bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracranial complications in adult patients with severe pneumococcal meningitis: a retrospective multicenter cohort study
Authors: Legouy Camille , Cornic Renaud , Razazi Keyvan , Contou Damien , Legriel Stéphane , Garrigues Eve , Buiche Pauline , Decavèle Maxens , Benghanem Sarah , Rambaud Thomas , Aboab Jérôme , Esposito-Farèse Marina , Timsit Jean-François , Couffignal Camille , Sonneville Romain 
Published: December 2024

Abstract

Background
We aimed to investigate the association of intracranial complications diagnosed on neuroimaging with neurological outcomes of adults with severe pneumococcal meningitis.

Methods
We performed a retrospective multicenter study on consecutive adults diagnosed with pneumococcal meningitis requiring at least 48 h of stay in the intensive care unit (ICU) and undergoing neuroimaging, between 2005 and 2021. All neuroimaging were reanalyzed to look for intracranial complications which were categorized as (1) ischemic lesion, (2) intracranial hemorrhage (3) abscess/empyema, (4) ventriculitis, (5) cerebral venous thrombosis, (6) hydrocephalus, (7) diffuse cerebral oedema. The primary outcome was unfavorable outcome at 90 days after ICU admission, defined by a modified Rankin Scale (mRS) score > 2.

Results
Among the 237 patients included, intracranial complications were diagnosed in 68/220 patients (31%, 95%CI 0.25–0.37) who underwent neuroimaging at ICU admission and in 75/110 patients (68%, 95%CI 0.59–0.77) who underwent neuroimaging during ICU stay. At 90 days, 103 patients (44%, 95%CI 37–50) had unfavorable outcome, including 71 (30%) deaths. The most frequent intracranial complications were ischemic lesion (69/237 patients, 29%), diffuse cerebral oedema (43/237, 18%) and ventriculitis (36/237, 15%). Through multivariable analysis, we found that intracranial complications (adjusted odds ratio (aOR) 2.88, 95%CI 1.37–6.21) were associated with unfavorable outcome, along with chronic alcohol consumption (aOR 3.10, 95%CI 1.27–7.90), chronic vascular disease (aOR 4.41, 95%CI 1.58–13.63), focal neurological sign(s) (aOR 2.38, 95%CI 1.11–5.23), and cerebrospinal fluid leukocyte count < 1000 cell/microL (aOR 4.24, 95%CI 2.11–8.83). Competing risk analysis, with persistent disability (mRS score 3–5) as the primary risk and ICU-death as the competing risk, revealed that chronic alcohol consumption was the sole significant variable associated with persistent disability at 90 days (cause-specific hazard ratio 4.26, 95%CI 1.83–9.91), whereas the remaining variables were associated with mortality.

Conclusions
In adults with severe pneumococcal meninigitis, intracranial complications were independently associated with a higher risk of poor functional outcome, in the form of persistent disability or death. This study highlights the value of neuroimaging studies in this population, and provides relevant information for prognostication.
Remote ischaemic conditioning for neurological disorders—a systematic review and narrative synthesis
Authors: Alhashimi Ali , Kamarova Marharyta , Baig Sheharyar S. , Nair Krishnan Padmakumari Sivaraman , Wang Tao , Redgrave Jessica , Majid Arshad , Ali Ali N. 
Published: December 2024

Abstract
Introduction
Remote ischaemic conditioning (RIC) refers to the use of controlled transient ischemic and reperfusion cycles, commonly of the upper or lower limb, to mitigate cellular damage from ischaemic injury. Preclinical studies demonstrate that RIC may have a neuroprotective effect and therefore could represent a novel therapeutic option in the management of neurological disorders. The aim of this review is to comprehensively describe the current clinical evidence of RIC in neurological disorders.

Methods
A computerised search of EMBASE and OVID MEDLINE was conducted from 2002 to October 2023 for randomised controlled trials (RCTs) investigating RIC in neurological diseases.

Results
A total of 46 different RCTs in 12 different neurological disorders (n = 7544) were included in the analysis. Conditions included acute ischaemic stroke, symptomatic intracranial stenosis and vascular cognitive impairment. The most commonly used RIC protocol parameters in the selected studies were as follows: cuff pressure at 200 mmHg (27 trials), 5-min cycle length (42 trials), 5 cycles of ischaemia and reperfusion (24 trials) and the application to the upper limb unilaterally (23 trials).

Conclusions
The comprehensive analysis of the included studies reveals promising results regarding the safety and therapeutic effect of RIC as an option for managing neurological diseases. Particularly, the strongest evidence supports its potential use in chronic stroke patients and vascular cognitive impairment. The neuroprotective effects of RIC, as demonstrated in preclinical studies, suggest that this therapeutic approach could extend its benefits to various other diseases affecting the nervous system. However, to establish the efficacy of RIC across different neurological disorders, further trials with larger sample sizes and more diverse patient populations are warranted. Upcoming trials are expected to provide valuable evidence that will not only confirm the efficacy of RIC in neurological disease management but also help identify the most optimal RIC regimen for specific conditions.
A whole food, plant-based diet reduces amino acid levels in patients with metastatic breast cancer
Authors: Scales TashJaé Q. , Smith Bradley , Blanchard Lisa M. , Wixom Nellie , Tuttle Emily T. , Altman Brian J. , Peppone Luke J. , Munger Joshua , Campbell Thomas M. , Campbell Erin K. , Harris Isaac S. 
Published: December 2024

Abstract
Background
Amino acids are critical to tumor survival. Tumors can acquire amino acids from the surrounding microenvironment, including the serum. Limiting dietary amino acids is suggested to influence their serum levels. Further, a plant-based diet is reported to contain fewer amino acids than an animal-based diet. The extent to which a plant-based diet lowers the serum levels of amino acids in patients with cancer is unclear.

Methods
Patients with metastatic breast cancer (n = 17) were enrolled in a clinical trial with an ad libitum whole food, plant-based diet for 8 weeks without calorie or portion restriction. Dietary changes by participants were monitored using a three-day food record. Serum was collected from participants at baseline and 8 weeks. Food records and serum were analyzed for metabolic changes.

Results
We found that a whole food, plant-based diet resulted in a lower intake of calories, fat, and amino acids and higher levels of fiber. Additionally, body weight, serum insulin, and IGF were reduced in participants. The diet contained lower levels of essential and non-essential amino acids, except for arginine (glutamine and asparagine were not measured). Importantly, the lowered dietary intake of amino acids translated to reduced serum levels of amino acids in participants (5/9 essential amino acids; 4/11 non-essential amino acids).

Conclusions
These findings provide a tractable approach to limiting amino acid levels in persons with cancer. This data lays a foundation for studying the relationship between amino acids in patients and tumor progression. Further, a whole-food, plant-based diet has the potential to synergize with cancer therapies that exploit metabolic vulnerabilities.

Trial registration
The clinical trial was registered with ClinicalTrials.gov identifier NCT03045289 on 2017–02-07.
A protocol and analysis of year-long simulations of global storm-resolving models and beyond
Authors: Takasuka Daisuke , Satoh Masaki , Miyakawa Tomoki , Kodama Chihiro , Klocke Daniel , Stevens Bjorn , Vidale Pier Luigi , Terai Christopher R. 
Published: December 2024

AbstractWe propose a protocol to evaluate and analyze year-long simulations of global storm-resolving models (GSRMs). The proposed protocol complements an earlier 40-day simulation protocol under the DYAMOND (DYnamics of the Atmospheric general circulation Modeled On Non-hydrostatic Domains) project to allow the analysis of the seasonal cycle and associated climatic relevant phenomena. This intercomparison aims to reveal how GSRMs, which can simulate mesoscale convective systems (MCSs) in the global domain, reproduce atmospheric large-scale structures related to convection beyond month-long simulations. The intercomparison for one-year simulations is conducted by either atmosphere-only models or atmosphere–ocean coupled models with atmospheric horizontal mesh sizes less than 5 km. We recommend the continuous four seasons from March 2020 to February 2021 as a target period for the intercomparison but with options for many groups to join more flexibly. The output variables are collected at 0.25° resolution, and archives of a small set of native grid variables are encouraged to analyze tropical cyclones and MCSs. Through the proposed global storm-resolving simulation, we will evaluate the climatological distributions of the atmospheric large-scale circulations, such as the Intertropical Convergence Zone (ITCZ), monsoon, midlatitude jets, their time evolution, and the upscale impacts on them. We present sample analyses from a one-year simulation using the 3.5 km mesh Nonhydrostatic Icosahedral Atmospheric Model (NICAM), revealing the realistic zonal contrast of tropical precipitation, no double ITCZ structure, the reasonable midlatitude jet position and intensity but a weak bias of storm track activities, and a warm bias over the Eurasia during boreal winter. We also clarify the cross-scale interaction, such as the effects of cold pools on mean precipitation over the Maritime Continent through the precipitation diurnal cycle and the effects of resolved gravity waves on midlatitude mean flows. The proposed one-year simulation protocol is referred to as the “Sendai Protocol.” This protocol is not unique or definite for evaluating GSRMs; we prospect a hierarchical set of experiments from short-term to multi-year simulations as GSRM intercomparisons.
Lack of canonical activities of connexins in highly aggressive human prostate cancer cells
Authors: Asencio Catalina , Véliz Loreto , Flores-Faúndez Emilia , Azócar Lorena , Echeverría Carolina E. , Torres-Estay Verónica , Orellana Viviana , Ramírez-Santelices Catalina , Sotomayor Paula , Cancino Jorge , Kerr Bredford , Fernandez-Olivares Ainoa , Retamal Mauricio A. , Sáez Juan C. , Godoy Alejandro S. 
Published: December 2024

AbstractConnexins (Cxs) have the ability to form channels that allow the exchange of ions/metabolites between adjacent cells (gap junction channels, GJC) or between the intra- and extra-cellular compartments (hemichannels, HC). Cxs were initially classified as tumor suppressors. However, more recently, it has been shown that Cxs exert anti- and pro-tumorigenic effects depending on the cell and tissue context. In prostate cancer (PCa), the expression and functionality of Cxs remain highly controversial. Here, we analyzed the expression pattern of Cx26, Cx32, Cx37, Cx40, Cx43 and Cx45 in PCa cell lines with increasing levels of tumor aggressiveness (LNCaP < LNCaP-C4-2 < Du-145 < PC-3). In addition, GJ and HC activities were evaluated in the PCa cell lines using dye coupling and dye uptake assays, respectively. Lastly, the cellular localization of Cx26, Cx32, and Cx43 was analyzed in LNCaP and PC-3 cell lines using immunofluorescence analyses. Our results showed a positive association between the mRNA levels of Cx26, Cx37 and Cx45 and the degree of aggressiveness of PCa cells, a negative association in the case of Cx32 and Cx43, and no clear pattern for Cx40. At the protein level, a negative relationship between the expression of Cx26, Cx32 and Cx43 and the degree of aggressiveness of PCa cell lines was observed. No significant differences were observed for the expression of Cx37, Cx40, and Cx45 in PCa cell lines. At the functional level, only LNCaP cells showed moderate GJ activity and LNCaP and LNCaP-C4-2 cells showed HC activity. Immunofluorescence analyses confirmed that the majority of Cx26, Cx32, and Cx43 expression was localized in the cytoplasm of both LNCaP and PC3 cell lines. This data indicated that GJ and HC activities were moderately detected only in the less aggressive PCa cells, which suggest that Cxs expression in highly aggressive PCa cells could be associated to channel-independent roles.
Comparison of continuous subcutaneous hydromorphone hydrochloride and morphine hydrochloride injection on skin disorders incidence: a retrospective study
Authors: Tanaka Rei , Hashizume Takahiro , Hisanaga Tadashi , Masuda Shinya , Sato Junya , Ishikawa Hiroshi , Tanaka Hironori , Saitoh Akiyoshi , Sato Tetsumi , Kamoshida Takeshi , Sato Tetsu , Shino Michihiro 
Published: December 2024

Abstract
Background
Continuous subcutaneous administration of injectable opioids is simple and effective; however, skin disorders may occur when high opioid dosages are used. Therefore, we investigated opioid injection drugs with a low risk of skin disorders.

Methods
A retrospective study was conducted using the electronic medical records of patients prescribed 1% hydromorphone hydrochloride or 4% morphine hydrochloride with instructions for continuous subcutaneous administration at Shizuoka Cancer Center from January 2017 to December 2021. The primary endpoint was skin disorders incidence, and the two groups were compared using Cox proportional hazards model analyses and Fisher’s exact test at 5% significance level. Patient background factors expected to influence skin disorders were also investigated, and multivariate logistic analysis of skin disorders incidence was performed.

Results
The incidence of skin disorders in the hydromorphone hydrochloride and morphine hydrochloride groups were 3.7% (1/27 patients) and 28.1% (9/32 patients), respectively, showing a significant difference in two statistical analyses between the two groups (Cox proportional hazards model analyses HR: 0.09, 95% CI: 0.01–0.70, P = 0.022. Fisher’s exact test OR: 0.10, 95% CI: 0.01–0.84, P = 0.016). In the multivariate analysis, the administration of hydromorphone hydrochloride (OR: 0.04, 95% CI: 0.003–0.48, P = 0.012) was also found to have a significant negative correlation with the occurrence of skin disorders. On the contrary, administration period ≥ 28 days (OR: 18.16, 95% CI: 2.22–148.60, P = 0.007) was a factor with a significant positive correlation.

Conclusions
Subcutaneous 1% hydromorphone hydrochloride administration had a lower risk of skin disorders than 4% morphine hydrochloride injection. Moreover, prolonging the administration period increased the risk of developing skin disorders. This suggests that a 1% hydromorphone hydrochloride Injection is a good clinical decision for patients who are likely to have a longer administration period and require a higher dosage of injectable opioids.

Trial registration
Retrospectively registered.
Science teachers’ perspectives and prior practices for science centre visit: strategies development
Authors: Gumede Lungile Philisiwe , Photo Patricia 
Published: December 2024

AbstractIn ongoing science education, utilising informal learning environments such as science centres has emerged as a crucial strategy to enhance learners’ engagement and understanding of complex scientific concepts. However, despite their evident benefits, out-of-school learning environments often fail to produce lasting improvements in learners’ understanding of scientific concepts, largely due to inadequate integration with classroom teaching and a lack of strategic planning. This qualitative study, grounded in a moderate constructivist framework, investigates the perspectives of high school science teachers regarding the significant influence and strategic optimization of science centre visits. Through interviews and document analysis, informed by thematic analysis methodology, the study examines teachers’ perceptions and their prior practices when visiting the science centre. Teachers articulate a compelling narrative of how science centre visits serve as catalysts for active, experiential learning, and bridging the gap between theoretical knowledge and practical application. Furthermore, the study identifies and describes five strategic imperatives aimed at enhancing the effectiveness of science centre visits in science education. These imperatives encompass pre-visit curriculum integration, differentiated learning activities, teacher-led guided exploration, parental involvement, and continuous evaluation and improvement. Grounded in constructivist principles and contemporary educational theories, these strategies offer an inclusive framework to enrich learners’ learning experiences, cultivate their scientific curiosity, and foster a profound and enduring appreciation for the details of science. These findings highlight how crucial it is for teachers to have access to continual professional development opportunities and institutional support to enable them to fully utilise the pedagogical potential of science centre visits in science curricula.
The performance of different prognostic scores in cirrhotic patients admitted to intensive care unit
Authors: Ahmed Nancy A. , Gouda Tarek E. , Hasan Ahmad S. , Elsaeed Aya E. , Atalla Hassan 
Published: December 2024

Abstract
Background and aim
Critically ill cirrhotic patients exhibit high in-hospital mortality and require substantial healthcare resources, including multiorgan support. Egypt has the highest age-standardized death rate from cirrhosis worldwide. This study aimed to compare the performance and accuracy of different prognostic scores for mortality prediction, including Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD), MELD with serum sodium incorporation (MELD-Na), Royal Free Hospital (RFH), as well as general intensive care unit (ICU) prognostic models, Acute Physiology and Chronic Health Evaluation II (APACHE II), and Chronic liver failure -sequential organ failure assessment (CLIF-SOFA), in cirrhotic patients admitted to an ICU in an Egyptian tertiary facility.

Patients and methods
This prospective observational study included ninety patients admitted to the ICU between July 2021 and June 2022. All patients underwent clinical assessment with the estimation of all included scores within the first 24 h of admission, alongside basic laboratory and radiological investigations.

Results
Mortality occurred in 56.7% (n = 51) of the patients. Non-survivors exhibited statistically significantly higher APACHE II, CLIF-SOFA, RFH, and CTP scores but lower Glasgow Coma Scale (GCS) than survivors. However, no statistically significant difference was found regarding the performance of the scoring systems. At cut-off levels > 20 for APACHE II and > 46 for CLIF-SOFA, these scores were the most independent predictors of in-hospital mortality.

Conclusions
While CTP, MELD, and MELD-Na scores demonstrated satisfactory performance in critically ill cirrhotic patients, APACHE II and CLIF-SOFA scores were superior in predicting short-term mortality in this patient population.
Genetic diversity of hepatitis delta virus in Afghanistan: insights from complete genome analysis
Authors: Husseini Abbas Ali 
Published: December 2024

Abstract
Background
A significant gap exists in the comprehensive genomic characterization of hepatitis delta virus in Afghanistan. Therefore, the primary aim of this investigation is to elucidate the molecular profile of the complete genome of HDV circulated among general population of Afghanistan.

Methods
Four serologically positive samples for anti-delta antibody were confirmed via real-time polymerase chain reaction and subjected to entire genome amplification using two sets of primers to generate partially overlapping segments, which were subsequently sequenced. Phylogenetic and evolutionary divergence analysis were conducted using the MEGA7 software package.

Results
Ultimately, the whole genomes of four HDV isolates from Afghanistan were assigned to genotype I. The amino acid composition of the hepatitis delta antigen and its functional motifs were consistent with genotype I. However, the subtype-specific amino acid signature revealed potential differences in subtypes.

Conclusion
Genotype I is the most common HDV genotype in analyzed samples, with potential subtype heterogeneity and no significant functional impact from HDAg variations.
Test–retest reliability and validity in lower limb proprioception tests using image capture technique in healthy adults
Authors: Takahashi Aisuke , Kawana Hikaru , Furukawa Katsuhiro 
Published: December 2024

Abstract
Background
Proprioceptive assessments in clinical practice remain confined to ordinal scales, with a lack of ratio scales. Quantitative proprioception assessments such as threshold to detect passive motion (TDPM) and joint position sense (JPS) help determine the severity of functional impairments and evaluate treatment efficacy. However, their clinical introduction remains challenging due to the extensive and costly equipment required for their measurement.

Purpose
To investigate the test–retest reliability and validity in the simplified TDPM and JPS using 14 image capture techniques in targeting hip, knee, and ankle joints.

Methods
This study included 16 volunteers. The measurements were conducted in individual rehabilitation rooms located within the wards of our hospital. Examiners measured a total of 12 TDPM and JPS, including hip, knee, and ankle joints, each performed three times. Moreover, the multi-joint TDPM, distinguished into lower limb flexion and extension patterns, was additionally performed. These measurements were repeated 1 week later. In statistical analysis, the test–retest reliability and construct validity were evaluated using intraclass correlation coefficients (ICC) and Spearman’s rank correlation coefficients.

Results
The TDPM, multi-joint TDPM, and JPS (variable data; VE) demonstrated moderate reliability across all tested movement directions (TDPM: ICC 0.52–0.70, limits of agreement [LOA] < 10°; multi-joint TDPM: ICC 0.64–0.73, LOA < 10°; JPS: ICC 0.55–0.78, LOA < 10°). No significant correlation was observed between these tests.

Conclusions
TDPM and JPS using image capture techniques can reliably measure proprioception and serve as independent tests to evaluate different aspects of proprioception. These findings contribute to future studies aimed at introducing quantitative proprioception tests into clinical practice and facilitating clinical decision-making for rehabilitation targeting proprioceptive impairment.
Anti-correlation network among China A-shares
Authors: Liu Peng 
Published: December 2024

Abstract
The correlation-based financial networks are studied intensively. However, previous studies ignored the importance of the anti-correlation. This paper is the first to consider the anti-correlation and positive correlation separately, and accordingly to construct the weighted temporal anti-correlation and positive correlation networks among stocks listed in the Shanghai and Shenzhen stock exchanges. For both types of networks during the first 24 years of this century, fundamental topological measurements are analyzed systematically. This paper unveils some essential differences in these topological measurements between the anti-correlation and positive correlation networks. It also observes an asymmetry effect between the stock market decline and rise. The methodology proposed in this paper has the potential to reveal significant differences in the topological structure and dynamics of a complex financial system, stock behavior, investment portfolios, and risk management, offering insights that are not visible when all correlations are considered together. More importantly, this paper proposes a new direction for studying complex systems: the anti-correlation network. It is well worth reexamining previous relevant studies using this new methodology.