bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial dynamics of acute pancreatitis: integrating culture, sequencing, and bile impact on bacterial populations and gaseous metabolites
Authors: Chmielarczyk Agnieszka , Golińska Edyta , Tomusiak-Plebanek Anna , Żeber-Lubecka Natalia , Kulecka Maria , Szczepanik Antoni , Jedlińska Katarzyna , Mech Krzysztof , Szaciłowski Konrad , Kuziak Agata , Pietrzyk Agata , Strus Magdalena 
Published: February 2025

BackgroundOur study examined the composition of the intestinal microflora in a hospitalized patient with AP symptoms treated several months earlier for diverticulitis. The therapeutic intervention necessitated Hartmann's procedure, culminating in colostomy creation.AimsEmploying a thorough microbiological analysis we attempted to demonstrate whether the microflora isolated from the peripancreatic fluid exhibited a stronger correlation with the contents of the stoma or with the rectal swab. Additionally, we sought to determine the association between later onset of AP and diverticulitis.MethodsFollowing clinical materials from the patient in the initial phase of AP were collected: rectal swab, colostomy bag contents (in the publication referred to as stoma content/stool) and peripancreatic fluid. Microbiological analysis was performed, including classic culture methodology, NGS techniques, and genotyping methodologies. Furthermore, the effect of bile on the shift in the population of selected bacterial species was examined.ResultsThe NGS technique confirmed greater consistency in bacteria percentage (phyla/family) between stoma content and peripancreatic fluid. In both samples, a clear dominance of the Proteobacteria phyla (over 75%) and the Enterobacteriaceae family was demonstrated. Moreover, NGS verified the presence of the Fusobacteriota phylum and Fusobacteriaceae family only in rectal swabs, which may indicate a link between this type of bacteria and the etiology of diverticulitis. We observed that Escherichia coli 33 isolated from stool exhibited active gaseous metabolite production (mainly hydrogen).ConclusionsThe abundant production of hydrogen may substantially impact enzymatic processes, inducing specific alterations in disulfide bonds and trypsin inactivation. Our investigation alludes to the conceivable active involvement of bile in effecting qualitative and quantitative modifications in the peripancreatic microbiota composition, establishing a correlation between released bile and bacterial generation of gaseous metabolites.
Multimodal fusion model for diagnosing mild cognitive impairment in unilateral middle cerebral artery steno-occlusive disease
Authors: Yuan Ziyi , Huang Zhaodi , Li Chaojun , Li Shengrong , Ren Qingguo , Xia Xiaona , Jiang Qingjun , Zhang Daoqiang , Zhu Qi , Meng Xiangshui 
Published: February 2025

ObjectivesTo propose a multimodal functional brain network (FBN) and structural brain network (SBN) topological feature fusion technique based on resting-state functional magnetic resonance imaging (rs-fMRI), diffusion tensor imaging (DTI), 3D-T1-weighted imaging (3D-T1WI), and demographic characteristics to diagnose mild cognitive impairment (MCI) in patients with unilateral middle cerebral artery (MCA) steno-occlusive disease.MethodsThe performances of different algorithms on the MCI dataset were evaluated using 5-fold cross-validation. The diagnostic results of the multimodal performance were evaluated using t-distributed stochastic neighbor embedding (t-SNE) analysis. The four-modal analysis method proposed in this study was applied to identify brain regions and connections associated with MCI, thus confirming its validity.ResultsBased on the fusion of the topological features of the multimodal FBN and SBN, the accuracy for the diagnosis of MCI in patients with unilateral MCA steno-occlusive disease reached 90.00%. The accuracy, recall, sensitivity, and F1-score were higher than those of the other methods, as was the diagnostic efficacy (AUC = 0.9149).ConclusionThe multimodal FBN and SBN topological feature fusion technique, which incorporates rs-fMRI, DTI, 3D-T1WI, and demographic characteristics, obtains the most discriminative features of MCI in patients with unilateral MCA steno-occlusive disease and can effectively identify disease-related brain areas and connections. Efficient automated diagnosis facilitates the early and accurate detection of MCI and timely intervention and treatment to delay or prevent disease progression.
Exploratory study on the ascending pain pathway in patients with chronic neck and shoulder pain based on combined brain and spinal cord diffusion tensor imaging
Authors: Qiu Zhiqiang , Liu Tianci , Zeng Chengxi , Yang Maojiang , Yang HongYing , Xu Xiaoxue 
Published: February 2025

ObjectiveTo explore the changes in the white matter microstructure of the ascending pain conduction pathways in patients with chronic neck and shoulder pain (CNSP) using combined brain and spinal cord diffusion tensor imaging techniques, and to assess its correlation with clinical indicators and cognitive functions.Materials and methodsA 3.0T MRI scanner was used to perform combined brain and spinal cord diffusion tensor imaging scans on 31 CNSP patients and 24 healthy controls (HCs), extracting the spinothalamic tract (STT) and quantitatively analyzing the fractional anisotropy (FA) and mean diffusivity (MD) which reflect the microstructural integrity of nerve fibers. Additionally, these differences were subjected to partial correlation analysis in relation to Visual Analog Scale (VAS) scores, duration of pain, Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS).ResultsCompared to HCs, CNSP patients showed decreased mean FA values and increased mean MD values in bilateral intracranial STT compared to the HC group, but two-sample t-test results indicated no statistically significant differences (p &gt; 0.05). FA values of the left STT (C2 segment, C5 segment) and right STT (C1 segment, C2 segment) were significantly decreased in bilateral cervical STTs of CNSP patients; MD values of the left STT (C1 segment, C2 segment, C5 segment) and right STT (C1 segment, C5 segment) were significantly increased (p &lt; 0.05). Partial correlation analysis results showed that FA values of STT in CNSP patients were negatively correlated with VAS scores, duration of pain, SAS scores, and SDS scores, while MD values were positively correlated with VAS scores and duration of pain (Bonferroni p &lt; 0.05).ConclusionThis research identified that patients with CNSP exhibited reduced mean FA and increased mean MD in the bilateral intracranial STT, although these differences were not statistically significant (p &gt; 0.05). Conversely, significant abnormalities were observed in specific segments of the bilateral cervical STT (p &lt; 0.05), which were also correlated with variations in pain intensity, illness duration, and levels of anxiety and depression. These findings contribute a novel neuroimaging perspective to the evaluation and elucidation of the pathophysiological mechanisms underlying chronic pain in the ascending conduction pathways.
Gestational diabetes induces autistic-like behaviors in offspring by disrupting the GABAergic system
Authors: Liu Xuan-Qi , Huang Tian-li , Zhang Shu-Yu , Huang Yu-Tong , Mo Jia-Ying , Yan Yi-Shang , Cao Yi-Ning , Cai Yue-Ran , Sheng Jian-Zhong , Zhu Hong , Huang He Feng 
Published: February 2025

BackgroundIncreasing evidence have shown that gestational diabetes mellitus (GDM) is associated with the risk of autism in offspring. However, the underlying mechanisms have not yet been fully elucidated.MethodsA mouse model of gestational diabetes mellitus (GDM) was established to investigate its impact on offspring. Behavioral analyses were conducted to assess social novelty and stereotypic behaviors. Neuronal excitability in the prefrontal cortex (PFC) was evaluated using c-Fos staining after social behavior stimulation. Single-cell transcriptomics and metabolomics were employed to analyze changes in the GABAergic system.ResultsBehavioral analyses revealed that GDM led to impaired social novelty and increased stereotypic behaviors in male offspring. c-Fos staining showed hyperexcitability in the PFC of male offspring from the GDM group following social behavior stimulation. Single-cell transcriptomics and metabolomics identified alterations in the GABAergic system, including a decrease in GABAergic neurons and reduced GABA levels. This reduction in GABA was associated with decreased GAD2 expression due to DNA hypermethylation in the GAD2 promoter region.ConclusionThese data suggest that GDM induces autistic-like behaviors, including reduced social novelty and increased stereotypic behaviors, in offspring by affecting the GABAergic system. These findings provide new insights into how GDM may influence neurodevelopment in offspring.
Reliability analysis of passive residual heat removal system for large advanced pressurized water reactors
Authors: Li Tianrui , Xiao Xinkun , Lu Guoqing , Chen Shikang , Chen Ronghua , Tian Wenxi 
Published: February 2025

This paper focuses on the passive residual heat removal system of a typical large advanced pressurized water reactor, analyzing its design, performance, and reliability during station blackout conditions combined with the failure of the auxiliary feedwater steam-driven pumps. The study employs modeling of passive safety systems and utilizes response surface methodology to evaluate system behavior during severe accident scenarios. Such comprehensive analysis contributes to ensuring the safe operation and advancement of nuclear power plants. The best-estimate program VITARS is used to analyze and calculate accident scenarios, with sensitivity analysis conducted based on preliminary thermal-hydraulic calculations to optimize parameter selection and simplify the response surface model structure, thereby streamlining the analysis process. An artificial neural network is employed as a surrogate model for complex thermal-hydraulic calculations, significantly improving analysis efficiency. The findings indicate that the passive residual heat removal system has zero failure probability under normal uncertainty ranges within 72 h. Even under extreme conditions, such as delayed opening of the steam generator’s safety valve, the system maintains reactor safety with a failure probability of only 0.035%.
Exploration of the quantitative-effectiveness association between acupuncture temporal parameters and chemotherapy-induced peripheral neuropathy in cancer patients: a dose-response meta-analysis of randomized controlled trials
Authors: Tian Hao , Luo Qin , Huang Liuyang , Chen Guang , Sun Mingsheng , Liang Fanrong 
Published: February 2025

BackgroundChemotherapy-induced peripheral neuropathy (CIPN) is one of the commonly reported symptoms impacting cancer survivors. This study evaluated and compared the effectiveness of acupuncture treatments for CIPN.MethodsWe searched six databases from their inception to August 2024 to identify eligible randomized controlled trials (RCTs). Primary outcome were pain scores. Secondary outcomes were quality of life including FACT/GOG-Ntx and EORTC QLQ-C30. The robust error meta-regression (REMR) method was used to evaluate the dose-response relationship across treatment parameters, including number of sessions, frequency, and duration.ResultsIn total, 11 RCTs featuring 740 participants were included. The meta-analysis demonstrated that the primary analysis achieved a significant reduction in pain scores, with a standardized mean difference of [SMD= -1.23, 95% CI = (-2.22, -0.24); P &lt; 0.01; I² = 95%], improvement quality of life including FACT/GOG-Ntx [SMD = 0.95, 95% CI = (0.02, 1.88); P &lt; 0.01; I² = 93%] and EORTC QLQ-C30 [SMD = 0.36, 95% CI = (0.03, 0.68); P = 0.14; I² = 46%]. The nonlinear dose-response analysis suggests that pain improvement achieves the MCID at 16 treatment sessions, over 8 weeks, with a frequency of twice per week. Furthermore, analysis of the treatment duration chart shows that acupuncture maintains therapeutic effects during the follow-up period. Sensitivity analysis confirmed the robustness of these findings.ConclusionAcupuncture demonstrates significant potential in managing CIPN, particularly through individualized treatment regimens. The identified time-dose-response relationship suggests that tailoring acupuncture frequency and duration can to optimize pain relief in CIPN patients. Future high-quality studies and large-scale multicenter clinical trials are needed to validate these findings.
Effect of chemoradiotherapy on the dynamics of circulating lymphocyte subsets in patients with non-metastatic nasopharyngeal carcinoma
Authors: Yi Lilan , Gu Yinfang , Guo Longhua , Zou Xiaofang , Wu Guowu 
Published: February 2025

BackgroundChemoradiotherapy (CRT) is the primary and most effective treatment for non-metastatic nasopharyngeal carcinoma (NPC), exerting antitumor effects by modulating immune cells. Distinct subpopulations of immune cells exhibit specific sensitivity to CRT. This study aimed to characterize the dynamics of the proportions and absolute counts of peripheral circulating lymphocyte subsets in non-metastatic NPC before and after CRT, and to elucidate their association with clinical responses.MethodsA total of 91 patients with non-metastatic NPC were enrolled. Flow cytometry was employed to detect the expression of CD3, CD4, CD8, CD56, and CD19 on peripheral blood cells. The composition of lymphocyte subsets before treatment, post-completion of CRT, and one month following CRT was retrospectively analyzed. Further, the relationship between the composition of circulating lymphocyte subpopulations and distinguish clinical responses was evaluated.ResultsThe proportion of CD3+ T cells showed an initial increase followed by a significant decrease at baseline, post-completion of CRT, and one month following CRT. The proportions of CD3+CD4+ T cells, CD4+/CD8+ ratio, and CD19+ B cells continued to decline at baseline, post-completion of CRT, and one month following CRT, while the proportions of CD3+CD8+ T cells and CD16+CD56+ NK cells progressively increased. The absolute counts of circulating lymphocyte subsets, including CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, CD45+, CD19+ B cells, and CD16+CD56+ NK cells, demonstrated a trend of initial decrease followed by an increase at baseline, post-completion of CRT, and one month following CRT. Patients with complete response (CR) and partial response (PR) presented similar dynamic trends in the percentages and absolute counts of circulating lymphocyte subpopulations at baseline, post-completion of CRT, and one month following CRT. The proportions and absolute counts of CD3+CD4+ T cells in CR patients were distinctly higher than those in PR patients at the end of CRT, whereas the absolute counts of CD16+CD56+ NK cells were remarkably lower in CR patients compared to PR patients. The baseline proportion and absolute count of CD19+ B cells, as well as the absolute count of CD3+CD4+ T cells, were significantly higher in CR patients compared with PR patients.ConclusionCRT induced dynamic alterations in the peripheral lymphocyte profile of non-metastatic NPC patients. Assessing the variations in the distribution of circulating lymphocyte subsets among patients with different clinical treatment responses will be helpful in developing protocols for the concurrent utilization of immunotherapeutic drugs and CRT.
Two rare cases of primary clear cell adenocarcinoma of the urethra: clinical experience, case report and literature review
Authors: Jiang Bohao , Hu Jiyuan , Wang Benqiao , Liu Xujia , Tong Ling , Xu Yitong , Zhang Hao 
Published: February 2025

BackgroundPrimary clear cell adenocarcinoma of the urethra (CCAU) is a kind of extremely rare genitourinary cancer. Despite the similarity in the clinical manifestations of these reported cases, diagnosis and determination of standard therapy remain challenging due to the rarity of findings and similarity with other urethral tumors.Case presentationHerein, we reported two cases of CCAU with the same chief complaint of hematuria: a 71-year-old female and a 66-year-old male. The male patient reported concomitant symptoms of frequent and painful urination. CT scans show abnormal enhancements. After a cystoscopy examination, both patients are diagnosed with malignant urethral tumors. Surgical resections and additional pathological examinations support the diagnosis of CCAU (palliative resection for case 1 and transurethral resection for case 2). Case 1 undergone progression 6 months after initial treatment with transurethral resection and chemotherapy with a 15-month overall survival. In contrast, the prognosis of case 2 remained uneventful 10 months after surgery without recurrence. After presenting our cases, we launched a literature review that included 23 articles and 33 cases of CCAU to summarize the characteristics of the disease.ConclusionPrimary clear cell adenocarcinoma of the urethra is a rare malignant urethral tumor with controversial histological origins. Primary symptoms include hematuria and changes in voiding habits. Middle-aged and elderly females are more susceptible to primary clear-cell adenocarcinoma of the urethra. Unfortunately, it is difficult to differentiate primary clear-cell adenocarcinoma of the urethra from other urethral tumors due to similar clinical features. However, imaging tools such as CT, MRI, and cystoscopy are adjunctive in confirming diagnoses. Even though surgical resection is the primary treatment to relieve clinical symptoms, prevent recurrence, and confirm diagnosis, no standard surgical protocol is available. The therapeutic effect of postoperative adjuvant therapies remains unclear. Future investigations on CCAU are necessary to advance clinical knowledge and to provide treatment guidance.
Perception of uncertainty concerning illness and coping styles among parents of children with central nervous system tumors: a correlation analysis
Authors: Lan Bai , Qinqin Zhao , Ying Li , Zhihuan Zhou 
Published: February 2025

PurposeTo investigate the perception of uncertainty concerning illness among parents of children with central nervous system tumors and their coping styles and to analyze correlations to provide a basis for developing targeted intervention measures.MethodsWe studied 108 parents of children with central nervous system tumors admitted from January 2023 to January 2024. Information about these children and their parents were analyzed using the modified Parents' Perception of Uncertainty in Illness Scale (PPUS) and the Coping Health Inventory for Parents to calculate correlations of parents' perceptions of uncertainty concerning illness and coping styles.ResultsThe total score of PPUS was 45.28 ± 8.428 for the parents of children. The most common coping styles were the maintenance of family unity, cooperation, and optimism. The correlation analysis revealed that parents' perception of uncertainty concerning illness negative correlated with coping style (p &lt; 0.05).ConclusionThe parents of children with central nervous system tumors show substantial perception of uncertainty concerning the illness and are susceptible to lack of communication and expression. Positive, effective coping methods should be adopted to reduce uncertainty concerning illness to reduce the psychological pressure on parents.
Use of a specialized peptide-based enteral formula containing medium-chain triglycerides for enteral tube feeding in children with cerebral palsy and previous tube feeding intolerance on standard enteral formula: a prospective observational TolerUP study
Authors: Kansu Aydan , Kutluk Gunsel , Caltepe Gonul , Arikan Cigdem , Urganci Nafiye , Tumgor Gokhan , Yuce Aysel , Tuna Kirsaclioglu Ceyda , Demir Arzu Meltem , Demirbas Fatma , Usta Merve , Yavuz Sibel , Demirtas Guner Duygu , Gumus Ersin , Dalgic Buket , Dogan Yasar , Gerenli Nelgin , Kocamaz Halil , Gulerman Fulya , Sag Elif , Alptekin Sarioglu Aysugul , Eksi Bozbulut Neslihan , Teker Duztas Demet , Altug Demirol Hatice , Celtik Coskun , Gungor Olcay , Demiroren Kaan , Uncuoglu Aydogan Aysen , Bekem Ozlem , Arslan Zeynep , Cakir Murat , Ekici Arzu , Uyar Aksu Nihal , Ecevit Cigdem , Erdogan Simge 
Published: February 2025

ObjectiveUse of peptide-based formulas supplemented with medium chain triglycerides (MCTs) is considered a beneficial strategy to decrease the tube-feeding associated gastrointestinal tolerance. In children with cerebral palsy (CP), overall effects of enteral tube feeding as well as the utility of peptide-based specialized enteral formulas in those with gastrointestinal intolerance have not been extensively studied. This study aimed to evaluate the utility of enteral tube feeding via specialized peptide-based formula containing MCTs in children with CP in terms of gastrointestinal intolerance, anthropometrics, defecation characteristics and parental satisfaction with enteral formula.MethodsChildren with CP who received enteral tube feeding via specialized peptide-based formula containing MCTs were included in this prospective observational study. Anthropometrics (z scores for weight for age [WFA], weight for height [WFH], triceps skinfold thickness [TSFT] and mid-upper arm circumference [MUAC]), gastrointestinal intolerance symptoms, defecation frequency and stool patterns and formula satisfaction were recorded at baseline and during 6-month follow up.ResultsA total of 96 children with CP (mean ± SD age: 5.6 ± 3.2 years, 56.3% were boys) were included. Significant improvements were noted in MUAC, TSFT and WFH z scores at the 6th month visit. The rate of “severe symptoms” and the likelihood of Type-1/Type-2 (constipation) stool pattern were significantly decreased. Majority of parents were satisfied with the study formula.ConclusionOur findings revealed favorable efficacy and safety of using a specialized peptide-based formula containing MCT in provision of enteral tube feeding among children with CP in terms of improved anthropometrics, amelioration of gastrointestinal intolerance symptoms and normalization of bowel movements along with a high parental satisfaction.
Review of rhythm disturbances in patient after fontan completion: epidemiology, management, and surveillance
Authors: Wall Kevin , Hebson Camden , D’Souza Roshan , Balaji Seshadri 
Published: February 2025

PurposeThe Fontan operation is commonly associated with alterations in heart rhythms, both tachycardic and bradycardic. Despite modifications to attempt to mitigate these complications, arrythmias still frequently occur. The purpose of this review is to examine the literature regarding the scope of the problem, therapeutic options, and current recommendations regarding screening and surveillance.Recent findingsModifications to the original Fontan procedure, antiarrhythmic medications, and improvements in catheter ablation procedures have improved the management of patients with arrhythmias following Fontan palliation. There is growing interest in the role of junctional rhythm in the role of Fontan dysfunction. While chronotropic incompetence has often been blamed for poor exercise testing, there is evidence that decreased performance may be related to ventricular filling and Fontan hemodynamics.SummaryTachyarrhythmias are an important cause of mortality and morbidity after the Fontan operation. Prompt and aggressive management of arrhythmias with the goal of maintaining sinus rhythm is vital. Management strategies such as anti-arrhythmic medications, ablation, anti-tachycardia pacing and Fontan conversion should be seen as complementary and used early to prevent hemodynamic deterioration. Bradyarrythmias likely also contribute to Fontan failure. Pacing is the primary management strategy with evidence supporting use of atrial pacing. However, ventricular pacing seems to often lead to deleterious effects. Current guidelines recommend surveillance with Holter monitor every 2–3 years in adolescents and every 1–2 years in adults. Future directions for research include further assessment of junctional rhythm and its management as well as further identifying patients in which pacing would be beneficial.