bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tolerance of Centrifuge-Simulated Spaceflight in Individuals with Diabetes Mellitus
Authors: King Samantha A. , Blue Rebecca S. 
Published: February 2025

INTRODUCTION: There is increasing interest in the screening and evaluation of individuals with underlying medical conditions for participation in commercial spaceflight, including those with diabetes mellitus. Diabetes risks incapacitation through hypoglycemic or hyperglycemic events. Limited analog data exist regarding tolerance of spaceflight in diabetics; here we evaluated diabetic tolerance of centrifuge-simulated spaceflight.
METHODS: Aggregated data from diabetic volunteers in prior studies of centrifuge-simulated spaceflight were compared to nondiabetic subjects. There were 20 (3 women) diabetic volunteers, with glycemic control methods including diet, oral medications, and insulin, who met screening criteria for inclusion and participated in up to 7 centrifuge profiles. Heart rate data collected prior to and during centrifuge spins and subjective postspin symptom questionnaires were analyzed.
RESULTS: Diabetic layperson subjects demonstrated similar hypergravity tolerance compared to nondiabetic laypersons. Two diabetic subjects did not complete all available profiles: one for nausea and one for scheduling constraints. Glycemic control methods (insulin vs. noninsulin) were not associated with differences in tolerance. There were no statistical differences in vital signs or symptoms. One subject had transient symptoms possibly related to hypoglycemia in the setting of decreased oral intake.
DISCUSSION: Diabetes poses a risk of incapacitation in high performance environments. Even so, these data suggest that, with appropriate screening and stratification, diabetic individuals can successfully tolerate spaceflight hypergravity exposures. Further research may allow for inclusion of diabetic individuals in future spaceflight.
King SA, Blue RS. Tolerance of centrifuge-simulated spaceflight in individuals with diabetes mellitus. Aerosp Med Hum Perform. 2025; 96(2):101–110.
Peri-flight Neuromusculoskeletal Injuries in Astronauts
Authors: Ward Gavin H. , Anderson Danielle N. , Scheuring Richard A. 
Published: February 2025

INTRODUCTION: The space sector is growing remarkably fast. Its value is expected to increase from $447 billion in 2022 to $2.7 trillion by 2040. The demand for astronauts and astro-civilians is growing, and there will be an increased need for experts who understand the effects of spaceflight on the neuromusculoskeletal (NMSK) system. Orthopedic specialists in space medicine are sparsely reported in the literature, and standards of care for astro-civilians are not well established. This review discusses the current prevalence of peri-flight NMSK injuries in astronauts, the role of orthopedic specialists, and considerations for standards of care for astro-civilians.
METHODS: A systematic review using PubMed, MEDLINE, and NASA Technical Report Server was performed to identify original research containing NMSK injuries in astronauts.
RESULTS: There were 29 studies included in the review. In 2388 documented injuries, the prevalence of injuries during preflight is 46.5%, in flight is 37.0%, and postflight is 16.5%. In 2081 documented injury locations, the prevalence of injuries in the upper extremity is 32.4%, in the shoulder is 31.4%, in the back is 26.4%, in the lower extremity is 5.5%, and in the neck is 2.3%.
DISCUSSION: Common peri-flight injuries involve the shoulder, back, and hand, such as shoulder tendonitis, space adaptation back pain, and herniated nucleus pulposus. It is critical to consider NMSK injuries for the growing space sector. As public interest grows, costs related to space are expected to decrease. Decreased costs increase accessibility to space and, consequently, the risk of NMSK injuries, increasing the demand for medical standards and experts in orthopedics and space medicine.
Ward GH, Anderson DN, Scheuring RA. Peri-flight neuromusculoskeletal injuries in astronauts. Aerosp Med Hum Perform. 2025; 96(2):155–167.
Adaptive Inert Gas Exchange Model for Improved Hypobaric Decompression Sickness Risk Estimation
Authors: De Ridder Sven , Neyt Xavier , Germonpré Peter 
Published: February 2025

INTRODUCTION: Future high-altitude military operations and spaceflight will require new procedures to protect crews from decompression sickness while limiting the operational impact. It is hypothesized that the current prediction models do not accurately reflect actual inert gas dynamics, making them unsuitable for the risk estimation of new hypobaric exposure profiles.
METHODS: A biophysical gas exchange model was created, allowing modification of various physiological parameters. Predicted nitrogen (N2) volume flows were compared with an experimental study by the Swedish Aerospace Physiology Centre. Bubble growth predictions, made using the Tissue Bubble Dynamics Model, were compared with measured venous gas emboli (VGE).
RESULTS: While the simulated washout curves captured the general trends, some important discrepancies were observed when using the nominal model parameters. The new biophysical gas exchange model, incorporating changes in cardiac output and individual anthropometric variations, improved the predictions and approximated the experimentally observed N2 washout. The standard bubble growth predictions did not match measured VGE. Using weighing factors based on the N2 gas flow components predicted by the new biophysical model, the bubble growth pattern agrees much better with the measured VGE scores.
DISCUSSION: Traditional decompression models do not account for variations in physiological and environmental factors, leading to incorrect estimates of N2 washout and bubble growth predictions. Using an adaptive biophysical gas exchange model significantly improves the predictions for various altitude exposure profiles. We therefore strongly recommend incorporating adaptive physiological parameters in any model to be used for estimating decompression sickness risk and designing mitigation procedures.
De Ridder S, Neyt X, Germonpré P. Adaptive inert gas exchange model for improved hypobaric decompression sickness risk estimation. Aerosp Med Hum Perform. 2025; 96(2):85–92.
Cardiac Causes of Disqualification in Portuguese Air Force Pilots
Authors: Pereira Joana Certo , Monge José , Baptista André , Reis Pedro , Dores Helder 
Published: February 2025

INTRODUCTION: Aviation is a high-risk activity, particularly in pilots with cardiovascular (CV) disease. The occurrence of acute clinical events during flight may have catastrophic implications, justifying the relevance of cardiological evaluation in aviation medicine. However, evidence of the impact of CV diseases in this population is scarce. The aim of this study was to analyze the cardiac causes of disqualification among pilot candidates and pilots of the Portuguese Air Force (PoAF) over a period of 20 yr.
METHODS: Retrospective analysis of cardiac causes of disqualification between 1999–2018, both in PoAF candidates and pilots.
RESULTS: In this period, the overall number of candidates was 2529 and the number of PoAF pilots was 760. Among the candidates, 41% (N = 1047) were considered unfit, of which 4% (N = 39) were due to cardiac causes (all men aged 17–25), namely valvular diseases (N = 27) and conduction/heart rhythm disturbances (N = 12). Among the pilots, 2% (N = 18) were considered unfit, mainly due to cardiac disease (50%; N = 9)—all men with mean age of 47 ± 9 (30–60) yr old, all unfit due to acute myocardial infarction, none occurring during flight.
DISCUSSION: Cardiac diseases were an uncommon cause of disqualification among the pilot aviator candidates, but it was the main cause among the pilots of the PoAF over two decades, all due to acute myocardial infarction. Cardiac evaluation in aviation medicine is essential, focusing on CV risk stratification and preclinical detection of coronary artery disease.
Certo Pereira J, Monge J, Baptista A, Reis P, Dores H. Cardiac causes of disqualification in Portuguese Air Force pilots. Aerosp Med Hum Perform. 2025; 96(2):128–134.
World-wide survey on the treatment of peripheral vestibular disorders
Authors: Strupp Michael , Kern Nils Lucca , Laurell Göran , Lehner Louisa , Grill Eva , Strobl Ralf 
Published: February 2025

ObjectiveThe aim of this world-wide survey was to evaluate the currently applied treatment options for the six most frequent peripheral vestibular disorders: benign paroxysmal positional vertigo (BPPV), acute unilateral vestibulopathy (AUVP)/vestibular neuritis, Menière’s disease (MD), bilateral vestibulopathy (BVP), vestibular paroxysmia (VP) and superior canal dehiscence syndrome (SCDS).BackgroundFor the therapy of vestibular disorders, there are four treatment options: vestibular physical therapy (canalith repositioning maneuvers or balance training), pharmacotherapy, surgery, and psychotherapy. Since there are very few state-of-the-art RCTs, the treatment of vestibular disorders is so far not standardized and various methods are applied with heterogeneous efficacy.Design/methodsA web-based standardized survey questionnaire on the treatment of the six most frequent peripheral vestibular disorders was used to collect data.Results234 replies from five continents, 47 countries, 162 cities and 188 centers were received: (% from all 234 replies; multiple answers possible): BPPV: posterior canal BPPV: 71% Epley, 40% Semont, and 12% others. Horizontal canal BPPV canalolithiasis: 58% Lempert (roll-over) maneuver, 33% Gufoni, 7% prolonged rest, and 9% others. Horizontal canal BPPV cupulolithiasis: 35% Gufoni, 27% Lempert (roll-over) maneuver, 9% Zuma, and 7% head shaking: AUVP: 79% pharmacotherapy, namely 47% glucocorticoids, 39% antiemetics, and 24% betahistine; 67% vestibular physical therapy. MD: 85% pharmacotherapy, namely 65% betahistine, 21% diuretics, 20% steroids, 16% antiemetics, 14% gentamicin; 37% surgery. VP: 65% pharmacotherapy, namely 57% anticonvulsants; 7% surgery. BVP: 77% vestibular physical therapy. SCDS: 50% surgery, namely 38.8% canal plugging, 23.3% capping and 15.5% resurfacing.ConclusionIn this world-wide survey with 234 replies from 188 centers, widely heterogeneous applied treatment options were reported for the six most frequent peripheral vestibular disorders. This study shows in particular that certain drugs are often used despite low or very low evidence. Namely in AUVP, MD and VP well-designed controlled trials with clinically meaningful endpoints are needed.
Higher oxidative balance score is associated with a decreased risk of infertility: an analysis of NHANES 2013–2020
Authors: Ma Mingjun , Xu Huanying , Wang Kexin , Chen Yanfen , Pan Ting , Zhu Qiaoling 
Published: February 2025

BackgroundOxidative stress plays a crucial role in the female reproductive system. The oxidative balance score (OBS) is a new measure for assessing the balance between antioxidant and pro-oxidative factors in diet and lifestyle. However, limited studies have explored the relationship between OBS and infertility.MethodsWe performed a cross-sectional study including 2,664 women aged 20–45 years, based on data from the 2013–2020 National Health and Nutrition Examination Survey (NHANES). The OBS was derived from 16 dietary components and 4 lifestyle factors. We used multivariate logistic regression analysis to examine the association between OBS and infertility.ResultsThe analysis revealed a significant negative association between higher OBS and infertility risk, with an odds ratio (OR) of 0.98 (95% CI, 0.95–1.00) after full adjustment. Compared to the first quartile of OBS, the second, third, and fourth quartiles showed ORs of 0.71 (95% CI, 0.45–1.11), 0.79 (95% CI, 0.51–1.22), and 0.57 (95% CI, 0.35–0.92), respectively. Similarly, women in the highest dietary OBS and lifestyle OBS quartiles had a lower infertility risk compared to those in the lowest quartiles, with ORs of 0.60 (95% CI, 0.39–0.94) and 0.54 (95% CI, 0.32–0.93), respectively. Furthermore, subgroup analysis indicated that the association between the fourth quartile of OBS and infertility remained consistent, except among women with other ethnicities—including multi-racial, and college graduate or higher.ConclusionThese findings suggest that high dietary OBS and lifestyle OBS are associated with a lower risk of infertility.
Association between the intake of potentially risky beverages and the occurrence of endometrial polyps: a case–control study
Authors: Fu Rui , Zhang Shipeng , Cai Chang , Wang Xiaocui , Jiang Yanjie , Zhuang Xiulian , Zhang Jiating , Ji Xiaoli , Yang Chengcheng 
Published: February 2025

BackgroundThis case–control study aimed to examine the association between the frequency of potentially risky beverage consumption, levels of anxiety, and the prevalence of endometrial polyps.MethodsA total of 418 participants were enrolled in the study, comprising 206 cases and 212 controls. The case group consisted of patients who visited the gynecological clinic at the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine and were diagnosed with endometrial polyps (Eps) based on international diagnostic criteria. The control group consisted of women of childbearing age who visited the gynecological clinic with similar clinical symptoms but did not have EPs. Basic information, consumption of potentially risky beverages (PRB), and anxiety levels for both groups were collected through a questionnaire survey. Finally, the relationship between the frequency of PRB consumption, anxiety levels, and the prevalence of EPs was evaluated.ResultsIn this study, we identified a significant positive association between the consumption of PRB and the prevalence of EPs. PRB intake was categorized into three groups based on the cumulative total score: 5–8 for the Low potentially risky beverages (LPRB) intake group, 9–12 for the medium potentially risky beverages (MPRB) intake group, and 13–21 for the high potentially risky beverages (HPRB) intake group. The results revealed that PRB consumption frequency was significantly associated with EPs (OR: 2.348, 95% CI: 1.153–4.78), with higher PRB intake correlating with an increased risk of EPs (p-value: 0.014). However, no significant difference was observed between the LPRB, MPRB, HPRB intake frequency groups and the different levels of anxiety (p-value: 0.793).ConclusionIncreased consumption of PRB was clearly associated with a greater risk of EPs, and over half of the participants exhibited varying degrees of anxiety. These findings suggest that the risk of EPs can be mitigated by controlling beverage intake and highlight the need for increased attention to women’s mental health.Clinical trial registrationNCT06295510.
Analysis of the prognostic value of thyroglobulin antibody change trends during follow-up after 131I treatment in patients with differentiated thyroid carcinoma
Authors: Ge Hua , Chen Wenxin , Lin Zhiyi , Li Yuxuan , Chen Shuting 
Published: February 2025

ObjectivesThe prognostic value of thyroglobulin antibody (TgAb) and its trends during follow-up periods may guide the treatment plans in patients with differentiated thyroid cancer (DTC) following surgery, however, there is still a lack of sufficient data. This study aims to evaluate the impact of change trends in TgAb levels on the prognosis of patients with DTC and to explore its potential application in clinical practice.Materials and methodsA retrospective analysis was conducted on the medical records of 2,981 DTC patients who underwent surgery followed by 131I treatment. Among these, 248 patients with positive TgAb before treatment and had a follow-up period at least 12 months were included. Patients were categorized into four subgroups based on changes in TgAb levels: the Negative Conversion Group (TgAb shifted from positive to sustained negativity), the Decrease Group (TgAb decreased by more than 50% but remained positive), the Stable Group (TgAb fluctuated by ≤ 50% throughout follow-up), and the Increase Group (TgAb increased by 50% or more). Clinical and histopathological data among the four groups, as well as disease persistence/recurrence status after 131I treatment, were compared.ResultsPre-treatment TgAb levels in the Negative Conversion Group were significantly lower than those in the other three groups (P&lt;0.001). Compared to the Negative Conversion Group, the Stable Group had more postoperative lymph node metastases (P&lt;0.05). Although pre-treatment TgAb levels in the Increase Group were lower than those in the Decrease Group, the Increase Group required significantly more treatments and a higher total dose of 131I (P&lt;0.05). Analysis of the relationship between TgAb trends and treatment outcomes revealed 34 cases of recurrent/persistent DTC. The Negative Conversion Group had significantly better outcomes than the Stable Group and Increase Group (P&lt;0.001, P=0.007), while the Decrease Group showed better outcomes than the Stable Group (P=0.045).ConclusionsNegative conversion or a decrease in TgAb levels was associated with a favorable prognosis, whereas stable or increased TgAb levels indicated a higher risk of persistent/recurrent DTC. For patients with positive TgAb serum levels, monitoring the TgAb trend changes during follow-up should be a clinical priority, with timely adjustments to individualized treatment plans.
Investigating the impact of persistent HPV infection on recurrence of lesions post-surgery for early-stage cervical cancer and related influencing factors
Authors: Na Jing , Li Ya , Lu Qiao , Wang Yang , Han Shichao , Wang Jun 
Published: February 2025

ObjectiveTo explore the influencing factors of recurrence after surgical treatment for early-stage cervical cancer (stages IA1-IIA1) and to investigate the relationship between human papillomavirus (HPV) infection and postoperative recurrence of lesions.MethodsA retrospective analysis was conducted on the clinical data of 242 patients who underwent surgical treatment for early-stage cervical cancer (FIGO stages IA1-IIA1) at the Second Affiliated Hospital of Dalian Medical University between 2015 and 2022. Cox regression analysis was employed to evaluate the relationship between persistent postoperative HPV infection and lesion vaginal local recurrence while identifying the associated risk factors for persistent HPV infection following surgery.ResultsWithin 12 months postoperatively, the HPV clearance rate was 88.11%. HPV infection persisted beyond 12 months in 19 patients (7.9%), with 3 cases demonstrating the same HPV genotypes (types 52, 58) as those identified preoperatively. Multivariate analysis identified persistent postoperative HPV infection (odds ratio [OR] 1.72, 95% confidence interval [CI] -1.14 to 5, p=0.001*) as an independent risk factor for recurrence. Additionally, smoking (OR 7.49, 95% CI 1.19 to 47.13, p=0.032), abnormal vaginal microbiota (OR 0.663, 95% CI 0.403 to 1.088, p=0.001*), and the type of surgical procedure (OR 0.32, 95% CI 0.11 to 0.91, p=0.033) were significantly associated with a higher rate of persistent HPV infection.ConclusionPersistent HPV infection after surgery is an independent risk factor for postoperative recurrence in early-stage cervical cancer. Surgical approach, abnormal vaginal microbiota, and smoking are associated factors for persistent HPV infection after surgery.
Ultrasonic radiomics-based nomogram for preoperative prediction of residual tumor in advanced epithelial ovarian cancer: a multicenter retrospective study
Authors: Li Shanshan , Ding Qiuping , Li Lijuan , Liu Yuwei , Zou Hanyu , Wang Yushuang , Wang Xiangyu , Deng Bingqing , Ai Qingxiu 
Published: February 2025

ObjectivesTo identify radiomic features extracted from ultrasound images and to develop and externally validate a comprehensive model that combines clinical data with ultrasound radiomics features to predict the residual tumor status in patients with advanced epithelial ovarian cancer (OC).MethodsThe study included 112 patients with advanced epithelial OC who underwent preoperative transvaginal ultrasound. Of these, 78 patients were assigned to the development cohort and 34 to the external validation cohort. Tumor contours were manually delineated as regions of interest (ROI) on the ultrasound images, and radiomic features were extracted. The final set of variables was identified using LASSO (least absolute shrinkage and selection operator) regression. Clinical features were also collected and incorporated into the model. A combination model integrating ultrasound radiomics and clinical variables was developed and externally validated. The performance of the predictive models was assessed.ResultsA total of 1,561 radiomic features and 18 clinical features were extracted. The final model included 10 significant ultrasound radiomic variables and 4 clinical features. The comprehensive model outperformed models based on either clinical or radiomic features alone, achieving an accuracy of 0.84, a sensitivity of 0.80, a specificity of 0.75, a precision of 0.88, a positive predictive value of 0.81, a negative predictive value of 0.86, an F1-score of 0.78, and an AUC of 0.82 in the external validation set.ConclusionsThe comprehensive model, which integrated clinical and ultrasound radiomic features, exhibited strong performance and generalizability in preoperatively identifying patients likely to achieve complete resection of all visible disease.
The Role of Traditional and Reverse Algorithms in the Diagnosis of Syphilis in HIV-Infected Individuals: A Case Study on Istanbul
Authors: Yapar Gizem , Köksal Muammer Osman , Sarsar Kutay , Soğuksu Pınar , Demirci Mehmet , Yurtseven Eray , Kır Murat Hakan , Allahverdiyeva Aytaj , Çağatay Arif Atahan , Ağaçfidan Ali , Kırkoyun Uysal Hayriye 
Published: February 2025

Background/Objectives: T. pallidum subsp. pallidum is a spirochete that only causes disease in humans as the causative agent of syphilis. HIV and syphilis have common transmission routes. In the present study, our aim was to evaluate the presence of syphilis coinfection in people living with HIV using conventional and reverse algorithms and to investigate its effects on laboratory parameters. Methods: The traditional algorithm for syphilis begins testing with the non-treponemal test. If the non-treponemal test is reactive, a treponemal test is then used to confirm syphilis infection. The reverse algorithm for syphilis begins testing with the treponemal test. If this test is reactive, then a non-treponemal test is performed. When the non-treponemal test is non-reactive, a second treponemal test is performed. Results: A total of 200 patients were included in the study. While 22 patients were determined to be syphilis-positive using the traditional algorithm, 37 patients were determined to be syphilis-positive using the reverse algorithm. Most of the patients who had syphilis coinfection were homosexual. Conclusions: It was found that syphilis coinfection had no effects on CD4+ T-lymphocyte and CD8+ T-lymphocyte values, CD4/CD8 rates, and HIV RNA amounts. People living with HIV must be screened and followed up for syphilis and other sexually transmitted diseases at certain intervals.