bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic and diagnostic value of circRNA expression in cervical cancer: a meta analysis
Authors: Xu Yi , Li Changxia , Cheng Lifang , Wang Shaoheng , Wu Yuqing , Li Shiyang , Liu Mingqiang , Tao Xiaohua 
Published: January 2025

IntroductionCervical cancer (CC) is a highly prevalent malignancy of the reproductive system. This study aimed to methodically assess the function of circular RNAs (circRNAs) as possible indicators of CC, with a specific emphasis on their usefulness in the identification, prediction, and correlation with clinicopathological elements.MethodsA comprehensive literature search was conducted using databases such as PubMed, Cochrane Library, Web of Science, Embase, and the China National Knowledge Infrastructure (CNKI). The latest data were extracted on May 3rd, 2024. The diagnostic potential of circRNA expression was evaluated using a range of metrics including sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). The importance of circRNAs was further evaluated in terms of clinical relevance, pathological features, and prognostic value using pooled odds ratios (ORs) and hazard ratios (HRs).ResultsThe meta-analysis included 27 studies, which were categorised based on diagnostic applications (n=3), clinicopathological correlations (n=15), and prognostic evaluations (n=23). Elevated expression levels of oncogenic circRNAs were significantly associated with poor clinical indicators, including tumour size (odds ratio [OR] = 0.425, 95% confidence interval [CI]: 0.267–0.676), International Federation of Gynaecology and Obstetrics (FIGO) stage (OR = 0.315, 95% CI: 0.224–0.443), and lymph node metastasis (OR = 2.975, 95% CI: 1.816–4.872). This upregulation of oncogenic circRNA was also identified as a predictor of worse survival outcomes, with a hazard ratio (HR) of 2.13 (95% CI: 1.73–2.62, P &lt; 0.001). The downregulation of circRNAs with tumour-suppressor properties was similarly associated with poor clinical parameters, such as tumour size (OR = 0.310, 95% CI: 0.102–0.941), FIGO stage (OR = 0.231, 95% CI: 0.101–0.527), and lymph node metastasis (OR = 2.430, 95% CI: 1.156–5.110), and was indicative of a worsened prognosis (HR = 2.20, 95% CI: 1.03–4.70, P = 0.042). In terms of diagnostic value, the pooled sensitivity, specificity, and area under the curve (AUC) were calculated to be 0.85, 0.83, and 0.91, respectively.ConclusionThe results of our meta-analysis indicate that circRNAs have the potential to serve as promising biomarkers for CC diagnosis, prognosis, and clinicopathology.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024544997.
Case report: Innovative approach to esophageal cancer with right aortic arch: neoadjuvant immunotherapy and 3D reconstruction
Authors: Luo Chengwen , Luo Zhilin 
Published: January 2025

BackgroundWe report a rare case of locally advanced esophageal cancer with a right aortic arch (RAA), successfully treated with neoadjuvant immunotherapy and minimally invasive esophagectomy, guided by three-dimensional (3D) reconstruction.Case presentationA 50-year-old male with stage III esophageal squamous cell carcinoma (cT3N0M0) and RAA underwent four cycles of neoadjuvant immunotherapy with sintilimab, resulting in significant tumor regression. Minimally invasive esophagectomy was performed with the aid of preoperative 3D reconstruction, which was critical in navigating the complex vascular anatomy and ensuring surgical precision.ConclusionThis case demonstrates the efficacy of neoadjuvant immunotherapy combined with 3D reconstruction in managing esophageal cancer complicated by vascular anomalies. This approach offers a promising alternative for complex cases where conventional treatments pose higher risks.
Biochemical characteristics, genetic variants and treatment outcomes of 55 Chinese cases with neonatal intrahepatic cholestasis caused by citrin deficiency
Authors: Li Juan , Duan Jintao , He Shuli , Li Ying , Wang Meifen , Deng Chengjun 
Published: January 2025

BackgroundThe diagnostic criteria of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) have not been established due to non-specific clinical manifestations, and our understanding on the treatment outcome is still limited. We aim to investigate the biochemical characteristics, genetic variants, and treatment outcome of NICCD patients.MethodsWe compared the nutritional status and biochemical characteristics of 55 NICCD infants and 27 idiopathic neonatal cholestasis (INC) infants. SLC25A13 gene variant analysis was performed for definitive diagnosis of NICCD. NICCD infants received 12 months of lactose-free and/or medium-chain triglyceride-enriched (LF/MCT) formula treatment. The treatment efficacy was evaluated by comparing the outcome of NICCD with the 24 healthy infants that were selected as normal controls. All NICCD patients were followed up until death or at least 1 year of age.ResultsCompared to INC group, significant increase was found in levels of total bilirubin, indirect bilirubin, total bile acid, gamma-glutamyl transpeptidase, alkaline phosphatase, prothrombin time, thrombin time, international normalized ratio, alpha-fetoprotein (AFP), Vitamin D, and Vitamin E of NICCD group, while alanine aminotransferase, albumin, fibrinogen, glucose, and Vitamin A levels showed significant decrease in the NICCD group (P &lt; 0.05). There were 7 novel variants among 19 SLC25A13 variant types. No significant differences were found between NICCD patients treated for 12 months and normal controls. In long term follow-up, 2 cases developed FTTDCD, 8 cases had special dietary habits, and 1 case died from cirrhosis.ConclusionsNICCD showed more severe impairments in liver, coagulation, and metabolic function than INC. Significantly increased AFP levels could provide reference for the differential diagnosis of NICCD. The newly discovered variants may be meaningful for the individualized treatment of NICCD patients. LF/MCT formula was recommended for NICCD patients.
Effects of acteoside from Cistanche tubulosa on the plasma metabolome of cancer-related fatigue mice inoculated with colon cancer cells
Authors: Zhang Shilei , Gong Fukai , Liu Jiali , You Shuping , Liu Tao , Yang Jianhua , Hu Junping 
Published: January 2025

ObjectiveTo elucidate the metabolic mechanisms by which acteoside (ACT) isolated from Cistanche tubulosa alleviates cancer-related fatigue (CRF) in a murine model of colon cancer with cachexia.MethodsBALB/c mice inoculated with C26 colon cancer cells were treated with paclitaxel (PTX, 10 mg/kg) and ACT (100 mg/kg) alone or in combination for 21 days. Fatigue-associated behaviors, tumor inhibition rate, and skeletal muscle morphology assessed by hematoxylin-eosin (H&amp;E) staining and electron microscopy were evaluated. Finally, liquid chromatography-mass spectrometry (LC/MS) was employed to investigate alterations in the plasma metabolic profile of tumor-bearing mice with CRF in response to ACT treatment, and the affinity between metabolite-associated proteins and ACT was verified by Surface plasmon resonance (SPR) assay.ResultsOur study demonstrated the presence of CRF in the colon cancer mouse model, with the severity of fatigue increasing alongside tumor growth. Administration of ACT ameliorated both tumor burden and PTX-induced muscle fatigue-like behavior. LC/MS analysis identified a panel of differentially regulated metabolites, including trans-aconitine, citric acid, 3-coumaric acid, ephedrine, thymine, cytosine, indole-3-acetic acid, and pantothenol-9. These metabolites were primarily enriched in pathways associated with valine biosynthesis, tyrosine metabolism, tryptophan metabolism, and biosynthesis of pyridine alkaloids. Furthermore, several key enzymes, including CYP3A4, CYP19A1, CYP2E1, TNF, BCL-2, RYR2, and ATP2A1, were identified as potential targets underlying the anti-CRF effects of ACT.ConclusionThis study suggests that ACT derived from C. tubulosa harbors protective properties against cancer-related fatigue mediated by tumor cells.
Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization
Authors: Lu Min , Li Jiaqi , Ni Huanyu , Qiao Tong , Wang Baoyan 
Published: January 2025

BackgroundTo evaluate the efficacy and safety of clopidogrel-rivaroxaban combination compared to aspirin-rivaroxaban combination in patients with symptomatic peripheral artery disease (PAD).MethodsConsecutive patients with symptomatic PAD patients were analyzed from January, 2018 to June, 2022 at Nanjing Drum Tower Hospital. Patients were divided into two groups based on the antithrombotic therapy. The primary efficacy outcome was a composite of major adverse cardiovascular events (MACE) and major adverse limb events (MALE), and the primary safety outcome was major bleeding. Patients were followed until the first occurrence of any outcomes or the study end date (30 June 2024).ResultsA total of 695 patients were enrolled into this study. The clopidogrel-rivaroxaban combination significantly reduced the risk of composite outcome (HR: 0.59, 95%CI: 0.41–0.83) without increasing the risk of major bleeding (HR: 0.68, 95%CI: 0.27–1.69). When analyzed separately, clopidogrel-rivaroxaban combination was associated with a reduced risk of MALE (HR: 0.61, 95%CI: 0.41–0.91), although no significant differences were observed in terms of MACE (HR: 0.64, 95%CI: 0.34–1.20) or all bleeding events (HR: 1.00, 95%CI: 0.52–1.93). In the subgroup analysis, there were no significant interactions between the treatment groups and the subgroups of age, diabetes, lesion sites, Rutherford classifications and renal function for composite outcome, MACE and MALE.ConclusionThe clopidogrel-rivaroxaban combination in PAD patients may offer enhanced cardiovascular protection without increasing the risk of bleeding complications. These findings suggested that clopidogrel could be a superior alternative to aspirin in dual antithrombotic therapy for PAD management.
Impact of muscle fatigue on anticipatory postural adjustments during gait initiation
Authors: Storniolo Jorge L. , Farinelli Veronica , Esposti Roberto , Cavallari Paolo 
Published: January 2025

IntroductionProlonged or strenuous exercise leads to a temporary decrease in muscle function and performance, which interferes with activity of both prime movers and postural muscles. This effect of fatigue has been reported both for single segment movements and for locomotion. However, little is known regarding the effects of fatigue on anticipatory postural adjustments (APAs) during gait initiation, a task in which the control of focal movement should be strictly coupled to a feedforward control of posture.MethodsWe studied APAs during gait initiation in 16 healthy well-trained adult males, searching for muscle activities that precede the backward shift of the Center of Pressure (CoP). Participants stood on a force plate for about 10 s and then started walking at their natural speed. APAs were evaluated before and after a 1 min exhausting sequence of countermovement jumps. An optoelectronic system captured the heel-off events while a force plate measured the CoP position and vertical ground reaction force. Wireless probes recorded the electromyogram of trunk and leg muscles from both sides.ResultsIt was observed that muscle fatigue delayed excitatory and inhibitory APAs, of about 40 and 80 ms, respectively, and a parallel delay was induced on prime movers; moreover, velocity and amplitude of backward CoP shift were reduced. Regarding APAs sign and occurrence, most of the participants showed bilateral inhibition in dorsal muscles and excitation in the ventral ones, displaying a forward “diving” strategy that was almost unaffected by fatigue. However, after fatigue, three of the “diving” participants switched to a “turning” strategy, i.e., they displayed a reciprocal activation/inhibition pattern in the dorsal muscles, compatible with a trunk rotation.DiscussionThe “turning” strategy has been previously described in untrained individuals and in a toes-amputee mountain climber, who showed a “diving” approach to gait initiation when wearing his prosthetic shoes and switched to the “turning” approach when barefoot. Altogether, these results support the idea that one and the same person may develop a repertoire of postural strategies among which the central nervous system will choose, according to the personal fitness and the constraints in which the action is performed.
Electroencephalographic markers in Major Depressive Disorder: insights from absolute, relative power, and asymmetry analyses
Authors: Özçoban Mehmet Akif , Tan Oğuz 
Published: January 2025

IntroductionMajor Depressive Disorder (MDD) leads to dysfunction and impairment in neurological structures and cognitive functions. Despite extensive research, the pathophysiological mechanisms and effects of MDD on the brain remain unclear. This study aims to assess the impact of MDD on brain activity using EEG power spectral analysis and asymmetry metrics.MethodsEEG recordings were obtained from 48 patients with MDD and 78 healthy controls. The data were segmented into 2-second windows (1024 data points) and analyzed using the Welch method, an advanced variant of the Fast Fourier Transform (FFT). A Hanning time window with 50% overlap was applied to compute the modified periodogram. Absolute and relative power, along with asymmetry values in the theta, alpha, and beta frequency bands, were calculated.ResultsPatients with MDD exhibited significantly higher absolute and relative power in the theta and beta bands and decreased power in the alpha band compared to healthy controls. Asymmetry analysis revealed significant differences between symmetric channels in the theta band (F7-F8, C3-C4, T3-T4, T5-T6), alpha band (F7-F8, C3-C4, T3-T4, T5-T6, O1-O2), and beta band (C3-C4, T3-T4, T5-T6, P3-P4).DiscussionThe findings suggest that MDD affects brain mechanisms and cognitive functions, as evidenced by altered power values in the theta and alpha bands. Additionally, asymmetry values in theta, alpha, and beta bands may serve as potential biomarkers for MDD. This study highlights that beyond the commonly used alpha asymmetry, theta and beta asymmetry can also provide valuable insights into the neurophysiological effects of MDD, aligning with previous neuroimaging studies that indicate impairments in memory, attention, and neuroanatomical connectivity in MDD.
AI-assisted neurocognitive assessment protocol for older adults with psychiatric disorders
Authors: Díaz-Guerra Diego D. , Hernández-Lugo Marena de la C. , Broche-Pérez Yunier , Ramos-Galarza Carlos , Iglesias-Serrano Ernesto , Fernández-Fleites Zoylen 
Published: January 2025

IntroductionEvaluating neurocognitive functions and diagnosing psychiatric disorders in older adults is challenging due to the complexity of symptoms and individual differences. An innovative approach that combines the accuracy of artificial intelligence (AI) with the depth of neuropsychological assessments is needed.ObjectivesThis paper presents a novel protocol for AI-assisted neurocognitive assessment aimed at addressing the cognitive, emotional, and functional dimensions of older adults with psychiatric disorders. It also explores potential compensatory mechanisms.MethodologyThe proposed protocol incorporates a comprehensive, personalized approach to neurocognitive evaluation. It integrates a series of standardized and validated psychometric tests with individualized interpretation tailored to the patient’s specific conditions. The protocol utilizes AI to enhance diagnostic accuracy by analyzing data from these tests and supplementing observations made by researchers.Anticipated resultsThe AI-assisted protocol offers several advantages, including a thorough and customized evaluation of neurocognitive functions. It employs machine learning algorithms to analyze test results, generating an individualized neurocognitive profile that highlights patterns and trends useful for clinical decision-making. The integration of AI allows for a deeper understanding of the patient’s cognitive and emotional state, as well as potential compensatory strategies.ConclusionsBy integrating AI with neuro-psychological evaluation, this protocol aims to significantly improve the quality of neurocognitive assessments. It provides a more precise and individualized analysis, which has the potential to enhance clinical decision-making and overall patient care for older adults with psychiatric disorders.
The environmental health literacy level was effectively improved of residents in Shaanxi Province, China, 2022
Authors: Deng Feidan , Wen Xinyue , Dong Guoqiang , Wang Xining , He Huifang , Zhu Ruixuan , Qiao Lichun , Han Jing 
Published: January 2025

BackgroundEnvironmental health literacy (EHL) aims to enable individuals to make informed choices to reduce health risks and protect the environment.ObjectivesTo assess the EHL of residents in Shaanxi Province, China in 2022 and analyze the influencing factors.MethodsThis study was a 2022 cross-sectional survey in Shaanxi Province, China, involving 2,237 residents aged 15 to 69. Participants were selected using a multi-stage random sampling method and surveyed through questionnaires in six cities. The weighted rate was calculated using the seventh National Census data, and influential factors were analyzed using multifactor logistic regression.ResultsAccording to the survey, the overall EHL level of Shaanxi residents in 2022 was 15.47%. The first-level classification literacy level of EHL was ranked in descending order: basic skills (21.64%), basic concepts (17.93%), and basic knowledge (14.44%). The EHL level was influenced by age, education level, and occupation. People with higher education and certain occupations were more likely to possess EHL, while older individuals and those with lower education levels, especially in rural areas, were less likely to possess it.ConclusionThe level of EHL among residents in Shaanxi Province in 2022 was higher than in 2020. The findings showed that targeted health education for low EHL groups effectively reduced urban–rural disparities and improved adolescents’ EHL levels.
Engaging older adults in diagnostic safety: implementing a diagnostic communication note sheet in a primary care setting
Authors: Tran Alberta , Blackall Leah , Hill Mary A. , Gallagher William 
Published: January 2025

IntroductionAdults over the age of 65 are at a higher risk for diagnostic errors due to a myriad of reasons. In primary care settings, a large contributor of diagnostic errors are breakdowns in information gathering and synthesis throughout the patient-provider encounter. Diagnostic communication interventions, such as the Agency for Healthcare Research and Quality's “Be the Expert on You” note sheet, may require adaptations to address older adults' unique needs.MethodsWe recruited and partnered with older adult patients (n = 6) in focus group sessions to understand their perspectives on diagnostic communication and the existing AHRQ note sheet. A two-page communication and clinic workflow tool was developed and implemented over a 6-month period using three Plan-Do-Check-Act cycles. Physicians, nurses, staff, and patients were surveyed.ResultsMost older adult patients (n = 31) found the tailored diagnostic communication note sheet to be easy-to-use, helpful for provider communication, and would recommend its use to other patients. Physicians and staff members were satisfied with the note sheet and described few challenges in using it in practice.DiscussionOur findings contribute to the growing body of evidence around diagnostic safety interventions and patient engagement by demonstrating the feasibility and benefits of actively involving older adult patients in quality initiatives.
Indocyanine green fluorescence-guided laparoscopic central pancreatectomy for complete pancreatic transection trauma: a rare case and literature review
Authors: Wang Xitao , Teng Xiong , Liu Yi , Cheng Wei 
Published: January 2025

BackgroundPancreatic trauma is a rare solid organ injury. Conservative treatment is often indicated in patients with no pancreatic duct injury, while patients with high-grade pancreatic damage most often require surgical intervention. Laparoscopic central pancreatectomy (LCP) is a parenchyma-sparing approach and can prevent endocrine and exocrine insufficiency after pancreatic resection. Indocyanine green (ICG) fluoroscopy can help the surgeon assess the blood supply of the target organ.Case presentationThe case we describe here is a 33-year-old male patient who was transferred to our hospital due to blunt abdominal trauma caused by a car accident. The patient was hemodynamically stable on admission and was diagnosed with isolated pancreatic trauma by a multidisciplinary team that included radiologists, emergency physicians, and pancreatic surgeons. The patient then underwent emergency laparoscopic central pancreatectomy, during which we used ICG fluoroscopy to assess the blood perfusion of the damaged pancreas to determine the extent of resection. The patient developed a biochemical fistula (grade A pancreatic fistula) after surgery, and no other intervention was performed except for continuous drainage. The patient was discharged on postoperative day 13. At the 3-month follow-up, the patient did not present any clinical manifestations of pancreatic endocrine and exocrine insufficiency.ConclusionTo the best of our knowledge, there have been no reports of ICG-guided emergency LCP for blunt abdominal trauma. In selected patients, emergency LCP is feasible and should be supported by a multidisciplinary team and performed by an experienced pancreatic surgeon with advanced laparoscopic skills.
Relationship between serum ECP and TIgE levels and the risk of postoperative recurrence in patients with chronic rhinosinusitis with nasal polyps
Authors: Zhang Qing , Li Hui , Xie Di , Fan SiJian 
Published: January 2025

ObjectiveThis study was undertaken to assess the association between the likelihood of surgical recurrence and serum ECP and TIgE levels in chronic rhinosinusitis with nasal polyps (CRSwNP).MethodologyClinical information was gathered retrospectively from 166 cases of surgically treated CRSwNP as well as 60 cases of chronic rhinosinusitis without nasal polyps (CRSsNP). A comparative analysis on serum levels of total immunoglobulin E (TIgE) and eosinophil cationic protein (ECP) was carried out between the two groups. The CRSwNP patients were assigned into recurrence and non-recurrence groups based on the absence/presence of disease recurrence after a 2-year follow-up. An analysis was conducted on the correlation between the patients' clinical data and their serum ECP and TIgE levels. Receiver operating characteristic (ROC) curves were utilized to assess the clinical utility of these two biomarkers.ResultsThe CRSwNP participants had higher serum levels of ECP and TIgE (4.28 ± 0.81 &gt; 3.58 ± 0.77 ng/L, P &lt; 0.001; 52.99 ± 8.62 &gt; 15.65 ± 3.25 KU/L, P &lt; 0.001) compared to CRSsNP participants. Univariate analysis indicated that neutrophil ratio, lymphocyte ratio, Lund-Kennedy score, Lund-Mackay score, SNOT-22 score, olfactory function score, and postoperative recurrence were significantly correlated with serum ECP and TIgE levels. Higher serum levels of TIgE and ECP (4.89 ± 0.79 &lt; 4.11 ± 0.72, P &lt; 0.001; 58.74 ± 8.27 &lt; 51.40 ± 8.04, P &lt; 0.001) were detected in the recurrence groups vs. the non-recurrence group. Multivariate analysis showed that serum ECP and TIgE were independent risk factors for recurrence of CRSwNP. Serum ECP and TIgE levels were found to be predictive of postoperative recurrence risk in CRSwNP patients (AUC: 0.77, 0.74, 0.84; P &lt; 0.05) according to ROC curve analysis. Significant differences were not observed in any general clinical data.ConclusionThe findings suggest that elevated serum ECP and TIgE levels in patients with CRSwNP can be as good predictors for the risk of recurrence after endoscopic sinus surgery.