bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and effectiveness of tigecycline combination therapy in renal transplant patients with infection due to carbapenem-resistant gram-negative bacteria
Authors: Wang Qin , Liao Guiyi , Xia Quan , Ge Chaoliang , Ding Handong 
Published: November 2023

BackgroundCarbapenem-resistant gram-negative bacterial (CRGNB) infections are increasing among kidney transplant recipients, and effective therapeutic options are limited. This study aimed to investigate the efficacy and adverse events associated with combination therapy tigecycline in renal transplant patients with CRGNB infections.MethodsThis study retrospectively analyzed 40 Chinese patients with confirmed or suspected CRGNB infections who received tigecycline therapy. The patients’ case features and clinical and microbiological data were analyzed.ResultsA total of 40 renal transplant recipients received tigecycline therapy for a median duration of 9 (range, 3–25) days. CRGNB isolates were obtained from the organ preservation solution of the donor kidney in 28 patients, with confirmed transmission in 4 patients. Infections were detected in the bloodstream, urinary tract, sputum, and wound. The most prevalent isolates were Klebsiella pneumoniae (75%, 30/40), Acinetobacter baumannii (15%, 6/40), and Escherichia coli (10%, 4/40). A clinical response was observed in 32 (80%) patients. The 28-day all-cause mortality rate was 7.5% (3/40), while the one-year all-cause mortality rate was 2.5% (1/40). While one patient died owing to severe pancreatitis, no serious adverse events related to tigecycline therapy were reported. However, multiple indices of liver function and pancreatitis precursors increased after treatment with tigecycline compared to before treatment.ConclusionTigecycline therapy appears to be well tolerated in renal transplant recipients with multidrug-resistant bacterial infections. Nevertheless, attention should be paid to adverse reactions related to tigecycline therapy, especially gastrointestinal reactions, and the related laboratory tests should be closely monitored.
Operation time and clinical outcomes for open infrarenal abdominal aortic aneurysms to remain stable in the endovascular era
Authors: Gruber M. , Sotir A. , Klopf J. , Lakowitsch S. , Domenig C. , Wanhainen A. , Neumayer C. , Busch A. , Eilenberg W. 
Published: November 2023

ObjectiveEndovascular aortic repair (EVAR) has become a routine procedure worldwide. Ultimately, the increasing number of EVAR cases entails changing conditions for open surgical repair (OSR) regarding patient selection, complexity, and surgical volume. This study aimed to assess the time trends of open abdominal aortic aneurysm (AAA) repair in a high-volume single center in Austria over a period of 20 years, focusing on the operation time and clinical outcomes.Materials and methodsA retrospective analysis of all patients treated for infrarenal AAAs with OSR or EVAR between January 2000 and December 2019 was performed. Infrarenal AAA was defined as the presence of a &gt;10-mm aortic neck. Cases with ruptured or juxtarenal AAAs were excluded from the analysis. Two cohorts of patients treated with OSR at different time periods, namely, 2000–2009 and 2010–2019, were assessed regarding demographical and procedure details and clinical outcomes. The time periods were defined based on the increasing single-center trend toward the EVAR approach from 2010 onward.ResultsA total of 743 OSR and 766 EVAR procedures were performed. Of OSR cases, 589 were infrarenal AAAs. Over time, the EVAR to OSR ratio was stable at around 50:50 (p = 0.488). After 2010, history of coronary arterial bypass (13.4% vs. 7.2%, p = 0.027), coronary artery disease (38.1% vs. 25.1%, p = 0.004), peripheral vascular disease (35.1% vs. 21.3%, p = 0.001), and smoking (61.6% vs. 34.3%, p &lt; 0.001) decreased significantly. Age decreased from 68 to 66 years (p = 0.023). The operation time for OSR remained stable (215 vs. 225 min, first vs. second time period, respectively, p = 0.354). The intraoperative (5.8% vs. 7.2%, p = 0.502) and postoperative (18.3% vs. 20.8%, p = 0.479) complication rates also remained stable. The 30-day mortality rate did not change over both time periods (3.0% vs. 2.4%, p = 0.666).ConclusionBalanced EVAR to OSR ratio, similar complexity of cases, and volume over the two decades in OSR showed stable OSR time without compromise in clinical outcomes.
Genetic characteristics of common variable immunodeficiency patients with autoimmunity
Authors: Liu Zhihui , Lu Chenyang , Qing Pingying , Cheng Ruijuan , Li Yujie , Guo Xue , Chen Ye , Ying Zhiye , Yu Haopeng , Liu Yi 
Published: November 2023

Background: The pathogenesis of common variable immunodeficiency disorder (CVID) is complex, especially when combined with autoimmunity. Genetic factors may be potential explanations for this complex situation, and whole genome sequencing (WGS) provide the basis for this potential.Methods: Genetic information of patients with CVID with autoimmunity, together with their first-degree relatives, was collected through WGS. The association between genetic factors and clinical phenotypes was studied using genetic analysis strategies such as sporadic and pedigree.Results: We collected 42 blood samples for WGS (16 CVID patients and 26 first-degree relatives of healthy controls). Through pedigree, sporadic screening strategies and low-frequency deleterious screening of rare diseases, we obtained 9,148 mutation sites, including 8,171 single-nucleotide variants (SNVs) and 977 Insertion-deletions (InDels). Finally, we obtained a total of 28 candidate genes (32 loci), of which the most common mutant was LRBA. The most common autoimmunity in the 16 patients was systematic lupus erythematosis. Through KEGG pathway enrichment, we identified the top ten signaling pathways, including “primary immunodeficiency”, “JAK-STAT signaling pathway”, and “T-cell receptor signaling pathway”. We used PyMOL to predict and analyse the three-dimensional protein structures of the NFKB1, RAG1, TIRAP, NCF2, and MYB genes. In addition, we constructed a PPI network by combining candidate mutants with genes associated with CVID in the OMIM database via the STRING database.Conclusion: The genetic background of CVID includes not only monogenic origins but also oligogenic effects. Our study showed that immunodeficiency and autoimmunity may overlap in genetic backgrounds.Clinical Trial Registration: identifier ChiCTR2100044035
Whole mitochondrial genome analysis in highland Tibetans: further matrilineal genetic structure exploration
Authors: Li Xin , Zhang Xianpeng , Yu Ting , Ye Liping , Huang Ting , Chen Ying , Liu Shuhan , Wen Youfeng 
Published: November 2023

Introduction: The Qinghai–Tibet Plateau is one of the last terrestrial environments conquered by modern humans. Tibetans are among the few high-altitude settlers in the world, and understanding the genetic profile of Tibetans plays a pivotal role in studies of anthropology, genetics, and archaeology.Methods: In this study, we investigated the maternal genetic landscape of Tibetans based on the whole mitochondrial genome collected from 145 unrelated native Lhasa Tibetans. Molecular diversity indices, haplotype diversity (HD), Tajima’s D and Fu’s Fs were calculated and the Bayesian Skyline Plot was obtained to determining the genetic profile and population fluctuation of Lhasa Tibetans. To further explore the genetic structure of Lhasa Tibetans, we collected 107 East Asian reference populations to perform principal component analysis (PCA), multidimensional scaling (MDS), calculated Fst values and constructed phylogenetic tree.Results: The maternal genetic landscape of Tibetans showed obvious East Asian characteristics, M9a (28.28%), R (11.03%), F1 (12.41%), D4 (9.66%), N (6.21%), and M62 (4.14%) were the dominant haplogroups. The results of PCA, MDS, Fst and phylogenetic tree were consistent: Lhasa Tibetans clustered with other highland Tibeto-Burman speakers, there was obvious genetic homogeneity of Tibetans in Xizang, and genetic similarity between Tibetans and northern Han people and geographically adjacent populations was found. In addition, specific maternal lineages of Tibetans also be determined in this study.Discussion: In general, this study further shed light on long-time matrilineal continuity on the Tibetan Plateau and the genetic connection between Tibetans and millet famers in the Yellow River Basin, and further revealed that multiple waves of population interaction and admixture during different historical periods between lowland and highland populations shaped the maternal genetic profile of Tibetans.
Palmatine treats urticaria by reducing inflammation and increasing autophagy
Authors: Xiao Tian , Yu Xingzhi , Yang Liping , Duan Xiaohua 
Published: November 2023

IntroductionChronic spontaneous urticaria (CSU) is mainly manifested as wheals and erythema on the skin accompanied by itching, which will cause emotional anxiety and seriously affect the quality of life in patients. Palmatine (PAL) is a main chemical component of Yajieshaba, which has been found to effectively alleviate the symptoms of food allergy. However, its role and mechanism in CSU remain unclear. The present study aimed to investigate the protective effect of PAL on CSU rats.MethodsWe replicated the CSU rat model by intraperitoneal injection of ovalbumin (OVA) in rats on days 0, 2, 4, and 14, with a double dose given on the last challenge. PAL, loratadine and saline were given by gavage from day 5 to day 14. We observed the skin pathologic changes, mast cell degranulation, immune factor levels, inflammatory response and autophagy-related protein expression in CSU rats.ResultsWe found PAL treatment to be effective in alleviating CSU-like skin lesions and reducing itching and mast cell degranulation in rats. Compared with the OVA group, the levels of immune and inflammatory factors were significantly reduced, neutrophil recruitment was alleviated, suggesting a reduced inflammatory response. The autophagy results showed that PAL further increased the expression of LC3, Beclin-1 and p-LKB1, p-AMPK, Atg5, Atg12 and Atg5-Atg12, while P62 and p-p70S6K1 expression decreased. They collectively suggested that autophagic flux was activated after PAL treatment. However, there was an increase in the expression of LC3I, probably due to the fact that PAL induced its accumulation in order to provide substrate for the generation of more LC3II.DiscussionOverall, PAL had a protective effect on CSU in normal rats, activated the expression of autophagy and improved the inflammatory response.
Association of inflammatory indicators with intensive care unit mortality in critically ill patients with coronary heart disease
Authors: Cheng Yuan , Chen Yang , Mao Mengxia , Wang Ruixuan , Zhu Jun , He Qing 
Published: November 2023

ObjectiveCoronary heart disease (CHD) is one of the major cardiovascular diseases, a common chronic disease in the elderly and a major cause of disability and death in the world. Currently, intensive care unit (ICU) patients have a high probability of concomitant coronary artery disease, and the mortality of this category of patients in the ICU is receiving increasing attention. Therefore, the aim of this study was to verify whether the composite inflammatory indicators are significantly associated with ICU mortality in ICU patients with CHD and to develop a simple personalized prediction model.Method7115 patients from the Multi-Parameter Intelligent Monitoring in Intensive Care Database IV were randomly assigned to the training cohort (n = 5692) and internal validation cohort (n = 1423), and 701 patients from the eICU Collaborative Research Database served as the external validation cohort. The association between various inflammatory indicators and ICU mortality was determined by multivariate Logistic regression analysis and Cox proportional hazards model. Subsequently, a novel predictive model for mortality in ICU patients with CHD was developed in the training cohort and performance was evaluated in the internal and external validation cohorts.ResultsVarious inflammatory indicators were demonstrated to be significantly associated with ICU mortality, 30-day ICU mortality, and 90-day ICU mortality in ICU patients with CHD by Logistic regression analysis and Cox proportional hazards model. The area under the curve of the novel predictive model for ICU mortality in ICU patients with CHD was 0.885 for the internal validation cohort and 0.726 for the external validation cohort. The calibration curve showed that the predicted probabilities of the model matched the actual observed probabilities. Furthermore, the decision curve analysis showed that the novel prediction model had a high net clinical benefit.ConclusionIn ICU patients with CHD, various inflammatory indicators were independent risk factors for ICU mortality. We constructed a novel predictive model of ICU mortality risk in ICU patients with CHD that had great potential to guide clinical decision-making.
Case Report: Multidisciplinary management of primary inferior vena cava leiomyosarcoma: a comprehensive case study
Authors: Li Wuchao , Zhang Xiaoyong , Zhang Yi , Wang Rongpin 
Published: November 2023

IntroductionPrimary Inferior vena cava (IVC) leiomyosarcoma, a rare malignant tumor, presents unique challenges in diagnosis and treatment due to its rarity and the lack of consensus on surgical and adjuvant therapy approaches.Case ReportA 39-year-old female patient presented with lower limb swelling and mild fatigue. Contrast-enhanced CT identified a tumor mass within the dilated IVC. Abdominal MRI revealed primary IVC leiomyosarcoma extending into the right hepatic vein. A multidisciplinary consultation established a diagnosis and devised a treatment plan, opting for Ex-vivo Liver Resection and Auto-transplantation (ELRA), tumor resection and IVC reconstruction. Pathological examination confirmed primary IVC leiomyosarcoma. Postoperatively, the patient underwent a comprehensive treatment strategy that included radiochemotherapy, immunotherapy, targeted therapy, and PRaG therapy (PD-1 inhibitor, Radiotherapy, and Granulocyte-macrophage colony-stimulating factor). Despite the tumor’s recurrence and metastasis, the disease progression was partially controlled.ConclusionThis case report emphasizes the complexities of diagnosing and treating IVC leiomyosarcoma and highlights the potential benefits of employing ELRA, IVC reconstruction, and PRaG therapy. Our study may serve as a valuable reference for future investigations addressing the management of this rare disease.
The combination of baseline neutrophil to lymphocyte ratio and dynamic changes during treatment can better predict the survival of osteosarcoma patients
Authors: Li Longqing , Li Ye , Lu Minxun , Wang Yitian , Li Zhuangzhuang , Hu Xin , He Xuanhong , Gong Taojun , Luo Yi , Zhou Yong , Min Li , Tu Chongqi 
Published: November 2023

BackgroundOsteosarcoma is a primary malignant bone tumor with a high metastatic potential that accounts for a significant proportion of all bone tumors. The prognosis for patients with metastatic or recurrence disease remains poor. The neutrophil-to-lymphocyte ratio (NLR) has become a potential prognostic biomarker for cancer. Recent evidence suggests that the dynamic changes in neutrophil-to-lymphocyte ratio (NLR) during treatment may be more informative in predicting patient prognosis, but the value of dynamic NLR in osteosarcoma has not yet been determined.MethodsThis retrospective study retrospectively analyzed the clinical information of 251 osteosarcoma patients diagnosed and treated in West China Hospital of Sichuan University, explored the impact of baseline NLR and changes in NLR during treatment on the prognosis of osteosarcoma patients, and further combined baseline NLR with Delta NLR to build an NLR staging system.ResultsThe results showed that both baseline NLR and delta NLR had some predictive ability for the prognosis of osteosarcoma patients (P = 6.90e-4, P = 0.022). Patients with high baseline NLR were more likely to have a decrease in delta NLR (P = 1.24e-10). The NLR stage had a better predictive ability than baseline NLR and delta NLR, and was an independent prognostic factor for overall survival in osteosarcoma patients HR: 2.456 (1.625-3.710) (P = 1.97e-05).ConclusionNLR has value in continuous monitoring, and continuous monitoring of NLR can better predict the survival of osteosarcoma patients compared to baseline NLR.
Help overcoming pain early, a brief person-centred intervention for adolescents with chronic pain in a school setting, may improve symptoms of insomnia
Authors: Wallbing Ulrika , Nilsson Stefan , Lundberg Mari , Wigert Helena , Kemani Mike K. 
Published: November 2023

Introduction and aimsChronic pain and symptoms of insomnia affect large numbers of adolescents and early interventions are prioritized. The aim of the current study was to evaluate potential secondary effects of the intervention, Help Overcoming Pain Early (HOPE), on symptoms of insomnia and self-rated health.MethodsThe study included non-randomized aggregated data from the active and control conditions in a previously conducted randomized controlled trial evaluating the efficacy of HOPE, after the participants in the control condition also had received the intervention. Symptoms of insomnia were assessed with the Minimal Insomnia Symptom Scale and self-rated health was assessed with one item, at the start of the intervention, post intervention, and at a six-month follow-up. Baseline variables included age, gender, pain localization, pain impact, school absence and symptoms of depression (assessed with the Center for Epidemiological Studies Depression Scale for Children). Inferential analyzes were performed using Linear Mixed Models (LMM). Effect sizes were evaluated by calculating Cohen's d.ResultsThere were statistically significant improvements in symptoms of insomnia at the six-month follow-up, and statistically significant improvements in self-rated health at the end of the intervention and at the six-month follow-up. Effect sizes were small across outcomes and assessments.Discussion and conclusionResults illustrated significant but small improvements in symptoms of insomnia and self-rated health in adolescents with chronic pain following the HOPE intervention. Although caution is needed when assessing the findings, results illustrate the potential utility of an accessible brief early intervention in a school context.
Stevens–Johnson syndrome induced by toripalimab in a previously EGFR-TKI-treated advanced lung adenocarcinoma patient harboring EGFR mutations 19 del/T790M/C797S in trans and cis: a case report
Authors: Chen Yang , Hong Hanhan , Bao Shujun , Tang Hao 
Published: November 2023

Background: The treatment paradigm for advanced non-small-cell lung cancer (NSCLC) is rapidly changing. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and anti-programmed death-1 (PD-1) antibodies have increasingly been incorporated into routine care for nearly all patients with NSCLC. Toripalimab was recently approved as the first-line treatment for advanced non-squamous NSCLC in combination with chemotherapy. Stevens–Johnson syndrome (SJS) is a rare but potentially fatal complication of TKI and anti-PD-1 therapy. We reported a case of SJS after sequential use of EGFR-TKIs and toripalimab in an NSCLC patient with EGFR mutations 19 del/T790M/C797S in trans and cis.Case presentation: A 58-year-old man with stage IV NSCLC received gefitinib because next-generation sequencing (NGS) revealed an EGFR 19del, followed by osimertinib and pemetrexed with the emergence of EGFR T790M. Four EGFR mutations 19 del/T790M/C797S in trans and cis were detected after osimertinib resistance. The combination of toripalimab and docetaxel was administered as a third-line treatment. The patient developed SJS at 21 days, and toripalimab was discontinued. After treatment with methylprednisolone and prednisolone, the skin toxicity of the patient gradually decreased and eventually disappeared. The patient received osimertinib and anlotinib after recovery, and SJS has not recurred. The ongoing treatment is still effective and results in stable disease.Conclusion: We reported the first case of SJS induced by toripalimab in a patient with lung adenocarcinoma harboring multiple EGFR mutations. The TKI treatment after SJS was well tolerated and effective.
Hyperspectral estimation of chlorophyll content in jujube leaves: integration of derivative processing techniques and dimensionality reduction algorithms
Authors: Tuerxun Nigela , Zheng Jianghua , Wang Renjun , Wang Lei , Liu Liang 
Published: November 2023

The leaf chlorophyll content (LCC) of vegetation is closely related to photosynthetic efficiency and biological activity. Jujube (Ziziphus jujuba Mill.) is a traditional economic forest tree species. Non-destructive monitoring of LCC of jujube is of great significance for guiding agroforestry production and promoting ecological environment protection in arid and semi-arid lands. Hyperspectral data is an important data source for LCC detection. However, hyperspectral data consists of a multitude of bands and contains extensive information. As a result, certain bands may exhibit high correlation, leading to redundant spectral information. This redundancy can distort LCC prediction results and reduce accuracy. Therefore, it is crucial to select appropriate preprocessing methods and employ effective data mining techniques when analyzing hyperspectral data. This study aims to evaluate the performance of hyperspectral data for estimating LCC of jujube trees by integrating different derivative processing techniques with different dimensionality reduction algorithms. Hyperspectral reflectance data were obtained through simulations using an invertible forest reflectance model (INFORM) and measurements from jujube tree canopies. The least absolute shrinkage and selection operator (LASSO) and elastic net (EN) were employed to identify the important bands in the original spectra (OS), first derivative spectra (FD), and second derivative spectra (SD). Support vector regression (SVR) was used to establish the estimation model. The results show that compared with full-spectrum modeling, LASSO and EN algorithms are effective methods for preventing overfitting in LCC machine learning estimation models for different spectral derivatives. The LASSO/EN-based estimation models constructed using FD and SD exhibited superior R2 compared to the OS. The important band of SD can best reveal the relevant information of jujube LCC, and SD-EN-SVR is the most ideal model in both the simulated dataset (R2 = 0.99, RMSE=0.61) and measured dataset (R2 = 0.89, RMSE=0.91). Our results provided a reference for rapid and non-destructive estimation of the LCC of agroforestry vegetation using canopy hyperspectral data.