bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of retroperitoneal fibrosis-related hydronephrosis and its risk factors for poor prognosis: a multi-center retrospective cohort study in Chinese patients
Authors: Liu Hongyan , Gao Hui , Zhao Jin-xia , Wong Ut-kei , Liu Shi-bo , Liu Jian , Zhang Ge , Wang Kuan-ting , Wang Yan , Zhao Lin , Ma Xiang-bo , Lu Yue-wu , Zhang Xue-wu 
Published: December 2024

ObjectiveRetroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of fibroinflammatory tissue that surrounds the abdominal aorta and the iliac arteries and often entraps the ureters. Hydronephrosis is a common complication of RPF, however, its clinical features and outcomes have not been well elucidated.MethodsA total of 115 RPF-related hydronephrosis patients have been recruited from 9 clinical centers in China since March 2010. They were followed up until death or September 2021, whichever came first.ResultsThe mean age at diagnosis was 58.83 ± 12.13 years, and 80 patients (69.57%) were men. The median disease duration was 3.00 (1.00, 9.00) months. Renal impairment was observed in 88.35% of the patients, and 49.57% showed bilateral ureteral involvement. Elevated ESR and CRP were presented in 80.28 and 62.02% of the patients, respectively. Overall, 28.21% (11/39) of the patients had increased IgG4 levels, and 41.38% (12/29) showed positive pathological IgG4 staining (IgG4+/IgG+ ≥ 40% or IgG4+ ≥ 10/HPF). Among them, three patients were diagnosed as IgG4RD. After 60.43 ± 34.53 months of follow-up, 36 patients had poor prognosis, which was associated with severe kidney impairment, bilateral hydronephrosis and inflammation status (elevated ESR and IgG) at diagnosis by case–control study. eGFR and creatinine were independent risk factors after adjusting for all other significant associations (p = 0.002 and p = 0.067, respectively). Glucocorticoid-based therapy could reduce the time of stenting, decrease the need for long-term ureteral stenting/percutaneous nephrostomy (PNS)/ureterolysis, increase the rate of mass shrinkage, and reduce the new requirement of hemodialysis compared to surgery-only strategy for RPF-related hydronephrosis patients in need of renal drainage, but did not reduce new-onset renal atrophy.ConclusionSeverity of kidney dysfunction and inflammation status were related to the poor prognosis of hydronephrosis induced by RPF. More efficient interventions and strategies are needed to further improve outcomes.
Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball
Authors: Wu Donghai , Lin Yuan , Wu Huping , Cai Jinhong 
Published: December 2024

ObjectiveTo evaluate systemic inflammatory markers in cases of exogenous endophthalmitis caused by metal foreign bodies after penetrating eye injury and identify risk factors for poor control post-initial emergency surgery.MethodsTwenty-nine patients with exogenous endophthalmitis underwent emergency surgery with vitrectomy at Xiamen Eye Center (2016–2024). Evaluations included systemic inflammatory markers, microbiology, clinical presentation, treatment strategies, complications, prognostic factors, and visual outcomes. Correlation analysis was performed between blood test results and disease control after initial surgery.ResultsThe median patient age was 44.8 ± 16.9 years, with an average treatment delay of 6.1 ± 10.6 days. Males represented 86.2% (n = 25), and 41.3% (n = 12) had metallic intraocular foreign bodies, which correlated with faster symptom onset (p &lt; 0.05) and higher inflammatory markers (WBC, neutrophils, basophils, CRP; p &lt; 0.05). Primary lens extraction and intraoperative vancomycin did not significantly improve control (p &gt; 0.05). Poor control post-vitrectomy was positively correlated with intraocular foreign bodies (R = 0.39, p &lt; 0.05) and negatively with lymphocyte and monocyte counts (R = −0.43, p &lt; 0.05; R = −0.46, p &lt; 0.05). Early intervention within 2 h of symptom exacerbation reduced complication risk (AUC = 0.708, 95% CI: 0.547–0.838, p = 0.047).ConclusionMetallic intraocular foreign bodies provoke stronger systemic inflammatory responses, posing control challenges, especially in patients with lower immune resilience. Timely vitrectomy during initial emergency surgery is crucial for managing endophthalmitis.
Cardiometabolic Index is associated with heart failure: a cross-sectional study based on NHANES
Authors: Zhu Xiao-Ming , Xu Yan , Zhang Jie 
Published: December 2024

IntroductionHeart failure is a complex syndrome characterized by impaired cardiac function. Despite improvements in treatment, the prevalence of heart failure continues to rise. The Cardiometabolic Index (CMI), a novel measure combining abdominal obesity and lipid levels, has emerged as a potential predictor of cardiac metabolic risk.MethodsWe analyzed data from the National Health and Nutrition Examination Survey (NHANES) involving 22,586 participants to investigate the association between CMI and heart failure. Multivariable logistic regression models and RCS analysis were used to explore the association between heart failure and CMI after adjusting for potential confounders. Subgroup analyses were performed among populations with different demographic and clinical characteristics.ResultsOur results revealed a significant positive correlation between CMI and heart failure, with odds ratios of 2.77 and 1.87 for the highest quartile after adjusting for confounders. Subgroup analyses indicated heightened risks among older adults and those with hypertension or diabetes. ROC curve analysis demonstrated that CMI offers good diagnostic value for heart failure, surpassing traditional measures like BMI.DiscussionOur findings suggest that CMI is a valuable tool for assessing the risk of heart failure, particularly in individuals with increased abdominal obesity or abnormal lipid profiles. This highlights the importance of addressing cardiac metabolic health in both prevention and treatment strategies for heart failure. Future research should focus on exploring causal relationships and refining predictive models that incorporate CMI to enhance early detection and intervention.
Deformable multi-level feature network applied to nucleus segmentation
Authors: Chang Shulei , Yang Tingting , Yin Bowen , Zhang Jiayi , Ma Liang , Ding Yanhui , Sui Xiaodan 
Published: December 2024

IntroductionThe nucleus plays a crucial role in medical diagnosis, and accurate nucleus segmentation is essential for disease assessment. However, existing methods have limitations in handling the diversity of nuclei and differences in staining conditions, restricting their practical application.MethodsA novel deformable multi-level feature network (DMFNet) is proposed for nucleus segmentation. This network is based on convolutional neural network and divides feature processing and mask generation into two levels. At the feature level, deformable convolution is used to enhance feature extraction ability, and multi-scale features are integrated through a balanced feature pyramid. At the mask level, a one-stage framework is adopted to directly perform instance segmentation based on location.ResultsExperimental results on the MoNuSeg 2018 dataset show that the mean average precision (mAP) and mean average recall (mAR) of DMFNet reach 37.8% and 47.4% respectively, outperforming many current advanced methods. Ablation experiments verified the effectiveness of each module of the network.DiscussionDMFNet provides an effective solution for nucleus segmentation and has important application value in medical image analysis.
Predicting sarcopenia risk in stroke patients: a comprehensive nomogram incorporating demographic, anthropometric, and biochemical indicators
Authors: Pu Yufan , Wang Ying , Wang Huihuang , Liu Hong , Dou Xingxing , Xu Jiang , Li Xuejing 
Published: December 2024

ObjectiveAlthough there is a strong correlation between stroke and sarcopenia, there has been a lack of research into the potential risks associated with post-stroke sarcopenia. Predictors of sarcopenia are yet to be identified. We aimed at developing a nomogram able to predict sarcopenia in patients with stroke.MethodsThe National Health and Nutrition Examination Survey (NHANES) cycle year of 2011 to 2018 was divided into two groups of 209 participants—one receiving training and the other validation—in a random manner. The Lasso regression analysis was used to identify the risk factors of sarcopenia, and a nomogram model was created to forecast sarcopenia in the stroke population. The model was assessed based on its discrimination area under the receiver operating characteristic curve, calibration curves, and clinical utility decision curve analysis curves.ResultsIn this study, we identified several predictive factors for sarcopenia: Gender, Body Mass Index (kg/m2), Standing Height (cm), Alkaline Phosphatase (ALP) (IU/L), Total Calcium (mg/dL), Creatine Phosphokinase (CPK) (IU/L), Hemoglobin (g/dL), and Waist Circumference (cm). Notably, female patients with stroke exhibited a higher risk of sarcopenia. The variables positively associated with increasing risk included Alkaline Phosphatase, Body Mass Index, Waist Circumference, and Hemoglobin, while those negatively associated with risk included Height, Total Calcium, and Creatine Phosphokinase. The nomogram model demonstrated remarkable accuracy in distinguishing between training and validation sets, with areas under the curve of 0.97 and 0.90, respectively. The calibration curve showcased outstanding calibration, and the analysis of the decision curve revealed a broad spectrum of beneficial clinical outcomes.ConclusionThis study creates a new nomogram which can be used to predict pre-sarcopenia in stroke. The new screening device is accurate, precise, and cost-effective, enabling medical personnel to identify patients at an early stage and take action to prevent and treat illnesses.
Open label pilot of personalized, neuroimaging-guided theta burst stimulation in early-stage Alzheimer’s disease
Authors: Kashyap Bhavani , Hanson Leah R. , Gustafson Sally K. , Barclay Terry , Howe Clarissa M. , Sherman Samantha J. , Hungs Marcel , Rosenbloom Michael H. 
Published: December 2024

BackgroundAlzheimer’s disease (AD) is characterized by cerebral amyloid plaques and neurofibrillary tangles and disruption of large-scale brain networks (LSBNs). Transcranial magnetic stimulation (TMS) has emerged as a potential non-invasive AD treatment that may serve as an adjunct therapy with FDA approved medications.MethodsWe conducted a 10-subject open label, single site study evaluating the effect of functional connectivity-resting state functional MRI guided-approach to TMS targeting with dysfunctional LSBNs in subjects with biomarker-confirmed early-stage AD (https://clinicaltrials.gov/study/NCT05292222). Subjects underwent pre-post imaging and testing to assess connectivity dysfunction and cognition. All participants received intermittent theta burst stimulation [(iTBS), (80% motor threshold; 5 sessions per day; 5 days; 3 targets; 18,000 pulses/day)] over 2 weeks. Three Human Connectome Project (HCP) defined parcellations were targeted, with one common right temporal area G dorsal (RTGd) target across all subjects and two personalized.ResultsWe identified the following parcellations to be dysfunctional: RTGd, left area 8A ventral (L8Av), left area 8B lateral (L8BL), and left area 55b (L55b). There were no changes in these parcellations after treatment, but subjects showed improvement on the Repeatable Battery for the Assessment of Neuropsychological Status attention index (9.7; p = 0.01). No subject dropped out of the treatment, though 3 participants were unable to tolerate the RTGd target due to facial twitching (n = 2) and anxiety (n = 1).ConclusionAccelerated iTBS protocol was well-tolerated and personalized target-based treatment is feasible in early-stage AD. Further sham-controlled clinical trials are necessary to determine if this is an effective adjunctive treatment in early-stage AD.
In vitro colonic fermentation of fermented Radix Astragali by Poria cocos and anti-hyperuricemia mechanism based on network pharmacology and experiment verification
Authors: Chen Caiyun , Liu Keyu , Wang Yishu , Song Xinru , Gao Wenjing , Wang Yanlin , Chen Yuxin , An Ziqi , Yin Changting , Wang Haiyan , Wang Shaoping 
Published: December 2024

AimThis research aimed to probe the effects of fecal microbiota and Lactobacillus acidophilus on the metabolism of Radix Astragali (RA) and Poria cocos solid fermenting Radix Astragali (FRA). It further explores pharmacological effects of RA, Poria cocos, and FRA on HUA mouse model and the mechanisms in HUA treatment.MethodsFecal microbiota and Lactobacillus acidophilus were used to ferment FRA and RA in vitro to probe the impacts of microbiota on the metabolism of active compound. A HUA mouse model was used to carry out pharmacodynamic experiment of anti-hyperuricemia. Network pharmacology and molecular docking was utilized to elucidate the underlying mechanisms of RA and Poria cocos in the treatment of HUA.ResultsThe results indicated that astragaloside IV (AG IV), total saponins, and flavonoids continuously decreased in FRA and RA during 48 h fecal microbiota colonic fermentation. During Lactobacillus acidophilus fermentation, in FRA, the content of AG IV peaked at 12 h with a value of 1.14 ± 0.20 mg/g; total saponins and flavonoids reached the highest values of 136.34 ± 6.15 mg/g at 12 h and 6.35 ± 0.06 mg/g at 6 h; AG IV and total saponins reached the highest values 0.63 ± 0.05 mg/g and 115.12 ± 4.12 mg/g at 12 h and 24 h in RA, respectively; and total flavonoids consecutively decreased. The counts of Lactobacillus acidophilus increased significantly in FRA compared with RA. Pharmacodynamic outcomes revealed that FRA effectively reduced blood levels of uric acid (UA), triglycerides (TG), xanthine oxidase (XOD), alanine aminotransferase (ALT), and aspartate transaminase (AST) in HUA mice, exerting protective effects on the liver and kidney. Network pharmacology showed that there were 93 common targets for RA, Poria cocos, and HUA with the top five core targets tumor necrosis factor (TNF), signal transducer and activator of transcription 3 (STAT3), cysteinyl aspartate specific proteinase 3 (CASP3), jun proto-oncogene (JUN), and estrogen receptor 1 (ESR1). Molecular docking analysis revealed that AG IV, calycosin and formononetin bond well to the core targets.ConclusionThis research revealed the interaction of RA and FRA with fecal microbiota and Lactobacillus acidophilus, RA and Poria cocos were featured with multiple components, target points, and signaling pathways in HUA treatment, which provided fresh insights for further HUA therapeutics.
Therapeutic controversies over use of antioxidant supplements during cancer treatment: a scoping review
Authors: Woldeselassie Mulugeta , Tamene Aynadis 
Published: December 2024

BackgroundAntioxidant supplements are widely used during cancer treatment to prevent oxidative stress, reduce treatment toxicities, and improve patient outcomes. However, current literature reveals significant gaps suggesting that antioxidants may protect both healthy and tumor cells from oxidative damage, thereby reducing treatment efficacy. It is for this reason that antioxidant supplements have become a source of therapeutic controversy.ObjectiveTo review therapeutic controversies over the use of antioxidant supplements during cancer treatment.MethodsScoping review of the international published articles following the Arksey and O’Malley framework, cross-sectional studies, clinical and pre-clinical studies, systematic and umbrella reviews and grey literatures published from 2014 to 2024 with all age patient populations were included. A structured literature search was conducted of CINAHL, EMBASE, MEDLINE, Google Scholar, using key medical subject heading words and Cochrane Collaboration and Joanna Briggs Institute databases. All included studies were reviewed independently by two investigators. Data were extracted, collated by type of antioxidants, summarized in tables and synthesized for analysis.ResultA total of 1, 550 articles were identified. After reviewing all literatures, twenty-one (21) were full-text articles, grey literatures (2), and systematic reviews (42) and umbrella reviews (3), met the criteria for inclusion. In this review, the use of antioxidant supplements can benefit cancer cells in the same way as they do for normal cells during cancer treatment. In addition, not all antioxidants were effective in inhibiting oxidative stress, reduce treatment toxicities, and improve patient outcomes.Conclusion and recommendationsAccording to this review, the use of antioxidant supplements can benefit tumor cells in the same manner as they do for normal cells. Therefore, oncologists should advise not to take antioxidant supplements during chemotherapy and/or radiotherapy. Future research including potential clinical and preclinical trials, mechanistic studies, and exploration of different vitamin and mineral supplement studies are required to uncover the complete potential of antioxidant supplements for cancer treatment or determine their safety and effectiveness when used alongside standard cancer treatments. Furthermore, the results of this review could be used for future systematic review of therapeutic controversies over use of antioxidant supplements during cancer treatment.
Patients’ perception on quality of care for prostate cancer at tertiary hospitals in Tanzania: a qualitative study
Authors: Nyongole Obadia , Kakoko Deodatus , Sirili Nathanael , Frumence Gasto , Simba Daudi , Urassa David , Sunguya Bruno 
Published: December 2024

BackgroundProstate cancer is a common cancer among men globally and its treatment affects quality of life. Poor patients’ perception of prostate cancer services may lead to their late presentation for care, often presenting with the advanced stage of the disease. This may vary from one region to another.ObjectiveThis study, therefore, aimed to explore patients’ perceptions of the quality of care for prostate cancer in Tanzania.MethodsThis qualitative case study was conducted in five tertiary hospitals in Tanzania in November 2023. In-depth interviews were conducted with prostate cancer patients on treatment for not less than 6 months. Data on patients’ perception of prostate cancer, quality of prostate cancer services, and quality of life among prostate cancer patients were collected. Thematic analysis used a hybrid inductive and deductive reasoning approach through NVivo 14 software.ResultsA total of 17 interviews were conducted, resulting in four themes. These were perception of prostate cancer on the causes and diagnostic methods, delays of care leading to late presentation, perception of quality of life after treatment for prostate cancer recovery versus cancer progression, and quality of service in terms of organization of service delivery for prostate cancer at tertiary hospitals in Tanzania.ConclusionQuality of services for prostate cancer was well-perceived, especially communication for psychosocial support. A good perception of the quality of service was found to influence the uptake of prostate cancer services. Prostate cancer patients have mixed perceptions about the quality of life after treatment, which delays health seeking, leading to late presentation. Despite efforts in awareness campaigns through different platforms, more effort is needed in determining the causes of prostate cancer, the diagnostic/screening methods necessary for prostate cancer, timely health seeking, the available treatment options for prostate cancer, and the expected quality of life after treatment.
Physiological characteristics and transcriptomic analyses of alfalfa root crown in wintering
Authors: Wang Xiaolong , Chai Hua , Li Shasha , Xu Yanxia , Wu Yue , Wang Jianli , Yang Zhao 
Published: December 2024

BackgroundAlfalfa, scientifically identified as Medicago sativa, is repeatedly referred to as the “king of forages”. Because of its tight relationship to winter hardiness, the alfalfa’s root crown plays a significant role as a storage organ over the winter. At present, it is still unknown what molecular process makes the alfalfa root crown resistant to cold. This study was aimed to study these knowledge gaps. Using RNA sequencing (RNA-Seq) technology, significant genes associated with cold hardiness were found.MethodsAccording to the random block design, Longmu 806 alfalfa and Sardi alfalfa were planted in regional experiments. Under the condition of low-temperature treatment in winter, the differentially expressed genes (DEGs), winter survival rate (WSR), and physiological characteristics were, in turn, calculated by RNA-Seq, chemical analysis, and field investigation.ResultsThe WSR of the Longmu 806 alfalfa was 3.68-fold greater than that of the Sardi alfalfa. The jasmonic acid (JA), soluble sugar (SS), proline (Pro), and glutathione (GSH) concentration in the roots of Longmu 806 alfalfa was more than the same amount in Sardi alfalfa in other words P is less than 0.05. An entire set of 878 DEGs related to winter hardiness was found by statistical analysis. Among them, 463 DEGs showed an increase in expression, whereas 415 DEGs showed a decrease in expression. The metabolic pathways’ examination presented that the DEGs (MsERF1, MsCHIB, MsJAZ, MsAOC, MsGST, MsINV, MsTPS, and MsOAT) were linked to the pathways of “plant hormone signaling transduction”, “Amino sugar and nucleotide sugar metabolism”, and “glutathione metabolism”. Furthermore, the physiological changes in JA, SS, Pro content, and GSH were influenced by the dynamic transcription profile of LT (low- temperature) resistance-related genes.
Evaluation of stripe rust resistance and analysis of resistance genes in wheat genotypes from Pakistan and Southwest China
Authors: Abbas Sakina , Li Yunfang , Lu Jing , Hu Jianming , Zhang Xinnuo , Lv Xue , Shahzad Armghan , Ao Donghui , Abbas Maryam , Wu Yu , Zhang Lei , Fayyaz Muhammad 
Published: December 2024

IntroductionStripe rust, caused by Puccinia striiformis f. sp. tritici, poses a significant threat to wheat quality and production worldwide. The rapid evolution of Pst races caused several resistance genes to be ineffective.MethodsThis study evaluated stripe rust resistance genes in 349 Pakistan and Southwest China genotypes. We utilized previously published functional and linked molecular markers to detect 13 major stripe rust resistance genes: Yr5, Yr9, Yr10, Yr15, Yr17, Yr18, Yr26, Yr29, Yr30, Yr36, Yr48, Yr65, and YrSp. Field evaluations assessed IT and resistance levels, while the impact of gene combinations on resistance was also analyzed.ResultsField evaluations showed that over 60% of Chuanyu wheat, 50% of recent Pakistani cultivars, and 20% of historic Pakistani lines were resistant to current stripe rust races. In Chuanyu wheat, the dominant genes were Yr17, YrSp, and Yr48; however, Yr17, Yr26, and YrSp were overused, while Yr36 was absent, and Yr18 was rare. In historic lines, Yr5, Yr17, Yr18, and Yr26 were prevalent, with Yr15, Yr26, and YrSp demonstrating effective resistance against current stripe rust races. Furthermore, the study identified specific combinations of Yr genes (Yr26+Yr48, Yr29+Yr5, Yr26+Yr30, and Yr30+Yr17) that enhanced resistance to Pst.DiscussionThis research highlights effective resistance genes and gene combinations for stripe rust in wheat and emphasizes the deployment of durable resistance. The findings guide the strategic use of these genes in breeding programs aimed at developing durable resistance in wheat genotypes in Pakistan and Southwest China.