bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with in-hospital and outpatient survival of patients with different types of stage IV cancer and venous thromboembolism
Authors: Reyes Edgar Julián , Ruiz-Talero Paula , Arenas Mayra Alejandra , Hernández-Flórez Catalina , Muñoz Oscar M 
Published: December 2023

Objective To identify factors associated with in-hospital and outpatient survival of patients with different types of stage IV cancer who present with venous thromboembolic disease (VTE). Methods In this prospective cohort, in-hospital and outpatient survival rates up to 180 days were analyzed using Kaplan–Meier curves. Cox regression was used to identify factors associated with different survival functions. Results One hundred patients were analyzed (median age, 67.5 years; 75% with Charlson index of <10; 69% with Eastern Cooperative Oncology Group (ECOG) score of 3–4). In-hospital mortality was 18%, and the median time from admission to death was 11 days (interquartile range, 1–61 days). Factors significantly associated with in-hospital mortality were the ECOG score and thrombocytopenia. The 180-day mortality rate was 52%, with deaths mainly occurring in the first 90 days since VTE diagnosis. Additional factors significantly associated with outpatient mortality included male sex and neoplasms with a high risk of thrombosis (lung, pancreas, stomach, uterus, bladder, and kidney neoplasms). Conclusion Patients with stage IV cancer and acute VTE have short survival. Poor prognostic factors are thrombocytopenia, the ECOG score, and certain types of cancer. These results may help physicians individualize decisions regarding initiation and continuation of anticoagulant therapy.
Pediatric Cluster Headache Case Series: Symptomatic Cases and the Migraine Relationship
Authors: Eberhard Spencer W. , Jackman Christopher T. 
Published: December 2023

Background Current criteria help differentiate cluster headache from migraine. However, children may have overlapping features making it difficult to distinguish the 2 conditions, which may delay diagnosis. Differentiating cluster headache from migraine is important regarding treatment as well as diagnostic workup of secondary headache etiologies. Methods Cases at a single pediatric children's hospital from 2015 to 2023 diagnosed with cluster headache before the age of 18 years were reviewed. Results Twenty-five cases were identified of which 22 cases met criteria for either chronic, episodic, or probable cluster headache. Three cases were diagnosed with cluster headache by their provider, but documentation was insufficient to meet criteria for cluster headache. There were 16 females and 9 males between ages 6 and 17 years. Five cases were identified as symptomatic, 2 cases as chronic, 7 cases as episodic, and 13 cases as probable cluster headache. Symptomatic etiologies include Graves disease, optic neuritis, prolactinoma, hypothalamic pilocytic astrocytoma with carotid stenosis, and congenital right eye blindness. Migrainous features were common, including 76% with nausea, 36% with vomiting, 68% with photophobia, and 56% with phonophobia. Patients with cluster headache also had an independent diagnosis of migraine in 64%. Conclusion Children with cluster headache have a high frequency of migrainous symptoms and co-occurrent diagnosis of migraine. A careful history may differentiate cluster headache from migraine and treated accordingly. Children with cluster headache features should undergo screening for secondary causes with appropriate imaging and other studies. Except for prolactinoma, the symptomatic associations noted in this case series have not been reported before.
Effect of autoclaving on the dimensional stability and surface characteristics of 3D printed PVDF composite-based implants
Authors: Husain Minhaz , Singh Rupinder , Pabla BS 
Published: December 2023

In the past decade, a lot of work has been reported on the use of polyvinylidene fluoride (PVDF) based thermoplastic composites as energy storage devices, and implant materials. But hitherto little has been reported on the dimensional stability and surface characteristics of 3D-printed PVDF composites after autoclaving for implant applications. In this study, the effect of autoclaving on surface characteristics (Shore-D hardness, surface roughness (Ra), morphological characteristics), and dimensional stability of 3D printed PVDF-hydroxyapatite (HAp)- chitosan (CS) composite has been reported for implant applications. The signal-to-noise (S/N) ratio approach was used to ascertain the best setting of process parameters for 3D printing by fused filament fabrication (FFF) process. This study suggests that the best setting for the FFF process, for the 3D printing of PVDF composite (90%PVDF-8%HAp-2%CS) are the nozzle temperature (NT) of 225°C, raster angle (RA) 0°, and printing speed (PS) 40 mm/s, resulting in Shore-D hardness 48.5 HD (before autoclaving) and 55.0 HD (after autoclaving), dimensional deviation 0.01 mm (after autoclaving). The results are supported by scanning electron microscopy (SEM) and Fourier transmission infrared (FTIR) spectroscopy analysis.
Mechanism of Schisandra chinensis in Treatment of Insomnia by Sleep–Wake Cycle Based on Network Pharmacology
Authors: Liang Ke , Qiao Tie , Sun Ning , Jiang Ning , Li Fangxiao , Jiang Haoxuan , Jiang Yutong 
Published: December 2023

Background Schisandra chinensis (SC) is the dried fruit of SC of Magnoliaceae, which has been used to treat many diseases, such as asthma, cough, insomnia, spontaneous sweating, and so on, for more than 2000 years. Lignans are important active ingredients of SC for improving insomnia, but it is not clear the exact material basis and mechanism of action. Objectives This study aimed to discover the mechanism by which SC treats insomnia through network pharmacology. Materials and Methods It was used to study the chemical constituents of SC by ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS). The SC–Insomnia network and the protein–protein interaction (PPI) network were set up using network pharmacology to research the mechanisms by which SC treats insomnia. The targets found in network pharmacology were proven by enzyme-linked immunosorbent assays (ELISA) and real-time polymerase chain reactions (RT-PCR). Results It identified 26 monomer compounds, all of which were lignans. From the SC–Insomnia and PPI networks, seven main active lignans were discovered, which could play an important part in treating insomnia, along with 11 targets that play an important part in the sleep−wake cycle. It was verified by the expression of GABA with ELISA and GABRA1 with RT-PCR. Conclusion Based on network pharmacology, the mechanism by which SC treats insomnia is through the sleep–wake cycle. It was a foundation to rationally apply SC for treating insomnia in the clinic.
Blood Biomarkers Panels for Screening of Colorectal Cancer and Adenoma on a Machine Learning-Assisted Detection Platform
Authors: Wang Hui , Zhou Zhiwei , Li Haijun , Xiang Weiguang , Lan Yilin , Dou Xiaowen , Zhang Xiuming 
Published: December 2023

Objective A mini-invasive and good-compliance program is critical to broaden colorectal cancer (CRC) screening and reduce CRC-related mortality. Blood testing combined with imaging examination has been proved to be feasible on screen for multicancer and guide intervention. The study aims to construct a machine learning-assisted detection platform with available multi-targets for CRC and colorectal adenoma (CRA) screening. Methods This was a retrospective study that the blood test data from 204 CRCs, 384 CRAs, and 229 healthy controls was extracted. The classified models were constructed with 4 machine learning (ML) algorithms including support vector machine (SVM), random forest (RF), decision tree (DT), and eXtreme Gradient Boosting (XGB) based on the candidate biomarkers. The importance index was used by SHapely Adaptive exPlanations (SHAP) analysis to identify the dominant characteristics. The performance of classified models was evaluated. The most dominating features from the proposed panel were developed by logistic regression (LR) for identification CRC from control. Results The candidate biomarkers consisted of 26 multi-targets panel including CEA, AFP, and so on. Among the 4 models, the SVM classifier for CRA yields the best predictive performance (the area under the receiver operating curve, AUC: .925, sensitivity: .904, and specificity: .771). As for CRC classification, the RF model with 26 candidate biomarkers provided the best predictive parameters (AUC: .941, sensitivity: .902, and specificity: .912). Compared with CEA and CA199, the predictive performance was significantly improved. The streamlined model with 6 biomarkers for CRC also obtained a good performance (AUC: .946, sensitivity: .885, and specificity: .913). Conclusions The predictive models consisting of 26 multi-targets panel would be used as a non-invasive, economical, and effective risk stratification platform, which was expected to be applied for auxiliary screening of CRA and CRC in clinical practice.
Evolution of anhedonia in adolescent depression: An interpretative phenomenological analysis study
Authors: R Amrtavarshini , Jacob Preeti , Vijay Sagar Kommu John 
Published: December 2023

Introduction Anhedonia is a symptom complex currently linked to dysfunctional reward processing. Phenomenological studies capture anhedonia as a loss of hedonic and eudemonic pleasure. However, there is a lack of integration between neurobiological understanding and clinical phenomenology. This study used a qualitative method to explore the interplay of sociocultural contexts and individual factors associated with the evolution of dysfunctional reward processing in adolescents with depression and anhedonia. Methods Ten female adolescents with a current or prior diagnosis of major depressive disorder were recruited from a public tertiary care child and adolescent psychiatry service. In-depth interviews were conducted, voice recorded, and transcribed verbatim. The transcripts were analyzed using Interpretative Phenomenological Analysis (IPA). Findings The adolescents hailed from urban families. Educational stress and relational difficulties figured prominently. Amotivation was the most important subdomain of anhedonia affected. An integrated framework for understanding the evolution of anhedonia is presented. Five main patterns of dysfunctional reward processing emerged in our study: an overworked system, erroneous reward valuation, reward-effort imbalance, and diversion of the reward processing system for self-preservation. Conclusion There is a necessity to build robust theoretical models of the evolution of anhedonia, hence finding homogenous sub-groups, paving the way for person-centric interventions for anhedonia.
‘I’m going to take my power back and do whatever I can’: The self-efficacy of survivors of intimate partner strangulation and their engagement in research interviews
Authors: Lowik Vicki , Cheyne Nicola , Lovatt Heather 
Published: December 2023

Purpose: Existing literature identifies the agency used by survivors of domestic violence when they participate in research. However, some human research ethics committees act as gatekeepers on research into survivors’ lived experience due to their perceived vulnerability. This article explores factors that influence survivors’ decision-making when they participate in research interviews. Methods: Sixteen survivors of intimate partner strangulation participated in interviews about their lived experience. The analysis of the interview transcripts was guided by the research question: What factors influence the agency that survivors of domestic violence draw on when making decisions about participating in research interviews? Results: The findings revealed four processes through which the self-efficacy of participants became apparent – cognitive, motivational, affective and selection processes. Self-efficacy underpins a person's agentic behaviours, particularly their decision-making. Conclusion: This article highlights how survivors of intimate partner strangulation, notwithstanding their lived experience of extreme violence, exercise self-efficacy. Knowledge in this area is valuable because it indicates survivors who have left the abusive relationship and have engaged in support can make informed decisions about their participation in research interviews. Such understandings can provide researchers with an increased awareness about the wellbeing of participants during interviews and human research ethics committees can be confident that research participants, who may be considered ‘vulnerable’, have the ability to assess their capacity to engage in research, if the caveats of having left the abusive relationship and having sought support are satisfied.
Late-onset stiff-person syndrome: challenges in diagnosis and management
Authors: Dalakas Marinos C. , Yi Jessica 
Published: December 2023

Background: Stiff person syndrome (SPS) is a rare slowly progressive autoimmune neuronal hyperexcitability disease with very-high GAD-65 antibody titers that most commonly presents above the age of 20, with muscle stiffness, painful muscle spasms, slow gait, and falls leading to disability. In other autoimmune disorders, late-onset disease has different symptom-spectrum and outcomes, but there is no information regarding late-onset SPS (LOSPS). Objective: Highlight delayed diagnosis and poor tolerance or incomplete response to therapies of patients with LOSPS and outline how best to increase disease awareness early at onset. Design: A retrospective chart review.Methods: We reviewed GAD-positive SPS patients with symptom onset above age 60, identified among 54 SPS patients, examined, treated and followed-up by the same clinicians, focused on clinical presentation, misdiagnoses, response and tolerance to therapies, and evolved disability. Results: Nine patients had LOSPS with symptom onset at median age of 61 years (range 60–78), and current median age of 73. The median time from symptom onset to SPS diagnosis was 3 years; prior to diagnosis, five patients were treated for lumbosacral radiculopathies (one with laminectomy), two for Parkinson’s disease, one for multiple sclerosis, and another for cerebellar degeneration. Progressive decline occurred rapidly in all patients; at time of diagnosis, six patients were already using a cane or walker and two were wheelchair-bound. Tolerance and response to treatment were limited; two patients did not respond to IVIg, two discontinued IVIg despite early response due to comorbidities (cardiac disease, thrombosis), four others partially responded to IVIg and one to rituximab; several could not tolerate high doses of oral antispasmodics due to somnolence; and two patients died. Conclusions: LOSPS is almost always misdiagnosed for other similar conditions commonly seen in the elderly. Patients with LOSPS decline quickly to clinically severe disease due to delayed treatment initiation, poor response or tolerance, other comorbidities, and possibly immunosenescence. Increased awareness that SPS can occur in the elderly mimicking other disorders is important for early diagnosis and treatment, even necessitating earlier immunotherapy initiation, compared to their younger counterparts, to prevent faster-evolving severe disability.
Antiplasmodial Profiling of Mangifera indica's Herbal Formulation and Its Ability to Ameliorate Hematological Derangements in Plasmodium berghei-Infected Mice
Authors: Asanga Edet E. , Okoroiwu Henshaw U. , Umoh EkementeAbasi A. , Eseyin Olorunfemi A. , Oko Mike O. , Okey Favour E. , Oli Mercy 
Published: December 2023

Background Malaria caused by Plasmodium falciparum with an average prevalence of 75% in Nigeria, can be treated. Chemical-based medications, one of the methods used to treat it, frequently causes hematological abnormalities in the blood tissues. However, the ethnobotanical and scientific usage of Mangifera indica for the management of malaria in Nigeria necessitated this study on the antiplasmodial evaluation, the hematological profiling of Plasmodium berghei-infected mice treated with Mangifera indica's herbal formulation as well as the isolation and characterization of bioactive compounds from the plants. Method The plant's coarse leaves (3 kg) and stem bark (3.2 g) were weighed, divided into groups of leaves (250.71 g), stem bark (509.34 g), leaves/stem bark (1:1) (101.24/101.24 g), leaves/stem bark (1:2) (164.39/328.78 g), and leaves/stem bark (2:1) (218.50/109.25 g), macerated in 3 L of ethanol for 72 h, filtered, and concentrated. For each extract, the following weights and yields were recorded: 31.3 g leaves (15.2%), 43.8 g stem bark (8.7%), 34.8 g leaves/stem bark (1:1) (17.2%), 29.2 g leaves/stem bark (1:2) (5.92%), and 26.1 g leaves/stem bark (2:1) (7.96%). According to established methods, the herbal formulation was employed for hematological testing, GC-MS analysis, and in vivo antiplasmodial evaluation based on standard protocols. Results The leaves: Stem bark (1:2) extract (the best therapeutic response) of 98.92% was better than ACT (98.63%). GCMS analysis revealed predominantly mangiferin and esters of linoleic acids that could have enhanced erythropoiesis, mitigated infections, as well as boosted platelet aggregation in P berghei-infected mice as observed from the hematological assay. Conclusion Therefore, the extract of leaves: stem bark (1:2) had the best antiplasmodial therapeutic response and hematoprotective activity in P berghei-infected mice.
In Silico Pharmacokinetics Properties and In Vitro Bioactivities of Pregnane Derivatives and Other Compounds From Stems of Caralluma speciosa
Authors: Kiros Tsegu , Mohammed Seid , Dekebo Aman , Melaku Yadessa 
Published: December 2023

Objectives Caralluma speciosa (N.E. Br.) N.E. Br. (Asclepiadaceae) and other succulent plants of the genus Caralluma have mainly been known for their appetite suppressing and weight loss properties, due to the presence of pregnane compounds. This study aimed to investigate chemical constituents and evaluate antimicrobial and antioxidant activities of stems of C speciosa. Methods The chloroform and methanol stems extracts were subjected to silica gel chromatographic separation. The structures of isolated compounds were established by FT-IR, 1D-NMR, and GC-MS instruments, and in comparison with reported data. The antimicrobial and antioxidant activities were performed using agar disc diffusion and DPPH assaying methods. Results The phytochemical investigation afforded 5 compounds, 3 pregnane derivatives (3-5), and 2 other compounds, heptacos-1-ene (1) and di-(2-ethylhexyl) phthalate (2). The chloroform: methanol (1:1) extract showed a good antifungal activity against Candida albicans up to 25 mg/mL dose (9.00 ± 1.00 mm to 17.17 ± 1.04 mm), equivalent to ketoconazole standard (17.67 ± 2.52 mm at 0.01 mg/disc). Compounds 3 and 5 were found violated 3 of the Lipinski's rule of 5. Compounds 2 and 4 exhibited a carcinogenicity property; while compounds 3, 4, and 5 were found as immunotoxic isolates. Conclusion All the extracts and isolated compounds 1-5 showed a negligible antibacterial and antioxidant activities compared to the antibiotic chloramphenicol (7.3 ± 0.4 to 21.15 ± 0.5 mm) and antioxidant ascorbic acid (IC50 value of 5.62 µg/mL). Hence, further biological activities study (including the anticancer, anti-inflammatory, and antifungal activities) would be needed on all the extracts and isolated compounds to look for better efficacy and predict the structure–activity relationship of the compounds.
A semi-automatic segmentation method for meningioma developed using a variational approach model
Authors: Burrows Liam , Patel Jay , Islim Abdurrahman I , Jenkinson Michael D , Mills Samantha J , Chen Ke 
Published: December 2023

Background Meningioma is the commonest primary brain tumour. Volumetric post-contrast magnetic resonance imaging (MRI) is recognised as gold standard for delineation of meningioma volume but is hindered by manual processing times. We aimed to investigate the utility of a model-based variational approach in segmenting meningioma. Methods A database of patients with a meningioma (2007–2015) was queried for patients with a contrast-enhanced volumetric MRI, who had consented to a research tissue biobank. Manual segmentation by a neuroradiologist was performed and results were compared to the mathematical model, using a battery of tests including the Sørensen–Dice coefficient (DICE) and JACCARD index. A publicly available meningioma dataset (708 segmented T1 contrast-enhanced slices) was also used to test the reliability of the model. Results 49 meningioma cases were included. The most common meningioma location was convexity ( n = 15, 30.6%). The mathematical model segmented all but one incidental meningioma, which failed due to the lack of contrast uptake. The median meningioma volume by manual segmentation was 19.0 cm3 (IQR 4.9–31.2). The median meningioma volume using the mathematical model was 16.9 cm3 (IQR 4.6–28.34). The mean DICE score was 0.90 (SD = 0.04). The mean JACCARD index was 0.82 (SD = 0.07). For the publicly available dataset, the mean DICE and JACCARD scores were 0.90 (SD = 0.06) and 0.82 (SD = 0.10), respectively. Conclusions Segmentation of meningioma volume using the proposed mathematical model was possible with accurate results. Application of this model on contrast-enhanced volumetric imaging may help reduce work burden on neuroradiologists with the increasing number in meningioma diagnoses.
Outcomes of mechanical thrombectomy in M1 occlusion patients with or without hyperdense middle cerebral artery sign: A systematic review and meta-analysis
Authors: Orscelik Atakan , Senol Yigit Can , Bilgin Cem , Kobeissi Hassan , Ghozy Sherief , Musmar Basel , Bilgin Gokce Belge , Zandpazandi Sara , Pakkam Madona , Arul Santhosh , Brinjikji Waleed , Kallmes David F 
Published: December 2023

Background The comparison of mechanical thrombectomy (MT) outcomes between patients with the hyperdense middle cerebral artery sign (HMCAS) and non-HMCAS is important to evaluate the impact of this radiological finding on treatment efficacy. This meta-analysis aimed to assess the association between HMCAS and clinical outcomes in patients undergoing thrombectomy, comparing the outcomes over non-HMCAS. Methods A systematic literature search was conducted in PubMed, Ovid Embase, Google Scholar, and Cochrane Library to identify studies on MT outcomes for M1 occlusions of HMCAS over non-HMCAS. Inclusion criteria encompassed modified Rankin Scale (mRS) score, mortality, symptomatic intracranial hemorrhage (sICH), and successful recanalization. Using R software version 4.1.2, we calculated pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CI). Results The meta-analysis was performed for 5 studies with 724 patients. There was no association found between presence of HMCAS and achieving mRS 0–2 (OR = 0.65, 95% CI: 0.29–1.47; p = .544). Mortality analysis also showed no significant association with presence of HMCAS (OR = 0.78, 95% CI: 0.37–1.65; p = .520). No significant difference in sICH risk (OR = 1.54, 95% CI: 0.24–9.66; p = .646) was found between groups. Recanalization analysis showed a non-significant positive association (OR = 1.23, 95% CI: 0.67–2.28; p = .501). Heterogeneity was observed in all analyses. Conclusion Our findings showed that there is no statistically significant difference in mRS scores, mortality, sICH, and recanalization success rates between the HMCAS and non-HMCAS groups.