bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary factors in relation to hypertension: a mendelian randomization study
Authors: Cai Jiasheng , Sun Xiaochen , Li Mingxuan , Luo Rong , Wang Wei , Wang Zilong , Akkaif Mohammed Ahmed , Liu Haibo 
Published: June 2024

Abstract
Background
Observational studies have elucidated the associations between dietary factors and hypertension. Nevertheless, the exploration of these relationships using Mendelian randomization remains scarce currently.

Methods
The Mendelian randomization approach investigated the potential causal relationships between 16 dietary factors and hypertension. To achieve this, we identified genetic variants associated with these dietary factors by utilizing data from European-descent genome-wide association studies with a stringent significance threshold (P < 5 × 10 − 8). Subsequently, we obtained genetic associations with hypertension from the extensive FinnGen Study, encompassing 92,462 cases and 265,626 controls. Our primary analytical method was the inverse variance weighted method, and we also conducted assessments for heterogeneity and pleiotropy to ensure the robustness and reliability of our findings.

Results
The study revealed significant associations with hypertension risk for various dietary factors. Specifically, higher weekly alcohol consumption (OR: 1.53, 95% CI: 1.19–1.96) and more frequent alcohol intake (OR: 1.20, 95% CI: 1.08–1.33) were positively correlated with an increased risk of hypertension. Likewise, increased poultry intake (OR: 3.25, 95% CI: 1.83–5.78) and beef intake (OR: 1.80, 95% CI: 1.09–2.97) were also linked to a higher risk of hypertension. Conversely, there were protective factors associated with a decreased risk of hypertension. These included consuming salad and raw vegetables, dried fruits, cheese, and cereals. It is important to note that no evidence of pleiotropy was detected, underscoring the robustness of these findings.

Conclusions
This study uncovered causal relationships between various dietary factors and hypertension risk. Specifically, alcohol consumption in terms of drinks per week and intake frequency, as well as poultry and beef intake, were causally associated with an elevated risk of hypertension. In contrast, consuming salad/raw vegetables, dried fruits, cheese, and cereals demonstrated an inverse causal association with hypertension, suggesting a potential protective effect.
Deep learning reconstruction for lumbar spine MRI acceleration: a prospective study
Authors: Tang Hui , Hong Ming , Yu Lu , Song Yang , Cao Mengqiu , Xiang Lei , Zhou Yan , Suo Shiteng 
Published: June 2024

Abstract
Background
We compared magnetic resonance imaging (MRI) turbo spin-echo images reconstructed using a deep learning technique (TSE-DL) with standard turbo spin-echo (TSE-SD) images of the lumbar spine regarding image quality and detection performance of common degenerative pathologies.

Methods
This prospective, single-center study included 31 patients (15 males and 16 females; aged 51 ± 16 years (mean ± standard deviation)) who underwent lumbar spine exams with both TSE-SD and TSE-DL acquisitions for degenerative spine diseases. Images were analyzed by two radiologists and assessed for qualitative image quality using a 4-point Likert scale, quantitative signal-to-noise ratio (SNR) of anatomic landmarks, and detection of common pathologies. Paired-sample t, Wilcoxon, and McNemar tests, unweighted/linearly weighted Cohen κ statistics, and intraclass correlation coefficients were used.

Results
Scan time for TSE-DL and TSE-SD protocols was 2:55 and 5:17 min:s, respectively. The overall image quality was either significantly higher for TSE-DL or not significantly different between TSE-SD and TSE-DL. TSE-DL demonstrated higher SNR and subject noise scores than TSE-SD. For pathology detection, the interreader agreement was substantial to almost perfect for TSE-DL, with κ values ranging from 0.61 to 1.00; the interprotocol agreement was almost perfect for both readers, with κ values ranging from 0.84 to 1.00. There was no significant difference in the diagnostic confidence or detection rate of common pathologies between the two sequences (p ≥ 0.081).

Conclusions
TSE-DL allowed for a 45% reduction in scan time over TSE-SD in lumbar spine MRI without compromising the overall image quality and showed comparable detection performance of common pathologies in the evaluation of degenerative lumbar spine changes.

Relevance statement
Deep learning-reconstructed lumbar spine MRI protocol enabled a 45% reduction in scan time compared with conventional reconstruction, with comparable image quality and detection performance of common degenerative pathologies.

Key points
• Lumbar spine MRI with deep learning reconstruction has broad application prospects.
• Deep learning reconstruction of lumbar spine MRI saved 45% scan time without compromising overall image quality.
• When compared with standard sequences, deep learning reconstruction showed similar detection performance of common degenerative lumbar spine pathologies.

Graphical Abstract
Quantum chemical modelling, molecular docking, synthesis and experimental anti-microbial activity of 1,4-diazepan linked piperidine derivative
Authors: Agrawal Khushbu , Patel Tarun M. , Thakur Shavi , Patel Kruti , Mittal Sumit 
Published: June 2024

Abstract
Background
In this work, we represent synthesis, in silico analysis and biological activity of 1,4 diazepine linked piperidine derivatives (6a–6o). All the derivatives were screened for their anti-microbial activity against gram-positive (Staphylococcus aureus, Bacillus Subtills, Bacillus megaterium) and gram-negative (Escherichia coli, Pseudonymous, Shigella sp.) bacteria. Compounds were synthesized from reaction of tert-butyl 1,4-diazepane-1-carboxylic, butyryl chloride and varied aromatic aldehyde, further characterized by 1H NMR and LCMS spectral techniques.

Result
Using ampicillin as a positive control, the synthetic compounds 6a–6o were tested for their in-silico study and experimental anti-microbial activity against gram-positive (Staphylococcus aureus, Bacillus Subtills, Bacillus megaterium) and gram-negative (Escherichia coli, Pseudonymous, Shigella sp.) bacteria. According to in vitro assay compound 6a, compound 6c, compound 6d, compound 6m and compound 6I showed higher activity against all the tested strains. Molecule 6i, compound 6j, compound 6k, compound 6f has good to moderate antibacterial activity. DFT computations were used to optimize the molecular geometry at the B3LYP/6-31G (d, p) theoretical level. The corresponding energy values of molecular orbitals were visualized using optimized geometries. Moreover, Auto Dock Vina 1.2.0 is used to assess molecular docking against two target proteins, Bacillus subtilis (PDB ID: 6UF6) and Protease Vulgaris (PDB ID: 5HXW). The target molecule 6b displayed the best binding energies for both. Additionally, we calculated the ADME for each molecule (6a–6o).

Conclusion
All fifteen synthesized compounds were screened for their in vitro and in silico analysis. In vitro analysis for anti-microbial activity was carried out against gram-positive (Staphylococcus aureus, Bacillus Subtills, Bacillus megaterium) and gram-negative (Escherichia coli, Pseudonymous, Shigella sp.) bacteria and compound 6a, compound 6c, compound 6d, compound 6m and compound 6I exhibits more potent activity towards all tested strains. Molecular docking is performed against target proteins, L-amino acid deaminase from Proteus Vulgaris and LcpA ligase from Bacillus subtilis, representing the Gram-negative bacterium and Gram-positive bacterium, respectively. Compound 6b showed the highest no. of interaction with protein according to molecular docking. With the advent of innovative techniques like ADME, we select their hit compounds early on and anticipate future pharmacokinetic and pharmacodynamic benefits and drawbacks of these promising therapeutic candidates.

Graphical abstract
Identifying the role of industrial heritage in the European Capital of Culture programme
Authors: Jones Zachary M. , Zhang Xinwen 
Published: June 2024

AbstractThere has been an increasing level of recognition of the interaction between cultural mega-events and built heritage in recent years. While research has broadly identified the need to align strategies and visions, as well as involve heritage actors and local communities, there has not been a systematic investigation of the position of industrial heritage within this tableau. This paper examines in depth the European Capital of Culture (ECoC) programme, as it is one of the longest standing Capital of Culture programmes in the world and has a significant record of investment and urban transformation. In this paper, we survey and categorise the inclusion of industrial heritage within the ECoC programme in 36 host cities and regions spread across Europe. This research provides the most comprehensive understanding to date of the specific forms of interaction between industrial heritage and ECoCs to better understand the kinds of relationships that have taken place. We then explore in detail the projects and decisions made in the cases of the 2023 Elefsina, 2017 Pafos and 2008 Liverpool ECoCs.
Modeling Klebsiella pneumonia infections and antibiotic resistance dynamics with fractional differential equations: insights from real data in North Cyprus
Authors: Amilo David , Bagkur Cemile , Kaymakamzade Bilgen 
Published: June 2024

AbstractThis study presents an enhanced fractional-order mathematical model for analyzing the dynamics of Klebsiella pneumonia infections and antibiotic resistance over time. The model incorporates fractional Caputo derivative operators and kernel, to provide a more comprehensive understanding of the complex temporal dynamics. The model consists of three groups: Susceptible (S), Infected (I), and Resistant (R) individuals, each controlled by a fractional differential equation. The model represents the interaction between infection, recovery from infection, and the possible development of antibiotic resistance in susceptible individuals. The existence, uniqueness, stability, and alignment of the model’s prediction to the observed data were analyzed and buttressed with numerical simulations. The results show that imipenem has the highest efficacy compared with ertapenem and meropenem category drugs. The estimated reproduction number and reproduction coefficient illustrate the potential impact of this model in improving treatment strategies, while the memory effects highlight the advantages of fractional differentiation. The model predicts an increased possibility of antibiotic resistance despite effective treatment, suggesting a new treatment approach.
Cisplatin and capecitabine as definitive chemoradiation for squamous cell carcinoma of the anal canal (SCCAC): A prospective cohort.
Authors: Dornellas Abraão , Bonadio Renata Colombo , Moraes Priscila Muniz , Galhera Denis , Victor Carolina Ribeiro , Chen Andre Tsin Chih , Muratori Carolina Teixeira , Ortega Cinthia , Alves Henrique Souza , Ibrahim Karim , Nahas Caio , Marques Carlos Frederico , Alban Luciana Bastos Valente , Braghiroli Maria Ignez , Hoff Paulo Marcelo , Venchiarutti Moniz Camila M 
Published: June 2024

e15503 Background: SCCAC is a rare disease. The standard of care treatment with curative intent is chemoradiation (CRT) with mitomycin (MMC) or cisplatin (CDDP) plus infusional 5-Fluoracil (5-FU). Capecitabine may replace 5-FU in MMC doublet. However, MMC and infusional pumps are frequently unavailable in underdeveloped countries. CCDP and capecitabine are widely available, but there is no prospective data about the feasibility and efficacy of this combination in a definitive SCCAC CRT setting. Methods: A Prospective cohort study aimed to evaluate the safety and efficacy of treatment with chemoradiation with CDDP 60mg/m2 D1 and D29 plus Capecitabine 825mg/m2 BID in a population without MMC and infusional pump access. Eligible patients (pts) had T2-4, N0-3, and M0 disease candidates for a full curative CRT regimen. The study data were prospectively collected using REDCap. The primary endpoint was the response by RECIST v.1.1 at 24 weeks(w). The secondary endpoints included toxicity by CTCAE v.5.0, adherence, PFS, and OS. Results: We enrolled 40 consecutive pts between Aug/2019-Dec/2022 in a tertiary cancer center in Brazil. The median age was 61y, the majority were stage III (n = 31, 77.5%) and ECOG 1 (n = 20, 50%). HIV+ serology was observed in 11 pts (27,5%). All patients received CRT, with a median dose of 54Gy in the primary tumor and 45Gy in the elective nodes. At 8w, 35% (n = 14) had a complete response (CR), 50% (n = 20) partial response (PR), and 2.5% (n = 1) progressive disease (PD). At 6 months, CR was observed in 55% (n = 22), PR in 22.5% (n = 9), and PD in 10% (n = 4). 11 pts had disease recurrence, and six died. 1y OS was 94.7% (IC95%: 80.7- 98.6%), and 1y PFS was 75.3% (IC95%:57.8 - 86.3%). Colostomy-free survival at one year was 89.6% (IC95%: 74.7 - 95.9%). Median PFS and OS were not reached with a 2-year median follow-up. Regarding toxicities, radiodermatitis was observed in 94% (n = 36), nausea in 90% (n = 36), and diarrhea in 65% (n = 26). Any grade 3/4 toxicity was present in 27.5% (n = 11), being the majority of radiodermatitis. Four older pts (average age 73y) had definitive suspension of treatment due to toxicity, 06 pts were hospitalized because of a skin infection, and one died due to treatment toxicity. Conclusions: Definitive chemoradiotherapy with cisplatin and capecitabine is feasible; however, older populations require extra attention to early toxicities management.
An Unusual Case of Pheochromocytoma Associated with von Hippel-Lindau Disease and Lynch Syndrome During Pregnancy
Authors: Tang Michael , Meng Shumei 
Published: June 2024

AbstractPheochromocytomas (PCCs) and/or paragangliomas (PGLs) are a challenge to diagnose during pregnancy because of elusive signs and testing difficulties. We report a 25-year-old woman with no pertinent medical history who presented to the hospital with hypertension, vision loss, and weakness and was initially diagnosed with preeclampsia. Imaging showed hemangioblastomas in the medulla and thoracic spine, pancreatic cysts, and a renal cyst. The endocrinology service was consulted for possible PCCs associated with von Hippel-Lindau disease (VHL). Serum and urine normetanephrine levels were elevated despite the lack of overt PCCs/PGLs seen on magnetic resonance imaging and magnetic resonance angiography. The patient was medically managed with doxazosin and then labetalol. Despite successful resection of the hemangioblastoma in the medulla, the patient suffered respiratory distress requiring tracheostomy and venous-venous extracorporeal membrane oxygenation (V-V ECMO) and fetal demise. After 3 months, the patient was discharged to rehabilitation. Follow-up genetics were heterozygous for VHL and Lynch syndrome. DOTATATE positron emission tomography/computed tomography scan showed a small hepatic focus of a maximum standard uptake value of 12.1. Altogether, this case illustrates the importance of prompt diagnosis and proper management of PCCs/PGLs during pregnancy and incorporating genetic information during surveillance to lower morbidity and mortality.
Delayed Type Hypersensitivity Reaction Induced By Liraglutide With Tolerance to Semaglutide
Authors: Moreno-Borque Ricardo , Guhl-Millán Guillermo , Mera-Carreiro Sara , Pazos-Guerra Mario , Cortés-Toro Jose Antonio , López-Bran Eduardo 
Published: June 2024

Abstract
Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the management of type 2 diabetes and obesity. It was the first GLP-1 receptor agonist to be approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of obesity. To date, numerous skin adverse reactions to liraglutide have been reported, but data regarding hypersensitivity reactions are scarce, raising concerns about its safety and clinical management. We present the case of a 56-year-old female patient with class 3 obesity who was started on subcutaneous liraglutide (Saxenda) by her endocrinologist. One month after starting the aforementioned treatment, the patient presented well-defined, round, erythematous pruriginous plaques surrounding the injection site, around 24 hours after the drug administration. A liraglutide-induced, delayed-type hypersensitivity reaction was suspected, which could be subsequently confirmed by allergy testing and histopathological study. This paper explores the clinical use of liraglutide, the occurrence of hypersensitivity reactions, diagnosis, management, and implications for future research. Understanding and managing liraglutide hypersensitivity is crucial to ensuring the safety and efficacy of this medication.
An Innovative Approach to Determine Programmed Intermittent Epidural Bolus Pump Settings for Labor Analgesia: A Randomized Controlled Trial
Authors: Munro Allana , George Ronald B. , Andreou Pantelis 
Published: June 2024

BACKGROUND:
Three settings are required on a programmed intermittent epidural bolus (PIEB) pump for labor analgesia: the PIEB next bolus (PIEBnb), PIEB interval (PIEBi), and PIEB volume (PIEBv). The ideal settings for these parameters are still unknown. We hypothesized a mathematical modeling tool, response surface methodology (RSM), could estimate 3 PIEB pump parameters while balancing 3 clinically important patient outcomes simultaneously. The study objective was to use RSM to estimate PIEB settings (PIEBnb, PIEBi, and PIEBv) while maximizing maternal satisfaction, minimizing the need for clinician-administered boluses, and optimizing the ratio of delivered/requested patient-controlled epidural analgesia (PCEA) boluses simultaneously.

METHODS:
With institutional ethics approval, a double-blind randomized trial was completed in a tertiary care labor and delivery center. Nulliparous, English-speaking American Society of Anesthesiologists (ASA) physical status II patients aged 18 to 45 years at full term, single gestation in vertex presentation, in spontaneous labor and ≤7 cm cervical dilation were included. Patients with comorbidities, contraindications to neuraxial analgesia, using chronic analgesics, <152 cm, or body mass index (BMI) >45 kg/m2 were excluded. After informed consent, labor analgesia was initiated using 10 mL ropivacaine 0.2% with 10 µg/mL fentanyl solution and PCEA (volume 6 mL every 10 minutes). Patients were randomized to predetermined PIEB settings. RSM identified 3 pump settings that represented a stationary point that best maximized or minimized 3 outcomes simultaneously: PCEA ratio (a ratio closest to 1), clinician bolus (optimal is 0), and maternal satisfaction (visual analog scale, 0–100, ideal response is ≥90).

RESULTS:
Of 287 potential participants, 192 did not meet inclusion criteria or declined to participate, and 26 were withdrawn, leaving 69 patients for study inclusion. Using RSM, the suggested PIEB settings for all the primary study outcomes were as follows: PIEBnb = 29.4 minutes, PIEBi = 59.8 minutes, and PIEBv = 6.2 mL. These PIEB settings corresponded to the following clinical outcomes: maternal satisfaction at 93.9%, PCEA ratio at 0.77, and need for clinician bolus at 0.29. The dermatome sensory score was between T10 and T5 in 89% of the patients. The median lowest Bromage score was 4.

CONCLUSIONS:
This novel study used a mathematical model to estimate PIEB pump settings while simultaneously maximizing 3 clinical outcomes. Equally weighted clinical outcomes prevent maximal outcome optimization and may not reflect patient priorities. Future studies or quality improvement endeavors could use RSM methodology to estimate PIEB pump settings targeting optimal values for a single clinical outcome of determined importance to parturients.
Breaking the Saffron Wave?
Authors: Schonthal Benjamin , Ginsburg Tom 
Published: June 2024

Abstract
In recent years, thousands of Buddhist monastics have marched in antiregime protests across South and Southeast Asia. Among the largest and most influential nonstate organizations in the region, monastic communities appear to be powerful agents for political change. Yet, like similar movements over the last half-century, recent monastic protests did not produce broader political resistance among the monkhood, nor did they lead to substantive political change. What explains this? Why has antigovernment activism among Buddhist monks been less durable or impactful than other types of monastic activism, such as the varieties of chauvinistic nationalism that have risen to prominence in recent years? This article draws on three case studies—Myanmar, Thailand, and Sri Lanka—to offer one answer: sangha capture, the strategic use of law, bureaucracy, patronage, and coercion by governing elites to induce compliance among monastics while also muffling and marginalizing would-be critics.
Pedicle Subtraction Osteotomies for Surgical Correction of Fixed Sagittal Imbalance: A Meta-Analysis and Systematic Review
Authors: Makineni Pratheek S. , El-Abtah Mohamed E. , Porto Joshua R. , Steinmetz Michael P. , Benzel Edward C. 
Published: June 2024

BACKGROUND AND OBJECTIVES:
Disruption of the spine's sagittal balance is associated with significant negative impacts on quality of life. Compared with other spinal osteotomies, pedicle subtraction osteotomy (PSO), which can potentially offer greater correction, is considered technically challenging and performed at lower rates. The aim of this study was to review the use of PSO to correct fixed sagittal imbalance and assess its efficacy and associated perioperative complications.

METHODS:
In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, EBSCO host, MEDLINE, and Google Scholar databases were queried for full-text English manuscripts published from 1961 to 2022, exploring PSO for the management of fixed sagittal imbalance. Studies were included if they reported preoperative and postoperative radiographic measurements. The mean Methodological Index for Nonrandomized Studies (MINORS) for included articles was 9.6 ± 1.1. The outcomes of interest included etiology, operative time, blood loss, complications, radiographic outcomes, and patient-reported outcomes. Statistical analysis was performed using a random-effects, inverse variance-weighted meta-analysis of observational data. Pre and postoperative radiographic and clinical outcomes were compared using a Student t-test.

RESULTS:
Fourteen studies with 595 patients were included. Meta-analysis showed that the mean operative time was 7.2 ± 2.0 hours, and the average blood loss was 2033 ± 629 mL. After PSO, there was a significant improvement in sagittal vertebral axis (12.41-3.92 cm, P = .0003), LL (13.35°-42.60°, P = .000002), PSO angle (5.11° to −26.91°, P = .0001), and Oswestry Disability Index (55.36-27.35, P = .02). Common complications include pseudarthrosis (8.1%), neurological deficits (7.8%), and proximal junctional failure (6.0%).

CONCLUSION:
PSO offers significant correction of sagittal vertebral axis, lumbar lordosis, PSO angle, and Oswestry Disability Index scores despite its reduced utilization in recent years. Blood loss and high complication rates must be considered when evaluating the efficacy of this procedure; however, surgeon experience and operative techniques can be used to reduce morbidity.