bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protective Role of Jimson Weed in Mitigating Dyslipidemia, Cardiovascular, and Renal Dysfunction in Diabetic Rat Models: In Vivo and in Silico Evidence
Authors: Alum Esther U. , Krishnamoorthy Rajapandiyan , Gatasheh Mansour K. , Subbarayan Shanthi , Vijayalakshmi Periyasamy , Uti Daniel Ejim 
Published: December 2024

Background Diabetes mellitus (DM) is characterized by irregular carbohydrate, protein, and fat metabolism, leading to elevated blood glucose levels. DM patients are at a high risk of developing dyslipidemia and cardiovascular and chronic kidney diseases. This study evaluated the impact of Jimson weed on blood glucose, lipid profile, and renal indices using rat models. Methodology The rats were divided into six classes, with rats in each class receiving alloxan intraperitoneally orally twice daily for 14 days. The rats were assigned into six classes (A-F), (n = 6). Rats in classes A-E were intraperitoneally injected with 2 g of alloxan dissolved in 20 mL of distilled water (100 mg/kg body weight). Rats in class F received neither alloxan nor any form of treatment. Rats in classes A, B, and C were given 100, 200, and 400 mg/kg of Jimson weed leaf extract, while rats in class D received 5 mg/kg body weight of Glibenclamide. Rats in class E were given normal saline (0.1 mL) only. Blood glucose levels were measured using a Glucometer, and lipid profile and renal markers were assayed using approved procedures. Docking analysis targeted key proteins with potential roles in lipid dysregulation and renal dysfunction associated with diabetes. Results The study found that diabetes in the rats led to abnormalities in lipid profiles, electrolytes, urea, and creatinine serum levels. In diabetic control rats, the level of total cholesterol increased by over 216.67%, while the concentrations of triacyglycerol and low density lipoprotein also showed a similar trend. Notably, there was a reciprocal impact on the high-density lipoprotein, which decreased by a similar magnitude in diabetic controls compared to normal control rats. In the other calculated indices; atherogenic and coronary risk indices, Cl-, urea, and creatinine levels were elevated, and a decreased cardio-protective index, Na+, and K + . Jimson weed ethanol extract alleviated these impacts. The study also investigated compounds’ molecular properties and docking results targeting key proteins in lipid metabolic pathways and immune response. The compounds showed promising binding affinities to acetyl-CoA carboxylase (ACC), fatty acid synthase (FASN), 3-hydroxyl-3-methyl-glutaryl-CoA reductase (HMG-CoAR), and melanoma 2 (AIM2) proteins. Conclusion Jimson weed offers a promising option for treating T2DM, cardiovascular, and renal complications, as it exhibits hypolipidemic, cardioprotective, and renal protective properties, overcoming limitations in traditional medicines.
Genomic Effects of Biomechanical Loading in Adolescent Human Growth Plate Cartilage: A Pilot Study
Authors: Zhang Zhengpei , Boggavarapu Nageswara Rao , Muhr Laila Sara Arroyo , Garcia-Serrango Ainhoa , Aeppli Tim RJ , Nava Tobia Sebastiano , Zhao Yunhan , Gutierrez-Farewik Elena M. , Kulachenko Artem , Sävendahl Lars , Zaman Farasat 
Published: December 2024

Objective The genomic effects of biomechanical loading on human growth plate cartilage are unknown so far. To address this, we used rare human growth plate biopsies obtained from children undergoing epiphysiodesis and exposed them to precisely controlled mechanical loading using a microloading device. The biopsies were cultured 24 hours after mechanical loading, followed by RNA-sequencing analyses to decipher the genomic regulation. Design We conducted RNA-seq analysis of human growth plate cartilage obtained from three patients cultured ex vivo and subjected to cyclical mechanical loading with peak 0.4 N with frequency 0.77 Hz during a 30-second duration, using a specialized microloading device. Results Gene ontology analysis revealed novel data showing three significantly upregulated signaling pathways, including notch, oxytocin, and tight junction, and three significantly downregulated signaling pathways, including lysosome, sphingolipid metabolism, and peroxisome proliferator-activated receptor (PPAR) in human growth plate cartilage. Moreover, we found 15 significantly regulated genes within these signaling pathways from all three patients. These genes included PSEN2, HEY1, and NCOR2 from the notch signaling; CACNB1 and PPP3R2 from the oxytocin signaling; ACTR3C, WHAMM, and ARHGEF18 from the tight junction signaling; ARSA, SMPD1, and CD68 from the lysosome signaling; ARSA and SMPD1 from the sphingolipid metabolism signaling; and SLC27A4 and AQP7 from the PPAR signaling pathway. In addition, 20 significantly upregulated genes and six significantly downregulated genes shared between two patient samples were identified. Conclusion Our study provides the first-ever transcriptomic data of mechanical loading of human growth plate cartilage. These findings can potentially provide genetic targets for future investigations in physiological and pathological bone growth conditions.
Establishing Reference Ranges for Doppler Parameters of the Fetal Aortic Isthmus in the Third Trimester
Authors: Eghbali Elham , Ezzati Khatab Maghsoud , Taheripour Mahboube , Nasiroghli Khiabani Zahra , Jaberinezhad Mehran , Hemmati Ghavshough Mahdi , Khodaei Farzaneh 
Published: December 2024

Objective: This study evaluated the significance of Doppler indices of the fetal aortic isthmus in diagnosing fetal hemodynamic disorders early. The aim was to determine the Doppler values within the fetal aortic isthmus in the third trimester of pregnancy. Materials and Methods: Patients who presented with pregnancies between 28 and 40 weeks of gestation were examined for Doppler indices of the fetal aorta and compared with the gestational age. Among these, 325 normal fetuses (mean gestational age, 25 weeks) were included in the study. The correlation between Doppler indices and gestational age was evaluated using regression equations. Linear, quadratic, and cubic models were applied to all the variables. Results: Curve estimation analysis showed that peak systolic velocity ( R2 = 0.168), end-diastolic velocity ( R2 = 0.042), pulsatility index ( R2 = 0.101), and time-averaged maximum velocity ( R2 = 0.090) correlated with gestational age (cubic model, p < .001). However, S/D, resistance index, and isthmic systolic index were not significantly correlated with gestational age. Notably, the R2 values were low for all variables. Conclusion: In this fetal cohort, the suggested normal reference values for Doppler indices based on gestational age in the third trimester of pregnancy were determined.
Preparation of dental and nursing professionals within Swedish higher education: navigating to confidence in literacies and professional knowledge
Authors: Christidis Nikolaos , Tomasson Jakob , Rataghi Armin , Christidis Maria 
Published: December 2024

Abstract
Background
The professional education of dentists and nurses includes literacy, academic and professional literacy, and professional knowledge. These have a reciprocal relationship and contribute to the development of students and professionals. However, this is an area in need of further exploration. Therefore, this study aimed to investigate dentists’ and nurses’ experiences of academic and professional literacy and professional knowledge at the time of their graduation, and five years into their profession.

Methods
The material consisted of an evaluation distributed twice to dentists and nurses. The first time was immediately after graduation (degree evaluation), and the second time was five years after graduation (alum evaluation). Approximately 30% of the dentists and the nurses responded both times. We analyzed the data using non-parametrical methods.

Results
Upon graduation, the dentists scored high in academic and professional literacy and knowledge. Five years into the profession, dentists reported experiencing challenges with communication in English and tasks related to equitable treatment and equal rights. Nurses followed a similar pattern as the dentists. Still, by graduation, the newly graduated nurses expressed concerns about communication in English, and promoting sustainable development within their profession. The challenges persisted five years into their profession, particularly in areas such as communication in English and sustainable development, as well as work related to equitable treatment and equal rights.

Conclusions
The level of confidence and perception of a sufficient degree of knowledge regarding academic literacy, professional literacy, and professional knowledge is higher at the time of graduation in both professions compared to five years into the profession, where there is a decrease in areas concerning work related to equitability, and equality, and for dentists also in communication in English. Furthermore, nurses had a constant low confidence rating in both evaluations concerning sustainable development and communication in English. This indicates that targeted and continuous professional development is crucial to address these challenges and to bridge the gap between the knowledge and confidence levels at graduation and the evolving demands of professional practice over time. Thus, when reconstructing the overall curriculum in professional educations it is of great importance to provide tools to enhance future professional development rather than the perception of that they can rely solely on their education at graduation time.
Vertebral artery dissection presenting as vertigo–a rare case presentation in a young adult
Authors: Yuniarti Mira , Andaka Deddy , Octavius Gilbert Sterling 
Published: December 2024

Abstract
Background
Vertebral artery dissection (VAD) is a rare condition, especially in young adults, with an annual incidence of about 1–1.5 per 100,000 people. This case report aims to present an unusual case of vertigo in an early 30s male, initially assumed to be due to travel sickness but was later proven to be vertebral artery dissection.
Case presentation: The patient reported dizziness, nausea, facial numbness, and a sore throat following travel and a massage. His medical history included no significant trauma, though he was an active boxer. Physical examination revealed vertical and horizontal nystagmus, but motor strength remained normal. A non-contrast CT scan revealed basilar artery dolichoectasia, and subsequent MRI confirmed a left VAD. The dissection was located in the fourth vertebral artery segment, a typical location for such cases. The patient was managed conservatively with anticoagulants and discharged with no new symptoms. VAD is an uncommon cause of vertigo, and its presentation in young adults without severe trauma is rare. However, subtle traumas, such as those experienced in contact sports or even minor cervical manipulation, may predispose individuals to this condition.

Conclusions
This case underscores the importance of thorough diagnostic evaluation for patients presenting with vertigo, as VAD can lead to life-threatening complications such as stroke. Early recognition and appropriate management are essential for a favorable prognosis​.
Trends and associated factors of mental health diagnoses in Catalan Primary Care (2010–2019)
Authors: Mas Ariadna , Clougher Derek , Anmella Gerard , Valenzuela-Pascual Clàudia , De Prisco Michele , Oliva Vincenzo , Fico Giovanna , Grande Iria , Morilla Ivette , Segú Xavier , Primé-Tous Mireia , Ruíz Victoria , Also María Antonieta , Murgui Sandra , Sant Elisenda , Sans-Corrales Mireia , Fullana Miquel Àngel , Sisó-Almirall Antoni , Radua Joaquim , Blanch Jordi , Cavero Myriam , Vieta Eduard , Hidalgo-Mazzei Diego 
Published: December 2024

Abstract

Background
The prevalence of mental health disorders has significantly increased in recent years, posing substantial challenges to healthcare systems worldwide, particularly primary care (PC) settings. This study examines trends in mental health diagnoses in PC settings in Catalonia from 2010 to 2019 and identifies associated sociodemographic, clinical characteristics, psychopharmacological treatments, and resource utilization patterns.

Methods
Data from 947,698 individuals without prior severe mental illness, derived from the Data Analytics Program for Health Research and Innovation (PADRIS), were analyzed for this study. Sociodemographic data, diagnoses, and resource utilization were extracted from electronic health records. Descriptive statistics, chi-square tests, Mann–Whitney tests, and a multivariate binary logistic regression were employed to analyze the data.

Results
Over the study period, 172,112 individuals (18.2%) received at least one mental health diagnosis in PC, with unspecified anxiety disorder (40.5%), insomnia (15.7%) and unspecified depressive disorder (10.2%) being the most prevalent. The prevalence of these diagnoses increased steadily until 2015 and stabilized thereafter. Significant associations were found between mental health diagnoses, female sex, lower socioeconomic status, higher BMI, and smoking status in a multivariate binary logistic regression.

Conclusions
This study highlights a growing burden of stress-related mental health diagnoses in PC in Catalonia, driven by demographic and socioeconomic factors. These findings may be indicative of broader trends across Europe and globally. Addressing this rising prevalence requires innovative approaches and collaborative strategies that extend beyond traditional healthcare resources. Engaging stakeholders is essential for implementing effective, sustainable solutions that promote mental health in Catalonia and potentially inform similar initiatives worldwide.
Aldosterone Synthase Inhibitors: A Revival for Treatment of Renal and Cardiovascular Diseases
Authors: Azizi Michel , Riancho Julien , Amar Laurence 
Published: December 2024

Abstract
Inappropriate aldosterone excess plays a key role in the pathophysiology of various cardiovascular, endocrine, and renal diseases. Mineralocorticoid receptor antagonists (MRAs) such as spironolactone block of the harmful effects of aldosterone and are recommended treatment in these various conditions. However, the sexual adverse effects of spironolactone from its lack of specificity for the mineralocorticoid receptor and the risk of hyperkalemia in patients with decreased renal function, limit its use. While eplerenone is a more selective MRA, it is less potent than spironolactone. Newer nonsteroidal MRAs, though promising, are either unavailable globally or still under development. Moreover, aldosterone exerts both genomic and nongenomic effects, the latter not fully blocked by MRAs. Aldosterone synthase inhibitors (ASIs) have thus emerged as potential alternatives to MRAs, though the development of selective ASIs has been challenging. This is due to the close homology between the final step of aldosterone synthesis, mediated by CYP11B2 in the zona glomerulosa of the adrenal cortex, and cortisol synthesis, mediated by CYP11B1 in the zona fasciculata. Despite these challenges, new ASIs have demonstrated high in vitro as well as in vivo selectivity for CYP11B2, effectively reducing aldosterone production without affecting cortisol synthesis in humans across large dose ranges. Early phase II trials demonstrated that these ASIs decrease (1) blood pressure in uncontrolled hypertension and (2) urinary albumin excretion in proteinuric chronic kidney disease. Further longer term trials will evaluate their efficacy in lowering blood pressure as well as in reducing kidney disease progression and cardiovascular outcomes in heart failure when given alone or in combination with SGLT2 inhibitors.
Prevalence of Psychiatric Comorbidities in Females With Classic Congenital Adrenal Hyperplasia
Authors: Khorashad Behzad Sorouri , Kaabi Oumaima , Gardner Melissa D , Getahun Darios , Goodman Michael , Lash Timothy L , Lee Peter A , May Joshua , McCracken Courtney , Muzik Maria , Vupputuri Suma , Yacoub Rami , Sandberg David E 
Published: December 2024

Abstract

Context
Although the increased burden of mental health problems among patients with classic 46,XX congenital adrenal hyperplasia (CAH) is well-documented, it remains unclear if this comorbidity is attributable to the burden of living with a chronic medical condition or the potential psychosocial/sexual consequences of being born with a difference of sex development (DSD) and its associated clinical management.

Objective
To compare the prevalence of psychiatric diagnoses among patients with CAH and 3 reference groups: matched males and females from the general population, and females with type 1 diabetes mellitus (T1DM).

Methods
This was a retrospective cross-sectional study using 3 large integrated health systems. Participants included patients with CAH (n = 115), general population male and female referents (n = 1150 per group), and 66 002 female T1DM referents.

Results
The prevalence of depression, anxiety, personality disorders, and suicidal ideation was higher among CAH participants than in males and females from the general population, but similar to or lower than in T1DM referents. Patients with CAH were more likely to be diagnosed with neurodevelopmental disorders than both female reference groups, whereas the prevalence of elimination disorders (predominantly enuresis) and gender dysphoria was higher in the CAH cohort than in all reference groups.

Conclusion
Females with classic CAH experience a higher burden of psychiatric illness, including anxiety and depression, than demographically similar men and women in the general population. The similar psychiatric burden between females with CAH and T1DM suggests that morbidity may be influenced by the challenges associated with managing a chronic condition. Investigating long-term mental health trajectories in this population will require longitudinal studies.
A Research Roadmap to Address the Heterogeneity of Diabetes and Advance Precision Medicine
Authors: Franks Paul W , Rich Stephen S , Linder Barbara , Zaghloul Norann A , Cefalu William T 
Published: December 2024

Abstract
The current classification of diabetes had its genesis over 85 years ago, when individuals with diabetes were first subclassified into insulin sensitive and insulin insensitive states based on the response to an oral glucose tolerance test. About 35 years later, the contemporary classifications of type 1 and type 2 diabetes were coined. Today's evidence, however, suggests that multiple etiologic and pathogenic processes lead to both type 1 and type 2 diabetes, reflecting significant heterogeneity in factors associated with initiation, progression, and clinical presentation of each disorder of glucose homeostasis. Further, the current classification fails to recognize what is currently defined as “atypical” diabetes. Heterogeneity of diabetes continues through the life-course of an individual, with modification of prognosis risk (eg, diabetic complications) altered by genetics, life experience, comorbidities, and therapy. Understanding the sources of heterogeneity in diabetes will likely improve diagnosis, prevention, treatment, and prediction of complications in both the medical and public health settings. Such knowledge will help inform progress in the emerging era of precision diabetes medicine. This article presents NIDDK's Heterogeneity of Diabetes Initiative and a corresponding roadmap for future research in type 2 diabetes heterogeneity.
A Nested Case–Control Study of Adverse Outcomes in Children With Diabetic Ketoacidosis
Authors: Yousif Maha F , Dolak Katie D , Adhikari Soumya , White Perrin C 
Published: December 2024

Abstract

Context
Adverse outcomes (death or intensive care unit [ICU] stays longer than 48 hours) in children with diabetic ketoacidosis (DKA) or hyperglycemic–hyperosmolar syndrome (HHS) can be predicted by a composite risk score based on severity of hyperglycemia and acidosis, and presence of type 2 diabetes.

Objective
Because most high-risk patients nevertheless do not experience an adverse outcome, we tried to identify differences in management or other clinical characteristics that influenced outcomes.

Methods
In a previously defined group of 4565 admissions for DKA-HHS in 2010-2023, 109 had adverse outcomes. We conducted a nested case–control study using the composite risk score to match 84 cases from the adverse outcome group with an equal number of controls without or with briefer ICU stays of 0 to 24 hours.

Results
The groups did not differ in risk score or initial pH, maximum blood glucose, or proportion with type 2 diabetes. However, the case group had more patients with new-onset diabetes and higher initial serum sodium and blood urea nitrogen. The case group had slower resolution of hyperglycemia, acidosis, and hypernatremia. The groups did not differ in total administered fluid bolus volumes, total fluid volumes, or urine output at 12 and 24 hours. Total insulin received did not differ between groups after 12 hours, but cases were more likely to still require intravenous insulin at 24 hours.

Conclusion
Hypernatremia is more likely to be present at admission and to persist over the first 24 hours of treatment in children with DKA-HHS who have adverse outcomes. This is not associated with differences in management.
The Wound Care Pathway: a Danish effect study
Authors: Jensen Merete Hartun , Landauro Malene Hornbak , Hansen Marianne 
Published: December 2024

The Wound Care Pathway (WCP) is a five-step guide to wound healing that was developed to overcome the challenges generalist nurses face during wound management. Aims: To investigate how the implementation and training in the WCP affects the behaviour of generalist nurses, focusing on four specific endpoints: motivation, confidence, critical thinking and knowledge. Methods: A total of 89 generalist nurses received 6 hours of training in the WCP, over a period of 10–16 weeks. The participants filled a questionnaire before and after the training. Data were collected between January 2023 and January 2024. Findings: There was a significant improvement in the participants' wound care knowledge, motivation and self-efficacy. The participants' confidence in their wound care skills also increased after the training. A notable improvement was seen in nurses' critical thinking when treating wounds and delivering wound care. Conclusions: The WCP guide supports healthcare professionals in their day-to-day work and strengthens their critical thinking and knowledge of wound care management.