bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral blood T-lymphocyte subsets are potential biomarkers of disease severity and clinical outcomes in patients with ulcerative colitis: a retrospective study
Authors: Geng Bailu , Ding Xueli , Li Xiaoyu , Liu Hua , Zhao Wenjun , Gong Haihong , Tian Zibin , Guo Jing 
Published: April 2023

Abstract
Background
Ulcerative colitis (UC) is considered an immune-mediated disease. The disorder of T-lymphocyte subsets plays an important role in the pathogenesis of UC. The aim of this study was to evaluate the significance of peripheral blood T-lymphocyte subsets in assessing disease severity and predicting clinical outcomes in UC patients.

Methods
The retrospective case-control study was performed in 116 UC patients with active disease and 90 healthy controls (HC). The UC patients included were followed up for 180 days. Analyses of t-test, Spearman’s correlation coefficient, multivariable Cox regression analysis, receiver operating characteristic (ROC) curves and cumulative survival analysis were done.

Results
The UC patients had lower proportions of CD4+T cells (42.85%±9.77% vs 45.71%±7.94%, P=0.021) and higher proportion of CD8+T cells (27.88%±8.86% vs 25.00%±6.47%, P=0.008) than HC. The severely active UC patients had higher proportion of CD3+HLA-DR+ T cells (8.83%±6.55% vs 2.80%±1.55%, P<0.001; 8.83%±6.55% vs 4.06%±5.01%, P<0.001) and CD8+T cells (31.35%±8.49% vs 26.98%±7.98%, P=0.029; 31.35%±8.49% vs 25.46%±9.15%, P=0.003) than mild and moderate group, whereas lower proportion of CD4+CD25+T cells (2.86%±1.35% vs 3.46%±1.07%, P=0.034) than mild group and CD4+T cells (40.40%±9.36% vs 44.73%±10.39%, P=0.049) than moderate group. The area under the curve (AUC) of CD3+HLA-DR+ T cells for assessing severely active UC was 0.885, with the cut-off value of 5.33%. The sensitivity was 76.32% and specificity was 89.74%. The combination of CD3+HLA-DR+ T cells and CRP had stronger assessment value with AUC of 0.929. The AUC of CD8+T cells, CD4+/CD8+ ratio and CD4+CD25+T cells for assessing disease severity was 0.677, 0.669 and 0.631 respectively. Within the 180 days follow-up, 24 patients (20.69%) had UC-related readmission or surgery, with higher proportion of CD3+HLA-DR+ T cells (10.66%±9.52% vs 3.88%±2.56%, P=0.003) and CD8+T cells (31.19%±10.59% vs 27.01%±8.20%, P=0.039) than those without readmission and surgery. The proportion of CD3+HLA-DR+ T cells was the independent predictor of UC-related readmission or surgery (HR=1.109, P=0.002). The AUC of CD3+HLA-DR+ T cells for predicting readmission or surgery was 0.796 with the cut-off value of 5.38%. UC patients with CD3+HLA-DR+T cells proportion>5.38% had a shorter time to readmission or surgery (log-rank test, P<0.001).

Conclusions
The combination of CD3+HLA-DR+T cells and CRP may be potential biomarker of disease severity in UC patients. The high proportion of CD3+HLA-DR+T cells may be associated with an increased risk of readmission or surgery in UC patients.
Sleep movements and respiratory coupling as a biobehavioral metric for early Alzheimer’s disease in independently dwelling adults
Authors: Khosroazad Somayeh , Gilbert Christopher F. , Aronis Jessica B. , Daigle Katrina M. , Esfahani Masoumeh , Almaghasilah Ahmed , Ahmed Fayeza S. , Elias Merrill F. , Meuser Thomas M. , Kaye Leonard W. , Singer Clifford M. , Abedi Ali , Hayes Marie J. 
Published: April 2023

Abstract
Introduction
Sleep disorder is often the first symptom of age-related cognitive decline associated with Alzheimer’s disease (AD) observed in primary care. The relationship between sleep and early AD was examined using a patented sleep mattress designed to record respiration and high frequency movement arousals. A machine learning algorithm was developed to classify sleep features associated with early AD.

Method
Community-dwelling older adults (N = 95; 62–90 years) were recruited in a 3-h catchment area. Study participants were tested on the mattress device in the home bed for 2 days, wore a wrist actigraph for 7 days, and provided sleep diary and sleep disorder self-reports during the 1-week study period. Neurocognitive testing was completed in the home within 30-days of the sleep study. Participant performance on executive and memory tasks, health history and demographics were reviewed by a geriatric clinical team yielding Normal Cognition (n = 45) and amnestic MCI-Consensus (n = 33) groups. A diagnosed MCI group (n = 17) was recruited from a hospital memory clinic following diagnostic series of neuroimaging biomarker assessment and cognitive criteria for AD.

Results
In cohort analyses, sleep fragmentation and wake after sleep onset duration predicted poorer executive function, particularly memory performance. Group analyses showed increased sleep fragmentation and total sleep time in the diagnosed MCI group compared to the Normal Cognition group. Machine learning algorithm showed that the time latency between movement arousals and coupled respiratory upregulation could be used as a classifier of diagnosed MCI vs. Normal Cognition cases. ROC diagnostics identified MCI with 87% sensitivity; 89% specificity; and 88% positive predictive value.

Discussion
AD sleep phenotype was detected with a novel sleep biometric, time latency, associated with the tight gap between sleep movements and respiratory coupling, which is proposed as a corollary of sleep quality/loss that affects the autonomic regulation of respiration during sleep. Diagnosed MCI was associated with sleep fragmentation and arousal intrusion.
Jejunal perforation secondary to blind insertion of peritoneal dialysis catheter: a case report and review of literature
Authors: Jacobs Lucas , Salaouatchi Mohammed , Taghavi Maxime , Sanoussi Said , Nortier Joelle , Mesquita Maria 
Published: April 2023

Abstract
Background
Peritoneal dialysis (PD) depends upon a functioning and durable access to the peritoneal cavity. Many techniques exist to insert a peritoneal catheter, showing similar outcomes and benefits. Blind percutaneous insertion represents a bedside intervention predominantly performed by nephrologists requiring only local anesthesia, sedation and minimal transcutaneous access. Although current guidelines recommend insertion techniques allowing visualization of the peritoneal cavity, the blind percutaneous approach is still widely used and has been proven safe and effective to bring durable peritoneal dialysis access. Herein, we described a rare case of jejunal perforation secondary to blind PD catheter placement, and conduct a review of the current medical literature describing early bowel perforations secondary to PD catheter placement, gathering descriptions of symptomatology and outcomes and their relations to the insertion technique.

Clinical presentation
We herein describe the case of a 48 year-old patient with a history of appendectomy who suffered from triple jejunal perforation after blind percutaneous insertion and subsequent embedment of his peritoneal catheter. Accurate diagnosis was made 1 month after insertion due to atypical clinical presentation and because physicians had no access to the peritoneal cavity after catheter embedment. After surgical repair and broad-spectrum antibiotics, the patient was switched to HD.

Conclusion
Early catheter-related visceral injury is a rare, yet threatening condition that is almost always causing a switch to hemodialysis or death. Our review highlights that laparoscopic catheter placement might bring better outcomes if perforation occurs, as it allows immediate diagnosis and treatment. On the contrary, catheter embedment may delay clinical diagnosis and therefore bring worse outcomes.
Sex-dependent gut microbiota-brain-cognition associations: a multimodal MRI study
Authors: Zhang Shujun , Cai Huanhuan , Wang Chunli , Zhu Jiajia , Yu Yongqiang 
Published: April 2023

Abstract
Background
There is bidirectional communication between the gut microbiota and the brain. Empirical evidence has demonstrated sex differences in both the gut microbiome and the brain. However, the effects of sex on the gut microbiota-brain associations have yet to be determined. We aim to elucidate the sex-specific effects of gut microbiota on brain and cognition.

Methods
One hundred fifty-seven healthy young adults underwent brain structural, perfusion, functional and diffusion MRIs to measure gray matter volume (GMV), cerebral blood flow (CBF), functional connectivity strength (FCS) and white matter integrity, respectively. Fecal samples were collected and 16S amplicon sequencing was utilized to assess gut microbial diversity. Correlation analyses were conducted to test for sex-dependent associations between microbial diversity and brain imaging parameters, and mediation analysis was performed to further characterize the gut microbiota-brain-cognition relationship.

Results
We found that higher gut microbial diversity was associated with higher GMV in the right cerebellum VI, higher CBF in the bilateral calcarine sulcus yet lower CBF in the left superior frontal gyrus, higher FCS in the bilateral paracentral lobule, and lower diffusivity in widespread white matter regions in males. However, these associations were absent in females. Of more importance, these neuroimaging biomarkers significantly mediated the association between gut microbial diversity and behavioral inhibition in males.

Conclusions
These findings highlight sex as a potential influential factor underlying the gut microbiota-brain-cognition relationship, and expose the gut microbiota as a biomarker-driven and sex-sensitive intervention target for mental disorders with abnormal behavioral inhibition.
Prenatally detected six duplications at Xp22.33-p11.22: a case report
Authors: Zhang Xue , Li Jian , Zhang Lan , Liu Hongli , Yi Hong , Liang Mingxing , Luo Jianyu , Li Junnan , Dong Yanling 
Published: April 2023

Abstract
Background
The discrepancy between the results of cytogenetics and the results of chromosome microarray analysis (CMA) has often led to confusion over genetic counselling for prenatal diagnosis.

Case presentation
The prenatal ultrasound results of a congenital heart defect (CHD) foetus displayed an apartial endocardial pad defect and permanently dilated coronary sinus and left superior vena cava at 21 weeks of gestation. Cytogenetic analysis, CMA, fluorescent in situ hybridization (FISH) and multiplex ligation-dependent probe amplification (MLPA) with foetal cord blood samples were used to detect the genetic aetiology. Routine G-binding cytogenetic analysis showed normal karyotypes in both the foetus’ and parents’ blood samples. CMA results demonstrated that there were 53.973-Mb recurrent CNVs at Xp22.33-p11.22, as confirmed by MLPA assay.

Conclusions
Herein, we described the CNV of six duplications at Xp22.33-p11.22 and the 53.973 Mb duplication CNV that was not found in foetal cord blood samples by conventional cytogenetic methods, and it was confirmed by CMA and MLPA. Our novel findings will provide helpful information for prenatal diagnosis and genetic counselling for foetal CHDs.
The impact of PIK3CA mutations and PTEN expression on the effect of neoadjuvant therapy for postmenopausal luminal breast cancer patients
Authors: Hayama Shouko , Nakamura Rikiya , Ishige Takayuki , Sangai Takafumi , Sakakibara Masahiro , Fujimoto Hiroshi , Ishigami Emi , Masuda Takahito , Nakagawa Ayako , Teranaka Ryotaro , Ota Satoshi , Itoga Sakae , Yamamoto Naohito , Nagashima Takeshi , Otsuka Masayuki 
Published: April 2023

Abstract
Background
There is pressing needs to find the biomarker in the selection of neoadjuvant therapy in postmenopausal luminal breast cancer patients. We examined the hypothesis that PIK3CA mutations and low phosphatase and tensin homolog (PTEN) expression affect the response to neoadjuvant therapy and prognosis in postmenopausal luminal breast cancer patients.

Methods
Postmenopausal patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative breast cancer, up to stage II, who underwent neoadjuvant chemotherapy (NAC; n = 60) or neoadjuvant endocrine therapy (NAE; n = 55) were selected. PIK3CA exon 9 and exon 20 mutations were screened by high resolution melting analysis and confirmed by Sanger sequence. PTEN expression was evaluated by immunohistochemistry. The relationships among PIK3CA mutations, PTEN expression, clinicopathological features, the pathological effect of neoadjuvant therapy, recurrence-free survival (RFS) and overall survival were analyzed.

Results
Among 115 patients, PIK3CA mutations and low PTEN expression before treatment were detected in 35 patients (30.4%) and in 28 patients (24.3%), respectively. In the NAC group, tumor with PIK3CA mutations showed significantly poorer response than tumor with PIK3CA wild-type (p = 0.03). On the other hand, in the NAE group, there was no significant difference in pathological therapeutic effect between tumor with PIK3CA mutations and tumor with PIK3CA wild-type (p = 0.54). In the NAC group, the log-rank test showed no difference in RFS between patients with PIK3CA mutations and PIK3CA wild-type (p = 0.43), but patients with low PTEN expression showed significantly worse RFS compared to patients with high PTEN expression (5 year RFS 0.64 vs. 0.87, p = 0.01). In the Cox proportional hazards model for RFS, PTEN expression, progesterone receptor, and pathological therapeutic effect were predictive factors for time to recurrence (All p < 0.05).

Conclusions
PIK3CA mutations are associated with resistance to NAC but do not affect the response to NAE. Low PTEN expression does not affect response to either NAC or NAE but correlates with shorter RFS in patients who received NAC. These biomarkers will be further evaluated for clinical use to treat postmenopausal luminal breast cancer patients.
Long-term surgical outcomes of basic-type exotropia in patients with hyperopia
Authors: Jeon Hyeshin , Choi Hee-young 
Published: April 2023

Abstract
Background
To investigate the surgical outcomes of basic-type exotropia in patients with hyperopia.

Methods
The medical records of patients who underwent surgery for basic-type exotropia and had been followed up for ≥ 2 years were retrospectively recruited. Patients with myopia and spherical equivalent (SE) < -1.0 diopters (D) were excluded. The patients were classified according to the SE: group H had a SE ≥  + 1.0 D, and group E had -1.0 ≤ SE <  + 1.0 D. The surgical success rate and sensory outcome were compared. Surgical success was defined as exodeviation ≤ 10 prism diopters (PD) and esodeviation ≤ 5 PD at 6 m fixation. Stereoacuity was measured using the Titmus Preschool Stereoacuity Test.

Results
Seventy-five patients (24 males and 51 females, mean age 5.1 ± 2.6 years, range 2.7–14.8) were included. The SE ranged from -0.9 to 4.4 and 21 patients were classified into group H and 54 into group E. The success rates were higher in group H than in group E during the entire follow-up period, but the differences were significant only at the final examination. At the final follow-up, 11 of the 21 (52.4%) patients in group H and 15 of the 54 (27.7%) in group E maintained successful alignment, whereas 10 (47.6%) and 38 (70.4%) patients exhibited recurrence. Overcorrection was exhibited in one (1.9%) patient in group E. Sensory results were comparable between the groups. The follow-up period did not differ between the two groups. The survival analysis showed no difference in the surgical results between the two groups.

Conclusions
Surgery for basic-type intermittent exotropia resulted in superior outcomes in patients with hyperopia compared to those with emmetropia.
Dynamic nomogram prediction model for diabetic retinopathy in patients with type 2 diabetes mellitus
Authors: Zhang Chunhui , Zhou Liqiong , Ma Minjun , Yang Yanni , Zhang Yuanping , Zha Xu 
Published: April 2023

Abstract
Background
To develop a dynamic prediction model for diabetic retinopathy (DR) using systemic risk factors.

Methods
This retrospective study included type 2 diabetes mellitus (T2DM) patients discharged from the Second Affiliated Hospital of Kunming Medical University between May 2020 and February 2022. The early patients (80%) were used for the training set and the late ones (20%) for the validation set.

Results
Finally, 1257 patients (1049 [80%] in the training set and 208 [20%] in the validation set) were included; 360 (28.6%) of them had DR. The areas under the curves (AUCs) for the multivariate regression (MR), least absolute shrinkage and selection operator regression (LASSO), and backward elimination stepwise regression (BESR) models were 0.719, 0.727, and 0.728, respectively. The Delong test showed that the BESR model had a better predictive value than the MR (p = 0.04899) and LASSO (P = 0.04999) models. The DR nomogram risk model was established according to the BESR model, and it included disease duration, age at onset, treatment method, total cholesterol, urinary albumin to creatinine ratio (UACR), and urine sugar. The AUC, kappa coefficient, sensitivity, specificity, and compliance of the nomogram risk model in the validation set were 0.79, 0.48, 71.2%, 78.9%, and 76.4%, respectively.

Conclusions
A relatively reliable DR nomogram risk model was established based on the BESR model.
Eosinophilia and potential antibody cross-reactivity between parasites in a child with pinworm and immune dysregulation: a case report
Authors: Di Cicco Maria , Bertolucci Giulia , Gerini Carlotta , Bruschi Fabrizio , Peroni Diego G. 
Published: April 2023

Abstract
Background
Intestinal parasitic infections are common in humans, especially among young children. These conditions are often asymptomatic and self-limiting, and diagnosis is mainly based on the search for ova and parasites in the stools since serology may be biased due to cross reactivity between parasites. Pinworm is common in children and is not usually associated with hypereosinophilia; adhesive-tape test is the gold standard testing for the microscopic detection of Enterobious vermicularis (Ev) eggs.

Case presentation
A 13-year-old boy was referred due to a self-resolving episode of vomiting and palpebral oedema after dinner, together with a history of chronic rhinitis, chronic cough, absolute IgA deficiency and Hashimoto’s thyroiditis and hypereosinophilia (higher value = 3140/µl). On evaluation we detected only palpable thyroid and hypertrophic nasal turbinates. Food allergy was excluded, but skin prick tests showed sensitization to house dust mites and cat epithelium and spirometry showed a marked obstructive pattern with positive bronchodilation test prompting the diagnosis of asthma for which maintenance inhaled treatment was started. Chest x-ray and abdomen ultrasound were negative. Further blood testing showed positive IgG anti-Echinococcus spp. and Strongyloides stercoralis and positive IgE for Ascaris, while Ev were detected both by the adhesive tape test and stool examination, so that we made a final diagnosis of pinworm infection. Three months after adequate treatment with pyrantel pamoate the adhesive-tape test turned out negative and blood testing showed a normal eosinophil count. The child later developed also type 1 diabetes.

Conclusions
We suggest the need to investigate for enterobiasis in children with hypereosinophilia and to consider autoimmunity as a potential confounding factor when interpreting serology for helminths.
The efficacy and safety of Sanqi Qushi Granule in patients with idiopathic membranous nephropathy ——protocol of a multicenter, randomized control trial (SQ-AUTUMN)
Authors: Li Chuang , Shan Wenjun , Liang Xing , Zhang Qinghua , Qin Xindong , Jiang Sha , Hong Xiaofan , Wang Lijuan , Li Ping , Gu Haowen , Wang Yi , Bao Kun 
Published: April 2023

Abstract
Background
Adult nephropathy is mainly caused by idiopathic membranous nephropathy (IMN). In cases of proteinuria, Modified Ponticelli Regimens (MPR) are often successful. However, it can cause adverse side effects. Oral Sanqi Qushi Granule (SQG) with MPR is effective in patients with IMN. However, whether it can improve the remission rate of IMN and shorten the remission time is unknown. In this trial, SQG with MPR on IMN will be evaluated clinically for its efficacy and safety.

Methods
We will randomly assign IMN patients who meet the criteria to receives SQG plus cyclical Cyclophosphamide (CTX)/steroids or with placebo plus cyclical CTX/steroids for 6 months. A 12-month follow-up will be conducted on them. Status of remission will be used to assess treatment efficacy.

Discussion
This study aims to appraise whether treatment with SQG plus cyclical CTX/steroids is superior to placebo plus cyclical CTX/steroids in the remission rate of patients with adult IMN. Adverse events of SQG plus MPR will be also evaluated for further researches about Chinese Medicine and MPR on whether it can improve the remission rate of IMN in half a year and shorten the remission time and relieve adverse effects will also be clarified.

Trial registration
Chinese Clinical Trial Registry ChiCTR2200061953. Registered on 13 July 2022.
A rare case of ocular and testicular T-cell lymphoma in a hermaphrodite koi carp (Cyprinus carpio Linnaeus 1758): clinical, histopathological, and immunohistochemical study
Authors: Rahmati-Holasoo Hooman , Shokrpoor Sara , Marandi Amin , Torjani Niyousha , Ebrahimzadeh Mousavi Hosseinali 
Published: April 2023

Abstract
Background
Lymphatic neoplasia may occur in various types, such as lymphoma, lymphosarcoma, lympholeukemia, and plasmacytoid leukemia. Lymphoma, defined as a malignant tumour of lymphoid tissue, has been found in a number of fish families including Esocidae and Salmonidae. However, the occurrence of lymphoma is rare in those belonging to the Cyprinidae. A final diagnosis of ocular and testicular T-cell lymphoma in the present study was based on the clinical signs, morphology, and texture of the tumour masses in the macroscopic and microscopic examinations. In addition, histopathological and immunohistochemical findings corresponded to T-cell lymphoma characteristics.

Case presentation
A 2-year-old hermaphrodite koi carp (Cyprinus carpio Linnaeus 1758) with a large ocular mass and severe exophthalmia in the right eye was referred to the Ornamental Fish Clinic in October 2020. Under anesthesia, enucleation was performed. 57 days after enucleation of the right eye, exophthalmia in the left eye was discovered. 221 days after surgery, the fish was discovered to be dead. At necropsy, a large soft tissue mass attached to the left testis was discovered. There were also small whitish nodules on the surface of the liver. Histopathology revealed a hypercellular ocular mass with scant connective tissue. The sections also revealed multifocal hemorrhages, round to ovoid neoplastic cells, mild-to-moderate anisokaryosis and anisocytosis, and mitotic figures. Basophilic neoplastic cells were found in blood vessels within the testicular mass, raising the possibility of systemic spread. The liver showed microscopic metastasis with morphologic similarities to the ocular and testicular tumors. The neoplastic cells infiltrating the left and right eyes as well as the testicular mass were immunohistochemically positive for CD3 but negative for CD20. The masses were diagnosed as T-cell lymphoma based on histopathological and immunohistochemical findings.

Conclusions
This case report provides the first evidence of clinical, histopathological, morphological, and immunohistochemical findings of an ocular and testicular T-cell lymphoma in a hermaphrodite koi carp (Cyprinus carpio) in Iran.