bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of renin-angiotensin system inhibitor in incident cancer among chronic hepatitis B patients: An emulated target trial using a nationwide cohort
Authors: Park Yewan , Kang Danbee , Sinn Dong Hyun , Kim Hyunsoo , Hong Yun Soo , Cho Juhee , Gwak Geum-Youn 
Published: December 2024

Background Although the renin-angiotensin system (RAS) has been reported to be associated with cancer development, the anticancer effects of RAS inhibitors (RASi) remain controversial. Objectives This study aimed to investigate the effect of RASi use on cancer incidence in chronic hepatitis B (CHB) patients. Design We designed a series of pragmatic trials for each week and followed the patients until the cancer diagnosis, death, or end of follow-up. Methods We analyzed CHB patients aged 40–84 years from the nationwide database between 2009 and 2017. We used 3:1 propensity score matching. Results Among 15,477 RASi non-users and 5263 RASi users, 2002 developed cancer. The adjusted hazard ratio (HR) for all cancer in RASi users was 0.89 [95% confidence interval (CI): 0.81–0.99]. The adjusted HR (95% CI) of hepatocellular carcinoma (HCC) and extrahepatic cancer were 0.79 (0.65–0.96) and 0.93 (0.82–1.04), respectively. When RASi was further divided, the adjusted HR (95% CI) for cancer of the angiotensin-converting enzyme inhibitor user and the angiotensin II receptor blocker user were 0.66 (0.50–0.87) and 0.93 (0.84–1.03), respectively. Conclusion RASi use was associated with a decreased incidence of all cancers, particularly HCC, in CHB patients, suggesting a chemopreventive effect of RASi in this population.
The Effect of Metformin on Radiation-Induced Lung Fibrosis in Mice
Authors: Chen Yu-Zhong , Zhao Lin , Wei Wei , Gu Jia , Liu Zhen-Hua , Shan Wen-Yue , Dong Jie , Li Chao , Qin Li-Qiang , Xu Jia-Ying 
Published: December 2024

Introduction: Radiation-induced lung fibrosis (RILF) is a common complication of thoracic radiotherapy. Metformin has been suggested to have a radioprotective effect. Objective: This study explored the radioprotective effects of metformin on RILF and its mechanisms. Methods: C57BL/6J mice were randomly divided into control, ionizing radiation (IR), low-dose metformin (L-Met), and high-dose metformin (H-Met) groups. The IR, L-Met, and H-Met groups received 15 Gy chest irradiation. The L-Met and H-Met groups were administrated 100 or 200 mg/kg metformin from 3 days before irradiation and continued for 6 months. The mice were then sacrificed, and samples were collected for further analysis. Results: RILF was induced in the irradiated mice. Metformin improved lung pathology, inhibited collagen deposition, and reduced inflammatory factors such as high mobility group box 1 (HMGB1), interleukin-1 beta, interleukin-6, tumor necrosis factor alpha in lung tissue, lavage fluid, and serum. Western blot and quantitative real-time PCR analyses revealed that metformin downregulated HMGB1, toll-like receptor 4 (TLR4), and nuclear factor kappaB (NF-κB) expression. Additionally, metformin reversed the irradiation-induced reduction in the abundance of Lactobacillus and Lachnospiraceae at the genus level. Conclusion: Our findings indicated that metformin ameliorates RILF by downregulating the inflammatory-related HMGB1/TLR4/NF-κB pathway and improving intestinal flora disorder.
Assessing the effectiveness of the Pregnancy And Newborn Diagnostic Assessment system on the quality of antenatal care in Burkina Faso: A cluster-randomised controlled trial
Authors: Coulibaly Abou , Sogo Armel Emmanuel , Chikvaidze Nutsa , Capello Cecilia , Gerbaba Tsion Kefene , Kouanda Séni 
Published: December 2024

Introduction The Pregnancy and Newborn Diagnostic Assessment (PANDA) system is a mobile application designed to facilitate diagnosis and decision-making by healthcare staff in antenatal care (ANC). This study aimed to evaluate its effectiveness in improving the quality of ANC. Methods This randomised controlled trial implemented the PANDA system in two groups of health facilities (intervention and comparison groups) using a matched-pair method in the Koupéla health district, Burkina Faso. Six health centres were included in each group. We included pregnant women presenting with more than 20 weeks of amenorrhea during their first antenatal consultation, and we followed them up until their sixth week postpartum. The primary outcome was a binary variable derived from the ANC quality score, coded yes or no. Six components of ANC quality were identified: welcoming the woman, history taking and dietary habits, physical examination, obstetric examination, preventive care, and counselling and advice. We used Poisson regression with robust variance to compare the unadjusted and adjusted primary outcomes results between the two study arms. Results We included 319 and 272 women in the intervention and comparison groups, respectively. In the intervention group, 15.67% (50 out of 319) of the women had at least 75% of the total ANC quality score, compared to 6.25% (17 out of 272) in the comparison group. Adjusted results showed that women in the intervention group were 2.71 times more likely to have an excellent total ANC quality score than women in the comparison group (RR = 2.71; 95% CI [1.60–4.60]; p < .001). Conclusion Although the proportion of women with good ANC quality was low, this study showed that the PANDA system significantly improves the ANC quality. These results are vital because Burkina Faso has decided to use these computerised clinical decision support systems for maternal and child health.
Trunk Muscle Cross-Sectional Areas at Hip Fractures and Their Association With Recovery of Postoperative Gait Ability: A Multicenter, Retrospective Cohort Study
Authors: Kawanishi Kengo , Fukuda Daisuke , Tsutsumi Masahiro , Miyashita Toshinori , Katayama Naoya , Yokomori Masaki , Matsuzaki Shinsuke , Kudo Shintarou 
Published: December 2024

Purpose To determine the relationship between trunk muscle cross-sectional area (CSA) measured using trunk computed tomography at the time of injury and gait ability at discharge. Methods This multicenter retrospective cohort study was performed in comprehensive rehabilitation units of four hospitals in Japan. The study included 442 patients with hip fractures who underwent surgery (bipolar hip arthroplasty or open reduction and internal fixation) and were hospitalized for treatment between January 2020 and January 2023. The main outcome measure was bilateral trunk muscle CSA (multifidus, erector spinae, psoas major, lateral abdominal muscles, and rectus abdominis). Participants who met the eligibility criteria were classified into two groups based on gait ability at the time of hospital discharge: those who maintained their gait ability (the maintenance group) and those who declined (the decline group). Results The CSA of the multifidus muscle was 0.015 ± 0.005 (CSA/Weight/fourth lumbar vertebrae) and 0.013 ± 0.004 (CSA/Weight/fourth lumbar vertebrae) in the maintenance and decline groups, respectively, being significantly lower in the decline group ( P = 0.028, effect size = 0.457). The CSA of the psoas major was 15.3 [13.1⁠–⁠18.0] (CSA/Weight/fourth lumbar vertebrae) and 13.4 [11.9⁠–⁠16.0] (CSA/Weight/fourth lumbar vertebrae) in the maintenance and decline groups, respectively, being significantly lower in the decline group ( P = 0.020, effect size = 0.335). Conclusion Smaller CSAs of the multifidus and psoas major muscles before injury were associated with decreased gait ability after hip fractures.
From Theory to Action: Evaluation of a Longitudinal Project-Based Antiracism Course for Post-Graduate Physicians
Authors: Mateo Camila M. , McCormick Danny , Connors Chrissie , Basu Gaurab 
Published: December 2024

Objectives Few opportunities exist for postgraduate physicians to learn to address racism in their professional practice. We created a virtual, 5-session antiracism course that included the development of a formal action project to address racism at participants’ home institution. Methods We delivered this curriculum virtually to 2 cohorts (2021 and 2022) of postgraduate physicians, nationally. The curriculum had 3 educational aims: (1) to increase knowledge on antiracism, (2) to increase comfort and engagement in discussing antiracism at home institutions, and (3) to increase self-efficacy to execute an institution-based project. Theory-informed practice, community building, and project-based learning were used to achieve our educational aims. We analyzed changes in these domains in addressing racism using matched 7-item Likert-scale questions from pre- and post-course surveys and the Wilcoxon signed rank test. We assessed perceptions and impacts of the course with post-course survey items using descriptive statistics. Results Forty-three of 50 participants (86%) who completed pre- and post-course surveys were included in the analysis. We found pre–post course increases in mean scores (converted from Likert scales), for all 15 paired questions. For example, we found improvements in understanding the historical context of racism in medical institutions (mean score change: 5.12 [SD 1.00] to 6.42 [SD 0.76], P < .001), comfort in talking to colleagues about racism (5.21 [SD 1.08] to 6.19 [SD 0.70], P < .001), and capacity to address racism in patient care at their home institution (4.51 [SD 1.35] to 5.56 [SD 0.91], P < 0.001). 93% reported the course increased the likelihood of working to address racism at their institution. Conclusion This project-based antiracism course for postgraduate learners increased self-reported knowledge of, comfort with, and self-efficacy in addressing racism and was well received by participants.
Astrocyte dysfunction alters GABAergic communication and ammonia metabolism in the streptozotocin-induced sporadic Alzheimer's disease model
Authors: Brezolin Éverton Carlos , Gayger-Dias Vitor , Da Silva Vanessa-Fernanda , Cigerce Anderson , Schultz Bruna , Sobottka Thomas Michel , Nardin Patrícia , de Assis Adriano Martimbianco , Leite Marina Concli , Quincozes-Santos André , Bobermin Larissa Daniele , Gonçalves Carlos-Alberto 
Published: December 2024

Background In the sporadic model of Alzheimer's disease (AD), induced by intracerebroventricular streptozotocin (STZ) administration, cognitive impairment is accompanied by specific astrocytic changes in the hippocampus prior to amyloid deposition. Objective Hypothesizing that the synthesis of GABA, via MAO-B, contributes to ammonia elevation, thereby compromising antioxidant defense and ATP synthesis, and possibly contributing to cognitive damage, we determined the hippocampal levels of glutamine synthetase (GS), monoamine oxidase B (MAO-B) and other enzymes related to GABA metabolism. Methods Immunoblotting and RT-PCR assays were carried out in hippocampal samples of Wistar rats, at 4 and 16 weeks post-STZ, in the sporadic STZ-induced AD model, corresponding to the pre-amyloid and amyloid phases, respectively. Results We observed a reduction in GS activity and increased MAO-B content, both in 4 weeks and in 16 weeks, reinforcing the idea that astroglial dysfunction precedes the amyloid phase. These alterations were accompanied by an increase in the content of ornithine decarboxylase 1 (ODC1), which catalyzes the synthesis of putrescine (substrate for GABA synthesis, via MAO-B), and a reduction in the gene expression of arginine-glycine amidinotransferase (AGAT), an enzyme involved in the synthesis of creatine, and in the generation of GABA agonists. These changes were only seen in the amyloid phase of the AD model. Conclusions Our findings contribute to explain the greater damage that occurs in energy metabolism at this stage, in addition to the greater GABAergic loss. The changes reinforce the importance of the STZ model and further our understanding of the changes in both AD phases.
The Comparison Between Fetal Renal Length and Sacral Length in Determining Gestational Age
Authors: Clark Jennifer Grace 
Published: December 2024

Objective: The purpose of this research was to compare the relationship between fetal renal length, sacral length, and gestational age (GA), in a cohort of second- and third-trimester pregnancies. Materials and Methods: Fetal renal and sacral length were measured on pregnant volunteers between 18 and 37 weeks gestation. Both parameters were then compared to GA using a Pearson correlation statistic. Results: Based on the Pearson test results, fetal renal length ( r = .772; p = .0001) was statistically significant and had a strongly positive association with GA. Likewise, the fetal sacral length ( r = .752; p = .0001) was statistically significant and had a strongly positive association with GA. Conclusion: This study demonstrated that fetal renal length may be slightly stronger in association, as diagnostic parameter, to determine GA. Certainly fetal sacral length also was a highly associated diagnostic for determining GA. Future research may identify if these diagnostic parameters should be considered, as part of obstetric biometry, especially if routine fetal measurements could not be obtained.
The Potential Diagnostic Value of Sonographic Fetal Parameters as Markers of Prematurity
Authors: Khoroushi Farzaneh , Seilanian Toosi Farrokh , Rastegar Tizabi Zahra , Hassan Nejad Ehsan , Mirzaeian Sara , Moradi Ali , Faramarzi Raheleh , Jarahi Lida 
Published: December 2024

Objective: The aim of this study was to determine the validity of fetal parameters measured by sonography, as an indicator of fetal lung maturity. Materials and Methods: The present cross-sectional study was conducted on pregnant women between 30- and 37-weeks’ gestation, who were at risk of preterm delivery and gave birth within the next 72 hours. Utilizing sonography, distal femoral epiphysis, placental grading, and free-floating particles in amniotic fluid were investigated. Upon birth, newborns were followed from birth and 72 hours postpartum, and those with respiratory distress syndrome (RDS) were identified. Results: The diameter of distal femoral epiphysis in patients without RDS was significantly higher than in patients with RDS ( p < .001). Moreover, there was a significant difference in placenta grading in patients with and without RDS ( p = .046). However, the frequency of free-floating particles in the amniotic fluid, within the two groups was not significantly different ( p = .106). The cutting point of the diameter of the distal femoral epiphysis was 2.20 mm (e.g., sensitivity 74%; specificity 89%). Conclusion: Based on the results obtained in this cohort study, measuring the diameter of the distal femoral epiphysis may have relatively good accuracy for gauging fetal lung maturity.
Male-female comparison of vasomotor effects of circulating hormones in human intracranial arteries
Authors: Edvinsson Jacob C. A. , Grubor Irena , Maddahi Aida , Edvinsson Lars 
Published: December 2024

Abstract
Background
The purpose of this study was to examine whether there are sex differences in vasomotor responses and receptor localization of hormones and neuropeptides with relevance to migraine (vasopressin, oxytocin, estrogen, progesterone, testosterone, amylin, adrenomedullin and calcitonin gene-related peptide (CGRP)) in human intracranial arteries.

Methods
Human cortical cerebral and middle meningeal arteries were used in this study. The tissues were removed in conjunction with neurosurgery and donated with consent. Vasomotor responses of arteries, after exposure to hormones or neuropeptides, were recorded using a wire myograph. Immunohistochemistry was performed to examine the expression and localization of their receptors within human intracranial arteries.

Results
Vasopressin showed the strongest contractile responses, followed by oxytocin and progesterone. CGRP displayed the strongest vasodilatory response when compared to adrenomedullin, amylin, testosterone and estrogen. No significant differences were observed in vasomotor responses between male and female arteries. The vasomotor effects were supported by the presence of corresponding receptors in the vascular smooth muscle cells. Estrogen receptors (ERα and ERβ), progesterone receptor (PR), vasopressin 1a receptor (V1aR), and the oxytocin receptor (OTR) were expressed in the walls of both cerebral arteries overlying the cerebral cortex and intracranial arteries of the dura mater. ERα, V1aR, and PR were found to be localized in both smooth muscle cells and endothelium, whereas OTR was exclusively located within the smooth muscle cells.

Conclusions
Hypothalamic, sex hormones and the pancreas hormone (amylin) receptors are expressed in the human intracranial artery walls. The vasomotor responses revealed no sex differences, however contractile responses to vasopressin was higher and more potent in MMA compared to CCA when pooling data from both sexes. Overall, the hormones estrogen, progesterone and oxytocin, which drop in circulating levels at onset of menstruation, only showed modest vasomotor responses as compared to CGRP. This suggests that their role in inducing menstrual migraine attacks is not directly related to vasomotor responses.

Graphical Abstract
Yellow nail syndrome linked to a mediastinal lipoma: a case report
Authors: Müller Christoph , Stricker Ingo , Hykel Peter , Dellweg Dominic 
Published: December 2024

Abstract
Background
Yellow nail syndrome is characterized by a yellow discoloration of the nails, respiratory symptoms, and lymphedema. It was first described in 1964 and has an estimated prevalence of less than 1:1.000.000. Despite its diverse manifestations affecting different organ systems and a wide range of associated diseases, yellow nail syndrome is most commonly related to impaired lymphatic drainage. The treatment depends on whether the underlying pathology can be identified and includes dietary, pharmacological, interventional, and surgical approaches.

Case presentation
We report the case of a 73-year-old Caucasian male patient presenting with exertional shortness of breath and orthopnea, nonpitting edema of his distal extremities, and yellow discoloration of both his finger and toe nails. The diagnostic workup, which included the drainage of a large chylous pleural effusion, computed tomography of the chest, and lymphangiography, led to the diagnosis of yellow nail syndrome, presumably caused by a mediastinal lipoma compressing the thoracic duct. Treatment-wise, a percutaneous lymphatic embolization was performed after conservative treatment did not lead to a significant improvement of symptoms.

Conclusion
While demonstrating the specific diagnostic findings of this case, we try to point out common pathogenetic aspects of the disorder and present the currently available treatment options.
A four-channel microfluidic model of the blood–brain and blood–cerebrospinal fluid barriers: fluid dynamics analysis
Authors: Libet Pavel A. , Polynkin Leonid Y. , Saridis Mikis R. , Yakovlev Egor V. , Korsakova Sofia A. , Salmina Alla B. , Averchuk Anton S. , Rozanova Natalia A. , Yurchenko Stanislav O. 
Published: December 2024

AbstractBrain-on-a-chip is an emerging field involving microfluidic devices capable of mimicking the structure and function of the human brain. Existing research often focuses on single barriers, such as the blood–brain barrier or blood–cerebrospinal fluid barrier (BCSFB). However, the brain has both barriers working together, and mimicking this dual system is crucial for better understanding of brain (patho)physiology. In this work, we present a four-channel microfluidic chip model that incorporates both the BBB and BCSFB, to reproduce physiologically correct architecture. Using computer simulations, we demonstrate that this model can mimic both healthy and diseased states by adjusting the shear stress experienced by the barriers, which is a key factor in their function. These findings offer valuable insights for designing future brain-on-a-chip devices with improved accuracy. This improved technology could contribute to wider advancements in tissue engineering and the study of brain function and diseases.
Cognitive behavioral therapy for emetophobia in 16-year-old adolescent: a case study
Authors: Kerkeni Ali , Abbes Wafa , Pons Charles Olivier 
Published: December 2024

Abstract
Background
A specific phobia of vomiting, often known as emetophobia, is a particularly common psychiatric disorder among adolescents. It is accompanied by a significant level of distress given the severity of its symptoms and the frequency of comorbidities, especially anxiety. Although no treatment protocols have been established for adolescents, cognitive behavioral therapy (CBT) is the most frequently recommended treatment in the few published reports on adolescents with emetophobia. This case study aims to add to existing data indicating that CBT could be an effective treatment for emetophobia in adolescents.

Case presentation
We illustrate the case of a 16-year-old adolescent girl who presented with a specific phobia of vomiting that had lasted 6 years and was comorbid with social anxiety. These diagnoses were made by the child psychiatrist according to the Diagnosis and Statistical Manual of Mental Disorder in its 5th version (DSM-5). CBT for his specific phobia of vomiting was recommended. The Emetophobia Questionnaire (EmetQ-13) and the Screen for Child Anxiety Related Emotional Disorders (SCARED-41) were used to assess disease evolution. CBT for emetophobia lasted 22 weekly sessions of 1 h each and included: psychoeducation, relaxation, positive self-talk techniques, cognitive restructuring, imagery rescripting of flashback memories, and graduated exposure in vivo. At the end of CBT, the specific phobia of vomiting was no longer retained as a diagnosis according to the DSM-5. The psychometric evaluation revealed that the EmetQ-13 scores considerably decreased. A decrease in both the total score and the social anxiety subscale score of the SCARED-41 was also obtained. The clinical and psychometric improvements were maintained 3 months after the end of therapy.

Conclusions
This case report suggests that CBT could be an effective treatment for emetophobia in adolescents. It also helps reduce the level of associated anxiety. This article may encourage future research into randomized and controlled trials to protocolize and adapt the psychotherapeutic management of emetophobia in adolescents.
Carbon sequestration and environmental impacts in ternary blended cements using dyeing sludge and papermaking sludge
Authors: Tian Dongyang , Cong Ming , Xu Zhen , Xu Xinrong , Tian Xianchun , Cong Xinyu , Lu Shuang 
Published: December 2024

AbstractThis research delves into the hydration processes and ecological repercussions of cement blended with papermaking sludge (PS) and dyeing sludge ash (DS). It targets the alleviation of detrimental environmental impacts from solid waste, alongside evaluating their prospective utilization in cement product fabrication. Low-temperature roasting DS is rich in phosphates, which impose a hindering effect on the initial hydration of cement clinker, and displays superior pozzolanic activity when juxtaposed with PS. Meanwhile, the incorporation of PS heightens the malleability of the cement paste blend, consequently modulating the pore size distribution within the cement matrix, resulting in amplified compressive resilience of the amalgamated cement samples. Additionally, the inclusion of DS and PS presents an augmented surface area, promoting the nucleation of hydration by-products. The infusion of a greater quantity of hydration by-products within the mixed cement matrix fosters pore refinement and advances strength development. Furthermore, the blended cement proficiently constrains heavy metals inherent in the sludge and curtails ecological implications during cement product fabrication. Furthermore, compared with conventional Portland cement, the ternary blended cement employs un-calcined PS and low-temperature activation DS. This approach facilitates enhanced carbonation and CO2 sequestration from industrial waste streams, thereby achieving carbon reduction at the source.