bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive value of EGSYS score in the differential diagnosis of cardiac syncope and neurally mediated syncope in children
Authors: Li Yunxi , Liu Jianglin , Wang Minmin , Zhao Haizhao , Liu Xiaoyue , Hu Jing , Zhao Cuifen , Kong Qingyu 
Published: March 2023

Background and objectiveSyncope is a common emergency with diverse etiologies in children. Among these, cardiac syncope (CS) is associated with high mortality and is usually difficult to diagnose. However, there is still no validated clinical prediction model to distinguish CS from other forms of pediatric syncope. The Evaluation of Guidelines in Syncope Study (EGSYS) score was designed to identify CS in adults and has been validated in several studies. In this study, we aimed to assess the ability of the EGSYS score in predicting CS in children.MethodsIn this retrospective study, we calculated and analyzed the EGSYS scores of 332 children hospitalized for syncope between January 2009 and December 2021. Among them, 281 were diagnosed with neurally mediated syncope (NMS) through the head-up tilt test, and 51 were diagnosed with CS using electrocardiography (ECG), echocardiography (ECHO), coronary computed tomography angiography (CTA), myocardial enzymes and genetic screening. The receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test were used to evaluate the predictive value of the EGSYS score system.ResultsThe median scores of 51 children with CS and 281 children with NMS were 4 [interquartile range (IQR): 3-5] and −1 (IQR: -2-1), respectively. The area under the ROC curve (AUC) was 0.922 [95% confidence interval (CI): 0.892-0.952; P &lt; 0.001], indicating that the EGSYS score system has good discrimination. The best cutoff point was ≥3, with a sensitivity and specificity of 84.3% and 87.9%, respectively. The Hosmer-Lemeshow test demonstrated satisfactory calibration (χ²=1.468, P &gt; 0.05) of the score, indicating a good fit of the model.ConclusionThe EGSYS score appeared to be sensitive for differentiating CS from NMS in children. It might be used as an additional diagnostic tool to aid pediatricians in accurately identifying children with CS in the clinical practice.
Hyperuricemia is associated with more cardiometabolic risk factors in hypertensive younger Chinese adults than in elderly
Authors: Su Xiaofeng , Liu Jing , Sun Ningling , Huo Yong ,   the SUCCESS Investigation Group
Published: March 2023

BackgroundNumerous studies have shown that hyperuricemia (HUA) is associated with cardiovascular and renal outcomes, but few studies specifically explored the effect of age on this relationship. Therefore, our study aimed to explore the relationship between HUA and other cardiometabolic risk factors in different age groups.MethodsThis cross-section study used the data from Survey on uric acid in Chinese subjects with essential hypertension (SUCCESS). We performed multivariate logistic regressions in different age groups.ResultsAfter adjusting for potential confounders, among young and middle-aged adults less than 60, HUA was associated with higher body mass index (BMI, adjusted OR = 1.114, 95% CI: 1.057–1.174), higher fasting blood glucose (FBG, adjusted OR = 1.099, 95% CI: 1.003–1.205), triglycerides (TG, adjusted OR = 1.425, 95% CI: 1.247–1.629), higher low-density lipoprotein cholesterol (LDL-C, adjusted OR = 1.171, 95% CI: 1.025–1.337), and lower estimated glomerular filtration rate (eGFR, adjusted OR = 0.992, 95% CI: 0.988–0.996). Among elderly adults 60 years or older, HUA was associated with higher SBP (adjusted OR = 1.024, 95% CI: 1.005–1.042), higher TG (adjusted OR = 1.716, 95% CI: 1.466–2.009), and higher LDL-C (adjusted OR = 1.595, 95% CI: 1.366–1.863).ConclusionHUA is associated with more cardiometabolic risk factors in younger adults with hypertension (HT). Comprehensive management of HT with HUA is needed in clinical settings.
Association between weight-adjusted waist index and arterial stiffness in hypertensive patients: The China H-type hypertension registry study
Authors: Xiong Yurong , Shi Weidong , Huang Xiao , Yu Chao , Zhou Wei , Bao Huihui , Cheng Xiaoshu 
Published: March 2023

ObjectiveExploring the relationship between (weight-adjusted waist index) WWI and arterial stiffness (AS) in the total and different BMI populations among patients with hypertension.MethodsThis study enrolled 5232 hypertensive subjects, a subset of the China H-type Hypertension Registry Study. WWI was calculated as WC (cm) divided by the square root of weight (kg). Brachial-ankle pulse wave velocity (baPWV) was measured to determine AS.ResultsThe mean WWI was 10.97 (0.78)cm/√kg. In multiple logistic analyses showed that there were significant dose-dependent association between WWI with baPWV in a dose-dependent manner in total population (β 57.98, 95% CI 44.06-71.90), and in different BMI group: group 1 (BMI&lt;18.5kg/m2) (β 94.30, 95% CI 39.36-149.23), group 2 (18.5-23.9kg/m2) (β 74.21, 95% CI 54.57-93.85), group 3 (≥24kg/m2) (β 26.11, 95% CI 5.22-47.01). In stratified analysis, stronger associations between WWI and baPWV were observed in patients with higher BP or lower BMI. Sensitivity analysis by excluding patients treated with lipid-lowering agents did not change the association between WWI and baPWV.ConclusionFor hypertensive patients, we found that WWI was positively associated with baPWV in different BMI groups. WWI might be considered as an intervening factor in preventing and treatment of AS, besides BP management.
CLPP inhibition triggers apoptosis in human ovarian granulosa cells via COX5A abnormality–Mediated mitochondrial dysfunction
Authors: Yuan Xiong , Ma Wenjie , Chen Shuping , Wang Huiyuan , Zhong Chenyi , Gao Li , Cui Yugui , Pu Danhua , Tan Rongrong , Wu Jie 
Published: March 2023

Premature ovarian insufficiency (POI) is characterized by early loss of ovarian function before the age of 40 years. It is confirmed to have a strong and indispensable genetic component. Caseinolytic mitochondrial matrix peptidase proteolytic subunit (CLPP) is a key inducer of mitochondrial protein quality control for the clearance of misfolded or damaged proteins, which is necessary to maintain mitochondrial function. Previous findings have shown that the variation in CLPP is closely related to the occurrence of POI, which is consistent with our findings. This study identified a novel CLPP missense variant (c.628G &gt; A) in a woman with POI who presented with secondary amenorrhea, ovarian dysfunction, and primary infertility. The variant was located in exon 5 and resulted in a change from alanine to threonine (p.Ala210Thr). Importantly, Clpp was mainly localized in the cytoplasm of mouse ovarian granulosa cells and oocytes, and was relatively highly expressed in granulosa cells. Moreover, the overexpression of c.628G &gt; A variant in human ovarian granulosa cells decreased the proliferative capacity. Functional experiments revealed that the inhibition of CLPP decreased the content and activity of oxidative respiratory chain complex IV by affecting the degradation of aggregated or misfolded COX5A, leading to the accumulation of reactive oxygen species and reduction of mitochondrial membrane potential, ultimately activating the intrinsic apoptotic pathways. The present study demonstrated that CLPP affected the apoptosis of granulosa cells, which might be one of the mechanisms by which CLPP aberrations led to the development of POI.
Profiling sociodemographic attributes and extreme precipitation events as mediators of climate-induced disasters in municipalities in the state of Minas Gerais, Brazil
Authors: Guedes Gilvan , Andrade Lara de Melo Barbosa , Silva Cláudio Moises Santos e , Noronha Kenya Valéria Micaela de Souza , Rodrigues Daniele , Martins Albert Smith Feitosa Suassuna 
Published: March 2023

IntroductionData indicate an increase in the number of natural disasters in Brazil, with a large share of these events occurring in the state of Minas Gerais. This study examines precipitation-related natural disasters recorded between 1991 and 2016 in Minas Gerais by identifying municipality profiles (encompassing the number of droughts, flash floods, and flooding events), their sensitivity to geophysical and extreme climatic exposure, and their relation to sociodemographic and infrastructure characteristics.MethodsWe combine climate data on seven extreme rainfall indices with elevation data for each municipal seat. We obtained data on droughts, flash floods, and floods from the Center for Engineering and Civil Defense Research and Studies. Population and socio-sanitary characteristics were obtained from the 2010 Brazilian Demographic Census. First, we modeled the climatic-geo-socio-sanitary data using latent class analysis as a pure latent cluster model (LCM) without covariates on seven extreme precipitation indices coupled with altitude data. Subsequently, the LCM was used to identify precipitation-related disaster clusters, including clusters from the 1S-LCM as an active covariate (2S-LCM). Finally, we utilized sociodemographic and infrastructure variables simultaneously with the clusters from the 2S-LCM on an LCM without active covariates (3S-LCM).ResultsOur results show an increase in precipitation-related disasters in Minas Gerais, with municipalities located in the northern part of the state being particularly affected. The state registered 5,553 natural disasters in this period, with precipitation-related disasters representing 94.5% of all natural disasters. The 1S-LCM identified four homoclimatic zones, encompassing a low-altitude dry zone, a relatively low-altitude intermediately wet zone, a relatively high-altitude intermediately wet zone, and a high-altitude wet zone. The 2S-LCM produced four precipitation-related disaster classes, denominated low risk, high risk of excess precipitation, intermediate risk of precipitation deficit and excess, and high risk of precipitation deficit.DiscussionCities with better infrastructure and sociodemographic profiles in semi-arid regions are more resilient to droughts. In richer areas, floods are still a concern where incomplete urbanization transitions may undermine resilience to these events as they increase in intensity with the advance of climate change.
Fueling the flames of colon cancer – does CRP play a direct pro-inflammatory role?
Authors: Køstner Anne Helene , Fuglestad Anniken Jørlo , Georgsen Jeanette Baehr , Nielsen Patricia Switten , Christensen Kristina Bang , Zibrandtsen Helle , Parner Erik Thorlund , Rajab Ibraheem M. , Potempa Lawrence A. , Steiniche Torben , Kersten Christian 
Published: March 2023

BackgroundSystemic inflammation, diagnostically ascribed by measuring serum levels of the acute phase reactant C-reactive protein (CRP), has consistently been correlated with poor outcomes across cancer types. CRP exists in two structurally and functionally distinct isoforms, circulating pentameric CRP (pCRP) and the highly pro-inflammatory monomeric isoform (mCRP). The aim of this pilot study was to map the pattern of mCRP distribution in a previously immunologically well-defined colon cancer (CC) cohort and explore possible functional roles of mCRP within the tumor microenvironment (TME).MethodsFormalin-fixed, paraffin-embedded (FFPE) tissue samples from 43 stage II and III CC patients, including 20 patients with serum CRP 0-1 mg/L and 23 patients with serum CRP &gt;30 mg/L were immunohistochemically (IHC) stained with a conformation-specific mCRP antibody and selected immune and stromal markers. A digital analysis algorithm was developed for evaluating mCRP distribution within the primary tumors and adjacent normal colon mucosa.ResultsmCRP was abundantly present within tumors from patients with high serum CRP (&gt;30 mg/L) diagnostically interpreted as being systemically inflamed, whereas patients with CRP 0-1 mg/L exhibited only modest mCRP positivity (median mCRP per area 5.07‰ (95%CI:1.32-6.85) vs. 0.02‰ (95%CI:0.01-0.04), p&lt;0.001). Similarly, tissue-expressed mCRP correlated strongly with circulating pCRP (Spearman correlation 0.81, p&lt;0.001). Importantly, mCRP was detected exclusively within tumors, whereas adjacent normal colon mucosa showed no mCRP expression. Double IHC staining revealed colocalization of mCRP with endothelial cells and neutrophils. Intriguingly, some tumor cells also colocalized with mCRP, suggesting a direct interaction or mCRP expression by the tumor itself.ConclusionOur data show that the pro-inflammatory mCRP isoform is expressed in the TME of CC, primarily in patients with high systemic pCRP values. This strengthens the hypothesis that CRP might not only be an inflammatory marker but also an active mediator within tumors.
Summer phytoplankton photosynthetic characteristics in the Changjiang River Estuary and the adjacent East China Sea
Authors: Li Ji , Gao Yonghui , Bao Yalin , Gao Xiu , Glibert Patricia M. 
Published: March 2023

IntroductionThe Changjiang (Yangtze) River is one of the largest rivers in the world, and its estuary and offshore plume create a diversity of ecological habitats for the phytoplankton community. The phytoplankton community has to balance between light limitation in the sediment-laden inshore waters and nutrient limitation in the offshore waters. Active fluorescence measurements can provide rapid, non-intrusive estimates of photosynthetic characteristics at high spatial and temporal resolution.MethodsIn the summer of 2020, a field survey of hydrodynamic characteristics, availability of nutrients, the maximum quantum efficiency of photosystem II (Fv/Fm), and rapid light curves across the Changjiang River Estuary and its adjacent sea was conducted, assessing relationships between photosynthetic physiology and biomass accumulation.ResultsThe photosynthetic activities significantly differed among the turbid river water, the stratified river plume water, and the oceanic East China Sea Water. The photosynthetic physiology of phytoplankton was the most active near the front of Changjiang Diluted Water, where the Fv/Fm was over 0.5.DiscussionPhytoplankton photosynthesis was alleviated from light limitation downstream of the river mouth, and benefited from phosphorus supply via tidal mixing and upwelling. The relatively suitable light and nutrients led to high photosynthetic activities, supporting increased productivity and biomass in this water. The phytoplankton in the Changjiang estuary rivermouth were under intense stress, suggested by the Fv/Fm values under 0.3. Also, the strong vertical mixing process diluted the river nutrients before the phytoplankton consumed them. Nutrients further limited the phytoplankton offshore in the East China Sea.
Reduction of drive for thinness and body dissatisfaction in people with self-reported dysregulated eating behaviors after intermittent theta burst stimulation (iTBS) of the left dorsolateral prefrontal cortex
Authors: Barone Jennifer , Oliveri Massimiliamo , Bonaventura Rosario Emanuele , Mangano Giuseppa Renata 
Published: March 2023

AimThis study aimed to explore the effect of intermittent theta burst stimulation (iTBS) of the right and left dorsolateral prefrontal cortex (DLPFC) in people with self-reported dysregulated eating behaviors but without a diagnosis of eating disorders (EDs).MethodsParticipants were randomly divided into two equivalent groups according to the side (right or left) of the hemisphere to be stimulated and they were tested before and after a single iTBS session. Outcome measurements were scores on self-report questionnaires assessing psychological dimensions related to eating behaviors (EDI-3), anxiety (STAI-Y), and tonic electrodermal activity.ResultsThe iTBS interfered with both psychological and neurophysiological measures. Significant variations of physiological arousal after iTBS of both the right and left DLPFC were witnessed by increased mean amplitude of non-specific skin conductance responses. With regard to the psychological measures, the iTBS on the left DLPFC significantly reduced the scores of the EDI-3 subscales drive for thinness and body dissatisfaction. Interestingly, these two scales are two of the three EDI-3 clinic scales (drive for thinness, body dissatisfaction, and bulimia) used as specific markers to assess the onset and/or maintenance of eating disorders.ConclusionOur results show that the left DLPFC iTBS has an impact on the psychological dimensions that are risk factors for the onset of eating disorders, suggesting that an altered hemispheric asymmetry similar to that encountered in clinical populations is present in normal subjects even in the absence of clinical symptoms.
Metabolic reprogramming by miRNAs in the tumor microenvironment: Focused on immunometabolism
Authors: Alshahrani Shadia Hamoud , Ibrahim Yousif Saleh , Jalil Abduladheem Turki , Altoum Abdelgadir Alamin , Achmad Harun , Zabibah Rahman S. , Gabr Gamal A. , Ramírez-Coronel Andrés Alexis , Alameri Ameer A. , Qasim Qutaiba A. , Karampoor Sajad , Mirzaei Rasoul 
Published: March 2023

MicroRNAs (miRNAs) are emerging as a significant modulator of immunity, and their abnormal expression/activity has been linked to numerous human disorders, such as cancer. It is now known that miRNAs potentially modulate the production of several metabolic processes in tumor-associated immune cells and indirectly via different metabolic enzymes that affect tumor-associated signaling cascades. For instance, Let-7 has been identified as a crucial modulator for the long-lasting survival of CD8+ T cells (naive phenotypes) in cancer by altering their metabolism. Furthermore, in T cells, it has been found that enhancer of zeste homolog 2 (EZH2) expression is controlled via glycolytic metabolism through miRNAs in patients with ovarian cancer. On the other hand, immunometabolism has shown us that cellular metabolic reactions and processes not only generate ATP and biosynthetic intermediates but also modulate the immune system and inflammatory processes. Based on recent studies, new and encouraging approaches to cancer involving the modification of miRNAs in immune cell metabolism are currently being investigated, providing insight into promising targets for therapeutic strategies based on the pivotal role of immunometabolism in cancer. Throughout this overview, we explore and describe the significance of miRNAs in cancer and immune cell metabolism.
Hypofractionated whole breast irradiation with simultaneous integrated boost in breast cancer using helical tomotherapy with or without regional nodal irradiation: A report of acute toxicities
Authors: Chitapanarux Imjai , Nobnop Wannapha , Onchan Wimrak , Klunklin Pitchayaponne , Nanna Thongtra , Sitathanee Chomporn , Kulpisitthicharoen Sutthisak , Sripan Patumrat 
Published: March 2023

PurposeWe prospectively investigated the acute toxicities focusing on skin and hematologic function in breast cancer patients who received hypofractionated whole breast irradiation with simultaneous integrated boost (HF-WBI-SIB) with helical tomotherapy (HT), with or without regional nodal irradiation (RNI).MethodsThe dose of WBI and RNI was 42.4 Gy in 16 fractions. Tumor bed was prescribed to 49.6 Gy in 16 fractions simultaneously. The association between the worst grade of acute toxicities during treatment and receiving RNI was analyzed. The integral dose to the whole body between the two groups was also compared.ResultsBetween May 2021 and May 2022, 85 patients were enrolled; 61 patients received HF-WBI-SIB only (71.8%) and 24 patients (28.2%) received HF-WBI-SIB with RNI. Grade 2 acute skin toxicity was found in 1.2%. The most frequent grade 2 or more hematologic toxicity was leukopenia, which occurred in 4.8% and 11% in the 2nd and 3rd week, respectively. Mean whole body integral dose was significantly higher in patients treated with RNI compared to patients treated without RNI: 162.8 ± 32.8 vs. 120.3 ± 34.7 Gy-L (p-value &lt; 0.001). There was no statistically significant difference in acute grade 2 or more skin and hematologic toxicities between the two groups.ConclusionsHF-WBI-SIB with or without RNI is feasible with acceptable acute skin and hematologic toxicities. RNI and whole body integral dose were not associated with these acute toxicities.
Endovascular image-guided sampling of tumor-draining veins provides an enriched source of oncological biomarkers
Authors: Tamrazi Anobel , Sundaresan Srividya , Gulati Aishwarya , Tan Frederick J. , Wadhwa Vibhor , Bartlett Bjarne R. , Diaz Luis A. Jr. 
Published: March 2023

IntroductionCirculating tumor-derived biomarkers can potentially impact cancer management throughout the continuum of care. This small exploratory study aimed to assess the relative levels of such biomarkers in the tumor-draining vascular beds in patients with solid tumors compared to levels in their peripheral veins.MethodsUsing an endovascular image-guided approach, we obtained blood samples from peripheral veins and other vascular compartments–including the most proximal venous drainage from solid tumors–from a set of nine oncology patients with various primary and metastatic malignancies. We then interrogated these samples for a panel of oncological biomarkers, including circulating tumor cells (CTCs), exosome-derived microRNAs (miRNAs), circulating tumor DNA (ctDNA) mutations, and certain cancer-related proteins/biochemical markers.ResultsWe found substantially higher levels of CTCs, certain miRNAs, and specific ctDNA mutations in samples from vascular beds closer to the tumor compared with those from peripheral veins and also noted that some of these signals were altered by treatment procedures.DiscussionOur results indicate that tumor-proximal venous samples are highly enriched for some oncological biomarkers and may allow for more robust molecular analysis than peripheral vein samples.
Identification of cuproptosis-based molecular subtypes, construction of prognostic signature and characterization of immune landscape in colon cancer
Authors: Wang Xu , Zuo Xiaomin , Hu Xianyu , Liu Yuyao , Wang Zhenglin , Chan Shixin , Sun Rui , Han Qijun , Yu Zhen , Wang Ming , Zhang Huabing , Chen Wei 
Published: March 2023

BackgroundCuproptosis is a newly discovered form of cell death induced by targeting lipoacylated proteins involved in the tricarboxylic acid cycle. However, the roles of cuproptosis-related genes (CRGs) in the clinical outcomes and immune landscape of colon cancer remain unknown.MethodsWe performed bioinformatics analysis of the expression data of 13 CRGs identified from a previous study and clinical information of patients with colon cancer obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases. Colon cancer cases were divided into two CRG clusters and prognosis-related differentially expressed genes. Patient data were separated into three corresponding distinct gene clusters, and the relationships between the risk score, patient prognosis, and immune landscape were analyzed. The identified molecular subtypes correlated with patient survival, immune cells, and immune functions. A prognostic signature based on five genes was identified, and the patients were divided into high- and low-risk groups based on the calculated risk score. A nomogram model for predicting patient survival was developed based on the risk score and other clinical features.ResultsThe high-risk group showed a worse prognosis, and the risk score was related to immune cell abundance, microsatellite instability, cancer stem cell index, checkpoint expression, immune escape, and response to chemotherapeutic drugs and immunotherapy. Findings related to the risk score were validated in the imvigor210 cohort of patients with metastatic urothelial cancer treated with anti-programmed cell death ligand 1.ConclusionWe demonstrated the potential of cuproptosis-based molecular subtypes and prognostic signatures for predicting patient survival and the tumor microenvironment in colon cancer. Our findings may improve the understanding of the role of cuproptosis in colon cancer and lead to the development of more effective treatment strategies.