bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toll-like receptor 4 inhibition by pyridostigmine is associated with a reduction in hypertension and inflammation in rat models of preeclampsia
Authors: Ali Md. Ahasan , Zeng Ming , Alkuhali Asma.A. , Zeng Zhaoshu , Yuan Meng , Wang Xiaomin , Liu Xiaoxu , Issotina Zibrila Abdoulaye , Liu Jinjun , Wang Zheng 
Published: January 2025

Background:
Preeclampsia (PE) is marked by hypertension and detrimental sterile inflammatory response. Despite the reported anti-inflammatory effect of pyridostigmine bromide (PYR) in different models, its anti-inflammatory mechanism in PE is unclear. This study assessed whether such an anti-inflammatory effect involves inhibition of placental Toll-like receptor 4 (TLR4) signaling.

Methods:
Placental TLR4 expression and its signaling were assessed respectively in PE women and Sprague-Dawley rats with reduced uterine perfusion pressure (RUPP) induced on gestational day14 (GD14). RUPP and lipopolysaccharides (LPS, 5 μg/kg)-induced PE rats were treated with a selective TLR4 signaling inhibitor (TAK-242, 2.5 mg/kg/day). The effect of PYR (20 mg/kg/day) on TLR4 expression and signaling was also assessed in RUPP or LPS-infused rats. On GD19, rats’ mean arterial pressure (MAP) and samples were collected and processed. At the cellular level, the effect of acetylcholine (ACh), the indirect by-product of PYR activity, on LPS-stimulated HTR-8/SVneo cells was assessed.

Results:
Both PE women and RUPP rats had increased (P
< 0.05) placental TLR4 expression and elevated (P
< 0.05) MAP. Selective inhibition of TLR4 signaling with TAK-242 blunted (P < 0.05) RUPP-elevated MAP. Activation of TLR4 induced PE-like symptoms in dams, which were prevented by TAK-242. PYR reduced (P < 0.05) MAP and downregulated placental TLR4 expression and TLR4/TRAF6/NF-κB signaling-mediated inflammation in RUPP and in response to TLR4 selective activation. ACh inhibited the same signaling pathway in LPS-stimulated HTR-8 in vitro.

Conclusion:
Our data support that PYR attenuates placental TLR4 expression and inhibits TLR4/TRAF6/NF-κB signaling pathway-mediated inflammation in RUPP, clarifying the anti-inflammatory mechanisms of PYR in the PE rat model.
Chronic Pain Treatment Utilization in Rural Versus Urban/Suburban Inhabitants Following Traumatic Brain Injury
Authors: Bale Levi , Sevigny Mitch , Hoffman Jeanne M. 
Published: January 2025

Objective: To determine whether there are differences in healthcare utilization for chronic pain based on location (rural vs urban/suburban) or healthcare system (civilians vs Military Service Members and Veterans [SMVs]) after moderate-severe TBI. Setting: Eighteen Traumatic Brain Injury Model Systems (TBIMS) Centers. Participants: A total of 1,741 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview. Primary Measures: Sociodemographic, injury, function outcome, pain, and pain treatment characteristics. Results: Participants were mostly male (72.9%), White (75.2%), civilian (76.9%), 46 years old on average, and had greater than high school education (59.9%). 32% of participants resided in rural areas and 67% in urban/suburban areas. No significant difference in healthcare utilization for chronic pain was observed between individuals living in rural versus urban/suburban locations after adjustment for relevant covariates. However, rural SMVs had odds ratios >3 for each major treatment category including medical services (OR = 3.56), exercise therapies (OR = 5.23), psychological services (OR = 4.43), complementary and alternative therapies (OR = 3.23), and pain rehabilitation program (OR = 4.16) compared to rural civilians. This same pattern of findings was seen SMVs in urban/suburban settings as well. Being married versus single, bachelor/graduate education versus high school or less, and employed versus unemployed all had odds ratios >1 for exercise therapies, psychological services, complementary and alternative therapies, and pain rehab program. Conclusion: Contrary to initial hypotheses, there were no significant differences in healthcare utilization for chronic pain treatment comparing those in rural versus urban/suburban areas. However, differences were found between SMVs and civilians across both rural and urban/suburban locations suggesting that SMVs have more access to chronic pain treatment. The improved access to social and financial services afforded by VHA programs to SMVs may serve as a model for improving healthcare utilization in similar civilian populations.
Anterior uveitis, pigmentary retinopathy, and pars plana exudates in Celiac disease
Authors: Agarwal Aniruddha , Rana Surinder S. , Gupta Kirti 
Published: January 2025

Purpose:
To report a case of bilateral anterior uveitis, pigmentary retinopathy, and pars plana exudates in a patient with Celiac disease with complete resolution of inflammation following gluten-free diet.

Methods:
Retrospective case report

Results:
A 19-year-old Asian Indian girl presented with bilateral non-granulomatous anterior uveitis for the past 2 months. Examination revealed bilateral pigmentary retinopathy and exudates near the inferior pars plana in the left eye. Laboratory evaluation revealed positive anti-tissue transglutaminase antibody, low thyroid stimulating hormone, low serum ferritin, anemia, and vitamin D deficiency. Her duodenal biopsy was confirmatory for Celiac disease. After initiation of gluten-free diet, there was complete resolution of anterior segment inflammation and vitreous exudates.

Conclusions:
Celiac disease is a rare cause of corticosteroid-resistant uveitis with a handful of cases reported in the literature. This condition has protean manifestations and resolves with gluten-free diet.
Extraintestinal Infections Caused by Aeromonas Species
Authors: Dsouza Nikhil Victor , Basak Sukanya , Shenoy M Suchitra 
Published: January 2025

Purpose
The gram negative bacteria of genus Aeromonas is one of the emerging group of pathogens causing infections in humans, both in immunocompromised and immunocompetent. With the development of resistance toward beta-lactam antibiotics, knowledge, and approach regarding Aeromonas is warranted. The study analyses the clinical presentation, risk factors, antimicrobial susceptibility, and outcomes of 31 cases of Aeromonas infection.

Methods
A retrospective record-based study was conducted in a tertiary care hospital after the approval of the institutional ethics committee. All patients diagnosed and admitted with Aeromonas infection over a period of 4 years (2017–2020) were enrolled. All information was collected from medical records, laboratory information systems, and analyzed using SPSS 17.

Results
A total of 31 confirmed cases of Aeromonas were enrolled. Blood and pus/wound swab samples yielded maximum number of isolates. The predominant associated risk factors were type 2 diabetes mellitus and malignancy. Main presentations were bacteremia followed by wound infection with a mortality of 16%. Strains were sensitive toward tigecycline followed by co-trimoxazole, gentamicin, and fluoroquinolones.

Conclusions
The Aeromonas species present with diverse clinical disease and can easily acquire multidrug resistance via plasmids. In immunocompromised individuals, it can give rise to life threatening infections. These are organisms are widely present in the aquatic environment. Therefore, it is prudent to check the contamination of the water bodies by sources like aquaculture and agriculture wastes containing residual antimicrobial agents.
Obesity paradox in coronary artery disease: national inpatient sample analysis
Authors: Salman Ali , Saad Muhammad , Batool Ruqiat Masooma , Ibrahim Zainab Siddiqua , Waqas Saad Ahmed , Ahmed Syed Zaeem , Ahsan Syed Ibad , Aisha Eliza , Aamer Haiqa , Sohail Muhammad Umer , Ansari Ifrah , Afridi Muhammad Khalid , Makda Fatima Aman , Aamir Jazza 
Published: January 2025

Background
Although existing literature highlights obesity as a significant predictor for coronary artery disease (CAD), the impact of BMI on hospital outcomes among CAD patients remains unclear.

Methods
We extracted data from the National Inpatient Sample database for adult patients with CAD from 2018 to 2020. The study cohort was stratified into six BMI categories: underweight, normal weight, overweight, class I obesity, class II obesity, and class III obesity. Using multivariable logistic and linear regression, we assessed the impact of BMI on in-hospital mortality, length of stay (LOS), and inflation-adjusted total charges.

Results
We identified a total of 3 693 570 hospitalizations (mean age: 69 ± 12 years). Underweight individuals had the highest in-hospital mortality rate (6.8%), followed by normal weight (5.2%), overweight (3.2%), class III obese (2.5%), class I obese (1.9%), and class II obese (1.8%) individuals. After adjusting for covariates, underweight patients had higher odds of in-hospital mortality compared to normal-weight individuals [odds ratio (OR), 1.38; 95% confidence interval (CI), 1.31–1.45; P < 0.001], while overweight or obese individuals had lower odds: overweight (OR, 0.75; 95% CI, 0.70–0.79; P < 0.001), obese class I: (OR, 0.54; 95% CI, 0.51–0.57; P < 0.001), obese class II: (OR, 0.56; 95% CI, 0.53–0.59; P < 0.001), obese class III: (OR, 0.78; 95% CI, 0.74–0.82; P < 0.001). Normal weight and underweight patients had the longest median LOS [5 days (3.0–9.0)]. Overweight patients incurred the highest total charges [$53 730 (28 587–105 184)].

Conclusion
Underweight patients experienced higher, while overweight and obese patients experienced lower in-hospital mortality than normal-weight patients, suggesting a protective effect of higher BMI against mortality in CAD.
Circadian rhythms, metabolism, and nutrition support in critically ill adult patients: a narrative review
Authors: Chiu Yu-Hsiang , Sharma Anushka , Dashti Hassan S. 
Published: January 2025

Purpose of review
The human circadian system regulates several physiological processes, including metabolism, which becomes significantly disrupted during critical illness. The common use of 24-h continuous nutrition support feeding in the intensive care unit (ICU) may further exacerbate these disruptions; this review evaluates recent evidence comparing continuous and intermittent feeding schedules in critically ill adults.

Recent findings
Research comparing different feeding schedules in critically ill adults remains limited. Recent meta-analyses suggest that continuous and intermittent feeding schedules in the ICU have comparable adverse event profiles, including gastrointestinal intolerance. A retrospective study found that continuous feeding did not impact the 24-h glucose variation in critically ill adults, and a randomized controlled trial reported no significant differences in amino acid, lipid-based, or small molecule metabolite profiles between the two feeding regimens. Potential benefits of intermittent feeding include stimulation of muscle protein synthesis, preservation of normal hormone secretion, and improved attainment of nutritional goals.

Summary
Current evidence suggests comparable safety profiles for continuous and intermittent feeding schedules in critically ill adult patients. However, intermittent and daytime cyclic feeding are expected to align more closely with normal circadian physiology. Given the lack of existing supportive data, a dynamic approach – transitioning from continuous feeding in the early-acute metabolic phase to intermittent feeding or daytime cyclic feeding – may be appropriate.
When neck lymph nodes metastases do not origin from a head and neck unknown primary
Authors: Pamuk Erim , Simon Christian 
Published: January 2025

Purpose of review
The evidence for a standardized approach to the management of cervical metastasis from a distant primary tumour is limited. The objective of this review is to provide an overview of the current status of research in this field and to present the latest diagnostic and therapeutic approaches.

Recent findings
Although infraclavicular tumours are typically observed to metastasise to levels IV and V of the neck, all levels may potentially be affected. In conjunction with imaging and immunohistochemical analyses, next-generation sequencing and artificial intelligence-based tools are emerging as potential methods for identifying the primary tumour. Cervical metastasis can be classified as N3 or M1 in accordance with the histology and site of the primary tumour. A neck dissection + adjuvant chemoradiotherapy may prove beneficial in selected patients with breast, nonsmall cell lung, renal cell, oesophageal and testicular cancers, resulting in improved survival rates.

Summary
The diagnosis and subsequent treatment of such cases requires the input of a multidisciplinary team, as the condition is often complex and requires a multifaceted approach. Isolated supraclavicular metastases should prompt the clinician to investigate a distant primary. In select patients with some types of primary tumours, surgical treatment of the neck may improve the prognosis. It is, therefore, essential to control the primary tumour in order to optimize the success of the overall treatment plan.
Minimally Invasive Total Versus Supracervical Hysterectomy With Sacrocolpopexy
Authors: Giugale Lauren E. , Ruppert Kristine M. , Muluk Sruthi L. , Glass Clark Stephanie M. , Bradley Megan S. , Wu Jennifer M. , Matthews Catherine A. 
Published: January 2025

Importance
Limited data exist comparing total laparoscopic hysterectomy (TLH) versus laparoscopic supracervical hysterectomy (LSCH) at the time of minimally invasive sacrocolpopexy for uterovaginal prolapse.

Objectives
The objective of this study was to compare TLH versus LSCH at the time of minimally invasive sacrocolpopexy for uterovaginal prolapse, hypothesizing that LSCH would demonstrate a higher proportion of recurrent prolapse, but a lower proportion of mesh exposures.

Study Design
This was a retrospective, secondary analysis comparing a prospective cohort of patients undergoing TLH sacrocolpopexy versus a retrospective cohort of patients who had undergone LSCH sacrocolpopexy. Our primary outcome was composite anatomic pelvic organ prolapse recurrence (prolapse beyond hymen, apical descent > half vaginal length, retreatment). Secondary outcomes included vaginal mesh exposures.

Results
There were 733 procedures: 184 (25.1%) TLH sacrocolpopexy and 549 (74.9%) LSCH sacrocolpopexy. Median follow-up was longer in the TLH cohort (369 [IQR 354–386] vs 190 [IQR 63–362] days, P < 0.01). There was no difference in composite prolapse recurrence between groups on bivariable analysis (3.3% vs 4.7%, P = 0.40). However, multivariable logistic regression demonstrated that TLH sacrocolpopexy had lower odds of composite pelvic organ prolapse recurrence than LSCH sacrocolpopexy (OR 0.21, 95% CI 0.05–0.82, P = 0.02). Among procedures with lightweight mesh types, TLH demonstrated a higher proportion of mesh exposures compared to LSCH (10 [5.4%] vs 4 [1.1%], P < 0.01); however, this was not significant after controlling for confounders (OR 4.51, 95% CI 0.88–39.25, P = 0.08). There were no differences in retreatment or reoperation.

Conclusion
For the treatment of uterovaginal prolapse, both TLH and LSCH are acceptable methods of concomitant hysterectomy at the time of minimally invasive sacrocolpopexy, albeit with likely different risk profiles.
The Pelvic Floor Disorders Network: Evolution Over Two Decades of Female Pelvic Floor Research
Authors: Richter Holly E. , Visco Anthony , Brubaker Linda , Sung Vivian , Nygaard Ingrid , Arya Lily , Menefee Shawn , Zyczynski Halina M. , Schaffer Joseph , Rogers Rebecca G. , Kenton Kimberly , Paraiso Marie F. R. , Fine Paul , Mazloomdoost Donna , Gantz Marie G. 
Published: January 2025

Importance
This review aimed to describe research initiatives, evolution, and processes of the Eunice Kennedy Shriver National Institute of Child Health and Human Development–supported Pelvic Floor Disorders Network (PFDN). This may be of interest and inform researchers wishing to conduct multisite coordinated research initiatives as well as to provide perspective to all urogynecologists regarding how the PFDN has evolved and functions.

Study Design
Principal investigators of several PFDN clinical sites and Data Coordinating Center describe more than 20 years of development and maturation of the PFDN.

Results
Over two decades, the PFDN used an intentionally driven approach to answering clinically important questions to inform the surgical and nonsurgical care of women with pelvic floor disorders (PFDs) including pelvic organ prolapse, urinary incontinence, and fecal incontinence. From its inception, the PFDN refined network procedures and processes affecting trial design, protocol development, and standardization of outcomes and publications. This strategy resulted in a credible, robust, and productive portfolio of randomized clinical trials, secondary analyses, prospective cohort, and supplementary studies emphasizing the use of validated patient-reported outcomes, longer-term outcomes, an increase in translational science aims, and standardized long-term collection of adverse events.

Conclusions
The processes the PFDN has developed and implemented have led to impactful research initiatives in women's PFDs. Patient participants and research coordinators have been an integral part of this contribution. Through consistent funding and committed investigators, the state of science in the surgical and nonsurgical care and understanding of PFD pathophysiology has been advanced.
WITHDRAWN: Comparative Analysis of Machine Learning Models for Cancer Diagnosis
Authors: Eladl Omar 
Published: January 2025

Withdrawal StatementThe authors have withdrawn this manuscript because of some errors and mistakes in the submission, including the data analysis and authority, that need to be corrected. A major reason for the manuscript being withdrawn is due to a lack of credit being given to the person who carried out the work. After reviewing the manuscript, we decided to withdraw it to make the necessary revisions before submitting it. Therefore, the authors do not wish this work to be cited as a reference for the project. If you have any questions, please contact the corresponding author.
CARDIAC DYSFUNCTION DURING ADVERSE MATERNAL OUTCOMES IN HYPERTENSIVE DISORDERS OF PREGNANCY
Authors: Giorgione Veronica , Kitt Jamie , Leeson Paul , Khalil Asma , O’Driscoll Jamie , Thilaganathan Basky 
Published: January 2025

ABSTRACTBackgroundHypertensive disorders of pregnancy (HDP) are associated with significant cardiac remodeling during pregnancy and are important contributors to maternal morbidity and mortality. Whether acute adverse outcomes during HDP are associated with additional clinically relevant cardiac impairment has not been widely studied.MethodsA prospective observational study was conducted on 255 women with HDP who underwent transthoracic echocardiography during the peripartum period. Maternal echocardiographic parameters, including left ventricular morphology and function, were analyzed to determine their association with adverse maternal outcomes by univariate and multivariate analyses. The composite adverse maternal outcome was defined as at least one of the following: admission to a high dependence unit, acute renal injury, adverse cardio-pulmonary events, stroke and disseminated intravascular coagulation.ResultsAdverse maternal outcomes occurred in 68 (26.7%) participants. Women with adverse outcomes had significantly higher left atrial volume index (LAVI) (28.8 [23.4-32.3] ml/m2vs 26.6 [22.2-30.9] ml/m2, p=0.045) and E/e′ ratio (7.8 [6.6-9.2] vs 7.0 [5.9-8.1], p=0.002) compared to those without complications. In multivariable analysis, both LAVI (adjusted OR 1.09 [1.02-1.16], p=0.009) and E/e′ ratio (adjusted OR 1.25 [1.04-1.49], p=0.018) remained independently associated with adverse maternal outcomes after adjusting for maternal factors and clinical variables.ConclusionsCardiac abnormalities, particularly in diastolic function, are more common in women with adverse maternal outcomes in HDP. Whether enhanced cardiovascular monitoring and management of these women in the peripartum period could have immediate and long-term health benefits requires further evaluation.GRAPHIC ABSTRACT
State-dependent modulation of spiny projection neurons controls levodopa-induced dyskinesia in a mouse model of Parkinson’s disease
Authors: Zhai Shenyu , Cui Qiaoling , Wokosin David , Sun Linqing , Tkatch Tatiana , Crittenden Jill R. , Graybiel Ann M. , Surmeier D. James 
Published: January 2025

AbstractIn the later stages of Parkinson’s disease (PD), patients often manifest levodopa-induced dyskinesia (LID), compromising their quality of life. The pathophysiology underlying LID is poorly understood, and treatment options are limited. To move toward filling this treatment gap, the intrinsic and synaptic changes in striatal spiny projection neurons (SPNs) triggered by the sustained elevation of dopamine (DA) during dyskinesia were characterized using electrophysiological, pharmacological, molecular and behavioral approaches. Our studies revealed that the intrinsic excitability and functional corticostriatal connectivity of SPNs in dyskinetic mice oscillate between the on- and off-states of LID in a cell- and state-specific manner. Although triggered by levodopa, these rapid oscillations in SPN properties depended on both dopaminergic and cholinergic signaling. In a mouse PD model, disrupting M1 muscarinic receptor signaling specifically in iSPNs or deleting its downstream signaling partner CalDAG-GEFI blunted the levodopa-induced oscillation in functional connectivity, enhanced the beneficial effects of levodopa and attenuated LID severity.
Analyses of biomarkers for tremor using local field potentials recorded from deep brain stimulation electrodes in the thalamus
Authors: Kumaravelu Karthik , Schmidt Stephen L. , Zhao Yi , Vittert Allison , Swan Brandon D. , Oza Chintan S. , Peters Jennifer J. , Mitchell Kyle T. , Turner Dennis A. , Grill Warren M. 
Published: January 2025

ABSTRACTBackgroundDeep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus (TH) is an effective therapy for suppressing tremor. One of the critical challenges to optimizing VIM-DBS therapy is the lack of robust neural biomarkers that correlate well with tremor.ObjectiveWe conducted intraoperative local field potential (LFP) recordings from DBS electrodes placed in the TH (including VIM and ventralis oralis posterior-VOP) to quantify biomarkers of tremor. We used computational modeling to understand the biophysical basis of the recorded LFP signal.MethodsWe simultaneously recorded intraoperative TH LFP and tremor from the hand dorsum (34 participants) and during DBS at different frequencies (16 participants). Then, we simulated the effects of DBS and spatial distribution of tremor cells on calculated LFPs in a TH model.ResultsThere was a moderate correlation between tremor and LFP spectral power in the theta and alpha bands (r = 0.445 and 0.389, respectively). There was a strong correlation between tremor and peak coherence between LFP and tremor signal (r = 0.559). Postural tremor was decoded from the LFP signal with an area under curve of ∼0.7. High frequency DBS reduced spectral power in the theta and alpha bands and tremor could be decoded from the LFP spectral power in the presence of DBS (0.429 goodness of fit R2). The theta power in the simulated LFP signal varied substantially with the specific location of the bipolar contact pair of the DBS electrode used for the LFP recordings as well as the spatial distribution of tremor cells.ConclusionsTheta power alone was not sufficient for prediction of tremor control. Simulations indicated that the number and distribution of tremor cells surrounding the DBS lead may explain the lack of strong correlation between tremor and theta power.HIGHLIGHTSRecorded intraoperative thalamic LFP in patients with ET, PD, or multiple sclerosis.Moderate correlation between tremor and spectral power in theta/alpha bands.Strong correlation between tremor and LFP-Accelerometer coherence.Tremor can be decoded from VIM-LFP with an AUC of 0.7.Thalamic model indicated theta power dependent on tremor cell distribution.