bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Nutritional Supplements for Reducing Homocysteine Levels in Healthy Adults: A Systematic Review and Network Meta-Analysis of Randomized Trials
Authors: Liu Cai , Yao Hui , Wang Fang 
Published: February 2025

Abstract

Context
There are various therapeutic approaches available to reduce homocysteine (Hcy) levels. However, it remains unclear which intervention is more effective for healthy adults.

Objectives
A systematic review and network meta-analysis (NMA) were conducted to comprehensively investigate the efficacy of different nutritional supplements in reducing Hcy levels in healthy adults.

Data Sources
The PubMed, Embase, Cochrane Library, and Web of Science databases were searched from inception to July 2023.

Data Extraction
The lead author, year of publication, sample size, population characteristics, intervention measures, duration, and mean difference of Hcy levels from baseline to endline were extracted.

Data Analysis
Data were pooled using a random-effects model. Network meta-analysis was conducted by integrating direct and indirect evidence. A total of 16 studies were included in this analysis. The nutritional supplement combination that achieved the highest ranking (surface under the cumulative ranking curve [SUCRA] = 75.8) was superior compared with a single supplement. Among similar or closely dosed folic acid (FA) supplements, 800 μg FA (SUCRA = 93.7) was the most effective option. When comparing various doses of different supplements, 1 mg of FA plus 7.2 mg of vitamin B6 (B6) plus 20 μg of vitamin B12 (B12; SUCRA = 83.9) ranked first and 800 μg of FA (SUCRA = 78.3) ranked second. In comparison with placebo or no-treatment control groups, interventions such as 1 mg of FA plus 7.2 mg of B6 plus 20 μg of B12 (mean difference [MD] = –1.03; 95% CI –1.71 to –0.36), 400 μg of FA plus 400 μg of B12 (MD = –0.87; 95% CI –1.46 to –0.27), and 800 μg of FA (MD =  –0.84; 95% CI –1.12 to –0.56) were more effective in reducing Hcy levels. The random-effects summary MD for all interventions compared with placebo was –0.59 (95% CI –0.71 to –0.48; P &lt; .0001).

Conclusions
The NMA demonstrated that the combination of FA with other vitamins is more effective in reducing Hcy levels, particularly when the dose of FA is close to 800 μg. The combination of 1 mg of FA, 7.2 mg of B6, and 20 μg of B12 is considered the most favorable option.

Systematic Review Registration
PROSPERO registration no. CRD42023453123.
Perspectives: Educating transfusion medicine professionals in planetary health and infectious diseases: Should blood banks have dedicated infectious diseases consultation services?
Authors: Miller Maureen J , De Giorgi Valeria 
Published: February 2025

Abstract
Transfusion medicine and blood banking educators across the world have identified a need to incorporate more education in planetary health and infectious diseases into clinical training. The urgency of these calls has increased as climate change has accelerated and deleterious health effects attributable to climate change have become more prevalent. Today, few academic hospital centers have dedicated infectious diseases consultation services within departments or divisions of transfusion medicine, but the presence of a dedicated team focusing on TTIs can impact clinical education in transfusion medicine, infectious diseases, and other specialties. This article presents several models for these multidisciplinary teams in clinical practice.
Metabolic Health Screening in Physical Therapist Private Practice in Australia: A Feasibility Study
Authors: Mastwyk Sally E , Taylor Nicholas F , Lowe A , Dalton C F , Peiris Casey L 
Published: February 2025

Abstract

Importance
Noncommunicable diseases are the leading cause of morbidity and mortality globally. Physical therapists working in private practice have an opportunity to embed health screening in their practice to support chronic disease prevention. However, it is not known if it is feasible to conduct health screenings in physical therapist private practice settings.

Objective
The aim of this study was to determine the feasibility of physical therapists conducting client health screening with point-of-care testing.

Design
This was a feasibility study, comprising of in-depth interviews and descriptive quantitative data.

Setting
The health screenings took place in physical therapist private practices in Australia. The 1-to-1 interviews were conducted via phone, video conference, or face-to-face, according to participant preference.

Participants
Two hundred and thirty adult clients participated in a health screen at a physical therapist practice. Follow-up interviews were completed with 20 clients and 8 physical therapists.

Interventions
Clients had a 30-minute health screen that included collection of self-reported physical activity and dietary intake and physical examination of metabolic risk factors including waist circumference, blood pressure, and point-of-care testing of cholesterol and glucose.

Main Outcomes and Measures
Using interpretative description methods and inductive thematic analysis, themes were identified from the interviews and then mapped deductively onto feasibility domains of acceptability, demand, implementation, practicality, and integration.

Results
Three themes were identified. Clients perceived screening as convenient and comfortable; provided important health information; and could be part of usual physical therapy. Physical therapists saw health screening as a valuable add-on service and beneficial for client management but were uncertain about future integration.

Conclusions and Relevance
Incorporating health screening into private practice physical therapist services is feasible and valued by clients but physical therapists were unsure how they could integrate this into their practice/business. Physical therapists working in private practice need additional training to incorporate health screening into their practice. Concurrently, funding models need to support this by prioritizing investment in health promotion and disease prevention.
Impact of Intravenous Laser Irradiation of Blood on Cognitive Function and Molecular Pathways in Long COVID Patients: A Pilot Study
Authors: Chang Cheng-Chiang , Li Yu-He , Chang Shin-Tsu , Chen Hsin-Hung 
Published: February 2025

Abstract

Background
Long COVID presents persistent neurological symptoms, including brain fog, with limited therapeutic options. Intravenous Laser Irradiation of Blood (ILIB) has been proposed as a potential intervention. This pilot study explores the efficacy of ILIB in alleviating brain fog symptoms and examines the underlying molecular mechanisms.

Aim
To evaluate the effectiveness of ILIB in improving cognitive function in long COVID patients with brain fog and to investigate the molecular pathways involved.

Design
A prospective, single-center pilot study involving six long COVID patients with brain fog who underwent ILIB therapy.

Methods
Patients received 30 ILIB sessions over eight weeks. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), and Athens Insomnia Scale (AIS) at baseline, post-treatment, and one-month follow-up. RNA sequencing and pathway enrichment analyses (KEGG, Gene Ontology) identified differentially expressed genes and molecular pathways influenced by ILIB.

Results
MoCA and AIS scores significantly improved post-ILIB, suggesting enhanced cognitive function and sleep quality. RNA sequencing revealed 141 upregulated and 130 downregulated genes. Upregulated pathways were associated with mitochondrial electron transport and oxidative phosphorylation, while immune response and inflammatory pathways were downregulated. Notably, the glutathione metabolism pathway was significantly altered, suggesting reduced oxidative stress.

Conclusions
ILIB shows potential in alleviating brain fog symptoms in long COVID patients, possibly through modulation of oxidative stress, mitochondrial function, and inflammation. However, larger randomized controlled trials are needed to confirm these findings and establish ILIB as a viable therapeutic option.
Trade-offs between residual conductance, hydraulic capacitance, and water access in Mediterranean species
Authors: Liu Junzhou , Hochberg Uri , Alon Asaf , Cohen Shabtai 
Published: February 2025

Abstract
Droughts during dry seasons may pose a greater threat to Mediterranean forests under climate change. Effective desiccation avoidance strategies include reduced water loss rates, enhanced tissue water storage capacity, and greater root water access, which can avoid or delay dehydration damage. However, resource allocation competition may lead to trade-offs among these strategies that are not yet fully understood. In this study, six woody species from a Mediterranean forest were selected. We measured their twig hydraulic capacitance, ranging from 0.32–2.81 mmol m−2 MPa−1, to assess tissue water storage capacity, and twig residual conductance (gres) at 25 °C, ranging from 1.23–7.73 mmol m−2 s−1, to evaluate water loss rate. We found that the leaves of all four evergreen Mediterranean species featured sunken or hidden stomata, which may contribute to their low gres. The gres was also measured across a 25 °C–30 °C-40 °C temperature gradient, revealing species-specific response patterns. Predawn water potential (ΨPD) and the difference between predawn and midday water potential (∆Ψ) at the end of the dry summer season were used to estimate root water access. Significant trade-offs in plant desiccation avoidance strategies were observed as gres positively correlated with ∆Ψ (R2 = 0.78, P = 0.02) and twig hydraulic capacitance negatively correlated with ΨPD (R2 = 0.68, P = 0.04). Consequently, species with greater root water access exhibited lower tissue water storage capacity and higher gres, potentially increasing their mortality risk during extreme droughts when soil moisture is unavailable. By inverting a plant desiccation model, we demonstrated that both the calculated minimum hydraulic capacitance required for daily plant survival and a novel risk index positively correlated with ΨPD, supporting this conclusion. Notably, these findings align with historical statistics of tree mortality. Additionally, the risk index increased under scenarios of elevated temperature.
Study on the influence of asymmetric mountain structures at tunnel portals on aerodynamics of intersecting trains
Authors: Zeng Hao-Yang , Liu Tang-Hong , Chen Xiao-Dong , Gao Hong-Rui , Xia Yu-Tao , Xu Bin , Gao Feng 
Published: February 2025

Abstract
During two trains passing through a tunnel intersect with each other, the difference of the surrounding space between a train's both sides rises, which induces abrupt aerodynamic force variations on trains resulting in a phenomenon of sudden swaying. This study employs URANS method for numerical simulation to analyze the effects of two terrain conditions, that is, a tunnel with and without asymmetric mountain structures at its portals, on the aerodynamic characteristics of two trains during their intersections. The results indicate that during two trains’ intersections at tunnel portals, the rear car suffers the highest risk of swaying. The presence of asymmetric mountain structures at tunnel portals reduces the risk of swaying the train adjacent to the mountains but increases the risk for trains farther away from the mountains. When trains intersect at the exit (for the train adjacent to the mountain) of the tunnel, the presence of mountain structures at the portal reduces the peak-to-peak lateral force values by 12.7% for the front car of the train adjacent to the mountain and increases by 16.5% for the rear car of the train away from the mountain. The impact of the mountain structures on the peak-to-peak values of a train's lateral force is minimal when two trains intersect at the midpoint of the tunnel. Therefore, it is suggested to consider the placement of symmetrical buffer structures or the modification of existing mountain structures at appropriate locations near tunnel portals to mitigate the abrupt lateral force variations experienced by passing trains.
Understanding Communication Apprehension in Undergraduate Nursing Students: A Qualitative Study
Authors: Schulenberg Shannon L. , Goldberg Debora , Kreps Gary , Oh Kyeung Mi 
Published: February 2025

Abstract

AIM
The aim of this qualitative study was to explore the lived experience of communication apprehension (CA) in undergraduate nursing students.

BACKGROUND
CA is the fear or anxiety elicited by communication encounters, either real or anticipated. Communication is a critical competency for nursing students and impacts patient outcomes and patient satisfaction.

METHOD
A phenomenological approach was utilized to understand the lived experience of moderate to high CA in 17 undergraduate nursing students.

RESULTS
Themes that emerged from interviews included the physical, behavioral, and cognitive symptoms experienced by participating students and the influences of their native spoken language and accent, their past communication experiences, and the caring and uncaring behaviors of faculty with regard to their CA.

CONCLUSION
Results of this study can inform nurse educators of the symptoms of CA in students and can be used to influence the design of communication education.
A Comparative Study of Self-Collected Versus Clinician-Collected Specimens in Detecting High-Risk HPV Infection: A Prospective Cross-Sectional Study
Authors: Parapob Natnipa , Lekawanvijit Suree , Tongsong Theera , Charoenkwan Kittipat , Tantipalakorn Charuwan 
Published: February 2025

(Abstracted from Obstet Gyencol Sci 2024;67:557–564)
Over 600,000 new cases of cervical cancer were reported by the World Health Organization in 2020, and estimated deaths from cervical cancer were 342,000. In Thailand, there are an estimated 12 deaths a day attributed to cervical cancer.
Clinical Utility of Comprehensive Liquid Molecular Profiling in Patients With Advanced Endometrial Cancer
Authors: Blanc-Durand Félix , Camilleri Geraldine M. , Bayle Arnaud , Aldea Mihaela , Vasseur Damien , Ouali Kaissa , Michels Judith , Pautier Patricia , Nicotra Claudio , Ngo-Camus Maud , Lacroix Ludovic , Rouleau Etienne , Ponce-Aix Santiago , Italiano Antoine , Leary Alexandra 
Published: February 2025

(Abstracted from Cancer 2024;130(19):3311–3320)
Endometrial cancer (EC) has been increasing in incidence and mortality rates due to increased prevalence of risk factors such as obesity, metabolic syndrome, and diabetes. Many cases are treatable through a combination of methods, but up to 20% of cases are detected at an advanced stage, which has a grim prognosis.
Pembrolizumab or Placebo With Chemoradiotherapy Followed by Pembrolizumab or Placebo for Newly Diagnosed, High-Risk, Locally Advanced Cervical Cancer (ENGOT-cx11/GOG-3047/KEYNOTE-A18): Overall Survival Results From a Randomized, Double-blind, Placebo-Controlled, Phase 3 Trial
Authors: Lorusso Domenica , Xiang Yang , Hasegawa Kosei , Scambia Giovanni , Leiva Manuel , Ramos-Elias Pier , Acevedo Alejandro , Cvek Jakub , Randall Leslie , de Santana Gomes Andrea Juliana Pereira , Mejia Fernando Contreras , Helpman Limor , Akilli Hüseyin , Lee Jung-Yun , Saevets Valeriya , Zagouri Flora , Gilbert Lucy , Sehouli Jalid , Tharavichitkul Ekkasit , Lindemann Kristina , Colombo Nicoletta , Chang Chih-Long , Bednarikova Marketa , Zhu Hong , Oaknin Ana , Christiaens Melissa , Petru Edgar , Usami Edgar , Liu Peng , Yamada Karin , Toker Sarper , Keefe Stephen M. , Pignata Sandro , Duska Linda R. 
Published: February 2025

(Abstracted from Lancet Oncol 2023;24:468–482)
An estimated 660,000 new cases of cervical cancer were reported globally in 2022, with 350,000 deaths attributable to the disease. Eternal beam radiotherapy with concurrent chemotherapy and subsequent brachytherapy is the current standard of care, and few advances have been made in recent years to increase the effectiveness of treatments for cervical cancer.
Excess of Severe Autoimmune Diseases in Women With Premature Ovarian Insufficiency: A Population-Based Study
Authors: Savukoski S.M. , Silvén H. , Pesonen P. , Pukkala E. , Gissler M. , Suvanto E. , Ollila M.-M. , Niinimaki M. 
Published: February 2025

(Abstracted from Hum Reprod 2024;39:2601–2607)
Ovarian function that stops before the age of 40 is classified as spontaneous premature ovarian insufficiency (POI) and affects up to 1% of women, bringing with the diagnosis a plethora of negative health and quality of life impacts. Etiologies range from previous cancers and oophorectomies to chromosomal disorders, but an estimated 4%–55% of cases stem from autoimmune diseases.
Effect of Coaching on Trainee Burnout, Professional Fulfillment, and Errors: A Randomized Controlled Trial
Authors: Parris Ritika S. , Dong Zhiyong , Clark Alicia , Hayes Margaret , Sullivan Amy M. , Tibbles Carrie , Palamara Kerri 
Published: February 2025

Abstract

Purpose
This study examines the effect of coaching on errors and burnout on graduate medical education trainees and mechanisms of this effect.

Method
In this explanatory, sequential, mixed-methods randomized controlled trial at a large, urban academic medical center, trainees and faculty were randomized to coaching with mentorship or mentorship alone from September 2021 to December 2022. Trainees randomized to coaching (coachees) were paired with faculty coaches from different specialties, who were trained in a novel coaching curriculum. Burnout was measured with the Stanford Professional Fulfillment Index subscales of professional fulfillment, work exhaustion, interpersonal disengagement, and overall burnout. Medical errors in the past 3 months were self-reported. Focus groups were conducted for each of the 4 cohorts (faculty control, faculty intervention, trainee control, and trainee intervention) to allow for an in-depth exploration of the coaching program experience.

Results
A total of 184 trainees and 150 faculty were randomized to standard mentorship with or without coaching. Paired analysis included 83 trainees (59% female) and 77 faculty (60% female). Difference-in-difference analyses showed reduced burnout among coachees compared with control trainees, with a score difference of −0.37 (95% CI, −0.64 to −0.09). Professional fulfillment improved in coachees, with a score difference of 0.50 (95% CI, 0.16-0.83) compared with control trainees. There were no significant differences in resilience or self-valuation. Coachees had 2.18 times greater odds of reporting no medical error than control trainees (not significant) and were less likely to report being “unsure” about medical error involvement. Qualitative analysis highlighted the importance of specialty discordance in coaching pairs and a coach’s holistic awareness of coachee well-being and demonstrated successful uptake and use of coaching skills, particularly positive reframing and normalization.

Conclusions
Coaching improved trainee burnout and professional fulfillment, likely through aspects of the relationship and teachable skills, which provided psychological safety and holistic support.
Geospatial Access to Extracorporeal Membrane Oxygenation in the United States
Authors: Gottula Adam L. , Van Wyk Hannah , Qi Man , Vogelsong Melissa A. , Shaw Chris R. , Tonna Joseph E. , Johnson Nicholas J. , Condella Anna , Bartos Jason A. , Berrocal Veronica J. , Benoit Justin L. , Hsu Cindy H. 
Published: February 2025

Objectives:
To conduct a Geospatial Information System analysis of extracorporeal membrane oxygenation (ECMO) centers in the United States utilizing data from the U.S. Census Bureau to better understand access to ECMO care and identify potential disparities.

Design:
A cross-sectional descriptive and statistical analysis of geospatial access to ECMO-capable centers in the United States, accounting for demographic variables.

Setting:
The unit of analysis were U.S. Census block groups and demographic variables of interest obtained from the American Community Survey.

Patients:
Patients accounted for in the U.S. Census data.

Interventions:
None.

Measurements and Main Results:
Sixty-seven percent of the U.S. population had direct access to ECMO-capable centers. Disparities were present, with Puerto Rico, Wyoming, North Dakota, and Alaska having no access. Poverty, increased age, and lower population density consistently correlated with limited access. We identified significant racial and ethnic disparities in the Midwest and Northeast.

Conclusions:
While 67% of the U.S. population had access to ECMO-capable centers by ground transportation, significant disparities in access exist. These findings emphasize the need for thoughtful implementation of ECMO systems of care to ensure equitable access. Future work should focus on developing novel systems of care that increase access utilizing advanced technology, such as aeromedical transport services.
Pleural infection: controversies on the therapeutic strategies
Authors: Chan Ken K.P. , Lau Estee P.M. , Lee Y.C. Gary 
Published: February 2025

Purpose of review
Management of pleural infection remains heterogeneous worldwide. This review highlights current controversies in therapeutic strategies for pleural infection, focusing particularly on recent studies and their implications.

Recent findings
The introduction of intrapleural therapy combining alteplase [a tissue plasminogen activator (tPA)] and deoxyribonuclease (DNase) has revolutionized treatment practices, though the optimal delivery and dosing regimen is an area of active investigation. Variations to simplify administration protocols and/or to lower the required drug doses have been published. Most were exploratory studies, but the variations showed maintained therapeutic efficacy.
Whether intrapleural alteplase/DNase or video-assisted thoracoscopic surgery (VATS) is superior is a topic of debate. Retrospective comparative analyses between the two revealed no clear benefits on all-cause mortality from either approach. Pilot randomized trials have been published and further full-scale, head-to-head trials are underway.

Summary
Effective management of pleural infection involves adequate pleural drainage and appropriate antibiotic use. This review outlines the current evidence (and its limitations) and highlights knowledge gaps in optimizing the therapeutic strategies.