bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the glycemic effects of Dolutegravir and its predictors among HIV patients in Uganda: A prospective cohort study
Authors: Ankunda Collins , Agolor Curthbert , Karamagi Yvonne , Nakubulwa Susan , Namasambi Sharon , Kasamba Ivan , Christopher Semei Mukama , Kukundakwe Patience , Odiit Mary , Mubangizi Ivan , Emunyu Jude , Kesi Diana Nakitto , Nambasa Victoria , Ndagije Helen , Mukasa Barbara 
Published: July 2024

Abstract

Dolutegravir (DTG), a key component of the recommended HIV treatment regimens in Uganda, has been associated with hyperglycemia. We evaluated its influence on hyperglycemia risk to create a hyperglycemia risk stratification tool to guide patients’ monitoring. We conducted a prospective cohort study at three selected sites, involving 628 HIV patients who had been on Tenofovir Disoproxyl Fumarate, Lamivudine, and Dolutegravir (TLD). Patients were divided into those with prior Nucleoside reverse transcriptase inhibitors treatment (exposed) and antiretroviral therapy (ART) naïve individuals starting TLD (non-exposed). Patients had six-month follow-ups with Random Blood Sugar (RBS) draws every three months. Hyperglycemia was defined as RBS ≥ 7 mmol/L, and diabetes mellitus as RBS ≥ 7 mmol/L plus HbA1c ≥ 6.5%. The study observed a hyperglycemia incidence rate of 24.5 cases per 100 person-years (95% CI: 19.3–31.1) and a diabetes incidence rate of 5.8 cases per 100 person-years (95% CI: 3.6–9.3). The incidence of hyperglycemia was slightly lower in the non-exposed group (20.8 cases per 100 person-years) compared to the exposed group (25.2 cases per 100 person-years). The multivariable analysis suggested a trend towards a lower risk of hyperglycemia in the non-exposed group (adjusted HR = 0.78, 95% CI: 0.37–1.66, p = 0.52); and a trend towards a substantially lower diabetes incidence in the non-exposed group compared to the exposed (adjusted HR = 0.34, 95% CI: 0.04–2.82, p = 0.32). The study identified age (p < 0.001), study site (p < 0.001), and duration of DTG-based ART (p = 0.02) as significant factors associated with hyperglycemia. Our study showed an increased incidence of Hyperglycemia with age, study site, and duration of DTG exposure in HIV patients on TLD. No association was observed with exposure to non-DTG regimens. We suggest integrated screening and care for hyperglycemia and diabetes in HIV services, especially when initiating DTG-based regimens.
The number of bars in the Nuss procedure: treatment outcomes and complications. A large single-center Propensity Score Matched cohort study.
Authors: Skrzypczak Piotr Jerzy , Rozmiarek Monika , Dobiecki Tomasz , Sielewicz Magdalena , Suchodolski Michał , Roszak Magdalena , Piwkowski Cezary , Pawlak Krystian 
Published: July 2024

Abstract

The Nuss procedure is the most common corrective surgery for pectus excavatum. We analyzed treatment outcomes and complication rates in 1,247 patients treated with the Nuss procedure from 2002 to 2021, focusing on the number of corrective bars used. Using Propensity Score Matching based on age, sex, BMI, pre-operative FEV1, and the Haller index, we created two groups: 546 patients with a single bar and 546 with two bars. Both groups achieved similar correction effects (Haller index: single bar = 2.58 vs. two bars = 2.56; p = 0.65). In the univariate analysis, in the two-bar group, the postoperative complications were observed more often (28.6% vs. 15.4%, p < 0.001), including pneumothorax (11.2% vs. 6.2%, p < 0.001), hemothorax (3.7% vs. 0.7%, p < 0.001), additional drainage (13.7% vs. 5.3%, p < 0.001), the need for thoracentesis (8.6% vs. 2.9%, p < 0.001), bar displacement (3.8% vs. 0.7%, p < 0.001), pleural effusion (10.6% vs 3.1%, p < 0.001), and fever (6.6% vs 3.8%, p < 0.041). In the logistic regression, two bars significantly increased the risk of postoperative complications (p = 0.019), including hematoma (p = 0.036), pleural effusion (p = 0.002), and the need for thoracentesis (p = 0.013). Using two corrective bars during the Nuss procedure is associated with a higher rate of postoperative complications but similar corrective results.
Correlation Between Mild Behavioral Impairment and Peripheral Blood Biomarkers in Patients with Mild Cognitive Impairment
Authors: Liang Wei , Wang Lan , Song Mei , MM Hao Geng , MM Xinyang Jing , Li Wei , MM Yaxin Huo , Huang Anqi , Wang Xueyi , An Cuixia 
Published: July 2024

Abstract

Objective
We examined the prevalence of Mild behavioral impairment (MBI) in healthy older adults (HOA) and individuals with mild cognitive impairment (MCI), and the association between MBI and plasma biomarkers of Alzheimer's disease(AD).
Methods
A total of 241 subjects (136 HOA and 105 MCI) were enrolled in the Yuhua District of Shijiazhuang City in China. The MBI Symptom Checklist (MBI-C) was employed for assessment and diagnosis of MBI (MBI-C ≥ 6.5). Fasting venous blood was collected from 70 patients (32 HOA, 38 MCI), and Aβ40, Aβ42, and P-Tau217 levels were measured using enzyme-linked immunosorbent assay.
Results
The prevalence of MBI in HOA and MCI groups was 4.4% and 15.3%, respectively (χ2 = 7.262, P = 0.007), especially in terms of decreased motivation, impulse dyscontrol (highest detection rate), and social inappropriateness (P < 0.05). MBI total score was correlated with Aβ42 and P-Tau217 (r=-0.385, P = 0.019; r=-0.330, P = 0.041), but not with Aβ40 or Aβ42/40 ratio. Among the subdomains, impulse dyscontrol submains was correlated with Aβ42 (r=-0.401, P = 0.025).
Conclusion
Both MCI and HOA demonstrated a higher prevalence of MBI, with change in impulse control behavior being the most common. MBI not only serves as an independent risk factor for cognitive decline but is also associated with AD-related peripheral biomarkers.
Identification of Key Genes and Exploration of Immune Activation Pathways in T-cell Mediated Rejection through Integrated Bulk and Single-Cell RNA-Seq Analysis with Machine Learning
Authors: Shao Wenhao , Ding Huaxing , Wang Yan , Shi Zhiyong , Zhang Hezhao , Meng Fanxiu , Chang Qingyao , Duan Haojiang , Lu Kairui , Zhang Li , Xu Jun 
Published: July 2024

Abstract

Liver transplantation is the definitive treatment for end-stage liver disease, yet T-cell mediated rejection (TCMR) remains a major challenge. This study aims to identify key genes associated with TCMR and their potential biological processes and mechanisms. The GSE145780 dataset was subjected to differential expression analysis, weighted gene co-expression network analysis (WGCNA), and machine learning algorithms to pinpoint key genes associated with TCMR. Gene Set Enrichment Analysis (GSEA), immune infiltration analysis were conducted, along with constructing regulatory networks were constructed to ascertain the biological relevance of these genes. Expression validation was performed using single-cell RNA-seq (scRNA-seq) data and liver biopsy tissues from patients. We identified 5 key genes ( ITGB2, FCER1G, IL-18, GBP1, and CD53) that are associated with immunological functions, such as chemotactic activity, antigen processing, and T cell differentiation. GSEA highlighted enrichment in chemokine signaling and antigen presentation pathways. A lncRNA-miRNA-mRNA network was delineated, and drug target prediction yielded 26 potential drugs. Evaluation of expression levels in non-rejection (NR) and TCMR groups exhibited significant disparities in T cells and myeloid cells. Tissue analyses from patients corroborated the upregulation of GBP1, IL-18, CD53, and FCER1G in TCMR cases. Through comprehensive analysis, this research has identified 4 genes intimately connected with TCMR following liver transplantation, shedding light on the underlying immune activation pathways and suggesting putative targets for therapeutic intervention.
Exploration of the relationship between the level of popliteal artery injury and the risk of amputation
Authors: Mao Jianjie , Chu Hui , Jin GengYang 
Published: July 2024

Abstract

Purpose To explore the impact of different levels of popliteal artery injury (PAI) on the risk of amputation in affected limbs.Method 94 patients were divided into the amputation group (n = 26) and the nonamputation group (n = 68) based on whether limb preservation was successful. The data was reconstructed from computed tomography angiography (CTA) of the patient's lower limbs and measured using AW Volume Share 5 software. Quantify the height of the popliteal artery injury plane: that is, the distance L from the bifurcation of the descending knee artery on the healthy limb to the bifurcation of the anterior tibial artery and the distance S from the bifurcation of the descending knee artery at the site of blood flow interruption on the affected limb. Take the ratio of R = S/L, where S and R represent the height of the blood flow interruption plane. Analyze the risk factors affecting amputation in two groups of PAI patients .Result There were an significant difference between R and S between the two groups;Univariate and multivariate logistic regression analysis showed that R (OR = 0.923, P = 0.015), S (OR = 0.712, P = 0.036), ischemic time (OR = 1.237, P = 0.004), and concurrent fascial compartment syndrome (OR = 5.496, P = 0.044) were all independent risk factors for amputation in PAI patients. Receiver operating characteristic curves of the subjects showed that the AUC (R, S) were 0.896 (P < 0.000, 95% CI: 0.816–0.949) and 0.775 (P < 0.000, 95% CI: 0.677–0.854), respectively; The diagnostic efficiency is highest when the diagnostic threshold values are 0.522mm and 11.4mm, respectively; AUCR>AUCS (Z = 1.974, P = 0.0484).Conclusion The level of injury is an independent risk factor for amputation in PAI patients, and the higher the level of injury, the greater the risk of amputation. In terms of evaluating the diagnostic efficiency of the injury plane in predicting amputation risk, R is superior to S.
Evaluation of the corticospinal drive during ground walking with visual guidance
Authors: Oya Chika , Muramatsu Erina , Teramoto Keisuke 
Published: July 2024

Abstract

Background
The methods used for evaluating body movements—driven by the functions of the brain and nervous system—do not facilitate the evaluation of internal events such as brain/nervous system activity related to the output process, thus necessitating development of an evaluation method for human physical function that focuses on the function of the brain and nervous system.
Aim
To investigate the differences in brain and nervous system function during different walking tasks.
Methods
The participants were 10 healthy adults (10 women, aged 19–35 years). The exercise tasks were (i) a 20-m round-trip walk as a normal walk and (ii) a target-task walk, which involved walking with the task of stepping on a line every 3 m on a course similar to that for normal walking. Electromyography (EMG) was applied to the proximal tibialis anterior (pTA), distal tibialis anterior (dTA), medial gastrocnemius (MG), and lateral gastrocnemius (LG) muscles to record muscle activity.
Results
No difference was noted between normal walking and target-task walking for the pTA and dTA (t(9) = 0.479, P = 0.643, d = 0.090). However, between the MG and LG, coherence in target-task walking showed a trend toward higher values ((t(8)) = -2.185, P = 0.060, d = -0.404), although this was not statistically significant.
Conclusions
The results of this study indicate that the neural drive might be stronger during target walking movements with visual tasks than during simple walking movements, and that neural activity tends to be more active when accompanied by visual feedback.
Health-related quality of life and its associated factors among children aged 8 to 18 years living in previous leprosarium and non-leprosarium areas in Eastern Ethiopia: A comparative cross-sectional study
Authors: Desalew Assefa , Adem Siraj Aliyi , Weldegebreal Fitsum , Mekonnen Getachew Kabew , Raru Temam Beshir , Umer Ukash , Keneni Mulualem , Urgesa Kedir 
Published: July 2024

Abstract

Background: Children and their families living in leprosarium areas may have a lower quality of life than the general population. However, there is limited evidence on health-related quality of life and its associated factors among children living in previous leprosarium settlement areas. Hence, this study aimed to compare the health-related quality of life and its associated factors among children aged 8 to 18 years living in previous leprosarium and non-leprosarium settlement areas in eastern Ethiopia.
Method: A community-based comparative cross-sectional study was conducted among 515 randomly selected children aged 8 to 18 years living in the Amir Nur and Babile districts from January to February 30, 2024. Data were collected through interviews with both children and parents using the Pediatric Quality of Life Inventory Version 4. The data were analyzed using STATA version 14. Simple and multiple linear regression was employed to identify associations between independent and outcome variables.
Results: The overall mean health-related quality of life scores were 73.98 ± 18.47 and 77.67 ± 14.72 in the child self-reports (P=0.01) and 55.78 ± 12.03 and 55.61±8.50 (P=0.85) in the parent proxy reports in the previous leprosarium and nonleprosarium settlement areas, respectively. In multiple linear regression, child education (β =14.69; 95% CI: 8.69, 20.69), the absence of neglected and tropical diseases (β = 4.02; 95% CI: 0.66, 7.37), and child face washing habits (β = 5.54, 95% CI: 2.14, 8.95) per day increased health-related quality of life. However, a previous history of neglected and tropical diseases (β = -8.54; 95% CI: -12.93, -4.15) and the absence of hand washing facilities (β = -8.57; 95% CI, -15.22, -1.92) decreased the mean health-related quality of life.
Conclusion: Overall, one in four and more than half of children from previous leprosarium areas had poorer health-related quality of life compared to their counterparts based on child self-reports and parent proxy reports, respectively. Educational status of the child, not having neglected and tropical diseases, and daily child-face washing habits improve health-related quality of life. To improve health-related quality of life, stakeholders should pay attention to and work on the early detection and treatment of neglected and tropical diseases, child education, and proper sanitation practices in this community.
Metformin induces ferroptosis and suppresses malignant behaviors in diabetic breast cancer
Authors: Chen Tao , Li Xiaoxin , Li Yuanyuan , Zhou Chunyan , Tang Chuangang , Wang Xiang , Li Changwen 
Published: July 2024

Abstract

This study investigates the potential role of metformin in breast cancer treatment, especially its impact on ferroptosis—an iron-dependent form of programmed cell death. Breast cancer is one of the most common malignancies globally, with limited treatment options, particularly for triple-negative breast cancer. The research involved analyzing tumor tissues from breast cancer patients. It was observed that the tumor tissues of diabetic patients treated with metformin had obvious iron accumulation, suggesting variations in the level of ferroptosis. Further analysis using gene transcription data from the TCGA database revealed correlations between diabetes-related genes and genes associated with ferroptosis. The experimental results indicated that metformin could evident inhibit the proliferation of breast cancer cells and induce ferroptosis in a diabetic model. Moreover, metformin was found to promote ferroptosis by affecting mitochondrial activity. In conclusion, the study suggests that metformin holds potential value in treating diabetic breast cancer, capable of suppressing tumor cell growth through the ferroptosis mechanism. These findings provide a new theoretical basis for using metformin as a treatment for breast cancer and lay the groundwork for future clinical applications.
Changes in blood glucose profile before and after kidney transplantation: a prospective cohort study using continuous glucose monitoring
Authors: Shin Jiyoung , Jo Eun-Ah , Cho Ara , Ko Myeonghyeon , Kim Sangwan , Han Ahram , Ha Jongwon , Min Sangil , Woo Hye Young 
Published: July 2024

Abstract

Post-transplantation diabetes mellitus (PTDM) negatively affects graft and patient survival after kidney transplantation (KT). This prospective study used continuous glucose monitoring (CGM) to evaluate perioperative blood glucose dynamics, identify PTDM risk factors, and compare predictive accuracy with capillary blood glucose monitoring (CBGM) in 60 non-diabetic living-donor KT recipients. Patients underwent 2-week pre- and postoperative CGM, including routine CBGM during their in-hospital stays. PTDM-related risk factors and glucose profiles were analyzed with postoperative CGM and CBG. PTDM developed in 14 (23.3%) patients and was associated with older age, male sex, higher baseline HbA1c, high-density lipoprotein cholesterol, and 3-month cumulative tacrolimus exposure levels. Male sex and postoperative time above the range (TAR) of 180 mg/dL by CGM were PTDM-related risk factors in the multivariate analysis. For predictive power, the CGM model with postoperative glucose profiles exhibited higher accuracy compared with the CBGM model (areas under the curves of 0.916, and 0.865 respectively). Therefore, we found that male patients with a higher postoperative TAR of 180 mg/dL have an increased risk of PTDM. Postoperative CGM provides detailed glucose dynamics and demonstrates superior predictive potential for PTDM than CBGM.
Association of hemoglobin glycation index with clinical outcomes in patients with coronary artery disease: A prospective cohort study
Authors: Wen Zhi-Ying , Li Fa-Peng , Wu Ting-Ting , Hou Xian-Geng , Pan Ying , Deng Chang-Jiang , Li Yan-Xiao , He Xue-Chun , Gao Wei-Tong , Chen Hong-Xia , Zheng Ying-Ying , Xie Xiang 
Published: July 2024

Abstract

Background
To analyze the association between the hemoglobin glycation index (HGI) and the long-term prognosis of patients with coronary artery disease (CAD).
Methods
HGI represented the difference between laboratory measured Hemoglobin A1c (HbA1c) and predicted HbA1c based on a liner regression between Hb1Ac and fasting plasma glucose (FPG). A total of 10 598 patients who treated with percutaneous coronary intervention (PCI) were stratified into three groups (low HGI group: HGI<-0.506, medium HGI group: -0.506 ≤ HGI < 0.179, and high HGI subgroup: HGI ≥ 0.179). The primary endpoints includes all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints were major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs).
Results
A total of 321 ACMs, 243 CMs, 774 MACEs, and 854 MACCEs were recorded during a 60-month follow-up period. After adjusting for confounders using a multivariate Cox regression analysis, the patients in the low HGI group had a significantly increased risk of ACM (adjusted HR = 1.683, 95%CI:1.179–2.404, P = 0.004) and CM (HR = 1.604, 95%CI:1.064–2.417, P = 0.024) as compared with patients in the medium HGI group. Similarly, the patients in the high HGI group had an increased risk of MACEs (HR = 1.247, 95% CI: 1.023–1.521, P = 0.029) as compared with patients in the medium HGI group. For ACM, CM, and MACEs, a U-shaped relation were found among these three groups. However, we did not find significant differences in the incidence of MACCEs among these three groups.
Conclusion
The present study indicates that HGI could be an independent predictor for the risk of mortality and MACEs in patients with CAD.
Clinical outcomes and synergistic effect between radiotherapy and immunotherapy in patients with extensive-stage small cell lung cancer: A real-world study
Authors: Sun Meiling , Ji Huaijun , Deng Fang , Xu Ning , Li Yu 
Published: July 2024

Abstract

Background
Patients with extensive-stage small cell lung cancer (ES-SCLC) experience significant therapeutic challenges and limited survival rates. This study aimed to investigate the efficacy of combining immunotherapy (IT) with chemotherapy (CT) for treating ES-SCLC and to explore the synergistic effect between radiotherapy (RT) and IT.
Methods
This retrospective analysis examined patients with ES-SCLC who received treatment at three centers. Furthermore, propensity score-matched (PSM) analysis was conducted. The Kaplan‒Meier method and Cox proportional hazards regression were used to compare the survival outcomes.
Results
A total of 257 eligible patients with ES-SCLC were included in the analysis. Among all patients, the median overall survival (mOS) was 18.0m in the chemoimmunotherapy (CT + IT) group and 15.7m in the CT group (p = 0.208). The median real-world progression-free survival (mrwPFS) was 7.7m and 6.8m (p = 0.043) in the CT + IT and CT group, respectively. Moreover, the mOS was 22.0m in the chemoradiotherapy (CT + RT) group and 13.6m in the CT group (p < 0.001). The mrwPFS was 7.4m and 6.0m (p = 0.175) in the CT + RT group and CT group, respectively. The multivariate analyses revealed that sex, liver metastasis and RT were independent prognostic factors for OS (p < 0.05), while liver metastasis and IT were found to be independent predictive factors of rwPFS (p < 0.05). After PSM, the mOS was 23.2m in the CT + IT group and 13.0m in the CT group (p = 0.008). The mrwPFS was 7.3m and 6.2m (p = 0.096) in the CT + IT group and the CT group, respectively. Moreover, the mOS was 21.4m in the CT + RT group and 12.5m in the CT group (p < 0.001). The mrwPFS was 7.3m and 5.2m (p = 0.220) in the CT + RT group and the CT group, respectively. Additionally, our study revealed that in the PD-1 group, RT significantly improved patient survival (36.0m vs. 15.8m, p = 0.041).
Conclusion
An increasing number of treatment options are being explored for ES-SCLC, and CT is the cornerstone of treatment for this disease. Combining CT with IT and RT has demonstrated remarkable efficacy and excellent safety profiles, and such treatments are worthy of further exploration.