bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytokine modulation in pelvic organ prolapse and urinary incontinence: from molecular insights to therapeutic targets
Authors: Chen Yongxiu , Ullah Amin , Chen Weifang , Xuan Jianyan , Huang Xiaowen , Liang Shiqi , Shen Bairong , Wu Tingfeng 
Published: November 2024

AbstractPelvic organ prolapse (POP) and urinary incontinence (UI) are common disorders that significantly impact women’s quality of life. Studies have demonstrated that cytokines, including pro- and anti-inflammatory immune mediators, play a role in illness genesis and progression. Research on the inflammatory milieu of the pelvic floor has shown that POP patients have increased inflammation in vaginal tissues. This evidence revealed that significant changes in the inflammatory milieu of the pelvic floor are an aspect of the pathogenesis of POP. POP patients exhibit increased levels of inflammatory cytokines (IL-1, TNF, IFN, and others) in the front vaginal wall, which may alter collagen metabolism and contribute to POP. Studies indicate that cytokines such as IL-6, IL-10, and TGF, which are involved in inflammation, remodelling, and repair, have dual effects on POP and UI. They can promote tissue healing and regeneration but also exacerbate inflammation and fibrosis, contributing to the progression of these conditions. Understanding the dual roles of these cytokines could help us improve the vaginal microenvironment of women and treat POP and UI. Given the considerable changes in these cytokines, this review addresses studies published between 2000 and 2024 on the molecular mechanisms by which pro- and anti-inflammatory cytokines affect women with POP and UI. Furthermore, we explain novel therapeutic strategies for cytokine regulation, emphasizing the possibility of personalized treatments that address the underlying inflammatory milieu of the vagina in POP and UI patients. This thorough analysis aims to establish a foundation for future research and clinical applications, ultimately improving patient outcomes via designed cytokine-based therapies.
Electroencephalography based delirium screening in acute supratentorial stroke
Authors: Hermann Gesine , Baumgarte Friederike , Welzel Julius , Nydahl Peter , Kuhlenbäumer Gregor , Margraf Nils Gerd 
Published: November 2024

Abstract
Background
Up to 25% of patients suffering from an acute stroke are diagnosed with delirium during the hospital stay, with older age increasing the risk. Generalized slowing in the electroencephalogram (EEG) supports the diagnosis of delirium. We examined the potential of single-channel EEG (DeltaScan®) as an easy-to-use device on intensive care units for detecting delirium. Our aim was to investigate characteristics of bihemispheric EEG recordings and single-channel EEG in patients suffering from strokes with and without delirium and to analyze the diagnostic accuracy of EEG-based diagnoses.

Methods
Within the first five days after stroke onset, patients received single-channel EEG DeltaScan® and a routine 21-channel EEG. The DeltaScan® analyzes right sided fronto-parietal EEG using a proprietary algorithm focusing on polymorphic delta activity (PDA). In routine EEG the power spectral density (PSD) in predefined frequency bands was analyzed based on 2-minute eyes-closed resting state segments. EEG-analyses were conducted in MNE (v1.3.1) in Python (3.10) and RStudio (v4.2.1).

Results
In 9 of 53 patients (52–90 years) delirium was diagnosed according to DSM-V criteria. Sensitivity of DeltaScan® was 44% (95% CI = 15.3–77.3%), while specificity was 71% (95% CI = 57–83%). We found patients with right hemispheric stroke having a higher probability to be false positive in DeltaScan® (p = 0.01). The 21-channel EEG based power analysis revealed significant differences in frontal delta and theta power between patients with and without delirium (p < 0.05).

Conclusions
When EEG is used in clinical practice to support a delirium diagnosis in stroke patients, bihemispheric recordings are likely preferable over unilateral recordings. Slowing in the delta- or theta-frequency spectrum over the site of stroke may lead to false-positive results in single channel EEG based delirium scoring.
Measurements of traditional Chinese medicine health literacy regarding chronic pain: a scoping review
Authors: Qian Zhiyi , Wang Grace Y , Henning Marcus , Chen Yan 
Published: November 2024

AbstractChronic pain is a prevalent health condition that imposes a significant burden on the global health system. Health literacy is a determinant of the quality of pain management which directly impacts public and individual health. However, the existing health literacy measurements have predominantly focused on medical models stemmed from Western culture and the knowledge of non-Western health models has largely been neglected. This review scopes refereed health literacy publications with regard to traditional Chinese medicine and chronic pain to explore and identify 1) the conceptual basis underlying the development of traditional Chinese medicine health literacy in this area, and 2) measurement tools used in this area and their associated psychometric qualities. Twenty-eight journal articles were assessed and the results showed that most studies’ conceptual frameworks were unable to cover three key health literacy aspects defined by the World Health Organization (access, understand, and apply). Furthermore, the identified health literacy measurement tools generally lacked rigorous psychometric evaluation. Future studies should focus on exploring a comprehensive model that encompasses various health models and developing measurement tools with more culturally representative psychometric assessments.
Trends in the practice environment of Chinese healthcare professionals from 2008 to 2023: an age period cohort analysis
Authors: Lin Liangquan , Che Yi , Zhou Jiaxin , Gui Yixin , Zhang Xinqing 
Published: November 2024

Abstract
Background
Healthcare practice environment plays a vital role in evaluation and the development of health sector in China. However, there are few comprehensive reviews and studies focusing on its state and changing trends. This study aimed to examine the dynamic trends in Chinese healthcare professionals’ perceptions of their practice environment from 2008 to 2023 using age period cohort (APC) analysis.

Methods
Four national cross-sectional surveys of healthcare professionals were conducted in 2008, 2013, 2018, and 2023. APC analysis was performed to distinguish effects of age, period and cohort. Covariates like gender, department, job satisfaction, and doctor–patient relationships were also analyzed.

Results
Between 2008 and 2023, healthcare professionals' perceptions of their practice environment first declined and then improved. Those aged 28–38 during 2013–2018 and born between 1978 and 1988 had the most negative perceptions. After 2018, perceptions improved, peaking in 2023. Those under 23 and over 43 exhibited larger age effects. Birth cohorts after 1993 also had more positive effects. Controlling for covariates attenuated APC effects. Females, those in obstetrics and emergency medicine, nurses, technicians, and administrators perceived better environments. Higher job satisfaction and doctor–patient relationship harmony are also associated with more positive perceptions. Income matching efforts and perceptions of promotion fairness had positive impacts, while increasing severity of physical fatigue and psychological anxiety negatively influenced perceptions of the practice environment.

Conclusions
The APC analysis provided nuanced insights into evolving practitioner perceptions amid healthcare reforms in China. Tailored policies focused on career stage and generation are needed to address disruptions and sustain improvements. Monitoring feedback on reforms and changes is essential for optimizing the practice environment over time.
Evaluation of the MAGLUMI HIV Ab/Ag combi test for the detection of HIV infection
Authors: Wang Chunling , Rao Jie , Fang Zhonggang , Zhang Hongwei , Yin Jun , Li Tinghua , Zhang Chen 
Published: November 2024

Abstract
Background
Human immunodeficiency virus (HIV) infection screening and diagnosis are critical to control the HIV epidemic. Testing for anti-HIV antibodies (Ab) and antigens (Ag) in blood samples is the first step to screen people who have been potentially exposed to the virus. This study aimed to evaluate the performance of the MAGLUMI HIV Ab/Ag Combi for detection of HIV antibodies and antigens.

Methods
We used residual samples to assess the diagnostic specificity and sensitivity of the MAGLUMI HIV Ab/Ag Combi retrospectively. All samples that met the test criteria were tested with the MAGLUMI HIV Ab/Ag Combi according to manufacturer’s instruction. Results of the MAGLUMI HIV Ab/Ag Combi were compared with the Architect HIV Ag/Ab Combo test.

Results
The specificity of the MAGLUMI HIV Ab/Ag Combi was 99.85% in 5,057 unselected blood donors and 100.00% in 213 hospitalized patient samples, respectively. The sensitivity of the Test in 614 HIV-1 Ab, HIV-1 Ag or HIV-2 Ab positive samples was 100.00%. Seroconversion sensitivity from results of 30 panels was comparable between the MAGLUMI HIV Ab/Ag Combi and the Architect assay.

Conclusions
The reactivity of the MAGLUMI HIV Ab/Ag Combi test is comparable to the Architect HIV Ag/Ab Combo assay.
Bilateral erector spinae plane block on opioid-sparing effect in upper abdominal surgery: study protocol for a bi-center prospective randomized controlled trial
Authors: Geng Changzhen , Wang Li , Shi Yaping , Shi Xinnan , Zhao Hanyi , Huang Ya , Ji Qiufang , Dai Yuanqiang , Xu Tao 
Published: November 2024

Abstract
Background
Erector spinae plane block (ESPB) is a promising technique for effective analgesia. It is still uncertain if ESPB offers the same opioid-sparing effect as thoracic paravertebral block (PVB) in midline incision for upper abdominal surgery.

Methods
The study is a prospective, bi-center, randomized, controlled, non-inferior trial. One hundred fifty-eight patients scheduled for upper abdominal surgery will be randomly assigned to receive bilateral ESPB or PVB before surgery. The primary outcome will be the equivalent cumulative analgesia dosage of sufentanil during the surgery, which is defined as the total dosage of sufentanil from anesthesia induction to tracheal extubation. The main secondary outcomes include postoperative complications and the quality of recovery-15 score at 24 h, 48 h, and 30 days after surgery.

Discussion
This study will assess the opioid-sparing efficacy of ESPB and PVB, complications, and the quality of recovery of two blocks.

Trial registration
ChiCTR2300073030 (https://www.chictr.org.cn/). Registered on 30 June 2023.
Improvement of osteogenic differentiation potential of placenta-derived mesenchymal stem cells by metformin via AMPK pathway activation
Authors: Manochantr Sirikul , Meesuk Ladda , Chadee Nuengruethai , Suwanprateeb Jintamai , Tantrawatpan Chairat , Kheolamai Pakpoom 
Published: November 2024

Abstract
Background
Placenta-derived human mesenchymal stem cells (PL-MSCs) have gained a lot of attention in the field of regenerative medicine due to their availability and bone-forming capacity. However, the osteogenic differentiation capacity of these cells remains inconsistent and could be improved to achieve greater efficiency. Although metformin, a widely used oral hypoglycemic agent, has been shown to increase bone formation in various cell types, its effect on osteogenic differentiation of PL-MSCs has not yet been investigated. Therefore, the objective of this study was to examine the effect of metformin on the osteogenic differentiation capacity of PL-MSCs and the underlying mechanisms.

Methods
The PL-MSCs were treated with 0.5 to 640 µM metformin and their osteogenic differentiation capacity was examined by an alkaline phosphatase (ALP) activity assay, Alizarin red S staining and expression levels of osteogenic genes. The role of adenosine 5′-monophosphate-activated protein kinase (AMPK) signaling in mediating the effect of metformin on the osteogenic differentiation capacity of PL-MSCs was also investigated by determining levels of phosphorylated AMPK (pAMPK)/AMPK ratio and by using compound C, an AMPK inhibitor.

Results
The results showed that 10–160 µM metformin significantly increased the viability of PL-MSCs in a dose- and time-dependent manner. Furthermore, 80–320 µM metformin also increased ALP activity, matrix mineralization, and expression levels of osteogenic genes, runt-related transcription factor 2 (RUNX2), osterix (OSX), osteocalcin (OCN) and collagen I (COL1), in PL-MSCs. Metformin increases osteogenic differentiation of PL-MSCs, at least in part, through the AMPK signaling pathway, since the administration of compound C inhibited its enhancing effects on ALP activity, matrix mineralization, and osteogenic gene expression of PL-MSCs.

Conclusions
This study demonstrated that metformin at concentrations of 80–320 μM significantly enhanced osteogenic differentiation of PL-MSCs in a dose- and time-dependent manner, primarily through activation of the AMPK signaling pathway. This finding suggests that metformin could be used with other conventional drugs to induce bone regeneration in various bone diseases. Additionally, this study provides valuable insights for future osteoporosis treatment by highlighting the potential of modulating the AMPK pathway to improve bone regeneration.
Advancements in ecological assets and ecological product supply: in-depth insights from Karst World Heritage sites
Authors: Liu Qiangqiang , Xiong Kangning , Chen Yue , Feng Mingjun 
Published: November 2024

Abstract
Ecological assets (EA) are fundamental to the supply of ecological products (EP). They underpin the provision of ecological functions by ecosystems, their existence, and health. However, a comprehensive assessment of EA and the supply of EP remains lacking. This study employs the Systematic Literature Review (SLR) method and identifies 215 relevant articles from the Scopus database. The study: (1) Analyzes selected literature by publication years, research themes, geographical distribution, affiliations, and stages. (2) Summarizes key advances and significant achievements in domestic and international research. (3) Formulates six critical scientific questions and provides recommendations based on the current status and characteristics of EA and the supply of EP in Karst World Heritage (WH) Sites. This study furnishes research insights for practitioners and policymakers in the field, contributing to the sustainable development of ecosystems in Karst WH Sites.
Porcine ear necrosis in nursery piglets is preceded by oral manipulations of the ear
Authors: Malik Mateusz , Chiers Koen , Chantziaras Ilias , Maes Dominiek 
Published: November 2024

Abstract
Background
Porcine ear necrosis (PEN) is characterized by dry crusts on the ear tip. The crusts often progress to moist and bloody lesions and may lead to partial loss of the ear tissue. The cause and pathophysiology of PEN are unknown. Skin infections, systemic infections, or ear biting have been suggested as a cause of PEN, but no proper evidence has been shown. The behavioural factor has not yet been investigated, therefore this study evaluated the importance of oral manipulations in the occurrence of PEN in nursery pigs. Three farms affected by PEN were visited weekly, and the prevalence and severity were recorded. Video recordings of the animals were performed, and the behaviour was evaluated. The presence of pathogens in the lesions and histological alterations were also analysed.

Results
The highest percentage of pigs with PEN lesions in the farms ranged between 58 and 93%, with most lesions being of mild to moderate severity. The first ear lesions occurred about 1–2 weeks after an increase in the number of ear manipulations in the pens. The frequency of the ear manipulations clearly changed over time, and the number of oral ear manipulation behaviour significantly differed (P < 0.05) between pigs in pens with high and low PEN prevalence. Increased ear manipulation behaviour was significantly related to a subsequent increase in PEN lesions (OR = 4.3; P < 0.001). Metagenomic investigation of lesion scrapings revealed a variety of pathogens mostly with low abundance, where microscopic alterations were found mainly in the epidermis.

Conclusions
Oral manipulation of the ear pinnae by pen mates was followed by the development of PEN lesions one to two weeks later. This suggests that the behaviour played an important role in the PEN lesions formation in the nursery pigs of the three farms. Bacteria found in PEN lesions most probably were secondary to initial external skin damage, but their relevance needs to be investigated further.
Confirming non-endemicity of podoconiosis in Guatemala and in Idukki District in Kerala (India): a comparison of two approaches potentially suitable for other neglected tropical diseases
Authors: Simpson Hope , Trueba Mei , Mendizábal-Cabrera Renata , George Sobha , Tomy Chitra , Sasi Silpa T. , Kartal Aran , Deribe Kebede , Panicker Kottarathil Narayanpillai Parameswa , Davey Gail 
Published: November 2024

Abstract
Background
Podoconiosis is an underreported lymphoedema whose distribution is uncertain at global level and within endemic countries. Previous work has identified countries with historical evidence of podoconiosis, but which do not currently report cases. Podoconiosis may persist in these countries or have been eliminated due to socioeconomic development. Here we describe two different approaches used to clarify podoconiosis endemicity status in Guatemala and in Idukki District (Kerala State, India).

Methods
Two different epidemiological approaches were used by different research teams, determined by the available resources and contextual factors in the two settings. In Guatemala, where lymphoedema cases are routinely recorded in the health information system, 102 municipalities with suspected cases, historical evidence of podoconiosis, high poverty rates, or environmental suitability for the disease were visited. Active case searches were conducted from July 2016 to October 2018, and suspected cases were clinically examined to confirm or rule out podoconiosis. In Idukki, where lymphoedema cases were not routinely recorded, a population-based prevalence survey for lymphoedema was conducted from September to December 2022, covering 13,664 individuals aged 15 years and older.

Results
Both approaches were effective at clarifying podoconiosis endemicity. In Guatemala, 20 cases with lower limb swelling were investigated. Podoconiosis was ruled out in all cases, and filarial lymphoedema was suspected in three. In Idukki District, 105 cases of lower limb swelling were identified. None was confirmed to have podoconiosis, with post-surgical lymphoedema and hypertension being the most common diagnoses. Active filarial infection was identified in two cases in Idukki District.

Conclusions
These investigations provide evidence that podoconiosis is currently non-endemic in Guatemala and in Idukki District in India. They also demonstrate that population-based surveys and targeted case searches both provide effective ways to explore disease endemicity in areas where this is uncertain. The most appropriate approach depends on a combination of contextual and research-based factors, including evidence for endemicity, resources available, and geographical, population, and health system factors.
Timing Matters: A Comprehensive Meta-Analysis on the Optimal Period for Cranioplasty After Severe Traumatic Brain Injury
Authors: Palavani Lucca B. , Ferreira Márcio Yuri , Camerotte Raphael , Mitre Lucas Pari , Piason Lucas , Andreão Filipi Fim , Pereira Anna Luiza , Monteiro Ruy , de Amorim Robson Luis Oliveira , Bertani Raphael , Paiva Wellingson 
Published: November 2024

BACKGROUND AND OBJECTIVES:
Craniectomy is a commonly performed procedure in severe traumatic brain injury (TBI) to control intracranial hypertension and reduce mortality. The optimal timing for cranioplasty after craniectomy remains a topic of debate. The aim of this study was to investigate the ideal timing for cranioplasty after severe TBI, focusing on complications associated with temporal aspects and materials used in cranioplasty.

METHODS:
Multiple databases, including PubMed, Embase, Cochrane, and Web of Science, were searched for studies reporting on the subject. Inclusion criteria involved randomized and observational studies comparing early and late cranioplasty procedures. Quality assessment was performed using the Methodological Index for Non-Randomized Studies scale. Results were pooled in a single-arm meta-analysis and presented as mean and 95% confidence interval.

RESULTS:
Early cranioplasty was associated with a lower likelihood of subdural effusion (odds ratio [OR] 0.3735 [0.1643; 0.8490], P = .0187). However, no differences were detected for the presence of infection between both groups (OR 0.7460 [0.2065; 2.6945], P = .6548). Cranioplasties performed within or equal to 3 months from the TBI incident were associated with a reduced likelihood of minor complications (OR 0.4471 [0.2467; 0.8102], P = .0080). Paradoxically, this time frame exhibited an elevated risk of hydrocephalus (OR 3.2035 [1.4860; 6.9059], P = .0030), as well as total complications (OR 1.4190 [1.0453; 1.9262] P = .0248).

CONCLUSION:
This comprehensive review highlights the current lack of consensus on the optimal timing for cranioplasty after severe TBI. Early cranioplasty, within 35 days, showed a reduced risk of subdural effusion, but no disparity in the odds of infection was found. A reduced incidence of minor complications was observed in the earlier approach, however with an elevated risk for hydrocephalus and total complications. The association between timing and complications, including hydrocephalus, highlights the need for further research and standardization in this critical aspect of TBI management.