bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Metabolic Syndrome and Physical Fitness in Firefighters in Cape Town, South Africa
Authors: Ras Jaron , Grace Jeanne 
Published: December 2024

Objective
To assess the relationship between metabolic syndrome (MetS) and physical fitness in firefighters.

Methods
Firefighters (n = 309) were systematically recruited to participate in this study. A questionnaire and physical measures were used to collect data on firefighters’ cardiometabolic health and physical fitness levels. Data were analyzed using binary and multinomial logistic regressions.

Results
The prevalence of MetS was 23.0%, which was most prevalent in station and platoon commanders. Multivariable analysis showed that age (P < 0.001), lean body mass (P < 0.001), absolute aerobic capacity (P < 0.001), and leg strength (P < 0.001) was significantly associated with MetS. In addition, relative aerobic capacity (P < 0.001), push-ups (P = 0.016), and sit-ups (P < 0.001) were inversely associated with MetS.

Conclusions
Firefighters with MetS had a higher absolute aerobic capacity and strength, and healthier fighters had a higher relative aerobic capacity, muscular endurance capacity, and flexibility.
Ultrasound-guided Percutaneous Fine-needle Aspiration Performed by In-training Pulmonologist
Authors: Perez-Gutierrez Victor , Khalid Amnah , Camere Maurizio , Perwaiz Muhammad 
Published: December 2024

Abstract
Ultrasound (US)-guided fine-needle aspiration (FNA) is a minimally invasive procedure that can be performed by an in-training pulmonologist. This is a retrospective study of 73 patients who underwent US-guided FNA by pulmonologist and interventional radiologist. Comparable diagnostic yield was found in this study (88.0% vs 81.3%, P = 0.460), but a higher number of second diagnostic procedures was seen in the Interventional Radiology group (22.9% vs 16.0%, P = 0.488). No significant complications were reported in the pulmonary group. In-training pulmonologists can safely perform US-guided FNA for thoracic and extrathoracic lesions.
Heterogeneity in Pancreatitis
Authors: Bellin Melena D. , Andersen Dana K. , Akshintala Venkata , Born Dianna , Coghill Robert C. , Easler Jeffrey , Fogel Evan L. , Forsmark Christopher E. , Freeman A. Jay , Hughes Steven J. , Jensen Amy , Liran Omer , Martin Linda , Pandol Stephen J. , Palermo Tonya M. , Papachristou Georgios I. , Park Walter G. , Phillips Anna Evans , Schwarzenberg Sarah Jane , Singh Vikesh K. , Toledo Frederico G. S. , VanDalfsen Jill , Whitcomb David C. , Wu Bechien , Yadav Dhiraj 
Published: December 2024

Abstract
Both the clinical management and study of recurrent acute pancreatitis and chronic pancreatitis are complicated by significant heterogeneity in the etiology, mechanisms, symptoms, and complications of pancreatitis. The National Institutes of Diabetes and Digestive and Kidney Disease recently convened a workshop to address current knowledge and knowledge gaps in the field. Preclinical models that better replicate human disease are important for development of new therapies. Pain is often the most common and most difficult symptom to treat, as the causes are multifactorial and effective treatment may vary depending on whether pain is neuropathic or nociceptive in origin, and the placebo effect can complicate evaluation of the efficacy of medical and procedural interventions. Novel technologies like functional magnetic resonance imaging and virtual reality may offer novel means for assessing and treating pain, respectively. Clinical trial designs will need to consider best approaches to addressing the heterogeneity of chronic pancreatitis, including careful attention to designing eligibility criteria, and establishing accepted and validated core outcomes criteria for the field. The latter may be informed by consensus in pain research. Recruitment of participants into clinical trials has been challenging, often requiring multiple centers. Establishment of a clinical trials network would facilitate greater opportunities for therapeutic trials in pancreatitis.
Current Understanding of Therapeutic and Diagnostic Applications of Exosomes in Pancreatic Cancer
Authors: Shakerian Neda , Tafazoli Aida , Razavinia Amir , Sadrzadeh Aghajani Zahra , Bana Nikoo , Mard-Soltani Maysam , Khalesi Bahman , Hashemi Zahra Sadat , Khalili Saeed 
Published: December 2024

ABSTRACT
Unusual symptoms, rapid progression, lack of reliable early diagnostic biomarkers, and lack of efficient treatment choices are the ongoing challenges of pancreatic cancer. Numerous research studies have demonstrated the correlation between exosomes and various aspects of pancreatic cancer. In light of these facts, exosomes possess the potential to play functional roles in the treatment, prognosis, and diagnosis of the pancreatic cancer. In the present study, we reviewed the most recent developments in approaches for exosome separation, modification, monitoring, and communication. Moreover, we discussed the clinical uses of exosomes as less invasive liquid biopsies and drug carriers and their contribution to the control of angiogenic activity of pancreatic cancer. Better investigation of exosome biology would help to effectively engineer therapeutic exosomes with certain nucleic acids, proteins, and even exogenous drugs as their cargo. Circulating exosomes have shown promise as reliable candidates for pancreatic cancer early diagnosis and monitoring in high-risk people without clinical cancer manifestation. Although we have tried to reflect the status of exosome applications in the treatment and detection of pancreatic cancer, it is evident that further studies and clinical trials are required before exosomes may be employed as a routine therapeutic and diagnostic tools for pancreatic cancer.
Curable giant hematoma due to small bowel mesenteric laceration after screening colonoscopy: a case report
Authors: Li Xue , Liu Chuntao , Zhang Lingye , Wang Yongjun , Zhang Shutian , Xing Jie 
Published: December 2024

Introduction and importance:
Mesenteric laceration after screening colonoscopy is a rare and fatal complication. This case reported a giant hematoma due to a small intestinal mesenteric laceration after a screening colonoscopy.

Case description:
A 56-year-old woman complained of persistent dramatic abdominal pain after the screening colonoscopy. This patient has appendectomy, rheumatic heart disease, IgG4-related disease, type 2 diabetes mellitus, and coronary atherosclerotic heart disease. Blood tests showed hemoglobin concentration sharply fell to 87 g/L and computed tomography scans confirmed a 16.4 cm × 6.1 cm × 9.5 cm hematoma abdominal hematoma near the small intestine. Digital subtraction angiography consistently showed rough and disordered the fourth group of the superior mesenteric artery. The main diagnosis was mesenteric laceration of the small intestine following colonoscopy. The patient was treated with fasting, gastrointestinal decompression, rehydration, inhibition of gastric acid, and meropenem to fight infection, 4 U suspended red blood cells and 400 mL fresh frozen plasma. Finally, this patient was discharged after conservative treatment, and the abdominal hematoma was significantly shrunk after 3 months.

Clinical discussion:
Anticoagulants, a history of previous abdominal surgery, and IgG-RD leading to abdominal fibrosis were possible risk factors for mesenteric laceration. When the patient’s condition is complex and has no absolute indication for surgery, conservative management could be appropriately considered.

Conclusions:
We reported a case of abdominal hematoma due to colonoscopy. The successful conservative therapy may provide a novel experience for intra-abdominal hematoma treatment.
Berberine in combination with anti-PD-L1 suppresses hepatocellular carcinoma progression and metastasis via Erk signaling pathway
Authors: Miao Ganggang , Zhang Zhiyu , Wang Meiyan , Gu Xingwei , Xiang Dongxiao , Cao Hongyong 
Published: December 2024

Background:
Berberine (BBR) is an isoquinoline alkaloid extracted from Huang Lian and other herbal medicines. It has been reported to play a crucial role in multiple metabolic diseases and cancers. Programmed cell death-1 (PD-L1) is known as the immune checkpoint; immunotherapy targeting PD1/PD-L1 axis can effectively block its pro-tumor activity. However, the effect of the combined use of BBR and anti-PD-L1 on hepatocellular carcinoma (HCC) has not been reported.

Methods:
Hep-3B and HCCLM3 cells were chosen as the experimental objects. To determine the potential anti-cancer activity of the combination of BBR and anti-PD-L1, we first treated v cells with BBR. The cell viability of Hep-3B and HCCLM3 with BBR treatment was measured by Cell Count Kit 8 assay. Cytometry by time-of-flight was performed to analyze tumor tissues after treatment with BBR and/or anti-PD-L1. Proliferation-, migration-, and invasion-related markers were measured by western blotting and immunohistochemistry.

Results:
The results showed that BBR significantly inhibited the proliferation of Hep-3B and HCCLM3.The combination treatment of BBR and anti-PD-L1 had a prominent inhibitory effect on HCC tumorigenesis. Cytometry by time-of-flight analysis indicated that BBR affects the immune subsets in the tumors. Besides, BBR and anti-PD-L1 inhibited the migration and invasion of HCC by inactivating the phosphorylation of Erk.

Conclusion:
Our study proposed that the combination treatment of BBR and anti-PD-L1 markedly inhibited the tumorigenesis of HCC by Erk signaling pathway. We hope our research can provide a new strategy for the potential of BBR as a therapeutic agent in the treatment of HCC.
The impact of ivermectin on COVID-19 outcomes: a systematic review and meta-analysis
Authors: Sai Yengu Nithin , Raheem Abdul , Pons Andrea Gómez , Ho Wing Lam , Ali Syed Muhammad Sinaan , Haseeb Abdul , Fadlalla Ahmad Tagwa Kalool , Mustafa Muhammad Saqlain 
Published: December 2024

Background:
The COVID-19 pandemic, resulting in approximately seven million deaths globally, underscores the urgency for effective treatments. Ivermectin, among several repurposed drugs, garnered interest due to its antiviral properties. However, conflicting evidence from observational studies and randomized controlled trials raised questions about its efficacy and safety.

Method:
This systematic review and meta-analysis followed MOOSE and PRISMA guidelines. Comprehensive searches were conducted in databases including Scopus, Embase, PubMed, and Web of Science up to April 2024. Data were extracted independently by two reviewers and analyzed using Comprehensive Meta-Analysis V3 software.

Results:
Across 33 studies encompassing 15,376 participants, ivermectin showed no significant impact on critical outcomes such as mortality [risk ratio (RR) 0.911, 95% confidence intervals (CI) 0.732–1.135], mechanical ventilation (RR 0.727, 95% CI 0.521–1.016), polymerase chain reaction conversion (RR 1.024, 95% CI 0.936–1.120), ICU admissions (RR 0.712, 95% CI 0.274–1.850), or hospitalization rates (RR 0.735, 95% CI 0.464–1.165) compared to controls. However, it significantly reduced time to symptom alleviation (standardized mean difference −0.302, 95% CI −0.587 to −0.018) and sustained symptom relief (RR 0.897, 95% CI 0.873–0.921). Adverse event (AE) rates were similar between the ivermectin and control groups (RR 0.896, 95% CI 0.797–1.007). Meta-regression indicated older age and diabetes as predictors of AEs.

Conclusion:
Despite its observed benefits in symptom management, ivermectin did not significantly influence critical clinical outcomes in COVID-19 patients. These findings highlight the importance of continued research to identify effective treatments for COVID-19, emphasizing the need for high-quality studies with robust methodology to inform clinical practice and public health policy effectively.
Management of Sprengel deformity by modified Woodward approach and outcome: a case series and literature review
Authors: Pandey Abhishek , Kayastha Sabik R. , Pande Prasamsa , Silwal Prabhat , Upadhyaya Prashant , Pandey Archana , Keshari Suraj , Dhungana Sanjay , Singh Yadvinder 
Published: December 2024

Introduction:
Sprengel deformity (SD) is a rare congenital deformity consisting of elevation of the scapula, leading to limited range of motion and a visible lump in severe cases. Klippel-Feil syndrome is a rare congenital abnormality characterized by the triad of cervical synostosis, low posterior hairline, and short neck. It is often associated with SD.

Case presentation:
We present two cases of SD of a 7-year-old boy and a 10-year-old boy. They were both born with the abnormality and complained of limited range of motion in the affected shoulder.

Clinical discussion:
Patients with less severe forms of SD can lead a normal life with supportive treatment, and it is not connected with cognitive impairment; however, there may be a limited range of motion and cosmetic concerns. In severe cases, treatment entails operative therapy with corrective placement of the scapula and resection of the omovertebral band.

Conclusion:
Patients with SD require supportive physiotherapy from a young age. Severe cases need operative treatment at a young age. The modified Woodward approach may be an excellent surgical option to correct the deformity.
Surgical strategies for hemorrhagic vestibular schwannoma with acute neurological decline: a case report with a literature review
Authors: Almahariq Fadi , Budimir Krunoslav , Kastelancic Andelo , Lakic Marin , Oreskovic Darko , Blazevic Andrea , Chaurasia Bipin 
Published: December 2024

Introduction and importance:
Vestibular schwannomas (VSs) are benign tumors of cranial nerve VIII, comprising 8% of primary intracranial neoplasms. Hemorrhagic VSs, though rare, present unique clinical challenges due to their potential for rapid neurological decline.

Case presentation:
We present a case of a 68-year-old male with sudden severe headache, nausea, vomiting, and balance issues, initially diagnosed with a hematoma at the right cerebellopontine angle until an magnetic resonance imaging (MRI) scan verified a bleeding schwannoma. Due to deteriorating neurological status and signs of obstructive hydrocephalus on computed tomography (CT), urgent neurosurgical neuromonitoring, successfully managed the hemorrhagic VS, with postoperative recovery intervention required. Neurosurgical treatment, guided by intraoperative outcomes, restoring normal life. Urgent transfer to a medical center with a neurosurgical showing favorable outcomes.

Clinical discussion:
Cerebellopontine hematoma verified by CT mandates MRI to exclude tumorous bleeding, which is crucial in cases lacking prior MRI.

Conclusion:
Though rare, hemorrhagic VS must be considered in neurologically decompensated patients, especially with risk factors. Timely surgical intervention, despite precipitating a comatose state, can yield satisfactory results.
A young female patient with severe traumatic hemifacial degloving avulsion injury successfully managed with reconstruction and full thickness skin graft: case report
Authors: Mohamed Hassan Muhumed , Hassan Ibrahim Ali , Ahmed Abdirisak Abdikarin , Sidow Nor Osman , Ali Abdullahi Yusuf 
Published: December 2024

Introduction and importance:
Road traffic accidents can result in severe ocular injuries, jeopardizing vision. High-speed collisions may lead to facial avulsion and degloving injuries, which pose risks such as airway compromise, bleeding, soft tissue loss, disfigurement, and post-traumatic impairments that necessitate prompt reconstruction.

Case presentation:
A 24-year-old woman sustained injuries in a motorcycle accident, which resulted in a left hemifacial avulsion, a degloving injury, and the loss of her left brow. Additionally, she lost the lower eyelid on the left side and a portion of the left maxilla near the medial canthus. Despite these injuries, the movements of her left eye remained normal.

Clinical discussion:
The primary objectives of periorbital reconstruction are to restore the patient’s vision with minimal discomfort while ensuring stable coverage for orbital protection and achieving functional reconstruction of the defect. Although there are various surgical reconstruction techniques available, skin grafting and regional flap reconstruction methods are the most commonly employed.

Conclusion:
The patient expressed satisfaction with the outcome and reported improved social comfort. After a one-year follow-up, both the patient’s facial functions and vision were found to be normal.
Acute renal infarction as an unusual presentation of hypertensive crisis in an elder female patient: a case report and literature review
Authors: Osman Ubah Mumin Ali , Iyow Sowdo Nur , Gedi Ismail Ibrahim , Farah Yusuf Mohamud Mohamed 
Published: December 2024

Introduction and importance:
Acute renal infarction is a rare condition characterized by the obstruction of renal arteries, leading to ischemia and infarction of the renal tissue. It is often underdiagnosed and can present with acute abdominal pain.

Case presentation:
A 70-year-old female with a 1-year history of hypertension presented to the emergency room with severe sharp flank pain and vomiting of 8 hours duration. She had no comorbidities and was taking Amlodipine 10 mg for hypertension. Vital signs revealed severely elevated blood pressure (230/180 mmHg) and a pulse rate of 98 bpm. Clinical examination showed tenderness over the right kidney without signs of abdominal guarding. Renal function was normal, and there were no signs of systemic inflammation. Imaging studies, including abdominal ultrasound and contrast-enhanced CT, confirmed the diagnosis of unilateral renal infarction.

Clinical discussion:
A multidisciplinary team, including Internal Medicine, Cardiovascular Surgery, Urology, and Interventional Radiology, convened to discuss the treatment approach. Considering the duration of symptoms and the preserved renal parenchyma, revascularization was not pursued. The patient was admitted and started on therapeutic dose low molecular heparin for anticoagulation. Blood pressure was controlled using intravenous Labetalol. The patient showed significant clinical improvement and was discharged on apixaban and Amlodipine. Follow-up lab tests after 1 month demonstrated normal kidney function.

Conclusion:
This case highlights the importance of considering renal infarction in the differential diagnosis of acute abdominal pain, especially in hypertensive patients. Early recognition and appropriate management are crucial for preventing complications and preserving renal function.
Microplastics and nanoplastics: emerging threats to cardiovascular health – a comprehensive review
Authors: Irfan Hamza , Irfan Haider , Khan Muhammad Ahtesham , Inanc Oyku , Hasibuzzaman Md. Al 
Published: December 2024

Background:
Global plastic production surged to 400.3 million metric tons in 2022, contributing significantly to environmental pollution. Projections estimate that 13.2 billion tons of plastic waste will be present in ecosystems by 2050. This increase in plastic production has led to substantial human exposure to microplastics (MPs) and nanoplastics (NPs). While their environmental and general health impacts are well-documented, the specific effects on cardiovascular health remain underexplored.

Objectives:
This review aims to examine the presence of MPs and NPs in the environment, their routes of human exposure, and their toxicological implications for the cardiovascular system (CVS), focusing on oxidative stress, apoptosis, cardiac fibrosis, and major adverse cardiovascular events (MACE).

Methods:
A comprehensive literature review was conducted using PubMed, Scopus, and Google Scholar. Relevant studies from the past 10 years were selected based on keywords like “microplastics,” “nanoplastics,” and “cardiovascular health.”

Results:
MPs and NPs are found in air, water, and food, entering the human body primarily through inhalation, ingestion, and dermal contact. These particles induce oxidative stress, mitochondrial dysfunction, and apoptosis, which impair cardiovascular health. MPs have been detected in arterial tissues, particularly in atherosclerotic plaques, correlating with increased MACE risk. MP exposure is linked to VC, reduced vessel flexibility, and increased thrombosis severity. Additionally, MPs contribute to inflammation and lipid metabolism disruption, which further exacerbate heart disease.

Conclusion:
The evidence suggests a concerning link between plastic exposure and cardiovascular health, highlighting the urgent need for further research to understand the long-term effects of MPs and NPs on CVSs.
Risk and pattern analysis of distant metastases in colon cancer: protocol for a systematic review and meta-analysis
Authors: Hu Yonghua , Wei Qinglin , Yu Yang , Li Haiyuan , Chen Hao 
Published: December 2024

Background:
Understanding the metastatic risks and patterns of colon cancer is crucial for patient evaluation and decision-making. However, high-quality evidence on colon cancer metastases is lacking. This study aims to conduct a systematic review and meta-analysis to determine the risk of site-specific metastasis and provide a complete profiling of distant metastasis in colon cancer.

Methods:
This review will include studies reporting the proportion of different-site metastases among colon cancer patients. Clinical trials, follow-up studies, and cross-sectional surveys with English publications are eligible for inclusion. We will search Medline, Embase, Web of Science, and the Cochrane Library from inception to June 2023. Two reviewers will independently screen the title/abstract and full texts of identified records according to the eligibility criteria. Data from eligible studies will be extracted and used for meta-analysis. Meta-analyses will be conducted to estimate the overall proportion of site-specific metastasis. During meta-analyses, two proportions will be analyzed, i.e., the incidence of metastasis and component proportion. We will select the appropriate tools to assess the risk of biases based on the study design of included studies.

Results:
This study is still in preparation for launch. Once all analyses are complete, the results will be submitted for publication in a peer-reviewed journal.

Conclusion:
This review will provide a clear and systematic metastatic pattern of colon cancer and evidence-based recommendations for the management of distant metastasis.
The Ratchet Model of Synovial Flares in Palindromic Rheumatism
Authors: Chakraborty S. , Phatak S. , Rath S. , Goel P. 
Published: December 2024

AbstractSynovial flares in palindromic rheumatism (PR) are aperiodic bursts of inflammation in the joints, which usually self-resolve in a timescale hours or days. PR patients are believed to transit to a chronic auto-immune disease called rheumatoid arthritis (RA) in most cases, however, many patients remain palindromic indefinitely. We utilize and adapt a minimal ODE model of rheumatoid arthritis (RA) developed by Baker et al. to study PR in greater detail. We address questions characterizing the incidence, decay and sustenance of synovial flares in palindromic patients. A key question is to describe the nature of the transition from palindromic to full RA. We show that PR flares ordinarily resolve spontaneously, however, there is a secondary equilibrium in the model into which the trajectory can sometimes get trapped. When this “meta-stable locking” occurs, it initiates an adaptation that helps rescue the flare. Furthermore, this adaptation in turn activates a secondary adaptation in response to fluctuations in the healthy steady state. Finally, we show that if metastable locking occurs frequently enough these adaptation sequences turn maladaptive and the system slowly progresses into fully developed RA.