bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the approaches to nausea and vomiting in pregnancy: insights from a nationwide survey of Italian gynecologists (PURITY light)
Authors: Di Iorio Romolo , Bianchi Paola , Casolati Elena , Piccolo Elena , Mangrella Mario 
Published: January 2025

IntroductionNausea and vomiting in pregnancy (NVP) affect approximately 70–85% of pregnant women, starting between weeks 6 and 8 and often subsiding by week 20. This study evaluates the therapeutic approaches of Italian gynecologists in the treatment of NVP. In the Italian healthcare system, gynecologists play a central role in prenatal care and are the primary healthcare providers for pregnant women, unlike in other countries where midwives may have a more prominent role.MethodsFrom June to September 2022, a survey of Italian gynecologists was conducted during 15 scientific conferences. The questionnaire collected demographic data and information on clinical practices to support the management of NVP. Statistical analysis assessed the effect of demographic characteristics on clinical behavior.ResultsData from 157 participants, mainly women (72.61%) and professionals from the Public Health System (63.69%), were analyzed. 77.71% always checked NVP during the first visit, based on patients’ reports (84.71%). 54.78% prescribed medication in mild cases, mainly the doxylamine/pyridoxine combination (64.97%).DiscussionThe results show varied practices influenced by demographic and professional factors. Many physicians treat only severe cases of NVP, perceiving it as a transient discomfort, which may lead to poor management. Balanced care is needed to improve the quality of life for pregnant women with NVP.
Experimental implementation of the peripheral nerve block clinical registry: an observational study
Authors: Dabbagh Ali , Madadi Firoozeh , Ebrahimi Moein , Dabir Shideh , Vosoughian Maryam , Dahi Mastaneh , Moshari Mohammadreza , Tabashi Soudeh , Ariannik Mohsen , Azizi Zahra 
Published: January 2025

Background and aimsPeripheral nerve block (PNB) is commonly used, but there is a lack of data on its effectiveness and safety in the clinic. Therefore, anesthesiologists have limited insight into how they are faring in terms of both safety and efficacy. Additionally, No PNB registry is recorded in IRAN. Herein, we reveal how a hospital might use information gathered in a hospital registry of PNB outcomes to guide future quality enhancement efforts.MethodThis was an observational, prospective, and unicenter study of all peripheral nerve blocks done in the operating room since December 22, 2022. After studying the data collected by the existing registries worldwide, the anesthesiology research center at Taleghani Hospital developed a questionnaire that incorporated the varying parameters set forth by earlier research and registries. Parameters were documented for each patient.ResultsA total of 105 patients, were accrued from December 22, 2022, to July 23, 2023. The brachial plexus blocks namely axillary, infraclavicular, and popliteal blocks were the most frequently used PNBs, respectively. The indications that generated the greatest demand for PNBs were upper limb fractures, I&amp;D, and amputation, respectively. 82.9% of blocks were conducted while patients were sedated employing systemic administration of sedatives. In this registry, there were no deaths or complications with sequelae. The median duration of hospitalization following admission to the hospital was 3 days. The mean patient satisfaction score was 9.46 out of 10.ConclusionOur analysis demonstrates the effectiveness, safety, and feasibility of peripheral nerve blocks in preoperative anesthesia. It is recommended to continue the registry and conduct additional studies to enhance our understanding of this procedure.
Pharmacological interventions for the management of anesthesia and sedation in patients with Duchenne muscular dystrophy: a systematic review and meta-analysis
Authors: Lian Xianghong , Jing Yang , Luo Ting , Guo Yixin , Lin Yunzhu 
Published: January 2025

BackgroundPatients with duchenne muscular dystrophy (DMD) have an increased risk of complications when they undergo sedation or general anesthesia. However, due to improvements in cardiopulmonary therapies during anesthetic care, patients with DMD are experiencing an unprecedented duration of survival. We performed a systematic analysis to assess the benefits and risks of pharmacological interventions for the management of anesthesia and sedation in DMD patients.MethodsWe included any type of study reporting any drug intervention to manage anesthesia and sedation in participants previously diagnosed with DMD. Our primary outcomes were the onset time, recovery time, and neurodevelopmental disabilities. Seven electronic databases and three clinical trial registry platforms were searched. Data from the eligible studies were combined to calculate pooled risk ratios or standardized mean differences, and some included studies are presented in a narrative synthesis.ResultsForty studies with 196 DMD participants were included in the analysis. Compared with those of the control group, the sensitivity of patients with DMD to neuromuscular blocking agents (NMBAs) may have resulted in a prolonged onset time [MD = −0.96, 95% CI (0.71, 2.60), I2 = 33%, P &lt; 0.0001] and recovery time [MD = 2.22, 95% CI (1.14, 3.30), I2 = 76%, P &lt; 0.0001] from anesthesia. The neuromuscular blocking effects showed a significant age dependence in DMD patients, and the safe use of 2 mg/kg sugammadex to antagonize deep neuromuscular blockade and rapid recovery has been reported. Furthermore, DMD patients are at risk of developing malignant hyperpyrexia with general/inhaled anesthesia, and dantrolene is often used for effective rescue. In addition, general anesthesia and central neuraxial blockade in patients with severe DMD are unsafe because respiratory depression and myocardial complications may occur after the administration of volatile anesthetics and depolarizing muscle relaxants (succinylcholine) during the induction of anesthesia.ConclusionsPatients with DMD are more sensitive to NMBAs with delayed onset times and prolonged recovery times. Precautions for DMD patients should include quantitative neuromuscular monitoring, electrocardiographic monitoring and rapid airway protection throughout anesthesia. Compared with general anesthesia, regional anesthesia may be a relatively safe option.
Study on influencing factors of age-adjusted Charlson comorbidity index in patients with Alzheimer's disease based on machine learning model
Authors: Ding Jian , Long Zheng , Liu Yiming , Wang Min 
Published: January 2025

BackgroundAlzheimer's disease (AD) is a widespread neurodegenerative disease, often accompanied by multiple comorbidities, significantly increasing the risk of death for patients. The age adjusted Charlson Comorbidity Index (aCCI) is an important clinical tool for measuring the burden of comorbidities in patients, closely related to mortality and prognosis. This study aims to use the MIMIC-V database and various regression and machine learning models to screen and validate features closely related to aCCI, providing a theoretical basis for personalized management of AD patients.MethodsThe research data is sourced from the MIMIC-V database, which contains detailed clinical information of AD patients. Multiple logistic regression, LASSO regression, random forest, Support Vector Machine (SVM), and Extreme Gradient Boosting (XGBoost) models were used to screen for feature factors significantly correlated with aCCI. By comparing model performance, evaluating the classification ability and prediction accuracy of each method, and ultimately selecting the best model to construct a regression model and a nomogram. The model performance is evaluated through classification accuracy, net benefit, and robustness. The feature selection results were validated by regression analysis.ResultsMultiple models have performed well in classifying aCCI patients, among which the model constructed using LASSO regression screening feature factors has the best performance, with the highest classification accuracy and net benefit. LASSO regression identified the following 11 features closely related to aCCI: age, respiratory rate, base excess, glucose, red blood cell distribution width (RDW), alkaline phosphatase (ALP), whole blood potassium, hematocrit (HCT), phosphate, creatinine, and mean corpuscular hemoglobin (MCH). The column chart constructed based on these feature factors enables intuitive prediction of patients with high aCCI probability, providing a convenient clinical tool.ConclusionThe results of this study indicate that the features screened by LASSO regression have the best predictive performance and can significantly improve the predictive ability of aCCI related comorbidities in AD patients. The column chart constructed based on this feature factor provides theoretical guidance for personalized management and precise treatment of AD patients.
Early identification of macrophage activation syndrome in adult-onset Still’s disease: a case report and literature review
Authors: Long Ting , Xu Jing , Lin Bo-Zhi , Li Sheng-Guang 
Published: January 2025

BackgroundAdult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder characterized by high spiking fevers, evanescent rash, and polyarthritis. A serious complication of AOSD is macrophage activation syndrome (MAS), a life-threatening hyperinflammatory condition that can lead to multiorgan failure if not promptly diagnosed and treated.ObjectiveThis case report and literature review focus on the early identification of MAS in patients with AOSD, highlighting diagnostic challenges, differential diagnoses, and the utility of scoring systems like the HScore and MS score in clinical practice.Case presentationWe report the case of an 80-year-old woman who presented with a complex diagnostic challenge involving AOSD complicated by MAS and concurrent cytomegalovirus (CMV) infection. Her clinical course was marked by recurrent high fevers, cytopenias, hyperferritinemia, and liver dysfunction. Despite extensive workup, initial diagnoses of infections and autoimmune conditions were considered and ruled out. The HScore and MS score were calculated to be 210 and 1.607, respectively, both indicative of MAS. The patient was treated according to the HLH-94 protocol, with high-dose dexamethasone and etoposide, alongside broad-spectrum antimicrobial and antiviral therapy. She responded well to treatment, with resolution of fever and improvement in clinical symptoms.DiscussionThe overlap between AOSD and MAS symptoms complicates early diagnosis, making scoring systems critical in differentiating MAS from other conditions. The HScore and MS score provided a structured approach to diagnosis, guiding timely intervention and improving the patient’s prognosis. Our literature review emphasizes the importance of early recognition and integration of these scoring systems into routine clinical practice to enhance outcomes.ConclusionThis case underscores the necessity of early identification and intervention in MAS associated with AOSD. The application of diagnostic scoring systems like the HScore and MS score is essential for prompt diagnosis and effective treatment, ultimately improving patient survival rates.
The role of SASP in ischemic stroke: a deep dive into cellular mechanisms
Authors: Xie Dong , Liu Yang , Xu Fang-Biao , Zhang Jin-Sheng 
Published: January 2025

BackgroundThe escalating incidence of ischemic stroke (IS) exerts a heavy toll on global health. Aging, a prominent risk factor, implicates the senescence-associated secretory phenotype (SASP) in IS pathogenesis. We postulated that alterations in SASP-related factor expression during IS correlate with remodeling of intercellular interaction networks and disease advancement. The present study endeavored to preliminarily dissect the SASP-IS nexus via combined bulk and single-cell transcriptome analysis.MethodsAggregated expression profiles from human peripheral blood bulk chips and MCAO mouse single-cell sequencing data, followed by SASP gene analysis. Executed protein interaction network and enrichment assays. Investigated immune infiltration in stroke patients, managed quality control and annotation of single-cell data, cherry-picked central cells based on SASP scores, unearthed essential genes via enrichment analysis, conducted pseudo-time and intercellular communication studies, and prognosticated drugs for hub genes. Finally, authenticated core gene expression in serum of MCAO and Sham rats using real-time fluorescent polymerase chain reaction (RT-qPCR).ResultsFourteen hub genes were discerned. Seven cell types were annotated in MCAO mouse peripheral blood single-cell data. Basophils exhibited the highest SASP scores, with Lcp1 upregulated and Ccl3 downregulated in basophils of the MCAO group. Enrichment analysis divulged a significant association of Ccl3 with the cell apoptosis pathway and Lcp1 with immune responses. The Ccl3 gene is pivotal in basophils and basophil-neutrophil crosstalk. Additionally, we forecasted nagrestipen’s regulatory function on Ccl3. RT-qPCR demonstrated a marked elevation in Lcp1 mRNA and a pronounced reduction in Ccl3 in the MCAO group relative to the Sham group.ConclusionThe Ccl3 gene in basophils and its immune cell interaction is a linchpin in the IS immune microenvironment. Ccl3 and Lcp1 might potentially modulate IS progression by influencing SASP, proffering novel prospects for IS clinical diagnosis and treatment.
Genetic and peripheral biomarkers of comorbid posttraumatic stress disorder and traumatic brain injury: a systematic review
Authors: Cowansage Kiriana , Nair Reshmi , Lara-Ruiz Jose M. , Berman Daniel E. , Boyd Courtney C. , Milligan Tiffany L. , Kotzab Daniel , Bellanti Dawn M. , Shank Lisa M. , Morgan Maria A. , Smolenski Derek J. , Babakhanyan Ida , Skopp Nancy A. , Evatt Daniel P. , Kelber Marija S. 
Published: January 2025

BackgroundPosttraumatic stress disorder (PTSD) commonly cooccurs with traumatic brain injury (TBI) in military populations and is a significant predictor of poor long-term outcomes; however, it is unclear to what extent specific biological variables are associated with comorbidity. This PROSPERO-registered systematic review evaluates the current body of literature on genetic and peripheral biomarkers associated with comorbid TBI and PTSD.MethodsSearches were conducted in four databases (PubMed, PsycInfo, PTSDPubs, Scopus). We included published studies examining differences in peripheral biomarkers among civilian, military, and veteran participants with both TBI and PTSD compared to those with TBI alone as well as, in some cases, PTSD alone and healthy controls. Data were extracted from included studies and evidence quality was assessed.ResultsOur final analysis included 16 studies, the majority of which were based on data from active duty military and veteran participants. The results suggest that multiple gene variants are likely to contribute to the cumulative risk of PTSD comorbid with TBI. An elevated circulating level of the pro-inflammatory cytokine IL-6 was the most consistently replicated blood-based indicator of comorbid illness, compared to mTBI alone.ConclusionSeveral genetic and protein markers of cellular injury and inflammation appear to be promising indicators of chronic pathology in comorbid TBI and PTSD. Additional research is needed to determine how such factors indicate, predict, and contribute to comorbidity and to what extent they represent viable targets for the development of novel diagnostic tools and therapeutic interventions.
Convergent construct validity and test-retest reliability of both German versions of the original and the revised Niigata PPPD Questionnaire: NPQ and NPQ-R
Authors: Chételat Sarah , Gerber Eve-Yaël , El Khadlaoui Sarah , Behrendt Frank , Stark Michaela , Schädler Stefan , Maywald Maximilian , Fabritius Lena , Gerb Johannes , Grabova Denis , Trost Wiebke , Zwergal Andreas , Strobl Ralf , Parmar Katrin , Gerth Hans Ulrich , Bonati Leo H. , Becker-Bense Sandra , Schuster-Amft Corina 
Published: January 2025

BackgroundPersistent Postural-Perceptual Dizziness (PPPD) is a frequent chronic functional disorder that manifests with dizziness, unsteadiness, or non-spinning vertigo present for at least 3 months. Characteristic provocation factors are moving or complex visual stimuli and exclusion of organic diseases. To assess the severity and impact of PPPD, Japanese researchers developed the Niigata PPPD Questionnaire (NPQ). The study's aim was to evaluate the concurrent construct validity and reliability [including test-retest reliability, internal consistency, standard error of measurement (SEM), and minimal detectable change (MDC)] of the German version of the NPQ (12 items) and its revised version, NPQ-R, which contains 19 items addressing additional symptoms and symptom behavior.MethodsThe Swiss Reha Rheinfelden and the German Center for Vertigo and Balance Disorders included 265 PPPD patients (mean age 50.2 ± 16.8 years, disease duration 46.3 ± 76.6 months). Patients completed the NPQ and the NPQ-R (twice), the DHI and potentially related constructs: anxiety (ABC-Scale, VSS), depression (HADS), and general health (SF-36) once. To assess the questionnaires' reliability and validity, several statistical measures were calculated, including Spearman's rank correlation coefficients, Intraclass Correlation Coefficients (ICC2, 1), Cronbach's alpha, SEM, and MDC.ResultsOn average, patients scored 29.9 ± 13.2 for NPQ and 52.3 ± 19.6 for NPQ-R. Correlations between NPQ/NPQ-R and (1) disease-specific questionnaires were rs= 0.712 and rs= 0.752 (DHI), rs=0.426 and rs= 0.0.462 (VSS-V), rs= -0.500 and rs= -0.545 (ABC-Scale), (2) anxiety-specific subscales rs = 0.394 and rs = 0.430 (VSS-A) and rs= 0.354 and rs= 0.430 (HADS-A), (3) depression-related subscales rs=0.438 and rs= 0.487 (HADS-D), and (4) general health rs ranged between rs= -0.216 and −0.578 (all SF-36 subscales). Internal consistency, test-retest reliability, SEM and MDC calculated for NPQ/NPQ-R were α = 0.88/α = 0.91, ICC=0.83 (CI 0.77 to 0.0.87), SEM 5.55/8.37, and MDC 15/23 points.ConclusionThe German versions of NPQ and NPQ-R are valid and reliable patient-reported outcome measures for assessing PPPD, demonstrating satisfactory psychometric measurement properties including convergent construct validity and reliability parameters: internal consistency, test-retest reliability, SEM, and MDC as an evaluative measure. The NPQ-R, with its additional subscales addressing associated symptoms and symptom behavior, represents both the patient and clinician perspective on PPPD-specific problems. Therefore, we recommend utilizing the NPQ-R for a comprehensive assessment of PPPD.
Comparative analysis of phytonutrients of Moringa oleifera leaves from South Africa and Nigeria, and their antimicrobial and antioxidant potentials by UPLC-ESI-QToF-MS and OPLS-DA chemometric analysis
Authors: Kayembe Jonathan , Sekelwa Cosa , Bassey Kokoette 
Published: January 2025

BackgroundMoringa oleifera Lam. has bioactive phytonutrients in abundance and offers diverse health benefits. The leaves of this plant have established significance in traditional medicine and nutrition. It is traditionally used by Nigerian and South African mothers to mitigate undernutrition. Usually, the powder leaves are added to porridge to feed the children. This study aimed to conduct a comparative analysis of the phytonutrients (nutrients protectors) or supplements, antioxidant, and antimicrobial potentials of M. oleifera leaves from Nigeria and South Africa to benchmark quality control protocols for commercial beverages such as Moringa porridge.MethodsStandard techniques, including high-performance liquid chromatography-photodiode array and ultra-high-performance liquid chromatography electrospray ionization quadruple time-of-flight mass spectrometry (UPLC-ESI-QToF-MS) and chemometrics orthogonal partial least square discriminant analysis (OPLS-DA) were employed for phytoconstituents fingerprinting. Whereas the antioxidant potentials of the extracts were determined using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and hydrogen peroxide scavenging assays, the antimicrobial potentials of the extracts were evaluated using minimum inhibitory concentrations protocol.ResultsThe chemometric analysis with a line regression (R2) = 0.97 revealed 70% significant similarities in the phytonutrients of samples between the two regions and an intriguing 30% variation within the same plant species. In addition, kaempferol, quercetin, luteolin, tangutorid E, and podophyllotoxin, among others were annotated as the major phytonutrients in the samples. The antioxidant assays unveiled concentration-dependent trends with scavenging activity of up to 98% (half-maximal inhibitory concentration [IC50] = 0.14 mg/mL) for 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 87% (IC50 = 0.28 mg/mL) for hydrogen peroxide assay. All the test extracts did not exhibit good to significant antibacterial inhibitory effect (minimum inhibitory concentration [MIC] = 1.25 mg/mL) compared to ciprofloxacin (MIC = 0.0156–0.0039 mg/mL).ConclusionThe variations in the phytonutrients of the same M. oleifera species harvested from different countries could have dire consequences including potential health risks and even death. This study should serve as a benchmark toward the phytonutrients and marketing implications on the quality of products formulated with samples harvested from different growth environments and exists as a reference for further research into the cultivation and marketing of M. oleifera leaves in South Africa.
Acute effect of endurance exercise on human milk insulin concentrations: a randomised cross-over study
Authors: Holm Rebecca Lyng , Holmen Mads , Sujan Md Abu Jafar , Giskeødegård Guro F. , Moholdt Trine 
Published: January 2025

IntroductionInsulin is present in human milk and its concentration correlates with maternal circulating levels. Studies on the association between human milk insulin concentrations and infant weight or growth show conflicting results, but some studies indicate that higher insulin concentrations in the milk can promote infant weight gain. Circulating levels of insulin decrease acutely after exercise, but no prior study has investigated the acute effect of exercise on human milk insulin concentrations. Our aim was to determine the acute effects of two endurance exercise protocols on human milk insulin concentration in exclusively breastfeeding individuals.MethodsIn a randomised cross-over trial, 20 exclusively breastfeeding participants who were 6–12 weeks postpartum completed three conditions on separate days: (1) moderate-intensity continuous training (MICT), (2) high-intensity interval training (HIIT), and (3) no activity (REST). Milk was collected before exercise/rest (at 07:00 h), immediately after exercise/rest (11:00 h), 1 h after exercise/rest (12:00 h), and 4 h after exercise/rest (15:00 h). We determined insulin concentrations in the milk using enzyme-linked immunosorbent assay and compared insulin concentrations after MICT and HIIT with REST using a linear mixed model with time-points and the interaction between time and condition as fixed factors.ResultsWe detected insulin in all 240 samples, with an average concentration of 12.3 (SD 8.8) μIU/mL (range 3.2–57.2 μIU/mL). There was no statistically significant effect of exercise on insulin concentration, but a tendency of reduced concentrations 4 h after HIIT (p = 0.093). There was an overall effect of time at 11:00 h and 15:00 h. In the fasted sample obtained at 07:00 h, the concentration was 9.9 (SD 7.2) μIU/mL, whereas the concentration was 12.7 (SD 9.0) μIU/mL at 11:00 h (p = 0.009), and 15.0 (SD 11.7) μIU/mL at 15:00 h (p &lt; 0.001).ConclusionOne session of endurance exercise, either at moderate- or high intensity, had no statistically significant effect on human milk insulin concentration. Future research should determine the effect of regular exercise on insulin in human milk and potential impact for infant health outcomes.Clinical trial registrationClinicalTrials.gov, identifier NCT05042414.