bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Kidney Injury in Critically Ill Older Adults: Baseline Estimated Glomerular Filtration Rate and Its Association With In-Hospital Mortality
Authors: Nascimento Ginivaldo Victor Ribeiro do , Teixeira Maria Clara Lopes , de Jesus Kezia França , Soares Isabella Melo , de Araújo Ludmila Carvalho 
Published: October 2023

Abstract
Background: The diagnosis and treatment of Acute Kidney Injury (AKI) rely on recognizing elevated serum creatinine levels as the indicator for suspicion. However, in older adults, lower baseline creatinine levels can hinder the diagnosis, as it may falsely appear normal even in the presence of established AKI. To mitigate this issue, the use of age-validated estimated glomerular filtration rate (eGFR) can enhance the timeliness of interventions.
Methods: This study aimed to analyze the baseline eGFR, before the confirmation of AKI, using the Berlin Initiative Study (BIS)-creatinine and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in older adults who developed AKI after admission to the ICU and its association with mortality.
Results: A total of 36 patients, who developed AKI after ICU admission were included. Women were 66.7% and average age of 71.67 years. All patients required mechanical ventilation support, and 91.7% required vasopressors. Initial serum creatinine levels appeared normal (0.87 ± 0.22 mg/dL), but eGFR values indicated reduced renal function, particularly using BIS-creatinine (33% vs 18.2%, CKD-EPI). Mortality was 88.9%, and in the multivariate analysis, the associated factors were age (odds ratio [OR] 1.2, 95% confidence interval [CI]: 1.07-1.5, p = 0.049), persistent AKI (OR 16.20, 95% CI: 2.38-48.88, p = 0.026) and baseline BIS-creatinine value < 60 mL/min/1.73 m² (OR 1.19, 95% CI: 1.07-4.79, p = 0.048).
Conclusion: monitoring renal function through eGFR calculation, particularly BIS-creatinine, is important for detecting patients at risk of AKI and contributes to the timely management of AKI in older adult ICU patients.
Sublingual immunotherapy for allergy to crustaceans: the nine-year clinical experience of a Midwest Allergy-Immunology practice.
Authors: Theodoropoulou Lydia Maria , Cullen Niamh A. 
Published: October 2023

Abstract

Background

Diet restrictions and fear of adverse reactions put a significant burden on the nutrition, growth and life styles of children and adults with food allergies. Desensitization to crustaceans by means of sublingual immunotherapy was assessed for efficacy and safety with a view of validating it as a disease-modifying modality. Allergy to crustaceans was chosen as a working model because of its well-defined immunological and clinical features.

Methods

Charts of a Midwest Allergy-Immunology practice from the period January 2014 – June 2023 were reviewed to identify patients with allergy to crustaceans treated with sublingual immunotherapy and to retrospectively evaluate their responses to oral challenge.

Results

Sixty-six patients were identified who had been treated by sublingual immunotherapy for either systemic or localized reactions to crustaceans. Demographics and relevant comorbidities were consistent with those of the atopic population. Sublingual immunotherapy with serially diluted mixtures was initiated at 6.4 - 160 ng/dose and was gradually escalated over a period of 5 – 48 months to 0.5 mg/dose three times a day. The sublingual immunotherapy course ranged from 5 to 72 months (average: 51 months), following which, eighteen patients underwent shrimp oral challenge.
No systemic reactions occurred upon challenge; no patient required epinephrine. Tolerance of target dose equal to or exceeding 42 g shrimp was achieved in 11 patients (61%), seven of whom had originally presented with systemic reactions to crustaceans.
Seven patients (38%) developed one or more of the following localized reactions: oral itching, nasal symptoms, localized perioral hives, localized hives at pressure points, nausea, vomiting, abdominal pain upon exposure to a cumulative dose of 39.2-148.2 g of shrimp during the 4 hours of the challenge. Five of these patients had originally presented with systemic reactions to crustaceans.
Five of the 7 patients who developed localized symptoms during the challenge were subsequently placed on routine exposure to 12-20 g shrimp every other day. Two patients continued sublingual immunotherapy but declined routine exposure to shrimp every other day because they had no intention to incorporate crustaceans to their routine diet. On repeat challenge 6-9 months after original challenge, all five patients who had routine exposure to 12-20 g shrimp every other day tolerated the procedure to target dose without any symptoms.

Conclusions

Desensitization to crustaceans by sublingual immunotherapy appears to be safe and effective. Whether the immune modification induced by sublingual immunotherapy is permanent resulting in sustained tolerance, or the achieved degree of desensitization depends on regular exposure is not known; therefore, following challenge, regular consumption three-four times per week was recommended.
The CCL2/CCR2 axis is related to primary non-response to infliximab therapy in patients with Crohn’s disease
Authors: Yongheng Wang , Weigang Shu , Mengfan Chen , Wang Xiaolei 
Published: October 2023

Abstract
Background: Nearly 30% of patients with Crohn's disease (CD) are primary non-response (PNR) to anti-tumor necrosis factor-α (TNF-α) therapy, however, the mechanisms still remain unclear. TNF-α is mainly secreted by macrophages which recruited by the CCL2/CCR2 axis. We inferred that PNR to infliximab may be correlated with the CCL2/CCR2 axis.
Methods: The dataset "GSE52746" including 19 responders and 17 PNR to infliximab was downloaded from Gene Expression Omnibus. The gene expressions were identified by differential gene analysis (DGA) between the two groups. Immune infiltration analysis and functional enrichment were used to determine the differential pathways. The CCL2 and CCR2 mRNA expressions were detected by quantitative PCR in the intestinal biopsy specimens from 11 responders and 13 PNR patients. The numbers of CD68+ macrophages in intestinal mucosa were determined by immunohistochemistry (IHC) staining.
Results: DGA identified 1395 up-regulated and 308 down-regulated genes in the primary non-responders. Compared with the responders, CCL2 and CCR2 expression were significantly upregulated, accompanied by the larger amount of immune cells accumulated in the intestinal mucosa (P<0.05). The signaling pathways related to immune cell migration were markedly enriched in the patients of PNR to infliximab (P<0.05). The significantly higher expressions of CCL2 mRNA (P<0.0001) and CCR2 mRNA (P=0.0072) were validated in the intestinal mucosa from 11 non-responders compared with that from 13 responders. Correspondingly, the numbers of CD68+ macrophages were significantly accumulated in the mucosal tissue of non-responders (P=0.006).
Conclusion: The enhanced CCL2/CCR2 axis recruited by accumulated macrophages in inflammatory intestinal mucosa is closely related with PNR to infliximab in CD patients. Our results provide a potential mechanism on anti-TNF treatment failure.
Effects of transcutaneous electrical acupoint stimulation on postoperative pulmonary complications in video‑assisted thoracic surgical lobectomy: a randomized controlled study
Authors: Jiang MengWei , Zhu JingWen , Wang HongFa , Wang JunLu 
Published: October 2023

Abstract
Background
Recent studies report that transcutaneous electrical acupoint stimulation (TEAS), a non-invasive and non-pharmacological adjunctive for perioperative rehabilitation, may improve respiratory function and reduce the incidence of postoperative pulmonary complications in patients undergoing video-assisted thoracic surgery (VATS).We studied the hypothesis that TEAS may improve inflammatory reaction,Oxygenation and post operative pulmonary complications(PPCs) in patients undergoing VATS lobectomy.
Methods
Data from 130 patients undergoing VATS lobectomy were analysed.All patients were randomized to two groups (TEAS group and Control group),and were managed using the same anaesthetic protocol.TEAS were performed from 30min before induction and during the operation at 2/100 Hz over acupoints Lieque and Hegu on the both side.Veinal blood was drawn for blood routine examination to count quantity of Neutrophil, Platelet and Lymphocyte and then to calculate two inflammatory indicators PLR and NLR at 5 time points.Mixed venous and arterial blood was drawn for measurement of shunt-fraction and dead-space at 3 time points.PPCs(following the ARISCAT study) during postoperative hospitalization were recorded.
Results
Among 130 patients,respiratory infection and pleural effusion were the most common complications.PPCs were less detected in TEAS group than Control group (12.5% vs. 27.3%, OR 2.44 [95% CI, 0.285–0.010]. At T2(Two Lung Ventilation after intubation 5 min),dead-space,and shunt-fraction were no difference between two groups,with the prolonged operation,TEAS group showed obvious advantages after acupoint stimulation,lower dead-space and shunt-fraction were detected in TEAS group(P < 0.001).NLR was lower in TEAS group,the difference was significant at T4(end of One Lung Ventilation,P＜0.001) and T5(first day after operation,P＜0.001),while PLR in there was difference at T5(P = 0.015).Furthermore,binary logistic regression model was built to analyses the correlation between PLR,NLR with PPCs respectively.Result shows PLR and NLR were meaningful in predicting postoperative lung complications as a risk factor.
Conclusions
The effect of TEAS during VATS lobectomy reduces the incidence of the PPCs recorded,attenuates the systemic inflammatory response and improve intraoperative oxygenation.PLR and NLR could be used as a risk factor to predict PPCs.
Evidence-Based Egyptian Clinical Practice Guidelines for the Prevention and Management of Iron Deficiency and Iron Deficiency Anemia in Infants, Children and Adolescents
Authors: Mokhtar Galila , Youssef Ahmed , Baky Ashraf Abdel , khashab Ehab Khairy El , Raafat Enas , Youssry Ilham , Ragab Iman , Sherief Laila , Fathy Manar Mohamed , Hesham Mervat Abdallah , Salah Nouran Yousef , Afifi Rasha AbdelRaouf AbdelAziz , Shalaby Sherein Abdelhamid , Habib Sonia Adolf , Omar Tarek , Gendy Yasmin Gamal El 
Published: October 2023

Abstract
Background: Iron deficiency (ID) is the most common nutritional disorder affecting all age groups. Infants and young children are vulnerable to anemia especially iron deficiency anemia (IDA), which represents a public health problem with defined impacts on the health of communities. IDA, however, is a preventable and treatable condition; therefore, early diagnosis represents the cornerstone in protection from its adverse consequences and combating its contributing factors. Several international guidelines for the management of ID/IDA are available, however national guidelines that can be implemented and suits our local needs are lacking.
Objective: To adapt the pre-existing high-quality practice guidelines for the screening, prevention and management of ID/IDA in different pediatric age groups, to be available for the national use by general practitioners, pediatricians, and other health care professionals.
Results:
The adaptation group for this guideline included key leaders from different Egyptian institutions. The panel used the ADAPTE methodology for adaptation of guidelines. The panel prioritized the health questions and recommendations according to their importance for clinicians and patients. The procedure included searching for existing guidelines, quality appraisal, and adaptation of the recommendations to the target context of use. The guideline covered all important aspects of detection, identification of infants, children, and adolescents at high risk of developing ID/IDA, proper management, and prevention. The final version of the adapted clinical practice guideline (CPG) has been made after thorough review of an external review panel and was guided by their official recommendations and modifications. Implementation tools included algorithms, tables, and flow charts to aid decision making in practice, as well as patient-directed information in the Arabic language.
Conclusions: This adapted guideline serves as a tool for the screening, prevention and management of ID/IDA in different pediatric age groups.
Standardized Nomenclature for Legal Prompting in Generative Language Models
Authors: Sivakumar Aditya , Gelman Ben , Simmons Robert , Yu Edward , Sharp Mackenzie 
Published: October 2023

Abstract
With the increasing availability of commercial Artificial Intelligence, General Language Models (GLMs) have been widely explored in various domains, including law. However, to ensure accurate and standardized legal results, it is crucial to establish a consistent framework for prompting GLMs. This paper presents one of the first instances of such nomenclature, providing a robust framework of “variables” and “clauses” that enhances legal-focused results. The proposed framework was applied in diverse legal scenarios, demonstrating its potential from both client and attorney perspectives. By introducing standardized variables and clauses, legal professionals can effectively communicate with GLMs. This not only improves the accuracy of the generated outcomes but also facilitates collaboration between AI systems and legal experts. With a common framework in place, legal practitioners can leverage AI technology confidently, knowing that the results produced align with established legal principles. Furthermore, the framework serves as a foundation for future research in the field of legal prompting with GLMs, and several avenues for future research are recommended in this paper. This standardization of nomenclature is expected to contribute to the wider adoption and benefit of GLMs in the legal field, leading to more accurate and reliable outcomes.
Social Isolation and the Risk of Parkinson Disease: the UK Biobank Study
Authors: Geng Tingting , Li Yaqi , Peng Yinshun , Chen Xiao , Xu Xinming , Wang Jian , Sun Liang , Gao Xiang 
Published: October 2023

Abstract
Background
Parkinson disease (PD) has become one of the most rapidly growing causes of disability among the older population and social isolation is a major concern in the PD community. However, the relationship between social isolation and future risk of PD remains unclear.
Methods
This study included 192,340 participants aged 60 or older who were free of dementia and PD at baseline from the UK Biobank study. Social isolation was measured using a composite score derived from three questions on number in household, frequency of friend/family visits, and leisure/social activities. Incident PD cases were identified through electronic health records. Multivariable-adjusted Cox regression models were used to compute the hazard ratio (HR) and 95% confidence interval (CI).
Results
Among the 192,340 participants (mean [standard deviation] age, 64.2 [2.9] years; 103,253 [53.7%] women), 89,075 (46.3%) participants were in the least isolated group and 26,161 (13.6%) were in the most isolated group. Over a median follow-up of 12.5 years, 2048 incident PD cases were documented. Compared to the least isolated group, the multivariable-adjusted HRs (95% CIs) for PD were 1.00 (0.91–1.10) for the moderately isolated group and 1.19 (1.05–1.36) for the most isolated group (P-trend=0.04). The observed association was independent of the genetic susceptibility to PD and consistent in subgroup analyses.
Conclusions
Social isolation was associated with a higher risk of PD regardless of genetic risk. Our findings highlighted the importance of developing screening and intervention strategies for social isolation among older adults to reduce the risk of PD.
Baricitinib improves the efficacy of nintedanib for the treatment of idiopathic pulmonary fibrosis
Authors: Wan Qin , Li Dongdong , Shang Shu , Wu Haifeng , Chen Faxiu , Li Qiugen 
Published: October 2023

Abstract

Background:Nintedanib has been approved to treat idiopathic pulmonary fibrosis (IPF) but with limited efficacy, while targeting Janus Kinases (JAK)/ Transducer and signal activator of transcription (STAT) has emerged as a feasible strategy in this disease recently. However, the therapeutic potential of intervening in both pathways is rarely defined, prompting us to investigate combinatory effects in preclinical studies.Methods:We evaluated both thein vitroandin vivoefficacy of a drug combination, nintedanib with baricitinb, a JAK1/JAK2 inhibitor. We first examined the cell viability of single agents or combinations by the MTT assay. Then we determined the migration of the fibroblasts by a wound healing assay. Meanwhile, we quantified the protein level of related growth factor or cytokines in the cell supernatant by ELISA. We finally investigated the therapeutic potential in a bleomycin-induced mouse model.Results:Our results showed that nintedanib reduced cell viability with a mild effect in both the fibroblast cell line and the fibroblast of a patient with IPF stimulated by TGF-β or IL-6, while increasing its ability to reduce cell viability when combined with baricitinib. Nintedanib was also found to slightly reduce fibroblast migration but dramatically increase efficacy when baricitinib was added. This combinatory effect was also observed by downregulating IL-6 and TGF-β and upregulating IL-10 and IL-13 in MLE12 cells pretreated with bleomycin. In the bleomycin-induced IPF mouse model, the combination therapy increased survival rate and body weight, and reduced lung/body weight ratio compared with single agents, which moderately improved these features, respectively. In addition, both drugs improved lung functions in mice but achieved higher performance when administered together. Furthermore, histopathological improvements were also found among drug treatments, in which the combination attenuated more pulmonary inflammation and fibrosis than the single compounds. Mechanically, baricitinib orchestrated nintedanib in IPF by regulating gene expressions such asil-6,tgf-β,col1α1andfibronectin.Conclusions:Baricitinib improves the efficacy of nintedanib by co-targeting the JAK / STAT pathway, suggesting that the drug combination can be used to therapeutically treat IPF patients.
Effects of Ripening Conditions on the Functional properties, Nutritive values and Oxalate compositions of plantain (Musa paradisiaca) flour
Authors: Oladeji Babatunde Stephen , Effa Emmanuel Bassey , Odama Love Ebenyin 
Published: October 2023

Abstract

Ripening in plantain results in various modifications of its chemical compositions. The objective of this project was to determine the effects of various ripening conditions on the functional properties, nutritive and oxalate composition of the plantain samples. Matured plantain was harvested and the fingers were divided into six portions coded as RP1- RP5 and UPc of five fingers in each group. RP1 was left on shelf, RP2 was wrapped in foil, RP3 was immersed in water, RP4 was immersed in 5% salt solution and RP5 was immersed in 6% salt solution to ripe while UPc was analyzed unripe as the control. The samples (RP1-RP5) were monitored as they underwent ripening and were prepared into flour upon ripening. Ripe plantain were dried in hot air oven and milled to flour similar to the unripe sample. The proximate, oxalate and mineral (Ca, Fe, Mg, P, K, and Na) compositions of the samples as well as their functional properties were determined. From the protein content values ranged from 2.19 to 6.65% and increased by ripening. The oxalate content values ranged from 11.34 to 36.06mg/100g with a significant reduction due to ripening (p ≤ 0.05). The water absorption capacity values ranged from 1.47 to 2.33g/ml. The calcium content values ranged from 1.17 to 9.05ppm. In conclusion, RP1 (plantain left on the shelf to ripe) was the best in terms of increased nutrient, reduced oxalate composition and better functional properties.
Comparing Flourishing training with Transactional Analysis training Regarding their Effectiveness on Students’ Career Path Optimism and Readiness for Transition from University to the Labor Market
Authors: Rouhafza Omid 
Published: October 2023

Abstract
Background and purpose: common point of view states that students should be prepared to face the world of work in a continuous plan. The purpose of this research was to compare Flourishing training with Transactional Analysis (TA) training regarding their effectiveness on career path optimism and students' readiness for transition from university to the labor market.
Method: The research is semi-experimental with a pretest, post-test design among a control group. The statistical population consisted of final-year undergraduates at Azad University of Gorgan, Iran, in the academic year 2022-2023. 45 people were selected from among the final-year undergraduates using the available sampling method and randomly assigned to two experimental groups and a control group. Experimental Group 1 was subjected to flourishing training, experimental Group 2 was subjected to transactional analysis training, and the control group did not receive any intervention. The research tool was Rottinghaus et al.'s career path optimism questionnaire (2005) and Sadeghi et al.'s (2017) readiness to transition from university to the labor market questionnaire. The research data was analyzed through multivariate analysis of covariance using statistical software SPSS version 26.
Findings: The results showed that both flourishing training and transactional analysis are effective in increasing career path optimism and preparation for the transition from university to the labor market (p<0.05). There was a significant difference in terms of effectiveness; In such a way, flourishing training was more effective in increasing the optimism of the career path and preparation for the transition from the university to the labor market.
Conclusion: The results indicate that flourishing training by strengthening the sense of competence, self-management, self-awareness, positive perception of qualifications, and creating optimism, constantly improves the path to success in transition from university to work.
Exploring Biotechnological Insights into the Variability of Seed Germination in Platanus orientalis L. within the Kashmir Himalayas
Authors: WAGAY OYAIS , Raj Anup 
Published: October 2023

Abstract
Platanus orientalis, commonly known as the Oriental plane tree, is a widely distributed and ecologically significant species with valuable insights for conservation practitioners, foresters, and plant breeders. Understanding the variability in seed germination within half-sib families is crucial for effective breeding programs, conservation efforts, and propagation techniques. This research paper investigates the patterns of seed germination variability in half-sib families of Platanus orientalis. Seeds from multiple half-sib families of Platanus orientalis were collected from a diverse range of parental trees across a natural population. The germination experiment was conducted under controlled environmental conditions, including temperature, moisture, and light. Germination rates, time to germination, and other related parameters were recorded for each seed within the half-sib families. The results demonstrated significant variability in seed germination within the half-sib families of Platanus orientalis. Germination rates ranged from 27.19–40.48%, indicating substantial differences in the reproductive success of individual parental trees. The time to germination also exhibited a wide range, with some seeds germinating within a few days while others took several weeks. Our findings demonstrate substantial variability in seed germination within half-sib families of Platanus orientalis. The study highlights the importance of considering genetic factors and environmental conditions in understanding and managing seed germination in tree populations. This research contributes to a broader understanding of plant floral biology and provides valuable information for conservation and breeding programs focused on Platanus orientalis and related species.