bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coexistence of muscle atrophy and high subcutaneous adipose tissue radiodensity predicts poor prognosis in hepatocellular carcinoma
Authors: Ohara Masatsugu , Suda Goki , Kohya Risako , Sasaki Takashi , Yoda Tomoka , Yoshida Sonoe , Fu Qingjie , Yang Zijian , Hosoda Shunichi , Maehara Osamu , Ohnishi Shunsuke , Tokuchi Yoshimasa , Kitagataya Takashi , Kawagishi Naoki , Nakai Masato , Sho Takuya , Natsuizaka Mitsuteru , Ogawa Koji , Sakamoto Naoya 
Published: October 2023

IntroductionWe aimed to assess the prognostic implications of muscle atrophy and high subcutaneous adipose tissue (SAT) radiodensity in patients with hepatocellular carcinoma (HCC).MethodsIn this retrospective study, muscle atrophy was assessed using the psoas muscle index (PMI) obtained from computed tomography. SAT radiodensity was evaluated based on radiodensity measurements. Survival and multivariate analyses were performed to identify factors associated with prognosis. The impact of muscle atrophy and high SAT radiodensity on prognosis was determined through survival analysis.ResultsA total of 201 patients (median age: 71 years; 76.6% male) with HCC were included. Liver cirrhosis was observed in 72.6% of patients, and the predominant Child–Pugh grade was A (77.1%). A total of 33.3% of patients exhibited muscle atrophy based on PMI values, whereas 12.9% had high SAT radiodensity. Kaplan–Meier survival analysis demonstrated that patients with muscle atrophy had significantly poorer prognosis than those without muscle atrophy. Patients with high SAT radiodensity had a significantly worse prognosis than those without it. Muscle atrophy, high SAT radiodensity, the Barcelona Clinic Liver Cancer class B, C, or D, and Child–Pugh score ≥ 6 were significantly associated with overall survival. Further classification of patients into four groups based on the presence or absence of muscle atrophy and high SAT radiodensity revealed that patients with both muscle atrophy and high SAT radiodensity had the poorest prognosis.ConclusionMuscle atrophy and high SAT radiodensity are significantly associated with poor prognosis in patients with HCC. Identifying this high-risk subgroup may facilitate the implementation of targeted interventions, including nutritional therapy and exercise, to potentially improve clinical outcomes.
The blood count as a compass to navigate in the ever-changing landscape of the carrier state of hemoglobinopathies: a single-center Italian experience
Authors: Marchesani Silvio , Di Mauro Margherita , Ceglie Giulia , Grassia Ginevra , Carletti Michaela , Cristofaro Rosa Carmela , Cossutta Matilde , Curcio Cristina , Palumbo Giuseppe 
Published: October 2023

IntroductionApproximately 7% of the worldwide population exhibits variations in the globin genes. The recent migration of populations from countries where hemoglobin disorders are endemic has resulted in important epidemiological changes with the diffusion of newly discovered or poorly characterized genetic variants and new combinations and very heterogeneous clinical phenotypes. The aim of our study is to assess the parameters that are more significant in predicting a positive genetic testing outcome for hemoglobinopathies in a pediatric population of patients presenting with anemia or microcythemia, without a definite diagnosis.Methods and materialsThis study included patients evaluated in our hematological outpatient clinic for anemia and/or microcythemia despite normal ferritin levels. A screening of pathological hemoglobins using high-performance liquid chromatography (HPLC) was performed for the entire population of the study. Subsequently, patients with hemoglobin (Hb) S trait and patients with an HPLC profile compatible with beta thalassemia trait were excluded from the study. Genetic screening tests for hemoglobinopathies were performed on the remaining patients, which involved measuring the red blood cell (RBC) counts, red blood cells distribution width (RDW), reticulocyte count, and mean corpuscular volume of reticulocytes (MCVr).ResultsThis study evaluated a total of 65 patients, consisting of nine patients with negative genetic analysis results and 56 patients with positive genetic analysis results. The Hb and RDW values in these two groups did not demonstrate statistical significance. On the other hand, there were statistically significant differences observed in the mean corpuscular volume (MCV), RBC count, reticulocyte count, and MCVr between the two groups. Furthermore, in the group of patients with positive genetic test results, specific genetic findings associated with different HPLC results were observed. In particular, 13 patients with positive genetic test results had normal HPLC findings.DiscussionThis study has demonstrated that HPLC, while serving as a valuable first-level test, has some limitations. Specifically, it has been observed that some patients may exhibit a negative HPLC result despite a positive genetic analysis. In addition to the presence of low levels of Hb and HPLC alterations, other parameters could potentially indicate the underlying mutations in the globin genes. Therefore, we propose that the complete blood cell count be utilized as a widely available parameter for conducting targeted genetic analyses to avoid the risk of overlooking rare hemoglobinopathies.
Genetic risk variants for childhood nephrotic syndrome and corticosteroid response
Authors: Cason Rachel K. , Chambers Eileen , Tu Tiffany , Chryst-Stangl Megan , Huggins Kinsie , Lane Brandon M. , Ochoa Alejandro , Jackson Annette M. , Gbadegesin Rasheed A. 
Published: October 2023

IntroductionThe etiology of most cases of nephrotic syndrome (NS) remains unknown, therefore patients are phenotypically categorized based on response to corticosteroid therapy as steroid sensitive NS (SSNS), or steroid resistant NS (SRNS). Genetic risk factors have been identified for SSNS from unbiased genome-wide association studies (GWAS), however it is unclear if these loci are disease risk loci in other forms of NS such as SRNS. Additionally, it remains unknown if these risk loci are associated with response to therapy. Thus, we investigated the association between SSNS risk loci and therapy response in a large, multi-race cohort of children along the entire spectrum of childhood-onset NS.MethodsWe enrolled 1,000 patients with childhood-onset NS comprised of SSNS and SRNS. Genotyping was done using TaqMan and Direct Sanger Sequencing for 9 previously reported childhood SSNS risk loci. We compared the allele frequencies (AF) and variant burden between NS vs. controls and SRNS vs. SSNS.ResultsAll 9 risk loci were associated with NS compared with healthy controls (p = 3.5 × 10−3–&lt;2.2 × 10−16). Variant burden greater than 7 was associated with risk of SRNS (OR 7.4, 95% CI 4.6–12.0, p = 8.2 × 10−16).ConclusionOur study showed that genetic risk loci for childhood SSNS are associated with pattern of therapy response, may help predict disease outcome, and set the stage for individualized treatment of NS.
Clinical features of febrile seizures in children with COVID-19: an observational study from a tertiary care hospital in China
Authors: Fang Cuiyun , Zhou Yuan , Fan Wei , Zhang Chunsheng , Yang Yi 
Published: October 2023

BackgroundFebrile seizures are a common neurologic manifestation in children with coronavirus disease 2019 (COVID-19). Compared to seasonal respiratory viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a pronounced neurological impact, with the result that febrile seizures with COVID-19 may exhibit unique clinical features.Materials and methodsWe conducted a retrospective study in a tertiary care hospital in China. We collected medical record information on febrile seizures with COVID-19, including demographic characteristics, clinical features, laboratory tests, and disease burden. Subsequently, the data were then analyzed descriptively.ResultsA total of 103 children diagnosed with febrile seizures and positive COVID-19 PCR results were included in our study. Among them, 81 (78.6%) were males and 22 (21.4%) were females. The age of onset of febrile seizures ranged from 14 to 57 months, with a mean age of 34.9 ± 6.24 months. Complex febrile seizures were observed in 34 (33%) cases. Antiseizure medications were administered to 24 (23.3%) patients. Laboratory tests showed a white blood cell count of (27.05 ± 8.20) × 103/µl, a neutrophil count of (20.09 ± 5.66) × 103/µl and a lymphocyte count of (6.44 ± 1.86) × 103/µl. A creatine kinase level was significantly elevated, with a mean value of (412.00 ± 158.96) U/L. The mean length of stay was 4.36 days. Twelve patients (11.7%) required intensive care services, but there were no deaths or patients remaining on antiseizure medications after discharge.ConclusionIn the post-epidemic era of COVID-19, pediatric clinicians should be aware of the changing clinical features of febrile seizures associated with COVID-19. The average age of onset has increased, with a higher proportion of males. Length of stay and hospitalization costs did not increase significantly. The prognosis remained favorable, although a small number of children required intensive care services during the acute phase.
Cortical oxygen extraction fraction using quantitative BOLD MRI and cerebral blood flow during vasodilation
Authors: Le Linh N. N. , Wheeler Gregory J. , Holy Emily N. , Donnay Corinne A. , Blockley Nicholas P. , Yee Alan H. , Ng Kwan L. , Fan Audrey P. 
Published: October 2023

Introduction: We aimed to demonstrate non-invasive measurements of regional oxygen extraction fraction (OEF) from quantitative BOLD MRI modeling at baseline and after pharmacological vasodilation. We hypothesized that OEF decreases in response to vasodilation with acetazolamide (ACZ) in healthy conditions, reflecting compensation in regions with increased cerebral blood flow (CBF), while cerebral metabolic rate of oxygen (CMRO2) remained unchanged. We also aimed to assess the relationship between OEF and perfusion in the default mode network (DMN) regions that have shown associations with vascular risk factors and cerebrovascular reactivity in different neurological conditions.Material and methods: Eight healthy subjects (47 ± 13 years, 6 female) were scanned on a 3 T scanner with a 32-channel head coil before and after administration of 15 mg/kg ACZ as a pharmacological vasodilator. The MR imaging acquisition protocols included: 1) A Gradient Echo Slice Excitation Profile Imaging Asymmetric Spin Echo scan to quantify OEF, deoxygenated blood volume, and reversible transverse relaxation rate (R2’) and 2) a multi-post labeling delay arterial spin labeling scan to measure CBF. To assess changes in each parameter due to vasodilation, two-way t-tests were performed for all pairs (baseline versus vasodilation) in the DMN brain regions with Bonferroni correction for multiple comparisons. The relationships between CBF versus OEF and CBF versus R2’ were analyzed and compared across DMN regions using linear, mixed-effect models.Results: During vasodilation, CBF significantly increased in the medial frontal cortex (P=0.004), posterior cingulate gyrus (pCG) (P=0.004), precuneus cortex (PCun) (P=0.004), and occipital pole (P=0.001). Concurrently, a significant decrease in OEF was observed only in the pCG (8.8%, P=0.003) and PCun (8.7%,P=0.001). CMRO2 showed a trend of increased values after vasodilation, but these differences were not significant after correction for multiple comparisons. Although R2’ showed a slightly decreasing trend, no statistically significant changes were found in any regions in response to ACZ. The CBF response to ACZ exhibited a stronger negative correlation with OEF (β=−0.104±0.027; t=−3.852,P<0.001), than with R2’ (β=−0.016±0.006; t=−2.692,P=0.008).Conclusion: Quantitative BOLD modeling can reliably measure OEF across multiple physiological conditions and captures vascular changes with higher sensitivity than R2’ values. The inverse correlation between OEF and CBF across regions in DMN, suggests that these two measurements, in response to ACZ vasodilation, are reliable indicators of tissue health in this healthy cohort.
Responses of community traits and soil characteristics of Achnatherum inebrians-type degraded grassland to grazing systems in alpine meadows on the Qinghai-Tibet Plateau
Authors: Chen Yanzhu , Xu Changlin , Ma Kaikai , Hou Qingqing , Yu Xiaojun 
Published: October 2023

IntroductionScientific grazing management is of great significance for the ecological health and sustainable use of alpine meadows.MethodsTo explore appropriate management methods of alpine grasslands of the Qinghai-Tibet Plateau degraded by Achnatherum inebrians (Hance) Keng ex Tzvele presence, we studied the effects of different grazing systems on the A. inebrians population, grassland vegetation community traits, soil characteristics and soil microbial community structure for cold- season grazing plus supplementary feeding pasture (CSF) and four-season open public pasture (FOP) in Tianzhu County, Gansu Province.ResultsCompared with FOP, the CSF site showed significantly inhibited reproduction of A. inebrians, especially the crown width, seed yield and number of reproductive branches per plant were as high as 50%, significantly increased the aboveground biomass of edible forage and soil water content by 57% and 43–55%, better soil nutrients, and significantly reduced soil bulk density by 10– 29%. Different grazing systems affected the composition and diversity of soil microbial communities, with a greater effect on fungi than on bacterial flora. The most abundant phyla of bacteria and fungi were Proteobacteria and Ascomycota for CSF (by 30–38% and 24–28%) and for FOP (by 67–70% and 68–73%), and the relative abundance and species of bacterial and fungal genera were greater for CSF than FOP. The α-diversity indexes of fungi were improved, and the β-diversity of fungi was significant difference between CSF and FOP. However, the grazing utilization time was prolonged in FOP, which reduced the diversity and abundance of soil bacteria and increased soil spatial heterogeneity. The use of A. inebrians-type degraded grassland in the cold season, and as a winter supplementary feeding and resting ground, could effectively inhibit expansion of A. inebrians, promote edible forage growth, enhance grassland productivity and community stability, and improve soil structure. DiscussionThe results guide healthy and sustainable utilization of A. inebrians-type degraded grassland in the Qinghai-Tibet Plateau.
Paliperidone long-acting injection in the treatment of an adolescent with schizophrenia with fluctuating mental symptoms during menstrual period: a case report
Authors: Wang Feng , Chen Juan , Guo Linglin , Li Zhixiong , Li Zhe 
Published: October 2023

BackgroundThe treatment of schizophrenia, a chronic disabling psychiatric disorder, mainly relies on antipsychotics to control the disease and improve clinical symptoms. Various medication options are available, and differences in treatment effects, even for the same medication, have been noted. Treatment efficacy is correlated with the patient’s sex, age, and physical condition. When a drug fails to achieve the desired effect or the symptoms are unstable, the drug dose is often increased or a change in medication is advised according to the patient’s situation.Case presentationWe report the case of a 16 years-old girl with schizophrenia and apparent psychotic symptoms. According to the genetic testing results, the symptoms were effectively controlled, and she was discharged from the hospital with the prescription of paliperidone sustained-release tablets. During the follow-up, her symptoms fluctuated during menstrual period, causing her great distress. Furthermore, her compliance gradually declined during the following 2 years of treatment, and the medication was often discontinued. We changed the drug from an oral tablet to an injection preparation while maintaining the active ingredients of the drug. The patient’s symptoms were significantly controlled, and no fluctuation of symptoms occurred during the menstrual cycle.ConclusionLong-acting antipsychotic injections can be administered to female adolescents with schizophrenia who experience fluctuating psychotic symptoms during menstruation. This technique can ensure both consistency of medication and improvement in clinical symptoms.
“I am Young, Why Should I Vaccinate?” How empathetic and aggressive communication on social media impact young adults’ attitudes toward COVID-19 vaccination
Authors: Kaňková Jaroslava , Saumer Melanie , Neureiter Ariadne , Darovskikh Sofia , Shargina Elena , Matthes Jörg 
Published: October 2023

IntroductionTo combat the current COVID-19 pandemic, high vaccination rates are of crucial value. However, young people in particular tend to be hesitant toward vaccination. On social media, young adults are often called to vaccinate in an aggressive tone, arguing that there is no choice than to vaccinate and that all else is wrong.MethodsIn an experimental study (N = 410), we investigated the effects of (a) empathetic vs. aggressive communication styles in social media postings and (b) the origin of the communicator on young adults’ supportive attitudes toward COVID-19 vaccinations. We treated the gender of the communicator as a moderator, and expectancy violation, psychological distance as well as the perceived credibility of the communicator as mediators.ResultsFindings showed that an aggressive communication style generally had a negative impact on young adults’ COVID-19 vaccination attitudes, fully mediated by expectancy violation and perceived credibility of the communicator. Gender and the origin of the communicator did not moderate this mediation processes.DiscussionFurther implications for online health communication strategies are discussed.
Improving weekend handover in a teaching hospital elective general surgery department
Authors: Dexter Eloise , Walshaw Josephine , Brown Ayla , Nadeem Tehmina , Yiasemidou Marina , Lo Terence 
Published: October 2023

BackgroundEffective documentation and transfer of clinical information are vital for the continuity of care, patient safety, and maintaining medico-legal records, as outlined by the Royal College of Surgeons “Safe Handover: Guidance from the Working Time Directive working party”. Our elective surgery weekend team cross-covers both Colorectal and Upper Gastrointestinal surgical specialties across multiple wards, which poses a significant challenge. The aim of this study was to improve the documentation of patients' weekend plans through the introduction of a weekend handover proforma.MethodWe reviewed the weekend plans of 199 patients overall. 41 records were initially reviewed over a 2-week period. The surgical multidisciplinary team was then surveyed to establish the need for an improved weekend handover. Following this, a weekend handover proforma was introduced as part of the Friday ward round and education on the expectations were provided at a local Surgery Clinical Governance meeting. The documentation of the weekend plan was reviewed for 158 patients over a 6-week period and a post-intervention survey was disseminated.ResultsThe preliminary survey highlighted concerns for delayed discharges and patient safety over the weekend, with 88.2% of respondents agreeing a weekend handover proforma would be beneficial. The initial data confirmed inadequate documentation of diagnosis (19.5%), operation/procedure (28.1%), and weekend plans for blood tests (19.5%), discharge planning (2.4%), diet (46.3%), antibiotics (19.5%), intravenous (IV) fluids (22.0%), mobility (19.5%) and drain/wound care (37.5%). After education and implementing a weekend handover proforma, these results increased for documentation of diagnosis (61.2%), operation/procedure (83.2%), blood tests (59.7%), and discharge planning (85.8%). However, there was little improvement in diet (53.0%) and no improvement in the weekend plans for antibiotics (14.2%), IV fluids (17.2%), mobility (14.9%) and drain/wound care (20.2%). The post-intervention survey showed an improvement across all areas, notably continuity of care and patient safety, with 95.5% of individuals finding the weekend handover proforma aided in patient care over the weekend.ConclusionEducation of the ward team and implementation of a weekend handover proforma resulted in a marked improvement in the documentation of patients' weekend plans, which is essential to ensure the continuation of safe and effective patient care.
Exploring the Antibacterial Potential of Konjac Glucomannan in Periodontitis: Animal and In Vitro Studies
Authors: Lestari Kartika Dhipta , Dwiputri Edlyn , Kurniawan Tan Geraldi Hartono , Sulijaya Benso , Soeroso Yuniarti , Natalina Natalina , Harsas Nadhia Anindhita , Takahashi Naoki 
Published: October 2023

Background and Objectives: Periodontitis is an inflammatory disease in the supporting tissues of the teeth caused by specific microorganisms or groups of microorganisms. P. gingivalis bacterium is the keystone pathogen in periodontitis, so even at low concentrations, it has a considerable influence on the oral community. Antimicrobials and antiplaque agents can be used as adjunctive therapy for periodontitis treatment. Konjac glucomannan (KGM), as a natural polysaccharide, has flavonoid (3,5-diacetyltambulin) and triterpenoids (ambylon) compounds that show antibacterial activity. This research aims to analyze the antibacterial activity of KGM on animal and in vitro periodontitis models. Materials and Methods: The animal study divided 48 mice into four groups (control, KGM, periodontitis, KGM + periodontitis). Mice were given an intervention substance by oral gavage from day 1 to day 14, periodontitis was induced on day 7, and decapitation was performed on day 14. Samples from the right maxillary jaw of mice were used for histological preparations and morphometrics analysis. In vitro studies were carried out by adding several concentrations of KGM (25, 50, and 100 μg/mL) into a planktonic P. gingivalis and P. gingivalis biofilm. Results: In the animal model, KGM could prevent alveolar bone loss in the periodontitis mice model, both in histologic and morphometrics assessments. In vitro, KGM had antibacterial activity against P. gingivalis with better bacteriostatic (15–23%) than bactericidal (11–20%) ability, proven by its ability to inhibit P. gingivalis proliferation. Conclusions: KGM can be considered to have the potential as an antibacterial agent to prevent periodontitis. The prevention of periodontitis may improve patient well-being and human quality of life.