bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aortic intimal sarcoma with abdominal metastasis: case report and management approach
Authors: Yao Gongji , Xu Jianwei 
Published: February 2025

BackgroundAortic intimal sarcoma is an exceptionally rare malignancy with a poor prognosis. Tumors are predominantly located in the abdominal aorta, thoracic aorta, and thoracoabdominal aorta. Abdominal metastasis of aortic sarcoma is rarely documented, and effective treatment regimens are lacking.Case presentationA 55-year-old female presented with recurrent abdominal pain and a history of hypertension and mesenteric thrombosis. Initial arterial computed tomography angiography (CTA) revealed multiple thrombi with significant luminal narrowing, leading to a diagnosis of aortic thrombosis. She was referred to the First Affiliated Hospital of Zhejiang University for surgical intervention. Pathological analysis confirmed a diagnosis of aortic intimal sarcoma with MDM2 positivity. One month later, the patient developed severe abdominal pain, and positron emission tomography-computed tomography (PET-CT) showed accumulation in the small intestine, jejunum, and back muscles. Palliative tumor removal was performed, and the patient received chemotherapy with platinum drugs and epirubicin. Post-treatment PET-CT indicated no significant tumor staining or progression.DiscussionAortic intimal sarcoma is a rare neoplasm with limited treatment options. MDM2 overexpression is commonly observed, but similar histological features can appear in other conditions, making diagnosis challenging. Imaging modalities, including MRI and PET-CT, are crucial for diagnosis and monitoring. Current treatment strategies are non-standardized, but small-molecule inhibitors targeting MDM2 show promise. This case highlights the potential effectiveness of combined surgical and chemotherapeutic approaches for managing abdominal metastasis of aortic intimal sarcoma and provides a foundation for future clinical trials.
ITGA4 as a potential prognostic and immunotherapeutic biomarker in human cancer and its clinical significance in gastric cancer: an integrated analysis and validation
Authors: Zhang Jiaxing , Wang Gang , Liu Jie , Tang Futian , Wang Song , Li Yumin 
Published: February 2025

BackgroundIntegrin Subunit Alpha 4 (ITGA4), a member of the integrin protein family, is involved in the progression of malignant tumors. However, its role across different cancer types is not well understood.MethodsUtilizing multi-omics data, we comprehensively evaluated ITGA4’s expression, clinical relevance, diagnostic and prognostic value, functions, mutations, and methylation status, along with its impact on immunity, mismatch repair (MMR), heterogeneity, stemness, immunotherapy responsiveness, and drug resistance in pan-cancer, with partial validation in gastric cancer (GC) using transcriptomic analysis, single-cell data, western blot (WB), wound-healing assay, flow cytometry and immunohistochemistry (IHC). We further investigated its correlation with clinicopathology and serological markers on tissues from 80 GC patients.ResultsITGA4 expression was generally low in normal tissues but varied significantly across tumor types, with higher levels in advanced stages and grades. It demonstrated diagnostic value in 20 cancer types and effectively predicted 1-, 3-, and 5-year survival rates as part of a prognostic model. ITGA4 played roles in cell adhesion, migration, immune regulation, and pathways like PI3K-Akt and TSC-mTOR. It showed alterations in 22 cancer types, with methylation at 9 sites inhibiting its expression. ITGA4 positively correlated with immune cell infiltration, immune regulatory genes, chemokines, and might reduce microsatellite instability (MSI) and tumor mutation burden (TMB) by promoting MMR gene expression. It could also predict immunotherapy efficacy and chemotherapy sensitivity. In GC, high ITGA4 expression was related to poor prognosis, promoted tumor proliferation and migration, and enhanced immune cell infiltration. ITGA4 expression was higher in GC cells and tissues than normal ones. Its downregulation inhibited GC cell migration and promoted apoptosis. Moreover, ITGA4 was correlated with N stage, pathological stage, neural and vascular invasion, serum levels of Ki-67, immune cells, CRP and CA125.ConclusionITGA4 is a potential biomarker and therapeutic target to enhance cancer treatment and improve patient outcomes.
Sinensetin attenuates hepatic ischemia-reperfusion injury through suppressing GRP78/CHOP-mediated endoplasmic reticulum (ER) stress in mice
Authors: Yang Yihong , Xiong Guanghua , Shi Huangqi , Peng Yulin , Liu Jinghong , Jiang Yaxuan , Lu Min , Liu Hongbo , Liu Yong 
Published: February 2025

ObjectiveHepatic ischemia-reperfusion injury (HIRI) frequently occurs as a complication in liver surgeries, which significantly impacting patient outcomes. Sinensetin (SEN) is a plant-derived polymethoxylated flavone with anti-inflammatory and anti-oxidative activities. However, the hepatoprotective effect of sinensetin in HIRI pathogenesis have not been fully explored.MethodsWe constructed the HIRI model in mice, with blood and liver samples collected at 6 and 24 h after reperfusion to evaluate liver injury. We also evaluated the protective effect of sinensetin in mice liver I/R injury through histopathological observation, enzyme activity, immunofluorescence, Western blot, molecular docking, and molecular pharmacology experiments.ResultsIn our study, we have successfully established the mouse HIRI injury model, and the liver function indicators such as ALT, AST and LDH were significantly increased in the HIRI model group, while SEN pretreatment could lead to a significant decrease in these enzymatic activities, especially perfusion at 6 h. In addition, hepatocytic necrosis and lipid deposition were significantly improved under SEN pretreatment conditions compared to the HIRI group alone. Meanwhile, HIRI can significantly increase the expression of genes related to liver injury and inflammation, while SEN pretreatment can lead to a concentration-dependent decrease in these genes. Besides, the level of liver apoptosis and apoptosis-related genes such as BAX and Bcl-2 were significantly reduced especially in the high concentration SEN pretreatment group, and antioxidant enzyme activities such as CAT and GSH-Px also showed similar changes. Moreover, the HIRI model and SEN pretreatment could lead to dynamic changes in key genes involved in endoplasmic reticulum (ER) stress signaling, while the expression and distribution of GRP78 and CHOP proteins in liver cells also showed significant decrease in HIRI + L-SEN and HIRI + H-SEN groups. Molecular docking simulation showed theoretical binding between SEN-GRP78 and SEN-IRE1α in three-dimensional structures. Ultimately, the use of 4-PBA to pharmacologically inhibit ER stress may substantially reduce liver damage caused by HIRI in mice.ConclusionTaken together, our results suggested that sinensetin could alleviate HIRI injury through suppressing GRP78/CHOP-mediated ER stress, which may provide a novel therapeutic strategy for treating liver ischemia-reperfusion injury in clinical practice.
Social environment, low-carbon cognition and low-carbon consumption behaviors of youth groups: evidence from Xizang, China
Authors: Ma Huifang , Chen Qin 
Published: February 2025

IntroductionGlobal warming has profoundly transformed the natural environment and significantly impacted people’s production methods, thereby promoting low-carbon consumption behaviors. While numerous scholars have examined the factors influencing low-carbon consumption behavior, their analyses predominantly rely on classical theoretical frameworks such as planned behavior theory, value-belief-norm theory and The ABC attitude theory. However, there is a notable scarcity of studies investigating the relationship between the social environment and low-carbon behaviors among youth groups. To address this gap in the literature, we aim to explore how the social environment influences youth groups’ low-carbon consumption behaviors, as well as identify the mechanisms through which this influence may manifest.MethodsThis study examines the factors influencing low-carbon consumption behavior from three perspectives: the social environment, low-carbon cognition, and conformity consumption. A theoretical model of low-carbon consumption has been developed, and data were collected through a questionnaire survey involving 600 young individuals in the Xizang Autonomous Region. The hypothesized relationships were tested using structural equation modeling techniques.ResultsThe findings indicate that the social environment has a significant positive impact on both low-carbon cognition and behavior. Furthermore, low-carbon cognition is shown to positively influence low-carbon behavior. In terms of the relationship between the social environment and low-carbon behavior, it is found that low-carbon cognition acts as a mediating variable. Additionally, it was observed that lower levels of conformity consumption negatively moderate both the relationship between the social environment and low-carbon behavior as well as that between low-carbon cognition and behavior.DiscussionThese findings suggest that engaging young individuals not only fosters environmental awareness but also promotes sustainable consumption, thereby establishing a solid foundation for the protection and enhancement ofour ecological environment. Furthermore, it is essential to disseminate the concept of low-carbon consumerism through various media channels and methodologies. This approach aims to enhance young individuals’ understanding of low-carbon principles, guiding them toward more scientifically informed consumption habits while reducing tendencies for blind conformity.
Moderating effect of social participation on the relationship between health status and depressive symptoms in older adults
Authors: Ow Yvonne Su Yong , Wei Chia-Shine , Li Yang-Tzu 
Published: February 2025

IntroductionDepression is a common mental health problem among older adults and a leading cause of disability worldwide. Health status and social participation has been found significantly associated with depression in older adults. However, the role of social participation in the relationship between health status and depression remains unclear. This study aims to investigate the relationship between health status and depressive symptoms in older adults and the moderating effect of social participation in the relationship.Materials and methodsA cross-sectional study with data from the National Health Interview Survey (NHIS) in 2013. Older adults aged 65 years or older were included in the study. Multiple regression analysis was performed to examine the relationship between health status and depressive symptoms and assess the moderating effect of social participation.ResultsOf the 2,731 participants, higher depressive symptoms were observed among older women, older adults who were single, living alone and having lower satisfaction on financial status. Regression analyses showed that activities of daily living (ADL) and instrumental activities of daily living (IADL) disability were positively associated with higher depressive symptoms. Perceived health status, cognitive functions and social participation were found negatively associated with depressive symptoms. A significant moderating effect of social participation between perceived health status and depressive symptoms was observed in this study.DiscussionThe findings highlight the role of social participation in moderating the effect of perceived health status on depressive symptoms and suggest that promoting social participation among older adults may be helpful for reducing depressive symptoms.
Telehealth and people with disabilities in the United Kingdom: a scoping review
Authors: Ko Mezhen , Azzopardi Matthew , Loizou Constantinos , Logeswaran Abison , Ng Benjamin , Pacho Agata , Chong Yu Jeat 
Published: February 2025

IntroductionTelehealth, also sometimes known as telemedicine, is the use of communication technologies to deliver healthcare remotely, has become increasingly vital, particularly since the COVID-19 pandemic. While telehealth can improve healthcare access, it may exacerbate inequities for people with disabilities. This scoping review explores the needs, experiences, and difficulties people with disabilities face when accessing telehealth services in the United Kingdom’s (UK) National Health Service (NHS).MethodsA systematic search was conducted using the PRISMA for Scoping Reviews (PRISMA-ScR) guidelines. The search terms included variations of “telehealth,” “disability,” “impairment,” “United Kingdom,” and “NHS.” Studies published after January 2010 were included if they addressed the experiences of people with disabilities when using telehealth. Ten studies met the inclusion criteria, and findings were synthesized into five key themes: patient and carer satisfaction, benefits of telehealth, healthcare provider perspectives, disability-specific barriers, and technological barriers.ResultsThe studies highlighted varied experiences across different disabilities, telehealth technologies, and medical specialties. While patients and carers generally expressed satisfaction with telehealth’s convenience and accessibility, a preference for face-to-face consultations remained. Key barriers included technological challenges such as poor internet connectivity, unfamiliarity with digital tools, and device access, as well as disability-specific challenges, particularly for sensory impairments. Reported benefits of telehealth included improved access to care and flexibility for patients with disabilities. However, healthcare provider perspectives highlighted concerns about the ability to build a rapport and perform thorough assessments remotely.ConclusionTelehealth should complement traditional care through a hybrid approach. Future efforts must focus on improving technological accessibility, training healthcare providers, and co-designing solutions with patients to promote equitable healthcare access for people with disabilities.
Association between Chinese visceral adiposity index and risk of new-onset hypertension in middle-aged and older adults with prediabetes: evidence from a large national cohort study
Authors: Li Lanlan , Xi Linqiang , Wang Qianhui 
Published: February 2025

PurposeChinese Visceral Adiposity Index (CVAI) has been found significantly associated with hypertension in general and type-2 diabetes adults. However, the predictive value of CVAI for the incidence of hypertension in adults with prediabetes is unclear. This study aimed to assess the predictive utility of the CVAI for the new onset of hypertension in middle-aged and older adult Chinese individuals with prediabetes.MethodsA prospective cohort study was conducted involving participants aged 45 years and above with prediabetes from the 2011–2012 cohort of the China Health and Retirement Longitudinal Study (CHARLS). Logistic regression models were utilized to investigate the association between CVAI levels and the risk of new-onset hypertension.ResultsThe study included 2,186 participants, among whom 444 (20.31%) developed hypertension. Significantly higher incidence rates of hypertension were observed in individuals belonging to the highest quartile group (Q4) compared to those in the lowest quartile group (Q1) of CVAI (29.41% vs. 14.69%, p &lt; 0.001). Multivariate logistic regression analysis indicated that participants in Q4 had a 1.91-fold greater risk of hypertension development compared to those in Q1 (odds ratio (OR): 1.91, 95% confidence interval (CI): 1.49–2.45, p &lt; 0.001). The area under the receiver operating characteristic (ROC) curve (AUC) demonstrated that CVAI exhibited superior performance in discriminating individuals at heightened risk of hypertension compared to other obesity-related indices (p &lt; 0.001). A subgroup analysis revealed that age may modulate the relationship between CVAI and new-onset hypertension, with a more pronounced interaction observed among participants below 60 years of age (P for interaction: 0.026).ConclusionElevated CVAI levels were significantly associated with an increased risk of developing hypertension. CVAI proves to be a reliable and effective tool for risk stratification in middle-aged and older adult Chinese individuals with prediabetes, underscoring its substantial implications for primary prevention of hypertension and public health strategies.
Conflicting health information increases fear of disease progression in HPV-infected individuals: disease uncertainty as mediator and tolerance of uncertainty as buffer
Authors: Huai Li , Liao Sihua , Lyu Xiaokang , Yang Tingting , Fu Chunye 
Published: February 2025

BackgroundHuman papillomavirus (HPV) infection is highly prevalent, and infected individuals frequently encounter HPV-specific conflicting health information about their condition. Although this phenomenon is well documented, the mechanisms by which such information influences fear of progression (FoP) and potential interventions remain unexplored.MethodsThis research was conducted in two phases. Phase 1 (n = 218) developed and validated the HPV-Specific Conflicting Health Information Scale. Phase 2 (n = 501) examined disease uncertainty as a mediator and tolerance of uncertainty as a moderator among HPV-positive female patients.ResultsThe HPV-Specific Conflicting Health Information Scale demonstrated a two-dimensional structure representing objective experiences and subjective perceptions of HPV-specific conflicting health information. Phase 2 revealed that HPV-specific conflicting health information indirectly influenced Fear of Progression via disease uncertainty, with this relationship moderated by individuals’ tolerance of uncertainty.ConclusionThis study established the first validated measure of HPV-specific conflicting health information. The findings indicate that enhancing tolerance of uncertainty may serve as an effective complement to reducing conflicting information exposure in addressing HPV-related psychological distress.
Weaving oral health provider perspectives to guide future dental therapy advocacy and implementation efforts
Authors: Llaneza Amanda J. , Stone Kara A. , Seward Julie 
Published: February 2025

IntroductionAmerican Indian and Alaska Native (AI/AN) communities in the United States (U.S.) face greater oral healthcare inequities than other groups in the country. A solution to improving oral healthcare access for American Indian and Alaska Native communities in the United States is the integration of dental therapists (DT). However, it has been met with opposition. The goal of this study was to explore oral health provider engagement and perspectives of DT implementation in local communities.MethodsEngagement related to DT from the dental provider perspective from the ADTA conference's attendees were analyzed via optional, electronic post-conference surveys. Descriptive statistics were utilized to report the position type of attendees, years of experience in the role, incorporation of clinical courses for DT scope of practice, and clinic management and administration for their patients. Surveys included two open-ended questions inquiring about personal objectives and comments and suggestions regarding the conference overall. From attendee's open-ended statements on objectives for attending this conference, key patterns were described.ResultsOne hundred people nationwide attended the conference. Of these attendees, 56% completed the post-conference survey evaluation. Among the respondents, 25% identified as dentists, 23% identified as dental hygienists, 46% identified as dental therapists, 6% identified as other oral health workforce members (i.e., dental assistant and/or Tribal oral health coordinator). The majority felt the strategies covered related to DT could be incorporated regardless of the type of workforce position. Fifty-seven percent of dentists felt it would be easy or very easy to implement strategies from the conference, and 75% of dental hygienists and other oral health workforce members felt it was easy or very easy to implement strategies from the conference. Education, advocacy, and networking were identified as the main objectives for attending the conference.DiscussionThe conference platform encouraged dissenting viewpoints to contribute to academic and policy debates to ultimately provide broader access to oral healthcare through a comprehensive team approach. There was strong support across positions to advocate for and expand DT to the lower 48 states of the U.S., particularly in areas with underserved communities. Additionally, most providers felt this could be done with ease and no providers indicated opposition in open-ended remarks. Collaborative efforts among policymakers, dental associations, educational institutions, and community advocates can create a pathway for the successful integration of dental therapists into the healthcare system.
Apriori algorithm based prediction of students’ mental health risks in the context of artificial intelligence
Authors: Fu You , Ren Fang , Lin Jiantao 
Published: February 2025

IntroductionThe increasing prevalence of mental health challenges among college students necessitates innovative approaches to early identification and intervention. This study investigates the application of artificial intelligence (AI) techniques for predicting student mental health risks.MethodsA hybrid predictive model, Prophet-LSTM, was developed. This model combines the Prophet time series model with Long Short-Term Memory (LSTM) networks to leverage their strengths in forecasting. Prior to model development, association rules between potential mental health risk factors were identified using the Apriori algorithm. These highly associated factors served as inputs for the Prophet-LSTM model. The model’s weight coefficients were optimized using the Quantum Particle Swarm Optimization (QPSO) algorithm. The model’s performance was evaluated using data from a mental health survey conducted among college students at a Chinese university.ResultsThe proposed Prophet-LSTM model demonstrated superior performance in predicting student mental health risks compared to other machine learning algorithms. Evaluation metrics, including the detection rate of psychological issues and the detection rate of no psychological issues, confirmed the model’s high accuracy.DiscussionThis study demonstrates the potential of AI-powered predictive models for early identification of students at risk of mental health challenges. The findings have significant implications for improving mental health services within higher education institutions. Future research should focus on further refining the model, incorporating real-time data streams, and developing personalized intervention strategies based on the model’s predictions.