bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of citrus fruit and hesperidin intake on multiple health outcomes: An umbrella review
Authors: Cheng Yu-Sen , Zhou Yong 
Published: December 2024

Abstract
Citrus fruits are rich sources of several biologically active flavonoids such as hesperidin, naringin, and polymethoxylated flavones. We evaluated the evidence of associations between citrus fruit or hesperidin intake and multiple health outcomes. An umbrella review was conducted for studies performed in humans. Overall, 246 articles were initially identified by searching in 4 databases. Twenty-two meta-analyses and systematic reviews with 28 health outcomes met the inclusion criteria. Citrus fruit intake had beneficial effects on all-cause mortality (relative risk [RR]. 0.90; 95% confidence interval [95% CI], 0.86 to 0.94), cardiovascular diseases (RR, 0.78; 95% CI, 0.66 to 0.92), coronary heart disease (RR, 0.91; 95% CI, 0.86 to 0.96), stroke (RR, 0.74; 95% CI, 0.65 to 0.84), type 2 diabetes mellitus (RR, 0.85; 95% CI, 0.78 to 0.92), and several cancers. Dose-response analyses indicated that each 100-g/d increase in citrus fruit intake could reduce the risks of all-cause mortality by 6% (RR, 0.94; 95% CI, 0.88 to 1.00), stroke by 22% (RR, 0.78; 95% CI, 0.69 to 0.90), and cardia gastric cancer by 40% (RR, 0.60; 95% CI, 0.44 to 0.83). Citrus fruit intake also had beneficial effects on the lipid profile and body weight control (weighted mean difference, −1.28; 95% CI, −1.82 to −0.74). Grapefruits could reduce the systolic blood pressure (weighted mean difference, −2.43, 95% CI, −4.77 to −0.09). Hesperidin supplementation significantly improved inflammation. Citrus fruit intake was generally safe and beneficial for multiple health outcomes in humans. However, grapefruit and pomelo juice may affect the bioavailability of various medications, so care should be exercised before increasing the intake of these fruits or their juices.
Exfoliative esophageal bleeding caused by blind placement of a nasogastric tube: Two cases and a literature review
Authors: Huang Qi-Qiang , Wei Jing-Jing , Zhuang Ze-Hao 
Published: December 2024

Abstract
Transnasal intubation is a clinical operation usually performed blindly at the bedside. Mild adverse events, such as epistaxis and tube misplacement, are relatively common. Esophageal bleeding or perforation and other serious adverse events are rare. In the present study, two cases of severe diffuse esophageal bleeding caused by the blind placement of a nasogastric tube are described. These cases were successfully treated using a covered metal stent or Sengstaken-Blakemore tube. A review of the literature regarding the possible causes of such adverse events and the potential endoscopic treatments for severe hemorrhage are discussed.
Association between the nutritional status and radiation pharyngeal mucositis in patients with head and neck cancer during radiotherapy: A longitudinal study
Authors: Zhang Li-Chuan , Wang Yu-Jie , Zhuang Bing , Zhang Tong , Jin San-Li , Wan Meng , Zhao Dan , Zheng Bao-Min , Xiao Shao-Wen , Liu Wei-Xin , Xu Xiao-Long , Huang Zhou , Sun Yan , Zhang Ya-Ru , Wang Wei-Hu , Lu Qian 
Published: December 2024

Abstract

Objective
Radiation mucositis, especially pharyngeal mucositis, severely affects the oral intake of patients of head and neck cancer (HNC) during radiotherapy. Whether the nutritional status affects the severity of pharyngeal mucositis is currently unknown. This study investigated the incidence of malnutrition and radiation pharyngeal mucositis in patients with HNC during radiotherapy and analyzed the impact of the nutritional status on radiation pharyngeal mucositis.

Methods
Consecutive patients with HNC receiving radiotherapy were recruited for this longitudinal observational study. Data were collected at baseline (T1), midtreatment (T2), and at the end of treatment (T3). The Common Terminology Criteria for Adverse Events version 4.0 and the Global Leadership Initiative on Malnutrition criteria were used to assess pharyngeal mucositis and the nutritional status, respectively.

Results
There were 348 HNC patients who completed all assessments. The pharyngeal mucositis of patients with HNC was aggravated during radiotherapy (χ
2 = 553.521, P < 0.001). At T3, 56.0% of patients had moderate or severe pharyngeal mucositis. The proportion of patients with malnutrition increased significantly during treatment (21.3% at T1 vs 46.8% at T2 vs 76.1% at T3, χ
2 = 209.768, P < 0.001). Both a multivariable analysis of generalized estimating equations and a logistic regression analysis showed that pharyngeal mucositis was associated with malnutrition.

Conclusions
Malnutrition was common in patients with HNC during radiotherapy, and it was closely related to pharyngeal mucositis. Joint interventions targeting nutrition and symptom management should be considered for patients with HNC.
Role of selenium in cell death
Authors: Gao Peng-Ning , Wang Chuan-Lin , Xu Jia-Li , Liu Shan-Ling , Zhou Lan 
Published: December 2024

Abstract
Selenium is an essential nutrient closely related to redox homeostasis in the body. A redox imbalance will adversely affect the microenvironment inside and outside the cell, leading to cell death. Various types of cell death have been discovered in recent years, but the role(s) of selenium and the associated mechanism(s) of action require further elaboration. We review the roles and mechanisms of action of selenium in cell necrosis, apoptosis, ferroptosis, autophagy, and pyroptosis. Under normal conditions, selenium inhibits cell necrosis, apoptosis, ferroptosis, autophagy, and pyroptosis by downregulating the nuclear factor κB pathway, upregulating antiapoptotic proteins, decreasing oxidative stress, increasing antioxidant enzyme activity, enhancing the mTOR pathway, and downregulating the NLRP3/caspase-1 pathway, thereby helping to maintain the normal physiological functions of cells. On the other hand, selenium deficiency leads to activation of the PI3K/AKT and Notch/Hes1 pathways, causing a significant increase in the level of oxidative stress in the organism, resulting in cell necrosis, apoptosis, and pyroptosis. In the case of malignancy, the in vivo metabolite of inorganic selenium, hydrogen selenide, plays an antitumor role by inducing apoptosis and ferroptosis in tumor cells because of its high redox activity. In conclusion, an adequate level of selenium in the body is essential for maintaining normal cellular physiological functions and reducing fibrotic alterations. Furthermore, the in vivo metabolites of inorganic selenium may have some clinical value in antitumor therapy.
Value of combining the serum d-lactate, diamine oxidase, and endotoxin levels to predict gut-derived infections in cancer patients
Authors: Yang Shou-Mei , Zhang Xiao-Dan , Ma Huai-Xing , Wu Dan , Liu Xing , Yu Hao-Bin , Li Shi-Wei , Gao Wen-Jun , Liu Wei-Wei , Li Su-Yi 
Published: December 2024

Abstract

Objective
This is a retrospective observational cohort study. The objective of this retrospective observational cohort study was to evaluate the value of the combined serum d-lactic acid, diamine oxidase (DAO), and endotoxin levels to predict intestinal barrier impairment and gut-derived infection (GDI) in cancer patients.

Methods
Cancer patients receiving chemotherapy or palliative care treatment at our hospital were enrolled in the study. The serum concentrations of DAO, d-lactic acid, and endotoxin were determined using the intestinal barrier function biochemical index analysis system. The patients' infection information came from the hospital's Medicom Prescription Automatic Screening System and the medical records. Three hundred fifty-three cancer patients were included in the study (53.8% female, 73.7% cancer stage IV, 27.8% had bowel obstruction).

Results
The total incidence of GDI was 33.4% (118/353). The median length of hospital stay was 16 days for patients with GDI, compared with 7 days for patients without GDI (P < 0.001). The media hospitalization costs were ¥27,362.35 for patients with GDI compared with ¥11,614.08 for patients without GDI (P < 0.001). The serum concentrations of DAO, d-lactic acid, and endotoxin were significantly higher in patients with GDI. As malignant bowel obstruction (MBO) worsened, the concentrations of DAO, d-lactic acid, and endotoxin increased. Multivariate logistic regression models revealed that the DAO, endotoxin, IL-6, and C-reactive protein levels were significantly associated with an increased risk of GDI. In addition, we also found a fivefold increased risk of infection in patients with MBO compared with those without bowel obstruction (OR = 6.210, P < 0.001). All of the areas under the receiver operating characteristic curve (AUCs) for DAO, d-lactate, and endotoxin to predict GDI were <0.7 (AUC = 0.648, P < 0.001; AUC = 0.624, P < 0.01; AUC = 0.620, P < 0.01, respectively). However, when the parameters were combined (DAO + d-lactate + endotoxin), the predictive power increased significantly (AUC = 0.797, P < 0.001). Moreover, combining these intestinal barrier indicators and the presence of MBO had better power to predict GDI than either alone (AUC = 0.837, P < 0.001).

Conclusions
Combining the serum DAO, d-lactic acid, and endotoxin levels was a better predictor of GDI than any of the indicators alone, and combining these with the diagnosis of MBO could further improve the efficacy for predicting GDI.
Serum albumin as a prognostic predictor reflecting host immunity in patients with non–small cell lung cancer
Authors: Li Ling-Yu , Sun Hai-Shuang , Chen Xiao , Xu Dong-Sheng , Chen Nai-Fei , Guo Han-Fei , Han Wei , Yan Xu , Guo Fei-Fei , Li Jia-Xuan , Zeng Tan-Lun , Li Wen-Qian , Cui Jiu-Wei 
Published: December 2024

Abstract

Objective
Serum albumin (ALB) can transport nutrients to circulating and local immune cells by passing through blood vessels and has attracted attention as a prognostic predictor of non–small cell lung cancer (NSCLC) because it reflects the host immunity from peripheral blood (PBL) to the tumor microenvironment.

Methods
Clinical data regarding the PBL and tumor tissues were obtained at The First Hospital of Jilin University between February 2009 and March 2017. We detected indices of glucose and lipid metabolism, classified and counted PBL lymphocytes using flow cytometry, determined the tumor-infiltrating lymphocytes by quantitative immunofluorescence, and analyzed the T-cell receptor (TCR) repertoire by high-throughput sequencing of the TCR β-chain. The correlations between ALB and metabolic immune indices were analyzed by t tests and Pearson chi-square test.

Results
A total of 211 enrolled NSCLC patients were divided into a relatively high-ALB group (> 41.75 g/L, n = 56) and a low-ALB group (≤ 41.75 g/L, n = 155); patients with high ALB had lower Treg cells (P < 0.05) and more CD8+ cytotoxic T cells in the PBL (P < 0.01) and a higher proportion of stromal CD8+ tumor-infiltrating lymphocytes (P = 0.047) than patients with low ALB. High ALB was also significantly related to more diversity in the TCR repertoire (P = 0.0021, r
2 = 0.5481). Moreover, ALB was identified as an independent prognostic factor based on a multivariate Cox regression analysis (P = 0.032; hazard ratio (HR) = 1.804; 95% confidence interval (CI) = 1.035–3.146). The median overall survival in patients with low ALB vs high ALB was 28.2 vs 42.2 months (P = 0.0142), respectively. Among patients with nonmetastatic NSCLC (stage I-III), there was a higher incidence of distant metastasis in the low-ALB group than that in the high-ALB group (41.3% and 22.2%, P = 0.043). A low ALB also had a strong association with a higher risk for disease progression (P < 0.001) and death (P < 0.01; HR = 0.555; 95%
CI = 0.312–0.988).

Conclusions
Albumin could affect the host immunity, and high ALB predicted a reduced risk of distant metastasis and improved the prognosis in NSCLC patients.
Application of medium-chain fatty acids in metabolic diseases
Authors: Yu Yang , Miao Ming-Yong , Zhang Jie 
Published: December 2024

Abstract
Medium-chain fatty acids (MCFAs), which are important dietary fats, can be rapidly metabolized to efficiently produce a high amount of energy owing to their unique transportation system. MCFAs have thus become high-value functional foods. MCFAs also have antibacterial and immunoregulatory effects, help to maintain intestinal health, and have shown benefits for disease prevention and treatment. Therefore, they have the potential to be used for a variety of purposes. We herein describe the metabolic pathways involving MCFAs and their main biological functions in the human body. In addition, the effects of MCFAs as adjuvant therapy for different diseases, such as obesity, polycystic ovary syndrome, sarcopenia, and malignancy are summarized, and the likely mechanisms of action are discussed. Finally, we describe possible future clinical applications of MCFAs in the field of metabolic diseases.
“Share the Fear”: Communication Concerns of Parents With Cancer With Dependents and Coparents: A Qualitative Needs Assessment Study
Authors: Caparso Cinzia , Bowen Zoe , Choi Sung Won 
Published: December 2024

Background
The estimated 1.6 million adults in the United States with cancer who also have dependents face unique challenges given the profound impact of cancer on their families, such as increased psychological distress, decreased quality of life, and altered family functioning. Unfortunately, little is known about the mutual cancer-related communication concerns from the perspectives of the parents with cancer or the coparents. Coparents care for the patient and dependents until they reach adulthood (eg, unmarried, divorced, stepparent, and/or same-sex partnerships).

Objective
To understand the mutual cancer-related communication concerns from the perspectives of parents with cancer and the coparents and intervention delivery preferences.

Methods
Fifteen parents with cancer and 15 coparents were recruited to participate in semistructured interviews between October 2022 and September 2023 within an academic medical center in Midwestern states. Interviews were conducted via Zoom. The data were analyzed through Charmaz’s inductive grounded theory approach.

Results
Parents with cancer and the coparents desire communication assistance with each other about discussing the cancer diagnosis with dependents, end-of-life planning, managing finances, and addressing mental health concerns and emotions. The majority of participants reported interest in a virtually delivered intervention.

Conclusions
Findings from this study provide a mutual understanding of cancer-related communication concerns from the perspectives of parents with cancer and the coparents.

Implications for Practice
These findings provide awareness for providers and the foundation to inform a web-based communication intervention about cancer-related concerns to promote family resiliency in this population, which provides a resource for providers to utilize.
Basilar Dolichoarteriopathy and Early Clinical Deterioration in Acute Isolated Pontine Infarction
Authors: Oge Dogan D. , Arsava Ethem M. , Topcuoglu Mehmet A. 
Published: December 2024

Objectives:
Early clinical worsening (ECW) in acute isolated pontine infarcts (AIPI) is frequent, associated with poor prognosis, and its predictors have not been adequately clarified. A possible role of dolichoectatic basilar artery (BA) anatomy in ECW in patients with AIPI is herein studied.

Methods:
In 146 AIPI patients, infarcts were grouped into tegmental, lateral, anterolateral, anteromedial horizontally; and low, mid, mid-up, and upper pontine vertically. BA dolichoectasia was categorized according to Smoker criteria. An additional criteria of BA laterality angle was described. The length between the infarct long-axis and BA cross-sectional center was measured, and named as “branch length (BL).” ECW was defined as any increase in NIHSS.

Results:
ECW was seen in 22 (15%) patients. Univariate analysis documented a higher female ratio (22% vs. 10%, P=0.007), higher atrial fibrillation (18% vs. 7%, P=0.067), more common anteromedial infarct location (77% vs. 49%, P=0.025), and Smoker category-3 BA height (32% vs. 10%, P=0.043) in these patients. In anteromedial infarcts, BL was longer (8.3 vs. 6.1 mm, P=0.052), and reaching to significance in those located at mid-up/upper pontine level (1.22 vs. 0.62 mm, P=0.006). BL >4.4 mm showed an acceptable discriminatory capacity for ECW with an AUC of ROC: 0.615 (95% CI: 0.511-0.712). A regression model indicated female sex (β±SE=1.129±0.551, P=0.040), BL (per 4.4 mm, β±SE=1.236±0.614, P=0.044), and BA height-category-3 (β±SE=1.711±0.645, P=0.008) as independent predictors for ECW.

Conclusions:
Some features of basilar dolichoarteriopathy, such as the extreme location of the height of the BA tip and the length of the involved perforator in the prepontine cistern, may be predictors of early clinical worsening in acute isolated pontine infarcts.
Pineal Gland Activity in Advanced-Stage Pediatric Neuroblastoma Patients on 68Ga-DOTATATE PET/CT
Authors: Isik Emine Goknur , Denizmen Dilara , Arslan Dilşad Fırat , Simsek Duygu Has , Özkan Zeynep Gözde 
Published: December 2024

Abstract
Neuroblastoma is the most common malignancy in infants and the most common extracranial solid tumor accounting for approximately 6% of pediatric cancer. Although surgical intervention serves as the primary treatment for early-stage disease, advanced-stage cases necessitate a variety of oncologic therapeutic approaches, including 131I-MIBG and peptide receptor radionuclide therapy. Herein we report incidental pineal gland activity, represented in 68Ga-DOTATATE PET/CT (SSTR-PET) in 3 pediatric patients diagnosed with stage 4 neuroblastoma, related to the physiological distribution of radiopharmaceuticals.
Factors Influencing Fronto-Orbital Relapse in Patients With Syndromic Craniosynostosis: A 2 Decade Review
Authors: Moshal Tayla , Lasky Sasha , Roohani Idean , Stanton Eloise W. , Jolibois Marah I. , Wolfe Erin M. , Urata Maya , Munabi Naikhoba C.O. , Hammoudeh Jeffrey A. , Urata Mark M. 
Published: December 2024

Fronto-orbital retrusion may occur after primary surgical correction of craniosynostosis, particularly in patients with syndromic craniosynostosis. This study investigated reoperation rates and factors contributing to FO relapse among this cohort. A retrospective review evaluated reoperation for FO relapse in patients with syndromic multisuture craniosynostosis who underwent primary fronto-orbital advancement (FOA) + calvarial vault remodeling (CVR) at our institution between 2004 and 2024. Revision surgeries included repeat FOA or monobloc advancement/distraction. FOA advancement distance was measured using postoperative computed tomography and Mimics software. ROC analysis evaluated the accuracy of FOA distance in predicting subsequent FO relapse. Conditional margins identified optimal advancement distances. Logistic regression of predictors of FO relapse adjusted for age at surgery, craniofacial syndrome, posterior vault distraction osteogenesis (PVDO), advancement distance, and postoperative helmet therapy. Fifty-two patients underwent a mean of 2.8±1.9 skeletal craniofacial procedures each. With a mean follow-up time of 9.2±6.5 years, 16 (30.8%) patients required reoperation for FO relapse. Larger advancement distances were the sole significant predictor of relapse, increasing the odds by 49.6% (OR 1.496, 95% CI: 1.085–2.063; P=0.014). Relapse rates were lower with advancements ≤17.2 mm (0.0%) than with further advancements (42.0%, P=0.002). Specifically, advancements >18.8 mm were associated with significantly higher relapse rates (P<0.05). Almost one-third of patients with multisuture syndromic craniosynostosis underwent FO region readvancement. Advancements <17.2 mm during initial FOA appeared to mitigate relapse, while advancing beyond 18.8 mm may increase the risk. Investigation of additional protective factors against FO relapse is encouraged to minimize surgical burden.
Functional Vision Questionnaire Detects Near Triad Impairments in Adolescent Athletes With Concussion History
Authors: Leinonen Jouko , Mikkola Roosa , Peltonen Kati , Hokkanen Laura , Laitala Tiina 
Published: December 2024

Background:
Concussions are mild traumatic brain injuries that often cause vision problems. They have significant impacts on everyday life, cognitive capacity, and sports performance, and may affect injury prevalence in fast contact sports such as ice hockey. A functional vision questionnaire specifically designed for sports was used here to study the correlation between vision problems and concussion history.

Methods:
In this national cross-sectional concussion study, 860 Finnish elite-level male adolescent ice hockey players (aged 13–21 years) answered a functional vision questionnaire and performed a computerized neurocognitive test, ImPACT. Totally 265 athletes reported a history of at least 1 concussion. All data were statistically compared with age-matched athletes with no concussion history (n = 595). For further analysis, athletes were divided into subgroups by age and number of previous concussions.

Results:
Previously concussed athletes reported more general and eye-specific symptoms than their healthy controls. Increases in eye fatigue, frontal headaches, and blinking were statistically significant. Also statistically more problems with depth perception and evaluating distances, concentration problems, blurred vision, and losing the object in sight were observed among athletes with concussion history.

Conclusions:
Concussion history reflects an increase in the prevalence of vision deficits, as determined by multiple disturbances in the near triad. The significant number of vision problems in the concussion history groups strongly suggests that functional vision should routinely be evaluated in athletes. The vision problems observed in the athletes with concussion history may indicate an increased injury risk that should be addressed.
Frequency & Relationship between Loneliness and Smartphone Addiction among Medical Students of Lahore
Authors: Sohail Ammar 
Published: December 2024

ABSTRACTSmartphone addiction is a widespread and concerning issue wherein individuals excessively and compulsively use their smartphones. It’s characterized by habitual and prolonged phone usage, resulting in negative impacts on physical and mental health, strained personal relationships, increased fixation on the device, and a notable decrease in both personal productivity and overall quality of life. This study aims to find relationship between smartphone addiction and loneliness & prevalence of loneliness and smartphone addiction among medical students in Pakistan. This will also help to gauge the extent of related health issues and will lead to formulation of better guidelines for people suffering from smartphone addiction & loneliness thus improving the social and mental wellbeing of people from all age groups in Pakistani society.