bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptom Patterns and Progression of Complications in Sickle Cell Anemia and Sickle Cell Trait: Implications for Enhanced Medical Care and Education
Authors: portilla Elizabeth , Suarez Andrés , Moreno Tulio , Hernández Enio , Fong Cristian 
Published: September 2023

Abstract
Background. Sickle cell anemia and sickle cell trait are two conditions characterized by the presence of hemoglobin S. However, sickle cell anemia is a disorder with wide clinical variability, and the sickle cell trait is considered an asymptomatic condition. Careful medical attention and educational programs about the disease have been successful in decreasing the mortality rate in patients with sickle cell anemia. A lack of these measures could increase the severity in patients with sickle cell disease and even in individuals with sickle cell trait who without adequate information may not take appropriate precautions. This study was conducted to establish the distribution of symptoms in patients with sickle cell anemia in Colombia and to determine whether there is an increase in the frequency of symptoms in sickle cell trait individuals in the context of Colombian medical care. Methods. We examined 109 patients with sickle cell anemia and 99 individuals with sickle cell trait. Symptom information was collected from the patients for both conditions. Pearson’s chi-square and Student’s t-test were used to identify differences between sickle cell anemia and sickle cell trait in clinical variables. To identify whether any clinical variable was associated with any condition, a correspondence analysis was performed. Results. The most frequent symptom was pain crisis, followed by dactylitis and pneumonia. Blood transfusion was required in 46% of this population. The frequency of pain crises and pneumonia was higher in patients with sickle cell anemia than in patients with sickle cell trait. However, 68.6% of patients with sickle cell trait suffered pain crises. Patients with sickle cell anemia also showed a 31-fold higher probability of receiving a blood transfusion than patients with sickle cell trait. Splenomegaly, pneumonia, and cardiac problems appeared to be interrelated symptoms in this population, suggesting an axis of progressive complications in patients with sickle cell anemia. Conclusions. These results show that the population with sickle cell anemia and sickle cell trait present clinical conditions that increase the severity of both conditions. Therefore, it is necessary to improve medical care and design educational campaigns to reduce the risk of complications.
Histopathological characterization of transient and nestling birds affected by the 2020 spill of diesel fuel in the Russian Arctic
Authors: Kireeva Anna V. , Kolenchukova Oksana A. , Esimbekova Elena N. , Savchenko Alexander P. , Temerova Victoria L. , Emelyanov Vladimir I. 
Published: September 2023

Abstract
Environmental pollution caused by spills of petroleum oil and its products poses a hazard to the health of wild birds. The purpose of the present study was to investigate morphological changes in the transient and nestling birds inhabiting the area affected by the spill of diesel fuel. Two groups of birds were studied: 1 – transient birds (Anas acuta and Mareca penelope); 2 – nestling birds (Aythya fuligula L. and Mergus serrator L.), which inhabit this ecotope. These species are all Anseriformes of the Anatidae family. Birds were caught along the Ambarnaya River in July and August 2022. Birds were captured, organs were removed (liver, lungs and heart) and examined using histological methods. Organ sections were stained with Hematoxylin & Eosin in automatic mode (AFOMK-16-26, Russia). The specimens were examined and scored under light microscope and with digital camera (Carl Zeiss, Germany). Histology of organs and tissues of breeding and migratory birds did not reveal any significant differences between the two groups. More pronounced pathologies were observed in breeding birds. All species had brown foreign particles distributed in blood and showed destructive changes in organs and tissues leading to pronounced dysfunction of the organs. In some bird species, neoplastic processes were observed.
Effect of exercise-induced muscle fatigue on reaction times under postural perturbation conditions in individuals with and without chronic low back pain
Authors: Xiao Wenwu , Peng Jiahui , Xie Hao , Xie Haoyu , Hao Zengming , Li Zifeng , Yang Huaichun , Mao Haian , Wang Chuhuai 
Published: September 2023

Abstract
Background: Total reaction time (TRT), composed of premotor time (PMT) and electromechanical delay (EMD), is susceptible to muscle fatigue and can be affected by pain. However, the muscle fatigue effects of chronic low back pain(cLBP) in postural perturbation conditions have not been adequately reported. This study aimed to examine the impact of pain and muscle fatigue on reaction time, so as to gain insights into the neuromuscular control strategy changes associated with muscle fatigue effect of cLBP.
Methods: Twenty-five subjects with cLBP (cLBP group) and twenty-three healthy individuals (HC group) were tested by Biering-Sorensen Test to generate exhaustive muscle fatigue. TRT, PMT and EMD were recorded by surface electromyography during the arm raising task with visual cues prior to and following muscle fatigue. The mean difference (MD) of reaction time was calculated before and after muscle fatigue, denoted as MDTRT, MDPMT, and MDEMD, respectively. Besides, the fear avoidance beliefs questionnaire (FABQ) and visual angle scores (VAS) was evaluated before muscle fatigue in cLBP group.
Results：The TRT and PMT were significantly prolonged after muscle fatigue in the cLBP group compared with before muscle fatigue (Z=-3.371, P=0.001; Z=-3.286, P=0.001, respectively). Meanwhile, the cLBP group had significantly shorter TRT and PMT before muscle fatigue than HC group (Z=-3.299, P=0.001; Z=-3.256, P=0.001, respectively). Additionally, the correlation analysis manifested that MDPMT and MDTRT were positively correlated with FABQ (r=0.422, P=0.040; r=0.418, P=0.042) and VAS (r=0.546, P=0.006; r=0.564, P=0.004) separately.
Conclusions：The reaction time would be altered by chronic pain in neuromuscular control processes, and muscle fatigue could further induce it delay. Besides, this reaction time delay was positively correlated with pain level and fear-avoidance beliefs. These findings highlight the importance of the muscle fatigue effects with cLBP, such as avoiding exhaustive muscle fatigue and paying more attention to fear-beliefs and pain during rehabilitation.
Trial registration: This trial is registered at chictr.org.cn, number ChiCTR2300074348. Registered August 4, 2023.
Invasive stratified mucin-producing carcinoma of the colorectum: Expanding the morphologic spectrum of large bowel cancer
Authors: Auld Finn Morgan , Moyana Terence N. 
Published: September 2023

Abstract
Background:
Invasive stratified mucin-producing carcinoma is a recently recognized adenocarcinoma with distinctive features. Morphologically, it is characterized by solid groups of tumor cells containing variable amounts of intracytoplasmic mucin stratified throughout the thickness of lesional epithelium. It was first described in the cervix but similar tumors have since been reported in the penis, anus and prostate, with or without an association with human papilloma virus. In the gastrointestinal tract, the phenomenon of epithelial stratification has an interesting embryologic morphogenesis. Gastrointestinal mucosa starts off as nascent columnar epithelium that is subsequently patterned to confer regional specific functions along the cephalocaudal axis. However, in disease states, normal architectural patterning can be disrupted by aberrant differentiation. Given this background and the phenotypic plasticity of neoplastic cells, we were interested in ascertaining whether invasive stratified mucin-producing carcinoma occurs in the colorectum.
Methods
This was a retrospective study of all 584 cases of colorectal carcinoma accessioned at our institution over a 2-year period (January 2021- December 2022). Cases were analyzed to determine which fulfilled the criteria for invasive stratified mucin-producing carcinoma.
Results
There were 9 cases of colorectal invasive stratified mucin-producing carcinoma - one pure form and 8 mixed. They showed the classic colorectal (CK20+, CDX2+, CK7-) immunostaining profile but, based on various morphologic criteria, they could be distinguished from conventional adenocarcinoma NOS, mucinous, signet ring cell, medullary, goblet cell and undifferentiated carcinomas. About half the cases were MLH1/PMS2 deficient and BRAF &/or PIK3CA mutated, which aligns with the hypermutated phenotype.
Conclusions
Colorectal invasive stratified mucin-producing carcinoma appears to be a real entity, best recognized in its early stages. It appears to be a high-grade carcinoma. With tumor progression, it evolves into a mucinous adenocarcinoma with a proclivity towards signet ring cells. In summary, the study of this tumor, particularly in its early stages, provides useful clues to further understanding the biology and progression of large bowel cancer. Further studies are required to learn more about this tumor.
Screening Optimal Candidates with Operable, Early-Stage Triple-Negative Breast Cancer Benefitting from Capecitabine Maintenance: A Post-Hoc Analysis of the SYSUCC-001 Study
Authors: Duan Fangfang , Hua Xin , Bi Xiwen , Wang Shusen , Shi Yanxia , Xu Fei , Wang Li , Huang Jiajia , Yuan Zhongyu , Huang Yuanyuan 
Published: September 2023

Abstract

Background
Recent clinical trials and meta-analyses suggest that addition of capecitabine to standard chemotherapy could be beneficial in early-stage triple-negative breast cancer (TNBC). We aimed to develop an individualized prediction model to quantify the clinical benefit of capecitabine maintenance in TNBC.
Methods
Data of patients from the SYSUCC-001 trial (NCT01112826), randomized to standard treatment with or without metronomic capecitabine maintenance, were analyzed. Candidate covariates included age, menstrual status, type of surgery, postoperative chemotherapy regimen, Ki-67 percentage, histologic grade, primary tumor size, lymphovascular invasion, node status, and capecitabine medication. The primary endpoint was disease-free survival (DFS). The nonlinear effects of continuous covariates were modeled by restricted cubic spline. A survival prediction model was constructed using Cox proportional hazards regression analysis.
Results
The data of 434 patients (306 in the development cohort and 128 in the validation cohort) were analyzed. The estimated 5-year DFS in the development cohort and validation cohort were 77.8% (95% CI, 72.9%-82.7%) and 78.2% (95% CI, 70.9%-85.5%), respectively. Age and node status had significant nonlinear effects on DFS. The prediction model constructed using four covariates (node status, lymphovascular invasion, capecitabine maintenance, and age) demonstrated satisfactory calibration and fair discrimination ability, with C-index of 0.722 (95% CI, 0.662–0.781) and 0.764 (95% CI, 0.668–0.859) in the development cohort and validation cohort, respectively. An easy-to-use online calculator for predicting benefit of capecitabine maintenance was also designed.
Conclusions
The evidence-based prediction model may help identify patients most likely to benefit from metronomic capecitabine maintenance and thus help in decision making in daily clinical practice.
Altered Cortical Activity During a Finger Tap in People with Stroke
Authors: Balasubramanian Priya , Snyder Dylan B. , Beardsley Scott A. , Hyngstrom Allison S. , Schmit Brian D. 
Published: September 2023

Abstract

This study describes temporal patterns of cortical activity during a simple finger movement in people with stroke to understand how temporal patterns of cortical activation and network connectivity align with prolonged muscle contraction at the end of a task. We investigated changes in the EEG temporal patterns in the beta band (13-26Hz) of people with chronic stroke (N = 10, 7F/3M) and controls (N = 10, 7F/3M), during and after a cued movement of the index finger. We quantified the change in beta band EEG power relative to baseline as activation at each electrode and the change in beta band task-based coherence (tbCoh) relative to baseline coherence as connectivity between EEG electrodes. Contrary to controls, finger tap cortical activity in the stroke group was spatially distributed bilaterally, and measurements from the post task period lacked a positive change in beta power relative to baseline, which has been described as event-related synchronization in controls. In addition, the stroke group exhibited no discernible reduction in tbCoh between the ipsilesional sensorimotor and frontal regions of the cortex during the post task period, which was a notable feature of tbCoh in controls. Our results suggest that divergent cortical activation patterns coupled with changes in connectivity between the sensorimotor and frontal cortices in the stroke group might explain clinical observations of prolonged muscle activation in people with stroke. This prolonged activation might be attributed to the combination of cortical reorganization and changes to sensory feedback post-stroke.
Neuromuscular Blocking Agent during Targeted Temperature Management for Out-of-Hospital Cardiac Arrest Patients: A Multicenter Prospective Observational Study (SOS-KANTO 2017 study)
Authors: Kawauchi Akira , Aoki Makoto , Kitamura Nobuya , Tagami Takashi , Hayashida Kei , Aso Shotaro , Yasunaga Hideo , Nakamura Mitsunobu 
Published: September 2023

Abstract
Background
Neuromuscular blocking agents (NMBAs) can control shivering during targeted temperature management (TTM) of patients with cardiac arrest. However, the effectiveness of NMBA use during TTM on neurologic outcomes remains unclear. We aimed to evaluate the association between NMBA use during TTM and favorable neurologic outcomes after out-of-hospital cardiac arrest (OHCA).
Methods
This was a multicenter prospective observational cohort study of OHCA patients from 2019 to 2021 (SOS-KANTO 2017 Study database). A total of forty-two emergency hospitals participated in this study. The study included adult OHCA patients who received TTM after hospitalization and excluded patients with missing data on NMBA use. After multiple imputations for missing data, we conducted overlap weight based on propensity-score analyses to compare outcomes between those with and without NMBA use during TTM. A favorable neurological outcome was defined as a cerebral performance category of 1 or 2 at discharge. Subgroup analyses were conducted according to initial monitored rhythm, findings of brain computed tomography (hypoxic encephalopathy and reduced gray-to-white-matter ratio), and each targeted temperature.
Results
Of the 516 eligible patients, 337 received NMBAs during TTM. The propensity score analysis showed a higher proportion of favorable neurologic outcomes in the NMBA group than in the non-NMBA group (32.7% vs. 20.9%; risk difference (RD), 11.8%; 95% confidence interval (CI), 1.2–22.3%). Subgroup analyses showed higher proportions of favorable neurologic outcome in the NMBA users among those with initial shockable rhythm (46.2% vs. 26.6%; RD, 19.6%; 95% CI, 3.5–35.6%), no hypoxic encephalopathy (48.3% vs. 27.9%; RD, 20.4%; 95% CI, 6.1–34.7%), and no reduced gray-to-white-matter ratio (36.2% vs. 20.5%; RD, 15.7%; 95% CI, 3.9–27.5%).
Conclusions
The use of NMBAs during TTM was significantly associated with favorable neurologic outcomes at hospital discharge for OHCA patients. NMBAs may have benefits in selected populations of patients with initial shockable rhythm and no poor prognostic computed tomography findings.
A Hybrid Deep Learning Framework for Skin Cancer Classification using Dermoscopy Images and Metadata
Authors: Mohamed Ensaf Hussein , Abubakr Ashraf Faroug , Abdu Nada , Khalil Mostafa , Kamal Hossam , Youssef Mohamed , Mohamed Heba , ElSayed Mai 
Published: September 2023

Abstract
Skin exposed to the sun is more likely to have skin cancer, which is an unnatural growth of skin cells. However, skin that isn’t frequently exposed to sunlight might potentially develop this prevalent type of cancer. This study attempts to detect and categorize six different types of skin cancer using clinical images accurately. The proposed approach used both clinical images and Metadata to feed into a hybrid model that benefits from deep learning in feature extraction and machine learning in classification. Many experiments have been applied to the PAD-UFES-20 dataset. Seven distinct algorithms of machine learning are applied with ten different pre-trained deep learning models. The hybrid model consists of MobileNetV2 as a feature extractor and logistic regression as a classifier for images, and random forest as a classi-fier for metadata has proved its superiority. The accuracy was 95.6%, precision 96.8%, recall 95.6%, F1-Score 95.7%. The evaluation process shows that metadata has an effective role in improving accuracy compared to previous studies that depend on images only in classification.
Increased AID Results in Mutations at the CRLF2 Locus Implicated in Latin American ALL Health Disparities
Authors: Pannunzio Nicholas , Rangel Valeria , Sterrenberg Jason , Garawi Aya , Mezcord Vyanka , Folkerts Melissa , Caulderon Sabrina , Wang Jinglong , Soyfer Eli , Eng Oliver , Valerin Jennifer , Tanjasiri Sora , Quintero-Rivera Fabiola , Masri Selma , Seldin Marcus , Frock Richard , Fleischman Angela 
Published: September 2023

Abstract

Activation-induced cytidine deaminase (AID) is a B cell-specific base editor required during class switch recombination and somatic hypermutation for B cell maturation and antibody diversification. However, it has also been implicated as a factor in the etiology of several B cell malignancies. Evaluating the AID-induced mutation load in patients at-risk for certain types of blood cancers is critical in assessing disease severity and treatment options. Here, we have developed a digital PCR (dPCR) assay that allows us to track the mutational landscape resulting from AID modification or DNA double-strand break (DSB) formation and repair at sites known to be prone to DSBs. Implementation of this new assay showed that increased AID levels in immature B cells increases genome instability at loci linked to translocation formation. This included the CRLF2 locus that is often involved in chromosomal translocations associated with a subtype of acute lymphoblastic leukemia (ALL) that disproportionately affects Latin Americans (LAs). To support this LA-specific identification of AID mutation signatures, we characterized DNA from immature B cells isolated from the bone marrow of ALL patients. Our ability to detect and quantify these mutation signatures will potentiate future risk identification, early detection of cancers, and reduction of associated cancer health disparities.
The prognostic value of CD39+CD8+ T cells as a potential surrogate marker of tumor-specific T cells in Asian triple-negative breast cancer
Authors: MENG JIA , Tira Tan Jing Ying , Joseph Craig Ryan , Ye Jiangfeng , Lim Jeffrey Chun Tatt , Goh Denise , Yuezhen Xue , Lim Xinru , Koh Valerie Cui Yun , Wee Felicia , Tay Timothy Kwang Yong , Chan Jason Yongsheng , Ng Cedric Chuan Young , Iqbal Jabed , Lau Mai Chan , Elaine Lim Hsuen , Chong Toh Han , Teh Bin Tean , Dent Rebecca Alexandra , Tan Puay Hoon , Sheng Joe Yeong Poh 
Published: September 2023

Abstract
Triple-negative breast cancer (TNBC) is a highly aggressive breast cancer subtype that is generally associated with poor prognosis in affected patients. Unfortunately, recently approved immune checkpoint inhibitors are efficacious in only a subset of patients. A surrogate marker for tumor-specific CD8+ T cells is urgently required to clarify the mechanisms of antitumor immune responses and help prognosticate TNBC patients. Here, we conducted a comparative interrogation of TNBC to evaluate the potential of CD39 as a surrogate marker of tumor-specific T cells. We first used flow cytometry to study more than 12,000 tumor-specific CD8+ T cells within both peripheral blood mononuclear cells and tumor-infiltrating lymphocyte populations in a mouse TNBC model and found that more than 99% of tumor-specific CD8+ T cells were present in the CD39+ subset. Multiplex immunohistochemistry/immunofluorescence staining demonstrated that the proportion of CD39+CD8+ T cells in human TNBC tumors correlated with improved overall survival. The frequencies of other CD39+ immune infiltrates, such as CD39+CD68+ macrophages, also correlated with improved OS. Thus CD39+CD8+ T cells might help predict prognosis in patients with TNBC.
Poly-γ-glutamic acid affects NH3 volatilization, soil nitrogen content, and soybean seedling growth
Authors: Liu Lu , Shi Wenjuan 
Published: September 2023

Abstract

Poly-γ-glutamic acid (γ-PGA) is a soil amendment that has been shown to enhance soil water retention capacity. However, the effects of γ-PGA on soil NH3 volatilization, soil nitrogen pool, and crop growth have been rarely studied. This study aimed to investigate the effect of γ-PGA on NH3 volatilization, soil mineral nitrogen content, and soybean seed productivity. We conducted an incubation experiment and a pot experiment using two different textured soils (sandy soil and sandy loam soil) with four γ-PGA application rates (0, 0.1, 0.3, and 0.5%, w/w). The results showed that the application of γ-PGA decreased the peak value of NH3 volatilization and cumulative NH3 emission through the incubation experiment. Cumulative NH3 volatilization decreased with increasing γ-PGA application amount. The addition of γ-PGA to sandy soil and sandy loam soil increased soil N content by 17–63% and 7–33%, respectively. Based on pot experimental results and principal component analysis, we recommend the optimal rates of γ-PGA application were 0.3% (w/w) in sandy soil and 0.1% (w/w) in sandy loam soil. This study provides a theoretical basis for the addition of γ-PGA as a promising strategy to reduce NH3 volatilization and increase soil nitrogen content.
Global Warming, Air Pollution and Health
Authors: Attfield Robin 
Published: September 2023

A new field of biomedical ethics is opening up, concerning what should be done to reduce the direct and indirect impacts of greenhouse gas emissions on human health. Some of these impacts could be described as ‘direct’, in the form of fatalities and illnesses due to the increasingly frequent heatwaves in many countries of recent years, ascribable to anthropogenic climate change. Other impacts are mediated through the air pollution that results from emissions from vehicles in the form of a cocktail of carbon oxides including carbon monoxide, nitrogen dioxide and particulates. Most of the world’s cities have streets with unsafe pollution levels, and one child’s death in Britain has been officially ascribed to air pollution (BBC 2020). This presentation aims to validate the above claims about the impacts of emissions on health, and to suggest remedies. The early phasing out of vehicles powered by internal combustion engines is the ultimate remedy for the latter set of impacts, while the urgent replacement of energy generated from fossil-fuel sources with renewable energy is the best way to remediate the former set. More immediate remedies for air pollution include restricting the use of roads and streets in urbanised areas by vehicles to bicycles and light vehicles with small engines. Medical and nursing education should include the diagnosis and treatment of pulmonary conditions resulting from increased levels of carbon oxides, nitrogen oxides and particulates. Medical and nursing practice should focus on the early identification of vulnerable adults and children at risk from air pollution, and warnings against walking, running or cycling along the most polluted thoroughfares.