bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interplay of urea nitrogen, uric acid, and HDL in mediating cystatin C's role in metabolic syndrome: evidence from NHANES 1999-2004
Authors: Zhu Meng , Pan Fuzhen 
Published: July 2024

Abstract

Background
Metabolic syndrome (MetS) significantly increases the risk for cardiovascular diseases and diabetes. This study investigates the associations and interactions between cystatin C, urea nitrogen, uric acid, and high-density lipoprotein (HDL), assessing their collective impact on MetS using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2004.
Methods
We conducted a retrospective longitudinal analysis on 54,555 participants from NHANES. Multivariate logistic regression models were employed to evaluate the impact of cystatin C on MetS, adjusting for demographic and lifestyle factors. Mediation analysis quantified the effects mediated by urea nitrogen, uric acid, and HDL. Generalized additive models (GAM) explored non-linear relationships and interactions among biomarkers. Stratified analysis further dissected these relationships across demographic groups, such as sex, age and BMI, to assess variability in biomarker impacts.
Results
Regression analysis demonstrated a robust association between increased cystatin C levels and higher MetS risk (adjusted OR for highest quartile: 1.69, 95% CI: 1.31–2.18, P < 0.001). Mediation analysis indicated that urea nitrogen and uric acid mediated 24.19% and 48.13% of the effect of cystatin C on MetS risk. HDL moderated these effects, reducing the likelihood of MetS where higher levels of HDL were present (mediated 52.58%). The three-way interaction between MetS, HDL, and urea nitrogen was also significant (estimate − 0.00232, P < 0.003). GAM shows a non-linear relationship between urea nitrogen and cystatin C, where cystatin C levels increase with urea nitrogen up to approximately 60 mg/dL, after which they decrease until about 60 mg/dL and increase until about 80 mg/dL. Stratified analysis underscored that the impact of these biomarkers varies significantly by age, with stronger associations observed in older adults (≥ 65 years), and socioeconomic status, where lower economic groups (PIR > 3.5) showed heightened vulnerability.
Conclusions
The study confirms the crucial role of cystatin C as a predictor of MetS, influenced by its interactions with urea nitrogen, uric acid, and HDL. The differential impact across demographic profiles emphasizes the need for personalized approaches in the management and prevention of MetS. These insights pave the way for targeted therapeutic strategies that consider individual and demographic-specific metabolic profiles.
Does the Initial Treatment of the Primary Tumor Impact Prognosis after Recurrence in Locally Advanced Rectal Cancer? Results From A Retrospective Cohort Analysis
Authors: Wang Zhangjie , Bai Feiyu , Chen Yufeng , Liu Xuanhui , Huang Zeping , Zhu Qiqi , Wu Xiaojian , Cai Zerong 
Published: July 2024

Abstract

Introduction:
Role of neoadjuvant therapy (NAT) for local advanced rectal cancer (LARC) has been well proved, but its impact on patients who relapse remains unknown. This study aims to delineate the influence of initial treatment and MRI-defined risk factors on post recurrent survival in recurrent LARC patients.
Patients and methods:
LARC patients who underwent radical surgery and subsequently developed recurrence were retrospectively identified. Patients were stratified based on MRI-defined local risk assessment and the initial treatment modality for the primary tumor (NAT or primary surgery). They were classified into four groups: high-risk LARC with NAT (HiN), high-risk LARC with primary surgery (HiS), low-risk LARC with NAT (LoN), and low-risk LARC with primary surgery (LoS). The primary endpoint was survival after recurrence.
Result
381 cases of relapsed patients were identified from 2,329 LARC patients. Salvage surgery was performed on 33.1% of these patients. Patients with single-site recurrence or who underwent salvage surgery exhibited significantly prolonged survival time after recurrence (P < 0.001). Patients in the HiS group showed poorer survival after recurrence compared to the other three subgroups (P = 0.034). This subset of patients, characterized by receiving less adjuvant treatment after primary surgery, had a shorter recurrence interval compared to the other groups (P = 0.001).
Conclusions
Our findings reaffirm the prognostic significance of salvage surgery in relapsed patients from a LARC cohort. Moreover, MRI defined high-risk LARC patients who received upfront surgery without NAT had shorter interval to recurrence and poorer survival outcome after recurrence. Our result underscore the critical role of NAT in improving patients’ survival after recurrence.
Trial registration:
Supplementary registration was carried out at clinicaltrials.gov (Registration number: NCT06314737) on March 14, 2024. The study was retrospectively registered.
Experiencing extremes: how Arapaima gigas (Schinz, 1822) deals with increasing water temperatures
Authors: Amanajás Renan Diego , Silva Jhonatan Mota , Paula-Silva Maria de Nazaré , Val Adalberto Luis 
Published: July 2024

Abstract

Temperature regulates the life cycle of aquatic organisms. However, in the current climate change scenario, the warming of the planet is putting the resilience of many species at risk, resulting in organic disturbances. In the Amazon, the effects of warming demonstrate the low thermal tolerance of species that are already living near their upper temperature limits. In this study, we evaluated the physiological and biochemical responses of specimens of pirarucu (Arapaima gigas) exposed to increasing levels of water temperature (normal environmental temperature of the period (Tenv), 31 ºC, 34 ºC and 37 ºC) for a period of 96 h, in triplicate (N = 3). Our main findings show an increase in hematological parameters with a temperature elevation up to 34 ºC, followed by suppression at 37 ºC. Increases in glucose and lactate levels and reduced triglyceride levels were observed with the elevation in water temperature. Cholesterol levels remained unchanged throughout the experimental period. ALT and AST enzymes increased at 34 and 37 ºC. Oxidative stress levels were elevated at Tenv, and were higher at 37 ºC when compared to animals at 31 ºC. In the liver, the activities of SOD and GPx enzymes increased with the increase in temperature, while the CAT enzyme showed reduced activity at 37 ºC. Thus, the data from the present study show that the pirarucu is a species that responds to increasing levels of water temperature. However, a temperature of 37 ºC seems to offer a greater risk to the species’ ability to cope with the effects of higher temperatures, as it requires greater energy expenditure and induces oxidative stress. Thus, the pirarucu seems to cope better with temperatures that do not exceed 34 ºC.
Does the management of anastomotic leakage after rectal cancer resection affect long-term oncological survival? A retrospective propensity score- adjusted cohort study
Authors: Ammann Yanic , Marti Lukas , Warschkow Rene , Bischofberger Stephan , Reißfelder Christoph , Schmied Bruno , Brunner Walter , Tarantino Ignazio 
Published: July 2024

Abstract

Background: The International Study Group of Rectal Cancer (ISREC) provides a classification of anastomotic leakage (AL). This classification allows good stratification regarding postoperative morbidity and mortality after rectal cancer resection. The aim of this study was to determine whether AL and its severity influence survival.
Methods: Patients who underwent elective mesorectal excision (PME or TME) for primary rectal cancer stages I–III and who underwent anastomosis were included. A retrospective analysis of clinical data retrieved from a prospectively conducted database was performed. The primary endpoint was cancer-specific survival (CSS). Risk factors were adjusted by propensity score matching (PSM). The secondary endpoints were overall survival (OS), disease-free survival (DFS), and local recurrence-free rate (RFR).
Results: Nine hundred forty-two patients underwent surgery between 1991 and 2020 and were followed for a mean of 71.9 (SD 48.5) months. AL occurred in 141 patients (15.0%). Twenty-three patients had grade A AL (16.3%), 48 patients had grade B AL (34.0%), and 70 patients had grade C AL (49.6%). AL had no significant negative influence on the 5-year propensity score-adjusted survival rate for CSS (no AL 92.2%, AL 87.9%, p=0.161), but on OS (no AL 78.6%, AL 66.9%, p=0.005), DFS (no AL 72.9%, AL 60.9%, p=0.011), and RFR (no AL 94.2%, AL 88.5%, p=0.047). The severity of AL did not have a significant influence on CSS (p=0.642).
Conclusions: AL had a negative influence on OS, DFS and RFR. Whether aggressive surgical clinical management of AL has any influence on CSS remains unclear.
Clinical trial registration
The study was registered at ClinicalTrials.gov (NCT06059924).
Structure of dimerized assimilatory NADPH-dependent sulfite reductase reveals the minimal interface for diflavin reductase binding
Authors: Stroupe M. Elizabeth , Esfahani Behrouz Ghazi , Walia Nidhi , Neselu Kasahun , Aragon Mahira , Askenasy Isabel , Wei Hui , Mendez Joshua 
Published: July 2024

Abstract

Escherichia coli NADPH-dependent assimilatory sulfite reductase (SiR) fixes sulfur for incorporation into sulfur-containing biomolecules. SiR is composed of two subunits: an NADPH, FMN, and FAD-binding diflavin reductase and an iron siroheme/Fe4S4 cluster-containing oxidase. How they interact has been unknown for over 50 years because SiR is highly flexible, thus has been intransigent for traditional X-ray or cryo-EM structural analysis. A combination of the chameleon plunging system with a fluorinated lipid overcame the challenge of preserving a dimer between the subunits for high-resolution (2.84 Å) cryo-EM analysis. Here, we report the first structure of the reductase/oxidase complex, revealing how they interact in a minimal interface. Further, we determined the structural elements that discriminate between pairing a siroheme-containing oxidase with a diflavin reductase or a ferredoxin partner to channel the six electrons that reduce sulfite to sulfide.
Service Delivery Preferences for Long-acting Pre-exposure Prophylaxis among Pregnant and Breastfeeding Women in South Africa and Botswana
Authors: DE VOS Lindsey , MUSSA Aamirah , ROUSSEAU Elzette , STRAUSS Michael , GEORGE Gavin , VUNDHLA Prisca , GEBENGU Avuyonke , TSUANENG Maipelo , TAMUTHIBA Lefhela , TUMAGOLE Aratwa , MOSHASHANE Neo , MORRONI Chelsea , PETERS Remco P.H. , BABALOLA Chibuzor , KLAUSNER Jeffrey D. , DAVEY Dvora JOSEPH 
Published: July 2024

Abstract

Objective
HIV particularly affects women during pregnancy and postpartum, where they face a two-fold or more increased risk of HIV acquisition. Structural and individual barriers hinder effective use of daily oral pre-exposure prophylaxis (PrEP). We explored preferences for long-acting PrEP and multipurpose prevention technologies among pregnant and breastfeeding women (PBFW) without HIV.
Design
Between April and December 2023, we evaluated preferences for long-acting PrEP in a discrete choice experiment among pregnant and breastfeeding, postpartum women accessing maternal services at the primary healthcare level.
Methods
The study included individuals with prior experience using oral PrEP (Cape Town, South Africa) and those PrEP naive (East London, South Africa, and Gaborone, Botswana). The discrete choice experiment was developed through qualitative interviews and focus group discussions. Analysis included demographic characterization, site stratification, mixed effects logistic regression, and latent class modelling.
Results
We surveyed 450 pregnant and breastfeeding women (52% pregnant, 47% breastfeeding). Women strongly disfavoured vaginally inserted and implanted PrEP compared to oral PrEP. Preferences varied by study population: clinic PrEP pick-up was preferred in East London and Gaborone, while Cape Town showed more indifference for community delivery. Women in East London and Gaborone prioritized PrEP effectiveness over frequency. Three latent classes emerged: Class 1, ‘comprehensive delivery seekers’ (43%); Class 2, ‘physical and physiological prioritisers’ (25%), and Class 3, ‘vaginal insertion avoiders’ (32%).
Conclusions
PrEP modality (long-acting), frequency, and pickup location were important factors in PrEP delivery. Future PrEP programs should prioritize user-centered approaches, aligning with user values and preferences to foster effective use.
A Comprehensive Review on Novel Pathways in Cancer Treatment: Clinical Applications and Future Prospects
Authors: Shifana A.S. , Adnan Mohammad , Gupta Akash , Ajazuddin  , Jain Parag 
Published: July 2024

Abstract:
Cancer is a global health issue that requires ongoing therapeutic advances. This review
provides an overview of recent treatment strategies focusing on novel pathways in cancer therapy.
Emerging research has unveiled promising targets that go beyond traditional modalities, offering
new avenues for precision medicine and improved patient outcomes. One key area of innovation
lies in targeted therapies directed at specific molecular pathways implicated in cancer progression.
The identification of novel biomarkers has paved the way for the development of precision
medicines tailored to individual patient profiles. Immunotherapy has also revolutionised cancer
treatment by using the immune system to identify and remove cancer cells.
Moreover, advancements in epigenetic therapies and RNA-based interventions demonstrate unprecedented
potential in modulating gene expression and disrupting cancer-specific signalling
pathways. We have discussed the pathophysiology of cancer, different immune checkpoint inhibitors,
and targeted therapies in signalling therapies. The epigenetic modulators, such as Histone
deacetylase (HDACs) inhibitors and DNA methyltransferase (DNMT) inhibitors, were studied. Recent
breakthroughs in cancer immunotherapy treatment (CAR-T) cell therapy showcase the potential
to enhance the immune response against various cancers; thus, related information was incorporated.
Further, RNA-based therapies like RNA interference and mRNA-based vaccines and therapies,
combination therapies, and novel therapies were discussed in the present article.
Pregnancy and Diabetes in Turin: Lights and Shadows from Real Life
Data
Authors: Garino Francesca , Gottero Cristina , Balbo Marcella , Visconti Felicia , Sansone Daniela , Oleandri Salvatore Endrio 
Published: July 2024

Background::
From 2021, PSDTA for women with pregnancy complicated by diabetes
will be active in the ASL city of Turin; given the city's increasing multiculturalism, we decided
to evaluate from this point of view the patients who entered this pathway.

Methods:
Data on women from 1/10/2022 to 30/09/2023 were collected from the computerized
medical record.

Results::
Total patients: 304, Type of diabetes: T1D 3%; MODY < 1%; T2D 4% Diabetes manifested
in pregnancy (DMIP) 2%, GDM 90%, Foreigners prevalence: GDM: 67%, T2D%, T1D:
Foreign 11%, Planned vs. neglected pregnancies: GDM 47% vs 18%, T2D 31% vs 32%, DMIP
28% vs 50%, T1D: 66% vs 11%, Therapy: GDM: insulin 31% (multi-injective <30%), metformin
5%, T2D: insulin 100% (multi-injective 68%, metformin in 20%); continuous glycemic
sensor in 48%, DMIP: insulin 50% (multi-injective 50%), T1D: multi-injective therapy 33%;
pump and glycemic sensor 33%; integrated sensor-micro-infuser system 33%.

Conclusion::
In the aspect of ISTAT data indicating that for northern Italy, a foreign origin for
26% of mothers, our population is "unbalanced” between GDM, T2D, and DMIP on one side
and T1D on the other. The higher percentage of foreigners in the GDM group could be attributable
to the higher share of Italian women opting for private practice, conversely, the "missing"
share of foreign women with T1D is more difficult to interpret. Unplanned or even neglected
pregnancies are significant in women with GDM and DMIP (who are mostly foreign). If these
data are confirmed in other Italian realities, corrective strategies need to be planned.
Cost-effective Phytohormone Extraction of Sargassum swartzii from the Persian Gulf Using Magnetic Ionic Liquid
Authors: Rajabiyan Ali , Zarei-Ahmady Amanollah , Izadi Mohammad , Kardani Fatemeh 
Published: July 2024

Introduction:
Algae extracts are utilized as biofertilizers instead of chemical ferti-lizers in agriculture. Further, algae are known to possess a high content of plant hormones, such as gibberellin, salicylic acid, abscisic acid, and brassinosteroids.

Objective:
The main objective of this study was to increase the extraction yield and simulta-neously extract hormones required for plant growth from Sargassum swartzii using Magnetic recoverable ionic liquid (IL).

Methods:
In this study, extraction was performed by acidic digestion with acetic acid and then alkaline digestion with potassium hydroxide.

Results:
The results showed the ionic liquid effect in extraction yield by 266 percent. The extracted phytohormones were analyzed using high-performance liquid chromatography (HPLC) methods. High levels of gibberellin, salicylic acid, abscisic acid, and brassinosteroids in improved algae extraction showed that seaweed extract could be used as environmentally friendly liquid bio-fertilizers to replace chemical fertilizers and could play a crucial role in organic farming for sustainable agriculture. Additionally, the recoverability of ionic liquid eight times with negligible leaching proved the introduced procedure to be cost-effective.

Conclusion:
The reported procedure for algae extraction improved by using an acidic/primary ionic liquid environment. This procedure is economical because of the simple reusability of ionic liquid due to its magnetic features.

conclusion:
The reported procedure for algae extraction improved by using an acidic/primary ionic liquid environment. This procedure is economic because of the simply reusability of ionic liquid due to its magnetic features.
Role of Virechana Karma in management of Psoriasis w.s.r. to Ekakushtha - A Case Study
Authors: Himanshu  , Ashish Mehta  , Mamta Rana  
Published: July 2024

Introduction: Psoriasis is one of the most common dermatologic diseases. A 24 years old female presenting complain of large itchy, erythematous plaques with dry scaling all over the body include scalp and nails. The patient had taken allopathic medicine irregularly from many skins specialist but did not get relief. Patient is diagnosed with psoriasis or Ekakushtha and treated with shodhan therapy as Virechana karma. Objective: To evaluate the effect of Virechan in Psoriasis w.s.r. to Ekakushtha. Materials & Methods: Deepan, Pachana with Chitrakadi Vati and Ajmodadi Churana for 5 days and Snehpana with Panchtikta Ghrita for 7 days. External Snehana, Swedana for 3 days. Virechana is done with the help of Trivrit Avaleha dose of 80 gm followed by Samsarjana Karma for 5 days as Pashchat Karma in the management of psoriasis. Result: After Virechana therapy, there was a reduction in the redness, itching and scaling of the plaque in the 7 days. Discussion: Psoriasis is one of the most common skin disorders and a chronic dermatologic condition marked by periodic flare-ups of sharply defined red patches, covered by a silvery, flaky surface. In Kushtha, Rakta is considered as one of the main Dhatu which is responsible for Prasara stage of Kushtha Samprapti. As the Pitta and Rakta have Ashreya- Ashryi relationship, treatment modality of Pitta Dosha and Rakta Dhatu resemble each other. Therefore, Virechana therapy is used in this case for Shodhan Karma.
Pendidikan karakter dalam perspektif keyogyakartaan
Authors: Widyastuti Sri Harti , Hartanto Doni Dwi 
Published: July 2024

Yogyakarta adalah kota pendidikan dan budaya yang terkenal di dunia internasional. Disampimg itu Yogyakarta merupakan daerah istimewa dengan keraton kasultanan yang sampai saat ini masih hidup dan berkembang. Sebagai pusat kebudayaan dan pendidikan maka sarana prasarana serta sistem kemasyarakatannya sangat lekat dengan budaya Jawa. Namun demikian ikon budaya yang tergambar dalam karakter budaya belum tampak secara spesifik nyata dalam kehidupan di Yogyakarta. Tujuan penulisan makalah ini adalah mendeskripsikan nilai-nilai pendidikan karakter Islam dengan perspektif keyogyakartaan, strategi implementasi sebagai penguatan pendidikan karakter. Makalah ini ditulis berdasarkan hasil penelitian berjudul Pendidikan Karakter Keyogyakartaan. Teori yang digunakan untuk penelitian ini adalah teori filologi modern dan pembacaan teks model heuristik serta hermeneutik. Metode yang digunakan adalah metode filologi modern dan penelitian deskriptif. Sumber data penelitian adalah manuskrip Babad Ngayogyakarta, Selanjutnya nilai-nilai khas karakter dengan perspektif keyogyakartaan mencakup indikator nilai ketakwaan dan memahami tentang sangkan paraning dumadi. Karakter wirasa terdiri atas indikator nilai menghormati, tidak adigang adigung adiguna, ramah, asih, berfikir sebelum melakukan, dan ikhlas. Karakter wiraga terdiri dari indikator nilai tenang, sopan santun, dan berwibawa. Karakter wirama terdiri atas indikator nilai menghargai budaya dan menghargai proses. Selanjutnya adalah karakter mikul dhuwur mendhem jero; hamangku, hamengku, hamengkoni. Karakter sengguh terdiri atas indikator nilai percaya diri dan mengutamakan kepentingan bersama. Karakter ora mingkuh terdiri atas indikator nilai disiplin, tanggung jawab, berani melakukan demi menunjukkan kebenaran, berani mengalah, tegas dan setia. Karakter momot mengandung indikator nilai akomodatif, wani ngalah dhuwur wekasane dan peduli. Karakter prasaja mengandung indikator nilai rendah hati dan apa adanya . Adapun strategi implementasi nilai-nilai pendidikan karakter Islam dalam bperspektif keyogyakartaan di lingkungan sekolah adalah melalui jalur formal dan non formal. Jalur formal adalah melalui menitipkan dalam pembelajaran formal pada kurikulum muatan lokal wajib, sedangkan jalur non formal melalui pembiasaan.
Application of stepping stones triple-P on parents of intellectually disabled adolescent with emotional and behavioral problems
Authors: Faizah Firsta , Madjid Erniza Miranda , Djuwita Efriyani 
Published: July 2024

This study was conducted to determine the effectiveness of the Stepping Stones Triple-P (SSTP) intervention in a family of teenagers with moderate intellectual disability with emotional and behavioral problems. This intervention program aims to help prevent emotional and behavioral problems in children with moderate intellectual disability through positive parenting training. This intervention program is carried out in 9 sessions; each session lasts ± 60 – 120 minutes at each meeting and lasts ± three weeks, carried out online through the Zoom meeting. The intervention method in this study was implemented through lectures, discussions, worksheets, and roleplay methods. Children's behavior problems were measured using the Child Behavior Checklist (CBCL) and a diary of children's behavior filled in by parents during pre-post intervention and follow-up. The Parenting Sense of Competence Scale (PSOC) measures parents' perceptions of competence in parenting practices. This study's participants were the parents (mother) of a boy aged 16 years 4 months (N) diagnosed with moderate intellectual disability with emotional and behavioral problems. The results of this study indicate that the SSTP intervention program effectively reduces the emotional and behavioral problems shown by N by increasing the knowledge and skills of parents in implementing positive parenting strategies. In this study, there were positive changes in parenting practices applied by mothers to children, such as forming a harmonious and warm relationship between mothers and children. The positive changes achieved by mothers in implementing positive parenting also influenced the change in problematic behavior in children (N) to decrease and become more positive.