bluuebunny/crossref_metadata_2025_split huggingface dataset:
The proof is in the pudding: Patient Engagement in Studying Cannabidiol in Mild Cognitive Impairment
Authors: Keck Antonia , Scheuermann Julia-Sophia , Scheerbaum Petra , Graessel Elmar , Mueller-Vahl Kirsten R. 
Published: October 2024

Abstract

Background
Patient engagement (PE) in clinical trials has gained importance yet remains uncommon, particularly in patients with mild cognitive impairment (MCI), a critical precursor to Alzheimer's disease (AD). Cannabidiol (CBD) shows potential in slowing MCI progression due to its neuroprotective properties. In CBD research, PE is underutilized too. To design a study on CBD for MCI, we administered an online survey to individuals with MCI to better understand their preferences for trial setup and outcomes.
Methods
We asked 209 individuals with MCI to complete an online survey assessing (i) willingness to participate in a trial using CBD; (ii) importance of improvements in various domains; (iii) acceptance of adverse events (AEs); (iv) reasons for AE-related dropout; (v) willingness to undergo blood sampling and lumbar puncture to assess AD pathology; and (vi) willingness to participate in a trial with a 50% chance of receiving a placebo. Data were analyzed with descriptive statistics.
Results
N = 118 agreed to participate and N = 88 completed the survey. Participants prioritized improvement in cognitive abilities (87.5%), followed by quality of life (63.6%), daily activities (55.7%), sleep (55.7%), pain (52.3%), mood (52.3%), behavior (48.9%), and anxiety (43.2%). Headache (55.7%) was the least accepted AE followed by nausea (46.6%), fatigue (35.2%), and diarrhea (35.2%). Persistent diarrhea (90.9%) and severe fatigue (84.1%) were the main reasons for potential dropout. While most would undergo blood sampling (67.0%), only a minority (21.6%) would accept lumbar puncture. One-third were ready to participate (34.1%), while 54.5% were interested pending details. Among those in favor of participation, 71.6% would participate even with a 50% chance of placebo.
Conclusions
Our study identified cognitive improvement as highly relevant for patients, indicating cognitive assessment tools as primary endpoints in MCI research. Given concerns about AEs, dose titration should be carefully considered to enhance acceptance and prevent AEs. Blood sampling seems well-accepted for AD biomarker assessment. Despite potential AEs, participation in a trial using CBD for MCI is seen as attractive, even under placebo-controlled conditions. This cross-sectional study emphasizes the importance of patient engagement in designing high-quality trials for using CBD to treat MCI.
Unsatisfactory Colposcopy in Late Postmenopausal Women: The Effectiveness of Conjugated Topic Estrogen
Authors: Schwingel Tatiane Andreia , Reis Leila Caroline Souza , de Mello Paula Vieira , Zanine Rita Maira 
Published: October 2024

Abstract

Background
Menopause’s hypoestrogenic state which is characterized by atrophy can lead to incorrect interpretation of the cytological smears, as well as it can turn colposcopy challenging because of non-visualization of squamocolumnar junction. This study aims to determine the effect of estrogen therapy on the topography of the colposcopic transformation zone in hypoestrogenic patients and its effect on the differentiation of abnormal Papanicolaou smears secondary to atrophy and true intraepithelial lesions to improve the management of cervical disease after menopause.
Methods
This was a retrospective evaluation of postmenopausal women aged 50 years or older who were treated between January 2010 and February 2019 at a public hospital in southern Brazil and who had abnormal cervical cytologies and negative initial colposcopies and who were subjected to topical conjugated estrogen therapy and follow-up evaluations.
Results
Ninety-eight patients aged 57 years and 9.5 years after menopause were included. After 3 months of conjugated-topic estrogen therapy, the rate of satisfactory colposcopy ranged from 20.4–32.7%. Of the 78 (79.6%) subjects with a type 3 transformation zone in the entry colposcopy, 66 (67.3%) remained in the same topography. Additionally, of the 98 patients, 67 (68%) had negative cervical cytology results after treatment. Persistence of high-grade intraepithelial lesions was observed in 33.3% of the patients, 16.7% of whom were diagnosed with microcarcinoma.
Conclusion
The use of conjugated topical estrogen improved the accuracy of cytology smears in late postmenopausal women. However, it did not show a good response in the topography of the transformation zone and, consequently, a satisfactory colposcopy rate.
Comparison of Clinical and Prognostic Characteristics Between Superficial Basaloid and Conventional Esophageal Squamous Carcinoma
Authors: Yuan Ying , Mao Shangtao , Wu Hai , Xiang Ying , Wang Zhenyu , Wang Yanan , Goncalves Viriania Berta Esperanca , Sun Qi , Tang Dehua , An Fangmei , Wang Lei , Huang Qin , Xu Guifang 
Published: October 2024

Abstract

Background and Aims: Superficial basaloid esophageal squamous cell carcinoma (SBSCC) is a rare subtype of early esophageal squamous cell carcinoma, and its characteristics have not been thoroughly investigated. This retrospective study aims to elucidate the clinicopathological features and outcomes of SBSCC resected via endoscopic submucosal dissection (ESD), with a comparison to superficial conventional esophageal squamous cell carcinoma (SCSCC).
Methods: We identified patients with ESD-resected superficial esophageal squamous cell carcinoma at the Center of Gastrointestinal Endoscopy, Nanjing Drum Tower Hospital, from January 2014 to December 2019.Based on histopathologic findings, eligible cases were divided into SBSCC and SCSCC groups. The medical records, endoscopic and pathologic reports were reviewed for clinicopathologic and endoscopic information. All patients were routinely followed up at clinic and the outcomes were tabulated and statistically compared between the two groups.
Results: Among 477 patients, 31 (6.5%) had SBSCC and 446 (93.5%) had SCSCC. The SBSCC group had a significantly higher proportion of male patients (P = 0.027), but there was no significant difference in age. Both groups showed similar rates of smoking, alcohol abuse, family cancer history, tumor size, location, en bloc resection, and ESD-related complications. However, complete and curative resection rates were significantly lower in the SBSCC group (74.2% and 58.1%) compared to the SCSCC group (91.5% and 75.6%) (P = 0.006 and P = 0.031). SBSCC also exhibited deeper invasion (P = 0.018) and more frequent vertical margin involvement (P = 0.010). The 5-year overall survival (OS) was comparable between the groups, but disease-free survival (DFS) was lower in the SBSCC group (90.3% vs. 97.8%; P = 0.046). Post-ESD surgery, chemoradiation therapy, and tumor recurrence were more common in the SBSCC group (P < 0.05). Multivariate analysis identified SBSCC as an independent risk factor for DFS (HR: 4.6; 95% CI: 1.990-10.650; P < 0.001), while lymphovascular invasion and complete resection were significant for OS.
Conclusions: Our findings demonstrate that ESD is a safe and effective treatment for both SBSCC and SCSCC, with minimal complications and excellent outcomes. Compared to SCSCC, SBSCC is associated with significantly deeper invasion, lower rates of complete and curative resections, and lower disease-free survival.
The Role of Inflammation and Nutrition-Based Scoring in Low-Risk Myelodysplastic Syndrome
Authors: ERSAL Tuba , ÖZKOCAMAN Vildan , ÇUBUKÇU Sinem , KOCA Tuba GÜLLÜ , Hunutlu Fazıl Çağrı , Yavuz Şeyma , Elgün Ezel , ÖZKALEMKAŞ Fahir 
Published: October 2024

Abstract

While the pathogenesis of Myelodysplastic Syndrome (MDS) is diverse, growing evidence suggests that inflammation significantly influences disease development and progression. This study sought to assess the impact of inflammation and nutritional status on mortality, with a particular focus on patients with low-risk MDS. A retrospective analysis was conducted on 175 newly diagnosed low-risk MDS patients. A low Prognostic Nutritional Index (PNI) was significantly associated with poorer prognosis (p<0.001). The optimal PNI cut-off value for predicting mortality was identified as 47.47. Based on this cut-off, 92 patients had a low PNI score while 83 patients had a high PNI score. The comparison between these groups revealed a statistically significant difference in median overall survival (OS), with 45.5 months for the low PNI group and 75.1 months for the high PNI group (p<0.001). In the multivariate OS analysis, several factors were identified as independent predictors of prognosis, including a high Revised International Prognostic Scoring System (R-IPSS) score, low PNI, high systemic oxidative stress (SOS) score, advanced age, male gender, and transformation to acute myeloid leukemia. The PNI is a readily available and cost-effective marker that can be utilized to predict prognosis in patients with low-risk MDS.
A four-m6A methylation regulator risk score was an independent prognostic biomarker for adrenocortical carcinoma
Authors: Liu Ziyang , Shan Jiahao , Tian Jia , Zhang Qiang , Ma Lianghong , Yang Feilong 
Published: October 2024

Abstract

N6-methyladenosine (m6A) is crucial in cancer prognosis, yet its role in adrenocortical carcinoma (ACC) is not well understood. This study investigates the prognostic value of m6A RNA methylation regulators in ACC using mRNA data and clinical information from the TCGA-ACC database. Patients were divided into two clusters based on the expression of 13 m6A genes. Univariate and LASSO Cox regression analyses identified four key prognostic m6A regulators (METTL14, RBM15, HNRNPC, WTAP), leading to the construction of a risk score (RS) model: RS = (-0.1828 × METTL14) + (0.3292 × RBM15) + (0.0219 × HNRNPC) + (0.0010 × WTAP). Kaplan-Meier survival analysis showed significant differences between high and low RS groups, with an AUC of 0.787, indicating good predictive accuracy. Univariate and multivariate Cox regression analyses revealed that T stage and RS were independent prognostic factors. RS was also closely correlated with stage and N status. High RS was associated with higher expression levels of RBM15, HNRNPC, and WTAP, and lower expression of METTL14. This study highlights the prognostic significance of m6A RNA methylation regulators in ACC, presenting a four-gene RS model as an independent prognostic biomarker. These results provide new insights into ACC prognosis, emphasizing the potential of targeting m6A RNA methylation in future therapeutic strategies and enhancing patient management through more accurate prognostic tools. Furthermore, this research underscores the importance of continued investigation into the molecular mechanisms of m6A RNA methylation and its broader implications in oncology, potentially guiding personalized treatment approaches for ACC patients.
A Comparative Study of Clinical Outcomes and Risk Factors of Tuberculosis in Kidney Transplant Recipients from Deceased Donors
Authors: Zhang Hedong , Zhong Mingda , Hu Shanbiao , Tan Liang , Peng Longkai , Xie Xubiao , Lan Gongbin 
Published: October 2024

Abstract

Objective: To investigate the clinical characteristics, diagnosis and treatment of tuberculosis infection after deceased donor kidney transplantation and to analyze the risk factors and prognosis of tuberculosis infection through a paired case-control study.
Methods:This study investigated 31 kidney transplant recipients who developed tuberculosis among 2185 total recipients during 2012-2021. We employed a 1:1 paired case-control design, utilizing 31 patients who received kidneys from the same donor as the control cases. The study analyzed clinical presentation, diagnosis, treatment, risk factors, and prognosis. Results: This study identified a 1.4% incidence of tuberculosis (TB) infection (31/2185) in kidney transplant recipients. The median onset was 10.8 months post-transplant (range: 5-24 months), with 51.6% occurring within the first year. Anti-TB therapy achieved cure in 30 patients, but 1 died and 3 experienced kidney transplant dysfunctions. While overall patient survival wasn't statistically different between groups, kidney graft survival was significantly lower in the TB group (p=0.042). While kidney function was initially similar, the TB group experienced significant declines in creatinine and GFR at 3, 6, and 12 months post-treatment (p<0.05). Multivariate analysis identified diabetes mellitus (p = 0.005) and hepatitis (p = 0.027) as independent risk factors for post-transplant TB infection.
Conclusion: Over half of the tuberculosis cases (51.6%) occurred within the first year post-transplant, highlighting the need for heightened vigilance during this early period. While standard anti-TB therapy achieved good overall patient survival, it takes a toll on kidney function which underscores the importance of close kidney function monitoring and delicate immunosuppressant management during TB treatment. Diabetes mellitus and hepatitis were identified as independent risk factors for post-transplant TB infection. Prophylaxis measures should be considered for these high-risk patients during early time post-transplant.
Alterationd in spontaneous brain activity of maintenance hemodialysis patients with restless legs syndrome: a cross-sectional case-control study
Authors: Wang Di , Li Wenqing , Tang Yushang , Zhang Wanfen , Liu Tongqiang , Shi Haifeng 
Published: October 2024

Abstract

Objective
Through resting state functional magnetic resonance imaging (rs-fMRI) we evaluate the spontaneous brain activity changes of maintenance hemodialysis (MHD) patients with restless legs syndrome (RSL) and analyzed the imaging features and related mechanisms of RLS in patients with MHD.
Method
We select 27 MHD patients with RLS and 27 patients without RSL matched by age, gender, cognitive function. Both groups underwent neuropsychological tests and MRI scans. MRI data analysis was performed to obtain and compare the amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) values, which were mALFF, mfALFF, and mReHo. Clinical data were collected and compared. Differentiated indicators and RLS scores conduct Pearson correlation analysis.
Result
Compared with the MHD-nRLS group, the MHD-RLS group showed significantly lower mALFF values in the left precentral and right precentral gyrus, lower mALFF values in the right postcentral gyrus ,left precentral gyrus, right precentral gyrus, left postcentral gyrus, right postcentral gyrus, left calcarine fissure, left lingual gyrus, and lower mReHo values in the left precentral gyrus, right precentral gyrus and right postcentral gyrus (P < 0.05). The MHD-RLS group exhibited lower hemoglobin levels (P = 0.001), higher total iron-binding capacity levels (P = 0.011), and higher folic acid levels (P = 0.022). The above indicators were correlated with RLS scores using Pearson correlation analysis, and it was found that the mfALFF value of the right precentral gyrus and the right postcentral gyrus, and the mReHo values of the right precentral gyrus and right postcentral gyrus were negatively correlated with the RLS score (r = -0.567, P = 0.002;r = -0.705, P < 0.001;r = -0.414, P = 0.032; r = -0.410, P = 0.034), and the hemoglobin concentration was negatively correlated with the RLS scores (r = 0.412, P = -0.394).
Conclusion
Patients with MHD-RLS exhibit abnormal spontaneous brain activity in the right precentral gyrus and right postcentral gyrus within the sensorimotor network, along with lower hemoglobin levels, which may be associated with the pathogenesis and severity of MHD-RLS.
Resumption of sexual activity and contraceptive use among postpartum women in the Kumasi Metropolis of Ghana
Authors: Peprah Amponsah , Danso Kwabena Antwi , Sarbeng Kwadwo , Ankobea Frank , Asubonteng Gerald Owusu , Dassah Edward T. , -Antwi Kwabena Amo , Tabi Seth Amponsah , Borlabi Samuel Bortier , Senaya Charles Mawunyo , Kwarko Ernest , Yiadom Jonathan Boakye , Kolbilla David Zawumya 
Published: October 2024

Abstract

Background: The postpartum period presents challenges to women as they contemplate on the desire to space or limit childbirth while meeting the sexual demands of their partners and their own sexual desires. The study looked at the factors that determine the resumption of sexual activity after delivery and their influence on contraceptive use among postpartum women in the Kumasi metropolis.
Method: An analytical cross-sectional study was conducted using an interviewer administered structured questionnaire with both closed and open-ended questions, on 853 mothers aged 15-49 years, attending child welfare clinics with babies who were up to one (1) year old in the Kumasi Metropolis of Ghana.
Results: Majority (76%) of the women initiated sexual intercourse from 6 weeks after delivery but only 34% used contraceptives, despite the 99% awareness of postpartum family planning services.
Response to partners’ demand for sex was the most important stimulus for resumption of sexual activity while unavailability of the partner was the main reason for sexual inactivity after delivery. Marital status (AOR: 4.94, CI=2.99-8.15), residence after delivery (AOR: 0.53, CI=0.38-0.76), resumption of menses (AOR= 0.19, CI= 0.13 – 0.27), birth limiting (AOR= 0.68, CI= 0.45 – 0.98), and birth spacing (AOR= 0.40, 95% CI= 0.18– 0.91) significantly predicted resumption of postpartum sexual activity and contraceptive uptake.
Conclusion: Reproductive health service providers in the metropolis should highlight the return to fertility and timing of sexual intercourse after delivery, and adopt strategies to demystify the fear of side effects during counselling and provision of Family Planning services.
Phylogeny and molecular approach of Lysurus (Phallaceae, Basidiomycota): proposal of Lysurus brachistriatus sp. nov. for the Brazilian Cerrado Biome, and an update of the geographic distribution for the genus
Authors: Barbosa Kairo Dourado , Oliveira Renan Lima , Marinho Paulo , Baseia Iuri Goulart , Cruz Rhudson Henrique Santos Ferreira da 
Published: October 2024

Abstract

In the present study, a new species of Lysurus with distinctive characteristics is reported in areas of the Brazilian Cerrado biome: Lysurus brachistriatus sp. nov. A detailed morphological analysis revealed, for the first time, the presence of four distinct layers in the volva of a species within this genus. Phylogenetic data obtained from the RPB2 genetic region using the primers bRPB2-6F/bRPB2-7.1R revealed a distinct and unexpected grouping, with the new Lysurus species positioned separately from L. cruciatus and L. cruciatus var. nanus, within a clade that also includes L. borealis. All detailed descriptions of the new taxon are accompanied by a map of the collection site, photographs of macroscopic structures taken in the field, and images of microscopic structures observed under optical microscope.
Mantle overturn drove early lunar volcanism and the lunar dynamo during the high intensity epoch
Authors: Nichols Claire , Wade Jon , Stephenson Simon 
Published: October 2024

Abstract

Generation of an apparently long-lived lunar magnetic field is a longstanding controversy. Palaeomagnetic studies provide conflicting evidence for both strong intrinsic fields (> 53 µT)1–6 and null fields7 between 1.92–4.25 billion years (Ga) ago, with crustal magnetic anomalies indicating no presence of an intrinsic magnetic field after 3.9 Ga ago8–11. During the intermittent high intensity epoch (IHIE) 3.16–3.85 Ga ago, we show that samples that have recorded strong fields are exclusively high-Ti basalts which, based on recent high resolution geochronology12, were erupted during < 1% of this time period. The short period over which these samples formed suggests that the dynamo was predominantly inactive, as evidenced by the continuous unmagnetized crater record throughout the IHIE, and intense fields were only generated for short periods of time while the high-Ti basalts erupted. A possible mechanism for generating an intermittent dynamo is mantle overturn, triggered by dense and gravitationally unstable Ti-rich cumulates sinking to the core-mantle boundary (CMB). We model this process, considering how Ti-rich diapirs melt and temporarily increase the core heat flux, resulting in the generation of a magnetic field13. We demonstrate that this mechanism is only feasible if magnetic field generation is coeval with the rapid eruption of high-Ti basalts following melting. Rapid ascent of Ti-rich melts is supported by petrological evidence14 and demonstrates a causal link between lunar dynamo generation and high-Ti eruptions of the mare basalts.
Association between pre-pregnancy body mass index and neonatal outcomes in women undergoing assisted reproductive technology: a retrospective study
Authors: Qian Huili , Wang Yunyun , Bai Caiying , Gao Lina , Liu Xiaoling , Cui Jinrui , Liu Xiaohui , Ding Xiaohua 
Published: October 2024

Abstract

Objective: ART and pre-pregnancy BMI are strongly associated with neonatal outcomes, but there are fewer relevant studies. Our objective was to analyze the association between pre-pregnancy body mass index (BMI) and neonatal outcomes in women planning assisted reproductive technology (ART).

Methods: This was a retrospective study that included 994 ART singleton mothers who delivered in hospitals from July 2020 to June 2024. Mothers were categorized into 4 groups based on BMI (kg/m2): underweight (<18.5), normal weight (18.5-23.9, reference), overweight (24.0–27.9), and obesity (≥28.0). Associations between BMI classification and neonatal outcomes were analyzed using univariate and multivariate logistic regression.
Results: Among all mothers, pre-pregnancy underweight increased the adjusted odds ratio (aOR) for small for gestational age (SGA) to 3.97-fold compared to normal-weight mothers; overweight/obesity significantly increased the risk of macrosomia and large for gestational age (LGA), with aORs of 5.047 and 2.935-fold, respectively. In gestational weight gain (GWG) subgroup analyses, when GWG was adequate, pre-pregnancy underweight mothers were more likely to develop SGA than normal-weight mothers (aOR 4.649, 95% CI: 1.316-16.426), and overweight/obese mothers were not associated with adverse neonatal outcomes. When GWG was excessive, pre-pregnancy underweight mothers were 3.986 times more likely to be at risk of developing SGA than normal-weight mothers; pre-pregnancy overweight/obese mothers were 4.466 and 3.010 times more likely to develop macrosomia and LGA, respectively, compared to normal-weight mothers.
Conclusion: Maternal preconception underweight is associated with SGA regardless of whether GWG is adequate or excessive. For pre-pregnancy overweight or obese mothers, maintaining GWG in the target range can reduce the risk of adverse neonatal outcomes; if GWG is excessive, it is associated with macrosomia and LGA.