bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the associations of gut microbiota with inflammatory and the early hematoma expansion in intracerebral hemorrhage: from change to potential therapeutic objectives
Authors: Jiang Haixiao , Zeng Wei , Zhu Fei , Zhang Xiaoli , Cao Demao , Peng Aijun , Wang Hongsheng 
Published: February 2025

BackgroundAlthough a great deal of research has explored the possibility of a systemic inflammatory response and dysbiosis of the gut microbiota after an intracerebral hemorrhage (ICH), the relationships between gut microbiota and blood inflammatory indicators as well as their role in the hematoma expansion following an early-stage mild-to-moderate ICH (emICH) remain unknown. This study analyzes these changes and associations in order to predict and prevent hematoma expansion after emICH.MethodsThe study included 100 participants, with 70 individuals diagnosed with emICH (30 with hematoma expansion and 40 without hematoma expansion, referred to as the HE and NE groups) and 30 healthy controls matched in terms of age and gender (HC). We used 16S rRNA gene sequencing to explore the gut microbial structure and its underlying associations with blood inflammatory parameters in the HE group.ResultsOur findings showed a significant decrease in the diversity and even distribution of microorganisms in the HE group when compared to the HC and NE groups. The composition of the gut microbiota experienced notable alterations in the emICH group, especially in HE. These changes included a rise in the number of gram-negative pro-inflammatory bacteria and a decline in the level of probiotics. Furthermore, we observed strong positive connections between bacteria enriched in the HE group and levels of systemic inflammation. Several microbial biomarkers (e.g. Escherichia_Shigella, Enterobacter, and Porphyromonas) were revealed in disparateiating HE from HC and NE. Analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) exposed disturbances in essential physiological pathways, especially those related to inflammation (such as the Toll-like receptor signaling pathway), in the HE group.ConclusionsOur exploration indicated that individuals with emICH, especially those with HE, demonstrate notably different host-microbe interactions when compared to healthy individuals. We deduced that emICH could rapidly trigger the dysbiosis of intestinal flora, and the disturbed microbiota could, in turn, exacerbate inflammatory response and increase the risk of hematoma expansion. Our comprehensive research revealed the potential of intestinal flora as a potent diagnostic tool, emphasizing its significance as a preventive target for HE.
Unusual hypertrophic cardiomyopathy: case report of an early onset wild-type ATTR amyloidosis accompanied by a chromosomal duplication involving the MYH6 and MYH7 gene
Authors: Hamidi Jassin , Hanel Yvonne , Dittmann Sven , Gerding Wanda Maria , Nguyen Huu Phuc , Klingel Karin , Schulze-Bahr Eric 
Published: February 2025

BackgroundHypertrophic cardiomyopathy (HCM) is characterized by an increased left ventricular (LV) wall thickness and LV mass. With an estimated prevalence of 1:200–500, HCM is among the most common genetically determined cardiac diseases. Functionally, enhanced tissue stiffness and reduced elasticity, combined with diastolic dysfunction and myocardial fibrosis, can eventually lead to life-threatening arrhythmias and impaired blood flow through the heart chamber. Typical symptoms associated with HCM include atrial fibrillation (AF), syncope, ventricular fibrillation, and cardiac arrest. At the molecular level, various genetic and/or non-genetic etiologies can lead to HCM.Case summaryIn this case, we report on a 60-year-old male patient with severe, progressive hypertrophic cardiomyopathy (HCM) in an uncommon and ambivalent setting. Right ventricular (RV) biopsy and multi-phase skeletal scintigraphy diagnosed transthyretin amyloidosis with cardiac involvement. Sanger sequencing of the transthyretin gene revealed a wild-type sequence. Phenotypically, the patient initially presented with syncopal episodes, atrioventricular (AV) block, and atrial fibrillation. Subsequently, bilateral carpal tunnel syndrome and polyneuropathy developed. However, the progressive and early onset of left ventricular hypertrophy did not align with the typical presentation of HCM in the context of ATTR. Therefore, next-generation sequencing (NGS) analysis revealed a rare chromosomal duplication in both cardiac myosin genes, MYH6 and MYH7. Consequently, two distinct and rare disease entities co-occurred in this patient, both ultimately leading to HCM.DiscussionTo date, no other case featuring wild-type transthyretin amyloidosis (wtATTR) concurrently with a chromosomal duplication affecting both cardiac myosin heavy chain genes has been reported in the literature. This highlights the extreme rarity of this condition, making it challenging to ascertain the extent to which a presumably mutated hybrid myosin gene construct or the TTR amyloid fibrils contribute to stiffness, tissue fibrosis, and cardiac dysfunction. Ultimately, both effects converged in this case, leading to the same cardiac disease with an exacerbated phenotypical outcome of hypertrophic cardiomyopathy (HCM). While early onset wtATTR is an uncommon clinical finding, another significant clinical condition was identified in this patient, marked by an unusual copy number variation (CNV) in the genes MYH6 and MYH7.
Association of pituitary neuroendocrine tumors and neurofibromatosis type 1: assessing causation versus coincidence. Case report
Authors: Aguilar-Soto Mercedes , Zuarth-Vázquez Julia M. , Leyva-Figueroa Laura , Zarco-Ávila Karla , Gamboa-Domínguez Armando , Eguiluz-Melendez Aldo , Hernández-Ramírez Laura C. 
Published: February 2025

IntroductionPatients with neurofibromatosis type 1 (NF1) are at risk for developing various neoplasms. Since the early twentieth century, multiple cases of pituitary neuroendocrine tumors (PitNETs) occurring in this context have been published. Yet, the role of NF1 (17q11.2) loss-of-function (LOF) variants in pituitary tumorigenesis remains unclear.AimWe report the clinical and molecular characterization of a case of PitNET diagnosed in a patient with NF1. We also review the available data for and against a causal association between NF1 defects and pituitary tumors.MethodsOur patient was recruited via an ongoing prospective study of individuals with neuroendocrine neoplasms. Genetic testing was carried out by means of targeted next generation sequencing (NGS) and Sanger sequencing in blood and tumor DNA, respectively. NF1 expression was analyzed via quantitative polymerase chain reaction (qPCR) in blood and tumor cDNA. Similar cases were searched in the literature.ResultsA 54-year-old-man was incidentally diagnosed with a clinically non-functioning PitNET via brain imaging. He had a personal and family history of NF1 and carried the germline pathogenic variant NF1 (NM_001042492.3): c.147C&gt;A, p.Y49*. Via transsphenoidal surgery, a 16 mm lesion was resected, showing strong granular cytoplasmic immunoreactivity with patchy distribution for NF1 and preserved heterozygosity for the NF1 defect. Additional NGS ruled out germline defects in PitNET-associated genes. By qPCR, NF1 was significantly overexpressed in the tumor when compared with another NF-PitNET, but not when compared with a corticotropinoma. We reviewed twenty-three case reports of PitNETs occurring in patients with either clinical NF1 without genetic study, individuals with NF1 germline variants with or without clinical NF1 or associated with somatic NF1 defects. Predominance of GH-secreting and large PitNETs, with young-onset in around half of the cases, were noticed. Two individuals developed multiple endocrine neoplasia-like phenotypes but tested negative for other relevant genetic defects.ConclusionsAlthough the association of NF1 and PitNETs could be coincidental, the clinical characteristics of the reviewed cases differ from those of typical incidentalomas. NF1 could drive pituitary tumorigenesis via haploinsufficiency, but this hypothesis requires further research. Additional clinical and molecular data from large cohorts of affected individuals should help clarify this question.
A U-shaped non-linear association between serum uric acid levels and the risk of Hashimoto’s thyroiditis: a cross-sectional study
Authors: Yan Manli , Shi Wenhua , Gong Ping , Xie Yunsi , Zhang Kaiyuan , Li Xiang , Wei Hua 
Published: February 2025

ObjectivePrevious studies have found that the relationship between metabolic indicators and Hashimoto’s thyroiditis (HT) in non-diabetic adults remains unclear. This study aims to explore the association between metabolic indicators and HT, providing new theoretical insights for the clinical management of HT.MethodsClinical data were collected from 2,015 non-diabetic adults at Guangdong Provincial Hospital of Chinese Medicine. The relationship between metabolic indicators and HT was analyzed using SPSS 26.0, R (version 4.2.1), and Zstats.ResultsAmong the 2,015 non-diabetic adult participants included in the study, 1,877 were in the non-HT group, while 138 were in the HT group. Significant differences were observed in metabolic indicators, including serum uric acid (SUA), serum creatinine (SCr), albumin (ALB) and high-density lipoprotein cholesterol (HDL-C), between the two groups, with statistical significance. A binary logistic regression model was established, revealing that SCr had a significant impact in both univariate and multivariate analyses. To further investigate the relationship between metabolic indicators and HT, we conducted a restricted cubic spline (RCS) analysis. The results demonstrated a clear non-linear relationship between SUA and HT, both before and after adjustment (All P &lt; 0.01). Therefore, based on the inflection points derived from the RCS analysis, a segmented logistic regression analysis was performed. The findings indicated a significant association between both low and high levels of SUA and HT (Lower OR: 2.043; 95% CI: 1.405-3.019; P &lt; 0.001; Higher OR: 2.369; 95% CI: 0.998-4.999; P = 0.034).ConclusionThis study is the first to reveal a U-shaped association between SUA levels and the risk of HT, suggesting that maintaining SUA levels within the range of 359.0-540.0 μmol/L may help reduce the risk of HT occurrence. This finding provides a new perspective for early intervention and long-term management of HT, particularly in terms of SUA regulation in HT patients, which holds potential clinical value.
COVID-19 in discharged patients with diabetes and chronic kidney disease: one-year follow-up and evaluation
Authors: Ran Enrong , Zou Yutong , Zhao Chuanyi , Liu Kai , Yuan Jiamin , Yang Wenjie , Zhao Lijun , Yang Qing , Yang Jia , Ju Xuegui , Cai Linli , Lang Yanlin , Li Xingyuan , Liu Ke , Liu Fang 
Published: February 2025

PurposeTo evaluate the all-cause mortality rate and renal outcomes in patients with diabetes and chronic kidney disease (CKD) following hospital discharge for COVID-19.MethodsThis single-center prospective observational study included 187 discharged COVID-19 patients with diabetes and CKD, admitted between December 2022 and January 2023 at West China Hospital, Sichuan University. Cox regression analysis was used to assess mortality risk, and logistic regression was applied to identify risk factors for rapid CKD progression after discharge.ResultsDuring the one-year follow-up, the all-cause mortality rate was 26.7%, with a COVID-19-related acute kidney injury (AKI) incidence of 35.3%, and 35.8% of patients experienced rapid CKD progression after discharge. Cox proportional hazards regression indicated that sepsis and mechanical ventilation were major risk factors for post-discharge all-cause mortality. Logistic regression identified baseline eGFR &lt; 60 mL/min/1.73 m² as an independent risk factor for rapid CKD progression.ConclusionsDuring the one-year follow-up period, we observed that patients with diabetes and CKD exhibited higher all-cause mortality and experienced rapid deterioration of kidney function after acute infection with COVID-19. This underscores the importance of ongoing longitudinal follow-up to more accurately track the long-term health effects of COVID-19 on patients with diabetes and CKD.
Dynamics of ecosystem service values in the Tarim River Basin
Authors: Sun Mengxin , Shen Xin , Xu Hailiang , Shajiang·Aili Ai 
Published: February 2025

IntroductionUnderstanding spatial and temporal variations in ecosystem service values (ESV) and their driving factors is essential for effective management and decision-making. This study focuses on the Tarim River Basin, specifically the Aksu, Yarkant, Hotan, and Kaidu Peacock Rivers, and the mainstream Tarim River, which flow through key administrative regions.MethodsWe analyzed multi-temporal land use and land cover (LULC) data from 2000, 2005, 2010, 2015, and 2020, applying the comparable coefficient method to assess ESV changes and their spatial distribution. Geospatial analysis was used to identify the key drivers of ESV and their interactions.Results(1) The land use pattern in the study area has remained stable, with fluctuations driven by government policies and climate change. Farmland expanded by over 10% from 2000 to 2015, but its growth slowed between 2015 and 2020 due to the “Grain for Green” policy. Built-up areas grew significantly between 2005 and 2010 but declined afterward due to stricter urban planning. Glaciers have reduced in area, though their meltwater contributed to the increase in water bodies and wetlands. (2) ESV increased by 99.34 billion, with grasslands and water bodies contributing 60% and 10%, respectively. ESV peaked in 2015 due to wetland and water body expansion, but declined as wetlands shrank and glaciers retreated. (3) Key natural drivers of ESV include vegetation health (NDVI), proximity to water bodies, and precipitation, while socioeconomic factors like GDP have grown in influence. Interactions between climate and socioeconomic development complicate the dynamics of land use and ESV.DiscussionThe results indicate that while government policies and climate change significantly influence land use and ESV in the Tarim River Basin, socioeconomic factors are increasingly impactful. The complex interactions between climate and socioeconomic development have important implications for ecosystem management and decision-making. This highlights the need to consider both natural and socioeconomic drivers in land use planning and ecosystem service management.
Long-acting family planning uptake and associated factors among women in the reproductive age group in East Africa: multilevel analysis
Authors: Enyew Ermias Bekele , Tareke Abiyu Abadi , Ngusie Habtamu Setegn , Kasaye Mulugeta Desalegn , Kebede Shimels Derso , Feyisa Mahider Shimelis 
Published: February 2025

IntroductionThe campaign to encourage sexually active women to utilize family planning is one of the primary initiatives being undertaken globally to reduce unintended pregnancies and fertility rates. Evidence suggests that family planning measures can lower this maternal mortality ratio by nearly 25%. According to our literature search, there is no known study that has reported on the study area to assess utilization and factors associated with the use of long-acting contraceptive methods (LACMs) among women of reproductive age. Therefore, this study aimed to assess long-acting contraceptive method uptake and its associated factors among women of reproductive age in East Africa.MethodsA weighted total of 50,525 women of reproductive age were included in this study. A community-based cross-sectional study was conducted on the most recent Demographic and Health Surveys in 12 East African countries. The pooled prevalence of long-acting contraceptive uptake with a 95% confidence interval (CI) was reported and presented in a forest plot for East African countries using STATA version 14.1. Intraclass correlation coefficient, likelihood ratio (LR) test, median odds ratio, and deviance (−2 log-likelihood) values were used for model comparison and fitness. Adjusted odds ratios (AOR) with a 95% CI and p-value ≤0.05 in the multilevel logistic model were used to declare significant factors associated with long-acting contraceptive uptake.ResultsThe overall prevalence of long-acting contraceptive methods in East African countries was 19.41% (95% CI 19.07%–19.76%). In the multilevel logistic regression analysis, women in the age group of 35–49 years (AOR 1.09, 95% CI 1.06–1.17), women who were married (AOR 1.31, 95% CI 1.10–1.56), and women who were exposed to media (AOR 1.06, 95% CI 1.00–1.13) were significantly associated with LACM uptake. Moreover, living in urban areas (AOR 1.23, 95% CI 1.14–1.32) and living in the highest household wealth index (AOR 1.09, 95% CI 1.01–1.17) were also significantly associated with long-acting contraceptive uptake.ConclusionThe overall utilization of acting contraceptive methods was low. Therefore, future interventions should be planned to target women in younger age groups, with lower socioeconomic backgrounds, and those living in rural areas to improve LACM uptake.
Transcriptome signature in the blood of neuromyelitis optica spectrum disorder under steroid tapering
Authors: Yamamura Ryohei , Kinoshita Makoto , Yasumizu Yoshiaki , Yata Tomohiro , Kihara Keigo , Motooka Daisuke , Shiraishi Naoyuki , Sugiyama Yasuko , Beppu Shohei , Murata Hisashi , Koizumi Naoshi , Sano Itsuki , Koda Toru , Okuno Tatsusada , Mochizuki Hideki 
Published: February 2025

BackgroundThe advent of biologics has significantly transformed treatment strategies for neuromyelitis optica spectrum disorder (NMOSD). However, there are no biomarkers that predict relapses associated with steroid tapering; therefore, it is critical to identify potential indicators of disease activity. In this study, we collected peripheral blood mononuclear cells (PBMCs) from NMOSD patients during steroid tapering and performed bulk RNA sequencing to analyze changes in immune dynamics caused by steroid reduction.MethodsPBMCs were collected at 3–5 timepoints from 10 NMOSD patients at our hospital (including one relapse case), and bulk RNA sequencing was performed. All patients were positive for anti-AQP4 antibodies and had no history of biologic use.ResultsIn one relapsed patient, gene groups with decreased expression at relapse were observed predominantly in monocytes, with upregulation in anti-inflammatory pathways such as IL-10, while the upregulated genes were related to interferon signaling. Moreover, after steroid tapering, in non-relapsed patients, genes with increased expression were enriched in inflammatory pathways, represented by interferon signaling, while genes with decreased expression were enriched in pathways related to IL-10 and glucocorticoid receptors. Weighted gene co-expression network analysis identified modules that correlated with steroid dosage, and the modules inversely correlated with steroid dosage were enriched in monocytes, with marked immune signature of interferon pathway.ConclusionThis study identified peripheral blood transcriptome signatures that could lead to the identification of clinically relevant NMOSD disease activity biomarkers, and further highlights the pivotal role of interferon and IL-10 signaling in NMOSD.
The prevalence and influencing factors of COVID-19 in pregnant women post-relaxation of epidemic control measures in Hunan Province, China
Authors: Wang Yingxia , Liu Yixu , Zou Kehan , Yang Min , Wu Yinglan , Xie Donghua 
Published: February 2025

ObjectiveTo investigate the epidemiological characteristics of COVID-19 in pregnant women after relaxation of epidemic control measures.MethodsThis cross-sectional study employed a multistage stratified sampling method, involving six sampling sites (districts/counties) of three cities (Zhuzhou, Chenzhou, and Huaihua) in Hunan Province, China. A questionnaire-based survey collected basic maternal information, COVID-19 infection status, and pregnancy-related information of the participants. Data were extracted and double checked for accuracy. Statistical analyses were conducted using SPSS 25.0 software.ResultsAmong the 7,761 pregnant women included in the study, 5,191 (66.9%) had a positive result of SARS-CoV-2 test or related symptoms. The majority of maternal infections were mild (90.0%), and a very small fraction were severe and critical (0.4% and 0.1 %). Headache and body aches (65.3%) were the most common symptoms. Of the 5,191 pregnant women with COVID-19, 4,150 (79.9%) had no complications during pregnancy. A total of 2,711 (52.2%) infected women had deliveries, and 449 (16.6%) newborns had infections. The impacts of COVID-19 on adverse pregnancy outcomes were limited. Logistic multivariable regression analysis showed that pregnant women with an education level of junior college and above (OR = 1.39, 95% CI: 1.18, 1.64), those with a monthly household income ≥ 3,000 yuan and above (OR = 1.18, 95% CI: 1.03, 1.34), those who lived with their family during family member infection (OR = 1.48, 95% CI: 1.32, 1.66), and those with pulmonary (OR = 1.41, 95% CI: 1.07, 1.85) or other (OR = 1.40, 95% CI: 1.19, 1.65) underlying diseases were more likely to have COVID-19. A farmer/worker occupation type (OR = 0.62, 95% CI: 0.48, 0.79) was a protective factor.ConclusionA high prevalence of COVID-19 in pregnant women following relaxation of control measures has been observed at provincial scale in China. Most cases were mild, and few effects on newborns were observed. Higher education and income, living with infected family members, and having pulmonary disease were identified as risk factors, suggesting that mobility is the most critical factor influencing infection rates. This study provides useful references for epidemic prevention and control in the future.
Comparative efficacy of sleep positional therapy, oral appliance therapy, and CPAP in obstructive sleep apnea: a meta-analysis of mean changes in key outcomes
Authors: Gao Yunjun , Zhu Sixiang , Li Wenjun , Lai Youqing 
Published: February 2025

BackgroundObstructive sleep apnea (OSA) is commonly treated with continuous positive airway pressure (CPAP), though many patients struggle with adherence. Sleep positional therapy (SPT) offers a potential alternative, especially for positional OSA (POSA). This study aimed to compare the efficacy and safety of SPT with CPAP, oral appliance therapy (OAT), and placebo.MethodsNineteen randomized controlled trials (RCTs) with 1,231 participants were included. Data extraction focused on changes in key outcomes such as apnea-hypopnea index (AHI), total sleep time (TST), oxygen desaturation index (ODI), and sleep architecture from pre- to post-intervention. Random-effects meta-analyses were conducted to compare mean changes between SPT and control groups (placebo, OAT, CPAP), with sensitivity analyses to assess heterogeneity.ResultsSleep positional therapy (SPT) showed a significant reduction in AHI in the supine position compared to placebo (MD = −7.46, 95% CI: −11.42, −3.49), although no difference was observed in overall AHI between SPT and placebo or OAT. Compared to CPAP, SPT was less effective in reducing AHI, with a trend toward greater reductions in AHI favoring CPAP. SPT demonstrated a significant improvement in arousal index compared to OAT (MD = −7.11, 95% CI: −10.52, −3.71) and a lower risk of device-related complications compared to both OAT (OR = 0.54, 95% CI: 0.31, 0.95) and CPAP (OR = 0.29, 95% CI: 0.12, 0.72). However, SPT did not lead to significant improvements in TST or oxygen saturation parameters across comparisons.ConclusionSleep positional therapy (SPT) is a safe alternative for managing positional OSA, particularly for patients intolerant to CPAP, though it remains less effective than CPAP in reducing overall AHI and improving oxygenation.