bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immune checkpoint Inhibitor related myocarditis reported through the FDA adverse event reporting system: pharmacovigilance trends in reporting and outcomes
Authors: Reeves David J. , Leffers Kevin , Rao Vijay U. 
Published: February 2025

IntroductionAs the use of immune checkpoint inhibitors (ICIs) continues to expand, it is important to be mindful of rare but serious side effects such as myocarditis. Multiple analyses of adverse effect databases have demonstrated an association between ICIs and myocarditis; however, given the rapid implementation of therapeutic use, introduction of multiple new ICIs, and expanding indications, it is unclear if trends are evolving in reporting and outcomes.MethodsWe analyzed the FDA Adverse Event Reporting System to investigate the association between ICIs and myocarditis and trends in myocarditis outcomes among reports submitted between 2012 and the first quarter of 2023.ResultsAfter removal of duplicate cases, 1,326 myocarditis cases were reported to the database in patients receiving ICIs. Of these, the majority of reported cases were in males (62%) and the median age was 69 years. Consistent with the increase in utilization, the number of cases reported per year increased with each passing year. The reporting odds ratio (ROR) for all ICI drugs included in the analysis was 30.1 (95% confidence interval: 28.4-32.0). RORs for the individual drugs ranged from 12.3 for durvalumab to 168.5 for nivolumab/ relatlimab. The overall fatality rate of all cases was 37%. A significant difference in fatality rate among reported cases was present when comparing outcomes in 2018 and 2022 (45% vs 33%, respectively, p=0.017).DiscussionMyocarditis continues to be associated with immune checkpoint inhibitors, with the number of reported cases increasing consistent with increasing utilization; however, the outcomes may be improving with less cases being reported as fatal.
Bibliometric analysis: a study of the microenvironment in cervical cancer (2000-2024)
Authors: Zhang Yun-Tao , Wei Yan-Ni , Liu Chen-Chen , Yang Mai-Qing 
Published: February 2025

ObjectiveThe incidence of cervical cancer has increased in recent years. The tumor microenvironment (TME) is the local biological environment involved in tumor occurrence and development. This study aimed to conduct a comprehensive analysis of the global research on the TME in cervical cancer (CC), providing a knowledge framework in this field from a holistic and systematic perspective based on a bibliometric analysis.MethodsStudies focusing on the TME in cervical cancer were searched using the Web of Science Core Collection database. The annual output, cooperation, hotspots, research status, and development trends in this field were analyzed using bibliometric softwares (VOSviewer and CiteSpace).ResultsA total of 1,057 articles published between 2000 and 2024 were selected. The number of publications and citations has recently increased. Cooperation network analysis indicated that China holds the foremost position in research on the TME in cervical cancer with the highest volume of publications, thus exerting the greatest influence. Fudan University had the highest output. Frontiers in Oncology showed the highest degree of productivity in this field. Rofstad, Einar K. made the most article contributions and was the most co-cited author. Four clusters were obtained after a cluster analysis of the keywords: TME, cervical cancer, immunotherapy, and prognosis. Immunotherapy, human papillomavirus, and biomarkers were relatively recent keywords that attracted increasing attention from researchers.DiscussionThis bibliometric analysis provides a data-based and objective introduction to the TME of cervical cancer, and offers readers a valuable reference for future research.ConclusionsComprehensive research in this field was mainly distributed in the TME of cervical cancer through the analysis of keywords and documents. Sufficient evidence supports mechanism research and application exploration. Further research should explore new topics related to the TME of cervical cancer.
Case Report: Ultralow-field portable MRI improves the diagnosis of congenital hydrocephalus
Authors: Groteklaes Anne , Dresbach Till , Born Markus , Mueller Andreas , Sabir Hemmen 
Published: February 2025

IntroductionCongenital hydrocephalus is an increasing condition both in high as in low and middle income countries. Main causes include aqueductal stenosis, neonatal central nervous system infections, intracranial hemorrhage, malformations and tumors. Investigation of its etiology should include magnetic resonance imaging (MRI) to detect especially pathologies of the fossa cranii posterior. However, MRI is not available to every infant presenting with congenital hydrocephalus especially in those countries with the highest prevalence. New portable ultralow-field MRI (ULF) allows low resource and bedside imaging and thus widens the access to MRI for those infants. This study presents two cases of newborns with congenital hydrocephalus who underwent ULF scanning revealing a tumor of the fossa cranii posterior as cause of hydrocephalus. This study shows that ULF scanning allows to detect and characterize brain tumors as well as metastases.Setting and patientsIn this case report, we present two cases of newborns antenatally diagnosed with hydrocephalus with no further pathology detected in repeated cranial ultrasound and, in one case, fetal MRI. We performed ULF imaging using a portable 0.064T MRI during natural sleep and high-field 3T MRI to investigate the etiology of congenital hydrocephalus in these infants.Main resultsULF imaging revealed a tumor of the fossa cranii posterior in both cases. MRI signalling detected in ULF imaging was specific for each tumor (ATRT, low grade glioma). In one case, ULF imaging also detected intracerebral metastasis.ConclusionsWe demonstrated that ULF imaging is able to detect tumors of the fossa cranii posterior that are not detected on ultrasound and shows their specific MR-signalling as well as detect metastasis. Additionally, compared to 3T MRI, ULF MRI was able to reveal significant findings while requiring fewer resources and being easier to perform. Therefore, we propose that children with congenital hydrocephalus not showing any abnormalities on cranial ultrasound should undergo ULF MRI. This imaging modality holds potential for monitoring neonatal tumors and detecting metastasis.
Wheelchair use confidence scale for Arab pediatric manual wheelchair users: preliminary evaluation of its measurement properties
Authors: Sarsak Hassan Izzeddin , Rushton Paula W. 
Published: February 2025

IntroductionThis study translated the pediatric Wheelchair Use Confidence Scale for Manual Wheelchair Users (WheelCon-M-P) into Arabic (WheelCon-M-A-P) and evaluated whether the translation produced scores similar to the original English version.MethodsThe English version was first translated into Arabic and then verified by back translation method by expert committee in the field of rehabilitation and wheelchair service provision. The final versions were administered to assess confidence with manual wheelchair use among children. Each participant was asked to complete both the WheelCon-M-P English version and the WheelCon-M-A-P Arabic version in a random sequence. Kappa statistics were used to quantify the level of agreement between scores obtained from both versions.ResultsParticipants (n = 48) had an average age of 14.2 years, were all bilingual, and 54% were male. Kappa agreement obtained was 0.54 (95% confidence interval, 0.49–0.62) indicating significant moderate agreement between the two versions (p &lt; 0.000).DiscussionThis study provides preliminary evidence of a valid WheelCon-M-A-P to assess confidence with manual wheelchair use among Arabic-speaking children. Future studies to further test its psychometric properties are crucial.
Eliglustat substrate reduction therapy in children with Gaucher disease type 1
Authors: Ain Noor Ul , Saith Armaan , Ruan Audrey , Yang Ruhua , Burton Aaron , Mistry Pramod K. 
Published: February 2025

ImportanceGaucher disease (GD) is a rare lysosomal storage disorder with limited treatment options for pediatric patients. Oral substrate reduction therapy (SRT) with eliglustat offers a potential alternative, particularly for those with barriers to enzyme replacement therapy (ERT).ObjectiveEvaluate the safety and efficacy of eliglustat SRT in pediatric patients with type 1 Gaucher disease (GD1), both as initial therapy and as a switch from intravenous ERT.DesignA prospective case series was conducted from 2017 to 2024.SettingYale's National Gaucher Disease Treatment Center, New Haven, CT, United States.ParticipantsFourteen pediatric GD1 patients with significant barriers to receiving ERT.InterventionEliglustat SRT was dosed pharmacogenomically based on CYP2D6 metabolizer status.Primary outcomes and measuresPrimary outcomes included safety and efficacy in reversing indicators of disease activity. Secondary outcomes involved changes in patient and parent-reported quality of life, assessed using PROMIS questionnaires.ResultsEliglustat was initiated at a mean age of 12.5 years (range: 6–17 years) and administered for a mean duration of 3.6 years (range: 1–7 years). All patients remained on treatment and exhibited sustained reductions in glucosylsphingosine (GlcSph) levels compared to baseline (p = 0.005). Other disease indicators demonstrated corresponding improvements. Adverse effects were limited to transient gastroesophageal reflux in 3/14 patients (21%). Serial electrocardiograms (EKGs) were normal. Growth and developmental milestones were appropriate for age in all patients. Patients and their parents reported a global improvement in quality of life.ConclusionsEliglustat demonstrated significant clinical benefits in pediatric GD1 patients, as evidenced by reductions in GlcSph levels and other disease indicators. The therapy showed a favorable safety profile comparable to that observed in adults. These findings suggest eliglustat is a promising therapeutic option for pediatric GD1 patients, providing an effective alternative to ERT.
Mulberry twig alkaloids for type 2 diabetes mellitus: a systematic review and meta-analysis
Authors: Chen Guoming , Yang Ruifeng , Yang Xiaoya , Jiang Jiazhen , Guo Yudan , Xu Mengshan , Chen Yi , Hou Yining , Zhang Cheng , Wang Ning , Feng Yibin 
Published: February 2025

BackgroundDiabetes has emerged as a significant global health concern, with over 95% of cases categorized as type 2 diabetes mellitus (T2DM). The disease not only imparts detrimental effects on individual health but also imposes a substantial burden on societal economics and healthcare systems. Notably, there is a paucity of meta-analyses on the efficacy of mulberry twig alkaloids (MTAs) for the treatment of T2DM.MethodsThe systematic review registration number is CRD42024523218. Data were retrieved from Cochrane Library, ClinicalTrials.gov, Embase, PubMed, Ovid, Web of Science, China National Knowledge Infrastructure (CNKI), Scopus, Chongqing VIP, CINAHL, SINOMED, ChiCTR, and Wanfang Data from their inception to 1 February 2024 for herbal product-related randomized controlled trials (RCTs). The risk of bias assessment and meta-analysis were performed using ReviewManager 5.4 and STATA 15.0. TSA software version 0.9.5.10 was used to assess whether the results achieved the required information size (RIS). GRADEprofiler 3.6 software was used to estimate the quality of evidence for the outcomes.ResultsNine studies were included for a total of 10 trials with 1,178 patients. The results indicated that MTAs were more effective than placebo in reducing HbA1cglycated hemoglobin (HbA1c), and MTAs combined with hypoglycemic drugs were more effective than hypoglycemic drugs alone in reducing HbA1c, fasting blood glucose (FBG), and 2-hour postprandial glucose (2hPG). In terms of lipid control, MTAs combined with hypoglycemic drugs showed better control of triglycerides (TGs) and low-density lipoprotein (LDL) efficacy than hypoglycemic drugs alone. After MTA treatment, there was no damage to liver function compared to placebo. The safety of MTAs, whether alone or in combination with hypoglycemic drugs, was comparable to that of hypoglycemic drugs alone.ConclusionIn T2DM patients, MTAs were more effective than placebo. MTAs combined with hypoglycemic drugs showed better results than hypoglycemic drugs alone. The safety of MTAs was equivalent to that of hypoglycemic drugs. However, due to heterogeneity and possible bias, the results should still be interpreted with caution.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=523218
Risks to the clinician of risk management: recalled and anticipated consequences of decision-making
Authors: Challinor Alexander , Bhandari Sahil , Boyle Sean , Gabbay Mark , Wilson Pete , Saini Pooja , Nathan Rajan 
Published: February 2025

BackgroundDespite extensive literature studying how we make decisions in the face of uncertainty, the empirical study of real-world clinical decision-making in mental health practice remains limited. Decisions in clinical settings are not just made on the basis of clinical factors. A key non-clinical influence on decision making is the clinician’s concerns about the ‘threat’ to themselves from a future adverse incident and the subsequent retrospective scrutiny of their decision-making. A better understanding of non-clinical processes is essential to inform better ways of guiding effective decision-making. More specifically, delineating the nature of this ‘threat’ process will also inform approaches to patient safety.AimsThe objective of the current study was to delineate consequences recalled and anticipated by mental health clinicians making decisions under uncertainty.MethodsThis was an analysis of data arising from six focus group discussions with professionals involved in decisions to admit patients to psychiatric hospitals (consultant psychiatrists, approved mental health practitioners, crisis resolution home treatment teams, and liaison psychiatry practitioners) in one National Health Service Trust, UK. The data were thematically analyzed to identify the nature of ‘threat’ processes that arise in clinical decision-making.ResultsThemes identified included (i) the location of the effect of the anticipated/recalled consequence(s), (ii) the location of the origin of the consequence, and (iii) the nature of the consequence. The recalled and anticipated consequences of decision-making were overwhelmingly, but not exclusively, negative. The consequences were largely perceived to be directed towards the self (i.e., the clinician) and were considered to originate from external scrutiny by peers, organizational leadership, and the patient safety system/processes.ConclusionsThe process of making decisions to admit patients to hospital consistently involved the decision-maker’s concern with the future consequences for them, either from a prior or future adverse event. The findings of this study, alongside other evidence of the complexity of decision-making, have implications for improving and studying clinical decision-making (and, by extension, patient care and outcomes), patient safety responses, and professional well-being.
Effectiveness of virtual reality therapy in the treatment of anxiety disorders in adolescents and adults: a systematic review and meta-analysis of randomized controlled trials
Authors: Zeng Weisi , Xu Jialan , Yu Jiayan , Chu Xin 
Published: February 2025

BackgroundTo evaluate the effect of virtual reality therapy on anxiety disorders in adolescents and adults by Meta-analysisMethodsA comprehensive literature search was conducted by PubMed, Web of Science, Embase, CINAHL, Scopus, Cochrane (from inception to November 2024). Two researchers independently performed literature screening, quality evaluation and data extraction, and Stata16.0 and Review Man 5.4 software were used for Meta-analysis.ResultsA total of 33 studies involving 3182 adolescents and adults with anxiety disorders were included. The results of Meta-analysis showed that compared with conventional interventions, virtual reality therapy significantly improved the symptoms and level of anxiety in patients with anxiety disorder [SMD = -0.95, 95%CI (-1.22,-0.69), Z = 7.05, P &lt; 0.00001].ConclusionThe current findings suggest that VR therapy interventions have a positive effect on improving the anxiety state of patients with anxiety disorders. The aforementioned research findings must be confirmed by more high-caliber studies due to the number and quality limitations of the contained literature.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display, identifier CRD42024574772.
A sustainability comparison of different traditional Chilean culinary preparations through an innovative method
Authors: Tiboni-Oschilewski Ornella , Corvalán Camila , Kanter Rebecca 
Published: February 2025

IntroductionDietary choices affect both human and planetary health; however, they are not always linked to public policies. For example, Food Based Dietary Guidelines (FBDGs) do not always consider sustainability in their recommendations. To date, no methods have been developed and agreed upon to assess the five sustainability dimensions proposed by the Food and Agriculture Organization (FAO) (nutritional, environmental, cultural, physical, and economical access) as a whole. The objective of this study was to compare the levels of sustainability of traditional Chilean culinary preparations using a newly proposed method that integrates five unique dimensions of sustainable diets with reference databases to generate recommendations about sustainable culinary preparations; in which the Chilean population serves as a test case.MethodsA database composed of 651 traditional Chilean culinary preparations was used. It was obtained through 10 focus groups from the Metropolitan Region. Culinary preparations were divided into eight different food groups based on their main ingredients. Sustainability estimations were conducted for physically accessible preparations. All the dimensions were estimated based on approaches and indicators previously used in scientific literature. Different weights were provided for all other dimensions: 30% for cultural and price, respectively, and 20% for nutritional and environmental dimensions. Culinary preparations we recommended as sustainable if they achieved a global sustainability score of 66% or above, provided each dimension individually scored 40% or above.ResultsAfter data management, 351 culinary preparations were analyzed. A total of 94 were selected as sustainable: 21/38 vegetables; 6/7 fruits; 28/105 proteins; 14/78 cereals; 6/41 soups; 0/32 dairy; 1/6 lipids; 18/443 beverages. The main reason a preparation was not classified as sustainable was failing to obtain 66% of global sustainability. No culinary preparations were excluded based on the economic dimension.DiscussionThis study shows that estimating sustainability of individual culinary preparations based on the five dimensions of sustainable diets of FAO is possible through the development of an innovative methodological approach that is useful for making dietary recommendations for a population, such as within FBDGs. Future research should continue developing this methodology as a tool for public health decision-making for healthier and sustainable diets. This would allow dietary patterns to develop into more sustainable ones, which is a useful strategy for public health and planetary health
Effect of circulating anti-Mullerian hormone on the reproductive potential of gilts
Authors: Xia Wei , Zhou Zhenmin , Cheng Linghua , Fang Xiaohuan , Tao Chenyu , Qi Yatian , Yu Yang , Zhang Di , Tian Xiaofeng , Gao Zihao , Bai Jiahua , Wen Junhui , Liu Yan , Li Junjie 
Published: February 2025

IntroductionDetermination of the ovarian follicular reserve is of great value for predicting fertility, while circulating anti-Müllerian hormone (AMH) plays an important role in maintaining the ovarian reserve.MethodsIn this study, we examined the effect of circulating AMH levels of gilts between 110 and 160 days of age on reproductive performance and evaluated the differences in the ovaries and uteruses of gilts with different AMH levels.ResultsThe results indicated a significant negative correlation between circulating AMH levels from days 110 to 160 and puberty (p &lt; 0.05). Moreover, the total born, live born, and the herd retention rate across 3 successive parities were found to be higher in high-AMH gilts than in low-AMH ones. Uterine morphology was assessed, and it was found that high-AMH gilts had significantly increased uterine glandular density, and the median vascular area and the relative expression levels of FOXA2, VEGF, VEGFR, and CD31 were significantly increased (p &lt; 0.05). Furthermore, high-AMH gilts had a greater number of antral follicles and higher expression levels in secondary and early antral follicles than low-AMH gilts (p &lt; 0.05). To further explain this mechanism, RNA-seq analysis was performed, which indicated that differentially expressed genes (DEGs) of high-AMH gilt ovaries were enriched in pathways, including steroid hormone biosynthesis, arachidonic acid metabolism, and the gonadotropin-releasing hormone signaling pathway.DiscussionOur findings indicate that circulating AMH levels can possibly predict the reproductive potential of gilts, with day 160 circulating AMH levels being a potential predictive indicator.
Investigation of serum thyroid hormones, iodine and cobalt concentrations across common aquarium-housed elasmobranchs
Authors: Wheaton Catharine J. , Sullivan Kathleen E. , Bassiouny Enass , Burns Charlene M. , Smukall Matthew J. , Hendon Jill M. , Mylniczenko Natalie D. 
Published: February 2025

IntroductionThyroid disease is an important condition to understand in elasmobranchs, with goiters being predominant. To identify dysfunction, measuring serum thyroid hormone levels is a standard of practice for diagnosing disease in most species. Although these levels have been reported in elasmobranch literature, the testing methodology is varied and values are not clinically useful for most aquarium species. In a group of aquarium-housed elasmobranchs, thyroid hormone levels had been persistently low or not detectable in otherwise healthy animals as well as animals with thyroid disease. The concern for reliability of these results to diagnose thyroid disease, prompted a shift to serum iodine levels as a proxy to determine thyroid health.MethodsThis study assesses thyroid hormone and iodine levels as compared to thyroid disease stage in elasmobranchs with and without dietary supplementation, to determine the efficacy of using these serum values to guide clinical decisions.ResultsSerum thyroid hormone results were lower than the readable range of the standard curve in both sharks and rays; thus reported values are usually extrapolated. Including additional standards down to the limit of sensitivity improved detection, however increasing the sample volume tested was determined to be the most important factor for obtaining measurable results in low-value thyroid hormone samples. Serum iodine levels are reported in three groups of southern stingrays (Hypanus americanus). Other elasmobranch species maintained in aquaria with and without thyroid disease were used for biological comparisons. Non-goiter, diseased animals reliably had elevated levels (over baseline) of thyroid hormones and iodine; in goiter cases, hormones were not useful. Additionally, it was found that cobalt levels were also elevated in some disease states and correlated positively with serum iodine levels.ConclusionCurrent available thyroid testing may not provide clinically useful values unless methodology is adjusted, or disease is severe. Serum iodine may be a useful marker to investigate thyroid health. Further, while thyroid disease may be identifiable with thyroid hormones, it is not straightforward or substantial enough alone for diagnosis.