bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of intravenous ferric carboxymaltose in the treatment of Restless Legs Syndrome: a systematic review and meta-analysis
Authors: Khan Ayesha , Kumar Harsh , Rai Kuldeep Dalpat , Saeed Anzel , Ishtiaq Jawad , Tanveer Alam Muhammad , Chawla Sakshi , Haque Md Ariful
Published: January 2025

Introduction

Restless Legs Syndrome (RLS), also known as Willis-Ekbom Disease (WED), is a sensorimotor disorder characterized by an uncontrollable urge to move the legs, typically accompanied by discomfort. Low iron levels, pregnancy, and age are some identified risk factors. RLS is treated using various pharmacological options, including dopamine agonists, benzodiazepines, anticonvulsants, opioids, and bupropion. Iron supplementation, particularly with intravenous Ferric carboxymaltose (FCM), has gained attention due to the role of iron deficiency in RLS pathophysiology. This meta-analysis evaluates the efficacy and safety of FCM in treating RLS symptoms.

Materials and methods

A systematic review and meta-analysis were conducted following the PRISMA guidelines, using databases such as PubMed, Google Scholar, and Cochrane. Studies involving intravenous FCM in patients diagnosed with RLS were included. Statistical analysis was performed using Review Manager 5.4.

Results

Seven studies involving 539 participants were analyzed. FCM significantly reduced IRLS scores (WMD = −5.77; 95% CI = [−8.85, −2.70]; p = 0.0002) and improved VAS and SF-36 scores compared to placebo. However, FCM did not significantly improve RLS quality of life scores. Adverse events were more common in the FCM group, particularly nausea, but no significant differences were found for severe adverse events.

Conclusion

In conclusion, intravenous ferric carboxymaltose significantly reduces Restless Legs Syndrome symptoms, especially in patients with confirmed iron deficiency. The treatment appears generally well-tolerated, with adverse effects being manageable. However, further long-term studies are needed to fully assess the safety profile and confirm sustained symptom improvement in a broader population.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier: CRD42024585233.
Suprasternal aortic arch echocardioscopy as a potential tool in detection and follow-up of mobile thrombi in patients with ischemic stroke
Authors: Esnaola Barriola Inhar , Escriche Gorospe Elena , Miguel Navas Paula , Martínez Campos Elisa , Molina Goicoechea María , Capell Pascual Ferran , Jiménez Delgado Adrián , Muñoz Arrondo Roberto
Published: January 2025

Introduction

Severe or complicated atheromatosis of the aortic arch represents an important and often underdiagnosed embolic source in patients with ischemic stroke. The presence of a floating thrombus has significant clinical relevance, as it is associated with a high risk of early recurrence. The aim of this study was to analyze the potential of echocardiographic examination through the suprasternal window in both the detection of embolic sources and the monitoring of the response to anticoagulant treatment in patients with mobile thrombi.

Methods

This case series study included ten consecutive patients with a mobile floating aortic arch thrombus associated with an atheromatous plaque, detected by focused echocardiography and confirmed by Computed Tomography Angiography (CTA). Epidemiological, clinical, radiological, and ultrasound characteristics were analyzed. Clinical and ultrasound follow-up was performed after initiation of anticoagulation as secondary prevention to assess the efficacy and safety of this treatment.

Results

Ten patients (seven female) with a mean age of 76 years were identified. After anticoagulation, a complete resolution of the mobile thrombus was observed in eight of them during ultrasound follow-up. One patient suffered an ischemic recurrence. Two patients receiving associated antiplatelet therapy presented severe hemorrhagic complications, one of which was fatal. Once the disappearance of the mobile thrombus was detected, anticoagulation was discontinued, and no further ischemic recurrences were observed.

Discussion

Floating thrombus of the aortic arch is an underdiagnosed but clinically relevant condition. The study of the aortic arch with echocardiography through the suprasternal window is a highly available and harmless technique, that may be highly useful for the detection and monitoring of response to treatment of this pathology. Furthermore, early anticoagulation could be an effective and safe treatment in these patients.
Linear incrementality in focus and accentuation processing during sentence production: evidence from eye movements
Authors: Zhang Zhenghua , Zhang Qingfang
Published: January 2025

Introduction

While considerable research in language production has focused on incremental processing during conceptual and grammatical encoding, prosodic encoding remains less investigated. This study examines whether focus and accentuation processing in speech production follows linear or hierarchical incrementality.

Methods

We employed visual world eye-tracking to investigate how focus and accentuation are processed during sentence production. Participants were asked to complete a scenario description task where they were prompted to use a predetermined sentence structure to accurately convey the scenario, thereby spontaneously accentuate the corresponding entity. We manipulated the positions of focus with accentuation (initial vs. medial) by changing the scenarios. The initial and medial positions correspond to the first and second nouns in sentences like “N1 is above N2, not N3.”

Results

Our findings revealed that speech latencies were significantly shorter in the sentences with initial focus accentuation than those with medial focus accentuation. Furthermore, eye-tracking data demonstrated that speakers quickly displayed a preference for fixating on initial information after scenarios onset. Crucially, the time-course analysis revealed that the onset of the initial focus accentuation effect (around 460 ms) preceded that of the medial focus accentuation effect (around 920 ms).

Discussion

These results support that focus and accentuation processing during speech production prior to articulation follows linear incrementality rather than hierarchical incrementality.
Graph analysis based on SCN reveals novel neuroanatomical targets related to tinnitus distress
Authors: Lu Yawen , Yang Yifeng , Yan Meijing , Sun Lianxi , Fu Caixia , Zhang Jianwei , Liu Yuehong , Li Kefeng , Han Zhao , Lin Guangwu , Li Shihong
Published: January 2025

Purpose

Tinnitus is considered a neurological disorder affecting both auditory and nonauditory networks. This study aimed to investigate the structural brain covariance network in tinnitus patients and analyze its altered topological properties.

Materials

Fifty three primary tinnitus patients and 67 age- and sex-matched healthy controls (HCs) were included. Gray matter volume (GMV) of each participant was extracted using voxel-based morphometry, a group-level structural covariance network (SCN) was constructed based on the GMV of each participant, and graph theoretic analyses were performed using graph analysis toolbox (GAT). The differences in the topological properties of SCN between both groups were compared and analyzed.

Results

Both groups exhibited small-world attributes. Compared with HCs, tinnitus patients had significantly higher characteristic path length, lambda, transitivity, and assortativity (p < 0.05), and significantly lower global efficiency (p < 0.05). Tinnitus patients had higher clustering coefficient and reduced gamma and modularity, but neither was remarkable. The hubs in tinnitus network focused on the temporal lobe. In addition, the tinnitus network was found to be reduced in robustness to targeted attacks compared with HCs. Besides, a significant negative correlation between Tinnitus Handicap Inventory (THI) score and GMV in the left angular gyrus (r = −0.283, p = 0.040) as well as left superior temporal pole (r = −0.282, p = 0.041) were identified.

Conclusion

Tinnitus patients showed reduced small-world properties, altered hub nodes, and reduced ability to respond to targeted attacks in brain network. The GMV in the left angular gyrus and left superior temporal pole showed significant negative correlation with tinnitus distress (THI score), indicating potential therapeutic target.
Sleep disturbance and social reward processing as characteristics linking minority victimization and suicidal ideation in youth
Authors: Seah T. H. Stanley , Eckstrand Kristen L. , Gupta Tina , Jensen Lily C. X. , Brodnick Zachary M. , Horter Chloe M. , Gregory Alice M. , Franzen Peter L. , Marshal Michael P. , Forbes Erika E.
Published: January 2025

Adolescence is characterized by heightened sleep disturbances (e.g., poor sleep quality and irregular/insufficient sleep) and sensitivity to social feedback that may exacerbate suicidal ideation (SI). Victimization experiences (e.g., bullying, humiliation) can contribute to sleep disturbances and SI, particularly among minoritized youth (e.g., sexual/gender, racial/ethnic minorities). However, sensitivity to social reward, despite social challenges, may buffer against the effects of victimization on sleep and SI. In a diverse sample of youth at varying suicide risk, we examined sleep disturbance as a mediator of victimization and SI, and if neural response to social reward moderated the link between victimization and sleep disturbance. Ninety eight youth (14–22 years old; 50% sexual and/or racial/ethnic minority) with varying SI severity provided self-report data on past-six-month identity-related victimization, past-week sleep disturbance, and past-month SI. Seventy four youth completed an fMRI task involving receipt of social feedback. Region-of-interest analyses examined ventral striatum (VS) activity during positive feedback. Mediation and moderation effects were examined using linear regressions. Sleep disturbance mediated the association between identity-related victimization and SI: higher victimization was associated with worse sleep disturbance, predicting more severe SI. Moderation analyses revealed a positive association between victimization and sleep disturbance at lower but not higher levels of VS response to social reward. Sleep disturbance occurring in the context of social stress heightens vulnerability for SI, particularly among minoritized youth. Greater neural sensitivity to social reward buffers against the effects of victimization on sleep, with implications for mitigating SI. Findings suggest potential mechanisms and individual difference factors underlying minority health disparities.
Application of MRI image segmentation algorithm for brain tumors based on improved YOLO
Authors: Yang Tao , Lu Xueqi , Yang Lanlan , Yang Miyang , Chen Jinghui , Zhao Hongjia
Published: January 2025

Objective

To assist in the rapid clinical identification of brain tumor types while achieving segmentation detection, this study investigates the feasibility of applying the deep learning YOLOv5s algorithm model to the segmentation of brain tumor magnetic resonance images and optimizes and upgrades it on this basis.

Methods

The research institute utilized two public datasets of meningioma and glioma magnetic resonance imaging from Kaggle. Dataset 1 contains a total of 3,223 images, and Dataset 2 contains 216 images. From Dataset 1, we randomly selected 3,000 images and used the Labelimg tool to annotate the cancerous regions within the images. These images were then divided into training and validation sets in a 7:3 ratio. The remaining 223 images, along with Dataset 2, were ultimately used as the internal test set and external test set, respectively, to evaluate the model’s segmentation effect. A series of optimizations were made to the original YOLOv5 algorithm, introducing the Atrous Spatial Pyramid Pooling (ASPP), Convolutional Block Attention Module (CBAM), Coordinate Attention (CA) for structural improvement, resulting in several optimized versions, namely YOLOv5s-ASPP, YOLOv5s-CBAM, YOLOv5s-CA, YOLOv5s-ASPP-CBAM, and YOLOv5s-ASPP-CA. The training and validation sets were input into the original YOLOv5s model, five optimized models, and the YOLOv8s model for 100 rounds of iterative training. The best weight file of the model with the best evaluation index in the six trained models was used for the final test of the test set.

Results

After iterative training, the seven models can segment and recognize brain tumor magnetic resonance images. Their precision rates on the validation set are 92.5, 93.5, 91.2, 91.8, 89.6, 90.8, and 93.1%, respectively. The corresponding recall rates are 84, 85.3, 85.4, 84.7, 87.3, 85.4, and 91.9%. The best weight file of the model with the best evaluation index among the six trained models was tested on the test set, and the improved model significantly enhanced the image segmentation ability compared to the original model.

Conclusion

Compared with the original YOLOv5s model, among the five improved models, the improved YOLOv5s-ASPP model significantly enhanced the segmentation ability of brain tumor magnetic resonance images, which is helpful in assisting clinical diagnosis and treatment planning.
Boosting the human antiviral response in conjunction with natural plant products
Authors: Srivastava Rashmi , Dubey Neeraj Kumar , Sharma Megha , Kharkwal Harsha , Bajpai Rajesh , Srivastava Rakesh
Published: January 2025

The increasing prevalence of viral infections and the emergence of drug-resistant or mutant strains necessitate the exploration of novel antiviral strategies. Accumulating evidence suggests that natural plant products have significant potential to enhance the human antiviral response. Various plant natural products (PNPs) known for their antiviral properties have been evaluated for their ability to modulate immune responses and inhibit viral infections. Research has focused on understanding the mechanisms by which these PNPs interact with the human immune system and their potential to complement existing antiviral therapies. PNPs control compounds such as alkaloids, flavonoids, terpenoids, and polyphenols to promote antiviral cytokine synthesis, increase T-cell and macrophage activity, and activate antiviral genes. Studies have investigated the molecular interactions between PNPs, viruses, and host cells, exploring the potential of combining PNPs with conventional antiviral drugs to enhance efficacy. However, several challenges remain, including identifying, characterizing, and standardizing PNP extracts, optimizing dosages, improving bioavailability, assessing long-term safety, and navigating regulatory approval. The promising potential of PNPs is being explored to develop new, effective, and natural antiviral therapies. This review outlines a framework for an integrative approach to connect the full potential of PNPs in combating viral infections and improving human health. By combining natural plant products with conventional antiviral treatments, more effective and sustainable management of viral diseases can be achieved.
Methods of saponin purification from Quillaja sp. for vaccine adjuvant production
Authors: Morais Victor , Suarez Norma , Silveira Fernando
Published: January 2025

Saponins are natural glycosides found in many plant species; they have a hydrophobic region, consisting of a steroid or triterpenoid skeleton called an aglycone, and a hydrophilic region, consisting of sugar chains attached to the aglycone through ether or ester linkages. This combination of polar and nonpolar elements endows saponins with soap-like behaviour in aqueous solutions. Owing to their structural characteristics, the amphiphilic nature of saponins is responsible for their foaming properties, as well as other biological functions, including their haemolytic activity. The adjuvant properties of saponins were known many years ago, but only in recent years have saponins been approved for human vaccine use in this manner. Saponins from Quillaja saponaria bark are the only source of approved preparations for human use, but a related species, Quillaja brasiliensis, also contains similar saponin compositions that can be obtained from leaves. In this work, we describe the different preparations of saponins used for adjuvants and the purification methods used to obtain each saponin.
NAFPD exacerbation by hyperlipidemia combined with hyperuricemia: a pilot rat experiment in lipidomics
Authors: Li Jingyun , Chen Yongjian , Li Shilin , Lyu Guorong , Yan Furong , Guo Jiajing , Cheng Jing , Chen Yun , Lin Jiaojiao , Zeng Yating
Published: January 2025

Background

Hyperuricemia and non-alcoholic fatty pancreas disease (NAFPD) are prevalent metabolic diseases, but the relationship between them remains underexplored.

Methods

Eighteen Sprague–Dawley rats were randomly assigned to three groups: normal (CON), high-fat (PO), and high-fat high-uric acid (PH). After 12 weeks, serum uric acid (SUA) and triacylglycerol levels were measured. Pathological changes in the pancreas were assessed using hematoxylin–eosin (HE) staining. Serum samples were analyzed using lipidomics technology, and multivariate statistical analysis was employed to identify differences in lipid metabolism.

Results

SUA levels in the PO group were not significantly different from those in the CON group (p > 0.05). However, from the 4th week onward, SUA levels in the PH group were significantly higher than those in both the PO and CON groups (p < 0.05). HE staining revealed that most rats in the CON group exhibited normal pancreatic islet and acinar cell morphology. The pathological NAFPD score in the PH group was higher than that in the PO group. Lipidomics analysis identified 34 potential serum biomarkers in the CON and PO groups, 38 in the CON and PH groups, and 32 in the PH and PO groups. These metabolites primarily included sphingolipids, cholesterol esters, fatty acids, triacylglycerols, phosphatidylcholines, lysophosphatidylcholine, phosphatidylethanolamine, and lysophosphatidylethanolamine.

Conclusion

Hyperlipidemia combined with hyperuricemia might exacerbates NAFPD. Glycerophospholipids may serve as key biomarkers in this process, potentially linked to a chronic inflammatory response mediated by glycerophospholipids.
Improved health outcomes of nasopharyngeal carcinoma patients 3 years after treatment by the AI-assisted home enteral nutrition management
Authors: Liu Jia , Wang Xiuying , Ye Xu , Chen Danna
Published: January 2025

Objectives

Patients with nasopharyngeal carcinoma (NPC) are prone to malnutrition, which leads to deterioration of health. This study is to clarify the effect of Artificial intelligence (AI)-assisted home enteral nutrition (HEN) management mode on the health status of patients with stage III to stage IV NPC after 3 years of treatment, and to provide a new strategy for improving the quality of life of patients.

Methods

Patients with stage III ~ IV NPC were determined whether to accept AI-assisted HEN management according to voluntary principle. After 3 years of management, the survival rate, distant metastasis rate and local recurrence rate were counted, and the basic body quality, laboratory detection, eating difficulty score, mental health score and other examinations were performed on the surviving patients to evaluate the overall health status.

Results

The three-year survival rate of patients with NPC who received AI-assisted HEN management after treatment was improved. Various tests showed that AI-assisted HEN improved the nutritional intake of patients, had a low positive rate of Epstein–Barr virus, reduced adverse reactions such as psychological stress and physical pain, and could improve the quality of life of patients.

Conclusion

AI-assisted HEN has a positive auxiliary effect on clinical treatment, which is helpful to promote the recovery of patients with NPC.

Clinical trial registration

NCT06603909.
Predictive value of circulating fibroblast growth factor-23 and Klotho on protein-energy wasting in patients undergoing hemodialysis
Authors: Zhou Xiaoling , Luo Yang , Guo Yidan , Jia Meng , Zhang Chunxia , Shi Zhihua , Du Ye
Published: January 2025

Background

As a state of metabolic and nutritional derangements, protein-energy wasting (PEW) is highly prevalent and associated with increased morbidity and mortality in hemodialysis patients. Fibroblast growth factor-23 (FGF-23) and Klotho have been proven to contribute to chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients undergoing hemodialysis. Previous evidence suggested that FGF-23 and Klotho may also contribute to the malnutritional status among these patients; however, the inter-relationship between the FGF-23–Klotho axis and PEW remains unclear. Therefore, we conducted this cross-sectional study to evaluate the association between plasma FGF-23 and Klotho levels and PEW in hemodialysis patients and to explore whether these markers could predict the presence of PEW.

Methods

Plasma concentrations of FGF-23 and Klotho were measured, and their associations with PEW were assessed. PEW was evaluated based on body weight, muscle mass, biochemical data, and protein and energy intake, according to the 2008 criteria from the International Society of Renal Nutrition and Metabolism (ISRNM).

Results

In this study, 147 hemodialysis patients (mean age 61.05 ± 13.32 years) were enrolled, of whom 66 (44.90%) had PEW. PEW was significant positively correlated with FGF-23 (r = 0.403, p < 0.001), age (r = 0.225, p = 0.006), C-reactive protein (r = 0.236, p = 0.004), intact parathyroid hormone (r = 0.237, p = 0.004), and single-pool Kt/V (r = 0.170, p = 0.040), while it was negatively correlated with Klotho (r = −0.361, p < 0.001), hemoglobin (r = −0.215, p = 0.009), and serum creatinine (r = −0.278, p = 0.001). Logistic regression analyses showed that plasma FGF-23 and Klotho were independently associated with PEW, even after adjusting for covariables. The area under the ROC curve (AUC) of FGF-23 and Klotho in predicting PEW was 0.734 and 0.710 (p < 0.001), respectively. When the combination of FGF-23 and Klotho was used to predict PEW, its sensitivity was 81.8%, specificity was 60.5%, and the AUC was 0.746.

Conclusion

Plasma levels of FGF-23 and Klotho are associated with PEW in hemodialysis patients. Higher plasma FGF-23 levels and lower Klotho levels may serve as valuable predictors of PEW in these patients.
Gender and sex differences in adherence to a Mediterranean diet and associated factors during the COVID-19 pandemic: a systematic review
Authors: Brandt Gerrit , Pahlenkemper Marie , Ballero Reque Cristina , Sabel Luisa , Zaiser Christopher , Laskowski Nora M. , Paslakis Georgios
Published: January 2025

Background

The COVID-19 pandemic has led to significant lifestyle changes, including alterations in dietary habits and increases in sedentary behavior. The Mediterranean diet (MD) has been associated with various health benefits, which are especially important given the health challenges posed by the pandemic. During the pandemic, an overall shift towards consuming more highly processed foods has been observed.

Methods

This systematic review investigated adherence to MD during the COVID-19 pandemic, focusing on gender differences and factors influencing adherence to MD in the general public. The literature search focused on papers published between January 1, 2019, and July 8, 2024, across various databases such as Web of Science (WOS), Scopus, PubMed MEDLINE, and PsycINFO.

Results

Following the PRISMA guidelines, this search identified 14,347 references, of which 5,734 were duplicates. After a thorough multi-level screening process, 29 studies, encompassing 55,242 participants, met the inclusion criteria. While seven studies reported that men adhered to a MD more than women during the COVID-19 pandemic, 12 studies also indicated that women had higher adherence to a MD compared to men. Nine studies, however, found no significant gender differences in MD adherence. Additionally, older age, higher education levels, higher socioeconomic status, and increased physical activity were linked to greater adherence to a MD in the pandemic context.

Conclusion

Gender-specific differences in dietary behavior are influenced by factors such as socioeconomic status, gender roles, and pandemic phases as well as biases in sample composition and methodological weaknesses. Significant gaps in the evidence, particularly concerning sexual and gender minorities, are highlighted.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421727.
Preparation, structural property, and antioxidant activities of a novel pectin polysaccharide from the flowers of Hibiscus syriacus Linn.
Authors: Chen Jialong , Ye Chaojun , Zhang Lu , Xie Zhiliang , Zhu Jianjun , Zhang Zhi
Published: January 2025

Introduction

Oxidative stress, triggered by an imbalance between reactive oxygen species (ROS) production and cellular antioxidant defense mechanisms, is implicated in various pathological conditions. Plant-derived polysaccharides have gained significant attention as potential natural antioxidants due to their biocompatibility, biodegradability, and structural versatility.

Methods

This study focuses on the purification, structural characterization, and antioxidant activities of a novel pectin polysaccharide (HFPS) isolated from the flowers of Hibiscus syriacus Linn. HFPS was purified using anion-exchange chromatography. Its chemical composition, monosaccharide profile, molecular weight distribution, and structural properties were elucidated through various analytical techniques.

Results

HFPS exhibited a predominant acidic monosaccharide composition, with galacturonic acid as the major constituent, indicating its pectin nature. The free radical scavenging activity of HFPS against ABTS·, DPPḤ, and ·OH radicals was evaluated, demonstrating a positive correlation between its antioxidant capacity and concentration. Furthermore, HFPS effectively protected HepG2 cells against H2O2-induced oxidative stress by reducing ROS accumulation, modulating redox-related enzymes (Superoxide dismutase, Catalase, Glutathione peroxidase), and alleviating oxidative damage. Notably, HFPS upregulated the expression of antioxidant-related genes, including B-cell lymphoma-2 (Bcl-2), heme oxygenase 1 (HO-1), NAD(P)H quinone oxidoreductase 1 (NQO1), and nuclear factor erythroid 2-related factor 2 (Nrf2), while downregulating pro-apoptotic genes like Bcl-2-associated X protein (Bax) and Caspase-3. These findings suggest that HFPS exerts its antioxidant effects by modulating the Nrf2/HO-1 pathway and redox homeostasis.

Discussion

This study contributes to the understanding of the structure-function relationships and antioxidant mechanisms of HFPS, highlighting its potential applications as a natural antioxidant in various fields.
Artificial intelligence in breast cancer survival prediction: a comprehensive systematic review and meta-analysis
Authors: Javanmard Zohreh , Zarean Shahraki Saba , Safari Kosar , Omidi Abbas , Raoufi Sadaf , Rajabi Mahsa , Akbari Mohammad Esmaeil , Aria Mehrad
Published: January 2025

Background

Breast cancer (BC), as a leading cause of cancer mortality in women, demands robust prediction models for early diagnosis and personalized treatment. Artificial Intelligence (AI) and Machine Learning (ML) algorithms offer promising solutions for automated survival prediction, driving this study’s systematic review and meta-analysis.

Methods

Three online databases (Web of Science, PubMed, and Scopus) were comprehensively searched (January 2016-August 2023) using key terms (“Breast Cancer”, “Survival Prediction”, and “Machine Learning”) and their synonyms. Original articles applying ML algorithms for BC survival prediction using clinical data were included. The quality of studies was assessed via the Qiao Quality Assessment tool.

Results

Amongst 140 identified articles, 32 met the eligibility criteria. Analyzed ML methods achieved a mean validation accuracy of 89.73%. Hybrid models, combining traditional and modern ML techniques, were mostly considered to predict survival rates (40.62%). Supervised learning was the dominant ML paradigm (75%). Common ML methodologies included pre-processing, feature extraction, dimensionality reduction, and classification. Deep Learning (DL), particularly Convolutional Neural Networks (CNNs), emerged as the preferred modern algorithm within these methodologies. Notably, 81.25% of studies relied on internal validation, primarily using K-fold cross-validation and train/test split strategies.

Conclusion

The findings underscore the significant potential of AI-based algorithms in enhancing the accuracy of BC survival predictions. However, to ensure the robustness and generalizability of these predictive models, future research should emphasize the importance of rigorous external validation. Such endeavors will not only validate the efficacy of these models across diverse populations but also pave the way for their integration into clinical practice, ultimately contributing to personalized patient care and improved survival outcomes.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42024513350.
Circulating proliferative factors versus portal inflow redistribution: mechanistic insights of ALPPS-derived rapid liver regeneration
Authors: Zhang Shiran , Ma Yu , Chen Xue , Wu Shuai , Chen Geng
Published: January 2025

Background

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can induce accelerated regeneration of future liver remnant (FLR) and effectively reduce the occurrence of liver failure due to insufficient FLR after hepatectomy, thereby increasing the probability of radical resection for previously inoperable patients with liver cancer. However, the exact mechanism by which ALPPS accelerates liver regeneration remains elusive.

Methods

A review of the literature was performed utilizing MEDLINE/PubMed and Web of Science databases in March of 2024. The key words “liver regeneration/hypertrophy”, “portal vein ligation/embolization”, “two-stage hepatectomy”, “liver partition/split” and “future liver remnant” in combination with “mechanisms”, “hemodynamics”, “cytokines”, “growth factors” or “collaterals” were searched in the title and/or abstract. The references of relevant articles were reviewed to identify additional eligible publications.

Results

Previously, a widely accepted view is that the primary role of liver splitting in ALPPS stage 1 is to accelerate liver regeneration by promoting proliferative factor release, but increasing evidence in recent years reveal that not the circulating factors, but the portal hemodynamic alternations caused by liver parenchyma transection play a pivotal role in ALPPS-associated rapid liver hypertrophy.

Conclusion

Parenchyma transection-induced portal hemodynamic alternations are the main triggers or driving forces of accelerated liver regeneration following ALPPS. The release of circulating proliferative factors seems to be a secondary response to liver splitting and plays an auxiliary role in this process.
Patient-reported quality of life and adherence outcomes after integrating exclusive liquid meal replacement in patients with head and neck cancer undergoing chemoradiation: results from a phase II study
Authors: Valle Luca F. , Chu Fang-I , Wang Xiaoyan , Erman Andrew , Hernandez Jackie , Kaoh Elizabeth , Edgar Nicolas , Raldow Ann C. , Wong Deborah J. , Steinberg Michael L. , Kishan Amar U. , Chin Robert K. , Hegde John V.
Published: January 2025

Objectives

Preventing malnutrition during chemoradiation (CRT) for head and neck cancer is critical maximizing quality of life (QOL). We sought to assess patient-reported QOL outcomes after integrating exclusive liquid meal replacement with Soylent, a novel meal replacement agent, in patients with head and neck cancer undergoing CRT.

Methods

Patients undergoing definitive or adjuvant concurrent CRT for locally advanced head and neck cancer enrolled on our single-institution, prospective phase II protocol evaluating nutritional replacement with Soylent. Patients who reached 5% body weight loss during CRT were transitioned to Soylent meal replacement for all nutritional needs. Patients who reached 10% body weight loss were recommended for gastrostomy tube (G-tube) placement. UW-QOL and FACT-H&N questionnaires assessed patient-reported QOL prior to the receipt of CRT and following conclusion of CRT. Paired t-test or Wilcoxon signed-rank test were performed to assess for differences between scores at each follow-up time point and baseline.

Results

Of the 60 enrolled patients, 51/60 (85%) lost 5% of their pre-treatment body weight. Among these patients, 48/51 (94%) were successfully transitioned to Soylent. 22/48 patients subsequently lost 10% of their pre-treatment body weight, and 3/22 (14%) underwent G-tube placement with the remainder declining. This resulted in an overall G-tube rate of 5%. Among the 41 patients evaluable for QOL data, the nadirs for overall and health-related UW-QOL were reached at 1 month and rebounded to exceed baseline by 6 months. FACT-H&N survey scores were reduced from 32 at baseline to 20 at 1 month (adjusted p<0.001) and 26 at 3 months (adjusted p<0.001), but increased to 29, 30, and 27 at 6, 12, and 18 months, without significant differences as compared to baseline (adjusted p>0.38 for all).

Conclusions

We report high patient adherence and a 5% G-tube placement rate with exclusive meal replacement with Soylent in patients undergoing concurrent CRT for head and neck cancers.
Pleural Rosai-Dorfman disease complicated with renal clear cell carcinoma: a case report and literature review
Authors: Tang Sudan , Yang Xinju , Wang Shunan , Xiao Qin
Published: January 2025

Background

Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare non-malignant disorder characterized by excessive proliferation of histiocytes, the cause of which remains unknown. Although the lymph nodes are the most commonly affected site, some patients may present with extranodal involvement, particularly in the skin, nasal cavity, eyes, and bones. In this report, we aim to present a unique case of RDD with pleural involvement in a 61-year-old patient. To our knowledge, only a few cases of RDD primarily manifesting as pleural disease have been reported thus far.

Case summary

A 61-year-old male with left brachial plexus neuropathy was found to have a space-occupying lesion in the left posterior pleura. Initial chest CT showed a 5.7cm × 1.3cm soft tissue density shadow, which grew to 6.8cm × 1.7cm two years later. Given a history of clear cell renal cell carcinoma, pleural metastasis was suspected. The patient declined a needle biopsy but underwent surgical excision. Postoperative pathology and immunohistochemistry confirmed Rosai-Dorfman disease (RDD). After surgery, the patient received anti-infection, phlegm reduction, rehydration, and analgesia treatments and recovered well.

Conclusion

RDD originating in pleura is rare, its clinical and imaging manifestations lack specificity, and it is easy to be misdiagnosed. It is crucial to consider the possibility of RDD when encountering nodular pleural masses or lamellar soft tissue lesions. Differential diagnosis should include pleural mesothelioma, pleural metastases, solitary fibrous neoplasms, and schwannomas of the pleura. Ultimately, a definitive diagnosis can be achieved through pathology and immunohistochemistry analysis.
Case report: One case of precise resection of gastric glomus tumor by gastroscopy combined with laparoscopy
Authors: Yang Xuan , Guo Yunping , Yan Xiaochen , Xu Bin , Cui Zhenqin , Guo Zhuang
Published: January 2025

Introduction

Gastric glomus tumor is a rare submucosal mesenchymal tumor with no distinct features on endoscopy. In clinical practice, it is often treated with laparoscopic partial gastrectomy. Here, we report a case of gastric glomus tumor successfully resected using a combination of gastroscopy and laparoscopy.

Case description

The patient was an elderly male who underwent gastroscopy, which revealed a submucosal mass in the gastric antrum. The lesion was suspected to be a stromal tumor. Further evaluation with computed tomography (CT) imaging indicated a space-occupying lesion in the gastric antrum, with the possibility of benign pathology. Endoscopic ultrasonography revealed that the tumor originated from the muscular layer and was approximately 28.8 mm ×22.5 mm. Blood flow was detected behind the lesion, suggesting the possibility of a gastric glomus tumor. The tumor was removed using a combination of gastroscopy and laparoscopy. Postoperative pathology suggested that it was a benign gastric glomus tumor. The patient recovered uneventfully and was discharged 7 days later.

Conclusion

Gastric glomus tumor is a rare submucosal tumor that should be included in the differential diagnosis of gastric submucosal tumors. A combined approach using gastroscopy and laparoscopy offers a minimally invasive and effective treatment option.
Machine learning-based identification of proteomic markers in colorectal cancer using UK Biobank data
Authors: Radhakrishnan Swarnima Kollampallath , Nath Dipanwita , Russ Dominic , Merodio Laura Bravo , Lad Priyani , Daisi Folakemi Kola , Acharjee Animesh
Published: January 2025

Colorectal cancer is one of the leading causes of cancer-related mortality in the world. Incidence and mortality are predicted to rise globally during the next several decades. When detected early, colorectal cancer is treatable with surgery and medications. This leads to the requirement for prognostic and diagnostic biomarker development. Our study integrates machine learning models and protein network analysis to identify protein biomarkers for colorectal cancer. Our methodology leverages an extensive collection of proteome profiles from both healthy and colorectal cancer individuals. To identify a potential biomarker with high predictive ability, we used three machine learning models. To enhance the interpretability of our models, we quantify each protein’s contribution to the model’s predictions using SHapley Additive exPlanations values. Three classifiers—LASSO, XGBoost, and LightGBM were evaluated for predictive performance along with hyperparameter tuning of each model using grid search, with LASSO achieving the highest AUC of 75% in the UK Biobank dataset and the AUCs for LightGBM and XGBoost are 69.61% and 71.42%, respectively. Using SHapley Additive exPlanations values, TFF3, LCN2, and CEACAM5 were found to be key biomarkers associated with cell adhesion and inflammation. Protein quantitative trait loci analyze studies provided further evidence for the involvement of TFF1, CEACAM5, and SELE in colorectal cancer, with possible connections to the PI3K/Akt and MAPK signaling pathways. By offering insights into colorectal cancer diagnostics and targeted therapeutics, our findings set the stage for further biomarker validation.
The effect of zopiclone co-administration on sertraline initial dosage optimization in pediatric major depressive disorder patients based on model-informed precision dosing
Authors: Chen Xiao , Hu Ke , Shi Hao-Zhe , He Su-Mei , Yang Yang , Yang Chao-Wen , Zhang Yue , Tian Xue , Li Ye , Gao Yu-Hang , Xu Wen-Yi , Zhang Cun , Wang Dong-Dong
Published: January 2025

Objective

The present study aims to explore the initial dosage optimization of sertraline in pediatric major depressive disorder (MDD) patients based on model-informed precision dosing (MIPD).

Methods

A total of 111 pediatric MDD patients treated with sertraline were included for analysis using MIPD. Sertraline concentration levels, physiological and biochemical indexes of pediatric MDD patients, combined drug information were included in the construction of model.

Results

Weight and zopiclone co-administration influenced sertraline clearance in pediatric MDD patients. With the same weight, the sertraline clearance rates were 0.453:1 in patients with, or without zopiclone, respectively. Furthermore, without zopiclone, for once-daily sertraline scheme, the dosages of 4.0, and 3.0 mg/kg/day were suggested for pediatric MDD patients with body weight of 30–38.5, and 38.5–80 kg, respectively; for twice-daily sertraline scheme, the dosage of 2.0 mg/kg/day was suggested for pediatric MDD patients with body weight of 30–80 kg. With zopiclone, for once-daily sertraline scheme, the dosage of 1.0 mg/kg/day was suggested for pediatric MDD patients with body weight of 30–80 kg; for twice-daily sertraline scheme, the dosage of 0.5 mg/kg/day was suggested for pediatric MDD patients with body weight of 30–80 kg.

Conclusion

This study first explored the initial dosage optimization of sertraline in pediatric MDD patients based on MIPD, and recommended the optimal sertraline initial dosage in pediatric MDD patients based on zopiclone co-administration.
Radix Codonopsis: a review of anticancer pharmacological activities
Authors: Liu Cai-Yue , Li Zheng , Cheng Fan-E. , Nan Yi , Li Wei-Qiang
Published: January 2025

Radix Codonopsis (Dangshen), derived from the dried root of plants in the Campanulaceae family, is a widely used Chinese herbal medicine. It is renowned for its pharmacological effects, including tonifying the middle qi, invigorating the spleen, benefiting the lungs, enhancing immunity, and nourishing the blood. Codonopsis extract is frequently incorporated into health products such as tablets and capsules, making it accessible for daily health maintenance. Additionally, it is commonly used in dietary applications like soups, teas, and porridges to nourish qi, enrich blood, and promote overall vitality. In recent years, increasing attention has been given to the anti-cancer potential of Radix Codonopsis. Studies have identified key active components such as luteolin, stigmasterol, polyacetylenes, lobetyolin, and glycitein, which exhibit anti-tumor properties through mechanisms like inhibiting cancer cell growth and proliferation, suppressing epithelial-mesenchymal transition (EMT), and inducing apoptosis. This review highlights the research progress on Radix Codonopsis, including its active constituents, anti-cancer mechanisms, and its role in the convergence of medicine and food in modern life. By doing so, it aims to provide valuable insights and references for future scientific studies and clinical applications of Radix Codonopsis.
The efficacy and safety of qiwei baizhu san in the treatment of type 2 diabetes mellitus: a systematic review and meta-analysis
Authors: Zhang Quan , Liu Hongyan , Zhang Jiahong , Ouyang Yujie , Fu Xiaoxu , Xie Chunguang
Published: January 2025

Background

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by chronic hyperglycemia, mostly resulting from impaired insulin production and diminished glucose metabolism regulation. Qiwei Baizhu San (QWBZS) is a classic formula used in traditional Chinese medicine for the treatment of T2DM. A comprehensive analysis of the efficacy and safety of QWBZS in the treatment of T2DM is essential.

Methods

This study’s protocol was registered with PROSPERO (CRD42024576129). As of August 2024, we searched eight databases to screen and include randomized controlled trials of QWBZS for T2DM. Heterogeneity sources were examined via subgroup analyses, the robustness of the results was determined by sensitivity analyses, publication bias was evaluated using funnel plots and Egger’s test, evidence quality was appraised with GRADEpro, and possible mechanisms of QWBZS for T2DM were categorized and summarized.

Results

This analysis encompassed 14 qualifying trials with a total of 1,169 subjects. The analytical results suggested that QWBZS, when combined with conventional treatment, was more effective than conventional treatment alone in improving FBG, 2hPG, HbA1c, HOMA-IR, TC, TG, LDL-C, and HDL-C. When QWBZS was used alone, it was more effective than conventional therapy in FBG, 2hPG, and HbA1c. And QWBZS could improve the overall effectiveness of clinical treatment in T2DM patients. The impact of QWBZS therapy alone on HOMA-IR and lipid metabolism remained unclear due to the limited number of trials included. Analysis of adverse events suggested that QWBZS was relatively safe.

Conclusion

This study suggested that QWBZS, when combined with conventional treatment, was more effective in improving glucose metabolism, insulin resistance, and lipid metabolism compared to conventional treatment alone in individuals with T2DM. QWBZS alone also contributed to the regulation of blood glucose levels. Meanwhile, QWBZS could improve the overall effective rate of clinical treatment with a relatively high safety profile. Nevertheless, owing to the inferior quality and significant heterogeneity of the existing evidence, additional high-quality studies are requisite to furnish more dependable evidence for the future clinical application of QWBZS.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=576129, identifier [CRD42024576129].
War and peace: exploring microbial defence systems as a source of new antimicrobial therapies
Authors: Dyson Paul J. , Banat Ibrahim M. , Quinn Gerry A.
Published: January 2025

The WHO has compiled a list of pathogens that urgently require new antibiotics in response to the rising reports of antibiotic resistance and a diminished supply of new antibiotics. At the top of this list is fluoroquinolone-resistant Salmonella typhi, fluoroquinolone-resistant Shigella spp. and vancomycin-resistant Enterococcus faecium. Although these problems have been covered in great detail by other contemporary reviews, there are still some fundamental gaps in the translation of current knowledge of the infectious process and the molecular ecology of antibiotic production into a sustainable protocol for the treatment of pathogenic diseases. Therefore, in this narrative review we briefly discuss newly approved antimicrobial drugs (since 2014) that could help to alleviate the burden of multiresistant pathogens listed on the WHO priority list. Being conscious that such treatments may eventually run the risk of future cycles of resistance, we also discuss how new understandings in the molecular ecology of antibiotic production and the disease process can be harnessed to create a more sustainable solution for the treatment of pathogenic diseases.