bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lotus (Nelumbo nucifera): a multidisciplinary review of its cultural, ecological, and nutraceutical significance
Authors: Yang Hang , He Simai , Feng Qi , Liu Zisen , Xia Shibin , Zhou Qiaohong , Wu Zhenbin , Zhang Yi 
Published: January 2024

AbstractThis comprehensive review systematically examines the multifarious aspects of Nelumbo nucifera, elucidating its ecological, nutritional, medicinal, and biomimetic significance. Renowned both culturally and scientifically, Nelumbo nucifera manifests remarkable adaptability, characterized by its extensive distribution across varied climatic regions, underpinned by its robust rhizome system and prolific reproductive strategies. Ecologically, this species plays a crucial role in aquatic ecosystems, primarily through biofiltration, thereby enhancing habitat biodiversity. The rhizomes and seeds of Nelumbo nucifera are nutritionally significant, being rich sources of dietary fiber, essential vitamins, and minerals, and have found extensive culinary applications. From a medicinal perspective, diverse constituents of Nelumbo nucifera exhibit therapeutic potential, including anti-inflammatory, antioxidant, and anti-cancer properties. Recent advancements in preservation technology and culinary innovation have further underscored its role in the food industry, highlighting its nutritional versatility. In biomimetics, the unique "lotus effect" is leveraged for the development of self-cleaning materials. Additionally, the transformation of Nelumbo nucifera into biochar is being explored for its potential in sustainable environmental practices. This review emphasizes the critical need for targeted conservation strategies to protect Nelumbo nucifera against the threats posed by climate change and habitat loss, advocating for its sustainable utilization as a species of significant value.
Graphical Abstract
Multimorbidity and its associated risk factors among adults in northern Sudan: a community-based cross-sectional study
Authors: Musa Imad R. , Hassan Ahmed Ali , Adam Ishag 
Published: January 2024

Abstract
Background
Multimorbidity (having two or more coexisting long-term conditions) is a growing global challenge. However, data on multimorbidity among adults in Africa, including Sudan, are scarce. Thus, this study aimed to investigate the prevalence of multimorbidity and its associated risk factors among adults in Sudan.

Methods
A community-based cross-sectional study was conducted in northern Sudan from March 2022 to May 2022. Participants’ sociodemographic characteristics were assessed using a questionnaire. Multimorbidity was defined as having two or more coexisting long-term conditions, including diabetes mellitus (DM), hypertension, obesity, anaemia and depression-anxiety. Multivariate logistic regression analyses were performed to determine the associated factors.

Results
The participants included 250 adults: 119 (47.6%) males and 131(52.4%) females. The median interquartile range (IQR) of the enrolled adults of the age was 43.0 (30.0‒55.0) years. Of the 250 adults, 82(32.8%), 17(6.8%), 84(33.6%), and 67(26.8%) were normal weight, underweight, overweight, and obese, respectively; 148(59.2%), 72(28.8%), 63(25.2%), 67(26.8%), and 98(39.2%) had hypertension, DM, anaemia, obesity, and depression-anxiety, respectively. A total of 154 adults (61.6%) had multimorbidity: 97(38.8%), 49(19.6%), and 8(3.2%) had two, three, and four morbidities, respectively. The remaining 21 (8.4%), and 75 (30.0%) adults had no morbidity, and one morbidity, respectively.
In amultivariate logistic regression analysis, increasing age (adjusted odd ratio [AOR] = 1.03, 95% CI = 1.01‒1.05), and female sex (AOR = 2.17, 95% CI = 1.16‒4.06) were associated with multimorbidity.

Conclusions
The high prevalence of multimorbidity revealed in this study uncovers a major public health problem among Sudanese adults. Our results show that increasing age and female sex are associated with multimorbidity. Additional extensive studies are necessary to evaluate the magnitude of multimorbidity for improved future planning and establishing effective health systems.
A balancing act: radicality and capture in institutionalising reflexive governance for urban sustainability transitions
Authors: de Geus Tessa , Wittmayer Julia M. , Silvestri Giorgia 
Published: January 2024

AbstractOver the past two decades, urban actors have sought to foster long-lasting change towards sustainability through reflexive governance. Related activities, including transition labs, arenas, experiments, and roadmaps, have been problematised for disparities between using a discourse of transformation and radicality while failing to materialise radical action and succumbing to ‘projectification’ – meaning that the impact of an intervention tends to evaporate after the initial experiment impulse. Enabling a transformative legacy of such interventions requires institutionalising reflexive governance arrangements, i.e. a process of integrating these arrangements as part of the existing institutional set-ups while maintaining ‘radical’ elements. Particularly as the focus in certain urban transitions shifts from emerging and supporting niche practices towards institutionalising new ways of working and breaking down regime structures, it becomes paramount to better understand such processes. Based on a comparative empirical analysis of six European cities, we explore how these cities attempt to institutionalise reflexive governance and take stock of the tensions encountered, particularly to what extent cities manage to safeguard their radical ambitions, or whether these become ‘captured’ in the process. Other highlighted tensions are a focus on internal dynamics, a struggle around voluntary structures and accountability, and a challenge of keeping momentum with new actor constellations while trying to address complexity and uncertainty. We conclude by putting forward three recommendations for how reflexive governance processes may increase their impact: through prioritising institutional embeddedness in and outside of the local authority; creating transparency around how governance arrangements are adjusted and modified throughout the process for accountability; and renewing commitment periodically to ensure continuity and commitment from actors involved.
Beverage Consumption, Genetic Predisposition, and Risk of Cardiovascular Disease Among Adults With Type 2 Diabetes
Authors: Zhu Kai , Geng Tingting , Qiu Zixin , Li Rui , Li Lin , Li Ruyi , Chen Xue , Pan An , Manson JoAnn E , Liu Gang 
Published: January 2024

Abstract

Background
The evidence regarding the relationship between different types of beverages and cardiovascular health in individuals with type 2 diabetes (T2D) is scarce.

Aims
To prospectively examine the associations between individual beverage consumption, genetic predisposition, and risk of incident cardiovascular disease (CVD) among adults with T2D.

Methods
We analyzed the associations of individual beverage intake with risks of CVD and ischemic heart disease (IHD) in 7315 participants with T2D, overall or stratified by genetic risk to CVD, using data from the UK Biobank study.

Results
During a median follow-up of 6.1 years, 878 incident CVD cases were identified, including 517 IHD cases. Higher intakes of sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and natural juices were each linearly associated with a higher CVD (Pnonlinearity &gt; .05). Comparing the highest to lowest groups of beverage consumption, the multivariable-adjusted hazard ratios (95% confidence intervals) of CVD were 1.54 (1.14, 2.07) for SSBs, 1.34 (1.07, 1.69) for ASBs, and 1.33 (1.01, 1.76) for natural juices. Similar results were observed for incident IHD. Moreover, no significant interactions between these beverages and the CVD genetic risk score were observed. Replacing half-unit/day of SSBs or natural juices with coffee, tea, or yogurt, but not ASBs, was associated with a 20% to 46% lower risk of CVD and IHD.

Interpretation
Higher intakes of SSBs, ASBs, and natural juices were each linearly associated with an increased risk of CVD among individuals with T2D, regardless of genetic predisposition. Our findings highlight the importance of selecting healthy beverage options to improve cardiovascular health in patients with T2D.
Maternal High-Fat Diet Affects the Contents of Eggs and Causes Abnormal Development in the Medaka Fish
Authors: Inoue Yusuke , Fukushima Manatsu , Hirasawa Go , Furukawa Fumiya , Takeda Hiroyuki , Umatani Chie 
Published: January 2024

Abstract
Maternal nutritional status can affect development and metabolic phenotypes of progeny in animals. The effects of maternal diet are thought to be mediated mainly by changes inside oocytes such as organelles, maternal RNAs, and metabolites. However, to what extent each factor contributes to offspring phenotypes remains uncertain, especially in viviparous mammalian systems, where factors other than oocytes, such as placenta and milk, need to be considered. Here, using the medaka fish as an oviparous vertebrate model, we examined whether maternal high-fat diet (mHFD) feeding affects offspring development and what kind of changes occur in the contents of mature eggs. We found that mHFD caused the high frequency of embryonic deformities of offspring, accompanied by downregulation of transcription- and translation-related genes and zygotic transcripts at the blastula stage. Transcriptomic and metabolomic analyses of mature eggs suggested decreased catabolism of amino acids and glycogen, moderate upregulation of endoplasmic reticulum stress-related genes, and elevated lipid levels in mHFD eggs. Furthermore, high-fat diet females showed a higher incidence of oocyte atresia and downregulation of egg protein genes in the liver. These data suggest that attenuated amino acid catabolism triggered by decreased yolk protein load/processing, as well as elevated lipid levels inside eggs, are the prime candidates that account for the higher incidence of embryonic deformities in mHFD offspring. Our study presents a comprehensive data on the changes inside eggs in a mHFD model of nonmammalian vertebrates and provides insights into the mechanisms of parental nutritional effects on offspring.
Second Malignancy Masquerading as Recurrence of Neuroendocrine Tumor
Authors: Chakraborty Ananda Mohan , Bhardwaj Neha , Rastogi Ashu , Bhadada Sanjay Kumar 
Published: January 2024

Abstract
Neuroendocrine tumors (NETs) may mimic many endocrine syndromes, including Cushing syndrome (CS) secondary to ectopic ACTH secretion. Radiotherapy (RT) is often used as adjuvant therapy for such persistent or recurrent NETs. However, RT may predispose a susceptible person to a second malignancy. Here, we reported the story of a 37-year-old male, who presented with progressive weight loss, bone pain, and shortness of breath in the emergency department. He was diagnosed with CS secondary to a carcinoid tumor in the bronchopulmonary tree a decade previous and underwent total bilateral adrenalectomy. He also underwent lobectomy, and subsequent RT for a primary NET and was in clinical remission. His presenting symptoms were considered a recurrence of pulmonary NETs. However, the biopsy suggested high-grade mucoepidermoid carcinoma (MEC). MEC of the lung is a rare tumor with a prevalence of &lt;1% of all lung malignancies. MEC of the lung after RT for bronchial NET-causing ectopic CS has not yet been reported in the literature. The present patient did not survive despite achieving remission of CS and primary tumor because of the aggressive second malignancy attributed to RT, which was given for the primary tumor.
Long-term Treatment of Pediatric Metastatic Papillary Thyroid Cancer With Lenvatinib
Authors: Donner Julia R , DeNardo Bradley , Topor Lisa Swartz 
Published: January 2024

Abstract
Papillary thyroid carcinoma (PTC) is the most common pediatric thyroid malignancy and incidence is increasing. Standard treatment for PTC in pediatric patients includes surgical intervention, suppression of TSH with levothyroxine, and radioactive iodine therapy (RAI) in select patients. In the setting of metastatic PTC or PTC refractory to RAI therapy, tyrosine kinase inhibitors (TKIs), such as lenvatinib, may be used. Until recently, experience with these targeted agents were largely limited to adult patients with progressive or refractory PTC. More recently, increased experience with TKI therapy has been reported in the pediatric population, with case reports and small series describing short-term TKI use. We report the case of a 15-year-old girl with RAI-refractory metastatic PTC who achieved stable disease with long-term lenvatinib treatment for more than 5.5 years. Prospective, longitudinal studies of TKIs in RAI-refractory pediatric PTC are needed.
Unraveling the Whipple Triad: Non–Islet Cell Tumor–Induced Hypoglycemia
Authors: Mohamed Farzahna , Raal Frederick J 
Published: January 2024

Abstract
Tumor-induced hypoglycemia (TIH) is a rare paraneoplastic phenomenon resulting from several tumor types and mechanisms. Insulinomas are the most common cause of TIH. However, non–islet cell tumors can also trigger hypoglycemia by releasing insulin-like growth factor 2 (IGF-II) or its precursor. We present a case of a 56-year-old woman experiencing spontaneous hypoglycemia due to a pleural-based solitary fibrous tumor. Diagnostic evaluations revealed diminished C-peptide levels, increased IGF-II, and a 4-fold increase in the IGF-II: IGF-I ratio, indicative of non–islet cell tumor hypoglycemia. Localization imaging identified a left pleural mass, confirming the diagnosis. Preoperatively, the patient received intravenous dextrose and corticosteroids, but surgical resection was essential for the resolution of symptoms. The identified tumor, a benign solitary fibrous tumor, was successfully removed, leading to an immediate postoperative cessation of hypoglycemia. Six years post resection, the patient remains symptom free. Managing TIH necessitates an early diagnosis aiming for complete tumor resection, with alternative approaches considered when complete resection is not possible. This case highlights the importance of a systematic diagnostic and management approach for TIH, emphasizing the need to identify the underlying cause, particularly in people without diabetes.
C-Reactive Protein/Albumin Ratio Is an Independent Risk Factor for Recurrence and Survival Following Curative Resection of Stage I–III Colorectal Cancer in Older Patients
Authors: Bekki Tomoaki , Shimomura Manabu , Hattori Minoru , Sato Saki , Watanabe Atsuhiro , Ishikawa Sho , Imaoka Kouki , Ono Kosuke , Matsubara Keiso , Mochizuki Tetsuya , Akabane Shintaro , Yano Takuya , Ohdan Hideki 
Published: January 2024

Abstract
Background
The number of older patients with cancer has increased, and colorectal cancer is expected to be affected by this trend. This study aimed to compare prognostic factors, including nutritional and inflammation-based indices, between patients aged ≥ 70 and < 70 years following curative resection of stage I–III colorectal cancer.

Patients and Methods
This study included 560 patients with stage I–III colorectal cancer who underwent curative resection between May 2010 and June 2018. A retrospective analysis was performed to identify prognosis-associated variables in patients aged ≥ 70 and < 70 years.

Results
Preoperative low body mass index, high C-reactive protein/albumin ratio, and comorbidities were mainly associated with poor prognosis in patients aged ≥ 70 years. Tumor factors were associated with a poor prognosis in patients aged < 70 years. The C-reactive protein/albumin ratio was independently associated with poor overall survival and recurrence-free survival in those aged ≥ 70 years. The time-dependent area under the curve for the C-reactive protein/albumin ratio was superior to those of other nutritional and inflammation-based indices in most postoperative observation periods in patients aged ≥ 70 years.

Conclusions
Tumor factors were associated with a poor prognosis in patients aged < 70 years. In addition to lymph node metastasis, preoperative statuses were associated with poor prognosis in patients aged ≥ 70 years. Specifically, the preoperative C-reactive protein/albumin ratio was independently associated with long-term prognosis in patients aged ≥ 70 years with stage I–III colorectal cancer after curative resection.
Critical Analysis of the Efficacy and Limitations of GLP-1 Pharmaceuticals in Obesity Management: A Comprehensive Literature Review
Authors: Gierlach Katarzyna , Nowak Karolina , Nowak Karolina , Olejarz Zuzanna , Słowik Magdalena , Drygała Zuzanna , Wyrwał Julia , Zielińska Zuzanna , Nieć Maria , Krasuska Martyna 
Published: January 2024

Introduction and purpose
Obesity, a pervasive global pandemic intricately linked to various comorbidities, necessitates a comprehensive and nuanced approach. This article delves into the intricate realm of obesity guidelines, underscoring the significance of lifestyle modifications, preventive measures for childhood obesity, population-based strategies, clinical management protocols, and vigilant monitoring.
GLP-1 drugs, originally designed for type 2 diabetes management, exhibit multifaceted effects beyond glycemic control. They influence appetite regulation, gastric emptying dynamics, and potentially contribute to cardiovascular health improvements. However, the commendable effects come with a caveat - potential side effects necessitating careful consideration in clinical decision-making. Despite gaining popularity through celebrity endorsements, this article firmly underscores the need to view GLP-1 pharmacotherapy as a recommended intervention rather than a miraculous solution.
A brief description of the state of knowledge
Integral to the obesity discourse is the imperative to address weight stigma, demanding evidence-based approaches in both clinical and public health domains. The narrative extends into the future landscape of obesity pharmacotherapy, contemplating the potential role of probiotics. Emphasizing the necessity for long-term studies and randomized trials, it positions probiotics as a low-risk alternative with significant potential in mitigating obesity while simultaneously addressing concerns related to antibiotic resistance.
Summary
The pursuit of a balanced and effective approach to obesity management necessitates a nuanced understanding of medical interventions, consideration of societal perceptions, and exploration of innovative possibilities within the evolving landscape of healthcare.
Association between deficient levels of vitamin D and the occurrence of selected retinal diseases
Authors: Żmijewska Aleksandra , Maleszewska Monika , Sztybór Mateusz , Nowak Gabriela , Kapica Marcin , Piątkiewicz Julia , Krzyżanowska Maria , Momot Karol , Wojtas Mikołaj , Głogowska Karen 
Published: January 2024

Introduction and Purpose:
Vision originates in the eye's retina, a complex structure essential for processing visual information. The connection between nutritional inadequacy, particularly vitamin deficiencies, and overall health, including ocular health, has long been acknowledged. Recent studies highlight the potential impact of vitamin D, a crucial nutrient, on retinal health. The aim is to investigate the association between low levels of vitamin D and retinal diseases like age-related macular degeneration (AMD) and diabetic retinopathy (DR), and to evaluate the potential benefits of vitamin D supplementation or lifestyle changes for at-risk patients.
Description of the State of Knowledge:
AMD, a significant cause of blindness in the elderly, involves factors like oxidative stress and inflammation. Various stages of AMD require different treatments, with limited options for advanced stages. DR, a complication of diabetes, leads to conditions such as retinal ischemia and neovascularization. Both conditions are potentially influenced by vitamin D levels. Studies show mixed results regarding the impact of vitamin D on these diseases. Some suggest lower levels may increase risk, while others report no significant effect or even contradictory findings.
Conclusions:
While some studies indicate a potential association between low vitamin D levels and the occurrence of retinal diseases, discrepancies exist in the findings. Lower vitamin D concentrations may be linked to a higher frequency of AMD and DR, but the evidence is not consistent across all studies. Therefore, a more in-depth exploration of this subject is warranted to draw conclusive insights. It is crucial to consider supplementation or dietary changes in cases of vitamin D deficiency, given its potential impact on systemic health.
Revolutionizing Pneumonia Assessment: Modern Diagnostics and Traditional Scales
Authors: Sikora Marcelina , Zarzycka Marta , Plewniok Ines , Maj-Dziedzic Monika , Dubiel Jeremiasz , Brzozowska Anna , Maj Adrian , Śmietana Greta , Warno Martyna , Kozik Wiktor 
Published: January 2024

Introduction and Purpose:
Pneumonia's severity demands a thorough assessment, guided by CRB-65 and CURB-65 scales. This article underscores the crucial role of accurate interpretation and effective use of these scales, emphasizing the need for a comprehensive understanding of pneumonia for proficient severity assessment.
Material and Method:
The article identifies populations disproportionately affected by pneumonia, stressing the necessity of standardized severity assessment due to diverse clinical manifestations. It highlights the importance of accurate diagnosis through the integration of clinical evaluation, imaging, and laboratory tests. While CRB-65 and CURB-65 offer a systematic approach, potential pitfalls are discussed, emphasizing the risk of misinterpretation.
Results: Principles for correct interpretation are outlined, emphasizing holistic evaluation, timely application, and clinical acumen. Common mistakes, including overreliance on scores and incomplete data collection, are identified. The discussion introduces advanced diagnostic techniques like biomarkers and imaging, enhancing severity assessment. Cardiac biomarkers and computed tomography contribute to refined evaluation, aligning with recommendations from renowned organizations.
Conclusion:
The integration of traditional tools with advanced diagnostics signifies a paradigm shift in pneumonia assessment. Emphasizing correct interpretation and avoiding common mistakes ensures a comprehensive approach. Recent research supports advanced diagnostic techniques, aligning with recommendations. The article advocates for continuous education and collaboration among healthcare professionals, contributing to improved patient outcomes and overall healthcare efficacy.
Low opioid and opioid-free anesthesia - a review of current data
Authors: Czeremańska-Koczkodaj Dorota , Grabek Agata , Domańska Anastazja 
Published: January 2024

Introduction: Opioids are one of the most frequently used drugs during anesthesia. Due to the side effects anesthesiologists try to limit their number during anesthesia. They use low-opioid and opioid-free anesthesia.
Purpose: The purpose of this work is to present the current state of knowledge and recent reports on low-opioid and non-opioid anesthesia and their use.
Materials and Methods: The search was conducted using PubMed and GoogleScholar databases. Articles were searched in English using the following keywords: "low-opioid anesthesia," "non-opioid anesthesia," "OFA," "LOA"
Key words: "low-opioid anesthesia", "non-opioid anesthesia", "OFA", "LOA", "opioids".
Conclusion: low-opioid anesthesia techniques are being used more and more frequently and reduce the incidence of opioid side effects: respiratory depression, postoperative nausea and vomiting. This helps ensure greater patient safety and shortens the postoperative recovery period.