bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapeutic potential of berberine in attenuating cholestatic liver injury: insights from a PSC mouse model
Authors: Wang Yanyan , Zhao Derrick , Su Lianyong , Tai Yun-Ling , Way Grayson W. , Zeng Jing , Yan Qianhua , Xu Ying , Wang Xuan , Gurley Emily C. , Zhou Xi-Qiao , Liu Jinze , Liu Jinpeng , Chen Weidong , Hylemon Phillip B. , Zhou Huiping 
Published: January 2024

Abstract
Background and aims
Primary sclerosing cholangitis (PSC) is a chronic liver disease characterized by progressive biliary inflammation and bile duct injury. Berberine (BBR) is a bioactive isoquinoline alkaloid found in various herbs and has multiple beneficial effects on metabolic and inflammatory diseases, including liver diseases. This study aimed to examine the therapeutic effect of BBR on cholestatic liver injury in a PSC mouse model (Mdr2−/− mice) and elucidate the underlying mechanisms.

Methods
Mdr2−/−mice (12–14 weeks old, both sexes) received either BBR (50 mg/kg) or control solution daily for eight weeks via oral gavage. Histological and serum biochemical analyses were used to assess fibrotic liver injury severity. Total RNAseq and pathway analyses were used to identify the potential signaling pathways modulated by BBR in the liver. The expression levels of key genes involved in regulating hepatic fibrosis, bile duct proliferation, inflammation, and bile acid metabolism were validated by qRT-PCR or Western blot analysis. The bile acid composition and levels in the serum, liver, small intestine, and feces and tissue distribution of BBR were measured by LC–MS/MS. Intestinal inflammation and injury were assessed by gene expression profiling and histological analysis. The impact on the gut microbiome was assessed using 16S rRNA gene sequencing.

Results
BBR treatment significantly ameliorated cholestatic liver injury, evidenced by decreased serum levels of AST, ALT, and ALP, and reduced bile duct proliferation and hepatic fibrosis, as shown by H&E, Picro-Sirius Red, and CK19 IHC staining. RNAseq and qRT-PCR analyses indicated a substantial inhibition of fibrotic and inflammatory gene expression. BBR also mitigated ER stress by downregulating Chop, Atf4 and Xbp-1 expression. In addition, BBR modulated bile acid metabolism by altering key gene expressions in the liver and small intestine, resulting in restored bile acid homeostasis characterized by reduced total bile acids in serum, liver, and small intestine and increased fecal excretion. Furthermore, BBR significantly improved intestinal barrier function and reduced bacterial translocation by modulating the gut microbiota.

Conclusion
BBR effectively attenuates cholestatic liver injury, suggesting its potential as a therapeutic agent for PSC and other cholestatic liver diseases.
Systemic inflammation and insulin resistance-related indicator predicts poor outcome in patients with cancer cachexia
Authors: Ruan Guo-Tian , Deng Li , Xie Hai-Lun , Shi Jin-Yu , Liu Xiao-Yue , Zheng Xin , Chen Yue , Lin Shi-Qi , Zhang He-Yang , Liu Chen-An , Ge Yi-Zhong , Song Meng-Meng , Hu Chun-Lei , Zhang Xiao-Wei , Yang Ming , Hu Wen , Cong Ming-Hua , Zhu Li-Chen , Wang Kun-Hua , Shi Han-Ping 
Published: January 2024

Abstract
Background
The C-reactive protein (CRP)-triglyceride-glucose (TyG) index (CTI), which is a measure representing the level of inflammation and insulin resistance (IR), is related to poor cancer prognosis; however, the CTI has not been validated in patients with cancer cachexia. Thus, this study aimed to explore the potential clinical value of the CTI in patients with cancer cachexia.

Methods
In this study, our prospective multicenter cohort included 1411 patients with cancer cachexia (mean age 59.45 ± 11.38, 63.3% male), which was a combined analysis of multiple cancer types. We randomly selected 30% of the patients for the internal test cohort (mean age 58.90 ± 11.22% 61.4% male). Additionally, we included 307 patients with cancer cachexia in the external validation cohort (mean age 61.16 ± 11, 58.5% male). Receiver operating characteristic (ROC) and calibration curves were performed to investigate the prognostic value of CTI. The prognostic value of the CTI was also investigated performing univariate and multivariate survival analyses.

Results
The survival curve indicated that the CTI showed a significant prognostic value in the total, internal, and external validation cohorts. Prognostic ROC curves and calibration curves revealed that the CTI showed good consistency in predicting the survival of patients with cancer cachexia. Multivariate survival analysis showed that an elevated CTI increased the risk of death by 22% (total cohort, 95% confidence interval [CI] = 1.13–1.33), 34% (internal test cohort, 95%CI = 1.11–1.62), and 35% (external validation cohort, 95%CI = 1.14–1.59) for each increase in the standard deviation of CTI. High CTI reliably predicted shorter survival (total cohort, hazard ratio [HR] = 1.45, 95%CI = 1.22–1.71; internal test cohort, HR = 1.62, 95%CI = 1.12–2.36; external validation cohort, HR = 1.61, 95%CI = 1.15–2.26). High CTI significantly predicted shorter survival in different tumor subgroups, such as esophageal [HR = 2.11, 95%CI = 1.05–4.21] and colorectal cancer [HR = 2.29, 95%CI = 1.42–3.71]. The mediating effects analysis found that the mediating proportions of PGSGA, ECOG PS, and EORTC QLQ-C30 on the direct effects of CTI were 21.72%, 19.63%, and 11.61%, respectively We found that there was a significant positive correlation between the CTI and 90-day [HR = 2.48, 95%CI = 1.52–4.14] and 180-day mortality [HR = 1.77,95%CI = 1.24–2.55] in patients with cancer cachexia.

Conclusion
The CTI can predict the short- and long-term survival of patients with cancer cachexia and provide a useful prognostic tool for clinical practice.
Estimation of normal lung weight index in healthy female domestic pigs
Authors: Fioccola Antonio , Nicolardi Rosmery Valentina , Pozzi Tommaso , Fratti Isabella , Romitti Federica , Collino Francesca , Reupke Verena , Bassi Gianluigi Li , Protti Alessandro , Santini Alessandro , Cressoni Massimo , Busana Mattia , Moerer Onnen , Camporota Luigi , Gattinoni Luciano 
Published: January 2024

Abstract
Introduction
Lung weight is an important study endpoint to assess lung edema in porcine experiments on acute respiratory distress syndrome and ventilatory induced lung injury. Evidence on the relationship between lung–body weight relationship is lacking in the literature. The aim of this work is to provide a reference equation between normal lung and body weight in female domestic piglets.

Materials and methods
177 healthy female domestic piglets from previous studies were included in the analysis. Lung weight was assessed either via a CT-scan before any experimental injury or with a scale after autopsy. The animals were randomly divided in a training (n = 141) and a validation population (n = 36). The relation between body weight and lung weight index (lung weight/body weight, g/kg) was described by an exponential function on the training population. The equation was tested on the validation population. A Bland–Altman analysis was performed to compare the lung weight index in the validation population and its theoretical value calculated with the reference equation.

Results
A good fit was found between the validation population and the exponential equation extracted from the training population (RMSE = 0.060). The equation to determine lung weight index from body weight was: $${\text{Lung}} {\text{Weight}} {\text{Index}} \left(\frac{{\text{g}}}{{\text{kg}}}\right)=26.26*{10}^{-0.011*{\text{Body}} {\text{Weight}} \left({\text{kg}}\right)}.$$

LungWeightIndex

g
kg

=
26.26

∗

10

-
0.011

∗
BodyWeight

kg

.

At the Bland and Altman analyses, the mean bias between the real and the expected lung weight index was − 0.26 g/kg (95% CI − 0.96–0.43), upper LOA 3.80 g/kg [95% CI 2.59–5.01], lower LOA − 4.33 g/kg [95% CI = − 5.54–(− 3.12)].

Conclusions
This exponential function might be a valuable tool to assess lung edema in experiments involving 16–50 kg female domestic piglets. The error that can be made due to the 95% confidence intervals of the formula is smaller than the one made considering the lung to body weight as a linear relationship.
How to govern greenwashing behaviors in green finance products: a tripartite evolutionary game approach
Authors: Liu Changyu , Li Wei , Chang Le , Ji Qiang 
Published: January 2024

AbstractGreenwashing behaviors (GWBs) in green finance products (GFPs) by enterprises seriously hinder the realization of environmental protection goals. However, methods for effectively regulating GWBs in GFPs are unclear. This study constructed a tripartite evolutionary game model to analyze the formation and governance mechanisms of GWBs in GFPs among regulatory authorities, enterprises, and investors. Subsequently, the stability equilibrium strategy and key factors influencing the system equilibrium were discussed. Several interesting conclusions were drawn. First, we demonstrated that an interdependence mechanism exists among three game agents who mutually influence each other. The larger the probability of regulatory authorities choosing active supervision and investors adopting feedback, the more enterprises are willing to carry out green projects. Second, three corresponding governance modes for GWBs were put forward following the developmental stages of GFPs. Among these, the collaboration mode is the most effective in incentivizing enterprises to implement green projects. Third, based on sensitivity simulations, the initial willingness of the tripartite stakeholders, investor feedback cost, investor compensation, the penalty for greenwashing enterprises, and the reputational benefit of enterprises are critical factors that influence evolutionary results. Finally, targeted countermeasures were provided for regulatory authorities to prevent enterprises from engaging in GWBs.
Time and frequency dynamics between NFT coins and economic uncertainty
Authors: Sadorsky Perry , Henriques Irene 
Published: January 2024

AbstractNon-fungible tokens (NFTs) are one-of-a-kind digital assets that are stored on a blockchain. Examples of NFTs include art (e.g., image, video, animation), collectables (e.g., autographs), and objects from games (e.g., weapons and poisons). NFTs provide content creators and artists a way to promote and sell their unique digital material online. NFT coins underpin the ecosystems that support NFTs and are a new and emerging asset class and, as a new and emerging asset class, NFT coins are not immune to economic uncertainty. This research seeks to address the following questions. What is the time and frequency relationship between economic uncertainty and NFT coins? Is the relationship similar across different NFT coins? As an emerging asset, do NFT coins exhibit explosive behavior and if so, what role does economic uncertainty play in their formation? Using a new Twitter-based economic uncertainty index and a related equity market uncertainty index it is found that wavelet coherence between NFT coin prices (ENJ, MANA, THETA, XTZ) and economic uncertainty or market uncertainty is strongest during the periods January 2020 to July 2020 and January 2022 to July 2022. Periods of high significance are centered around the 64-day scale. During periods of high coherence, economic and market uncertainty exhibit an out of phase relationship with NFT coin prices. Network connectedness shows that the highest connectedness occurred during 2020 and 2022 which is consistent with the findings from wavelet analysis. Infectious disease outbreaks (COVID-19), NFT coin price volatility, and Twitter-based economic uncertainty determine bubbles in NFT coin prices.
Traumatic spinal cord and peripheral nerve injuries: correlation of trauma type with subsequent disability
Authors: Kaya Ahsen , Senol Ender , Bayrakci Engin , Altindag Hayrettin 
Published: January 2024

Abstract
Background
Traumatic spinal cord and peripheral nerve injuries may lead to neurological deficits and fatal consequences. This study aimed to evaluate the characteristics of traumatic spinal cord and peripheral nerve injuries, examine the relationship between the type of injury and the affected nerves, and discuss appropriate prevention measures.

Results
Of these, 236 were males and 63 were females, and the mean age was 35.56 ± 15.10 years. Traffic accidents (56.9%) were the most common etiological factor. This study included 288 peripheral nerve injuries and 82 spinal cord injuries. The fibular nerve (n = 49) and cervical spinal cord (n = 35) were the most frequently injured areas. Permanent functional and sensorial losses associated with traumatic nerve injuries were observed in 239 (79.9%) cases, of which 171 exhibited loss of muscle strength, 114 presented with neuro-sensorial symptoms, 37 had urinary/faecal incontinence, and 1 demonstrated erectile dysfunction. And, the incidence of permanent loss of function was significantly higher following traffic accidents ($$\chi$$
χ
2 = 50.095, Adj. p < 0.001).

Conclusions
Peripheral and spinal nerve injuries play a crucial role in forensic investigations, providing valuable insights into the circumstances surrounding a crime or injury. Their significance extends to both criminal and civil proceedings, influencing legal strategies, determinations of liability, and the quantification of damages. In this study, especially traffic accidents were significantly associated with nerve injuries leading to permanent loss of function, and the type of trauma was associated with the nerves injured. Therefore, this study will contribute to criminal and civil proceedings.
Never too young for a salivary gland carcinoma ex-pleomorphic adenoma
Authors: Fuad Ahmad Muizzuddin Ahmad , Guan Lum Sai , Yunus Mohd Razif Mohamad 
Published: January 2024

Abstract
Background
Carcinoma ex-pleomorphic adenoma (CXPA) can either arise primarily as a de novo or from the malignant transformation of a benign pleomorphic adenoma (PA). CXPA mostly occurs in adults aged 50 to 70 years; hence, the occurrence of CXPA in younger ages is not common.

Case presentation
We report a 27-year-old female who had a history of submandibulectomy for pleomorphic adenoma, and presented with recurrent left submandibular swelling for 4 months. The mass was rapidly increasing in size and was associated with occasional throbbing pain. Examination showed a multilobulated, firm left submandibular swelling with no overlying skin changes. FNAC was performed twice, by conventional and ultrasound-guided techniques, and both concluded as benign salivary gland tumours. CT scan and MRI revealed a well-demarcated tumour with an area of necrosis within, with no obvious invasion into surrounding soft tissue and no significant lymphadenopathy. Having high suspicion of a malignant transformation, the tumour was resected with a concurrent modified radical neck dissection. The histopathological examination confirmed a carcinoma ex-pleomorphic adenoma with the myoepithelial malignant component. The patient subsequently received adjuvant radiotherapy. This case demonstrated that CXPA, although rare, can occur in young adults. Pre-operative FNAC and radiological imaging may mimic a pleomorphic adenoma.

Conclusion
The presence of recurrent tumours with rapid growth should alarm the clinician about a possible malignant transformation of a benign parotid tumour.
Cryoglobulinemia: the “cold” problem in cardiac surgery, a single-center experience and a literature review
Authors: Raimondo Pasquale , Intini Gianmarco , Lauletta Gianfranco , Teora Valentina , Lenoci Sergio Domenico , Rubino Giovanni , Villani Maria Arcangela , Armenise Agnese , Stripoli Antonia , Colantuono Giuseppe , Di Bari Nicola , Fiore Giuseppe , Paternoster Gianluca , Grasso Salvatore 
Published: January 2024

AbstractCardiac surgery with cardiopulmonary bypass (CBP) is essential for different cardiac procedures in order to perform surgery with a clear sight field.To safely perform surgery with CPB and preserve brain, kidney, and patient tissue from ischemic damage, cold cardioplegia, and mild to deep hypothermia are induced during the operation.Cryoglobulinemia is a hematological/infective-related disease (in certain cases idiopathic) in which temperature-dependent antibodies tend to aggregate and form emboli in the vascular system causing tissue damage if exposed to low temperature.The patient with cryoglobulinemia (known and unknown) can be at risk of a major ischemic event during CPB and induced hypothermia.This article’s aim is to evaluate the present scientific literature in order to understand how, in years, the therapeutic or preventive approach, is evolving, and to analyze and make improvements to the management of a cryoglobulinemic patient who must undergo elective or emergency cardiac surgery.In the last part of our article, we expose our single-center experience during a 32-month-long period of survey.In all cases, our medical team (anesthesiologists, perfusionists, and cardiac surgeons) opted for a normothermic cardiopulmonary bypass to lower the risk of cryoglobulin-associated complications.In our experience, along with therapeutic intervention to lower the cryoglobulin titer, normothermic management of cardiopulmonary bypass is as safe as hypothermic management.Notwithstanding our results, further studies with a larger population are needed to confirm this perioperative management in a cardiac surgery setting.
Characterization of cannabis withdrawal symptoms and serum levels of neurotransmitters
among cannabis-dependent smokers during sustained abstinence within a controlled residential
environment
Authors: Sharma R. , Tikka S. K. , Bhute A. R. , Dhamija P. , Bastia B. K. 
Published: January 2024

Introduction
Cannabis (aka marijuana) is the most frequently consumed illicit substance worldwide,
and a subset of frequent cannabis smokers (up to 30%) develop dependence. A less well-known
consequence of cannabis dependence is withdrawal syndrome, characterized by a time-dependent
constellation of symptoms (Lafaye et al. Dialogues Clin Neurosci 2017;19(3),
309-316).

Objectives
This study aims to prospectively assess the course of cannabis withdrawal symptoms
within a controlled inpatient detoxification setting and to correlate the severity of
withdrawal symptoms with the serum levels of neurotransmitters (NT).

Methods
N=45 treatment-seeking chronic cannabis dependents (assessed by ICD-10) were enrolled,
and their withdrawal symptoms were assessed prospectively from admission (Day-0) to 28 days
using Marijuana withdrawal checklist (MWC). Sociodemographic characteristics and
self-reported drug use histories were reported. Serum levels of dopamine, serotonin,
norepinephrine, epinephrine, and cortisol were measured. Cannabis abstinence symptoms were
assessed daily using MWC for 4 weeks, and serum neurotransmitter levels were analyzed at
admission (Day 0), 7, 14, 21, and 28. Comparison between groups was done using Friedman’s
test. Correlation between NT level and MWC scores was performed using linear regression
spearman correlation analysis

Results
The follow-up NT levels from Day 0 to 28 showed a significant (p<0.05) decrease in
serotonin and dopamine, whereas epinephrine levels showed a significant increase (Fig 1) with
the course of withdrawal. Withdrawal symptoms like decreased appetite, sweating, and craving
were significantly and positively correlated with serotonin, dopamine, and epinephrine NT
levels (Fig 2).
Image:

Image 2:

Conclusions
Findings support the presence of clinically significant cannabis withdrawal symptoms
with NT levels in subjects with cannabis dependence seeking substance abuse treatment. The
data of this study determine the relationship between observed withdrawal symptoms and
changes in brain chemistry and evaluate its possible utility as a predictor of
relapse.

Disclosure of Interest
None Declared
A case of Pathological Laughter in a patient with recurrent stroke
Authors: Lakhotia S. , Parikh M. N. 
Published: January 2024

Introduction
Stroke survivors frequently deal with neuropsychiatric sequelae - depression, anxiety
and apathy being the most common ones. Pathological laughing and crying (PLC) is a post
stroke condition characterized by brief, intense uncontrollable crying and/or laughing due to
a neurological disorder. Prevalence of PLC post stroke has been reported to be 15-20%.
Pathological laughter (PL) is commonly associated with bilateral or diffuse cerebral lesions.
Ischemic injury involving the internal capsule and basal ganglia seems to be associated with
emotional disorders.

Objectives
To discuss an uncommon case of pathological laughter developing after recurrent
infarct.

Methods
A 32-year-old male patient presented to the medical emergency for complaints of
slurring of speech since 7 hours. On examination, patient was alert, oriented, with blood
pressure 150/90 mmHg. He had a history of similar stroke 2 years prior to current complaints
and was on treatment for hypertension since then.
Baseline investigations were done. MRI brain revealed acute lacunar
infarcts in bilateral ganglio-capsular region, chronic small vessel ischaemic
changes in B/L periventricular white matter (Fazeka grade 2) and micro-haemorrhages in
various brain regions. Patient was managed conservatively (antiplatelets, statins,
antihypertensives).
Patient was then referred to Psychiatry department for uncontrollable laughing spells,
which started few hours after onset of above complaints. These occurred without any
provocation, every 1-2 hours, lasting for several seconds to a minute, and relieved
spontaneously. Patient was aware of episodes and found them embarrassing socially. Mental
status examination revealed no mood features or other abnormalities.
Patient was prescribed Escitalopram, but shifted to homeopathic medicine and was lost
to follow up. Telephonic interview one year later revealed that while other complaints have
remitted, patient still has laughing spells of similar quality and frequency.

Results
Discussion: In post stroke PLC, pathological crying represents about 80% cases, while
Pure Pathological Laughing, as in the present case, is uncommon. It is generally seen in
diffuse CNS pathologies (eg. multiple sclerosis) or bilateral – ischaemic or
degenerative.
In case of strokes, PL may herald symptom onset, or may immediately follow focal
deficits. The aetiology of PLC is unknown; monoaminergic neurotransmission may be altered in
post stroke PLC. SSRIs are regarded as first choice treatment agents, given their greater
tolerability overall.

Conclusions
Pathological laughter is a comparatively uncommon but recognisable and treatable post
stroke sequela, more commonly seen in bilateral lesions. Patients often describe PL as
distressing and socially disabling, but awareness about this condition and available
treatments is lacking.

Disclosure of Interest
None Declared