bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report
Authors: Liu Zhoujun , Zhao Yueting , Han Xue , Hu Xin , Zhang Yuzhi , Xu Lan , Chen Guofang , Liu Chao , Xu Shuhang 
Published: September 2023

BackgroundMultiple endocrine neoplasia type 1 (MEN1) is an inherited endocrine syndrome caused by the mutation in the tumor suppressor gene MEN1. The recurrence rate of primary hyperparathyroidism (PHPT) in patients with MEN1 after parathyroidectomy remains high, and the management of recurrent hyperparathyroidism is still challenging.Case presentationWe reported a 44-year-old woman with MEN1 combined with PHPT who was diagnosed through genetic screening of the patient and her family members. After parathyroidectomy to remove one parathyroid gland, the patient suffered from persistent high levels of serum calcium and parathyroid hormone, which returned to normal at up to 8 months after ultrasound-guided microwave ablation (MWA) for bilateral parathyroid glands, suggesting an acceptable short-term prognosis.ConclusionUltrasound-guided MWA for parathyroid nodules may be an effective therapeutic strategy for recurrent PHPT in MEN1 patients.
Causal association between common rheumatic diseases and glaucoma: a Mendelian randomization study
Authors: Meng Yang , Tan Zongbiao , Su Yu , Li Lu , Chen Changzheng 
Published: September 2023

BackgroundAutoimmunity and inflammation are the main characteristics of rheumatic diseases and have both been found to be related to glaucoma. However, it remains unclear whether rheumatic diseases increase the risk of glaucoma. Here, we performed a Mendelian randomization (MR) analysis to investigate the causal effects of six common rheumatic diseases on glaucoma.MethodsSix rheumatic diseases were included: ankylosing spondylitis (AS), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sicca syndrome/Sjögren’s sydrome (SS), dermatomyositis (DM), and gout. Glaucoma included primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Genetic variants associated with these rheumatic diseases and glaucoma were extracted from the genome-wide association studies and FinnGen8 database, respectively. First, a two-sample MR was used to investigate the potential causal association. Then, a multivariable MR was conducted to further verify the results. Inverse-variance weighted MR analysis was used as the main method, together with several sensitivity analyses.ResultsTwo-sample MR suggests that AS is related to a higher risk of both POAG [odds ratio (OR): 1.28, 95% confidence interval (CI) 1.13–1.44; p = 1.1 × 10−4] and PACG (OR: 1.55, 95% CI: 1.09–2.09, p = 1.4 × 10−2). Multivariable MR shows a similar trend of the effect of AS on POAG (OR: 1.52, 95% CI: 1.22–1.90, p = 1.9 × 10−4) and PACG (OR: 2.05, 95% CI: 1.06–3.95, p = 3.2 × 10−2). No significant association was observed between the other five rheumatic diseases and glaucoma.ConclusionsAS is related to an increased risk of POAG and PACG. We stress the importance of glaucoma screening for AS patients.
Ball-milling of titanium dioxide and zinc oxide for enhanced UV protection
Authors: Yang Panpan , Wang Hongxia , Chen Yuyan , Li Yanan , Zhang Jun , Zhang Chunxiao , Lin Bao , Wei Xiaolan 
Published: September 2023

Among various sunscreen materials, zinc oxide and titanium dioxide are excellent physical sunscreen components; however, these two materials tend to aggregate and form micrometer-sized particles that may impact their performance. This study utilizes fine grinding techniques to break up the aggregated oxide particles into small nanoparticles with a narrow size distribution averaging around 200 nm in diameter. The ground zinc oxide and titanium dioxide particles exhibit enhanced ability in absorbing and scattering ultraviolet radiation compared to their original state before grinding. Consequently, this research offers innovative concepts as well as approaches towards developing highly efficient yet low-toxic physical sunscreen components while significantly contributing to the preparation process optimization for mixed material performance.
Insight of novel biomarkers for papillary thyroid carcinoma through multiomics
Authors: Liu Wei , Zhu Junkan , Wu Zhen , Yin Yongxiang , Wu Qiao , Wu Yiming , Zheng Jiaojiao , Wang Cong , Chen Hongyan , Qazi Talal Jamil , Wu Jun , Zhang Yuqing , Liu Houbao , Yang Jingmin , Lu Daru , Zhang Xumin , Ai Zhilong 
Published: September 2023

IntroductionThe overdiagnosing of papillary thyroid carcinoma (PTC) in China necessitates the development of an evidence-based diagnosis and prognosis strategy in line with precision medicine. A landscape of PTC in Chinese cohorts is needed to provide comprehensiveness.Methods6 paired PTC samples were employed for whole-exome sequencing, RNA sequencing, and data-dependent acquisition mass spectrum analysis. Weighted gene co-expression network analysis and protein-protein interactions networks were used to screen for hub genes. Moreover, we verified the hub genes' diagnostic and prognostic potential using online databases. Logistic regression was employed to construct a diagnostic model, and we evaluated its efficacy and specificity based on TCGA-THCA and GEO datasets.ResultsThe basic multiomics landscape of PTC among local patients were drawn. The similarities and differences were compared between the Chinese cohort and TCGA-THCA cohorts, including the identification of PNPLA5 as a driver gene in addition to BRAF mutation. Besides, we found 572 differentially expressed genes and 79 differentially expressed proteins. Through integrative analysis, we identified 17 hub genes for prognosis and diagnosis of PTC. Four of these genes, ABR, AHNAK2, GPX1, and TPO, were used to construct a diagnostic model with high accuracy, explicitly targeting PTC (AUC=0.969/0.959 in training/test sets).DiscussionMultiomics analysis of the Chinese cohort demonstrated significant distinctions compared to TCGA-THCA cohorts, highlighting the unique genetic characteristics of Chinese individuals with PTC. The novel biomarkers, holding potential for diagnosis and prognosis of PTC, were identified. Furthermore, these biomarkers provide a valuable tool for precise medicine, especially for immunotherapeutic or nanomedicine based cancer therapy.
Prophylactic intravenous norepinephrine for the prevention of hypotension during spinal anesthesia for elective cesarean section: a systematic review and dose–response meta-analysis of randomized controlled trials
Authors: Li Yuan , Shuai Bingxing , Huang Han 
Published: September 2023

Introduction: In this study, we aimed to evaluate the potential dose–response relationship between prophylactic norepinephrine (NE) infusion rates and the risks of hypotension during cesarean section following spinal anesthesia.Methods: Randomized controlled trials with two or more NE doses for post-spinal hypotension prophylaxis during cesarean section were systematically searched in the MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and US Clinical Trials Registry databases until 31 July 2022. The primary outcome was the relative risk of maternal hypotension with different NE regimens (infusion rates or bolus doses). Secondary outcomes included the relative risks of maternal and fetal adverse events with different NE regimens.Results: Ten studies with 1,144 parturients were included for final analysis using restricted cubic splines and random-effects dose–response meta-analysis models. A significant dose–response relationship existed between NE infusion rates and the relative risks of maternal hypotension. Every 0.01 μg/kg/min increment in the NE infusion rate was associated with a 14% decrease in the incidence of post-spinal hypotension. ED50 and ED95 of NE infusion rates for post-spinal hypotension prophylaxis were estimated to be 0.046 (95% CI from 0.032 to 0.085) and 0.2 (95% CI from 0.14 to 0.37) μg/kg/min, respectively. However, a higher NE infusion rate was associated with a higher incidence of maternal hypertension.Conclusion: An increased NE infusion rate was associated with a decreased incidence of post-spinal hypotension but an increased incidence of hypertension. Therefore, 0.07 μg/kg/min was recommended as the initial NE infusion rate for clinical practice, as it was associated with the lowest risk of physician intervention for unstable hemodynamics after spinal anesthesia for cesarean delivery.Systematic Review Registration: (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349934), identifier (CRD42022349934).
Comprehensive deep learning-based framework for automatic organs-at-risk segmentation in head-and-neck and pelvis for MR-guided radiation therapy planning
Authors: Czipczer Vanda , Kolozsvári Bernadett , Deák-Karancsi Borbála , Capala Marta E. , Pearson Rachel A. , Borzási Emőke , Együd Zsófia , Gaál Szilvia , Kelemen Gyöngyi , Kószó Renáta , Paczona Viktor , Végváry Zoltán , Karancsi Zsófia , Kékesi Ádám , Czunyi Edina , Irmai Blanka H. , Keresnyei Nóra G. , Nagypál Petra , Czabány Renáta , Gyalai Bence , Tass Bulcsú P. , Cziria Balázs , Cozzini Cristina , Estkowsky Lloyd , Ferenczi Lehel , Frontó András , Maxwell Ross , Megyeri István , Mian Michael , Tan Tao , Wyatt Jonathan , Wiesinger Florian , Hideghéty Katalin , McCallum Hazel , Petit Steven F. , Ruskó László 
Published: September 2023

Introduction: The excellent soft-tissue contrast of magnetic resonance imaging (MRI) is appealing for delineation of organs-at-risk (OARs) as it is required for radiation therapy planning (RTP). In the last decade there has been an increasing interest in using deep-learning (DL) techniques to shorten the labor-intensive manual work and increase reproducibility. This paper focuses on the automatic segmentation of 27 head-and-neck and 10 male pelvis OARs with deep-learning methods based on T2-weighted MR images.Method: The proposed method uses 2D U-Nets for localization and 3D U-Net for segmentation of the various structures. The models were trained using public and private datasets and evaluated on private datasets only.Results and discussion: Evaluation with ground-truth contours demonstrated that the proposed method can accurately segment the majority of OARs and indicated similar or superior performance to state-of-the-art models. Furthermore, the auto-contours were visually rated by clinicians using Likert score and on average, 81% of them was found clinically acceptable.
Effect of isokinetic muscle strength training on knee muscle strength, proprioception, and balance ability in athletes with anterior cruciate ligament reconstruction: a randomised control trial
Authors: Wang Kun , Cheng Liang , Wang Bingcheng , He Benxiang 
Published: September 2023

Objective: This study aimed to investigate the effects of regular isokinetic muscle strength training on knee muscle strength, proprioception, and balance ability in athletes after anterior cruciate ligament (ACL) reconstruction.Methods: Forty-one athletes who underwent ACL reconstruction were randomly divided into the experimental (n = 21) and control (n = 20) groups. The experimental group used an isokinetic muscle strength tester for 4 weeks (five times/ week) of knee flexion and extension isokinetic muscle strength training. The control group used the knee joint trainer (pneumatic resistance) for the same exercise regimen as the experimental group.Results: 1) Four weeks when compared with the baseline. Experimental group: the knee flexion and extension PT (60°/s and 240°/s) increased by 31.7%, 40.3%, 23.4%, and 42.9% (p &lt; 0.01), and the flexion muscular endurance increased by 21.4% and 19.7% (p &lt; 0.01). The flexion and extension kinaesthesia and the 30° and 60° position sense decreased by 36.2%, 32.3%, 40.0%, and 18.9% (p &lt; 0.05). The anterior–posterior and medial–lateral displacement and speed decreased by 30.2%, 44.2%, 38.4%, and 24.0% (p &lt; 0.05). Control group: the knee peak torque (60°/s) increased by 18.8% (p &lt; 0.01). The anterior–posterior and medial–lateral displacement and speed decreased by 14.9%, 40.0%, 26.8%, and 19.5% (p &lt; 0.01). 2) After 4 weeks, compared with the control group, the knee flexion and extension peak torque (60°/s), extension, peak torque (240°/s), and extension muscular endurance of the treatment group increased to varying degrees (p &lt; 0.05). However, the kinaesthesia, 30° position sense, and anterior–posterior displacement decreased to varying degrees (p &lt; 0.05).Conclusion: Adding regular isokinetic muscle strength training to rehabilitation training further improved the knee flexion and extensor strength and extensor endurance of athletes with ACL reconstruction, as well as enhanced the kinaesthesia and 30° position sense and the balance between the anterior and posterior directions. However, the treatment had limited effects on knee flexion kinaesthesia and muscle endurance.
Functional trait divergence associated with heteromorphic leaves in a climbing fig
Authors: Deng Jun-Yin , Wang Yong-Jin , Chen Lu-Fan , Luo Tong , Wang Rong , Chen Xiao-Yong 
Published: September 2023

IntroductionPlants that display heteroblasty possess conspicuous variations in leaf morphology between their juvenile and adult phases, with certain species retaining juvenile-like leaves even in adulthood. Nevertheless, the ecological advantages of maintaining two or more distinct leaf types in heteroblastic plants at the adult stage remain unclear.MethodThe aim of this study is to examine the adaptive significance of heteroblastic leaves sampled from branches with divergent functions (sterile and fertile branches) of mature Ficus pumila individuals by comparing their morphological, anatomical, and physiological characteristics.ResultLeaves on sterile branches (LSs) exhibited a significantly larger specific leaf area, thinner palisade and spongy tissues, lower chlorophyll contents, and lower light saturation points than leaves on fertile branches (LFs). These results demonstrate that LSs are better adapted to low light environments, while LFs are well equipped to take advantages of high light conditions. However, both LFs and LSs have a low light compensation point with no significant difference between them, indicating that they start to accumulate photosynthetic products under similar light conditions. Interestingly, significant higher net photosynthetic rate was detected in LFs, showing they have higher photosynthetic capacity. Furthermore, LFs produced significant more nutrients compared to LSs, which may associate to their ability of accumulating more photosynthetic products under full light conditions and higher photosynthetic capacity.DiscussionOverall, we observed a pattern of divergence in morphological features of leaves on two functional branches. Anatomical and physiological features indicate that LFs have an advantage in varied light conditions, providing amounts of photosynthetic products to support the sexual reproduction, while LSs adapt to low light environments. Our findings provide evidence that heteroblasty facilitates F. pumila to utilize varying light environments, likely associated with its growth form as a climbing plant. This strategy allows the plant to allocate resources more effectively and optimize its overall fitness.
The development and initial feasibility testing of D-HOMES: a behavioral activation-based intervention for diabetes medication adherence and psychological wellness among people experiencing homelessness
Authors: Vickery Katherine Diaz , Ford Becky R. , Gelberg Lillian , Bonilla Zobeida , Strother Ella , Gust Susan , Adair Edward , Montori Victor M. , Linzer Mark , Evans Michael D. , Connett John , Heisler Michele , O'Connor Patrick J. , Busch Andrew M. 
Published: September 2023

IntroductionCompared to stably housed peers, people experiencing homelessness (PEH) have lower rates of ideal glycemic control, and experience premature morbidity and mortality. High rates of behavioral health comorbidities and trauma add to access barriers driving poor outcomes. Limited evidence guides behavioral approaches to support the needs of PEH with diabetes. Lay coaching models can improve care for low-resource populations with diabetes, yet we found no evidence of programs specifically tailored to the needs of PEH.MethodsWe used a multistep, iterative process following the ORBIT model to develop the Diabetes Homeless Medication Support (D-HOMES) program, a new lifestyle intervention for PEH with type 2 diabetes. We built a community-engaged research team who participated in all of the following steps of treatment development: (1) initial treatment conceptualization drawing from evidence-based programs, (2) qualitative interviews with affected people and multi-disciplinary housing and healthcare providers, and (3) an open trial of D-HOMES to evaluate acceptability (Client Satisfaction Questionnaire, exit interview) and treatment engagement (completion rate of up to 10 offered coaching sessions).ResultsIn step (1), the D-HOMES treatment manual drew from existing behavioral activation and lay health coach programs for diabetes as well as clinical resources from Health Care for the Homeless. Step (2) qualitative interviews (n = 26 patients, n = 21 providers) shaped counseling approaches, language and choices regarding interventionists, tools, and resources. PTSD symptoms were reported in 69% of patients. Step (3) trial participants (N = 10) overall found the program acceptable, however, we saw better program satisfaction and treatment engagement among more stably housed people. We developed adapted treatment materials for the target population and refined recruitment/retention strategies and trial procedures sensitive to prevalent discrimination and racism to better retain people of color and those with less stable housing.DiscussionThe research team has used these findings to inform an NIH-funded randomized control pilot trial. We found synergy between community-engaged research and the ORBIT model of behavioral treatment development to develop a new intervention designed for PEH with type 2 diabetes and address health equity gaps in people who have experienced trauma. We conclude that more work and different approaches are needed to address the needs of participants with the least stable housing.
Protocol for randomized personalized trial for stress management compared to standard of care
Authors: Goodwin Ashley M. , Miller Danielle , D’Angelo Stefani , Perrin Alexandra , Wiener Ruby , Greene Brittney , Romain Anne-Marie N. , Arader Lindsay , Chandereng Thevaa , Kuen Cheung Ying , Davidson Karina W. , Butler Mark 
Published: September 2023

Stress is a significant public health burden in the United States, with most Americans reporting unhealthy levels of stress. Stress management techniques include various evidence-based treatments shown to be effective but with heterogeneous treatment responses, indicating a lack of uniform benefits for all individuals. Designed to assess a participant’s response to a specific intervention, personalized (N-of-1) trials provide guidance for which treatment (s) work (s) best for the individual. Prior studies examining the effects of mindfulness meditation, yoga, and walking for stress reduction found all three interventions to be associated with significant reductions in self-reported measures of stress. Delivering these treatments using a personalized trial approach has the potential to assist clinicians in identifying the best stress management techniques for individuals with persistently high stress while fostering treatment decisions that consider their personal condition/barriers. This trial will evaluate a personalized approach compared to standard of care for three interventions (guided mindfulness meditation; guided yoga; and guided brisk walking) to manage perceived stress. Participants will respond to daily surveys and wear a Fitbit device for 18 weeks. After a 2-week baseline period, participants in the personalized trial groups will receive 12 weeks of interventions in randomized order, while participants in the standard-of-care group will have access to all interventions for self-directed stress management. After intervention, all participants will undergo 2 weeks of observation, followed by two additional weeks of the stress management intervention of their choosing while continuing outcome measurement. At study completion, all participants will be sent a satisfaction survey. The primary analysis will compare perceived stress levels between the personalized and standard of care arms. The results of this trial will provide further support for the use of personalized designs for managing stress.Clinical Trial Registration: clinicaltrials.gov, NCT05408832.Protocol version: 9/14/2022, 21-0968-MRB.
Farmers in the transition toward sustainability: what is the role of their entrepreneurial identity?
Authors: Rossi Eleonora Sofia , Materia Valentina C. , Caracciolo Francesco , Blasi Emanuele , Pascucci Stefano 
Published: September 2023

IntroductionThe European Union has recently prompted a shift toward Ecological Intensification (EI) practices, aiming to harmonize agricultural productivity and environmental conservation. Despite the benefits of EI, its implementation has been limited, as farmers face challenges in business reorganization and supply chain adaptation. This paper investigates the role of contract farming (CF) in promoting the adoption of sustainable practices among Italian wheat producers. Specifically, it analyzes the influence of farmers’ entrepreneurial identity on their engagement in such initiatives.MethodsUsing the case study of Barilla Group’s Carta del Mulino initiative, an innovative contract farming scheme incentivizing sustainable EI practices, the study explores the relationship between entrepreneurial identity and participation in CF schemes supporting EI. Data from a sample of 314 soft wheat farmers in four regions of Northern Italy were collected to examine the role of entrepreneurial identity in the adoption of sustainable practices and participation in CF schemes. To evaluate the research hypotheses, two distinct econometric models were developed.Results and discussionThe findings reveal that farmers with a more developed entrepreneurial identity are more likely to adopt more sustainable agricultural practices and engage in contractual schemes involving EI practices. The study highlights the importance of fostering and supporting farmers’ entrepreneurial identity while increasing their knowledge of alternative agricultural techniques to address the challenges of the agricultural sector. This integration of individual perspectives (entrepreneurial identity) with a systems view (contract farming schemes) offers valuable insights for future research, policy, and practice in agri-food systems sustainability.