bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defective proviruses significantly impact viral transcription and immune activation in men and women with HIV-1 subtype C in rural South Africa
Authors: Buchholtz Ninée V. E. J. , Hermans Lucas E. , Umunnakwe Chijioke N. , Nühn Marieke M. , Voss Regina , Need Emma , Kootstra Neeltje A. , Maurer Irma , de Jong Dorien C. M. , Symons Jori , Tempelman Hugo A. , Wensing Annemarie M. J. , Nijhuis Monique 
Published: November 2024

IntroductionThe main obstacle to achieving an HIV-1 cure is the proviral reservoir. To promote equity in HIV cure strategies, it is crucial to study the viral reservoir of the predominant HIV-1 subtype C in both women and men. Therefore, we investigated the dynamics of the (intact) viral reservoir in relation to plasma viral load (VL), CD4+ T cell count, and immune activation before and during 96 weeks of successful antiretroviral therapy (ART).MethodsEighty-two participants (62% female) newly initiating ART in a rural clinic in South Africa were included in the study. Blood samples were collected at baseline, week 48, and week 96, and CD4 count was determined. Plasma was used for VL and immune marker analyses, while isolated peripheral blood mononuclear cells (PBMCs) were used for the quantification of cellular multiple spliced HIV-1 RNA (msRNA) and the intact proviral DNA assay. For the longitudinal analyses on ART, we selected only those participants who durably suppressed their VL to &lt;200 copies/mL during 48 (n=65) and/or 96 (n=60) weeks of treatment.ResultsAt ART initiation, the median CD4 count was 234 cells/mm3 and VL was 68,897 copies/mL. Interestingly, at baseline the number of defective proviruses was significantly correlated with VL (p&lt;0.0001), msRNA (p&lt;0.0001), CD4 count (p=0.0008), CXCL10 (p=0.0003) and TNF-α (p=0.0394). During successful ART, a significant decrease of both the intact and defective proviral reservoir was observed (p&lt;0.0001). The decrease of the intact proviral reservoir was more profound compared to the defective fraction after 96 weeks of therapy. In addition, a significant decrease in cellular msRNA and IL-6, IL-7, TNF-α, sCD14, sCD163, CCL2, CXCL10, and CRP was detected.DiscussionThis study underscores the significant relationship observed prior to therapy initiation between the number of defective proviruses, viral transcription/production and their association with immune response indicators such as CD4 count, CXCL10, and TNF-α. Furthermore, the observation of a less pronounced decrease of the defective proviral DNA highlights the importance of addressing both intact and defective proviruses in therapeutic strategies to enhance clinical outcomes for people with HIV-1. Together, these findings suggest a significant role of the defective proviruses in HIV-related disease progression.
Development and external validation of a prediction model for the risk of relapse in psoriasis after discontinuation of biologics
Authors: Huang Shan , Chen Bailin , Qi Yiming , Duan Xingwu , Bai Yanping 
Published: November 2024

BackgroundSome patients with psoriasis experience relapses shortly after discontinuation of biologics. However, there is a lack of risk prediction tools to identify those at high risk of relapse.ObjectiveTo develop and validate a risk prediction model for psoriasis relapse after biologics discontinuation.MethodsPublications from PubMed, EMBASE, Medline, and the Cochrane Library were systematically searched and meta-analyses were conducted to identify risk factors for psoriasis relapse after biologics discontinuation. Statistically significant risk factors were identified and used to create a risk assessment model weighted by the impact of each factor. The model was externally validated using a cohort of 416 Chinese psoriasis patients.ResultsEight studies (N = 2066) were included in the meta-analysis. Body mass index (BMI), smoking, disease duration, comorbid psoriatic arthritis (PsA), remission speed and extent during treatment, history of biologic therapy, and therapy duration were identified as correlates of relapse in the meta-analysis and were incorporated into the prediction model. The median age of the 416 patients in the validation cohort was 41.5 (IQR 32, 53) years, with 63% male, and a baseline PASI score of 15.4 (IQR 10.5, 21). It was verified that the area under the curve (AUC) of the prediction model was 0.796 (95% CI, 0.753–0.839), with an optimal cut-off value of 11.25 points, sensitivity of 65.1%, and specificity of 82.2%.ConclusionMultivariate models using available clinical parameters can predict relapse risk in psoriasis patients after biologics discontinuation. Early individual identification of patients at risk of relapse, and screening of candidate cohorts for long-term treatment or dose reduction may benefit both patients and physicians.
Comparison of different exercise modalities on fatigue and muscular fitness in patients with multiple sclerosis: a systematic review with network, and dose–response meta-analyses
Authors: Zhang Xi-Nuan , Liang Zhi-De , Li Ming-Da 
Published: November 2024

BackgroundFatigue and muscular fitness are closely related to the quality of life in patients with multiple sclerosis (MS). However, the optimal exercise dosage to improve these outcomes remains unclear.ObjectiveWe evaluated the effects of different exercise modalities and dosages on fatigue levels and muscular fitness in patients with MS.MethodsA systematic search was conducted across five electronic databases, including randomized controlled trials involving exercise interventions for patients with MS. The data covered literature from the establishment of each database up to August 2024. Two independent reviewers assessed the quality of the studies. Network and dose–response meta-analyses were performed using a random-effects model to evaluate the impact of exercise.ResultsA total of 84 papers were included, involving 3,786 participants. The network meta-analysis revealed that mind–body exercise (MBE) had the most significant effect on reducing fatigue (SMD = −0.94; 95% CrI: −1.3 to −0.6), followed by resistance training (RT) (SMD = −0.86; 95% CrI: −1.2 to −0.58), combined exercise (COM) (SMD = −0.70; 95% CrI: −1.2 to −0.22), and high-intensity interval training (HIIT) (SMD = −0.50; 95% CrI: −1.1 to 0.14). Additionally, HIIT were found to be the most effective in improving muscular fitness (SMD = −0.86; 95% CrI: −1.5 to −0.27), followed by COM (SMD = −0.81; 95% CrI: −1.2 to −0.41), MBE (SMD = −0.64; 95% CrI: −1.1 to −0.16), and RT (SMD = −0.62; 95% CrI: −0.89 to −0.16). Moreover, a dose as low as 240 METs-min/week was sufficient to improve fatigue, while a dose of 430 METs-min/week was required to enhance muscular fitness. The optimal dose for reducing fatigue was 650 METs-min/week, and the best dose for improving muscular fitness was 530 METs-min/week.ConclusionExercise is an effective method for improving fatigue and muscular fitness in patients with MS. While MBE and COM rank relatively higher compared to other exercise modalities. The optimal exercise dosage for reducing fatigue and improving muscular fitness ranges between approximately 530 to 860 MET-minutes per week.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, CRD42024577643.
Immediate consecutive microvascular decompression for bilateral classical trigeminal neuralgia
Authors: Segura-Lozano Mauro Alberto , del Real-Gallegos Mario Alexis , Mendoza-Lemus Pedro , Carranza-Rentería Octavio , Torres-Torres Yael Rodrigo , González-Silva Alejandro , Santoyo-Pantoja Arturo , Munguía-Rodríguez Aarón Giovanni 
Published: November 2024

BackgroundClassical trigeminal neuralgia (TN) is characterized by sudden, severe facial pain, typically resulting from a neurovascular conflict affecting the trigeminal nerve. In rare cases, both nerves are affected simultaneously causing bilateral TN (BTN), increasing the complexity of the treatment. Microvascular decompression (MVD) is a well-established treatment for TN; however, the experience with immediate consecutive bilateral MVD procedures is limited and requires further evaluation.ObjectiveTo evaluate the safety and efficacy of immediate consecutive bilateral MVD in patients with severe BTN compared to non-consecutive bilateral MVD procedures.MethodsA retrospective analysis was conducted on 15 patients with BTN who underwent bilateral MVD. The data on clinical presentation, surgical technique, perioperative findings, complications, and follow-up outcomes of three cases of BTN treated with consecutive bilateral MVD surgeries were analyzed and compared to 12 who received separated procedures. Moreover, a detailed presentation of the three cases of consecutive MVD is provided to illustrate clinical decision-making, surgical nuances, and individual outcomes.ResultsBoth groups achieved significant pain relief (p &lt; 0.001) without notable differences in Barrow Neurological Institute (BNI) pain intensity score (p = 0.305), indicating that both approaches were equally effective. The consecutive MVD group experienced a shorter total surgical duration (p = 0.025), while postoperative complications were comparable (p = 0.077), mostly transient with no major adverse events or mortality. At the last follow-up, the patients remained pain-free without recurrence of TN symptoms.ConclusionConsecutive bilateral MVD is a safe and effective option, comparable to non-consecutive procedures for treating BTN. This approach provides a viable alternative for patients with severe bilateral symptoms or when medical constraints limit the possibility of two separate surgeries. Further studies with larger cohorts and extended follow-up periods are needed to support these results.
Methylphenidate treatment of a Chinese boy with Becker muscular dystrophy combined with attention deficit hyperactivity disorder: a case report
Authors: Shen Fang , Zhou Hui 
Published: November 2024

BackgroundBecker muscular dystrophy (BMD) is an X-linked recessive inherited disorder characterized by slowly progressing muscle weakness of the legs and pelvis, caused by mutations in the DMD gene, which encodes dystrophin protein. Different from Duchenne Muscular Dystrophy (DMD), in which dystrophin is completely absent in muscle tissue, while in BMD, the dystrophin gene can express some protein, but not enough. It has also been shown that a proportion of patients with DMD suffer from attention deficit hyperactivity disorder (ADHD), and the use of the stimulant methylphenidate has been suggested for the treatment of patients with DMD in combination with ADHD. However, there are no case reports on the treatment of co-occurring ADHD in BMD.Case presentationThe patient was a 9-year-old boy who presented with elevated serum creatine kinase levels and inattention. The magnetic resonance imaging of the thigh muscles of both lower limbs suggested partial fatty infiltration of the gluteus maximus muscle bilaterally, and a novel heterozygous mutation (c.31 + 6 T &gt; C) was identified in the DMD gene by Next Generation Sequencing (NGS) and the sequencing results were verified by using the Sanger method. The child was also diagnosed with co-morbid ADHD after a thorough evaluation and considering this new diagnosis, we started treatment with methylphenidate at a dose of 18 mg/day, and after 6 months of treatment, he showed a significant improvement in his attention span.ConclusionWe identified a novel heterozygous mutation in the DMD gene, which will expand the spectrum of pathogenic variants in BMD. Simultaneously, methylphenidate treatment significantly improved attention in children with BMD co-morbid with ADHD, and this study provides value for future therapeutic protocols for BMD combined with ADHD. However, to the best of our knowledge, this is the only reported case report on the treatment of BMD co-morbid ADHD. So further studies are needed to determine the interrelationship between these disorders and their treatment.
Case report: Successful use of ruxolitinib to treat interstitial pneumonia as an unusual primary presentation in primary myelofibrosis—two birds with one stone
Authors: Xiao Pingping , Dong Zhigao , Wang Qingqing , Su Junnan , Chen Yongquan , Lin Yiwan 
Published: November 2024

BackgroundInterstitial lung disease (ILD) is a rare clinical presentation of primary myelofibrosis (PMF).Case presentationWe report a case of ILD as the main manifestation on admission. A 58-year-old man was diagnosed with PMF owing to worsening anemia following treatment failure for conventional interstitial pneumonia.ResultsAnemia and interstitial pneumonia both significantly improved following treatment with a Janus kinase 2 gene inhibitor. In this report, we discuss the possible mechanisms underlying PMF complicated with ILD.
Asystematic review and meta-analysis of clinical prognostic factors linked to extravesical recurrence after radical nephroureterectomy to treat upper tract urothelial carcinoma
Authors: Zhang Guanlan , Jiang Zhaoqiang , Chen Jiawei , Zhao Ying , Wang Jianan , Liu Jinxing , Ding Zhenshan , Shan Lei 
Published: November 2024

ObjectiveNumerous studies have investigated predictors of intravesical recurrence following radical nephrectomy (RNU) in patients with upper urinary tract uroepithelial carcinoma (UTUC). In contrast, extravesical recurrence (EUR) has received less focus. Consequently, this study aims to evaluate the significant predictors of EUR after RNU through a systematic review of the literature and a meta-analysis.MethodologyWe conducted a computerized bibliographic search across PubMed, Embase, and Cochrane databases to identify reports that include detailed results from multivariate analyses of predictors of EUR. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) criteria, we selected thirteen retrospective studies, each with a sample size exceeding 100 cases. Using Review Manager 5.4 software, we performed cumulative analyses of available HR and their corresponding 95% confidence intervals to evaluate potential predictors of EUR.ResultsOur findings indicate that patient-specific predictors include preoperative Ki-67 with a HR of 3.61 (P = 0.003), neutrophil-to-lymphocyte ratio with an HR of 2.20 (P = 0.0005), and glomerular filtration rate with an HR of 3.35 (P = 0.0009). Tumor-specific predictors identified were tumor stage with an HR of 4.67 (P &lt; 0.00001), lymphovascular invasion with an HR of 2.37 (P = 0.004), and lymph node status with an HR of 2.68 (P &lt; 0.0001). Regarding treatment-specific predictors, positive surgical margins were associated with an HR of 3.97 (P = 0.0005), and adjuvant chemotherapy was associated with an HR of 1.65 (P = 0.03).DiscussionOur study identified three significant predictors across patient, tumor, and treatment dimensions for extravesical recurrence following radical nephroureterectomy in patients with upper urinary tract uroepithelial carcinoma. We hypothesize that history of bladder cancer, platelet-to-lymphocyte ratio, and urinary cytology could also be strong predictors of post- RNU extravesical recurrence in patients with upper UTUC, assuming adequate sample size and controlled heterogeneity. This research aims to provide urological clinicians with enhanced guidance for postoperative decision-making.
Role of anoikis-related gene RAC3 in prognosis, immune microenvironment, and contribution to malignant behavior in vitro and in vivo of bladder urothelial carcinoma
Authors: Zhou Yusong , Huang Shiwei , Yang Bing , Tan Jing , Zhang Zhun , Liu Wei 
Published: November 2024

BackgroundAnoikis disrupts the normal apoptotic process in cells, leading to abnormal proliferation and migration, thereby promoting tumor formation and development. However, the role of anoikis in bladder urothelial carcinoma (BLCA) still requires further exploration.MethodsAnoikis-related genes (ARGs) were retrieved from the GeneCards and Harmonizome databases to distinguish various subtypes of BLCA and develop a predictive model for BLCA. The immune microenvironment and enrichment pathways between various subtypes were also analyzed using consensus clustering. Potential medications were screened by utilizing drug sensitivity analysis. In vitro and vivo, the character of the independent prognostic gene in BLCA was confirmed through cell studies and mouse xenograft models.ResultsOne hundred thirty differentially expressed genes (DEGs) were identified, and nine of them were chosen to construct predictive models that can accurately forecast the prognosis of BLCA patients. K = 2 was correctly identified as the optimal clustering type for BLCA, showing prominent differences in survival rates between the two subgroups. The immune-related functional studies manifested that the two subtypes’ immune cell expressions differed. It was verified that RAC3 is an independent prognostic gene for BLCA. RAC3 shows high expression levels in BLCA, as indicated by its consistent mRNA and protein levels across different gene expressions. The functional verification results of RAC3 in BLCA showed that silencing RAC3 can significantly inhibit BLCA cell proliferation, colony formation, and migration. RAC3 knockdown inhibited the growth and migration of BLCA in vivo. SB505124 exhibited a significant inhibitory effect on the proliferation of BLCA cells.ConclusionBased on the predictive model developed in this study, BLCA patients’ prognoses can be accurately predicted. SB505124 could become an important drug in the treatment of BLCA patients. RAC3 is essential in prognosis, immune microenvironment, and malignant behavior of BLCA in vitro and in vivo. It will also offer the potential for personalized treatment for BLCA patients and generate new research avenues for clinical investigators.
Optimal management strategies for promoting gestational extension in dichorionic diamniotic twin pregnancies
Authors: Chen Caixia , Fan Changyou , Wang Bufei , Zhu Ping 
Published: November 2024

BackgroundPreterm birth is a significant concern in multiple pregnancies, warranting effective strategies to improve outcomes. Delaying delivery of the second fetus is crucial for reducing perinatal mortality rates.Case PresentationIn a dichorionic diamniotic twin pregnancy, one fetus experienced premature rupture of membranes (PROM) at 16+6 weeks gestation. Proactive fetal reduction through potassium chloride injection and emergency cervical cerclage at 19+1 week successfully extended the pregnancy to 39+5 weeks, resulting in a notable 160-day prolongation. Postoperative management encompassed comprehensive tocolytic therapy.ConclusionThe combined approach of proactive fetal reduction and emergency cervical cerclage proved successful in managing PROM in dichorionic diamniotic twin pregnancies. This innovative strategy offers a promising clinical solution for optimizing outcomes and prolonging gestation in high-risk multiple pregnancies, underscoring the importance of tailored interventions in complex obstetric scenarios.
Effect of arbuscular mycorrhiza and rhizobium on physiology and yield of peanut under drought conditions
Authors: Aninbon Chorkaew , Teamkao Pattrarat , Buram Kiattisak , Kaewnoo Tipawan , Ruttanaprasert Ruttanachira , Janket Anon , Mon Yi Yi , Kaewtaphan Phissanu 
Published: November 2024

Drought is the one primary issue limiting peanut growth and productivity. The study aimed to investigate the effects of arbuscular mycorrhizal fungi (AMF), rhizobium (Rhi), and their combinations on phenolic content, proline content, growth, and yield of peanut under different soil water regimes. The pot experiments were carried out for two growing seasons under greenhouse conditions and designed based on a 2×3 factorial in randomized complete block design (RCBD) with four replications. Factor A comprised two soil water regimes: field capacity (FC) and 1/3 available soil water (1/3 AW), whereas factor B included three different types of microorganisms: (i) uninoculated control, (ii) arbuscular mycorrhiza (AMF), and (iii) a combination of AMF and rhizobium (Rhi) inoculations. Data were collected for growth, proline content, phenolic content, yield, and yield components. Drought stress significantly reduced in relative water content, leaf area, biomass, yield, and yield components of peanut, whereas leaf phenolic content was increased under drought stress. Higher pod dry weight was achieved under FC conditions (28.87 g plant-1), and it was reduced to 16.06 g plant-1 under 1/3 FC. Interestingly, AMF+Rhi synergistically increased the leaf area compared with non-incubated peanut under 1/3 FC conditions. AMF-inoculated peanut tended to increase biomass, while the combination of AMF+Rhi tended to have higher yield components compared with uninoculated control, especially for the weight of 100 seeds.
High-resolution dendrometer measurements reveal different responses of Douglas-fir to extreme drought in 2018 depending on soil and rooting characteristics
Authors: Spangenberg Göran , Zimmermann Reiner , Küppers Manfred , Hein Sebastian 
Published: November 2024

IntroductionDouglas-fir (Pseudotsuga menziesii (Mirb.) Franco) is considered an important non-native substitute tree species in Europe, especially for Norway spruce (Picea abies (L.) Karst.), mainly due to its higher drought tolerance. However, Douglas-fir has also shown increasing mortality in certain regions of the world. One of the main reasons is the increase in drought and heat periods due to climate change. There is still a need for research on the influence of important soil properties and rooting characteristics on the drought tolerance of Douglas-fir. Therefore, we analyzed the influence of soil texture, plant-available water capacity (PAWC), fine root density, and effective rooting depth on water status and thus drought stress in Douglas-fir during the extreme drought of 2018.MethodsWe selected seven closely spaced sites along a soil texture gradient from sand to clay at an elevation of ca. 500 m a.s.l. in southern Germany and determined soil physical and rooting characteristics. Water status parameters and growth duration were derived from dendrometer data at five Douglas-firs per site. The influence of soil and rooting characteristics on these drought stress-related parameters was analyzed using mixed-effects models. The focus was on two summer drought periods in 2018.Results and discussionIn the initial stage of the extreme summer drought of 2018 (in June), a higher PAWC and a higher fine root density reduced drought stress. However, these influences were no longer noticeable in the later stage of drought (in August), probably due to deeper soil desiccation. In August, a higher effective rooting depth reduced drought stress. Soil texture had a significant influence, particularly on growth duration. This study provides information on site selection for Douglas-fir cultivation under the predicted increase in severe drought, showing the importance of deep and intensive rooting, and points to the need for combined above- and belowground investigations for a better understanding of the drought response patterns of tree species.