bluuebunny/crossref_metadata_2025 huggingface dataset:
Diffusion Basis Spectrum Imaging of White Matter in Schizophrenia and Bipolar Disorder
Authors: Mamah Daniel , Patel Aakash , Chen ShingShiun , Wang Yong , Wang Qing
Published: October 2024

Background:
Multiple studies point to the role of neuroinflammation in the pathophysiology of schizophrenia (SCZ), however, there have been few in vivo tools for imaging brain inflammation. Diffusion basis spectrum imaging (DBSI) is an advanced diffusion-based MRI method developed to quantitatively assess microstructural alternations relating to neuroinflammation, axonal fiber, and other white matter (WM) pathologies.
Methods:
We acquired one-hour-long high-directional diffusion MRI data from young control (CON, n =27), schizophrenia (SCZ, n =21), and bipolar disorder (BPD, n =21) participants aged 18-30. We applied Tract-based Spatial Statistics (TBSS) to allow whole-brain WM analyses and compare DBSI-derived isotropic and anisotropic diffusion measures between groups. Clinical relationships of DBSI metrics with clinical symptoms were assessed across SCZ and control participants.
Results:
In SCZ participants, we found a generalized increase in DBSI-derived cellularity (a putative marker of neuroinflammation), a decrease in restricted fiber fraction (a putative marker of apparent axonal density), and an increase in extra-axonal water (a putative marker of vasogenic edema) across several WM tracts. There were only minimal WM abnormalities noted in BPD, mainly in regions of the corpus callosum (increase in DTI-derived RD and extra-axonal water). DBSI metrics showed significant partial correlations with psychosis and mood symptoms across groups.
Conclusion:
Ourfindings suggest that SCZ involves generalized white matter neuroinflammation, decreased fiber density, and demyelination, which is not seen in bipolar disorder. Larger studies are needed to identify medication-related effects. DBSI metrics could help identify high-risk groups requiring early interventions to prevent the onset of psychosis and improve outcomes.
Exosomes derived from SOX9 overexpressing human umbilical cord mesenchymal stem cells ameliorate osteoarthritis by potentially activating autophagy
Authors: Qin Shangzhu , Zhang Aijie , Liu Haibo , Wang Fen , Liu Lianghua , Xu Peng , Duan Lian , Lin Fang , Zhao Mingcai
Published: October 2024

The exosomes derived from modified mesenchymal stem cells are a promising treatment for osteoarthritis (OA). The aim of this study was to explore the therapeutic effects of SOX9-overexpressing human umbilical cord mesenchymal stem cells (hucMSCs) exosomes on OA and their potential mechanisms. SOX9 was overexpressed in hucMSCs, and the exosomes derived from these modified hucMSCs were isolated (ExosSOX9). An IL-1β-stimulated OA chondrocytes model and a surgically induced OA rat model were established. These models were subsequently treated with the prepared exosomes. Western blot results indicated that the ExosSOX9 markedly enhanced the synthesis of cartilage extracellular matrix and inhibited its degradation in vitro. Histological, imaging, immunohistochemical, and chip analysis demonstrated that the ExosSOX9 markedly alleviated OA progression and decreased serum inflammatory markers in OA rats. Furthermore, the autophagy/Wnt signaling axis served as a potential target pathway for the ExosSOX9 in both in vivo and in vitro studies. Consequently, the ExosSOX9 may alleviate OA by simultaneously inhibiting the Wnt pathway and inducing autophagy. The findings indicate that the ExosSOX9 may represente a promising approach for cell-free therapy in OA.
Impact of para-aortic lymphadenectomy on clinically FIGO stage IIIC1 high- grade endometrial cancer: a retrospective cohort study from two tertiary centers Running title: Lymphadenectomy in high-grade endometrial cancer
Authors: Seo Jun-Hyeong , Lee Yoo-Young , Chang Koping , Kim Hyun-Soo , Chen Jung , Yang Tyan-Shin , Lai Yen-Ling , Chen Yu-Li
Published: October 2024

The therapeutic effect of para-aortic lymphadenectomy in patients with clinically pelvic node-positive but para-aortic node-negative endometrial cancer remains controversial. In this study, we investigated whether combined pelvic and para-aortic lymphadenectomy has a survival benefit compared with pelvic lymphadenectomy alone in these patients. We retrospectively reviewed patients with clinically FIGO stage IIIC1 high-grade endometrial cancer at two tertiary centers. Patients were stratified according to type of lymphadenectomy and subgroup analyses were performed. Kaplan–Meier analysis and a Cox proportional-hazards model were used to evaluate survival outcomes. A total of 56 patients were identified. Of these patients, 18 underwent pelvic lymphadenectomy alone, and 38 underwent combined pelvic and para-aortic lymphadenectomy. After staging surgery, 34 (60.7%) patients had pathologically confirmed lymph node metastases. Within a median follow-up of 57.5 months, there were no significant differences in recurrence-free survival (RFS) and overall survival (OS) between the two groups. In subgroup analyses, the node- and lymphovascular space invasion (LVSI)-positive patients characterized by grade 3 endometrioid histologic type (p = 0.010) or negative peritoneal washing cytology (p = 0.035) had an RFS benefit from combined pelvic and para-aortic lymphadenectomy.
A novel program-controlled mode for stage Ⅰ of sacral neuromodulation-the remote programming: a multicenter retrospective study
Authors: Yinjun Gu , Jiashun Yu , Xin Song , Qixiang Song , Tingting Lv , Xueyan Bai , Wenhao Shen , Jiayi Li , Jing Leng , Chen Jiang , Jianwei Lv
Published: October 2024

Objectives
To evaluate the feasibility of using a novel network-based remote programming mode for the stage Ⅰ of sacral neuro modulation.
Methods
We retrospectively analyzed the data of patients from other provinces and cities who underwent sacral neuromodulation at three medical centers in Shanghai.
Results
It was found that the network remote programming modehad shorter single test time and lower transportation cost than the outpatient face-to-face programming mode based on Bluetooth connection, thus improving the cost-effective ratio of the time for sacral neuromodulation surgery and medical cost, and making patients get a better experience. Meanwhile, there is no significant difference in the short-term and medium-term efficacy between the two groups.
Conclusion
We think that the network remote programming mode has the advantages of convenience, speed, and low cost, which greatly complements the traditional outpatient face-to-face programming mode and can effectively solve the problem that patients who need reprogramming cannot receive face-to-face diagnosis in an outpatient department.
Quantitative Analysis of Choroidal Vascular Structures and Anatomical Changes in Pachychoroid Spectrum Diseases Using ultra-widefield SS-OCTA
Authors: Xiao Bei , Song Yanping , Yan Ming , Ye Ya , Huang Zhen
Published: October 2024

This study utilized ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA) to quantitatively assess and compare choroidal blood flow structures and anatomical changes in eyes affected by central serous chorioretinopathy (CSC), pachychoroidal neovasculopathy (PNV), and uncomplicated pachychoroid (UCP). Additionally, we examined the distribution patterns of vortex veins across the three patient groups and conducted a preliminary investigation into the origin of choroidal neovascularization (CNV) in PNV. A total of 44 patients with CSC, 38 with PNV, and 46 with UCP were included in the analysis. Three-dimensional data were obtained from scans with dimensions of 20 mm vertically by 24 mm horizontally and a scan depth of 6 mm, covering nine subfields. The results demonstrated higher choroidal vessel volume per unit area (mCVV/a), choroidal vascularity index (CVI), and choroidal thickness (CT) in CSC eyes, while the PNV group exhibited similarities with the UCP group. Notably, PNV eyes showed the lowest foveal choriocapillaris density, suggesting that PNV and CSC may represent a continuous pathological spectrum, whereas UCP could be considered either a precursor to CSC or a remission stage following CSC resolution. CNV in PNV may result from choriocapillaris occlusion and ischemia due to mechanical compression by hypertrophic choroidal vessels. These findings provide valuable insights into choroidal structure analysis, hemodynamics within the pachychoroid spectrum disease (PSD), and the pathogenesis of CNV in PNV, thereby contributing to the understanding of shared etiologies within the PSD spectrum.
Childhood Adversities, Race, and Late-life Cognition: Socio-behavioral pathways
Authors: Li Miao , Luo Ye
Published: October 2024

Background
Alzheimer’s Disease and Related Dementia (ADRD) poses a significant public health burden, with pronounced racial disparities in its prevalence. Adverse Childhood Experiences (ACEs) have been implicated as predictors of later-life cognitive decline, potentially contributing to these disparities. However, the pathways linking ACEs to cognition in later life, and how these pathways vary by race, remain understudied.
Methods
This study utilized data from the Health and Retirement Study (HRS), focusing on a cohort of 9,894 U.S. adults aged 50 and older who participated in the 2008 and 2010 Enhanced Face-to-Face interviews. An innovative structural equation modeling (SEM) approach assessed the cumulative cognitive impact of 23 ACEs by estimating a single overall impact parameter and differentially weighting ACEs to identify the most and least harmful. This was integrated within a race-stratified mediation framework to evaluate the mediating roles of education, smoking, depressive symptoms, and physical activity for Whites and Blacks.
Results
In the overall model, cumulative ACEs were linked to lower education, increased smoking, higher depressive symptoms, and lower physical activity, all of which contributed to lower cognitive function. In race-stratified models, education emerged as the most significant mediator for Black participants, with depressive symptoms as a secondary mediator, together fully mediating the ACE-cognition relationship. For Whites, all mediators played a role in the ACE-cognition link, with education remaining the most important. A direct association between ACEs and cognition persisted for Whites even after accounting for mediators. The study also highlighted race-specific differences in ACE significance, with parental risky behaviors more impactful for Whites and physical disabilities for Blacks. Grade retention and learning problems were impactful ACEs for both groups.
Conclusion
This study highlights the complex, race-specific socio-behavioral pathways linking ACEs to cognitive decline in later life. Education plays a crucial mediating role, particularly for Black individuals, while White individuals are influenced by a broader set of factors. These findings suggest the need for targeted public health interventions that address the unique experiences of different racial groups. Future research should continue to explore these pathways to better understand and mitigate racial disparities in ADRD.
PTGDS is a potential marker for lung adenocarcinoma identified from multi-omics pan-cancer data
Authors: Wang Runzhi , Shao Fengling , Chen Jun , Zhou Qin
Published: October 2024

Prostaglandin D2 Synthase (PTGDS) is an enzyme responsible for synthesizing prostaglandin D2. Despite its crucial role, PTGDS remains relatively understudied in tumor therapy, lacking comprehensive pan cancer analyses. Leveraging multi omics data integration, this study elucidates PTGDS's widespread dysregulation across various cancers and its correlation with patient survival. Moreover, PTGDS exhibits significant associations with stem cell scores, microenvironmental scores, microsatellite instability (MSI), tumor mutational burden (TMB), and methylation status in diverse tumor types. Additionally, immune correlations with PTGDS are evident across most cancers, with single cell transcriptome data indicating predominant associations with natural killer cells and macrophages. Notably, experimental validation reveals PTGDS's role in inhibiting lung adenocarcinoma cell A549 proliferation, linked to fatty acid degradation and cell cycle regulation. In summary, PTGDS demonstrates prognostic potential, influences pan cancer tumor immunity, and acts as a tumor suppressor in lung adenocarcinoma (LUAD).
Navigating the Storm: Pathways from Fear to Self-Management in Decompensated Cirrhosis-— A Cross-Sectional Study
Authors: Zhang Man , Zheng Xutong , Cui Yi , Chen Changchang , Yang Qian , Guo Hua , Yu Xingfeng
Published: October 2024

Background: Decompensated cirrhosis is a critical stage of liver disease where liver function becomes insufficient, leading to severe complications and a decreased quality of life. Fear of disease progression is a significant psychological burden that affects patients' self-management behaviors. Effective self-management is crucial for delaying disease progression, preventing complications, and improving overall outcomes in patients with decompensated cirrhosis. However, few studies have explored the direct relationship between fear of disease progression and self-management from a theoretical perspective and analyzed the pathways that influence this relationship in patients with decompensated cirrhosis.
Objective: Based on social cognitive theory and self-depletion theory, this study aims to construct a structural equation model of self-management in patients with decompensated cirrhosis. The objective is to explore the pathway relationships between fear of disease progression, disease self-perception, self-perceived burden, and self-management ability.
Design: A single-center cross section study from mainland China.
Setting: A general hospital ward in a large tertiary care hospital
Participants: A total of 412 patients with decompensated liver cirrhosis in the ward were surveyed.
Methods: Analytical approach using structural equation modelling，and the COREQ checklist was followed.
Results: The final model demonstrated a good fit. Fear of disease progression directly impacted self-management behaviors (β = -0.533, p < 0.001) and indirectly influenced self-management behaviors through disease perception (β = -0.169, p < 0.001) and self-perceived burden (β = -0.143, p < 0.001). Additionally, fear of disease progression was negatively correlated with self-management but positively correlated with disease self-perception and self-perceived burden.
Discussion & Conclusions: Our study found that fear of disease progression, disease self-perception, and self-perceived burden directly or indirectly influence self-management behaviors in patients with decompensated cirrhosis. These findings provide evidence for the development of targeted self-management interventions for this population, aiming to improve their health behaviors.
Reporting Method: This study was reported using the STROBE Checklist for cross-sectional studies.
Clinical trial number: not applicable.
Neural Mechanisms of Early Motor Learning in Laparoscopic Surgery: EEG Connectivity, BDNF, and Cognitive Load
Authors: Omurtag Ahmet , Sunderland Caroline , Mansfield Neil J. , Zakeri Zohreh
Published: October 2024

This paper investigates the neural mechanisms underlying the early phase of motor learning in laparoscopic surgery training, using electroencephalography (EEG), brain-derived neurotrophic factor (BDNF) concentrations and subjective cognitive load recorded from n = 31 novice participants during laparoscopy training. Functional connectivity was quantified using inter-site phase clustering (ISPC) and subjective cognitive load was assessed using NASA-TLX scores. The study identified frequency-dependent connectivity patterns correlated with motor learning and BDNF expression. Gains in performance were associated with beta connectivity, particularly within prefrontal cortex and between visual and frontal areas, during task execution (r = − 0.73), and were predicted by delta connectivity during the initial rest episode (r = 0.83). The study also found correlations between connectivity and BDNF, with distinct topographic patterns emphasizing left temporal and visuo-frontal links. By highlighting the shifts in functional connectivity during early motor learning associated with learning, and linking them to brain plasticity mediated by BDNF, the multimodal findings could inform the development of more effective training methods and tailored interventions involving practice and feedback.
Seasonal Modulation of Progesterone Receptor, PCNA, and Enzyme Activity in Buffalo Uterus: Implications for Endometrial Growth During Estrous
Authors: DEHURY SAGARIKA , Uppal Varinder , Pathak Devendra , Gupta Anuradha
Published: October 2024

Reproductive ability in buffalo is influenced by longer day length during the summer. Factors like Progesterone receptor (PR), proliferating cell nuclear antigen (PCNA), alkaline phosphatase, and succinic dehydrogenase activity were assessed during the follicular and luteal phase of the estrous cycle in the summer and winter seasons to visualize any changes in the uterine endometrial histoarchitecture that affect the reproductive ability in buffalo. Progesterone receptor (PR) and proliferating cell nuclear antigen (PCNA) immunoexpression are important indicators for endometrial cell growth and differentiation. The overall percentage of PR and PCNA immunopositive cell count and immunostaining intensity (optical density) in different compartments of the uterus was higher during the luteal phase than during the follicular phase. Alkaline phosphatase and succinic dehydrogenase activity are related to endometrial cell growth, uterine secretion, and functional status of the uterus. The activity of these enzymes was also more during the luteal phase than the follicular phase of the estrous cycle. However, the values and activities of all these parameters were lesser during the summer than in the winter. The decline in activities of all these factors would have a negative impact on buffalo reproduction and might cause summer infertility.
A Two-Stage Spatio-Geometrical Clustering of Football Team Shape for Post-Match Review
Authors: Zardiny Ali Zare , Bahramian Zahra
Published: October 2024

The existence of a significant amount of spatio-temporal data in a football match creates a good potential for Post-Match Review and analysis of team behavior. These analyses can be done by focusing on the whole team or individual players. The purpose of this paper is to analyze the efficiency and general behavior of the team in the form of a single entity, from a spatio-geometrical point of view. This process starts by defining a convex hull as the team shape in each time frame. In the next step, a set of spatial, geometric, zone-based, and event-based parameters are introduced and extracted to describe the shape of the team at each frame. These descriptors are the basis of the two-stage spatio-geometrical clustering of the team during the match. What is obtained from clustering is the identification of similar patterns for the shape of the team in situations of in-possession and out-of-possession of the ball. Examining these clusters in the Post-Match Review process determines the overall performance of the team in different situations, the extent of the team's dominance over different areas of the field, as well as the team's technical strategies. No need to transfer the team shape to the image space, no need for image processing techniques for analysis and thus reducing the computational load, introducing a new geometric descriptor and performing clustering in two stages for a better and more meaningful interpretation of the team shape from the points are the distinguishing points of this article.
Altered Subchondral Bone Mineral Density in Painful Knee Osteoarthritis Without Cysts: A Comparative Analysis of Lateral and Medial Regions
Authors: Xu Pengjun , Xu Chensi , Zhang Yi , Zhao Suli , Feng Yabin , Sun Gang , Liu Kai
Published: October 2024

Objectives
​This study aims to elucidate the mechanisms underlying pain generation and progression in knee osteoarthritis (KOA) by investigating alterations in proximal tibial subchondral bone mineral density (BMD) among individuals experiencing painful KOA without subchondral cysts, utilizing three-dimensional (3D) bone densitometry.
Methods
​A prospective, single-center data collection was conducted at the 960th Hospital of the Joint Logistics Support Force of the PLA. We employed a 3D bone densitometry technique to assess BMD in specific regions. Knee pain was evaluated using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Based on WOMAC scores, the knees of each patient were categorized into a moderate-severe pain group and a mild pain group. We explored the correlation between BMD and pain and analyzed differences among various pain subgroups.
Results
​Computed tomography (CT) imaging of 84 knees from 42 patients revealed a significant association between BMD and pain. The moderate-to-severe pain group exhibited higher BMD in the lateral compartment compared to the mild pain group. Statistically significant differences were observed in 0-2.5 mm lateral-posterior, 2.5-5.0 mm lateral-anterior, 5.0-7.5 mm medial-posterior, and 7.5-10.0 mm lateral-posterior.
Conclusions
​The altered subchondral bone density of the proximal tibia may play a pivotal role in the pathogenesis of KOA-related pain in patients.
Identification of Energy Metabolism and m6A-Related Gene Clusters in Kashin-Beck Disease Based on Bioinformatics Analysis
Authors: Ao Zhou , Ji Wang , An Jia , Qi Zhang , Zeren Duoji , Zhiyong Huang , Zhengqiang Yu
Published: October 2024

Kashin-Beck disease (KBD) is a chronic and debilitating osteoarthropathy predominantly affecting populations in certain endemic regions. Despite extensive research, the underlying mechanisms of KBD remain poorly understood. Here we analyzed gene expression profiles from KBD patients and healthy controls, identifying 16 differentially expressed genes. Key pathways related to oxidative stress, apoptosis, and epigenetic regulation were implicated in KBD's development. Notably, GPX4 upregulation and differential m6A RNA methylation suggest potential therapeutic targets. Additionally, distinct metabolic regulation patterns were observed among KBD patients. These insights not only advance our understanding of KBD's molecular basis but also suggest promising directions for future research and clinical applications.
The viability of an Integrated Water Resource Management(IWRM) approach to alleviate potable water shortages, the case of Chimoio, Mozambique
Authors: Tsoca Shylet
Published: October 2024

The study examines water management in Chimoio, Mozambique while focusing on water availability, distribution, quality, and stakeholder participation through data collected via questionnaires and interviews. The are significant challenges in urban water supply being experienced in Chimoio, for instance, water stress due to unreliable supply and infrastructure issues. While the majority of the population relies on municipal and groundwater sources, water shortages and high non-revenue water (NRW) levels persist. There is a public health risk concern and low economic growth due to water scarcity. Water scarcity seem to be mostly due to economic constraints, rather than ecological factors. Water quality concerns are prevalent, with a significant portion of the population relying on untreated groundwater, raising health risks. The study also highlights the limited implementation of Integrated Water Resource Management (IWRM) and inadequate wastewater treatment and recycling practices in the city. Despite government promotion of IWRM, local efforts remain inadequate, especially in stakeholder and public participation in water management. The research emphasizes the need for innovative and sustainable water management practices, including the promotion of rainwater harvesting and active leakage control, to address water shortages and improve overall water governance in Chimoio.
Pivoting to the Positive: A Novel Strategy for Evaluating Programs Serving Children of Incarcerated Parents
Authors: Hunsucker Chelsea
Published: October 2024

Understanding children of incarcerated parents frequently reflects a myopic focus on risk, disadvantage, and likelihood of intergenerational justice system involvement. Thankfully, we now see pivots towards using positive research frameworks to research youth and evaluate programming. One such initiative was undertaken by Prison Fellowship® to develop and assess their new program, the First Chance Network™. The program aims to promote family resilience and youth flourishing for families impacted by incarceration. A participatory, sequential mixed-methods evaluation design strategy was developed, taking inspiration from the HOPE framework, resilience theory, and PCE research. Initial findings support the importance of PCEs, mentors, and supportive peers in promoting child well-being, even amongst adversity. Positive research strategies serve not only as a new way to evaluate programs and promote youth flourishing but also to redirect the defeatist narrative we often speak over children and families impacted by incarceration.
The proof is in the pudding: Patient Engagement in Studying Cannabidiol in Mild Cognitive Impairment
Authors: Keck Antonia , Scheuermann Julia-Sophia , Scheerbaum Petra , Graessel Elmar , Mueller-Vahl Kirsten R.
Published: October 2024

Background
Patient engagement (PE) in clinical trials has gained importance yet remains uncommon, particularly in patients with mild cognitive impairment (MCI), a critical precursor to Alzheimer's disease (AD). Cannabidiol (CBD) shows potential in slowing MCI progression due to its neuroprotective properties. In CBD research, PE is underutilized too. To design a study on CBD for MCI, we administered an online survey to individuals with MCI to better understand their preferences for trial setup and outcomes.
Methods
We asked 209 individuals with MCI to complete an online survey assessing (i) willingness to participate in a trial using CBD; (ii) importance of improvements in various domains; (iii) acceptance of adverse events (AEs); (iv) reasons for AE-related dropout; (v) willingness to undergo blood sampling and lumbar puncture to assess AD pathology; and (vi) willingness to participate in a trial with a 50% chance of receiving a placebo. Data were analyzed with descriptive statistics.
Results
N = 118 agreed to participate and N = 88 completed the survey. Participants prioritized improvement in cognitive abilities (87.5%), followed by quality of life (63.6%), daily activities (55.7%), sleep (55.7%), pain (52.3%), mood (52.3%), behavior (48.9%), and anxiety (43.2%). Headache (55.7%) was the least accepted AE followed by nausea (46.6%), fatigue (35.2%), and diarrhea (35.2%). Persistent diarrhea (90.9%) and severe fatigue (84.1%) were the main reasons for potential dropout. While most would undergo blood sampling (67.0%), only a minority (21.6%) would accept lumbar puncture. One-third were ready to participate (34.1%), while 54.5% were interested pending details. Among those in favor of participation, 71.6% would participate even with a 50% chance of placebo.
Conclusions
Our study identified cognitive improvement as highly relevant for patients, indicating cognitive assessment tools as primary endpoints in MCI research. Given concerns about AEs, dose titration should be carefully considered to enhance acceptance and prevent AEs. Blood sampling seems well-accepted for AD biomarker assessment. Despite potential AEs, participation in a trial using CBD for MCI is seen as attractive, even under placebo-controlled conditions. This cross-sectional study emphasizes the importance of patient engagement in designing high-quality trials for using CBD to treat MCI.
Unsatisfactory Colposcopy in Late Postmenopausal Women: The Effectiveness of Conjugated Topic Estrogen
Authors: Schwingel Tatiane Andreia , Reis Leila Caroline Souza , de Mello Paula Vieira , Zanine Rita Maira
Published: October 2024

Background
Menopause’s hypoestrogenic state which is characterized by atrophy can lead to incorrect interpretation of the cytological smears, as well as it can turn colposcopy challenging because of non-visualization of squamocolumnar junction. This study aims to determine the effect of estrogen therapy on the topography of the colposcopic transformation zone in hypoestrogenic patients and its effect on the differentiation of abnormal Papanicolaou smears secondary to atrophy and true intraepithelial lesions to improve the management of cervical disease after menopause.
Methods
This was a retrospective evaluation of postmenopausal women aged 50 years or older who were treated between January 2010 and February 2019 at a public hospital in southern Brazil and who had abnormal cervical cytologies and negative initial colposcopies and who were subjected to topical conjugated estrogen therapy and follow-up evaluations.
Results
Ninety-eight patients aged 57 years and 9.5 years after menopause were included. After 3 months of conjugated-topic estrogen therapy, the rate of satisfactory colposcopy ranged from 20.4–32.7%. Of the 78 (79.6%) subjects with a type 3 transformation zone in the entry colposcopy, 66 (67.3%) remained in the same topography. Additionally, of the 98 patients, 67 (68%) had negative cervical cytology results after treatment. Persistence of high-grade intraepithelial lesions was observed in 33.3% of the patients, 16.7% of whom were diagnosed with microcarcinoma.
Conclusion
The use of conjugated topical estrogen improved the accuracy of cytology smears in late postmenopausal women. However, it did not show a good response in the topography of the transformation zone and, consequently, a satisfactory colposcopy rate.
Comparison of Clinical and Prognostic Characteristics Between Superficial Basaloid and Conventional Esophageal Squamous Carcinoma
Authors: Yuan Ying , Mao Shangtao , Wu Hai , Xiang Ying , Wang Zhenyu , Wang Yanan , Goncalves Viriania Berta Esperanca , Sun Qi , Tang Dehua , An Fangmei , Wang Lei , Huang Qin , Xu Guifang
Published: October 2024

Background and Aims: Superficial basaloid esophageal squamous cell carcinoma (SBSCC) is a rare subtype of early esophageal squamous cell carcinoma, and its characteristics have not been thoroughly investigated. This retrospective study aims to elucidate the clinicopathological features and outcomes of SBSCC resected via endoscopic submucosal dissection (ESD), with a comparison to superficial conventional esophageal squamous cell carcinoma (SCSCC).
Methods: We identified patients with ESD-resected superficial esophageal squamous cell carcinoma at the Center of Gastrointestinal Endoscopy, Nanjing Drum Tower Hospital, from January 2014 to December 2019.Based on histopathologic findings, eligible cases were divided into SBSCC and SCSCC groups. The medical records, endoscopic and pathologic reports were reviewed for clinicopathologic and endoscopic information. All patients were routinely followed up at clinic and the outcomes were tabulated and statistically compared between the two groups.
Results: Among 477 patients, 31 (6.5%) had SBSCC and 446 (93.5%) had SCSCC. The SBSCC group had a significantly higher proportion of male patients (P = 0.027), but there was no significant difference in age. Both groups showed similar rates of smoking, alcohol abuse, family cancer history, tumor size, location, en bloc resection, and ESD-related complications. However, complete and curative resection rates were significantly lower in the SBSCC group (74.2% and 58.1%) compared to the SCSCC group (91.5% and 75.6%) (P = 0.006 and P = 0.031). SBSCC also exhibited deeper invasion (P = 0.018) and more frequent vertical margin involvement (P = 0.010). The 5-year overall survival (OS) was comparable between the groups, but disease-free survival (DFS) was lower in the SBSCC group (90.3% vs. 97.8%; P = 0.046). Post-ESD surgery, chemoradiation therapy, and tumor recurrence were more common in the SBSCC group (P < 0.05). Multivariate analysis identified SBSCC as an independent risk factor for DFS (HR: 4.6; 95% CI: 1.990-10.650; P < 0.001), while lymphovascular invasion and complete resection were significant for OS.
Conclusions: Our findings demonstrate that ESD is a safe and effective treatment for both SBSCC and SCSCC, with minimal complications and excellent outcomes. Compared to SCSCC, SBSCC is associated with significantly deeper invasion, lower rates of complete and curative resections, and lower disease-free survival.
The Role of Inflammation and Nutrition-Based Scoring in Low-Risk Myelodysplastic Syndrome
Authors: ERSAL Tuba , ÖZKOCAMAN Vildan , ÇUBUKÇU Sinem , KOCA Tuba GÜLLÜ , Hunutlu Fazıl Çağrı , Yavuz Şeyma , Elgün Ezel , ÖZKALEMKAŞ Fahir
Published: October 2024

While the pathogenesis of Myelodysplastic Syndrome (MDS) is diverse, growing evidence suggests that inflammation significantly influences disease development and progression. This study sought to assess the impact of inflammation and nutritional status on mortality, with a particular focus on patients with low-risk MDS. A retrospective analysis was conducted on 175 newly diagnosed low-risk MDS patients. A low Prognostic Nutritional Index (PNI) was significantly associated with poorer prognosis (p<0.001). The optimal PNI cut-off value for predicting mortality was identified as 47.47. Based on this cut-off, 92 patients had a low PNI score while 83 patients had a high PNI score. The comparison between these groups revealed a statistically significant difference in median overall survival (OS), with 45.5 months for the low PNI group and 75.1 months for the high PNI group (p<0.001). In the multivariate OS analysis, several factors were identified as independent predictors of prognosis, including a high Revised International Prognostic Scoring System (R-IPSS) score, low PNI, high systemic oxidative stress (SOS) score, advanced age, male gender, and transformation to acute myeloid leukemia. The PNI is a readily available and cost-effective marker that can be utilized to predict prognosis in patients with low-risk MDS.
A four-m6A methylation regulator risk score was an independent prognostic biomarker for adrenocortical carcinoma
Authors: Liu Ziyang , Shan Jiahao , Tian Jia , Zhang Qiang , Ma Lianghong , Yang Feilong
Published: October 2024

N6-methyladenosine (m6A) is crucial in cancer prognosis, yet its role in adrenocortical carcinoma (ACC) is not well understood. This study investigates the prognostic value of m6A RNA methylation regulators in ACC using mRNA data and clinical information from the TCGA-ACC database. Patients were divided into two clusters based on the expression of 13 m6A genes. Univariate and LASSO Cox regression analyses identified four key prognostic m6A regulators (METTL14, RBM15, HNRNPC, WTAP), leading to the construction of a risk score (RS) model: RS = (-0.1828 × METTL14) + (0.3292 × RBM15) + (0.0219 × HNRNPC) + (0.0010 × WTAP). Kaplan-Meier survival analysis showed significant differences between high and low RS groups, with an AUC of 0.787, indicating good predictive accuracy. Univariate and multivariate Cox regression analyses revealed that T stage and RS were independent prognostic factors. RS was also closely correlated with stage and N status. High RS was associated with higher expression levels of RBM15, HNRNPC, and WTAP, and lower expression of METTL14. This study highlights the prognostic significance of m6A RNA methylation regulators in ACC, presenting a four-gene RS model as an independent prognostic biomarker. These results provide new insights into ACC prognosis, emphasizing the potential of targeting m6A RNA methylation in future therapeutic strategies and enhancing patient management through more accurate prognostic tools. Furthermore, this research underscores the importance of continued investigation into the molecular mechanisms of m6A RNA methylation and its broader implications in oncology, potentially guiding personalized treatment approaches for ACC patients.
A Comparative Study of Clinical Outcomes and Risk Factors of Tuberculosis in Kidney Transplant Recipients from Deceased Donors
Authors: Zhang Hedong , Zhong Mingda , Hu Shanbiao , Tan Liang , Peng Longkai , Xie Xubiao , Lan Gongbin
Published: October 2024

Objective: To investigate the clinical characteristics, diagnosis and treatment of tuberculosis infection after deceased donor kidney transplantation and to analyze the risk factors and prognosis of tuberculosis infection through a paired case-control study.
Methods:This study investigated 31 kidney transplant recipients who developed tuberculosis among 2185 total recipients during 2012-2021. We employed a 1:1 paired case-control design, utilizing 31 patients who received kidneys from the same donor as the control cases. The study analyzed clinical presentation, diagnosis, treatment, risk factors, and prognosis. Results: This study identified a 1.4% incidence of tuberculosis (TB) infection (31/2185) in kidney transplant recipients. The median onset was 10.8 months post-transplant (range: 5-24 months), with 51.6% occurring within the first year. Anti-TB therapy achieved cure in 30 patients, but 1 died and 3 experienced kidney transplant dysfunctions. While overall patient survival wasn't statistically different between groups, kidney graft survival was significantly lower in the TB group (p=0.042). While kidney function was initially similar, the TB group experienced significant declines in creatinine and GFR at 3, 6, and 12 months post-treatment (p<0.05). Multivariate analysis identified diabetes mellitus (p = 0.005) and hepatitis (p = 0.027) as independent risk factors for post-transplant TB infection.
Conclusion: Over half of the tuberculosis cases (51.6%) occurred within the first year post-transplant, highlighting the need for heightened vigilance during this early period. While standard anti-TB therapy achieved good overall patient survival, it takes a toll on kidney function which underscores the importance of close kidney function monitoring and delicate immunosuppressant management during TB treatment. Diabetes mellitus and hepatitis were identified as independent risk factors for post-transplant TB infection. Prophylaxis measures should be considered for these high-risk patients during early time post-transplant.
Alterationd in spontaneous brain activity of maintenance hemodialysis patients with restless legs syndrome: a cross-sectional case-control study
Authors: Wang Di , Li Wenqing , Tang Yushang , Zhang Wanfen , Liu Tongqiang , Shi Haifeng
Published: October 2024

Objective
Through resting state functional magnetic resonance imaging (rs-fMRI) we evaluate the spontaneous brain activity changes of maintenance hemodialysis (MHD) patients with restless legs syndrome (RSL) and analyzed the imaging features and related mechanisms of RLS in patients with MHD.
Method
We select 27 MHD patients with RLS and 27 patients without RSL matched by age, gender, cognitive function. Both groups underwent neuropsychological tests and MRI scans. MRI data analysis was performed to obtain and compare the amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) values, which were mALFF, mfALFF, and mReHo. Clinical data were collected and compared. Differentiated indicators and RLS scores conduct Pearson correlation analysis.
Result
Compared with the MHD-nRLS group, the MHD-RLS group showed significantly lower mALFF values in the left precentral and right precentral gyrus, lower mALFF values in the right postcentral gyrus ,left precentral gyrus, right precentral gyrus, left postcentral gyrus, right postcentral gyrus, left calcarine fissure, left lingual gyrus, and lower mReHo values in the left precentral gyrus, right precentral gyrus and right postcentral gyrus (P < 0.05). The MHD-RLS group exhibited lower hemoglobin levels (P = 0.001), higher total iron-binding capacity levels (P = 0.011), and higher folic acid levels (P = 0.022). The above indicators were correlated with RLS scores using Pearson correlation analysis, and it was found that the mfALFF value of the right precentral gyrus and the right postcentral gyrus, and the mReHo values of the right precentral gyrus and right postcentral gyrus were negatively correlated with the RLS score (r = -0.567, P = 0.002;r = -0.705, P < 0.001;r = -0.414, P = 0.032; r = -0.410, P = 0.034), and the hemoglobin concentration was negatively correlated with the RLS scores (r = 0.412, P = -0.394).
Conclusion
Patients with MHD-RLS exhibit abnormal spontaneous brain activity in the right precentral gyrus and right postcentral gyrus within the sensorimotor network, along with lower hemoglobin levels, which may be associated with the pathogenesis and severity of MHD-RLS.
Resumption of sexual activity and contraceptive use among postpartum women in the Kumasi Metropolis of Ghana
Authors: Peprah Amponsah , Danso Kwabena Antwi , Sarbeng Kwadwo , Ankobea Frank , Asubonteng Gerald Owusu , Dassah Edward T. , -Antwi Kwabena Amo , Tabi Seth Amponsah , Borlabi Samuel Bortier , Senaya Charles Mawunyo , Kwarko Ernest , Yiadom Jonathan Boakye , Kolbilla David Zawumya
Published: October 2024

Background: The postpartum period presents challenges to women as they contemplate on the desire to space or limit childbirth while meeting the sexual demands of their partners and their own sexual desires. The study looked at the factors that determine the resumption of sexual activity after delivery and their influence on contraceptive use among postpartum women in the Kumasi metropolis.
Method: An analytical cross-sectional study was conducted using an interviewer administered structured questionnaire with both closed and open-ended questions, on 853 mothers aged 15-49 years, attending child welfare clinics with babies who were up to one (1) year old in the Kumasi Metropolis of Ghana.
Results: Majority (76%) of the women initiated sexual intercourse from 6 weeks after delivery but only 34% used contraceptives, despite the 99% awareness of postpartum family planning services.
Response to partners’ demand for sex was the most important stimulus for resumption of sexual activity while unavailability of the partner was the main reason for sexual inactivity after delivery. Marital status (AOR: 4.94, CI=2.99-8.15), residence after delivery (AOR: 0.53, CI=0.38-0.76), resumption of menses (AOR= 0.19, CI= 0.13 – 0.27), birth limiting (AOR= 0.68, CI= 0.45 – 0.98), and birth spacing (AOR= 0.40, 95% CI= 0.18– 0.91) significantly predicted resumption of postpartum sexual activity and contraceptive uptake.
Conclusion: Reproductive health service providers in the metropolis should highlight the return to fertility and timing of sexual intercourse after delivery, and adopt strategies to demystify the fear of side effects during counselling and provision of Family Planning services.
Phylogeny and molecular approach of Lysurus (Phallaceae, Basidiomycota): proposal of Lysurus brachistriatus sp. nov. for the Brazilian Cerrado Biome, and an update of the geographic distribution for the genus
Authors: Barbosa Kairo Dourado , Oliveira Renan Lima , Marinho Paulo , Baseia Iuri Goulart , Cruz Rhudson Henrique Santos Ferreira da
Published: October 2024

In the present study, a new species of Lysurus with distinctive characteristics is reported in areas of the Brazilian Cerrado biome: Lysurus brachistriatus sp. nov. A detailed morphological analysis revealed, for the first time, the presence of four distinct layers in the volva of a species within this genus. Phylogenetic data obtained from the RPB2 genetic region using the primers bRPB2-6F/bRPB2-7.1R revealed a distinct and unexpected grouping, with the new Lysurus species positioned separately from L. cruciatus and L. cruciatus var. nanus, within a clade that also includes L. borealis. All detailed descriptions of the new taxon are accompanied by a map of the collection site, photographs of macroscopic structures taken in the field, and images of microscopic structures observed under optical microscope.
Mantle overturn drove early lunar volcanism and the lunar dynamo during the high intensity epoch
Authors: Nichols Claire , Wade Jon , Stephenson Simon
Published: October 2024

Generation of an apparently long-lived lunar magnetic field is a longstanding controversy. Palaeomagnetic studies provide conflicting evidence for both strong intrinsic fields (> 53 µT)1–6 and null fields7 between 1.92–4.25 billion years (Ga) ago, with crustal magnetic anomalies indicating no presence of an intrinsic magnetic field after 3.9 Ga ago8–11. During the intermittent high intensity epoch (IHIE) 3.16–3.85 Ga ago, we show that samples that have recorded strong fields are exclusively high-Ti basalts which, based on recent high resolution geochronology12, were erupted during < 1% of this time period. The short period over which these samples formed suggests that the dynamo was predominantly inactive, as evidenced by the continuous unmagnetized crater record throughout the IHIE, and intense fields were only generated for short periods of time while the high-Ti basalts erupted. A possible mechanism for generating an intermittent dynamo is mantle overturn, triggered by dense and gravitationally unstable Ti-rich cumulates sinking to the core-mantle boundary (CMB). We model this process, considering how Ti-rich diapirs melt and temporarily increase the core heat flux, resulting in the generation of a magnetic field13. We demonstrate that this mechanism is only feasible if magnetic field generation is coeval with the rapid eruption of high-Ti basalts following melting. Rapid ascent of Ti-rich melts is supported by petrological evidence14 and demonstrates a causal link between lunar dynamo generation and high-Ti eruptions of the mare basalts.
Association between pre-pregnancy body mass index and neonatal outcomes in women undergoing assisted reproductive technology: a retrospective study
Authors: Qian Huili , Wang Yunyun , Bai Caiying , Gao Lina , Liu Xiaoling , Cui Jinrui , Liu Xiaohui , Ding Xiaohua
Published: October 2024

Objective: ART and pre-pregnancy BMI are strongly associated with neonatal outcomes, but there are fewer relevant studies. Our objective was to analyze the association between pre-pregnancy body mass index (BMI) and neonatal outcomes in women planning assisted reproductive technology (ART).

Methods: This was a retrospective study that included 994 ART singleton mothers who delivered in hospitals from July 2020 to June 2024. Mothers were categorized into 4 groups based on BMI (kg/m2): underweight (<18.5), normal weight (18.5-23.9, reference), overweight (24.0–27.9), and obesity (≥28.0). Associations between BMI classification and neonatal outcomes were analyzed using univariate and multivariate logistic regression.
Results: Among all mothers, pre-pregnancy underweight increased the adjusted odds ratio (aOR) for small for gestational age (SGA) to 3.97-fold compared to normal-weight mothers; overweight/obesity significantly increased the risk of macrosomia and large for gestational age (LGA), with aORs of 5.047 and 2.935-fold, respectively. In gestational weight gain (GWG) subgroup analyses, when GWG was adequate, pre-pregnancy underweight mothers were more likely to develop SGA than normal-weight mothers (aOR 4.649, 95% CI: 1.316-16.426), and overweight/obese mothers were not associated with adverse neonatal outcomes. When GWG was excessive, pre-pregnancy underweight mothers were 3.986 times more likely to be at risk of developing SGA than normal-weight mothers; pre-pregnancy overweight/obese mothers were 4.466 and 3.010 times more likely to develop macrosomia and LGA, respectively, compared to normal-weight mothers.
Conclusion: Maternal preconception underweight is associated with SGA regardless of whether GWG is adequate or excessive. For pre-pregnancy overweight or obese mothers, maintaining GWG in the target range can reduce the risk of adverse neonatal outcomes; if GWG is excessive, it is associated with macrosomia and LGA.