bluuebunny/crossref_metadata_2025_split huggingface dataset:
Untargeted Metabolomic Analysis Reveals a Potential Role of Saponins in the Partial Resistance of Pea (Pisum sativum) Against a Root Rot Pathogen, Aphanomyces euteiches
Authors: Goyal Ravinder K. , Hui Joseph P. M. , Ranches Jeffrey , Stefanova Roumiana , Jones Alysson , Banskota Arjun H. , Burton Ian , Yu Bianyun , Berrue Fabrice , Hannig Albert , Clark Shawn , Chatterton Syama , Dhaubhadel Sangeeta , Zhang Junzeng 
Published: August 2024

In soilborne diseases, the plant–pathogen interaction begins as soon as the seed germinates and develops into a seedling. Aphanomyces euteiches, an oomycete, stays dormant in soil and is activated by sensing the host through chemical signals present in the root exudates. The composition of plant exudates may, thus, play an important role during the early phase of infection. To better understand the role of root exudates in plant resistance, we investigated the interaction between partially resistant lines (PI660736 and PI557500) and susceptible pea cultivars (CDC Meadow and AAC Chrome) against A. euteiches during the pre-invasion phase. The root exudates of the two sets of cultivars clearly differed from each other in inducing oospore germination. PI557500 root exudate not only had diminished induction but also inhibited the oospore germination. The contrast between the root exudates of resistant and susceptible cultivars was reflected in their metabolic profiles. Data from fractionation and oospore germination inhibitory experiments identified a group of saponins that accumulated differentially in susceptible and resistant cultivars. We detected 56 saponins and quantified 44 of them in pea root and 30 from root exudate; the majority of them, especially soyasaponin I and dehydrosoyasaponin I with potent in vitro inhibitory activities, were present in significantly higher amounts in both roots and root exudates of PI660736 and PI557500 compared with Meadow and Chrome. Our results provide evidence for saponins as deterrents against A. euteiches, which might have contributed to the resistance against root rot in the studied pea cultivars. [Formula: see text] Copyright © 2024 His Majesty the King in Right of Canada, as represented by the Minister of Agriculture and Agri-Food Canada and the National Research Council of Canada. This is an open access article distributed under the CC BY 4.0 International license .
The Effect of Intravenous Tranexamic Acid on Postoperative Ecchymoses after Upper Blepharoplasty
Authors: Vogt Ashtyn Z. , Kivanany Pouriska B. , De Niear Matthew A. , Vrcek Ivan M. , Homer Natalie A. 
Published: August 2024

Background:
Tranexamic acid has been increasingly used in facial plastic surgery to improve perioperative hemostasis. While subcutaneous tranexamic acid has been found to not significantly decrease postoperative ecchymoses following upper blepharoplasty, systemic administration has not previously been studied.

Methods:
A total of 325 patients undergoing upper blepharoplasty were randomly assigned to either receive intravenous tranexamic acid or serve as a control. Patients in the experimental group were administered 1 g of tranexamic acid intravenously 10 minutes before surgical incision. A similar upper blepharoplasty technique was performed by two American Society of Ophthalmic Plastic and Reconstructive Surgery-trained surgeons. Follow-up was conducted at a median of 8 days postsurgery. Patient photographs were evaluated by two independent graders to rate ecchymoses on a scale of 0 (least) to 10 (most).

Results:
Of the 325 included patients, 138 patients received intravenous tranexamic acid and 187 patients did not. The average ecchymosis rating for the control group at day 8 was 5.8 ± 1.7, while the average rating for the tranexamic acid group at the same time point was 4.1 ± 1.6 (P < 0.0001). There was a trend toward decreased ecchymoses in the tranexamic acid group at earlier and later postoperative timepoints that did not reach statistical significance. No hemorrhagic or systemic embolic complications occurred.

Conclusions:
Systemic tranexamic acid may reduce postoperative ecchymoses after upper blepharoplasty surgery, reaching significance at the eighth postoperative day, which may lead to improved patient satisfaction and decreased occupational downtime.
Effects of Isometric Handgrip Training on Ambulatory Blood Pressure in Individuals Over 18 Years Old
Authors: Oliveira Marcelo de Santana , Melo Paulo Henrique , Correia Marilia de Almeida , Gerage Aline Mendes , Ritti-Dias Raphael Mendes , Farah Breno Quintella 
Published: August 2024

Purpose:
The aim of this study was to analyze the effects of isometric handgrip training (IHT) on ambulatory blood pressure (BP) in individuals aged 18 yr and older.

Review Methods:
A systematic review and meta-analysis was performed in Medline and Web of Science, encompassing studies published until July 2023, as well as the gray literature. We calculated the mean difference (MD) and 95% CI using an inverse variance method with a random effects model.

Summary:
Considering both published and unpublished studies, we observed an effect of IHT on awake diastolic BP (MD = −2.02; 95% CI, −3.89 to −0.15 mmHg; P = .03). There were no significant effects on 24-hr systolic BP (MD = −1.31; 95% CI, −3.84 to 1.22 mmHg; P = .31), asleep systolic BP (MD = −0.84; 95% CI, −3.31 to 1.63 mmHg; P = .50), awake systolic BP (MD = −0.93: 95% CI, −3.10 to 1.23 mmHg; P = .40), 24-hr diastolic BP (MD = −0.96; 95% CI, −2.65 to 0.74 mmHg; P = .27), or asleep diastolic BP (MD = −1.27; 95% CI, −3.22 to 0.67 mmHg; P = .20). In conclusion, the effects of IHT on ambulatory BP were observed primarily in awake diastolic BP among individuals over 18 yr of age.
Comparison of different tracers in sentinel lymph node detection for endometrial cancer: a systematic review and network meta-analysis
Authors: Feng Chuanli , Jiang Xuji , Feng Lianlian , Sun Wanying , Liu Qingqing , Hao Yiping , Cui Baoxia 
Published: August 2024

Background:
In the realm of endometrial cancer (EC) therapeutics and prognostic assessments, lymph nodes’ status is paramount. The sentinel lymph node (SLN) detection, recognized for its reliability, has been progressively adopted as a standard procedure, posing a compelling alternative to conventional systematic lymphadenectomy. However, there remains a lack of agreement on the most effective choice of tracers for this procedure.

Objective:
This investigation was dedicated to a comparative analysis of various tracers to identify the most effective combination that achieves the highest detection rate. This endeavor sought to enhance the efficacy of SLN biopsy in the surgical management of EC.

Methods:
A systematic review was conducted across multiple databases, including the Cochrane Central Register of Controlled Trials, PubMed, Web of Science, Embase, and clinicaltrials.gov, to analyze studies employing different tracers for SLN biopsy during surgery in EC. Using Bayesian network meta-analysis, the authors compared the total and bilateral detection rates of various tracers.

Results:
After screening 1431 articles, 11 studies, including 2699 participants, were selected in this network meta-analysis. The combination of radioactive isotopes and indocyanine green (ICG) emerged as the most efficacious method in total and bilateral detection rates, with the Surface Under the Cumulative Ranking Curve (SUCRA) scores of 80.00 and 86.36%, respectively. Additionally, carbon nanoparticles (CNPs) demonstrated superior performance in the detection of para-aortic lymph nodes with an SUCRA score of 97.77%.

Conclusion:
Network meta-analysis shows that the application of radioactive isotopes and ICG is the optimal tracer combination for SLN biopsy during surgery in EC.
Radiation-induced liver disease mimicking liver metastasis after low-dose hepatic irradiation during radiotherapy for gastric mucosa-assisted lymphoid tissue lymphoma: A case report
Authors: Park Hyeli , Lee Sun Young 
Published: August 2024

Rationale:
Radiation-induced liver disease (RILD) is an established complication of hepatic irradiation that is typically reported in patients receiving high-dose radiotherapy for hepatocellular carcinoma or liver metastases. However, RILD can also occur after unintentional low-dose liver exposure during radiotherapy for other gastrointestinal malignancies when careful precautions are not taken.

Patient concerns:
We report the case of a 44-year-old woman with gastric mucosa-associated lymphoid tissue lymphoma who underwent salvage radiotherapy administered to the entire stomach. One month after completing this radiotherapy, computed tomography and magnetic resonance imaging of the patient’s abdomen revealed a 4 cm lesion in the left lateral liver segment, suggestive of metastasis.

Diagnoses:
An ultrasound-guided biopsy was performed, and the histopathological findings were consistent with those of RILD.

Interventions:
Conservative management was pursued with close monitoring of liver function tests.

Outcomes:
The patient’s imaging findings and liver enzyme levels normalized approximately 3 months after the initial diagnosis.

Lessons:
This case highlights the importance of considering RILD in the differential diagnosis of new hepatic lesions detected after radiotherapy, even in patients with low-dose liver exposure within generally acceptable limits. Careful correlation with the radiotherapy plan is crucial to avoid misdiagnosing RILD as metastatic disease and to guide appropriate management.
Unveiling a rare BRAF mutation in minimally invasive follicular thyroid carcinoma: A case report
Authors: Lee Po-Sheng , Chen Jui-Yu , Pan Li-Hsin , Hwu Chii-Min , Hang Jen-Fan , Kuo Chin-Sung 
Published: August 2024

Rationale:
Molecular testing is becoming more widely used; however, the accuracy of diagnostic testing remains a primary consideration, especially for molecular testing that detects specific mutations associated with cancers.

Patient concerns:
A 45-year-old female without documented comorbidities presented a thyroid nodule during a routine health examination. Initial evaluation revealed a 3.8-cm nodule in the left lobe of thyroid, classified as Bethesda System category III on fine needle aspiration cytology. Genetic molecular testing detected the BRAF V600E mutation via quantitative polymerase chain reaction assay, raising concern for papillary thyroid cancer (PTC).

Diagnoses:
The preoperative impression was PTC based on the detection of BRAF V600E mutation.

Interventions:
The patient underwent thyroidectomy as well as lymph node dissection with the expectation to treat PTC.

Outcomes:
The final pathology unexpectedly revealed minimally invasive follicular carcinoma. Confirmatory Sanger sequencing unveiled a novel sequence variation involving nucleotide duplication within the range of 1794 to 1802, a non-V600E BRAF mutation not previously reported in follicular thyroid carcinoma.

Lessons:
This case study demonstrates the clinical relevance of exercising caution in molecular testing and its interpretation of results. For genetic testing used for diagnostic purposes, rigorous validation or cross-checking using different methods should always be considered to ensure appropriate interpretation of molecular results.
The “blownknee” patient’s stress fracture of distal tibial component after unilateral TKA: A case report
Authors: Sun Quanxiang , Liu Changjie , Sun Xuedong , Liu Zezhong , Liu Xiaoguang , Li Wei , Zhang Yimin 
Published: August 2024

Rationale:
Periprosthetic fractures (PPF) are rare complications of total knee arthroplasty (TKA). The most common PPF after TKA is supracondylar femoral fracture, which is a relatively rare complication that is usually associated with high-energy trauma, with a reported incidence ranging from 0.4 to 1.7% according to the AOANJRR. However, in TKA patients, it is rarer that the stress fracture around the tibial prosthesis occurs due to changes in the lower limb force line, increasing weight-bearing, and changes in walking gait.

Patient concerns:
A 68-year-old woman visited our hospital with “both knees had aggravated pain and deformity for 8 years.” TKA was performed first on the left knee and the patient was discharged within 1 week. Three months later, the patient complained of pain in the upper middle 1/3 part of the medial tibia for 2 weeks, which gradually worsened and affected weight-bearing.

Diagnoses:
Physical examination showed that the left knee joint presented varus deformity, and the right valgus deformity, which diagnosed as osteoarthritis of both knees and was so-called “blownknee”. The disease was initially diagnosed as osteoarthritis of both knees on first admission and PPF of the tibia in second.

Interventions:
Three operations were performed on this patient. The first was TKA of the left knee, the second was open reduction and internal fixation of the PPF of the tibia 3 months after the first operation, and the third was TKA of the right knee.

Outcomes:
Until now, the patient has had no recurrent PPF, and the fracture is healing from the last X-ray.

Lessons:
Clinicians should be aware of the possibility of PPF after TKA, especially in such patients, the most preferred surgical treatment method was open reduction and internal fixation of fractures using locking plates, and if the PPF with loosened implants, Revision TKA, or megaprosthesis was the better choice.
CONSORT article: Single-cell sequencing analysis revealed CMKLR1+ macrophage as a subpopulation of macrophage with tumor-suppressive characteristics in oral squamous cell carcinoma
Authors: Lou Jiaqi , Luo Guanghui , Zhao Lei , Zhang Huiya 
Published: August 2024

Background:
Oral squamous cell carcinoma (OSCC) is an aggressive oral malignancy. Metastasis and postoperative recurrence are major causes of a high mortality of OSCC. The landscape of immune cells in OSCC remained to be comprehensively explored.

Methods:
Tumor tissues of OSCC patients were collected from the Gene Expression Omnibus database, based on which single-cell sequencing analysis was performed to identify subtypes of macrophages and to annotate the subpopulations according to the expression levels of cell marker genes. Functional enrichment analysis was performed to explore the biological processes involved in each cell subcluster. Gene regulatory networks driven by SPECIFIC transcription factors (TFs) were developed applying single-cell regulatory network inference and clustering (SCENIC) analysis. Binding strength between receptors and ligands between different cells was analyzed using cell communication analysis.

Results:
A single-cell landscape in OSCC was successfully developed and a total of 11 cell clusters were identified. Specifically, CD163 + macrophages were a crucial type of macrophage with 4 cell subpopulations, namely, SAT1 + macrophages, IDO1 + macrophages, TRIM29 + macrophages, and CMKLR1 + macrophages. IDO1 + macrophages and CMKLR1 + macrophages mainly had the characteristics of M1-type macrophages. CMKLR1 + macrophages fulfilled the function of M1-type macrophages to inhibit OSCC progression. IDO1 + macrophages and CMKLR1 + macrophages were both involved in the activation response of T cells. CMLKR1 + macrophages had a stronger activating effect on T cells. CMKLR1 + macrophages directly regulated the proliferation of epithelial cells and inhibited the progression of OSCC.

Conclusion:
CMKLR1 + macrophages in OSCC were identified as a crucial cell subpopulation of macrophages in inhibiting tumor progression. Adjusting the infiltration abundance and cell activity of CMKLR1 + macrophages may be a novel therapeutic direction to improve OSCC prognosis.
Association between prediabetes and the incidence of gastric cancer: A meta-analysis
Authors: Wang Shenggang , Zhao Jiamin , Liu Chong 
Published: August 2024

Background:
Prediabetes has been found to be associated with an elevated overall risk of cancer, which may be site-specific. we performed a protocol for systematic review and meta-analysis to investigate the correlation between prediabetes and the incidence of gastric cancer (GC).

Methods:
A thorough review of the literature was conducted in the PubMed, Embase, and Web of Science databases to identify pertinent observational studies with longitudinal follow-up. The random-effects model was employed to consolidate the data, taking into account the potential impact of heterogeneity.

Results:
A total of 13 datasets from 8 prospective cohort studies were included. The prevalence of prediabetes was 9.6%. During the mean follow-up duration of 7.1 to 12.2 years, 33,135 patients were diagnosed with GC. According to the results of the pooled analysis, prediabetes was associated with a mildly higher incidence of GC over time (risk ratio: 1.07, 95% confidence interval: 1.01–1.13, P = .03; I
2 = 44%). Subsequent subgroup analyses indicated that the relationship between prediabetes and the heightened risk of GC may not be substantially influenced by factors such as the country in which the study was conducted, the average age of participants, their gender, the definition of prediabetes used, the prevalence of prediabetes at the beginning of the study, the incidence of GC within the studied population, or the adjustment made for body mass index (P for subgroup difference all >.05).

Conclusion:
The presence of prediabetes may increase the risk of GC by a mild amount when compared with people with normoglycemia in community-derived adult populations.
Successful corticosteroid therapy for severe liver injury secondary to herbal traditional Chinese medicine, Mega Defends X, assessed for causality by the updated RUCAM: A case report
Authors: Chai Lu , Wang Ran , Teschke Rolf , Jin Shenghao , Deng Jiao , Qi Xingshun 
Published: August 2024

Rationale:
In China, herbal traditional Chinese medicine products are readily obtained without any requirement of prescription and widely used in real life, thereby increasing the incidence of their related herb-induced liver injury (HILI). However, the diagnosis of HILI is still challenging because its clinical manifestations are variable due to lack of any specific biomarkers. Misdiagnosis and inappropriate treatment may result in the progression of HILI.

Patient concerns:
A 55-year-old female patient was admitted to the hospital due to progressive jaundice.

Diagnoses:
The diagnoses of HILI secondary to Mega Defends X, an herbal traditional Chinese medicine product, for which the score was 9 based on the updated Roussel Uclaf Causality Assessment Method of 2016.

Interventions:
The patient received corticosteroid with a stepwise dosage reduction.

Outcomes:
The liver injury significantly improved by corticosteroid treatment.

Lessons:
Corticosteroids should be potentially effective and safe in patients with severe HILI.
Polyarteritis nodosa complicated by renal aneurysm and intestinal perforation: A case report
Authors: Ma Yingying , Luan Luan , Zhang Junjun , Ren Chunfeng , Hou Chunfeng 
Published: August 2024

Rationale:
Polyarteritis nodosa (PAN) is a necrotizing vasculitis that affects small- and medium-sized arteries, presenting with diverse clinical manifestations. It can impact tissues and organs throughout the body and may be life-threatening in severe cases. Common causes of death include cardiac, renal, and gastrointestinal complications or aneurysm rupture. While separate reports of renal aneurysm and intestinal perforation exist, the coexistence of these conditions is rarely documented. This study reports a severe case of PAN complicated by both renal aneurysm and intestinal perforation, aiming to deepen the understanding of this disease, aid in clinical diagnosis and treatment, and improve patient prognosis.

Patient concerns:
The patient presented to the hospital with dorsal foot pain and abdominal pain persisting for more than 4 months, along with pain and discomfort in both lower extremities for over 1 month.

Interventions:
The patient was diagnosed with PAN, renal aneurysm, intestinal perforation, and grade 3 hypertension (high risk).

Outcomes:
After treatment, the patient showed normal temperature and blood pressure, relief from abdominal pain, and disappearance of myalgia and numbness in the lower limbs. Additionally, the renal aneurysm shrank significantly, the intestinal perforation healed, the ileostomy was reduced, and the patient’s condition stabilized.

Lessons:
The clinical symptoms of PAN mostly lack specificity, and should be distinguished from microscopic polyangiitis and simulated vasculitis. For patients with intestinal perforation similar to this case, tocilizumab treatment may be effective, but further research is needed to confirm it.
Clinical efficacy of traditional Chinese medicine combined with Western medicine in the treatment of persistent human papillomavirus infection in patients with infertility
Authors: Yang Ling , Zhang Ting , Li Yan , Ma Hong-Long 
Published: August 2024

Objective:
To investigate the clinical efficacy of Fuzheng Jiedu formula combined with interferon in the treatment of human papillomavirus (HPV) infection in patients with infertility.

Methods:
A total of 750 infertile patients with persistent HPV infection were randomly divided into Group A (n = 240, interferon), Group B (n = 260, Fuzheng Jiedu formula), and Group C (n = 250, interferon + Fuzheng Jiedu formula). The traditional Chinese medicine (TCM) symptoms, efficacy, immune function, and HPV conversion were compared among the three groups, and statistical analysis was conducted on the data before and after treatment among the three groups, including TCM symptom score, total efficacy, CD3+, CD4+, CD8+, CD4+/CD8+ levels, and HPV-DNA conversion rate.

Results:
The total efficacies of Group A, Group B, and Group C were 89.58%, 62.50%, and 98.00%, respectively; the conversion rates of HPV-DNA in Group A, Group B, and Group C were 62.50%, 67.31%, and 90.00%, respectively. The TCM symptom score of the three groups was most significantly reduced in Group C, followed by Group B, and there was a statistical difference between the groups (P <0.05). The efficacy of the three groups was highest in Group C, followed by Group A, and Group B, with statistical differences (P <0.05). A pairwise comparison of the HPV conversion rates of the three groups showed that Group C had the highest HPV conversion rate (P <0.05); HPV16 and HPV18 subtypes displayed high conversion rates among the different HPV subtypes (P <0.05), whereas the comparisons between the remaining subtypes showed no statistically significant differences (P >0.05). CD3+, CD4+, and CD4+/CD8+ levels showed an increasing trend in the three groups after treatment, whereas the CD8+ level decreased (P <0.05). Pairwise comparison showed that CD3+, CD4+, and CD4+/CD8+ levels were more elevated in Group C than those in Groups A and B (P <0.05).

Conclusion:
Fuzheng Jiedu formula notably improves the efficacy of HPV persistent infection and HPV conversion rate in patients with infertility, and its efficacy is better than that of TCM and Western medicine alone. The mechanism is mainly related to the fact that TCM improves the symptom score of syndromes of spleen asthenia and dampness encumbrance and increases CD3+, CD4+, CD4+/CD8+ levels. The effect of combined therapy on improving immunity is more advantageous than that of TCM or Western medicine alone.