bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrated multi-level omics profiling of disulfidptosis identifis SPAG4 as an innovative immunotherapeutic target in glioblastoma
Authors: Chen Shenbo , Zeng Man , Chen Taixue , Ding Hui , Lin JiaHan , Ye Fuyue , Wu Ran , Yang Liangwang , Yang Kun 
Published: October 2024

ObjectiveTo investigate the association between disulfidptosis-related genes (DFRGs) and patient prognosis, while concurrently identifying potential therapeutic targets in glioblastoma (GBM).MethodsWe retrieved RNA sequencing data and clinical characteristics of GBM patients from the TCGA database. We found there was a total of 6 distinct clusters in GBM, which was identified by the t-SNE and UMAP dimension reduction analysis. Prognostically significant genes in GBM were identified using the limma package, coupled with univariate Cox regression analysis. Machine learning algorithms were then applied to identify central genes. The CIBERSORT algorithm was utilized to assess the immunological landscape across different GBM subtypes. In vitro and in vivo experiments were conducted to investigate the role of SPAG4 in regulating the proliferation, invasion of GBM, and its effects within the immune microenvironment.Results23 genes, termed DFRGs, were successfully identified, demonstrating substantial potential for establishing a prognostic model for GBM. Single cell analysis revealed a significant correlation between DFRGs and the progression of GBM. Utilizing individual risk scores derived from this model enabled the stratification of patients into two distinct risk groups, revealing significant variations in immune infiltration patterns and responses to immunotherapy. Utilizing the random survival forests algorithm, SPAG4 was identified as the gene with the highest prognostic significance within our model. In vitro studies have elucidated SPAG4’s significant role in GBM pathogenesis, potentially through the regulation of fatty acid metabolism pathways. Our in vivo investigations using a subcutaneous xenograft model have confirmed SPAG4’s influence on tumor growth and its capacity to modulate the immune microenvironment. Advanced research hints that SPAG4 might achieve immune evasion by increasing CD47 expression, consequently reducing phagocytosis.ConclusionsThese findings highlight SPAG4 as a potential GBM therapeutic target and emphasize the complexity of the immune microenvironment in GBM progression.
Efficacy of integrated traditional Chinese and western medicine in managing mild-moderate acute pancreatitis: a real-world clinical perspective analysis
Authors: Jia Sailei , Chen Qian , Liu Xitong , Li Yanhong , Wang Lihui , Li Xian , Hu Shixiang 
Published: October 2024

BackgroundGiven the prevalent utilization of integrated traditional Chinese and western medicine (ITCWM) in the management of acute pancreatitis, the majority of studies have concentrated on severe cases, lacking robust evidence-based medical research. Real-world investigations can provide an objective assessment of the clinical effectiveness of combining traditional Chinese medicine with western medicine. Consequently, relying on real-world research, we intend to evaluate the clinical efficacy and safety of the combined approach in treating mild to moderate acute pancreatitis.MethodsA total of 563 AP patients from Henan Provincial Hospital of Traditional Chinese Medicine were collected from January 2019 to October 2023. A propensity score matching (PSM) analysis was conducted to evaluate the clinical efficacy of traditional Chinese medicine (TCM) in treating mild to moderate acute pancreatitis. Patients were divided into a control group (61 cases) and an integrated traditional Chinese and Western medicine (ITCWM) group (120 cases). To further assess the clinical efficacy of TCM enema in the treatment of mild to moderate acute pancreatitis, PSM analysis was conducted across three groups. The patients were categorized into a control group (n = 49), an oral TCM treatment group (OCM group, n = 274), and an oral TCM plus enema treatment group (OCM+E group, n = 131). Logistic regression was used to analyze factors after treatment in each group, and the Kaplan-Meier method compared symptom duration in each group.ResultsCompared with the control group, the ITCWM group significantly decreased C-reactive protein (CRP, mg/L) (17.8 [1.2–59.5] vs. 8.0 [3.3–33.5], P = 0.022), shortened the duration of abdominal distension, abdominal pain, nausea and bitter taste symptoms (P &lt; 0.05), and shortened the length of hospital stay (median 19.0 and 11.5 days, respectively, P = 0.001); Compared with the other two groups, the neutrophil percentage (NEUT%) was lower (74.1 vs. 61.9 vs. 59.5, P &lt; 0.05) and serum prealbumin (PA, mg/L) was higher (116.0 vs. 184.4 vs. 220.0, P &lt; 0.05), the length of hospitalization (days) was shortened (19.0 vs.12.0 vs.10.0, P &lt; 0.05) in the OCM+E group.ConclusionThe combination of traditional Chinese medicine and modern medicine has been shown to effectively decrease inflammatory indicators in patients with mild to moderate acute pancreatitis, leading to a reduction in symptom duration and hospitalization period, as well as promoting disease recovery. Notably, the use of traditional Chinese medicine in conjunction with enema therapy yields more pronounced benefits.
Comparation of abdominal aortic balloon occlusion versus uterine artery embolization in the treatment of cesarean scar pregnancy
Authors: Rui Tan , Wei He , Huaibo Jing , Han Mou , Cheung Kenneth C. P. , Yang Chai 
Published: October 2024

Study objectiveThis study is to uncover the advantages of abdominal aortic balloon occlusion in the uterine curettage treatment for patients with cesarean scar pregnancy (CSP).MethodsTo retrospectively analyze the clinical data of eighty patients with CSP after treatment in our hospital from 01/10/2019 to 01/05/2021. The 80 patients were divided into 2 groups: 41 patients were treated with abdominal aortic balloon occlusion and the control group (n = 39) underwent Uterine artery embolization (UAE). The amount of bleeding during the operation, the operation time of the uterine curettage, the X-ray fluoroscopy time under DSA, the surface dose in radiation, the length of hospital stay (LOS), and the postoperative complications were compared between these 2 groups (type II and type III).ResultsAll the operations successfully retained the uterus. No balloon-related complications occurred in the experimental group. And in the control group, there were 14 cases of fever and 19 cases of pain after UAE. The fluoroscopy time of experimental group and control group were: (type II: (20.3 ± 7.1)s vs. (593.7 ± 284.5)s, p &lt; 0.01), (type III: (21.2 ± 7.2)s vs. (509.8 ± 164.2)s, p &lt; 0.01), the surface dose in radiation: (type II: (1.9 ± 0.7)mGy vs. (248.3 ± 85.9)mGy, p &lt; 0.01), (type III: (2.1 ± 0.8)mGy vs.(252.0 ± 74.9)mGy, p &lt; 0.01), the amount of bleeding during the operation: (type II:30.0(20.0, 50.0)ml vs. 20.0(10.0, 50.0)ml, p = 0.113), (type III:50.0 (17.5,162.5)ml vs. 50.0 (22.5, 72.5)ml, p = 0.623), the operation time of the uterine curettage:(type II: (54.8 ± 19.4)min vs.(43.9 ± 21.9)min, p = 0.071), (type III: (65.2 ± 50.4)min vs.(52.8 ± 20.1)min, p = 0.426), LOS: (type II:(5.4 ± 1.7)d vs.(5.4 ± 1.2)d, p = 0.816), (type III:(5.8 ± 2.4)d vs. (7.0 ± 1.7)d, p = 0.161). The follow-up was more than 3 months. No adverse reaction in the experimental group and 6 patients in the control group presented menstrual volume decrease.ConclusionNo balloon-related complications occurred in the abdominal aortic balloon occlusion and lower radiation exposure for both the operator and patient. And both abdominal aortic balloon occlusion and UAE can effectively reduce the bleeding during uterine curettage in patients with type II and III CSP.
A randomized control trial evaluating the advice of a physiological-model/digital twin-based decision support system on mechanical ventilation in patients with acute respiratory distress syndrome
Authors: Patel Brijesh V. , Mumby Sharon , Johnson Nicholas , Handslip Rhodri , Patel Sunil , Lee Teresa , Andersen Martin S. , Falaschetti Emanuela , Adcock Ian M. , McAuley Danny F. , Takata Masao , Staudinger Thomas , Karbing Dan S. , Jabaudon Matthieu , Schellongowski Peter , Rees Stephen E. ,   On behalf of the DeVENT Study Group
Published: October 2024

BackgroundAcute respiratory distress syndrome (ARDS) is highly heterogeneous, both in its clinical presentation and in the patient’s physiological responses to changes in mechanical ventilator settings, such as PEEP. This study investigates the clinical efficacy of a physiological model-based ventilatory decision support system (DSS) to personalize ventilator therapy in ARDS patients.MethodsThis international, multicenter, randomized, open-label study enrolled patients with ARDS during the COVID-19 pandemic. Patients were randomized to either receive active advice from the DSS (intervention) or standard care without DSS advice (control). The primary outcome was to detect a reduction in average driving pressure between groups. Secondary outcomes included several clinically relevant measures of respiratory physiology, ventilator-free days, time from control mode to support mode, number of changes in ventilator settings per day, percentage of time in control and support mode ventilation, ventilation- and device-related adverse events, and the number of times the advice was followed.ResultsA total of 95 patients were randomized in this study. The DSS showed no significant effect on average driving pressure between groups. However, patients in the intervention arm had a statistically improved oxygenation index when in support mode ventilation (−1.41, 95% CI: −2.76, −0.08; p = 0.0370). Additionally, the ventilatory ratio significantly improved in the intervention arm for patients in control mode ventilation (−0.63, 95% CI: −1.08, −0.17, p = 0.0068). The application of the DSS led to a significantly increased number of ventilator changes for pressure settings and respiratory frequency.ConclusionThe use of a physiological model-based decision support system for providing advice on mechanical ventilation in patients with COVID-19 and non-COVID-19 ARDS showed no significant difference in driving pressure as a primary outcome measure. However, the application of approximately 60% of the DSS advice led to improvements in the patient’s physiological state.Clinical trial registrationclinicaltrials.gov, NCT04115709.
Efficacy of non-invasive brain stimulation for post-stroke sleep disorders: a systematic review and meta-analysis
Authors: Huang Linyu , Zhang Xingling , Zhang Jie , Li Long , Zhou Xianyu , Yang Tingyu , An Xuemei 
Published: October 2024

ObjectiveThis study aimed to systematically assess the clinical efficacy of non-invasive brain stimulation (NIBS) for treating post-stroke sleep disorders (PSSD).MethodsWe conducted thorough literature search across multiple databases, including PubMed, Web of Science, EmBase, Cochrane Library, Scopus, China Biology Medicine (CBM); China National Knowledge Infrastructure (CNKI); Technology Periodical Database (VIP), and Wanfang Database, focusing on RCTs examining NIBS for PSSD. Meta-analyses were performed using RevMan 5.4 and Stata 14.ResultsEighteen articles were reviewed, including 16 on repetitive Transcranial Magnetic Stimulation (rTMS), one on Theta Burst Stimulation (TBS), and two on transcranial Direct Current Stimulation (tDCS). Meta-analysis results indicated that rTMS within NIBS significantly improved the Pittsburgh Sleep Quality Index (PSQI) score (MD = −1.85, 95% CI [−2.99, −0.71], p &lt; 0.05), the 17-item Hamilton Depression Rating Scale (HAMD-17) score [MD = −2.85, 95% CI (−3.40, −2.30), p &lt; 0.05], and serum brain-derived neurotrophic factor (BDNF) levels [MD = 4.19, 95% CI (2.70, 5.69), p &lt; 0.05], while reducing the incidence of adverse reactions [RR = 0.36, 95% CI (0.23, 0.55), p &lt; 0.05]. TBS significantly improved the PSQI score in patients with PSSD (p &lt; 0.05). Conversely, tDCS significantly improved the HAMD-17 score in PSSD patients [MD = −1.52, 95% CI (−3.41, −0.64), p &lt; 0.05]. Additionally, rTMS improved sleep parameters, including Stage 2 sleep (S2%) and combined Stage 3 and 4 sleep (S3 + S4%) (p &lt; 0.05), while tDCS improved total sleep time (TST) and sleep efficiency (SE) (p &lt; 0.05).Subgroup analysis results indicated: (1) Both LF-rTMS and HF-rTMS improved PSQI scores (p &lt; 0.05). (2) Both rTMS combined with medication and rTMS alone improved PSQI scores (p &lt; 0.05). Compared to the sham/blank group, the rTMS group showed improvements in SE, sleep latency (SL), S1%, S3 + S4%, and REM sleep (REM%). The rTMS combined with medication group showed improved SL compared to the medication-only group (p &lt; 0.05).ConclusionNIBS effectively improves sleep quality, structure, depression levels, and BDNF levels in PSSD patients, while also being safe. Further investigations into the potential of NIBS in PSSD treatment may provide valuable insights for clinical applications.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, CRD42023485317.
Admission albumin-globulin ratio associated with delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage
Authors: Guo Xiumei , Xiong Yu , Gao Wen , Huang Xinyue , Zheng Hanlin , Wu Huiqiang , Jiang Xutang , Lin Qingxin , Xiao Yinfeng , Liu Qiaoling , Pan Zhigang , Chen Chunhui , Hu Weipeng , Stavrinou Pantelis , Liu Aihua , Wang Lingxing , Zheng Feng 
Published: October 2024

BackgroundDespite the widespread use in ischemic stroke, cancer, and malnutrition, the predictive ability of serum albumin to globulin ratio (A/G) among patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) remains unknown. This study aimed to determine if serum A/G ratio is associated with the occurrence of delayed cerebral ischemia (DCI) after aSAH.MethodsWe retrospectively viewed the medical records of aSAH patients from 08/2017 to 08/2022. Serum albumin and globulin laboratory test results were collected within 24 hours after admission. Serum A/G were dichotomized based on whether the DCI occurred. Logistic regression was used to determine the predictors of DCI. The relationship between serum A/G and the occurrence of DCI was analyzed with receiver operating characteristic(ROC) curve.ResultsA total of 363 eligible patients with aSAH were included in the study, among which DCI occurred in 87 patients(23.97%). Serum A/G[OR=2.720, 95%CI (1.190-6.270), P=0.018], non-surgical[OR=0.228, 95%CI (0.065-0.621), P=0.008], lactate dehydrogenase[OR=1.004, 95%CI (1.000-1.008), P=0.029], P[OR=0.354, 95%CI (0.130-0.926), P=0.038], plasma fibrinogen[OR=1.266, 95%CI (1.019-1.583), P=0.035] were associated with the occurrence of DCI. ROC showed that serum A/G, non-surgical, LDH, P, plasma fibrinogen could predict the occurrence of DCI in aSAH patients with values 0.575, 0.560, 0.602, 0.571 and 0.539 for serum A/G, non-surgical, LDH, P, plasma fibrinogen, respectively.ConclusionsIn conclusion, serum A/G levels are correlated with DCI in individuals with aSAH, and high serum A/G levels on admission may be associated with the occurrence of DCI.
Akkermansia muciniphila is associated with normal muscle mass and Eggerthella is related with sarcopenia in cirrhosis
Authors: Efremova Irina , Alieva Aliya , Maslennikov Roman , Poluektova Elena , Zharkova Maria , Kudryavtseva Anna , Krasnov George , Zharikov Yury , Nerestyuk Yaroslav , Karchevskaya Anna , Ivashkin Vladimir 
Published: October 2024

BackgroundSarcopenia and gut dysbiosis are common in cirrhosis. The aim is to study the correlations between the gut microbiota taxa and muscle mass level in cirrhosis.MethodsThe study included 40 cirrhosis patients including 18 patients with sarcopenia. The gut microbiota composition was assessed using amplicon sequencing of the hypervariable V3-V4 regions of the 16S rRNA gene. The skeletal muscle mass, subcutaneous and visceral fat levels were assessed with abdominal computed tomography as skeletal muscle, subcutaneous and visceral fat indices (SMI, SFI and VFI).ResultsPatients with sarcopenia had more relative abundance (RA) of Agathobacter, Anaerostipes, Butyricicoccus, Dorea, Eggerthella, Microbacteriaceae, Veillonella and less RA of Akkermansiaceae, Akkermansia muciniphila, Verrucomicrobiae and Bilophila compared to patients with normal muscle mass. SMI directly correlated with RA of Akkermansia, Alistipes indistinctus, Anaerotruncus, Atopobiaceae, Bacteroides clarus, Bacteroides salyersiae, Barnesiellaceae, Bilophila wadsworthia, Pseudomonadota, Olsenella, and Parabacteroides distasonis, and negatively correlated with RA of Anaerostipes and Eggerthella. Sarcopenia was detected in 20.0% patients whose gut microbiota had Akkermansia but not Eggerthella, and in all the patients, whose gut microbiota had Eggerthella but not Akkermansia. The Akkermansia and Eggerthella abundances were independent determinants of SMI. RA of Akkermansia, Akkermansia muciniphila, Akkermansiaceae, Bacteroides salyersiae, Barnesiella, Bilophila, Desulfobacterota, Verrucomicrobiota and other taxa correlated positively and RA of Anaerovoracaceae, Elusimicrobiaceae, Elusimicrobium, Kiritimatiellae, Spirochaetota, and other taxa correlated negatively with the SFI. RA of Alistripes, Romboutsia, Succinivibrio, and Succinivibrionaceae correlated positively and RA of Bacteroides thetaiotaomicron correlated negatively with VFI.ConclusionThe muscle mass level in cirrhosis correlates with the abundance of several gut microbiota taxa, of which Akkermansia and Eggerthella seems to be the most important.
Effect of malnutrition at admission on length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia: prospective cohort study
Authors: Gebregziabher Zewdu , Nane Debritu , Dake Samson Kastro , Handiso Yoseph Halala 
Published: October 2024

BackgroundMalnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Even though malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical in patients in Ethiopia while nutritional assessment is also often a neglected component of the health service practice.ObjectiveThis study aims to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022.MethodsA facility-based prospective cohort study was conducted among 398 admitted surgical adult patients. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 h within 48 h after admission (SGA). Data were collected by open data kit (ODK) version 2022.3.3 software while Stata version 14.1 software was employed for statistical analysis. Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusted for several potential confounders taken at admission. Adjusted hazard ratio (HR) with 95% confidence interval was used to show the effect of malnutrition.ResultsThe prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59–69%) according to subjective global assessment (SGA) classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11–13) as compared to well-nourished patients (8 days: 95% CI: 8–9), which means adult surgical patients who were malnourished at admission were at a higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29–0.47) as compared to well-nourished patients. The presence of comorbidity (AHR: 0.68, 95% CI: 0.50–90), poly medication (AHR: 0.69, 95% CI: 0.55–0.86), and history of admission (AHR: 0.70, 95% CI: 0.55–0.87) within the previous 5 years were found to be the significant covariates of LOS.ConclusionThe magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, poly medication, and history of admission were found to be the significant covariates of LOS. All stakeholders should pay attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.
A systematic review of surgical and interventional radiology procedures for pediatric idiopathic intracranial hypertension
Authors: Friso Sofia , Giacobbo Vittoria , Toscano Luca Mattia , Baldo Beatrice , Guariento Chiara , Lacarra Fabrizio , Pin Jacopo Norberto , Ancona Claudio , Sartori Stefano , Causin Francesco , Toldo Irene 
Published: October 2024

BackgroundIdiopathic intracranial hypertension (IIH) is defined as elevated intracranial pressure and consequent symptoms (mainly headache and visual deterioration) occurring in the absence of secondary causes. Surgical and interventional radiology procedures should be considered for refractory IIH and mainly include cerebrospinal fluid (CSF) diversion techniques, optic nerve sheath fenestration (ONSF), and venous sinus stenting (VSS). Our study aims to review the current literature on the application of these techniques in clinical practice.MethodsA systematic literature review on the surgical and interventional radiology treatment of IIH was conducted, focusing on ONSF, VSS, and CSF diversion techniques. According to PRISMA guidelines, all reports published in PubMed in the last 30 years (1993–2023) were considered, and among 722 papers, 48 were included in the present study, resulting in a total study population of 454 children or adolescents (11 months–17 years old).ResultsAmong 454 patients, 193 underwent an invasive approach, divided into CSF diversion (115/193), ONSF (65/193), VSS (11/193), cranial subtemporal decompression (8/193), and internal cranial expansion (9/193). Sixteen of the 193 patients (8%) required reintervention due to relapsing symptoms or surgical complications, particularly those who underwent CSF diversion. Furthermore, 9/115 required shunt revision due to shunt obstruction or malfunction. We extracted data on the outcome of each procedure: of the 193 patients, 71 experienced a positive outcome with symptom resolution or improvement, while 27 demonstrated a negative outcome.Discussion and conclusionsSevere and refractory cases of IIH are eligible for invasive treatments. CSF diversion is the most frequently used technique, despite its high failure risk and need for reintervention. ONSF has shown good results in terms of outcome and safety, particularly in children with visual symptoms. VSS is the most recent approach, indicated in children with stenosis of the venous sinus. In our study population, VSS demonstrated good results in terms of symptom resolution and need for reintervention, but its use remains limited to a few centers.Systematic Review Registrationhttps://www.crd.york.ac.uk/, PROSPERO (CRD42024504244).