bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary calcium intake in primary hyperparathyroidism and in its normocalcemic variant: a case-control study
Authors: Bisceglia Nicolò , Malagrinò Matteo , Piazza Anna , Vandi Giulia , Repaci Andrea , Pagotto Uberto , Zavatta Guido 
Published: February 2025

IntroductionNormocalcemic primary hyperparathyroidism (NHPT) is considered to be an early stage in the evolution of primary hyperparathyroidism (PHPT). To formulate a correct diagnosis, secondary hyperparathyroidism due to low calcium intake must be excluded. Whether dietary calcium intake might affect the clinical presentation of PHPT or NHPT has never been addressed consistently.ObjectiveTo describe patients with a diagnosis of NHPT or PHPT in relation to their calcium intake, through three standard validated questionnaires; to describe clinical, biochemical and radiological features of NHPT and PHPT patients compared to each other and to a control group.DesignCross-sectional study.SettingOutpatient, single academic medical center.Patients109 consecutive women recruited from February 2021 through April 2023. 54 patients with mild primary hyperparathyroidism (PHPT or NHPT) were age-matched with 55 unselected women undergoing bone density test screening due to recently diagnosed hormone-positive breast cancer. NHPT diagnosis was based on multiple determinations of both total and albumin-corrected serum calcium.InterventionsAdministration of all the following during routine endocrine consultation: a country-specific food-frequency questionnaire (LOC), the International Osteoporosis Foundation Calcium Calculator (IOF) and the National Osteoporosis Foundation calcium questionnaire (NOF).Main outcome measuresAny association between dietary calcium intake and clinical, radiological, or biochemical features.ResultsAll three questionnaires confirmed that NHPT patients had similar calcium intake as those with PHPT or controls. Biochemistries and bone turnover markers were similar between the two variants of hyperparathyroidism, except for serum calcium (sCa). NHPT patients had a significantly lower BMD and T-score at one-third distal radius compared to PHPT, while the prevalence of nephrolithiasis and clinical fractures were similar. Multivariate analysis investigating predictors of serum calcium showed that age, eGFR, calcium intake and 25(OH)D did not significantly affect serum calcium, while multivariate analysis investigating predictors of PTH (age, variant NHPT vs. PHPT, eGFR, calcium intake, 25(OH)D, cholecalciferol supplements) showed that calcium intake, variant and renal function, significantly influenced PTH levels.ConclusionsAll patients with primary hyperparathyroidism, particularly those with low dietary calcium intake, should be advised not to restrict dietary calcium to prevent further increase in PTH levels. Whether maintaining adequate calcium intake might positively impact bone density or biochemistries in patients refraining from surgery, should be addressed in longitudinal studies.
Gestational diabetes mellitus in previous pregnancy associated with the risk of large for gestational age and macrosomia in the second pregnancy
Authors: Wang Ying , Yang Juan , Liu Yuzhen , Yang Ao , Deng Yuqing , Xu Chang , Zhong Shilin 
Published: February 2025

BackgroundSince the implementation of China’s new birth policy, the incidence of large for gestational age (LGA) and macrosomia associated with gestational diabetes mellitus (GDM) has increased. It remains unclear whether a history of GDM in a previous pregnancy raises the risk of LGA or macrosomia in Chinese women planning two or more pregnancies.AimTo analyze the association between previous GDM and the risk of LGA and macrosomia in second pregnancy.MethodA retrospective study was conducted on a cohort of 3,131 women who had experienced two consecutive singleton births. The incidences of LGA and macrosomia in the second pregnancy were compared between women with and without previous GDM. The relationship between previous GDM and the occurrence of LGA and macrosomia was analyzed using multivariate logistic regression and stratified analysis.ResultsThe incidence of LGA and macrosomia during the second pregnancy was significantly higher in women with previous GDM (22.67% and 10.25%, respectively) compared to those without prior GDM (15.34% and 5.06%, respectively) (P &lt; 0.05). After adjusting for potential confounders, previous GDM was significantly associated with LGA (aOR: 1.511, 95% CI: 1.066-2.143) and macrosomia (aOR: 1.854, 95% CI: 1.118-3.076) in the second pregnancy. Stratified analysis revealed that these associations were present only in women without previous LGA, those with GDM, appropriate gestational weight gain (AGWG), non-advanced maternal age, and male newborns during the second pregnancy (P &lt; 0.05). Compared to excessive GWG (EGWG), AGWG correlated with lower risks for LGA and macrosomia during the second pregnancy in women without prior GDM, an association not observed in those with previous GDM. Among women without previous GDM, if the pre-pregnancy BMI is normal, the risk of LGA and macrosomia is significant lower in AGWG compared with EGWG (P&lt; 0.001), while this difference was no significant among women with prior GDM (P&gt;0.05).ConclusionPrevious GDM is strongly linked to LGA and macrosomia in subsequent pregnancies. However, this relationship is influenced by GWG, prior LGA history, fetal sex, and maternal age. Managing weight alone may not sufficiently reduce the risk of LGA or macrosomia for women with a history of GDM.
Large-scale analysis highlights obesity as a risk factor for chronic, non-communicable inflammatory diseases
Authors: Mousavi Sadegh , Bieber Katja , Zirpel Henner , Vorobyev Artem , Olbrich Henning , Papara Cristian , De Luca David A. , Thaci Diamant , Schmidt Enno , Riemekasten Gabriele , Lamprecht Peter , Laudes Matthias , Kridin Khalaf , Ludwig Ralf J. 
Published: February 2025

BackgroundOverweight and obesity are a global pandemic, contributing to death and disability-adjusted life-years. Obesity is a major factor in the onset of chronic inflammatory diseases (CIDs). Yet, several knowledge gaps remain: For several CIDs, inconsistent results have been reported, relating to their obesity-imposed risk, data on most rare CIDs remain unavailable, sex differences and racial disparities remain mostly unaddressed.MethodsA large-scale cohort study compared the risk of developing 46 CIDs in individuals with overweight/obesity (n=3,101,824) to an equal number of non-overweight/obese individuals. Propensity score matching optimized between-group comparability, and sensitivity analyses assessed study robustness.ResultsThe risk of developing any CID was 28.48% in overweight/obese individuals versus 17.55% in non-overweight/obese controls, with a hazard ratio (95%-confidence interval) of 1.52 (1.509-1.521, p&lt;0.0001). This risk was consistent across all sensitivity, sex-, and race-stratified analyses. Overweight and obesity were associated with an increased risk for 24 of 46 CIDs in the primary analysis and all sensitivity analyses. For 12 diseases, increased risks were confirmed to one of the two sensitivity analyses, while for 10 diseases, results were discordant. No increased risk was observed for one disease. In sex-stratified analysis, overweight and obesity posed a more pronounced risk for four CIDs in female individuals. In race-stratified analysis, overweight and obesity were linked to a higher risk for seven CIDs in White individuals and to one CID in “Black or African American” individuals.ConclusionOverweight and obesity increase the risk for the majority of CIDs in a sex- and race-specific manner.
Integrated analysis of M2 macrophage-related gene prognostic model and single-cell sequence to predict immunotherapy response in lung adenocarcinoma
Authors: Li Meifang , Wang Zhiping , Huang Bin , Lai Yanyun , Zhang Meng , Lin Cheng 
Published: February 2025

BackgroundLung adenocarcinoma (LUAD) patients have high heterogeneity. The significance and clinical value of M2 macrophage-related genes in LUAD require further exploration. We aimed to construct a prognostic signature to predict the immunotherapy efficacy and prognosis in LUAD.MethodsGSE26939 and GSE19188 chips were downloaded from the Gene Expression Omnibus (GEO). Weighted gene co-expression network analysis (WGCNA) and least absolute shrinkage and selection operator (LASSO) analysis were used to screen M2 macrophage-related prognostic genes. A signature based on M2 macrophage-related prognostic genes was established and used to predict the prognosis and immunotherapy efficacy in LUAD.ResultsTwenty-two M2 macrophage-related genes associated with the prognosis of LUAD were confirmed using WGCNA, and then two molecular subtypes were identified with significantly different survival, gene expressions, and clinic characteristics were classified. LASSO analysis identified nine M2 macrophage-related prognostic genes to establish a risk signature, classifying patients into low- and high-risk groups. Data indicated that low-risk patients had better survival. Moreover, the signature was an independent prognostic factor for LUAD and a potential biomarker for patients receiving immunotherapy. Single-cell transcriptome analysis may provide important information on molecular subtypes and heterogeneity.ConclusionRisk signature based on M2 macrophage-related genes is a valuable tool for predicting prognosis and immunotherapy response in patients with LUAD.
Health care provider's perceived factors for the increased practice of caesarean delivery in North West Amhara referral hospitals, Ethiopia, 2022: a qualitative study
Authors: Ayele Mulat , Berta Marta , Zewudie Amare , Shitie Lake Eyob , Yilak Gizachew , Tilahun Befkad Derese , Aklil Mastewal Belayneh 
Published: February 2025

BackgroundCaesarean delivery is an essential obstetric intervention to reduce maternal and newborn mortality in emergencies. However, in Ethiopia, there is a high prevalence of caesarean deliveries. Therefore, this study aimed to explore the factors perceived by healthcare providers that contribute to the excessive rates of caesarean deliveries in North West Amhara referral hospitals, Ethiopia, in 2022.MethodsA phenomenological study design was employed, utilizing semi-structured interview guide for data collection. Fifteen healthcare providers working in referral hospitals in the north-western region of Amhara were interviewed using a heterogeneous purposive sampling approach until data was saturated. Transcribed interviews were translated coded and finally thematic analyses were employed using Open Code 4.0 software.ResultsHealthcare providers observed a significant increase in the frequency of caesarean deliveries. Multiple factors were identified as contributing to this rise, including the involvement of medical students, the use of cardiotocography, a decline in instrumental deliveries, inadequate trial of labor after previous caesarean deliveries, and the absence of clear indications for performing caesarean deliveries for social or maternal requests. Notably, patients who had received care in private clinics were more likely to undergo caesarean deliveries.ConclusionCaesarean deliveries were observed to be performed based on subjective or approximate indications, rather than clear obstetric indications. Encouraging greater emphasis on trial of labor, instrumental delivery, and performing caesarean deliveries only when there are definitive obstetric indications, rather than for social or maternal requests, can contribute to reducing the prevalence of caesarean delivery rates.
An integrative analysis of ASCL1 in breast cancer and inhibition of ASCL1 increases paclitaxel sensitivity by activating ferroptosis via the CREB1/GPX4 axis
Authors: Yang Xiaolu , Li Yilun , Peng Yaqi , Chang Yuan , He Binglu , Zhang Tianqi , Zhang Shiyu , Geng Cuizhi , Liu Yunjiang , Li Xiaolong , Hao Jun , Ma Li 
Published: February 2025

ObjectiveOur previous study found that Achaete-scute complex homolog 1 (ASCL1) is involved in classifying BC subtypes with different prognostic and pathological characteristics. However, the biological role of ASCL1 in BC still remains largely unexplored. This study aims to elucidate the function of ASCL1 in BC using bioinformatics analyses, as well as in vitro and in vivo experimental approaches.MethodsData from the TCGA, GEO, and Human Protein Atlas databases were utilized to evaluate ASCL1 expression in BC and its association with patient prognosis. Genetic alterations in ASCL1 were assessed through the COSMIC and cBioPortal databases, while the TIMER2.0 database provided insights into the relationship between ASCL1 expression and key gene mutations in BC. The GDSC database was used to examine correlations between ASCL1 levels and sensitivity to standard chemotherapeutic agents. Associations between ASCL1 expression and cytokines, immunomodulatory factors, MHC molecules, and receptors were analyzed using Pearson and Spearman correlation methods. The TIP database was employed to investigate the connection between ASCL1 expression and immunoreactivity scores, and six computational approaches were applied to evaluate immune cell infiltration. Functional assays were conducted on BC cell lines MCF-7 and MDA-MB-231, and nude mouse models were used for in vivo studies.ResultsASCL1 was found to be upregulated in BC and correlated with unfavorable prognosis and mutations in key oncogenes. Its expression was linked to immunomodulatory factors, immune cell infiltration, and immunoreactivity scores in the tumor microenvironment. Additionally, ASCL1 influenced tumor immune dynamics and chemosensitivity in BC. Overexpression of ASCL1 enhanced BC cell proliferation, migration and invasion, while its knockdown had the opposite effect. Notably, inhibition of ASCL1 increased BC cell sensitivity to paclitaxel both in vitro and in vivo. In addition, inhibition of ASCL1 activated ferroptosis in BC, including altered mitochondrial morphology, increased MDA and ROS levels, decreased GSH levels and reduced GSH/GSSG ratio. Mechanistically, inhibition of ASCL1 decreases the phosphorylation of CREB1, thus reducing the expression of GPX4. In summary, inhibition of ASCL1 increases paclitaxel sensitivity by activating ferroptosis via the CREB1/GPX4 axis.ConclusionsASCL1 exerts oncogenic effects in BC and represents a potential therapeutic target for intervention.
Introduction of Panax notoginseng into pine forests significantly enhances the diversity, stochastic processes, and network complexity of nitrogen-fixing bacteria in the soil
Authors: Zhao Xiaoyan , He Shu , Rui Rui , Hei Jingying , He Xiahong , Wang Shu 
Published: February 2025

IntroductionNitrogen-fixing bacteria (NFB) have a pivotal impact on the nitrogen cycle within agroforestry systems. The organic management of the Panax notoginseng (sanqi)-Pinus armandii agroforestry (SPA) system resulted in nitrogen deficiency because of the lack of application of chemical fertilizers. Therefore, assessing the variability in NFB due to the cultivation of sanqi in the SPA system becomes crucial.MethodsThe seasonal dynamics in the abundance, diversity, and community structure of NFB in the soil of monocropping pine (MP) and SPA systems were assessed using real-time quantitative polymerase chain reaction and high-throughput sequencing technology.Results and discussionSanqi cultivation triggered a decrease in the abundance of NFB but increased α diversity. Additionally, significant differences in the community structure of NFB were noted between the MP and SPA systems. Moreover, the abundance of Bradyrhizobium and Azospirillum increased in the soil after sanqi was cultivated. Furthermore, the cultivation of sanqi broadened the ecological niche breadth of NFB and increased the stochasticity in its community structure assembly (i.e., dispersal limitation). Additionally, the SPA system increased the network complexity but not the stability of NFB. The structural equation model (SEM) revealed that pH directly impacted the network complexity and stability of NFB in the SPA system. Sanqi cultivation positively influences the community characteristics of NFB in the soil in the SPA system. Our study provides new insights into nitrogen cycling and utilization in the SPA system.
The inhibitory effect of intraspinal microstimulation of the sacral spinal cord on nonlinear bladder reflex dynamics in cats
Authors: Qasemi Amirhossein , Aminian Alireza , Erfanian Abbas 
Published: February 2025

ObjectiveElectrical stimulation of the pudendal nerve, pelvic nerve, sacral dorsal root ganglion (DRG), and spinal cord has been explored to treat urinary incontinence and overactive bladder (OAB). This study introduces sacral intraspinal microstimulation (ISMS) as a novel method to inhibit spontaneous bladder reflexes in anesthetized cats. In addition, we investigated the effects of intermittent and switching stimulation patterns on bladder inhibition.MethodsThe electrode was implanted in the dorsal horn of the S2 spinal cord. Bladder pressure was recorded under isovolumetric conditions, and the stimulation parameters were adjusted to inhibit spontaneous bladder contractions. Nonlinear dynamic methods, including chaos theory, were employed to analyze the complexity of bladder reflexes.ResultsResults demonstrated that ISMS targeting the dorsal horn of the S2 spinal segment effectively suppressed high-amplitude spontaneous contractions. Furthermore, bladder reflexes exhibited complex dynamics, ranging from regular to chaotic patterns, with transitions between these states. Importantly, ISMS was able to stabilize these chaotic dynamics, leading to more controlled bladder behavior.ConclusionThese findings suggest that sacral ISMS offers a promising, targeted alternative to traditional stimulation therapies, potentially providing a new therapeutic approach for managing OAB and urinary incontinence by regulating chaotic bladder activity.
Association of a novel nutritional index with cognitive impairment in middle-aged and elderly Chinese adults: a cross-sectional analysis from the China Health and Retirement Longitudinal Study
Authors: Liu Guotao , Zhang Jianyuan 
Published: February 2025

PurposeThe triglyceride-cholesterol-body weight index (TCBI), a novel and easily computable nutritional index, incorporates serum triglyceride (TG), total cholesterol (TC), and body weight (BW). This study explored the association between TCBI and cognitive impairment in middle-aged and elderly Chinese populations.Patients and methodsThis cross-sectional study employed data from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey, including 7,145 participants. TCBI was calculated as TG (mg/dL) × TC (mg/dL) × BW (kg)/1,000. Cognitive function was assessed based on mental status and episodic memory, with a total score below 11 indicating cognitive impairment. The relationship between TCBI and cognitive impairment was examined using multiple logistic regression, smooth curve fitting, and subgroup analyses.ResultsAfter full adjustment, each 1-unit increase in log-transformed TCBI (Lg TCBI) was associated with a 29.7% reduction in cognitive impairment risk [odds ratio (OR) = 0.703, 95% confidence interval (CI): 0.529–0.933; p = 0.015]. When Lg TCBI was categorized into quartiles, the Q2, Q3, and Q4 groups exhibited a reduced risk of cognitive impairment by 19.9, 16.3, and 22.9%, respectively (p for trend = 0.043), compared to the Q1 group. Smooth curve fitting revealed a consistent decrease in cognitive impairment risk with higher Lg TCBI levels. Subgroup analysis indicated that the association was stronger among participants aged ≥60 years (OR = 0.655, 95% CI: 0.438–0.979), non-current drinkers (OR = 0.643, 95% CI: 0.451–0.917), and those who engaged in socializing (OR = 0.568, 95% CI: 0.371–0.871).ConclusionTCBI was significantly and negatively associated with cognitive impairment in Chinese middle-aged and elderly individuals, with the effect more pronounced in those aged ≥60 years, non-current drinkers, and socially active participants.
The effect of locomotive syndrome on the trajectory of sleep disturbance in geriatric oncology inpatients
Authors: Yang Yu-Ling , Su Hui , Lu Hui , Wang Jing , Zhou Yu-Qing , Li Ling , Yu Hui , Lv Yan , Chen Ying 
Published: February 2025

ObjectiveTo explore the developmental trajectory of sleep disturbance in geriatric oncology inpatients and assess the impact of locomotive syndrome (LS) on this trajectory.MethodsThis longitudinal study enrolled 284 geriatric oncology inpatients through convenience sampling from August 2023 to February 2024 at the Oncology Center of the Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China. Sleep quality was monitored for seven days following admission (T0-T6) using a wrist motion analyzer. The developmental trajectory of sleep disturbance was analyzed using the latent category growth model (LCGM). Patients were categorized into the LS group (n=177) and the non-LS group (n=107) based on the 25-question Geriatric Locomotive Function Scale (GLFS-25). Comparisons were made between the two groups regarding the distribution of sleep disturbance trajectories.ResultsThree potential categories for the development trajectory of sleep disturbance in inpatients were identified: non-sleep disturbance, sleep disturbance improvement, and sleep disturbance persistence. The lowest sleep quality was observed on the second day after admission (T2). In the non-LS group, 40 cases (37.4%) experienced no sleep disturbance, 45 cases (42.1%) showed improvement, and 22 cases (20.6%) showed persistence of sleep disturbance. In the LS group, 32 cases (18.1%) experienced no sleep disturbance, 50 cases (28.2%) showed improvement, and 95 cases (53.7%) exhibited persistent sleep disturbance. Significant differences were found in the trajectory distribution of sleep disturbance between the two groups (P&lt;0.001).ConclusionsSleep disturbance is prevalent in geriatric oncology inpatients, with an incidence of 74.6% (212/284), and is most severe on the third day after admission. Patients with LS exhibit lower overall sleep quality and a higher likelihood of persistent sleep disturbances.
Development and validation of a nomogram to predict recurrence in epithelial ovarian cancer using complete blood count and lipid profiles
Authors: Tang Xi , He Jingke , Huang Qin , Chen Yi , Chen Ke , Liu Jing , Tian Yingyu , Wang Hui 
Published: February 2025

ObjectiveOvarian cancer is one of the most lethal gynecological malignancies. This study aimed to evaluate the prognostic significance of complete blood count (CBC) and lipid profile in patients with optimally debulked epithelial ovarian cancer (EOC) and develop a nomogram model to predict recurrence-free survival (RFS).MethodsThis retrospective study analyzed patients diagnosed with EOC between January 2018 and June 2022.ResultsA total of 307 patients were randomly divided into training and validation sets in a ratio of 7:3. Grade, International Federation of Gynecology and Obstetrics (FIGO) stage, platelet-to-lymphocyte ratio, red blood cell distribution width-coefficient of variation, triglycerides, and human epididymal protein 4 were identified as independent prognostic factors. The novel nomogram displayed a good predictive performance, with a concordance index (C-index) of 0.787 in the training group and 0.807 in the validation group. The areas under the curve for 1-, 3-, and 5-year RFS were 0.770, 0.881, and 0.904, respectively, in the training group, and 0.667, 0.906, and 0.886, respectively, in the validation group. The calibration curves exhibited good concordance between the predicted survival probabilities and actual observations. Time-dependent C-index curves, integrated discrimination improvement, net reclassification index, and decision curve analysis showed that the nomogram outperformed FIGO staging.ConclusionThis study established and validated a nomogram combining CBC and lipid profiles to predict RFS in patients with optimally debulked EOC, which is expected to aid gynecologists in individualized prognosis assessment and clinical management.