bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammatory changes in the choroid plexus following subarachnoid hemorrhage: the role of innate immune receptors and inflammatory molecules
Authors: Solár Peter , Brázda Václav , Bareš Martin , Zamani Alemeh , EmamiAref Parisa , Joukal Andrea , Kubíčková Lucie , Kročka Erik , Hašanová Klaudia , Joukal Marek 
Published: January 2025

IntroductionThe choroid plexus is located in the cerebral ventricles. It consists of a stromal core and a single layer of cuboidal epithelial cells that forms the blood-cerebrospinal barrier. The main function of the choroid plexus is to produce cerebrospinal fluid. Subarachnoid hemorrhage due to aneurysm rupture is a devastating type of hemorrhagic stroke. Following subarachnoid hemorrhage, blood and the blood degradation products that disperse into the cerebrospinal fluid come in direct contact with choroid plexus epithelial cells. The aim of the current study was to elucidate the pathophysiological cascades responsible for the inflammatory reaction that is seen in the choroid plexus following subarachnoid hemorrhage.MethodsSubarachnoid hemorrhage was induced in rats by injecting non-heparinized autologous blood to the cisterna magna. Increased intracranial pressure following subarachnoid hemorrhage was modeled by using artificial cerebrospinal fluid instead of blood. Subarachnoid hemorrhage and artificial cerebrospinal fluid animals were left to survive for 1, 3, 7 and 14 days. Immunohistochemical staining of TLR4, TLR9, FPR2, CCL2, TNFα, IL-1β, CCR2 and CX3CR1 was performed on the cryostat sections of choroid plexus tissue. The level of TLR4, TLR9, FPR2, CCL2, TNFα, IL-1β was detected by measuring immunofluorescence intensity in randomly selected epithelial cells. The number of CCR2 and CX3CR1 positive cells per choroid plexus area was manually counted. Immunohistochemical changes were confirmed by Western blot analyses.ResultsImmunohistochemical methods and Western blot showed increased levels of TLR9 and a slight increase in TLR4 and FRP2 following both subarachnoid hemorrhage as well as the application of artificial cerebrospinal fluid over time, although the individual periods were different. The levels of TNFα and IL-1β increased, while CCL2 level decreased slightly. Accumulation of macrophages positive for CCR2 and CX3CR1 was found in all periods after subarachnoid hemorrhage as well as after the application of artificial cerebrospinal fluid.DiscussionOur results suggest that the inflammation develops in the choroid plexus and blood-cerebrospinal fluid barrier in response to blood components as well as acutely increased intracranial pressure following subarachnoid hemorrhage. These pro-inflammatory changes include accumulation in the choroid plexus of pro-inflammatory cytokines, innate immune receptors, and monocyte-derived macrophages.
Association between HALP (hemoglobin, albumin, lymphocyte, and platelet) score and poor outcomes in acute ischemic stroke patients with type 2 diabetes mellitus: a study from the Third China National Stroke Registry
Authors: Zhu Xu , Zhang Yijun , Wang Anxin , Zhang Xiaoli , Yu Guoyuan , Xiang Shifeng , Wu Yiping , Meng Xia 
Published: January 2025

BackgroundThe combined index (HALP) of hemoglobin, albumin, lymphocytes, and platelets is considered a novel scoring system that reflects systemic inflammation and nutritional status. This study aimed to investigate the relationship between HALP scores and poor outcomes in acute ischemic stroke (AIS) patients with type 2 diabetes mellitus (DM).MethodsPatients with AIS and type 2 DM were screened from the Third China National Stroke Registry (CNSR-III) and divided into quartiles based on their HALP scores at admission. Clinical outcomes were adverse functional outcomes (modified Rankin scale [mRS] score of 3–6 or 2–6) and all-cause mortality at 3 months and 1 year. The association of HALP with the risk of poor functional outcome and all-cause mortality were analyzed by multivariable logistic regression and Cox proportional hazards regression.ResultsA total of 3,603 patients were included in this study. After adjusting for confounders, it was found that patients in the highest HALP score quartile had lower mRS scores of 2–6 (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.51–0.80) and 3–6 (OR, 0.53; 95% CI, 0.51–0.82) at the 3-month follow-up. At the 1-year follow-up, a significant correlation was observed between HALP scores and mRS scores of 2–6 (OR, 0.65; 95%CI, 0.57–0.81) and 3–6 (OR, 0.64; 95%CI, 0.47–0.86). Additionally, the highest HALP score quartile was associated with a reduced risk of all-cause mortality at the 3-month follow-up (hazard ratio [HR], 0.35; 95%CI, 0.13–0.93). Similar results were observed at the 1-year follow-up (HR, 0.34; 95%CI, 0.18–0.63).ConclusionAt 3 months of AIS patients with type 2 diabetes and 1-year follow-up, lower HALP scores were associated with poorer functional outcomes and all-cause mortality.
Involvement of the posterior limb of the internal capsule independently predicts the prognosis of patients with basal ganglia and thalamic hemorrhage
Authors: Gupta Sohan , Xiao Mengxuan , Liu Na , Zhao Yunxiao , Zhao Xiaolin , Huang Yunqiang , Wu Yongming , Lin Zhenzhou , Ji Zhong , Xu Haihao , Zhu Minzhen , Pan Suyue , Huang Kaibin 
Published: January 2025

BackgroundIntracerebral hemorrhage (ICH) is the most lethal and devastating subtype of stroke. Basal ganglia hemorrhage and thalamic hemorrhage are the most common types of ICH, accounting for 50–70% of all ICH cases, leading to disability and death, and it involves the posterior limb of the internal capsule to varying degrees. In this study, we investigated the impact of varying degrees of the involvement of the posterior limb of the internal capsule on the prognosis of patients with basal ganglia and thalamic ICH and assessed whether it improves the predictive accuracy of the max-ICH score, an existing scale for ICH functional outcome.MethodsThis is a multicenter, retrospective, observational study. We graded the involvement of the posterior limb of the internal capsule according to the degree of compression and injury (called iICH, ranging from 0 to 4). An unfavorable outcome was defined as a 90-day modified Rankin Scale (mRS) of &gt; 2. Multivariate logistic regression analysis was used to identify independent risk factors associated with unfavorable prognosis. The discrimination was verified using receiver operating characteristic curve (ROC) analysis, while the calibration was verified by the Hosmer-Lemeshow test.ResultsOf the 305 patients included, 188 from Nanfang Hospital were assigned to the development cohort, and 117 from Heyuan People's Hospital and Huadu District People's Hospital were assigned to the validation cohort. In the development cohort, iICH was identified as an independent factor of a 90-day unfavorable outcome, and the area under the ROC (AUC) was 0.774. When combined with the iICH, the AUC of max-ICH was significantly elevated from 0.816 to 0.866. Comparable results were found in the validation cohort.ConclusionsIncreased involvement of the posterior limb of the internal capsule is associated with a worse outcome in patients with basal ganglia and thalamic ICH.
Preliminary evaluation of the FastCAP for users of the Nurotron cochlear implant
Authors: Yang Xue-Ying , Huang Sui , Fu Qian-Jie , Galvin John , Chen Bing , Liu Ji-Sheng , Tao Duo-Duo 
Published: January 2025

BackgroundElectrically evoked compound action potential (ECAP) can be used to measure the auditory nerve’s response to electrical stimulation in cochlear implant (CI) users. In the Nurotron CI system, extracting the ECAP waveform from the stimulus artifact is time-consuming.MethodWe developed a new paradigm (“FastCAP”) for use with Nurotron CI devices. In electrically evoked compound action potential in fast mode (FastCAP), N recordings are averaged directly on the CI hardware before data transmission, significantly reducing data transmission time. FastCAPs and ECAPs were measured across five electrodes and four stimulation levels per electrode. The FastCAP stimulation rate (33.3 Hz) is also faster than the ECAP rate (2.5 Hz).ResultsResults showed strong correlations between ECAPs and FastCAPs for N1 latency (r = 0.84, p &lt; 0.001) and N1 amplitude (r = 0.97, p &lt; 0.001). Test-retest reliability for FastCAPs was also high, with intraclass correlation coefficients of r = 0.87 for N1 latency (p &lt; 0.001) and r = 0.96 for N1 amplitude (p &lt; 0.001). The mean test time was 46.9 ± 1.4 s for the FastCAP and 340.3 ± 6.3 s for the ECAP. The FastCAP measurement time was significantly shorter than the ECAP measurement time (W = −210.0, p &lt; 0.001). FastCAP thresholds were significantly correlated with behavioral thresholds in 7/20 participants and with comfortable loudness levels in 11/20 participants. The time required to measure FastCAPs was significantly lower than that for ECAPs. The FastCAP paradigm maintained the accuracy and reliability the ECAP measurements while offering a significant reduction in time requirements.ConclusionThis preliminary evaluation suggests that the FastCAP could be an effective clinical tool to optimize CI processor settings (e.g., threshold stimulation levels) in users of the Nurotron CI device.
Global, regional, and national esophageal cancer deaths and DALYs attributable to diet low in vegetables and fruits, 1990–2019: analysis for the global burden of disease study
Authors: Cui Bing , Chen Aqin , Xu Chengcheng 
Published: January 2025

BackgroundThis study aimed to comprehensively assess the global, regional, and national burden of esophageal cancer (EC) attributable to inadequate vegetable and fruit intake from 1990 to 2019 and explore the potential impact of existing dietary intervention programs on EC prevention.MethodsUsing the Global Burden of Disease Study 2019 (GBD 2019) database, we conducted descriptive analyses stratified by age, sex, Socio-demographic Index (SDI), and regional levels. Temporal trends were assessed using linear regression models, and cluster analysis was employed to explore burden patterns across different GBD regions. Decomposition analysis quantified the contributions of aging, population dynamics, and epidemiological changes to deaths and disability-adjusted life years (DALYs). Frontier analysis was used to evaluate the relationship between dietary risk-related disease burden and sociodemographic progress.ResultsIn 2019, inadequate vegetable and fruit intake contributed to 65,919 global EC deaths, accounting for 0.12% of all deaths, with an age-standardized death rate of 0.81 per 100,000 population. The associated DALYs totaled 16,065,68, representing 0.06% of total global DALYs, with an age-standardized DALY rate of 19.24. The disease burden attributable to insufficient fruit intake (51,210 deaths, 12,497,75 DALYs) was significantly higher than that from inadequate vegetable intake (17,176 deaths, 4,203,09 DALYs). The burden was greater in males than females, peaking in middle-aged groups. Substantial regional differences were observed, with low-SDI regions bearing the highest burden. From 1990 to 2019, while the absolute numbers of deaths and DALYs followed a complex trajectory of initial increase followed by decline, age-standardized rates consistently decreased, reflecting the positive impact of epidemiological improvements. Existing dietary intervention programs, such as subsidies for fruit and vegetable production and health education initiatives, have contributed to a reduction in dietary risk-related disease burden but exhibited varying effectiveness across SDI regions.ConclusionTargeted dietary interventions, such as promoting fruit and vegetable consumption, are critical for the prevention and control of the EC disease burden. Future efforts should focus on optimizing the implementation of current programs, enhancing nutritional supplementation in resource-limited regions, and expanding health education initiatives to achieve broader health benefits.
The moderating effect of alternate Mediterranean diet on the association between sedentary behavior and insomnia in postmenopausal women
Authors: Sheng Zhumei , Zhou Mincong 
Published: January 2025

AimThe study aimed to explore the moderating role of the alternate Mediterranean diet (aMED) adherence on the association between sedentary behavior and insomnia symptoms in postmenopausal women.MethodsData regarding postmenopausal women were obtained for this cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Sedentary behavior and insomnia symptoms were assessed using the questionnaire. aMED adherence was evaluated according to 24-h dietary recalls. Weighted univariate logistic regression models were utilized to screen potential covariates. The relationship between sedentary behavior, aMED adherence, and insomnia symptoms was explored using weighted univariate and multivariate logistic regression models. All results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs).ResultsA total of 1,793 postmenopausal women were included in the final analysis. Of them, 643 (37.56%) reported experiencing insomnia symptoms. Among the postmenopausal women, sedentary time of &gt;8 h was associated with insomnia symptoms (OR = 1.41, 95% CI = 1.01–1.96), prolonged nocturnal awakening (OR = 1.38, 95% CI = 1.06–1.79), and undesired early morning awakening (OR = 1.59, 95% CI = 1.09–2.30). No association was observed between adherence to the aMED and insomnia symptoms (OR = 1.05, 95% CI: 0.77–1.44). Among the postmenopausal women with lower adherence to the aMED, the odds of insomnia symptoms were higher in those with sedentary time ≥8 h (OR = 1.63, 95% CI: 1.02–2.62). Similarly, in the participants with low aMED adherence, sedentary time ≥8 h was also associated with prolonged nocturnal awakening (OR = 1.90, 95% CI = 1.27–2.83) and undesired early morning awakening (OR = 1.85, 95% CI = 1.09–3.16).ConclusionAdherence to the aMED modulates the association between sedentary behavior and insomnia symptoms in postmenopausal women. Interventions targeting sedentary behavior and dietary patterns may improve sleep quality and overall health in postmenopausal women.
Interpretable machine learning models for predicting skip metastasis in cN0 papillary thyroid cancer based on clinicopathological and elastography radiomics features
Authors: Yao Xiaohua , Tang Mingming , Lu Min , Zhou Jie , Yang Debin 
Published: January 2025

BackgroundSkip lymph node metastasis (SLNM) in papillary thyroid cancer (PTC) involves cancer cells bypassing central nodes to directly metastasize to lateral nodes, often undetected by standard preoperative ultrasonography. Although multiple models exist to identify SLNM, they are inadequate for clinically node-negative (cN0) patients, resulting in underestimated metastatic risks and compromised treatment effectiveness. Our study aims to develop and validate a machine learning (ML) model that combines elastography radiomics with clinicopathological data to predict pre-surgical SLNM risk in cN0 PTC patients with increased risk of lymph node metastasis (LNM), improving their treatment strategies.MethodsOur study conducted a retrospective analysis of 485 newly diagnosed primary PTC patients, divided into training and external validation cohorts. Patients were categorized into SLNM and non-SLNM groups based on follow-up outcomes and postoperative pathology. We collected preoperative clinicopathological data and extracted, standardized radiomics features from elastography imaging to develop various ML models. These models were internally validated using radiomics and clinicopathological data, with the optimal model’s feature importance analyzed through the Shapley Additive Explanations (SHAP) approach and subsequently externally validated.ResultsIn our study of 485 patients, 67 (13.8%) exhibited SLNM. The extreme gradient boosting (XGBoost) model, integrating elastography radiomics with clinicopathological data, demonstrated superior performance in both internal and external validations. SHAP analysis identified five key determinants of SLNM: three radiomics features from elastography images, one clinical variable, and one pathological variable.ConclusionOur evaluation highlights the XGBoost model, which integrates elastography radiomics and clinicopathological data, as the most effective ML approach for the prediction of SLNM in cN0 PTC patients with increased risk of LNM. This innovative model significantly enhances the accuracy of risk assessments for SLNM, enabling personalized treatments that could reduce postoperative metastases in these patients.
Comparison of outcomes following prepectoral and subpectoral implants for breast reconstruction in patients with breast cancer
Authors: Zhang Jun , An Ran , Yu Zhi-Hao , Zhang Li 
Published: January 2025

BackgroundIn recent years, different approaches to implant-based breast reconstruction have increasingly become an important option to meet both the treatment and postoperative aesthetic needs of breast cancer patients. This study selected two commonly used techniques for the prepectoral approach: single-incision, gas-inflated endoscopic prepectoral breast reconstruction (SIE-BR) and open prepectoral implant-based breast reconstruction (C-BR), as well as a commonly used technique for the subpectoral approach: open subpectoral implant-based breast reconstruction (SI-BR). By comparing the clinical efficacy and aesthetic outcomes of these three techniques in the treatment of breast cancer patients, this study aims to summarize the advantages of the prepectoral approach.MethodsThis study screened the clinicopathological data of a total of 136 breast cancer patients from January 2023 to December 2023. Among them, 38 patients underwent SIE-BR, 51 patients underwent C-BR, and 47 patients underwent SI-BR. The patient characteristics, intraoperative and postoperative conditions were analyzed in detail, and satisfaction was assessed using the BREAST-Q questionnaire.ResultsThe SIE-BR group had the longest surgery time, followed by the SI-BR group, with the C-BR group having the shortest surgery time. The C-BR group had the least blood loss, while the SIE-BR group had the most. The C-BR group also had the lowest drainage volume, and the SIE-BR group had the highest. Patients were categorized into a prepectoral implant-based reconstruction group (PIBR) and a subpectoral implant-based reconstruction group (SIBR). None of the patients experienced implant loss or flap necrosis. The PIBR group had significantly lower rates of wound infection, capsular contracture, and chest muscle pain compared to the SIBR group. The rates of wound dehiscence and implant wrinkling were statistically similar between the two groups. BREAST-Q scores indicated similar satisfaction in terms of breast appearance and sexual life between the groups, but the PIBR group showed significantly better scores in physical health (chest muscle function preservation) and mental health. Additional advantages of the prepectoral approach, including less postoperative pain, reduced movement-related deformity, and shorter surgery time, have contributed to the steady growth of this technique in recent years.ConclusionThe three implant-based breast reconstruction techniques mentioned above are safe and feasible. Compared to the previously more common subpectoral approach, the prepectoral approach improves patients’ postoperative physical and psychological comfort, making it an ideal surgical option.
Prevalence of overweight and obesity among preschool children in Hainan: a cross-sectional study in China's largest free-trade zone
Authors: Wu Wei-Jia , Chen Ping-Hao , Huang Zhen-Ning , Lei Xue-Lu , Wang Chen , Zhang Chun-hui , Wang Ping , Huang Chui-can , Luo Qing , Fan Li-Chun 
Published: January 2025

Background and aimsChildhood obesity leads to significant health risks, emphasizing the critical need for effective preventive measures during the preschool years. However, there is a lack of comprehensive studies on overweight and obesity among preschool children in Hainan Island, China's largest free-trade zone. Our study assessed the prevalence of overweight and obesity among preschool children across Hainan Island using Chinese, World Health Organization (WHO), and International Obesity Task Force (IOTF) criteria. Additionally, the potential factors influencing overweight and obesity among preschool children in Hainan Island were further explored.MethodsWe conducted a cross-sectional survey of children aged 3–6 years covering 18 cities and counties in China's largest free trade zone. The survey primarily involved anthropometric data collection and questionnaires on children's information and the sociodemographic characteristics of their parents or guardians. We recorded the height and weight of each child and calculated their body mass index (BMI). The z-score for BMI-for-age was calculated using the WHO-recommended Anthro and AnthroPlus software, and diagnoses of overweight and obesity were determined separately according to the Chinese, WHO, and IOTF criteria. The chi-squared test, t-test, or rank-sum test was applied to describe and statistically analyze the baseline characteristics of the participating children. Additionally, potential factors affecting overweight and obesity were analyzed using a multifactor binary logistic regression model.ResultsThe prevalence of overweight and obesity among preschool children in Hainan Island was 11.30% based on the Chinese criteria, significantly higher than the rates of 5.80% and 5.40% observed according to the WHO and IOTF criteria, respectively (χ2 = 12,870.368, P &lt; 0.001). After multifactorial adjusted analyses, we found that according to the three growth criteria, having overweight fathers or mothers, family incomes of more than 100,000 Yuan, fully active eating, and higher birth weights increased the risk of overweight and obesity among preschool children in Hainan Island.ConclusionThe prevalence of overweight and obesity among preschool children in Hainan Island was lower compared to rates reported in other regions. Considering that the growth and development indicators for children under 7 years old in Hainan Island are generally lower than international standards, the use of Chinese standards may be more suitable for detecting overweight and obesity among preschool children in this area. Based on the risk factors identified in this study, preventive measures can be targeted in the future to reduce the risk of overweight and obesity in preschool children in Hainan Island.