bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous Preterm Birth: a Fetal-Maternal Metabolic Imbalance
Authors: Battat Tayla Lanxner , Erez Offer 
Published: October 2023

Abstract
Preterm delivery is a major global health problem associated with increased neonatal morbidity and mortality. To develop effective strategies to reduce preterm birth, it is important to address the causes of and risk factors for this condition. Maternal metabolism plays a crucial role in pregnancy outcomes, as it affects the availability of nutrients, energy, and other essential factors required for fetal development and growth. Several aspects of maternal metabolism can potentially contribute to the risk of preterm delivery. Severe energy deficiency as observed in women suffering from eating disorders can affect the hypothalamic-pituitary-gonadal axis resulting in amenorrhea and infertility, suggesting that maintaining a minimum maternal weight is essential to uphold a functional reproductive system, thus ensuring a successful pregnancy. Maternal undernutrition as observed in past famine and observations and animal studies may affect fetal growth and trigger an early activation of the parturition pathway leading to preterm delivery. A correlation exists between maternal size and gestation duration. Obesity is associated with a higher likelihood of medically indicated preterm birth. Low maternal body mass index and low gestational weight gain during pregnancy have been associated with preterm birth, potentially due to fetal-maternal metabolic imbalance; however, the exact mechanism remains to be determined, thus emphasizing the importance of appropriate weight management before and during pregnancy. Addressing metabolic-related risk factors for preterm delivery requires a comprehensive approach to reduce the burden of preterm delivery and improve neonatal outcomes. This review aims to explore various aspects of fetal-maternal metabolic imbalance that could potentially contribute to preterm birth. By doing so, we suggest a novel and comprehensive approach that sheds light on the intricate connection between fetal-maternal imbalance and the susceptibility to preterm birth.
Natural Radioactivity of Granitic Rocks and Their Health Risk around Ingesana Mountains, Sudan
Authors: Fadol Nooreldin , Abdelrazig Ali , Idriss Hajo , Alashban Yazeed , Shubayr Nasser 
Published: October 2023

AbstractThis work was carried out mainly to analyze radioactive elements40K,232Th, and226Ra and non-radioactive elements in some granitic rocks and study their health risk for humans and non-humans. Radioisotope activity was evaluated using a high-purity germanium (HPGe) detector, and various radiological hazard indices were calculated. We also measured some non-radioactive elements using x-ray fluorescence analysis and performed Pearson correlation analysis to examine the relationships between the radionuclides and the non-radioactive elements. Furthermore, we used the ERICA software to estimate the total dose rate per organism for some non-human biota. The means of226Ra,232Th, and40K are 25.13 ± 5.22 Bq kg−1, 29.01 ± 6.95 Bq kg−1, and 323.07 ± 97.83 Bq kg−1, respectively. Hence,226Ra,232Th, and40K radioactivities were lower than the worldwide average limits. The226Ra,232Th, and40K levels were under the global average values. The hazardous radiometric variables were computed, and the findings observed that the mean absorbed dosage was 23.48 ± 7.36 nGy h−1, the yearly effective dose rate was 29.82 ± 10.46 μSv y−1, and the radium equivalent activity was 88.88 ± 18.64 Bq kg−1. The average dose and yearly effective dose rates were lower than the global average absorbed dose rate of 60 nGy h−1and the ICRP standard of 1.0 mSv y−1. The results of Ra-equivalent activity were lower than the recommended maximum criterion for building materials limit of Ra-equivalent activity (370 Bq kg−1) proposed by UNSCEAR. Tests of Pearson correlation coefficients indicate a substantial positive relationship between226Ra and232Th and a modest correlation between226Ra and40K. Meanwhile, no association between226Ra and40K and non-radioactive components has been identified. Thorium-232 exhibits a moderately favorable connection with Ti, Fe, and Ni. The estimated total dose rate per organism for the studied non-human is less than the ambient dose rate. However, the total dose rate for small burrowing mammals and reptiles exceeds the background exposure rate. In accordance with the findings, granite rocks may be safe to use as construction materials and pose no threat to human health.
Effects of Cumulative Head Impact Exposure in Adolescent Male Contact and Collision Sport Student Athletes
Authors: Ransom Danielle M. , Ahumada Luis , Amankwah Ernest K. , Katzenstein Jennifer M. , Goldenberg Neil A. , Bauer Timothy A. , Mularoni P. Patrick 
Published: October 2023

Objective:
This prospective cohort study aimed to investigate the association between head impact exposure (HIE) and neuropsychological sequelae in high school football and ice hockey players over 1 year.

Setting:
Community sample.

Participants:
A cohort of 52 adolescent American football and ice hockey players were enrolled in the study, with a final study sample of 35 included in analyses.

Design:
The study followed a prospective cohort design, with participants undergoing neuropsychological screening and accelerometer-based measurement of HIE over 1 season.

Main Measures:
Changes in cognition, emotions, behavior, and reported symptoms were assessed using standardized neuropsychological tests and self-reported questionnaires.

Results:
Cumulative HIE was not consistently associated with changes in cognition, emotions, behavior, or reported symptoms. However, it was linked to an isolated measure of processing speed, showing inconsistent results based on the type of HIE. History of previous concussion was associated with worsened verbal memory recognition (ImPACT Verbal Memory) but not on a more robust measure of verbal memory (California Verbal Learning Test [CVLT]). Reported attention-deficit/hyperactivity disorder history predicted improved neurocognitive change scores. No associations were found between reported history of anxiety/depression or headaches/migraines and neuropsychological change scores.

Conclusion:
Overall, our findings do not support the hypothesis that greater HIE is associated with an increase in neuropsychological sequelae over time in adolescent football and ice hockey players. The results align with the existing literature, indicating that HIE over 1 season of youth sports is not consistently associated with significant neuropsychological changes. However, the study is limited by a small sample size, attrition over time, and the absence of performance validity testing for neurocognitive measures. Future studies with larger and more diverse samples, longer follow-up, and integration of advanced imaging and biomarkers are needed to comprehensively understand the relationship between HIE and neurobehavioral outcomes. Findings can inform guidelines for safe youth participation in contact sports while promoting the associated health and psychosocial benefits.
Accelerated corneal crosslinking with 20′-soaking hydroxypropyl methyl cellulose/riboflavin vs conventional crosslinking with 30′-soaking dextran/riboflavin
Authors: Chacra Lily M. , Helwe Chadi , Assaf Jad F. , Yehia Madeleine , Baroud Serge , Torres-Netto Emilio A. , Hafezi Farhad , Awwad Shady T. 
Published: October 2023

Purpose:
To evaluate and compare functional and structural outcomes of accelerated corneal crosslinking (A-CXL) using riboflavin with hydroxypropyl methyl cellulose (HPMC) vs conventional corneal crosslinking (C-CXL) using riboflavin with dextran.

Setting:
American University of Beirut Medical Center, Beirut, Lebanon.

Design:
Retrospective analysis.

Methods:
Retrospective analysis of 83 eyes of 73 patients with mild to moderate keratoconus. First group (n = 44 eyes) underwent C-CXL using a 30-minute riboflavin/dextran soaking between June 2014 and March 2016. Second group (n = 39 eyes) underwent A-CXL using a 20-minute riboflavin/HPMC soaking between April 2016 and December 2017. Patients were evaluated preoperatively and at 1, 3, and 12 months postoperatively. Main outcome measures were simulated keratometry (simK), maximum axial keratometry (Kmax), demarcation line depth, and haze intensity measured using optical coherence tomography–based image analysis software.

Results:
Demarcation line (DL) was 298.30 ± 64.60 μm and 335.61 ± 99.76 μm for C-CXL and A-CXL groups, respectively (P = .04). Haze profile was similar for both groups. The mean simK values were reduced from 46.93 ± 3.50 and 46.44 ± 2.93 preoperatively to 46.18 ± 3.65 and 45.54 ± 2.78 at 12 months postoperatively, for C-CXL and A-CXL, respectively (P = .003 for both groups). The mean Kmax decreased from 52.46 ± 4.82 and 51.50 ± 3.87 preoperatively to 51.30 ± 4.42 and 50.30 ± 3.52 postoperatively, for the C-CXL and A-CXL, respectively (P < .001 for both groups). There was no difference in the simK and Kmax changes between the C-CXL and A-CXL groups (P = .814 and P = .913), visual acuity, and refraction between the 2 groups (P > .05).

Conclusions:
A-CXL with a 20-minute riboflavin/HPMC soaking produced deeper DL and similar corneal haze, topographic, refractive, and visual results to C-CXL with a 30-minute riboflavin/dextran soaking.
Integrated skin microbiome and metabolome analyses reveal altered bacterial community composition and metabolites in psoriasis
Authors: Tao Rong , Wan Zhe , Li Ruo-Yu , Wang Ruo-Jun 
Published: October 2023

Objective:
Current theories highlight the role of the microbiome in the pathogenesis of psoriasis. Additionally, abnormal metabolism can alter disease processes in terms of occurrence, progression, and prognosis. Therefore, an integrative microbiome and metabolome analysis of the skin may aid in understanding the disease pathogenesis and identify therapeutic targets for psoriasis.

Methods:
We recruited 22 patients with psoriasis and 22 age- and sex-matched healthy controls. Skin swabs were collected from the participants’ scalps. All samples underwent amplicon sequencing of the ITS1 and V3V4 16S rRNA regions and metabolome analysis.

Results:
The psoriatic lesions were characterized by higher bacterial diversity, significantly higher abundances of Corynebacterium and Staphylococcus, and a lower abundance of Cutibacterium compared with healthy controls. However, no significant alterations in the fungal diversity or fungal taxonomies were detected. Metabolome analysis revealed that prostaglandin-related metabolites, nucleotides, and cysteine- and methionine-related metabolites were significantly enriched in patients with psoriasis, and these metabolites were positively correlated with the disease-associated bacteria Staphylococcus and Corynebacterium.

Conclusions:
We demonstrated significant alterations in the skin microbiome and metabolome in patients with psoriasis compared with healthy controls.
Personalized acute kidney injury treatment
Authors: Porschen Christian , Strauss Christian , Meersch Melanie , Zarbock Alexander 
Published: October 2023

Purpose of review
Acute kidney injury (AKI) is a complex syndrome that might be induced by different causes and is associated with an increased morbidity and mortality. Therefore, it is a very heterogeneous syndrome and establishing a “one size fits all” treatment approach might not work. This review aims to examine the potential of personalized treatment strategies for AKI.

Recent findings
The traditional diagnosis of AKI is based on changes of serum creatinine and urine output, but these two functional biomarkers have several limitations. Recent research identified different AKI phenotypes based on clinical features, biomarkers, and pathophysiological pathways. Biomarkers, such as Cystatin C, NGAL, TIMP2∗IGFBP7, CCL14, and DKK-3, have shown promise in predicting AKI development, renal recovery, and prognosis. Biomarker-guided interventions, such as the implementation of the KDIGO bundle, have demonstrated an improvement in renal outcomes in specific patient groups.

Summary
A personalized approach to AKI treatment as well as research is becoming increasingly important as it allows the identification of distinct AKI phenotypes and the potential for targeted interventions. By utilizing biomarkers and clinical features, physicians might be able to stratify patients into subphenotypes, enabling more individualized treatment strategies. This review highlights the potential of personalized AKI treatment, emphasizing the need for further research and large-scale clinical trials to validate the efficacy of these approaches.
Prevention and management of antibiotic associated acute kidney injury in critically ill patients: new insights
Authors: Karimzadeh Iman , Strader Michael , Kane-Gill Sandra L. , Murray Patrick T. 
Published: October 2023

Purpose of review
Drug associated kidney injury (D-AKI) occurs in 19–26% of hospitalized patients and ranks as the third to fifth leading cause of acute kidney injury (AKI) in the intensive care unit (ICU). Given the high use of antimicrobials in the ICU and the emergence of new resistant organisms, the implementation of preventive measures to reduce the incidence of D-AKI has become increasingly important.

Recent findings
Artificial intelligence is showcasing its capabilities in early recognition of at-risk patients for acquiring AKI. Furthermore, novel synthetic medications and formulations have demonstrated reduced nephrotoxicity compared to their traditional counterparts in animal models and/or limited clinical evaluations, offering promise in the prevention of D-AKI. Nephroprotective antioxidant agents have had limited translation from animal studies to clinical practice. The control of modifiable risk factors remains pivotal in avoiding D-AKI.

Summary
The use of both old and new antimicrobials is increasingly important in combating the rise of resistant organisms. Advances in technology, such as artificial intelligence, and alternative formulations of traditional antimicrobials offer promise in reducing the incidence of D-AKI, while antioxidant medications may aid in minimizing nephrotoxicity. However, maintaining haemodynamic stability using isotonic fluids, drug monitoring, and reducing nephrotoxic burden combined with vigilant antimicrobial stewardship remain the core preventive measures for mitigating D-AKI while optimizing effective antimicrobial therapy.
Revisiting the promise, practice and progress of resuscitative endovascular balloon occlusion of the aorta
Authors: Marsden Max , Lendrum Robert , Davenport Ross 
Published: October 2023

Purpose of review
The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) to temporarily control bleeding and improve central perfusion in critically injured trauma patients remains a controversial topic. In the last decade, select trauma services around the world have gained experience with REBOA. We discuss the recent observational data together with the initial results of the first randomized control trial and provide a view on the next steps for REBOA in trauma resuscitation.

Recent findings
While the observational data continue to be conflicting, the first randomized control trial signals that in the UK, in-hospital REBOA is associated with harm. Likely a result of delays to haemorrhage control, views are again split on whether to abandon complex interventions in bleeding trauma patients and to only prioritize transfer to the operating room or to push REBOA earlier into the post injury phase, recognizing that some patients will not survive without intervention.

Summary
Better understanding of cardiac shock physiology provides a new lens in which to evaluate REBOA through. Patient selection remains a huge challenge. Invasive blood pressure monitoring, combined with machine learning aided decision support may assist clinicians and their patients in the future. The use of REBOA should not delay definitive haemorrhage control in those patients without impending cardiac arrest.
Comparative efficacy and safety of Chinese patent medicines of acute ischemic stroke: A network meta-analysis
Authors: Xu Yuan , Cao Shan , Wang Shu-fei , Hou Xin-li , Guo Si-si , Gou Xiao-jun 
Published: October 2023

Background:
Acute ischemic stroke (AIS) is characterized by high morbidity, disability, mortality, recurrence, and economic burden. Clinical trials have demonstrated that the clinical efficacy of combining oral Chinese patent medicines (CPMs) with chemical drugs (CDs) is better than that of CDs alone. In this study, we performed a network meta-analysis (NMA) of RCTs to assess the efficacy of different CPMs in combination with CDs in the treatment of AIS.

Methods:
Search 6 databases from the beginning to January 10, 2023. The Cochrane Risk of Bias tool assessed the methodological quality of the included studies. The NMA was then performed using the STATA 13.0 program. The surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the studied treatments, and cluster analysis was used to compare the effects of CPMs between 2 different outcomes.

Results:
A total of 94 eligible RCTs, involving 9581 participants, were included in this analysis. Nine CPMs, including Nao-mai-li granule (NML), Nao-mai-tai granule (NMT), Qi-long granule (QL), Long-sheng-zhi capsule (LSZ), Nao-xin-tong capsule (NXT), Nao-xue-shu oral liquid (NXS), Tong-xin-luo capsule (TXL), Xiao-shuan-chang-rong capsule (XSCR), and Xue-shuan-xin-mai-ning capsule (XSXMN) were included. Regarding the clinical effective rate, all types of CPMs + CDs treatments were significantly better than CDs treatments alone, with significant differences among the 9 selected CPMs. Compared with CDs, results showed that NXS + CDs performed best in improving clinical effective rate [OR = 4.73; 95% CI: 1.26–17.78; (SUCRA: 76.1%)]. TXL + CDs showed the most effective effect in alleviating National Institutes of Health Stroke Scale (NIHSS) [MD = −3.84; 95% CI: −5.23, −2.45; (SUCRA: 81.6%)]; NXT + CDs were most effective in improving Barthel index [MD = 13.05; 95% CI: 3.98–22.12; (SUCRA: 63.5%)]. Combined with other outcome indicators and the results of cluster analysis, NXS + CDs may assist in the potential optimal treatment regimen for AIS.

Conclusion:
In conclusion, CPMs were found to be beneficial as adjuvant therapy in patients with AIS. Taking into account the clinical effective rate and other outcomes, NXS + CDs may be the most effective option to improve the condition of AIS patients.
End-effector lower limb robot-assisted gait training effects in subacute stroke patients: A randomized controlled pilot trial
Authors: Lee Junekyung , Kim Dae Yul , Lee Seung Hak , Kim Ji Hye , Kim Deog Young , Lim Kil-Byung , Yoo Jeehyun 
Published: October 2023

Background:
This pilot study investigated end-effector lower limb rehabilitation robot training effects in subacute stroke patients.

Methods:
Forty-nine stroke patients were randomly assigned to 2 treatment groups: a 30-minute end-effector lower limb rehabilitation robot training plus 1.5-hour conventional physiotherapy (robot group; n = 26), or a 2-hour conventional physiotherapy (control group; n = 23). All patients received 5 treatments weekly for 4 weeks. The functional ambulatory category was the primary outcome and the motricity index, Fugl Meyer assessment-lower extremity, rivermead mobility index, 10 meter walk test, Berg balance scale, and modified Barthel index were secondary outcomes.

Results:
All outcome measures significantly improved in both groups after training (P > .05). The robot group improved more in FAC than the control group (P = .005).

Conclusions:
Compared with conventional physiotherapy alone, end-effector lower limb robot-assisted gait training with conventional physiotherapy improved subacute stroke patients walking ability.
Do patients receive any benefit from the addition of perioperative immunotherapy-chemotherapy for solid tumors?
Authors: Quan Rencui , Li Zaishang , Zhang Huaqing , Li Xueying 
Published: October 2023

Background:
Progress in the use of neoadjuvant immunotherapy combined with chemotherapy has become a highlight of cancer research. Our meta-analysis aimed to better elucidate the activity, efficacy and safety of this combination using data obtained from randomized controlled trials (RCTs).

Methods:
A systematic search of PubMed, Embase, Web of Science, the Cochrane Library and conference proceedings up to January 31, 2023 was carried out to identify RCTs investigating neoadjuvant immunotherapy combined with chemotherapy for the treatment of solid tumors. Using fixed- and random-effects models, pooled odds ratios (ORs) and hazard ratios with 95% confidence intervals (CIs) were calculated for pathological complete response (pCR, defined as ypT0/is pN0) and immunotherapy treatment-related adverse events.

Results:
A total of 1876 studies were identified, and 6 RCTs (N = 2558 patients) were included. The pCR was significantly higher with neoadjuvant immunotherapy combined with chemotherapy than with neoadjuvant chemotherapy alone (OR = 2.30, 95% CI: 1.43–3.71, P < .001). The pCR was confirmed to be statistically significant in the PD-L1-positive subgroup (OR = 2.01; 95% CI: 1.55–2.59, P = .012). The pCR was confirmed to be statistically significant in the PD-1 inhibitor subgroup (OR = 4.17; 95% CI: 1.47–11.87, P = .000), while no statistically significant was observed in the PD-L1 inhibitor subgroup (OR = 1.52; 95% CI: 1.12–2.07, P = .308). The pooled ORs of any grade treatment-related or immunotherapy-related adverse events were significant, but the grade 3–4 immunotherapy-related adverse events were not.

Conclusion:
Our study provides comprehensive data that the addition of PD1 blockade to neoadjuvant chemotherapy resulted in better treatment efficacy than neoadjuvant chemotherapy alone in patients with solid tumors and had a similar safety profile.
An uncommon complication of a common injury: Acute foot compartment syndrome following an ankle sprain: A case report and review of the literature
Authors: Otayek Joeffroy , Assi Chahine , Yammine Kaissar 
Published: October 2023

Introduction:
Acute foot compartment syndrome (FCS) is a rare but potentially devastating complication that can occur following severe trauma of the limbs. In very are cases, such syndrome occurs following minor trauma. We present an exceptional case of acute FCS as a complication of an ankle sprain.

Clinical findings:
A 32-year-old male patient presented with excruciating foot pain and swelling 48 hours following an ankle sprain. Physical examination revealed severe swelling of the right foot, pale and swollen toes, and tense and pale dorsal skin and severe pain upon passive extension of the toes.

Diagnosis:
An acute FCS was considered.

Intervention and outcomes:
The patient underwent a fasciotomy using a double-dorsal incision technique. The patient’s symptoms were controlled, and he was discharged from the hospital 2 days after the surgery.

Conclusion:
Acute FCS could occur following minor trauma such as an ankle sprain. Early recognition and timely surgical intervention are crucial to prevent severe complications. The diagnosis is primarily clinical and immediate fasciotomy is needed to reduce intracompartment pressure and prevent muscular necrosis and other complications.