bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Efficacy and Gut Microbiota Regulating-Related Effect of Si-Jun-Zi Decoction in Postoperative Non-Small Cell Lung Cancer Patients: A Prospective Observational Study
Authors: He Yiyun , Qi Ao , Gu Yifeng , Zhang Congmeng , Wang Yichao , Yang Wenxiao , Bi Ling , Gong Yabin , Jiao Lijing , Xu Ling 
Published: March 2024

Background: Postoperative non-small cell lung cancer (NSCLC) patients frequently encounter a deteriorated quality of life (QOL), disturbed immune response, and disordered homeostasis. Si-Jun-Zi Decoction (SJZD), a well-known traditional Chinese herbal formula, is frequently employed in clinical application for many years. Exploration is underway to investigate the potential therapeutic effect of SJZD for treating postoperative NSCLC. Objective: To assess the efficacy of SJZD on QOLs, hematological parameters, and regulations of gut microbiota in postoperative NSCLC patients. Methods: A prospective observational cohort study was conducted, enrolling 65 postoperative NSCLC patients between May 10, 2020 and March 15, 2021 in Yueyang Hospital, with 33 patients in SJZD group and 32 patients in control (CON) group. The SJZD group comprised of patients who received standard treatments and the SJZD decoction, while the CON group consisted of those only underwent standard treatments. The treatment period was 4 weeks. The primary outcome was QOL. The secondary outcomes involved serum immune cell and inflammation factor levels, safety, and alterations in gut microbiota. Results: SJZD group showed significant enhancements in cognitive functioning ( P = .048) at week 1 and physical functioning ( P = .019) at week 4. Lung cancer-specific symptoms included dyspnea ( P = .001), coughing ( P = .008), hemoptysis ( P = .034), peripheral neuropathy ( P = .019), and pain (arm or shoulder, P = .020, other parts, P = .019) eased significantly in the fourth week. Anemia indicators such as red blood cell count ( P = .003 at week 1, P = .029 at week 4) and hemoglobin ( P = .016 at week 1, P = .048 at week 4) were significantly elevated by SJZD. SJZD upregulated blood cell cluster differentiation (CD)3+ ( P = .001 at week 1, P < .001 at week 4), CD3+CD4+ ( P = .012 at week 1), CD3+CD8+ ( P = .027 at week 1), CD19+ ( P = .003 at week 4), increased anti-inflammatory interleukin (IL)-10 ( P = .004 at week 1, P = .003 at week 4), and decreased pro-inflammatory IL-8 ( P = .004 at week 1, p = .005 at week 4). Analysis of gut microbiota indicated that SJZD had a significant impact on increasing microbial abundance and diversity, enriching probiotic microbes, and regulating microbial biological functions. Conclusions: SJZD appears to be an effective and safe treatment for postoperative NSCLC patients. As a preliminary observational study, this study provides a foundation for further research.
Prefrontal Cortex Activity During Gait in People With Persistent Symptoms After Concussion
Authors: Martini Douglas N. , Mancini Martina , Antonellis Prokopios , McDonnell Paul , Vitorio Rodrigo , Stuart Samuel , King Laurie A. 
Published: March 2024

Background Concussions result in transient symptoms stemming from a cortical metabolic energy crisis. Though this metabolic energy crisis typically resolves in a month, symptoms can persist for years. The symptomatic period is associated with gait dysfunction, the cortical underpinnings of which are poorly understood. Quantifying prefrontal cortex (PFC) activity during gait may provide insight into post-concussion gait dysfunction. The purpose of this study was to explore the effects of persisting concussion symptoms on PFC activity during gait. We hypothesized that adults with persisting concussion symptoms would have greater PFC activity during gait than controls. Within the concussed group, we hypothesized that worse symptoms would relate to increased PFC activity during gait, and that increased PFC activity would relate to worse gait characteristics. Methods The Neurobehavior Symptom Inventory (NSI) characterized concussion symptoms. Functional near-infrared spectroscopy quantified PFC activity (relative concentration changes of oxygenated hemoglobin [HbO2]) in 14 people with a concussion and 25 controls. Gait was assessed using six inertial sensors in the concussion group. Results Average NSI total score was 26.4 (13.2). HbO2 was significantly higher ( P = .007) for the concussed group (0.058 [0.108]) compared to the control group (−0.016 [0.057]). Within the concussion group, HbO2 correlated with NSI total symptom score (ρ = .62; P = .02), sagittal range of motion ( r = .79; P = .001), and stride time variability ( r = −.54; P = .046). Conclusion These data suggest PFC activity relates to symptom severity and some gait characteristics in people with persistent concussion symptoms. Identifying the neurophysiological underpinnings to gait deficits post-concussion expands our knowledge of motor behavior deficits in people with persistent concussion symptoms.
Atrial natriuretic peptide protects against gut barrier injury through PLC-γ1/ROS feedback loop in rats following traumatic hemorrhagic shock
Authors: Jiang Shou-Yin , Rao Tai-Wen , Shen Ye-Hua , Zhao Xiao-Gang 
Published: March 2024

Introduction The mechanisms underlying the protective effects of atrial natriuretic peptide (ANP) on the gut barrier during traumatic hemorrhagic shock (THS) remain elusive. This study aimed to explore the potential role of ANP in safeguarding against gut barrier dysfunction after THS, focusing on the PLC-γ1/ROS feedback loop. Methods In our THS rat model, we randomly allocated male Sprague-Dawley rats to receive intravenous ANP with or without a concurrent NADPH oxidase/p38 MAPK inhibitor during the shock phase. After 24 h, we assessed circulatory and jejunal ANP, ROS, intestinal tight junction proteins, and apoptosis to evaluate the effects of ANP on the gut barrier and its interplay with intestinal ANP and ROS. Rat small intestinal epithelial cells (IECs) were also treated with ANP and subjected to hypoxia/re-oxygenation injury, with or without PI3K/PLC inhibition, to elucidate the relationship between ANP/ROS signaling and PLC-γ1. Furthermore, we modulated PLC-γ1 expression in these IECs to examine its impact on ROS and ANP production. Results Intravenous ANP administration at 0.025 μg/kg/min during THS significantly increased intestinal ANP and ROS levels at 24 h. ANP treatment enhanced the expression of intestinal tight junction proteins and reduced IEC apoptosis. Inhibition of circulatory ROS diminished intestinal ANP levels, while suppression of circulatory ANP led to a reduction in intestinal ROS. Decreasing PLC-γ1 expression in hypoxia/re-oxygenation-treated IECs resulted in lower ROS and ANP levels, whereas augmenting PLC-γ1 expression did not alter these levels. Additionally, PI3K inhibition markedly decreased PLC-γ1 expression in these cells. Conclusion ANP-induced protection of the intestinal barrier in THS is mediated by an intrinsic PLC-γ1/ROS positive feedback loop. ANP preserves gut barrier integrity and reduces IEC apoptosis through this mechanism. Further studies are warranted to investigate the interaction between IECs and other cellular components within the PLC-γ1/ROS loop.
Pharmacological Mechanisms of Periplocae Cortex Against Congestive Heart Failure Based on Network Pharmacology and Experimental Evaluation
Authors: Zhang Xiaojing , Liu Zhijie , Guo Baojian , Cui Qingbin , Gao Jun , Kang Zhanfang , Xiao Guanghui 
Published: March 2024

Background Periplocae cortex is a well-known Traditional Chinese Medicine with abundant effects, including the treatment of chronic congestive heart failure (CHF). However, the principal components and mechanisms have not been fully elucidated. This study aims to analyze the active ingredients and potential mechanisms of the periplocae cortex in CHF treatment. Methods TCMSP, GeneCards, and Comparative Toxicogenomics databases were used to mine the active ingredients and potential targets of the periplocae cortex. Cytoscape 3.9.1 software was employed to construct the “periplocae cortex-active ingredients-potential targets” and protein–protein interaction network. The DAVID 6.8 database was used for Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of the predicted targets. The protective effects of β-sitosterol (BSS) were detected in doxorubicin (Dox)-induced H9c2 cells using MTT assay, while the regulatory pathways of BSS were examined using various assays, including real-time quantitative PCR and Western blot. The cardiac troponin I (cTn-I) concentration was also measured. Results A total of 13 active ingredients were identified, and 33 targets of CHF were predicted. Network analysis highlighted BSS as the key active ingredient, interacting with 29 targets. GO and KEGG analyses indicated significant involvement of these targets in calcium and apoptosis signaling pathways. Experimental findings demonstrated that BSS enhanced cell viability, reduced intracellular calcium ion concentration, and inhibited caspase 3 activity in Dox-induced H9c2 cells. BSS significantly altered the expression of CHRM1, CASP3, and CASP9 genes ( P < .05), and increased CHRM2 expression. Additionally, BSS significantly increased cTn-I concentration. Notably, suppression of calcium and apoptosis signaling pathways partially mitigated BSS's effects on cell viability and cTn-I concentration. Conclusion Through network pharmacology and experimental verification, establishes BSS as a key active ingredient in the periplocae cortex for CHF treatment. BSS appears to modulate calcium and apoptosis signaling pathways, thereby exerting therapeutic effects in the treatment of CHF.
Foot and Ankle Patient Education Materials and Artificial Intelligence Chatbots: A Comparative Analysis
Authors: Parekh Aarav S. , McCahon Joseph A.S. , Nghe Amy , Pedowitz David I. , Daniel Joseph N. , Parekh Selene G. 
Published: March 2024

Background The purpose of this study was to perform a comparative analysis of foot and ankle patient education material generated by the AI chatbots, as they compare to the American Orthopaedic Foot and Ankle Society (AOFAS)-recommended patient education website, FootCareMD.org. Methods ChatGPT, Google Bard, and Bing AI were used to generate patient educational materials on 10 of the most common foot and ankle conditions. The content from these AI language model platforms was analyzed and compared with that in FootCareMD.org for accuracy of included information. Accuracy was determined for each of the 10 conditions on a basis of included information regarding background, symptoms, causes, diagnosis, treatments, surgical options, recovery procedures, and risks or preventions. Results When compared to the reference standard of the AOFAS website FootCareMD.org, the AI language model platforms consistently scored below 60% in accuracy rates in all categories of the articles analyzed. ChatGPT was found to contain an average of 46.2% of key content across all included conditions when compared to FootCareMD.org. Comparatively, Google Bard and Bing AI contained 36.5% and 28.0% of information included on FootCareMD.org, respectively (P < .005). Conclusion Patient education regarding common foot and ankle conditions generated by AI language models provides limited content accuracy across all 3 AI chatbot platforms. Level of Evidence: Level IV
Comparison of different medical treatments for primary hyperaldosteronism: a systematic review and network meta-analysis
Authors: Ho Wen-Yu , Hsiao Ching-Chung , Wu Ping-Hsun , Chen Jui-Yi , Tu Yu-Kang , Wu Vin-Cent , Chen Jia-Jin 
Published: March 2024

Background: The effectiveness and side effects between different medical treatments in patients with primary hyperaldosteronism have not been systematically studied. Objective: To analyze the efficacy between different mineralocorticoid receptor antagonists (MRAs) and epithelial sodium channel (ENaC) inhibitors in a network meta-analysis (NMA) framework, while also evaluating adverse events. Design: Systematic review and NMA. Data sources and methods: The systematic review and NMA was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, MEDLINE, the Cochrane library, and Excerpta Medica database (EMBASE) were searched for randomized controlled trials (RCTs) involving adult patients with primary hyperaldosteronism until 23 June 2023. Studies that compared the efficacy and side effects of different medical treatments of primary hyperaldosteronism were included. The primary outcomes included the effect on blood pressure, serum potassium, and major adverse cardiovascular events. The secondary outcomes were adverse events related to MRAs (hyperkalemia and gynecomastia). Frequentist NMA and pairwise meta-analysis were conducted. Results: A total of 5 RCTs comprising 392 participants were included. Eplerenone, esaxerenone, and amiloride were compared to spironolactone and demonstrated comparable effect on the reduction of systolic blood pressure. In comparison to spironolactone, eplerenone exhibited a less pronounced effect on reducing diastolic blood pressure [−4.63 mmHg; 95% confidence interval (CI): −8.87 to −0.40 mmHg] and correcting serum potassium (−0.2 mg/dL; 95% CI: −0.37 to −0.03 mg/dL). Spironolactone presented a higher risk of gynecomastia compared with eplerenone (relative risk: 4.69; 95% CI: 3.58–6.14). Conclusion: The present NMA indicated that the blood pressure reduction and potassium-correcting effects of the three MRAs may demonstrate marginal differences, with confidence levels in the evidence being very low. Therefore, further research is needed to explore the efficacy of these MRAs, especially regarding their impact on mortality and cardiovascular outcomes. Trial registration: PROSPERO (CRD: 42023446811).
Label-free quantitative proteomics reveals the mechanisms of Aurora kinase B in renal cell carcinoma
Authors: Li Yulong , Yang Yang 
Published: March 2024

Background: Renal cell carcinoma is the most common form of kidney cancer which is a global threat to human health, needing to explore effective therapeutic targets and treatment methods. Aurora kinase B acts as an important carcinogenic role in various kinds of tumors, while its mechanism in renal cell carcinoma is indistinct. Herein we explore the underlying mechanism of Aurora kinase B in renal cell carcinoma. Methods and results: Label-free quantitative proteomics analysis was employed to analyze the differentially expressed proteins in 786-O cells which were treated with si-Aurora kinase B or si-ctrl. In the current study, 169 differentially expressed proteins were identified. The top 10 upregulated proteins were MX2, IFI44L, ISG20, DDX58, F3, IFI44, ECE1, PRIC285, NIT1, and IFIT2. The top 10 downregulated proteins were FKBP9, FSTL1, DDAH1, TGFB2, HMGN3, COIL, FAM65A, PTPN14, ARFGAP2, and EIF2C2. GO enrichment analysis showed that these differentially expressed proteins participated in biological processes, including defense response to virus, response to virus, and type I interferon signaling pathway. These differentially expressed proteins participated in cellular components, including focal adhesion, cell-substrate adherens junction, cell-substrate junction, and endoplasmic reticulum lumen. These differentially expressed proteins participated in molecule functions, including guanyl nucleotide binding, nucleotidase activity, double-stranded RNA binding, 2′-5′-oligoadenylate synthetase activity, and virus receptor activity. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that the significantly changed proteins including OAS3, OAS2, JAK1, TAP1, and RAC1 were involved in Epstein-Barr virus infection. Conclusions: Taken together, our results demonstrate the possible mechanisms that Aurora kinase B may participate in renal cell carcinoma. These findings may provide insights into tumorigenesis and a theoretical basis for developing potential therapies of renal cell carcinoma.
Nationwide prevalence of glucocorticoid prescriptions over 17 years and osteoporosis prevention among long-term users
Authors: Bjornsdottir Hulda Hrund , Einarsson Ólafur Brynjólfur , Gröndal Gerdur , Gudbjornsson Bjorn 
Published: March 2024

Objectives: Glucocorticoid steroids are frequently prescribed, and side effects are well-known, such as glucocorticoid-induced osteoporosis. Our aim was to estimate the nationwide trend in the prevalence of glucocorticoid steroid prescriptions over 17 years and to elucidate the proportion of patients on long-term glucocorticoid steroid therapy who receive active bone protective therapy. As well as to examine which medical specialties prescribe glucocorticoid steroids the most. Methods: This study was a retrospective observational registry study extended over 17 years (2003–2020). Data were retrieved from the Icelandic Prescription Medicine Register on all delivered glucocorticoid steroids (Anatomic therapeutic chemical code: H02AB) for oral use. Long-term users were defined as those who annually received ⩾90 defined daily doses of glucocorticoid steroids. Results: Annually, 3.8% of the population received oral glucocorticoid steroids, from 3.3% in 2006 to 4.3% in 2017. Prednisolone was most frequently prescribed. Females dispatched glucocorticoid steroid prescriptions more often than males (55.8%). Males and females reached their peak prevalence between the ages of 60 and 70. General practitioners most often prescribe glucocorticoid steroids, followed by physicians in training, rheumatologists, internists, and medical students. Of those who received prescriptions for glucocorticoid steroids, 12.2%–18.1% were classified as long-term users. A declining number of patients have been receiving bone-protective therapy in recent years. Only 13.0% of chronic users received bone protective therapy in 2020. Conclusion: The use of glucocorticoid steroids has increased during the last 2 decades despite improvements in treatment for inflammatory disorders. The prevalence of long-term users has remained stable. Meanwhile, the use of parallel active bone-protective therapy among long-term users of glucocorticoid steroids is declining. Thus, improvements in prophylaxis for corticosteroid-induced osteoporosis are urgently needed for patients who require long-term treatment with glucocorticoid steroids.
Impact of mHealth application on adherence to cardiac rehabilitation guidelines after a coronary event: Randomised controlled clinical trial protocol
Authors: Cruz-Cobo Celia , Bernal-Jiménez María Ángeles , Calle-Pérez Germán , Gheorghe Livia , Gutiérrez-Barrios Alejandro , Cañadas-Pruaño Dolores , Rodríguez-Martín Amelia , Tur Josep A , Vázquez-García Rafael , Santi-Cano María José 
Published: March 2024

Background Coronary disease is the main cause of death around the world. mHealth technology is considered attractive and promising to promote behavioural changes aimed at healthy lifestyle habits among coronary patients. The purpose of this study is to evaluate the efficacy of an mHealth intervention regarding improved results in secondary prevention in patients after an acute myocardial infarction (AMI) or angina in terms of lifestyle, clinical variables and therapeutic compliance. Methods Randomised clinical trial with 300 patients who underwent a percutaneous coronary intervention (PCI) with stent implant. They will be assigned to either the mHealth group, subject to a self-monitored educational intervention involving an internet application installed on their mobile phone or tablet, or to a control group receiving standard healthcare (150 patients in each arm). The primary outcome variables will be adherence to the Mediterranean diet, physical activity, smoking, therapeutic compliance, knowledge acquired, user-friendliness and satisfaction with the application. Measurements of blood pressure, heart rate, body weight, waist circumference (WC) and the 6-min walk test will be taken. Furthermore, the blood lipid profile, glucose and HbA1c will be evaluated. Clinical interview will be conducted, and validated questionnaires completed. The primary quantitative results will be compared using an analysis of covariance adjusted for age and sex. A multivariate analysis will be performed to examine the association of the intervention with lifestyle habits, the control of cardiovascular risk factors (CDRFs) and the results after the hospital discharge (major adverse events, treatment compliance and lifestyle). Conclusions The study will provide evidence about the effectiveness of an mHealth intervention at improving the lifestyle of the participants and could be offered to patients with coronary disease to complement existing services. Trial registration NCT05247606. [ https://ClinicalTrials.gov ]. 21/02/2022
Sex Workers in Canada Face Unequal Access to Healthcare: A Systems Thinking Approach
Authors: Squires Kaitlyn 
Published: March 2024

Objectives: Despite Canada’s universal health system, sex workers across the country face an alarmingly high number of barriers when they seek to healthcare services. This has resulted in unmet healthcare needs and substantially poorer health outcomes than the general Canadian population. The objective of this study was to use a systems thinking approach to gain an in-depth understanding of the barriers sex workers face and how access could be improved. Methods: The analysis was conducted using a systems thinking methodology, which incorporates systems tools and inquiry processes. The methodology comprised 2 domains of inquiry: (1) Problem Landscape, (2) Solutions Landscape. Systems tools and methods, such as causal loop diagrams, iceberg diagram, and systems mapping, investigated the problem landscape for understanding the interconnected nature of the issue, alongside review of both published and gray literature. An environmental scan explored the current solutions landscape. These methods connected through systemic inquiry processes, including ongoing review and application of diverse perspectives, boundary judgments, interrelationships; enabled gaps and levers of change to be determined. Results: The main barriers sex workers face are stigma, criminalization, accessibility, and cost of healthcare. The stigma of sex work stems from otherization, paternalism, and moralistic, faith-based beliefs. The barriers unique to sex work are stigma and criminalization; both of which surface as avoidance, dislike, and/or fear of medical professionals. Five gaps each with a lever of change to improve access were identified: (1) Stigma – Collectivization and external collaboration, (2) Criminal status of sex work – Decriminalization, (3) Lack of adequate education - Improved healthcare professional training and anti-discriminatory health policies, (4) Lack of support – Increased community-based healthcare services, (5) Cost of healthcare – Universal coverage of “secondary” healthcare components. Conclusion: Through reducing the stigma surrounding sex work, making changes that improve the healthcare services that sex workers receive, and collaboration between involved parties, sex workers can be prevented from falling through the cracks of the Canadian healthcare system; lessening the health inequities sex workers face and improving their health outcomes.