bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research progress on the depth of anesthesia monitoring based on the electroencephalogram
Authors: He Xiaolan , Li Tingting , Wang Xiao 
Published: December 2024

AbstractGeneral anesthesia typically involves three key components: amnesia, analgesia, and immobilization. Monitoring the depth of anesthesia (DOA) during surgery is crucial for personalizing anesthesia regimens and ensuring precise drug delivery. Since general anesthetics act primarily on the brain, this organ becomes the target for monitoring DOA. Electroencephalogram (EEG) can record the electrical activity generated by various brain tissues, enabling anesthesiologists to monitor the DOA from real‐time changes in a patient's brain activity during surgery. This monitoring helps to optimize anesthesia medication, prevent intraoperative awareness, and reduce the incidence of cardiovascular and other adverse events, contributing to anesthesia safety. Different anesthetic drugs exert different effects on the EEG characteristics, which have been extensively studied in commonly used anesthetic drugs. However, due to the limited understanding of the biological basis of consciousness and the mechanisms of anesthetic drugs acting on the brain, combined with the effects of various factors on existing EEG monitors, DOA cannot be accurately expressed via EEG. The lack of patient reactivity during general anesthesia does not necessarily indicate unconsciousness, highlighting the importance of distinguishing the mechanisms of consciousness and conscious connectivity when monitoring perioperative anesthesia depth. Although EEG is an important means of monitoring DOA, continuous optimization is necessary to extract characteristic information from EEG to monitor DOA, and EEG monitoring technology based on artificial intelligence analysis is an emerging research direction.
Serotype 3 Streptococcus pneumoniae Escapes the Immune Responses Induced by PCV13 in Mice With High Susceptibility to Infection
Authors: Oliveira Giuliana S. , Rivera Johanna , Rodrigues Tasson C. , Carneiro Giovanna B. , Ribeiro Orlando G. , Miyaji Eliane N. , Pirofski Liise‐anne , Oliveira Maria Leonor S. 
Published: December 2024

ABSTRACTBackgroundStreptococcus pneumoniae (pneumococcus) is a common cause of respiratory and invasive infections in humans. PCV13, a pneumococcal conjugate vaccine used globally, is highly effective against diseases caused by pneumococcal serotypes included in its formulation. However, one of them, the serotype 3 (ST3) is still being relatively commonly isolated from patients, suggesting an escape from vaccine‐induced immunity. The thick capsule produced by ST3 facilitates bacterial evasion from the immune system. Additionally, host immune responses may influence the outcome of ST3 infection. Here we evaluated the influence of inflammation in the adaptive immune responses and protection induced by PCV13 against ST3, using two outbred mice lines that were phenotypically selected for high (AIRmax) and low (AIRmin) inflammatory responses.MethodsAIRmin and AIRmax mice were immunized with PCV13. Inbred BALB/c mice were used as reference for vaccine efficacy. Induction of IgG against polysaccharides (PS) from pneumococcal serotype 1 (ST1) and ST3 were evaluated by ELISA. Protection was tested against invasive infections with ST1 and ST3 pneumococcal strains. Sera were compared by IgG binding to pneumococcal surface, induction of pneumococcal agglutination and opsonophagocytosis. The phagocytic capacity of mice‐derived neutrophils was also evaluated.ResultsImmunization of AIRmin, AIRmax and BALB/c mice with PCV13 induced IgG against PS from ST1 and ST3 pneumococci. Despite vaccination, AIRmin mice were not protected against fatal infection with ST3. Sera from AIRmin mice immunized with PCV13 presented lower levels of anti‐PS3 IgG, with reduced capacity to bind to pneumococcal surface. Reduced capacity to induce opsonophagocytosis of ST3 pneumococci in vitro was also observed. Conversely, PCV13 protected AIRmin mice against fatal infection with ST1 and this correlated with the capacity of the sera to induce ST1 opsonophagocytosis.ConclusionsOur results show that both host and bacterial features can influence the outcome of protection induced by PCV13 against ST3 pneumococcal infection.
Association of the Inflammatory Burden Index With Increased Mortality Among Cancer Patients: Insights From the NHANES Study
Authors: Qiu Xiuxiu , Zhang Yiyi , Zhu Yingjie , Yang Ming , Tao Li 
Published: December 2024

ABSTRACTBackgroundThe systemic inflammatory response significantly influences the progression and prognosis of various cancers. The novel Inflammatory Burden Index (IBI) was recently introduced as a biomarker to gauge systemic inflammation and evaluate cancer patient prognosis. However, studies investigating the relationship between IBI and mortality rates in cancer patients remain limited.MethodsThis study analyzed data from 2748 cancer patients enrolled in the National Health and Nutrition Examination Surveys between 1999 and 2018. We used weighted Cox regression analysis and restricted cubic spline models to examine the relationship between the IBI and mortality due to all causes, cardiovascular disease (CVD), and cancer. Furthermore, we employed Kaplan‐Meier survival curves, subgroup analyses, and receiver operating characteristic curves to elaborate on these associations.ResultsOver a median follow‐up period of 112 months, the cohort experienced 1067 deaths, including 320 from cancer, 239 attributable to heart disease, and 508 from various other causes. The Kaplan‐Meier curve indicated that individuals in the higher quartiles of the IBI faced significantly increased mortality risks compared to those in lower quartiles. Analyses using weighted Cox proportional hazards models demonstrated that subjects in the top IBI quartile were at a substantially higher risk for all‐cause mortality (Hazard Ratio [HR] 2.09, 95% Confidence Interval [CI] 1.67–2.62, p < 0.001), CVD mortality (HR = 1.95, 95% CI= 1.18–3.23, p = 0.010), and cancer mortality (HR = 2.06, 95% CI = 1.31–3.26, p = 0.002). Furthermore, stratification and interaction analyses affirmed the uniformity of these initial findings. The areas under the curve for the 3‐, 5‐, and 10‐year survival predictions for all‐cause mortality were 0.62, 0.62, and 0.67, respectively; for cardiovascular mortality, they were 0.64, 0.64, and 0.70; and for cancer mortality, they were 0.62, 0.77, and 0.70.ConclusionIn cancer patients, higher IBI levels significantly correlate with increased mortality from all causes, CVD, and cancer‐specific deaths. This index could possess considerable diagnostic and prognostic importance, possibly acting as a new biomarker for evaluating outcomes in cancer patients.
Unusual synchronous and metachronous association of hematologic neoplasms with gynecologic neoplasms: A case series and literature review
Authors: Ozcivit Erkan Ipek Betul , Kuru Oguzhan , Turker Saricoban Cansu , Wardak Marwa , Hamzaoglu Canbolat Kubra , Eskazan Ahmet Emre 
Published: December 2024

AbstractThe aim of the present study was to evaluate the occurrence of synchronous or metachronous hematologic and gynecologic malignancies. The medical database of the pathology department at a tertiary center was searched from 2016 to 2024 for cases involving both hematologic and gynecologic tumors. A literature search using Google Scholar and PubMed was also conducted between May and June 2024. Articles reporting surgical pathology data were included, while radiologic studies and those lacking pathology data were excluded. Cases involving one gynecologic cancer and one hematologic malignancy were analyzed. Three cases from our center and 25 cases from 15 English‐language articles were identified. The mean age of the cases at diagnosis was 61.4 ± 9.4 years. A total of 19 patients (68%) were diagnosed with synchronous cancers, while the rest had metachronous diagnoses. Endometrial cancer was seen in 20 cases (71.4%): 14 synchronous and five metachronous endometrioid adenocarcinomas, and one unspecified metachronous endometrial cancer. This was followed by five cases of ovarian cancer (17.9%): three synchronous serous ovarian carcinomas, one metachronous serous ovarian carcinoma, and one synchronous ovarian adenocarcinoma. Additionally, there were two cases of cervical cancer (7.1%): one synchronous adenosquamous carcinoma and one metachronous invasive squamous carcinoma, and one case of carcinosarcoma (3.6%). Involvement of more than one site is possible for hematolymphoid cancer, commonly affecting the pelvic or para‐aortic lymph nodes in 16 patients (57.1%), with other sites including the cervix (4 cases, 14.3%), ovary (4 cases, 14.3%), uterus (2 cases, 7.1%), iliac/inguinal lymph nodes (2 cases, 7.1%), fallopian tube (1 case, 3.6%), vagina (1 case, 3.6%), liver (1 case, 3.6%), abdomen (1 case, 3.6%), and appendix (1 case, 3.6%). Two cases were unspecified. Non‐Hodgkin lymphoma (NHL), primarily of B cell lineage, was the most common hematologic malignancy (25 cases, 89.3%, with 22 cases being B cell lineage). In contrast, Hodgkin lymphoma was observed in two cases (7.1%), and acute leukemia in one case (3.6%). Among 21 patients with available follow‐up data, eight died during the follow‐up period. The co‐occurrence of NHL, Hodgkin lymphoma, and acute leukemia with gynecologic cancers is rare. However, during surgery for gynecologic cancers, the potential of synchronous lymphoma should be considered, particularly in cases with unusual retroperitoneal lymphadenopathy.
Propofol‐induced moderate–deep sedation modulates pediatric neural activity: A functional connectivity study
Authors: Zheng Qiang , Zhang Yiyu , Zhang Lin , Wang Jian , Liu Jungang 
Published: December 2024

AbstractBackgroundPrevious studies have demonstrated the underlying neurophysiologic mechanism during general anesthesia in adults. However, the mechanism of propofol‐induced moderate–deep sedation (PMDS) in modulating pediatric neural activity remains unknown, which therefore was investigated in the present study based on functional magnetic resonance imaging (fMRI).MethodsA total of 41 children (5.10 ± 1.14 years, male/female 21/20) with fMRI were employed to construct the functional connectivity network (FCN). The network communication, graph‐theoretic properties, and network hub identification were statistically analyzed (t test and Bonferroni correction) between sedation (21 children) and awake (20 children) groups. All involved analyses were established on the whole‐brain FCN and seven sub‐networks, which included the default mode network (DMN), dorsal attentional network (DAN), salience network (SAN), auditory network (AUD), visual network (VIS), subcortical network (SUB), and other networks (Other).ResultsUnder PMDS, significant decreases in network communication were observed between SUB‐VIS, SUB‐DAN, and VIS‐DAN, and between brain regions from the temporal lobe, limbic system, and subcortical tissues. However, no significant decrease in thalamus‐related communication was observed. Most graph‐theoretic properties were significantly decreased in the sedation group, and all graphical features of the DMN showed significant group differences. The superior parietal cortex with different neurological functions was identified as a network hub that was not greatly affected.ConclusionsAlthough the children had a depressed level of neural activity under PMDS, the crucial thalamus‐related communication was maintained, and the network hub superior parietal cortex stayed active, which highlighted clinical practices that the human body under PMDS is still perceptible to external stimuli and can be awakened by sound or touch.
Intrinsic Factors Behind the Long‐COVID: V. Immunometabolic Disorders
Authors: Adilović Muhamed , Hromić‐Jahjefendić Altijana , Mahmutović Lejla , Šutković Jasmin , Rubio‐Casillas Alberto , Redwan Elrashdy M. , Uversky Vladimir N. 
Published: December 2024

ABSTRACTThe complex link between COVID‐19 and immunometabolic diseases demonstrates the important interaction between metabolic dysfunction and immunological response during viral infections. Severe COVID‐19, defined by a hyperinflammatory state, is greatly impacted by underlying chronic illnesses aggravating the cytokine storm caused by increased levels of Pro‐inflammatory cytokines. Metabolic reprogramming, including increased glycolysis and altered mitochondrial function, promotes viral replication and stimulates inflammatory cytokine production, contributing to illness severity. Mitochondrial metabolism abnormalities, strongly linked to various systemic illnesses, worsen metabolic dysfunction during and after the pandemic, increasing cardiovascular consequences. Long COVID‐19, defined by chronic inflammation and immune dysregulation, poses continuous problems, highlighting the need for comprehensive therapy solutions that address both immunological and metabolic aspects. Understanding these relationships shows promise for effectively managing COVID‐19 and its long‐term repercussions, which is the focus of this review paper.
Distribution of HPV Types in Cervical Cancer in Pakistan: Implications for Screening and Vaccination Programs
Authors: Aziz Hafsa , Mehmood Humera , Arif Sarosh , Afzal Khadija , Hanif Saba , Saeed Muhammad Adnan , Faheem Mohammad 
Published: December 2024

ABSTRACTBackgroundHPV plays a key role in the development of cervical cancer. This study aims to investigate the prevalence of HPV genotypes in patients with Squamous cell carcinoma (SSC) and Adenocarcinoma (ADC) at NORI cancer Hospital Pakistan, with the aim of improving screening and prevention strategies.MethodCervical scrapings were collected from 129 diagnosed cervical cancer patients. HPV typing was performed using a real‐time PCR assay and sequencing.ResultAmong the patients, 73.6% (90/129) were HPV positive. Proportion of HPV positivity was observed within each group. The highest incidence of HPV was observed in the 50–60 years age group (80.9%), followed by the 40‐to‐50‐year group (75.8%). The positivity rate declined in the 60‐to‐70‐year‐old (63.6%) and further in the 70–80 years (62.5%). Eight different HPV subtypes were identified, with HPV 16 being the most prevalent (80.0%), followed by HPV 18 (9.5%), HPV 45 in 2 (2.1%), HPV 31 in 1 (1.1%), HPV 35 in 1 (1.1%), HPV 59 in 1 (1.1%), HPV 66 in 1 (1.1%), and HPV 89 in 1 (1.15). Histologically, 89.2% of the cases were Squamous cell carcinoma (SCC) and 10.8% were Adenocarcinomas. In SCC patients, HPV 16 was found in 80.9% of cases, while in Adenocarcinoma patients, HPV 16 was detected in 66.7% of cases.ConclusionThe prevalence of high‐risk HPV types, both vaccine and non‐vaccine, targeted in Pakistan highlights the urgent need for widespread screening and vaccination programs. Tailored public health strategies are essential to effectively reduce cervical cancer rates and mortality.
DMT1 Maintains Iron Homeostasis to Regulate Mitochondrial Function in Porcine Oocytes
Authors: Zhang Jin‐Xin , Lan Meng‐Fan , Shang Jian‐Zhou , Lai Xin‐Le , Li Li‐Shu , Duan Tong‐Tong , Xu Ru‐Hai , Chen Kun‐Lin , Duan Xing 
Published: December 2024

ABSTRACTIron plays critical roles in many cellular functions, including energy production, metabolism, and cell proliferation. However, the role of iron in maintaining oocyte quality remains unclear. In this study, DMT1 was identified as a key iron transporter during porcine oocyte maturation. The results demonstrated that iron deficiency in porcine oocyte led to aberrant meiotic progression, accompanied by increased gene expression of DMT1. Inhibition of DMT1 resulted in the failure of cumulus cell expansion and oocyte maturation, along by the abnormal actin and microtubule assembly. Furthermore, loss of DMT1 function caused disruption in mitochondrial function and dynamics, resulting in oxidative stress and Ca2+ dyshomeostasis. Additionally, the absence of DMT1 function activated PINK1/Parkin‐dependent mitophagy in porcine oocyte. These findings suggested that DMT1 played a crucial role in safeguarding oocyte quality by protecting against iron‐deficiency‐induced mitochondrial dysfunction and autophagy. This study provided compelling evidence that DMT1 and iron homeostasis were crucial for maintaining the capacity of porcine oocyte maturation. Moreover, the results hinted at the potential of DMT1 as a novel therapeutic target for treating iron deficiency‐related female reproductive disorders.
Long‐Term Changes in the Relative Humidity in Poland in 1966–2020
Authors: Krawczyk Ewelina 
Published: December 2024

ABSTRACTThe main purpose of this paper was to identify significant changes in air moisture conditions in Poland, which accompany climate warming. Meteorological data used in the research included the relative humidity (RH) values from 48 stations obtained from the Institute of Meteorology and Water Management—National Research Institute from 1966 to 2020. The monthly mean, standard deviation (SD) and coefficient of variation of RH from 12 PM for all months (with particular reference to the middle months of seasons—January, April, July and October) were used. Additionally, the dry weather (RH < 30%) frequency in the warm half of the year was observed. Long‐term changes were found by comparing relative humidity values in three 15‐year subperiods (1966–1980, 1986–2000 and 2006–2020) and the statistical significance was estimated using the Mann‐Kendall test. The most considerable long‐term changes were noticed in April and July, especially in the last 15‐year subperiod. The statistical significance was higher, mostly in warmer months. The SD was also higher in April and July than in January and October. Hence the humidity conditions in the warmer half of the year fluctuated more and more widely. A significant decrease in the RH mean values and an increase in SDs in spring and summer impact the increasing frequency of dry weather. Relations between meteorological characteristics suggest the warming climate contributes to drying the near‐surface atmosphere but also impacts intensive precipitation events or snow cover parameters. The decreasing trend of long‐term relative humidity may negatively impact the environment, human health and well‐being and cause serious economic losses.
Structure Elucidation of New Kavalactone Dimers From Alpinia zerumbet Pericarps Using NMR Calculations
Authors: Nishidono Yuto , Tanaka Ken 
Published: December 2024

ABSTRACTAlpinia zerumbet (Pers.) B.L.Burtt & R.M.Sm, known as shell ginger, is an aromatic plant widely distributed in tropical and subtropical regions. In Guizhou Province of China, its mature fruits have been used by the Miao people for the treatment of cardiovascular diseases. Although the bioactivities of mature fruits of A. zerumbet are derived from phytochemicals in the seeds and pericarps of the plant, there remains a dearth of reports on the isolation of phytochemicals from the pericarp of A. zerumbet. In the present study, the pericarps of mature fruits of A. zerumbet were extracted, and two new kavalactone dimers, alpingsin E (1) and aniba dimer D (2), were isolated. Their structures were determined on the basis of extensive spectroscopic analysis and NMR calculations. Especially, density functional theory–based NMR chemical shift calculations were employed to elucidate and confirm the relative configuration of 1 and 2.
What Are the Predictors of Acute Care Nurses' Stroke Knowledge?: Empirical Research Quantitative
Authors: Leach Catherine T. , Bolin Linda P. , Swanson Melvin S. , Burch Ashley E. , Woltz Patricia C. 
Published: December 2024

ABSTRACTAimsTo examine the predictability of categorical and quantitative study variables on acute stroke knowledge amongst study participants.DesignNon‐experimental, descriptive correlational.MethodsA convenience sample of registered nurses caring for adult, hospitalized patients recruited from the urban Southeast. A three‐part survey was emailed to the nurses: demographics, stroke education and experience, and the Acute Stroke Management Questionnaire.ResultsIntensive Care Unit and Emergency Department nurses had the highest level of stroke knowledge. Nurses reporting three or more post‐licensure education modalities had higher stroke knowledge scores than those reporting two or less. Practice setting, self‐perception of stroke knowledge, self‐identified knowledge of acute stroke management and three items related to code stroke were significantly correlated with stroke knowledge.ConclusionVarious methods of training and reinforcement of learning using varying teaching styles are effective in increasing nurses' stroke knowledge. Further stroke education is needed for nurses across the acute care setting.ImplicationsFuture studies should explore lived experiences of nurses to gain understanding of nonquantifiable factors that nurses feel have strengthened their stroke knowledge.Impact

What Problem Did the Study Address?

Addressing the gap in the knowledge of predictors of nurse stroke knowledge.

Main Findings?Practice setting, post‐licensure stroke education, code stroke familiarity, confidence and understanding were all predictive of the overall stroke knowledge.Whom Will the Research Have an Impact?Nurses, nurse educators, patients experiencing and at risk for stroke.Reporting MethodThe STROBE checklist was used to strengthen the reporting of the results.Patient or Public ContributionNurses voluntarily participated in this study by completing the online questionnaire.What Does This Paper Contribute to the Wider Global Clinical Community?

Provides predictors of stroke knowledge for nurse leaders to have a better understanding of nurses' educational needs.

Provides evidence of a quick, effective measure of nurses' stroke knowledge.
Prenatal Ultrasound in the Diagnosis of Anorectal Malformations: Correlating Prenatal Signs With Postnatal Outcomes
Authors: Huijgen D. , Versteegh H. P. , Wijnen R. M. H. , Galjaard S. , Peters N. C. J. , Sloots C. E. J. 
Published: December 2024

ABSTRACTObjectiveThis study explored prenatal ultrasound markers in patients with anorectal malformations (ARMs).MethodsAll patients treated for ARM in our institution from January 2014 to December 2021 with an available expert fetal anomaly scan (eFAS) were reviewed. The eFAS images were assessed to evaluate the fetal anus, specifically by identifying hyperechoic anal mucosa surrounded by hypoechoic anal sphincter, referred to as “target sign” (TS). Furthermore, indirect signs of ARM were assessed and correlated with postnatal clinical symptoms.ResultsOf the 115 patients treated for ARM, 32 mothers underwent eFAS. TS was assessed in 22 fetuses, of which 17 (77.3%) had an absent or abnormal TS. Of the patients with a postnatally confirmed complex type of ARM, 90% had an absent or abnormal TS. One or more indirect signs of ARM were found in 16 out of 32 fetuses (50.0%), comprising echogenic bowel (n = 3), echogenic meconium (n = 2), dilated intestines (n = 7), echo‐lucent cavity behind the urinary bladder (n = 4), abnormal external genitalia (n = 6), and polyhydramnios (n = 5).ConclusionThis retrospective cohort study provides valuable insights into the potential role of TS assessment and indirect signs in the prenatal diagnosis of ARM. Future studies should further validate our findings and elicit whether TS assessment should be incorporated into prenatal screening protocols.