bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of dienogest versus GnRH-a combined with dienogest therapy for adenomyosis
Authors: Zhu Shu , Wang Qiqin , Sun Jiafan , Xu Wei , Zhang Huiyuan , Wang Xianglian , Yu Wennian , Wang Xiuli 
Published: November 2023

Abstract
Objective
To investigate the efficacy and safety of dienogest((DNG) monotherapy and gonadotropin-releasing hormone agonist (GnRH-a) combined with DNG sequential treatment for adenomyosis.
Methods
This is a retrospective study.157 patients with symptomatic adenomyosis from the first affiliated hospital of Nanjing Medical University were enrolled in the study. 61patients treated with DNG (2mg/day) alone(Group 1). 96 patients treated with DNG (2mg/day) after 3–6 injections of GnRH-a(Group 2).
Results
(1) The Visual analogue scale (VAS) for dysmenorrhea, serum carbohydrate antigen (CA-125) and CA19-9 levels significantly decreased in both groups compared with pre-treatment (P < 0.05). (2) The hemoglobin (Hb) level in both groups after treatment were significantly higher than pre-treatment (P < 0.05). (3) At 15–24 months of DNG treatment, uterine volume decreased significantly in Group2 compared to pre-treatment (P < 0.05), with no significant change in Group1. (4) Group 2 showed a higher rate of amenorrhea and a lower incidence of irregular spotting and breakthrough bleeding. (5) There were no significant changes in coagulation, hepatorenal function and breast tissue before and after treatment in both groups.
Conclusion
Both DNG monotherapy and GnRH-a + DNG sequential therapy significantly relieved dysmenorrhea, improved anemia, and reduced CA125 and CA19-9 levels in patients with symptomatic adenomyosis, with no adverse effects on coagulation, hepatorenal function and breast tissue. The sequential therapy is superior to DNG monotherapy in reducing uterine volume and lowering CA125 levels. Sequential therapy achieved better amenorrhea rate. Diffuse lesions and lesion involvement of the endometrium were the high-risk factors of heavy breakthrough bleeding during DNG treatment.
Efficacy of Danzhixiaoyao pills in the treatment of burning mouth syndrome：An randomized controlled trial
Authors: Gao Ya , Yang Jingwen , Sun Huimin , Zhou Haiwen 
Published: November 2023

Abstract
Objectives: This randomized controlled trial compared the efficacy and tolerability of danzhixiaoyao pills in the accurate treatment of patients with burning mouth syndrome (BMS) .
Method: Collect a total of 78 patients (75 female patients and 3 male patients) from the oral mucosa department who were considered eligible fromOctober 2020 to October 2022.The patients were randomized and divided into trial group and control group.The trail group received danzhixiaoyao pills and mecobalamine tablets while the control group was given mecobalamine tablets.The Visual Analogue Scale (VAS), Beck Anxiety Inventory(BAI), Beck Depression Inventory (BDI), Oral Health Impact Profile (OHIP-14), Traditional Chinese medicine（TCM） syndrome integral and adverse reactions were performed at baseline and after 2, 4, and 6 weeks of treatment. Descriptive statistics, including the Wilcoxon rank-sum test and the Chi-square test for median comparisons between different times, were used.
Result: 1.After treatment, the VAS, BDI,OHIP-14, and TCM syndrome integral in the trial group had a significant decrease than the control group(P< 0.05).However, there was no statistical difference in the BAI scores between the two groups (P> 0.05). 2.According to the efficacy determination criteria , the total effective rate of the test group was 73.68% , the control group was 52.94% and the recurrence rate was 0. There was a significant difference between the two groups (Z=-2.688, P < 0.05). The results showed that the curative effect of test group was better than that of control group.3. No adverse effects occurred in patients in either group.
Conclusion: Danzhixiaoyao pills has demonstrated to have a positive effect in relieving BMS symptoms and in improving a patient's overall quality of life with no AEs compared with the control group. The efficacy evaluation systems that can be verified and complementary in this study provide a perfect, effective and referential evaluation system for the use of Chinese patent medicine in the treatment of oral mucosal diseases.
Investigating the Heterogeneity of NOx-VOCs-Ozone Relationships in Chinese Cities: Systematic Assessment and Spatiotemporal Maps
Authors: Guan Yang , Xiao Yang , Li Bin , Zhang Nannan 
Published: November 2023

Abstract
Ozone is a pollutant threatening the atmospheric environment and public health. Investigating the relationship and sensitivity between ozone level and its precursors, including nitrogen oxides (NOx) and volatile organic compounds (VOC), has been a significant basis and reference for pollution mitigation. Through mining the internal comparability between individual data and the entire dataset, this study develops indexes assessing the ozone-NOx-VOC relationship while performing a case study on Chinese cities from 2015 to 2020. From the results, (1) the ozone-precursor correlation in Chinese cities generally showed increase-decrease trends in the assessing period while significantly correlating cities aggregating in two eastern city groups. (2) Differentiation in NOx- and VOC-limited ozone production regimes between cities located on the left and right sides of the Hu Huanyong Line has gradually formed over the past several years. (3) To effectively and efficiently mitigate ozone pollution, reducing NOx emission on a large scale while preventing VOC emission in key urban agglomerations with relatively developed economies and aggregated populations is recommended. The ozone-NOx-VOC relationship is assessed based on the quantitative and individual evaluation of ozone-NOx and ozone-VOC correlation, providing a novel local-to-global perspective to understand the contribution of precursors to ozone pollution.
Genome-Wide association study (GWAS) identified PCOS susceptibility variants and replicates reported risk variants
Authors: Sharma Priya , Senapati Sabyasachi , Goyal Lajya Devi , Kaur Balpreet , Kamra Pooja , Khetarpal Preeti 
Published: November 2023

Abstract
Background: Genetic predisposition and environmental factors are considered as risk factors for polycystic ovary syndrome (PCOS). Genome-wide association studies (GWAS) have been reported from various subpopulations to evaluate SNPs associated with PCOS risk. As no PCOS associated GWAS study has been reported from India.
Purpose: Present study was conducted to identify the PCOS-susceptible loci among the North Indian population and validation of significant loci reported by previous GWAS studies.
Methods: A total of 272 age-matched participants with 134 PCOS patients and 138 healthy controls were recruited. Genomic DNA was isolated and genotyped by using Infinium Global Screening Array v3.0 microchip considering HWE 10e-5 statistically significant.
Results: A total of fifteen markers have been identified as candidate PCOS risk factors. Only two SNPs, namely rs17186366 and rs11171739 have been identified through replication analysis while comparing the previously reported PCOS GWAS data. In-silico analysis was performed to study the functional impact of identified gene variants in terms of gene ontology, pathways related to gene set, and cluster analysis to determine protein-protein interaction among genes or gene products.
Conclusion: Study suggests that multiple variants play an important role in PCOS pathogenesis and emphasize the importance of further genetic studies among Indian subpopulations.
Unravelling the complexity of kidney renal clear cell carcinoma prognosis: integrating chromatin regulators, gene signatures and associated immune landscapes
Authors: Wang Guobing , Huang Jinbang , Chen Haiqing , Li Yi , Pei Jingwen , Li Lan , Li Chang , Tian Gang 
Published: November 2023

Abstract
Background
Kidney-renal clear cell carcinoma (KIRC) is the main subtype of renal cell carcinoma. KIRC exhibits significant resistance to conventional treatments, highlighting the need for pioneering therapeutic approaches. Within this framework, chromatin regulators (CRs) - proteins important for managing gene expression and orchestrating key biological processes - have been recognized as key players in the initiation and development of KIRC.
Methods
Utilizing the TCGA-KIRC dataset, we conducted differential gene analysis pertaining to chromatin regulators through application of the "limma" R package. We proceeded to establish and validate a prognostic model via LASSO Cox regression, with a particular emphasis on genes exerting substantial influence on KIRC prognosis. Our investigation was further extended to investigate the interrelationship between gene attributes, clinical parameters, the tumor microenvironment, and drug responsiveness. To enhance the predictive efficacy of our models, we harnessed advanced bioinformatics methodologies and techniques for visualizing protein interaction networks.
Results
Through the related studies, we found that the risk score obtained for CRs constituted an autonomous prognostic determinant in KIRC. Subsequently, a Nomogram prediction model was crafted that amalgamated clinical attributes with their corresponding risk evaluations. Ultimately, Polymerase chain reaction (PCR) was applied for comparative analysis of BRD9 expression levels in normal tissues and tumor specimens. Notably, the utilization of BRD9 marker-based constructs yielded significant predictive results.
Conclusion
We have introduced a novel prognostic framework for KIRC that seamlessly incorporates Chromatin Regulators. This innovative model exhibits substantial promise in enhancing the precision of prognostic forecasts for individuals afflicted with KIRC, thereby establishing a foundational platform for the refinement of therapeutic approaches.
Trends of hypertensive disorders of pregnancy among the Medicaid population before and during COVID-19
Authors: Hu Gang , Lin Jessica , Feng Heidi , Horswell Ronald , Chu San , Shen Yun 
Published: November 2023

Abstract
Hypertensive disorders of pregnancy (HDP) are a group of high blood pressure disorders during pregnancy that are a leading cause of maternal and infant morbidity and mortality. The trend of HDP among the Medicaid population during the coronavirus disease of 2019 (COVID-19) is severely lacking. To determine the trends in the annual prevalence of HDP among Louisiana Medicaid pregnant women before and during the COVID-19 pandemic (2016-2021),
a total of 113,776 pregnant women aged 15-50 years was included in this study. For multiparous individuals, only the first pregnancy was used in the analyses. Women with a diagnosis of each type-specific HDP were identified by using the ICD-10 codes. The prevalence of HDP increased from 10.5% in 2016 to 17.7% in 2021. The highest race/ethnicity-specific incidence of HDP was seen in African American women (13.1%), then white women (9.4%), followed by other women (7.9%). HDP remains as a very prevalent and significant global health issue, especially in African American women. Obesity and physical inactivity are major risk factors of HDP, which became amplified during the COVID-19 pandemic and led to a higher prevalence of HDP. Severe HDP substantially increases the risk of mortality in offspring and long-term issues in both the mother and infant. This is very pertinent to the Medicaid population due to the disparities and barriers that diminish the quality of healthcare they receive.
Microclimatic niche shifts predict long-term survival and body mass declines in a warmer and more degraded world
Authors: Bharadwaj Akshay , Chanda Ritobroto , Biswakarma Aman , Tamang Bharat , Munda Binod , Pradhan Dambar K , Rai Mangal , Rai Shambu , Sriniva Umesh 
Published: November 2023

Abstract
The synergistic impacts of climate change and habitat degradation threaten tropical species worldwide. However, how species’ microclimatic niches affect their demographic and phenotypic responses to anthropogenic change remains poorly understood. Using an 11-year mark-recapture dataset from primary and selectively logged forest in the Eastern Himalaya, we investigated how species-specific microclimatic niches predicted body mass and survival trends in understorey insectivorous birds in each habitat. Overall, logged forest is hotter and drier than primary forest, and the arthropod prey community shows shifts in composition upon selective logging. For understorey insectivorous birds, the degree of dissimilarity between species-specific primary and logged forest microclimatic niches was strongly and negatively correlated with survival and less strongly with body mass trends in logged forest. Microclimatic niche shifts in response to anthropogenic habitat modification can impact both demographic rates and body condition, crucial for population persistence. Our results can inform prompt, targeted conservation efforts toward the most threatened species in a warmer and more degraded world.
Potential the relationship between clinical use metformin and frailty index:a Mendelian randomization study
Authors: Jiao Deqiang , Liang Jiang 
Published: November 2023

Abstract
Background: Observational studies present conflicting evidence regarding the association between metformin use and the risk of an increase in the Frailty Index. Some studies suggest a significant increase, while others indicate the opposite.
Objective: This study aims to explore the causal relationship between metformin use and an increased risk of the Fraility Index .
Methods: We conducted a two-sample Mendelian randomization (MR) analysis using various methods: inverse-variance weighted (IVW), weighted median, MR-Egger regression, simple mode, and weighted mode. Publicly available summary statistics datasets from genome-wide association studies (GWAS) meta-analyses were utilized. These datasets focused on metformin use in individuals of European descent (n = 462933) as the exposure variable, and a GWAS on doctor-diagnosed frailty index increase in individuals from the UK Biobank (n =175226) as the outcome variable. Additionally, we validated the outcomes using data from another group of metformin patients.
Results: We identified 61 single nucleotide polymorphisms (SNPs) associated with metformin use at genome-wide significance as instrumental variables (P<1e-5; linkage disequilibrium r2 <0.001). The IVW (b = 2.646518, SE = 0.3763135, P = 2.03E-12), MR-Egger regression (b = 1.986775, SE = 1.4747723, P = 1.83E-01), simple mode (b = 3.450373, SE = 1.0903862, P = 2.44E-03), weighted median (b = 2.388585, SE = 0.4366406, P =4.49E-08), and Weighted mode (b = 3.08067, SE = 0.9913658, P =2.88E-03) methods all indicated a potential causal relationship between metformin use and the frailty index. Cochran’s Q test and funnel plot analysis showed no evidence of heterogeneity or asymmetry, suggesting no directional pleiotropy. Similar trends were observed in both forward and reverse validation within an additional 49 datasets.
Conclusion: Our MR analysis findings suggest a potential causal relationship between metformin use and an increase risk of frailty index.
Future changes in intense tropical cyclone hazards in the Pearl River Delta region: An air-wave-ocean coupled model study
Authors: Li Zhenning , Fung Jimmy C.H. , Wong Mau Fung , Lin Shangfei , Cai Fenying , Lai Wenfeng , Lau Alexis K.H. 
Published: November 2023

Abstract
The Pearl River Delta (PRD) region is highly vulnerable to tropical cyclone (TC)-caused coastal hazards due to its long and meandering shoreline and well-developed economy. With global warming expected to continue or worsen in the rest of the 21st century, this study examines the TC impact on the PRD coastal regions by reproducing three intense landfalling TCs using a sophisticated air-wave-ocean coupled model of high spatial resolution (1-km atmosphere and 500-m wave and ocean). The simulations are conducted using present-day reanalysis data and the same TCs occurring in a pseudo-global warming scenario projected for the 2090s. Results indicate that the coupled model accurately reproduces the air-wave-ocean status during the TC episodes. The 2090s thermodynamic status effectively increases the intensity of intense TCs, leading to more severe coastal hazards including gale, rainstorm, and storm surges and waves. On average, the maximum surface wind speed within 50–200 km to the right of the TC center can increase by 4.3 m/s (+ 22%). The 99th and the 99.9th percentile of accumulated rainfall will increase from 405 mm to 475 mm (+ 17.3%), and from 619 mm to 735 mm (+ 18.6%), respectively. The maximum significant wave height at the ocean is lifted by an average of 57 cm (+ 13.8%), and the coastline typically faces a 40–80 cm increase. The maximum storm surges are lifted by 30–80 cm over the open sea but aggravate much higher along the coastline, especially for narrowing estuaries. For Typhoon Vicente (2012), there is more than a 200 cm wave height increase observed both at open sea and along the coastline. In the 2090s context, a combination of mean sea level rise, storm surge, and wave height can reach more than 300 cm increase in total water level at certain hot-spot coastlines, without considering the superposition of spring tides.
Prevalence of radiological cerebral small vessel disease: an insight from routinely collected data
Authors: Maskery Mark P. , Rennie Nicola , Mathur Sachin , Knight Jo , Emsley Hedley C.A. 
Published: November 2023

Abstract
Background:
Approximately 900,000 MRI brain scans are performed annually in the United Kingdom alone, with incidental findings frequently encountered.
One of the most prevalent findings is white matter hyperintensities (WMHs). WMHs often indicate cerebral small vessel disease (cSVD) but can also be associated with migraine and demyelination. Prospective population studies have already confirmed a high prevalence of WMHs in elderly patients. In younger patients, or when the radiological burden is low, WMHs are commonly considered non-specific. Routinely collected data represents a valuable resource to facilitate further study.
Methods:
We performed a service evaluation of our local two-week wait suspected central nervous system cancer pathway to understand the association between age, demographics, performance status, referral criteria, imaging outcomes and both the prevalence and radiological characteristics of WMHs. Analysis was performed using R version 4.1.3.
Results:
We identified 1033 patients, referred over a 30-month period. Mean patient age was 51.3±18.3 years with 65% females. As expected, WMHs were present on 89.7% of scans in patients aged over 80, with 98.1% of these consistent with cSVD upon review by a neuroradiologist. We show an important association between cSVD and both performance status and levels of deprivation.
However, WMHs were also present in approximately 1 in 5 patients under 50 years old and were typically deemed non-specific. Our analysis showed increasing age was associated with increased WMH prevalence, radiological burden and the likelihood of WMHs being attributed to cSVD. It is therefore feasible to consider that these changes may represent early cSVD.
Conclusions:
We demonstrate a prevalence of cSVD comparable to the wider literature in elderly patients whilst highlighting the potential underestimation of cSVD in the younger population, in whom further study of WMHs is required.
There is potential for routinely collected data to define the prevalence and characteristics of cSVD more accurately whilst facilitating further research.
Hypoplastic left heart syndrome identified or displaying anomalies during the first trimester of pregnancy: case reports
Authors: Lei Wenjia , Han Jijing , Wang Jingjing , Hou Chenxiao , Zhang Simin , Xiong Xiaowei , Wu Qingqing 
Published: November 2023

Abstract
Hypoplastic left heart syndrome (HLHS) represents the most prevalent form of functional single-ventricle heart disease developing in utero. Enhanced ultrasound technology, featuring a spectrum of high-frequency probes, coupled with the diagnostic “window” at the 11–14 weeks’ scan, facilitates the early detection of HLHS during the first trimester of pregnancy. This not only permits timely genetic testing and management planning but, crucially, might uncover early indicators of hemodynamic alterations in HLHS. It is in this context that we described two different evolution of HLHS in utero. We present three instances of fetal HLHS identified or displaying anomalies in the first trimester: two exhibited the typical clinical phenotype early on, while the other manifested an outflow tract obstruction that evolved into HLHS by the second trimester. Insights into the HLHS spectrum may bridge the knowledge gap regarding the etiology of HLHS, which is essential for providing antenatal counseling, and guiding intrauterine therapy for the affected fetus.
Blood pressure screening in Mata Sector, a rural area of Rwanda
Authors: Parati Gianfranco , Hunjan Isabella , Umulisa Alice , Parati Gianfranco , Bianchetti Mario , Milani Gregorio , Muvunyi Bienvenu , Ntaganda Evariste , Radovanovic Dragana , Stroppa Clara , Suter Paolo , Muggli Franco 
Published: November 2023

Abstract

In rural sub-Saharan Africa, knowledge of non-communicable diseases such as high blood pressure (BP) is rather limited. This report provides information about a BP screening in Mata Sector, a rural region in Southern Province of Rwanda. Community-based, house-to-house screening was performed between February and July 2020 on more than 7,000 inhabitants. The screening was conducted by a local team composed by 20 community health care workers, five community health care supervisors, and one nurse with hypertension surveillance training. BP and heart rate were recorded after 5 minutes of resting, using a validated automated oscillometric OMRON M6 IT-HEM-7322-E monitor with Intelli Wrap Cuff (HEM-FL31-E) technology. The mean of the second and third value was retained. BP was normal (< 140/90 mm Hg) in 6,340 (88%) and elevated in 863 (12%) participants with 95% of unawareness. Grade 1 (140–159/90–99 mm Hg) hypertensive BP readings were detected in 697 (81%), grade 2 (160–179/100–109 mm Hg) in 134 (16%), and grade 3 (≥ 180/≥110 mm Hg) in 32 (3.7%) individuals. The prevalence of hypertensive readings was significantly age-dependent. Additionally, a slightly greater proportion of participants with high BP (14% versus 11%) had a body mass index (BMI) ≥ 25.0 kg/m2. Also resting heart rate was higher in individuals with high BP (82 versus 77 beats/min). Although individuals identified with occasionally elevated BP values need further confirmatory measurements to establish the diagnosis of hypertension, these data suggest that high BP represents an escalating concern within sub-Saharan Africa.