bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case Report: A missed diagnosis of cardiac amyloidosis using echocardiography due to immunoglobulin light chain amyloidosis with normal wall thickness in the early stage
Authors: Li Xiaohui , Mu Tongge , Deng Yangxue , Zhang Yu , Ti Yun , Zhang Lei 
Published: December 2024

BackgroundCardiac amyloidosis (CA) is a challenging diagnosis, particularly when the classic signs, such as increased wall thickness in a non-dilated left ventricle (LV), are absent. This makes the diagnosis more difficult in patients with normal LV wall thickness. We present a case of CA without increased wall thickness and without the characteristic granular sparkling echotexture in a non-dilated LV.Case summaryA 50-year-old female patient presented with worsening breathlessness on exertion, paroxysmal nocturnal dyspnea, oliguria, and lower-extremity edema. Electrocardiography showed low voltage in the limb leads and a pseudoinfarction pattern in the anterior leads. The echocardiographic evaluation revealed a non-dilated LV with normal wall thickness, no granular sparkling echotexture of the myocardium, a mildly dilated left atrium, restrictive filling (grade 3 diastolic dysfunction), and pericardial effusion. A follow-up quantitative echocardiographic study 2 weeks later showed a slight increase in LV wall thickness (still within the normal range), decreased global longitudinal strain, and a relative “apical sparing” pattern of longitudinal strain in the apex of the LV. After 1 month, LV wall thickness increased beyond the normal range, and the granular sparkling echotexture became evident. Cardiac amyloidosis was subsequently confirmed by delayed gadolinium enhancement on cardiac magnetic resonance imaging, abnormal serum-free light chain levels, positive serum immunofixation, and an extracardiac biopsy positive for amyloid.DiscussionPatients presenting with normal wall thickness in a non-dilated LV might only be in an early stage of CA. Thus, the diagnosis can be easily overlooked. For smaller individuals, relative wall thickness (RWT) may be a more sensitive indicator for further investigation. In patients presenting with increased RWT, restrictive filling, and pericardial effusion in the absence of other plausible causes, CA should be considered, even in the absence of the classic echocardiographic signs of amyloid deposition. Furthermore, two-dimensional speckle-tracking echocardiography can enhance clinical suspicion of CA and should be recommended as part of the diagnostic workup.
ECPR for cardiac arrest caused by abnormal uterine bleeding and coronary vasospasm: a case report
Authors: Sheng Qiping , Wang Yingjie , Wu Zhiyang , Zhao Xiangyang , Wu Dawei , Li Zhi , Guo Xi 
Published: December 2024

IntroductionCardiac arrest during pregnancy is receiving increasing attention. However, there are few reports on cardiac arrest in nonpregnant women caused by abnormal uterine bleeding (AUB). We report a case in which extracorporeal cardiopulmonary resuscitation (ECPR) was used in a patient with cardiac arrest caused by AUB and coronary vasospasm.Patient presentationA 52-year-old female patient presented to the emergency department because of sudden chest pain, with a history of hypertension, coronary heart disease and AUB for more than half a month. At the initial stage of admission, cardiac arrest occurred after the ECG demonstrated ST-segment elevation in leads II, III and a VF. ECPR was started after traditional cardiopulmonary resuscitation, and coronary angiography was performed with the support of extracorporeal membrane oxygenation (ECMO). The left and right coronary arteries were slender and narrow, which was relieved after the injection of 100 µg nitroglycerine through the left coronary artery. After performing a coronary angiogram, the patient was given long-acting nitrates and calcium channel blockers orally, and her chest pain did not reoccur. The patient was weaned from ECMO support after 4 days.ConclusionThis clinical case highlights the challenges that clinicians face in accurately diagnosing and possibly treating AUB and coronary vasospasm-induced acute myocardial infarction because of its rare occurrence and serious adverse events. ECPR can effectively improve the success rate of cardiopulmonary resuscitation.
The landscape of recurrent spontaneous abortion registered on clinical trials.gov
Authors: Zhou Xiaoling , Lai Fan , Chen Wei , Zhou Congrong , Deng Yi , Wang Tao , Xing Shasha , Diao Haoyang , Tang Mi , Guo Wenmei , Luo Erdan 
Published: December 2024

ObjectiveRecurrent spontaneous abortion (RSA) presents a significant challenge in the field of reproductive medicine, as effective treatments remain limited despite extensive research efforts. A comprehensive understanding of current RSA clinical trials is essential for enhancing trial design and identifying existing research gaps. The aim of this study is to characterize RSA related clinical trials registered on Clinical Trials.gov.MethodsA thorough search was conducted to identify and review clinical trials focusing on RSA that were registered on Clinical Trials.gov up to March2, 2024.ResultsA total of 138 trials were identified in the analysis, with 72 (52.17%) classified as intervention trials and 66 (47.83%) as observational trials. Approximately half of the studies (67,48.55%) had an enrollment of 100 participants or fewer. The majority of trials included only female participants. Asia hosted the highest number of clinical trials (46,33.33%), followed by Europe (36,26.09%), Africa (29,21.01%), America (13,9.42%). The majority of trials (61,44.20%) focused on individuals with unexplained recurrent spontaneous abortion (URSA). The predominant intervention types examined in the reviewed studies were drug interventions (49,62.82%), with a notable rise in behavioral intervention trials.ConclusionOur research findings suggest that existing research efforts in the realm of RSA are inadequate for the progression of prevention and treatment strategies. The majority of clinical trials have primarily targeted individuals with URSA, with a particular emphasis on drug interventions, notably anticoagulants.
Balancing choice and socioeconomic realities: analyzing behavioral and economic factors in social oocyte cryopreservation decisions
Authors: Gonen Limor Dina 
Published: December 2024

PurposeThis research investigates the influence of personal income, the likelihood of pregnancy from cryopreserved oocytes, and the risk of infertility, on the decision-making process of women. The study employs the economic stated preference framework alongside the Theory of Planned Behavior in order to comprehend the process of decision-making.Design/methodology/approachThe data had been collected from women between the ages of 18 and 65 via questionnaire employing conjoint analysis (CA). Through the utilization of this methodology, the factors influencing women’s choices concerning oocyte cryopreservation were quantified.FindingsThe study identified crucial factors that impact the determination to cryopreserve oocytes, such as personal financial resources, the likelihood of achieving a successful pregnancy using frozen oocytes, and the potential for infertility. The analysis reveals that a considerable number of participants perceive cryopreservation as a feasible alternative for augmenting their prospects for future procreation.Research implicationsThe results validate the patterns and the ways in which personal and socioeconomic elements impact choices regarding fertility. This has the potential to inform forthcoming health policies and educational initiatives that aim to provide more comprehensive support for women’s fertility decisions.Social implicationsThe research highlights the necessity of policy and societal support for women who are contemplating oocyte cryopreservation. It is recommended that public health policies incorporate provisions for state financing of cryopreservation in order to safeguard reproductive autonomy and alleviate the fertility risk linked to the aging process.Originality/valueHis research is unique in that it employs the Theory of Planned Behavior and an economic stated-preference framework to analyze the dynamics of oocyte cryopreservation decisions. This work enhances the existing body of literature by drawing attention to the socio-economic persona factors that influence choices regarding fertility preservation.
Exploring the genetic resources of yam in the Democratic Republic of Congo: implications for breeding
Authors: Adejumobi Idris , Adewumi Adeyinka Saburi , Ouattara Fatim , Olatunde Esther , Adheka Joseph , Onautshu Didy , Kayondo Siraj Ismail , Alaba Oluwafemi , Mushoriwa Hapson , Agre Paterne Angelot 
Published: December 2024

IntroductionLandrace accession of yam species in the Democratic Republic of Congo (DRC) represents a valuable genetic resource for yam breeding programs. These accessions possess traits such as stress resilience and desirable food quality attributes that can be introduced into modern yam varieties. By analyzing the genetic diversity, identifying quantitative trait loci (QTLs) linked to key traits, and the genetic merits of these landraces, we can identify promising genetic markers for breeding programs aimed at improving yam production in DRC.Materials and methodsWe analyzed 181 yam accessions from the Democratic Republic of Congo (DRC), representing six species commonly cultivated by farmers and their wild relatives. These accessions were genotyped using 10,621 DArTseq SNP markers and characterized for key productivity and food quality traits.Results and discussionPopulation structure analysis revealed six distinct genetic groups within the yam accessions. Genome-wide association studies (GWAS) identified 14 SNP markers associated with five key traits, suggesting the accessions’ potential as a valuable genetic resource. Further dissection of their genetic merits in yam breeding using the Genomic Prediction of Cross Performance (GPCP) allowed the identification of several accessions with high crossing merit for multiple traits. Genomic Prediction of Cross Performance (GPCP) identified 20 accessions with high crossing merit (&gt;2).ConclusionsThese accessions demonstrate favorable genetic combinations for multiple traits, making them promising progenitors for developing segregating populations with improved characteristics. These findings highlight the potential of these accessions to contribute to genetic improvement in yam breeding programs in the DRC, focusing on traits such as productivity and food quality.
The modulation of immune cell death in connection to microRNAs and natural products
Authors: Chuang Ya-Ting , Yen Ching-Yu , Tang Jen-Yang , Chang Fang-Rong , Tsai Yi-Hong , Wu Kuo-Chuan , Chien Tsu-Ming , Chang Hsueh-Wei 
Published: December 2024

Immunogenic cell death (ICD) spatiotemporally regulates damage-associated molecular patterns (DAMPs) derived from dying cancer cells to signal the immune response. Intriguingly, these DAMPs and cytokines also induce cellular responses in non-immune cells, particularly cancer cells. Several ICD-modulating natural products and miRNAs have been reported to regulate the DAMP, cytokine, and cell death responses, but they lack systemic organization and connection. This review summarizes the impacts of natural products and miRNAs on the DAMP and cytokine responses and cancer cell death responses (apoptosis, autophagy, ferroptosis, necroptosis, and pyroptosis). We establish the rationale that ICD inducers of natural products have modulating effects on miRNAs, targeting DAMPs and cytokines for immune and cancer cell death responses. In conclusion, DAMP, cytokine, and cell death responses are intricately linked in cancer cells, and they are influenced by ICD-modulating natural products and miRNAs.
Recursive partitioning staging system based on the log odds of the negative lymph node/T stage ratio in colon mucinous adenocarcinoma
Authors: Cai Huajun , Zeng Jintao , Wang Ye , Zhuang Jinfu , Liu Xing , Guan Guoxian 
Published: December 2024

BackgroundThis study aimed to investigate the prognostic significance of the log odds of negative lymph nodes/T stage ratio (LONT) and develop an efficient prognostic staging system using LONT in patients with colon mucinous adenocarcinoma (MAC).MethodsThis study included 5,236 patients diagnosed with colon MAC obtained from the Surveillance, Epidemiology, and End Results database. The Kaplan–Meier method, subgroup analysis, receiver operating characteristic (ROC) curve, and Cox proportional hazard regression model were used to determine the clinical outcomes. Recursive partitioning analysis (RPA) was used to develop a novel prognostic system.ResultsThe 1-, 3-, and 5-year ROC curves, used to predict cancer-specific survival (CSS) and overall survival (OS), demonstrated that the areas under the ROC curve for LONT were superior to those of pT, pN, and pTNM stages. Additionally, a lower LONT was correlated with worse clinical outcomes. The LONT classification efficiently differentiated the prognosis of patients in terms of OS and CSS. Multivariate Cox analyses revealed that LONT was an independent prognostic factor for both CSS and OS. Based on the pT stage and LONT, a novel prognostic staging system was developed using RPA, demonstrating a good prognostic predictive performance.ConclusionA lower LONT was associated with worse survival in patients with colon MAC. The pT stage and LONT-based prognostic staging system facilitated risk stratification in these patients.
Targeting CEA in metastatic triple negative breast cancer with image-guided radiation followed by Fab-mediated chimeric antigen receptor (CAR) T-cell therapy
Authors: Aniogo Eric , Kujawski Maciej , Awuah Dennis , Cha Seung E. , Espinosa Ruby , Hui Susanta , Ghimire Hemendra , Yazaki Paul J. , Brown Christine E. , Wang Xiuli , Shively John E. 
Published: December 2024

IntroductionAlthough CAR-T cell therapy has limited efficacy against solid tumors, it has been hypothesized that prior treatment with Image-Guided Radiation Therapy (IGRT) would increase CAR-T cell tumor infiltration, leading to improved antigen specific expansion of CAR-T cells.MethodsTo test this hypothesis in a metastatic triple negative breast cancer (TNBC) model, we engineered two anti-CEA single-chain Fab (scFab) CAR-T cells with signaling domains from CD28zeta and 4-1BBzeta, and tested them in vitro and in vivo.ResultsThe anti-CEA scFab CAR-T cells generated from three different human donors demonstrated robust in vitro expression, expansion, and lysis of only CEA-positive TNBC cells, with the CD28z-CAR-T cells showing the highest cytotoxicity. IFN-γ and granzyme B release assays revealed significantly higher IFN-γ production at a 4:1 effector-to-target (E:T) ratio in CD28z-CAR-T cells compared to 4-1BBz-CAR-T cells. Treatment of CEA-positive TNBC MDA-MB231 xenografts in the mammary fat pads of NSG mice, that produced spontaneous lung metastases over time, resulted in significant tumor growth reduction compared to either therapy alone (p&lt;0.01). Immunohistochemical (IHC) analysis revealed that only combined IGRT and CAR-T therapy resulted in the elimination of lung metastases.DiscussionThese findings demonstrate that the combination of IGRT and anti-CEA scFab CAR-T therapy induces a strong antitumor response, effectively targeting both the primary tumor and distant metastatic lesions in the lungs, thus demonstrating that IGRT enhances CAR-T cell infiltration, persistence, and overall efficacy within both primary and metastatic lesions.
Sex hormone imbalance and rheumatoid arthritis in American men: a cross-sectional analysis from NHANES 2011–2016
Authors: Wen Pengfei , Wang Yidian , Yang Mingyi , Qiao Xincun , Yang Peng , Hu Shouye , Liu Lin , Yang Zhi 
Published: December 2024

BackgroundEmerging evidence suggests that sex hormones, particularly testosterone and sex hormone-binding globulin (SHBG), play a critical role in the pathophysiology of Rheumatoid arthritis (RA). However, the precise relationship between these hormonal factors and RA risk in men remains underexplored.MethodsWe conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. A total of 3,110 male participants were included after excluding those with missing data on testosterone, SHBG, RA, or key covariates. Serum testosterone and SHBG levels were measured, and RA status was determined based on self-reported physician diagnosis. Multivariate logistic regression models were used to assess the association between testosterone, SHBG, and RA. Restricted cubic spline (RCS) regression was applied to explore nonlinear relationships. Subgroup and interaction analyses were performed to assess effect modifications by age, race/ethnicity, body mass index (BMI), hypertension, and poverty-income ratio (PIR).ResultsOf the 3,110 men analyzed, 191 were diagnosed with RA. Low testosterone levels (&lt;300 ng/dL) were significantly associated with increased RA risk (OR = 2.30, 95% CI: 1.65–3.21, p &lt; 0.001), and elevated SHBG levels (&gt;57 nmol/L) were also associated with a higher risk of RA (OR = 1.65, 95% CI: 1.14–2.39, p = 0.008). RCS analysis indicated a nonlinear relationship between testosterone, SHBG, and RA risk, with sharp increases in RA risk at the lower ends of testosterone and SHBG levels. Interaction analyses revealed that age, race/ethnicity, hypertension, and PIR significantly modified the relationship between these hormonal factors and RA, while BMI did not exhibit any significant interaction.ConclusionThis study provides evidence that low testosterone and high SHBG levels are associated with an increased risk of RA in men. These associations are nonlinear and modified by factors such as age, race/ethnicity, hypertension, and PIR. Our findings highlight the importance of considering hormonal status in RA risk assessment and suggest potential avenues for targeted therapeutic strategies aimed at hormonal regulation.
Elevated Galectin-3 levels in the tumor microenvironment of ovarian cancer – implication of ROS mediated suppression of NK cell antitumor response via tumor-associated neutrophils
Authors: Karlsson Veronika , Stål Ebba , Stoopendahl Emma , Ivarsson Anton , Leffler Hakon , Lycke Maria , Sundqvist Martina , Sundfeldt Karin , Christenson Karin , Bernson Elin 
Published: December 2024

IntroductionOvarian cancer is a lethal disease with low survival rates for women diagnosed in advanced stages. Current cancer immunotherapies are not efficient in ovarian cancer, and there is therefore a significant need for novel treatment options. The β-galactoside-binding lectin, Galectin-3, is involved in different immune processes and has been associated with poor outcome in various cancer diagnoses. Here, we investigated how Galectin-3 affects the interaction between natural killer (NK) cells and neutrophils in the tumor microenvironment of ovarian cancer.MethodAscites from the metastatic tumor microenvironment and cyst fluid from the primary tumor site were collected from patients with high-grade serous carcinoma (HGSC) together with peripheral blood samples. Galectin-3 concentration was measured in ascites, cyst fluid and serum or plasma. Neutrophils isolated from HGSC ascites and autologous blood were analyzed to evaluate priming status and production of reactive oxygen species. In vitro co-culture assays with NK cells, neutrophils and K562 target cells (cancer cell line) were conducted to evaluate NK cell viability, degranulation and cytotoxicity.ResultsHigh levels of Galectin-3 were observed in cyst fluid and ascites from patients with HGSC. Neutrophils present in HGSC ascites showed signs of priming; however, the priming status varied greatly among the patient samples. Galectin-3 induced production of reactive oxygen species in ascites neutrophils, but only from a fraction of the patient samples, which is in line with the heterogenous priming status of the ascites neutrophils. In co-cultures with NK cells and K562 target cells, we observed that Galectin-3-induced production of reactive oxygen species in neutrophils resulted in decreased NK cell viability and lowered anti-tumor responses.ConclusionTaken together, our results demonstrate high levels of Galectin-3 in the tumormicroenvironment of HGSC. High levels of Galectin-3 may induce production of reactiveoxygen species in ascites neutrophils in some patients. In turn, reactive oxygen species produced by neutrophils may modulate the NK cell anti-tumor immunity. Together, this study suggests further investigation to evaluate if a Galectin-3-targeting therapy may be used in ovarian cancer.
Hypertensive disorders of pregnancy in Hunan Province, China, 2012–2022
Authors: Zhou Xu , Wu Yinglan , Chen Xiaoying , Jiang Yurong 
Published: December 2024

ObjectiveTo explore the relationship between hypertensive disorders of pregnancy (HDP) and adverse pregnancy outcomes and explore the risk factors for HDP.MethodsData were obtained from the Maternal Near-Miss Surveillance System in Hunan Province, China, 2012–2022. Chi-square trend tests (χ2trend) were used to determine trends in prevalence by year. Unadjusted odds ratios (uORs) were used to examine the association between HDP and adverse pregnancy outcomes. Multivariate logistic regression analysis (method: Forward, Wald, α = 0.05) and adjusted odds ratios (aORs) were used to identify risk factors for HDP.ResultsOur study included 780,359 pregnant women, and 38,397 women with HDP were identified, with a prevalence of 4.92% (95% CI 4.87–4.97). The prevalence of preeclampsia-eclampsia, gestational hypertension, chronic hypertension, and chronic hypertension with superimposed preeclampsia was 2.28% (95% CI 2.25–2.31), 2.04% (95% CI 2.00–2.07), 0.43% (95% CI 0.41–0.44), and 0.18% (95% CI 0.17–0.19), respectively. From 2012 to 2022, the prevalence of HDP increased from 3.11 to 7.39%, showing an upward trend (χ2trend = 2220.88, p &lt; 0.01). HDP was associated with the following adverse pregnancy outcomes: maternal deaths (uOR =4.05), maternal near-miss (uOR =6.37), preterm birth (uOR =2.51), stillbirth and neonatal death (uOR =1.45), low birthweight (uOR =4.37), abruptio placentae (uOR =4.45), uterine atony (uOR =1.49), retained placenta (uOR =1.54), puerperal infections (uOR =2.14), abdominal surgical site infections (uOR =2.50), urinary tract infections (uOR =1.60), upper respiratory tract infections (uOR =1.75), heart disease (uOR =2.76), embolism (uOR =2.66), liver disease (uOR =1.25), anemia (uOR =1.38), diabetes mellitus (uOR =2.35), renal disease (uOR =4.66), and pulmonary disease (uOR =4.70, p &lt; 0.05). Results of multivariate logistic regression analysis showed risk factors for HDP: maternal age &gt; 30 years (aOR &gt; 1, p &lt; 0.05), gravidity &gt; = 4 (aOR =1.10, 95% CI 1.05–1.14), primipara (aOR &gt; 1, p &lt; 0.05), and previous cesarean sections (aOR =1.27, 95% CI 1.24–1.31).ConclusionThe prevalence of HDP was relatively high in Hunan Province. HDP was associated with many adverse pregnancy outcomes. Advanced maternal age, high gravidity, primipara, and previous cesarean section were risk factors for HDP.