bluuebunny/crossref_metadata_2025_split huggingface dataset:
Food order affects blood glucose and insulin levels in women with gestational diabetes
Authors: Murugesan Ria , Kumar Janardanan , Thiruselvam Shubhashree , Leela Kakithakara Vajravelu , Geetha K. , Satheesan Abhishek , Chaithanya Venkata , Angelin Matcha 
Published: December 2024

BackgroundGestational diabetes mellitus (GDM) poses significant risks to both maternal and fetal health, including a heightened risk of developing type 2 diabetes (T2DM) in the future. Effective management often involves dietary changes, such as food-order, where vegetables are consumed first, followed by proteins, and then carbohydrates last. This study investigates whether food sequence improves glycemic control in women with GDM by slowing carbohydrate absorption, reducing glucose spikes, and enhancing insulin sensitivity.MethodsTwenty-five women with GDM participated in a four-week trial with three phases: baseline measurement (week 0), phase 1 (regular diet), and phase 2 (food-order) intervention. Primary outcomes were blood glucose and serum insulin levels, measured at fasting, 1-h, and 2-h postprandial intervals during each phase. In phase 1 (weeks 0–2), participants followed their usual diet. In phase 2 (weeks 2–4), the same participants followed a food-order regimen: vegetables first, then proteins, and carbohydrates last. Customized meal plans for vegetarians and non-vegetarians were provided. Participants were monitored via a mobile application (Jotform) for adherence. Follow-up blood glucose and insulin were measured before, and 60 and 120 min after, consuming a standardized meal (339 kcal, 16.4 g protein, 56.1 g carbohydrates, 3.4 g fat) in the clinic.ResultsThe food-order intervention resulted in a significant reduction in postprandial blood glucose by 5.87% (p = 0.001) at 60 min and 6.06% (p = 0.001) at 120 min. Also, Serum insulin levels decreased by 8.13% (p = 0.001) at 60 min and 11.10% (p = 0.001) at 120 min, compared to the regular diet. These results suggest improved metabolic control and insulin sensitivity.ConclusionPrioritizing vegetables before protein and carbohydrates improves glycemic control and insulin sensitivity in women with GDM. This simple strategy helps regulate blood glucose and may reduce the long-term risk of T2DM. It offers a practical approach to managing GDM, but further research with larger cohorts and longer interventions is needed to assess its long-term effects.Clinical trial registrationhttps://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&amp;compid=19&amp;EncHid=81473.12293, identifier CTRI/2024/01/061220.
Left ventricular global longitudinal strain in patients treated with immune checkpoint inhibitors
Authors: Celebi Coskun Ece , Coskun Alper , Sahin Ahmet Bilgehan , Levent Fatih , Coban Eyup , Koca Fatih , Sali Seda , Demir Omer Furkan , Deligonul Adem , Tenekecioglu Erhan , Cubukcu Erdem , Evrensel Turkkan , Vatansever Agca Fahriye 
Published: December 2024

BackgroundImmune checkpoint inhibitors (ICI) are generally associated with rare cardiac side effects, yet instances like myocarditis can be fatal. Therefore, detecting and managing left ventricular dysfunction early in ICI therapy is vital.ObjectivesThis study aims to evaluate whether left ventricular global longitudinal strain (LV GLS) is a predictor for early detection of cardiac dysfunction in patients receving ICI.MethodsThis retrospective cohort study included 44 cancer patients who received ICI therapy and underwent pre- and post- treatment assessments of left ventricular ejection fraction (LVEF) and LV GLS between May 2022 and November 2023. Retrospective comparisons and evaluations were conducted on pre-treatment and 3-month interval LVEF and LV GLS measurements during the first year of treatment.ResultsThe median follow-up duration was 5.3 months (0.5-18.9). No statistically significant difference between baseline and subsequent time points was observed in LVEF and LV GLS values (p&gt;0.05). At the 3-month evaluation, a notable decrease in LVEF and LV GLS was observed in two patients. One patient with reduced LVEF and LV GLS succumbed to myocarditis, and another experienced sudden death of unknown etiology. The other two patients had decreased LV GLS with normal LVEF. Subsequent follow-ups of the patients exhibiting decreased LV GLS alone revealed no further decline in LVEF or LV GLS.ConclusionIn our study, a reduction in LV GLS did not demonstrate a significant role in the early prediction of ICI-related myocarditis or cardiac dysfunction. Further validation through multicenter, large-scale, prospective studies with extended follow-up periods is needed to confirm these findings.
Panel containing three serum microRNAs: a promising biomarker for early detection of bladder cancer
Authors: Ge Zhenjian , Lin Shengjie , Lu Chong , Xia Yong , Li Rongkang , Li Xinji , Sun Chen , Wen Zhenyu , Chen Wenkang , Li Yingqi , Li Mingyang , Lin Yu , Dong Jing , Tao Lingzhi , Ji Ling , Lai Yongqing 
Published: December 2024

BackgroundBladder cancer (BC) is a common tumor worldwide. Screening for BC currently lacks a highly efficient, non-invasive, and inexpensive method. Serum microRNA (miRNA), which is stable and commonly present, has the potential to serve as a novel marker for BC diagnosis.Materials &amp; methodsBased on a study involving 112 BC patients and 112 healthy subjects, we conducted this research in three phases to identify applicable microRNAs (miRNAs) in serum for BC diagnosis using quantitative reverse transcription polymerase chain reaction (qRT-PCR). A panel with optimal diagnostic value was developed. Additionally, we used bioinformatic analysis to explore the potential biological functions of the crucial miRNAs.ResultsThe diagnostic panel consisted of miR-212-3p, miR-30c-5p, and miR-206, with an area under the curve (AUC) of 0.838, sensitivity of 83.33%, and specificity of 73.81%. Furthermore, ATF3, GJA1, JPH2, MVB12B, RUNX1T1, SLC8A1, SPATA6, and TPM3 may be potential target genes of these three miRNAs.ConclusionWe developed a three-miRNA panel that could serve as a highly efficient and inexpensive biomarker for BC diagnosis and screening.
Multiple sarcomatoid carcinoma of the small intestine with perforation as the initial symptom: case report and review of the literature
Authors: Fu Jixin , Kong Qingbin , Sui Xin , Wang Xinjian 
Published: December 2024

BackgroundSarcomatoid carcinoma of the small bowel is an exceedingly rare gastrointestinal tumor characterized by a biphasic cellular pattern of epithelioid and mesenchymal-like cells. Due to its rarity and non-specific clinical presentation, it is frequently misdiagnosed, and there is a lack of standardized management guidelines. We report a case of multiple sarcomatoid carcinoma of the small intestine, presenting initially with gastrointestinal perforation. Additionally, we conducted a comprehensive review and analysis of the clinical manifestations, immunohistological characteristics, and prognostic factors associated with small intestinal sarcomatoid carcinoma, aiming to enhance diagnostic accuracy and therapeutic strategies for this rare malignancy.Case presentationAn 82-year-old man was admitted with a 1-week history of abdominal pain, exacerbated by the onset of fever in the last 24 hours. Abdominal CT revealed thickening of the small intestinal wall and free gas within the mesenteric space, indicating gastrointestinal perforation. Emergency surgery identified multiple tumors in the small intestine, accompanied by perforation. Postoperative pathology confirmed the diagnosis of sarcomatoid carcinoma of the small intestine.ConclusionWe report a rare case of sarcomatoid carcinoma of the small intestine and conduct a thorough literature review to offer new insights into its diagnosis, treatment, and prognosis. This highly malignant tumor, predominantly found in the jejunum and ileum, is characterized by high recurrence and metastasis rates, leading to a poor prognosis. Notably, postoperative radiotherapy does not improve outcomes. Abdominal CT is highly sensitive for detecting small bowel tumors but cannot confirm SCA due to its nonspecific imaging features. In contrast, small enteroscopy or capsule endoscopy offers greater diagnostic clarity. Increased awareness among clinicians is crucial for early detection and intervention.
Clinical and ultrasound features of fibrous pseudotumor of tunica vaginalis of the testis: eight cases and literature review
Authors: Yang Jiali , Chen Hongyan , Yan Hualin , Zhang Yue , Liu Juxian 
Published: December 2024

ObjectiveTo investigate the clinical and ultrasound features of fibrous pseudotumor of tunica vaginalis of the testisMethodsThe clinical and ultrasound features of fibrous pseudotumor of the tunica vaginalis diagnosed by pathology in West China Hospital of Sichuan University from 2006 to 2023 were retrospectively analyzed.ResultsThe study included 8 patients diagnosed with fibrous pseudotumor of the tunica vaginalis. The average age was 51.8 ± 17 years(range:25 to 80 years). Painless nodules or masses were present in 87.5% of cases, while 12.5% presented with painless scrotal enlargement. Ultrasound findings were as follows: Lesions were nodular in 7 cases and diffuse in 1 case (left side 50%, right side 50%). 75% involved the tunica vaginalis wall; 25% involved the epididymis with concurrent epididymitis. The tunica vaginalis wall on the affected side was significantly thicker than the contralateral side (4.58 ± 2.19 mm vs. 2.59 ± 0.48 mm, P=0.012). Hydrocele was present in 62.5% of the affected cases, poor sound transmission was noted in 62.5%, and septation was observed in 12.5%. 62.5% of cases exhibited multiple small solid nodules, with a maximum diameter ranging from 8∼19 mm. Nodules were well-circumscribed, regularly shaped and isoechoic or slightly hyperechoic. In 37.5% of cases, adjacent nodules were fused and 37.5% exhibited posterior attenuation. Punctate calcifications were present in 25% of cases. There is usually less blood flow in the lesion.ConclusionThis study demonstrates that fibrous pseudotumor of the tunica vaginalis is a rare scrotal disease affecting primarily middle-aged and elderly men. It typically presents unilaterally and carries a favorable prognosis following surgical treatment. Ultrasound commonly reveals multiple slightly hyperechoic or isoechoic solid nodules with ipsilateral thickening of the tunica vaginalis wall. In some cases, nodules may involve the epididymis, with associated epididymitis, fusion of adjacent nodules, occasional calcification, and posterior echo attenuation. Most lesions exhibit poor blood flow, and hydrocele is frequently present on the affected side. The distinct clinical and ultrasound features of the disease make non-radiative ultrasound imaging an effective tool for rapid detection, differential diagnosis, and guidance for appropriate clinical treatment.
PGD2/PTGDR2 signaling pathway affects the self-renewal capacity of gastric cancer stem cells by regulating ATG4B ubiquitination
Authors: Zhang Qiang , Tian HengJin , Ge Kunpeng , Wang FeiFan , Gao PeiYao , Chen AMin , Wang Lulu , Zhao YanMing , Lian Chaoqun , Wang FengChao 
Published: December 2024

BackgroundProstaglandin D2 (PGD2) inhibits the development of different malignant tumors; however, the underlying mechanism of inhibiting tumor development is not yet clear. This study aimed to elucidate how PGD2 inhibits the stemness of gastric cancer stem cells (GCSCs) via autophagy and its underlying molecular mechanism to provide a theoretical basis for the treatment of gastric cancer.MethodsIn this study, GCSCs were enriched in vitro by serum-free incubation. Furthermore, the effects of PGD2 and PGD2 receptor (PTGDR2) on autophagy were detected by Western blotting, immunofluorescence analysis, and transmission electron microscopy. Moreover, the ATG4B ubiquitination levels were assessed via immunoprecipitation and other methods.ResultsThe results indicated that PGD2 induced LC3I/LC3II conversion in GCSCs to activate autophagy, while PGD2 promoted the expression of PTGDR2, thereby further activating autophagy. Furthermore, PTGDR2 competes with ATG4B for binding with E3 ligase RNF5 (also known as RMA1) to promote autophagy protein ATG4B expression. Moreover, PTGDR2 knockdown blocked the activation of autophagy by PGD2 and the level of ATG4B ubiquitination in GCSCs.ConclusionsIn summary, it was elucidated that the PGD2/PTGDR2 signaling cascade affects GCSCs stemness by regulating autophagy, suggesting that the PGD2/PTGDR2 signaling pathway could serve as a novel target for cancer therapy.
Hepatic arterial infusion chemotherapy combined with lenvatinib and PD-1 inhibitors versus lenvatinib and PD-1 inhibitors for unresectable HCC: a meta-analysis
Authors: Wei Min , Zhang Pengwei , Yang Chaofeng , Li Yang 
Published: December 2024

ObjectivesThis study aimed to evaluate the effectiveness of combining hepatic arterial infusion chemotherapy (HAIC) with lenvatinib and programmed cell death protein 1 (PD-1) inhibitors in the treatment of advanced, unresectable hepatocellular carcinoma (HCC).MethodsA comprehensive search across multiple databases was conducted to identify relevant studies published up to May 2024. This search focused on clinical trials investigating the combination of HAIC with lenvatinib and PD-1 inhibitors for the treatment of advanced HCC. Data from these trials were analyzed using either fixed-effects or random-effects models, with results reported as hazard ratios (HRs) or risk ratios (RRs) with 95% confidence intervals (CIs). To evaluate the robustness of the findings, trial sequential analysis was employed.ResultsA total of 8 cohort studies encompassing 1073 patients with unresectable HCC were included. Compared with other treatment regimens, the combined use of HAIC, lenvatinib, and PD-1 inhibitors significantly improved overall survival (OS) (HR=0.53 [95% CI 0.45, 0.63], P&lt;0.00001), progression-free survival (PFS) (HR 0.56 [95% CI 0.46, 0.61], P&lt;0.0001), the objective response rate (ORR) (RR=1.82 [95% CI 1.52, 2.18], P&lt;0.00001), and the disease control rate (DCR) (RR=1.24 [95% CI 1.16, 1.33], P&lt;0.00001). Trial sequential analysis (TSA) results indicated that the existing data were sufficient for making quantitative conclusions about the ORR and DCR.ConclusionCombining HAIC with lenvatinib and PD-1 inhibitors enhances the effectiveness of treatment for unresectable HCC. This approach is particularly beneficial for patients who have a high tumor burden or those who are refractory to transarterial chemoembolization (TACE), providing a more effective solution for these challenging cases.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024575853, identifier CRD42024575853.
Case report: Aggressive NSCLC with partial BRG-1 deficiency and KRAS G12C mutation: a case study and treatment challenges
Authors: Jin Chengwei , Ge Hong , Hou Dongsheng , Li Jing , Tan Mingming 
Published: December 2024

BackgroundSMARCA4-deficient (BRG-1 deficient) primary thoracic tumors are rare aggressive malignancies associated with poor prognosis. While complete BRG-1 loss is well-documented, the clinical implications of partial BRG-1 deficiency remain unclear. This case report explores a case of mixed lung cancer with partial BRG-1 deficiency and KRAS G12C mutation, highlighting its clinical relevance, treatment challenges, and the importance of comprehensive molecular profiling.MethodsWe performed immunohistochemistry, next-generation sequencing, and PD-L1 expression analysis to characterize the tumor. Treatment included surgical resection, chemotherapy, and immunotherapy.Case presentationWe present a case of early-stage mixed lung cancer with partial BRG-1 deficiency in a 66-year-old male, treated with surgical resection, chemotherapy, and later, a PD-1 inhibitor. Despite aggressive treatment, rapid progression to brain metastasis was observed, underscoring the need for tailored approaches.ConclusionPartial BRG-1 deficiency may lead to aggressive clinical behavior, similar to complete BRG-1 loss. This case emphasizes the importance of comprehensive molecular profiling to guide treatment decisions and suggests further investigation into combined therapeutic strategies, including immunotherapy.
Prediction of prognosis, immunogenicity and efficacy of immunotherapy based on cholesterol metabolism in gastric cancer
Authors: Zhu Chengjun , Yan Mengpei , Zhang Zhijun , Shen Yikai , Wang Wangwen , Chen Zetian , Cai Changsheng , Liu Hongda , Xu Zekuan , Li Zheng 
Published: December 2024

BackgroundCholesterol metabolism plays a crucial role in tumor progression and immune response modulation. However, the precise connection between cholesterol metabolism-related genes (CMRGs) and their implications for clinical prognosis, the tumor microenvironment (TME), and the outcomes of immunotherapy in gastric cancer remains to be fully elucidated.MethodsTranscriptome data and related clinical information from 675 gastric cancer patients were downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. A total of 50 cholesterol metabolism-related genes (CMRGs) were identified from the Kyoto Encyclopedia of Genes and Genomes (KEGG, hsa04979). Consensus clustering analysis was used to classify patients into distinct molecular subgroups, while principal component analysis (PCA) was applied to develop a prognostic scoring system for predicting survival and immunotherapy response. The scoring system was validated using three independent cohorts of gastric cancer patients.ResultsBased on 49 CMRGs, 675 gastric cancer patients were categorized into three distinct subgroups with varying prognoses, tumor microenvironment features, and clinical characteristics. Further differential gene analysis and consensus clustering identified two additional subgroups. The prognostic scoring system developed through PCA demonstrated that the high-score subgroup had significantly improved survival, higher tumor mutational burden (TMB), and microsatellite instability (MSI), as well as a greater number of mutated genes, indicating greater sensitivity to immunotherapy. This system was validated in a real-world cohort undergoing immunotherapy. Additionally, the correlation between GPC3 expression and cholesterol levels was confirmed, highlighting GPC3’s potential biological role.ConclusionThis study highlights the importance of CMRGs in gastric cancer, deepens our understanding of the tumor immune microenvironment, and guides individualized immunotherapy.
Clinical, laboratory, and orbital imaging features of giant cell arteritis in comparison to non-arteritic anterior ischemic optic neuropath: a single center case series
Authors: Eldaya Rami W. , Yeh Yi-Hsien , Stunkel Leanne , Parsons Matthew S. , Van Stavern Gregory P. 
Published: December 2024

BackgroundGiant cell arteritis (GCA) is the most common vasculitis in patients older than 50 years and is considered a “do not miss” diagnosis. However, it remains a diagnostic challenge given overlapping clinical syndromes such as non-arteritic anterior ischemic optic neuropathy (NAION) and poorly explored imaging findings.Materials and methodsIn this retrospective study between the time period of January 2013 and December 2021, a total of 13 consecutive patients with a pathological diagnosis of GCA and 8 patients with clinical diagnosis of NAION were isolated. Demographic and clinical data for each patient were collected, including pertinent laboratory data. Pertinent physical exam data was also collected, including fundoscopic exam and visual acuity. Two neuroradiologist assessed the orbital MRI imaging findings of GCA and NAION for the presence and characterization of imaging abnormalities. Assessment for potential relationship between GCA orbital findings, laboratory and visual outcomes was performed. Finally, comparison between GCA and NAION imaging findings was performed.Results13 GCA patients were assessed. 9 patients had abnormal orbital findings. Of these 8 patients had bilateral orbital involvement The most common imaging findings was perineuritis of the optic nerve sheath, present in 7 patients. In total, 8 NAION patients were assessed. All patients demonstrate optic nerve involvement. The Snellen test was converted to logmar, and visual acuity was assessed for both NAION and GCA for each eye at diagnosis and at the last follow-up. There was no statistical significance for either eye for both GCA and NAION at initial diagnosis and final follow-up. In the 4 GCA patients with normal MRI findings and 9 GCA patients with abnormal MRI findings, there was no statistical significance between initial presentation and final follow-up visual acuity.ConclusionGCA and NAION are potentially overlapping clinical syndromes with different treatment approach and poorly explored imaging findings. Our case series assesses the orbital imaging findings of both syndromes while noting different imaging pattern of both on MRI, which can serve as a potential tool to aid in diagnosis of both.
Reforming early intervention for premature infants: insights into integrated nursing and medical care in Western China
Authors: Zhou Meicen , Lin Xin , Luo Huan , Liu Haiting , Wang Shaopu , Wang Hua , Mu Dezhi 
Published: December 2024

BackgroundPremature births has imposed substantial burdens on medical resources. Consequently, a specialized team was established and a model focused on early intervention, namely the Delivery Room Intensive Care Unit (DICU) emphasizing “care, support, and treatment” was introduced and its impact on the morbidity and mortality outcomes of newborns was assessed. Additionally, we aimed to develop a nomogram model for predicting the risk of intraventricular hemorrhage (IVH) in preterm infants.MethodsA retrospective study involving 2,788 infants was conducted to compare the characteristics and outcomes of infants admitted following the transition from the previous “neonatal intensive care unit (NICU)-centered” approach to the current early “care, support, and treatment” model. Clinical and laboratory data were recorded from birth until their discharge. The primary outcome was IVH, with additional evaluation of mortality and morbidities related to the neurological, respiratory, circulatory, and digestive systems.ResultsThe DICU approach significantly declined the incidence of IVH [OR: 0.16, 95% CrI (0.11,0.23)], hypothermia [OR: 0.33, 95% CrI (0.21,0.50)], apnea [OR: 0.60, 95% CrI (0.47,0.75)], perinatal respiratory diseases [OR: 0.63, 95% CrI (0.52,0.75)] and metabolic acidosis [OR: 0.24, 95% CrI (0.16,0.34)]. Five predictors were selected: DICU exposure, gestational age, birth weight, ventilation mode within seven days, and ibuprofen use (d). The model built by these predictors displayed good prediction ability with the area under the ROC curve of 0.793 in the training set and 0.803 in the validation set.ConclusionsThe standardized DICU model had significantly reduced the incidences of morbidities. The risk nomogram is useful for prediction of IVH risk in eligible infants, with a high accuracy, sensitivity, consistency, and practicability. This study emphasizes the shift in early intervention concepts and team collaboration sets “neonatologists, neonatal nurse practitioners, and respiratory therapists”, which advocates for standardized decision-making for treatment from the delivery room to improve the success rate of resuscitation and enhance the prognosis of these infants.