bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repetitive transcranial magnetic stimulation in the treatment of middle-aged and elderly major depressive disorder: A randomized controlled trial
Authors: Wang Xiaofang , Fan Xiubo , Zhang Lihui , Liu Xin , Ji Zhi 
Published: September 2023

Background:
Studies have reported the use of repetitive transcranial magnetic stimulation (rTMS) in patients with major depressive disorder (MDD). However, most studies focus on antidepressant effect of rTMS, but few on cognitive aspects. The present study aimed to explore the effect of rTMS on BDNF levels and cognitive function in the treatment of middle-aged and elderly MDD.

Methods:
This was a randomized controlled trial. A total of 120 elderly patients with MDD treated in The Second Affiliated Hospital of Xi’an Medical University from January 2021 to January 2023 were selected as research subjects. The patients were randomly divided into control group (n = 60, patients received simple oral treatment with escitalopram and sham rTMS) and study group (n = 60, patients received oral treatment with escitalopram combined with rTMS) according to the random number table method. We compared the clinical efficacy, serum BDNF levels, and cognitive function between the 2 groups.

Results:
After treatment, the HAMD-17 score in the study group was lower than that in the control group [13.00 (12.00–16.00) vs 17.00 (15.00–19.00), P < .05], and the RBANS score was higher than that in the control group [166.00 (161.25–171.75) vs 133.00 (130.00–136.75), P < .05]. The total effective rate of the research group was 95.0%, which was higher than the 82.0% of the control group (P < .05). The serum BDNF levels [36.00 (33.00–38.00) vs 30.00 (28.00–32.00), P < .05] and MoCA scores [24.00 (22.00–26.75) vs 23.00 (21.00–25.00), P < .05] of the study group were higher than those of the control group. There were no significant adverse reactions during the treatment of both groups.

Conclusions:
Compared with oral escitalopram alone, repeated transcranial magnetic stimulation in the treatment of middle-aged and elderly patients with major depressive disorder can further improve the efficacy, and can more effectively improve the BDNF level and cognitive function, with ideal safety.
Resection for malignant tumors in the elbow and individualized reconstruction under assistance of 3D printing technology: A case report
Authors: Liao Guang-Jun , Su Qing , Zhang Yong-Quan , Chang Li-Ming 
Published: September 2023

Rationale:
With a high failure rate and multiple postoperative complications, the resection for tumors in the elbow and reconstruction present a formidable challenge to orthopedic surgeons. The maturation of 3-dimension (3D) printing technology has facilitated the preoperative design, intraoperative navigation, and reconstruction of bone defects in patients with complex malignant tumors of the elbow joint. In order to improve prognosis, we explored a method of tumor resection and elbow reconstruction aided by 3D printing technology in this research.

Patient concerns:
The patient underwent nephrectomy for clear cell carcinoma of the left kidney 3 years ago. Six months ago, the patient presented with limited movement and lateral tenderness in the right elbow joint. The tumor puncture biopsy demonstrated renal clear cell carcinoma metastasis.

Diagnoses:
Renal clear cell carcinoma with distal humerus bone metastasis.

Interventions:
Thin-layer CT scan data of the patient was acquired, and a 3D reconstruction of both upper limb bones and joints was conducted, followed by a simulation of diseased tissue excision. According to the model, individualized osteotomy guidelines and elbow prostheses were designed and manufactured. Then, prior to the completion of the actual operation, a simulation of the preoperative phase was performed.

Outcomes:
The operation was completed without incident. At the 1-, 3-, and 6-month postoperative examinations, both the position and mobility of the prosthesis were found to be satisfactory, and no complications were observed. The hospital for special surgery score and mayo elbow performance score scores increased in comparison to the preoperative period.

Lessons:
For patients with complex tumors in the elbow joint, 3D printing technology may assist in the precise excision of the tumor and provide an individualized elbow joint prosthesis that is more precise and effective than traditional surgery. It can accomplish a satisfactory treatment effect for patients when combined with early postoperative scientific rehabilitation training, so it is a method worth promoting.
Inr tracking with face-to-face and phone app
Authors: Hanedan Muhammet Onur , Alkan Kayhan Semiha , Dizdar Ebru , Kiliç Aşkin , Arslan Ali Kemal , Yürük Mehmet Ali , Sayar Ufuk 
Published: September 2023

Background:
Warfarin has a narrow therapeutic window. Maintaining the patient’s international normalized ratio (INR) within a predefined therapeutic range is one of the main challenges of warfarin treatment. This study aimed to compare the INR values of patients followed by face-to-face and telephone applications.

Methods:
This study was designed as a randomized controlled trial. Twelve patients living in a distant place were assigned to the experimental group, and 12 patients living nearby and followed-up in the outpatient clinic were assigned to the control group. A Patient Information Form and the Adherence to Refills and Medications Scale were used to collect data.

Results:
There was no significant difference between the groups in terms of demographic and clinical characteristics except for age (P > .05). The INR values of 67% of the patients followed in the outpatient clinic and 72% of the patients followed with the application were in the therapeutic range. There was no significant difference between the groups and medication adherence was high in both groups (P > .05).

Conclusion:
In light of the findings of our study, which demonstrated that the INR levels of patients who were monitored both face-to-face and via a telephone application were within the same therapeutic range, it was concluded that the telephone application can be used to manage warfarin therapy.
A rare imaging presentation with multisystemic clinicopathological features of Langerhans cell histiocytosis: Case report and literature review
Authors: Li Xiaofen , Wang Yulu , Liu Qian , Zeng Qingyun , Fu Huan , He Jianlin , Schmidt-Wolf Ingo G.H. , Sharma Amit , Liao Fengxiang 
Published: September 2023

Rationale:
Langerhans cell histiocytosis (LCH) is a kind of rare disease in which dendritic cells proliferate abnormally. It often occurs in children and can involve any tissue and organ. The affected sites usually include bone, skin, pituitary gland, and lungs, while the thyroid gland and external auditory canal are rarely observed. The perineal and labial involvement of this disease has not been reported yet.

Patient concerns:
A 47-year-old female patient experienced a swelling of the anterior neck area without an obvious inducement. She noticed a quail egg-like mass on the left side, and the mass increased progressively within 3 months. The anterior neck area was found to be swollen, and some flaky red rashes were seen on the scalp and bilateral external auditory canals.

Diagnoses:
Imaging examination showed enlarged thyroid and cervical lymph nodes, multiple low-density nodules in the liver, and reduced signal in the posterior pituitary gland. The biopsy pathological result of the increased left cervical lymph node indicated that LCH was detected.

Interventions:
VP regimen (vincristine, dexamethasone per os) and related supportive treatments were given as inducing chemotherapy for 6 weeks.

Outcomes:
After the second chemotherapy, the rash on the scalp and external auditory canal improved, and the neck mass was significantly reduced. After the third chemotherapy, the rash was mostly disappeared, while the neck lumps increased during chemotherapy. Thus, clatribine chemotherapy was recommended as the follow-up.

Lessons:
Imaging examinations played an important role in the diagnosis and follow-up of the disease, especially 18F-FDG PET/CT, which could show multiple involving organs at the same time. When a patient suffering from diabetes insipidus, skin rash, or fever, has a high FDG uptake PET/CT result in multiple tissues and organs throughout the body, it is necessary to consider the possibility of LCH.
Laparoscopic surgery for female posterior urethral bladder diverticulum with bladder outlet obstruction: A case report
Authors: Liao Chongzhou , He Zhenqiang , Wang Xiaoxiao , Guo Pu , Xiong Wei 
Published: September 2023

Introduction:
Bladder diverticula (BD) can be classified into congenital and acquired forms, with the latter accounting for approximately 90% of all cases, primarily among male patients. Although BD-associated anatomical bladder outlet obstruction (BOO) is uncommon, existing literature suggests that congenital BD are more frequently observed in male children and rarely in female children. While around 70% of acquired BD are linked to BOO secondary to benign prostatic hyperplasia in male patients, clinical reports of female BD are less common. Furthermore, cases of female BD located posterior to the urethra, which lead to voiding difficulties, are exceedingly rare.

Case presentation:
Herein, we present a case of laparoscopic treatment in a 53-year-old female patient diagnosed with congenital bladder diverticulum causing progressively worsening dysuria. Voiding cystourethrography revealed a soft cystic protrusion of the posterior urethral wall during voiding, which reinforced the patient’s symptoms. Urodynamic examination showed elevated detrusor muscle contraction during voiding, a reduced urinary flow rate, and P/Q values indicative of significant BOO. Considering the patient’s clinical condition, we performed laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty.

Results:
The laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty procedures were completed thoroughly and with great success. However, complete removal of the diverticular epithelium proved challenging, resulting in an overall operative time of approximately 3 hours and 32 minutes. At the postoperative follow-up, the patient presented with symptoms of a lower urinary tract infection for a week, which were effectively resolved with oral antibiotics. At the 8-month follow-up, the patient reported normal urination and the absence of any discomfort during urination.

Conclusion:
Female bladder outlet obstruction resulting from posterior urethral BD can be challenging to visualize during transurethral cystoscopy, especially with limited angulation, and may even be overlooked. Furthermore, conventional transvaginal diverticulectomy is often difficult to perform effectively. Therefore, laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty are considered appropriate treatment options for such cases.
Decorin suppresses tumor lymphangiogenesis: A mechanism to curtail cancer progression
Authors: Mondal Dipon K. , Xie Christopher , Buraschi Simone , Iozzo Renato V. 
Published: September 2023

AbstractThe complex interplay between malignant cells and the cellular and molecular components of the tumor stroma is a key aspect of cancer growth and development. These tumor-host interactions are often affected by soluble bioactive molecules such as proteoglycans. Decorin, an archetypical small leucine-rich proteoglycan primarily expressed by stromal cells, affects cancer growth in its soluble form by interacting with several receptor tyrosine kinases (RTK). Overall, decorin leads to a context-dependent and protracted cessation of oncogenic RTK activity by attenuating their ability to drive a pro-survival program and to sustain a pro-angiogenic network. Through an unbiased transcriptomic analysis using deep RNAseq, we discovered that decorin downregulated a cluster of tumor-associated genes involved in lymphatic vessel development when systemically delivered to mice harboring breast carcinoma allografts. We found that Lyve1 and Podoplanin, two established markers of lymphatic vessels, were markedly suppressed at both the mRNA and protein levels and this suppression correlated with a significant reduction in tumor lymphatic vessels. We further discovered that soluble decorin, but not its homologous proteoglycan biglycan, inhibited lymphatic vessel sprouting in anex vivo3D model of lymphangiogenesis. Mechanistically, we found that decorin interacted with VEGFR3, the main lymphatic RTK, and its activity was required for the decorin-mediated block of lymphangiogenesis. Finally, we discovered that Lyve1 was in part degraded via decorin-evoked autophagy in a nutrient- and energy-independent manner. These findings implicate decorin as a new biological factor with anti-lymphangiogenic activity and provide a potential therapeutic agent for curtailing breast cancer growth and metastasis.
Changes in child and adolescent mental health across the COVID-19 pandemic (2018-2023): Insights from general population and clinical samples in the Netherlands
Authors: van Oers Hedy A. , Alrouh Hekmat , Tieskens Jacintha M. , Luijten Michiel A.J. , de Groot Rowdy , Broek Emma , van der Doelen Daniël , Klip Helen , De Meyer Ronald , van der Mheen Malindi , Ruisch I. Hyun , van den Berg Germie , Bruining Hilgo , Buitelaar Jan , van der Rijken Rachel , Hoekstra Pieter J. , Kleinjan Marloes , Lindauer Ramón , Oostrom Kim J. , Staal Wouter , Vermeiren Robert , Cornet Ronald , Haverman Lotte , Popma Arne , Bartels Meike , Polderman Tinca J. C. , Zijlmans Josjan 
Published: September 2023

AbstractBackgroundThe COVID-19 pandemic negatively affected child and adolescent mental health and at the end of the pandemic (April 2022) child mental health had not returned to pre-pandemic levels. We investigated whether this observed increase in mental health problems has continued, halted, or reversed after the end of the pandemic in children from the general population and in children in psychiatric care.MethodsWe collected parent-reported and child-reported data at two additional post-pandemic time points (November/December 2022 and March/April 2023) in children (8-18 years) from two general population samples (N=818-1056 per measurement) and one clinical sample receiving psychiatric care (N=320-370) and compared these with data from before the pandemic. We collected parent-reported data on internalizing and externalizing problems with the Brief Problem Monitor (BPM) and self-reported data on Anxiety, Depressive symptoms, Sleep-related impairments, Anger, Global health, and Peer relations with the Patient-Reported Outcomes Measurement Information System (PROMIS®).ResultsIn the general population, parents reported no changes in externalizing problems but did report higher internalizing problems post-pandemic than pre-pandemic. Children also reported increased mental health problems post-pandemic, especially in anxiety and depression, to a lesser extent in sleep-related impairment and global health, and least in anger. In the clinical sample, parents reported higher internalizing, but not externalizing problems post-pandemic compared to the start of the pandemic. Children reported greatest increases in problems in anxiety, depression, and global health, to a lesser extent on sleep-related impairment, and least on anger.ConclusionsChild mental health problems in the general population are substantially higher post-pandemic compared to pre-pandemic measurements. In children in psychiatric care mental health problems have increased during the pandemic and are substantially higher post-pandemic than at the start of the pandemic. Longitudinal and comparative studies are needed to assess what the most important drivers of these changes are.
Bayesian Spatiotemporal Projection of Chagas Disease Incidence in Brazil
Authors: Roubenoff Ethan 
Published: September 2023

AbstractChagas Disease is a parasitic infection caused by theT. Cruziparasite endemic to Central and South America and transmitted through contact withTriatomineinsects, commonly known as “kissing bugs.” Although the symptoms of Acute Chagas Disease (ACD) are nonspecific, untreated chronic infection can lead to heart disease, enlarged esophagus and colon, and stroke. Chagas disease has become increasingly rare owing to a series of public health interventions, including insect eradication campaigns in Brazil through the 1980’s that considerably reduced the number of new acute cases. However, hundreds of new acute cases still are diagnosed annually, primarily in the states of Pará, Amapá, and Acre. Moreover, the population in areas of high Chagas endemicity are changing: many areas are growing and becoming increasingly urban, whereas others are decreasing in population. We estimate the Incidence Rate (IR) for Acute Chagas disease over the period 2001-2019 in Brazil at the municipal level and investigate the variation of these rates with climatic factors. These estimates are used to project forward incidence of Acute Chagas Disease over the following decade 2020-2029. Modeling ACD presents numerous methodological challenges since incidence is rare, with extreme overdispersion of zero-case counts, and vectors exhibit a highly spatially- and temporally-clustered pattern. We use a spatially- and temporally-autoregressive small-area smoothing models to estimate the true latent risk in developing Acute Chagas Disease. The Bayesian model presented here involves spatio-temporal smoothing via a Zero-Inflated (Lambert 1992), Knorr-Held (2000)-Type spatio-temporal model with a BYM2 (Morris, 2019) spatial convolution to predict smoothed incidence rates of Chagas disease. As well, we include estimates of Brazil’s growing population and projected bioclimate to evaluate how climate and population change may affect ACD rates. We estimate that cases will continue to increase in the absence of control efforts, primarily driven by a growing peri-urban population in regions of Chagas endemicity.
Association of heart rate variability and atrial fibrillation in patients with obstructive hypertrophic cardiomyopathy
Authors: Nie Changrong , Lu Zhengyang , Zhu Changsheng , Xiao Minghu , Wu Zining , Yang Qiulan , Lu Tao , Meng Yanhai , Wang Shuiyun 
Published: September 2023

AbstractBackgroundAtrial fibrillation (AF) is surprisingly common in patients with obstructive hypertrophic cardiomyopathy (oHCM) and is associated with significant symptoms and poor survival. Globally accepted models for AF detection are yet to be established. We aimed to investigate the relationship between heart rate variability (HRV) and AF in patients with oHCM.MethodsWe enrolled 1112 consecutively recruited patients with oHCM, including 158 and 954 patients with and without AF, respectively. The HRV variables mainly included the standard deviation of the mean R-R intervals (SDNN), root mean squared successive difference (rMSSD), and percentage of cycles differing from the preceding one by > 50 ms (pNN50). The SDNN, rMSSD, and pNN50 were transformed into binary variables underlying the cutoff for AF detection (termed SDNN_cutoff, rMSSD_cutoff, and pNN50_cutoff, respectively).ResultsThe mean age of this cohort was 48.94 ± 12.37 years, and 451 patients were females. The patients with AF were older, more likely to have palpitations, had a larger left atrial diameter and lower left ventricular outflow gradient, and a significantly higher SDNN, rMSSD, and pNN50 than those without AF. In multivariable logistic regression analysis, pNN50_cutoff was independently associated with AF (odds ratio: 7.86, 95% confidence interval [CI]: 4.25–14.7), while the model including pNN50_cutoff had the largest area under the curve (0.736; 95% CI: 0.690–0.782) and the lowest Akaike information criterion (774).ConclusionHRV was associated with a higher incidence of AF. Among the HRV variables, pNN50_cutoff (cutoff value = 43.5) may be a good predictor of AF in patients with oHCM.
Molecular Mechanisms Underlying Phenotypic Degeneration inCordyceps militaris: Insights from Transcriptome Reanalysis and Osmotic Stress Studies
Authors: Hoang Chinh Q. , Dương Giang H , Trần Mai H. , Vu Tao X. , Tran Tram B. , Hằng T. N. Phạm 
Published: September 2023

AbstractPhenotypic degeneration is a well-known phenomenon in fungi, yet the underlying mechanisms remain poorly understood.Cordyceps militaris, a valuable medicinal fungus with therapeutic potential and known bioactive compounds, is vulnerable to degeneration, which is a concern for producers. However, the causes of this process are still unclear. To shed light on the molecular mechanisms responsible for phenotypic degeneration inC. militaris, we isolated two strains with different abilities to form fruiting bodies. Our observations revealed that the degenerated strain had reduced ability to develop fruiting bodies, limited radial expansion, and increased spore density. We also conducted a transcriptome reanalysis and identified dysregulation of genes involved in the MAPK signaling pathway in the degenerate strain. Our RT-qPCR results showed lower expression of genes associated with sexual development and upregulation of genes linked to asexual sporulation in the degenerate strain compared to the wild-type strain. We also found dysregulation of genes involved in glycerol synthesis and MAPK regulation. Additionally, we discovered that osmotic stress reduced radial growth but increased conidia sporulation and glycerol accumulation in both strains, and hyperosmotic stress inhibited fruiting body formation in all neutralized strains. These findings suggest that the MAPK signaling pathway is dysregulated in the degenerate strain and the high-osmolarity glycerol and spore formation modules may be continuously activated, while the pheromone response and filamentous growth cascades may be downregulated. Overall, our study provides valuable insights into the mechanisms underlyingC. militarisdegeneration and identifies potential targets for future studies aimed at improving cultivation practices.
Elimination of subtelomeric repeat sequences exerts little effect on telomere functions inSaccharomyces cerevisiae
Authors: Hu Can , Zhu Xue-Ting , He Ming-Hong , Shao Yangyang , Qin Zhongjun , Wu Zhi-Jing , Zhou Jin-Qiu 
Published: September 2023

ABSTRACTTelomeres, which are chromosomal end structures, play a crucial role in maintaining genome stability and integrity in eukaryotes. In the baker’s yeastSaccharomyces cerevisiae, the X- and Y’-elements are subtelomeric repetitive sequences found in all thirty-two and seventeen telomeres, respectively. While the Y’-elements serve as a backup for telomere functions in cells lacking telomerase, the function of the X-elements remains unclear. This study utilized theS. cerevisiaestrain SY12, which has three chromosomes and six telomeres, to investigate the role of X-elements (as well as Y’-elements) in telomere maintenance. Deletion of Y’-elements (SY12YΔ), X-elements (SY12XYΔ+Y), or both X- and Y’-elements (SY12XYΔ) did not impact the length of the terminal TG1-3tracks or telomere silencing. However, inactivation of telomerase in SY12YΔ, SY12XYΔ+Y, and SY12XYΔcells resulted in cellular senescence and the generation of survivors. These survivors either maintained their telomeres through homologous recombination-dependent TG1-3track elongation or underwent microhomology-mediated intra-chromosomal end-to-end joining. Our findings indicate the non-essential role of subtelomeric X- and Y’-elements in telomere regulation in both telomerase-proficient and telomerase-null cells and suggest that these elements may represent remnants ofS. cerevisiaegenome evolution. Furthermore, strains with fewer or no subtelomeric elements exhibit more concise telomere structures and offer potential models for future studies in telomere biology.