bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case report: The efficacy of adding high doses of intravenous vitamin C to the combination therapy of atezolizumab and bevacizumab in unresectable HCC
Authors: Kian Waleed , Remilah Areen A. , Shatat Celine , Spector Maria , Roisman Laila C. , Ryvo Larisa 
Published: October 2024

IntroductionVitamin C (L-ascorbic acid) plays a vital role in human physiology, serving as both an antioxidant and a cofactor in enzymatic reactions. High-dose intravenous Vitamin C can achieve significantly elevated plasma concentrations, potentially enhancing its anticancer effects. This case study explores the synergistic impact of high-dose intravenous vitamin C in combination with bevacizumab and atezolizumab in the treatment of a patient with unresectable hepatocellular carcinoma (HCC).Case presentationA 68-year-old male was diagnosed with unresectable HCC, presenting with elevated liver enzymes and an alpha-fetoprotein (AFP) level of 2018 ng/mL. Initial treatment with atezolizumab and Bevacizumab commenced in February 2022. Although imaging indicated stable disease, AFP levels decreased modestly to 1,526 ng/mL, while liver function tests remained elevated, accompanied by further clinical deterioration and weight loss. Subsequently, intravenous vitamin C (30 grams) was introduced into the treatment regimen. This addition led to a rapid and significant reduction in AFP levels, normalization of liver function tests, and marked improvement in clinical symptoms. The patient continued on this combined regimen of vitamin c, atezolizumab, and bevacizumab. Four months later, CT scans revealed significant tumor shrinkage and necrosis. As of 30 months post-diagnosis, the patient remains on the regimen with normal liver function and an AFP level of 1.8 ng/mL, maintaining normal activities and stable weight.ConclusionTo our knowledge, this is the first reported case of combining high-dose intravenous vitamin C with Bevacizumab and atezolizumab, which proved to be safe and resulted in significant clinical and radiological improvements in unresectable hepatocellular carcinoma (HCC). Further studies are recommended to explore the potential of this combination therapy.
WSSS-CRAM: precise segmentation of histopathological images via class region activation mapping
Authors: Pan Ningning , Mi Xiangyue , Li Hongzhuang , Ge Xinting , Sui Xiaodan , Jiang Yanyun 
Published: October 2024

IntroductionFast, accurate, and automatic analysis of histopathological images using digital image processing and deep learning technology is a necessary task. Conventional histopathological image analysis algorithms require the manual design of features, while deep learning methods can achieve fast prediction and accurate analysis, but rely on the drive of a large amount of labeled data.MethodsIn this work, we introduce WSSS-CRAM a weakly-supervised semantic segmentation that can obtain detailed pixel-level labels from image-level annotated data. Specifically, we use a discriminative activation strategy to generate category-specific image activation maps via class labels. The category-specific activation maps are then post-processed using conditional random fields to obtain reliable regions that are directly used as ground-truth labels for the segmentation branch. Critically, the two steps of the pseudo-label acquisition and training segmentation model are integrated into an end-to-end model for joint training in this method.ResultsThrough quantitative evaluation and visualization results, we demonstrate that the framework can predict pixel-level labels from image-level labels, and also perform well when testing images without image-level annotations.DiscussionFuture, we consider extending the algorithm to different pathological datasets and types of tissue images to validate its generalization capability.
Investigating the effects of combined treatment of mesalazine with Lactobacillus casei in the experimental model of ulcerative colitis
Authors: Bahrami Shabnam , Babaei Nahid , Esmaeili Gouvarchin Ghaleh Hadi , Mohajeri Borazjani Jaleh , Farzanehpour Mahdieh 
Published: October 2024

IntroductionUlcerative colitis (UC), a common gastrointestinal disorder in affluent nations, involves chronic intestinal mucosal inflammation. This research investigated the effects of combined probiotic treatment of Lactobacillus casei (L. casei) and mesalazine on disease activity index and inflammatory factors in the UC model.Methods20 male BALB/c mice were utilized and divided into four groups. To induce UC, all groups received 100 μL of 4% acetic acid (AA) intra-rectally. The first group received phosphate-buffered saline (PBS) (as a control group), the second group was treated with L. casei, the third group was treated with mesalazine and, the fourth group was treated with L. casei and mesalazine. Treatment with L. Casei and mesalazine commenced after the manifestation of symptoms resulting from UC induction. Finally, the mice were euthanized and the disease activity index, myeloperoxidase activity, nitric oxide rate, cytokines level (IL-1β, IL-6, TNF-α) and, gene expression (iNOS, COX-2, and cytokines) were evaluated.ResultsThe combined treatment of L. casei and mesalazine led to a significant decrease in the levels of NO, MPO and inflammatory cytokines. In addition, the expression of cytokines, iNOS and COX-2 genes decreased in mice treated with the combination.DiscussionThis study shows that combined treatment of L. casei and mesalazine improves of experimental UC, which can be attributed to the anti-inflammatory properties of L. casei and mesalazine. In conclusion, this combination therapy can be considered a suitable option for the management of UC.
The impact of aerobic exercise dose based on ACSM recommendations on patients with Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials
Authors: Cui Wenlai , Hu Zepeng , Li Jian , Wang Siji , Xu Ruilin 
Published: October 2024

BackgroundTo explore the effects of different dose of aerobic exercise on motor function, balance, mobility, and quality of life in Parkinson’s disease patients, aiming to provide insights into determining the optimal aerobic exercise dose for treating PD.MethodsSearching was conducted in four databases: PubMed, Embase, Web of Science, and Cochrane. The dose of aerobic exercise intervention was evaluated based on the recommendations of the American College of Sports Medicine regarding the development and maintenance of cardiorespiratory health, muscle strength, and functional mobility in patients with PD. The exercise intervention dose of the included studies were first classified into high ACSM compliance and low ACSM compliance based on meeting 4/6 of the ACSM recommendations. The reliability of the results was then validated using the criterion of meeting 5/6 of the ACSM recommendations. Comparisons of the effects of aerobic exercise dose on Motor function, Balance, Mobility, and QOL in PD patients using standardized mean difference with 95% confidence intervals.ResultsWhen using the 4/6 ACSM compliance criterion, 17 studies were categorized as high ACSM compliance and 12 as low ACSM compliance. The SMD ratios for high versus low ACSM compliance were: UPDRS-III (−0.79: −0.18), BBS (0.60: 0.05), TUG (−0.60: −0.60), and QOL (−1.05: −0.15). When using the 5/6 ACSM compliance criterion, 11 studies were categorized as high ACSM compliance and 19 as low ACSM compliance. The SMD ratios for high versus low ACSM compliance were: UPDRS-III (−0.95: −0.38), BBS (0.48: 0.37), TUG (−0.71: −0.55), and QOL (−0.7: 0.04).ConclusionThis study provides preliminary support for the potential of aerobic exercise to improve certain clinical symptoms in patients with PD. Furthermore, the results indicate that compliance to higher doses of aerobic exercise, as per ACSM standards, may contribute to improvements in motor function, balance, mobility, and quality of life for patients with PD. However, due to the heterogeneity in the studies and the influence of factors that have not yet been fully explored, these conclusions should be interpreted with caution. More high-quality randomized controlled trials are needed in the future to further verify and clarify the effects of aerobic exercise.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier PROSPERO: CRD42024517548.
A CT-based machine learning model for using clinical-radiomics to predict malignant cerebral edema after stroke: a two-center study
Authors: Zhang Lingfeng , Xie Gang , Zhang Yue , Li Junlin , Tang Wuli , Yang Ling , Li Kang 
Published: October 2024

PurposeThis research aimed to create a machine learning model for clinical-radiomics that utilizes unenhanced computed tomography images to assess the likelihood of malignant cerebral edema (MCE) in individuals suffering from acute ischemic stroke (AIS).MethodsThe research included 179 consecutive patients with AIS from two different hospitals. These patients were randomly assigned to training (n = 143) and validation (n = 36) sets with an 8:2 ratio. Using 3DSlicer software, the radiomics features of regions impacted by infarction were derived from unenhanced CT scans. The radiomics features linked to MCE were pinpointed through a consistency test, Student’s t test and the least absolute shrinkage and selection operator (LASSO) method for selecting features. Clinical parameters associated with MCE were also identified. Subsequently, machine learning models were constructed based on clinical, radiomics, and clinical-radiomics. Ultimately, the efficacy of these models was evaluated by measuring the operating characteristics of the subjects through their area under the curve (AUCs).ResultsLogistic regression (LR) was found to be the most effective machine learning algorithm, for forecasting the MCE. In the training and validation cohorts, the AUCs of clinical model were 0.836 and 0.773, respectively, for differentiating MCE patients; the AUCs of radiomics model were 0.849 and 0.818, respectively; the AUCs of clinical and radiomics model were 0.912 and 0.916, respectively.ConclusionThis model can assist in predicting MCE after acute ischemic stroke and can provide guidance for clinical treatment and prognostic assessment.
Effect of vitamin C supplementation on outcomes in patients with COVID-19: a systematic review and meta-analysis
Authors: Xu Wenhao , Wang Peng , Wan Jun , Tan Yaheng , Liu Yuyang , Chen Qiwen , Zheng Yuxin , Yu Xueying , Fan Sitong , Jorge Luis Cuyubamba Dominguez , Zhang Yu 
Published: October 2024

BackgroundSince the emergence of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), millions of lives have been lost, posing formidable challenges to healthcare systems worldwide. Our study aims to conduct a meta-analysis to evaluate the efficacy of vitamin C supplementation in reducing in-hospital mortality rates and shortening the length of ICU or hospital stays among patients diagnosed with COVID-19.MethodsA comprehensive systematic review and meta-analysis was conducted, sourcing data from PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials. Our analysis focused on randomized clinical trials comparing the efficacy of vitamin C supplementation with standard care in adult COVID-19 patients.ResultsThrough meticulous examination of 11 clinical trials, our meta-analysis found that vitamin C supplementation did not reduce in-hospital mortality rates in COVID-19 patients compared to those receiving standard care (Risk Ratio [RR] = 0.85; 95% Confidence Interval [CI]: 0.62–1.17; p = 0.31). Similarly, the analysis indicated no significant difference in the length of ICU stays between both cohorts. Additionally, the occurrence of other adverse events was found to be similar across both groups treated with vitamin C supplementation and standard care (all p &gt; 0.05).ConclusionVitamin C supplementation did not reduce in-hospital mortality or ICU stay durations in patients with COVID-19. The interpretation of these findings is limited by the small number of available studies and participants, which affects the strength of the conclusions.Clinical trial registrationIdentifier CRD42024497474.
Neutrophil-to-lymphocyte ratio and its association with latent tuberculosis infection and all-cause mortality in the US adult population: a cohort study from NHANES 2011–2012
Authors: Huang Yingxiu , Ao Ting , Zhen Peng , Hu Ming 
Published: October 2024

BackgroundThere has been little study done on the possible connection between all-cause mortality and the neutrophil-to-lymphocyte ratio (NLR), particularly in individuals with latent tuberculosis infection (LTBI). The objective of this research was to examine the correlation between the NLR and LTBI, along with their effects on all-cause mortality in a cohort of individuals who had either LTBI or not.MethodsThis research incorporated data from the National Health and Nutrition Examination Survey (NHANES) 2011–2012, with a total of 4938 subjects involved. To investigate the connection between LTBI and variables, multivariable logistic regression models were used. Multivariable Cox proportional hazards models and Kaplan-Meier (KM) survival curves were employed to examine the association between NLR and all-cause death in individuals with and without LTBI.ResultsWhen analyzed as a continuous variable, The calculated odds ratios (ORs) for the different models-Model 1, Model 2, and Model 3 were 0.86, 0.83, and 0.84 (P &lt; 0.005). NLR was evaluated as a categorical parameter, revealing that individuals in the tertile T3 had a notably lower rate of LTBI in comparison to those in the T1 group. After adjusting for different confounders, the odds ratio for T3 varied in the various models, being 0.75 (0.60∼0.95), 0.69 (0.54∼0.89), and 0.71 (0.56∼0.92), respectively. Additionally, higher NLR was significantly link to a greater risk of all-cause mortality in individuals with or without LTBI. Following multivariate adjustment, an 8% (Model 3, HR 1.08, 95% CI 1.05–1.12, P &lt; 0.001) greater risk of mortality from all-cause was linked to every unit rise in NLR.ConclusionResults from the study revealed a negative correlation between NLR and the likelihood of LTBI as well as a higher risk of death from all causes. Therefore, NLR may be a helpful technique for risk categorization in the adult LTBI in the United States. To clarify the underlying mechanisms and any therapeutic implications of these findings, more investigation is necessary.
Correlation between fruit consumption and 10-year all-cause mortality in patients with dyslipidemia
Authors: Zheng Yuanjuan , Sun Feifei , Ye Suling , Zhu Jinzhou , Ma Yu , Shan Mengmeng , Li Shaomi , Chen Yingying , Li Jie 
Published: October 2024

BackgroundConsuming fruit provides health benefits. Reportedly, increased fruit consumption reduces the risks of hypertension and cardiovascular disease. However, existing studies have not clarified the effect of fruit consumption on mortality risk in patients with dyslipidemia. This study aimed to assess the correlation between the consumption of different types of fruits and all-cause mortality in patients with dyslipidemia.MethodsA total of 2,184 patients with dyslipidemia were included in this study, and trends in the correlation between the frequency of consumption of different types of fruits and the 10-year all-cause mortality risk in patients with dyslipidemia were analyzed by smoothed curve fitting, Cox regression, and Kaplan–Meier curve analysis. Subgroup analysis and interaction test were applied to analyze the stability of the effect of apple consumption on 10-year all-cause mortality in patients with dyslipidemia.ResultsSmoothed curve fitting and Cox regression analyses revealed a significant reduction in the 10-year all-cause mortality risk in patients with dyslipidemia who consumed apples 3–4 times/week (hazard ratio [HR] = 0.61, 95% confidence interval [CI]: 0.43–0.87, p = 0.007) and in those who consumed bananas 3–4 times/week (HR = 0.71, 95% CI: 0.52–0.98, p = 0.039), with a more pronounced effect in patients who consumed both apples and bananas (HR = 0.55, 95% CI: 0.30–0.99, p = 0.045). Other fruits did not exhibit similar effects.ConclusionConsuming apples or bananas 3–4 times/week significantly improved the 10-year survival rate in patients with dyslipidemia, and the effect was even more profound in patients who consumed both fruits.
In-vitro anti-acne activity of Teucrium oliverianum methanolic extract against Cutibacterium acnes
Authors: Al-Ghanayem Abdullah A. 
Published: October 2024

BackgroundAcne vulgaris is a skin infection widely seen in adolescents between 10–19 years with males affected more than females. It mainly affects the face but may also affect the back and chest. The symptoms vary with mild acne manifesting as comedones and moderate acne as inflammatory lesions (papulopustular), nodules, and mild scarring while severe acne has the same symptoms that have not subsided within 6 months of treatment. Various treatments including topical medications containing different antibiotics are used to treat acne. Recently, herbal treatments have been shown as better alternatives to conventional treatment. Teucrium oliverianum Ging. ex Benth (Lamiaceae) is traditionally used for skin infections such as wound healing and biofilm formation.MethodologyMethanolic extract of T. oliverianum was subjected to liquid chromatography-mass spectrometry (LC-MS) analysis, and its antibacterial effect against Cutibacterium acnes. The anti-acne, anti-inflammatory, and antioxidant effects were also assessed using HaCaT cells infected with C. acnes. The cytotoxicity of the extract was evaluated using a neutral red uptake assay, and anti-inflammatory effects were determined by measuring TNF-α, IL-1β, INF-γ, and COX2 inhibition. The antioxidant action was assessed by ROS generation in HaCaT cells infected with C. acnes.ResultsLC-MS analysis of the extract showed the presence of 16 different metabolites with L-carnitine, esculin sesquihydrate, and gamma-linoleic acid as major metabolites. The methanolic extract of T. oliverianum showed an antibacterial effect against C. acnes with an IC50 value of 263.2 μg/mL. The extract attenuated the cytotoxicity of C. acnes on the HaCaT cell and the IC50 was found to be 676.2 μg/mL. It also decreased dose-dependently the expression of TNF-α, IL-1β, INF-γ, and inhibited COX2 in the HaCaT cells infected with C. acnes. It also decreased the generation of reactive oxygen species.ConclusionThe results support the use of T. oliverianum as an anti-acne agent but it possesses mild antibacterial action. It showed anti-inflammatory effects in HaCaT cells infected with C. acnes. It is also an effective antioxidant and decreased the generation of reactive oxygen species. Comparison of the anti-acne effects and adverse reactions of extract with other treatments will provide more insight into its clinical efficacy and toxicity.
Examination of language, cognitive, and mathematical skills in childhood endocrine diseases
Authors: Çavuşoğlu Ebrar , Savaş Merve , Dilek Emine , Elgörmüş Yusuf , Kahraman Beğen Senanur 
Published: October 2024

IntroductionChildren diagnosed with endocrine disorders may exhibit atypical development and may encounter challenges in language, academic, and cognitive skills, as well as social–emotional issues. The objective of this study was to identify potential therapeutic requirements in the areas of language, cognition, and mathematical skills among children with endocrine disorders who experience school failure. This will enable an early evaluation of speech and language disorders and the planning of interventions to be possible.MethodsIn this study, children with endocrine disorders were compared with their normally developing peers in terms of language, cognition, mathematical skills, and psychosocial characteristics. In this study, 15 children diagnosed with endocrine disorders (8 females, 7 males; mean age: 10, SD: 2) and 15 children with normal development (8 females, 7 males; mean age: 10, SD: 2) participated. The participants were subjected to the Test of Language Development-Primary: Fourth Edition Turkish Revision (TOLDP-4:T), the Turkish Nonword Repetition Test (TNRT), the Turkish Multilingual Sentence Repetition Test (LITMUS-TR), the Wechsler Intelligence Scale for Children (WISC-R), the Problem-Solving Test (PST), the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), the Coopersmith Self-Esteem Inventory (CSEI), and the Child Behavior Checklist (CBCL).ResultsThe findings of the study indicate that children with endocrine disease have lower performance in language, cognition, and mathematical skills compared to their healthy peers. Otherwise, they do not differ in terms of social–emotional status assessed by psychological scales.DiscussionThese findings suggest that while children with endocrine disorders face challenges in academic and cognitive domains, their social-emotional development remains relatively unaffected. Early identification and intervention in language, cognition, and mathematical skills may help address the academic struggles of these children, potentially improving their school performance and overall well-being.
Psychological status of general population 1 year after the outbreak of COVID-19: a cross-sectional study based on SCL-90
Authors: Chen Xia , Hu Yue , Deng Yuan , Wang Xin , Yang Xiao , Wang Ying , Lian Yanli , Wang Shiping , Xiang Xinju , Liu Chan , Wu Fang , Chen Shaochuan , Li Huimin 
Published: October 2024

IntroductionThe mental health of populations is usually affected after a disaster event. However, it is not known what the level of mental health of Chinese population 1 year after COVID-19, nor what factors influence it.AimThis study aimed to examine the mental health status of general population in Chengdu 1 year after COVID-19, and then analyse influencing factors.MethodThis study is a cross-sectional survey based on the SCL-90 questionnaire. Continuous data were described as M and SD, and counting data were described as frequencies(n) and percentages (%). Chi-square test or Fisher’s exact test were used for statistical inference, and significance variables were included in the binary logistic regression equation for multivariate analysis.ResultsThere were 172 participants with positive screening results. Age, marital status, number of kids, self-perceived health and the presence of chronic disease had an effect on screening results. Logistic regression analysis showed that age and self-perceived health were the main influencing factors.DiscussionYoung people aged 18–19 and those who consider themselves not very healthy were at higher risk of poor mental health 1 year after the COVID-19 outbreak.Impact statementCommunity institutions and community workers should focus on the mental health status of people 1 year after COVID-19, with a focus on people with poor self-perceived health and younger age groups, and take early preventive measures.