bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of school-going adolescent girls’ health and nutritional status in district Malir, Karachi: a baseline cross-sectional study
Authors: Zafar Saira , Shaikh Babar Tasneem , Malik Zoha Imtiaz , Ahmad Abdul Momin Rizwan
Published: January 2025

Introduction

Adolescence is a phase of life marked by rapid growth. Adequate nutrition is essential during this developmental stage, leading to significant physical performance, improved cognitive ability, and productivity. Improving adolescent girls’ nutrition is crucial for breaking the intergenerational cycle of malnutrition, but research in Pakistan has largely focused on children under five and pregnant women, often neglecting this vulnerable group.

Objective

This study aimed to determine the contextual and sociodemographic factors contributing toward undernutrition to improve the health and nutritional status of adolescent girls.

Methods

A school based cross sectional study was conducted as the baseline survey for a mixed methods study leading to a pilot cluster randomized controlled trial. n = 84 girls (10–14 years) from two public schools were selected by simple random sampling. Data were collected through a structured questionnaire including socio demographic profile, anthropometric measurements, dietary patterns, preferences, safe water and hygiene practices, access to health care facilities, and understanding of malnutrition-related symptoms. The data collected were analyzed through SPSS version 27.0. The chi-square test was used to determine the association between the two BMI categories; underweight and normal weight, and various socio-demographic variables.

Results

Among the total of 84 adolescent girls, overall mean height was 143.9 ± 8.1 cm and mean weight was 34.4 ± 6.9 kg, while mean BMI was 16.4 ± 2.2 kg/m2. 86.9% of girls were underweight, whereas 13.1% had a normal BMI. The z-scores for both height-for-age and BMI-for-age were in negative values, i.e., −1.62 ± 0.89 and −1.18 ± 1.05, respectively.

Conclusion

Findings of this study demonstrated that the high burden of underweight among school-going adolescent girls needs targeted approaches like nutrition education interventions to enhance awareness about healthy dietary behaviors, food preferences, and ensuring access to safe, sufficient, and healthy diet.

Recommendation

A multipronged approach is required to improve health and nutritional status of adolescent girls by involving individuals, families, education sector, health and other relevant sectors. Larger scale studies are still required for better understanding of the issue and to guide in designing targeted programs to address specific needs of this particular age group.
Global research trends in the application of artificial intelligence in oncology care: a bibliometric study
Authors: Xu Mianmian , Chen Yafang , Wu Tianen , Chen Yuyan , Zhuang Wanling , Huang Yinhui , Chen Chuanzhen
Published: January 2025

Objective

To use bibliometric methods to analyze the prospects and development trends of artificial intelligence(AI) in oncology nursing from 1994 to 2024, providing guidance and reference for oncology nursing professionals and researchers.

Methods

The core set of the Web of Science database was searched for articles from 1994 to 2024. The R package “Bibliometrix” was used to analyze the main bibliometric features, creating a three-domain chart to display relationships among institutions, countries, and keywords. VOSviewer facilitated co-authorship analysis and its visualization was used for co- occurrence analysis. CiteSpace calculated citation bursts and keyword occurrences.

Results

A total of 517 articles were retrieved, representing 80 countries/regions. The United States had the highest number of publications, with 188 articles (36.4%), followed by China with 79 articles (15.3%). The top 10 institutions in terms of publication output were all U.S.-based universities or cancer research institutes, with Harvard University ranking first. Prominent research teams, such as those led by Repici, Aerts, and Almangush, have made significant contributions to studies on AI in tumor risk factor identification and symptom management. In recent years, the keywords with the highest burst strength were “model” and “human papillomavirus.” The most studied tumor type was breast cancer. While Cancers published the highest number of articles, journals such as CA: A Cancer Journal for Clinicians and PLOS ONE had higher impact and citation rates.

Conclusion

By analyzing the volume of AI literature in oncology nursing, combined with the statistical analysis of institutions, core authors, journals, and keywords, the research hotspots and trends in the application of AI in oncology nursing over the past 30 years are revealed. AI in oncology nursing is entering a stage of rapid development, providing valuable reference for scholars and professionals in the field.
Medullary thyroid cancer in MEN2 pediatric/adolescent carriers of RET mutation: genotype/phenotype correlation and outcome in a retrospective series of 23 patients
Authors: Di Benedetto Guenda , Barca Ignazio , De Gregorio Laura , Scollo Claudia , Gianì Fiorenza , Martorana Federica , Russo Marco , Frasca Francesco , Pellegriti Gabriella , Sapuppo Giulia
Published: January 2025

Background

Multiple endocrine neoplasia type 2 syndrome (MEN2) is a hereditary disease resulting from mutations of the rearranged during transfection (RET) protooncogene subclassified into MEN2A [medullary thyroid carcinoma (MTC), pheochromocytoma, and primary hyperparathyroidism] and MEN2B (MTC, pheochromocytoma, Marfanoid habitus, mucous neuromas, and intestinal ganglioneuromatosis). Prophylactic thyroidectomy is recommended in RET-mutated patients. The age at which it should be performed depends on the type and aggressiveness of the mutation.

Aim of the study

This study aimed to evaluate the genotype/phenotype correlation and outcome in pediatric/adolescent carriers of MEN2 RET mutation.

Patients and methods

In a retrospective series of 23 carriers of RET MEN2 mutation who were ≤19 years old at diagnosis and had undergone total thyroidectomy ± lymphadenectomy, the following were analyzed: 1) specific RET mutation, 2) clinical and histopathological characteristics, 3) genotype/phenotype correlation, and 4) outcome at last follow-up.

Results

In our series, the female gender was more prevalent (F/M ratio 2.8/1), and the median age was 14.9 years [interquartile range (IQR) 12.6–17.2]. RET mutations were at very high risk in 4.3% of patients (M918T), high risk in 43.5% (C634), and moderate risk in 52.2% (47.8% C618 and 4.3% C620). All patients underwent surgery: at histology, MTC was found in 19/23 (82.6%) patients, C-cell hyperplasia in 2/23 (8.7%), and benign histology in 2/23 (8.7%). Ten patients (52.6%) had a disease event during the follow-up: 2/19 (10.5%) showed biochemical disease, 6/19 (31.6%) lymph node recurrences, and 2/19 (10.5%) distant metastases (50% liver, 50% bone). At the last follow-up, nine MTCs were not cured. One patient died after 9 years of follow-up at 21 years old (M918T RET+).

Conclusions

From these data, it is clear to see the importance of genetic counseling and RET screening in all first-degree relatives of patients with proven MEN2. The goal should be to subject patients to surgery for prophylactic and not curative purposes, i.e., before the onset of MTC, given the high risk of persistent or recurrent disease also in pediatric/adolescent patients.
Case report: Basal cell carcinoma arising within the nevus sebaceous: report of 4 cases and literature review
Authors: Lei Tianbing , Lu Yonghong , Feng Yanyan , Ni Yao
Published: January 2025

Nevus sebaceous (NS) is a congenital hamartoma characterized by the presence of skin structures, including the epidermis, sebaceous glands, and hair follicles. NS predominantly occurs on the scalp and has the potential to give rise to secondary tumors, with a small proportion being malignant; the most frequently observed malignant tumor associated with NS is basal cell carcinoma. In this report, we retrospectively present four cases of sebaceous nevus on the scalp complicated by basal cell carcinoma. The pathological diagnoses were unequivocal in all four patients, who exhibited typical clinical manifestations, with all cases localized to the left parietotemporal region of the scalp. The etiology of NS may be linked to genetic mutations or ultraviolet exposure. Treatment options vary, with surgical resection likely being the most common method of eradication.
A case report of comprehensive treatment for primary intraspinal carcinosarcoma
Authors: Yan Chang , Zhang Chao-Jun , Wei Jun-bao , Liang Hui-wen , Qu Song
Published: January 2025

Background

Carcinosarcoma is a rare and highly aggressive biphasic malignant tumor. To date, no cases of primary intraspinal carcinosarcoma have been reported.

Case presentation

This study reports a case of a 36-year-old female with primary intra dural extramedullary carcinosarcoma. The patient underwent surgery at initial diagnosis, followed by two courses of radiotherapy due to residual tumor, as part of a comprehensive antitumor treatment. Despite good tumor control, she ultimately died of respiratory failure.

Discussion

This is the first reported case of primary intra dural extramedullary carcinosarcoma, detailing its imaging characteristics, pathological morphology, and treatment process. The tumor was responsive to radiotherapy. The rapid progression of intraspinal carcinosarcoma suggests it may be underdiagnosed or underreported, highlighting the need for more cases for clinical evaluation and treatment strategies.
Diagnosis and treatment of hepatocellular carcinoma with pelvic metastasis expressing AFP: a case report
Authors: Huang Legang , Wang Zijie , Lu Jiankuan
Published: January 2025

This report presents the case of a 68-year-old female patient with hepatocellular carcinoma (HCC) who experienced persistently elevated alpha-fetoprotein (AFP) levels following resection of the primary liver tumor. The patient had previously undergone transcatheter arterial chemoembolization (TACE) and liver tumor resection, but postoperative AFP levels continued to rise, suggesting the possibility of extrahepatic metastasis. PET-CT scans revealed an irregular soft tissue mass in the recto-uterine pouch, which was later confirmed as a HCC metastasis through needle biopsy. The patient subsequently received radioactive seed implantation therapy, leading to a significant decrease in AFP levels. This case highlights the rarity of isolated pelvic metastasis in HCC patients and underscores the importance of AFP in postoperative monitoring. The combination of PET-CT imaging and pathological biopsy is instrumental in improving the detection rate of HCC metastases, enabling more accurate treatment planning for patients.
Selenium in cancer management: exploring the therapeutic potential
Authors: He Lingwen , Zhang Lu , Peng Yulong , He Zhijun
Published: January 2025

Selenium (Se) is important and plays significant roles in many biological processes or physiological activities. Prolonged selenium deficiency has been conclusively linked to an elevated risk of various diseases, including but not limited to cancer, cardiovascular disease, inflammatory bowel disease, Keshan disease, and acquired immunodeficiency syndrome. The intricate relationship between selenium status and health outcomes is believed to be characterized by a non-linear U-shaped dose-response curve. This review delves into the significance of maintaining optimal selenium levels and the detrimental effects that can arise from selenium deficiency. Of particular interest is the important role that selenium plays in both prevention and treatment of cancer. Finally, this review also explores the diverse classes of selenium entities, encompassing selenoproteins, selenium compounds and selenium nanoparticles, while examining the mechanisms and molecular targets of their anticancer efficacy.
Detection of cervical precancerous lesions and cancer by small-scale RT-qPCR analysis of oppositely deregulated mRNAs pairs in cytological smears
Authors: Artyukh Anastasia A. , Ivanov Mikhail K. , Titov Sergei E. , Dzyubenko Victoria V. , Krasilnikov Sergey E. , Shumeikina Anastasia O. , Afanasev Nikita A. , Malek Anastasia V. , Glushkov Sergei A. , Agletdinov Eduard F.
Published: January 2025

Background

Cervical screening, aimed at detecting precancerous lesions and preventing cancer, is based on cytology and HPV testing. Both methods have limitations, the main ones being the variable diagnostic sensitivity of cytology and the moderate specificity of HPV testing. Various molecular biomarkers are proposed in recent years to improve cervical cancer management, including a number of mRNAs encoded by human genes involved in carcinogenesis. Many scientific papers have shown that the expression patterns of cellular mRNAs reflect the severity of the lesion, and their analysis in cervical smears may outperform HPV testing in terms of diagnostic specificity. However, such analysis has not yet been implemented in broad clinical practice. Our aim was to devise an assay detecting severe cervical lesions (≥HSIL) via analysis of cellular mRNA expression in cytological smears.

Methods

Through logistic regression analysis of a reverse-transcription quantitative PCR (RT-qPCR) dataset generated from analysis of six mRNAs in 167 cervical smears with various cytological diagnoses, we generated a family of linear classifiers based on paired mRNA concentration ratios. Each classifier outputs a dimensionless decision function (DF) value that increases with lesion severity. Additionally, in the same specimens, the HPV genotyping, viral load assessment, diagnosis of cervicovaginal microbiome imbalance and profiling of some relevant mRNAs and miRNAs were performed by qPCR-based methods.

Results

The best classifiers were obtained with pairs of mRNAs whose expression changes in opposite directions during lesion progression. With this approach based on a five-mRNA combination (CDKN2A, MAL, TMPRSS4, CRNN, and ECM1), we generated a classifier having ROC AUC 0.935, diagnostic sensitivity 89.7%, and specificity 87.6% for ≥HSIL detection. Based on this classifier, a two-tube RT-qPCR based assay was developed and it confirmed the preliminary characteristics on 120 cervical smears from the test sample. DF values weakly correlated with HPV loads and cervicovaginal microbiome imbalance, thus being independent markers of ≥HSIL risk.

Conclusion

Thus, we propose a high-throughput method for detecting ≥HSIL cervical lesions by RT-qPCR analysis of several cellular mRNAs. The method is suitable for the analysis of cervical cytological smears prepared by a routine method. Further clinical validation is necessary to clarify its clinical potential.
Comparative study of robotic-assisted vs. laparoscopic surgery for colorectal cancer: a single-center experience
Authors: Wang Wenpeng , Liu Jia , Wang Jiefu , Li Li , Kong Dalu , Wang Junfeng
Published: January 2025

Background

Colorectal cancer (CRC) surgeries are commonly performed using either robotic-assisted colorectal surgery (RACS) or laparoscopic colorectal surgery (LCS). This study aimed to compare clinical and surgical outcomes between RACS and LCS for CRC patients.

Methods

We included 225 patients from Tianjin Medical University Cancer Institute & Hospital (TJMUCH) between January 2021 and June 2024, divided into RACS (n=82) and LCS (n=143) groups. Data on demographics, clinicopathological variables, surgical parameters, and perioperative outcomes were analyzed. Statistical significance was set at p < 0.05.

Results

RACS was associated with longer surgery durations (median: 218.5 vs. 165 minutes) and greater blood loss (median: 100 vs. 50 mL) compared to LCS (p < 0.001 for both). Additionally, the median hospitalization cost was notably higher for RACS at 117,822 RMB compared to 78,174 RMB for LCS (p < 0.0001). RACS was used more frequently for proctectomy (87.80% vs. 72.48%). No significant differences were found in lymph node dissection (LND), postoperative hospital stay, conversion to open surgery, or postoperative complications between the groups (p > 0.05). Anastomotic leakage was the most common complication in both groups (RACS: 3.66%, LCS: 4.20%), with no significant difference in incidence (p = 0.876). To reduce bias due to surgical site, cases of rectal and sigmoid colon cancer were singled out. Hierarchical analysis showed significant differences still remained in surgical duration, blood loss, and surgical site distribution for proctectomy and sigmoid colon resection (p < 0.001). RACS did not show a clear advantage in surgical field exposure or tissue retraction.

Conclusion

RACS, despite superior visualization, involved longer operative times and more blood loss than LCS. Both techniques had similar clinical outcomes, with LCS offering specific technical advantages.
Primary cardiac lymphoma: a clinicopathological study of 121 cases
Authors: Zhuang Shuhui , Chang Liudi , Feng Xiaoxi , Hu Weiwen , Yang Zhaobo , Zhang Yuanyuan
Published: January 2025

Background

Primary cardiac lymphoma (PCL) is an exceedingly uncommon type of lymphoma that primarily affects the heart and/or pericardium, or manifests through cardiac symptoms due to myocardial infiltration. The infrequency of PCL, coupled with its non-specific clinical presentations, often complicates early diagnosis. This study aims to fill the existing gap in clinical knowledge regarding PCL by detailing a case of PCL and examining its clinical features, auxiliary examinations, treatment approaches, and prognostic outcomes, thereby facilitating early detection and enhancing patient care.

Methods

A thorough search of the PubMed and Chinese National Knowledge Infrastructure (CNKI) database was performed using keywords “heart” and “lymphoma” or “primary cardiac lymphoma”. This search encompassed publications from January 1, 2014, to November 1, 2024.

Results

The review included 121 cases. These cases usually present with atypical symptoms, mainly circulatory and respiratory, including chest tightness, dyspnea, and edema, along with occasional neurological and gastrointestinal symptoms. Echocardiography served as the primary diagnostic method in 92.6% of cases, while a definitive diagnosis was achieved through pathological examination in all cases (100%). Treatment strategies predominantly included surgical intervention (44.6%) and chemotherapy (76.0%). Although surgery did not have a significant effect on survival rates, chemotherapy proved to be critical in improving patient survival.

Conclusions

PCL, which arises in the cardiac or pericardial areas, is generally associated with a poor prognosis. It is essential for clinicians to develop a greater awareness and understanding of the characteristics of PCL to enhance early diagnosis. The timely initiation of chemotherapy is vital for improving survival rates and the overall quality of life for patients with PCL.
Consonant aspiration in Mandarin-speaking children: a developmental perspective from perception and production
Authors: Li Yani , Li Qun , Du Yihang , Wang Lili , Li Lin , Wen Jian , Zheng Yun
Published: January 2025

Introduction

This study investigates Mandarin-speaking children's acquisition of aspirated/unaspirated voiceless consonants in terms of perception and production, to track children's developmental profile and explore the factors that may affect their acquisition, as well as the possible association between perception and production.

Methods

Mandarin-speaking children (N = 95) aged 3–5 and adults (N = 20) participated in (1) a perception test designed based on the minimal pairs of unaspirated/aspirated consonants in the quiet and noisy conditions respectively; (2) a production test where participants produced the target words, with syllable-initial consonants focusing on aspiration and non-aspiration. Six pairs of unaspirated/aspirated consonants in Mandarin were included.

Results

(1) Children's perception and production accuracy of aspirated and unaspirated consonants increased with age. Five-year-olds achieved high accuracy in the perception under the quiet condition and in the production (over 90%), though not yet adult-like. (2) Noise adversely affected children's perception, with all child groups showing poor performance in the noisy condition. In terms of perception, stops were more challenging to children than affricates, but in terms of production, children performed better on stops. Furthermore, the presence of noise had a greater detrimental effect on the perception of aspirated consonants compared to unaspirated ones. (3) A weak positive correlation was found between children's perception of consonant aspiration in the quiet condition and their production.

Discussion

The findings indicate that age, aspiration state, and manner of articulation (MOA) would affect children's acquisition of consonant aspiration. Although 5-year-olds have almost acquired aspirated/unaspirated consonants, compared to adults, the perception of consonant aspiration in noise remains a challenge for children.
Appropriateness and inappropriate medication predictors of stress ulcer prophylaxis in the intensive care unit
Authors: Zhang Pan , Wang Siyang , Zhi Tingting , Ye Naobei , Sun Haonan , Qin Xingyu , Xu Shuhan , Zhang Ruiqin
Published: January 2025

Introduction

Preventive drugs for stress ulcers are widely and unreasonably used in the Intensive Care Unit (ICU). This study aims to examine the appropriate utilization of medications for stress ulcer prophylaxis (SUP) and identify factors that contribute to the inappropriate use of these medications in the ICU of the Second Hospital of Shanxi Medical University.

Methods

Patient cases admitted to the ICU during the period from May 2022 to May 2023 were extracted from the hospital’s information management system. Single-factor analysis and multivariate logistic regression model analysis were performed using the SPSS to identify factors associated with inappropriate medication for prophylaxis. The efficacy of this predictive model was assessed through the use of the Receiver Operating Characteristic Curve (ROC), while the Hosmer test was utilized to evaluate the model fit.

Results

This study included a total of 651 patient cases that met the inclusion criteria. Among these cases, 48.39% were found to have received inappropriate medication of SUP. The analysis revealed a significant association between inappropriate medication and partial transfer to departments (P < 0.05), as well as the use of anticoagulants (P = 0.009) in the prophylaxis group. In the non-prophylaxis group, the multifactorial logistic analysis indicated a significant correlation between inadequate prescriptions and partial transfer to departments (P < 0.05), as well as the presence of artificial airways (P < 0.01).

Conclusion

There is a notable prevalence of inappropriate SUP in the ICU of this hospital. Attention should be paid to the SUP of some patients transferred to the department, the use of anticoagulants and the presence of artificial airway.
Cost-effectiveness analysis of pembrolizumab plus chemotherapy versus chemotherapy in untreated advanced pleural mesothelioma in the Chinese healthcare system
Authors: Lang Wenwang , He Yulong , Hou Changchun , Li Hua , Jiang Qinling , Mei Liuyong
Published: January 2025

Objective

The combination of pembrolizumab and chemotherapy has demonstrated notable clinical advantages in improving overall survival than chemotherapy alone for patients with untreated advanced pleural mesothelioma. The purpose of this study was to assess its cost-effectiveness.

Materials and methods

A Markov state-transition model was constructed using data from the IND227 phase 3 randomized clinical trial. Utility values for health states were taken from the IND227 trial, and direct medical costs were from the pertinent literature and local pricing data. Outcomes measured included quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), incremental net health benefit (INHB), and incremental net monetary benefit (INMB). To manage the uncertainty in the model, both probabilistic sensitivity analysis (PSA) and one-way sensitivity analysis (OWSA) were used.

Results

In the base-case analysis, pembrolizumab plus chemotherapy resulted in an incremental gain of 0.23 QALYs at an additional cost of $18,199.63, resulting in an ICER of $80,557.23/QALY. This was not favorable compared to China’s willingness-to-pay (WTP) threshold of $38,042.49/QALY, with an INHB of −0.25 QALYs and an INMB of $-9,605.00. Subgroup analyses showed ICERs for pembrolizumab plus chemotherapy versus chemotherapy of $33,917.61 and $99,536.73 in non-epithelioid and epithelioid patients, respectively. PSA indicated probabilities of cost-effectiveness for pembrolizumab plus chemotherapy at 0.55%, 69.41%, and 0.14% for the entire population and the non-epithelioid and epithelioid subgroups, respectively.

Conclusion

In the Chinese healthcare system, the combination of pembrolizumab and chemotherapy did not prove to be more cost-effective than chemotherapy alone as an initial treatment for untreated advanced pleural mesothelioma, with the exception of patients who have non-epithelioid histology.
Portulaca oleracea L. (purslane) extract ameliorates intestinal inflammation in diet-induced obese mice by inhibiting the TLR4/NF-κB signaling pathway
Authors: Miao Lingchao , Cheong Meng Sam , Zhang Haolin , Khan Haroon , Tao Hongxun , Wang Yuxiao , Cheang Wai San
Published: January 2025

Background

Portulaca oleracea L. (purslane) is a dietary plant and a botanical drug with antioxidant, antidiabetic, and anti-inflammatory activities. However, the effects of purslane against intestinal-inflammation-associated obesity are yet to be studied. In the present study, we hypothesized that purslane extract could reduce intestinal inflammation associated with metabolic disorder.

Results

Male C57BL/6J mice were fed a high-fat diet (HFD, 60% kcal% of fat) for a total duration of 14 weeks to establish an obesity model; further, the treatment group was orally administered purslane extract (200 mg/kg/day) during the last 4 weeks. Then, intestinal tissues were detached from the mice for detecting protein expressions through Western blot and immunohistochemical analyses. Pro-inflammatory cytokines were determined using ELISA kits, whereas the components of purslane extract were detected by ultra performance liquid chromatography/electrospray ionization quadrupole time-of-flight mass spectrometry. Chronic oral administration of purslane extract ameliorated colon shortening syndrome and reduced bowel inflammation in HFD-induced obese mice through suppression of the toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway to downregulate TLR4, myeloid differentiation factor 88 (MyD88), Ser32 phosphorylation of NF-κB inhibitor alpha (IκBα), and Ser536 phosphorylation of NF-κB p65 expression levels, thereby inhibiting the pro-inflammatory cytokines, tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels.

Conclusion

The present study supports the anti-inflammatory potential of purslane extract for modulating bowel inflammation under obesity through inhibition of the TLR4/NF-κB signaling pathway.
LC-MS/MS assisted pharmacokinetic and tissue distribution study of ropivacaine and 3-OH-ropivacaine on rats after plane block anesthesia
Authors: Butiulca Mihaela , Farczadi Lenard , Imre Silvia , Vari Camil Eugen , Vlase Laurian , Cordos Bogdan , Azamfirei Leonard , Lazar Alexandra Elena
Published: January 2025

Knowledge of drug pharmacokinetics and tissue distribution is precious for ensuring patient safety and optimizing treatments. The varied use of local anesthetics, as well as the fact that anesthetics can sometimes have low therapeutic indices and numerous adverse drug reactions, makes any novel pharmacokinetics information valuable. The present manuscript describes a pharmacokinetic study of ropivacaine carried out after plane block anesthesia on an animal model, using high sensitivity, accurate, and precise LC-MS/MS bioanalysis. Both plasmatic concentrations and tissue distribution of ropivacaine and its primary active metabolite were determined. The results showed a tissue affinity of the anesthetics, a clearance of ropivacaine mainly by hepatic metabolism, and the final, mainly renal excretion of the hydroxylated metabolite. While the results cannot simply and directly be transposed to human pharmacokinetics, they offer a valuable basis for future studies and can contribute to a better understanding of the bioavailability and toxicology of the widely used modern anesthetic.
Pharmacogenetic and pharmacokinetic factors for dexmedetomidine-associated hemodynamic instability in pediatric patients
Authors: Guan Yanping , Li Bilian , Zhang Yiyu , Luo Hao , Wang Xueding , Bai Xue , Zheng Zhuoling , Huang Yaying , Wei Wei , Huang Min , Song Xingrong , Zhong Guoping
Published: January 2025

Purpose

The incidence of hemodynamic instability associated with dexmedetomidine (DEX) sedation has been reported to exceed 50%, with substantial inter-individual variability in response. Genetic factors have been suggested to contribute significantly to such variation. The aim of this study was to identify the clinical, pharmacokinetic, and genetic factors associated with DEX-induced hemodynamic instability in pediatric anesthesia patients.

Methods

A cohort of 270 pediatric patients scheduled for elective interventional surgery received an intranasal dose of 3 mcg·kg-1 of dexmedetomidine, and subsequent propofol induction was conducted when patients had a UMSS of 2–4. The primary endpoint was hemodynamic instability—defined as a composite of hypotension and/or bradycardia, which is characterized by a 20% reduction from age-specific baseline values. Plasma concentrations of dexmedetomidine were determined, and single-nucleotide polymorphisms (SNPs) were genotyped. A validated population pharmacokinetic model was used to estimate pharmacokinetic parameters. LASSO regression was used to identify significant factors, and a Cox’s proportional hazards model-derived nomogram for hemodynamic instability was developed.

Results

Hemodynamic instability was observed in 52 out of 270 patients (209 events), resulting in a cumulative incidence of 16.30% at 90 min, as estimated by Kaplan–Meier estimation, and it was associated with a median time to event of 35 min. The interval time between DEX initiation and propofol induction was 16 min (IQR: 12–22 min). The cumulative incidence was 8.2% within 22 min after DEX initiation. The identified significant risk factors for DEX-associated hemodynamic instability included weight, DEX clearance, concomitant propofol use, and the following gene variants UGT2B10 rs1841042 (hazard ratio (HR):1.41, 95% confidence interval (CI): 1.12–1.79), CYP2A6 rs8192733 (HR:0.28, 95%CI:0.09–0.88), ADRA2B rs3813662 (HR:1.39,95%CI:1.02–1.89), CACNA2D2 rs2236957 (HR:1.46, 95%CI:1.09–1.96), NR1I2 rs3814057 (HR:0.64, 95%CI:0.43–0.95), and CACNB2 rs10764319 (HR:1.40,95%CI:1.05–1.87). The areas under the curve for the training and test cohorts were 0.881 and 0.762, respectively. The calibration curve indicated excellent agreement.

Conclusion

The predictive nomogram, which incorporates genetic variants (UGT2B10, CYP2A6, ADRA2B, CACNA2D2, NR1I2, and CACNB2) along with clinical factors such as weight, DEX clearance, and propofol use, may help prevent DEX-associated hemodynamic instability. Delayed hemodynamic instability is likely to occur after 35-min DEX initiation in patients with lower DEX clearance after propofol induction.
The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients
Authors: Mach Anna , Wnorowska Anna , Siwek Marcin , Wojnar Marcin , Radziwoń-Zaleska Maria
Published: January 2025

Background

Due to its exceptional effectiveness, clozapine (CLO), whose metabolite is norclozapine (NCLO), is a drug of choice in the management of treatment-resistant schizophrenia. The purpose of this study was to assess the factors modifying the CLO/NCLO ratio (CNR).

Methods

A total of 446 blood samples (233 of which were drawn from females and 213 from males, aged from 18 to 77 years) were analyzed in this study. The patients were treated at a psychiatric hospital in the period 2016–2021. Serum CLO and NCLO levels were determined with high-performance liquid chromatography coupled with a UV detector.

Results

The median CNR was 2.38 (minimum 0.30, maximum 14.36). Our analysis showed that neither sex (p= 0.135) nor smoking (p = 0.774) had any significant effect on the CNR. However, increased doses of CLO resulted in lower CNR values (p = 0.005). Concomitant use of other psychotropic drugs increased the CNR (p = 0.001).

Discussion

The results of our study indicate a need for personalized CLO treatment. Assessing the CNR may be useful in identifying CLO interaction with other psychotropic drugs.
Therapeutic effects of composite probiotics derived from fermented camel milk on metabolic dysregulation and intestinal barrier integrity in type 2 diabetes rats
Authors: Manaer Tabusi , Sailike Jialehasibieke , Sun Xin , Yeerjiang Baheban , Nabi Xinhua
Published: January 2025

Background

In the Kazakh community of Xinjiang, China, fermented camel milk has been traditionally used to manage diabetes. This study evaluates the effects of composite probiotics derived from fermented camel milk (CPCM) on metabolic disturbances in a rat model of Type 2 diabetes (T2DM).

Methods

T2DM was induced in Wistar rats using streptozotocin. Experimental groups included a diabetic control, Metformin, and low- and high-dose CPCM. Measurements over 6 weeks included body weight (BW), fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), C-peptide (CP), lipid profiles, inflammatory markers, fecal short-chain fatty acids (SCFAs), and tight junction protein expression in colonic tissues.

Results

High-dose CPCM significantly increased BW by 22.2% (p < 0.05) and reduced FBG by 6.5 mmol/L (p < 0.001). The OGTT AUC decreased by 40.1% (p < 0.001), and HbA1c levels fell by 22.9% (p < 0.01). CP levels rose by 21.8% (p < 0.05). Lipid profiles improved: TC decreased by 40.0%, TG by 17.1%, and LDL-C by 30.4% (all p < 0.001). Fecal SCFAs, including acetate (75.4%, p < 0.001), methyl acetate (18.9%, p < 0.05), and butyrate (289.9%, p < 0.001), increased, with total SCFAs rising by 89.7% (p < 0.001). Inflammatory markers IL-1β (12.7%, p < 0.01), TNF-α (16.7%, p < 0.05), and IL-6 (17.3%, p < 0.01) were significantly reduced. Tight junction protein expression (ZO-1, occludin, claudin-1) and mucin (MUC2) in colonic tissues increased (p < 0.05). CPCM treatment also reduced serum total bile acids by 24.9%, while hepatic and fecal bile acids increased by 114.0% and 37.8% (all p < 0.001). CPCM lowered serum DAO, D-lactate, and LPS levels (all p < 0.001). mRNA levels of TGR5 and CYP7A1 in the liver, and TGR5 and FXR in the colon, were markedly elevated (all p < 0.001). Histological examinations revealed reduced pancreatic inflammation and hepatic steatosis, with restored colonic structure.

Conclusion

CPCM treatment significantly improved metabolic dysregulation in the T2DM rat model, reducing blood glucose and lipid levels, enhancing intestinal barrier function, and increasing insulin secretion. These findings highlight the therapeutic potential of CPCM in T2DM management and probiotics’ role in metabolic health.
Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning
Authors: Huang Huai , Ren Guangqin , Sun Shanghui , Li Zhi , Zheng Yongtian , Dong Lijuan , Zhu Shaoliang , Zhu Xiaosheng , Jiang Wenyu
Published: January 2025

Objective

This study aims to evaluate the association between the white blood cell-to-platelet ratio (WPR) and 28-day all-cause mortality among patients experiencing cardiac arrest.

Methods

Utilizing data from 748 cardiac arrest patients in the Medical Information Mart for Intensive Care-IV (MIMIC-IV) 2.2 database, machine learning algorithms, including the Boruta feature selection method, random forest modeling, and SHAP value analysis, were applied to identify significant prognostic biomarkers. Key patient characteristics, encompassing demographic data, comorbidities, hematological and biochemical indices, and vital signs, were extracted using PostgreSQL Administration Tool (pgAdmin) software. The Cox proportional hazards model assessed the impact of WPR on mortality outcomes, while Kaplan-Meier survival curves and restricted cubic spline (RCS) analysis further validated the findings. Subgroup analyses stratified the prognostic value of WPR by demographic and clinical factors.

Results

WPR demonstrated the highest prognostic significance among the variables studied, showing a strong association with 28-day all-cause mortality. In the unadjusted Model 1, hazard ratios (HRs) for WPR quartiles ranged from 1.88 (95% CI: 1.22–2.90) in Q2 to 3.02 (95% CI: 2.04–4.47) in Q4 (Ptrend <0.05). Adjusted models (Models 2–4) confirmed the robustness of these associations, even after accounting for demographic and clinical covariates. Kaplan-Meier and RCS analyses revealed a significant U-shaped relationship between WPR and mortality risk. Subgroup analyses indicated that elevated WPR was particularly associated with increased mortality in males, elderly patients, married individuals, and those with chronic pulmonary disease.

Conclusion

WPR serves as an independent and reliable prognostic biomarker for 28-day mortality in cardiac arrest patients. Its integration into clinical decision-making may enhance the early identification of high-risk patients and guide tailored therapeutic interventions.
Doctor, what is my risk of bleeding after cardiac surgery while on combined anticoagulant with antiplatelet therapy? A validated nomogram for risk assessment
Authors: Han Haolong , Xu Hang , Zhang Jifan , Zhang Weihui , Yang Yi , Wang Xia , Wang Li , Wang Dongjin , Ge Weihong
Published: January 2025

Background

Patients with comorbid coronary artery disease and valvular heart disease usually undergo coronary artery bypass grafting alongside valve replacement or ring repair surgeries. Following these procedures, they typically receive a combination of anticoagulation and antiplatelet therapy, which notably heightens their bleeding risk. However, Current scoring systems provide limited predictive capability.

Methods

A total of 500 adult patients treated with anticoagulation plus antiplatelet therapy after cardiac surgery were randomly divided into the training set and the validation set at a ratio of 7:3. Predictive factors were identified using univariate logistic regression, LASSO regression and multivariable analysis. Various models were developed, validated and evaluated by using methods including ROC curves, calibration curves, the Hosmer-Lemeshow test, net reclassification improvement (NRI), integrated discrimination improvement (IDI) index, decision curve analysis (DCA) and clinical impact curves (CIC).

Results

Mod2 showed the best performance (AUC of validation set = 0.863) which consists of 8 independent predictive factors (gender, age > 65 years, diabetes, anemia, atrial fibrillation, cardiopulmonary bypass time, intraoperative bleeding and postoperative drainage), with a significantly higher AUC compared to Mod1 (only preoperative factors) and Mod3 (the HAS-BLED scoring model). NRI and IDI analyses further confirmed the superior predictive ability of Mod2 (NRI < 0.05, IDI < 0.05). Both DCA and CIC indicated that Mod2 exhibited good clinical applicability.

Conclusion

This research established and validated a nomogram model incorporating eight predictive factors to evaluate the bleeding risk in patients who receive anticoagulation combined with antiplatelet therapy following cardiac surgery. The model holds significant potential for clinical applications in bleeding risk assessment, decision-making and personalized treatment strategies.
Double array system identification research based on LSTM neural network
Authors: Gao Chunhua , Wang Mingyang , Sima Yifei , Yuan Zihan
Published: January 2025

The earthquake simulation shaking table array is an important experimental equipment with a wide range of applications in the field of earthquake engineering. To efficiently address the complex nonlinear problems associated with earthquake simulation shaking array systems, this paper proposes the identification of the earthquake simulation shaking array system using the Long Short-Term Memory (LSTM) algorithm. A dual array system model with flexible specimen connections is established, and this system is identified using the LSTM neural network. The LSTM neural network was validated for identifying the dual array closed-loop system of the earthquake simulation shaking table by using three natural waves and one artificial wave. The results demonstrated that the similarity between the predicted output and the theoretical output of the network identified by LSTM exceeded 0.999. This indicates that the algorithm can accurately reproduce the characteristics of the shaking table itself and shows good performance in time series prediction and data mining. References for earthquake simulation shaking array system experiments are provided.
The effects of strength and conditioning interventions on serve speed in tennis players: a systematic review and meta-analysis
Authors: Deng Nuannuan , Soh Kim Geok , Xu Fan , Yang Xinggang
Published: January 2025

Background

Tennis performance is highly influenced by serve speed. This review aimed to evaluate and quantitatively compare the efficacy of popular strength and conditioning (S&C) training methods in enhancing the speed of the ball in the serves of tennis players.

Methods

Following PRISMA guidelines, a systematic search was conducted in the Scopus, Web of Science, SportsDiscuss, and PubMed databases without date constraints, up to July 2024. Studies included in this meta-analysis met PICOS criteria: a) randomized controlled trials with healthy tennis players, b) isolated or combined S&C training programs, c) evaluation of tennis serve speed, and d) adequate data to compute effect sizes (ESs). The PEDro scale was used to assess methodological quality.

Results

Out of 271 identified papers, 16 studies of moderate to high quality were included in the meta-analysis. Resistance training demonstrated a small but significant effect on serve speed (ES = 0.53; p < 0.001), while multimodal training exhibited a moderate and significant effect (ES = 0.79; p = 0.001). However, core training did not have a significant effect on serve speed (ES = 0.32, p = 0.231).

Conclusion

The findings suggested that S&C interventions, including resistance and multimodal training, were beneficial for increasing serve speed in tennis players. Further high-quality research is recommended to confirm this conclusion.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_ record.php?RecordID=519790, identifier CRD42024519790.
Neuromuscular factors predicting lower limb explosive strength in male college sprinters
Authors: Li YanJin , Guo QiaoFeng , Shao Jia , Gan YanMing , Zhao YaJing , Zhou Yue
Published: January 2025

Purpose

This study aimed to explore the effects of neural and muscular factors on lower limb explosive strength in male college sprinters, and build models based on those factors to identify the key neuromuscular factors that predict the rate of force development (RFD) and 30 m sprint time.

Method

15 male college sprinters were recruited in this study, with 100 m personal best times under 10.93 s. The neuromuscular data were collected by H-reflex and V-wave, isokinetic muscle strength, vertical jumps, and 30 m sprint tests. Pearson correlation and multiple stepwise regression were used for data analysis. The level of statistical significance was set at p ≤ 0.05 for all analyses.

Results

30 m sprint time had a significant moderate positive correlation with Achilles tendon stiffness (r = 0.50, p = 0.05, 95%CI: 0.01–0.81) and a significant moderate negative correlation with the H-index (r = −0.54, p = 0.04, 95%CI: 0.82 to −0.03), V wave (V/MmaxA, r = −0.59, p = 0.02, 95%CI: 0.85 to −0.11) and the eccentric strength of Hamstring (HECC, r = −0.53, p = 0.04, 95%CI: 0.82 to −0.03). The rate of force development (RFD) had a significant positive correlation with H reflex (Hmax/Mmax, r = 0.57, p = 0.03.95%CI:0.08–0.84), and the eccentric strength of Quadriceps (QECC, r = 0.53, p = 0.04, 95%CI: 0.02–0.82). V/MmaxA and HECC were identified as predictors of 30 m sprint time, and the R2 explained 57.5% of the variance. Vertical stiffness and QECC explained 82.7% of the variation in the RFD.

Conclusion

This study found that V/MmaxA and HECC were predictive factors of 30 m sprint time, vertical stiffness and QECC were the predictive factors of RFD. Neural factors such as the α-motoneurons excitability of the spinal and supraspinal centers, have a greater influence on lower limb explosive strength in male college sprinters. Therefore, training related to the neural function of sprinters should be emphasized. In addition, H reflex and V wave can be used widely to assess and monitor the neural function of sprinters in future research. The impact of neural drive on muscles in different levels and sexes of sprinters, and the neuromuscular modulation during muscle contractions can be further explored.
Maternal exposure to dim light at night induces behavioral alterations in the adolescent and adult offspring Wistar rat
Authors: González-González Shellye , Gutiérrez-Pérez Mariana , Guzmán-Ruiz Mara A. , Espitia-Bautista Estefania , Pavón Rosa María , Estrada-Rodríguez Karla P. , Díaz-Infante R. Alejandro , Guadarrama Gándara Cecilia G. , Escobar Carolina , Guerrero-Vargas Natalí N.
Published: January 2025

Introduction

Access to electric light has exposed living organisms to varying intensities of light throughout the 24 h day. Dim light at night (DLAN) is an inappropriate signal for the biological clock, which is responsible for the circadian organization of physiology. During the gestational period, physiological adaptations occur to ensure a successful pregnancy and optimal fetal development. Environmental maternal conditions, such as disruptions of maternal circadian rhythms, could negatively affect offspring health. We have previously demonstrated that exposure of female Wistar rats to DLAN results in circadian, metabolic, and behavioral alterations. A relevant behavior during adolescence is social play, primarily regulated by the nucleus accumbens (NAc) which is crucial for the proper performance of important behaviors in adulthood. Throughout development, microglia are responsible for the remodeling of diverse brain regions via synaptic pruning. During adolescence, this process occurs within the NAc, where immune-mediated remodeling directly impacts social play behavior.

Methods

This study investigated the effects of maternal exposure to DLAN or a light-dark cycle (LD) before (5 weeks) and during the gestational period (21–23 days) on the metabolism and behavior of offspring in adolescence and adulthood. Body mass was measured every 5 days from postnatal day 1 (PN1) to PN25 and every 10 days from PN40 to PN90; food consumption was monitored weekly from PN40 to PN90. Social play behavior was evaluated at PN40. The quantification and morphology of microglia in the NAc were measured on PN30. An open field test was conducted at PN60, and anhedonia test was assessed at PN90.

Results and discussion

Male and female offspring from mothers exposed to DLAN showed increased body mass gain at PN25. DLAN male offspring had lower food consumption, while DLAN females exhibited increased food consumption. In social play behavior, no differences were found between DLAN and LD female offspring. In contrast, DLAN male offspring exhibited a significant decrease in social play behavior compared to LD animals, which was associated with higher numbers of microglia in the NAc that had more ramified morphology. Importantly, at PN90, DLAN offspring presented increased anxiety-like behaviors. These results demonstrate that DLAN exposure induces intergenerational behavioral alterations that persist until adulthood.