bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case report: Refractory focal motor seizure associated with cerebrospinal fluid neurochondrin antibody
Authors: Ahmad Rowaid , Huang Yumeng , Wang Peter R. , Masel Todd , Li Xiangping 
Published: September 2024

BackgroundFocal onset seizures, characterized by localized neuronal hyperexcitability in the brain, can be related to various structural, immune, genetic, or metabolic abnormalities. Autoimmune epilepsies are increasingly recognized. Neurochondrin antibody has been reported in a variety of rare autoimmune neurological disorders. This article aims to highlight the relevance of anti-neurochondrin in autoimmune epilepsy.MethodsThis is a case presentation and literature review of autoimmune epilepsy associated with anti-neurochondrin antibody.Case presentationA 26-year-old African American right-handed man with a history of Sjogren’s syndrome presented with near constant, rhythmic left-sided facial twitching movements, and one episode of generalized tonic clonic seizure. Magnetic resonance imaging (MRI) of the brain revealed borderline low volume right hippocampus. Cerebrospinal fluid (CSF) studies yielded elevated protein and mild lymphocytic pleocytosis. Antibody Prevalence in Epilepsy 2 (APE2) score was 6, and autoimmune workup was initiated. Anti-neurochondrin antibody returned positive in the CSF autoimmune encephalitis panel with a titer of 1:512 (Mayo Clinic TEST ID: ENC2). Seizures remained refractory to anti-seizure medications including divalproex, lacosamide, and oxcarbazepine. Immunotherapy with methylprednisolone and immunoglobulin improved his epileptic seizures.ConclusionThis is the first reported case of refractory autoimmune epilepsy with positive CSF anti-neurochondrin antibody. This study contributes to the body of evidence supporting the role of neurochondrin antibody in epilepsy. Considering autoimmune testing in individuals with seizures having APE2 score &gt; 4 can aid in timely diagnosis of immune-mediated epilepsy and initiation of immunotherapy, which can result in favorable clinical outcomes. Diagnosis of autoimmune epilepsy, in most cases, is based on clinical characteristics, MRI results, and CSF findings. In addition to the traditional antibody panel for autoimmune encephalitis, some novel antibodies, such as anti-neurochondrin, should also be considered.
Regulating the lncRNA DSCR9/RPLP2/PI3K/AKT axis: an important mechanism of Xinfeng capsules in improving rheumatoid arthritis
Authors: Wang Fanfan , Liu Jian 
Published: September 2024

BackgroundRheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic and symmetrical polyarthritis. RA patients often experience inflammatory reaction and hypercoagulable state, which together affect the self-perception of patient (SPP). Currently, inhibiting inflammation and hypercoagulable state are common treatment methods for alleviating RA symptoms. Xinfeng Capsules (XFC) has a long history of treating RA, and can effectively improve the inflammatory response and hypercoagulable state of RA. However, the potential mechanisms have not yet been determined.Purpose and study designThis study elucidated the action mechanism of XFC in RA inflammation and hypercoagulability through the lncDSCR9/RPLP2/PI3K/AKT axis.ResultsClinical observations indicated that there was a strong link between XFC therapy and improvements in inflammatory and coagulation biomarkers, as well as SPP among RA patients. The subsequent network pharmacology analysis results identified the PI3K/AKT signaling pathway as a potential mediator for XFC treatment of RA. Furthermore, clinical validation and sequencing results revealed that lncRNA DSCR9 expression (a gene implicated in inflammation and coagulation) was negatively correlated with clinical markers of inflammation and coagulation, while positively correlated with SF-36 indicators. Notably, XFC treatment remarkably upregulated lncRNA DSCR9 expression and downregulated PI3K and AKT expressions, showing opposite expression trends to the untreated cases.The regulatory effect of XFC on the lncRNA DSCR9/RPLP2/PI3K/AKT axis in RA was investigated using techniques such as RNA pull-down assay, Western blot analysis, RT-PCR, and EdU assay. Moreover, the administration of the PI3K/AKT agonist RMH can counteract the effects of XFC on p-PI3K, p-AKT, inflammation, and hypercoagulability, reinforcing the role of pathway. Finally, animal studies utilizing HE staining and transmission electron microscopy (TEM) demonstrated that XFC notably decreased PI3K and AKT expressions in adjuvant-induced arthritis (AA) rats, mitigated inflammation and hypercoagulability, and enhanced the ultrastructure of synovial cells. These findings underscored the potential mechanisms of XFC in the treatment of RA.ConclusionRegulating the lncRNA DSCR9/RPLP2/PI3K/AKT axis may be an important mechanism by which XFC improved RA inflammatory response and hypercoagulable state.
A systematic review and meta-analysis of the globally reported International Classification of Diseases to Perinatal Mortality (ICD-PM)
Authors: Kumsa Henok , Mislu Esuyawkal , Yimer Nigus Bililign 
Published: September 2024

IntroductionAccurate recording and identification of perinatal mortality causes are crucial to reducing the global burden of perinatal mortality through targeted interventions. However, existing studies on the International Classifications of Diseases to Perinatal Mortality (ICD-PM) are limited by inconsistent results and variations by gestational age. Thus, this review aims to synthesize and document updated data on the causes of death using the ICD-PM classification.MethodsElectronic databases such as the PubMed via MEDLINE, SCOPUS, Web of Sciences, EMBASE, Cochrane Library, and PROSPERO were searched to retrieve studies published from 2016 to February 2024. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of the included studies, and heterogeneity between the studies was assessed using I2 statistics. ICD-PM coded reported data were extracted to Microsoft Excel, and aggregate data of frequencies and percentages were reported.ResultsOut of the 23 included studies, 48,596 perinatal mortalities were reported, and approximately 96% (46,816 deaths) were classified according to the ICD-PM. The pooled rate of stillbirths in high-income countries was 23/1,000 births; in low-income countries, it was found to be approximately twice as in high-income countries. Regarding the category of deaths, 25,563 (54.6%) deaths were recorded in the antepartum period, and more than half, 14,887 (58.2%), were classified under unspecified causes (A6). Moreover, 6,148 (13.7%) and 14,835 (31.7%) deaths were coded with intrapartum and neonatal period causes, respectively. The leading causes of perinatal mortality during the intrapartum were acute intrapartum events (I3) 3,712 (57.8%). Furthermore, neonatal death was caused by low birth weight and prematurity (N9) 4,091 (27.6%), congenital malformations, and chromosomal abnormalities (N1) 2,512(16.9%).ConclusionCongenital malformations, and chromosomal abnormalities contribute to 1 in every 10 perinatal deaths and 1 in every 4 neonatal deaths. Other specified antepartum disorders are responsible for over half of antepartum deaths, while acute intrapartum events are the leading cause of intrapartum deaths, with a significant proportion remaining unexplained. Maternal complications related to the placenta, membranes, cord, labor, and delivery play a significant role in antepartum and intrapartum deaths. Targeted interventions and improved monitoring of high-risk pregnancies are crucial to reducing perinatal mortality rates. Further investigation is needed to enhance understanding and address unexplained perinatal deaths.Systematic review registration[https://clinicaltrials.gov/], identifier [CRD4202452549].
WHO-listed authorities (WLA) framework: transparent evidence-based approach for promoting regulatory reliance towards increased access to quality-assured medical products
Authors: Broojerdi Alireza Khadem , Salvati Anna Laura , Abdelfattah Mohammed Refaat , Dehaghi Razieh Ostad Ali , Sillo Hiiti B. , Gaspar Rogerio 
Published: September 2024

BackgroundIncreased global access to safe, effective and quality-assured medical products remains a primary goal for the full realization of the World Health Assembly Resolution WHA 67.20 on regulatory systems strengthening for medical products as well as target 3.8 of the Sustainable Development Goals (SDG). To promote the development of efficient regulatory systems, the WHO introduced the Global Benchmarking Tool (GBT) in 2016, upon which the WHO–Listed Authority (WLA) framework was later established. This study aimed to appraise the development of the WLA framework across various phases while highlighting its achievements, challenges, and areas for improvement.MethodsAn exploratory study design using a qualitative approach was used to gather information from relevant documents as well as views and experiences from purposefully selected participants from diverse backgrounds. Data was collected using a combination of desk reviews and In-depth one-to-one or small group interviews employing semi-structured interview guides with open-ended questions. Data was analysed using an inductive thematic analysis approach.ResultsThe leading role of the WHO was noted in developing and implementing essential documents and mediating consultative processes among stakeholders. The framework was revealed to bring an evidence-based, inclusive, and transparent approach to recognizing regulatory authorities (RAs) operating at the highest standards of performance. The framework was anticipated to promote regulatory reliance among all RAs, the WHO’s prequalification programme, and procurement agencies. Furthermore, remarkable progress towards WLA listing was noted among transitional WLAs including the Stringent Regulatory Authorities (SRAs). Challenges related to the availability of resources, resistance to change, and complexity were associated with the framework.ConclusionThe study provides a well-rounded view with regard to the roles of the WHO, Member States and other stakeholders in establishing and operationalizing the WLA framework. Furthermore, evaluating the performance and possible WLA designation of RAs operating at international regulatory standards underscores its high relevance in contributing to public health globally. Maintenance along with timely addressing of highlighted next steps to improve the framework particularly in creating better understanding, more communication, and coordination are highly encouraged.
A “love match” score to compare root exudate attraction and feeding of the plant growth-promoting rhizobacteria Bacillus subtilis, Pseudomonas fluorescens, and Azospirillum brasilense
Authors: Fourneau Eulalie , Pannier Mélissa , Riah Wassila , Personeni Emmanuelle , Morvan-Bertrand Annette , Bodilis Josselin , Pawlak Barbara 
Published: September 2024

IntroductionThe rhizosphere is the zone of soil surrounding plant roots that is directly influenced by root exudates released by the plant, which select soil microorganisms. The resulting rhizosphere microbiota plays a key role in plant health and development by enhancing its nutrition or immune response and protecting it from biotic or abiotic stresses. In particular, plant growth-promoting rhizobacteria (PGPR) are beneficial members of this microbiota that represent a great hope for agroecology, since they could be used as bioinoculants for sustainable crop production. Therefore, it is necessary to decipher the molecular dialog between roots and PGPR in order to promote the establishment of bioinoculants in the rhizosphere, which is required for their beneficial functions.MethodsHere, the ability of root exudates from rapeseed (Brassica napus), pea (Pisum sativum), and ryegrass (Lolium perenne) to attract and feed three PGPR (Bacillus subtilis, Pseudomonas fluorescens, and Azospirillum brasilense) was measured and compared, as these responses are directly involved in the establishment of the rhizosphere microbiota.ResultsOur results showed that root exudates differentially attracted and fed the three PGPR. For all beneficial bacteria, rapeseed exudates were the most attractive and induced the fastest growth, while pea exudates allowed the highest biomass production. The performance of ryegrass exudates was generally lower, and variable responses were observed between bacteria. In addition, P. fluorescens and A. brasilense appeared to respond more efficiently to root exudates than B. subtilis. Finally, we proposed to evaluate the compatibility of each plant–PGPR couple by assigning them a “love match” score, which reflects the ability of root exudates to enhance bacterial rhizocompetence.DiscussionTaken together, our results provide new insights into the specific selection of PGPR by the plant through their root exudates and may help to select the most effective exudates to promote bioinoculant establishment in the rhizosphere.
Pilot turning behavior cognitive load analysis in simulated flight
Authors: Zhou Wen-gang , Yu Pan-pan , Wu Liang-hai , Cao Yu-fei , Zhou Yue , Yuan Jia-jun 
Published: September 2024

BackgroundTo identify the cognitive load of different turning tasks in simulated flight, a flight experiment was designed based on real “preliminary screening” training modules for pilots.MethodsHeart Rate Variability (HRV) and flight data were collected during the experiments using a flight simulator and a heart rate sensor bracelet. The turning behaviors in flight were classified into climbing turns, descending turns, and level flight turns. A recognition model for the cognitive load associated with these turning behaviors was developed using machine learning and deep learning algorithms.Resultspnni_20, range_nni, rmssd, sdsd, nni_20, sd1, triangular_index indicators are negatively correlated with different turning load. The LSTM-Attention model excelled in recognizing turning tasks with varying cognitive load, achieving an F1 score of 0.9491.ConclusionSpecific HRV characteristics can be used to analyze cognitive load in different turn-ing tasks, and the LSTM-Attention model can provide references for future studies on the selection characteristics of pilot cognitive load, and offer guidance for pilot training, thus having significant implications for pilot training and flight safety.
Expression of p16 and Ki67 in laryngeal squamous cell carcinoma and their clinical significance
Authors: Liu Xue-Ying , Hanjing Shangguan , Zhang Bing-huang , Luo Xian-Yang 
Published: September 2024

ObjectiveThe objective of this study is to assess the prognostic value of Ki67 and p16 proteins in laryngeal cancer.Materials and methodsThis retrospective cohort analysis comprised 260 patients diagnosed with laryngeal cancer. Immunohistochemistry (IHC) was employed to assess the expression levels of p16 and Ki67, and their correlation with the survival time of laryngeal cancer patients was analyzed.ResultsThe Ki67 index level exhibited a significant association with the prognosis of laryngeal cancer. Patients with higher Ki67 index levels demonstrated shorter survival times, more severe pathological classification, and higher tumor stages (P &lt; 0.05). Conversely, no significant differences in prognostic characteristics of laryngeal cancer were observed in the p16 (-/+) population (P &gt; 0.05). The median survival times for patients with Ki67 index levels of 0-35%, 36-70%, and 70-100% were 3.54 years, 2.10 years, and 1.92 years, respectively. After adjusting for age, smoking, alcohol consumption, pathological classification, surgical intervention, recurrence, and metastasis, the risk of death for patients with Ki67 index levels of 70-100% was 2.0504 times higher than that of patients with Ki67 index levels of 0-35% (95% CI: 1.2997-3.2345, P = 0.0020).ConclusionThe Ki67 index level is strongly associated with survival time and the risk of death in laryngeal cancer, making it a valuable prognostic indicator. However, the prognostic value of p16 levels in laryngeal cancer is limited. These findings provide important insights for prognosis evaluation and treatment decision-making in patients with laryngeal cancer.
Systemic immune-inflammation index is associated with high risk for prostate cancer among the U.S. elderly: Evidence from NHANES 2001-2010
Authors: He Ran , Ye Youjun , Zhu Qilei , Xie Changsheng 
Published: September 2024

PurposeThe Systemic Immuno-Inflammation Index (SII) is a crucial clinical measure of inflammation, and there is currently no solid evidence linking SII to an increased risk of prostate cancer (PCa). Through the analysis of serum total prostate-specific antigen (tPSA), free prostate-specific antigen (fPSA), and the tPSA/fPSA (fPSA%) ratio, this study sought to investigate the relationship between SII and PCa risk among the U.S. elderly.MethodsElderly male participants were gathered from the NHANES database between 2001 and 2010.SII was calculated by platelet count * neutrophil count/lymphocyte count. High risk individuals for prostate cancer were defined as those with tPSA &gt; 4 ng/ml and fPSA% &lt; 16%. Multivariate logistic regression models, restricted cubic spline curves, and subgroup analyses were used to assess the relationship between SII and PCa risk.ResultsThis research comprised 2664 people in total, 137 (5.14%) of whom were deemed to be at high risk of developing PCa. Multivariate logistic regression analysis, after controlling for variables, revealed a significant positive correlation between high PCa risk and an increase in SII (p = 0.009). The RCS suggested a turning point at 9.01. Restricted cubic spline curves revealed a non-linear U-shaped association between SII and high PCa risk (p for nonlinear = 0.028). Education level, marital status, PIR, alcohol status, smoking status, rheumatoid arthritis status, and heart problem were not significantly correlated with this positive connection, according to subgroup analyses and interaction tests.ConclusionThe results of this study suggest that inflammation represented by SII is associated with high PCa risk.
Lifestyle and risk factors associated with elevated prostate-specific antigen levels in rural men: implications for health counseling
Authors: Hsieh Kun-Lu , Chang Chia-Hao , Lin Yu-Chih , Huang Tung-Jung , Chen Mei-Yen 
Published: September 2024

BackgroundThe use of prostate-specific antigen (PSA) for early detection of prostate cancer (PCa) is common but controversial. In rural areas, PSA is widely used for screening because it is convenient and early-stage PCa often shows no symptoms. Studies suggest that PSA levels are linked to factors like unhealthy lifestyles, obesity, lack of exercise, inflammation, and aging. Proper use and interpretation of PSA are crucial for healthcare providers, especially in primary care settings. This study aims to explore the prevalence and factors linked to higher PSA levels in rural men.MethodsWe conducted a community-based cross-sectional study from March to December 2023 in the western coastal region of Taiwan. Men aged 40-75 years participated, completing a lifestyle questionnaire and providing blood samples for cardiometabolic biomarkers and PSA levels. PSA levels of ≥ 4.0 ng/mL were considered elevated. We used propensity score matching (PSM) and genetic matching (GM) for analysis, followed by regression analysis.ResultsIn total, 3347 male adults with a mean age of 56.3 years (SD=11.8, range 40-75), and without cancer-related diseases, were enrolled. Findings indicated that 3.9% (n=130) of men aged 40-75 years had a PSA ≥ 4 ng/mL. and many of them did not adopt health-related behaviors, including inadequate servings of vegetables, water intake, and engaging in regular exercise. Furthermore, more than half of the participants had high blood pressure, and over one-quarter exhibited a higher waist-hip ratio and cardiometabolic diseases. After employing propensity score matching (PSM) and genetic matching (GM) with respect to age and education, the multivariate logistic regression model indicated that less water intake (p&lt;0.01), higher waist-hip ratio (&gt; 0.95) (p&lt;0.05), and being diagnosed with cardiometabolic diseases (p&lt;0.05) were significantly associated with a higher serum PSA level.ConclusionThis study revealed that inadequate water intake and obesity related diseases are significant risk factors associated with elevated PSA levels among male adults living in rural areas. It is important for frontline healthcare providers to carefully interpret the meaning of a high PSA level. Additionally, launching a longitudinal study is necessary to further investigate its relation to PCa.
Application of different CO2 pneumoperitoneum pressure in laparoscopic pyeloplasty for infants with ureteropelvic junction obstruction
Authors: Peng Yan , Zhu Min , Chen Chunmei 
Published: September 2024

BackgroundLaparoscopic pyeloplasty is a minimally invasive approach for the therapy of infant ureteropelvic junction obstruction (UPJO), reliant on CO2 pneumoperitoneum insufflation. While the impact of CO2 insufflation on adult and older pediatric populations has been studied, its effects on infants remain less explored.MethodsThis prospective randomized controlled trial included infants with UPJO undergoing laparoscopic pyeloplasty. Patients were allocated to low pneumoperitoneum pressure (LPP, 5 mmHg) or high pneumoperitoneum pressure (HPP, 8 mmHg) groups. Surgical parameters, postoperative complications, acid-base balance, stress markers, inflammatory cytokines, and oxidative stress markers were evaluated and compared.ResultsA total of 116 infants were analyzed. Preoperative characteristics were comparable between LPP and HPP groups. No significant differences in blood loss, operation time, or hospitalization time were observed. Postoperative complications were similar between groups. Acid-base balance analysis revealed a decrease in pH after pneumoperitoneum in both groups, with greater reductions in actual base excess and standard base excess in the HPP group. Stress markers, cytokines, and oxidative stress markers increased postoperatively in both groups, with higher levels in the HPP group.ConclusionHPP leads to more pronounced physiological responses, including acid-base alterations, stress reactions, and inflammatory cytokine elevations.
α-Arbutin ameliorates UVA-induced photoaging through regulation of the SIRT3/PGC-1α pathway
Authors: Lu Fang , Zhou Qi , Liang Mengdi , Liang Huicong , Yu Yiwei , Li Yang , Zhang Yan , Lu Ling , Zheng Yan , Hao Jiejie , Shu Peng , Liu Jiankang 
Published: September 2024

Owing to its tyrosinase inhibitory activity, α-arbutin has been added to several skin care products as a skin-lightening agent. However, the protective effect of α-arbutin against ultraviolet A (UVA)-induced photoaging has not been well investigated. The present study was designed to investigate the photoprotective effect and mechanism of α-arbutin against UVA-induced photoaging. In vitro experiments, HaCaT cells were treated with UVA at a dose of 3 J/cm2 to evaluate the anti-photoaging effect of α-arbutin. α-Arbutin was found to exhibit a strong antioxidant effect by increasing glutathione (GSH) level and inhibiting reactive oxygen species (ROS) production. Meanwhile, α-arbutin markedly improved the expression of sirtuin 3 (SIRT3) and peroxisome proliferator-activated receptor γ coactivator 1 α (PGC-1α) proteins, initiating downstream signaling to increase mitochondrial membrane potential and mediate mitochondrial biogenesis, and improve mitochondrial structure significantly. In vivo analysis, the mice with shaved back hair were irradiated with a cumulative UVA dose of 10 J/cm2 and a cumulative ultraviolet B (UVB) dose of 0.63 J/cm2. The animal experiments demonstrated that α-arbutin increased the expression of SIRT3 and PGC-1α proteins in the back skin of mice, thereby reducing UV-induced skin damage. In conclusion, α-arbutin protects HaCaT cells and mice from UVA damage by regulating SIRT3/PGC-1α signaling pathway.