bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic pain management in fibromyalgia: the INTEGRO (INTEGRated Psychotherapeutic InterventiOn) protocol and its application on two case studies
Authors: Pasini Ilenia , Donisi Valeria , Veneziani Elisa , Perlini Cinzia , Nizzero Marta , Lippolis Irma , Polati Enrico , Schweiger Vittorio , Del Piccolo Lidia 
Published: October 2024

ObjectivesTo present an innovative integrated manualized psychotherapeutic intervention for fibromyalgia (FM) based on cognitive and behavioral therapy, acceptance and commitment therapy, and somatic experiential techniques (namely the INTEGRated Psychotherapeutic InterventiOn, INTEGRO) and illustrate its application on two case studies.MethodsINTEGRO is composed of 12 individual sessions. The main objectives of the intervention were psychoeducation of chronic pain mechanisms, understanding the role of cognitive and emotional variables in one’s pain perception, teaching patient-tailored skills to increase pain awareness and its management, and learning how to live with pain experience. A 57-year-old woman (patient A) and a 26-year-old woman (patient B) with FM have been selected to describe their care pathways connected to the INTEGRO protocol. Data related to assessment variables and clinical processes have been reported, focusing on the mechanisms that contribute to the maintenance (i.e., avoidance or overcompensation) of chronic pain in FM, on the role of patients’ naïf theories, and on the implications that all these aspects may have on the burden related to pain management.ResultsBoth patients showed a reduction in FM burden and an increase in self-efficacy in pain management: patient A reported an improvement in emotional regulation ability; patient B showed a decrease in pain interference in work activities and on emotional dimension.ConclusionExamining each phase of the clinical protocol through the lens of its clinical application, the paper provides insights into the relationship among crucial psychosocial mechanisms, pain perception, management in FM treatment, and how all these aspects have been dealt with during psychotherapeutic treatment.
Associations between environmental perchlorate, nitrate, and thiocyanate exposure and severe headache or migraine: a cross-sectional, population-based analysis
Authors: Mao Jiesheng , Zhou Mi , Yanjun Li , Zhao Yunhan , Hu Haoxiang , Yang Xiaokai 
Published: October 2024

BackgroundEnvironmental contaminants may play a significant role in the development of migraine. Perchlorate, nitrate, and thiocyanate were selected for this study due to their known impact on thyroid function, which is closely linked to neurological processes. Disruptions in thyroid function have been associated with various neurological disorders, including migraines. However, there is currently no evidence linking exposure to these specific chemicals to migraine. The study aims to evaluate the association between urinary concentrations of perchlorate, nitrate, and thiocyanate with the prevalence of severe headache or migraine in U.S. adults.MethodsA cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2001–2004. Utilizing electrospray tandem mass spectrometry in conjunction with ion chromatography, urinary concentrations of perchlorate, nitrate, and thiocyanate urine were measured. Multiple logistic regression models were employed to evaluate the linear correlation between perchlorate, nitrate, and thiocyanate exposure and severe headache or migraine. The non-linear relationship is described analytically using a fitted smoothing curve and a two-piecewise regression model. Subgroup analyses were used to further clarify the stability of this relationship across different populations.ResultsThere were 1,446 participants in this population-based study, ranging in age from 20 to 85. After adjusting for potential confounding variables, the multiple logistic regression findings demonstrated that thiocyanate was significantly positively associated with the prevalence of migraine (odds ratio [OR] = 1.18; [1.06, 1.30]; p &lt; 0.001). There was consistency in this connection across different subgroups (p for interaction &gt;0.05). Furthermore, there was a non-linear correlation between urinary thiocyanate and migraine. Using a fitted smoothing curve and a two-piecewise regression model, it was found that the correlation between urinary thiocyanate and migraine was U-shaped (p for Log-likelihood ratio = 0.002). According to the findings of the multiple regression analysis, there was no significant correlation between urinary perchlorate and nitrate and migraine (both p &gt; 0.05).ConclusionWe should limit our exposure to thiocyanate by keeping it within a reasonable range, as indicated by the U-shaped correlation between urinary thiocyanate and migraine.
Serum glial cell line-derived neurotrophic factor: a potential biomarker for white matter alteration in Parkinson’s disease with mild cognitive impairment
Authors: Liu Yi , Xu Yan , Tong SuYan 
Published: October 2024

ObjectiveMild cognitive impairment (MCI) is a common non-motor manifestation of Parkinson’s disease, commonly referred to as PD-MCI. However, there is a lack of comprehensive data regarding the role of glial cell line-derived neurotrophic factor (GDNF) and cerebral white matter damage in the pathogenesis of PD-MCI. The objective of this study is to investigate the association between alterations in GDNF levels and cerebral white matter damage in individuals diagnosed with PD-MCI, as well as to explore their potential involvement in cognitive progression.MethodsNeuropsychological assessments were conducted on 105 patients with Parkinson’s disease and 45 healthy volunteers to examine various cognitive domains. An enzyme-linked immunosorbent assay (ELISA) was employed to measure serum levels of GDNF. Additionally, all participants underwent 3.0T magnetic resonance imaging (MRI) to acquire diffusion tensor images (DTI), and a voxel-based analysis (VBA) approach was utilized to compare the fractional anisotropy (FA) values of white matter in the brain.ResultsThere was a significant correlation between the right corpus callosum, right cingulate gyrus, and the Digit Span Backward Test (DSB-T) as well as the Trail Making Test A (TMT-A), both of which assess attention and working memory functions. The left internal capsule exhibited a significant correlation with the Trail Making Test B (TMT-B) and the Clock Drawing Test (CDT), which evaluate executive function. Additionally, the right cingulate gyrus showed a significant association with scores on the Auditory Verbal Learning Test-HuaShan (AVLT-H), assessing memory function. Abnormal fiber structures that demonstrated significant correlations with serum GDNF levels included the left internal capsule, left corticospinal tract, right corpus callosum, and right cingulate gyrus.ConclusionThe decrease in serum GDNF levels among PD-MCI patients exhibiting impairments in attention and working memory function was significantly correlated with alterations in the corpus callosum (knee) and posterior cingulate gyrus. Furthermore, the reduction of serum GDNF levels in PD-MCI patients with impaired executive function is associated with changes in the internal capsule (forelimb) projection fibers. Additionally, the decline of serum GDNF levels in PD-MCI patients experiencing memory function impairment is related to alterations in the right cingulate gyrus.
A combined radiomics and anatomical features model enhances MRI-based recognition of symptomatic nerves in primary trigeminal neuralgia
Authors: Li Hongjian , Li Bing , Zhang Chuan , Xiao Ruhui , He Libing , Li Shaojie , Yang Yu-Xin , He Shipei , Sun Baijintao , Qiu Zhiqiang , Yang Maojiang , Wei Yan , Xu Xiaoxue , Yang Hanfeng 
Published: October 2024

BackgroundThe diagnosis of primary trigeminal neuralgia (PTN) in radiology lacks the gold standard and largely depends on the identification of neurovascular compression (NVC) using magnetic resonance imaging (MRI) water imaging sequences. However, relying on this imaging sign alone often fails to accurately distinguish the symptomatic side of the nerve from asymptomatic nerves, and may even lead to incorrect diagnoses. Therefore, it is essential to develop a more effective diagnostic tool to aid radiologists in the diagnosis of TN.PurposeThis study aims to establish a radiomics-based machine learning model integrating multi-region of interest (multiple-ROI) MRI and anatomical data, to improve the accuracy in differentiating symptomatic from asymptomatic nerves in PTN.MethodsA retrospective analysis of MRI data and clinical anatomical data was conducted on 140 patients with clinically confirmed PTN. Symptomatic nerves of TN patients were defined as the positive group, while asymptomatic nerves served as the negative group. The ipsilateral Meckel’s cavity (MC) was included in both groups. Through dimensionality reduction analysis, four radiomics features were selected from the MC and 24 radiomics features were selected from the trigeminal cisternal segment. Thirteen anatomical features relevant to TN were identified from the literature, and analyzed using univariate logistic regression and multivariate logistic regression. Four features were confirmed as independent risk factors for TN. Logistic regression (LR) models were constructed for radiomics model and clinical anatomy, and a combined model was developed by integrating the radiomics score (Rad-Score) with the clinical anatomy model. The models’ performance was evaluated using receiver operating characteristic curve (ROC) curves, calibration curves, and decision curve analysis (DCA).ResultsThe four independent clinical anatomical factors identified were: degree of neurovascular compression, site of neurovascular compression site, thickness of the trigeminal nerve root, and trigeminal pons angle (TPA). The final combined model, incorporating radiomics and clinical anatomy, achieved an area under the curve (AUC) of 0.91/0.90 (95% CI: 0.87–0.95/0.81–0.96) and an accuracy of approximately 82% in recognizing symptomatic and normal nerves.ConclusionThe combined radiomics and anatomical model provides superior recognition efficiency for the symptomatic nerves in PTN, offering valuable support for radiologists in diagnosing TN.
Clinical utility of circulating tumor DNA profiling in detecting targetable fusions in non-small cell lung cancer
Authors: Kim Young-gon , Lee Boram , Ha Changhee , Lee Cheonghwa , Jung Hyun Ae , Sun Jong-Mu , Lee Se-Hoon , Ahn Myung-Ju , Choi Yoon-La , Park Sehhoon , Kim Jong-Won 
Published: October 2024

IntroductionNumerous studies have suggested high concordance between tissue and circulating tumor DNA (ctDNA) comprehensive genomic profiling (CGP) tests but only few of them focused on fusions. In addition, atypical breakpoints occasionally detected from DNA-based fusion detection make interpretation difficult, and their clinical significance remains unclear. This study evaluated the clinical utility of ctDNA CGP for fusion detection.MethodsThe results of ctDNA CGP tests performed on patients with stage IV non-small cell lung cancer during routine clinical care were retrospectively reviewed. The concordance between ctDNA CGP and combined tissue test results was analyzed using CGP, immunohistochemistry, fluorescence in situ hybridization, and reverse transcription polymerase chain reaction. The clinical significance of fusions detected by ctDNA CGP, including those with atypical breakpoints at the DNA level, was assessed.ResultsIn total, 264 patients were tested with ctDNA CGP. Fusions were detected in 27 patients (10.2%), and the fusion drivers were RET (n=12, 4.6%), ALK (n=9, 3.4%), ROS1 (n=4, 1.5%), and FGFR2 (n=2, 0.8%). The overall prevalence of fusion in tissue CGP was comparable to that in ctDNA CGP. A total of 371 ctDNA-tissue test pairs were available, and the overall positive and negative percent agreement rates were 92.9% (13/14) and 100.0% (357/357), respectively. One ALK IHC-positive and ctDNA CGP-negative case did not respond to ALK-targeted therapy. Response to targeted therapy was assessed in 16 patients, and a partial response was achieved in all patients, including four with atypical breakpoints.ConclusionFusion detection using ctDNA CGP showed high concordance with tissue tests and accuracy in predicting therapeutic responses in patients with non-small cell lung cancer. ctDNA CGP may provide an important diagnostic tool for fusion detection.
Analysis of risk factors associated with cervical HPV infection and their effects on female sexual function and anxiety: a multicenter cross-sectional study based on Chinese women
Authors: Wang Haoye , Nie Keyi , Liu Zixuan , Zhao Yumeng , Ha Yingxin , Zhang Huanyan , Mao Dongwei 
Published: October 2024

IntroductionThis research aimed to explore the determinants of cervical HPV infection and evaluate how cervical cancer screening outcomes influence sexual functioning and anxiety among women across three provinces in China.MethodsStudy participants were categorized into HPV-positive or HPV-negative groups, after which they completed the General Characteristics Questionnaire and the SAS Anxiety Scale. The HPV-positive cohort was further divided into four subgroups: Subgroup 1 consisted of individuals with HPV types 16 or 18 but no cytological abnormalities. Subgroup 2 included those with cytological abnormalities and infections with HPV types 16 or 18. Subgroup 3 included participants infected with high-risk HPV types other than 16 and 18, who did not show cytological abnormalities, while Subgroup 4 encompassed individuals with both cytological abnormalities and infections with high-risk HPV types other than 16 and 18. All participants were assessed using the Female Sexual Function Index Scale (FSFI), which measures sexual function across these subgroups.ResultsA total of 531 questionnaires were analyzed. Logistic regression identified several risk factors for HPV infection, including manual labor, service occupations, other occupations, low- and middle-income groups, and cervical columnar epithelial ectasia, as well as an increase in the number of previous sexual partners. Conversely, protective factors included condom use during sexual activity and mutual genital hygiene prior to intercourse. The incidence of lower genital tract infections was significantly higher in the HPV-positive group compared to the HPV-negative group, with rates of chlamydia (13.3% versus 4.6%, P&lt;0.001), gonococcal infections (5.2% versus 0.4%, P&lt;0.001), and mycobacterial diseases (38.9% versus 23.4%, P&lt;0.001). Additionally, anxiety levels were significantly higher in the HPVpositive group compared to the HPV-negative group (p&lt;0.005). Anxiety levels and cytological outcomes were significantly correlated across the four HPV-positive subgroups (p&lt;0.05), with type 16/18 infections being associated with notably lower FSFI scores compared to other high-risk HPV types (p&lt;0.05).ConclusionsThe findings suggest that infections with HPV type 16/18, especially when accompanied by abnormal cytological findings,significantly elevate anxiety and distress in women and are associated with reduced FSFI scores. These results highlight the complex impact of HPV infection on women’s sexual health and psychological well-being with HPV type 16/.
Pediatric kidney transplantation in Europe, a clinical snapshot pilot
Authors: Oomen Loes , Bootsma-Robroeks Charlotte M. H. H. T. , Bouts Antonia H. M. , Carbonell Pradas Mar , Gander Romy , Kienzl-Wagner Katrin , König Paul , Pereira Pedro Lopez , Dunand Olivier , Mosca Sara M. F. S. , Pac Michal , Podracka Ludmila , Prytula Agnieszka A. , Sangermano Maria , Vitkevic Renata , Zieg Jakub , van der Zanden Loes F. M. , Feitz Wout F. J. , de Wall Liesbeth L. 
Published: October 2024

BackgroundPediatric kidney transplantations are rarely performed, and there is limited knowledge about the diversity in current clinical practices across Europe. This study aims to explore the utility of clinical snapshot studies in identifying these disparities, establishing a foundation for future snapshot studies and standardization efforts.MethodsA pilot clinical snapshot study was conducted, with invitations extended to all 109 pediatric kidney transplant centres in Europe. Each participating centre provided pre-, peri-, and postoperative data concerning their most recent thirty transplantations. The primary outcomes encompassed the evaluation of disparities in donor-recipient selection, surgical techniques, post-operative drainage procedures, and immunosuppressive therapy protocols. Secondary outcomes involved the analysis of rejection rates, incidence of infections, and graft survival.ResultsThe study involved 439 patients from fifteen centres (14%) in twelve countries, with varying transplant volumes (range 1–29 transplantations per year) and follow-up periods. Significant differences were found among centres in terms of donor types, cold and warm ischemia time, pre-emptive transplant rates, and kidney transplant drainage methods. The rate of living donors varied between 3% and 90% and the median duration of cold ischemia ranged was 770 min after deceased donation and 147 min after living donation. Basiliximab was the dominant induction therapy, yet steroid withdrawal varied widely. Infection, rejection, and graft survival rates also varied significantly between centres.ConclusionThis study revealed substantial variation in clinical practices among European centres performing pediatric kidney transplantations. These findings could serve as a stimulus for international dialogue and collaboration.
Synergistic anti-osteoporosis effects of Anemarrhena asphodeloides bunge–Phellodendron chinense C.K. Schneid herb pair via ferroptosis suppression in ovariectomized mice
Authors: Deng Xuehui , Xiao Wenlong , Lin Bingfeng , Wang Fang , Song Li , Wang Nani 
Published: October 2024

IntroductionFerroptosis plays a crucial role in the progression of postmenopausal osteoporosis. Anemarrhena asphodeloides Bunge/Phellodendron chinense C.K. Schneid (AA/PC) is the core herb pair in traditional Chinese medicines formulae for postmenopausal osteoporosis treatment. However, the synergistic effects, and mechanisms, of AA/PC on alleviating ferroptosis and postmenopausal osteoporosis remain unclear.MethodsThe goal herein was to analyze the effective ingredients and molecular mechanisms of AA/PC in the treatment of osteoporosis through serum pharmacochemistry, network pharmacology, metabolomics analysis, and pharmacodynamics evaluation. A bilateral ovariectomized (OVX) mouse model was established.Results and DiscussionMicron-scale computed tomography analysis showed that AA/PC increased bone mineral density in OVX mice. The effects of AA/PC were better than AA or PC alone on inhibiting the bone resorption marker nuclear factor of activated T-cells 1. Furthermore, five absorbable compounds were detected in serum: mangiferin, magnoflorine, berberine, timosaponin BIII, and timosaponin AIII. Network pharmacology showed these compounds had close relationship with seven ferroptosis targets. Importantly, compared with AA or PC alone, the AA/PC herb pair exerted better effects on regulating crucial ferroptosis pathways, including the system xc-/glutathione/glutathione peroxidase 4, transferrin receptor/ferritin, and acyl-CoA synthetase long chain family member 4/polyunsaturated fatty acids signaling pathways. These results indicate that AA/PC exerts synergistic effects on regulating glutathione synthesis, iron homeostasis, and lipid metabolism in ferroptosis. This work lays the foundation for further development and use of AA/PC herb pair for preventing and treating postmenopausal osteoporosis.
Towards contextualized complex systems approaches to scaling-up hepatitis B birth-dose vaccination in the African region: a qualitative systematic review
Authors: Solomon-Rakiep Tasneem , Olivier Jill , Amponsah-Dacosta Edina 
Published: October 2024

BackgroundDespite the longstanding implementation of universal hepatitis B infant vaccination programs, the World Health Organization African region (WHO AFRO) maintains the highest prevalence (2.5%) of chronic hepatitis B virus (HBV) infection among children ≤5 years of age. Scaling-up hepatitis B birth-dose (HepB BD) vaccination could avert mother-to-child transmission of HBV infection and advance regional progress towards eliminating viral hepatitis.ObjectiveTo describe whether – and how – complexities within the health system or intervention influence the performance of HepB BD vaccination programs in the WHO AFRO.MethodsUsing a complexity perspective, we conducted a qualitative systematic review of literature published between 2009–2022. A Boolean search strategy retrieved relevant literature indexed in PubMed, EBSCOhost databases, Scopus, and Web of Science, with supplementary searches conducted to identify any missed articles. No language restrictions were applied. Data extraction, synthesis and analysis were guided by a systems-based logic model tailored to systematic reviews of complex interventions.ResultsOur search yielded 672 published records. Of these, 28 (26 English, 2 French) were eligible for inclusion. Among the 12 WHO AFRO member states represented, the origin of evidence weighted highest in Nigeria (n = 12) and Senegal (n = 5). The performance of HepB BD vaccination programs across member states are influenced by underlying complexities across eight cross-cutting themes: (i) availability and interpretation of HepB BD vaccination policies, (ii) capacity of vaccine supply and cold chain systems, (iii) availability of equitable and sustainable financing, (iv) capacity and capability of health care workers (HCWs), (v) immunization monitoring systems and impaired feedback loops, (vi) influence of context vs system design on the timeliness of vaccination, (vii) maternal knowledge and socio-economic factors, and (viii) wider contextual factors (geography, climate, cultural practices).ConclusionCountries looking to introduce, or scale-up HepB BD vaccination programs will benefit from careful consideration of components of the intervention design that are dependent on the end-user’s context and capabilities in accessing the vaccine; the adherence and interpretation of essential components of the policy; the provision of adequate support of stakeholders specifically HCWs and government ministries; and the need for innovative approaches to underlying complexities. Lessons offered by these African experiences provide pragmatic approaches to successfully implementing HepB BD vaccination programs in the region.