abdominal visceral adipose tissue (VAT) implies an adverse cardio-metabolic profile. We examined the association of abdominal VAT parameters and all-cause mortality risk.MethodsWe systematically searched four databases. We performed citations/articles screening, data abstraction, and quality assessment in duplicate and independently (CRD42020205021).ResultsWe included 12 cohorts, the majority used computed tomography to assess abdominal VAT area. Six cohorts with a mean age ≤ 65 years, examining all-cause mortality risk per increment in VAT area (cm2) or volume (cm3), showed a 11-98% relative risk increase with higher VAT parameters. However, the association lost significance after adjusting for glycemic indices, body mass index, or other fat parameters. In 4 cohorts with a mean age &gt;65 years, the findings on mortality were inconsistent. Conversely, in two cohorts (mean age 73-77 years), a higher VAT density, was inversely proportional to VAT area, and implied a higher mortality risk.ConclusionA high abdominal VAT area seems to be associated with increased all-cause mortality in individuals ≤ 65 years, possibly mediated by metabolic complications, and not through an independent effect. This relationship is weaker and may reverse in older individuals, most likely secondary to confounding bias and reverse causality. An individual participant data meta-analysis is needed to confirm our findings, and to define an abdominal VAT area cutoff implying increased mortality risk.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205021, identifier CRD42020205021.
Remediation of nitrate contaminated groundwater using a simulated PRB system with an La–CTAC–modified biochar filler
Authors: Li Sen , Wu Yong , Nie Fuyu , Tu Weiguo , Li Xueling , Luo Xuemei , Luo Yong , Fan Hua , Song Tao 
Published: August 2022

In the present study, the Erigeron canadensis L., a typical invasive plant in Southwest China, was utilized as the raw material to prepare original biochar (ECL), a rare earth element La–modified biochar (La–ECL), and a rare earth element La coupling cationic surfactant [cetyltrimethylammonium chloride (CTAC)]–modified biochar (La/CTAC–ECL). These materials were then added to simulated permeable reactive barriers (PRBs) and their nitrate (NO3−) contaminant remediation performances were evaluated in groundwater. The results show that the breakthrough time for NO3− in a simulated PRB column increases as the concentration of the influent NO3− and the flow rate decreases, whereas with the increases of filler particle size and the height of the filler in the column initially increases, and then decreases. Considering an initial NO3− concentration of 50 mg L−1, and a filler particle size range of 0.8–1.2 mm, the maximum adsorption capacity of the La/CTAC–ECL column for NO3− is 18.99 mg g−1 for a filler column height of 10 cm and an influent flow rate of 15 ml min−1. The maximum quantity of adsorbed NO3− of 372.80 mg is obtained using a filler column height of 15 cm and an influent flow rate of 10 ml min−1. The Thomas and Yoon–Nelson models accurately predict the breakthrough of NO3− in groundwater in the simulated PRB column under different conditions, and the results are consistent with those from dynamic NO3− adsorption experiments. TEM, XRD, FTIR, and XPS analyses demonstrate that the modification using the La and CTAC improves the surface structure, porosity, permeability, and configuration of functional groups of the biochar. The mechanisms of NO3− removal from groundwater using the La/CTAC–ECL include pore filling, surface adsorption, ion exchange, and electrostatic adsorption. The composite La/CTAC–ECL exhibits a superior potential for the remediation of NO3− contaminated groundwater.
Impact of glucocorticoids on short-term and long-term outcomes in patients with relapsed/refractory multiple myeloma treated with CAR-T therapy
Authors: Wang Xue , Qi Yuekun , Li Hujun , Liu Fengan , Cao Jiang , Chen Wei , Wang Ying , Qi Kunming , Yan Zhiling , Zhu Feng , Li Zhenyu , Cheng Hai , Xu Kailin 
Published: August 2022

BackgroundGlucocorticoids (GCs) are often used to treat cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). The effects of GCs on the efficacy of CAR-T cell treatment in relapsed/refractory multiple myeloma (RRMM) have not been fully established. We evaluated the impact of GCs on clinical outcomes of RRMM patients treated with CAR-T cells.MethodsThis study involved RRMM patients treated with CAR-T cells at our center between June 2017 and December 2020. Patients were stratified into GC-used group (GC-group) and non-GC-used group (NGC-group). CRS or ICANS was graded on the basis of the American Society of Transplantation and Cellular Therapy consensus grading system. Response status was evaluated by the IMWG Uniform Response Criteria. The duration of response (DOR), progression-free survival (PFS), and overall survival (OS) were calculated.ResultA total of 71 patients were included in this study. In the NGC group (40 patients), 34 (85%) had responses to CAR-T cell therapy, including 16 (40%) stringent complete response (sCR), seven (17.5%) complete response (CR), five (12.5%) very good partial response (VGPR), and six (15%) partial response (PR). The overall response rate (ORR) and complete response rate (CRR) in the NGC group were 85% and 57.5%. In the GC group (31 patients), 29 (93.5%) had responses, including 11 (35.5%) sCR, nine (29%) CR, two (6.4%) VGPR, and seven (22.6%) PR. Differences in ORR and CRR between the two groups were insignificant. The dose, duration, and timing of GCs did not affect ORR and CRR. At a median follow-up of 28.2 months, the median PFS was 20.4 months (95% CI, 7.9 to 32.9) while the median OS was 36.6 months (95% CI, 25.9 to 47.2) for the GC group. The median PFS and OS for the NGC group were 13.7 months (95% CI, 8.8 to 18.6) and 27.5 months (95% CI, 14.1 to 41.0). There were no significant differences in either PFS or OS between the GC group and the NGC group. Differences in median DOR for the patients with CR or better in the GC group and NGC group were not significant (p = 0.17). Earlier, prolonged use and high dose of GCs were not associated with any effects on either PFS or OS. Additionally, GCs had no effects on CAR-T cell proliferation.ConclusionAdministration of GCs, dose, timing, and duration does not influence the clinical efficacy of CAR-T cells in RRMM in this study.
Two-step widefield fundus fluorescein angiography-assisted laser photocoagulation in pediatric retinal vasculopathy: A pilot study
Authors: Peng Jie , Ren Jianing , Zhang Xuerui , Yang Yuan , Zou Yihua , Xiao Haodong , Xu Yu , Zhao Peiquan 
Published: August 2022

PurposeTo introduce the procedures of two-step fundus fluorescein angiography (FFA) and evaluate its utility in the management of pediatric retinal vasculopathy.Materials and methodsIn this retrospective study, medical records of 12 patients who received two-step FFA were studied. The two-step FFA consisted of step 1 [low-dose (LD)] FFA at an intravenous dose of 1.5 mg/kg fluorescein, followed by step 2 [reduced dose (RD)] FFA at a dose of 6.2 mg/kg fluorescein. Demographic data, including age, gender, diagnosis, weight, gestational age, birth weight, and weight on the examination day were taken, were collected. The results of two-step FFA and treatment were recorded.ResultsA total of 20 eyes were studied. The top 5 common FFA changes in RD-FFA included peripheral avascular zone (15 eyes), fluorescein leakage (10 eyes), supernumerous vascular branching (10 eyes), neovascularization (NV) (8 eyes), and absence of the foveal avascular zone (6 eyes). LD-FFA was efficient to show all the NV without severe vitreous dye in 8/8 (100.0%) eyes with NV, partial peripheral avascular zone in 11/15 (73.3%) eyes, while RD-FFA always offered more information in all the eyes. Thirteen eyes had laser photocoagulation under the guidance of LD-FFA. In 4 (30.8%) eyes, RD-FFA revealed more lesions and an immediate relaser was performed. Laser photocoagulation was successfully performed in all the 13 eyes in one session without being rearranged. After a median follow-up of 28.1 months, all the eyes were in a stable status.ConclusionStep-one LD-FFA acted as a pre-FFA to show the NV, and step-two RD-FFA acted as a double-check. The modified strategy may be a helpful clinical adjuvant in the laser photocoagulation of pediatric retinal disorders, especially for young ophthalmologists.
Study protocol for feasibility and safety of adopting early oral feeding in post total laparoscopic total gastrectomy (overlap esophagojejunostomy): A multicentre randomized controlled trial
Authors: Yang Jun , Yang Qinchuan , Wang Weidong , Chai Xiaoyan , Zhou Haikun , Yue Chao , Gao Ruiqi , Mo Zhenchang , Ji Panpan , Dong Danhong , Wei Jiangpeng , Liu Jinqiang , Zhang Ying , Li Xiaohua , Ji Gang 
Published: August 2022

BackgroundTotal laparoscopic total gastrectomy (TLTG) for gastric cancer, especially with overlap esophagojejunostomy, has been verified that it has advantages of minimally invasion, less intraoperative bleeding, and faster recovery. Meanwhile, early oral feeding (EOF) after the operation has been demonstrated to significantly promote early rehabilitation in patients, particularly with distal gastrectomy. However, due to the limited application of TLTG, there is few related research proving whether it is credible or safe to adopt EOF after TLTG (overlap esophagojejunostomy). So, it is urgent to start a prospective, multicenter, randomized clinical trials to supply high level evidence.Methods/designThis study is a prospective, multicenter, randomized controlled trial with 200 patients (100 in each group). These eligible participants are randomly allocated into two different groups, including EOF group and delay oral feeding (DOF) group after TLTG (overlap esophagojejunostomy). Anastomotic leakage will be carefully observed and recorded as the primary endpoints; the period of the first defecation and exhaust, postoperative length of stay and hospitalization expenses will be recorded as secondary endpoints to ascertain the feasibility and safety of adopting EOF after TLTG (overlap esophagojejunostomy).DiscussionRecently, the adoption of TLTG was limited due to its difficult anastomotic procedure, especially in vivo esophagojejunostomy. With the innovation and improvement of operating techniques, overlap esophagojejunostomy with linear staplers simplified the anastomotic steps and reduced operational difficulties after TLTG. Meanwhile, EOF had received increasing attention from surgical clinicians as a nutrition part of enhanced recovery after surgery (ERAS), which had shown better results in patients after distal gastrectomy. Considering the above factors, we implemented EOF protocol to evaluate the feasibility and safety of adopting EOF after TLTG (overlap esophagojejunostomy), which provided additional evidence for the development of clinical nutrition guidelines.Clinical trial registration[www.chictr.org.cn], identifier [ChiECRCT20200440 and ChiCTR2000040692].
Changes in cytomegalovirus load in the breast milk of very/extremely premature infants and the effect of pasteurization and freeze–thawing on reducing viral load
Authors: Huang Tingting , Cai Wenhong , Ni Chen , Lai Shuhua , Lin Shuidi , Wang Quangui 
Published: August 2022

ObjectiveThis study aimed to clarify the change in Cytomegalovirus (CMV) loads in breast milk (BM) of very/extremely premature infants (VPI/EPI) with birth weight &lt; 1,500 g after birth, and to compare the effectiveness of pasteurization and freeze–thawing methods in reducing the CMV load of BM.MethodsBreast milk samples were collected and tested every 2 weeks by fluorescence quantitative polymerase chain reaction (FQ-PCR). We determined CMV load in BM before and after pasteurizing, and freeze-thawing.ResultsCytomegalovirus DNA can already be detected in colostrum. The viral load gradually increased in the first 4 weeks, peaked in the 4th to 6th weeks, and gradually decreased thereafter. The viral load gradually returned to the initial level approximately 10–12 weeks postpartum. During the peak period of the CMV load in BM, the viral load was higher in the EPI than the VPI (P &lt; 0.05). The average CMV load (logarithmic [LG]) in the pasteurization group was significantly lower than that in the raw BM group. The average CMV load in the freeze-thawed BM group was significantly lower than that in the raw BM group. The mean CMV load in the pasteurized BM group was lower than that in the freeze–thawed BM group, but the difference was not statistically significant. The CMV-DNA clearance rate in pasteurized was higher than in freeze–thawed (P &lt; 0.05).ConclusionThe CMV detoxification rate in BM is high and the peak load period is mainly between 4 and 6 weeks. The CMV load values detected are higher than the threshold values (7 × 103 copy number/mL) of CMV infection that are reported in the literature as a concern. Both the freeze-thaw and pasteurization techniques can effectively reduce the CMV load.
Effects of exercise training in hypoxia versus normoxia on fat-reducing in overweight and/or obese adults: A systematic review and meta-analysis of randomized clinical trials
Authors: Chen Shuning , Su Hao , Liu Xinhong , Li Qiaochu , Yao Yingchi , Cai Jiachen , Gao Ye , Ma Qirui , Shi Yajun 
Published: August 2022

Objective: Fat loss theory under various oxygen conditions has been disputed, and relevant systematic review studies are limited. This study is a systematic review and meta-analysis to assess whether hypoxic exercise training (HET) leads to superior fat-reducing compared with normoxic exercise training (NET).Methods: We searched PubMed, Web of Science, CNKI, ProQuest, Google Scholar, Cochrane Library, and EBSCOhost from inception to June 2022 for articles comparing the effects of hypoxic and normoxic exercise on body composition indicators, glycometabolism, and lipometabolism indicators in obese and overweight adults. Only randomized controlled trials (RCTs) were included. The effect sizes were expressed as standardized mean difference (SMD) and 95% confidence intervals (CI). Between-study heterogeneity was examined using the I2 test and evaluated publication bias via Egger’s regression test. The risk of bias assessment was performed for each included trial using Cochrane Evaluation Tool second generation. The meta-analysis was performed by using R 4.1.3 and RevMan 5.3 analytic tools.Results: A total of 19 RCTs with 444 subjects were analyzed according to the inclusion and exclusion criteria. Among them, there were 14 English literature and five Chinese literature. No significant difference in body composition (SMD -0.10, 95% CI -0.20 to -0.01), glycometabolism and lipid metabolism (SMD -0.01, 95% CI -0.13 to -0.10) has been observed when comparing the HET and NET groups. We only found low heterogeneity among trials assessing glycometabolism and lipometabolism (I2 = 20%, p = 0.09), and no publication bias was detected.Conclusion: The effects of HET and NET on fat loss in overweight or obese people are the same. The application and promotion of HET for fat reduction need further exploration.
Longitudinal impact of parent-teacher relationship on middle school students’ academic achievements in China
Authors: Fu Wangqian , Pan Qianqian , Yuan Ying , Chen Guanyu 
Published: August 2022

ObjectiveThe study aims to discuss the longitudinal impact of the parent-teacher relationship on students’ academic achievements in China.MethodBased on the China Education Panel Survey, covering the data from 438 classes of 112 schools in 28 county-level administrative areas in China, we used the hierarchical linear model to analyze the data.ResultsWe found that the parents’ active communication with teachers, parents’ participation in parent meetings, teachers’ active contact, whether parents are afraid to communicate with teachers, and parents’ willingness to participate in parent meetings have significant relationships with students’ academic achievements. At the class level, the extent of teachers’ stress from parents’ requests and teachers’ perception of respect from parents also affected students’ academic achievements significantly in the Chinese context.ConclusionThere was a longitudinal association between the parent-teacher relationship and students’ academic achievements. The practical implication was discussed in the paper.