bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case report: Diagnostic trap: metastatic endometrial stromal sarcoma with breast metastasis
Authors: Tian Xiaoxue , Luo Shuai , Xu Ting , Wang Jinjing 
Published: October 2024

BackgroundEndometrial stromal sarcoma (ESS) is a rare type of uterine malignancy typically classified into low-grade ESS (LG-ESS) and high-grade ESS. LG-ESS is characterized by low malignancy and limited metastasis, primarily to the lungs. Metastasis of the breast is extremely rare, posing significant challenges in clinical diagnosis and treatment.Case demonstrationA 33-year-old female with a history of two cesarean sections was diagnosed with uterine LG-ESS five months prior. She was admitted for the excision of a left breast mass discovered during a routine examination. A histopathological biopsy confirmed the mass as a breast metastasis of LG-ESS. Postoperatively, she underwent radiotherapy and chemotherapy at a cancer hospital. She has been followed up on for two years with no recurrence.ConclusionsESS with breast metastasis is extremely rare. The morphological features of ESS with breast metastasis can resemble mesenchymal and sex cord-stromal tumors, complicating imaging and pathological diagnosis, especially if there is no known history of uterine ESS. This study highlights the clinicopathological features of LG-ESS with breast metastasis, including clinical manifestations, imaging features, histopathology, immunohistochemistry, molecular genetic features, and treatment prognosis. It aims to provide new insights for the clinical diagnosis and treatment of ESS with breast metastasis.
Effect of SiHuangQingXinWan on Klebsiella pneumoniae-induced pneumonia: mechanistic insights
Authors: Liu Haihui , Sun Xiaoluo , Tao Sian , Liu Shu , Wang Xin , Chen Qiuping , Wu Wenjun , Xi Chongcheng , Li Baixue , Feng Quansheng , Liu Jibin 
Published: October 2024

IntroductionDue to the high mortality rate and increasing severity of antibiotic resistance, there is a growing interest in new treatments for Klebsiella pneumoniae (KP)-induced pneumonia. Research has shown that the single herbs of SiHuangQingXinWan (SHQXW) are effective in treating pneumonia caused by KP. The PI3K/AKT signaling pathway has garnered attention for its potential role in the management of bacterial infections. This study aimed to evaluate the anti-pneumonia effect of SHQXW and to investigate its mechanism of action.Materials and MethodsThe potential plant metabolites and molecular targets of SHQXW in the context of pneumonia were determined through ultra-high performance liquid chromatography-tandem mass-spectrometry (UHPLC-MS/MS) and bioinformatics analysis. The therapeutic effect of SHQXW was evaluated in a KP-induced pneumonia murine model with imipenem/cilastatin as a positive control. Transcriptomics and non-targeted metabolomics were carried out to unveil potential mechanisms and targets for anti-pneumonia effects. Additionally, an in-depth exploration on the PI3K/AKT signaling pathway was conducted in this study.ResultsA total of 24 potential plant metabolites and 285 SHQXW-pneumonia-related targets selected by Homo sapiens were identified in this study. The tested doses of SHQXW significantly reduced mortality, improved body weight, decreased the lung index, reduced the bacterial load, and alleviated lung pathological damage in the KP-induced pneumonia murine model (p &lt; 0.05). Notably, 1.3 g/kg/day of SHQXW provided the most effective protective outcome. Furthermore, SHQXW demonstrated the ability to suppress the production of inflammatory factors such as IL-1α, IL-1β, IL-3, IL-6, IL-12p70, G-CSF, GM-CSF, MCP-1, KC, and TNF-α. Analysis of transcriptomic and metabolomic data revealed that SHQXW could modulate inflammation-related signaling pathways (TNF, HIF-1, NF-κB, and PI3K/AKT) and metabolites to regulate pulmonary inflammation. Additional experiments using RT-qPCR and western blotting indicated that SHQXW may exert anti-inflammatory effects by activating the PI3K/AKT pathway.DiscussionThe findings indicate that SHQXW effectively reduces inflammation in mice with KP-induced pneumonia by modulating inflammatory signaling pathways and metabolites, rather than by directly inhibiting the growth of KP. This study introduces a novel treatment approach for KP-induced pneumonia and presents a new outlook on drug development.
Radiotherapy plus lenvatinib versus radiotherapy plus sorafenib for hepatocellular carcinoma with portal vein tumor thrombus: a retrospective study
Authors: Zhang Min , Zheng Zhuangzhuang , Ding Qiuhui , Su Jing , Xin Ying , Jiang Xin 
Published: October 2024

Background and AimsPortal vein tumor thrombus (PVTT) occurs frequently in hepatocellular carcinoma (HCC) patients. However, there is currently no satisfactory treatment. Radiotherapy (RT) and tyrosine kinase inhibitors (TKI) are currently commonly used. However, whether their combined use provides a survival benefit is debatable. This retrospective study compared the efficacy and safety between radiotherapy plus lenvatinib (RT + L) and radiotherapy plus sorafenib (RT + S) in the treatment of hepatocellular carcinoma with portal vein tumor thrombus (PVTT).MethodsAmong patients with PVTT who received RT + L or RT + S between March 2017 and September 2022, the primary endpoints were overall survival (OS) and progression-free survival (PFS). The secondary endpoints were objective response rate (ORR), disease control rate (DCR), and incidence of treatment-related adverse effects. The prognostic factors were also assessed.ResultsThe analysis included 152 patients (RT + L: 48; RL: 25; RT + S: 55; S: 24). Compared with the RT + S group, the RT + L group had a longer OS and PFS. Among patients with type I/II PVTT, the median OS times were 19.8 months and 13.5 months (p = 0.047) and the median PFS was 12.3 months and 7.3 months (p = 0.042), respectively. And the median OS of the patients with type I/II PVTT were 14.4 months and 8.3 months (p = 0.030) and the median PFS was 8.3 months and 6.2 months (p = 0.026). ORR and DCR in RT + L group (25.0% and 75.0%) were also little higher than those in RT + S group (20.0% and 70.9%), but not statistically significant. In univariate analysis, etiology, Type of PVTT, alpha-fetoprotein (AFP) level, Child–Pugh score, and treatment method influenced OS. Multivariate analysis confirmed that treatment method, etiology, alpha-fetoprotein (AFP) level, and Child–Pugh score were independent prognostic factors for OS. Similar safety profiles were observed in the RT + L and RT + S groups. The most common adverse events were myelosuppression, decreased liver function, fatigue, diarrhea, nausea, and vomiting. Most adverse reactions were grade 1–2.ConclusionThe side effects of radiotherapy plus lenvatinib were acceptable. Compared to RT + S, RT + L had good efficacy in the treatment of hepatocellular carcinoma with PVTT. Validation is needed in prospective studies with larger sample sizes.
Cancer and lymphatic marker FOXC2 drives wound healing and fibrotic tissue formation
Authors: Granoski Maia B. , Fischer Katharina S. , Hahn William W. , Sivaraj Dharshan , Kussie Hudson C. , Quintero Filiberto , Alsharif Abdelrahman M. , McKenna Eamonn , Yasmeh Jonathan P. , Hostler Andrew C. , Mora Pinos Maria Gracia , Erickson Robert P. , Witte Marlys H. , Chen Kellen , Gurtner Geoffrey C. 
Published: October 2024

IntroductionThe FOXC2 transcription factor has been tied to a wide range of disease states, serving as a promising prognostic biomarker associated with aggressive basal-like human breast cancers (increased cancer invasion and metastasis). Dysregulation of FOXC2 expression has also been found to promote defects in lymphatic remodeling and hyperplastic lymphedema-distichiasis (LD). Since chronic lymphedema is a forerunner of several malignancies and cancers have been known to arise from poorly healing chronic wounds (e.g., Marjolin ulcers), we examined the effect of Foxc2 dysfunction on skin wound healing.MethodsWe used our splinted excisional wounding model that mimics human-like wound healing on wildtype and Foxc2+/− mice (n = 4), which demonstrate incomplete lymphatic vasculature and lymphatic dysfunction. Wound size was measured over the course of 18 days. Tissue was explanted from both groups at post-operative day (POD) 14 and 18 and stained with Masson’s Trichrome to assess scar formation, Picrosirius Red for dermal integrity, or immunofluorescence to assess lymphatic (LYVE1) cell populations.ResultsWildtype mice completely healed by POD 14, while Foxc2+/−mice did not completely heal until POD18. Scar area of healed Foxc2+/−mice (POD 18) was larger than that of healed wild-type mice (POD 14; p = 0.0294). At POD 14, collagen "bers in the scars of Foxc2+/−mice to be narrower (p = 0.0117) and more highly aligned (p = 0.0110), indicating signi"cantly more "brosis in these mice. Collagen "bers in both groups became longer (p = 0.0116) and wider (p = 0.0020) from POD 14 to 18, indicating a temporal evolution of "brosis. Foxc2+/−mice also had lower numbers of LYVE1+, F4/80+ and CD4+ cells compared to wildtype mice.DiscussionIndividuals over 65 years old are more likely to develop cancer and are highly susceptible to developing chronic wounds. Here, we found that FOXC2, which is tied to cancer metastasis and lymphatic dysregulation, also impairs wound healing and promotes "brotic tissue architecture. With FOXC2 proposed as a potential therapeutic target for cancer metastasis, its downstream systemic effects should be considered against the increased chance of developing nonhealing wounds. Further delineation of the microenvironment, cellular events, and molecular signals during normal and Foxc2-associated abnormal wound healing will improve clinical therapies targeting this important marker.
A multimodal physiological-psychological data-driven study on differentiation in miners’ job burnout and risk preferences
Authors: Tian Fangyuan , Qiu Weishuai , Li Hongxia , Zhao Ziyi 
Published: October 2024

BackgroundExisting research indicates that the personality traits of miners influence their emotional regulation strategies, and these strategies in turn affect their performance in work fatigue. However, whether there is an intermediary or moderating role among these factors remains unclear. Additionally, while some studies suggest an increased likelihood of unsafe behavior among miners following fatigue, physiological data concerning their cognition remains incomplete and requires further exploration. This study aims to explore the mediating and moderating effects of emotional regulation strategies among miners regarding their personality traits and work fatigue, and to expand understanding of the cognitive and physiological data related to miners’ risk decision-making following fatigue.MethodFifty adult miners (Mage = 25, aged 18–40, 100% male) were selected as participants. Emotional regulation tendency, significant levels of personality traits based on the Big Five Personality Traits questionnaire, and the three-dimensional levels of work fatigue were measured using emotional regulation strategy scale, Big Five Personality Traits questionnaire, and work fatigue scale, respectively. The eye–brain consistency hypothesis posits that eye movement trajectories and fixation points reflect the brain’s cognitive processes and focus. Therefore, combining eye-tracking experiments, miners’ preferences in risk decision-making were further measured.ResultsExpressive suppression strategies mediated between conscientiousness and depersonalization; expressive suppression strategies moderated between agreeableness and emotional exhaustion. In eye-tracking physiological experiments, significant differences were found in eye movement data among miners with varying levels of emotional exhaustion.ConclusionPreferences in emotional regulation strategies play mediating and moderating roles between miners’ Big Five Personality Traits and work fatigue. The levels and dimensions of work fatigue are influenced not only by personality traits but also by individual tendencies in emotional regulation strategies, which significantly affect performance in risk decision-making. The findings of this study can further enrich theories related to work fatigue among miners and provide insights for personalized safety management in mining.
Influence of slow and rapid weight loss periods on physiological performance, mood state and sleep quality in male freestyle wrestlers: a study from Sichuan Province, China
Authors: Yu Liang , Lei Lan , Cheng Liang 
Published: October 2024

ObjectiveThis study aims to investigate the changes in physiological performance, mental state and sleep quality during the weight reduction phase prior to competition in male freestyle wrestlers.MethodsThis study included 16 male freestyle wrestlers from Sichuan Province, China. Participants were evaluated at three time points: the first day of slow weight reduction (T1, March 26), the first day of rapid weight reduction (T2, April 26) and the day before the competition (T3, May 3), and measurements were taken for physiological performance, mood state and sleep quality.ResultsThe most relevant findings indicated the following: Morning heart rate, creatine kinase and fatigue scores increased by 12.6, 64.6, and 19.0%, respectively, from T1 to T2 (p &lt; 0.05), and decreased by 14.1, 36.6, and 16.8%, respectively, from T2 to T3 (p &lt; 0.05). Hemoglobin and testosterone levels decreased by 3.0 and 16.8%, respectively, from T1 to T3 (p &lt; 0.05), and by 2.9 and 18.2%, respectively, from T2 to T3 (p &lt; 0.05); The secondary findings revealed the following: The total mood disturbance scores decreased by 3.8% from T2 to T3 (p = 0.072), positive mood scores decreased by 9.0% from T1 to T2 (p = 0.090), the Pittsburgh Sleep Quality Index total scores increased by 14.4% from T1 to T2 (p = 0.323) and total work output and average power output decreased by 7.3 and 7.8%, respectively, from T1 to T3 (p = 0.067, p = 0.052); Regression analyses predicted negative mood (Y1 = 62.306–0.018 × maximum power output) and sleep quality (Y2 = 2.527 + 0.278 × Immunoglobulin G) during the weight reduction period.ConclusionThe combined slow and rapid weight reduction approach effectively minimized body fat in athletes with limited effect on their physiological performance and sleep quality. However, the effects were adverse on certain health variables and anaerobic power in Chinese male freestyle wrestlers. The identified correlations between negative mood and maximum power, and between sleep quality and immunoglobulin G, shed new light on factors influencing athletes’ well-being during weight reduction, and underscored the need for careful monitoring of physiological variables in future weight management strategies.
Latent profile of personality traits for American older adults and its transition during the COVID-19 pandemic
Authors: Fu Mingqi , Guo Jing , Kang Hao , Huang Xiaorui 
Published: October 2024

BackgroundThe impact of COVID-19 on older adults’ personality development is essential for emergency management but under-researched. This study seeks to explore the personality profiles of older adults living in the United States and how these profiles transitioned during the pandemic.MethodsLongitudinal data were collected from 3,550 adults aged 60 and older who participated in both the 2016 and 2020 waves of the Health and Retirement Survey (61.18% female, mean age 65.85 in 2016). Personality traits were assessed using the Midlife Development Inventory. COVID-19-related experiences including pandemic concerns, restricted healthcare access, financial instability, work challenges, disrupted social connections, and mutual aid behaviors. Latent Profile Analysis and Transition Analysis were used for analysis.ResultsThree distinct personality profiles were identified: Well-adjusted, Moderate-adjusted, and Poor-adjusted. About 42% of respondents experienced personality changes during the pandemic. Higher levels of COVID-19 concern were linked to an increased likelihood of transitioning to Poor-adjusted from Moderate (OR=1.06, p&lt;0.05) or Well-adjusted (OR=1.05, p&lt;0.01). Challenges such as healthcare delays and financial hardships hindered transitions from Poor- to Moderate-adjusted (Healthcare delay: OR=0.39, p&lt;0.05; Financial hardships: OR=0.67, p&lt;0.05) but increased the likelihood of Moderate-adjusted individuals transitioning to Poor-adjusted (Healthcare delay: OR=1.46, p&lt;0.05; Financial hardships: OR=1.51, p&lt;0.05). However, Poor-adjusted individuals who provided help to others were more likely to transition to Moderate-adjusted (OR=2.71, p&lt;0.01).ConclusionsPersonality transitions during crisis are significant among older adults. Future interventions should focus on addressing traumatic concerns, encouraging helping behaviors, and mitigating healthcare and financial challenges to support older adults’ personality development during crisis.
The total joint arthroplasty care patterns in China during the COVID-19 pandemic: a multicenter cohort study
Authors: Zhang Tianyi , Wang Shan , Yan Li , Bai Huajuan , Guo Jiugong , Liu Jianchao , Liu Lihua 
Published: October 2024

BackgroundThe COVID-19 pandemic has profoundly affected the care practices of total joint arthroplasty (TJA) throughout the world. However, the impact of the pandemic on TJA care practices has not yet been studied in China.MethodsThis retrospective multicenter cohort included patients aged 18 years or older who underwent TJA between January 2019 and December 2019 (prepandemic period) and January 2020 to December 2021 (pandemic period). Data were obtained from the medical records of 17 Chinese hospitals. Interrupted time series (ITS) analysis was used to estimate differences in monthly TJA volume, hospitalization proportion of TJA, preoperative characteristics, postoperative complications, 30-day readmissions, length of stay (LOS), and costs in inpatients undergoing TJA between the prepandemic and pandemic periods. Multivariate regression and propensity score matching (PSM) analyses were used to assess the impact of the COVID-19 pandemic on hospital complications, readmissions at 30 days, LOS, and costs at the patient level.ResultsA total of 752,477 inpatients undergoing TJA in the prepandemic period, 1,291,248 in the pandemic period, with an average 13.1% yearly decrease in the volume of TJA during the pandemic. No significant changes were observed in the proportion of hospitalizations for TJA. ITS analyses showed increases in the proportion of comorbidities (8.5%, 95% CI: 3.4–14.0%) and the number of comorbidities (15.6%, 95% CI: 7.7–24.1%) in TJA cases during the pandemic, without increasing LOS, costs, complications, and readmission rates. Multivariate and PSM analyses showed 6% and 26% reductions in costs and readmission rates during the pandemic, respectively.ConclusionsThe COVID-19 pandemic was associated with more severe preoperative conditions and decreased volume, costs, and readmission rates in patients undergoing TJA in China. These findings demonstrate that the COVID-19 pandemic did not have a dramatic impact on the TJA care pattern in China, which may have resulted from active and strict strategies in combating COVID-19 as well as a rapid response in hospital management.
A scoping review of COVID-19 vaccine hesitancy: refusal rate, associated factors, and strategies to reduce
Authors: Bahreini Rona , Sardareh Mehran , Arab-Zozani Morteza 
Published: October 2024

ObjectiveThis study aimed to investigate the evidence regarding vaccine hesitancy including refusal rate, associated factors, and potential strategies to reduce it.MethodsThis is a scoping review. Three main databases such as PubMed, Scopus, and Web of Science were searched from 1 January 2020 to 1 January 2023. All original studies in the English language that investigated one of our domains (vaccine hesitancy rate, factors associated with vaccine hesitancy, and the ways/interventions to overcome or decrease vaccine hesitancy) among the general population were included in this study. The data were charted using tables and figures. In addition, a content analysis was conducted using the 3C model of vaccine hesitancy (Confidence, Complacency, and Convenience) that was previously introduced by the WHO.ResultsFinally, 184 studies were included in this review. Of these, 165, 181, and 124 studies reported the vaccine hesitancy rate, associated factors, and interventions to reduce or overcome vaccine hesitancy, respectively. Factors affecting the hesitancy rate were categorized into 4 themes and 18 sub-themes (contextual factors, confidence barriers, complacency barriers, and convenience barriers).ConclusionVaccine hesitancy (VH) rate and the factors affecting it are different according to different populations, contexts, and data collection tools that need to be investigated in specific populations and contexts. The need to conduct studies at the national and international levels regarding the reasons for vaccine refusal, the factors affecting it, and ways to deal with it still remains. Designing a comprehensive tool will facilitate comparisons between different populations and different locations.
Social isolation and loneliness prevention among rural older adults aging-in-place: a needs assessment
Authors: Southerland Jodi L. , Zheng Shimin , Dodson Kayla , Mauck Erin , Bacsu Juanita-Dawne R. , Brown Monique J. , Holloway Jeremy , Kim Steffi M. , Malatyali Ayse , Smith Matthew Lee 
Published: October 2024

IntroductionThe adverse effects of social isolation and loneliness (SI/L) have been documented among older adults in rural communities and contribute to poor health outcomes, premature disability and mortality, and increased burden on the healthcare system. The identification of factors contributing to SI/L among older adults can build the foundation for rural policymakers and leaders to allocate resources and develop tailored strategies more efficiently. The purpose of this article is to describe findings from a needs assessment designed to understand local factors that contribute to SI/L among rural older adults in a county in Northeast Tennessee. Findings from the needs assessment will be used by local stakeholders to develop strategies to promote age-friendly initiatives.MethodsEighty-two older adults [ages 62 to 74 years (59%); non-Hispanic white (95%); female (71%)] from three senior apartment complexes in a Northeast Tennessee county completed an 87-item needs assessment survey. The evaluation of social isolation utilized Lubben’s 6-item Social Network Scale, while loneliness was assessed using the 3-item UCLA Loneliness Scale. Logistic regression analysis was used to identify predictors of SI/L. Given the limited sample size, statistical significance was considered at p &lt; 0.10.ResultsThe prevalence of social isolation and loneliness was 42% and 37%, respectively. Residing in the county &lt;5 years [Adjusted OR (AOR): 3.35; 95% CI: 1.04–10.81; p = 0.04] and reporting resource-related barriers to aging-in-place (AOR: 6.56; 95% CI: 2.00–21.57; p = 0.004) were associated with increases in the odds of social isolation; whereas interest in intergenerational activities decreased the odds of social isolation (AOR: 0.19; 95% CI: 0.05–0.69; p = 0.01). Boredom (AOR: 4.06; 95% CI: 1.63–12.11; p = 0.01) and limited knowledge about community services (AOR: 4.61; 95% CI: 1.42–15.02; p = 0.01) quadrupled the odds of loneliness. Similarly, older adults who were frail (AOR: 2.69; 95% CI: 0.88–8.17; p = 0.08) and who rated their community livability as low (AOR: 3.35; 95% CI: 0.81–13.87; p = 0.09) were more likely to experience loneliness.DiscussionThis needs assessment provided important information about the individual and social drivers of SI/L among rural older adults in the community. Findings support the generation of localized data to support muti-partner efforts to design sustainable programs to address SI/L.