bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of 18F-FDG PET/CT in Treatment Strategies for Patients With Cancer of Unknown Primary: A Single-Center, Retrospective Change-in-Management Study
Authors: Huang Rong , Hu Yuxiao , Zhang Yun 
Published: April 2024

Background: Cancer of unknown primary (CUP) is difficult to diagnose and classify clinically, and the disease develops rapidly. Therefore, the primary tumor detected in patients with CUP plays a profound role in the diagnosis and treatment of patients. The search for the primary tumor of CUP is also one of the indications for 18F-fluoro-2-deoxyglucose-positron emission tomography and computed tomography (FDG-PET/CT). Our objective was to evaluate the role of 18F-FDG PET/CT imaging in primary tumor detection and treatment formulation in patients with CUP. Methods: Sixty-two patients with CUP were selected from a database consisting of 18 802 cases in the Jiangsu Cancer Hospital PET/CT center from May 18, 2016 to November 18, 2022. Clinical data and changes in treatment strategies before and after PET/CT were collected. Results: A total of 42 primary tumors (42/62, 67.7%) were identified by PET/CT examination. The tumor staging of patients before conventional PET/CT imaging (such as CT/magnetic resonance imaging [MRI]/US) and after PET/CT did not change in 28 patients (28/62, 45.2%), whereas for 34 patients (34/62, 54.8%), tumor staging changed. Forty-five patients (45/62, 72.6%) had not developed treatment plans before PET/CT examination, but treatment plans were clarified after PET/CT examination. Thirteen patients (13/62, 21.0%) underwent changes in treatments before and after PET/CT examination. Among the 20 patients (20/62, 32.3%) whose primary tumors were not detected, 16 patients (16/20, 80.0%) had no treatment plans before PET/CT and the treatment plans were defined after PET/CT, 3 patients (3/20, 15.0%) changed the treatment plans before and after PET/CT, and 1 patient (1/20, 5.0%) did not change the treatment plan. Conclusions: The 18F-FDG PET/CT plays an important role in the detection and staging of primary tumors in patients with CUP. The PET/CT findings can not only help clinicians develop appropriate treatment plans for patients with CUP but also serve as an effective approach to improve real-life treatment strategies for these patients.
Anthocyanins from Lycium ruthenicum Murray Prevent High-Fat Diet-Induced Obesity in Female Mice via Gut Microbiota-Related Bile Acids Metabolism
Authors: Li Hui , Zhang Meng , Tan Tingting , Li Shiying , Mi Jia , Lu Lu , Yan Yamei , Ran Linwu 
Published: April 2024

Objectives Female obesity may be improved by the consumption of a high-polyphenolic-rich diet. Lycium ruthenicum Murray is a renowned edible plant, the fruit of which is abundant in anthocyanins and exhibits many biological activities. This study aimed to investigate the potential impact of anthocyanins derived from Lycium ruthenicum Murray (ACN) intervention on improving obesity by regulating the gut microbiota and bile acids (BAs) metabolism in high-fat diet (HFD)-induced female mice. Methods A total of 32 C57BL/6J female mice were divided into four distinct groups: the Ctrl group (fed a normal diet), Ctrl + ACN group (fed a normal diet plus 8 mg/mL extract of ACN), HFD group (fed a high-fat diet), and HFD + ACN group (fed a HFD plus 8 mg/mL extract of ACN). Results The findings showed that ACN significantly reduced the body weight, periovarian adipose mass, and adipocyte diameter, ameliorated lipid accumulation in the liver, and lowered the serum total cholesterol and low-density lipoprotein (LDL-C) levels in HFD-induced female mice. In addition, ACN exhibited a reversal of gut microbial dysbiosis in HFD-fed female mice, such as by enhancing the quantity of Lactobacillus and Allobaculum and reducing the abundance of Blautia and Faecalibaculum. Moreover, the results of fecal BAs showed that ACN led to a decrease in the ratio of primary to secondary BAs, mainly attributed to decreased levels of primary BAs, including CA, CDCA, αMCA, and HCA in HFD-induced female mice. Further analysis revealed that ACN may exert its anti-obesity effect by increasing the relative abundance of Lactobacillus_ jonsonii and Lactobacillus_reuteri within the gut and subsequently affecting the metabolism of fecal HDCA and GUDCA. Conclusion These results indicated that ACN effectively inhibits HFD-induced obesity in female mice by regulating gut microbiota-related BA metabolism.
How Overconfident Financial Knowledge Hinders Retirement Planning? Mediating Analysis and Heterogeneity of Retirement Funding Sources
Authors: Chen Fuzhong , Fan Yingchao , Jiang Guohai , Chen Jinwei 
Published: April 2024

Under the background of general financial knowledge confidence and insufficient retirement planning, this study investigates the relationship between overconfident financial knowledge and consumer retirement planning. Using data from the National Financial Capability Study, this study employs probit regressions and finds that consumers with overconfident financial knowledge are less likely to have retirement planning, that is, contribute to retirement accounts regularly. This study further explores the mediators in this relationship and concludes that consumers who are overconfident in their financial knowledge tend to be more preference to risk, fail to make ends meet, and do not care about their financial situation, therefore are less likely to plan for retirement. Furthermore, compared to retirement accounts such as 401(k) that are through an employer, consumers with overconfident financial knowledge are more willing to engage in those such as IRA that are not through an employer. This study also finds that underconfident financial knowledge, another type of incorrect subjective evaluation of financial knowledge, is positively associated with retirement planning. Based on these findings, this study recommends policymakers reduce financial knowledge overconfidence, guide individuals to regularly pay attention to their financial situation, and encourage employers to actively participate in retirement plans. JEL Classification: D12, N30, D80, D91.
Testing for t(3;8) in MYC/BCL6-rearranged large B-cell lymphoma identifies a high-risk subgroup with inferior survival
Authors: Maybury Bernard D. , James Lisa , Phillips Neil , Venkatadasari Indrani , Qureshi Iman , Riley James , Talbot Georgina , Moosai Shivir , Giles Hannah , Chadderton Nicola , Dowds James , Rakesh Pallav , Crosland Henry , Haslam Aidan , Lane Sarah , Vega Gonzalez Monica , Davies David , Cherian George , Shenouda Amir , Kaudlay Praveen , Starczynski Jane , Rudzki Zbigniew , Chaganti Sridhar 
Published: April 2024

Abstract
A reciprocal t(3;8) BCL6::MYC fusion is common in large B-cell lymphoma (LBCL) with MYC and BCL6 disruption. These pseudo–double-hit cases are not adverse, whereas t(3;8)−MYC/BCL6 lymphoma has an inferior prognosis relative to other MYC-rearranged LBCL.
Development of a performance-based toolkit of the treatable traits of functioning in hospitalised patients with exacerbation of COPD: a survey-based study protocol
Authors: Leonardi Naiara Tais , Kawakami Débora Mayumi Oliveira , Cruz Joana , Burtin Chris , Borghi-Silva Audrey , Mendes Renata Gonçalves 
Published: April 2024

BackgroundThe management of COPD has been based on the premise of identifying problems that guide personalised treatment based on a multidimensional assessment, known as treatable traits. Exacerbation of COPD (ECOPD) results in physical and functional impairments, limitation of daily activities and negative impact on patients’ quality of life and prognosis. In this context, identifying treatable traits in patients with ECOPD is essential to properly guide individualised patient care. There is a need to develop a performance-based toolkit to identify the main treatable traits of functioning in hospitalised patients with ECOPD.Methods and analysisThis is a study protocol of a survey method observational study to develop a performance-based toolkit. The study will include the following steps: 1) definition of treatable traits by both physiotherapists who provide or have provided care to hospitalised patients with ECOPD on a regular basis, and patients who have experienced at least one ECOPD which required hospitalisation; 2) selection of the most appropriate measures (markers) for each treatable trait based on established criteria and a previous systematic review; and 3) implementation of the toolkit in a pilot/feasibility study with hospitalised patients with ECOPD.ConclusionThe development of a feasible performance-based toolkit with the best markers for each key treatable trait of functioning in hospitalised patients with ECOPD will make it possible to create individualised patient care for the specific demands of these patients.
Diagnostic utility of capnography in emergency department triage for screening acidemia: a pilot study
Authors: Peng Paul , Manini Alex F. 
Published: April 2024

Abstract
Background
Capnography is a quantitative and reliable method of determining the ventilatory status of patients. We describe the test characteristics of capnography obtained during Emergency Department triage for screening acidemia.

Results
We performed an observational, pilot study of adult patients presenting to Emergency Department (ED) triage. The primary outcome was acidemia, as determined by the basic metabolic panel and/or blood gas during the ED visit. Secondary outcomes include comparison of estimated and measured respiratory rates (RR), relationships between end-tidal CO2 (EtCO2) and venous partial pressure of CO2, admission disposition, in-hospital mortality during admission, and capnogram waveform analysis. A total of 100 adult ED encounters were included in the study and acidemia ($$ \left[HC{O}_{3}^{-}\right]\le 22 \text{mEq/L}$$ or $$ pH< 7.35$$) was identified in 28 patients. The measured respiratory rate (20.3 ± 6.4 breaths/min) was significantly different from the estimated rate (18.4 ± 1.6 breaths/min), and its area under the receiver operating curve (c-statistic) to predict acidemia was only 0.60 (95% CI 0.51–0.75, p = 0.03). A low end-tidal CO2 (EtCO2 < 32 mmHg) had positive (LR+) and negative (LR−) likelihood ratios of 4.68 (95% CI 2.59–8.45) and 0.34 (95% CI 0.19–0.61) for acidemia, respectively—corresponding to sensitivity 71.4% (95% CI 51.3–86.8) and specificity 84.7% (95% CI 74.3–92.1). The c-statistic for EtCO2 was 0.849 (95% CI 0.76–0.94, p = 0.00). Waveform analysis further revealed characteristically abnormal capnograms that were associated with underlying pathophysiology.

Conclusions
Capnography is a quantitative method of screening acidemia in patients and can be implemented feasibly in Emergency Department triage as an adjunct to vital signs. While it was shown to have only modest ability to predict acidemia, triage capnography has wide generalizability to screen other life-threatening disease processes such as sepsis or can serve as an early indicator of clinical deterioration.
SynGenes: a Python class for standardizing nomenclatures of mitochondrial and chloroplast genes and a web form for enhancing searches for evolutionary analyses
Authors: Rabelo Luan Pinto , Sodré Davidson , de Sousa Rodrigo Petry Corrêa , Watanabe Luciana , Gomes Grazielle , Sampaio Iracilda , Vallinoto Marcelo 
Published: April 2024

Abstract
Background
The reconstruction of the evolutionary history of organisms has been greatly influenced by the advent of molecular techniques, leading to a significant increase in studies utilizing genomic data from different species. However, the lack of standardization in gene nomenclature poses a challenge in database searches and evolutionary analyses, impacting the accuracy of results obtained.

Results
To address this issue, a Python class for standardizing gene nomenclatures, SynGenes, has been developed. It automatically recognizes and converts different nomenclature variations into a standardized form, facilitating comprehensive and accurate searches. Additionally, SynGenes offers a web form for individual searches using different names associated with the same gene. The SynGenes database contains a total of 545 gene name variations for mitochondrial and 2485 for chloroplasts genes, providing a valuable resource for researchers.

Conclusions
The SynGenes platform offers a solution for standardizing gene nomenclatures of mitochondrial and chloroplast genes and providing a standardized search solution for specific markers in GenBank. Evaluation of SynGenes effectiveness through research conducted on GenBank and PubMedCentral demonstrated its ability to yield a greater number of outcomes compared to conventional searches, ensuring more comprehensive and accurate results. This tool is crucial for accurate database searches, and consequently, evolutionary analyses, addressing the challenges posed by non-standardized gene nomenclature.

Graphical abstract
Metabolomics and proteomics insights into subacute ruminal acidosis etiology and inhibition of proliferation of yak rumen epithelial cells in vitro
Authors: Wang JunMei , Shi Liyuan , Zhang Xiaohong , Hu Rui , Yue Ziqi , Zou Huawei , Peng Quanhui , Jiang Yahui , Wang Zhisheng 
Published: April 2024

AbstractBackgroundUntargeted metabolomics and proteomics were employed to investigate the intracellular response of yak rumen epithelial cells (YRECs) to conditions mimicking subacute rumen acidosis (SARA) etiology, including exposure to short-chain fatty acids (SCFA), low pH5.5 (Acid), and lipopolysaccharide (LPS) exposure for 24 h.ResultsThese treatments significantly altered the cellular morphology of YRECs. Metabolomic analysis identified significant perturbations with SCFA, Acid and LPS treatment affecting 259, 245 and 196 metabolites (VIP > 1,P < 0.05, and fold change (FC) ≥ 1.5 or FC ≤ 0.667). Proteomic analysis revealed that treatment with SCFA, Acid, and LPS resulted in differential expression of 1251, 1396, and 242 proteins, respectively (FC ≥ 1.2 or ≤ 0.83,P < 0.05, FDR < 1%). Treatment with SCFA induced elevated levels of metabolites involved in purine metabolism, glutathione metabolism, and arginine biosynthesis, and dysregulated proteins associated with actin cytoskeleton organization and ribosome pathways. Furthermore, SCFA reduced the number, morphology, and functionality of mitochondria, leading to oxidative damage and inhibition of cell survival. Gene expression analysis revealed a decrease the genes expression of the cytoskeleton and cell cycle, while the genes expression associated with inflammation and autophagy increased (P < 0.05). Acid exposure altered metabolites related to purine metabolism, and affected proteins associated with complement and coagulation cascades and RNA degradation. Acid also leads to mitochondrial dysfunction, alterations in mitochondrial integrity, and reduced ATP generation. It also causes actin filaments to change from filamentous to punctate, affecting cellular cytoskeletal function, and increases inflammation-related molecules, indicating the promotion of inflammatory responses and cellular damage (P < 0.05). LPS treatment induced differential expression of proteins involved in the TNF signaling pathway and cytokine-cytokine receptor interaction, accompanied by alterations in metabolites associated with arachidonic acid metabolism and MAPK signaling (P < 0.05). The inflammatory response and activation of signaling pathways induced by LPS treatment were also confirmed through protein interaction network analysis. The integrated analysis reveals co-enrichment of proteins and metabolites in cellular signaling and metabolic pathways.ConclusionsIn summary, this study contributes to a comprehensive understanding of the detrimental effects of SARA-associated factors on YRECs, elucidating their molecular mechanisms and providing potential therapeutic targets for mitigating SARA.
Genetic and phenotypic analysis of 225 Chinese children with developmental delay and/or intellectual disability using whole-exome sequencing
Authors: Ma Heqian , Zhu Lina , Yang Xiao , Ao Meng , Zhang Shunxiang , Guo Meizhen , Dai Xuelin , Ma Xiuwei , Zhang Xiaoying 
Published: April 2024

AbstractDevelopmental delay (DD), or intellectual disability (ID) is a very large group of early onset disorders that affects 1–2% of children worldwide, which have diverse genetic causes that should be identified. Genetic studies can elucidate the pathogenesis underlying DD/ID. In this study, whole-exome sequencing (WES) was performed on 225 Chinese DD/ID children (208 cases were sequenced as proband-parent trio) who were classified into seven phenotype subgroups. The phenotype and genomic data of patients with DD/ID were further retrospectively analyzed. There were 96/225 (42.67%; 95% confidence interval [CI] 36.15–49.18%) patients were found to have causative single nucleotide variants (SNVs) and small insertions/deletions (Indels) associated with DD/ID based on WES data. The diagnostic yields among the seven subgroups ranged from 31.25 to 71.43%. Three specific clinical features, hearing loss, visual loss, and facial dysmorphism, can significantly increase the diagnostic yield of WES in patients with DD/ID (P = 0.005, P = 0.005, and P = 0.039, respectively). Of note, hearing loss (odds ratio [OR] = 1.86%; 95% CI = 1.00-3.46, P = 0.046) or abnormal brainstem auditory evoked potential (BAEP) (OR = 1.91, 95% CI = 1.02–3.50, P = 0.042) was independently associated with causative genetic variants in DD/ID children. Our findings enrich the variation spectrums of SNVs/Indels associated with DD/ID, highlight the value genetic testing for DD/ID children, stress the importance of BAEP screen in DD/ID children, and help to facilitate early diagnose, clinical management and reproductive decisions, improve therapeutic response to medical treatment.
Effect of converting from propofol to remimazolam with flumazenil reversal on recovery from anesthesia in outpatients with mental disabilities: a randomized controlled trial
Authors: Jeon Sooyoung , Kim Jieun , Karm Myong-Hwan , Kim Jin-Tae 
Published: April 2024

Abstract
Background
General anesthesia is often necessary for dental treatment of outpatients with mental disabilities. Rapid recovery and effective management of postoperative nausea and vomiting (PONV) are critical for outpatients. This study aimed to investigate the effect of transitioning from propofol to remimazolam with flumazenil reversal administered toward the end of surgery during propofol-based total intravenous anesthesia (TIVA) on recovery.

Methods
Adults with mental disabilities scheduled to undergo dental treatment were randomly assigned to receive either propofol-based TIVA (Group P) or propofol-remimazolam-based TIVA with flumazenil reversal (Group PR). Propofol was replaced with remimazolam 1 h before the end of surgery in Group PR; moreover, 0.5 mg of flumazenil was administered after the neuromuscular blockade reversal agent. The primary outcome was the duration of stay in the post-anesthesia care unit (PACU). The secondary outcomes included time to eye-opening, time to extubation, occurrence of PONV, and quality of recovery.

Results
Fifty-four patients were included in this study. The duration of stay in the PACU in Group PR was significantly shorter than that in Group P (mean difference, 8.7 min; confidence interval [95% CI], 3.3–14.2; P = 0.002). Group PR exhibited a shorter time to eye opening (mean difference, 5.4 min; 95% CI, 3.3–8.1; P < 0.001) and time to extubation (mean difference, 5.5 min; 95% CI, 3.6–7.9; P < 0.001) than Group P. Neither group required the administration of rescue analgesics, and the incidence of PONV was not reported.

Conclusions
Transitioning from propofol to remimazolam 1 h before the end of surgery followed by flumazenil reversal reduced the duration of stay in the PACU and the time to eye opening and extubation without affecting the incidence of PONV and quality of recovery.

Trial registration number
Clinical Research Information Service (KCT0007794), Clinical trial first registration date: 12/10/2022.
Regional analgesia using ultrasound-guided intermediate cervical plexus block versus cervical erector spinae block for anterior cervical spine surgery: a randomized trial
Authors: Kamel Alshaimaa Abdel Fattah , Fahmy Ahmed M. , Fathi Heba M. , Elmesallamy Wael Abd Elrahman Ali , Khalifa Osama Yehia A. 
Published: April 2024

Abstract
Background
Regional analgesia techniques are crucial for pain management after cervical spine surgeries. Anesthesiologists strive to select the most effective and least hazardous regional analgesia technique for the cervical region. Our hypothesis is that an intermediate cervical plexus (IC) block can provide adequate postoperative analgesia compared to a cervical erector spinae (ES) block in patients undergoing anterior cervical spine surgery.

Methods
In this double-blind prospective trial, 58 patients were randomly assigned into two equal groups prior to the administration of general anesthesia. Patients in the IC group (n = 29) underwent ultrasound-guided bilateral intermediate cervical plexus block with 15 ml of bupivacaine 0.25% administered to each side. The ES group (n = 29) underwent ultrasound-guided bilateral cervical erector spinae plane blocks with 15 ml of 0.25% bupivacaine administered to each side at the C6 level. The primary outcome was to record the time to the first call for rescue analgesia (nalbuphine), and the secondary outcomes were to measure the performance time, the onset of the sensory block, the intraoperative fentanyl consumption, postoperative pain intensity using VAS, the postoperative total nalbuphine consumption, and postoperative complications such as nausea, vomiting, hypotension, and bradycardia.

Results
The performance and onset of sensory block times were significantly shorter in the IC group compared to the ES group. The time to first call for nalbuphine was significantly shorter in the IC group (7.31 ± 1.34 h) compared to the ES group (11.10 ± 1.82 h). The mean postoperative VAS scores were comparable between the two groups at the measured time points, except at 8 h, where it was significantly higher in the IC group, and at 12 h, where it was significantly higher in the ES group. The total nalbuphine consumption was significantly higher in the IC group (33.1 ± 10.13 mg) compared to the ES group (22.76 ± 8.62 mg).

Conclusions
For patients undergoing anterior cervical spine surgery, the intermediate cervical plexus block does not provide better postoperative regional analgesia compared to the cervical erector spinae block. Performance time and onset time were shorter in the IC group, whereas nalbuphine consumption was lower in the ES group.

Trial registration
The trial was registered at clinicaltrials.gov. (NCT05577559, and the date of registration: 13–10-2022).